北京生物醫(yī)學工程

錐形束 CT 引導機器人輔助反肩關(guān)節(jié)肩盂基座螺釘導針置入精準度研究

Accuracy of robot-assisted glenoid gaseplate screw guide wire placement in reverse shoulder arthroplasty under cone beam CT-guided

作者：韓巍張騰黃強張勇王彬彬吳新寶王軍強

單位：北京積水潭醫(yī)院創(chuàng)傷骨科(北京 100035) 北京天智航醫(yī)療科技股份有限公司天璣實驗室 (北京 100192) 清華大學醫(yī)學院生物醫(yī)學工程學院( 北京 100085)北京市醫(yī) 療機器人產(chǎn) 業(yè) 創(chuàng) 新中心 ( 北京 100192)

關(guān)鍵詞：錐形束; 機器人輔助; 肩盂基座; 手術(shù)導航; 精準度

分類號：R318.04

出版年·卷·期（頁碼）：2021·40·3（245-251）

摘要：

評估錐形束 CT(cone beam CT, CBCT)引導下機器人輔助置入反肩關(guān)節(jié)肩盂基座螺釘導針的精準度,為機器人輔助反肩關(guān)節(jié)置換手術(shù)的開展提供理論支持。方法使用 CBCT 對 12 例SYNBONE 肩胛骨模型置入反肩關(guān)節(jié)肩盂基座螺釘導針前后行斷層掃描。采用 TiRobot 軟件術(shù)前規(guī)劃螺釘導針入針點、尾端止點及導針置入路徑的位置坐標。計算機根據(jù)規(guī)劃位置控制機械臂定位并輔助置入肩盂基座螺釘導針,術(shù)后比較規(guī)劃入止點、路徑與實際入止點、路徑的差異。結(jié)果所有肩胛骨模型均一次完成導針置入。規(guī)劃與實際入針點位置偏差為(1.155±0.517) mm,規(guī)劃與實際尾端止點位置偏差為(1.047±0.288)mm,計劃路徑與實際路徑夾角偏差為(1.564±0.888)°。結(jié)論 CBCT 引導下機器人輔助反肩關(guān)節(jié)肩盂基座螺釘導針置入精確度高,為臨床中反肩關(guān)節(jié)置換精準治療手術(shù)重要步驟提供可行性選擇。

Objective To evaluate the accuracy of CT -guided robot -assisted glenoid baseplate screw guide wire placement in reverse shoulder arthroplasty, and to provide theoretical support for robot assisted shoulder arthroplasty. Methods Preoperative cone beam CT ( CBCT ) scans of 12 SYNBONE scapula models were performed using CBCT. The data was uploaded to the robot workstation, and preoperative planning was carried out. After the planning was confirmed, the computer - controlled robot arm was positioned and assisted to place glenoid baseplate screw guide wire. CBCT scan was performed for all model bones after surgery, the guide wire position of both preoperative plan and postoperative position were recorded to compare entry point deviation (mm) and path angulation deviation(°). Results All guide wires were successfully implanted in bone models only by one try. The coordinate of planned and practical surgical path showed that the deviation of the wire entry point position was (1.155±0.517) mm, the deviation of the tip position was (1.047±0.288) mm, the deviation of path angulation was (1.564±0.888)°. Conclusions Under the CBCT guidance, robot can precisely assist the guide wire placement in the scapula glenoid, providing a feasible option for the important steps of precise treatment of reverse shoulder joint replacement in clinical practice.

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