Computer Assisted Surgery最新文献

{"title":"The accuracy and the safety of individualized 3D printing screws insertion templates for cervical screw insertion","authors":"Ting Deng, Minghui Jiang, Qing Lei, Lihong Cai, Li Chen","doi":"10.1080/24699322.2016.1236146","DOIUrl":"https://doi.org/10.1080/24699322.2016.1236146","url":null,"abstract":"Abstract Study design: Clinical trial for cervical screw insertion by using individualized 3-dimensional (3D) printing screw insertion templates device. Objective: The objective of this study is to evaluate the safety and accuracy of the individualized 3D printing screw insertion template in the cervical spine. Materials and methods: Ten patients who underwent posterior cervical fusion surgery with cervical pedicle screws, laminar screws or lateral mass screws between December 2014 and December 2015 were involved in this study. The patients were examined by CT scan before operation. The individualized 3D printing templates were made with photosensitive resin by a 3D printing system to ensure the screw shafts entered the vertebral body without breaking the pedicle or lamina cortex. The templates were sterilized by a plasma sterilizer and used during the operation. The accuracy and the safety of the templates were evaluated by CT scans at the screw insertion levels after operation. Results: The accuracy of this patient-specific template technique was demonstrated. Only one screw axis greatly deviated from the planned track and breached the cortex of the pedicle because the template was split by rough handling and then we inserted the screws under the fluoroscopy. The remaining screws were inserted in the track as preoperative design and the screw axis deviated by less than 2 mm. Vascular or neurologic complications or injuries did not happen. And no infection, broken nails, fracture of bone structure, or screw pullout occurred. Conclusion: This study verified the safety and the accuracy of the individualized 3D printing screw insertion templates in the cervical spine as a kind of intraoperative screw navigation. This individualized 3D printing screw insertion template was user-friendly, moderate cost, and enabled a radiation-free cervical screw insertion.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"21 1","pages":"143 - 149"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1236146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60126281","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}

{"title":"Tracking multiple surgical instruments in a near-infrared optical system","authors":"Ken Cai, Rongqian Yang, Qinyong Lin, Zhigang Wang","doi":"10.1080/24699322.2016.1184312","DOIUrl":"https://doi.org/10.1080/24699322.2016.1184312","url":null,"abstract":"Abstract Surgical navigation systems can assist doctors in performing more precise and more efficient surgical procedures to avoid various accidents. The near-infrared optical system (NOS) is an important component of surgical navigation systems. However, several surgical instruments are used during surgery, and effectively tracking all of them is challenging. A stereo matching algorithm using two intersecting lines and surgical instrument codes is proposed in this paper. In our NOS, the markers on the surgical instruments can be captured by two near-infrared cameras. After automatically searching and extracting their subpixel coordinates in the left and right images, the coordinates of the real and pseudo markers are determined by the two intersecting lines. Finally, the pseudo markers are removed to achieve accurate stereo matching by summing the codes for the distances between a specific marker with the other two markers on the surgical instrument. Experimental results show that the markers on the different surgical instruments can be automatically and accurately recognized. The NOS can accurately track multiple surgical instruments.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"21 1","pages":"46 - 55"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1184312","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60125752","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}

{"title":"10-Year patient satisfaction compared between computer-assisted navigation and conventional techniques in minimally invasive surgery total knee arthroplasty","authors":"S. Khuangsirikul, Kreangsak Lekkreusuwan, T. Chotanaphuti","doi":"10.1080/24699322.2016.1249959","DOIUrl":"https://doi.org/10.1080/24699322.2016.1249959","url":null,"abstract":"Abstract Background: Both minimally invasive surgery (MIS) and computer-assisted surgery (CAS) in total knee arthroplasty have been scientifically linked with surgical benefits. However, the long-term results of these techniques are still controversial. Most surgeons assessed the surgical outcomes with regard to knee alignment and range of motion, but these factors may not reflect subjective variables, namely patient satisfaction. Purpose: To compare satisfaction and functional outcomes between two technical procedures in MIS total knee arthroplasty, namely computer-assisted MIS and conventional MIS procedure, operated on a sample group of patients after 10 years. Methods: Seventy cases of posterior-stabilized total knee prostheses were implanted using a computer-assisted system and were compared to 74 cases of matched total knee prostheses of the same implant using conventional technique. Both groups underwent arthrotomy by 2 cm limited quadriceps exposure minimally invasive surgery (2 cm Quad MIS). At an average of 10 years after surgery, self-administered patient satisfaction and WOMAC scales were administered and analyzed. Results: Demographic data of both groups including sex, age, preoperative WOMAC and post-operative duration were not statistically different. Post-operative WOMAC for the computer-assisted group was 38.94 ± 5.68, while the conventional one stood at 37.89 ± 6.22. The median of self-administered patient satisfaction scales of the computer-assisted group was 100 (min37.5–max100), while the conventional one was 100 (min25–max100). p Value was 0.889. There was one re-operative case in the conventional MIS group due to peri-prosthetic infection which was treated with debridement, polyethylene exchanged and intravenous antibiotics. Conclusions: The 10-year outcomes of computer-assisted MIS total knee arthroplasty are not superior to that of the conventional MIS technique in function and patient satisfaction. 10 years may not be enough to show the difference between these two techniques.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"21 1","pages":"172 - 175"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1249959","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60126123","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}

{"title":"Biomechanical comparison of fixation systems in posterior wall fracture of acetabular by finite element analysis","authors":"Jianyin Lei, Hai-bo Liu, Zhiqiang Li, Zhihua Wang, Ximing Liu, Longmao Zhao","doi":"10.1080/24699322.2016.1218052","DOIUrl":"https://doi.org/10.1080/24699322.2016.1218052","url":null,"abstract":"Abstract Background: The use of reconstruction plates and lag screws has been recommended for fractures to the posterior wall of the acetabulum. However, little information about the rigidity of recommended forms of fracture fixation is available. This study aimed to evaluate the biomechanical difference among the fixation systems. Methods: A posterior wall fracture, which is represented by softer elements with lower elastic modulus, was created along an arc of 40–90° about the acetabular rim. Three different fixation systems: screws alone, reconstruction plate with screws, reconstruction plate with T-shaped plates were used to fix the posterior wall fractures to the acetabulum. Results: All three fixation system can be used to obtain good functional outcomes. The reconstruction plate with T-shaped plates was beneficial to increasing the effective stiffness, decreasing the stress concentration and enhancing the rigidity of fracture fixation. So this fixation system served an ideal result in the analysis. Conclusion: Theoretically, the reconstruction plate with T-shaped plates system may reduce many of the risks and limitations compared to the other fixation systems. This fixation system may result in a clinical benefit.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"21 1","pages":"117 - 126"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1218052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60126202","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}

{"title":"Accuracy of estimating Unicondylar Knee Replacement implant varus/valgus angles from antero-posterior radiographs","authors":"R. Khare, B. Jaramaz","doi":"10.1080/24699322.2016.1199736","DOIUrl":"https://doi.org/10.1080/24699322.2016.1199736","url":null,"abstract":"Abstract Unicondylar Knee Replacement (UKR) is an orthopedic surgical procedure to reduce pain and improve function in the knee. Load-bearing long-standing antero-posterior (AP) radiographs are typically used postoperatively to measure the leg alignment and assess the varus/valgus implant orientation. However, implant out-of-plane rotations, user variability, and X-ray acquisition parameters introduce errors in the estimation of the implant varus/valgus estimation. Previous work has explored the accuracy of various imaging modalities in this estimation. In this work, we explored the impact of out-of-plane rotations and X-ray acquisition parameters on the estimation of implant component varus/valgus angles. For our study, we used a single CT scan and positioned femoral and tibial implants under varying orientations within the CT volume. Then, a custom software application was used to obtain digitally reconstructed radiographs from the CT scan with implants under varying orientations. Two users were then asked to manually estimate the varus/valgus angles for the implants. We found that there was significant inter-user variability (p < 0.05) in the varus/valgus estimates for the two users. However, the ‘ideal’ measurements, obtained using actual implant orientations, showed small errors due to variations in implant orientation. We also found that variation in the projection center does not have a statistically significant impact (p < 0.01) on the estimation of implant varus/valgus angles. We conclude that manual estimates of UKR implant varus/valgus orientations are unreliable.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"12 1","pages":"80 - 84"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1199736","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60126072","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}