Formulating a pedicle screw fastening strength surrogate via Patient-Specific virtual templating and planning

Abstract

Traditional 2D images provide limited use for accurate planning of spine interventions, mainly due to the complex 3D anatomy of the and spine, and close proximity of nerve bundles and vascular structures that must be avoided during the procedure. Our clinician-friendly platform for spine surgery planning takes advantage of 3D pre-operative images, to enable oblique reformatting and 3D rendering of individual or multiple vertebrae, interactive templating and placement of virtual pedicle implants, and provide surrogate estimates of the “fastening strength” of implanted pedicle screws based on implant dimension and bone mineral density of the displaced bone substrate. Preliminary studies using retrospective clinical data have demonstrated the feasibility of the platform in assisting the surgeon with selection of appropriate size implant and trajectory that provides optimal “fastening strength”, given the intrinsic vertebral geometry and bone mineral density.