First reported use of machine vision image guided system for unstable thoracolumbar fusion: Technical case report

Abstract

Introduction: Gross segmental spinal instability and disoriented anatomy associated with unstable spinal fractures can make spinal fixation challenging. Intraoperative navigation improves screw placement accuracy; however, navigation may be inaccurate in the setting of spinal instability. Furthermore, if the unstable spine moves relative to the spinous process clamp, additional intra-operative computed tomography (CT) may be needed for most spinal navigation platforms. The machine-vision image guided system (MvIGS) uses optical topographic imaging to rapidly register intra-op spinal anatomy to preoperative CT imaging. Here, we present the first report of intraoperative navigation with MvIGS to perform a T7-L1 posterolateral fusion for a traumatic unstable thoracolumbar fracture. Case Report: A 52-year-old female presented to our trauma service following a pedestrian versus vehicle incident. Thoracic CT revealed an unstable horizontal three-column fracture of the superior T10 vertebral body extending into the T10 lamina and pedicles, with T8/T9 spinous process involvement (AOSpine Classification = CNXM2). A T7-L1 posterolateral fusion was performed using MvIGS technology. Conclusion: CT-guided navigation is becoming the standard of care in spinal surgery, with improved screw accuracy and decreased fluoroscopic time and blood loss compared to traditional fluoroscopic and free-hand techniques. The use of intraoperative MvIGS during unstable spinal fracture fusions may result in decreased operative time with no additional radiation exposure.

Keywords

• Machine vision
• Navigation
• Unstable thoracolumbar fusion