CN106859711B

CN106859711B - Vertebral plate rotating opener for cervical vertebra single-door opening operation

Info

Publication number: CN106859711B
Application number: CN201611256771.2A
Authority: CN
Inventors: 丁琛; 刘浩; 刘艮英
Original assignee: West China Hospital of Sichuan University
Current assignee: West China Hospital of Sichuan University
Priority date: 2016-12-30
Filing date: 2016-12-30
Publication date: 2020-07-31
Anticipated expiration: 2036-12-30
Also published as: CN106859711A

Abstract

The invention discloses a vertebral plate rotary opener for a single-door opening operation of cervical vertebra, which comprises two forceps handles connected through a pin shaft, wherein each forceps handle comprises a holding part and a clamping part, the clamping part of one forceps handle is provided with two spines, the two spines are distributed at intervals, the clamping part of the other forceps handle is provided with a transverse plate, and the transverse plate and the two spines are both bent towards the opposite surfaces of the inner sides of the two forceps handles. The vertebral plate clamp can stably clamp the vertebral plate, and the vertebral plate is prevented from sliding and rebounding in the process of lifting the vertebral plate, so that medical accidents are effectively avoided; the vertebral plate can be rotated and lifted by taking the hinge side bone groove as an axis through rotating the holding part, the operation strength is controllable, the probability of complete fracture of the hinge side vertebral plate is obviously reduced, and the damage and even fracture of the articular process at the opening side are avoided; the instrument can not enter the vertebral canal in the operation process, thereby avoiding spinal cord injury and being safe and reliable; the surgeon can open the vertebral plate through one-hand visual operation, and can perform operations of hemostasis, separation of adhesion in the vertebral canal and the like simultaneously.

Description

Vertebral plate rotating opener for cervical vertebra single-door opening operation

Technical Field

The invention relates to the field of medical instruments, in particular to a vertebral plate rotary opener used in a cervical posterior single-door spinal canal expansion plasty.

Background

The cervical vertebra single-door opening spinal canal enlargement plasty is a common method for treating cervical vertebra pathological changes such as cervical canal stenosis, multi-segment cervical intervertebral disc protrusion, posterior longitudinal ligament ossification and the like in the prior surgery, and has excellent long-term clinical effect. The mechanism widely accepted by the art is that the spinal cord moves to the back side by utilizing the 'bow-string principle' formed by the physiological lordosis of the cervical vertebra and the spinal cord, the compression in front of the spinal cord is avoided to achieve the purpose of indirect decompression, and the direct decompression in the back is realized for the person with the compression in front and back of the spinal cord. The operation steps of the cervical vertebra single-door spinal canal enlargement plasty are as follows: the patient takes the prone position after general anesthesia, the cervical vertebra is slightly bent, and the head is fixed by a head frame. The posterior medial incision of the neck is adopted, the inferior periosteum is stripped after the medial ligament is cut to expose the spinous process, the vertebral plates at two sides and the inner side part of the articular process, and the upper vertebral segment and the lower vertebral segment of the lesion segment are exposed according to the positioning of the shape of the spinous process. The overlong end of the spinous process is removed and the ligamentum flavum connection between the door-opening segment and the superior and inferior vertebral plates is severed. The heavy symptom side is generally selected to be the door-opening side, and the opposite side is the hinge side. Grinding outer cortical bone of vertebral plate at the vertebral plate of the joint inner edge of hinge side by using a grinding drill, reserving inner cortical bone, making a longitudinal bone groove, and grinding the vertebral plate at the corresponding position of the vertebral plate of the joint inner edge of opening door side. Carefully open the lamina, separate the dura from the ligamentum flavum and lamina, and carefully stop bleeding. The lifted vertebral plates are supported and fixed by a miniature steel plate, or suspended and sutured on the joint capsule at the hinge side by a silk thread. The opening is not suitable for being too wide, otherwise, the possibility of complete fracture of the hinge side is easily increased, and even serious consequences such as collapse into the vertebral canal are caused. A blood plasma drainage tube is arranged on the wound.

The key point is that the vertebral plate is opened at the door side for decompression in the single-door spinal canal enlargement operation, but no operation tool which is convenient and safe to use exists at present. Some doctors adopt tools such as periosteum strippers to pry open the vertebral lamina at the door side and lift the vertebral lamina, but the operation has no fixed pivot, and the strippers easily slide towards the vertebral canal, so that serious consequences such as spinal cord injury are caused; the prying force is difficult to control, complete fracture of the vertebral plate at the hinge side is easily caused, the bony healing at the hinge is affected, the postoperative vertebral plate is unstable, the vertebral plate is closed again possibly, and serious neurological symptoms can be caused if the broken end of the vertebral plate at the hinge side is collapsed into the vertebral canal; the damage and even the fracture of the joint protruding fulcrum at the side of the door opening can be easily caused in the prying process. Some doctors use the vertebral plate distracter to achieve the purpose of opening the door, but the force in the process of distraction is still uncontrollable, and the distracter enters the vertebral canal through the door opening part and still can damage the spinal cord if sliding. There are also doctors who use tools such as nipper rongeurs to open the vertebral plate, and during the process, the opened vertebral plate may rebound due to unstable fixation of the rongeurs, and paralysis of the patient may be caused when the rongeurs are hit on the spinal cord. There is therefore a need for an easy to operate, safe to use surgical tool that can be used to open the lamina in a single-opening procedure.

Disclosure of Invention

The invention aims to provide a vertebral plate rotary opener for a single-door opening operation of cervical vertebra, which is firm and powerful in clamping vertebral plate and can prevent the lifted vertebral plate from sliding and rebounding, thereby effectively avoiding medical accidents; the instrument can not enter the vertebral canal in the operation process, so that the instrument can be prevented from sliding to damage the spinal cord, and the instrument is safe and reliable; the vertebral plate is rotated and lifted by taking the hinge side bone groove as an axis, the door opening strength can be controlled, the probability of complete fracture of the hinge side vertebral plate is obviously reduced, and the damage and even fracture of the articular process at the door opening side are avoided; the operator can open the vertebral plate with one hand and visual operation, and can perform operations of hemostasis, separation of adhesion in the vertebral canal and the like simultaneously.

In order to achieve the purpose, the technical scheme adopted by the invention is as follows:

the utility model provides a rotatory ware of opening of cervical vertebra single-door operation vertebral plate, includes two pincers handles through the round pin hub connection, the pincers handle is including the portion of gripping and clamping part, the clamping part end of a pincers handle is equipped with two spine, and two spine intervals set up, and the clamping part end of another pincers handle is equipped with the diaphragm, and diaphragm and two spine all incline to the inboard opposite face of two pincers handles.

The spine clamping device is characterized in that one clamping part is provided with the spine bent inwards, the other clamping part is provided with the transverse plate bent inwards, the lifter can realize good positioning of the vertebral plate through occlusion of the spine and the broken end of the opening side vertebral plate when clamping the vertebral plate, the contact area of the two spines and the broken end of the vertebral plate is small, the pressure intensity is high during clamping, the holding force is strong, the broken end of the vertebral plate can be well bitten, the spine enters the broken end bone, and the clamping point cannot move easily.

The plate structure of the other clamping part enables the clamping part to be in line type occlusion contact with the vertebral plate at the hinge side, the pressure of the contact part is increased, slipping can be avoided, the axial line of the occlusion part is perpendicular to the lifting direction of the vertebral plate, rotational stress is convenient to apply, the vertebral plate cannot rotate and shift during clamping, and therefore slipping cannot occur in the lifting process, and medical accidents are effectively avoided.

The vertebral plate can be rotated and opened by taking the hinge side bone groove as an axis by applying the rotating stress on the holding part, the opening force is convenient to control, the probability of complete fracture of the hinge side vertebral plate is reduced, and the serious spinal cord injury caused by the fact that the broken end of the hinge side vertebral plate collapses into the vertebral canal is avoided; meanwhile, the injury of articular processes on the side of opening the door and even fracture can be avoided.

Because the invention does not shield the sight between the broken end of the side vertebral plate with the door open and the zygapophysis joint, an operator can open the vertebral plate and maintain the vertebral plate with one hand under the visible state, and can perform the operations of hemostasis, adhesion separation and the like in the vertebral canal with the other hand, thereby shortening the operation time to a certain extent.

Preferably, the transverse plate is provided with anti-slip teeth.

Preferably, the anti-slip teeth are uniformly distributed on the transverse plate in a grid shape.

Preferably, the end of the spike forms an obtuse angle with the clamping portion.

Preferably, the two spikes are arranged at the tail end of the clamping part at intervals in parallel.

Preferably, the clamp handles are all subjected to blunting treatment.

Preferably, the forceps handle is made of metal materials.

Preferably, the diameter of the spine gradually decreases from the front end to the tail end.

The holding part of one forceps handle can be also provided with a through groove and a ratchet braking handle which is positioned at the lower side of the through groove; the holding part of the other forceps handle is provided with an arc ratchet bar which penetrates through the through groove, and the arc ratchet bar is matched with the ratchet braking handle. And the arc ratchet bar is provided with scale marks.

In the process of lifting the vertebral plate, the spine and the transverse plate of the clamping part are firmly combined with the broken end of the vertebral plate at the door-opening side and the vertebral plate at the hinge side respectively, so that the vertebral plate can be prevented from sliding and rebounding, and the operation is safer; in the operation process, any part of the invention does not enter the vertebral canal, so the spinal cord injury can be effectively avoided; the invention has simple structure, convenient use, safety and effectiveness, and improves the safety and the operation efficiency of the single-door operation.

Drawings

Fig. 1 is a schematic structural diagram of embodiment 1.

FIG. 2 is a schematic structural view of example 2

FIG. 3 is a schematic structural view of example 3

FIG. 4 is a schematic structural view of example 4

Fig. 5 is a front view of the spike.

Fig. 6 is a side view of the spike.

In the figure: 1-clamp handle, 2-pin shaft, 3-holding part, 4-clamping part, 5-spine, 6-notch, 7-transverse plate, 8-through groove, 9-ratchet braking handle and 10-arc ratchet bar.

Detailed Description

In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is further described in detail below with reference to the accompanying drawings.

Example 1: as shown in fig. 1 and fig. 5-6, a vertebral plate rotary opener for cervical vertebra single-door opening operation comprises two forceps handles 1 connected through a pin shaft 2, wherein each forceps handle 1 comprises a holding part 3 and a clamping part 4, the clamping part 4 of one forceps handle 1 is provided with two spines 5, the two spines 5 are arranged at intervals, a gap 6 is formed between the two spines 5, the clamping part 4 of the other forceps handle 1 is provided with a transverse plate 7, and the transverse plate 7 and the two spines 5 are both bent towards the opposite surfaces of the inner sides of the two forceps handles 1. And anti-skid teeth are arranged on the transverse plate 7. The anti-skid teeth are uniformly distributed on the transverse plate 7 in a grid shape. The end of the spike 5 forms an obtuse angle with the clamping part 4. The two spikes 5 are arranged at the tail end of the clamping part 4 in parallel at intervals. And the clamp handles 1 are all subjected to blunting treatment. The forceps handle 1 is made of metal materials. The diameter of the spine 5 gradually decreases from the front end to the tail end.

Example 2: as shown in fig. 2, the end of the overlong spinous process is cut off, the inner edges of the articular processes of the vertebral plates at two sides are grooved, one side is selected as a hinge side, the outer cortical bone and part of cancellous bone of the vertebral plate are ground or bitten off to form a V-shaped bone groove, the bottom of the V-shaped bone groove reaches the inner cortex of the vertebral plate but is not cut off, the other side is an opening side, the longitudinal vertebral plate is cut, and both sides of the V-shaped bone groove are operated on the vertebral plate at the inner side of the.

In the operation, one side of the vertebral plate of the decompression section is cut off, the forceps handles 1 with the spikes are extended into the cut-off part, the spikes 5 are enabled to correspond to the gaps, the forceps handles 1 with the transverse plates 7 are attached to the vertebral plate at the hinge side, the two forceps handles 1 are slowly compressed, the clamping parts 4 of the forceps handles 1 are enabled to bite the vertebral plate, and when the clamping reaches the expected target, the vertebral plate is maintained at a proper opening amplitude. The lamina is then slowly rotated about the hinge side to open the lamina.

The two sharp spines have small contact area with the broken end of the vertebral plate, the pressure intensity is high during clamping, the holding force is high, the broken end of the vertebral plate can be well bitten, the sharp spines enter into broken end bone, and a clamping point cannot easily move.

The vertebral plate can be rotated and opened by taking the hinge side bone groove as an axis by applying the rotating stress on the holding part, the opening force is convenient to control, the probability of complete fracture of the hinge side vertebral plate is reduced, the serious spinal cord injury caused by the collapse of the broken end of the hinge side vertebral plate into the vertebral canal is avoided, and the injury and even the fracture of the articular process at the opening side can be avoided;

Example 3: as shown in fig. 3, a rotatory ware of opening of cervical vertebra single-door operation vertebral plate, includes two pincers handles 1 through round pin axle 2 connection, pincers handle 1 is including the portion of gripping 3 and clamping part 4, the clamping part 4 of a pincers handle 1 is equipped with two spine 5, and two spine 5 intervals set up, form a breach 6 between two spine 5, and the clamping part 4 of another pincers handle 1 is equipped with diaphragm 7, and diaphragm 7 all is crooked to the opposite face of two pincers handle 1 inboards with two spine 5. A through groove 8 is formed in the holding part 3 of one forceps handle 1, and a ratchet braking handle 9 is installed on the holding part, and the ratchet braking handle 9 is positioned on the lower side of the through groove 8; the holding part 3 of the other forceps handle 1 is provided with an arc ratchet bar 10 which penetrates through the through groove 8, and the arc ratchet bar 10 is matched with the ratchet braking handle 9. And anti-skid teeth are arranged on the transverse plate 7. The anti-skid teeth are uniformly distributed on the transverse plate 7 in a grid shape. The end of the spike 5 forms an obtuse angle with the clamping part 4. The arc ratchet 10 is provided with scale marks. The two spikes 5 are arranged at the tail end of the clamping part 4 in parallel at intervals. And the clamp handles 1 are all subjected to blunting treatment. The forceps handle 1 is made of metal materials. The diameter of the spine 5 gradually decreases from the front end to the tail end.

Example 4: as shown in fig. 4, the end of the overlong spinous process is cut off, the inner edges of the articular processes of the vertebral plates at two sides are grooved, one side is selected as a hinge side, the outer cortical bone and part of cancellous bone of the vertebral plate are ground or bitten off to form a V-shaped bone groove, the bottom of the V-shaped bone groove reaches the inner cortex of the vertebral plate but is not cut off, the other side is an opening side, the longitudinal vertebral plate is cut, and both sides of the V-shaped bone groove are operated on the vertebral plate at the inner side of the.

One side of the vertebral plate of the decompression section is cut off in the operation, the forceps handle 1 with the spine extends into the cut-off part, the spine 5 is enabled to correspond to the gap, the forceps handle 1 with the transverse plate 7 is attached to the vertebral plate at the hinge side, the two forceps handles 1 are slowly compressed, the clamping part 4 of the forceps handle 1 is enabled to bite the vertebral plate, and due to the mutual matching of the arc ratchet bar 10 and the ratchet braking handle 9, the forceps handle 1 cannot be withdrawn in the clamping process, and the fixation is facilitated. When the clamping reaches the desired target, the curved ratchet bar 10 and ratchet detent 9 define the distracting distance of the lifter while maintaining the lamina at an appropriate distraction amplitude. The lamina is then slowly rotated about the hinge side to open the lamina.

The present invention is capable of other embodiments, and various changes and modifications may be made by one skilled in the art without departing from the spirit and scope of the invention.

Claims

1. The utility model provides a rotatory ware of opening of cervical vertebra single-door operation vertebral plate which characterized in that: the clamp comprises two clamp handles connected through a pin shaft, each clamp handle comprises a holding part and a clamping part, two spines are arranged at the tail end of the clamping part of one clamp handle at intervals, a transverse plate is arranged at the tail end of the clamping part of the other clamp handle, and the transverse plate and the two spines are inclined towards the opposite surfaces of the inner sides of the two clamp handles; the transverse plate is provided with anti-slip teeth; the anti-slip teeth are uniformly distributed on the transverse plate in a grid shape; an included angle formed by the end part of the spine and the clamping part forms an obtuse angle; the two spikes are arranged at the tail end of the clamping part at intervals in parallel.

2. The rotary vertebral plate opener according to claim 1, characterized in that: and the clamp handles are all subjected to blunting treatment.

3. The rotary vertebral plate opener according to claim 1, characterized in that: the forceps handle is made of metal materials.

4. The rotary vertebral plate opener according to claim 1, characterized in that: the diameter of the spine from the front end to the tail end is gradually reduced.