Document Detail


Computer-assisted navigation in bone tumor surgery: seamless workflow model and evolution of technique.
MedLine Citation:
PMID:  20635175     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Computer-assisted navigation was recently introduced to aid the resection of musculoskeletal tumors. However, it has not always been possible to directly navigate the osteotomy with real-time manipulation of available surgical tools. Registration techniques vary, although most existing systems use some form of surface matching.
QUESTIONS/PURPOSES: We developed and evaluated a workflow model of computer-assisted bone tumor surgery and evaluated (1) the applicability of currently available software to different bones; (2) the accuracy of the navigated excision; and (3) the accuracy of a new registration technique of fluoro-CT matching.
METHODS: Our workflow involved detailed preoperative planning with CT-MRI image fusion, three-dimensional mapping of the tumor, and planning of the resection plane. Using the workflow model, we reviewed 15 navigation procedures in 12 patients, including four with joint-saving resections and three with custom implant reconstructions. Intraoperatively, registration was performed with either paired points and surface matching (Group 1, n = 10) or a new technique of fluoro-CT image matching (Group 2, n = 5). All osteotomies were performed under direct computer navigation. Postoperatively, each case was evaluated for histologic margin and gross measurement of the achieved surgical margin.
RESULTS: The margins were free from tumor in all resected specimens. In the Group 1 procedures, the correlation between preoperative planned margins and actual achieved margins was 0.631, whereas in Group 2 procedures (fluoro-CT matching), the correlation was 0.985.
CONCLUSIONS: Our findings suggest computer-assisted navigation is accurate and useful for bone tumor surgery. The new registration technique using fluoro-CT matching may allow more accurate resection of margins.
Authors:
Timothy Y C So; Ying-Lee Lam; Ka-Lok Mak
Related Documents :
8410245 - Variables affecting the accuracy of stereotactic localization using computerized tomogr...
16539295 - A comparison of computer-aided surgery registration methods for endoscopic sinus surgery.
22057405 - Transcranial sonography in pantothenate kinase-associated neurodegeneration.
15695925 - Error analysis of mri and leksell stereotactic frame target localization in deep brain ...
701515 - Evaluation of abdominal abscess with computed tomography.
9541435 - Clinical study of [123i] n-(2-diethylaminoethyl)-4-iodobenzamide in the diagnosis of pr...
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  468     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-09-30     Completed Date:  2010-10-21     Revised Date:  2011-11-01    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2985-91     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Hong Kong, 30 Gascoigne Road, Kowloon, Hong Kong, SAR, China. soyc@ha.org.hk
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bone Neoplasms / mortality,  radiography,  secondary,  surgery*
Child
China
Female
Fluoroscopy
Humans
Image Interpretation, Computer-Assisted
Magnetic Resonance Imaging
Male
Middle Aged
Osteotomy / instrumentation,  methods*
Predictive Value of Tests
Prosthesis Implantation / instrumentation,  methods*
Surgery, Computer-Assisted* / instrumentation
Time Factors
Tomography, X-Ray Computed* / instrumentation
Treatment Outcome
Workflow*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Electronic data capture for registries and clinical trials in orthopaedic surgery: open source versu...
Next Document:  Cardiovascular and psychological reactivity and recovery from harassment in a biracial sample of hig...