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导航技术在腰椎手术中的影响:历史回顾、当前技术及未来发展方向研究

The Impact of Navigation in Lumbar Spine Surgery: A Study of Historical Aspects, Current Techniques and Future Directions.

作者信息

Heydar Ahmed Majid, Tanaka Masato, Prabhu Shrinivas P, Komatsubara Tadashi, Arataki Shinya, Yashiro Shogo, Kanamaru Akihiro, Nanba Kazumasa, Xiang Hongfei, Hieu Huynh Kim

机构信息

Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Okayama 702-8055, Japan.

Orthopedic and Traumatology Clinic, Memorial Bahçelievler Hospital, Bahçelievler Merkez, Adnan Kahveci Blv. No: 227, 34180 İstanbul, Turkey.

出版信息

J Clin Med. 2024 Aug 8;13(16):4663. doi: 10.3390/jcm13164663.

DOI:10.3390/jcm13164663
PMID:39200805
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11354833/
Abstract

: We sought to improve accuracy while minimizing radiation hazards, improving surgical outcomes, and preventing potential complications. Despite the increasing popularity of these systems, a limited number of papers have been published addressing the historical evolution, detailing the areas of use, and discussing the advantages and disadvantages, of this increasingly popular system in lumbar spine surgery. Our objective was to offer readers a concise overview of navigation system history in lumbar spine surgeries, the techniques involved, the advantages and disadvantages, and suggestions for future enhancements to the system. : A comprehensive review of the literature was conducted, focusing on the development and implementation of navigation systems in lumbar spine surgeries. Our sources include PubMed-indexed peer-reviewed journals, clinical trial data, and case studies involving technologies such as computer-assisted surgery (CAS), image-guided surgery (IGS), and robotic-assisted systems. : To develop more practical, effective, and accurate navigation techniques for spine surgery, consistent advancements have been made over the past four decades. This technological progress began in the late 20th century and has since encompassed image-guided surgery, intraoperative imaging, advanced navigation combined with robotic assistance, and artificial intelligence. These technological advancements have significantly improved the accuracy of implant placement, reducing the risk of misplacement and related complications. Navigation has also been found to be particularly useful in tumor resection and minimally invasive surgery (MIS), where conventional anatomic landmarks are lacking or, in the case of MIS, not visible. Additionally, these innovations have led to shorter operative times, decreased radiation exposure for patients and surgical teams, and lower rates of reoperation. As navigation technology continues to evolve, future innovations are anticipated to further enhance the capabilities and accessibility of these systems, ultimately leading to improved patient outcomes in lumbar spine surgery. : The initial limited utilization of navigation system in spine surgery has further expanded to encompass almost all fields of lumbar spine surgeries. As the cost-effectiveness and number of trained surgeons improve, a wider use of the system will be ensured so that the navigation system will be an indispensable tool in lumbar spine surgery. However, continued research and development, along with training programs for surgeons, are essential to fully realize the potential of these technologies in clinical practice.

摘要

我们力求在将辐射危害降至最低的同时提高准确性,改善手术效果,并预防潜在并发症。尽管这些系统越来越受欢迎,但针对这一在腰椎手术中日益普及的系统的历史演变、详细使用领域以及优缺点进行论述的论文数量有限。我们的目的是为读者提供腰椎手术导航系统历史、所涉及技术、优缺点以及该系统未来改进建议的简要概述。

对文献进行了全面综述,重点关注导航系统在腰椎手术中的开发与应用。我们的资料来源包括PubMed索引的同行评审期刊、临床试验数据以及涉及计算机辅助手术(CAS)、图像引导手术(IGS)和机器人辅助系统等技术的病例研究。

为了开发更实用、有效和准确的脊柱手术导航技术,在过去四十年中不断取得进展。这一技术进步始于20世纪后期,此后涵盖了图像引导手术、术中成像、结合机器人辅助的先进导航以及人工智能。这些技术进步显著提高了植入物放置的准确性,降低了误置风险及相关并发症。还发现导航在肿瘤切除和微创手术(MIS)中特别有用,因为在这些手术中缺乏传统的解剖标志,或者在MIS情况下这些标志不可见。此外,这些创新导致手术时间缩短、患者和手术团队的辐射暴露减少以及再次手术率降低。随着导航技术不断发展,预计未来的创新将进一步提升这些系统的功能和可及性,最终改善腰椎手术的患者预后。

导航系统在脊柱手术中最初的有限应用已进一步扩展到几乎所有腰椎手术领域。随着成本效益的提高和经过培训的外科医生数量的增加,将确保该系统得到更广泛的应用,从而使导航系统成为腰椎手术中不可或缺的工具。然而,持续的研发以及针对外科医生的培训项目对于在临床实践中充分发挥这些技术的潜力至关重要。

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