Preliminary Design And Study Of Visual Pedicle Probe

1 background: pedicle access is the important surgical approach point in the spinal biopsy,pedicle screw fixation,vertebroplasty,posterior kyphoplasty and other modern spine surgery.However,there are still a lot ofcases with bone cement leakage and inaccurate pedicle screw at the present stage,which pedicle channel factors often can not be ignored.Therefore,it is important to establish a better pedicle channel.At present,the method of establishing pedicle channel is mainly established by free hand technology,digital image navigation technology,in recent years there are also ball tip technology.Free hand technology is currently the most widely used technology,but it is not enough in terms of fluoroscopy times,inaccurate pedicle screw,bone cement leakage,learning curve and experience threshold.Digital image navigation technology is developed in recent years,high-tech,but it has not yet universal,while increasing the economic costs of hospitals and patients.The ball tip technology is still in development,but also has the number of fluoroscopy,poor nail,bone leakage and other aspects of insufficient.Therefore,it is important to design and develop a new visual pedicle probe to assist in the establishment of the pedicle channel.2 Objective: to design and study a new type of visual pedicle probe,which can be used in spinal surgery.2.1 Through the CT imaging technology,the measurement of the lumbar spine imaging parameters of the Chinese people,to provide a basis for the design of a new type of visual pedicle probe.2.2 To design and develop a new type of visual pedicle probe with the ability to distinguish the pedicle cortical bone and cancellous bone.Use the new type of puncture needle was used to establish the pedicle channel.3 method:3.1.We selected 36 cases of lumbar and abdominal CT examination in our hospital,excludedlumbar disease.The PACS system was used to reconstruct the lumbar spine,and the imaging parameters were measured.3.2 To design a new type of visual pedicle probe with reference to the relevant imaging parameters and researches.3.3 With X-ray fluoroscopy assisted,in the fresh bovine lumbarpedicle,we usd the visual probe to establish the pedicle channel,to simulate the various types of pedicle cortex perforation,and to record the corresponding X-ray image and the visual field of the puncture needle.4 results:4.1 36 cases were randomly selected,including 20 males and 16 females,aged 43.3 ± 12.3 years.There was no significant difference between the left and right sides of the pedicle for paired t test(p> 0.05).PSA has downward trend,the level of change is small,L4 relative L3 increased,L5 level is minimum at the average of-1.3 °;PTA is gradually increasing the trend,L5 at the maximum,the average is 25.4 ° The The length of the pedicle channel increased first and then decreased in the lumbar segment,the longest average of 52.2mm in the L2 segment,the shortest L5,with an average of 47.4mm.The pedicle height was slightly narrowed at L1-L3 level,the smallest was 15.4mm(L3 mean),and reached the maximum L5 at 22.7mm(L5).Cancellous bone height also showed the same trend,the minimum L3 is 10.2mm,the maximum L5 is 17.9mm.Lumbar pedicle width showed an upward trend,L1 minimum of 7.7mm,L5 maximum of 12.5mm;cancellous bone width also became a similar upward trend,the narrowest L1 average of 4.9mm,the maximum L5 average of 8.5mm.Overall,the upper lumbar pedicle channel slender,while the lower lumbar spine slightly short.4.2 Successfully designed a visual pedicle needle,and done simulation test in vitro.It can be intuitive distinction between cancellous bone and cortical bone,and even can see the spinal canal periosteum.5 Conclusion : lumbar pedicle pedicle morphology has a certain difference there is a certain law,accurate grasp of its structure and image characteristics of pedicle screw fixation is the basis of surgery.By measuring the parameters of the pedicle,the length of the pedicle channel,the width of the pedicle isthmus is the basis for the design of puncture needle and can be used to select the appropriate screw.Visual pedicle needle has the characteristics of direct vision puncture.There are unique clinical significance and development prospects and insufficient need to further improve.