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Accuracy of computer-assisted drilling of equine cervical vertebral bodies using a purpose-built cervical frame-An
Thimo Maurer1, Mathieu de Preux1, Christina Precht2
1Division of Equine Surgery, Swiss Institute of Equine Medicine (ISME), Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.
Objective:
To assess the accuracy of computer-assisted surgery (CAS) of equine cervical vertebrae using a purpose-built cervical frame (CF) for neck stabilization.
Study Design:
Experimental cadaveric study.
Sample Population:
Six whole fresh equine cadavers.
Methods:
Cadavers were positioned in dorsal recumbency with the neck extended within the CF. A cone-beam computed tomography (CBCT)-based surgical navigation system with optical tracking was used. A ventral approach exposed cervical vertebrae C3-C5. In each cadaver, 12 drill corridors were prepared with the patient tracker on the CF (position CF), followed by 12 corridors with the patient tracker on C3 (position C3). Surgical accuracy aberration (SAA) was assessed by measuring Euclidean distances between planned and executed entry and target points on merged pre- and postoperative datasets. Descriptive statistics and repeated-measures analyses of variance (rep.-meas. ANOVA) compared SAA measurements between groups.
Results:
The mean ± SD SAA (Euclidean distance) was 2.00 ± 0.98 mm in patient tracker position CF, and 2.41 ± 1.31 mm in position C3 (rep.-meas. ANOVA p = .215). At the most dorsal point of the drill corridor, dorsoventral deviations >2 mm occurred in 5/72 measurements in patient tracker position CF, and in 12/72 measurements in position C3.
Conclusion:
The CF allowed for unrestricted pre- and intraoperative CBCT imaging and computer-assisted drilling with a SAA in the close range of 2 mm. Positioning the patient tracker on the CF, outside the surgical field, did not compromise surgical accuracy.
Clinical Significance:
A CF can facilitate CAS for surgeries with a ventral approach to the equine cervical vertebral column.
