Grant: Project Grant

Each year more than 28,000 Canadians are treated surgically for lower back pain. Many of these cases require instrumentation with pedicle screws, which requires some form of X-ray imaging like fluoroscopy or intra-operative CT thus exposing patients and operating room personnel to significant amounts of harmful radiation. This project will adapt and clinically test a new intra-operative ultrasound-based navigation system that is an inexpensive, radiation-free alternative to intra-operative X-ray imaging. This novel technology allows for precise identification of the bony surface of the vertebrae without exposing the spine by merging the pre-operative CT and intra-operative ultrasound images. Such 3D renditions of the spine improve patient-to-image registration facilitating image-guided spine surgery. The novel system will be validated as a safe, accurate, and novel method for intraoperative guidance to perform instrumented lumbar spinal fusion and decompressions. The immediate benefits of this system compared to current standard intraoperative X-ray-based imaging technology are: 1) Elimination of all intraoperative radiation exposure to patient and operating room personnel 2) Real-time navigation at every level of the spine with intuitive visualization. 3) Increased accessibility (in terms of lower costs, smaller footprint, less cumbersome) of navigated spine surgery for all surgeons. 4) Decreased operating room time and thus decreased morbidity of spine surgery. 5) Improved accuracy of navigation through better registration. 6) Decreased numbers of malpositioned screws and consequently, reduced numbers of revision surgeries. And finally, 7) unlimited levels of fusion may be performed with the novel navigation method. This is of particular importance in scoliosis cases where current technology only captures 5 to 6 segments at a time and dose constraints limits the number of X-ray based images.