导航机器人系统应用于下颌骨精确截骨的实验研究

目的探讨下颌骨手术导航机器人系统辅助下颌骨截骨的精确性及稳定性。方法选择就诊于泰州市人民医院的下颌角肥大患者1例,女性,27岁,应用三维打印技术,根据其头颅CT扫描数据制作5个同样的下颌骨模型。搭建下颌骨导航机器人系统,将头颅三维数据导入FaceGraph软件形成虚拟三维图像,并按照理想截骨线的标准预设截骨线;通过三维激光扫描仪扫描模型局部表面特征,将其与虚拟三维图像进行配准;机械臂通过信号传输连线将臂间关节角度值传输至主机,在对机械臂空间建模的基础上,运算得出机械臂末端的实时位置信息,经过以上步骤,将虚拟空间、现实空间的坐标以及机械臂的相对位置进行统一。在导航系统的辅助下,由术者操作末端机械臂分别在5个下颌骨模型上完成截骨手术。采用SPSS 20.0软件,对5个模型的总体40个偏差数值进行描述性统计,计算模型实际截骨线与软件中预设截骨线的偏差情况,并对5个模型各自的偏差数值进行单因素方差分析,了解不同模型间的偏差有无差异。结果在对下颌骨模型进行模拟截骨的实验过程中,机器人末端铣刀运行平稳,能够根据实验前设定的截骨线行走;在预先设定的位置计算实际截骨线与预设截骨线的总体偏差值为(0.92±0.43)mm(95%CI:0.78~1.05 mm),对5个模型截骨后的偏差值进行方差分析,相互间差异无统计学意义(F=0.320,P>0.05)。结论在术者控制下,导航机器人系统能够按照预设的截骨线精确、稳定地对下颌骨模型进行截骨。

Experimental study on the application of navigation robot system in precise mandible osteotomy

Objective To study the accuracy and stability of mandible osteotomy assisted by navigation robot system.Methods One 27-year-old female patient with hypertrophic mandible angle was selected from Taizhou People’s Hospital,and five same mandible manikins were made by 3D printing technology,according to the CT scan data of her head.The mandible navigation robot system was built,and the 3D data of the skull was imported into FaceGraph software to form the virtual 3D image,then the osteotomy line was preset according to theideal osteotomy line.The surface features of the manikin was scanned by a 3D laser scanner,and registered with the virtual 3D images.The robot arms transmitted the inter-arm joints angle value to the host computer through signal transmission connections,and the real-time position of the end of the robot arm was calculated,based on the spatial modeling of the robot arms.After the steps above,the coordinates of virtual space,real space and the relative position of the robot arm were unified.With the assistance of navigation system,the operator held the end of the arms and completed 5 cases of osteotomy on mandible manikins.SPSS 20.0 software was used to make descriptive statistics on the total 40 deviation values of the 5 manikins,which were between the actual osteotomy line on the manikins and the preset osteotomy line in the software.One-way ANOVA was performed on the respective deviation values of the five manikins to find out whether there was a difference among deviations of the five manikins.Results The milling cutter in the end of the robot operated steadily,and could run along the osteotomy line on the mandible manikins preseted before the experiment.The deviation value between the actual osteotomy line and the preset one in the pre-set locations was(0.92±0.43)mm(95%CI:0.78-1.05 mm);there was no statistic difference of the deviation values comparing the five manikins with one-way ANOVA(F=0.320,P>0.05).Conclusions Under the operator’s control,the navigation robot system can perform an osteotomy to the mandible model accurately and stably according to the preset osteotomy line.