应用数字化模板导航颅颈交界区后路螺钉内固定(附9例报告)  

Application of digitalized modular navigation in the posterior screw fixation of cranio-vertebral junction(report of 9 cases)

作　　者：李栋平[1] 邓洵鼎[1] 朱兴宝[1] 黄伟[1] 王典春[1] 封雨[1] 杨云华[1] 秦培韬[1] 王宇飞[1] 陆声[2] 

机构地区：[1]成都军区昆明总医院神经外科,云南昆明650032 [2]成都军区昆明总医院骨科,云南昆明650032

出　　处：《中华神经外科疾病研究杂志》2010年第1期65-68,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：中国博士后基金资助项目(20080431420);云南省社会发展科技计划(2008CD210)

摘　　要：目的结合人体解剖学、现代影像学、计算机三维重建、逆向工程技术及快速成形技术,设计一种新的颈椎弓根后路螺钉内固定方法。方法采集患者CT原始三维数据建立颈椎三维模型,导入三维重建软件Amira3.1,虚拟图像上采集拟固定椎弓根数据,应用逆向成形技术(RE)设计进针导航模板,利用激光快速成形(RP)技术制作颈椎模型和导航模板。在该模板导航下,后路螺钉内固定治疗9例颅底畸形。术中利用制作的导航模板与颈椎的后部结构相贴合,通过导航孔进行颈椎椎弓根的定位,植入椎弓根螺钉。术后根据X平片和CT扫描评价椎弓根螺钉的位置。结果建立制作个体化颈椎导航模板的方法,通过RE、RP技术生产出的导航模板具有较好的准确性、安全性、可靠性,适用于颅颈交界区后路螺钉内固定。结论利用RE和RP技术为颅颈交界区后路螺钉内固定定位、固定提供了一种全新、准确、安全、可靠的方法,在神经外科领域具有较大的应用前景,可广泛应用于颅颈交界和胸腰椎椎弓根的固定。Objective To develop a novel method to guide the posterior screw fixation of eranio-vertebral junction using reverse engineering （RE） and rapid prototyping （RP） techniques based on human anatomy, modem medical imaging and three-dimensional （3-D） computerized reeonstmetion. Methods Original 3-D CT data of cervical vertebra were collected and introduced to the 3-D reconstruction software, Amira 3.1 ; cervical models and navigation modules were established based on the analog imaging of the target cervical vertebra using RE and RP techniques. This digitalized modular navigation technique was applied to nine eases of skull base malformation, i.e. , a digitalized module in accordance with anatomical features was closely placed on the target cervical arch leading to accurate emplacement of the vertebral pedicle screw confirmed by postoperative X-ray and CT examination. Results A novel method guiding the posterior screw fixation of craniovertebral junction was established using RE and RP techniques. The digitalized modular navigation technique was proven to be accurate, safe and reliable. Conclusion The novel digitalized modular navigation technique is accurate, safe, reliable and potential in neurosurgical field as it is suitable not only for cranio-vertebral junction, and for thoracolumbar vertebral pedicles.

关 键 词：数字技术 寰椎 枢椎 导航 内固定 

分 类 号：R68[医药卫生—骨科学]