Gonschorek O, Hauck S, Spiegl U, Weiß T, Pätzold R, Bühren V
Department of Spinal Surgery, Trauma Center, BGU-Murnau, Prof. Küntscher Str. 8, 82418, Murnau, Germany.
Eur J Trauma Emerg Surg. 2011 Apr;37(2):99-108. doi: 10.1007/s00068-011-0089-2. Epub 2011 Mar 31.
Since the first use of instrument-tracking techniques in the early 1990s, image-guided technologies became a leading topic in all branches of spine surgery. Today, navigation is a widely available tool in spine surgery and has become a part of clinical routine in many centers for a large variety of indications. Spinal navigation may not only contribute to more precision during surgery, but it may also reduce radiation exposure and fluoroscopy time, with advantages not only for the patient but also for the operating room personnel. Different registration algorithms have been developed differing in terms of the type of image data used by the navigation system (preoperatively acquired computed tomography [CT] images, intraoperatively acquired fluoroscopy images) and the way virtual and physical reality is matched. There is a tendency toward a higher accuracy for 3D fluoroscopy-based registration algorithms. The O-arm(®) represents a new flat-panel technology with the source and detector moving in a 360° arc around the patient. In combination with the Stealth(®) station system, navigation may start immediately after automated registration with already referenced instruments. After instrumentation, an additional scan may confirm intraoperatively the correct positioning of the instrumentation. The first experiences with the system are described in this paper.
自20世纪90年代初首次使用器械跟踪技术以来，图像引导技术已成为脊柱外科各分支领域的热门话题。如今，导航技术在脊柱外科中已广泛应用，在许多中心的各种适应证中，它已成为临床常规操作的一部分。脊柱导航不仅有助于提高手术精度，还能减少辐射暴露和透视时间，这不仅对患者有益，对手术室工作人员也有好处。已开发出不同的配准算法，这些算法在导航系统使用的图像数据类型（术前获取的计算机断层扫描[CT]图像、术中获取的透视图像）以及虚拟现实与现实匹配的方式上存在差异。基于3D透视的配准算法有更高精度的趋势。O-arm（®）代表一种新的平板技术，其X射线源和探测器围绕患者在360°弧线上移动。与Stealth（®）工作站系统相结合，在使用已参考器械进行自动配准后即可立即开始导航。器械置入后，额外的扫描可在术中确认器械的正确位置。本文介绍了该系统的初步使用经验。
