Show simple item record

dc.contributor.authorBurstom, Gustav
dc.contributor.authorSwamy, Akash
dc.contributor.authorSpliethoff, Jarich W.
dc.contributor.authorReich, Christian
dc.contributor.authorBabic, Drazenko
dc.contributor.authorHendriks, Benno H. W.
dc.contributor.authorSkulason, Halldor
dc.contributor.authorPersson, Oscar
dc.contributor.authorTerander, Adrian Elmi
dc.contributor.authorEdstrom, Erik
dc.date.accessioned2019-11-22T12:55:41Z
dc.date.available2019-11-22T12:55:41Z
dc.date.issued2019-11
dc.date.submitted2019-11
dc.identifier.citationBurström G, Swamy A, Spliethoff JW, Reich C, Babic D, Hendriks BH, Skulason H, Persson O, Terander AE, Edström E. Diffuse reflectance spectroscopy accurately identifies the pre-cortical zone to avoid impending pedicle screw breach in spinal fixation surgery. Biomedical Optics Express. 2019 Nov 1;10(11):5905-20. https://doi.org/10.1364/BOE.10.005905en_US
dc.identifier.issn2156-7085
dc.identifier.urihttp://hdl.handle.net/2336/621195
dc.descriptionTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Downloaden_US
dc.description.abstractPedicle screw placement accuracy during spinal fixation surgery varies greatly and severe misplacement has been reported in 1-6.5 % of screws. Diffuse reflectance (DR) spectroscopy has previously been shown to reliably discriminate between tissues in the human body. We postulate that it could be used to discriminate between cancellous and cortical bone. Therefore, the purpose of this study is to validate DR spectroscopy as a warning system to detect impending pedicle screw breach in a cadaveric surgical setting using typical clinical breach scenarios. DR spectroscopy was incorporated at the tip of an integrated pedicle screw and screw driver used for tissue probing during pedicle screw insertions on six cadavers. Measurements were collected in the wavelength range of 400-1600 nm and each insertion was planned to result in a breach. Measurements were labelled as cancellous, cortical or representing a pre-cortical zone (PCZ) in between, based on information from cone beam computed tomographies at corresponding positions. In addition, DR spectroscopy data was recorded after breach. Four typical pedicle breach types were performed, and a total of 45 pedicle breaches were recorded. For each breach direction, the technology was able to detect the transition of the screw tip from the cancellous bone to the PCZ (P < 0.001), to cortical bone (P < 0.001), and to a subsequent breach (P < 0.001). Using support vector machine (SVM) classification, breach could reliably be detected with a sensitivity of 98.3 % [94.3-100 %] and a specificity of 97.7 % [91.0-100%]. We conclude that DR spectroscopy reliably identifies the area of transition from cancellous to cortical bone in typical breach scenarios and can warn the surgeon of impending pedicle breach, thereby resulting in safer spinal fixation surgeries. (C) 2019 Optical Society of America under the terms of the OSA Open Access Publishing Agreementen_US
dc.language.isoenen_US
dc.publisherOSA Publishingen_US
dc.relation.urlhttps://www.osapublishing.org/boe/abstract.cfm?uri=boe-10-11-5905en_US
dc.subject.meshPedicle Screwsen_US
dc.subject.meshSpectrum Analysisen_US
dc.titleDiffuse reflectance spectroscopy accurately identifies the pre-cortical zone to avoid impending pedicle screw breach in spinal fixation surgeryen_US
dc.typeArticleen_US
dc.contributor.department[ 1 ] Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden Show more [ 2 ] Karolinska Univ Hosp, Dept Neurosurg, Stockholm, Sweden Show more [ 3 ] Delft Univ Technol, Dept Biomech Engn, Delft, Netherlands Show more [ 4 ] Royal Philips NV, Philips Res, Dept In Body Syst, Eindhoven, Netherlands Show more [ 5 ] Landspitali Univ Hosp, Dept Neurosurg, Reykjavik, Icelanden_US
dc.identifier.journalBiomedical Optics Expressen_US
dc.rights.accessOpen Access - Opinn aðganguren_US
dc.departmentcodeBRA12
refterms.dateFOA2019-11-22T12:55:42Z


Files in this item

Thumbnail
Name:
Diffuse ....pdf
Size:
6.595Mb
Format:
PDF

This item appears in the following Collection(s)

Show simple item record