本研究發展一套智慧型脊椎手術導航流程以及電腦輔助椎足鑽孔導引訓練系統，經由數位X光機取得腰椎人工假骨頭(Sawbone)之Biplane(AP/Lat.)影像，經影像失真校正與對正建立雙影像間的座標關係，再導入三維座標量測儀整合實物與影像系統座標轉換。本研究同時提供專業醫師以滑鼠於AP與Lat.影像上繪製二維安全區域，以建立代表椎足鑽孔通道之三維安全區塊，住院醫師便可根據影像上展示的三維安全區域，以量測儀探針對應引導設定椎足安全鑽孔方位，根據專業醫師所定義探針進與出區域的數個等級以評定受訓成果，加以記錄並輸出。
本研究結合相機校正、影像處理與對正等技術，經由空間幾何的圖學技術於軟體上即時展現導引設備的方位資訊，提供醫師直覺化的3D空間資訊介面。此系統為臨床應用之先導性研究，相同流程可分別套用在胸椎及腰椎的訓練使用，未來其完整流程將可直接轉移至臨床上使用。

In this research, we developed an intelligent navigation workflow and computer-aided training system for pedicle screw implantation in spinal surgery. Base on the biplane X-ray imaging of a lumbar saw bone, spatial coordinate correlations between the physical saw bone and the 3D digitizer built an off-line training environment. A senior spine surgeon sketched 2D safety areas on biplane images to be projective intersection to generate 3D safety zones for pedicle insertion. The physicians are able to operate a 3D digitizer to set pedicle drilling position and orientation on saw bones in which 3D visualization is associated to the safety zones. Grading levels were preset by the senior spine surgeon to represent the test results of pedicle screw implantation.
The techniques developed in this system involve X-ray imaging rectification, registration, image processing, imaging dilation and erosion, bi-plane calibration, and spatial geometric transformation, which will be a pioneer study of further clinical applications. The same principles of pedicle insertion can be applied to either thoracic or lumbar spine.

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