CN106994035B - Three-dimensional centrum puncture angle positioning instrument - Google Patents
Three-dimensional centrum puncture angle positioning instrument Download PDFInfo
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- CN106994035B CN106994035B CN201710332207.2A CN201710332207A CN106994035B CN 106994035 B CN106994035 B CN 106994035B CN 201710332207 A CN201710332207 A CN 201710332207A CN 106994035 B CN106994035 B CN 106994035B
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
- A61B2017/3405—Needle locating or guiding means using mechanical guide means
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Abstract
The invention discloses a vertebral body puncture positioning instrument which is used for determining puncture point positions and puncture angles of vertebral body puncture, and comprises a horizontal staff gauge, a longitudinal staff gauge, a puncture needle sleeve and an angle adjusting device thereof, wherein the horizontal staff gauge and the longitudinal staff gauge are vertically crossed, an intersection point can slide and lock at will along two ends of the horizontal staff gauge, the angle adjusting device of the puncture needle sleeve consists of a crown position angle measuring plate and a sagittal position angle measuring plate, the crown position angle measuring plate is horizontally arranged on the horizontal staff gauge through a vernier, the crown position angle measuring plate can slide and lock at will along two ends of the horizontal staff gauge through a first vernier, and the circle center projection of the crown position angle measuring plate falls on the central axis of the horizontal staff gauge; the sagittal angle plate is vertically arranged on the coronal angle plate through a hinge shaft, and the center projection of the sagittal angle plate falls on the central axis of the transverse staff and coincides with the center projection of the coronal angle plate. The invention can rapidly puncture and locate in operation and has high puncture accuracy.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a three-dimensional cone puncture angle positioning instrument.
Background
Osteoporosis is a very common problem in the elderly population, and it is reported that about 140 tens of thousands of people worldwide each year are thus experiencing osteoporotic vertebral compression fractures (osteoporotic vertebral compression fractures, OVCFs). Vertebroplasty is a treatment means with small invasiveness and remarkable analgesic effect, which is commonly used at present. Vertebroplasty includes percutaneous vertebroplasty (percutaneous vertebro ⁃ play, PVP) and percutaneous kyphoplasty (percutaneous kyphoplasty, PKP). PVP and PKP are percutaneous puncture to inject bone cement into the vertebral body, so as to achieve the purposes of preventing the vertebral body from collapsing, relieving pain and improving the life quality of patients.
However, PVP and PKP techniques require puncture operation from outside the body by bare hands under the monitoring of X-ray fluoroscopy equipment, and puncture points and angles are required to be adjusted under repeated fluoroscopy, so that puncture difficulty is high, accuracy is low, a human body needs to be contacted with a large amount of X-ray radiation, pain of a patient is increased due to repeated puncture, operation time is prolonged, accidental operation and infection probability are increased, and an optimal pathological change cone target point can not be necessarily punctured, so that the treatment effect of the operation is reduced.
Disclosure of Invention
The invention aims at: aiming at the defects of the prior art, the three-dimensional vertebral body puncture angle positioning instrument with high puncture accuracy is provided for rapid puncture positioning in operation. It can ensure that the X-ray irradiation times are reduced, the operation time is shortened, accidents in the operation and infections in the operation are reduced, and the treatment effect of the operation is improved.
The technical scheme adopted by the invention is that the vertebral body puncture positioning instrument is used for determining puncture point positions and puncture angles of vertebral body puncture, and comprises a transverse staff, a longitudinal staff, a puncture needle sleeve and an angle adjusting device thereof, wherein the transverse staff and the longitudinal staff are vertically crossed, the intersection point can slide and lock at will along two ends of the transverse staff, the angle adjusting device of the puncture needle sleeve consists of a coronal angle measuring plate and a sagittal angle measuring plate, the coronal angle measuring plate is horizontally arranged on the transverse staff through a vernier, the first vernier can slide and lock at will along two ends of the transverse staff, and the center projection of the circle of the first vernier falls on the central axis of the transverse staff; the sagittal angle measuring plate is vertically arranged on the coronal angle measuring plate through a hinge shaft, and the center projection of the sagittal angle measuring plate falls on the central axis of the transverse staff and coincides with the center projection of the coronal angle measuring plate; the puncture needle sleeve is arranged on the vertical face of the sagittal angle plate through the second cursor, and the center line of the puncture needle sleeve is consistent with the radial scale mark of the sagittal angle plate; the second cursor is adjusted, so that the installation angle of the puncture needle sleeve on the sagittal position angle measuring plate, namely the pitching angle of the puncture needle sleeve in the vertical direction, can be adjusted; the sagittal angle measuring plate is rotated, so that the matching angle of the sagittal angle measuring plate on the coronal angle measuring plate can be adjusted, namely, the left and right deflection angles of the puncture needle sleeve in the horizontal direction are adjusted; and adjusting the first cursor to adjust the offset distance between the puncture point and the pathological change centrum target point.
The scale range of the crown-shaped angle measuring plate is 0-180 degrees, and the crown-shaped angle measuring plate is semicircular.
The scale range of the sagittal angle plate is 0-180 degrees, and the sagittal angle plate is semicircular in shape.
The puncture needle sleeve is an open tube, and the tube wall is provided with a longitudinal through opening.
The beneficial effects of the invention are as follows:
the invention not only can rapidly puncture and locate and has high puncture accuracy, but also can ensure that the X-ray irradiation times are reduced, the operation time is shortened, accidents in operation and infection in operation are reduced, and the treatment effect of operation is improved.
Drawings
The invention is further described below with reference to the accompanying drawings.
Fig. 1 is a schematic view of the operational structure of the present invention.
Fig. 2 is a schematic diagram of the structure of A-A in fig. 1.
Fig. 3 is a schematic view of the needle cannula of fig. 1.
The meaning of the symbols in the figures: 1-a transverse scale; 11-a bar-shaped chute; 12-a first cursor; 13. 43-hinge shaft; 14-fastening screws; 2-a longitudinal scale; 3-crown-position angle plate; 4-sagittal measuring angle plate; 41-an arc chute; 42-a second cursor; 44-a nut; 5-a puncture needle cannula; 6-vertebral body; 61-spinous process center point; 62-lesion cone target; m is a datum point; n-puncture points; l-offset; alpha-pitch angle; beta-deflection angle.
Detailed Description
See fig. 1 to 3: the invention discloses a vertebral body puncture positioning instrument which is used for determining puncture point positions and puncture angles of puncture of vertebral bodies 6. The invention not only can rapidly puncture and locate and has high puncture accuracy, but also can ensure that the X-ray irradiation times are reduced, the operation time is shortened, accidents in operation and infection in operation are reduced, and the treatment effect of operation is improved. The cone puncture positioning instrument is applied to the technical field of medical instruments, so that the cone puncture positioning instrument is preferably made of medical polyethylene materials.
The centrum puncture positioning instrument comprises a transverse position scale 1, a longitudinal position scale 2, a puncture needle sleeve 5 and an angle adjusting device thereof, wherein the transverse position scale 1 and the longitudinal position scale 2 are vertically crossed, the intersection point can slide and lock at will along the two ends of the transverse position scale 1, the transverse position scale 1 and the longitudinal position scale 2 are connected together by adopting a hinge shaft 13 in the embodiment, and the bottom of the hinge shaft 13 is locked by a locking piece. Preferably, the radial section of the part of the hinge shaft 13 matched with the strip-shaped chute 11 on the transverse position scale 1 is square. So as to ensure that the transverse scale 1 and the longitudinal scale 2 intersect vertically.
The angle adjusting device of the puncture needle sleeve 5 consists of a coronal position angle measuring plate 3 and a sagittal position angle measuring plate 4, wherein the coronal position angle measuring plate 3 is horizontally arranged on a transverse position scale 1 through a cursor, the angle adjusting device can slide and lock at will along two ends of the transverse position scale 1 through a first cursor 12, a fastening screw 14 with a locking function is arranged on the first cursor 12, and the projection of the center of a circle of the fastening screw falls on the central axis of the transverse position scale 1; the sagittal angle gauge 4 is vertically arranged on the coronal angle gauge 3 through a hinge shaft 43, the bottom of the hinge shaft extends out of the lower end face of the strip-shaped chute 11 on the transverse position scale 1 and is locked by a nut 44 with a locking function, and the projection of the circle center of the sagittal angle gauge falls on the central axis of the transverse position scale 1 and coincides with the projection of the circle center of the coronal angle gauge 3. The hinge shaft 43 of the sagittal angle gauge 4 vertically arranged on the coronal angle gauge 3 is of an axial hollow structure, so that the puncture needle can smoothly pass through the hinge shaft 43 of the hollow structure and reach the puncture point N above the epidermis of the patient body under different adjusting angles.
The puncture needle sleeve 5 is arranged on the arc-shaped chute 41 on the vertical face of the sagittal angle plate 4 through the second cursor 42, the central line of the puncture needle sleeve is consistent with the radial scale mark of the sagittal angle plate 4, and meanwhile, the second cursor 42 is ensured to slide and lock on the arc-shaped chute 41 on the vertical face of the sagittal angle plate 4, so that the puncture needle sleeve 5 is driven to slide back and forth along the arc-shaped chute 41 on the vertical face of the sagittal angle plate 4; the second cursor 42 is adjusted, so that the installation angle of the puncture needle sleeve 5 on the sagittal position angle plate 4, namely the pitching angle alpha of the puncture needle sleeve 5 in the vertical direction can be adjusted; the sagittal angle gauge 4 is rotated, so that the matching angle of the sagittal angle gauge 4 on the coronal angle gauge 3 can be adjusted, namely, the left-right deflection angle beta of the puncture needle sleeve 5 in the horizontal direction is adjusted; adjusting the first cursor 12 adjusts the offset L of the puncture point N from the lesion cone target 62. Namely, the distance from the reference point M defined at the patient epidermis position, corresponding to the center of the hinge shaft 13, directly above the lesion cone target point 62 to the puncture point N above the patient's somatic epidermis. Wherein, the scale range of the crown position angle gauge 3 is 0-180 degrees, and the shape of the crown position angle gauge is semicircular; the scale range of the sagittal angle plate 4 is 0-180 degrees, and the sagittal angle plate is semicircular in shape.
The puncture needle sleeve 5 is an open tube, and the tube wall is provided with a longitudinal through opening. To facilitate visualization and removal of the needle.
The invention relates to an operation method of a vertebral body puncture positioning instrument, which comprises the following steps:
before operation, the positions of a pathological change centrum target point 62 and a pathological change centrum spinous process center point 61 which need to be punctured are determined by a CT three-dimensional imaging technology, and the puncture point position and the puncture angle of the centrum 6 during operation are measured by a computer, so that the installation angle of the puncture needle sleeve 5 on the sagittal position angle plate 4, namely the pitching angle alpha of the puncture needle sleeve 5 in the vertical direction can be adjusted; the sagittal angle gauge 4 is rotated, so that the matching angle of the sagittal angle gauge 4 on the coronal angle gauge 3 can be adjusted, namely, the left-right deflection angle beta of the puncture needle sleeve 5 in the horizontal direction is adjusted; marking a datum point M determined on the patient epidermis position right above a lesion cone spinous process center point 61 on a three-dimensional image of a CT (computed tomography) three-dimensional imaging technology, namely, measuring the distance between the arranged datum point M and the circle center position of a sagittal angle plate 4 (the circle center position is actually a puncture point N above the patient body epidermis) at the center of a hinge shaft 13 at the intersection point of a transverse position scale 1 and a longitudinal position scale 2, namely, measuring the distance between the corresponding datum point M of the lesion cone target point 62 and the puncture point N above the patient body epidermis;
in operation, first, the body position of a patient is adjusted by moving a C-arm X-ray machine to perspective the vertebral body 6, a datum point M of the patient epidermis right above a center point 61 of a pathological change vertebral body spinous process is found, and a connecting line of the center point 61 of the pathological change vertebral body spinous process and the datum point M of the patient epidermis right above the center point 61 of the pathological change vertebral body spinous process is perpendicular to a plane formed by a transverse position scale 1 and a longitudinal position scale 2 of an angle positioner. On the basis, a datum point M is found on the patient epidermis right above the center point 61 of the pathological change spinous process on the patient body, the connecting line on the patient body epidermis is corresponding to the connecting line above the center point 61 of the longitudinal spinous process of the body passing through the datum point M, the intersection point of the transverse scale 1 and the longitudinal scale 2 of the angle positioning instrument is correspondingly placed on the position of the datum point M right above the pathological change spinous process of the patient, and the longitudinal scale 2 is arranged on the connecting line on the patient body epidermis corresponding to the connecting line above the center point 61 of the longitudinal spinous process of the body passing through the datum point M.
In operation, the offset distance L and the solid angle (pitch angle α and yaw angle β) of the puncture needle sheath 5 of the puncture locator are then adjusted and fixed.
In the operation, finally, under the irradiation of the centrum X-ray film, the puncture needle is inserted into the position of the pathological change centrum target point 62 through the puncture needle sleeve 5, and the puncture positioning instrument is removed after the puncture is completed.
The above embodiments are only for illustrating the present invention, and are not to be construed as limiting the invention. Although the invention has been described in detail with reference to the specific embodiments described above, it will be appreciated by those skilled in the art that: the specific technical scheme can be modified or part of technical features in the technical scheme can be replaced equivalently; such modifications and substitutions do not depart from the spirit and scope of the invention.
Claims (4)
1. The utility model provides a centrum puncture positioning instrument for confirm puncture point position and puncture angle of centrum puncture, its characterized in that: the cone puncture positioning instrument comprises a horizontal staff gauge, a longitudinal staff gauge, a puncture needle sleeve and an angle adjusting device thereof, wherein the horizontal staff gauge and the longitudinal staff gauge are vertically crossed, the intersection point can slide and lock at will along the two ends of the horizontal staff gauge, the angle adjusting device of the puncture needle sleeve consists of a coronal position angle measuring plate and a sagittal position angle measuring plate, the coronal position angle measuring plate is horizontally arranged on the horizontal staff gauge through a vernier, the first vernier can slide and lock at will along the two ends of the horizontal staff gauge, and the projection of the center of a circle of the angle measuring plate falls on the central axis of the horizontal staff gauge; the sagittal angle measuring plate is vertically arranged on the coronal angle measuring plate through a hinge shaft, and the center projection of the sagittal angle measuring plate falls on the central axis of the transverse staff and coincides with the center projection of the coronal angle measuring plate; the puncture needle sleeve is arranged on the vertical face of the sagittal angle plate through the second cursor, and the center line of the puncture needle sleeve is consistent with the radial scale mark of the sagittal angle plate; the second cursor is adjusted, so that the installation angle of the puncture needle sleeve on the sagittal position angle measuring plate, namely the pitching angle of the puncture needle sleeve in the vertical direction, can be adjusted; the sagittal angle measuring plate is rotated, so that the matching angle of the sagittal angle measuring plate on the coronal angle measuring plate can be adjusted, namely, the left and right deflection angles of the puncture needle sleeve in the horizontal direction are adjusted; adjusting the first cursor to adjust the offset distance between the puncture point and the pathological change centrum target point; the hinge shaft of the sagittal angle plate vertically arranged on the coronal angle plate is of an axial hollow structure, and the puncture needle smoothly passes through the hinge shaft of the hollow structure and reaches a puncture point above the epidermis of the patient body under different adjusting angles.
2. The vertebral body puncture locator according to claim 1, wherein: the scale range of the crown-shaped angle measuring plate is 0-180 degrees, and the crown-shaped angle measuring plate is semicircular.
3. The vertebral body puncture locator according to claim 1, wherein: the scale range of the sagittal angle plate is 0-180 degrees, and the sagittal angle plate is semicircular in shape.
4. The vertebral body puncture locator according to claim 1, wherein: the puncture needle sleeve is an open tube, and the tube wall is provided with a longitudinal through opening.
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| CN201710332207.2A CN106994035B (en) | 2017-05-12 | 2017-05-12 | Three-dimensional centrum puncture angle positioning instrument |
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| CN201710332207.2A CN106994035B (en) | 2017-05-12 | 2017-05-12 | Three-dimensional centrum puncture angle positioning instrument |
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| CN106994035A CN106994035A (en) | 2017-08-01 |
| CN106994035B true CN106994035B (en) | 2023-05-12 |
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