Accuracy of image-guided surgical navigation using near infrared (NIR) optical tracking

Raphael Jakubovic; Hamza Farooq; Joseph Alarcon; Victor X. D. Yang

doi:10.1117/12.2079722

10 March 2015 Accuracy of image-guided surgical navigation using near infrared (NIR) optical tracking

Raphael Jakubovic, Hamza Farooq, Joseph Alarcon, Victor X. D. Yang

Proceedings Volume 9305, Optical Techniques in Neurosurgery, Neurophotonics, and Optogenetics II; 93050U (2015) https://doi.org/10.1117/12.2079722
Event: SPIE BiOS, 2015, San Francisco, California, United States

Abstract

Spinal surgery is particularly challenging for surgeons, requiring a high level of expertise and precision without being able to see beyond the surface of the bone. Accurate insertion of pedicle screws is critical considering perforation of the pedicle can result in profound clinical consequences including spinal cord, nerve root, arterial injury, neurological deficits, chronic pain, and/or failed back syndrome. Various navigation systems have been designed to guide pedicle screw fixation. Computed tomography (CT)-based image guided navigation systems increase the accuracy of screw placement allowing for 3- dimensional visualization of the spinal anatomy. Current localization techniques require extensive preparation and introduce spatial deviations. Use of near infrared (NIR) optical tracking allows for realtime navigation of the surgery by utilizing spectral domain multiplexing of light, greatly enhancing the surgeon’s situation awareness in the operating room. While the incidence of pedicle screw perforation and complications have been significantly reduced with the introduction of modern navigational technologies, some error exists. Several parameters have been suggested including fiducial localization and registration error, target registration error, and angular deviation. However, many of these techniques quantify error using the pre-operative CT and an intra-operative screenshot without assessing the true screw trajectory. In this study we quantified in-vivo error by comparing the true screw trajectory to the intra-operative trajectory. Pre- and post- operative CT as well as intra-operative screenshots were obtained for a cohort of patients undergoing spinal surgery. We quantified entry point error and angular deviation in the axial and sagittal planes.

Citation Download Citation

Raphael Jakubovic, Hamza Farooq, Joseph Alarcon, and Victor X. D. Yang "Accuracy of image-guided surgical navigation using near infrared (NIR) optical tracking", Proc. SPIE 9305, Optical Techniques in Neurosurgery, Neurophotonics, and Optogenetics II, 93050U (10 March 2015); https://doi.org/10.1117/12.2079722

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