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Proceedings Paper

Visualization of custom drill bit tips in a human vertebra for photoacoustic-guided spinal fusion surgeries
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Paper Abstract

Spinal fusion surgeries require the insertion of screws into the pedicles of vertebrae in order to connect multiple vertebrae with a metal rod and stabilize the spine after an injury or deformity. One outstanding challenge to this surgical procedure is to ensure that a drill tip maintains the correct trajectory when drilling pilot holes for screw insertion. In this work, we demonstrate a photoacoustic imaging system for drill tip tracking that will co-register photoacoustic images with pre-operative CT images. Our approach was tested with custom drill bits containing an optical fiber inside a hollow core with single-hole and multi-hole tips that were inserted in an ex vivo human vertebra. A 32 mm-deep hole was drilled in the pedicle, with the first 13 mm corresponding to the pedicle and the remaining 19 mm extending into the vertebral body. Data was acquired using a 760 nm laser with energies of 1.0 mJ, 2.2 mJ, and 3.4 mJ at the fiber tip. For the single-hole drill tip, the signal was detectable at 0-6 mm depths into the pedicle (SNR: 53.7), which represents 46% of the 13 mm pedicle length. From 6 to 14 mm, the photoacoustic signal was either no longer visualized (SNR: 26.7) or shifted from its expected location in the image due to reflection artifacts. SNR was improved to 31.14 with coherence-based beamforming methods when compared to previously reported conventional delay-and-sum beamformming methods. This enhancement provided clear visualization of low energy photoacoustic signals. Results are generally promising for photoacoustic-guided drilling during pedicle screw insertion.

Paper Details

Date Published: 27 February 2019
PDF: 7 pages
Proc. SPIE 10878, Photons Plus Ultrasound: Imaging and Sensing 2019, 108785M (27 February 2019); doi: 10.1117/12.2510688
Show Author Affiliations
Eduardo Gonzalez, Johns Hopkins Univ. (United States)
Alycen Wiacek, Johns Hopkins Univ. (United States)
Muyinatu A. Lediju Bell, Johns Hopkins Univ. (United States)

Published in SPIE Proceedings Vol. 10878:
Photons Plus Ultrasound: Imaging and Sensing 2019
Alexander A. Oraevsky; Lihong V. Wang, Editor(s)

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