Head-mounted display augmented reality to guide pedicle screw placement utilizing computed tomography

Autor: Jacob T. Gibby, Steve Cvetko, Ramin Javan, Raj D. Rao, Samuel A. Swenson
Rok vydání: 2018
Předmět:
Computer science
medicine.medical_treatment
0206 medical engineering
Biomedical Engineering
Optical head-mounted display
Health Informatics
02 engineering and technology
Lumbar vertebrae
Virtual reality
Imaging phantom
030218 nuclear medicine & medical imaging
03 medical and health sciences
Imaging
Three-Dimensional
0302 clinical medicine
Lumbar
Pedicle Screws
medicine
Humans
Fluoroscopy
Radiology
Nuclear Medicine and imaging
Lumbar Vertebrae
medicine.diagnostic_test
Phantoms
Imaging
Virtual Reality
General Medicine
020601 biomedical engineering
Computer Graphics and Computer-Aided Design
Computer Science Applications
Spinal Fusion
medicine.anatomical_structure
Surgery
Computer-Assisted
Spinal fusion
Surgery
Augmented reality
Computer Vision and Pattern Recognition
Tomography
X-Ray Computed
Biomedical engineering
Zdroj: International Journal of Computer Assisted Radiology and Surgery. 14:525-535
ISSN: 1861-6429
1861-6410
DOI: 10.1007/s11548-018-1814-7
Popis: Augmented reality has potential to enhance surgical navigation and visualization. We determined whether head-mounted display augmented reality (HMD-AR) with superimposed computed tomography (CT) data could allow the wearer to percutaneously guide pedicle screw placement in an opaque lumbar model with no real-time fluoroscopic guidance. CT imaging was obtained of a phantom composed of L1–L3 Sawbones vertebrae in opaque silicone. Preprocedural planning was performed by creating virtual trajectories of appropriate angle and depth for ideal approach into the pedicle, and these data were integrated into the Microsoft HoloLens using the Novarad OpenSight application allowing the user to view the virtual trajectory guides and CT images superimposed on the phantom in two and three dimensions. Spinal needles were inserted following the virtual trajectories to the point of contact with bone. Repeat CT revealed actual needle trajectory, allowing comparison with the ideal preprocedural paths. Registration of AR to phantom showed a roughly circular deviation with maximum average radius of 2.5 mm. Users took an average of 200 s to place a needle. Extrapolation of needle trajectory into the pedicle showed that of 36 needles placed, 35 (97%) would have remained within the pedicles. Needles placed approximated a mean distance of 4.69 mm in the mediolateral direction and 4.48 mm in the craniocaudal direction from pedicle bone edge. To our knowledge, this is the first peer-reviewed report and evaluation of HMD-AR with superimposed 3D guidance utilizing CT for spinal pedicle guide placement for the purpose of cannulation without the use of fluoroscopy.
Databáze: OpenAIRE
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