New technology helps surgeons perform complex spinal deformity surgery. A 3D spinal navigation system and tactile 3D model displays allow surgeons to recognize abnormal spine anatomy without mentally reconstructing images. The 3D displays facilitate pre-operative planning of pedicle screw insertion and osteotomies, and provide visual support during surgery to accurately determine screw entry points and the extent of bone resection.

1. Complex Deformity Surgery
New technology helps us
Okayama University, Dept. of Orthopaedics
Yoshihisa Sugimoto, M.D.

2. Spinal Navigation System 3D models

3. 12 y.o. congenital scoliosis

4. Complex Deformity
Screw insertion ??
Osteotomy??

5. Why is this surgery difficult?

6. First point: Abnormal Spine
During PS insertion we can not look inside
Insert screw into spine based on normal
anatomy images
But this is abnormal spine……

7. We can recognize anatomy
with mental reconstruction of multiple images
such as Xp, CT, MRI
If we treat complex deformity…….
mental reconstruction of multiple images is difficult

8. 3D model helps us to recognize
anatomy without mental reconstruction

9. Tactile 3D display
Rotate by own
Mental reconstruction of images is easy
Surgical planning
Support tool during surgery

10. Case 1. 00 y.o. female Kyphoscoliosis

11. Surgical planning

12. Pedicle screw insertion
narrow pedicle

13. Osteotomy
cut line

14. Figure 4.

15. 2D-Display 3D-Display

16. Display
X-ray
CT Films
MRI

17. Is this 3D-CT ??
DICOM data have 3D data
2D image on 2D monitor
Shadow is expressive of concavity and convexity.

18. 3D model (A tactile 3D display)
recognize anatomic relations between ant. and post
elements without mental reconstruction of multiple images
✓Surgical planning about PS insertion and bony resection.
✓Rotate 3D model by own.

19.
Navigation system
recognize anatomy which is invisible in operative field
✓Determine PS entry point, direction
✓Confirm range of vertebral body or disc resection.

20.
Navigation system
recognize anatomy which is invisible in operative field
✓Determine PS entry point, direction
✓Confirm range of vertebral body or disc resection.

21. Musashi was a master of
two swords.
First sword: Navigation
Second sword: 3D model
Thank you for your attention