2D Spinal Surgery Planning With Virtual 3D Landmark Registration

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Solution Overview

Problem

Conventional spinal surgery planning based on CT images exposes patients to harmful radiation and requires cumbersome and technically difficult registrations between 2D and 3D images, complicating surgical procedures.

Innovation Solution

A method and apparatus that utilizes a 2D medical image, such as a C-arm image, to generate a virtual 3D figure by calculating a registration relationship, adjusting its shape and position to match spinal landmarks, and setting insertion positions and paths for spinal prostheses, eliminating the need for CT scans and 2D-3D registrations.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If a CT scan is used for preoperative planning, then the axial view is available for accurate planning, but the patient is exposed to harmful radiation

Engineering Contradiction:
Improveplanning accuracyVSAvoidradiation exposure
Core Design Contradiction:
Measurement precisionVSObject-affected harmful factors

Solution Approach 1:

The patent creates a virtual 3D model (copy) of the spinal anatomy from 2D C-arm images, allowing planning to be performed on this digital replica rather than requiring direct CT scanning of the patient. This copying approach eliminates radiation exposure while preserving planning accuracy through the use of registration technology that aligns the virtual model with actual anatomy.

Inventive Principle:
Principle #26Copying

Solution Approach 2:

The patent transforms the imaging modality from high-radiation CT to low-radiation C-arm fluoroscopy, changing the radiation parameter from high to low exposure levels. Simultaneously, it applies image registration and 3D reconstruction algorithms to maintain the necessary anatomical detail and planning precision despite using lower-quality 2D images.

Inventive Principle:
Principle #35Parameter changes

2Measurement precision

If registration between 2D and 3D images is performed, then the planning can be aligned with actual anatomy, but the process is cumbersome and time-consuming

Engineering Contradiction:
Improveregistration accuracyVSAvoidsurgical time
Core Design Contradiction:
Measurement precisionVSLoss of time

Solution Approach 1:

The patent performs the image registration process during the preoperative planning phase, before the actual surgery begins. By completing the alignment of 2D C-arm images with the virtual 3D model in advance, the registration work is done beforehand, eliminating the need for time-consuming registration procedures during the surgical operation itself.

Inventive Principle:
Principle #10Preliminary action

Solution Approach 2:

The patent introduces a virtual 3D model as an intermediary representation that bridges the 2D C-arm images and the actual 3D spinal anatomy. This intermediate model can be registered with 2D images more efficiently than direct 2D-3D registration, and once registered, serves as a reference for accurate surgical planning without requiring repeated registration during surgery.

Inventive Principle:
Principle #24Intermediary (Mediator)

3Object-affected harmful factors

If a 2D medical image is used for planning, then radiation exposure is reduced and registration is simplified, but the axial view is not available for accurate planning

Engineering Contradiction:
Improveradiation exposureVSAvoidplanning accuracy
Core Design Contradiction:
Object-affected harmful factorsVSMeasurement precision

Solution Approach 1:

The patent reconstructs a virtual 3D model from 2D C-arm fluoroscopy images, effectively adding the third dimension back to the imaging data. This 3D reconstruction provides axial, sagittal, and coronal views along with isometric perspectives, enabling accurate surgical planning with the same radiation exposure levels as conventional 2D fluoroscopy, thereby resolving the limitation of missing axial view information.

Inventive Principle:
Principle #17Another dimension (Dimensionality change)

Data Source

PatentEP4134034B1Two-dimensional medical image-based spinal surgery planning apparatus and method
Publication Date: 2025.11.12 CUREXO
  • EP4134034B1 patent drawingFigure 1
  • EP4134034B1 patent drawingFigure 2
  • EP4134034B1 patent drawingFigure 3

AI summary

Disclosed are an apparatus and method for spinal surgery planning, the spinal surgery planning method including: acquiring a two-dimensional (2D) spinal image of a patient through a medical imaging apparatus; calculating a registration relationship between coordinates in an image space and coordinates in a surgical space by registering the image space for the spinal image and the surgical space where spinal surgery is performed on the patient; generating a virtual three-dimensional (3D) figure in the surgical space; projecting the 3D figure onto the spinal image based on the registration relationship; adjusting the 3D figure so that the 3D figure can correspond to a predetermined landmark on the spinal image; and setting an insertion position and insertion path of a spinal prosthesis based on the spinal image and the 3D figure. Thus, the planning is performed based on the 2D spinal image without a computed tomography (CT) scan, and it is therefore possible to accurately take the planning while decreasing a patient's radiation exposure and procedure complexity due to CT image registration, thereby effectively replacing a CT image.