三维数字个性化手术设计在青少年特发性脊柱侧凸矫形手术中的应用（英文）  

Application of three-dimensional digital operation planning to individualized adolescent idiopathic scoliosis surgery

作　　者：付裕[1] 张云凤[2] 苏宝科 赵岩[1] 辛大奇[1] 王海燕 许阳阳 张聪 王一丹 王星 高尚 恩和 蔡永强 王建忠 王志强 高明杰 李志军 马界荣 李筱贺 Fu Yu;Zhang Yunfeng;Su Baoke;Zhao Yan;Xin Daqi;Wang Haiyan;Xu Yangyang;Zhang Cong;Wang Yidan;Wang Xing;Gao Shang;En He;Cai Yongqiang;Wang Jianzhong;Wang Zhiqiang;Gao Mingjie;Li Zhijun;Ma Jierong;Li Xiaohe(Department of Spine,the Second Affiliated Hospital of Inner Mongolia Medical University,Huhhot 010010,Inner Mongolia Autonomous Region,China;Department of CT Center,the Second Affiliated Hospital of Inner Mongolia Medical University,Huhhot 010010,Inner Mongolia Autonomous Region,China;Department of Human Anatomy,Basic Medical School,Inner Mongolia Medical University,Huhhot 010010,Inner Mongolia Autonomous Region,China;Third Clinical Teaching Hospital of Inner Mongolia Medical University,Huhhot 010010,Inner Mongolia Autonomous Region,China)

机构地区：[1]内蒙古医科大学第二附属医院脊柱外科,内蒙古自治区呼和浩特市010010 [2]内蒙古医科大学第二附属医院影像科,内蒙古自治区呼和浩特市010010 [3]内蒙古医科大学基础医学院人体解剖教研室,内蒙古自治区呼和浩特市010010 [4]内蒙古医科大学第三临床教学医院,内蒙古自治区呼和浩特市010010

出　　处：《中国组织工程研究》2019年第32期5158-5163,共6页Chinese Journal of Tissue Engineering Research

基　　金：the National Natural Science Foundation of China,No.81560348,81260269,81550042(to LZJ),No.81460330(to LXH);the Youth Elite of Science and technology of Inner Mongolia Autonomous Region Colleges and Universities “Young Science and Technology Talents Program”,No.NJYT-15-B05(to LXH);the Inner Mongolia Autonomous Region Science and Technology Plan Project(2016)(to LXH);the Natural Science Foundation of Inner Mongolia Autonomous Region,No.2016MS08131(to LXH);the Science and Technology Innovation Leading Project of Inner Mongolia Autonomous Region(2017)(to LXH);the Fund for Returnees from the Department of Human Resources and Social Security of Inner Mongolia Autonomous Region(to LXH)~~

摘　　要：背景:青少年特发性脊柱侧凸为青少年脊柱侧凸的最常见类型,畸形所导致的脊柱解剖学变化使得临床螺钉固定风险较高。目的:针对青少年特发性脊柱侧凸患者建立数字化虚拟仿真手术设计方案。方法:内蒙古医科大学第二附属医院脊柱外科收治的17岁青少年特发性脊柱侧凸患者1例行术前16排螺旋CT扫描,将CT资料利用Mimics16.0软件进行三维重建,测量经椎弓根固定螺钉直径,长及固定角度后进行导航模板设计和3D打印,利用导航模板进行手术螺钉固定,术后CT扫描后评估置钉疗效。结果与结论:对该位患者脊柱进行三维重建,利用软件逆向工程设计功能设计导航模板,使得固定螺钉避免穿透椎体前缘皮质和椎弓根内外侧皮质骨,对设计导航模板畸形3D打印,并利用其进行脊柱矫形手术矫形,术后评估,未见螺钉穿出皮质,置钉准确率达100%。结果证实,对于特发性脊柱侧凸患者利用三维数字化重建设计导航模板进行手术置钉具有较高置钉成功率。试验方案经已患者本人及家属知情同意并于2014年4月通过内蒙古医科大学伦理委员会审核,批准号:20140408。BACKGROUND:Adolescent idiopathic scoliosis is the most common form of scoliosis.Spinal anatomical changes caused by malformation make the risk of clinical screw fixation high.OBJECTIVE:To investigate the method to establish a digital virtual surgery planning system for adolescent idiopathic scoliosis.METHODS:One 17-year-old patient with adolescent idiopathic scoliosis was selected and underwent 16-slice spiral CT scan in Department of Spine,the Second Affiliated Hospital of Inner Mongolia Medical University.Three-dimensional reconstruction of CT data was conducted using Mimics 16.0 software.Navigation template design and three-dimensional printing were performed after measuring the diameter,length of transpedicular screw and angle after fixation.Surgical screw fixation was performed with navigation template,and the effect of screw placement was evaluated after CT scan.RESULTS AND CONCLUSION:Three-dimensional reconstruction was conducted in the patient’s spine.Navigation templates were designed using software reverse engineering design function to prevent the screw from penetrating the anterior cortex of the vertebral body and the inner and outer cortical bone of the pedicle.Three-dimensional printing of deformity of navigation template was conducted and it was used in spinal orthopedic surgery.Postoperative evaluation showed that no screw penetrated the cortex and the accuracy of screw placement was 100%.The results showed that the successful rate of screw placement was high for patients with idiopathic scoliosis by using three-dimensional digital reconstruction design navigation template.The patient and her family member signed the informed consent.This study was approved by the Ethics Committee of Inner Mongolia Medical University in April 2014(approval No.20140408).

关 键 词：青少年特发性脊柱侧凸 椎弓根固定 椎弓根 数字化三维重建 导航模板 3D打印 

分 类 号：R459.9[医药卫生—治疗学] R604[医药卫生—临床医学]