Image-Guided Intramedullary Nail Localization With Reduced X-Ray Use
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Solution Overview
Problem
Existing image-guided surgical procedures face challenges with radiation exposure to patients and medical personnel due to frequent X-ray imaging, which can lead to increased cancer risk and reduced image resolution, while current virtual representation systems are inaccurate and time-consuming, disrupting workflow and requiring significant human interaction.
Innovation Solution
A computer-assisted imaging localization system that overlays actual instrument images on baseline anatomical images, using tracking elements and low-dose X-ray imaging to guide surgery with high accuracy, minimizing radiation exposure and maintaining real-time precision.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If frequent X-ray imaging is used to guide surgical procedures, then real-time image guidance is achieved, but radiation exposure to patient and medical personnel increases significantly
Solution Approach 1:
A baseline anatomical image is acquired before the surgical procedure to establish a reference framework. This preliminary imaging action allows subsequent surgical instrument positions to be tracked and displayed on the pre-acquired anatomical image, eliminating the need for frequent repeat X-rays during the procedure and thereby reducing radiation exposure while maintaining guidance accuracy.
Solution Approach 2:
The system creates a digital copy of the baseline anatomical image and overlays virtual representations of surgical instruments onto this static image. As instruments are moved, their positions are tracked and reflected on the copied image, providing real-time guidance without requiring new X-ray exposures. This copying approach maintains reliability while minimizing radiation.
2Object-affected harmful factors
If manual tracking and virtual representation systems are used to reduce radiation, then radiation exposure decreases, but system accuracy and response time deteriorate
Solution Approach 1:
Radio-opaque effecters are introduced as intermediary components that are attached to or integrated with surgical instruments. These effecters contain tracking markers visible on X-ray images, serving as mediators between the physical instrument and the imaging system. The effecters enable precise automatic tracking of instrument positions by providing detectable reference points, thereby maintaining high measurement precision while reducing the need for frequent manual imaging.
Solution Approach 2:
The system implements automatic tracking that continuously monitors the positions of radio-opaque effecters on the baseline image and provides real-time feedback by updating the overlay display. This automated feedback mechanism eliminates manual tracking delays and maintains high response time, achieving both reduced radiation exposure and preserved measurement precision.
3Object-affected harmful factors
If collimators are used to reduce radiation exposure area, then radiation dose to patient decreases, but available anatomical information in the image is reduced
Solution Approach 1:
A complete baseline anatomical image is acquired before the procedure using standard imaging parameters. This preliminary full-field image preserves all anatomical information for reference. During the procedure, only low-dose tracking images of radio-opaque effecters are acquired, and these are automatically overlaid on the complete baseline image, thereby maintaining full anatomical information availability while minimizing radiation dose during the procedure.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The system allows for precise instrument placement with reduced radiation by overlaying actual instrument images on anatomical images, enhancing accuracy and reducing the need for repeated X-rays, thus minimizing radiation exposure and maintaining workflow efficiency.
Implementation Method 1
using tracking elements and low-dose X-ray imaging to guide surgery with high accuracy
Implementation Method 2
using tracking elements and low-dose X-ray imaging to guide surgery with high accuracy
Implementation Method 3
A processor in the system moves an image of the effecter on the displayed x-ray image based on the effecter's position
Data Source
AI summary
A computer-assisted imaging and localization system assists the physician in positioning surgical effecters, such as implants, tools and instruments, within a surgical site in a patient's body. An image-guided intramedullary nail arrangement includes an intramedullary nail connected to a U-shaped drill guide. The body of the guide defines a plurality of thru-holes that are aligned with a plurality of openings in the nail, with the thru-holes acting as guides for conventional fasteners for engagement within the nail openings. The drill guide includes a tracking element fixed to the body of the guide that allows the position of the drill guide to be determined by a tracking system. The position of the intramedullary nail, and the plurality of openings, is determined by software based on the fixed geometry between the tracking element and the nail fastened to the drill guide.