PDF(Pubmed)
Abstract：
UNASSIGNED: Many diseases of the spine require surgical treatments that are currently performed based on the experience of the surgeon. The basis of this study is to deliver an automatic and patient-specific algorithm able to come to the aid of the surgeons in pedicle arthrodesis operations, by finding the optimal direction of the screw insertion, the maximum screw diameter and the maximum screw length.
UNASSIGNED: The paper introduce an algorithm based on the reconstructed geometry of a vertebra by 3D-scan that is able to identify the best introduction direction for screw and to select, from commercial and/or personalised databases, the best screws in order to maximize the occupation of the bone while not intersecting each other and not going through the walls of the pedicle and the bounds of the vertebral body. In fact, for pedicle arthrodesis surgery, the incorrect positioning of the screws may cause operating failures, an increase in the overall duration of surgery and, therefore, more harmful, real-time X-ray checks. In case of not availability on market, the algorithm also suggests parameters for designing and manufacturing an \'ad hoc\' solution. The algorithm has been tested on 6 vertebras extracted by a medical database. Furthermore, the algorithm is based on a procedure through which the surgeon can freely choose the entering point of the screw (based on his/her own experience and will). A real patient vertebra has been processed with almost 400 different entering point, always giving a feedback on the possibility to use the entering point (in case of unavailability of a good trajectory) and on the individuation of the right trajectory and the choose of the better screws.
UNASSIGNED: In very recent bibliography, several papers deal with procedure to screw\' trajectory planning in arthrodesis surgery by using Computer Aided surgery systems, and some of them used also modern methodologies (KBE, AI, Deep learning, etc.) methods for planning the surgery as better as possible. Nevertheless, no methodologies or algorithm have been still realized to plan the trajectory and choose the perfect fitting screws on the basis of the patient-specific vertebra. This paper represents a wind of novelty in this field and allow surgeons to use the proposed algorithm for planning their surgeries. Finally, it allows also the easy creation of a customized surgical template, characterized by two cylindrical guides that follow a correct trajectory previously calculated by means of that automatic algorithm generated on the basis of a vertebra CAD model for a specific patient. The surgeon will be able to set the template (drilling guides) on the patient\'s vertebra and safely apply the screws.
UNASSIGNED: The paper introduce an algorithm based on the reconstructed geometry of a vertebra by 3D-scan that is able to identify the best introduction direction for screw and to select, from commercial and/or personalised databases, the best screws in order to maximize the occupation of the bone while not intersecting each other and not going through the walls of the pedicle and the bounds of the vertebral body. In fact, for pedicle arthrodesis surgery, the incorrect positioning of the screws may cause operating failures, an increase in the overall duration of surgery and, therefore, more harmful, real-time X-ray checks. In case of not availability on market, the algorithm also suggests parameters for designing and manufacturing an \'ad hoc\' solution. The algorithm has been tested on 6 vertebras extracted by a medical database. Furthermore, the algorithm is based on a procedure through which the surgeon can freely choose the entering point of the screw (based on his/her own experience and will). A real patient vertebra has been processed with almost 400 different entering point, always giving a feedback on the possibility to use the entering point (in case of unavailability of a good trajectory) and on the individuation of the right trajectory and the choose of the better screws.
UNASSIGNED: In very recent bibliography, several papers deal with procedure to screw\' trajectory planning in arthrodesis surgery by using Computer Aided surgery systems, and some of them used also modern methodologies (KBE, AI, Deep learning, etc.) methods for planning the surgery as better as possible. Nevertheless, no methodologies or algorithm have been still realized to plan the trajectory and choose the perfect fitting screws on the basis of the patient-specific vertebra. This paper represents a wind of novelty in this field and allow surgeons to use the proposed algorithm for planning their surgeries. Finally, it allows also the easy creation of a customized surgical template, characterized by two cylindrical guides that follow a correct trajectory previously calculated by means of that automatic algorithm generated on the basis of a vertebra CAD model for a specific patient. The surgeon will be able to set the template (drilling guides) on the patient\'s vertebra and safely apply the screws.
摘要：
■许多脊柱疾病需要目前根据外科医生的经验进行的手术治疗。这项研究的基础是提供一种自动的，针对患者的算法，能够在椎弓根关节固定术中帮助外科医生，通过找到螺钉插入的最佳方向，最大螺杆直径和最大螺杆长度。
■本文介绍了一种基于通过3D扫描重建椎骨几何结构的算法，该算法能够识别螺钉的最佳引入方向并选择，来自商业和/或个性化数据库，最好的螺钉，以最大限度地占据骨头，同时不相互交叉，不穿过椎弓根壁和椎体的边界。事实上,用于椎弓根关节固定术,螺钉的不正确定位可能会导致操作故障，手术总持续时间的增加，因此,更有害,实时X射线检查。在市场上不可用的情况下，该算法还建议了用于设计和制造“临时”解决方案的参数。该算法已在医学数据库提取的6个椎骨上进行了测试。此外，该算法基于一个程序，通过该程序，外科医生可以自由选择螺钉的进入点（基于他/她自己的经验和意愿）。一个真正的患者椎骨已经处理了近400个不同的进入点，总是对使用进入点的可能性（在无法使用良好轨迹的情况下）以及正确轨迹的个性化和更好的螺钉的选择给予反馈。
■在最近的参考书目中，几篇论文涉及使用计算机辅助手术系统在关节固定术中进行螺旋轨迹规划的程序，其中一些还使用了现代方法(KBE，AI,深度学习,等。)计划手术的方法尽可能好。然而，仍然没有实现方法或算法来计划轨迹并根据患者特定的椎骨选择完美的配合螺钉。本文代表了该领域的新颖性，并允许外科医生使用所提出的算法来计划手术。最后,它还允许轻松创建定制的手术模板，其特征在于,两个圆柱形引导件遵循先前借助于基于针对特定患者的椎骨CAD模型生成的自动算法计算的正确轨迹。外科医生将能够在患者的椎骨上设置模板（钻孔导向）并安全地使用螺钉。
■本文介绍了一种基于通过3D扫描重建椎骨几何结构的算法，该算法能够识别螺钉的最佳引入方向并选择，来自商业和/或个性化数据库，最好的螺钉，以最大限度地占据骨头，同时不相互交叉，不穿过椎弓根壁和椎体的边界。事实上,用于椎弓根关节固定术,螺钉的不正确定位可能会导致操作故障，手术总持续时间的增加，因此,更有害,实时X射线检查。在市场上不可用的情况下，该算法还建议了用于设计和制造“临时”解决方案的参数。该算法已在医学数据库提取的6个椎骨上进行了测试。此外，该算法基于一个程序，通过该程序，外科医生可以自由选择螺钉的进入点（基于他/她自己的经验和意愿）。一个真正的患者椎骨已经处理了近400个不同的进入点，总是对使用进入点的可能性（在无法使用良好轨迹的情况下）以及正确轨迹的个性化和更好的螺钉的选择给予反馈。
■在最近的参考书目中，几篇论文涉及使用计算机辅助手术系统在关节固定术中进行螺旋轨迹规划的程序，其中一些还使用了现代方法(KBE，AI,深度学习,等。)计划手术的方法尽可能好。然而，仍然没有实现方法或算法来计划轨迹并根据患者特定的椎骨选择完美的配合螺钉。本文代表了该领域的新颖性，并允许外科医生使用所提出的算法来计划手术。最后,它还允许轻松创建定制的手术模板，其特征在于,两个圆柱形引导件遵循先前借助于基于针对特定患者的椎骨CAD模型生成的自动算法计算的正确轨迹。外科医生将能够在患者的椎骨上设置模板（钻孔导向）并安全地使用螺钉。
