TWI641358B - Spinal percutaneous puncture guidance system and puncture azimuth planning method - Google Patents

Abstract

A spinal percutaneous puncture guiding system and a puncture azimuth planning method, the system comprising a puncture guiding mechanism for guiding a puncture needle percutaneous puncture, and an image for capturing two X-ray images of the back and sides of the patient The picking device and a puncture azimuth calculation subsystem. The puncture path calculation subsystem can plan a puncture azimuth data for the medical staff to adjust the puncture guiding mechanism to guide the guiding ball of the puncture needle according to a path indicated by a medical staff in the X-ray images. In addition to the stable and accurate guidance of the puncture needle, the system can reduce the number of X-ray images during the operation because it does not need to take X-ray images multiple times to confirm the puncture state. It is an innovative spinal percutaneous skin. The puncture guidance system uses a new puncture azimuth planning method.

Description

Spinal percutaneous puncture guidance system and puncture azimuth planning method

The invention relates to a percutaneous puncture guiding system and a percutaneous puncture azimuth planning system, in particular to a spinal percutaneous puncture guiding system and a spinal percutaneous puncture azimuth planning method.

Common spinal lesions are caused by external forces, degenerative diseases (such as disc herniation, lumbar spondylolisthesis, etc.), lumbar scoliosis and osteoporosis, etc. For the treatment of the above-mentioned spinal lesions, the general degree of lesions usually Medical treatment and physical therapy will be given, but for more severe lesions, it will be treated by spinal surgery.

When performing spinal surgery, due to the large open wounds, high blood loss, and general anesthesia, the chances of complications are also increased. Therefore, the doctor will change the spinal percutaneous puncture according to the patient's condition. Implants such as bone fusion materials and artificial bone mud.

Because the shape of the vertebrae of the spine is different and there are individual differences, when performing spinal transcutaneous surgery, the doctor will first determine the puncture position by X-ray images of multiple spinal affected parts, and plan the surgical puncture path according to experience. The puncture needle is directly punctured through the body surface into a predetermined vertebral portion. However, during the spinal percutaneous puncture procedure, the physician confirms that the puncture angle and position are still guessed by experience and is approximated by trial and error. The puncture angle and orientation are adjusted one by one according to the X-ray images taken during the operation. The needle passes through the vertebral foot and reaches the inside of the vertebral body correctly. According to past experience, a spinal percutaneous puncture operation needs to be adjusted and adjusted at least ten times. In addition to causing the operation time to be too long, such high-frequency X-ray images enable both medical personnel and patients to withstand considerable radiation doses.

Therefore, how to provide a spine percutaneous acuity planning system and azimuth planning method that can reduce the number of X-ray images and improve the stability and accuracy of surgery is an urgent problem to be solved in the medical field.

Accordingly, it is an object of the present invention to provide a spinal percutaneous acuity planning method and planning system that improves at least one of the disadvantages of the prior art.

Therefore, the spinal percutaneous puncture guiding system of the present invention is suitable for puncture guiding of a puncture needle of one of the patients for spinal percutaneous puncture. The spinal percutaneous puncture guiding system includes a puncture guiding mechanism for setting on the back surface of the patient, and a photograph for capturing the patient's spine from the back and sides of the patient. The X-ray image capturing device and a signal connected to the image capturing device are capable of receiving a puncture azimuth calculation subsystem for displaying the X-ray images. The puncture guiding mechanism includes a guiding ball that is positionally rotatable relative to the patient and is used for perforating the puncture needle for percutaneous puncture. The puncture azimuth calculation subsystem includes a spatial relationship analysis unit, a path planning unit, and a puncture azimuth calculation unit. The spatial relationship analyzing unit can calculate a spatial correspondence relationship between the image space of the X-ray images and the practical space of the puncture guiding mechanism according to the X-ray images. The path planning unit is operable to plan a path image extending through a particular portion of the spine for each X-ray image. The puncture azimuth calculating unit can analyze the path images of the X-ray images to be planned according to the spatial correspondence, and calculate a puncture path for guiding the puncture needle into a specific part of the spine of the patient via the guiding ball. Puncture orientation data.

Thus, the puncture azimuth calculation subsystem of the present invention is adapted to pass through a puncture guiding mechanism disposed on a back surface of a patient, and two X-ray images respectively taken from the patient's back and sides to the patient. The patient underwent a puncture azimuth planning for spinal percutaneous puncture. The puncture guiding mechanism includes a guiding ball that is rotatable relative to the patient and is used to guide a puncture needle. The puncture azimuth calculation subsystem is capable of receiving and displaying the X-ray images, and includes a spatial relationship analysis unit, a path planning unit, and a puncture azimuth calculation unit. The spatial relationship analyzing unit can calculate a spatial correspondence relationship between the image space of the X-ray images and the practical space of the puncture guiding mechanism according to the X-ray images. The path planning unit is operable to plan a path image extending through a particular portion of the spine for each X-ray image. The puncture azimuth calculating unit can analyze the path images of the X-ray images to be planned according to the spatial correspondence, and calculate a puncture path for guiding the puncture needle into a specific part of the spine of the patient via the guiding ball. Puncture orientation data.

Therefore, the puncture azimuth planning method for spinal percutaneous puncture of the present invention is suitable for performing a puncture azimuth planning with a puncture guiding mechanism for setting a back surface of a patient who is to undergo spinal percutaneous puncture. The guiding mechanism includes a guiding ball that is rotatable relative to the patient and is used to guide a puncture needle. The puncture azimuth planning method comprises the following steps: (A) causing an image capturing device to capture an X-ray image of the patient's spine from the back and sides of the patient; (B) making a The spinal percutaneous puncture guiding system calculates a spatial correspondence relationship between the image space of the X-ray image and the practical space of the puncture guiding mechanism according to the X-ray images; (C) the spinal percutaneous puncture guiding system The analysis extracts a path image of each of the X-ray images that is extended through a specific portion of the patient's spine; and (D) causes the spinal percutaneous puncture guidance system to analyze the path images according to the spatial correspondence relationship, A puncture azimuth data for guiding a puncture path of the puncture needle into a specific portion of the patient's spine via the guiding ball is calculated.

The effect of the invention is that the system can accurately plan the puncture orientation data corresponding to the puncture guiding mechanism by directly marking the path image in the X-ray images, which can facilitate the medical personnel to according to the puncture position data. Directly adjusting the puncturing guide mechanism for guiding the eccentric rotation of the guiding ball of the puncturing needle, in addition to stably and accurately guiding the puncturing needle, the number of X-ray images taken during the spinal percutaneous puncture operation can be reduced. An innovative azimuth planning and guiding technique for spinal percutaneous puncture.

The invention will be further illustrated by the following examples, but it should be understood that this embodiment is for illustrative purposes only and is not to be construed as limiting The number is indicated.

Referring to Figures 1, 3 and 6, an embodiment of the spinal percutaneous aspiration orientation planning system of the present invention is applicable to a puncture needle 900 for spinal percutaneous puncture of a patient 800 lying on the operating table 700 (shown in Figure 9) Puncture azimuth planning and guidance. For convenience of description, in the following embodiments, the horizontal extension direction of the head and foot when the patient is lying on the operating table 700 is defined as a first direction 802, and a level with the first direction 802 is defined accordingly. Orthogonal second direction 803.

The spinal percutaneous aspiration planning system includes a puncture guiding mechanism 3 for positioning on the back of the patient 800 for guiding the puncture needle 900, and an angle meter 4 for being disposed on the puncture guiding mechanism 3, An image capturing device 5 disposed around the operating table 700, and a puncture azimuth calculation subsystem 6. In this embodiment, the puncture azimuth calculation subsystem 6 is an electronic device capable of communicating and data transmission with the angle meter 4 and the image capturing device 5, and the communication may be through wired communication technology or wireless communication technology. . However, in another embodiment of the present invention, the puncture azimuth calculation subsystem 6 can also be implemented in an electronic device through a software program type, and the angle meter 4 can be connected through the electronic device signal. The image capture device 5 performs communication and data transmission.

Referring to Figures 2 and 3, the puncture guide mechanism 3 includes a base 31 extending along the first direction 802 for positioning on the back surface of the patient 800 (shown in Figure 6), spaced along the second direction 803. a positioning seat 33 mounted on the base 31 and a guiding base unit 32, a guiding ball 34 mounted on the guiding base unit 32 and movably positioned relative to the patient 800 by the guiding base unit 32, a first ruler rod 35 extending along the first direction 802 and mounted on the base 31 and having a size scale on the top surface, and a first surface of the guide seat unit 32 extending along the second direction 803 A second ruler lever 36 having a size scale is provided. The displacement of the guide ball 34 includes a horizontal displacement in the first direction 802 and the second direction 803, and a rotation in the first direction 802 and the second direction 803.

The positioning block 33 has a plurality of three-dimensionally spaced-apart markers 331 that can be imaged in the X-ray image 50 captured by the image capturing device 5 when the image capturing device 5 performs X-ray imaging. As shown in Figures 8 and 9. In the present embodiment, the three-dimensional distribution orientation of the markers 331 is designed to enable X-ray photography in the two orthogonal directions of the back and the side of the patient 800 by the image capturing device 5 The X-ray images 50 are imaged separately without overlapping each other.

In this embodiment, each of the markers 331 is a metal ball, such as a stainless steel material. However, the material of the markers 331 is not limited thereto.

The guiding unit 32 includes a first screw 321 extending along the first direction 802 and movably mounted on the base 31 along the first direction 802. A screw sleeve is sleeved on the first screw 321 and can be The first transfer member 322 positioned in the base 31 is rotatably mounted, and a second screw 323 extending along the second direction 803 and having one end connected to one end of the first screw 321 is driven along the second screw 323. The second direction 803 is slidably disposed on the slider 324 outside the second screw 323, and the second shifting sleeve is sleeved on the second screw 323 and can be driven to be engaged in the second shift of the slider 324. A member 325, and a positioning member 326 mounted on the slider 324 for locking the guiding ball 34.

The guiding ball 34 is mounted on the slider 324, can rotate relative to the slider 324 in the first direction 802 (as shown in FIG. 5), and rotates in the second direction 803 (as shown in FIG. 4), and has a top and bottom A puncture hole 341 that is inserted radially for insertion of the puncture needle 900.

The first ruler rod 35 is located above the first screw 321 , and the second ruler rod 36 is fixed at one end of the first screw 321 at one end thereof, and the second screw 323 is along the first One direction 802 is spaced apart from each other, and the slider 324 is slidably disposed outside the second screw 323 and the second ruler lever 36.

Referring to FIGS. 2 and 3, when the guiding ball 34 is to be moved in the first direction 802, the first transfer member 322 can be driven, and the first screw 321 screwed by the transmission phase is connected via the connection. The second screw 323 drives the slider 324, the second ruler lever 36 and the guiding ball 34 to be displaced along the first direction 802, and can view the first screw by viewing the size scale of the first ruler lever 35. 321 is at a position relative to the base 31 in the first direction 802, and the horizontal displacement position of the guiding ball 34 in the first direction 802 can be known.

When the guiding ball 34 is to be moved in the second direction 803, the second transfer member 325 can be adjusted, and the second transfer member 325 that is driven to be driven is long along the second screw 323 that is screwed to the phase. To the displacement, the slider 324 of the interlocking phase card drives the guiding ball 34 to be synchronously displaced along the second direction 803, and the slider 324 can be known by viewing the size scale of the second ruler lever 36. Relative to the position of the base 31 in the second direction 803, the horizontal displacement position of the guiding ball 34 in the second direction 803 is known. The guide ball 34 can be moved to a specific position by shifting the slider 324.

The positioning member 326 is a bolt. When the guiding ball 34 needs to be positioned at a specific rotation angle, the positioning member 326 can be rotated and rotated relative to the sliding member 324 to urge the positioning member 326 to be tight relative to the sliding member 324. The guiding ball 34 is fixed.

Referring to FIGS. 3 and 7, the angle meter 4 has a carrier 41 for detachably inserting the puncture hole 341 of the guiding ball 34, and is mounted on the carrier 41 and can sense the bearing. The angle sensing module 42 of the rotation angle of the seat 41 and a wireless communication module 43 mounted on the carrier 41 and connected to the angle sensing module 42 are connected. The wireless communication module 43 can wirelessly communicate with the puncture azimuth calculation subsystem 6, and the rotation angle measured by the angle sensing module 42 can be wirelessly transmitted to the puncture azimuth calculation subsystem 6. In this embodiment, the wireless communication between the wireless communication module 43 and the puncture azimuth calculation subsystem 6 uses Bluetooth wireless communication technology, but the implementation is not limited thereto, and other common wireless communication technologies are also available. Replace.

Referring to Figures 1, 8, and 9, the image capturing device 5 is mounted around the operating table 700 and can be separately moved in two orthogonal directions of the back and sides of the patient 800 lying on the operating table 700. Two X-ray images 50 are obtained by X-ray photography, and each X-ray image 50 presents the image of the spine 801 of the patient 800 and the image of the marker 331 of the puncture guiding mechanism 3. In the implementation, the image capturing device 5 does not need to be orthogonal to the two imaging directions when the X-ray images 50 are captured on the back and side of the patient 800, and may be performed in the case of being nearly orthogonal. Shooting of the light image 50.

Referring to Figures 1, 7, and 8, the puncture azimuth calculation subsystem 6 includes a display unit 61, a path planning unit 62, a spatial relationship analysis unit 63, and a puncture azimuth calculation unit 64. The display unit 61 can display the X-ray images 50 captured by the image capturing device 5.

The spatial relationship analyzing unit 63 reads and analyzes the distribution orientations of the markers 331 in the X-ray images 50 to calculate an image space of the X-ray images and a practical space of the puncture guiding mechanism 3. The spatial correspondence. Since the markers 331 located in the X-ray images 50 correspond to each other, the image coordinates of each marker 331 in the respective X-ray images 50 are analyzed by image processing techniques, and then according to each marker. The image coordinates of each of the markers 331 are converted into camera coordinates corresponding to the image capturing device 5 according to the relative distribution orientation of the objects 331 in the X-ray images 50, and according to the positioning block 33 and the image capturing device The spatial orientation information is calculated for the five camera orientation data and the camera coordinates of the markers 331 of the X-ray images 50.

The path planning unit 62 can be configured on each X-ray image 50 displayed by the display unit 61 by directly touching the display unit 61 or by inputting a tool such as a keyboard and a mouse. A linear path image 620 extending through a particular portion of the spine 801. In this embodiment, the path image 620 is a vertebral foot portion that extends through a specific vertebra of the spine 801 of the patient 800, but is not limited thereto.

The puncture azimuth calculation unit 64 analyzes the path image 620 planned on the X-ray images 50 according to the spatial correspondence, and calculates a guide puncture needle 900 (shown in FIG. 9) from the patient 800 body surface. The puncture path of the specific portion of the spine 801 of the patient 800 is extended, and the puncture position data of the puncture path is calculated. The content of the piercing position information includes a scale position of the guiding ball 34 relative to the first ruler bar 35 and the second ruler bar 36, and the guiding ball 34 is relative to the specific portion of the spine of the patient 800 The angle of rotation of the first direction 802 and the second direction 803.

Referring to Figures 6, 7, and 8 of the present invention, the spinal percutaneous aspiration orientation planning system is used to fix the puncture guiding mechanism 3 to the back of the patient 800, and is located substantially above the affected part of the spine 801 of the patient 800, and then the image is used. The capturing device 5 takes an X-ray image 50 toward the back and sides of the patient 800.

At this time, the puncture azimuth calculation subsystem 6 calculates the spatial correspondence corresponding to the puncture guiding mechanism 3 based on the X-ray images 50. Then, the medical staff can plan a path image 620 of each of the X-ray images 50 displayed by the puncture azimuth calculation subsystem 6 to extend the vertebral foot through the diseased vertebra according to the position of the diseased vertebra. The puncture azimuth calculation subsystem 6 analyzes the path images 620 in which the X-ray images 50 are planned according to the spatial correspondence, and calculates a piece for guiding the puncture needle 900 to extend from the puncture guide mechanism 3. The puncture path of the vertebral foot of the diseased vertebra, and the puncture position data of the puncture path is displayed on the display unit 61.

Referring to FIG. 4 and FIG. 5, the medical staff can display the first shifting lever 35 and the second gauge rail 36 according to the piercing position data, and adjust the first shifting member 322 and the second tone. In the manner of the moving member 325, the slider 324 is moved relative to the base 31 along the first direction 802 and the second direction 803, so that the slider 324 drives the guiding ball 34 to the corresponding scale position.

Then, based on the rotation angle displayed by the puncture azimuth data, the angle 4 is used to assist in adjusting the guiding ball 34. First, the angle meter 4 is erected on the base 31, as shown in the imaginary line of FIG. 2, and after the angle meter 4 is set to zero, the angle meter 4 is inserted into the guide ball. In the puncture hole 341 of the 34, the angle meter 4 is swung in the first direction 802 and the second direction 803, so as to synchronously drive the guiding ball 34 to rotate. At this time, the angle meter 4 will measure it. The rotation angle data is wirelessly transmitted to the puncture azimuth calculation subsystem 6 and displayed on the display unit 61 in real time. The medical staff can know the current rotation angle of the guide ball 34 according to the rotation angle data displayed by the display unit 61. When the guiding ball 34 is adjusted to the desired deflection angle, the positioning member 326 can be driven to tighten the guiding ball 34, so that the guiding ball 34 can be rotationally positioned relative to the sliding block 324, and then the positioning The angle meter 4 is detached from the guide ball 34.

Referring to Figures 6, 8, and 9, after the adjustment operation is completed, the puncture hole 341 of the guiding ball 34 is coaxial with the puncture path, and the medical staff can pass the puncture needle 900 through the guiding ball 34. The hole 341 is used for percutaneous puncture of the spine. During the spinal percutaneous puncture operation, due to the guiding of the guiding ball 34, the puncture needle 900 can be stably guided into the patient 800 in a predetermined puncture direction, although it is necessary to pass through the shooting. The patient's 800 back and side X-ray images 50 confirm whether the puncture needle 900 has reached the predetermined puncture site, but during the puncture process, the X-ray image 50 can be greatly reduced to confirm the number of times the puncture needle 900 is oriented. The X-ray dose received by the medical staff and the patient 800 can be greatly reduced.

In this embodiment, the content of the puncture azimuth data generated by the puncture azimuth calculation subsystem 6 includes a horizontal displacement position and a rotation angle of the guiding ball 34 in the first direction 802 and the second direction 803, but is implemented. In another embodiment of the present invention, the slider 324 can be designed to be horizontally shiftable relative to the base 31 in the first direction 802 and the second direction 803, so that the guiding ball 34 can only The patient is rotated relative to the patient and cannot be displaced horizontally relative to the patient. In this case, the puncture azimuth calculation subsystem 6 can be designed to generate the puncture azimuth data only for the rotational angle analysis of the guiding ball 34. With this design, the guiding position of the puncture hole 34 and the puncture path can be stably guided by the rotation of the guiding ball 34, and the puncture needle 900 can be stably guided to perform a percutaneous puncture along the puncture path.

Moreover, in still another embodiment of the present invention, the guiding ball 34 can be designed to be unable to rotate relative to the slider 324, and can only be linked by the slider 324 in the first direction 802 and the second. The direction 803 is horizontally displaced. At this time, the puncture azimuth calculation subsystem 6 can be designed to generate the puncture azimuth data only for the horizontal displacement analysis of the guiding ball 34, thereby designing the same through the guiding ball. The horizontal displacement is positioned at a position coaxial with the puncture path of the puncture hole 341, and the puncture needle 900 can be stably guided to perform a percutaneous puncture operation along the puncture path.

In addition, in the present embodiment, the markers 331 fixed to the positioning base 33 of the base 31 are designed such that the puncture azimuth calculation subsystem 6 can display the markers according to the X-ray images 50. 331 distribution orientation, the spatial relationship between the image space of the X-ray image 50 and the practice space of the puncture guiding mechanism 3 is calculated, but in practice, it may be additionally disposed on the image capturing device 5, Or a marker disposed in the shooting range of the image capturing device 55 for capturing the X-ray images for calculating the spatial correspondence. Since there are many methods for calculating the spatial correspondence by analyzing the X-ray images 50, the implementation is not limited to the above.

In summary, the puncture path 6 allows the medical staff to quickly calculate the design of the puncture azimuth data corresponding to the puncture guiding mechanism 3 by directly planning the path images 620 in the X-ray images 50. And the angle meter 4 transmits the measured rotation angle data to the design of the puncture path calculation subsystem 6 to facilitate the medical staff to adjust the level of the guiding ball 34 of the puncture guiding mechanism 3 according to the puncture azimuth data. The displacement position and the rotation angle, in addition to accurately guiding the puncture path of the puncture needle 900, can also reduce the number of X-ray images taken during the spinal percutaneous puncture operation, and relatively reduce the dose of the X-rays contacted by the medical staff and the patient, which is a kind of Innovative puncture azimuth planning guidance system design for spinal percutaneous puncture surgery. Therefore, the object of the present invention can be achieved.

However, the above is only the embodiment of the present invention, and the scope of the invention is not limited thereto, and all the simple equivalent changes and modifications according to the scope of the patent application and the patent specification of the present invention are still Within the scope of the invention patent.

3‧‧‧Puncture guide mechanism

31‧‧‧Base

32‧‧‧Guide unit

321‧‧‧First screw

322‧‧‧First transfer

323‧‧‧Second screw

324‧‧‧ Slider

325‧‧‧Second transfer

326‧‧‧ positioning parts

34‧‧‧guide ball

341‧‧‧Puncture hole

33‧‧‧ Positioning Block

331‧‧‧ mark

35‧‧‧First ruler

36‧‧‧Second ruler

4‧‧‧ Angle meter

41‧‧‧ bearing seat

42‧‧‧Angle sensing module

43‧‧‧Wireless communication module

5‧‧‧Image capture device

50‧‧‧X-ray image

6‧‧‧Puncture Azimuth Calculation Subsystem

61‧‧‧Display unit

62‧‧‧Path Planning Unit

620‧‧‧Path image

63‧‧‧ Spatial Relationship Analysis Unit

64‧‧‧Puncture Azimuth Calculation Unit

700‧‧‧Operation table

800‧‧‧ patients

801‧‧‧ spine

802‧‧‧ first direction

803‧‧‧second direction

900‧‧‧Puncture needle

Other features and advantages of the present invention will be apparent from the embodiments of the present invention, wherein: Figure 1 is a schematic view of an embodiment of a spinal percutaneous puncture guidance system of the present invention; 3 is a perspective view of a puncture guiding mechanism of the embodiment; FIG. 4 is a side view of the puncture guiding mechanism of the embodiment in a first direction; 5 is a side view of the puncture guiding mechanism of the embodiment in a second direction; FIG. 6 is a top plan view of the puncture guiding mechanism disposed on a back of a patient lying on an operating table; FIG. 8 is a schematic diagram of two X-ray images taken by an image capturing device of the embodiment before surgery, and a path image is set on each X-ray image, wherein (A) is from the The patient's back is photographed, (B) is taken from the side of the patient; and FIG. 9 is a view similar to FIG. 8 showing that the puncture needle of the spine is used to accurately puncture the image along the path, wherein A) was taken from the back of the patient, (B) was taken from a side portion of the patient.

Claims (17)

A spinal percutaneous puncture guiding system, which is suitable for puncture guiding of a puncture needle of a spinal percutaneous puncture operation of a patient, and comprising: a puncture guiding mechanism for setting on the back surface of the patient, including a guide ball positionable relative to the patient for interspersing the needle for percutaneous puncture; an image capture device for capturing a display of the patient from the back and sides of the patient An X-ray image of the patient's spine; and a puncture azimuth calculation subsystem, the signal being coupled to the image capture device for receiving and displaying the X-ray image, comprising: a spatial relationship analysis unit capable of being based on the X-rays The image calculates a spatial correspondence relationship between the image space of the X-ray image and the practice space of the puncture guiding mechanism, and a path planning unit operable to plan a specific extension of the X-ray image through the spine a path image of the part and a puncture azimuth calculation unit capable of analyzing the path images of the X-ray images to be planned according to the spatial correspondence relationship, Calculate a puncture needle of the puncture path of the puncture location information for a particular portion of the spine of the patient through the guiding ball guide. The spinal percutaneous puncture guiding system according to claim 1, wherein the image capturing device respectively captures the X-ray images in two orthogonal directions of the back and the side of the patient. The spinal percutaneous puncture guiding system of claim 1 or 2, wherein the puncture guiding mechanism further comprises a positioning seat having a plurality of spaced-apart markers, each X-ray image showing the patient's spine and The markers, the spatial relationship analyzing unit calculates the spatial correspondence according to the distribution orientations of the markers displayed by the X-ray images. The spinal percutaneous puncture guiding system of claim 1 or 2, wherein the guiding ball is rotatable relative to the patient, the puncture site position data comprising a rotation angle of the guiding ball relative to a particular portion of the spine of the patient. The spinal percutaneous puncture guiding system of claim 4, further comprising an angle meter detachably disposed on the guiding ball and connected to the puncture azimuth calculation subsystem signal, the angle meter being linked The guiding ball rotates and instantly detects the rotation angle of the guiding ball. The puncture azimuth calculation subsystem further includes a display unit for displaying the rotation angle and the rotation angle. The spinal percutaneous puncture guiding system of claim 5, wherein the guiding ball has a puncture hole extending radially through the center thereof for piercing the puncture needle, the angle meter including a detachable a carrier that is inserted into the puncture hole and can rotate the guiding ball, an angle sensing module mounted on the bearing seat for measuring and outputting the rotation angle, and a calculation for the puncture orientation The wireless communication module wirelessly communicates the rotation angle of the subsystem. The spinal percutaneous puncture guiding system of claim 4, wherein the puncture guiding mechanism further comprises a guiding unit having a horizontal direction adjustable to the patient in two orthogonal directions Positioning the slider, the guiding ball is mounted on the slider in a relative displacement and relatively rotationally positionable, and the piercing position information further includes the guiding ball at the level relative to the specific part of the spine of the patient The horizontal displacement position of the direction. The spinal percutaneous puncture guiding system according to claim 7, wherein the horizontal extension direction of the head and foot when the patient lies on the operating table is defined as a first direction, and a horizontally orthogonal to the first direction is defined accordingly The second direction, wherein the puncture guiding mechanism further comprises a base, the guiding base unit is mounted on the base, and further comprising a first portion extending along the first direction and movably mounted in the first direction a screw, a screw sleeve is disposed on the first screw and is disposed at the base and can be driven to drive the first shifting member of the first screw displaced relative to the base, and one extending along the second direction a second screw fixed at one end of the first screw, and a second adjusting member disposed on the second screw, the slider being sleeved in the second direction a second screw, the guiding ball is rotatably mounted to the slider in the first direction and the second direction, and the second shifting member can be driven to drive the slider in the second direction relative to the first Two screw displacement. The spinal percutaneous puncture guiding system of claim 8, wherein the puncture guiding mechanism further comprises a first step extending in the first direction and fixed to the base to be parallel to the first screw and provided with a size scale. a one-foot ruler, and a second ruler rod mounted on the first screw in parallel with the second screw and provided with a size scale, the slider being traversable in the second direction Two screws and the second ruler rod. A puncture azimuth calculation subsystem is applicable to a patient through a puncture guiding mechanism disposed on a back surface of a patient and two X-ray images taken from the patient's back and sides respectively The puncture azimuth planning of the spinal percutaneous puncture surgery, the puncture guiding mechanism includes a guiding ball for guiding a puncture needle, and the puncture azimuth calculation subsystem can receive and display the X-ray images, and includes: a spatial relationship The analyzing unit can calculate a spatial correspondence relationship between the image space of the X-ray image and the practical space of the puncture guiding mechanism according to the X-ray images; a path planning unit capable of operating for each X-ray The image planning a path image extending through a specific part of the spine; and a puncture azimuth calculating unit capable of analyzing the path images of the X-ray images to be planned according to the spatial correspondence, and calculating a path through the guiding ball The puncture azimuth data of the puncture path of the specific site of the spine of the patient is guided by the puncture needle. The puncture azimuth calculation subsystem of claim 10, wherein the guiding ball is rotatable relative to the patient, wherein the puncture position information comprises a rotation angle of the guiding ball relative to a specific portion of the spine of the patient. The puncture azimuth calculation subsystem of claim 11, the puncture guiding mechanism further comprising a slider that can be positioned relative to the patient in two orthogonal horizontal directions, the guiding ball being movable and displaced The slider is mounted to the slider in a relatively rotatable manner, wherein the piercing position calculation unit calculates the position information of the piercing position further includes a horizontal displacement position of the guiding ball relative to the specific portion of the spine of the patient in the horizontal direction. A puncture azimuth planning method for spinal percutaneous puncture, which is suitable for performing a puncture azimuth planning with a puncture guiding mechanism for setting a back body surface of a patient undergoing spinal percutaneous puncture, the puncture guiding mechanism comprising A guiding ball for guiding a puncture needle, the puncture azimuth planning method comprises the following steps: (A) causing an image capturing device to capture a picture of the patient from the back and sides of the patient An X-ray image of the patient's spine; (B) causing a spinal percutaneous puncture guidance system to calculate a spatial correspondence between the image space of the X-ray image and the practice space of the puncture guiding mechanism based on the X-ray images (C) causing the spinal percutaneous puncture guidance system to extract a path image of each of the X-ray images that is projected through a particular portion of the patient's spine; and (D) percutaneous puncture of the spine The indexing system analyzes the path images according to the spatial correspondence, and calculates a puncture through the guiding ball to guide the puncture needle into a specific part of the patient's spine Diameter puncture position information. The puncture azimuth planning method for spinal percutaneous puncture according to claim 13, wherein the step (A) is to obtain the image capturing device from two directions orthogonal to the back and the side of the patient. These X-ray images. The puncture azimuth planning method for spinal percutaneous puncture according to claim 13 or 14, wherein the puncture guiding mechanism further comprises a positioning seat having a plurality of spaced-apart markers, wherein the step (A) is The image capturing device captures an X-ray image of the patient's spine and the markers from the back and sides of the patient, and the step (B) is to percutaneously guide the spine. The indexing system converts the image coordinates of each of the X-ray images into camera coordinates corresponding to the image capturing device, and then according to the shooting orientation of the image capturing device relative to the positioning seat, and the markings The camera coordinates of the object calculate the spatial correspondence. The puncture azimuth planning method for spinal percutaneous puncture according to claim 13 or 14, wherein the guiding ball can be rotationally positioned relative to the patient, wherein the puncture position information calculated in the step (D) includes the guiding The angle of rotation of the ball relative to a particular part of the spine. The puncture azimuth planning method for spinal percutaneous puncture according to claim 16, wherein the puncture guiding mechanism further comprises a slider that can be positioned relative to the patient in two orthogonal horizontal directions, the guiding ball The slider is mounted in the slider and can be relatively rotationally positioned, wherein the step (D) of the spinal percutaneous puncture guidance system calculates the puncture position data according to the spatial correspondence relationship. And including a horizontal displacement position of the guiding ball relative to the specific portion of the spine of the patient in the horizontal direction.