An Ultrasound Technique of Bone Thickness Estimation for Pedicle Screw Insertion

Abstract

Information on bone thickness is useful to surgeons in fixing pedicle screws in place. The quality of pedicle screw insertion continues to increase with the introduction of such techniques as navigation based on computed tomography and fluoroscopy. These techniques reduce error in pedicle screw placement and injury. However, the information reported on the real time measurement of depths drilled through cancellous bone, also known as trabecular bone or sponge bone, by the pedicle screw is minimal. It currently depends on palpation by the physician for judging the boundary between cortical and cancellous bone – an inaccurate technique that may produce errors in screw placement and the risk of injury during surgical processes. Ultrasound is used to help overcome such problems. Bone thickness is estimated in this study using an ultrasound transducer attached to 20 mm of polymethyl methacrylate, a clear glass-like acrylic. The bone thickness of five specimens was measured using ultrasound echo signals. Error in estimating bone thickness was small, 8.121%, showing the accuracy in bone thickness to be more than 90.00% which is suitable for use in estimating bone thickness in pedicle screw insertion.