应用Mimics软件对胸腔镜下胸椎侧凸前路松解术胸壁锁孔的术前个体化设计  

Mimics software used for individualized preoperative design of chest portals in thoracoscopic anterior release for thoracic scoliosis

作　　者：刘立岷[1] 宋跃明[1] 周忠杰[1] 周春光[1] 杨光辉[1] 

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《中华创伤骨科杂志》2011年第12期1152-1155,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨应用Mimics软件对胸腔镜下胸椎侧凸前路松解术胸壁锁孔的术前个体化设计的可行性及优点。方法2009年3月至2010年9门收治特发性脊柱侧凸患者9例，男3例，女6例；12-18岁，平均14．7岁；脊柱侧凸采用Lenke分型：Ⅰ型3例，Ⅱ型6例。术前主胸弯cobb角85°-110°，平均96°；柔软率15％-29％，平均25．3％；术前利用Mimics软件和CT数据完成锁孔个体化设计并应川于临床完成脊柱松解术，二期行后路的矫形、内固定及植骨融合。结果9例患者均完成镜下脊柱松解（6例患者松解5个椎间隙，3例患者松解6个椎间隙），其中5例患者选择4个锁孔，4例患者选择3个锁孔。手术时间为85-150min（平均113min），术中出血蛙为200-400mL（平均275mL）；术后均未出现呼吸衰竭及其他严重并发症；矫形率52％-69％（平均57．6％），外观改薄口月显。9例患者经个体化设计的各孔（32孔）位置较常规设计开孔位置均后移约1-7cm（平均3．5cm）。结论应刖Mimics软件对胸腔镜下胸椎侧凸前路松解术胸壁锁孔的术前个体化设计可提供理想的开孔位置，有利于术中操作。Objective To investigate the feasibility and advantage of using Mimics software to in- dividually design chest portals preoperatively in thoracoscopic anterior release for patients with thoracic scol- iosis. Methods This series consisted of 3 males and 6 females, with an average age of 14.7 years （ranging from 12 to 18 years）. By Lenke classification, there were 3 cases of type Ⅰ and 6 eases of type Ⅱ. Their preoperative main thoracic Cobb angles at the coronal plane ranged from 85° to 110°（average, 96°）, and their average flexibility was 25.3% （from 15% to 29% ）. Before operation, CT data of the patients （including spine and thorax） were imported into the Mimics software to complete design for chest portals （including the number and site） for each individual patient. The individually designed chest portals were used in clinic, anterior spinal release to correct the stiff curve. Posterior correction, internal fixation, bone graft and fusion were c, arried out in the secondary surgery for the scoliosis. Results All the 9 eases completed anterior spinal release under thoracoscopy. Five intervertebral spaces were released in 6 cases, and 6 in 3. Four portals were designed tor 5 patients and 3 portals for the rest 4 cases. The operative time ranged from 85 to 150 minutes （average, 113 minutes）, and blood loss ranged from 200 to 400 mL（average, 275 ml,） during the operation. No respiratory failure, death or other serious complications occurred after the operation. The last correction rates after 2 operations ranged from 52% to 69% （average, 57.6% ） . Appearances of the patients were greatly improved. The positions of individually designed 32 portals for the 9 patients were 1 to 7 cm （average, 3.5 cm） more backward than those conventionally designed. Conclusions Mimics software can be used to individually design preoperative chest portals in thoracoscopic anterior release for patients with thoracic senliosis. The individual design can be completed in computer and thus provide

关 键 词：软件 胸腔镜检查 脊柱侧凸 

分 类 号：R687.3[医药卫生—骨科学]