The possibilities with decision support systems in surgery of spine-pelvic complex (analytical review)

Abstract

Objective To explore decision support systems (DSS) used in spine-pelvic surgery, analyze its functional possibilities and approaches that allow the surgeon to make a correct decision. Material and methods Functional possibilities with modern DSSs used in surgery of spine-pelvic complex were reviewed with unified criteria using websites of DSS manufacturers and publications in scientific journals. Results MediCAD, TraumaCAD, Surgimap, Sectra AB and OrthoView are most common DSSs used for spine and hip surgery planning. The above systems can be applied in orthopedic surgery of several independent anatomical regions (e.g., spine, pelvis, femur, tibia, foot). But none of the systems can be applied to spine-pelvic complex. DSS facilitates only geometrical planning with geometric measurements, simulation of physiologically normal location of anatomical elements as well as selection and semi-automatic implant positioning. Conclusion Both geometrical planning and biomechanical simulation are required to achieve positive long-term follow-up of surgical treatment. Biomechanical simulation allows assessment of an extent and pattern of injury caused by malalignment of spine-pelvic complex and surgical intervention planning with the help of reconstruction options offered. The use of DSS should involve geometric planning, biomechanical simulation of the expected surgical outcome and prediction of a long-term follow-up. Introduction of DSS into clinical practice will facilitate the quality of medical care and rehabilitation with concurrent optimization of the national expenditure on health care.