CN105534588B - A kind of percutaneous individuation pedicle screw navigation template of detachable bilateral type - Google Patents
A kind of percutaneous individuation pedicle screw navigation template of detachable bilateral type 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 present invention relates to technical field of medical instruments, a kind of more particularly to percutaneous individuation pedicle screw navigation template of detachable bilateral type, the navigation template is provided with detent mechanism, horizontal company, screw conduit and screw pilot hole, screw pilot hole connects located at horizontal, is communicated and in screw conduit with screw conduit through horizontal company from the top down；Detent mechanism is provided with mastoid process detent mechanism and attached prominent detent mechanism, mastoid process detent mechanism and attached its form of prominent detent mechanism respectively with preoperative simulation needed for the mastoid process of Thoracolumbar disk, attached thumping be bonded completely；Horizontal to be connected with as left horizontal company, right horizontal company, left horizontal even one end is provided with fixture block, it is right it is horizontal be even provided with neck in one end, make left horizontal company during use in fixture block insertion neck and right horizontal connect formation integrally；Screw conduit with left horizontal company and right horizontal downlink connection, and horizontal company and detent mechanism is linked into an integrated entity respectively.It is simple in construction, easy to operate, cost is low, reduce operating difficulty, shorten operating time, be particularly suitable for application to minimally invasive pedicle screw internal fixation operation.
Description
Technical field
The present invention relates to technical field of medical instruments, more particularly to a kind of percutaneous individuation pedicle of vertebral arch screw of detachable bilateral type
Follow closely navigation template.
Background technology
Thoracolumbar fracture refers to because external force causes the successional destruction of Thoracolumbar disk sclerotin.This is most common backbone damage
Wound.In between twenty and fifty patient, high-energy damage is its main Risk Factors, such as traffic accident, high falling wound etc..Gerontal patient due to
Osteoporosis itself be present, Risk Factors are mostly low violence damage, such as slip, fall.Patients with thoracolumbar fracture often merges god
Through function damage, and because Risk Factors are essentially high-energy injury, often merge other organs damage, this is that treatment is brought greatly
Difficulty and challenge.
Thoracolumbar disk vertebral compression and blow-out fracture are the common types of spine fracture, are through fixed in posterior Pedicle
System is the preferred measure for handling such damage.But tack operation wound is larger, tissue dissection scope is relatively wide, hand because conventional open is put
Surrounding tissue can be pulled for a long time in art, the recovery of patient's postoperative function is seriously influenceed, so recently as vertebral column minimally invasive
The development of surgery, percutaneous cervical arc root screw technique for fixing are increasingly subject to pay attention to, pedicle screw entry point and screw way side in its art
To determination be this technology key, but the percutaneous cervical arc root hand that Thoracolumbar disk anatomical structure is more complicated and variation is big, conventional
Often need continuously to have an X-rayed underlying nail in art, cause medical worker and patient radiation dose to increase, can cause for a long time leukaemia and
The generation of cutaneum carcinoma, though free-hand pedicle of vertebral arch puts nail and can reduce perspective, operating time is extended, and be harder to meet same centrum
Bilateral Screw entrance point and the uniformity in direction, influence reset effect, and costly are not easy to popularize.
The guide plate structure for having some to be gone out according to Thoracolumbar disk articular process structure fabrication at present, can help to perform the operation smoothly enters
OK, but still there is needing the open surgery exposure region of anatomy, screw orientation to change because of Body Position Change, operating process
Middle stability is inadequate, bad placement, inconvenient for operation, and the technical problem that postoperative dismounting is not easy etc., is not suitable for percutaneous
The minimally invasive internal fixation operation of vertebra.
The content of the invention
To solve above technical problem, the present invention provides a kind of detachable bilateral type percutaneous individuation pedicle screw navigation
Template, it is simple in construction, easy to operate, cost is low, it is convenient, be efficiently accurately positioned, operating difficulty is reduced, shortens operating time, is protected
Demonstrate,prove surgical effect；Particularly suitable in invasive surgery.
Solves the percutaneous individuation pedicle screw navigation of a kind of detachable bilateral type in the present invention of above technical problem
Template, including percutaneous individuation pedicle screw navigation template, it is characterised in that：The navigation template is provided with detent mechanism, horizontal stroke
Even, screw conduit and screw pilot hole, screw pilot hole connect located at horizontal, communicated from the top down with screw conduit through horizontal company and
In screw conduit, nail is most preferably entered in the part that screw pilot hole is connected with detent mechanism for preoperative simulation pedicle screw
Point, the direction of pilot hole are consistent with preoperative simulation pedicle screw direction；
The detent mechanism is provided with mastoid process detent mechanism and attached prominent detent mechanism, mastoid process detent mechanism and attached prominent detent mechanism
Be connected as a body, applied on Thoracolumbar disk, its form respectively with preoperative simulation needed for Thoracolumbar disk mastoid process, attached prominent be bonded completely；
Horizontal be connected with is provided with fixture block, is provided with neck in right horizontal company one end, makes for left horizontal company, right horizontal company, left horizontal company one end
Make left horizontal company and right horizontal even formation one in used time fixture block insertion neck；
Two, the screw conduit, respectively with left horizontal company and right horizontal downlink connection, and every screw conduit both ends respectively with horizontal stroke
Company and detent mechanism, horizontal company and detent mechanism are linked into an integrated entity.
Fixture block and the neck relevant position is provided with kirschner pin insertion apertures, inserts Kirschner wire with fixation left horizontal company during use
With right horizontal company.
The horizontal surface that connects is provided with instruction block, accurate to determine to distinguish left and right horizontal even conduit and corresponding detent mechanism
The position of articular process, the positioning in Thoracolumbar disk both sides, the time is saved, reduce error.
The screw catheter inner diameter is consistent with screw guiding pore diameter size, a diameter of 4-4.1mm.
A diameter of 4mm described in prioritization scheme.
The screw conduit diameter is 8mm.
The a diameter of 2-2.1mm of kirschner pin insertion apertures.
The a diameter of 2.1mm of kirschner pin insertion apertures described in further prioritization scheme, makes to be just passed through Kirschner wire.
The horizontal company forms inside angle of inclination with two screw conduits, to ensure that pedicle screw being capable of introversion plant
Enter.
Because screw has an inside angle of inclination, if being integrally formed, it is not easy to the problem of placing.Shape of the present invention
Into detachable, the problem of being not easy to place is avoided, operational convenience and the stability of guide plate is added, accordingly increases art
In success rate.
Detent mechanism is used for positioning Thoracolumbar disk interarticular screw entry point in the present invention, determines the position of Screw entrance point；
Guide-localization hole determines that screw enters to follow closely direction.Joint mastoid process detent mechanism blocks mastoid process, joint lateral mass localization machine in detent mechanism
Structure auxiliary is fixed, and entry point and screw openings can just be decided well.
By the horizontal company of navigation template in the present invention, less soft tissue can be peeled off, is easy to the placement of navigation template, carries
High accuracy.The screw conduit of horizontal downlink connection bilateral, then by screw conduit connecting locating mechanism, become an entirety.
Every screw conduit all communicates with a screw pilot hole.
The present invention is low to implementing personnel's technical requirements in Design of digital and clinical manipulation, has basic computer basic to know
Know and the medical worker of plastic surgery technical ability can implement；For patient, it is thus only necessary to which one time CBCT is checked without doing height
The spiral CT examination of radiation；If medical institutions, which possess desktop rapid forming equipment, designed, designed and to process guide plate, remove from
The Design of digital expense of third company and time-consuming mould rod transportation.The process of whole mould rod shaping only needs 3-5 small
When, and cost is cheap, simple operation and precision height, greatly advances the clinical practice of technique.
Surgical doctor need not receive special training and can be used, and the stripping of soft tissue is significantly reduced in operation（It is particularly prominent
Save teat point）And bleeding, can fast and accurately dispose dentata screw in art, also improve security, reduce operation into
This.
The present invention is applied to the implantation of hollow pedicle screw, is particularly suitable for use in Minimally Invasive Surgery, and stable operation, accurate
Operated with convenient, cost is low, can reduce the dose of radiation in patient's art, avoids radiating in the art of medical worker, ensures operation
Effect, installation and removal are easy.
Brief description of the drawings
Fig. 1 is the navigation template structural representation in the present invention
Fig. 2 is the structural representation that navigation template is combined with Thoracolumbar disk in the present invention
Wherein, sequence number is specially in figure：1. detent mechanism, 2. screw conduits, 3. screw pilot holes, 4. horizontal companies, 5.
Mastoid process detent mechanism, 6. attached prominent detent mechanisms, 7. Thoracolumbar disks, 8. mastoid processes, 9. instruction blocks, 11. fixture blocks, 12. Kirschner wires are inserted
Enter hole, 13. necks, 14. is attached prominent
Embodiment
Below by the present invention will be further described in conjunction with the embodiments, it should be understood that these embodiments are only used for
The purpose of illustration, is never limited in protection scope of the present invention.
Embodiment 1
A kind of percutaneous individuation pedicle screw navigation template of detachable bilateral type, leads provided with detent mechanism, horizontal company, screw
Pipe and screw pilot hole, screw pilot hole connect located at horizontal, are communicated from the top down through horizontal company with screw conduit and be included in spiral shell
Follow closely in conduit, the optimal entry point of pedicle screw, pilot hole are simulated in the part that screw pilot hole is connected with detent mechanism to be preoperative
Direction it 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 is connected with attached prominent detent mechanism
Integrally, applied on Thoracolumbar disk, its form respectively with preoperative simulation needed for Thoracolumbar disk mastoid process, attached prominent be bonded completely；
Horizontal to be connected with as left horizontal company, right horizontal company, left horizontal even one end is provided with fixture block, is provided with neck in right horizontal company one end, during use
Make left horizontal company and right horizontal even formation one in fixture block insertion neck；
Two, screw conduit, respectively with left horizontal company and right horizontal downlink connection, and every screw conduit both 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 guiding pore diameter size, directly
Footpath is 4.1mm, and screw conduit diameter is 8mm.
Horizontal company forms inside angle of inclination with both sides conduit in the present invention.Therefore it is stranded as an overall transcutaneous placement
It is difficult.- the present invention forms detachable, avoids the problem of being not easy to place, adds operational convenience and the stabilization of guide plate
Property, the corresponding success rate increased in art.
Detent mechanism is used for positioning 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, is easy to navigation template
Lay, improve the degree of accuracy.
Example is used in invasive surgery, the entry point of pedicle screw just just mastoid process and it is attached dash forward on, therefore set first
The meter reverse template registering with articular process；Puncture needle is squeezed into by guide plate and disposes guide pin, hollow spiral shell is then screwed into by guide pin
Nail.
Embodiment 2
A kind of detachable bilateral individuation Thoracolumbar disk articular process navigation template, provided with detent mechanism, horizontal company, screw conduit and
Screw pilot hole, screw pilot hole are connected located at horizontal, communicated from the top down through horizontal company with screw conduit included in screw conduit
Interior, the optimal entry point of pedicle screw, the direction of pilot hole are simulated in the part that screw pilot hole is connected with detent mechanism to be preoperative
It is consistent with preoperative simulation pedicle screw direction；
Detent mechanism is used for positioning axis arch root Screw entrance point, determines the position of Screw entrance point；Guide-localization hole
Determine that screw enters to follow closely direction.By the horizontal link structure of navigation template, less soft tissue can be peeled off, is easy to the peace of navigation template
Put, improve the degree of accuracy.
Horizontal to be connected with as left horizontal company, right horizontal company, left horizontal even one end is provided with fixture block, is provided with neck in right horizontal company one end, during use
Make left horizontal company and right horizontal even formation one in fixture block insertion neck；Fixture block and neck relevant position are provided with kirschner pin insertion apertures,
Kirschner wire is inserted during use with the left horizontal company of fixation and right horizontal company.Kirschner pin insertion apertures are a diameter of 2,2.2mm or 2.1mm, a diameter of
It can pass through just 2.0mm Kirschner wire during 2.1mm.
Two, screw conduit, respectively with left horizontal company and right horizontal downlink connection, and every screw conduit both 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 guiding pore diameter size, directly
Footpath is 4mm, and screw conduit diameter is 8mm.
The horizontal surface that connects is additionally provided with instruction block, to distinguish left and right horizontal even conduit and corresponding detent mechanism, accurately determines chest
Lumbar vertebrae mastoid process, attached prominent position, save the time, reduce error.
Experiment one
Experiment is to picture：
If two groups that guide underlying nail using percutaneous individuation navigation template in nail and the present invention is single-handedly put under conventional mammogram
Case, wherein conventional mammogram group：Man 19, female 13；It is 27~56 years old age, average 37.5 years old.Damage reason：Traffic accident injury
20, high falling hinders 8, injures 4 by a crashing object.Damage section：T112, T128, L113, L29.
Percutaneous guide plate group in the present invention：Man 18, female 12；It is 25~57 years old age, average 37.1 years old.Damage reason：Hand over
Interpreter thus wound 19, high falling hinder 7, injure 4 by a crashing object.Damage section：T112, T128, L112, L28.
The general information comparing differences such as two groups of Genders, age, damage reason, damage section are not statistically significant（P
>0.05）, there is comparativity.
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 training, art
2 weeks Go to ground activity under brace protection afterwards.Brace uses 3 months, fixed in postoperative taking-up in 10~December.Periodic review X-ray film,
Continuous follow-up is more than December.
Evaluation index
A, clinical indices：Intraoperative blood loss, operating time, fluoroscopy during operation number, otch total length, postoperative 7 days, pain in January
Pain visual analogue scale.
B, radiographic index：CT data is imported in Mimics softwares, measures following index：1. anterior margin of vertebral body height percentage
Than：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 is sweared
Shape curvature：The angle of the upper soleplate vertical line of the next centrum in fixed-segment；Fixed-segment sagittal curvature corrects the number of degrees：Postoperative fixed knot
Section sagittal curvature-preoperative fixed-segment sagittal curvature；3. the relation of pedicle of vertebral arch cortex and screw：By 3 grades of classification, CT horizontal positions are commented
Estimate, pedicle nail completely in pedicle of vertebral arch for I grade, it is excellent；Break through the mm of cortex≤2 be II grade, can；The mm of ＞ 2 be III grade, it is poor.I、
II grade represents to put to follow closely successfully.4. nail success rate is planted in art first：It is normal that pedicle of vertebral arch perspective entry point position is punctured first, and art
Verify that screw is put by CT afterwards to follow closely successfully（Do not include puncture failure first and adjust success again）.5. sagittal plane screw placement
Angle：Measure the angle of pedicle screw axis and centrum upper limb in CT sagittal plains, two lines going cross each other be located at reading in front of centrum be just,
Rear reading is negative.6. screw sagittal plane angle：The difference of same centrum bilateral pedicle screw sagittal plane implant angle.7. screw
Entry point horizontal position differences：It is horizontal with upper soleplate that same centrum bilateral pedicle screw entry point center is measured in CT sagittal plains
Vertical range difference.8. screw leaning angle difference：Same centrum bilateral pedicle screw and centrum are measured on CT horizontal positions just
The difference of midplane angle.
C, statistical method
Analyzed using SPSS19.0 statistical softwares.Continuous data is with mean±Standard deviation represents, each time point in group
Between compare using one-way analysis of variance, compare two-by-two using pairingtExamine, compare between group using independent sampletExamine；Count
Data is represented with rate, is compared between group using χ2Examine；Compare use rank test between ranked data group；Inspection level α=
0.05。
Interpretation of result：
All patients smoothly complete operation, are implanted into 372 pieces of pedicle screw altogether.Wherein conventional mammogram group and percutaneous guide plate
Group respectively has 1 superficial infection occur, is healed after Wound during Dressing Change, antibiosis extract for treating.Without important blood vessels and neurotrosis.Last with
Visit and have no the interior fixed patient for loosening or being broken.Two groups of patients obtain follow-up, and follow up time 12 ~ 24 months is average 13.6
Month.
Two groups of intraoperative blood losses, operating time difference are statistically significant（P<0.05）, it is shown in Table 1.Percutaneous guide plate group operation
When medical worker because hiding to operating room outdoors, protected with stereotype, therefore have an X-rayed radiological dose and can be neglected.Therefore medical worker
And the transmission metering of patient, two groups are statistically significant（P<0.05）, percutaneous guide plate group is significantly lower than conventional mammogram group.Two groups
Incision length, preoperative, postoperative 7 days and postoperative January VAS scorings, two groups of no significant differences（P ＞ 0.05）, it is shown in Table 1.
1 two groups of each clinical indices of patient of table compare（x±s）
Results of imaging
The number of degrees are more preoperative is obviously improved for two groups of postoperative anterior margin of vertebral body height, the correction of fixed-segment sagittal curvature, and difference has
Statistical significance（P<0.05）, it is shown in Table 2.Percutaneous guide plate group screw plants the accurate number of nail first, final plant follows closely accurate number and sagittal plane
Screw placement angle is superior to conventional mammogram group, and two groups of differences are statistically significant（P<0.05）, it is shown in Table 3.Percutaneous guide plate group is double
Side screw sagittal plane angle, Screw entrance point horizontal position differences, screw leaning angle difference are respectively less than conventional mammogram group, poor
It is different statistically significant（P<0.05）, percutaneous guide plate group bilateral screw has more preferable uniformity, is shown in Table 4.
Each radiographic index compares after 2 two groups of patients of table are preoperative（x±s）
（Note：*The P compared with preoperative<0.05,#The P compared with control group<0.05 ）
3 two groups of screw placement situations of table compare
4 two groups of bilateral screw comparison of coherence of table（x±s）
It can be drawn from upper table, the pedicle screw instrumentation of the percutaneous guide plate auxiliary of the present invention had both drawn digital orthopaedics
Precisely the characteristics of operation, minimal invasive techniques are had concurrently again, obtain that operative incision is small, bleeding is few, assembling is simple, puts nail by this research
Accurately, the advantages that radiation exposure is few, better reduction, reduces the disposable input of hospital, and clinic is worthy of popularization.
Its advantage of the invention specifically mainly has the following aspects：1. guide plate easily percutaneous accurate placement：3D printing is fast
A kind of form of fast manufacturing technology, optimal pedicle screw entry point and direction is designed in a computer by preoperative, then
The location navigation template assisted surgery of limited exposure is produced, the difficult point of design is to determine rationally reliable guide plate registration point.This
The guide plate scope of group patient's design is T10~L3Section, these centrum rears have the dissection such as obvious mastoid process, processus paramastoideus, transverse process
Structure and position is relatively shallower, guide plate not only can be with transcutaneous placement, but also can accomplish effective screens registration.Ours
In practical operation, patient is preoperative to be understood patient personalized anatomical structure and participates in guide plate design, and can is shot the arrow at the target in art
Appear and need screens anatomical structure, guide plate is effectively pasted on bone mark.Percutaneous guide plate group is first in our current research
It is 92.2% to put nail success rate, hence it is evident that better than conventional mammogram group（P<0.05）, illustrate that the transcutaneous placement accuracy rate of guide plate is high.In addition,
In our current research, the guide plate pedestal of each centrum is divided into left and right sides two parts, the purpose for the arrangement is that for the ease of guide plate
Transcutaneous placement and taking-up, after patient suitably exposes centrum rear structure in art, by placing special drag hook, guide plate is just easier to
Unilateral percutaneous rotation disposes and screens is in bony structure, " bumps " knot that then patient can be designed by left and right flipper guide
Both sides are connected as a single entity by structure, not only strengthen its stability, also allow for controlling the introversion direction of screw, while such design is also just
In the taking-up of insertion positioning guide pin back guide, save operating time, in the present invention operating time of percutaneous guide plate group for 71.6 ±
11.9min, amount of bleeding are 79.7 ± 25.1ml, hence it is evident that better than conventional mammogram group, illustrate that percutaneous guide plate is easily placed and taken out, save
About operating time, reduce bleeding；
2. the transcutaneous placement of guide plate can accomplish minimally invasive：The registration point of guide plate（The area contacted with bony structure）Control exists
Diameter 16mm or so, it is suitable with the diameter of minimally invasive screw outer sleeve, guide plate can be placed in the case where not increasing incision length
The damage of soft tissue is reduced, the incision length of percutaneous guide plate group is 12.0 ± 2.0cm, postoperative 7 days and pain VAS scorings point in January
Not Wei 5.5 ± 0.9 and 1.7 ± 0.9, without significant difference compared with conventional mammogram group, it was demonstrated that it is in minimally invasive aspect and conventional mammogram
Group is the same.
3. guide plate can ensure that screw arrangement is consistent and left and right sides is symmetrical：It is according to doctor's art in percutaneous guide plate group centering guide
Preplanning and complete, so ensure that Screw entrance point is consistent in homonymy arrangement, is easy to the placement of pitman；Positioning guide plate
Preoperative planning also ensure that same centrum bilateral pedicle screw left and right sides symmetrical [Screw entrance point of percutaneous guide plate group be horizontal
Position difference, screw leaning angle difference are obviously reduced compared with conventional mammogram group（P<0.05）, improve sagittal curvature Cobb angles and
[anterior margin of vertebral body height ratio and fixed-segment sagittal curvature the correction number of degrees of percutaneous guide plate group are relatively to passing for the recovery of vertebral height
Perspective of uniting group is obvious more advantageous（P<0.05）.
5. percutaneous guide plate reduces the radiation exposure of medical worker and patient：One of biggest obstacle of minimally invasive screw application at present
It is to need repeatedly to have an X-rayed in art, increases the radiation exposure of medical worker and patient, percutaneous guide plate group can be once in this research
Property accurately inserts 6 pieces of puncture needles and inserts guide pin simultaneously, that is, reducing operating time also reduces perspective number, medical matters
It can hide to operating room outdoors completely in personnel's art, be protected with stereotype, avoid radiation exposure.
6. there is preferable replicability：Digital medical can realize the accurate operation of operation, and it is also modern surgery hand
One of developing direction of art.The guide plate of this research and design seem construction it is relative complex, but for reverse engineering software design for,
The design used time is not grown, and disclosure satisfy that clinical operation requirement, has generalization.This group of patient beats from extraction data of being admitted to hospital to guide plate
Print can be completed in 8h.For no 3D printer and the basic hospital of guide plate designed capacity also can by interconnection path, on
Initial data, outsourcing runners and 3D printings in kind are passed, is then sent to by logistics express delivery.It is increasingly general with 3D printing
And the printing cost of guide plate at present is not high, the financial burden on patient influences little, can be on the contrary operation doctor using guide plate
It is raw that more safety guarantee are provided, its technical merit is improved, complication for patients is reduced, patient is benefited.
The preferred embodiments of the present invention are the foregoing is only, are merely illustrative for the purpose of the present invention, and it is nonrestrictive；
Those of ordinary skill in the art understand that can carry out many to it in the spirit and scope that the claims in the present invention are limited changes
Become, modification, or even equivalent change, but fall within protection scope of the present invention.
Claims (7)
1. a kind of percutaneous individuation pedicle screw navigation template of detachable bilateral type, including percutaneous cervical arc root screw navigation template
Body, it is characterised in that：The navigation template is provided with detent mechanism（1）, horizontal company（4）, screw conduit（2）With screw pilot hole
（3）, screw pilot hole（3）Located at horizontal company（4）On, from the top down through horizontal company（4）With screw conduit（2）Communicate and be included in spiral shell
Follow closely conduit（2）It is interior, screw pilot hole（3）With detent mechanism（1）Nail is most preferably entered in the part of connection for preoperative simulation pedicle screw
Point, screw pilot hole（3）Direction it is consistent with preoperative simulation pedicle screw direction；
Detent mechanism（1）Provided with mastoid process detent mechanism（5）With attached prominent detent mechanism（6）, mastoid process detent mechanism（5）With attached prominent positioning
Mechanism（6）It is connected as a body, applied to Thoracolumbar disk（7）On, its form respectively with preoperative simulation needed for Thoracolumbar disk（7）Mastoid process
（8）, it is attached prominent（14）Fitting completely；
The horizontal company（4）It 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）, right horizontal company
（4-2）Neck is provided with one end（13）, fixture block during use（11）Insert neck（13）In make left horizontal company（4-1）With right horizontal company（4-
2）Form one；The fixture block（11）And neck（13）Relevant position is provided with kirschner pin insertion apertures（12）, insertion gram during use
Family name's pin is with the left horizontal company of fixation（4-1）With right horizontal company（4-2）；
The screw conduit（2）Two, respectively with left horizontal company（4-1）With right horizontal company（4-2）Connection, and every screw conduit（2）
Both ends respectively with horizontal company（4）And detent mechanism（1）Connection, by horizontal company（4）And detent mechanism（1）Link into an integrated entity；The horizontal company
（4）With two screw conduits（2）Inside angle of inclination is formed, to ensure that pedicle screw being capable of introversion implantation.
2. according to the percutaneous individuation pedicle screw navigation template of a kind of detachable bilateral type described in claim 1, it is special
Sign is：The horizontal company（4）Upper surface is provided with instruction block（9）.
3. according to the percutaneous individuation pedicle screw navigation template of a kind of detachable bilateral type described in claim 1, it is special
Sign is：The screw conduit（2）Interior diameter and screw pilot hole（3）Diameter is consistent, a diameter of 4-4.1mm.
4. according to the percutaneous individuation pedicle screw navigation template of a kind of detachable bilateral type described in claim 3, it is special
Sign is：A diameter of 4mm.
5. according to the percutaneous individuation pedicle screw navigation template of a kind of detachable bilateral type described in claim 1, it is special
Sign is：The screw conduit（2）A diameter of 8mm.
6. according to the percutaneous individuation pedicle screw navigation template of a kind of detachable bilateral type described in claim 1, it is special
Sign is：The kirschner pin insertion apertures（12）A diameter of 2-2.1mm.
7. according to the percutaneous individuation pedicle screw navigation template of a kind of detachable bilateral type described in claim 6, it is special
Sign is：The kirschner pin insertion apertures（12）A diameter of 2.1mm.
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| Application Number | Priority Date | Filing Date | Title |
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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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| Application Number | Priority Date | Filing Date | Title |
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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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| CN105534588B true CN105534588B (en) | 2018-02-13 |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN106175908B (en) * | 2016-06-29 | 2017-10-27 | 自贡市第四人民医院 | A kind of minimally invasive pedicle screw navigation template of outer individuation of the skin for having an X-rayed auxiliary |
| CN108095802B (en) * | 2018-02-09 | 2023-09-08 | 陕西东望科技有限公司 | Orthopedic positioning osteotomy guide plate device |
Family Cites Families (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6579244B2 (en) * | 2001-10-24 | 2003-06-17 | Cutting Edge Surgical, Inc. | Intraosteal ultrasound during surgical implantation |
| CN101953713B (en) * | 2007-09-19 | 2012-05-23 | 陆声 | Navigation template capable of being used for positioning vertebral pedicle |
| WO2012020707A1 (en) * | 2010-08-12 | 2012-02-16 | 国立大学法人 富山大学 | Three-dimensional guide for wire for preparing pedicle screw insertion hole |
| ITPI20110040A1 (en) * | 2011-04-08 | 2012-10-09 | Univ Pisa | DRILLING MASK FOR PLANTING A TRANSPEDUNCULAR SCREW |
| CN202515768U (en) * | 2011-11-27 | 2012-11-07 | 严丹 | Pedicle screw locator |
| CA2914005C (en) * | 2013-06-07 | 2018-01-09 | George Frey | Patient-matched apparatus and methods for performing surgical procedures |
| CN104546111B (en) * | 2015-01-27 | 2017-02-22 | 南京医科大学第一附属医院 | Individualized guiding template assisting in setting pedicle screw into small incision and manufacturing method of individualized guiding template |
| CN104739501B (en) * | 2015-03-31 | 2017-02-01 | 首都医科大学附属北京友谊医院 | 3D-printed cervical vertebra pedicle screw guide and implantation plate and preparation method thereof |
| CN105078566B (en) * | 2015-09-23 | 2017-10-20 | 自贡市第四人民医院 | A kind of bilateral type dentata screw navigation template |
| CN105266868B (en) * | 2015-10-09 | 2017-11-10 | 郝明仲 | One kind realizes pinpoint Limb bone osteotomy guider |
| CN205667580U (en) * | 2016-02-15 | 2016-11-02 | 自贡市第四人民医院 | A kind of dismountable bilateral type percutaneous individuation pedicle screw navigation template |
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