Objectives: Transforaminal percutaneous endoscopic discectomy (TPED) is one of the most commonly used minimally invasive spine surgeries around the world. However, conventional surgical planning and intraoperative procedures for TPED have relied on surgeons' experience, which limits its standardization and popularization. Virtual reality (VR) is a novel technology for pre-surgical planning in various fields of medicine, while isocentric navigation can guide intraoperative procedures for TPED. The present study aimed to explore the feasibility of applying VR combined with isocentric navigation in TPED on cadavers.
Methods: The surgical levels were L /L and L /L as well as L /S of both sides of each cadaver specimen. First, the surgeon manually conducted the above procedures on the left side of every specimen without preoperative simulation and isocentric navigation (Group A). Then the same surgeon conducted the VR simulation for surgical planning of the right side (Group B). After VR simulation, the same surgeon made the percutaneous punctures and placed the working channel on the right side of the specimen at all levels.
Results: At the L /L level, the puncture-channel time was 11.36 ± 2.13 min in Group A and 11.29 ± 2.23 min in Group B (t = 0.097, P = 0.938). The exposure time was 17.21 ± 2.91 s in Group A and 14.64 ± 1.60 s in Group B (t = 2.534, P = 0.025). At the L /L level, the puncture-channel time was 13.86 ± 3.90 min in Group A and 11.93 ± 2.95 min in Group B (t = 2.291, P = 0.039). Exposure time was 20.64 ± 3.84 s in Group A and 16.43 ± 2.47 s in Group B (t = 6.118, P < 0.01). There were 7 patients undergoing foraminotomy in Group A and 3 patients undergoing foraminotomy in Group B (t = 2.280, P = 0.236). At the L /S level, the puncture-channel time was 18.21 ± 1.85 min in Group A and 15.71 ± 3.20 min in Group B (t = 2.476, P = 0.028). Exposure time was 26.07 ± 3.17 s in Group A and 22.50 ± 2.68 s in Group B (t = 2.980, P = 0.011). There were 14 patients receiving foraminotomy in Group A and 13 patients receiving foraminotomy in Group B (t = 1.000, P = 1.000).
Conclusions: Virtual reality combined with isocentric navigation is feasible in TPED. It enables precise surgical planning and improves intraoperative procedures, and has the potential for application in clinical practice.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6595140 | PMC |
| http://dx.doi.org/10.1111/os.12473 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effect of the cone-beam CT acquisition trajectory on image quality in spine surgery: experimental cadaver study.
Spine J
January 2025
BG Klinik Ludwigshafen, Department of Orthopedics and Trauma Surgery, Research group Medical Imaging and Navigation in Trauma and Orthopedic Surgery (MINTOS), BG Klinik Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany; Heidelberg University, Grabengasse 1, D-69117 Heidelberg, Germany. Electronic address:
Background: Intraoperative 3D imaging with cone-beam CT (CBCT) improves assessment of implant position and reduces complications in spine surgery. It is also used for image-guided surgical techniques, resulting in improved quality of care. However, in some cases, metal artifacts can reduce image quality and make it difficult to assess pedicle screw position and reduction.
View Article and Find Full Text PDFIncreasing the scan-efficiency of pulmonary imaging at 0.55 T using iterative concomitant field and motion-corrected reconstruction.
Magn Reson Med
July 2024
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
Purpose: To develop an iterative concomitant field and motion corrected (iCoMoCo) reconstruction for isotropic high-resolution UTE pulmonary imaging at 0.55 T.
Methods: A free-breathing golden-angle stack-of-spirals UTE sequence was used to acquire data for 8 min with prototype and commercial 0.
3D C-arm navigated acromioclavicular joint stabilization.
Arch Orthop Trauma Surg
February 2024
Department of Trauma Hand and Reconstructive Surgery, Ulm University, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Introduction: Surgical treatment options for acromioclavicular joint separations are varied. Frequently, suspension devices (SD) are inserted for stabilization under arthroscopic view. This study investigates the feasibility and accuracy of three-dimensional (3D) digital-volume-tomography (DVT) C-arm navigated implantation with regard to the general trend toward increasingly minimally invasive procedures.
View Article and Find Full Text PDFMachine learning for automated and real-time two-dimensional to three-dimensional registration of the spine using a single radiograph.
Neurosurg Focus
June 2023
6Department of Neurosurgery, Duke Hospital, Durham, North Carolina.
Objective: The goal of this work was to methodically evaluate, optimize, and validate a self-supervised machine learning algorithm capable of real-time automatic registration and fluoroscopic localization of the spine using a single radiograph or fluoroscopic frame.
Methods: The authors propose a two-dimensional to three-dimensional (2D-3D) registration algorithm that maximizes an image similarity metric between radiographic images to identify the position of a C-arm relative to a 3D volume. This work utilizes digitally reconstructed radiographs (DRRs), which are synthetic radiographic images generated by simulating the x-ray projections as they would pass through a CT volume.
Real-time B compensation during gantry rotation in a 0.35-T MRI-Linac.
Med Phys
October 2022
Departments of Radiation Oncology, Radiology, and Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri, USA.
Background: Rotation of the ferromagnetic gantry of a low magnetic field MRI-Linac was previously demonstrated to cause large center frequency offsets of ±400 Hz. The B off-resonances cause image artifacts and imaging isocenter shifts that would preclude MRI-guided arc therapy.
Purpose: The purpose of this study was to measure and compensate for center frequency offsets in real time during gantry rotation on a 0.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!