基于CT图像建立的小儿枢椎齿状突病理性骨折三维数字化模型

背景：在进行寰枢椎椎弓根内固定过程中,由于儿童的骨骼局部解剖结构复杂及椎弓根结构常存在变异,且置钉时极易损伤椎动脉或脊髓,导致严重后果。目的：基于CT扫描图像建立精确的小儿枢椎齿状突病理性骨折数字化模型,评估其在临床诊断及内固定治疗中的应用效果。方法：将1例2岁枢椎齿状突病变患儿的CT扫描结果导入三维建模Simpleware软件中进行三维重建,用逆向工程与快速成型原理制作个体化的骨骼模型实物并经树脂后处理,利用该模型指导内固定治疗。结果与结论：成功建立了小儿寰枢椎及齿状突的三维立体模型,可直接观察病变部位,精确测量置钉入点、角度及其他数据,对内固定方案设计起到了良好的指导作用,从而提高了寰枢椎椎弓根内固定治疗的安全性和准确性。

Digital three-dimensional model reconstruction in pathological fractures of pediatric odontoid process based on CT images

BACKGROUND：Children＇s bone structure of the pedicle anatomy is often complicated and variable,the three-dimensional model of odontoid process fracture via three-dimensional reconstruction can be used to guide the surgery and improve the success rate of surgery.OBJECTIVE：To study an accurate digital model of pathologic odontoid process fracture in pediatrics and its clinical applications.METHODS：One child with pathologic odontoid process fracture,2 years old,was chosen,and his slice scanning CT images were read by Simpleware software for three-dimensional reconstruction.Based on reverse engineering and rapid prototyping technique,the individual skeleton model was obtained.Subsequently treated by resin,the model was guided to the surgery.RESULTS AND CONCLUSION：The three-dimensional model of pediatric atlantoaxial including odontoid process was successfully established.With the model,the region could be directly observed,and the position and angel of screw fixation could be measured accurately,which played a good role on the operation design.The three-dimensional model intuitively and accurately reflected the structure of patient＇s atlantoaxial and odontoid fracture,which improved the safety and accuracy of atlantoaxial pedicle screw fixation.