CN106618650B

CN106618650B - Retractor assembly for interbody fusion and application method thereof

Info

Publication number: CN106618650B
Application number: CN201611036518.6A
Authority: CN
Inventors: 吕国华; 邝磊; 王冰; 张文桥
Original assignee: Shanghai Sanyou Medical Co ltd
Current assignee: Shanghai Sanyou Medical Co ltd
Priority date: 2016-11-16
Filing date: 2016-11-16
Publication date: 2023-06-23
Anticipated expiration: 2036-11-16
Also published as: CN106618650A

Abstract

The invention provides a retractor assembly for interbody fusion and a using method thereof, which relate to the technical field of medical appliances, wherein the retractor assembly comprises two retractor bodies; the drag hook body includes: the pull plate and the pull handle are connected; the upper end of the pulling plate is connected with one end of the pulling handle, the side surface of the pulling plate, which is close to the pulling handle, is the inner side surface of the pulling plate, and two side surfaces which are connected with the inner side surface of the pulling plate and are oppositely arranged are positioning side surfaces of the pulling plate; positioning connecting parts are respectively arranged on the two positioning side surfaces of the pull plate; each positioning connecting part is provided with a positioning through hole which is penetrated downwards; the pulling plate is of an arc-shaped structure, the middle of the pulling plate is sunken towards the direction close to the pulling handle, and the two positioning side faces of the pulling plate face the direction far away from the pulling handle. The pulling plate is of an arc-shaped structure, the structure can provide space for other equipment accessories, the arc-shaped structure is abutted against muscles, and the pulling of the muscles can be reduced.

Description

Retractor assembly for interbody fusion and application method thereof

Technical Field

The invention relates to the technical field of medical instruments, in particular to a retractor assembly for interbody fusion and a using method thereof.

Background

By the fusion of the outer oblique and lateral vertebrae of the peritoneum, english is called OLIF, oblique lumbar Interbody Fusion. The interbody fusion operation is characterized in that skin and subcutaneous are cut along the outer oblique muscle fiber, a single-section incision is about 3cm long, the outer oblique fascia is acutely separated, the inner oblique muscle, the transverse muscle and the transverse fascia are acutely separated, surgical section intervertebral spaces are accessed from between the large blood vessel sheath of the abdomen and the large muscle of the waist and are separated and exposed, an expansion catheter is inserted step by step, finally an operation sleeve is arranged, windows are opened at the sides of the corresponding section intervertebral spaces, the nucleus pulposus of a lesion section is scraped, and finally, the interbody fusion cage filled with bones is implanted into the corresponding intervertebral spaces to finish the operation. The fusion is suitable for lumbar disc herniation, combined segment instability, recurrent lumbar disc herniation, intervertebral disc-derived lumbago, lumbar spinal stenosis, degenerative lumbar lateral bending, lumbar disc laminectomy decompression postoperative segment instability, lumbar disc postoperative adjacent vertebral disease, lumbar pseudojoint formation, lumbar disc replacement postoperative revision and the like. Compared with the traditional treatment method, the Olif technology has the characteristics of small damage in operation, quick postoperative recovery and the like. At present, an OLIF operation channel is generally established by expanding a sleeve step by step and adding an operation sleeve, the operation of the mode is slightly complicated, a large blood vessel is easy to damage in operation and is not exposed enough, so that an operation space is limited, and in addition, the problems of unstable fixation in operation and the like are solved.

Disclosure of Invention

In view of the above-mentioned drawbacks of the prior art, the present invention provides a retractor assembly for interbody fusion and a method of using the same.

To achieve the above and other objects, the present invention provides a retractor assembly for interbody fusion, comprising two retractor bodies; the drag hook body includes: the pull plate and the pull handle are connected; the upper end of the pulling plate is connected with one end of the pulling handle, the side surface, close to the pulling handle, of the pulling plate is the inner side surface of the pulling plate, and two side surfaces which are connected with the inner side surface of the pulling plate and are oppositely arranged are positioning side surfaces of the pulling plate; positioning connecting parts are respectively arranged on the two positioning side surfaces of the pull plate; each positioning connecting part is provided with a positioning through hole which penetrates downwards; the pull plate is of an arc-shaped structure, the middle of the pull plate is sunken towards the direction close to the pull handle, and the two positioning side faces of the pull plate face towards the direction far away from the pull handle.

Preferably, a bottom groove is formed in the bottom surface of the pull plate.

Further, a fixing part is arranged on the pull handle, the fixing part comprises a supporting part arranged on the top surface of the pull handle and a guiding part connected with one end, close to the pull plate, of the supporting part, and at least one downward through guiding hole is formed in one end, far away from the supporting part, of the guiding part.

Further, an elastic fixing part is arranged on the guide part, and the end part of the elastic fixing part penetrates into the guide hole through the side wall of the guide hole.

Further, the support part is provided with at least one support groove.

Preferably, the drag hook body further comprises a limiting hook, and the limiting hook is arranged on one end, far away from the pull plate, of the pull handle.

Further, the limit hook extends from the top surface of the pull handle to one end of the pull handle, which is close to the pull plate.

The invention also relates to a using method of the drag hook assembly for interbody fusion, which comprises the following steps:

1) After determining lumbar vertebra segment, cutting skin and subcutaneous fat, separating paraspinal muscles and retracting nerve roots, respectively inserting two pull plates into the separated muscles, wherein the two pull plates are oppositely arranged; pulling two oppositely arranged pull handles outwards to further separate the muscles;

2) Penetrating a positioning nail into the positioning through hole, fixing the positioning nail on the vertebral body, and forming an interval area between the two pull plates as a surgical channel;

3) And inserting the equipment pipeline into the guide hole.

Preferably, the support part is provided with at least one support groove, and the equipment pipe in the step 3) is inserted into the support groove.

As described above, the retractor assembly for interbody fusion and the use method thereof have the following beneficial effects:

the invention can effectively avoid accidental injury to the large blood vessel, is simple and convenient to operate, and the retractor assembly can be firmly fixed on the vertebral body during operation, and is very stable; the expansion space is larger, which is beneficial to the intervertebral treatment and the operation of implanting the fusion device; the pulling plate is of an arc-shaped structure, the structure can provide space for other equipment accessories, the arc-shaped structure is abutted against muscles, and the pulling of the muscles can be reduced.

Drawings

Fig. 1 is a schematic view showing a structure of a retractor assembly for interbody fusion of the present embodiment in use and inserted into a device channel.

Fig. 2 is a schematic view showing the structure of the retractor assembly for interbody fusion according to the present embodiment in use and without insertion into a device tract.

Fig. 3 is a schematic front view showing the structure of the retractor body of the retractor assembly for interbody fusion according to the present embodiment.

Fig. 4 is a schematic top view showing the retractor body of the retractor assembly for interbody fusion of the present embodiment.

Fig. 5 is a left side view schematically showing a retractor body of the retractor assembly for interbody fusion of the present embodiment.

Description of the reference numerals

100. Drag hook body

110. Pulling plate

111. Inner side surface of pulling plate

120. Pull handle

121. Bottom surface of pull handle

200. Positioning connection part

210. Positioning through hole

300. Bottom groove

400. Fixing component

410. Support part

411. Support groove

420. Guide part

421. Guide hole

422. Elastic fixing part

500. Limiting hook

600. Positioning nail

700. Equipment pipeline

900. Screw driver

Detailed Description

Further advantages and effects of the present invention will become apparent to those skilled in the art from the disclosure of the present invention, which is described by the following specific examples.

Please refer to the accompanying drawings. It should be understood that the structures, proportions, sizes, etc. shown in the drawings are for illustration purposes only and should not be construed as limiting the invention to the extent that it can be practiced, since modifications, changes in the proportions, or otherwise, used in the practice of the invention, are not intended to be critical to the essential characteristics of the invention, but are intended to fall within the spirit and scope of the invention. Also, the terms such as "upper," "lower," "left," "right," "middle," and "a" and the like recited in the present specification are merely for descriptive purposes and are not intended to limit the scope of the invention, but are intended to provide relative positional changes or modifications without materially altering the technical context in which the invention may be practiced.

As shown in fig. 1 to 5, the retractor assembly for interbody fusion of the present embodiment includes two retractor bodies 100;

the retractor body 100 includes: a pulling plate 110 and a pulling handle 120 connected; the upper end of the pull plate 110 is connected with one end of the pull handle 120, the side surface of the pull plate 110, which is close to the pull handle 120, is the inner side surface 111 of the pull plate 110, and two side surfaces which are connected with the inner side surface 111 of the pull plate 110 and are oppositely arranged are positioning side surfaces of the pull plate 110; positioning connection parts 200 are respectively arranged on the two positioning side surfaces of the pull plate 110; each positioning connecting part 200 is provided with a positioning through hole 210 which penetrates downwards; the pull plate 110 has an arc structure, the middle of the pull plate 110 is concave towards the direction approaching the pull handle 120, and two positioning side surfaces of the pull plate 110 face towards the direction far away from the pull handle 120.

After determining lumbar vertebra segment, cutting skin and subcutaneous fat, separating paraspinal muscles and retracting nerve roots, respectively inserting the pulling plates 110 of the two pulling hook bodies 100 into the separated muscles, wherein the two pulling plates 110 are oppositely arranged, and the two pulling handles 120 are oppositely arranged; the medical staff pulls the two oppositely arranged pull handles 120 outwards to further separate the muscles; the positioning nail 600 is inserted into the positioning through hole 210, and the positioning nail 600 is fixed on the vertebral body, the interval area formed between the two pull plates 110 is a surgical channel, and after the surgical channel is formed, the rest of the surgical operations can be performed. Since the pulling plate 110 is a plate body, large blood vessels are easily avoided when being inserted into separated muscles, thereby preventing accidental injury to the large blood vessels. The positioning pin 600 can be firmly fixed to the vertebral body, so that the space of the formed surgical channel is large. The pulling plate 110 of the present invention is an arcuate structure that provides room for other equipment accessories, and the arcuate structure rests against the muscles, reducing the pulling on the muscles and reducing the pressure on the muscles. The positioning pin 600 can be connected with the vertebral body through the positioning through holes 210 on the positioning connection parts 200, so that the two positioning connection parts 200 are respectively disposed on the two positioning sides of the pull plate 110, so that the pull plate 110 can be stably connected with the vertebral body.

To facilitate the installation of the positioning pin 600, the top-to-bottom height of the positioning connection portion 200 is smaller than the height of the pull plate 110.

The bottom groove 300 is formed on the bottom surface of the pulling plate 110, so that the compression of the pulling plate 110 to the intervertebral disc can be avoided, and in addition, when the blood vessel is pulled to one side of the pulling plate 110 close to the pulling handle 120, the blood vessel can be pulled and protected conveniently due to the arrangement of the bottom groove 300. The bottom groove 300 is a V-shaped groove designed to conform to the anatomy of the human body. For patients with herniated disk, which is connected to the first sacral vertebra below the fifth lumbar vertebra, the blood vessel at the position, which is connected to the first sacral vertebra, below the fifth lumbar vertebra is complex, so that the bottom groove 300 is arranged to make the invention very suitable for the surgical treatment at the position.

The pull handle 120 is provided with a fixing component 400, the fixing component 400 comprises a supporting portion 410 arranged on the top surface of the pull handle 120 and a guiding portion 420 connected with one end, close to the pull plate 110, of the supporting portion 410, and one end, far away from the supporting portion 410, of the guiding portion 420 is provided with at least one guiding hole 421 penetrating downwards. Since the guide hole 421 is provided downward, when the device pipe 700 is inserted into the guide hole 421, the head of the device pipe 700 can be downward for easy use.

In the present embodiment, the number of the guide holes 421 is two. The apparatus pipe 700 into which one of the guide holes 421 is inserted provides a cold light source, and the head of the apparatus pipe 700 into which the other guide hole 421 is inserted is mounted with a camera.

Since the device pipe 700 inserted into the guide hole 421 is located between the two positioning connection parts 200, the pulling plate 110 has an arc-shaped structure, which can provide a space for the device pipe 700 and maintain a large surgical path.

The guide part 420 is provided with an elastic fixing part 422, and an end of the elastic fixing part 422 penetrates into the guide hole 421 through a side wall of the guide hole 421. After the device pipe 700 passes through the guide hole 421, the end of the elastic fixing portion 422 contacts the outer wall of the device pipe 700, and the device pipe 700 is pressed by the elastic fixing portion 422. The number of elastic fixing portions 422 corresponds to the number of the guide holes 421.

To facilitate positioning of the equipment pipe 700, the support portion 410 is provided with at least one support slot 411. In the present embodiment, there are two supporting slots 411.

In order that the medical staff can not be blocked by the body of the patient when pulling the pull handle 120 when using the invention, the included angle alpha between the inner side surface 111 of the pull plate 110 and the bottom surface 121 of the pull handle 120 is more than or equal to 90 degrees.

The retractor body 100 further includes a limiting hook 500, where the limiting hook 500 is disposed on an end of the pull handle 120 away from the pull plate 110. Since the medical staff holds the pull handle 120 and pulls the pull handle 120 outwards, the hand is easy to separate from the pull handle 120, and the limiting hook 500 is provided, the hand can be limited, and the hand is prevented from separating from the pull handle 120.

The limit hook 500 extends from the top surface of the pull handle 120 toward one end of the pull handle 120 near the pull plate 110. This structure enables the hand holding the pull handle 120 to be caught in the limit hook 500, facilitating the medical staff to grasp the pull handle 120 and separate the muscles.

1) Determining lumbar vertebra segment, taking about 12cm beside the midline, cutting the incision with the length of 2.5-3cm and 45 degrees towards the vertebral body, cutting skin and subcutaneous fat layer by layer, passively separating paraspinal muscles, retracting nerve roots, respectively inserting two pull plates 110 into the separated muscles, and arranging the two pull plates 110 oppositely; the hands of the medical staff hold the two oppositely arranged pull handles 120 and pull the two pull handles 120 outwards to further separate the muscles;

2) Penetrating the positioning nail 600 into the positioning through hole 210, and fixing the positioning nail 600 on the vertebral body, wherein a spacing area formed between the two pull plates 110 is a surgical channel;

four positioning nails 600 are respectively inserted into the corresponding positioning through holes 210, and the screw driver 900 screws the nail heads of the positioning nails 600 to fix the positioning nails 600 on the vertebral bodies, and the interval area formed between the two pull plates 110 is a surgical channel.

3) The apparatus pipes 700 are inserted into the two guide holes 421, respectively, wherein the apparatus pipe 700 into which one guide hole 421 is inserted provides a cold light source, and the head of the apparatus pipe 700 into which the other guide hole 421 is inserted is mounted with a camera.

The support part 410 is provided with two support slots 411, and the two equipment pipes 700 in step 3) are respectively inserted into the corresponding support slots 411.

The invention can effectively avoid accidental injury to the large blood vessel, is simple and convenient to operate, and the retractor assembly can be firmly fixed on the vertebral body during operation, and is very stable; the expansion space is larger, which is beneficial to the intervertebral treatment and the operation of implanting the fusion device; the tension plate 110 of the present invention is an arcuate structure that provides room for other equipment accessories, the arcuate structure resting against the muscles and reducing the drag on the muscles.

In conclusion, the invention effectively overcomes various defects in the prior art and has high industrial utilization value.

The above embodiments are merely illustrative of the principles of the present invention and its effectiveness, and are not intended to limit the invention. Modifications and variations may be made to the above-described embodiments by those skilled in the art without departing from the spirit and scope of the invention. Accordingly, it is intended that all equivalent modifications and variations of the invention be covered by the claims, which are within the ordinary skill of the art, be within the spirit and scope of the present disclosure.

Claims

1. A retractor assembly for interbody fusion procedures, comprising two retractor bodies (100);

the retractor body (100) comprises: a pull plate (110) and a pull handle (120) which are connected;

the upper end of the pull plate (110) is connected with one end of the pull handle (120), the side surface of the pull plate (110) close to the pull handle (120) is an inner side surface (111) of the pull plate (110), and two opposite side surfaces which are connected with the inner side surface (111) of the pull plate (110) are positioning side surfaces of the pull plate (110); positioning connection parts (200) are respectively arranged on the two positioning side surfaces of the pull plate (110); each positioning connecting part (200) is provided with a positioning through hole (210) which is penetrated downwards;

the pull plate (110) is of an arc-shaped structure, the middle part of the pull plate (110) is sunken towards the direction close to the pull handle (120), and two positioning side surfaces of the pull plate (110) face towards the direction far away from the pull handle (120);

the pull handle (120) is provided with a fixing component (400), the fixing component (400) comprises a supporting part (410) arranged on the top surface of the pull handle (120) and a guide part (420) connected with one end, close to the pull plate (110), of the supporting part (410), and one end, far away from the supporting part (410), of the guide part (420) is provided with at least one guide hole (421) penetrating downwards; the guide hole (421) is used for inserting the equipment pipeline (700);

an elastic fixing part (422) is arranged on the guide part (420), and the end part of the elastic fixing part (422) penetrates into the guide hole (421) through the side wall of the guide hole (421); after passing through the guide hole (421), the end part of the elastic fixing part (422) is contacted with the outer wall of the equipment pipe (700), and the equipment pipe (700) is pressed by the elastic fixing part (422);

at least one supporting groove (411) is arranged on the supporting part (410), and the supporting groove (411) is used for inserting the equipment pipeline (700);

the bottom surface of the pull plate (110) is provided with a bottom groove (300); the bottom groove (300) is a V-groove.

2. The retractor assembly of interbody fusion according to claim 1, wherein: the drag hook body (100) further comprises a limiting hook (500), and the limiting hook (500) is arranged on one end, far away from the pull plate (110), of the pull handle (120).

3. The retractor assembly of interbody fusion according to claim 2, wherein: the limit hook (500) extends from the top surface of the pull handle (120) to one end of the pull handle (120) close to the pull plate (110).