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ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024

Computerized surgical navigation resection of pelvic region simulated bone tumors using skin fiducial marker registration: an in vitro cadaveric study.

John Whitaker, Tolani Are, Campbell Edwards, John Nyland, Shikha Sachdeva, Jon Carlson, Rodolfo Zamora

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

John WhitakerDepartment of Orthopaedic Surgery, University of Louisville, 550 S. Jackson St., 1st Floor ACB, Louisville, KY, 40202, USA.
Tolani AreDepartment of Orthopaedic Surgery, University of Louisville, 550 S. Jackson St., 1st Floor ACB, Louisville, KY, 40202, USA.
Campbell EdwardsDepartment of Orthopaedic Surgery, University of Louisville, 550 S. Jackson St., 1st Floor ACB, Louisville, KY, 40202, USA.
John NylandDepartment of Orthopaedic Surgery, University of Louisville, 550 S. Jackson St., 1st Floor ACB, Louisville, KY, 40202, USA.
Shikha SachdevaDepartment of Orthopaedic Surgery, University of Louisville, 550 S. Jackson St., 1st Floor ACB, Louisville, KY, 40202, USA.
Jon CarlsonDepartment of Orthopaedic Surgery, University of Louisville, 550 S. Jackson St., 1st Floor ACB, Louisville, KY, 40202, USA.
Rodolfo ZamoraDepartment of Orthopaedic Surgery, University of Louisville, 550 S. Jackson St., 1st Floor ACB, Louisville, KY, 40202, USA. rodolfo.zamora@louisville.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionComputerized surgical navigation system guidance can improve bone tumor surgical resection accuracy. This study compared the 10-mm planned resection margin agreement between simulated pelvic-region bone tumors (SPBT) resected using either skin fiducial markers or Kirschner (K)-wires inserted directly into osseous landmarks with navigational system registration under direct observation. We hypothesized that skin fiducial markers would display similar resection margin accuracy.

methodsSix cadaveric pelvises had one SPBT implanted into each supra-acetabular region. At the left hemi-pelvis, the skin fiducial marker group had guidance from markers placed over the pubic tubercle, the anterior superior iliac spine, the central and more posterior iliac crest, and the greater trochanter (5 markers). At the right hemi-pelvis, the K-wire group had guidance from 1.4-mm-diameter wires inserted into the pubic tubercle, and 3 inserted along the iliac crest (4 K-wires). The senior author, a fellowship-trained surgeon performed "en bloc" SPBT resections. The primary investigator, blinded to group assignment, measured actual resection margins.

resultsTwenty of 22 resection margins (91%) in the skin fiducial marker group were within the Bland-Altman plot 95% confidence interval for actual-planned margin mean difference (mean = -0.23 mm; 95% confidence intervals = 2.8 mm, - 3.3 mm). Twenty-one of 22 resection margins (95%) in the K-wire group were within the 95% confidence interval of actual-planned margin mean difference (mean = 0.26 mm; 95% confidence intervals = 1.7 mm, - 1.1 mm).

conclusionPelvic bone tumor resection with navigational guidance from skin fiducial markers placed over osseous landmarks provided similar accuracy to K-wires inserted into osseous landmarks. Further in vitro studies with different SPBT dimensions/locations and clinical studies will better delineate use efficacy.

Indexed as

Bone NeoplasmsCadaverFiducial MarkersMargins of ExcisionPelvic BonesSurgery, Computer-AssistedAnatomic LandmarksBone WiresFemaleHumansIliumMaleMedical imagingOrthopedic oncologySurgical planningTumor resection

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.