Jun Eun Kyung, Lim Sunghwan, Seo Joonho, Lee Kae Hong, Lee Jae Hee, Lee Deukhee, Koh Jae Chul
Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Seoul, Korea.
Center for Healthcare Robotics, Artificial Intelligence and Robotics Institute, Korea Institute of Science and Technology, Seoul, Korea.
J Pain Res. 2023 Mar 17;16:921-931. doi: 10.2147/JPR.S400955. eCollection 2023.
Multiple studies have attempted to demonstrate the benefits of augmented reality (AR)-assisted navigation systems in surgery. Lumbosacral transforaminal epidural injection is an effective treatment commonly used in patients with radiculopathy due to spinal degenerative pathologies. However, few studies have applied AR-assisted navigation systems to this procedure. The study aimed to investigate the safety and effectiveness of an AR-assisted navigation system for transforaminal epidural injection.
Through a real-time tracking system and a wireless network to the head-mounted display, computed tomography images of the spine and the path of a spinal needle to the target were visualized on a torso phantom with respiration movements installed. From L1/L2 to L5/S1, needle insertions were performed using an AR-assisted system on the left side of the phantom, and the conventional method was performed on the right side.
The procedure duration was approximately three times shorter, and the number of radiographs required was reduced in the experimental group compared to the control group. The distance from the needle tips to the target areas in the plan showed no significant difference between the two groups. (AR group 1.7 ± 2.3mm, control group 3.2 ± 2.8mm, P value 0.067).
An AR-assisted navigation system may be used to reduce the time required for spinal interventions and ensure the safety of patients and physicians in view of radiation exposure. Further studies are essential to apply AR-assisted navigation systems to spine interventions.
多项研究试图证明增强现实(AR)辅助导航系统在手术中的益处。腰骶部经椎间孔硬膜外注射是治疗因脊柱退行性病变导致神经根病患者常用的有效方法。然而,很少有研究将AR辅助导航系统应用于该手术。本研究旨在探讨AR辅助导航系统用于经椎间孔硬膜外注射的安全性和有效性。
通过实时跟踪系统和无线网络连接到头戴式显示器,在安装有呼吸运动的躯干模型上可视化脊柱的计算机断层扫描图像以及脊柱穿刺针到达目标的路径。从L1/L2至L5/S1,在模型左侧使用AR辅助系统进行穿刺针插入,在右侧采用传统方法。
与对照组相比,实验组的手术时间缩短了约三倍,所需的X线片数量减少。计划中穿刺针尖端到目标区域的距离在两组之间无显著差异。(AR组1.7±2.3mm,对照组3.2±2.8mm,P值0.067)。
AR辅助导航系统可用于减少脊柱干预所需时间,并鉴于辐射暴露确保患者和医生的安全。将AR辅助导航系统应用于脊柱干预还需要进一步研究。