Foley K T, Simon D A, Rampersaud Y R
Image-Guided Surgery Research Center; Department of Neurosurgery, University of Tennessee, Memphis, Tennessee, USA.
Spine (Phila Pa 1976). 2001 Feb 15;26(4):347-51. doi: 10.1097/00007632-200102150-00009.
In vitro accuracy assessment of a novel virtual fluoroscopy system.
To investigate a new technology combining image-guided surgery with C-arm fluoroscopy.
Fluoroscopy is a useful and familiar technology to all musculoskeletal surgeons. Its limitations include radiation exposure to the patient and operating team and the need to reposition the fluoroscope repeatedly to obtain surgical guidance in multiple planes.
Fluoroscopic images of the lumbar spine of an intact, unembalmed cadaver were obtained, calibrated, and saved to an ). A was used for the sequential insertion of a light-emitting diode-fitted probe into the pedicles of L1-S1 bilaterally. The trajectory of a "virtual tool" corresponding to the tracked tool was overlaid onto the saved fluoroscopic views in real time. Live fluoroscopic images of the inserted pedicle probe were then obtained. Distances between the tips of the virtual and fluoroscopically displayed probes were quantified using the image-guided computer's measurement tool. Trajectory angle differences were measured using a standard goniometer and printed copies of the workstation computer display. The surgeon's radiation exposure was measured using thermolucent dosimeter rings.
Excellent correlation between the virtual fluoroscopic images and live fluoroscopy was observed. Mean probe tip error was 0.97 +/- 0.40 mm. Mean trajectory angle difference between the virtual and fluoroscopically displayed probes was 2.7 degrees +/- 0.6 degrees. The thermolucent dosimeter rings measured no detectable radiation exposure for the surgeon.
Virtual fluoroscopy offers several advantages over conventional fluoroscopy while providing acceptable targeting accuracy. It enables a single C-arm to provide real-time, multiplanar procedural guidance. It also dramatically reduces radiation exposure to the patient and surgical team by eliminating the need for repetitive fluoroscopic imaging for tool placement.
一种新型虚拟荧光透视系统的体外准确性评估。
研究一种将图像引导手术与C形臂荧光透视相结合的新技术。
荧光透视对所有肌肉骨骼外科医生来说是一项有用且熟悉的技术。其局限性包括对患者和手术团队的辐射暴露，以及需要反复重新定位荧光透视仪以在多个平面上获得手术指导。
获取一具完整、未防腐尸体腰椎的荧光透视图像，进行校准并保存到一个（此处原文缺失具体内容）。使用一个（此处原文缺失具体内容）将装有发光二极管的探针依次双侧插入L1 - S1椎弓根。与被跟踪工具对应的“虚拟工具”的轨迹实时叠加到保存的荧光透视图像上。然后获取插入椎弓根探针的实时荧光透视图像。使用图像引导计算机的测量工具对虚拟探针和荧光透视显示探针的尖端之间的距离进行量化。使用标准测角仪和工作站计算机显示器的打印副本测量轨迹角度差异。使用热释光剂量计环测量外科医生的辐射暴露。
观察到虚拟荧光透视图像与实时荧光透视之间具有良好的相关性。平均探针尖端误差为0.97±0.40毫米。虚拟探针和荧光透视显示探针之间的平均轨迹角度差异为2.7°±0.6°。热释光剂量计环未检测到外科医生有可检测到的辐射暴露。
虚拟荧光透视相比传统荧光透视具有多个优势，同时提供了可接受的靶向准确性。它使单个C形臂能够提供实时、多平面的手术指导。通过消除工具放置时对重复荧光透视成像的需求，它还显著减少了对患者和手术团队的辐射暴露。
