CAJ | 학술논문

目的介绍利用数字化技术为脊柱畸形手术提供更好的术前设计和术中实施措施.方法 2006年11月至2011年8月利用三维可视化技术进行脊柱畸形术前计划,并采用个体化导航模板辅助置钉进行脊柱畸形纠正手术58例,男 21例,女37例;年龄3～68岁,平均21岁.先对脊柱畸形部位行三维CT扫描,图像以dicom格式保存,然后转换到Mimics软件里生成需要的脊柱三维重建模型,通过术前脊柱畸形三维可视化研究进行手术规划；通过建立与椎体后部解剖学形态一致的模板设计虚拟的导向模板,将椎体和定位模板通过快速成型技术生产出实物导航模板,通过导航模板辅助畸形椎体的置钉 . 结果通过虚拟三维模型的术前规划为手术的准确实施提供了良好参考在术中通过建立的导航模板准确地完成了各种螺钉的精确置入,每枚螺钉的置入时间0.7～1.2min,平均1.03 min,未出现与置钉相关的并发症. 结论利用数字化技术提高了对脊柱畸形的一进步认识,并为脊柱畸形手术各种内固定螺钉的置入提供了一种新的方法.
목적 개소이용수자화기술위척주기형수술제공경호적술전설계화술중실시조시.방법 2006년11월지2011년8월이용삼유가시화기술진행척주기형술전계화,병채용개체화도항모판보조치정진행척주기형규정수술58례,남 21례,녀37례;년령3～68세,평균21세.선대척주기형부위행삼유CT소묘,도상이dicom격식보존,연후전환도Mimics연건리생성수요적척주삼유중건모형,통과술전척주기형삼유가시화연구진행수술규화；통과건립여추체후부해부학형태일치적모판설계허의적도향모판,장추체화정위모판통과쾌속성형기술생산출실물도항모판,통과도항모판보조기형추체적치정 . 결과 통과허의삼유모형적술전규화위수술적준학실시제공료량호삼고재술중통과건립적도항모판준학지완성료각충라정적정학치입,매매라정적치입시간0.7～1.2min,평균1.03 min,미출현여치정상관적병발증. 결론 이용수자화기술제고료대척주기형적일진보인식,병위척주기형수술각충내고정라정적치입제공료일충신적방법.
Objective To provide a better preoperative design and precise intraoperative navigation in the spinal deformity surgery by digital technique. Methods From Decenber 2006 through August 2011.58 patients with spinal defornity requiring instrumcntation were recruited for the present study.They were 21 men and 37 women.aged from 3 to 68 years (average,21 years) After a three dimensional CT senning of the deformmed spine was performed,the data were transferred via a.dicom network to a computer workstattion Mimics software was used to generate three dimensional reconstruction models of the spine.Visual prcoperational plans simulating the actual surgery were designed.And visual drill templates which potentially enabled a fit in a lock-and-key fashion similar to a physical casting of the vertebral surfaee were also dcsigned.Acrylate drill guides were manufactured using rapid prototyping.The biomodels and drill guides were sterilized and used intraoperatively to asist surgical navigation and placement of instnumentation.Results The three dimensional preopcrational plans were found to he of great assishnce in the execution of the surgery.The navigational templates provided accurate screw placcrment without instrumental complications.The designs of the first 2 templates were suboptimal as the contact surfaee was too large and eomplex.Operating time was reduced as a result of less reliance on intraoperative radiographs Conclusion The digital technique is a novel method which can produce better preoperative design and precise intraoperative navigation for pedicle screw placcment in the spinal deformity surgery.