臺灣博碩士論文加值系統

椎弓根螺釘植入技術在脊椎手術中扮演至關重要的角色，其錯位率和依賴程度因外科醫生的經驗而異。因此，手術導板已成為提高脊椎手術精確度、縮短手術時間並減少術中問題的可行工具。本研究探討了一種結合電腦斷層掃描（CT）成像、3D建模、電腦輔助工程（CAE）和增材製造的新穎流程，以增強術前規劃並為個別患者開發客製化手術導板。該方法首先收集CT掃描數據，然後對特定感興趣區域（ROI）進行分割和3D重建。術前規劃利用這些模型提供個人化的手術指導。隨後，使用CAE分析來優化導板設計。最終的導板通過3D列印技術製作。最後，列印出的導板在臨床應用之前會進行徹底的測試和驗證，以確保其精確性和安全性。這個全面的數位工作流程旨在優化手術精確度、縮短手術時間，並在各種手術領域中提高患者的效果。此外，通過對現有研究進行全面分析，本研究展示了結合CT掃描成像、計算機建模和3D列印的能力，以轉變個性化手術方法並建立進行矯正性脊椎手術的可靠程序。論文還討論了手術導板在脊椎手術中的擴大應用，以及它們如何改善手術結果和患者護理。

Pedicle screw insertion techniques play a crucial role in spinal surgery, with varying rates of misplacement and dependence on surgeon experience. Therefore, surgical guides have become a viable tool for improving procedure accuracy in spine surgery while reducing operating time and intraoperative problems. This study investigates a novel process that combines computed tomography (CT) imaging, 3D modelling, computer-aided engineering (CAE), and additive manufacturing to enhance pre-surgical planning and develop customized surgical guides for individual patients. The method starts with the gathering of CT scan data, which is then followed by the segmentation and 3D reconstruction of specific Regions of Interest (ROI). Preoperative planning utilizes these models to provide personalized surgical guidance. Subsequently, CAE analysis is utilized to enhance guide designs. The final guidelines are produced with 3D printing technology. Ultimately, the printed guides undergo thorough testing and validation to guarantee their precision and safety prior to being used in a clinical setting. The purpose of this comprehensive digital workflow is to optimize surgical accuracy, minimize surgical duration, and increase patient results across a range of surgical disciplines. Furthermore, it showcases the capacity to merge CT scan imaging, computational modelling, and 3D printing to transform individualized surgical methods and establish reliable procedures for conducting corrective spine surgery by conducting a comprehensive analysis of existing research. A discussion of the expanding use of surgical guides in spine surgery and how they can improve surgical results and patient care is also included.

Abstract......i
摘要......iii
Acknowledgments......v
Table of Content......vii
List of Figures......ix
List of Tables......xi
Symbols......xii
Chapter 1 Introduction......1
1.1 Overview Research......1
1.2 Issue Description......2
1.3 Research Motivation......4
1.4 Thesis Organization......5
Chapter 2 Literature Review......7
2.1 Spine anatomy and biomechanics......7
2.2 Vertebral structure and function......9
2.3 Pedicle Screw Insertion Techniques......11
2.4 Sugical Guide Device......15
Chapter 3 Research Methodology......17
3.1 Medical image data collection......18
3.2 Segmentation of the ROI and 3D modeling......20
3.2.1 Segmentation of the Region of Interest......20
3.2.2 3D modeling......21
3.3 Pre-surgical planning and guide design......22
3.4 Finite element analysis (FEA)......26
3.4.1 Mechanical properties of vertebra structure and surgical guides......26
3.4.2 Deformation, stress and strain analysis......28
3.5 3D printing......31
3.6. Testing and validation......34
Chapter 4 Results and Discussion......36
4.1 Segmentation ROI and 3D modeling......36
4.2 Surgical guide design......43
4.3 Deformation, stress and strain analysis......46
4.4 Testing and validation......52
Chapter 5 Conclusion......55
5.1 Conclusion......55
5.2 Future Work......57
References......58

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