針對嚴重脊椎側彎患者，臨床上多採用長節段後融合術治療，有時會延伸至骨盆以雙側雙骨盆釘固定增加脊椎的穩定性。嚴重脊椎側彎且骨盆變形或需接受二次手術的患者，骨盆可植入雙骨釘的安全空間有限，且固定強度需求更高，有術前植釘規劃必要性。以人工規劃骨盆植釘路徑仰賴醫師的臨床經驗，難以判斷固定性佳的植釘路徑與尺寸。
本研究開發電腦輔助雙骨盆釘植釘規劃軟體，透過骨盆解剖特徵，基於臨床安全需求的幾何拘束條件，半自動計算骨盆內安全植釘路徑及配合該路徑的最適合尺寸。我們比較三例人工規劃與本軟體規劃嚴重脊椎側彎案例的植釘路徑差異，以實作模型檢驗本方法的可行性。結果顯示，人工規劃植釘路徑未能完全滿足臨床安全需求，本半自動植釘規劃軟體則可完全滿足。
同時，分析不同路徑規劃與植釘尺寸組合下的骨盆釘力學表現。生物力學分析顯示，側彎患者在屈曲、伸展、左右側彎或軸向旋轉姿勢下，骨盆釘最大等效應力為438MPa，小於材料降伏強度；最大軸向力為181N，小於骨盆釘拔出強度。
本研究開發的半自動化植釘規劃軟體能根據個體骨盆解剖構造計算可行植釘路徑，同時最大化配合該路徑的骨盆釘尺寸，經生物力學分析模擬，植釘規劃有較低固定失效風險，可提供術前植釘路徑的建議。

This study presents a computer-assisted planning approach for bilateral dual pelvic screw implantation in patients with severe scoliosis, particularly those with pelvic deformity or undergoing revision surgery. Biomechanical analysis was conducted to evaluate the fixation stability of the planned constructs. Based on clinically defined safety requirements, geometric constraints were established to identify safe osseous corridors for dual pelvic screw placement and to determine the maximum allowable screw dimensions for each trajectory. Physical models were used to verify the feasibility of the proposed planning approach. Subsequently, patient-specific finite element models were constructed based on the planned screw trajectories and dimensions to simulate loading induced by spinal motion and body weight, and to analyze the biomechanical behavior of the pelvic screws.
The automated pelvic screw planning software was applied to three patients with severe scoliosis, and the planning results satisfied the prescribed safety clearances from critical anatomical structures while providing recommendations for the maximum allowable screw diameter and length. Biomechanical analysis indicated that the maximum von Mises stress remained below the material's yield strength, and that axial forces were lower than the commonly reported pull-out force.
The proposed automatic planning approach enables the computation of feasible screw trajectories based on patient-specific pelvic anatomy, and biomechanical evaluation indicates a lower risk of fixation failure. This approach may provide useful guidance for preoperative planning of dual pelvic screw implantation in complex scoliosis cases.

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