计算机3D建模在个体化寰枢椎椎弓根钉最佳进钉方式的研究

doi:10.13418/j.issn.1001-165x.2015.03.014

Abstract

Abstract:

Objective To study the regular patterns of atlantoaxial pedicle channel, screw safety zone, and the best screw channel by means of 3D-array model； To establish standards and simplify preoperative design for axis pedicle screws operation. Methods CT scan of axis data of 14 healthy adult from PACS system were collected and imported into Mimics10.01software to reconstruct three-dimensional (3D) models. Then, the 3D reconstruction models were imported into 3Dmax 2009 as .dwg format for analysis of the pedicle screw channels. The three-dimensional coordinates and the origin were determined, then the array model was imported.as for the atlas , the screw with a diameter of 3.5 mm and a length of 22 mm was used as an object of study. As for the axis, the screw with a diameter of 3.5 mm and a length of 24 mm was used as an object of study the screw placement in the safety zone was simulated and the optimal placement scheme was explored. the best placement data was recorded and was then used for guidance of computer simulation of pedicle screws. Results There are 185 elements that meet the demand to place the screws in the atlas, and there are 395 elements that meet the demand to place the screws in the axis. In the transparent mode, 53 nails, 27 nails in the atlas and 25 nails in the axis, all precisely gained entrance to the vertebral body through the vertebral arch pedicle. Therewas no significant difference between the left side and the right side (P> 0.05). Conclusions The digital 3D modeling technology is a standard, simple, accurate way in the preoperative design and measurement for axis pedicle surgery.

Key words: Atlas, Axis, 3D modeling, Pedicle screw channel, Array model

References

[1] Goel A, Laheri V. Plate and screw fixation for atlantoaxial subluxation[J]. Acta Neurochir (Wien), 1994，129（1）：47-53.
[3] 张昊,白净,谭明生,等.寰椎后路椎弓根螺钉及侧块螺钉的生物力学分析[J]. 清华大学学报, 2008,48（3）:421-424.
[4] Lapsiwala SB, Anderson PA, Oza A, et al. Biomechanical comparison of four C1 to C2 rigid fixative techniques: anteriortransarticular, posterior transarticular, C1 to C2 pedicle, and C1 toC2 intralaminar screws[J]. Neurosurgery,2006,58（3）:516-521.
[5] 何帆, 尹庆水, 马向阳. 寰椎后弓形态分类与椎弓螺钉固定的解剖学研究[J]. 中国临床解剖学杂志，2006，24(3): 275-278.
[6] 曹正霖, 钟世镇, 徐达传．寰枢椎的解剖学测量及其临床意义[J].中国临床解剖学杂志,2000，18(4): 299-301．
[7] 吴春立,张沛.不同年龄寰枢椎椎弓根的数字化测量[J]. 中国组织工程研究,2013,17(26): 4896-4903
[8] 汪国友,扶世杰.寰椎椎弓螺钉在寰枢椎不稳中的临床应用[J].中国修复重建外科杂志，2013,27(10): 1210-1213.
[9] Resnick DK, Lapsiwala S, Trost GR. Anatomic suitability of the C1-C2complex for pedicle screw fixation[J]. Spine (Phila Pa 1976), 2002,27（14）: 1494-1498.
[10] Ebraheim NA, Xu R, Ahmad M, et al. The quantitative anatomy of the vertebral artery groove of the atlas and its relation to the posterior atlantoaxial approach[J]. Spine (Phila Pa 1976), 1998, 23（3）: 320-323.
[11] 李严兵，谢叻.胸椎椎弓根进钉通道随外偏角变化的数字解剖学研究[J]. 中国骨科临床与基础杂志,2010,2（2）:120-125.
[12] 谭健，王文军，李严兵.寰椎椎弓根通道的数字解剖学研究[J].中国脊柱脊髓杂志，2010,20(11):885-890.
[13] 谭明生,张光铂,李子荣,等.寰椎测量及其经后弓侧块螺钉同定通道的研究[J].中国脊柱脊髓杂志,2002, 12(1): 5-8.
[14] 谭明生,移平,王文军,等.经寰椎“椎弓根”螺钉内同定技术的临床应用[J].中国脊柱脊髓杂志, 2006, 16(5): 336-340.
[15] 马向阳, 尹庆水,吴增晖,等.寰椎椎弓根与枢椎侧块关系的解剖与临床研究[J].中华骨科杂志, 2004, 24(5): 295-298.
[16] 林山，尹庆水. 数字化重建与快速成型技术在复杂的上颈椎疾患诊治中的应用[J].中国脊柱脊髓杂志 ,2011，21(1):16-21.
[17] 艾福志，尹庆水.数字骨科技术在颅颈交界疾患外科治疗中的临床应用[J].脊柱外科杂志,2011,9(3),169-173.
[18] 覃炜，权正学.寰枢椎椎弓根螺钉个体化导向模板的研制与实验研究 [J].中国修复重建外科杂志，2010,10（24）:1168-1173.
[19] Ebraheim NA, Fow J, Xu R, et al. The location of the pedicle and parsinterarticularis in the axis[J]. Spine , 2001,1526（4）: E34-37.
[20] Naderi S, Arman C, Guvencer M, et al. An anatomical study of the C-2 pedicle[J]. J Neurosurg Spine, 2004, 1（3）: 306-310.
[21]沈军, 李力, 王东来, 等. 下颈椎椎弓根三维CT测量及个体化置钉术的实验研究[J]. 中国骨与关节损伤杂志, 2005, 20(6): 398-400.

[1]	Pan Baoshun, Chen Jinshui, Fang Zhen, Gao Mingjie . Anatomical study and clinical significance of posterior atlantoaxial structure [J]. Chinese Journal of Clinical Anatomy, 2022, 40(6): 633-638.
[2]	Tong Jie, Ji Wei, Huang Zhiping, Zhou Ruozhou, Fang Zuozhong, Zhu Qingan. Biomechanical study of posterior flexible and dynamic fixations in the occipitocervical region [J]. Chinese Journal of Clinical Anatomy, 2022, 40(3): 315-319.
[3]	Wang Fasheng, Chen Jie, Xie Yun. Study on the application of inertia principal axis in the precise positioning of the radial tuberosity [J]. Chinese Journal of Clinical Anatomy, 2022, 40(2): 168-172.
[4]	Tong Jie, Ji Wei, Huang Zhiping, Zhou Ruozhou, Fang Zuozhong, Zhu Qingan. Biomechanical research on posterior flexible fixation at atlantoaxial joint [J]. Chinese Journal of Clinical Anatomy, 2022, 40(1): 72-77.
[5]	YANG Sheng, TANG Chao, ZHONH De-jun. Imaging evaluation of sagittal curvature of subaxial cervical spine in 150 normal population and its clinical significance [J]. Chinese Journal of Clinical Anatomy, 2020, 38(5): 549-553.
[6]	SU Bao-ke, WANG Wei, CAI Yong-qiang, ZHANG Yun-feng, WANG Li-dong, XU Yang-yang，FENG Hui-mei, HE Yu-jie, WANG Hai-yan, LI Zhi-jun, WANG Xing, WANG Zhi-qiang, LI Xiao-he. Anatomical measurement and clinical significance of 38 cases of atlas lateral mass nourishment hole [J]. Chinese Journal Of Clinical Anatomy, 2019, 37(2): 126-129.
[7]	WANG Bin-bin, MA Xiang-yang, DUAN Ming-yang, YANG Jin-cheng, YANG Hao-zhi. Measurements of posterior arch of atlas and its significance [J]. Chinese Journal Of Clinical Anatomy, 2017, 35(6): 610-614.
[8]	XU Ling-ling, WANG Yu-hai . The applied anatomical comparison of two combined approaches in treatment of communicating tumors in the jugular foramen region [J]. Chinese Journal Of Clinical Anatomy, 2017, 35(4): 361-366.
[9]	. The feasibility study of cervical pedicle screwed with new individual-oriented template by 3D printing technology [J]. Chinese Journal Of Clinical Anatomy, 2017, 35(2): 147-150.
[10]	XIAO Yao-sheng,MA Xiang-yang,XIAO Jian-hua, YANG Jin-cheng,QIU Feng,ZHOU Xing,HU Hai-sheng. The application of CTA in TARP: studying in the relationship of ICA and atlas lateral mass [J]. Chinese Journal Of Clinical Anatomy, 2016, 34(5): 509-513.
[11]	SUN Qiu-min, WANG Ai-ping, ZHOU Zi-jia, CHEN Xi, LIU Fang, XIE Wei, ZHOU Xiao-bing, PENG Tian-hong, CHEN Sheng-hua, LV Yun-cheng, LI Yan-bing. The study of the three-dimensional relationship between medial axis line of spinous processes in lumbarvertebrae and the pedicle insertion channel [J]. Chinese Journal Of Clinical Anatomy, 2016, 34(2): 145-150.
[12]	. Radiographic measurement and the screw placement strategies of axis quadricortical pedicle screw [J]. Chinese Journal Of Clinical Anatomy, 2016, 34(1): 53-58.
[13]	LIU Jia-Meng, JIANG Jian, LIU Zhi-Li, LONG Xin-Hua, CHEN Wen-Zhao, ZHOU Yang, GAO Song, HE Lai-Chang, HUANG Shan-Hu. The anatomical study of the entry point of axis pedicle screw by posterior nutrient foramens [J]. Chinese Journal Of Clinical Anatomy, 2014, 32(6): 637-639.
[14]	CHAI Yu, LI Shi, LI Xi-Kai. The study on the classification of the Chinese dry atlas articular surface [J]. Chinese Journal of Clinical Anatomy, 2014, 32(5): 533-537.
[15]	JIA Gong, LIN Hong-Heng, HU Guo-Qiang, HE Xiao-Hua, YIN Qiang-Shui, WANG Zhi-Yun, HU Dun-Jie. Study of technical parameters of C1 lateral screws placement in Jefferson-fracture reduction plate [J]. Chinese Journal Of Clinical Anatomy, 2012, 30(6): 641-645.

Computer simulation of the 3D modeling to study the best screw channel in Atlantoaxial pedicle

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 0