Islamic International Medical College, Rawalpindi, 44000, MBBS, Pakistan.
Neurosurg Rev. 2024 Sep 4;47(1):535. doi: 10.1007/s10143-024-02803-4.
Spine surgery is essential for restoring alignment, stability, and function in patients with cervical spine injuries, especially when instability, pain, deformity, or progressive nerve damage is present. Effective wound closure is vital in these procedures, aiming to promote rapid healing, reduce infection risks, enable early mobilization, and ensure satisfactory cosmetic results. However, there is limited evidence on the optimal wound closure technique for posterior spine surgery, highlighting the need for innovative approaches. A study by Glener et al. evaluated the effectiveness of STRATAFIX™ Symmetric barbed sutures compared to traditional braided absorbable sutures in spinal surgery. In a randomized trial involving 20 patients, the STRATAFIX™ group demonstrated a shorter mean closure time and significantly fewer sutures used, though without a statistically significant reduction in closure time. No significant differences were observed in postoperative complications between the groups during a six-month follow-up. While the findings suggest potential cost savings and efficiency improvements with STRATAFIX™, the study's small sample size and short follow-up period limit its generalizability. Furthermore, AI-based models, such as the Xception deep learning model, show promise in improving suture training accuracy for medical students, which could enhance surgical outcomes and reduce complications. Despite the promising results, further research with larger sample sizes, extended follow-up periods, and multi-center trials is necessary to validate the effectiveness of barbed sutures like STRATAFIX™ in neurosurgery. The integration of AI in surgical training and continued exploration of innovative techniques are essential to advancing the field and optimizing patient care in spinal surgery.
脊柱手术对于恢复颈椎损伤患者的脊柱排列、稳定性和功能至关重要,特别是在存在不稳定、疼痛、畸形或进行性神经损伤时。有效的伤口闭合对于这些手术至关重要,旨在促进快速愈合、降低感染风险、实现早期活动并确保满意的美容效果。然而,对于后脊柱手术的最佳伤口闭合技术,目前证据有限,需要创新方法。Glener 等人的研究评估了 STRATAFIX™ 对称型倒钩缝线与传统编织可吸收缝线在脊柱手术中的效果。在一项涉及 20 名患者的随机试验中,STRATAFIX™ 组的平均闭合时间更短,使用的缝线明显更少,但闭合时间没有统计学显著减少。在 6 个月的随访期间,两组之间在术后并发症方面没有观察到显著差异。虽然研究结果表明 STRATAFIX™ 可能具有成本节约和效率提高的潜力,但研究的样本量小且随访时间短限制了其普遍性。此外,基于人工智能的模型,如 Xception 深度学习模型,有望提高医学生缝线训练的准确性,从而改善手术结果并减少并发症。尽管取得了有希望的结果,但需要进行更大样本量、更长随访期和多中心试验的进一步研究,以验证 STRATAFIX™ 等倒钩缝线在神经外科中的有效性。人工智能在手术培训中的整合以及对创新技术的持续探索,对于推进脊柱外科领域并优化患者护理至关重要。