Surgeons' perceptions of spinal navigation: analysis of key factors affecting the lack of adoption of spinal navigation technology.
Surgeons' perceptions of spinal navigation: analysis of key factors affecting the lack of adoption of spinal navigation technology.
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DOI：
10.1016/sasj-2008-0007-rr
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Kim, Choll W
中科院分区：
文献类型：
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作者：
Choo, Alexander D;Regev, Gilad;Garfin, Steven R;Kim, Choll W
计算机辅助脊柱导航允许在多个视图中实时定位手术器械。它的使用减少了辐射暴露，并清除了c臂透视镜的手术视野。尽管有这些优点，脊柱导航还没有得到脊柱外科医生的普遍接受。本研究的目的是调查脊柱外科医生对脊柱导航的优缺点的看法。来自脊柱关节成形术学会（SAS）和微创脊柱外科学会（SMISS）会员的脊柱外科医生被调查了他们目前使用脊柱导航的情况以及他们对脊柱导航的优缺点的看法（N = 147）。采用双侧卡方检验对反应进行分析。大多数脊柱外科医生（63.4%）只有肤浅的脊柱导航经验，76.2%的外科医生很少在他们的病例中使用脊柱导航。脊柱外科医生使用虚拟透视脊柱导航系统的经验最多（35.9%）。外科医生认为脊柱导航的主要缺点是手术时间长（63.5%）、费用增加（48.3%）、缺乏必要性（40.7%）、导航精度不可靠（37.9%）和术中故障过多（35.2%）。外科医生认为脊柱导航的最大优点是减少了对外科医生的辐射暴露（76.1%），提高了螺钉放置的准确性（65.7%），减少了对患者的辐射暴露（41.8%），使c型臂远离手术视野（29.1%）。外科医生认为最有可能从脊柱导航中获益的手术类型是微创内固定和融合（72.5%）和复杂开放畸形（55.6%）。大多数脊柱外科医生在脊柱导航方面只有肤浅的经验。脊柱导航术最常见的缺点是增加手术时间、费用和缺乏必要性。未来增加透视检查和MIS的使用可能会将焦点从脊柱导航的弱点转移到优势，包括减少辐射暴露和从手术视野中消除c臂。
Computer-assisted spinal navigation allows for real time localization of surgical instruments in multiple views. Its use decreases radiation exposure and clears the surgical field of the C-arm fluoroscope. Despite these advantages, spinal navigation has yet to gain general acceptance among spine surgeons. The purpose of this study is to survey spine surgeons about their opinions on the strengths and weaknesses of spinal navigation. Spine surgeons from the membership of the Spine Arthroplasty Society (SAS) and the Society for Minimally Invasive Spine Surgery (SMISS) were surveyed regarding their current use of spinal navigation and their perceptions of the strengths and weaknesses of spinal navigation (N = 147). Responses were analyzed using 2-sided chi-square tests. Most spine surgeons (63.4%) have only superficial experience with spinal navigation, and 76.2% of surgeons rarely use spinal navigation in their cases. Spine surgeons have the most experience with virtual fluoroscopy spinal navigation systems (35.9%). Surgeons considered longer operating times (63.5%), increased cost (48.3%), lack of necessity (40.7%), unreliable navigation accuracy (37.9%), and too many intraoperative glitches (35.2%) to be the major weaknesses of spinal navigation. Surgeons considered decreased radiation exposure to the surgeon (76.1%), increased screw placement accuracy (65.7%), decreased radiation exposure to the patient (41.8%), and keeping the C-arm away from the operating field (29.1%) to be the greatest advantages of spinal navigation. Among the types of procedures surgeons believe are most likely to benefit from spinal navigation are minimally invasive instrumentation and fusion (72.5%) and complex open deformity (55.6%). Most spine surgeons have only superficial experience in spinal navigation. The most commonly selected weaknesses of spinal navigation are increased operative time, cost, and lack of necessity. Increased fluoroscopy and MIS use in the future may shift focus from weaknesses to the strengths of spinal navigation, including decreased radiation exposure and elimination of the C-arm from the operative field.