摘要
目的利用计算机三维重建软件和逆向工程软件个性化分析并确定第1骶椎椎弓根螺钉最佳进钉通道,测量最佳进钉通道的相关数据,为临床个性化精准置入第1骶椎椎弓根螺钉提供数据参考。方法将随机选择的50例健康成人的腰骶部(含第1骶椎及两侧髂后上嵴)CT资料按性别分为男女两组,分别利用Mimics 17.0软件进行三维重建,建立第1骶椎及两侧髂骨的三维数字图像模型,以.stl格式保存,将模型导入CATIA V5R20软件,确定并测量椎弓根螺钉横断面上最佳进钉角度、最大螺钉半径、理论最大进钉深度、最佳进钉点距上终板水平切面及正中矢状面的距离,按照所测量的数据进行计算机虚拟置钉,并将所得数据参数进行统计学分析。结果 (1)本研究的研究方法既可以实现第1骶椎椎弓根螺钉最佳进钉通道的个性化术前设计,为临床个性化精准置入第1骶椎椎弓根螺钉提供数据参考,又可以实现大样本量的解剖学研究。(2)个体间存在个体差异,应重视个性化治疗。(3)男性与女性第1骶椎椎弓根螺钉在横断面上最佳进钉角度以及最佳进钉点位置上存在差异,女性较男性最佳进钉点位置靠外,横断面上最佳进钉角度更大,置钉时要区别对待。结论本研究的研究方法可以实现第1骶椎椎弓根螺钉最佳进钉通道的个性化术前设计,为临床个性化置入第1骶椎椎弓根螺钉提供数据参考。
Objective Using computer three-dimensional reconstruction software and reverse engineering software to personalized analyze and determine the optimal pedicle screw channel of the first sacral vertebra, then to provide theoretical evidence for the first sacral vertebra pedicle screw customized placement. Methods CT scan data （include the first sacral vertebra and ilium） of lumber from 50 normal adults ,and dividing CT scan data into two groups by gender, that were digitally analyzed by Mimics 17.0 software to establish three-dimensional models which were saved as .stl format and then imported into CATIA V5R20 software, and measure the optimal transverse section angle of pedicle screw, the maximum screw radius, the theoretical maximum screw length, the distance between the best screw entrance point and upper endplate, the distance between the best screw entrance point and the middle sagittal, then simulating screw placement, last analyzing the data. Results （1） Customized screw placement can be reached by using computer three-dimensional reconstruction software and reverse engineering software to preoperative digital design of pedicle screw channels, and also can be used to large sample anatomy study. （2）There are differences between personals, we should pay more attention to personalized treatment.（3）The optimal transverse section angle of pedicle screw had significant difference between male and female, and the distance between the best screw entrance point and the median sagittal also had significant difference, the distance between the best screw entrance point and the median sagittal in female was longer then male, and the optimal transverse section angle of pedicle screw was bigger then male. Conclusion Customized screw placement can be reached by using computer three-dimensional reconstruction software and reverse engineering software to preoperative digital design of pedicle screw channels.
出处
《中国继续医学教育》
2017年第12期99-102,共4页
China Continuing Medical Education
关键词
第1骶椎
计算机三维重建
椎弓根螺钉通道
数字解剖学
first sacral vertebra
pedicle screw channel
digital anatomy
computer three-dimensional reconstruction technique
