三维重建仿真模拟手术辅助颈椎间盘置换

Simulation of cervical disc replacement with computer assistant three-dimensional reconstruction

背景:人工颈椎间盘置换要求具有规范的操作程序,这样才能减少置入假体下沉、异位骨化、假体脱位等并发症。个体化的颈椎三维模型重建模型能够模拟自身颈椎间盘的真实结构,有利于人工颈椎间盘置换过程的精准操作。目的:分析颈椎间盘置换手术模拟的方法及临床应用。方法:选择42岁男性患者资料,颈椎间突出症(C4/5)脊髓型,颈椎间盘置换前行颈椎64排CT平扫,进行三维几何重建,测量C4/5间盘间隙,C5上终板,C4下终板尺寸,并适当撑开椎间隙,选择合适的假体尺寸,在scanCAD软件中模拟手术,安装假体,并再次修改假体尺寸,应用于临床。结果与结论:利用计算机模拟手术预计假体,模拟手术过程,可以有效减少置换时间,方便假体置换操作,置换过程中获得满意的临床疗效。提示三维重建仿真模拟手术能准确测量置入假体,数据真实可靠,或得满意疗效。

BACKGROUND： The cervical disc replacement requires standard operational procedure to reduce complications such as prosthetic subsidence, ectopic ossification or prosthetic dislocation. Individuated three-dimensional （3-D） reconstruction of cervical disc replacement can simulate structures of cervical disc, which is benefit for precise operation. OBJECTIVE： To study the method of computer assistant simulating the cervical disc replacement and clinic application. METHODS： A 42 years old male with C4-5 disc protrusion was selected. 64-row CT scan was performed before replacement, which was reconstructed using 3-D geometry. The interspace between 4/5, size of C5 upper endplate, and C4 low endplate was calculated. The interspace was enlarged and a prosthesis with appreciate size was choose. The cervical disc replacement was simulated by scanCAD software and the prosthetic size was modified, and then the procedure performed in operation. RESULTS AND CONCLUSION： It could reduce placement times effectively by simulating cervical disc replacement operation and design prosthetic sizes, which was convenient for operation and obtained good clinical curative effects. 3-D reconstruction simulating operation can measure the size of endplate and interspace of inter vertebra accuracy. The data were reliable and the operation could harvest satisfactory results.