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评估个性化微创技术在腰椎脊柱神经外科中使用的临床决策支持系统效率。

Assessment of Clinical Decision Support System Efficiency in Spinal Neurosurgery for Personalized Minimally Invasive Technologies Used on Lumbar Spine.

机构信息

Professor, Head of the Department of Neurosurgery and Innovative Medicine Irkutsk State Medical University, 1 Krasnogo Vosstaniya St., Irkutsk, 664003, Russia;; Chief of Neurosurgery Center Road Clinical Hospital, 10 Botkin St., Irkutsk, 664005, Russia;; Professor, Department of Traumatology, Orthopedics and Neurosurgery Irkutsk State Medical Academy for Postgraduate Education, 100 Yubileyny Microdistrict, Irkutsk, 664049, Russia.

Associate Professor, Department of Neurosurgery and Innovative Medicine Irkutsk State Medical University, 1 Krasnogo Vosstaniya St., Irkutsk, 664003, Russia;; Neurosurgeon, Neurosurgery Center Road Clinical Hospital, 10 Botkin St., Irkutsk, 664005, Russia.

出版信息

Sovrem Tekhnologii Med. 2021;13(5):13-21. doi: 10.17691/stm2021.13.5.02. Epub 2021 Oct 29.

Abstract

UNLABELLED

was to assess clinical decision support system (CDSS) in spinal surgery for personalized minimally invasive technologies on lumbar spine.

MATERIALS AND METHODS

The prospective study involved 59 patients operated on using CDSS based on a personalized surgical algorithm considering patient-specific parameters of lumbar segments. Among them, 11 patients underwent total disk replacement (TDR), 25 and 23 patients had minimally invasive (MI-TLIF) and open (O-TLIF) dorsal rigid stabilization, respectively, according to an original technology. The comparative analysis was carried out using retrospective findings of 196 patients operated on involving TDR (n=42), MI-TLIF (n=79), and O-TLIF (n=75). The efficiency of CDSS medical algorithms was assessed by pain syndrome in the lumbar spine and lower limbs, as well as by patients' functional status on discharge according to ODI, 3 and 6 months after the operation.

RESULTS

The comparison by gender characteristics and anthropometric data revealed no significant intergroup differences among the groups under study (p>0.05). Intergroup analysis of functional status by ODI, pain intensity in lower limbs and lumbar spine showed better clinical outcomes in patients operated using CDSS compared to a retrospective group (p<0.05): 6 months after TDR and O-TLIF, and 3 months after MI-TLIF.

CONCLUSION

The study findings demonstrated high efficiency of CDSS developed for personalized surgical treatment of patients with degenerative lumbar spine diseases taking into consideration individual biometric parameters of lumbar segments.

摘要

目的

评估脊柱外科中基于个性化微创手术的临床决策支持系统(CDSS)在腰椎的应用。

材料和方法

前瞻性研究共纳入 59 例患者,这些患者均根据考虑腰椎节段个体生物测量参数的个性化手术算法,接受了基于 CDSS 的治疗。其中,11 例患者接受了全椎间盘置换术(TDR),25 例和 23 例患者分别根据原始技术接受了微创(MI-TLIF)和开放(O-TLIF)后路刚性稳定术。通过回顾性分析接受 TDR(n=42)、MI-TLIF(n=79)和 O-TLIF(n=75)治疗的 196 例患者的发现进行了对比分析。通过腰椎和下肢疼痛综合征以及术后根据 ODI 评估的患者功能状态,评估 CDSS 医疗算法的效率,术后 3 个月和 6 个月进行评估。

结果

根据性别特征和人体测量数据进行的组间比较显示,研究组之间无显著的组间差异(p>0.05)。ODI、下肢和腰椎疼痛强度的功能状态组间分析显示,与回顾性组相比,使用 CDSS 治疗的患者具有更好的临床结果(p<0.05):TDR 和 O-TLIF 术后 6 个月,MI-TLIF 术后 3 个月。

结论

该研究结果表明,针对退行性腰椎疾病患者,基于个性化手术治疗的 CDSS 具有较高的效率,考虑了腰椎节段的个体生物测量参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eae8/8858415/7cbd4ce39d4b/STM-13-5-02-f1.jpg

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