中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (13): 2331-2334.doi: 10.3969/j.issn.1673-8225.2011.13.013

• 数字化骨科 digital orthopedics • 上一篇    下一篇

计算机辅助术前预测青少年特发性脊柱侧凸内置物的长度

周忠杰，刘立岷，宋跃明   

  1. 四川大学华西医院骨科，四川省成都市   610041
  • 收稿日期:2010-10-02 修回日期:2011-02-07 出版日期:2011-03-26 发布日期:2013-10-23
  • 通讯作者: 宋跃明，博士，教授，四川大学华西医院骨科，四川省成都市 610041 sym_cd@yahoo.com.cn
  • 作者简介:周忠杰☆，男，1981年生，辽宁省盘锦市人，汉族，四川大学华西临床医学院在读博士，主要从事脊柱外科方面的研究。 pjzhouzhongjie@163.com

Computer-assisted preoperative calculation of the orthopaedic rod length for patients with adolescent idiopathic scoliosis

Zhou Zhong-jie, Liu Li-min, Song Yue-ming   

  1. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu  610041, Sichuan Province, China
  • Received:2010-10-02 Revised:2011-02-07 Online:2011-03-26 Published:2013-10-23
  • Contact: Song Yue-ming, Doctor, Professor, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China sym_cd@yahoo.com.cn
  • About author:Zhou Zhong-jie☆, Studying for doctorate, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China pjzhouzhongjie@163.com

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376

被引次数

4

摘要：

背景：青少年特发性脊柱侧凸常需要根据患者脊柱畸形的特点和棒模板的长度对棒长进行估计，但这种方法并不精确。
目的：计算机辅助术前预测青少年特发性脊柱侧凸矫形棒的长度，并评价该法的可重复性及准确性。
方法：将青少年特发性脊柱侧凸患者术前脊柱的CT资料通过MIMICS软件进行三维重建并模拟手术矫形效果，然后利用系统自带的测量工具以连续的短直线测量矫形棒长。选择7例青少年特发性脊柱侧凸患者，测量术前用计算机辅助预测的棒长、术中传统方法估计的棒长、术后通过前后位X射线平片测量的理想棒长，评价本方法的准确性。
结果与结论：重复测量操作，同一操作者连续相邻两次测量结果的变化值为(2.492±2.089) mm，不同操作者测量结果之间t检验，P=0.719；信度分析：r=0.986，P=0.000。计算机辅助预测棒长值较理想值长(4.23±3.84) mm，传统估计棒长较理想值长(9.32±5.23) mm，P=0.021。提示，计算机辅助术前预测青少年特发性脊柱侧凸矫形手术矫形棒长度具有较好的操作者自身的可靠性和不同操作者之间的可重复性。计算机辅助预测矫形棒长度，具有较好的准确性，能够准确预测矫形棒的长度，为指导手术操作提供依据。

关键词: 青少年特发性脊柱侧凸, 三维重建, 计算机辅助术, 矫形棒长, 术前测量

Abstract:

BACKGROUND: Surgeons usually need to estimate the rod length according to the feature of the deformity and the length of the rod model made before the correction. But such estimation is not precise.
OBJECTIVE: To calculate preoperatively the length of the rod for patients with adolescent idiopathic scoliosis (AIS) using computer and to evaluate the validity and accuracy of this method.
METHODS: The spinal spiral CT of the patients with AIS was manipulated by the MIMICS software to reconstruct a three-dimensional model of all the vertebrae needing to be corrected. The vertebrae’s positions were adjusted to mimic the orthopaedic result of the operation, and the length of the orthopaedic rod can be calculated using short straight line by the software’s measuring tool. Seven patients were selected. The length of the orthopedic rod was calculated by MIMICS software and traditional method, anterior and posterior position X-ray of vertebral column were done postoperatively to measure the ideal length of the orthopaedic rod to evaluate the accuracy of the method.
RESULTS AND CONCLUSION: For validity evaluation, the interobserver variability was (2.492±2.089) mm, and r=0.986, P=0.000 for the intra observer variability. The rod length measured by the software was (4.23±3.84) mm longer than the ideal length, while the length measured by the traditional method was (9.32±5.23) mm longer. The P value was 0.021, and the difference was statistically significant. The method of calculating preoperatively the length of the orthopaedic rod for patients with AIS using MIMICS software has good validity and reproducibility; this method also has good accuracy, which can be put into practical use.

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