Advanced surface-recording techniques for computer-assisted oral and maxillofacial surgery

Marmulla, Ruediger; Mühling, Joachim; Lüth, Tim; Eggers, Georg; Hassfeld, S

doi:10.1016/s0266-4356(04)00150-0

Cited by 14 publications

(12 citation statements)

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“…Previously, noninvasive external referencing techniques have been established in neurosurgery and ear, nose, and throat surgery [14]. Experimental attempts to use noninvasive array systems for cranial interventions consisting of a small base plate fixated by an attachment headband around the distal thigh of cadavers revealed substantial translational and rotational movements during minor manipulations of the affected lower extremity [11].…”

Section: Discussionmentioning

confidence: 99%

“…However, bony fixation of a reference marker array in the femur during these navigation procedures theoretically involves the risk of infection at the pin implantation site and/or the risk of iatrogenic femoral stress fractures and/or may loosen in osteoporotic bone [8,11,13,16,29]. Noninvasive registration techniques with external reference markers are used predominantly in navigated procedures around the cranium [14], but also have been used in total joint arthroplasty [24].…”

Section: Introductionmentioning

confidence: 99%

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Leg Length and Offset Measures with a Pinless Femoral Reference Array during THA

Renkawitz

Schuster²,

Grifka

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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The bony fixation of reference marker arrays used for computer-assisted navigation during total hip arthroplasty (THA) theoretically involves the risk of fracture, infection, and/or pin loosening. We asked whether intraoperative assessment of leg length (LL) and offset (OS) changes would be accurate using a novel pinless femoral reference system in conjunction with an imageless measurement algorithm based on specific realignment of the relationship between a dynamic femoral and pelvis reference array. LL/OS measurements were recorded during THA in 17 cadaver specimen hips. Preoperatively and postoperatively, specimens were scanned using CT. Linear radiographic LL/OS changes were determined by two investigators using visible fiducial landmarks and image processing software. We found a high correlation of repeated measurements within and between (both 0.95 or greater) the two examiners who did the CT assessments. Pinless LL/OS values showed mean differences less than 1 mm and correlations when compared with CT measurements.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Leg Length and Offset Measures with a Pinless Femoral Reference Array during THA

Renkawitz

Schuster²,

Grifka

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…In the past, noninvasive external referencing techniques have been clinically established in neurosurgery, and ear, nose, and throat surgery 7, 10, 11. Earlier studies concerning noninvasive referencing of peripheral extremities in traumatology used immobilization casts or splints applied to the extremity for pre‐ or intraoperative CT imaging.…”

Section: Discussionmentioning

confidence: 99%

“…A number of potential complications have been reported, including pin site infections, soft tissue morbidity, and stress fractures 4–6. So far, noninvasive registration techniques with external reference markers are predominantly used in navigated procedures around the cranium 7. While the rigid skull and the thin soft tissue cover permit the use of pinless external referencing devices, no regular clinical application of pinless femoral reference arrays has been reported in orthopedic surgery.…”

mentioning

confidence: 99%

Experimental validation of a pinless femoral reference array for computer‐assisted hip arthroplasty

Renkawitz

Wegner

Gneiting

et al. 2009

Journal Orthopaedic Research

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The use of computer navigation systems during total hip arthroplasty requires the femoral fixation of a reflective dynamic reference base (DRB), which theoretically involves the risk of bony fracture, infection, and pin loosening. The first objective of this study was to evaluate the relative movements between a novel, noninvasive external femoral DRB system and the femur. Secondly, the maximum effects of these 3D movements on intraoperative, computer-assisted leg length and offset measures were evaluated. An imageless navigation system was used to track the positions of the soft tissue attached, pinless DRB relative to an invasive reference marker on the femur during a less-invasive, anterior surgical hip approach. Relative translatory movements up to 8.2 mm mediolaterally and up to 8.88 in rotation were measured. Using a measurement technique in which the calculation of leg length and offset changes is primarily based on a specific realignment of the leg, maximum differences of 1.3 mm for leg length and 1.2 mm for offset were found when comparing the pin-based and pinless methods. Thus, invasive fixation techniques with screws or pins are still the method of choice when standard measurement algorithms for intraoperative leg length and offset measures are used. Though direct translatory and rotational variations between the pinless array and the femoral bone were detected, the pinless array can be used to assess leg length and offset when used with a specific measurement technique that compensates for such variations. ß

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“…In neurosurgery, craniomaxillofacial, and ENT surgery, the rigid skull and the thin soft tissue cover permit accurate noninvasive external referencing. 10,12 This study evaluated the use of an existing external referencing system for the head on navigated procedures of the lower extremities.…”

Section: Introductionmentioning

confidence: 99%

Experimental validation of noninvasive referencing in navigated procedures on long bones

Kendoff

Bogojević

Citak

et al. 2006

Journal Orthopaedic Research

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Navigation procedures in orthopedic surgery require fixation of reference markers to the anatomic region of interest. Inadequate fixation might lead to micromotion or loosening of the reference marker, consequently causing registration failures or errors in navigation. Osseous rigid fixation is usually achieved by minimally invasive Schanz screws or pins. The goal of this study was to evaluate a non invasive external fixation device, a headband so far used in cranial navigation, as an alternative invasive fixation technique to reference markers in the femur. A common navigation system with an adapted trauma software application was used to track the positions of the soft tissueattached headband relative to an invasive reference marker on the femur during manipulations of the thigh. Relative translative and rotational movements of the headband were measured during defined movements of the hip and knee and manipulations of the headband itself. The results revealed high translative and rotational movements, up to 6 mm and 38, respectively, due to minor manipulations of the affected lower extremity. Noninvasive soft tissue fixation with a headband does not allow rigid fixation for accurate navigated registration or operative procedures at the femur. Necessary intraoperative movements or manipulations would cause substantial registration failures. Invasive fixation techniques with screws or pins are still the method of choice. ß

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Advanced surface-recording techniques for computer-assisted oral and maxillofacial surgery

Cited by 14 publications

References 0 publications

Leg Length and Offset Measures with a Pinless Femoral Reference Array during THA

Leg Length and Offset Measures with a Pinless Femoral Reference Array during THA

Experimental validation of a pinless femoral reference array for computer‐assisted hip arthroplasty

Experimental validation of noninvasive referencing in navigated procedures on long bones

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