CAJ | 학술논문

背景:对伴发骨质疏松患者,为提高脊柱固定稳定性进行椎体双皮质椎弓根螺钉固定是可行的方法.但双皮质椎弓根螺钉置入不当除了易误伤脊髓、神经根外,还会损伤椎前大血管和脏器,所以术前测量双皮质椎弓根螺钉置入参数很有必要. 目的:应用CT和数字骨科技术,术前虚拟腰椎双皮质椎弓根螺钉置入,测量个体化双皮质腰椎椎弓根螺钉置入参数. 方法:将骨质疏松患者L1-4 CT扫描数据导入Mimics10.0软件和GE工作站,三维重建并虚拟椎弓根螺钉置入双皮质固定L1,3椎体,定位并测量置钉相关数据. 结果与结论:通过Mimics10.0软件重建CT三维腰椎影像并虚拟椎弓根螺钉人字嵴顶点置入,测量椎弓根的最小宽径、虚拟置入双皮质椎弓根螺钉的矢状面角、内倾角(水平面角)、水平置入最大限深,推算出平行上终板置入的最大限深.获取个体化腰椎双皮质椎弓根螺钉置入数据,从而提高螺钉固定的安全度和精确性.
배경:대반발골질소송환자,위제고척주고정은정성진행추체쌍피질추궁근라정고정시가행적방법.단쌍피질추궁근라정치입불당제료역오상척수、신경근외,환회손상추전대혈관화장기,소이술전측량쌍피질추궁근라정치입삼수흔유필요. 목적:응용CT화수자골과기술,술전허의요추쌍피질추궁근라정치입,측량개체화쌍피질요추추궁근라정치입삼수. 방법:장골질소송환자L1-4 CT소묘수거도입Mimics10.0연건화GE공작참,삼유중건병허의추궁근라정치입쌍피질고정L1,3추체,정위병측량치정상관수거. 결과여결론:통과Mimics10.0연건중건CT삼유요추영상병허의추궁근라정인자척정점치입,측량추궁근적최소관경、허의치입쌍피질추궁근라정적시상면각、내경각(수평면각)、수평치입최대한심,추산출평행상종판치입적최대한심.획취개체화요추쌍피질추궁근라정치입수거,종이제고라정고정적안전도화정학성.
BACKGROUND:To improve the lumbar stability after operation, inserting bi-cortical pedicle screws in the vertebrae is viable when the patients associated with osteoporosis. But the bi-cortical pedicle screws improperly invert may lead to serious complications such as spinal cord, nerve root, abdominal aorta, inferior vena cava and organs damage. So it is important to measure the parameters of inverting the screws pre-operation. @@@@OBJECTIVE:To measure the preoperative individual parameters of inserting bi-cortical pedicle screws in the lumbar vertebrae with CT and digital orthopedic technique. @@@@METHODS:The image data of L1-4 that scanned by CT was imported into the Mimics 10.0 software and GE workstation, and L1-4 three-dimensional image was reconstructed. The individual parameters of inserting bi-cortical pedicle screws in the L1, 3 were measured. @@@@RESULTS AND CONCLUSION:The three-dimensional CT lumbar image was reconstructed clearly, and the placement of bi-cortical pedicle screws on the crista lambdoidalis was simulated by Mimics10.0 software. The minimum diameter, sagittal angle of simulated inserting bi-cortical pedicle screws, leaning angle (horizontal angle) and the horizontal depth were measured by the Mimics 10.0 software. Meanwhile, the limited depth of the screws when paral el to vertebral end-plate was calculated. It is a reliable method to get individual parameters of inserting bi-cortical pedicle screws in the lumbar vertebrae and it can improve the safety and accuracy of screw fixation.