CN110638495B - Split type expansible percutaneous spinal endoscope is with intervertebral space sleeve device that struts - Google Patents
Split type expansible percutaneous spinal endoscope is with intervertebral space sleeve device that struts Download PDFInfo
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- CN110638495B CN110638495B CN201910934344.2A CN201910934344A CN110638495B CN 110638495 B CN110638495 B CN 110638495B CN 201910934344 A CN201910934344 A CN 201910934344A CN 110638495 B CN110638495 B CN 110638495B
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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
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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
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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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/90—Identification means for patients or instruments, e.g. tags
- A61B90/92—Identification means for patients or instruments, e.g. tags coded with colour
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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
- A61B2017/00336—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
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Abstract
The invention discloses a split type intervertebral space opening sleeve device for an expandable percutaneous spine endoscope, and belongs to the field of medical instruments. The device comprises a first-stage sleeve group, a second-stage sleeve group and a third-stage sleeve group which are same in shape and are increased in size in equal proportion, and a first expansion guide rod, a second expansion guide rod and a third expansion guide rod which respectively correspond to the first-stage sleeve group, the second-stage sleeve group and the third-stage sleeve group, wherein the first expansion guide rod, the second expansion guide rod and the third expansion guide rod are hollow, and the color of each stage of sleeve and the color of each stage of expansion guide rod are different; the invention can effectively open the intervertebral space and implant the intervertebral fusion cage to complete the operation; the sleeve is replaced step by step, so that the injury caused by repeated and repeated insertion and expansion of the lumbar tissue gap of the patient in the operation process is avoided; the closed annular structure enables an operator to directly use the closed annular structure as a sleeve of a spinal endoscope operation system, and improves the practicability and functionality of the invention.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to a intervertebral space distraction sleeve device for a split expandable percutaneous spine endoscope.
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 clearance of the spinal intervertebral space is small, the existing spinal endoscope operation channel is integrated, the internal channel is small, 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. In addition, the original operating sleeve device is circular, so that for patients with serious degeneration, intervertebral space reduction and nerve clamping tissues are reduced, intervertebral space expansion is needed in the operation, and an intervertebral fusion device is implanted into bone fusion to maintain the sequence and the stability of the spinal segment, and the conventional spinal endoscope technology cannot be applied to operation.
Disclosure of Invention
Aiming at the defects of the prior art, the invention provides a split type intervertebral space distraction sleeve device for an expandable percutaneous spine endoscope, which has the following specific technical scheme:
a split type expandable intervertebral space distraction sleeve device for a percutaneous spine endoscope comprises a first-stage sleeve group, a second-stage sleeve group and a third-stage sleeve group which are same in shape and are increased in size in equal proportion, and a first expansion guide rod, a second expansion guide rod and a third expansion guide rod which respectively correspond to the first-stage sleeve group, the second-stage sleeve group and the third-stage sleeve group, wherein the first expansion guide rod, the second expansion guide rod and the third expansion guide rod are hollow, and the colors of all stages of sleeves and expansion guide rods are different;
the first-stage sleeve group comprises a first-stage circular sleeve and a first-stage elliptical sleeve, the first-stage elliptical sleeve is elliptical, the minor axis of the first-stage elliptical sleeve is equal to the diameter of the first-stage circular sleeve, the major axis of the first-stage elliptical sleeve is larger than the diameter of the first-stage circular sleeve, the second-stage sleeve group comprises a second-stage circular sleeve and a second-stage elliptical sleeve, and the third-stage sleeve group comprises a third-stage circular sleeve and a third-stage elliptical sleeve;
the first-stage circular sleeve comprises a first circular clamping ring, a first circular connecting ring, a first circular clamping rail arranged on the inner side of the first circular clamping ring, a first circular clamping groove arranged on the inner side of the first circular connecting ring and corresponding to the first circular clamping rail, and the first-stage elliptical sleeve comprises a first elliptical clamping ring, a first elliptical connecting ring, a first elliptical clamping rail arranged on the inner side of the first elliptical clamping ring and corresponding to the first circular connecting ring, and a first elliptical clamping groove arranged on the inner side of the first elliptical connecting ring and corresponding to the first circular clamping rail and the first elliptical clamping rail;
the second-stage circular sleeve comprises a second circular clamping ring, a second circular connecting ring, a second circular clamping rail arranged on the inner side of the second circular clamping ring, a second circular clamping groove arranged on the inner side of the second circular connecting ring and corresponding to the second circular clamping rail, the second-stage elliptical sleeve comprises a second elliptical clamping ring, a second elliptical connecting ring, a second elliptical clamping rail arranged on the inner side of the second elliptical clamping ring and corresponding to the second circular connecting ring, and a second elliptical clamping groove arranged on the inner side of the second elliptical connecting ring and corresponding to the second circular clamping rail and the second elliptical clamping rail, and the second elliptical clamping rail is also matched with the first circular clamping groove and the first elliptical clamping groove for use;
the third-stage circular sleeve comprises a third circular clamping ring, a third circular connecting ring, a third circular clamping rail arranged on the inner side of the third circular clamping ring, a third circular clamping groove arranged on the inner side of the third circular connecting ring and corresponding to the third circular clamping rail, and the third-stage elliptical sleeve comprises a third elliptical clamping ring, a third elliptical connecting ring, a third elliptical clamping rail arranged on the inner side of the third elliptical clamping ring and corresponding to the third circular connecting ring, and a third elliptical clamping groove arranged on the inner side of the third elliptical connecting ring and corresponding to the third circular clamping rail and the third elliptical clamping rail; the third elliptical clamping rail is also matched with the second circular clamping groove and the second elliptical clamping groove for use.
Preferably, the inner sides of the first-stage circular sleeve, the first-stage elliptical sleeve, the second-stage circular sleeve, the second-stage elliptical sleeve, the third-stage circular sleeve and the third-stage elliptical sleeve are all provided with an X-ray developing net.
Preferably, the X-ray imaging screen comprises a plurality of imaging wires arranged in parallel and imaging rings arranged perpendicular to the imaging wires.
Preferably, the front ends of the first expanding guide rod, the second expanding guide rod and the third expanding guide rod are all provided with X-ray developing bodies, and the X-ray developing bodies are made of metal.
Preferably, the first-stage sleeve group, the second-stage sleeve group and the third-stage sleeve group are respectively provided with a single-side handle at the outer side.
Preferably, the opening ends of the first-stage sleeve group, the second-stage sleeve group and the third-stage sleeve group are respectively provided with a sealing cap, and a sealing hole is formed in each sealing cap.
Preferably, scales are arranged on the outer sides of the first-stage sleeve group, the second-stage sleeve group and the third-stage sleeve group.
Preferably, the first expanding guide rod, the second expanding guide rod and the third expanding guide rod are respectively provided with a detachable handle movably connected with the first expanding guide rod, the second expanding guide rod and the third expanding guide rod.
Preferably, the outer sides of the front ends of the first-stage sleeve group, the second-stage sleeve group and the third-stage sleeve group are provided with inserting inclined planes.
Preferably, the materials adopted by the first-stage sleeve group, the second-stage sleeve group and the third-stage sleeve group are all medical novel polymer materials.
The invention has the following beneficial effects:
the invention adopts the matching among the circular and elliptical first-stage circular sleeve, the second circular sleeve, the third circular sleeve, the first elliptical sleeve, the second elliptical sleeve and the third elliptical sleeve with sequentially increasing diameters and the matched guide rods thereof, the elliptical sleeve implanted in the intervertebral space is rotated to be used as a tool for expanding the lumbar intervertebral space, and a closed annular sleeve structure can be provided to be used as a sleeve of a spinal endoscope operating system, so that an operator can perform lumbar nerve decompression on a patient and perform intervertebral fusion, the lumbar tissue space and the intervertebral space are replaced by adjacent groups among a first-stage sleeve group, a second-stage sleeve group and a third-stage sleeve group with different diameters under the condition of keeping the continuous expansion, so that the operator can use surgical instruments with different sizes and specifications in the first-stage sleeve group, the second-stage sleeve group and the third-stage sleeve group with different diameters, meanwhile, the intervertebral space can be effectively expanded, and the interbody fusion cage is implanted to complete the operation, so that the injury caused by repeated insertion and expansion of the lumbar tissue space of the patient in the operation process is avoided;
the invention is applied to lumbar fusion under percutaneous spinal endoscopy, can gradually enlarge the diameter of the operation channel by replacing the first elliptical sleeve, the second elliptical sleeve and the third elliptical sleeve with different diameters at one side in sequence, and can realize the expansion and the distraction of the lumbar intervertebral space of a patient by changing the long axis and the short axis direction of the elliptical sleeves in a rotating way, thereby being beneficial to enlarging the operation space of the operation and implanting an intervertebral fusion device and restoring the spinal sequence; meanwhile, all the sleeves can keep a closed sleeve type structure, and an operator can directly use the sleeve as a sleeve of a spinal endoscope operation system, so that the practicability and the functionality of the invention are improved.
Drawings
FIG. 1 is a schematic structural view of the present invention;
FIG. 2 is a schematic structural view of a first stage circular sleeve according to the present invention;
FIG. 3 is a schematic view of the first stage circular sleeve and the second stage circular sleeve of the present invention;
FIG. 4 is a schematic structural view of a second stage circular sleeve according to the present invention;
FIG. 5 is a schematic view of the second stage circular sleeve and the third stage circular sleeve of the present invention;
FIG. 6 is a schematic structural view of a third stage circular sleeve according to the present invention;
FIG. 7 is a schematic view of the first stage circular sleeve and the first stage oval sleeve of the present invention in combination;
FIG. 8 is a schematic view of a first stage oval sleeve according to the present invention;
FIG. 9 is a schematic view of the engagement of the first stage circular sleeve with the second stage elliptical sleeve of the present invention;
FIG. 10 is a schematic view of a second stage oval sleeve according to the present invention;
FIG. 11 is a schematic view of the engagement of a first stage circular sleeve with a first stage oval sleeve in accordance with the present invention;
FIG. 12 is a schematic view of the second stage elliptical sleeve of the present invention after installation;
FIG. 13 is a schematic view of the second stage circular sleeve and the third stage elliptical sleeve of the present invention mated together;
FIG. 14 is a schematic structural view of a third stage elliptical sleeve of the present invention;
FIG. 15 is an enlarged view of a portion of FIG. 2 at A;
FIG. 16 is an enlarged view of a portion of FIG. 3 at B;
FIG. 17 is an enlarged view of a portion of FIG. 4 at C;
FIG. 18 is an enlarged view of a portion of FIG. 5 at D;
FIG. 19 is an enlarged view of a portion of FIG. 6 at E;
FIG. 20 is an enlarged view of a portion of FIG. 7 at F;
FIG. 21 is an enlarged view of a portion of FIG. 8 at G;
FIG. 22 is an enlarged view of a portion of FIG. 9 at H;
FIG. 23 is an enlarged view of a portion of FIG. 10 at I;
FIG. 24 is an enlarged view of a portion of FIG. 11 at J;
FIG. 25 is an enlarged view of a portion of FIG. 12 at K;
FIG. 26 is an enlarged view of a portion of FIG. 13 at L;
FIG. 27 is an enlarged view of a portion of FIG. 14 at M;
FIG. 28 is a schematic view of the first stage circular sleeve and the first expandable guide rod in use;
figure 29 is a schematic structural view of a second stage circular sleeve in use with a spinal endoscope system;
FIG. 30 is a schematic view of the initial configuration of the first stage oval sleeve of the present invention;
FIG. 31 is a schematic structural view of a first stage elliptical sleeve rotated 45 to partially distract the intervertebral space in accordance with the present invention;
FIG. 32 is a schematic view of the first stage oval sleeve rotated 90 to distract the intervertebral space in accordance with the present invention.
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 32, the present invention includes a first stage sleeve group 1, a second stage sleeve group 2, a third stage sleeve group 3, and a first expansion guide rod 4, a second expansion guide rod 5, and a third expansion guide rod 6 corresponding to the first stage sleeve group 1, the second stage sleeve group 2, and the third stage sleeve group 3, respectively, which are identical in shape and are increased in size in equal proportion, and the first expansion guide rod 4, the second expansion guide rod 5, and the third expansion guide rod 6 are hollow so as to be matched with a guide wire to perform implant guidance and positioning of the first expansion guide rod 4, the second expansion guide rod 5, and the third expansion guide rod 6. And the materials adopted by the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3 are all medical novel high polymer materials. According to the invention, the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3 which are made of medical novel high polymer materials are adopted, so that the hardness and the use strength are improved on the premise of meeting the medical operation hygiene, the material cost is reduced, and the developing shielding of adjacent tissue structures and instruments can be avoided by permeating X rays so as to meet different requirements of operators. And the color of each stage of sleeve and the color of the expansion guide rod are different, so that the sleeve and the expansion guide rod are convenient for medical personnel to distinguish in the using process.
With further reference to fig. 2 to 14, the first stage sleeve set 1 comprises a first stage circular sleeve 11 and a first stage elliptical sleeve 12, the first stage elliptical sleeve 12 is elliptical and the minor axis of the first stage elliptical sleeve 12 is equal to the diameter of the first stage circular sleeve 11, the major axis of the first stage elliptical sleeve 12 is greater than the diameter of the first stage circular sleeve 11, the second stage sleeve set 2 comprises a second stage circular sleeve 21 and a second stage elliptical sleeve 22, the third stage sleeve set 3 comprises a third stage circular sleeve 31 and a third stage elliptical sleeve 32;
the first-stage circular sleeve 11 comprises a first circular clamping ring 111, a first circular connecting ring 112, a first circular clamping rail 113 arranged on the inner side of the first circular clamping ring 111, and a first circular clamping groove 114 arranged on the inner side of the first circular connecting ring 112 and corresponding to the first circular clamping rail 113, and the first-stage elliptical sleeve 12 comprises a first elliptical clamping ring 121, a first elliptical connecting ring 122, a first elliptical clamping rail 123 arranged on the inner side of the first elliptical clamping ring 121 and corresponding to the first circular connecting ring 112, and a first elliptical clamping groove 124 arranged on the inner side of the first elliptical connecting ring 122 and corresponding to the first circular clamping rail 113 and the first elliptical clamping rail 123;
the second-stage circular sleeve 21 comprises a second circular clamping ring 211, a second circular connecting ring 212, a second circular clamping rail 213 arranged on the inner side of the second circular clamping ring 211, and a second circular clamping groove 214 arranged on the inner side of the second circular connecting ring 212 and corresponding to the second circular clamping rail 213, the second-stage elliptical sleeve 22 comprises a second elliptical clamping ring 221, a second elliptical connecting ring 222, a second elliptical clamping rail 223 arranged on the inner side of the second elliptical clamping ring 221 and corresponding to the second circular connecting ring 212, and a second elliptical clamping groove 224 arranged on the inner side of the second elliptical connecting ring 222 and corresponding to the second circular clamping rail 213 and the second elliptical clamping rail 223, and the second elliptical clamping rail 223 is also matched with the first circular clamping groove 114 and the first elliptical clamping groove 124;
the third-stage circular sleeve 31 comprises a third circular snap ring 311, a third circular connecting ring 312, a third circular clamping rail 313 arranged on the inner side of the third circular snap ring 311, and a third circular clamping groove 314 arranged on the inner side of the third circular connecting ring 312 and corresponding to the third circular clamping rail 313, the third-stage elliptical sleeve 32 comprises a third elliptical snap ring 321, a third elliptical connecting ring 322, a third elliptical clamping rail 323 arranged on the inner side of the third elliptical snap ring 321 and corresponding to the third circular connecting ring 312, and a third elliptical clamping groove 324 arranged on the inner side of the third elliptical connecting ring 322 and corresponding to the third circular clamping rail 313 and the third elliptical clamping rail 323; the third elliptical clamping rail 323 also cooperates with the second circular clamping groove 214 and the second elliptical clamping groove 224.
The invention is applied to lumbar fusion under percutaneous spinal endoscopy, can gradually enlarge the diameter of the operation channel by replacing a first elliptical sleeve, a second elliptical sleeve and a third elliptical sleeve with different diameters at one side in sequence, and can realize the expansion and the distraction of the lumbar intervertebral space of a patient by changing the long axis and the short axis direction of the elliptical sleeve inserted into the intervertebral space through rotation, thereby being beneficial to enlarging the operation space and implanting an intervertebral fusion device and restoring the spinal sequence; meanwhile, all the sleeves can keep a closed sleeve type structure, and an operator can directly use the sleeve as a sleeve of a spinal endoscope operation system, so that the practicability and the functionality of the invention are improved. The invention adopts the matching among the first-stage circular sleeve 11, the second circular sleeve, the third circular sleeve, the first elliptic sleeve, the second elliptic sleeve and the third elliptic sleeve which are circular and have sequentially increasing diameters and matched guide rods, and is used as a tool for expanding the lumbar tissue gap and the lumbar intervertebral space, and can provide a closed annular sleeve structure which can be used as a spinal endoscope operation sleeve, so that an operator can perform lumbar nerve decompression on a patient and perform intervertebral fusion, the lumbar tissue gap and the intervertebral space can be continuously expanded to perform adjacent group replacement among the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3 with different diameters, so that the operator can use surgical instruments with different sizes and specifications in the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3 with different diameters, so as to complete the operation, and avoid the injury caused by repeated insertion and expansion of the lumbar tissue gap and the intervertebral space of the patient in the operation process;
referring to fig. 28 to 29, the inside of the first-stage circular sleeve 11, the first-stage elliptical sleeve 12, the second-stage circular sleeve 21, the second-stage elliptical sleeve 22, the third-stage circular sleeve 31 and the third-stage elliptical sleeve 32 are provided with an X-ray developing net 7, the X-ray developing net 7 comprises a plurality of developing wires 71 arranged in parallel and developing rings 72 arranged perpendicular to the developing wires 71, the positions of the developing wires 71 and the X-ray developing net 7 can be displayed on an intraoperative X-ray fluoroscopy instrument, so that an operator can observe the positions and directions of the developing wires, and meanwhile, the meshed X-ray permeable areas avoid perspective shielding of adjacent tissue structures and instruments. The single-side handles 9 are arranged on the outer sides of the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3, and the single-side handles 9 arranged on the outer sides of the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3 are convenient for an operator to press, push or pull the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3 in the operation process. The front ends of the first expansion guide rod 4, the second expansion guide rod 5 and the third expansion guide rod 6 are all provided with an X-ray developing body 8, the X-ray developing body 8 is made of metal, the X-ray developing body 8 is arranged at the front ends of the first expansion guide rod 4, the second expansion guide rod 5 and the third expansion guide rod 6, so that an operator can conveniently insert the X-ray developing body into a target point position in a lumbar tissue gap and a lumbar intervertebral space through a corresponding sleeve under the perspective detection of an X-ray perspective instrument in an operation, the waist tissue of the patient cannot be injured in the inserting process, the practicability and the use safety of the X-ray developing body 8 are improved, and the position can be displayed on the X-ray perspective instrument in the operation through the X-ray developing body 8 made of metal, so that the operator can conveniently observe the position and the direction of the X-ray developing body.
According to the invention, through the sealing caps 10 arranged at the opening ends of the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3, the leakage of liquid in the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3 is reduced as much as possible so as to improve or maintain the internal water pressure, so that the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3 can be used as sleeves of a spinal endoscope operating system. The front ends of the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3 are respectively provided with an insertion inclined plane 104 for separating soft tissues, and the angle of the insertion inclined plane 104 is 30 degrees. According to the invention, the insertion inclined planes 104 arranged at the front ends of the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3 are respectively composed of two inclined planes with the same structure, so that the sharpness of the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3 is improved, an operator can conveniently insert the first-stage sleeve group 1, the second-stage sleeve group 2 and the third-stage sleeve group 3 into a lumbar tissue gap and a lumbar intervertebral gap, the operation efficiency is improved, and the soft tissue injury is reduced.
With further reference to fig. 15 to 27, in the process of applying the spinal endoscope technique to perform lumbar nerve decompression and interbody fusion on a patient, when implanting the first-stage circular sleeve 11, the operator attaches the hollow first expansion guide rod 4 to the target position along the targeted and accurate guide wire, takes out the first expansion guide rod 4 and implants the same into the spinal endoscope operation channel, and ablates the herniated disc under continuous 0.9% saline infusion to complete nerve decompression. After decompression is finished, the operator takes out the spinal endoscope operating system, and inserts the first expansion guide rod 4 into the inner cavity of the first-stage circular sleeve 11 after the residual perfusion fluid in the sleeve is completely absorbed.
When the operator needs to convert the first-stage circular sleeve 11 into the first elliptical sleeve, the first circular connecting ring 112 is pulled out from the first circular snap ring 111 along the first circular snap groove 114, so that the first elliptical connecting ring 122 fits around and props open soft tissues by means of the first expansion guide rod 4 and is placed in an intervertebral space, and the first elliptical connecting ring 122 of the first elliptical sleeve is mounted on the first circular snap ring 111 through the matching of the first circular snap rail 113 and the first elliptical snap groove 124. Then the art person takes out and takes off first circular snap ring 111, installs first oval snap ring 121 of first order sleeve group 1 on first oval-shaped connects ring 122 through the cooperation of first oval-shaped joint rail 123 and first oval-shaped joint groove 124, then the art person rotates first oval-shaped sleeve, can strut the distance in intervertebral space and keep the sleeve simultaneously for airtight structure, reduces because of the waist soft tissue damage that the check sleeve led to the fact repeatedly and provides the function of strutting the intervertebral space.
When an operator needs to convert the first-stage circular sleeve 11 into a second circular sleeve, the first expansion guide rod 4 is inserted into the inner cavity of the first-stage circular sleeve 11, the first circular connecting ring 112 is pulled out from the first circular clamping ring 111 along the first circular clamping groove 114, the second circular connecting ring 212 is attached to the first circular clamping ring 111, soft tissues are propped open by the aid of the first expansion guide rod 4 and are placed to a target point position, and the second circular connecting ring 212 of the second circular sleeve is installed on the first circular clamping ring 111 through matching of the first circular clamping rail 113 and the second circular clamping groove 214. Then, the operator takes off the first circular snap ring 111, and installs the second circular snap ring 211 of the second circular sleeve on the second circular snap ring 212 through the cooperation of the second circular snap rail 213 and the second circular snap groove 214, so as to enlarge the inner diameter of the sleeve and simultaneously keep the sleeve in a closed structure, thereby reducing the damage to the soft tissues of the waist caused by repeatedly checking the sleeve.
In the same way, when the surgeon needs to convert the second circular sleeve into the second oval sleeve, the second circular connecting ring 212 is pulled out from the second circular snap ring 211 along the second circular snap groove 214, so that the second oval connecting ring 222 is attached to the soft tissue and is placed in the intervertebral space by means of the second expansion guide rod 5, and the second oval connecting ring 222 of the second oval sleeve is mounted on the second circular snap ring 211 through the matching of the second circular snap rail 213 and the second oval snap groove 224. Then the operation person takes off the second circular snap ring 211, install the second oval snap ring 221 of second level sleeve group 2 on the second oval connects ring 222 through the cooperation of second oval joint rail 223 and second oval joint groove 224, then the operation person rotates the second oval sleeve, can prop open the distance in intervertebral space and keep the sleeve to be airtight structure simultaneously, reduce the waist soft tissue damage because of repeatedly spot check sleeve causes, can regard as airtight ring structure to use as backbone scope operating system's sleeve simultaneously.
When an operator needs to convert the second circular sleeve into a third circular sleeve, the second expansion guide rod 5 is inserted into the inner cavity of the second circular sleeve, the second circular connecting ring 212 is pulled out from the second circular clamping ring 211 along the second circular clamping groove 214, the third circular connecting ring 312 is attached to the second circular clamping ring 211, soft tissues are propped open by the aid of the second expansion guide rod 5 and are placed in a target point position, and the third circular connecting ring 312 of the third circular sleeve is installed on the second circular clamping ring 211 through matching of the second circular clamping rail 213 and the third circular clamping groove 314. Then the operator takes off the second circular snap ring 211, installs the third circular snap ring 311 of the third circular sleeve on the third circular connecting ring 312 through the cooperation of the third circular clamping rail 313 and the third circular clamping groove 314, expands the inner diameter of the sleeve and simultaneously keeps the sleeve in a closed structure, reduces the damage of the soft tissues at the waist caused by repeatedly checking the sleeve, and simultaneously, the sleeve can be used as a sleeve of a closed ring structure as a spinal endoscope operation system by matching with a sealing cap.
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 (10)
1. The intervertebral space distraction sleeve device for the split type expandable percutaneous spine endoscope is characterized by comprising a first-stage sleeve group (1), a second-stage sleeve group (2) and a third-stage sleeve group (3) which are same in shape and are increased in size in equal proportion, and a first expansion guide rod (4), a second expansion guide rod (5) and a third expansion guide rod (6) which respectively correspond to the first-stage sleeve group (1), the second-stage sleeve group (2) and the third-stage sleeve group (3), wherein the first expansion guide rod (4), the second expansion guide rod (5) and the third expansion guide rod (6) are hollow, and the colors of the sleeves and the expansion guide rods at all stages are different;
the first-stage sleeve group (1) comprises a first-stage circular sleeve (11) and a first-stage elliptical sleeve (12), the first-stage elliptical sleeve (12) is elliptical, the minor axis of the first-stage elliptical sleeve (12) is equal to the diameter of the first-stage circular sleeve (11), the major axis of the first-stage elliptical sleeve (12) is larger than the diameter of the first-stage circular sleeve (11), the second-stage sleeve group (2) comprises a second-stage circular sleeve (21) and a second-stage elliptical sleeve (22), and the third-stage sleeve group (3) comprises a third-stage circular sleeve (31) and a third-stage elliptical sleeve (32);
the first-stage circular sleeve (11) comprises a first circular clamping ring (111), a first circular connecting ring (112), a first circular clamping rail (113) arranged on the inner side of the first circular clamping ring (111), and a first circular clamping groove (114) which is arranged on the inner side of the first circular connecting ring (112) and corresponds to the first circular clamping rail (113), and the first-stage elliptical sleeve (12) comprises a first elliptical clamping ring (121), a first elliptical connecting ring (122), a first elliptical clamping rail (123) which is arranged on the inner side of the first elliptical clamping ring (121) and corresponds to the first circular connecting ring (112), and a first elliptical clamping groove (124) which is arranged on the inner side of the first elliptical connecting ring (122) and corresponds to the first circular clamping rail (113) and the first elliptical clamping rail (123);
the second-stage circular sleeve (21) comprises a second circular snap ring (211), a second circular connecting ring (212), a second circular clamping rail (213) arranged at the inner side of the second circular snap ring (211) and a second circular clamping groove (214) which is arranged at the inner side of the second circular connecting ring (212) and corresponds to the second circular clamping rail (213), the second-stage oval sleeve (22) comprises a second oval snap ring (221), a second oval connecting ring (222), a second oval clamping rail (223) which is arranged at the inner side of the second oval snap ring (221) and corresponds to the second circular connecting ring (212), and a second oval clamping groove (224) which is arranged at the inner side of the second oval connecting ring (222) and corresponds to the second circular clamping rail (213) and the second oval clamping rail (223), the second oval clamping rail (223) is also matched with the first round clamping groove (114) and the first oval clamping groove (124) for use;
the third-stage circular sleeve (31) comprises a third circular snap ring (311), a third circular connecting ring (312), a third circular clamping rail (313) arranged on the inner side of the third circular snap ring (311), and a third circular clamping groove (314) which is arranged on the inner side of the third circular connecting ring (312) and corresponds to the third circular clamping rail (313), and the third-stage elliptical sleeve (32) comprises a third elliptical snap ring (321), a third elliptical connecting ring (322), a third elliptical clamping rail (323) which is arranged on the inner side of the third elliptical snap ring (321) and corresponds to the third circular connecting ring (312), and a third elliptical clamping groove (324) which is arranged on the inner side of the third elliptical connecting ring (322) and corresponds to the third circular clamping rail (313) and the third elliptical clamping rail (323); the third elliptical clamping rail (323) is also matched with the second circular clamping groove (214) and the second elliptical clamping groove (224) for use.
2. The split expandable intervertebral space distraction sleeve device for the percutaneous spinal endoscope according to claim 1, wherein the inner sides of the first-stage circular sleeve (11), the first-stage elliptical sleeve (12), the second-stage circular sleeve (21), the second-stage elliptical sleeve (22), the third-stage circular sleeve (31) and the third-stage elliptical sleeve (32) are respectively provided with an X-ray developing net (7).
3. The split expandable intervertebral space distraction sleeve device for the percutaneous spinal endoscope according to claim 1, wherein the X-ray visualization mesh (7) comprises a plurality of visualization wires (71) arranged in parallel and a visualization ring (72) arranged perpendicular to the visualization wires (71).
4. The split expandable intervertebral space distraction sleeve device for the percutaneous spinal endoscope according to any one of claims 1 to 3, wherein the front ends of the first expansion guide rod (4), the second expansion guide rod (5) and the third expansion guide rod (6) are respectively provided with an X-ray developing body (8), and the X-ray developing body (8) is made of metal.
5. The split expandable intervertebral space distraction sleeve device for the percutaneous spinal endoscope according to any one of claims 1 to 3, wherein the outer sides of the first-stage sleeve group (1), the second-stage sleeve group and the third-stage sleeve group (3) are respectively provided with a single-side handle (9).
6. The split expandable intervertebral space distraction sleeve device for the percutaneous spinal endoscope according to any one of claims 1 to 3, wherein the open ends of the first-stage sleeve group (1), the second-stage sleeve group (2) and the third-stage sleeve group (3) are respectively provided with a sealing cap (10), and a sealing hole (101) is arranged in each sealing cap (10).
7. The split expandable intervertebral space distraction sleeve device for the percutaneous spinal endoscope according to any one of claims 1 to 3, wherein scales (102) are arranged on the outer sides of the first-stage sleeve group (1), the second-stage sleeve group (2) and the third-stage sleeve group (3).
8. The split expandable intervertebral space distraction sleeve device for the percutaneous spinal endoscope according to any one of claims 1 to 3, wherein the first expansion guide rod (4), the second expansion guide rod (5) and the third expansion guide rod (6) are respectively provided with a detachable handle (103) movably connected with the first expansion guide rod, the second expansion guide rod and the third expansion guide rod.
9. The split expandable intervertebral space distraction sleeve device for the percutaneous spinal endoscope according to any one of claims 1 to 3, wherein the outer sides of the front ends of the first-stage sleeve group (1), the second-stage sleeve group (2) and the third-stage sleeve group (3) are provided with insertion inclined planes (104).
10. The split expandable intervertebral space distraction sleeve device for the percutaneous spinal endoscope according to any one of claims 1 to 3, wherein the materials adopted by the first-stage sleeve group (1), the second-stage sleeve group (2) and the third-stage sleeve group (3) are all medical novel polymer materials.
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US7892203B2 (en) * | 2004-09-09 | 2011-02-22 | Onset Medical Corporation | Expandable transluminal sheath |
CN2829650Y (en) * | 2005-07-08 | 2006-10-25 | 王建华 | Adjusting microwound spondylodesis appliance and opening holder thereof |
CN201088619Y (en) * | 2007-08-31 | 2008-07-23 | 周跃 | Combinated multifunctional lumbar fusion device |
CA2750154A1 (en) * | 2009-01-23 | 2010-07-29 | Intersect Ent, Inc. | Devices and methods for dilating tissues |
TW201031379A (en) * | 2009-02-24 | 2010-09-01 | Univ Nat Yang Ming | The insertion apparatus for aligning cage of intervertebral fusion |
CN204446073U (en) * | 2015-03-05 | 2015-07-08 | 复旦大学附属中山医院 | A kind of torsion controllable type interbody space dilator |
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Address after: 563002 No.113 Dalian Road, development zone, Zunyi City, Guizhou Province Patentee after: AFFILIATED HOSPITAL OF ZUNYI MEDICAL University Address before: 563000 Guizhou Province, Zunyi City Development Zone, No. 113 Dalian Road Patentee before: AFFILIATED HOSPITAL OF ZUNYI MEDICAL College |