Intraoperative Error Propagation in 3-Dimensional Spinal Navigation From Nonsegmental Registration: A Prospective Cadaveric and Clinical Study Article Swipe
Daipayan Guha
,
Raphael Jakubovic
,
Shaurya Gupta
,
Michael G. Fehlings
,
Todd G. Mainprize
,
Albert Yee
,
Victor X. D. Yang
·
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.1177/2192568218804556
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.1177/2192568218804556
Study Design: Prospective pre-clinical and clinical cohort study. Objectives: Current spinal navigation systems rely on a dynamic reference frame (DRF) for image-to-patient registration and tool tracking. Working distant to a DRF may generate inaccuracy. Here we quantitate predictors of navigation error as a function of distance from the registered vertebral level, and from intersegmental mobility due to surgical manipulation and patient respiration. Methods: Navigation errors from working distant to the registered level, and from surgical manipulation, were quantified in 4 human cadavers. The 3-dimensional (3D) position of a tracked tool tip at 0 to 5 levels from the DRF, and during targeting of pedicle screw tracts, was captured in real-time by an optical navigation system. Respiration-induced vertebral motion was quantified from 10 clinical cases of open posterior instrumentation. The 3D position of a custom spinous-process clamp was tracked over 12 respiratory cycles. Results: An increase in mean 3D navigation error of ≥2 mm was observed at ≥2 levels from the DRF in the cervical and lumbar spine. Mean ± SD displacement due to surgical manipulation was 1.55 ± 1.13 mm in 3D across all levels, ≥2 mm in 17.4%, 19.2%, and 38.5% of levels in the cervical, thoracic, and lumbar spine, respectively. Mean ± SD respiration-induced 3D motion was 1.96 ± 1.32 mm, greatest in the lower thoracic spine ( P < .001). Tidal volume and positive end-expiratory pressure correlated positively with increased vertebral displacement. Conclusions: Vertebral motion is unaccounted for during image-guided surgery when performed at levels distant from the DRF. Navigating instrumentation within 2 levels of the DRF likely minimizes the risk of navigation error.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1177/2192568218804556
- https://journals.sagepub.com/doi/pdf/10.1177/2192568218804556
- OA Status
- gold
- Cited By
- 31
- References
- 24
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2896097762
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W2896097762Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1177/2192568218804556Digital Object Identifier
- Title
-
Intraoperative Error Propagation in 3-Dimensional Spinal Navigation From Nonsegmental Registration: A Prospective Cadaveric and Clinical StudyWork title
- Type
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articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2018Year of publication
- Publication date
-
2018-10-09Full publication date if available
- Authors
-
Daipayan Guha, Raphael Jakubovic, Shaurya Gupta, Michael G. Fehlings, Todd G. Mainprize, Albert Yee, Victor X. D. YangList of authors in order
- Landing page
-
https://doi.org/10.1177/2192568218804556Publisher landing page
- PDF URL
-
https://journals.sagepub.com/doi/pdf/10.1177/2192568218804556Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://journals.sagepub.com/doi/pdf/10.1177/2192568218804556Direct OA link when available
- Concepts
-
Medicine, Cadaveric spasm, Lumbar, Cadaver, Prospective cohort study, Surgery, Nuclear medicineTop concepts (fields/topics) attached by OpenAlex
- Cited by
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31Total citation count in OpenAlex
- Citations by year (recent)
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2025: 2, 2024: 3, 2023: 5, 2022: 11, 2021: 4Per-year citation counts (last 5 years)
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24Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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