CN113456092B - Intraoperative spinal column crown state balance assessment tool - Google Patents
Intraoperative spinal column crown state balance assessment tool Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
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Abstract
The invention belongs to the technical field of medical instruments, and particularly relates to an intraoperative coronal balance assessment tool for a spinal column, which solves the problems of large error and complex operation of a traditional assessment method. The invention comprises a developing perspective plate, wherein a plurality of square grids formed by transverse lines and longitudinal lines are arranged on the perspective plate, and the side length of each grid is half of the width of a Harington stable area; the longitudinal line at the center is a center line, and the lines on the left and right sides of the center line are boundary lines. The invention has simple structure, convenient and fast operation, practicality and easy popularization; the method is suitable for intraoperative perspective evaluation of all patients with spinal deformity, including accurate intraoperative perspective evaluation of patients with unequal lower limbs and asymmetric pelvis, and the evaluation accuracy is high; ensuring the judgment result and improving the evaluation efficiency.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to an intraoperative coronal balance assessment tool for a spinal column.
Background
Scoliosis, also known as scoliosis, is a three-dimensional deformity of the spine, including abnormalities in the sequence of coronal, sagittal and axial positions.
Scoliosis deformity is particularly indicated in the deviation of the spine in the coronal position, mild scoliosis can be observed, and severe ones need surgical treatment. Scoliosis deformity is a common disease endangering adolescents and children, and is mainly discovered and treated early. Along with the improvement of the operation level, more and more scoliosis malformed patients are fixed and treated by posterior pedicle screw fixation and osteotomy orthopedic bone grafting fusion internal fixation, along with the development of instruments, the orthopedic effect of the operation gradually becomes better, but the incidence of the scoliosis malformation is still higher, and the scoliosis malformation can influence the living quality of the patients to a certain extent. In specific practice, it is often necessary to evaluate the coronal plane balance of a scoliosis patient, specifically when the distance between the perpendicular bisector of the anterior superior iliac spine connecting line and the spinous process of the C7 vertebral body is greater than 20mm, it is determined that the coronal plane of the vertebral column is unbalanced, i.e. a significant trunk deviation occurs. Therefore, evaluating the equilibrium state of the coronal plane of the spine can determine to some extent the severity of the scoliotic deformity and the damage to the human body. More importantly, the equilibrium state of the coronal part of the spine in the orthopedic operation and after the operation is an important evaluation index for the orthopedic curative effect of the spine operation; meanwhile, the method is one of the measurement standards for satisfaction of the appearance and the function of the patient after the operation.
Although the related research of the coronal position is controversial and is ignored by the same general public to some extent, a lot of researches show that the unbalance of the coronal position also affects the mobility and the quality of life of scoliosis patients, so that the assessment of the coronal position balance in the operation is important, and the traditional assessment in the operation only depends on intraoperative fluoroscopy, visual observation and experience estimation, and the method has great error; some are by T-stands, which are generally a relatively reliable choice, but have the disadvantage that: (1) When facing to the patients with partial lower limbs of unequal length or asymmetric pelvis, the method is more complicated, the pelvis inclination of the coronal X-ray pelvis of the standing position needs to be continuously compared, and the X-ray pelvis inclination is continuously adjusted and matched in the operation, and the repeated determination of the left and right sides causes the head of the operator to be bent; (2) A slight angular error of the "T-frame" base has the effect of magnifying the distance, and a 1 ° error at the sacral pelvis will cause C7 to deviate from the sacral midline (CSVL) by a distance (CBD) of about 1 cm.
Disclosure of Invention
The invention provides an intraoperative spinal column coronal balance assessment tool, aiming at solving the problems of large error and complex operation of the traditional assessment method.
The invention is realized by adopting the following technical scheme: a tool for evaluating coronal balance of an intraoperative spinal column comprises a developable perspective plate, wherein a square grid formed by a plurality of transverse lines and longitudinal lines is arranged on the perspective plate, and the side length of the grid is half of the width of a Harington stable area; the longitudinal line at the center is a center line, and the lines on the left and right sides of the center line are boundary lines.
Furthermore, the perspective plate comprises a top plate and a bottom plate which are light-permeable, the top plate and the bottom plate are arranged in parallel and are fixedly connected, a developable plate is hinged between the top plate and the bottom plate, the developable plate rotates around a hinge shaft relative to the top plate and the bottom plate, and the grid is arranged on the developable plate.
Furthermore, marks are arranged on the longitudinal lines of the grid of the perspective plate, and the marks on two adjacent longitudinal lines are different; the left and right corners of the top of the perspective plate are respectively marked with a left mark and a right mark.
Further, be equipped with the angle scale on the perspective board, the angle scale includes angle scale mark and pointer, and the angle scale mark is located the bottom plate top of perspective board, the pointer is fixed on the board that can develop, and the pointer is located the top of angle scale mark, sets up the groove of dodging of avoiding the angle scale on the roof, dodges the top that the trench is located the pointer.
Furthermore, the number of the angle scales is two, and the two angle scales are symmetrically arranged on the left side and the right side of the perspective plate.
Furthermore, the top plate and the bottom plate of the perspective plate are carbon fiber plates.
Compared with the prior art, the invention has the beneficial effects that:
1. the device is simple in structure, convenient and quick to operate, practical and easy to popularize, only the device needs to be placed below a position pad of a spinal surgery bed, and then the angle of the developing plate can be adjusted to evaluate the spinal coronal balance;
2. the method is suitable for intraoperative perspective assessment of all patients with spinal deformity, the sacrum median line and the midline are overlapped, and then the angle of the developable plate is adjusted to enable the transverse line to be parallel to the connecting lines of the iliac crests on the two sides, so that accurate intraoperative perspective assessment can be performed on the patients with unequal lower limbs and asymmetric pelvis, the influence on the inaccurate coronal position assessment before the operation is eliminated, and the assessment precision is high;
3. the perspective plate is designed into three layers, namely a top plate, a bottom plate and a developable plate, so that the developable plate can rotate conveniently; can develop net and mark (rectangle, triangle-shaped and left direction mark and the setting of right direction mark on the board, the C arm appears the stagger arrangement when reciprocating segmentation shooting in the art of being convenient for), its error is less relatively, reduces the error, can not produce the distance amplification effect that "T type frame" base angular adjustment error brought to guarantee the judged result and improve aassessment efficiency.
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FIG. 1 is a schematic front projection view of the present invention;
FIG. 2 is a schematic view of a horizontal plane projection of the present invention;
FIG. 3 is a schematic diagram of an embodiment of the present invention;
in the figure: 1-perspective plate, 1.1-developable plate, 1.2-midline, 1.3-borderline, 1.4-top plate, 1.5-bottom plate, 2-angle scale, 2.1-angle scale, 2.2-pointer, L-left mark, R-right mark.
Detailed Description
The following description of the embodiments of the present invention is provided for illustrative purposes, and other advantages and effects of the present invention will become apparent to those skilled in the art from the present disclosure.
It should be understood that the structures, ratios, sizes, etc. shown in the drawings and attached to the description are only for understanding and reading the disclosure of the present invention, and are not intended to limit the practical conditions of the present invention, so that the present invention has no technical significance, and any modifications of the structures, changes of the ratio relationships, or adjustments of the sizes, should still fall within the scope of the technical contents disclosed in the present invention without affecting the efficacy and the achievable purpose of the present invention. In addition, the terms "upper", "lower", "left", "right", "middle" and "one" used in the present specification are used for clarity of description, and are not intended to limit the scope of the present invention, and the relative relationship between the terms and the terms may be changed or adjusted without substantial change in the technical content.
The terms "left and right" and "lateral" as used herein refer to the width direction of the see-through plate; "Up-down" and "longitudinal" refer to the length of the perspective plate (i.e., the orientation of the spine).
Referring to fig. 1 to 2, the present invention provides a technical solution: a tool for evaluating coronal balance of an intraoperative spinal column comprises a visual plate 1 capable of being developed, wherein a square grid formed by a plurality of transverse lines and longitudinal lines is arranged on the visual plate 1, and the side length of the grid is half of the width of a Harington stable area; the longitudinal line at the center is a center line 1.2, and the border lines 1.3 are located on the left and right sides of the center line 1.2.
The perspective board 1 comprises a top board 1.4 and a bottom board 1.5 which are light-permeable, the top board 1.4 and the bottom board 1.5 are arranged in parallel and are fixedly connected, a developable board 1.1 is hinged between the top board 1.4 and the bottom board 1.5, the developable board 1.1 rotates relative to the top board 1.4 and the bottom board 1.5 around a hinge shaft, and the grid is arranged on the developable board 1.1.
The longitudinal lines of the grid of the perspective plate 1 are provided with marks, and the marks on two adjacent longitudinal lines are different (such as small rectangle and triangle marks); the left and right corners of the top of the perspective plate 1 are respectively marked with a left mark L and a right mark R (the left and right marks are convenient for intraoperative confirmation and accurate judgment); the marks are arranged to facilitate intraoperative confirmation and accurate judgment, deviation is avoided, and because intraoperative C-arm fluoroscopy can only contain 4-5 vertebral bodies, the C-arm needs to be moved up and down to shoot the whole spine in a segmented manner, longitudinal lines of adjacent grids are easily mixed (staggered), and the judgment of the deviation is influenced.
Be equipped with angle scale 2 on perspective board 1, angle scale 2 includes angle scale mark 2.1 and pointer 2.2, and angle scale mark 2.1 is located perspective board 1's bottom plate 1.5 top, and pointer 2.2 is fixed on developable board 1.1, and pointer 2.2 is located angle scale mark 2.1's top, sets up the groove of dodging of avoiding angle scale 2 on roof 1.4, dodges the groove and is located pointer 2.2's top, but the adjustment developable board 1.1 of being convenient for the horizontal line and the two side iliac crest lines of net or two side acetabular crowns lines are parallel (as the balanced benchmark of judgement coronation).
The angle scales 2 are two, and the two angle scales 2 are symmetrically arranged on the left side and the right side of the perspective plate 1, so that the angle can be observed conveniently.
The top plate 1.4 and the bottom plate 1.5 of the perspective plate 1 are carbon fiber plates, and have the advantages of light permeability and light weight and are convenient to move back and forth.
But development board 1.1, roof 1.4 and bottom plate 1.5 are "sandwich" structure, and the middle development board 1.1 that is equipped with the net is equipped with roof 1.4 and bottom plate 1.5 (light in weight) of light-permeable carbon fiber board from top to bottom, are equipped with angle scale 2 on the perspective board 1, carry out the accuracy regulation to development board 1.1 according to the perspective condition.
As shown in fig. 3, the perspective plate 1 is placed under the position pad of the operation bed, the central line 1.2 should overlap with the sacrum median line (CSVL), the transverse line should be parallel with the bilateral iliac crest connecting line or the bilateral vertex connecting line, (the upper and lower endplates of the normal vertebral body should be parallel with this line), if the transverse line is not parallel with the bilateral iliac crest connecting line during the operation, the included angle between the two lines is measured, then the developable plate 1.1 is adjusted by rotation (the rotation angle is observed by the angle scale 2 and is consistent with the above included angle), the transverse line should be parallel with the bilateral iliac crest connecting line, the two boundary lines 1.3 pass through the lumbosacral joint respectively to form a Harington stable area, if the orthopedic vertebral body is located in the boundary line 1.3 stable area during the operation, the coronary equilibrium is indicated to be better.
The foregoing embodiments are merely illustrative of the principles and utilities of the present invention and are not intended to limit the invention. Any person skilled in the art can modify or change the above-mentioned embodiments without departing from the spirit and scope of the present invention. Accordingly, it is intended that all equivalent modifications or changes which can be made by those skilled in the art without departing from the spirit and technical spirit of the present invention be covered by the claims of the present invention.
Claims (3)
1. An intraoperative coronal balance assessment tool, comprising: the visual plate comprises a visual plate (1) capable of being developed, wherein a plurality of square grids formed by transverse lines and longitudinal lines are arranged on the visual plate (1), and the side length of each grid is half of the width of a Harington stable area; the longitudinal line positioned at the center is a center line (1.2), and the longitudinal lines positioned at the left side and the right side of the center line (1.2) are boundary lines (1.3);
the perspective plate (1) comprises a top plate (1.4) and a bottom plate (1.5) which are light-permeable, the top plate (1.4) and the bottom plate (1.5) are arranged in parallel and fixedly connected, a developable plate (1.1) is hinged between the top plate (1.4) and the bottom plate (1.5), the developable plate (1.1) rotates around a hinge shaft relative to the top plate (1.4) and the bottom plate (1.5), and the grid is arranged on the developable plate (1.1);
marks are arranged on the longitudinal lines of the grids of the perspective plate (1), and the marks on two adjacent longitudinal lines are different; the left corner and the right corner of the top of the perspective plate (1) are respectively marked with a left mark (L) and a right mark (R);
be equipped with angle scale (2) on perspective board (1), angle scale (2) are located including angle scale mark (2.1) and pointer (2.2), angle scale mark (2.1) bottom plate (1.5) top of perspective board (1), pointer (2.2) are fixed on can developing board (1.1), and pointer (2.2) are located the top of angle scale mark (2.1), set up the groove of dodging of avoiding angle scale (2) on roof (1.4), dodge the top that the trench is located pointer (2.2).
2. The intraoperative coronal balance assessment tool of claim 1, wherein: the two angle scales (2) are symmetrically arranged on the left side and the right side of the perspective plate (1).
3. The intraoperative coronal balance assessment tool of claim 1, wherein: the top plate (1.4) and the bottom plate (1.5) of the perspective plate (1) are carbon fiber plates.
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