Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.
Sci Rep. 2023 Feb 14;13(1):2644. doi: 10.1038/s41598-023-29710-w.
The aim of this study was to evaluate the influence of skin distortion due to surgical positioning on the clinical accuracy of the navigation system. The distance errors were measured in four fiducial markers (anterior, posterior, right, and left of the head) after the registration of the navigation system. The distance errors were compared between the surface-merge registration (SMR) method using preoperative imaging and the automatic intraoperative registration (AIR) method using intraoperative imaging. The comparison of the distance errors were performed in various surgical positions. The AIR method had the significant accuracy in the lateral markers than the SMR method (lateral position, 3.8 mm vs. 8.95 mm; p < 0.0001; prone position, 4.5 mm vs. 13.9 mm; p = 0.0001; 5.2 mm vs. 11.5 mm; p = 0.0070). The smallest distance errors were obtained close to the surgical field in the AIR method (3.25-3.85 mm) and in the forehead in the SMR method (3.3-8.1 mm). The AIR method was accurate and recommended for all the surgical positions if intraoperative imaging was available. The SMR method was only recommended for the supine position, because skin distortion was frequently observed in the lateral region.
本研究旨在评估因手术定位导致的皮肤变形对导航系统临床准确性的影响。在注册导航系统后，测量了四个基准标记物（头部的前、后、右和左侧）的距离误差。比较了使用术前成像的表面融合注册（SMR）方法和使用术中成像的自动术中注册（AIR）方法的距离误差。比较了各种手术位置的距离误差。AIR 方法在侧位标记物上的准确性明显优于 SMR 方法（侧位，3.8mm 比 8.95mm；p<0.0001；俯卧位，4.5mm 比 13.9mm；p=0.0001；5.2mm 比 11.5mm；p=0.0070）。在 AIR 方法中，距离误差最小接近手术区域（3.25-3.85mm），在 SMR 方法中，距离误差最小接近额头（3.3-8.1mm）。如果术中成像可用，AIR 方法准确且推荐用于所有手术位置。如果术中成像不可用，则仅推荐在仰卧位使用 SMR 方法，因为在侧区经常观察到皮肤变形。
