Dr. Joseph Goerres, postdoctoral fellow in the I-STAR Lab and Carnegie Center for Surgical Innovation, recently published a paper in Physics in Medicine and Biology that highlights the challenge of achieving precision guidance in spinal surgery.
His work addresses the challenging task of high-precision placement of instrumentation in spine surgery. Screw placement in particular is a challenging task due to the small bone corridors of the spinal pedicle in proximity to nerves and vessels. Spine surgeons benefit from precision guidance and navigation, as well as intraoperative quality assurance (QA) to ensure that each screw is placed safely. Implicit to both surgical guidance and QA is the definition of a surgical plan – i.e., definition of the desired screw trajectories and device selection for each vertebrae. Conventional approaches to surgical planning require time-consuming, manual annotation of preoperative CT or MRI by a skilled surgeon. Dr. Goerres’ paper demonstrates a method for automatically determining both the optimal trajectory and device (screw length and diameter). By leveraging a pre-defined atlas of vertebral shapes and trajectories in combination with deformable 3D registration to the patient’s preoperative image, the method demonstrated accurate, automatic plan definitions that agreed well with those defined by an expert spine surgeon.
Read the full paper here.