Validation of single dynamic 3D structured light in precise pedicle puncture navigation

BACKGROUND: Spinal surgery navigation is a current research hotspot, with no reports on dynamic structured light navigation. This study explores a single 3D structured light system, utilizing one structured light camera to continuously emit light during surgery for dynamic guidance in pedicle screw placement.To investigate the methodology and principles governing minimally invasive puncture navigation utilizing single dynamic three-dimensional (3D) structured light, and evaluate its feasibility and accuracy. METHODS: Nineteen bovine lumbar spine bone experimental models were used. Performing percutaneous minimally invasive pedicle screw placement. Preoperative computed tomography (CT) scans were performed, 3D reconstructions were generated, and a screw pathway was designed. Intraoperative registration was then conducted, and the navigation channel was adjusted to align with the planned screw pathway. Kirschner wires were inserted, and their positions were graded using the Gertzbein–Robbins (G–R) scale. The alignment of the CT images and actual morphology was assessed. The entry and exit point 3D coordinates were collected before and after surgery to calculate offset values and angles. RESULTS: A total of 218 Kirschner wires were inserted, all achieving a grade of level A on the G–R scale, for a puncture accuracy of 100%. The intraoperative root mean squared was 0.442 ± 0.091 mm, and the point cloud-to-surface distance was 0.01 ± 0.007 mm. The preoperative and postoperative entry point offset was 1.044 ± 0.35 mm, respectively, and 1.439 ± 0.524 mm at the exit point. The screw path deviation was 1.12 ± 0.576º. A high correlation was observed in the distribution of entry and exit points both preoperatively and postoperatively. Trajectory deviations primarily occurred during wire insertion. CONCLUSION: The single 3D structured light system enabled simultaneous real-time intraoperative scene scanning, static registration, and dynamic instrument tracking, facilitating high-precision navigation for minimally invasive puncture procedures.