Application Of Mixed Reality Technology In Sacral Chordoma Osteotomy Through Sacral Foramen

Objective: To explore the effect of mixed reality technology in sacral chordoma osteotomy through sacral foramen and its influence on sacral nerve function and physiological and psychological health of patients.Methods: A retrospective analysis was conducted on 26 patients who underwent sacral tumor surgery at the Orthopedics Department of Shengjing Hospital Affiliated to China Medical University from January 2019 to July 2022,with postoperative pathological reports of chordoma.They were divided into mixed reality surgery group(n=13)and traditional surgery group(n=13)based on whether mixed reality technology was applied.The patients in the mixed reality surgery group use the mixed reality visualization imaging technology to assist in the formulation of the surgical plan,the explanation of the condition and the complete resection of the tumor,while the patients in the traditional surgery group use the conventional imaging examination and traditional surgical methods for treatment.The general data,tumor invasion level,tumor size,operation time,intraoperative blood loss,postoperative total drainage volume,VAS score of 7 days after operation,postoperative hospital stay,incision adverse events,tumor resection boundary and postoperative recurrence of the two groups were recorded,and the inter-group comparison analysis was performed.The sacral nerve function scores of the two groups were compared before operation,3months after operation and 6 months after operation.The overall health status and mental health status of patients in the two groups before and 6 months after operation were recorded and compared by using the health survey and symptom checklist.Results: There was no statistically significant difference in all preoperative data between the two groups of patients.The average surgical time of patients in the mixed reality surgery group was 199.76 ± 39.28 minutes,while that in the traditional surgery group was 240.46 ± 47.22 minutes.The mixed reality surgery group saved about 40 minutes of surgical time compared to the traditional surgery group,with a statistically significant difference(P=0.025).The average intraoperative blood loss in the mixed reality surgery group was 1141.30 ± 275.61 ml,compared to 1465.84 ±426.83 ml in the traditional surgery group,with a statistically significant difference(P=0.030).The average postoperative total drainage volume in the mixed reality surgery group was 1436.92 ± 419.71 ml,compared to 1783.07 ± 398.13 ml in the traditional surgery group,with a statistically significant difference(P=0.041).The average postoperative hospital stay in the mixed reality surgery group was 13.69 ±3.32 days,while in the traditional surgery group it was 17.53 ± 4.67 days,with a statistically significant difference(P=0.012).There was no statistically significant difference in VAS scores between the two groups of patients at 7 days after surgery(P=0.332>0.05).There was no statistically significant difference between the two groups of patients in terms of incision adverse events(P=0.673>0.05),tumor resection boundary(P=1.000>0.05),and tumor recurrence(P=0.593>0.05).There was no statistically significant difference in sacral nerve function scores between the two groups of patients at 3 months after surgery.At 6 months after surgery,the sacral nerve function score in the mixed reality surgery group was better than that in the traditional surgery group(P=0.048).The health score results showed that patients in the mixed reality surgery group had higher scores in three factors: social function(P=0.018),total physical health score(P=0.035),and total mental health score(P=0.038)compared to the traditional surgery group.In addition,the mixed reality surgery group scored better than the traditional surgery group on three psychological health factors: somatization(P=0.045),interpersonal sensitivity(P=0.013),and anxiety(P=0.010),with statistically significant differences.Conclusion: Mixed reality technology visualization imaging fully presents the adjacent relationship between sacral chordoma and surrounding tissue structures,assists in surgical planning and rapid localization of the target sacral foramen,simplifies surgical procedures,avoids damage to the anterior sacral venous plexus,effectively shortens surgical time,reduces intraoperative blood loss and postoperative drainage,and shortens hospital stay.By setting the osteotomy plane before surgery and matching the edge of the posterior sacral foramen during surgery,the accidental injury of the sacral nerve is reduced,and the recovery of sacral nerve function after surgery is accelerated.By utilizing mixed reality glasses for doctor-patient communication and education,patients can better understand their own condition,alleviate anxiety and inferiority,and ensure their mental health while improving surgical efficacy.