Frameless Patient Tracking With Adhesive Optical Skin Markers for Augmented Reality Surgical Navigation in Spine Surgery.
Adhesives
/ administration & dosage
Adolescent
Adult
Aged
Aged, 80 and over
Augmented Reality
Cadaver
Cone-Beam Computed Tomography
/ methods
Female
Humans
Lumbar Vertebrae
/ diagnostic imaging
Male
Middle Aged
Neuronavigation
/ methods
Patient Identification Systems
/ methods
Pedicle Screws
Sacrum
/ diagnostic imaging
Surgery, Computer-Assisted
/ methods
Thoracic Vertebrae
/ diagnostic imaging
Young Adult
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
15 Nov 2020
15 Nov 2020
Historique:
pubmed:
7
8
2020
medline:
27
1
2021
entrez:
7
8
2020
Statut:
ppublish
Résumé
Observational study. The aim of this study was to evaluate the accuracy of a new frameless reference marker system for patient tracking by analyzing the effect of vertebral position within the surgical field. Most modern navigation systems for spine surgery rely on a dynamic reference frame attached to a vertebra for tracking the patient. This solution has the drawback of being bulky and obstructing the surgical field, while requiring that the dynamic reference frame is moved between vertebras to maintain accuracy. An augmented reality surgical navigation (ARSN) system with intraoperative cone beam computed tomography (CBCT) capability was installed in a hybrid operating room. The ARSN system used input from four video cameras for tracking adhesive skin markers placed around the surgical field. The frameless reference marker system was evaluated first in four human cadavers, and then in 20 patients undergoing navigated spine surgery. In each CBCT, the impact of vertebral position in the surgical field on technical accuracy was analyzed. The technical accuracy of the inserted pedicle devices was determined by measuring the distance between the planned position and the placed pedicle device, at the bone entry point. The overall mean technical accuracy was 1.65 ± 1.24 mm at the bone entry point (n = 366). There was no statistically significant difference in technical accuracy between levels within CBCTs (P ≥ 0.12 for all comparisons). Linear regressions showed that null- to negligible parts of the effect on technical accuracy could be explained by the number of absolute levels away from the index vertebrae (r ≤ 0.007 for all, β ≤ 0.071 for all). The frameless reference marker system based on adhesive skin markers is unobtrusive and affords the ARSN system a high accuracy throughout the navigated surgical field, independent of vertebral position. 3.
Sections du résumé
STUDY DESIGN
METHODS
Observational study.
OBJECTIVE
OBJECTIVE
The aim of this study was to evaluate the accuracy of a new frameless reference marker system for patient tracking by analyzing the effect of vertebral position within the surgical field.
SUMMARY OF BACKGROUND DATA
BACKGROUND
Most modern navigation systems for spine surgery rely on a dynamic reference frame attached to a vertebra for tracking the patient. This solution has the drawback of being bulky and obstructing the surgical field, while requiring that the dynamic reference frame is moved between vertebras to maintain accuracy.
METHODS
METHODS
An augmented reality surgical navigation (ARSN) system with intraoperative cone beam computed tomography (CBCT) capability was installed in a hybrid operating room. The ARSN system used input from four video cameras for tracking adhesive skin markers placed around the surgical field. The frameless reference marker system was evaluated first in four human cadavers, and then in 20 patients undergoing navigated spine surgery. In each CBCT, the impact of vertebral position in the surgical field on technical accuracy was analyzed. The technical accuracy of the inserted pedicle devices was determined by measuring the distance between the planned position and the placed pedicle device, at the bone entry point.
RESULTS
RESULTS
The overall mean technical accuracy was 1.65 ± 1.24 mm at the bone entry point (n = 366). There was no statistically significant difference in technical accuracy between levels within CBCTs (P ≥ 0.12 for all comparisons). Linear regressions showed that null- to negligible parts of the effect on technical accuracy could be explained by the number of absolute levels away from the index vertebrae (r ≤ 0.007 for all, β ≤ 0.071 for all).
CONCLUSION
CONCLUSIONS
The frameless reference marker system based on adhesive skin markers is unobtrusive and affords the ARSN system a high accuracy throughout the navigated surgical field, independent of vertebral position.
LEVEL OF EVIDENCE
METHODS
3.
Identifiants
pubmed: 32756274
doi: 10.1097/BRS.0000000000003628
pii: 00007632-202011150-00019
doi:
Substances chimiques
Adhesives
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1598-1604Références
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