Kim K D, Johnson J P, Masciopinto J E, Bloch O, Saracen M J, Villablanca J P
Division of Neurosurgery, School of Medicine, University of California, Los Angeles, USA.
Neurosurgery. 1999 Jan;44(1):173-7; discussion 177-8. doi: 10.1097/00006123-199901000-00105.
To describe new software applications and interchangeable instrumentation enabling the use of standard surgical instruments with image-guided systems for stereotactic spinal procedures.
The ability to adapt essentially any surgical instrument for stereotactic procedures will improve the safety and accuracy of image-guided spinal surgery.
Using universal dynamic registration hardware and software, standard surgical instruments are adapted for real-time image-guided surgery. The Radionics Optical Tracking System (Radionics, Inc., Burlington, MA) has custom software applications and universal hardware adaptation devices for spinal stereotaxy that allows the use of standard instruments for intraoperative guidance. An array of light-emitting diodes can be attached to essentially any rigid instrument with a definable tip and can then be calibrated to the system for intraoperative use. Stereotactic guidance of a drill, tap, and screwdriver may improve screw placement accuracy in spinal surgery because every step of the procedure can be monitored in real time.
Most stereotactic systems have only a standard probe or limited instruments for localization, targeting, and tracking a procedure. The surgeon then resumes the operation using standard surgical instruments without the benefit of image guidance for the key steps of the procedure. Because each surgical step for screw placement in the spine has a potential for error, use of multiple instruments that can be interchanged for real-time image-guided spinal surgery may increase the accuracy and safety of spinal instrumentation procedures. These techniques can also be applied to intracranial image-guided surgery.
描述新的软件应用程序和可互换器械，使标准手术器械能够与图像引导系统配合用于立体定向脊柱手术。
使基本上任何手术器械都能适用于立体定向手术的能力将提高图像引导脊柱手术的安全性和准确性。
使用通用动态注册硬件和软件，标准手术器械可适用于实时图像引导手术。Radionics光学跟踪系统（Radionics公司，马萨诸塞州伯灵顿）具有用于脊柱立体定向的定制软件应用程序和通用硬件适配装置，允许使用标准器械进行术中引导。一系列发光二极管可附着在基本上任何具有可定义尖端的刚性器械上，然后可针对术中使用校准至该系统。在脊柱手术中，对钻头、丝锥和螺丝刀进行立体定向引导可提高螺钉置入的准确性，因为手术的每个步骤都可实时监测。
大多数立体定向系统仅具有标准探头或有限的器械用于定位、靶向和跟踪手术过程。然后外科医生在手术的关键步骤中使用标准手术器械继续手术，而没有图像引导的优势。由于脊柱中螺钉置入的每个手术步骤都有可能出错，使用可互换用于实时图像引导脊柱手术的多种器械可能会提高脊柱器械操作程序的准确性和安全性。这些技术也可应用于颅内图像引导手术。
