Accuracy and safety of a new intraoperative Cone-Beam CT imaging system for pedicle screw insertion in spine surgery
(2018)
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- Abstract
- This PhD thesis aims to study the clinical and experimental use of a new intraoperative cone beam computed tomography (CBCT) imaging system for pedicle screw insertion in spine surgery. In spine surgery, some pathologies such as vertebral fracture or deformities require surgical stabilization in order to prevent, for example, spinal cord damages or spine malalignment. To reach the bone fusion required for spine stabilization, titanium instrumentation is used to connect vertebrae. Pedicle screw is the most widely used implant to obtain a solid anchorage in a given vertebra. The screw-rods construct allows spine stabilization and later definitive segmental fusion. Pedicle screws require accurate placement in the pedicle center to ensure the best anchorage and avoid pedicle cortical effractions. Indeed, misplacement can lead to instability of the construct and delayed fusion, or to potentially dramatic complications such as spinal cord, nerve and vascular lesions. Assistive technologies have been developed to control pedicle screw insertion during surgery and improve the accuracy of pedicle screw placement. The Artis zeego II is a new intraoperative CBCT robotic system allowing two-dimensional (2D) and three-dimensional (3D) fluoroscopy acquisitions. The purpose of this device is to assist the pedicle screw insertion and to assess screw placement intraoperatively. This thesis firstly aims to assess the clinical use of the Artis zeego II in terms of accuracy and safety of use for pedicle screw insertion. The second aim, consists proposing a new standardized and quantitative approach based on the intraoperative 3D CBCT images to objectively assess screw placement.
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Citations
Cordemans, V. (2018). Accuracy and safety of a new intraoperative Cone-Beam CT imaging system for pedicle screw insertion in spine surgery. https://hdl.handle.net/2078.5/54930