Estimating pedicle screw fastening strength via a virtual templating platform for spine surgery planning: a retrospective preliminary clinical demonstration

Cristian A. Linte, Jon J. Camp, Kurt E. Augustine, Paul M. Huddleston, Richard A. Robb, David R. Holmes III

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Traditional 2D images provide limited use for accurate planning of spine interventions, due to their inability to display the complex 3D spine anatomy and proximity of nerve bundles and vascular structures that must be avoided during the procedure. We have developed a platform for spine surgery planning that employs standard of care 3D preoperative images and enables oblique reformatting and 3D rendering of individual or multiple vertebrae, interactive templating and placement of virtual pedicle implants into the patient-specific computed tomography data. Here we propose a combined surrogate metric – the fastening strength – to provide estimates of the optimal implant selection and trajectory based on implant dimension and bone mineral density (BMD) of the displaced bone substrate. We conducted a retrospective clinical study based on pre- and post-operative data from four patients who underwent procedures involving pedicle screw implantation. We assessed the retrospective plans against the post-operative imaging data according to implant dimension, mean voxel intensity of implant trajectory, and fastening strength and showed consistency between the proposed plans and the post-operative procedure outcome. Our preliminary studies have demonstrated the feasibility of the platform in assisting the surgeon with the selection of appropriate size implant and trajectory that optimises fastening strength, given the intrinsic vertebral geometry and BMD.

Original languageEnglish (US)
Pages (from-to)204-212
Number of pages9
JournalComputer Methods in Biomechanics and Biomedical Engineering: Imaging and Visualization
Volume3
Issue number4
DOIs
StatePublished - Oct 2 2015

Fingerprint

Surgery
Bone
Spine
Demonstrations
Trajectories
Planning
Minerals
Bone Density
Tomography
Operative Surgical Procedures
Standard of Care
Blood Vessels
Imaging techniques
Anatomy
Geometry
Retrospective Studies
Substrates
Bone and Bones
Pedicle Screws

Keywords

  • applications of imaging and visualisation
  • image-based geometric modelling
  • imaging and visualisation in biomechanics
  • planning and intervention
  • spine imaging
  • templating
  • virtual modelling
  • virtual reality

ASJC Scopus subject areas

  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging
  • Computational Mechanics
  • Computer Science Applications

Cite this

Estimating pedicle screw fastening strength via a virtual templating platform for spine surgery planning : a retrospective preliminary clinical demonstration. / Linte, Cristian A.; Camp, Jon J.; Augustine, Kurt E.; Huddleston, Paul M.; Robb, Richard A.; Holmes III, David R.

In: Computer Methods in Biomechanics and Biomedical Engineering: Imaging and Visualization, Vol. 3, No. 4, 02.10.2015, p. 204-212.

Research output: Contribution to journalArticle

@article{5315351c2a014bd5b94780c430bfd909,
title = "Estimating pedicle screw fastening strength via a virtual templating platform for spine surgery planning: a retrospective preliminary clinical demonstration",
abstract = "Traditional 2D images provide limited use for accurate planning of spine interventions, due to their inability to display the complex 3D spine anatomy and proximity of nerve bundles and vascular structures that must be avoided during the procedure. We have developed a platform for spine surgery planning that employs standard of care 3D preoperative images and enables oblique reformatting and 3D rendering of individual or multiple vertebrae, interactive templating and placement of virtual pedicle implants into the patient-specific computed tomography data. Here we propose a combined surrogate metric – the fastening strength – to provide estimates of the optimal implant selection and trajectory based on implant dimension and bone mineral density (BMD) of the displaced bone substrate. We conducted a retrospective clinical study based on pre- and post-operative data from four patients who underwent procedures involving pedicle screw implantation. We assessed the retrospective plans against the post-operative imaging data according to implant dimension, mean voxel intensity of implant trajectory, and fastening strength and showed consistency between the proposed plans and the post-operative procedure outcome. Our preliminary studies have demonstrated the feasibility of the platform in assisting the surgeon with the selection of appropriate size implant and trajectory that optimises fastening strength, given the intrinsic vertebral geometry and BMD.",
keywords = "applications of imaging and visualisation, image-based geometric modelling, imaging and visualisation in biomechanics, planning and intervention, spine imaging, templating, virtual modelling, virtual reality",
author = "Linte, {Cristian A.} and Camp, {Jon J.} and Augustine, {Kurt E.} and Huddleston, {Paul M.} and Robb, {Richard A.} and {Holmes III}, {David R.}",
year = "2015",
month = "10",
day = "2",
doi = "10.1080/21681163.2014.900725",
language = "English (US)",
volume = "3",
pages = "204--212",
journal = "Computer Methods in Biomechanics and Biomedical Engineering: Imaging and Visualization",
issn = "2168-1163",
publisher = "Taylor and Francis Ltd.",
number = "4",

}

TY - JOUR

T1 - Estimating pedicle screw fastening strength via a virtual templating platform for spine surgery planning

T2 - a retrospective preliminary clinical demonstration

AU - Linte, Cristian A.

AU - Camp, Jon J.

AU - Augustine, Kurt E.

AU - Huddleston, Paul M.

AU - Robb, Richard A.

AU - Holmes III, David R.

PY - 2015/10/2

Y1 - 2015/10/2

N2 - Traditional 2D images provide limited use for accurate planning of spine interventions, due to their inability to display the complex 3D spine anatomy and proximity of nerve bundles and vascular structures that must be avoided during the procedure. We have developed a platform for spine surgery planning that employs standard of care 3D preoperative images and enables oblique reformatting and 3D rendering of individual or multiple vertebrae, interactive templating and placement of virtual pedicle implants into the patient-specific computed tomography data. Here we propose a combined surrogate metric – the fastening strength – to provide estimates of the optimal implant selection and trajectory based on implant dimension and bone mineral density (BMD) of the displaced bone substrate. We conducted a retrospective clinical study based on pre- and post-operative data from four patients who underwent procedures involving pedicle screw implantation. We assessed the retrospective plans against the post-operative imaging data according to implant dimension, mean voxel intensity of implant trajectory, and fastening strength and showed consistency between the proposed plans and the post-operative procedure outcome. Our preliminary studies have demonstrated the feasibility of the platform in assisting the surgeon with the selection of appropriate size implant and trajectory that optimises fastening strength, given the intrinsic vertebral geometry and BMD.

AB - Traditional 2D images provide limited use for accurate planning of spine interventions, due to their inability to display the complex 3D spine anatomy and proximity of nerve bundles and vascular structures that must be avoided during the procedure. We have developed a platform for spine surgery planning that employs standard of care 3D preoperative images and enables oblique reformatting and 3D rendering of individual or multiple vertebrae, interactive templating and placement of virtual pedicle implants into the patient-specific computed tomography data. Here we propose a combined surrogate metric – the fastening strength – to provide estimates of the optimal implant selection and trajectory based on implant dimension and bone mineral density (BMD) of the displaced bone substrate. We conducted a retrospective clinical study based on pre- and post-operative data from four patients who underwent procedures involving pedicle screw implantation. We assessed the retrospective plans against the post-operative imaging data according to implant dimension, mean voxel intensity of implant trajectory, and fastening strength and showed consistency between the proposed plans and the post-operative procedure outcome. Our preliminary studies have demonstrated the feasibility of the platform in assisting the surgeon with the selection of appropriate size implant and trajectory that optimises fastening strength, given the intrinsic vertebral geometry and BMD.

KW - applications of imaging and visualisation

KW - image-based geometric modelling

KW - imaging and visualisation in biomechanics

KW - planning and intervention

KW - spine imaging

KW - templating

KW - virtual modelling

KW - virtual reality

UR - http://www.scopus.com/inward/record.url?scp=84981360650&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84981360650&partnerID=8YFLogxK

U2 - 10.1080/21681163.2014.900725

DO - 10.1080/21681163.2014.900725

M3 - Article

AN - SCOPUS:84981360650

VL - 3

SP - 204

EP - 212

JO - Computer Methods in Biomechanics and Biomedical Engineering: Imaging and Visualization

JF - Computer Methods in Biomechanics and Biomedical Engineering: Imaging and Visualization

SN - 2168-1163

IS - 4

ER -