计算机辅助导航模板辅助颈椎椎弓根置钉可行性研究  

Feasibility Study of Computer - assisted Navigation Template in Cervical Pedicle Stereotaxy

作　　者：陈国平[1] 陆声[1] 徐永清[1] 张元智[2] 师继红[1] 李军[1] 陈玉兵[1] 

机构地区：[1]成都军区昆明总医院全军骨科中心,昆明医学院昆明总医院临床学院,成都昆明650032 [2]内蒙古医学院第一附属医院骨科

出　　处：《解剖与临床》2010年第3期164-167,共4页Anatomy and Clinics

基　　金：国家博士后基金资助课题（20080431420）

摘　　要：目的：利用逆向工程原理和快速成型技术，通过尸体标本试验验证导航模板可行性及准确性。方法：选取成年男性正常颈椎骨标本1具，范围从C1-7CT连续断层扫描数据集，采用Mimics 8．1三维重建颈椎数字解剖模型。分别在Geomagic studio9、Magics 9．5软件平台打开三维重建模型，定位三维参考平面，利用逆向工程（RE）原理寻找椎弓根的最佳进钉通道，提取椎板的表面解剖学形态，建立与椎体后部解剖学形态一致的反向模板，拟合模板和椎弓根孔道成定位模板，将导航模板通过激光快速成形技术制造出实物模型。将制作的实物模板和标本的椎板相吻合，利用导航模板的导航孔置入椎弓根螺钉，术后根据CT扫描评价椎弓根螺钉位置的准确性。结果：成功的设计并制作出与椎体后部解剖学结构一致的导航模板。术后CT扫描显示，模拟手术置入的14枚椎弓根钉位置均为Ⅰ类。结论：利用逆向工程原理和快速成型（RP）技术为颈椎弓根的定位、定向提供了一种新的方法，具有较好的应用前景。Objective：To develop a novel method of spinal pedical stereotaxy by reverse engineering and rapid prototyping, and validate the accuracy by experimental study. Methods：A three dimensional CT scan of C-7 vertebrae of a adult man cadaver was performed. Three dimensional software Mimics8.1. was used to establish the C1-7 3D model. Then open 3D model in Geomagic studio 9 ,Magies 9.5 ,and located 3D coordinate system. Then extract the best pedicle channel according to the reverse engineering and establish a template according with the laminec anatomic trait, and fuse the best pedicle channel and template as the navigational template at last. Manufactures exact vertebrae and navigational template by rapid prototyping （SLA technique ）. The accurate was confirmed with CT scan. Results：A new method of spinal pedical stereotaxy by reverse engineering and rapid prototyping was established. The navigational template were found to be highly accurate. Conclusions：The authors have developed a novel method of spinal stereotaxy using reverse engineering and rapid prototyping. It may has great expectation in clinics.

关 键 词：颈椎 计算机辅助 导航模板 逆向工程 快速成型 

分 类 号：R687.3[医药卫生—骨科学]