CN100435735C - Human body orthopedic navigation system - Google Patents

Human body orthopedic navigation system Download PDF

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CN100435735C
CN100435735C CNB200610122578XA CN200610122578A CN100435735C CN 100435735 C CN100435735 C CN 100435735C CN B200610122578X A CNB200610122578X A CN B200610122578XA CN 200610122578 A CN200610122578 A CN 200610122578A CN 100435735 C CN100435735 C CN 100435735C
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servo
controller
type arm
arm
line machine
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CN1931097A (en
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李鉴轶
张美超
冯前进
鲍旭东
赵卫东
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Southern Medical University
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Southern Medical University
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Abstract

The present invention discloses one kind of human body orthopedic navigation system. The system has one computer with display and input terminal as the core, one CT or MR tomographic scanner connected to the I/O port of the computer, one C-arm or G-arm X ray unit, and one spatial servo location controller. The 2D images taken with the C-arm or G-arm X ray unit is first used in establishing virtual stereo operation scene, the 3D bone model established with CT or MR tomographic scanner before operation is then set into the established virtual stereo scene for registration to obtain position mapping relation between the 3D bone model and the 2D images, and the spatial servo location controller is finally computer controlled for orthopedic navigation. The system of the present invention has saving in apparatus investment and no strict requirement in the electromagnetic interference resisting capacity of the operation room.

Description

A kind of human body orthopedic navigation system
Technical field
The present invention relates to a kind of surgical operating instrument, be specifically related to the three-dimensional location of a kind of bone surgery, navigation system.
Background technology
Surgical navigational under the area of computer aided is a brand new technical that is rising, it is based on medical image, assisting down of high-performance computer and professional software, by track and localization to operating theater instruments, realize the visual of Minimally Invasive Surgery, thereby improve the success rate of operation greatly, reduced the appearance of postoperative complication.
Present orthopaedics operation navigation system mainly divides two classes:
One class is led with C type arm X line power traction, the image document that center C type arm X-ray perspective machine obtains operative region such as pass through, image data set is transferred to image guiding work station, work station designs and demonstrates the track of the pedicle screw that will insert, inserts pedicle screw under a series of continuous images guiding.Although C type arm X line image perspective navigation system can compare U.S. with the accuracy of 3-D view navigation system, strictly speaking, it still is a two dimensional navigation system, can not provide three dimension system such more intuitive image.
Another kind of is to navigate in the basis with the three-dimensional reconstruction data, clinically in extensive use and the comparatively sophisticated spinal operation air navigation aid, the most intuitive and reliable with 3D-CT and 3D-MR method abroad.Present following factor has restricted the popularization of MRI in the spinal operation navigation: (1) costs an arm and a leg, and general patient is difficult to accept; (2) require metallic weapons such as operation, anesthesia necessary antimagnetic, operating room must be special-purpose, and this is difficult to accomplish in general hospital; (3) MRI has limited the working place of operator, makes troubles to operation; (4) MRI is undesirable to the development of bone structure.CASSNS based on 3D-CT mainly is made of CT, navigation system, central control system in the art.It obtains and finishes the CT scan 3D image reconstruction of area for treatment vertebra before art, be stored in the computer; In operation, utilize space positioning system that real-time tracking is carried out in the position of scalpel or navigation rod, and the 3-D view of rebuilding before its position and the art is presented on the screen jointly based on technology such as infrared ray, electromagnetism.Surgeon is by observing the relative position of scalpel or navigation rod and vertebra, in operation, constantly adjust position and direction, or by robotics, according to the information of from tracker, obtaining, automatically adjust position and direction, make operation finish according to working out good plan in advance.Though can guarantee to cost an arm and a leg the needs of bone surgery, limited the application of navigator and popularized based on the navigator precision of infrared technology and electromagnetic technique.
The 2D/3D image registration techniques has been carried out in existing research, and [TomazevicD waits .3-D/2-Dregistration of CT and MR to X-ray images.IEEE Trans Med Imaging.2003Nov to Tomazevic etc.; 22 (11): 1407-1416.] proposition is based on the new method of one or many two-dimentional X line image autoregistration three-dimensional CT images, this method is used the shade of gray of X line image and 3-D view surface predefine point, the rigid transformation of primary study CT volume data is by the optimum matching between amplitude and directional information realization surface normal and the contrary projection gradient.Lumbar vertebra is carried out registration checking with the method, and registration speed is very fast, at displacement 6mm, rotate 17 ° within the time, its success rate is 91%.The root-mean-square error of image registration is 0.5mm.[Li G such as Li G, Wuerz TH, DeFrate LE. Feasibility of using orthogonalfluoroscopic images to measure in vivo joint kinematics.J Biomech Eng.2004,126 (2): 314-318.] report utilizes the kneed three dimensional structure of MRI image reconstruction, take the knee joint X-ray film under the different flexion of patient then, with the knee joint of the X line plain film of various flexion and three-dimensional reconstruction registration mutually, the position change of each bone structure of knee joint in the time of just can obtaining different flexion angle, and reported that 2D/3D registration accuracy to the regular shape object can reach 0.1mm and 0.1 °.Still not having bibliographical information at present utilizes 2D/3D method for registering images production orthopaedics navigator to be applied to clinical.
In addition, in the above-mentioned prior art, utilize the image registration of the navigator of threedimensional model registration all to need surgical incision skin, behind the expose portion osseous tissue, could realize the registration of the position, Virtual Space in patient's real space position and the computer.These navigators can not be applied to as operations such as percutaneous vertebroplasty and percutaneous balloon expandable plastys.
State know the office on November 26th, 2003 Granted publication a kind of " based on the electromagnetic image guided surgery equipment of C type arm X-ray machine " (notification number is: 2587369) utility model patent, the described equipment of this utility model patent is by C type arm X-ray machine, the magnetic field tracking device, control section and display part are formed, just obtaining the patient by gathering and handle C type arm X-ray machine before the art, side bit image information is delivered to control section and is handled, proofread and correct, registration, by Magnetic Field Source in the magnetic field tracking device and image calibration device the most advanced and sophisticated spatial positional information of instrument handle being delivered to control section again handles, proofread and correct, registration, thus set up the mapping relations of medical image and locating and tracking system and show in the display part; The pick off that is located in the art on the instrument handle is constantly experienced the Magnetic Field that Magnetic Field Source is sent, and the most advanced and sophisticated locus of instrument handle is presented at the patient that obtains before the art just, on the side bit image, realize the navigation of operation.This utility model patent also is based on the navigator of infrared technology and electromagnetic technique, though precision can guarantee the needs of bone surgery, not only needs surgical incision skin, and equipment is also very expensive, is difficult to penetration and promotion equally.
Summary of the invention
In view of there is above-mentioned deficiency in prior art, the purpose of this invention is to provide a kind of improved human body orthopedic navigation system, this system not only has the three-dimensional navigation effect, and it is little to have an equipment investment, the advantage that surgery cost is low.
The present invention realizes that the technical scheme of above-mentioned purpose is:
A kind of human body orthopedic navigation system is characterized in that:
This system is a core with the computer with demonstration and input terminal, establishes a CT or MR tomoscanner, a C type arm or G type arm X line machine and a space servo-positioning controller on its input/output end port respectively; Described
Space servo-positioning controller is located at C type arm or G type arm X line machine emission source and receives between the head, and adjusts the locus and the attitude of operating theater instruments anchor clamps; Described
CT or MR tomoscanner carry out tomoscan to the corrective surgery position; Described
C type arm or G type arm X line machine are taken two X-ray films that the corrective surgery position becomes 30~90 degree; Described
Computer imports the scan-data of CT or MR tomoscanner earlier, carry out three-dimensional reconstruction, obtain patient's bone threedimensional model, that gathers that C type arm or G type arm X line machine take contains corrective surgery position osseous tissue information again, the image that contains the relative position information between servo-positioning controller and the corrective surgery position osseous tissue that has living space again, and assignment is on screen, set up virtual three-dimensional surgical scene, then patient's bone threedimensional model is inserted in the virtual three-dimensional scene of being set up and carry out 2D/3D image registration, set up the position mapping relations between the patient's bone threedimensional model and C type arm or G type arm X line machine bidimensional image under the surgical environments, realize surgical navigational by computer control space servo-positioning controller at last.
A kind of human body orthopedic navigation system of the present invention, wherein said space servo-positioning controller by two plane servo-positioning controllers of upper and lower settings, be located at operating theater instruments anchor clamps on the two plane servo-positioning controllers respectively, the vertical connecting and the support column that connect two plane servo-positioning controllers form; Wherein,
Each plane servo-positioning controller is by vertically disposed horizontal linear servo controller and vertically linear servo controller composition mutually, wherein on the horizontal servomechanism installation that vertically of the long rails of linear servo controller is fixed on horizontal linear servo controller, the other end is enclosed within on the guide rod of horizontal linear servo controller;
Two operating theater instruments anchor clamps are separately fixed at up and down on the two servo longitudinal devices;
Two support columns are separately fixed at the middle part of the horizontal brace rod at servo-positioning controller two, plane.
A kind of human body orthopedic navigation system of the present invention, another formation scheme of wherein said space servo-positioning controller is: intersect on the column and fix a transverse arm, the end of transverse arm is hinged with universal movable joint, upright arm, universal movable joint, trailing arm successively, the end of trailing arm is hinged with an angle servo controller, and the operating theater instruments anchor clamps are fixed on the angle servo controller; Wherein said universal movable joint constitutes: establish a connector on the output shaft of servomotor, the outside of this connector and the afterbody of servomotor are respectively equipped with orthogonal connecting pin.
Human body orthopedic navigation system of the present invention adopts servo-positioning controller in space to replace infrared ray of the prior art or electromagnetism tracking means, the bidimensional image that utilizes C type arm or G type arm X line machine to take is set up virtual three-dimensional surgical scene, and insert and carry out registration in the virtual three-dimensional scene of being set up rebuilding good patient's bone threedimensional model before the art, obtain the position mapping relations between bone threedimensional model and the bidimensional image, at last by the navigation that undergos surgery of computer control space servo-positioning controller, have following advantage and effect than prior art: 1, because it all is known being located at the size of the space servo-positioning controller between C type arm or G type arm X line machine emission source and the reception head and the kinematic parameter of servo controller, therefore as long as registration accuracy is enough high, although the three-dimensional surgical scene of being set up is virtual, its 3-D effect and Navigation Control precision can satisfy the needs of bone surgery; 2, utilize the preceding true osseous tissue of rebuilding good patient's bone threedimensional model simulated patient of art, need not surgical incision skin, expose portion osseous tissue and just can see the relative position of operating theater instruments and patient's osseous tissue intuitively, so just can navigate, improve the safety of this type of operation operation techniques such as biopsy, vertebroplasties; 3, both can save equipment investment, also need not the ability of the overcritical anti-electromagnetic interference of operating room, and help applying.
Description of drawings
Fig. 1 is that human body orthopedic navigation system of the present invention is formed structural representation;
Fig. 2 is the structural representation of a kind of embodiment 4A of collective of servo-positioning controller in space of the present invention;
Fig. 3 is the structural representation of the another kind of embodiment 4B of collective of servo-positioning controller in space of the present invention.
Fig. 4 and Fig. 5 are the structural representation of universal movable joint 4B-3 among Fig. 3, and wherein Fig. 4 is a front view, and Fig. 5 is a vertical view.
The structural representation of Fig. 6 operating theater instruments anchor clamps 4B-7.
The specific embodiment
Below in conjunction with accompanying drawing the present invention is explained in further detail, so that the public grasps concrete enforcement means of the present invention better, fully understand advantage and effect that the present invention has, but the present invention is not limit by described embodiment.
Referring to Fig. 1, human body orthopedic navigation system of the present invention is a core with the computer 1 with demonstration and input terminal, establishes a CT tomoscanner 2, a C type arm X line machine 3 and a space servo- positioning controller 4A or 4B respectively and form on the input/output end port of computer 1.Wherein, described space servo- positioning controller 4A or 4B are located at the emission source of C type arm X line machine 3 and receive between the head.The terminal unit that system of the present invention adopts is known equipment except that space servo- positioning controller 4A or 4B, wherein the CT tomoscanner can replace with the MR tomoscanner, and C type arm X line machine can replace with G type arm X line machine.
Human body orthopedic navigation system of the present invention, wherein space servo- positioning controller 4A or 4B are to adjust the attitude of operating theater instruments 5 and the site, space of operating theater instruments 5 cutting edges under the control of computer 1 automatically in the effect that whole system is born.Space servo-positioning controller (referring to Fig. 3 and Fig. 4) in two kinds of concrete structures that Fig. 3, Fig. 4 require to design for system according to the invention.
Fig. 2 is the structural representation of a kind of embodiment 4A of collective of servo-positioning controller in space of the present invention.Referring to Fig. 2, the cross track 4A-2 that be arranged in parallel and guide rod 4A-1 and the horizontal brace rod 4A-3 that is connected the two connect and compose a rectangular frame, and laterally servomechanism installation 4A-4 is located at cross track 4A-2 and goes up and constitute described horizontal linear servo controller; One of long rails 4A-6 is fixed on the horizontal servomechanism installation 4A-4, and the other end is enclosed within on the described guide rod 4A-1, and a servo longitudinal device 4A-5 constitutes a vertical linear servo controller; Be provided with vertical with vertical linear servo controller of described horizontal linear servo controller constitutes described plane servo-positioning controller.The flat up and down shape of the plane servo-positioning controller that two structures are identical is provided with, and corner is connected to form a rectangle hexahedron by four vertical connecting 4A-8.On the two servo longitudinal device 4A-5, operating theater instruments (being hand drill in embodiment illustrated in fig. 2) 5 the attitude and the site, space of operating theater instruments 5 cutting edges can be adjusted in the position of two servo longitudinal device 4A-5 about adjusting about two operating theater instruments anchor clamps 4A-7 were separately fixed at.Two support column 4A-9 are separately fixed at the middle part of the horizontal brace rod 4A-3 at servo-positioning controller two, plane.
Fig. 3 is the structural representation of the another kind of embodiment 4B of collective of servo-positioning controller in space of the present invention.Referring to Fig. 3, one column 4B-1 goes up to intersect and fixes a transverse arm 4B-2, the end of transverse arm 4B-2 is hinged with universal movable joint 4B-3, upright arm 4B-4, universal movable joint 4B-3, trailing arm 4B-5 successively, the end of trailing arm 4B-5 is hinged with an angle servo controller 4B-6, and operating theater instruments anchor clamps 4B-7 is fixed on the angle servo controller 4B-6; Wherein universal movable joint 4B-3 constitutes like this: establish a connector 4B-3-2 on the output shaft of servomotor 4B-3-1, the outside of this connector 4B-3-2 and the afterbody of servomotor 4B-3-1 are respectively equipped with orthogonal connecting pin 4B-3-3,4B-3-4 (seeing Fig. 4 and Fig. 5); Wherein angle servo controller 4B-6 is made of a pulse corner motor 4B-6-1, and the afterbody of this pulse corner motor 4B-6-1 is also established a connecting pin 4B-6-2, and operating theater instruments anchor clamps 4B-7 is located at the output shaft (see figure 6) of pulse corner motor 4B-6-1.Reach between trailing arm 4B-5 and the angle servo controller 4B-6 between transverse arm 4B-2, upright arm 4B-4 and trailing arm 4B-5 and the universal movable joint 4B-3 and fix (seeing Fig. 4 and Fig. 5) by dog screw 4B-8.
Fig. 3 also is a kind of user mode figure of the space servo-positioning controller embodiment 4B of collective of the present invention.Referring to Fig. 3 and in conjunction with Fig. 4 and Fig. 5 and Fig. 6, transverse arm 4B-2, upright arm 4B-4 and trailing arm 4B-5 are mutually the universal movable joint 4B-3 that 90 degree are provided with by two successively and are connected, and wherein the connecting pin 4B-3-4 of the end of transverse arm 4B-2 and servomotor 4B-3-1 afterbody is hinged and fixed by dog screw 4B-8; The outside connecting pin 4B-3-3 with the connector 4B-3-2 of last one universal movable joint 4B-3 of upright arm 4B-4 is hinged, and the connecting pin 4B-3-4 of the servomotor 4B-3-1 afterbody of other end and next universal movable joint 4B-3 is hinged; The outside connecting pin 4B-3-3 with the connector 4B-3-2 of universal movable joint 4B-3 of trailing arm 4B-5 is hinged, and the connecting pin 4B-6-2 of the pulse corner motor 4B-6-1 afterbody of other end and angle servo controller 4B-6 is hinged.Connecting pin 4B-3-3 among the universal movable joint 4B-3 of the other end of connecting pin 4B-6-2 and trailing arm 4B-5 is 90 degree each other.
Referring to Fig. 3 and in conjunction with Fig. 4 and Fig. 5 and Fig. 6, before the use, lesions position according to patient, loosening dog screw 4B-8, can be in 0~± 90 degree scope fixing universal movable joint 4B-3 of manual adjustments or angle servo controller 4B-6 in advance, self-support arm 4B-4 all can be rotated in the face that becomes fixed angle (0~± 90 degree) with last rod member by (servomotor or pulse corner) Electric Machine Control to all rod members of operating theater instruments 5 like this, thus adjustment operating theater instruments (being hand drill in embodiment illustrated in fig. 3) 5 the attitude and the site, space of operating theater instruments 5 cutting edges.
Be example with pedicle puncture procedure below, describe the operation principle and the using method of human body orthopedic navigation system of the present invention in detail compression fracture of vertabral body patient row vertebroplasty.
With carrying out lumbar vertebra scanning before 2 pairs of patient's Rhizoma Atractylodis Macrocephalae of CT tomoscanner, view data is imported three-dimensional reconstruction software Mimics9.11 (Belgian Materialise company), utilize technology such as image segmentation and reconstruction that osseous tissue is carried out three-dimensional reconstruction, set up each vertebra three-dimensional configuration, rebuild good threedimensional model and preserve with the output of STL form.
The patient enters after operating room fixes operation position, has fixedly mounted space servo-positioning controller 4A on operation table.Utilize C type arm X line machine 3 take operative sites be mutually the right angle just, side position X-ray film, this X line is just, lateral projection both comprised corrective surgery position osseous tissue, has comprised space servo-positioning controller 4A again.Described X line just, the angle of cut of lateral projection is advisable 90 degree best (can remove) with 30~90 degree.With the X line of gained just, lateral projection imports in the virtual two-dimensional camera system of being set up by 3ds max software by the former angle of cut, and with its assignment on screen.
Then will rebuild good bone threedimensional model imports in the above-mentioned virtual two-dimensional camera system, with the mimic C type of virtual video camera light source arm X line machine 3 emission sources in the 3ds max software with the threedimensional model orthographic projection in the X line just, on the plane, lateral projection place, by with screen on the C type arm X line machine real image given registration mutually, set up the position mapping relations between the patient's bone structure and C type arm X line machine 3 bidimensional images under the surgical environments.Again the threedimensional model of known space servo-positioning controller 4A is called in the virtual two-dimensional camera system of being set up, adopt the position mapping relations between same procedure implementation space servo-positioning controller and the C type arm X line bidimensional image, finally realize the position mapping relations between patient's bone structure and the space servo-positioning controller 4A, finish the Location Registration of navigation system.
Intuitively reproduce the secure path that pedicle nail is inserted in operation according to the three-dimensional configuration of lumbar vertebra at last, calculate the three-dimensional relationship of this secure path and patient's lumbar vertebra, and be converted to the positional parameter of the required adjusting of space servo-positioning controller 4A.At this moment, determine to adjust the locus of two points that operating theater instruments (hand drill) 5 will pass through, fix the hand drill cover and insert hand drill again and promptly finish surgical navigational by computer 1 control two plane servo-positioning controller adjustment.
The using method of space servo-positioning controller 4B shown in Figure 3, the public can be with reference to top description, and analyzes voluntarily in conjunction with Fig. 3 and structrual description thereof.

Claims (1)

1, a kind of human body orthopedic navigation system, this system shows and the computer (1) of input terminal is a core to have, on its input/output end port, establish respectively a CT or MR tomoscanner (2) ,-C type arm X line machine or a G type arm X line machine (3) and a space servo-positioning controller (4A); Described CT or MR tomoscanner (2) carry out tomoscan to the corrective surgery position; Described C type arm X line machine or G type arm X line machine (3) are taken two X-ray films that the corrective surgery position becomes 30~90 degree; Described computer imports the scan-data of CT or MR tomoscanner (2) earlier, carries out three-dimensional reconstruction, obtains patient's bone threedimensional model; That gathers that C type arm X line machine or G type arm X line machine (3) take both contains corrective surgery position osseous tissue information again, the image that contains the relative position information between servo-positioning controller and the corrective surgery position osseous tissue that has living space again, and assignment is set up virtual three-dimensional surgical scene on screen; Then patient's bone threedimensional model is inserted in the virtual three-dimensional scene of being set up and carry out 2D/3D image registration, set up the position mapping relations between the patient's bone threedimensional model and C type arm X line machine or G type arm X line machine (3) bidimensional image under the surgical environments, realize surgical navigational by computer (1) control space servo-positioning controller (4A) at last, it is characterized in that:
Described space servo-positioning controller (4A) by two plane servo-positioning controllers of upper and lower settings, be located at operating theater instruments anchor clamps (4A-7) on the two plane servo-positioning controllers, the vertical connecting (4A-8) that connects two plane servo-positioning controllers and support column (4A-9) respectively and form; Wherein,
Described plane servo-positioning controller is by vertically disposed horizontal linear servo controller and vertical linear servo controller are formed mutually, wherein on the horizontal servomechanism installation (4A-4) that vertically of the long rails (4A-6) of linear servo controller is fixed on horizontal linear servo controller, the other end is enclosed within on the guide rod (4A-1) of horizontal linear servo controller;
Two operating theater instruments anchor clamps (4A-7) are separately fixed on the servo longitudinal device (4A-5) of two vertical linear servo controllers up and down;
Two support columns (4A-9) are separately fixed at the middle part of the horizontal brace rod (4A-3) at servo-positioning controller two, plane.
CNB200610122578XA 2006-09-30 2006-09-30 Human body orthopedic navigation system Expired - Fee Related CN100435735C (en)

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CN112717281B (en) * 2021-01-14 2022-07-08 重庆翰恒医疗科技有限公司 Medical robot platform and control method

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