数字及逆向工程技术在复杂骨科应用进展

Application of digital technology and reverse engineering technology in complex orthopaedic surgery

背景:医学数据可视化技术的快速发展及不断对医学领域地渗透,尤其使脊柱外科在诊断和治疗上发生了根本性地改变,朝着"精确化、个性化、微创化"方向发展,已成为临床骨科治疗中不可或缺的重要手段。目的:通过对数字技术在复杂骨科应用进展,明确研究突破口。方法:由第一作者在PubMed数据库、万方数据库、维普数据、中国知网库检索,时间范围为1990/2011。检索词为"个性化的定位导航模板,数字解剖模型,螺钉内固定术,逆向工程技术,快速成型技术"。纳入标准为导航模板制备工艺及技术的研究、有限元相关理论的研究、实验及临床应用。排除标准为与此文目的无关、较陈旧的文献和重复同类研究。结果与结论:利用数字化技术重建的导航模板为骨科螺钉内固定的定位、定向固定提供了一种新的方法。通过数字化重建技术可以制作个体化导航模板,将模板紧密贴合于相应的解剖结构上进行导航穿刺,即可完成对术区的准确定位和定向。对复杂骨科手术,尤其是解剖结构畸形变的患者有着不可替代的意义。为临床手术设计奠定良好的基础,提高准确性和安全性。

BACKGROUND： The rapid development of medical data visualization technology and constantly permeate to the medical field make a fundamental change in diagnosis and treatment of orthopedics. The changes are developing toward the ＂precision, individuality and minimally invasive＂, and the medical data visualization technology has become an important means in the clinical orthopaedic surgery. OBJECTIVE： To determine the breakthrough of research by analyzing the application of digital technology in complex orthopaedic surgery. METHODS： The PubMed database, Wanfang database, VIP database and CNKI database from 1990 to 2011 were searched by the first author with the key words of ＂personalized navigation template, digital anatomical models, screw internal fixation, reverse engineering technology, rapid prototyping technology＂. The literatures were related to the research on the navigation template preparation process and technology, the study of finite element theory, and the experimental and clinical applications. The old and repetitive literatures were excluded as well as the literatures have nothing to do with this article. RESULTS AND CONCLUSION： The navigation template reconstructed by digital technology provides a new method for orientation and directional fixation of orthopaedics bolts internal fixation. The individual navigation templates can be made by the digital reconstruction technique, and closely stick to the corresponding anatomical structure for the navigation puncture, then the accurate positioning and orientation are completed, which has a irreplaceable significance for the complex orthopaedic surgery, especially the anatomical structure deformity patients. It lays a good foundation for clinical surgery design and improves accuracy and safety of the surgery.