CN113081181A

CN113081181A - Intervertebral disc cutter

Info

Publication number: CN113081181A
Application number: CN202110507472.6A
Authority: CN
Inventors: 姜帅; 王承夏; 李卓夫; 李危石
Original assignee: Peking University Third Hospital Peking University Third Clinical Medical College
Current assignee: Peking University Third Hospital Peking University Third Clinical Medical College
Priority date: 2021-05-10
Filing date: 2021-05-10
Publication date: 2021-07-09
Anticipated expiration: 2041-05-10
Also published as: CN113081181B

Abstract

The invention relates to an intervertebral disc resectoscope which comprises a knocking column and a cutting tube, wherein the cutting tube is fixedly arranged at one end part of the knocking column, and the central axes of the knocking column and the cutting tube are superposed; the interior of the cutting pipe is provided with a hollow pore canal extending along the central axis; the hollow pore passage penetrates through the knocking column and the cutting pipe; the cross sections of the cutting pipe and the hollow pore passage are both square; and a knife edge is arranged at the end part of one end of the cutting pipe, which is far away from the knocking column, and the knife edge is provided with inward knife edges which are inclined towards the inside of the hollow pore passage, and the inward knife edges are distributed on four edges of the square cross section of the cutting pipe. This intervertebral disc excising device just can solve the loaded down with trivial details step that needs cut four sides one by one through the chisel hammer mode, and can be with excision edge neatness, clear operation field of vision, remove the loaded down with trivial details of taking out the intervertebral disc piece of excision once away from, and can avoid the unexpected damage because of the edge sharpness of scalpel or osteotome causes in the cutting process.

Description

Intervertebral disc cutter

Technical Field

The invention relates to the technical field of medical instruments, in particular to an intervertebral disc resectoscope.

Background

The most traditional old method is still used for solving the problem of the currently common clinical method for cutting the annulus fibrosus on the outer layer of the intervertebral disc, namely, the traditional scalpel is used for cutting the annulus fibrosus which is seriously calcified or ossified, the scalpel cannot smoothly cut the annulus fibrosus, even the peripheral important nerves and the dura mater are possibly damaged due to hand loss in the force exerting process, at the moment, the main method is to cut the annulus fibrosus along the upper edge, the lower edge, the left edge and the right edge of the intervertebral disc by the osteotome, but the method has the defects that the edge of the ossified intervertebral disc needs to be confirmed during each cutting, the centrum cortex is damaged by too large range to cause more bleeding, the cutting range cannot be met by too small range to enlarge the cutting again, the operation wastes time and labor, and.

It can be seen from a review of the relevant literature and patents that there are fewer convenient instruments for discectomy, the most proximal of which is shown in figure 1. Fig. 1 shows a lumbar intervertebral disc extractor, which mainly comprises an outer sleeve 3 and an inner sleeve 2, wherein the top end of the outer sleeve is connected with a handle 6, the bottom of the outer sleeve is fixedly connected with a support frame 5, the top of the inner sleeve is fixedly connected with a rotating disc 1, and the bottom of the inner sleeve is provided with an annular knife 4. When the lumbar intervertebral disc cutting device is used, the outer sleeve 3 is placed on the lumbar intervertebral disc aiming at the protrusion, the support frame 5 arranged at the bottom of the outer sleeve 3 mainly plays a role in supporting and fixing, the handle 6 is held by a hand to keep the outer sleeve 3 stable, then the inner sleeve 2 is sleeved in the outer sleeve 3, the rotary disk 1 at the top of the inner sleeve 2 is rotated to drive the annular knife 4 at the bottom of the inner sleeve 2 to rotate, the protruded lumbar intervertebral disc is cut, and after the inner sleeve and the outer sleeve are taken out, the cut lumbar intervertebral disc is taken.

Although above-mentioned lumbar disc extractor can surely get some intervertebral discs, its appearance is heavy, shelters from the operation field of vision during the operation, and complex operation, needs the sleeve intussusception just to use, and the intervertebral disc of surely getting is the annular, can't realize neatly surely getting the intervertebral disc edge, surely get the in-process still need cooperate scalpel or osteotome clearance annular cutting scope outside the surplus part.

Disclosure of Invention

The invention aims to provide a novel intervertebral disc resectoscope for quickly, simply and safely resecting intervertebral discs, and the technical problems to be solved comprise the complicated steps of cutting four sides one by a chiseling mode, the resected edges can be tidied, the operation visual field is clear, the trouble of taking out the resected intervertebral disc fragments one time is avoided, and the accidental injury caused by the sharp edges of a scalpel or a osteotome can be avoided in the cutting process.

The invention aims to solve the defects of the prior art and provides an intervertebral disc resectoscope which comprises a knocking column and a cutting tube, wherein the cutting tube is fixedly arranged at one end part of the knocking column, and the central axes of the knocking column and the cutting tube are superposed; the interior of the cutting pipe is provided with a hollow pore canal extending along the central axis; the hollow pore passage penetrates through the knocking column and the cutting pipe; the cross sections of the cutting pipe and the hollow pore passage are both square; and a knife edge is arranged at the end part of one end of the cutting pipe, which is far away from the knocking column, and is provided with inward knife edges which are inclined towards the inside of the hollow pore passage, and the inward knife edges are distributed on four edges of the square cross section of the cutting pipe.

Preferably, the cross section of the knocking column is circular.

The diameter of the knocking column is 10mm, and the length of the knocking column is 100 mm.

The side length of the outer peripheral wall of the cutting pipe is 5mm, and the side length of the inner peripheral wall of the hollow pore passage is 4 mm.

The total length of the discectomy device is 200 mm.

The width of the cutting edge of the inward knife is 0.5 mm.

Preferably, the discectomy device comprises a plurality of different sizes, and the cutting tubes of the discectomy devices with different sizes have different side lengths.

Further preferably, the side length of the cutting tube of an adjacent gauge discectomy device is incremented by a predetermined value.

In a preferred embodiment, the cutting tubes of adjacent gauge discectors have side lengths that increase sequentially from 2mm to a model size up to 15 mm.

Further preferably, the outer contour of the discectomy device is rounded.

Advantageous effects

Compared with the prior art, the invention has the beneficial effects that:

1. after the safe edge of the discectomy is confirmed, the time and the effect of cutting the discectomy cutter are equal to four times of the cutting time and the effect of the scalpel every time the discectomy cutter is knocked, the cutting depth can be kept consistent, the process of searching the edge of the fibrous ring of the intervertebral disc every time is omitted, the operation time is shortened, and the operation efficiency is improved.

2. The hollow pore canal design in the discectomy device enables the discectomy device to directly collect all the cut fractured tissues of the intervertebral disc in the cutting process, so that the fractured tissues of the intervertebral disc enter the hollow pore canal of the discectomy device, and the trouble of taking out the fractured tissues of the intervertebral disc every time is eliminated. And directly cutting a piece of intervertebral disc fractured tissue, and then directly carrying out next step cutting until the cutting process is finished, wherein at the moment, the kirschner wire can be used for passing through the hollow pore channel once, and all the intervertebral discs blocking the pore channel can be taken out.

3. The opening of the discectomy device is 5mm square, and the size of each 2mm type is increased gradually until the size reaches 15 mm. The intervertebral space with different sizes can be used, so that the times of excision are reduced. A certain range of resection is satisfied with a minimum number of times.

4. When the intervertebral disc resectoscope is used, as the four sides of the intervertebral disc resectoscope are processed by fillets and the cutting edge is designed to be an inward cutting edge, the cutting process is realized by knocking the top of the intervertebral disc resectoscope after the cutting range is wrapped around the cutting edge, the accidental injury of peripheral adjacent soft tissues can not be caused in the whole cutting process, the injury risks of peripheral important nerves, dura mater and the like caused by the fact that an operation knife or a bone knife has sharp edges in the cutting process and is difficult to avoid due to accidental deviation of positions in the process of feeding into a focus of a vertebral body or in the knocking process can be avoided, and once the injury risks occur, the consequences can not be imagined. This is another advantage of discectors, namely the high safety factor and reduced surgical risk.

5. The intervertebral disc resectoscope can flexibly control the cutting depth and angle according to needs, can vertically cut and can realize certain specific ranges and depths in an inclined direction.

6. The intervertebral disc resectoscope provided by the invention can realize the tidiness of the excision of the edge of the intervertebral disc annulus and the clear excision process through the square incision, the clear operation visual field is beneficial to the excision of the subsequent intervertebral disc nucleus pulposus and the vertebra and fusion of the intervertebral space, and the discectomy is not artificially performed by using a scalpel or a osteotome for one time to meet the tidiness of the edge of the intervertebral disc as far as possible.

7. The intervertebral disc resectoscope disclosed by the invention is simple in manufacturing process, low in cost, economical and practical, can be repeatedly sterilized and utilized, and can solve the problem of headache of a patient in clinic without high cost.

Drawings

The accompanying drawings are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the principles of the invention and not to limit the invention.

FIG. 1 is a schematic view of a prior art lumbar disc extractor.

FIG. 2 is a schematic view of the construction of a discectomy device of the present invention.

FIG. 3 is a front view of an intervertebral disc resector of the present invention.

FIG. 4 is a side view of the discectomy device of the present invention.

FIG. 5 is a front view of a bottom edge of a discectomy device modified to have a skewed edge cut 30.

FIG. 6 is an oblique view of a bottom edge of a discectomy device modified to have an oblique incision 30 degrees removed.

FIG. 7 is an elevation view of a bottom edge of a discectomy device modified to have a skewed edge cut at 45.

FIG. 8 is an oblique view of a bottom edge of a discectomy device modified to have an oblique cutting edge cut at 45.

FIG. 9 is an elevation view of a bottom edge of a discectomy device modified to have a skewed edge that is 60 cut.

FIG. 10 is an oblique view of a bottom edge of a discectomy device modified to have an oblique incision 60 degrees removed.

Detailed Description

The present invention is described in more detail below to facilitate an understanding of the present invention.

As shown in fig. 2 to 4, the discectomy device comprises a knocking column 1 and a cutting tube 2, wherein the cutting tube 2 is fixedly arranged at one end of the knocking column 1, and the central axes of the knocking column 1 and the cutting tube 2 are coincident; the cutting pipe 2 is internally provided with a hollow pore canal 3 extending along the central axis; the hollow pore canal 3 penetrates through the knocking column 1 and the cutting pipe 2; the cross sections of the cutting pipe 2 and the hollow pore passage 3 are both square; a knife edge is arranged at the end part of one end, far away from the knocking column 1, of the cutting pipe 2, the knife edge is provided with inward knife edges 4 inclined towards the inside of the hollow pore passage 3, and the inward knife edges 4 are distributed on four edges of the square cross section of the cutting pipe 2.

Preferably, the cross section of the knocking column 1 is circular.

The diameter R1 of knocking post 1 is 10mm, and the length L2 is 100 mm.

The side length R2 of the outer peripheral wall of the cutting pipe 2 is 5mm, and the side length R3 of the inner peripheral wall of the hollow pore passage 3 is 4 mm.

The total length L1 of the discectomy device is 200 mm.

The width of the inward knife edge 4 is 0.5 mm.

Preferably, the discectomy device comprises a plurality of different specifications, and the cutting tubes 2 of the discectomy devices with different specifications have different side lengths.

Further preferably, the side length of the cutting tube 2 of an adjacent-sized discectomy device is increased by a predetermined value.

In a preferred embodiment, the side length of the cutting tube 2 of an adjacent-sized discectomy device increases in size from 2mm to a model size, up to 15 mm.

It is further preferred that the four sides (i.e., the outer contour) of the discectomy device are rounded.

In another preferred embodiment, the shape of the bottom edge of the discectomy device can be modified, for example, the edge is modified into an oblique edge (shown in fig. 5 to 10) cutting off 30 degrees, 45 degrees and 60 degrees, so as to meet the requirements of different cutting ranges.

When the intervertebral disc resectoscope is used, the intervertebral disc resectoscope with a proper size is selected according to the height of a pathological intervertebral disc measured by preoperative images, so that the cutting times are reduced as much as possible in the using process, and a set resection range is completed in a short time. When the novel intervertebral disc resectoscope is used, pathological intervertebral space is exposed by traction, the intervertebral disc resectoscope is slowly and carefully avoided from important soft tissue structures until the knife edge of the intervertebral disc resectoscope is aligned to a fibrous ring on a pathological intervertebral disc, the safe excision edge of the intervertebral disc is searched, the edge of the intervertebral disc resectoscope is pressed close to the most edge planned to be excised, the top end of a knocking column 1 of the intervertebral disc resectoscope is knocked outside the body after important dura mater spinalis, nerves and other structures are not mixed in the excision range, the depth of the intervertebral disc cut by the knife edge is controlled through the knocking force, the intervertebral disc resectoscope is knocked every time, the cutting time and the cutting effect are equal to that of a four-time scalpel are used, the cutting depth can be kept consistent, the process that the fibrous ring of the intervertebral disc needs to be searched every time is. Meanwhile, the four sides of the intervertebral disc resectoscope are processed by round corners, and the knife edge is designed to be an inward knife edge, so that accidental damage to surrounding adjacent soft tissues cannot be caused in the whole in-vivo entering stage and cutting process, and the risk of damage to surrounding important nerves, dura mater and the like caused by accidental deviation of positions in the process of feeding the surgical knife or the osteotome into a vertebral body focus or in the process of knocking due to sharp edges can be avoided. With the difference of the knocking angle (vertical and inclined) of the discectomy device and the difference of the range of each cutting, the adjustment is changed according to the operation requirement of an operator. In the cutting process, the discectomy device can directly collect all the cut fractured tissues of the intervertebral disc and enable the fractured tissues to enter the hollow pore canal of the discectomy device, so that the trouble of taking out the fractured tissues of the intervertebral disc every time is eliminated. And directly continuing to perform the next cutting after cutting a piece of intervertebral disc cracked tissue until the cutting process is finished, and then, communicating the hollow pore channel by using a kirschner wire, thus taking out all the intervertebral discs blocking the hollow pore channel. The cutting of the square crossing can realize the trimming of the edge of the intervertebral disc annulus fibrosus, the clear operation visual field is beneficial to the subsequent excision of the intervertebral disc nucleus pulposus and the vertebra and fusion of the intervertebral space, and the trimming of the edge of the intervertebral disc is met as much as possible by not artificially using an operating knife or a osteotome for once and again excision.

The foregoing describes preferred embodiments of the present invention, but is not intended to limit the invention thereto. Modifications and variations of the embodiments disclosed herein may be made by those skilled in the art without departing from the scope and spirit of the invention.

Claims

1. The intervertebral disc resectoscope is characterized by comprising a knocking column and a cutting tube, wherein the cutting tube is fixedly arranged at one end of the knocking column, and the central axes of the knocking column and the cutting tube are coincided; the interior of the cutting pipe is provided with a hollow pore canal extending along the central axis; the hollow pore passage penetrates through the knocking column and the cutting pipe; the cross sections of the cutting pipe and the hollow pore passage are both square; and a knife edge is arranged at the end part of one end of the cutting pipe, which is far away from the knocking column, and is provided with inward knife edges which are inclined towards the inside of the hollow pore passage, and the inward knife edges are distributed on four edges of the square cross section of the cutting pipe.

2. The disc resector of claim 1, wherein the striking post is circular in cross-section.

3. The disc resector of claim 2 wherein the striking post is 10mm in diameter and 100mm in length.

4. The disc resector of claim 1, wherein the cutting tube has an outer peripheral wall of 5mm on a side and an inner peripheral wall of the hollow tunnel has a side of 4mm on a side.

5. The disc resectoscope according to claim 1, wherein the total length of the disc resectoscope is 200 mm.

6. The disc resectoscope according to claim 1, wherein the width of the inward-facing blade edge is 0.5 mm.

7. The discectomy device of claim 1, wherein the discectomy device comprises a plurality of different sizes, the different sizes of the cutting tube of the discectomy device differing in side length.

8. The discectomy device of claim 7, wherein the side length of the cutting tube of adjacent gauge discectors increases by a predetermined value.

9. The discectomy device of claim 8, wherein the side lengths of the cutting tubes of adjacent gauge discectors increase sequentially from 2mm to a size up to 15 mm.

10. The discectomy device of claim 1, wherein the outer profile of the discectomy device is radiused.