2017-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/644622摘要：隨著科技的進步，脊椎手術也慢慢朝向微創的方向前進，脊椎導航也因此越來越受重視。脊椎導航系統的可能好處有快速、準確、安全、術前規劃、減少輻射暴露、避免開錯節、讓手術更微創等。但是，也有醫師認為脊椎導航打亂手術流程、增加手術室時間、昂貴，而不喜歡使用脊椎導航系統。我們曾經透過機械手臂、雷射測距儀，搭配CT 斷層掃描三維重建影像技術，成功的針對治療腦部手術進行導航，準確地找出最適合穿刺的位置，同時將這套系統搭配3D 列印頭形假體，製作出一套模擬腦室穿刺練習訓練組，可用於臨床教學訓練之用，適合醫學生、住院醫師、專科醫師等對象。在本計畫中，我們打算利用類似的方式，製作出微創脊椎手術使用的導航機器人，更進一步的，我們會在機器手臂上架設攝影機，利用機器視覺的方式自動搜尋fiducial marker，以減少registration 的人力和時間。我們會使用3D point set registration 和2D/3D registration 兩種對位方式，讓使用者更多的選擇，並比較其誤差。我們希望能夠減少透視的次數，並盡量將registration 自動化以增進醫師使用脊椎導航和微創手術的意願。<br> Abstract: With advancement of technology and imaging techniques, minimally invasive spine surgery(MISS) has gained popularity in recent years. Spine navigation can be very helpful for MISS, aswell as some open surgery. The main advantages are accuracy, potential of facilitating complexsurgery, and reduction in radiation exposure. However, spine surgeons acknowledge the value ofnavigation, yet current systems do not meet their expectations in terms of ease of use and integrationinto the surgical work flow.We had developed a surgical robot system to guide cranial surgery using robotic arm and lasersensor using computed tomography (CT) images. We had verified that system by simulatingventricular puncture on phantom and the accuracy was acceptable in clinical use. Before approvedfor clinical practice, the system could be very useful in surgical training.In this project, we wish to extend similar methodology to spine surgery and create a surgicalrobot to guide MISS. We plan to integrate a camera to the robotic arm so that the surface fiducialmarkers can be localized without additional human interaction. The fiducial will also be identifiedautomatically in CT images. In such way, registration process can be fully automated. In thebeginning, we will try to implement 3D point set registration, and this is probably good enough withintraoperative 3D imaging. We will then develop 2D/3D registration for use with 2D x-rayfluoroscope.We wish to make the system very easy to use so that spine surgeons can adopt it and integratethe system into their everyday practice.