Image Guided Surgery using Rapid Prototyping Models

描述(由候选人提供)： 神经外科计划的基本用途之一是能够产生一种手术方法，在允许所需的暴露于目标组织的同时将对正常组织的破坏降至最低。在处理儿科神经外科病人时，这一原则被推向了极端。为了帮助外科医生了解目标组织的位置以及它们与正常组织的关系，已经开发了图形工作站。这样的系统允许外科医生了解目标组织相对于其他正常组织的位置。手术轨迹的优化和引导外科医生沿着优化的轨迹的能力一直是微创神经外科技术的基石。为了将真实的患者注册到三维计算机模型，通常需要严格的固定和动态参考。这些参照物通常是某种形式的颅骨或脊柱夹紧系统。对于儿科人群来说，这些设备是不合适的。在我们的父母资助中，我们提出了一个新的指导系统，该系统利用了定制的患者特定框架的设计和制造。 这些新的框架被设计成机械地对准患者的解剖结构，并通过表面拟合在三维模型和患者之间提供所需的对准。手术轨迹被结合到导向消除框架和操作跟踪装置中。这些导轨是使用快速成型技术制造的。开发和测试计算机算法以实现这一方法是父母赠款的目标。颅骨和脊柱手术现在可以计划和定制框架，并被带到手术中。然而，儿童患者的设计标准与成人患者的设计标准非常不同。从成像到手术定位的每一个方面都必须为儿科人群进行检查和优化。这项提案涉及这项新技术的扩展，目标是优化儿科神经外科系统。

DESCRIPTION (provided by candidate): One of the basic tenants of Neurosurgical planning is the ability to generate an operative approach that minimizes the disruption of normal tissue while allowing the required exposure to target tissues. This tenet is pushed to an extreme when dealing with pediatric neurosurgical patients. To aid the surgeon in his or her ability to appreciate the location of target tissues as well as their relationship to normal tissues, graphical workstations have been developed. Such systems allow a surgeon to appreciate the position of the target tissues in relation to other normal tissues. The optimization of a surgical trajectory and the ability to guide a surgeon along that optimized trajectory has been the cornerstone of minimally invasive neurosurgical techniques. In order to register the real patient to the 3 dimensional computer model rigid fixation and dynamic referencing is usually required. These references are usually some form of cranial or spinal clamping system. For the pediatric population these devices are inappropriate. In our parent grant we proposed a new guidance system that utilized the design and fabrication of custom patient specific frames. These new frames are designed to mechanically register to the patient's anatomy and provide the required registration between the 3 dimensional model and the patient through surface fitting. The surgical trajectory is incorporated into the guide eliminating frames and operative tracking devices. These guides are fabricated using rapid prototyping technology. The development and testing of computer algorithms to enable this approach is the goal of the parent grant. Cranial and spinal procedures can now be planned and custom frames fabricated and brought to surgery. The design criteria for pediatric patients are, however, very different from that of adult patients. Every aspect of the procedure from imaging through operative positioning must be examined and optimized for the pediatric population. This proposal addresses the extension of this new technology, with the goal optimizing a system for pediatric neurosurgery.