Chang Chia-Ning, Li Chi-Ruei, Liao Sian-Siang, Shen Chiung-Chyi, Chen Kai-Yuan, Lee Chung-Hsin, Yang Meng-Yin
Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard, Sec. 4, Taichung City 40705, Taiwan.
Medicina (Kaunas). 2025 Mar 24;61(4):576. doi: 10.3390/medicina61040576.
: Recent advancements in spinal navigation methodologies, particularly augmented reality (AR) techniques, have significantly enhanced the precision of spinal instrumentation procedures. This study aimed to evaluate the efficacy of AR-assisted navigation in spinal instrumentation surgery for thoracolumbar scoliosis. : This retrospective observational study included 10 patients with thoracolumbar scoliosis who met specific inclusion criteria and were recruited at a single medical center. Two neurosurgeons and one neuroradiologist used the Gertzbein-Robbins scale (GRS) for radiological evaluation. Preoperative and postoperative Cobb angles were measured to assess the correction of scoliosis. Overall, 257 screws were placed using the AR-assisted navigation system during thoracic and lumbar spinal deformity surgeries. : Among the 257 screws, 197 were placed in the thoracic spine and 60 in the lumbar spine, achieving an overall instrumentation accuracy of 98%. The preoperative Cobb angle of 69.5 ± 22.2° significantly improved to 10.1 ± 4.1° postoperatively. Regarding first-attempt screw placement accuracy, 97.4% of the screws in the thoracic spine (graded as GRS A or B) and 100% in the lumbar spine were placed with precision. Five grade C thoracic screws were identified, one of which required re-instrumentation. : The AR navigation technique substantially improved the precision of spinal deformity surgery, with a high screw placement accuracy rate and significant scoliosis correction. The benefits of reduced attention diversion and an intuitive surgical experience suggest that AR technology could significantly improve spinal surgery practices and training programs, indicating potential for broader applicability in the future.
脊柱导航方法的最新进展，尤其是增强现实（AR）技术，显著提高了脊柱内固定手术的精度。本研究旨在评估AR辅助导航在胸腰椎脊柱侧弯脊柱内固定手术中的疗效。：这项回顾性观察研究纳入了10例符合特定纳入标准的胸腰椎脊柱侧弯患者，这些患者均在单一医疗中心招募。两名神经外科医生和一名神经放射科医生使用Gertzbein-Robbins量表（GRS）进行放射学评估。测量术前和术后的Cobb角以评估脊柱侧弯的矫正情况。总体而言，在胸腰椎脊柱畸形手术中，使用AR辅助导航系统共置入了257枚螺钉。：在这257枚螺钉中，197枚置入胸椎，60枚置入腰椎，总体置入准确率达到98%。术前Cobb角为69.5±22.2°，术后显著改善至10.1±4.1°。关于首次尝试螺钉置入的准确性，胸椎中97.4%的螺钉（分级为GRS A或B）和腰椎中100%的螺钉均精确置入。发现5枚C级胸椎螺钉，其中1枚需要重新置入内固定。：AR导航技术显著提高了脊柱畸形手术的精度，螺钉置入准确率高，脊柱侧弯矫正效果显著。注意力转移减少和手术体验直观的益处表明，AR技术可显著改善脊柱手术实践和培训项目，显示出未来更广泛应用的潜力。
