Barbara Carl1, Miriam Bopp2,3, Benjamin Saß2, Benjamin Voellger2, Christopher Nimsky2,3. 1. Department of Neurosurgery, University Marburg, Baldingerstrasse, 35033, Marburg, Germany. carlb@med.uni-marburg.de. 2. Department of Neurosurgery, University Marburg, Baldingerstrasse, 35033, Marburg, Germany. 3. Marburg Center for Mind, Brain and Behavior (MCMBB), Marburg, Germany.
Abstract
PURPOSE: To implement a straightforward workflow that allows to establish augmented reality (AR) support in spine surgery. METHODS: Intraoperative computed tomography (iCT) applying a 32-slice movable scanner was used for navigation registration in a series of 10 patients who underwent surgery for extra- or intradural spinal lesions. Preoperative multimodal image data were integrated by nonlinear registration with the iCT images. Automatic segmentation was used to delineate the 3-dimensional (3-D) outline of the vertebra, and in addition, the tumor extent, as well as implants, was segmented and visualized. RESULTS: Automatic patient registration without user interaction resulted in high navigation accuracy with a mean registration error of only about 1 mm. Moreover, the workflow for establishing AR was straightforward and could be easily integrated in the normal surgical procedure. Low-dose iCT protocols resulted in a radiation exposure of 0.35-0.98 mSv for cervical, 2.16-6.92 mSv for thoracic, and 3.55-4.20 mSv for lumbar surgeries, which is a reduction in the effective radiation dose by 70%. The segmented structures were intuitively visualized in the surgical field using the heads-up display of the operating microscope. In parallel, the microscope video was superimposed with the segmented 3-D structures, which were visualized in a semitransparent manner along with various display modes of the image data. CONCLUSIONS: A microscope-based AR environment was successfully implemented for spinal surgery. The application of iCT for registration imaging ensures high navigational accuracy. AR greatly supports the surgeon in understanding the 3-D anatomy thereby facilitating surgery. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: To implement a straightforward workflow that allows to establish augmented reality (AR) support in spine surgery. METHODS: Intraoperative computed tomography (iCT) applying a 32-slice movable scanner was used for navigation registration in a series of 10 patients who underwent surgery for extra- or intradural spinal lesions. Preoperative multimodal image data were integrated by nonlinear registration with the iCT images. Automatic segmentation was used to delineate the 3-dimensional (3-D) outline of the vertebra, and in addition, the tumor extent, as well as implants, was segmented and visualized. RESULTS: Automatic patient registration without user interaction resulted in high navigation accuracy with a mean registration error of only about 1 mm. Moreover, the workflow for establishing AR was straightforward and could be easily integrated in the normal surgical procedure. Low-dose iCT protocols resulted in a radiation exposure of 0.35-0.98 mSv for cervical, 2.16-6.92 mSv for thoracic, and 3.55-4.20 mSv for lumbar surgeries, which is a reduction in the effective radiation dose by 70%. The segmented structures were intuitively visualized in the surgical field using the heads-up display of the operating microscope. In parallel, the microscope video was superimposed with the segmented 3-D structures, which were visualized in a semitransparent manner along with various display modes of the image data. CONCLUSIONS: A microscope-based AR environment was successfully implemented for spinal surgery. The application of iCT for registration imaging ensures high navigational accuracy. AR greatly supports the surgeon in understanding the 3-D anatomy thereby facilitating surgery. These slides can be retrieved under Electronic Supplementary Material.
Authors: Simrin Nagpal; Purang Abolmaesumi; Abtin Rasoulian; Ilker Hacihaliloglu; Tamas Ungi; Jill Osborn; Victoria A Lessoway; John Rudan; Melanie Jaeger; Robert N Rohling; Dan P Borschneck; Parvin Mousavi Journal: Int J Comput Assist Radiol Surg Date: 2015-07-15 Impact factor: 2.924
Authors: Andrew Hersh; Smruti Mahapatra; Carly Weber-Levine; Tolulope Awosika; John N Theodore; Hesham M Zakaria; Ann Liu; Timothy F Witham; Nicholas Theodore Journal: HSS J Date: 2021-07-14
Authors: Fabian Sommer; Ibrahim Hussain; Sertac Kirnaz; Jacob L Goldberg; Rodrigo Navarro-Ramirez; Lynn B McGrath; Franziska A Schmidt; Branden Medary; Pravesh Shankar Gadjradj; Roger Härtl Journal: Neurospine Date: 2022-09-30
Authors: Joon Ha; Priya Parekh; David Gamble; James Masters; Peter Jun; Thomas Hester; Timothy Daniels; Mansur Halai Journal: J Clin Orthop Trauma Date: 2021-05-05