CN110693600A - Circle-center-sphere-center universal rotation radius-adjusting minimally invasive sacroiliac screw guider - Google Patents
Circle-center-sphere-center universal rotation radius-adjusting minimally invasive sacroiliac screw guider Download PDFInfo
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- 210000003692 ilium Anatomy 0.000 claims description 67
- 230000000149 penetrating effect Effects 0.000 claims description 29
- 201000010099 disease Diseases 0.000 abstract description 15
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 abstract description 15
- 210000003484 anatomy Anatomy 0.000 abstract description 9
- 230000001105 regulatory effect Effects 0.000 abstract 1
- 210000000988 bone and bone Anatomy 0.000 description 24
- 238000000034 method Methods 0.000 description 19
- 230000001054 cortical effect Effects 0.000 description 17
- 210000003131 sacroiliac joint Anatomy 0.000 description 6
- 238000010586 diagram Methods 0.000 description 5
- 230000006378 damage Effects 0.000 description 4
- 230000000994 depressogenic effect Effects 0.000 description 4
- 230000000694 effects Effects 0.000 description 4
- 238000003780 insertion Methods 0.000 description 4
- 230000037431 insertion Effects 0.000 description 4
- 238000011160 research Methods 0.000 description 4
- 230000007547 defect Effects 0.000 description 2
- 238000005553 drilling Methods 0.000 description 2
- 238000002594 fluoroscopy Methods 0.000 description 2
- 238000002513 implantation Methods 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 238000005259 measurement Methods 0.000 description 2
- 210000001696 pelvic girdle Anatomy 0.000 description 2
- 210000004197 pelvis Anatomy 0.000 description 2
- 230000000087 stabilizing effect Effects 0.000 description 2
- 208000028389 Nerve injury Diseases 0.000 description 1
- 206010071229 Procedural haemorrhage Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 210000003164 cauda equina Anatomy 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 210000005036 nerve Anatomy 0.000 description 1
- 230000008764 nerve damage Effects 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
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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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8897—Guide wires or guide pins
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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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
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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
- A61B90/10—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 for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/11—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 for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
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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
- A61B90/10—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 for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B2090/101—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 for stereotaxic surgery, e.g. frame-based stereotaxis for stereotaxic radiosurgery
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Abstract
The invention discloses a minimally invasive sacroiliac screw guider capable of universally adjusting rotation radius and offset distance by centering a circle and a sphere, which comprises a rectangular main positioner, a transverse arc adjuster, a hollow positioning rod and a hollow guiding controller. The invention combines the rectangular main positioner with the transverse arc regulator, can realize the functions of determining the nail feeding point according to different disease conditions of patients, regulating the inserting direction of the sacroiliac screw and accurately inserting the sacroiliac screw at one time, and solves the problems in the prior art. The use of the transverse arc regulator enables a doctor to freely regulate the scales on the transverse arc scale rod inserted into the transverse arc slideway according to the anatomical structure and different disease conditions of a patient so as to match the included angle between the sacroiliac screw and the sagittal plane of a human body on the transverse section and enable the extension line of the sacroiliac screw nail track to pass through the virtual rotation circle center or the virtual rotation sphere center O point, so that the internal inclination angle of the sacroiliac screw can be accurately determined.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and relates to a minimally invasive sacroiliac screw guider capable of fixing a circle center and a sphere center and adjusting a rotation radius offset in a universal mode.
Background
The injury of the posterior pelvic ring such as the dislocation of the sacroiliac joint and the fracture around the sacroiliac joint can cause the rotational instability and the vertical instability of the pelvis, and the superior method for realizing the fixation of the posterior pelvic ring is to implant sacroiliac screws in a patient body. In recent years, both clinical and biomechanical studies of pelvic fixation have demonstrated: the sacroiliac screw enters from the posterior lateral aspect of the ilium ala, passes through the sacroiliac joint and enters the middle upper part of the sacrum 1 or sacrum 2 vertebral body, and is a good internal fixation type. The percutaneous minimally invasive sacroiliac screw implantation can effectively reduce intraoperative hemorrhage, operative trauma and various complications, and becomes the first choice of clinical orthopedics doctors.
The core technology and the operation difficulty of the sacroiliac joint screw are that the guide pin and the screw are placed, the current sacroiliac joint screw is placed mostly by hands under the perspective of a C-arm X-ray machine, and the sacroiliac joint screw has the following defects: 1. in the process of nail placement, multi-angle X-ray repeated perspective is needed, the positioning is inaccurate, the stability is poor, and if a satisfactory fixed position cannot be achieved after multiple attempts, the fixed holding force is greatly reduced due to the damage of the guide pin to the bone structure. 2. Since the screw is fixed across the joint and needs to pass through 3 layers of cortical bone, accurate positioning of the point of insertion is extremely difficult. 3. The sacrum is anatomically tilted backwards, the sacroiliac screw has a certain angle in the transverse plane and the sagittal plane, and the individual difference is large, so the running direction of the screw is difficult to be accurately determined. 4. The length of the screw is preferably such that it does not break through the cortical bone of the contralateral sacrum, which is difficult to determine accurately by fluoroscopy. 5. The anterior part of the screw is adjacent to the iliac vessels, the posterior part of the screw is the cauda equina nerve in the vertebral canal, and the upper part of the screw is the intervertebral disc, so that the screw has slight deviation, not only can not achieve effective fixation, but also is easy to damage important nerves and vessels, and even endangers life. 6. Uncertainty of parameters such as a screw feeding point, an external inclination angle, a head-tail side inclination angle, a screw length, the drilling frequency of a guide pin and the like becomes a bottleneck for restricting the development of scientific researches such as sacroiliac screw biomechanics research, sacroiliac screw placement standardization research and the like for a long time. In summary, the insertion of the screw lacks objective criteria in determining the point of insertion, the direction of travel, the length of the screw, etc., and is not possible to succeed at one time, thus being technically very difficult and challenging.
In the existing sacroiliac screw guiding device, a pedicle screw guiding needle must be firstly drilled into a sacral 1 vertebral body, and then the guiding needle of the sacroiliac screw is drilled into the sacroiliac screw in a point-to-point aiming mode through a connecting rod with the radian of pi/2. The device improves the accuracy and the safety of nail placement to a certain extent, but has the following defects: 1. the guide pin of the pedicle screw of the sacrum 1 must be accurately placed, so that the technical threshold is greatly improved, and meanwhile, the sacrum which is fractured originally is seriously injured; if the sacrum 1 pedicle guide needle cannot be accurately placed in one time, the fixing strength of the sacrum iliac screw can be greatly reduced by repeated operation, and nerve injury is caused. 2. Because the guide pin of the sacroiliac screw takes the direction of the guide pin of the pedicle screw as reference, and the guide pin of the sacroiliac screw has included angles with the sagittal plane and the upper transverse plane of the sacrum and has large individual difference, the included angles (including the inner inclination angle and the head-tail side inclination angle) between the guide pin of the sacroiliac screw and the guide pin of the pedicle screw are difficult to select before and during the operation, and the placement of the guide pin of the sacroiliac screw also has great uncertainty in the actual operation process; thus, the sacroiliac screw can enter the sacrum, but the direction is not necessarily optimal, nor is the length and fixation strength of the screw necessarily optimal. 3. In the case of sacral pedicle fractures, it cannot be used. 4. The device cannot be used with sacroiliac screws for the sacral 2 and other segments.
In the prior art, a sighting device which only depends on anatomical marks of lumbar vertebrae and pelvis, has no obvious damage to vertebral pedicle, has low technical threshold, can randomly adjust the angle according to individual difference of patients, is simple and convenient to operate and can accurately place the sacroiliac screw guide pin at one time is lacked.
Disclosure of Invention
The invention aims to provide a minimally invasive sacroiliac screw guider with fixed circle center and spherical center and universal adjustment of rotating radius offset, which combines a rectangular main positioner with a transverse arc-shaped adjuster, can realize the functions of determining a screw feeding point according to different disease conditions of a patient, adjusting the inserting direction of sacroiliac screws and accurately inserting the sacroiliac screws at one time, and solves the problems in the prior art. The use of the transverse arc regulator enables a doctor to freely regulate the scales on the transverse arc scale rod inserted into the transverse arc slideway according to the anatomical structure and different disease conditions of a patient so as to match the included angle between the sacroiliac screw and the sagittal plane of a human body on the transverse section and enable the extension line of the sacroiliac screw nail track to pass through the virtual rotation circle center or the virtual rotation sphere center O point, so that the internal inclination angle of the sacroiliac screw can be accurately determined.
In order to achieve the purpose, the technical scheme adopted by the invention is as follows:
a minimally invasive sacroiliac screw guider with a fixed circle center and a ball center and capable of universally adjusting the rotating radius offset comprises a rectangular main positioner, a transverse arc-shaped adjuster, a hollow positioning rod and a hollow guiding controller.
The rectangular main positioner comprises a positioner body and a transverse arc-shaped sleeve arranged at the front end of the positioner body, wherein a sacrum positioning hole and an ilium fixing hole which are through up and down are formed in the positioner body, the sacrum positioning hole is used for being inserted by the guide pin and plays a guiding role for the guide pin, the rectangular main positioner can be fixed to the ilium through the ilium fixing hole through threaded nails, and locking members are arranged on the sacrum positioning hole and the ilium fixing hole.
The transverse arc regulator comprises a transverse arc scale rod and a guider arranged at the left end of the transverse arc scale rod; the transverse arc-shaped scale rod penetrates through the transverse arc-shaped sleeve and can slide in the transverse arc-shaped sleeve; the scales are arranged on the transverse arc-shaped scale rod, the scales inserted into the transverse arc-shaped scale rod of the transverse arc-shaped slide way can be freely adjusted according to the anatomical structure and different disease conditions of a patient to match the included angle between the sacroiliac screw and the sagittal plane of a human body on the cross section, and the extension line of the sacroiliac screw nail track passes through a virtual rotation circle center O point or a virtual rotation sphere center O point, so that the internal inclination angle of the sacroiliac screw can be accurately determined.
The hollow positioning rod is arranged on the rectangular main positioner, a detachably connected threaded guide pin is arranged in the hollow positioning rod, and the hollow positioning rod can be movably inserted into the sacrum positioning hole and can be locked by a locking component on the sacrum positioning hole. The hollow positioning rod is matched with the thread guide pin to be inserted into a sacrum positioning hole on the positioner body to penetrate into the skin, the tip end of the hollow positioning rod is tightly attached to the outer side of an upper articular process of a first sacrum, which is sunken on the cortical bone surface (the point where the hollow positioning rod is tightly attached is A point) or the bone surface of other key anatomical marks, and the thread guide pin can be screwed into the sacrum to stabilize the hollow positioning rod and can also not be screwed into the sacrum. Avoiding cumbersome and risky procedures that must rely on pedicle screws of the sacrum as a reference. A virtual straight line which is parallel to the sagittal plane and vertically enters the inner part of the sacrum downwards is made through the point A, a certain distance below the point A is selected to be a point O on the virtual straight line (the point O is a virtual rotating circle center or a virtual rotating sphere center and is positioned in the sacrum and the middle point of the front cortical bone and the front wall of the sacrum in front of the sacrum on an AO connecting line), the distance from the point A to the point O is a stagger distance, and the stagger distance can be set by adjusting scales on a hollow positioning rod inserted into a positioning hole of the sacrum during operation. And thereby the precise location of a virtual center of rotation or virtual sphere of rotation O-point (also the point through which the sacroiliac screw and guide pin must pass) within the sacrum.
The hollow guide controller comprises a hollow sleeve, and the hollow sleeve is arranged on the guide.
The top surface of the transverse arc-shaped sleeve is arranged horizontally or forwards and downwards inclined relative to the top surface of the locator body, and the top surface of the transverse arc-shaped sleeve is horizontal, so that the circle center of the transverse arc-shaped scale rod is adjusted to be a virtual rotation circle center O point in a matching manner, and a doctor can adjust the scales inserted into the transverse arc-shaped scale rod of the transverse arc-shaped sleeve according to different disease conditions of a patient so as to determine the internal inclination angle of the sacroiliac screw guide pin and the embedding direction of the sacroiliac screw. The top surface of the transverse arc-shaped sleeve is downwards inclined forwards so as to match the circle center of the longitudinal arc-shaped scale rod to be adjusted to a virtual rotating sphere center O point, so that a doctor can adjust the scales on the transverse arc-shaped scale rod and the longitudinal arc-shaped scale rod inserted into the transverse arc-shaped slide way and the longitudinal arc-shaped slide way according to different disease conditions of a patient so as to determine the internal inclination angle and the head-tail side inclination angle of the sacroiliac screw guide pin and further determine the embedding direction of the sacroiliac screw.
The technical scheme is that a left and right penetrating transverse arc-shaped slide way is arranged in the transverse arc-shaped sleeve, the radian of the transverse arc-shaped slide way is consistent with that of the transverse arc-shaped scale rod, and scales are arranged on the surface of the transverse arc-shaped scale rod.
The technical scheme is that the upper part and the lower part of the hollow positioning rod are both cylindrical, the diameter of the lower part of the hollow positioning rod is smaller than that of the upper part of the hollow positioning rod, scales are arranged on the outer surface of the cylindrical upper part of the hollow positioning rod, and the position of a rotation center (a virtual rotation circle center or a virtual rotation sphere center) can be accurately set through the scales on the outer surface of the upper part of the hollow positioning rod.
The technical scheme is that the guider is a guide block or a longitudinal arc-shaped scale rod; the hollow sleeve penetrates through the guide block and then is movably arranged on the guide block or is arranged on the longitudinal arc-shaped scale rod through the sliding block, and scales are arranged on the surface of the longitudinal arc-shaped scale rod. The guide block and the slide block are internally provided with open chutes which are through from left to right and open downwards, the open chutes are provided with locking members, the hollow sleeve penetrates through the open chutes of the guide block and can slide in the guide block; the hollow sleeve penetrates through the opening sliding groove of the sliding block and can slide in the sliding block. The hollow sleeve is used for inserting the opening sliding groove of the guide block or the sliding block to reach the rear outer side of the iliac wing to play a role in positioning and guiding, and the extension line of the inserting direction of the hollow sleeve passes through the rotating spherical center O point.
The technical scheme is that a longitudinal arc-shaped sleeve is further arranged outside the longitudinal arc-shaped scale rod and is connected with the transverse arc-shaped scale rod, and the longitudinal arc-shaped scale rod is matched with the longitudinal arc-shaped sleeve and can freely slide in the longitudinal arc-shaped sleeve. A longitudinal arc-shaped slide way which is through from front to back is arranged in the longitudinal arc-shaped sleeve, and the longitudinal arc-shaped scale rod freely slides in the longitudinal arc-shaped sleeve through the longitudinal arc-shaped slide way. The longitudinal arc-shaped scale rod is also provided with scales, the scales inserted into the longitudinal arc-shaped scale rod of the longitudinal arc-shaped slide way can be freely adjusted according to the anatomical structure and different disease conditions of a patient to match the included angle between the sacroiliac screw and the plane above the sacrum on the coronal plane, and the extension line of the sacroiliac screw nail track passes through the virtual rotation sphere center O point, so that the head side or tail side inclination angle of the sacroiliac screw can be accurately determined, and the inserting direction of the sacroiliac screw can be determined.
Further technical scheme is, still include offside fixing device, offside fixing device includes fixed block and screw thread nail, and the fixed block divide into haplopore fixed block and diplopore fixed block, is equipped with on the haplopore fixed block about penetrating square connecting hole and upper and lower penetrating ilium fixed orifices, all is equipped with locking member on square connecting hole and ilium fixed orifices, is equipped with about penetrating and two square connecting holes penetrating around with on the diplopore fixed block, is equipped with locking member on controlling penetrating, two square connecting holes penetrating around.
The further technical scheme is that the number of the single-hole fixing blocks is two, the number of the double-hole fixing blocks is one, the number of the threaded nails is two, and the threaded nails can penetrate through the ilium fixing holes in the single-hole fixing blocks, drill into the opposite ilium and are locked by the locking members in the ilium fixing holes.
The technical scheme is that the positioner comprises a positioner body, and is characterized by further comprising a transverse square connecting rod and a longitudinal square connecting rod, wherein one end of the transverse square connecting rod is connected with a square connecting hole in the positioner body, the other end of the transverse square connecting rod penetrates through the square connecting hole in the first single-hole fixing block to be connected with left and right through square connecting holes in the double-hole fixing block and is locked by a locking component in the three square connecting holes, one end of the longitudinal square connecting rod is connected with the front and back through square connecting holes in the double-hole fixing block, the other end of the longitudinal square connecting rod is connected with the square connecting hole in.
The technical scheme is that the plane of the transverse arc-shaped scale rod is vertical to the plane of the longitudinal arc-shaped scale rod; and the horizontal arc-shaped scale rod and the longitudinal arc-shaped scale rod have the same rotating radius and the common sphere center.
Compared with the prior art, the invention has the beneficial effects that:
1. the invention has simple structure, low cost and convenient use,
2. the invention does not need multi-angle X-ray repeated fluoroscopy and does not need to puncture into the bone, has accurate positioning and strong stability, and ensures the one-time success of the safe implantation of the guide pin and the screw.
3. The hollow positioning rod is matched with the thread guide pin to penetrate into skin, the tip end of the hollow positioning rod is tightly attached to the outer side of the upper articular process of the first sacrum and is sunken on cortical bone or the surface of bone of other key anatomical marks, and the thread guide pin can be screwed into the sacrum to stabilize the hollow positioning rod and can also not be screwed into the sacrum. Avoiding cumbersome and risky procedures that must rely on pedicle screws of the sacrum as a reference.
4. The use of the transverse arc regulator enables a doctor to freely regulate the scales on the transverse arc scale rod inserted into the transverse arc slideway according to the anatomical structure and different disease conditions of a patient so as to match the included angle between the sacroiliac screw and the sagittal plane of a human body on the transverse section and enable the extension line of the sacroiliac screw nail track to pass through the virtual rotation circle center or the virtual rotation sphere center O point, so that the internal inclination angle of the sacroiliac screw can be accurately determined.
5. The use of the longitudinal arc-shaped scale rod enables a doctor to freely adjust the scale on the longitudinal arc-shaped scale rod inserted into the longitudinal arc-shaped slide way according to the anatomical structure and different disease conditions of a patient to match the included angle between the sacroiliac screw and the plane above the sacrum on the coronal plane and enable the extension line of the sacroiliac screw nail track to pass through the virtual rotation sphere center O point, so as to accurately determine the head side or tail side inclination angle of the sacroiliac screw and determine the inserting direction of the sacroiliac screw.
6. The circle center-fixed rotation radius offset-minimally invasive sacroiliac screw positioning guider has a simpler structure, and can be used for cases in which only sacroiliac screws need to be placed in sacrum and the head-tail side inclination angle is not considered. The sphere centering rotation radius offset-minimally invasive sacroiliac screw positioning guider can accurately set all parameters of the internal inclination angle, the head side or tail side inclination angle of the sacroiliac screw, the position of the virtual rotation circle center in the sacrum, the rotation radius offset, the screw feeding point, the screw length and the like, and can ensure that the sacroiliac screw is successfully and accurately placed at one time according to preoperative design; therefore, the surgical instrument is not only suitable for clinical operation, but also can completely meet the requirements of scientific research.
Drawings
Fig. 1 is a schematic view of a combined structure of a rectangular main positioner and a transverse arc adjuster according to embodiment 1 of the present invention.
Fig. 2 is a schematic structural diagram of a rectangular main positioner according to embodiment 1 of the present invention.
Fig. 3 is a schematic structural view of a lateral arc adjuster according to embodiment 1 of the present invention.
Fig. 4 is a use state diagram of embodiment 1 of the present invention.
Fig. 5 is a partially enlarged view of B in fig. 4.
Fig. 6 is a contralateral fixation device of the present invention.
FIG. 7 is a schematic structural diagram of the hollow sleeve, the hollow positioning rod and the threaded guide pin according to the present invention.
Fig. 8 is a schematic view of a combined structure of a rectangular main positioner and a transverse arc adjuster according to embodiment 2 of the present invention.
Fig. 9 is a schematic structural diagram of a rectangular main positioner according to embodiment 2 of the present invention.
FIG. 10 is a left side view of a rectangular main retainer according to embodiment 2 of the present invention.
Fig. 11 is a usage state diagram of embodiment 2 of the present invention.
Fig. 12 is a partial enlarged view of B of fig. 11.
In the figure: 1. a locator body; 2. a sacral locating hole; 3. a hollow positioning rod; 4. a threaded guide pin; 5. an ilium fixation hole; 6. a threaded nail; 7. locking the bolt; 8. a transverse arcuate sleeve; 9. a transverse arc-shaped scale bar; 10. a locking hole; 11. a hollow sleeve; 12. an open chute; 13. a guide block or slide; 14. the ilium; 15. a sacrum; 16. a square connecting hole; 17. a transverse square connecting rod; 18. a double-hole fixing block; 19. a single-hole fixing block; 20. a longitudinal square connecting rod; 21. a transverse arc-shaped slideway; 22. connecting blocks; 23. a longitudinal arc-shaped scale bar; 24. a longitudinal arcuate sleeve; 25. a longitudinal arc-shaped slideway.
Detailed Description
In order to better understand the technical content of the invention, specific embodiments are provided below, and the invention is further described with reference to the accompanying drawings.
Example 1:
as shown in fig. 1 to 5, the minimally invasive sacroiliac screw guider with circle center-sphere center universal adjustment of rotation radius offset provided by the invention comprises a rectangular main positioner, a transverse arc-shaped adjuster, a hollow positioning rod 3 and a hollow guiding controller.
The rectangular main positioner comprises a positioner body 1 and a transverse arc-shaped sleeve 8 arranged at the front end of the positioner body, wherein a sacrum positioning hole 2 and an ilium fixing hole 5 which are through up and down are arranged on the positioner body 1, the sacrum positioning hole 2 is used for being inserted by a guide pin and plays a guiding role on the guide pin, and the ilium fixing hole 5 can be used for fixing the rectangular main positioner to an ilium 14 through a threaded nail. The sacrum positioning holes 2 on the positioner body 1 are positioned at the inner side of the ilium fixing holes 5, the number of the ilium fixing holes 5 is four, the ilium fixing holes are longitudinally arranged, only one sacrum positioning hole 2 is provided, the four ilium fixing holes 5 are designed to use the ilium fixing holes 5 at different positions according to different disease conditions of patients, and one sacrum positioning hole 2 is designed to use the depressed cortical bone or other key anatomical marks at the outer side of the upper articular process of the first sacrum 15 as a positioning reference point. Locking components are arranged on the sacrum positioning hole 2 and the ilium fixing hole 5, and the locking components are divided into a locking hole 10 and a locking bolt 7 detachably connected with the locking hole 10. Locking holes 10 on the sacrum positioning hole 2 and the ilium fixing hole 5 are located on the positioner body 1, two locking holes 10 are arranged on each sacrum positioning hole 2 and each ilium fixing hole 5, the locking holes 10 of the sacrum positioning hole 2 are located on the right side of the positioner body 1, the locking holes 10 of the ilium fixing hole 5 are located on the left side of the positioner body 1, and the guide pin can be locked by screwing the locking bolts 7 from the outside during use. And a left and right transparent transverse arc-shaped slide way 21 is arranged in the transverse arc-shaped sleeve 8, and the radian of the transverse arc-shaped slide way 21 is consistent with that of the transverse arc-shaped scale rod 9. The arc slideway 21 is provided with a locking component, and a locking hole 10 of the locking component is positioned on the transverse arc sleeve 8 and can be screwed in from the outside by using a locking bolt 7 for locking when in use. The positioner body 1 is also provided with a left and right through square connecting hole 16, and the square connecting hole 16 is provided with a locking component. The top surface of the transverse arc-shaped sleeve 8 is horizontally arranged relative to the top surface of the locator body 1, so that the center of the transverse arc-shaped scale rod 9 is adjusted to be a virtual rotation center O point in a matching manner, and a doctor can adjust the scales inserted into the transverse arc-shaped scale rod 9 of the transverse arc-shaped sleeve 8 according to different conditions of a patient so as to determine the inserting direction of the sacroiliac screw.
The transverse arc-shaped adjuster comprises a transverse arc-shaped scale rod 9 and a guider arranged at the left end of the transverse arc-shaped scale rod, the transverse arc-shaped scale rod 9 penetrates through the transverse arc-shaped sleeve 8, and the transverse arc-shaped scale rod 9 can slide in the transverse arc-shaped sleeve 8; the scale on the transverse arc scale rod 9 can be freely adjusted according to the anatomical structure and different disease conditions of a patient to be inserted into the scale on the transverse arc scale rod 9 of the transverse arc slide rail 21 to match the included angle between the sacroiliac screw and the sagittal plane of a human body on the cross section, and the extension line of the sacroiliac screw nail track passes through the virtual rotation circle center O point, so that the internal inclination angle of the sacroiliac screw can be accurately determined. The guider is a guide block 13, and the hollow sleeve 11 is movably arranged on the guide block 13 after penetrating through the guide block 13. An opening sliding groove 12 which is through from left to right and is opened downwards is arranged in the guide block 13, a locking component is arranged on the opening sliding groove 12, a locking hole 10 of the locking component is arranged on the guide block 13, the hollow sleeve 11 penetrates through the opening sliding groove 12 of the guide block 13 and can slide in the guide block 13, the hollow sleeve 11 is used for being inserted into the opening sliding groove 12 of the guide block 13 to reach the rear outer side of the ilium wing to play a role in positioning and guiding, and the extension line of the insertion direction of the hollow sleeve passes through a rotating circle center O point.
The upper portion and the lower part of hollow locating lever 3 are cylindricly and the lower part diameter is less than the upper portion diameter, hollow locating lever 3 sets up on rectangle main positioning ware, be equipped with detachable connected screw thread guide pin 4 in hollow locating lever 3, the cylindric upper portion internal surface of hollow locating lever 3 is equipped with the screw thread, the surface is equipped with the scale, 4 tops of screw thread guide pin are the cylinder, the lower part is the guide pin, in the below of cylinder, the outside of guide pin is equipped with the screw thread, hollow locating lever 3 can the activity insert sacrum locating hole 2 and can be locked by the locking member above that. The hollow positioning rod 3 is inserted into the sacrum positioning hole 2 on the positioner body 1 to penetrate into the skin in cooperation with the threaded guide pin 4, the tip of the hollow positioning rod 3 is closely attached to the cortical bone surface (the point where the hollow positioning rod is closely attached to is the point A) or the bone surface of other key anatomical signs on the outer side of the upper articular process of the first sacrum 15, and the threaded guide pin 4 can be screwed into the sacrum 15 to stabilize the hollow positioning rod 3 and can not be screwed into the sacrum 15. Cumbersome and risky procedures that must rely on pedicle screws of the sacrum 15 as a reference are avoided. A virtual straight line which is parallel to the sagittal plane and vertically enters the sacrum 15 downwards is made through the point A, a certain distance below the point A is selected to be a point O (the point O is a virtual rotation center) on the virtual straight line, the distance from the point A to the point O is a stagger distance, and the stagger distance can be set by adjusting scales on a hollow positioning rod 3 inserted into a sacrum positioning hole during an operation. And in turn, the precise location of the virtual rotation center O point (which is also the point through which the sacroiliac screw and guide pin must pass) within the sacrum 15.
The hollow guide controller comprises a hollow sleeve 11, and the hollow sleeve 11 is arranged on a guide block 13.
The fixing device comprises a fixing block and a threaded nail 6, and the fixing block is divided into a single-hole fixing block 19 and a double-hole fixing block 18. The number of the single-hole fixing blocks 19 is two, the number of the double-hole fixing blocks 18 is one, and the number of the screw nails 6 is two. Be equipped with on haplopore fixed block 19 about penetrating square connecting hole 16 and upper and lower penetrating ilium fixed orifices 5, all be equipped with locking member on square connecting hole 16 and ilium fixed orifices 5, the locking hole 10 of two locking member all establishes on haplopore fixed block 19, be equipped with on diplopore fixed block 18 about penetrating and front and back penetrating two square connecting hole 16, it is penetrating about, be equipped with locking member on two front and back penetrating square connecting holes 16, the locking hole 10 of two locking member all establishes on diplopore fixed block 18, screw 6 can pass ilium fixed orifices 5 on haplopore fixed block 19 and bore on contralateral ilium 14 and be locked by the locking member of ilium fixed orifices 5, play fixed contralateral fixing device's effect.
Still include horizontal square connecting rod 17 and vertical square connecting rod 20, the contained angle of horizontal square connecting rod 17 and vertical square connecting rod 20 becomes 90 contained angles, the one end of horizontal square connecting rod 17 is connected with square connecting hole 16 on the locator body 1, the other end passes square connecting hole 16 of first piece single-hole fixed block 19 and is connected with the left and right sides through square connecting hole 16 of double-hole fixed block 18, and be locked by the locking member on three square connecting hole 16, vertical square connecting rod 20 one end is connected with the front and back through square connecting hole 16 of double-hole fixed block 18, the other end is connected with square connecting hole 16 of second piece single-hole fixed block 19, and be locked by the locking member on two square connecting hole 16. The transverse square connecting rod and the longitudinal square connecting rod are used for connecting the positioner body 1 and the opposite side fixing device, and the function of stabilizing the rectangular main positioner is achieved.
The working principle of example 1 is as follows:
before an operation, a patient is in a prone position, the upper surface of a sacrum 15 is perpendicular to the ground, a grid-shaped positioner is placed at the lumbosacral part, the sacrum 15 is positioned in a perspective mode, a point on the surface of a depressed bone on the outer side of an articular process on the sacrum 15 is determined and called as an A point, a virtual straight line which is parallel to a sagittal plane and vertically enters the sacrum downwards is made through the A point, a certain distance below the A point is selected to be an O point on the virtual straight line (the distance from the A point to the O point is an offset distance, the distance can be determined through CT measured data before the operation and is realized by adjusting scales on a hollow positioning rod 3), the O point is used as a virtual rotation center, and a proper rotation radius is selected on a backward extension line of an OA connecting line. And determining the included angle alpha between the nail path and the sagittal plane according to CT measurement data.
In the operation process, puncture is carried out in a vertical horizontal plane, a hollow positioning rod 3 reaches cortical bone at the point A, a thread guide pin 4 is inserted into the hollow positioning rod 3 and is screwed into cortical bone at the point A of a sacrum 15, a sacrum positioning hole 2 of a rectangular main positioner is sleeved on the hollow positioning rod 3, the hollow positioning rod 3 is locked by a locking hole 10 and a locking bolt 7 on the sacrum positioning hole 2 to fix the rectangular main positioner, different ilium fixing holes 5 on a positioner body 1 are selected according to different illness states of a patient, a screw 6 is inserted into the ilium fixing hole 5 and is drilled into an ilium 14, a locking component on the ilium fixing hole 5 is used for locking the screw 6 to stabilize the rectangular main positioner, and finally, the rectangular main positioner and an opposite side fixing device are connected by a transverse square connecting rod 17 through a square connecting hole 16 on the positioner body 1 and a square connecting hole 16 of the opposite side fixing device, the stability of the rectangular main positioner is improved.
Since the rotation offset (i.e. the distance from the rotation center O point to the cortical surface of the bone at the point a) and the included angle α between the nail track and the sagittal plane are determined before the operation, the arc-shaped scale rod 9 of the transverse arc-shaped adjuster is inserted into the arc-shaped slide way 21 of the transverse arc-shaped sleeve 8, the abduction angle of the transverse arc-shaped adjuster is adjusted to α according to the scale on the arc-shaped scale rod 9, and the transverse arc-shaped adjuster is locked by the locking member of the arc-shaped slide way 21 positioned on the transverse arc-shaped sleeve 8.
Inserting the hollow sleeve 11 into an opening sliding groove 12 of a rectangular guide block 13 of the transverse arc-shaped adjuster, enabling the tip of the hollow sleeve 11 to reach cortex outside the rear of an ilium 14 wing, enabling the extension line of the tip to pass through a point O, locking the hollow sleeve 11 by a locking component on the opening sliding groove 12, inserting a guide pin into the hollow sleeve 11, confirming the guide pin again through the perspective of a C-arm X-ray machine, drilling the guide pin into the outer cortex of the ilium 14 and the sacrum 15 through the hollow sleeve 11, maintaining the position of the hollow sleeve 11 after the guide pin enters 30-40mm, withdrawing the guide pin, and replacing the guide pin with a channel opener.
And (3) continuously opening the way by using the opener, selecting a proper limit resistance gear, enabling the opener to advance in the sacrum 15 and pass through the point O in the advancing process until reaching the opposite cortical bone of the sacrum 15, namely, observing the right side of the sacrum 15, measuring the depth and screwing in a sacroiliac screw with proper length and diameter.
Example 2:
as shown in fig. 8 to 12, the minimally invasive sacroiliac screw guide with fixed circle center-sphere center universal adjustment of rotation radius offset provided by the invention comprises a rectangular main positioner, a transverse arc-shaped adjuster, a hollow positioning rod and a hollow guide controller.
The rectangular main positioner comprises a positioner body 1 and a transverse arc-shaped sleeve 8 arranged at the front end of the positioner body, wherein a sacrum positioning hole 2 and an ilium fixing hole 5 which are through up and down are arranged on the positioner body 1, the sacrum positioning hole 2 is used for being inserted by a guide pin and plays a guiding role on the guide pin, and the ilium fixing hole 5 can be used for fixing the rectangular main positioner to an ilium 14 through a threaded nail. The sacrum positioning holes 2 on the positioner body 1 are positioned at the inner side of the ilium fixing holes 5, the number of the ilium fixing holes 5 is four, the ilium fixing holes are longitudinally arranged, only one sacrum positioning hole 2 is provided, the four ilium fixing holes 5 are designed to use the ilium fixing holes 5 at different positions according to different disease conditions of patients, and one sacrum positioning hole 2 is designed to use the depressed cortical bone or other key anatomical marks at the outer side of the upper articular process of the first sacrum 15 as a positioning reference point. Locking components are arranged on the sacrum positioning hole 2 and the ilium fixing hole 5, and the locking components are divided into a locking hole 10 and a locking bolt 7 detachably connected with the locking hole 10. Locking holes 10 on the sacrum positioning hole 2 and the ilium fixing hole 5 are located on the positioner body 1, two locking holes 10 are arranged on each sacrum positioning hole 2 and each ilium fixing hole 5, the locking holes 10 of the sacrum positioning hole 2 are located on the right side of the positioner body 1, the locking holes 10 of the ilium fixing hole 5 are located on the left side of the positioner body 1, and the guide pin can be locked by screwing the locking bolts 7 from the outside during use. And a left and right transparent transverse arc-shaped slide way 21 is arranged in the transverse arc-shaped sleeve 8, and the radian of the transverse arc-shaped slide way 21 is consistent with that of the transverse arc-shaped scale rod 9. The arc slideway 21 is provided with a locking component, and a locking hole 10 of the locking component is positioned on the transverse arc sleeve 8 and can be screwed in from the outside by using a locking bolt 7 for locking when in use. The positioner body 1 is also provided with a left and right through square connecting hole 16, and the square connecting hole 16 is provided with a locking component. The top surface of the transverse arc-shaped sleeve 8 is arranged in a forward and downward inclined shape relative to the positioner body 1 so as to adjust the circle center of the longitudinal arc-shaped scale rod 23 to be a virtual rotation sphere center O point, so that a doctor can adjust the scales on the transverse arc-shaped scale rod 9 and the longitudinal arc-shaped scale rod 23 inserted into the transverse arc-shaped slide way 21 and the longitudinal arc-shaped slide way 25 according to different conditions of a patient so as to determine the inserting direction of the sacroiliac screw.
The transverse arc-shaped adjuster comprises a transverse arc-shaped scale rod 9 and a guider arranged at the left end of the transverse arc-shaped scale rod, the transverse arc-shaped scale rod 9 penetrates through the transverse arc-shaped sleeve 8, and the transverse arc-shaped scale rod 9 can slide in the transverse arc-shaped sleeve 8; the scale on the transverse arc scale rod 9 can be freely adjusted according to the anatomical structure and different disease conditions of a patient to be inserted into the scale on the transverse arc scale rod 9 of the transverse arc slide rail 21 to match the included angle between the sacroiliac screw and the sagittal plane of a human body on the cross section, and the extension line of the sacroiliac screw nail track passes through the virtual rotation sphere center O point, so that the internal inclination angle of the sacroiliac screw can be accurately determined. The guider is a longitudinal arc-shaped scale rod 23, the hollow sleeve is arranged on the longitudinal arc-shaped scale rod through a sliding block 13, an opening sliding groove 12 which is through from left to right and is opened downwards is arranged in the sliding block 13, a locking component is arranged on the opening sliding groove 12, a locking hole 10 of the locking component is arranged on the sliding block 13, and the hollow sleeve 11 penetrates through the opening sliding groove 12 of the sliding block 13 and can slide in the sliding block 13. The hollow sleeve 11 is used for inserting the opening sliding groove 12 of the guide block 13 to reach the rear outer side of the ilium wing to play a role in positioning and guiding, and the extension line of the inserting direction of the hollow sleeve passes through the rotating spherical center O point. The longitudinal arc-shaped scale rod 23 is also externally provided with a longitudinal arc-shaped sleeve 24, the longitudinal arc-shaped sleeve 24 is connected with the transverse arc-shaped scale rod 9, and the longitudinal arc-shaped scale rod 23 is matched with the longitudinal arc-shaped sleeve 24 and can freely slide in the longitudinal arc-shaped sleeve 24. A longitudinal arc-shaped slide way 25 which is through from front to back is arranged in the longitudinal arc-shaped sleeve 24, and the longitudinal arc-shaped scale rod 9 freely slides in the longitudinal arc-shaped sleeve 24 through the longitudinal arc-shaped slide way 25. The longitudinal arc-shaped scale rod 23 is also provided with scales, the scales on the longitudinal arc-shaped scale rod 23 inserted into the longitudinal arc-shaped slide way 25 can be freely adjusted according to the anatomical structure and different disease conditions of a patient to match the included angle between the sacroiliac screw and the plane above the sacrum on the coronal plane, and the extension line of the sacroiliac screw nail track passes through the virtual rotation sphere center O point, so that the inclination angle of the cephalic side or the caudal side of the sacroiliac screw can be accurately determined, and the inserting direction of the sacroiliac screw can be determined. The plane of the transverse arc-shaped scale rod 9 is vertical to the plane of the longitudinal arc-shaped scale rod 23; and the transverse arc-shaped scale rod 9 and the longitudinal arc-shaped scale rod 23 both have the same rotating radius and the common sphere center.
The upper portion and the lower part of hollow locating lever 3 are cylindricly and the lower part diameter is less than the upper portion diameter, hollow locating lever 3 sets up on rectangle main positioning ware, be equipped with detachable connected screw thread guide pin 4 in hollow locating lever 3, the cylindric upper portion internal surface of hollow locating lever 3 is equipped with the screw thread, the surface is equipped with the scale, 4 tops of screw thread guide pin are the cylinder, the lower part is the guide pin, in the below of cylinder, the outside of guide pin is equipped with the screw thread, hollow locating lever 3 can the activity insert sacrum locating hole 2 and can be locked by the locking member above that. The hollow positioning rod 3 is inserted into the sacrum positioning hole 2 on the positioner body 1 to penetrate into the skin in cooperation with the threaded guide pin 4, the tip of the hollow positioning rod 3 is closely attached to the cortical bone surface (the point where the hollow positioning rod is closely attached to is the point A) or the bone surface of other key anatomical signs on the outer side of the upper articular process of the first sacrum 15, and the threaded guide pin 4 can be screwed into the sacrum 15 to stabilize the hollow positioning rod 3 and can not be screwed into the sacrum 15. Cumbersome and risky procedures that must rely on pedicle screws of the sacrum 15 as a reference are avoided. A virtual straight line which is parallel to the sagittal plane and vertically enters the sacrum 15 downwards is made through the point A, a point O (the point O is a virtual rotating sphere center) is selected at a certain distance below the point A on the virtual straight line, the distance from the point A to the point O is a misalignment distance, and the misalignment distance can be set by adjusting scales on a hollow positioning rod 3 inserted into a sacrum positioning hole during surgery. And thereby the exact location of the virtual sphere of rotation O point (also the point through which the sacroiliac screw and guide pin must pass) within the sacrum 15.
The hollow guiding controller comprises a hollow sleeve 11, and the hollow sleeve 11 is arranged on the guiding device.
The fixing device comprises a fixing block and a threaded nail 6, and the fixing block is divided into a single-hole fixing block 19 and a double-hole fixing block 18. The number of the single-hole fixing blocks 19 is two, the number of the double-hole fixing blocks 18 is one, and the number of the screw nails 6 is two. Be equipped with on haplopore fixed block 19 about penetrating square connecting hole 16 and upper and lower penetrating ilium fixed orifices 5, all be equipped with locking member on square connecting hole 16 and ilium fixed orifices 5, the locking hole 10 of two locking member all establishes on haplopore fixed block 19, be equipped with on diplopore fixed block 18 about penetrating and front and back penetrating two square connecting hole 16, it is penetrating about, be equipped with locking member on two front and back penetrating square connecting holes 16, the locking hole 10 of two locking member all establishes on diplopore fixed block 18, screw 6 can pass ilium fixed orifices 5 on haplopore fixed block 19 and bore on contralateral ilium 14 and be locked by the locking member of ilium fixed orifices 5, play fixed contralateral fixing device's effect.
Still include horizontal square connecting rod 17 and vertical square connecting rod 20, the contained angle of horizontal square connecting rod 17 and vertical square connecting rod 20 becomes 90 contained angles, the one end of horizontal square connecting rod 17 is connected with square connecting hole 16 on the locator body 1, the other end passes square connecting hole 16 of first piece single-hole fixed block 19 and is connected with the left and right sides through square connecting hole 16 of double-hole fixed block 18, and be locked by the locking member on three square connecting hole 16, vertical square connecting rod 20 one end is connected with the front and back through square connecting hole 16 of double-hole fixed block 18, the other end is connected with square connecting hole 16 of second piece single-hole fixed block 19, and be locked by the locking member on two square connecting hole 16. Horizontal square connecting rod, vertical square connecting rod are used for connecting locator body 1 and offside fixing device, play the function of stabilizing rectangle main positioning ware.
The working principle of example 2 is as follows:
before an operation, a patient is in a prone position, the upper surface of a sacrum 19 is perpendicular to the ground, a grid-shaped positioner is placed at the lumbosacral part, the sacrum 19 is positioned in a perspective mode, a point on the surface of a depressed bone on the outer side of an articular process on the sacrum 19 is determined and called as an A point, a virtual straight line which is parallel to a sagittal plane and vertically enters the sacrum downwards is made through the A point, a certain distance below the A point is selected to be an O point on the virtual straight line (the distance from the A point to the O point is an offset distance, the distance can be determined through CT measured data before the operation and is realized by adjusting scales on a hollow positioning rod 3), the O point is used as a virtual rotating sphere center, and a proper rotating radius is selected on a backward extension line of an OA connecting line. Before the operation, the included angle alpha between the nail path and the sagittal plane is determined according to CT measurement data.
In the operation process, puncture is carried out in a vertical horizontal plane, a hollow positioning rod 3 reaches cortical bone at the point A, a thread guide pin 4 is inserted into the hollow positioning rod 3 and is screwed into cortical bone at the point A of a sacrum 19, a sacrum positioning hole 2 of a rectangular main positioner is sleeved on the hollow positioning rod 3, the hollow positioning rod 3 is locked by a locking hole 8 and a locking bolt 11 on the sacrum positioning hole 2 to fix the rectangular main positioner, different ilium fixing holes 5 on a positioner body 1 are selected according to different illness states of a patient, a screw 6 is inserted into the ilium fixing hole 5 and is drilled into an ilium 18, a locking component on the ilium fixing hole 5 is used for locking the screw 6 to stabilize the rectangular main positioner, and finally a transverse square connecting rod 22 is used for connecting the rectangular main positioner with an opposite side fixing device through a square connecting hole 21 on the positioner body 1 and a square connecting hole 21 of the opposite side fixing device, the stability of the rectangular main positioner is improved.
Since the rotation offset (i.e. the distance from the rotation center O to the cortical surface at a point) and the included angle α between the nail track and the sagittal plane are determined before the operation, the transverse arc-shaped graduated rod 10 of the transverse arc-shaped adjuster is inserted into the transverse arc-shaped slideway 20 of the transverse arc-shaped sleeve 9 which is inclined forwards and inwards, the abduction angle of the transverse arc-shaped adjuster is adjusted to α according to the scale on the transverse arc-shaped graduated rod 10, and the transverse arc-shaped slideway 20 on the transverse arc-shaped sleeve 9 is locked by the locking member. The longitudinal arc scale rod 15 of the longitudinal arc adjuster is inserted into the longitudinal arc slideway 17 of the longitudinal arc sleeve 16 of the transverse arc adjuster and locked by the locking component of the longitudinal arc slideway 17 on the longitudinal arc sleeve 16. Finally, the hollow sleeve 12 is inserted into an opening sliding groove 13 of a rectangular guide block 14 of the longitudinal arc-shaped adjuster, the tip of the hollow sleeve 12 reaches the cortex of the back outer side of the ilium 18 wing, the extension line of the tip passes through a point O, the hollow sleeve 12 is locked by a locking component on the opening sliding groove 13, a guide pin is inserted into the hollow sleeve 12 and is confirmed again through the perspective of a C-arm X-ray machine, the guide pin drills into the outer cortex of the ilium 18 and the sacrum 19 through the hollow sleeve 11, the position of the hollow sleeve 12 is maintained after the guide pin enters 30-40mm, the guide pin is withdrawn, and the route opener is replaced.
And (3) continuously opening the way by using the opener, selecting a proper limit resistance gear, and enabling the opener to advance in the sacrum 19 and pass through the point O in the advancing process until reaching the opposite cortical bone of the sacrum 19, so that the right side of the sacrum 19 can be seen through, the depth can be measured, and the sacroiliac screw with proper length and diameter can be screwed in.
The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents, improvements and the like that fall within the spirit and principle of the present invention are intended to be included therein.
Claims (10)
1. A minimally invasive sacroiliac screw guider with fixed circle center and spherical center for universal adjustment of rotating radius offset is characterized in that: comprises a rectangular main positioner, a transverse arc regulator, a hollow positioning rod and a hollow guide controller;
the rectangular main positioner comprises a positioner body and a transverse arc-shaped sleeve arranged at the front end of the positioner body, the positioner body is provided with a sacrum positioning hole and an ilium fixing hole which are through up and down, and the sacrum positioning hole and the ilium fixing hole are both provided with locking members;
the transverse arc regulator comprises a transverse arc scale rod and a guider arranged at the left end of the transverse arc scale rod; the transverse arc-shaped scale rod penetrates through the transverse arc-shaped sleeve and can slide in the transverse arc-shaped sleeve;
the hollow positioning rod is arranged on the rectangular main positioner, a detachably connected threaded guide pin is arranged in the hollow positioning rod, and the hollow positioning rod can be movably inserted into the sacrum positioning hole and can be locked by a locking component on the sacrum positioning hole;
the hollow guide controller comprises a hollow sleeve, and the hollow sleeve is arranged on the guide.
2. The circle-center-sphere-center universally-adjustable rotation radius offset minimally invasive sacroiliac screw guide of claim 1, wherein: the top surface of the transverse arc-shaped sleeve is arranged horizontally or forwards and downwards obliquely relative to the top surface of the positioner body.
3. The circle-center-sphere-center universally-adjustable rotation radius offset minimally invasive sacroiliac screw guide of claim 1, wherein: penetrating horizontal arc slide about being equipped with in the horizontal arc sleeve, horizontal arc slide is unanimous with the radian of horizontal arc scale rod, horizontal arc scale rod is equipped with the scale on the surface.
4. The circle-center-sphere-center universally-adjustable rotation radius offset minimally invasive sacroiliac screw guide of claim 1, wherein: the upper portion and the lower portion of the hollow positioning rod are cylindrical, the diameter of the lower portion of the hollow positioning rod is smaller than that of the upper portion of the hollow positioning rod, and scales are arranged on the outer surface of the cylindrical upper portion of the hollow positioning rod.
5. The circle-center-sphere-center universally-adjustable rotation radius offset minimally invasive sacroiliac screw guide of claim 1, wherein: the guider is a guide block or a longitudinal arc-shaped scale rod; the hollow sleeve penetrates through the guide block and then is movably arranged on the guider or is arranged on the longitudinal arc-shaped scale rod through the sliding block, and scales are arranged on the surface of the longitudinal arc-shaped scale rod.
6. The circle-center-sphere-center universally-adjustable rotation radius offset minimally invasive sacroiliac screw guide of claim 5, wherein: the longitudinal arc-shaped scale rod is externally provided with a longitudinal arc-shaped sleeve, the longitudinal arc-shaped sleeve is connected with the transverse arc-shaped scale rod, and the longitudinal arc-shaped scale rod is matched with the longitudinal arc-shaped sleeve and can freely slide in the longitudinal arc-shaped sleeve.
7. The circle-center-sphere-center universally-adjustable rotation radius offset minimally invasive sacroiliac screw guide of claim 1, wherein: still include offside fixing device, offside fixing device includes fixed block and screw thread nail, and the fixed block divide into haplopore fixed block and diplopore fixed block, is equipped with about on the haplopore fixed block penetrating square connecting hole and upper and lower penetrating ilium fixed orifices, all is equipped with locking member on square connecting hole and ilium fixed orifices, controls penetrating and two front and back penetrating square connecting holes about being equipped with on the diplopore fixed block, is equipped with locking member on controlling penetrating, front and back penetrating two square connecting holes.
8. The circle-center-sphere-center universally-adjustable radius of rotation offset minimally invasive sacroiliac screw guide of claim 7, wherein: the single-hole fixing blocks are two, the double-hole fixing blocks are one, the threaded nails are two, and the threaded nails can penetrate through the ilium fixing holes in the single-hole fixing blocks, drill into the opposite ilium and are locked by the locking members in the ilium fixing holes.
9. The circle-center-sphere-center universally-adjustable rotation radius offset minimally invasive sacroiliac screw guide of claim 1, wherein: still include horizontal square connecting rod and vertical square connecting rod, the one end of horizontal square connecting rod is connected with the square connecting hole on the locator body, the other end passes the square connecting hole of first haplopore fixed block and the penetrating square connecting hole of controlling of diplopore fixed block is connected, and by the locking member locking on the three square connecting hole, vertical square connecting rod one end is connected with the penetrating square connecting hole around the diplopore fixed block, the other end is connected with the square connecting hole of second haplopore fixed block, and by the locking member locking on two square connecting holes.
10. The circle-center-sphere-center universally-adjustable rotation radius offset minimally invasive sacroiliac screw guide of claim 1, wherein: the plane of the transverse arc-shaped scale rod is vertical to the plane of the longitudinal arc-shaped scale rod; and the horizontal arc-shaped scale rod and the longitudinal arc-shaped scale rod have the same rotating radius and the common sphere center.
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