Current concepts and applications of computer navigation in orthopedic trauma surgery

Kendoff, Daniel; Citak, Musa; Hüfner, T.; Chaudhary, Sachin; Krettek, Christian

doi:10.2478/s11536-007-0042-2

Cited by 11 publications

(8 citation statements)

References 34 publications

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“…With the development of the 3-D C-arm, 3D FluoroNav gradually gained popularity in spinal surgeries. Though its image quality is lower than that of CT, 3D FluoroNav provides real-time three-dimensional images, which serves as both C-arm and CT-based navigation, and does not need registration [57,58].…”

Section: Navigation Methods For Pedicle Screw Insertionmentioning

confidence: 99%

“…On comparing the navigated and conventional methods, most studies indicated that CTNav increased the time for spinal surgeries [15,23,26,37,41,44]. This might be attributed to extra protocols such as preoperative images, modeling and simulation, and registration [12,40,57,58]. One of the drawbacks of the CTNav is the considerable learning curve in the registration process.…”

Section: Other Perioperative Findingsmentioning

confidence: 99%

“…One of the drawbacks of the CTNav is the considerable learning curve in the registration process. A quick registration requires an intimate knowledge of surgical anatomy and good cooperation between the surgeon and the navigation system [58]. FluoroNav that does not require registration might reduce surgical time.…”

Section: Other Perioperative Findingsmentioning

confidence: 99%

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Pedicle screw insertion accuracy with different assisted methods: a systematic review and meta-analysis of comparative studies

et al. 2010

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Studies revealed that navigation systems that provided intraoperative assistance might improve pedicle screw insertion accuracy, and also implied that different systems provided different pedicle screw insertion accuracy. A systematic review and meta-analysis was conducted to focus on the pedicle screw insertion accuracy with or without the assistance of image-guided system, and the variance among the different navigation systems. Comparative studies were searched on pedicle screw insertion accuracy between conventional and navigated method, and among different navigation systems. A total of 43 papers, including 28 clinical, 14 cadaveric and 1 model studies, were included in the current study. For clinical articles, there were 3 randomized clinical trials, 4 prospective comparative studies and 21 retrospective comparative studies. The incidence of pedicle violation among computer tomography-based navigation method group was statistically significantly less than that observed among the conventional group (OR 95% CI, in vivo: 0.32-0.60; in vitro: 0.24-0.75 P \ 0.01). Two-dimensional fluoroscopybased navigation system (OR 95% CI, in vivo: 0.27-0.48; in vitro: 0.43-0.88 P \ 0.01) and three-dimension fluoroscopy-based navigation system (OR 95% CI, in vivo: 0.09-0.38; in vitro: 0.09-0.36 P \ 0.01) also obtained significant reduced screw deviation rate over traditional methods. Between navigated approaches, statistically insignificant individual and pooled RR values were observed for all in vivo subgroups. Pooled estimate of in vitro studies show that computer tomography-based and three-dimension fluoroscopy-based navigation system provided more accurate pedicle screw insertion over two-dimension fluoroscopy-based navigation system. Our review showed that navigation provided a higher accuracy in the placement of pedicle screws compared with conventional methods. The superiority of navigation systems was obvious when they were applied to abnormal spinal structure. Although no strong in vivo evidence has detected significantly different pedicle screw placement accuracy among the three major navigation systems, meta-analysis revealed the variance in pedicle screw insertion accuracy with different navigation methods.

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Section: Navigation Methods For Pedicle Screw Insertionmentioning

confidence: 99%

Section: Other Perioperative Findingsmentioning

confidence: 99%

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Pedicle screw insertion accuracy with different assisted methods: a systematic review and meta-analysis of comparative studies

et al. 2010

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“…On the other hand, although recent developments in computer assisted technologies have improved objective accuracy by use of a navigation system, its indications are still limited [11], [12]. We have attempted to apply navigation assistance for debridement arthroplasty to gain an accurate bony morphometric evaluation during the operation and to quantitatively resect osteophytes.…”

Section: Introductionmentioning

confidence: 99%

Navigation-assisted Debridement Arthroplasty for Osteoarthritis of the Elbow: A Preliminary Report

et al. 2012

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Background Debridement arthroplasty is a widely accepted operative treatment for elbow osteoarthritis. However, it is sometimes difficult to define the extent of appropriate osteophyte resection. In the present study, a navigation system was used to resect the osteophytes. Methods Eight male patients (mean age, 62 years) were enrolled in the present study. When the osteophytes around the olecranon, coronoid and radial fossae of the distal humerus were removed, the operation was monitored using a navigation system. Pre‐ and postoperative clinical and radiographical assessments were performed with a mean follow‐up of 29 months. Results There were no major complications during the operations. Postoperative computed tomography showed that the osteophytes were properly removed. The mean range of motion of the elbow improved from −21° to 110° pre‐operatively to −13° to 130° at the time of follow‐up (p < 0.05). The mean Mayo Elbow Performance Score improved from 75 points to 98 points (p < 0.05) and the mean Disabilities of the Arm, Shoulder and Hand score improved from 24.2 points to 8.7 points (p < 0.05). Conclusions The findings of the present study demonstrate that the osteophytes formed at the distal humerus could be precisely visualized using a navigation system. This system effectively defined the region and depth of the morphological configuration for resection.

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“…Echnologically-advanced surgical platforms exploit navigation and/or robotic systems to improve the outcome of procedures in several fields, such as orthopedic surgery [1], abdominal surgery [2], and neurosurgery [3]. A. Enquobahrie is with Kitware Inc., Carrboro, NC, USA Thus, the need for different sensors in the operating room (OR) has highly increased in the past two decades with the purpose of improving the accuracy and the safety of surgical procedures for both patients and operators.…”

Section: Introductionmentioning

confidence: 99%

Sensors management in robotic neurosurgery: The ROBOCAST project

Vaccarella

Comparetti

Enquobahrie

et al. 2011

2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Abstract-Robot and computer-aided surgery platforms bring a variety of sensors into the operating room. These sensors generate information to be synchronized and merged for improving the accuracy and the safety of the surgical procedure for both patients and operators. In this paper, we present our work on the development of a sensor management architecture that is used is to gather and fuse data from localization systems, such as optical and electromagnetic trackers and ultrasound imaging devices. The architecture follows a modular client-server approach and was implemented within the EU-funded project ROBOCAST (FP7 ICT 215190). Furthermore it is based on very well-maintained open-source libraries such as OpenCV and Image-Guided Surgery Toolkit (IGSTK), which are supported from a worldwide community of developers and allow a significant reduction of software costs.We conducted experiments to evaluate the performance of the sensor manager module. We computed the response time needed for a client to receive tracking data or video images, and the time lag between synchronous acquisition with an optical tracker and ultrasound machine.Results showed a median delay of 1.9 ms for a client request of tracking data and about 40 ms for US images; these values are compatible with the data generation rate (20-30 Hz for tracking system and 25 fps for PAL video).Simultaneous acquisitions have been performed with an optical tracking system and US imaging device: data was aligned according to the timestamp associated with each sample and the delay was estimated with a cross-correlation study. A median value of 230 ms delay was calculated showing that realtime 3D reconstruction is not feasible (an offline temporal calibration is needed), although a slow exploration is possible. In conclusion, as far as asleep patient neurosurgery is concerned, the proposed setup is indeed useful for registration error correction because the brain shift occurs with a time constant of few tens of minutes. A. Enquobahrie is with Kitware Inc., Carrboro, NC, USA Thus, the need for different sensors in the operating room (OR) has highly increased in the past two decades with the purpose of improving the accuracy and the safety of surgical procedures for both patients and operators. The main typologies of sensors used in the OR include localization systems, inertial sensors, force sensors, and intra-operative imaging devices. Surgical navigation systems usually rely on information acquired using localization systems (mechanical, optical, or electromagnetic) in order to localize the pose of surgical instruments and to overlay them on the CT or MR images to assist surgeons during procedures [4].Inertial Measurement Unit (IMU) allows for determination of an object's position and orientation at a high rate, even with no line of sight; on the other hand, IMUs are limited by noise amplification and drift, due to the double integration of the acceleration signal. They have recently been proposed in robotic surgery, in addition to an optical tracking system, ...

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Current concepts and applications of computer navigation in orthopedic trauma surgery

Cited by 11 publications

References 34 publications

Pedicle screw insertion accuracy with different assisted methods: a systematic review and meta-analysis of comparative studies

Pedicle screw insertion accuracy with different assisted methods: a systematic review and meta-analysis of comparative studies

Navigation-assisted Debridement Arthroplasty for Osteoarthritis of the Elbow: A Preliminary Report

Sensors management in robotic neurosurgery: The ROBOCAST project

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