CN110638494A - Novel intervertebral fusion expandable sleeve device under split type percutaneous spinal endoscope - Google Patents
Novel intervertebral fusion expandable sleeve device under split type percutaneous spinal endoscope Download PDFInfo
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- CN110638494A CN110638494A CN201910933481.4A CN201910933481A CN110638494A CN 110638494 A CN110638494 A CN 110638494A CN 201910933481 A CN201910933481 A CN 201910933481A CN 110638494 A CN110638494 A CN 110638494A
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- stage sleeve
- sleeve
- guide rod
- expansion guide
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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
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- 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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/00336—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means with a protective sleeve, e.g. retractable or slidable
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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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/0034—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
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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
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
- A61B2017/0256—Joint distractors for the spine
- A61B2017/0262—Joint distractors for the spine with a provision for protecting nerves
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- 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
- A61B2034/2068—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis using pointers, e.g. pointers having reference marks for determining coordinates of body points
Abstract
The invention discloses a novel split type expandable sleeve device for intervertebral fusion under percutaneous spinal endoscopy, which belongs to the field of medical instruments and comprises a first-stage sleeve, a second-stage sleeve and a third-stage sleeve with diameters increasing in sequence, and a first expansion guide rod, a second expansion guide rod and a third expansion guide rod which correspond to the first-stage sleeve, the second-stage sleeve and the third-stage sleeve respectively; the invention avoids the injury of organism soft tissue caused by repeated insertion due to the need of integrally replacing the operation channel in the operation process; the arc-shaped sleeve structure can pass through the lumbar soft tissue space to reach the vertebral body space (intervertebral disc) to achieve the function of opening the vertebral body space, thereby being beneficial to expanding the operation space and implanting the intervertebral fusion cage; meanwhile, all the sleeves can keep a closed sleeve structure and can be used together with sealing caps with different diameters, so that an operator can directly use the sleeve as an endoscope sleeve, and the practicability and the functionality of the endoscope sleeve are improved.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to a novel split type expandable sleeve device for intervertebral fusion under percutaneous spinal endoscopy.
Background
The lumbar degenerative disease is a spinal mid-axis osseous organic lesion caused by age increase and injury accumulation, mainly affects nerve structures in intervertebral discs, ligaments and vertebral canals, including a series of diseases such as lumbar disc herniation and lumbar spinal stenosis, and often causes limb pain, numbness and weakness, even paralysis, and influences normal life and work of patients. The disease has complex pathogenic mechanism, high morbidity and wide sick population, is a frequently encountered disease which troubles the health of human beings and becomes the main reason of medical expenditure, absenteeism and disability of the masses. Especially, the morbidity of physical workers in rural areas is higher. Patients with lumbar degenerative diseases with poor conservative treatment effect often need surgical treatment. The prior surgical treatment is mainly open surgery, and has good clinical curative effect, but the traditional surgical treatment has large trauma, much bleeding and slow postoperative recovery, and the damage of the normal spinal structure caused by iatrogenic property in the operation often causes or aggravates the body injury. How to reduce surgical trauma, reduce complications and accelerate patient recovery while ensuring good treatment effect is a world problem to be solved urgently in the field of orthopedics.
The minimally invasive surgery is the key to solve the problems, and the endoscopic open spine surgery is an important way to realize the minimally invasive surgery. An aqueous medium spinal endoscope operating system developed by Anthony Yeung in 2000 is implanted into an operating sleeve with the diameter of about 7mm through a small skin incision and a muscle soft tissue and a lumbar intervertebral foramen, is implanted into a spinal endoscope and an operating instrument through the operating sleeve to perform discectomy decompression, reaches a protruded nucleus pulposus part and performs accurate discectomy, has small surgical trauma, is called a spinal minimally invasive surgery technology with real meaning, and lays the foundation of the modern percutaneous spinal endoscope operation technology. However, because the original natural gap of the spine is small, the existing spine endoscope operation channel is thin and fixed, and the application of the technology is greatly limited due to the difficulty in passing through the existing intervertebral fusion device and instrument with matched specifications. For the seriously degenerated patients, the intervertebral fusion device and the bone fusion are required to be implanted to maintain the stability of the spinal segment, so the spinal endoscopic technology cannot be applied to operation.
Disclosure of Invention
Aiming at the defects of the prior art, the invention provides a novel split type expandable sleeve device for intervertebral fusion under percutaneous spinal endoscopy, and the specific technical scheme is as follows:
a novel split type expandable sleeve device for intervertebral fusion under percutaneous spinal endoscopy comprises a first-stage sleeve, a second-stage sleeve and a third-stage sleeve with diameters increasing in sequence, and a first expansion guide rod, a second expansion guide rod and a third expansion guide rod which correspond to the first-stage sleeve, the second-stage sleeve and the third-stage sleeve respectively; the first-stage sleeve, the second-stage sleeve and the third-stage sleeve are all formed by clamping two parts with the same structure, and the first expansion guide rod, the second expansion guide rod and the third expansion guide rod are all hollow;
the first-stage sleeve comprises a first clamping ring, a first connecting ring, a first clamping rail arranged on the inner side of the first clamping ring and a first clamping groove which is arranged on the inner side of the first connecting ring and corresponds to the first clamping rail, the second-stage sleeve comprises a second clamping ring, a second connecting ring, a second clamping rail arranged on the inner side of the second clamping ring and a second clamping groove which is arranged on the inner side of the second connecting ring and corresponds to the first clamping rail and the second clamping rail, the third-stage sleeve comprises a third clamping ring, a third connecting ring, a third clamping rail arranged on the inner side of the third clamping ring and a third clamping groove which is arranged on the inner side of the third connecting ring and corresponds to the second clamping rail and the third clamping rail.
In the process of applying the spinal endoscope technology to perform lumbar nerve decompression and interbody fusion on a patient, an operator pastes the hollow first expansion guide rod to be implanted to a target point position along a targeted accurate guide wire when implanting the first-stage sleeve, implants the first expansion guide rod into the spinal endoscope operation channel after taking out the first expansion guide rod, and extirpates a herniated disc under continuous 0.9% physiological saline infusion to complete nerve decompression. The decompression accomplishes back art person and takes out backbone scope operating system, inhales to remain behind the perfusate in the sleeve and inserts first expansion guide rod in the telescopic inner chamber of first order, follows the draw-in groove and takes out first connecing ring from first snap ring, makes the second connect the ring subsides clothes and with the help of first expansion guide rod struts the soft tissue and puts into to the target position to the cooperation through first joint rail and second joint groove connects the ring with the telescopic second of second level and installs on first snap ring. Then the first snap ring is taken off to the art person, installs the telescopic second of second level meets the ring on the second snap ring through the cooperation in second joint rail and second joint groove, enlarges the sleeve internal diameter and keeps the sleeve for airtight structure simultaneously, reduces because of the waist soft tissue damage that the sleeve caused is taken out to the spot and examine repeatedly.
If the sleeve endoscope does not meet the requirement of placing the intervertebral fusion instrument, the second-stage sleeve and the third-stage sleeve are further replaced in sequence, and the sleeve endoscope is expanded while the sleeve endoscope is kept in a closed sleeve structure. The same operation person takes out the first expansion guide rod and inserts the second expansion guide rod into the inner cavity of the second-stage sleeve, the lower second connecting ring is extracted from the second clamping ring, and the third connecting ring of the third-stage sleeve is arranged on the second clamping ring through the matching of the second clamping rail and the third clamping groove. Then the second clamping ring is drawn out from the gap of the lumbar tissue, the third clamping rail is guided by the second expansion guide rod to be matched with the third clamping groove, and the third connecting ring of the third-stage sleeve is arranged on the third clamping ring. Because the stable supporting effect of the first expansion guide rod inserted into the first-stage sleeve, the waist tissue gap can still keep the expanded state when the first connecting ring and the first snap ring are taken down, and because the stable supporting effect of the second expansion guide rod inserted into the second-stage sleeve, the waist tissue gap can still keep the expanded state when the second connecting ring and the second snap ring are taken down, and the damage to the waist soft tissue caused by repeated spot check of the sleeve is reduced.
Preferably, the expansion guide rod further comprises a fourth-stage sleeve and a fourth expansion guide rod corresponding to the fourth-stage sleeve, wherein the fourth-stage sleeve comprises a fourth clamping ring, a fourth connecting ring, a fourth clamping rail arranged on the inner side of the fourth clamping ring and a fourth clamping groove arranged on the inner side of the fourth connecting ring and corresponding to the third clamping rail and the fourth clamping rail.
In the invention, when an operator takes out the second expansion guide rod and inserts the third expansion guide rod into the inner cavity of the third-stage sleeve, the third connecting ring is taken down from the third clamping ring, and the fourth connecting ring of the fourth-stage sleeve is arranged on the third clamping ring through the matching of the third clamping rail and the fourth clamping groove. Then take out the third snap ring to install the telescopic fourth of fourth level and connect the ring on the fourth snap ring through the cooperation in fourth joint rail and fourth joint groove, form airtight sleeve structure, cooperate normal saline to fill and seal the cap and use and can keep the malleation to do benefit to as backbone scope operation passageway implementation operation.
Preferably, the outsides of the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve are respectively provided with a single-side handle.
The handle arranged outside the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve is convenient for an operator to press, push, rotate or pull the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve in the operation process.
Preferably, the front ends of the first expanding guide rod, the second expanding guide rod, the third expanding guide rod and the fourth expanding guide rod are all provided with an X-ray developing body, and the X-ray developing body is made of metal.
The X-ray developing body is arranged at the front ends of the first expansion guide rod, the second expansion guide rod, the third expansion guide rod and the fourth expansion guide rod, so that an operator can conveniently insert the X-ray developing body into the corresponding sleeve and expand the gap of the soft tissue of the waist, the injury to the waist tissue of the patient is reduced in the insertion process, the practicability and the use safety of the X-ray developing body are improved, and meanwhile, the position and the direction can be displayed on an X-ray fluoroscopy machine instrument in the operation through the X-ray developing body made of metal, and the operator can conveniently and clearly know the position in the operation.
Preferably, the materials adopted by the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve are all medical stainless steel or carbon fiber.
The invention adopts the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve which are made of medical stainless steel or carbon fiber, so that the hardness and the use strength of the invention are improved on the premise of meeting the medical operation sanitation, and different requirements of operators are met.
Preferably, the open ends of the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve are respectively provided with a sealing cap, and a sealing hole is formed in each sealing cap.
According to the invention, the sealing caps arranged at the opening ends of the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve are used for reducing the leakage of liquid in the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve as much as possible so as to improve the internal water pressure, and the operation of the spinal endoscope system is favorably implemented.
Preferably, the front ends of the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve are provided with inserting inclined planes.
According to the invention, the inserting slopes arranged at the front ends of the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve are used for improving the sharpness of the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve, so that an operator can conveniently insert the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve into lumbar tissues, the operation efficiency is improved, and tissue damage is reduced.
Preferably, the outside and the first expansion guide rod, the second expansion guide rod, the third expansion guide rod and the fourth expansion guide rod of the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve are provided with scales.
According to the invention, through the scales arranged at the outer sides of the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve and at the outer sides of the first expansion guide rod, the second expansion guide rod, the third expansion guide rod and the fourth expansion guide rod, an operator can observe and know the insertion depths of the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve, the first expansion guide rod, the second expansion guide rod, the third expansion guide rod and the fourth expansion guide rod in the operation process.
As the preferred, all be equipped with rather than swing joint's the handle of dismantling on first expansion guide rod, second expansion guide rod, third expansion guide rod and the fourth expansion guide rod, be convenient for the art person press, impel or pull first expansion guide rod, second expansion guide rod, third expansion guide rod and fourth expansion guide rod in the operation process to dismantle it when needs are dismantled, avoid influencing art person's follow-up operation.
The invention has the following beneficial effects:
the invention adopts the matching among the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve which are round and have sequentially increasing diameters and the matched guide rod thereof as a tool for expanding the waist soft tissue gap, and can provide a closed annular sleeve structure which can be applied as a spinal endoscope operation sleeve, so that in the process of performing lumbar nerve decompression and intervertebral fusion on a patient by an operator, the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve with different diameters are replaced under the condition that the lumbar tissue clearance is kept continuously expanded, so that the surgeon can use the surgical instruments with different sizes and specifications in the first-stage sleeve, the second-stage sleeve, the third-stage sleeve and the fourth-stage sleeve with different diameters, so as to complete the operation, and avoid the injury caused by repeated insertion and expansion of the lumbar tissue gap of the patient in the operation process;
the invention is applied to lumbar fusion under percutaneous spinal endoscopy, and can gradually enlarge the diameter of the operation channel by replacing the first-stage sleeve, the second-stage sleeve and the third-stage sleeve with different diameters at one side in sequence, so that an operator can use surgical instruments with different sizes and specifications in the first-stage sleeve, the second-stage sleeve and the third-stage sleeve with different diameters to complete the operation, thereby avoiding the soft tissue injury of the body caused by repeated insertion due to the need of integrally replacing the operation channel in the operation process; the round sleeve structure can be implanted into the soft tissue gap to achieve the function of opening the soft tissue gap through rotation, thereby being beneficial to expanding the operation space and implanting the interbody fusion cage; meanwhile, all the sleeves can keep a closed sleeve type structure, and an operator can directly use the sleeve as an endoscope sleeve, so that the practicability and the functionality of the endoscope sleeve are improved.
Drawings
FIG. 1 is a schematic structural view of the present invention;
FIG. 2 is a schematic view of the first snap ring and the first connecting ring of the present invention;
FIG. 3 is a schematic view of the first snap ring and the second connecting ring of the present invention;
FIG. 4 is a schematic view of a second snap ring and a second adapter ring according to the present invention;
FIG. 5 is a schematic view of the second snap ring and the third connecting ring of the present invention;
FIG. 6 is a schematic view of a third snap ring and a third adapter ring according to the present invention;
FIG. 7 is a schematic view of a third snap ring and a fourth adapter ring according to the present invention;
FIG. 8 is a schematic view of a fourth snap ring and a fourth adapter ring according to the present invention;
FIG. 9 is an enlarged view of a portion of FIG. 2 at A;
FIG. 10 is an enlarged view of a portion of FIG. 3 at B;
FIG. 11 is an enlarged view of a portion of FIG. 4 at C;
FIG. 12 is an enlarged view of a portion of FIG. 5 at D;
FIG. 13 is an enlarged view of a portion of FIG. 6 at E;
FIG. 14 is an enlarged view of a portion of FIG. 7 at F;
FIG. 15 is an enlarged view of a portion of FIG. 8 at G;
FIG. 16 is a schematic view of the first stage sleeve and the first expandable guide rod during use;
figure 17 is a schematic view of a second stage sleeve in use with an endoscopic spinal system.
Detailed Description
The principles and features of this invention are described below in conjunction with the following drawings, which are set forth by way of illustration only and are not intended to limit the scope of the invention.
Examples
Referring to fig. 1 to 17, the present invention comprises a first stage sleeve 1, a second stage sleeve 2, a third stage sleeve 3, a fourth stage sleeve 4 with sequentially increasing diameters, and a first expansion guide rod 5, a second expansion guide rod 6, a third expansion guide rod 7 and a fourth expansion guide rod 8 for assisting in expanding the lumbar tissue space of a patient and corresponding to the first stage sleeve 1, the second stage sleeve 2, the third stage sleeve 3 and the fourth stage sleeve 4, respectively. First order sleeve 1, second level sleeve 2, third level sleeve 3 and fourth level sleeve 4 are constituteed by the same two parts joint of structure, and stick 5 is the cavity form for first expansion is led to first order sleeve 1, second level sleeve 2, third level sleeve 3 and fourth level sleeve 4 adopt the material be medical stainless steel or carbon fiber. According to the medical sleeve, the first-stage sleeve 1, the second-stage sleeve 2, the third-stage sleeve 3 and the fourth-stage sleeve 4 are made of medical stainless steel or carbon fiber, so that the hardness and the use strength of the medical sleeve are improved on the premise of meeting the medical operation hygiene, and different requirements of operators are met.
With further reference to fig. 2 to 4 and 9 to 11, the first-stage sleeve 1 includes a first snap ring 11, a first connecting ring 12, a first clamping rail 13 disposed inside the first snap ring 11, and a first clamping groove 14 disposed inside the first connecting ring 12 and corresponding to the first clamping rail 13, the first snap ring 11 and the first connecting ring 12 are both in a half-open ring shape, the inner diameter of the first-stage sleeve 1 is 8mm, and the thickness of the first-stage sleeve 1 is 2 mm. The second-stage sleeve 2 comprises a second clamping ring 21, a second connecting ring 22, a second clamping rail 23 arranged on the inner side of the second clamping ring 21 and a second clamping groove 24 which is arranged on the inner side of the second connecting ring 22 and corresponds to the first clamping rail 13 and the second clamping rail 23, the second clamping ring 21 and the second connecting ring 22 are in a half-open ring shape, the inner diameter of the second-stage sleeve 2 is 10mm, and the thickness of the second-stage sleeve 2 is 2 mm.
Further referring to fig. 1, the outer sides of the first-stage sleeve 1, the second-stage sleeve 2, the third-stage sleeve 3 and the fourth-stage sleeve 4 are respectively provided with a unilateral handle 9, and the handle arranged on the outer sides of the first-stage sleeve 1, the second-stage sleeve 2, the third-stage sleeve 3 and the fourth-stage sleeve 4 is convenient for an operator to press, push or pull the first-stage sleeve 1, the second-stage sleeve 2, the third-stage sleeve 3 and the fourth-stage sleeve 4 in the operation process. The front ends of the first expansion guide rod 5, the second expansion guide rod 6, the third expansion guide rod 7 and the fourth expansion guide rod 8 are all provided with an X-ray developing body 10, and the X-ray developing body 10 is made of metal, so that an operator can insert the X-ray developing body into a corresponding sleeve and a gap of lumbar tissues conveniently by the X-ray developing body arranged at the front ends of the first expansion guide rod 5, the second expansion guide rod 6, the third expansion guide rod 7 and the fourth expansion guide rod 8, and the lumbar tissues of the patient cannot be injured in the inserting process, the practicability and the use safety of the X-ray developing body are improved, and meanwhile, the position can be displayed on an X-ray developing machine instrument in the operation by the X-ray developing body made of metal, so that the operator can observe the position and the direction of the X-ray developing body.
The open ends of the first-stage sleeve 1, the second-stage sleeve 2, the third-stage sleeve 3 and the fourth-stage sleeve 4 are respectively provided with a sealing cap 110, and sealing holes are formed in the sealing caps. The front ends of the first-stage sleeve 1, the second-stage sleeve 2, the third-stage sleeve 3 and the fourth-stage sleeve 4 are all provided with insertion inclined planes 111 for separating soft tissues, and the angle of the insertion inclined planes 111 is 30 degrees. According to the invention, the insertion inclined planes 111 arranged at the front ends of the first-stage sleeve 1, the second-stage sleeve 2, the third-stage sleeve 3 and the fourth-stage sleeve 4 are respectively composed of two inclined planes with the same structure, so that the sharpness of the first-stage sleeve 1, the second-stage sleeve 2, the third-stage sleeve 3 and the fourth-stage sleeve 4 is improved, an operator can conveniently insert the first-stage sleeve 1, the second-stage sleeve 2, the third-stage sleeve 3 and the fourth-stage sleeve 4 into a waist tissue gap, the operation efficiency is improved, and the soft tissue injury is reduced. The scales 112 are arranged on the outer sides of the first-stage sleeve 1, the second-stage sleeve 2, the third-stage sleeve 3 and the fourth-stage sleeve 4 and the outer sides of the first expansion guide rod 5, the second expansion guide rod 6, the third expansion guide rod 7 and the fourth expansion guide rod 8, and scales 112 are arranged on the outer sides of the first-stage sleeve 1, the second-stage sleeve 2, the third-stage sleeve 3 and the fourth-stage sleeve 4 and the outer sides of the first expansion guide rod 5, the second expansion guide rod 6, the third expansion guide rod 7 and the fourth expansion guide rod 8, so that an operator can observe and know the insertion depth of the first-stage sleeve 1, the second-stage sleeve 2, the third-stage sleeve 3 and the fourth-stage sleeve 4 and the first expansion guide rod 5, the second expansion guide rod 6, the third expansion guide rod 7 and the fourth expansion guide rod 8 in the operation process.
All be equipped with on first expansion guide rod 5, second expansion guide rod 6, third expansion guide rod 7 and the fourth expansion guide rod 8 rather than swing joint can dismantle handle 113, be convenient for the art person press in the operation process, impel or pull, take out first expansion guide rod 5, second expansion guide rod 6, third expansion guide rod 7 and fourth expansion guide rod 8 to dismantle it when needs are demolishd, avoid influencing art person's follow-up operation. In the process of lumbar nerve decompression and intervertebral fusion of a patient, an operator inserts a first expansion guide rod 5 into a lumbar tissue gap along guide wire guide and obtusely expands the lumbar tissue gap in the operation, implants a first-stage sleeve 1 to a target position along the first expansion guide rod 5 after the position and direction of the first expansion guide rod 5 are satisfied by displaying on an X-ray fluoroscopy machine instrument in the operation, takes out the first expansion guide rod 5 and replaces the first expansion guide rod with a spine endoscope operating system to carry out the discectomy and the neural decompression operation, after the decompression operation is finished, the operator takes out the spine endoscope operating system and inserts the first expansion guide rod 5 along the first-stage sleeve 1 to expand and support soft tissues, extracts a lower first connecting ring 12 from a first snap ring 11, and the second connecting ring 22 of the second-stage sleeve 2 is arranged on the first snap ring 11 through the matching of the first snap rail 13 and the second snap groove 24. Then, the first snap ring 11 is drawn out from the lumbar tissue gap, and the second snap ring 21 of the second-stage sleeve 2 is mounted on the second connecting ring 22 through the cooperation of the second snap rail 23 and the second snap groove 24. Because the stable supporting effect of the first expansion guide rod 5 inserted into the first-stage sleeve 1, after the first connecting ring 12 and the first clamping ring 11 are taken down, the opening state can be kept when the second-stage sleeve 2 is inserted into the waist gap through sequential half-side replacement, the damage to soft tissues is reduced, and meanwhile, the position stability of the operation channel is ensured.
Referring further to fig. 5 to 8, and 11 to 15, the third stage sleeve 3 includes a third snap ring 31, a third snap ring 32, a third snap rail 33 disposed inside the third snap ring 31, and a third snap groove 34 disposed inside the third snap ring 32 and corresponding to both the second snap rail 23 and the third snap rail 33. The third snap ring 31 and the third adapter ring 32 are also shaped like half-opened rings, the inner diameter of the third stage sleeve 3 is 12mm, and the thickness of the third stage sleeve 3 is also 2 mm. The fourth stage sleeve 4 includes a fourth snap ring 41, a fourth joint ring 42, a fourth snap rail 43 disposed inside the fourth snap ring 41, and a fourth snap groove 44 disposed inside the fourth joint ring 42 and simultaneously corresponding to the third snap rail 33 and the fourth snap rail 43. The fourth snap ring 41 and the fourth adapter ring 42 are also shaped like half-opened rings, the inner diameter of the fourth stage sleeve 4 is 14mm, and the thickness of the fourth stage sleeve 4 is also 2 mm.
The same thing art person changes second level sleeve 2 to third level sleeve 3, takes out first expansion guide rod 5 earlier and changes into second expansion guide rod 6 to second level sleeve 2 in, extracts second from second snap ring 21 down and connects ring 22 to install third of third level sleeve 3 and connect ring 32 on second snap ring 21 through the cooperation of second joint rail 23 and third joint groove 34. The second snap ring 21 is then extracted from the lumbar soft tissue space, and the third snap ring 31 of the third stage sleeve 3 is mounted on the third snap ring 32 by the cooperation of the third snap rail 33 and the third snap groove 34. Due to the stable supporting function of the second dilation guide bar 6 inserted into the lumbar tissue gap, the lumbar tissue gap is still maintained in the dilated state when the second adapter ring 22 and the second retainer ring 21 are sequentially extracted. When the operator replaces the third-stage sleeve 3 to the fourth-stage sleeve 4, the second expansion guide rod 6 is taken out first and replaced by a third expansion guide rod 7 to a third-stage sleeve 3, the third connecting ring 32 is extracted from the third clamping ring 31, and the fourth connecting ring 42 of the fourth-stage sleeve 4 is mounted on the third clamping ring 31 through the matching of the third clamping rail 33 and the fourth clamping groove 44. Then, the third snap ring 31 is extracted from the gap of the lumbar tissues, and the fourth snap ring 41 of the fourth-stage sleeve 4 is mounted on the fourth snap ring 42 through the cooperation of the fourth snap rail 43 and the fourth snap groove 44.
According to the invention, the circular first-stage sleeve 1, the circular second-stage sleeve 2 and the circular third-stage sleeve 3 with sequentially increasing diameters are adopted to be used as a tool for expanding the lumbar tissue gap, so that in the process of lumbar nerve decompression and intervertebral fusion of a patient, the lumbar tissue gap is replaced by the first-stage sleeve 1, the second-stage sleeve 2 and the third-stage sleeve 3 with different diameters under the condition of keeping the lumbar tissue gap continuously expanded, so that an operator can use surgical instruments with different sizes and specifications in the first-stage sleeve 1, the second-stage sleeve 2 and the third-stage sleeve 3 with different diameters to complete an operation, and the injury caused by repeated insertion and expansion of the lumbar tissue gap of the patient in the operation process is avoided; meanwhile, the first-stage sleeve 1, the second-stage sleeve 2 and the third-stage sleeve 3 which are in an annular closed structure are adopted, so that an operator can directly use the first-stage sleeve 1, the second-stage sleeve 2 and the third-stage sleeve 3 as endoscope sleeves in a closed state, and the practicability of the endoscope is further improved.
It is to be noted that, in this document, the terms "comprises", "comprising" or any other variation thereof are intended to cover a non-exclusive inclusion, so that an article or apparatus including a series of elements includes not only those elements but also other elements not explicitly listed or inherent to such article or apparatus. Without further limitation, an element defined by the phrase "comprising … …" does not exclude the presence of additional like elements in the article or device comprising the element.
The present invention is not limited to the above preferred embodiments, and any modifications, equivalent replacements, improvements, etc. within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (9)
1. The novel split type expandable sleeve device for intervertebral fusion under percutaneous spinal endoscopy is characterized by comprising a first-stage sleeve (1), a second-stage sleeve (2) and a third-stage sleeve (3) with diameters sequentially increasing, and a first expansion guide rod (5), a second expansion guide rod (6) and a third expansion guide rod (7) which respectively correspond to the first-stage sleeve (1), the second-stage sleeve (2) and the third-stage sleeve (3), wherein the first-stage sleeve (1), the second-stage sleeve (2) and the third-stage sleeve (3) are respectively formed by clamping two parts with the same structure, and the first expansion guide rod (5), the second expansion guide rod (6) and the third expansion guide rod (7) are all hollow;
the first-stage sleeve (1) comprises a first snap ring (11), a first connecting ring (12), a first clamping rail (13) arranged on the inner side of the first snap ring (11) and a first clamping groove (14) which is arranged on the inner side of the first connecting ring (12) and corresponds to the first clamping rail (13), the second-stage sleeve (2) comprises a second snap ring (21), a second connecting ring (22), a second clamping rail (23) arranged on the inner side of the second snap ring (21) and a second clamping groove (24) which is arranged on the inner side of the second connecting ring (22) and corresponds to the first clamping rail (13) and the second clamping rail (23) at the same time, and the third-stage sleeve (3) comprises a third clamping ring (31), a third connecting ring (32), a third clamping rail (33) arranged on the inner side of the third clamping ring (31) and a third clamping groove (34) which is arranged on the inner side of the third connecting ring (32) and corresponds to the second clamping rail (23) and the third clamping rail (33) at the same time.
2. The novel split type expandable sleeve device for the percutaneous endoscopic spine interbody fusion as claimed in claim 1, further comprising a fourth stage sleeve (4) and a fourth expansion guide rod (8) corresponding to the fourth stage sleeve (4), wherein the fourth stage sleeve (4) comprises a fourth snap ring (41), a fourth connecting ring (42), a fourth snap rail (43) disposed inside the fourth snap ring (41), and a fourth snap groove (44) disposed inside the fourth connecting ring (42) and simultaneously corresponding to the third snap rail (33) and the fourth snap rail (43).
3. The novel split type expandable sleeve device for the percutaneous spinal endoscopic intervertebral fusion according to claim 2, wherein the first-stage sleeve (1), the second-stage sleeve (2), the third-stage sleeve (3) and the fourth-stage sleeve (4) are provided with a single-side handle (9) at the outer sides.
4. The novel expandable sleeve device for the intervertebral fusion under the split type percutaneous spinal endoscope of claim 2, wherein the front ends of the first expansion guide rod (5), the second expansion guide rod (6), the third expansion guide rod (7) and the fourth expansion guide rod (8) are all provided with an X-ray developing body (10), and the X-ray developing body (10) is made of metal.
5. The novel split type expandable sleeve device for the percutaneous endoscopic spinal interbody fusion as claimed in claim 2, wherein the first-stage sleeve (1), the second-stage sleeve (2), the third-stage sleeve (3) and the fourth-stage sleeve (4) are made of medical stainless steel or carbon fiber.
6. The novel split type expandable sleeve device for the percutaneous spinal endoscopic interbody fusion as claimed in claim 2, wherein the open ends of the first-stage sleeve (1), the second-stage sleeve (2), the third-stage sleeve (3) and the fourth-stage sleeve (4) are respectively provided with a sealing cap (110), and a sealing hole (1101) is formed in the sealing cap (110).
7. The novel split type expandable sleeve device for the percutaneous spinal endoscopic intervertebral fusion according to claim 2, wherein the front ends of the first-stage sleeve (1), the second-stage sleeve (2), the third-stage sleeve (3) and the fourth-stage sleeve (4) are provided with insertion bevels (111).
8. The novel split type expandable sleeve device for the percutaneous endoscopic spinal interbody fusion as claimed in claim 2, wherein the outside of the first-stage sleeve (1), the second-stage sleeve (2), the third-stage sleeve (3) and the fourth-stage sleeve (4) and the outside of the first expansion guide rod (5), the second expansion guide rod (6), the third expansion guide rod (7) and the fourth expansion guide rod (8) are provided with scales (112).
9. The novel split type expandable sleeve device for the intervertebral fusion under the percutaneous spinal endoscope of claim 2, wherein the first expansion guide rod (5), the second expansion guide rod (6), the third expansion guide rod (7) and the fourth expansion guide rod (8) are respectively provided with a detachable handle (113) movably connected with the first expansion guide rod, the second expansion guide rod, the third expansion guide rod and the fourth expansion guide rod.
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| CN201910933481.4A CN110638494B (en) | 2019-09-29 | 2019-09-29 | Novel intervertebral fusion expandable sleeve device under split type percutaneous spinal endoscope |
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|---|---|---|---|---|
| CN111329536A (en) * | 2020-03-06 | 2020-06-26 | 重庆医科大学附属第二医院 | Visual working channel outer sleeve special for endoscopic surgery |
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