KR102256557B1 - A method for manufacturing surgical guide using 3d image - Google Patents

Abstract

The present invention relates to a method of manufacturing a guide for maxillofacial surgery using a three-dimensional image, comprising the steps of: (a) generating a first three-dimensional image through a CT scan; (b) performing a surgical simulation using the 3D image and then generating a 3D model through 3D printing; (c) applying a fixing plate to conform to the shape of the 3D model, and inserting and fixing a scanning screw through the screw hole of the fixing plate; (d) generating a second 3D image using a 3D model in which the scanning screw is fixed; (e) registering the first 3D image and the second 3D image; And (f) manufacturing a guide using the matched three-dimensional image.

Description

Manufacturing method for surgical guide using 3D image{A METHOD FOR MANUFACTURING SURGICAL GUIDE USING 3D IMAGE}

The present invention relates to a new method of manufacturing a surgical guide using a three-dimensional image.

For modern people, the appearance of the face, especially the impression, not only plays a functional role, but also acts as a criterion for judging a person during interviews such as employment or admission, and plays a very important role in social life such as socialization and employment. It is acting as an element.

In addition, the appearance of the face is largely influenced by facial bones such as the maxilla and mandible, and this surgery on the facial bone is called maxillofacial surgery.

Maxillofacial surgery can be classified into maxillofacial deformity surgery to treat congenital and acquired disharmony of the facial bone, maxillofacial trauma surgery to treat fractures of the facial bone, and maxillofacial reconstruction surgery to reconstruct facial bones that were damaged by tumors or infections.

In general, maxillofacial surgery is a surgery in which bones are cut and positioned appropriately and then fixed, or when the jaw bone is excised, the bones of other areas such as the fibula are taken and fixed to make them into an ideal shape.

The plate is used together with a screw to fix the bones cut in this way, but the existing plate must be bent to match the shape of the bone during surgery, so it takes a long time to operate and the accuracy may be low. There was.

In order to overcome this, a patient-specific plate has been developed through 3D printing, but there is a disadvantage in that it takes a lot of time to manufacture and is difficult to use for many patients due to high cost.

In order to overcome the above problems, the present inventors have attempted to provide a method of manufacturing a fixed plate and a guide capable of using existing off-the-shelf plates as they are, increasing the accuracy of surgery, and shortening the operation time.

The present invention is a method that can replace a patient-specific plate that requires expensive cost, and provides a guide manufacturing method that can efficiently utilize an existing off-the-shelf plate. The purpose.

According to an aspect of the present invention, (a) generating a first 3D image through a CT scan; (b) performing a surgical simulation using the 3D image and then generating a 3D model through 3D printing; (c) applying a fixing plate (bending and generating a screw hole) to conform to the shape of the 3D model, and inserting and fixing a scanning screw through the screw hole of the fixing plate; (d) generating a second 3D image using a 3D model in which the scanning screw is fixed; (e) registering the first 3D image and the second 3D image; And (f) manufacturing a guide using the matched three-dimensional image; a method for manufacturing a guide for maxillofacial surgery is provided.

In one embodiment, the scanning screw may provide three-dimensional information on a screw introduction position and path of the guide.

In one embodiment, the scanning screw is composed of a screw portion including a head portion and a screw thread, and the diameter of the head portion may match the diameter of the screw guide.

In one embodiment, the head portion of the scanning screw may have a cylindrical shape.

In one embodiment, the guide is an osteotomy guide for maxillofacial deformity surgery, a fibula cutting guide for maxillofacial reconstruction surgery, a fibula screw guide, or It may be a mandible resection guide.

In one embodiment, the guide may include a screw hole formed using an image to which the scanning screw is fixed.

In one embodiment, the surgical simulation may form a bone cutting and bonding structure.

According to the present invention, since the existing off-the-shelf plate is used as it is, the operation cost is very cheap compared to the patient-specific fixed plate, and the same precision as the patient-specific plate can be obtained.

In particular, since the existing fixing plate has to be applied directly to the facial bone of the patient during surgery, the accuracy is low and it takes a long time, but the operation time can be significantly reduced by using the guide of the present invention.

The effects of the present invention are not limited to the above effects, and should be understood to include all effects that can be deduced from the configuration of the invention described in the detailed description or claims of the present invention.

1 is a flow chart of a method of manufacturing a guide for maxillofacial surgery according to an embodiment of the present invention.
2 shows step (a) of generating a first 3D image through CT scan.
3 and 4 show a step (b) of generating an actual model from a 3D model generated by a surgical simulation using a 3D printer.
5 shows a step (c) of applying a fixing plate according to the shape of a 3D model and fixing it with a scanning screw.
6 shows steps (d) and (e) of scanning a 3D model in which a scanning screw is fixed and matching it with the 3D image of step (b).
7 shows the steps of manufacturing a mandibular resection guide.
8 shows the steps of manufacturing the fibula cutting guide and the fibula screw guide.
9 shows a state in which a mandibular resection guide is applied during an actual operation.
10 shows a state in which the fibula screw guide is applied during an actual operation.
11 shows a state in which a fibula cutting guide is applied during an actual operation.
12 shows a state in which the mandible and fibula are fixed through a fixing plate during an actual operation.
13 is a schematic diagram of a scanning screw according to an embodiment of the present invention.
14 is a schematic diagram of a screw guide according to an embodiment of the present invention.

Hereinafter, the present invention will be described with reference to the accompanying drawings. However, the present invention may be implemented in various different forms, and is not limited to the embodiments described below.

In addition, parts irrelevant to the description are omitted in the drawings in order to clearly describe the present invention, and similar reference numerals are attached to similar parts throughout the specification.

Throughout the specification, when a part is said to be "connected" with another part, this includes not only "directly connected" but also "indirectly connected" with another member interposed therebetween. . In addition, when a part "includes" a certain component, this means that other components may be further provided, not excluding other components, unless specifically stated to the contrary. Hereinafter, the present invention will be described in more detail with reference to the drawings.

Referring to FIG. 1, an aspect of the present invention includes the steps of: (a) generating a first 3D image through a CT scan; (b) performing a surgical simulation using the 3D image and then generating a 3D model through 3D printing; (c) applying a fixing plate (bending and generating a screw hole) to conform to the shape of the 3D model, and inserting and fixing a scanning screw through the screw hole of the fixing plate; (d) generating a second 3D image using a 3D model in which the scanning screw is fixed; (e) registering the first 3D image and the second 3D image; And (f) manufacturing a guide using the matched three-dimensional image.

Referring to FIG. 12, the plate is a member for joining the cut bone during surgery, and includes a plurality of screw holes, and may be fixed to the surgical site by a fixing screw.

When applying the fixation plate to the patient's surgical site (bone) during surgery, it is difficult to predict the location where the screw is fixed, and the path may be different depending on the shape or location of the bone despite the same location. It is difficult to accurately judge.

The surgical guide manufacturing method is different from the method in which the conventional fixing plate is applied to the surgical site of the patient during surgery, after applying the fixing plate to the 3D model produced through simulation in advance, it is possible to provide a patient-tailored surgical guide using this. I can.

In the guide manufacturing method using the 3D model, the guide is for the purpose of accurate fracture cutting and accurate screw placement, for example, a fibula cutting guide, a fibula screw guide, or a mandibular resection guide ( mandible resection guide), but is not limited thereto.

That is, various types of guides required in most maxillofacial bone surgery can be manufactured through the 3D model.

Referring to Figures 9 to 11, by using the 3D model in surgery that requires the bonding of the fibula processed into a predetermined shape for reconstruction of the mandible, it is possible to easily and accurately manufacture a guide for cutting or processing the surgical site. have.

Hereinafter, a method of manufacturing a guide for maxillofacial surgery of the present invention will be described in more detail.

In step (a), a first 3D image may be generated through CT imaging.

The “Computed Tomography (CT)” is an imaging device that displays a tomographic image of the body that cannot be represented by general photographing. X-rays transmitted from various angles of the human body are measured with a computer and the absorption value for the cross-section of the human body is reconstructed. It is a tomography apparatus represented by and can collectively refer to all imaging equipment, such as CBCT (cone beam computed tomography) and MDCT (multi-detector computed tomography), which are recently used.

Referring to FIG. 2, an image and a model of the surgical site of the human body can be obtained through the CT scan, and if a cutting process for the fibula is required, not only image information on the mandible, but also other parts of the body for bone transplantation. It is also possible to create a 3D image of a part (including the fibula, ilium, etc.).

The “three-dimensional image” may mean multi-dimensional data composed of discrete image elements. The image may include a medical image of an object acquired by a CT imaging apparatus, and may include, for example, a mandible image and a fibula image.

The 3D image is generated based on the result of collecting and analyzing CT images, and may be generated by an electronic device capable of image processing. For example, a digital imaging and communications in medicine (DICOM) device, a personal computer, a laptop, a smart phone, and It may be created by the same portable device or the like.

In step (b), after performing a surgical simulation using the 3D image, a 3D model may be generated through 3D printing.

3 and 4, the surgical simulation can form a cutting and bonding structure of the fibula and mandible.

The “surgical simulation” is performed by the same method on the same area as the actual surgery, and the surgical method can be accurately implemented in advance through the three-dimensional movement and rotation of the digital three-dimensional model.

Since the surgical simulation is performed based on a 3D image generated by CT imaging, a virtual result identical to the actual surgical result can be calculated.

The “three-dimensional printing” is a process of fabricating the generated virtual three-dimensional image as a model of the same type, and can be generally achieved by an additive process.

The 3D printer used for 3D printing may be an equipment for rapid prototyping based on data using CAD/CAM technology.

The “three-dimensional model” is 3D printed and may be composed of a material including a synthetic material such as high-strength plastic, but the material is particularly limited if it has a certain level of strength and shape-retaining power to realize the actual surgical result. It does not become. The material may have antibacterial, waterproof, and dustproof properties as needed.

Particularly, the 3D model has the same size and shape as the surgical result of the actual surgical site based on the surgical simulation, and the fixing plate can be applied in advance and the screw introduction position can be checked.

In addition, a guide manufactured based on the 3D model may provide accurate 3D information on a screw introduction position or a cutting position during an actual operation.

In the step (c), a fixing plate may be applied to conform to the shape of the 3D model, and a scanning screw may be inserted and fixed through a screw hole of the fixing plate. In addition, in step (d), the three-dimensional model to which the scanning screw is fixed may be three-dimensionally scanned.

The fixing plate includes a plurality of screw holes, and is fixed by a screw during an actual operation to maintain the joint structure of the facial bone and the fibula.

Referring to FIG. 5, since the joint structure of the fibula and facial bone formed by the surgical simulation is the same as the actual surgical result, the fixing plate applied to the surgical site during the actual operation may be applied in the same shape before the operation.

Therefore, since the procedure for applying the fixing plate after bending the plate in the same shape as the surgical site in the actual operation is omitted, the operation time can be shortened, and the same result as the shape applied in the actual operation can be secured in advance.

The scanning screw may provide three-dimensional information on the screw introduction position and path of the guide.

Since the cut bone is fixed using a screw and a fixing plate during an actual operation, it is possible to easily manufacture a guide when information on the path as well as the introduction position of the screw is secured in advance.

Referring to FIG. 13, the scanning screw may be composed of a screw portion including a head portion and a screw thread, and the diameter of the head portion coincides with the screw guide diameter. The screw hole can be easily formed.

Referring to FIG. 14, the screw guide includes a through hole for introducing a screw, and a diameter of the screw guide may match a diameter of a head portion of the scanning screw.

That is, the position and path of the screw hole may be preliminarily identified and analyzed in three dimensions by the head of the scanning screw, and may be utilized as accurate information for manufacturing an actual guide.

In one embodiment, the head portion of the scanning screw may have a cylindrical shape, and the position and fixation angle of the cylindrical head portion may provide information on the position and path of the screw introduced during an actual operation.

However, in actual surgery, the screw is not directly introduced, but may be introduced through the screw guide (FIGS. 9 to 11).

Referring to FIG. 7, the mandible resection guide must accurately indicate the position and shape of the mandible as well as the position of screw introduction.

The mandibular resection guide may be manufactured in the same shape as the mandible excised based on the three-dimensional model, and a guide hole having the same shape as the position and path to which the screw is introduced during surgery may be formed.

In addition, referring to FIG. 8, a fibula cutting guide and a fibula screw guide may accurately indicate not only the resected position and shape of the fibula, but also the screw introduction position.

In step (e), the first 3D image and the second 3D image may be superimposed, and in step (f), a guide may be manufactured using the matched 3D image.

Referring to FIG. 6, by matching the scanned first 3D image and the second 3D image in step (e), a 3D image in which the scanning screw is fixed may be finally obtained. Guides can be easily manufactured by using images.

The guide may be manufactured in a virtual form using the 3D image and then 3D printed, or may be separately manufactured in the same shape and size.

The guide is not particularly limited as long as it can accurately indicate the position of the ablation or the position of the screw during surgery, and may be manufactured using a synthetic material that is generally widely used in the industry.

It can be performed in the general CAD/CAM (computer aided design / computer aided manufacturing) program.

An embodiment of the present invention may also be implemented in the form of a recording medium including instructions executable by a computer, such as a program module executed by a computer. In addition, the above-described method can be written as a program that can be executed on a computer, and can be implemented in a general-purpose digital computer that operates the program using a computer-readable medium.

The structure of the data used in the above-described method can be recorded on a computer-readable medium through various means. A recording medium for recording executable computer programs or codes for performing the various methods of the present invention should not be understood as including temporary objects such as carrier waves or signals.

The computer-readable medium may include a storage medium such as a magnetic storage medium (eg, ROM, floppy disk, hard disk, etc.), and an optical reading medium (eg, CD-ROM, DVD, etc.).

The above description of the present invention is for illustrative purposes only, and those of ordinary skill in the art to which the present invention pertains will be able to understand that other specific forms can be easily modified without changing the technical spirit or essential features of the present invention. will be. Therefore, it should be understood that the embodiments described above are illustrative and non-limiting in all respects. For example, each component described as a single type may be implemented in a distributed manner, and similarly, components described as being distributed may also be implemented in a combined form.

The scope of the present invention is indicated by the claims to be described later, and all changes or modified forms derived from the meaning and scope of the claims and the concept of equivalents thereof should be construed as being included in the scope of the present invention.

100: fixed plate
101: screw hole
200: screw for scanning
201: threaded part
202: head
300: screw guide

Claims (8)

(a) generating a first 3D image through CT imaging;
(b) performing a surgical simulation using the 3D image and then generating a 3D model through 3D printing;
(c) applying a fixing plate to conform to the shape of the 3D model, and inserting and fixing a scanning screw through the screw hole of the fixing plate;
(d) generating a second 3D image using a 3D model in which the scanning screw is fixed;
(e) obtaining a 3D image in which the scanning screw and the fixing plate are fixed by superimpositioning the first 3D image and the second 3D image; And
(f) manufacturing a guide using the matched three-dimensional image; Including,
The scanning screw provides three-dimensional information on the screw introduction position and path of the guide,
The guide includes a screw hole formed using an image in which the scanning screw is fixed,
The scanning screw is composed of a head portion and a screw portion including a screw thread, the diameter of the head portion coincides with the screw guide diameter, and the head portion of the scanning screw is a cylindrical shape extending longer than the screw portion, manufacturing a surgical guide Way. delete delete delete The method of claim 1,
The guide is a facial bone fracture guide (osteotomy guide), a fibula cutting guide (fibula cutting guide), a fibula screw guide (fibula screw guide), or a mandible resection guide (mandible resection guide) for manufacturing a surgical guide. delete The method of claim 1,
The surgical simulation is a method of manufacturing a surgical guide for forming a bone cutting and bonding structure. As a screw used in the method of any one of claims 1, 5 and 7,
It is composed of a head portion, and a screw portion including a thread,
The diameter of the head portion is a scanning screw that matches the screw guide diameter.

Images