Accuracy of computer-assisted drilling of equine cervical vertebral bodies using a purpose-built cervical frame-An experimental cadaveric study.
Authors: Maurer Thimo, de Preux Mathieu, Precht Christina, Vidondo Beatriz, Koch Christoph
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Surgical navigation systems promise greater precision during complex spinal procedures, yet their practical application in equine cervical surgery remains underexplored. This cadaveric study evaluated a cone-beam computed tomography (CBCT)-based navigation system paired with a bespoke cervical frame designed to stabilise the neck whilst accommodating imaging and surgical access to vertebrae C3–C5 via a ventral approach. Across six equine cadavers, researchers drilled 24 bilateral corridors per specimen (144 total) and compared surgical accuracy when the optical tracking patient marker was positioned either on the stabilisation frame itself or directly on the C3 vertebra, measuring deviation between planned and actual entry and target points. Mean accuracy aberrations were negligible (2.00 mm with the frame-mounted marker versus 2.41 mm with vertebral attachment; p = 0.215), with dorsoventral deviations exceeding 2 mm occurring in only 5 of 72 corridors using frame-based tracking. Clinically, these findings support using computer-assisted navigation for ventral cervical procedures, with the practical advantage that markers need not be attached to bone—reducing operative time and soft-tissue disruption—without sacrificing the sub-3 mm precision necessary for safe instrumentation placement around critical neurovascular structures.
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Practical Takeaways
- •A purpose-built cervical frame enables accurate computer-assisted drilling of cervical vertebrae (±2 mm accuracy) with the added benefit of allowing unrestricted imaging without compromising the surgical field
- •Attaching the optical tracking system to the stabilization frame rather than the vertebra itself simplifies the surgical setup and reduces intraoperative adjustments while maintaining surgical precision
- •This technology may improve outcomes for ventral cervical spine surgeries by reducing navigation errors and improving vertebral body screw placement accuracy
Key Findings
- •Computer-assisted surgery using the cervical frame achieved mean surgical accuracy aberration of 2.00 ± 0.98 mm with patient tracker on frame versus 2.41 ± 1.31 mm with tracker on C3 vertebra (no significant difference, p = 0.215)
- •Positioning the patient tracker on the cervical frame outside the surgical field did not compromise accuracy while allowing unrestricted pre- and intraoperative imaging
- •Dorsoventral deviations >2 mm occurred in only 5/72 measurements (6.9%) with frame-based tracking compared to 12/72 (16.7%) with vertebra-based tracking