基于Mimics软件分析不同下颈椎前路椎弓根钉联合零切迹融合器内固定方式的可行性
Mimics-based analysis of feasibility of different anterior cervical pedicle screws with a zero-trace internal fixation
侯志鹏 1叶森琦 2赵刘军 3张吉辉 3于亮 3顾勇杰3
作者信息
- 1. 宁波大学医学部,浙江宁波 315211
- 2. 余姚市人民医院脊柱外科,浙江 315499
- 3. 宁波市第六医院脊柱外科,浙江 315040
- 折叠
摘要
目的 通过Mimics软件建立正常下颈椎三维图像,比较分析不同下颈椎前路椎弓根钉联合零切迹融合器内固定方式的可行性.方法 选取自2021-01-2022-09进行颈椎CT扫描检查后颈部正常的患者,将50例颈椎CT数据采用Mimics软件分析,通过三维重建得到C3～7三维图像.第一组模拟右侧下颈椎前路椎弓根钉联合零切迹融合器内固定,第二组模拟左侧下颈椎前路椎弓根钉联合零切迹融合器内固定,第三组模拟双侧下颈椎前路椎弓根钉联合零切迹融合器内固定.观察并比较3组下颈椎前路椎弓根钉与零切迹融合器螺钉的相互位置.结果 第一组48例C3、4节段零切迹融合器下位螺钉与颈椎前路椎弓根钉相交,46例C4、5节段零切迹融合器下位螺钉与颈椎前路椎弓根钉相交,第二组C3、4、C4、5节段所有零切迹融合器下位螺钉与颈椎前路椎弓根钉相交,其余零切迹融合器螺钉与颈椎前路椎弓根钉均处于安全位置.第三组C3～7节段中零切迹融合器螺钉与颈椎前路椎弓根钉均处于安全位置.调整零切迹融合器下位螺钉的角度后,第一组C3、4节段、C4、5节段零切迹融合器下位螺钉的尾倾角均大于第二组,差异有统计学意义(P＜0.05).结论 通过右侧下颈椎前路椎弓根钉(采用刘建东的方法置钉)联合零切迹融合器内固定是可行性的,但是还需要进行生物力学研究来验证其稳定性.
Abstract
Objective To compare and analyze the feasibility of different lower cervical anterior pedicle screws combined with a zero-trace internal fixation with three-dimensional images of the normal lower cervical spine created by Mimics software.Methods Patients with normal necks after cervical spine CT scan examination were selected from January 2021 to September 2022,and the cervical spine CT data of 50 cases were analyzed by Mimics software,and C3-7 three-dimensional images were ob-tained by three-dimensional reconstruction.The first group simulated internal fixation of right anterior lower cervical pedicle root nail combined with a zero-trace internal fixation,the second group simulated internal fixation of left anterior lower cervical pedicle root nail combined with a zero-trace internal fixation,and the third group simulated internal fixation of bilateral anterior lower cervical pedicle root nail combined with a zero-trace internal fixation.The mutual positions of the anterior lower cervical pedicle screws and zero-trace fusion screws in the three groups were observed and compared.Results In the first group,48 ze-ro-trace fusion device inferior screws in segments C3,4 intersected with anterior cervical pedicle screws,46 zero-trace fusion de-vice inferior screws in segments C4,5 intersected with anterior cervical pedicle screws.In the second group,all zero-trace fusion device inferior screws in segments C34 and C4,5 intersected with anterior cervical pedicle screws,and the rest of the zero-trace fu-sion device screws were in a safe position with anterior cervical pedicle screws.In the third group,the zero-trace fusion screws were in a safe position with the anterior cervical pedicle screws in the C3-7 segments.After adjusting the angle of the zero-trace fusion device inferior screws,the caudal inclination of the zero-trace fusion device inferior screws in the C34 and C4,5 segments of the first group was greater than that of the second group,and the difference was statistically significant(P＜0.05).Conclusion Internal fixation via right anterior lower cervical pedicle screws(using the method of Liu Jiandong for nailing)in combination with a zero-trace fusion is feasible,but biomechanical studies are needed to verify its stability.
关键词
颈椎三柱损伤/颈椎前路椎弓根钉/零切迹融合器/内固定/Mimics软件Key words
Cervical three-column injury/Anterior lower cervical pedicle screw fixation/Zero-trace fusion device/Internal fix-ation/Mimics software引用本文复制引用
基金项目
浙江省卫生健康科技计划项目(2022KY341)
出版年
2024
NETL
NSTL
万方数据