基于近红外光谱技术的脊椎外科手术导航路径光学参数研究

Research on Optical Parameter along Puncture Path in Spinal Surgery Navigation Based on Near Infrared Spectroscopy

椎弓根螺钉准确植入是脊柱手术成功的关键,可靠的术中实时监测技术有助于椎弓根螺钉准确植入,是临床应用研究的重要方向。本文以猪椎骨为实验对象,研究了椎弓根螺钉植入过程中正常穿刺路径、内偏刺破路径及外偏刺破路径上的约化散射系数μ′s变化规律,发现约化散射系数值在整个穿刺过程中出现两个明显的峰值,分别为螺钉穿入过程通过骨密质与骨疏质的交界处时,以及螺钉穿出过程通过骨疏质与骨密质交界处时。这说明在螺钉穿刺过程中约化散射系数μ′s可作为术中实时监测的监测因子,有效识别螺钉是否即将到达脊椎刺破的临界位置,获得的μ′s变化规律曲线更为脊椎外科手术导航过程提供重要的参考依据。

Accurate placement of pedicle screws is a key factor of spinal surgery.Investigation of a new real-time intra-operative monitoring method is an important area of clinical application research which makes a contribution to planting pedicle screw accurately.Porcine spines were chosen as experimental objects.The changes of reduced scattering coefficient（μ′s）along normal puncture path,medial perforation path and lateral perforation path were measured and studied.A conclusion is drawn that there are two distinct peaks throughout the puncture process,appearing at the junction of cancellous bone and cortical bone,at the beginning and at the end,respectively.The reduced scattering coefficient is proved to be a good monitoring factor which can identify whether the screw is about to reach the critical position of the spine puncture.Moreover,the variation provides an important reference for spinal surgical navigation process.