This paper presents an advanced augmented reality system for spinal surgery assistance and develops entry-point guidance prior to vertebroplasty spinal surgery. Degenerative and osteoporotic spinal diseases have become increasingly prevalent over the past two decades. And now have an advanced augmented reality based system that to let the doctor able to see through the patients anatomy thats call arcass system. It using the proposed camera-projector system superimposes pre-operative 3d images into the patient. arcass system is experimentally tested on a preoperative 3d model dummy patient model and animal cadaver model. During minimally invasive procedures they must track needles and other operative instruments. Navigation systems are complicated expensive and often require extra training. They sometimes need tracking devices which are them invasive since they are fixed to rigid body parts such as bones. Ar has been extensively researched for intraoperative visualization throughout the past decade. In this technique real images are merged with computer graphics to enhance the multimedia information surrounding the user. Therefore we propose that spinal surgeons may be intraoperatively guided by projection-based ar techniques using preoperative ct images of the patient. Compared to traditional laparoscopy ar systems offer extended field of view multiple viewing directions flexible positioning of patients and less mismatch between the views of surgeon and instruments. During the test on dummy simulation arcass system shows the dummy and a spinal image projected onto the dorsal surface of the dummy. Next for the animal cadaver test it was performed on two pieces of pork using real-time patient surgical procedures. First the ct images were scanned and 3d modeling and labeling were performed using the visible patient tool. The arcass system performed well on dummy and animal cadaver experiments and also in clinical trials of orthopedic surgery. Because the feasibility of the system has been demonstrated in real patients the trials have been accepted by the institutional review board. The spinal surgeons provided very positive feedback on the proposed system. However the arcass system contains some potential errors which may limit its applicability. First if the patients significantly alter their postures between ct scan and intra-operative surgery the projected spinal image may not satisfactorily map onto the body surface. Second errors are inherent in both the camera calibration step and in manually selecting the markers for image registration.
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