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胸腰段椎体成形术单侧经椎弓根穿刺的数字化模拟研究 被引量:2

Digital simulated research of unipedicular thoracolumbar vertebroplasty puncturing
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摘要 [目的]数字化模拟测量经皮穿剌经椎弓根植骨最佳进针点、角度、深度等相关参数,总结经单侧椎弓根穿刺的规范化方案,为临床手术操作提供依据。[方法]10例健康成年人体检胸腰段CT连续扫描数据集导入医学3D图像编辑处理软件Mimics10.01并三维重建椎骨模型,在Mimics分析视窗中,确定初始进针点和靶点,使用测量功能得到上倾角、外倾角、深度、最大上倾角和最大下倾角等相关参数。[结果]安全穿刺途径的上倾角、外倾角随T11~L3逐渐增大,深度T11~T12逐渐增大,L1~3逐渐增大,可允许误差的最大下倾角、最大上倾角T11~L3逐渐增大。外倾角的可变动范围极其狭小。[结论]本实验得到安全穿刺途径的各参数数据,对单侧经椎弓根穿刺椎体成形术的临床操作有指导意义。并发现当椎弓根细小或角度偏小时,单侧经椎弓根穿刺胸腰段椎体成形术对操作的精确度提出了非常高的要求。 [Objective]The protocol was designed by digital simulated research to measure the operative-related parameters of unipedicular kyphoplasty including best entry point,angle and depth,so as to lay a foundation for the operation techniques.It is expected to finish an optimum operative protocol for unipedicular vertebroplasty.[Method]Thoracolumbar CT scanning images of 10 healthy adults were analyzed in medical image control system Mimics 10.01 and created into 3D model.In the analyzing windows,we defined the entry point and the target point and used the measuring tools of Mimics to get the lengths and the angles including outside oblique angle,upward oblique angle,largest declination angle and largest upward oblique angle.[Result]For the safe puncturing,outside oblique angle and upward oblique angle enlarged from T11 to L3,and their length enlarged from T11 to T12,and from L1 to L3.The accepted error was that the largest upward oblique angle and largest declination angle enlarged from T11 to L3.The alteration range for outside oblique angle was extremely narrow.[Conclusion]The data of this research supplied the guiding significance for the clinical operation of unipedicular thoracolumbar vertebroplasty.If the pedicle is small or the angle is narrow,the operation of vertebroplasty is highly demanded.
出处 《中国矫形外科杂志》 CAS CSCD 北大核心 2010年第24期2042-2045,共4页 Orthopedic Journal of China
关键词 椎体成形术 椎弓根 三维重建 测量 vertebroplasty pedicle three dimensional reconstruction measurement
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