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A photoacoustics-enhanced drilling probe for radiation-free pedicle screw implantation in spinal surgery

This article proposes a novel intra-operative navigation and sensing system that optimizes the functional accuracy of spinal pedicle screw implantation. It does so by incorporating radiation-free and multi-scale macroscopic 3D ultrasound (US) imaging and local tissue-awareness from in situ photoacou...

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Autores principales: Liu, Li, Zhao, Yongjian, Li, Ang, Yu, Xianghu, Xiao, Xiao, Liu, Siyu, Meng, Max Q.-H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9520603/
https://www.ncbi.nlm.nih.gov/pubmed/36185423
http://dx.doi.org/10.3389/fbioe.2022.1000950
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author Liu, Li
Zhao, Yongjian
Li, Ang
Yu, Xianghu
Xiao, Xiao
Liu, Siyu
Meng, Max Q.-H.
author_facet Liu, Li
Zhao, Yongjian
Li, Ang
Yu, Xianghu
Xiao, Xiao
Liu, Siyu
Meng, Max Q.-H.
author_sort Liu, Li
collection PubMed
description This article proposes a novel intra-operative navigation and sensing system that optimizes the functional accuracy of spinal pedicle screw implantation. It does so by incorporating radiation-free and multi-scale macroscopic 3D ultrasound (US) imaging and local tissue-awareness from in situ photoacoustic (PA) sensing at a clinically relevant mesoscopic scale. More specifically, 3D US imaging is employed for online status updates of spinal segment posture to determine the appropriate entry point and coarse drilling path once non-negligible or relative patient motion occurs between inter-vertebral segments in the intra-operative phase. Furthermore, a sophisticated sensor-enhanced drilling probe has been developed to facilitate fine-grained local navigation that integrates a PA endoscopic imaging component for in situ tissue sensing. The PA signals from a sideways direction to differentiate cancellous bone from harder cortical bone, or to indicate weakened osteoporotic bone within the vertebrae. In so doing it prevents cortical breaches, strengthens implant stability, and mitigates iatrogenic injuries of the neighboring artery and nerves. To optimize this PA-enhanced endoscopic probe design, the light absorption spectrum of cortical bone and cancellous bone are measured in vitro, and the associated PA signals are characterized. Ultimately, a pilot study is performed on an ex vivo bovine spine to validate our developed multi-scale navigation and sensing system. The experimental results demonstrate the clinical feasibility, and hence the great potential, for functionally accurate screw implantation in complex spinal stabilization interventions.
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spelling pubmed-95206032022-09-30 A photoacoustics-enhanced drilling probe for radiation-free pedicle screw implantation in spinal surgery Liu, Li Zhao, Yongjian Li, Ang Yu, Xianghu Xiao, Xiao Liu, Siyu Meng, Max Q.-H. Front Bioeng Biotechnol Bioengineering and Biotechnology This article proposes a novel intra-operative navigation and sensing system that optimizes the functional accuracy of spinal pedicle screw implantation. It does so by incorporating radiation-free and multi-scale macroscopic 3D ultrasound (US) imaging and local tissue-awareness from in situ photoacoustic (PA) sensing at a clinically relevant mesoscopic scale. More specifically, 3D US imaging is employed for online status updates of spinal segment posture to determine the appropriate entry point and coarse drilling path once non-negligible or relative patient motion occurs between inter-vertebral segments in the intra-operative phase. Furthermore, a sophisticated sensor-enhanced drilling probe has been developed to facilitate fine-grained local navigation that integrates a PA endoscopic imaging component for in situ tissue sensing. The PA signals from a sideways direction to differentiate cancellous bone from harder cortical bone, or to indicate weakened osteoporotic bone within the vertebrae. In so doing it prevents cortical breaches, strengthens implant stability, and mitigates iatrogenic injuries of the neighboring artery and nerves. To optimize this PA-enhanced endoscopic probe design, the light absorption spectrum of cortical bone and cancellous bone are measured in vitro, and the associated PA signals are characterized. Ultimately, a pilot study is performed on an ex vivo bovine spine to validate our developed multi-scale navigation and sensing system. The experimental results demonstrate the clinical feasibility, and hence the great potential, for functionally accurate screw implantation in complex spinal stabilization interventions. Frontiers Media S.A. 2022-09-15 /pmc/articles/PMC9520603/ /pubmed/36185423 http://dx.doi.org/10.3389/fbioe.2022.1000950 Text en Copyright © 2022 Liu, Zhao, Li, Yu, Xiao, Liu and Meng. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Liu, Li
Zhao, Yongjian
Li, Ang
Yu, Xianghu
Xiao, Xiao
Liu, Siyu
Meng, Max Q.-H.
A photoacoustics-enhanced drilling probe for radiation-free pedicle screw implantation in spinal surgery
title A photoacoustics-enhanced drilling probe for radiation-free pedicle screw implantation in spinal surgery
title_full A photoacoustics-enhanced drilling probe for radiation-free pedicle screw implantation in spinal surgery
title_fullStr A photoacoustics-enhanced drilling probe for radiation-free pedicle screw implantation in spinal surgery
title_full_unstemmed A photoacoustics-enhanced drilling probe for radiation-free pedicle screw implantation in spinal surgery
title_short A photoacoustics-enhanced drilling probe for radiation-free pedicle screw implantation in spinal surgery
title_sort photoacoustics-enhanced drilling probe for radiation-free pedicle screw implantation in spinal surgery
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9520603/
https://www.ncbi.nlm.nih.gov/pubmed/36185423
http://dx.doi.org/10.3389/fbioe.2022.1000950
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