2023, Altermatt, Matthias, Kalt, Denise, Blättler, P., Schkommodau, Erik

2020-01-30, Shah, Ashesh, Vogel, Dorian, Pison, Daniela, Schkommodau, Erik, Hemm-Ode, Simone

2016, Shah, Ashesh, Coste, Jérôme, Lemaire, Jean-Jaques, Taub, Ethan, Schüpbach, W.M. Michael, Pollo, Claudio, Schkommodau, Erik, Guzman, Raphael, Hemm-Ode, Simone

Deep brain stimulation (DBS) surgery is extensively used in the treatment of movement disorders. Nevertheless, methods to evaluate the clinical response during intraoperative stimulation tests to identify the optimal position for the implantation of the chronic DBS lead remain subjective. In this paper, we describe a new, versatile method for quantitative intraoperative evaluation of improvement in tremor with an acceleration sensor that is mounted on the patient’s wrist during surgery. At each anatomical test position, the improvement in tremor compared to the initial tremor is estimated on the basis of extracted outcome measures. This method was tested on 15 tremor patients undergoing DBS surgery in two centers. Data from 359 stimulation tests were acquired. Our results suggest that accelerometric evaluation detects tremor changes more sensitively than subjective visual ratings. The effective stimulation current amplitudes identified from the quantitative data (1.1 ± 0.8 mA) are lower than those identified by visual evaluation (1.7 ± 0.8 mA) for similar improvement in tremor. Additionally, if these data had been used to choose the chronic implant position of the DBS lead, 15 of the 26 choices would have been different. These results show that our method of accelerometric evaluation can potentially improve DBS targeting.

2022-10-18, Degen, Markus, Babrak, Lmar, Smakaj, Erand, Agac, Teyfik, Asprion, Petra, Grimberg, Frank, Van der Werf, Daan, Van Ginkel, Erwin Willem, Tosoni, Deniz David, Clay, Ieuan, Brodbeck, Dominique, Natali, Eriberto, Schkommodau, Erik, Miho, Enkelejda

Digital technologies are transforming the health care system. A large part of information is generated as real-world data (RWD). Data from electronic health records and digital biomarkers have the potential to reveal associations between the benefits and adverse events of medicines, establish new patient-stratification principles, expose unknown disease correlations, and inform on preventive measures. The impact for health care payers and providers, the biopharmaceutical industry, and governments is massive in terms of health outcomes, quality of care, and cost. However, a framework to assess the preliminary quality of RWD is missing, thus hindering the conduct of population-based observational studies to support regulatory decision-making and real-world evidence.

2017-09, Shah, Ashesh, Coste, Jérôme, Lemaire, Jean-Jaques, Schkommodau, Erik, Taub, Ethan, Guzman, Raphael, Hemm-Ode, Simone

2013, de Wild, Michael, Schumacher, Ralf, Kyrill, Maier, Schkommodau, Erik, Thoma, Daniel, Bredell, Marius, Kruse, Astrid, Grätz, Klaus, Weber, Franz

The treatment of large bone defects still poses a major challenge in orthopaedic and cranio-maxillofacial surgery. One possible solution could be the development of personalized porous titanium-based implants that are designed to meet all mechanical needs with a minimum amount of titanium and maximum osteopromotive properties so that it could be combined with growth factor-loaded hydrogels or cell constructs to realize advanced bone tissue engineering strategies. Such implants could prove useful for mandibular reconstruction, spinal fusion, the treatment of extended long bone defects, or to fill in gaps created on autograft harvesting. The aim of this study was to determine the mechanical properties and potential of bone formation of light weight implants generated by selective laser melting (SLM). We mainly focused on osteoconduction, as this is a key feature in bone healing and could serve as a back-up for osteoinduction and cell transplantation strategies. To that end, defined implants were produced by SLM, and their surfaces were left untreated, sandblasted, or sandblasted/acid etched. In vivo bone formation with the different implants was tested throughout calvarial defects in rabbits and compared with untreated defects. Analysis by micro computed tomography (µCT) and histomorphometry revealed that all generatively produced porous Ti structures were well osseointegrated into the surrounding bone. The histomorphometric analysis revealed that bone formation was significantly increased in all implant-treated groups compared with untreated defects and significantly increased in sand blasted implants compared with untreated ones. Bone bridging was significantly increased in sand blasted acid-etched scaffolds. Therefore, scaffolds manufactured by SLM should be surface treated. Bone augmentation beyond the original bone margins was only seen in implant-treated defects, indicating an osteoconductive potential of the implants that could be utilized clinically for bone augmentation purposes. Therefore, designed porous, lightweight structures have potential for bone regeneration and augmentation purposes, especially when complex and patient-specific geometries are essential.

2022-07-04, Bischofberger, Micha, Schkommodau, Erik, Böhringer, Stephan

This paper proposes a conceptual method to calculate the pose of a stereo-vision camera relative to an artificial mandible without additional markers. The general method for marker-free navigation has four steps: 1) parallel image acquisition by a stereo-vision camera, 2) automatic identification of 2d point pairs (landmark pairs) in a left and a right image, 3) calculation of related 3d points in the joint camera coordinate system and 4) matching of 3d points generated to a preoperative 3d model (i.e., CT data based). To identify and compare landmarks in the acquired stereo images, well-known algorithms for landmark detection, description and matching were compared within the developed approach. Finally, the BRISK algorithm (Leutenegger S, Chli M, Siegwart RY. BRISK: Binary Robust invariant scalable keypoints. Proceedings of the IEEE International Conference on Computer Vision; 2011: 2548–2555) was used. The proposed method was implemented in MATLAB and validated with one artificial mandible. The accuracy evaluation of the camera positions calculated resulted in an average deviation error of 1.45 mm ± 0.76 mm to the real camera displacement. This value was calculated using only stereo images with over 100 reconstructed landmark pairs each. This provides the basis for marker-free navigation.

2016-09-30, Coigny, Florian, Todor, Adrian, Rotaru, Horatiu, Schumacher, Ralf, Schkommodau, Erik

Patient-specific bone and joint replacement implants lead to better functional and aesthetic results than conventional methods [1], [2], [3]. But extracting 3D shape information from CT Data and designing individual implants is demanding and requires multiple surgeon-to-engineer interactions. For manufacturing purposes, Additive Manufacturing offers various advantages, especially for low volume manufacturing parts, such as patient specific implants. To ease these new approaches and to avoid surgeon-to-engineer interactions a new design software approach is needed which offers highly automated and user friendly planning steps.