Free-walking:Pedestrian inertial navigation based on dual foot-mounted IMU

The inertial navigation system(INS),which is frequently used in emergency rescue operations and other situations,has the benefits of not relying on infrastructure,high positioning frequency,and strong real-time performance.However,the intricate and unpredictable pedestrian motion patterns lead the INS localization error to significantly diverge with time.This paper aims to enhance the accuracy of zero-velocity interval(ZVI)detection and reduce the heading and altitude drift of foot-mounted INS via deep learning and equation constraint of dual feet.Aiming at the observational noise problem of low-cost inertial sensors,we utilize a denoising autoencoder to automatically eliminate the inherent noise.Aiming at the problem that inaccurate detection of the ZVI detection results in obvious displacement error,we propose a sample-level ZVI detection algorithm based on the U-Net neural network,which effectively solves the problem of mislabeling caused by sliding windows.Aiming at the problem that Zero-Velocity Update(ZUPT)cannot suppress heading and altitude error,we propose a bipedal INS method based on the equation constraint and ellipsoid constraint,which uses foot-to-foot distance as a new observation to correct heading and altitude error.We conduct extensive and well-designed experiments to evaluate the performance of the proposed method.The experimental results indicate that the position error of our proposed method did not exceed 0.83% of the total traveled distance.

BDSec:Security Authentication Protocol for BeiDou-Ⅱ Civil Navigation Message

Due to the lack of authentication mechanism in BeiDou navigation satellite system(BDS),BD-Ⅱ civil navigation message(BDⅡ-CNAV) are vulnerable to spoofing attack and replay attack.To solve this problem,we present a security authentication protocol,called as BDSec,which is designed by using China’s cryptography Shangyong Mima(SM) series algorithms,such as SM2/4/9 and Zu Chongzhi(ZUC)algorithm.In BDSec protocol,both of BDⅡ-CNAV and signature information are encrypted using the SM4 algorithm(Symmetric encryption mechanism).The encrypted result is used as the subject authentication information.BDSec protocol applies SM9 algorithm(Identity-based cryptography mechanism) to protect the integrity of the BDⅡ-CNAV,adopts the SM2 algorithm(Public key cryptosystem) to guarantee the confidentiality of the important session information,and uses the ZUC algorithm(Encryption and integrity algorithm) to verify the integrity of the message authentication serial number and initial information and the information in authentication initialization sub-protocol respectively.The results of the SVO logic reasoning and performance analysis show that BDSec protocol meets security requirements for the dual user identity authentication in BDS and can realize the security authentication of BDⅡ-CNAV.

Method of improving pedestrian navigation performance based on chest card

With the development of positioning technology,loca-tion services are constantly in demand by people.As a primary location service pedestrian navigation has two main approaches based on radio and inertial navigation.The pedestrian naviga-tion based on radio is subject to environmental occlusion lead-ing to the degradation of positioning accuracy.The pedestrian navigation based on micro-electro-mechanical system inertial measurement unit(MIMU)is less susceptible to environmental interference,but its errors dissipate over time.In this paper,a chest card pedestrian navigation improvement method based on complementary correction is proposed in order to suppress the error divergence of inertial navigation methods.To suppress atti-tude errors,optimal feedback coefficients are established by pedestrian motion characteristics.To extend navigation time and improve positioning accuracy,the step length in subsequent movements is compensated by the first step length.The experi-mental results show that the positioning accuracy of the pro-posed method is improved by more than 47%and 44%com-pared with the pure inertia-based method combined with step compensation and the traditional complementary filtering com-bined method with step compensation.The proposed method can effectively suppress the error dispersion and improve the positioning accuracy.

Computer-assisted three-dimensional individualized extreme liver resection for hepatoblastoma in proximity to the major liver vasculature

BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,extreme liver resection can be considered a potential option.AIM To explore whether computer-assisted three-dimensional individualized extreme liver resection is safe and feasible for children with HB who still have PMV after a full course of NAC.METHODS We retrospectively collected data from children with HB who underwent surgical resection at our center from June 2013 to June 2023.We then analyzed the detailed clinical and three-dimensional characteristics of children with HB who still had PMV after a full course of NAC.RESULTS Sixty-seven children diagnosed with HB underwent surgical resection.The age at diagnosis was 21.4±18.8 months,and 40 boys and 27 girls were included.Fifty-nine(88.1%)patients had a single tumor,39(58.2%)of which was located in the right lobe of the liver.A total of 47 patients(70.1%)had PRE-TEXT III or IV.Thirty-nine patients(58.2%)underwent delayed resection.After a full course of NAC,16 patients still had close PMV(within 1 cm in two patients,touching in 11 patients,compressing in four patients,and showing tumor thrombus in three patients).There were 6 patients of tumors in the middle lobe of the liver,and four of those patients exhibited liver anatomy variations.These 16 children underwent extreme liver resection after comprehensive preoperative evaluation.Intraoperative procedures were performed according to the preoperative plan,and the operations were successfully performed.Currently,the 3-year event-free survival of 67 children with HB is 88%.Among the 16 children who underwent extreme liver resection,three experienced recurrence,and one died due to multiple metastases.CONCLUSION Extreme liver resection for HB that is still in close PMV after a full course of NAC is both safe and feasible.This approach not only reduces the necessity for liver transplantation but also results in a favorable prognosis.Individualized three-dimensional surgical planning is beneficial for accurate and complete resection of HB,particularly for assessing vascular involvement,remnant liver volume and anatomical variations.

Effect of navigation endoscopy combined with threedimensional printing technology in the treatment of orbital blowout fractures

●AIM:To explore the combined application of surgical navigation nasal endoscopy(NNE)and three-dimensional printing technology(3DPT)for the adjunctive treatment of orbital blowout fractures(OBF).●METHODS:Retrospective analysis was conducted on the data of patients with OBF who underwent surgical treatment at the Affiliated Eye Hospital of Nanchang University between July 2012 and November 2022.The control group consisted of patients who received traditional surgical treatment(n=43),while the new surgical group(n=52)consisted of patients who received NNE with 3DPT.The difference in therapeutic effects between the two groups was evaluated by comparing the duration of the operation,best corrected visual acuity(BCVA),enophthalmos difference,recovery rate of eye movement disorder,recovery rate of diplopia,and incidence of postoperative complications.●RESULTS:The study included 95 cases(95 eyes),with 63 men and 32 women.The patients’age ranged from 5 to 67y(35.21±15.75y).The new surgical group and the control group exhibited no statistically significant differences in the duration of the operation,BCVA and enophthalmos difference.The recovery rates of diplopia in the new surgical group were significantly higher than those in the control group at 1mo[OR=0.03,95%CI(0.01–0.15),P<0.0000]and 3mo[OR=0.11,95%CI(0.03–0.36),P<0.0000]postoperation.Additionally,the recovery rates of eye movement disorders at 1 and 3mo after surgery were OR=0.08,95%CI(0.03–0.24),P<0.0000;and OR=0.01,95%CI(0.00–0.18),P<0.0000.The incidence of postoperative complications was lower in the new surgical group compared to the control group[OR=4.86,95%CI(0.95–24.78),P<0.05].●CONCLUSION:The combination of NNE and 3DPT can shorten the recovery time of diplopia and eye movement disorder in patients with OBF.

Anti-Spoofing:Integrated Information Authentication of BeiDou-ⅡCivil Navigation Message

The BeiDou-Ⅱcivil navigation message(BDⅡ-CNAV)is transmitted in an open environment and no information integrity protection measures are provided.Hence,the BDⅡ-CNAV faces the threat of spoofing attacks,which can lead to wrong location reports and time indication.In order to deal with this threat,we proposed a scheme of anti-spoofing for BDⅡ-CNAV based on integrated information authentication.This scheme generates two type authentication information,one is authentication code information(ACI),which is applied to confirm the authenticity and reliability of satellite time information,and the other is signature information,which is used to authenticate the integrity of satellite location information and other information.Both authentication information is designed to embed into the reserved bits in BDⅡ-CNAV without changing the frame structure.In order to avoid authentication failure caused by public key error or key error,the key or public key prompt information(KPKPI)are designed to remind the receiver to update both keys in time.Experimental results indicate that the scheme can successfully detect spoofing attacks,and the authentication delay is less than 1%of the transmission delay,which meets the requirements of BDⅡ-CNAV information authentication.

Diagnostic efficacy of virtual organ computer-assisted analysis in measuring the volume ratio of subchorionic hematoma with serum progesterone

BACKGROUND Subchorionic hematoma(SCH)is a common complication in early pregnancy characterized by the accumulation of blood between the uterine wall and the chorionic membrane.SCH can lead to adverse pregnancy outcomes such as miscarriage,preterm birth,and other complications.Early detection and accurate assessment of SCH are crucial for appropriate management and improved pregnancy outcomes.AIM To evaluate the diagnostic efficacy of virtual organ computer-assisted analysis(VOCAL)in measuring the volume ratio of SCH to gestational sac(GS)combined with serum progesterone on early pregnancy outcomes in patients with SCH.METHODS A total of 153 patients with SCH in their first-trimester pregnancies between 6 and 11 wk were enrolled.All patients were followed up until a gestational age of 20 wk.The parameters of transvaginal two-dimensional ultrasound,including the circumference of SCH(Cs),surface area of SCH(Ss),circumference of GS(Cg),and surface area of GS(Sg),and the parameters of VOCAL with transvaginal three-dimensional ultrasound,including the three-dimensional volume of SCH(3DVs)and GS(3DVg),were recorded.The size of the SCH and its ratio to the GS size(Cs/Cg,Ss/Sg,3DVs/3DVg)were recorded and compared.RESULTS Compared with those in the normal pregnancy group,the adverse pregnancy group had higher Cs/Cg,Ss/Sg,and 3DVs/3DVg ratios(P<0.05).When 3DVs/3DVg was 0.220,the highest predictive performance predicted adverse pregnancy outcomes,resulting in an AUC of 0.767,and the sensitivity,specificity were 70.2%,75%respectively.VOCAL measuring 3DVs/3DVg combined with serum progesterone gave a diagnostic AUC of 0.824 for early pregnancy outcome in SCH patients,with a high sensitivity of 82.1%and a specificity of 72.1%,which showed a significant difference between AUC.CONCLUSION VOCAL-measured 3DVs/3DVg effectively quantifies the severity of SCH,while combined serum progesterone better predicts adverse pregnancy outcomes.

A dual adaptive unscented Kalman filter algorithm for SINS-based integrated navigation system

In this study, the problem of measuring noise pollution distribution by the intertial-based integrated navigation system is effectively suppressed. Based on nonlinear inertial navigation error modeling, a nested dual Kalman filter framework structure is developed. It consists of unscented Kalman filter (UKF)master filter and Kalman filter slave filter. This method uses nonlinear UKF for integrated navigation state estimation. At the same time, the exact noise measurement covariance is estimated by the Kalman filter dependency filter. The algorithm based on dual adaptive UKF (Dual-AUKF) has high accuracy and robustness, especially in the case of measurement information interference. Finally, vehicle-mounted and ship-mounted integrated navigation tests are conducted. Compared with traditional UKF and the Sage-Husa adaptive UKF (SH-AUKF), this method has comparable filtering accuracy and better filtering stability. The effectiveness of the proposed algorithm is verified.

MA-Res U-Net:Design of Soybean Navigation System with Improved U-Net Model

Traditional machine vision algorithms have difficulty handling the interference of light and shadow changes,broken rows,and weeds in the complex growth circumstances of soybean fields,which leads to erroneous navigation route segmentation.There are additional shortcomings in the feature extractFion capabilities of the conventional U-Net network.Our suggestion is to utilize an improved U-Net-based method to tackle these difficulties.First,we use ResNet’s powerful feature extraction capabilities to replace the original U-Net encoder.To enhance the concentration on characteristics unique to soybeans,we integrate a multi-scale high-performance attention mechanism.Furthermore,to do multi-scale feature extraction and capture a wider variety of contextual information,we employ atrous spatial pyramid pooling.The segmented image generated by our upgraded U-Net model is then analyzed using the CenterNet method to extract key spots.The RANSAC algorithm then uses these important spots to delineate the soybean seedling belt line.Finally,the navigation line is determined using the angle tangency theory.The experimental findings illustrate the superiority of our method.Our improved model significantly outperforms the original U-Net regarding mean Pixel Accuracy(mPA)and mean Intersection over Union(mIOU)indices,showing a more accurate segmentation of soybean routes.Furthermore,our soybean route navigation system’s outstanding accuracy is demonstrated by the deviation angle,which is only 3°between the actual deviation and the navigation line.This technology makes a substantial contribution to the sustainable growth of agriculture and shows potential for real-world applications.

Cognitive Navigation for Intelligent Mobile Robots:A Learning-Based Approach With Topological Memory Configuration

Autonomous navigation for intelligent mobile robots has gained significant attention,with a focus on enabling robots to generate reliable policies based on maintenance of spatial memory.In this paper,we propose a learning-based visual navigation pipeline that uses topological maps as memory configurations.We introduce a unique online topology construction approach that fuses odometry pose estimation and perceptual similarity estimation.This tackles the issues of topological node redundancy and incorrect edge connections,which stem from the distribution gap between the spatial and perceptual domains.Furthermore,we propose a differentiable graph extraction structure,the topology multi-factor transformer(TMFT).This structure utilizes graph neural networks to integrate global memory and incorporates a multi-factor attention mechanism to underscore elements closely related to relevant target cues for policy generation.Results from photorealistic simulations on image-goal navigation tasks highlight the superior navigation performance of our proposed pipeline compared to existing memory structures.Comprehensive validation through behavior visualization,interpretability tests,and real-world deployment further underscore the adapt-ability and efficacy of our method.

A data and physical model dual-driven based trajectory estimator for long-term navigation

Long-term navigation ability based on consumer-level wearable inertial sensors plays an essential role towards various emerging fields, for instance, smart healthcare, emergency rescue, soldier positioning et al. The performance of existing long-term navigation algorithm is limited by the cumulative error of inertial sensors, disturbed local magnetic field, and complex motion modes of the pedestrian. This paper develops a robust data and physical model dual-driven based trajectory estimation(DPDD-TE) framework, which can be applied for long-term navigation tasks. A Bi-directional Long Short-Term Memory(Bi-LSTM) based quasi-static magnetic field(QSMF) detection algorithm is developed for extracting useful magnetic observation for heading calibration, and another Bi-LSTM is adopted for walking speed estimation by considering hybrid human motion information under a specific time period. In addition, a data and physical model dual-driven based multi-source fusion model is proposed to integrate basic INS mechanization and multi-level constraint and observations for maintaining accuracy under long-term navigation tasks, and enhanced by the magnetic and trajectory features assisted loop detection algorithm. Real-world experiments indicate that the proposed DPDD-TE outperforms than existing algorithms, and final estimated heading and positioning accuracy indexes reaches 5° and less than 2 m under the time period of 30 min, respectively.

Navigation Finsler metrics on a gradient Ricci soliton

In this paper,we study a class of Finsler metrics defined by a vector field on a gradient Ricci soliton.We obtain a necessary and sufficient condition for these Finsler metrics on a compact gradient Ricci soliton to be of isotropic S-curvature by establishing a new integral inequality.Then we determine the Ricci curvature of navigation Finsler metrics of isotropic S-curvature on a gradient Ricci soliton generalizing result only known in the case when such soliton is of Einstein type.As its application,we obtain the Ricci curvature of all navigation Finsler metrics of isotropic S-curvature on Gaussian shrinking soliton.

Single-center experience with Knee+^(TM) augmented reality navigation system in primary total knee arthroplasty

BACKGROUND Computer-assisted systems obtained an increased interest in orthopaedic surgery over the last years,as they enhance precision compared to conventional hardware.The expansion of computer assistance is evolving with the employment of augmented reality.Yet,the accuracy of augmented reality navigation systems has not been determined.AIM To examine the accuracy of component alignment and restoration of the affected limb’s mechanical axis in primary total knee arthroplasty(TKA),utilizing an augmented reality navigation system and to assess whether such systems are conspicuously fruitful for an accomplished knee surgeon.METHODS From May 2021 to December 2021,30 patients,25 women and five men,under-went a primary unilateral TKA.Revision cases were excluded.A preoperative radiographic procedure was performed to evaluate the limb’s axial alignment.All patients were operated on by the same team,without a tourniquet,utilizing three distinct prostheses with the assistance of the Knee+™augmented reality navigation system in every operation.Postoperatively,the same radiographic exam protocol was executed to evaluate the implants’position,orientation and coronal plane alignment.We recorded measurements in 3 stages regarding femoral varus and flexion,tibial varus and posterior slope.Firstly,the expected values from the Augmented Reality system were documented.Then we calculated the same values after each cut and finally,the same measurements were recorded radiolo-gically after the operations.Concerning statistical analysis,Lin’s concordance correlation coefficient was estimated,while Wilcoxon Signed Rank Test was performed when needed.RESULTS A statistically significant difference was observed regarding mean expected values and radiographic mea-surements for femoral flexion measurements only(Z score=2.67,P value=0.01).Nonetheless,this difference was statistically significantly lower than 1 degree(Z score=-4.21,P value<0.01).In terms of discrepancies in the calculations of expected values and controlled measurements,a statistically significant difference between tibial varus values was detected(Z score=-2.33,P value=0.02),which was also statistically significantly lower than 1 degree(Z score=-4.99,P value<0.01).CONCLUSION The results indicate satisfactory postoperative coronal alignment without outliers across all three different implants utilized.Augmented reality navigation systems can bolster orthopaedic surgeons’accuracy in achieving precise axial alignment.However,further research is required to further evaluate their efficacy and potential.

Research on the navigation method of large-scale differential tail-control improvised guided munitions based on rotational speed constraints

In the process of launching guided projectile under the conventional system, it is difficult to effectively obtain the precise navigation parameters of the projectile in the high dynamic environment. Aiming at this problem, this paper describes a new system of guided ammunition based on tail spin reduction. After analyzing the mechanism of the ammunition's tail spin reduction, a navigation method of large scale difference tail control simple guided ammunition based on speed constraint is proposed. In this method,the corresponding navigation constraints can be carried out by combining the rotation speed state of the ammunition itself, and the optimal solution of navigation parameters during the flight of the missile can be obtained by Extended Kalman Filter(EKF). Finally, the performance of the proposed method was verified by the simulation environment, and the hardware-in-the-loop simulation test and flight test were carried out to verify the performance of the method in the real environment. The experimental results show that the proposed method can achieve the optimal estimation of navigation parameters for simple guided ammunition with large-scale difference tail control. Under the conditions of simulation test and hardware-in-loop simulation test, the position and velocity errors calculated by the method in this paper converged. Under the condition of flight test, the spatial average error calculated by the method described in this paper is 6.17 m, and the spatial error of the final landing point is 3.50 m.Through this method, the accurate acquisition of navigation parameters in the process of projectile launching is effectively realized.

Improving path planning efficiency for underwater gravity-aided navigation based on a new depth sorting fast search algorithm

This study focuses on the improvement of path planning efficiency for underwater gravity-aided navigation.Firstly,a Depth Sorting Fast Search(DSFS)algorithm was proposed to improve the planning speed of the Quick Rapidly-exploring Random Trees*(Q-RRT*)algorithm.A cost inequality relationship between an ancestor and its descendants was derived,and the ancestors were filtered accordingly.Secondly,the underwater gravity-aided navigation path planning system was designed based on the DSFS algorithm,taking into account the fitness,safety,and asymptotic optimality of the routes,according to the gravity suitability distribution of the navigation space.Finally,experimental comparisons of the computing performance of the ChooseParent procedure,the Rewire procedure,and the combination of the two procedures for Q-RRT*and DSFS were conducted under the same planning environment and parameter conditions,respectively.The results showed that the computational efficiency of the DSFS algorithm was improved by about 1.2 times compared with the Q-RRT*algorithm while ensuring correct computational results.

Three-dimensional printing for preoperative rehearsal and intraoperative navigation during laparoscopic rectal cancer surgery with left colic artery preservation

BACKGROUND Prior studies have shown that preserving the left colic artery(LCA)during laparo-scopic radical resection for rectal cancer(RC)can reduce the occurrence of anasto-motic leakage(AL),without compromising oncological outcomes.However,anatomical variations in the branches of the inferior mesenteric artery(IMA)and LCA present significant surgical challenges.In this study,we present our novel three dimensional(3D)printed IMA model designed to facilitate preoperative rehearsal and intraoperative navigation to analyze its impact on surgical safety.AIM To investigate the effect of 3D IMA models on preserving the LCA during RC surgery.METHODS We retrospectively collected clinical dates from patients with RC who underwent laparoscopic radical resection from January 2022 to May 2024 at Fuyang People’s Hospital.Patients were divided into the 3D printing and control groups for sta-tistical analysis of perioperative characteristics.RESULTS The 3D printing observation group comprised of 72 patients,while the control group comprised 68 patients.The operation time(174.5±38.2 minutes vs 198.5±49.6 minutes,P=0.002),intraoperative blood loss(43.9±31.3 mL vs 58.2±30.8 mL,P=0.005),duration of hospitalization(13.1±3.1 days vs 15.9±5.6 days,P<0.001),postoperative recovery time(8.6±2.6 days vs 10.5±4.9 days,P=0.007),and the postoperative complication rate(P<0.05)were all significantly lower in the observation group.CONCLUSION Utilization of a 3D-printed IMA model in laparoscopic radical resection of RC can assist surgeons in understanding the LCA anatomy preoperatively,thereby reducing intraoperative bleeding and shortening operating time,demonstrating better clinical application potential.

Computer-assisted navigation systems for insertion of cannulated screws in femoral neck fractures： a comparison of bi-planar robot navigation with optoelectronic navigation in a Synbone hip model trial

Computer-assisted procedures have recently been introduced for navigated femoral neck screw placement. Currently there is little information available regarding accuracy and efficiency of the different navigated procedures. The aim of this study was to compare two fluoroscopic navigation tracking technologies, a novel bi-planar robot navigation and standardized optoelectronic navigation, versus standard freehand fluoroscopic insertion in a Synbone hip model. Methods Eighteen fixed Synbone hip models were divided into 3 groups. C-arm navigated cannulated screws （AO-ASIF, diameter 7.3 mm） were inserted using freehand targeting （control group）. A novel bi-planar robot system （TINAV, GD2000） and an optoelectronic system （Stryker OTS Navigation System） were used for the navigated procedures （robot group and optoelectronic group）. Accuracy was measured using radiographic evaluation including the measurement of screw parallelism and decentralization, and joint penetration. To evaluate the efficiency, the number of guidewire passes, operative time and fluoroscopic images taken were noted. Results The two computer-assisted systems provided significantly improved accuracy compared to the freehand technique. Each of the parameters, including guidewire passes and number of fluoroscopy images, was significantly lower when using the computer-assisted systems than for freehand-unguided insertion （P 〈0.05）, but operative time was significantly shorter when using freehand-unguided insertion than for the computer-assisted systems （P 〈0.05）. Accuracy, operative time and number of fluoroscopy images taken were similar among the two navigated groups （P 〉0.05）, but guidewire passes in the robot group were significantly less than in the optoelectronic group （P 〈0.05）. Conclusions Both bi-planar robot navigation and optoelectronic navigation were similarly accurate and have the potential to improve accuracy and reduce radiation for freehand fluoroscopic targeting for insertion of cannulated screws in femoral neck fractures. Guidewire passes in the robot group were significantly less than in the optoelectronic group. However, both navigated procedures were associated with time-consuming registration and hi.qh rates of failed matching procedures.

Learning curve of computer-assisted navigation system in spine surgery

Background Spine surgery using computer-assisted navigation （CAN） has been proven to result in low screw misplacement rates, low incidence of radiation exposure and excellent operative field viewing versus the conventional intraoperative image intensifier （CⅢ）. However, as we know, few previous studies have described the learning curve of CAN in spine surgery.Methods We performed two consecutive case cohort studies on pedicel screw accuracy and operative time of two spine surgeons with different experience backgrounds, A and B, in one institution during the same period. Lumbar pedicel screw cortical perforation rate and operative time of the same kind of operation using CAN were analyzed and compared using CⅢ for the two surgeons at initial, 6 months and 12 months of CAN usage.Results CAN spine surgery had an overall lower cortical perforation rate and less mean operative time compared with CⅢ for both surgeon A and B cohorts when total cases of four years were included. It missed being statistically significant,with 3.3% versus 4.7% （P=0.191） and 125.7 versus 132.3 minutes （P=0.428） for surgeon A and 3.6% versus 6.4%（P=0.058）, and 183.2 versus 213.2 minutes （P=0.070） for surgeon B. in an attempt to demonstrate the learning curve,the cases after 6 months of the CAN system in each surgeon＇s cohort were compared. The perforation rate decreased by 2.4% （P=0.039） and 4.3% （P=0.003） and the operative time was reduced by 31.8 minutes （P=0.002） and 14.4 minutes （P=0.026） for the CAN groups of surgeons A and B, respectively. When only the cases performed after 12 months using the CAN system were considered, the perforation rate decreased by 3.9% （P=0.006） and 5.6% （P 〈0.001） and the operative time was reduced by 20.9 minutes （P 〈0.001） and 40.3 minutes （P 〈0.001） for the CAN groups of surgeon A and B, respectively.Conclusions In the long run, CAN spine surgery decreased the lumbar screw cortical perforation rate and operative time. The learning curve showed a sharp drop after 6 months of using CAN that plateaued after 12 months; which was demonstrated by both perforation rate and operative time data. Careful analysis of the data showed CAN is especially useful for less experienced surgeon to reduce perforation rate and intraoperative time, although further comparative studies are anticipated.

Application of computer-assisted navigation in treating congenital maxillomandibular syngnathia:A case report

BACKGROUND Congenital maxillomandibular syngnathia is an extremely rare disorder characterized by craniofacial malformations and inability to open the mouth adequately, which leads to problems with feeding, swallowing, and breathing as well as temporomandibular joint ankylosis. The main goal of the surgery is to release the ankylosis, establish functioning mandible, and prevent re-fusion.However, surgical procedures for this disease are rarely reported.CASE SUMMARY Here, we report a 7-mo-old girl with bilateral maxillomandibular syngnathia. The patient presented with difficulty in feeding, breathing, sounding, and swallowing and had developmental dysplasia. For treatment, we performed bone isolation by computer-assisted navigation and used silicone to fix the wound surface to prevent refusion of bone. To our knowledge, this is the only syngnathia case in the literature treated using computer-assisted navigation. With the guidance of precise navigation, we were able to minimize operation time by at least one hour,the patient's blood vessels, nerves, and tooth germs were well protected, and excessive bleeding was avoided. After six weeks, the patient showed improvement in mouth opening and no major issues of feeding.CONCLUSION Application of computer-assisted navigation can significantly improve accuracy,effectiveness, and surgical safety in correcting congenital maxillomandibular syngnathia.

Clinical application of improved 2D computer-assisted fluoroscopic navigation through simulating a 3D vertebrae image to guide pedicle screw internal fixation

Objective To study the effect of using improved 2D computer-assisted fluoroscopic navigation through simulating 3D vertebrae image to guide pedicle screw internal fixation.Methods Posterior pedicle screw internal fixation,distraction