| 数字建模分析倒退旋转法在腰椎椎体单侧穿刺椎体后凸成形术的适用性 |
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Received:November 27, 2018
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王雷宁 |
WANG Lei-ning |
宁波市第六医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, No.6 Hospital of Ningbo, Ningbo 315000, Zhejiang, China |
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| 赵刘军 |
ZHAO Liu-jun |
宁波市第六医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, No.6 Hospital of Ningbo, Ningbo 315000, Zhejiang, China |
zhaoliujun555@sina.com |
| 于亮 |
YU Liang |
宁波市第六医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, No.6 Hospital of Ningbo, Ningbo 315000, Zhejiang, China |
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| 顾勇杰 |
GU Yong-jie |
宁波市第六医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, No.6 Hospital of Ningbo, Ningbo 315000, Zhejiang, China |
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| 徐荣明 |
XU Rong-ming |
宁波市第六医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, No.6 Hospital of Ningbo, Ningbo 315000, Zhejiang, China |
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| 王力冉 |
WANG Li-ran |
宁波市第六医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, No.6 Hospital of Ningbo, Ningbo 315000, Zhejiang, China |
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| 张吉辉 |
ZHANG Ji-hui |
宁波市第六医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, No.6 Hospital of Ningbo, Ningbo 315000, Zhejiang, China |
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| 肖武 |
XIAO Wu |
宁波市第六医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, No.6 Hospital of Ningbo, Ningbo 315000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2019年32卷，第6期，第524-530页 |
| DOI：10.3969/j.issn.1003-0034.2019.06.008 |
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目的：利用Mimics软件建立腰椎的3D模型，使用模拟穿刺来观察倒退旋转法在腰椎椎体单侧穿刺椎体后凸成形术的适用性及进针参数。
方法：选取24例全腰椎螺旋CT扫描初次胸椎骨质疏松性骨折、腰椎无异常骨质破坏的影像学资料，其中男女各12例，应用Mimics软件对原始DICOM文件进行3D建模，分离出各节段椎体，直接导入3-matic软件后约束其椎体后壁进行标准化测量后以椎弓根中点作一垂直于中切面及椎体后壁的素描图，在素描图上进行模拟穿刺，记录穿刺针可活动范围的角度参数及距离参数，记录穿刺针在最大外倾角时落在椎体中切线前、中、后区的穿越点，并进行比较分析。
结果：所有数据在左右两侧差异均无统计学意义（P>0.05），不同节段数据在两性差异有统计学意义（P<0.05），男女性L1-L5最大外倾角均逐渐增大，男性从（33.41±1.31）°到（56.53±4.71）°，女性从（28.58±2.55）°到（53.86±2.68）°，所有穿越点未落在前区，其中女性26.67%落在中区，男性3.33%落在中区，A、B、C分区在性别上差异有统计学意义（P<0.05）。
结论：倒退旋转法理论上均能满足椎体压缩性骨折对穿刺点的要求，其中男性及下腰椎更加适用倒退旋转法。最大外倾角的测定对倒退旋转法有指导性意义。 |
| [关键词]:穿刺术 椎体后凸成形术 计算机 模拟 骨质疏松性骨折 |
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| Digital modeling and analysis of the applicability of backward rotation method in lumbar kyphoplasty with unilateral puncture |
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Abstract:
Objective:The 3D model of lumbar spine was established by using Mimics software. To observe the applicability and needling parameters of lumbar vertebral kyphoplasty with unilateral puncture by backward rotation method using simulated puncture.
Methods:Twenty-four patients (12 males and 12 females) with osteoporotic thoracic fracture in the first time and no signs of lumbar misalignment and bone destruction were scanned by spiral CT on the lumbar spine. The original DICOM file was modeled in 3D with Mimics software,and the vertebral bodies were separated. After being imported into 3-matic software,the posterior wall of the vertebral body was restrained for standardized measurement. A sketch perpendicular to the mid-section of the pedicle and the posterior wall of the vertebral body was drawn. The simulated puncture was performed on the sketch. The angle and distance parameters of the range of motion of the puncture needle were recorded,and the puncture needle was recorded at the top. The crossing points of the anterior,middle and posterior zones of the tangential line of the vertebral body were located at the high extraversion angle,and the results were compared and analyzed.
Results:All the data in the left and right sides had no significantly differences(P>0.05). Data of different segments in different gender were significantly differences(P<0.05). The maximal extraversion angle in lumbar spine increased gradually from (33.41±1.31) degree to (56.53±4.71) degree in males,as same as in females from(28.58±2.55) to(53.86±2.68) degree. There was no crossing point in area A,3.3% of males and 26.67% of females in area B,rest in area C. The distribution areas on gender showed statistically significance (P<0.05).
Conclusion:Backward rotation method can theoretically meet the requirements of puncture point for vertebral compression fracture,especially for males and lower lumbar spine. The determination of the maximum inclination angle is of guiding significance to the backward rotation method. |
| KEYWORDS:Punctures Kyphoplasty Computers analog Osteoporotic Fractures |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王雷宁,赵刘军,于亮,顾勇杰,徐荣明,王力冉,张吉辉,肖武.数字建模分析倒退旋转法在腰椎椎体单侧穿刺椎体后凸成形术的适用性[J].中国骨伤,2019,32(6):524~530 |
| 英文格式: | WANG Lei-ning,ZHAO Liu-jun,YU Liang,GU Yong-jie,XU Rong-ming,WANG Li-ran,ZHANG Ji-hui,XIAO Wu.Digital modeling and analysis of the applicability of backward rotation method in lumbar kyphoplasty with unilateral puncture[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(6):524~530 |
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