mimics及脊柱模型用于下頸椎椎弓根個體化置釘?shù)膽?yīng)用研究(已修改)
2024-10-06 01:12 本頁面
【正文】 Mimics及脊柱模型用于下頸椎椎弓根個體化置釘?shù)膽?yīng)用研究 王遠政1 ，田曉濱1，劉 洋2，李 波1，孫 立1，張 一1，王楠筑1 （550002 貴陽，貴州省人民醫(yī)院骨科1；400010 重慶，重慶醫(yī)科大學(xué)附屬第二醫(yī)院骨科2）[摘要] 目的 利用快速成型技術(shù)及Mimics軟件設(shè)計一種新的下頸椎椎弓根釘個體化置入技術(shù)，并探討其臨床應(yīng)用意義。 方法 對16例成人下頸椎標本行CT掃描收集數(shù)據(jù)，導(dǎo)入Mimics軟件對標本進行三維重建。利用Mimics相關(guān)功能在三維重建圖像上尋找下頸椎椎弓根最佳軸線并測量椎弓根相關(guān)參數(shù)，制定椎弓根螺釘個體化置入方案。然后將三維重建圖像以STL格式導(dǎo)入三維打印機，制作出下頸椎的實體模型，根據(jù)個體化置釘角度置入導(dǎo)向針。依照制定的個體化指定參數(shù)，并配合實體模型的直觀指導(dǎo)，在標本上進行置釘。置釘后標本行CT掃描，判斷置入準確性。利用上述方法對2例患者進行個體化置釘，術(shù)后通過CT掃描驗證螺釘位置準確性。 結(jié)果 成功建立了與標本相似度極高的下頸椎三維重建圖像和實物模型，通過測量結(jié)果設(shè)計了每個椎弓根的置釘參數(shù)。共在標本上置入148枚椎弓根螺釘，140枚位于椎弓根骨皮質(zhì)之內(nèi)，8枚稍穿破椎弓根骨皮質(zhì)。對患者置入10枚椎弓根螺釘，CT示螺釘位置滿意。結(jié)論 用Mimics軟件對下頸椎進行三維重建，制定個體化置釘參數(shù)，同時配合實物模型的直觀指導(dǎo)，提供了一種下頸椎椎弓根釘個體化置釘?shù)姆椒?，利用該法能提高置釘安全性?[關(guān)鍵詞] 頸椎；椎弓根螺釘；Mimics軟件；快速成型；三維重建 [中圖法分類號] [文獻標志碼] AIndividualization of lower cervical pedicle screw fixation withApplication of rapid prototyping and MIMICSimics software in lower cervical pedicle screw fixationthreedimensional (3D) reconstruction model was generated withMIMICSa workstation runningMIMICS softwareWang Yuanzheng1, Tian Xiaobin1, Liu Yang2, Li Bo1, Sun Li1, Zhang Yi1, Wang Nanzhu1 (1 Department of Orthopaedics Surgery,Guiz Zhou Provinceial People’s Hospital, Guiyang, Guizhou Province, 550002，China。 2 Department of Orthopaedics Surgery, XinqiaoSecond affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China)[Abstract] Objective To design a new lower cervical pedicle screw placement based on study the application of Mimics software and rapid prototyping technology and evaluate its clinical valuein lower cervical pedicle screw placement, and explore its clinic application. Methods CT scans scanning was performed of on 16 adult cadaveric cervical specimens (C3 to C7). were performed. The obtained CT data were imported into a workstation running MIMICS reverse engineering software Mimics to generate establish cervical three dimensional (3D) reconstruction images which saved as STL files. Then these STL files were used to manufacture produce cervical physical models using rapid prototyping technique. The optimal trajectory pedicle was explored and marked on 3D images using puter assistant aided design module of Mimics, and the related parameters of cervical pedicle were measured using measurement tools of Mimics. So the individualized surgery plan of pedicle screw fixation was determined according to the location of pedicle trajectory and parameters. The trajectory pins were drilled into physical model to supervise the entry point and orientation of pedicle screw. With the visualized guidance of physical model, pedicle screws were inserted in cadaveric specimens in strict accordance with individualized surgery plan determined previously. Pedicle screw fixation was performed in two 2 patients with cervical disorders requiring instrumentation using this individualized surgery method as mentioned above. Results The cervical 3D image and physical model were found to be anatomically similar with each other and of
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