Neurosurgery Division, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Department of Anesthesiology and Operating Room, Phramongkutklao Hospital, Bangkok, Thailand.
Neurosurg Rev. 2024 Jan 18;47(1):52. doi: 10.1007/s10143-023-02260-5.
Digital twins are virtual replicas of their physical counterparts, and can assist in delivering personalized surgical care. This PRISMA guideline-based systematic review evaluates current literature addressing the effectiveness and role of digital twins in many stages of neurosurgical management. The aim of this review is to provide a high-quality analysis of relevant, randomized controlled trials and observational studies addressing the neurosurgical applicability of a variety of digital twin technologies. Using pre-specified criteria, we evaluated 25 randomized controlled trials and observational studies on the applications of digital twins, including navigation, robotics, and image-guided neurosurgeries. All 25 studies compared these technologies against usual surgical approaches. Risk of bias analyses using the Cochrane risk of bias tool for randomized trials (Rob 2) found "low" risk of bias in the majority of studies (23/25). Overall, this systematic review shows that digital twin applications have the potential to be more effective than conventional neurosurgical approaches when applied to brain and spinal surgery. Moreover, the application of these novel technologies may also lead to fewer post-operative complications.
数字孪生是物理实体的虚拟复制品，可以帮助提供个性化的手术护理。本基于 PRISMA 指南的系统评价评估了当前文献中数字孪生在神经外科管理的许多阶段的有效性和作用。本综述的目的是对涉及各种数字孪生技术在神经外科应用的相关随机对照试验和观察性研究进行高质量分析。使用预先指定的标准，我们评估了 25 项关于数字孪生应用的随机对照试验和观察性研究，包括导航、机器人和图像引导神经外科手术。所有 25 项研究均将这些技术与常规手术方法进行了比较。使用 Cochrane 对随机试验的偏倚风险工具（Rob 2）进行的偏倚风险分析发现，大多数研究（23/25）存在“低”偏倚风险。总体而言，本系统评价表明，当应用于脑和脊髓手术时，数字孪生应用可能比传统神经外科方法更有效。此外，这些新技术的应用还可能导致术后并发症更少。
