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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Huh, Jisoon (Department of Neurosurgery, Jeju National University School of Medicine) Hyun, Jae Hwan (Department of Neurosurgery, Jeju National University School of Medicine) Park, Hyeong Geon (Department of Neurosurgery, Jeju National University School of Medicine) Kwak, Ho-Young (Department of Computer Engineering, Jeju National University College of Engineering)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제62권 제4호
발행연도
2019.1
수록면
376 - 381 (6page)

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Objective : To define optimal method that calculate the safe direction of cervical pedicle screw placement using computed tomography (CT) image based three dimensional (3D) cortical shell model of human cervical spine. Methods : Cortical shell model of cervical spine from C3 to C6 was made after segmentation of in vivo CT image data of 44 volunteers. Three dimensional Cartesian coordinate of all points constituting surface of whole vertebra, bilateral pedicle and posterior wall were acquired. The ideal trajectory of pedicle screw insertion was defined as viewing direction at which the inner area of pedicle become largest when we see through the biconcave tubular pedicle. The ideal trajectory of 352 pedicles (eight pedicles for each of 44 subjects) were calculated using custom made program and were changed from global coordinate to local coordinate according to the three dimensional position of posterior wall of each vertebral body. The transverse and sagittal angle of trajectory were defined as the angle between ideal trajectory line and perpendicular line of posterior wall in the horizontal and sagittal plane. The averages and standard deviations of all measurements were calculated. Results : The average transverse angles were $50.60^{\circ}{\pm}6.22^{\circ}$ at C3, $51.42^{\circ}{\pm}7.44^{\circ}$ at C4, $47.79^{\circ}{\pm}7.61^{\circ}$ at C5, and $41.24^{\circ}{\pm}7.76^{\circ}$ at C6. The transverse angle becomes more steep from C3 to C6. The mean sagittal angles were $9.72^{\circ}{\pm}6.73^{\circ}$ downward at C3, $5.09^{\circ}{\pm}6.39^{\circ}$ downward at C4, $0.08^{\circ}{\pm}6.06^{\circ}$ downward at C5, and $1.67^{\circ}{\pm}6.06^{\circ}$ upward at C6. The sagittal angle changes from caudad to cephalad from C3 to C6. Conclusion : The absolute values of transverse and sagittal angle in our study were not same but the trend of changes were similar to previous studies. Because we know 3D address of all points constituting cortical shell of cervical vertebrae. we can easily reconstruct 3D model and manage it freely using computer program. More creative measurement of morphological characteristics could be carried out than direct inspection of raw bone. Furthermore this concept of measurement could be used for the computing program of automated robotic screw insertion.
#Cervical vertebrae #Computer-assisted image analysis #Pedicle screws #Three dimensional images

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참고문헌 (16)

참고문헌 신청
Cha SH / 2007 / C-arm assessment of cervical pedicle screw: screw coaxial fluoroscopy and oblique view / Spine (Phila Pa 1976) 32:1721~1727 google schola Chanplakorn P / 2014 / Morphometric evaluation of subaxial cervical spine using multi-detector computerized tomography (MD-CT)scan: the consideration for cervical pedicle screws fixation / BMC Musculoskelet Disord 15:125 google schola Hojo Y / 2014 / A multicenter study on accuracy and complications of freehand placement of cervical pedicle screws under lateral fluoroscopy in different pathological conditions:CT-based evaluation of more than 1,000 screws / Eur Spine J 23:2166~2174 google schola Ito Z / 2014 / Pedicle screws can be 4 times stronger than lateral mass screws for insertion in the midcervical spine: a biomechanical study on strength of fixation / J Spinal Disord Tech 27:80~85 google schola 조대진 / 2012 / Cervical Pedicle Screw Insertion Using the Technique with Direct Exposure of the Pedicle by Laminoforaminotomy / 대한신경외과학회지 52(5):459~465 Crossref

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