1 / 39

A telematic tool for computer aided lumbar spine surgery planning

A telematic tool for computer aided lumbar spine surgery planning. CRAFT-1999-71634 / IST-1999-57. Context and Introduction. GEOMETRY. APPLY CONSTRAINTS. MATERIAL PROPERTIES. MODEL : VIRTUAL ANALOGUE. PREDICT RESPONSE. Background. ISO 17025. Numerical simulation. In vitro experiments.

vernon-lowery
Download Presentation

A telematic tool for computer aided lumbar spine surgery planning

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A telematic tool for computer aided lumbar spine surgery planning CRAFT-1999-71634 / IST-1999-57

  2. Context and Introduction

  3. GEOMETRY APPLY CONSTRAINTS MATERIAL PROPERTIES MODEL : VIRTUAL ANALOGUE PREDICT RESPONSE

  4. Background ISO 17025 Numerical simulation In vitro experiments complementary

  5. Comparison of implant designs

  6. fixation compensatory motion OP OP OP Lumbar Spine surgery WHAT IS THE BEST STRATEGY FOR A GIVEN PATIENT? Long term disc degenerescence (Guigui 98, Schlegel 96, ...).

  7. Some biomechanical Finite Element Method (FEM) models exist but not accessible to non-FEM experts such as: surgeons, implant designers and implant manufacturers. Devaspim = a tool accessible via internet, to calculate the biomechanical behaviour of the instrumented spine using the FEM and to aid for surgery planning

  8. This tool will help to minimise the number of implant failures : - Optimise design process of lumbar spine implants • by reducing failure due to implant design and improving competitiveness of the manufacturers (implant industries) in the segment of spine implants. • - Minimise technical failures • due to the selection of inappropriate configurations, through a better preoperative planning. The application use will be a service offered to surgeons/designers by the implant manufacturers

  9. DESCRIPTION USER RESULT INPUT WEB PAGE (Spain) spine surgery data: - patient general data - pathology data User User friendly friendly - surgical method Interface Interface input output - implant configurations Output Output parameters parameters Storage in a transmission transmission data base Devaspim CALCULATION SERVER (France) Interface Instrumented Interface input output spine FEM model Biomechanical behaviour of instrumented spine

  10. Description of the full process, step by step

  11. STEP1 : Morphology Manually Introducing the X-Rays Spine Morphology

  12. STEP1 : Morphology 3D shape and position

  13. STEP1 : Morphology Personalised FEM Generic FEM 3D Reconstruction

  14. STEP1 : Morphology Example : degenerative L4/L5 Spondylolisthesis

  15. STEP 2 : General Data • Bone quality • Imbalance • Weight • Height

  16. STEP 2 : General Data FEM : Personalized bone mechanical Properties (osteoporosis) FEM : Personalized calculations of Loads to apply on the model • Bone quality • Imbalance • Weight • Height

  17. Pathology type: • Spondyloarthrose • Spondylolisthesis • Fractures • Affected level • Restoration estimation STEP 3 : Pathology definition

  18. STEP 3 : Pathology definition • Pathology type: • Spondyloarthrose • Spondylolisthesis • Fractures • Affected level • Restoration estimation

  19. STEP 3 : Pathology definition • Pathology type: • Spondyloarthrose • Spondylolisthesis • Fractures • Affected level • Restoration estimation

  20. STEP 3 : Pathology definition IT IS POSSIBLE TO MODEL AUTOMATIQUELY A WIDE RANGE OF LESIONS Disc Disease Modification of components Osteoporosis Modification of the bone’s Young Modulus

  21. STEP 4 : Kind of instrumentation Choose the implant system to simulate

  22. STEP 4 : Kind of instrumentation Choose the implant system to simulate

  23. STEP 5 : Implant Configuration • Characteristics to define for the implant system chosen • Material • Symmetric or not • Screw diameter by level • Screw length by level • Connectors by level • Rod diameter

  24. STEP 5 : Implant Configuration • Parameterization : • Material • Connector • For each instrumented vertebra, kind of connector to model

  25. STEP 5 : Implant Configuration • Parameterization : • Material • Connector • For each instrumented vertebra, kind of connector to model • Screw • For each instrumented vertebra, diameter, length, angle of insertion

  26. STEP 5 : Implant Configuration • Parameterization : • Material • Connector • For each instrumented vertebra, kind of connector to model • Screw • For each instrumented vertebra, diameter, length, angle of insertion • Rod diameter • Hooks • DTT Kind, number and localization

  27. STEP 6 : Surgical technique (optional) A surgical gesture is associated to the implant chosen

  28. Discectomy Facectomy Laminectomy Arthrectomy STEP 6 : Surgical technique (optional) A surgical gesture is associated to the implant chosen …

  29. STEP 7 : Results SPECIFIC IMPLANTS RESULTS • Assembly stiffness • Rods stress • Screw stress • Biomechanical behaviour of the assembly

  30. STEP 7 : Results The simulation outputs An html report automatically generated will be send to the user : Result.html

  31. STEP 7 : Results Analysis of the anatomical entities : • Stress in the adjacent intervertebral disc • Facets loads • …

  32. STEP 7 : Results Shear load Low, medium, high Bending moment Low, medium, high Pull out load Low, medium, high Bone implants stresses Qualitative estimation of configuration

  33. 3D Reconstruction Finite Element Model Calculation. Example L4 L5 Degenerative Spondylo L4 L5 instrumenation

  34. Flexion STRESSES IN LOWER SCREWS Calculation. Example

  35. Conclusion

  36. Lumbar Spine surgery PATIENT SURGICAL ACT Devaspim IMPLANT

  37. CONCLUSION Computer aided surgery planning: innovative tool For Surgeons: • understand mechanical effects of a given strategy • minimise implant failures • Better clinical outcome • For implant designers • implant design improvements • implant effects in expected indications

  38. CONCLUSION DEVASPIM SPIN-OFF - Implant manufacturers: decreased design costs - Orthopaedic surgeons: better preoperative planning - Patients: increased clinical outcome and quality of life - Health Services: cost reduction due to less re-operations.

  39. www.MyWebPage.com

More Related