Mr. Dejan Knez Profile

Dejan Knez

at Univ of Ljubljana

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Proceedings Article | 21 March 2016 Paper

Quantitative comparison between the straight-forward and anatomical insertion technique for pedicle screw placement

Dejan Knez, Janez Mohar, Boštjan Likar, Franjo Pernuš, Tomaž Vrtovec

Proceedings Volume 9784, 978439 (2016) https://doi.org/10.1117/12.2216028

KEYWORDS: Computed tomography, Image analysis, Rods, Surgery, Biological research, Model-based design, 3D modeling, 3D image processing, Spine, Optimization (mathematics), Bone, Fourier transforms, Roentgenium, Visualization

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Spinal deformity correction with vertebral fixation is nowadays the preferred surgical treatment, where pedicle screws are inserted through pedicles into corresponding vertebral bodies and afterwards connected with rods. In clinical practice, the straight-forward and anatomical insertion technique are currently being used for pedicle screw placement surgery. However, it is difficult to quantitatively compare both techniques and determine which technique is more adequate for each planned pedicle screw before surgery (i.e. preoperatively). In this paper, we therefore describe a framework for quantitative comparison between the straight-forward and anatomical insertion technique for pedicle screw placement surgery by evaluating the screw fastening strength. Quantitative comparisons were performed on computed tomography images of 11 patients with 74 manually planned pedicle screws, who underwent the vertebral fixation procedure. The first quantitative comparison was performed between the straight-forward and anatomical pedicle screw insertion technique, which resulted in a relatively high agreement with mean absolute difference of 0.0mm in screw diameter, 2.9mm in screw length, 1.2mm in pedicle crossing point and 6.5° in screw inclinations. The second quantitative comparison was performed between the best resulting pedicle screw insertion technique and manually obtained pedicle screw plans, which again resulted in a relatively high agreement with mean absolute difference of 0.5mm in screw diameter, 4.7mm in screw length, 2.4mm in pedicle crossing point and 6.0° in screw inclinations. Both the straight-forward and anatomical insertion technique proved approximately equal in terms of the screw fastening strength.

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