Department of Neurosurgery, Klinik Hirslanden, Zürich, Switzerland.
Neurosurgery. 2013 Jan;72 Suppl 1:78-88. doi: 10.1227/NEU.0b013e3182739aae.
BACKGROUND: In the past 2 decades, intraoperative navigation technology has changed preoperative and intraoperative strategies and methodology tremendously. OBJECTIVE: To report our first experiences with a stereoscopic navigation system based on multimodality-derived, patient-specific 3-dimensional (3-D) information displayed on a stereoscopic monitor and controlled by a virtual user interface. METHODS: For the planning of each case, a 3-D multimodality model was created on the Dextroscope. The 3-D model was transferred to a console in the operating room that was running Dextroscope-compatible software and included a stereoscopic LCD (liquid crystal display) monitor (DexVue). Surgery was carried out with a standard frameless navigation system (VectorVision, BrainLAB) that was linked to DexVue. Making use of the navigational space coordinates provided by the VectorVision system during surgery, we coregistered the patient's 3-D model with the actual patient in the operating room. The 3-D model could then be displayed as seen along the axis of a handheld probe or the microscope view. The DexVue data were viewed with polarizing glasses and operated via a 3-D interface controlled by a cordless mouse containing inertial sensors. The navigational value of DexVue was evaluated postoperatively with a questionnaire. A total of 39 evaluations of 21 procedures were available. RESULTS: In all 21 cases, the connection of VectorVision with DexVue worked reliably, and consistent spatial concordance of the navigational information was displayed on both systems. The questionnaires showed that in all cases the stereoscopic 3-D data were preferred for navigation. In 38 of 39 evaluations, the spatial orientation provided by the DexVue system was regarded as an improvement. In no case was there worsened spatial orientation. CONCLUSION: We consider navigating primarily with stereoscopic, 3-D multimodality data an improvement over navigating with image planes, and we believe that this technology enables a more intuitive intraoperative interpretation of the displayed navigational information and hence an easier surgical implementation of the preoperative plan.
背景：在过去的 20 年中，术中导航技术极大地改变了术前和术中的策略和方法。
目的：报告我们使用基于多模态衍生的、患者特异性的三维（3-D）信息的立体导航系统的首次经验，该信息显示在立体显示器上，并通过虚拟用户界面控制。
方法：对于每个病例的规划，在 Dextroscope 上创建了一个 3-D 多模态模型。该 3-D 模型被传输到手术室中的控制台，该控制台运行与 Dextroscope 兼容的软件，包括一个立体液晶显示器（DexVue）。手术是在与 DexVue 连接的标准无框架导航系统（VectorVision，BrainLAB）下进行的。在手术过程中利用 VectorVision 系统提供的导航空间坐标，我们将患者的 3-D 模型与手术室中的实际患者进行配准。然后可以将 3-D 模型显示为沿着手持探头或显微镜视图的轴查看。使用偏光眼镜查看 DexVue 数据，并通过包含惯性传感器的无线鼠标控制的 3-D 界面进行操作。使用问卷调查评估 DexVue 的导航价值。共有 21 个手术的 39 个评估结果可用。
结果：在所有 21 例中，VectorVision 与 DexVue 的连接可靠，两个系统都显示了一致的空间一致性导航信息。问卷调查显示，在所有情况下，立体 3-D 数据都更适合导航。在 39 次评估中的 38 次中，认为 DexVue 系统提供的空间定向有所改善。在任何情况下，空间定向都没有恶化。
结论：我们认为，主要使用立体、3-D 多模态数据进行导航比使用图像平面导航更好，并且我们相信这项技术能够更直观地解释显示的导航信息，从而更容易地执行术前计划。
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