技术领域：Technical field:
本发明涉及骨骼矫形器技术领域，具体涉及一种用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器及应用方法。The present invention relates to the technical field of bone orthoses, and in particular to an intelligent dynamic orthosis for osteoporotic compression fractures of lumbar vertebrae and an application method thereof.
背景技术：Background technique:
骨质疏松症是由于多种原因导致的骨密度和骨质量下降，骨微结构破坏，造成骨脆性增加，从而容易发生骨折的全身性骨病。骨质疏松症每年引起全球范围约890万例患者发生骨折，平均每3秒发生1例次，50岁以上约1/3的女性和1/5的男性将会发生骨质疏松性骨折。椎体是最常见的骨质疏松性骨折发生部位，骨质疏松性椎体压缩性骨折(Osteoporotic vertebral compression fracture，OVCF)，约50％以上骨质疏松性骨折发生于椎体，好发于胸腰段。2017年我国流行病学研究显示，北京绝经后女性影像学椎体骨折的患病率随年龄增加，50～59岁患病率为13.4％，80岁以上高达58.1％；北京另一项研究显示，2000年，椎体骨折患病率50～59岁为15％，80岁以上为36.6％。一项应用模拟模型研究显示，我国2015年50岁以上人群，新发OVCF约为127万例；预计到2020年，将达到约149万例；到2050年，则可高达约300万例。对于骨质疏松引起的椎体压缩性骨折，多见于老年人。在老年人出现椎体部位钙质异常流失以后，很容易导致椎体部位的骨质出现异常的骨量流失，引起骨质疏松，从而引起椎体的牢固性减弱，特别是对于椎体部位的承重力会明显的遭受破坏，从而在椎体部位遭受轻度的外伤以后，就会引起椎体压缩性的骨折。《骨质疏松性椎体压缩性骨折诊疗与管理专家共识(2018版)》提出，如果骨质疏松椎体压缩性骨折，椎体的高度压缩不超过1/3，这种情况可以采用保守的卧床休息治疗就可以，一般采用矫形器辅助治疗，并且治疗期间一定要注意钙质的补充，以避免出现骨质疏松椎体压缩的加重。Osteoporosis is a systemic bone disease caused by a decrease in bone density and quality, destruction of bone microstructure, increased bone brittleness, and increased risk of fractures due to a variety of reasons. Osteoporosis causes about 8.9 million fractures in patients worldwide each year, with an average of one fracture every three seconds. About one-third of women and one-fifth of men over the age of 50 will suffer from osteoporotic fractures. The vertebral body is the most common site of osteoporotic fractures. Osteoporotic vertebral compression fractures (OVCF), about 50% of osteoporotic fractures occur in the vertebral body, and are more common in the thoracolumbar region. An epidemiological study in my country in 2017 showed that the prevalence of radiographic vertebral fractures in postmenopausal women in Beijing increased with age, with a prevalence of 13.4% in those aged 50 to 59 and as high as 58.1% in those aged 80 and above; another study in Beijing showed that in 2000, the prevalence of vertebral fractures was 15% in those aged 50 to 59 and 36.6% in those aged 80 and above. A study using a simulation model showed that in 2015, there were about 1.27 million new cases of OVCF in people over 50 years old in my country; it is expected to reach about 1.49 million cases by 2020; and up to about 3 million cases by 2050. Vertebral compression fractures caused by osteoporosis are more common in the elderly. After the elderly have abnormal loss of calcium in the vertebral part, it is easy to cause abnormal bone loss in the vertebral part, causing osteoporosis, which will weaken the firmness of the vertebral body, especially the load-bearing capacity of the vertebral part will be significantly damaged, so after a mild trauma to the vertebral part, it will cause vertebral compression fractures. The "Expert Consensus on Diagnosis, Treatment and Management of Osteoporotic Vertebral Compression Fractures (2018 Edition)" proposes that if the height of the vertebral body is compressed by no more than 1/3 in osteoporotic vertebral compression fractures, conservative bed rest can be used for treatment, and orthotics are generally used for auxiliary treatment. During the treatment, attention must be paid to calcium supplementation to avoid the aggravation of osteoporotic vertebral compression.
现有的用于OVCF的矫形器主要可归为穿戴式与平台式两种。其中穿戴式矫形器整体为固定的外部支撑固定，其原理是利用内加弹性支条增强的材料裹住躯干，给腰部及腹部软组织施加一定的压力提高腹腔内压，借以减轻体重对胸腰椎的负重，限制脊柱运动，主要起到固定支撑脊柱、矫治脊柱畸形、减轻脊柱纵向压力以及避免二次伤害的作用。穿戴式矫形器虽然经济适用，穿戴方便，患者依从性好等优点，但其治疗作用有限，并造成废用性肌萎缩及腰椎关节僵硬及功能障碍等缺点。平台式矫形器主要是大型固定式矫形平台，一般分为矫形床与控制器两部分组成，该型矫形器可以做到多体位功能康复训练，有一定的临床数据支撑，但往往因为其治疗费用以及便捷程度而造成患者依从性较低。专利申请号为CN201611235348.4的专利通过三点压力机构及其压板装置在人体脊柱前后形成三点压力系统，并通过调节装置调整压板装置的压力大小，不仅能起到对胸腰椎的固定作用，还可有效地矫正或控制胸腰椎体的非正常弯曲；并且配合控制机构以及测试元件，根据压板装置的实际施压大小及施压需求，进行手动调节，或者通过控制机构自动调节，也可二者结合进行调压，用以维持脊柱的正常生理曲线，使压缩、变形的椎体及椎间隙恢复到原有位置，达到治疗压缩性骨折的效果。但是现有的矫形器均无法满足智能化动态矫形器的要求，即不具备收集佩戴患者的背部肌电信号、收集佩戴患者6自由度获得的运动数据，如旋转角速度等；收集患者腹背部作用力及压力大小、基于多关节串、并联的力输出机构支持可调节幅度和方向的动态扭矩输出等功能，亦无法完成个体数据收集与分析，建档与归纳、治疗周期与治疗模式的设定安全值限定与最大值限定、肌肉电刺激等康复功能、可穿戴性等舒适性/小型化/便捷式设计反馈跟进机制以及结合数据根据矫治路径判断治疗方案及流程。因此，现有的矫形器无法满足老年OVCF的快速康复以及较高质量的功能锻炼的功能。Existing orthoses for OVCF can be mainly divided into two types: wearable and platform. Among them, the wearable orthosis is fixed externally supported as a whole. Its principle is to wrap the trunk with materials reinforced by internal elastic strips, apply a certain pressure to the waist and abdominal soft tissues to increase the intra-abdominal pressure, thereby reducing the weight load on the thoracic and lumbar spine, and limiting the movement of the spine. It mainly plays the role of fixing and supporting the spine, correcting spinal deformities, reducing the longitudinal pressure of the spine, and avoiding secondary injuries. Although wearable orthoses are economical, easy to wear, and have good patient compliance, their therapeutic effects are limited, and they cause disuse muscle atrophy, lumbar joint stiffness, and dysfunction. Platform orthoses are mainly large fixed orthopedic platforms, generally divided into two parts: an orthopedic bed and a controller. This type of orthosis can achieve multi-position functional rehabilitation training and has certain clinical data support, but it often causes low patient compliance due to its treatment costs and convenience. The patent with patent application number CN201611235348.4 forms a three-point pressure system in front and behind the human spine through a three-point pressure mechanism and its pressure plate device, and adjusts the pressure of the pressure plate device through an adjusting device, which can not only fix the thoracic and lumbar vertebrae, but also effectively correct or control the abnormal curvature of the thoracic and lumbar vertebrae; and cooperates with the control mechanism and the test element, according to the actual pressure size and pressure demand of the pressure plate device, manual adjustment is performed, or automatic adjustment is performed through the control mechanism, or the two can be combined for pressure adjustment to maintain the normal physiological curve of the spine, so that the compressed and deformed vertebral bodies and intervertebral spaces are restored to their original positions, thereby achieving the effect of treating compression fractures. However, the existing orthoses cannot meet the requirements of intelligent dynamic orthosis, that is, they do not have the functions of collecting the back electromyographic signals of the patient, collecting the motion data obtained by the patient's 6 degrees of freedom, such as rotational angular velocity, etc., collecting the force and pressure of the patient's abdomen and back, and supporting dynamic torque output with adjustable amplitude and direction based on multi-joint series and parallel force output mechanisms. They are also unable to complete individual data collection and analysis, file creation and induction, setting safety value limits and maximum value limits for treatment cycles and treatment modes, rehabilitation functions such as muscle electrical stimulation, wearable and other comfort/miniaturization/convenient design feedback follow-up mechanisms, and combining data to judge the treatment plan and process according to the correction path. Therefore, the existing orthosis cannot meet the functions of rapid rehabilitation and high-quality functional training for elderly OVCF.
发明内容：Summary of the invention:
(一)解决的技术问题1. Technical issues to be solved
本发明旨在提供一种用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器及应用方法，解决现有设备无法满足老年骨质疏松性椎体压缩性骨折的快速康复以及无法辅助进行较高质量的功能锻炼的问题。The present invention aims to provide an intelligent dynamic orthosis for osteoporotic vertebral compression fractures of the lumbar vertebrae and an application method, so as to solve the problem that the existing equipment cannot meet the rapid recovery of osteoporotic vertebral compression fractures in the elderly and cannot assist in high-quality functional training.
(二)技术方案(II) Technical solution
为解决上述技术问题，本发明采用如下技术方案：一种用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器，包括外固定架、内衬和驱动装置，所述外固定架包括上固定环、中固定环和下固定环，所述内衬设置在所述上固定环、所述中固定环和所述下固定环的内侧，所述驱动装置包括电源、控制系统和驱动机构，所述驱动机构有六个，其中两个所述驱动机构连接所述上固定环和所述中固定环的背面，两个所述驱动机构连接所述中固定环和所述下固定环的背面，两个所述驱动机构连接所述上固定环、所述中固定环和所述下固定环的侧面，所述驱动机构在所述控制系统的控制下实现所述上固定环、所述中固定环相对于所述下固定环的六自由度运动。In order to solve the above technical problems, the present invention adopts the following technical solutions: an intelligent dynamic orthosis for osteoporotic compression fractures of lumbar vertebrae, comprising an external fixator, an inner liner and a driving device, wherein the external fixator comprises an upper fixing ring, a middle fixing ring and a lower fixing ring, the inner liner is arranged on the inner side of the upper fixing ring, the middle fixing ring and the lower fixing ring, the driving device comprises a power supply, a control system and a driving mechanism, there are six driving mechanisms, two of which are connected to the back sides of the upper fixing ring and the middle fixing ring, two of which are connected to the back sides of the middle fixing ring and the lower fixing ring, and two of which are connected to the side sides of the upper fixing ring, the middle fixing ring and the lower fixing ring, and the driving mechanism realizes six-degree-of-freedom movement of the upper fixing ring and the middle fixing ring relative to the lower fixing ring under the control of the control system.
所述上固定环用于贴合固定在患者的胸段周围，所述中固定环用于贴合固定在患者的腹段周围，所述下固定环用于贴合固定在患者骨盆处，所述驱动装置通过控制所述驱动机构的运动方向和角度，使所述上固定环和所述中固定环相对于所述下固定环在垂直和前后、左右六个方向活动，从而实现模拟脊柱六自由度运动，可以帮助患者便捷精确地进行康复功能锻炼，避免关节僵硬，废用性肌萎缩；还可以对脊柱进行纵向垂体拉伸，通过保守治疗地方式一定程度上恢复骨折压缩程度，从而获得更好的预后。The upper fixing ring is used to fit and fix around the patient's thoracic segment, the middle fixing ring is used to fit and fix around the patient's abdominal segment, and the lower fixing ring is used to fit and fix at the patient's pelvis. The driving device controls the movement direction and angle of the driving mechanism to make the upper fixing ring and the middle fixing ring move in six directions: vertical, front and back, and left and right relative to the lower fixing ring, thereby simulating six-degree-of-freedom movement of the spine, which can help patients perform rehabilitation functional exercises conveniently and accurately, avoid joint stiffness and disuse muscle atrophy; it can also perform longitudinal pituitary stretching on the spine, and restore the degree of fracture compression to a certain extent through conservative treatment, thereby obtaining a better prognosis.
进一步地，所述驱动机构包括上安装座、下安装座、两个支撑杆、伸缩杆和直线电机，两个所述支撑杆分别设置在所述上安装座和所述下安装座上，所述直线电机驱动所述伸缩杆，所述直线电机与所述伸缩杆的一端分别与所述上安装座和所述下安装座上的所述支撑杆铰接，所述上安装座与所述下安装座用于与所述外固定架固定连接。所述上安装座和所述下安装座分别用于与所述上固定环、所述中固定环和所述下固定环的外侧固定连接，所述直线电机用于在所述控制系统的控制下驱动所述伸缩杆伸缩，以根据规划的矫正路径调整所述伸缩杆的杆长和相对于所述支撑杆的旋转角度。Furthermore, the driving mechanism includes an upper mounting seat, a lower mounting seat, two support rods, a telescopic rod and a linear motor, the two support rods are respectively arranged on the upper mounting seat and the lower mounting seat, the linear motor drives the telescopic rod, the linear motor and one end of the telescopic rod are respectively hinged with the support rods on the upper mounting seat and the lower mounting seat, and the upper mounting seat and the lower mounting seat are used to be fixedly connected to the external fixation frame. The upper mounting seat and the lower mounting seat are respectively used to be fixedly connected to the outer sides of the upper fixing ring, the middle fixing ring and the lower fixing ring, and the linear motor is used to drive the telescopic rod to extend and retract under the control of the control system, so as to adjust the rod length of the telescopic rod and the rotation angle relative to the support rod according to the planned correction path.
进一步地，所述上安装座和所述下安装座上均设有力传感器，所述力传感器与所述控制系统电连接。所述控制系统可以为不同患者的不同类型压缩性骨折的治疗提供个性化治疗方案，根据已有的矫治路径进行智能化矫形，所述力传感器用于测量所述外固定架不同部位的受力，为所述控制系统提供患者身体不同部位的受力反馈，以修正矫正路径，保证较好的矫正效果。Furthermore, the upper mounting seat and the lower mounting seat are both provided with force sensors, and the force sensors are electrically connected to the control system. The control system can provide personalized treatment plans for the treatment of different types of compression fractures of different patients, and perform intelligent correction according to the existing correction path. The force sensor is used to measure the force on different parts of the external fixator, and provide the control system with force feedback on different parts of the patient's body to correct the correction path and ensure a better correction effect.
进一步地，所述伸缩杆上设有用于测量所述伸缩杆杆长的位移传感器。以便于所述控制系统获取每个所述伸缩杆的实时杆长参数，方便对所述伸缩杆的伸缩长度进行精准调节。Furthermore, the telescopic rod is provided with a displacement sensor for measuring the length of the telescopic rod, so that the control system can obtain the real-time length parameter of each telescopic rod and accurately adjust the telescopic length of the telescopic rod.
进一步地，所述支撑杆与所述上安装座之间为竖直方向可滑动式连接，所述支撑杆与所述下安装座之间为水平方向可滑动式连接，所述上安装座和所述下安装座上均设有用于锁紧所述支撑杆位置的锁紧螺钉。所述上安装座上的所述支撑杆可以调节竖直方向的安装长度，所述下安装座上的所述支撑杆可以调节水平方向的安装长度，便于根据患者体型调整所述上固定环、所述中固定环和所述下固定环在患者身上的安装距离和角度，保证患者舒适性。Furthermore, the support rod is slidably connected to the upper mounting seat in the vertical direction, and is slidably connected to the lower mounting seat in the horizontal direction. The upper mounting seat and the lower mounting seat are both provided with locking screws for locking the position of the support rod. The support rod on the upper mounting seat can adjust the installation length in the vertical direction, and the support rod on the lower mounting seat can adjust the installation length in the horizontal direction, so as to facilitate adjusting the installation distance and angle of the upper fixing ring, the middle fixing ring and the lower fixing ring on the patient according to the patient's body shape, thereby ensuring the patient's comfort.
进一步地，所述外固定架上设有若干个振动按摩器。所述振动按摩器用于对患者脊柱部位进行振动按摩，促进椎体骨折部位的恢复。Furthermore, the external fixator is provided with a plurality of vibration massagers, which are used to perform vibration massage on the patient's spine to promote the recovery of the vertebral fracture.
进一步地，所述外固定架采用轻质合金制作，所述内衬为柔性透气软垫。保证在患者身上固定效果的同时提高舒适性。Furthermore, the external fixator is made of light alloy, and the inner lining is a flexible breathable cushion, thereby ensuring the fixation effect on the patient and improving comfort.
本发明还提供了一种用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器的应用方法，包括以下步骤：The present invention also provides an application method of an intelligent dynamic orthosis for lumbar vertebral osteoporotic compression fractures, comprising the following steps:
步骤一，获取健康志愿者和椎体压缩性骨折患者在多种姿态下的样本集数据，所述样本集数据包括：健康者和椎体压缩性骨折患者对应胸椎和腰椎的Cobb角信息、冠状位偏移距、顶椎偏移距以及患者基础信息；Step 1: obtaining sample set data of healthy volunteers and patients with vertebral compression fractures in various postures, wherein the sample set data includes: Cobb angle information, coronal offset, apical vertebra offset and basic information of the thoracic and lumbar vertebrae of the healthy volunteers and patients with vertebral compression fractures;
步骤二，通过所述样本集数据建立深度神经网络DNN模型，以收集到的健康者的所述样本集数据为基准，确定椎体压缩性骨折患者的矫正路径规划；Step 2: establishing a deep neural network (DNN) model through the sample set data, and determining the correction path planning for patients with vertebral compression fractures based on the sample set data collected from healthy people;
步骤三，将所述外固定架设置在椎体压缩性骨折患者身上，根据所述控制系统获取的所述力传感器和所述位移传感器的反馈数据，结合获取的所述样本集数据，建立外固定数学模型，量化反馈输入，对矫正路径进行优化；所述外固定数学模型用于描述矫正骨段在三维空间的位置信息以及运动信息；通过直角坐标路径控制法对所述矫正骨段进行直线轨迹规划，获取所述矫正骨段的位置姿态参数；根据所述矫正骨段的位置姿态参数，获取六个所述伸缩杆的长度参数；Step three, the external fixator is set on the patient with vertebral compression fracture, and according to the feedback data of the force sensor and the displacement sensor obtained by the control system, combined with the obtained sample set data, an external fixation mathematical model is established, the feedback input is quantified, and the correction path is optimized; the external fixation mathematical model is used to describe the position information and motion information of the correction bone segment in three-dimensional space; the straight line trajectory of the correction bone segment is planned by the rectangular coordinate path control method to obtain the position and posture parameters of the correction bone segment; according to the position and posture parameters of the correction bone segment, the length parameters of the six telescopic rods are obtained;
步骤四，基于六个多关节串、并联的所述驱动机构，通过所述控制系统控制所述驱动机构进行可以调节幅度和方向的动态扭矩输出，以使分别贴合在骨盆、腰段和胸段上的所述下固定环、所述中固定环和所述上固定环实现六自由度运动，从而实现腰部(移动骨段)和胸部(移动骨段)相对于骨盆(参照骨段)的全自由度运动，实现对脊柱位姿的精确控制。Step 4: Based on the six multi-joint serial and parallel drive mechanisms, the control system controls the drive mechanisms to output dynamic torque with adjustable amplitude and direction, so that the lower fixing ring, the middle fixing ring and the upper fixing ring respectively attached to the pelvis, waist segment and thoracic segment can achieve six-degree-of-freedom movement, thereby achieving full-degree-of-freedom movement of the waist (moving bone segment) and chest (moving bone segment) relative to the pelvis (reference bone segment), and achieving precise control of the spinal posture.
其中，所述健康者和椎体压缩性骨折患者对应胸椎和腰椎的Cobb角信息、冠状位偏移距、顶椎偏移距，具体为：获取健康者和椎体压缩性骨折患者的CT或X射线图片，将骶1椎体中点作为原点，将其与胸1椎体的竖直方向距离标记为纵坐标的单位100，通过标注的12个胸椎、5个腰椎的中点位置得到每个椎体的坐标，测量得到胸椎和腰椎弯曲方向切线相交得到的夹角记作Cobb角，胸1椎体横坐标为冠状位偏移距，顶椎中点横坐标为顶椎偏移距。Among them, the Cobb angle information, coronal offset, and apical vertebra offset of the thoracic and lumbar vertebrae corresponding to the healthy people and patients with vertebral compression fractures are specifically as follows: CT or X-ray images of healthy people and patients with vertebral compression fractures are obtained, the midpoint of the sacral 1 vertebra is taken as the origin, and the vertical distance between it and the thoracic 1 vertebra is marked as the unit of the ordinate 100, and the coordinates of each vertebra are obtained by the midpoint positions of the marked 12 thoracic vertebrae and 5 lumbar vertebrae. The angle obtained by the intersection of the tangents of the thoracic and lumbar bending directions is measured and recorded as the Cobb angle, the horizontal coordinate of the thoracic 1 vertebra is the coronal offset, and the horizontal coordinate of the midpoint of the apical vertebra is the apical vertebra offset.
所述外固定数学模型包括：The external fixation mathematical model includes:
以所述下固定环(参照环)中心为原点建立局部坐标系{B}，分别以所述中固定环(移动环)和所述上固定环(移动环)中心为原点建立局部坐标系{P}，以参照骨段的“起始点”为原点建立全局坐标系{U}；读取六个所述驱动机构上所述伸缩杆的杆长的初始值：L1、L2、L3、L4、L5、L6，利用位姿正解算法计算出移动环相对于参照环的初始位姿，用位姿矩阵表示：A local coordinate system {B} is established with the center of the lower fixed ring (reference ring) as the origin, a local coordinate system {P} is established with the centers of the middle fixed ring (moving ring) and the upper fixed ring (moving ring) as the origin, and a global coordinate system {U} is established with the "starting point" of the reference bone segment as the origin; the initial values of the lengths of the telescopic rods on the six driving mechanisms are read: L1, L2, L3, L4, L5, L6, and the initial posture of the moving ring relative to the reference ring is calculated using the posture forward solution algorithm, and the posture matrix is used. express:
式中，表示移动环坐标{P}相对于参照环坐标{B}的姿态转换矩阵，/>表示{P}坐标原点相对于{B}坐标系的位置；In the formula, represents the attitude transformation matrix of the mobile ring coordinates {P} relative to the reference ring coordinates {B},/> Indicates the position of the {P} coordinate origin relative to the {B} coordinate system;
由标准正位X光片和标准侧位X光片测量畸形参数，所述畸形参数包括由标准正位X光片和标准侧位X光片测得的三个位移和三个成角：Deformity parameters are measured from standard anteroposterior X-rays and standard lateral X-rays, and the deformity parameters include three displacements and three angles measured from standard anteroposterior X-rays and standard lateral X-rays:
内侧或外侧的正位位移：标准正位X光片上测量，从起始点到对应点沿X轴方向的距离；Medial or lateral anteroposterior displacement: measured on a standard anteroposterior X-ray film, the distance from the starting point to the corresponding point along the X-axis;
外翻或内翻的正位角度：标准正位X光片上测量，两骨段轴线的夹角；The anteroposterior angle of valgus or varus is the angle between the axes of the two bone segments measured on a standard anteroposterior X-ray.
前部或后部的侧位位移：标准侧位X光片上测量，从起始点到对应点沿Y轴方向的距离；Anterior or posterior lateral displacement: measured on a standard lateral X-ray film, the distance from the starting point to the corresponding point along the Y axis;
屈曲或反张的侧位角度：侧位X光片上测量，两骨段轴线的夹角；Lateral angle of flexion or extension: the angle between the axes of the two bone segments measured on a lateral X-ray;
压缩或分离的轴向位移：在正位X光片或侧位X光片上测量，从起始点到对应点沿Z轴方向的距离；Axial displacement of compression or separation: measured on the anteroposterior or lateral X-ray film, the distance from the starting point to the corresponding point along the Z axis;
外旋或内旋的轴向角度：测量参照骨段与移动骨段矢状面上的旋转夹角。Axial angle of external or internal rotation: Measure the angle of rotation between the reference bone segment and the translated bone segment in the sagittal plane.
其中，设绕固定轴X-Y-Z的转角为α’，β’，γ’，从测量的所述畸形参数中得到：Wherein, assuming that the rotation angles around the fixed axis X-Y-Z are α', β', γ', the following are obtained from the measured deformity parameters:
式中，cα＝cosα，sα＝sinα，cβ＝cosβ，sβ＝sinβ，cγ＝cosγ，sγ＝sinγIn the formula, cα＝cosα，sα＝sinα，cβ＝cosβ，sβ＝sinβ，cγ＝cosγ，sγ＝sinγ
令make
联立(2)和(3)得解得结果如下：Combining (2) and (3) we get The solution is as follows:
(1)cosβ’≠0则：(1) cosβ’≠0:
α’＝Atan2(r23,r33)α'＝Atan2(r23 ,r33 )
γ’＝Atan2(r12,r11)γ'＝Atan2(r12 ,r11 )
(2)β’＝±90°则：(2) β’＝±90° then:
α’＝0α’＝0
γ’＝±Atan2(r21,r22)γ'＝±Atan2(r21 ,r22 )
其中，Atan2(y，x)表示双变量反正切函数，x和y的符号确定角度所在的象限，上式解出的[α’，β’，γ’]T即为实际中所述外固定架绕X、Y、Z轴的旋转量。Wherein, Atan2(y, x) represents a two-variable inverse tangent function, the signs of x and y determine the quadrant in which the angle is located, and the [α', β', γ']T obtained by solving the above formula is the actual rotation amount of the external fixator around the X, Y, and Z axes.
测量框架参数，所述框架参数包括由标准正位X光片和标准侧位X光片测得的3个偏移及1个成角：The framework parameters are measured, including 3 offsets and 1 angle measured from standard anteroposterior and lateral X-rays:
内侧或外侧的参照环中心正位偏移：标准正位X光片上测量，参照环中心相对于起始点的偏移；Medial or lateral anteroposterior deviation of the reference ring center: the deviation of the reference ring center relative to the starting point measured on a standard anteroposterior radiograph;
前部或后部的参照环中心侧位偏移：标准侧位X光片上测量，参照环中心相对于起始点的偏移；Anterior or posterior lateral deviation of the reference ring center: the deviation of the reference ring center relative to the starting point measured on a standard lateral radiograph;
参照环中心轴向偏移：标准正位X光片上测量或标准侧位X光片上测量，从参照环的边缘至起始点之间的轴向距离；Axial offset of the reference ring center: the axial distance from the edge of the reference ring to the starting point measured on a standard anteroposterior X-ray or a standard lateral X-ray;
外旋或内旋的参照环旋转角度：临床测量参照环的矢状面相对于参照骨段矢状面的旋转角度；External or internal rotation of the reference ring: The rotation angle of the sagittal plane of the reference ring relative to the sagittal plane of the reference bone segment is clinically measured;
从测量的所述框架参数中得到参照环相对于参照骨段的位姿矩阵，用表示，得到移动环相对于参照骨段的位姿矩阵：The pose matrix of the reference ring relative to the reference bone segment is obtained from the measured frame parameters. Indicates that the position matrix of the moving ring relative to the reference bone segment is obtained:
将以移动环中心、移动骨段所述对应点为原点建立的局部坐标系{P}、{U}拟合到全局坐标系得到移动环相对于移动骨段的位姿矩阵：The local coordinate systems {P} and {U} established with the center of the mobile ring and the corresponding points of the mobile bone segment as the origin are fitted to the global coordinate system to obtain the position matrix of the mobile ring relative to the mobile bone segment:
式中，表示移动骨段相对于参照骨段的位姿矩阵，由变量[x，y，z，α’，β’，γ’]构成，其中[x，y，z]和[α’，β’，γ’]分别表示所述对应点相对于“起始点”在三个方向上的位移偏移量及三个方向的旋转角度。In the formula, The pose matrix representing the moving bone segment relative to the reference bone segment is composed of the variables [x, y, z, α', β', γ'], where [x, y, z] and [α', β', γ'] represent the displacement offsets of the corresponding points in three directions and the rotation angles in three directions relative to the "starting point", respectively.
(三)有益效果(III) Beneficial effects
相对于现有技术，本发明产生的有益效果是：通过在患者身上设置外固定架、内衬和驱动装置，外固定架包括上固定环、中固定环和下固定环，驱动装置包括电源、控制系统和驱动机构，驱动机构有六个，驱动机构在控制系统的控制下实现上固定环、中固定环相对于下固定环的六自由度运动，从而实现模拟脊柱六自由度运动，可以良好地固定患者腰椎骨折部位，并帮助患者便捷精确地进行康复功能锻炼，避免关节僵硬，废用性肌萎缩；还可以对脊柱进行纵向垂体拉伸，通过保守治疗地方式一定程度上恢复骨折压缩程度，以帮助患处进行较好的功能锻炼，从而获得更好的预后。Compared with the prior art, the beneficial effects of the present invention are as follows: an external fixator, an inner liner and a driving device are arranged on the patient, the external fixator includes an upper fixing ring, a middle fixing ring and a lower fixing ring, the driving device includes a power supply, a control system and a driving mechanism, there are six driving mechanisms, and the driving mechanism realizes six-degree-of-freedom movement of the upper fixing ring and the middle fixing ring relative to the lower fixing ring under the control of the control system, thereby simulating six-degree-of-freedom movement of the spine, which can well fix the patient's lumbar fracture site and help the patient to perform rehabilitation functional exercises conveniently and accurately to avoid joint stiffness and disuse muscle atrophy; the spine can also be longitudinally pituitary stretched, and the degree of fracture compression can be restored to a certain extent through conservative treatment to help the affected area to perform better functional exercises, thereby obtaining a better prognosis.
附图说明：Description of the drawings:
为了更清楚地说明本发明实施例中的技术方案，下面将对实施例中所需要使用的附图作简单地介绍。In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings required for use in the embodiments are briefly introduced below.
图1是本发明实施例所述用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器的整体结构示意图；FIG1 is a schematic diagram of the overall structure of an intelligent dynamic orthosis for treating osteoporotic compression fractures of lumbar vertebrae according to an embodiment of the present invention;
图2是本发明实施例所述用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器的俯视剖视图；FIG2 is a top cross-sectional view of the intelligent dynamic orthosis for lumbar vertebral osteoporotic compression fractures according to an embodiment of the present invention;
图3是本发明实施例所述用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器所述驱动机构部位的结构示意图；3 is a schematic structural diagram of the driving mechanism of the intelligent dynamic orthosis for lumbar vertebral osteoporotic compression fractures according to an embodiment of the present invention;
图4是本发明实施例所述用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器所述驱动机构部位的剖视图；4 is a cross-sectional view of the driving mechanism of the intelligent dynamic orthosis for lumbar vertebral osteoporotic compression fractures according to an embodiment of the present invention;
图5是本发明实施例所述用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器所述下固定座部位的剖视图；5 is a cross-sectional view of the lower fixing seat of the intelligent dynamic orthosis for lumbar vertebral osteoporotic compression fractures according to an embodiment of the present invention;
图6是本发明实施例所述用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器的控制原理框图；6 is a control principle block diagram of the intelligent dynamic orthosis for lumbar vertebral osteoporotic compression fractures according to an embodiment of the present invention;
图中：1、外固定架；11、上固定环；12、中固定环；13、下固定环；2、内衬；3、驱动装置；31、电源；32、控制系统；33、驱动机构；331、上安装座；332、下安装座；333、支撑杆；334、伸缩杆；335、直线电机；4、力传感器；5、位移传感器；6、锁紧螺钉；7、振动按摩器In the figure: 1, external fixing frame; 11, upper fixing ring; 12, middle fixing ring; 13, lower fixing ring; 2, lining; 3, driving device; 31, power supply; 32, control system; 33, driving mechanism; 331, upper mounting seat; 332, lower mounting seat; 333, support rod; 334, telescopic rod; 335, linear motor; 4, force sensor; 5, displacement sensor; 6, locking screw; 7, vibration massager
具体实施方式：Detailed ways:
下面将结合本发明实施例中的附图，对本发明实施例中的技术方案进行清楚、完整地描述。The technical solutions in the embodiments of the present invention will be described clearly and completely below in conjunction with the accompanying drawings in the embodiments of the present invention.
如图1、图2、图3、图4、图5和图6所示的一种用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器，包括外固定架1、内衬2和驱动装置3，外固定架1包括上固定环11、中固定环12和下固定环13，内衬2设置在上固定环11、中固定环12和下固定环13的内侧，驱动装置3包括电源31、控制系统32和驱动机构33，驱动机构33有六个，其中两个驱动机构33连接上固定环11和中固定环12的背面，两个驱动机构33连接中固定环12和下固定环13的背面，两个驱动机构33连接上固定环11、中固定环12和下固定环13的侧面，驱动机构33在控制系统32的控制下实现上固定环11、中固定环12相对于下固定环13的六自由度运动。As shown in Figures 1, 2, 3, 4, 5 and 6, an intelligent dynamic orthosis for lumbar vertebral osteoporotic compression fractures includes an external fixator 1, a liner 2 and a drive device 3. The external fixator 1 includes an upper fixing ring 11, a middle fixing ring 12 and a lower fixing ring 13. The liner 2 is arranged on the inner side of the upper fixing ring 11, the middle fixing ring 12 and the lower fixing ring 13. The drive device 3 includes a power supply 31, a control system 32 and a drive mechanism 33. There are six drive mechanisms 33, two of which are connected to the back of the upper fixing ring 11 and the middle fixing ring 12, two of which are connected to the back of the middle fixing ring 12 and the lower fixing ring 13, and two of which are connected to the side surfaces of the upper fixing ring 11, the middle fixing ring 12 and the lower fixing ring 13. The drive mechanism 33 realizes six-degree-of-freedom movement of the upper fixing ring 11 and the middle fixing ring 12 relative to the lower fixing ring 13 under the control of the control system 32.
优选地，驱动机构33包括上安装座331、下安装座332、两个支撑杆333、伸缩杆334和直线电机335，两个支撑杆333分别设置在上安装座331和下安装座332上，直线电机335驱动伸缩杆334，直线电机335与伸缩杆334的一端分别与上安装座331和下安装座332上的支撑杆333铰接，上安装座331与下安装座332用于与外固定架1固定连接。上安装座331和下安装座332分别用于与上固定环11、中固定环12和下固定环13的外侧固定连接，直线电机335用于在控制系统32的控制下驱动伸缩杆334伸缩，以根据规划的矫正路径调整伸缩杆334的杆长和相对于支撑杆333的旋转角度。Preferably, the driving mechanism 33 includes an upper mounting seat 331, a lower mounting seat 332, two support rods 333, a telescopic rod 334 and a linear motor 335. The two support rods 333 are respectively arranged on the upper mounting seat 331 and the lower mounting seat 332. The linear motor 335 drives the telescopic rod 334. One end of the linear motor 335 and the telescopic rod 334 are respectively hinged with the support rods 333 on the upper mounting seat 331 and the lower mounting seat 332. The upper mounting seat 331 and the lower mounting seat 332 are used to be fixedly connected to the external fixation frame 1. The upper mounting seat 331 and the lower mounting seat 332 are respectively used to be fixedly connected to the outer sides of the upper fixing ring 11, the middle fixing ring 12 and the lower fixing ring 13. The linear motor 335 is used to drive the telescopic rod 334 to extend and retract under the control of the control system 32, so as to adjust the rod length of the telescopic rod 334 and the rotation angle relative to the support rod 333 according to the planned correction path.
优选地，上安装座331和下安装座332上均设有力传感器4，力传感器4与控制系统32电连接。控制系统32可以为不同患者的不同类型压缩性骨折的治疗提供个性化治疗方案，根据已有的矫治路径进行智能化矫形，力传感器4用于测量外固定架1不同部位的受力，为控制系统32提供患者身体不同部位的受力反馈，以修正矫正路径，保证较好的矫正效果。Preferably, both the upper mounting seat 331 and the lower mounting seat 332 are provided with force sensors 4, and the force sensors 4 are electrically connected to the control system 32. The control system 32 can provide personalized treatment plans for the treatment of different types of compression fractures of different patients, and perform intelligent correction according to the existing correction path. The force sensor 4 is used to measure the force on different parts of the external fixator 1, and provide the control system 32 with force feedback on different parts of the patient's body, so as to correct the correction path and ensure a better correction effect.
优选地，伸缩杆334上设有用于测量伸缩杆334杆长的位移传感器5。以便于控制系统32获取每个伸缩杆334的实时杆长参数，方便对伸缩杆333的伸缩长度进行精准调节。Preferably, the telescopic rod 334 is provided with a displacement sensor 5 for measuring the length of the telescopic rod 334 , so that the control system 32 can obtain the real-time length parameters of each telescopic rod 334 , and precisely adjust the telescopic length of the telescopic rod 333 .
优选地，支撑杆333与上安装座331之间为竖直方向可滑动式连接，支撑杆333与下安装座332之间为水平方向可滑动式连接，上安装座331和下安装座332上均设有用于锁紧支撑杆333位置的锁紧螺钉6。上安装座331上的支撑杆333可以调节竖直方向的安装长度，下安装座332上的支撑杆333可以调节水平方向的安装长度，便于在为患者穿戴外固定架1时，可以根据患者体型调整上固定环11、中固定环12和下固定环13在患者身上的安装距离和角度，保证患者舒适性。Preferably, the support rod 333 is slidably connected to the upper mounting seat 331 in the vertical direction, and the support rod 333 is slidably connected to the lower mounting seat 332 in the horizontal direction, and the upper mounting seat 331 and the lower mounting seat 332 are both provided with locking screws 6 for locking the position of the support rod 333. The support rod 333 on the upper mounting seat 331 can adjust the installation length in the vertical direction, and the support rod 333 on the lower mounting seat 332 can adjust the installation length in the horizontal direction, so that when the patient wears the external fixator 1, the installation distance and angle of the upper fixing ring 11, the middle fixing ring 12 and the lower fixing ring 13 on the patient can be adjusted according to the patient's body shape to ensure the patient's comfort.
优选地，外固定架1上设有若干个振动按摩器7。振动按摩器7用于对患者脊柱部位进行振动按摩，促进椎体骨折部位的恢复。Preferably, a plurality of vibration massagers 7 are provided on the external fixator 1. The vibration massagers 7 are used to perform vibration massage on the patient's spine to promote the recovery of the vertebral fracture site.
优选地，外固定架1采用轻质合金制作，内衬2为柔性透气软垫。保证在患者身上固定效果的同时提高舒适性。Preferably, the external fixator 1 is made of light alloy, and the inner lining 2 is a flexible breathable cushion, so as to ensure the fixation effect on the patient and improve the comfort.
本发明还提供了一种用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器的应用方法，包括以下步骤：The present invention also provides an application method of an intelligent dynamic orthosis for lumbar vertebral osteoporotic compression fractures, comprising the following steps:
步骤一，获取健康志愿者和椎体压缩性骨折患者在多种姿态下的样本集数据，样本集数据包括：健康者和椎体压缩性骨折患者对应胸弯和腰弯的Cobb角信息、冠状位偏移距、顶椎偏移距以及患者基础信息；Step 1: Obtain sample data of healthy volunteers and patients with vertebral compression fractures in various postures. The sample data includes: Cobb angle information of thoracic and lumbar curves, coronal offset, apical vertebra offset, and basic information of patients corresponding to healthy volunteers and patients with vertebral compression fractures;
步骤二，通过样本集数据建立深度神经网络DNN模型，以收集到的健康者的样本集数据为基准，确定椎体压缩性骨折患者的矫正路径规划；Step 2: A deep neural network (DNN) model is established through the sample set data, and the correction path planning for patients with vertebral compression fractures is determined based on the collected sample set data of healthy subjects;
步骤三，将外固定架1设置在脊柱侧弯患者身上，根据控制系统32获取的力传感器4和位移传感器5的反馈数据，结合获取的样本集数据，建立外固定数学模型，量化反馈输入，对矫正路径进行优化；外固定数学模型用于描述矫正骨段在三维空间的位置信息以及运动信息；通过直角坐标路径控制法对矫正骨段进行直线轨迹规划，获取矫正骨段的位置姿态参数；根据矫正骨段的位置姿态参数，获取六个伸缩杆334的长度参数；Step three, the external fixator 1 is set on the scoliosis patient, and according to the feedback data of the force sensor 4 and the displacement sensor 5 obtained by the control system 32, combined with the obtained sample set data, an external fixation mathematical model is established, the feedback input is quantified, and the correction path is optimized; the external fixation mathematical model is used to describe the position information and motion information of the correction bone segment in three-dimensional space; the straight line trajectory of the correction bone segment is planned by the rectangular coordinate path control method to obtain the position and posture parameters of the correction bone segment; according to the position and posture parameters of the correction bone segment, the length parameters of the six telescopic rods 334 are obtained;
步骤四，基于六个多关节串、并联的驱动机构33，通过控制系统32进行可以调节幅度和方向的动态扭矩输出，以使分别贴合在骨盆、腰段和胸段上的下固定环13(参照环)、中固定环12(移动环)和上固定环11(移动环)实现六自由度运动，从而实现腰部和胸部相对于骨盆的全自由度运动，实现对脊柱位姿的精确控制。Step four, based on six multi-joint serial and parallel driving mechanisms 33, a dynamic torque output with adjustable amplitude and direction is performed through the control system 32, so that the lower fixed ring 13 (reference ring), the middle fixed ring 12 (moving ring) and the upper fixed ring 11 (moving ring) respectively attached to the pelvis, waist and thoracic segments can achieve six-degree-of-freedom movement, thereby achieving full-degree-of-freedom movement of the waist and chest relative to the pelvis, and realizing precise control of the spinal posture.
健康者和椎体压缩性骨折患者对应胸弯和腰弯的Cobb角信息、冠状位偏移距、顶椎偏移距，具体为：获取健康者和椎体压缩性骨折患者的CT/X射线图片，将骶1椎体中点作为原点，将其与胸1椎体的竖直方向距离标记为纵坐标的单位100，通过标注的12个胸椎、5个腰椎的中点位置得到每个椎体的坐标，测量得到胸弯和腰弯切线相交得到的夹角记作Cobb角，胸1椎体横坐标为冠状位偏移距，顶椎中点横坐标为顶椎偏移距。The Cobb angle information, coronal offset, and apical vertebra offset of the thoracic and lumbar curves of healthy people and patients with vertebral compression fractures were obtained as follows: CT/X-ray images of healthy people and patients with vertebral compression fractures were obtained, the midpoint of the sacral 1 vertebra was taken as the origin, and the vertical distance between it and the thoracic 1 vertebra was marked as the unit of the ordinate 100. The coordinates of each vertebra were obtained by the midpoints of the marked 12 thoracic vertebrae and 5 lumbar vertebrae. The angle obtained by the intersection of the tangents of the thoracic curve and the lumbar curve was measured and recorded as the Cobb angle. The horizontal coordinate of the thoracic 1 vertebra was the coronal offset, and the horizontal coordinate of the midpoint of the apical vertebra was the apical vertebra offset.
外固定数学模型包括：The external fixation mathematical model includes:
以下固定环13(参照环)中心为原点建立局部坐标系{B}，分别以中固定环12和上固定环11(移动环)中心为原点建立局部坐标系{P}，以参照骨段的“起始点”为原点建立全局坐标系{U}；读取六个驱动机构33上伸缩杆334的杆长的初始值：L1、L2、L3、L4、L5、L6，利用位姿正解算法计算出移动环相对于参照环的初始位姿，用位姿矩阵表示：A local coordinate system {B} is established with the center of the lower fixed ring 13 (reference ring) as the origin, a local coordinate system {P} is established with the center of the middle fixed ring 12 and the upper fixed ring 11 (moving ring) as the origin, and a global coordinate system {U} is established with the "starting point" of the reference bone segment as the origin; the initial values of the rod lengths of the telescopic rods 334 on the six drive mechanisms 33 are read: L1, L2, L3, L4, L5, L6, and the initial posture of the moving ring relative to the reference ring is calculated using the posture forward solution algorithm, and the posture matrix express:
式中，表示移动环坐标{P}相对于参照环坐标{B}的姿态转换矩阵，/>表示{P}坐标原点相对于{B}坐标系的位置；In the formula, represents the attitude transformation matrix of the mobile ring coordinates {P} relative to the reference ring coordinates {B},/> Indicates the position of the {P} coordinate origin relative to the {B} coordinate system;
由标准正位X光片和标准侧位X光片测量畸形参数，畸形参数包括由标准正位X光片和标准侧位X光片测得的三个位移和三个成角：Deformity parameters were measured from standard anteroposterior and lateral X-rays. The deformity parameters included three displacements and three angles measured from standard anteroposterior and lateral X-rays:
内侧或外侧的正位位移：标准正位X光片上测量，从起始点到对应点沿X轴方向的距离；Medial or lateral anteroposterior displacement: measured on a standard anteroposterior X-ray film, the distance from the starting point to the corresponding point along the X-axis;
外翻或内翻的正位角度：标准正位X光片上测量，两骨段轴线的夹角；The anteroposterior angle of valgus or varus is the angle between the axes of the two bone segments measured on a standard anteroposterior X-ray.
前部或后部的侧位位移：标准侧位X光片上测量，从起始点到对应点沿Y轴方向的距离；Anterior or posterior lateral displacement: measured on a standard lateral X-ray film, the distance from the starting point to the corresponding point along the Y axis;
屈曲或反张的侧位角度：侧位X光片上测量，两骨段轴线的夹角；Lateral angle of flexion or extension: the angle between the axes of the two bone segments measured on a lateral X-ray;
压缩或分离的轴向位移：在正位X光片或侧位X光片上测量，从起始点到对应点沿Z轴方向的距离；Axial displacement of compression or separation: measured on the anteroposterior or lateral X-ray film, the distance from the starting point to the corresponding point along the Z axis;
外旋或内旋的轴向角度：测量参照骨段与移动骨段矢状面上的旋转夹角。Axial angle of external or internal rotation: Measure the angle of rotation between the reference bone segment and the translated bone segment in the sagittal plane.
其中，设绕固定轴X-Y-Z的转角为α’，β’，γ’，从测量的畸形参数中得到：Among them, the rotation angles around the fixed axis X-Y-Z are assumed to be α’, β’, γ’, and obtained from the measured deformity parameters:
式中，cα＝cosα，sα＝sinα，cβ＝cosβ，sβ＝sinβ，cγ＝cosγ，sγ＝sinγIn the formula, cα＝cosα，sα＝sinα，cβ＝cosβ，sβ＝sinβ，cγ＝cosγ，sγ＝sinγ
令make
联立(2)和(3)得解得结果如下：Combining (2) and (3) we get The solution is as follows:
(1)cosβ’≠0则：(1) cosβ’≠0:
α’＝Atan2(r23,r33)α'＝Atan2(r23 ,r33 )
γ’＝Atan2(r12,r11)γ'＝Atan2(r12 ,r11 )
(2)β’＝±90°则：(2) β’＝±90° then:
α’＝0α’＝0
γ’＝±Atan2(r21,r22)γ'＝±Atan2(r21 ,r22 )
其中，Atan2(y，x)表示双变量反正切函数，x和y的符号确定角度所在的象限，上式解出的[α’，β’，γ’]T即为实际中外固定架1绕X、Y、Z轴的旋转量。Wherein, Atan2(y, x) represents a two-variable inverse tangent function, the signs of x and y determine the quadrant in which the angle is located, and the [α', β', γ']T obtained by solving the above formula is the actual rotation amount of the external fixator 1 around the X, Y, and Z axes.
测量框架参数，框架参数包括由标准正位X光片和标准侧位X光片测得的3个偏移及1个成角：Measure the framework parameters, which include 3 offsets and 1 angle measured from standard anteroposterior and lateral X-rays:
内侧或外侧的参照环中心正位偏移：标准正位X光片上测量，参照环中心相对于起始点的偏移；Medial or lateral anteroposterior deviation of the reference ring center: the deviation of the reference ring center relative to the starting point measured on a standard anteroposterior radiograph;
前部或后部的参照环中心侧位偏移：标准侧位X光片上测量，参照环中心相对于起始点的偏移；Anterior or posterior lateral deviation of the reference ring center: the deviation of the reference ring center relative to the starting point measured on a standard lateral radiograph;
参照环中心轴向偏移：标准正位X光片上测量或标准侧位X光片上测量，从参照环的边缘至起始点之间的轴向距离；Axial offset of the reference ring center: the axial distance from the edge of the reference ring to the starting point measured on a standard anteroposterior X-ray or a standard lateral X-ray;
外旋或内旋的参照环旋转角度：临床测量参照环的矢状面相对于参照骨段矢状面的旋转角度；External or internal rotation of the reference ring: The rotation angle of the sagittal plane of the reference ring relative to the sagittal plane of the reference bone segment is clinically measured;
从测量的框架参数中得到参照环相对于参照骨段的位姿矩阵，用表示，得到移动环相对于参照骨段的位姿矩阵：The pose matrix of the reference ring relative to the reference bone segment is obtained from the measured frame parameters. Indicates that the position matrix of the moving ring relative to the reference bone segment is obtained:
将以移动环中心、移动骨段的对应点为原点建立的局部坐标系{P}、{U}拟合到全局坐标系得到移动环相对于移动骨段的位姿矩阵：The local coordinate systems {P} and {U} established with the center of the mobile ring and the corresponding points of the mobile bone segment as the origin are fitted to the global coordinate system to obtain the position matrix of the mobile ring relative to the mobile bone segment:
式中，表示移动骨段相对于参照骨段的位姿矩阵，由变量[x，y，z，α’，β’，γ’]构成，其中[x，y，z]和[α’，β’，γ’]分别表示所述对应点相对于“起始点”在三个方向上的位移偏移量及三个方向的旋转角度。In the formula, The pose matrix representing the moving bone segment relative to the reference bone segment is composed of the variables [x, y, z, α', β', γ'], where [x, y, z] and [α', β', γ'] represent the displacement offsets of the corresponding points in three directions and the rotation angles in three directions relative to the "starting point", respectively.
本发明所述的一种用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器的使用方法如下：The method of using the intelligent dynamic orthosis for lumbar vertebral osteoporotic compression fractures described in the present invention is as follows:
将上固定环11贴合固定在患者的胸段周围，中固定环12贴合固定在患者的腹段周围，下固定环13贴合固定在患者骨盆处，控制系统32根据患者的骨折状况以及胸段、腹段、骨盆处的位姿信息等样本集数据，规划矫正路径，并通过力传感器4和位移传感器5的反馈输入，结合获取的样本集数据，建立外固定数学模型，量化反馈输入，对矫正路径进行优化，并通过控制驱动机构33的运动方向和角度，使上固定环11和中固定环12相对于下固定环13在垂直和前后、左右六个方向活动，从而实现腰部和胸部相对于骨盆的全自由度运动，实现对脊柱位姿的精确控制，可以帮助患者便捷精确地进行康复功能锻炼，避免关节僵硬，废用性肌萎缩；还可以对脊柱进行纵向垂体拉伸，通过保守治疗地方式一定程度上恢复骨折压缩程度，以帮助患处进行较好的功能锻炼，从而获得更好的预后。The upper fixing ring 11 is fitted and fixed around the patient's thoracic segment, the middle fixing ring 12 is fitted and fixed around the patient's abdominal segment, and the lower fixing ring 13 is fitted and fixed at the patient's pelvis. The control system 32 plans the correction path according to the patient's fracture condition and the sample set data such as the posture information of the thoracic segment, abdominal segment, and pelvis, and establishes an external fixation mathematical model through the feedback input of the force sensor 4 and the displacement sensor 5 in combination with the acquired sample set data, quantifies the feedback input, optimizes the correction path, and controls the movement direction and angle of the driving mechanism 33 so that the upper fixing ring 11 and the middle fixing ring 12 can move in six directions: vertical, front and back, and left and right relative to the lower fixing ring 13, thereby realizing full-degree-of-freedom movement of the waist and chest relative to the pelvis, realizing precise control of the spinal posture, and can help patients to conveniently and accurately perform rehabilitation functional exercises to avoid joint stiffness and disuse muscle atrophy; the spine can also be longitudinally pituitary stretched, and the degree of fracture compression can be restored to a certain extent through conservative treatment to help the affected area to perform better functional exercises, thereby obtaining a better prognosis.
综上所述，本发明提供的一种用于腰椎椎体骨质疏松性压缩性骨折的智能动态矫形器及应用方法，解决现有设备无法满足老年骨质疏松性椎体压缩性骨折的快速康复以及较高质量的功能锻炼的问题。In summary, the intelligent dynamic orthosis and application method for lumbar vertebral osteoporotic compression fractures provided by the present invention solves the problem that existing equipment cannot meet the needs of rapid recovery and high-quality functional training for elderly osteoporotic vertebral compression fractures.
上面以举例方式对本发明进行了说明，但本发明不限于上述具体实施例，凡基于本发明所做的任何改动或变型均属于本发明要求保护的范围。The present invention is described above by way of examples, but the present invention is not limited to the above specific embodiments, and any changes or modifications made based on the present invention belong to the scope of protection required by the present invention.
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