杂交手术室在脊柱外科的应用进展

Application Progress of Hybrid Operating Room in Spinal Surgery

摘要: 近年，脊柱外科技术发生了飞跃式的发展和进步，使得脊柱相关疾病的诊治和预后得到了显著改善。然而，由于脊柱结构复杂且具有变异性，周围毗邻血管神经等重要组织，诸如椎弓根螺钉置入之类技术，仍可能带来与手术相关的重大风险。随着外科治疗技术的微创化和医学影像技术的发展，术中成像和可视化水平的改进，杂交手术室的出现将传统的外科手术和现代影像学技术等有效地整合在一起，使患者的创伤最小化，疗效最大化，真正体现了一站式服务理念，代表了现代医学发展的趋势。杂交手术室是将医学影像系统集成到洁净手术室中，可同时进行影像学检查和常规外科手术，避免了患者多次麻醉和转运可能带来的风险，且术前、术中、术后都能得到即时高质量的影像，为手术实施、疗效和预后评估提供了直接的影像资料，对于术者及患者意义重大。在脊柱外科，术者可在离开手术室之前通过三维成像确认病例的复位和植入物情况，对于不满意者可及时修正、重新置钉，降低术后翻修率，杂交手术室已成为脊柱外科的重要组成部分。

Abstract: In recent years, spinal surgical techniques have made great progress, which have significantly improved the diagnosis, treatment and prognosis of spine-related diseases. However, techniques, such as pedicle screw placement, may still carry significant risk associated with surgery due to the complex structure and variability of the spine, and peripheral vital nerves and blood vessels. With the development of minimally invasive technology and medical imaging technology and the improvement of intraoperative imaging and visualization level, the hybrid operating room effectively integrates traditional surgery and modern imaging techniques to minimize patient trauma and maximize efficacy, which truly reflects the one-stop service concept and represents the development trend of modern medicine. Hybrid operating room can perform imaging examination and conventional surgery, where the medical imaging system is integrated into a clean operating room. It avoids the risk of multiple anesthesia and transports of patients, and can obtain instant high-quality images. It provides direct imaging data for surgical implementation, efficacy and prognosis evaluation, which is of great significance for the surgeons and the patients. In spinal surgery, the surgeon can confirm the reduction and implants through 3D imaging before leaving the operating room. If the screw position is not satisfactory, the surgeon can promptly correct and reinsert the screw to reduce the rate of postoperative revision. Hybrid operating rooms have become an important part of spine surgery.