Intraoperative Spinal Level Verification via Surface Data Registration

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Solution Overview

Problem

In image-guided spinal surgery, accurately associating fiducials selected in volumetric image data with those selected intraoperatively is challenging due to difficulties in identifying the correct spinal level, often requiring additional imaging modalities like X-rays, which increases surgical time and exposes staff and patients to radiation.

Innovation Solution

A system and method that utilize intraoperatively acquired surface data to verify the correspondence of the selected spinal level with pre-selected levels from volumetric image data by generating segmented surface data, registering it with adjacent levels, and providing quality measures to assess the registration accuracy, thereby aiding in the identification of the correct spinal level.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If additional imaging modalities like X-rays are used to verify spinal levels, then measurement precision of spinal level identification is improved, but loss of time increases and harmful factors (radiation exposure) are introduced

Engineering Contradiction:
Improvespinal level identification accuracyVSAvoidsurgical time
Core Design Contradiction:
Measurement precisionVSLoss of time

Solution Approach 1:

The system performs preliminary registration and verification of spinal levels using preoperative volumetric image data and intraoperative surface topology data before the actual surgical procedure begins. This allows the correct spinal level to be identified and confirmed in advance, eliminating the need for time-consuming intraoperative X-ray imaging during the surgical procedure itself.

Inventive Principle:
Principle #10Preliminary action

Solution Approach 2:

The patent replaces the mechanical/radiological imaging system (X-rays) with an optical/computational system that uses surface topology imaging and image registration algorithms. The surface imaging device captures three-dimensional surface data, which is then registered with preoperative volumetric images to identify spinal levels without ionizing radiation.

Inventive Principle:
Principle #28Mechanics substitution (Replace mechanical system)

2Measurement precision

If additional imaging modalities like X-rays are used to verify spinal levels, then measurement precision of spinal level identification is improved, but object-affected harmful factors (radiation exposure) are introduced

Engineering Contradiction:
Improvespinal level identification accuracyVSAvoidradiation exposure
Core Design Contradiction:
Measurement precisionVSObject-affected harmful factors

Solution Approach 1:

The patent replaces the radiological imaging system (X-rays) with an optical/computational system that uses surface topology imaging and image registration algorithms. The surface imaging device captures three-dimensional surface data, which is then registered with preoperative volumetric images to identify spinal levels without ionizing radiation, thereby eliminating harmful radiation exposure to patients and surgical staff.

Inventive Principle:
Principle #28Mechanics substitution (Replace mechanical system)

Solution Approach 2:

The system introduces surface topology data as an intermediary between the patient's anatomy and the verification process. Instead of directly using X-rays to image internal structures, the system first captures surface topology information and uses it as a mediator to register with preoperative volumetric data, indirectly identifying spinal levels without radiation.

Inventive Principle:
Principle #24Intermediary (Mediator)

3Productivity

If manual identification of spinal levels is performed without verification, then productivity is improved, but reliability of spinal level selection deteriorates

Engineering Contradiction:
Improvesurgical efficiencyVSAvoidspinal level selection accuracy
Core Design Contradiction:
ProductivityVSReliability

Solution Approach 1:

The system provides automated feedback by comparing the intraoperatively identified spinal level with the pre-selected level from volumetric images. The registration algorithm calculates quality measures and provides verification feedback to the surgeon, confirming whether the identified level matches the planned level, thereby maintaining high reliability without sacrificing productivity.

Inventive Principle:
Principle #23Feedback

Data Source

PatentEP3474765B1Systems and methods for intraoperative spinal level verification
Publication Date: 2023.08.02 D SURGICAL ULC
  • EP3474765B1 patent drawingFigure 1
  • EP3474765B1 patent drawingFigure 2A
  • EP3474765B1 patent drawingFigure 2B

AI summary

Systems and methods are provided in which intraoperatively acquired surface data is employed to verify the correspondence of an intraoperatively selected spinal level with a spinal level that is pre-selected based on volumetric image data. Segmented surface data corresponding to the pre-selected spinal levels may be obtained from the volumetric image data, such that the segmented surface data corresponds to a spinal segment that is expected to be exposed and identified intraoperatively during the surgical procedure. The segmented surface data from the pre-selected spinal level, and adjacent segmented surface data from an adjacent spinal level that is adjacent to the pre-selected spinal level, is registered to the intraoperative surface data, and quality measures associated with the registration are obtained, thereby permitting an assessment or a determination of whether or not the pre-selected spinal surface (in the volumetric frame of reference) is likely to correspond to the intraoperatively selected spinal level.