Journal of Medical and Biological Engineering

, Volume 36, Issue 1, pp 44–52 | Cite as

Clinical Pedicle Screw Insertion Trials and System Improvement of C-arm Image Navigation System

  • Chih-Ju Chang
  • Ching-Hsiao Yu
  • Geng-Li Lin
  • Alex Tse
  • Hong-Yu Chu
  • Ching-Shiow Tseng
Original Article


C-arm-image-assisted navigation systems for orthopedic surgery have been applied clinically for several years. Pedicle screw implantation is one of the important applications. A precise definition of a C-arm X-ray projection model is the key requirement for a C-arm-assisted navigation system. This study proposes using a high-pass filter to extract the contour of large markers of the image calibrator and an adaptive threshold method to segment images of small markers, thus improving the overall recognition rate of markers and enhancing the robustness of image calibration. A method for time synchronization of X-ray imaging and the detection of a patient’s lumbar position data for respiration compensation is also proposed. Positioning accuracy evaluation of the developed C-arm-assisted navigation system was carried out clinically. The results show that the mean positioning error is 2.409 mm and that the mean direction error is 1.449°.


C-arm Surgical navigation Spinal surgery X-ray detection Image recognition 


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Copyright information

© Taiwanese Society of Biomedical Engineering 2016

Authors and Affiliations

  • Chih-Ju Chang
    • 1
    • 2
    • 3
  • Ching-Hsiao Yu
    • 1
    • 4
  • Geng-Li Lin
    • 1
  • Alex Tse
    • 1
  • Hong-Yu Chu
    • 1
  • Ching-Shiow Tseng
    • 1
  1. 1.Department of Mechanical EngineeringNational Central UniversityJhongli CityTaiwan, ROC
  2. 2.Department of NeurosurgeryCathay General HospitalTaipeiTaiwan
  3. 3.Department of Medicine, School of MedicineFu Jen Catholic UniversityNew Taipei CityTaiwan
  4. 4.Department of OrthopedicsTaoyuan General HospitalTaoyuanTaiwan

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