机器人辅助导航需要外科手术期间CT在后脊柱融合和仪器仪表用于异常脊椎病,与增加的整体累积有效辐射剂量有关
Isabella G Marsh1, Ithika S Senthilnathan, Patrick P Nian
1Hospital for Special Surgery, New York, NY.
Journal of pediatric orthopedics
|March 4, 2026
概括
针对儿科脊椎形手术的机器人辅助导航 (RAN) 显著减少了手术内辐射,但与自由手 (FH) 技术相比,显著增加了患者的总辐射暴露. 需要进一步的研究,以优化机器人脊柱手术中的辐射安全.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 医疗机器人 医疗机器人
- 辐射安全 辐射安全
背景情况:
- 机器人辅助导航 (RAN) 越来越多地用于儿科异常脊椎病手术,比传统的自由手 (FH) 技术提供更高的准确性.
- 由于RAN需要先进的成像,人们对患者和外科医生的辐射暴露产生了担忧.
- 这项研究旨在比较后脊髓融合和仪器仪表 (PSFI) 中的RAN和FH方法之间的辐射剂量.
研究的目的:
- 为了比较RAN和FH技术之间的手术内光学辐射剂量.
- 为了比较RAN和FH技术之间的整个外科手术期间的辐射剂量.
- 评估儿童脊柱融合中辐射暴露的安全影响.
主要方法:
- 一项比较研究包括121名患有异常学脊椎病的儿科患者接受PSFI (41 FH,80 RAN).
- 使用FH与光学或RAN进行了手术前CT和手术内注册.
- 用ANCOVA分析了辐射剂量,控制了相关的患者和手术因素.
主要成果:
- 与FH (0.5mSv) 相比,RAN显示了手术内光学辐射 (0.4mSv) 的显著减少.
- 然而,FH的累积术前辐射剂量比RAN (12.5 mSv) 低得多 (0.5 mSv).
- RAN导致手术内辐射减少了1.5倍,但总辐射暴露增加了25倍.
结论:
- RAN降低了外科医生手术期间的辐射,但显著增加了患者的外科期间的辐射暴露.
- 研究结果表明,需要在机器人脊椎手术中改进辐射降低策略,可能使用低剂量CT.
- 手术团队应重新评估成像协议,以尽量减少患者在使用RAN时的辐射暴露.
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