脊柱椎弓根定位数字化导航模板的设计

A new digital template as navigation in spinal pedicle instrumentation

目的利用逆向工程原理和快速成型技术为脊柱椎弓根定位提供一种新方法。方法C3单关节交锁伴关节突骨折患者CT连续扫描数据集，将断层扫描数据导入Amira 3．1软件，三维重建C3椎体模型，以．stl格式导出模型。在Imageware 12．0平台打开三维重建模型，定位三维参考平面。利用逆向工程原理寻找椎弓根的最佳进钉钉道。提取椎板的表面解剖学形态，建立与椎体后部解剖学形态一致的模板。拟合模板和椎弓根孔道成定位模板，将椎体和定位模板通过激光快速成形技术生产出实物模板。结果建立了制作个体化导航模板的方法，通过快速成型技术生产出的带椎弓根的导航模板具有较好的准确性。结论利用逆向工程原理和快速成型技术为椎弓根的定位和置钉提供了一种新的方法，具有较大的应用前景。

Objective To validate a new method of spinal pedicel stereotaxy by Reverse Engineering and rapid prototyping. Methods A 3D CT scan of C3 vertebra was performed. The data were transferred via a. dicom network into a computer workstation. A 3D model of C3 vertebra was reconstructed with software Amira 3.1, and saved in. stl format. The 3D model was imported into Imageware 12.0. The extract location of the best pedicle channel was defined using Reverse Engineering. A template was designed according to the anatomic features of the lamina before the best pedicle channel and the template were overlapped as the navigational template. The navigational template was manufactured by rapid prototyping （SLA technique） . Results The navigational template was found to be highly accurate. Conclusion The spinal stereotaxy using reverse engineering and rapid prototyping may be a new method for exact insertion of pedicle screws in clinic.