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直轨:迈向用于经皮克氏针插入的混合现实导航系统

StraightTrack: Towards mixed reality navigation system for percutaneous K-wire insertion.

作者信息

Zhang Han, Killeen Benjamin D, Ku Yu-Chun, Seenivasan Lalithkumar, Zhao Yuxuan, Liu Mingxu, Yang Yue, Gu Suxi, Martin-Gomez Alejandro, Osgood Greg, Unberath Mathias

机构信息

Department of Computer Science Johns Hopkins University Baltimore Maryland USA.

Department of Orthopaedic Surgery Johns Hopkins Medicine Baltimore Maryland USA.

出版信息

Healthc Technol Lett. 2024 Dec 7;11(6):355-364. doi: 10.1049/htl2.12103. eCollection 2024 Dec.


DOI:10.1049/htl2.12103
PMID:39720744
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11665788/
Abstract

In percutaneous pelvic trauma surgery, accurate placement of Kirschner wires (K-wires) is crucial to ensure effective fracture fixation and avoid complications due to breaching the cortical bone along an unsuitable trajectory. Surgical navigation via mixed reality (MR) can help achieve precise wire placement in a low-profile form factor. Current approaches in this domain are as yet unsuitable for real-world deployment because they fall short of guaranteeing accurate visual feedback due to uncontrolled bending of the wire. To ensure accurate feedback, StraightTrack, an MR navigation system designed for percutaneous wire placement in complex anatomy, is introduced. StraightTrack features a marker body equipped with a rigid access cannula that mitigates wire bending due to interactions with soft tissue and a covered bony surface. Integrated with an optical see-through head-mounted display capable of tracking the cannula body, StraightTrack offers real-time 3D visualization and guidance without external trackers, which are prone to losing line-of-sight. In phantom experiments with two experienced orthopedic surgeons, StraightTrack improves wire placement accuracy, achieving the ideal trajectory within   mm and , compared to over 12.08  mm and 4.07 for comparable methods. As MR navigation systems continue to mature, StraightTrack realizes their potential for internal fracture fixation and other percutaneous orthopedic procedures.

摘要

在经皮骨盆创伤手术中,克氏针(K 线)的准确放置对于确保有效的骨折固定以及避免因沿不合适的轨迹穿透皮质骨而引发并发症至关重要。通过混合现实(MR)进行手术导航有助于以低调的外形实现精确的克氏针放置。该领域目前的方法尚不适用于实际应用,因为由于克氏针的不受控制弯曲,它们无法保证准确的视觉反馈。为确保准确反馈,引入了 StraightTrack,这是一种专为在复杂解剖结构中经皮放置克氏针而设计的 MR 导航系统。StraightTrack 的特点是标记体配备了刚性接入套管,可减轻因与软组织和覆盖的骨表面相互作用而导致的克氏针弯曲。与能够跟踪套管主体的光学透视头戴式显示器集成在一起,StraightTrack 无需容易失去视线的外部跟踪器即可提供实时 3D 可视化和引导。在与两位经验丰富的骨科医生进行的模拟实验中,与可比方法的超过 12.08 毫米和 4.07 毫米相比,StraightTrack 提高了克氏针放置的准确性,在 毫米和 范围内实现了理想轨迹。随着 MR 导航系统不断成熟,StraightTrack 实现了它们在内部骨折固定和其他经皮骨科手术中的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/ab9595fe361a/HTL2-11-355-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/9ffa88898ac8/HTL2-11-355-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/7a3432087730/HTL2-11-355-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/790c397433f6/HTL2-11-355-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/30c23f7bb005/HTL2-11-355-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/b936ce922788/HTL2-11-355-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/93dbfa83b2fb/HTL2-11-355-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/ab9595fe361a/HTL2-11-355-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/9ffa88898ac8/HTL2-11-355-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/7a3432087730/HTL2-11-355-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/790c397433f6/HTL2-11-355-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/30c23f7bb005/HTL2-11-355-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/b936ce922788/HTL2-11-355-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/93dbfa83b2fb/HTL2-11-355-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6747/11665788/ab9595fe361a/HTL2-11-355-g002.jpg

相似文献

[1]
StraightTrack: Towards mixed reality navigation system for percutaneous K-wire insertion.

Healthc Technol Lett. 2024-12-7

[2]
A multi-view interactive virtual-physical registration method for mixed reality based surgical navigation in pelvic and acetabular fracture fixation.

Int J Comput Assist Radiol Surg. 2023-9

[3]
Minimally Invasive, Stereotactic, Wireless, Percutaneous Pedicle Screw Placement in the Lumbar Spine: Accuracy Rates With 182 Consecutive Screws.

Int J Spine Surg. 2018-12-21

[4]
Deformable 3D-2D Registration for Guiding K-Wire Placement in Pelvic Trauma Surgery.

Proc SPIE Int Soc Opt Eng. 2017-3

[5]
An autonomous X-ray image acquisition and interpretation system for assisting percutaneous pelvic fracture fixation.

Int J Comput Assist Radiol Surg. 2023-7

[6]
Electromagnetic navigation for percutaneous guide-wire insertion: accuracy and efficiency compared to conventional fluoroscopic guidance.

Neuroimage. 2009-8

[7]
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J Med Imaging (Bellingham). 2021-1

[8]
Applications of Mixed Reality Technology in Orthopedics Surgery: A Pilot Study.

Front Bioeng Biotechnol. 2022-2-22

[9]
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J Med Imaging (Bellingham). 2022-7

[10]
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Int J Comput Assist Radiol Surg. 2017-8-5

引用本文的文献

[1]
Localization of sentinel lymph nodes using augmented-reality system: a cadaveric feasibility study.

Eur J Nucl Med Mol Imaging. 2025-3-24

本文引用的文献

[1]
Wearable Mechatronic Ultrasound-integrated AR Navigation System for Lumbar Puncture Guidance.

IEEE Trans Med Robot Bionics. 2023-11

[2]
Stand in surgeon's shoes: virtual reality cross-training to enhance teamwork in surgery.

Int J Comput Assist Radiol Surg. 2024-6

[3]
Mixed reality guided root canal therapy.

Healthc Technol Lett. 2024-4-2

[4]
Toward Perception-based Anticipation of Cortical Breach During K-wire Fixation of the Pelvis.

Proc SPIE Int Soc Opt Eng. 2022

[5]
Pelphix: Surgical Phase Recognition from X-ray Images in Percutaneous Pelvic Fixation.

Med Image Comput Comput Assist Interv. 2023-10

[6]
An autonomous X-ray image acquisition and interpretation system for assisting percutaneous pelvic fracture fixation.

Int J Comput Assist Radiol Surg. 2023-7

[7]
STTAR: Surgical Tool Tracking Using Off-the-Shelf Augmented Reality Head-Mounted Displays.

IEEE Trans Vis Comput Graph. 2024-7

[8]
Is percutaneous fixation of the superior pubic ramus possible in all types of pelvis?

Ulus Travma Acil Cerrahi Derg. 2023-3

[9]
How different augmented reality visualizations for drilling affect trajectory deviation, visual attention, and user experience.

Int J Comput Assist Radiol Surg. 2023-8

[10]
The HoloLens in medicine: A systematic review and taxonomy.

Med Image Anal. 2023-4

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