本文關鍵詞： 腰椎 Dynesys系統(tǒng) 椎弓根螺釘 Mimics軟件 快速成型 三維重建　出處：《寧波大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的利用Mimics軟件及快速成型技術設計一種Dynesys椎弓根螺釘個體化置釘技術,探討Mimics軟件及快速成型技術在Dynesys椎弓根釘個體化置釘中的臨床應用價值及意義。材料與方法選取16例正常成人離體腰椎干燥骨標本,以腰4、腰5為靶節(jié)段,解剖分離腰4、腰5并進行螺旋CT掃描,收集DICOM格式數(shù)據(jù)。利用Mimics軟件對1-16號標本進行三維重建,并以STL+格式導出。利用快速成型技術(RP技術)制作出相應的實體模型。通過游標卡尺、量角器及Mimics軟件自帶的測量工具測量1-16號離體骨標本、相應三維重建圖像及實體模型的相關椎弓根參數(shù)。再對三維重建圖像、實體模型和腰椎骨標本三者的測量數(shù)據(jù)進行統(tǒng)計學分析,驗證三維重建圖像和實體模型的精確性。在Mimics軟件上設計出1-16號骨標本的最佳進釘通道,制定Dynesys螺釘個體化置釘參數(shù),并進行模擬置釘。在個體化置釘參數(shù)基礎上,配合實體模型的直觀指導,在1-16號離體骨標本上進行個體化置釘。置釘后再CT掃描,判斷置釘準確性。結(jié)果三維重建圖像和實體模型與離體腰椎骨標本在椎弓根相關參數(shù)測量上均無統(tǒng)計學差異(P0.05),能準確反映腰椎標本椎弓根解剖形態(tài)。利用Mimics軟件及快速成型技術,對32個腰椎標本共64個椎弓根進行置釘,置釘后CT掃描顯示共有1枚螺釘稍穿破內(nèi)側(cè)骨皮質(zhì),其余均位于椎弓根內(nèi)。置釘準確率為98.44%(63/64)。結(jié)論應用Mimics軟件對腰椎進行三維重建,制定個體化置釘參數(shù),同時配合實體模型的直觀指導,能提供一種新的腰椎后路Dynesys椎弓根螺釘個體化置釘?shù)姆椒?有效提高了椎弓根置釘?shù)陌踩浴?br/>[Abstract]:Objective to design an individual screw placement technique for Dynesys pedicle screw by using Mimics software and rapid prototyping technique. To explore the clinical application value and significance of Mimics software and rapid prototyping technique in Dynesys pedicle screw individualized nailing. Materials and methods 16 normal adult lumbar vertebrae dry bone specimens were selected, with lumbar 4 and 5 as target segments. Lumbar 4 and L5 were dissected, and spiral CT scanning was performed to collect DICOM format data. Three-dimensional reconstruction of 1-16 specimens was performed by Mimics software. The corresponding solid model was made by using rapid prototyping technique (RP) and derived in STL format. 1-16 bone specimens were measured by Vernier caliper, protractor and measuring tool of Mimics software. The relevant pedicle parameters of the corresponding 3D reconstruction image and the solid model were analyzed statistically, and the measured data of the 3D reconstruction image, the solid model and the lumbar vertebrae specimen were analyzed statistically. To verify the accuracy of 3D reconstruction images and solid models, the optimal approach for 1-16 bone specimens was designed on Mimics software, and the parameters of individual screw placement of Dynesys screws were established, and the parameters of individual screw placement were simulated. In accordance with the direct guidance of the solid model, the individual nail was placed on the 1-16 bone specimen in vitro. The nail was placed and then scanned by CT. Results there was no statistical difference in the measurement of pedicle parameters between 3D reconstruction images and solid model and in vitro lumbar vertebrae bone specimen, which could accurately reflect the anatomical morphology of pedicle of lumbar vertebrae specimen. Mimics software was used to evaluate the anatomical morphology of pedicle of lumbar vertebrae. And rapid prototyping technology, A total of 64 pedicles of 32 lumbar vertebrae were nailed. Ct scanning showed that one screw slightly penetrated the medial cortex of the bone, and the rest were located in the pedicle. The accuracy of nailing was 98.44% 63 / 64. Conclusion the Mimics software is used to reconstruct the lumbar spine. It can provide a new method of individualized screw placement with Dynesys pedicle screw through lumbar posterior approach, and improve the safety of pedicle screw placement effectively.
【學位授予單位】：寧波大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3

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