title: Patient Registration Using Intraoperative Stereovision in Image-guided Open Spinal Surgery.
abstract: Despite its widespread availability and success in open cranial neurosurgery, image-guidance technology remains more limited in use in open spinal procedures, in large part, because of patient registration challenges. In this study, we evaluated the feasibility of using intraoperative stereovision (iSV) for accurate, efficient, and robust patient registration in an open spinal fusion surgery. Geometrical surfaces of exposed vertebrae were first reconstructed from iSV. A classical multistart registration was then executed between point clouds generated from iSV and preoperative computed tomography images of the spine. With two pairs of feature points manually identified to facilitate the registration, an average registration accuracy of 1.43 mm in terms of surface-to-surface distance error was achieved in eight patient cases using a single iSV image pair sampling 2-3 vertebral segments. The iSV registration error was consistently smaller than the conventional landmark approach for every case (average of 2.02 mm with the same error metric). The large capture ranges (average of 23.8 mm in translation and 46.0° in rotation) found in the iSV patient registration suggest the technique may offer sufficient robustness for practical application in the operating room. Although some manual effort was still necessary, the manually-derived inputs for iSV registration only needed to be approximate as opposed to be precise and accurate for the manual efforts required in landmark registration. The total computational cost of the iSV registration was 1.5 min on average, significantly less than the typical ∼30 min required for the landmark approach. These findings support the clinical feasibility of iSV to offer accurate, efficient, and robust patient registration in open spinal surgery, and therefore, its potential to further increase the adoption of image guidance in this surgical specialty.
authors.forename: Songbai
authors.initials: S
authors.lastname: Ji
authors.forename: Xiaoyao
authors.initials: X
authors.lastname: Fan
authors.forename: Keith D
authors.initials: KD
authors.lastname: Paulsen
authors.forename: David W
authors.initials: DW
authors.lastname: Roberts
authors.forename: Sohail K
authors.initials: SK
authors.lastname: Mirza
authors.forename: S Scott
authors.initials: SS
authors.lastname: Lollis
mesh_terms: D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D011446:Prospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed
references.citation: Med Image Anal. 2012 Apr;16(3):675-86
references.pmid: 21982123
references.citation: World Neurosurg. 2013 Jan;79(1):162-72
references.pmid: 22469525
references.citation: Eur Spine J. 2012 Feb;21(2):247-55
references.pmid: 21901328
references.citation: IEEE Trans Biomed Eng. 2014 Jun;61(6):1833-43
references.pmid: 24845293
references.citation: Eur Spine J. 2010 Jan;19(1):25-45
references.pmid: 19763640
references.citation: N Engl J Med. 2004 Feb 12;350(7):722-6
references.pmid: 14960750
references.citation: Med Phys. 2012 Dec;39(12):7540-52
references.pmid: 23231302
references.citation: Med Image Comput Comput Assist Interv. 2006;9(Pt 1):932-9
references.pmid: 17354980
references.citation: Eur Spine J. 2011 Jun;20(6):846-59
references.pmid: 20862593
references.citation: Neurosurg Focus. 2010 Mar;28(3):E11
references.pmid: 20192656
references.citation: Ultrasound Med Biol. 2001 Jul;27(7):945-55
references.pmid: 11476929
references.citation: Med Image Comput Comput Assist Interv. 2014;17(Pt 1):440-7
references.pmid: 25333148
references.citation: J Neurosurg Spine. 2010 Sep;13(3):403-6
references.pmid: 20809738
references.citation: Annu Rev Biomed Eng. 2011 Aug 15;13:297-319
references.pmid: 21568713
references.citation: Neurosurgery. 1993 Feb;32(2):209-13; discussion 213
references.pmid: 8437658
references.citation: Int J Cardiovasc Imaging. 2003 Dec;19(6):483-94
references.pmid: 14690187
references.citation: Med Image Anal. 2014 Oct;18(7):1169-83
references.pmid: 25077845
references.citation: IEEE Trans Med Imaging. 2005 Aug;24(8):1039-52
references.pmid: 16092335
references.citation: Acta Neurochir (Wien). 1997;139(6):551-9
references.pmid: 9248590
references.citation: Orthop Traumatol Surg Res. 2014 Sep;100(5):569-73
references.pmid: 25023930
references.citation: IEEE Trans Pattern Anal Mach Intell. 2012 Nov;34(11):2121-33
references.pmid: 22331856
references.citation: Med Phys. 2008 Oct;35(10):4612-24
references.pmid: 18975707
references.citation: Med Image Anal. 2012 Apr;16(3):662-74
references.pmid: 21126904
references.citation: IEEE Trans Biomed Eng. 2011 Jul;58(7):1985-93
references.pmid: 21317077
references.citation: IEEE Trans Med Imaging. 2003 Aug;22(8):973-85
references.pmid: 12906252
references.citation: Int J Comput Assist Radiol Surg. 2012 Jul;7(4):601-10
references.pmid: 22113426
references.citation: IEEE Trans Med Imaging. 2002 Jan;21(1):9-22
references.pmid: 11838664
references.citation: IEEE Trans Inf Technol Biomed. 2009 Nov;13(6):976-83
references.pmid: 19546046
references.citation: Int J Med Robot. 2006 Mar;2(1):7-15
references.pmid: 17520608
references.citation: Annu Rev Biomed Eng. 2010 Aug 15;12:119-42
references.pmid: 20415592
references.citation: J Neurosurg Sci. 2012 Mar;56(1):35-47
references.pmid: 22415381
references.citation: IEEE Trans Med Imaging. 2005 Jun;24(6):767-81
references.pmid: 15959938
references.citation: Spine (Phila Pa 1976). 2007 Jan 15;32(2):E56-64
references.pmid: 17224800
references.citation: Spine (Phila Pa 1976). 2014 Apr 15;39(8):683-7
references.pmid: 24480963
references.citation: IEEE Trans Med Imaging. 2010 Feb;29(2):322-38
references.pmid: 20129844
references.citation: Comput Aided Surg. 2002;7(6):342-52
references.pmid: 12731097
references.citation: Med Phys. 2014 Oct;41(10):102302
references.pmid: 25281972