Perspective on the integration of optical sensing into orthopedic surgical devices

Abstract

. Significance: Orthopedic surgery currently comprises over 1.5 million cases annually in the United States alone and is growing rapidly with aging populations. Emerging optical sensing techniques promise fewer side effects with new, more effective approaches aimed at improving patient outcomes following orthopedic surgery. Aim: The aim of this perspective paper is to outline potential applications where fiberoptic-based approaches can complement ongoing development of minimally invasive surgical procedures for use in orthopedic applications. Approach: Several procedures involving orthopedic and spinal surgery, along with the clinical challenge associated with each, are considered. The current and potential applications of optical sensing within these procedures are discussed and future opportunities, challenges, and competing technologies are presented for each surgical application. Results: Strong research efforts involving sensor miniaturization and integration of optics into existing surgical devices, including K-wires and cranial perforators, provided the impetus for this perspective analysis. These advances have made it possible to envision a next-generation set of devices that can be rigorously evaluated in controlled clinical trials to become routine tools for orthopedic surgery. Conclusions: Integration of optical devices into surgical drills and burrs to discern bone/tissue interfaces could be used to reduce complication rates across a spectrum of orthopedic surgery procedures or to aid less-experienced surgeons in complex techniques, such as laminoplasty or osteotomy. These developments present both opportunities and challenges for the biomedical optics community.

Optical spectroscopy and imaging in surgical management of cancer patients

“…The following are among emerging trends that “feed this translational pipeline.” Analogous to in‐needle optical biopsy, optical sensors can be integrated directly into surgical tools, such as bone drills or screws, to avoid damaging vulnerable soft tissue structures [166, 167]. Resection of skull‐base tumors is one oncological example where this would be useful.…”

Fiber-Optic Pedicle Probes to Advance Spine Surgery through Diffuse Reflectance Spectroscopy

“…Bone tissue exhibits absorption peaks due to fat, water, and collagen, key absorbers within the wavelength range of interest (visible (VIS) -near infrared (NIR)). DRS technology is sufficiently small to allow for integration into a variety of surgical devices, including pedicle screws [12] and surgical drills [13]. While these are feasible options, we aim to develop a more practical and effective method to integrate DRS into the surgical workflow by investigating the incorporation of optical fibers into pedicle probes, the main means for pedicle cannulation.…”

Inter-Specimen Analysis of Diverse Finite Element Models of the Lumbar Spine

“…Consequently, the investigation of medical devices and treatments in this field has gained substantial popularity in the literature [3]. These studies primarily focus on in vitro (cadaver studies) [4][5][6][7] or finite element analysis (FEA) methodologies [8][9][10][11]. FEA has emerged as a favored approach for studying the biomechanics of the lumbar spine [12][13][14][15][16] and the cervical spine [17][18][19][20].…”