背景:椎动脉损伤是C1-2后路融合术的潜在并发症。术中导航可以降低神经血管并发症的风险,提高螺钉放置精度。然而,术中计算机断层扫描(CT)的使用增加了辐射暴露和手术时间,它无法成像血管结构。机器视觉图像引导手术(MvIGS)系统使用光学地形成像和机器视觉软件使用术前成像快速配准。作者介绍了在C1-2后路融合期间使用术前CT血管造影(CTA)注册的MvIGS术中导航的第一份报告。
方法:MvIGS可以在几秒钟内注册,减少手术时间,没有额外的辐射暴露。此外,外科医生可以更好地调整异常的椎动脉解剖结构并提高手术安全性。
结论:CTA引导的导航产生了颈椎解剖的三维重建,在手术过程中帮助外科医生。虽然还需要进一步的研究,术中使用MVIGS可以降低C1-2后路融合术中椎动脉损伤的风险.
BACKGROUND: Vertebral artery injury is a devastating potential complication of C1-2 posterior fusion. Intraoperative navigation can reduce the risk of neurovascular complications and improve screw placement accuracy. However, the use of intraoperative computed tomography (CT) increases radiation exposure and operative time, and it is unable to image vascular structures. The Machine-vision Image Guided Surgery (MvIGS) system uses optical topographic imaging and machine vision software to rapidly register using preoperative imaging. The authors presented the first report of intraoperative navigation with MvIGS registered using a preoperative CT angiogram (CTA) during C1-2 posterior fusion.
METHODS: MvIGS can register in seconds, minimizing operative time with no additional radiation exposure. Furthermore, surgeons can better adjust for abnormal vertebral artery anatomy and increase procedure safety.
CONCLUSIONS: CTA-guided navigation generated a three-dimensional reconstruction of cervical spine anatomy that assisted surgeons during the procedure. Although further study is needed, the use of intraoperative MvIGS may reduce the risk of vertebral artery injury during C1-2 posterior fusion.