CN107432764A - The controllable reach apparatus of anterior cervical vertebrae - Google Patents
The controllable reach apparatus of anterior cervical vertebrae Download PDFInfo
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- CN107432764A CN107432764A CN201710729235.8A CN201710729235A CN107432764A CN 107432764 A CN107432764 A CN 107432764A CN 201710729235 A CN201710729235 A CN 201710729235A CN 107432764 A CN107432764 A CN 107432764A
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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
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
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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
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
- A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
- A61B17/7005—Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit in the screw or hook heads
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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
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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
- A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
- A61B17/7077—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae
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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
- A61B2017/564—Methods for bone or joint treatment
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Abstract
The present invention relates to a kind of controllable reach apparatus of anterior cervical vertebrae, and it is provided with fixed arm, transfer arm, rack, slot type gag lever post and lifting rod；Described fixed arm and transfer arm lower end assembles centrum screw；Described rack and slot type gag lever post is connected arm and transfer arm, and relative with transfer arm can slide；Described lifting rod is inserted in the stopper slot of slot type gag lever post, lifting rod is provided with the regulation screw mandrel and adjusting nut to socket-connect, for described adjusting nut incarceration in the top of stopper slot, described lifting rod lower end is provided with oblique through hole, described oblique through hole mounted inside angle fixing glue；The controllable reach apparatus of described anterior cervical vertebrae is also comprising synchronous lifting component.The controllable reach apparatus of anterior cervical vertebrae of the present invention can realize preceding road centrum side approach, realize the reach of posterior longitudinal ligament ossification correlation centrum, using flexible, operate quantitative, controllable, lifting is uniform, can obtain good surgical effect, it is small to patient's damage, there is wide potential applicability in clinical practice.
Description
Technical field
The present invention relates to technical field of medical instruments, specifically, is related to a kind of approach surgery for cervical posterior longitudinal ligament ossification
The controllable reach apparatus of anterior cervical vertebrae of disease.
Background technology
Cervical ossified posterior longitudinal ligament (OPLL) refers to that the posterior longitudinal ligament in Cervical Vertebral Canal Procedures is substituted by calcified tissue, so as to lure
A kind of disease of intraspinal tube spinal compression and nervous function deterioration is sent out, limbs can be caused to feel and dyskinesia and internal organ plant god
Through dysfunction.Can be four types by OPLL points according to the performance on cervical vertebra X pieces：1. focal type, isolate ossified posterior longitudinal ligament
Focus only involves single centrum or intervertenral space；2. segmental pattern, multiple independent posterior longitudinal ligament ossification focuses, each focus scope
Only involve single centrum or intervertenral space；3. continuous type, single focus, involve multiple intervertenral spaces and interverbebral disc；4. mixed type, above-mentioned
The mixing of three types.The disease has generation in worldwide ethnic group, and its incidence is 0.1%-1.7%.
Clinician is needed to be fully understood by OPLL Pathological Physiology, disease when being treated to the patient of posterior longitudinal ligament ossification
The clinical symptoms and Features of disease, and it is familiar with the basic principle and strategy of OPLL operative treatments.It is to imaging diagnosis
OPLL and without the patient of severe spinal compressing, if without obvious clinical symptoms, row is regularly observed, without to this kind of trouble
Person carries out prophylactic surgery.But for having serious cord symptom, Nurick Neuroscore 3-4 levels or having serious god
OPLL patient through root disease, then need decompression.Operative approach includes preceding road, the way of escape or facet locking.Anterior decompression
Modus operandi generally includes Subtotal vertebrectomy, or discectomy combines the ossified posterior longitudinal ligament resection in preceding road, and intervertebral melts
Close；Posterior approach is OPLL indirect decompression mode, including laminoplasty, or vertebrae plate resection+fusion.But each hand above
Art mode is respectively provided with the defects of certain.The shortcomings that anterior decompression merges is that technical difficulty is larger, to the posterior longitudinal ligament bone of C2 sections
Change be difficult accomplish directly to depressurize, postoperative pseudarthrosis formation probability is higher, the centrum scope if desired depressurized at 3 or more,
Easily there is dysphagia, while anterior approach is easier dura mater tear occur compared with posterior approach；Way of escape vertebrae plate resection+fusion category
In indirect decompression, there is the risk of OPLL continuing advances, it is poor to the case effect of severe spinal compressing, C5 Radiculopathies
Risk Lu Genggao earlier above；The shortcomings that way of escape laminoplasty, is similar with vertebrae plate resection+fusion, but the risk that its progression of disease deteriorates
It is higher, if the lordosis that patient has cervical vertebra is lost, the art formula can not be used.
At present, it yet there are no and centrum corresponded to by the ossified posterior longitudinal ligament of preceding road reach, in conjunction with intervertebral fusion so that after ossified
Longitudinal ligament forms isolated island, releases the modus operandi of spinal compression.
Patent document CN102895017A, publication date 2013.01.30, disclose a kind of parallel vertebral fusion of corpus vertebrae replacement
It is fixed, strut lifting reduction forceps, carrying handle I between the final lumbar vertebra for recovering the normal Axial symptoms of backbone and line of force relation
Head rotate with closing up the head of handle II around rivet to form caliper rotation and be rotatably assorted, screw rod is through closing up the rear side of handle II
The through hole in face coordinates with the triangle neck of the afterbody of carrying handle I in buckle-type is dynamic, and nut, which is embedded in, to be closed up in the through hole of handle II
And helically move and coordinate with screw rod, carrying handle I is hollow tube slot structure, and flexible pulling item is worn from the head of carrying handle I
Go out and be collectively forming flexible lifting mouth with closing up the jaw on the head of handle II afterwards, flexible pulling item afterbody passes through spiral handle.Patent text
CN204863423U, day for announcing 2015.12.16 are offered, discloses a kind of pulling off reset device for cervical operation, including pedestal
And sliding shoe, the sliding shoe are located at the side of pedestal and be slidably matched with pedestal, the end of the pedestal is extended to side
Limited block, the limited block and sliding shoe are located at the same side of pedestal, a screw are respectively provided with the limited block and sliding shoe,
Release link is threaded with two screws respectively, the end of release link has insertion cervical vertebra and fixes the fixation of cervical vertebra
Tip, the device, which not only possesses, basic struts function, moreover it is possible to makes the centrum of dislocation progressively multiple using the lifting effect of release link
Position, reseting procedure is steady, accurate, controllable, it is not necessary to and insert intervertenral space and operated, safe to use, conveniently, energy after corpus vertebrae replacement
Interpyramidal reset relation is kept until completing reliable intervertebral fixed operation.But corpus vertebrae replacement is pertained only in the prior art
Related equipment, but the dislocation such as articuli intervertebrales is very different with ossification of cervical posterior longitudinal ligament on anatomical features, pathology, treatment
Strategy and the details considered are also different, therefore above apparatus is not particularly suited for treating the centrum reach during OPLL.
To sum up, clinical shortage technical difficulty is relatively low at present, and complication probability of happening is small, and effect of easing stress is good, suitable for each section
The operation plan and its corresponding apparatus of section ossification of cervical posterior longitudinal ligament treatment.
The content of the invention
The purpose of the present invention is to be directed to deficiency of the prior art, there is provided a kind of controllable reach apparatus of anterior cervical vertebrae.
To achieve the above object, the present invention adopts the technical scheme that：
A kind of controllable reach apparatus of anterior cervical vertebrae, provided with fixed arm, transfer arm, rack, slot type gag lever post and lifting rod；Institute
The fixed arm stated is provided with the first screw fixed arm and the first rack bridging arm, described transfer arm be provided with the second screw fixed arm,
Second rack bridging arm and mobile sliding block；Centrum is assembled in the first described screw fixed arm and the lower end of the second screw fixed arm
Screw；Described rack one end is fixed in the first rack bridging arm, and the other end passes through the second rack bridging arm and mobile sliding block
Common first through hole so that described transfer arm can relative rack slip；Described slot type gag lever post one end is fixed on
In one rack bridging arm, the other end passes through the second through hole of the second rack bridging arm so that described transfer arm can relative slot type
Gag lever post slides；Described lifting rod is inserted in the stopper slot of slot type gag lever post, and lifting rod is provided with the regulation screw mandrel to socket-connect
And adjusting nut, for described adjusting nut interim card in the top of stopper slot, described lifting rod lower end is provided with oblique through hole, described
Oblique through hole mounted inside angle fixing glue.
The controllable reach apparatus of described anterior cervical vertebrae is additionally provided with synchronous lifting component；Described synchronous lifting component includes the
One synchronous lifting arm, the second Synchronous lifting bar and slot type fix bar；The first described Synchronous lifting bar includes the positioned at upper end
One synchronous threaded rod and the first synchronous polished rod positioned at lower end, the described first synchronous polished rod lower end are rotatably connected on the first rack
In bridging arm；The second described Synchronous lifting bar is synchronous including the second synchronous threaded rod positioned at upper end and second positioned at lower end
Polished rod, the described second synchronous polished rod lower end are rotatably connected on slot type gag lever post；The both ends difference of described slot type fix bar
It is threaded on the first synchronous threaded rod and the second synchronous threaded rod；Slot type fix bar is provided with fixing groove；Described regulation
Screw mandrel upper end is mutually fixed by adjusting nut and fixing nut with slot type fix bar.
The first described synchronous threaded rod or the second synchronous threaded rod are provided with the first indicating graduation.
Described lifting rod and the number of angle fixing glue are more than three.
Described slot type gag lever post is provided with some stopper slots, and described stopper slot is circle, and each stopper slot is connected with each other
It is logical.
The outer wall of described adjusting nut is provided with the second indicating graduation.
Described regulation screw mandrel includes regulation screw mandrel body, angular adjustment bar and hold-doun nut, adjusts screw mandrel body and angle
Degree adjusting rod is connected by hold-doun nut, and described oblique through hole is located on angular adjustment bar.
Angle between the first described screw fixed arm and the first rack bridging arm is 120-160 degree, described second
Angle between screw fixed arm and the second rack bridging arm is 120-160 degree, and described fixed arm is consistent with transfer arm shape.
Described adjusting nut upper end is equipped with nut swing handle, and described nut swing handle is interior hexagonal structure, with adjusting spiral shell
Outer six square joint of female upper end matches.
Described angle fixing glue tail end is outer six square joint and arranges regulation spanner, and described regulation spanner head end is interior
Hexagonal structure.
The present invention proposes a kind of new OPLL operation methods, and the controllable reach of anterior cervical vertebrae of the present invention is devised based on this
Apparatus, it the advantage is that：
1st, the controllable reach apparatus of anterior cervical vertebrae of the invention is provided with fixed arm, transfer arm, rack, coordinates centrum screw to form
Pedestal, then the cooperation based on lifting rod and slot type gag lever post, and then the reach of centrum is realized, it is applied to different number centrums
Reach, isolated island is formed by the ossified posterior longitudinal ligament of centrum reach order, it is cumbersome compared to operation plan of the prior art
Degree is remarkably decreased, and effect of easing stress is more notable；
2nd, centrum is driven to move forward by angle fixing glue and lifting rod, and the gradient of oblique through hole is reasonable in design, in vertebra
The reach of centrum in vertical direction is realized in the case of side side's approach, is easy to operation technique, it is small to patient's damage, significantly
Reduce postoperative complications；
3rd, present invention is particularly suitable for the posterior longitudinal ligament ossification operation for being related to multi-segmental centrum, more set lifting rods can be equipped with
Overall uniformly lifting is realized Deng part, improves surgical effect, reduces operation wound, reduces operating difficulty；
4th, in the presence of slot type gag lever post, it is ensured that what lifting rod can correctly be fixed to specific centrum along one
Direction force drawing, improve the accuracy of operation；
5th, lifting rod includes angular adjustment rod unit, can be wider according to real needs quick-replaceable, the scope of application in art；
6th, the shape and Position Design of fixed arm, transfer arm, rack and slot type gag lever post are reasonable, can fully expose operation and regard
Open country, it is easy to patient to operate；
7th, each regulating member, such as nut swing handle, regulation spanner, shape is reasonable in design, can Rapid matching completion in art
Operation, operating difficulty is reduced, shorten operating time；
8th, provided with indicating graduation, centrum reach controllable precise, fineness height are made.
To sum up, the controllable reach apparatus using flexible of anterior cervical vertebrae of the invention, operation is quantitative, controllable, can realize multi-segmental
Centrum is uniformly lifted, and meets the approach requirement of centrum side, is easy to operation technique, can obtain good surgical effect, and patient is damaged
Hinder small, there is wide potential applicability in clinical practice.
Brief description of the drawings
Fig. 1 is the controllable reach apparatus structural representation one of anterior cervical vertebrae of the embodiment of the present invention 1.
Fig. 2 is the controllable reach apparatus structural representation two of anterior cervical vertebrae of the embodiment of the present invention 1.
Fig. 3 is the slot type gag lever post structural representation of the embodiment of the present invention 1.
Fig. 4 is the controllable reach apparatus structural representation of anterior cervical vertebrae of the embodiment of the present invention 2.
Fig. 5 is the schematic diagram of the first indicating graduation.
Fig. 6 is the controllable reach apparatus structural representation of anterior cervical vertebrae of the embodiment of the present invention 3.
Fig. 7 is the controllable reach apparatus structural representation of anterior cervical vertebrae of the embodiment of the present invention 4.
Embodiment
Present inventor has abundant clinic and research experience, Neng Gouchong in the diagnosis of cervical vertebra joint disease and therapy field
The defects of point recognizing each art formulas of current OPLL, based on sturdy theory of medicine basis and sufficient surgical experience, it is proposed that one
Kind treats OPLL new art formula, i.e., first by preceding road centrum side approach, the ossified posterior longitudinal ligament that moves forward corresponds to centrum, then in conjunction with
Intervertebral fusion is so that ossified posterior longitudinal ligament forms isolated island, releasing spinal compression.The operation method has compared to existing operation method
Standby advantages below：1. because ossified posterior longitudinal ligament forms independent isolated island, therefore it can effectively release the compressing to spinal cord；2. for
Different segment posterior longitudinal ligament ossification can realize decompression, to the posterior longitudinal ligament bone of focal type, segmental pattern, continuous type and mixed type
Change is all suitable for；3. being depressurized by moving forward centrum, operation technique is simply too much；4. due to do not cut off ossified posterior longitudinal ligament or
Vertebral plate etc., therefore injured nerve root etc. causes the probability of postoperative complications to be remarkably decreased.The new art formula based on more than, inventor's design
The anterior cervical vertebrae controllable reach apparatus of the present invention, safely and effectively to perform the reach of the centrum in the surgical procedure.
Embodiment provided by the invention is elaborated below in conjunction with the accompanying drawings.
The reference and part being related in accompanying drawing are as follows：
1. fixed arm, 11. first screw fixed arms, 12. first rack bridging arm
2. transfer arm, 21. second screw fixed arms, 22. second rack bridging arm, 23. movement sliding blocks, 231. gear shafts,
232. regulation handles, 233. lock banking stops, 234. lock banking stop rotating pins, 235. springs, 24. first through hole, 25. second through holes
3. rack
4. slot type gag lever post, 41. spacing holes
5. lifting rod, 51. regulation screw mandrels, 511. regulation screw mandrel bodies, 512. angular adjustment bars, 513. hold-doun nuts, 52.
Adjusting nut, 53. nut swing handles, 54. oblique through holes, 55. second indicating graduations
6. centrum screw
7. angle fixing glue
8. adjust spanner
9. synchronous lifting component, 91. first Synchronous lifting bars, 911. first synchronous threaded rods, 912. first synchronous polished rods,
92. the second Synchronous lifting bar, 921. second synchronous threaded rods, 922. second synchronous polished rods, 93. slot type fix bars, 931. fix
Groove, 94. fixing nuts, 95. are adjusted in synchronism swing handle, 96. first indicating graduations
Embodiment 1
Referring to Fig. 1, Fig. 1 is the controllable reach apparatus structural representation of anterior cervical vertebrae of the embodiment of the present invention 1.Described cervical vertebra
The preceding controllable reach apparatus in road is provided with fixed arm 1, transfer arm 2, rack 3, slot type gag lever post 4 and lifting rod 5.Described fixed arm 1
Provided with the first screw fixed arm 11 and the first rack bridging arm 12, the first described screw fixed arm 11 is cylindrical shape, described
First rack bridging arm 12 is prism-shaped, and angle therebetween is 120-160 degree.Described transfer arm 2 is provided with the second screw
Fixed arm 21, the second rack bridging arm 22 and mobile sliding block 23；The second described screw fixed arm 21 is cylindrical shape, described the
Two rack bridging arm 22 are prism-shaped, and angle therebetween is 120-160 degree.Described fixed arm 1 and the shape one of transfer arm 2
Causing, the first described screw fixed arm 11 is parallel with the second screw fixed arm 21, and centrum screw 6 is assembled in the lower end of the two,
Described the first rack bridging arm 12 and the second rack bridging arm 22 bends towards the same side.Described mobile sliding block 23 is connected to
In two rack bridging arm 22, the first through hole of a shared insertion is provided with the mobile rack bridging arm 22 of sliding block 23 and second
24.Described one end of rack 3 is fixed in the first rack bridging arm 12, and the other end is slided through the second rack bridging arm 22 and movement
First through hole 24 common to block 23, and rack 3 can slide in first through hole 24.Referring to Fig. 2, Fig. 2 is the embodiment of the present invention 1
The controllable reach apparatus structural representation two of anterior cervical vertebrae.The described inside of mobile sliding block 23 is provided with gear shaft 231, described tooth
Wheel shaft 231 is meshed with rack 3, and the end face of gear shaft 231 is provided with regulation handle 232, for turning gear wheel shaft 231 and then drives shifting
Swing arm 2 moves relative to rack 3.The outside of mobile sliding block 23 is additionally provided with lock banking stop 233, and described lock banking stop 233 passes through lock banking stop
Rotating pin 234 is connected on mobile sliding block 23, and spring 235, described lock are socketed with described lock banking stop rotating pin 234
The head end of limited step 233 is entrenched in fix transfer arm 2 on rack 3, when pressing 233 tail end of lock banking stop, then can adjust transfer arm 2
Position.
Referring to Fig. 1.Described one end of slot type gag lever post 4 is fixed in the first rack bridging arm 12, and the other end passes through second
Second through hole 25 of rack bridging arm 22, and slot type gag lever post 4 can slide in the second through hole 25.Slot type gag lever post 4 is located at tooth
The lower section of bar 3, and it is parallel with rack 3.Referring to Fig. 3, Fig. 3 is the slot type gag lever post structural representation of the embodiment of the present invention 1.It is described
Slot type gag lever post 4 be provided with some stopper slots 41, described stopper slot 41 is circle, and each stopper slot 41 be connected with each other it is logical.Again
Referring to Fig. 1.Described lifting rod 5 is inserted in the stopper slot 41 of slot type gag lever post 4, and lifting rod 5 is provided with and socket-connected by screw thread
Regulation screw mandrel 51 and adjusting nut 52.The described interim card of adjusting nut 52 in the top of stopper slot 41, adjusting nut 52 it is upper
End is equipped with nut swing handle 53, and described nut swing handle 53 is interior hexagonal structure, and outer six side of itself and the upper end of adjusting nut 52 connects
Head matches.The lower end of described regulation screw mandrel 51 is provided with oblique through hole 54, and specifically, described regulation screw mandrel 51 includes regulation
Screw mandrel body 511, angular adjustment bar 512 and hold-doun nut 513, regulation screw mandrel body 511 is above, hold-doun nut 513
In lower section, regulation screw mandrel body 511 and angular adjustment bar 512 are connected by hold-doun nut 513, and described oblique through hole 54 is located at
On angular adjustment bar 512.The angle of its place axis of oblique through hole 54 and the regulation place axis of screw mandrel 51 is 40-60 degree.It is oblique
The mounted inside angle fixing glue 7 of through hole 54.The tail end of described angle fixing glue 7 is equipped with regulation spanner 8, specifically, described
The tail end of angle fixing glue 7 be outer six square joint, the described head end of regulation spanner 8 is interior hexagonal structure, and the two is mutually matched.
It should be noted that the controllable reach apparatus of anterior cervical vertebrae of the present invention is that the new art formula based on inventor is developed,
It is applied to anterior cervical vertebrae side approach reach centrum, is particularly suitable for use in while the centrum of more than 2 of moving forward, before centrum
Shifting makes ossified posterior longitudinal ligament form isolated island, releases spinal compression.Described fixed arm 1, transfer arm 2, rack 3 coordinate centrum screw
6, it is fixed on by centrum screw 6 on centrum, collectively forms the pedestal of reach centrum, and due between fixed arm 1 and transfer arm 2
Spacing it is adjustable so that the controllable reach apparatus of anterior cervical vertebrae of the invention is applied to different types of OPLL, for example, be related to two,
Segmental pattern, continuous type or the mixed type OPLL of three, four etc. centrums.Described angle fixing glue 7 is used to be fixed on to need to move forward
The preceding trackside side of centrum, described lifting rod 5 are adjusted in vertical direction by the oblique connection angle fixing glue 7 of through hole 54
Section lifting rod 5 can lift angle fixing glue 7 and corresponding centrum indirectly, and ensure that centrum is in vertical direction by before entirety
Move, obtain satisfied traction and spinal cord decompression effect, operation technique is also simpler.Where described oblique through hole 54 is designed to
The angle of axis and the regulation place axis of screw mandrel 51 is 40-60 degree, and the angular range can guarantee that the direction that centrum is lifted is in
In vertical direction.The controllable reach apparatus of anterior cervical vertebrae of the present invention can be equipped with more set lifting rods 5 and angle fixing glue 7, it is preferable that
Described lifting rod 5 and the number of angle fixing glue 7 are two or more, it is highly preferred that be more than three, most preferably,
It it is more than four, this is applied to the synchronous reach of multi-segmental centrum.Described slot type gag lever post 4 is used to realize lifting rod 5
The position of length change and elementary proving lifting rod 5；In the case where regulation screw mandrel 51 and adjusting nut 52 coordinate, turn adjusting nut 52
The length for the section that lifting rod 5 is located at below slot type gag lever post can be changed, the length is adjusted in short-term, centrum reach；Slot type limits
Be not between the spacing hole 41 and lifting rod 5 of position bar 4 it is fixed, spacing hole 41 be capable of the position of elementary proving lifting rod 5 with
Its significantly rocking to periphery is prevented, this allows for lifting rod 5 can be to specific centrum along a correct fixed direction
Force drawing, the accuracy of operation is improved, operation is more controllable, and difficulty declines.The shape of described spacing hole 41 is unlimited, may be used also
To be the other shapes such as square, rhombus, but the circular home position that can preferably demarcate lifting rod 5；Between each spacing hole 41
In addition to being connected, it can also be independent mutually；Described spacing hole 41 is preferably designed to diameter and is more than regulation screw mandrel 51
Maximum gauge, lifting rod 5 directly can be from top to bottom inserted into spacing hole 41 by patient in operation, easily operated.
Described regulation screw mandrel 51, which is designed to include, adjusts 513 3 screw mandrel body 511, angular adjustment bar 512 and hold-doun nut parts,
The angular adjustment bar 512 of plurality of specifications can be so designed, their oblique through hole 54 is designed to different gradients, fully to meet hand
The different demands of art, the scope of application are wider.The first described screw fixed arm 11 and the angle of the first rack bridging arm 12 and
Second screw fixed arm 21 and the angle of the second rack bridging arm 22 are designed as 120-160 degree, and fixed arm 1 and transfer arm 2
Shape is consistent, and the first screw fixed arm 11 is parallel with the second screw fixed arm 21, and slot type gag lever post 4 is located at the lower section of rack 3, with
Rack 3 is parallel, and above design can expose surgical field of view well, facilitate the operation of the specific art formula.Described adjusting nut
52 upper ends design nut swing handle 53, and connected by internal-external hexagon structure matching, described angle fixing glue 7 arranges regulation spanner
8, and connected by internal-external hexagon structure matching, above design can facilitate operation technique, shorten operating time.Described movement
Sliding block 23 is provided with lock banking stop 233, the design simple structure of lock banking stop 233, can play good braking action, and be easy to grasp
Control.
It is using the controllable reach apparatus row OPLL of the anterior cervical vertebrae of the present invention concrete operations performed the operation：First according to iconography
Data is determined to need the section where the centrum section of integral forward lead, loaded onto respectively on the centrum on the outside of the section both ends in art
Centrum screws 6, fixed arm 1, transfer arm 2 are adjusted to suitable spacing through mobile sliding block 23, are then fitted on centrum screw 6,
In the preceding trackside side for the centrum that need to the move forward regulation fixed angle fixing glue 7 of spanner 8, lifting rod 5 is from top to bottom inserted into properly
In the spacing hole 41 of position, the suitable angular adjustment bar 512 of oblique through hole gradient is then selected to be assembled with angle fixing glue 7, then
By the secured adjusted screw mandrel body 511 of hold-doun nut 513 and angular adjustment bar 512, so far assembling is completed, and turns nut swing handle
53, adjusting nut 52 rotates, and then the length of the regulation screw mandrel 51 below slot type gag lever post shortens, then drives angle indirectly
Fixing glue 7 moves forward vertically upward, that is, completes the reach of centrum.
Embodiment 2
Referring to Fig. 4, Fig. 4 is the controllable reach apparatus structural representation of anterior cervical vertebrae of the embodiment of the present invention 2.The present embodiment
The controllable reach apparatus structure of anterior cervical vertebrae and the controllable reach apparatus structure of anterior cervical vertebrae described in embodiment 1 are essentially identical, different
Part is only that：First, the controllable reach apparatus of described anterior cervical vertebrae is additionally provided with synchronous lifting component 9；Described synchronous lifting
Component 9 includes the first Synchronous lifting bar 91, the second Synchronous lifting bar 92 and slot type fix bar 93；The first described Synchronous lifting bar
91 and second Synchronous lifting bar 92 it is parallel with the first screw fixed arm 11.The first described Synchronous lifting bar 91 is included positioned at upper
The first synchronous threaded rod 911 and the first synchronous polished rod 912 positioned at lower end at end, the described first synchronous lower end of polished rod 912 turn
It is dynamic to be connected in the first rack bridging arm 12；The second described Synchronous lifting bar 92 includes the second synchronous threaded rod positioned at upper end
921 and the second synchronous polished rod 922 positioned at lower end, the described second synchronous lower end of polished rod 922 be rotatably connected on slot type gag lever post 4
Positioned at the end in the outside of the second rack bridging arm 22.Described slot type fix bar 93 is parallel with slot type gag lever post 4；Slot type fix bar
93 both ends are respectively provided with a through hole, are connected by the synchronous screw thread of threaded rod 921 of through hole threaded rod 911 and second synchronous with first
Connect；The center of slot type fix bar 93 is provided with up/down perforation and the axially fixing groove 931 parallel with slot type gag lever post 4, described fixation
Groove 931 is a rectangular slot.Second, the upper end of the regulation screw mandrel 51 of described lifting rod 5 is inserted in fixing groove 931, regulation
Nut 52 is located at the lower section of slot type fix bar 93, and fixing nut 94 is socketed in the upper end of regulation screw mandrel 51, by with adjusting nut 52
Coordinate and fix regulation screw mandrel 51 with the phase of slot type fix bar 93.The first described synchronous 911 and second synchronous threaded rod of threaded rod
921 upper end, which is equipped, is adjusted in synchronism swing handle 95.
Referring to Fig. 5, Fig. 5 is the schematic diagram of the first indicating graduation.The first described synchronous (not shown) of threaded rod 911
The first indicating graduation 96 is equipped with synchronous threaded rod 921 with second.
In the present embodiment：Synchronous lifting component 9 is added, this is very suitable for multi-segmental centrum and synchronously lifted, can be really
The uniformity of each section centrum dip direction is protected, uniformly lifting is realized, the injury to centrum can be mitigated, it is general to reduce complication generation
Rate, the troublesome operation lifted one by one is also eliminate the need, both improve surgical effect, saved the time again.In this embodiment, due to
It is that lifting operation is performed by synchronously lifting component 9, therefore described lifting rod 5 can not have to the spiral shell for being designed to that screw thread is socketed
Female screw structure, it may be designed as single bar structure, as long as ensureing that lifting rod 5 can be relative to groove in the case where other assemblies coordinate
Formula fix bar 93 is fixed.Described fixing groove 931 is rectangle, inner wall smooth, is easy to assembling and the position of lifting rod 5
Fine setting.The first described indicating graduation 96 is used to indicate lifted distance, realizes quantitative controllable centrum reach, improves operation
Accuracy.
The upper end of lifting rod 5 is fixed on slot type and consolidated by the controllable reach apparatus of anterior cervical vertebrae of the present embodiment in surgical procedure
In fixed pole 93, swing handle 95 is then adjusted in synchronism come the centrum that moves forward by turn, understands vertebra by observing the first indicating graduation 96
The height of body reach.Due to two synchronous adjustment swing handles 95, therefore can realize all centrums wait height lifting, also may be used
To realize the highly stepping lifting of all centrums reaches, patient's vertebra state can be better adapted to, suitable for different characteristic
Ossified posterior longitudinal ligament operation.
Embodiment 3
Referring to Fig. 6, Fig. 6 is the controllable reach apparatus structural representation of anterior cervical vertebrae of the embodiment of the present invention 3.The present embodiment
The controllable reach apparatus structure of anterior cervical vertebrae and the controllable reach apparatus structure of anterior cervical vertebrae described in embodiment 2 are essentially identical, different
Part is only that：The outer wall of adjusting nut 52 of described lifting rod 5 is provided with the second indicating graduation 55.The second described instruction is carved
Degree 55 helps to judge the reach distance of centrum corresponding to every lifting rod 5 respectively, is easy to patient to make more accurate judgement, enters
One step improves the accuracy of operation technique.
Embodiment 4
Referring to Fig. 7, Fig. 7 is the controllable reach apparatus structural representation of anterior cervical vertebrae of the embodiment of the present invention 4.The present embodiment
The controllable reach apparatus structure of anterior cervical vertebrae and the controllable reach apparatus structure of anterior cervical vertebrae described in embodiment 1 are essentially identical, different
Part is only that：The regulation screw mandrel 51 of described lifting rod 5 is only single screw structure, and does not include angular adjustment bar and fixation
Nut structure.The outer wall of lifting rod 5 of the structure is bright and clean, is easy to sterilize, preparation technology is simpler.The regulation screw mandrel 51 can be set
Different size is counted into, their oblique through hole 54 is designed to different gradients, to meet the different demands of operation.
Described above is only the preferred embodiment of the present invention, it is noted that for the ordinary skill people of the art
Member, on the premise of the inventive method is not departed from, can also make some improvement and supplement, and these are improved and supplement also should be regarded as
Protection scope of the present invention.
Claims (10)
- A kind of 1. controllable reach apparatus of anterior cervical vertebrae, it is characterised in that provided with fixed arm, transfer arm, rack, slot type gag lever post and Lifting rod；Described fixed arm is provided with the first screw fixed arm and the first rack bridging arm, and described transfer arm is provided with the second spiral shell Follow closely fixed arm, the second rack bridging arm and mobile sliding block；The first described screw fixed arm and the lower end of the second screw fixed arm Assemble centrum screw；Described rack one end is fixed in the first rack bridging arm, and the other end passes through the second rack bridging arm With the first through hole common to mobile sliding block so that described transfer arm can relative rack slip；Described slot type gag lever post one End is fixed in the first rack bridging arm, and the other end passes through the second through hole of the second rack bridging arm so that described transfer arm Can relative slot type gag lever post slip；Described lifting rod is inserted in the stopper slot of slot type gag lever post, and lifting rod is provided with and socket-connected Regulation screw mandrel and adjusting nut, in the top of stopper slot, described lifting rod lower end is provided with oblique described adjusting nut interim card Shape through hole, described oblique through hole mounted inside angle fixing glue.
- 2. the controllable reach apparatus of anterior cervical vertebrae according to claim 1, it is characterised in that before described anterior cervical vertebrae is controllable Move apparatus and be additionally provided with synchronous lifting component；Described synchronous lifting component includes the first Synchronous lifting bar, the second Synchronous lifting bar With slot type fix bar；The first described Synchronous lifting bar includes first positioned at the first synchronous threaded rod of upper end and positioned at lower end Synchronous polished rod, the described first synchronous polished rod lower end are rotatably connected in the first rack bridging arm；The second described Synchronous lifting Bar includes the second synchronous threaded rod positioned at upper end and the second synchronous polished rod positioned at lower end, the described second synchronous polished rod lower end It is rotatably connected on slot type gag lever post；The both ends of described slot type fix bar are threaded in the first synchronous threaded rod and respectively On two synchronous threaded rods；Slot type fix bar is provided with fixing groove；Described regulation screw mandrel upper end passes through adjusting nut and fixed spiral shell Mother mutually fixes with slot type fix bar.
- 3. the controllable reach apparatus of anterior cervical vertebrae according to claim 2, it is characterised in that the first described synchronous threaded rod Or second synchronous threaded rod be provided with the first indicating graduation.
- 4. the controllable reach apparatus of anterior cervical vertebrae according to claim 1, it is characterised in that described lifting rod and angle is consolidated Surely the number followed closely is more than three.
- 5. the controllable reach apparatus of anterior cervical vertebrae according to claim 4, it is characterised in that described slot type gag lever post is provided with Some stopper slots, described stopper slot for circle, and each stopper slot be connected with each other it is logical.
- 6. the controllable reach apparatus of anterior cervical vertebrae according to claim 1 or 2, it is characterised in that described adjusting nut Outer wall is provided with the second indicating graduation.
- 7. the controllable reach apparatus of anterior cervical vertebrae according to claim 1, it is characterised in that described regulation screw mandrel includes adjusting Screw mandrel body, angular adjustment bar and hold-doun nut are saved, regulation screw mandrel body is connected with angular adjustment bar by hold-doun nut, described Oblique through hole be located on angular adjustment bar.
- 8. the controllable reach apparatus of anterior cervical vertebrae according to claim 1, it is characterised in that the first described screw fixed arm And the first angle between rack bridging arm is 120-160 degree, the second described screw fixed arm and the second rack bridging arm it Between angle be 120-160 degree, described fixed arm is consistent with transfer arm shape.
- 9. the controllable reach apparatus of anterior cervical vertebrae according to claim 1, it is characterised in that match somebody with somebody described adjusting nut upper end Provided with nut swing handle, described nut swing handle is interior hexagonal structure, is matched with outer six square joint of adjusting nut upper end.
- 10. the controllable reach apparatus of anterior cervical vertebrae according to claim 1, it is characterised in that described angle fixing glue tail Hold as outer six square joint and arrange regulation spanner, described regulation spanner head end is interior hexagonal structure.
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| CN201710729235.8A CN107432764B (en) | 2017-08-23 | 2017-08-23 | Anterior cervical vertebrae controllably moves forward instrument |
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| CN201710729235.8A CN107432764B (en) | 2017-08-23 | 2017-08-23 | Anterior cervical vertebrae controllably moves forward instrument |
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| CN111603229A (en) * | 2020-05-28 | 2020-09-01 | 上海长征医院 | Multifunctional novel pedicle screw assembly |
| CN111603228A (en) * | 2020-05-28 | 2020-09-01 | 上海长征医院 | Novel lumbar vertebra fixing and supporting device |
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| Publication number | Publication date |
|---|---|
| CN107432764B (en) | 2019-07-12 |
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