Feasibility of Virtual Reality Combined with Isocentric Navigation in Transforaminal Percutaneous Endoscopic Discectomy: A Cadaver Study
Objectives Transforaminal percutaneous endoscopic discectomy (TPED) is one of the most commonly used minimally invasive spine surgeries around the world. However, conventional surgical planning and intraoperative procedures for TPED have relied on surgeons’ experience, which limits its standardizati...
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doaj-ab297fae584a447ba5ba8f9b4f0bfa3e2020-11-24T21:21:29ZengWileyOrthopaedic Surgery1757-78531757-78612019-06-0111349349910.1111/os.12473Feasibility of Virtual Reality Combined with Isocentric Navigation in Transforaminal Percutaneous Endoscopic Discectomy: A Cadaver StudyZhi Zhou0Shuo Hu1Yong‐zhao Zhao2Yan‐jie Zhu3Chuan‐feng Wang4Xin Gu5Guo‐xin Fan6Shi‐sheng He7Orthopaedics Department, Shanghai Tenth People's Hospital Shanghai ChinaOrthopaedics Department, Shanghai Tenth People's Hospital Shanghai ChinaOrthopaedics Department, Shanghai Tenth People's Hospital Shanghai ChinaOrthopaedics Department, Shanghai Tenth People's Hospital Shanghai ChinaOrthopaedics Department, Shanghai Tenth People's Hospital Shanghai ChinaOrthopaedics Department, Shanghai Tenth People's Hospital Shanghai ChinaOrthopaedics Department, Shanghai Tenth People's Hospital Shanghai ChinaOrthopaedics Department, Shanghai Tenth People's Hospital Shanghai ChinaObjectives Transforaminal percutaneous endoscopic discectomy (TPED) is one of the most commonly used minimally invasive spine surgeries around the world. However, conventional surgical planning and intraoperative procedures for TPED have relied on surgeons’ experience, which limits its standardization and popularization. Virtual reality (VR) is a novel technology for pre‐surgical planning in various fields of medicine, while isocentric navigation can guide intraoperative procedures for TPED. The present study aimed to explore the feasibility of applying VR combined with isocentric navigation in TPED on cadavers. Methods The surgical levels were L3/L4 and L4/L5 as well as L5/S1 of both sides of each cadaver specimen. First, the surgeon manually conducted the above procedures on the left side of every specimen without preoperative simulation and isocentric navigation (Group A). Then the same surgeon conducted the VR simulation for surgical planning of the right side (Group B). After VR simulation, the same surgeon made the percutaneous punctures and placed the working channel on the right side of the specimen at all levels. Results At the L3/L4 level, the puncture‐channel time was 11.36 ± 2.13 min in Group A and 11.29 ± 2.23 min in Group B (t = 0.097, P = 0.938). The exposure time was 17.21 ± 2.91 s in Group A and 14.64 ± 1.60 s in Group B (t = 2.534, P = 0.025). At the L4/L5 level, the puncture‐channel time was 13.86 ± 3.90 min in Group A and 11.93 ± 2.95 min in Group B (t = 2.291, P = 0.039). Exposure time was 20.64 ± 3.84 s in Group A and 16.43 ± 2.47 s in Group B (t = 6.118, P < 0.01). There were 7 patients undergoing foraminotomy in Group A and 3 patients undergoing foraminotomy in Group B (t = 2.280, P = 0.236). At the L5/S1 level, the puncture‐channel time was 18.21 ± 1.85 min in Group A and 15.71 ± 3.20 min in Group B (t = 2.476, P = 0.028). Exposure time was 26.07 ± 3.17 s in Group A and 22.50 ± 2.68 s in Group B (t = 2.980, P = 0.011). There were 14 patients receiving foraminotomy in Group A and 13 patients receiving foraminotomy in Group B (t = 1.000, P = 1.000). Conclusions Virtual reality combined with isocentric navigation is feasible in TPED. It enables precise surgical planning and improves intraoperative procedures, and has the potential for application in clinical practice.https://doi.org/10.1111/os.12473Isocentric navigationTransforaminal percutaneous endoscopic discectomyVirtual reality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zhi Zhou Shuo Hu Yong‐zhao Zhao Yan‐jie Zhu Chuan‐feng Wang Xin Gu Guo‐xin Fan Shi‐sheng He |
spellingShingle |
Zhi Zhou Shuo Hu Yong‐zhao Zhao Yan‐jie Zhu Chuan‐feng Wang Xin Gu Guo‐xin Fan Shi‐sheng He Feasibility of Virtual Reality Combined with Isocentric Navigation in Transforaminal Percutaneous Endoscopic Discectomy: A Cadaver Study Orthopaedic Surgery Isocentric navigation Transforaminal percutaneous endoscopic discectomy Virtual reality |
author_facet |
Zhi Zhou Shuo Hu Yong‐zhao Zhao Yan‐jie Zhu Chuan‐feng Wang Xin Gu Guo‐xin Fan Shi‐sheng He |
author_sort |
Zhi Zhou |
title |
Feasibility of Virtual Reality Combined with Isocentric Navigation in Transforaminal Percutaneous Endoscopic Discectomy: A Cadaver Study |
title_short |
Feasibility of Virtual Reality Combined with Isocentric Navigation in Transforaminal Percutaneous Endoscopic Discectomy: A Cadaver Study |
title_full |
Feasibility of Virtual Reality Combined with Isocentric Navigation in Transforaminal Percutaneous Endoscopic Discectomy: A Cadaver Study |
title_fullStr |
Feasibility of Virtual Reality Combined with Isocentric Navigation in Transforaminal Percutaneous Endoscopic Discectomy: A Cadaver Study |
title_full_unstemmed |
Feasibility of Virtual Reality Combined with Isocentric Navigation in Transforaminal Percutaneous Endoscopic Discectomy: A Cadaver Study |
title_sort |
feasibility of virtual reality combined with isocentric navigation in transforaminal percutaneous endoscopic discectomy: a cadaver study |
publisher |
Wiley |
series |
Orthopaedic Surgery |
issn |
1757-7853 1757-7861 |
publishDate |
2019-06-01 |
description |
Objectives Transforaminal percutaneous endoscopic discectomy (TPED) is one of the most commonly used minimally invasive spine surgeries around the world. However, conventional surgical planning and intraoperative procedures for TPED have relied on surgeons’ experience, which limits its standardization and popularization. Virtual reality (VR) is a novel technology for pre‐surgical planning in various fields of medicine, while isocentric navigation can guide intraoperative procedures for TPED. The present study aimed to explore the feasibility of applying VR combined with isocentric navigation in TPED on cadavers. Methods The surgical levels were L3/L4 and L4/L5 as well as L5/S1 of both sides of each cadaver specimen. First, the surgeon manually conducted the above procedures on the left side of every specimen without preoperative simulation and isocentric navigation (Group A). Then the same surgeon conducted the VR simulation for surgical planning of the right side (Group B). After VR simulation, the same surgeon made the percutaneous punctures and placed the working channel on the right side of the specimen at all levels. Results At the L3/L4 level, the puncture‐channel time was 11.36 ± 2.13 min in Group A and 11.29 ± 2.23 min in Group B (t = 0.097, P = 0.938). The exposure time was 17.21 ± 2.91 s in Group A and 14.64 ± 1.60 s in Group B (t = 2.534, P = 0.025). At the L4/L5 level, the puncture‐channel time was 13.86 ± 3.90 min in Group A and 11.93 ± 2.95 min in Group B (t = 2.291, P = 0.039). Exposure time was 20.64 ± 3.84 s in Group A and 16.43 ± 2.47 s in Group B (t = 6.118, P < 0.01). There were 7 patients undergoing foraminotomy in Group A and 3 patients undergoing foraminotomy in Group B (t = 2.280, P = 0.236). At the L5/S1 level, the puncture‐channel time was 18.21 ± 1.85 min in Group A and 15.71 ± 3.20 min in Group B (t = 2.476, P = 0.028). Exposure time was 26.07 ± 3.17 s in Group A and 22.50 ± 2.68 s in Group B (t = 2.980, P = 0.011). There were 14 patients receiving foraminotomy in Group A and 13 patients receiving foraminotomy in Group B (t = 1.000, P = 1.000). Conclusions Virtual reality combined with isocentric navigation is feasible in TPED. It enables precise surgical planning and improves intraoperative procedures, and has the potential for application in clinical practice. |
topic |
Isocentric navigation Transforaminal percutaneous endoscopic discectomy Virtual reality |
url |
https://doi.org/10.1111/os.12473 |
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