JP2020199186A - Sharp spoon for spine surgery - Google Patents

Abstract

To provide an instrument, a bent sharp spoon, that improves efficiency in operation for peeling and removing a yellow ligament from a rear surface of a bone in a spinal canal extension surgery for lumbar spinal canal stenosis.SOLUTION: A sharp spoon of the present invention includes: a spoon part 31 that is bent in a spoon mouth direction close to the perpendicular direction with respect to a shaft 32; and a sharp edge around a spoon mouth, the sharp edge existing only on the hand side. The sharp spoon is made to abut on a bone rear surface and is moved to the cranial side or the caudal side; a yellow ligament is peeled using the sharp edge, is received on a spoon surface, and is pushed out in a block-like shape on the mesial side. Thereby, the yellow ligament can be removed safely and efficiently.SELECTED DRAWING: Figure 9

Description

The present invention relates to surgical instruments used in spinal surgery.

In the operation for spinal canal stenosis, as shown in FIG. 1, it is necessary to remove the ligamentum flavum L, which is fixed to the back surface of the bone B, that is, the ventral side V, by the approach from the dorsal side D. Since the nerve N also exists around the ligament L, it is necessary to operate it so as not to damage the nerve N. Bending sharp spoon 2 has been often used for this operation. As shown in FIG. 2, the sharp spoon has a shaft 12 including a handle and a handle, and a spoon portion 11 is at the tip thereof, and the edge of the spoon portion 11 is a sharp blade. The sharp blade 13 is almost all around the edge of the spoon 11 (left figure in FIG. 5 and left figure in FIG. 6). FIGS. 2 and 3 show a straight spoon 1 in which the shaft 12 and the spoon 11 are straight. Conventionally, there is already a bent spoon 2 (Fig. 1, Fig. 4, right figure) in which the spoon portion 21 and the shaft 22 are bent, but the bending direction is the spoon direction M. The spoon direction is the direction in which the concave surface of the spoon is facing, that is, the perpendicular direction of the plane assuming a plane including the spoon-shaped margin ring.

The procedure for using the flexion sharp spoon 2 in surgery for spinal canal stenosis is the ventral side of the ligamentum flavum L, which attaches the flexion sharp spoon 2 inserted from the dorsal side D to the back surface of the bone B as shown in FIG. Insert it into V, pull it toward you (dorsal side D), sandwich the ligamentum flavum L between the sharp blade and bone B, then pull it along the back surface of bone B to peel off the ligamentum flavum L and drag it out. Remove.

JP 2000-287979

In this conventional method, as shown in the left figure of FIG. 7 (schematic view seen from the dorsal side), the excision range of the ligamentum flavum L in one operation is only the width of the sharp spoon, and since it is a small range, it is wide in the body axis direction. It is inefficient for excision of the ligamentum flavum L in. If the ligamentum flavum L is thick, the ligamentum flavum L cannot be bitten between the sharp blade of the spoon and the bone B, and the ligamentum flavum L may not be removed.

Therefore, the purpose is to improve the efficiency and effectiveness of sharp spoons in spinal surgery.

Regarding the flexion spoon 3 for spinal surgery of the present invention for solving the above problem, the direction is defined using the straight spoon 1 as a prototype and expressed by the difference from it. The direction in which the concave surface of the spoon of the straight spoon is facing (detailed above) is the spoon direction M (Fig. 2, FIG. 4, left), and the spoon portion 11 side is the tip side T on the long axis of the shaft 12. The opposite side is the hand side N (Fig. 2). The bending direction of the spoon 31 with respect to the shaft 32 is not the spoon direction M as in the conventional bending sharp spoon 2 (Fig. 4, right figure), but is close to the direction perpendicular to the spoon direction (Fig. 5, right figure), and the spoon side. The sharp edge 33 has only the hand side N (Fig. 6, right figure), not the conventional full circumference (Fig. 6, left figure).

The procedure used is to insert the flexion sharp spoon 3 of the present invention from the dorsal side, insert the spoon portion 31 into the ventral side of the ligamentum flavum L attached to the back surface of the bone B, and sandwich the ligamentum flavum L between the bone surface. Then, instead of pulling it toward you as in the past (Fig. 7, left figure), move it in the body axis direction A, and proceed while peeling the ligamentum flavum L from the bone surface with the sharp blade 33 (Fig. 7, center view and right figure). ..

With the above procedure, a wide range of ligaments can be peeled off and removed with a single operation. When the ligamentum flavum L is detached from the bone B, the exfoliated ligamentum flavum L is received by the concave surface of the spoon 31 and extruded, but since the ligamentum flavum L is extruded as a mass, the sharp blade and the bone The peeling action is more widespread than the peeling at the contact site.

At this time, there is a nerve N around the tip side of the spoon (Fig. 1), but the surface of the spoon 31 facing the nerve N on the tip side is blunt and does not damage the nerve.

Axial fracture of the spine during surgery. Overall side view (slightly oblique) of an existing straight spoon. Tip view of an existing straight spoon (upper view is side view (slightly oblique) view, lower figure is front view). The tip side surface (slightly oblique) of the existing straight spoon (left figure) and the existing bending sharp spoon (right figure). Front view of the tip of the existing straight spoon (left figure) and the sharp spoon of the present invention (right figure). Cross-sectional view of the existing straight spoon (left figure) and the sharp spoon of the present invention (right figure). Schematic diagram of the procedure comparison between the existing bending spoon (left figure) and the sharp spoon of the present invention (center figure and right figure). Front view of the spoon of the present invention. Overall front view of the sharp spoon of the present invention.

The embodiment of the sharp spoon 3 of the present invention will be described with reference to FIGS. 5, 6 and 9. As shown in the right figure of FIG. 5, the bending direction of the spoon 31 with respect to the shaft 32 is close to the direction perpendicular to the spoon direction M. As shown in the right figure of FIG. 6, the sharp blade 33 on the edge of the spoon is only N on the hand side. As a whole, it is as shown in Fig. 9.

As shown in FIG. 8, the front shape of the spoon may be an ellipse 31, an oval 41, a rounded rectangle 51, or the like.

Claims (1)

In the sharp spoon used in spinal surgery
The bending direction of the spoon with respect to the shaft is a direction close to perpendicular to the spoon direction.
An instrument characterized in that the sharp blade on the edge of the spoon is only on the hand side.