CN106510775B

CN106510775B - Working channel placer in intervertebral disc operation

Info

Publication number: CN106510775B
Application number: CN201610970962.9A
Authority: CN
Inventors: 邹德威
Original assignee: Individual
Current assignee: Individual
Priority date: 2016-10-28
Filing date: 2016-10-28
Publication date: 2024-05-03
Anticipated expiration: 2036-10-28
Also published as: CN106510775A

Abstract

The present invention provides a working channel placer in an intervertebral disc operation, comprising: a guide rail mount, the guide rail mount comprising: the device comprises a top platform, a bottom annular platform, a fixed pipe connected between the top platform and the bottom annular platform and a sleeve sleeved outside the fixed pipe; the top platform has two ends; the number of the fixed pipes is two, and one fixed pipe is respectively connected below each end of the top platform; the sleeve can move along the length direction of the fixed pipe; a needle guide rail connected to the top platform and located between the two fixing pipes and passing through the through holes; a reaming string, the reaming string comprising: the tube body and the outer tube sleeved outside the tube body, and the tube body can be movably sleeved on the needle type guide rail. The working channel established by the invention is characterized in that only a wound smaller than 10mm is left on the surface of the skin, and a needle is sewn at most, so that the band-aid can be covered.

Description

Working channel placer in intervertebral disc operation

Technical Field

The invention relates to the field of medical appliances, in particular to a placement device for a small-diameter working channel reaching a lesion part in intervertebral disc operation, namely a working channel placement device in intervertebral disc operation.

Background

In spinal surgery, along with the deep research of spinal pathology and the continuous progress of auxiliary technologies such as intervertebral bone grafting fusion technology, the excision of intervertebral disc soft tissues and the clean formation of regular intervertebral spaces form ideal spaces which are matched with bone grafting fusion devices as completely as possible, and become an important link for successful surgery.

However, due to the special position of the intervertebral disc, the deepest position of the human body and the surrounding barrier which completely embeds the intervertebral disc, a room which has no door and no window and is completely sealed around is provided. The "ceiling" and "floor" are both rigid bone plates oriented through the long axis of the body without any access at all, and even if an artificial attempt is made to drill an access, there is no "working face" of "construction" at all, and 360 ° all around is tightly wrapped by thick "fiber rings" as if it were multi-layered leather, and located in the center of the long axis of the body, in fact the "axis" of the body's load bearing axis, with the space therein being completely filled with "nucleus pulposus" tissue.

The nucleus pulposus (Nucleus pulposus) is a semi-liquid mass with high elasticity, and is a mucilaginous substance with special creep property like jelly, the constituent components of which are 70-90% of water and the rest: proteoglycans (proteoglycan) account for 65% and collagen (collagen) account for 15-20%, forming a semi-liquid viscous mass (semifluid mass of mucoid material) of a thick-like substance, which is particularly "creep", first of all, manifested by a pliable elasticity. The position is called as a top-to-bottom position, bears the stress (weight and gravity acceleration of falling high) from a ceiling (the lower endplate of the upper bony vertebrae), and is compressed and deformed after being absorbed, and the stress is transferred to a floor (the upper endplate of the lower bony vertebrae) after being released uniformly and slowly like a spring; at the same time, the "nucleus pulposus" tissue located between each segment, which is also the organ of the largest single volume in the human body that is completely avascular (avascular), is harvested and metabolized by diffuse infiltration of the upper and lower endplates in close contact therewith.

Thus, aging deterioration must occur with age or other adverse factors of overstress; once denatured, it cannot be repaired by regeneration like some other tissues, such as skin, muscle. Therefore, when the function of the cervical vertebra is attenuated, the cervical vertebra is necessarily narrowed, the ceiling is close to the floor, the stress is lost to buffer and temporarily breathe, and the cervical vertebra is gradually changed into hard direct transmission, so that a series of pathological changes such as instability dislocation of the vertebral segment, hyperosteogeny, spinal nerve compression and the like are caused.

The effective solution is to remove the degenerated disc tissue as much as possible. At present, a minimally invasive operation is adopted to perform an intervertebral disc operation, but how to obtain an accurate and effective working channel under the condition of damaging spinal cord central and peripheral nerves as little as possible is a difficult problem, and the existing operation tool is difficult to provide the accurate and effective working channel under the condition of damaging the spinal cord central and peripheral nerves.

In summary, the following problems exist in the prior art: the existing surgical tools are difficult to provide accurate and effective working channels with minimal damage to spinal central and peripheral nerves.

Disclosure of Invention

The invention provides a working channel placer in intervertebral disc operation, which is used for establishing a small-diameter working channel which can penetrate through a wall, has small trauma and accurately reaches a lesion part in the intervertebral disc operation.

To this end, the present invention proposes a working channel placer in an intervertebral disc operation, comprising:

a guide rail mount, the guide rail mount comprising: the device comprises a top platform, a bottom annular platform, a fixed pipe connected between the top platform and the bottom annular platform and a sleeve sleeved outside the fixed pipe;

the top platform has two ends;

the number of the fixed pipes is two, and one fixed pipe is respectively connected below each end of the top platform;

the sleeve can move along the length direction of the fixed pipe;

The middle of the bottom annular platform is provided with a through hole;

A needle guide rail connected to the top platform and located between the two fixing pipes and passing through the through holes; the needle guide rail includes: a rod-shaped rail body and a first puncture part connected to the end part of the rod-shaped rail body;

The reaming column comprises a pipe body with a hollow channel, the top of the reaming column is connected with the needle type guide rail, and the bottom of the reaming column is provided with a second puncture part; the hollow passage includes: a first channel positioned at the bottom of the reaming column and a second channel connected above the first channel, wherein the inner diameter of the first channel is smaller than that of the second channel, and the first channel is positioned in the second puncture part;

an outer tube with a working channel is sleeved and connected outside the tube body.

Further, the inner diameter of the outer tube is 10mm or less.

Further, the reaming column and the outer tube are detachably connected through threaded connection, and the second puncture part extends out of the outer tube body.

Further, the bottom annular platform is a circular ring-shaped platform, and the through hole is a circular hole pipe body.

Further, a first scale groove is formed in the outer side wall of the outer tube.

Further, the top platform is shaped as a T-shaped platform.

Further, a positioning button for positioning the sleeve on the fixed pipe is arranged on the sleeve.

Further, the positioning button is a positioning screw which is in threaded connection with the sleeve, and the positioning screw is perpendicular to the sleeve.

Further, a second scale groove is formed in the fixed pipe.

Further, the top of the reaming column is provided with a nut cover, the inner wall of the nut cover is in threaded connection with the needle type guide rail, the outer wall of the nut cover is in threaded connection with the outer tube, and the outer diameter of the nut cover is larger than the caliber tube body of the through hole.

The invention firstly enters the body through the needle type guide rail via the skin puncture point until the center of the intervertebral disc is fixed, then the reaming column moves downwards along the needle type guide rail, is sent into the body via the skin, and after reaching a proper depth, removes the needle type guide rail, the pipe body and the guide rail seat, only leaves the outer pipe, thus completing the establishment of the working channel and being capable of implementing the operation. After the whole operation is finished, the working channel is pulled out, only a wound smaller than 10mm is left on the surface of the skin, and at most one needle is sewn, so that the band-aid can be covered.

Drawings

FIG. 1 is a schematic view of the overall structure of a working channel applicator in an intervertebral disc surgery according to the present invention;

FIG. 2 is a schematic front view showing the overall structure of the working channel placement device in the intervertebral disc surgery according to the present invention;

FIG. 3 is a schematic perspective view of a guide rail seat according to the present invention;

FIG. 4 is a schematic perspective view of an outer tube of the present invention;

FIG. 5 is a schematic view of the front view of the outer tube of the present invention;

FIG. 6 is a schematic perspective view of a pipe body according to the present invention;

FIG. 7 is a schematic view of the front view of the pipe body of the present invention;

FIG. 8 is a schematic view showing the working channel placer in the intervertebral disc surgery according to the invention in a working state in which the needle guide rail has just been inserted into the skin;

FIG. 9 is a schematic view showing the working channel placer in the intervertebral disc surgery according to the invention, in which the rail seat is against the skin;

FIG. 10 is a schematic view showing the working channel placer in the intervertebral disc surgery according to the invention in a working position in which the reaming pin is inserted into the skin;

FIG. 11 is a schematic view showing an operation state of the working channel placer in the intervertebral disc surgery according to the invention, in which the outer tube is inserted into the skin and the guide rail seat and the needle guide rail have been pulled out;

fig. 12 is an enlarged schematic view of the structure at a in fig. 7.

Reference numerals illustrate:

1 guide rail seat 2 needle type guide rail (positioning guide rail needle) 3 reaming column 4 skin

11 Top platform 12 bottom annular platform 13 fixed tube 15 sleeve 111 first puncture part 120 through hole 151 positioning button

31, The hollow passage 311 of the outer tube 310 of the tube body 33 of the reaming column is provided with the second puncture part 313 screw thread 315 screw thread 330, the inner cavity (working passage) 333 screw thread 3101 of the outer tube is provided with the first passage 3102 of the second passage

Detailed Description

For a clearer understanding of technical features, objects, and effects of the present invention, the present invention will be described with reference to the accompanying drawings.

The present invention provides a working channel placer in an intervertebral disc operation, as shown in fig. 1 and 2, comprising: a guide rail seat 1, a needle guide rail 2, a reaming post 3, and an outer tube 33.

The guide rail seat 1 includes: a top platform 11, a bottom annular platform 12, a fixed pipe 13 connected between the top platform and the bottom annular platform, and a sleeve 15 sleeved outside the fixed pipe;

the top platform 11 is provided with two ends and plays a role in supporting and connecting;

The number of the fixed pipes 13 is two, and one fixed pipe 13 is respectively connected below each end of the top platform 11;

the sleeve 15 is movable in the longitudinal direction of the fixed tube 13;

the middle of the bottom annular platform 12 has a through hole 120;

Needle rail 2 (also called positioning rail needle or quantitatively adjustable positioning rail needle) connected to the top platform 11 and located between the two fixed pipes 13 and passing through the through holes 120; the needle guide rail includes: a rod-shaped rail body (in a cylindrical shape) and a first puncture part 111 connected to the end of the rod-shaped rail body, wherein the first puncture part 111 is in a conical shape and is used for puncturing the skin, inserting into the skin and positioning;

A reaming column 3 (also called a hollow double-inner diameter leading-in reaming column) which comprises a pipe body 31 with a hollow channel 310, wherein the top of the reaming column is detachably connected or movably connected with the needle type guide rail 2, and the bottom of the reaming column is provided with a second puncture part 311 (which is conical) for puncturing the skin and inserting the reaming column into the skin; the second piercing portion 311 has an inner diameter larger than an outer diameter of the first piercing portion 111, and the second piercing portion 311 is disposed at a bottom end of the tubular body 31, so that the tubular body 31 has a tubular shape with a cylindrical main body portion and a tapered bottom portion, as shown in fig. 6 and 7;

As shown in fig. 7 and 12, the hollow passage 310 includes: a first channel 3101 at the bottom of the reaming column and a second channel 3102 connected above the first channel, the first channel 3101 having an inner diameter smaller than the inner diameter of the second channel 3102, the first channel 3101 being located in the second puncture 311; the length of the first channel 3101 is smaller than that of the second channel 3102, and the tube 31 is movably sleeved on the needle guide rail 2;

An outer tube 33 with a working channel 330 is sleeved and connected outside the reaming post 3, and the working channel 330 is the inner cavity of the outer tube 33. The second puncture part 311 extends out of the bottom of the outer tube; to provide a preliminary preparation for the creation of the working channel 330, on the basis of the positioning of the needle rail 2 in the skin, an entry of the outer tube 33 into the skin is created; wherein, in order to connect the second puncture part 311 with the outer tube 33, the inner diameter of the outer tube 33 is equal to or slightly larger than the outer diameter of the tube body 31, so as to reduce the resistance to entering the skin; further, the bottom of the outer tube 33 may be chamfered to provide a smooth transition with the bottom of the tube body 31.

Referring to fig. 8, 9, 10 and 11, the present invention firstly enters the body through the skin puncture point of the needle guide rail 2 until the center position of the intervertebral disc is fixed, then the reaming column 3 moves downwards along the needle guide rail 2, and is sent into the body through the skin 4, after reaching a proper depth, the needle guide rail, the tube body and the guide rail seat are removed, and only the outer tube 33 is left, so that the establishment of the working channel is completed, and the operation can be implemented. After the entire procedure is completed, the outer tube 33 is removed, i.e., the working channel is removed, leaving only a small incision in the skin surface.

Further, the inner diameter of the outer tube is 10mm or less. Therefore, the wound is smaller, and the woundplast can be covered by stitching a needle at most.

Further, the tube body 31 and the outer tube 33 are detachably connected. Further, the top of the pipe body is detachably connected with the top of the outer pipe through threaded connection. As shown in fig. 4, 5, 6 and 7, the top end of the outer tube 33 has external threads, i.e., threads 333. The top end of the tubular body 31 has a hollow threaded post with external threads, i.e., threads 315, capable of achieving a threaded connection with the rail seat or top platform 12 to complete a detachable connection. The hollow threaded column is also provided with an internal thread, which can be screwed with the needle rail 2.

The top end of the pipe body 31 is further provided with a nut cover (nut sleeve) 313 which is sleeved on the screw 315, and the nut cover (nut sleeve) 313 is connected with the screw 315 by a bolt. Furthermore, the nut cover (nut case) 313 has a ring of internal threads to cooperate with the threads 333 of the outer tube 33 to achieve a detachable connection of the tube body 31 with said outer tube 33. In this way, the pipe body 31 and the outer pipe 33 are conveniently connected and detached in a matched manner, and the connection or separation between the pipe body 31 and the outer pipe 33 is realized. Further, the nut cover 313 is screwed with the needle guide rail, the outer diameter of the nut cover 313 is larger than the caliber or the inner diameter of the through hole 120, and the bottom annular platform 12 has a limiting function on the nut cover 313.

Further, as shown in fig. 1, 4 and 8 to 11, a first scale groove is formed on the outer sidewall of the outer tube 33, and the unit is mm, so as to observe the depth of the outer tube 33.

Further, the top platform 11 is shaped as a T-shaped platform so as to achieve up-down connection and left-right connection.

Further, the maximum extension of the sleeve 15 can exceed the bottom end of the needle rail 2 or the first penetration 111 to achieve a large range of adjustment margins. As shown in fig. 3, the sleeve 15 is provided with a positioning button 151 for positioning the sleeve on the fixed tube to facilitate positioning and adjustment movement over this wide range.

Further, the positioning button 151 is a positioning screw, the positioning screw is screwed on the sleeve 15, and the positioning screw is perpendicular to the sleeve, so that the adjustment is convenient and rapid.

Further, a second scale groove is formed in the fixing tube, and the second scale groove is used for observing the insertion depth of the needle guide rail 2 in mm.

In the invention, the hollow double-inner diameter leading-in reaming column is in a sharp-pointed cylindrical shape, the center of the tail end (the top end in figures 1,3,4,5,6 and 7) is a small-diameter stud, the lower end is connected with a large-diameter nut cover, the nut cover can be connected with a quantitative adjustable positioning guide rail needle through a bolt, the nut cover is connected with an outer tube sleeved outside the nut cover into a whole, the reaming column is hollow and penetrates through the whole length, and the reaming column penetrates through the guide rail needle and can accurately reach the stopping point of the needle point along the reaming column.

Unlike a generally hollow design, the reaming post 3 of the present invention is characterized by a "double diameter" (i.e., having a first channel 3101 and a second channel 3102) that functions to both ensure accurate travel along the track needle trajectory and effectively reduce or eliminate frictional resistance resulting from long contact distances between rails, in practical applications, this unique design will effectively eliminate resistance when the operator is not able to discern the reaming post, whether it is solely from gripping of surrounding soft tissue or from excessive rail frictional resistance, and the superposition of both will necessarily increase resistance to propulsion, allowing the operator to only blindly apply force. The neutral vertical track is easy to bend under the blind stress state, and at the moment, the guide rail needle is clamped by the reaming column, and when the clamping force is larger than the resistance of surrounding soft tissues but cannot be distinguished, the opposite result is generated, namely, the guide rail needle is not led into a preset point by the reaming column, but pushed to the deep part by the reaming column, even beyond a safety boundary, and other irrelevant important organs and structures are stabbed, so that serious consequences are caused. While a double diameter design for this condition would effectively eliminate this risk.

In the invention, the needle type guide rail enters the body through the skin puncture point under the guidance of the X-ray perspective of the C-shaped arm until reaching the center position of the spinal disc, and is confirmed through the X-ray of the C-shaped arm. The double-sided sleeve 15 is then extended, the front (bottom) ring (bottom annular platform 12) is placed against the skin, the guide rail needle (needle guide rail 2) is fixed, the depth of entry is precisely read, and the reaming column working channel combination (i.e., reaming column 3) is screwed off the frame tail end (top of guide rail seat 1 or bottom of top platform 11 in fig. 1) and fed into the body through the skin along the guide rail needle. According to the measured depth, the reaming column 3 is delivered to 18cm (180 mm), namely, the reaming column is accurately and safely in place. Then the guide rail needle and the tube body of the reaming column in the sleeve are removed, and the outer tube 33 is left, so that the establishment of the working channel is completed, and the operation can be implemented. After the whole operation is finished, the outer tube 33, namely the working channel, is pulled out, only a wound smaller than 10mm is left on the surface of the skin, and a needle is sewn at most, so that the band-aid can be covered.

The invention has simple, accurate and safe placing process, only one operation and X-ray projection of minimum dose (only one X-ray projection is needed). Compared with the prior art, the method has clear advantages.

The foregoing is illustrative of the present invention and is not to be construed as limiting the scope of the invention. In order that the components of the invention may be combined without conflict, any person skilled in the art shall make equivalent changes and modifications without departing from the spirit and principles of the invention.

Claims

1. A working channel applicator in an intervertebral disc procedure, the working channel applicator comprising:

the top platform has two ends;

The sleeve is connected with the bottom annular platform, and the sleeve can move along the length direction of the fixed pipe so that the bottom annular platform can prop against the skin;

The middle of the bottom annular platform is provided with a through hole;

An outer tube with a working channel is sleeved and connected outside the tube body; the top end of the pipe body is provided with a nut cover, and the ring internal thread of the nut cover is matched with the external thread of the outer pipe to realize the detachable connection of the pipe body and the outer pipe;

the reaming column can move downwards along the needle guide rail after the needle guide rail can enter the body through the skin puncture point and drive the outer tube to be sent into the body together through the skin, and then the needle guide rail, the tube body and the guide rail seat can be removed to establish a working channel for operation by using the outer tube.

2. The working channel applicator in disc surgery of claim 1, wherein the inner diameter of the outer tube is 10mm or less.

3. The working channel placer in disc surgery of claim 1 wherein the body of the reamer spindle is detachably connected to the outer tube by a threaded connection.

4. The working channel placer in disc surgery of claim 3 wherein the bottom annular platform is a torus-shaped platform and the through hole is a circular hole.

5. The working channel applicator for use in disc surgery of claim 1, wherein the outer tube has a first score groove formed in an outer wall thereof.

6. The intra-discal access applicator of claim 1, wherein the top platform is shaped as a T-shaped platform.

7. The working channel placer in an intervertebral disc procedure of claim 1 wherein a positioning button is provided on the sleeve to position the sleeve on the stationary tube.

8. The working channel placer in an intervertebral disc procedure of claim 7 wherein the positioning knob is a positioning screw that is threaded onto the sleeve and the positioning screw is perpendicular to the sleeve.

9. The working channel placer in disc surgery of claim 1 wherein the stationary tube is provided with a second graduated slot.

10. The working channel placer in disc surgery of claim 1, wherein an inner wall of the nut housing is threadably coupled to the needle guide, and wherein an outer diameter of the nut housing is greater than a caliber of the through hole.