Image-Guided Osteoporotic Bone Augmentation with Intraoperative Biomechanical Gui

描述(由申请人提供)：有大量的研究表明，骨质丢失可能会削弱强度并增加骨折的风险。据报道，老年骨质疏松症患者髋部骨折后的死亡率高达30%。提示股骨增大是降低高度骨质疏松性髋部骨折风险的有效对策。这项技术对于那些跌倒风险高、死亡率和发病率最高的患者尤其有价值，如果他们要继续跌倒的话。少数几个关于股骨隆起术的临床病例研究表明，成功的结果需要详细的计划、生物力学分析和对隆起术的精确控制，以避免由于隆起术而产生的高应力区域。我们的长期目标是开发一种技术，使外科医生能够准确地确定骨质疏松症的程度和骨折风险水平，基于计算机化的机械分析获得优化的手术方案，通过术中生物力学反馈执行快速和微创的髋关节隆起术，并最终在一次患者访问中验证结果。在这个项目中，我们将开发一种股骨近端隆起术的手术试验台，并论证其可行性。针对这一目标，我们提出了三个目标：1.开发一个几何和生物力学规划模块，用于使用术前CT扫描对患者特定的增骨操作进行优化。2.开发一个综合手术执行系统，包括将术前模型和手术工具与专门为该项目开发的透视和光学导航系统共同登记。3.验证功能性能和系统整体准确性。该项目开发的技术可能会带来一种亟需的替代治疗方法，这可能对因骨质疏松而有骨折风险的患者至关重要。该项目开发的技术将为因骨质疏松而高度易感骨折的患者提供一种急需的替代治疗方法。

DESCRIPTION (provided by applicant): There is a wealth of research on the extent to which bone loss may impair strength and increase the risk of fracture. The rate of mortality after hip fracture in elderly patients with osteoporosis is reported to be as high as 30%. It is suggested that augmentation of the femur is an effective countermeasure to reduce the risk of fracture in highly osteoporotic hips. This technique would be especially valuable for those patients at high risk of falls and the highest risk of mortality and morbidity if they were to sustain a fall. The few clinical case studies that have been performed on augmentation of the femur, suggest that a successful outcome requires detailed planning, biomechanical analysis, and precise control of the augmentation procedure to avoid generation of areas of high stress due to augmentation. Our long term goal is to develop a technology that enables the surgeon to precisely determine the extent of osteoporosis and fracture risk level, obtain an optimized surgical plan based on computerized mechanical analysis, perform a rapid and minimally invasive hip augmentation with intraoperative biomechanical feedback, and finally verify the outcome in one patient visit. In this project, we will develop a surgical testbed for proximal femur augmentation and demonstrate its feasibility. Towards this goal, we propose three aims: 1. Develop a geometrical and biomechanical planning module for patient-specific optimization of the bone augmentation procedures using preoperative CT scans. 2. Develop an integrated surgical execution system that will involve co-registration of the preoperative model and surgical tools with a fluoroscope and an optical navigation system specifically developed for this project. 3. Validate functional performance and overall system accuracy. The technology developed in this project may lead to a highly needed alternative treatment that may be pivotal for patients at the risk of bone fracture due to osteoporosis. The technology developed in this project, will provide a highly needed alternative treatment for patients highly susceptible to bone fracture due to osteoporosis.