Ha Wenbo, Yang DeLin, Gu Shixin, Xu Qi-Wu, Che Xiaoming, Wu Jin-Song, Li Wensheng
Department of Neurosurgery, 5th Hospital affiliated Harbin Medical College, Daqing, China (mainland).
Department of Neurosurgery, Huashun Hospital, Shanghai Medical College, Fudan University, Shanghai, China (mainland).
Med Sci Monit. 2014 May 15;20:802-6. doi: 10.12659/MSM.890840.
This work aimed to evaluate the efficacy of virtual reality (VR) technology in neurosurgical anatomy through a comparison of the virtual 3D microanatomy of the suboccipital vertebral arteries and their bony structures as part of the resection of tumors in the craniovertebral junction (CVJ) of 20 patients compared to the actual microanatomy of the vertebral arteries of 15 cadaveric headsets.
The study was conducted with 2 groups of data: a VR group composed of 20 clinical cases and a physical body group (PB group) composed of 15 cadaveric headsets. In the VR group, the dissection and measurements of the vertebral arteries were simulated on a Dextroscope. In the PB group, the vertebral arteries in the cadaver heads were examined under a microscope and anatomical measurements of VA and bony structures were performed. The length and course of the vertebral arteries and its surrounding bony structures in each group were compared.
The distances from the inferior part of the transverse process foramen (TPF) of C1 to the inferior part of TPF of C2 were 17.68±2.86 mm and 18.4±1.82 mm in the PB and VR groups, respectively. The distances between the middle point of the posterior arch of the atlas and the medial intersection of VA on the groove were 17.35±2.23 mm in the PB group and 18.13±2.58 mm in the VR group. The distances between the middle line and the entrance of VA to the lower rim of TPF of Atlas were 28.64±2.67 mm in PB group and 29.23±2.89 mm in VR group. The diameters of the vertebral artery (VA) at the end of the groove and foramen of C2 transverse process were 4.02±046 mm and 4.25±0.51 mm, respectively, in the PB group and 3.54±0.44 mm and 4.47±0.62 mm, respectively, in VR group. The distances between the VA lumen center and midline of the foramen magnum at the level of dural penetration was 10.4±1.13 mm in the PB group and 11.5±1.34 mm in the VR group (P>0.05).
VR technology can accurately simulate the anatomical features of the suboccipital vertebral arteries and their bony structures, which facilitates the planning of individual surgeries in the CVJ.
本研究旨在通过比较20例颅颈交界区(CVJ)肿瘤切除术中枕下椎动脉及其骨性结构的虚拟三维微观解剖结构与15个尸体头颅标本椎动脉的实际微观解剖结构,评估虚拟现实(VR)技术在神经外科解剖学中的有效性。
本研究采用两组数据:一组为VR组,由20例临床病例组成;另一组为实体组(PB组),由15个尸体头颅标本组成。在VR组中,使用Dextroscope模拟椎动脉的解剖和测量。在PB组中,在显微镜下检查尸体头颅中的椎动脉,并对椎动脉及其骨性结构进行解剖测量。比较两组中椎动脉及其周围骨性结构的长度和走行。
PB组和VR组中,从C1横突孔(TPF)下部到C2横突孔下部的距离分别为17.68±2.86mm和18.4±1.82mm。PB组中寰椎后弓中点与椎动脉在沟内的内侧交点之间的距离为17.35±2.23mm,VR组中为18.13±2.58mm。PB组中中线与椎动脉进入寰椎横突孔下缘入口之间的距离为28.64±2.67mm,VR组中为29.23±2.89mm。PB组中C2横突沟和孔末端椎动脉(VA)的直径分别为4.02±0.46mm和4.25±0.51mm,VR组中分别为3.54±0.44mm和4.47±0.62mm。PB组中硬脑膜穿透水平处椎动脉管腔中心与枕骨大孔中线之间的距离为10.4±1.13mm,VR组中为11.5±1.34mm(P>0.05)。
VR技术能够准确模拟枕下椎动脉及其骨性结构的解剖特征,有助于CVJ区个体化手术的规划。