阅读说明：本技术 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 (Intelligent dynamic orthosis for lumbar vertebral osteoporotic compression fracture and application method ) 是由 刘国辉 闫晨晨 米博斌 熊元 曹发奇 陈朗 于 2021-09-02 设计创作，主要内容包括：本发明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,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,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。本发明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,从而获得更好的预后。(The invention relates to an intelligent dynamic orthosis for lumbar vertebral osteoporotic compression fracture and an application method thereof. The invention can well fix the fracture part of the lumbar vertebra of the patient, help the patient to carry out rehabilitation function exercise conveniently and accurately, and avoid the joint stiffness and the disuse muscle atrophy; the vertebral column can also be subjected to longitudinal pituitary stretching, and the fracture compression degree can be recovered to a certain extent in a conservative treatment mode, so that better prognosis is obtained.)

1. An intelligent dynamic orthosis for osteoporotic and compressive fracture of lumbar vertebral body, characterized in that: including external fixation frame, inside lining and drive arrangement, external fixation frame includes upper fixed ring, well fixed ring and lower fixed ring, the inside lining sets up upper fixed ring well fixed ring with the inboard of lower fixed ring, drive arrangement includes power, control system and actuating mechanism, actuating mechanism has six, wherein two actuating mechanism connects upper fixed ring with well fixed ring's the back, two actuating mechanism connects well fixed ring with the back of lower fixed ring, two actuating mechanism connects upper fixed ring well fixed ring with the side of lower fixed ring, actuating mechanism is in realize under control system's control upper fixed ring well fixed ring for the six degree of freedom motions of lower fixed ring.

2. The intelligent dynamic orthosis of claim 1, wherein: actuating mechanism includes mount pad, two bracing pieces, telescopic link and linear electric motor down, two the bracing piece sets up respectively go up the mount pad with on the mount pad down, linear electric motor drives the telescopic link, linear electric motor with the one end of telescopic link respectively with go up the mount pad with on the mount pad down the bracing piece is articulated, go up the mount pad with the mount pad is used for with external fixation frame fixed connection down.

3. The intelligent dynamic orthosis of claim 2, wherein: and force sensors are arranged on the upper mounting seat and the lower mounting seat and are electrically connected with the control system.

4. The intelligent dynamic orthosis of claim 3, wherein: the telescopic rod is provided with a displacement sensor for measuring the length of the telescopic rod, and the displacement sensor is electrically connected with the control system.

5. The intelligent dynamic orthosis of claim 4, wherein: the bracing piece with go up and be vertical direction slidable connection between the mount pad, the bracing piece with be horizontal direction slidable connection between the mount pad down, go up the mount pad with all be equipped with on the mount pad down and be used for locking the locking screw of bracing piece position.

6. The intelligent dynamic orthosis of claim 5, wherein: the outer fixing frame is provided with a plurality of vibration massagers.

7. The intelligent dynamic orthosis of claim 6, wherein: the external fixing frame is made of light alloy, and the lining is a flexible breathable cushion.

8. The method of claim 7, wherein the method comprises the steps of:

step one, acquiring sample set data of healthy volunteers and patients with vertebral compression fracture in various postures, wherein the sample set data comprises: cobb angle information, coronary offset distance, apical offset distance and patient basic information of thoracic vertebrae and lumbar vertebrae corresponding to healthy people and patients with vertebral compression fracture;

establishing a deep neural network DNN model through the sample set data, and determining a correction path plan of the patient with vertebral compression fracture by taking the collected sample set data of the healthy person as a reference;

thirdly, arranging the external fixing frame on a patient with vertebral compression fracture, establishing an external fixing mathematical model according to feedback data of the force sensor and the displacement sensor acquired by the control system and the acquired sample set data, quantizing feedback input, and optimizing a correction path; the external fixation mathematical model is used for describing position information and motion information of the correction bone segment in a three-dimensional space; performing linear trajectory planning on the correction bone segment by a rectangular coordinate path control method to obtain a position posture parameter of the correction bone segment; acquiring length parameters of the six telescopic rods according to the position and posture parameters of the correction bone section;

and fourthly, based on the six multi-joint driving mechanisms connected in series and in parallel, the control system controls the driving mechanisms to carry out dynamic torque output capable of adjusting amplitude and direction so as to enable the lower fixing ring, the middle fixing ring and the upper fixing ring respectively attached to the pelvis, the waist section and the chest section to realize six-degree-of-freedom motion, thereby realizing full-degree-of-freedom motion of the waist (moving bone section) and the chest (moving bone section) relative to the pelvis (reference bone section) and realizing accurate control of the posture of the spine.

9. The method of claim 8, wherein the orthopedic device comprises a first orthopedic device and a second orthopedic device, wherein the first orthopedic device comprises: the Cobb angle information, the coronal offset distance and the apical offset distance of the thoracic vertebra and the lumbar vertebra corresponding to the healthy person and the patient with vertebral compression fracture specifically comprise: the CT or X-ray pictures of a healthy person and a patient with vertebral compression fracture are obtained, the middle point of the sacrum 1 vertebral body is used as an original point, the vertical direction distance between the sacrum 1 vertebral body and the thoracic 1 vertebral body is marked as a unit 100 of a longitudinal coordinate, the coordinate of each vertebral body is obtained through the marked middle point positions of 12 thoracic vertebrae and 5 lumbar vertebrae, the included angle obtained by intersecting tangent lines in the bending direction of the thoracic vertebrae and the lumbar vertebrae is measured and marked as a Cobb angle, the horizontal coordinate of the thoracic vertebrae 1 vertebral body is a coronal offset distance, and the horizontal coordinate of the middle point of the apical vertebrae is an apical vertebrae offset distance.

10. The method of claim 8, wherein said external fixation mathematical model comprises:

establishing a local coordinate system { B } with the center of the lower fixed ring (reference ring) as an origin, and respectively using the middle fixed ring (moving ring) and the upper fixed ring(s) ((B))Moving rings) as an origin, and a global coordinate system { U } is established by taking the 'initial point' of the reference bone segment as the origin; reading initial values of the rod lengths of the telescopic rods on the six driving mechanisms: l1, L2, L3, L4, L5 and L6, calculating the initial position of the moving ring relative to the reference ring by using a position-posture forward solution algorithm, and using a position-posture matrixRepresents:

in the formula (I), the compound is shown in the specification,an attitude transformation matrix representing the mobile ring coordinate { P } relative to the reference ring coordinate { B },represents the position of the { P } origin of coordinates relative to the { B } coordinate system;

the deformity parameters were measured from a standard orthostatic X-ray film and a standard lateral position X-ray film, including three displacements and three angulations measured from a standard orthostatic X-ray film and a standard lateral position X-ray film:

medial or lateral orthostatic displacement: measuring the distance from the starting point to the corresponding point along the X-axis direction on a standard positive X-ray film;

righting angle of valgus or varus: measuring an included angle between the axes of the two bone segments on a standard positive X-ray film;

lateral displacement of the front or rear part: measuring the distance from the starting point to the corresponding point along the Y-axis direction on a standard side position X-ray film;

lateral angle of flexion or of reversal: measuring an included angle between the axes of the two bone segments on a lateral X-ray film;

axial displacement of compression or separation: measuring the distance from the starting point to the corresponding point along the Z-axis direction on the positive X-ray film or the lateral X-ray film;

axial angle of external or internal rotation: measuring a rotation included angle between the sagittal plane of the reference bone segment and the moving bone segment;

wherein, assuming the rotation angles around the fixed axis X-Y-Z as α ', β ', γ ', deriving from the measured malformation parameters:

where, c α ═ cos α, s α ═ sin α, c β ═ cos β, s β ═ sin β, c γ ═ cos γ, and s γ ═ sin γ

Order to

Combine (2) and (3) to obtainThe results were obtained as follows:

(1) cos β' ≠ 0 then:

α’＝Atan2(r₂₃,r₃₃)

γ’＝Atan2(r₁₂,r₁₁)

(2) β' ± 90 ° then:

α’＝0

γ’＝±Atan2(r₂₁,r₂₂)

wherein Atan2(y, x) represents a bivariate arctangent function, and the signs of x and y determine the quadrant in which the angle is located, and [ alpha ', beta', gamma 'solved by the above formula']^TNamely the actual rotation amount of the external fixing frame around the X, Y, Z shaft;

frame parameters were measured, including 3 offsets and 1 angulation measured from standard orthostatic and standard lateral radiographs:

medial or lateral reference ring center positive offset: measuring on a standard positive X-ray film, and referring to the offset of the center of the ring relative to the starting point;

anterior or posterior reference ring medial offset: measuring on a standard lateral X-ray film, and referring to the offset of the center of the ring relative to the starting point;

reference ring center axial offset: measuring on a standard positive X-ray film or measuring on a standard lateral X-ray film, and measuring the axial distance from the edge of the reference ring to the starting point;

reference ring rotation angle for external or internal rotation: clinically measuring the rotation angle of the sagittal plane of the reference ring relative to the sagittal plane of the reference bone segment;

deriving from said measured frame parameters a matrix of positions of the reference ring relative to the reference bone segmentsAnd representing to obtain a pose matrix of the moving ring relative to the reference bone segment:

fitting a local coordinate system { P }, { U } established by taking the center of the moving ring and the corresponding point of the moving bone segment as an origin to a global coordinate system to obtain a pose matrix of the moving ring relative to the moving bone segment:

in the formula (I), the compound is shown in the specification,a pose matrix representing the moving bone segments relative to the reference bone segments, formed by the variables x, y, z, α ', β ', γ ']Wherein [ x, y, z)]And [ alpha ', beta ', gamma ']Respectively indicate displacement offset amounts of the corresponding point in three directions and rotation angles in three directions with respect to the "starting point".

The technical field is as follows:

the invention relates to the technical field of bone orthotics, in particular to an intelligent dynamic orthotics for lumbar vertebral osteoporotic compression fracture and an application method.

Background art:

osteoporosis is a systemic bone disease in which bone density and bone quality are reduced due to various causes, bone microstructures are destroyed, bone brittleness is increased, and thus fracture is likely to occur. Osteoporosis causes fractures in about 890 patients worldwide each year, with an average of 1 occurring every 3 seconds, with osteoporotic fractures occurring in women over 50 years of age about 1/3 and in men 1/5. The vertebral body is the most common occurrence site of Osteoporotic fracture, Osteoporotic Vertebral Compression Fracture (OVCF), and more than about 50% of Osteoporotic fractures occur in vertebral bodies, preferably in the thoracolumbar region. The 2017 Chinese epidemiological research shows that the prevalence rate of vertebral fracture of Beijing postmenopausal women in imaging increases with age, the prevalence rate is 13.4% at 50-59 years, and is up to 58.1% above 80 years; another study in Beijing showed that in 2000, the prevalence of vertebral fracture was 15% between 50 and 59 years old and 36.6% above 80 years old. An application simulation model research shows that the newly-discovered OVCF is about 127 ten thousand cases for people over 50 years old in 2015 in China; it is expected that by 2020, about 149 million cases will be reached; by 2050, up to about 300 ten thousand cases can be obtained. For vertebral compression fracture caused by osteoporosis, it is often seen in the elderly. After the calcium in the vertebral body of the old people abnormally loses, the bone in the vertebral body is easily abnormally lost, so that the bone loss is caused, the osteoporosis is caused, the firmness of the vertebral body is weakened, particularly, the bearing capacity of the vertebral body is obviously damaged, and the vertebral body compression fracture is caused after the vertebral body is subjected to mild trauma. People in the diagnosis and treatment of osteoporotic vertebral compression fracture (2018), suggested that if osteoporotic vertebral compression fracture does not exceed 1/3 in height compression, conservative bed rest treatment can be adopted for the osteoporotic vertebral compression fracture, an orthopedic device is generally adopted for auxiliary treatment, and calcium supplement is required during treatment so as to avoid aggravation of osteoporotic vertebral compression.

Existing orthoses for OVCF can be largely classified into both wearable and platform types. The whole body of the wearable orthosis is fixedly supported by the fixed outside, and the principle of the wearable orthosis is that the trunk is wrapped by the material reinforced by the elastic supporting strips, and certain pressure is applied to the waist and the soft tissues of the abdomen to improve the intra-abdominal pressure, so that the weight is lightened to bear the weight of the thoracolumbar vertebrae, the movement of the spine is limited, and the wearable orthosis mainly plays the roles of fixedly supporting the spine, correcting the deformity of the spine, reducing the longitudinal pressure of the spine and avoiding secondary injury. The wearable orthosis has the advantages of economy, applicability, convenient wearing, good patient compliance and the like, but has limited treatment effect and causes the defects of disuse muscular atrophy, lumbar vertebra joint stiffness, dysfunction and the like. The platform type orthosis is mainly a large fixed type orthopedic platform and generally comprises an orthopedic bed and a controller, can be used for multi-position function rehabilitation training, has certain clinical data support, and is generally low in patient compliance due to treatment cost and convenience. Patent application No. CN201611235348.4 forms a three-point pressure system in front of and behind the spine of a human body through a three-point pressure mechanism and a pressure plate device thereof, and adjusts the pressure of the pressure plate device through an adjusting device, thereby not only playing a role in fixing the thoracolumbar vertebrae, but also effectively correcting or controlling abnormal bending of the thoracolumbar vertebrae; and the pressure can be adjusted manually or automatically through the control mechanism or by combining the control mechanism and the test element according to the actual pressure application size and pressure application requirement of the pressure plate device, so that the normal physiological curve of the spine can be maintained, the compressed and deformed vertebral bodies and intervertebral spaces can be restored to the original positions, and the effect of treating the compression fracture can be achieved. However, the existing orthoses can not meet the requirements of the intelligent dynamic orthoses, namely the existing orthoses do not collect back electromyographic signals of a patient and collect movement data, such as rotation angular velocity and the like, obtained by wearing the patient with 6 degrees of freedom; the device has the advantages that the device collects the abdominal and back acting force and pressure of a patient, supports the functions of amplitude and direction adjustable dynamic torque output and the like based on the multi-joint serial and parallel force output mechanisms, cannot complete individual data collection and analysis, and has the functions of filing and induction, set safety value limitation and maximum value limitation of treatment cycles and treatment modes, rehabilitation functions such as muscle electrical stimulation and the like, comfort/miniaturization/portable design feedback follow-up mechanism such as wearability and the like, and judges treatment schemes and flows according to the correction path by combining data. Therefore, the existing orthoses cannot meet the functions of rapid rehabilitation and higher-quality functional exercise of the elderly OVCF.

The invention content is as follows:

technical problem to be solved

The invention aims to provide an intelligent dynamic orthosis for lumbar vertebral osteoporotic compression fracture and an application method thereof, and solves the problems that the existing equipment cannot meet the requirements of rapid rehabilitation of senile osteoporotic vertebral compression fracture and cannot assist in performing high-quality functional exercises.

(II) technical scheme

In order to solve the technical problems, the invention adopts the following technical scheme: an intelligent dynamic orthopedic device for lumbar vertebra osteoporotic compression fracture comprises an external fixing frame, a lining and a driving device, the external fixing frame comprises an upper fixing ring, a middle fixing ring and a lower fixing ring, the lining is arranged at the inner sides 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 six driving mechanisms, wherein the two driving mechanisms are connected with the back surfaces of the upper fixing ring and the middle fixing ring, the two driving mechanisms are connected with the back surfaces of the middle fixing ring and the lower fixing ring, the two driving mechanisms are connected with the side surfaces of the upper fixing ring, the middle fixing ring and the lower fixing ring, 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.

The upper fixing ring is used for being attached and fixed around a chest section of a patient, the middle fixing ring is used for being attached and fixed around an abdomen section of the patient, the lower fixing ring is used for being attached and fixed at a pelvis of the patient, and the driving device enables the upper fixing ring and the middle fixing ring to move in six directions, namely vertical, front-back, left-right directions relative to the lower fixing ring by controlling the movement direction and angle of the driving mechanism, so that six-degree-of-freedom movement of a spine is simulated, the patient can be helped to conveniently and accurately perform rehabilitation function exercise, and joint stiffness and disuse muscular atrophy are avoided; the vertebral column can also be subjected to longitudinal pituitary stretching, and the fracture compression degree can be recovered to a certain extent in a conservative treatment mode, so that better prognosis is obtained.

Further, actuating mechanism includes mount pad, two bracing pieces, telescopic link and linear electric motor down, two the bracing piece sets up respectively go up the mount pad with on the mount pad down, linear electric motor drives the telescopic link, linear electric motor with the one end of telescopic link respectively with go up the mount pad with on the mount pad down the bracing piece is articulated, go up the mount pad with the mount pad is used for with external fixation frame fixed connection down. The upper mounting seat and the lower mounting seat are respectively used for being fixedly connected with the outer sides of the upper fixing ring, the middle fixing ring and the lower fixing ring, and the linear motor is used for driving the telescopic rod to stretch under the control of the control system so as to adjust the rod length of the telescopic rod and the rotating angle of the telescopic rod relative to the supporting rod according to a planned correction path.

Furthermore, force sensors are arranged on the upper mounting seat and the lower mounting seat, and the force sensors are electrically connected with the control system. The control system can provide personalized treatment schemes for the treatment of different types of compression fractures of different patients, intelligent correction is carried out according to the existing correction path, the force sensors are used for measuring the stress of different parts of the external fixing frame, stress feedback of different parts of the body of the patient is provided for the control system, the correction path is corrected, and a better correction effect is ensured.

Furthermore, a displacement sensor for measuring the length of the telescopic rod is arranged on the telescopic rod. So that control system acquires every the real-time pole length parameter of telescopic link, it is convenient right the flexible length of telescopic link carries out accurate regulation.

Furthermore, the bracing piece with be vertical direction slidable connection between the last mount pad, the bracing piece with be horizontal direction slidable connection between the mount pad down, go up the mount pad with all be equipped with on the mount pad down and be used for locking the locking screw of bracing piece position. Go up on the mount pad the installation length of vertical direction can be adjusted to the bracing piece, down on the mount pad the installation length of horizontal direction can be adjusted to the bracing piece, is convenient for adjust according to patient's size go up solid fixed ring well solid fixed ring with gu fixed ring's installation distance and angle on patient's body down guarantees patient's travelling comfort.

Furthermore, a plurality of vibration massagers are arranged on the external fixing frame. The vibration massager is used for performing vibration massage on the spine part of a patient to promote the recovery of the vertebral fracture part.

Furthermore, the external fixing frame is made of light alloy, and the lining is a flexible breathable cushion. The comfort is improved while the effect of fixing on the body of the patient is guaranteed.

The invention also provides an application method of the intelligent dynamic orthosis for the osteoporotic and compressive fracture of the lumbar vertebral body, which comprises the following steps:

step one, acquiring sample set data of healthy volunteers and patients with vertebral compression fracture in various postures, wherein the sample set data comprises: cobb angle information, coronary offset distance, apical offset distance and patient basic information of thoracic vertebrae and lumbar vertebrae corresponding to healthy people and patients with vertebral compression fracture;

establishing a deep neural network DNN model through the sample set data, and determining a correction path plan of the patient with vertebral compression fracture by taking the collected sample set data of the healthy person as a reference;

thirdly, arranging the external fixing frame on a patient with vertebral compression fracture, establishing an external fixing mathematical model according to feedback data of the force sensor and the displacement sensor acquired by the control system and the acquired sample set data, quantizing feedback input, and optimizing a correction path; the external fixation mathematical model is used for describing position information and motion information of the correction bone segment in a three-dimensional space; performing linear trajectory planning on the correction bone segment by a rectangular coordinate path control method to obtain a position posture parameter of the correction bone segment; acquiring length parameters of the six telescopic rods according to the position and posture parameters of the correction bone section;

and fourthly, based on the six multi-joint driving mechanisms connected in series and in parallel, the control system controls the driving mechanisms to carry out dynamic torque output capable of adjusting amplitude and direction so as to enable the lower fixing ring, the middle fixing ring and the upper fixing ring respectively attached to the pelvis, the waist section and the chest section to realize six-degree-of-freedom motion, thereby realizing full-degree-of-freedom motion of the waist (moving bone section) and the chest (moving bone section) relative to the pelvis (reference bone section) and realizing accurate control of the posture of the spine.

Wherein, the healthy person and the patient with vertebral compression fracture correspond to the Cobb angle information, the coronary offset distance and the apical vertebral offset distance of the thoracic vertebra and the lumbar vertebra, and specifically comprise: the CT or X-ray pictures of a healthy person and a patient with vertebral compression fracture are obtained, the middle point of the sacrum 1 vertebral body is used as an original point, the vertical direction distance between the sacrum 1 vertebral body and the thoracic 1 vertebral body is marked as a unit 100 of a longitudinal coordinate, the coordinate of each vertebral body is obtained through the marked middle point positions of 12 thoracic vertebrae and 5 lumbar vertebrae, the included angle obtained by intersecting tangent lines in the bending direction of the thoracic vertebrae and the lumbar vertebrae is measured and marked as a Cobb angle, the horizontal coordinate of the thoracic vertebrae 1 vertebral body is a coronal offset distance, and the horizontal coordinate of the middle point of the apical vertebrae is an apical vertebrae offset distance.

The external fixation mathematical model comprises:

using the center of the lower fixing ring (reference ring) as the originEstablishing a local coordinate system { B }, establishing a local coordinate system { P } by taking the centers of the middle fixed ring (moving ring) and the upper fixed ring (moving ring) as original points respectively, and establishing a global coordinate system { U } by taking the 'initial point' of the reference bone segment as an original point; reading initial values of the rod lengths of the telescopic rods on the six driving mechanisms: l1, L2, L3, L4, L5 and L6, calculating the initial position of the moving ring relative to the reference ring by using a position-posture forward solution algorithm, and using a position-posture matrixRepresents:

in the formula (I), the compound is shown in the specification,an attitude transformation matrix representing the mobile ring coordinate { P } relative to the reference ring coordinate { B },represents the position of the { P } origin of coordinates relative to the { B } coordinate system;

the deformity parameters were measured from a standard orthostatic X-ray film and a standard lateral position X-ray film, including three displacements and three angulations measured from a standard orthostatic X-ray film and a standard lateral position X-ray film:

medial or lateral orthostatic displacement: measuring the distance from the starting point to the corresponding point along the X-axis direction on a standard positive X-ray film;

righting angle of valgus or varus: measuring an included angle between the axes of the two bone segments on a standard positive X-ray film;

lateral displacement of the front or rear part: measuring the distance from the starting point to the corresponding point along the Y-axis direction on a standard side position X-ray film;

lateral angle of flexion or of reversal: measuring an included angle between the axes of the two bone segments on a lateral X-ray film;

axial displacement of compression or separation: measuring the distance from the starting point to the corresponding point along the Z-axis direction on the positive X-ray film or the lateral X-ray film;

axial angle of external or internal rotation: and measuring the rotation included angle of the reference bone segment and the moving bone segment on the sagittal plane.

Wherein, assuming the rotation angles around the fixed axis X-Y-Z as α ', β ', γ ', deriving from the measured malformation parameters:

where, c α ═ cos α, s α ═ sin α, c β ═ cos β, s β ═ sin β, c γ ═ cos γ, and s γ ═ sin γ

Order to

Combine (2) and (3) to obtainThe results were obtained as follows:

(1) cos β' ≠ 0 then:

α’＝Atan2(r₂₃,r₃₃)

γ’＝Atan2(r₁₂,r₁₁)

(2) β' ± 90 ° then:

α’＝0

γ’＝±Atan2(r₂₁,r₂₂)

wherein Atan2(y, x) represents a bivariate arctangent function, and the signs of x and y determine the quadrant in which the angle is located, and [ alpha ', beta', gamma 'solved by the above formula']^TI.e. the amount of rotation of the external fixator around axis X, Y, Z in practice.

Frame parameters were measured, including 3 offsets and 1 angulation measured from standard orthostatic and standard lateral radiographs:

medial or lateral reference ring center positive offset: measuring on a standard positive X-ray film, and referring to the offset of the center of the ring relative to the starting point;

anterior or posterior reference ring medial offset: measuring on a standard lateral X-ray film, and referring to the offset of the center of the ring relative to the starting point;

reference ring center axial offset: measuring on a standard positive X-ray film or measuring on a standard lateral X-ray film, and measuring the axial distance from the edge of the reference ring to the starting point;

reference ring rotation angle for external or internal rotation: clinically measuring the rotation angle of the sagittal plane of the reference ring relative to the sagittal plane of the reference bone segment;

deriving from said measured frame parameters a matrix of positions of the reference ring relative to the reference bone segmentsAnd representing to obtain a pose matrix of the moving ring relative to the reference bone segment:

fitting a local coordinate system { P }, { U } established by taking the center of the moving ring and the corresponding point of the moving bone segment as an origin to a global coordinate system to obtain a pose matrix of the moving ring relative to the moving bone segment:

in the formula (I), the compound is shown in the specification,a pose matrix representing the moving bone segments relative to the reference bone segments, formed by the variables x, y, z, α ', β ', γ ']Wherein [ x, y, z)]And [ alpha ', beta ', gamma ']Respectively indicate displacement offset amounts of the corresponding point in three directions and rotation angles in three directions with respect to the "starting point".

(III) advantageous effects

Compared with the prior art, the invention has the following beneficial effects: the external fixing frame, the lining and the driving device are arranged on the body of a patient, the external fixing frame comprises an upper fixing ring, a middle fixing ring and a lower fixing ring, the driving device comprises a power supply, a control system and six driving mechanisms, and the six driving mechanisms realize six-degree-of-freedom motion of the upper fixing ring and the middle fixing ring relative to the lower fixing ring under the control of the control system, so that the six-degree-of-freedom motion of a spine is simulated, the fracture part of the lumbar vertebra of the patient can be well fixed, the patient can be helped to conveniently and accurately perform rehabilitation function exercise, and the joint stiffness and the disuse muscle atrophy are avoided; the vertebral column can be longitudinally stretched by the pituitary, and the fracture compression degree can be recovered to a certain extent in a conservative treatment mode, so that the affected part can be helped to perform better functional exercise, and better prognosis can be obtained.

Description of the drawings:

in order to more clearly illustrate the technical solution in the embodiments of the present invention, the drawings required to be used in the embodiments will be briefly described below.

Fig. 1 is a schematic overall structure diagram of an intelligent dynamic orthosis for osteoporotic compression fracture of lumbar vertebral body according to an embodiment of the present invention;

fig. 2 is a top cross-sectional view of an intelligent dynamic orthosis for osteoporotic compression fractures of a lumbar vertebral body in accordance with an embodiment of the present invention;

fig. 3 is a schematic structural diagram of the driving mechanism part of the intelligent dynamic orthosis for the osteoporotic compression fracture of the lumbar vertebral body according to the embodiment of the present invention;

fig. 4 is a cross-sectional view of the drive mechanism location of the intelligent dynamic orthosis for osteoporotic compression fractures of the lumbar vertebral body, in accordance with an embodiment of the present invention;

fig. 5 is a cross-sectional view of the lower fixed seat portion of the intelligent dynamic orthosis for osteoporotic compression fracture of the lumbar vertebral body according to the embodiment of the present invention;

fig. 6 is a control schematic diagram of an intelligent dynamic orthosis for osteoporotic compression fracture of a lumbar vertebral body according to an embodiment of the present invention;

in the figure: 1. an outer fixing frame; 11. an upper fixing ring; 12. a middle fixed ring; 13. a lower fixing ring; 2. a liner; 3. a drive device; 31. a power source; 32. a control system; 33. a drive mechanism; 331. an upper mounting seat; 332. a lower mounting seat; 333. a support bar; 334. a telescopic rod; 335. a linear motor; 4. a force sensor; 5. a displacement sensor; 6. locking the screw; 7. vibration massage device

The specific implementation mode is as follows:

the technical solution in the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention.

As shown in fig. 1, 2, 3, 4, 5 and 6, the intelligent dynamic orthosis for osteoporotic compression fracture of lumbar vertebral body comprises an external fixation frame 1, a lining 2 and a driving device 3, wherein the external fixation frame 1 comprises an upper fixing ring 11, a middle fixing ring 12 and a lower fixing ring 13, the lining 2 is arranged at the inner side of the upper fixing ring 11, the middle fixing ring 12 and the lower fixing ring 13, the driving device 3 comprises a power supply 31, a control system 32 and a driving mechanism 33, the driving mechanism 33 has six, two driving mechanisms 33 are connected with the back surfaces of the upper fixing ring 11 and the middle fixing ring 12, two driving mechanisms 33 are connected with the back surfaces of the middle fixing ring 12 and the lower fixing ring 13, two driving mechanisms 33 are connected with the side surfaces of the upper fixing ring 11, the middle fixing ring 12 and the lower fixing ring 13, and the driving mechanisms 33 realize 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.

Preferably, the driving mechanism 33 includes an upper mounting base 331, a lower mounting base 332, two supporting rods 333, an expansion link 334 and a linear motor 335, the two supporting rods 333 are respectively disposed on the upper mounting base 331 and the lower mounting base 332, the linear motor 335 drives the expansion link 334, one ends of the linear motor 335 and the expansion link 334 are respectively hinged to the supporting rods 333 on the upper mounting base 331 and the lower mounting base 332, and the upper mounting base 331 and the lower mounting base 332 are used for being fixedly connected to the external fixing frame 1. The upper mounting seat 331 and the lower mounting seat 332 are respectively used for being fixedly connected with the outer sides of the upper fixing ring 11, the middle fixing ring 12 and the lower fixing ring 13, and the linear motor 335 is used for driving 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 supporting rod 333 according to the planned correction path.

Preferably, 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 with the control system 32. The control system 32 can provide personalized treatment schemes for the treatment of different types of compression fractures of different patients, intelligent correction is carried out according to the existing correction path, the force sensor 4 is used for measuring the stress of different parts of the external fixing frame 1, stress feedback of different parts of the body of the patient is provided for the control system 32, the correction path is corrected, and a better correction effect is ensured.

Preferably, the telescopic rod 334 is provided with a displacement sensor 5 for measuring the rod length of the telescopic rod 334. So that the control system 32 can obtain the real-time rod length parameter of each telescopic rod 334, and the telescopic length of the telescopic rod 333 can be accurately adjusted.

Preferably, the support rod 333 is slidably connected with the upper mounting seat 331 in a vertical direction, the support rod 333 is slidably connected with the lower mounting seat 332 in a horizontal direction, and the upper mounting seat 331 and the lower mounting seat 332 are both provided with locking screws 6 for locking the positions of the support rod 333. The supporting rod 333 on the upper mounting seat 331 can adjust the mounting length in the vertical direction, and the supporting rod 333 on the lower mounting seat 332 can adjust the mounting length in the horizontal direction, so that when the external fixing frame 1 is worn by a patient, the mounting distances and angles of the upper fixing ring 11, the middle fixing ring 12 and the lower fixing ring 13 on the body of the patient can be adjusted according to the body size of the patient, and the comfort of the patient is ensured.

Preferably, the external fixing frame 1 is provided with a plurality of vibrating massagers 7. The vibration massager 7 is used for performing vibration massage on the spine part of the patient to promote the recovery of the vertebral fracture part.

Preferably, the external fixing frame 1 is made of light alloy, and the inner lining 2 is a flexible breathable soft cushion. The comfort is improved while the effect of fixing on the body of the patient is guaranteed.

The invention also provides an application method of the intelligent dynamic orthosis for the osteoporotic and compressive fracture of the lumbar vertebral body, which comprises the following steps:

step one, acquiring sample set data of healthy volunteers and patients with vertebral compression fracture under various postures, wherein the sample set data comprises: cobb angle information, coronary offset distance, apical offset distance and patient basic information of chest bend and waist bend corresponding to healthy patients and patients with vertebral compression fracture;

establishing a deep neural network DNN model through the sample set data, and determining the correction path plan of the patient with vertebral compression fracture by taking the collected sample set data of the healthy person as a reference;

thirdly, arranging the external fixing frame 1 on the body of the scoliosis patient, establishing an external fixing mathematical model according to feedback data of the force sensor 4 and the displacement sensor 5 acquired by the control system 32 and by combining acquired sample set data, quantizing feedback input, and optimizing a correction path; the external fixation mathematical model is used for describing the position information and the motion information of the correction bone segment in a three-dimensional space; performing linear trajectory planning on the correction bone segment by a rectangular coordinate path control method to obtain a position posture parameter of the correction bone segment; acquiring length parameters of six telescopic rods 334 according to the position posture parameters of the correction bone segment;

and fourthly, based on the six multi-joint driving mechanisms 33 which are connected in series and in parallel, the control system 32 outputs dynamic torque which can adjust the amplitude and the direction, so that the lower fixing ring 13 (reference ring), the middle fixing ring 12 (moving ring) and the upper fixing ring 11 (moving ring) which are respectively attached to the pelvis, the waist section and the chest section realize six-degree-of-freedom motion, thereby realizing the full-degree-of-freedom motion of the waist and the chest relative to the pelvis and realizing the accurate control of the posture of the spine.

The Cobb angle information, the coronary offset distance and the apical vertebral offset distance of the chest bend and the waist bend corresponding to the healthy patient and the patient with the vertebral compression fracture specifically comprise: the CT/X-ray pictures of a healthy person and a patient with vertebral compression fracture are obtained, the middle point of the sacrum 1 vertebral body is used as an original point, the vertical direction distance between the sacrum 1 vertebral body and the thoracic 1 vertebral body is marked as a unit 100 of a vertical coordinate, the coordinate of each vertebral body is obtained through the marked middle point positions of 12 thoracic vertebrae and 5 lumbar vertebrae, the included angle obtained by intersecting tangent lines of thoracic curve and lumbar curve is measured and recorded as a Cobb angle, the horizontal coordinate of the thoracic 1 vertebral body is a coronal offset distance, and the horizontal coordinate of the middle point of a apical vertebra is a apical vertebra offset distance.

The external fixation mathematical model includes:

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 centers of the middle fixed ring 12 and the upper fixed ring 11 (moving ring) as the origins, and a global coordinate system { U } is established with the "start point" of the reference bone fragment as the origin; the initial values of the rod lengths of the telescopic rods 334 on the six driving mechanisms 33 are read: l1, L2, L3, L4, L5 and L6, calculating the initial position of the moving ring relative to the reference ring by using a position-posture forward solution algorithm, and using a position-posture matrixRepresents:

in the formula (I), the compound is shown in the specification,an attitude transformation matrix representing the mobile ring coordinate { P } relative to the reference ring coordinate { B },represents the position of the { P } origin of coordinates relative to the { B } coordinate system;

the deformity parameters were measured from a standard orthostatic X-ray film and a standard lateral position X-ray film, and the deformity parameters included three displacements and three angulations measured from the standard orthostatic X-ray film and the standard lateral position X-ray film:

medial or lateral orthostatic displacement: measuring the distance from the starting point to the corresponding point along the X-axis direction on a standard positive X-ray film;

righting angle of valgus or varus: measuring an included angle between the axes of the two bone segments on a standard positive X-ray film;

lateral displacement of the front or rear part: measuring the distance from the starting point to the corresponding point along the Y-axis direction on a standard side position X-ray film;

lateral angle of flexion or of reversal: measuring an included angle between the axes of the two bone segments on a lateral X-ray film;

axial displacement of compression or separation: measuring the distance from the starting point to the corresponding point along the Z-axis direction on the positive X-ray film or the lateral X-ray film;

axial angle of external or internal rotation: and measuring the rotation included angle of the reference bone segment and the moving bone segment on the sagittal plane.

Wherein, assuming the rotation angles around the fixed axis X-Y-Z as α ', β ', γ ', derived from the measured malformation parameters:

where, c α ═ cos α, s α ═ sin α, c β ═ cos β, s β ═ sin β, c γ ═ cos γ, and s γ ═ sin γ

Order to

Combine (2) and (3) to obtainThe results were obtained as follows:

(1) cos β' ≠ 0 then:

α’＝Atan2(r₂₃,r₃₃)

γ’＝Atan2(r₁₂,r₁₁)

(2) β' ± 90 ° then:

α’＝0

γ’＝±Atan2(r₂₁,r₂₂)

wherein Atan2(y, x) represents a bivariate arctangent function, and the signs of x and y determine the quadrant in which the angle is located, and [ alpha ', beta', gamma 'solved by the above formula']^TI.e. the actual amount of rotation of the external fixator 1 around the axis X, Y, Z.

Frame parameters were measured, including 3 offsets and 1 angulation measured from standard orthostatic and standard lateral radiographs:

medial or lateral reference ring center positive offset: measuring on a standard positive X-ray film, and referring to the offset of the center of the ring relative to the starting point;

anterior or posterior reference ring medial offset: measuring on a standard lateral X-ray film, and referring to the offset of the center of the ring relative to the starting point;

reference ring center axial offset: measuring on a standard positive X-ray film or measuring on a standard lateral X-ray film, and measuring the axial distance from the edge of the reference ring to the starting point;

reference ring rotation angle for external or internal rotation: clinically measuring the rotation angle of the sagittal plane of the reference ring relative to the sagittal plane of the reference bone segment;

deriving from the measured frame parameters a matrix of positions of the reference ring relative to the reference bone segmentsAnd representing to obtain a pose matrix of the moving ring relative to the reference bone segment:

fitting a local coordinate system { P }, { U } established by taking the center of the moving ring and the corresponding point of the moving bone segment as an origin to a global coordinate system to obtain a pose matrix of the moving ring relative to the moving bone segment:

in the formula (I), the compound is shown in the specification,a pose matrix representing the moving bone segments relative to the reference bone segments, formed by the variables x, y, z, α ', β ', γ ']Wherein [ x, y, z)]And [ alpha ', beta ', gamma ']Respectively representing the displacement of the corresponding point in three directions relative to the' starting pointOffset and rotation angles in three directions.

The invention discloses a use method of an intelligent dynamic orthosis for lumbar vertebra osteoporotic compression fracture, which comprises the following steps:

an upper fixing ring 11 is attached and fixed around the chest section of a patient, a middle fixing ring 12 is attached and fixed around the abdomen section of the patient, a lower fixing ring 13 is attached and fixed at the pelvis of the patient, a control system 32 plans a correction path according to the fracture condition of the patient and the position and posture information and other sample set data of the chest section, the abdomen section and the pelvis, an external fixation mathematical model is established by combining the feedback input of a force sensor 4 and a displacement sensor 5 and combining the acquired sample set data, the feedback input is quantified, the correction path is optimized, and the upper fixing ring 11 and the middle fixing ring 12 move in the vertical direction, the front and back direction, the left and right direction relative to the lower fixing ring 13 by controlling the movement direction and the angle of a driving mechanism 33, so that the full-degree-of-freedom movement of the waist and the chest relative to the pelvis is realized, the accurate control of the position and posture of the spine is realized by helping the patient to conveniently and accurately carry out rehabilitation function exercise, the joint stiffness and the disuse muscle atrophy are avoided; the vertebral column can be longitudinally stretched by the pituitary, and the fracture compression degree can be recovered to a certain extent in a conservative treatment mode, so that the affected part can be helped to perform better functional exercise, and better prognosis can be obtained.

In conclusion, the intelligent dynamic orthosis for the lumbar vertebral osteoporotic compression fracture and the application method provided by the invention solve the problems that the existing equipment cannot meet the requirements of quick rehabilitation and high-quality functional exercise of senile osteoporotic vertebral compression fracture.

The present invention has been described above by way of example, but the present invention is not limited to the above-described specific embodiments, and any modification or variation made based on the present invention is within the scope of the present invention as claimed.