CN116687631A - Scanning method of intervertebral space and endplate shape during operation - Google Patents

Abstract

The present invention provides a scanning method of intervertebral space and endplate shape during operation, and relates to the technical field of cervical spine treatment. The present invention includes the following steps: S1: Determine the most matching specification of intervertebral fusion device according to the completed intervertebral space during operation ; S2: Scan the intervertebral space and endplate shape with a 3D scanner to establish a model of the intervertebral space; S3: In the 3D model editing software, compare the original model of the intervertebral fusion cage in S1 with the model of the intervertebral space, and use The Boolean difference operation establishes the three-dimensional reconstructed morphological model of the intervertebral cage; the present invention scans the shape of the intervertebral space and the endplate during the ACDF operation to obtain the three-dimensional digital intervertebral space model of the intervertebral space and the endplate after intraoperative processing , to provide a morphological basis for the processing of the intervertebral fusion device during the operation, making the perfect match between the intervertebral fusion device and the intervertebral space, improving the integration effect of the intervertebral fusion device and the intervertebral space, ensuring the quality of ACDF surgery, and enabling patients to obtain the best treatment effect.

Description

Scanning method of intervertebral space and endplate shape during operation

technical field

The invention relates to the technical field of cervical spine treatment, in particular to a scanning method for intervertebral space and endplate morphology during operation.

Background technique

Cervical spondylosis is a common degenerative disease in which the pathological changes caused by the degenerative changes of the cervical intervertebral disc involve the surrounding tissue structure and produce clinical symptoms. The most commonly used surgical method for the treatment of cervical spondylosis is anterior cervical discectomy and fusion, or ACDF for short. ACDF treats cervical spondylosis by removing the diseased disc to relieve its compression on the nerve and placing implants to fuse the vertebral bodies at adjacent levels. In ACDF surgery, an intervertebral fusion device is implanted in the target intervertebral space, and the intervertebral fusion device contacts with the upper and lower adjacent vertebral body endplates in the space to maintain the height of the intervertebral space and provide stable support for the adjacent vertebral bodies, so as to achieve the ultimate goal. Fusion purpose.

In order to realize the complete matching of the intervertebral fusion cage with the shape of the intervertebral space and the endplate, the existing technology adopts the method of preoperative 3D printing customization to produce the personalized intervertebral fusion cage. Firstly, obtain CT and MRI images of the patient's cervical spine before operation, perform 3D reconstruction, segmentation, repair, etc., and construct a 3D morphological model of the intervertebral space and endplate of the surgical segment; then, use the model to guide intervertebral fusion The design of the intervertebral cage makes the height of the designed intervertebral cage match the intervertebral space, and the part of the intervertebral cage in contact with the endplate can completely fit the patient's endplate to construct a three-dimensional model of the intervertebral cage; finally, the intervertebral cage The fusion cage model is imported into the 3D printer, printed with biomedical orthopedic materials, such as tantalum metal, titanium alloy, polyether ether ketone, etc., and then undergoes processing steps such as powder removal, bracket removal, annealing, grinding and polishing, disinfection and sterilization, and finally Obtain an intervertebral fusion cage ready for implantation.

The applicant finds that the prior art has at least the following technical problems:

Before placing the intervertebral fusion device in ACDF, it is necessary to remove the osteophyte at the edge of the vertebral body, remove the intervertebral disc, open the intervertebral space, and polish the endplate. The gap between the implant and the endplate of the cervical vertebrae cannot be fully fitted, so that there are interface gaps of different sizes and shapes between the implant and the bony endplate. Post-implant loosening, prolapse, sinking and other complications.

Contents of the invention

The purpose of the present invention is to provide a scanning method of intervertebral space and endplate morphology in order to solve the problem in the prior art that before placing the intervertebral fusion device in ACDF operation, it is necessary to remove the osteophyte at the edge of the vertebral body and remove the intervertebral disc. , opening the intervertebral space, grinding the endplate, etc. These operations will change the shape of the endplate in the target space, resulting in the incomplete fit between the intervertebral fusion cage and the cervical endplate, and the general difference in size between the implant and the bony endplate. 1. Interfacial gaps of various shapes. The existence of such gaps can affect the osseointegration of the implant-endplate interface, leading to technical problems such as postoperative implant loosening, prolapse, and subsidence. The many technical effects that can be produced by the preferred technical solutions among the many technical solutions provided by the present invention are described in detail below.

To achieve the above object, the present invention provides the following technical solutions:

The present invention provides a scanning method for intervertebral space and endplate morphology, comprising the following steps:

S1: According to the intervertebral space that has been processed during the operation, determine the most matching specification of the intervertebral fusion device;

S2: Scan the intervertebral space and endplate shape with a 3D scanner to establish a model of the intervertebral space;

S3: In the 3D model editing software, compare the original model of the intervertebral cage in S1 with the model of the intervertebral space, and use the Boolean difference operation to establish a 3D reconstructed morphological model of the intervertebral cage.

Preferably, the S1 specifically includes the following steps: During the ACDF operation, when the intervertebral space is completely treated and the shape of the intervertebral space and the endplate no longer changes, multiple specifications of intervertebral fusion cage trial molds are sequentially placed in the intervertebral space. Gap testing to determine the most appropriate size for the fusion cage to be implanted;

Preferably, the S2 specifically includes the following steps: repeatedly and multi-dimensionally scan the morphology of the intervertebral space and the endplate with a 3D scanner, record and integrate the 3D shape data to form a complete model data, generate an STL format file and import the 3D model Editing software to build intervertebral space model;

Preferably, said S3 specifically includes the following steps: selecting the original model of the most suitable specification of the intervertebral fusion device selected in S1 and importing it into the three-dimensional model editing software, and then combining the original model of the intervertebral fusion device with the intervertebral space The model is matched, the height of the intervertebral space of the original model is adjusted until the intervertebral space model overlaps, and then Boolean operation is used to subtract the intersecting part of the intervertebral space model from the endplate contact surface of the upper and lower end surfaces of the original model, The reverse curved surfaces of the upper and lower endplates are generated as the upper and lower end surfaces of the intervertebral fusion device respectively to obtain a three-dimensional reconstructed morphological model of the intervertebral fusion device;

Preferably, before the S2, the intervertebral space and the endplate are fully hemostatic;

Preferably, the three-dimensional scanner adopts a non-contact active scanning method;

Preferably, the three-dimensional shape data includes the height of the intervertebral space, the angle of the bone surface of the endplate and the curvature of the bone surface of the endplate, and the three-dimensional shape of the endplate is obtained by integrating the angle of the bone surface of the endplate and the curvature of the bone surface of the endplate .

The preferred technical solution of the present invention can also produce the following technical effects at least:

The present invention effectively avoids the need to remove osteophytes on the edge of the vertebral body, remove the intervertebral disc, open the intervertebral space, and polish the endplate before placing the intervertebral fusion device in the prior art. Changing the shape of the endplate of the target space leads to the incomplete fit between the intervertebral fusion cage and the cervical vertebral endplate, so that there are generally interface gaps of different sizes and shapes between the implant and the bony endplate. The existence of this gap can affect the The osseointegration effect of the interface between the implant and the endplate leads to technical problems such as postoperative implant loosening, prolapse, and subsidence. The present invention scans the shape of intervertebral space and endplate during ACDF operation to obtain the three-dimensional digital model of intervertebral space and endplate after intraoperative processing, and provides morphological basis for processing intervertebral fusion device during operation. The original model of the best-matched intervertebral fusion cage is matched with the intervertebral space model obtained during the operation, and the 3D reconstruction shape model of the intervertebral fusion cage is established by using Boolean difference operation, so that the intervertebral fusion cage and the intervertebral space can be perfectly matched and improved. It improves the integration effect of the intervertebral fusion device and the cervical intervertebral space, minimizes the risk of postoperative complications caused by the gap between the implant and the endplate, ensures the quality of ACDF surgery, and enables patients to obtain the best treatment effect.

Description of drawings

In order to more clearly illustrate the technical solutions in the embodiments of the present invention or the prior art, the following will briefly introduce the drawings that need to be used in the description of the embodiments or the prior art. Obviously, the accompanying drawings in the following description are only These are some embodiments of the present invention. Those skilled in the art can also obtain other drawings based on these drawings without creative work.

Fig. 1 is a block flow diagram of a scanning method for intraoperative intervertebral space and endplate morphology provided by the present invention;

Fig. 2 is a flow chart of another method for scanning intervertebral space and endplate shape during operation provided by the present invention.

Detailed ways

In order to make the purpose, technical solution and advantages of the present invention clearer, the technical solution of the present invention will be described in detail below. Apparently, the described embodiments are only some of the embodiments of the present invention, but not all of them. Based on the embodiments of the present invention, all other implementations obtained by persons of ordinary skill in the art without making creative efforts fall within the protection scope of the present invention.

Example 1:

As shown in Figure 1, the present invention provides a scanning method for intervertebral space and endplate morphology, comprising the following steps:

S1: According to the size of the intervertebral space that has been processed during the operation, determine the most matching specification of the intervertebral fusion cage;

S2: Scan the intervertebral space and endplate shape with a 3D scanner to establish a model of the intervertebral space;

S3: In the 3D model editing software, the original model of the intervertebral fusion cage in S1 is compared with the intervertebral space model, and the 3D reconstruction morphological model of the intervertebral fusion cage is established by using Boolean difference operation.

The present invention scans the shape of intervertebral space and endplate during ACDF operation to obtain the three-dimensional digital model of intervertebral space and endplate after intraoperative processing, and provides morphological basis for processing intervertebral fusion device during operation. The best matching original model of the intervertebral fusion was matched with the intervertebral space model obtained during the operation, and the three-dimensional reconstruction model of the intervertebral fusion was established by using Boolean difference operation, so that the upper and lower end surfaces of the intervertebral fusion were in line with the endplate The perfect matching and complete fit of the intervertebral fusion cage and the cervical intervertebral space improve the integration effect of the intervertebral fusion cage and the cervical intervertebral space, minimize the risk of postoperative complications caused by the gap between the implant and the endplate, ensure the quality of ACDF surgery, and enable patients Get the best therapeutic effect.

Example 2:

As shown in Figure 2, the present invention provides a scanning method for intervertebral space and endplate morphology, including the following steps:

S1: During the ACDF operation, when all the treatment of the intervertebral space is completed and the shape of the intervertebral space and the endplate no longer change, take multiple specifications of intervertebral fusion cage trial molds and place them in the intervertebral space test in order to determine the ones to be implanted. The most suitable specification for the intervertebral fusion cage;

S2: Repeatedly and multi-dimensionally scan the shape of the intervertebral space and endplate with a three-dimensional scanner, integrate the height of the intervertebral space, the angle of the bone surface of the endplate, and the curvature parameters of the bone surface of the endplate to form complete data, and generate an STL format file And import Material ise Magics software to build intervertebral space model;

S3: Select the original model of the intervertebral cage with the most suitable specifications selected in S1 and import it into MaterializeMagics software, then match the original model of the intervertebral cage with the intervertebral space model, and adjust the height of the intervertebral space of the original model to the intervertebral space The models overlap, and then use the Boolean difference operation to subtract the intersecting part of the intervertebral space model from the endplate contact surfaces of the upper and lower end surfaces of the original model to generate the reverse curved surfaces of the upper and lower endplates, which are respectively used as intervertebral fusion The upper and lower end faces of the intervertebral fusion cage were obtained to obtain the three-dimensional reconstruction shape model of the intervertebral fusion cage.

Realize the perfect match between the height of the intervertebral fusion cage and the height of the intervertebral space, the endplate contact surfaces of the upper and lower end surfaces of the intervertebral fusion cage perfectly match and completely fit the endplates of the intervertebral fusion cage, and the endplates of the intervertebral fusion cage contact Surface contact with the surface of the endplate increases the contact area, improves the supporting effect and load-bearing effect of the intervertebral fusion cage, the integration effect of the intervertebral fusion cage and the cervical intervertebral space is good, and minimizes the impact of the implant and the endplate. The risk of postoperative complications caused by gaps ensures the quality of ACDF surgery and enables patients to obtain the best therapeutic effect.

As an optional implementation, the front end of the intervertebral fusion cage trial mold is detachably connected with multiple intervertebral fusion cage models of different specifications, and the rear end is provided with a connecting handle. The intervertebral fusion cage model is sequentially inserted into the intervertebral space to determine the specification of the intervertebral fusion cage that best matches the intervertebral space, improving the efficiency and accuracy of the trial model.

As an optional implementation manner, the three-dimensional scanner adopts a non-contact active scanning method, preferably a laser three-dimensional scanner and an optical three-dimensional scanner. The probe of the 3D scanner emits light to irradiate the intervertebral space. By moving the probe of the 3D scanner, multi-dimensional and comprehensive data collection and integration are performed on the surrounding contour of the intervertebral space and the shape of the endplate to complete a complete and accurate 3D reconstruction model.

As an optional implementation, before S2, adequate hemostasis is performed on the intervertebral space and endplate to avoid blood contamination and interference with the probe of the three-dimensional scanner, and effectively ensure the accuracy and reliability of the intervertebral space scanning process.

The present invention scans the morphology of the intervertebral space and the endplate during the ACDF operation to obtain the three-dimensional digital model of the intervertebral space and the endplate after the intraoperative treatment, and provides a morphological basis for the processing of the intervertebral fusion device during the operation. The original model of the matched intervertebral fusion cage is matched with the intervertebral space model obtained during the operation, and the 3D reconstruction shape model of the intervertebral fusion cage is established by using the Boolean difference operation, so that the height of the intervertebral fusion cage perfectly matches the height of the intervertebral space , The contact surface of the upper and lower end surfaces of the intervertebral cage perfectly matches and fits perfectly with the endplate, the contact surface of the endplate of the intervertebral cage contacts the surface of the endplate, which increases the contact area and improves the intervertebral fusion The supporting effect and load-bearing effect of the intervertebral fusion cage and the cervical intervertebral space are well integrated, which minimizes the risk of postoperative complications caused by the gap between the implant and the endplate, ensures the quality of ACDF surgery, and enables patients to obtain optimal therapeutic effect.

It can be understood that, the same or similar parts in the above embodiments can be referred to each other, and the content that is not described in detail in some embodiments can be referred to the same or similar content in other embodiments.

In the description of the present invention, it should be noted that, unless otherwise specified, "plurality" means two or more; the terms "upper", "lower", "left", "right", "inner" The orientation or positional relationship indicated by "," outer", "front end", "rear end", "head", "tail", etc. is based on the orientation or positional relationship shown in the accompanying drawings, and is only for the convenience of describing the present invention and Simplified descriptions, rather than indicating or implying that the device or element referred to must have a particular orientation, be constructed and operate in a particular orientation, and thus should not be construed as limiting the invention. In addition, the terms "first", "second", "third", etc. are used for descriptive purposes only and should not be construed as indicating or implying relative importance.

In the description of the present invention, it should also be noted that, unless otherwise clearly specified and limited, the terms "installation", "connection", and "connection" should be understood in a broad sense, for example, it can be a fixed connection or a flexible connection. Detachable connection, or integral connection; it can be mechanical connection or electrical connection; it can be direct connection or indirect connection through an intermediary. For those skilled in the art, the specific meanings of the above terms in the present invention can be understood according to specific situations.

In the description of this specification, descriptions referring to the terms "one embodiment", "some embodiments", "example", "specific example" or "an example" mean specific features described in connection with the embodiment or example, A structure, material or characteristic is included in at least one embodiment or example of the present application. In this specification, schematic representations of the above terms do not necessarily refer to the same embodiment or example. Furthermore, the specific features, structures, materials or characteristics described may be combined in any suitable manner in any one or more embodiments or examples.

The above is only a specific embodiment of the present invention, but the scope of protection of the present invention is not limited thereto. Anyone skilled in the art can easily think of changes or substitutions within the technical scope disclosed in the present invention. Should be covered within the protection scope of the present invention. Therefore, the protection scope of the present invention should be determined by the protection scope of the claims.

Claims (8)

1. a scanning method of intervertebral space and endplate shape in operation, is characterized in that, comprises the steps: S1: According to the intervertebral space that has been processed during the operation, determine the most matching specification of the intervertebral fusion device; S2: Scan the intervertebral space and endplate shape with a 3D scanner to establish a model of the intervertebral space; S3: In the 3D model editing software, compare the original model of the intervertebral cage in S1 with the model of the intervertebral space, and use the Boolean difference operation to establish a 3D reconstructed morphological model of the intervertebral cage. 2. The scanning method of intraoperative intervertebral space and endplate shape according to claim 1, characterized in that, said S1 specifically comprises the following steps: in ACDF operation, when all the treatment of intervertebral space is completed, intervertebral space When the shape of the intervertebral fusion cage and the endplate no longer change, multiple specifications of intervertebral fusion cage trial molds are placed in the intervertebral space test in order to determine the most suitable specification of the intervertebral fusion cage to be implanted. 3. The scanning method of intervertebral space and endplate shape in a kind of operation according to claim 2, it is characterized in that, described S2 specifically comprises the following steps: carry out repeated, multi-dimensional scanning to intervertebral space and endplate shape by three-dimensional scanner Dimensional scanning, recording and integrating three-dimensional shape data to form complete model data, generating STL format files and importing them into three-dimensional model editing software to establish intervertebral space models. 4. A method for scanning intraoperative intervertebral space and endplate morphology according to claim 3, characterized in that said S3 specifically comprises the following steps: selecting the intervertebral fusion device of the most suitable specification selected in said S1 Import the original model of the intervertebral cage into the 3D model editing software, then match the original model of the intervertebral cage with the intervertebral space model, adjust the relative height and depth of the original model and the intervertebral space model until the intervertebral space model coincides, and then use Boolean operation, the intersecting part of the intervertebral space model is subtracted from the endplate contact surface of the upper and lower end surfaces of the original model to generate the reverse curved surface of the upper and lower endplates, which are used as the upper and lower surfaces of the intervertebral cage respectively. , and the lower end surface to obtain the three-dimensional reconstructed shape model of the intervertebral fusion cage. 5 . The scanning method of intraoperative intervertebral space and endplate morphology according to claim 3 , characterized in that, before the S2, the intervertebral space and endplate are fully hemostatically treated. 6 . 6 . The scanning method of intervertebral space and endplate shape during operation according to claim 4 , wherein the three-dimensional model editing software adopts Materialize Magics software. 7 . 7 . The scanning method of intervertebral space and endplate shape during operation according to claim 3 , wherein the three-dimensional scanner adopts a non-contact active scanning method. 8 . 8. The scanning method of intraoperative intervertebral space and endplate morphology according to claim 3, wherein the three-dimensional shape data includes the height of the intervertebral space, the angle of the endplate bone surface and the curvature of the endplate bone surface , the three-dimensional shape of the endplate is obtained by integrating the angle of the bone surface of the endplate and the curvature of the bone surface of the endplate.