Innovative design and accuracy of optical and electromagnetic integrated surgical navigation system: phantom and in vivo studies

BACKGROUND: The application of different surgical navigation technologies has been moderate in gaining widespread acceptance on account of accuracy concerns, the technical complexity of different navigation systems and the cost-effectiveness. Until now, there is no study concentrated on integration of optical and electromagnetic system to solve the above problems. This study aims to develop a novel optical and electromagnetic integrated surgical navigation system and evaluate the accuracy. MATERIALS AND METHODS: The components, key techniques, and operating mechanisms of an optical and electromagnetic integrated surgical navigation system were detailed described. A tailored prosthesis module was used to estimate the technical error of the novel navigation system. The application accuracy of optical and electromagnetic navigation function was respectively evaluated in a controlled animal experiment. RESULTS: The technical error of optical electromagnetic integrated navigation system was 0.5 ± 0.1 mm in the phantom study. The application accuracy of electromagnetic navigation was 1.82 ± 0.05 mm in the in-vivo experiment. The application accuracy of optical navigation has detected no significant difference between experimental group and controlled group. The absolute translation and angular errors of all K-wires in both axial and sagittal planes found no significant difference between two groups. However, axial translational errors were higher than sagittal translation errors within the experimental group or the controlled group. Compared with in-vivo studies, a significantly lower needle-position error was found in the phantom study. CONCLUSION: The novel optical and electromagnetic integrated surgical navigation system is demonstrated that it not only retains the accuracy and stability compared with the traditional optical navigation system, but also has high precision electromagnetic navigation function. The registration accuracy of navigation can only represent the principle error of engineering, and the overall error of the actual application of navigation system should include the system registration error, human operation error and the error of navigation special tools.