提出MR导航系统StraightTrack,解决骨科穿刺导针弯曲导致定位不准问题。
StraightTrack: Towards Mixed Reality Navigation System for Percutaneous K-wire Insertion
- 用刚性套管减少软组织干扰,抑制导针弯曲
- 在模拟实验中定位误差<5.26mm,角度误差<2.88度
- 适合骨科医生做微创内固定手术的实时导航
经皮骨盆创伤手术中,克氏针(K-wires)的精准植入对骨折固定至关重要,避免因轨迹不当穿透骨皮质引发并发症。混合现实(MR)导航可实现低外形的精准引导,但现有方法因导针在体内易弯曲,难以保证视觉反馈精度,限制了实际应用。为此,我们提出StraightTrack,一种专为复杂解剖结构下经皮导针植入设计的MR导航系统。该系统采用带有刚性套管的标记体,有效减少导针与软组织及骨表面接触时的弯曲;结合光学透视头戴式显示器(OST HMD),通过追踪套管本体实现无需外部跟踪器的实时3D可视化与导航。两名经验丰富的骨科医生在模型实验中验证,StraightTrack将导针置入精度提升至5.26±2.29 mm、2.88±1.49°,显著优于对比方法(>12.08 mm,4.07°)。随着MR导航技术成熟,StraightTrack为内部骨折固定及其他经皮骨科操作提供了可行方案。
原文摘要 · Abstract (English)
In percutaneous pelvic trauma surgery, accurate placement of Kirschner wires (K-wires) is crucial to ensure effective fracture fixation and avoid complications due to breaching the cortical bone along an unsuitable trajectory. Surgical navigation via mixed reality (MR) can help achieve precise wire placement in a low-profile form factor. Current approaches in this domain are as yet unsuitable for real-world deployment because they fall short of guaranteeing accurate visual feedback due to uncontrolled bending of the wire. To ensure accurate feedback, we introduce StraightTrack, an MR navigation system designed for percutaneous wire placement in complex anatomy. StraightTrack features a marker body equipped with a rigid access cannula that mitigates wire bending due to interactions with soft tissue and a covered bony surface. Integrated with an Optical See-Through Head-Mounted Display (OST HMD) capable of tracking the cannula body, StraightTrack offers real-time 3D visualization and guidance without external trackers, which are prone to losing line-of-sight. In phantom experiments with two experienced orthopedic surgeons, StraightTrack improves wire placement accuracy, achieving the ideal trajectory within $5.26 \pm 2.29$ mm and $2.88 \pm 1.49$ degree, compared to over 12.08 mm and 4.07 degree for comparable methods. As MR navigation systems continue to mature, StraightTrack realizes their potential for internal fracture fixation and other percutaneous orthopedic procedures.
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