University of Twente Student Theses
How to Improve Sacroiliac Joint Fusion Surgery? : An automated workflow with an intraoperative visualisation of the surgical planning
Lankheet, S. (2023) How to Improve Sacroiliac Joint Fusion Surgery? : An automated workflow with an intraoperative visualisation of the surgical planning.
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| Abstract: | Introduction: Within the guidelines of MDR and ISO, a workflow for (semi)-automated intraop- erative visualization of virtual surgical planning during sacroiliac joint fusion surgery was developed and preclinically evaluated. This study investigated whether incorporating perioperative visualization could enhance implant accuracy during sacroiliac joint fusion surgery. A retrospective cohort, without perioperative visualization, was compared to a prospective cohort with real-time visualization of the planning. Method: The retrospective cohort included all patients who underwent primary sacroiliac joint fusion surgery in 2022. All patients who underwent primary sacroiliac joint fusion surgery in June 2023 were included in the prospective cohort. In both cohorts, a virtual surgical planning was created and visualized intraoperatively. In the prospective cohort, the planning was registered and visualised on top of the perioperative image, for the lateral, inlet, and outlet views. Postoperative CT scans were used to evaluate implant accuracy and surgical metrics were compared between the two cohorts. Results: A total of 29 patients were included in the study, with 24 in the retrospective cohort and 4 in the prospective cohort. In the retrospective cohort, the implant accuracy was 4.78 ± 1.31 mm for the tip of the implant and 4.17 ± 1.80° for the direction of the implant. The prospective cohort showed a significant improvement of 1.07 ± 0.42° (P = 0.022) in the average angle error compared to the retrospective cohort. No significant improvement was seen in implant accuracy based on the tip position. Conclusion: This study successfully demonstrated the feasibility of intraoperatively registering and vi- sualizing the virtual surgical planning on top of the lateral, inlet, and outlet views. Although the results show promising trends towards improved implant accuracy, the retrospective cohort size was insufficient to establish a statistically significant difference in surgery metrics. Further research with a larger sample size is needed to validate the potential improvement in reproducing the virtual surgical planning. |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/96575 |
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