Single dynamic structured light navigation for minimally invasive cervical pedicle screw insertion: Achieving complex...

Area of Science:

• Spinal Surgery
• Medical Navigation Systems
• Minimally Invasive Procedures

Background:

• Cervical pedicle puncture is a critical step in spinal surgery.
• Minimally invasive techniques aim to reduce surgical trauma.
• Accurate preoperative planning and intraoperative guidance are essential for successful pedicle screw placement.

Purpose of the Study:

• To explore preoperative design and intraoperative navigation for minimally invasive cervical pedicle punctures.
• To validate the feasibility and accuracy of a single dynamic structured light navigation system for this application.

Main Methods:

• Utilized nine bovine cervical spine models for CT scanning and 3D reconstruction.
• Performed preoperative segmentation and navigation channel design.
• Employed structured light scanning for intraoperative scene capture and registration.
• Inserted 2.0 mm Kirschner wires through designed channels and evaluated accuracy using the Neo classification system.

Main Results:

• Achieved 100% puncture accuracy with all 124 Kirschner wires classified as Grade 0.
• Demonstrated high consistency between postoperative trajectories and preoperative designs.
• Reported average intraoperative root mean square (RMS) of 0.424 ± 0.12 mm and registration accuracy of 0.01 ± 0.008 mm.
• Observed entry and exit point deviations of 0.904 ± 0.419 mm and 1.253 ± 0.607 mm, respectively, with an angle deviation of 0.918 ± 0.421°.

Conclusions:

• A single dynamic structured light navigation system enables simultaneous preoperative design, intraoperative scanning, registration, and instrument tracking.
• This system facilitates high-precision minimally invasive cervical pedicle punctures.
• The technology holds promise for improving accuracy and safety in spinal surgery.