数字骨科技术在寰枢椎个体化置钉手术中的应用  

Application of digital orthopaedic technique in personalized pedicle screw placement for upper cervical spine

作　　者：王建华[1] 尹庆水[1] 夏虹[1] 吴增辉[1] 马向阳[1] 艾福志[1] 章凯[1] 

机构地区：[1]广州军区广州总医院,广东510010

出　　处：《脊柱外科杂志》2011年第3期165-168,共4页Journal of Spinal Surgery

基　　金：军队临床高新技术项目(2010gxjs032)

摘　　要：目的探讨数字骨科技术在寰枢椎椎弓根螺钉个性化置钉的应用价值。方法将术前接受薄层CT扫描的30例上颈椎疾患患者(其中男16例,女14例)的数据输入Mimic和Simpleware软件后,建立三维仿真模型,并设计最佳的椎弓根钉道,然后根据钉道设计导航模版。用激光快速成型机打印导航模版,用于手术时辅助寰枢椎椎弓根螺钉置钉。结果 60枚寰椎椎弓根螺钉及60枚枢椎椎弓根螺钉均位于设计的椎弓根钉道内,未出现向外偏入椎动脉孔及向内偏向椎管的现象,置钉成功率达100%。结论采用数字骨科技术进行术前手术设计,并采用数字化导航模版辅助手术置钉,能够有效提高置钉的成功率,是一项值得推广的新技术。Objective To assess the application of digital orthopaedic technique in the personalized pedicle screw placement in the upper cervical spine.Methods A total of 30 patients（16 men,14 women） with upper cervical disorders underwent thin slice CT scan before operation,and the digital data were fed into the Mimics and simpleware software to setup a three dimensional simulation model of the atlas and axis.Then the optimized pedicle screw trajectory path was designed by computer;a pedicle screw navigation device was produced by reverse engineering technique using a laser fast-produce machine.All the pedicle screws of atlas or axis were inserted guided by this digital navigation device.Results All the 60 screws were correctly placed through the designed canal of atlas or axis,without penetration into the vertebrae canal or the vertebrae artery groove,achieving a successful rate of 100%.Conclusion Operation design by digital orthopaedic technique before surgery and guiding the pedicle screw placement with digital navigation device can effectively improve the successful rate of screw insertion,which is worth popularizing.

关 键 词：寰椎 枢椎 寰枢关节 内固定器 外科手术 计算机辅助 

分 类 号：R681.531[医药卫生—骨科学]