Helen Karimi, Nicholas Taylor, Jainith Patel, Liana Wiepert, Ron I Riesenburger, James Kryzanski
{"title":"基于全国神经外科调查的腰椎椎弓根螺钉置入术中使用神经监测、图像引导和机器人技术的实践模式差异。","authors":"Helen Karimi, Nicholas Taylor, Jainith Patel, Liana Wiepert, Ron I Riesenburger, James Kryzanski","doi":"10.1016/j.wneu.2024.10.017","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Lumbar pedicle screw placement surgery involves various assistive technologies, including fluoroscopic, stereotactic, or robotic navigation and intraoperative neuromonitoring (IONM). We aimed to discern neurosurgeons' preferences for screw placement techniques and IONM utility, while also considering the influence of experience.</p><p><strong>Methods: </strong>A survey was distributed to members of the Congress of Neurological Surgeons using REDCap software, collecting demographic data and querying preferred techniques for screw placement and IONM modalities. Opinions on IONM use during stereotactic or robotic navigation were also obtained. Responses were analyzed using Pearson's Chi-square and analysis of variance tests via R software.</p><p><strong>Results: </strong>Of 188 responses, 35.5% (n = 67) reported 1-10 years of experience and 64.5% (n = 121) reported ≥ 11 years. Less experienced neurosurgeons used stereotactic navigation more than those with greater experience (P < 0.001). Seasoned neurosurgeons used fluoroscopic guidance more often (P = 0.038). Less experienced neurosurgeons employed 1.69 (± 0.11) techniques for their fixation surgeries compared to 1.50 (± 0.0.8) for more experienced neurosurgeons. Robotic navigation utilization was low and comparable between the groups. Surgeons employing multiple techniques used triggered electromyography the most (62.1%, P = 0.024). No strong opinions emerged on the necessity of multimodality IONM with robotic or stereotactic navigation.</p><p><strong>Conclusions: </strong>This national survey shows that stereotactic navigation is the predominant technique for pedicle screw placement among less experienced neurosurgeons, with seasoned neurosurgeons leaning toward fluoroscopic guidance. Robotic guidance was the least used technique with no observed difference based on experience. Neurosurgeons employing multiple techniques use IONM the most, compared with surgeons who only use stereotactic navigation and/or robotic guidance.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"e539-e546"},"PeriodicalIF":1.9000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Practice Pattern Variations in the Use of Neuromonitoring, Image Guidance, and Robotics for Lumbar Pedicle Screw Placement Based on a Nationwide Neurosurgery Survey.\",\"authors\":\"Helen Karimi, Nicholas Taylor, Jainith Patel, Liana Wiepert, Ron I Riesenburger, James Kryzanski\",\"doi\":\"10.1016/j.wneu.2024.10.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Lumbar pedicle screw placement surgery involves various assistive technologies, including fluoroscopic, stereotactic, or robotic navigation and intraoperative neuromonitoring (IONM). We aimed to discern neurosurgeons' preferences for screw placement techniques and IONM utility, while also considering the influence of experience.</p><p><strong>Methods: </strong>A survey was distributed to members of the Congress of Neurological Surgeons using REDCap software, collecting demographic data and querying preferred techniques for screw placement and IONM modalities. Opinions on IONM use during stereotactic or robotic navigation were also obtained. Responses were analyzed using Pearson's Chi-square and analysis of variance tests via R software.</p><p><strong>Results: </strong>Of 188 responses, 35.5% (n = 67) reported 1-10 years of experience and 64.5% (n = 121) reported ≥ 11 years. Less experienced neurosurgeons used stereotactic navigation more than those with greater experience (P < 0.001). Seasoned neurosurgeons used fluoroscopic guidance more often (P = 0.038). Less experienced neurosurgeons employed 1.69 (± 0.11) techniques for their fixation surgeries compared to 1.50 (± 0.0.8) for more experienced neurosurgeons. Robotic navigation utilization was low and comparable between the groups. Surgeons employing multiple techniques used triggered electromyography the most (62.1%, P = 0.024). No strong opinions emerged on the necessity of multimodality IONM with robotic or stereotactic navigation.</p><p><strong>Conclusions: </strong>This national survey shows that stereotactic navigation is the predominant technique for pedicle screw placement among less experienced neurosurgeons, with seasoned neurosurgeons leaning toward fluoroscopic guidance. Robotic guidance was the least used technique with no observed difference based on experience. Neurosurgeons employing multiple techniques use IONM the most, compared with surgeons who only use stereotactic navigation and/or robotic guidance.</p>\",\"PeriodicalId\":23906,\"journal\":{\"name\":\"World neurosurgery\",\"volume\":\" \",\"pages\":\"e539-e546\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.wneu.2024.10.017\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.10.017","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/1 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Practice Pattern Variations in the Use of Neuromonitoring, Image Guidance, and Robotics for Lumbar Pedicle Screw Placement Based on a Nationwide Neurosurgery Survey.
Objective: Lumbar pedicle screw placement surgery involves various assistive technologies, including fluoroscopic, stereotactic, or robotic navigation and intraoperative neuromonitoring (IONM). We aimed to discern neurosurgeons' preferences for screw placement techniques and IONM utility, while also considering the influence of experience.
Methods: A survey was distributed to members of the Congress of Neurological Surgeons using REDCap software, collecting demographic data and querying preferred techniques for screw placement and IONM modalities. Opinions on IONM use during stereotactic or robotic navigation were also obtained. Responses were analyzed using Pearson's Chi-square and analysis of variance tests via R software.
Results: Of 188 responses, 35.5% (n = 67) reported 1-10 years of experience and 64.5% (n = 121) reported ≥ 11 years. Less experienced neurosurgeons used stereotactic navigation more than those with greater experience (P < 0.001). Seasoned neurosurgeons used fluoroscopic guidance more often (P = 0.038). Less experienced neurosurgeons employed 1.69 (± 0.11) techniques for their fixation surgeries compared to 1.50 (± 0.0.8) for more experienced neurosurgeons. Robotic navigation utilization was low and comparable between the groups. Surgeons employing multiple techniques used triggered electromyography the most (62.1%, P = 0.024). No strong opinions emerged on the necessity of multimodality IONM with robotic or stereotactic navigation.
Conclusions: This national survey shows that stereotactic navigation is the predominant technique for pedicle screw placement among less experienced neurosurgeons, with seasoned neurosurgeons leaning toward fluoroscopic guidance. Robotic guidance was the least used technique with no observed difference based on experience. Neurosurgeons employing multiple techniques use IONM the most, compared with surgeons who only use stereotactic navigation and/or robotic guidance.
期刊介绍：
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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