扩展现实(XR)技术是指使用计算机技术增强现实世界对象的任何情况,包括虚拟现实,增强现实,混合现实增强现实和混合现实技术已广泛应用于骨科临床,包括在教学中,术前计划,术中导航,和手术结果评估。这篇叙述性综述的主要目的是总结XR技术辅助术中导航在创伤领域的有效性和优越性。接头,脊柱,和骨肿瘤手术,以及讨论目前术中导航应用中的不足。我们用以下搜索词回顾了从PubMed获得的200多项研究的标题:扩展现实,混合现实,增强现实,虚拟现实,术中导航,和骨科手术;在这200项研究中,选择69篇相关论文进行摘要综述。最后,对55项研究的全文进行了分析和综述。他们被分为四组创伤,接头,脊柱,和骨肿瘤手术-根据它们的内容。我们回顾的大多数研究表明,XR技术辅助术中导航可以有效提高植入物放置的准确性,比如螺钉和假体,减少植入不准确引起的术后并发症,促进无瘤手术边缘的实现,缩短手术时间,减少患者和外科医生的辐射暴露,最大限度地减少手术期间需要视觉暴露造成的进一步损害,并提供更丰富,更有效的术中沟通,从而促进学术交流,医疗援助,以及远程医疗的实施。
Extended reality (XR) technology refers to any situation where real-world objects are enhanced with computer technology, including virtual reality, augmented reality, and mixed reality. Augmented reality and mixed reality technologies have been widely applied in orthopedic clinical practice, including in teaching, preoperative planning, intraoperative navigation, and surgical outcome evaluation. The primary goal of this narrative review is to summarize the effectiveness and superiority of XR-technology-assisted intraoperative navigation in the fields of trauma, joint, spine, and bone tumor surgery, as well as to discuss the current shortcomings in intraoperative navigation applications. We reviewed titles of more than 200 studies obtained from PubMed with the following search terms: extended reality, mixed reality, augmented reality, virtual reality, intraoperative navigation, and orthopedic surgery; of those 200 studies, 69 related papers were selected for abstract review. Finally, the full text of 55 studies was analyzed and reviewed. They were classified into four groups-trauma, joint, spine, and bone tumor surgery-according to their content. Most of studies that we reviewed showed that XR-technology-assisted intraoperative navigation can effectively improve the accuracy of implant placement, such as that of screws and prostheses, reduce postoperative complications caused by inaccurate implantation, facilitate the achievement of tumor-free surgical margins, shorten the surgical duration, reduce radiation exposure for patients and surgeons, minimize further damage caused by the need for visual exposure during surgery, and provide richer and more efficient intraoperative communication, thereby facilitating academic exchange, medical assistance, and the implementation of remote healthcare.