Skip to main content
Springer Nature Link
Log in

Evaluation of a navigated and power controlled milling system “navigated control spine” for spinal surgery

  • Original Article
  • Published:
International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Purpose

The aim of this work was the evaluation of a navigated and power controlled milling system for spine surgery (navigated control spine). The navigation is based on a set of intraoperatively taken fluoroscopic images from different angles. A manually planned workspace limits the power of the mill and assures a higher automatisation degree than any other established navigation system for spine surgery.

Methods

Both a technical study in workspace planning from fluoroscopic images and a milling study on a spine phantom were performed with participants with different level of knowledge of spinal surgery.

Results

In the region of interest the workspace planning could be performed with a maximum excess of 1.40 mm for surgeons. In the study performing the milling of a standardised workspace the remnant bone after milling had a mean difference from the planned workspace margin of 1.96–2.12 mm in the region of most interest. Accurate handling of the mill still required a certain level of medical knowledge and experience. In both studies the time needed for application of the system proved acceptable for clinical purposes.

Discussion

This concept of navigated and power controlled spinal surgery has proven feasible in an experimental study. This navigation system seems therefore promising for clinical application.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Holly LT (2006) Image-guided spinal surgery. Int J Med Robot 2(1): 7–15. doi:10.1002/rcs.69

    PubMed  Google Scholar 

  2. Foley KT, Simon DA, Rampersaud YR (2001) Virtual fluoroscopy: computer-assisted fluoroscopic navigation. Spine 26(4): 347–351. doi:10.1097/00007632-200102150-00009

    Article  PubMed  CAS  Google Scholar 

  3. Neumuth T, Trantakis C, Eckhardt F, Dengl M, Meixensberger J, Burgert O (2007) Supporting the analysis of intervention courses with surgical process models on the example of 14 microsurgical lumbar discectomies. Int J CARS 2: 436–438

    Google Scholar 

  4. Grumme T, Kolodziejczyk D (1995) Komplikationen in der Neurochirurgie. Blackwell Wissenschafts-Verlag, Berlin

    Google Scholar 

  5. Jank E, Rose A, Huth S, Trantakis C, Korb W, Meixensberger J, Krueger J (2006) A new fluoroscopy based navigation system for milling procedures in spine surgery. In: Proceedings of CARS 2006

  6. Rose A, Jank E, Huth S, Trantakis C, Korb W, Meixensberger J, Krueger J (2006) Experimental comparison of fluoroscopy and ct based segmentation for spine application. In: Proceedings of CARS 2006

  7. Strauss G, Koulechov K, Hofer M, Dittrich E, Grunert R, Moeckel H, Mueller E, Korb W, Trantakis C, Schulz T, Meixensberger J, Dietz A, Lueth T (2007) The navigation-controlled drill in temporal bone surgery: a feasibility study. Laryngoscope 117(3): 434–441. doi:10.1097/MLG.0b013e31802c93a1

    Article  PubMed  Google Scholar 

  8. Hofer M, Grunert R, Dittrich E, Mueller E, Moeckel M, Koulechov K, Strauss M, Korb W, Schulz T, Dietz A, Lueth T, Strauss G (2007) Surgery on the lateral skull base with the navigated controlled drill employed for a mastoidectomy (pre clinical evaluation). Stud Health Technol Inform 125: 179–184

    PubMed  CAS  Google Scholar 

  9. Lueth T, Bier J. Method and device system for removing material or for working material. WO 02/076302 A3.25.03.2002

  10. Grunert R, Strauss G, Moeckel H, Hofer M, Poessneck A, Fickweiler U, Thalheim M, Schmiedel R, Jannin P, Schulz T, Oeken J, Dietz A, Korb W (2006) ElePhant—an anatomical electronic phantom as simulation-system for otologic surgery. In: Proceedings of the 28th annual international. Conf Proc IEEE Eng Med Biol Soc 1: 4408–4411

    CAS  Google Scholar 

  11. Maier B, Zheng G, Ploss C, Zhang X, Welle K, Nolte LP, Marzi I (2007) A CT-free, intra-operative planning and navigation system for minimally invasive anterior spinal surgery—an accuracy study. Comput Aided Surg 12(4): 233–241. doi:10.1080/10929080701552894

    Article  PubMed  CAS  Google Scholar 

  12. Laine T, Lund T, Ylikoski M, Lohikoski J, Schlenzka D (2000) Accuracy of pedicle screw insertion with and without computer assistance: a randomised controlled clinical study in 100 consecutive patients. Eur Spine J 9(3): 235–240. doi:10.1007/s005860000146

    Article  PubMed  CAS  Google Scholar 

  13. Assaker R, Cinquin P, Cotten A, Lejeune JP (2001) Image-guided endoscopic spine surgery: Part I. A feasibility study. Spine 26(15): 1705–1710. doi:10.1097/00007632-200108010-00015

    CAS  Google Scholar 

  14. Assaker R, Reyns N, Pertruzon B, Lejeune JP (2001) Image-guided endoscopic spine surgery: Part II: clinical applications. Spine 26(15): 1711–1718. doi:10.1097/00007632-200108010-00016

    Article  PubMed  CAS  Google Scholar 

  15. Reinhold M, Bach C, Audigé L, Bale R, Attal R, Blauth M, Magerl F (2008) Comparison of two novel fluoroscopy-based stereotactic methods for cervical pedicle screw placement and review of the literature. Eur Spine J 17(4): 564–575

    Article  PubMed  CAS  Google Scholar 

  16. Holly LT, Bloch O, Johnson JP (2006) Evaluation of registration techniques for spinal image guidance. J Neurosurg Spine 4(4): 323–328. doi:10.3171/spi.2006.4.4.323

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, University of Leipzig, Leipzig, Germany

    C. Trantakis, M. Dengl & J. Meixensberger

  2. Innovation Center for Computer-Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany

    C. Trantakis, M. Dengl, R. Grunert, W. Korb, G. Strauss & J. Meixensberger

  3. Department of Oto-Rhino-Laryngology, University of Leipzig, Leipzig, Germany

    G. Strauss

  4. The Institute of Micro Technology and Medical Device Technology (MIMED), Technical University Munich, Munich, Germany

    T. Lueth

Authors
  1. C. Trantakis
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. M. Dengl
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. R. Grunert
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. W. Korb
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. G. Strauss
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. T. Lueth
    View author publications

    You can also search for this author inPubMed Google Scholar

  7. J. Meixensberger
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to M. Dengl.

Additional information

C. Trantakis and M. Dengl contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Trantakis, C., Dengl, M., Grunert, R. et al. Evaluation of a navigated and power controlled milling system “navigated control spine” for spinal surgery. Int J CARS 4, 487–495 (2009). https://doi.org/10.1007/s11548-009-0357-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11548-009-0357-3

Keywords