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Abstract：
The range of assistive technology options available for spinal fusion surgery has significantly increased. However, surgeons and hospital administrators may lack sufficient information to compare options and make purchasing decisions. We summarize currently available navigation, robotics, and imaging technologies for spinal surgery, highlighting key characteristics, utility, differences, price, and compatibility with other technologies and spinal implants. Guidelines for optimal use and combinations are provided based on surgical approach, operative site, patient anatomy, optimal image quality, and workflow efficiency. Key recommendations include the following. (I) Open-platform navigation and robotics systems that provide surgeons with access to all software and hardware features regardless of implant choice are preferred. (II) Imaging systems that have maximum compatibility with navigation and robotics platforms are optimal. (III) Navigation systems that offer a universal registration mechanism should be standard. (IV) 3D fluoroscopy provides the greatest benefit when speed, operative efficiency, and mobility are required. (V) Intraoperative CT is more useful for imaging long constructs, high BMI, or cervicothoracic anatomy. (VI) Radiation safety awareness that new 3D-fluoroscopy units can deliver radiation comparable to that of CT is needed. (VII) New robotic arm platforms require more clinical and health economic data to justify increased costs.
摘要：
可用于脊柱融合手术的辅助技术选择的范围已经显著增加。然而,外科医生和医院管理人员可能缺乏足够的信息来比较选择和做出购买决定。我们总结了当前可用的导航，机器人,和脊柱手术的成像技术，突出关键特征，实用程序，差异,价格,以及与其他技术和脊柱植入物的兼容性。根据手术方法提供了最佳使用和组合指南，手术部位,病人解剖学,最佳图像质量，和工作流效率。主要建议包括以下内容。（i）开放平台导航和机器人系统，使外科医生能够访问所有软件和硬件功能，而无需选择植入物。(II)与导航和机器人平台具有最大兼容性的成像系统是最佳的。(三)提供普遍登记机制的导航系统应该是标准的。(IV)当速度、手术效率，和流动性是必需的。（V）术中CT对长结构成像更有用，高BMI,或颈胸解剖学。（六）辐射安全意识，新的3D透视单位可以提供与CT相当的辐射是必要的。新的机器人手臂平台需要更多的临床和健康经济数据来证明成本增加的合理性。
