Yuk Frank J, Maragkos Georgios A, Sato Kosuke, Steinberger Jeremy
Department of Neurosurgery, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Hospital for Special Surgery, New York, NY, USA.
Ann Transl Med. 2021 Jan;9(1):94. doi: 10.21037/atm-20-1132.
In spinal surgery, outcomes are directly related both to patient and procedure selection, as well as the accuracy and precision of instrumentation placed. Poorly placed instrumentation can lead to spinal cord, nerve root or vascular injury. Traditionally, spine surgery was performed by open methods and placement of instrumentation under direct visualization. However, minimally invasive surgery (MIS) has seen substantial advances in spine, with an ever-increasing range of indications and procedures. For these reasons, novel methods to visualize anatomy and precisely guide surgery, such as intraoperative navigation, are extremely useful in this field. In this review, we present the recent advances and innovations utilizing simulation methods in spine surgery. The application of these techniques is still relatively new, however quickly being integrated in and outside the operating room. These include virtual reality (VR) (where the entire simulation is virtual), mixed reality (MR) (a combination of virtual and physical components), and augmented reality (AR) (the superimposition of a virtual component onto physical reality). VR and MR have primarily found applications in a teaching and preparatory role, while AR is mainly applied in hands-on surgical settings. The present review attempts to provide an overview of the latest advances and applications of these methods in the neurosurgical spine setting.
在脊柱外科手术中，手术结果与患者和手术方式的选择以及所植入器械的准确性和精确性直接相关。器械放置不当可能导致脊髓、神经根或血管损伤。传统上，脊柱手术通过开放手术方法进行，在直视下放置器械。然而，微创脊柱手术（MIS）在脊柱领域取得了重大进展，适应证和手术方式的范围不断扩大。因此，诸如术中导航等可视化解剖结构并精确指导手术的新方法在该领域极为有用。在本综述中，我们介绍了脊柱手术中利用模拟方法的最新进展和创新。这些技术的应用仍然相对较新，但正迅速在手术室内外得到整合。这些技术包括虚拟现实（VR）（整个模拟是虚拟的）、混合现实（MR）（虚拟和物理组件的组合）以及增强现实（AR）（将虚拟组件叠加到物理现实上）。VR和MR主要用于教学和准备工作，而AR主要应用于实际手术场景。本综述试图概述这些方法在神经外科脊柱手术中的最新进展和应用。
