Clinical Study Of Mimics Three-dimensional Visualization Technology Combined With The Guidance System Of Minimally Invasive Spine Surgery

Part Ⅰ Research on three-dimensionalvisualization technology of MIMICS softwareObjective: Toexplore the preliminary application of Mimics 3D visualization technique in preoperative planning in spine surgery.Methods:CT/MRI images of the spine area in our hospital were sent into Mimics19.0 software,to complete the three-dimensional reconstruction of the vertebral structure.The preoperative virtual simulation operation was performed on the three-dimensional model to obtain the puncture operation point,orientation,depth and diameter of the four surgical parameters,and further explore the volume of the responsible vertebral body to assess the amount of bone cement that was safely and accuracy filled,designed to assist complex,deformed spine surgery surgical guide.Results: Mimics threedimensional visual reconstruction,reconstruction of high quality,responsible vertebral "personalized" visual reconstruction,to achieve preoperative precision diagnosis;through preoperative virtual simulation surgery and other techniques to obtain surgical parameters,the estimated bone cement dose,the formation of surgical guide and other auxiliary,to guide clinical surgerytreatment.Conclusions: Mimics software three-dimensionalvisual reconstruction can be multi-level,multi-angle,all-round visual observation of the responsibility of the vertebral "personality" features,to achieve preoperative precision diagnosis,combined with preoperative simulation planning can achieve accurate preoperative planning to guide the surgical procedure.Part Ⅱ Clinical application of three-dimensional visualization technology of Mimics combined with GPMISSfor the Treatment of patients with OVCFObjective: To evaluate the application value of Mimics three-dimensional visualization technique preoperative planning combined with GPMISS for the treatment of patients with OVCF.Methods: 43 patients(47 vertebraes)with thoracolumbar OVCF were treated with PVP / PKP in the Third Affiliated Hospital of Guangzhou Medical University from January 2015 to April 2017.All cases were randomly divided into GPMISS group and free-hand manual group.19 cases were treated with GPMISS assisted guider,while the other group was treated with manual puncture in 24 cases.GPMISS group cases were acquired the surgical parameters through three-dimensional visualization reconstruction,combined with GPMISS assisted puncture for the treatment of OVCF patients.Statistical analysis was performed on the time of puncture and positioning,the number of fluoroscopy of C-arm X-ray machine,the operation time,imaging results and bone cement leakage rate.Results: 43 patients were successfully completed operation,no serious complications were found in traoperative and postoperative.The puncture timeof GPMISS and free-hand manual group was(7.57 ± 1.63)min,(10.12 ± 1.53)min,respectively;the average number of single vertebral fluoroscopy was(7.33±1.39),(9.08 ±1.92),respectively;the excellent rate of puncture was 90.48%,65.38%,respectively;there was a statistical significance of above-mentioned items between the two groups(P<0.05).The average operation timewas(59.4 ± 16.68)min,(54.29 ± 15.49)min,respectively;the bone cement leakage rate was 9.52%,15.38%,respectively;and both of the average operation time and the bone cement leakage rate were no significant difference between the two groups cases(P > 0.05).Conclusions: Mimicsthree-dimensional visualization combined with GPMISS was used to treat for patients with OVCF,which can significantly shorten the puncture time,reduce the number of intraoperative fluoroscopy to improve puncture accuracy,worthy of clinical trial,and application.