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学科主题: 临床医学
题名:
Navigated Percutaneous Lumbosacral Interbody Fusion A Feasibility Study With Three-Dimensional Surgical Simulation and Cadaveric Experiment
作者: Wang, Yu1,2; Le, Dang Q. S.3; Li, Haisheng1; Wang, Miao1; Bunger, Cody Eric1
关键词: computer aided surgery ; computer assisted surgery ; navigation ; navigated surgery ; lumbosacral interbody fusion ; minimally invasive spine surgery
刊名: SPINE
发表日期: 2011-07-15
DOI: 10.1097/BRS.0b013e3181fc22d4
卷: 36, 期:16, 页:E1105-E1111
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology ; Orthopedics
研究领域[WOS]: Neurosciences & Neurology ; Orthopedics
关键词[WOS]: SURGERY
英文摘要:

Study Design. A feasibility study with three-dimensional surgical simulation and cadaveric experiment.

Objective. To verify the feasibility of a new navigated surgical method for lumbosacral interbody fusion.

Summary of Background Data. The advances in surgical navigation have opened new possibilities for lumbosacral interbody fusion procedure. We designed a novel navigated surgical method that enables lumbosacral discectomy and bone grafting to be performed percutaneously and safely.

Methods. First, to prove that the newly designed surgical method is feasible from an anatomic perspective, the new method, navigated percutaneous lumbosacral interbody fusion (NPLSIF), was simulated on the three-dimensional models of lumbosacral spine. The three-dimensional models were established using the computed tomographic (CT) data of 60 patients. Feasibility could be verified if both working corridor and S1 pedicle screw could be accommodated in sacral ala without overlapping and without penetrating either the spinal canal or the anterior or upper sacral wall. Second, to verify the feasibility of the NPLSIF procedure in reality, cadaveric experiment was performed. Two cadavers were included; one was a 67-year-old male, and the other a 65-year-old female. CT scanning was performed with an intraoperative CT scanner before surgery, after the discectomy and after bone grafting. These three series of CT images were compared to evaluate the efficacy of the NPLSIF procedure. After the procedures, the lumbosacral spines were separated from the cadaver trunks in the department of anatomy. The lumbosacral disc of one cadaver was bisected coronally, while the lumbosacral disc of the other cadaver was bisected sagittally. The internal view of the lumbosacral discs helped to further evaluate the efficacy of the NPLSIF procedures.

Results. In the three-dimensional surgical simulation experiment, the feasibility of the NPLSIF procedure was verified in every case. In the cadaveric experiment, the NPLSIF procedures were successfully executed. The surgical procedure on the first cadaver took 3 hours. After improving the workflow and having gained some experience, the procedure on the second cadaver took 1.5 hours. On the navigation workstation, the preoperative plan was completed in 3 to 5 minutes and each intraoperative CT scanning took 30 seconds. The quality of the intraoperative CT images was comparable to that of normal CT images. CT images and the internal view of the lumbosacral discs showed that the NPLSIF procedures had yielded satisfactory discectomy and endplate preparation.

Conclusion. The feasibility of NPLSIF was verified by the means of three-dimensional surgical simulation and cadaveric experiment. Clinical studies are needed to further investigate the efficacy and efficiency of NPLSIF in clinical practice.

语种: 英语
WOS记录号: WOS:000292450300008
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/52881
Appears in Collections:北京大学第一临床医学院_骨科_期刊论文

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作者单位: 1.Aarhus Univ Hosp, Dept Orthopaed E, DK-8000 Aarhus, Denmark
2.Aarhus Univ, Interdisciplinary Nanosci Ctr, Aarhus, Denmark
3.Peking Univ, Dept Orthopaed, Hosp 1, Beijing 100871, Peoples R China

Recommended Citation:
Wang, Yu,Le, Dang Q. S.,Li, Haisheng,et al. Navigated Percutaneous Lumbosacral Interbody Fusion A Feasibility Study With Three-Dimensional Surgical Simulation and Cadaveric Experiment[J]. SPINE,2011,36(16):E1105-E1111.
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