Lu Sheng, Xu Yong-qing, Zhang Yuan-zhi, Li Yan-bing, Shi Ji-hong, Chen Guo-ping, Li Dong-ping, Fan Quan-shui
Department of Orthopedics, Kunming General Hospital of Chengdu Military Area Command of Chinese PLA, Kunming 650032, China.
Zhonghua Wai Ke Za Zhi. 2009 Mar 1;47(5):359-62.
To observe the primary clinical result of digital template as navigation to the upper cervical pedicle instrumentation.
CT scan of upper cervical vertebrae was performed. 3-D model of upper cervical vertebrae was reconstructed by software Amira 3.1 and was preserved in STL format. Then 3-D model was run in software UG Imageware 12.0, the best pedicle channel was extracted according to the reverse engineering principle. A virtual navigational template was established according to he lamina anatomic trait, and the best pedicle channel. The virtual vertebrae and navigational template were manufactured using rapid prototyping. The navigational template was sterilized and used intra operative to assist with the placement of pedicle screw. The Accuracy of screw placement was confirmed with postoperative X-ray and CT scanning.
The digital navigational template had been established and used in the 3 cases, the good trajectory of cervical pedicle had been showed by the CT scan of post operation. There were not complications of related pedicle screw insertion.
A novel method of upper cervical pedicle location using Reverse Engineering and rapid prototyping has been developed; the navigational template is found to be highly accuracy and has great expectation.
观察数字模板导航在上颈椎椎弓根内固定术中的初步临床效果。
对上颈椎进行CT扫描,采用Amira 3.1软件重建上颈椎三维模型,并保存为STL格式。然后在UG Imageware 12.0软件中运行该三维模型,根据逆向工程原理提取最佳椎弓根通道。根据椎板解剖特征和最佳椎弓根通道建立虚拟导航模板。利用快速成型技术制作虚拟椎体和导航模板。将导航模板消毒后术中用于辅助椎弓根螺钉置入。术后通过X线和CT扫描确认螺钉置入的准确性。
已建立数字导航模板并应用于3例患者,术后CT扫描显示颈椎椎弓根轨迹良好。未发生与椎弓根螺钉置入相关的并发症。
开发了一种利用逆向工程和快速成型技术进行上颈椎椎弓根定位的新方法;发现导航模板具有很高的准确性,具有很大的应用前景。