数字矩阵建模在寰椎椎弓根螺钉通道研究中的应用  

Digital matrix modeling to study atlas pedicle screw channel

作　　者：覃涛[1] 杜远立[1] 王华[1] 周才胜[1] 郑东[2] 杨述华[1] 

机构地区：[1]三峡大学人民医院骨科,湖北省宜昌市443000 [2]华中科技大学同济医学院附属协和医院骨科

出　　处：《中华创伤骨科杂志》2013年第1期41-44,共4页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金（81101376）

摘　　要：目的观察寰椎椎弓根通道在不同水平面角（TSA）、矢状面角（SSA）的变化规律，以及使用不同规格螺钉的变化规律，探泔数字矩阵建模在术前设计寰椎椎弓根螺钉进钉方案中的作用。方法将9位健康成人受试者（男5例，女4例；年龄26～70岁，平均45岁）的寰椎CT连续断层扫描数据导入Mimics10．01软件，三维重建后川．dwg文件导入3dmax2009。确定三维参照坐标和进钉点，用3dmax中参学建模命令建立17×17×2．间距2．5°，TSA0—40°、SSA0～40°，共578个元素模拟椎0根螺钉矩阵模型，观察当模拟螺钉进钉角度、直径、长度变化时椎弓根螺钉通道的变化规律。结果TSA、SSA均明强影响左、右侧螺钉进钉长度，差异有统计学意义（P〈0．05）。TSA=0°、SSA=10°时螺钉长度最佳f左侧平均为（1．91±0．26mm，右侧平均为（1．51±0．29）mm]。直径为3．5mm、长为22mm的螺钉往寰枢椎进钉数11较由：径为3．5mm、长度为26mm的螺钉多，直径为3．5mm、长度为22mm螺钉住寰怄椎进钉数目较直径为4．0mm、长度为22mm的螺钉多，差异均有统计学意义（P〈0．05）。结论利用数字矩阵建模能够简化复杂逆向建模可以全方位观察不同TSA、SSA、螺钉规格变化时椎弓根通道的变化规律。术前设计时不仅需要综合考虑椎弓根螺钉本身的TSA、直径及长度，而且要考虑SSA，以确定个性化的进钉方案。Objective To investigate the regular patterns of atlas pedicle channel as well as different screw specifications at different sagittal section angles （SSA） and transverse section angles （TSA） by means of digital nmtrix modeling. Methods CT scan images of atlas of 9 heahhy aduh volunteers [5 males and 4 fe- males, aged 26 to 70 （average, 45） years] were digitally analyzed by Mimics 10.01 software （Materalise） to re- construct three-dimensional （31）） models. The 3D reconstrtlction models were imported into 3dmax 2009 as. dwg formal for analysis of the pedicle screw channels. The reference 31） planes and the sites of nail insertion were determined by the matrix modeling. The modeling consisted of 17 × 17 × 2 elements and the TSA and the SSA ranged from 0° to 40°. Pedicle screw channels were analyzed at different TSA and SSA and with different screw specifications. Results The length of atlas pedicle screws was significantly affected by both TSA and SSA as well as by interaction between TSA and SSA （ P 〈 0.05） . TSA = 0° and SSA = 10° yielded the optimum screw length （1.91 ±0.26 nun for the left side and 1.51 ±0, 29 man for the right side）. When the diameter was 3.5 nun, significantly more screws of 22 mm in length were inserted al both sides than the screws of 26 mm in length （ P 〈 0. 05） . When the length was 22 mm, significantly more screws of 3.5 mm in diameter were inserted at both sides than the screws of 4. 0 mm in diameter （ P 〈 0. 05） . Conclusions The digital matrix nmdeling can simplify the complicated reverse modeling procedure to achieve omni-directional observation of pediele screw channels at various SSAs and TSAs and with different screw specifications. The pre- operative individual design should not only consider TSA, length and diameter but also SSA of the screws.

关 键 词：寰椎 成像 三维 骨钉 椎弓根通道 数字矩阵模型 

分 类 号：R687.3[医药卫生—骨科学]