학술논문

Patient-specific instrument can achieve same accuracy with less resection time than navigation assistance in periacetabular pelvic tumor surgery: a cadaveric study
Document Type
Original Paper
Source
International Journal of Computer Assisted Radiology and Surgery: A journal for interdisciplinary research, development and applications of image guided diagnosis and therapy. February 2016 11(2):307-316
Subject
Navigation assistance
Patient-specific instruments
Periacetabular pelvic tumors
Surgical accuracy
Language
English
ISSN
1861-6410
1861-6429
Abstract
Purpose:Inaccurate resection in pelvic tumors can result in compromised margins with increase local recurrence. Navigation-assisted and patient-specific instrument (PSI) techniques have recently been reported in assisting pelvic tumor surgery with the tendency of improving surgical accuracy. We examined and compared the accuracy of transferring a virtual pelvic resection plan to actual surgery using navigation-assisted or PSI technique in a cadaver study.Methods:We performed CT scan in twelve cadaveric bodies including whole pelvic bones. Either supraacetabular or partial acetabular resection was virtually planned in a hemipelvis using engineering software. The virtual resection plan was transferred to a CT-based navigation system or was used for design and fabrication of PSI. Pelvic resections were performed using navigation assistance in six cadavers and PSI in another six. Post-resection images were co-registered with preoperative planning for comparative analysis of resection accuracy in the two techniques.Results:The mean average deviation error from the planned resection was no different (p=0.0006) for the navigation group than for the PSI group: 16.2 versus 1.1 min, respectively.Conclusions:In simulated periacetabular pelvic tumor resections, PSI technique enabled surgeons to reproduce the virtual surgical plan with similar accuracy but with less bone resection time when compared with navigation assistance. Further studies are required to investigate the clinical benefits of PSI technique in pelvic tumor surgery.