Intraoperative surgical guidance for placement of orthopedic hardware

Purpose: To develop a computerized intraoperative tracking system that directs the surgeon in the precise positioning of orthopedic surgical hardware. This would allow for reduced operating time and less radiation exposure.

Methods: Currently, the surgeon is able to direct placement of hardware by using intraoperative fluoroscopy. Specifically, in the case of long bone fixation, intramedullary rods are frequently used for fixation. Interlocking screws are used to control rotation of the rod. Placement of the interlocking screws is achieved by positioning the fluoroscan to create a "perfect circle". This perfect circle then acts as a visual guide for the surgeon the direct the drill and then the screw. Obviously, the current method has multiple trial and error steps which lead to greater radiation exposure and prolonged surgical time. The current system has several disadvantages that can be overcome by the use of intraoperative surgical guidance using a computerized tracking system. Computerized tracking systems have a 1mm accuracy, which is adequate for this purpose. Images can be displayed on a computer monitor or incorporated in an augmented reality display system such as the Sony Glasstron head-mounted display shown here.

Results: Similar systems are currently used by neurosurgeons for access to brain lesions that are difficult to get to. Adaptation of this system for other surgical procedures is currently in progress. Within the next six months this system will be used in the operating room for craniofacial surgery.