Principle investigator: Nasim Dadashi

     Co-PI: Alireza Ahmadian

Surgical navigation systems are used to assist surgeons in navigating within an intraoperative environment and in planning and guiding surgery. Similar to a car or mobile Global Positioning System (GPS), image guided surgery systems (IGS) use cameras or electromagnetic fields to capture and relay the patient’s anatomy and the surgeon’s precise movements in relation to the patient, to computer monitors in the operating room. Indeed, IGS is the use of a real-time correlation of the operative field to a preoperative imaging dataset that reflects the precise location of a selected surgical instrument to the surrounding anatomic structures. The accuracy of the IGS system is very crucial in localizing and positioning surgical instruments during surgery. Navigation surgery and Image-guided techniques have not been widely used in spinal surgery due to complicated patient registration process. It has been limited by several factors such as vertebral and intervertebral motions and inadequate immobilization of spine. In current techniques of spinal IGS, the surgical field is registered with a pre-operative computed tomography (CT), often obtained in a different spinal confirmation, or with intraoperative imaging such as fluoroscopy or intraoperative computed tomography (iCT). Intraoperative Stereovision (iSV) offers an alternative radiation-free method of registration to intraoperative CT (iCT). Intervertebral cumulative movements make the impossible use of skin-affixed fiducials and registration at the start of surgery could not compensate intervertebral motion between preoperative CT scans and intraoperative patient position. An automated registration procedure is proposed using iSV, which could accelerate adoption and improve outcomes, in addition to reducing costs, complexity, and x-ray dose associated with current spine surgical guidance methods. A total of four phases (phantom, cadaver, live animal, and human subjects) will be performed. The primary purpose of this study is to evaluate the performance of the iSV methods we previously developed in the setting of image-guided cranial surgery for rapid intraoperative patient registration and compensate intervertebral motion in open spinal surgery procedures with minimal operator intervention. If this proposal would be successful, these findings support the clinical feasibility of iSV to offer radiation-free, noninvasive imaging technique as the basis for establishing accurate, efficient and robust image-guidance and navigation during spinal surgery, and therefore, its potential to further increase the adoption of image-guidance in this surgical specialty.