CN111000620A - Guide template for percutaneous vertebroplasty and manufacturing and resetting method thereof - Google Patents
Guide template for percutaneous vertebroplasty and manufacturing and resetting method thereof Download PDFInfo
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- CN111000620A CN111000620A CN201911250255.2A CN201911250255A CN111000620A CN 111000620 A CN111000620 A CN 111000620A CN 201911250255 A CN201911250255 A CN 201911250255A CN 111000620 A CN111000620 A CN 111000620A
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- A61B17/34—Trocars; Puncturing needles
- A61B17/3472—Trocars; Puncturing needles for bones, e.g. intraosseus injections
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- 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 ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7094—Solid vertebral fillers; devices for inserting such fillers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
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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
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
- B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
- B29C64/00—Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
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- 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
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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
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Abstract
The invention provides a guide template for percutaneous vertebroplasty, which comprises a template body and a matched guide column, wherein the template body comprises a positioning plate, and the shape of the positioning plate is matched with the skin of a diseased centrum region; the positioning plate is provided with 2 guide post inserting holes, the central line direction of the guide post inserting holes is the puncture path direction, inner holes and outer walls of the guide post inserting holes are conical, the positioning plate is provided with positioning holes and light-weight through holes, the outer walls of the guide posts are the same as the inner holes of the guide post inserting holes in shape, puncture needle guiding holes are formed in the guide posts, and the inner diameters of the puncture needle guiding holes are the same as the outer diameters of puncture needles. The invention can realize accurate positioning of the puncture vertebral body, and the puncture needle is accurately punctured into the pathological vertebral body through the guide column, and multiple X-ray fluoroscopy is not needed in the operation, thereby not only reducing the radiation dose of patients and doctors, but also reducing the technical difficulty of percutaneous vertebroplasty, enabling more primary doctors to quickly master the technology, and benefiting more patients.
Description
Technical Field
The invention belongs to the field of medical appliances, and particularly relates to a guide template for percutaneous vertebroplasty and a manufacturing and resetting method thereof.
Background
Percutaneous puncture vertebroplasty, which belongs to minimally invasive surgery, is a technique for strengthening a vertebral body by injecting bone cement (polymethyl methacrylate (PMMA) or artificial bone into a diseased vertebral body. Can be used for treating vertebral hemangioma, myeloma, osteolytic metastasis tumor and osteoporosis vertebral compression fracture complicated with intractable pain, and has effects of increasing vertebral body strength, stabilizing vertebral body and relieving pain.
The operation has small wound, low bleeding amount and quick response, can be moved in the field within 24 hours after operation, greatly shortens the hospitalization and recovery time of patients, relieves the pain of the patients, and is easier to be accepted by the patients.
However, the technical difficulty of percutaneous puncture vertebroplasty is that the puncture needle is accurately punctured into the diseased vertebral body and needs to avoid peripheral blood vessels and nerves, the puncture difficulty is high, the risk is high, the learning period of a doctor is long, the position of the puncture needle needs to be determined by repeatedly irradiating X-rays in the operation, the radiation dose of the doctor and a patient is increased, and the health of the doctor and the patient is damaged.
Disclosure of Invention
The technical problem to be solved by the invention is to provide a guide template for percutaneous vertebroplasty and a manufacturing and resetting method thereof, so that the puncture centrum can be accurately positioned, a puncture needle can be accurately punctured into a diseased centrum through the guide of a guide column, multiple X-ray fluoroscopy is not needed in the operation, the radiation dose of a patient and a doctor is reduced, the technical difficulty of the percutaneous vertebroplasty is reduced, more primary doctors can quickly master the technology, and more patients can benefit.
The technical solution for realizing the purpose of the invention is as follows:
a guide template for percutaneous vertebroplasty comprises a template body and a matched guide column, wherein the template body comprises a positioning plate, and the shape of the positioning plate is matched with the skin corresponding to a diseased centrum region; the positioning plate is provided with 2 guide post inserting holes penetrating through the middle, and through holes with the same hole diameter as the inner holes of the guide post inserting holes are correspondingly formed in the positioning plate; the guide column inserting hole corresponds to the vertebral pedicle at two sides of the pathological vertebral body, the direction of the center line of the guide column inserting hole is the puncture path direction, the inner hole and the outer wall of the guide column inserting hole are conical, the bottom diameter of the outer wall is larger than the top diameter, and the bottom diameter of the inner hole is smaller than the top diameter; a plurality of positioning holes and light-weight through holes are randomly arranged on the positioning plate, the positioning holes are used for being matched with metal mark points on the skin to position the template body, and the light-weight through holes are used for observing the skin and bleeding conditions of an affected part in the operation; the outer wall of the guide column is the same as the inner hole of the guide column insertion hole in shape, a puncture needle guide hole is formed in the guide column, and the inner diameter of the puncture needle guide hole is the same as the outer diameter of the puncture needle.
Furthermore, the guide template for percutaneous vertebroplasty is characterized in that the size of the positioning plate is 2-10mm of the skin external expansion corresponding to a diseased centrum, and the thickness of the positioning plate is 2-10 mm.
Furthermore, the guide template for percutaneous vertebroplasty of the invention is characterized in that the guide post insertion hole and the outer surface of the guide post are respectively provided with a guide post mark, and the matched guide post insertion hole and the guide post mark on the guide post are the same.
Furthermore, the upper end and the lower end of the upper surface of the positioning plate of the guide template for percutaneous vertebroplasty are respectively provided with a position mark, and the position mark comprises an upper mark and a lower mark.
Furthermore, the number of the positioning holes of the guide template for percutaneous vertebroplasty is 3-10.
Further, the guide template for percutaneous vertebroplasty of the invention, the positioning plate and the guide post insertion hole are integrally formed.
A method for manufacturing and resetting a guide template for percutaneous vertebroplasty, comprising the following steps:
the manufacturing steps are as follows:
step 1: placing an deflated medical vacuum pad on a CT scanning bed, enabling a patient to lie prone on the vacuum pad, evacuating gas in the vacuum pad through a vacuum pump to harden the vacuum pad, performing personalized shaping on the outline of a human body through the vacuum pad, performing enhanced positioning CT scanning on a diseased vertebral body region, introducing CT continuous tomographic image data into three-dimensional reconstruction software to perform three-dimensional model reconstruction, and deriving a continuous curved surface model; determining the specific position of a pathological change vertebral body in a model, marking the projection position of the pathological change vertebral body on the body surface, drawing 3-10 cross marks around the projection position of the body surface of the pathological change vertebral body, and attaching metal mark points on cross points;
step 2: rescanning the CT and reconstructing a three-dimensional model to obtain the position of the metal mark point on the model;
and step 3: inputting the three-dimensional model into 3D design software, and externally expanding the skin curved surface corresponding to the pathological change vertebral body by 2-10mm to be used as a positioning plate of a guide template;
and 4, step 4: according to the position of the pathological change centrum, two puncture paths are respectively designed at the vertebral pedicles at two sides of the centrum by adopting 3D design software, and the puncture path design step comprises the following steps:
step 4-1: simulating a cylinder with the same size as the puncture needle in software;
step 4-2: designing needle feeding points at the vertebral pedicle at two sides of the pathological change vertebral body, and dragging the cylinder above the needle feeding points;
step 4-3: reconstructing the coronal and sagittal positions of the diseased vertebral body;
step 4-4: designing the direction of the cylinder in the new coronal and sagittal images to ensure that the cylinder punctures into the vertebral body from the vertebral pedicle at two sides of the pathological vertebral body and avoids the nerve vessel;
and 5: designing a positioning hole according to the corresponding position of the metal mark point in the three-dimensional model on the positioning plate, and designing a light-weight through hole at the blank position on the positioning plate;
step 6: designing a guide post insertion hole on the positioning plate according to the puncture path, wherein the inner hole of the guide post insertion hole is conical with the bottom diameter smaller than the top diameter, and the outer wall of the guide post insertion hole is conical with the bottom diameter larger than the top diameter;
and 7: designing a guide column by adopting engineering software, wherein the outer wall of the guide column is the same as the shape of an inner hole of an insertion hole of the guide column, a puncture needle guide hole is designed in the guide column, and the inner diameter of the puncture needle guide hole is the same as the outer diameter of a puncture needle;
and 8: designing guide post marks on the outer side walls of the guide post insertion holes and the guide posts, and designing position marks on the upper surface of the positioning plate;
and step 9: and exporting the designed three-dimensional model by using an STL format file which can be identified by a three-dimensional printer, and inputting the three-dimensional model into a 3D printer to print and form the positioning plate and the guide column respectively.
Resetting:
the individualized and shaped vacuum pad is placed on an operating table, the position of a patient lying in the individualized and shaped vacuum pad is consistent with the position of preoperative scanning CT, positioning holes on a printing and forming positioning plate are in one-to-one correspondence with cross marks on the skin of the patient, and the template is accurately reset according to a preoperative plan. Compared with the prior art, the invention adopts the technical scheme that the invention has the beneficial effects that: the application of the personalized vacuum pad can ensure that the preoperative examination body position of the patient is consistent with the intraoperative body position, and the skin contour and the skin form are not easy to change. Obtain pathological change centrum skin data through three-dimensional reconstruction and generate the locating plate, can laminate the skin that pathological change centrum corresponds completely, locating hole corresponding with the skin setting-out can reset the locating plate accuracy, guide post patchhole can accurately avoid the vascular nerve in the puncture passageway through planning before the art, the doctor can insert the pjncture needle alright with accurate inserting the puncture needle to pathological change centrum assigned position with the guide post after the mould resets in the art, both avoided intraoperative many times X light perspective, patient and doctor's X line acceptance has been reduced, the technical degree of difficulty of percutaneous vertebroplasty has been reduced again, make more primary doctors can master this technique rapidly, let more patients benefit, the cost of manufacture is low, high speed, be worth popularizing and applying widely.
Drawings
FIG. 1 is a general schematic view of a guide template for percutaneous vertebroplasty of the invention;
FIG. 2 is a schematic view of a positioning plate of the guide template for percutaneous vertebroplasty according to the present invention;
FIG. 3 is a side sagittal view of a guide template for percutaneous vertebroplasty of the invention in use;
FIG. 4 is a cross-sectional view of a guide template for percutaneous vertebroplasty in accordance with the present invention in use;
FIG. 5 is a schematic view of a guide post of the guide template for percutaneous vertebroplasty of the invention;
reference signs mean: 1: positioning plate, 2: guide post, 3: guide post insertion hole, 4: lightweight through-hole, 5: positioning hole, 6: position marker, 7: guide post mark, 8: puncture needle, 9: vertebral body, 10: skin, 11: a puncture needle guide hole.
Detailed Description
Reference will now be made in detail to embodiments of the present invention, examples of which are illustrated in the accompanying drawings, wherein like reference numerals refer to the same or similar elements or elements having the same or similar function throughout. The embodiments described below with reference to the accompanying drawings are illustrative only for the purpose of explaining the present invention, and are not to be construed as limiting the present invention.
A guide template for percutaneous vertebroplasty, as shown in fig. 1-5, comprises a template body and a mating guide post 2. The template body comprises a positioning plate 1, the shape of the positioning plate 1 is matched with the skin corresponding to the pathological change vertebral body area, the size of the positioning plate 1 is 2-10mm of the skin corresponding to the pathological change vertebral body, and the thickness of the positioning plate 1 is 2-10 mm. The upper end and the lower end of the upper surface of the positioning plate 1 are respectively provided with a position mark 6, and the position mark 6 comprises an upper mark and a lower mark and is used for guiding the accurate placement of the template.
Be provided with 2 guide post patchholes 3 that run through in the middle of on locating plate 1, guide post patchhole 3 sets up the both sides at the locating plate according to preoperative surgical planning's puncture route, and the corresponding through-hole that has the same with the hole aperture of guide post patchhole 3 that opens on locating plate 1, locating plate 1 and guide post patchhole 3 integrated into one piece. The guide column inserting hole 3 corresponds to the vertebral pedicle at two sides of a pathological change vertebral body, the direction of the central line of the guide column inserting hole 3 is the puncture path direction, the inner hole and the outer wall of the guide column inserting hole 3 are conical, the bottom diameter of the outer wall is larger than the top diameter, and the bottom diameter of the inner hole is smaller than the top diameter.
3-10 positioning holes 5 and light-weight through holes 4 are randomly arranged on the positioning plate 1, the positioning holes 5 are used for being matched with metal mark points on skin to position the template body, the light-weight through holes 4 are used for observing the skin and bleeding conditions of an affected part in an operation, the weight of the template can be reduced, and the cost is saved;
the outer wall of the guide column 2 is the same as the inner hole shape of the guide column inserting hole 3, the guide column 2 can be smoothly inserted into the guide column inserting hole 3 and cannot fall out, a puncture needle guiding hole 11 is formed in the guide column 2, and the inner diameter of the puncture needle guiding hole 11 is the same as the outer diameter of the puncture needle 8.
The outer surfaces of the guide post insertion hole 3 and the guide post 2 are provided with guide post marks 7, and the matched guide post insertion hole 3 and the guide post marks 7 on the guide post 2 are the same, so that the guide post 2 is prevented from being placed in the wrong guide post insertion hole 3.
The manufacturing and resetting method of the guide template for the percutaneous vertebroplasty comprises the following steps:
the manufacturing steps are as follows:
step 1: placing an deflated medical vacuum pad on a CT scanning bed, enabling a patient to lie prone on the vacuum pad, evacuating gas in the vacuum pad through a vacuum pump to harden the vacuum pad, performing personalized shaping on the outline of a human body through the vacuum pad, performing enhanced positioning CT scanning on a diseased vertebral body region, introducing CT continuous tomographic image data into three-dimensional reconstruction software to perform three-dimensional model reconstruction, and deriving a continuous curved surface model; determining the specific position of a pathological change vertebral body in a model, marking the projection position of the pathological change vertebral body on the body surface, drawing 3-10 cross marks around the projection position of the body surface of the pathological change vertebral body, and attaching metal mark points on cross points;
step 2: rescanning the CT and reconstructing a three-dimensional model to obtain the position of the metal mark point on the model;
and step 3: inputting the three-dimensional model into 3D design software, and externally expanding the skin curved surface corresponding to the pathological change vertebral body by 2-10mm to be used as a positioning plate 1 of a guide template;
and 4, step 4: according to the position of the pathological change centrum, two puncture paths are respectively designed at the vertebral pedicles at two sides of the centrum by adopting 3D design software, and the puncture path design step comprises the following steps:
step 4-1: a cylinder with the same size as the puncture needle 8 is simulated in software;
step 4-2: designing needle feeding points at the vertebral pedicle at two sides of the pathological change vertebral body, and dragging the cylinder above the needle feeding points;
step 4-3: reconstructing the coronal and sagittal positions of the diseased vertebral body;
step 4-4: designing the direction of the cylinder in the new coronal and sagittal images to ensure that the cylinder punctures into the vertebral body from the vertebral pedicle at two sides of the pathological vertebral body and avoids the nerve vessel;
and 5: designing a positioning hole 5 according to the corresponding position of the metal mark point in the three-dimensional model on the positioning plate 1, and designing a light-weight through hole 4 at the blank position on the positioning plate 1;
step 6: designing a guide post inserting hole 3 on the positioning plate 1 according to the puncture path, wherein the inner hole of the guide post inserting hole 3 is conical with the bottom diameter being less than the top diameter, and the outer wall of the guide post inserting hole is conical with the bottom diameter being greater than the top diameter;
and 7: designing a guide column 2 by adopting engineering software, wherein the outer wall of the guide column 2 is the same as the inner hole shape of a guide column insertion hole 3, a puncture needle guide hole 11 is designed in the guide column 2, and the inner diameter of the puncture needle guide hole 11 is the same as the outer diameter of a puncture needle 8;
and 8: a guide post mark 7 is designed on the outer side wall of the guide post insertion hole 3 and the guide post 2, and a position mark 6 is designed on the upper surface of the positioning plate 1;
and step 9: exporting the designed three-dimensional model by using an STL format file which can be identified by a three-dimensional printer, inputting the three-dimensional model into a 3D printer, and respectively printing and molding the positioning plate 1 and the guide column 2;
resetting:
the individualized and shaped vacuum pad is placed on an operating table, the position of a patient lying in the individualized and shaped vacuum pad is consistent with the position of a preoperative scanning CT, the positioning holes 5 on the printing and forming positioning plate 1 are in one-to-one correspondence with the cross marks on the skin of the patient, and the template is accurately reset according to a preoperative plan.
The specific use method of the guide template for percutaneous vertebroplasty comprises the following steps:
the method comprises the steps of fixing the operation body position of a patient to be consistent with the CT scanning body position by using a personalized shaping vacuum pad, disinfecting and paving a towel, carrying out sterile gloves, placing a guide column 2 in a corresponding guide column inserting hole 3, placing a 3D printed guide template of percutaneous vertebroplasty on the skin of a pathological change vertebral body of the patient, and aligning a plurality of positioning holes 5 to corresponding skin cross points respectively. The method comprises the steps of inserting an injector into a puncture needle guide hole 11, performing local layer-by-layer infiltration anesthesia by using 2% lidocaine, inserting a puncture needle 8 into the puncture needle guide hole 11, inserting a guide steel wire from the tail part of the puncture needle 8 after the puncture needle 8 reaches a pathological change vertebral body, pulling out a guide column insertion hole 3 from the puncture needle 8 and a guide column 2 together, inserting a bone cement injection sleeve with a large diameter into the pathological change vertebral body through the guide steel wire, injecting bone cement in times, pulling out the bone cement injection sleeve after determining that the bone cement has no leakage through X-ray perspective in the operation, and covering a puncture point with an adhesive sterile dressing.
The guide template can be completely attached to the skin corresponding to the pathological change vertebral body, and the positioning plate can be accurately reset through the positioning hole. Can accurately avoid the vascular nerve among the puncture passageway through planning before the art, the doctor inserts the pjncture needle alright accurately with the pjncture needle to the pathological change centrum assigned position through the guide post after the template resets in the art, multiple X-ray perspective in the art has both been avoided, patient and doctor's X line acceptance has been reduced, the technical degree of difficulty of percutaneous vertebroplasty has been reduced again, make more primary doctors can master this technique rapidly, let more patients benefit, the cost of manufacture is low, and is fast, and is worth widely popularizing and applying.
The foregoing is directed to embodiments of the present invention and, more particularly, to a method and apparatus for controlling a power converter in a power converter, including a power converter, a power.
Claims (7)
1. The guide template for percutaneous vertebroplasty is characterized by comprising a template body and a matched guide column (2), wherein the template body comprises a positioning plate (1), and the shape of the positioning plate (1) is matched with the skin corresponding to a diseased centrum region; 2 guide post inserting holes (3) penetrating through the middle are formed in the positioning plate (1), and through holes with the same hole diameter as that of the inner holes of the guide post inserting holes (3) are correspondingly formed in the positioning plate (1); the guide column inserting hole (3) corresponds to the vertebral pedicle at two sides of a pathological vertebral body, the direction of the center line of the guide column inserting hole (3) is the puncture path direction, the inner hole and the outer wall of the guide column inserting hole (3) are conical, the bottom diameter of the outer wall is larger than the top diameter, and the bottom diameter of the inner hole is smaller than the top diameter; a plurality of positioning holes (5) and light-weight through holes (4) are randomly arranged on the positioning plate (1), the positioning holes (5) are used for being matched with metal mark points on the skin to position the position of the template body, and the light-weight through holes (4) are used for observing the skin and bleeding conditions of an affected part in an operation;
the outer wall of the guide column (2) is the same as the inner hole shape of the guide column insertion hole (3), a puncture needle guide hole (11) is formed in the guide column (2), and the inner diameter of the puncture needle guide hole (11) is the same as the outer diameter of the puncture needle (8).
2. The guide template for percutaneous vertebroplasty as in claim 1, wherein the positioning plate (1) has a size of 2-10mm for skin expansion corresponding to a diseased vertebral body and a thickness of 2-10 mm.
3. The guide template for percutaneous vertebroplasty as in claim 1, wherein the guide post marks (7) are provided on the outer surface of the guide post insertion hole (3) and the outer surface of the guide post (2), and the guide post marks (7) on the guide post insertion hole (3) and the guide post (2) are the same.
4. The guide template for percutaneous vertebroplasty as in claim 1, wherein the positioning plate (1) has position marks (6) at upper and lower ends of its upper surface, respectively, and the position marks (6) comprise a superscript and a subscript.
5. The guiding template for percutaneous vertebroplasty according to claim 1, wherein the number of positioning holes (5) is 3-10.
6. The guide template for percutaneous vertebroplasty according to claim 1, wherein the positioning plate (1) is integrally formed with the guide post insertion hole (3).
7. A method for manufacturing and resetting a guide template for percutaneous vertebroplasty, which is characterized by comprising the following steps:
the manufacturing steps are as follows:
step 1: placing an deflated medical vacuum pad on a CT scanning bed, enabling a patient to lie prone on the vacuum pad, evacuating gas in the vacuum pad through a vacuum pump to harden the vacuum pad, performing personalized shaping on the outline of a human body through the vacuum pad, performing enhanced positioning CT scanning on a diseased vertebral body region, introducing CT continuous tomographic image data into three-dimensional reconstruction software to perform three-dimensional model reconstruction, and deriving a continuous curved surface model; determining the specific position of a pathological change vertebral body in a model, marking the projection position of the pathological change vertebral body on the body surface, drawing 3-10 cross marks around the projection position of the body surface of the pathological change vertebral body, and attaching metal mark points on cross points;
step 2: rescanning the CT and reconstructing a three-dimensional model to obtain the position of the metal mark point on the model;
and step 3: inputting the three-dimensional model into 3D design software, and externally expanding the skin curved surface corresponding to the pathological change vertebral body by 2-10mm to be used as a positioning plate (1) of a guide template;
and 4, step 4: according to the position of the pathological change centrum, two puncture paths are respectively designed at the vertebral pedicles at two sides of the centrum by adopting 3D design software, and the puncture path design step comprises the following steps:
step 4-1: a cylinder with the same size as the puncture needle (8) is simulated in software;
step 4-2: designing needle feeding points at the vertebral pedicle at two sides of the pathological change vertebral body, and dragging the cylinder above the needle feeding points;
step 4-3: reconstructing the coronal and sagittal positions of the diseased vertebral body;
step 4-4: designing the direction of the cylinder in the new coronal and sagittal images to ensure that the cylinder punctures into the vertebral body from the vertebral pedicle at two sides of the pathological vertebral body and avoids the nerve vessel;
and 5: designing a positioning hole (5) according to the corresponding position of the metal mark point in the three-dimensional model on the positioning plate (1), and designing a light-weight through hole (4) at the blank position on the positioning plate (1);
step 6: designing a guide post inserting hole (3) on the positioning plate (1) according to a puncture path, wherein an inner hole of the guide post inserting hole (3) is conical with the bottom diameter being less than the top diameter, and the outer wall of the guide post inserting hole is conical with the bottom diameter being greater than the top diameter;
and 7: designing a guide column (2) by adopting engineering software, wherein the outer wall of the guide column (2) is the same as the shape of an inner hole of a guide column insertion hole (3), a puncture needle guide hole (11) is designed in the guide column (2), and the inner diameter of the puncture needle guide hole (11) is the same as the outer diameter of a puncture needle (8);
and 8: a guide post mark (7) is designed on the outer side wall of the guide post insertion hole (3) and the guide post (2), and a position mark (6) is designed on the upper surface of the positioning plate (1);
and step 9: exporting the designed three-dimensional model by using an STL format file which can be identified by a three-dimensional printer, inputting the three-dimensional model into a 3D printer, and respectively printing and molding the positioning plate (1) and the guide column (2);
resetting:
the individualized and shaped vacuum pad is placed on an operating table, the position of a patient lying in the individualized and shaped vacuum pad is consistent with the position of a preoperative scanning CT, the positioning holes (5) on the printing and forming positioning plates (1) are in one-to-one correspondence with the cross marks on the skin of the patient, and the template is accurately reset according to a preoperative plan.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201911250255.2A CN111000620A (en) | 2019-12-09 | 2019-12-09 | Guide template for percutaneous vertebroplasty and manufacturing and resetting method thereof |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201911250255.2A CN111000620A (en) | 2019-12-09 | 2019-12-09 | Guide template for percutaneous vertebroplasty and manufacturing and resetting method thereof |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN111000620A true CN111000620A (en) | 2020-04-14 |
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| CN201911250255.2A Pending CN111000620A (en) | 2019-12-09 | 2019-12-09 | Guide template for percutaneous vertebroplasty and manufacturing and resetting method thereof |
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112315561A (en) * | 2020-11-24 | 2021-02-05 | 井波 | Medical three-dimensional guide system based on three-dimensional reconstruction |
| CN117122401A (en) * | 2023-10-26 | 2023-11-28 | 首都医科大学附属北京友谊医院 | Nine-grid division method 3D printing percutaneous pedicle puncture guide plate and preparation method |
Citations (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101972165A (en) * | 2010-11-18 | 2011-02-16 | 王铁铸 | X-ray-film-based method for locating coordinates of pedicle screws |
| CN202314846U (en) * | 2011-11-09 | 2012-07-11 | 张自强 | Nasal gastrointestinal tube with plastic-coated metal guide wire |
| CN204655392U (en) * | 2015-05-12 | 2015-09-23 | 中国人民解放军总医院 | Head dressing change bracket |
| CN107157580A (en) * | 2017-06-27 | 2017-09-15 | 刘大鹏 | A kind of Digital location minimally invasive spine surgical 3D printing guide plate and preparation method |
| CN107349003A (en) * | 2017-07-11 | 2017-11-17 | 哈尔滨理工大学 | A kind of lumbar vertebrae screw placement guide plate and preparation method based on FEM mechanics analysis |
| CN107616838A (en) * | 2017-11-01 | 2018-01-23 | 于江平 | A kind of 3D printing personalization plunger type puncture for treating template with fixing device |
| CN207804782U (en) * | 2017-06-23 | 2018-09-04 | 于江平 | A kind of cranium brain seeds implanted guidance system based on 3D printing personalization |
| CN108742822A (en) * | 2018-04-04 | 2018-11-06 | 广东医科大学附属医院 | A kind of preparation method of navigation module for the blocking nail implantation of fracture of tibia Medullary fixation |
| CN208525074U (en) * | 2017-10-13 | 2019-02-22 | 浙江大学 | Stereotaxis guide |
| CN109567923A (en) * | 2018-11-22 | 2019-04-05 | 自贡市第四人民医院(自贡市急救中心) | A kind of personalization Pedicle Screw Placement in Lower Cervical navigation template device and preparation method thereof step by step |
| US20190223887A1 (en) * | 2018-01-24 | 2019-07-25 | Daniel D. Fritzinger | Method of designing and manufacturing low-profile customized patient-specific orthopaedic surgical instruments |
-
2019
- 2019-12-09 CN CN201911250255.2A patent/CN111000620A/en active Pending
Patent Citations (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101972165A (en) * | 2010-11-18 | 2011-02-16 | 王铁铸 | X-ray-film-based method for locating coordinates of pedicle screws |
| CN202314846U (en) * | 2011-11-09 | 2012-07-11 | 张自强 | Nasal gastrointestinal tube with plastic-coated metal guide wire |
| CN204655392U (en) * | 2015-05-12 | 2015-09-23 | 中国人民解放军总医院 | Head dressing change bracket |
| CN207804782U (en) * | 2017-06-23 | 2018-09-04 | 于江平 | A kind of cranium brain seeds implanted guidance system based on 3D printing personalization |
| CN107157580A (en) * | 2017-06-27 | 2017-09-15 | 刘大鹏 | A kind of Digital location minimally invasive spine surgical 3D printing guide plate and preparation method |
| CN107349003A (en) * | 2017-07-11 | 2017-11-17 | 哈尔滨理工大学 | A kind of lumbar vertebrae screw placement guide plate and preparation method based on FEM mechanics analysis |
| CN208525074U (en) * | 2017-10-13 | 2019-02-22 | 浙江大学 | Stereotaxis guide |
| CN107616838A (en) * | 2017-11-01 | 2018-01-23 | 于江平 | A kind of 3D printing personalization plunger type puncture for treating template with fixing device |
| US20190223887A1 (en) * | 2018-01-24 | 2019-07-25 | Daniel D. Fritzinger | Method of designing and manufacturing low-profile customized patient-specific orthopaedic surgical instruments |
| CN108742822A (en) * | 2018-04-04 | 2018-11-06 | 广东医科大学附属医院 | A kind of preparation method of navigation module for the blocking nail implantation of fracture of tibia Medullary fixation |
| CN109567923A (en) * | 2018-11-22 | 2019-04-05 | 自贡市第四人民医院(自贡市急救中心) | A kind of personalization Pedicle Screw Placement in Lower Cervical navigation template device and preparation method thereof step by step |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112315561A (en) * | 2020-11-24 | 2021-02-05 | 井波 | Medical three-dimensional guide system based on three-dimensional reconstruction |
| CN117122401A (en) * | 2023-10-26 | 2023-11-28 | 首都医科大学附属北京友谊医院 | Nine-grid division method 3D printing percutaneous pedicle puncture guide plate and preparation method |
| CN117122401B (en) * | 2023-10-26 | 2024-01-23 | 首都医科大学附属北京友谊医院 | Nine-grid division method 3D printing percutaneous pedicle puncture guide plate and preparation method |
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