Estimating pedicle screw fastening strength via a virtual templating platform for spine surgery planning: a retrospective preliminary clinical demonstration

Abstract

III (2014): Estimating pedicle screw fastening strength via a virtual templating platform for spine surgery planning: a retrospective preliminary clinical demonstration, Traditional 2D images provide limited use for accurate planning of spine interventions, due to their inability to display the complex 3D spine anatomy and proximity of nerve bundles and vascular structures that must be avoided during the procedure. We have developed a platform for spine surgery planning that employs standard of care 3D preoperative images and enables oblique reformatting and 3D rendering of individual or multiple vertebrae, interactive templating and placement of virtual pedicle implants into the patient-specific computed tomography data. Here we propose a combined surrogate metric -the fastening strength -to provide estimates of the optimal implant selection and trajectory based on implant dimension and bone mineral density (BMD) of the displaced bone substrate. We conducted a retrospective clinical study based on pre-and post-operative data from four patients who underwent procedures involving pedicle screw implantation. We assessed the retrospective plans against the post-operative imaging data according to implant dimension, mean voxel intensity of implant trajectory, and fastening strength and showed consistency between the proposed plans and the postoperative procedure outcome. Our preliminary studies have demonstrated the feasibility of the platform in assisting the surgeon with the selection of appropriate size implant and trajectory that optimises fastening strength, given the intrinsic vertebral geometry and BMD.

Path planning algorithm for percutaneous puncture lung mass biopsy procedure based on the multi-objective constraints and fuzzy optimization

“…The first type is radiofrequency ablation of masses (Schumann et al 2010, Ren et al 2014, Chen et al 2018, Bao et al 2020, Li et al 2020, Liang et al 2019, Bao et al 2022, which requires a high level of target point selection on the mass and multiple surgical paths to be planned during the procedure to ensure complete coverage of the mass area. The second type is percutaneous puncture biopsy of the mass (Linte et al 2015, Jinfeng 2016, Sun et al 2022, which is more lenient in target point selection since the purpose of the procedure is to take samples.…”