Artikel
Intraoperative computer-animated real-time visualization of vertebral body motion using a microsensor system implanted in the cervical spine
Intraoperative computeranimierte Echtzeitdarstellung von Wirbelkörperbewegungen mit Hilfe eines implantierbaren Mikro-Sensor-Systems bei neurochirurgischen Eingriffen an der degenerativ veränderten Halswirbelsäule
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Autoren
Veröffentlicht: | 23. April 2004 |
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Gliederung
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Objective
Degenerative diseases alter the biomechanical function and statics of the cervical spine. The aim of the surgery is not only to decompress the compressed neural structures but also to guarantee the highest stability with the best possible preservation of function. Regardless of the surgical technique used, the objective here is to be able to intraoperatively predict the functional (neurological and biomechanical) results of surgery.
Methods
In addition to specific surgical planning, optimization of anatomical orientation and improvement of surgical accuracy, so-called "navigation" has also been used for some time in cervical spinal interventions. In this research project, the reference sensors of an electromagnetic navigation system have been reduced to such an extent that they can be implanted in one or more vertebral bodies. Microsensors were implanted in up to three segments in a model and up to two segments in the first clinical trials.
Results
Various surgical techniques (ventral fusion, dorsal fixateur implantation, ventrolateral plate osteosynthesis, foramenotomy, cage implantation) were performed in a total of five cervical spine models using different segments (C1-3, C5/6, C6-T1). The isolated vertebral body movements were intraoperatively registered and visualized. First examinations were performed in vivo during ventral C4/5 and C5/6 fusions.
Conclusions
The implanted reference sensors enable computer-animated, real-time visualization of isolated movements in individual vertebral bodies or entire motion segments like intraoperative changes in vertebral body positioning. This means that motion can be immediately visualized during surgery without the need for additional intraoperative imaging procedures such as intraoperative fluoroscopy or computed tomography. Especially in the case of degenerative changes, important information about the expected postoperative biomechanical result can be obtained by continuous intraoperative three-dimensional animation of joint and vertebral body motion.