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Automatic registration with continuous pose updates for marker-less surgical navigation in spine surgery.

作者信息

Liebmann Florentin, von Atzigen Marco, Stütz Dominik, Wolf Julian, Zingg Lukas, Suter Daniel, Cavalcanti Nicola A, Leoty Laura, Esfandiari Hooman, Snedeker Jess G, Oswald Martin R, Pollefeys Marc, Farshad Mazda, Fürnstahl Philipp

机构信息

Research in Orthopedic Computer Science, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; Laboratory for Orthopaedic Biomechanics, ETH Zurich, Zurich, Switzerland.

Research in Orthopedic Computer Science, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; Laboratory for Orthopaedic Biomechanics, ETH Zurich, Zurich, Switzerland.

出版信息

Med Image Anal. 2024 Jan;91:103027. doi: 10.1016/j.media.2023.103027. Epub 2023 Nov 10.


DOI:10.1016/j.media.2023.103027
PMID:37992494
Abstract

Established surgical navigation systems for pedicle screw placement have been proven to be accurate, but still reveal limitations in registration or surgical guidance. Registration of preoperative data to the intraoperative anatomy remains a time-consuming, error-prone task that includes exposure to harmful radiation. Surgical guidance through conventional displays has well-known drawbacks, as information cannot be presented in-situ and from the surgeon's perspective. Consequently, radiation-free and more automatic registration methods with subsequent surgeon-centric navigation feedback are desirable. In this work, we present a marker-less approach that automatically solves the registration problem for lumbar spinal fusion surgery in a radiation-free manner. A deep neural network was trained to segment the lumbar spine and simultaneously predict its orientation, yielding an initial pose for preoperative models, which then is refined for each vertebra individually and updated in real-time with GPU acceleration while handling surgeon occlusions. An intuitive surgical guidance is provided thanks to the integration into an augmented reality based navigation system. The registration method was verified on a public dataset with a median of 100% successful registrations, a median target registration error of 2.7 mm, a median screw trajectory error of 1.6°and a median screw entry point error of 2.3 mm. Additionally, the whole pipeline was validated in an ex-vivo surgery, yielding a 100% screw accuracy and a median target registration error of 1.0 mm. Our results meet clinical demands and emphasize the potential of RGB-D data for fully automatic registration approaches in combination with augmented reality guidance.

摘要

相似文献

[1]
Automatic registration with continuous pose updates for marker-less surgical navigation in spine surgery.

Med Image Anal. 2024-1

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
Augmented Reality Spine Surgery Navigation: Increasing Pedicle Screw Insertion Accuracy for Both Open and Minimally Invasive Spine Surgeries.

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[10]
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引用本文的文献

[1]
Artificial Intelligence in Planning for Spine Surgery.

Curr Rev Musculoskelet Med. 2025-8-26

[2]
SurgPointTransformer: transformer-based vertebra shape completion using RGB-D imaging.

Comput Assist Surg (Abingdon). 2025-12

[3]
Benchmarking commercial depth sensors for intraoperative markerless registration in neurosurgery applications.

Int J Comput Assist Radiol Surg. 2025-5-23

[4]
Is Overlain Display a Right Choice for AR Navigation? A Qualitative Study of Head-Mounted Augmented Reality Surgical Navigation on Accuracy for Large-Scale Clinical Deployment.

CNS Neurosci Ther. 2025-1

[5]
Augmenting Reality in Spinal Surgery: A Narrative Review of Augmented Reality Applications in Pedicle Screw Instrumentation.

Medicina (Kaunas). 2024-9-12

[6]
Design, fabrication, and evaluation of single- and multi-level 3D-printed non-covering cervical spinal fusion surgery templates.

Front Bioeng Biotechnol. 2024-7-12

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