CN111759365A - Intervertebral foramen shaping surgical instrument - Google Patents
Intervertebral foramen shaping surgical instrument Download PDFInfo
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- CN111759365A CN111759365A CN202010617236.5A CN202010617236A CN111759365A CN 111759365 A CN111759365 A CN 111759365A CN 202010617236 A CN202010617236 A CN 202010617236A CN 111759365 A CN111759365 A CN 111759365A
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- 238000007493 shaping process Methods 0.000 title claims abstract description 14
- 238000000034 method Methods 0.000 claims abstract description 36
- 210000004872 soft tissue Anatomy 0.000 claims abstract description 36
- 230000001681 protective effect Effects 0.000 claims abstract description 23
- 238000004873 anchoring Methods 0.000 claims abstract description 20
- 108010048734 sclerotin Proteins 0.000 claims abstract description 4
- 230000010339 dilation Effects 0.000 claims description 18
- 238000011105 stabilization Methods 0.000 claims description 8
- 230000000670 limiting effect Effects 0.000 claims description 5
- 238000001802 infusion Methods 0.000 claims description 3
- 229940079593 drug Drugs 0.000 claims description 2
- 239000003814 drug Substances 0.000 claims description 2
- 230000008878 coupling Effects 0.000 claims 2
- 238000010168 coupling process Methods 0.000 claims 2
- 238000005859 coupling reaction Methods 0.000 claims 2
- 241000425571 Trepanes Species 0.000 abstract description 23
- 210000000988 bone and bone Anatomy 0.000 abstract description 22
- 238000006073 displacement reaction Methods 0.000 abstract description 6
- 210000005036 nerve Anatomy 0.000 abstract description 6
- 238000000605 extraction Methods 0.000 abstract 1
- 230000000916 dilatatory effect Effects 0.000 description 13
- 238000005516 engineering process Methods 0.000 description 10
- 239000000463 material Substances 0.000 description 3
- 230000009286 beneficial effect Effects 0.000 description 2
- 230000007423 decrease Effects 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000002690 local anesthesia Methods 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 230000036407 pain Effects 0.000 description 2
- 230000002829 reductive effect Effects 0.000 description 2
- 238000006467 substitution reaction Methods 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 206010002091 Anaesthesia Diseases 0.000 description 1
- 206010050296 Intervertebral disc protrusion Diseases 0.000 description 1
- 230000037005 anaesthesia Effects 0.000 description 1
- 230000003444 anaesthetic effect Effects 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 210000001951 dura mater Anatomy 0.000 description 1
- 230000007613 environmental effect Effects 0.000 description 1
- 239000010985 leather Substances 0.000 description 1
- 210000003041 ligament Anatomy 0.000 description 1
- 238000002324 minimally invasive surgery Methods 0.000 description 1
- 210000003205 muscle Anatomy 0.000 description 1
- 230000036961 partial effect Effects 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 230000000452 restraining effect Effects 0.000 description 1
- 238000010079 rubber tapping Methods 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 230000001502 supplementing effect Effects 0.000 description 1
- 230000009897 systematic effect Effects 0.000 description 1
- 210000000115 thoracic cavity Anatomy 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
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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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/147—Surgical saws ; Accessories therefor with circularly moving saw blades, i.e. non-reciprocating saw blades
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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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
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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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1671—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the spine
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3401—Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
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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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00261—Discectomy
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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
The invention relates to the technical field of medical instruments and discloses a set of intervertebral foramen forming surgical instruments, which comprise a puncture needle, a skin expanding guide rod, a soft tissue expanding tube, a self-stabilizing guide rod, a protective sleeve, a trepan and an anchoring drill, wherein the puncture needle is used for forming a surgical channel leading to an intervertebral foramen from the skin surface on the body of a patient, the skin expanding guide rod is used for expanding the surgical channel to guide the soft tissue expanding tube to enter the surgical channel, the soft tissue expanding tube is used for expanding the surgical channel to guide the self-stabilizing guide rod to enter the surgical channel and be fixed on an upper articular process, the protective sleeve is used for replacing the self-stabilizing guide rod to guide the trepan to enter the surgical channel, the trepan is used for cutting sclerotin of the upper articular process, and the anchoring drill is used for taking. Compared with the prior art, the intervertebral foramen shaping surgical instrument has the advantages of convenient use, low operation technical requirement, difficult displacement, accurate guiding, good nerve root protection, well-controlled depth, smooth bone extraction and the like.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a set of intervertebral foramen forming surgical instruments.
Background
The percutaneous intervertebral foramen mirror technology belongs to the endoscope auxiliary technology in the spine minimally invasive surgery, has the advantages of small wound, less bleeding, quick recovery, small influence on the stability of the spine, local anesthesia operation and the like, and has good clinical curative effect on the aspect of treating the protrusion of the lumbar intervertebral disc and the like at present. Compared with the traditional operation, the intervertebral foramen mirror technology is operated through lumbar vertebra lateral rear under the local anesthesia, the back puncture approach, do not influence lumbar vertebra rear muscle, also destroy important bone joint ligament structure, can directly remove deviate from or free intervertebral disc tissue, also need not tractive nerve root and dura mater sac, the environmental disturbance to the spinal canal is very little, also there is not obvious influence to lumbar vertebra stability, consequently, this technique provides safe effectual operation treatment for lumbar disc herniation patient.
The intervertebral foramen forming technology is one essential technology for percutaneous intervertebral foramen mirror technology, and aims at eliminating partial bone of upper articular process, opening operation passage for the percutaneous intervertebral foramen mirror to stretch into vertebral canal, reducing pressure effectively in intervertebral foramen area and side recess, expanding the adaptability of percutaneous intervertebral foramen mirror and raising the curative effect and safety. Although the intervertebral foramen forming technology is mastered by most minimally invasive spinal surgeons in recent years, no special and systematic intervertebral foramen forming surgical instrument is used by people, and the doctors can only use common spinal endoscopic surgical instruments, so that the defects of high operating technical requirement, easy displacement, inaccurate guiding, incapability of smoothly taking out bone substances and the like exist.
Disclosure of Invention
The invention aims to provide a set of intervertebral foramen forming surgical instrument which is convenient to use, simplifies the technical steps of operation, has accurate guiding, is not easy to shift, can protect nerve roots, can safely limit the depth and can smoothly take out bone.
In order to achieve the above objects, the present invention provides a set of intervertebral foramen shaping surgical instruments including a puncture needle for forming a surgical channel on a patient's body leading from a skin surface to an intervertebral foramen, a soft tissue dilation tube for dilating the surgical channel to guide the soft tissue dilation tube into the surgical channel, a self-stabilization guide rod for dilating the surgical channel to guide the self-stabilization guide rod into the surgical channel and fixing on an upper articular process, a protection sleeve for replacing the self-stabilization guide rod to guide the trephine into the surgical channel, and an anchoring drill for taking out a bone cut by the trephine.
In some embodiments of the present application, the surgical instrument further comprises a guide wire for guiding the skin expanding guide rod into the surgical channel, and the skin expanding guide rod is provided with a through hole for the guide wire to pass through.
In some embodiments of the present application, the front end of the soft tissue dilation tube has a tongue portion.
In some embodiments of the present application, the soft tissue dilation tube has a plurality of models, and the different models of the soft tissue dilation tube have different outer diameters and different lengths.
In some embodiments of the present application, the side wall of the self-stabilizing guide rod has a tooth-shaped portion near the front end thereof for engaging with the articular process.
In some embodiments of the present application, the self-stabilizing guide rod includes a cylindrical self-stabilizing guide rod and a flat self-stabilizing guide rod, the cross section of the cylindrical self-stabilizing guide rod is circular, and the cross section of the flat self-stabilizing guide rod is kidney-shaped or oval.
In some embodiments of the present application, the dilating guide and the self-stabilizing guide each have an infusion channel for injecting a drug.
In some embodiments of the present application, the protection sleeve includes a sleeve body and a protruding portion provided at a front end of the sleeve body, an outer side wall of the sleeve body is provided with a rib, and the rib extends to an outer side wall of the protruding portion.
In some embodiments of the present application, the rear end of the sleeve body is provided with a handle portion perpendicular to the sleeve body.
In some embodiments of the present application, the protective sleeve has a plurality of sizes, and the outer diameters of the sleeve bodies of the different sizes of the protective sleeve are different.
In some embodiments of this application, the trepan is including cutting pipe, control tube, adjustment handle and spacing pipe, cut the pipe the control tube and adjustment handle passes through the connecting piece and connects as an organic wholely, spacing pipe box in outside the control tube, and the two threaded connection, the front end of cutting the pipe has sawtooth edge.
In some embodiments of the present application, the cutting tube is displaced a fixed distance relative to the restraining tube for every 360 ° of rotation of the adjustment handle.
In some embodiments of the present application, the fixed distance is 2 mm.
In some embodiments of the present application, the outer sidewall of the cutting tube is provided with a scale.
In some embodiments of this application, cut the pipe and insert in the adjusting pipe, the top of cutting the pipe is equipped with first connecting hole, the lateral wall of adjusting pipe is equipped with the second connecting hole, adjustment handle is equipped with the third connecting hole, the connecting piece passes first connecting hole the second connecting hole with the third connecting hole will cut the pipe the adjusting pipe with adjustment handle connects as an organic wholely.
In some embodiments of the present application, the connector is a socket head cap screw.
In some embodiments of the present application, the trepan has a plurality of models, and the bone material that different models of trepan can cut is not the same size.
In some embodiments of the present application, the anchoring drill includes a drill rod, a drill bit and a joint, the drill bit is disposed at a front end of the drill rod, the front end of the drill bit has a cutting edge, an outer side wall of the drill bit has threads, and the joint is disposed at a rear end of the drill rod for connecting to a T-handle.
In some embodiments of the present application, the drill bit is conical, the diameter of the drill bit decreases from its rear end to its front end, and the rear end diameter of the drill bit is less than or equal to the diameter of the drill rod.
In some embodiments of the present application, the joint is a regular hexagonal prism and the circumscribed circular diameter of the joint is less than or equal to the diameter of the drill rod.
In some embodiments of the present application, the foraminal shaping surgical instrument further comprises a hammer.
In some embodiments of the present application, the intervertebral foramen forming surgical instrument further comprises a container, the puncture needle expand the skin guide rod from the steady guide rod the soft tissue dilation tube from last to transversely arrange in right side region in the container down, the hammer the anchoring drill the trepan and the protection sleeve vertically arrange in left side region in the container, just the trepan with the protection sleeve is crisscross each other.
The invention provides a set of intervertebral foramen forming surgical instruments, compared with the prior art, the intervertebral foramen forming surgical instruments have the following beneficial effects:
the intervertebral foramen forming surgical instrument provided by the invention comprises a puncture needle for forming a surgical channel on the body of a patient, a skin expanding guide rod for expanding the surgical channel, a soft tissue expanding tube for expanding the surgical channel, a self-stabilizing guide rod for fixing on an upper articular process, a protective sleeve for positioning, a trepan for cutting the bone of the upper articular process and an anchoring drill for taking out the bone. Based on the structure, the intervertebral foramen forming surgical instrument has a complete system, and can complete each link from forming a surgical channel to taking out bone in the intervertebral foramen forming surgery, so that the technical requirement on an operator is low, the operator can conveniently and skillfully master the intervertebral foramen forming technology, the operator can complete the surgical operation in 5-10 minutes, the surgical time is shortened, and the number of times of perspective is reduced; moreover, because the self-stabilizing guide rod and the protective sleeve have the characteristics of difficult displacement, accurate guide and slidable adjustment, the intervertebral foramen forming surgical instrument does not need strict side-opening distance when in use, and has multiple chances of obtaining the optimal forming position, thereby reducing the surgical risk and relieving the pain of a patient.
Drawings
FIG. 1 is a schematic view of the components of a foraminal shaping surgical instrument according to an embodiment of the present invention;
FIG. 2 is a schematic structural view of a soft tissue dilation tube according to an embodiment of the present invention;
FIG. 3 is a schematic structural diagram of a self-stabilizing guide rod according to an embodiment of the present invention;
fig. 4 is a schematic structural view of a protective sleeve according to an embodiment of the present invention;
FIG. 5 is a schematic structural diagram of a trepan of an embodiment of the present invention;
fig. 6 is a schematic structural view of an anchoring drill according to an embodiment of the present invention.
In the figure: 1. puncturing needle; 2. a leather expanding guide rod; 3. a soft tissue dilation tube; 31. a tongue plate portion; 4. a self-stabilizing guide rod; 41. a tooth-shaped portion; 5. protecting the sleeve; 51. a sleeve body; 52. a handle portion; 53. a protrusion; 54. ribs; 6. trepanning; 61. cutting the pipe; 611. a serrated edge; 62. an adjusting tube; 63. an adjusting handle; 64. a limiting pipe; 7. anchoring a drill; 71. a drill stem; 72. a drill bit; 721. a drill edge; 73. a joint; 8. a guide wire; 9. a hammer; 10. a receiving member.
Detailed Description
The technical solutions in the embodiments of the present application will be described clearly and completely with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only a part of the embodiments of the present application, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present application.
It will be understood that in the description of the present application, the terms "center," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," and the like are used in the orientation or positional relationship indicated in the drawings for ease of description and simplicity of description, and do not indicate or imply that the referenced device or element must have a particular orientation, be constructed and operated in a particular orientation, and thus should not be considered as limiting the present application. The terms "first", "second" are used for descriptive purposes only and are not to be construed as indicating or implying a relative importance or implicitly indicating the number of technical features indicated, i.e. a feature defined as "first", "second" may explicitly or implicitly include one or more of such features. Further, unless otherwise specified, "a plurality" means two or more.
It should be noted that, in the description of the present application, unless otherwise explicitly specified or limited, the terms "mounted," "connected," and "connected" are to be construed broadly, e.g., as meaning either a fixed connection, a removable connection, or an integral connection; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meaning of the above terms in the present application can be understood in a specific case by those of ordinary skill in the art.
As shown in fig. 1, the embodiment of the present invention provides a set of intervertebral foramen forming surgical instruments, which includes a puncture needle 1, a percutaneous dilation guide 2, a soft tissue dilation tube 3, a self-stabilization guide 4, a protection sleeve 5, a trepan 6 and an anchoring drill 7; the puncture needle 1 is used for forming a surgical channel on a patient body from a skin surface to an intervertebral foramen; the skin expanding guide rod 2 is used for expanding the operation channel so as to guide the soft tissue expansion tube 3 to enter the operation channel; the soft tissue expansion tube 3 is used for expanding the operation channel so as to guide the self-stabilizing guide rod 4 into the operation channel and fix the self-stabilizing guide rod on the superior articular process; the protective sleeve 5 is used to replace the soft tissue dilation tube 3 to guide the trepan 6 into the surgical passage; the trephine 6 is used for cutting the upper articular process sclerotin; the anchoring drill 7 is used to remove the bone material cut by the trepan 6.
Based on the structure, the intervertebral foramen shaping surgical instrument has a complete system, and can complete each link from the formation of a surgical channel to the taking out of bone in the intervertebral foramen shaping surgery, so that the technical requirement on an operator is low, the operator can skillfully master the intervertebral foramen shaping technology, the operator can complete the surgical operation in 5-10 minutes, the surgical time is shortened, and the number of perspective times is reduced; moreover, because the self-stabilization guide rod 4 and the protective sleeve 5 have the characteristics of difficult displacement, accurate guiding and slidable adjustment, the intervertebral foramen forming surgical instrument does not need strict side-opening distance when in use, and has multiple chances of obtaining the optimal forming position, thereby reducing the surgical risk and relieving the pain of a patient.
In some embodiments, as shown in fig. 1, in order to ensure that the percutaneous dilation guide 2 can enter the operation channel accurately and smoothly, the intervertebral foramen forming surgical instrument provided by the invention further comprises a guide wire 8, the percutaneous dilation guide 2 is provided with a through hole for the guide wire 8 to pass through, and the guide wire 8 is placed in the operation channel after the puncture needle 1 forms the operation channel which is communicated with the intervertebral foramen from the skin surface.
As shown in FIG. 1, in some embodiments, the soft tissue dilation tube 3 has multiple models, and the different models of soft tissue dilation tube 3 have different outer diameters and different lengths. In the intervertebral foramen forming operation process, the soft tissue expansion tubes 3 with a plurality of models are sequentially placed into the operation channel from small to large in outer diameter so as to gradually expand the operation channel and prevent the soft tissue from being damaged due to severe expansion.
Further, as shown in fig. 2, the front end of the soft tissue dilating tube 3 has a tongue portion 31 which is used to extend to the outside of the superior articular process after the soft tissue dilating tube 3 enters the operation channel, so as to protect the exiting nerve root and make the foraminal plasty safer.
As shown in fig. 3, in some embodiments, the lateral wall of the self-stabilizing guide rod 4 has a tooth-shaped portion 41 near the front end thereof for engaging with the superior articular process, when the self-stabilizing guide rod 4 enters the operation channel, the operator can knock the rear end of the self-stabilizing guide rod 4 to insert the tooth tip of the tooth-shaped portion 41 into the superior articular process, so that the self-stabilizing guide rod 4 forms a self-stabilizing mechanism fixed on the superior articular process, thereby avoiding displacement and improving the guiding stability and precision.
Further, the self-stabilizing guide rod 4 comprises a cylindrical self-stabilizing guide rod 4 and a flat self-stabilizing guide rod 4, the cross section of the cylindrical self-stabilizing guide rod 4 is circular, and the cross section of the flat self-stabilizing guide rod 4 is kidney-shaped or oval. When the intervertebral foramen forming operation is carried out, if the aperture of the target intervertebral foramen is larger than or equal to 4mm, such as intervertebral foramen of thoracolumbar region and waist 1-4, a cylindrical self-stabilizing guide rod 4 is selected; if the aperture of the target intervertebral foramen is less than 4mm, such as the intervertebral foramen of thoracic vertebra, 4-5 lumbar vertebra, 5-sacral 1 lumbar vertebra, then the flat self-stabilizing guide rod 4 is selected.
Optionally, in some embodiments, the percutaneous guide rod 2 and the self-stabilizing guide rod 4 are provided with infusion channels for injecting anesthetic into the intervertebral foramen during operation so as to realize the purpose of supplementing anesthesia at any time.
As shown in fig. 4, in some embodiments, the protection sleeve 5 includes a sleeve body 51, a handle portion 52 and a protrusion portion 53, the handle portion 52 is provided at the rear end of the sleeve body 51 to facilitate the operation of the protection sleeve 5, and the protrusion portion 53 is provided at the front end of the sleeve body 51 and is used for catching the ventral side of the superior articular process after the protection sleeve 5 enters the surgical passage to achieve positioning.
Further, the outer side wall of the sleeve body 51 is provided with ribs 54, and the ribs 54 extend to the outer side wall of the projection 53. When the protection sleeve 5 enters the operation channel, if the protruding part 53 of the protection sleeve 5 does not reach the position reached by the front end of the self-stabilizing guide rod 4, the operator can slide on the upper articular process by using the ribs 54, so that the protruding part 53 of the protection sleeve 5 enters the intervertebral hole.
As shown in fig. 5, in some embodiments, the trepan 6 is used with the protection sleeve 5, and includes a cutting tube 61, an adjusting tube 62, an adjusting handle 63, and a limiting tube 64, the cutting tube 61 has a serrated edge 611 at the front end, the cutting tube 61, the adjusting tube 62, and the adjusting handle 63 are connected together by a connecting member, and the limiting tube 64 is sleeved outside the adjusting tube 62 and is connected with the adjusting tube 62 by a screw thread.
Specifically, the cutting pipe 61 is inserted into the adjusting pipe 62, a first connecting hole is formed in the top end of the cutting pipe 61, a second connecting hole is formed in the side wall of the adjusting pipe 62, a third connecting hole is formed in the adjusting handle 63, and the connecting piece penetrates through the first connecting hole, the second connecting hole and the third connecting hole to connect the cutting pipe 61, the adjusting pipe 62 and the adjusting handle 63 into a whole. Preferably, the connecting piece is a hexagon socket head cap screw.
Further, for every 360 ° of rotation of the adjustment handle 63, the cutting tube 61 is displaced a fixed distance, typically 2mm, relative to the stop tube 64; in order to facilitate observation of the cutting depth of the cutting tube 61, the outer side wall of the cutting tube 61 is provided with scales.
Based on the structure, the trephine 6 can accurately control the cutting depth, is safe and efficient, can retreat in real time and adjust, is beneficial to releasing space, and can effectively improve the forming quality of intervertebral foramen.
As shown in fig. 1, in some embodiments, the protection sleeve 5 has a plurality of models, and the outer diameters of the sleeve bodies 51 of the protection sleeves 5 of different models are different; correspondingly, the trephine 6 has a plurality of models, and the bone materials which can be cut by the trephine 6 with different models are different in size. During the intervertebral foramen forming operation, an operator selects the trepan 6 and the protective sleeve 5 matched with the trepan according to actual conditions.
As shown in fig. 6, in some embodiments, the anchoring drill 7 includes a drill stem 71, a drill bit 72, and a connector 73, wherein the drill bit 72 is provided at a front end of the drill stem 71, the front end of the drill bit 72 has a drill edge 721, an outer side wall of the drill bit 72 has threads, and the connector 73 is provided at a rear end of the drill stem 71 for connecting a T-handle. After the cutting tube 61 of the trepan 6 clamps part of the bone of the superior articular process, the anchoring drill 7 is placed into the operation channel in a way that the drill bit 72 is behind the front joint 73, and the drill bit 72 is anchored to the clamped bone; after the cutting tube 61 of the trepan 6 cuts all the stuck bone, the trepan 6 and the anchoring drill 7 are synchronously pulled out backwards, and the cut bone is taken out smoothly.
Specifically, the drill 72 is conical, the diameter of the drill 72 gradually decreases from the rear end thereof to the front end thereof, and the rear end diameter of the drill 72 is smaller than or equal to the diameter of the drill rod 71; the joint 73 is a regular hexagonal prism, and the diameter of the circumscribed circle of the joint is smaller than or equal to the diameter of the drill rod 71.
As shown in fig. 1, in some embodiments, the foraminal shaping surgical instrument provided by the present invention also includes a hammer 9 for use in a tapping operation.
As shown in fig. 1, in some embodiments, in order to facilitate portability and prevent loss of tools, the intervertebral foramen shaping surgical device provided by the present invention further includes a box-shaped or bag-shaped housing 10, the puncture needle 1, the dilating guide 2, the self-stabilizing guide 4, and the soft tissue dilating tube 3 are transversely arranged in a right region inside the housing 10 from top to bottom, the hammer 9, the anchoring drill 7, the trephine 6, and the protecting sleeve 5 are vertically arranged in a left region inside the housing 10, and the trephine 6 and the protecting sleeve 5 are staggered with each other.
The use method of the intervertebral foramen forming surgical instrument provided by the embodiment of the invention comprises the following steps:
s1, after a positioning line and a needle inserting point are marked on the skin surface of a patient, the puncture needle 1 is placed, and the puncture needle 1 is ensured to reach the inner upper edge (positive position) of the pedicle of vertebral arch and the upper back corner (lateral position) of the vertebral body so as to form an operation channel;
s2, anaesthetizing the patient, and then placing the guide wire 8 into the operation channel;
s3, the skin expanding guide rod 2 is placed into the operation channel by the guide wire 8, and the front end of the skin expanding guide rod reaches the outer edge of the intervertebral foramen to expand the operation channel;
s4, selecting a soft tissue dilating tube 3 with the diameter slightly larger than the outer diameter of the skin dilating guide rod 2, placing the soft tissue dilating tube into an operation channel, and ensuring that the tongue plate part 31 of the soft tissue dilating tube 3 extends to the outer side of the superior articular process to avoid the exiting nerve root in the process;
s5, pulling out the guide wire 8 and the skin expanding guide rod 2 from the operation channel;
s6, selecting the self-stabilizing guide rod 4 according to the distance between the ventral side of the superior articular process and the posterior edge of the vertebral body, then placing the self-stabilizing guide rod 4 into the operation channel, and enabling the front end of the self-stabilizing guide rod to reach the vicinity (the right position) of the inner edge of the pedicle of vertebral arch and the space (the lateral position) between the posterior edge of the vertebral body and the superior articular process;
s7, sliding the self-stabilizing guide rod 4 along the upper articular process to enable the front end of the self-stabilizing guide rod 4 to reach the ventral side of the upper articular process, knocking the rear end of the self-stabilizing guide rod 4 to enable the front end of the self-stabilizing guide rod 4 to extend into the intervertebral foramen, and simultaneously enabling the tooth tip of the tooth-shaped part 41 to be embedded into the ventral side of the upper articular process;
s8, placing a plurality of soft tissue expansion tubes 3 into the operation channel according to the sequence of the outer diameters from small to large so as to gradually expand the operation channel;
s9, selecting the protection sleeve 5 according to actual requirements, and then rotating the protection sleeve 5 along the soft tissue expansion tube 3 into the operation channel in a counterclockwise way, wherein the protruding part 53 of the protection sleeve 5 extends to the base part of the superior articular process in the process;
s10, pulling out all the soft tissue expansion tubes 3 from the operation channel;
s11, rotating the protruding part 53 of the protective sleeve 5 into the intervertebral hole along the self-stabilizing guide rod 4;
s12, pulling out the self-stabilizing guide rod 4 from the operation channel, then adjusting the position of the protruding part 53 of the protective sleeve 5 to replace the position of the front end of the self-stabilizing guide rod 4, if the protruding part 53 of the protective sleeve 5 does not reach the position reached by the front end of the self-stabilizing guide rod 4, sliding on the upper articular process by using the rib 54, and enabling the protruding part 53 of the protective sleeve 5 to enter the intervertebral hole;
s13, confirming that the protruding part 53 of the protective sleeve 5 is positioned on the ventral side (lateral position) of the superior articular process and inside the lateral margin of the superior articular process (normal position), and then knocking the rear end of the protective sleeve 5 to make the protruding part 53 to catch the ventral side of the superior articular process;
s14, selecting a trepan 6 matched with the used protective sleeve 5, then placing the trepan into an operation channel, and simultaneously adjusting the angle of the protective sleeve 5 to enable the protective sleeve to be approximately parallel to the coronal plane of the human body;
s15, rotating the adjusting handle 63 of the trepan 6 to make the cutting tube 61 clamp part of the bone of the upper articular process, then placing the anchoring drill 7 into the operation channel and making the drill bit 72 anchor the clamped bone;
s16, continuing to rotate the adjusting handle 63 of the trephine 6, after the bone clamped by the tube 61 to be cut is completely cut, synchronously pulling out the trephine 6 and the anchoring drill 7 backwards, and taking out the cut bone, so that the intervertebral foramen forming operation is almost completed.
In summary, the present invention provides a set of intervertebral foramen forming surgical instruments, which includes a puncture needle 1, a skin dilating guide 2, a soft tissue dilating tube 3, a self-stabilizing guide 4, a protective sleeve 5, a trepan 6, an anchoring drill 7, a guide wire 8, a hammer 9 and a receiver 10. Compared with the prior art, the intervertebral foramen shaping surgical instrument has the advantages of convenience in use, simplicity in operation technology, accuracy in guiding, difficulty in displacement, capability of protecting nerve roots, safety in depth control, capability of smoothly taking out bone and the like.
The above description is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, various modifications and substitutions can be made without departing from the technical principle of the present invention, and these modifications and substitutions should also be regarded as the protection scope of the present invention.
Claims (10)
1. Intervertebral foramen shaping surgical instrument, its characterized in that includes pjncture needle, expands skin guide bar, soft tissue expansion pipe, self-stabilization guide bar, protective case, trephine and anchoring and bores, the pjncture needle is used for forming the operation passageway that leads to intervertebral foramen from the skin surface on patient's body, it is used for strutting to expand the skin guide bar to guide the soft tissue expansion pipe gets into in the operation passageway, the soft tissue expansion pipe is used for expanding the operation passageway, in order to guide the self-stabilization guide bar gets into in the operation passageway and fix on the superior articular process, protective case is used for replacing the self-stabilization guide bar, in order to guide the trephine gets into in the operation passageway, the trephine is used for cutting the superior articular process sclerotin, anchoring bores is used for taking out by the sclerotin that the trephine cut off.
2. The foraminous forming surgical instrument of claim 1, further comprising a guide wire for guiding the percutaneous guide into the surgical channel, the percutaneous guide having a through hole through which the guide wire passes.
3. The foraminous forming surgical instrument of claim 1, wherein the front end of the soft tissue dilation tube has a lingual portion.
4. The foraminal forming surgical instrument of claim 1, wherein the soft tissue dilation tube has a plurality of sizes, and wherein different sizes of the soft tissue dilation tube have different outer diameters and different lengths.
5. The foraminous forming surgical instrument of claim 1, wherein the side wall of the self-stabilizing guide rod has teeth near its forward end for engaging the superior articular process.
6. The foraminal forming surgical instrument of claim 1, wherein the self-stabilizing guide includes a cylindrical self-stabilizing guide having a circular cross-section and a flat self-stabilizing guide having a kidney-shaped or oval cross-section.
7. The foraminous forming surgical instrument of claim 1, wherein the percutaneous guide and the self-stabilizing guide each have an infusion channel for injecting medication.
8. The foraminous forming surgical instrument of claim 1, wherein the protective sleeve comprises a sleeve body and a projection at a forward end of the sleeve body, wherein a rib is provided on an outer sidewall of the sleeve body and extends to an outer sidewall of the projection.
9. The foraminal shaping surgical instrument of claim 1, wherein the trephine comprises a cutting tube, an adjustment handle and a stop tube, the cutting tube, the adjustment tube and the adjustment handle being connected together by a connector. The limiting pipe is sleeved outside the adjusting pipe and is in threaded connection with the adjusting pipe.
10. The surgical instrument of claim 1, wherein the anchoring drill comprises a drill shaft, a drill bit disposed at a forward end of the drill shaft, the drill bit having a drill edge at a forward end thereof, the drill bit having threads on an outer sidewall thereof, and a coupling disposed at a rearward end of the drill shaft for coupling to a T-handle.
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CN202010617236.5A CN111759365A (en) | 2020-06-30 | 2020-06-30 | Intervertebral foramen shaping surgical instrument |
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