CN104027159A - Posterior longitudinal ligment ossification forwards-floating device - Google Patents
Posterior longitudinal ligment ossification forwards-floating device Download PDFInfo
- Publication number
- CN104027159A CN104027159A CN201310067989.3A CN201310067989A CN104027159A CN 104027159 A CN104027159 A CN 104027159A CN 201310067989 A CN201310067989 A CN 201310067989A CN 104027159 A CN104027159 A CN 104027159A
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- China
- Prior art keywords
- handle
- plate
- ossification
- clamping
- ossified
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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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in 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
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
Abstract
The invention relates to the technical field of medical instruments and discloses a device applied to floating and decompressing posterior longitudinal ligment ossification to a ventral part through trans-thoracic vertebra posterior approach. The device comprises ossification clamping and pushing tongs, fixed connecting rods and a fixed pushing board. The jaw of the ossification clamping and pushing tongs is an arc space composed of an upper clamping bite and a lower clamping bite for placing and locking ossification; the fixed pushing board is composed of two fixing plates and a pushing sliding plate, wherein the fixing plates are fixed onto fixed connecting rod maintaining positions of vertebral pedicle screws on both sides of a dural sac through fixing slots at the lower ends of the fixing plates. After clamping tong tail end longitudinal connecting rods for clamping both ends of the ossification penetrate the sliding groove in the pushing sliding plate, an operator can rotate nuts on the longitudinal connecting rods to push the ossification forwards at a constant speed. The device applied to floating and decompressing the posterior longitudinal ligment ossification to the ventral part through the trans-thoracic vertebra posterior approach achieves the aim of thorough thoracic spinal cord decompression by integrally pushing the ossification and the dural sac towards the ventral part and accordingly avoids injuries to the dural sac, spinal cord and nerve roots due to the operation of separating the ossification and the dural sac.
Description
Technical field
The present invention relates to technical field of medical instruments, be a set of be applied to through thoracic vertebra Posterior approach by ossified thoracic vertebra posterior longitudinal ligament pass forward, floating device, it is passed pincers, fixed connecting rod and fixing plate three parts of passing by the thing clamping of ossify and forms.
Background technology
Thoracic vertebra ossified posterior longitudinal ligament is comprising that the Asian countries such as Japan, China sickness rate is higher.Due to higher rate of missed diagnosis and misdiagnosis rate, majority of cases is very serious and need row surgical procedure in the breast spinal compression of when diagnosis.The desirable art formula of removing chest section spinal cord compressing through breastbone or thorax approach by thorough ossified thing excision, but this art formula is high to patient's technical requirement, and the severe complication incidence rate such as postoperative cerebral cerebrospinal fluid leakage, function of nervous system's deterioration, pulmonary infection, contiguous trachea, esophagus and Great Vascular Injury is high.Cause pressure factor because approximately 70% ossified posterior longitudinal ligament patient merges the rears such as OsificationoftheLigamentumFlavumoftheThoracicSpine, calcification, spinal canal stenosis, therefore comparatively safe thoracic vertebra way of escape laminectomy or the thoracic vertebra way of escape laminoplasty of clinical many employings reduces pressure simultaneously.But the existence of thoracic vertebra physiological kyphosis deformity is to the postoperative chest section spinal cord part restriction of having drifted about backward, and that this acts in middle hypomere thoracic vertebra is the most obvious, the ossified posterior longitudinal ligament that if front merges is untreated, Spinal canal encroachment rate is larger simultaneously, the recovery of postoperative function of nervous system is often poor.
Can on vertebral body rear wall, do a bone groove through thoracic vertebra Posterior approach, this space permission patient will be ossify after thing separates with dural sac and be excised.But due to some patients were, to merge dural sac ossified, dural sac is separated and taken out in ossified process from ossified thing, tears and cause the risk of cerebrospinal leak high because of dural sac, and Spinal Cord very easily in this course.Based on this, retain ossified thing and it is passed, fixed in bone groove, drift about and reach effect of easing stress by spinal cord, be one of scheme addressing this problem.But the adhesion degree between ossified thing and dural sac is conventionally comparatively serious, often may be because of inhomogeneous dural sac and the spinal cord of damaging of exerting oneself in the process that it is passed forward, the risk of postoperative generation cerebrospinal leak, acute nervous function damage is higher.Based on this, we have designed a kind of ossified thing clamping and have passed pincers, and are connected and fixed device and have realized the object that ossified thing is at the uniform velocity passed forward by being fixed on surrounding that pedicle of vertebral arch screw nails on.
Summary of the invention
The present invention for through the capable thoracic vertebra ossification of posterior longitudinal ligament of thoracic vertebra Posterior approach thing forward floating art a set of device that can firmly grasp ossified thing and it forward at the uniform velocity, is stably passed is provided, pass pincers, fixed connecting rod and fixing passing plate three parts by ossified thing clamping and form.
Pincers two jaw medial borders are passed in ossified thing clamping respectively upper and lower two clamping teeth, and homonymy two between cog are the semicircle space of diameter 4mm, in order to place the two ends of the ossified thing longitudinal axis; Clamping tooth in upper end is all vertical with clamp handle top with lower end clamping tooth, the wherein long 2mm of lower end clamping tooth, the long 3mm of upper end tooth.Lower end clamping tooth, in order to control ossified thing, prevents that ossified thing from moving up and down in jaw; Upper end clamping tooth is oppressed ossified thing in the time that pliers moves forward, and ensures that it moves forward with gripper clamp.
The clamp handle of gripper clamp is divided into upper end, lower end two parts, cross-shaped and fixed by active screw, ensure two upper end handles mutually near time lower end handle also mutually close; Two lower end handles are folding shape, and epimere, lower intersegmental length ratio are 1: 2, and the two intersegmental 150 degree angles that are, and ensure that two jaws can clamp the two ends of the ossified thing longitudinal axis abreast, and for providing safe distance between two lower end handles.[0006] pincers one handle middle part, side upper end is passed in ossified thing clamping an arc-shaped gear that Open Side Down, and this gear is through the opening part of relevant position, handle top, opposite side upper end, the outer top of this opening part have a bottom can with the elastic switch of engaged gears.In the time playing elastic switch to upper plate, dentation groove and the arc gear wheel of elastic switch bottom are separated from each other, both sides jaw can free phases to activity; Unclamp after elastic switch, switch lower end dentation groove under the pressure of inner shell fragment with the mutual interlock of arc gear wheel, the position of fixing both sides jaw.
Have apart from the fixing starting point 4mm of arc gear wheel place one equate with arc gear wheel thickness, diameter is 10mm and length higher than the vertical shape connecting rod that clamps clamp handle tail end, its time 2/3 is smooth round bar, upper 1/3 is threaded rod.All there is scale the front and back of threaded rod, and have supporting nut.In the time that nut contacts with top fixing head, firmly upwards turn nut, counteracting force can make ossified thing grasp to pass pincers to move downwards equably.Distance and speed that patient can move down according to the scale control gripper clamp on threaded rod.
Fixed connecting rod is the cylindrical structural of titanium alloy, and cross-sectional diameter is 6.0mm, to be fixed on the nut of bilateral pedicle screw.
The fixing plate of passing is made up of two fixing heads and passing slide plate three parts.Two fixing heads are identical, form by top and bottom two parts.Wherein upper end is the plate of " Y " shape structure, and thickness is all identical; In top, upper end 3/4 part be height lower than the notch of both sides height 2mm, the centre of groove has the staple road that a diameter 1mm is vertical, is screwed into after screw and can fixes being placed on the position of passing slide plate in draw-in groove.
The hollow cylinder holddown groove that the plate that the lower end of fixing head is is upper head plate 1/3 by thickness forms, its hollow parts diameter is 6.5mm; Near the outer center of the end plates place of upper end, bottom plate intersection top 3mm have a center of circle, sensing hollow cylinder transverse section, diameter Wei2mmDing road.When fixed connecting rod penetrates after hollow cylinder holddown groove, be screwed into screw by nail road, fixed connecting rod and the fixing plate of passing can be connected as one, keep the fixing invariant position of passing plate.
Passing slide plate is that a thickness is the plate of fixing head upper end thickness 2/3, and its center 1/2 is the central chute of width 10.5mm, inserts and slides along the axis of plate for the stringer connecting rod of gripper clamp tail end; Each oriented outside, center, plate two ends is open, just middle part, length are the chute that plate 1/5 and width are 2mm to be positioned at plate, after passing slide plate two ends are positioned over respectively in two fixing head upper end chutes, auxiliary screw is screwed in nail road, fixing head upper end by plate two ends bathtub construction, can passes by sliding the position of plate and fix.
Brief description of the drawings
Fig. 1: the positive bitmap of ossified thing gripper clamp; Fig. 2: the side bitmap of ossified thing gripper clamp; Fig. 3: the fixing positive bitmap of passing plate fixing head; Fig. 4: the fixing positive bitmap of passing plate passing slide plate; Fig. 5: the fixing skew back bitmap (containing fixed connecting rod) of passing after plate assembling; Fig. 6: ossified thing gripper clamp and the fixing plate assembling effect side bitmap of passing; Fig. 7: ossified thing gripper clamp and the fixing positive bitmap of plate assembling effect of passing.
The numbering of figure elements: 1, upper end clamping tooth; 2, lower end clamping tooth; 3, gripper clamp lower end handle; 4, active screw; 5, gripper clamp upper end handle; 6, arc gear wheel; 7, shell fragment; 8, elastic switch; 9, vertical shape connecting rod; 10, vertical shape connecting rod matching nut; 11, fixing head upper end 12, fixing head upper end draw-in groove; 13, fixing head upper end staple road; 14, fixing head upper end hold-down screw; 15, fixing head lower end staple road; 16, fixing head lower end holddown groove; 17, fixed connecting rod; 18, pass slide plate; 19, pass slide plate central authorities chute; 20, pass slide plate two ends chute; 21, ossified thing.
Detailed description of the invention
In order to understand better content of the present invention, below by detailed description of the invention, and by reference to the accompanying drawings, the present invention is described in further detail.
Preoperative conventional row thoracic vertebra x-ray, CT be unenhanced+three-dimensional reconstruction and the unenhanced inspection of magnetic resonance, and determine the scope of ossified thing 21 and plan to implement operative region, in operative region, bilateral pedicle of vertebral arch is implanted into the pedicle screw of suitable size.According to the scope of involving of ossified thing 21, with thoracic vertebra Posterior approach cut-out dorsal part vertebral body cortical bone, spongy bone, cut-out intervertebral disc if desired, does the bone groove that length, width are all greater than ossified thing scope 1-2mm in vertebral body rear.
Separate dural sac and posterior longitudinal ligament in ossified thing 21 upper ends of distance or 2mm place, lower end, and on edge, spinal cord rear perpendicular to the direction of posterior longitudinal ligament thoroughly from disconnected this ligament.Detect respectively the top and bottom of ossified thing 21 with nerve dissector, determine according to thickness, width and the hardness of ossified thing the particular location that ossified thing gripper clamp lower end handle 3 can be placed.
Play elastic switch 8 to upper plate, two gripper clamp upper end handles 5 are opened laterally, in the time that the distance of 3 of two gripper clamp lower end handles is a bit larger tham spinal cord maximum transverse diameter, unclamp elastic switch 8, keep the invariant position of 5 of two gripper clamp upper end handles.
Breast spinal cord is placed in the middle of ossified thing gripper clamp two handles, move gripper clamp lower end handle 3 lentamente vertically downward position in the ossified thing dorsal part bite of having determined, when lower end, clamping tooth 2 is crossed over spinal cord maximum transverse diameter, is visited to ossified thing, upwards start elastic switch 8, suitably expand the spacing of two gripper clamp lower end handles 3, lower end is clamped to tooth 2 slightly to be moved down, the thing that will ossify is placed in 2, upper end clamping tooth 1, lower end clamping tooth, slightly exert oneself gripper clamp upper end handle 5 near the thing 18 so that clamping is ossify, unclamp elastic switch 8, the invariant position of bone fixation compound gripper clamp.
In kind, with the other end of ossified thing gripper clamp clamping, bone fixation compound, assistant keeps the invariant position of two gripper clamps.
Two fixed connecting rods 17 are inserted respectively to two fixing passing in plate bottom holddown groove 16, again fixed connecting rod 17 is nailed on along being positioned over the symmetrical pedicle of vertebral arch screw in four of dural sac both sides perpendicular to the direction of dural sac, keep the position of two fixing heads, tighten the supporting nut that pedicle of vertebral arch screw nails on, keep the invariant position of fixed connecting rod 17.
Patient adjusts position by two fixing heads along the direction vertical, parallel with fixed connecting rod 17, suitably adjust the position of ossified thing gripper clamp, two fixing head upper ends 11 and two vertical shape connecting rods 9 of ossified thing gripper clamp are parallel to each other, and four are located along the same line.Supporting hold-down screw is screwed into along two staple roads, fixing head lower end 15, to keep the invariant position of two fixing heads.
The supporting nut 10 of vertical shape connecting rod 9 is screwed to the lowermost end of vertical shape connecting rod 9 threaded portions of ossified thing gripper clamp.Vertical shape connecting rod 9 vertically insert pass the central chute 19 of slide plate 18 interior after, move along the both direction vertical, parallel with the dural sac longitudinal axis passing slide plate 18, the staple road 13 of adjusting in fixing head upper end, position to two draw-in groove 12 is all positioned at the chute 20 of passing slide plate 18 two ends again.
Supporting hold-down screw 14 is screwed in nail road, to keep two fixing relative positions of passing plate, passing slide plate and two ossified thing gripper clamps to fix.
The nut 10 that is positioned at vertical shape connecting rod 9 screw thread lowermost ends is upwards turned, until ossified thing 21 enters in bone groove completely, and dural sac front is without obvious compressing.
The supporting nut 10 of vertical shape connecting rod 9 is down turned, take out to lock and fix after the nut at two connecting rod 17 two ends, upwards lift the fixing plate of passing, two fixing two fixed connecting rods 17 passing plate and insertion holddown groove 16 are taken out to visual area.In the process of upwards taking out, assistant keeps ossified thing gripper clamp invariant position.
Upwards start elastic switch 8, unclamp two gripper clamp upper end handles 5, sandwich is clamped to lower end handle 3 and move to bone groove two lateral walls lentamente, extremely ossified thing is by after free in the space between upper end clamping tooth 1 and lower end clamping tooth 2, again that gripper clamp lower end handle 3 is upwards movable, taken out by operation technique region.
Claims (12)
1. this invention is a set of device of through thoracic vertebra Posterior approach, ossified thoracic vertebra posterior longitudinal ligament being passed forward in quadrate bone groove before ossified thing that is applied to, and it is passed pincers, fixingly passed plate and fixed connecting rod three parts form by the thing clamping of ossify.
2. pincers are passed in the ossified thing clamping described in claim 1, it is characterized by: be made up of gripper clamp upper end handle and lower end handle two parts, length ratio is 3: 1 between the two, cross-shaped and fix by active screw, wherein upper end handle is stress point, and lower end handle is ossified thing retaining part.
3. pincers lower end handle is passed in the ossified thing clamping described in claim 2, it is characterized by: lower end, both sides handle is divided into epimere, hypomere two parts, the ratio of length is 1: 2, and both sides epimere bends to the inside, with the lower intersegmental 150 degree angles that are, in the time that upper end, both sides handle is drawn close completely, intersegmentally under two lower end handles be parallel to each other and still have certain safe distance.
4. the gripper clamp lower end handle hypomere described in claim 3, it is characterized by: respectively there is a clamping tooth vertical with clamp handle at the 4mm place, top, He Ju top, top of hypomere, the length of upper end clamping tooth is greater than the length of lower end clamping tooth, and forms an opening semicircle space inwardly between two clamping teeth.
5. pincers upper end handle is passed in the ossified thing clamping described in claim 2, it is characterized by: the top of both sides handle is ring-shaped handle, on a side handle middle part, fix an arc gear wheel, there is an opening at opposite side handle middle part, opening inner side is fixed with shell fragment, and outside is fixed with elastic switch.
6. the arc gear wheel described in claim 5, is characterized by: Open Side Down, and gear is positioned at top, through the opening at offside clamp handle middle part.Have apart from arc gear wheel stiff end 4mm place that a thickness equates, diameter is the vertical shape connecting rod that 10mm and length are greater than gripper clamp upper end handle.
7. the vertical shape connecting rod described in claim 6, is characterized by: upper 1/3 section of connecting rod is screw thread, and lower 2/3 section is smooth connecting rod, and the two diameter is identical, and wherein thread segment is carved with the graduation mark of its decile.
8. the elastic switch described in claim 5 and shell fragment, is characterized by: elastic switch is fixed on the top of gripper clamp upper end handle open outer side by screw, and the gear with arc gear wheel interlock is carved with in its below, and through opening.Shell fragment is fixed on top in opening, and fits tightly through the position of opening with elastic switch below.
9. the fixing passing plate described in claim 1, is characterized by: combined by hold-down screw by two identical fixing heads and passing slide plate three parts.
10. the fixing head described in claim 9 is made up of upper end, lower end two parts, being characterized as of its upper end: the plate that the upper end of fixing head is " Y " shape structure, and the thickness of plate is identical; Central authorities' 3/4 part at top, upper end is the draw-in groove of height lower than both sides height 2mm, and the centre of draw-in groove has the staple road that a diameter 1mm is vertical, and has supporting hold-down screw.
Fixing head lower end described in 11. claim 10, is characterized by: be the hollow cylinder holddown groove that upper head plate 1/3 plate forms by thickness, its hollow parts diameter is 6.5mm; There is a staple road center of circle, sensing hollow cylinder transverse section, that diameter is 2mm at the outer center of end plates place near upper end, bottom plate intersection top 3mm.
Passing slide plate described in 12. claim 9, it is characterized in that: be that a thickness is the plate of fixing head upper end thickness 2/3, its center 1/2 is the sealing chute of width 10.5mm, and the positive middle part of plate is opened, is positioned in each oriented outside, center, two ends place of plate, length is the chute that plate 1/5 and width are 2mm.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310067989.3A CN104027159A (en) | 2013-03-04 | 2013-03-04 | Posterior longitudinal ligment ossification forwards-floating device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310067989.3A CN104027159A (en) | 2013-03-04 | 2013-03-04 | Posterior longitudinal ligment ossification forwards-floating device |
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| Publication Number | Publication Date |
|---|---|
| CN104027159A true CN104027159A (en) | 2014-09-10 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201310067989.3A Pending CN104027159A (en) | 2013-03-04 | 2013-03-04 | Posterior longitudinal ligment ossification forwards-floating device |
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Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP0153831A2 (en) * | 1984-02-13 | 1985-09-04 | Bahaa Botros Seedhom | Instruments for use in the surgical replacement of ligaments |
| US4781182A (en) * | 1986-10-03 | 1988-11-01 | Purnell Mark L | Apparatus and method for use in performing a surgical operation |
| CN2132498Y (en) * | 1992-04-19 | 1993-05-12 | 刘庆荣 | Multifunction treatment instrument for cervical vertebra |
| WO2008042793A2 (en) * | 2006-10-03 | 2008-04-10 | Baxano, Inc. | Articulating tissue cutting device |
| CN101283920A (en) * | 2008-05-05 | 2008-10-15 | 张立 | Abnormal undercut osteotome with bifurcated frontend |
| US7713290B2 (en) * | 2001-10-03 | 2010-05-11 | Vaughan Medical Technologies, Inc. | Vertebral stabilization assembly and method |
| CN202288428U (en) * | 2011-10-24 | 2012-07-04 | 中国人民解放军第二军医大学 | Vertebral plate spreader adopting laminoplasty |
| CN202554080U (en) * | 2012-02-29 | 2012-11-28 | 北京爱乐曼科技有限公司 | Bone cutting pliers |
-
2013
- 2013-03-04 CN CN201310067989.3A patent/CN104027159A/en active Pending
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP0153831A2 (en) * | 1984-02-13 | 1985-09-04 | Bahaa Botros Seedhom | Instruments for use in the surgical replacement of ligaments |
| US4781182A (en) * | 1986-10-03 | 1988-11-01 | Purnell Mark L | Apparatus and method for use in performing a surgical operation |
| CN2132498Y (en) * | 1992-04-19 | 1993-05-12 | 刘庆荣 | Multifunction treatment instrument for cervical vertebra |
| US7713290B2 (en) * | 2001-10-03 | 2010-05-11 | Vaughan Medical Technologies, Inc. | Vertebral stabilization assembly and method |
| WO2008042793A2 (en) * | 2006-10-03 | 2008-04-10 | Baxano, Inc. | Articulating tissue cutting device |
| CN101283920A (en) * | 2008-05-05 | 2008-10-15 | 张立 | Abnormal undercut osteotome with bifurcated frontend |
| CN202288428U (en) * | 2011-10-24 | 2012-07-04 | 中国人民解放军第二军医大学 | Vertebral plate spreader adopting laminoplasty |
| CN202554080U (en) * | 2012-02-29 | 2012-11-28 | 北京爱乐曼科技有限公司 | Bone cutting pliers |
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Application publication date: 20140910 |