Medical image computing and computer-assisted intervention, miccai'99, proceedings vol:1679 pages:860-867
Posterior transarticular spine fusion is a surgical procedure used to stabilize the cervical bodies Cl and C2. Currently, spine. screws are used most frequently, according to the procedure of Magerl. As the anatomy is rather complex and the view is limited, this procedure has a high risk factor. Thus we present and validate a planning system for cervical screw insertion based oil preoperative CT imaging. It allows a neurosurgeon to interactively determine the desired position of the cervical screws, based on appropriate and in real-time calculated reslices through the preoperative CT data. Guided by this information, a personalized mechanical drill guide is produced. The system is validated by five cadaver experiments. Based on the preoperative planning, screws are inserted through the drill guide. A semi-automatic technique is used to extract the screw locations from the postoperative images. The deviations of the axes of the planned and the inserted screws are determined in this way. We have observed that the drill guides are not yet stable enough to cope with the drilling forces that they are subjected to. As a result, they tend to displace. However, most of the inserted screws were judged to be adequately placed. No vascular compromise nor invasion of the spinal canal was observed.