Sakai Daisuke, Schol Jordy, Kawachi Asami, Sako Kosuke, Hiyama Akihiko, Katoh Hiroyuki, Sato Masato, Watanabe Masahiko
Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Japan.
Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Japan.
World Neurosurg. 2023 Oct;178:e96-e103. doi: 10.1016/j.wneu.2023.06.144. Epub 2023 Jul 8.
Augmented reality (AR) is becoming more common and slowly being integrated into the surgical field. With the continuous progression of navigation and visualization techniques, AR has great potential to improve surgical quality and safety. Nevertheless, the effects of AR on surgical outcomes and surgeons' well-being remains poorly studied. The present prospective controlled study aims to assess the effect of surgery assisted with AR smart glasses on adolescent idiopathic scoliosis (AIS) deformity correction outcomes and surgeon fatigue.
AIS patients scheduled for surgical deformity correction were prospectively recruited and assigned to standard or AR-supported surgery, using lightweight AR smart glasses. The demographic and clinical features were recorded. The pre- and postoperative spinal features, operative time, and blood loss were recorded and compared. Finally, the participating surgeons were asked to complete a questionnaire (e.g., visual analog scale for fatigue) to compare the effects of AR on their well-being.
Our results have shown enhanced spinal deformity corrections with Cobb angle (-35.7° vs. -46.9°), thoracic kyphosis (8.1° vs. 11.6°), and vertebral rotation (-9.3° vs. -13.8°) changes favoring AR-supported surgery. Moreover, AR resulted in significantly lower violation rates per patient (7.5% vs. 6.6%; P = 0.023). Finally, the visual analog scale for fatigue scores consistently showed a significant reduction in fatigue (5.7 ± 1.7 vs. 3.3 ± 1.2; P < 0.001) and other fatigue classifiers for the surgeons after AR-supported surgery.
Our controlled study has highlighted the enhanced spinal correction rates in AR-supported surgery and also improved surgeons' well-being and fatigue. These results endorse the adaptation of AR techniques to support AIS surgical correction.
增强现实(AR)正变得越来越普遍,并逐渐被整合到外科手术领域。随着导航和可视化技术的不断进步,AR在提高手术质量和安全性方面具有巨大潜力。然而,AR对外科手术结果和外科医生幸福感的影响仍研究不足。本前瞻性对照研究旨在评估使用AR智能眼镜辅助手术对青少年特发性脊柱侧凸(AIS)畸形矫正效果及外科医生疲劳程度的影响。
前瞻性招募计划接受手术畸形矫正的AIS患者,并使用轻便的AR智能眼镜将其分为标准手术组或AR辅助手术组。记录人口统计学和临床特征。记录并比较术前和术后的脊柱特征、手术时间和失血量。最后,要求参与手术的外科医生完成一份问卷(如疲劳视觉模拟量表),以比较AR对他们幸福感的影响。
我们的结果显示,在Cobb角(-35.7°对-46.9°)、胸椎后凸(8.1°对11.6°)和椎体旋转(-9.3°对-13.8°)方面,AR辅助手术在脊柱畸形矫正方面效果更好。此外,AR导致每位患者的违规率显著降低(7.�%对6.6%;P = 0.023)。最后,疲劳视觉模拟量表评分始终显示,AR辅助手术后外科医生的疲劳程度显著降低(5.7±1.7对3.3±1.2;P < 0.001),以及其他疲劳分类指标也有改善。
我们的对照研究突出了AR辅助手术中脊柱矫正率的提高,同时也改善了外科医生的幸福感和疲劳程度。这些结果支持采用AR技术来辅助AIS手术矫正。