计算机辅助设计在强直性脊柱炎后凸畸形矫形手术中的应用  

The application of computer simulation of spinal osteotomy in making surgical plan for correction of kyphosis in ankylosing spondylitis

作　　者：李景欣[1] 瞿东滨[1] 王博亮[2] 蔡明[2] 罗吉伟[1] 金大地[1] 

机构地区：[1]南方医科大学附属南方医院脊柱骨病外科,广州510515 [2]厦门大学计算机科学系,福建厦门361000

出　　处：《中国临床解剖学杂志》2008年第6期619-623,共5页Chinese Journal of Clinical Anatomy

摘　　要：目的:探讨计算机辅助设计在强直性脊柱炎后凸畸形矫形术手术方案制定中的应用价值。方法:将5例强直性脊柱炎后凸畸形患者在手术前后进行胸腰椎CT扫描,获得的数据导入Mimics10.01软件进行三维重建。手术前在重建模型上模拟经椎弓根椎体截骨术进行虚拟截骨、预测矫形效果,并测算截骨椎体所需截骨角度及相应在椎板及椎体后缘的截骨宽度。手术后在预测模型及术后重建模型上分别测量全脊柱后凸角,颈7椎体中心点与骶骨后上角的水平距离,截骨节段相邻上下椎体棘突间及双侧横突间距离等指标,并进行比较。结果:5例手术前后均顺利完成三维建模。术前模拟截骨测算出截骨椎体所需截骨角度、椎板截骨宽度和椎体后缘截骨宽度的值分别为(26.34±3.16)°(23.30～30.11°)、(27.71±1.22)mm(26.53～29.15mm)和(14.45±1.62)mm(12.17～16.62mm),在虚拟截骨模型上及术后重建模型上测得的比较指标相近。结论:应用计算机对强直性脊柱炎后凸畸形截骨矫正手术进行仿真模拟设计的方法具有可行性,能比较直观、精确反映矫形效果,可为制定手术方案提供较科学的依据。ObjeCtive： To discuss the application of computer simulation of spinal osteotomy in making surgical plans for patients with kyphosis deformity due to ankylosing spondylifis. Methods： 4 patients underwent CT scan before and after the operation and the collected data were put intothe Mimics 10.01 to reconstruct 3D images. Virtual vertebrectomies were carried out on the models to guide actual operations. The corrected angle, the width of the lamina, the width of resected lumbar posterior marginal bone was predicted. In the model of virtual vertebrectomies and the postoperative reconstructed, the total spinal kyphosis angle, the distance between the cervical line on the center of C7 and the postero-superior part of S1, the distance of the spinous process and the distance of both sides of transverse process were measured and compared. Results： The models were successfully reconstructed and virtual vertebrectomies were well completed in every case. The mean predictive value of the corrected angle, the width of the lamina, the width ofresected lumbar posterior marginal bone were （26.34±3.16）°（23.30±30.11°）, （27.71±1.22） mm （26.53±29.15 mm）, and （14.45±1.62） mm （12.17-16.62 ram） respectively. The mean predictive value was close to the mean real values. Conclusions： Computer simulation of vertebrectomy can directly and accurately reflect the correction effects before surgery, which is convenient for defining the best surgical plan as well as improving the safety and accuracy of the operation.

关 键 词：计算机辅助骨科 手术模拟 强直性脊柱炎 后凸畸形 

分 类 号：R682.3[医药卫生—骨科学] R593.28[医药卫生—外科学]