中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (17): 3124-3126.doi: 10.3969/j.issn.1673-8225.2011.17.020

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

空间“十”字配准脊柱手术机器人导航方法

张春霖，严  旭，朱红鹤，苗  森   

  1. 郑州大学第一附属医院骨科，河南省郑州市450052
  • 收稿日期:2010-12-20 修回日期:2011-03-30 出版日期:2011-04-23 发布日期:2011-04-23
  • 作者简介:张春霖☆，男，1965年生，河南省光山县人，汉族，1999年苏州大学毕业，博士，教授，主要从事脊柱微创、脊柱手术机器人的研究。 zzclin@126.com

The space “十” registration method for a self-designed spinal surgery navigation robot

Zhang Chun-lin, Yan Xu, Zhu Hong-he, Miao Sen   

  1. Department of Orthopedics, First Affiliated Hospital of Zhengzhou University, Zhengzhou  450052, Henan Province, China
  • Received:2010-12-20 Revised:2011-03-30 Online:2011-04-23 Published:2011-04-23
  • About author:Zhang Chun-lin☆, Doctor, Professor, Department of Orthopedics, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China zzclin@126.com

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摘要：

背景：现有用于椎弓根置入的脊柱手术机器人都要依赖计算机辅助导航系统进行定位和姿态控制，这样计算机辅助导航系统的不足在它们身上都会有体现。包含计算机辅助导航系统的手术机器人，不仅构成复杂，椎弓根置入的精度也难以进一步提高。
目的：探索空间“十”字配准导航方法，控制自主研制的脊柱手术机器人进行更为精准、高效和安全的椎弓根置入。
方法：将依据CT测量值设置的机器手的2枚导针置于两椎弓根中心轴线置入点上并通过X射线正侧位透视确定。令X射线设备的中心投照线先后与2枚导针的中心轴线重合，再从椎弓根轴位进行投照，使体外与体内“十”字配准，定位椎弓根峡部中心点(以下简称中心点)。依据“两点定一线”的原理，使导针通过两椎弓中心轴线置入点和椎弓根峡部中心点，脊柱导航手术机器人即可沿椎弓根中心轴线准确置入。依据规划置入点和置入线相应偏离两椎弓中心轴线置入点的距离和椎弓根中心轴线的角度，完成上述两点的确定或定位后，重新设置两导针中心轴线针尖水平之间的距离及夹角，同样“十”字配准后即可按规划路径准确置入。
结果与结论：“十字配准、两点一线”的导航原理可引导脊柱手术机器人沿椎弓根中心轴线或规划路径准确置入，从而为脊柱手术机器人确定了新的、更为准确高效的导航方法。

关键词: 机器人, 空间, 脊柱, 导航, 十字配准, 椎弓根, 置入

Abstract:

BACKGROUND: The transpedicular placement used by spinal surgery robot must depend on the computer aided surgery navigation system (CASNS) at present. Due to the disadvantages of the CASNS, the robot not only has complexity in structure, but also difficulty of further improving the insertion accuracy.
OBJECTTIVE: To analyze the value of the external and internal “十” registration method for improving the insertion accuracy of the self-designed spinal navigation surgery robot.
METHODS: According to the data measured on CT scanning, the distance and angle of the two guide wires of the manipulator were set, and its needlepoint locating at the two pedicle central axis (PCA) entry points (EP) were confirmed by the lateral and anteroposterior fluoroscopy. After the two central axis of guide wire and central view axis of C-Arm were coincided respectively, the pedicle axis view was acquired via C-arm, the external “十” was adjusted to register with the internal “十”, then the centre of pedicle isthmus(CPI) was confirmed. Depending on the principle two points making a line, the insertion along the PCA was achieved by the robot when the guide wire was inserted through the EP and CPI. Similarly, after the EP and CPI was confirmed, the two guide wires were reset in accordance with the distance and angle deviating from the EP and PCA measured on CT scanning, it was inserted along the palnned trajectory accurately.
RESULTS AND CONCLUSION: Depending on the principle of the external and internal “十” registration and two points making a line, the guide wire can be inserted along the PCA or the planned trajectory, which provides a new and efficient method of improving the accuracy for the spinal surgery navigation robot.

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