CN113143438B - Percutaneous lumbar vertebrae vertebral plate articular process screw targeting device - Google Patents
Percutaneous lumbar vertebrae vertebral plate articular process screw targeting device Download PDFInfo
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- CN113143438B CN113143438B CN202110223633.9A CN202110223633A CN113143438B CN 113143438 B CN113143438 B CN 113143438B CN 202110223633 A CN202110223633 A CN 202110223633A CN 113143438 B CN113143438 B CN 113143438B
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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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- 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
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
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Abstract
The invention relates to a percutaneous lumbar vertebral plate articular process screw targeting device which comprises a fixed rod, a first locating rod, a second locating rod, a first aiming rod and a second aiming rod, wherein the first locating rod, the second locating rod, the first aiming rod and the second aiming rod are fixed on the fixed rod in a sliding mode, a first puncture hole is formed in the lower end of the first locating rod, a second puncture hole is formed in the lower end of the second locating rod, an aiming sleeve is connected between the first aiming rod and the second aiming rod, and the first puncture hole, the second puncture hole and the aiming sleeve are coaxial. The invention has compact structure, strict design and convenient and quick operation, and can quickly and accurately find the nail feeding point and the nail feeding direction in the process of inserting the percutaneous lumbar vertebral plate articular process screw, thereby ensuring the success rate of nail placement under the condition of reducing the operation time and the perspective times.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to a percutaneous lumbar vertebrae lamina articular process screw targeting device.
Background
Lumbar fusion has been widely used in the treatment of degenerative diseases of the lumbar spine. The operation is performed with extensive nerve decompression and often causes local instability of the spine, and the stability of the operation part is generally required to be rebuilt. Currently, pedicle screw internal fixation is considered to be the most effective method of reconstructing spinal stability. In recent years, with the deep and continuous concept of minimally invasive spinal surgery, smaller surgical wounds and smaller soft tissue injuries are the targets of continuous pursuits by clinical students. Compared with the traditional pedicle screw, the laminar articular process screw has the advantages of smaller wound, lower cost, quicker postoperative recovery and the like while achieving the same biomechanical stability, and has been applied to the minimally invasive spinal fusion operation. The screw placement technology of the laminar articular process screw is gradually operated through percutaneous under the guidance of open steering perspective, and has the advantages of small wound, low cost, quick recovery and the like, but is limited by complex anatomical structure of the screw placement position, the screw placement accuracy is insufficient, repeated operation is needed, serious consequences are caused if the operation is careless, the technical threshold is raised, and the wide application of the screw placement technology is hindered. Therefore, how to improve the accuracy and safety of the insertion of the laminboard articular process screw is a current clinical challenge.
Disclosure of Invention
The invention aims to provide a percutaneous lumbar vertebrae articular process screw targeting device which has the advantages of compact structure, strict design and convenient and quick operation, and can quickly and accurately find a screw feeding point and a screw feeding direction in the process of placing the percutaneous lumbar vertebrae articular process screw, so that the screw placing success rate can be ensured under the condition of reducing the operation time and the perspective times.
In order to solve the problems in the prior art, the percutaneous lumbar vertebral lamina articular process screw targeting device provided by the invention comprises a fixed rod, a first positioning rod, a second positioning rod, a first aiming rod and a second aiming rod, wherein the first positioning rod, the second positioning rod, the first aiming rod and the second aiming rod are fixed on the fixed rod in a sliding manner, a first puncture hole is formed in the lower end of the first positioning rod, a second puncture hole is formed in the lower end of the second positioning rod, an aiming sleeve is connected between the first aiming rod and the second aiming rod, and the first puncture hole, the second puncture hole and the aiming sleeve are coaxial.
Furthermore, the invention relates to a percutaneous lumbar vertebral plate articular process screw targeting device, wherein a first aiming hole is formed in the lower end of a first aiming rod, a second aiming hole is formed in the lower end of a second aiming rod, the first aiming hole and the second aiming hole are coaxial, and an aiming sleeve is slidably arranged in the first aiming hole and the second aiming hole.
Furthermore, the invention relates to a percutaneous lumbar vertebral lamina articular process screw targeting device, wherein the fixed rod is provided with a T-shaped guide groove along the axial direction, the first positioning rod, the second positioning rod, the first aiming rod and the second aiming rod are hung in the T-shaped guide groove through bosses arranged at the upper ends, and the T-shaped guide groove is also provided with a device for fixing the positions of the first positioning rod, the second positioning rod, the first aiming rod and the second aiming rod.
Furthermore, the invention relates to a percutaneous lumbar vertebral plate articular process screw targeting device, wherein the device for fixing the positions of a first positioning rod, a second positioning rod, a first aiming rod and a second aiming rod is a pressing plate positioned above a boss, a plurality of threaded holes penetrating through a T-shaped guide groove are formed in the length direction of the fixing rod, fastening screws are connected in the threaded holes, and the fastening screws are propped against the pressing plate through the threaded holes.
Furthermore, the percutaneous lumbar vertebral plate articular process screw targeting device is characterized in that the lower end face of the pressing plate is provided with saw-tooth-shaped protrusions, and the upper end face of the boss is provided with saw-tooth-shaped grooves which are embedded with the saw-tooth-shaped protrusions.
Further, the invention relates to a percutaneous lumbar vertebral plate articular process screw targeting device, wherein the serrated protrusions are arranged along the length direction of the pressing plate.
Furthermore, the invention relates to a percutaneous lumbar vertebral plate articular process screw targeting device, wherein the first positioning rod consists of a first upper section rod and a first lower section rod, the lower end of the first upper section rod is provided with a stepped hole with a downward opening, a deep groove ball bearing and a thrust bearing are sequentially arranged in the stepped hole from top to bottom, a plurality of vertically distributed positioning grooves are circumferentially arranged on the inner peripheral wall of an inner ring of the deep groove ball bearing, and positioning protrusions matched with the positioning grooves are arranged at the upper end of the first lower section rod.
Furthermore, the invention relates to a percutaneous lumbar vertebral plate articular process screw targeting device, wherein the second positioning rod consists of a second upper section rod and a second lower section rod, a blind hole with a downward opening is arranged at the lower end of the second upper section rod, and a protrusion and a groove which are in clearance fit with each other are respectively arranged on the peripheral wall of the upper end of the second lower section rod and the inner wall of the blind hole.
Compared with the prior art, the percutaneous lumbar vertebral plate articular process screw targeting device system and the control method thereof comprise a fixed rod, a first positioning rod, a second positioning rod, a first targeting rod and a second targeting rod, wherein the first positioning rod, the second positioning rod, the first targeting rod and the second targeting rod are fixed on the fixed rod in a sliding mode, a first puncture hole is formed in the lower end of the first positioning rod, a second puncture hole is formed in the lower end of the second positioning rod, a targeting sleeve is connected between the first targeting rod and the second targeting rod, and the first puncture hole, the second puncture hole and the targeting sleeve are coaxial. During actual use, the first locating rod is anchored at the root of one lateral process, then the second locating rod is slid to anchor the second locating rod at the root of the opposite lateral process of the upper vertebral body, thus the first puncture hole and the second puncture hole locate the required fixing positions of the screw, then the characteristics of the aiming sleeve and the three points of the first puncture hole and the second puncture hole are utilized to accurately point the introduction point and the screw feeding direction in vitro, and finally the fixation of the vertebral lamina articular process screw is completed. The screw feeding device has the advantages of compact structure, strict design and convenient and quick operation, can quickly and accurately find the screw feeding point and the screw feeding direction in the process of inserting the percutaneous lumbar vertebral plate articular process screw, and can also ensure the success rate of the operation under the condition of reducing the operation duration and the perspective times.
The percutaneous lumbar vertebral plate articular process screw targeting device of the invention is further described in detail below with reference to the specific embodiments shown in the drawings:
drawings
FIG. 1 is a schematic diagram of a first embodiment of the present invention;
FIG. 2 is a cross-sectional view taken along line A-A of FIG. 1;
FIG. 3 is a side view of a first embodiment of the invention;
FIG. 4 is a cross-sectional view taken along line B-B of FIG. 3;
FIG. 5 is a schematic cross-sectional view of a second embodiment of the present invention
FIG. 6 is an enlarged view of a portion A of FIG. 5;
FIG. 7 is an enlarged view of part B of FIG. 5;
fig. 8 is a schematic diagram of the actual operation of the present invention.
Detailed Description
It should be noted that the terms of up, down, front, back, left, right and the like in the present invention are merely described according to the drawings, so as to facilitate understanding, and are not limited to the technical solution of the present invention and the scope of protection claimed.
Example 1
As shown in fig. 1 and 4, the percutaneous lumbar vertebral plate articular process screw targeting device of the invention comprises a fixed rod 1, a first positioning rod 2, a second positioning rod 3, a first aiming rod 4 and a second aiming rod 5 which are fixed on the fixed rod in a sliding manner, wherein a first puncture hole 21 is formed in the lower end of the first positioning rod 2, a second puncture hole 31 is formed in the lower end of the second positioning rod 3, an aiming sleeve 6 is connected between the first aiming rod 4 and the second aiming rod 5, and the first puncture hole 21, the second puncture hole 31 and the aiming sleeve 6 are coaxial.
In practical use, as shown in fig. 8, the first positioning rod 2 is anchored at the root of a lateral process, then the second positioning rod 3 is slid to anchor the second positioning rod 3 at the root of a lateral process of an upper vertebral body, so that the first puncture hole 21 and the second puncture hole 31 position the final fixing position of the laminboard articular process screw, the characteristics of three points of the aiming sleeve 6, the first puncture hole 21 and the second puncture hole 31 are utilized in vitro to precisely point the introduction point and the nailing direction (i.e. the direction indicated by the dotted line in fig. 8), then the puncture needle 9 penetrates from the aiming sleeve 6, the guide wire is arranged, and finally the laminboard articular process screw is fixed at the final fixing position along the guide wire. The screw feeding device has the advantages of compact structure, strict design and convenient and quick operation, can quickly and accurately find the screw feeding point and the screw feeding direction in the process of inserting the percutaneous lumbar vertebral plate articular process screw, and can also ensure the success rate of the operation under the condition of reducing the operation duration and the perspective times.
As an optimization scheme, as shown in fig. 4, in this embodiment, a first aiming hole 41 is provided at the lower end of the first aiming rod 4, a second aiming hole 51 is provided at the lower end of the second aiming rod 5, the first aiming hole 41 and the second aiming hole 5 are coaxial, and the aiming sleeve 6 is slidably disposed in the first aiming hole 41 and the second aiming hole 5. In this way, the first aiming hole 41 and the second aiming hole 5 are coaxial with the first puncture hole 21 and the second puncture hole 31, and the aiming sleeve 6 can be finely adjusted to tightly prop against the body surface in the operation process under the condition that the positions of the first aiming rod 4 and the second aiming rod 5 are fixed, and meanwhile, the aiming sleeve 6 is convenient to replace when worn.
As an optimization scheme, as shown in fig. 2 and 4, in this embodiment, a T-shaped guide groove 11 is provided in the axial direction of the fixing rod 1, and the first positioning rod 2, the second positioning rod 3, the first aiming rod 4 and the second aiming rod 5 are suspended in the T-shaped guide groove 11 through bosses provided at the upper ends. The first positioning rod 2, the second positioning rod 3, the first aiming rod 4 and the second aiming rod 5 can slide freely in the T-shaped guide groove 11 without fixation. The T-shaped guide groove 11 is also provided with a device for fixing the positions of the first positioning rod 2, the second positioning rod 3, the first aiming rod 4 and the second aiming rod 5, so that the first positioning rod 2, the second positioning rod 3, the first aiming rod 4 and the second aiming rod 5 can be fixed at the same time. The means for fixing the positions of the first positioning rod 2, the second positioning rod 3, the first aiming rod 4 and the second aiming rod 5 is actually a pressing plate 7 positioned above the boss. The fixing rod 1 is provided with a plurality of threaded holes penetrating through the T-shaped guide groove 11 along the length direction, the threaded holes are connected with fastening screws 8, and the fastening screws 8 are propped against the pressing plate 7 through the threaded holes. During actual use, the positions of the first positioning rod 2 and the second positioning rod 3 on the fixed rod 1 are firstly determined, then the positions of the first aiming rod 4 and the second aiming rod 5 on the fixed rod 1 are adjusted, and finally the fastening screw 8 is screwed down to fix the first positioning rod 2, the second positioning rod 3, the first aiming rod 4 and the second aiming rod 5 at the same time, so that the operation time is saved.
As an optimization scheme, as shown in fig. 4, in this embodiment, serrated protrusions are disposed on the lower end surface of the pressing plate 7, and serrated grooves engaged with the serrated protrusions are disposed on the upper end surface of the boss, so that relative sliding can be limited while positioning is performed. And the saw-tooth-shaped bulges are arranged along the length direction of the pressing plate 7, so that the first positioning rod 2, the second positioning rod 3, the first aiming rod 4 and the second aiming rod 5 can be prevented from sliding left and right after being fixed, the fixing effect is more stable, and further, the preset fixing position of the vertebral plate articular process screw is prevented from being changed.
Example two
As an optimization scheme, as shown in fig. 5 and 6, the difference between the present embodiment and the first embodiment is that the first positioning rod 2 is composed of a first upper segment rod 22 and a first lower segment rod 23, the lower end of the first upper segment rod 22 is provided with a stepped hole 221 with a downward opening, a deep groove ball bearing 222 and a thrust bearing 223 are sequentially arranged in the stepped hole 221 from top to bottom, a plurality of vertically distributed positioning grooves are circumferentially arranged on the inner peripheral wall of the inner ring of the deep groove ball bearing 222, and the upper end of the first lower segment rod 23 is provided with positioning protrusions matched with the positioning grooves. Thus, the first positioning rod 2 is divided into two sections, when in actual use, the first lower section rod 23 can be anchored first, then the first upper section rod 22 is inserted onto the first lower section rod 23 through the positioning groove, and then the first upper section rod 22 can rotate relative to the first lower section rod 23 under the driving of the positioning rod 1 by utilizing the deep groove ball bearing 222 and the thrust bearing 223, so that the anchoring position of the second positioning rod 3 can be conveniently found.
As a further optimization scheme, as shown in fig. 5 and 7, the second positioning rod 3 in this embodiment is composed of a second upper section rod 32 and a second lower section rod 33, the lower end of the second upper section rod 32 is provided with a blind hole with a downward opening, and the peripheral wall of the upper end of the second lower section rod 33 and the inner wall of the blind hole are respectively provided with a protrusion and a groove which are in clearance fit with each other. This makes it possible to facilitate the rotation anchoring operation of the second lower rod 33 without reducing the overall strength of the second positioning rod 3.
It should be noted that, in actual use, coaxial spikes are usually connected to the bottoms of the first positioning rod 2 and the second positioning rod 3, so as to facilitate the anchoring operation.
The above examples are only illustrative of the preferred embodiments of the present invention and are not intended to limit the scope of the claimed invention, and various modifications made by those skilled in the art according to the technical solution of the present invention should fall within the scope of the present invention as defined in the claims without departing from the spirit of the present invention.
Claims (3)
1. The utility model provides a percutaneous lumbar vertebrae vertebral plate articular process screw targeting instrument, its characterized in that includes dead lever (1) and slide fastening first locating lever (2), second locating lever (3), first sighting rod (4) and second sighting rod (5) on the dead lever, the lower extreme of first locating lever (2) is equipped with first puncture hole (21), the lower extreme of second locating lever (3) is equipped with second puncture hole (31), be connected with between first sighting rod (4) and second sighting rod (5) and aim sleeve (6), first puncture hole (21), second puncture hole (31) and sighting sleeve (6) coaxial, dead lever (1) are equipped with a T type guide way (11) along the axis direction, first locating lever (2), second locating lever (3), first sighting rod (4) and second sighting rod (5) all hang in T type guide way (11) through the boss that the upper end set up, be equipped with in T type guide way (11) first locating lever (3), second sighting rod (4) and second sighting rod (5) are located fixed device (5) and first locating lever (3), second locating lever (4) are fixed device and first locating lever (4), the utility model discloses a fixing device for the electronic device, including clamp plate (7), fixed lever (1), first sighting rod (4), second sighting rod (5), clamp screw (8) are connected with in the screw hole along length direction a plurality of screw holes that run through T type guide way (11), clamp screw (8) are on clamp plate (7) through the screw hole top, be equipped with the cockscomb structure arch on the lower terminal surface of clamp plate (7), be equipped with on the up end of boss with cockscomb structure protruding gomphosis's cockscomb structure recess, cockscomb structure arch is arranged along the length direction of clamp plate (7), the lower extreme of first sighting rod (4) is equipped with first sighting hole (41), the lower extreme of second sighting rod (5) is equipped with second sighting hole (51), first sighting hole (41) and second sighting hole (51) are coaxial, sighting sleeve (6) slip set up in first sighting hole (41) and second sighting hole (51).
2. The percutaneous lumbar vertebral plate articular process screw targeting device according to claim 1, wherein the first positioning rod (2) is composed of a first upper segment rod (22) and a first lower segment rod (23), a stepped hole (221) with a downward opening is formed in the lower end of the first upper segment rod (22), a deep groove ball bearing (222) and a thrust bearing (223) are sequentially arranged in the stepped hole (221) from top to bottom, a plurality of vertically distributed positioning grooves are formed in the inner peripheral wall of the inner ring of the deep groove ball bearing (222) along the circumferential direction, and positioning protrusions matched with the positioning grooves are formed in the upper end of the first lower segment rod (23).
3. The percutaneous lumbar vertebral plate articular process screw targeting device according to claim 2, wherein the second positioning rod (3) is composed of a second upper segment rod (32) and a second lower segment rod (33), a blind hole with a downward opening is arranged at the lower end of the second upper segment rod (32), and a protrusion and a groove which are in clearance fit with each other are respectively arranged on the peripheral wall of the upper end of the second lower segment rod (33) and the inner wall of the blind hole.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110223633.9A CN113143438B (en) | 2021-03-01 | 2021-03-01 | Percutaneous lumbar vertebrae vertebral plate articular process screw targeting device |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110223633.9A CN113143438B (en) | 2021-03-01 | 2021-03-01 | Percutaneous lumbar vertebrae vertebral plate articular process screw targeting device |
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| CN113143438A CN113143438A (en) | 2021-07-23 |
| CN113143438B true CN113143438B (en) | 2023-06-23 |
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| CN114557760A (en) * | 2022-03-01 | 2022-05-31 | 戴建辉 | Guider for spinous process vertebral lamina articular process screw and using method thereof |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| FR2885513B1 (en) * | 2005-05-13 | 2007-08-10 | Newdeal S A S Soc Par Actions | ARTHRODESIS APPARATUS FOR ARTICULATION, OF THE GENUS ARTICULATION OF THE ANKLE, AND NAIL OF ATHRODESE FOR USE IN SUCH AN APPARATUS |
| CN100467000C (en) * | 2006-12-29 | 2009-03-11 | 中国人民解放军南京军区南京总医院 | Distal lockhole positioning system for interlocking of intramedullary nail |
| CN104127231B (en) * | 2014-07-16 | 2016-07-06 | 王钢 | A kind of Wicresoft S1 femoral neck cannulated screw locating guider |
| CN205459007U (en) * | 2016-02-24 | 2016-08-17 | 袁峰 | Percutaneous lumbar vertebrae vertebral plate articular process screw director |
| CN106120595B (en) * | 2016-08-16 | 2018-01-09 | 无锡市政设计研究院有限公司 | A kind of adjustable traffic rod member of height x length |
| CN209826940U (en) * | 2019-04-09 | 2019-12-24 | 孙宜保 | Percutaneous lumbar vertebra lamina articular process screw nail placing device |
| CN211409318U (en) * | 2019-07-17 | 2020-09-04 | 泸州市中医医院(泸州市中西医结合医院、泸州市江阳区中医医院) | Kirschner wire guiding device |
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