FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Veterinary surgery : VS2025; 54(5); 898-908; doi: 10.1111/vsu.14271

Accuracy of computer-assisted drilling of equine cervical vertebral bodies using a purpose-built cervical frame-An experimental cadaveric study.

Abstract: To assess the accuracy of computer-assisted surgery (CAS) of equine cervical vertebrae using a purpose-built cervical frame (CF) for neck stabilization. Methods: Experimental cadaveric study. Methods: Six whole fresh equine cadavers. Methods: Cadavers were positioned in dorsal recumbency with the neck extended within the CF. A cone-beam computed tomography (CBCT)-based surgical navigation system with optical tracking was used. A ventral approach exposed cervical vertebrae C3-C5. In each cadaver, 12 drill corridors were prepared with the patient tracker on the CF (position CF), followed by 12 corridors with the patient tracker on C3 (position C3). Surgical accuracy aberration (SAA) was assessed by measuring Euclidean distances between planned and executed entry and target points on merged pre- and postoperative datasets. Descriptive statistics and repeated-measures analyses of variance (rep.-meas. ANOVA) compared SAA measurements between groups. Results: The mean ± SD SAA (Euclidean distance) was 2.00 ± 0.98 mm in patient tracker position CF, and 2.41 ± 1.31 mm in position C3 (rep.-meas. ANOVA p = .215). At the most dorsal point of the drill corridor, dorsoventral deviations >2 mm occurred in 5/72 measurements in patient tracker position CF, and in 12/72 measurements in position C3. Conclusions: The CF allowed for unrestricted pre- and intraoperative CBCT imaging and computer-assisted drilling with a SAA in the close range of 2 mm. Positioning the patient tracker on the CF, outside the surgical field, did not compromise surgical accuracy. Conclusions: A CF can facilitate CAS for surgeries with a ventral approach to the equine cervical vertebral column.
© 2025 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
Get Full Text
Publication Date: 2025-05-15 PubMed ID: 40371965PubMed Central: PMC12282039DOI: 10.1111/vsu.14271Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This study evaluated the accuracy of computer-assisted drilling in the cervical vertebrae of horses using a specially designed cervical frame to stabilize the neck during surgery on cadaver specimens.
  • The research compared two different patient tracker positions during navigation to determine if the frame impacted surgical precision.

Background and Purpose

  • The cervical vertebrae (neck bones) are critical anatomical structures in horses, and precision is essential during surgical interventions to avoid complications.
  • Computer-assisted surgery (CAS) techniques improve accuracy in human and veterinary spine procedures by guiding instruments based on imaging and navigation systems.
  • This study tested a purpose-built cervical frame (CF) designed to stabilize the horse’s neck during surgery to facilitate cone-beam computed tomography (CBCT) imaging and navigation-assisted drilling.
  • The main goal was to assess the drilling accuracy using CBCT-based CAS with the patient tracker placed on the CF versus directly on the vertebra (C3) to see if the frame affected precision.

Methods

  • Six fresh equine cadavers were used, providing intact cervical spine anatomy for realistic testing.
  • Cadavers were positioned lying on their backs (dorsal recumbency) with extended necks secured within the cervical frame.
  • A ventral (front) surgical approach was used to expose cervical vertebrae C3 through C5 for drilling.
  • The CBCT-based surgical navigation system, equipped with optical tracking, was employed for visualizing anatomical targets and guiding drilling.
  • For each cadaver, 24 drill corridors (channels) were planned: 12 drilled with the patient tracker attached to the cervical frame (CF position) and 12 with the tracker directly on vertebra C3 (C3 position).
  • The surgical accuracy aberration (SAA) was quantified by measuring the Euclidean distance (3D straight-line distance) between the planned entry and target points and their actual locations post-drilling, using merged pre- and postoperative CBCT datasets.
  • Statistical analysis, including descriptive stats and repeated-measures ANOVA, compared the accuracy between the two tracker positions.

Results

  • The average surgical accuracy deviation (SAA) was approximately 2.00 ± 0.98 mm when the tracker was on the cervical frame (CF), and 2.41 ± 1.31 mm when on the vertebra C3; this difference was not statistically significant (p = 0.215).
  • At the most dorsal (back) point of the drill corridor, dorsoventral deviations greater than 2 mm were less frequent with the tracker on the CF (5 out of 72 measurements) compared to when on C3 (12 out of 72 measurements), suggesting slightly better control with the CF.
  • These deviations are considered clinically small and within acceptable limits for surgical procedures involving the equine cervical spine.

Conclusions and Implications

  • The purpose-built cervical frame allowed stable positioning and unrestricted access for intraoperative CBCT imaging and computer-assisted drilling in horse neck surgery.
  • Locating the patient tracker on the cervical frame, avoiding interference with the surgical field, did not reduce surgical accuracy compared to placing it directly on a vertebra.
  • This design facilitates surgical navigation workflows by keeping tracking devices outside the operating area, potentially improving sterility and ease of use.
  • The reported average deviation of about 2 mm is encouraging for use in clinical settings where precision is crucial, supporting application of CAS with the cervical frame in equine cervical spine surgeries.
  • Future directions may include clinical validation in live surgeries and exploration of the frame’s utility in various surgical interventions at different cervical levels.

Cite This Article

APA
Maurer T, de Preux M, Precht C, Vidondo B, Koch C. (2025). Accuracy of computer-assisted drilling of equine cervical vertebral bodies using a purpose-built cervical frame-An experimental cadaveric study. Vet Surg, 54(5), 898-908. https://doi.org/10.1111/vsu.14271

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 54
Issue: 5
Pages: 898-908

Researcher Affiliations

Maurer, Thimo
  • Division of Equine Surgery, Swiss Institute of Equine Medicine (ISME), Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.
de Preux, Mathieu
  • Division of Equine Surgery, Swiss Institute of Equine Medicine (ISME), Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.
Precht, Christina
  • Division of Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.
Vidondo, Beatriz
  • Veterinary Institute for Public Health, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.
Koch, Christoph
  • Division of Equine Surgery, Swiss Institute of Equine Medicine (ISME), Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.

MeSH Terms

  • Animals
  • Horses / surgery
  • Cervical Vertebrae / surgery
  • Cervical Vertebrae / diagnostic imaging
  • Cadaver
  • Surgery, Computer-Assisted / veterinary
  • Surgery, Computer-Assisted / methods
  • Surgery, Computer-Assisted / instrumentation
  • Cone-Beam Computed Tomography / veterinary

Grant Funding

  • Specialization Commission of the Vetsuisse Faculty, University of Bern
  • European College of Veterinary Surgeons (ECVS)

Conflict of Interest Statement

The authors declare no conflict of interest related to this report.

References

This article includes 23 references
  1. Pezzanite L, Easley J. Update on surgical treatment of wobblers.. Vet Clin North Am Equine Pract 2019;35:299‐309.
    doi: 10.1016/j.cveq.2019.04.002pubmed: 31147149google scholar: lookup
  2. Fürst AE. Vertebral column and spinal cord.. In: Auer JA, Stick JA, Kümmerle JM, Prange T, eds. Equine surgery. 5th ed. Elsevier; 2019; Ch. 53:864‐895.
  3. Woodie B, Johnson AL, Grant B. Cervical vertebral stenotic myelopathy.. Vet Clin North Am Equine Pract 2022;38:225‐248.
    doi: 10.1016/j.cveq.2022.05.002pubmed: 35953144google scholar: lookup
  4. Kühnle C, Fürst AE, Ranninger E, Suárez Sánchez‐Andrade J, Kümmerle JM. Outcome of ventral fusion of two or three cervical vertebrae with a locking compression plate for the treatment of cervical stenotic myelopathy in eight horses.. Vet Comp Orthop Traumatol 2018;31:356‐363.
    doi: 10.1055/s-0038-1666979pubmed: 30138950google scholar: lookup
  5. Pezzanite LM, Easley JT, Bayless R. Outcomes after cervical vertebral interbody fusion using an interbody fusion device and polyaxial pedicle screw and rod construct in 10 horses (2015‐2019).. Equine Vet J 2022;54:347‐358.
    doi: 10.1111/evj.13449pmc: PMC8505580pubmed: 33844334google scholar: lookup
  6. Rossignol F. Fractures of the vertebrae and sacrum.. In: Wright I, ed. Fractures in the Horse. Wiley; 2022; Ch. 34:715‐737.
  7. Tian N‐F, Huang Q‐S, Zhou P. Pedicle screw insertion accuracy with different assisted methods: a systematic review and meta‐analysis of comparative studies.. Eur Spine J 2011;20:846‐859.
    doi: 10.1007/s00586-010-1577-5pmc: PMC3099151pubmed: 20862593google scholar: lookup
  8. Peters KM, Hutter E, Siston RA, Bertran J, Allen MJ. Surgical navigation improves the precision and accuracy of tibial component alignment in canine total knee replacement.. Vet Surg 2016;45:52‐59.
    doi: 10.1111/vsu.12429pubmed: 26731596google scholar: lookup
  9. Rossol M, Gygax D, Andritzky‐Waas J. Comparison of computer assisted surgery with conventional technique for treatment of abaxial distal phalanx fractures in horses: an in vitro study.. Vet Surg 2008;37:32‐42.
    doi: 10.1111/j.1532-950X.2007.00346.xpubmed: 18199055google scholar: lookup
  10. de Preux M, Klopfenstein Bregger MD, Brünisholz HP, Van der Vekens E, Schweizer‐Gorgas D, Koch C. Clinical use of computer‐assisted orthopedic surgery in horses.. Vet Surg 2020;49:1075‐1087.
    doi: 10.1111/vsu.13486pubmed: 32677115google scholar: lookup
  11. de Preux M, Van der Vekens E, Racine J. Accessory carpal bone fracture repair by means of computer‐assisted orthopaedic surgery in a warmblood stallion.. Equine Vet Educ 2022;34:478‐484.
    doi: 10.1111/eve.13594google scholar: lookup
  12. Claeys I, Van der Vekens E, Kümmerle J, de Preux M, Koch C. Computer‐assisted surgery for placing toggle constructs across the coxofemoral joints of small equids using a minimally invasive approach‐a proof‐of‐concept cadaveric study.. Vet Surg 2023;52:994‐1008.
    doi: 10.1111/vsu.14004pubmed: 37496312google scholar: lookup
  13. Guevar J, Samer ES, Precht C, Rathmann JMK, Forterre F. Accuracy and safety of neuronavigation for minimally invasive stabilization in the thoracolumbar spine using polyaxial screws‐rod: a canine cadaveric proof of concept.. Vet Comp Orthop Traumatol 2022;35:370‐380.
    doi: 10.1055/s-0042-1750056pubmed: 35760365google scholar: lookup
  14. Uehara M, Takahashi J, Ikegami S. Are pedicle screw perforation rates influenced by distance from the reference frame in multilevel registration using a computed tomography‐based navigation system in the setting of scoliosis?. Spine J 2017;17:499‐504.
    doi: 10.1016/j.spinee.2016.10.019pubmed: 27777053google scholar: lookup
  15. Cammarata G, Scalia G, Costanzo R. Fluoroscopy‐assisted freehand versus 3D‐navigated imaging‐assisted pedicle screw insertion: a multicenter study.. Acta Neurochir Suppl 2023;135:425‐430.
    doi: 10.1007/978-3-031-36084-8_65pubmed: 38153504google scholar: lookup
  16. de Preux M, Vidondo B, Koch C. Influence of a purpose‐built frame on the accuracy of computer‐assisted orthopedic surgery of equine extremities.. Vet Surg 2020;49:1367‐1377.
    doi: 10.1111/vsu.13484pubmed: 32652599google scholar: lookup
  17. Medtronic . StealthStation S8 cranial optical Kurzhandbuch. Medtronic Navigation. Louisville; 2019.
  18. de Preux M, Precht C, Travaglini AT. Influence of the Vertek aiming device on the surgical accuracy of computer‐assisted drilling of the equine distal sesamoid bone‐an experimental cadaveric study.. Vet Surg 2024;54:118‐128.
    doi: 10.1111/vsu.14176pmc: PMC11734870pubmed: 39445680google scholar: lookup
  19. Mota F, Welch N, Montgomery BK, Birch C, Hedequist D. Use of a high‐speed drill in robotics coupled with navigation for pediatric spine surgery.. J Robot Surg 2023;17:1511‐1516.
    doi: 10.1007/s11701-023-01534-wpubmed: 36862349google scholar: lookup
  20. Mihalko WM, Duquin T, Axelrod JR, Bayers‐Thering M, Krackow KA. Effect of one‐ and two‐pin reference anchoring systems on marker stability during total knee arthroplasty computer navigation.. Comput Aided Surg 2006;11:93‐98.
    doi: 10.3109/10929080600668122pubmed: 16782645google scholar: lookup
  21. Frisk H, Burström G, Persson O. Automatic image registration on intraoperative CBCT compared to surface matching registration on preoperative CT for spinal navigation: accuracy and workflow.. Int J Comput Assist Radiol Surg 2024;19:665‐675.
    doi: 10.1007/s11548-024-03076-4pmc: PMC10973038pubmed: 38378987google scholar: lookup
  22. Jin M, Liu Z, Qiu Y, Yan H, Han X, Zhu Z. Incidence and risk factors for the misplacement of pedicle screws in scoliosis surgery assisted by O‐arm navigation‐analysis of a large series of one thousand, one hundred and forty five screws.. Int Orthop 2017;41:773‐780.
    doi: 10.1007/s00264-016-3353-6pubmed: 27999927google scholar: lookup
  23. Stieglitz LH, Fichtner J, Andres R. The silent loss of neuronavigation accuracy: a systematic retrospective analysis of factors influencing the mismatch of frameless stereotactic systems in cranial neurosurgery.. Neurosurgery 2013;72:796‐807.
    doi: 10.1227/NEU.0b013e318287072dpubmed: 23334280google scholar: lookup

Citations

This article has been cited 1 times.
  1. Klopfenstein Bregger MD, de Preux M, Brünisholz HP, Van der Vekens E, Schweizer D, Koch C. Cheek tooth repulsion aided by computer-assisted surgery in 16 equids. Front Vet Sci 2025;12:1571539.
    doi: 10.3389/fvets.2025.1571539pubmed: 41133193google scholar: lookup
Subscribe to our newsletter
Join 99,970 horse owners like you who receive our email updates on horse health and nutrition.