Secondary Logo

Institutional members access full text with Ovid®

Comparison of the Clinical Accuracy Between Point-to-Point Registration and Auto-Registration Using an Active Infrared Navigation System

Zhao, Jingwei, MD∗,†; Liu, Yajun, MD∗,†; Fan, Mingxing, MD∗,†; Liu, Bo, MD∗,†; He, Da, MD∗,†; Tian, Wei, MD, PhD∗,†

doi: 10.1097/BRS.0000000000002704

Study Design. A model experiment.

Objective. To measure and compare the clinical accuracy of point-to-point registration (PR) and auto-registration (AR) in an operative set using an active infrared navigation system.

Summary of Background Data. PR and AR are two major registration methods of navigation assisted spinal surgery. No previous study compared the difference between the two methods with respect to clinical accuracy.

Methods. A novel method was used to measure the clinical accuracy of the navigation system under an operative set using a Sawbone model with titanium beads on the surface, which was essential to measure the accuracy numerically, instead of a real patient. Both the operative set and the procedure mimicked a regular surgery. The clinical accuracy was defined as the average distance between the “navigation coordinate” and the “image coordinate.” The clinical accuracy of the PR using preoperative computed tomography (CT) images and the AR using intraoperative CT images was measured and compared.

Results. The average clinical accuracy of PR was different among different segments. The accuracy of the most accurate segment, which provided the reference points during the PR, was 1.10 mm. In the two segments adjacent to the reference segment, the clinical accuracy deteriorated to 1.37 and 1.50 mm. The accuracy of the farther segments was worse. In comparison, the clinical accuracy of different segments of AR was of no significant difference. The average accuracy of AR was 0.74 mm, which was significantly better than the best accuracy of PR.

Conclusion. AR is better than PR with respect to clinical accuracy in navigation assisted spinal surgery.

Level of Evidence: N/A

Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, People's Republic of China

Beijing Key Laboratory of Robotic Orthopaedics, Beijing, People's Republic of China.

Address correspondence and reprint requests to Wei Tian, MD, PhD, Department of Spine Surgery, Beijing Jishuitan Hospital, 31 Xinjiekou East Street, Xicheng District, 100035, Beijing, People's Republic of China; E-mail:

Received 6 March, 2018

Revised 9 April, 2018

Accepted 16 April, 2018

J.Z. and Y.L. have contributed equally to the work and should be regarded as co-first authors.

The device(s)/drug(s) is/are FDA approved or approved by corresponding national agency for this indication.

The National Natural Science Foundation of China (CN) (U1713221), the National Key Research and Development Program (CN) (2016YFC0105801), the National High-Tech Research and Development Program of China (CN) (2015AA043201), and the Beijing Municipal Science and Technology Program (CN) (Z171100000417019) grant funds were received in support of this work.

No relevant financial activities outside the submitted work.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.