Minimally invasive spine surgery (MISS) has proven to be advantageous over traditional open
surgery as it minimizes the likelihood of tissue damage and infections. During MISS, surgeons
create small incisions to allow access to the surgery site, however, opting for smaller incisions
decreases the surgeon’s field of vision. To compensate, surgeons rely on preoperative and
intraoperative ionizing imaging technologies for guidance.
Conventional localization of the spine, registration of digital images to the patient during surgery,
depends heavily on the surgeon’s anatomical knowledge and their experience. Preoperative
images are typically created using 3D technology while intraoperative images use 2D technology.
While the integration of preoperative 3D images and intraoperative 2D images can provide
valuable assistance, patient’s preoperative and intraoperative positions do not coincide leading to
additional use of ionizing imaging.
The objective of this research was to propose a workflow that assists with image registration for
MISS. The main component of the workflow was the creation of a script that automatically
generates patient-specific digital guides, which will then be manufactured, to align the patient’s
intraoperative and preoperative body position. By aligning the patient’s positions, the 3D printed
surgical guide serves as a shared feature between the preoperative digital image and the actual
patient. This allows for the intraoperative image to be registered to the preoperative image more
accurately. Additionally, the guide acts as an attachment site for any additional instrument
guides/supports.
The surgical guide generating script utilizes the skin contour of patient’s torso region, extracted
from medical images, to automatically produce the guide’s horizontal and vertical components.
Adjustments are made to the components using CAD software before proceeding to
manufacturing, via 3D printing, and assembly of the guide. To validate the workflow, more
specifically the script’s ability to automatically generate surgical guides that fit over the patient’s
back, a guide was created for a mannequin. The maximum gap between the mannequin and the
horizontal components was 0.8 cm and 1.5 cm for the vertical component.
| Identifer | oai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/42931 |
| Date | 17 November 2021 |
| Creators | Hujaleh, Iffa |
| Contributors | Lee, Wonsook |
| Publisher | Université d'Ottawa / University of Ottawa |
| Source Sets | Université d’Ottawa |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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