Table-mounted vs. Bone-mounted Reference Frame Attachment in
Navigation-Assisted Orthopedic Surgery

Ilsar I. (1), Weil Y. (1), Mosheiff R. (1), Joskowicz L. (2), Peyser
A. (1), Liebergall M. (1)

(1) Department of Orthopedic Surgery, Hadassah Hebrew University Medical
    Center, Jerusalem, Israel.

(2) School of Engineering and Computer Science, Hebrew University, Jerusalem, Israel.

Abstract: 

Fluoroscopy-based navigation systems enable surgeons to simultaneously
correct parameters while placing implants in multiple two-dimensional
views. This facilitates implant placement in all planes with less radiation
and provides maximal accuracy. To enable a navigated procedure, a reference
rigid bony tracker named reference frame is rigidly attached fixed to a
stable bony structure. This may create technical obstacles such as
interference with surgical instruments and the fluoroscope and create an
additional albeit small operative site and subsequently local wound
complications could arise.  As an alternative, we propose to attach the
reference frame to the fracture table instead of the iliac crest, under the
assumption that no motion between the table-mounted reference frame and the
target organ will occur. We validate this assumption by comparing the
navigation accuracy while fixing the reference frame to the patient's bony
anatomy and to the operating table are not unfeasable.

Keywords: computer-aided orthoapedic surgery, trauma, navigation 

Published in: Proc. Int. Conf. on Computer-Aided Orthopaedic Surgery, CAOS
2005, Helsinki, Finland, June 2005, pp 180--183.