骨科冲击波治疗的智能化发展现状及趋势分析

Progresses and trends of intelligent technologies in orthopedic shock wave therapy

体外冲击波治疗以其安全无创的临床优势在骨科得到了广泛应用,但传统治疗手段普遍存在的主观经验决策和手动长时操作等问题限制了该方法的推广和进一步发展。智能技术已经开始进入骨科冲击波治疗领域,并发展迅速。本文总结了计算机导航、机器学习和机器人三类智能技术在骨科冲击波治疗中的研究现状及应用特点,表明:现阶段,计算机导航可以有效辅助医生完成冲击波探头的准确定位,机器学习方法能够辅助实现冲击波治疗能量参数的自动预测;机器人已经表现出了显著的潜在临床效能,尤其是能够大幅降低医师操作强度;三类技术分别从“眼”“脑”“手”的角度,为提升骨科冲击波治疗智能化水平提供全面支持。在此基础上,本文从临床治疗机制与量效关系、方案规划智能化与临床适宜性、治疗操作自动化与机器人辅助等方面,展望了未来发展趋势。

Extracorporeal shock wave therapy(ESWT)is widely adopted in clinical orthopedics for its safe and non-invasive treatment.However,the experience-based subjective decision-making and long-lasting manual operation of physicians in the conventional orthopedic ESWT have limited its further development.As intelligent technologies are rapidly getting into the orthopedic ESWT,this review summarizes the state-of-the-art of research and application of intelligent technologies in orthopedic ESWT from aspects of computer navigation,machine learning and robotics.Computer navigation technologies can intuitively assist physicians to accurately locate the shock wave probe on the anatomical target of patients.The machine learning methods can automatically predict energy parameters in ESWT.Robotic systems have demonstrated their potential advantages in clinical efficacy especially in the dramatical alleviation of the operation intensity of physicians.These intelligent technologies provide comprehensive support for intellectualization of orthopedic ESWT from eye,brain and hand,respectively.This review also concludes the future technical trends from aspects of the ESWT biological mechanism and dose-effect relationship,the treatment protocol planning and usability of machine learning,and the treatment automation and robotic assistance.