Sacral foramen positioning method, positioning system and application based on holographic imaging

Abstract

The present invention relates to a sacral foramen positioning method based on holographic imaging technology, the method comprising determining the position of the sacral foramen in a three-dimensional space in a human body, and determining the position of the sacral foramen projected on the body surface; the present invention also relates to a sacral foramen positioning system based on holographic imaging and the application of the sacral foramen positioning system based on holographic imaging.

Description

[0001] The present invention claims the priority of Chinese patent application CN202110500790.X, and the contents of the specification, drawings and claims of the priority document are fully incorporated into the specification of the present invention and are regarded as part of the original description of the present invention. The applicant further declares that the applicant has the right to modify the specification and claims of the present invention based on the priority document. Technical Field

[0002] The present invention relates to a sacral foramen positioning method based on holographic imaging technology, the method comprising determining the position of the sacral foramen in a three-dimensional space in a human body, and determining the position of the sacral foramen projected on the body surface; the present invention also relates to a sacral foramen positioning system based on holographic imaging and the application of the sacral foramen positioning system based on holographic imaging. Background Art

[0003] As our society becomes increasingly aging, the incidence of urinary dysfunction is gradually increasing, and more and more patients are receiving sacral N regulation treatment.

[0004] Sacral nerve regulation is a neuromodulation technique that uses interventional technology to continuously apply low-frequency electrical pulses to specific sacral nerves to excite or inhibit neural pathways, regulate abnormal sacral nerve reflex arcs, and then affect and regulate the functions of bladder, urethral / anal sphincter, pelvic floor and other sacral nerve-controlled target organs, thereby achieving therapeutic effects. Sacral nerve regulation is an effective treatment for refractory overactive bladder, urge urinary incontinence, non-obstructive urinary retention and defecation dysfunction, interstitial cystitis, pelvic floor pain syndrome, neurogenic bladder, etc., and has been increasingly used in clinical practice in recent years.

[0005] The sacrum is formed by the fusion of five sacral vertebrae, and the superior and inferior notches of each vertebra form four pairs of anterior sacral foramina and four pairs of posterior sacral foramina. The sacral nerve foramina are located on the back of the sacrum, distributed on both sides of the median sacral crest, and are basically symmetrically distributed. The posterior branches of the sacral nerve pass through. The first step of the surgical method of sacral nerve regulation is to install the test electrode, among which the puncture of the third sacral nerve foramina is the key link. The sacral nerve foramina is located deep, with a narrow aperture, variable angles, and unclear surface features, making blind puncture and positioning difficult.

[0006] At present, X-rays, B-ultrasound or 3D printed models are mostly used for sacral foramen positioning, but these methods all have defects to varying degrees. For example, B-ultrasound has problems such as low penetration and repeated reflections in reflections; 3D printing has problems such as high cost and long preparation time, and is currently difficult to popularize; in addition, the X-ray positioning method currently commonly used in clinical practice has a large amount of radiation, which can cause harm to doctors and patients.

[0007] In addition, the accurate location of the sacral nerve foramen has great application value for traditional Chinese medicine massage, acupuncture, self-rehabilitation training, and posterior sacral nerve block or sacral epidural anesthesia supplementary anesthesia through the posterior sacral foramen. In practice, accurately finding the location of the posterior sacral foramen on the body surface plays a decisive role in the effect of anesthesia or blockade.

[0008] Therefore, there is an urgent need in the prior art for a method of accurately, quickly and conveniently locating the sacral foramen. Summary of the invention

[0009] The inventors of the present invention unexpectedly discovered that the use of holographic imaging technology to locate the sacral foramen can effectively achieve accurate and convenient positioning of the sacral foramen.

[0010] In this regard, the inventor creatively proposed a "double-plane positioning method" to achieve accurate positioning of the sacral foramen. According to the relevant principles of solid geometry, a line can be defined by two spatial planes, and then a point can be defined by two intersecting lines, or a method such as directly picking up a three-dimensional coordinate point with a mouse can be used to define anatomical feature points, and the straight-line distance between two points in space and its projection length on another reference plane can be measured. In addition, the spatial line-line angle and line-plane angle can also be conveniently measured. Therefore, three-dimensional reconstruction measurement has obvious advantages in accuracy compared with other measurement tools. However, since the human spine is a complex and changeable special structure, it is also difficult to accurately quantify and formulate measurement specifications based on certain anatomical feature points in the three-dimensional reconstruction model. Therefore, the measurement of complex three-dimensional images of human bones that cannot be measured by mathematical functions is still a hot spot and difficulty in three-dimensional measurement.

[0011] Specifically, the inventors have discovered that by acquiring the pelvic data of an object through CT or MRI, and performing three-dimensional reconstruction of the data through holographic image processing to obtain a virtual image, and by performing specific processing on the holographic image to obtain the projection point of the center point of the sacral foramen on the body surface, the relative position relationship between the projection point and the real point can be determined, thereby achieving the purpose of locating the sacral foramen through holographic images.

[0012] Based on the above findings, in a first aspect, the present invention provides a method for locating a sacral neural foramen, characterized in that the method comprises the following steps:

[0013] Step A. Determine the position of the center point of the sacral foramen in the three-dimensional space of the human body;

[0014] Step B: Determine the position of the center point of the sacral foramen at the body surface projection point A', specifically including:

[0015] 1) Perform pelvic CT or MRI examination on the subject in prone position to obtain data;

[0016] 2) Using data obtained from CT or MRI to create pelvic holographic images;

[0017] 3) applying the processing to the subject in the prone position, including the step of rotating the holographic image to observe the back side of the human body using the workstation with the buttocks as the center;

[0018] 4) Mark the tip of the coccyx as point A, and make a vertical longitudinal section A through point A, wherein the A section passes through the midline of the sacrum of the spine;

[0019] 5) Remove the skin and subcutaneous tissue from the hologram to expose the sacrum;

[0020] 6) Using holographic images, mark the center points of the left and right third sacral foramina as point B and point B', mark the vertical intersection of straight line BB' and the midline of the sacrum as point C, measure the distance BC, and make a cross section BC through the straight line BC, wherein the cross section BC is perpendicular to the vertical longitudinal section A;

[0021] 7) Use the holographic image sagittal plane to measure the vertical distance from the center point B of the third sacral nerve foramen to the buttocks skin surface.

[0022] In the sacral foramen locating method of the present invention, the position of the sacral foramen can be determined based on the cross section BC and the vertical longitudinal section A and the vertical distance from the center point B of the third sacral foramen to the buttocks skin surface.

[0023] Preferably, by using holographic images and based on the virtual vertical hole, the inclination angle of the real sacral foramen relative to the virtual vertical hole can be measured, and the angle relationship can be used to assist medication in determining the position of the sacral neural foramen.

[0024] In the sacral foramen locating method of the present invention, preferably, the workstation is installed on a personal computer, a mobile phone or a tablet computer; more preferably, the workstation is installed on a mobile phone or a tablet computer; the tablet computer may be, for example, an iPad.

[0025] In a preferred embodiment of the present invention, in step 3) of step B, an abdominal pad is placed on the abdomen of the subject to keep the subject in the same position as that during the CT / MRI examination before the sacral foramen is located. Preferably, the abdominal pad includes two specifications, large and small, each specification includes two identical abdominal pads, which are respectively suitable for use in CT / MRI examinations and in operating rooms.

[0026] In a preferred embodiment of the present invention, in step 2) of step B, a pelvic holographic image is produced using CT DICOM data.

[0027] In a preferred embodiment of the present invention, the sacral foramen positioning method further comprises the step of performing morphological processing on the image, specifically comprising:

[0028] Perform median filtering on the image;

[0029] Perform an opening operation on the median filtered image to obtain a specific sacral foramen area image;

[0030] Performing Gaussian smoothing on the specific sacral foramen area image;

[0031] The sacral foramen area image after Gaussian smoothing is opened to obtain the sacral foramen area image.

[0032] In the second aspect of the present invention, a sacral foramen positioning system is also provided, characterized in that the system includes: a graphics measurement module, a CT system or an MRI system, a three-dimensional reconstruction module, holographic imaging glasses and a holographic imaging processing module.

[0033] Preferably, the sacrum positioning system further comprises a positioning marker or a body surface positioning QR code sticker for marking. In some preferred embodiments, the positioning marker is a body surface positioning marker, preferably there are three body surface positioning markers; in other preferred embodiments, the positioning marker is a body surface positioning QR code sticker, preferably there are three body surface positioning QR code stickers.

[0034] The holographic imaging glasses used in the sacral foramen locating system of the present invention are preferably HoloLens2 glasses.

[0035] Particularly preferably, the sacral nerve foramen positioning system of the present invention is used for the purpose of sacral nerve puncture positioning guidance. Accordingly, the system may further include a surgery demonstration module and / or a preoperative planning module.

[0036] The sacral neural foramen positioning system of the present invention can also be used for anesthesia, acupuncture, self-rehabilitation training, posterior sacral foramen block anesthesia or sacral epidural anesthesia supplementary anesthesia.

[0037] Therefore, in a third aspect, the present invention provides the use of the sacral positioning system described in the present invention for sacral nerve puncture positioning guidance, sacral nerve regulation surgery training, anesthesia, acupuncture, self-rehabilitation training, posterior sacral foramen block anesthesia or sacral epidural anesthesia supplementary anesthesia.

[0038] In the method of the present invention, MRI can also be used to obtain a scanned image of the patient's back, and the patient's spine length and sacral width can be measured based on the scanned image. An equilateral triangle can be constructed with the patient's sacral width as the base, and the vertex of the equilateral triangle (BB'C) is located on the lumbar spine. BRIEF DESCRIPTION OF THE DRAWINGS

[0039] Figure 1 It is a schematic diagram of the projection of the center point of the sacral neural foramen on the body surface at the position of point A';

[0040] Figure 2 This is a schematic diagram with the tip of the coccyx marked as point A;

[0041] Figure 3 is a schematic diagram of a vertical longitudinal section A through point A of the coccyx tip determined by the present invention;

[0042] Figure 4 is a schematic diagram in which the center points of the left and right third sacral nerve foramina in the present invention are marked as point B and point B' respectively;

[0043] Figure 5 is a schematic diagram showing the determination of the straight line BB' and its perpendicular intersection point C with the midline of the sacrum of the spine in the positioning method of the present invention;

[0044] Figure 6 It is a schematic diagram of a cross section BC perpendicular to the vertical longitudinal section A made by the straight line BC in the positioning solution of the present invention. DETAILED DESCRIPTION

[0045] It should be understood that the specific embodiments described herein are only used to explain the present invention, and are not used to limit the present invention.

[0046] The specific implementation modes of the present invention are described below to facilitate the understanding of the present invention by those skilled in the art. However, it should be clear that the present invention is not limited to the scope of the specific implementation modes. For those skilled in the art, as long as various changes are within the spirit and scope of the present invention as defined and determined by the attached claims, these changes are obvious, and all inventions and creations utilizing the concept of the present invention are within the scope of the present invention.

[0047] Unless otherwise defined, the terms used in the present disclosure have the general meanings as understood by one of ordinary skill in the art.

[0048] The present invention is further described and illustrated below in conjunction with the accompanying drawings.

[0049] In a specific embodiment of the present invention, the position of the center point of the sacral foramen in the three-dimensional space of the human body is first determined; then the position of the center point of the sacral foramen at the body surface projection point A' is determined by the following steps, specifically including:

[0050] 1) The clinical patient is placed in a prone position, and a pelvic examination is performed using CT to obtain CT scan data;

[0051] 2) Upload the DICOM data of the above CT scan to the data processing module (3D reconstruction module) to produce a pelvic holographic image;

[0052] 3) Applying treatment to the patient in prone position, using the workstation to rotate the holographic image to observe the back of the human body with the buttocks as the center; during the actual treatment, the holographic image can be observed in a three-dimensional, intuitive, and multi-angle manner, and can also be enlarged, reduced, moved, and adjusted in transparency;

[0053] 4) The tip of the patient's coccyx is marked as point A, and a vertical longitudinal section A is made through point A, so that the A section passes through the midline of the sacrum of the spine (see Figure 3 );

[0054] 5) removing the skin and subcutaneous tissue from the above pelvic hologram to expose the sacrum;

[0055] 6) Use the holographic image to mark the center points of the left and right third sacral nerve foramina as point B and point B', draw a straight line BB', and mark the vertical intersection of the straight line BB' and the midline of the sacrum as point C. Measure the distance between BC, and make a cross section BC through the straight line BC, making it perpendicular to the vertical longitudinal section A (see Figure 4 and Figure 5 );

[0056] 7) Use the holographic image sagittal plane to measure the vertical distance from the center point B of the third sacral nerve foramen to the buttocks skin surface.

[0057] The location of the sacral foramen can be determined based on the transverse section BC and the vertical longitudinal section A as well as the vertical distance from the center point B of the third sacral foramen to the buttocks skin surface.

[0058] In another specific embodiment of the present invention, the position of the center point of the sacral foramen in the three-dimensional space of the human body is first determined; then the position of the center point of the sacral foramen at the body surface projection point A' is determined by the following steps, specifically including:

[0059] 1) The clinical patient is placed in a prone position, and a pelvic examination is performed using CT to obtain CT scan data;

[0060] 2) Upload the DICOM data of the above CT scan to the data processing module (3D reconstruction module) to produce a pelvic holographic image;

[0061] 3) Applying treatment to the patient in prone position, using the workstation to rotate the holographic image to observe the back of the human body with the buttocks as the center; during the actual treatment, the holographic image can be observed in a three-dimensional, intuitive, and multi-angle manner, and can also be enlarged, reduced, moved, and adjusted in transparency;

[0062] 4) The tip of the patient's coccyx is marked as point A, and a vertical longitudinal section A is made through point A, so that the A section passes through the midline of the sacrum of the spine (see Figure 3 );

[0063] 5) removing the skin and subcutaneous tissue from the above pelvic hologram to expose the sacrum;

[0064] 6) Use the holographic image to mark the center points of the left and right third sacral nerve foramina as point B and point B', draw a straight line BB', and mark the vertical intersection of the straight line BB' and the midline of the sacrum as point C. Measure the distance between BC, and make a cross section BC through the straight line BC, making it perpendicular to the vertical longitudinal section A (see Figure 4 and Figure 5 );

[0065] 7) Use the holographic image sagittal plane to measure the vertical distance from the center point B of the third sacral nerve foramen to the buttocks skin surface;

[0066] 8) Using the holographic image, based on the virtual vertical hole, the inclination angle of the real sacral foramen relative to the virtual vertical hole is measured.

[0067] The position of the sacral foramen was determined based on the vertical distance from the transverse section BC and the vertical longitudinal section A and the center point B of the third sacral foramen to the buttocks skin surface, and with reference to the inclination angle of the real sacral foramen relative to the virtual vertical foramen.

[0068] The position of the sacral nerve foramen determined according to the above implementation scheme has been verified through multiple surgical practices and can well achieve the positioning of the sacral nerve foramen and complete the intended purpose of the surgery. The method of the present invention is accurate and convenient, and is conducive to the planning and demonstration of surgeries such as sacral nerve regulation, and the planning and demonstration results are used as navigation for surgical operations.

[0069] The holographic image information obtained by the above processing is integrated with the patient's actual affected area, thereby achieving the purposes of preoperative planning, intraoperative demonstration and navigation.

Claims

1. A method for locating a sacral foramen, characterized in that: The method comprises the following steps: Step A. Determine the position of the center point of the sacral foramen in the three-dimensional space of the human body; Step B: Determine the position of the center point of the sacral foramen at the body surface projection point A', specifically including: 1) Perform pelvic CT or MRI examination on the subject in prone position to obtain data; 2) Use data obtained from CT or MRI to create pelvic holographic images; 3) applying the treatment to the subject in the prone position, including the step of rotating the holographic image to observe the back side of the human body using the workstation with the hip as the center; 4) Mark the tip of the coccyx as point A, and make a vertical longitudinal section A through point A, wherein the A section passes through the midline of the sacrum of the spine; 5) remove the skin and subcutaneous tissue from the hologram to expose the sacrum; 6) Using holographic images, mark the center points of the left and right third sacral foramina as point B and point B', mark the vertical intersection of straight line BB' and the midline of the sacrum as point C, measure the distance BC, and make a cross section BC through the straight line BC, wherein the cross section BC is perpendicular to the vertical longitudinal section A; 7) Use the holographic sagittal image to measure the vertical distance from the center point B of the third sacral nerve foramen to the buttocks skin surface.

2. The sacral foramen locating method as claimed in claim 1, wherein the position of the sacral foramen is determined based on the cross section BC and the vertical longitudinal section A and the vertical distance from the center point B of the third sacral foramen to the buttocks skin surface.

3. The sacral foramen locating method according to claim 1 or 2, wherein the workstation is installed on a mobile phone or a tablet computer.

4. The method for locating the sacral foramen according to claim 1 or 2, wherein in step 3) of step B, an abdominal pad is placed on the abdomen of the subject to keep the subject in the same position as that during the CT examination before locating the sacral foramen.

5. The sacral foramen locating method according to claim 1 or 2, further comprising performing morphological processing on the image, specifically comprising: Perform median filtering on the image; Perform an opening operation on the median filtered image to obtain a specific sacral foramen area image; Performing Gaussian smoothing on the specific sacral foramen area image; The sacral foramen area image after Gaussian smoothing is opened to obtain the sacral foramen area image.

6. A sacral foramen locating system for implementing the sacral foramen locating method according to claim 1, characterized in that: The system includes: a graphics measurement module, a CT system or an MRI system, a three-dimensional reconstruction module, holographic imaging glasses and a holographic imaging processing module.

7. The sacral foramen locating system according to claim 6, further comprising a positioning marker for marking.

8. The sacral nerve foramen locating system according to claim 6 or 7, which is used for sacral nerve puncture positioning guidance.

9. The sacral foramen locating system according to claim 6 or 7, further comprising a preoperative planning module.

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