摘要
背景:脊柱转移瘤往往破坏椎体和附件,患者会患有严重的疼痛,并发症发生率较高,例如截瘫和脊柱后凸畸形等。脊柱转移瘤治疗原则是早期诊断,手术完全切除,术后化疗。影像学技术如CT可判断脊柱转移瘤的转移情况,进行准确的术前定位。目前可视化仿真手术及虚拟现实技术已经逐渐应用于整形外科领域。目的:通过探索虚拟现实技术来寻找一种实行经前后路联合治疗腰椎转移性肿瘤的途径。方法:基于腰椎的64排螺旋CT连续薄层二维图像,Mimics软件分别重建正常腰椎、破坏病椎、腹主动脉及双侧肾脏的三维可视化结构,在三维模型拟行经前路病灶清除、钛网骨水泥支撑、后路椎弓根螺钉内固定。结果与结论:基于Dicom格式数据进行三维重建图像结构清晰,可真实再现腰椎病椎和邻近脏器的结构,整个虚拟仿真手术真实直观。虚拟仿真手术准确重建腰椎恶性肿瘤及邻近结构的三维立体结构,明确病椎清除范围,经后路重建脊柱序列,此方法可为个体化的治疗方案提供了客观的依据。
BACKGROUND： Vertebral metastatic tumor often damages vertebral body and the appendix, and causes severe pain in patients and high incidence of complications, such as paraplegia and spinal kyphosis. The principle of metastatic tumor treatment is early diagnosis, complete surgical resection, and postoperative chemotherapy. Imaging techniques such as CT can detect spinal metastases and accurately position the tumor before surgery. Currently visualized simulation and virtual reality techniques have been increasingly used in the field of orthopedics.
OBJECTIVE： To find an anterior-posterior approach for the treatment of vertebral metastases using visual reality technique.
METHODS： Based on the 64-layer spiral CT two-dimensional images of lumbar vertebra, we reconstructed the structure of normal vertebrae, affected vertebrae, abdominal aorta and bilateral kidney three-dimensionally using Mimics software. Then anterior debridement, titanium bone cement supporting, and posterior pedicle screw fixation were performed on three-dimensional models.
RESULTS AND CONCLUSION： Three-dimensionally reconstructed models were clearly visible in Dicom format, and can reproduce the structure of affected vertebrae and adjacent organs. The virtual stimulation operation provided clarity with strong relief perception. Virtual simulation surgery accurately visualize three-dimensional structure of malignant tumor and adjacent structure, position the lesion site, and reconstruct spinal sequence via the posterior approach. This method provides an objective evidence for individualized treatment programs.
出处
《中国组织工程研究》
CAS
CSCD
2014年第48期7844-7848,共5页
Chinese Journal of Tissue Engineering Research
