北京生物医学工程

锥形束 CT 引导机器人辅助反肩关节肩盂基座螺钉导针置入精准度研究

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

作者：韩巍张腾黄强张勇王彬彬吴新宝王军强

单位：北京积水潭医院创伤骨科(北京 100035) 北京天智航医疗科技股份有限公司天玑实验室 (北京 100192) 清华大学医学院生物医学工程学院( 北京 100085)北京市医疗机器人产业创新中心 ( 北京 100192)

关键词：锥形束; 机器人辅助; 肩盂基座; 手术导航; 精准度

分类号：R318.04

出版年·卷·期（页码）：2021·40·3（245-251）

摘要：

评估锥形束 CT(cone beam CT, CBCT)引导下机器人辅助置入反肩关节肩盂基座螺钉导针的精准度,为机器人辅助反肩关节置换手术的开展提供理论支持。方法使用 CBCT 对 12 例SYNBONE 肩胛骨模型置入反肩关节肩盂基座螺钉导针前后行断层扫描。采用 TiRobot 软件术前规划螺钉导针入针点、尾端止点及导针置入路径的位置坐标。计算机根据规划位置控制机械臂定位并辅助置入肩盂基座螺钉导针,术后比较规划入止点、路径与实际入止点、路径的差异。结果所有肩胛骨模型均一次完成导针置入。规划与实际入针点位置偏差为(1.155±0.517) mm,规划与实际尾端止点位置偏差为(1.047±0.288)mm,计划路径与实际路径夹角偏差为(1.564±0.888)°。结论 CBCT 引导下机器人辅助反肩关节肩盂基座螺钉导针置入精确度高,为临床中反肩关节置换精准治疗手术重要步骤提供可行性选择。

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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