A pilot study to assess feasibility of a computer-assisted surgery system for navigation in the equine cervical spine.

Research Overview

• This study evaluated the feasibility and accuracy of the Synaptive Medical computer-assisted surgery (CAS) system for guiding surgical navigation in the equine cervical spine using cadaver models.
• The aim was to determine whether the system could accurately assist with targeting specific anatomical structures critical in spine surgery.

Introduction and Purpose

• The cervical spine in horses is a complex area where precise surgical navigation is essential to avoid complications.
• Computer-assisted surgery (CAS) systems are emerging technologies designed to improve surgical precision by providing real-time navigational guidance.
• The Synaptive Medical CAS system was selected for evaluation to see if it could be effectively used for equine cervical spine surgery.
• The primary goals were to test the accuracy of the system and assess whether surgical experience affected outcomes.

Materials and Methods

• Three equine cervical spine cadavers (from vertebrae C1 to T1) were prepared for an experimental pilot study.
• A custom fiducial array (a marker system used for tracking and registration) was mounted on the dorsal spinous process of the second cervical vertebra (C2), serving as a fixed reference point for navigation.
• Additional fiducial markers were distributed around the area to enhance landmark registration for the navigation system.
• Four participants with different levels of surgical experience were recruited to perform navigation tasks using the CAS system.
• Each participant guided radiodense pins into three distinct anatomical targets within the cervical spine:
  • Intervertebral foramen – the opening where nerves exit the spine
  • Articular process joint – a joint in the spine critical for motion and stability
  • Intervertebral disc – the cushioning structure between vertebrae
• Pre- and post-procedural computed tomography (CT) scans were used to measure the positions of planned target points and actual pin placements.
• Accuracy was quantified by calculating the Euclidean distance between the planned and achieved target points.
• Procedure duration was also recorded to measure how surgical experience may influence time taken for navigation-assisted pin placement.

Results

• The average navigation error across all placements was 11.33 mm, with a high variability indicated by a standard deviation of 11.02 mm.
• This shows that while some placements were very accurate, others had larger deviations from the planned target.
• Fiducial array placement on the dorsal spinous process of C2 proved effective for registration during the navigation procedure, meaning the system could reliably use these markers for spatial orientation.
• Surgical experience impacted the duration of the procedure, with more experienced surgeons typically completing the task faster.
• However, experience did not have a statistically significant effect on the accuracy of pin placement, suggesting that the CAS system may help to level the playing field regarding precision.

Conclusions and Implications

• The Synaptive Medical CAS system is feasible for use in equine cervical spine navigation-assisted surgery, showing promise for improving surgical precision in veterinary procedures.
• This pilot validation supports the integration of CAS technology into minimally invasive approaches that seek to reduce complications by enhancing accurate targeting of critical anatomical structures.
• The findings suggest CAS could serve as a valuable tool in clinical veterinary practice, potentially improving outcomes in complicated equine spine surgeries.
• Further studies with larger sample sizes and live animal models would be necessary to confirm system performance and clinical benefits.