CN100389729C - Three dimensional orientating instrument and technology of sacro-iliac screw by biological mechanism - Google Patents

Three dimensional orientating instrument and technology of sacro-iliac screw by biological mechanism Download PDF

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CN100389729C
CN100389729C CNB2005100489324A CN200510048932A CN100389729C CN 100389729 C CN100389729 C CN 100389729C CN B2005100489324 A CNB2005100489324 A CN B2005100489324A CN 200510048932 A CN200510048932 A CN 200510048932A CN 100389729 C CN100389729 C CN 100389729C
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chi
cyclic coordinate
coordinatometer
horizontal alignment
coordinate chi
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CN1644175A (en
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李明
徐荣明
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Abstract

The present invention discloses a three dimensional orientating instrument for fixing sacroiliac screws by a biomechanics method and a fixing technology thereof. The three dimensional orientating instrument comprises a level correction scale with a level correction device, a left positioning rod, a right positioning rod, an upper annular coordinatometer, a lower annular coordinatometer and a hollow protection sleeve pipe, wherein the left positioning rod, the right positioning rod and the upper annular coordinatometer can be sheathed on the level correction scale in a sliding sleeve pipes in a sliding mode, the sliding sleeve pipes of the left positioning rod, the right positioning rod and the upper annular coordinatometer are provided with fastening holes, and the corresponding heads of a left fastener, a middle fastener and a right fastener fall into a groove of the level correction scale to increase integral firmness. A side sliding block of the lower annular coordinatometer is sheathed in the upper annular coordinatometer, the lower annular coordinatometer is fixed by the fastener arranged on the side sliding block of the lower annular coordinatometer which is perpendicular to the upper annular coordinatometer, and the side sliding block of the hollow protection sleeve is sheathed into the lower annular coordinatometer in a sliding mode. The positions of the upper annular coordinatometer and the lower annular coordinatometer on the level correction scale can be determined in advance before an operation. The present invention has the advantages of simplicity, practicality, safe and convenient operation, accurate orientation, small operative wound and high firmness.

Description

The fixing three-dimensional orientation instrument of using of sacroiliac screw biomechanics mode
Technical field
The invention belongs to technical field of medical instruments, relate to orthopaedics internal fixation operation technical field, relate in particular to the fixing three-dimensional orientation instrument of using of sacroiliac screw biomechanics mode.
Background technology
The both at home and abroad at present open surgery that adopt of sacroiliac joint complex damage exist wound big more, and it is many to lose blood, and the patient recovers, the shortcoming that complication is many.Though the CT that newly carries out both at home and abroad recently guiding is the more above-mentioned method advanced person of percutaneous sacroiliac screw internal fixation down, complication reduces; But need move the patient to CT Room, exist infection chance many, operating time is long, and moves patient in the operation repeatedly and can increase the weight of damage.There is very big defective in the present conventional sacrum ilium lag screw of using: because the nail road is long, be easy to damage the preceding neural blood vessel of sacrum, the lesson of this respect has been arranged clinically.And its fixed position and do not meet the physiological requirement of sacroiliac joint complex, the incidence rate that screw is deviate from is higher.
The applying date is that 05 day Chinese utility model patent ZL03270002.4 of calendar year 2001 December " sacrum rod internal fixation sight " (notification number is CN2657596Y) discloses a kind of sacrum rod internal fixation sight, when correcting the sacroiliac joint transverse shift, can determine the position of holing, and be the drill bit guiding by the drilling rod guide hole of aiming cover, it is accurate to guarantee to hole.It comprises guide rod, two linking arms are separately fixed at the downside at guide rod two ends, the linking arm lower end is connected with the aiming cover, and the aiming cover that is separately positioned on the linking arm of guide rod two ends is oppositely arranged on the same axis, the aiming cover is sleeve-like structure, its core hole is the drilling rod guide hole, is complementary with the diameter of drilling rod.The one, because the utilization structure parts are many and securing member uses manyly, cause guide rod to be difficult to accurately directed and displacement occurs, the 2nd, because the characteristics of human body, this structure wants big otch to expose in clinical, and operation wound is big, the damage of soft tissue and bone structure is big, and blood loss increases; Operating time is longer simultaneously, and moves the patient to radiology department, the potential danger that damage is increased the weight of; Its disadvantage is that fixed fastness is poor, can only resist the pelvis rotation, corrects the sacroiliac joint transverse shift, can not correct the vertical movement of sacroiliac joint.Since above-mentioned shortcoming, the clinical existing trend of eliminating gradually of present this technology.
Summary of the invention
Technical problem to be solved by this invention is to provide simple and practical at above-mentioned prior art deficiency, the handling safety facility, and accurately directed, operation wound is little, the fixing three-dimensional orientation instrument of using of the sacroiliac screw biomechanics mode that fastness is high.
The present invention solves the problems of the technologies described above the technical scheme that is adopted:
Sacroiliac screw biomechanics mode is fixing uses the three-dimensional orientation instrument, and the technical measures of taking comprise: the horizontal alignment chi that has master scale and horizontal alignment device; Have the left locating rod of sliding sleeve and screw thread foot, right locating rod; The last cyclic coordinate chi that has master scale and sliding sleeve; The following cyclic coordinate chi that has master scale and slip lateral mass; The hollow protective casing that has master scale and slip lateral mass; Described horizontal alignment chi upper center is shaped on arc-shaped groove, and left locating rod, right locating rod and last cyclic coordinate chi slidably are sleeved on the horizontal alignment chi by sliding sleeve;
The sliding sleeve of a. described left locating rod, right locating rod upper end has fastener hole, and left securing member, the middle fastener head equipped with this fastener hole can fall in the described horizontal alignment chi groove;
B. described upward cyclic coordinate chi and horizontal alignment chi are perpendicular, and the sliding sleeve of last cyclic coordinate chi upper end has fastener hole, and the right fastener head equipped with this fastener hole can fall in the described horizontal alignment chi groove;
The slip lateral mass of c. described cyclic coordinate chi down upper end is inserted in the cyclic coordinate chi, and by the fixing cyclic coordinate chi down of the securing member on the slip lateral mass of following cyclic coordinate chi upper end, last cyclic coordinate chi is perpendicular with following cyclic coordinate chi;
D. described hollow protective casing upper end is connected with the slip lateral mass, slides by this slip lateral mass and is inserted in down the cyclic coordinate chi, and be fixed on down on the cyclic coordinate chi by securing member.
For optimizing technique scheme, the measure of being taked also comprises:
Slide flexibly for making it adaptive wide also assurance of scope, right section of above-mentioned horizontal alignment chi is garden arc shape body or rhabodoid, and last cyclic coordinate chi can slide and assembling by flat downstream calibrated ruler.
For reaching the optimum efficiency of use, the circular arc degree of the right section circular arc of above-mentioned horizontal alignment chi is 45 degree~90 degree, and radius is 25cm~80cm; Left side segment length is 280mm~350mm.
Be convenient for assembly and increase fastness, above-mentioned horizontal alignment chi is the tubular body of interior hollow or solid cylinder.
Compared with prior art, the present invention is by being sleeved on the horizontal check chi in left and right two locating rod sliding sleeves; Adjust left and right sides locating rod screw thread foot in the fixing intravital degree of depth, make the horizontal check chi remain on the level position; To go up the cyclic coordinate chi with right securing member and be sleeved on the horizontal check chi, the left, center, right fastener head falls in the horizontal alignment chi groove, improves whole fastness; To descend the cyclic coordinate chi to be sleeved on the cyclic coordinate chi; Hollow protective casing is sleeved on second cyclic coordinate chi; The position of last cyclic coordinate chi on the horizontal check chi, the position of following cyclic coordinate chi on last cyclic coordinate chi pre-determines in the X-ray sheet of measurement on the fixed body and fixed body, the measurement on the CT sheet before performing the operation, overcome the operation of acting blindly, guarantee safety and accuracy that screw is inserted, be convenient to the operator and use.It is simple and practical, the handling safety facility, and accurately directed, operation wound is little, the fastness height.It provides new technology for the damage of clinical treatment sacroiliac joint complex, has reduced the danger of damaging important nerve, blood vessel, makes clinical operation safer, and Wicresoft more meets the physiological requirement of human body.
Description of drawings
Fig. 1 is the present invention program's one overall structure sketch map;
Fig. 2 is the present invention program's two overall structure sketch maps;
Fig. 3 is a horizontal alignment chi cross section cross-sectional schematic among Fig. 1, Fig. 2;
Fig. 4 is Fig. 1, Fig. 2 hollow core protective casing longitudinal section cross-sectional schematic;
Fig. 5 is Fig. 1, Fig. 2 hollow core protective casing structural representation;
Fig. 6 is a guide needle sleeve structure sketch map;
Fig. 7 is a hollow boring bit sleeve structure sketch map;
Fig. 8 is the screw grommet structural representation.
The specific embodiment
Embodiment describes in further detail the present invention below in conjunction with accompanying drawing.
Fig. 1 to Fig. 2 illustrates, and the present invention solves the problems of the technologies described above the technical scheme that is adopted and is:
Sacroiliac screw biomechanics mode is fixing uses the three-dimensional orientation instrument, comprising: the horizontal alignment chi 1 that has master scale and horizontal alignment device 7; Slide flexibly for making it adaptive wide also assurance of scope, the right section of horizontal alignment chi 1 is garden arc shape body or rhabodoid, last cyclic coordinate chi 4 can slide and assembling by flat downstream calibrated ruler 1, for reaching the optimum efficiency of use, the circular arc degree of the right section circular arc of horizontal alignment chi 1 is 45 degree~90 degree, and radius is 25cm~80cm; Left side segment length is 280mm~350mm, and is convenient for assembly and the increase fastness, and horizontal alignment chi 1 is the tubular body of interior hollow or solid cylinder, as Fig. 3 horizontal alignment chi cross section cross-sectional schematic is shown; The left locating rod 2, the right locating rod 3 that have sliding sleeve and screw thread foot; The last cyclic coordinate chi 4 that has master scale and sliding sleeve; The following cyclic coordinate chi 5 that has master scale and slip lateral mass; The hollow protective casing 6 that has master scale and slip lateral mass illustrates hollow protective casing longitudinal section cross-sectional schematic as Fig. 4; Horizontal alignment chi 1 upper center is shaped on arc-shaped groove 1a, and left locating rod 2, right locating rod 3 and last cyclic coordinate chi 4 slidably are sleeved on the horizontal alignment chi 1 by sliding sleeve;
The sliding sleeve of left side locating rod 2, right locating rod 3 upper ends has fastener hole, and left securing member 21, middle securing member 31 heads equipped with this fastener hole can fall in the horizontal alignment chi 1 groove 1a;
Last cyclic coordinate chi 4 is perpendicular with horizontal alignment chi 1, and the sliding sleeve of last cyclic coordinate chi 4 upper ends has fastener hole, and right securing member 41 heads equipped with this fastener hole can fall in the horizontal alignment chi 1 groove 1a;
The slip lateral mass of following cyclic coordinate chi 5 upper ends is inserted in cyclic coordinate chi 4, and by the 51 fixing cyclic coordinate chis 5 down of the securing member on the slip lateral mass of following cyclic coordinate chi 5 upper ends, last cyclic coordinate chi 4 and following cyclic coordinate chi 5 are perpendicular;
Hollow protective casing 6 upper ends are connected with the slip lateral mass, slide by this slip lateral mass and are inserted in down cyclic coordinate chi 5, and be fixed on down on the cyclic coordinate chi 5 by securing member 61.As Fig. 4, shown in Figure 5;
The present invention can select the medical stainless steel material for use according to description and accompanying drawing, adopts numerically controlled lathe, and car, dig, wash technology and get final product, or the employing die casting.
The fixing operation with the three-dimensional orientation instrument of sacroiliac screw biomechanics mode of the present invention comprises the steps:
Step 1: the screw thread foot 2a of left locating rod 2, the screw thread foot 3a of right locating rod 3 are screwed into fixed body, then horizontal check chi 1 are sleeved in the sliding sleeve of left and right two locating rods upper end; Sliding sleeve 2b through left locating rod 2 upper ends tightens fixing horizontal verification chi 1 with left securing member 21, and the head of left securing member 21 falls in the horizontal alignment chi 1 groove 1a; Sliding sleeve 3b through right locating rod 3 upper ends tightens fixing horizontal verification chi 1 with middle securing member 31, and the head of middle securing member 31 falls in the horizontal alignment chi 1 groove 1a; Understand whether horizontal level of horizontal check chi 1 by the horizontal alignment device on the eye-level verification chi 17; Adjust left and right sides locating rod screw thread foot in the fixing intravital degree of depth, make horizontal check chi 1 remain on the level position;
Step 2: the sliding sleeve that will go up cyclic coordinate chi 4 upper ends is sleeved on the horizontal check chi 1, tightens the fixing cyclic coordinate chi 4 of going up with the sliding sleeve 4b of right securing member 41 through last cyclic coordinate chi 4 upper ends; The head of right securing member 41 falls in the horizontal alignment chi 1 groove 1a; To descend the slip lateral mass of cyclic coordinate chi 5 upper ends to be sleeved on the cyclic coordinate chi 4 then, tighten fixing cyclic coordinate chi 6 down through the slip lateral mass 5b of cyclic coordinate chi 5 upper ends down with following securing member 51; The position of last cyclic coordinate chi 4 on horizontal check chi 1, the position of following cyclic coordinate chi 5 on last cyclic coordinate chi 4 all are that basis is predetermined in the X-ray sheet of measurement on the fixed body and fixed body, measurement on the CT sheet before the operation.
Step 3: the slip lateral mass 6b of hollow protective casing 6 upper ends is sleeved on second cyclic coordinate chi 5, and the securing member 61 on slip lateral mass 6b is tightened fixation hollow protective casing 6.
Step 4: hollow protective casing 6 inserts in the fixed body, inserts guide needle sleeve pipe 62 then in protective casing, as shown in Figure 6, pierces the guide needle that has master scale with electric drill, arrives the predetermined safe degree of depth; Extract guide needle sleeve pipe 62, insert hollow boring bit sleeve pipe 63, as shown in Figure 7, hole with core drill; Extract hollow boring bit sleeve pipe 63 then, insert screw grommet 64, as shown in Figure 8, select and the suitable hollow titanium alloy lag screw of fixed body, be inserted in guide needle, through screw grommet, be screwed into the cored screw cutter in the negative stress zone of fixed body sacroiliac joint complex, the degree of depth reaches in the interior or first sacral vertebra lateral mass of first sacral vertebra vertebral body; Insert hollow titanium alloy lag screw with same technique for fixing, implantation site is in the direct stress zone of sacroiliac joint complex, and the degree of depth reaches in the lateral mass of first sacral vertebra; Described negative stress zone is the bony region on every side at sacroiliac joint ligamenta interossea position, pelvic ring rear; Described direct stress zone is the articular cartilage portion bony region on every side of pelvic ring rear sacroiliac joint;
Step 5: the C type arm x-ray fluoroscopy that can carry out fixed body pelvis ap, pelvis side position, inferior pelvic aperture position, pelvic inlet position after fixing at fixed chamber; Fixed body pelvis ap, pelvis side position, inferior pelvic aperture position, pelvic inlet position X-ray sheet are taken in perhaps fixing back, determine the radiology performance of fixed body after fixing, guarantee that screw inserts fixing intravital accuracy, safety, fastness.
The embodiment that in clinical the said fixing body is used during as patient's sick body adopts following steps:
Step 1: after patient's sacroiliac joint complex fracture or dislocation reset, patient ventricumbent position, conventional orthopaedics sterilization, shop aseptic towel, aseptic list; On the skin at the posterior superior iliac spine place, body surface bone mark both sides at pelvis rear, do and be about the 5mm otch, the screw thread foot of two locating rods is inserted in the posterior superior iliac spine of patient both sides by skin incision, the horizontal check chi is placed on two locating rods then, the hold-down screw on the horizontal check chi is tightened fixing horizontal verification chi.Make the patient keep horizontal prone position by the horizontal alignment device of adjusting on the horizontal check chi;
Step 2: will go up cyclic coordinate chi 4 and be placed on the horizontal check chi 1, and tighten the fixing cyclic coordinate chi 4 of going up of hold-down screw, and determine on the human body coronalplane, to advance to follow closely angle; To descend cyclic coordinate chi 5 to be placed on the cyclic coordinate chi 4 then, and determine to advance to follow closely angle on the human body transverse section, the hold-down screw on the cyclic coordinate chi 5 is tightened down; The position of last cyclic coordinate chi 4 on horizontal check chi 1, the position of following cyclic coordinate chi 5 on last cyclic coordinate chi 4 pre-determines in the X-ray sheet of measurement on the fixed body and fixed body, the measurement on the CT sheet before performing the operation, overcome the operation of acting blindly, guarantee safety and accuracy that screw is inserted, be convenient to the operator and use;
Step 3: be about 1.0cm at the skin upper cut, hollow protective casing is placed in down on the cyclic coordinate chi 5, hollow protective casing 6 inserts in the fixed body, tightens hold-down screw fixation hollow protective casing 6.In protective casing, insert guide needle sleeve pipe 62 then, pierce the guide needle (diameter 1.5mm/2.0mm) that has master scale, arrive the predetermined safe degree of depth with electric drill.Extract the guide needle sleeve pipe, insert hollow boring bit sleeve pipe 63, hole with core drill; Extract the hollow boring bit sleeve pipe then, insert screw grommet 64, select diameter 5.0mm~5.5mm, the hollow titanium alloy lag screw of length 50mm~70mm, be inserted in guide needle, through screw grommet 64, be screwed into the cored screw cutter in negative stress (pull strap) zone of sacroiliac joint complex, the degree of depth reaches in the interior or first sacral vertebra lateral mass of first sacral vertebra vertebral body.Use the same method and insert diameter 5.0mm~5.5mm, the hollow titanium alloy lag screw of length 40mm~45mm, implantation site is in direct stress (press belt) zone of sacroiliac joint complex, and the degree of depth reaches in the lateral mass of first sacral vertebra, sews up the wrapping edge of a knife;
Step 4: the C type arm x-ray fluoroscopy that can carry out pelvis ap, side position, outlet position, inlet position after the operation in operating room; Perhaps pelvis ap, side position, outlet position, inlet position X-ray sheet are taken in the operation back, determine postoperative radiology performance, guarantee safety and accuracy that screw is inserted;
Step 5: patient safety returns the ward, does not generally need to move the patient and makes film to radiology department, gets final product at operating room C type arm perspective checking screw position in case of necessity.
Advantage 1: use position finder, because the location accurately, can perform the operation by percutaneous, do not need big otch to expose, make operation " Wicresoft ", reduce the wound of operation, the damage of soft tissue and bone structure is reduced, blood loss reduces; Operating time shortens simultaneously.Avoid repetitious X ray examination, reduced radiation injury.Avoided repeatedly moving the patient potential danger that damage is increased the weight of to radiology department.
Advantage 2: owing to used biomechanics mode technique for fixing to insert screw, the length and the diameter of screw reduce greatly, and be far away apart from the neural blood vessel in sacral the place ahead, greatly reduces the danger of these important structure of damage human body, safe.Importantly, this fixing means is through the check of domestic authoritative biomechanics experiment chamber, prove that this technology is than present similar technology both domestic and external, its fixed fastness is bigger, more meet the body biomechanics requirement, can identify that through domestic expert testimony present technique is leading domestic, international advanced technology.
Though the present invention illustrates and describes by the reference preferred embodiment,, those skilled in the art should understand, and in the scope of claims, can do the various variation on form and the details.

Claims (4)

1. sacroiliac screw biomechanics mode is fixing uses the three-dimensional orientation instrument, it is characterized in that: the horizontal alignment chi (1) that has master scale and horizontal alignment device (7); Have the left locating rod (2) of sliding sleeve and screw thread foot, right locating rod (3); The last cyclic coordinate chi (4) that has master scale and sliding sleeve; The following cyclic coordinate chi (5) that has master scale and slip lateral mass; The hollow protective casing (6) that has master scale and slip lateral mass; Described horizontal alignment chi (1) upper center is shaped on arc-shaped groove (1a), and left locating rod (2), right locating rod (3) and last cyclic coordinate chi (4) slidably are sleeved on the horizontal alignment chi (1) by sliding sleeve;
The sliding sleeve of a. described left locating rod (2), right locating rod (3) upper end has fastener hole, and left securing member (21), middle securing member (31) head equipped with this fastener hole can fall in described horizontal alignment chi (1) groove (1a);
B. described upward cyclic coordinate chi (4) is perpendicular with horizontal alignment chi (1), the sliding sleeve of last cyclic coordinate chi (4) upper end has fastener hole, and right securing member (41) head equipped with this fastener hole can fall in described horizontal alignment chi (1) groove (1a);
The slip lateral mass of c. described cyclic coordinate chi (5) down upper end is inserted in cyclic coordinate chi (4), by the fixing cyclic coordinate chi (5) down of the securing member (51) on the slip lateral mass of following cyclic coordinate chi (5) upper end, last cyclic coordinate chi (4) is perpendicular with following cyclic coordinate chi (5);
D. described hollow protective casing (6) upper end is connected with the slip lateral mass, slides by this slip lateral mass and is inserted in down cyclic coordinate chi (5), and be fixed on down on the cyclic coordinate chi (5) by securing member (61).
2. sacroiliac screw biomechanics mode according to claim 1 is fixing uses the three-dimensional orientation instrument, it is characterized in that:
The right section of described horizontal alignment chi (1) is garden arc shape body or rhabodoid, and last cyclic coordinate chi (4) can slide and assembling by flat downstream calibrated ruler (1).
3. sacroiliac screw biomechanics mode according to claim 2 is fixing uses the three-dimensional orientation instrument, it is characterized in that: the circular arc degree of the right section circular arc of described horizontal alignment chi (1) is 45 degree~90 degree, and radius is 25cm~80cm; Left side segment length is 280mm~350mm.
4. sacroiliac screw biomechanics mode according to claim 1 is fixing uses the three-dimensional orientation instrument, and it is characterized in that: described horizontal alignment chi (1) is the tubular body of interior hollow or solid cylinder.
CNB2005100489324A 2005-01-19 2005-01-19 Three dimensional orientating instrument and technology of sacro-iliac screw by biological mechanism Expired - Fee Related CN100389729C (en)

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Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10179014B1 (en) 2012-06-01 2019-01-15 Nuvasive, Inc. Systems and methods for promoting sacroiliac joint fusion
CN110123436A (en) * 2019-06-21 2019-08-16 创辉医疗器械江苏有限公司 A kind of sacroiliac fusion system and application method
CN113907859B (en) * 2021-09-07 2023-10-13 上海市第十人民医院 Auxiliary screw placement device for sacroiliac joint screw navigation
CN113907860B (en) * 2021-09-14 2023-03-31 郑州大学第一附属医院 Auxiliary positioning device for embedding sacroiliac screw

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998046145A1 (en) * 1997-04-11 1998-10-22 Fernando Colchero Rosas System for the treatment of fractures and other injuries of the femur, tibia and humerus
DE10110246A1 (en) * 2001-03-05 2002-10-10 Koenigsee Implantate & Instr Target for implanting cross fixable bone marrow pins into shinbones, has central part with pin aiming and positioning devices at both ends
CN2655822Y (en) * 2003-09-29 2004-11-17 赵景才 Intervertebral disc puncture three dimensional locating instrument
CN2657596Y (en) * 2003-09-28 2004-11-24 潘进社 Sacral rod internal fixation sighting device
CN2762772Y (en) * 2005-01-19 2006-03-08 李明 3-D director for fixing sacroiliac screw in way of biological mechanics

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998046145A1 (en) * 1997-04-11 1998-10-22 Fernando Colchero Rosas System for the treatment of fractures and other injuries of the femur, tibia and humerus
DE10110246A1 (en) * 2001-03-05 2002-10-10 Koenigsee Implantate & Instr Target for implanting cross fixable bone marrow pins into shinbones, has central part with pin aiming and positioning devices at both ends
CN2657596Y (en) * 2003-09-28 2004-11-24 潘进社 Sacral rod internal fixation sighting device
CN2655822Y (en) * 2003-09-29 2004-11-17 赵景才 Intervertebral disc puncture three dimensional locating instrument
CN2762772Y (en) * 2005-01-19 2006-03-08 李明 3-D director for fixing sacroiliac screw in way of biological mechanics

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