数字化重建技术在腰椎经椎弓根置钉三维CT影像解剖学研究中的应用
Application of Digital Reconstruction Technique in the Anatomical Study of Lumbar Pedicle Screw Placement Based on Three-dimensional CT Images
石运力 1李硕 1朱江 1王磊 1郭晓辉2
作者信息
- 1. 063000 河北 唐山,唐山市第二医院放射科
- 2. 063000 河北 唐山,唐山市第二医院脊柱科
- 折叠
摘要
目的 探讨数字化重建技术在腰椎经椎弓根置钉三维CT影像解剖学研究中的应用价值.方法 选取2020 年1 月—2022 年1 月120 例腰椎骨折患者,收集其CT影像,以DICOM格式导入Mimics 17.0 中,进行图像处理和三维模型重建,测量椎弓根宽度、高度和虚拟皮质骨钉道螺钉直径、长度、下倾角、外旋角,并对其进行分析.结果 椎弓根宽度从L1～5呈增大趋势,不同节段间比较差异有统计学意义(P＜0.05);椎弓根高度L4 与L5 节段比较差异无统计学意义(P＞0.05),余节段两两比较差异有统计学意义(P＜0.05);男性L1～5 节段椎弓根宽度、高度均大于女性(P＜0.01).虚拟皮质骨钉道螺钉直径及钉尾间距L2～5呈显著增大趋势,L1 与L2 节段比较差异无统计学意义(P＞0.05),余节段两两比较差异有统计学意义(P＜0.05);同一椎体左右两侧虚拟皮质骨钉道螺钉长度、直径、钉尾间距、外旋角、下倾角比较差异均无统计学意义(P＞0.05);男性L1～5 节段皮质骨钉道螺钉长度均长于女性(P＜0.05,P＜0.01).结论 数字化重建技术可指导制订腰椎骨折患者个性化椎弓根置钉方案,为不同节段、不同性别患者手术设计提供解剖学依据.
Abstract
Objective To investigate the application value of digital reconstruction technique in the anatomical study of lumbar pedicle screw placement based on three-dimensional(3D)CT image.Methods From January 2020 to January 2022,120 patients with lumbar spine fractures were selected,and their CT images were collected and imported into Mim-ics17.0 in DICOM format for image processing and 3D model reconstruction.The width and height of the pedicle,pedicle screw diameter,length,downtilt angle and abduction angle of virtual cortical bone trajectory screws were measured and ana-lyzed.Results The pedicle width increased from L1-5,and the difference was statistically significant among different seg-ments(P＜0.05).There was no significant difference in pedicle height between L4 and L5 segments(P＞0.05),but there was significant difference in pedicle height between the remaining segments(P＜0.05).The width and height of pedicle at L1-5 segments in males were greater than those in females(P＜0.01).The diameter of virtual cortical bone trajectory screws and distance between the nails at L2-5 were significantly increased,there was no significant difference between L1 and L2 seg-ments(P＞0.05),and pairwise difference between the remaining segments was statistically significant(P＜0.05).There were no significant differences in the length,diameter,distance between the nails,abduction angle,and downtilt angle of vir-tual cortical bone trajectory screws on both sides of the same vertebral body(P＞0.05).The length of cortical bone trajectory screws at L1-5 segments in males was longer than that in females(P＜0.05,P＜0.01).Conclusion Digital reconstruction technique can guide the clinical formulation of personalized pedicle nailing scheme for patients with lumbar fracture,and pro-vide anatomical basis for the surgical design of patients with pedicle screw placement at different segments and of different gen-ders.
关键词
脊柱骨折/数字化重建技术/椎弓根置钉/三维模型重建/椎弓根宽度/椎弓根高度/螺钉长度/螺钉直径Key words
Spinal fractures/Digital reconstruction technology/Pedicle nail/3D model reconstruction/Pedicle width/Pedicle height/Screw length/Screw diameter引用本文复制引用
基金项目
2021年度河北省医学科学研究课题计划项目(20210250)
出版年
2023
国家科技期刊平台
NSTL
万方数据