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山东大学学报 (医学版) ›› 2023, Vol. 61 ›› Issue (3): 127-133.doi: 10.6040/j.issn.1671-7554.0.2022.1328

• 临床医学 • 上一篇    下一篇

人工智能辅助设计3D打印手术导板在脊柱侧凸矫形术中的应用

王辉1,王连雷1,吴天驰2,田永昊1,原所茂1,王霞1,吕维加2,刘新宇1   

  1. 1.山东大学齐鲁医院脊柱外科, 山东 济南 250012;2.香港大学骨科与创伤科, 中国 香港 999077
  • 发布日期:2023-03-24
  • 通讯作者: 刘新宇. E-mail:newyuliu@163.com
  • 基金资助:
    国家自然科学基金(81874022,82172483,82102522);山东省自然科学基金(ZR202102210113);泰山学者工程专项经费资助(tsqn202211317)

Artificial intelligence-assisted 3D printing of surgical guides for pedicle screw Insertion in scoliosis surgeries

WANG Hui1, WANG Lianlei1, WU Tianchi2, TIAN Yonghao1, YUAN Suomao1, WANG Xia1, LYU Weijia2, LIU Xinyu1   

  1. 1. Department of Spinal Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong 999077, China
  • Published:2023-03-24

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摘要： 目的 分析人工智能辅助设计3D打印导板在脊柱侧凸矫形手术中的应用价值。 方法 回顾性分析2018年6月至2022年9月接受脊柱侧凸矫形手术患者66例的临床资料。采用人工智能辅助设计3D打印导板置入椎弓根螺钉患者24例(智能导板组),其中先天性脊柱侧凸10例,特发性脊柱侧凸8例,退变性脊柱侧凸6例。且均在术前应用SurigiPlan V1.0辅助规划螺钉型号及路径。42例采用徒手置入椎弓根螺钉(徒手组),其中先天性脊柱侧凸16例,特发性脊柱侧凸13例,退变性脊柱侧凸13例。对比两组住院时间、手术时间、术中出血量、术中辐射量、术后椎弓根螺钉置入的准确率和安全性、术前规划与实际置入应用螺钉的符合率以及治疗前后脊柱影像学参数变化。 结果 两组共置入1 342枚椎弓根螺钉,其中智能导板组与徒手组分别置入468枚和874枚螺钉。智能导板组置钉安全性高于徒手组(98.29% vs 92.33%,P<0.05),置钉准确性高于徒手组(94.23% vs 82.95%,P<0.05)。智能导板组468枚螺钉中,术前规划螺钉的长度及直径与实际应用螺钉的符合率分别为97.01%(454枚)和95.51%(447枚)。两组术前及术后主弯的Cobb角及顶椎旋转角、手术时间、出血量等指标差异无统计学意义(P>0.05)。智能导板组患者的术中辐射剂量低于徒手组(P<0.05),两组医生的术中辐射剂量差异无统计学意义(P>0.05)。 结论 与徒手置钉相比,人工智能辅助设计制造的3D打印手术导板可显著提高置钉准确性、安全性及置钉效率。

关键词: 脊柱畸形, 3D打印, 人工智能, 手术导板, 椎弓根螺钉

Abstract: Objective To assess the value of artificial intelligence-assisted 3D printing surgical guides in scoliosis surgeries. Methods The clinical data of 66 patients who underwent scoliosis orthopedic surgery during Jun. 2018 and Sep. 2022 were retrospectively analyzed. Artificial intelligence-assisted design of 3D printed guides for pedicle screws were placed in 24 cases(intelligent guide group), including 10 cases of congenital scoliosis, 8 cases of idiopathic scoliosis, and 6 cases of degenerative scoliosis, and all patients used SurigiPlan V1.0 to assist in the preoperative planning of the screw type and path. Freehand pedicle screws were placed in 42 cases(freehand group), including 16 cases of congenital scoliosis, 13 cases of idiopathic scoliosis, and 13 cases of degenerative scoliosis. The postoperative stay, operation time, intraoperative bleeding, intraoperative radiation, accuracy and safety of postoperative pedicle screw placement, compliance between preoperative planning and actual placement of screws, and changes in pre- and postoperative imaging spine parameters were compared between the two groups. Results A total of 1,342 pedicle screws were placed, including 468 in the intelligent guide group and 874 in the freehand group. The intelligent guide group had a higher safety than the freehand group(98.29% vs 92.33%, P<0.05)and a higher accuracy(94.23% vs 82.95%, P<0.05). Of the 468 screws in the intelligent guide group, the preoperative planning of screw length and diameter matched the actual application of screws by 97.01%(454 screws)and 95.51%(447 screws)respectively. There were no statistically significant differences in the Cobb angle, apical vertebral rotation, operation time and bleeding between the two groups before and after operation(P>0.05). The intraoperative radiation dose of patients in the intelligent guide group was lower than that in the freehand group(P<0.05), but there was no statistically significant difference in the intraoperative radiation dose of surgeons(P>0.05). Conclusion Compared to freehand screws placement, the artificial intelligence-assisted 3D printing of surgical guides can significantly improve the accuracy, safety and efficiency of screws placement.

Key words: Scoliosis, 3D-printed, Artificial intelligence, Assistant surgical guides, Pedicle screws

中图分类号: 

  • R681.5
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