腰5骶1椎间盘突出症介入治疗的术前模拟研究  

Study on Interventional Preoperative Simulation of Disc Herniation for the Fifth Lumbar and First Sacral Disc

作　　者：魏欣[1] 钟立明[1] 游箭[1] 胡鸿[1] 胡孔琼[1] 赵晓伟[1] 

机构地区：[1]川北医学院第二临床学院南充市中心医院医学影像科介入医学中心,四川南充637000

出　　处：《实用放射学杂志》2010年第10期1511-1514,共4页Journal of Practical Radiology

基　　金：国家自然科学基金面上项目（编号：30770611）;四川省科技厅应用基础项目（编号：07JY029-030）.

摘　　要：目的 探讨腰骶椎和介入器械的虚拟三维模型在经皮腰5骶1（L5S1）椎间盘髓核切除术（PLD）术前模拟中的作用.方法 利用多层螺旋CT（MSCT）获得29例患者俯卧位腰骶部的薄层扫描数据,在Mimics、3DMAX软件中重建腰椎三维结构,根据介入手术器械尺寸在3DMAX软件中建立虚拟手术器械模型,在计算机上进行L5S1椎间盘侧后方穿刺路径的术前模拟和髓核钳夹取髓核组织范围的模拟评估.结果 术前模拟评估穿刺路径显示25例可穿刺成功,4例失败;实际手术中26例穿刺成功,3例失败.实际手术中夹取髓核组织的范围与术前模拟评估的结果基本一致.结论 在患者个体化骨骼模型基础上进行的穿刺模拟过程逼真可靠,对于促进椎间盘虚拟手术研究具有指导作用.Objective To explore the value of the models using three--dimensional moulding software for interventional preoperative simulation of percutaneous lumbar disectomy in the fifth lumbar and first sacral disc. Methods Multislice spiral CT（MSCT} scanning for lumbosacral vertebrae was performed in 29 patients at prone position. The three--dimensional reconstruction of lumbar spine based on MSCT data was done using software on Mimics 10.0 and 3D Studio MAX R3. Results The results of simulation showed that the puncture approach was found in 25 cases and not be found in 4 eases. As a result of the actual operation, 26 eases were succeed and 3cases were failed. The results between the preoperative simulation and the actual operation about clipping range of vertebral pulp by clamp were similar on the whole. Conclusion The puncture simulation process based on individualized skeleton model is closed to be real and reliable,which may play a guide role in promoting researches at lumbar disc virtual operations.

关 键 词：腰椎 椎间盘突出 体层摄影术 X线计算机 介入放射学 

分 类 号：R681.53[医药卫生—骨科学] R814.42[医药卫生—外科学]