Image Guidance in Spine Surgery

Jost, Gregory F.; Yonemura, Kenneth S.; Jako, Ronald A. von

doi:10.1007/978-1-4614-7657-3_47

Cited by 3 publications

(2 citation statements)

References 68 publications

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“…PET, SPECT, and optical fluorescence image function. The speed of acquisition, ease of imaging during surgery, and quality/usefulness of image data during surgery will determine if the modality will be used primarily for preplanning or interventionally [8,9].…”

Section: Imaging Modalities Used For Ignmentioning

confidence: 99%

“…Because no one modality offers real-time physiological and anatomical information, a wide range of imaging modalities must be used. This results in the potential for different modalities used at each phase of the surgery based on speed, accuracy (resolution), and compatibility or ease of use in the operating room [3,8,19]. During the diagnosis, images are taken to verify possible pathologies and begin planning treatment or surgery (preoperative).…”

Section: Image-guided Neurosurgerymentioning

confidence: 99%

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Image-Guided Neurosurgery

Miner

2017

Journal of Medical Imaging and Radiation Sciences

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Section: Imaging Modalities Used For Ignmentioning

confidence: 99%

Section: Image-guided Neurosurgerymentioning

confidence: 99%

Image-Guided Neurosurgery

Miner

2017

Journal of Medical Imaging and Radiation Sciences

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Intraoperative CT as a registration benchmark for intervertebral motion compensation in image-guided open spinal surgery

Fan

Paulsen

et al. 2015

Int J CARS

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Purpose An accurate and reliable benchmark of registration accuracy and intervertebral motion compensation is important for spinal image guidance. In this study, we evaluated the utility of intraoperative CT (iCT) in place of bone-implanted screws as the ground-truth registration and illustrated its use to benchmark the performance of intraoperative stereovision (iSV). Methods A template-based, multi-body registration scheme was developed to individually segment and pair corresponding vertebrae between preoperative CT and iCT of the spine. Intervertebral motion was determined from the resulting vertebral pair-wise registrations. The accuracy of the image-driven registration was evaluated using surface-to-surface distance error (SDE) based on segmented bony features and was independently verified using point-to-point target registration error (TRE) computed from bone-implanted mini-screws. Both SDE and TRE were used to assess the compensation accuracy using iSV. Results The iCT-based technique was evaluated on four explanted porcine spines (20 vertebral pairs) with artificially induced motion. We report a registration accuracy of 0.57 ± 0.32 mm (range 0.34–1.14 mm) and 0.29 ± 0.15 mm (range 0.14–0.78 mm) in SDE and TRE, respectively, for all vertebrae pooled, with an average intervertebral rotation of 4.9° ± 1.2° (range 1.5°–7.9°). The iSV-based compensation accuracy for one sample (four vertebrae) was 1.32 ± 0.19 mm and 1.72 ± 0.55 mm in SDE and TRE, respectively, exceeding the recommended accuracy of 2 mm. Conclusion This study demonstrates the effectiveness of iCT in place of invasive fiducials as a registration ground truth. These findings are important for future development of on-demand spinal image guidance using radiation-free images such as stereovision and ultrasound on human subjects.

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Patient Registration Using Intraoperative Stereovision in Image-guided Open Spinal Surgery

Ji¹,

Fan²,

Paulsen³

et al. 2015

IEEE Trans. Biomed. Eng.

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Despite its widespread availability and success in open cranial neurosurgery, image-guidance technology remains more limited in use in open spinal procedures, in large part because of patient registration challenges. In this study, we evaluated the feasibility of using intraoperative stereovision (iSV) for accurate, efficient and robust patient registration in open spinal fusion surgery. Geometrical surfaces of exposed vertebrae were first reconstructed from iSV. A classical multi-start registration was then executed between point clouds generated from iSV and preoperative CT (pCT) images of the spine. With two pairs of feature points manually identified to facilitate the registration, an average registration accuracy of 1.43 mm in terms of surface-to-surface distance error was achieved in 8 patient cases using a single iSV image pair sampling 2–3 vertebral segments. The iSV registration error was consistently smaller than the conventional landmark approach for every case (average of 2.02 mm with the same error metric). The large capture ranges (average of 23.8 mm in translation and 46.0 deg in rotation) found in the iSV patient registration suggest the technique may offer sufficient robustness for practical application in the operating room. Although some manual effort was still necessary, the manually-derived inputs for iSV registration only needed to be approximate as opposed to be precise and accurate for the manual efforts required in landmark registration. The total computational cost of the iSV registration was 1.5 min on average, significantly less than the typical ~30 min required for the landmark approach. These findings support the clinical feasibility of iSV to offer accurate, efficient and robust patient registration in open spinal surgery, and therefore, its potential to further increase the adoption of image-guidance in this surgical specialty.

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Image Guidance in Spine Surgery

Cited by 3 publications

References 68 publications

Image-Guided Neurosurgery

Image-Guided Neurosurgery

Intraoperative CT as a registration benchmark for intervertebral motion compensation in image-guided open spinal surgery

Patient Registration Using Intraoperative Stereovision in Image-guided Open Spinal Surgery

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