A percutaneous pedicle puncture position positioning method and a nine-square positioning plate

Abstract

The application discloses a percutaneous pedicle puncture position positioning method, which innovatively sets a nine-square unit on a plane parallel to a vertebral body image obtained under patient frontal X-ray perspective, directly compares the nine-square unit with a pedicle region under the vertebral body image obtained under patient frontal X-ray perspective, ensures that the nine-square unit is directly above the pedicle region, promotes accurate and direct comparison between the two, and then obtains a nine-square region where a needle tip of the pedicle region with the needle tip is located under the image obtained under patient frontal X-ray perspective, so as to accurately judge whether the needle tip is located at an optimal puncture needle entry point; the nine-square unit can be a nine-square positioning plate or a nine-square image frame, the nine-square positioning plate comprises a basic frame and a nine-square structure, and nine-square structures with different sizes are set to adapt to different pedicle regions; the nine-square image frame is adapted to the range of the pedicle region and can be effectively set above the corresponding pedicle region through tracking.

Description

Technical Field

[0001] This invention belongs to the field of surgical aids for percutaneous pedicle surgery, specifically a method for locating the percutaneous pedicle puncture site and a nine-square grid positioning plate. Background Technology

[0002] With the continuous advancement of computer-aided technology and precision surgery, preoperative digital design combined with intraoperative external navigation devices has been applied in various minimally invasive surgeries (such as PVP) via the percutaneous pedicle approach. Compared to traditional surgical methods that rely on repeated fluoroscopy with a C-arm X-ray machine during surgery, its advantages are significant: the number of fluoroscopy attempts to determine the skin entry point, the total number of fluoroscopy attempts during surgery, and the total intraoperative fluoroscopy dose are reduced, resulting in a significant reduction in the total surgical time; due to the more precise puncture position of the percutaneous puncture instruments, the incidence of bone cement leakage is reduced; and with the corresponding three-dimensional reconstruction of the fractured vertebral body before surgery, this technique is more valuable for the treatment of patients with complex osteoporotic vertebral compression fractures.

[0003] However, accurately locating the puncture site in the pedicle region and matching the precise puncture direction is crucial for achieving ideal surgical results. Existing technology, such as the "3D-printed percutaneous pedicle puncture guide plate based on a nine-square grid and its preparation method," discloses a guide device with a nine-square grid that is fixed to the patient's skin. This device combines a nine-square grid structure, which corresponds to the pedicle region image and can be captured by the imaging system, with a puncture guide structure. The puncture instrument is then inserted into the pedicle region image via the puncture guide structure. Subsequently, anteroposterior fluoroscopy of the patient's C-arm X-ray is performed, visually displaying the position of the puncture instrument in the pedicle region on the digital image, allowing for timely adjustments and identification of the optimal nine-square grid location.

[0004] However, this combination of the nine-square grid structure and the puncture guide structure has drawbacks: while fixing the nine-square grid structure to the local curved skin surface can achieve a certain degree of fixation, it faces the challenge of matching it with the human body's curvature. It's difficult to ensure that the nine-square grid in the patient's anteroposterior X-ray fluoroscopy image perfectly matches the pedicle region in the anteroposterior image, making it difficult to accurately determine the position of the puncture needle tip relative to the pedicle region. Therefore, it is often necessary to adjust the nine-square grid position and re-image beforehand to ensure that the nine-square grid and pedicle region correspond in the patient's anteroposterior X-ray fluoroscopy image. Only by understanding the relative positional relationship between the puncture needle and the nine-square grid can the optimal puncture position be determined. However, this process not only increases the risk of radiation exposure but also increases the operational difficulty.

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

[0006] Existing technology places a nine-square grid for dividing the pedicle region on the surface of the skin and connects it to a puncture guide structure. After the puncture needle is percutaneously inserted into the pedicle region through the puncture guide device, the image obtained under the patient's anteroposterior X-ray fluoroscopy is used to determine whether the puncture needle is in the optimal puncture area of ​​the pedicle region based on the nine-square grid area where the needle tip is located in the image. If it is in the optimal puncture area, the puncture continues to construct a surgical channel through the pedicle region; if it is not in the optimal 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 optimal puncture area.

[0007] However, this method involves setting the nine-square grid on the plate and then fixing it to the patient's skin surface. The fixation process is prone to positional shifts, which can interfere with the determination of the needle insertion point. Moreover, 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 that is parallel to the vertebral body image obtained under the patient's anteroposterior X-ray fluoroscopy, and directly compares the pedicle region image in the nine-square grid unit with the pedicle region image in the patient's anteroposterior X-ray fluoroscopy, and ensures that the nine-square grid unit is directly above the pedicle region image in the patient's anteroposterior X-ray fluoroscopy, so that the two can be directly compared, thereby obtaining the nine-square grid area where the pedicle region with the puncture needle tip is located in the patient's anteroposterior X-ray fluoroscopy image; based on the comparison result, it is determined whether the needle tip is at the optimal puncture point.

[0009] More specifically, the nine-square grid unit can be a structure fixed on the display plane. By fixing the image distance of the patient and accurately locating the display position of the pedicle region, the nine-square grid unit is placed on the display plane. In this way, after the puncture needle is guided percutaneously into the pedicle region image by the guide puncture instrument, the image with the puncture needle can be displayed on the structure using the image obtained under the patient's anteroposterior X-ray fluoroscopy. Because the display method is uniform and the pedicle region with the puncture needle can be displayed in the same position, the position of the puncture needle can be accurately known by using the nine-square grid on the screen corresponding to the pedicle region image. By setting up the nine-square grid unit and placing it on the display plane, the pedicle region with the puncture needle in the image obtained under the patient's anteroposterior X-ray fluoroscopy can be adjusted to the position corresponding to the nine-square grid unit. The position of the puncture needle tip in the nine-square grid unit can be clearly determined, and it can be judged whether the needle tip position is in the optimal state. This makes the determination of the needle tip position simpler and easier. Even if it is inaccurate, an adjustment method can be quickly found to obtain the optimal puncture needle tip position.

[0010] Alternatively, the nine-square grid unit can also be a nine-square image frame that tracks the corresponding area of ​​the pedicle region above the image obtained under anteroposterior fluoroscopy of the patient. First, the center of the nine-square image frame is obtained and aligned with the center of the pedicle region, ensuring they coincide. Then, the length of the nine-square image frame is matched to the long side of the pedicle region in the image obtained under anteroposterior fluoroscopy, and the width of the nine-square image frame is matched to the width of the long side perpendicular to the long side of the pedicle region in the image obtained under anteroposterior fluoroscopy. In this way, the position of the needle tip in the nine-square image under anteroposterior fluoroscopy with the needle tip projection can be determined extremely quickly.

[0011] One implementation method is that the nine-square grid unit is a nine-square grid positioning plate for percutaneous pedicle puncture location, encompassing a basic frame and a nine-square grid structure, wherein:

[0012] The base frame is a plate-shaped frame with an adhesive structure on it, which is used to attach it to the display structure that can display the pedicle region of the image obtained under the patient's anteroposterior X-ray fluoroscopy. The base frame is a polygonal frame with a through channel on at least one side.

[0013] The nine-grid structure includes an operation section and a nine-grid section. The nine-grid section enters the hollow space of the polygon frame through a through-channel. After one or four nine-grid sections enter the hollow space, they appear as a strip nine-grid.

[0014] Thanks to the above structural design, the base frame can accurately position the nine-grid lines, avoiding deformation of the lines caused by direct manipulation of the nine-grid lines, and ultimately ensuring the positioning effect. When the nine-grid positioning plate is fixed to the display structure, the nine-grid lines are unaffected.

[0015] Furthermore, the basic frame is a square basic frame, and the striped nine-square grid is a quadrilateral nine-square grid constructed from 4 horizontal lines and 4 vertical lines.

[0016] Furthermore, a nine-square grid section is provided, which includes a complete strip nine-square grid; two operating parts are provided on the two opposite sides of the strip nine-square grid. The operating parts are plate-shaped and their thickness is greater than the thickness of the strips of the strip nine-square grid, so as to achieve the purpose of sending the strip nine-square grid into the hollow space by stably holding the operating parts.

[0017] Furthermore, the two operating parts are symmetrically distributed on both sides of the nine-square grid. The sum of the lengths of the two operating parts and the nine-square grid is greater than the outer frame length of the base frame. Only the two borders of the base frame have through channels. This arrangement ensures that the operating parts can be operated from any direction.

[0018] Furthermore, the through-passage includes two nine-square grid passages on both sides and a middle passage. The spacing between the upper and lower side walls of the nine-square grid passages is adapted to the thickness of the lines in the nine-square grid, and the spacing between the upper and lower side walls of the middle passage is adapted to the thickness of the operating part. In this way, when one nine-square grid is set, each structure can pass smoothly through its own passage without structural deformation due to large shaking, thus maintaining the stable setting of all structures.

[0019] Alternatively, four identical nine-square grid sections can be set up. Each nine-square grid section contains an operating part and a rectangular structure with a line. The length of the rectangular structure is equal to the inner side length of the base frame, and the width is equal to one-third of the inner side length of the base frame. A through-channel is set on the border of each base frame, with two layers of through-channels. Through-channels on the same layer are set on the borders of two parallel base frames. A nine-square grid section enters the hollow space of the base frame through a through-channel. The two-layer design avoids mutual interference when setting up the nine-square grid sections. Furthermore, the four nine-square grid sections can be joined to form a complete linear nine-square grid. This method also allows for flexible adjustment of the size of the linear nine-square grid by continuously adjusting the depth of the operating part entering the hollow space, creating smaller linear nine-square grids. All nine-square grid sections are recessed towards one corner, forming a relatively uniform nine-square grid. Moreover, dividing it into four parts reduces the area of ​​each individual nine-square grid section, making it more stable and less prone to deformation.

[0020] Furthermore, different sizes of nine-square grid sections are set, and entry restriction marks are set in the operation section. With the help of the restriction marks, it can be confirmed whether the nine-square grid section has entered the correct position.

[0021] Furthermore, a central structure is set in the center of the nine-grid section, and a corresponding center point of the pedicle region is set in the pedicle region of the screen. When using it, the central structure is aligned with the center point to complete the setting of the nine-grid strip.

[0022] Specifically, this covers a method for determining the location of the puncture needle in percutaneous pedicle surgery, with detailed steps as follows:

[0023] Obtain vertebral images under anteroposterior fluoroscopy, including images of the pedicle region under anteroposterior fluoroscopy of the patient, and display the images on the display structure. Based on the size of the pedicle region image on the display structure, place appropriately sized nine-square grid portions within the base frame to construct a suitable nine-square grid structure. Align the center of the nine-square grid structure with the center of the pedicle region image, and place the base frame on the display structure. By observing the position of the puncture needle tip in the nine-square grid of the pedicle region image, determine the location of the puncture needle insertion point for subsequent adjustments.

[0024] Alternatively, one method for determining the puncture needle location in percutaneous pedicle surgery utilizes a nine-square grid image frame. The specific procedure is as follows: Obtain an image of the pedicle region corresponding to the surgery under anteroposterior X-ray fluoroscopy. Use image tracking technology to track and identify the two points with the greatest distance in the pedicle region image, constructing a first line segment. Then construct a second line segment perpendicular to the first line segment, with the ends of the second line segment representing the edges of the pedicle region image. Find two points that divide the first and second line segments into three equal parts. At these two points, set two first nine-square grid line segments perpendicular to the first line segment. At the two points on the second line segment, set two points that divide the first and second line segments into three equal parts. Two second nine-grid lines perpendicular to the second line segment are set at the dividing points. A tracking nine-grid image frame is constructed by the first nine-grid line segment, the second nine-grid line segment, and the pedicle region image. When the pedicle region image obtained from the anteroposterior X-ray fluoroscopy of a patient with a puncture needle is displayed on the screen, the tracking nine-grid image frame automatically tracks the corresponding pedicle region image for the surgery, obtaining the positional relationship between the puncture needle and the tracking nine-grid. The surgery continues when the needle tip is in the optimal tracking nine-grid position; an output adjustment prompt is given when the needle tip is not in the optimal nine-grid position. In this way, it is possible to determine very quickly and effectively whether the needle insertion point is in the optimal insertion position within the pedicle region.

[0025] Technical effect

[0026] By setting a nine-square grid structure on the vertebral body images obtained under anteroposterior fluoroscopy, the comparison process becomes simpler and more intuitive. Whether a positioning plate with a nine-square grid structure is affixed to the display screen, or a nine-square grid image frame of the pedicle region image is tracked using tracking technology, comparison with the pedicle region image can be quickly achieved on a plane parallel to the vertebral body image obtained under anteroposterior fluoroscopy. Both of these setup methods are simple to operate and provide direct and efficient comparison.

[0027] The positioning plate adopts a design that combines a basic frame and its through channels with nine-square grid structures of different sizes, which allows for flexible replacement of nine-square grid structures of different sizes, while ensuring that the stability of the nine-square grid structure is not affected during the installation process. Attached Figure Description

[0028] Figure 1 A schematic diagram of the overall structure of a positioning plate with one of the nine grid sections of this invention;

[0029] Figure 2 A schematic diagram of the basic frame structure for setting up a nine-square grid in this invention;

[0030] Figure 3A schematic diagram of the overall structure of the present invention, which includes four positioning plates for the nine-grid section and whose area is equal to the hollow space of the base frame.

[0031] Figure 4 A schematic diagram of the overall structure of the present invention, in which four positioning plates are set in the nine-square grid section and some operating parts enter the hollow space of the through channel.

[0032] Figure 5 This is a schematic diagram of the overall structure of the present invention, in which four positioning plates are set in the nine-square grid section and all operating parts enter the through channel and the hollow space, with the adhesive structure facing upwards.

[0033] Figure 6 This is a schematic diagram of the main view structure of the basic frame with four elements in the nine-square grid section of this invention.

[0034] Figure 7 A side view diagram of the basic frame structure with four elements in the nine-square grid section of this invention;

[0035] Figure 8 This is a schematic diagram of the structure of the present invention, consisting of only four nine-square grid components.

[0036] Figure 9 A schematic diagram of the structure of two opposing nine-square grid sections of the nine-square grid section of the present invention, with four positioning plates.

[0037] Figure 10 This is a schematic diagram of an embodiment of the present invention in which two basic frames are combined together by a connecting plate, wherein each nine-square grid section is provided with a central structure;

[0038] Explanation of main figure symbols

[0039] 1. Basic frame; 11. Through channel; 111. Nine-square grid channel; 112. Middle channel; 113. Connecting block; 114. Upper channel; 115. Lower channel; 12. Paste structure; 13. Hollow space; 21. Operation part; 22. Nine-square grid part; 221. Horizontal line; 222. Vertical line; 31. Setting bar line; 32. Dot structure; 41. Connecting plate. Detailed Implementation

[0040] Example 1

[0041] By setting the nine-square grid unit on a plane parallel to the vertebral body image obtained under the patient's anteroposterior X-ray fluoroscopy, the pedicle region image in the vertebral body image obtained under the patient's anteroposterior X-ray fluoroscopy is directly compared with the pedicle region image in the vertebral body image obtained under the patient's anteroposterior X-ray fluoroscopy. The nine-square grid unit is positioned directly above the pedicle region image in the vertebral body image obtained under the patient's anteroposterior X-ray fluoroscopy, allowing direct comparison between the pedicle region image in the vertebral body image obtained under the patient's anteroposterior X-ray fluoroscopy and the nine-square grid unit. This results in an image containing the puncture needle tip, the nine-square grid unit, and the patient's anteroposterior pedicle region. The location of the needle tip within the nine-square grid is then compared, and the comparison results are used to determine whether the needle tip is at the optimal puncture point.

[0042] refer to Figure 1-10 The nine-square grid unit is a nine-square grid positioning plate for percutaneous pedicle puncture location. It includes a base frame and a nine-square grid structure. The base frame is a plate-shaped frame with an adhesive structure for attaching to a display structure that shows the pedicle region in images obtained under anteroposterior X-ray fluoroscopy. The base frame is a polygonal frame with a through-channel on at least one edge. The nine-square grid structure includes an operating part and a nine-square grid part. The nine-square grid part enters the hollow space of the polygonal frame through the through-channel. The base frame is a square base frame, and the strip nine-square grid is a quadrilateral nine-square grid constructed with four horizontal lines and four vertical lines. One or four nine-square grid parts are set into the hollow space to present a strip nine-square grid.

[0043] In use, the nine-square grid is sequentially inserted into the hollow space through the corresponding through-channels, forming a nine-square grid within the hollow space. Then, the protective film on the adhesive structure at the bottom of the base frame is peeled off. Locate the image area on the display structure corresponding to the pedicle region obtained under anteroposterior fluoroscopy of the patient, ensuring the nine-square grid aligns with the image area obtained under anteroposterior fluoroscopy of the patient's pedicle region. The base frame is then attached to the display structure. If the image obtained under anteroposterior fluoroscopy of the patient contains a puncture structure, the display structure allows for direct observation of the nine-square grid area where the needle tip of the puncture structure is located. This indicates whether the needle tip position is the optimal grid. If not, an adjustment plan is provided based on the nine-square grid area indicated in the image to adjust the puncture position of the puncture structure. After adjustment, the image image obtained under anteroposterior fluoroscopy of the patient is obtained again, and the image area obtained under anteroposterior fluoroscopy of the patient's pedicle region is displayed in the same area of ​​the display structure.

[0044] By setting up the above structure, it is possible to ensure that the positioning of the nine-grid stripes is completed through the basic frame, avoiding the deformation of the stripes caused by directly operating on the nine-grid stripes, which would ultimately affect the positioning effect. After limiting the nine-grid stripes by the basic frame, it is possible to ensure that the nine-grid stripes are not affected when the nine-grid positioning plate is positioned on the display structure.

[0045] The specific implementation method is as follows, refer to Figure 1-2 Set up one nine-square grid section, which contains a complete strip nine-square grid; set up two operating parts on two opposite sides of the strip nine-square grid. The operating parts are plate-shaped structures, and the thickness of the operating parts is greater than the thickness of the strip nine-square grid. In this way, the strip nine-square grid can be sent into the hollow space by holding the operating parts stably.

[0046] More specifically, the two operation parts are symmetrically set on both sides of the nine-square grid. The sum of the lengths of the two operation parts and the nine-square grid is greater than the outer frame length of the base frame. Only the two borders of the base frame have through channels. This arrangement ensures that the operation parts can be operated from any direction.

[0047] More specifically, the through channel includes two nine-square grid channels on both sides and a middle channel. The distance between the upper and lower side walls of the nine-square grid channels is adapted to the thickness of the lines in the nine-square grid, and the distance between the upper and lower side walls of the middle channel is adapted to the thickness of the operating part. This setting can ensure that when setting one nine-square grid, each structure passes through its own channel without large shaking that could cause structural deformation, thus maintaining a stable setting for all structures.

[0048] More specifically, this involves setting up nine-square grids of different sizes, each corresponding to an operating section of varying length. The length of the operating section and the nine-square grid is greater than the side length of the outer frame of the base frame, and the area of ​​the hollow space within the base frame is the same as the area of ​​the largest nine-square grid. This setup is designed because the height of the patient's vertebral body or the size of the pedicle region varies depending on the anteroposterior X-ray fluoroscopy. By setting up nine-square grids of different sizes, an appropriate size can be selected and placed within a unified base frame as needed.

[0049] More specifically, see reference Figure 2 The base frame is composed of two plate-type structures, with connecting blocks between the upper and lower layers corresponding to the two side frames that do not have through channels. The upper and lower layers are connected together by the connecting blocks. This design can reduce the weight of the base frame to the greatest extent without significantly affecting its stability.

[0050] Another implementation method is, as described in the reference... Figure 3-9The system consists of four identical nine-square grid sections. Each grid section includes an operating part and a rectangular structure with a line. The length of the rectangular structure is equal to the side length of the inner frame of the base frame, and the width is one-third of the side length of the inner frame. A through-channel is provided on the border of each base frame, with two layers: an upper channel and a lower channel. Channels of the same layer are positioned on the borders of two parallel base frames. A nine-square grid section enters the hollow space of the base frame through a through-channel. This two-layer design avoids mutual interference when setting up the nine-square grid sections. Furthermore, the four grid sections are joined to form a complete linear nine-square grid. This method allows for adjustment of the size of the linear nine-square grid by continuously adjusting the depth of the operating part entering the hollow space, creating smaller linear nine-square grids. All grid sections are recessed towards one corner, resulting in a relatively uniform grid. The four-part design also reduces the area of ​​individual nine-square grid sections, making them more stable and preventing deformation. More specifically, different sizes of nine-square grid sections are set up, and entry restriction indicators are set on the operation part. The restriction indicators indicate that the nine-square grid section has entered the correct position.

[0051] The thickness of the operating section is greater than that of the long line of a rectangular structure. This arrangement of the rectangular structure allows the operating section, which always has a combined area with the through channel, to function effectively.

[0052] Whether it is a single grid or a quad grid, the base frame is made of lightweight alloy material, while the strip grid is made of lightweight plastic material, and the diameter of the strips in the strip grid is less than 2mm.

[0053] Whether you set up one 3x3 grid section or four 3x3 grid sections, refer to... Figure 10 A central structure is set in the center of the 3x3 grid area, corresponding to a central point in the pedicle region of the screen. When using it, the central structure is aligned with the central point to complete the 3x3 grid layout. The central structure is set on the layout line of the 3x3 grid area, and it is a dot structure on the layout line. This setup makes it very easy to align this point with the central point of the pedicle region.

[0054] A more specific implementation method is as follows, refer to Figure 10 A length-adjustable connecting plate connects the two nine-grid structures to meet the needs of bilateral pedicle surgery. This setup allows for precise determination of bilateral puncture needle positions using a single structural configuration, making the entire procedure simpler and more effective. Alternatively, a connecting plate with adjustable length and angle can be used to ensure the effective placement of the two nine-grid plates.

[0055] The specific steps for determining the puncture location using the aforementioned positioning plate are as follows:

[0056] The vertebral body images obtained under anteroposterior fluoroscopy of the patient are presented. These images include the pedicle region, and the structures are displayed in the images.

[0057] By combining the size of the pedicle region area in the displayed structure of the image, a suitable nine-grid section of appropriate size is set within the basic frame to construct a suitable nine-grid structure.

[0058] The center of the nine-grid structure is aligned with the center of the pedicle region image, and the basic frame is set on the display structure.

[0059] By observing the position of the needle tip in the nine-square grid in the pedicle region image, we can understand the location of the needle insertion point and facilitate subsequent adjustments.

[0060] Furthermore, by fixing the patient's imaging distance and locating a fixed image display position for the pedicle region on the display structure, a nine-square grid is applied to the display plane. This allows the image of the pedicle region, obtained under anteroposterior fluoroscopy after the puncture needle is percutaneously inserted into the pedicle region via a guided puncture instrument, to be displayed on the display structure. Because the display method is the same, the image of the pedicle region with the puncture needle can be displayed at the same location, and the specific position of the puncture needle can be accurately determined through the nine-square grid structure fixed to the display unit. Specifically, by setting the nine-square grid unit on the display plane and adjusting the pedicle region with the puncture needle in the image obtained under anteroposterior fluoroscopy to the corresponding position within the nine-square grid unit, the position of the needle tip within the nine-square grid unit can be determined. This allows for accurate judgment of whether the needle tip position is optimal, making needle tip position determination simpler and easier. Even if inaccurate, adjustments can be quickly made to obtain the optimal needle tip position.

[0061] Example 2

[0062] By setting the nine-square grid unit on a plane parallel to the vertebral body image obtained under anteroposterior fluoroscopy, the pedicle region image in the vertebral body image obtained under anteroposterior fluoroscopy is directly compared with the pedicle region image in the vertebral body image obtained under anteroposterior fluoroscopy. The nine-square grid unit is positioned directly above the pedicle region image in the vertebral body image obtained under anteroposterior fluoroscopy, allowing direct comparison between the pedicle region image in the vertebral body image obtained under anteroposterior fluoroscopy and the nine-square grid unit. This allows for the acquisition of the nine-square grid area containing the pedicle region of the puncture needle tip in the pedicle region image obtained under anteroposterior fluoroscopy. Based on this comparison result, it can be determined whether the needle tip is at the optimal puncture insertion point.

[0063] The nine-square grid unit tracks the corresponding area of ​​the pedicle region in the image obtained under anteroposterior fluoroscopy. It obtains the center of the nine-square grid image frame and the center of the pedicle region, ensuring they coincide. The length of the nine-square grid image frame is consistent with and coincides with the long side of the pedicle region in the anteroposterior fluoroscopy image, and the width of the nine-square grid image frame is consistent with and coincides with the width of the long side perpendicular to the long side of the pedicle region in the anteroposterior fluoroscopy image. This method allows for a very quick determination of the position of the needle tip within the nine-square grid image under anteroposterior fluoroscopy projection of the patient.

[0064] The specific method for determining the puncture location using a nine-square grid image frame is as follows:

[0065] The pedicle region image corresponding to the surgery was obtained under the patient's anteroposterior X-ray fluoroscopy. Image tracking technology was used to track and find the two points with the largest distance between them in the pedicle region image, and a first line segment was constructed. Then, a second line segment perpendicular to the first line segment was constructed. The two ends of the second line segment were the edges of the pedicle region image. Two trisection points were found for the first line segment and the second line segment respectively. Two first nine-square grid line segments perpendicular to the first line segment were set at the two trisection points on the first line segment. Two second nine-square grid line segments perpendicular to the second line segment were set at the two trisection points on the second line segment. The first nine-square grid line segments and the second nine-square grid line segments and the pedicle region image constructed a tracking nine-square grid image frame.

[0066] When the pedicle region image obtained from the anteroposterior X-ray fluoroscopy of a patient with a puncture needle is displayed on the screen, the tracking nine-square image frame automatically tracks the corresponding pedicle region image for the surgery, obtaining the positional relationship between the puncture needle and the tracking nine-square grid. The surgery continues when the needle tip is in the optimal tracking nine-square position; when the needle tip is not in the optimal nine-square position, an output adjustment prompt is given. This method allows for a very quick and effective determination of whether the needle insertion point is in the optimal insertion position within the pedicle region.

[0067] The technical solutions of the embodiments of the present invention have been clearly and completely described above through specific embodiments. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. Those skilled in the art can easily understand other advantages and effects of the present invention from the content disclosed in this specification. The present invention can also be implemented or applied through other different specific embodiments. In the absence of conflict, the above embodiments and features in the embodiments can be combined with each other. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.

Claims

1. A nine-square grid positioning plate for percutaneous pedicle puncture location, characterized in that, The nine-square grid positioning plate is a structure fixed to the display plane; by adjusting the image distance of the patient, a fixed display position of the pedicle region is found, and the nine-square grid positioning plate is affixed to the display plane, including... The base frame is a plate-shaped frame with an adhesive structure for attaching to a display structure that can display the pedicle region of the image obtained under the patient's anteroposterior X-ray fluoroscopy. The base frame is a polygonal frame with a through channel on at least one border. The nine-grid structure includes an operation part and a nine-grid part. The nine-grid part enters the hollow space of the polygon frame through a through channel. One or four nine-grid parts enter the hollow space to form a strip nine-grid. The basic frame is a square frame, and the nine-square grid is a quadrilateral nine-square grid constructed by 4 horizontal lines and 4 vertical lines. Different quadrilateral nine-square grids with different areas are set. One nine-grid section is set up, which contains a complete nine-grid with stripes. Two operation parts are set on two opposite sides of the nine-grid with stripes. The operation parts are plate-shaped structures and their thickness is greater than the thickness of the stripes of the nine-grid with stripes. The through channel includes the nine-grid channels on both sides and the middle channel. The distance between the upper and lower side walls of the nine-grid channels is adapted to the thickness of the stripes of the nine-grid with stripes. The distance between the upper and lower side walls of the middle channel is adapted to the thickness of the operation parts. Alternatively, four identical nine-square grid sections can be set up. Each nine-square grid section includes an operation part and a rectangular structure with a line. The length of the rectangular structure with the line is equal to the side length of the inner frame of the base frame, and the width of the rectangular structure is equal to one-third of the side length of the inner frame of the base frame. A through-passage is set on the border of each base frame, and the through-passage is a two-layer through-passage. The through-passage of the same layer corresponds to the border position of two parallel base frames. A nine-square grid section enters the hollow space of the base frame through a through-passage.

2. The positioning plate according to claim 1, characterized in that, The base frame is set to a square frame.

3. The positioning plate according to claim 1, characterized in that, The positioning plate is used for locating the percutaneous pedicle puncture site; the positioning method is as follows. 1) Obtain vertebral body images of the pedicle region of the patient under anteroposterior X-ray fluoroscopy and display them on the display structure; 2) The nine-square grid area of ​​the positioning plate corresponds to a plane parallel to the vertebral body image obtained under the anteroposterior X-ray fluoroscopy of the patient. The nine-square grid area of ​​the positioning plate corresponds to the pedicle region image in the vertebral body image obtained under the anteroposterior X-ray fluoroscopy of the patient. The nine-square grid area is directly above the pedicle region image in the vertebral body image obtained under the anteroposterior X-ray fluoroscopy of the patient, so that the pedicle region image in the vertebral body image obtained under the anteroposterior X-ray fluoroscopy of the patient can be directly compared with the nine-square grid area of ​​the positioning plate to obtain the nine-square grid area where the pedicle region with the puncture needle tip is located in the image obtained under the anteroposterior X-ray fluoroscopy of the patient. The puncture position in the pedicle region is located and adjusted according to the nine-square grid area where the needle tip is located.

4. The positioning plate according to claim 1, characterized in that, When setting one nine-grid section, two operation sections are symmetrically set on both sides of the nine-grid line. The sum of the lengths of the two operation sections and the nine-grid line is greater than the outer frame side length of the base frame, and only the two borders of the base frame have through channels.

5. The positioning plate according to claim 4, characterized in that, Set up 3x3 grids of different sizes, and set up operation parts of different lengths accordingly. The length of the operation parts and the 3x3 grids is greater than the side length of the outer frame of the base frame, and the area of ​​the hollow space in the base frame is the same as the area of ​​the largest 3x3 grid.

6. The positioning plate according to claim 5, characterized in that, The basic frame is composed of two plate-shaped structures, and connecting blocks are set between the upper and lower layers corresponding to the two side frames where there is no through channel. The upper and lower layers are connected together as a whole by the connecting blocks.

7. The positioning plate according to claim 1, characterized in that, When a nine-grid section is set, the base frame is made of lightweight alloy material, while the strip nine-grid is made of lightweight plastic material, and the diameter of the strips in the strip nine-grid is less than 2mm.

8. The positioning plate according to claim 1, characterized in that, When a 3x3 grid is set, a central structure is set in the center of the 3x3 grid, corresponding to a central point of the pedicle region on the screen.

9. The positioning plate according to claim 8, characterized in that, The central structure is set on the setting line of the nine-square grid, and the central structure is a dot structure on the setting line.

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