Inertial Measurement Unit-Assisted Implantation of Pedicle Screws in Combination With an Intraoperative 3-Dimensional/2-Dimensional Visualization of the Spine

Operative Neurosurgery
Gregory F JostPhilippe Cattin

Abstract

Inertial measurement units (IMUs) are microelectromechanical systems used to track orientation and motion. To use instruments mounted with IMUs in combination with a 3- and 2-dimensional (3D/2D) rendering of the computed-tomography scan (CT) to guide implantation of pedicle screws. Pedicle screws were implanted from T1 to S1 in 2 human cadavers. A software application enabled the surgeon to select the starting points and trajectories on a 3D/2D image of the spine, then locate these starting points on the exposed spine and apply the IMU-mounted instruments to reproduce the trajectories. The position of the screws was evaluated on the postoperative CT scan. A total of 72 pedicle screws were implanted. Thirty-seven (77%) of the thoracic screws were within the pedicle (Heary I), 7 (15%) showed a lateral breach of the pedicle, and 4 (8%) violated the anterior or lateral vertebral body (Heary III). In the lumbar spine and S1, 21 screws (88%) were within the pedicle (Gertzbein 0), 2 (8%) screws had a pedicle wall breach < 2 mm (Gertzbein 1), and 1 > 2 to < 4 mm (Gertzbein 2). In the second cadaver, the position was compared to the intraoperatively shown virtual position. The median offset was 3°(mean 3° ± 2°, variance 5, range 0°-9°) ...Continue Reading

References

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Jul 3, 2007·The Spine Journal : Official Journal of the North American Spine Society·Kadir Kotil, Turgay Bilge
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Nov 17, 2009·Medical & Biological Engineering & Computing·Alberto FerrariAngelo Davalli
Sep 9, 2011·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Ioannis D GelalisTheodoros A Xenakis
Feb 17, 2015·International Journal of Computer Assisted Radiology and Surgery·Erik SmistadFrank Lindseth
Nov 14, 2015·Journal of Neurosurgery. Spine·Gregory F JostPhilippe Cattin
Mar 30, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Yong HuBingke Zhu

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