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International Journal of Computer Assisted Radiology and Surgery

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Open Access 01-10-2017 | Original Article

Statistical shape modelling to aid surgical planning: associations between surgical parameters and head shapes following spring-assisted cranioplasty

Authors: Naiara Rodriguez-Florez, Jan L. Bruse, Alessandro Borghi, Herman Vercruysse, Juling Ong, Greg James, Xavier Pennec, David J. Dunaway, N. U. Owase Jeelani, Silvia Schievano

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 10/2017

Abstract

Purpose

Spring-assisted cranioplasty is performed to correct the long and narrow head shape of children with sagittal synostosis. Such corrective surgery involves osteotomies and the placement of spring-like distractors, which gradually expand to widen the skull until removal about 4 months later. Due to its dynamic nature, associations between surgical parameters and post-operative 3D head shape features are difficult to comprehend. The current study aimed at applying population-based statistical shape modelling to gain insight into how the choice of surgical parameters such as craniotomy size and spring positioning affects post-surgical head shape.

Methods

Twenty consecutive patients with sagittal synostosis who underwent spring-assisted cranioplasty at Great Ormond Street Hospital for Children (London, UK) were prospectively recruited. Using a nonparametric statistical modelling technique based on mathematical currents, a 3D head shape template was computed from surface head scans of sagittal patients after spring removal. Partial least squares (PLS) regression was employed to quantify and visualise trends of localised head shape changes associated with the surgical parameters recorded during spring insertion: anterior–posterior and lateral craniotomy dimensions, anterior spring position and distance between anterior and posterior springs.

Results

Bivariate correlations between surgical parameters and corresponding PLS shape vectors demonstrated that anterior–posterior (Pearson’s \(r=0.64, p=0.002\)) and lateral craniotomy dimensions (Spearman’s \(\rho =0.67, p<0.001\)), as well as the position of the anterior spring (\(r=0.70, p<0.001\)) and the distance between both springs (\(r=0.67, p=0.002\)) on average had significant effects on head shapes at the time of spring removal. Such effects were visualised on 3D models.

Conclusions

Population-based analysis of 3D post-operative medical images via computational statistical modelling tools allowed for detection of novel associations between surgical parameters and head shape features achieved following spring-assisted cranioplasty. The techniques described here could be extended to other cranio-maxillofacial procedures in order to assess post-operative outcomes and ultimately facilitate surgical decision making.

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Title: Statistical shape modelling to aid surgical planning: associations between surgical parameters and head shapes following spring-assisted cranioplasty
Authors: Naiara Rodriguez-Florez
Jan L. Bruse
Alessandro Borghi
Herman Vercruysse
Juling Ong
Greg James
Xavier Pennec
David J. Dunaway
N. U. Owase Jeelani
Silvia Schievano
Publication date: 01-10-2017
Publisher: Springer International Publishing
Published in: International Journal of Computer Assisted Radiology and Surgery / Issue 10/2017
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-017-1614-5

At a glance: The STEP trials

Springer Medicine

Statistical shape modelling to aid surgical planning: associations between surgical parameters and head shapes following spring-assisted cranioplasty

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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