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Patient specific pre-operative plan for orthopedic surgery: from software to guides

Graaf, J.W. van der (2019) Patient specific pre-operative plan for orthopedic surgery: from software to guides.

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Abstract:With the increasing complexity of current day surgery, a 3-dimensional surgical plan is often needed. These can be difficult and time consuming to make. The current study aims to improve the workflow of creating pre-operative plans in orthopedic surgery. For this purpose, a graphical user-interface (GUI) was created in which a surgical plan can be manipulated by the physician. First, four clinical cases were described in which a preoperative surgical plan is created in combination with patient specific instrumentation (PSI). The four cases were used to obtain input for the different user and system requirements for the GUI. Three different types of visualization (2D, 3D and hybrid) were evaluated to determine the most suitable method for a physician to interact with a 3D surgical planning. The usability and accuracy of the software was investigated. MeVisLab was used to create software in which pedicle screws can be planned for spinal fusion surgery. In total 15 users were included in this research. The participants had to place six pedicle screws in three different vertebrae. Two criteria were given for the screw placement: 1. the screw must be placed inside the pedicle; 2. the screw must be placed parallel to the vertebral body. The time needed per screw was recorded. A system usability scale (SUS) was filled in as well as a confidence score, to determine how confident the user is, that the planning is correct. The screw position was evaluated automatically, calculating the angle between the screw and the vertebral body. Screws that penetrated the pedicle wall or the vertebral body were automatically found. An average SUS of 78,5 was found for all three visualization methods, scoring between good and excellent. However, no significant differences in usability (SUS) and confidence score were found. In total time needed, the hybrid method worked significantly faster than the 2D method. The screw angle was significantly larger in 3D compared to hybrid. All other results were not statistically different. In this research four cases are presented in which a PSI surgical guide was successfully used. This research proves it is possible to create an intuitive user interface which allows physicians to create a surgical plan. A better visualization can be made of a surgical plan for PSI’s. With a combination of the 2D and hybrid method all information is clearly visualized to assess whether screws are correctly placed.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/80205
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