Application of the ‘Surgical GPS’ to posterior spinal fusion procedures for scoliosis correction

ABSTRACT

Scoliotic deformity correction is usually addressed with a posterior spinal fusion (PSF) approach. PSF operations are significantly invasive but can become safer and more efficient by reducing the number of ligament releases performed. However, PSF pre-operative planning to lessen ligament releases is constrained by current diagnostic imaging, which struggles with soft tissue localization, causing ligament release minimisation to be indeterminable. Patient-specific meshes that encompass vertebrae, intervertebral disks, ligaments, and other soft tissue may more accurately guide these pre-operative planning studies as well as intra-operative, computer-assisted surgery (CAS) systems supporting deformity correction. Further, merging physician-designated anatomical landmarks and pre-existing surgical ontologies into a resource description framework (RDF) format permits real-time, CAS guidance accommodating countless surgical workflows. By combining RDF-driven CAS guidance and patient-specific meshes, preoperative and intraoperative support of PSF procedures can be achieved at an individualised level. This study presents an early implementation of this combination, as the ‘Surgical GPS’.

KEYWORDS:

• Computer assisted surgery
• patient-specific meshes
• surgical process modelling

Acknowledgments

I would like to express my appreciation to Dr. Michel Audette for his support, supervision and constructive criticism throughout this study and its related works.I am thankful to Dr. James Bennett of The Children’s Hospital of the Kings’ Daughters for his participation in this study and his invaluable assistance in validating the procedures described herein.I wish to thank the Biomedical Engineering department at Old Dominion University and The Children’s Hospital of the Kings’ Daughters for the financial support they both provided that made this study possible.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Austin Tapp

AUSTIN TAPP is a biomedical engineering Ph.D. student at the Frank Batten College of Engineering and Technology at Old Dominion University. He received a Bachelor of science from the College of William and Mary. His research interests are in surgical planning software as well as anatomical modelling and simulation.

James Bennett

JAMES BENNETT is a paediatric orthopaedic spine surgeon at Children’s Hospital of the King’s Daughters. He earned his medical degree through the Keith B. Taylor Global Scholars Program at St. George’s University School of Medicine and Northumbria University. He completed a research fellowship in paediatric spinal deformity at the Shriners Hospital for Children of Philadelphia, finished his orthopaedic surgery training at Temple University Hospital in Philadelphia, and then pursued advanced training in paediatric orthopaedics with a focus on paediatric spinal deformity at the Children’s Hospital of Los Angeles.

Michel. A. Audette

MICHEL AUDETTE is an Associate Professor in the Department of Computational Modelling and Simulation Engineering in the Batten College of Engineering and Technology at Old Dominion University. He holds a Ph.D. in Biomedical Engineering from McGill University. His research interests include surgical modelling, simulation and navigation for orthopaedic, oncological and neurosurgical procedures.