Computer simulation for the optimization of patient positioning in spinal deformity instrumentation surgery

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Spinal Deformity Correction

Background:

• Scoliosis curve correction is observed during patient positioning before spinal instrumentation.
• Biomechanical factors influencing patient positioning for scoliosis correction remain understudied.

Purpose of the Study:

• To simulate patient positioning during scoliosis instrumentation surgery.
• To evaluate the impact of various trunk adjustment parameters on spinal geometry.
• To recommend optimal patient positioning strategies based on finite element analysis.

Main Methods:

• A finite element model of a scoliotic spine was developed.
• Six positioning parameters were systematically adjusted.
• Ten geometric measures of spinal alignment were recorded and analyzed statistically.

Main Results:

• All tested model parameters significantly affected at least five geometric measures.
• Optimizing individual geometric measures often led to deterioration in others.
• Simultaneous optimization of geometric measures improved overall spinal geometry correction by 75%.

Conclusions:

• Finite element simulations effectively optimize patient positioning for scoliosis surgery.
• Patient positioning is a critical surgical step for maximizing scoliosis correction.
• While significant improvements are achievable, ideal correction for all measures simultaneously remains challenging.