2019-06-012024-05-15https://scholars.lib.ntu.edu.tw/handle/123456789/665401摘要：「經皮脊骨整型術」(Percutaneous Vertebroplasty, PVP)是對於骨鬆椎骨之壓迫性骨折有良好效果的積極性療法，醫師主要利用動態X光顯像(Fluoroscopy)及電腦斷層影像導引(CT Image Guide)來協助其施打骨水泥至骨折位置。然而X光顯像較無法精確判讀，發生手術併發症的機率較高，醫師亦須接收輻射線劑量成為職業風險。CT影像導引的方式則因電腦斷層掃瞄儀已逐漸成為國內各醫院的標準配備而逐漸普及，醫師也可避免接收輻射，臨床上即發展出CT影像導航系統協助手術。市面上導航系統的器械皆須特製，以供系統追蹤同時進行巡航診斷及導引手術，因此設計上為可重複使用。而這提高了滅菌不完全之風險，並造成器械笨重而影響醫師手術習慣及手感。 　　本計畫考量此情境，欲開發一套更加融入PVP手術流程的「脊椎穿刺雷射導引系統」，預期利用雷射投射元件同步巡航診斷探針方位，將手術路徑以雷射光擴增至患者實境以協助導引穿刺，避免了前述器械使用疑慮。此創新概念改善了醫學導航系統手術的安全性，預期技轉至合作公司執行商品化，發展成具臨床使用性產品。計畫執行過程中將協助合作公司擴展臨床工程合作管道。另外本單位研究助理人員與參與研究學生亦可在參與過程中提升醫療及工程的轉譯能力，培育政府長遠規劃的產業人才。 <br> Abstract: “Percutaneous Vertebroplasty” (PVP) is an active treatment for “Osteoporotic Vertebral Compression Fracture” (OVCF). Clinically, the bone cement is injected to the fractured vertebra under the imaging guidance of fluoroscopy and CT. However, X-ray image of fluoroscopy is less accurate that may result in higher surgical complication. In addition, surgeons and medical staff may suffer from receiving accumulated radiation exposure. On the other hand, CT imaging guidance is gradually popularized thanks to that the CT scanning device is becoming the standard care equipment in hospitals. Under CT scanning operation, the radiation exposure of surgeons is avoided. Therefore, the CT image navigation system has been developed to assist in a variety of operations, including PVP procedure. By introducing the imaging navigation capability, the surgical device is required to be re-fabricated to enable being tracked under operation. This increases the risk of incomplete sterilization and causes the device to be cumbersome such that the surgeon`s surgical habit is altered. To resolve the problem, this project proposes a laser-guide surgical navigation system that could be seamlessly integrated into the PVP procedure. We develop a laser projection device to augment the surgical site with a laser guidance of the needle trajectory. The augmented guidance relieves the burden of fabrication of that tracked device. The sterilization and bulky problems are also avoided. This innovative concept improves the safety of CT-image navigation surgery. The technique is expected to be transferred to a cooperative company for commercialization in order to develop to a clinical product. Through this project, we will assist the cooperative company in establishing their clinical R&D environment. In addition, the participating research assistants and graduate students of our department can also enhance their translation skills from clinical need to medical device. The cultivation of talented persons can meet the medical device industry`s long-term goal.經皮脊骨整型術脊椎穿刺雷射導引系統(Percutaneous VertebroplastyPVPlaser-guide surgical navigation system