Surgimap 手术规划预测矢状面失衡的准确性：一项队列研究。
Predictive Accuracy of Surgimap Surgical Planning for Sagittal Imbalance: A Cohort Study.
机构信息
Orthopedic Division, Second University of Naples, Naples, Italy.
IRCCS Don Gnocchi Foundation, Milan, Italy.
出版信息
Spine (Phila Pa 1976). 2017 Nov 15;42(22):E1297-E1304. doi: 10.1097/BRS.0000000000002230.
UNLABELLED
MINI: Surgical planning in sagittal imbalance is recognized as a key step of treatment to ensure good clinical results. Surgimap is a reliable tool to predict satisfactory postoperative sagittal alignment. Setting by default pelvic tilt to 20° improves predictive value during surgical planning.
STUDY DESIGN
A cohort study.
OBJECTIVE
To evaluate the predictive value of surgical planning using Surgimap regarding postoperative sagittal alignment.
SUMMARY OF BACKGROUND DATA
Surgical planning in sagittal imbalance is recognized as a key step of treatment to ensure results.
METHODS
The study involved 40 nonconsecutive patients who underwent surgery for sagittal misalignment. Postoperative alignment measured by sagittal vertical axis (SVA) and pelvic tilt was considered the gold standard. Surgimap prediction of final alignment was considered the test. Planning and postoperative films were classified as properly and improperly aligned. Sensitivity, specificity, and positive and negative predictive values of Surgimap planning [using two different methods: direct simulation (method A) and simulation after correction of pelvic tilt to 20° (method B)] to detect postoperative improper alignment were calculated.
RESULTS
Seventeen (42.5%) of 40 patients had proper postoperative alignment. According to method A, a proper alignment was achieved in 13 patients [S = 76.5%, Sp = 73.9%, RR = 2.93 (95% confidence interval, CI 1.40; 6.12), P < 0.001]; According to method B, a proper alignment was achieved in 15 patients [S = 88.2%, Sp = 60.9%, RR = 2.25 (95% CI 1.32; 23.86), P < 0.001]. Kappa statistics indicate moderate agreement between actual postoperative alignment and computer prediction.
CONCLUSION
The ability of Surgimap to predict proper postoperative sagittal alignment was excellent in this cohort. Its ability to predict proper alignment was improved by correction of pelvic tilt to 20° during planning.
LEVEL OF EVIDENCE
未加标签
MINI：矢状面失衡的手术规划被认为是确保良好临床效果的关键治疗步骤。Surgimap 是一种可靠的预测术后矢状面矫正的工具。默认情况下将骨盆倾斜设置为 20°可提高手术规划中的预测值。
研究设计
队列研究。
目的
评估 Surgimap 用于手术规划的预测值，以确定术后矢状面的排列情况。
背景资料概述
矢状面失衡的手术规划被认为是确保治疗效果的关键步骤。
方法
该研究纳入了 40 例非连续的矢状面错位患者。术后通过矢状垂直轴（SVA）和骨盆倾斜来测量，将其作为金标准。Surgimap 对最终排列的预测被视为测试。将规划和术后的片子分为正确和不正确排列。计算 Surgimap 规划的灵敏度、特异性、阳性和阴性预测值[使用两种不同的方法：直接模拟（方法 A）和模拟后将骨盆倾斜纠正为 20°（方法 B）]，以检测术后不正确的排列。
结果
40 例患者中，有 17 例（42.5%）术后排列正确。根据方法 A，13 例患者达到了适当的排列[S=76.5%，Sp=73.9%，RR=2.93（95%置信区间，1.40;6.12），P<0.001]；根据方法 B，15 例患者达到了适当的排列[S=88.2%，Sp=60.9%，RR=2.25（95%置信区间，1.32;23.86），P<0.001]。Kappa 统计表明，实际术后排列与计算机预测之间存在中等程度的一致性。
结论
在本队列中，Surgimap 预测适当术后矢状面排列的能力非常出色。在规划时将骨盆倾斜纠正为 20°可提高其预测适当排列的能力。
证据等级
2。
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