摘要
[目的]探讨使用交互式医学影像控制系统重建CT数据并模拟脊柱矫形对临床手术的指导意义。[方法]选取2010年6月～2012年6月广州军区广州总医院骨科医院收治的脊柱畸形病例共62例,分为模拟手术组31例及非模拟手术组31例。所有病例术前行T1～S1脊柱多层螺旋CT扫描,模拟手术组病例获取CT数据导入Mimics 10.01软件进行脊柱及周围软组织的数字化三维重建并模拟手术操作。非模拟手术组术前不进行上述操作。术后通过X线检查及CT钉道扫描比较两组矫形效果及椎弓根螺钉位置,并随访10～28个月。[结果]应用Mimics软件平台可以清晰地重建脊柱及周围重要软组织,术前可以反复多次进行模拟手术操作。两组病例术后所有患者均未见神经、血管损伤及感染并发症,模拟手术组置钉418枚,成功率为97.1%,非模拟手术组置钉451枚,成功率90.5%,两组有显著性差异(P<0.001);Cobb角纠正率(模拟手术组63.3%±14.3%,非模拟手术组58.3%±13.0%),两组无显著性差异(P>0.05)。[结论]相比传统方式而言,术前应用Mimics软件重建CT数据并模拟脊柱矫形可以获得更好的脊柱畸形个体化诊疗效果。
[ Objective] To explore the clinical application and outcomes of surgery simulation based on the reconstruction of computed tomography （CT） data using the Mimics system for the correction of spinal deformities. [ Methods] Between June 2010 and June 2012, 62 patients with spinal deformity were divided into 2 groups according to their superintendence： a simula- tion group and traditional group, each comprising 31patients. Spinal columns from T1 to S1 were scanned by multi -detector - row CT. In the simulation group, the Mimics system was used to reconstruct the spine and the surrounding soft tissue using CT data, thus enabling the simulation of spinal deformity correction surgery, whereas this approach was not used in the traditional group. After 10 -28 months, the Cobb angle correction rate and pedicle screw accuracy were compared using postoperative radio- graphs and CT scans in the 2 groups. [ Results] Distinct images were obtained during reconstruction of the spine and the sur- rounding soft tissue using the Mimics system, and the surgery simulation could be repeated in advance. No neurological compli- cations, vascular injury, or infection was observed in both the groups. The success rate of the 418 cases of Mimics - assisted pedicle screw fixation was 97.1% , whereas the success rate of the 451 cases in which screws were set by traditional methods was 90. 5% ; the difference between these values was statistically significant （P 〈 0. 001 ） . There was no significant difference in the Cobb angle correction rate （simulation group, 63.3% ± 14. 3% ; traditional group, 58. 3% ± 13.0% ; P 〉0. 05） . [ Conclusion] Reconstruction of CT data and surgery simulation using the Mimics systemyields an improved outcome compared to that obtained by traditional methods for individualized spinal deformity correction.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2013年第19期1912-1917,共6页
Orthopedic Journal of China
基金
国家自然科学基金面上项目(项目编号:81171768)
广东省科技计划项目(项目编号:2011B031800185)
