Study On The Application Of 3D Reconstruction Model Of Lumbar Vertebrae In L4/5 Lateral Approach For Endoscopic Surgery Planning

Objective: Through digital 3D reconstruction and simulation surgery,on the one hand,it can improve the success rate of PETD catheter insertion in L4/5 lateral approach and reduce the number of intraoperative fluoroscopy;on the other hand,it can shorten the operation time and reduce the learning curve of PETD.Method : In this study,we selected the patients who underwent L4/5lateral approach discectomy,they were randomly divided into experimental group and control group by random number table method,in the experimental group,3D reconstruction software was used to reconstruct the 3D visual model of lumbar vertebrae,then carried out the catheter insertion of preoperative simulated operation,the data of skin puncture point and puncture angle were calculated by Mimics anatomical measurement module;the control group was treated with manual catheter insertion by experience.The age,gender and other general data were recorded before surgery,and the classification of patients with disc herniation was recorded.During the operation,the time of catheterization,mirror operation time and the number of X-ray fluoroscopy were recorded.After operation,the surgical efficacy evaluation data of patients was recorded(The VAS score and JOA score of 1day before operation,1 day after operation,after 1 month and after 3 months)The data of the patients were compared and analyzed.Statistics method:measurement data using independent sample t test,count data using chi square test;test standard for ?=0.05,P< 0.05 indicates that the difference is statistically significant.Results: The age data of the two groups were examined by independent sample t test,the difference was not statistically significant(t=0.614,P > 0.05);gender by chi square test,the difference was not statistically significant(x2=0.191,P > 0.05).The time of catheterization,mirror operation time and the number of X-ray fluoroscopy of the experimental group and control group by independent sample t test,the values of P were less than 0.05,the difference was statistically significant.Preoperative VAS score(t=0.336,P > 0.05)and JOA score(t=0.336,P >0.05)of the patients in two groups after independent sample t test showed that the difference was not statistically significant.Same,the VAS score and JOA score of 1 day before operation,1 day after operation,after 1 month and after3 months in two groups through independent sample t test showed that the difference was not statistically significant.Preoperative and postoperative VAS score of the patients after independent sample t test showed that the difference was statistically significant(t=16.207,P < 0.05);same, Preoperative and postoperative JOA score of the patients after independent sample t test showed that the difference was statistically significant(t=12.700,P<0.05).Conclusion: Using 3D software to reconstruct the 3D visual model for virtual surgery planning on the one hand can be intuitive to determine the feasibility of surgery and shorten the time of catheterization and mirror operation,in the meantime,reduce the number of fluoroscopy and protect the health of patients.On the other hand,the technology can help young doctors to better understand the endoscopic technique and the lumbar vertebrae anatomy,and shorten the learning cycle of PETD,reduce the learning curve.