CN112617991A - Positioning needle and pedicle screw positioner for infant spine - Google Patents
Positioning needle and pedicle screw positioner for infant spine Download PDFInfo
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- CN112617991A CN112617991A CN202011098521.7A CN202011098521A CN112617991A CN 112617991 A CN112617991 A CN 112617991A CN 202011098521 A CN202011098521 A CN 202011098521A CN 112617991 A CN112617991 A CN 112617991A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
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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
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Abstract
The invention belongs to the field of orthopedic medical operations, and provides a positioning needle for a pedicle screw positioner for an infant spine and a pedicle screw positioner for an infant spine using the positioning needle. And the fixing holder and the positioning needle are fixedly locked into a whole, and the fixing holder fixes or releases the positioning needle through the lifting ring. The safety and the accuracy of the positioning of the pedicle screws are improved, and the process of inserting the pedicle screws of the infants is optimized.
Description
Technical Field
The invention belongs to the field of orthopedic medical operations, and particularly relates to a positioning needle and a pedicle screw positioner for an infant spine.
Background
The spinal internal fixation system can provide holding force for spinal orthopedic operations and the like and help to reconstruct spinal stability, which is of great importance in spinal surgery. The pedicle screw device can provide strong three-dimensional holding force, is the most common spinal internal fixation system at present, and is widely applied to spinal surgery decompression fixation operation and deformity correction operation. Pedicle screws need to pass through the pedicle forward to the front of the vertebral body, adjacent to important structures: the spinal cord, nerve roots and other important structures exist around the pedicle of vertebral arch, while the anterior lateral side of the spinal cord has important structures such as great vessels and the like, and the poor position of the pedicle screw can cause disastrous consequences such as nerve injury, blood vessel injury and the like, and even endanger the life of a patient in serious cases. Therefore, in the process of placing the pedicle screws, after the nail path is prepared by using the opener with the diameter smaller than that of the pedicle screws, the positioning needle is placed, the X-ray is used for carrying out perspective positioning, and whether the nail path needs to be adjusted or not is determined according to the perspective result.
The use of pedicle screw systems in adult spinal surgery has matured, but has a shorter history of use in infant patients. The study of scholars shows that the development of the vertebral column is slightly influenced by using a pedicle screw system in children of 1-2 years old, and complications such as spinal stenosis, nerve compression and the like can not be caused. In recent years, with the progress of surgical operations and the application of pedicle screw systems in infants, spinal surgeries, such as spinal deformity correction surgery, spondylolisthesis reduction surgery, etc., have been increasingly performed. However, the most common complications of the internal fixation operation in the spine surgery of infants are related to internal fixation, and pedicle fracture, screw loosening, extraction and the like are common, so that the fixation fails, even the nerve structure is pressed, and the fixed segment needs to be adjusted and even prolonged again through the operation. The main reasons are that the pedicle of vertebral arch of the infant grows small, the bone quality is poor, and the requirement on the accuracy of the pedicle of vertebral arch screw placement is extremely high. The technical process of the pedicle screw system adopted by the existing infant spine surgery is the same as that of adults, and the traditional pedicle screw inserting process comprises the steps of opening cortex, preparing a pedicle screw channel by an open circuit device, inserting a positioning needle into the pedicle screw channel for perspective positioning and inserting a screw. The main problems with the use of this procedure in infant patients are: the pedicle of vertebral arch of the infant is small, and once the passage of the pedicle of vertebral arch screw prepared by the road opener fails, the adjustment cannot be carried out; the traditional positioning needle is too thick and too long, and the problems of needle breakage, increase of blood loss and the like can exist when the hollow syringe needle is adopted. The technical process has certain problems for infants: 1. different from adolescents and adults, the pedicles of the infants and children are very small, the bone development period is poor, the length of a nail path is short, the nail placement opportunity is usually only carried out once, if the positions of the screws are not good, the four walls of the pedicles of the infants and children are damaged, and the adjustment is difficult, so that the fixed fusion segments are prolonged, and the development and the movement functions of the spines of the children are influenced; 2. when the channel opener is used for preparing a nail channel, the pedicle of vertebral arch is passed through the whole process, and if the pedicle wall of vertebral arch is damaged, the pedicle wall of vertebral arch is difficult to adjust and remedy; 3. traditional pedicle of vertebral arch locator is all unsuitable to children's diameter and length, uses 20ml syringe needle (diameter 1.6mm) to fix a position in the clinical work, cuts out length and uses as the locator after being 20mm, but the problem exists: 1) the syringe needle is hollow, the strength is not good, and the risk of breaking in vivo exists; 2) cancellous bone is arranged around the nail path, bleeding is more, blood loss from the periphery of the needle and the inner core can be caused by using the hollow needle with the diameter smaller than that of the opener in the perspective positioning process, the blood volume of the infant is less, adverse effects are caused on the operation safety, and the blood transfusion probability is increased; 3) the length of the cut syringe needle is about 20mm, the syringe needle passes through the whole process of the pedicle of vertebral arch, and if the position is not good, the adjustment is difficult, so that the holding force of the pedicle of vertebral arch screw is reduced, and even the implantation fails.
Aiming at the problems of pedicle screws in the existing infant spine surgery, the pedicle screw positioner is required to be improved in the application of infant patients.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provides a positioning needle and a pedicle screw positioner for an infant spine, so that the safety and the accuracy of pedicle screw positioning are improved, and the implantation process of the pedicle screws of the infants is optimized.
In order to solve the technical problems, the invention provides the following technical scheme:
the positioning needle for the pedicle screw positioner for the spine of the infant is characterized in that a needle handle and a needle body are sequentially arranged on the positioning needle, the rear portion of the needle handle is arc-shaped, an annular clamping groove and a clamping portion on the front side of the clamping groove are formed in the needle handle, a conical needle point is arranged at one end, away from the needle handle, of the needle body, first protrusions and second protrusions are arranged on the needle body at intervals, a space avoiding section is further arranged between the first protrusions and the second protrusions, the first protrusions are connected with the clamping portion, and the second protrusions are connected with the needle body.
Further, the positioning needle is of a solid positioning needle structure.
Further, the positioning needle is a cobalt-chromium-molybdenum alloy positioning needle or a 316 stainless steel positioning needle.
Furthermore, the total length of the positioning needle is 38-40mm, and the diameter of the needle body is 1.2-1.5 mm.
Further, the first protrusion is a cylindrical protrusion, and the second protrusion is a cylindrical protrusion or a spherical protrusion.
Further, the first protrusion diameter or the second protrusion diameter is larger than the needle body diameter.
Further, the conical needle point is provided with a cone angle of 25-30 degrees.
A pedicle screw positioner for an infant spine, comprising: the positioning device comprises a fixed holder and the positioning needle, and is characterized in that the fixed holder and the positioning needle are locked into a whole through clamping, a lifting ring is connected to the fixed holder, and the fixed holder fixes or releases the positioning needle through the lifting ring.
Furthermore, the fixed holder comprises a holder handle and a fixed rod, the fixed rod is inserted into a holder handle interface, a lifting ring is sleeved outside the fixed rod and is installed between the fixed rod and the holder handle, a compression spring is installed in a left part interface of the holder handle and between the right end part of the lifting ring, the compression spring is sleeved on the fixed rod, two steel balls are respectively installed on two sides of the left part opening of the lifting ring, a positioning needle clamp interface is arranged in the left end part of the fixed rod, and two steel ball holes are respectively formed in the radial two sides of the positioning needle clamp interface; after the positioning needle enters the vertebral pedicle, the positioning needle is released from the fixed holder by lifting a lifting ring on the fixed holder.
The technical scheme provided by the embodiment of the invention has the following beneficial effects:
the screw inserting device can greatly improve the accuracy and the safety of the pedicle screw inserting of the infant, improve the screw inserting efficiency, reduce the X-ray perspective times in the operation and the ray exposure of the infant and a doctor, reduce the blood loss, avoid the postoperative internal fixation failure caused by the poor position of the screw channel and the adjustment, prolong the fixed segment and other complications, and contribute to ensuring the operation safety. The positioning needle is made of solid cobalt-chromium-molybdenum alloy or stainless steel, and the problems that the existing needle head of an injector is mostly used for positioning in the process of putting in the pedicle screw of the infant, the needle head is hollow, and blood loss and fracture risks exist are solved.
Drawings
Fig. 1 is a disassembled schematic view of the pedicle screw positioner for the infant spine of the invention.
Fig. 2 is a disassembled top view of the pedicle screw positioner for infant spines.
Fig. 3 is a disassembled three-dimensional schematic view of the pedicle screw positioner for the infant spine of the invention.
Fig. 4 is a schematic view of a cylindrical positioning needle of the pedicle screw positioner for an infant spine of the invention.
Fig. 5 is a left side view of the cylindrical positioning needle of the pedicle screw positioner for the infant spine of the invention.
Fig. 6 is a top view of the cylindrical positioning needle of the pedicle screw positioner for infant spines.
Fig. 7 is a perspective view of the cylindrical positioning pin of the pedicle screw positioner for the spine of the infant of the invention.
Fig. 8 is a schematic view of a spherical positioning needle of the pedicle screw positioner for an infant spine of the invention.
Fig. 9 is a left side view of the spherical positioning needle of the pedicle screw positioner for the infant spine of the invention.
Fig. 10 is a top view of the spherical positioning needle of the pedicle screw positioner for infant spines of the invention.
Fig. 11 is a perspective view of a spherical positioning needle of the pedicle screw positioner for the infant spine of the invention.
FIG. 12 is a schematic view of a fixing holder of the pedicle screw positioner for infant spine of the present invention.
FIG. 13 is a top view of the fixing holder of the pedicle screw positioner for infant spine of the present invention.
FIG. 14 is a perspective view of the fixing holder of the pedicle screw positioner for infant spine of the present invention.
FIG. 15 is a cross-sectional view of the fixed holder of the pedicle screw positioner for spine of an infant.
Fig. 16 is a cross-sectional view of the reduction of the fixing holder of the pedicle screw positioner for the spine of an infant.
FIG. 17 is a cross-sectional view of the clamping positioning needle of the fixing holder of the pedicle screw positioner for infant spine according to the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, embodiments of the present invention will be described in detail with reference to the accompanying drawings.
Referring to fig. 4-11, the invention provides a positioning needle for a pedicle screw locator for a spine of an infant, wherein a needle handle and a needle body are arranged on a positioning needle 1, the rear part of the needle handle is arc-shaped, an annular clamping groove 11 and a clamping part 12 positioned on the front side of the clamping groove are formed in the needle handle, the clamping groove is matched with a steel ball of a fixed holder, the clamping part is of an outer six-part structure, and the clamping part is matched with the fixed holder to prevent rotation. The needle body 16 is provided with a conical needle point 15 at one end far away from the needle handle, a first protrusion 13 and a second protrusion 14 are arranged between the needle body and the needle body at intervals, and the distance between the conical needle point and the root of the second protrusion is 8-11 mm. An escape section 17 is arranged between the first protrusion 13 and the second protrusion 14, the first protrusion 13 is connected with the clamping part 12, and the second protrusion 14 is connected with the needle body 16.
The positioning needle 1 is of a solid positioning needle structure, and is suitable for a harder pedicle of vertebral arch when the positioning needle 1 is a cobalt-chromium-molybdenum alloy positioning needle, or is suitable for a softer pedicle of vertebral arch when the positioning needle is a 316 stainless steel positioning needle. The strength of the cobalt-chromium-molybdenum alloy is superior to that of the traditional steel, titanium alloy and other materials. The total length of the positioning needle (1) is 38-40mm, the diameter of the needle body is 1.2-1.5mm, and the diameter of the needle handle and the diameter of the clearance section are 2.2-2.5 mm. The problem of at present put into the in-process at infant's pedicle of vertebral arch screw and use syringe needle location more, it is hollow, has blood loss and fracture risk is solved.
The first protrusion 13 is a cylindrical protrusion, and the first protrusion is used for limiting the fit with the fixed holder and preventing the fit from being too deep or too shallow. The second projection 14 is a cylindrical or spherical projection and is a stop to prevent the needle from being inserted too far into the vertebral body. The diameter of the first protrusion 13 or the diameter of the second protrusion 14 are both larger than the diameter of the needle body, and the diameter of the cylindrical protrusion or the spherical protrusion is 5-5.5 mm. The conical needle point is provided with a cone angle of 25-30 degrees.
Referring to fig. 1-3, a pedicle screw positioner for an infant spine comprises a fixed holder 2 and any one of the positioning needles 1, wherein the fixed holder 2 and the positioning needle 1 are locked into a whole by clamping, a lifting ring 3 is connected to the fixed holder 2, and the fixed holder 2 fixes or releases the positioning needle 1 by the lifting ring 3. The lifting ring is used for fixing or releasing the positioning needle. The structure of the device is explained by adopting the prior art as follows:
referring to fig. 12-17, the fixed holder comprises a holder handle 21 and a fixed rod 22, the fixed rod 22 is inserted into an interface of the holder handle 21, a lifting ring 23 is sleeved outside the fixed rod 22, the lifting ring 23 is installed between the fixed rod and the holder handle, a compression spring 24 is installed in an interface at the left part of the holder handle 21 and between the right end part of the lifting ring 23, the compression spring 24 is sleeved on the fixed rod 22, steel balls 25 are respectively installed at two sides of the opening at the left part of the lifting ring 23, a positioning needle card interface is arranged in the left end part of the fixed rod 22, the section of the positioning needle card interface is of an inner six-part structure, and steel ball holes are respectively formed at two radial sides of the positioning needle card; after the positioning needle 1 enters the pedicle of a vertebral arch, the positioning needle is released from the fixed holder by lifting a lifting ring 3 on the fixed holder 2. The handle of the holder is a silica gel handle, and the tail part of the handle 21 of the holder is provided with a rotary beating sliding block 26 to avoid rubbing hands during operation.
When the lifting ring is lifted, the lifting ring is extruded under the action of external force, the compression spring is contracted towards the handle, the steel balls on two sides of the lifting ring slide out of the steel ball hole and enter a clearance between the fixed rod and the lifting ring, and the clearance between the two steel balls is enlarged, so that the positioning pin is conveniently inserted into the fixed rod.
When the lifting ring is reset, the compression spring returns to be elastically popped out leftwards after the lifting ring is loosened, steel balls on two sides of the lifting ring are pushed into the steel ball holes, the gap between the two steel balls is reduced, and the positioning needle is clamped on the fixing rod. The lifting ring is reset to be the same as the initial state, and the working principle is like the steel balls of the folding umbrella rod.
The positioning needle has a different end structure compared with the traditional pedicle positioning needle. The traditional pedicle of vertebral arch positioning needle is blunt, the front end of the positioning needle is a conical needle point, the fixing holder can be fixedly locked with the pedicle of vertebral arch positioning needle, the fixing holder and the positioning form an integrated structure after locking, and the positioning needle can directly and easily drill into cancellous bone of the pedicle of vertebral arch without opening a way to prepare a nail path after a cortical opening through the fixing holder.
The diameter of the needle body of the infant positioning needle is 1.2-1.5mm, the total length is 38-40mm, compared with the traditional pedicle screw positioning needle, the diameter of the infant positioning needle is thinner and shorter, the damage to the pedicle anatomical structure is very small, and even if the position is not good, the pedicle bone structure and the surrounding normal anatomical structure cannot be obviously damaged; can easily adjust after the perspective is confirmed and not influence the intensity of screw, improve the accuracy that pedicle of vertebral arch screw put into greatly, avoid the internal fixation that the nail says that the good causes and fail and fuse the section extension.
The traditional positioning needle is used after a nail channel is prepared for a pedicle screw open circuit device, the diameter of the positioning needle is smaller than that of the open circuit device, cancellous bones are arranged around the nail channel, and blood loss can be caused in the process of waiting for fluoroscopy and screw insertion. And use special pedicle of vertebral arch screw locator of infant, can directly put into pedicle of vertebral arch cancellous bone with pedicle of vertebral arch screw pilot pin, avoided the breaker to the destruction of cancellous bone and pilot pin and the nail track mismatch the blood loss that leads to, can directly adopt the breaker to prepare the nail track and implant the screw after the position is confirmed in the perspective, greatly reduced the blood loss volume.
The using method of the pedicle screw positioner for the spine of the infant comprises the following steps:
step S1, opening the cortex;
step S2, a pedicle screw positioner is used for being placed into a pedicle for positioning, and after the pedicle screw positioner enters cancellous bone, the lifting ring is released to release the positioning needle;
step S3, after the positioning needle is placed, the positioning needle position is confirmed by using X-ray fluoroscopy;
and step S4, placing the pedicle screw after probe test and depth measurement under the guidance of the positioning needle.
The special pedicle screw positioner for the infants is adopted to optimize the pedicle screw placement of the infants: the method comprises the following steps that firstly, the cortex is opened, secondly, a pedicle screw positioning needle is placed into a pedicle for positioning, the tail end of the positioning needle is in a conical needle point shape, the positioning needle can easily enter cancellous bone, and after the positioning needle enters the cancellous bone, a trigger is loosened, so that the positioning needle can be released; moreover, the positioning needle is thinner and shorter, and can not cause obvious damage to the bone structure of the vertebral pedicle and the surrounding organ structure. After the positioning needle is placed, the position is confirmed by X-ray fluoroscopy, and the positioning needle is ideally positioned at the center of the oval pedicle of vertebral arch. Then preparing a nail path by adopting a pedicle screw open circuit device under the guidance of a positioning needle, and placing a pedicle screw after probe testing and depth measurement. By the infant pedicle screw positioner and the use method for implanting the pedicle screws, the accuracy and the safety of the infant pedicle screw implantation can be greatly improved, the screw implantation efficiency is improved, the X-ray perspective times in the operation and the ray exposure of the infant and a doctor are reduced, the blood loss is reduced, the postoperative internal fixation failure caused by poor screw channel position and adjustment, the fixed segment lengthening and other complications are avoided, and the operation safety is favorably ensured.
It will be appreciated by those skilled in the art that the invention may be embodied in other specific forms without departing from the spirit or essential characteristics thereof. The embodiments disclosed above are therefore to be considered in all respects as illustrative and not restrictive. All changes which come within the scope of or equivalence to the invention are intended to be embraced therein.
Claims (9)
1. A positioning needle for a pedicle screw positioner for an infant spine, which is characterized in that,
the positioning needle (1) is provided with a needle handle and a needle body,
the rear part of the needle handle is arc-shaped, an annular clamping groove (11) and a clamping part (12) positioned at the front side of the clamping groove are arranged on the needle handle,
a conical needlepoint (15) is arranged at one end of the needle body (16) far away from the needle handle,
a first protrusion (13) and a second protrusion (14) are arranged between the needle handle and the needle body at intervals,
a space avoidance section (17) is arranged between the first protrusion (13) and the second protrusion (14),
the first protrusion (13) is connected with the clamping part (12), and the second protrusion (14) is connected with the needle body (16).
2. The positioning needle according to claim 1,
the positioning needle (1) is of a solid positioning needle structure.
3. The positioning needle according to claim 1,
the positioning needle (1) is a cobalt-chromium-molybdenum alloy positioning needle or a 316 stainless steel positioning needle.
4. The positioning needle according to claim 1,
the total length of the positioning needle (1) is 38-40mm, and the diameter of the needle body is 1.2-1.5 mm.
5. The positioning needle according to claim 1,
the first protrusion (13) is a cylindrical protrusion, and the second protrusion (14) is a cylindrical protrusion or a spherical protrusion.
6. The positioning needle according to claim 5,
the diameter of the first protrusion (13) or the diameter of the second protrusion (14) is larger than that of the needle body.
7. The positioning needle according to claim 1,
the conical needle point is provided with a cone angle of 25-30 degrees.
8. The utility model provides an infant is pedicle of vertebral arch screw locator for backbone which characterized in that includes:
a stationary holder (2) and a positioning needle (1) according to any one of claims 1 to 7,
the fixed holder (2) and the positioning needle (1) are locked into a whole through clamping, a lifting ring (3) is connected to the fixed holder (2), and the fixed holder (2) fixes or releases the positioning needle (1) through the lifting ring (3).
9. A pedicle screw positioner for the spine of an infant according to claim 8,
the fixed holder comprises a holder handle (21) and a fixed rod (22), the fixed rod (22) is inserted in the interface of the holder handle (21), a lifting ring (23) is sleeved outside the fixed rod (22), the lifting ring (23) is positioned between the fixed rod and the handle of the holder, a compression spring (24) is arranged between the left interface of the holder handle (21) and the right end of the lifting ring (23), the compression spring (24) is sleeved on the fixed rod (22), two steel balls (25) are respectively arranged on two sides of the left opening of the lifting ring (23), a positioning needle clamp interface is arranged in the left end part of the fixed rod (22), two steel ball holes are respectively arranged on the radial two sides of the positioning needle clamp interface, after the positioning needle (1) enters the vertebral pedicle, the positioning needle is released from the fixed holder by pulling a lifting ring (3) on the fixed holder (2).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011098521.7A CN112617991A (en) | 2020-10-14 | 2020-10-14 | Positioning needle and pedicle screw positioner for infant spine |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011098521.7A CN112617991A (en) | 2020-10-14 | 2020-10-14 | Positioning needle and pedicle screw positioner for infant spine |
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| Publication Number | Publication Date |
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| CN112617991A true CN112617991A (en) | 2021-04-09 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN202011098521.7A Pending CN112617991A (en) | 2020-10-14 | 2020-10-14 | Positioning needle and pedicle screw positioner for infant spine |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114469246A (en) * | 2021-12-21 | 2022-05-13 | 中国人民解放军空军军医大学 | Open circuit awl with positioning needle assembly for field spine surgery |
-
2020
- 2020-10-14 CN CN202011098521.7A patent/CN112617991A/en active Pending
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114469246A (en) * | 2021-12-21 | 2022-05-13 | 中国人民解放军空军军医大学 | Open circuit awl with positioning needle assembly for field spine surgery |
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