整合导航辅助以重定向自由手脊柱仪器:经验和技术
Lauren Stone1, Marin McDonald2, Luke Wojdyla2
1Department of Neurological Surgery, UC San Diego, San Diego, CA, USA.
Journal of robotic surgery
|September 4, 2023
概括
在胸腔关和关结合中错误指向的脊柱螺丝可以通过手术内CT和导航成功重定向. 这种技术确保了准确的螺丝放置,避免了修复手术和术后缺陷.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 脊柱融合技术 脊柱融合技术
背景情况:
- 脊柱融合涉及胸脊柱和神经骨区域是复杂的程序.
- 精确的螺丝放置对于融合成功和预防神经损伤至关重要.
- 在手术期间识别和纠正错误方向的螺丝是必不可少的.
研究的目的:
- 评估使用手术内CT (iCT) 和导航来重定向误导的脊柱螺丝的有效性和安全性.
- 评估与螺丝重定向相关的神经监测值.
- 为了确定螺丝重定向后修复手术和术后神经学缺陷的发生率.
主要方法:
- 脊柱融合 (>3级) 的回顾性审查,涉及胸关节和/或神经关节.
- 包括在iCT上被识别为误导并随后使用导航重新定向的螺丝.
- 对电肌学 (EMG) 值的神经监测报告的分析.
- 导向前和导向后成像的独立放射学审查.
主要成果:
- 使用iCT和导航,成功地重新定向了50个误导的螺丝 (胸部,腰部,肋骨,阴茎).
- 所有重定向的螺丝在独立的神经放射学家和神经外科医生审查中都得到了令人满意的确认.
- 没有螺丝需要修复手术,没有患者经历了术后缺陷.
- 重定向螺丝的EMG刺激值始终为>15 mA.
结论:
- 在手术内CT和导航提供了可靠的方法来检测和纠正错误的脊柱螺丝在胸脊和结合.
- 使用这种技术的螺丝重定向是安全有效的,最大限度地减少了修复手术的需要.
- 这种方法可以提高复杂的脊髓融合手术过程中的手术精度和患者安全.
相关概念视频
01:18Leveling Equipment
As leveling involves measuring vertical distances relative to a horizontal line of sight, it requires a graduated rod, called a level rod, for vertical measurements and an instrument called a level for a horizontal sight line. A level includes a high-powered telescope with a mechanism for leveling to ensure the line of sight is horizontal when the bubble in the spirit level is centered. Leveling rods, made of wood, metal, or fiberglass, are graduated in feet or meters and commonly used in two-...
01:30Design Example: Identifying the Locations of Monuments in the Field Using Global Positioning System Device
Surveyors use Global Positioning System (GPS) technology to measure the precise location and elevation of points on Earth. In a recent survey, GPS receivers were used to determine the coordinates and elevations of two park monuments. The process involved careful mission planning, data collection, and correction to ensure accuracy. The survey began with mission planning to identify optimal satellite visibility and minimize Position Dilution of Precision (PDOP). A geodetic control point served as...