Optimal surgical planning guidance for lumbar spinal fusion considering operational safety and vertebra-screw interface strength
- Title
- Optimal surgical planning guidance for lumbar spinal fusion considering operational safety and vertebra-screw interface strength
- Author
- 김영수
- Keywords
- planning guidance; pedicle screw insertion; surgical robot; operational safety; MINIATURE ROBOTIC GUIDANCE; PEDICLE SCREW; PLACEMENT; ACCURACY; SURGERY; SYSTEM; Surgery
- Issue Date
- 2012-08
- Publisher
- WILEY-BLACKWELL
- Citation
- The International Journal of Medical Robotics and Computer Assisted Surgery, Vol. 8, No. 3, Pages 261?272
- Abstract
- BackgroundAn optimized pre-operative planning framework for lumbar spinal fusion was proposed, which augmented a novel functionality of suggesting optimal insertion trajectories and the screw size, considering operational safety and vertebra?screw interface strength, autonomously.MethodsBased on an accurate 3D pedicle model with pre-operative computed tomography (CT) data, the framework begins with safety margin estimation for each potential insertion trajectory, followed by procedures to collect a set of insertion trajectories satisfying the operation safety objective. Among the trajectory candidates, the insertion trajectory, which maximized the insertable depth of a pedicle screw into the vertebral body, was then chosen as optimal, because the insertable depth enhanced the strength of the screw?vertebra interface. The radius of a pedicle screw was chosen as 70% of the pedicle radius.ResultsThis framework has been tested on 176 spinal pedicles of 20 patients requiring spinal fusion. It was successfully applied, resulting in an average success rate of 100% and a final safety margin of 2.1?±?0.2?mm. Planning accuracy and usefulness of the proposed surgical planner show significant differences compared with a conventional manual planner.ConclusionWe can expect that the derived conservative safety margin mitigates screw misplacement or pedicle breach, despite potential errors induced during registrations or intraoperative screw insertion. Copyright ⓒ 2012 John Wiley & Sons, Ltd.
- URI
- http://onlinelibrary.wiley.com/doi/10.1002/rcs.1413/fullhttp://hdl.handle.net/20.500.11754/41355
- ISSN
- 1478-5951
- DOI
- 10.1002/rcs.1413
- Appears in Collections:
- COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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