腰椎个体化微创技术在脊柱神经外科中的临床决策支持系统效率评估

V. Byvaltsev, А.А. Kalinin
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引用次数: 2

摘要

本研究的目的是评估临床决策支持系统(CDSS)在脊柱手术中对腰椎进行个性化微创技术的应用。材料和方法前瞻性研究纳入59例患者,采用基于个性化手术算法的CDSS手术,考虑患者腰椎节段的具体参数。其中,11例患者采用全椎间盘置换术(TDR), 25例患者采用微创(MI-TLIF), 23例患者采用开放式(O-TLIF)背侧刚性稳定术。回顾性分析196例合并TDR (n=42)、MI-TLIF (n=79)和O-TLIF (n=75)的患者。通过腰椎和下肢疼痛综合征,以及术后3个月和6个月患者出院时ODI功能状态来评估CDSS医疗算法的有效性。结果性别特征和人体测量数据比较,各组间差异无统计学意义(p>0.05)。通过ODI、下肢和腰椎疼痛强度的组间分析显示,与回顾性组相比,CDSS手术患者在TDR和O-TLIF后6个月和MI-TLIF后3个月的临床结果更好(p<0.05)。结论考虑腰椎节段个体生物特征参数的CDSS对退行性腰椎疾病患者的个体化手术治疗具有较高的效率。
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Assessment of Clinical Decision Support System Efficiency in Spinal Neurosurgery for Personalized Minimally Invasive Technologies Used on Lumbar Spine
The aim of the study was to assess clinical decision support system (CDSS) in spinal surgery for personalized minimally invasive technologies on lumbar spine. Materials and Methods The prospective study involved 59 patients operated on using CDSS based on a personalized surgical algorithm considering patient-specific parameters of lumbar segments. Among them, 11 patients underwent total disk replacement (TDR), 25 and 23 patients had minimally invasive (MI-TLIF) and open (O-TLIF) dorsal rigid stabilization, respectively, according to an original technology. The comparative analysis was carried out using retrospective findings of 196 patients operated on involving TDR (n=42), MI-TLIF (n=79), and O-TLIF (n=75). The efficiency of CDSS medical algorithms was assessed by pain syndrome in the lumbar spine and lower limbs, as well as by patients’ functional status on discharge according to ODI, 3 and 6 months after the operation. Results The comparison by gender characteristics and anthropometric data revealed no significant intergroup differences among the groups under study (p>0.05). Intergroup analysis of functional status by ODI, pain intensity in lower limbs and lumbar spine showed better clinical outcomes in patients operated using CDSS compared to a retrospective group (p<0.05): 6 months after TDR and O-TLIF, and 3 months after MI-TLIF. Conclusion The study findings demonstrated high efficiency of CDSS developed for personalized surgical treatment of patients with degenerative lumbar spine diseases taking into consideration individual biometric parameters of lumbar segments.
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