C_1侧块骨折Magerl技术内固定的数字化模拟及应用
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摘要
目的探讨计算机软件应用于C1侧块骨折三维重建、复位以及数字化模拟Magerl技术内固定的方法及临床意义,以指导临床应用。方法将1具颈椎标本制作成C1侧块骨折类型,进行高速CT薄层扫描,在Mimics中对C1侧块骨折模型进行重建、复位,以Solidworks进行螺钉的设计,并在骨折复位三维模型上进行虚拟Magerl技术内固定。结果对骨折进行了三维重建、复位,根据三维模型测量数据,完成虚拟螺钉内固定,并成功指导临床手术21例。结论应用Mimics及Solidworks可在个人电脑上设计出C1侧块骨折数字化螺钉固定,对临床手术有很好的参考意义。
Objective To summarize the methods and results to perform three-dimensional reconstruction,reduction and analoging Magerl screw fixation on C 1 lateral mass fracture with computer software. So as to guiding the surgery. Methods One specimen of cervical spine was built to be C 1 lateral mass fracture. The specimen was treated with CT scan. Three-dimensional reconstruction,reduction on C 1 lateral mass fracture model was performed in Mimics. The digital screws were designed in Solidworks. Virtual Magerl technique internal fixation on the reduced three-dimensional models were performed. Results The C 1 lateral mass fracture model was three-dimensional reconstructed and reduced,and the design for internal fixation screws as well as virtual internal fixation were accomplished based on the data of three-dimensional model and successfully guided 21 cases clinical surgery. Conclusions The digital screws for C 1 lateral mass fracture can be designed in Mimics and Solidworks with a personal computer. The experience can be used to design the digital plates and screws for other type of bone fractures. It can provide good reference value for clinical surgery.
Objective To summarize the methods and results to perform three-dimensional reconstruction,reduction and analoging Magerl screw fixation on C 1 lateral mass fracture with computer software. So as to guiding the surgery. Methods One specimen of cervical spine was built to be C 1 lateral mass fracture. The specimen was treated with CT scan. Three-dimensional reconstruction,reduction on C 1 lateral mass fracture model was performed in Mimics. The digital screws were designed in Solidworks. Virtual Magerl technique internal fixation on the reduced three-dimensional models were performed. Results The C 1 lateral mass fracture model was three-dimensional reconstructed and reduced,and the design for internal fixation screws as well as virtual internal fixation were accomplished based on the data of three-dimensional model and successfully guided 21 cases clinical surgery. Conclusions The digital screws for C 1 lateral mass fracture can be designed in Mimics and Solidworks with a personal computer. The experience can be used to design the digital plates and screws for other type of bone fractures. It can provide good reference value for clinical surgery.
引文
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[2]Hein C,Richter H P,Rath S A.Atlantoaxial screw fixation for the treatment of isolated and combined unstable jefferson fracturesexperiences with 8 patients[J].Acta Neurochir(Wien),2002,144(11):1187-1192.
[3]Kim S M,Lim T J,Paterno J,et al.Biomechanical comparison of anterior and posterior stabilization methods in atlantoaxial instability[J].J Neurosurg,2004,100(3 Suppl Spine):277-283.
[4]Menendez J A,Wright N M.Techniques of posterior C1-C2stabilization[J].Neurosurgery,2007,60(Suppl 1):S103-S111.
[5]裴国献,张元智.数字骨科学:一门骨科学新分支的萌生[J].中华创伤骨科杂志,2007,9(7):601-604.
[6]Klein S,Whyne C M,Rush R,et al.CT-based patient-specific simulation software for pedicle screw insertion[J].J Spinal Disord Tech,2009,22(7):502-506.
[7]Rajasekaran S,Vidyadhara S,Ramesh P,et al.Randomized clinical study to compare the accuracy of navigated and non-navigated thoracic pedicle screws in deformity correction surgeries.[J].Spine,2007,32(2):E56-E64.
[8]瞿东滨,金大地,朱志红,等.国人寰枢椎经关节螺钉固定术的解剖学研究[J].中国矫形外科杂志,2000,7(11):1117-1119.
[9]何建荣,杨砚伟,杨捷,等.寰枢椎椎弓根内固定植骨融合术治疗寰枢椎疾患[J].临床骨科杂志,2012,15(5):577.
[10]Elgafy H,Potluri T,Goel V K,et al.Biomechanical analysis comparing three C1-C2transarticular screw salvaging fixation techniques.[J].Spine,2010,35(4):378-385.
[11]Finn M A,Apfelbaum R I.Atlantoaxial transarticular screw fixation:update on technique and outcomes in 269 patients[J].Neurosurgery,2010,66(3 Suppl):184-192.
[12]Radua C,Rosca I.Some contributions to the design of osteosynthesis implants[J].Estonian J Engineer,2009,15(2):121-130.
[13]Alvin M D,Abdullah K G,Steinmetz M P,et al.Translaminar screw fixation in the subaxial cervical spine:quantitative laminar analysis and feasibility of unilateral and bilateral translaminar virtual screw placement[J].Spine,2012,37(12):E745-E751.
[14]Blemker S S,Asakawa D S,Gold G E,et al.Image-based musculoskeletal modeling:applications,advances,and future opportunities[J].J Magn Reson Imaging,2007,25(2):441-451.
[15]Aurouer N,Obeid I,Gille O,et al.Computerized preoperative planning for correction of sagittal deformity of the spine[J].Surg Radiol Anat,2009,31(10):781-792.