椎弓根螺钉植入近红外实时监测技术基础分析-basic analysis of near infrared real - time monitoring technology for pedicle screw implantation.docxVIP

南京航天航天大学硕士学位论文 摘 要 椎弓根螺钉内固定是脊柱外科的常用手术，目前存在植偏、误植等问题，对钉道偏差缺乏 直观有效的监测手段。本文提出了一种基于近红外光谱技术的椎弓根螺钉植入监测技术，对提 高椎弓根螺钉内固定手术植钉的准确性与安全性具有重要意义。 论文围绕近红外椎弓根螺钉植入监测技术的算法原理、监测系统设计与实现以及验证性实 验等方面进行研究。主要研究内容包括：1、提出了一种组织光学参数的漫反射率反演算法并通 过实验对算法准确性验证；2、搭建了一套近红外椎弓根螺钉植入监测系统，能够实时监测植钉 过程中钉道前方组织约化散射系数( μs′ )的变化；3、通过动物实验研究发现椎弓根钉穿刺钉道 上的组织 μs′ 与组织结构存在密切关联，并研究了正常穿刺钉道与内偏植钉钉道上的 μs′ 随深度 的变化规律；4、通过人尸体实验证实 μs′ 可作为反映植钉穿刺钉道偏差的识别因子，并得到了 植钉穿刺钉道上的 μs′ 安全阈值，将来可将此阈值作为开发植钉导航报警设备的参考依据。 论文主要创新点：(1) 首次将近红外光谱技术用于椎弓根螺钉植入手术的钉道监测；(2) 探 索并通过实验证明了约化散射系数( μs′ )可以作为钉道导航的识别因子；(3) 获得了穿刺钉道上 的 μs′ 随深度的变化规律及人体植钉穿刺钉道上的 μs′ 安全阈值。 关键词：近红外光谱、植入监测、约化散射系数、椎弓根螺钉、钉道 I 椎弓根螺钉植入近红外实时监测技术基础研究 椎弓根螺钉植入近红外实时监测技术基础研究 II II ABSTRACT Currently pedicle screw fixation is a common spinal surgery and exist some problems such as perforation deviation and incorrect implantation. Since lacking intuitive and effective monitoring methods during clinical pedicle screw fixation surgery, a real-time monitoring technique for pedicle screw fixation based on NIRs was brought to improve the accuracy and safety of screw implantation. This study mainly focuses on the simulation and implementation of algorithm principle, the design and implementation of monitoring system and validatable experiments revolving this monitoring technique.The aspects mainly include as follows: (1) Develop a kind of optical properties retrieval algorithm based on the diffuse reflectance and verify the accuracy of the algorithm through experiments;(2) Implement a set of NIRs monitoring system for pedicle screw planting which can measure the reduced scattering coefficient( μs′ ) ahead of screw path during the surgery;(3) Animal experiments verify that the reduced scattering coefficient of tissue in screw path is closely associated with tissue structure of screw path. Meanwhile we have discussed the reduced scattering coefficient variation of the normal puncture and internal perforation; (4) Adult cadaver experiments verify that the reduced scattering coefficient is the identifying factor t