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Proceedings Paper

Spinal intra-operative three-dimensional navigation with infra-red tool tracking: correlation between clinical and absolute engineering accuracy
Author(s): Daipayan Guha; Raphael Jakubovic; Shaurya Gupta; Victor X. D. Yang
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Paper Abstract

Computer-assisted navigation (CAN) may guide spinal surgeries, reliably reducing screw breach rates. Definitions of screw breach, if reported, vary widely across studies. Absolute quantitative error is theoretically a more precise and generalizable metric of navigation accuracy, but has been computed variably and reported in fewer than 25% of clinical studies of CAN-guided pedicle screw accuracy. We reviewed a prospectively-collected series of 209 pedicle screws placed with CAN guidance to characterize the correlation between clinical pedicle screw accuracy, based on postoperative imaging, and absolute quantitative navigation accuracy. We found that acceptable screw accuracy was achieved for significantly fewer screws based on 2mm grade vs. Heary grade, particularly in the lumbar spine. Inter-rater agreement was good for the Heary classification and moderate for the 2mm grade, significantly greater among radiologists than surgeon raters. Mean absolute translational/angular accuracies were 1.75mm/3.13° and 1.20mm/3.64° in the axial and sagittal planes, respectively. There was no correlation between clinical and absolute navigation accuracy, in part because surgeons appear to compensate for perceived translational navigation error by adjusting screw medialization angle. Future studies of navigation accuracy should therefore report absolute translational and angular errors. Clinical screw grades based on post-operative imaging, if reported, may be more reliable if performed in multiple by radiologist raters.

Paper Details

Date Published: 8 February 2017
PDF: 7 pages
Proc. SPIE 10050, Clinical and Translational Neurophotonics, 100500I (8 February 2017); doi: 10.1117/12.2255050
Show Author Affiliations
Daipayan Guha, Univ. of Toronto (Canada)
Raphael Jakubovic, Ryerson Univ. (Canada)
Shaurya Gupta, Univ. of Toronto (Canada)
Victor X. D. Yang, Univ. of Toronto (Canada)
Ryerson Univ. (Canada)

Published in SPIE Proceedings Vol. 10050:
Clinical and Translational Neurophotonics
Steen J. Madsen; Victor X. D. Yang, Editor(s)

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