Patient-Specific 3D Virtual Surgical Planning Using Simulated Fluoroscopic Images to Improve Sacroiliac Joint Fusion

Abstract

Sacroiliac (SI) joint dysfunction can lead to debilitating pain but can be treated with minimally invasive sacroiliac joint fusion (SIJF). This treatment is commonly performed using 2D fluoroscopic guidance. This makes placing the implants without damaging surrounding neural structures challenging. Virtual surgical planning (VSP) using simulated fluoroscopic images may improve intraoperative guidance. This article describes a workflow with VSP in SIJF using simulated fluoroscopic images and evaluates achieved implant placement accuracy. Ten interventions were performed on 10 patients by the same surgeon, resulting in a total of 30 implants; the median age was 39 years, and all patients were female. The overall mean implant placement accuracy was 4.9 ± 1.26 mm and 4.0 ± 1.44°. There were no malpositioning complications. VSP helped the surgeon understand the anatomy and determine the optimal position and length of the implants. The planned positions of the implants could be reproduced in surgery with what appears to be a clinically acceptable level of accuracy.

Impact of 3D imaging techniques and virtual patients on the accuracy of planning and surgical placement of dental implants: A systematic review

“… 18 Virtual patient simulations involve the creation of 3D models that simulate the patient's anatomy and allow the clinician to virtually plan and perform implant surgery. 19 This technology provides a platform for clinicians to assess the feasibility of implant placement, evaluate surrounding structures, determine the optimal implant size and angulation, and virtually place implants in a simulated environment. 20 The integration of 3D imaging techniques and virtual patient simulations offers several advantages.…”