CAJ | 학술논문

背景：椎弓根是连接椎体与椎板之间最坚强的骨性结构，通过椎弓根进行螺钉固定为重建脊柱稳定提供了可靠的力学基础。 　　目的：对腰椎椎弓根的三维模拟进钉的测量参数进行分析，提高椎弓根螺钉内固定临床应用的准确性和稳定性。 　　方法：分析椎弓根螺钉治疗脊柱(L1-L5)相关疾病患者的原始CT资料，利用Mimics软件建立三维多平面重建成像模型，通过Mimics软件对腰椎行三维重建并预测钉长、直径、水平面角及矢状面角度，并与临床置钉内固定后实际数据进行统计学比较。 　　结果与结论：病例分析可见内固定后置钉位置及长度均良好，未出现螺钉偏移、断裂等。内固定前模拟预测的椎弓根螺钉长、直径及水平面角与螺钉内固定后实际数据的差异无显著性意义(P>0.05)，只有部分节段矢状面角度模拟值小于实际测量值(P<0.05)。说明通过Mimics软件对腰椎进行三维重建模拟置钉并制定置钉参数，能比较精确的指导内固定中实际置钉，提高椎弓根螺钉的置钉安全。
배경：추궁근시련접추체여추판지간최견강적골성결구，통과추궁근진행라정고정위중건척주은정제공료가고적역학기출。 　　목적：대요추추궁근적삼유모의진정적측량삼수진행분석，제고추궁근라정내고정림상응용적준학성화은정성。 　　방법：분석추궁근라정치료척주(L1-L5)상관질병환자적원시CT자료，이용Mimics연건건립삼유다평면중건성상모형，통과Mimics연건대요추행삼유중건병예측정장、직경、수평면각급시상면각도，병여림상치정내고정후실제수거진행통계학비교。 　　결과여결론：병례분석가견내고정후치정위치급장도균량호，미출현라정편이、단렬등。내고정전모의예측적추궁근라정장、직경급수평면각여라정내고정후실제수거적차이무현저성의의(P>0.05)，지유부분절단시상면각도모의치소우실제측량치(P<0.05)。설명통과Mimics연건대요추진행삼유중건모의치정병제정치정삼수，능비교정학적지도내고정중실제치정，제고추궁근라정적치정안전。
BACKGROUND:Pedicle is the strongest bone structure for the connection between vertebrae and lamina, and the screw fixation through pedicle can provide reliable mechanical basis for the reconstruction of spinal stabilization. OBJECTIVE:To analyzed the three-dimensional analogue measurement parameters of lumbar pedicle, in order to improve the accuracy and stability of the clinical application of pedicle screw fixation. METHODS:The original CT data of the spine (L 1-L 5 ) related diseases patients who treated with pedicle screw were analyzed, and the three-dimensional multiplanar reconstruction imaging model was established with Mimics software. By the using of the Mimics software, the lumbar three-dimensional construction was conducted, and the screw length, diameter, transverse section angle and sagittal section angle were predicted, and then statistical y compared with the actual data of the patient postoperative. RESULTS AND CONCLUSION:Case analysis showed that the position and the length of the screw were good without screw offset and fracture after internal fixation. There were no significant differences in the screw length, diameter, transverse section angle and sagittal section angle between the preoperative predicted parameters and the actual parameter after fixation (P>0.05), while the sagittal section angle of partial segments were smal er than the actual measure value (P<0.05). The lumbar three-dimensional reconstruction and simulation of pedicle screws placement through Mimics software can precisely guide the actual screw placement and improve the safety of pedicle screws placement.