Computer Aided Surgery最新文献

{"title":"Robotic assisted microsurgery in hypothenar hammer syndrome: a case report.","authors":"Sybille Facca,&nbsp;Philippe Liverneaux","doi":"10.3109/10929088.2010.507942","DOIUrl":"https://doi.org/10.3109/10929088.2010.507942","url":null,"abstract":"<p><p>We report the case of a patient with bilateral hypothenar hammer syndrome. The therapeutic decision was to resect a thrombosed segment of the distal ulnar artery then reconstruct it using a forearm venous graft. The original aspect of this case concerns the microsurgical technique employed: All vascular sutures were made by separate nylon 10/0 stitches using a da Vinci S surgical robot. No particular problems were observed postoperatively and, except for some cold-related pain, the patient no longer experienced any symptoms at 6 months post-surgery. This clinical case shows that robots may be employed for some specific tele-microsurgical procedures.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"15 4-6","pages":"110-4"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2010.507942","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29277033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of optical localizer accuracy for computer aided surgery systems.","authors":"Robert Elfring,&nbsp;Matías de la Fuente,&nbsp;Klaus Radermacher","doi":"10.3109/10929081003647239","DOIUrl":"https://doi.org/10.3109/10929081003647239","url":null,"abstract":"<p><p>The technology for localization of surgical tools with respect to the patient's reference coordinate system in three to six degrees of freedom is one of the key components in computer aided surgery. Several tracking methods are available, of which optical tracking is the most widespread in clinical use. Optical tracking technology has proven to be a reliable method for intra-operative position and orientation acquisition in many clinical applications; however, the accuracy of such localizers is still a topic of discussion. In this paper, the accuracy of three optical localizer systems, the NDI Polaris P4, the NDI Polaris Spectra (in active and passive mode) and the Stryker Navigation System II camera, is assessed and compared critically. Static tests revealed that only the Polaris P4 shows significant warm-up behavior, with a significant shift of accuracy being observed within 42 minutes of being switched on. Furthermore, the intrinsic localizer accuracy was determined for single markers as well as for tools using a volumetric measurement protocol on a coordinate measurement machine. To determine the relative distance error within the measurement volume, the Length Measurement Error (LME) was determined at 35 test lengths. As accuracy depends strongly on the marker configuration employed, the error to be expected in typical clinical setups was estimated in a simulation for different tool configurations. The two active localizer systems, the Stryker Navigation System II camera and the Polaris Spectra (active mode), showed the best results, with trueness values (mean +/- standard deviation) of 0.058 +/- 0.033 mm and 0.089 +/- 0.061 mm, respectively. The Polaris Spectra (passive mode) showed a trueness of 0.170 +/- 0.090 mm, and the Polaris P4 showed the lowest trueness at 0.272 +/- 0.394 mm with a higher number of outliers than for the other cameras. The simulation of the different tool configurations in a typical clinical setup revealed that the tracking error can be estimated to be 1.02 mm for the Polaris P4, 0.64 mm for the Polaris Spectra in passive mode, 0.33 mm for the Polaris Spectra in active mode, and 0.22 mm for the Stryker Navigation System II camera.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"15 1-3","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929081003647239","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28781004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress concentration near pin holes associated with fracture risk after computer navigated total knee arthroplasty.","authors":"Kyungsoo Kim,&nbsp;Yoon Hyuk Kim,&nbsp;Won Man Park,&nbsp;Kee Hyung Rhyu","doi":"10.3109/10929088.2010.515419","DOIUrl":"https://doi.org/10.3109/10929088.2010.515419","url":null,"abstract":"<p><p>During computer navigated total knee arthroplasty, pin holes are drilled in the femur and tibia to allow the placement of navigation trackers, and fractures associated with these pin holes have recently been reported. We hypothesized that an increase in stress around the pin holes is one of the most relevant factors contributing to the fracture. In this study, we used finite element analysis to investigate the stresses around femoral pin holes with respect to the mode of pin penetration, the diameter of the pin holes, and the degree of osteoporosis. Our results indicate that increases in pin hole diameter and reduction in bone strength as a result of osteoporosis intensify the stresses around the pin holes, especially in cases of transcortical pin penetration.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"15 4-6","pages":"98-103"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2010.515419","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29305319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deviations between intra-operative navigation data and post-operative weight-bearing X-rays.","authors":"I Livshetz,&nbsp;Y S Brin,&nbsp;C Holcroft,&nbsp;J Antoniou,&nbsp;D J Zukor","doi":"10.3109/10929088.2010.480884","DOIUrl":"https://doi.org/10.3109/10929088.2010.480884","url":null,"abstract":"<p><p>Several studies have shown that computer-navigated TKA reduces the rate of outliers. Thirty-one consecutive patients were operated on by the same surgeon using a computer assisted navigation system. Data collected by the system included the final mechanical axis of the extremity (HKA angle) and the coronal angle of the tibial and femoral implants. These same values were measured using CAD software on full weight-bearing long X-rays taken 6 weeks post-surgery. Deviations were observed when X-ray measurements were compared to intra-operative data collected from the navigation system. A statistically significant difference was found in the tibial cut (1.29 degrees +/- 1.35 degrees; p < 0.0001) and in the HKA (1.59 degrees +/- 2.36 degrees; p = 0.0007). Outliers of more than 3 degrees were observed in the coronal plane of the tibial implant in 9.6% of patients, in the coronal plane of the femoral implant in 6.4% of patients, and in the HKA angle of 29% of patients. Our results indicate that the use of navigation alone is insufficient to prevent outliers beyond an acceptable range of 3 degrees .</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"15 1-3","pages":"56-62"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2010.480884","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29034882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual models for virtual bone drilling in mastoid surgery.","authors":"B Tolsdorff,&nbsp;A Petersik,&nbsp;B Pflesser,&nbsp;A Pommert,&nbsp;U Tiede,&nbsp;R Leuwer,&nbsp;K H Höhne","doi":"10.3109/10929080903040540","DOIUrl":"https://doi.org/10.3109/10929080903040540","url":null,"abstract":"<p><p>Segmented training cases for virtual simulation of bone-drilling interventions in middle ear surgery have proven to be helpful in learning about surgical anatomy of the temporal bone. The anatomy of the mastoid shows a high degree of variability, however, and the aim of this study was to evaluate whether individual virtual models could be created within an affordable timeframe, and to what extend they reflected natural individual anatomy during virtual mastoid surgery. Automatic segmentation schemes were used, and these reduced the time required to create individual models on the basis of DICOM CT scans to less than 5 minutes. Models based on CT data with a slice distance of 0.4 mm or better were found to provide excellent handling, an acceptable depiction of mastoidal organs, and a helpful impression of the individual surgical situation. Although landmarks are still more easily detected in real mastoids, virtual drilling of individual models makes the 3D estimation of specific anatomy more effective than estimations based on interpretation of CT scans alone.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"14 1-3","pages":"21-7"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929080903040540","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28269633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A potential means of improving the evaluation of deformity corrections with Taylor spatial frames over time by using volumetric imaging: preliminary results.","authors":"Vanessa Starr,&nbsp;H Olivecrona,&nbsp;M E Noz,&nbsp;G Q Maguire,&nbsp;M P Zeleznik,&nbsp;Karl-åke Jannsson","doi":"10.3109/10929080903454969","DOIUrl":"https://doi.org/10.3109/10929080903454969","url":null,"abstract":"<p><strong>Objective: </strong>In this study we explore the possibility of accurately and cost-effectively monitoring tibial deformation induced by Taylor Spatial Frames (TSFs), using time-separated computed tomography (CT) scans and a volume fusion technique to determine tibial rotation and translation.</p><p><strong>Materials and methods: </strong>Serial CT examinations (designated CT-A and CT-B, separated by a time interval of several months) of two patients were investigated using a previously described and validated volume fusion technique, in which user-defined landmarks drive the 3D registration of the two CT volumes. Both patients had undergone dual osteotomies to correct for tibial length and rotational deformity. For each registration, 10 or more landmarks were selected, and the quality of the fused volume was assessed both quantitatively and via 2D and 3D visualization tools. First, the proximal frame segment and tibia in CT-A and CT-B were brought into alignment (registered) by selecting landmarks on the frame and/or tibia. In the resulting \"fused\" volume, the proximal frame segment and tibia from CT-A and CT-B were aligned, while the distal frame segment and tibia from CT-A and CT-B were likely not aligned as a result of tibial deformation or frame adjustment having occurred between the CT scans. Using the proximal fused volume, the distal frame segment and tibia were then registered by selecting landmarks on the frame and/or tibia. The difference between the centroids of the final distal landmarks was used to evaluate the lengthening of the tibia, and the Euler angles from the registration were used to evaluate the rotation.</p><p><strong>Results: </strong>Both the frame and bone could be effectively registered (based on visual interpretation). Movement between the proximal frame and proximal bone could be visualized in both cases. The spatial effect on the tibia could be both visually assessed and measured: 34 mm, 10 degrees in one case; 5 mm, 1 degrees in the other.</p><p><strong>Conclusion: </strong>This retrospective analysis of spatial correction of the tibia using Taylor Spatial Frames shows that CT offers an interesting potential means of quantitatively monitoring the patient's treatment. Compared with traditional techniques, modern CT scans in conjunction with image processing provide a high-resolution, spatially correct, and three-dimensional measurement system which can be used to quickly and easily assess the patient's treatment at low cost to the patient and hospital.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"14 4-6","pages":"100-8"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929080903454969","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28684166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A computer aided method for closed reduction of diaphyseal tibial fracture using projection images: A feasibility study.","authors":"Terry K K Koo,&nbsp;M Owen Papuga","doi":"10.3109/10929080903016102","DOIUrl":"https://doi.org/10.3109/10929080903016102","url":null,"abstract":"A computer aided method for closed tibial shaft fracture reduction based on measurements of 12 projection parameters (6 angulations and 6 translations) from an anteroposterior radiograph, a lateral radiograph, and a transverse projection photograph is examined. The development, validation and reliability of the computer aided method are presented. A custom-made unilateral external fixation device consisting of 7 calibrated one-degree-of-freedom joints was employed to execute the reduction. Five tibial fracture phantoms with initial deformities that covered a wide range of misalignments were tested. The mean (standard deviation) resultant rotational and translational errors after the reduction were 3.32° (0.96°) and 1.65 (0.86) mm, respectively, which indicates good reduction accuracy. Three independent raters made the measurements of the projection parameters to test inter-rater reliability. The intra-class correlation coefficients were found to range between 0.935 and 1, indicating good reliability. Since ideal patient positioning for AP, lateral and transverse image acquisition is not easily attainable, the effect of patient positioning errors on the measurement of projection parameters was explored using a tibial phantom. The preliminary results revealed that 10° deviations in positioning do not greatly affect the measurement of AP and lateral angulation parameters (<1.7°). However, a 10° positioning error about the long bone axis may result in a change of as much as 10.7° in the measurements of transverse projection angulation parameters. In addition, a 10° positioning error about an arbitrary anatomical axis may result in translational projection parameter changes of up to 6.8 mm. For these reasons, a previously validated method that allows for accurate positioning of the tibia about its long axis and a two-step reduction strategy to achieve the best possible deformity reduction are proposed. Procedures to facilitate reliable measurement of tibial torsion are also discussed. It appears that the projection-based reduction method exposes the patient to less radiation and allows for simple, quick and accurate reductions, making it an attractive choice for acute clinical applications.","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"14 1-3","pages":"45-57"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929080903016102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28684231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation- and reference base-free navigation procedure for placement of instruments and implants: application to retrograde drilling of osteochondral lesions of the knee joint.","authors":"Matthias Müller,&nbsp;Florian Gras,&nbsp;Ivan Marintschev,&nbsp;Thomas Mückley,&nbsp;Gunter O Hofmann","doi":"10.3109/10929080903306305","DOIUrl":"https://doi.org/10.3109/10929080903306305","url":null,"abstract":"<p><strong>Objective: </strong>A novel, radiation- and reference base-free procedure for placement of navigated instruments and implants was developed and its practicability and precision in retrograde drillings evaluated in an experimental setting.</p><p><strong>Materials and methods: </strong>Two different guidance techniques were used: One experimental group was operated on using the radiation- and reference base-free navigation technique (Fluoro Free), and the control group was operated on using standard fluoroscopy for guidance. For each group, 12 core decompressions were simulated by retrograde drillings in different artificial femurs following arthroscopic determination of the osteochondral lesions. The final guide-wire position was evaluated by postoperative CT analysis using vector calculation.</p><p><strong>Results: </strong>High precision was achieved in both groups, but operating time was significantly reduced in the navigated group as compared to the control group. This was due to a 100% first-pass accuracy of drilling in the navigated group; in the control group a mean of 2.5 correction maneuvers per drilling were necessary. Additionally, the procedure was free of radiation in the navigated group, whereas 17.2 seconds of radiation exposure time were measured in the fluoroscopy-guided group.</p><p><strong>Conclusion: </strong>The developed Fluoro Free procedure is a promising and simplified approach to navigating different instruments as well as implants in relation to visually or tactilely placed pointers or objects without the need for radiation exposure or invasive fixation of a dynamic reference base in the bone.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"14 4-6","pages":"109-16"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929080903306305","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28684167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2D XFEM-based modeling of retraction and successive resections for preoperative image update.","authors":"Lara M Vigneron,&nbsp;Marc P Duflot,&nbsp;Pierre A Robe,&nbsp;Simon K Warfield,&nbsp;Jacques G Verly","doi":"10.3109/10929080903052677","DOIUrl":"https://doi.org/10.3109/10929080903052677","url":null,"abstract":"<p><p>This paper considers an approach to improving outcomes for neurosurgery patients by enhancing intraoperative navigation and guidance. Currently, intraoperative navigation systems do not accurately account for brain shift or tissue resection. We describe how preoperative images can be incrementally updated to take into account any type of brain tissue deformation that may occur during surgery, and thus to improve the accuracy of image-guided navigation systems. For this purpose, we have developed a non-rigid image registration technique using a biomechanical model, which deforms based on the Finite Element Method (FEM). While the FEM has been used successfully for dealing with deformations such as brain shift, it has difficulty with tissue discontinuities. Here, we describe a novel application of the eXtended Finite Element Method (XFEM) in the field of image-guided surgery in order to model brain deformations that imply tissue discontinuities. In particular, this paper presents a detailed account of the use of XFEM for dealing with retraction and successive resections, and demonstrates the feasibility of the approach by considering 2D examples based on intraoperative MR images. To evaluate our results, we compute the modified Hausdorff distance between Canny edges extracted from images before and after registration. We show that this distance decreases after registration, and thus demonstrate that our approach improves alignment of intraoperative images.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"14 1-3","pages":"1-20"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929080903052677","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28330732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Registration accuracy in computer-assisted pelvic surgery.","authors":"P L Docquier,&nbsp;L Paul,&nbsp;O Cartiaux,&nbsp;X Banse","doi":"10.3109/10929080903024361","DOIUrl":"https://doi.org/10.3109/10929080903024361","url":null,"abstract":"<p><strong>Introduction: </strong>An in vitro study was performed to assess the global registration accuracy of a computer-assisted system in pelvic orthopaedic surgery. The system was applied to a putative tumor resection in a pelvic sawbone.</p><p><strong>Methods: </strong>Twenty landmarks were created on the surface of the pelvis, and a virtual model of the sawbone was constructed based on surface extraction from computed tomography. The coordinates of the landmarks were defined in the CT-scan coordinate system, and registration of the sawbone with the virtual model was achieved using a surface-based matching algorithm. The landmarks were considered as control points, and deviations between their physical locations and their locations in the virtual model were calculated, thereby quantifying the global accuracy error.</p><p><strong>Results: </strong>The location of the initialization points was unimportant. The dynamic reference base gave the best results when placed far from the working area. Accuracy was improved when the sampling area was increased, but was decreased by its excessive expansion.</p><p><strong>Conclusions: </strong>It is recommended that the DRB be located on the contralateral side of the pelvis. Extending the approach posteriorly and including the entire working area in the sampling surface area, if possible, will also help increase accuracy in computer-assisted pelvic surgery.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"14 1-3","pages":"37-44"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929080903024361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28238475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}