CN111053631A - Novel spinal full-endoscope fusion implantation system - Google Patents
Novel spinal full-endoscope fusion implantation system Download PDFInfo
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- CN111053631A CN111053631A CN201911175526.2A CN201911175526A CN111053631A CN 111053631 A CN111053631 A CN 111053631A CN 201911175526 A CN201911175526 A CN 201911175526A CN 111053631 A CN111053631 A CN 111053631A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
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- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00163—Optical arrangements
- A61B1/00174—Optical arrangements characterised by the viewing angles
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/015—Control of fluid supply or evacuation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
- A61B1/317—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for bones or joints, e.g. osteoscopes, arthroscopes
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Abstract
The invention provides a novel spinal full-endoscope fusion implantation system, which comprises a forward-looking endoscope, a backward-looking endoscope, a fusion device and a fusion device implantation tool assembly, wherein a clamping tube and the backward-looking endoscope are fixedly installed as a whole after being nested and connected with a clamping tube handle, the fusion device locker penetrates through the clamping tube and is fixedly connected with the fusion device through threads, a forward-looking endoscope adjuster is nested and connected with a combination of the forward-looking endoscope and a buckle seat, a knocking end cover is sleeved on the forward-looking endoscope adjuster, and a combination formed by the forward-looking endoscope adjuster, the forward-looking endoscope, the buckle seat and the knocking end cover penetrates into the tail part of the fusion device locker to ensure that the foremost end of the forward-looking endoscope reaches the foremost end of the fusion device; the system adopts one endoscope or two endoscopes with different specifications and special tools to be combined according to different operations, monitors peripheral tissues under the whole-process endoscope direct vision, and avoids compression and traction mechanical damage of fusion devices to peripheral important tissues to the maximum extent.
Description
Technical Field
The invention relates to the field of medical equipment, in particular to a novel spinal full-endoscopic fusion implantation system which is used for intervertebral fusion operation under percutaneous spinal endoscopy and realizes the implantation of a fusion cage under the monitoring of the full-endoscopic.
Background
In recent years, with the development and popularization of minimally invasive surgery, an endoscope system for operation is applied in the fields of orthopedics, spinal surgery, gynecology, urology surgery, neurosurgery and the like on a large scale, an instrument channel is arranged in a percutaneous spinal endoscope, an eyepiece adopts an oblique angle design, a thick and powerful surgical instrument is convenient to use, in order to ensure that the field of vision in the operation is clear, a liquid perfusion channel, a water outlet channel and an illumination light channel are integrated in a lens body, and the illumination light channel is usually composed of a bundle of optical fibers, so that illumination light generated by an external light source is introduced and used for illuminating the field of the operation; an intervertebral fusion device, as an orthopedic implantable medical instrument, is an implant for realizing the fusion of adjacent vertebral bodies of a vertebral column, and is generally used for being implanted into a vertebral body gap of the vertebral column, replacing a taken out intervertebral disc, fixing a vertebral canal and recovering the height lost due to the lesion of the vertebral body so as to avoid the compression of nerves. The percutaneous spinal endoscope is designed to realize basically the same functions aiming at different indications and approaches of spinal surgery, simultaneously, the aim of any surgical operation is to achieve the best clinical effect on the basis of minimal trauma, and the endoscopic of intervertebral fusion surgery is also the main development trend of spinal minimally invasive surgery treatment.
The MED technique was first introduced by Smith and Foley in 1995 and was later adopted by the American company SOFAMR DANK. The MED technology, namely the lumbar discectomy under the assistance of an endoscope, is an endoscopic lumbar discectomy through a posterior vertebral plate gap, and is characterized in that all operation operations are completed through a working channel with the diameter of 16-18mm under the assistance of the endoscope, which is essentially different from a percutaneous endoscope. The MED technology can be operated under the direct vision of an endoscope, is matched with special surgical instruments, has the advantages of small incision, small range of stripped tissues, less bleeding and the like compared with the conventional open surgery, and has similar surgical indications to the conventional open surgery; the defect is obvious, as the diameter of the working channel is large, more tissues need to be cut off during the operation, the damage to the bony and muscular tissues of the spine is serious, the stability of the lumbar vertebra is affected, the vertebral pedicle screw rod needs to be implanted to fix the spine after the fusion, the damage to the patient with good spine stability before the operation or the patient with simple slippage is large, and the prognosis is poor.
In recent years, home and abroad clinicians adopt the full-endoscope to treat intervertebral discs and bony stenosis under the full-endoscope technology, treat intervertebral discs and vertebral body end plates under the direct vision of the endoscope and implant a fusion cage, but are limited by the size, shape and volume of the traditional fusion cage, the implantation process of the fusion cage cannot be operated under the direct vision of the endoscope, only protective sheath tubes or special fusion cages with small size and special specification can be used, or larger bony tissues are cut off to avoid the mechanical damage to important tissues such as nerve vessels and the like in the implantation process of the fusion cage, so serious complications are caused, the implantation process of the fusion cage cannot be monitored by the endoscope in the technology, so the technology cannot be called the full-endoscope technology and shall be called the spine fusion technology under the assistance of the endoscope.
The endoscope-assisted fusion technology has the advantages that the fusion channel is established under the condition of direct vision through the endoscope, direct vision operation is performed, tissue damage is small compared with the prior open or minimally invasive technology, bleeding is less, visual field perfusion is clearer, and due to small damage, part of operators do not need to fix a nail after implanting the fusion device, but the operation is limited by the size of the fusion device, and the operation can not be performed under the condition of endoscope monitoring during implantation, so that the blind vision operation easily causes compression or traction damage to important tissues (such as blood vessels, nerves, muscles and the like) at the periphery of the implantation channel; once the nerves and important blood vessels are damaged, the operation fails, the postoperative recovery and prognosis of the patient are poor, and secondary open operation revision is needed in severe cases, so that the burden and the pressure of the patient are greatly increased. Meanwhile, the technology adopts the fusion cage and the channel which are specially designed to reduce the occurrence of the problems, and the popularization of the technology has risks and limitations due to the defects, so that the safety and popularization value of the technology are greatly improved by designing a system which can implant the fusion cage under the whole-process endoscopic monitoring.
Disclosure of Invention
The invention aims to overcome the defects in the prior art, and provides a novel spinal full-endoscope fusion implantation system which can observe the tissue structure at the front end of a fusion device in the whole process and monitor the peripheral tissue structure of the fusion device from the tail end of the fusion device so as to ensure that the peripheral tissue is monitored under the whole-process endoscope direct vision in the fusion device implantation process and avoid the compression and traction mechanical damage of the fusion device to the peripheral important tissue to the maximum extent.
In order to achieve the purpose, the invention is realized by the following technical scheme:
the utility model provides a novel full scope of backbone fuses system of implanting, includes that foresight endoscope, rear-view endoscope, fusion ware and fusion ware implant the instrument subassembly, fusion ware implant the instrument subassembly and include centre gripping pipe, centre gripping pipe handle, fusion ware locker, foresight endoscope regulator, knot seat and strike the end cover, fixed mounting is carried out as whole and centre gripping pipe handle after centre gripping pipe and the rear-view endoscope nested connection, the fusion ware is installed at centre gripping pipe front end, fusion ware locker passes through screw thread and fusion ware fastening connection from the centre gripping intraduct, the knot seat passes foresight endoscope's optical fiber splice and chucking on the foresight endoscope, foresight endoscope regulator and the combination nested connection of knot seat, strike the end cover suit on foresight endoscope regulator, the end cover, The combination body formed by the buckling seat and the knocking end cover penetrates through the tail part of the fusion device locker, so that the foremost end of the forward-looking endoscope reaches the foremost end of the fusion device.
Preferably, the instrument channel inside the rear view endoscope is sized to receive a cage implantation tool assembly.
Preferably, the cage implantation tool assembly is of a hollow design and is strong to withstand blows.
Preferably, the rear view endoscope has an irrigation channel.
Preferably, the rear-view endoscope can rotate and move back and forth on the clamping tube.
A novel spine full-endoscope fusion implantation system comprises a forward-looking endoscope, a fusion cage and a fusion cage implantation tool assembly, wherein the fusion cage implantation tool assembly comprises a clamping tube, a clamping tube handle, a fusion cage locker, a forward-looking endoscope adjuster, a buckle seat and a knocking end cover, the clamping tube and the clamping tube handle are nested and installed, the fusion cage is installed at the front end of the clamping tube, the fusion cage locker penetrates through the clamping tube and is fixedly connected with the fusion cage through threads, the buckle seat penetrates through an optical fiber connector of the forward-looking endoscope and is clamped on the forward-looking endoscope, the forward-looking endoscope adjuster is nested and connected with a combination of the forward-looking endoscope and the buckle seat, the knocking end cover is sleeved on the forward-looking endoscope adjuster, and a combination formed by the forward-looking endoscope adjuster, the forward-looking endoscope, the buckle seat and the knocking end cover penetrates into the tail part of the fusion cage locker, the foremost end of the forward looking endoscope is brought to the foremost end of the fusion device.
Preferably, the two sides of the buckle seat are provided with limiting structures protruding in parallel.
Preferably, the diameter of the through hole of the fusion device is larger than or equal to the diameter of the outer working tube of the forward-looking endoscope.
Preferably, the forward looking endoscope employs an impact resistant optical system comprising a fiber optic or electronic endoscope.
Preferably, the forward looking endoscope has an irrigation channel.
Preferably, the forward looking endoscope has an irrigation instrument channel insertable into a k-wire used for the implantation of the fusion device.
Preferably, the body of the forward looking endoscope is connected with a limit structure for adjusting the axial movement of the forward looking endoscope in a nested manner.
Preferably, the fusion cage locker comprises a spring block compression ring, the spring block compression ring is connected with a spring block in a nested manner, the spring block is connected with a spring block pressure spring in a nested manner, the spring block pressure spring is connected with a spring block sheath in a nested manner, the spring block sheath is connected with a locking screw fixed block in a nested manner, the locking screw fixed block is connected with a locking wrench in a nested manner, the locking wrench is connected with a first damping ring in a nested manner, an integral assembly formed by the spring block compression ring, the spring block pressure spring, the spring block sheath, the locking screw fixed block, the locking wrench and the first damping ring is embedded at the tail end of the locking screw, and the locking wrench adopts a polygonal star structure with 2-8 corners twisted by hands.
Preferably, the foresight endoscope regulator is including strikeing the pipe, rotating ring, endoscope adjustable ring, locking spanner connector have been arranged in proper order to the front end of strikeing the pipe, install the location pearl on the locking spanner connector, driving ring and endoscope adjustable ring and strike and all be provided with the second damping circle between the pipe, set up the spacing collar of injecing endoscope adjustable ring axial displacement between endoscope adjustable ring and the locking wrench connector, the driving ring axial displacement is further injecing through the screw connection with the driving ring to the endoscope adjustable ring, the internally mounted who strikes the pipe has the endoscope holding ring, through pin joint between driving ring and the endoscope holding ring, the end of strikeing the pipe is connected with the end cover of strikeing.
Preferably, the driving ring is provided with a spiral groove for the rotation of the pin and two circular screw holes.
Preferably, the knocking end cover comprises an end cover, an end cover pressure spring is arranged at the tail end of the end cover and the knocking pipe, the end cover pressure spring is connected to the end cover in a screw fixing mode through three hole gaskets, and buttons, button pressure springs and movable clamping pins which are centrosymmetric and are sequentially arranged in a nested mode are arranged at two ends of the end cover.
Preferably, a water drop-shaped clamping groove is formed in the joint of the tail end of the knocking pipe and the end cover in a nested mode, and the water drop-shaped clamping groove and the movable clamping pin are nested to lock or release the position connection relation between the knocking end cover and the knocking pipe.
Preferably, the angle of field of the forward looking endoscope is larger than 90 degrees, and the forward looking endoscope can adopt a rigid endoscope with 0 degrees or semi-soft optical fibers with a certain visual angle.
Preferably, the fusion cage type can be a hollow fixed-height fusion cage, a distractable fusion cage, a dovetail type fusion cage.
The invention has the beneficial effects that:
1. the novel spinal full-endoscope fusion implantation system can implant a fusion device under the whole-course endoscope monitoring, and allows one endoscope or two endoscopes with different specifications to be combined with a special tool according to different operation indications, so that the tissue structure at the front end of the fusion device can be observed in the whole course in the process of implanting the fusion device, and the peripheral tissue structure of the fusion device can be monitored from the tail end of the fusion device, so that the peripheral tissue can be monitored under the whole-course endoscope direct vision in the process of implanting the fusion device, the compression and traction mechanical damage of the fusion device to peripheral important tissues (such as blood vessels or nerves) can be avoided to the maximum extent, and due to the whole-course operation, the fusion device with larger size and different shapes can be adopted, and the requirement on the spinal minimally invasive operation indications under the endoscope is reduced.
2. The angle of field of the forward-looking endoscope of the spinal full-endoscope fusion implantation system is larger than 90 degrees, a hard endoscope of a semi-soft optical fiber with 0 degree or a certain visual angle can be adopted, the forward-looking endoscope with a smaller diameter can be placed in the middle of a fusion device and does not influence the strength of the fusion device, the fusion device is knocked without damaging an optical imaging system of the endoscope, the outer diameter of an outer working tube of the forward-looking endoscope is smaller than the diameter of a through hole at the front end of the hollow fusion device, so that the front end of the outer working tube of the middle-placed endoscope can pass through the hollow fusion device and penetrate out of the through hole, the condition of tissues around the front end of the fusion device is observed, and.
3. The rearview endoscope of the spinal full-endoscope fusion implantation system has a larger instrument channel (which can be arranged in the middle or offset), and can be used for placing a thicker fusion device implantation tool by combining the self viewing direction angle (generally adopting 15-30 degrees) and a large viewing field (more than or equal to 75 degrees) of the endoscope, and meanwhile, the instrument channel implantation tool can be used as a shaft for rotating, so that the situation of 360-degree tissues around the fusion device can be observed from the rear end of the fusion device through the viewing angle, the viewing field and 360-degree rotation of the rearview endoscope, and the compression or damage to the surrounding tissues in the implantation process can be prevented.
4. The foresight endoscope of the spinal full-endoscope fusion implantation system is provided with a perfusion channel and an instrument channel and is used for liquid perfusion and placing a Ke's guide pin.
5. The spinal full-endoscope fusion implantation system can independently complete the operation of implanting the fusion device under the direct view of the endoscope, and can also complete the operation of implanting the fusion device together by adding a baffle or a working sheath for protecting nerves or blood vessels.
6. The spinal full-endoscopic fusion implantation system of the invention is applicable to, but not limited to, the following fusion cage types, including hollow fixed-height fusion cages, distractable fusion cages, dovetail type fusion cages, and the like.
Drawings
FIG. 1a is a schematic diagram of the overall structure of the system apparatus of the present invention using two mirrors;
FIG. 1b is a schematic diagram of an exploded structure of the system apparatus of the present invention using two mirrors;
FIG. 1c is a partial cross-sectional block diagram of the system apparatus of the present invention employing a double mirror;
FIG. 2a is a view of the retainer assembly of the cage of the system of the present invention;
FIG. 2b is a block diagram of a locking wrench of the system of the present invention;
FIG. 3a is a view of the assembled front endoscope adjuster of the system of the present invention;
FIG. 3b is a block diagram of the assembled knocking end cap of the system-assembly of the present invention;
FIG. 3c is a schematic view of a drive ring of the system of the present invention;
FIG. 3d is a schematic view of a knocking tube structure of the system-apparatus of the present invention;
FIG. 3e is a schematic view of a buckle seat structure of the system apparatus of the present invention;
FIG. 4 is a schematic diagram of the overall structure of the system device of the present invention using a single mirror.
In the figure: 1. a fusion device; 2. clamping the tube; 3. a rearview endoscope; 4. a clamping tube handle; 5. a fusion cage locker; 6. a forward looking endoscope adjuster; 7. a forward looking endoscope; 8. a buckle seat; 9. knocking the end cover; 10. a positioning bead; 11. a spring block compression ring; 12. a spring block; 13. a spring block compression spring; 14. a bullet sheath; 15. locking the screw rod fixing block; 16. locking the wrench; 17. a first damping ring; 18. locking the screw rod; 19. locking the wrench connector; 20. an endoscope adjustment ring; 21. a second damping ring; 22. a drive ring; 23. knocking the tube; 24. an endoscope positioning ring; 25. knocking the end cover; 26. a button; 27. a movable bayonet lock; 28. an end cap; 29. a button pressure spring; 30. and an end cover compression spring.
Detailed Description
The invention will be further described with reference to the accompanying drawings and the detailed description below:
as shown in fig. 1a to fig. 3e, a novel spinal column full-endoscope fusion implantation system comprises a front-view endoscope 7, a rear-view endoscope 3, a fusion cage 1 and a fusion cage implantation tool component, wherein the fusion cage implantation tool component comprises a clamping tube 2 and a clamping tube handle 4, the fusion cage locker 5, the forward-looking endoscope adjuster 6, the buckle seat 8 and the knocking end cover 9, the clamping tube 2 and the backward-looking endoscope 3 are fixedly installed with the clamping tube handle 4 as a whole after being nested and connected, the fusion cage 1 is installed at the front end of the clamping tube 2, the fusion cage locker 5 penetrates through the clamping tube 2 and is fixedly connected with the fusion cage 1 through threads, the buckle seat 8 penetrates through an optical fiber connector of the forward-looking endoscope 7 and is clamped on the forward-looking endoscope 7, and the two sides of the buckle seat 8 are provided with parallel raised limiting structures and regulate the axial movement of the forward-looking endoscope 7 together with the forward-looking endoscope adjuster 6; the foresight endoscope regulator 6 is nested with a combination of the foresight endoscope 7 and the buckle seat 8, the knocking end cover 9 is sleeved on the foresight endoscope regulator 6, and a combination formed by the foresight endoscope regulator 6, the foresight endoscope 7, the buckle seat 8 and the knocking end cover 9 penetrates into the tail part of the fusion device locker 5, so that the foremost end of the foresight endoscope 7 reaches the foremost end of the fusion device 1.
The fusion cage locker 5 comprises a spring block compression ring 11, the spring block compression ring 11 is connected with a spring block 12 in a nested manner, the spring block 12 is connected with a spring block compression spring 13 in a nested manner, the spring block compression spring 13 is connected with a spring block sheath 14 in a nested manner, the spring block sheath 14 is connected with a locking screw rod fixing block 15 in a nested manner, the locking screw rod fixing block 15 is connected with a locking wrench 16 in a nested manner, the locking wrench 16 is connected with a first damping ring 17 in a nested manner, an integral assembly formed by the spring block compression ring 11, the spring block 12, the spring block compression spring 13, the spring block sheath 14, the locking screw rod fixing block 15, the locking wrench 16 and the first damping ring 17 is nested at the tail end of a locking screw rod 18, and the locking wrench 16 adopts a polygonal star structure.
The front-view endoscope adjuster 6 comprises a knocking pipe 23, a driving ring 22 is sequentially arranged at the front end of the knocking pipe 23, an endoscope adjusting ring 20 and a locking wrench connector 19, a positioning ball 10 is mounted on the locking wrench connector 19, a second damping ring 21 is arranged between the driving ring 22 and the endoscope adjusting ring 20 and between the knocking pipe 23, a limiting ring limiting the axial movement of the endoscope adjusting ring 20 is arranged between the endoscope adjusting ring 20 and the locking wrench connector 19, the endoscope adjusting ring 20 and the driving ring 22 are connected through screws to further limit the axial movement of the driving ring 22, an endoscope positioning ring 24 is mounted inside the knocking pipe 23, the driving ring 22 and the endoscope positioning ring 24 are connected through pins, the tail end of the knocking pipe 23 is connected with a knocking end cover 9, and a spiral groove and a circular hole for the rotation of the pins are formed in the driving ring 22.
The knocking end cover 9 comprises an end cover 28, end cover pressure springs 30 are arranged at the tail ends of the end cover 28 and the knocking pipe 23, the end cover pressure springs 30 are connected to the end cover 28 through three-hole gaskets in a screw fixing mode, and two ends of the end cover 28 are provided with a button 26, a button pressure spring 29 and a movable clamping pin 27 which are centrosymmetric and sequentially nested. The joint of the end of the knocking pipe 23 and the end cover 28 is provided with a water drop-shaped clamping groove, and the water drop-shaped clamping groove and the movable clamping pin 27 are embedded to lock or release the position connection relation between the knocking end cover 9 and the knocking pipe 23.
The size of an instrument channel in the rearview endoscope 3 can be used for placing a fusion device implantation tool assembly, and the fusion device implantation tool assembly is hollow and has the strength of resisting knocking; the rear-view endoscope 3 also has an irrigation channel and can be rotated and moved back and forth on the holding tube 2.
Forward looking endoscope 7 has an irrigation channel and an irrigation instrument channel and employs an impact resistant optical system, which may be a fiber or electronic endoscope. Because the angle of field of the forward-looking endoscope 7 is larger than 90 degrees, the forward-looking endoscope 7 can adopt a rigid endoscope with 0 degree or semi-flexible optical fibers with a certain angle of view; the infusion instrument channel can be inserted with a Kirschner wire which is used for implanting the fusion cage 1, and the fusion cage 1 can be a hollow fusion cage with fixed height, a distracting fusion cage or a dovetail fusion cage; the diameter of the through hole of the fusion device 1 is larger than or equal to the diameter of the outer working tube of the forward-looking endoscope.
As shown in figure 4, the invention also provides another novel spine full-endoscope fusion implantation system, which comprises a forward-looking endoscope 7, a fusion cage 1 and a fusion cage implantation tool assembly, wherein the fusion cage implantation tool assembly comprises a clamping tube 2, a clamping tube handle 4, a fusion cage locker 5, a forward-looking endoscope regulator 6, a buckle seat 8 and a knocking end cover 9, the clamping tube 2 and the clamping tube handle 4 are nested and installed, the fusion cage 1 is installed at the front end of the clamping tube 2, the fusion cage locker 5 penetrates through the clamping tube 2 and is fixedly connected with the fusion cage 1 through threads, the buckle seat 8 penetrates through an optical fiber connector of the forward-looking endoscope 7 and is clamped on the forward-looking endoscope 7, the forward-looking endoscope regulator 6 is nested and connected with a combination of the forward-looking endoscope 7 and the buckle seat 8, the knocking end cover 9 is sleeved on the forward-looking endoscope regulator 6, the forward, The combination body formed by the buckle seat 8 and the knocking end cover 9 penetrates into the tail part of the fusion device locker 5, so that the foremost end of the forward looking endoscope 7 reaches the foremost end of the fusion device 1.
This single mirror structural design compares the novel full scope of percutaneous backbone that adopts the double mirror, only reduces on the basis of rearview endoscope 3, make the main treatment doctor who performs the operation can adopt an endoscope or adopt the endoscope and the specialized tool of two different specifications to make up according to different operation indications, improve the convenience and the security of treatment, when only needing an endoscope can satisfy the operation needs, peep 3 excision in the back vision and become the novel full scope of percutaneous backbone that possesses an endoscope in the mechanism of double mirror.
Example 1:
referring to the embodiment shown in fig. 1a to 3e, the novel spinal full-endoscope fusion implantation system of the invention adopts a clamping tube 2 to pass through a rearview endoscope 3 to be installed on a clamping tube handle 4, a fusion device 1 is installed at the front end of the clamping tube 2, the fusion device 1 adopts a hollow fixed-height fusion device commonly used in medicine, a fusion device locker 5 passes through the clamping tube 2 and is connected and fastened with the hollow fixed-height fusion device through threads, a buckle base 8 passes through an optical fiber connector on the rearview endoscope 7 to be clamped thereon, the combination of the two devices is penetrated into a knocking tube 23, as the two sides of the buckle base 8 are designed with limiting structures with parallel bulges, the combination can slide along the axial direction of the knocking tube 23 and cannot rotate mutually, finally, a knocking end cover 9 is sleeved on the knocking tube 23, the knocking tube 23 together with the rearview endoscope 3 and the like is penetrated from the tail part of the fusion device locker 5, the frontmost end of the rearview endoscope 3 can reach the frontmost end of the hollow fixed height fusion device to realize the observation of the outer side of the hollow fixed height fusion device (the under-lens monitoring of the hollow fixed height fusion device), and the frontmost end of the rearview endoscope 7 also changes relative to the position of the fusion device 1 because the buckle seat 8 can axially move relative to the knocking tube 23 to realize the monitoring position adjustment, and the rearview endoscope 3 is sleeved outside the clamping tube 2 and can rotate and move to realize the monitoring of the external condition of the fusion device 1; the invention adopts a hexagonal hexagram locking wrench, as the locking wrench 16 is provided with the first damping ring 17, the knocking tube 23 is internally provided with the positioning ball 10, and the positioning ball 10 is just clamped in the circumferential groove arranged on the locking wrench 16, the knocking tube 23 can rotate with the fusion device locker 5 mutually and cannot move axially, the forward-looking endoscope 7 is safely limited in a position which is relatively stable with the fusion device 1 and cannot fall off naturally, and the safety of the backward-looking endoscope 7 is ensured and the condition of the front end of the fusion device 1 can be observed rotationally; two positioning balls 10 are arranged on a locking wrench connector 19, a driving ring 22, a second damping ring 21, an endoscope adjusting ring 20 and the locking wrench connector 19 are sequentially arranged in front of a knocking tube 23, an endoscope positioning ring 24 is arranged in the knocking tube 23, the driving ring 22 is connected with the endoscope positioning ring 24 through a pin, a spiral track for the pin to move is arranged on the driving ring 22, when the driving ring 22 rotates on the endoscope adjusting ring 20 connected with the driving ring through a screw, the endoscope positioning ring 24 moves along the axial direction of the endoscope positioning ring due to the fact that the axial movement of the endoscope adjusting ring 20 is limited, and after a knocking end cover 25 is arranged at the tail end of the knocking tube 23, a pressure spring 30 on the knocking end cover 25 forces a forward looking endoscope 7 to be attached to the endoscope positioning ring 24, so that the axial position of the forward; the tail end of the knocking pipe 23 is provided with a water drop-shaped clamping groove, movable clamping pins 27, button pressure springs 29 and buttons 26 are installed on two sides of the end cover 28, the buttons 26 are pressed down, the thin diameter sections above the movable clamping pins 27 are used for clamping the tail end of the knocking pipe 23, the whole knocking end cover 9 can be buckled into the tail end of the knocking pipe 23, the buttons 26 are loosened, the thick diameter sections above the movable clamping pins 27 are clamped at the tail end of the knocking pipe 23, and therefore the knocking end cover 9 is locked on the knocking pipe 23.
The fusion device 1 is delivered to a designated position through a sheath tube which is previously installed on a human body, the medical hammer is used for lightly knocking and knocking the end cover 9, the transmission of force enables the fusion device 1 to reach the designated position of the spinal column and be clamped between the designated position and the designated position, after the fusion device 1 is confirmed to be in a proper position, the knocking tube 23, the forward-looking endoscope 7 and the like are drawn out from the tail part of the fusion device locker 5, the clamping tube handle 4 is held, threads between the fusion device locker 5 and the fusion device 1 are unscrewed and loosened, the fusion device 1 is separated from other parts, all parts except the fusion device 1 are taken out, and the fusion device 1 is left at the expected position in the human body.
Various other modifications and changes may be made by those skilled in the art based on the above-described technical solutions and concepts, and all such modifications and changes should fall within the scope of the claims of the present invention.
Claims (19)
1. The utility model provides a novel full scope of backbone fuses implants system, its characterized in that, includes that foresight endoscope, rear-view endoscope, fusion ware and fusion ware implant the instrument subassembly, fusion ware implant the instrument subassembly and include grip tube, grip tube handle, fusion ware locker, foresight endoscope regulator, knot seat and strike the end cover, fixed mounting is carried out as whole and grip tube handle after grip tube and the rear-view endoscope nested connection, the fusion ware is installed at the grip tube front end, the fusion ware locker passes through screw thread and fusion ware fastening connection from the grip tube is inside, the knot seat passes the optical fiber splice of foresight endoscope and blocks on the foresight endoscope, foresight endoscope regulator and the combination nested connection of knot seat, strike the end cover suit on foresight endoscope regulator, front-view endoscope regulator, The combination body formed by the forward-looking endoscope, the buckle seat and the knocking end cover penetrates through the tail part of the fusion device locker, so that the foremost end of the forward-looking endoscope reaches the foremost end of the fusion device.
2. The system of claim 1, wherein the instrument channel inside the rear view endoscope is sized to receive a cage implantation tool assembly.
3. The system of claim 2, wherein said cage implant tool assembly is hollow and strong to resist knocking.
4. The system of claim 1, wherein said rear view endoscope has an irrigation channel.
5. The system of claim 1, wherein the rear view endoscope can be rotated and moved back and forth on the holding tube.
6. A novel spinal full-endoscope fusion implantation system is characterized by comprising a forward-looking endoscope, a fusion cage and a fusion cage implantation tool assembly, wherein the fusion cage implantation tool assembly comprises a clamping tube, a clamping tube handle, a fusion cage locker, a forward-looking endoscope adjuster, a buckle seat and a knocking end cover, the clamping tube and the clamping tube handle are nested and installed, the fusion cage is installed at the front end of the clamping tube, the fusion cage locker penetrates through the clamping tube from the inside and is fixedly connected with the fusion cage through threads, the buckle seat penetrates through an optical fiber connector of the forward-looking endoscope and is clamped on the forward-looking endoscope, the forward-looking endoscope adjuster is nested and connected with a combination of the forward-looking endoscope and the buckle seat, the knocking end cover is sleeved on the forward-looking endoscope adjuster, and a combination formed by the forward-looking endoscope adjuster, the forward-looking endoscope, the buckle seat and the knocking end cover penetrates into the tail part of the fusion cage, the foremost end of the forward looking endoscope is brought to the foremost end of the fusion device.
7. The system for spinal full-endoscopic fusion implantation according to claim 1 or 6, wherein two sides of said fastener seat are designed with parallel convex limiting structures.
8. The system for implanting the spinal column full-endoscope fusion according to the claim 1 or 6, characterized in that the diameter of the through hole of the fusion device is larger than or equal to the diameter of the outer working tube of the forward-looking endoscope.
9. The novel spinal endoendoscopic fusion implant system of claims 1 or 6 wherein said forward looking endoscope employs an impact resistant optical system comprising a fiberoptic or electronic endoscope.
10. The system of claim 1 or 6, wherein the forward looking endoscope has an irrigation channel.
11. The novel spinal total endoscopic fusion implantation system according to claim 1 or 6, characterized in that said forward looking endoscope has an irrigation instrument channel into which a K-wire for the implantation of a fusion device can be inserted.
12. The novel spinal column full-endoscope fusion implantation system according to claim 1 or 6, characterized in that a limiting structure for adjusting the axial movement of the forward-looking endoscope is embedded in the endoscope body of the forward-looking endoscope.
13. The system of claim 1 or 6, wherein the cage locker comprises a spring block clamp ring, the spring block clamp ring is connected with a spring block in a nested manner, the spring block is connected with a spring block pressure spring in a nested manner, the spring block pressure spring is connected with a spring block sheath in a nested manner, the spring block sheath is connected with a locking screw rod fixing block in a nested manner, the locking screw rod fixing block is connected with a locking wrench in a nested manner, the locking wrench is connected with a first damping ring in a nested manner, and an integral assembly formed by the spring block clamp ring, the spring block pressure spring, the spring block sheath, the locking screw rod fixing block, the locking wrench and the first damping ring is nested at the end of the locking screw rod, and the locking wrench adopts a polygonal star structure with 2-8 corners twisted by hand.
14. The system of implanting is fused to novel full scope of backbone of claim 1 or 6, its characterized in that, the endoscope regulator of looking ahead is including strikeing the pipe, rotating ring, endoscope adjustable ring, locking spanner connector have been arranged in proper order to the front end of strikeing the pipe, install the location pearl on the locking spanner connector, all be provided with the second damping circle between driving ring and endoscope adjustable ring and the strikeing pipe, set up the spacing collar of injecing endoscope adjustable ring axial displacement between endoscope adjustable ring and the locking wrench connector, the endoscope adjustable ring further injecing driving ring axial displacement with the driving ring through the screw connection, the internally mounted who strikes the pipe has the endoscope holding ring, through pin joint between driving ring and the endoscope holding ring, the end of strikeing the pipe is connected with the end cover of strikeing.
15. The system of claim 14, wherein the driving ring has a spiral groove and two circular screw holes for the rotation of the pin.
16. The novel spinal full-endoscope fusion implantation system according to claim 1 or 6, wherein the knocking end cover comprises an end cover, an end cover pressure spring is arranged at the tail end of the end cover and the knocking tube, the end cover pressure spring is connected to the end cover in a screw fixing mode through a three-hole gasket, and a button, a button pressure spring and a movable clamping pin which are centrosymmetric and are sequentially arranged in a nested mode are arranged at two ends of the end cover.
17. The system according to claim 16, wherein a drop-shaped slot is provided at the connection position of the end of the knocking tube and the end cap nesting, and the drop-shaped slot and the movable pin nesting are used for locking or releasing the position connection relationship between the knocking end cap and the knocking tube.
18. The system for spinal endoscopic fusion implantation according to claim 1 or 6, wherein said forward looking endoscope has an angle of field greater than 90 °, said forward looking endoscope can be a hard endoscope with 0 ° or semi-soft fiber optic having a certain angle of view.
19. The system of claim 1 or 6, wherein the cage is a hollow fixed-height cage, a distractor, or a dovetail cage.
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| CN112274234A (en) * | 2020-10-28 | 2021-01-29 | 珠海维尔康生物科技有限公司 | Hollow screw system under spinal column mirror |
| CN112704527A (en) * | 2020-12-24 | 2021-04-27 | 珠海维尔康生物科技有限公司 | Elastic deformable nerve baffle for endoscope fusion |
| CN112716664A (en) * | 2021-04-06 | 2021-04-30 | 珠海维尔康生物科技有限公司 | Fence type bone cement spine fusion device adopting balloon forming |
| CN112741588A (en) * | 2021-01-19 | 2021-05-04 | 珠海维尔康生物科技有限公司 | Fusion device |
| CN112971960A (en) * | 2021-04-26 | 2021-06-18 | 珠海维尔康生物科技有限公司 | Fence type endoscope fusion device adopting absorbable material and fusion method thereof |
| CN114209270A (en) * | 2021-11-25 | 2022-03-22 | 北京大学第三医院 | Spinal interbody fusion endoscope structure |
| KR102417210B1 (en) * | 2021-12-13 | 2022-07-07 | 주식회사 텍코드 | Interbody Fusion endoscope instrument |
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| CN117017466A (en) * | 2023-09-27 | 2023-11-10 | 南方医科大学 | Lumbar vertebra working channel for soft electronic endoscope and lumbar vertebra working system |
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