摘要
目的将三维手术模拟及术中实时导航技术应用于陈旧性颌面部骨折修复,提高手术的精度。方法收集颌面部陈旧性骨折患者6例,经临床及影像学检查确认为单侧颌面部陈旧性骨折,术前将患者的CT图像重建为三维立体模型,通过旋转和平移断骨,将其重新定位在合适的位置上完成骨折模拟修复。同时,通过镜像健侧模型对比患侧复位后断骨位置是否合理。术中,完成空间配准后,通过实时跟踪手术器械和患者的空间位置,将手术器械与患者的关系实时反映在屏幕上,引导医师完成断骨的复位,实现实时手术导航。结果术前实现颌面部骨折修复的三维模拟,术中实现患者和手术器械的实时跟踪,配准误差<1 mm。6位患者的术后CT检查显示,骨折复位与术前设计误差均<1.5 mm,手术创伤小,无并发症。结论计算机辅助手术模拟和手术导航技术可有效地提高颌面部陈旧性骨折修复的手术精度。
Objective To apply the three-dimensional pre-operative simulation and intra-operative real-time navigation in the reconstruction of old maxillofacial fractures so as to increase the surgical precision. Methods Six patients with old maxillofacial fractures were enrolled, and the diagnosis of unilateral old maxillofacial fractures was confirmed by clinical and imaging examinations. Virtual three-dimensional skull models were reconstructed from pre-operative CT images. The fractured bone was moved or rotated, and was reposed in a desired site according to the mirrored part from the heahby side. After patient-to-image registration, the surgical instruments and patients were tracked in real-time by optical tracking system during operation, and in this way the maxillofacial fractures were reposed satisfactorily guided by the virtual image. Results Three-dimensional simulation before operation and real-time navigation of patients and instruments during operation were realized. The error of registration was less than 1 mm. The post-operative CT examinations of these six patients revealed that the fracture reposition was same to the pre-operative planning, and the difference between them was less than 1.5 mm. The operations were minimally-invasive, with no complications. Conclusion Computer-aided surgical simulation and navigation system can effectively increase the surgical precision of reconstruction of old maxillofacial fractures.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2010年第1期112-115,共4页
Journal of Shanghai Jiao tong University:Medical Science
基金
国家自然科学基金(30872906
30801302)~~
关键词
手术模拟
实时导航
颌面部陈旧性骨折修复
surgical simulation
real-time navigation
reconstruction of old maxillofacial fractures
