Preoperative Planning and Simulation for Pedicle Screw Insertion Using Computed Tomography-Based Patient Specific Volume Rendering Combined with Projection Fluoroscopy

Abstract

Background: It is still difficult to perform pedicle screw insertion on patients with abnormal spine morphology. There is an urgent need to provide projection fluoroscopy images to surgeons to practice pedicle screw insertion. Methods:The simulation software uses a volume rendering algorithm to generate a three-dimensional spine, and it uses a digitally reconstructed radiograph algorithm to simulate anteroposterior and lateral radiographs as the intraoperative image for minimally invasive surgery.Results: Pedicle screw insertion can be accomplished using a bone drill and multidimensional pedicle screws, and can be exhibited or evaluated in both two and three dimensions. Simultaneously, advanced expert preoperative planning can be shown in system. Conclusion:A simulator that develops a three-dimensional, patient-specific volume rendered simulation combined with the projection fluoroscopy for pedicle screw insertion is introduced. The simulator can help the surgeon to plan the operation trajectory and can help to predict the complex situation of the operation.