经枕下远外侧入路切除枢椎齿状突的三维可视化研究

Three-dimensional virtual reality assessment on far lateral approach for resection of the dens.

目的利用三维可视化技术研究经远外侧入路切除枢椎齿状突,以指导其临床应用并分析目前虚拟现实系统的优缺点。方法利用Dextroscope虚拟现实系统对20例CTA数据进行三维重建、观察、测量和手术入路模拟。结果三维可视化技术使枕颈结合处椎动脉和骨结构的三维构象得到清晰的观察和测量;入路中磨除1/3枕髁能改善齿状突的显露,但应结合病变状态下齿状突与枕髁等结构的关系决定是否磨除或磨除的范围。结论经枕下远外侧入路切除枢椎齿状突可获得良好的手术显露,利用虚拟现实技术对治疗对象进行个体化分析有助于手术的成功和减少创伤。

Objective To assess the clinical use of far lateral approach for resection of the dens and evaluate the clinical value of present virtual reality system. Methods CTA data of 20 cases were three - dimensionally reconstructed, observed and measured using the Dextroscope virtual reality system. Results VA and bone structures of the craniovertebral junction were clearly observed and measured in three-dimensional visualization. The exposure of dens was improved in one third condylectomy. However, the decision to perform condylectomy and its extent should be made based on relationship between abnormal dens and occipital condyle. Conclusions Far lateral approach for resection of the dens may achieve good exposure. Individual assessment by virtual reality technique contributes to a successful operation with less structure damage.