Computer-assisted Surgery
Conditions
Brief summary
For a significant number of patients suffering from back pain, even basic daily activities become impossible. It is at this time that spinal surgery becomes necessary in order to improve the patient's quality of life. To combat these symptoms, surgical implants (e.g. pedicle screws, rods, etc.) are used to aid in stabilizing and correcting the deformities of the spine, particularly after spinal decompression. The clinical need for spinal surgery is compounded by current and continuing demographic trends. As the general population continues to age, the number of orthopaedic surgical interventions is expected to rise drastically. Therefore, a significant opportunity exists for the implementation of surgical guidance technologies, for orthopaedic procedures, to combat this overwhelming health care burden.
Detailed description
The hypothesis is that optical visualization of surgically exposed anatomy with the Biophotonics and Bioengineering Lab (BBL) surgical navigation prototype, when registered with pre-operative imaging (CT or MRI), can accurately estimate subsurface anatomy and allow tracking the position of surgical instruments in real-time, using an intraoperative non-contact optical imaging system during spinal surgical procedures.
Interventions
Comparison of accuracy of screw placement using experimental system while monitored by clinically approved system.
Sponsors
Sunnybrook Health Sciences Centre
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Greater than 18 years of age, able to provide consent, or has substitute decision maker available to consent. * Scheduled to undergo spinal instrumentation surgery involving pedicle or lateral mass screw insertion. * Scheduled for pre-operative CT scan and the surgical plan includes open exposure of the posterior bony elements of two or more level(s) of the vertebra(e). * No contra-indication for a post-operative CT scan.
Exclusion criteria
* Previous spinal decompression with significant laminectomy performed at the level intended for instrumentation. * Previous spinal instrumentation with significant metallic artefact on pre-operative CT scan
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pilot hole and screw trajectory accuracy as compared between post-operative CT and intraoperative images | Within 1 week of screw placement | Comparison and quantification of accuracy of pilot holes including entry point and trajectory as taken from experimental navigation system as compared to absolute (or actual) entry point and trajectory of screws as determined by post-operative computed tomography scans. |
Outcome results
None listed