JP4892005B2 - 脊髄手術における椎弓根用のスクリューまたは椎弓根用の内固定器具の設置のための椎弓根周辺、椎弓根峡部、および椎弓根峡部の中心の決定方法 - Google Patents
脊髄手術における椎弓根用のスクリューまたは椎弓根用の内固定器具の設置のための椎弓根周辺、椎弓根峡部、および椎弓根峡部の中心の決定方法 Download PDFInfo
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- 210000000056 organ Anatomy 0.000 description 1
- 238000009790 rate-determining step (RDS) Methods 0.000 description 1
- 238000011160 research Methods 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- 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
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1757—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the spine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- 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
- A61B2017/564—Methods for bone or joint treatment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/061—Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
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- A—HUMAN NECESSITIES
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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
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- Health & Medical Sciences (AREA)
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Description
本発明は、一般的に脊髄手術の分野に関するものであり、脊髄手術において椎弓根用のスクリュー類または椎弓根用の内固定用の器具類の正確な配置のためのコンピューター化される方法、または自動化される方法に関する。より詳しくは、椎弓根周辺、椎弓根峡部、および椎弓根峡部の中心の決定方法に関する。
ヒト脊椎にスクリュー類を設置することは、多数の脊髄手術の実施を可能にするための通常の外科的措置である。通常、スクリュー類は、患者の腰椎および仙椎の椎弓根に挿入される。他の固定形態よりも生体力学的に有利であるので、外科医は、上記脊椎部分を拡げるために、上記脊椎部分に椎弓根用のスクリューを設置する。
本発明の方法によれば、好適な方法を用い、椎体について、その任意の面の連続的な積み重ねられた各画像が得られる。次に、これらの各画像を再構築し、椎体の正確な三次元画像を得る。椎弓根周辺および椎弓根峡部は、三次元画像および二次元画像として表される。
〔実施形態1.椎弓根周辺および椎弓根峡部の決定〕
本発明の方法に基づき、椎体10について、任意の好適な方法により任意の平面の一連の積み重ねられる各画像を得た。次に、これらの各画像を椎体10の正確な三次元画像を得るために再構築した。椎弓根周辺部Bおよび椎弓根峡部Xを、図1Aおよび図1Bにおいて模式的に示したように三次元画像および二次元画像として表した。
一度、椎弓根峡部Xが定義されれば、椎弓根峡部の中心Cは必ず定義される。上記中心Cの決定は、同心での挿入経路の決定および椎弓根の円柱構造の構築を可能にするために必要である。多くの椎弓根は、楕円または不規則な形状を有するが、大部分の椎弓根については円柱状として概念化される。前記のように、これらの各椎弓根の中心の決定は最も重要である。
Claims (5)
- 椎体の椎弓根に対しスクリューまたは内固定器具の最適な設置を可能にするための椎体の椎弓根周辺および椎弓根峡部の決定方法であって、
上記椎体の三次元画像をコンピュータにより作成するステップと、
上記三次元画像の横断面での部分を取得することによる上記椎体の外皮表面構造の画像をコンピュータにより作成するステップと、
上記横断面において、上記椎体の内部の椎弓根、および上記椎体に近い椎弓根の外皮表面上にて接して接線方向に延びる一連の各第一線をコンピュータにより得るステップと、
上記一連の各第一線に対して直交し、上記椎弓根における内部および近くの上記椎体を通って延びる一連の各第二線をコンピュータにより得るステップと、
互いに隣り合う上記各第二線が最大の角度となる上記外皮表面の領域として上記椎弓根周辺をコンピュータにより同定するステップと、および
互いに向かい合う上記各第二線が、互いに最も平行に近くなる上記外皮表面の領域として上記椎弓根峡部をコンピュータにより同定するステップとを含む方法。 - 前記各第一線、および前記各第二線の設定のために、上記外皮表面上において各極小ポイントをコンピュータにより設定する、請求項1に記載の方法。
- 前記椎弓根周辺および前記椎弓根峡部の構造的三次元位置を、上記椎弓根周辺および上記椎弓根峡部を定義する多数の各横断面に照合することによりコンピュータによって決定する、請求項2に記載の方法。
- 上記椎弓根峡部の断面から得られ、前記外皮表面の各微小ポイントから延び、互いに平行な各第一線分の各中心を通る第1のラインと、前記外皮表面の各微小ポイントから延び、上記各第一線分に対してそれぞれ直交し、かつ互いに平行な別の各第二線分の各中心を通る第2のラインとの2本の各ラインの交差する点として、上記椎弓根峡部の中心をコンピュータにより同定するステップをさらに含む、請求項1に記載の方法。
- コンピューターで作成された画像からコンピュータにより実行される、請求項1に記載の方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US76136506P | 2006-01-24 | 2006-01-24 | |
US60/761,365 | 2006-01-24 | ||
PCT/US2007/002001 WO2007087381A2 (en) | 2006-01-24 | 2007-01-24 | Methods for determining pedicle base circumference, pedicle isthmus and center of the pedicle isthmus for screw placement |
Publications (2)
Publication Number | Publication Date |
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JP2009524488A JP2009524488A (ja) | 2009-07-02 |
JP4892005B2 true JP4892005B2 (ja) | 2012-03-07 |
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Application Number | Title | Priority Date | Filing Date |
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JP2008552400A Expired - Fee Related JP4892005B2 (ja) | 2006-01-24 | 2007-01-24 | 脊髄手術における椎弓根用のスクリューまたは椎弓根用の内固定器具の設置のための椎弓根周辺、椎弓根峡部、および椎弓根峡部の中心の決定方法 |
Country Status (8)
Country | Link |
---|---|
US (1) | US8277461B2 (ja) |
EP (1) | EP1976441B1 (ja) |
JP (1) | JP4892005B2 (ja) |
KR (1) | KR101286362B1 (ja) |
CN (1) | CN101374470B (ja) |
AU (1) | AU2007208271B2 (ja) |
CA (1) | CA2640075C (ja) |
WO (1) | WO2007087381A2 (ja) |
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- 2007-01-24 US US11/657,119 patent/US8277461B2/en active Active
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US6792071B2 (en) * | 2002-03-27 | 2004-09-14 | Agfa-Gevaert | Method of performing geometric measurements on digital radiological images |
US20040240715A1 (en) * | 2003-05-29 | 2004-12-02 | Wicker Ryan B. | Methods and systems for image-guided placement of implants |
US20050192575A1 (en) * | 2004-02-20 | 2005-09-01 | Pacheco Hector O. | Method of improving pedicle screw placement in spinal surgery |
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AU2007208271A1 (en) | 2007-08-02 |
WO2007087381A2 (en) | 2007-08-02 |
WO2007087381A3 (en) | 2007-12-21 |
JP2009524488A (ja) | 2009-07-02 |
US20070232960A1 (en) | 2007-10-04 |
CN101374470A (zh) | 2009-02-25 |
EP1976441A2 (en) | 2008-10-08 |
EP1976441A4 (en) | 2012-09-12 |
CA2640075C (en) | 2012-07-17 |
EP1976441B1 (en) | 2013-03-13 |
AU2007208271B2 (en) | 2012-04-26 |
CN101374470B (zh) | 2011-01-05 |
KR20080098621A (ko) | 2008-11-11 |
KR101286362B1 (ko) | 2013-07-15 |
US8277461B2 (en) | 2012-10-02 |
CA2640075A1 (en) | 2007-08-02 |
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