Percutaneous vertebral pedicle puncture position positioning method and Sudoku positioning plate

Abstract

The invention discloses a percutaneous vertebral pedicle puncture position positioning method, which innovatively and accurately arranges a sudoku unit on a plane parallel to a vertebral body image obtained by a patient under normal X-ray fluoroscopy, and directly compares the sudoku unit with a vertebral pedicle area under the vertebral body image obtained by the patient under normal X-ray fluoroscopy. It is ensured that the sudoku units are located over the vertebral pedicle area, accurate and direct comparison of the sudoku units and the vertebral pedicle area is promoted, then the sudoku area, where the needle point is located, of the vertebral pedicle area with the puncture needle point under an image obtained under normal position X-ray fluoroscopy of a patient is obtained, and accordingly whether the needle point is located at the optimal puncture needle inserting point or not is accurately judged; the Sudoku unit can be a Sudoku positioning plate or a Sudoku image frame, the Sudoku positioning plate comprises a basic frame and a Sudoku structure, and the Sudoku structures of different sizes are set to meet the requirements of different vertebral pedicle areas; the sudoku image frame is matched with the range of the vertebral pedicle area, and the sudoku image frame can be effectively arranged above the corresponding vertebral pedicle area through tracking.

Description

Technical Field

[0001] The invention belongs to the field of percutaneous pedicle regional surgery auxiliary instruments, and specifically relates to a percutaneous pedicle puncture position positioning method and a nine-square positioning plate. Background Art

[0002] With the continuous progress of computer-assisted technology and precision surgery, preoperative digital design combined with intraoperative external auxiliary navigation devices have been applied in various minimally invasive surgeries (such as PVP surgery) with percutaneous pedicle regional access. Compared with the traditional surgical method that relies on repeated fluoroscopy of C-arm X-ray machines during surgery, it has significant advantages: the number of fluoroscopy to determine the skin entry point, the total number of intraoperative fluoroscopy and the total intraoperative fluoroscopy dose are reduced, and the total duration of the operation is significantly shortened; because the puncture position of the percutaneous puncture instrument is more accurate, the incidence of bone cement leakage is reduced; corresponding to the three-dimensional reconstruction of the fractured vertebra before surgery, this procedure is more valuable for the treatment of patients with complex osteoporotic vertebral compression fractures.

[0003] However, how to accurately find the puncture position in the pedicle area and match the accurate puncture direction has become a key link in achieving ideal surgical results. The "3D printed percutaneous pedicle puncture guide plate and preparation method using the nine-square grid division method" in the prior art discloses a guide device fixed on the patient's skin with a nine-square grid. The nine-square grid structure that basically corresponds to the pedicle area image and can be captured by the imaging system is combined with the puncture guide structure to probe the pedicle area image through the puncture guide structure, and then the patient's C-arm X-ray machine is used for the positive image perspective, and the position of the puncture device in the pedicle area is intuitively presented on the digital image, so that timely adjustments can be made to find the best location of the nine-square grid.

[0004] However, this mode of combining the nine-square grid structure with the puncture guide structure has disadvantages: although the nine-square grid structure can be fixed to the local curved skin to a certain extent, it faces the problem of difficulty in matching with the curved surface of the human body. It is difficult to ensure that the nine-square grid in the image obtained under the patient's anteroposterior X-ray fluoroscopy is completely consistent with the anteroposterior image of the pedicle area, which makes it difficult to accurately determine the position of the puncture needle tip and the position of the pedicle area. In this way, it is often necessary to adjust the position of the nine-square grid in advance and re-image it to ensure that the nine-square grid and the pedicle area correspond to each other in the image obtained under the patient's anteroposterior X-ray fluoroscopy. Only then can the best puncture position be determined by understanding the relative position relationship between the puncture needle and the nine-square grid. However, this process not only increases the risk of radiation exposure, but also increases the difficulty of operation.

[0005] In view of the above technical difficulties, the present invention takes a different approach and proposes a new method for positioning the position of percutaneous pedicle puncture and a matching nine-square positioning plate. Summary of the invention

[0006] The prior art places a nine-square grid for zoning the pedicle area on the surface of human skin and connects it to a puncture guide structure. After the puncture needle is percutaneously inserted into the pedicle area through the puncture guide device, an image is obtained under the patient's anteroposterior X-ray fluoroscopy, and based on the nine-square grid area where the puncture needle tip is located in the image, it is determined whether the puncture needle is in the best puncture area of ​​the pedicle area: if it is in the best puncture area, the puncture continues to be performed to construct a surgical channel through the pedicle area; if it is not in the best puncture area, the corresponding position is adjusted according to the current nine-square grid area, and the adjustment is verified again until the puncture needle reaches the best puncture area.

[0007] However, this method sets the nine-square grid on a plate and then fixes it on the patient's skin surface. Position deviation is prone to occur during the fixation process, which interferes with the judgment of the needle insertion point. In addition, the patient's skin is curved, making fixation quite difficult.

[0008] In view of this, the present invention innovatively sets the nine-square grid unit on a plane parallel to the vertebral image obtained under the patient's AP X-ray fluoroscopy, directly compares the nine-square grid unit with the pedicle area image in the vertebral image obtained under the patient's AP X-ray fluoroscopy, and ensures that the nine-square grid unit is directly above the pedicle area image of the vertebral image obtained under the patient's AP X-ray fluoroscopy, so that the two can be directly compared, and then obtain the nine-square grid area where the needle tip is located in the image obtained under the AP X-ray fluoroscopy of the patient's pedicle area with the puncture needle tip; and judge whether the needle tip is at the optimal puncture insertion point based on the comparison result.

[0009] More specifically, the nine-square grid unit can be a structure fixed on the display structure plane. By fixing the patient's image distance, the fixed pedicle area display position is found, and the nine-square grid unit is posted on the display plane. In this way, after simply relying on the guide puncture instrument to guide the puncture needle percutaneously into the pedicle area image, with the help of the image obtained under the patient's anteroposterior X-ray fluoroscopy, the image with the puncture needle can be presented on the display structure. Since the display method is unified and the pedicle area with the puncture needle can be displayed at the same position, the position of the puncture needle can be accurately known with the help of the nine-square grid corresponding to the pedicle area image on the screen. By setting the nine-square grid unit and placing it on the display plane, the pedicle area with the puncture needle in the image image obtained under the patient's anteroposterior X-ray fluoroscopy is adjusted to the corresponding position of the nine-square grid unit, the position of the puncture needle tip in the nine-square grid unit is clearly grasped, and it is judged whether the needle tip position is in the best state, making it easier to determine the needle tip position. Even if it is inaccurate, the adjustment method can be quickly found to obtain the best puncture needle tip position.

[0010] Alternatively, the nine-square grid unit may also be a nine-square grid image frame that tracks the area corresponding to the pedicle area above the image obtained under the patient's anteroposterior X-ray fluoroscopy. First, the center of the nine-square grid image frame and the center of the pedicle area are obtained, so that the two coincide, and the length of the nine-square grid image frame is matched to be consistent with and coincide with the long side of the pedicle area of ​​the image obtained under the patient's anteroposterior X-ray fluoroscopy, and the width of the nine-square grid image frame is consistent with and coincides with the width of the long side of the pedicle area of ​​the image obtained perpendicular to the patient's anteroposterior X-ray fluoroscopy. In this way, the position of the nine-square grid image where the needle tip is located under the image obtained under the anteroposterior X-ray fluoroscopy of the patient with the projection of the puncture needle tip in the projection state can be understood very quickly.

[0011] In one embodiment, the nine-square grid unit is a nine-square grid positioning plate for percutaneous pedicle puncture position positioning, including a basic frame and a nine-square grid structure, wherein: The basic frame is a plate-shaped frame, on which a pasting structure is provided, and is used to be pasted on a display structure that can display the pedicle area portion of the image obtained under the patient's anteroposterior X-ray fluoroscopy. The basic frame is a polygonal frame, and a through channel is provided on at least one frame. The nine-square grid structure includes an operation part and a nine-square grid part. The nine-square grid part enters the hollow space of the polygonal frame through a through channel. After 1 or 4 nine-square grid parts enter the hollow space, they appear as a line nine-square grid.

[0012] With the above structural design, the basic frame can accurately position the line grid, avoid deformation of the line grid caused by direct operation of the line grid, and ultimately ensure the positioning effect. When the grid positioning plate is fixed to the display structure, the line grid is not affected.

[0013] Furthermore, the basic frame is a square basic frame, and the line nine-square grid is constructed by 4 horizontal lines and 4 vertical lines to form a four-sided nine-square grid.

[0014] Furthermore, a nine-square grid part is set, which includes a complete line nine-square grid; two operating parts are provided on two opposite sides of the line nine-square grid, the operating part is a plate-shaped structure, and the thickness of the operating part is greater than the thickness of the lines of the line nine-square grid, so as to achieve the purpose of sending the line nine-square grid into the hollow space by stably holding the operating part.

[0015] Furthermore, the two operating parts are symmetrically distributed on both sides of the linear nine-square grid, the sum of the lengths of the two operating parts and the linear nine-square grid is greater than the length of the outer frame of the basic frame, and only the two borders of the basic frame are provided with through channels. This arrangement ensures that the operating parts can be operated from any direction.

[0016] Furthermore, the through channel includes nine-square channels on both sides and a middle channel. The spacing between the upper and lower channel side walls of the nine-square channels is adapted to the thickness of the lines of the nine-square grid, and the spacing between the upper and lower channel side walls of the middle channel is adapted to the thickness of the operating part. In this way, when setting up one nine-square grid, each structure can pass smoothly through its own channel, and the structure will not be deformed due to large shaking, thereby maintaining the stable setting of all structures.

[0017] Alternatively, four identical nine-square grid parts are set, each nine-square grid part includes an operating part and a rectangular structure of a strip, the length of the rectangular structure of the strip is equal to the side length of the inner frame of the basic frame, and the width of the rectangular structure is equal to one-third of the side length of the inner frame of the basic frame. A through channel is set on the border of each basic frame, and the through channel is a two-layer through channel; the through channels of the same layer are correspondingly set at the border position of two parallel basic frames; a nine-square grid part enters the hollow space of the basic frame through a through channel. The design of the upper and lower layers can avoid mutual interference when setting the nine-square grid part. In addition, the four nine-square grid parts can be docked to form a complete strip nine-square grid. This method can also flexibly adjust the size of the strip nine-square grid by continuously adjusting the depth of the operating part entering the hollow space, so that it forms a small strip nine-square grid, and all the nine-square grid parts are indented toward one corner to form a relatively uniform nine-square grid. Moreover, the setting divided into four parts can reduce the area of ​​a single nine-square grid part, making it more stable and not easy to deform.

[0018] Furthermore, nine-grid sections of different sizes are provided, and entry restriction marks are provided on the operation section, and it can be confirmed whether the nine-grid section has entered the correct position with the help of the restriction marks.

[0019] Furthermore, a median structure is set in the center of the nine-square grid part, and a pedicle area midpoint is set in the corresponding area of ​​the pedicle area of ​​the screen. When in use, the median structure is aligned with the midpoint to complete the setting of the line nine-square grid.

[0020] Specifically, it covers a method for determining the position of a puncture needle in a percutaneous pedicle area surgery, and the detailed steps are as follows: A vertebral image under AP X-ray fluoroscopy is obtained, including an image of the pedicle region under AP X-ray fluoroscopy of the patient, and the image is displayed on a display structure; a nine-square grid portion of appropriate size is placed in a basic frame according to the size of the pedicle region image on the display structure, and an adapted nine-square grid structure is constructed; the center of the nine-square grid structure is aligned with the center of the pedicle region image of the pedicle region image, and the basic frame is placed on the display structure; the position of the puncture needle insertion point is determined by observing the position of the nine-square grid where the puncture needle tip is located in the pedicle region image, so as to facilitate subsequent adjustments.

[0021] Alternatively, a method for determining the position of a puncture needle in a percutaneous pedicle region surgery uses a nine-square image frame to determine the puncture position, and the specific process is: obtaining an image of the pedicle region corresponding to the surgery under an image obtained under an AP X-ray fluoroscopy of the patient, using image tracking technology to track and find the two points with the largest distance between the pedicle region images, constructing a first line segment, and then constructing a second line segment perpendicular to the first line segment, with the two ends of the second line segment being the edges of the pedicle region image, respectively finding two three-division points of the first line segment and the second line segment, setting two first nine-square line segments perpendicular to the first line segment at the two three-division points on the first line segment, and setting two first nine-square line segments perpendicular to the first line segment at the two three-division points on the second line segment. Two second nine-square grid line segments perpendicular to the second line segment are set at the equally divided points, and the first nine-square grid line segment, the second nine-square grid line segment and the pedicle area image jointly construct a tracking nine-square grid image frame; when the pedicle area image of the image obtained under the anteroposterior X-ray fluoroscopy of the patient with the puncture needle is displayed on the screen, the tracking nine-square grid image frame automatically tracks the pedicle area image of the corresponding operation, obtains the position relationship between the puncture needle and the tracking nine-square grid, and when the needle tip of the puncture needle is in the best tracking nine-square grid position, the operation is continued; when the needle tip of the puncture needle is not in the best nine-square grid position, an output adjustment prompt is given. In this way, it is possible to quickly and effectively determine whether the insertion point of the puncture needle is in the best insertion position of the pedicle area.

[0022] Technical Effects By setting a nine-square grid structure for comparison on the vertebral image obtained under the patient's anteroposterior X-ray fluoroscopy, the comparison process is made simpler and more intuitive. Whether a positioning plate with a nine-square grid structure is posted on the display screen of the display structure, or a nine-square grid image frame of the pedicle area image is tracked by tracking technology, the comparison with the pedicle area image can be quickly achieved on a plane parallel to the vertebral image obtained under the anteroposterior X-ray fluoroscopy. The above two setting methods are easy to operate, and the comparison is direct and efficient.

[0023] The positioning plate adopts a design in which the basic frame and its through-channel cooperate with the nine-square grid structures of different sizes. It can flexibly replace the nine-square grid structures of different sizes while ensuring that the stability of the nine-square grid structure is not affected during the setting process. BRIEF DESCRIPTION OF THE DRAWINGS

[0024] Figure 1 A schematic diagram of the overall structure of a positioning plate provided for the nine-square grid part of the present invention; Figure 2 A schematic diagram of a basic frame structure for setting a nine-square grid part of the present invention; Figure 3 This is a schematic diagram of the overall structure of the present invention in which four positioning plates are arranged on the nine-square grid part and the area of ​​the nine-square grid structure is equal to the hollow space of the base frame; Figure 4This is a schematic diagram of the overall structure of the present invention in which four positioning plates are arranged on the nine-square grid part and part of the operating part enters the hollow space of the through channel; Figure 5 A schematic diagram of the overall structure of the present invention in which four positioning plates are arranged on the nine-square grid part and all operating parts enter the through-channel and the hollow space and the pasting structure faces upward; Figure 6 A schematic diagram of a main view structure of four basic frames provided for the nine-square grid part of the present invention; Figure 7 A schematic diagram of a side view structure of a nine-square grid part of the present invention with four basic frames; Figure 8 This is a schematic diagram of the structure of the present invention with only four nine-square grid parts combined; Fig. 9 A schematic diagram of the structure of two opposite nine-square grid parts in which four positioning plates are arranged in the nine-square grid part of the present invention; Fig.10 It is a schematic diagram of the structure of an embodiment of the present invention in which two basic frames are combined together through a connecting plate, wherein each nine-square grid part is provided with a central structure; Description of main reference numerals 1. Basic frame; 11. Through channel; 111. Nine-grid channel; 112. Middle channel; 113. Connecting block; 114. Upper channel; 115. Lower channel; 12. Pasting structure; 13. Hollow space; 21. Operating part; 22. Nine-grid part; 221. Horizontal line; 222. Vertical line; 31. Setting line; 32. Dot structure; 41. Connecting plate. DETAILED DESCRIPTION

[0025] Example 1

[0026] The nine-square grid unit is set on a plane parallel to the vertebral image obtained under the patient's anteroposterior X-ray fluoroscopy, and the nine-square grid unit is directly compared with the pedicle area image in the vertebral image obtained under the patient's anteroposterior X-ray fluoroscopy, and the nine-square grid unit is located directly above the pedicle area image of the vertebral image obtained under the patient's anteroposterior X-ray fluoroscopy, so that the pedicle area image of the vertebral image obtained under the patient's anteroposterior X-ray fluoroscopy is directly compared with the nine-square grid unit, and an image with the puncture needle tip, the nine-square grid unit and the patient's anteroposterior pedicle area is obtained, and the area of ​​the nine-square grid where the needle tip is located is compared, and according to the comparison result, it is understood whether the needle tip is at the best puncture insertion point.

[0027] refer to Figure 1-10The nine-square grid unit is a nine-square grid positioning plate for percutaneous pedicle puncture position positioning, including a basic frame and a nine-square grid structure, wherein the basic frame is a plate-shaped frame, on which a pasting structure is arranged, and is used to be posted on a display structure that can display the pedicle area part of the image obtained under the patient's anteroposterior X-ray fluoroscopy, and the basic frame is a polygonal frame, and a through channel is arranged on at least one frame; the nine-square grid structure includes an operating part and a nine-square grid part, and the nine-square grid part enters the hollow space of the polygonal frame through the through channel, the basic frame is a square basic frame, and the line nine-square grid is a four-sided nine-square grid constructed by 4 horizontal lines and 4 vertical lines. One or four nine-square grid parts are arranged to enter the hollow space to present as a line nine-square grid.

[0028] When in use, the nine-square grid parts are sequentially passed through the corresponding through channels into the hollow space to form a nine-square grid in the hollow space; then the protective film of the adhesive structure at the bottom of the plate frame of the basic frame is torn off, and the image area corresponding to the pedicle region obtained under the anteroposterior X-ray fluoroscopy of the patient on the display structure is found, so that the nine-square grid is opposite to the image area obtained under the anteroposterior X-ray fluoroscopy of the patient in the pedicle region, and the basic frame is posted on the display structure; if the image obtained under the anteroposterior X-ray fluoroscopy of the patient contains a puncture structure, the nine-square grid area where the needle tip of the puncture structure is located can be intuitively understood by observing the display structure, and whether the position of the needle tip is the best grid; if not, an adjustment plan is given according to the nine-square grid area prompted by the picture to adjust the puncture position of the puncture structure, and after the adjustment, the image image obtained under the anteroposterior X-ray fluoroscopy of the patient continues to be obtained, and the image area obtained under the anteroposterior X-ray fluoroscopy of the patient in the pedicle region is displayed in the same area of ​​the display structure.

[0029] Through the setting of the above structure, it can be ensured that the positioning of the strip grid is completed through the basic frame, avoiding the deformation of the lines caused by direct operation of the strip grid, which ultimately affects the positioning effect. After the strip grid is limited by the basic frame, it can be ensured that when the grid positioning plate is positioned on the display structure, the strip grid is not affected.

[0030] The specific implementation method is as follows: Figure 1-2 ; One nine-square grid part is set, and one nine-square grid part includes a complete line nine-square grid; two operating parts are set on two opposite sides of the line nine-square grid, the operating part is a plate-type structure, and the thickness of the operating part is large, so that the purpose of sending the line nine-square grid into the hollow space can be achieved by stably holding the operating part.

[0031] More specifically, the two operating parts are symmetrically arranged on both sides of the linear nine-square grid, the sum of the lengths of the two operating parts and the linear nine-square grid is greater than the length of the outer frame of the basic frame, and only the two borders of the basic frame are provided with through channels. This arrangement can ensure that the operating part can be operated from any direction.

[0032] More specifically, the through channel includes nine-square channels on both sides and a middle channel. The distance between the upper and lower channel side walls of the nine-square channels is adapted to the thickness of the lines of the nine-square grid, and the distance between the upper and lower channel side walls of the middle channel is adapted to the thickness of the operating part. This setting can ensure that when a nine-square grid is set up, each structure passes through its own channel without large shaking causing structural deformation, so that all structures maintain a stable setting.

[0033] More specifically, different sizes of line grids are set, and corresponding operation parts of different lengths are set. The length of the operation part and the line grid is greater than the side length of the outer frame of the basic frame, and the area of ​​the hollow space of the basic frame is the same as the area of ​​the largest line grid. The purpose of this setting is that the height of the patient obtained under the anteroposterior X-ray fluoroscopy is different, or the vertebral body is different, and the size of the pedicle area is also different. By setting different sizes of line grids, the appropriate size of the line grid can be selected according to the needs and placed in a unified basic frame.

[0034] More specifically, refer to Figure 2 The foundation frame is composed of an upper and lower plate structure. A connecting block is set between the upper and lower layers corresponding to the two frame frames where no through-channel is set. The upper and lower layers of the structure are connected together through the connecting block. This setting can reduce the weight of the foundation frame to the greatest extent without causing much impact on the stability of the foundation frame.

[0035] Another embodiment is to refer to Figure 3-9; Set up 4 identical nine-square grid parts, each nine-square grid part includes an operating part and a rectangular structure of a strip, the length of the rectangular structure of the strip is equal to the side length of the inner frame of the basic frame, and the width of the rectangular structure is equal to one-third of the side length of the inner frame of the basic frame. A through channel is set on the border of each basic frame, and the through channel is an upper and lower through channel; respectively, an upper channel and a lower channel; and the through channels of the same layer are correspondingly set at the border positions of two parallel basic frames; a nine-square grid part enters the hollow space of the basic frame through a through channel; the upper and lower layers can be set to avoid mutual interference when setting the nine-square grid part, and a complete strip nine-square grid is formed by the docking of the four nine-square grid parts. This method can also adjust the size of the strip nine-square grid by continuously adjusting the depth of the operating part entering the hollow space, so that it forms a small strip nine-square grid, and all the nine-square grid parts are indented toward one corner, so as to form a relatively uniform nine-square grid. In addition, the setting divided into 4 parts can reduce the area of ​​a single nine-square grid part, making the single nine-square grid part more stable and not deformed. More specifically, nine-grid sections of different sizes are provided, and an entry restriction mark is provided on the operation section, so that the user can know that the nine-grid section has entered a correct position through the restriction mark.

[0036] The thickness of the operating part is thicker than the long line of the rectangular structure of a line. When the rectangular structure of the line is arranged in this way, the operating part of the combined area with the through channel can be always Regardless of whether one or four nine-square grid parts are set, the basic frame is made of a light alloy material, and the line nine-square grid is made of a light plastic material, and the diameter of the line nine-square grid is less than 2 mm; Whether setting up 1 or 4 nine-square grid sections, refer to Fig.10 ; A center structure is set in the center of the nine-square grid, and a center point of the pedicle area is set in the corresponding area of ​​the pedicle area of ​​the screen. When in use, the center structure is aligned with the center point to complete the setting of the line nine-square grid. The center structure is set on the setting line of the nine-square grid, and the center structure is a dot structure on the setting line. This setting can easily correspond this point to the center point of the pedicle area.

[0037] A more specific implementation method is to refer to Fig.10 A length-adjustable connecting plate is set up to connect the two nine-grid structures to meet the needs of bilateral pedicle area surgery. This setting can meet the determination of the bilateral puncture needle puncture position through a single structure setting, making the entire operation simpler and more effective. Of course, a connecting plate with adjustable length and angle can also be set up to ensure the effectiveness of the placement of the two nine-grid plates.

[0038] The method for determining the puncture position using the positioning plate comprises the following specific steps: The vertebral images of the patient obtained under the anteroposterior X-ray fluoroscopy are obtained. The vertebral images include the pedicle area images obtained under the anteroposterior X-ray fluoroscopy of the patient. The images are displayed on the display structure. Combined with the size of the pedicle area image on the display structure, set the appropriate size of the nine-square grid part to the basic frame to construct a suitable nine-square grid structure. The center of the nine-square grid structure is aligned with the center of the pedicle region image of the pedicle region image, and the basic frame is set on the display structure; Observe the position of the nine-square grid where the puncture needle tip is located in the pedicle area image to understand the position of the puncture needle insertion point, which is convenient for subsequent adjustments.

[0039] Furthermore, by fixing the image distance of the patient, finding a fixed pedicle area image display position on the display structure, and posting a nine-square grid unit on the display plane, after the puncture needle is percutaneously inserted into the pedicle area image through the guidance of the guided puncture instrument, the image obtained under the patient's anteroposterior X-ray fluoroscopy can be displayed on the display structure with the puncture needle. Because the display method is the same, the pedicle area image with the puncture needle can be displayed at the same position, and the specific position of the puncture needle can be accurately understood through the nine-square grid structure fixed on the display unit. Specifically, by setting the nine-square grid unit on the display plane, adjusting the pedicle area with the puncture needle of the image image obtained under the patient's anteroposterior X-ray fluoroscopy to the corresponding position of the nine-square grid unit, understanding the position of the needle tip of the puncture needle in the nine-square grid unit, and accurately judging whether the needle tip position of the puncture needle is in the best position, making it easier to determine the needle tip position, even if it is inaccurate, it is possible to quickly find an adjustment method to obtain the best needle tip position of the puncture needle.

[0040] Example 2

[0041] The nine-square grid unit is set on a plane parallel to the vertebral image obtained under the patient's anteroposterior X-ray fluoroscopy, and the nine-square grid unit is directly compared with the pedicle area image in the vertebral image obtained under the anteroposterior X-ray fluoroscopy of the patient, and the nine-square grid unit is located directly above the pedicle area image of the vertebral image obtained under the anteroposterior X-ray fluoroscopy of the patient, so that the pedicle area image of the vertebral image obtained under the anteroposterior X-ray fluoroscopy of the patient is directly compared with the nine-square grid unit, and the nine-square grid area where the needle tip of the puncture needle is located in the image obtained under the anteroposterior X-ray fluoroscopy of the patient with the pedicle area of ​​the puncture needle tip is obtained; according to this comparison result, it is understood whether the needle tip is at the best puncture insertion point.

[0042] The nine-square grid unit is a nine-square grid image frame corresponding to the pedicle area above the image obtained under the patient's anteroposterior X-ray fluoroscopy to track, obtain the center of the nine-square grid image frame and the center of the pedicle area, and make the center of the nine-square grid image frame coincide with the center of the pedicle area, and match the length of the nine-square grid image frame to be consistent with and coincide with the long side of the pedicle area of ​​the image obtained under the patient's anteroposterior X-ray fluoroscopy, and the width of the nine-square grid image frame is consistent with and coincides with the width of the long side of the pedicle area of ​​the image obtained under the patient's anteroposterior X-ray fluoroscopy. In this way, the position of the nine-square grid image where the needle tip is located under the image obtained under the anteroposterior X-ray fluoroscopy of the patient with the projection of the puncture needle tip in the projection state can be very quickly understood.

[0043] The specific method of determining the puncture position using the nine-square grid image frame is as follows: The pedicle region image corresponding to the surgery under the patient's anteroposterior X-ray fluoroscopy is obtained, and the image tracking technology is used to track and find the two points with the largest distance between the pedicle region images, and a first line segment is constructed, and then a second line segment perpendicular to the first line segment is constructed, and the two ends of the second line segment are the edges of the pedicle region image, and two three-division points of the first line segment and the second line segment are found respectively, and two first nine-square grid line segments perpendicular to the first line segment are set at the two three-division points on the first line segment, and two second nine-square grid line segments perpendicular to the second line segment are set at the two three-division points on the second line segment, and the first nine-square grid line segment, the second nine-square grid line segment and the pedicle region image construct a tracking nine-square grid image frame; When the pedicle area image of the patient with the puncture needle obtained under the anteroposterior X-ray fluoroscopy is displayed on the screen, the tracking nine-square image frame automatically tracks the pedicle area image corresponding to the operation, obtains the position relationship between the puncture needle and the tracking nine-square, and continues the operation when the needle tip of the puncture needle is in the best tracking nine-square position; when the needle tip of the puncture needle is not in the best nine-square position, an output adjustment prompt is given. In this way, it is very quick and effective to know whether the insertion point of the puncture needle is in the best insertion position of the pedicle area.

[0044] The technical solutions in the embodiments of the present invention are clearly and completely described above through specific embodiments. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Those skilled in the art can easily understand other advantages and effects of the present invention from the contents disclosed in this specification. The present invention can also be implemented or applied through other different specific implementation methods. In the absence of conflict, the above embodiments and features in the embodiments can be combined with each other. Based on the embodiments in the present invention, all other embodiments obtained by ordinary technicians in this field without making creative work are within the scope of protection of the present invention.

Claims

1. A method for positioning a percutaneous pedicle puncture, characterized in that: 1) Obtain the vertebral body image of the patient's surgical pedicle area under the patient's anteroposterior X-ray fluoroscopy and display it on the display structure; 2) The nine-square area of ​​the nine-square unit corresponds to a plane parallel to the vertebral image obtained under the patient's AP X-ray fluoroscopy, and the nine-square area of ​​the nine-square unit corresponds to the pedicle area image in the vertebral image obtained under the AP X-ray fluoroscopy of the patient, and the nine-square area is located directly above the pedicle area image of the vertebral image obtained under the AP X-ray fluoroscopy of the patient, so that the pedicle area image of the vertebral image obtained under the AP X-ray fluoroscopy of the patient is directly compared with the nine-square area of ​​the nine-square unit, and the nine-square area where the needle tip of the pedicle area with the puncture needle tip is located in the image obtained under the AP X-ray fluoroscopy of the patient is obtained, and the puncture position of the pedicle area is positioned and adjusted according to the nine-square area where the needle tip is located.

2. The positioning method according to claim 1, characterized in that: The nine-square grid unit is a structure fixed to the display structure plane; the fixed pedicle area display position is found by adjusting the image distance of the fixed patient, and the nine-square grid unit is posted on the display plane.

3. The positioning method according to claim 1, characterized in that: The nine-square grid unit is a nine-square grid image frame corresponding to the pedicle region above the image obtained under the patient's anteroposterior X-ray fluoroscopy, and the center of the nine-square grid image frame and the center of the pedicle region are obtained, and the center of the nine-square grid image frame is made to coincide with the center of the pedicle region, and the length of the nine-square grid image frame is matched to coincide with the long side of the pedicle region of the image obtained under the patient's anteroposterior X-ray fluoroscopy, and the width of the nine-square grid image frame is matched to coincide with the width of the long side of the pedicle region of the image obtained under the patient's anteroposterior X-ray fluoroscopy, and coincides with the width of the nine-square grid image frame; Preferably, the image tracking technology is used to track and find the two points with the largest distance in the pedicle area image, a first line segment is constructed, and then a second line segment perpendicular to the first straight line is constructed, the two ends of the second line segment are the edges of the pedicle area image, and two three-division points of the first line segment and the second line segment are found respectively, two first nine-square grid line segments perpendicular to the first line segment are set at the two three-division points on the first line segment, and two second nine-square grid line segments perpendicular to the second line segment are set at the two three-division points on the second line segment, and the first nine-square grid line segment, the second nine-square grid line segment and the pedicle area image construct a tracking nine-square grid image frame.

4. A nine-grid positioning plate for percutaneous pedicle puncture, characterized in that: It is the nine-square grid unit described in claim 2, comprising The basic frame is a plate-shaped frame, on which a pasting structure is arranged, and is used to be pasted on a display structure capable of displaying a pedicle region portion of an image obtained under an X-ray fluoroscopy of a patient in an anteroposterior position. The basic frame is a polygonal frame, and a through channel is arranged on at least one frame. The nine-square grid structure includes an operation part and a nine-square grid part. The nine-square grid part enters the hollow space of the polygonal frame through a through channel. One or four nine-square grid parts enter the hollow space and appear as a line nine-square grid. The basic frame is a square frame, and the line grid is a quadrilateral grid constructed by 4 horizontal lines and 4 vertical lines. Set quadrilateral grids of different areas; Preferably, the basic frame is configured as a square frame.

5. The positioning plate according to claim 4, characterized in that: One nine-square grid part is set, and one nine-square grid part includes a complete line nine-square grid; two operation parts are set on two opposite sides of the line nine-square grid, the operation part is a plate-type structure, and the thickness of the operation part is large, and the thickness of the line nine-square grid is large.

6. The positioning plate according to claim 5, characterized in that: The through channel includes nine-square grid channels on both sides and a middle channel. The distance between the upper and lower channel side walls of the nine-square grid channels is adapted to the line thickness of the nine-square grid, and the distance between the upper and lower channel side walls of the middle channel is adapted to the thickness of the operating part.

7. The positioning plate according to claim 5, characterized in that: The two operating parts are symmetrically arranged on both sides of the line nine-square grid, the sum of the lengths of the two operating parts and the line nine-square grid is greater than the outer frame side length of the basic frame, and only the two borders of the basic frame are provided with penetrating channels.

8. The positioning plate according to claim 5, characterized in that: Set the striped nine-square grids of different sizes, and set the operation parts of different lengths accordingly. The length of the operation part and the striped nine-square grid is greater than the side length of the outer frame of the basic frame, and the area of ​​the hollow space of the basic frame is the same as the area of ​​the largest striped nine-square grid; Preferably, the basic frame is composed of an upper and lower plate-shaped structure, and a connecting block is provided between the upper and lower layers corresponding to the two frame frames where no through-channel is provided, and the upper and lower layers of the structure are integrally connected together through the connecting block.

9. The positioning plate according to claim 4, characterized in that: Four identical nine-square grid parts are set, each of which includes an operating part and a rectangular structure of a line, the length of the rectangular structure of the line is equal to the side length of the inner frame of the basic frame, and the width of the rectangular structure is equal to one-third of the side length of the inner frame of the basic frame. A through channel is set on the border of each basic frame, and the through channels are two layers of through channels, and the through channels on the same layer correspond to the border positions of two parallel basic frames; a nine-square grid part enters the hollow space of the basic frame through a through channel; Preferably, nine-grid sections of different sizes are provided, and entry restriction marks are provided on the operation section.

10. The positioning plate according to claim 5, characterized in that: The thickness of the operating portion is thicker than the long line of the rectangular structure of one line; Preferably, the base frame is made of a light alloy material, and the line grid is made of a light plastic material, and the diameter of the line grid is less than 2 mm; Preferably, a median structure is arranged in the center of the nine-square grid part, and a median point of the pedicle area is arranged in the corresponding area of ​​the pedicle area of ​​the screen; Preferably, the center structure is arranged on the setting line of the nine-square grid part, and the center structure is a dot structure on the setting line.

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