Mimics及快速成型技术在Dynesys椎弓根螺钉个体化置钉中的应用研究

发布时间：2018-02-08 19:39

本文关键词： 腰椎 Dynesys系统椎弓根螺钉 Mimics软件快速成型三维重建　出处：《宁波大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的利用Mimics软件及快速成型技术设计一种Dynesys椎弓根螺钉个体化置钉技术,探讨Mimics软件及快速成型技术在Dynesys椎弓根钉个体化置钉中的临床应用价值及意义。材料与方法选取16例正常成人离体腰椎干燥骨标本,以腰4、腰5为靶节段,解剖分离腰4、腰5并进行螺旋CT扫描,收集DICOM格式数据。利用Mimics软件对1-16号标本进行三维重建,并以STL+格式导出。利用快速成型技术(RP技术)制作出相应的实体模型。通过游标卡尺、量角器及Mimics软件自带的测量工具测量1-16号离体骨标本、相应三维重建图像及实体模型的相关椎弓根参数。再对三维重建图像、实体模型和腰椎骨标本三者的测量数据进行统计学分析,验证三维重建图像和实体模型的精确性。在Mimics软件上设计出1-16号骨标本的最佳进钉通道,制定Dynesys螺钉个体化置钉参数,并进行模拟置钉。在个体化置钉参数基础上,配合实体模型的直观指导,在1-16号离体骨标本上进行个体化置钉。置钉后再CT扫描,判断置钉准确性。结果三维重建图像和实体模型与离体腰椎骨标本在椎弓根相关参数测量上均无统计学差异(P0.05),能准确反映腰椎标本椎弓根解剖形态。利用Mimics软件及快速成型技术,对32个腰椎标本共64个椎弓根进行置钉,置钉后CT扫描显示共有1枚螺钉稍穿破内侧骨皮质,其余均位于椎弓根内。置钉准确率为98.44%(63/64)。结论应用Mimics软件对腰椎进行三维重建,制定个体化置钉参数,同时配合实体模型的直观指导,能提供一种新的腰椎后路Dynesys椎弓根螺钉个体化置钉的方法,有效提高了椎弓根置钉的安全性。
[Abstract]:Objective to design an individual screw placement technique for Dynesys pedicle screw by using Mimics software and rapid prototyping technique. To explore the clinical application value and significance of Mimics software and rapid prototyping technique in Dynesys pedicle screw individualized nailing. Materials and methods 16 normal adult lumbar vertebrae dry bone specimens were selected, with lumbar 4 and 5 as target segments. Lumbar 4 and L5 were dissected, and spiral CT scanning was performed to collect DICOM format data. Three-dimensional reconstruction of 1-16 specimens was performed by Mimics software. The corresponding solid model was made by using rapid prototyping technique (RP) and derived in STL format. 1-16 bone specimens were measured by Vernier caliper, protractor and measuring tool of Mimics software. The relevant pedicle parameters of the corresponding 3D reconstruction image and the solid model were analyzed statistically, and the measured data of the 3D reconstruction image, the solid model and the lumbar vertebrae specimen were analyzed statistically. To verify the accuracy of 3D reconstruction images and solid models, the optimal approach for 1-16 bone specimens was designed on Mimics software, and the parameters of individual screw placement of Dynesys screws were established, and the parameters of individual screw placement were simulated. In accordance with the direct guidance of the solid model, the individual nail was placed on the 1-16 bone specimen in vitro. The nail was placed and then scanned by CT. Results there was no statistical difference in the measurement of pedicle parameters between 3D reconstruction images and solid model and in vitro lumbar vertebrae bone specimen, which could accurately reflect the anatomical morphology of pedicle of lumbar vertebrae specimen. Mimics software was used to evaluate the anatomical morphology of pedicle of lumbar vertebrae. And rapid prototyping technology, A total of 64 pedicles of 32 lumbar vertebrae were nailed. Ct scanning showed that one screw slightly penetrated the medial cortex of the bone, and the rest were located in the pedicle. The accuracy of nailing was 98.44% 63 / 64. Conclusion the Mimics software is used to reconstruct the lumbar spine. It can provide a new method of individualized screw placement with Dynesys pedicle screw through lumbar posterior approach, and improve the safety of pedicle screw placement effectively.
【学位授予单位】：宁波大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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