Vadalà Gianluca, De Salvatore Sergio, Ambrosio Luca, Russo Fabrizio, Papalia Rocco, Denaro Vincenzo
Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy.
Neurospine. 2020 Mar;17(1):88-100. doi: 10.14245/ns.2040060.030. Epub 2020 Mar 31.
Instrumented spine procedures have been performed for decades to treat a wide variety of spinal disorders. New technologies have been employed to obtain a high degree of precision, to minimize risks of damage to neurovascular structures and to diminish harmful exposure of patients and the operative team to ionizing radiations. Robotic spine surgery comprehends 3 major categories: telesurgical robotic systems, robotic-assisted navigation (RAN) and virtual augmented reality (AR) systems, including AR and virtual reality. Telesurgical systems encompass devices that can be operated from a remote command station, allowing to perform surgery via instruments being manipulated by the robot. On the other hand, RAN technologies are characterized by the robotic guidance of surgeon-operated instruments based on real-time imaging. Virtual AR systems are able to show images directly on special visors and screens allowing the surgeon to visualize information about the patient and the procedure (i.e., anatomical landmarks, screw direction and inclination, distance from neurological and vascular structures etc.). The aim of this review is to focus on the current state of the art of robotics and AR in spine surgery and perspectives of these emerging technologies that hold promises for future applications.
使用仪器辅助的脊柱手术已经开展了数十年,用于治疗各种脊柱疾病。新技术已被用于实现高度精确性,将对神经血管结构造成损伤的风险降至最低,并减少患者和手术团队受到电离辐射的有害暴露。机器人脊柱手术主要包括三大类:远程手术机器人系统、机器人辅助导航(RAN)和虚拟增强现实(AR)系统,包括AR和虚拟现实。远程手术系统包括可以从远程指挥站操作的设备,能够通过机器人操纵的器械进行手术。另一方面,RAN技术的特点是基于实时成像对外科医生操作的器械进行机器人引导。虚拟AR系统能够直接在特殊护目镜和屏幕上显示图像,使外科医生能够可视化有关患者和手术的信息(即解剖标志、螺钉方向和倾斜度、与神经和血管结构的距离等)。本综述的目的是关注脊柱手术中机器人技术和AR的当前技术水平,以及这些有望在未来应用中发挥作用的新兴技术的前景。
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