INTRODUCTION: Advanced virtual simulators can be used to accurately detect the best allograft according to size and shape. STEP 1 ACQUISITION OF MEDICAL IMAGES: Obtain a multislice CT scan and a magnetic resonance imaging (MRI) scan preoperatively for each patient; however, if the time between the scans and the surgery is >1 month, consider repeating the MRI because the size of the tumor may have changed during that time. Load DICOM images into a virtual simulation station (Windows 7 Service Pack 1, 64 bit, Intel Core i5/i7 or equivalent) and use mediCAS planning software ( medicas3d.com ) or equivalent (Materialise Mimics or Amira software [FEI]) for image segmentation and virtual simulation with STL (stereolithography) files. STEP 3 PLAN AND OUTLINE THE TUMOR MARGINS ON THE PREOPERATIVE IMAGING: Determine and outline the tumor margin on manually fused CT and MRI studies using the registration tool of the mediCAS planning software or equivalent (Materialise Mimics software.). STEP 4 PLAN AND OUTLINE THE SAME OSTEOTOMIES ON THE ALLOGRAFT: Determine and outline the osteotomies between host and donor using the registration tool of the mediCAS planning software or equivalent (Materialise Mimics software.). STEP 5 ASSESS THE PATIENT AND ALLOGRAFT IN A VIRTUAL SCENARIO: Be sure to consider the disintegration of bone tissue that occurs during the osteotomy and corresponds to the thickness of the blade (approximately 1.5 mm). STEP 6 NAVIGATION SETTINGS: A tool of the mediCAS planning software allows the virtual preoperative planning (STL files) to be transferred to the surgical navigation format, DICOM files. STEP 7 PATIENT AND ALLOGRAFT INTRAOPERATIVE NAVIGATION: The tumor and allograft are resected using the navigated guidelines, which were previously planned with the virtual platform. RESULTS: The 3D virtual preoperative planning and surgical navigation software are tools designed to increase the accuracy of bone tumor resection and allograft reconstruction3.
INTRODUCTION: Advanced virtual simulators can be used to accurately detect the best allograft according to size and shape. STEP 1 ACQUISITION OF MEDICAL IMAGES: Obtain a multislice CT scan and a magnetic resonance imaging (MRI) scan preoperatively for each patient; however, if the time between the scans and the surgery is >1 month, consider repeating the MRI because the size of the tumor may have changed during that time. Load DICOM images into a virtual simulation station (Windows 7 Service Pack 1, 64 bit, Intel Core i5/i7 or equivalent) and use mediCAS planning software ( medicas3d.com ) or equivalent (Materialise Mimics or Amira software [FEI]) for image segmentation and virtual simulation with STL (stereolithography) files. STEP 3 PLAN AND OUTLINE THE TUMOR MARGINS ON THE PREOPERATIVE IMAGING: Determine and outline the tumor margin on manually fused CT and MRI studies using the registration tool of the mediCAS planning software or equivalent (Materialise Mimics software.). STEP 4 PLAN AND OUTLINE THE SAME OSTEOTOMIES ON THE ALLOGRAFT: Determine and outline the osteotomies between host and donor using the registration tool of the mediCAS planning software or equivalent (Materialise Mimics software.). STEP 5 ASSESS THE PATIENT AND ALLOGRAFT IN A VIRTUAL SCENARIO: Be sure to consider the disintegration of bone tissue that occurs during the osteotomy and corresponds to the thickness of the blade (approximately 1.5 mm). STEP 6 NAVIGATION SETTINGS: A tool of the mediCAS planning software allows the virtual preoperative planning (STL files) to be transferred to the surgical navigation format, DICOM files. STEP 7 PATIENT AND ALLOGRAFT INTRAOPERATIVE NAVIGATION: The tumor and allograft are resected using the navigated guidelines, which were previously planned with the virtual platform. RESULTS: The 3D virtual preoperative planning and surgical navigation software are tools designed to increase the accuracy of bone tumor resection and allograft reconstruction3.
Authors: Lucas E Ritacco; Federico E Milano; Germán L Farfalli; Miguel A Ayerza; D Luis Muscolo; Luis A Aponte-Tinao Journal: Orthopedics Date: 2013-07 Impact factor: 1.390
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