{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T04:34:57Z","timestamp":1793248497619,"version":"4.5.0"},"reference-count":57,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To develop and validate a computer-assisted model for planning screw trajectories to support modified cortical bone trajectory (MCBT), cortical bone trajectory (CBT), and pedicle screw (PS) techniques, based on iterative closest point (ICP) registration and weighted k-nearest neighbors (kNN) algorithms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CT data from 110 patients undergoing lumbar surgery were analyzed, comprising an internal set of 50 younger patients with normal bone density and an external set of 60 patients including younger and older individuals with or without bone loss. L4\u2013L5 segments were reconstructed using Mimics 21.0. Two surgeons manually planned MCBT, CBT, and PS trajectories bilaterally in the internal set to serve as reference standards. A personalized computer-assisted screw planning model was developed using ICP registration and weighted kNN, where the template library consisted of manually generated screw plans. Accuracy was evaluated by comparing algorithm-generated screw trajectories against expert manually planned trajectories to calculate deviations in sagittal inclination (\u03b1), axial inclination (\u03b2), screw head, pedicle entry point, pedicle crossing point, and screw tip. Hounsfield unit (HU) values along screw trajectories were also measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the external set (total of 720 screws: 240 PS, 240 CBT, 240 MCBT), deviations for CBT weresagittal inclination (\u03b1) 4.117 (2.028, 7.251)\u00b0, axial inclination (\u03b2) 3.714 (1.901, 6.316)\u00b0, screw head 3.382 (2.514, 4.803) mm, pedicle entry point 3.0 (1.999, 4.149) mm, pedicle crossing point 1.511 (1.008, 2.443) mm, screw tip 3.586 (2.465, 4.542) mm. Those for MCBT were 4.865 (2.126, 7.547)\u00b0, 3.801 (1.658, 6.147)\u00b0, 4.153 (3.14, 5.658) mm, 3.818 (2.43, 6.209) mm, 1.545 (1.061, 2.222) mm, 3.777 (2.768, 5.241) mm, respectively. Computational acceptance rates for PS were 97.06% (HU: 238.4\u00b167.71) in younger normal bone group, 92.71% (173.6\u00b153.83) in older normal bone group, and 97.37% (113.3\u00b158.68) in older bone loss group. For CBT, rates were 100% (477.2\u00b1168.6 HU), 100% (338.5\u00b1125.8 HU), and 100% (178.1\u00b199.75 HU), respectively. For MCBT, rates were 100% (475.8\u00b1131 HU), 98.96% (376.8\u00b1104.9 HU), and 97.37% (213.4\u00b1106 HU), respectively. MCBT and CBT achieved significantly higher HU values than PS (P &lt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The ICP registration and weighted kNN-based planning model demonstrates high computational acceptance rates and excels in planning cortical bone screw trajectories with low breach rates and high HU values.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261485860","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:40:26Z","timestamp":1788511226000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and Validation of a Computer-Assisted Screw Trajectory Planning Model Based on Iterative Closest Point Registration and Weighted K-Nearest Neighbors Algorithms for Cortical Bone and Pedicle Screw Techniques"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9315-0177","authenticated-orcid":false,"given":"Abudusalamu","family":"Tuoheti","sequence":"first","affiliation":[{"name":"Xinjiang International Medical Center (Xinjiang International Hospital)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Gufuding","sequence":"additional","affiliation":[{"name":"The Sixth People\u2019s Hospital of Xinjiang Uygur Autonomous Region"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musitapa","family":"Mijiti","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Xinjiang Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitao","family":"Yang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Xinjiang Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hali","family":"Habulihan","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Xinjiang Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awuzhaer","family":"Abuliken","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Xinjiang Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilixiati","family":"Mamuti","sequence":"additional","affiliation":[{"name":"Xinjiang International Medical Center (Xinjiang International Hospital)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5889-0179","authenticated-orcid":false,"given":"Paerhati","family":"Rexiti","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Xinjiang Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2008.07.008"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04254-0"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2017.03.137"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-015-2432-6"},{"issue":"8","key":"e_1_3_7_6_2","first-page":"2413","article-title":"Measurement of lumbar isthmus parameters for novel starting points for cortical bone trajectory screws using computed radiography","volume":"10","author":"Rexiti P","year":"2018","unstructured":"Rexiti P, Abudurexiti T, Abuduwali N, Wang S, Sheng W. Measurement of lumbar isthmus parameters for novel starting points for cortical bone trajectory screws using computed radiography. Am J Transl Res. 2018;10(8):2413-2423.","journal-title":"Am J Transl Res"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0300060518762986"},{"issue":"11","key":"e_1_3_7_8_2","first-page":"2413","article-title":"Anatomical research on strength of screw track fixation in novel cortical bone trajectory for osteoporosis lumbar spine","volume":"11","author":"Rexiti P","year":"2019","unstructured":"Rexiti P, Aierken G, Wang S, et al. Anatomical research on strength of screw track fixation in novel cortical bone trajectory for osteoporosis lumbar spine. 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