Department of Orthopaedic Surgery, Tokai University School of Medicine, Kanagawa, Japan.
Department of Orthopaedic Surgery, Tokai University School of Medicine, Kanagawa, Japan.
World Neurosurg. 2021 Feb;146:232-239. doi: 10.1016/j.wneu.2020.11.089. Epub 2020 Nov 24.
BACKGROUND: We describe a new technique that combines navigation-assisted extreme lateral interbody fusion (NALIF) and percutaneous placement of pedicle screws in the lateral decubitus position with the surgeon using wearable smart glasses. METHODS: We explain our method for nonfluoroscopic NALIF and single-position (SP)- percutaneous pedicle screw (PPS) surgery for patients with degenerative lumbar diseases using wearable smart glasses. The wearable smart glasses provide a semitransparent overlay of the navigation information onto the image seen through the lenses. This technique does not require fluoroscopy during lateral interbody fusion or PPS insertion. It is convenient because it does not require a Jamshidi needle or guidewire when inserting PPSs. RESULTS: Using this method, the surgeon can glance at the 3-dimensional images on the wearable smart glasses while still viewing the operation field. A review of 24 cases yielded an average operation time of 89.5 ± 16.4 minutes and 66.7 ± 67.0 mL of blood loss, without any severe intra- or postoperative complications. CONCLUSIONS: Nonfluoroscopic NALIF and SP-PPS placement surgery is a safe and effective means for implanting cages and PPSs in this minimally invasive approach without compromising the results. Although further investigations are needed, the wearable smart glasses may be a useful surgical aid when performing NALIF and SP-PPS placement in patients with degenerative lumbar diseases.
背景:我们描述了一种新的技术,该技术结合了导航辅助极外侧椎间融合术(NALIF)和经皮侧卧位椎弓根螺钉置入术,外科医生使用可穿戴智能眼镜。
方法:我们解释了使用可穿戴智能眼镜进行非透视 NALIF 和单体位(SP)经皮椎弓根螺钉(PPS)手术的方法,用于治疗退行性腰椎疾病的患者。可穿戴智能眼镜将导航信息的半透明叠加层覆盖在通过镜头看到的图像上。该技术在进行侧路椎间融合或 PPS 插入时不需要透视。它很方便,因为在插入 PPS 时不需要 Jamshidi 针或导丝。
结果:使用该方法,外科医生在观察手术区域的同时,还可以查看可穿戴智能眼镜上的三维图像。对 24 例患者的回顾性研究显示,平均手术时间为 89.5±16.4 分钟,失血量为 66.7±67.0 mL,无严重的围手术期并发症。
结论:非透视 NALIF 和 SP-PPS 置钉术是一种安全有效的方法,可在微创入路中植入椎间融合器和 PPS,而不会影响结果。尽管需要进一步的研究,但在进行退行性腰椎疾病患者的 NALIF 和 SP-PPS 置钉术时,可穿戴智能眼镜可能是一种有用的手术辅助工具。
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