Abstract
PurposeThe purpose of this paper is to present and validate a new semi-automated 3D surface mesh segmentation approach that optimizes the laborious individual human vertebrae separation in the spinal virtual surgical planning workflow and make a direct accuracy and segmentation time comparison with current standard segmentation method.MethodsThe proposed semi-automatic method uses the 3D bone surface derived from CT image data for seed point-based 3D mesh partitioning. The accuracy of the proposed method was evaluated on a representative patient dataset. In addition, the influence of the number of used seed points was studied. The investigators analyzed whether there was a reduction in segmentation time when compared to manual segmentation. Surface-to-surface accuracy measurements were applied to assess the concordance with the manual segmentation.ResultsThe results demonstrated a statically significant reduction in segmentation time, while maintaining a high accuracy compared to the manual segmentation. A considerably smaller error was found when increasing the number of seed points. Anatomical regions that include articulating areas tend to show the highest errors, while the posterior laminar surface yielded an almost negligible error.ConclusionA novel seed point initiated surface based segmentation method for the laborious individual human vertebrae separation was presented. This proof-of-principle study demonstrated the accuracy of the proposed method on a clinical CT image dataset and its feasibility for spinal virtual surgical planning applications.
Highlights
Patients suffering from spinal pathologies that cause instability of the spine are often treated with posterior rigid fixation surgery in order to immobilize the spine and to prevent further damage to the spinal cord [1,2,3]
We propose a semi-automated software tool that uses threshold-based 3D bone surface mesh derived from CT image data and separates individual vertebrae based on 3D surface positioned seed points
This study presents a semi-automated user-independent method for individual vertebrae separation
Summary
Patients suffering from spinal pathologies that cause instability of the spine are often treated with posterior rigid fixation surgery in order to immobilize the spine and to prevent further damage to the spinal cord [1,2,3]. Screws are inserted bilaterally through the pedicles or in the lateral mass at each segment level. The spinal segments to be fused are immobilized by the insertion of a rod through the polyaxial screw heads. Accurate screw insertion is important to minimize the risk of injuring nearby vital structures, such as the spinal cord and the nerve roots, and to facilitate a biomechanical stable fixation [4]. Due to advances in medical technology and the well-understood importance of accurate screw insertion, three-dimensional (3D) virtual surgical planning (VSP) has become increasingly popular since its emergence approximately two decades ago [5,6,7,8,9,10]. In the University Medical Center Groningen, VSP including the use of 3D printed drill guides is one of standard techniques for pedicle or lateral mass screw insertion in the cervical and upper thoracic spine
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