A pilot study on computer-assisted optimal contouring of orthopedic fixation devices.

Bending and shaping of longitudinal orthopedic fixation devices like rods and plates is often a difficult and time-consuming process to perform during surgery under sterile conditions. This study presents a novel device for implant contouring and introduces two strategies to obtain parameters necessary for the bending process. The first strategy is based on surgical navigation techniques as established within the framework of computer-assisted orthopedic surgery. Geometrical landmarks, e.g., the location of pedicle screws in a case of posterior spinal fixation, are collected with a three-dimensional pointing device. Subsequently, the final shape of the implant and the associated contouring parameters are calculated. The alternative strategy utilizes a flexible material intended to be used intra-operatively to enable the optimal shape of the implant to be modeled by hand. Contour parameters are calculated from a depth image of this model obtained using an object scanner. Bending of spinal rod systems is used to illustrate both strategies. A newly designed semi-automatic bending machine is proposed to impose the computed deformation on the implant material once parameters are obtained. Integrating the bending device into a system for computer-assisted surgery allows for the interactive control of the contouring process.