Name: 3d printing model of a patient's specific lumbar vertebra
Uploaded: 2023-04-14T13:15:00
Description: Watch this Scientific Journal Video about 3D Printing Model of a Patient's Specific Lumbar Vertebra at JoVE.com

本刊由北京市自然科学基金（L192059）资助。

所有数据均来自临床患者，其SDR手术在北京东直门医院进行。该方案遵循东直门医院研究伦理委员会的指导方针，并得到其批准。
注意：模型重建协议的整个图如图 1 所示。高分辨率计算机断层扫描（HRCT）数据和Dixon数据是建模的原材料;然后，3D模型创建包括图像配准和融合。最终的3D数字模型由PolyJet技术打印，这是一种高精度的3D打印工艺，使用各种...

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A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Selective+posterior+rhizotomy:+evolution+of+theory+and+practice.">Selective posterior rhizotomy: evolution of theory and practice.</a> Pediatric Neurosurgery. 17 (3), 128-134 (1991).</li><li>Vitrikas, K., Dalton, H., Breish, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cerebral+palsy:+an+overview.">Cerebral palsy: an overview.</a> American Family Physician. 101 (4), 213-220 (2020).</li><li>Niikura, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tactile+surgical+navigation+system+for+complex+acetabular+fracture+surgery.">Tactile surgical navigation system for complex acetabular fracture surgery.</a> Orthopedics. 37 (4), 237-242 (2014).</li><li>Lepisto, J., Armand, M., Armiger, R. 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本研究为建立脑瘫患者腰椎术前3D打印模型提供了工作流程，旨在促进SDR手术的术前计划，并根据患者的具体模型加强解剖学训练。该研究旨在建立一个高度可靠的3D打印模型，准确展示患者的腰椎和神经结构。通过在手术前测量叶片和脊神经在模型中的位置，可以实现叶片切割的精确规划，从而优化手术程序并掌握SDR手术技术。
本研究中研究的主要关键步骤是CT和Dixon序列的...

痉挛性脑瘫影响了一半以上的脑瘫患儿1，导致肌腱挛缩、骨骼发育异常、活动能力下降，严重影响患儿的生活质量2。选择性背神经根切断术（SDR）作为治疗痉挛性脑瘫的主要手术方法，已被许多国家充分验证和推荐3，4。然而，SDR手术的复杂性和高风险性，包括叶片的精确切割，神经根的定位和分离以及神经纤维的切断，对刚刚开始在临床实践中参与SDR的年轻医生来说是一个重大挑战;此外，SDR的学习曲线非常陡峭。
在传统的骨科手术中，外科医生必须在精神上整合所有术前二维（2D）图像并制定3D手术计划5.这种方法对于涉及复杂解剖结构和手术操作（如SDR）的术前计划尤其困难。随着医学成像和计算机技术的进步，可以处理二维轴向图像，例如计算机断层扫描（CT）和磁共振成像（MRI），以创建具有患者特定解剖结构的3D虚拟模型6。通过改进的可视化，外科医生可以分析这些处理后的信息，以便根据患者的病情做出更详细的诊断、计划和手术干预。近年来，多模态图像融合技术在骨科中的应用逐渐受到关注7。该技术可以融合CT和MRI图像，大大提高了数字3D模拟模型的准确性。然而，该技术在SDR术前模型中的应用尚未得到研究。
在SDR手术过程中，椎板和脊神经的准确定位以及精确切割对于成功的结果至关重要。通常，这些任务依赖于专家的经验，并在手术过程中由C型臂反复确认，导致手术过程复杂且耗时。3D数字模型是未来SDR手术导航的基础，也可用于椎板切除术的术前计划。该模型融合了CT的骨骼结构和MRI的脊神经结构，并根据手术计划为标记为切割的腰椎部分分配了不同的颜色。这种用于SDR的全息3D打印模型不仅便于术前计划和模拟，还可以将精确的3D导航坐标输出到术中机械臂进行精确切割。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>J55 Prime 3D-Printer</td>
			<td>Stratasys</td>
			<td>J55 Prime</td>
			<td>Manufacturing the model</td>
		</tr>
		<tr>
			<td>MATLAB</td>
			<td>MathWorks&#160;</td>
			<td>2022B</td>
			<td>Computing and visualization&#160;</td>
		</tr>
		<tr>
			<td>Mimics</td>
			<td>Materialise</td>
			<td>Mimics Research V20</td>
			<td>Model format transformation</td>
		</tr>
		<tr>
			<td>Tools for volum fusion</td>
			<td>Intelligent Entropy</td>
			<td>VolumeFusion V1.0</td>
			<td>Beijing Intelligent Entropy Science &#38; Technology Co Ltd. 
			Modeling for CT/MRI fusion</td>
		</tr>
	</tbody>
</table>

3d printing model of a patient's specific lumbar vertebra

选择性背神经根切断术 （SDR） 是一项困难、危险且复杂的手术，其中椎板切除术不仅应暴露足够的手术视野，还应保护患者的脊神经免受伤害。数字模型在SDR的术前和术中起着重要作用，因为它们不仅可以使医生更加熟悉手术部位的解剖结构，还可以为机械手提供精确的手术导航坐标。本研究旨在创建患者特定腰椎的 3D 数字模型，可用于 SDR 操作的计划、手术导航和培训。3D打印模型的制造也是为了在这些过程中更有效地工作。
传统的骨科数字模型几乎完全依赖于计算机断层扫描（CT）数据，这些数据对软组织不太敏感。CT的骨结构与磁共振成像（MRI）的神经结构融合是本研究模型重建的关键要素。针对手术区域的真实面貌重建患者特定的三维数字模型，并显示结构间距离和区域分割的精确测量，可有效帮助SDR的术前计划和训练。3D打印模型的透明骨结构材料使外科医生能够清楚地区分手术段的脊神经和椎板之间的相对关系，增强他们对结构的解剖理解和空间感。个体化三维数字模型的优点及其脊神经与骨骼结构的准确关系使该方法成为SDR手术术前计划的良好选择。

基于脑瘫患儿腰椎CT/MRI图像融合数据，我们创建了腰椎结合脊神经的代表性模型。采用高通滤波从HRCT中提取CT值范围190-1656的高信号，实现手术区腰椎骨骼结构重建。通过MRI中Dixon-w序列的高通滤波重建脊神经结构。通过刚性配准获得腰椎结构和脊神经融合的数字模型和点云数据坐标，并以立体光刻（STL）格式保存文件，用于数据测量和进一步打印处理。STL数字模型文件被转换为VRML格式，以传输到...

Watch this Scientific Journal Video about 3D Printing Model of a Patient's Specific Lumbar Vertebra at JoVE.com

3D Printing Model of a Patient's Specific Lumbar Vertebra

这项研究旨在创建一个患者特异性腰椎的3D打印模型，其中包含从高分辨率计算机断层扫描（HRCT）和MRI-Dixon数据融合的椎骨和脊神经模型。

患者特定腰椎的3D打印模型

Selective dorsal rhizotomy (SDR) is a difficult, risky, and sophisticated operation, in which a laminectomy should not only expose an adequate surgical ...

该协议利用了两种类型成像的各自优势，填充了人体解剖结构的复杂CT和MRI图像。这是医学成像领域的一项重大创新。在融合模型中，医生可以从CT查看骨骼结构，也可以通过MRI查看较软的组织结构。此外，3D模型可用于手术机器人的精确3D导航。该技术几乎适用于所有需要多模态融合的老年人，例如超声图像融合。三维融合模型对于仲裁前规划和仲裁后评估也具有重要意义。使用此技术时，您将同时从多模态成像中获得洞察力。不同的维度视角将同步展开，诊断和治疗过程将不断发展。首先，从CT机站设置数据资源。打开单个CT 2012 B软件，从扫描协议SpineRoutine_1接收数据。使用一毫米的切片厚度，矩阵大小为 512 x 512 像素，其中像素间距为 0.3320 毫米。实现的 3D 体积的实际大小为 512 x 512 x 204 体素。在 MATLAB 工作区中调用 Dicom2Mat 子进程，从存储在 HRCT 数据文件夹中的 DICOM 文件中获取 3D 体积。通过图形用户界面或 GUI 查看 3D 体积中的每个切片。然后通过抢劫功能可视化椎骨HRCT数据的强度分布。调用噪声清理子进程以删除 HRCT 数据文件部分下设备形成的信号噪声。并在同一路径下使用椎骨功能子过程，获得椎骨模型，该模型也是3D体积，但仅具有骨骼结构。使用高通滤波器参数和强度范围从 190 到 1， 656。在Dixon-In和Dixon_W序列的两个部分中使用Dicom2Mat子过程，并获得其3D体积。可视化构成 3D 体积的每个单独切片，并在 Dicom2Mat 子流程完成后访问此可视化。利用脊神经功能，用高通滤波参数重建脊神经模型，强度范围从180到643。过滤掉低强度的点以提取脊神经3D体积，因为Dixon_W序列中的神经信号非常高。脊神经子过程完成后，检查GUI中生成的模型。将三个 3D 体积复制到项目的文件路径。HRCT和DIXON-In的模型包括相同的椎骨结构。DIXON-In和Dixon_W的模型具有相同的坐标。将三个模型文件名放入椎骨融合子流程中，作为生成融合模型的输入。如果从医生的角度需要微调，请将所有方向的坐标参数添加到同一函数中以校正融合模型。如果从临床角度观察到融合有轻微误差，请使用椎骨融合功能微调融合坐标。此过程涉及对坐标方向的六个维度进行参数调整。在项目目录中创建一个单独的文件夹，用于输出融合模型的结果。在融合目录的文件路径下以 DICOM 格式序列导出要用于 3D 打印的融合模型。利用 mat2dicom 算法执行导出操作。通过输入融合模型。打开以前使用具体模拟版本 20 导出的 DICOM 文件序列以执行导出操作。导航到文件选项卡下的导出菜单，然后选择 VRML 格式。导出的文件路径可以根据用户的要求自由定制。由于透明彩色3D打印是一项专业服务，因此压缩并打包VRML文件并将其发送给服务提供商。CT和MRI的多模态融合模型用于选择性背神经根切断术或SDR的术前计划和培训。HRCT数据中卷切片的GUI如图所示。通过此GUI，外科医生可以查看所有CT数据中包含的脊柱结构。此处显示的图形图像表示椎骨HRCT数据的强度分布。该定量信息有助于确定椎骨结构的过滤范围。用于选择性背神经根切断术或SDR规划和训练的3D打印模型如图所示。不同颜色的染料用于鄙视和区分骨骼和神经等结构。脊神经结构染成黄色，相应手术区域的L4和L5节段的叶片通过红色和蓝色染色来区分。骨骼结构使用透明树脂材料打印，使医生可以通过骨骼结构观察薄片下的神经结构。等效、不敏感或多模态融合技术势必会带来各种新的应用，因为医生可以在一个模型中从不同维度获取信息。基于医学成像的诊断治疗和手术导航是医学成像领域多模态融合技术的主要战场。

Research

JoVE Journal

Medicine

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

3D-神经导航<em&gt;在体内</em&gt;通过患者的大脑在一个自发性偏头痛

A growing body of research, generated primarily from MRI-based studies, shows that migraine appears to occur, and possibly endure, due to the alteration ...

科研

医学

Ovine Lumbar Intervertebral Disc Degeneration Model Utilizing a Lateral Retroperitoneal Drill Bit Injury

Ovine Lumbar椎间盘退变模型利用横向腹膜后位钻伤

Intervertebral disc degeneration is a significant contributor to the development of back pain and the leading cause of disability worldwide. Numerous ...

A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations

腰椎间盘椎间盘经神经孔腰椎内窥镜的移动外技术

Percutaneous endoscopic transforaminal lumbar discectomy (PETLD) has now become a standard of care for the management of lumbar disc disease. There are ...

Isometric Contractility Measurement of the Mouse Mesenteric Artery Using Wire Myography

用线 Myography 测定小鼠肠系膜动脉的等轴收缩力

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and ...

Three-Dimensional Printing of a Complex Aortic Anomaly

复杂主动脉异常的三维打印

Complex congenital aortic anomalies include diverse types of malformations that may be clinically asymptomatic or present with respiratory or esophageal ...

Multicolor 3D Printing of Complex Intracranial Tumors in Neurosurgery

神经外科复杂颅内肿瘤的多色3D打印

Three-dimensional (3D) printing technologies offer the possibility of visualizing patient-specific pathologies in a physical model of correct dimensions. ...

Combining Augmented Reality and 3D Printing to Display Patient Models on a Smartphone

结合增强现实和 3D 打印，在智能手机上显示患者模型

Augmented reality (AR) has great potential in education, training, and surgical guidance in the medical field. Its combination with three-dimensional (3D) ...

3D Planning and Printing of Patient Specific Implants for Reconstruction of Bony Defects

患者特异性植入物重建的三维规划与打印

We are in the midst of the 3D era in most aspects of life, and especially in medicine. The surgical discipline is one of the major players in the medical ...

Treatment of Facial Deformities using 3D Planning and Printing of Patient-Specific Implants

使用患者特定植入物的 3D 规划和打印治疗面部畸形

Technological advancements in surgical planning and patient-specific implants are constantly evolving. One can either adopt the technology to achieve ...

Creation of a High-Fidelity, Low-Cost, Intraosseous Line Placement Task Trainer via 3D Printing

通过 3D 打印创建高保真、低成本、骨内线放置任务训练器

The description of procedural task trainers includes their use as a training tool to hone technical skills through repetition and rehearsal of procedures ...