中国现代神经疾病杂志 ›› 2025, Vol. 25 ›› Issue (3): 234-239. doi: 10.3969/j.issn.1672-6731.2025.03.010

• 新技术新方法 • 上一篇    下一篇

2 脊柱手术中基于视觉追踪导板的增强现实导航系统的模型构建与验证

张培海1, 孙振兴1, 张恺1, 郭毅1, 陈刚2, 杨学军1,*()   

  1. 1. 102218 清华大学附属北京清华长庚医院神经外科(张培海,孙振兴,张恺,郭毅,杨学军)
    2. 519009 广东省珠海市人民医院 北京理工大学附属医院 暨南大学珠海临床医学院神经外科(陈刚)
  • 收稿日期:2025-02-05 出版日期:2025-03-25 发布日期:2025-04-21
  • 通讯作者: 杨学军
  • 基金资助:
    北京市自然科学基金资助项目(L246048); 清华大学精准医学科研计划战略项目(2022ZLB007)

Construction and validation of augmented reality navigation system based on visual tracking guide template in spinal surgery

Pei-hai ZHANG1, Zhen-xing SUN1, Kai ZHANG1, Yi GUO1, Gang CHEN2, Xue-jun YANG1,*()   

  1. 1. Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China
    2. Department of Neurosurgery, Zhuhai People's Hospital; The Affiliated Hospital of Beijing Institute of Technology; Zhuhai Clinical Medical College of Ji'nan University, Zhuhai 519009, Guangdong, China
  • Received:2025-02-05 Online:2025-03-25 Published:2025-04-21
  • Contact: Xue-jun YANG
  • Supported by:
    Beijing Natural Science Foundation(L246048); Strategic Project of Precision Medicine Research Program of Tsinghua University(2022ZLB007)

摘要:

目的: 构建椎弓根置钉过程中基于视觉追踪导板的增强现实导航模型, 并评价该导航系统的应用价值。方法: 设计并制作可用于脊柱手术导航的视觉追踪导板, 并采用视觉追踪导板和增强现实设备完成增强现实图像与真实物体之间的图像配准和实时追踪。增强现实导航系统辅助下, 先后由两位操作者以克氏针模拟椎弓根置钉操作, 并按照克氏针置入点与视觉追踪导板的距离分为邻近组(< 100 mm)和远离组(100 ~ 200 mm), 对比分析不同操作者以及邻近组与远离组置入点误差值和角度误差值以评估增强现实导航系统的精度。结果: 两位操作者均顺利完成模型置钉, 共获得100例置入点误差值和角度误差值。两位操作者置入点误差值(t = 0.835, p =0.406)和角度误差值(t = 0.220, p =0.826)差异均无统计学意义。远离组置入点误差值大于邻近组(t = 3.221, p =0.002), 进一步将其分解为x值和y值, 远离组置入点误差x值(t = 4.980, p =0.000)和y值(t = 2.416, p =0.018)均大于邻近组; 而角度误差值组间差异无统计学意义(t = 1.786, p =0.077)。结论: 初步构建基于视觉追踪导板的增强现实导航模型, 并完成导航系统精度评估, 随着置入点与视觉追踪导板距离的增加, 置入点定位能力下降, 但角度指向性较为稳定。

关键词: 脊柱疾病, 神经外科手术, 增强现实, 视觉,眼, 手术导航系统, 椎弓根钉

Abstract:

Objective: To construct an augmented reality (AR) navigation system model based on visual tracking guide template during pedicle screw placement, and to evaluate the application value of the model. Methods: A visual tracking guide template was designed and fabricated for spinal surgery navigation. The visual tracking guide template and AR equipment were used to complete image registration and real-time tracking between AR images and real objects. With the assistance of AR navigation technology, 2 operators performed screw insertion with Kirschner wire respectively. According to the distance between the insertion point of Kirschner wire and the visual tracking guide template, the model was divided into adjacent group (< 100 mm) and distant group (100-200 mm). The accuracy of the AR navigation system was evaluated by comparing and analyzing the insertion point error value and angle error value of different operators and the adjacent group and the distant group. Results: The 2 operators successfully completed the screw placement, and a total of 100 cases of insertion point error value and angle error values were obtained. There was no significant difference in the insertion point error (t = 0.835, p = 0.406) and angle error value (t = 0.220, p = 0.826) between the 2 operators. The error value of the insertion point in the distant group was higher than that in the adjacent group (t = 3.221, p = 0.002), while there was no significant difference in the angle error value between the 2 groups (t = 1.786, p = 0.077). Further, the insertion point error value is decomposed into x vaue and y value. There were significant differences in x value (t = 4.980, p = 0.000) and y value (t = 2.416, p = 0.018) between the adjacent group and the distant group. Conclusions: The AR navigation system model based on visual tracking guide template is preliminarily constructed, and the navigation accuracy is evaluated. As the distance between the insertion point and the visual tracking guide template increases, the positioning ability of the insertion point decreases, but the angle directivity is stable.

Key words: Spinal diseases, Neurosurgical procedures, Augmented reality, Vision, ocular, Surgical navigation systems, Pedicle screws