Abstract
Although spinal surgeries with minimal incisions and a minimal amount of X-ray exposure (MIMA) mostly occur in a prone posture on a Wilson table, the prone posture’s effects on spinal muscles have not been investigated. Thus, this study used ultrasound shear-wave elastography (SWE) to compare the material properties of the erector spinae and multifidus muscles when subjects lay on the Wilson table used for spinal surgery and the flat table as a control condition. Thirteen male subjects participated in the study. Using ultrasound SWE, the shear elastic moduli (SEM) of the erector spinae and multifidus muscles were investigated. Significant increases were found in the SEM of erector spinae muscle 1, erector spinae muscle 2, and multifidus muscles on the Wilson table (W) compared to in the flat table (F; W:22.19 ± 7.15 kPa, F:10.40 ± 3.20 kPa, p < 0.001; W:12.10 ± 3.31 kPa, F: 7.17 ± 1.71 kPa, p < 0.001; W: 18.39 ± 4.80 kPa, F: 11.43 ± 2.81 kPa, p < 0.001, respectively). Our results indicate that muscle material properties measured by SWE can be changed due to table posture, which should be considered in biomechanical modeling by guiding surgical planning to develop minimal-incision surgical procedures.
Highlights
There has been a steady shift in spinal surgical techniques toward using minimal incisions and a minimal amount of X-ray exposure (MIMA) to lower blood loss, accelerate patient recovery, and shorten hospital stays [1]
Among several errors that could be made by robots, deviation in robotic-arm positioning and the trajectory of the robotic drill might be influenced by pressure that occurs while going through tissue [11]
Hypotheses supported our findings that muscles there were significant in the shear elasticOur moduli of the erector spinae and multifidus between the flat differences in the shear elastic moduli of the erector spinae and multifidus muscles and Wilson table postures
Summary
There has been a steady shift in spinal surgical techniques toward using minimal incisions and a minimal amount of X-ray exposure (MIMA) to lower blood loss, accelerate patient recovery, and shorten hospital stays [1]. To precisely perform spine surgery with MIMA, it might be necessary to accurately register a patient and an image to develop surgical robots and image-guided navigation systems. Various image-to-patient registration technologies exist on image-guided navigation systems for spinal surgeries [2,3,4,5,6]. Among several errors that could be made by robots, deviation in robotic-arm positioning and the trajectory of the robotic drill might be influenced by pressure that occurs while going through tissue [11]. To aid surgical procedures that use MIMA, utilizing aforementioned various image-to-patient registration technologies on the basis of the surface information of patients’ backs might not be enough to accurately estimate the spine location and possible biomechanics that could influence the trajectory of the robotic drill. Surgical training and planning can be better informed by surgical instrument and position [14,15]
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