Herman Amir, Dekel Assaf, Botser Itamar B, Steinberg Ely L
Department of Orthopaedic Surgery, Sheba Medical Centre, Tel Hashomer, Israel.
Int J Med Robot. 2009 Mar;5(1):45-50. doi: 10.1002/rcs.231.
We present Surgix, a new computer-assisted surgery system (CASS). This system uses image analysis technology in order to measure three-dimensional (3D) distances, visualize implant templates and view the guided trajectory on standard fluoroscopy. Our purpose was to compare surgery results and technique with and without the Surgix CASS.
The study included 61 dynamic hip screw (DHS) procedures. The Surgix system was used in 41 procedures. We compared the number of guide wire insertion trials and the time needed for each trial, the number of X-ray pulses, tip-apex index, nine-quadrant position and shaft-neck angle.
The procedures were carried out by experienced users (> or = five operations, using the system) and had a first-trial guide wire insertion success rate of 77.8%, compared to a rate of 10% for the control group (p = 0.001) and fewer insertion trials (1.33 vs. 3.05, respectively; p = 0.001). The mean number of fluoroscopy pulses was 41.5% lower for the experienced group than for the control (17.6 vs. 30.1; p = 0.009). There were no significant differences in tip-apex distance, favourable quadrant screw placement or neck-shaft angle.
The results of this study demonstrate that the Surgix CASS significantly improves the accuracy of hardware positioning and reduces radiation exposure time, thus enhancing patient outcome.
我们介绍了Surgix，一种新型计算机辅助手术系统（CASS）。该系统使用图像分析技术来测量三维（3D）距离、可视化植入物模板并在标准荧光透视下查看引导轨迹。我们的目的是比较使用和不使用Surgix CASS的手术结果和技术。
该研究包括61例动力髋螺钉（DHS）手术。41例手术使用了Surgix系统。我们比较了导丝插入试验的次数和每次试验所需的时间、X射线脉冲的数量、尖顶指数、九象限位置和头颈角度。
这些手术由经验丰富的使用者（≥5次手术，使用该系统）进行，首次导丝插入成功率为77.8%，而对照组为10%（p = 0.001），且插入试验次数更少（分别为1.33次和3.05次；p = 0.001）。经验丰富组的荧光透视脉冲平均数量比对照组低41.5%（17.6次对30.1次；p = 0.009）。在尖顶距离、螺钉放置在有利象限或头颈角度方面没有显著差异。
本研究结果表明，Surgix CASS显著提高了硬件定位的准确性并减少了辐射暴露时间，从而改善了患者预后。
