Towards Ultrasound-guided Spinal Fusion Surgery (eBook)

Dr. Amir Manbachi graduated with a Ph.D. in biomaterials and biomedical engineering from the University of Toronto in Ontario, Canada, and is currently at the Massachusetts Institute of Technology in the Division of Health Science and Technology.

Foreword 6
Parts of This Thesis Have Been Published in the Following Journal Articles and Patent Applications 8
Acknowledgements 10
Contents 12
About the Author 14
Chapter 1: Introduction 15
1.1 Spine Anatomy 15
1.2 Spinal Fusion Surgery 17
1.3 Screw Insertion in Spinal Fusion Procedure 17
1.4 Screw Misplacement: Error Rates and Clinical Significance 18
1.5 Thesis Motivation and Objectives 20
1.6 Organization of This Book 21
References 22
Chapter 2: Background Review 24
2.1 Educational Tools for Teaching Screw Insertion 24
2.2 Navigation Techniques for Guided Screw Insertion 27
2.2.1 Image-Guided Pedicle Screw Insertion 27
2.2.1.1 Intraoperative Fluoroscopy 27
2.2.1.2 Computer--Assisted Surgery 28
2.2.1.3 Ultrasonic-Guided Pedicle Screw Insertion 34
2.2.1.4 Other Imaging Approaches 36
2.2.2 Non-imaging Techniques 38
2.3 Concluding Remarks 40
2.4 Preliminary Transducer Design Specifications 40
References 44
Chapter 3: Organization of Pedicle Trabeculae 47
References 47
Chapter 4: Single Element Transducers 49
4.1 Background and Motivation 49
4.2 Design Aspects of the Transducers 50
4.2.1 Human Factors Aspects 50
4.2.2 Acoustic Design Aspects 51
4.3 Fabrication Methods of the Transducers 53
4.4 Characterization of the Transducers 56
4.5 Pulse-Echo Measurements of the Transducers 56
4.6 Experimental Image Acquisition of Human Pedicles 59
4.7 Comparison with Anatomy 62
4.8 Post-Processing the Ultrasound Images 64
4.9 Summary 66
References 67
Chapter 5: Ultrasound Imaging Radial Array: Design and Fabrication 68
5.1 Array Design 68
5.2 Array Fabrication 75
5.2.1 Fabrication Processes 75
5.2.2 Electrical Connections and Soldering 78
5.2.3 Electrical Impedance Matching 78
5.2.4 Incorporation of the Fabricated Array to the Surgical Toolkit 80
5.2.5 Electronic Interfacing with an Ultrasound System 81
5.2.6 Final Hardware Prototype 81
References 83
Chapter 6: Experimental Evaluation of the Array Performance 84
6.1 Small Metal Strip Reflector Inside a Water Tank 86
6.2 Water-Filled Glass Test Tube with an Embedded Small Reflector 89
6.3 Summary and Conclusions 93
References 94
Chapter 7: Summary of Contributions, Limitations, and Future Directions 95
7.1 Summary of Contributions 96
7.2 Limitations and Future Directions 97
7.2.1 Software Development 97
7.2.2 Hardware Development 99
References 101
Index 102