Construction d'un modèle per-opératoire 3D du rachis pour la navigation en thoracoscopie.

Visualization tools available while doing thoracoscopic diskectomy do not show depth information and the field of view of the miniaturized camera inserted into the patient is small. Also, simultaneous movement of the camera and surgical tools may result in disorientation. The learning curve for the use of this technology is very steep and numbers of surgeons choose not to use minimally invasive surgery despite important advantages for the patients. Indeed, thoracoscopic diskectomy reduce blood loss, trauma of surrounding soft tissues to access intervertebral disks and hospitalization time. Diskectomy are prescribed to specific scoliotic patients to gain flexibility of the spine before instrumentation surgery (fixation of screws and rod to correct the deformation). The intervertebral disk is partly resected depending on the level of flexibility the patient has to gain according to the surgeon. During thoracoscopic diskectomy, it is impossible for the surgeon to rapidly visualize the remaining disk tissue and this further increase the disadvantages for the surgeons. Hence, it is relevant to try to reduce visualization problems encountered during thoracoscopic diskectomy by providing to the surgeons a 3D view of the whole spine during the surgery, without adding supplementary radiation to the patient. The computer assisted surgery system would also increase the security of the patient by allowing the surgeons to localize rapidly in 3D the spinal canal as well as the remaining disk. The fusion of the video images with 3D spine of the patient is of great interest for the surgeons.