Background technology
Pedicle of vertebral arch is the robust construction that connects the forward and backward part of spinal column, the pedicle screw fixedly has three-dimensional stability and high fusion rate, be better than other cervical vertebra fixing meanss, but because the anatomical features of pedicle of cervical vertebra and complicated neighbouring relationship thereof, cause that operation risk is big, difficulty is high, make the cervical vertebra pedicle plant the clinical further popularization of nail and be restricted.The pedicle for cervical vertebra arch screw of using is put the nail method and can be reduced two classes at present: one is the free-hand nail method of putting, promptly the rich experience that on top of reaches of pedicle for cervical vertebra arch anatomical structure is implanted screw by the patient, the method expense is lower, but needs to rely on doctors experience to put nail, and operation risk is huge; Another puts the nail method for the computer navigation technology, be about to the CT data input navigation system master controller of spinal column, systems soft ware carries out three-dimensional reconstruction to spinal column, the doctor determines ideal trajectory, length and the diameter that each pedicle screw is inserted on this basis, accurately put nail, the method is put nail accurately, but the expense costliness.
Be the disclosed a kind of sacrum rod internal fixation sight of Chinese utility model patent " sacrum rod internal fixation sight " (notification number is CN2657596Y) of ZL03270002.4 in addition as the patent No., when correcting the sacroiliac joint transverse shift, can determine the position of holing, and be the drill bit guiding by the drilling rod guide hole of aiming cover, it is accurate to guarantee to hole.It comprises guide rod, two linking arms are separately fixed at the downside at guide rod two ends, the linking arm lower end is connected with the aiming cover, and the aiming cover that is separately positioned on the linking arm of guide rod two ends is oppositely arranged on the same axis, the aiming cover is sleeve-like structure, its core hole is the drilling rod guide hole, is complementary with the diameter of drilling rod.Its shortcoming is: the one, because the utilization structure parts are many and securing member uses manyly, cause guide rod to be difficult to accurately directed and displacement occurs, and the 2nd, because the characteristics of human body, this structure wants big otch to expose in clinical, and operation wound is big, the damage of soft tissue and bone structure is big, and blood loss increases; Operating time is longer simultaneously, and moves the patient to radiology department, the potential danger that damage is increased the weight of; Its disadvantage is that fixed fastness is poor, can only resist the pelvis rotation, corrects the sacroiliac joint transverse shift, can not correct the vertical movement of sacroiliac joint.Since above-mentioned shortcoming, the clinical existing trend of eliminating gradually of present this technology.
Summary of the invention
Technical problem to be solved in the utility model is the present situation at prior art, and a kind of simple and practical, handling safety, the accurately directed and low pedicle for cervical vertebra arch screw positioner of surgery cost are provided.For the clinical treatment cervical vertebra provides the new nail method of putting, reduced the danger of damaging important nerve, blood vessel, make safer, the Wicresoft of clinical operation, and more meet the physiological requirement of human body.
This utility model solves the problems of the technologies described above the technical scheme that is adopted: the pedicle for cervical vertebra arch screw positioner; comprise diopter; this diopter two ends respectively be connected with can with fixed left secured adjusted frame of operation table bulk phase and right secured adjusted frame; be shaped on arc plate in the middle of the diopter; the suit slippage has at least one slide block on this arc plate, all is plugged with protective casing on each slide block.
The measure of taking also comprises:
Each extension of above-mentioned arc plate two ends is shaped on and the mutually orthogonal connection flat board of arc plate; Above-mentioned arc plate one side at least evenly is shaped on the angle measuring calibration body; This slide block is two, and each slide block back side is bolted with the first annular knurl holding screw.
Above-mentioned angle measuring calibration body is positioned at the medial surface of arc plate, and this angle measuring calibration body is two that evenly extend to both sides according to arc plate center cut-off rule, and the angulation value range of every angle measuring calibration body is 0 degree to 60 degree; Article two, the angle measuring calibration system has 0 identical degree graduation mark and this 0 degree graduation mark to be positioned on the cut-off rule of arc plate center.
Above-mentioned left secured adjusted frame comprises left L shaped rotor plate, and the L shaped rotor plate in this left side is divided into upper left seesaw and the left horizontal plate that is hinged, and left horizontal plate quadrature is connected with at least one vertical supporting rod.
The hinged end end of above-mentioned left horizontal plate is shaped on first chute of circular arc, be equipped with in this first chute to tighten rotating disk with first of upper left seesaw bolt, and upper left seesaw first is tightened rotating disk and left horizontal plate phase position is fixed through this.
Above-mentioned right secured adjusted frame comprises right L shaped rotor plate, and the L shaped rotor plate in this right side is divided into upper right seesaw and the right horizontal plate that is hinged, and right horizontal plate quadrature is connected with at least one vertical supporting rod.
The hinged end end of above-mentioned right horizontal plate is shaped on second chute of circular arc, be equipped with in this second chute to tighten rotating disk with first of upper right seesaw bolt, and upper right seesaw first is tightened rotating disk and right horizontal plate phase position is fixed through this.
Above-mentioned vertical supporting rod is two, and the vertical supporting rod upper end is with an energy and first fixed block that left horizontal plate or right horizontal plate socket-connect, and is connected with first on this first fixed block and tightens rotating disk.
Each above-mentioned vertical supporting rod lower end is equipped with the seat that anchors of a few phase plug-in mounting, and this anchors seat and is fixed on the operation table body, and each anchors and is connected with second on the seat and tightens rotating disk.
Above-mentioned upper left seesaw upper end be shaped on can with is connected second fixed block that flat board socket-connects, this second fixed block is connected with the second annular knurl holding screw; Above-mentioned upper right seesaw upper end be shaped on can with is connected the 3rd fixed block that flat board socket-connects, the 3rd fixed block is connected with the 3rd annular knurl holding screw.
Compared with prior art; diopter of the present utility model two ends respectively be connected with can with fixed left secured adjusted frame of operation table bulk phase and right secured adjusted frame; be shaped on arc plate in the middle of the diopter, the suit slippage has at least one slide block on this arc plate, all is plugged with protective casing on each slide block.Advantage of the present utility model is: pedicle of vertebral arch is the robust construction that connects the forward and backward part of spinal column, has three-dimensional stability height and the high advantage of fusion rate after the pedicle screw is fixing; The utilization structure parts are few, and are simple to operate and securing member is easy to use; Adopt the guide rod of angulation locate mode, can realize the accurate orientation of pedicle screw; According to the characteristics of human body, operative incision is little, and operation wound is little, reduces blood loss.
The specific embodiment
Embodiment describes in further detail this utility model below in conjunction with accompanying drawing.
Embodiment as shown in Figure 1 to Figure 3, figure grade explanation: diopter 1, arc plate 11; angle measuring calibration body 11a connects flat board 12, left secured adjusted frame 2; the L shaped rotor plate 21 in a left side, upper left seesaw 21a, left horizontal plate 21b; the first chute 21c, the second fixed block 21d, first tightens rotating disk 22; the second annular knurl holding screw 23, right secured adjusted frame 3, right L shaped rotor plate 31; upper right seesaw 31a, right horizontal plate 31b, the 3rd fixed block 31c; the 3rd milled screw 32; slide block 4, the first annular knurl holding screws 41, protective casing 5; vertical supporting rod 6; the first fixed block 6a anchors seat 7, the second and tightens rotating disk 71.
The pedicle for cervical vertebra arch screw positioner of present embodiment; comprise diopter 1; this diopter 1 two ends respectively be connected with can with fixed left secured adjusted frame 2 of operation table bulk phase and right secured adjusted frame 3; be shaped on arc plate 11 in the middle of the diopter 1; the suit slippage has at least one slide block 4 on this arc plate 11, all is plugged with protective casing 5 on each slide block 4.
Present embodiment is achieved in that each extension of arc plate 11 two ends is shaped on and arc plate 11 mutually orthogonal connections dull and stereotyped 12; Arc plate 11 one side at least evenly is shaped on angle measuring calibration body 11a; General slide block 4 is two, and each slide block 4 back side be bolted with the first annular knurl holding screw, 41, the first annular knurl holding screws 41 be mainly used in can be effectively fixing slide block 4, small the departing from of position behind anti-limited slip block 4 location; Slide block 4 guaranteed navigation system can be in use before and after and move up and down, satisfy pinpoint needs.
Be positioned at the medial surface of arc plate 11 simultaneously at general quantity angle index body 11a, and this angle measuring calibration body 11a is to even two of extending in both sides according to arc plate 11 center cut-off rules, for reaching the optimum efficiency of use, be 0 degree to 60 degree at the angulation value range of every angle measuring calibration body 11a; Article two, angle measuring calibration body 11a is shaped on identical 0 degree graduation mark and this 0 degree graduation mark is positioned on the arc plate 11 center cut-off rules, the sighting angle of pedicle screw was measured when angle measuring calibration body 11a was mainly used in operation, its angle measuring calibration body 11a is equivalent to a kind of angular adjustment rule, and arc plate 11 is equivalent to a kind of protractor.
Left side secured adjusted frame 2 comprises left L shaped rotor plate 21, the L shaped rotor plate 21 in this left side is divided into upper left seesaw 21a and the left horizontal plate 21b that is hinged, upper left seesaw 21a upper end be shaped on can with is connected the flat board 12 second fixed block 21d that socket-connect, the second fixed block 21d is connected with the second annular knurl holding screw 23; This left side horizontal plate 21b quadrature is connected with at least one vertical supporting rod 6; The hinged end end of left side horizontal plate 21b is shaped on the first chute 21c of circular arc, be equipped with in the first chute 21c and can tighten rotating disk 22, and upper left seesaw 21a first tightens rotating disk 22 and fixes with left horizontal plate 21b phase position through this with first of upper left seesaw 21a bolt.
Right secured adjusted frame 3 comprises right L shaped rotor plate 31, the L shaped rotor plate 31 in this right side is divided into upper right seesaw 31a and the right horizontal plate 31b that is hinged, upper right seesaw 31a upper end be shaped on can with is connected flat board 12 the 3rd fixed block 31c that socket-connect, the 3rd fixed block 31c is connected with the 3rd annular knurl holding screw 32; Right horizontal plate 31b quadrature is connected with at least one vertical supporting rod 6, and this vertical supporting rod 6 is generally one; The hinged end end of right horizontal plate 31b is shaped on second chute of circular arc, be equipped with in second chute and can tighten rotating disk 22 with first of upper right seesaw 31a bolt, and upper right seesaw 31a first tightens rotating disk 22 and fixes with right horizontal plate 31b phase position through this.
The first chute 21c and second chute are mainly used in the guiding that is hinged and rotatablely moves, and general vertical supporting rod 6 is two, vertical supporting rod 6 upper ends are with the first fixed block 6a that an energy and left horizontal plate 21b or right horizontal plate 31b socket-connect, the first fixed block 6a on be connected with first and tighten rotating disk 22, this first tightens the locking that rotating disk 22 is used for the position, it is not a holding screw yet, can have into locking nut or alternate manner made to order by the specific design requirement.And what each vertical supporting rod 6 lower end was equipped with a few phase plug-in mounting anchors seat 7, anchors seat 7 and is fixed on the operation table body, and each anchors and is connected with second on the seat 7 and tightens rotating disk 71.
Link together by vertical supporting rod 6, diopter 1 and left secured adjusted frame 2, right secured adjusted frame 3 and to be installed to the operation table body; Adjust left secured adjusted frame 2 and right secured adjusted frame 3, make localizer remain on the level position; With each connecting portion locking, improve the whole fastness of localizer with each locking device; Adjust the rotation of slide block 4 and left secured adjusted frame 2, right secured adjusted frame 3 and regulate, guarantee range of accommodation; Protective casing 5 is sleeved on the slide block 4 of diopter 1; According to pre-determining in the X-ray sheet of measurement on the fixed body and fixed body, the measurement on the CT sheet before the operation, overcome the operation of acting blindly, guarantee safety and accuracy that pedicle screw is inserted, be convenient to the operator and use.It is simple and practical, the handling safety facility, and accurately directed, expense is lower, and is safe.It provides the new nail technology of putting for the damage of clinical treatment cervical vertebra unstability, has reduced the danger of damaging important nerve, blood vessel, makes clinical operation safer, more meets the physiological requirement of human body.
The operating technology of this utility model embodiment comprises the steps:
Step 1: vertical supporting rod 6 inserted be fixed on anchoring seat 7 and tightening screw and fix of operation table body both sides, then left secured adjusted frame 2 and right secured adjusted frame 3 are socketed in the first fixed block 6a of vertical supporting rod 6 upper ends and tighten locking, again diopter 1 is inserted in the 3rd fixed block 31c connecting hole of the second fixed block 21d of upper left seesaw 21a and upper right seesaw 31a; Adjust the position, localizer is fixed on the operation table body;
Step 2: about the adjusting by the L shaped rotor plate 21 in a left side, right L shaped rotor plate 31 and vertical supporting rod 6 realizes, the adjustment of front and back position; regulate degree of tilt end to end by the hinged slip of the L shaped rotor plate 21 in a left side, right L shaped rotor plate 31 then; regulate inside and outside degree of tilt by two slide blocks 4 on diopter 1 arc plate 11 at last; protective casing 5 is put into slide block 4; just finished three-dimensional localization of the present utility model this moment, and concrete angle all is according to predetermined at the X-ray sheet of fixed body, measurement on the CT sheet before the operation.
Step 3: hand drill is gone in protective casing 5 interpolations after determining then in protective casing 5 locus, and careful boring arrives the predetermined safe degree of depth; Extract drill bit, select and the suitable pedicle screw of fixed body, be screwed into screw.
Step when this utility model embodiment uses in clinical is as follows:
Step 1: the patient ventricumbent position, routine disinfection, shop aseptic towel, aseptic list are installed to the operation table body with localizer; Back median incision, after unsettled cervical vertebra resets, the pedicle of vertebral arch of determining to put nail;
Step 2: about regulating by the second fixed block 21d and the 3rd fixed block 31c, front and back position, rotate by left secured adjusted frame 2 and right secured adjusted frame 3 then and regulate degree of tilt end to end, make put the nail direction horizontal plane with put that to follow closely terminal plate of vertebral body parallel, regulate inside and outside degree of tilt by two slide blocks 4 on the diopter 1 again, the CT measured value is consistent before making angle of pedicle screw and art, and last protective casing 5 is put into slide block 4; Inclined angle according to art before measurement on the CT sheet on the fixed body pre-determine, overcome the operation of acting blindly, guarantee safety and accuracy that screw is inserted, be convenient to the operator and use;
Step 3: after treating that direction is determined; two protective casings 5 carry out bilateral pedicle of vertebral arch location simultaneously; can avoid causing the location inaccurate according to pedicle of vertebral arch symmetry knowledge because of the rotation of cervical vertebra position; put into hand drill; careful boring; enter in the vertebral body always, pedicle probe find out errorless after, be screwed into pedicle screw.Use the same method and insert other pedicle screws.After installing inner fixing device, the wrapping otch is sewed up in flushing;
Step 4: can carry out the C type arm x-ray fluoroscopy of side position after the operation in operating room, determine postoperative radiology performance, guarantee safety and accuracy that screw is inserted;
Advantage of the present utility model is: pedicle of vertebral arch is the robust construction that connects the forward and backward part of spinal column, has three-dimensional stability height and the high advantage of fusion rate after the pedicle screw is fixing; The utilization structure parts are few, and are simple to operate and securing member is easy to use; Adopt the guide rod of angulation locate mode, can realize the accurate orientation of pedicle screw; According to the characteristics of human body, operative incision is little, and operation wound is little, reduces blood loss.
Most preferred embodiment of the present utility model is illustrated, and various variations or the remodeling made by those of ordinary skills can not break away from scope of the present utility model.