CN105125253B - A kind of articular process of controlling drilling bone depth bores bone object - Google Patents
A kind of articular process of controlling drilling bone depth bores bone object Download PDFInfo
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- CN105125253B CN105125253B CN201510506628.3A CN201510506628A CN105125253B CN 105125253 B CN105125253 B CN 105125253B CN 201510506628 A CN201510506628 A CN 201510506628A CN 105125253 B CN105125253 B CN 105125253B
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- bone
- drilling rod
- drill
- locating sleeve
- articular process
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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
Abstract
Bone object is bored the invention provides a kind of articular process of controlling drilling bone depth, its structure includes locating sleeve and mill bone drill;Mill bone drill is to be terminated with operation handle on cylindrical staight shank drilling rod, drill bit is provided with the lower end of drilling rod, provided with one section of thread segment on the drilling rod adjacent with operation handle, the Major Diam of thread segment is more than the diameter of drilling rod, and stop nut is threaded with thread segment;Locating sleeve be provided with sleeve body axially through, cylindrical channel to interspersed mill bone drill drilling rod, can accommodate the flared section of drill rod thread section provided with one section in the upper end of passage;The lower end of sleeve body is provided with wide-mouth spoon groove or the wide-mouth support that can be straddled in articular process.Processus articular superior position can be accurately positioned using the present invention, and can control to grind the depth of bone, therefore can be abraded the sclerotin being blocked on operative approach direction exactly on the premise of safety and stability, accurate, broad implantation space is provided for working column.
Description
Technical field
The present invention relates to a kind of orthopedic medical device, the articular process of specifically a kind of controlling drilling bone depth bores bone
Device.
Background technology
Protrusion of lumber intervertebral disc is Spinal fractures common disease and frequently-occurring disease, is due to that interverbebral disc occurs after degenerative change, fine
Ring breakage is tieed up, Nucleus pulposus to canalis spinalis, stimulation, pressuring neural root, blood vessel or spinal cord etc. organizes caused pain in waist and lower extremities, numbness etc.
Based on illness.Patient pain is often relatively more violent, it is impossible to walks, has a strong impact on life.Traditional operation treatment wound is big, bleeding
Many, post-operative recovery is slow, and there is the adverse reactions such as postoperative long-term chronic problem and recurrence rate height.Go deep into people with minimally invasive theory
The heart, foramen intervertebrale lens technology is arisen at the historic moment.By feat of indication is wide, wound is small, safe, few intercurrent disease, determined curative effect etc. it is aobvious
Advantage is write, foramen intervertebrale lens are rapidly popularized and developed.
Foramen intervertebrale lens were initiated in 1999 by U.S. Anthony professors Yeung(Young technology), and in Germany in 2002
Spinal surgery association is developed by Thomas Hoogland professors in Young technical foundation, the Tessys skills innovated at present
Art obtains the extensive approval of spinal applications scholar.Its general principle operated is triangle of safety area of the percutaneous puncture by intervertebral foramen
It is implanted into working column(Service aisle can be formed by being implanted into working column), outside annulus fibrosus disci intervertebralis, using endoscope and
Matched Nuclectomy apparatus thoroughly removes prominent or prolapsus nucleus pulposus to release the pressure of nerve root.The technology is current not
Disc herniation is only treated, is also largely used to that diverse bone types are narrow, senile regression treatment, patient is created in similar operation
Wound is minimum, determined curative effect.World vertebral column minimally invasive surgical field has been recognized that foramen intervertebrale lens in the leading of this field at present.
Foramen intervertebrale lens operation will expect smooth implementation, and the accurate implantation of working column is crucial.Because working column will
By intervertebral foramen, this slype is implanted to intraspinal tube, therefore, for patient there is lumbar vertebrae congenital dysplasia or regression to increase
Raw etc. situation, it is easy to stop is formed to operative approach by the abnormal bone of articular process, causes working column not to be implanted into
To correct position and failure.In conventional method, bone object is bored in insertion at intervertebral foramen can abrade the abnormal bone in part at articular process
Matter, still, due to the limitation of device design, bores bone object when abrading the abnormal bone at articular process, if abrading depth mistake
It is deep, bore bone object end and enter canalis spinalis, it is easy to be damaged to dural sac and nerve root, therefore the peace of patient is difficult to ensure that when boring bone
Entirely, i.e. existing method can not removing abnormal bone as much as possible under the premise that security is guaranteed, it is impossible to provide foot for endoscope
Enough visible angles, and then the pathological interspinal disk that can be extractd in art is limited, influence operative effect.
The content of the invention
Bone object is bored it is an object of the invention to provide a kind of articular process of controlling drilling bone depth, bone object is bored to solve tradition
Abnormal bone at articular process can not be abraded under the premise that security is guaranteed, and then the problem of influence operative treatment.
What the present invention was realized in:A kind of articular process of controlling drilling bone depth bores bone object, including locating sleeve and mill
Bone drill;
The mill bone drill is to be terminated with operation handle on cylindrical staight shank drilling rod, is provided with the lower end of the drilling rod
Drill bit, provided with one section of thread segment on the drilling rod adjacent with operation handle, the Major Diam of the thread segment is more than described
The diameter of drilling rod, stop nut is threaded with the thread segment;
The locating sleeve be provided with sleeve body axially through, lead to the cylinder of interspersed mill bone drill drilling rod
Road, the diameter of the passage is less than the Major Diam of drill rod thread section more than the diameter of the drilling rod, in the upper of the passage
End can accommodate the flared section of drill rod thread section provided with one section;The lower end of described sleeve pipe body is wide in articular process provided with that can straddle
Mouth spoon groove or wide-mouth support;The length of described sleeve pipe body is equal to or equivalent to non-threaded section of length of the drilling rod.
The drill bit is fluted drill, chit drill, or end face has the trepan of annulus sawtooth.
The flared section of the passage is screw thread and the spiral shell of drill rod thread section in unthreaded hole section or internal thread segment, internal thread segment
Line matches.
It is further connected with the thread segment of the drilling rod and line-locked locknut is entered to the stop nut.
It is described mill bone drill on be provided with axially through seal wire jack hole.
Neck and flexible clamping mechanism are provided with the operation handle, card body is provided with the upper end of the drilling rod, it is described
Card body is connected in the neck, and is connected and fixed by the flexible clamping mechanism.
Handle part is provided with the upper end of sleeve body.
The articular process of controlling drilling bone depth provided by the present invention, which bores bone object, includes locating sleeve and mill bone drill, grinds bone drill
It is that operation handle is terminated on drilling rod, drill bit is set in drilling rod lower end, one section of thread segment is set on the drilling rod adjacent with operation handle,
And stop nut is connected on thread segment;Locating sleeve be provided with sleeve body axially through, to interspersed mill bone drill
The cylindrical channel of drilling rod, passage can also hold seal wire and pass through, and the expansion of drill rod thread section can be accommodated provided with one section in the upper end of passage
Mouth section, the lower end of sleeve body is that can straddle wide-mouth spoon groove or the wide-mouth support in articular process.In use, seal wire is passed through in advance
Skin puncture is navigated near articular process(Articular process is contacted as far as possible), locating sleeve then is inserted along seal wire, positioning sleeve is adjusted
The direction of pipe, makes the lower end of locating sleeve body(Wide-mouth spoon groove or wide-mouth support)Straddle articular process(That is processus articular superior)On,
Now, also just alignment articular process position needs the sclerotin abraded to the passage in locating sleeve, then will the drilling rod insertion of mill bone drill
In the passage of locating sleeve, the stop nut for making drilling rod lower end touch in articular process, adjustment drill rod thread section makes under stop nut
The distance away from locating sleeve upper port is held to be equal to the depth of sclerotin to be abraded, the operation handle of rotation mill bone drill makes drilling rod lower end
Drill bit is abraded to the sclerotin at articular process position, during mill bone, when stop nut is contacted with locating sleeve upper port,
Bone drill is ground under the barrier effect of stop nut can not continue to move down, it is achieved thereby that the control to grinding bone depth.
The flared section of passage upper end can be unthreaded hole section in the present invention, or internal thread segment.It is interior for flared section
The situation of thread segment, should make screw thread and the screw thread of drill rod thread section in internal thread segment match;Now, in order to realize to bore bone
The control of depth, should also set in drill rod thread section and enter line-locked locknut to stop nut.
In the present invention, because the lower end of locating sleeve body can be straddled on processus articular superior, hence in so that locating sleeve with
The contact of " face and point " is formed between articular process, the contact of this " face and point ", which can be easily achieved, to be determined processus articular superior
Position;Realized by accurate, the reliable location of locating sleeve, then by the mill bone drill drilling rod through locating sleeve inner passage to joint
Teat position sclerotin removing, and mill bone depth can manually control.Grind during bone, because locating sleeve is fixed, therefore grind
Bone drill drilling rod can rotate using locating sleeve to rely on, even if articular process position sclerotin is harder, relatively sharply, drilling rod is not yet
It can be glided along articular process edge, it is to avoid nerve of the drilling rod because of downslide beyond damage reason location sleeve pipe, relative with articular process, it is ensured that
The safety of patient.
The articular process of controlling drilling bone depth provided by the present invention bores bone object, be current spinal surgery it is clinical in the urgent need to
A kind of device, the device can be accurately positioned processus articular superior position, straddle locating sleeve and be difficult to slide on processus articular superior,
It is safe and stable during guarantee mill bone drill mill bone, and can control to grind the depth of bone, it is to avoid mill bone is too deep and is damaged to dural sac
And nerve root, therefore, the present invention can abrade the bone being blocked on operative approach direction exactly on the premise of safety and stability
Removing scope can be expanded by running fix sleeve pipe during matter, removing sclerotin, accurate, broad plant is provided for working column
Enter space, enough visible angles are provided for endoscope, and then create favorable conditions for the thorough excision of pathological interspinal disk.This hair
It is bright simple in construction, and for easy to operate when performing the operation.
Brief description of the drawings
Fig. 1 ~ Fig. 4 is the structural representation of the present invention.
Embodiment
As shown in Fig. 1 ~ Fig. 4, the articular process of controlling drilling bone depth provided by the present invention, which bores bone object, includes locating sleeve
With mill bone drill.
Grinding bone drill includes the staight shank drilling rod 2 of cylinder, operation handle 6 is terminated with drilling rod 2, in the lower end of drilling rod 2
Provided with drill bit.Provided with one section of thread segment 7 on the drilling rod 2 adjacent with operation handle 6, the Major Diam of thread segment 7 is more than drilling rod 2
Diameter, stop nut 8 is threaded with thread segment 7.
Locating sleeve includes locating sleeve body 1, and locating sleeve body 1 is cylindrical barred body structure, in locating sleeve sheet
Be provided with body 1 axially through, cylindrical channel 9 to interspersed mill bone drill drilling rod 2, the axial line and locating sleeve of passage 9
The axial line of body 1 is overlapped.The diameter of passage 9 is more than the diameter of drilling rod 2 but is less than the Major Diam of thread segment 7 on drilling rod 2, i.e.,
Passage 9 can penetrate drilling rod 2 but can not accommodate the thread segment 7 on drilling rod 2.In the upper end of passage 9 drilling rod 2 can be accommodated provided with one section
On thread segment 7 flared section 5.The general length for setting flared section 5 is more than the depth that bone is bored in articular process.Locating sleeve sheet
The length of body 1 is equal to or equivalent to non-threaded section of length on drilling rod 2, and " equivalent to " is to be slightly larger than or meaning slightly smaller than
Think.
By setting the lower end of locating sleeve body 1 to allow it to straddle in articular process, specifically, locating sleeve sheet
The lower end of body 1 can be arranged to wide-mouth spoon groove-like structure, and wide-mouth spoon groove can also regard " horn mouth " shape structure of an indent as,
" horn mouth " can be circular symmetric structure 3(As depicted in figs. 1 and 2), or unsymmetric structure 11(As shown in Figure 3);
The lower end of locating sleeve body 1 can also be arranged to wide-mouth stent-like structure, and wide-mouth support can regard " high-heeled shoes " shape knot as
Structure 12, as shown in Figure 4.In the settable handle part 13 for facilitating human hand to hold in the upper end of locating sleeve body 1, such as Fig. 3 and Fig. 4 institutes
Show.
When grinding bone, make locating sleeve along the seal wire insertion being previously implanted first, the lower end of locating sleeve is straddled joint
On prominent;Then the drilling rod 2 of bone drill is ground along the passage insertion of locating sleeve, the lower end of drilling rod 2 is touched articular process, now regulation limit
Position nut 8, makes distance of the lower end of stop nut 8 away from locating sleeve upper port be equal to the depth of sclerotin to be abraded;Rotate afterwards
Operation handle 6, makes the drill bit of drilling rod 2 abrade the sclerotin at articular process position.With moving down for drilling rod 2, stop nut 8 is treated
After the upper port of lower end touching locating sleeve, rotating operating handle 6 can not make drilling rod 2 continue to move down, and now grind bone and complete, real
The control to grinding bone depth is showed.
The flared section 5 of the upper end of passage 9 can be unthreaded hole section, shown as shown in Figure 1, Figure 3 and Figure 4, or internal thread segment, such as
Shown in Fig. 2.When flared section 5 is internal thread segment, the screw thread in flared section 5 should match with the screw thread of the thread segment 7 on drilling rod.
When flared section 5 be internal thread segment when, by rotating operating handle 6 make thread segment 7 enter flared section 5 after can screw advancement, it is this
In the case of, the stop nut 8 on thread segment 7 may not have the spacing function of complete locking, but be visually observed by people spacing
Nut 8 still can play position-limiting action., can be in the upper limit spiral shell of thread segment 7 in the case where flared section 5 is internal thread segment
The threaded upper ends connecting lock nut 16 of mother 8, thread segment 7 is when the internal thread of flared section 5 advances, when stop nut 8 touches locating sleeve
During upper port, stop nut 8 is locked in the presence of locknut 16 so that thread segment 7 can not be moved on.
The drill bit of the lower end of drilling rod 2 can be designed as solid, twisted shape screw thread drill bit structure 14, such as Fig. 2, Fig. 3 and Fig. 4
Shown, it is in the hollow trepan structure 4 of annular sawtooth that can also be designed to lower end edge, as shown in figure 1, chit drill can also be designed to
Structure.
Mill bone drill on can also open axially through seal wire jack hole, seal wire jack hole can be located at mill bone drill axial line
On, when making in the passage 9 on mill bone drill drilling rod insertion locating sleeve body 1, it can be inserted along the seal wire being previously implanted.
Operation handle 6 can be fixedly connected on the upper end of drilling rod 2, can also set neck and flexible clamping in operation handle 6
Mechanism, sets card body in the upper end of drilling rod 2, card body is connected in neck, and is connected and fixed by flexible clamping mechanism.
Hard steel can be used to make shaping for locating sleeve body 1 and drilling rod 2.
The articular process of controlling drilling bone depth provided by the present invention bores bone object, it is adaptable to resection of nucleus pulposus under foramen intervertebrale lens
Middle percutaneous puncture positioning operation approach, locating sleeve is implanted into by seal wire, and adjustment locating sleeve rides the lower end of locating sleeve
In articular process, now, also just alignment articular process position needs the sclerotin abraded to the passage in locating sleeve, will then grind bone
In passage on the drilling rod insertion locating sleeve of brill, drilling rod lower end is set to touch the spacing spiral shell in articular process, regulation drill rod thread section
Mother, makes distance of the stop nut lower end away from locating sleeve upper port be equal to the depth of sclerotin to be abraded, in drill rod thread
Section is provided with the situation of locknut, and locknut should be made to be located above stop nut and both are in close contact, afterwards rotating operating handle
Articular process sclerotin to be abraded can be ground off by the drill bit of drilling rod lower end, mill bone process safety is reliable.
Bone object is bored using the articular process of the controlling drilling bone depth in the present invention to carry out the patient with disc herniation
Foramen intervertebrale lens are performed the operation, and specific operation process is:
(1)Patient is made to lie on one's side, suffering limb is positioned in upper, padded waist using under the C-arm of X-ray machine, true in patient body-surface
Determine inserting needle route, and do body surface marking.
(2)Routine disinfection drape, after local anaesthesia success, according to body surface marking, puncture needle is inserted extremely under C-arm guiding
Need adjustment to puncture direction and position if causing patient's lower limb radiated pain in correct position, puncture process, extract puncture needle
Nook closing member, the needle guard by seal wire along puncture needle is inserted into precalculated position, extracts needle guard, and Iohexol and methylene are injected into interverbebral disc
Indigo plant dyeing, in order to observe form and the excision of disc herniation thing.
(3)At the seal wire puncture of patient body-surface cut about 1cm sizes otch, using expander step by step to seal wire around
Expanded, be expanded to after suitable size, locating sleeve is implanted into by seal wire, adjustment locating sleeve makes its lower end straddle joint
On prominent, now, also just alignment articular process position needs the sclerotin abraded to the passage in locating sleeve, will then grind the brill of bone drill
Passage on bar insertion locating sleeve is interior and the lower end of drilling rod is touched articular process, the position of regulation drill rod thread section upper limit nut
Put, distance of the lower end away from locating sleeve upper port of stop nut is equal to the depth of sclerotin to be abraded, in drilling rod spiral shell
Line section is provided with the situation of locknut, and locknut should be made to be located above stop nut and both are in close contact, afterwards rotation process hand
Handle can be ground off articular process sclerotin to be abraded by drill bit, treat that drilling rod is displaced downwardly to stop nut and locating sleeve upper port phase
During contact, drilling rod can not be further continued for moving down, and now grind bone and complete.Adjustable positioning sleeve pipe as needed and the position for grinding bone drill,
Widen sclerotin and abrade scope to suitable size and Orientation.
(4)After sclerotin removing on operative approach direction is finished, mill bone drill and locating sleeve are taken out, along seal wire implantation work
Sleeve pipe takes out seal wire, foramen intervertebrale lens imaging system is put into along working column to correct position, and prominent change is taken with different nucleus pulposus clamps pincers
Property nucleus pulposus, Microscopic observation nerve root loosens situation, it was observed that dural sac and nerve root are god when there is autonomous beating
Loosened thoroughly through root.
(5)After the nucleus pulposus for thoroughly extracing denaturation, the disposable radio frequency cutter heads of U.S. elezma are inserted, energy is transferred to 24
Joule, normal nucleus pulposus is persistently burnt, is allowed to back to receive atrophy, after shaping, the fibrous ring that closing ruptures thoroughly releases canalis spinalis
Interior high pressure.
(6)Observe after the no active bleeding of operative region, take out working column, skin suture, operation terminates.
Claims (7)
1. a kind of articular process of controlling drilling bone depth bores bone object, it is characterized in that, including locating sleeve and mill bone drill;
The mill bone drill includes the staight shank drilling rod of cylinder, operation handle is terminated with drilling rod, in the lower end of the drilling rod
Provided with drill bit, provided with one section of thread segment on the drilling rod adjacent with operation handle, the Major Diam of the thread segment is more than
The diameter of the drilling rod, stop nut is threaded with the thread segment;
The locating sleeve includes locating sleeve body, and locating sleeve body is cylindrical barred body structure, in locating sleeve body
In be provided with axially through cylindrical channel, the drilling rod of the mill bone drill is interspersed in the passage, and the diameter of the passage is big
It is less than the Major Diam of drill rod thread section in the diameter of the drilling rod, drilling rod can be accommodated provided with one section in the upper end of the passage
The flared section of thread segment;The lower end of the locating sleeve body is provided with wide-mouth spoon groove or the wide-mouth branch that can be straddled in articular process
Frame;The wide-mouth spoon groove is " horn mouth " shape structure of indent, and " horn mouth " is circular symmetric structure or unsymmetric structure;
The wide-mouth support is " high-heeled shoes " shape structure;The length of the locating sleeve body is equal to or equivalent to the non-spiral shell of the drilling rod
The length of line section;
When grinding bone, locating sleeve is first implanted into, adjustment locating sleeve makes its lower end straddle in articular process;Then the brill of bone drill will be ground
Passage on bar insertion locating sleeve is interior and the lower end of drilling rod is touched articular process, the position of regulation drill rod thread section upper limit nut
Put, distance of the lower end away from locating sleeve upper port of stop nut is equal to the depth of sclerotin to be abraded;Rotation process afterwards
Handle, makes the drill bit of drilling rod abrade the sclerotin at articular process position;With moving down for drilling rod, treat that stop nut lower end is touched
After the upper port of locating sleeve, rotating operating handle can not make drilling rod continue to move down, and now grind bone and complete, and realize to mill bone
The control of depth.
2. the articular process of controlling drilling bone depth according to claim 1 bores bone object, it is characterized in that, the drill bit is fried dough twist
Brill, chit drill, or end face have the trepan of annulus sawtooth.
3. the articular process of controlling drilling bone depth according to claim 1 bores bone object, it is characterized in that, the enlarging of the passage
Section is that screw thread and the screw thread of drill rod thread section in unthreaded hole section or internal thread segment, internal thread segment match.
4. the articular process of controlling drilling bone depth according to claim 1 bores bone object, it is characterized in that, in the spiral shell of the drilling rod
It is further connected with line section and line-locked locknut is entered to the stop nut.
5. the articular process of controlling drilling bone depth according to claim 1 bores bone object, it is characterized in that, on the mill bone drill
Be provided with axially through seal wire jack hole.
6. the articular process of controlling drilling bone depth according to claim 1 bores bone object, it is characterized in that, in the operation handle
Neck and flexible clamping mechanism are provided with, card body is provided with the upper end of the drilling rod, the card body is connected in the neck, and
Connected and fixed by the flexible clamping mechanism.
7. the articular process of controlling drilling bone depth according to claim 1 bores bone object, it is characterized in that, in the upper of sleeve body
End is provided with handle part.
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CN105832378B (en) * | 2016-06-12 | 2018-07-13 | 贵州梓锐科技有限公司 | Abrasion drill for orthopedic operation |
CN105997188B (en) * | 2016-06-12 | 2018-08-14 | 贵州梓锐科技有限公司 | Abrasion drill for orthopedic operation device |
CN106725720A (en) * | 2017-03-03 | 2017-05-31 | 周晓光 | One kind bores bone device |
CN106725708A (en) * | 2017-03-09 | 2017-05-31 | 北京安德思考普商贸有限公司 | Can spacing safe trepan device |
TWI686166B (en) * | 2018-03-19 | 2020-03-01 | 愛派司生技股份有限公司 | Location constrain apparatus for osteotomy surgery |
CN108814673B (en) * | 2018-04-03 | 2021-04-02 | 管廷进 | Depth-limiting osteotomy device and osteotomy method thereof |
CN108836422B (en) * | 2018-04-03 | 2021-02-23 | 管廷进 | Electric osteotomy device and working method thereof |
CN111759365A (en) * | 2020-06-30 | 2020-10-13 | 广州中医药大学第一附属医院 | Intervertebral foramen shaping surgical instrument |
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