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Keywords = pedicle screws fixation training

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15 pages, 5272 KiB  
Article
Design, Fabrication, and Preliminary Validation of Patient-Specific Spine Section Phantoms for Use in Training Spine Surgeons Outside the Operating Room/Theatre
by Marina Carbone, Rosanna Maria Viglialoro, Sara Stagnari, Sara Condino, Marco Gesi, Michelangelo Scaglione and Paolo Domenico Parchi
Bioengineering 2023, 10(12), 1345; https://doi.org/10.3390/bioengineering10121345 - 23 Nov 2023
Cited by 1 | Viewed by 1662
Abstract
Pedicle screw fixation (PSF) demands rigorous training to mitigate the risk of severe neurovascular complications arising from screw misplacement. This paper introduces a patient-specific phantom designed for PSF training, extending a portion of the learning process beyond the confines of the surgical room. [...] Read more.
Pedicle screw fixation (PSF) demands rigorous training to mitigate the risk of severe neurovascular complications arising from screw misplacement. This paper introduces a patient-specific phantom designed for PSF training, extending a portion of the learning process beyond the confines of the surgical room. Six phantoms of the thoracolumbar region were fabricated from radiological datasets, combining 3D printing and casting techniques. The phantoms were employed in three training sessions by a fifth-year resident who performed full training on all six phantoms; he/she placed a total of 57 pedicle screws. Analysis of the learning curve, focusing on time per screw and positioning accuracy, revealed attainment of an asymptotic performance level (around 3 min per screw) after 40 screws. The phantom’s efficacy was evaluated by three experts and six residents, each inserting a minimum of four screws. Initial assessments confirmed face, content, and construct validity, affirming the patient-specific phantoms as a valuable training resource. These proposed phantoms exhibit great promise as an essential tool in surgical training as they exhibited a demonstrable learning effect on the PSF technique. This study lays the foundation for further exploration and underscores the potential impact of these patient-specific phantoms on the future of spinal surgical education. Full article
(This article belongs to the Topic Applied System on Biomedical Engineering, Healthcare and Sustainability 2023)
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13 pages, 5758 KiB  
Review
Minimally Invasive Spinal Treatment (MIST)—A New Concept in the Treatment of Spinal Diseases: A Narrative Review
by Ken Ishii, Goichi Watanabe, Takashi Tomita, Takuya Nikaido, Tomohiro Hikata, Akira Shinohara, Masato Nakano, Takanori Saito, Kazuo Nakanishi, Tadatsugu Morimoto, Norihiro Isogai, Haruki Funao, Masato Tanaka, Yoshihisa Kotani, Takeshi Arizono, Masahiro Hoshino and Koji Sato
Medicina 2022, 58(8), 1123; https://doi.org/10.3390/medicina58081123 - 18 Aug 2022
Cited by 6 | Viewed by 4483
Abstract
In the past two decades, minimally invasive spine surgery (MISS) techniques have been developed for spinal surgery. Historically, minimizing invasiveness in decompression surgery was initially reported as a MISS technique. In recent years, MISS techniques have also been applied for spinal stabilization techniques, [...] Read more.
In the past two decades, minimally invasive spine surgery (MISS) techniques have been developed for spinal surgery. Historically, minimizing invasiveness in decompression surgery was initially reported as a MISS technique. In recent years, MISS techniques have also been applied for spinal stabilization techniques, which were defined as minimally invasive spine stabilization (MISt), including percutaneous pedicle screws (PPS) fixation, lateral lumbar interbody fusion, balloon kyphoplasty, percutaneous vertebroplasty, cortical bone trajectory, and cervical total disc replacement. These MISS techniques typically provide many advantages such as preservation of paraspinal musculature, less blood loss, a shorter operative time, less postoperative pain, and a lower infection rate as well as being more cost-effective compared to traditional open techniques. However, even MISS techniques are associated with several limitations including technical difficulty, training opportunities, surgical cost, equipment cost, and radiation exposure. These downsides of surgical treatments make conservative treatments more feasible option. In the future, medicine must become “minimally invasive” in the broadest sense—for all patients, conventional surgeries, medical personnel, hospital management, nursing care, and the medical economy. As a new framework for the treatment of spinal diseases, the concept of minimally invasive spinal treatment (MIST) has been proposed. Full article
(This article belongs to the Special Issue Minimally Invasive Spinal Treatment (MIST)—a New Concept in the Treatment of Spinal Diseases)
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17 pages, 10614 KiB  
Article
Hybrid Spine Simulator Prototype for X-ray Free Pedicle Screws Fixation Training
by Sara Condino, Giuseppe Turini, Virginia Mamone, Paolo Domenico Parchi and Vincenzo Ferrari
Appl. Sci. 2021, 11(3), 1038; https://doi.org/10.3390/app11031038 - 24 Jan 2021
Cited by 12 | Viewed by 3819
Abstract
Simulation for surgical training is increasingly being considered a valuable addition to traditional teaching methods. 3D-printed physical simulators can be used for preoperative planning and rehearsal in spine surgery to improve surgical workflows and postoperative patient outcomes. This paper proposes an innovative strategy [...] Read more.
Simulation for surgical training is increasingly being considered a valuable addition to traditional teaching methods. 3D-printed physical simulators can be used for preoperative planning and rehearsal in spine surgery to improve surgical workflows and postoperative patient outcomes. This paper proposes an innovative strategy to build a hybrid simulation platform for training of pedicle screws fixation: the proposed method combines 3D-printed patient-specific spine models with augmented reality functionalities and virtual X-ray visualization, thus avoiding any exposure to harmful radiation during the simulation. Software functionalities are implemented by using a low-cost tracking strategy based on fiducial marker detection. Quantitative tests demonstrate the accuracy of the method to track the vertebral model and surgical tools, and to coherently visualize them in either the augmented reality or virtual fluoroscopic modalities. The obtained results encourage further research and clinical validation towards the use of the simulator as an effective tool for training in pedicle screws insertion in lumbar vertebrae. Full article
(This article belongs to the Special Issue Serious Games and Mixed Reality Applications for Healthcare)
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17 pages, 3021 KiB  
Article
State Recognition of Bone Drilling Based on Acoustic Emission in Pedicle Screw Operation
by Fengqing Guan, Yu Sun, Xiaozhi Qi, Ying Hu, Gang Yu and Jianwei Zhang
Sensors 2018, 18(5), 1484; https://doi.org/10.3390/s18051484 - 9 May 2018
Cited by 30 | Viewed by 5425
Abstract
Pedicle drilling is an important step in pedicle screw fixation and the most significant challenge in this operation is how to determine a key point in the transition region between cancellous and inner cortical bone. The purpose of this paper is to find [...] Read more.
Pedicle drilling is an important step in pedicle screw fixation and the most significant challenge in this operation is how to determine a key point in the transition region between cancellous and inner cortical bone. The purpose of this paper is to find a method to achieve the recognition for the key point. After acquiring acoustic emission (AE) signals during the drilling process, this paper proposed a novel frequency distribution-based algorithm (FDB) to analyze the AE signals in the frequency domain after certain processes. Then we select a specific frequency domain of the signal for standard operations and choose a fitting function to fit the obtained sequence. Characters of the fitting function are extracted as outputs for identification of different bone layers. The results, which are obtained by detecting force signal and direct measurement, are given in the paper. Compared with the results above, the results obtained by AE signals are distinguishable for different bone layers and are more accurate and precise. The results of the algorithm are trained and identified by a neural network and the recognition rate reaches 84.2%. The proposed method is proved to be efficient and can be used for bone layer identification in pedicle screw fixation. Full article
(This article belongs to the Section Physical Sensors)
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