Radiographs in AP view, lateral flexion-extension view, and open-month view were checked for bone structure and stability (Figures 1(a) and 1(b) ). Before surgery, 128-slice spiral CT scanning (Philips, iCT 256) was carried out. Patients were placed supine for spinal CT axial scanning, and the data were recorded in DICOM format in the computer. The scanning conditions were 140 kV voltage and 171 mA electric current. The scanning parameters included image matrix 512 × 512, slice thickness 0.9 mm, pitch 0.49, and reconstruction slice thickness of 1 mm. Careful preoperative study of this CT scan with 3D reconstruction including the occiput was acquired to check occipital bone thickness, vertebral artery, and diameter and length estimation of the lateral mass or transpedicle screw before operation (Figure 2 ). In the cases with CT-based IGS, the images were then transferred into the navigation system (BrainLAB Vector Vision Navigation System).
Vector vision navigation system
Manufactured by Brainlab
The Vector Vision Navigation System is a surgical navigation tool designed to assist medical professionals during surgical procedures. The core function of this system is to provide accurate and real-time tracking of surgical instruments in relation to the patient's anatomy, enabling enhanced precision and guidance during the operation.
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Lab products found in correlation
2 protocols using vector vision navigation system
1
Preoperative Radiographic and CT Evaluation for Spinal Surgery
2
Marker-Assisted Surgical Navigation for ZMC Fracture Reduction
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For patients in the navigation group, the intervention was completed according to the method of marker-assisted surgical navigation. 20 After 3D image construction and segmentation, 3D cylindrical objects (STL format) were positioned in specific locations on the surface of the digital model of the ZMC fragments. Then, the cylindrical object data were merged with the skull data to create ''the localization plan'' (Fig 1A). The data also were merged with the ZMC fracture segments and the simulated reduction was performed according to the mirrored image, thus yielding ''the reduction plan'' (Fig 1B). The VectorVision navigation system (BrainLAB) was used for intraoperative navigation. After the induction of general anesthesia, a reference frame with 3 light-reflecting balls was rigidly fixed to the patient's skull to identify the patient's position. Subsequently, the registration was completed through facial surface scanning using a Z-touch wireless laser pointer; this software automatically verified the registration accuracy of the surgical area in all patients, and the registration error was smaller than 1.0 mm in all cases. The surface markers were added by drilling holes in the fractured bones before osteotomy according to the localization plan. Then, the segments were reduced to the planned positions according to the reduction plan (Fig 1C,D).
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