CN113171175A - Lumbar under-mirror fusion technology under assistance of electromagnetic navigation - Google Patents
Lumbar under-mirror fusion technology under assistance of electromagnetic navigation Download PDFInfo
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- CN113171175A CN113171175A CN202110519572.0A CN202110519572A CN113171175A CN 113171175 A CN113171175 A CN 113171175A CN 202110519572 A CN202110519572 A CN 202110519572A CN 113171175 A CN113171175 A CN 113171175A
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- 230000004927 fusion Effects 0.000 title claims abstract description 14
- 238000005516 engineering process Methods 0.000 title abstract description 15
- 241000425571 Trepanes Species 0.000 claims abstract description 16
- 238000000034 method Methods 0.000 claims abstract description 10
- 238000012800 visualization Methods 0.000 claims abstract description 8
- 238000002591 computed tomography Methods 0.000 claims description 8
- 238000013507 mapping Methods 0.000 claims description 5
- 210000000988 bone and bone Anatomy 0.000 claims description 4
- 238000013170 computed tomography imaging Methods 0.000 claims description 4
- 238000005553 drilling Methods 0.000 claims description 4
- 238000003384 imaging method Methods 0.000 claims description 4
- 210000000080 chela (arthropods) Anatomy 0.000 claims description 2
- 230000000694 effects Effects 0.000 abstract description 3
- 230000008569 process Effects 0.000 abstract description 3
- 208000028389 Nerve injury Diseases 0.000 abstract description 2
- 238000002324 minimally invasive surgery Methods 0.000 abstract description 2
- 210000003205 muscle Anatomy 0.000 abstract description 2
- 230000008764 nerve damage Effects 0.000 abstract description 2
- 230000005855 radiation Effects 0.000 abstract description 2
- 238000002513 implantation Methods 0.000 description 6
- 238000010586 diagram Methods 0.000 description 4
- 238000012986 modification Methods 0.000 description 3
- 230000004048 modification Effects 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 206010061310 Nerve root injury Diseases 0.000 description 2
- 201000010099 disease Diseases 0.000 description 2
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 2
- 238000001839 endoscopy Methods 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 208000007103 Spondylolisthesis Diseases 0.000 description 1
- 206010052428 Wound Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 230000032683 aging Effects 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 230000006837 decompression Effects 0.000 description 1
- 238000002674 endoscopic surgery Methods 0.000 description 1
- 238000002594 fluoroscopy Methods 0.000 description 1
- 230000036541 health Effects 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 210000005036 nerve Anatomy 0.000 description 1
- 208000015122 neurodegenerative disease Diseases 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
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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
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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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
- 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
-
- 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
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2051—Electromagnetic tracking systems
-
- 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
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2065—Tracking using image or pattern recognition
Abstract
The invention discloses a lumbar under-mirror fusion technology under the assistance of electromagnetic navigation, in particular to the technical field of lumbar minimally invasive surgery, which comprises the following steps: the method comprises the following steps: matching images; step two: registering an open-circuit cone; step three: registering a puncture needle, a guide rod and a working channel; step four: registering a trepan; step five: registering an under-the-mirror instrument. The invention combines the electromagnetic navigation technology with the steps from one to five, realizes the visualization of the whole operation process, continuously tracks the operation instrument, avoids the perspective in the operation, shortens the operation time, reduces the radiation in the operation of patients and medical care personnel, plans the operation path before the operation, can timely adjust the angle and the position of the instrument in the operation according to the holographic image presented by the electromagnetic navigation system, realizes the precision of the operation, avoids the multiple adjustment of the pipeline, the excessive traction of muscles and the unnecessary excision of bony structures, avoids the nerve injury and ensures the operation effect.
Description
Technical Field
The invention relates to the technical field of lumbar minimally invasive surgery, in particular to an electromagnetic navigation-assisted lumbar under-mirror fusion technology.
Background
With the continuous progress of the aging of Chinese population, the lumbar degenerative disease becomes a common disease affecting the health of the elderly, the disability rate is high, and serious people even completely lose normal living ability. Generally, conservative treatment is not effective, and lumbar surgery decompression and fusion are effective means of treating the disease. In the minimally invasive treatment and the precise treatment, the spinal endoscopic surgery has become the most common surgical technique of the spinal surgery at present due to the advantages of small trauma, quick recovery and the like. However, along with the spinal endoscopy, the operator loses the direct visualization of the anatomical structure of the patient in the operation, so the spinal endoscopy operation has steep learning curve and great operation difficulty.
The under-mirror fusion operation not only combines the percutaneous pedicle screw internal fixation technology, but also can be implanted into the interbody fusion cage by means of a working pipeline to reconstruct the lumbar stability of the patient, thereby providing an ideal operation mode for the minimally invasive operation treatment of the patient suffering from lumbar spondylolisthesis. The steps of percutaneous pedicle screw implantation, endoscope working channel placement, endoscopic operation and the like in the traditional endoscopic fusion technology are generally completed by hands by combining self experience under the guidance of perspective of an operator in an operation. The traditional technology can not be directly visualized, so that the positions, the depths and the angles of the screws and the instruments need to be repeatedly confirmed by fluoroscopy, the steps are complicated, the operation time is long, and the risk of nerve root injury exists.
Disclosure of Invention
Therefore, the invention provides a lumbar under-mirror fusion technology under the assistance of electromagnetic navigation, which is combined with the electromagnetic navigation technology to solve the problem that the traditional under-mirror fusion technology in the background technology cannot realize full-range visualization.
In order to achieve the above purpose, the invention provides the following technical scheme: a lumbar under-mirror fusion technology under the assistance of electromagnetic navigation comprises the following specific steps:
(professional name: registration, colloquially, to present a tool on a hologram of a navigation system and to dynamically track it)
The method comprises the following steps: image matching: collecting lumbar vertebra three-dimensional CT (computed tomography) imaging data of a patient before an operation and transmitting the lumbar vertebra three-dimensional CT imaging data to an electromagnetic navigation host; a positioner and a mapping ring are placed in the operation, and the images are matched after perspective so as to carry out the next operation planning;
step two: registering an open-circuit cone: registering the open-circuit cone, planning a percutaneous pedicle screw path through the open-circuit cone, and realizing visualization of pedicle screw bone tunnel drilling;
step three: registering puncture needles, guide rods and working channels: the puncture needle, the guide rod and the working channel are registered, and a puncture path, a guide rod path, a depth and an angle are planned, so that the working channel is accurately placed and continuously tracked;
step four: registering a trepan: planning a path and an angle of the trepan, and continuously tracking the depth and the sawtooth position of the trepan;
step five: registering an under-the-mirror instrument: planning the path and angle of the under-mirror instrument and continuously tracking the head position of the instrument.
Further, the scope instruments in step five include, but are not limited to, nucleus pulposus pincers, square chisels, reamers, curettes, and the like.
The invention has the following advantages:
1. through the arrangement of the third step, the fourth step and the fifth step, compared with the prior art, the visualization of the whole operation process is realized, the operation instrument is continuously tracked, the perspective during the operation is avoided, the operation time is shortened, and the radiation of a patient and medical staff during the operation is reduced;
2. according to the invention, through the arrangement of the step one, compared with the prior art, the operation path is planned before the operation, the angle and the position of the instrument can be timely adjusted in the operation according to the holographic image presented by the electromagnetic navigation system, the precision of the operation is realized, the multiple adjustment of the pipeline, the excessive traction of the muscle and the unnecessary excision of the bony structure are avoided, the nerve injury is avoided, and the operation effect is ensured;
3. compared with the prior art, the invention has the advantages that through the arrangement of the step two, the screw path is individually designed, the hand feeling of a surgeon in the traditional screw placing step is kept, the screw placing step is perfected, and the repeated screw placing is avoided. Therefore, the postoperative wound of the patient is small, the recovery is fast, the life quality is high, and the complication is few.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below. It should be apparent that the drawings in the following description are merely exemplary, and that other embodiments can be derived from the drawings provided by those of ordinary skill in the art without inventive effort.
The structures, ratios, sizes, and the like shown in the present specification are only used for matching with the contents disclosed in the specification, so as to be understood and read by those skilled in the art, and are not used to limit the conditions that the present invention can be implemented, so that the present invention has no technical significance, and any structural modifications, changes in the ratio relationship, or adjustments of the sizes, without affecting the effects and the achievable by the present invention, should still fall within the range that the technical contents disclosed in the present invention can cover.
FIG. 1 is a diagram of a placement locator and mapping ring of the present invention;
FIGS. 2 and 3 are image matching diagrams according to the present invention;
FIG. 4 is a schematic representation of the implantation path planning and real-time navigation of the percutaneous pedicle screw of the present invention;
FIG. 5 is a diagram of the path planning and real-time navigation of the needle and guide of the present invention;
FIG. 6 is a working channel path planning and continuous navigation diagram of the present invention;
FIG. 7 is an under-mirror trepan path planning and continuing navigation view of the present invention;
fig. 8 is a view of the endoscopic instrument path planning and continuous navigation of the present invention.
Detailed Description
The present invention is described in terms of particular embodiments, other advantages and features of the invention will become apparent to those skilled in the art from the following disclosure, and it is to be understood that the described embodiments are merely exemplary of the invention and that it is not intended to limit the invention to the particular embodiments disclosed. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
Referring to the attached fig. 1-8 of the specification, the lumbar under-mirror fusion technology with the electromagnetic navigation assistance of the embodiment specifically comprises the following steps:
(professional name: registration, colloquially, to present a tool on a hologram of a navigation system and to dynamically track it)
The method comprises the following steps: image matching: collecting lumbar vertebra three-dimensional CT (computed tomography) imaging data of a patient before an operation and transmitting the lumbar vertebra three-dimensional CT imaging data to an electromagnetic navigation host; a positioner and a mapping ring are placed in the operation, and the images are matched after perspective so as to carry out the next operation planning;
step two: registering an open-circuit cone: registering the open-circuit cone, planning a percutaneous pedicle screw path through the open-circuit cone, and realizing visualization of pedicle screw bone tunnel drilling;
step three: registering puncture needles, guide rods and working channels: the puncture needle, the guide rod and the working channel are registered, and a puncture path, a guide rod path, a depth and an angle are planned, so that the working channel is accurately placed and continuously tracked;
step four: registering a trepan: planning a path and an angle of the trepan, and continuously tracking the depth and the sawtooth position of the trepan;
step five: registering an under-the-mirror instrument: planning the placement path and angle of the under-the-mirror instruments, such as chisels, reamers, curettes, etc., and continuously tracking the instrument head position.
The working principle is as follows: referring to the drawings of the specification 1-8:
(professional name: registration, colloquially, to present a tool on a hologram of a navigation system and to dynamically track it)
FIG. 1, FIG. 2, and FIG. 3 show: image matching: collecting lumbar vertebra three-dimensional CT (computed tomography) imaging data of a patient before an operation and transmitting the lumbar vertebra three-dimensional CT imaging data to an electromagnetic navigation host; a positioner and a mapping ring are placed in the operation, and the images are matched after perspective so as to carry out the next operation planning;
FIG. 4 shows: registering an open-circuit cone, planning the implantation path of the percutaneous pedicle screw and navigating in real time. The open-circuit awl is registered, and the percutaneous pedicle screw path is planned through the open-circuit awl, so that the visualization of drilling of the pedicle screw bone tunnel is realized, the repeated adjustment of a bony channel is avoided, the repeated nail placement in the operation is avoided, and the loosening of the screw after the operation is also avoided;
FIGS. 5 and 6 show: and registering a puncture needle, a guide rod and a working channel, planning the path of the puncture needle and the guide rod and navigating in real time. The puncture needle, the guide rod and the working channel are registered, and the puncture path, the guide rod path, the depth and the angle are planned, so that the accurate skin puncture point, the target point of the working pipeline, the implantation angle and the implantation depth are obtained. The three steps of puncture by a puncture needle, expansion of a guide rod and placement of a working channel are completed in sequence, and each step corrects errors under navigation, so that the accurate placement of the working channel is realized, the working channel is continuously tracked, and a foundation is laid for the subsequent under-microscope operation;
FIG. 7 shows: registration of the trepan, endoscopic trepan path planning and continuous navigation. Planning the path and the angle of the trepan and continuously tracking the position of the sawteeth of the trepan, so that the implantation depth of the trepan can be accurately controlled when the articular process is cut off, and the damage to nerves is avoided;
FIG. 8 shows: registration of the sub-scope instruments (square chisels, reamers, curettes, etc.), path planning of the sub-scope instruments and continuous navigation. Planning the path and angle of the under-mirror instrument, and continuously tracking the position of the head end of the instrument to avoid excessive or insufficient treatment of intervertebral discs and intervertebral spaces;
the embodiment specifically solves the problems that in the prior art, due to the fact that the traditional operation technology cannot be used for direct-vision operation, the positions, the depths and the angles of the screws and the instruments need to be determined through repeated perspective, the steps are complex, the operation time is long, and the risk of nerve root injury in the operation exists.
Although the invention has been described in detail above with reference to a general description and specific examples, it will be apparent to one skilled in the art that modifications or improvements may be made thereto based on the invention. Accordingly, such modifications and improvements are intended to be within the scope of the invention as claimed.
Claims (2)
1. The utility model provides a lumbar vertebrae mirror fusion technique under supplementary of electromagnetic navigation which characterized in that: the method comprises the following specific steps:
(professional name: registration, colloquially, to present a tool on a hologram of a navigation system and to dynamically track it)
The method comprises the following steps: image matching: collecting lumbar vertebra three-dimensional CT (computed tomography) imaging data of a patient before an operation and transmitting the lumbar vertebra three-dimensional CT imaging data to an electromagnetic navigation host; a positioner and a mapping ring are placed in the operation, and the images are matched after perspective so as to carry out the next operation planning;
step two: registering an open-circuit cone: registering the open-circuit cone, planning a percutaneous pedicle screw path through the open-circuit cone, and realizing visualization of pedicle screw bone tunnel drilling;
step three: registering puncture needles, guide rods and working channels: the puncture needle, the guide rod and the working channel are registered, and a puncture path, a guide rod path, a depth and an angle are planned, so that the working channel is accurately placed and continuously tracked;
step four: registering a trepan: planning a path and an angle of the trepan, and continuously tracking the depth and the sawtooth position of the trepan;
step five: registering an under-the-mirror instrument: planning the path and angle of the under-mirror instrument and continuously tracking the head position of the instrument.
2. The electromagnetic navigation-assisted lumbar under-mirror fusion technique of claim 1, wherein: the scope instruments in step five include, but are not limited to, nucleus pulposus pincers, square chisels, reamers, curettes, and the like.
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| Application Number | Priority Date | Filing Date | Title |
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| CN202110519572.0A CN113171175A (en) | 2021-05-13 | 2021-05-13 | Lumbar under-mirror fusion technology under assistance of electromagnetic navigation |
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| CN202110519572.0A CN113171175A (en) | 2021-05-13 | 2021-05-13 | Lumbar under-mirror fusion technology under assistance of electromagnetic navigation |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114288018A (en) * | 2022-01-04 | 2022-04-08 | 青岛大学附属医院 | Robot-assisted under-mirror fusion technical method |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101518447A (en) * | 2009-03-02 | 2009-09-02 | 北京积水潭医院 | Precision improving method for spinal surgery computer navigation system |
| CN103976779A (en) * | 2014-05-30 | 2014-08-13 | 上海市东方医院 | Intervertebral foramen mirror puncturing system |
| US20170156816A1 (en) * | 2015-12-04 | 2017-06-08 | Zaki G. Ibrahim | Methods for performing minimally invasive transforaminal lumbar interbody fusion using guidance |
| CN107811684A (en) * | 2017-11-23 | 2018-03-20 | 中山大学附属第三医院 | Visualize foramen intervertebrale lens auxiliary navigation method and ultrasonic navigation system supplymentary instrument |
| CN108420529A (en) * | 2018-03-26 | 2018-08-21 | 上海交通大学 | The surgical navigational emulation mode guided based on image in magnetic tracking and art |
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- 2021-05-13 CN CN202110519572.0A patent/CN113171175A/en active Pending
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101518447A (en) * | 2009-03-02 | 2009-09-02 | 北京积水潭医院 | Precision improving method for spinal surgery computer navigation system |
| CN103976779A (en) * | 2014-05-30 | 2014-08-13 | 上海市东方医院 | Intervertebral foramen mirror puncturing system |
| US20170156816A1 (en) * | 2015-12-04 | 2017-06-08 | Zaki G. Ibrahim | Methods for performing minimally invasive transforaminal lumbar interbody fusion using guidance |
| CN107811684A (en) * | 2017-11-23 | 2018-03-20 | 中山大学附属第三医院 | Visualize foramen intervertebrale lens auxiliary navigation method and ultrasonic navigation system supplymentary instrument |
| CN108420529A (en) * | 2018-03-26 | 2018-08-21 | 上海交通大学 | The surgical navigational emulation mode guided based on image in magnetic tracking and art |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114288018A (en) * | 2022-01-04 | 2022-04-08 | 青岛大学附属医院 | Robot-assisted under-mirror fusion technical method |
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Application publication date: 20210727 |