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In-Depth Information
7 Summary and Future Work
In this paper we have described the augmentation of our existing spine surgery
planning platform with a new metric
that provides a
surrogate measure for the screw holding power. The proposed metric is evaluated in
conjunction with the virtual implant selection and 3D templating of the patient-
speci
—
the Fastening Strength
—
c 3D CT dataset and enables optimal selection and trajectory planning by
taking into consideration the effect of implant dimension and geometric path, as
well as the strength (i.e., bone mineral density) of the bone substrate, which is
critical to achieve improved
fixation. The conducted experiments showed agree-
ment between the implants suggested by the retrospective plans and the actual
procedure outcome.
In addition to the enhanced planning platform led to similar decisions as far as
implant dimension selection and trajectory planning, it also provides the surgeons
with the ability and choice to perform the planning pre-operatively, outside of the
OR and rely on objective measures for safe and secure implant positioning that
combine both implant dimension, trajectory and strength of the bone substrate into
a single metric.
Future directions will involve further evaluation via both retro- and prospective
studies, as well as the integration of virtual planning platform with existing com-
puter-assisted navigation platforms [
28
]. In addition, we plan to compare the screw
fastening strength outcome yielded by our surrogate formulation to that predicted
by classical
finite element models under different loading conditions, and demon-
strate the feasibility of employing the proposed Fastening Strength formulation as a
validated predictor of the holding power of the implanted pedicle screws.
Acknowledgments The authors would like to thank all members of the Biomedical Imaging
Resource who have helped with the development and implementation of this project, especially
Alan Larson, Bruce Cameron, Phillip Edwards, and Dennis Hanson. Also, we would like to
acknowledge our clinical collaborators for their continuous support: Dr. Paul M. Huddleston, Dr.
Jonathan Morris, Dr. Jane Matsumoto, and Dr. Shyam Shridharani.
References
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