Department of Orthopaedic Surgery, Xijing Hospital, The Air Force Medical University, No. 127 Changlexi Road, Xincheng District, Xi'an, 710032, Shaanxi, China.
Department of Orthopaedics, Shenzhen Hospital, Southern Medical University, No. 1333, Xinhu Road, Bao'an District, Shenzhen City, 518100, China.
Eur Spine J. 2019 Oct;28(10):2302-2310. doi: 10.1007/s00586-019-05992-5. Epub 2019 May 3.
To build a mathematical model which could calculate the desired laminoplasty opening size (LOS) based on the target sagittal canal diameter (SCD) before single-door cervical laminoplasty (SDCL) when taking the effects of surgery drill into consideration.
The model was based on geometric analysis on deformation of spinal canal; the formula was derived and characterized as: y (mm) = 2 [Formula: see text] × sin(β/2) = c - d (y is the size of LOS, [Formula: see text] the size of transverse canal diameter, β the size of laminoplasty opening size, c the size of mini-plate and d the diameter of the drill bit used during the surgery operation). The parameters of pre- and postoperative computed tomography scans of 20 patients who had undergone SDCL were measured by the picture archiving and communication system (PACS) software and a new instrument named as Lei's ruler, respectively.
The effects of surgery SDCL were very significant; for each patient, the SCD was enlarged dramatically after the surgery (P < 0.01). The differences between the data obtained by PACS and Lei's ruler were no statistically significant (P > 0.05). According to the derived formula, the 95% confidence intervals of SCD after the surgery were within the range of 14 mm and 14.5 mm.
Applying the mathematical model and derived formula, the desired LOS could be calculated according to the target SCD which could help the surgeon select an optimum mini-plate before SDCL. At the same time, a new measuring device named Lei's ruler is designed for the convenience of the derived formula. These slides can be retrieved under Electronic Supplementary Material.
构建一个数学模型,该模型可以在考虑手术钻头影响的情况下,根据单开门颈椎管成形术(SDCL)前目标矢状管直径(SCD)计算所需的椎板切开术开口大小(LOS)。
该模型基于椎管变形的几何分析;推导出公式并将其特征描述为:y(mm)=2 [Formula: see text] × sin(β/2)=c-d(y 为 LOS 大小,[Formula: see text]为横径大小,β为椎板切开术开口大小,c 为微型板大小,d 为手术中使用的钻头直径)。通过图片存档和通信系统(PACS)软件和一种名为 Lei's ruler 的新仪器分别测量了 20 例接受 SDCL 的患者的术前和术后计算机断层扫描参数。
SDCL 手术效果非常显著;对于每个患者,手术后 SCD 显著增大(P<0.01)。PACS 和 Lei's ruler 获得的数据之间没有统计学差异(P>0.05)。根据推导公式,手术后 SCD 的 95%置信区间在 14mm 和 14.5mm 范围内。
应用数学模型和推导公式,可以根据目标 SCD 计算所需的 LOS,帮助外科医生在 SDCL 前选择最佳的微型板。同时,设计了一种名为 Lei's ruler 的新测量装置,方便推导公式的使用。这些幻灯片可在电子补充材料中检索。