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(存儲版)
【正文】 解剖標(biāo)志定位法。 臨床應(yīng)用結(jié)果本組2例患者，置入頸椎椎弓根螺釘10枚，所有螺釘置入過程順利，術(shù)中和術(shù)后均未出現(xiàn)血管和神經(jīng)并發(fā)癥。 （177。 177。表 2 頸椎三維重建圖像椎弓根角度測量結(jié)果(177。 177。 177。C4 177。 mm即為個體化螺釘直徑參考值；椎弓根軸線長度減去該軸線在椎體內(nèi)長度的1/2即為螺釘長度參考值；椎弓根軸線的α和β角即為個體化置釘角度。A、B:患者下頸椎模型在術(shù)中與實(shí)體比對。將頸椎標(biāo)本固定在操作臺上，暴露側(cè)塊后緣骨皮質(zhì)，通過比對標(biāo)本和已實(shí)體模型確定標(biāo)本進(jìn)釘點(diǎn)。利用軟件的測量工具測量椎弓根軸線長度L、椎弓根最窄處截面上下皮質(zhì)骨高度H、椎弓根最窄處截面兩側(cè)皮質(zhì)骨寬度W、椎弓根軸線在橫斷面上投影與椎體冠狀面垂線成的內(nèi)傾角α、椎弓根軸線在矢狀面投影與椎體冠狀面垂線所成的頭/尾傾角β（圖1B）。運(yùn)用閾值選取技術(shù)(Thresholding)，獲得頸椎原始蒙罩（Mask）后，在運(yùn)用三維區(qū)域增長技術(shù)(3D Region Growing)對原始蒙罩進(jìn)行修改，得到新蒙罩。頸椎內(nèi)固定是實(shí)現(xiàn)這些目的的有效手段。 pedicle screw。a workstation running利用上述方法對2例患者進(jìn)行個體化置釘，術(shù)后通過CT掃描驗(yàn)證螺釘位置準(zhǔn)確性。 方法 對16例成人下頸椎標(biāo)本行CT掃描收集數(shù)據(jù)，導(dǎo)入Mimics軟件對標(biāo)本進(jìn)行三維重建。對患者置入10枚椎弓根螺釘，CT示螺釘位置滿意。 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 great assistance in designing individualized surgery plan and supervising placement of pedicle screw. There were pP148 pedicle screws were inserted in the 16 cervical specimens,. Among them, 140 were inserted in the pedicle cortical, and the left 8only one of them breached the pedicle cortical mildly. CT scanning indicated that the 10 pedicle screws were satisfyingly inserted in the 2 patients. Conclusion Combination of 3D image by Mimics and intuitive guidance of physical model by rapid prototyping technique improve the accuracy and safety of lower c
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