基于虚拟现实技术的旋提手法下颈椎间孔结构变化动态分析  

Dynamic analysis of structural changes in the lower cervical intervertebral foramen during rotationtraction manipulation by virtual reality technology

作　　者：刘广伟 冯敏山[1,2] 朱立国[1,2] 尹逊路 陈焯贤 Liu Guangwei;Feng Minshan;Zhu Liguo;Yin Xunlu;Chen Zhuoxian(Beijing Key Laboratory of Manipulative Technique,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China;Second Department of Spine,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院中医正骨技术北京市重点实验室,北京市1001022 [2]中国中医科学院望京医院脊柱二科,北京市100102

出　　处：《中国组织工程研究》2023年第9期1346-1351,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金青年科学基金项目(81302992),项目负责人:冯敏山;国家中医药管理局中医药创新团队及人才支持计划项目(ZYYCXTD-C-202003),项目负责人:朱立国。

摘　　要：背景:神经根型颈椎病是一类临床常见病,旋提手法是治疗神经根型颈椎病的有效手段,椎间孔的测量是临床上重要的参考标准。目的:分析不同状态下旋提手法对下颈椎间孔结构变化的影响,探讨旋提手法的生物力学作用机制。方法:颈椎标本置入螺钉方便CT成像时定位,首先应用MTS材料机在新鲜颈段标本上模拟不同状态下的旋提手法,同时利用运动捕捉技术获取旋提手法过程中Marker点的运动轨迹;然后,通过螺旋CT薄层扫描颈椎标本,运用Mimics软件进行三维颈椎实体重建,依据旋提手法过程下颈椎体的运动轨迹,通过Autodesk maya软件进行多模医学图像三维配准实现动态虚拟现实仿真,进行动态图像处理;最后,分别采用ImageJ软件及Adobe photoshop软件测量旋提手法前后下颈椎间孔的纵径及面积。结果与结论:(1)定位牵引有利于提前打开下颈椎间孔,牵引效果略差于中立位牵引,但定位牵引具有更好的安全性;(2)扳动力在150 N以内,旋提手法的扳动力越小,颈椎间孔的纵径及面积的增加幅度也越小;扳动力超过150 N之后,颈椎间孔纵径及面积的增加幅度影响不大;(3)旋提手法通过增大下颈椎间孔可能有助于松解椎间孔周缘的粘连,从而缓解神经根刺激症状。BACKGROUND:Cervical spondylotic radiculopathy is a common clinical disease.Rotation-tra ction manipulation is an effective means to treat cervical spondylotic radiculopathy.The measurement of interve rtebral foramen is an important reference standard in clinic.OBJECTIVE:To analyze the effects of diffe rent states of rotation-tra ction manipulation on the structural changes of lower cervical intervertebral foramen,and to explore the biomechanical mechanism of rotation-tra ction manipulation.METHODS:Ce rvical spine specimens were implanted with screws to facilitate positioning during CT imaging.Firstly,MTS material machine was used to simulate the rotation manipulation with different positioning angles on fresh cervical specimens.The motion trajecto ry of Marker points was obtained by motion capture technology.Then,the ce rvical specimens were scanned by thin-layer spiral CT.The three-dimensional cervical solid reconstruction was carried out by using Mimics software.According to the motion trajectory of cervical ve rtebra under the process of rotation-tra ction manipulation,the multi-mode medical image three-dimensional registration was carried out by Autodesk Maya software to realize dynamic virtual reality simulation,and then the dynamic image processing was carried out.Finally,ImageJ software and Adobe Photoshop software were used to measure the longitudinal diameter and area of lower cervical interve rtebral fo ramen before and after rotation-tra ction manipulation.RESULTS AND CONCLUSION:(1) Positioning traction was helpful to open the lower cervical intervertebral foramen in advance.The traction effect was slightly worse than neutral traction,but positioning traction had better safety.(2) When the pulling force was within 150 N,the smaller the pulling force of rotation-traction manipulation,the smaller the increase of the longitudinal diameter and area of the lower cervical intervertebral foramen.After the pulling force exceeded 150 N,the increase of longitudinal diameter and area of cervical intervertebral fo

关 键 词：神经根型颈椎病 旋提手法 颈椎间孔 虚拟现实 动态 定位牵引 中立位牵引 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R25