CN114631962A - Vertebral pedicle screw positioning system - Google Patents
Vertebral pedicle screw positioning system Download PDFInfo
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- CN114631962A CN114631962A CN202210226069.0A CN202210226069A CN114631962A CN 114631962 A CN114631962 A CN 114631962A CN 202210226069 A CN202210226069 A CN 202210226069A CN 114631962 A CN114631962 A CN 114631962A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
-
- 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
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
-
- 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
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
-
- 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
- A61B17/8605—Heads, i.e. proximal ends projecting from bone
-
- 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
- A61B17/8625—Shanks, i.e. parts contacting bone tissue
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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
- 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
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
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- A61G13/00—Operating tables; Auxiliary appliances therefor
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- A61G13/101—Clamping means for connecting accessories to the operating table
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
- A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
- A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
- A61G13/121—Head or neck
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- A—HUMAN NECESSITIES
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- A61G13/00—Operating tables; Auxiliary appliances therefor
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- A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
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- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
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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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3983—Reference marker arrangements for use with image guided surgery
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- A61G2210/00—Devices for specific treatment or diagnosis
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- A—HUMAN NECESSITIES
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- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G2210/00—Devices for specific treatment or diagnosis
- A61G2210/50—Devices for specific treatment or diagnosis for radiography
Abstract
The invention discloses a vertebral pedicle screw positioning system, wherein three rulers used for marking the space coordinate of an affected part are arranged on an operating bed, two limiting columns are arranged at the front end of the operating bed and are used for helping a patient to fix, a movable plate is arranged at the front end of the operating bed and can move back and forth and position according to the length of the cervical vertebra of the patient, a vertical arm is arranged at the left side of the operating bed through a sliding table and can move back and forth and position, a cross arm is arranged at the upper end of the vertical arm and forms a revolute pair, a rotary piece is arranged at the front end of the cross arm and forms a revolute pair, an inclined arm is arranged at the lower side of the rotary piece and forms a revolute pair, an executive piece is arranged at the lower end of the inclined arm and forms a revolute pair, a positioning mechanism is arranged at the lower end of the executive piece and forms a thread pair, and the positioning mechanism can be used for guiding the installation of pedicle screws; the control system collects images of affected parts through the medical X-ray machine, calculates space coordinate data of the target vertebral pedicle, controls each driving part to perform corresponding action, and finally enables the positioning mechanism to move to the target vertebral pedicle.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a vertebral pedicle screw positioning system.
Background
The spine fracture is a common spine disease in orthopedics department, the morbidity of patients is mainly caused by high fall, traffic accidents, heavy object smashing injuries and the like, and the morbidity of the thoracolumbar spine is high; the pain of the patient with the thoracolumbar spine fracture is strong, the physiological function of the patient is seriously affected, the patient has higher disability probability, the nerve function of the patient is lost, the life and the labor of the patient are affected, and serious patients even cause life danger, so the patient is required to receive treatment immediately after the disease occurs.
The decompression reduction operation is mainly adopted for clinical treatment of thoracolumbar spine fracture, so that the spinal nerves can be effectively prevented from being secondarily injured, and the risk of complications of patients is reduced; although the injury of a patient can be relieved to a certain extent and the height of the vertebral body of the patient can be improved by the traditional injured vertebral fixation treatment, the overall treatment effect is limited; with the continuous progress of modern medical technology, the pedicle screw embedding and internal fixing technology provides a new approach for treating thoracolumbar spine fracture; the pedicle screw embedding and internal fixing technology has excellent biomechanical stability, can obtain better treatment and recovery effects, and is lighter in the condition that the nerve of a patient is damaged; however, due to the anatomical characteristics of thoracolumbar spine, the conventional pedicle screw placing mode which is operated only by the experience of doctors has higher difficulty and danger, so that the vertebral pedicle screw positioning system provided by the invention has obvious significance, can effectively reduce the blindness and uncertainty of manual operation, and improves the treatment effect.
Disclosure of Invention
In order to solve the defects of the prior art, the invention aims to provide a vertebral pedicle screw positioning system which can assist a doctor in implementing a vertebral pedicle screw placing internal fixation operation, effectively reduce the blindness and uncertainty of manual operation and improve the treatment effect.
The technical scheme adopted by the invention is as follows: vertebra pedicle of vertebral arch screw positioning system, its characterized in that: the operation bed can be stably placed on the ground and can be used for enabling a patient to lie on the back, and a longitudinal axis scale, a transverse axis scale and a vertical axis scale are arranged on the operation bed and used for marking the space coordinate position of an affected part; the first limiting column and the second limiting column are respectively arranged on two sides of the front end of the operating bed and locked by two locking wheels, and the rear sides of the first limiting column and the second limiting column are respectively provided with a first arc plate and a second arc plate which are used for abutting against shoulders of a patient so as to help to realize fixation of the body of the patient; the movable plate is arranged at the front end of the operating bed and can move back and forth and be positioned according to the length of the cervical vertebra of a patient, and an elliptical hole for the patient to place the face to ensure smooth breathing is formed in the upper side of the movable plate; the vertical arm is arranged on the left side of the operating table through a sliding table and can move back and forth and be positioned; the cross arm is arranged at the upper end of the vertical arm and forms a rotating pair, and the vertical shaft of the cross arm can be driven to rotate by a first motor arranged at the upper end of the vertical arm; the rotating part is arranged at the front end of the transverse arm and forms a rotating pair, and the transverse shaft of the rotating part can be driven to rotate by a second motor arranged at the front end of the transverse arm; the oblique arm is arranged at the lower side of the rotating part and forms a rotating pair, the vertical shaft of the oblique arm can be driven by a third motor arranged in the rotating part to rotate, and the included angle between the extending direction of the main body of the oblique arm and the rotating axis of the output shaft of the third motor is 45 degrees; the executing part is arranged at the lower end of the oblique arm and forms a rotating pair, and the rotation of the executing part is driven by a fourth motor arranged at the lower end of the oblique arm; the positioning mechanism is arranged at the lower end of the executive component and forms a thread pair, and the positioning mechanism can be used for guiding the installation of the pedicle screws; the control system collects images of affected parts through a medical X-ray machine and calculates space coordinate data of the target vertebral pedicle, then transmits the processed data to the sliding table, the first motor, the second motor, the third motor and the fourth motor and enables the sliding table, the first motor, the second motor, the third motor and the fourth motor to perform corresponding actions, and finally the left end of the positioning mechanism is moved to the target vertebral pedicle.
Preferably, the scale lines of the vertical axis scale, the horizontal axis scale and the vertical axis scale are made of lead wire.
Preferably, the first motor, the second motor, the third motor and the fourth motor are all connected with a cycloidal reducer to serve as power transmission parts.
Preferably, the hand wheel is installed at the front end of the moving plate, and the moving plate can be adjusted to a proper position according to the length of the cervical vertebra of the patient by rotating the hand wheel, so that the face of the patient can be placed in the elliptical hole to ensure smooth breathing.
Preferably, the control system can determine the space three-dimensional coordinate data of the target vertebral pedicle of the affected part according to the projection positions of the affected part on the vertical axis scale, the horizontal axis scale and the vertical axis scale.
Preferably, the positioning mechanism comprises a threaded pipe, a first nut, a second nut, a spring, a first connecting rod, a first clamping jaw, a screw, a second clamping jaw, a second connecting rod and a sliding part, wherein the first clamping jaw and the second clamping jaw are respectively installed on the upper side and the lower side of the threaded pipe and respectively form a revolute pair, the sliding part and the threaded pipe form a moving pair and are respectively connected with the first clamping jaw and the second clamping jaw through the first connecting rod and the second connecting rod, and the spring can push the sliding part to move forwards so as to realize mutual clamping of the first clamping jaw and the second clamping jaw.
Preferably, a lower semicircular groove is formed in the upper side of the left end of the first clamping jaw, an upper semicircular groove is formed in the lower side of the left end of the second clamping jaw, and the lower semicircular groove and the upper semicircular groove are combined to form a guide circular hole for guiding a screw.
Preferably, the left end of the first clamping jaw is provided with a first inclined plane, the left end of the second clamping jaw is provided with a second inclined plane, and the tail cap of the screw can extrude the first inclined plane and the second inclined plane to prop open the first clamping jaw and the second clamping jaw, so that the screw can be separated from the positioning mechanism and fixed on the pedicle of vertebral arch.
Preferably, the first nut may be used to adjust the spring force of the spring, thereby enabling adjustment of the clamping force between the first jaw and the second jaw.
Preferably, the second nut is mounted to a rear end of the threaded pipe to form a screw pair, and the second nut and the actuator may form a double nut lock structure.
The invention has the beneficial effects that: firstly, the patient can be effectively fixed after lying on the operating bed, the control system can establish the space coordinate of the target vertebral pedicle according to the collected pattern of the affected part of the spine of the patient by the X-ray machine, determine the accurate data of the screw placement position, and then convert the space position data into the motion data of each electric execution component; in the whole process, the work of establishing a space coordinate, performing space positioning and the like is processed by the control system, and a doctor only needs to perform nail placing operation according to the position specified by the positioning mechanism, so that the operation is simple, the positioning is accurate, and the nail placing operation difficulty is greatly reduced; the diameter of a guide round hole formed by combining the upper semicircular groove and the lower semicircular groove is equal to the diameter of the upper thread of the screw and is smaller than the diameter of a central round hole in the threaded pipe, so that the screw cannot shake in the guide round hole, and the screw placing position is more accurate; inclined planes are arranged on the two clamping jaws at the left end of the positioning mechanism, so that a tail cap of the screw can extrude the two inclined planes to expand the two clamping jaws outwards, the screw can be separated from the positioning mechanism and fixed on the vertebral pedicle, and additional opening structure and operation are not needed, so that the positioning mechanism has the advantages of simple structure and convenience in operation; the front end of the central round hole of the screw tube is radially opened by the empty groove at the left end of the screw tube, so that the screw can be placed into the guide round hole through the right end of the screw tube and can also be placed into the guide round hole through the empty groove, and meanwhile, a doctor can observe the matching condition of the screwdriver and the screw tail cap through the empty groove, thereby facilitating the screwing operation of the screw; when the three-dimensional coordinates are established, the three-dimensional coordinates of a plurality of target vertebral pedicles can be established at the same time, so that X-ray fluoroscopy is not required to be frequently performed on a patient, the image acquisition times can be effectively reduced, the X-ray absorption dose of the patient and medical staff can be reduced, and the three-dimensional coordinates have obvious improvement significance; the invention adopts a plurality of cycloid reducers for power transmission, and the cycloid reducers have the advantages of small volume, light weight, large transmission ratio range, stable operation and the like, and can be completely suitable for the positioning operation of a positioning mechanism on the vertebral pedicle.
Drawings
Fig. 1 is a schematic view of the overall structure of the present invention.
Fig. 2 is an enlarged partial cross-sectional view of the present invention.
Fig. 3 is a schematic view of the overall structure of the positioning mechanism.
Fig. 4 is a schematic view of the entire structure of the positioning mechanism.
Fig. 5 is a partial sectional view of the front end of the moving plate.
Reference numerals: 1 operating table, 1.1 longitudinal axis scale, 1.2 transverse axis scale, 1.3 vertical axis scale, 2 first limit column, 2.1 first arc plate, 3 first locking wheel, 4 first lead screw, 4.1 first belt wheel, 5 moving plate, 5.1 elliptical hole, 6 hand wheel, 6.1 driving belt wheel, 7 second locking wheel, 8 second limit column, 8.1 second arc plate, 9 sliding table, 10 first motor cover, 11 vertical arm, 12 cross arm, 13 rotating piece, 14 oblique arm, 15 fourth motor cover, 16 first motor, 17 second motor, 18 third motor, 19 fourth motor, 20 executing piece, 21 threaded pipe, 21.1 empty groove, 21.2 smooth section, 22 second nut, 23 first nut, 24 spring, 25 first connecting rod, 26 first clamping jaw, 26.1 first inclined plane, 27 screw, 28 second clamping jaw, 28.1 second inclined plane, 29 second connecting rod, 30, 30.1 first lead screw, 30.1 second sliding piece, 31.31 second sliding piece, 31.32 ear synchronous belt wheel, 31.1 synchronous belt, 31 second ear, 33 second guide wheels, 34 first guide wheels.
Detailed Description
The present invention will be further described with reference to specific examples, which are intended to illustrate, but not limit the scope of the invention.
As shown in fig. 1, in the vertebral pedicle screw positioning system, an operating bed 1 is stably placed on the ground, two threaded holes with the same size are longitudinally arranged at the front end of the operating bed 1, the positions of the two threaded holes are symmetrical about a longitudinal vertical central plane of the operating bed 1, two square jacks in the vertical direction are arranged on the upper side of the front end of the operating bed 1, the two square jacks have the same structure and are bilaterally symmetrical about the longitudinal vertical central plane of the operating bed 1, two locking screw holes are arranged at the front end of the operating bed 1, and the two locking screw holes are respectively positioned at the front sides of the two square jacks and communicated with the corresponding square jacks; the first locking wheel 3 is coaxially arranged in a locking screw hole on the right side of the front end of the operating bed 1 to form a screw pair, and the second locking wheel 7 is coaxially arranged in a locking screw hole on the left side of the front end of the operating bed 1 to form a screw pair; the side vertically is equipped with axis of ordinates scale 1.1 on the operation table 1 for the axis of ordinates position in sign affected part, and the side transversely is equipped with cross axle scale 1.2 on the operation table 1 for the cross axle position in sign affected part, and 1 right side of operation table is equipped with vertical axis scale 1.3 for the vertical axis position in sign affected part, and the scale mark of scale adopts the lead wire material.
A square shaft is arranged at the lower end of the first limiting column 2, the size of the square shaft is the same as that of a square jack at the front end of the operating bed 1, a first arc plate 2.1 is arranged on the rear side of the first limiting column 2, the first arc plate 2.1 is of a concave surface structure, the central axis of the concave surface is in the horizontal direction, and the first limiting column 2 is arranged in the square jack on the right side of the front end of the operating bed 1 and is locked by a first locking wheel 3; the structure of the second spacing column 8 is the same as that of the first spacing column 2, the lower end of the second spacing column 8 is provided with a square shaft, the rear side of the second spacing column is provided with a second arc plate 8.1, the second arc plate 8.1 is of a concave surface structure, the central axis of the concave surface is in the horizontal direction, and the second spacing column 8 is arranged in a square jack on the left side of the front end of the operating bed 1 and is locked by a second locking wheel 7.
As shown in fig. 1 and 2, a slide block is arranged on the slide table 9, a driving motor and an encoder are integrated in the slide table 9, the driving motor can move and position the slide block, the encoder can record the position of the slide block and transmit data to a control system, and the slide table 9 is fixedly mounted on the left side surface of the operating table 1; a lightening hole is formed in the vertical arm 11, and the lower end of the vertical arm 11 is fixedly connected with a sliding block on the sliding table 9, so that the sliding table 9 can drive the vertical arm 11 to move back and forth and position; the first motor 16 is internally integrated with an encoder and a brake, so that accurate angle rotation and locking positioning can be realized, the first motor 16 is fixedly arranged at the upper end of the vertical arm 11 through a cycloid speed reducer, the rotation axis is in the vertical direction, and the first motor cover 10 is arranged at the outer side of the first motor 16 and used for beautifying the appearance of equipment; the rear end of the cross arm 12 is arranged at the upper end of the vertical arm 11 and forms a rotating pair, and the rear end of the cross arm 12 is coaxially and tightly connected with an output shaft of a cycloidal speed reducer at the upper end of a first motor 16, so that the first motor 16 can drive the cross arm 12 to rotate and position; the second motor 17 is internally integrated with an encoder and a brake, so that accurate angle rotation and locking positioning can be realized, the second motor 17 is fixedly arranged at the front end of the cross arm 12 through a cycloid speed reducer, and the rotation axis is in the horizontal direction; a cylindrical table is arranged on the rear side of the rotating part 13 and is arranged at the front end of the cross arm 12, and the cylindrical table is coaxially and fixedly connected with an output shaft of a cycloidal reducer at the front end of a second motor 17, so that the second motor 17 can drive the rotating part 13 to rotate and position; the third motor 18 is internally integrated with an encoder and a brake, so that accurate angle rotation and locking positioning can be realized, the third motor 18 is fixedly arranged in the rotating part 13 through a cycloid speed reducer, and the rotating axis is in the vertical direction; the upper end of the oblique arm 14 is arranged at the lower end of the rotating part 13 to form a rotating pair, and the upper end of the oblique arm 14 is coaxially and fixedly connected with an output shaft of a cycloid speed reducer at the lower end of the third motor 18, so that the third motor 18 can drive the oblique arm 14 to rotate and position, and the included angle between the main body extending direction of the oblique arm 14 and the rotating axis of the output shaft of the third motor 18 is 45 degrees; the encoder and the brake are integrated in the fourth motor 19, accurate angle rotation and locking positioning can be achieved, the fourth motor 19 is fixedly installed at the lower end of the inclined arm 14 through a cycloid speed reducer, the rotating axis is parallel to the extending direction of the main body of the inclined arm 14, and the fourth motor cover 15 is installed on the outer side of the fourth motor 19 and used for beautifying the appearance of equipment; the upper end of the actuating element 20 is mounted at the lower end of the oblique arm 14 and forms a rotating pair, and the upper end of the actuating element 20 is coaxially and tightly connected with the output shaft of the cycloid reducer at the lower end of the fourth motor 19, so that the fourth motor 19 can drive the actuating element 20 to rotate and position, the lower end of the actuating element 20 is provided with a threaded hole, and the central axis of the threaded hole is perpendicular to the rotation axis of the output shaft of the fourth motor 19.
As shown in fig. 3 and 4, the positioning mechanism includes a threaded pipe 21, a second nut 22, a first nut 23, a spring 24, a first connecting rod 25, a first clamping jaw 26, a screw 27, a second clamping jaw 28, a second connecting rod 29, and a sliding member 30, wherein the threaded pipe 21 is of an inverted T-shaped structure, a round hole penetrating from left to right is formed in the center of the threaded pipe 21, a hollow groove 21.2 is formed in the left end of the round hole in the center of the threaded pipe 21, the hollow groove 21.2 radially opens the front end of the round hole in the center of the threaded pipe 21, a smooth section 21.2 is formed on the threaded pipe 21 on the right side of the hollow groove 21.2, the smooth section 21.2 is of a cylindrical section structure with a smooth outer surface, and an external thread structure is formed on the right side of the smooth section 21.2; a lower semicircular groove is formed in the upper side of the left end of the first clamping jaw 26, a first inclined surface 26.1 is formed in the right side of the lower semicircular groove, two circular holes are formed in the right end of the first clamping jaw 26, the circular hole in the left side is rotatably connected with the lower side of the left end of the threaded pipe 21, and the circular hole in the right side is rotatably connected with the left end of the first connecting rod 25; an upper semicircular groove is formed in the lower side of the left end of the second clamping jaw 28, a second inclined surface 28.1 is formed in the right side of the upper semicircular groove, two circular holes are formed in the right end of the second clamping jaw 28, the circular hole in the left side is rotatably connected with the upper side of the left end of the threaded pipe 21, and the circular hole in the right side is rotatably connected with the left end of the second connecting rod 29; the lower side of the sliding part 30 is provided with a first lug 30.1, the upper side is provided with a second lug 30.2, the sliding part 30 and the threaded pipe 21 are coaxially arranged and can slide left and right on the smooth section 21.2, the right end of the first connecting rod 25 is rotatably connected with the first lug 30.1, and the right end of the second connecting rod 29 is rotatably connected with the second lug 30.2; the first nut 23 and the threaded pipe 21 are coaxially arranged and form a thread pair, the spring 24 is arranged between the sliding part 30 and the first nut 23, so that under the action of the elastic force of the spring 24, the sliding part 30 moves forwards and enables the first clamping jaw 26 and the second clamping jaw 28 to approach and clamp each other through the first connecting rod 25 and the second connecting rod 29, so that the lower semicircular groove on the first clamping jaw 26 and the upper semicircular groove on the second clamping jaw 28 are combined to form a guide circular hole for guiding the screw 27, and the first nut 23 can be used for adjusting the elastic force of the spring 24, so that the clamping force between the first clamping jaw 26 and the second clamping jaw 28 can be adjusted; the threaded pipe 21 is arranged in a threaded hole at the lower end of the actuating element 20 to form a thread pair, the second nut 22 is arranged at the rear end of the threaded pipe 21 to form the thread pair, and the second nut 22 and the actuating element 20 can form a double-nut locking structure.
The positioning mechanism can be used for guiding the installation of the screw 27, the screw 27 can be placed into the guide round hole through the right end of the threaded pipe 21 and can also be placed into the guide round hole through the empty groove 21.2, the long rod screwdriver can be inserted from the right end of the threaded pipe 21 and abut against the tail cap of the screw 27, the screw 27 can be screwed into the vertebral pedicle by rotating the screwdriver, in the process, the tail cap of the screw 27 props the first clamping jaw 26 and the second clamping jaw 28 apart by squeezing the first inclined plane 26.1 and the second inclined plane 28.1, and therefore the screw 27 can be separated from the positioning mechanism and fixed on the vertebral pedicle.
As shown in fig. 5, the moving plate 5 is installed at the front end of the operating bed 1, the width of the moving plate 5 is equal to the width of the rectangular notch at the front end of the operating bed 1, an elliptical hole 5.1 is formed in the upper side of the moving plate 5, and a transmission cavity 5.2 is formed in the front end of the moving plate 5; the front end of the first lead screw 4 is provided with a first belt pulley 4.1, the first lead screw 4 is arranged inside the right side of the moving plate 5 and forms a revolute pair, the first belt pulley 4.1 is positioned in the transmission cavity 5.2, and the first lead screw 4 and a threaded hole on the right side of the front end of the operating bed 1 are coaxially arranged and form a threaded pair; the front end of the second lead screw 31 is provided with a second belt wheel 31.1, the second lead screw 31 is mounted inside the left side of the moving plate 5 and forms a revolute pair, the second belt wheel 31.1 is positioned in the transmission cavity 5.2, and the second lead screw 31 and a threaded hole in the left side of the front end of the operating bed 1 are coaxially mounted and form a threaded pair; the front end of the hand wheel 6 is of a circular wheel structure convenient for manual rotation, the rear end of the hand wheel is provided with a driving belt wheel 6.1, the hand wheel 6 is mounted at the front end of the moving plate 5 and forms a revolute pair, the driving belt wheel 6.1 is positioned in the transmission cavity 5.2, the first guide wheel 34 is mounted in the transmission cavity 5.2 on the right side of the driving belt wheel 6.1 and forms a revolute pair, the second guide wheel 33 is mounted in the transmission cavity 5.2 on the left side of the driving belt wheel 6.1 and forms a revolute pair, the synchronous belt 32 is mounted in the transmission cavity 5.2, the synchronous belt 32 sequentially bypasses the lower side of the driving belt wheel 6.1, the upper side of the first guide wheel 34, the right side of the first belt wheel 4.1, the left side of the second belt wheel 31.1 and the upper side of the second guide wheel 33, so that the clockwise rotation of the hand wheel 6 can enable the synchronous belt 32 to drive the first lead screw 4 and the second lead screw 31 to rotate clockwise simultaneously, the moving plate 5 moves backwards and approaches the operating table 1, and the counterclockwise rotation of the hand wheel 6 can enable the moving plate 5 to move forwards, thereby can adjust movable plate 5 to suitable position according to patient's cervical vertebra length when the patient lies prostrate, make the patient can place face in elliptical aperture 5.1 in order to guarantee smooth and easy breathing.
The working principle of the invention is as follows: when the spine pedicle screw is placed into the internal fixation operation of the patient:
(1) the first limiting column 2 is inserted into a square insertion hole on the right side of the front end of the operating bed 1 and is locked by the first locking wheel 3, and the second limiting column 8 is inserted into a square insertion hole on the left side of the front end of the operating bed 1 and is locked by the second locking wheel 7;
(2) the patient lies on the upper side of the operating bed 1, the first arc plate 2.1 and the second arc plate 8.1 are made to prop against the shoulders of the patient, the hand wheel 6 is rotated to adjust the moving plate 5 to a proper position, the face of the patient is placed in the elliptical hole 5.1, and the medical bandage is used for fixing the patient so that the patient does not move;
(3) the medical X-ray machine is used for collecting patterns of affected parts of spines of patients and transmitting image information to the control system, the control system has a data processing function, the control system can determine space three-dimensional coordinate data of target vertebral pedicles of the affected parts according to projection positions of the affected parts on a longitudinal axis scale 1.1, a transverse axis scale 1.2 and a vertical axis scale 1.3, the control system transmits the processed data to the sliding table 9, the first motor 16, the second motor 17, the third motor 18 and the fourth motor 19 and enables the sliding table, the first motor 16, the second motor 17, the third motor 18 and the fourth motor 19 to perform corresponding actions, and finally the left end of the positioning mechanism is moved to the target vertebral pedicles;
(4) the screw 27 is placed in a guide circular hole formed by combining the lower semicircular groove of the first clamping jaw 26 and the upper semicircular groove of the second clamping jaw 28, and the screw 27 is screwed into the pedicle of vertebral arch through a screwdriver, so that the placing action of the pedicle of vertebral arch screw is completed.
Claims (10)
1. A vertebral pedicle screw positioning system, comprising:
the operation bed can be stably placed on the ground and can be used for the patient to lie on the back; a longitudinal axis scale, a transverse axis scale and a vertical axis scale are arranged on the operating bed and used for marking the space coordinate position of the affected part;
the first limiting column and the second limiting column are respectively arranged on two sides of the front end of the operating bed and locked by two locking wheels, and a first arc plate and a second arc plate are respectively arranged on the rear sides of the first limiting column and the second limiting column and used for abutting against shoulders of a patient to help to fix the body of the patient;
the movable plate is arranged at the front end of the operating bed and can move back and forth and be positioned according to the length of the cervical vertebra of a patient, and an elliptical hole for the patient to place the face to ensure smooth breathing is formed in the upper side of the movable plate;
the vertical arm is arranged on the left side of the operating table through a sliding table and can move back and forth and be positioned;
the vertical shaft of the cross arm can rotate and can be driven by a first motor arranged at the upper end of the vertical arm;
the rotating part is arranged at the front end of the cross arm and forms a rotating pair, and the cross shaft of the rotating part can be driven by a second motor arranged at the front end of the cross arm to rotate;
the inclined arm is arranged on the lower side of the rotating part and forms a rotating pair, the vertical shaft of the inclined arm can be driven by a third motor arranged in the rotating part to rotate, and the included angle between the extending direction of the main body of the inclined arm and the rotating axis of the output shaft of the third motor is 45 degrees;
the executing piece is arranged at the lower end of the oblique arm and forms a rotating pair, and the rotation of the executing piece is driven by a fourth motor arranged at the lower end of the oblique arm;
the positioning mechanism is arranged at the lower end of the executive component and forms a thread pair, and the positioning mechanism can be used for guiding the installation of the pedicle screws;
and the control system acquires images of the affected part through a medical X-ray machine, calculates space coordinate data of the target vertebral pedicle, transmits the processed data to the sliding table, the first motor, the second motor, the third motor and the fourth motor, makes the sliding table, the first motor, the second motor, the third motor and the fourth motor perform corresponding actions, and finally makes the left end of the positioning mechanism move to the target vertebral pedicle.
2. The vertebral pedicle screw positioning system of claim 1, wherein: the scale marks of the longitudinal axis scale, the transverse axis scale and the vertical axis scale are made of lead wires.
3. The vertebral pedicle screw positioning system of claim 1, wherein: the first motor, the second motor, the third motor and the fourth motor are all connected with a cycloid speed reducer to serve as power transmission parts.
4. The vertebral pedicle screw positioning system of claim 1, wherein: the hand wheel is arranged at the front end of the moving plate, the moving plate can be adjusted to a proper position according to the length of the cervical vertebra of the patient by rotating the hand wheel, and the patient can place the face in the elliptical hole to ensure smooth breathing.
5. The vertebral pedicle screw positioning system of claim 1, wherein: the control system can determine the space three-dimensional coordinate data of the target vertebral pedicle of the affected part according to the projection positions of the affected part on the longitudinal axis scale, the transverse axis scale and the vertical axis scale.
6. The vertebral pedicle screw positioning system of claim 1, wherein: the positioning mechanism comprises a threaded pipe, a first nut, a second nut, a spring, a first connecting rod, a first clamping jaw, a screw, a second clamping jaw, a second connecting rod and a sliding part, wherein the first clamping jaw and the second clamping jaw are respectively installed on the upper side and the lower side of the threaded pipe and respectively form a revolute pair, the sliding part and the threaded pipe form a moving pair and are respectively connected with the first clamping jaw and the second clamping jaw through the first connecting rod and the second connecting rod, and the spring can push the sliding part to move forwards so as to realize mutual clamping of the first clamping jaw and the second clamping jaw.
7. The vertebral pedicle screw positioning system of claim 6, wherein: the upper side of the left end of the first clamping jaw is provided with a lower semicircular groove, the lower side of the left end of the second clamping jaw is provided with an upper semicircular groove, and the lower semicircular groove and the upper semicircular groove are combined to form a guide circular hole for guiding a screw.
8. The vertebral pedicle screw positioning system of claim 6, wherein: the left end of the first clamping jaw is provided with a first inclined plane, the left end of the second clamping jaw is provided with a second inclined plane, and a tail cap of the screw can extrude the first inclined plane and the second inclined plane to prop open the first clamping jaw and the second clamping jaw, so that the screw can be separated from the positioning mechanism and fixed on the pedicle of vertebral arch.
9. The vertebral pedicle screw positioning system of claim 6, wherein: the first nut can be used for adjusting the elastic force of the spring, so that the clamping force between the first clamping jaw and the second clamping jaw is adjusted.
10. The vertebral pedicle screw positioning system of claim 6, wherein: the second nut is arranged at the rear end of the threaded pipe and forms a thread pair, and the second nut and the executing piece can form a double-nut locking structure.
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| Application Number | Priority Date | Filing Date | Title |
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| CN202210226069.0A CN114631962B (en) | 2022-03-08 | 2022-03-08 | Vertebral pedicle screw positioning system |
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| CN202210226069.0A CN114631962B (en) | 2022-03-08 | 2022-03-08 | Vertebral pedicle screw positioning system |
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| CN114631962B CN114631962B (en) | 2023-10-10 |
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| CN114631962B (en) | 2023-10-10 |
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Inventor after: Zhao Zhili Inventor after: Gao Hong Inventor before: Gao Hong |
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Effective date of registration: 20230907 Address after: No. 169, Changle West Road, Xi'an, Shaanxi 710038 Applicant after: Air Force Medical University Address before: 134599 Department of Orthopaedics, Fusong people's Hospital, No. 116, Jinjiang Road, Fusong County, Baishan City, Jilin Province Applicant before: Gao Hong |
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