JP6633353B2 - Spinal deformity correction and fixation support device, spinal deformity correction and fixation support method, program, and rod manufacturing method used for spinal deformity correction and fixation - Google Patents

Description

  The present invention relates to a technique for supporting an operation for correcting and fixing a deformed spine.

  The spine is generally composed of a plurality of vertebrae (seven cervical vertebrae, twelve thoracic vertebrae, five lumbar vertebrae, sacral vertebrae, coccyx), intervertebral discs connecting the vertebrae, and the like. In a normal state, the spine is generally straight when viewed from the front, and when viewed from the side, the cervical vertebra and the lumbar vertebra are lordotic, and the thoracic and sacral vertebrae are kyphotic, forming a generally S-shape.

  Spine deformity correction surgery is an operation to correct and fix a deformed spine to a normal state or a state close thereto, and is generally performed for treatment of spinal deformity. Spine deformity is a disease in which the spine is deformed, and examples include scoliosis and kyphosis. Scoliosis is a disease in which the spine is bent laterally or the spine is twisted. Kyphosis is a disease in which the angle of the thoracic kyphosis becomes extremely large, or the lumbar lordosis is lost, resulting in a kyphosis state.

  In spinal deformity correction surgery, a rod made mainly of titanium, cobalt chrome, etc. is held by bolts screwed into vertebrae to correct and fix the spine in a normal state or a state close to it. . The rod is usually bent by the physician's hand during surgery using various tools. The shape of the bent rod generally determines the condition of the spine after correction. Therefore, how to bend the rod is an important factor in spinal deformity correction surgery.

  For example, the computer described in Patent Literature 1 determines a spatial relationship of a connecting device mounting element (for example, a bolt) installed on a body structure, and determines a bending parameter and the like of a rod.

Japanese Patent No. 5572898

  However, the technique described in Patent Document 1 still requires a doctor to determine the state of the spine after correction.

  Generally, when a patient is viewed from the side, the degree to which the spine of the patient is bent in a normal state varies depending on the individual patient. The degree to which the spine can be brought close to a healthy state of the patient also differs depending on the degree of deformation of the spine of the patient, the flexibility of the patient's disc, and the like. In consideration of these factors, the physician determines the corrected state of the spine for each patient during the operation, based on expert knowledge, experience, and the like. Therefore, the rod is not always bent into a shape suitable for each patient.

  In general, it is desirable that the operation time be short in order to reduce the burden on the patient's body during the operation. In spinal deformity correction surgery, if the time for determining the state of the spine after correction can be eliminated or shortened, the operation time can be shortened.

  The present invention has been made in view of the above-described circumstances, and a spinal deformity correction and fixation support apparatus, a spinal deformity correction and fixation support method, and a program that can perform appropriate spinal deformity correction and fixation in a short time. Further, it is an object of the present invention to provide a method for manufacturing a rod used for spinal deformity correction surgery.

In order to achieve the above object, the spinal deformity correction and fixation assisting device according to the present invention,
A first acquisition unit configured to acquire first image data for specifying a positional relationship of a plurality of vertebrae of a patient in a natural body in three dimensions;
A second acquisition unit that acquires second image data for specifying an interval between vertebrae in a state where a force is applied to the spine of the patient;
On the basis of the acquired first image data and the acquired second image data, a plurality of rigid bodies corresponding to a plurality of vertebrae and a plurality of elastic bodies corresponding to a plurality of intervertebral discs are configured. A model generation unit for generating a three-dimensional spine model,
A simulation unit that determines a positional relationship between the plurality of rigid bodies when a specific portion included in the generated spinal column model is moved.

  According to the present invention, a three-dimensional spine model is generated based on the first image data and the second image data of a patient, and the positions of a plurality of rigid bodies when a specific portion included in the spine model is moved Determine the relationship. Thereby, by appropriately moving the rigid body, simulate the state of the spine after correction, based on the result of the simulation, to study in advance the state of the spine after correction suitable for the patient, during surgery, after the correction The time for determining the condition of the spine can be reduced at least. Therefore, it is possible to perform appropriate spinal deformity correction and fixation in a short time.

BRIEF DESCRIPTION OF THE DRAWINGS It is a figure which shows the structure of the spine deformity correction | amendment fusion support system which concerns on one Embodiment of this invention. BRIEF DESCRIPTION OF THE DRAWINGS It is a figure which shows the functional structure of the spine deformity correction | amendment fixation assistance apparatus which concerns on one Embodiment. It is a flowchart which shows the flow of the spinal deformity correction and fixation assistance process which concerns on one Embodiment. 4 is a flowchart illustrating a flow of a model generation process S103 illustrated in FIG. 3. It is a figure showing an example of the state where a vertebra was extracted from a part of a patient's spine image in a natural body. FIG. 7 is a diagram for explaining a method of determining parameters for modeling a vertebra using a rigid body having a three-dimensional shape. It is a figure for explaining the method of determining the elasticity coefficient for modeling an intervertebral disc by an elastic body. FIG. 7 is a diagram showing an example in which a spine model in a pulled state is displayed on a display unit. FIG. 9 is a diagram illustrating an example of a spine model displayed on a display unit as a result of simulation when a position of a specific vertebra model among vertebra models constituting the spine model illustrated in FIG. 8 is changed. FIG. 9 is a diagram illustrating an example of a spine model displayed on a display unit as a result of a simulation when the position of the upper end of the spine model illustrated in FIG. 8 is changed. It is an example of the manufacturing drawing of a rod. It is another example of the manufacturing drawing of a rod. It is a photograph of an example of the manufactured rod. FIG. 11 is a diagram showing an example of modeling a disc with a structure having a ramen structure in a spinal column model according to a modification.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. The same reference numerals are given to the same elements throughout the drawings.

  An apparatus for supporting spinal deformity correction and fixation according to an embodiment of the present invention is an apparatus for supporting an operation for correcting and fixing a patient's spine to a normal state or a state close to the normal state (spine deformity correction and fixation). It is. In the present embodiment, it is assumed that the patient suffers from a disease (spine deformity) in which the spine is deformed, such as scoliosis and kyphosis.

  As shown in FIG. 1, the spinal deformity correction / surgery support device 100 constitutes a spinal deformity correction / fixation support system together with a CT device 101, an X-ray imaging device 102 and a rod manufacturing device 103.

  Each of the CT apparatus 101, the X-ray imaging apparatus 102, and the rod manufacturing apparatus 103 is communicably connected to the spinal deformity correction / fixation assisting apparatus 100 via a wired, wireless, or combination communication line.

  The CT apparatus 101 is an apparatus that outputs data indicating a tomographic image of a patient by performing computer processing on information obtained by scanning a patient using radiation or the like.

  In the present embodiment, the CT apparatus 101 outputs first image data for specifying the positional relationship of a plurality of vertebrae of a patient in a natural body in three dimensions to the spinal deformity correction / fusion assisting apparatus 100. Specifically, the CT apparatus 101 photographs the entire spine of a patient in a natural body and outputs the first image data including a plurality of photographed tomographic images. According to the first image data, the state of the spine of the patient can be recognized in three dimensions. When imaging with the CT apparatus 101, the patient is, for example, in a supine position.

  Here, the vertebrae are generally composed of seven cervical vertebrae, twelve thoracic vertebrae, five lumbar vertebrae, sacrum and coccyx, but it is rare that the coccyx is involved in spinal deformity in spinal deformity. It is. Therefore, in the present embodiment, the vertebrae refers to all or a part of the vertebrae other than the coccyx, ie, 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, and the sacrum.

  An X-ray imaging apparatus 102 is an apparatus that irradiates a patient with X-rays and outputs data indicating an image of a patient's bone or the like by computer processing information obtained by detecting X-rays transmitted through the patient. It is.

  In the present embodiment, the X-ray imaging apparatus 102 specifies the distance between the vertebrae (substantially the length of the intervertebral disc along the spine) when the spine of the patient is pulled with a predetermined magnitude of force. Image data is output to the spinal deformity correction / surgery support device 100 for the purpose. Specifically, the X-ray imaging apparatus 102 captures an image of the entire spine of a patient in a state where the patient is pulled by a force of a predetermined magnitude, and outputs the second image data including the captured image. When imaging with the X-ray imaging apparatus 102, the patient is, for example, in a supine position. In the pulled state, the magnitude of the force for pulling the patient (hereinafter, also simply referred to as “pull force”) is, for example, about 20 kg to 25 kg.

  The rod manufacturing apparatus 103 is an apparatus that manufactures a three-dimensional member, and is, for example, an electron beam three-dimensional additive manufacturing apparatus that is a 3D printer for metal. In the present embodiment, when the rod manufacturing apparatus 103 acquires the rod shape data indicating the shape of the rod and the parameter for determining the rigidity of the rod from the spinal deformity correction / fixation assisting apparatus 100, the rod shape data and the parameter for determining the rigidity are obtained. The rod is manufactured based on. The electron beam additive manufacturing technology used in the electron beam three-dimensional additive manufacturing apparatus is a technique for manufacturing a three-dimensional structure by stacking layers obtained by melting and solidifying metal powder by an electron beam. The rod manufacturing apparatus 103 scans an electron beam based on the 3D CAD data to manufacture a rod used for spinal deformity correction and fusion. More specifically, the electron beam three-dimensional additive manufacturing apparatus first selectively irradiates two metal powder layers with an electron beam, thereby melting the metal powder layers and manufacturing a part of the rod. Next, a third metal powder layer is formed thereon, and the second and third metal powder layers are melted by irradiating an electron beam to manufacture a rod. By repeating this, a three-dimensional rod is completed. In this manufacturing method, no bending stress is applied to the rod during the manufacturing process. Therefore, the product life of the rod can be extended without causing metal fatigue on the rod.

  The data format of the rod shape data is, for example, 3DCAD (Three-Dimensional Computer Aided Design) software, 3DCG (Three-Dimensional Computer Graphics) software, DICOM (Digital Imaging and Communication in accordance with the Digital Imaging and Communication) standard.

  Here, the rod is a rod-shaped member used in a patient's spinal deformity correction surgery, and is made of, for example, titanium, cobalt chrome, or the like as a main material. The rod is held by a bolt or the like embedded in the vertebra of the patient, whereby the spine of the patient is corrected and fixed to a normal state or a state close to the normal state.

  Based on the first image data and the second image data of a patient, the spinal deformity correction / surgery support device 100 generates a spine model of the patient. In the spine model, the vertebrae are modeled by rigid bodies and the discs are modeled by elastic bodies. Therefore, the spine model is composed of a plurality of rigid bodies corresponding to each of the plurality of vertebrae and a plurality of elastic bodies corresponding to each of the plurality of intervertebral discs.

  Then, the spinal deformity correction / fixation assisting apparatus 100 determines the positional relationship between a plurality of rigid bodies when a specific rigid body is moved. Thus, a user (typically, an operator, a doctor who makes a treatment plan for a patient, or the like) can simulate the state of the corrected spine by giving an instruction to appropriately move the rigid body.

  As shown in FIG. 2, the spinal deformity correction / fixation assisting apparatus 100 functionally includes a first acquisition unit 104, a second acquisition unit 105, a model generation unit 106, a model data storage unit 107, and a simulation. A unit 108, a rod shape specifying unit 109, a display unit 110, and an instruction receiving unit 111 are provided.

  The first acquisition unit 104 acquires the first image data from the CT device 101. The second acquisition unit 105 acquires the second image data from the X-ray imaging device 102.

  The model generating unit 106 generates a spine model of the patient based on the first image data obtained by the first obtaining unit 104 and the second image data obtained by the second obtaining unit.

  The model generation unit 106 includes a vertebral body extraction unit 112, a positional relationship determination unit 113, and an elastic coefficient determination unit 114 in detail.

  The vertebral body extraction unit 112 extracts each of a plurality of vertebral bodies constituting the vertebral column of the natural body from the image indicated by the first image data acquired by the first acquisition unit 104. The vertebral body extraction unit 112 extracts each of the plurality of vertebral bodies constituting the pulled spine from the image indicated by the second image data acquired by the second acquisition unit 105.

  Based on the first image data and the second image data obtained by each of the first obtaining unit 104 and the second obtaining unit 105, the positional relationship determining unit 113 generates a spine model in each of the natural body and the pulled state. Determine the positional relationship between the constituent rigid bodies.

  In the present embodiment, the positional relationship determining unit 113 determines a plurality of vertebral bodies corresponding to a plurality of vertebral bodies in the natural body based on the positions of the vertebral bodies extracted from the first image data by the vertebral body extracting unit 112. Determine the positional relationship between the rigid bodies. In addition, the positional relationship determination unit 113 determines a plurality of rigid bodies corresponding to each of the plurality of vertebral bodies in the pulled state based on the positions of the vertebral bodies extracted from the second image data by the vertebral body extraction unit 112. Is determined.

  The elastic modulus determination unit 114 estimates the amount of deformation of each disc based on the first image data acquired by the first acquisition unit 104 and the second image data acquired by the second acquisition unit 105. Then, the elastic modulus determination unit 114 determines the elastic modulus of each of the plurality of elastic bodies corresponding to each of the plurality of intervertebral discs based on the estimated amount of deformation and the magnitude of the tensile force.

  Here, since the intervertebral discs generally connect the vertebral bodies, for example, based on the positional relationship of each rigid body in each of the natural body and the stretched state determined by the positional relationship determining unit 113, the The amount of deformation can be estimated. Alternatively, the amount of deformation of each intervertebral disc may be estimated based on the positional relationship of each vertebral body in each of the natural state and the pulled state extracted by the vertebral body extraction unit 112.

  The model data storage unit 107 stores model data for specifying a spine model of a patient. The model data includes, for example, a positional relationship between a plurality of rigid bodies determined by the model generation unit 106 and an elastic coefficient of each elastic body.

  Specifically, for example, in the model data, information for identifying a vertebral body is associated with information indicating the position, posture (direction), and size of a rigid body corresponding to the vertebral body. For example, in the model data, information for identifying an intervertebral disc is associated with an elastic coefficient of an elastic body corresponding to the intervertebral disc.

  The simulating unit 108 determines a positional relationship between a plurality of rigid bodies when a specific part included in the spine model generated by the model generating unit 106 is moved. Further, the simulation unit 108 calculates the energy stored in each elastic body when a specific part is moved. Further, the simulating unit 108 determines a parameter for determining the rigidity of the rod according to the energy stored in each elastic body.

  The rod shape specifying unit 109 specifies a rod shape along the positional relationship of the plurality of rigid bodies determined by the simulation unit 108, generates rod shape data indicating the specified rod shape, and sends the data to the rod manufacturing apparatus 103. Output. Further, the rod shape specifying unit 109 outputs a parameter for determining the rigidity of the rod determined by the simulation unit 108 to the rod manufacturing apparatus 103.

  The display unit 110 displays various information. For example, the display unit 110 displays an image corresponding to the positional relationship between the plurality of rigid bodies determined by the simulation unit 108. Further, for example, the display unit 110 displays the energy stored in each elastic body calculated by the simulation unit 108.

  The instruction receiving unit 111 receives an instruction from a user.

  Specifically, for example, the instruction receiving unit 111 receives an instruction such as a position to be moved in the spinal column model and a position after the movement.

  Further, for example, the instruction receiving unit 111 receives an instruction to manufacture a rod by the rod manufacturing apparatus 103. This instruction may include information for identifying a spine model obtained by the simulation that the user considers most desirable. In this case, the rod shape specifying unit 109 generates rod shape data based on information included in the instruction received by the instruction receiving unit 111, and outputs the data to the rod manufacturing apparatus 103.

  The spinal deformity correction / fusion assisting apparatus 100 physically includes, for example, one or more processors, a RAM (Random Access Memory), a ROM (Read Only Memory), a flash memory, a communication interface, a keyboard, a mouse, a touch panel, and the like. Is a device configured by appropriately combining some or all of the devices, such as a general-purpose computer and a dedicated device. The functions of the spinal deformity correction / fixation assisting device 100 and the processing executed by the spinal deformity correction / fixation assisting device 100 (details described later) include, for example, a software program in which the device having the above-described physical configuration is installed in advance. It is realized by executing. Therefore, the present invention may be realized as a program, or may be realized as a storage medium on which the program is recorded.

  The configuration of the spinal deformity correction / fixation assisting device 100 according to one embodiment of the present invention has been described above. The processing executed by the spinal deformity correction and fixation assisting device 100 according to the embodiment will now be described.

  The spinal deformity correction / support device 100 executes a spinal deformity correction / fixation assisting process (see FIG. 3) for supporting the spinal deformity correction / fixation, for example, during execution of the above-described pre-installed software program.

  The first acquisition unit 104 acquires the first image data from the CT device 101 (Step S101). At this time, the first image data may include information for identifying the patient.

  The second acquisition unit 105 acquires the second image data from the X-ray imaging device 102 (Step S102). At this time, the second image data may include information for identifying the patient.

  The model generation unit 106 generates a three-dimensional vertebra model that models the spine of the patient based on the first image data and the second image data of the same patient (step S103).

  FIG. 4 shows details of the model generation process (step S103).

  As shown in the figure, the vertebral body extraction unit 112 extracts a vertebral body in a patient's natural body by extracting the vertebral body from the image indicated by the first image data acquired in step S101 (step S101). S201). Thereby, the three-dimensional positional relationship of the vertebral body in the natural body of the patient can be estimated.

  Here, in an image (CT image) captured by the CT apparatus 101, bones are generally displayed in white. Therefore, when extracting a vertebral body from the image indicated by the first image data, for example, a pixel value may be compared with a preset threshold value, and a white portion may be extracted as a vertebra based on the comparison result. Then, the vertebral body extraction unit 112 assigns, for example, a number in order from the top as information for identifying the extracted vertebrae.

  FIG. 5 shows an example of extracting each vertebra in this manner. In the figure, a part of the spine is shown. “N” in the figure is a number assigned to the vertebra. For example, when the patient has 25 vertebrae (this embodiment excludes the coccyx as described above, and has one sacrum), “N” shown in FIG. It is the following integer.

  In addition, the vertebra has a projection such as a spinous process, an upper joint process, and a lower joint process in addition to a vertebral body. When the model is formed including the protrusions, the shape of the spine model becomes complicated. Therefore, in order to generate a spine model, the protrusions are removed from the spine, and only the vertebral body is extracted.

  Since the protruding portions abut generally between the upper and lower vertebrae, for example, in a CT image, the protruding portions are continuously white regions. By removing the continuous white area from the image, the protrusions included in the image can be substantially removed.

  The positional relationship determining unit 113 determines the positional relationship of the rigid body in the natural body by associating each of the vertebral bodies extracted in step S201 with a rigid body having a predetermined shape (step S202).

  In the present embodiment, each of the vertebral bodies is modeled by a rigid body having a predetermined shape. In detail, as shown by a dotted line in FIG. 6, a square prism having a predetermined ratio of the width WD, the height HG, and the depth DP is adopted as a predetermined shape. The predetermined shape adopted for modeling the vertebral body may have any three-dimensional shape.However, since the vertebral body is generally columnar, for example, a prism such as a prism or a cylinder is preferably used. Adopted.

  Here, the positional relationship determination unit 113 determines a predetermined columnar solid body based on the positional relationship (in this embodiment, the position and size including the posture) of the vertebral bodies of the vertebrae of the patient. A method for determining the positional relationship will be described with reference to FIG.

  In the present embodiment, a predetermined coordinate system of the entire spine (spine coordinate system) is an XYZ coordinate system, and a coordinate system fixed to a rigid body is a UVW coordinate system. The XYZ coordinate system is an orthogonal coordinate system composed of an X axis, a Y axis, and a Z axis. For example, when a person lies on his / her back, the X axis is an axis extending from left to right of the human body among horizontal axes. , The Y axis is an axis extending from the foot of the human body to the head of the horizontal axis, and the Z axis is an axis extending vertically upward.

  As shown in FIG. 6, the UVW coordinate system according to the present embodiment has the center of gravity G of the rigid body as the origin, the U axis and the W axis are parallel to the bottom surface of the rigid body, and the V axis is the U axis and the W axis. The axis is perpendicular to the axis.

  Further, in the present embodiment, the position of the center of gravity of the rigid body expressed in the XYZ coordinate system (center of gravity position GO) is defined as the position of the rigid body. The rotation matrix for converting the XYZ coordinate system into the UVW coordinate system is defined as a posture matrix M representing the posture of the rigid body. The size of the rigid body with respect to the square prism having the reference width WD, height HG, and depth DP is defined as size S. The size S is a positive real number, and means that the rigid body is modeled by a square prism having a size obtained by multiplying each of the reference width WD, height HG, and depth DP by S. FIG. 6 shows an example in which the size S is “1”.

  The positional relationship determining unit 113 selects one of the vertebral bodies extracted in S201 as a modeling target.

  The positional relationship determining unit 113 determines the center of gravity of the vertebral body to be processed as the center of gravity position GO. The positional relationship determining unit 113 sets a UVW coordinate system having the center of gravity position GO as the origin. Here, the UVW coordinate system is set such that the U axis is parallel to the X axis, the V axis is parallel to the Y axis, and the W axis is parallel to the Z axis as an initial state.

  The positional relationship determination unit 113 arranges a vertebral body having a standard shape according to the set UVW coordinate system. For example, since a human vertebral body has a roughly the same shape of a column having a horizontally long cross section, a vertebral body having a standard shape has a columnar axial direction coinciding with the V-axis and a lateral direction of the columnar cross section being U-shaped. They are arranged so that they coincide with the axis and the vertical direction of the columnar cross section coincides with the W axis.

  Here, as the standard shape of the vertebral body, for example, a shape in which a plurality of characteristic points appropriately determined for the vertebral body may have an average positional relationship may be adopted. Data indicating a standard shape of the vertebral body (standard vertebral body outline data) is held in advance by the positional relationship determination unit 113, for example. The width WD, the height HG, and the depth DP, which are the references of the square pillar 115, are such that each surface of the square pillar 115 is in contact with a vertebral body having a standard shape, and the square pillar 115 has a standard shape. Vertebral bodies are defined to be included. Note that the sacrum often has a different shape from other vertebrae (cervical vertebra, thoracic vertebra, and lumbar vertebra), so the standard shape of the sacrum may be included in the standard vertebral body outline data.

  The positional relationship determination unit 113 determines the posture matrix M and the size S by performing contour matching between the vertebral body to be processed and the shape indicated by the standard vertebral body contour data.

  More specifically, for example, the positional relationship determination unit 113 rotates a vertebral body having a standard shape together with the UVW coordinate system by changing each variable included in the posture matrix M at predetermined intervals. In addition, the positional relationship determination unit 113 determines the size S by changing the value of a predetermined range (for example, 0.9 to 1.1) at predetermined intervals, and determines a standard size according to the determined size S. Expand and contract the size of the vertebral body in a typical shape. As described above, when the orientation and the size are changed, the positional relationship determination unit 113 determines the posture matrix M and the size S that maximize the degree of coincidence with the rigid posture matrix corresponding to the vertebral body (vertebra) to be processed. Determined as M and size S.

  The degree of coincidence is a value indicating the degree of coincidence between two shapes. For example, here, the volume of a portion where a vertebral body of a standard shape whose orientation and size are changed and a vertebral body to be processed overlaps It is.

  When determining the posture matrix M of the rigid body corresponding to the vertebral body to be processed, if the processing for the adjacent vertebral body has been completed, the posture matrix M of the rigid body corresponding to the vertebral body is set as an initial value. Good to be adopted. Since the spine is usually continuous, the amount of calculation for determining the posture matrix M can be reduced by adopting a rigid posture matrix M corresponding to an adjacent vertebral body as an initial value. Therefore, the amount of calculation for determining the positional relationship between the rigid bodies can be reduced.

  The center of gravity position GO, posture matrix M, and size S of the rigid body obtained by modeling each vertebral body are appropriately corrected by, for example, giving a command to the command receiving unit 111 while checking the image displayed on the display unit 110. You may.

  Such processing is performed for each of the vertebrae constituting the spine in order (for example, in the order of the numbers assigned to the vertebrae). As a result, the center-of-gravity position GO, the posture matrix M, and the size S can be determined for each of the plurality of rigid bodies corresponding to each of the plurality of vertebrae. Thereby, the positional relationship of the rigid body in the natural body is determined.

  As shown in FIG. 4, the vertebral body extracting unit 112 extracts the vertebral body in a state where the patient is pulled by extracting the vertebral body from the image indicated by the second image data acquired in step S102. (Step S203). This makes it possible to estimate the two-dimensional positional relationship of the vertebral body in a state where the patient is pulled.

  The positional relationship determination unit 113 determines the positional relationship of the rigid body in a state where the patient is pulled by associating each of the vertebral bodies extracted in step S201 with a rigid body having a predetermined shape (step S204). .

  Here, the second image data according to the present embodiment indicates a two-dimensional image in a state where the patient is pulled. Therefore, the shape of the rigid body adopted in step S204 is, for example, the shape of each of the rigid bodies having the positional relationship determined in step S202 as viewed from the shooting direction of the image indicated by the second image data. By matching the center of gravity of the rigid body having this shape with the center of gravity of the corresponding vertebral body in the two-dimensional image, the positional relationship of the rigid body corresponding to each vertebra can be determined. At this time, the orientation of the rigid body may be appropriately changed such that the degree of coincidence between the vertebral body and the rigid body shown in the second image data is maximized. The degree of matching here is a value indicating the degree to which the rigid body whose orientation has been changed matches the vertebral body to be processed, and is, for example, the area of a portion where both overlap.

  The elastic modulus determination unit 114 estimates each distance L1 between the rigid bodies in the natural body based on the positional relationship of the rigid bodies determined in step S202. Note that the distance L1 may be estimated based on the position of each of the vertebral bodies extracted in step S201.

  More specifically, for example, the distance L1 is determined as the distance between vertically adjacent rigid bodies, that is, the distance between the center of the lower surface of the rigid body located above and the center of the upper surface of the rigid body located immediately below the rigid body. The distance L1 can be said to be the length of each intervertebral disc in a natural body.

  The elastic coefficient determining unit 114 estimates each distance L2 between the rigid bodies in a state where the patient is pulled, based on the positional relationship of the rigid bodies determined in step S204. Note that the distance L2 may be estimated based on the position of each of the vertebral bodies extracted in step S203.

  Specifically, the distance L2 is determined as the distance between the vertically adjacent rigid bodies, for example, the distance between the center of the lower side of the rigid body located above and the center of the upper side of the rigid body located immediately below the rigid body. The distance L2 can be said to be the length of each disc in a state where the patient is pulled.

  The elastic coefficient determining unit 114 calculates the difference between the estimated distances L1 and L2 between the rigid bodies. Thereby, the elastic coefficient determination unit 114 calculates, for each of the rigid bodies, a change in distance between the case where the patient is a natural body and the case where the patient is in a pulled state (step S205).

  The elastic coefficient determining unit 114 determines each elastic coefficient of the elastic body constituting the spine model based on the change in each distance between the rigid bodies calculated in step S205 (step S206).

  In the present embodiment, each of the intervertebral discs is modeled as a member that connects rigid bodies and expands and contracts in one dimension. In other words, the rigid bodies are treated as being connected by a spring, rubber, or the like.

  For example, as shown in FIG. 7, it is assumed that, in a natural body, rigid bodies 117a_1, 117b_1, and 117c_1 that model vertebrae are connected by elastic bodies 116a_1 and 116b_1 that model intervertebral discs. Then, in a state where the patient is pulled by a predetermined pulling force, the elastic bodies 116a_1 and 116b_1 in the natural body extend to elastic bodies 116a_2 and 116b_2, and the positions of the rigid bodies 117a_1, 117b_1 and 117c_1 are respectively set to the rigid bodies 117a_2 and 117a_2. It is assumed that the position has been changed to the positions of 117b_2 and 117c_2. In this case, the value obtained by subtracting the length of the elastic body 116a_1 (corresponding to the above-described distance L1) from the length of the elastic body 116a_2 (corresponding to the above-described distance L2) is divided by the pulling force to obtain the elastic body 116a_1 ( The elastic coefficient of the elastic body 116a_2) is calculated. Similarly, the elastic coefficient of the elastic body 116b_1 (elastic body 116b_2) can be calculated.

  The positional relationship determination unit 113 and the elastic modulus determination unit 114 store the model data including the content determined in steps S202 and S206 in the model data storage unit 107 (step S207).

  More specifically, the positional relationship determination unit 113 converts the data including the center of gravity position GO, the posture matrix M, and the size S of each of the rigid bodies in the natural body, that is, in three dimensions, into the image indicated by the first image data. It is stored in the model data storage unit 107 as patient model data. Further, the elastic coefficient determination unit 114 causes the model data storage unit 107 to store data including the elastic coefficient of each elastic body as model data of the patient.

  The elastic modulus determination unit 114 refers to the model data stored in the model data storage unit 107 in step S207, and refers to the data including the three-dimensional spine model in a state of being pulled by the pulling force and the energy stored in each disc. Generate Then, the elastic modulus determination unit 114 outputs to the display unit 110 display data including an image of the spine model viewed from a predetermined angle and the energy stored in each intervertebral disc. The display unit 110 acquires display data from the elastic modulus determination unit 114, and displays the spine model in a pulled state indicated by the display data and the energy stored in each intervertebral disc (step S208). FIG. 8 shows an example of the image displayed in step S208.

  In the example shown in the figure, the energy stored in each intervertebral disc is displayed by a numeral, but each energy is displayed in a corresponding color of the intervertebral disc area in a predetermined color in accordance with the size. May be displayed. Further, for example, since the spine model is created in three dimensions as described above, an image viewed from a desired angle can be displayed on the display unit 110 when the user gives an instruction through the instruction receiving unit 111. . The same applies to the case where the result of a simulation described later is displayed (see FIGS. 9 and 10).

  Thus, the model generation processing (Step S103) ends.

  Referring to FIG. 3 again, simulation section 108 determines whether or not instruction receiving section 111 has received an instruction to move a specific portion included in the spinal column model (step S104).

  If it is determined that an instruction to move a specific part has been received (step S104; Yes), the simulation unit 108 performs a simulation process (step S105).

  This simulation processing is for determining the positional relationship between a plurality of rigid bodies when a specific part included in the spine model generated in step S103 is moved. As a result, a three-dimensional spine model when a specific part is moved is determined, and data indicating the spine model is generated.

  Specifically, the simulation unit 108 refers to the model data stored in the model data storage unit 107. Then, the simulating unit 108 determines a positional relationship between a plurality of rigid bodies when a specific part is moved based on the elastic modulus of each elastic body included in the model data. At this time, the positional relationship between the plurality of rigid bodies is determined so that the total sum of the energy stored in each elastic body included in the entire spinal column model when a specific portion of the spinal column model is moved. Boundary conditions and the like for this determination may be determined as appropriate. In the present embodiment, for example, at least the lower end of the spine model is fixed. The simulation unit 108 stores the data indicating the positional relationship of the plurality of rigid bodies determined as described above in the model data storage unit 107 as data indicating the spine model when a specific part is moved.

  Further, the simulation unit 108 calculates the energy stored in each elastic body when a specific part of the spine model is moved, based on the elastic coefficient of each elastic body included in the model data. Each of the calculated energies is included in the data indicating the spine model when a specific part is moved, together with information for identifying the corresponding elastic body.

  Further, the simulating unit 108 determines a parameter for determining the rigidity of the rod according to the energy stored in each elastic body. The parameter that determines the rigidity of the rod may be generated as a unified parameter for the entire rod based on the total energy stored in each elastic body included in the entire spinal column model. Further, the parameters may be determined for each rod portion corresponding to each elastic body according to the energy stored in each elastic body. Specifically, the thickness of the rod may be changed according to the required strength.

  Specific examples of the parameters include, for example, the type of the metal material, the thickness of the metal material layer, the density of the metal particles, the electric energy of the electron beam, and the irradiation time of the electron beam. Which parameter and how to set according to the energy stored in the elastic body is obtained in advance through experiments or the like and stored in the simulation unit 108. Then, the simulating unit 108 obtains a parameter for determining the rigidity of the rod by pulling the table based on the simulation result. The parameters also include parameters for determining the thickness of the rod.

  The simulation unit 108 outputs, to the display unit 110, display data including an image of the spine model viewed from a predetermined angle and the energy stored in each disc based on the data generated in step S105. I do. The display unit 110 acquires the display data from the simulation unit 108, and displays the spine model indicated by the display data and the energy stored in each intervertebral disc (step S106). Then, the process of step S104 is performed again.

  FIG. 9 shows an example of a screen displayed on the display unit 110 in step S106 when a specific portion of the spinal column model shown in FIG. 8 is moved as indicated by an arrow in FIG. The screen illustrated in FIG. 9 includes a spine model (a solid line in FIG. 9) in which a specific part other than both ends of the spine model is moved, and a spine model before the specific part is moved, ie, the spine shown in FIG. It includes the model (dotted line in FIG. 9) and the energy stored in each disc when a particular location is moved.

  As described above, the spine model when a part other than the end is moved as a specific portion is determined so that the total sum of energy stored in each elastic body included in the entire spine model is minimized. The conditions for this determination include, in addition to fixing the lower end at the position before the movement as described above, further, for example, fixing the upper end to the position before the movement, and the position after the movement at a specific position. And fixing the same.

  FIG. 10 illustrates an example of a screen displayed on the display unit 110 in step S106 when the upper end of the spine model illustrated in FIG. 8 is moved as a specific location as indicated by an arrow in FIG. The screen illustrated in FIG. 10 includes a spine model in which the upper end is moved (solid line in FIG. 10), a spine model before moving the upper end, that is, a spine model (dotted line in FIG. 10) shown in FIG. And the energy stored in each disc when moved.

  As described above, the spine model when the end (in this embodiment, the end is fixed and the upper end is fixed) is moved to each elastic body included in the entire spine model as described above. It is determined that the sum of the stored energy is minimized. Conditions for this determination include, for example, fixing the upper end to the position after the movement in addition to fixing the lower end to the position before the movement as described above.

  When it is determined that the instruction to move the specific portion has not been received (Step S104; No), the rod shape specifying unit 109 determines whether the instruction receiving unit 111 has received an instruction to manufacture a rod (Step S104). S107).

  When it is determined that the instruction to manufacture the rod has not been received (Step S107; No), the process of Step S104 is executed again.

  When it is determined that an instruction to manufacture a rod has been received (Step S107; Yes), the rod shape specifying unit 109 specifies a rod shape that matches the spine model displayed on the display unit 110 (Step S108).

  More specifically, for example, the rod shape specifying unit 109 specifies the rod shape along the positional relationship of a plurality of rigid bodies included in the spine model displayed on the display unit 110. More specifically, for example, the shape of the rod is specified by a smooth approximate curve passing through the center of gravity of each of the rigid bodies. The approximate curve is a curve or the like that is represented by a higher-order function of a predetermined degree or a degree specified by the user.

  According to the present embodiment, when the spine model that the user considers most desirable is displayed on display unit 110, the user may give an instruction to instruction reception unit 111. As a result, the information for specifying the spine model displayed on the display unit 110 is output to the rod shape specification unit 109, and rod shape data conforming to the shape of the spine model is generated. The rod shape data may indicate a three-dimensional shape including, for example, the thickness of the rod specified by the user.

  The rod shape specifying unit 109 generates rod shape data indicating the shape of the rod specified in step S108 and outputs the data to the rod manufacturing apparatus 103 (step S109), and the process of step S104 is executed again. Then, the rod manufacturing apparatus 103 obtains rod shape data, and manufactures a rod having the shape indicated by the obtained rod shape data.

  FIGS. 11 and 12 show examples of drawing the rod shape data output by the rod shape specifying unit 109. FIG. FIGS. 11 and 12 are examples in which the curvatures of the rods for correcting the spine are different and the curvatures are relatively small.

  FIG. 13 is a photograph of a rod actually manufactured by the rod manufacturing apparatus 103 based on the rod shape data shown in FIGS. 11 and 12 output by the rod shape specifying unit 109. It was confirmed that the manufactured rod was faithful to the shape data generated by the rod shape specifying unit 109. It was also confirmed that no bending stress or the like was applied to the rod during manufacture.

  As described above, according to the present embodiment, the spinal deformity correction / fixation assisting apparatus 100 generates a three-dimensional spine model based on the first image data and the second image data of the patient, The positional relationship between a plurality of rigid bodies when a specific part included in the spinal column model is moved is determined. Thereby, by appropriately moving the rigid body, simulate the state of the spine after correction, based on the result of the simulation, to study in advance the state of the spine after correction suitable for the patient, during surgery, after the correction The time for determining the condition of the spine can be reduced at least. Therefore, it is possible to perform appropriate spinal deformity correction and fixation in a short time.

  In general, conventional spinal deformity correction where the physician bends the rod during surgery can leave residual stress on the rod. And, the rod may be broken in the patient's body after the operation due to residual stress. Also, the rod may deform after surgery to reduce residual stress, and the spine may not be fixed in the state intended by the physician.

  In order to prevent the rod from being bent or deformed after the operation, it is desirable to manufacture a rod made of a material having higher strength in advance. According to the present embodiment, based on the result of the simulation, it is possible to manufacture in advance a rod suitable for the state of the spine after appropriate correction. At this time, for example, by performing a heat treatment, a rod having higher strength than before can be manufactured in advance before the operation. This enables appropriate spinal deformity correction and fusion.

  In addition, by preparing the rod before the operation, the time for bending the rod during the operation can be reduced or omitted, and the operation time can be shortened. Therefore, it becomes possible to perform spinal deformity correction and fixation in a short time.

  Furthermore, in general, doctors cut and use rods of a certain length for each case, but if rods having a predetermined length can be used, material costs can be reduced, Inventory management becomes easier.

  According to the present embodiment, based on the elastic modulus of each elastic body, the positional relationship between a plurality of rigid bodies that minimizes the total energy stored in each elastic body when a specific part is moved is determined. Thereby, the state of the spine model when a specific part is moved is determined. According to such a method, the state of the spine model when a specific portion is moved can be relatively easily obtained without performing a complicated calculation based on the force applied to each rigid body. Therefore, it is possible to support appropriate spinal deformity correction / fixation while suppressing the load of the spinal deformity correction / support device 100 for performing the arithmetic processing.

  According to the present embodiment, the energy stored in each elastic body included in the spinal column model is displayed on display unit 110. This makes it possible to estimate how much load will be applied to the spine after the correction, so that it is possible to avoid, for example, correction that causes an excessive load on the patient. Therefore, it is possible to perform safer and more appropriate spinal deformity correction and fixation than before.

  According to the present embodiment, each of the intervertebral discs is modeled as a member that expands and contracts one-dimensionally. Thereby, it is possible to simulate the state of the corrected spine while expressing the intervertebral disc as a relatively simple model. Therefore, it is possible to support appropriate spinal deformity correction / fixation while suppressing the load of the spinal deformity correction / support device 100 for performing the arithmetic processing.

  According to the present embodiment, each of the vertebrae is modeled by a rigid body having a predetermined shape. Thus, it is possible to simulate the state of the corrected spine while expressing the vertebra as a relatively simple model. Therefore, it is possible to support appropriate spinal deformity correction / fixation while suppressing the load of the spinal deformity correction / support device 100 for performing the arithmetic processing.

  According to the present embodiment, each of the vertebrae is modeled by a quadrangular prism as an example of a columnar solid. Then, the position and size of the columnar solid are determined based on the position and size of the vertebral body of each vertebra of the patient. Thus, it is possible to simulate the state of the corrected spine while expressing the vertebra as a relatively simple model. Therefore, it is possible to support appropriate spinal deformity correction / fixation while suppressing the load of the spinal deformity correction / support device 100 for performing the arithmetic processing.

  In the present embodiment, a rod suitable for the spine model generated by the simulation is manufactured by the rod manufacturing apparatus 103 in accordance with a user's instruction. This makes it possible to easily manufacture a rod that conforms to the condition of the spine after proper correction.

  In the present embodiment, the first image data indicates an image captured by the CT device 101, and the second image indicates an image captured by the X-ray imaging device 102. In general, the CT apparatus 101 has a larger patient dose than the X-ray imaging apparatus 102. According to the present embodiment, it is not necessary to use the CT device 101 for generating both the first image data and the second image data, so that the three-dimensional spine model can be generated while suppressing the exposure dose of the patient. It is possible to simulate the state of the spine after building and correcting it.

  In the embodiment, in step S208, the three-dimensional spine model in a pulled state and the energy stored in each disc are displayed. Instead, in step S208, data including a three-dimensional spine model of a natural body and energy (in this case, for example, zero) stored in each disc is generated, and these are displayed on the display unit 110. May be displayed. However, according to the embodiment, the user can see the state corrected to some extent, correct it, and simulate it. Therefore, according to the embodiment, it is possible to efficiently perform the simulation.

  As described above, one embodiment of the present invention has been described, but the present invention is not limited to this embodiment. For example, it may be modified as follows.

  For example, in the embodiment, each of the intervertebral discs is modeled as a member that connects rigid bodies and expands and contracts one-dimensionally. However, as shown in FIG. 14, each of the intervertebral discs may be modeled as a structure 118 having a rigid frame structure connecting between rigid bodies 117d and 117e that model a vertebral body.

  In this case, the amount of deformation of each intervertebral disc may be estimated based on the same image of the vertebral column as in the case of the natural body and the case of the pulled state. Then, the longitudinal elastic modulus and the lateral elastic modulus may be determined as the elastic coefficients of the intervertebral discs based on the estimated deformation amount and the tensile force of each intervertebral disc.

  According to this, at the time of the simulation, the energy stored in the intervertebral disc due to torsion can also be considered. Therefore, it is possible to more accurately obtain the state of the spine after the correction, and more accurately obtain the energy stored in the intervertebral disc in the corrected spine, so that it is possible to support appropriate spinal deformity correction and fusion. .

  For example, the spine model may be generated only for a part of the patient's spine including the deformed part (deformed part).

  In this case, for example, the positional relationship determination unit 113 compares the curvature of each part of the spine with a threshold determined according to a normal curvature, and determines a deformed part as a part where the curvature is determined to be abnormal as a result of the comparison. You may. Then, the positional relationship determining unit 113 may determine the spine included in a predetermined range in the up and down directions from the deformed part and the deformed part as the part for generating the spine model. Here, the predetermined range may be determined by, for example, the length, the ratio to the deformed portion, or the like.

  Also, for example, the part that models the spine may be specified by the user. According to this, it is possible to generate a spine model composed of less rigid and elastic bodies than modeling the entire spine. Also, with this spine model, it is possible to simulate the state of the spine after correction. Therefore, it is possible to support appropriate spinal deformity correction / fixation while suppressing the load of the spinal deformity correction / support device 100 for performing the arithmetic processing.

  For example, the first image data only needs to be able to three-dimensionally specify the positional relationship between a plurality of vertebrae of a patient in a natural body, and is generated by, for example, an X-ray imaging device, an MRI (Magnetic Resonance Imaging) device, or the like. May be done. When an X-ray imaging apparatus is employed, the first image data may include a plurality of X-ray images obtained by imaging the patient's spine at different angles. Even when such first image data is adopted, the same effect as that of the embodiment can be obtained.

  For example, the second image data may be any data as long as the interval between the vertebrae can be specified when a force is applied to the spine of the patient. The state in which a force is applied to the patient's spine is not limited to the state described in the embodiment, that is, the state in which the patient's spine is pulled by a force of a predetermined magnitude, but the standing, deformed spine The state where the vertex is pressed may be used. Data indicating a plurality of images obtained by appropriately combining these states may be adopted as the second image data. When standing, the force applied to each disc can be estimated based on the patient's body type, weight, and the like. When pushing the apex of the deformed spine, the force applied to each disc can be estimated by measuring the pushing force.

  Further, for example, the device that generates the second image data is not limited to the X-ray imaging device 102. As a device that generates the second image data, a CT device, an MRI device, or the like may be appropriately used according to a state in which a patient's spine is imaged.

  Even when such second image data is employed, the flexibility of each intervertebral disc can be represented by the elastic modulus of the corresponding elastic body. Can be estimated. Therefore, even when such second image data is adopted, the same effect as that of the embodiment is achieved.

  For example, in the embodiment, the example has been described in which the position of the center of gravity of the rigid body (the center of gravity position GO) is adopted as the position of the rigid body. However, the way of representing the position of the rigid body may be changed as appropriate. The coordinate system used in the present embodiment is an example of a coordinate system used in the model generation process (step S103) and the simulation process (step S105), and is a coordinate system used in each of these processes. Is not limited to a rectangular coordinate system, but may be changed as appropriate, such as a polar coordinate system. According to such a modification, the same effect as that of the embodiment can be obtained.

  For example, in the embodiment, an example has been described in which the center of gravity position GO, the posture matrix M, and the size S are determined based on the shape of each vertebral body of the patient and the shape indicated by the standard vertebral body outline data. However, the method of determining the position of the center of gravity GO, the posture matrix M, and the size S is not limited to this. For example, the center of gravity position GO, the posture matrix M, and the size S may be determined based on each vertebra of the patient and the shape indicated by the standard vertebral body outline data in a procedure similar to the procedure described in the embodiment. . According to such a modification, the same effect as that of the embodiment can be obtained.

  For example, in the embodiment, the example in which the size S is determined for each vertebral body in the model generation processing (step S103) has been described. However, since the vertebral bodies of humans are generally the same in size, determination of the size S may be omitted. In this case, the vertebral body is modeled by a rigid body having a predetermined shape that differs only in posture. This makes it possible to reduce the amount of calculation for determining the positional relationship between the rigid bodies.

  In the above description, the doctor or the like determines the specific location, the moving direction, and the moving amount with reference to the spine model displayed on the display unit 110 and the energy stored in each elastic body. The present invention is not limited to this, and the spinal deformity correction / fixation assisting device 100 may be configured to specify and move a specific portion, and also to automatically specify a simulation.

In this case, for example, a threshold of energy that may be stored in the elastic body is set in advance from an allowable load that may be applied to the vertebra of the patient in consideration of the age of the patient and registered in the simulation unit 108. If a physician's instruction cannot be detected after the spine model is generated in the process of step S103, the simulating unit 108 compares the model obtained in step S103 with a threshold, and stores energy equal to or higher than the threshold. It is determined whether or not any elastic body exists. When determining that there is an elastic body storing energy equal to or greater than the threshold, the simulating unit 108 divides the rigid bodies on both sides of the elastic body into a plurality of directions and distances by the method described with reference to FIG. A plurality of spine models moved in combination are generated, and the energy stored in each elastic body is simulated for each spine model (steps S104 and S105).
Subsequently, the simulation unit 108 searches the generated plurality of spine models for a combination of the movement direction and the movement distance at which the energy stored in all the elastic bodies is equal to or less than the threshold value and the spine model at that time. Subsequently, the simulation unit 108 displays an arbitrary number of spine models on the display unit 110 in ascending order of the total energy stored in all the elastic bodies in the spine model (step S106).

  The doctor or the like selects an arbitrary one of the displayed spinal column models. When this selection operation is detected in steps S104 and S107, the rod shape specifying unit 109 generates rod shape data corresponding to the selected spine model and outputs the data to the rod manufacturing apparatus 103 (step S108, S109)

  According to such a method, when there is an elastic body in which energy equal to or higher than the threshold value is stored in the spine model generated in step S103, a corrected spine model candidate is automatically generated. . Therefore, a doctor or the like can select and use an arbitrary spinal column model from the candidates. Therefore, the simulation work for finding the optimal spine model becomes easier.

  Note that a doctor or the like selects an arbitrary one of the plurality of displayed candidates, receives an instruction to specify and move an arbitrary position of the selected spinal column model (step S104), and simulates steps S105 and S106. And display processing may be performed.

  Although the example using the correction method described with reference to FIG. 9 has been described, the correction method described with reference to FIG. 10 may be used. Further, both of the methods shown in FIGS. 9 and 10 may be simulated together.

  Further, in the above description, the case where the electron beam 3D additive manufacturing apparatus which is the 3D printer for metal using the electron beam additive manufacturing technique is used for the rod manufacturing apparatus 103 has been described, but the electron beam additive manufacturing technique is used. It is not necessary to limit to a 3D printer, and another additive manufacturing technology may be used. Although it is desirable to use a 3D printer for the rod manufacturing apparatus 103, an apparatus for bending a metal rod may be used.

  The present invention is capable of various embodiments and modifications without departing from the broad spirit and scope of the invention. Further, the above-described embodiment is for describing the present invention, and does not limit the scope of the present invention. That is, the scope of the present invention is shown not by the embodiments but by the claims. Various modifications made within the scope of the claims and the scope of the invention equivalent thereto are considered to be within the scope of the present invention.

REFERENCE SIGNS LIST 100 spinal deformity correction / fixation support device 101 CT device 102 X-ray imaging device 103 rod manufacturing device 104 first acquisition unit 105 second acquisition unit 106 model generation unit 107 model data storage unit 108 simulation unit 109 rod shape identification unit 110 display Unit 111 instruction receiving unit 112 vertebral body extracting unit 113 positional relationship determining unit 114 elastic coefficient determining unit

Claims (13)

A first acquisition unit configured to acquire first image data for specifying a positional relationship of a plurality of vertebrae of a patient in a natural body in three dimensions;
A second acquisition unit that acquires second image data for specifying an interval between vertebrae in a state where a force is applied to the spine of the patient;
On the basis of the obtained first image data and the obtained second image data, a plurality of rigid bodies corresponding to a plurality of vertebrae and a plurality of elastic bodies corresponding to a plurality of intervertebral discs are configured. A model generation unit for generating a three-dimensional spine model,
A spine deformity correction / fixation assisting device, comprising: a simulation unit that determines a positional relationship between the plurality of rigid bodies when a specific part included in the generated spinal column model is moved. The model generation unit includes:
A positional relationship determining unit that determines a positional relationship between the plurality of rigid bodies based on the obtained first image data;
Based on the acquired first image data and the acquired second image data, the amount of deformation of each disc is estimated, and based on the estimated amount of deformation and the magnitude of the force, The spinal deformity correction and fixation assisting device according to claim 1, further comprising: an elastic coefficient determining unit that determines an elastic coefficient of the elastic body. The simulating unit is configured to determine, based on the determined elastic modulus of each elastic body, the positions of the plurality of rigid bodies at which the sum of energy stored in each elastic body is minimized when the specific part is moved. The spinal deformity correction and fixation assisting device according to claim 2, wherein the relationship is determined. The simulating unit further stores, in the respective elastic bodies, when the specific location is moved, based on the determined positional relationship between the plurality of rigid bodies and the determined elastic coefficient of each elastic body. Calculated energy,
The spine deformity correction / fixation assisting device further includes a display unit that displays an image corresponding to the determined positional relationship between the plurality of rigid bodies and the calculated energy stored in each elastic body. 4. The spinal deformity correction and fixation assisting device according to 3. The spinal deformity correction and fixation assisting device according to any one of claims 1 to 4, wherein each of the intervertebral discs is modeled as a member that connects between the rigid bodies and expands and contracts one-dimensionally. The spinal deformity correction and fixation assisting device according to any one of claims 1 to 4, wherein each of the intervertebral discs is modeled as a structure having a rigid frame structure connecting the rigid bodies. The spine deformity correction and fixation assisting device according to any one of claims 1 to 6, wherein each of the vertebrae is modeled by a rigid body having a predetermined shape. The predetermined shape of the rigid body is a columnar solid,
The spine deformity correction and fixation assisting device according to claim 7, wherein the model generation unit determines the position and size of the rigid body based on the position and size of a vertebral body of each vertebra of the patient. 9. A rod shape specifying unit that specifies a rod shape according to the determined positional relationship between the plurality of rigid bodies and outputs rod shape data indicating the specified rod shape to a rod manufacturing apparatus. The spinal deformity correction and fixation assisting device according to any one of the above. A first acquisition unit acquiring first image data for specifying a positional relationship of a plurality of vertebrae of the patient in a natural body in three dimensions;
And the second acquisition unit acquires the second image data in order to identify the distance between the vertebrae in a state in which forces the spinal column of the patient is applied,
A model generator configured to generate a plurality of rigid bodies corresponding to a plurality of vertebrae and a plurality of elastic bodies corresponding to a plurality of intervertebral discs based on the obtained first image data and the obtained second image data, Generating a three-dimensional spine model composed of a body and
A method for assisting spinal deformity correction and fixation, wherein the simulating unit determines a positional relationship between the plurality of rigid bodies when a specific part included in the generated spine model is moved. Computer
First acquisition means for acquiring first image data for specifying a positional relationship of a plurality of vertebrae of a patient in a natural body in three dimensions;
Second acquisition means for acquiring second image data for specifying an interval between vertebrae in a state where a force is applied to the spine of the patient;
On the basis of the obtained first image data and the obtained second image data, a plurality of rigid bodies corresponding to a plurality of vertebrae and a plurality of elastic bodies corresponding to a plurality of intervertebral discs are configured. Model generating means for generating a three-dimensional spine model,
A program for functioning as simulation means for determining a positional relationship between the plurality of rigid bodies when a specific portion included in the generated spinal column model is moved. A first acquisition step of acquiring first image data for specifying a positional relationship of a plurality of vertebrae of a patient in a natural body in three dimensions;
A second acquisition step of acquiring second image data for specifying an interval between vertebrae in a state where a force is applied to the spine of the patient;
On the basis of the obtained first image data and the obtained second image data, a plurality of rigid bodies corresponding to a plurality of vertebrae and a plurality of elastic bodies corresponding to a plurality of intervertebral discs are configured. A model generation step of generating a three-dimensional spine model,
A data generation step of generating rod shape data indicating a rod shape along a positional relationship of a plurality of rigid bodies constituting the spine model generated in the model generation step,
Based on the rod shape data generated in the data generation step, using an electron beam additive manufacturing technology, a manufacturing step of manufacturing a rod used in spinal deformity correction surgery,
A rod manufacturing method including: A simulation step of determining a positional relationship between the plurality of rigid bodies when a specific part included in the spine model generated in the model generation step is moved,
The simulating step is a step of simulating energy stored in each elastic body included in the spinal column model based on the determined positional relationship between the plurality of rigid bodies and an elastic coefficient of the elastic body; Displaying the energy stored in the
The method for manufacturing a rod according to claim 12, comprising:

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