Ultrasound navigated spinal fusion surgery

超声引导脊柱融合手术

• 批准号: 461382-2014
• 负责人: Cobbold, Richard
• 金额: $ 8.74万
• 依托单位: University of Toronto
• 依托单位国家: 加拿大
• 项目类别: Idea to Innovation
• 财政年份: 2014
• 资助国家: 加拿大
• 起止时间: 2014-01-01 至 2015-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=556313
• 关键词: Ultrasound; navigated; spinal; fusion; surgery

In 2012, approximately 1.3 million cases of spine surgeries were performed in the United States alone, 53% of which consisted of spinal fusion surgeries necessitating insertion of screw implants. The placement of these screws is complex due to limited visibility of the spine, continuous bleeding in the exposed regions, and variability in morphology. Unfortunately, literature reports an alarmingly high rate of screw misplacements (20-40%). Of major concern is the fact that improperly placed screws could place the surrounding vital structures at risk. This could lead to potential patient paralysis, lawsuits for hospitals and the financial burden of revision surgeries for healthcare. A potential guidance method for determining the best screw trajectory is by using real-time ultrasound imaging: a miniaturized ultrasound device that can be inserted into the center of the pedicle bone in order to image the anatomy from within, for identification of bone boundaries. Our current technology development goals are to reduce to practice a very novel design for an imaging device to help ensure surgeon acceptance and smooth integration with their workflow. Our technology will be portable, affordable and will have advantage over X-ray technologies from a safety and cost standpoint, as well as with other technologies that do not provide real time feedback. It is estimated that through a reduction in the rate of revision surgeries, our imaging device could result in up to $600M of annual cost savings to the U.S. healthcare, an equivalent of $60M to Ontario. In addition, it could be used for reducing training time for surgical residents and could be used in battlefield clinics, where no portable imaging available.

2012年，仅在美国就进行了大约130万例脊柱手术，其中53%的脊柱融合手术需要置入螺钉植入物。由于脊柱的能见度有限，暴露区域持续出血，以及形态的变化，这些螺钉的放置是复杂的。不幸的是，文献报道螺钉错位率高得惊人（20-40%）。最令人担忧的是，放置不当的螺钉可能会使周围的重要结构处于危险之中。这可能会导致潜在的病人瘫痪，医院的诉讼和医疗保健的修正手术的经济负担。一种确定最佳螺钉轨迹的潜在指导方法是使用实时超声成像：一种微型超声设备，可以插入椎弓根骨的中心，以便从内部对解剖结构进行成像，以识别骨边界。我们目前的技术发展目标是减少一种非常新颖的成像设备的设计，以帮助确保外科医生的接受，并与他们的工作流程顺利集成。我们的技术便携、经济实惠，从安全和成本的角度来看，与x射线技术以及其他不能提供实时反馈的技术相比，我们的技术具有优势。据估计，通过降低翻修手术的比率，我们的成像设备每年可以为美国医疗保健节省高达6亿美元的成本，相当于安大略省6000万美元。此外，它还可用于减少外科住院医生的培训时间，并可用于没有便携式成像设备的战场诊所。