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ORIGINAL RESEARCH article
Front. Vet. Sci.
Sec. Veterinary Surgery
Volume 11 - 2024 |
doi: 10.3389/fvets.2024.1510253
This article is part of the Research Topic The Integration of Clinical Veterinary Anatomy and Diagnostic Imaging View all 11 articles
Feline sacroiliac luxation: comparison of fluoroscopy-controlled freehand versus computer-navigated drilling in the sacrum -a cadaveric study
Provisionally accepted- 1 Tierklinik Marigin, Feusisberg, Switzerland
- 2 Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Bern, Switzerland
- 3 Department of Clinical Research and Veterinary Public Health, Vetsuisse-Faculty, University of Bern, Bern, Switzerland
Introduction: Sacroiliac luxation is a common traumatic feline injury, with the small size of the sacral body being a challenge for surgical stabilization. This study compared an innovative computerguided drilling method with the conventional fluoroscopy-controlled freehand technique. Neuronavigation, using CT-based planning and real-time tracking, was evaluated against the freehand method for accuracy and time efficiency.Material and Methods: Bilateral sacroiliac luxation was induced in 20 feline cadavers. One side of the sacral body was drilled using fluoroscopy, and the other with neuronavigation (Stealth Station S8). A reference frame was affixed to the sacral spinous process for tracking. Ten cats were operated on by an ECVS diplomate and ten by a resident. Postoperative cone beam CT images were used to assess both techniques, comparing the accuracy of the planned corridor versus the actual drill hole in the sacrum. A learning curve for both methods was estimated by measuring procedure time.Results: CT scan assessments showed all 40 drill holes achieved "surgically satisfactory" results. The computer-navigated technique demonstrated an average deviation of 1.9 mm (SD 1.0 mm) at the entry point and 1.6 mm (SD 0.8 mm) at the exit point. The pins of 3/20 reference frames penetrated the vertebral canal, creating a risk for potential clinical complications. The neuronavigation-guided procedures took an average of 23 minutes and 37 seconds (SD 8 minutes 34 seconds), significantly longer than the freehand technique, which averaged 9 minutes and 47 seconds (SD 3 minutes 26 seconds). A steep learning curve was observed with neuronavigation.Discussion: The neuronavigation-guided technique achieved accuracy is comparable to the fluoroscopy-controlled method, is offering real-time feedback and has potential for highly precise surgeries near critical anatomical structures. However, significant attention must be given to the placement of the reference frame, as it is placed blindly and presents a potential risk for errors and complications. Despite its longer duration, the neuronavigation method shows promise for improving precision in complex surgical scenarios.
Keywords: Neuronavigation, Stealth Station S8, Computer-navigated surgery, Sacroiliac luxation, cat, Cadaveric study
Received: 12 Oct 2024; Accepted: 31 Dec 2024.
Copyright: © 2024 Kleiner, Wolf, Precht, Haenssgen, Forterre and Duever. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lukas Kleiner, Tierklinik Marigin, Feusisberg, Switzerland
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