CN107260286A - Minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective - Google Patents
Minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective Download PDFInfo
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- CN107260286A CN107260286A CN201710637055.7A CN201710637055A CN107260286A CN 107260286 A CN107260286 A CN 107260286A CN 201710637055 A CN201710637055 A CN 201710637055A CN 107260286 A CN107260286 A CN 107260286A
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- 238000002594 fluoroscopy Methods 0.000 claims abstract description 56
- 238000000034 method Methods 0.000 claims abstract description 47
- 230000008569 process Effects 0.000 claims abstract description 45
- 238000003780 insertion Methods 0.000 claims abstract description 20
- 230000037431 insertion Effects 0.000 claims abstract description 20
- 239000000178 monomer Substances 0.000 claims abstract description 13
- 239000000203 mixture Substances 0.000 claims abstract description 3
- 238000009826 distribution Methods 0.000 claims description 4
- 238000000338 in vitro Methods 0.000 abstract description 3
- 230000009467 reduction Effects 0.000 description 4
- 206010017076 Fracture Diseases 0.000 description 3
- 210000000988 bone and bone Anatomy 0.000 description 3
- 238000013461 design Methods 0.000 description 3
- 238000010586 diagram Methods 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 238000002513 implantation Methods 0.000 description 3
- 208000010392 Bone Fractures Diseases 0.000 description 2
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 230000015572 biosynthetic process Effects 0.000 description 2
- 238000006073 displacement reaction Methods 0.000 description 2
- 238000002161 passivation Methods 0.000 description 2
- 230000005855 radiation Effects 0.000 description 2
- 210000001519 tissue Anatomy 0.000 description 2
- 238000005303 weighing Methods 0.000 description 2
- 208000020084 Bone disease Diseases 0.000 description 1
- 201000009030 Carcinoma Diseases 0.000 description 1
- 206010010214 Compression fracture Diseases 0.000 description 1
- 208000028826 Kernig sign Diseases 0.000 description 1
- 208000007825 Orbital Fractures Diseases 0.000 description 1
- 210000001015 abdomen Anatomy 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 230000002146 bilateral effect Effects 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 238000002224 dissection Methods 0.000 description 1
- 239000000686 essence Substances 0.000 description 1
- 238000002695 general anesthesia Methods 0.000 description 1
- 208000032839 leukemia Diseases 0.000 description 1
- 238000002324 minimally invasive surgery Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 230000001144 postural effect Effects 0.000 description 1
- 238000012913 prioritisation Methods 0.000 description 1
- 108010048734 sclerotin Proteins 0.000 description 1
- 210000004872 soft tissue Anatomy 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 210000001364 upper extremity Anatomy 0.000 description 1
Classifications
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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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
- A61B17/7083—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B2017/681—Alignment, compression, or distraction mechanisms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Medical Informatics (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Neurology (AREA)
- Robotics (AREA)
- Surgical Instruments (AREA)
Abstract
The invention belongs to technical field of medical instruments, it is related to minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective, guider is by N>=3 monomer template composition, monomer template is provided with left horizontal company and right horizontal company, it is left it is horizontal be provided with fixture block, it is right it is horizontal be provided with neck, makes left horizontal company when using in fixture block insertion neck and right horizontal even forms one；Template is additionally provided with horizontal Fluoroscopy location needle guide hole, minimally invasive positioning needle guide hole, spinous process positioning needle guide hole and longitudinal Fluoroscopy location needle guide hole may be selected, horizontal Fluoroscopy location needle guide hole to through laterally perspective guide pin, may be selected minimally invasive positioning needle guide hole to through positioning guide pin, spinous process positioning needle guide hole to through spinous process Fluoroscopy location pin and longitudinal Fluoroscopy location needle guide hole to have an X-rayed guide pin through longitudinal direction.Template in the present invention is fully seated in vitro, is improved its accuracy by having an X-rayed auxiliary, is reduced the radiation exposure of medical worker and patient, wound.
Description
Technical field
The invention belongs to minimally invasive pedicle of vertebral arch outside technical field of medical instruments, more particularly to a kind of detachable skin of combination perspective
Screw guider.
Background technology
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.Because conventional open is put, tack operation wound is larger, tissue dissection scope is relatively wide, operation
In can to surrounding tissue for a long time pull, and influence patient's postoperative function recover, so recently as vertebral column minimally invasive surgery
Development, percutaneous cervical arc root screw technique for fixing is increasingly subject to pay attention to, the determination in pedicle screw entry point and screw way direction in art
It is the key of this technology, but Thoracolumbar disk anatomical structure is more complicated and variation is big, in conventional percutaneous cervical arc root operation often
Underlying nail need to be continuously had an X-rayed, causes medical worker and patient radiation dose to increase, leukaemia and cutaneum carcinoma can be caused for a long time
Occur, though the pedicle of vertebral arch of free-hand limited touch, which puts nail method, can reduce perspective, extend operating time, and be harder to meet same
Centrum bilateral Screw entrance point and the uniformity in direction, influence reset effect.
The outer individuation template of the skin that currently exists in addition, be using the form outside skin as template Individual design,
But skin soft tissue activity is big, the influence such as receptor site, and do not allow to be fixed easily, hence it is evident that the accuracy of influence positioning.
The content of the invention
In order to solve the above-mentioned technical problem, the present invention provides minimally invasive pedicle screw outside a kind of detachable skin of combination perspective
Guider, makes percutaneous cervical arc root screw implantation in minimally invasive spine surgical accurate, while reducing the radiation of patient and medical personnel.
Minimally invasive pedicle screw outside a kind of detachable skin of combination perspective in the present invention of above technical problem is solved to lead
Panel assembly, it is characterised in that：The guider is by N>=3 monomer template composition, the monomer template is provided with left horizontal company and the right side
Horizontal company, left horizontal even one end is provided with fixture block, right horizontal even one end and is provided with neck, makes left horizontal company and the right side in fixture block insertion neck when using
It is horizontal even to form one；Guide plate is additionally provided with horizontal Fluoroscopy location needle guide hole, minimally invasive positioning needle guide hole, spinous process pilot pin may be selected
Pilot hole and longitudinal Fluoroscopy location needle guide hole, horizontal Fluoroscopy location needle guide hole to through laterally perspective guide pin, may be selected
Minimally invasive positioning needle guide hole to through positioning guide pin, spinous process positioning needle guide hole to through spinous process Fluoroscopy location pin and longitudinal direction
Fluoroscopy location needle guide hole through longitudinal direction to have an X-rayed guide pin.
Horizontal Fluoroscopy location needle guide hole is horizontal both sides insertion in prioritization scheme in the present invention, is respectively arranged on left horizontal company
Sidepiece and right horizontal even sidepiece；It is two surface insertions up and down that minimally invasive positioning needle guide hole, which may be selected, two groups, respectively positioned at left horizontal company and
It is right horizontal to connect on lower surface；Longitudinal Fluoroscopy location needle guide hole is front and rear sides insertion, the side before and after left horizontal company and right horizontal company
On face；Spinous process positioning needle guide hole for up and down two surface insertions, two groups, one group be located at it is left it is horizontal connect lower surface, another group is located at
Fixture block upper and lower surface horizontal is connected on the corresponding position of lower surface with right.
Optional minimally invasive two groups of the needle guide hole of positioning is symmetrically positioned in spinous process positioning needle guide hole both sides, spinous process pilot pin
Pilot hole staggers parallel distribution, positioned at the center of guide plate upper and lower surface.
The quantity that minimally invasive positioning needle guide hole may be selected>=20, the quantity of minimally invasive positioning needle guide hole preferably may be selected
=90。
It is described that minimally invasive positioning needle guide hole may be selected（2）Minimally invasive pedicle of vertebral arch screw outside a diameter of 2.1mm, described detachable skin
Guider is followed closely according to optional minimally invasive positioning needle guide hole（2）The difference of inclined angle is configured to multiple guide plate arrangements,
Inclined angle is respectively 4 °, 6 °, 8 °, 10 °, 12 ° or 14 °.
The outer navigation template of skin in the present invention is universal template, may be selected minimally invasive positioning needle guide hole leaning angle have 4 °,
6 °, 8 °, 10 °, 12 °, the Multiple Types such as 14 °, disclosure satisfy that the operation requirement of the different patients of different centrums.
The left horizontal company and the right horizontal surface that connects are respectively equipped with number of degrees mark.
The guide plate thickness 14-16mm.
The aperture of the horizontal Fluoroscopy location needle guide hole, spinous process positioning needle guide hole and longitudinal Fluoroscopy location needle guide hole
For 2.1mm.
The guide plate is cuboid.
The horizontal Fluoroscopy location needle guide hole is 1, and longitudinal Fluoroscopy location needle guide hole is 3.
In the present invention template edge can also Passivation Treatment, to avoid weighing skin wounded.
Template in the present invention is fully seated in vitro, improves its accuracy by having an X-rayed auxiliary, template can be by each
Sample Kirschner wire（Pilot pin）Connection, which is integral, improves its stability, appropriate in sagittal plain can also be adjusted, is adapted to
Different positions；While it is also smaller on the radiation exposure of reduction medical worker and patient, bed, with preferable replicability.
Heretofore described optional minimally invasive positioning needle guide hole forms inside angle of inclination, to ensure pedicle screw
Being capable of introversion implantation.Because guide pin has an inside angle of inclination after placing, if being integrally formed, it is not easy to take out guide plate
Device.The present invention forms detachable, it is to avoid the problem of guide pin is not easy to take out after placing, and adds operational convenience；
Independent navigation template is designed to the device of an entirety again, the possibility that detachable navigation template teetertotters is reduced, it is to avoid
Success rate in the problem of screw enters the bad assurance of angle when following closely, increase art.
Minimally invasive pedicle screw guider outside the individuation skin of perspective auxiliary is combined in the present invention, it is auxiliary by fluoroscopy during operation
Positioning is helped, template is solved and moves the problem of changing with skin, the spinous process Fluoroscopy location pin for being fixed on spinous process is also increased in addition,
Prevent movement.
Device in the present invention is fully seated in vitro, improves its accuracy by having an X-rayed auxiliary, monomer template can lead to
Cross Kirschner wire connection and be integral raising its stability, appropriate in sagittal plain can also be adjusted, be adapted to different bodies
Position；While it is also smaller on the radiation exposure of reduction medical worker and patient, bed, with preferable replicability.
In the present invention monomer template be universal navigation template, it is adaptable to most thoracolumbar fractures, osteopathy need through
Skin puncture pedicle of vertebral arch implements the patient of operation, and the present apparatus ensures the accurate of puncture by the way that X-ray examination is auxiliary, can punctured simultaneously multiple
Centrum nut, thus the wound of patient can be not only reduced, the radiation exposure of medical worker and patient can also be reduced.
Brief description of the drawings
Fig. 1 is the structural representation of guider in the present invention
Fig. 2 is monomer template schematic diagram in the present invention
Fig. 3 and Fig. 4 is the combination schematic diagram of guider and Thoracolumbar disk bone in the present invention
Fig. 5 is the combination schematic diagram of positioning guide pin and Thoracolumbar disk bone in the present invention
Being specifically identified wherein in figure is as follows:1. horizontal Fluoroscopy location needle guide hole, 2. may be selected minimally invasive positioning needle guide hole
3. spinous process positions needle guide hole, 4, number of degrees mark, 5. longitudinal Fluoroscopy location needle guide holes, 6. templates, 7. template upper and lower surfaces,
8. template front and back sides, the left horizontal even sidepieces of 9-1., the right horizontal even sidepieces of 9-2., 10. left horizontal companies, 11. right horizontal companies, 12. fixture blocks,
13. neck, 14. skins, 15. longitudinal direction perspective guide pins, 16. laterally have an X-rayed guide pin, 17. positioning guide pins, 18. spinous process Fluoroscopy locations
Pin, 19. normal vertebral bodies, 20. suffer from vertebra, 21. Thoracolumbar disk bones
Embodiment
With specific embodiment, the present invention is further illustrated below：
Embodiment 1
Minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective, guider by N=3 monomer template group
Into monomer template is provided with left horizontal company and right horizontal company, and left horizontal even one end is provided with fixture block, right horizontal even one end and is provided with neck, when using
Make left horizontal company and right horizontal even formation one in fixture block insertion neck；Guide plate is additionally provided with horizontal Fluoroscopy location needle guide hole, may be selected
Minimally invasive positioning needle guide hole, spinous process positioning needle guide hole and longitudinal Fluoroscopy location needle guide hole, horizontal Fluoroscopy location needle guide hole
To through laterally perspective guide pin, may be selected it is minimally invasive positioning needle guide hole to through positioning guide pin, spinous process positioning needle guide hole
To through spinous process Fluoroscopy location pin and longitudinal Fluoroscopy location needle guide hole to have an X-rayed guide pin through longitudinal direction.
Horizontal Fluoroscopy location needle guide hole is horizontal both sides insertion, is respectively arranged on left horizontal even sidepiece and right horizontal even sidepiece；Can
The minimally invasive positioning needle guide hole of selection is two surface insertions up and down, two groups, positioned at left horizontal company and right horizontal is connected respectively on lower surface；It is vertical
It is front and rear sides insertion to Fluoroscopy location needle guide hole, in left horizontal company and right horizontal even front and back sides；Spinous process pilot pin is oriented to
Hole is two surface insertions up and down, two groups, one group be located at it is left it is horizontal connect lower surface, another group is located at fixture block upper and lower surface and right horizontal company
Spinous process Fluoroscopy location pin is inserted on the corresponding position of upper and lower surface, when using to fix and connect left horizontal company and right horizontal company.
Minimally invasive two groups of needle guide hole of positioning may be selected and is symmetrically positioned in spinous process positioning needle guide hole both sides, spinous process pilot pin is oriented to
Hole is staggered parallel distribution, positioned at the center of guide plate upper and lower surface.
The outer navigation template of skin is universal template（Non-individualsization are designed）, may be selected it is minimally invasive positioning needle guide hole have 4 °, 6 °,
8 °, 10 °, 12 °, the Multiple Types such as 14 °, disclosure satisfy that the operation requirement of the different patients of different centrums, with generalization.
The quantity 60 of minimally invasive positioning needle guide hole may be selected.
The preoperative inclined angle that required operated level centrum pedicle screw is measured by CT individuations, selects the corresponding number of degrees
The outer guide plate of skin, in art in the case where keeping inclined angle constant, directly adjusted in different ducts, more convenient for being grasped in art
Make.Horizontal Fluoroscopy location needle guide hole, optional minimally invasive positioning needle guide hole, spinous process positioning needle guide hole and longitudinal Fluoroscopy location
The aperture of needle guide hole is 2.1mm, fits in through 2mm diameter Kirschner wires.Spinous process table is shallow, in pedicle of vertebral arch low level.Spine can be used
Prominent Fluoroscopy location pin, which is fixed, avoids displacement.Guide plate thickness 14-16mm, convenient operation.
Embodiment 2
Minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective, guider by N=4 monomer template group
Into monomer template is provided with left horizontal company and right horizontal company, and left horizontal even one end is provided with fixture block, right horizontal even one end and is provided with neck, when using
Make left horizontal company and right horizontal even formation one in fixture block insertion neck；Guide plate is additionally provided with horizontal Fluoroscopy location needle guide hole, may be selected
Minimally invasive positioning needle guide hole, spinous process positioning needle guide hole and longitudinal Fluoroscopy location needle guide hole, horizontal Fluoroscopy location needle guide hole
To through laterally perspective guide pin, may be selected it is minimally invasive positioning needle guide hole to through positioning guide pin, spinous process positioning needle guide hole
To through spinous process Fluoroscopy location pin and longitudinal Fluoroscopy location needle guide hole to have an X-rayed guide pin through longitudinal direction.
Horizontal Fluoroscopy location needle guide hole is horizontal both sides insertion, is respectively arranged on left horizontal even sidepiece and right horizontal even sidepiece；Can
The minimally invasive positioning needle guide hole of selection is two surface insertions up and down, two groups, positioned at left horizontal company and right horizontal is connected respectively on lower surface；It is vertical
It is front and rear sides insertion to Fluoroscopy location needle guide hole, in left horizontal company and right horizontal even front and back sides；Spinous process pilot pin is oriented to
Hole is two surface insertions up and down, two groups, one group be located at it is left it is horizontal connect lower surface, another group is located at fixture block upper and lower surface and right horizontal company
Spinous process Fluoroscopy location pin is inserted on the corresponding position of upper and lower surface, when using to fix and connect left horizontal company and right horizontal company.
Quantity=90 of minimally invasive positioning needle guide hole may be selected, it is two groups 180, preoperative to measure required by CT individuations
The inclined angle of operated level centrum pedicle screw, selects keeping inclined angle not in the outer guide plate of skin of the corresponding number of degrees, art
In the case of change, directly adjusted in different ducts, more convenient for being operated in art.The outer navigation template of skin is universal template（It is non-
Individual design）, minimally invasive pedicle screw outside the minimally invasive positioning a diameter of 2.1mm of needle guide hole, described detachable skin may be selected
Guider is configured to multiple guide plate arrangements, leaning angle according to the difference that minimally invasive positioning needle guide hole inclined angle may be selected
Degree is respectively 4 °, 6 °, 8 °, 10 °, 12 ° or 14 °.
Minimally invasive positioning needle guide hole, which may be selected, 4 °, 6 °, 8 °, 10 °, 12 °, the Multiple Types such as 14 °, disclosure satisfy that different vertebras
The operation requirement of body difference patient, with generalization.
Horizontal Fluoroscopy location needle guide hole is 1, and longitudinal Fluoroscopy location needle guide hole is 3, spinous process positioning needle guide hole
18, it is divided to two groups, every group 9, two groups of parallel distributions of staggering, positioned at the center of guide plate upper and lower surface.
The aperture of horizontal Fluoroscopy location needle guide hole, spinous process positioning needle guide hole and longitudinal Fluoroscopy location needle guide hole is
2.1mm, fits in through 2mm diameter Kirschner wires.Spinous process table is shallow, in pedicle of vertebral arch low level.It can be fixed with spinous process Fluoroscopy location pin
Avoid displacement.
Template upper surface provided with indicate block, and template edge can also Passivation Treatment, to avoid weighing skin wounded.
Minimally invasive pedicle screw guider outside the detachable skin of perspective is combined in the present invention, it is fixed to be aided in by fluoroscopy during operation
Position, solves template and moves the problem of changing with skin, the pilot pin for being fixed on spinous process is also increased in addition, prevent movement.
Device in the present invention makes percutaneous accurate placement and easily fixed, and device is disposed entirely within outside skin, when in art not
Need otch to place, spinous process pilot pin is designed in addition and strengthens locating effect.
Heretofore described optional minimally invasive positioning needle guide hole forms inside angle of inclination, to ensure pedicle screw
Being capable of introversion implantation.Because guide pin has an inside angle of inclination, if being integrally formed, it is not easy to take out guide plate.This hair
Bright shape is designed to detachable, it is to avoid the problem of being not easy to take out guide plate, adds operational convenience；To individually it lead again
Model plane plate is designed to the device of an entirety, reduces the possibility that detachable navigation template teetertotters, it is to avoid screw enters when following closely
Success rate in the problem of angle bad assurance, increase art.
Process of the guider of the present invention in art：
Fixation is long-armed single pedicle screw system in art, and patient takes the prone position of hanging belly after general anesthesia.Use c-type
Arm X-ray machine standard normotopia centered on hindering vertebra takes the photograph piece, confirms that spinous process is located at the center of left and right sides pedicle of vertebral arch projection join line.Body
The line of vertebra and the adjacent upper limb of pleurocentrum end to end, the line of each centrum spinous process and the projection of left and right sides pedicle of vertebral arch is hindered in list notation.Choosing is straight
Many pieces of footpath 2mm Kirschner wires are respectively penetrated in the pilot hole of above-mentioned each template, and being driven into spinous process with shorter diameter 2mm Kirschner wires is used in combination
The sticky pad pasting of operation is fixed.
By above-mentioned normotopia take the photograph piece on the basis of substantially suitable pilot hole is selected in template, diameter 2mm is percutaneously driven into successively
Kirschner wire is reached after sclerotin, and piece is taken the photograph in row positive side position, pilot hole adjustment positioning Kirschner wire is closed on according to X-ray film selection, until being driven into
Kirschner wire be adjusted to normotopia and reach pedicle of vertebral arch projecting edge, it is parallel that soleplate is gone up in side position with centrum（It is identical with Design）, after
Continuous to be driven into Kirschner wire, when its needlepoint side position is reached centrum rear wall, normotopia is located at pedicle of vertebral arch and projects inner side, continues to be driven into kernig sign
1/3 before into centrum.Positioning Kirschner wire in edge is put into expansion sleeve and protection sleeve step by step successively, with hollow screw tap edge positioning kirschner
Pin expands screw way, selects suitable diameter and the long-armed single pedicle screw of length to be screwed into centrum along positioning Kirschner wire, hinders vertebra choosing
Screw length is slightly shorter.The angle of appropriate adjustment operation table, vertebra etc. is hindered by Postural reduction.Screw tail cap is inserted again, suitably
Distraction reduction centrum is simultaneously locked, and fracture nail tail, and art finishes.
The foregoing is merely illustrative of the preferred embodiments of the present invention, is not intended to limit the invention, all essences in the present invention
Any modifications, equivalent substitutions and improvements made within refreshing and principle etc., should be included in the scope of the protection.
Claims (10)
1. minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective, including stencil body, it is characterised in that：
The guider is by N>=3 monomer template composition, the monomer template（6）Left horizontal company（10）With right horizontal company（11）, Zuo Heng
（10）Even one end is provided with fixture block（12）, right horizontal company（11）Neck is provided with one end（13）, fixture block when using（12）Insert neck
（13）In make left horizontal company（10）With right horizontal company（11）Form one；Guide plate（6）It is additionally provided with horizontal Fluoroscopy location needle guide hole（1）、
Minimally invasive positioning needle guide hole may be selected（2）, spinous process positioning needle guide hole（3）With longitudinal Fluoroscopy location needle guide hole（5）, laterally thoroughly
Depending on positioning needle guide hole（1）To have an X-rayed guide pin through horizontal（16）, may be selected minimally invasive positioning needle guide hole（2）To through calmly
Position guide pin（17）, spinous process positioning needle guide hole（3）To through spinous process Fluoroscopy location pin（18）It is oriented to longitudinal Fluoroscopy location pin
Hole（5）To have an X-rayed guide pin through longitudinal direction（15）.
2. minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective according to claim 1, it is special
Levy and be：The horizontal Fluoroscopy location needle guide hole（1）For horizontal both sides insertion, left horizontal even sidepiece is respectively arranged on（9-1）And the right side
Horizontal even sidepiece（9-2）；Minimally invasive positioning needle guide hole may be selected（2）The two surface insertions for above and below, two groups, respectively positioned at left horizontal company
（10）On right horizontal company (11) upper and lower surface (7)；Longitudinal Fluoroscopy location needle guide hole（5）For front and rear sides insertion, positioned at left horizontal stroke
Even（10）With right horizontal company (11) front and back sides（8）On；Spinous process positions needle guide hole（3）For two surface insertions, two groups, one group up and down
Positioned at left horizontal company (10) upper and lower surface, another group corresponding with right horizontal company (11) upper and lower surface positioned at fixture block (12) upper and lower surface
Position on.
3. minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective according to claim 1, it is special
Levy and be：It is described that minimally invasive positioning needle guide hole may be selected（2）Two groups are symmetrically positioned in spinous process positioning needle guide hole（3）Both sides, it is described
Spinous process positions needle guide hole（3）Stagger parallel distribution.
4. minimally invasive pedicle screw guide plate arrangement outside a kind of detachable skin of combination perspective according to claim 1, it is special
Levy and be：It is described that minimally invasive positioning needle guide hole may be selected（2）Quantity>=20, minimally invasive positioning needle guide hole preferably may be selected（2）
Quantity=90.
5. minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective according to claim 3, it is special
Levy and be：It is described that minimally invasive positioning needle guide hole may be selected（2）Minimally invasive pedicle of vertebral arch screw outside a diameter of 2.1mm, described detachable skin
Guider is followed closely according to optional minimally invasive positioning needle guide hole（2）The difference of inclined angle is configured to multiple guide plate arrangements,
Inclined angle is respectively 4 °, 6 °, 8 °, 10 °, 12 ° or 14 °.
6. minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective according to claim 1, it is special
Levy and be：The left horizontal company（10）With right horizontal company（11）Upper surface is respectively equipped with number of degrees mark（4）.
7. minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective according to claim 1, it is special
Levy and be：The template（6）Thick 14-16mm.
8. minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective according to claim 1, it is special
Levy and be：The horizontal Fluoroscopy location needle guide hole（1）, spinous process positioning needle guide hole（3）With longitudinal Fluoroscopy location needle guide hole
（5）Aperture be 2.1mm.
9. minimally invasive pedicle screw leads guider outside a kind of detachable skin of combination perspective according to claim 1, its
It is characterised by：The guide plate（6）For cuboid.
10. minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective according to claim 1, it is special
Levy and be：The horizontal Fluoroscopy location needle guide hole（1）For 1, longitudinal Fluoroscopy location needle guide hole（5）For 3.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710637055.7A CN107260286A (en) | 2017-07-31 | 2017-07-31 | Minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710637055.7A CN107260286A (en) | 2017-07-31 | 2017-07-31 | Minimally invasive pedicle screw guider outside a kind of detachable skin of combination perspective |
Publications (1)
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| CN108272514A (en) * | 2017-12-12 | 2018-07-13 | 南华大学附属第医院 | Backbone probe positions and intersection point lancing system |
| CN108378931A (en) * | 2018-01-03 | 2018-08-10 | 中国人民解放军陆军总医院 | Backbone Fluoroscopy location guide plate |
| CN109431583A (en) * | 2018-11-13 | 2019-03-08 | 深圳市艾科赛龙科技股份有限公司 | A kind of pedicle of vertebral arch navigation model method for building up and device |
| TWI671763B (en) * | 2018-07-25 | 2019-09-11 | 品臻聯合系統股份有限公司 | An augmented reality instrument for accurately positioning pedical screw in minimally invasive spine surgery |
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