Automated measurement of lumbar pedicle screw parameters using deep learning algorithm on preoperative CT scans

Purpose: This study aims to devise and assess an automated measurement framework for lumbar pedicle screw parameters leveraging preoperative computed tomography (CT) scans and a deep learning algorithm. Methods: A deep learning model was constructed employing a dataset comprising 1410 axial preoperative CT images of lumbar pedicles sourced from 282 patients. The model was trained to predict several screw parameters, including the axial angle and width of pedicles, the length of pedicle screw paths, and the interpedicular distance. The mean values of these parameters, as determined by two radiologists and one spinal surgeon, served as the reference standard. Results: The deep learning model achieved high agreement with the reference standard for the axial angle of the left pedicle (ICC = 0.92) and right pedicle (ICC = 0.93), as well as for the length of the left pedicle screw path (ICC = 0.82) and right pedicle (ICC = 0.87). Similarly, high agreement was observed for pedicle width (left ICC = 0.97, right ICC = 0.98) and interpedicular distance (ICC = 0.91). Overall, the model's performance paralleled that of manual determination of lumbar pedicle screw parameters. Conclusion: The developed deep learning-based model demonstrates proficiency in accurately identifying landmarks on preoperative CT scans and autonomously generating parameters relevant to lumbar pedicle screw placement. These findings suggest its potential to offer efficient and precise measurements for clinical applications.