CN104537939B - Virtual method and device for pedicle screw implantation - Google Patents

Abstract

The present invention is applicable to the field of computer-aided medicine, and provides a virtual method for pedicle screw implantation: acquiring CT data including spinal images; performing segmentation and three-dimensional reconstruction of the spinal region in the region of interest to generate a Mesh model; constructing an operation tool; import the Mesh model and the surgical tool into the virtual surgical environment; receive the surgical scene change drawn by the force feedback device; wherein the force feedback device is used to follow the drag operation movement, and generate a motion state, and Feedback motion effects; perform stereoscopic display processing on the drawn surgical scene changes, and output the processed stereoscopic images. The invention enables trainees to understand the anatomical relationship of the operation area more intuitively and in detail, and can understand whether the position of the nail is accurate and whether there is damage to the adjacent structure from multiple perspectives, thereby improving the quality of teaching and allowing users to obtain the operation The tactile sensation in the process.

Description

A virtual method and device for pedicle screw implantation

technical field

The invention belongs to the field of computer-aided medicine, in particular to a virtual method and device for pedicle screw implantation.

Background technique

In the medical field, pedicle surgery requires accurate implantation of pedicle screws with a diameter of 4-7mm in a pedicle with a transverse diameter of 5-10mm without damaging important structures such as adjacent nerve roots and dural sac. , this is a huge challenge for beginners. Inserting pedicle screws into the pedicle by hand is the most common surgical method in clinical open surgery. According to the tactile sensation of the probe, the screw is implanted according to the doctor's surgical experience and the preoperative X-ray and CT images of the patient.

In order to make the clinical experience of beginners more mature, the existing technology provides a virtual surgery system for spinal pedicle screw insertion to help beginners learn and train. The system reconstructs the three-dimensional structure of the spine based on the patient's personalized CT image It can not only train surgeons to insert pedicle screws minimally invasively under intraoperative fluoroscopy guidance, but also guide surgeons to insert pedicle screws under open conditions through anatomical landmarks, improving The accuracy of the surgeon's pedicle screw placement plays a very important role in the anatomical teaching of spinal pedicle screw placement.

This system uses CT images of real patients to reconstruct the model of the spine for virtual surgery, and designs virtual surgical tools such as puncture needles and pedicle screws. The trainees connected the position of the Kirschner wire on the anteroposterior and lateral projection images with the position of the Kirschner wire on the cross-sectional image of the nail entry plane, observed the corresponding relationship between the two, and provided guidance for percutaneous implantation during the operation. The pedicle screw can be inserted into the pedicle for personalized preoperative training. At the same time, the diameter and length of the implanted screw required during the operation can be calculated through distance measurement and angle measurement on the three-dimensional model.

The above system effectively solves the problem of insufficient experience in open spinal pedicle screw implantation surgery. For surgeons who have just performed percutaneous pedicle screw implantation, how to determine the entry point and entry point of the percutaneous pedicle screw? Nail trajectory is a very important anatomy teaching content. The use of virtual surgery system for pedicle screw implantation can stimulate the surgeon's interest in learning, enhance the surgeon's autonomy and participation in learning, and promote the surgeon's understanding and mastery of knowledge.

However, the spinal pedicle screw implantation virtual surgery system provided by the prior art can only solve the difficulties in the pedicle screw implantation operation from the perspective of anatomy, without training for the trainee's hand feeling, and the sense of reality is not strong , the training effect is not good.

Contents of the invention

In view of this, the present invention provides a virtual method and device for implanting pedicle screws. Difficulties in implant surgery, but there is no training for the trainee's hand feeling, the sense of reality is not strong, and the training effect is not good.

In a first aspect, the present invention provides a virtual method for pedicle screw implantation, the method comprising the following steps:

Obtain CT data comprising images of the spine;

Carry out segmentation and 3D reconstruction of the spine area in the region of interest to generate a Mesh model;

construct surgical tools;

Importing the Mesh model and the surgical tool into a virtual surgical environment;

Receive the surgical scene changes drawn by the force feedback device; wherein the force feedback device is used to follow the drag operation movement, generate a motion state, and feed back the motion effect;

Stereo display processing is performed on the drawn surgical scene changes, and the processed stereo images are output.

Preferably, the virtual method of pedicle screw implantation also includes the following steps:

Operational processing is performed on the drawn operation scene changes to obtain a final operation effect diagram, and the operation effect diagram is displayed.

Preferably, the virtual method of pedicle screw implantation also includes the following steps:

Calculate the completion time of drawing the surgical scene change through the force feedback device;

Judging which grade range the completion time falls within;

According to the judgment result, the grade is determined.

Preferably, the virtual method of pedicle screw implantation also includes the following steps:

Display the prompt information of the entry point in the surgery simulation.

Preferably, the virtual method of pedicle screw implantation also includes the following steps:

Set different widths and stiffnesses for surgical objects in the virtual surgical environment.

In a second aspect, the present invention provides a virtual device for pedicle screw implantation, the device comprising:

Obtaining module, for obtaining the CT data that comprises spine image;

A three-dimensional reconstruction module, which is used to segment and three-dimensionally reconstruct the spine region of the region of interest to generate a Mesh model;

Surgical tool building blocks for constructing surgical tools;

Import module, for importing the Mesh model and the surgical tool into the virtual surgical environment;

The receiving module is used to receive the change of the surgical scene drawn by the force feedback device; wherein the force feedback device is used to follow the drag operation movement, generate a movement state, and feed back the movement effect;

The stereoscopic display processing module is used for performing stereoscopic display processing on the drawn surgical scene changes, and outputting the processed stereoscopic images.

Preferably, the virtual device for pedicle screw implantation also includes:

The effect image processing module is used for calculating and processing the drawn operation scene changes to obtain a final operation effect image and displaying the operation effect image.

Preferably, the virtual device for pedicle screw implantation also includes:

A time calculation module, used to calculate the completion time of drawing surgical scene changes through the force feedback device;

A grade judging module, configured to judge which grade range the completion time falls within;

The grade determination module is configured to determine the grade according to the judgment result.

Preferably, the virtual device for pedicle screw implantation also includes:

The entry point prompt module is used to display the prompt information of the entry point in the operation simulation.

Preferably, the virtual device for pedicle screw implantation also includes:

The setting module is used to set different widths and hardnesses for surgical objects in the virtual surgical environment.

In the present invention, a Mesh model is generated by segmenting and three-dimensionally reconstructing the spinal column region of the region of interest; constructing surgical tools; introducing the Mesh model and the surgical tools into a virtual surgical environment; receiving images drawn by a force feedback device The operation scene changes; wherein, the force feedback device is used to follow the drag operation movement, generate a movement state, and feed back the movement effect. The invention enables trainees to understand the anatomical relationship of the operation area more intuitively and in detail, and can understand whether the position of the nail is accurate and whether there is damage to the adjacent structure from multiple perspectives, thereby improving the teaching quality, shortening the teaching period, and being able to Let the user get the tactile feeling during the operation. At the same time, a scoring mechanism has been added to enable trainees to better integrate into the training, effectively helping trainees to practice from shallow to deep, and finally to have a solid grasp of anatomical structures and surgical skills. The use of stereoscopic display technology simulates the real pedicle screw placement process, which increases the immersion of the system and has strong ease of use and practicality.

Description of drawings

In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the following will briefly introduce the accompanying drawings that need to be used in the descriptions of the embodiments or the prior art. Obviously, the accompanying drawings in the following description are only of the present invention. For some embodiments, those of ordinary skill in the art can also obtain other drawings based on these drawings without paying creative efforts.

Fig. 1 is a schematic flow diagram of a virtual method for pedicle screw implantation provided by an embodiment of the present invention;

Fig. 2 is a schematic structural diagram of a virtual device for pedicle screw implantation provided by an embodiment of the present invention.

detailed description

In order to make the object, technical solution and beneficial effects of the present invention more clear, the present invention will be further described in detail below in conjunction with the accompanying drawings and embodiments. It should be understood that the specific embodiments described here are only used to explain the present invention, not to limit the present invention.

In order to illustrate the technical solutions of the present invention, specific examples are used below to illustrate.

Please refer to Fig. 1, which is the implementation process of the virtual method for pedicle screw implantation provided by the embodiment of the present invention, which includes the following steps:

In step S101, obtain CT data comprising a spine image;

In the embodiment of the present invention, the CT data in the format of the two-dimensional sequence dicom is read into the computer.

In step S102, the spine region of the region of interest is segmented and three-dimensionally reconstructed to generate a Mesh model;

In the embodiment of the present invention, the spine region of the region of interest is segmented and three-dimensionally reconstructed to generate a Mesh model in obj format;

In step S103, a surgical tool is constructed;

In the embodiment of the present invention, according to actual retractors, bone drills, bone nails, etc., surgical tools are built in Maya software according to actual size.

In step S104, the Mesh model and the surgical tool are imported into a virtual surgical environment;

In the embodiment of the present invention, the Mesh model and the surgical tool are imported into the virtual surgical environment according to the same scaling.

In step S105, the surgical scene change drawn by the force feedback device is received; wherein the force feedback device is used to follow the drag operation movement, generate a movement state, and feed back the movement effect;

In the embodiment of the present invention, the user drags the operating handle of the force feedback device to move the operating handle of the force feedback device in any direction, and then feeds back the motion effect to the user, so that the user can get the tactile feeling during the operation . The motion state of the force feedback device records the position of the handle of the force feedback device and the force exerted by the user on the handle.

In the embodiment of the present invention, OpenGL is used to draw each step of the surgical scene, and the real-time calculation of the rendering speed helps the trainee to grasp the progress of the operation, and can zoom and rotate to observe the virtual surgical scene from various angles.

In step S106, a stereoscopic display process is performed on the rendered surgical scene change, and a processed stereoscopic image is output.

In the embodiment of the present invention, the output processed stereoscopic image is viewed through 3D glasses.

As a preferred embodiment of the present invention, in order for trainees to understand the operation results, the virtual method of pedicle screw implantation also includes the following steps:

Operational processing is performed on the drawn operation scene changes to obtain a final operation effect diagram, and the operation effect diagram is displayed.

As another preferred embodiment of the present invention, in order to increase the trainee's interest in learning, different scoring mechanisms are set to increase the trainee's interest in learning, and its implementation is as follows:

Calculate the completion time of drawing the surgical scene change through the force feedback device;

Judging which grade range the completion time falls within;

According to the judgment result, the grade is determined.

For example, if you complete it within 15 seconds, you will be determined as an advanced level; if you complete it within 25 seconds, you will be determined as an intermediate level;

As another preferred embodiment of the present invention, in order to allow beginners to have an intuitive understanding of the area to be operated after they have a systematic grasp of the pedicle screw placement operation, it is ensured that inexperienced trainers can learn from experience. The point prompt transitions gradually to the state of no entry point prompt. Therefore, the embodiment of the present invention displays the prompt information of the entry point in the operation simulation.

As another preferred embodiment of the present invention, the virtual method of pedicle screw implantation further includes: setting different widths and hardnesses for surgical objects in the virtual surgical environment, allowing trainees to increase the difficulty of the operation step by step, Be able to be familiar with the characteristics of the spinal bones of various surgical objects, thus virtually completing the learning process of different surgical objects in pedicle screw surgery.

As another preferred embodiment of the present invention, the virtual method of pedicle screw implantation also includes: providing the ideal range of the end of the bone drill for pedicle surgery in the virtual operation environment, and cooperating with the force feedback algorithm and The force feedback device ensures that trainees can form muscle memory for the operation process during the training process, and provides a guarantee for the accurate completion of the bone drilling process in the operation simulation system.

Please refer to FIG. 2 , which is a schematic structural diagram of a virtual device for pedicle screw implantation provided by an embodiment of the present invention. For ease of description, only parts related to the embodiments of the present invention are shown.

The virtual device for pedicle screw implantation includes: an acquisition module 101 , a three-dimensional reconstruction module 102 , a surgical tool construction module 103 , an import module 104 , a reception module 105 , and a stereoscopic display processing module 106 . The virtual device for pedicle screw implantation may be a software unit, a hardware unit or a combination of software and hardware.

An acquisition module 101, configured to acquire CT data comprising a spine image;

In the embodiment of the present invention, the CT data in the format of the two-dimensional sequence dicom is read into the computer.

The three-dimensional reconstruction module 102 is used to segment and three-dimensionally reconstruct the spine region of the region of interest to generate a Mesh model;

In the embodiment of the present invention, the spine region of the region of interest is segmented and three-dimensionally reconstructed to generate a Mesh model in obj format;

Surgical tool construction module 103, used for constructing surgical tool;

In the embodiment of the present invention, surgical tools are constructed according to actual sizes based on actual retractors, bone drills, bone nails, and the like.

An import module 104, configured to import the Mesh model and the surgical tool into a virtual surgical environment;

In the embodiment of the present invention, the Mesh model and the surgical tool are imported into the virtual surgical environment according to the same scaling.

The receiving module 105 is configured to receive the change of the surgical scene drawn by the force feedback device; wherein, the force feedback device is used to follow the drag operation movement, generate a motion state, and feed back the motion effect;

In the embodiment of the present invention, the user drags the operating handle of the force feedback device to move the operating handle of the force feedback device in any direction, and then feeds back the motion effect to the user, so that the user can get the tactile feeling during the operation . The motion state of the force feedback device records the position of the handle of the force feedback device and the force exerted by the user on the handle.

In the embodiment of the present invention, OpenGL is used to draw each step of the surgical scene, and the real-time calculation of the rendering speed helps the trainee to grasp the progress of the operation, and can zoom and rotate to observe the virtual surgical scene from various angles.

The stereoscopic display processing module 106 is configured to perform stereoscopic display processing on the rendered operation scene change, and output the processed stereoscopic image.

As a preferred embodiment of the present invention, in order for trainees to understand the operation results, the virtual device for pedicle screw implantation also includes:

The effect image processing module is used for calculating and processing the drawn operation scene changes to obtain a final operation effect image and displaying the operation effect image.

As another preferred embodiment of the present invention, in order to increase the trainee's interest in learning, different scoring mechanisms are set to increase the trainee's interest in learning, and the virtual device for pedicle screw implantation also includes:

A time calculation module, used to calculate the completion time of drawing surgical scene changes through the force feedback device;

A grade judging module, configured to judge which grade range the completion time falls within;

The grade determination module is configured to determine the grade according to the judgment result.

As another preferred embodiment of the present invention, in order to allow beginners to have an intuitive understanding of the area to be operated after they have a systematic grasp of the pedicle screw placement operation, it is ensured that inexperienced trainers can learn from experience. The point hint transitions smoothly to the state of no entry point hint, and the virtual device for pedicle screw implantation also includes:

The entry point prompt module is used to display the prompt information of the entry point in the operation simulation.

As another preferred embodiment of the present invention, the virtual device for pedicle screw implantation further includes: a setting module, configured to set different widths and hardnesses for surgical objects in the virtual surgical environment. While increasing the difficulty of the operation step by step, the trainees can be familiar with the characteristics of the spinal bones of various surgical objects, thus virtually completing the learning process of different surgical objects in the pedicle screw surgery.

As another preferred embodiment of the present invention, the virtual device for pedicle screw implantation also includes: a target point prompt module, which is used to give the ideal position of the end of the bone drill for pedicle surgery in the virtual operation environment. The range, together with the force feedback algorithm and force feedback device, ensures that the trainees can form muscle memory for the surgical process during the training process, which provides a guarantee for the accurate completion of the bone drilling process in the surgical simulation system.

Those skilled in the art can clearly understand that for the convenience and brevity of description, only the division of the above-mentioned functional modules is used as an example for illustration. In practical applications, the above-mentioned function allocation can be completed by different functional modules according to needs. The internal structure of the device is divided into different functional units or modules to complete all or part of the functions described above. Each functional module in the embodiment can be integrated into one processing module, or each module can exist separately physically, or two or more modules can be integrated into one unit, and the above-mentioned integrated modules can be implemented in the form of hardware , can also be implemented in the form of software function modules. In addition, the specific names of the functional modules are only for the convenience of distinguishing each other, and are not used to limit the protection scope of the present application. For the specific working process of the modules in the above-mentioned device, reference may be made to the corresponding process in the aforementioned method embodiments, which will not be repeated here.

In summary, the embodiment of the present invention generates a Mesh model by segmenting and three-dimensionally reconstructing the spine region of the region of interest; constructs a surgical tool; imports the Mesh model and the surgical tool into a virtual surgical environment; receives the force The operation scene drawn by the feedback device changes; wherein, the force feedback device is used to follow the drag operation movement, generate a motion state, and feed back the motion effect. The invention enables trainees to understand the anatomical relationship of the operation area more intuitively and in detail, and can understand whether the position of the nail is accurate and whether there is damage to the adjacent structure from multiple perspectives, thereby improving the teaching quality, shortening the teaching period, and being able to Let the user get the tactile feeling during the operation. At the same time, a scoring mechanism has been added to enable trainees to better integrate into the training, effectively helping trainees to practice from shallow to deep, and finally to have a solid grasp of anatomical structures and surgical skills. The use of stereoscopic display technology simulates the real pedicle screw placement process, which increases the immersion of the system and has strong ease of use and practicality.

Those skilled in the art can appreciate that the modules and algorithm steps of the examples described in conjunction with the embodiments disclosed herein can be implemented by electronic hardware, or a combination of computer software and electronic hardware. Whether these functions are executed by hardware or software depends on the specific application and design constraints of the technical solution. Those skilled in the art may use different methods to implement the described functions for each specific application, but such implementation should not be regarded as exceeding the scope of the present invention.

In the embodiments provided in the present invention, it should be understood that the disclosed devices and methods can be implemented in other ways. For example, the device embodiments described above are only illustrative. For example, the division of the modules is only a logical function division. In actual implementation, there may be other division methods. For example, multiple modules or components can be combined or It may be integrated into another device, or some features may be omitted, or not implemented. In another point, the mutual coupling or direct coupling or communication connection shown or discussed may be through some interfaces, and the indirect coupling or communication connection of devices or modules may be in electrical, mechanical or other forms.

The modules described as separate components may or may not be physically separated, and the components displayed as modules may or may not be physical modules, that is, they may be located in one place, or may also be distributed to multiple network units. Part or all of the modules can be selected according to actual needs to achieve the purpose of the solution of this embodiment.

In addition, each functional module in each embodiment of the present invention may be integrated into one processing module, each module may exist separately physically, or two or more modules may be integrated into one module. The above-mentioned integrated modules can be implemented in the form of hardware or in the form of software function modules.

If the integrated modules are realized in the form of software function modules and sold or used as independent products, they can be stored in a computer-readable storage medium. Based on such an understanding, the technical solution of the embodiment of the present invention is essentially or the part that contributes to the prior art or all or part of the technical solution can be embodied in the form of a software product, and the computer software product is stored in a storage In the medium, several instructions are included to make a computer device (which may be a personal computer, server, or network device, etc.) or a processor (processor) execute all or part of the steps of the methods described in the various embodiments of the embodiments of the present invention. The aforementioned storage medium includes: U disk, mobile hard disk, read-only memory (ROM, Read-Only Memory), random access memory (RAM, Random Access Memory), magnetic disk or optical disk and other media that can store program codes. .

The above-described embodiments are only used to illustrate the technical solutions of the present invention, rather than to limit them; although the present invention has been described in detail with reference to the foregoing embodiments, those of ordinary skill in the art should understand that: it can still carry out the foregoing embodiments The technical solutions described in the examples are modified, or some of the technical features are equivalently replaced; and these modifications or replacements do not make the essence of the corresponding technical solutions deviate from the spirit and scope of the technical solutions of the embodiments of the present invention.

Claims (10)

1. the virtual method that a kind of pedicle screw is implanted into, it is characterised in that the method comprising the steps of：

Obtain the CT data comprising spine image；

The spine regions of area-of-interest are split and three-dimensional reconstruction, generated Mesh models；

Build operation tool；

The Mesh models and the operation tool are imported in virtual surgical environment；

Receive the surgical scene change drawn by device for force feedback；Wherein, the device for force feedback is used to follow drag operation Motion, and kinestate is generated, and feed back motion effect；Specifically, the operation handle of device for force feedback is dragged by using person, The operation handle of device for force feedback is made to move along any direction, and then to user feed back motion effect, in order to allow user Obtain the touch feeling in operating process；The kinestate of the device for force feedback have recorded the handle position of device for force feedback with And user puts on the power on handle；

Surgical scene change to drawing carries out stereo display process, and exports the stereo-picture after processing.

2. the virtual method that pedicle screw as claimed in claim 1 is implanted into, it is characterised in that the pedicle screw implantation Virtual method it is further comprising the steps of：

Surgical scene change to drawing carries out calculation process, obtains final surgical effect figure, and shows the surgical effect figure.

3. the virtual method that pedicle screw as claimed in claim 1 is implanted into, it is characterised in that the pedicle screw implantation Virtual method it is further comprising the steps of：

Calculate the deadline that surgical scene change is drawn by device for force feedback；

Judge which rate range the deadline falls in；

According to judged result, grade is determined.

4. the virtual method that pedicle screw as claimed in claim 1 is implanted into, it is characterised in that the pedicle screw implantation Virtual method it is further comprising the steps of：

The information into nail point is shown in surgical simulation.

5. the virtual method that pedicle screw as claimed in claim 1 is implanted into, it is characterised in that the pedicle screw implantation Virtual method it is further comprising the steps of：

Different width and hardness are arranged to the surgical object in virtual surgical environment.

6. the virtual bench that a kind of pedicle screw is implanted into, it is characterised in that described device includes：

Acquisition module, for obtaining the CT data comprising spine image；

Three-dimensional reconstruction module, for being split to the spine regions of area-of-interest and three-dimensional reconstruction, generates Mesh models；

Operation tool builds module, for building operation tool；

Import modul, for the Mesh models and the operation tool are imported in virtual surgical environment；

Receiver module, for receiving the surgical scene change drawn by device for force feedback；Wherein, the device for force feedback is used for Follow drag operation to move, and generate kinestate, and feed back motion effect；Specifically for dragging force feedback dress by using person The operation handle put, makes the operation handle of device for force feedback move along any direction, and then to user feed back motion effect, with It is easy to allow user to obtain the touch feeling in operating process；The kinestate of the device for force feedback have recorded device for force feedback Handle position and user put on the power on handle；

Stereo display processing module, carries out stereo display process for the surgical scene change to drawing, and after exporting process Stereo-picture.

7. the virtual bench that pedicle screw as claimed in claim 6 is implanted into, it is characterised in that the pedicle screw implantation Virtual bench also include：

Design sketch processing module, carries out calculation process for the surgical scene change to drawing, obtains final surgical effect figure, and Show the surgical effect figure.

8. the virtual bench that pedicle screw as claimed in claim 6 is implanted into, it is characterised in that the pedicle screw implantation Virtual bench also include：

Time Calculation module, for calculating the deadline that surgical scene change is drawn by device for force feedback；

Grade judge module, for judging which rate range the deadline falls in；

Level determination module, for according to judged result, determining grade.

9. the virtual bench that pedicle screw as claimed in claim 6 is implanted into, it is characterised in that the pedicle screw implantation Virtual bench also include：

Access point reminding module, for by the information into nail point is shown in surgical simulation.

10. the virtual bench that pedicle screw as claimed in claim 6 is implanted into, it is characterised in that the pedicle screw is planted The virtual bench for entering also includes：

Setup module, for arranging different width and hardness to the surgical object in virtual surgical environment.