School of Mechanical and Automotive Engineering, South China University of Technology, Guangzhou, 510640, China.
Department of Thoracic Surgery, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
Sci Rep. 2017 Jun 14;7(1):3543. doi: 10.1038/s41598-017-03622-y.
Pectus excavatum (PEX) is the most common chest deformity in children, which is usually corrected by using the minimally invasive Nuss method. The orthopedic effect of the Nuss operation is mainly evaluated by both the Haller index and the appearance of the chest wall configuration, which is dependent on the operator's clinical experience to a great extent. To improve the orthopedic effect, we proposed a novel method to individually design and optimize the shape of the Nuss bar and to advise its location as well as the incisions. By using the CT imaging data, the three-dimensional model of the PEX thoracic structure is reconstructed, which is further employed in finite element analysis to determine the operation plan. By referring to a healthy person who has similar chest dimensions to the PEX patient, the Nuss bar shape is designed, and according to the finding that the healthy chest wall boundary is almost convex with positive curvature, the Nuss bar shape is tuned to be a convex curve to ensure the orthopedic effect. Finite element analysis is employed to analyze the orthopedic effect and to determine the incision position of the Nuss bar. Experiments were carried out to verify the orthopedic effect of the customized Nuss bar, which showed that this method is more accurate and individualized, compared to conventional methods.
漏斗胸（PEX）是儿童中最常见的胸部畸形，通常采用微创 Nuss 方法进行矫正。Nuss 手术的矫形效果主要通过 Haller 指数和胸廓壁结构的外观来评估，这在很大程度上取决于术者的临床经验。为了提高矫形效果，我们提出了一种新的方法，即对 Nuss 棒的形状进行个性化设计和优化，并建议其位置和切口。通过使用 CT 成像数据，重建 PEX 胸壁结构的三维模型，并进一步在有限元分析中确定手术方案。参考与 PEX 患者具有相似胸廓尺寸的健康人，设计 Nuss 棒的形状，根据健康的胸壁边界几乎是凸面且具有正曲率的发现，将 Nuss 棒的形状调整为凸曲线，以确保矫形效果。通过有限元分析来分析矫形效果，并确定 Nuss 棒的切口位置。进行了实验以验证定制 Nuss 棒的矫形效果，结果表明，与传统方法相比，该方法更准确和个体化。
