Boddapati Venkat, Lombardi Joseph M, Urakawa Hikari, Lehman Ronald A
The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.
Hospital for Special Surgery, New York, NY, USA.
Ann Transl Med. 2021 Jan;9(1):91. doi: 10.21037/atm-20-2765.
Operative management of adult spinal deformity (ASD) has been increasing in recent years secondary to an aging society. The advance of intraoperative image guidance, such as the development of navigation and robotics systems has contributed to the growth and safety of ASD surgery. Currently, intraoperative image guidance is mainly used for pedicle screw placement and the evaluation of alignment correction in ASD surgery. Though it is expected that the use of navigation and robotics would result in increasing pedicle screw accuracy as reported in other spine surgeries, there are no well-powered studies specifically focusing on ASD surgery. Currently, deformity correction relies heavily on preoperative planning, however, a few studies have shown the possibility that intraoperative image modalities may accurately predict postoperative spinopelvic parameters. Future developments of intraoperative image guidance are needed to overcome the remaining challenges in ASD surgery such as radiation exposure to patient and surgeon. More novel imaging modalities may result in evolution in ASD surgery. Overall there is a paucity of literature focusing on intraoperative image guidance in ASD surgery, therefore, further studies are warranted to assess the efficacy of intraoperative image guidance in ASD surgery. This narrative review sought to provide the current role and future perspectives of intraoperative image guidance focusing on ASD surgery.
近年来，随着社会老龄化，成人脊柱畸形（ASD）的手术治疗呈上升趋势。术中图像引导技术的进步，如导航和机器人系统的发展，推动了ASD手术的发展并提高了其安全性。目前，术中图像引导主要用于ASD手术中的椎弓根螺钉置入和对线矫正评估。尽管预计导航和机器人技术的应用会像其他脊柱手术那样提高椎弓根螺钉置入的准确性，但尚无专门针对ASD手术的有力研究。目前，畸形矫正严重依赖术前规划，不过，一些研究表明术中成像方式有可能准确预测术后脊柱骨盆参数。需要进一步发展术中图像引导技术，以克服ASD手术中尚存的挑战，如患者和外科医生所受的辐射暴露。更新颖的成像方式可能会推动ASD手术的发展。总体而言，专注于ASD手术中术中图像引导的文献较少，因此，有必要进行进一步研究以评估术中图像引导在ASD手术中的疗效。本叙述性综述旨在阐述术中图像引导在ASD手术中的当前作用及未来前景。
