椎體成型術為目前治療骨質疏鬆所引起之脊椎壓迫性骨折最安全的手術方式，但在決定骨髓針穿刺路徑方面仍有一定的難度，且術中需大量使用C-arm，醫護人員長期暴露在具有放射線的環境下，恐影響身體健康。為協助醫師於術前決定骨髓針穿刺路徑、降低放射線對醫護人員的影響，本研究提出一術前規劃流程，並設計一骨髓針穿刺模擬方式，以電腦輔助醫師進行診斷與模擬骨髓針穿刺路徑，於術前即取得充分的手術資訊，此外更與術中輔助系統結合，運用術前規劃資訊輔助手術進行。本研究以多組案例進行骨髓針穿刺模擬，並實際與術中輔助系統結合，進行豬背骨穿刺試驗，驗證該術前規劃流程的可行性，更驗證運算資料的正確性，確保手術模擬的可信度。以本研究提出之術前規劃流程，能協助醫師於術前更充分了解手術資訊，增加醫師進行手術時的信心，並可望加快手術進行速度與減少術中C-arm的使用次數。 Percutaneous vertebroplasty is the safest surgical approach to treat vertebral compression fractures caused by osteoporosis, but it is still difficult to determine the path of puncture. The surgeons generally require extensive use of C-arm images during surgery, which will increase the risk of radiation exposure in the long term. In this study, a computer aided preoperative planning system for the percutaneous vertebroplasty is developed, which aims to assist the surgeon to simulate and plan the path of puncture before surgery, and to combine with the intraoperative auxiliary system to reduce the impact of radiation for this kind of surgery. Several examples, including simulated human’s vertebral cases and real pig spine puncture tests are presented, to demonstrate the feasibility of the proposed method. Furthermore, this study demonstrates the accuracy of several kinds of data to ensure the credibility of the proposed surgical simulation method. It is expected that study can assist surgeons to get more information before surgery, and accelerate the operation speed in reducing the excessive use of C-arm images.
