Advances in tissue state recognition in spinal surgery: a review

doi:10.1007/s11684-020-0816-3

Front. Med.

2021, Vol. 15

Issue (4) : 575-584 https://doi.org/10.1007/s11684-020-0816-3

REVIEW

Advances in tissue state recognition in spinal surgery: a review

Hao Qu, Yu Zhao(

)

Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

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Abstract

Spinal disease is an important cause of cervical discomfort, low back pain, radiating pain in the limbs, and neurogenic intermittent claudication, and its incidence is increasing annually. From the etiological viewpoint, these symptoms are directly caused by the compression of the spinal cord, nerve roots, and blood vessels and are most effectively treated with surgery. Spinal surgeries are primarily performed using two different techniques: spinal canal decompression and internal fixation. In the past, tactile sensation was the primary method used by surgeons to understand the state of the tissue within the operating area. However, this method has several disadvantages because of its subjectivity. Therefore, it has become the focus of spinal surgery research so as to strengthen the objectivity of tissue state recognition, improve the accuracy of safe area location, and avoid surgical injury to tissues. Aside from traditional imaging methods, surgical sensing techniques based on force, bioelectrical impedance, and other methods have been gradually developed and tested in the clinical setting. This article reviews the progress of different tissue state recognition methods in spinal surgery and summarizes their advantages and disadvantages.

Keywords spinal surgery tissue state recognition image force sensing bioelectrical impedance

Corresponding Author(s): Yu Zhao

Just Accepted Date: 07 February 2021 Online First Date: 14 May 2021 Issue Date: 23 September 2021

Cite this article:

Hao Qu,Yu Zhao. Advances in tissue state recognition in spinal surgery: a review[J]. Front. Med., 2021, 15(4): 575-584.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-020-0816-3
https://academic.hep.com.cn/fmd/EN/Y2021/V15/I4/575

Fig.1 Application of mixed reality technology to PTED training. Reprinted from Ref. [29] with permission.

Tab.1 Different methods for tissue state recognition

Fig.2 Schematic of the analysis of milling force (A) and the safety control strategy (B). Reprinted from Ref. [37] with permission.

Fig.3 Mean impedance magnitude and phase angle spectra of cerebrospinal fluid (CSF), ligamentum flavum, and epidural space. Reprinted from Ref. [52] with permission.

Fig.4 Distribution of frequency between 10 and 15 kHz after using the recursive FFT for different moments: (A) drilling the cortical born; (B) cancellous bone; (C) transition region from cortical born to cancellous bone; (D) transition region from cancellous bone to inner cortical born. Reprinted from Ref. [57] with permission.

Fig.5 Bur temperature (A) and fresh-milled bone temperature (B) as a function of feed rate and spindle speed. Reprinted from Ref. [61] with permission.

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