Virtual realityを応用した脊椎外科手術の3次元シミュレーション

Three-Dimensional Surgical Simulation : Application of Virtual Reality to Spinal Surgery

　近年，工業，デザイン領域においてvirtual realityを応用して3次元立体データを処理できるforce feedback systemが用いられている．力覚を感じつつコンピュータ上で自由に3次元物体のモデリングを行うことができるforce feedback systemを使用して，複雑な形態を持つ先天性側弯症3例に3次元手術シミュレーションを試みた．CTで脊椎を撮影し，force feedback systemに取り込み，バーチャルツールをエアトームのように用い，3次元的骨切りを行った．本法は視覚のみならず，触覚を用いて脊椎の3次元構造を理解することができ，骨切りの高位や範囲などを繰り返し修正しながら検討することが可能であり非常に有用であった．今後，脊椎手術のトレーニング，教育のツールとしても応用が期待される．

　Because of the highly complicated structures involved in spinal surgery, a three-dimensional understanding of the anatomy and surgical planning is essential. The present study applied virtual reality technology to osteotomy of the spine. Virtual osteotomy in three cases of congenital scoliosis was performed on models of the spine created from computed tomographic (CT) data by a force feedback system, which provided the user with tactile cues from drill-like tools. The lines of the osteotomy and the extent of resection could be determined in the virtual scene, and the predicted appearance after osteotomy could be visualized. The virtual reality system facilitated comprehension of the complex structures and allowed simulation of a variety of congenital scoliosis pathology and verification that osteotomy was the most appropriate treatment. The system provides a useful means of training and education for spinal surgeons without putting patients at risk.