Medical image-based design of an individualized surgical guide for pedicle screw insertion

Brussel, Karel Van; Sloten, J. Vander; Audekercke, Remy Van; Swaelens, B; Richard, F.; Assaker, R.; Kulik, JF

doi:10.1109/iembs.1996.656927

Cited by 14 publications

(10 citation statements)

References 3 publications

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“…The first report of RP-PSGs being used in orthopaedic surgery dates from 1997: a pedicle screw placement in the lumbar spine. 3 Since then, different authors presented cadaver and clinical studies for screws insertions in the thoracic, 51,53,57 cervical, 9,44,46,55,58,59 and lumbar spine. 3,10,11,38,56 Good screws insertion accuracy, shorter intervention time and cost savings are the main advantages reported by authors.…”

Section: Discussionmentioning

confidence: 99%

“…The use of RP processes to manufacture patient-specific surgical guides (RP-PSGs) specially designed for a specific patient can be traced back in 1997, when Van Brussel et al 3 reported the design, manufacture and use of the first individualised template for drilling trajectories when inserting pedicle screws into the vertebra of a human spine. In 1998, Radermacher et al 4 employed the stereolithography (SL) process to obtain the physical prototype of a PSG for pelvic osteotomies.…”

Section: Introductionmentioning

confidence: 99%

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Rapid prototyping for patient-specific surgical orthopaedics guides: A systematic literature review

Popescu

Lăptoiu

2016

Proc Inst Mech Eng H

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There has been a lot of hype surrounding the advantages to be gained from rapid prototyping processes in a number of fields, including medicine. Our literature review aims objectively to assess how effective patient-specific surgical guides manufactured using rapid prototyping are in a number of orthopaedic surgical applications. To this end, we carried out a systematic review to identify and analyse clinical and experimental literature studies in which rapid prototyping patient-specific surgical guides are used, focusing especially on those that entail quantifiable outcomes and, at the same time, providing details on the guides' design and type of manufacturing process. Here, it should be mentioned that in this field there are not yet medium- or long-term data, and no information on revisions. In the reviewed studies, the reported positive opinions on the use of rapid prototyping patient-specific surgical guides relate to the following main advantages: reduction in operating times, low costs and improvements in the accuracy of surgical interventions thanks to guides' personalisation. However, disadvantages and sources of errors which can cause patient-specific surgical guide failures are as well discussed by authors. Stereolithography is the main rapid prototyping process employed in these applications although fused deposition modelling or selective laser sintering processes can also satisfy the requirements of these applications in terms of material properties, manufacturing accuracy and construction time. Another of our findings was that individualised drill guides for spinal surgery are currently the favourite candidates for manufacture using rapid prototyping. Other emerging applications relate to complex orthopaedic surgery of the extremities: the forearm and foot. Several procedures such as osteotomies for radius malunions or tarsal coalition could become standard, thanks to the significant assistance provided by rapid prototyping patient-specific surgical guides in planning and performing such operations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rapid prototyping for patient-specific surgical orthopaedics guides: A systematic literature review

Popescu

Lăptoiu

2016

Proc Inst Mech Eng H

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“…The same holds true for individual templates, which are designed to fit very well on the corresponding part of the skeleton so that the surgeon can accurately perform the planned action (e.g., sawing the top of the tibia). 17,22 Moreover, a new template has to be designed for every new application; the robot is general purpose and only the surgical plan entered into the workstation changes. On the other hand, robot systems using a mill can not only make bone cuts at the correct location but also improve the surface flatness; a flat surface is very important in operations like total knee replacement.…”

Section: Discussionmentioning

confidence: 99%

Machining and accuracy studies for a tibial knee implant using a force-controlled robot

Van Ham,

Denis,

Vander Sloten

et al. 1998

Comput. Aided Surg.

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Total knee arthroplasty requires accurate preparation of the bone surfaces to maximize bone implant contact area in cementless surgery and to obtain proper joint kinematics and ligament balancing. Robots can make the cuts with the necessary high precision. The purpose of this article is threefold: to propose an alternative method for intraoperative registration using an intramedullary rod and an alternative method for force control using the hybrid force-velocity control scheme; to demonstrate that the accuracy and the surface flatness of the cuts machined by a robot are better than in a conventional operation; and to monitor the machining process and to try to derive some information about the local bone quality from it. The results of the laboratory study are promising: the surface flatness of the tibial plateau, calculated using a least squares method, is 0.1-0.2 mm, which is significantly better than in conventional surgery; and the high angular accuracy of the robot allows the bone cuts to be located precisely. Further, an exponential relation between milling forces and local bone density was established, so measurements of the milling forces can provide the surgeon with on-line information about the local bone quality.

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“…The first method concerns the part of the guide that interfaces with the bone surface. Van Brussel et al were the first to design patient‐specific spine surgical templates. These were later differentiated by Berry et al for cervical, thoracic, and lumbar levels.…”

Section: Introductionmentioning

confidence: 99%

Novel design for a customized, 3D‐printed surgical template for thoracic spinal arthrodesis

Naddeo

Fontana

Naddeo

et al. 2019

Robotics Computer Surgery

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Background The integration of computer‐aided design/computer‐aided manufacturing (CAD/CAM) tools and medicine is rapidly developing for designing medical devices. A novel design for a 3D‐printed patient‐specific surgical template for thoracic pedicle screw insertion, using a procedure based on reverse engineering, is presented. Methods The surgeon chooses the entry point on the vertebra. The optimal insertion direction and the size of the screws are defined via an algorithm on the basis of a patient‐specific vertebra CAD model. The template features an innovative shape for a comfortable and univocal placement and a novel disengaging device. Results Three spinal fusions were performed to test the template. Excellent results were achieved in terms of the accuracy of the screw positioning, reduction in surgery duration, and number of X‐rays. Conclusions A novel design for a customized, 3D‐printed surgical template for thoracic spinal arthrodesis was presented, and improvements in terms of precision, duration, and safety were achieved without changing the standard procedure.

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Medical image-based design of an individualized surgical guide for pedicle screw insertion

Cited by 14 publications

References 3 publications

Rapid prototyping for patient-specific surgical orthopaedics guides: A systematic literature review

Rapid prototyping for patient-specific surgical orthopaedics guides: A systematic literature review

Machining and accuracy studies for a tibial knee implant using a force-controlled robot

Novel design for a customized, 3D‐printed surgical template for thoracic spinal arthrodesis

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