CN107432764B - Anterior cervical vertebrae controllably moves forward instrument - Google Patents
Anterior cervical vertebrae controllably moves forward instrument Download PDFInfo
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- CN107432764B CN107432764B CN201710729235.8A CN201710729235A CN107432764B CN 107432764 B CN107432764 B CN 107432764B CN 201710729235 A CN201710729235 A CN 201710729235A CN 107432764 B CN107432764 B CN 107432764B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
- A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
- A61B17/7005—Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit in the screw or hook heads
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
- A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
- A61B17/7077—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
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Abstract
It controllably moves forward instrument the present invention relates to a kind of anterior cervical vertebrae, is equipped with fixed arm, moving arm, rack gear, slot type gag lever post and lifting rod；The fixed arm and moving arm lower end assembles centrum screw；The rack gear and slot type gag lever post is connected and fixed arm and moving arm, and being capable of sliding opposite with moving arm；The lifting rod is inserted in the limiting slot of slot type gag lever post, lifting rod is equipped with the adjusting screw rod and adjusting nut to socket-connect, the adjusting nut incarceration is equipped with oblique through-hole, the oblique through-hole mounted inside angle fixing glue in the top of limiting slot, the lifting rod lower end；The anterior cervical vertebrae instrument that controllably moves forward also includes synchronous lifting component.The anterior cervical vertebrae of the invention instrument that controllably moves forward is able to achieve preceding road centrum side approach, realizes the Forward of posterior longitudinal ligament ossification correlation centrum, using flexible, operate it is quantitative, controllable, lifting uniformly, can get good surgical effect, it is small to patient's damage, there is wide potential applicability in clinical practice.
Description
Technical field
The present invention relates to the field of medical instrument technology, specifically, being related to a kind of approach surgery for cervical posterior longitudinal ligament ossification
The anterior cervical vertebrae of disease controllably moves forward instrument.
Background technique
Cervical ossified posterior longitudinal ligament (OPLL) refers to that the posterior longitudinal ligament in Cervical Vertebral Canal Procedures is substituted by calcified tissue, to lure
A kind of disease for sending out intraspinal tube spinal compression and nervous function deterioration can lead to limbs feeling and dyskinesia and internal organ plant mind
Through dysfunction.According to the performance of cervical vertebra X on piece, it can be four seed types: 1. focal types by OPLL points, isolate ossification posterior longitudinal ligament
Lesion only involves single centrum or intervertenral space；2. segmental pattern, multiple independent posterior longitudinal ligament ossification lesions, each lesion range
Only involve single centrum or intervertenral space；3. continuous type, single lesion involve multiple intervertenral spaces and interverbebral disc；4. mixed type, above-mentioned
The mixing of three types.The disease has generation, incidence 0.1%-1.7% in worldwide ethnic group.
Clinician is needed to fully understand the Pathological Physiology of OPLL, disease when treating to the patient of posterior longitudinal ligament ossification
The clinical symptoms and Features of disease, and it is familiar with the basic principle and strategy of OPLL operative treatment.It is to imaging diagnosis
OPLL and patient without severe spinal compressing, if row is regularly observed without apparent clinical symptoms, without to this kind of trouble
Person carries out prophylactic surgery.But for having serious cord symptom, 3-4 grades of Nurick Neuroscore or having serious mind
OPLL patient through root disease, then need decompression.Operative approach includes preceding road, the way of escape or facet locking.Anterior decompression
Modus operandi generally includes Subtotal vertebrectomy or discectomy combines preceding road ossification posterior longitudinal ligament resection, and intervertebral melts
It closes；Posterior approach is the indirect decompression mode of OPLL, including laminoplasty or vertebrae plate resection+fusion.But above each hand
Art mode all has certain defect.The shortcomings that anterior decompression merges is that technical difficulty is larger, to the posterior longitudinal ligament bone of the segment C2
Change be difficult to accomplish directly to depressurize, postoperative pseudarthrosis formation probability is higher, the centrum range if desired depressurized at 3 or more,
It is easy to appear dysphagia, while anterior approach is easier dura mater tearing occur compared with posterior approach；Way of escape vertebrae plate resection+fusion category
In indirect decompression, there is the risk of OPLL continuing advances, it is poor to the case effect of severe spinal compressing, C5 Radiculopathy
Risk Lu Genggao earlier above；The shortcomings that way of escape laminoplasty, is similar with vertebrae plate resection+fusion, but the risk that its progression of disease deteriorates
It is higher, if patient has the lordosis of cervical vertebra to lose, the art formula cannot be used.
Centrum is corresponded to by preceding road Forward ossification posterior longitudinal ligament currently, yet there are no, in conjunction with intervertebral fusion so that after ossification
Longitudinal ligament forms isolated island, releases the modus operandi of spinal compression.
Patent document CN102895017A, publication date 2013.01.30 disclose a kind of parallel vertebral fusion of corpus vertebrae replacement
It is fixed, it is final to restore to strut lifting reduction forceps, carrying handle I between the normal Axial symptoms of backbone and the lumbar vertebra of line of force relationship
Head to form caliper rotation with closing up the head of handle II around rivet and rotating and be rotatably assorted, screw rod, which passes through, closes up II rear side of handle
In the dynamic cooperation of buckle-type, nut is embedded in the through-hole for closing up handle II for the through-hole in face and the triangle card slot of I tail portion of carrying handle
And cooperation is helically moved with screw rod, carrying handle I is hollow tube slot structure, and flexible pulling item is worn from the head of carrying handle I
Flexible lifting mouth is collectively formed after out with the plier for closing up II head of handle, pulling item tail portion of stretching passes through spiral handle.Patent text
CN204863423U, day for announcing 2015.12.16 are offered, a kind of pulling off reset device for cervical operation, including pedestal are disclosed
And sliding shoe, the sliding shoe are located at the side of pedestal and are slidably matched with pedestal, the end of the pedestal is extended to side
Limited block, the limited block and sliding shoe are located at the same side of pedestal, and a screw hole is respectively provided on the limited block and sliding shoe,
Release link is threaded in two screw holes respectively, the end of release link has insertion cervical vertebra and fixes the fixation of cervical vertebra
Tip, which, which not only has, basic struts function, moreover it is possible to keep the centrum of dislocation gradually multiple using the lifting effect of release link
Position, reseting procedure is steady, accurate, controllable, does not need insertion intervertenral space and is operated, using conveniently, safely, energy after corpus vertebrae replacement
Interpyramidal reset relationship is kept until completing reliable intervertebral fixed operation.However corpus vertebrae replacement is pertained only in the prior art
Related equipment, but the dislocations such as articuli intervertebrales and ossification of cervical posterior longitudinal ligament are very different in anatomical features, pathologically, treatment
Strategy and the details considered are also different, therefore the above instrument is not particularly suited for the centrum Forward during treatment OPLL.
To sum up, clinical shortage technical difficulty is lower at present, and complication probability of happening is small, and effect of easing stress is good, is suitable for each section
The operation plan and its corresponding instrument of section ossification of cervical posterior longitudinal ligament treatment.
Summary of the invention
The purpose of the present invention is aiming at the shortcomings in the prior art, provide a kind of anterior cervical vertebrae controllably to move forward instrument.
To achieve the above object, the technical solution adopted by the present invention is that:
A kind of anterior cervical vertebrae controllably moves forward instrument, is equipped with fixed arm, moving arm, rack gear, slot type gag lever post and lifting rod；Institute
The fixed arm stated be equipped with the first screw fixed arm and the first rack gear bridging arm, the moving arm be equipped with the second screw fixed arm,
Second rack gear bridging arm and mobile sliding block；Assemble centrum in the lower end of the first screw fixed arm and the second screw fixed arm
Screw；Described rack gear one end is fixed in the first rack gear bridging arm, and the other end passes through the second rack gear bridging arm and mobile sliding block
Common first through hole enables the moving arm to slide with respect to rack gear；Described slot type gag lever post one end is fixed on
In one rack gear bridging arm, the other end passes through the second through-hole of the second rack gear bridging arm, enables the moving arm with respect to slot type
Gag lever post sliding；The lifting rod is inserted in the limiting slot of slot type gag lever post, and lifting rod is equipped with the adjusting screw rod to socket-connect
And adjusting nut, for the adjusting nut Caton in the top of limiting slot, the lifting rod lower end is equipped with oblique through-hole, described
Oblique through-hole mounted inside angle fixing glue.
The anterior cervical vertebrae instrument that controllably moves forward is additionally provided with synchronous lifting component；The described synchronous lifting component includes the
One synchronous lift lever, the second Synchronous lifting bar and slot type fixed link；The first Synchronous lifting bar includes positioned at the of upper end
For one synchronous threaded rod with positioned at the first synchronous polished rod of lower end, the described first synchronous polished rod lower end is rotatably connected on the first rack gear
In bridging arm；The second Synchronous lifting bar includes that the second synchronous threaded rod positioned at upper end is synchronous with second positioned at lower end
Polished rod, the described second synchronous polished rod lower end are rotatably connected on slot type gag lever post；Distinguish at the both ends of the slot type fixed link
It is threaded on the first synchronous threaded rod and the second synchronous threaded rod；Slot type fixed link is equipped with fixing groove；The adjusting
Screw rod upper end is mutually fixed by adjusting nut and fixture nut with slot type fixed link.
The synchronous threaded rod of described first or the second synchronous threaded rod are equipped with the first indicating graduation.
The number of the lifting rod and angle fixing glue is at three or more.
The slot type gag lever post is equipped with several limiting slots, and the limiting slot is circle, and each limiting slot is connected with each other
It is logical.
The outer wall of the adjusting nut is equipped with the second indicating graduation.
The adjusting screw rod includes adjusting screw rod ontology, angular adjustment bar and hold-doun nut, adjusts screw rod ontology and angle
It spends adjusting rod to connect by hold-doun nut, the oblique through-hole is located on angular adjustment bar.
Angle between the first screw fixed arm and the first rack gear bridging arm is 120-160 degree, described second
Angle between screw fixed arm and the second rack gear bridging arm is 120-160 degree, and the fixed arm is consistent with moving arm shape.
The adjusting nut upper end is equipped with nut rotating handle, and the nut rotating handle is interior hexagonal structure, with adjusting spiral shell
Outer six square joint of female upper end matches.
The angle fixing glue tail end is outer six square joint and adjusting spanner is arranged, and the adjusting spanner head end is interior
Hexagonal structure.
The invention proposes a kind of new OPLL operation methods, devise anterior cervical vertebrae of the invention based on this and controllably move forward
Instrument, the advantage is that:
1, anterior cervical vertebrae of the invention controllably moves forward instrument equipped with fixed arm, moving arm, rack gear, and cooperation centrum screw is constituted
Pedestal, then the cooperation based on lifting rod and slot type gag lever post, and then the Forward of centrum is realized, it is suitable for different number centrums
Forward, by centrum move forward enable ossification posterior longitudinal ligament formed isolated island, compared with the prior art in operation plan it is cumbersome
Degree is remarkably decreased, and effect of easing stress is more significant；
2, centrum is driven to move forward by angle fixing glue and lifting rod, and the gradient design of oblique through-hole is rationally, in vertebra
The Forward of centrum in vertical direction is realized in the case where side side's approach, is convenient for surgical procedure, it is small to patient's damage, significantly
Reduce postoperative complications；
3, present invention is particularly suitable for the posterior longitudinal ligament ossification operation of multi-segmental centrum is related to, more set lifting rods can be equipped with
Equal components lift to realize that entirety is uniform, improve surgical effect, reduce operation wound, reduction operating difficulty；
4, under the action of slot type gag lever post, it is ensured that lifting rod can correctly fix specific centrum along one
Direction force drawing, improves the accuracy of operation；
5, lifting rod includes angular adjustment rod unit, can be according to specific requirements quick-replaceable in art, and the scope of application is wider；
6, the shape and Position Design of fixed arm, moving arm, rack gear and slot type gag lever post are reasonable, can sufficiently expose operation view
Open country operates convenient for patient；
7, each regulating member, such as nut rotating handle, adjusting spanner, shape design rationally, can Rapid matching completions in art
Operation reduces operating difficulty, shortens operating time；
8, it is equipped with indicating graduation, makes centrum Forward controllable precise, fineness is high.
To sum up, anterior cervical vertebrae of the invention controllably moves forward instrument using flexible, operates quantitative, controllable, is able to achieve multi-segmental
Centrum uniformly lifts, and meets the approach requirement of centrum side, is convenient for surgical procedure, can get good surgical effect, damages to patient
Hurt it is small, have wide potential applicability in clinical practice.
Detailed description of the invention
Fig. 1 is that the anterior cervical vertebrae of the embodiment of the present invention 1 controllably moves forward instrument structural schematic diagram one.
Fig. 2 is that the anterior cervical vertebrae of the embodiment of the present invention 1 controllably moves forward instrument structural schematic diagram two.
Fig. 3 is the slot type gag lever post structural schematic diagram of the embodiment of the present invention 1.
Fig. 4 is that the anterior cervical vertebrae of the embodiment of the present invention 2 controllably moves forward instrument structural schematic diagram.
Fig. 5 is the schematic diagram of the first indicating graduation.
Fig. 6 is that the anterior cervical vertebrae of the embodiment of the present invention 3 controllably moves forward instrument structural schematic diagram.
Fig. 7 is that the anterior cervical vertebrae of the embodiment of the present invention 4 controllably moves forward instrument structural schematic diagram.
Specific embodiment
Present inventor has clinical and research experience abundant, Neng Gouchong in cervical vertebra joint disease diagnosing and treating field
Divide the defect for recognizing each art formula of current OPLL, based on sturdy theory of medicine basis and sufficient surgical experience, proposes one
The new art formula of kind treatment OPLL, i.e., first by preceding road centrum side approach, Forward ossification posterior longitudinal ligament corresponds to centrum, then in conjunction with
Intervertebral fusion is so that ossification posterior longitudinal ligament forms isolated island, releasing spinal compression.The operation method has compared to existing operation method
Standby following advantages: 1., since ossification posterior longitudinal ligament forms independent isolated island, can effectively release the compressing to spinal cord；2. for
Different segment posterior longitudinal ligament ossification can realize decompression, to the posterior longitudinal ligament bone of focal type, segmental pattern, continuous type and mixed type
Change is all suitable for；3. being depressurized by Forward centrum, surgical procedure wants much simpler；4. due to do not cut off ossification posterior longitudinal ligament or
Vertebral plate etc., therefore injuring nerve root etc. causes the probability of postoperative complications to be remarkably decreased.Based on the above new art formula, inventor's design
Anterior cervical vertebrae of the invention controllably moves forward instrument, safely and effectively to execute the Forward of centrum in the surgical procedure.
It elaborates with reference to the accompanying drawing to specific embodiment provided by the invention.
Appended drawing reference involved in attached drawing and component part are as follows:
1. fixed arm, 11. first screw fixed arms, 12. first rack gear bridging arm
2. moving arm, 21. second screw fixed arms, 22. second rack gear bridging arm, 23. mobile sliding blocks, 231. gear shafts,
232. regulation handles, 233. lock banking stops, 234. lock banking stop rotating pins, 235. springs, 24. first through hole, 25. second through-holes
3. rack gear
4. slot type gag lever post, 41. limit holes
5. lifting rod, 51. adjusting screw rods, 511. adjusting screw rod ontologies, 512. angular adjustment bars, 513. hold-doun nuts, 52.
Adjusting nut, 53. nut rotating handles, 54. oblique through-holes, 55. second indicating graduations
6. centrum screw
7. angle fixing glue
8. adjusting spanner
9. synchronous lifting component, 91. first Synchronous lifting bars, 911. first synchronous threaded rods, 912. first synchronous polished rods,
92. the second Synchronous lifting bar, 921. second synchronous threaded rods, 922. second synchronous polished rods, 93. slot type fixed links, 931. is fixed
Slot, 94. fixture nuts, 95. are adjusted in synchronism rotating handle, 96. first indicating graduations
Embodiment 1
It controllably moves forward instrument structural schematic diagram referring to the anterior cervical vertebrae that Fig. 1, Fig. 1 are the embodiment of the present invention 1.The cervical vertebra
Preceding road controllably moves forward instrument equipped with fixed arm 1, moving arm 2, rack gear 3, slot type gag lever post 4 and lifting rod 5.The fixed arm 1
Equipped with the first screw fixed arm 11 and the first rack gear bridging arm 12, the first screw fixed arm 11 is cylindrical shape, described
First rack gear bridging arm 12 is prism-shaped, and angle between the two is 120-160 degree.The moving arm 2 is equipped with the second screw
Fixed arm 21, the second rack gear bridging arm 22 and mobile sliding block 23；The second screw fixed arm 21 is cylindrical shape, described the
Two rack gear bridging arm 22 are prism-shaped, and angle between the two is 120-160 degree.2 shape one of fixed arm 1 and moving arm
It causing, the first screw fixed arm 11 is parallel with the second screw fixed arm 21, and centrum screw 6 is assembled in the lower end of the two,
The first rack gear bridging arm 12 and the second rack gear bridging arm 22 bends towards the same side.The mobile sliding block 23 is connected to
In two rack gear bridging arm 22, the first through hole of a shared perforation is equipped in mobile sliding block 23 and the second rack gear bridging arm 22
24.Described 3 one end of rack gear is fixed in the first rack gear bridging arm 12, and the other end passes through the second rack gear bridging arm 22 and mobile cunning
First through hole 24 common to block 23, and rack gear 3 can slide in first through hole 24.Referring to fig. 2, Fig. 2 is the embodiment of the present invention 1
Anterior cervical vertebrae controllably move forward instrument structural schematic diagram two.Gear shaft 231, the tooth are equipped with inside the mobile sliding block 23
Wheel shaft 231 is meshed with rack gear 3, and 231 end face of gear shaft is equipped with regulation handle 232, for turning gear wheel shaft 231 and then drives shifting
Swing arm 2 is mobile relative to rack gear 3.The outside of mobile sliding block 23 is additionally provided with lock banking stop 233, and the lock banking stop 233 passes through lock banking stop
Rotating pin 234 is connected on mobile sliding block 23, and spring 235, the lock are socketed on the lock banking stop rotating pin 234
233 head end of limited step is entrenched in fix moving arm 2 on rack gear 3, when pressing 233 tail end of lock banking stop, then adjustable moving arm 2
Position.
Referring to Fig. 1.Described 4 one end of slot type gag lever post is fixed in the first rack gear bridging arm 12, and the other end passes through second
Second through-hole 25 of rack gear bridging arm 22, and slot type gag lever post 4 can slide in the second through-hole 25.Slot type gag lever post 4 is located at tooth
The lower section of item 3, and it is parallel with rack gear 3.It is the slot type gag lever post structural schematic diagram of the embodiment of the present invention 1 referring to Fig. 3, Fig. 3.It is described
Slot type gag lever post 4 be equipped with several limiting slots 41, the limiting slot 41 be circle, and each limiting slot 41 be connected with each other it is logical.Again
Referring to Fig. 1.The lifting rod 5 is inserted in the limiting slot 41 of slot type gag lever post 4, and lifting rod 5 is equipped with and is socket-connected by screw thread
Adjusting screw rod 51 and adjusting nut 52.52 Caton of adjusting nut in the top of limiting slot 41, adjusting nut 52 it is upper
End is equipped with nut rotating handle 53, and the nut rotating handle 53 is interior hexagonal structure, connects with outer six side of 52 upper end of adjusting nut
Head matches.The lower end of the adjusting screw rod 51 is equipped with oblique through-hole 54, and specifically, the adjusting screw rod 51 includes adjusting
Screw rod ontology 511, angular adjustment bar 512 and hold-doun nut 513 adjust screw rod ontology 511 and are located above, and hold-doun nut 513
In lower section, adjusts screw rod ontology 511 and angular adjustment bar 512 and connected by hold-doun nut 513, the oblique through-hole 54 is located at
On angular adjustment bar 512.The angle of its place axis of oblique through-hole 54 and adjusting 51 place axis of screw rod is 40-60 degree.It is oblique
54 mounted inside angle fixing glue 7 of through-hole.The tail end of the angle fixing glue 7, which is equipped, adjusts spanner 8, specifically, described
The tail end of angle fixing glue 7 be outer six square joint, 8 head end of adjusting spanner is interior hexagonal structure, and the two is mutually matched.
It should be noted that anterior cervical vertebrae of the invention controllably moves forward, instrument is that the new art formula based on inventor is developed,
It moves forward centrum it is suitable for anterior cervical vertebrae side approach, be particularly suitable for moving forward simultaneously 2 or more centrums, before centrum
Shifting makes the posterior longitudinal ligament formation isolated island that ossify, and releases spinal compression.The fixed arm 1, moving arm 2, rack gear 3 cooperate centrum screw
6, it is fixed on centrum by centrum screw 6, collectively forms the pedestal of Forward centrum, and due between fixed arm 1 and moving arm 2
Spacing it is adjustable so that anterior cervical vertebrae of the invention controllably moves forward instrument be suitable for different types of OPLL, such as be related to two,
Segmental pattern, continuous type or the mixed type OPLL of the centrums such as three, four.The angle fixing glue 7 needs to move forward for being fixed on
The preceding trackside side of centrum, the lifting rod 5 connects angle fixing glue 7 by oblique through-hole 54, therefore adjusts in vertical direction
Section lifting rod 5 can lift angle fixing glue 7 and corresponding centrum indirectly, and guarantee that centrum is in vertical direction by before entirety
It moves, it is also simpler to obtain satisfied traction and spinal cord decompression effect, surgical procedure.Where the oblique through-hole 54 is designed to
Axis and the angle for adjusting 51 place axis of screw rod are 40-60 degree, and the direction which can guarantee that centrum is lifted is in
In vertical direction.The anterior cervical vertebrae of the invention instrument that controllably moves forward can be equipped with more set lifting rods 5 and angle fixing glue 7, it is preferable that
The number of the lifting rod 5 and angle fixing glue 7 is two or more, it is highly preferred that be three or more, most preferably,
It is four or more, this is suitable for the synchronous Forward of multi-segmental centrum.The slot type gag lever post 4 is for realizing lifting rod 5
The position of length variation and elementary proving lifting rod 5；In the case where adjusting screw rod 51 and the cooperation of adjusting nut 52, turn adjusting nut 52
I.e. changeable lifting rod 5 is located at the length of the section below slot type gag lever post, which is adjusted in short-term, centrum Forward；Slot type limit
Be not between the limit hole 41 and lifting rod 5 of position bar 4 it is fixed, limit hole 41 be capable of the position of elementary proving lifting rod 5 with
Its significantly shaking to periphery is prevented, this allows for the direction that lifting rod 5 can correctly fix specific centrum along one
Force drawing, improves the accuracy of operation, operates more controllable, difficulty decline.The shape of the limit hole 41 is unlimited, may be used also
To be the other shapes such as square, diamond shape, but the round home position that can preferably demarcate lifting rod 5；Between each limit hole 41
Other than being connected, it can also be independent of each other；The limit hole 41 is preferably designed to diameter and is greater than adjusting screw rod 51
Maximum gauge, lifting rod 5 directly can be from top to bottom inserted into limit hole 41 by patient in operation, easily operated.
The adjusting screw rod 51 is designed to include to adjust 513 3 screw rod ontology 511, angular adjustment bar 512 and hold-doun nut components,
The angular adjustment bar 512 of plurality of specifications can be so designed, their oblique through-hole 54 is designed to different gradients, sufficiently to meet hand
The different demands of art, the scope of application are wider.The angle of the first screw fixed arm 11 and the first rack gear bridging arm 12 and
Second screw fixed arm 21 and the angle of the second rack gear bridging arm 22 are designed as 120-160 degree, and fixed arm 1 and moving arm 2
Shape is consistent, and the first screw fixed arm 11 is parallel with the second screw fixed arm 21, and slot type gag lever post 4 is located at the lower section of rack gear 3, with
Rack gear 3 is parallel, and the above design can expose surgical field of view well, facilitate the operation of the specific art formula.The adjusting nut
Nut rotating handle 53 is designed in 52 upper ends, and is connected by internal-external hexagon structure matching, and the angle fixing glue 7, which is arranged, adjusts spanner
8, and connected by internal-external hexagon structure matching, the above design can facilitate surgical procedure, shorten operating time.The movement
Sliding block 23 is equipped with lock banking stop 233, and the design structure of lock banking stop 233 is simple, can play good braking action, and convenient for behaviour
Control.
Using anterior cervical vertebrae of the invention controllably move forward instrument row OPLL operation concrete operations are as follows: first according to iconography
Data determines the section needed where the centrum segment of integral forward lead, loads onto respectively on the centrum on the outside of the section both ends in art
Fixed arm 1, moving arm 2 are adjusted to suitable spacing through mobile sliding block 23, are then fitted on centrum screw 6 by centrum screw 6,
In the preceding trackside side for the centrum that need to move forward with 8 fixed angle fixing glue 7 of spanner is adjusted, lifting rod 5 is from top to bottom inserted into properly
In the limit hole 41 of position, the suitable angular adjustment bar 512 of oblique through-hole gradient is then selected to assemble with angle fixing glue 7, then
By 513 secured adjusted screw rod ontology 511 of hold-doun nut and angular adjustment bar 512, so far assembly is completed, and turns nut rotating handle
53, adjusting nut 52 rotates, and then the length for being located at the adjusting screw rod 51 below slot type gag lever post shortens, then drives angle indirectly
Fixing glue 7 moves forward vertically upward, that is, completes the Forward of centrum.
Embodiment 2
Referring to fig. 4, Fig. 4 is that the anterior cervical vertebrae of the embodiment of the present invention 2 controllably moves forward instrument structural schematic diagram.The present embodiment
Anterior cervical vertebrae apparatus structure and the anterior cervical vertebrae described in embodiment 1 apparatus structure that controllably moves forward that controllably moves forward is essentially identical, different
Place is only that: first, the anterior cervical vertebrae instrument that controllably moves forward is additionally provided with synchronous lifting component 9；The synchronous lifting
Component 9 includes the first Synchronous lifting bar 91, the second Synchronous lifting bar 92 and slot type fixed link 93；The first Synchronous lifting bar
91 and second Synchronous lifting bar 92 it is parallel with the first screw fixed arm 11.The first Synchronous lifting bar 91 includes positioned at upper
With positioned at the first synchronous polished rod 912 of lower end, the described first synchronous 912 lower end of polished rod turns the synchronous threaded rod 911 of the first of end
It is dynamic to be connected in the first rack gear bridging arm 12；The second Synchronous lifting bar 92 includes the second synchronous threaded rod positioned at upper end
921 are rotatably connected on slot type gag lever post 4 with the second synchronous polished rod 922 positioned at lower end, the described second synchronous 922 lower end of polished rod
Positioned at the end in 22 outside of the second rack gear bridging arm.The slot type fixed link 93 is parallel with slot type gag lever post 4；Slot type fixed link
93 both ends are respectively provided with a through-hole, are connected by through-hole threaded rod 911 synchronous with first and the second synchronous 921 screw thread of threaded rod
It connects；The center of slot type fixed link 93 is equipped with up and down and the axial fixing groove 931 parallel with slot type gag lever post 4 fixation
Slot 931 is a rectangular slot.Second, the upper end of the adjusting screw rod 51 of the lifting rod 5 is inserted in fixing groove 931, is adjusted
Nut 52 is located at the lower section of slot type fixed link 93, and fixture nut 94 is socketed in the upper end for adjusting screw rod 51, by with adjusting nut 52
Cooperation will adjust screw rod 51 and fix with 93 phase of slot type fixed link.The synchronous threaded rod 911 of described first threaded rod synchronous with second
921 upper end, which is equipped, is adjusted in synchronism rotating handle 95.
It is the schematic diagram of the first indicating graduation referring to Fig. 5, Fig. 5.Synchronous 911 (not shown) of threaded rod of described first
The first indicating graduation 96 is equipped on threaded rod 921 synchronous with second.
In the present embodiment: increasing synchronous lifting component 9, this is very suitable for the synchronous lifting of multi-segmental centrum, can be really
The consistency of each segment centrum dip direction is protected, uniformly lifting is realized, the injury to centrum can be mitigated, it is general to reduce complication generation
Rate also eliminates the need the troublesome operation lifted one by one, not only improves surgical effect, but also saved the time.In this embodiment, due to
It is lifting operation to be executed by synchronous lifting component 9, therefore the lifting rod 5 can not have to the spiral shell for being designed to screw thread socket
Female screw structure may be designed as single rod structure, as long as guaranteeing that lifting rod 5 can be relative to slot in the case where other assemblies cooperate
Formula fixed link 93 is fixed.The fixing groove 931 is rectangle, inner wall smooth, assembling and position convenient for lifting rod 5
Fine tuning.First indicating graduation 96 is used to indicate lifted distance, realizes quantitative controllable centrum Forward, improves operation
Accuracy.
The anterior cervical vertebrae of the present embodiment controllably moves forward instrument in the course of surgery, and 5 upper end of lifting rod is fixed on slot type and is consolidated
In fixed pole 93, rotating handle 95 is then adjusted in synchronism come the centrum that moves forward by turn, vertebra is understood by the first indicating graduation 96 of observation
The height of body Forward.Since tool is there are two rotating handle 95 is adjusted in synchronism, all centrums may be implemented waits height to lift, can also
To realize the stepping lifting of all centrum Forward height, patient's vertebra state can be better adapted to, different characteristic is suitable for
Ossification posterior longitudinal ligament operation.
Embodiment 3
It controllably moves forward instrument structural schematic diagram referring to the anterior cervical vertebrae that Fig. 6, Fig. 6 are the embodiment of the present invention 3.The present embodiment
Anterior cervical vertebrae apparatus structure and the anterior cervical vertebrae as described in example 2 apparatus structure that controllably moves forward that controllably moves forward is essentially identical, different
Place is only that: 52 outer wall of adjusting nut of the lifting rod 5 is equipped with the second indicating graduation 55.Second instruction is carved
Degree 55 facilitates the Forward distance for judging centrum corresponding to every lifting rod 5 respectively, makes more accurate judgement convenient for patient, into
The accuracy of one step raising surgical procedure.
Embodiment 4
It controllably moves forward instrument structural schematic diagram referring to the anterior cervical vertebrae that Fig. 7, Fig. 7 are the embodiment of the present invention 4.The present embodiment
Anterior cervical vertebrae apparatus structure and the anterior cervical vertebrae described in embodiment 1 apparatus structure that controllably moves forward that controllably moves forward is essentially identical, different
Place is only that: the adjusting screw rod 51 of the lifting rod 5 is only single screw structure, and does not include angular adjustment bar and fixation
Nut structure.5 outer wall of lifting rod of the structure is bright and clean, and convenient for disinfection, preparation process is simpler.The adjusting screw rod 51 can be set
Different size is counted into, their oblique through-hole 54 is designed to different gradients, to meet the different demands of operation.
The above is only a preferred embodiment of the present invention, it is noted that for the ordinary skill people of the art
Member, under the premise of not departing from the method for the present invention, can also make several improvement and supplement, these are improved and supplement also should be regarded as
Protection scope of the present invention.
Claims (9)
- The instrument 1. a kind of anterior cervical vertebrae controllably moves forward, which is characterized in that be equipped with fixed arm, moving arm, rack gear, slot type gag lever post and Lifting rod；The fixed arm is equipped with the first screw fixed arm and the first rack gear bridging arm, and the moving arm is equipped with the second spiral shell Follow closely fixed arm, the second rack gear bridging arm and mobile sliding block；Between the first screw fixed arm and the first rack gear bridging arm Angle is 120-160 degree, and the angle between the second screw fixed arm and the second rack gear bridging arm is 120-160 degree, and Fixed arm is consistent with moving arm shape, and the first screw fixed arm and the second screw fixed arm are parallel；First screw is fixed Centrum screw is assembled in the lower end of arm and the second screw fixed arm；Described rack gear one end is fixed in the first rack gear bridging arm, The other end passes through first through hole common to the second rack gear bridging arm and mobile sliding block, enables the moving arm with respect to rack gear Sliding；The slot type gag lever post is located at the lower section of rack gear, parallel with rack gear；Described slot type gag lever post one end is fixed on first In rack gear bridging arm, the other end passes through the second through-hole of the second rack gear bridging arm, and the moving arm is limited with respect to slot type Position bar sliding；The lifting rod is inserted in the limiting slot of slot type gag lever post, lifting rod be equipped with the adjusting screw rod that socket-connects and Adjusting nut, for the adjusting nut Caton in the top of limiting slot, the lifting rod lower end is equipped with oblique through-hole, described Oblique through-hole mounted inside angle fixing glue.
- The instrument 2. anterior cervical vertebrae according to claim 1 controllably moves forward, which is characterized in that before the anterior cervical vertebrae is controllable It moves instrument and is additionally provided with synchronous lifting component；The synchronous lifting component includes the first Synchronous lifting bar, the second Synchronous lifting bar With slot type fixed link；The first Synchronous lifting bar includes positioned at the first synchronous threaded rod of upper end and positioned at the first of lower end Synchronous polished rod, the described first synchronous polished rod lower end are rotatably connected in the first rack gear bridging arm；Second Synchronous lifting Bar includes that the second synchronous threaded rod positioned at upper end synchronizes polished rod lower end with positioned at the second synchronous polished rod of lower end, described second It is rotatably connected on slot type gag lever post；The both ends of the slot type fixed link are threaded in the first synchronous threaded rod and the respectively On two synchronous threaded rods；Slot type fixed link is equipped with fixing groove；The adjusting screw rod upper end passes through adjusting nut and fixed spiral shell Mother mutually fixes with slot type fixed link.
- The instrument 3. anterior cervical vertebrae according to claim 2 controllably moves forward, which is characterized in that the synchronous threaded rod of described first Or second synchronous threaded rod be equipped with the first indicating graduation.
- The instrument 4. anterior cervical vertebrae according to claim 1 controllably moves forward, which is characterized in that the lifting rod and angle is solid Surely the number followed closely is at three or more.
- The instrument 5. anterior cervical vertebrae according to claim 4 controllably moves forward, which is characterized in that the slot type gag lever post is equipped with Several limiting slots, the limiting slot be circle, and each limiting slot be connected with each other it is logical.
- The instrument 6. anterior cervical vertebrae according to claim 1 or 2 controllably moves forward, which is characterized in that the adjusting nut Outer wall is equipped with the second indicating graduation.
- The instrument 7. anterior cervical vertebrae according to claim 1 controllably moves forward, which is characterized in that the adjusting screw rod includes adjusting Screw rod ontology, angular adjustment bar and hold-doun nut are saved, screw rod ontology is adjusted and is connected with angular adjustment bar by hold-doun nut, it is described Oblique through-hole be located on angular adjustment bar.
- The instrument 8. anterior cervical vertebrae according to claim 1 controllably moves forward, which is characterized in that match the adjusting nut upper end Equipped with nut rotating handle, the nut rotating handle is interior hexagonal structure, is matched with outer six square joint of adjusting nut upper end.
- The instrument 9. anterior cervical vertebrae according to claim 1 controllably moves forward, which is characterized in that the angle fixing glue tail end For outer six square joint and adjusting spanner is arranged, the adjusting spanner head end is interior hexagonal structure.
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| CN201710729235.8A CN107432764B (en) | 2017-08-23 | 2017-08-23 | Anterior cervical vertebrae controllably moves forward instrument |
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| CN201710729235.8A CN107432764B (en) | 2017-08-23 | 2017-08-23 | Anterior cervical vertebrae controllably moves forward instrument |
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Families Citing this family (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110859665A (en) * | 2019-11-26 | 2020-03-06 | 天津正天医疗器械有限公司 | Vertebral body reduction fixing device and surgical instrument comprising same |
| CN111603228B (en) * | 2020-05-28 | 2021-04-13 | 上海长征医院 | Lumbar vertebra fixing and supporting device |
| CN111603229B (en) * | 2020-05-28 | 2021-04-23 | 上海长征医院 | Multifunctional pedicle screw assembly |
| CN113813031B (en) * | 2020-06-18 | 2024-10-25 | 四川大学华西医院 | Cervical anterior approach operation centrum lifting and fixing device |
| CN114948166A (en) * | 2022-04-18 | 2022-08-30 | 上海市第四人民医院 | Improved operating system for cervical vertebra centrum forward movement operation |
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| US9072504B2 (en) * | 2004-04-19 | 2015-07-07 | Cervitech, Inc. | Bone separator |
| CN201147359Y (en) * | 2008-02-01 | 2008-11-12 | 刘兰泽 | Anterior cervical positor |
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| CN107432764A (en) | 2017-12-05 |
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