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研究生: 鄭哲明
Che-ming Cheng
論文名稱: 椎弓根螺釘定位演算法及導引夾治具自動化設計流程開發
指導教授: 廖昭仰
口試委員:
學位類別: 碩士
Master
系所名稱: 工學院 - 機械工程學系
Department of Mechanical Engineering
論文出版年: 2014
畢業學年度: 103
語文別: 中文
論文頁數: 65
中文關鍵詞: 椎弓根螺釘術中定位積層製造電腦輔助手術導引夾治具
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  • 椎弓根螺釘是目前用於治療脊椎側彎或畸形的主要工具,而施行此類手術需要非常準確地將螺釘植入適當的位置,在不傷到神經及血管的情況下將螺釘穿過椎弓根植入椎骨,本論文基於積層製造技術發展出一套定位演算法及導引夾治具自動化設計流程,用以減輕醫師在手術時的工作及增加植釘的準確度。
    本研究所發展的定位演算法主要概念是先將病患的電腦斷層影像由軟體建立出三維網格模型,醫師僅需輸入進釘點及椎弓根約略位置,本演算法將會自行推得椎弓根螺釘最佳進釘路徑,並計算出可植入的最大螺釘半徑、長度、進釘位置及角度。接著上述數據將傳遞給本論文發展的另一個自動化流程,用以產生椎弓根螺釘進釘導引夾治具。本夾治具與病患之患部的接觸面係由電腦斷層影像重建之三維網格模型選取得來,因此可以穩固地扣在患部,提高精確度的定位。
    最後,本論文以年幼病患的頸椎及胸椎椎骨的電腦斷層影像作為例子,用以驗證本文發展之方法。


    Pedicle screw is the primary tool for scoliosis or spinal deformities treatment. The treatment is to implant screws in both side’s pedicles of the vertebral body, and fixing abnormal vertebral by connected metal rod. And this process requires accurate screw implanting in the implementation of the surgery. In case of injuring the nerves and blood vessels, pedicle screws pass through the vertebral body. Physicians usually using computer navigation system to determine the position of implantation when performing operation. It is difficult using two-dimensional image to determine the three-dimensional structure of complex spine structure. Therefore, this study will use self-developed program to improved registration of the surgical procedure, and reduce the workload of physicians, increasing the accuracy of screw planting.
    The developed registration program of this study will load CT images of patients by the software to create a computer model, and preoperative planning on the computer. Physicians enter only pedicle screw insertion point and approximate location, the program will generate its pedicle screw entrance path and calculate the maximum radius of implantable screw length, position and angle. Physicians also can be observed the position of the screw results calculated by program on the computer model. These data will be used to generate guide template after confirmed for physicians quickly find the pedicle screw location during surgery. By careful preoperative simulation and the assistance of guide template, spine surgery will be more efficient and safer.

    摘要 I ABSTRACT II 誌謝 III 目錄 IV 圖目錄 V 表目錄 VIII 符號說明 IX 第一章 緒論 1 1-1前言 1 1-2文獻回顧 3 1-3研究動機與目的 7 1-4論文架構 8 第二章 理論說明 9 2-1脊椎構造 9 2-2頸椎手術 12 2-3積層製造技術發展及應用 15 第三章 研究方法 20 3-1研究用軟體及設備介紹 20 3-2脊椎三維網格模型重建 25 3-3椎弓根螺釘定位演算法 27 3-4導引夾治具自動化設計流程 35 第四章 實驗結果與討論 39 4-1椎弓根螺釘定位演算法參數分析 39 4-2導引夾治具自動化設計流程參數分析 44 4-3實體模型驗證 45 第五章 結論與未來展望 49 5-1結論 49 5-2未來展望 49 參考文獻 50

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