CN-121971167-A - Preoperative risk parameter determination method for percutaneous post Lu Huan pivot joint screw internal fixation

CN121971167ACN 121971167 ACN121971167 ACN 121971167ACN-121971167-A

Abstract

The invention relates to the technical field of atlantoaxial fixation and discloses a preoperative risk parameter determination method for an atlantoaxial screw internal fixation operation after percutaneous, which comprises the steps of acquiring a target image, wherein the target image is an image containing an atlantoaxial to be measured, determining preoperative risk parameters for the percutaneous posterior Lu Huan axial screw internal fixation operation based on the target image, and the preoperative risk parameters comprise the width of a right/left axial isthmus, the height of the right/left axial isthmus, the distance travelled by the right/left axial isthmus screw in bone, the maximum width of a right/left atlas lateral mass screw nail inlet path, the maximum height of the right/left atlas lateral mass screw nail inlet path and the distance travelled by the right/left atlas lateral mass screw in bone. The invention constructs a preoperative parameter measurement system of percutaneous post Lu Huan pivot joint screw internal fixation, provides quantitative basis for the direction of screw placement, screw feeding point, angle and the like, and improves the accuracy and safety of percutaneous post Lu Huan pivot joint screw internal fixation.

Inventors

XI MINGJUN
TANG JIAGUANG
BAO BEIXI
QU XIAOXIA

Assignees

首都医科大学附属北京同仁医院

Dates

Publication Date: 20260505
Application Date: 20260326

Claims (16)

1. A method for pre-operative risk parameter determination for percutaneous post Lu Huan pivot screw internal fixation, the method comprising: acquiring a target image, wherein the target image is an image containing an atlantoaxial joint to be measured; determining pre-operative risk parameters for percutaneous post Lu Huan pivot screw internal fixation based on the target image; The preoperative risk parameters include a width of a right axial isthmus, a width of a left axial isthmus, a height of a right axial isthmus, a height of a left axial isthmus, a distance traveled by a right axial isthmus screw in bone, a distance traveled by a left axial isthmus screw in bone, a maximum width of a right atlas lateral mass screw approach path, a maximum width of a left atlas lateral mass screw approach path, a maximum height of a right atlas lateral mass screw approach path, a maximum height of a left atlas lateral mass screw approach path, a distance traveled by a right atlas lateral mass screw in bone, and a distance traveled by a left atlas lateral mass screw in bone.
2. The method of claim 1, wherein the target image is a three-dimensional image containing the atlantoaxial to be measured, and wherein the determining pre-operative risk parameters for percutaneous post Lu Huan-axis intra-fix surgery based on the target image comprises: Determining an axial horizontal plane image, an axial sagittal plane image, an atlas horizontal plane image and an atlas sagittal plane image corresponding to the atlantoaxial joint to be measured based on the target image; Determining the preoperative risk parameter based on the axial level image, the axial sagittal plane image, the atlas level image, the atlas sagittal plane image.
3. The method of claim 2, wherein determining the width of the right-sided isthmus based on the target image comprises: On the level image of the pivotes, the following steps are performed: determining a first midline of the pivot; Rotating the first normal line clockwise to obtain a first line, wherein the first normal line and the first line form a first preset angle; determining a second line parallel to the first line, the second line being tangential to the inner lateral edge of the spinal canal; Moving the first line in parallel towards a direction away from the vertebral canal to obtain a third line, and enabling the third line and the second line to be separated by a first preset distance; Determining a fourth line parallel to the third line, the fourth line being tangential to the vertebral artery running region; Determining a vertical distance between the second line and the fourth line, obtaining a width of the right lateral isthmus.
4. The method of claim 3, wherein determining a distance traveled by the right-sided dentate isthmus screw in bone based on the target image comprises: Determining a first intersection point and a second intersection point of the third line intersecting with the boundary of the pivot region; And determining the distance between the first intersection point and the second intersection point to obtain the distance that the right-side axial isthmus screw walks in the bone.
5. The method of claim 3, wherein determining the height of the right lateral isthmus based on the target image comprises: adjusting a nail feeding position so that the nail feeding path passes through the middle points of the upper edge of the isthmus and the lower edge of the isthmus; determining a fifth line and a sixth line parallel to the staple feeding path, wherein the fifth line is tangent to the upper edge of the isthmus, and the sixth line is tangent to the lower edge of the isthmus; determining a vertical distance between the fifth line and the sixth line to obtain a height of the right lateral isthmus.
6. The method of claim 2, wherein determining the width of the left-sided isthmus based on the target image comprises: On the level image of the pivotes, the following steps are performed: determining a second midline of the pivot; Rotating the second normal line anticlockwise to obtain a seventh line, wherein the second normal line and the seventh line form a second preset angle; Determining an eighth line parallel to the seventh line, the eighth line being tangent to the inner lateral edge of the spinal canal; Moving the seventh line in parallel towards a direction away from the vertebral canal to obtain a ninth line, and enabling the ninth line and the eighth line to be separated by a second preset distance; Determining a tenth line parallel to the ninth line, the tenth line being tangential to the vertebral artery running region; determining a vertical distance between the ninth line and the tenth line to obtain a width of the left lateral isthmus.
7. The method of claim 6, wherein determining a distance traveled by the left-side axial isthmus screw in bone based on the target image comprises: Determining a third intersection point and a fourth intersection point of the ninth line intersecting with the boundary of the pivot region; And determining the distance between the third intersection point and the fourth intersection point to obtain the distance that the left-side axial isthmus screw walks in the bone.
8. The method of claim 6, wherein determining the height of the left-sided isthmus based on the target image comprises: adjusting a nail feeding position so that the nail feeding path passes through the middle points of the upper edge of the isthmus and the lower edge of the isthmus; determining an eleventh line parallel to the approach path and a twelfth line tangential to the upper edge of the isthmus, the twelfth line tangential to the lower edge of the isthmus; determining a vertical distance between the eleventh line and the twelfth line, obtaining a height of the left lateral isthmus.
9. The method of claim 2, wherein determining a maximum width of the right atlas lateral mass screw approach path based on the target image comprises: The third normal midline of the atlas is determined on the atlas horizontal plane image, and the thirteenth line is obtained by rotating the third normal midline clockwise, wherein the third normal midline and the thirteenth line form a third preset angle; A fourteenth line parallel to the thirteenth line is determined, the fourteenth line is tangent to the inner side edge of the vertebral canal, the fourteenth line is moved in parallel towards the direction far away from the vertebral canal, a fifteenth line is obtained, and the fifteenth line and the fourteenth line are separated by a third preset distance; Determining the midpoint of the posterior border of the atlas side block and the midpoint of the anterior border of the atlas side block on the atlas sagittal plane image, so that the nail feeding path of the screw on the atlas sagittal plane passes through the midpoint of the posterior border of the atlas side block and the midpoint of the anterior border of the atlas side block; Determining a sixteenth line parallel to the fifteenth line on the atlas horizontal plane image, the sixteenth line being tangential to the vertebral artery running region; determining the vertical distance between the fifteenth line and the sixteenth line, and adding the third preset distance to obtain the maximum width of the right atlas lateral mass screw feeding path.
10. The method of claim 9, wherein determining a distance traveled by the right atlas lateral mass screw in bone based on the target image comprises: and determining the distance between the midpoint of the posterior edge of the atlas lateral mass and the midpoint of the anterior edge of the atlas lateral mass on the atlas sagittal plane image to obtain the running distance of the right atlas lateral mass screw in bone.
11. The method of claim 9, wherein determining a maximum height of the right atlas lateral mass screw approach based on the target image comprises: Connecting the midpoint of the posterior edge of the atlas lateral mass with the midpoint of the anterior edge of the atlas lateral mass on the atlas sagittal plane image to obtain a seventeenth line; determining an eighteenth line parallel to the seventeenth line and a nineteenth line, the eighteenth line intersecting the lower edge of the atlas vertebral arch, the nineteenth line intersecting the lower edge of the atlas lateral mass; and determining the vertical distance between the eighteenth line and the nineteenth line to obtain the maximum height of the screw feeding path of the right atlas lateral mass screw.
12. The method of claim 2, wherein determining a maximum width of the left atlas lateral mass screw approach path based on the target image comprises: The method comprises the steps of acquiring an atlas horizontal plane image, determining a fourth normal midline of the atlas on the atlas horizontal plane image, rotating the fourth normal midline anticlockwise to obtain a twentieth line, determining a twenty-first line parallel to the twentieth line, tangential to the inner side edge of the vertebral canal, moving the twentieth line parallel to the direction away from the vertebral canal to obtain a twenty-second line, and enabling the twenty-second line to be separated from the first line by a fourth preset distance; Determining the midpoint of the posterior border of the atlas side block and the midpoint of the anterior border of the atlas side block on the atlas sagittal plane image, so that the nail feeding path of the screw on the atlas sagittal plane passes through the midpoint of the posterior border of the atlas side block and the midpoint of the anterior border of the atlas side block; Determining a twenty-third line parallel to the twenty-second line on the atlas horizontal plane image, the twenty-third line being tangential to the vertebral artery running region; determining the vertical distance between the twenty-second line and the twenty-third line, and adding the fourth preset distance to obtain the maximum width of the left atlas lateral mass screw feeding path.
13. The method of claim 12, wherein determining a distance traveled by the left atlas lateral mass screw in bone based on the target image comprises: And determining the distance between the midpoint of the posterior edge of the atlas lateral mass and the midpoint of the anterior edge of the atlas lateral mass on the atlas sagittal plane image to obtain the running distance of the left atlas lateral mass screw in bone.
14. The method of claim 12, wherein determining a maximum height of the left atlas lateral mass screw approach based on the target image comprises: Connecting the midpoint of the posterior edge of the atlas lateral mass with the midpoint of the anterior edge of the atlas lateral mass on the atlas sagittal plane image to obtain twenty-four lines; determining a twenty-fifth line parallel to the twenty-fourth line intersecting the lower edge of the atlas vertebral arch and a twenty-sixth line intersecting the lower edge of the atlas lateral mass; and determining the vertical distance between the twenty-fifth line and the twenty-sixth line to obtain the maximum height of the left atlas lateral mass screw feeding path.
15. A pre-operative risk parameter determination device for percutaneous post Lu Huan pivot screw internal fixation, the device comprising: The acquisition module is used for acquiring a target image, wherein the target image is an image containing an atlantoaxial joint to be measured; The determination module is used for determining preoperative risk parameters of percutaneous post Lu Huan axial screw internal fixation operation based on the target image, wherein the preoperative risk parameters comprise width of a right axial isthmus, width of a left axial isthmus, height of a right axial isthmus, height of a left axial isthmus, distance traveled by the right axial isthmus screw in bone, distance traveled by the left axial isthmus screw in bone, maximum width of a right atlas screw feeding path, maximum width of a left atlas screw feeding path, maximum height of a right atlas screw feeding path, maximum height of a left atlas screw feeding path, distance traveled by the right atlas screw in bone, and distance traveled by the left atlas screw in bone.
16. An electronic device, comprising: A memory and a processor communicatively coupled to each other, the memory having stored therein computer instructions that, upon execution, perform the pre-operative risk parameter determination method for percutaneous post Lu Huan pivot screw endoprosthesis of any one of claims 1 to 14.

Description

Preoperative risk parameter determination method for percutaneous post Lu Huan pivot joint screw internal fixation Technical Field The invention relates to the technical field of atlantoaxial fixation, in particular to a method for determining preoperative risk parameters of percutaneous post-Lu Huan axial screw internal fixation. Background Percutaneous post Lu Huan axial screw internal fixation is a key minimally invasive spinal surgery technique for treating diseases such as atlantoaxial instability, dislocation, fracture, deformity and the like. The screw is placed through a small incision in the skin behind the neck, and the atlantoaxial joint is directly fixed, so that the advantages of small trauma, less bleeding, quick postoperative recovery, reliable spine stability reconstruction and the like are achieved, and the screw is one of the main surgical methods of upper cervical vertebra surgery. Because of the complex anatomy of the atlantoaxial region, the narrow pedicle and the close relationship with the vertebral artery, the intra-operative nailing channel is very easy to collide with the vertebral artery, and once damaged, serious neurovascular complications can be caused. At present, although three-dimensional image reconstruction and measurement software (such as RadiAnt, 3D slice, etc.) is widely used for preoperative image analysis in clinic, subjective judgment and empirical analysis of images by doctors are often relied on. The doctor usually selects the observation layer on the basis of two-dimensional or three-dimensional images by himself, determines the measurement site and judges the safe area of the nail placement, and the process lacks unified, standard and repeatable standardized parameters, which easily causes preoperative nail path planning deviation and risk prejudgement deficiency. Disclosure of Invention The invention provides a preoperative risk parameter determination method for percutaneous post Lu Huan pivot bolt internal fixation, which aims to solve the problem that parameters required for percutaneous post Lu Huan pivot bolt internal fixation are determined through subjective experience in the prior art, and a systematic and quantized preoperative risk parameter measurement system is lacked. In a first aspect, the present invention provides a method for pre-operative risk parameter determination for percutaneous post Lu Huan pivot screw internal fixation, the method comprising: Acquiring a target image, wherein the target image is an image containing an atlantoaxial joint to be measured; determining preoperative risk parameters for percutaneous post Lu Huan pivot screw internal fixation based on the target image; The preoperative risk parameters include a width of the right axial isthmus, a width of the left axial isthmus, a height of the right axial isthmus, a height of the left axial isthmus, a distance traveled by the right axial isthmus screw in bone, a distance traveled by the left axial isthmus screw in bone, a maximum width of a right atlas lateral mass screw approach path, a maximum width of a left atlas lateral mass screw approach path, a maximum height of a right atlas lateral mass screw approach path, a maximum height of a left atlas lateral mass screw approach path, a distance traveled by the right atlas lateral mass screw in bone, and a distance traveled by the left atlas lateral mass screw in bone. The preoperative risk parameters jointly form a preoperative parameter measurement system of percutaneous post Lu Huan pivot joint screw internal fixation, preoperative risk parameters such as width, height, bone running distance and the like of the lateral masses of the axial isthmus and the atlas are measured based on target images, quantitative basis is provided for the nail placement direction, the nail feeding point, the angle and the like, the risk of vascular nerve injury can be effectively reduced, and the accuracy and the safety of percutaneous post Lu Huan pivot joint screw internal fixation are improved. In an alternative embodiment, the target image is a three-dimensional image containing the atlantoaxial to be measured, and determining pre-operative risk parameters for percutaneous post Lu Huan-axial screw internal fixation based on the target image, comprises: determining an axial horizontal plane image, an axial sagittal plane image, an atlas horizontal plane image and an atlas sagittal plane image corresponding to an atlas axial joint to be measured based on the target image; the preoperative risk parameters are determined based on the axial level image, the axial sagittal plane image, the atlas level image, and the atlas sagittal plane image. In an alternative embodiment, determining the width of the right-sided isthmus based on the target image includes: On the level image of the pivotes, the following steps are performed: determining a first midline of the pivot; clockwise rotating the first neutral line to obtain a first line, wherein the first