Toward the next generation of simulator for intraoperative navigation of scoliotic spine surgeries
(2012) 9th Biennal Scientific Meeting of the International Research Society of Spinal Deformities — Location: Poznan, Poland (1.July.2012)
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- Abstract
- Introduction: Surgical navigation systems are useful for planning pedicle screw positioning and guiding drilling trajectories. However, it is not yet possible to intraoperatively predict the correction of the scoliotic spine resulting from a specific screws and rods configuration and instrumentation maneuvers. Objective: To develop a novel intraoperative simulator for navigated scoliotic spine surgeries. Methods: An instrumentation strategy (pedicle screw insertion, rod attachment and rotation, set screw tightening) was computationally simulated on a synthetic model of a scoliotic spine using the preoperative radiographs in the standing position and various parameters recreating the preoperative conditions. The intraoperative decubitus position was then simulated. The resulting geometry was identified using a navigation system and transferred to the simulator, enabling to update the preoperative planning, to compute clinical indices (Cobb angles, etc.) and to simulate the instrumentation maneuvers. Results: The Cobb angle decreased from 34° to 24° between the simulated pre- and intraoperative spine (before the instrumentation). Difference in pedicle screw positioning between the preoperative planning and the intraoperative situation was less than 0.5 mm. The intra-operative simulation of the rod attachment and rotation maneuvers resulted in a 12° Cobb angle. Preliminary conclusion: This study is a first step toward developing an integrated simulator for preoperative planning and intraoperative navigation of scoliotic spine surgeries. Significance: When completed, the new intraoperative simulator will enable to obtain real-time biomechanical feedback during the navigated surgery of a scoliotic spine, and would help to optimize the resulting correction and the instrumentation parameters (instrumented levels, surgical maneuvers, generated forces, etc.). Acknowledgements: Funded by the Canadian Foundation for Innovation / Government of Quebec, and NSERC (Industrial Research Chair with Medtronic).
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Cartiaux, O., Aubin, C.-E., Labelle, H., & Cheriet, F. (2012). Toward the next generation of simulator for intraoperative navigation of scoliotic spine surgeries. 9th Biennal Scientific Meeting of the International Research Society of Spinal Deformities, Poznan, Poland. https://hdl.handle.net/2078.5/81557