CN105534588A - Disassembly type double-side type percutaneous individualized pedicle screw guiding template - Google Patents
Disassembly type double-side type percutaneous individualized pedicle screw guiding template Download PDFInfo
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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
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
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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
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
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Abstract
The invention relates to the technical field of medical equipment, in particular to a disassembly type double-side type percutaneous individualized pedicle screw guiding template. The guiding template is provided with a positioning mechanism, a cross connection part, a screw guiding pipe and a screw guiding hole; the screw guiding hole is formed in the cross connection part and penetrates the cross connection part from top to bottom, is communicated with the screw guiding pipe and is contained in the screw guiding pipe; the positioning mechanism is provided with a mastoid process positioning mechanism and an appendage positioning mechanism, and the mastoid process positioning mechanism and the appendage positioning mechanism are totally attached to the mastoid process and the appendage of the thoracolumbar vertebra needed for simulation before an operation respectively in the aspect of form; the cross connection part is composed of a left cross connection part body and a right cross connection part body; a clamping block is arranged at one end of the left cross connection part body; a clamping groove is formed in one end of the right cross connection part body; in use, the clamping block is inserted in the clamping groove so that the left cross connection part body and the right cross connection part body can be connected into a whole; the screw guiding pipe is connected with the left cross connection part body and the right cross connection part body, and the cross connection part and the positioning mechanism are connected into a whole. The structure is simple, operation is convenient, cost is low, operating difficulty is reduced, operation time is shortened, and the disassembly type double-side type percutaneous individualized pedicle screw guiding template is particularly suitable for being applied to a minimally-invasive pedicle screw internal fixation operation.
Description
Technical field
The present invention relates to technical field of medical instruments, particularly relate to a kind of dismountable bilateral type percutaneous individuation pedicle screw navigation template.
Background technology
Lumbar vertebra compression fracture refers to because external force causes the successional destruction of Thoracolumbar disk sclerotin.This is modal spinal injury.In between twenty and fifty patient, high-energy damage is its main causative factors of injury, as traffic accident, and high falling wound etc.There is osteoporosis due to itself in gerontal patient, causative factors of injury mostly are low violence damage, as slipped, falling.Patients with thoracolumbar fracture often merges nervous function damage, and due to causative factors of injury be high-energy injury substantially, normal merge other organs damage, this brings difficulty and challenging greatly for treatment.
Thoracolumbar disk vertebral compression and bursting fracture are the common types of spinal fracture, are the first-selected measure of this type of damage of process through posterior Pedicle internal fixation system.But because of conventional open, to put tack operation wound larger, the scope of tissue dissection is wider, can to the long-time tractive of surrounding tissue in operation, serious and affect functional rehabilitation after operation in patients, so in recent years along with the development of vertebral column minimally invasive surgery, percutaneous cervical arc root screw technique for fixing comes into one's own day by day, in its art, the determination in pedicle screw entry point and nail direction, road is the key of this technology, but Thoracolumbar disk anatomical structure more complicated and variation is large, often need to have an X-rayed underlying nail continuously in conventional percutaneous cervical arc root operation, medical worker and patient radiation dose is caused to strengthen, the generation of leukemia and skin carcinoma can be caused for a long time, though free-hand pedicle of vertebral arch puts nail can reduce perspective, but extend operating time, and the more difficult concordance meeting same vertebral body bilateral Screw entrance point and direction, affect reset effect, and costly not easily popularize.
There is the guide plate structure that some go out according to Thoracolumbar disk articular process structure fabrication at present, carrying out smoothly of operation can be helped, but still also existing needs that open surgery exposes the region of anatomy, screw orientation can change because of Body Position Change, in operating process, stability is inadequate, bad arrangement, inconvenient operation, and the technical problem that postoperative dismounting is not easy etc., be not suitable for the vertebra Wicresoft internal fixation operation of percutaneous.
Summary of the invention
For solving above technical problem, the invention provides a kind of dismountable bilateral type percutaneous individuation pedicle screw navigation template, structure is simple, easy to operate, cost is low, convenient, high-efficiency precision determines position, reduce operating difficulty, shorten operating time, ensure surgical effect; Be particularly suitable in invasive surgery.
Solve a kind of dismountable bilateral type percutaneous individuation pedicle screw navigation template in the present invention of above technical problem, comprise percutaneous individuation pedicle screw navigation template, it is characterized in that: described navigation template is provided with detent mechanism, horizontal company, screw conduit and screw pilot hole, horizontal connecting be located at by screw pilot hole, communicate with screw conduit through horizontal company and be included in screw conduit from the top down, the part that screw pilot hole is connected with detent mechanism is the best entry point of preoperative simulation pedicle screw, the direction of pilot hole is consistent with preoperative simulation pedicle screw direction,
Described detent mechanism is provided with mastoid process detent mechanism and attached prominent detent mechanism, and mastoid process detent mechanism and attached prominent detent mechanism are connected as a body, and are applied on Thoracolumbar disk, and its form is fitted completely with the mastoid process of Thoracolumbar disk needed for preoperative simulation, attached dashing forward respectively;
Describedly horizontally be connected with as left horizontal company, right horizontal company, left horizontal one end that connects is provided with fixture block, and right horizontal company in one end is provided with draw-in groove, and during use, fixture block inserts in draw-in groove and makes left horizontal company and right horizontal company form one;
Two, described screw conduit, respectively with left horizontal company and right horizontal downlink connection, and every root screw conduit two ends respectively with horizontal company and detent mechanism, horizontal company and detent mechanism are linked into an integrated entity.
Described fixture block and draw-in groove relevant position are provided with Kirschner wire patchhole, insert Kirschner wire with fixing left horizontal company and right horizontal company during use.
The described horizontal surface that connects is provided with indicator collet, and to distinguish, left and right is horizontal connects conduit and corresponding detent mechanism, and accurately determine the position of articular process, in the location of Thoracolumbar disk both sides, save time, minimizing makes mistakes.
Described screw catheter inner diameter is consistent with screw pilot hole diameter, and diameter is 4-4.1mm.
Diameter described in prioritization scheme is 4mm.
Described screw conduit diameter is 8mm.
Described Kirschner wire patchhole diameter is 2-2.1mm.
The diameter of Kirschner wire patchhole described in further prioritization scheme is 2.1mm, makes just through Kirschner wire.
Described horizontal company forms inside angle of inclination with two screw conduits, to ensure that pedicle screw can be implanted in introversion.
Because screw has an inside angle of inclination, if make an entirety, be not easy the problem of placing.The present invention forms dismountable, avoids the problem being not easy to place, adds the stability of operational convenience and guide plate, the success rate in corresponding increase art.
In the present invention, detent mechanism is used for locating Thoracolumbar disk interarticular screw entry point, determines the position of Screw entrance point; Guide-localization hole determines that screw enters to follow closely direction.In detent mechanism, joint mastoid process detent mechanism blocks mastoid process, and joint lateral mass detent mechanism is auxiliary fixing, and entry point and screw openings just can well be decided.
By the horizontal company of navigation template in the present invention, less soft tissue can be peeled off, be convenient to laying of navigation template, improve accuracy.The screw conduit of horizontal downlink connection bilateral, then by screw tubes connection detent mechanism, become an entirety.Every root screw conduit all communicates with a screw pilot hole.
The present invention is in Design of digital and clinical manipulation, low to enforcement personnel technical requirement, has the medical worker of basic computer basic knowledge and plastic surgery's technical ability to implement; Concerning patient, a CBCT is only needed to check and the spiral CT inspection of high radiation need not be done; Get final product designed, designed if medical institutions have desktop rapid forming equipment and process guide plate, eliminating Design of digital expense and the time-consuming mould rod transportation of third company.The process of whole mould rod molding only needs 3-5 hour, and with low cost, simple operation and precision is high, advances the clinical practice of technique greatly.
Surgical doctor can use without the need to accepting special training, obviously reduces the stripping (particularly prominent joint teat divides) of soft tissue and hemorrhage, can settle dentata screw fast and accurately, also improve safety, reduce operation cost in art in operation.
The present invention is applicable to the implantation of hollow pedicle screw, is particularly useful in Minimally Invasive Surgery, and stable operation, accurate and handled easily, cost is low, can reduce the radiation dose in operation in patients, avoids radiation in the art of medical worker, ensure surgical effect, installation and removal easily.
Accompanying drawing explanation
Fig. 1 is the navigation template structural representation in the present invention
Fig. 2 is the structural representation that in the present invention, navigation template is combined with Thoracolumbar disk
Wherein, in figure, sequence number is specially: 1. detent mechanism, 2. screw conduit, 3. screw pilot hole, 4. horizontal company, 5. mastoid process detent mechanism, 6. attached prominent detent mechanism, 7. Thoracolumbar disk, 8. mastoid process, 9. indicator collet, 11. fixture blocks, 12. Kirschner wire patchholes, 13. draw-in grooves, and 14. is attached prominent
Detailed description of the invention
Below by the present invention will be further described in conjunction with the embodiments, it should be understood that these embodiments only for the object of illustration, never limit the scope of the invention.
Embodiment 1
A kind of dismountable bilateral type percutaneous individuation pedicle screw navigation template, be provided with detent mechanism, horizontal company, screw conduit and screw pilot hole, horizontal connecting be located at by screw pilot hole, communicate with screw conduit through horizontal company and be included in screw conduit from the top down, the part that screw pilot hole is connected with detent mechanism is the best entry point of preoperative simulation pedicle screw, and the direction of pilot hole is consistent with preoperative simulation pedicle screw direction;
Detent mechanism is provided with mastoid process detent mechanism and attached prominent detent mechanism, and mastoid process detent mechanism and attached prominent detent mechanism are connected as a body, and are applied on Thoracolumbar disk, and its form is fitted completely with the mastoid process of Thoracolumbar disk needed for preoperative simulation, attached dashing forward respectively;
Horizontally be connected with as left horizontal company, right horizontal company, left horizontal one end that connects is provided with fixture block, and right horizontal company in one end is provided with draw-in groove, and during use, fixture block inserts in draw-in groove and makes left horizontal company and right horizontal company form one;
Two, screw conduit, respectively with left horizontal company and right horizontal downlink connection, and every root screw conduit two ends respectively with horizontal company and detent mechanism, horizontal company and detent mechanism are linked into an integrated entity.Screw catheter inner diameter is consistent with screw pilot hole diameter, and diameter is 4.1mm, and screw conduit diameter is 8mm.
In the present invention, horizontal company forms inside angle of inclination with both sides conduit.Therefore integrally percutaneous places difficulty.-the present invention forms dismountable, avoids the problem being not easy to place, adds the stability of operational convenience and guide plate, the success rate in corresponding increase art.
Detent mechanism is used for locating Thoracolumbar disk pedicle screw entry point, determines the position of Screw entrance point; Guide-localization hole determines that screw enters to follow closely direction.By the horizontal link structure of navigation template, less soft tissue can be peeled off, be convenient to laying of navigation template, improve accuracy.
Example is used in invasive surgery, the entry point of pedicle screw just just mastoid process and attached prominent on, be therefore first the reverse template of design and articular process registration; Squeeze into puncture needle by guide plate and settle guide pin, be then screwed into hollow screw by guide pin.
Embodiment 2
A kind of dismountable bilateral individuation Thoracolumbar disk articular process navigation template, be provided with detent mechanism, horizontal company, screw conduit and screw pilot hole, horizontal connecting be located at by screw pilot hole, communicating with screw conduit through horizontal company is from the top down included in screw conduit, the part that screw pilot hole is connected with detent mechanism is the best entry point of preoperative simulation pedicle screw, and the direction of pilot hole is consistent with preoperative simulation pedicle screw direction;
Detent mechanism is used for locating axis arch root Screw entrance point, determines the position of Screw entrance point; Guide-localization hole determines that screw enters to follow closely direction.By the horizontal link structure of navigation template, less soft tissue can be peeled off, be convenient to laying of navigation template, improve accuracy.
Horizontally be connected with as left horizontal company, right horizontal company, left horizontal one end that connects is provided with fixture block, and right horizontal company in one end is provided with draw-in groove, and during use, fixture block inserts in draw-in groove and makes left horizontal company and right horizontal company form one; Fixture block and draw-in groove relevant position are provided with Kirschner wire patchhole, insert Kirschner wire with fixing left horizontal company and right horizontal company during use.Kirschner wire patchhole diameter is 2,2.2mm or 2.1mm, can just make the Kirschner wire of 2.0mm pass when diameter is 2.1mm.
Two, screw conduit, respectively with left horizontal company and right horizontal downlink connection, and every root screw conduit two ends respectively with horizontal company and detent mechanism, horizontal company and detent mechanism are linked into an integrated entity.Screw catheter inner diameter is consistent with screw pilot hole diameter, and diameter is 4mm, and screw conduit diameter is 8mm.
The horizontal surface that connects also is provided with indicator collet, and to distinguish, left and right is horizontal connects conduit and corresponding detent mechanism, and accurately determine Thoracolumbar disk mastoid process, attached prominent position, save time, minimizing makes mistakes.
Test one
Experiment is to picture:
Put percutaneous individuation navigation template in nail and the present invention guide two groups of cases of underlying nail, wherein conventional mammogram group if free-hand under employing conventional mammogram: man 19 example, female 13 is routine; 27 ~ 56 years old age, average 37.5 years old.Damage reason: traffic accident injury 20 example, high falling wound 8 example, injures 4 examples by a crashing object.Damage sections: T
112 examples, T
128 examples, L
113 examples, L
29 examples.
Percutaneous guide plate group in the present invention: man 18 example, female 12 example; 25 ~ 57 years old age, average 37.1 years old.Damage reason: traffic accident injury 19 example, high falling wound 7 example, injures 4 examples by a crashing object.Damage sections: T
112 examples, T
128 examples, L
112 examples, L
28 examples.
The equal not statistically significants of physical data comparing difference (P>0.05) such as two groups of Genders, age, damage reason, damage sections, have comparability.
Clinical follow
Antibiotic 1 time is applied in postoperative 24 hours.X-ray film and CT examination in postoperative 5d, encourage low back muscle functional exercise, postoperative 2 weeks Go to ground activities under brace protection.Brace uses 3 months, and postoperative 10 ~ December takes out internal fixtion.Periodic review X-ray film, follows up a case by regular visits to more than December continuously.
Evaluation index
A, clinical indices: intraoperative blood loss, operating time, fluoroscopy during operation number of times, otch total length, postoperative 7 days, January pain visual imitation assessment.
B, radiographic index: CT data is imported in Mimics software, measures following index: 1. anterior margin of vertebral body height percent: anterior margin of vertebral body height ÷ [(upper anterior margin of vertebral body height+the next anterior margin of vertebral body height) ÷ 2] × 100%; 2. fixed-segment sagittal curvature: the angle of the upper soleplate vertical line of the next vertebral body in fixed-segment; Fixed-segment sagittal curvature corrects the number of degrees: postoperative fixed-segment sagittal curvature-preoperative fixed-segment sagittal curvature; 3. the relation of pedicle of vertebral arch cortex and screw: classify by 3 grades, CT horizontal position is assessed, and pedicle nail is complete is I grade in pedicle of vertebral arch, excellent; Break through cortex≤2mm be II grade, can; > 2mm is III grade, poor.I, II grade of expression are put and are followed closely successfully.4. plant nail success rate first in art: the pedicle of vertebral arch that punctures first perspective entry point position is normal, and postoperatively verify that screw is put and followed closely successfully (do not comprise first puncture failure and again adjust successfully) by CT.5. sagittal plane screw placement angle: angle CT sagittal plain being measured pedicle screw axis and vertebral body upper limb, it is that just rear reading is negative that two lines going cross each other are positioned at vertebral body front reading.6. screw sagittal plane angle: the difference of same vertebral body bilateral pedicle screw sagittal plane implant angle.7. Screw entrance point horizontal position differences: vertical dimension difference CT sagittal plain being measured same vertebral body bilateral pedicle screw entry point center and upper soleplate level.8. screw leaning angle difference: difference CT horizontal position being measured same vertebral body bilateral pedicle screw and vertebral body midplane angle.
C, statistical method
SPSS19.0 statistical software is adopted to analyze.Continuous data is with mean
±standard deviation represents, compares employing one factor analysis of variance in group between each time point, compares between two and adopts pairing
tinspection, compares employing independent sample between group
tinspection; Enumeration data represents with rate, compares and adopt χ between group
2inspection; Employing rank test is compared between ranked data group; Inspection level α=0.05.
Interpretation of result:
All patients complete operation all smoothly, implant pedicle screw 372 pieces altogether.Wherein conventional mammogram group and percutaneous guide plate group respectively have 1 example to occur superficial infection, heal after Wound during Dressing Change, antibiotic therapy.Without important blood vessels and nerve injury.Last follows up a case by regular visits to the patient having no internal fixtion and loosen or rupture.Two groups of patients all obtain and follow up a case by regular visits to, follow up time 12 ~ 24 months, average 13.6 months.
Two groups of intraoperative blood losses, operating time difference have statistical significance (
p<0.05), in table 1.Percutaneous guide plate group operation time medical worker because of hide to operating room outdoors, with stereotype protection, therefore have an X-rayed radiological dose can ignore.Therefore medical worker and patient transmission metering, two groups all have statistical significance (
p<0.05), percutaneous guide plate group is starkly lower than conventional mammogram group.The VAS scoring in two groups of incision lengths, preoperative, postoperative 7 days and postoperative January, two groups of no significant difference (
p > 0.05), in table 1.
The table 1 liang each clinical indices of group patient compares (x ± s)
Results of imaging
Two groups of postoperative anterior margin of vertebral body height, fixed-segment sagittal curvatures correct all more preoperative obvious improvement of the number of degrees, difference have statistical significance (
p<0.05), in table 2.Percutaneous guide plate group screw plant first nail accurately number, finally plant nail and be accurately all better than conventional mammogram group in number and sagittal plane screw placement angle, two groups of difference all have statistical significance (
p<0.05), in table 3.Percutaneous guide plate group bilateral screw sagittal plane angle, Screw entrance point horizontal position differences, screw leaning angle difference are all less than conventional mammogram group, comparing difference have statistical significance (
p<0.05), percutaneous guide plate group bilateral screw has better concordance, in table 4.
Before and after table 2 liang group operation in patients, each radiographic index compares (x ± s)
(note:
*p<0.05 is compared with preoperative,
#p<0.05 is compared) with matched group
A table 3 liang group screw placement situation compares
Table 4 liang group bilateral screw comparison of coherence (x ± s)
Can draw from above table, the pedicle screw instrumentation that percutaneous guide plate of the present invention is assisted both had drawn the feature that digital orthopaedics is precisely performed the operation, have less invasive techniques concurrently again, by this research obtain operative incision little, go out insufficiency of blood, assembling simple, put nail accurately, the advantage such as few, the better reduction of radiation exposure, decrease the disposable input of hospital, to be clinically worthy of popularization.
Its advantage of the present invention specifically mainly contains the following aspects: 1. the easy percutaneous of guide plate is accurately placed: 3D printing is a kind of form of Rapid Manufacturing Technology, best pedicle screw entry point and direction is designed in a computer by preoperative, then produce the location navigation template assisted surgery of limited exposure, the difficult point of design determines rationally guide plate registration point reliably.The guide plate scope of this group patient design is T
10~ L
3sections, these vertebral body rears have the anatomical structures such as obvious mastoid process, processus paramastoideus, transverse process and position is relatively shallow, and guide plate not only can be placed by percutaneous, but also can accomplish effective screens registration.In our practical operation, the anatomical structure that the preoperative understanding of patient is patient personalized also participates in guide plate design, and appearing of just can shooting the arrow at the target in art needs screens anatomical structure, makes guide plate effectively stick on bone mark.In this research, percutaneous guide plate group puts nail success rate is first 92.2%, is obviously better than conventional mammogram group (P<0.05), illustrates that the percutaneous placement accuracy rate of guide plate is high.In addition, in this research, the guide plate pedestal of each vertebral body is divided into left and right sides two parts, the object done like this is placed for the ease of the percutaneous of guide plate and take out, after patient suitably exposes vertebral body rear structure in art, by placing special drag hook, guide plate be just easier to one-sided percutaneous rotate settle and screens in bone structure, both sides are connected as a single entity by " concavo-convex " structure that then patient can be designed by left and right sides guide plate, not only strengthen its stability, also the introversion direction controlling screw is convenient to, the taking-up of inserting location guide pin back guide is also convenient in such design simultaneously, save operating time, in the present invention, the operating time of percutaneous guide plate group is 71.6 ± 11.9min, amount of bleeding is 79.7 ± 25.1ml, obviously be better than conventional mammogram group, illustrate that percutaneous guide plate is easily placed and takes out, save operating time, decrease hemorrhage,
2. the percutaneous of guide plate is placed and can be accomplished Wicresoft: the registration point (with the area of bone form touch) of guide plate controls at diameter about 16mm, suitable with the diameter of Wicresoft screw outer sleeve, the damage that guide plate reduces soft tissue can be placed when not increasing incision length, the incision length of percutaneous guide plate group be 12.0 ± 2.0cm, postoperative 7 days and January pain VAS be respectively 5.5 ± 0.9 and 1.7 ± 0.9, compare without significant difference with conventional mammogram group, prove that it is the same with conventional mammogram group in Wicresoft.
3. guide plate can ensure that screw arrangement one is made peace left and right sides symmetry: complete according to the preoperative planning of doctor at percutaneous guide plate group centering guide, so just can ensure that Screw entrance point arranges unanimously at homonymy, be convenient to the placement of pitman; The preoperative planning of positioning guide plate also ensure that same vertebral body bilateral pedicle screw left and right sides symmetry [the Screw entrance point horizontal position differences of percutaneous guide plate group, screw leaning angle difference comparatively conventional mammogram group obviously reduce (
p<0.05) [the anterior margin of vertebral body height ratio of percutaneous guide plate group and fixed-segment sagittal curvature are corrected the number of degrees and are all comparatively obviously had more advantage (P<0.05) to conventional mammogram group, to improve the recovery of sagittal curvature Cobb angle and vertebral height.
5. percutaneous guide plate reduces the radiation exposure of medical worker and patient: one of biggest obstacle of Wicresoft's screw application at present needs in art repeatedly to have an X-rayed; increase the radiation exposure of medical worker and patient; in this research, percutaneous guide plate group disposablely can be inserted 6 pieces of puncture needles comparatively accurately and insert guide pin simultaneously; namely decrease operating time and also reduce perspective number of times; can hide completely in medical worker's art to operating room outdoors; with stereotype protection, avoid radiation exposure.
6. have good replicability: digital medical can realize the accurate operation of performing the operation, it is also one of developing direction of modern surgery operation.The guide plate of this research design seems structure relative complex, but for reverse engineering software design, the design used time is not long, can meet clinical operation requirement, have generalization.This group patient extracts data from being admitted to hospital and prints can complete in 8h to guide plate.For not having the basic hospital of 3D printer and guide plate designed capacity also by interconnection path, upload initial data, outsourcing runners and 3D material object print, and are then sent to by logistics express delivery.Along with 3D print day by day universal, the printing cost of current guide plate is not high, little on the financial burden of patient impact, applies guide plate on the contrary and can provide more safety guarantee for operative doctor, improve its technical merit, reduce complication for patients, make patients benefit.
The foregoing is only the preferred embodiments of the present invention, is only illustrative for the purpose of the present invention, and nonrestrictive; Those of ordinary skill in the art understand, and can carry out many changes in the spirit and scope that the claims in the present invention limit to it, amendment, and even equivalence is changed, but all will fall within the scope of protection of the present invention.
Claims (9)
1. a dismountable bilateral type percutaneous individuation pedicle screw navigation template, comprise percutaneous cervical arc root screw navigation template body, it is characterized in that: described navigation template is provided with detent mechanism (1), horizontal company (4), screw conduit (2) and screw pilot hole (3), screw pilot hole (3) is located in horizontal company (4), communicate with screw conduit (2) through horizontal company (4) and be included in screw conduit (2) from the top down, the part that screw pilot hole (3) is connected with detent mechanism (1) is the best entry point of preoperative simulation pedicle screw, the direction of pilot hole (1) is consistent with preoperative simulation pedicle screw direction,
Described detent mechanism (1) is provided with mastoid process detent mechanism (5) and attached prominent detent mechanism (6), mastoid process detent mechanism (5) and attached prominent detent mechanism (6) are connected as a body, be applied on Thoracolumbar disk (7), its form is fitted completely with the mastoid process (8) of Thoracolumbar disk (7) needed for preoperative simulation, attached prominent (14) respectively;
Described horizontal company (4) is set to left horizontal company (4-1), right horizontal company (4-2), left horizontal company (4-1) one end is provided with fixture block (11), be provided with draw-in groove (13) in right horizontal company (4-2) one end, during use, fixture block (11) inserts in draw-in groove (13) and makes left horizontal company (4-1) and right horizontal company (4-2) form one;
(2) two, described screw conduit, is connected with left horizontal company (4-1) and right horizontal company (4-2) respectively, and every root screw conduit (2) two ends are connected with horizontal company (4) and detent mechanism (1) respectively, horizontal company (4) and detent mechanism (1) are linked into an integrated entity.
2. according to a kind of dismountable bilateral type percutaneous individuation pedicle screw navigation template described in claim 1, it is characterized in that: described fixture block (11) and draw-in groove (13) relevant position are provided with Kirschner wire patchhole (12), insert Kirschner wire during use with fixing left horizontal company (4-1) and right horizontal company (4-2).
3., according to a kind of dismountable bilateral type percutaneous individuation pedicle screw navigation template described in claim 1, it is characterized in that: described horizontal company (4) upper surface is provided with indicator collet (9).
4., according to a kind of dismountable bilateral type percutaneous individuation pedicle screw navigation template described in claim 1, it is characterized in that: described screw conduit (2) interior diameter is consistent with screw pilot hole (3) diameter, and diameter is 4-4.1mm.
5., according to a kind of dismountable bilateral type percutaneous individuation pedicle screw navigation template described in claim 4, it is characterized in that: described diameter is 4mm.
6. according to a kind of dismountable bilateral type percutaneous individuation pedicle screw navigation template described in claim 1, it is characterized in that: described screw conduit (2) diameter is 8mm.
7., according to a kind of dismountable bilateral type percutaneous individuation pedicle screw navigation template described in claim 1, it is characterized in that: described Kirschner wire patchhole (12) diameter is 2-2.1mm.
8., according to a kind of dismountable bilateral type percutaneous individuation pedicle screw navigation template described in claim 7, it is characterized in that: described Kirschner wire patchhole (12) diameter is 2.1mm.
9. according to a kind of bilateral type percutaneous individuation pedicle screw navigation template described in claim 1, it is characterized in that: described horizontal company (4) and two screw conduits (2) form inside angle of inclination, to ensure that pedicle screw can be implanted in introversion.
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| CN201610085716.5A CN105534588B (en) | 2016-02-15 | 2016-02-15 | A kind of percutaneous individuation pedicle screw navigation template of detachable bilateral type |
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