CN101953713A - Navigation template capable of being used for positioning vertebral pedicle - Google Patents
Navigation template capable of being used for positioning vertebral pedicle Download PDFInfo
- Publication number
- CN101953713A CN101953713A CN2010105010694A CN201010501069A CN101953713A CN 101953713 A CN101953713 A CN 101953713A CN 2010105010694 A CN2010105010694 A CN 2010105010694A CN 201010501069 A CN201010501069 A CN 201010501069A CN 101953713 A CN101953713 A CN 101953713A
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- pedicle
- template
- vertebral
- navigation template
- vertebral arch
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1757—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the spine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/568—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor produced with shape and dimensions specific for an individual patient
Abstract
The invention discloses a navigation template capable of being used for positioning vertebral pedicle. A manufacture method of the navigation template comprises the following steps of: firstly, acquiring original data and establishing a three-dimensional vertebra model on a computer; secondly, carrying out three-dimensional analysis on a vertebral pedicle needle-entering channel, extracting an outline of the rear part of a vertebral plate, establishing a virtual reverse template coincide to the outline at the rear part of the vertebral plate in a system; thirdly, fitting the virtual reverse template with the vertebral pedicle needle-entering channel, establishing a virtual needle-entering template; and fourthly, manufacturing the needle-entering template by using a quick forming technology, wherein the needle-entering template is a reverse navigation template coincide to the outline of the rear part of the vertebral plate. The invention organically integrates a digital technology, reverse engineering and the quick forming technology, thereby achieving the purpose of rapidly, cheaply and efficiently accurately positioning the vertebral pedicle.
Description
Technical field
The present invention relates to a kind of manufacture method that can be used for the localized navigation template of pedicle of vertebral arch, and can be used for the localized navigation template of pedicle of vertebral arch with what this method was made.
Background technology
Reset at spinal trauma, in the bone surgery such as malformation correction, generally believe that utilizing pedicle screw fixation is a kind of the most stable spinal fixation mode.But owing to make progress from lumbar vertebra, the diameter of the pedicle of vertebral arch of thoracic vertebra, cervical vertebra reduces gradually, and the difficulty and the danger of carrying out LOCATION OF PEDICLE SCREW FIXATION also increase gradually, may cause very big infringement after the error, and the pedicle of vertebral arch technology of thoracic vertebra and cervical vertebra is difficult in clinical popularizing.
Therefore, people begin to seek can be accurate localized spinal navigation system, to carry out the accurate location of pedicle of vertebral arch, guarantee carrying out smoothly of operation.The appliance computer navigation system is carried out spinal operation and is started from the nineties in 20th century, at first reports the pedicle of vertebral arch internal fixation operation of computer navigation system under auxiliary in 1994, and later developed country is applied to clinical gradually.Wherein, clinical practice is the photoelectricity computer navigation system that infrared light emitting diode is installed the most widely.China began in 2002 computer navigation system is applied to the canalis spinalis operation, the scope of using comprises upper cervical spine, pedicle for cervical vertebra arch, thoracic vertebra and lumbar vertebra etc., and the result of report thinks that the computer navigation technology provides incomparable accuracy and the real-time information of multi-angle of clinical experience in the past.But the computer navigation technology of using at present clinical has some shortcomings equally, and is still not high enough as degree of accuracy, complicated operation, and the costing an arm and a leg of equipment, operating time is long etc.In addition, utilize existing computer navigation system to carry out the pedicle of vertebral arch location, the patient must can carry out operation in the hospital with navigator, still is difficult to extensive popularization at present.
Since the eighties in 20th century U.S. 3D System Inc. Charle invented fast shaping technology after, in a short period of time, different according to moulding material and Parts manufacturing technology, various fast shaping technologies occur in succession, as photocuring molding method (SLA), laminated solid mass autofrettage LOM), selective laser sintering method (SLS), fusion sediment autofrettage (FDM) and 3 D-printing method etc., its application also from prototype manufacturing, mould manufacturing, the part manufacturing of industrial quarters, is expanded to art, education and medical domain.Reverse engineering is meant the data that record according to mock-up, and structure CAD (computer-aided design) model is analyzed manufacturing then.Along with industrial automation and development of computer, the rise of reverse technology and Rapid Prototyping technique is accurately performed the operation for medical domain technical support is provided.Reverse engineering combines with quick shaping, has brought a kind of brand-new product design, manufacturing and three-dimensional dimension measurement pattern.
At medical domain, people attempt reverse engineering is combined with the quick shaping manufacturing, utilize CT and nuclear magnetic resonance, NMR equipment such as (MRI) to gather the shape data at positions such as human organ, skeleton, joint, the reconstruction of three-dimensional digital model, with Rapid Prototyping technique manufacturing teaching and referential model of performing the operation, be usually used in helping to make artificial limb or carry out surgical repair then.But, the report that this technology is applied to fixation of pedicle is not arranged at present as yet, in addition in the fixation of pedicle art, even utilize above-mentioned technology to produce patient's pedicle of vertebral arch model before the art, and carried out the simulation test that screw advances to follow closely the direction and the degree of depth, in the operation because patient body position's variation, want accurately to find and original mimicly advance to follow closely direction and squeeze into pedicle screw, difficulty is huge, in case error occurs, consequence is hardly imaginable.
Summary of the invention
The objective of the invention is, provide a kind of can be widely used, the manufacture method that is used for the localized navigation template of pedicle of vertebral arch, and can be used for the localized navigation template of pedicle of vertebral arch with what this method was made, with reach fast, cheap, efficiently pedicle of vertebral arch is accurately located.
Manufacture method of the present invention is: before the art patient is carried out CT or MRI thin slice scan, gather the digital image in corrective surgery zone.Utilize three-dimensional reconstruction software that the data of being gathered are analyzed, derive the three-dimensional reconstruction model of the vertebra of waiting to perform the operation.Use reverse engineering software, enter the ailing road according to the best of the three-dimensional reconstruction modelling pedicle of vertebral arch of vertebra.Then, extract the surface information at vertebral plate rear portion, set up the reverse template model consistent with vertebral plate rear portion anatomical shape in system, with reverse template, the mathematical model in vertebral body and pedicle nail road fits, and observes the accuracy that pedicle of vertebral arch is crossed in the nail road.Utilize the laser fast forming fabrication techniques to have the reverse navigation template in pedicle nail road.Perhaps, can gather initial data earlier and set up the vertebra threedimensional model on computers, utilize Rapid Prototyping technique to make the vertebra mock-up, on mock-up, set up the nail road of pedicle of vertebral arch then, have the reverse navigation template in pedicle nail road according to the direction design in pedicle nail road.In the art,, can be used for the accurate location of pedicle nail with this navigation template and vertebra rear portion tabling to be performed the operation.
Among the present invention, the threedimensional model that obtains in the reverse engineering that increases to of CT or MRI scanning speed and precision provides accurate tomography picture, utilize the software of three-dimensional reconstruction and on dummy model, to carry out random distortion and boring, advance to follow closely route with the pedicle nail of designing optimal with the histoorgan Fast Reconstruction of needs.On the basis of dummy model, the reverse navigation template of utilizing rapid shaping technique to produce can in art, to use.In the art that the vertebral body rear portion of template and human body is chimeric, that can accurately guide pedicle nail advances to follow closely the direction and the degree of depth, finishes operation smoothly.Simultaneously,, need in art, not use the location that miscellaneous equipment carries out pedicle of vertebral arch before operation, significantly reduce the time of operation, reduce the patient suffering because the present invention just completes navigation template.In addition, each small-middle hospital has all been popularized CT examination now, after these hospitals carry out the vertebra CT scan, utilize network to be transferred to the CT data and can carry out the unit that navigation template designs and has rapid shaping technique, these units make be used for the localized reverse navigation template of art after, be delivered to the hospital that need carry out canalis spinalis operation soon.Like this, just overcome when utilizing computer navigation system to position now, must each hospital that positions operation all need buy the deficiency of an equipment, significantly reduced the wasting of resources.Certainly, consider the simplicity that realizes present device, its realization expense is quite cheap.
The present invention is digital technology, and reverse engineering and Rapid Prototyping technique organically combine, and set up the bridge block between virtual and real, is expected to open up new field for medical development.
Description of drawings
The vertebra virtual three-dimensional model of accompanying drawing 1 for utilizing three-dimensional reconstruction software to set up.
Accompanying drawing 2 is the reverse navigation template dummy model of bringing the nail duct into of design
Vertebral body and the reverse navigation template material object of accompanying drawing 3 for utilizing Rapid Prototyping technique to produce can be simulated vertebral body and the involutory accuracy of template before the art
The specific embodiment
Provide two embodiment of the present invention below in conjunction with accompanying drawing, certainly, embodiments of the present invention are not limited in subordinate's embodiment.For example, utilize the vertebra data of digital technology collections such as MRI also can be used for the reconstruction of vertebra threedimensional model; Utilize other three-dimensional reconstruction software, three dimensional analysis software, reverse engineering software can carry out the making of reverse navigation template mathematical model too; Simultaneously, also can utilize other forming technique, make the pedicle of vertebral arch location reverse navigation template of practical application in the art.
Embodiment one:
1. the collection of initial data: before the art, the vertebra in corrective surgery zone is carried out thin-layer CT scanning, gather the CT initial data.
2. the foundation of vertebra threedimensional model: the continuous faultage image data of CT is imported three-dimensional reconstruction software, the gray scale segmented extraction vertebra boundary profile information area at first, the application region is cut apart and is extracted the vertebra information area once more then, adopt the optimal reconstruction pattern of system default, the three-dimensional reconstruction vertebral body model of setting up is with STL form reduced model.Adopt single vertebral body reconstruction the localized vertebral body of needs, as accompanying drawing 1, wherein pedicle of vertebral arch 1 is the position that need pay close attention to.
3. pedicle of vertebral arch is advanced to follow closely passage and carry out three dimensional analysis: (U.S. EDS company) opens the three-dimensional reconstruction model at UG Imageware12.0 platform, locatees three-dimensional reference plane, extracts the pedicle of vertebral arch surface profile.Rotating model is determined and the vertical plane of direction, with pedicle of vertebral arch along planar process to definite its forward projection region, match forward projection region inner edge boundary line, its inscribed circle of match, ellipse obtain the interior bias curve of oval certain vertical distance again.Respectively vertebral body and lamina surface are arrived in inner edge boundary line, inscribed circle, elliptic projection along direction.Setting-out curved surface between the inner boundary drop shadow curve advances to follow closely passage for this direction pedicle of vertebral arch, setting-out curved surface between the inscribed circle drop shadow curve is the maximum screw conduits of this direction, setting-out curved surface between the fitted ellipse drop shadow curve is similar to into nail passage for this direction, setting-out curved surface between the drop shadow curve of interior bias curve is the approximate axis passage of this direction, straight line between the translation incenter is the best axis of this direction, and the straight line between the oval center of circle of translation is the approximate axis of this direction.Interior bias curve advances nail safety in the drop shadow curve of vertebral plate for this direction and enters the nail district.Incenter is the best entry point of this direction at vertebral plate in the corresponding point of vertebral plate, and the fitted ellipse center of circle is the approximate entry point of this direction at vertebral plate in the corresponding point of vertebral plate.After finding accurately the pedicle of vertebral arch passage, passage is extended to the rear portion of vertebral plate, and on vertebral plate, determine the direction of pedicle of vertebral arch passage.
4. the virtual foundation of advancing to follow closely navigation template: in reverse engineering software UG imageware (U.S. EDS company), extract the vertebral plate rear outline, in system, set up the virtual reverse template that matches with the vertebral plate rear outline, template and the previous pedicle of vertebral arch passage of setting up fitted, so just set up as shown in Figure 2 virtual navigation template 3.
5. as shown in Figure 3, utilize the laser fast forming technology that vertebral body and navigation template 3 are made simultaneously, external template 3 and vertebral body are fitted, advance dolly set to pedicle for cervical vertebra arch 1 direction and intend, the accuracy that in art, navigates with this template of further observation from entering to follow closely the duct.When operation, only the rear portion of template and vertebral plate need be fitted, can locate the direction of pedicle of vertebral arch.
In order to guarantee the into accuracy of nail direction, can utilize geomagic software that the part, position, duct of advancing to follow closely in the virtual template is suitably thickened, as shown in accompanying drawing 2 or accompanying drawing 3, enter to follow closely duct 2, its thickness is preferably in about 5mm or 3mm.
In addition, in order to reduce operating procedure, can not make the vertebra model, only making is used for localized reverse navigation template, uses to get final product in art.
Embodiment two:
1. the collection of initial data: before the art, the vertebra in corrective surgery zone is carried out thin-layer CT scanning, gather the CT initial data.
2. the foundation of vertebra threedimensional model: the continuous faultage image data of CT is imported three-dimensional reconstruction software, the gray scale segmented extraction vertebra boundary profile information area at first, the application region is cut apart and is extracted the vertebra information area once more then, adopt the optimal reconstruction pattern of system default, the three-dimensional reconstruction vertebral body model of setting up is with STL form reduced model.Adopt single vertebral body reconstruction the localized vertebral body of needs.
3. the foundation of vertebra mock-up: utilize the laser fast forming technology,, the vertebral body mock-up is set up out according to the vertebral body model of three-dimensional reconstruction on computers.
4. on the mock-up of vertebral body, set up the nail road of pedicle of vertebral arch, have the reverse navigation template in pedicle nail road according to the direction design in pedicle nail road.
Claims (7)
1. one kind can be used for the localized navigation template of pedicle of vertebral arch, and the manufacture method of this navigation template comprises the steps: to gather initial data earlier and set up the vertebra threedimensional model on computers; Then pedicle of vertebral arch is entered to follow closely the duct and carry out three dimensional analysis, extract the vertebral plate rear outline, in system, set up the virtual reverse template that matches with the vertebral plate rear outline; Described virtual reverse template and described pedicle of vertebral arch are entered to follow closely the duct fit, set up the virtual dolly set plate that advances; Utilizing rapid shaping technique will advance the dolly set plate then makes;
It is characterized by: describedly advance the reverse navigation template of dolly set plate for matching with the vertebral plate rear outline.
2. localized navigation template of pedicle of vertebral arch that can be used for as claimed in claim 1, it is characterized by: the initial data of collection is CT signal or NMR signal.
3. localized navigation template of pedicle of vertebral arch that can be used for as claimed in claim 1, it is characterized by: used rapid shaping technique is photocuring molding method, laminated solid mass autofrettage, selective laser sintering method, fusion sediment autofrettage or 3 D-printing method.
4. localized navigation template of pedicle of vertebral arch that can be used for as claimed in claim 1 is characterized by: describedly advance to follow closely the local thickening in duct, thickness is about 3mm.
5. localized navigation template of pedicle of vertebral arch that can be used for as claimed in claim 1 is characterized by: describedly advance to follow closely the local thickening in duct, thickness is about 5mm.
6. one kind as the described localized navigation template of pedicle of vertebral arch that can be used for of arbitrary claim in the claim 1 to 5, it is characterized by: when making the reverse navigation template, the vertebra model that is complementary is with it made simultaneously, external with template and vertebral body applying, carry out the vertebral body pedicle of vertebral arch and advance dolly set and intend, the accuracy that in art, navigates with this template of further observation.
7. one kind can be used for the localized navigation template of pedicle of vertebral arch, and the manufacture method of this navigation template comprises the steps: to gather initial data earlier and set up the vertebra threedimensional model on computers; Utilize Rapid Prototyping technique to make the vertebra mock-up; Set up the nail road of pedicle of vertebral arch then on mock-up, what design had a pedicle nail road according to the direction in pedicle nail road advances the dolly set plate;
It is characterized by: describedly advance the reverse navigation template of dolly set plate for matching with the vertebral plate rear outline.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2010105010694A CN101953713B (en) | 2007-09-19 | 2007-09-19 | Navigation template capable of being used for positioning vertebral pedicle |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2010105010694A CN101953713B (en) | 2007-09-19 | 2007-09-19 | Navigation template capable of being used for positioning vertebral pedicle |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2007101512986A Division CN101390773B (en) | 2007-09-19 | 2007-09-19 | Production method of navigation template for positioning the pediculus arcus vertebrae |
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| Publication Number | Publication Date |
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| CN101953713A true CN101953713A (en) | 2011-01-26 |
| CN101953713B CN101953713B (en) | 2012-05-23 |
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| CN2010105010694A Expired - Fee Related CN101953713B (en) | 2007-09-19 | 2007-09-19 | Navigation template capable of being used for positioning vertebral pedicle |
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