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WO2021206403A1 - Procédé de simulation de chirurgie de fusion de corps vertébraux - Google Patents

Procédé de simulation de chirurgie de fusion de corps vertébraux Download PDF

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Publication number
WO2021206403A1
WO2021206403A1 PCT/KR2021/004246 KR2021004246W WO2021206403A1 WO 2021206403 A1 WO2021206403 A1 WO 2021206403A1 KR 2021004246 W KR2021004246 W KR 2021004246W WO 2021206403 A1 WO2021206403 A1 WO 2021206403A1
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Prior art keywords
vertebral body
vertebral
image
cage
vertebral bodies
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Ceased
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English (en)
Korean (ko)
Inventor
채동식
강경일
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Catholic Kwandong University Industry Cooperation Foundation
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Catholic Kwandong University Industry Cooperation Foundation
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/568—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor produced with shape and dimensions specific for an individual patient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/102—Modelling of surgical devices, implants or prosthesis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107—Visualisation of planned trajectories or target regions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2002/4632—Special tools for implanting artificial joints using computer-controlled surgery, e.g. robotic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2002/4632—Special tools for implanting artificial joints using computer-controlled surgery, e.g. robotic surgery
    • A61F2002/4633—Special tools for implanting artificial joints using computer-controlled surgery, e.g. robotic surgery for selection of endoprosthetic joints or for pre-operative planning

Definitions

  • the present invention relates to a method for simulating vertebral body fusion surgery, and more particularly, to a method capable of simulating the insertion state of a cage through simulation before vertebral body fusion surgery.
  • spinal fusion is a surgical procedure that inserts between the upper and lower vertebrae and then fractures the two bones and merges them into one.
  • the cage or intervertebral fusion implant used for fusion surgery restores the height of the intervertebral body and the curvature of the spine, and restores the biomechanical stability of the spine by structurally supporting the vertebral body. serves to make
  • Intervertebral body fusion implants are widely used for the treatment of spinal diseases such as intervertebral stenosis, intervertebral disc herniation, and facet joint hypertrophy, which are increasing due to an aging society, and are being developed in various types depending on design, treatment method, and material.
  • Bone fusion device is a cage-type device usually used to treat structural abnormalities caused by degenerative intervertebral disks. To provide mechanical stability or sufficient space for intervertebral fusion to occur, it is implanted between the bones or bones for grafting. It is composed of materials whose stability has been confirmed, and includes those with surface treatment (porous coating of metal materials, oxide film, etc.).
  • Intervertebral fusion prosthesis is classified into VBR (vertebral body replacement) for corpectomy and intervertebral replacement for fusion according to the purpose of use. And it is largely divided into cervical (cervical) and lumbar (lumbar) according to the area of use. Intervertebral fusion implants are mainly used in the cervical and lumbar regions, and the size of the intervertebral fusion implants inserted into the cervical and lumbar vertebrae depends on the anatomical characteristics of the intervertebral disc and the vertebral body (width, end plate). curvature, etc.).
  • intervertebral body fusion prosthesis may be provided in various types and forms as shown in FIG. 1 .
  • Threaded (horizontal cylinders) intervertebral fusion prosthesis is mainly composed of anterior and posterior approaches, and a method is used to fix the intervertebral fusion prosthesis by twisting it along the screw thread at the surgical and insertion position by giving a thread to the outside of the intervertebral fusion prosthesis. do. Due to the screw thread of the intervertebral body fusion prosthesis, in addition to the role of supporting the vertical direction of the spine due to the increase of the contact cross-sectional area, the additional fixation effect with the end plate by the screw thread provides the front and rear fixing force. However, there are also reports of cases in which the coupling force increases due to the presence of the screw thread, but damage to the intervertebral disc of the vertebral body reduces the stability of the spine.
  • the open box intervertebral body fusion prosthesis mainly takes a posterior approach and, unlike the screw type, serves to support only the vertical direction between the end plates. It is not usually used alone and is used in conjunction with rigid fixation, such as posterior fusion.
  • Cylindrical (thick-walled vertical rings) intervertebral body fusion prosthesis is mainly performed anteriorly and plays a role of supporting only in the vertical direction between the end plates like the box type.
  • the size of cylindrical products is larger than that of screw-type and box-type products, so more fibrous annulus removal is required during the procedure.
  • Anterior (anterior lumbar/cervical interbody fusion, ALIF/ACIF), posterior lumbar interbody fusion (PLIF), lateral (direct lateral Interbody fusion, DLIF), and transforaminal lumbar interbody fusion (TLIF) fusions are performed according to the insertion method during surgery. It can be classified as an intervertebral fusion prosthesis.
  • the size of the cage is determined through simulation in advance to predict the spine line after surgery, or an ideal spine line after surgery is assumed. It provides a means to predict the physical dimensions of suitable cages.
  • a vertebral body fusion surgery simulation method includes an image processing step of recognizing and separating images of each vertebral body through image processing from an X-ray photograph of a patient; an operation level determination step performed in parallel with the image processing step and determining a surgical site by selecting vertebral bodies into which a cage is to be inserted from the X-ray photograph or an MRI photograph corresponding to the X-ray photograph; and a simulation step of receiving the separated vertebral body image and information on the determined surgical part, arranging the separated vertebral body images according to a first kyphosis line, and providing the separated vertebral body images to the user.
  • the image processing step may include: a first image processing step of recognizing each vertebral body through edge detection and binarization image processing from the X-ray photograph; and a second image processing step of storing the recognized vertebral bodies as individual object images.
  • the first kyphosis line may be an arrangement line in which vertebral bodies are arranged according to preset angles of the first lumbar vertebrae and the fifth lumbar vertebrae.
  • the preset angles of the first lumbar vertebrae and the fifth lumbar vertebrae may be 28 degrees to 32 degrees.
  • the operation level determining step may receive input from the user adjacent vertebral bodies into which the cage is to be inserted and determine the operation site.
  • the operation level determination step when the distance between adjacent vertebral bodies is less than or equal to the standard, when the change in brightness to white at the boundary of the vertebral body is greater than or equal to the reference value, when the degree of osteophyte development of the vertebral body is greater than or equal to the standard, and whether compression fracture is recognized You can display that part to the user.
  • the first kyphotic line may be determined by reflecting the distance and rotation angle range of each vertebral body recognized from the x-ray image of the patient in a bent state and an x-ray image in a bent state.
  • the vertebral bodies to be non-surgical are first arranged along the first kyphotic line, and then the vertebral bodies corresponding to the surgical site are arranged, and appropriate according to the distance and angle between the vertebral bodies corresponding to the surgical site.
  • the physical dimensions of the cage can be recommended.
  • the first kyphotic line may be finely adjusted according to the user's input.
  • the vertical and horizontal positions and rotation angles of each of the vertebral bodies may be adjusted by the user's input.
  • an image of a cage having a suitable standard between the vertebral bodies corresponding to the surgical site may be further displayed on the corresponding surgical site.
  • the physical standard of the displayed cage image may be changed according to the user's input, and the arrangement of the vertebral bodies may be changed according to the changed physical standard of the cage image.
  • the vertebral body fusion surgery simulation method minimizes the hassle of confirming the prognosis of the surgery through the post-operative x-ray photograph by allowing the cage to be inserted and fixed in advance through simulation and trial and error is eliminated. has the effect of reducing it.
  • 1 is a photograph showing the appearance of general intervertebral body fusion prosthesis.
  • FIG. 2 is a block diagram illustrating a vertebral body fusion surgery simulation system according to an embodiment of the present invention.
  • FIG. 3 is a flowchart illustrating a vertebral body fusion surgery simulation method according to an embodiment.
  • FIG. 4 is an X-ray photograph showing the lumbar spine of a patient.
  • FIG. 5 is a diagram illustrating separated vertebral body images of a patient.
  • 6 and 7 are diagrams showing an abnormal state of the vertebral body due to degeneration or fracture.
  • FIG. 8 is a diagram illustrating an embodiment of arranging separated vertebral body images.
  • 9 to 11 show X-ray photographs of the patient in a normal posture, bent forward, and tilted back, respectively.
  • FIG. 12 is a diagram illustrating vertebral bodies arranged along a kyphotic line in consideration of a patient's physical characteristics and condition.
  • FIG. 13 is a diagram illustrating the difference between the arrangement of the vertebral bodies of FIG. 12 and an ideal kyphotic line.
  • a vertebral body fusion surgery simulation method includes an image processing step of recognizing and separating images of each vertebral body through image processing from an X-ray photograph of a patient; a surgical level determination step performed in parallel with the image processing step and determining a surgical site by selecting vertebral bodies into which a cage is to be inserted from the X-ray photograph or an MRI photograph corresponding to the X-ray photograph; and a simulation step of receiving the separated vertebral body image and information on the determined surgical part, arranging the separated vertebral body images according to a first kyphosis line, and providing the separated vertebral body images to the user.
  • the vertebral body fusion surgery is an operation to release the surgical application site, that is, the part where the nerve is pressed a lot, and fix it with a cage.
  • the vertebral body fusion surgery simulation method according to the present invention confirms the spinal line according to the cage or the size of the cage suitable for the ideal spinal line by checking the part to be inserted and fixed in the cage in advance through simulation. -Ray images have the effect of minimizing the hassle of confirming the prognosis of surgery and reducing trial and error.
  • the vertebral body fusion surgery simulation method according to the present invention is divided into an image processing and patient condition analysis process performed in parallel as a pre-step, and a simulation process using the same after that.
  • image processing and patient condition analysis process performed in parallel as a pre-step
  • simulation process using the same after that will be described in detail.
  • FIGS. 2 to 8 A vertebral body fusion surgery simulation system and method according to the first embodiment will be described with reference to FIGS. 2 to 8 .
  • 2 is a block diagram illustrating a vertebral body fusion surgery simulation system according to an embodiment of the present invention
  • FIG. 3 is a flowchart illustrating a vertebral body fusion surgery simulation method according to an embodiment.
  • the vertebral body fusion surgery simulation method includes an image processing step (S100), a surgical level determination step (S200), and a simulation step (S300) as shown in FIG. 3 .
  • the image processing step (S100) is a step of separating the images of each vertebral body from the X-ray photograph through image processing
  • the surgical level determination step (S200) is a step performed in parallel with the image processing step (S100). It is a step of determining the surgery, that is, the surgical part into which the cage is to be inserted using a ray photograph, etc.
  • the simulation step (S300) is a step of performing a simulation of vertebral body fusion surgery using the separated vertebral body image and data on the determined surgical part am.
  • the image processing step S100 is performed by the image processing unit 200 using patient-related information, such as an X-ray image input from the patient information input unit 100 or read from an existing database through the patient information input unit 100 .
  • patient-related information such as an X-ray image input from the patient information input unit 100 or read from an existing database through the patient information input unit 100 .
  • the operation level determination unit 300 provides the user with data that can check the state of the patient's vertebral bodies, such as X-ray photos, and provides information about the vertebral body to which the vertebral body fusion operation will be performed from the user. get input
  • the simulation step (S300) is performed by the simulation unit 400, and indicates to the user the arrangement of the vertebral body according to the insertion of the cage according to a specific standard, or the physical standard of the cage to be applied to the surgical site according to the setting of the vertebral body line after surgery. provide users with information about
  • the vertebral body that is, each of the five lumbar vertebrae in particular, is recognized from the x-ray photograph.
  • the first process can be performed using the X-ray image.
  • the vertebrae particularly the lumbar vertebrae, are numbered from 1 to 5 from the top as shown in FIG. 4 , and the thoracic vertebrae are connected to the upper part of the lumbar vertebrae, and the sacrum (tailbone) and the coccyx are connected to the lower lumbar vertebrae.
  • a task of recognizing each of these vertebral bodies on an image is performed.
  • This recognition operation may be performed by recognizing the outline of the vertebral body using edge detection and binarization among image processing techniques.
  • each vertebral body recognized from a photograph of a vertebral body of a patient with an abnormality such as anterior curvature is separated into a separate image.
  • the separated vertebral body image is separated and stored as a separate object for each vertebral body, and is arranged to enable movement and rotation for each vertebral body on the image.
  • the surgical level that is, the surgical site is determined and input. At this time, it can be determined as the "part where the nerve is pressed" through MRI, or the "part that looks the most severe” on the x-ray image can be determined as the part where the cage is to be inserted.
  • the "part where the nerve is pressed” does not necessarily correspond to the "part that looks the most severe” on the x-ray image, and can be confirmed through MRI.
  • Determination of the surgical site for example, when two cages are inserted, can be determined as "the most severe part" in the X-ray picture as follows without taking an MRI.
  • the distance and angle between the vertebral bodies determined as the surgical site are determined according to the physical dimensions of the cage, but the remaining vertebral bodies naturally change according to the angle change of the cage inserted into the surgical site or the patient's original physical characteristics or condition. do.
  • the determination of "the most severe part" on the X-ray can be determined by referring to the following conditions.
  • the degree of stenosis between the upper vertebral body and the lower vertebral body is determined through the distance between the upper and lower vertebral bodies, and when the distance between the upper and lower vertebral bodies is close to a certain degree or more, it can be determined that the stenosis has progressed.
  • the degree of degenerative change (degree of sclerosis) can be determined. As shown in FIG. 6 , in the X-ray image, a white brightness change (P1) occurs at the boundary of the vertebral body, or the degree of bone spurs (P2) may be considered. Normal vertebrae have a uniform height and smooth edges, whereas degenerated vertebrae are distorted, overgrown, and unevenly spaced.
  • the presence or absence of a compression fracture can be considered.
  • the degree of deformation of one side due to compression compared to a normal vertebral body may be considered.
  • the surgical level determining unit 300 displays such an abnormal state on the X-ray image to provide information so that the user can determine the number of surgical sites and cage insertions, and receives information on the surgical site and cage insertion from the user. .
  • the vertebral bodies on the X-ray in which abnormalities are found may be recognized and displayed to the user so that a surgical site may be input from the user or the user may select.
  • the separated vertebral body image is displayed in a normal state (kyphosis, L2), for example, the angle between the 1st lumbar vertebrae (A1) and the 5th lumbar vertebrae (A5) is 28 degrees to 32 degrees, preferably about 30 degrees, is determined in advance and arranged in a state closest to it.
  • kyphosis L2
  • the angle between the 1st lumbar vertebrae (A1) and the 5th lumbar vertebrae (A5) is 28 degrees to 32 degrees, preferably about 30 degrees, is determined in advance and arranged in a state closest to it.
  • the vertebral bodies 1, 2, and 3 that are not the surgical site are arranged at a predetermined angle according to the predetermined angle with respect to the kyphotic (L2) state, that is, the 1st and 5th lumbar vertebrae.
  • the front curve (L1) to the kyphosis (L2) state is changed, the frontal space of each vertebral body is expanded, and the vertebral bodies are in a state of rotation from the front part to the rear part.
  • the arrangement in the kyphotic state can be achieved.
  • the spacing and angle of the vertebral bodies (between No. 3 and No. 4, No. 4 and No. 5) determined as the surgical site are determined according to the insertion of the cage rather than depending on the patient's biological characteristics or condition.
  • the kyphotic angle can be formed by setting the interval and the degree of rotation to the remaining vertebral bodies by setting the interval and the degree of rotation of the first lumbar vertebra to the maximum value.
  • the simulation unit 400 recommends the size of the cage to be inserted between No. 3 and No. 4 and the size of the cage to be inserted between No. 4 and No. 5, or by applying a pre-prepared cage image to the corresponding surgical site. make it possible to check
  • FIGS. 9 to 11 show X-ray photographs of the patient in a normal posture, bent forward, and tilted back, respectively.
  • the vertebral body fusion surgery simulation method according to the second embodiment is different in terms of a method of arranging images of each of the separated vertebral bodies.
  • X-ray pictures of the patient are taken and received in three sets of a correct posture, a forward bent posture, and a backward posture.
  • the image processing unit 200 recognizes each vertebral body from the three sets of x-ray pictures, and calculates an interval and an angle between each vertebral body.
  • the simulation unit 400 may consider the patient's body characteristics obtained from three sets of photos when determining the angle of the kyphosis, that is, the interval between the 1st lumbar vertebra and the 5th lumbar vertebra. In addition, after determining the distance between each vertebral body to be non-surgical in consideration of the x-ray set image, the distance and angle of the surgical site can be formed.
  • FIGS. 12 and 13 A vertebral body fusion surgery simulation method according to the third embodiment will be described with reference to FIGS. 12 and 13 .
  • 12 is a diagram illustrating vertebral bodies arranged along a kyphotic line in consideration of a patient's physical characteristics and condition
  • FIG. 13 is a diagram illustrating a difference between the arrangement of the vertebral bodies of FIG. 12 and an ideal kyphotic line.
  • the vertebral body fusion surgery simulation method relates to a technique for adding a function to manually fine-tune the distance and angle of the vertebral bodies compared to the previously described embodiment.
  • the simulation unit 400 provides, for example, the following functions so that the user can make fine adjustments.
  • the actual post-operative kyphotic spine line can be set through fine adjustment.
  • the horizontal and vertical movement and rotation functions of the 1st to 5th lumbar vertebrae (vertebrae) for various purposes such as minimizing the physical size of each cage (C1, C2) and preventing the patient's body from putting a strain on the patient's body provides the ability to do it manually.
  • each cage C1, C2
  • the line in which the entire vertebral bodies are arranged is changed.

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  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Molecular Biology (AREA)
  • Transplantation (AREA)
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  • Oral & Maxillofacial Surgery (AREA)
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  • Apparatus For Radiation Diagnosis (AREA)

Abstract

Un procédé de simulation de chirurgie de fusion de corps vertébraux selon la présente invention comprend : une étape de traitement d'image pour reconnaître et séparer, à partir d'une image aux rayons X d'un patient, une image de chaque corps vertébral par l'intermédiaire d'un traitement d'image ; une étape de détermination de niveau de chirurgie effectuée en parallèle avec l'étape de traitement d'image et la détermination d'un site chirurgical par sélection de corps vertébraux dans lesquels une cage doit être introduite, à partir de l'image aux rayons X ou d'une image IRM correspondant à l'image aux rayons X ; et une étape de simulation pour agencer les images séparées de corps vertébraux selon une première ligne de courbe postérieure par réception des images séparées des corps vertébraux et des informations concernant le site chirurgical déterminé, et la fourniture de celles-ci à un utilisateur.
PCT/KR2021/004246 2020-04-10 2021-04-06 Procédé de simulation de chirurgie de fusion de corps vertébraux Ceased WO2021206403A1 (fr)

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KR10-2020-0044166 2020-04-10

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WO2025239649A1 (fr) * 2024-05-13 2025-11-20 영남대학교 산학협력단 Appareil et procédé de mesure de la rotation spinale

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