Alozai Muhammad Ilyas, Amgad Yehia Elassra Omar, Alkhazendar Aliaa H, Ibrahim Ahmed S, Sattar Gatta Abdul, Raza Syed Muhammad Baqar, Sahnon Abdelrahman Sahnon Abaker, Hj Alkhazendar Jarallah, Oriko David O, Mushtaq Shafaq
Internal Medicine, Punjab Medical College, Faisalabad Medical University, Faisalabad, PAK.
Emergency Medicine, North Manchester General Hospital, Manchester, GBR.
Cureus. 2025 Jun 15;17(6):e86035. doi: 10.7759/cureus.86035. eCollection 2025 Jun.
This systematic review evaluates the impact of intraoperative imaging on surgical outcomes in combined neurosurgical and reconstructive procedures. A comprehensive literature search was conducted across four databases, including PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), focusing on clinical trials published between 2019 and 2024. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, six studies that met stringent eligibility criteria were selected, including randomized controlled trials (RCTs) and prospective cohort studies involving imaging modalities such as intraoperative MRI (iMRI), intraoperative ultrasound (iUS), fluoroscopy, neuronavigation, and machine vision-based systems. Data were extracted on sample size, intervention type, control group characteristics, and primary surgical outcomes, including extent of resection, complication rates, and functional recovery. Qualitative synthesis revealed consistent benefits associated with intraoperative imaging, including enhanced anatomical precision, reduced complication rates, improved extent of resection, and fewer reoperations. Quality appraisal indicated low to moderate risk of bias across most studies. These findings endorse the broader integration of intraoperative imaging into complex surgical workflows and highlight the need for further research in reconstructive domains.
本系统评价评估了术中成像对神经外科与重建联合手术的手术效果的影响。在四个数据库中进行了全面的文献检索，包括PubMed、Scopus、科学网和Cochrane对照试验中央注册库（CENTRAL），重点关注2019年至2024年发表的临床试验。按照系统评价和Meta分析的首选报告项目（PRISMA）指南，选择了六项符合严格纳入标准的研究，包括随机对照试验（RCT）和前瞻性队列研究，涉及术中磁共振成像（iMRI）、术中超声（iUS）、荧光透视、神经导航和基于机器视觉的系统等成像方式。提取了样本量、干预类型、对照组特征以及主要手术结果的数据，包括切除范围、并发症发生率和功能恢复情况。定性综合分析显示，术中成像具有一致的益处，包括提高解剖精度、降低并发症发生率、改善切除范围以及减少再次手术。质量评估表明，大多数研究的偏倚风险为低到中度。这些发现支持将术中成像更广泛地整合到复杂的手术流程中，并强调在重建领域进行进一步研究的必要性。
