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International Journal of Computer Assisted Radiology and Surgery

Erschienen in:

09.05.2023 | Original Article

Fast and versatile platform for pedicle screw insertion planning

verfasst von: Rafael Benito, Álvaro Bertelsen, Verónica de Ramos, Amaia Iribar-Zabala, Niccoló Innocenti, Nicoló Castelli, Karen Lopez-Linares, Davide Scorza

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 7/2023

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Abstract

Purpose

Computer-assisted surgical planning methods help to reduce the risks and costs in transpedicular fixation surgeries. However, most methods do not consider the speed and versatility of the planning as factors that improve its overall performance. In this work, we propose a method able to generate surgical plans in minimal time, within the required safety margins and accounting for the surgeon’s personal preferences.

Methods

The proposed planning module takes as input a CT image of the patient, initial-guess insertion trajectories provided by the surgeon and a reduced set of parameters, delivering optimal screw sizes and trajectories in a very reduced time frame.

Results

The planning results were validated with quantitative metrics and feedback from surgeons. The whole planning pipeline can be executed at an estimated time of less than 1 min per vertebra. The surgeons remarked that the proposed trajectories remained in the safe area of the vertebra, and a Gertzbein–Robbins ranking of A or B was obtained for 95 % of them.

Conclusions

The planning algorithm is safe and fast enough to perform in both pre-operative and intra-operative scenarios. Future steps will include the improvement of the preprocessing efficiency, as well as consideration of the spine’s biomechanics and intervertebral rod constraints to improve the performance of the optimisation algorithm.

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Titel: Fast and versatile platform for pedicle screw insertion planning
verfasst von: Rafael Benito
Álvaro Bertelsen
Verónica de Ramos
Amaia Iribar-Zabala
Niccoló Innocenti
Nicoló Castelli
Karen Lopez-Linares
Davide Scorza
Publikationsdatum: 09.05.2023
Verlag: Springer International Publishing
Erschienen in: International Journal of Computer Assisted Radiology and Surgery / Ausgabe 7/2023
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-023-02940-z

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Fast and versatile platform for pedicle screw insertion planning