Dr. Franziska Heider // Schön Klinik Munich Harlaching
Evaluating cervical fusion with a novel, innovative, bioactive 3D-printed titanium cage
Challenge
Manually measuring range of motion (RoM, I.e., segmental movement in flexion and extension) is a highly subjective and time-consuming clinical task with high variance between different observers.
Solution
As part of a study on the clinical and radiological outcomes of a novel, innovative, bioactive 3D-printed titanium cage, Dr. Fraziska Heider and her research colleagues used RAYLYTIC’s FXA™ (Functional X-Ray Analysis) method to precisely and accurately measure RoM.
Outcome
The method saved Dr. Heider enormous amounts of time as well as generated high-quality, absolutely valid and comparable data that are helping improve patient care and safety.
Excerpt
Dr. Franziska Heider is a senior physician at the Spine Center at the Schön Klinik Munich Harlaching. She needed a way to precisely, accurately, and objectively measure complex radiological parameters.
The analyses conducted by RAYLYTIC are helping her to better understand fusion behavior and improve the care of her patients.
Complex measurements in sensitive cervical fusoin surgeries
As part of a study investigating the clinical and radiological outcomes after anterior cervical discectomy and fusion (ACDF) using novel, innovative, bioactive 3D-printed titanium cages1, Dr. Franziska Heider and her research colleagues were looking for a valid and precise method to measure fusion.
They were interested in observing the postoperative behavior of these implants, for which range of motion (RoM) served as the most important indicator.
Previously, Dr. Heider had conducted exclusively manual RoM measurements to quantify cervical fusion. These were typically conducted on standardized DICOM viewers, so identifying and placing anatomical landmarks had to take place completely by hand.
In a study as sensitive as this one, manual RoM measurements would be too subjective and unreliable. Manual RoM measurements often suffer from high inter-rater variability. As Dr. Heider put it, “Even millimeter-wide variations in the placement of anatomical landmarks can maximally impact RoM values.”
Solution: FXA™ from RAYLYTIC
When confronted with this challenge, Dr. Heider and her colleagues remembered RAYLYTIC from their encounters at professional conferences over the years. They had always been impressed with the precisions of RAYLYTIC’s FXA™ method and knew this would be a solution to the problem of subjective cervical fusion measurements.
FXA™ is a scientifically validated software solution for automatically measuring complex parameters in functional radiographs. The method is remarkably precise, FDA approved, and has already been used in numerous international studies. It can calculate RoM values with a mean error of 0,04° ± 0,13°2 and therefore alleviates the problem of subjective and inaccurate measurements.
In this study, FXA™ was applied to functional radiographs gathered from a cohort of 28 patients having undergone ACDF with a porous titanium cage implant. Functional radiographs were captured preoperatively as well as at 3 and 12 months postoperatively in four different planes: anterior-posterior, lateral with the surgical site in both flexion and extension.
Outcomes
Winning back time
First and foremost, Dr. Heider was amazed at the method’s efficiency for quantifying cervical fusion. She noted that it saved the research team enormous amounts of time. Especially given the validity and precision of the measurements, Dr. Heider said that the method was an “unbelievably huge benefit” to the study.
Ready-to-use results
In addition to winning back time, Dr. Heider also benefited from the method during the preparation and interpretation of the results. The reports she received back from RAYLYTIC could be integrated directly into the study.
The results are also improving knowledge on implant behavior and thus patient satisfaction and safety. Dr. Heider observed statistically significant rapid integration of the bioactive implants just three months post-operatively. Furthermore, patients reported less pain and high levels of satisfaction. With this information, care processes and patient well-being can be improved.
Now more than ever, radiologists and surgeons are expected to optimize imaging workflows and consistently deliver high-quality care. RAYLYTIC is helping them to do both by unlocking the clinical value of artificial intelligence.
1. Mayer, Frizzi & Heider F, Haasters F, Mehren C (2022): Radiological and Clinical Outcomes after Anterior Cervical Discectomy and Fusion (ACDF) with an Innovative 3D Printed Cellular Titanium Cage Filled with Vertebral Bone Marrow. BioMed Research International. 2022(2): 1-8.
2. Schulze, Martin & Trautwein F, Vordemvenne T, Raschke M, Heuer F (2011): A method to perform spinal motion analysis from functional X-ray images. J Biomech 44(9): 1740-1746.