数字化重建与快速成型技术在复杂上颈椎疾患诊治中的应用  

Application of digital spine and rapid prototyping in complicated upper cervical spine disease

作　　者：林山[1,2] 尹庆水[1] 夏虹[1] 艾福志[1] 吴增辉[1] 马向阳[1] 万磊[1] 

机构地区：[1]广州军区广州总医院全军创伤骨科中心,广州市510010 [2]南方医科大学博士研究生,广州市510515

出　　处：《中国脊柱脊髓杂志》2011年第1期16-20,共5页Chinese Journal of Spine and Spinal Cord

基　　金：全军医学科学技术研究“十一五”计划第二批课题专项基金(08Z010)

摘　　要：目的:利用数字化三维重建和快速成型技术制作头颈部三维实体模型,并探讨其在复杂上颈椎疾患诊治中的应用效果。方法:采集32例复杂上颈椎疾患患者头颈部CT断层扫描数据,进行数字化三维重建、快速成型制备1∶1三维实体模型,并将其应用于诊治、手术规划和术中参照。结果:32例患者均在三维实体模型指导下完成,手术过程顺利。32例患者术中所见与术前数字化三维重建模型和三维实体模型的病灶结构变化一致,三者间进钉点距中线距离、钉道外倾角及钉道长度与术中实际测量的数据差异无显著性(P>0.05)。术后ASIA评分与术前比较差异有显著性(P<0.01)。术后复查X线、CT和MRI示:脊髓受压解除,病灶清除满意,内固定物在位良好,未出现神经、血管损伤等并发症。结论:数字化重建与快速成型技术能够准确和直观地反映上颈椎病变情况,可指导制定手术计划和手术操作。Objective：To construct three-dimensional model of craniocervical region by using digital spine and rapid prototyping and investigate its value in managing complicated upper cervical spine disease.Method：The CT scans of 32 patients who sustained complicated upper cervical spine disease were used for three-dimension reconstruction and the rapid prototype model（1：1） of the upper cervical spine were achieved for clinical practice.Result：All operations for these patients were successfully performed under the guidance of 3-D entity model.The complete decompression of cervical spinal cord,the satisfactory debridement and reliable correction and internal fixation were achieved in all patients with no neurovascular injury.Intraoperative findings,distance from the entry point to the midline,extroversion angle and length of screw path of 32 patients were the same as those on the models of preoperative digital 3-D reconstruction and the model of rapid prototyping（P0.05）.The postoperative ASIA score was significantly higher than the preoperative ones（P0.01）.Conclusion：Digital reconstruction and rapid prototyping can reveal uppercervical disorders accurately and directly,which can be used for making a surgical plan.

关 键 词：上颈椎 快速成型 数字化骨科 三维重建 

分 类 号：R681.5[医药卫生—骨科学] TP391.4[医药卫生—外科学]