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增强现实头戴式显示器在胸腰椎脊柱创伤手术管理中的应用。

Utilization of Augmented Reality Head-Mounted Display for the Surgical Management of Thoracolumbar Spinal Trauma.

机构信息

Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.

University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.

出版信息

Medicina (Kaunas). 2024 Feb 6;60(2):281. doi: 10.3390/medicina60020281.


DOI:10.3390/medicina60020281
PMID:38399568
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10890598/
Abstract

: Augmented reality head-mounted display (AR-HMD) is a novel technology that provides surgeons with a real-time CT-guided 3-dimensional recapitulation of a patient's spinal anatomy. In this case series, we explore the use of AR-HMD alongside more traditional robotic assistance in surgical spine trauma cases to determine their effect on operative costs and perioperative outcomes. : We retrospectively reviewed trauma patients who underwent pedicle screw placement surgery guided by AR-HMD or robotic-assisted platforms at an academic tertiary care center between 1 January 2021 and 31 December 2022. Outcome distributions were compared using the Mann-Whitney U test. : The AR cohort (n = 9) had a mean age of 66 years, BMI of 29.4 kg/m, Charlson Comorbidity Index (CCI) of 4.1, and Surgical Invasiveness Index (SII) of 8.8. In total, 77 pedicle screws were placed in this cohort. Intra-operatively, there was a mean blood loss of 378 mL, 0.78 units transfused, 398 min spent in the operating room, and a 20-day LOS. The robotic cohort (n = 13) had a mean age of 56 years, BMI of 27.1 kg/m, CCI of 3.8, and SII of 14.2. In total, 128 pedicle screws were placed in this cohort. Intra-operatively, there was a mean blood loss of 432 mL, 0.46 units transfused units used, 331 min spent in the operating room, and a 10.4-day LOS. No significant difference was found between the two cohorts in any outcome metrics. : Although the need to address urgent spinal conditions poses a significant challenge to the implementation of innovative technologies in spine surgery, this study represents an initial effort to show that AR-HMD can yield comparable outcomes to traditional robotic surgical techniques. Moreover, it highlights the potential for AR-HMD to be readily integrated into Level 1 trauma centers without requiring extensive modifications or adjustments.

摘要

增强现实头戴式显示器 (AR-HMD) 是一种新颖的技术,可为外科医生提供实时 CT 引导的患者脊柱解剖学三维重现。在本病例系列中,我们探讨了在手术脊柱创伤病例中使用 AR-HMD 与更传统的机器人辅助相结合对手术成本和围手术期结果的影响。

我们回顾性分析了 2021 年 1 月 1 日至 2022 年 12 月 31 日在一家学术三级护理中心接受 AR-HMD 或机器人辅助平台引导下椎弓根螺钉放置手术的创伤患者。使用 Mann-Whitney U 检验比较结果分布。

AR 组(n = 9)的平均年龄为 66 岁,BMI 为 29.4kg/m2,Charlson 合并症指数 (CCI) 为 4.1,手术侵袭指数 (SII) 为 8.8。共有 77 枚椎弓根螺钉植入该组。术中平均失血量为 378mL,输血量为 0.78 单位,手术室时间为 398 分钟,住院时间为 20 天。机器人组(n = 13)的平均年龄为 56 岁,BMI 为 27.1kg/m2,CCI 为 3.8,SII 为 14.2。共有 128 枚椎弓根螺钉植入该组。术中平均失血量为 432mL,输血量为 0.46 单位,手术室时间为 331 分钟,住院时间为 10.4 天。两组在任何结果指标上均无显著差异。

尽管需要处理紧急脊柱状况对脊柱外科中创新技术的实施构成了重大挑战,但本研究代表了首次努力表明 AR-HMD 可以产生与传统机器人手术技术相当的结果。此外,它突出了 AR-HMD 可以在无需进行广泛修改或调整的情况下轻松集成到一级创伤中心的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51d7/10890598/1902f41bddfc/medicina-60-00281-g003a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51d7/10890598/fcfe95963c5f/medicina-60-00281-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51d7/10890598/98fe92b921e4/medicina-60-00281-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51d7/10890598/1902f41bddfc/medicina-60-00281-g003a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51d7/10890598/fcfe95963c5f/medicina-60-00281-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51d7/10890598/98fe92b921e4/medicina-60-00281-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51d7/10890598/1902f41bddfc/medicina-60-00281-g003a.jpg

相似文献

[1]
Utilization of Augmented Reality Head-Mounted Display for the Surgical Management of Thoracolumbar Spinal Trauma.

Medicina (Kaunas). 2024-2-6

[2]
Augmented reality in minimally invasive spine surgery: early efficiency and complications of percutaneous pedicle screw instrumentation.

Spine J. 2023-1

[3]
First in-human report of the clinical accuracy of thoracolumbar percutaneous pedicle screw placement using augmented reality guidance.

Neurosurg Focus. 2021-8

[4]
Real-time navigation guidance with intraoperative CT imaging for pedicle screw placement using an augmented reality head-mounted display: a proof-of-concept study.

Neurosurg Focus. 2021-8

[5]
Accuracy of robot-guided versus freehand fluoroscopy-assisted pedicle screw insertion in thoracolumbar spinal surgery.

Neurosurg Focus. 2017-5

[6]
Feasibility and Accuracy of Thoracolumbar Pedicle Screw Placement Using an Augmented Reality Head Mounted Device.

Sensors (Basel). 2022-1-11

[7]
Clinical accuracy and initial experience with augmented reality-assisted pedicle screw placement: the first 205 screws.

J Neurosurg Spine. 2021-10-8

[8]
Robotic versus fluoroscopy-guided pedicle screw insertion for metastatic spinal disease: a matched-cohort comparison.

Neurosurg Focus. 2017-5

[9]
Head-mounted display augmented reality to guide pedicle screw placement utilizing computed tomography.

Int J Comput Assist Radiol Surg. 2018-6-22

[10]
The XVS System During Open Spinal Fixation Procedures in Patients Requiring Pedicle Screw Placement in the Lumbosacral Spine.

World Neurosurg. 2022-8

引用本文的文献

[1]
Using Patient-Specific 3D-Printed C1-C2 Interfacet Spacers for the Treatment of Type 1 Basilar Invagination: A Clinical Case Report.

Biomimetics (Basel). 2025-6-17

[2]
The Application of Augmented Reality Technology in Perioperative Visual Guidance: Technological Advances and Innovation Challenges.

Sensors (Basel). 2024-11-19

[3]
Complications in Minimally Invasive Spine Surgery in the Last 10 Years: A Narrative Review.

Neurospine. 2024-9

[4]
Metaverse in surgery - origins and future potential.

Nat Rev Urol. 2024-9-30

[5]
Assessment of head-mounted display for exoscopic neurosurgery.

Surg Neurol Int. 2024-8-2

本文引用的文献

[1]
Robotic and navigated pedicle screws are safer and more accurate than fluoroscopic freehand screws: a systematic review and meta-analysis.

Spine J. 2023-2

[2]
Augmented reality in minimally invasive spine surgery: early efficiency and complications of percutaneous pedicle screw instrumentation.

Spine J. 2023-1

[3]
Augmented Reality Spine Surgery Navigation: Increasing Pedicle Screw Insertion Accuracy for Both Open and Minimally Invasive Spine Surgeries.

Spine (Phila Pa 1976). 2022-6-15

[4]
Augmented Reality-Assisted Spine Surgery: An Early Experience Demonstrating Safety and Accuracy with 218 Screws.

Global Spine J. 2023-9

[5]
Clinical accuracy and initial experience with augmented reality-assisted pedicle screw placement: the first 205 screws.

J Neurosurg Spine. 2021-10-8

[6]
Less Invasive Pediatric Spinal Deformity Surgery: The Case for Robotic-Assisted Placement of Pedicle Screws.

HSS J. 2021-10

[7]
First in-human report of the clinical accuracy of thoracolumbar percutaneous pedicle screw placement using augmented reality guidance.

Neurosurg Focus. 2021-8

[8]
Augmented reality-mediated stereotactic navigation for execution of en bloc lumbar spondylectomy osteotomies.

J Neurosurg Spine. 2021-3-5

[9]
Clinical Accuracy, Technical Precision, and Workflow of the First in Human Use of an Augmented-Reality Head-Mounted Display Stereotactic Navigation System for Spine Surgery.

Oper Neurosurg (Hagerstown). 2021-2-16

[10]
A cadaveric precision and accuracy analysis of augmented reality-mediated percutaneous pedicle implant insertion.

J Neurosurg Spine. 2020-10-30

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