Int J Comput Assist Radiol Surg - Volume slicing of cone-beam computed tomography images for navigation of percutaneous scaphoid fixation.

Tópicos

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Resumo

RPOSE: Percutaneous scaphoid fixation (PSF) is growing in popularity as a treatment option for non-displaced fractures. Success of this procedure demands high-precision screw placement, which can be difficult to achieve with standard 2D imaging. This study aimed to develop and test a system for computer-assisted navigation using volume slicing of 3D cone-beam computed tomography (CBCT).METHODS: The navigated technique involved a distinctive workflow in which a 3D CBCT imager was calibrated preoperatively, circumventing the need for intraoperative patient-based registration. Intraoperatively, a 3D CBCT image was acquired for both preoperative planning and direct navigation using volume-rendered slices. An in vitro study was conducted to compare the navigated approach to two conventional fluoroscopic methods for volar PSF. The surgical goal was to insert a guide wire to maximize both length and central placement.RESULTS: There was no significant difference in the mean central placement of guide wire, although the variance in central placement was significantly lower using VS navigation (P < 0.01). The lengths of the drill paths were significantly longer for the VS-navigated group compared with one 2D group (P < 0.1). Each navigated trial required only one drilling attempt and resulted in less radiation exposure than conventional C-arm (P < 0.01).CONCLUSIONS: Volume-sliced navigation achieved a more repeatable and reliable central pin placement, with fewer drilling attempts than conventional 2D techniques. Volume-sliced navigation had a higher number of drill paths within the optimal zone maximizing both length of the path and depth from the surface.

Resumo Limpo

rpose percutan scaphoid fixat psf grow popular treatment option nondisplac fractur success procedur demand highprecis screw placement can difficult achiev standard d imag studi aim develop test system computerassist navig use volum slice d conebeam comput tomographi cbctmethod navig techniqu involv distinct workflow d cbct imag calibr preoper circumv need intraop patientbas registr intraop d cbct imag acquir preoper plan direct navig use volumerend slice vitro studi conduct compar navig approach two convent fluoroscop method volar psf surgic goal insert guid wire maxim length central placementresult signific differ mean central placement guid wire although varianc central placement signific lower use vs navig p length drill path signific longer vsnavig group compar one d group p navig trial requir one drill attempt result less radiat exposur convent carm p conclus volumesl navig achiev repeat reliabl central pin placement fewer drill attempt convent d techniqu volumesl navig higher number drill path within optim zone maxim length path depth surfac

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