Computer Assisted Surgery最新文献

Deep learning diagnosis model of spinal tuberculosis based on CT bone window gradient attention mechanism: multi-center study. 基于CT骨窗梯度注意机制的脊柱结核深度学习诊断模型：多中心研究。

IF 1.9 4区医学

Computer Assisted Surgery Pub Date : 2026-12-01 Epub Date: 2025-12-29 DOI: 10.1080/24699322.2025.2599329

Sen Mo, Chong Liu, Jiang Xue, Jiarui Chen, Hao Li, Zhaojun Lu, Zhongxian Zhou, Xiaopeng Qin, Rongqing He, Boli Qin, Yahui Huang, Wei Wei, Xinli Zhan

{"title":"Deep learning diagnosis model of spinal tuberculosis based on CT bone window gradient attention mechanism: multi-center study.","authors":"Sen Mo, Chong Liu, Jiang Xue, Jiarui Chen, Hao Li, Zhaojun Lu, Zhongxian Zhou, Xiaopeng Qin, Rongqing He, Boli Qin, Yahui Huang, Wei Wei, Xinli Zhan","doi":"10.1080/24699322.2025.2599329","DOIUrl":"10.1080/24699322.2025.2599329","url":null,"abstract":"Purpose: To develop a deep learning model based on CT bone window images to enhance the accuracy of early diagnosis of spinal tuberculosis.Methods: This study adopted multicenter retrospective data (n = 1027). Firstly, the vertebral body region of the spine was extracted through the U-Net segmentation model. Then, the segmented images were input into the improved ResNet50 network. Combined with the CT bone window gradient attention mechanism, an end-to-end deep learning diagnostic model was constructed.Results: In the internal validation datasets, the model achieved an AUC of 0.920, accuracy of 0.874 and sensitivity of 0.876. For External test datasets 1, the AUC was 0.867, accuracy 0.801 and sensitivity 0.794; for External test datasets 2, the AUC was 0.866, accuracy 0.769, and sensitivity 0.883; and for External test datasets 3, the AUC was 0.941, accuracy 0.843 and sensitivity 0.790.Conclusion: The multi-center study built up a deep learning model for spinal tuberculosis diagnosis with the assist of the CT bone window gradient attention mechanism. The model achieved a good internal verification ability (AUC = 0.920, accuracy rate = 0.874) and external verification ability (AUC = 0.866-0.941, accuracy rate = 0.769-0.843) which showed the wide applicability of the model to different medical institutions. The main developments of this work are the good performances for features that extract relevant information about trabecular micro-fractures and calcification contours' gradients.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"31 1","pages":"2599329"},"PeriodicalIF":1.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rebuilding the pelvis: advances in robotic-assisted management of complex pelvic fractures. 骨盆重建：复杂骨盆骨折的机器人辅助治疗进展。

IF 2.3 4区医学

Computer Assisted Surgery Pub Date : 2026-12-01 Epub Date: 2026-01-16 DOI: 10.1080/24699322.2026.2615212

Linpeng Ge, Long Wang, Leilei Duan, Taiyuan Zhang

{"title":"Rebuilding the pelvis: advances in robotic-assisted management of complex pelvic fractures.","authors":"Linpeng Ge, Long Wang, Leilei Duan, Taiyuan Zhang","doi":"10.1080/24699322.2026.2615212","DOIUrl":"10.1080/24699322.2026.2615212","url":null,"abstract":"Complex pelvic fractures are infamously challenging to fix surgically because of their fine anatomy and proximity to vital neurovascular structures. Traditional open reduction and internal fixation (ORIF) improves stability but is complicated by excessive blood loss, longer operative time, and morbidity. Robotic-assisted surgical methods, i.e. Robot-Assisted Fracture Reduction (RAFR) and the TiRobot platform, provide a paradigm shift toward precise, minimally invasive fracture reduction and fixation. The RAFR system blends preoperative high-definition 3D CT imaging with intraoperative cone-beam CT and real-time navigation for dynamic visualization and accurate fragment control to eliminate guesswork and minimize the risk of malposition. Its cutting-edge robotic arm, electrically actuated holding devices, and elastic counterforces of traction ensure controlled and safe fracture reduction with soft tissue and neurovascular integrity preservation. Robot-assisted support is assisted by extensive clinical evidence to enhance the accuracy of surgery with sub-millimeter positioning discrepancies, reduce intraoperative blood loss, reduce exposure to radiation, reduce operative and hospital stay times, and enhance functional restoration according to scores demonstrated. Robot over conventional techniques reduces postoperative infection, implant loosening, nonunion, and nerve or vessel injury. TiRobot enhances fixation using artificial intelligence-assisted screw path planning and navigation. Albeit promising, it has limitations in adoption, such as being costly, having no feedback, and a high learning curve. More multicenter randomized clinical trials are required to estimate long-term efficacy, safety, and cost-effectiveness. Robot-assisted pelvic fracture surgery is a leading-edge development that has the ability to improve patient outcomes and the delivery of trauma care.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"31 1","pages":"2615212"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between preoperative serum albumin levels and the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic surgery: a single-center retrospective cohort study. 腹腔镜手术患者术前血清白蛋白水平与术后恶心呕吐发生率之间的关系：一项单中心回顾性队列研究

IF 1.9 4区医学

Computer Assisted Surgery Pub Date : 2026-12-01 Epub Date: 2026-06-10 DOI: 10.1080/24699322.2026.2678776

Jiegang Zhou, Yanping Liu, Qiang Zhong, Xinwei Feng

{"title":"Association between preoperative serum albumin levels and the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic surgery: a single-center retrospective cohort study.","authors":"Jiegang Zhou, Yanping Liu, Qiang Zhong, Xinwei Feng","doi":"10.1080/24699322.2026.2678776","DOIUrl":"10.1080/24699322.2026.2678776","url":null,"abstract":"Postoperative nausea and vomiting (PONV) is a common complication after laparoscopic surgery and may impair recovery. This study investigated the independent association between preoperative serum albumin (ALB) levels and PONV, and assessed the value of ALB as a preoperative predictor. In this single-center retrospective cohort study, 263 adult patients undergoing elective laparoscopic surgery at Ganzhou People's Hospital between June 2022 and May 2025 were consecutively enrolled. Patients were stratified into tertiles according to preoperative ALB levels. ROC analysis was used to determine the optimal ALB cutoff for predicting PONV, and multivariable logistic regression was performed after adjustment for potential confounders. The incidence of PONV was 45.5% in the low-ALB group, 17.2% in the middle-ALB group, and 13.6% in the high-ALB group, showing a significant inverse trend (P<0.001). Compared with the low-ALB group, the adjusted odds ratios for PONV were 0.24 (95% CI: 0.11-0.53) in the middle-ALB group and 0.21 (95% CI: 0.09-0.48) in the high-ALB group (P<0.001). ROC analysis showed that preoperative ALB had moderate predictive ability for PONV (AUC=0.792, 95% CI: 0.732-0.852), with an optimal cutoff of 37.2 g/L (sensitivity 74.6%, specificity 70.4%). Subgroup analyses showed consistent associations across sex, ASA physical status, and surgical type. Among patients with low ALB levels, female sex and total intraoperative remifentanil dose were independently associated with PONV. Preoperative hypoalbuminemia (ALB <37.2 g/L) was independently associated with increased PONV risk after laparoscopic surgery. Serum albumin may be a simple and useful marker for preoperative risk stratification and individualized prophylaxis.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"31 1","pages":"2678776"},"PeriodicalIF":1.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of deep learning techniques in computer-aided diagnosis for meniscus injuries: a systematic literature review. 深度学习技术在半月板损伤计算机辅助诊断中的应用分析：系统文献综述。

IF 2.3 4区医学

Computer Assisted Surgery Pub Date : 2026-12-01 Epub Date: 2026-08-14 DOI: 10.1080/24699322.2026.2692844

Vengas Memon, Sayed A Zikri Bin Syed Aluwee, Yogan Jaya Kumar, Vinod Kumar Perhakaran

{"title":"Analysis of deep learning techniques in computer-aided diagnosis for meniscus injuries: a systematic literature review.","authors":"Vengas Memon, Sayed A Zikri Bin Syed Aluwee, Yogan Jaya Kumar, Vinod Kumar Perhakaran","doi":"10.1080/24699322.2026.2692844","DOIUrl":"10.1080/24699322.2026.2692844","url":null,"abstract":"Meniscus informatics is a growing subject of study in the healthcare industry. One of the major hindrances to the healthcare system's transformation is obtaining knowledge and meaningful information from complicated, high-dimensional and diverse sources. Modern biomedical research, for instance, has seen an increase in the use of complex, dissimilar, poorly documented, and generally unstructured electronic health records, imaging, sensor data and text, even after many current techniques have been used to extract more robust and useful elements from the data for analysis. New efficient standards for building end-to-end learning models from complex data are therefore needed. Therefore, the current study aims to examine the most recent research on the use of deep learning techniques for diagnosing meniscus tears and recommend creating comprehensive and meaningful interpretable structures that might benefit the healthcare industry. We also draw attention to shortcomings and the need for better technique development, and we provide new perspectives about this exciting new development in the field.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"31 1","pages":"2692844"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Learning curve associated with CT-based navigation assisted cup orientation for muscle-sparing total hip arthroplasty: a cumulative summation analysis. 学习曲线与基于ct的导航辅助的保肌全髋关节置换术中的杯形定位相关：累积和分析。

IF 2.3 4区医学

Computer Assisted Surgery Pub Date : 2026-12-01 Epub Date: 2026-01-27 DOI: 10.1080/24699322.2026.2621330

Hiroshi Watanabe, Keisuke Atsumi, Naohiko Tomita, Daiki Saito, Makoto Hirao

{"title":"Learning curve associated with CT-based navigation assisted cup orientation for muscle-sparing total hip arthroplasty: a cumulative summation analysis.","authors":"Hiroshi Watanabe, Keisuke Atsumi, Naohiko Tomita, Daiki Saito, Makoto Hirao","doi":"10.1080/24699322.2026.2621330","DOIUrl":"10.1080/24699322.2026.2621330","url":null,"abstract":"The accurate cup placement is still crucial for total hip arthroplasty (THA). However, achieving adequate registration accuracy is difficult in the initial cases, which leads surgeons to discontinue the use of CT-based navigation. The objective of this study was to evaluate its learning curve using a cumulative summation (CUSUM) analysis of the absolute registration error for cup orientation. A retrospective review was performed on 75 consecutive patients who underwent minimally invasive THA, allowing the calculation of the difference in cup anteversion and inclination between the intraoperative values shown on the navigation system and postoperative values measured by postoperative CT. We reviewed those absolute registration errors and the patient reported outcomes (PROMs) one-year postoperatively. We plotted the CUSUM values of the absolute registration error in chronological order and added subgroup analysis regarding body mass index (BMI). CUSUM analysis revealed that performing THA using CT-based navigation was associated with a learning curve in 7 cases for cup inclination and anteversion. There were no significant differences in the absolute registration error of cup orientation between high and low BMI groups, or in the mean PROMs at one-year postoperatively, regardless of time sequence or BMI. In conclusion, CT-based navigation assisted acetabular cup placement was associated with a learning curve of 7 cases for achieving suitable registration accuracy. These findings are important, as orthopedic surgeons often discontinue CT-based navigation surgery early in the initial cases, despite its benefits in severe cases. Therefore, careful use of CT-based navigation is critical particularly within the first 7 cases.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"31 1","pages":"2621330"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Robotic-assisted versus standard laparoscopic surgery for colorectal cancer in obese patients: a systematic review and meta-analysis. 机器人辅助与标准腹腔镜手术治疗肥胖患者的结直肠癌：系统回顾和荟萃分析。

IF 1.9 4区医学

Computer Assisted Surgery Pub Date : 2026-12-01 Epub Date: 2025-12-27 DOI: 10.1080/24699322.2025.2604610

Hongbin Wu, Lei Zheng, Tonghai Xu, Bin Zhao, Huawu Yang

{"title":"Robotic-assisted versus standard laparoscopic surgery for colorectal cancer in obese patients: a systematic review and meta-analysis.","authors":"Hongbin Wu, Lei Zheng, Tonghai Xu, Bin Zhao, Huawu Yang","doi":"10.1080/24699322.2025.2604610","DOIUrl":"10.1080/24699322.2025.2604610","url":null,"abstract":"Colorectal cancer represents a major global health concern and obesity adds complicates its surgical management. This meta-analysis aimed to evaluate the comparative effectiveness and safety of robotic-assisted surgery and standard laparoscopic surgery in obese colorectal cancer patients. A comprehensive literature search performed across databases from inception to April 2024. Pooled estimates included hospital stay duration, drainage tube removal time, first ventilation time, complication rates, re-admission rates and re-operative rates. Six studies involving 4215 patients were included. Robotic-assisted surgery was associated with a statistically significant but modest reduction in hospital stay time compared to laparoscopic surgery (p = 0.02). No significant differences were found for drainage tube removal time (p = 0.42) and first ventilation time (p = 0.27). Complication rates (OR [odds ratio] = 0.92, 95% confidence interval [CI]: 0.74 to 1.13, p = 0.41), re-admission rates (OR = 0.81, 95% CI: 0.31 to 2.13, p = 0.67) and re-operative rates (OR = 1.20, 95% CI: 0.77 to 1.86, p = 0.41) did not significantly differ between surgical approaches. Robotic-assisted surgery significantly provides a modest reduction in hospital stay duration without compromising patient safety for obese colorectal cancer patients. These findings should be interpreted with caution. Future randomized controlled trials are required to confirm these results.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"31 1","pages":"2604610"},"PeriodicalIF":1.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multi-factorial biomechanical evaluation of plate-screw fixation in femoral shaft fractures using numerical and machine learning approaches. 应用数值和机器学习方法对股骨骨干骨折钢板-螺钉内固定的多因素生物力学评价。

IF 1.9 4区医学

Computer Assisted Surgery Pub Date : 2026-12-01 Epub Date: 2025-12-21 DOI: 10.1080/24699322.2025.2605494

Halil Burak Mutu

{"title":"Multi-factorial biomechanical evaluation of plate-screw fixation in femoral shaft fractures using numerical and machine learning approaches.","authors":"Halil Burak Mutu","doi":"10.1080/24699322.2025.2605494","DOIUrl":"10.1080/24699322.2025.2605494","url":null,"abstract":"Plate and screw fixation is a widely used method in the surgical treatment of femoral shaft fractures; however, mechanical performance may vary depending on implant material, fracture gap size and loading conditions. This study aimed to investigate the biomechanical behavior of femoral shaft fractures stabilized with plate and screw fixation by applying finite element analysis (FEA) and to evaluate the predictive performance of machine learning (ML) algorithms based on numerical results. Three different fracture gap sizes (1, 2,and 3 mm) were modeled on a femur geometry, and axial loads ranging from 400 N to 1200 N (in 100 N increments) were applied. Two implant materials, Ti-6Al-4V and 316 L stainless steel (SS), were assessed. The stress distribution on the plate and first screw and the displacements at the femoral head and fracture site were analyzed using two different mesh densities. Subsequently, ML algorithms including Decision Tree (DT), Multilayer Perceptron (MLP) and Support Vector Machine (SVM) were used to predict the stress and displacement values based on the numerical dataset. The finer mesh provided more accurate results. Ti-6Al-4V showed lower von Mises stress values and displacement magnitudes compared to 316 L SS. Among the ML methods, MLP and SVM demonstrated better prediction accuracy than DT. The integration of FEA and ML techniques enables efficient prediction of implant biomechanics, offering a promising approach for preclinical evaluation and optimization of orthopedic fixation systems.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"31 1","pages":"2605494"},"PeriodicalIF":1.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Toward real-time alignment of 3D CT and 2D X-ray with multi-stage CNNs. 基于多级cnn的三维CT和二维x线实时对准研究。

IF 2.3 4区医学

Computer Assisted Surgery Pub Date : 2026-12-01 Epub Date: 2026-06-16 DOI: 10.1080/24699322.2026.2684372

Federica Facente, Benjamin Billot, Vivek Gopalakrishnan, Manasi Kattel, Wen Wei, Polina Golland, Hervé Delingette, Nicholas Ayache, Pierre Berthet-Rayne

{"title":"Toward real-time alignment of 3D CT and 2D X-ray with multi-stage CNNs.","authors":"Federica Facente, Benjamin Billot, Vivek Gopalakrishnan, Manasi Kattel, Wen Wei, Polina Golland, Hervé Delingette, Nicholas Ayache, Pierre Berthet-Rayne","doi":"10.1080/24699322.2026.2684372","DOIUrl":"10.1080/24699322.2026.2684372","url":null,"abstract":"2D X-ray imaging is widely employed in image-guided interventions to provide real-time visualization of patient anatomy and interventional devices. However, lacking depth information and soft-tissue contrast, intraoperative X-rays are often complemented with high-resolution preoperative 3D computed tomography (CT) scans. Clinicians must mentally register the 3D preoperative information onto the 2D visualization, increasing cognitive workload and motivating the need for automated solutions. Traditionally, this registration task is formulated as estimating the position of the X-ray source relatively to the CT scan. State-of-the-art 3D/2D registration approaches are trained using synthetic CT-to-X-ray projections, but these methods still require manual annotations and employ a time-consuming optimization that limits their deployment for live image guidance. In this paper, we propose LXPose (live X-ray pose estimation), a fast multi-stage 3D/2D registration framework for real-time image guidance. Specifically, we introduce an efficient two-stage CNN that effectively bypasses slow optimization for fast inference. Critically, we also eliminate the need for any manual annotations by introducing an automated strategy for landmark extraction. Finally, we train LXPose using a projection loss for high accuracy, and apply extensive data augmentation in a first attempt to reduce the domain gap between the synthetic training X-rays and real testing data. We demonstrate LXPose on two datasets from different anatomical regions, where it yields results comparable to the state-of-the-art, while reducing inference time by two orders of magnitude, from several seconds to 20 ms. Overall, our results demonstrate the potential of LXPose for real-time clinical deployment. Our code is available at https://github.com/fedefacente/LXPose.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"31 1","pages":"2684372"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of a web-based preoperative planner for right vertical infra-axillary thoracotomy. 基于网络的右侧垂直腋窝下开胸术前计划器的开发。

IF 2.3 4区医学

Computer Assisted Surgery Pub Date : 2026-12-01 Epub Date: 2026-03-07 DOI: 10.1080/24699322.2026.2635776

Szu-Yen Hu, Yi-Chia Wang, Heng-Wen Chou, Yih-Sharng Chen, Chih-Ting Lin, Shu-Chien Huang

{"title":"Development of a web-based preoperative planner for right vertical infra-axillary thoracotomy.","authors":"Szu-Yen Hu, Yi-Chia Wang, Heng-Wen Chou, Yih-Sharng Chen, Chih-Ting Lin, Shu-Chien Huang","doi":"10.1080/24699322.2026.2635776","DOIUrl":"10.1080/24699322.2026.2635776","url":null,"abstract":"Right Vertical Infra-Axillary Thoracotomy (RVIAT) offers superior cosmetic outcomes but presents challenges due to restricted access. In pediatric patients, the 'crowded thorax' necessitates simultaneous visualization of intracardiac defects and central cannulation sites. Therefore, the choice of the intercostal incision can significantly affect the surgical field. To address this, we propose a patient-specific, geometry-driven framework to objectively optimize surgical corridors. A web-based surgical planner was developed to simulate incision strategies using patient-specific computed tomography data. The system utilizes ray-casting algorithms to compute a quantitative 'Visibility Score' for multiple anatomical targets. The framework was validated through a complex dual-pathology case and a multi-parametric sensitivity analysis involving varying chest wall thicknesses and instrument constraints. The system was successfully implemented as a platform-independent web application capable of real-time, client-side processing. In the dual-pathology validation, the simulation revealed that the standard 4th intercostal space (ICS) provided limited visibility for the secondary target (Patent Ductus Arteriosus, PDA: 72%). The optimizer identified the 3rd ICS as the superior vector, increasing PDA visibility to 86% without compromising primary Ventricular septal defect exposure (100%). Sensitivity analysis further indicated that while deep intracardiac targets maintained robust visibility across varying anatomical conditions, the exposure of cannulation sites was reduced. The proposed framework provides a deterministic method to evaluate surgical corridors preoperatively. By objectively quantifying exposure for both intracardiac defects and obligatory cannulation sites, the system assists surgeons in selecting the optimal incision level to ensure comprehensive procedural safety.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"31 1","pages":"2635776"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of an in silico hybrid model for scoliosis correction using Ansys Motion. 基于Ansys Motion的脊柱侧凸校正计算机混合模型的开发。

IF 2.3 4区医学

Computer Assisted Surgery Pub Date : 2026-12-01 Epub Date: 2026-05-06 DOI: 10.1080/24699322.2026.2666465

Damiano Simeoni, Matteo Traversani, Alberto Ruffilli, Marco Viceconti, Cristina Curreli

{"title":"Development of an in silico hybrid model for scoliosis correction using Ansys Motion.","authors":"Damiano Simeoni, Matteo Traversani, Alberto Ruffilli, Marco Viceconti, Cristina Curreli","doi":"10.1080/24699322.2026.2666465","DOIUrl":"10.1080/24699322.2026.2666465","url":null,"abstract":"Surgical techniques for correcting scoliotic deformities are continuously evolving, and computer modeling has become a valuable tool to support surgeons in testing and optimizing spinal instrumentation and corrective strategies. This study introduces a novel hybrid model capable of simultaneously computing rigid-body dynamics during surgical correction and estimating mechanical stresses within deformable structures. The model was developed using Ansys Motion, an integrated simulation environment that enables coupled multibody dynamics and finite element analyses to simulate complex interactions between rigid and flexible bodies. As a case study, spinal correction maneuvers were simulated on a simplified scoliotic spine model with vertebral bodies derived from publicly available CT scan data of a female subject. Simplified surgical instrumentation, representing commercially available systems, was applied to the T2-L1 segment and included a concave rod contoured to the desired sagittal profile. Different implant density patterns and corrective maneuver sequences were also investigated. The simulations of rod rotation followed by translation showed a deformity correction of approximately 39%. This correction was less pronounced when the number of instrumented vertebrae was limited to six or three, where a decrease in the estimated maximum pullout forces at the screw-vertebra interface was also observed. The reduction in forces transmitted by the screws during correction led to a decrease in the mechanical stress experienced by the intervertebral disks, as transmitted through the vertebral bodies. This effect may vary slightly depending on how the corrective maneuvers are performed. The preliminary results are promising and highlight the potential of this simulation tool for modeling the mechanical behavior of spinal deformities.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"31 1","pages":"2666465"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0