Worldwide Survey on the Use of Navigation in Spine Surgery
Worldwide Survey on the Use of Navigation in Spine Surgery
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DOI：
10.1016/j.wneu.2012.03.011
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发表时间：
2013-01-01
影响因子：
2
通讯作者：
Audige, Laurent
中科院分区：
文献类型：
--
作者：
Haertl, Roger;Lam, Khai Sing;Audige, Laurent
目的：计算机辅助手术（CAS）可以提高螺钉放置的准确性并减少辐射暴露，但这并没有被脊柱外科医生广泛接受。脊柱外科医生在日常实践中对导航的当前观点是一个尚未研究的重要问题。一项基于调查的研究评估了对CAS的意见，以描述当前全球外科医生对脊柱外科手术中使用导航的态度。方法：向3348名AO脊柱外科医生（AO [Arbeitsgemeinschaft fur Osteosynthesefragen]基金会内的一个专业组）分发了一份12项问卷，重点是手术病例的数量和类型、可用设备的类型以及对CAS的一般意见。潜类分析被用来调查存在的特定群体的基础上，受访者的意见profiles.RESULTS：20%的回应率被记录。尽管导航系统在北美和欧洲广泛分布，但只有11%的外科医生经常使用它。大手术量的外科医生、神经外科医生和从事忙碌微创手术实践的外科医生更有可能使用CAS。“常规用户”认为准确性、促进复杂手术的潜力和减少辐射暴露是主要优势。缺乏设备，培训不足，成本高的主要原因是“nonusers”不使用CAS.CONCLUSIONS：脊柱外科医生承认CAS的价值，但目前的系统不符合他们的期望，在易用性和整合到手术工作流程。为了增加其使用，CAS必须变得更具成本效益，并且需要科学数据来阐明其潜在的好处。
OBJECTIVE: Computer-assisted surgery (CAS) can improve the accuracy of screw placement and decrease radiation exposure, yet this is not widely accepted among spine surgeons. The current viewpoint of spine surgeons on navigation in their everyday practice is an important issue that has not been studied. A survey-based study assessed opinions on CAS to describe the current global attitudes of surgeons on the use of navigation in spine surgery.METHODS: A 12-item questionnaire focusing on the number and type of surgical cases, the type of equipment available, and general opinions toward CAS was distributed to 3348 AOSpine surgeons (a specialty group within the AO [Arbeitsgemeinschaft fur Osteosynthesefragen] Foundation). Latent class analysis was used to investigate the existence of specific groups based on the respondent opinion profiles.RESULTS: A response rate of 20% was recorded. Despite a widespread distribution of navigation systems in North America and Europe, only 11% of surgeons use it routinely. High-volume procedure surgeons, neurological surgeons, and surgeons with a busy minimal invasive surgery practice are more likely to use CAS. "Routine users" consider the accuracy, potential of facilitating complex surgery, and reduction in radiation exposure as the main advantages. The lack of equipment, inadequate training, and high costs are the main reasons that "nonusers" do not use CAS.CONCLUSIONS: Spine surgeons acknowledge the value of CAS, yet current systems do not meet their expectations in terms of ease of use and integration into the surgical work flow. To increase its use, CAS has to become more cost efficient and scientific data are needed to clarify its potential benefits.