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A convenient and stable vertebrae instance segmentation method for transforaminal endoscopic surgery planning.

Wuke Peng¹, Liang Li¹, Libin Liang¹

¹Department of Biomedical Engineering, School of Medicine, Tsinghua University, Room C249, Beijing, 100084, People's Republic of China.

International Journal of Computer Assisted Radiology and Surgery

|June 12, 2021

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This summary is machine-generated.

A new method accurately segments lumbar vertebrae and intervertebral foramina (IVF) from CT scans, crucial for planning transforaminal endoscopic surgery (TES). This segmentation ensures safety and meets requirements for minimally invasive spinal procedures.

Area of Science:

Medical Imaging
Spinal Surgery
Computational Anatomy

Background:

Transforaminal endoscopic surgery (TES) offers effective treatment for intervertebral disc diseases.
Accurate preoperative planning, including patient-specific vertebral segmentation, is vital for safe surgical access and avoiding critical structure injury.
Developing a reliable method for lumbar vertebrae segmentation is essential for optimizing TES planning.

Purpose of the Study:

To develop a convenient, stable, and feasible method for segmenting lumbar vertebrae and related structures for TES planning.
To create an automated or semi-automated segmentation technique that enhances the precision of preoperative surgical planning.

Main Methods:

An interactive dual-output vertebrae instance segmentation network was designed, leveraging the chain structure of the spine.

Keywords:

Dual-output network Interactive positioning Transforaminal endoscopic surgery Vertebral segmentation

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An initialization locator module provided initial bounding boxes for segmentation.

The network iteratively segmented adjacent vertebrae within the locating boxes until all target vertebrae were identified.

Main Results:

On a public dataset, the method achieved a Dice coefficient of 96.8% ± 1.2% for vertebral segmentation and 96.1% ± 1.5% for the intervertebral foramen (IVF) region.
Average surface distance (ASD) was 0.25 mm ± 0.10 mm for vertebrae and 0.29 mm ± 0.10 mm for the IVF region.
Over 90% of segmentations on a private dataset were suitable for TES planning, with IVF region Dice coefficient of 94.4% ± 1.8%.

Conclusions:

The developed method offers a convenient, stable, and feasible approach for segmenting lumbar vertebrae, IVF, and IVF-forming regions.
The segmentation accuracy meets the requirements for transforaminal endoscopic surgery planning.
This technique contributes to safer and more precise surgical interventions in spinal disc-related diseases.