基于增强现实头戴设备的胸腰椎椎弓根螺钉置钉的可行性和准确性研究。

BACKGROUND: To investigate the accuracy of augmented reality (AR) navigation using the Magic Leap head mounted device (HMD), pedicle screws were minimally invasively placed in four spine phantoms. METHODS: AR navigation provided by a combination of a conventional navigation system integrated with the Magic Leap head mounted device (AR-HMD) was used. Forty-eight screws were planned and inserted into Th11-L4 of the phantoms using the AR-HMD and navigated instruments. Postprocedural CT scans were used to grade the technical (deviation from the plan) and clinical (Gertzbein grade) accuracy of the screws. The time for each screw placement was recorded. RESULTS: The mean deviation between navigation plan and screw position was 1.9 ± 0.7 mm (1.9 [0.3-4.1] mm) at the entry point and 1.4 ± 0.8 mm (1.2 [0.1-3.9] mm) at the screw tip. The angular deviation was 3.0 ± 1.4° (2.7 [0.4-6.2]°) and the mean time for screw placement was 130 ± 55 s (108 [58-437] s). The clinical accuracy was 94% according to the Gertzbein grading scale. CONCLUSION: The combination of an AR-HMD with a conventional navigation system for accurate minimally invasive screw placement is feasible and can exploit the benefits of AR in the perspective of the surgeon with the reliability of a conventional navigation system.

背景：为了研究使用 Magic Leap 头戴式设备 (HMD) 的增强现实 (AR) 导航的准确性，我们在四个脊柱模型中微创放置了椎弓根螺钉。

方法：使用常规导航系统与 Magic Leap 头戴式设备 (AR-HMD) 相结合的 AR 导航。使用 AR-HMD 和导航仪器规划并插入模型的 Th11-L4 中的 48 个螺钉。术后 CT 扫描用于评估螺钉的技术（与计划的偏差）和临床（Gertzbein 分级）准确性。记录每个螺钉放置的时间。

结果：导航计划与螺钉位置之间的平均偏差在进钉点为 1.9 ± 0.7 mm（1.9 [0.3-4.1] mm），在螺钉尖端为 1.4 ± 0.8 mm（1.2 [0.1-3.9] mm）。角度偏差为 3.0 ± 1.4°（2.7 [0.4-6.2]°），螺钉放置的平均时间为 130 ± 55 s（108 [58-437] s）。根据 Gertzbein 分级标准，临床准确性为 94%。

结论：将 AR-HMD 与常规导航系统相结合，可实现准确的微创螺钉放置，既利用了 AR 在外科医生视角下的优势，又具有常规导航系统的可靠性。