Augmented reality-navigated pedicle screw placement: a cadaveric pilot study
| Autor: | Simon Roner, Mazda Farshad, Florentin Liebmann, José Miguel Spirig, Philipp Fürnstahl |
|---|---|
| Přispěvatelé: | University of Zurich, Spirig, José Miguel |
| Rok vydání: | 2020 |
| Předmět: |
3d model
610 Medicine & health Pilot Projects Lumbar 2732 Orthopedics and Sports Medicine Imaging Three-Dimensional Cadaver Pedicle Screws Medicine Humans Orthopedics and Sports Medicine Pedicle screw Orthodontics Augmented Reality Lumbar Vertebrae business.industry Vertebra 2746 Surgery medicine.anatomical_structure Surgery Computer-Assisted Surgery Augmented reality 10046 Balgrist University Hospital Swiss Spinal Cord Injury Center Tomography business Cadaveric spasm |
| Zdroj: | European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 30(12) |
| ISSN: | 1432-0932 |
| Popis: | Augmented reality (AR) is an emerging technology with great potential for surgical navigation through its ability to provide 3D holographic projection of otherwise hidden anatomical information. This pilot cadaver study investigated the feasibility and accuracy of one of the first holographic navigation techniques for lumbar pedicle screw placement. Lumbar computer tomography scans (CT) of two cadaver specimens and their reconstructed 3D models were used for pedicle screw trajectory planning. Planned trajectories and 3D models were subsequently uploaded to an AR head-mounted device. Randomly, k-wires were placed either into the left or the right pedicle of a vertebra (L1-5) with or without AR-navigation (by holographic projection of the planned trajectory). CT-scans were subsequently performed to assess accuracy of both techniques. A total of 18 k-wires could be placed (8 navigated, 10 free hand) by two experienced spine surgeons. In two vertebrae, the AR-navigation was aborted because the registration of the preoperative plan with the intraoperative anatomy was imprecise due to a technical failure. The average differences of the screw entry points between planning and execution were 4.74 ± 2.37 mm in the freehand technique and 5.99 ± 3.60 mm in the AR-navigated technique (p = 0.39). The average deviation from the planned trajectories was 11.21° ± 7.64° in the freehand technique and 5.88° ± 3.69° in the AR-navigated technique (p = 0.09). This pilot study demonstrates improved angular precision in one of the first AR-navigated pedicle screw placement studies worldwide. Technical shortcomings need to be eliminated before potential clinical applications. |
| Databáze: | OpenAIRE |
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