Registration accuracy in computer-assisted pelvic surgery

Introduction: An in vitro study was performed to assess the global registration accuracy of a computer-assisted system in pelvic orthopaedic surgery. The system was applied to a putative tumor resection in a pelvic sawbone. Methods: Twenty landmarks were created on the surface of the pelvis, and a virtual model of the sawbone was constructed based on surface extraction from computed tomography. The coordinates of the landmarks were defined in the CT-scan coordinate system, and registration of the sawbone with the virtual model was achieved using a surface-based matching algorithm. The landmarks were considered as control points, and deviations between their physical locations and their locations in the virtual model were calculated, thereby quantifying the global accuracy error. Results: The location of the initialization points was unimportant. The dynamic reference base gave the best results when placed far from the working area. Accuracy was improved when the sampling area was increased, but was decreased by its excessive expansion. Conclusions: It is recommended that the DRB be located on the contralateral side of the pelvis. Extending the approach posteriorly and including the entire working area in the sampling surface area, if possible, will also help increase accuracy in computer-assisted pelvic surgery.