ELECTROMAGNETIC STEREOTACTIC COMPUTER （电磁立体电脑）.pdf

Egyetemi doktori (PhD) értekezés tézisei ELECTROMAGNETIC STEREOTACTIC COMPUTER-ASSISTED NAVIGATION IN MINIMALLY INVASIVE SURGERY Dr. Ronald von Jako Advisor: Professor Gyorgy Weber PhD Leader: Professor Erzsebet Roth University of Pecs, Faculty of Medicine Department of Surgical Research and Techniques Pécs, 2009 1. INTRODUCTION Stereotactic surgery also known as surgical navigation or image guided surgery (IGS) with computer assistance, is a technique utilizing imaging to guide surgery which was first developed for neurosurgery nearly two decades ago. It has continued to evolve and expand into additional applications such as endoscopic sinus surgery for procedures involving the paranasal sinuses, minimally invasive spine and orthopedic procedures. Surgery in these regions is particularly suited for navigation applications because of the proximity to the orbit and cranial cavities in rhinological procedures and neurovascular stuctures in spine and orthopedic surgeries that require higher degrees of anatomical precision. The key issue regarding navigation in paranasal sinus surgery is the inability to update preoperative CT images during dissection. An issue in pedicle screw instrumentation for spinal stabilization, is the accurate placement to avoid neurological or vascular injury. In spine, many techniques exist to aid in the accurate placement of pedicle screws, including blunt pedicle probes, ball-tipped feelers, intra-operative fluoroscopy, and more recently computer assisted image-guidance systems. Additionally, the use of intra-operative fluoroscopy for placement of pedicle screws or other modes of internal fixation has resulted in prolonged fluoroscopy time and radiation exposure to the surgical personnel and patient. Based on existing technology and principles used in stere