基于CT值的脊柱椎弓根螺钉轨迹自动规划在骨质疏松患者中的应用价值研究  

Study on the application value of automatic planning of pedicle screw trajectory of spine based on CT value

作　　者：刘嘉斌 夏桂锋 左睿 张超 郑文杰 李长青 周跃 LIU Jia-bin;XIA Gui-feng;ZUO Rui(Department of Orthopaedics,Xinqiao Hospital,Amy Medical University,Chongqing 400037,China;不详)

机构地区：[1]陆军军医大学第二附属医院骨科,重庆400037 [2]重庆博仕康科技有限公司,重庆400722

出　　处：《中国医学装备》2022年第2期58-63,共6页China Medical Equipment

基　　金：重庆市科委基金资助(cstc2020jscx-gksb X0009)“微创脊柱手术机器人智能操作环境关键技术研究”。

摘　　要：目的:提出一种基于CT值的脊柱椎弓根螺钉软件自动规划方法,用于骨质疏松患者治疗中。方法:以CT值为主要指标,设计椎弓根螺钉自动规划方法(简称自动规划方法),选取医院收治的行CT检查的10例腰椎退变患者,在其CT图像上评价自动规划方法与手动人工规划所得螺钉轨迹的位置及CT值的区别。结果:自动规划推荐的螺钉直径和长度较为保守,其螺钉进钉点更加的靠外靠下,轨迹有更大的尾倾角和更小的外展角。自动规划的轨迹CT值(245.52±38.30)HU大于人工规划的轨迹CT值(190.14±45.17)HU的29.13%,差异有统计学意义(t=7.496,P<0.05)。结论:基于CT值软件自动规划的脊柱椎弓根螺钉轨迹可获得更高的CT值,能够提高骨质疏松椎弓根螺钉的抗拔出力,具有较好的临床应用价值。Objective:To propose an automatic planning method of pedicle screw software of spine based on computed tomography(CT)values,which could was used in the treatment of patient with osteoporosis.Methods:CT value was used as main index to design automatic planning method of pedicle screw,and 10 patients with lumbar vertebra regression who underwent CT examination in hospital were selected.The differences of the location and CT value of screw trajectory,which were obtained from automatic planning method and manual planning method,were evaluated on CT images.Results:The diameter and length of screw which was recommended by automatic planning were more conservative,and enter point of screw of that was outer and lower,and the trajectory has a larger tail dip dangle and a smaller abduction angle.The CT value(245.52±38.30)of automatic planning trajectory was larger 29.13%by that(190.14±45.17)of manual planning trajectory(t=7.496,P<0.05).Conclusion:Pedicle screw trajectory of spine that is on the basis of automatic planning of CT value software can obtain higher CT value,which can enhance the anti-withdrawal force of pedicle screw for osteoporosis.It has favorable clinical application value.

关 键 词：骨质疏松 椎弓根钉 自动规划 算法 CT值 

分 类 号：R318.04[医药卫生—生物医学工程]