3D Surgical Alignment with 100µm Resolution Using Magnetic-Field Gradient-Based Localization

Abstract

Substantial advances in the field of surgery have taken place in recent years, which aim at decreasing patient morbidity through innovations in endoscopy, optical imaging, laparoscopic and robotic technologies. However, real-time imaging and navigation during high precision surgery necessitates the use of X-Ray fluoroscopy with most existing technologies to achieve precise localization. Intramedullary (IM) nailing is a common example of such high precision orthopedic surgery, which requires insertion of a nail into the medullary canal of a fractured bone followed by locking screws [1]. Proximal screw locking is performed using a mechanical guide, which is not possible for distal locking owing to the deformation (≈15mm) caused during insertion [2]. Freehand technique is typically used to localize distal holes, in which the surgical drill is aligned with the hole axis through fluoroscopic imaging. This process is time-consuming and exposes the patient and surgical team to high ionizing radiation. Various other methods, which reduce or eliminate irradiation during distal locking, are not widely used. This is attributed to their lack of compensation for significant deformation of the nail, added requirements such as computing systems, extra robotic arms, CT images, sophisticated hardware and software that require training for the surgeon and staff.