CN201147351Y - Auxiliary device of percutaneous vertebrae minimal invasive surgery - Google Patents
Auxiliary device of percutaneous vertebrae minimal invasive surgery Download PDFInfo
- Publication number
- CN201147351Y CN201147351Y CNU2008200065222U CN200820006522U CN201147351Y CN 201147351 Y CN201147351 Y CN 201147351Y CN U2008200065222 U CNU2008200065222 U CN U2008200065222U CN 200820006522 U CN200820006522 U CN 200820006522U CN 201147351 Y CN201147351 Y CN 201147351Y
- Authority
- CN
- China
- Prior art keywords
- vertebral body
- push rod
- scale
- outer sleeve
- handle
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
Images
Abstract
The utility model discloses an auxiliary device for percutaneous centrum minimally invasive operation, which comprises a hollow twist drill, a puncture guide needle, an outer sleeve of a positioning target card, an operation bushing and an implantation push rod, wherein, the body of the hollow twist drill is marked with scales and is provided with a center hole passage which is matched with the puncture guide needle; the outer sleeve of the positioning target card is sleeved on the hollow twist drill and the 0 scale position is determined; the operation bushing which is provided with a handle is hollow tube body, the outer wall of the bushing body is marked with scales, the distance from the 0 scale to the free end of the bushing body is equal to the length of the outer sleeve of the positioning target card; the hollow tube body of the implantation push rod is matched with the puncture guide needle, an anterior protrusion mark is arranged at the free end of the hollow tube body, a mark which is positioned with the anterior protrusion is arranged at a push handle and positioning scales are marked on the tube wall. Accurate positioning, convenient operation and X-ray trans-illumination reduction can be realized for the percutaneous centrum minimally invasive operation via making accurate matching of the scales and proper pipe diameters among the components.
Description
Technical field
This utility model relates to a kind of auxiliary device of percutaneous vertebral body Minimally Invasive Surgery, be applicable to percutaneous vertebral body operation elements such as operation of vertebroplasty or kyphoplasty art or the puncture of vertebral body pathologic finding, relate in particular to a kind of auxiliary conveyer spare that is applicable to as the expansible vertebral body orthopedic repositor of memorial alloy.
Background technology
Spinal column way of escape short-segment pedicle instrument screw technology is present clinical main spinal vertebral fractures technology, and the way of escape is cut, and experiences two operations usually; Getting nail future trouble vertebra all has degree of correction in various degree to lose.
Percutaneous vertebroplasty, percutaneous kyphoplasty art are the minimally-invasive treatment technology of the developed recently spinal vertebral pathological changes of getting up.The percutaneous vertebroplasty is at a kind of Wicresoft intervene operation that late nineteen eighties grows up, method is under the guiding of image monitoring equipment such as X ray, approach by percutaneous puncture injects the pathological changes vertebral body with bone cement, glue is solid because of being subjected to factors such as tumor destruction or osteoporosis to compress the vertebral body of subsiding, and removes or eases the pain.Fa Zhan kyphoplasty art subsequently, be to vertebral body compressed subside or the vertebral body of pathological changes with high withstand voltage resin sacculus, produce a cavity trouble vertebra intramedullary expansion pathological changes vertebral body, and fresh vertebral body of subsiding played to a certain degree distraction reduction, the purpose of the rectification post kyphosis deformity that acquires a certain degree, and then inject bone cement and fixed.
The approach of vertebroplasty and kyphoplasty art treatment osteoporosis spinal fracture is the other pathway of percutaneous cervical arc root or pedicle of vertebral arch, use in the pedicle of vertebral arch and the secure path of the avascular area of other (thoracic vertebra) rib horizontal stroke of pedicle of vertebral arch, costovertebral joints enters vertebral body, packing material is implanted in the pathological changes vertebral body by working column.Still have some defectives in the location depthkeeping design of the auxiliary conveying appliance of existing this class operation to piercing process, the actual operation operating process is bigger to the dependence of X ray transillumination, X ray to patient and operator when vertebroplasty and kyphoplasty art exposes infringement greatly, consuming time also long, auxiliary conveying appliance also has the room for improvement of needs, purpose is to simplify operation technique, makes the operating procedure standardization, and the X line that reduces operation exposes.
Summary of the invention
This utility model purpose is: provide a kind of self have can pinpoint scale, between each parts coupling accurately, make percutaneous vertebral body puncture procedure Minimally Invasive Surgery succinctly, the auxiliary device of percutaneous vertebral body Minimally Invasive Surgery easily.
The technical solution of the utility model is: a kind of auxiliary device of percutaneous vertebral body Minimally Invasive Surgery comprises cannulated threaded brill, puncture guide pin, location mark card outer sleeve, working column and implantation push rod; The drill bit that described cannulated threaded is bored has the helical form burr, bores to indicate scale on one's body, bores WEILIAN and is connected to handle, and cannulated threaded is bored the whole axial central duct that has; Puncture guide pin and central duct coupling; Described location mark card outer sleeve can be enclosed within cannulated threaded and bore, and when an end flushes with drill end, the other end flushes with " 0 " scale position on the brill body scale; Described working column is a hollow tube body, can insert in the mark cutting ferrule tube of location, body one end is connected with the sleeve pipe handle, and the other end is a free end, tube wall is marked with scale, and " 0 " scale position is identical with the length of aforementioned location mark card outer sleeve to the distance between the body free end; Described implantation push rod can be inserted in the working column, but and the axial and circumferential activity, the one end is connected with and pushes away handle, the other end is a free end; Also have the axial centre duct that is complementary with aforementioned puncture guide pin in this implantation push rod, and its outer wall is marked with the depthkeeping scale.
In this utility model, also can be connected with a detachable arc holder handle on the handle that cannulated threaded is bored, be provided with in the arc holder handle and can embed and fixed draw-in groove for puncture guide pin tail end; The effect of arc holder handle is the comfort of operator's hands when increasing piercing process and the moment of puncture, makes things convenient for the percutaneous puncture operation.
Simultaneously this utility model further is provided with radial screens screw rod at described location mark card outer sleeve one end, and the screens screw rod can be screwed in the mark card outer sleeve of location and withstand on one's body the brill that cannulated threaded bores, and compresses the brill body that cannulated threaded is bored.The screens screw rod makes location mark card outer sleeve to bore compound one with cannulated threaded, and is convenient at the initial stage of piercing process, bores with cannulated threaded and together passes skin incision, arrives at the intersection at muscle and vertebra rear.
The auxiliary device of this utility model pathological changes vertebral body Minimally Invasive Surgery, each parts form by medical seamless stainless steel pipe fitting material, puncture guide pin wherein can use clinical Kirschner wire commonly used, and this utility model mainly with Kirschner wire as instructing and design each parameters of operating part, purpose is in order to be convenient to the combination with existing operation technique more; This utility model specifically needs anatomy relationship and the geometric parameter by spinal vertebral, and mathematical calculation mutual relation therebetween designs.
This utility model mainly is divided into two steps in concrete work, and the firstth, the puncture step:
Scale mark between outer sleeve and cannulated threaded brill is blocked as the puncture procedure reference in the main length difference that bores with puncture guide pin and the cannulated threaded location of puncturing, location mark.
The puncture track is also determined in the pedicle or pedicle of vertebral arch punctures behind the track outward in existing surveillance equipment such as C shape arm X ray location, it at first is the percutaneous puncture operation, cut osculum on patient skin, puncture track (the position relation of X ray monitor detection puncture guide pin and pedicle of vertebral arch waist central point is thrust in the puncture guide pin pedicle or the pedicle of vertebral arch bypass that then tail end are fixed in the arc holder handle draw-in groove; The position of observing puncture guide pin and rib head and pedicle of vertebral arch waist during the other approach of thoracic vertebra pedicle concerns.Determining of this relation is the key of whole percutaneous cervical arc root puncture technique).To locate mark card outer sleeve then is fixed on the cannulated threaded brill by the screens screw rod, and insert the location along guide pin and mark the complex that blocks outer sleeve and cannulated threaded brill, when they enter the vertebra rear, arc holder handle dismounting and the screens screw rod is lax can be convenient to the pierce operation of follow-up cannulated threaded brill along guide pin.
In the time of outside vertebra, puncture guide pin tail end is longer than cannulated threaded and is bored, and the distance that grows preestablishes, and is generally 30mm; After under image monitoring, determining the puncture track, the puncture guide pin is hammered into track between the outer costovertebral joints of pedicle of vertebral arch or pedicle of vertebral arch, and (whether the resistance that piercing process can the perception puncture needle is in the bone road, and safety that can be by X line image documentation equipment supervisory work pathway), bore tail end when concordant when puncture guide pin and cannulated threaded, the guide pin that punctures this moment should arrive at vertebral body rear wall (can carry out the detection of X line supervision) by design.And then edge puncture guide pin pierces the cannulated threaded brill.At this moment, the puncture guide pin can be taken out, tail end is inserted in reversing, purpose be prevent to rotate cannulated threaded when boring the puncture guide pin follow it and bore moving entering outside the vertebral body, the outer blood vessel of damage vertebral body; Because the location mark card outer sleeve vertebra rear that is fixed in this process, do not enter in the puncture track, so it is progressive with respect to location mark card outer sleeve that cannulated threaded is bored, forward travel distance can be read by the displacement of cannulated threaded brill scale relative localization mark card outer sleeve one end on one's body, and this distance should be substantially equal to front predefined puncture guide pin tail end and grow the distance that cannulated threaded is bored.When the hollow threaded bore pierces when arriving at the vertebral body rear wall, roughly mutually concordant with puncture guide pin position, the guide pin that will puncture once more hammers into vertebral body, and to make its tail end and cannulated threaded bore tail end roughly concordant, and the guide pin head that punctures this moment roughly arrives at the anterior margin of vertebral body rear wall, and (depth distance of vertebral body spongy bone part is roughly 30mm～35mm).Detect puncture guide pin and vertebral body position relation by the X line, pierce cannulated threaded once more and bore, pierce the degree of depth with identical before, last cannulated threaded pierces the anterior margin of vertebral body rear wall, finishes the foundation to the service pipe of vertebral body.This process is finished the percutaneous microtrauma puncture to vertebral body, has set up Wicresoft's service aisle of vertebral body and body surface.
For preventing in the percutaneous puncture process, because puncture guide pin and cannulated threaded drill the relative fixed of the thorn process guide pin that causes puncturing and pierce the soft tissue and the trunk of anterior margin of vertebral body, the tail end (being generally blunt nosed) of puncture guide pin can be turned and insert the puncture of finishing the vertebral body spongy bone, to guarantee puncture safety.
Locate by length relation and scale that puncture guide pin and cannulated threaded are bored, piercing process is with reference to boring body scale and radioscopy, as the telltale mark that puncture puts in place, the X ray transmiting time makes percutaneous cervical arc root vertebral body puncture procedure step simplicity, standardization in the time of can significantly reducing puncture.
After the puncture step of setting up vertebral body and body surface Wicresoft service aisle is finished, second is exactly to implant and the treatment step: take out cannulated threaded earlier and bore, the working column that carries the vertebral body orthopedic repositor is inserted in the passage that previous puncture procedure sets up, to implant push rod then and insert working column, and snap in positor " C " shape tail end by the lordosis labelling of push rod front end, distinguish the direction of positor lobe leaf and terminal plate of vertebral body by the labelling of the outer tail end of pusher body, and positor is pushed in the vertebral body along working column.When pushing, draw the amount of moving according to the depthkeeping scale of implanting on the push rod with the relative of " 0 " scale position on the working column, and location mark card outer sleeve and the scale displacement between working column considering simultaneously to be fixed in the integumentary musculature judge that implanting push rod enters the intravital degree of depth.
Adopt working column and implantation push rod in this utility model to finish in the process of implant procedure, the vertebral body orthopedic repositor that we preferably cooperate with them is the expansible reset cradle of being made by memorial alloy of vertebral body, the existing applicant of the expansible reset cradle of this vertebral body had before submitted patent application to, it adopts nickel titanium temperature memorial alloy sheet material to be integrated into, constitute by head, main body and tail, wherein main body is to support the hollow basket that lobe surrounds by some arcs, and adjacent two are supported between lobe gapped; Head and tail is the portion that converges that respectively supports lobe, and wherein head is provided with preceding hole, and afterbody is provided with metapore, and preceding hole is relative with metapore, and all is communicated with main intravital cavity.And described head is that the cross section is the short tube of " O " shape, and preceding hole is that the cross section is the lipostomous of " O " shape; Tail is that the cross section is the short tube of " C " shape, and metapore is that the cross section is the non-lipostomous of " C " shape.
The expansible reset cradle of this vertebral body need to be shaped as tubulose in advance under frozen water, and " C " tee section short tube shaping under this state was that closure state is so that enter working column before not implanting vertebral body.The end on two noncontact limits of " C " tee section short tube in working column also is the little breach of the expansible formation of the gap of the non-lipostomous of " C " tee section one, and breach is special in advance, and the effect of this breach is as follows:
In this utility model, implant the further ad hoc lordosis labelling in free-ended top of push rod, and the handle that pushes away of implanting push rod is provided with and the corresponding labelling of lordosis, and described labelling and the relation of the angle and direction position between the lordosis labelling that pushes away handle determined, is preferably parallel to each other or vertical.After the tail end of the expansible reset cradle of vertebral body is fixed on the free end of implanting push rod, described lordosis labelling can mate with the breach on the non-lipostomous of " C " tee section, recognizes that by the labelling that pushes away on the handle the expansible reset cradle of vertebral body respectively supports the direction of the relative terminal plate of vertebral body of lobe when implanting in the vertebral body simultaneously.
After implant procedure finishes, can carry out the perfusion operation of follow-up packing material, (for example between twenty and fifty compression fracture) selected or also can not poured into to the particular type of pouring material according to patient age, lesion nature.
Therefore the auxiliary device of this utility model percutaneous vertebral body Minimally Invasive Surgery further includes intrusion pipe and perfusion push rod, and intrusion pipe is a hollow tube body, can insert in the aforementioned working column, and the perfusion push rod is positioned at intrusion pipe, and with the internal diameter coupling of intrusion pipe.The end of perfusion push rod is connected with injects handle, and the shaft of perfusion push rod is marked with scale.Scale on the perfusion push rod is used for determining to pour into the distance that push rod moves relative to intrusion pipe, and then determines to pour into the volume of packing material.
Intrusion pipe can carry out the material perfusion of volume quantitative to the cavity of implanting the expansible reset cradle generation of Intrapyramidal vertebral body with the perfusion push rod.When specific design, the volume of the volume of intrusion pipe and the expansible reset cradle of vertebral body is suitable, more convenient clinical manipulation, especially when the perfusion bone cement, needn't gradation fill bone cement and the gradation perfusion, reduced because fill bone cement and the time difference of injecting have reduced the operate miss that this time bone cement may harden and bring.Certainly if do not implant the expansible reset cradle of vertebral body in the process, then dabbling packing material dosage can be controlled by scale intrusion pipe and that pour between push rod, carries out the operation of clinical vertebroplasty.
Adopt this utility model to carry out the vertebral plasty operation, operating process is simple relatively.Suffering from the transfer passage of setting up one " advance and go out " between vertebra and back body surface through aforesaid puncture, implantation step, after passage is set up, can carry out pathologic finding to suffering from vertebra, also can directly inject packing materials such as bone cement, reach suffering from the solid purpose of perfusion therapy, filling or glue of vertebra with filling apparatus.
After implant procedure finishes, suffer from vertebra,, also can insert the subcutaneous drainage catheter that has sieve aperture according to the drainage treatment principle of inflammation abscess at the spinal lesion of need drain, to the vertebral body abscess wash, drain and treatment of drug perfusion.At the spinal lesion vertebral body of need chemotherapy of tumors, then can insert bipolar electrothermal therapy pipe, carry out the local chemotherapy or the thermotherapy of tumor, reach the purpose of percutaneous minimally-invasive treatment.
This utility model advantage is:
1. the auxiliary device of this utility model pathological changes vertebral body Minimally Invasive Surgery, himself having can pinpoint scale, and accurately mate between each parts, can reduce Clinical X sensitivity of film number of times more than conventional device when therefore adopting it to carry out vertebral plasty or afterwards protruding plastic operation, shorten operating time, it is many to overcome present vertebroplasty, kyphoplasty art and similar percutaneous vertebral body Minimally Invasive Surgery X ray transmiting time, and patient and operator's X ray expose the big defective of infringement; Make the other puncture procedure standardization of percutaneous cervical arc root or pedicle of vertebral arch, program is more succinct, and X ray is to patient and patient's infringement in reducing to perform the operation.
2. this utility model is particularly useful for the auxiliary conveying by the expansible reset cradle of vertebral body of memorial alloy making, and with the application that combines of the expansible reset cradle of memorial alloy vertebral body, for the minimally-invasive treatment of spinal vertebral pathological changes provides complete, succinct, a safe, practical operational means.
Description of drawings
Below in conjunction with drawings and Examples this utility model is further described:
Fig. 1 is a critical piece structural representation of the present utility model;
Fig. 2 further comprises the modular construction sketch map for this utility model;
Fig. 3 is for implanting the lordosis mark structure enlarged diagram (comprising three-dimensional and axial two kinds of views) on the push rod free end among Fig. 1
Fig. 4 is for implanting the another kind of structure enlarged diagram of lordosis labelling on the push rod free end;
Fig. 5 is the expansible reset cradle structural representation of vertebral body that is used with this utility model;
Fig. 6 carries out the puncture step sketch map of Wicresoft's intervene operation for adopting this utility model;
Fig. 7 is the implantation step sketch map that memorial alloy vertebral body orthopedic repositor is implanted vertebral body.
Wherein: 1, cannulated threaded is bored; 2, puncture guide pin; 3, location mark card outer sleeve; 4, working column; 40, free end; 41, scale; 410, " 0 " scale position; 5, implant push rod; 50, free end; 500, lordosis labelling; 51, central duct; 52, depthkeeping scale; 6, bore body; 60, scale; 600, " 0 " scale position; 7, hands handle; 8, central duct; 9, sleeve pipe hands handle; 10, push away handle; 100, labelling; 11, arc holder handle; 110, draw-in groove; 12, screens screw rod; 13, head; 14, main body; 15, tail; 16, support lobe; 17, preceding hole; 18, metapore; 19, breach; 20, the expansible reset cradle of vertebral body; 21, intrusion pipe; 22, perfusion push rod; 220, scale; 23, inject the hands handle; 24, skin.
The specific embodiment
Embodiment: in conjunction with Fig. 1, Figure 2 shows that a kind of specific embodiment of the auxiliary device of this utility model percutaneous vertebral body Minimally Invasive Surgery, its complete parts are bored 1, puncture guide pin 2, location mark card outer sleeve 3, working column 4, are implanted push rod 5, intrusion pipe 21 and perfusion push rod 22 and constituted by cannulated threaded.
The drill bit of described cannulated threaded brill 1 has the helical form burr, bores body 6 and is marked with scale 60, bores WEILIAN and is connected to handle 7, and cannulated threaded is bored 1 integral body and had axial central duct 8; Puncture guide pin 2 and central duct 8 couplings; Also be connected with a detachable arc holder handle 11 on the handle 7 in the present embodiment, be provided with in the arc holder handle 11 and can embed and fixed draw-in groove 110 for puncture guide pin 2.The effect of arc holder handle 11 is the comfort of staff when increasing piercing process and the moment of puncture, makes things convenient for the percutaneous puncture operation.
Described location mark card outer sleeve 3 is set in cannulated threaded and bores on 1, and the one end flushes with drill end, and the other end flushes with " 0 " scale position 600 on brill body 6 scales 60; Location mark card outer sleeve 3 in the present embodiment is provided with screens screw rod 12.Screens screw rod 12 can be screwed in the location mark card outer sleeve 3 and withstand on the brill body 6 of cannulated threaded brill 1, compresses cannulated threaded and bores 1 brill body 6.Screens screw rod 12 makes location mark card outer sleeves 3 to bore 1 compound one with cannulated threaded, and the convenient initial stage at piercing process is together passed skin incision to the puncture of skin and Musclar layer with cannulated threaded brill 1, enters the vertebra rear.
Described working column 4 is a hollow tube body, can insert in the location mark cutting ferrule tube 3, body one end is connected with sleeve pipe handle 9, the other end is a free end 40, tube wall is marked with scale 41, and " 0 " scale position 410 is identical with the length of aforementioned location mark card outer sleeve 3 to the distance of 40 of body free ends;
Described implantation push rod 5 is positioned at working column 4, but and the axial and circumferential activity, the one end is connected with and pushes away handle 10, the other end is a free end 50; Also have the axial centre duct 51 that is complementary with aforementioned puncture guide pin 2 in this implantation push rod 5, and its outer wall is marked with depthkeeping scale 52.
Intrusion pipe 21 is hollow tube body, can insert in the aforementioned working column 4, and perfusion push rod 22 is positioned at intrusion pipe 21, and with the internal diameter of intrusion pipe 21 coupling; The end of perfusion push rod 22 is connected with injects handle 23, and the shaft of perfusion push rod 22 is marked with scale 220.
In conjunction with shown in Figure 3, the top of the free end 50 of the described implantation push rod 5 in the present embodiment is provided with a lordosis labelling 500, be provided with labelling 100 and push away handle 10, described labelling 100 is determined with lordosis labelling 500 directions, standing be decided to be parallel or vertical, the shape of lordosis labelling 500 is illustrated in figure 3 as triangle body, square body that also can be as shown in Figure 4.
It is 5.0mm～5.5mm that cannulated threaded is bored 1 external diameter, axial central duct 8 internal diameter 2.0mm, and entire length is 205mm.Handle 7 diameter 10mm wherein; In the dissection, pedicle of vertebral arch to the bone length of vertebral body rear vertebral plate is that 25mm～30mm and vertebral body pathway length respectively are about 30mm～35mm.
Location mark card outer sleeve 3 length specifications are 80mm (the thin person of build, thoracic vertebra)/90mm (the fat person of build, lower lumbar spine), and internal diameter is 5.6mm.Scale 60 initial " 0 " the scale position 600 of boring on the body 6 is positioned at apart from drill bit 80mm place.
Working column 4 length overall 165mm; External diameter 5.0mm, internal diameter 4.6mm; " 0 " scale position 410 is apart from free end 80mm.
As shown in Figure 5, the expansible reset cradle of vertebral body for the implantation vertebral body selected in the present embodiment, it adopts nickel titanium temperature memorial alloy sheet material to be integrated into, by 13, main body 14 and tail 15 constitute, wherein main body 14 is to support the spheroid that lobe 16 surrounds by some arcs, and two adjacent 16 of lobes of support are gapped; 13 and tail 15 be the portion that converges that respectively supports lobe 16, wherein 13 be provided with preceding hole 17, tail 15 is provided with metapore 18, preceding hole 17 is relative with metapore 18, and all is communicated with cavity in the main body 14.Described head is that the cross section is the short tube of " O " shape, and preceding hole 17 is that the cross section is the lipostomous of " O " shape; Tail is that the cross section is the short tube of " C " shape, and metapore 18 is that the cross section is the non-lipostomous of " C " shape.The expansible reset cradle of vertebral body is a spheroid, and height is 11mm～18mm, and breast waist section positor commonly used is about and is 20mm, and height is 14mm, the volume V=4/3 * π ab of spheroid
2, i.e. V=4/3 * π * 10 * 7
2=2.0 (cm
3), so the expansible reset cradle overall volume of vertebral body is about 2.0 milliliters, the volume V=π r of intrusion pipe 21 in the corresponding present embodiment
2L=π * 2
2* 185=2.3 (cm
3), make that the volume of the perfusion volume of intrusion pipe 21 and the expansible reset cradle of vertebral body is suitable, greatly facilitate the material of vertebral body is filled perfusion, especially do not need the replace tubes operation in this very short time of bone cement bulk phase to hardening period.
The expansible reset cradle of vertebral body is not before implanting vertebral body, need under frozen water, to be shaped as tubulose in advance, and insert in the working column, the breach 19 of the non-lipostomous gap in " C " shape tail end cross section is joined with the lordosis labelling 500 shape cards that the top of implanting push rod 5 free ends 50 is provided with, because it is fixing with the position relation of lordosis labelling 500 to implant push rod tail end labelling 100.Thus, can be outside body surface push away labelling 100 on the handle 10 and discern and enter the direction relations that the expansible reset cradle of Intrapyramidal vertebral body respectively supports lobe 16 and terminal plate of vertebral body by implanting push rod 5.
In conjunction with Fig. 6,7 are depicted as the process sketch map that employing this utility model carries out percutaneous vertebral body (breast waist section) Minimally Invasive Surgery, comprise puncture and implant two steps:
The firstth, the puncture step, carry out according to the order of a, b, c, d as shown in Figure 6:
Mainly bore 1 the length difference location of puncturing with puncture guide pin 2 and cannulated threaded, the scale mark of location mark card outer sleeve 3 and 1 on cannulated threaded brill is the committed step that this microtrauma puncture is operated as the puncture procedure reference by the pedicle of vertebral arch position.
The puncture track is also determined in the pedicle or pedicle of vertebral arch punctures behind the track outward in existing surveillance equipment such as C shape arm X ray location, it at first is the percutaneous puncture operation, on patient skin 24, cut osculum, then tail end is fixed on arc holder handle 11 draw-in grooves, 110 interior puncture guide pin 2 pedicles or pedicle of vertebral arch bypass and thrusts; In the present embodiment, described location mark card outer sleeve 3 is enclosed within cannulated threaded in advance and bores on 1, screens screw rod 12 heads into location mark card outer sleeve 3 and compresses cannulated threaded brill 1 brill body 6, thus in the percutaneous puncture operating process, in the time of also promptly outside vertebra, cannulated threaded brill 1 and location mark card outer sleeve 3 are made as a whole skin 24 Musclar layers that pass, and are convenient to target approach vertebral body vertebral plate rear.
After the hollow threaded bore 1 and the guide pin 2 that punctures enter the vertebra rear, just arc holder handle 11 and card can be dismantled for screw rod 12 and are relaxed, so that the inserting needle of follow-up puncture guide pin 2 reaches cannulated threaded and bores 1 operation that pierces along the guide pin 2 that punctures.
In the time of outside vertebra, puncture guide pin 2 tail ends are longer than cannulated threaded and are bored 1, and the distance that grows is preset as 30mm; Under image monitoring, puncture guide pin 2 continues inserting needle, bore 1 tail end when concordant up to tail end and cannulated threaded, puncture guide pin 2 arrives at the vertebral body rear wall, pierce cannulated threaded along puncture guide pin 2 then and bore 1, because in this operating process, location mark card outer sleeve 3 self is fixed in skin and the Musclar layer, suffer from outside the vertebra vertebra, so it is that relative localization mark card outer sleeve 2 is progressive that cannulated threaded bores 1, its forward travel distance can bore 1 displacement that bores scale 60 relative localizations mark card outer sleeve 3 one ends on the body 6 by cannulated threaded and read; When puncture guide pin 2 tail end length differences were got back to the 30mm left and right sides, cannulated threaded was bored 1 and is pierced the vertebral body trailing edge.
In the said process, when puncture guide pin 2 passes pedicle locations when arriving at the vertebral body trailing edge, puncture guide pin 2 can be extracted out, blunt nosed tail end is inserted, finish puncture to the vertebral body spongy bone, prevent in the piercing process that boring 1 the guide pin 2 that punctures of fixedly causing because of puncture guide pin 2 and cannulated threaded pierces this destructive anterior margin of vertebral body of having fractured, the large artery trunks blood vessel of damage anterior margin of vertebral body guarantees the safety that punctures.In this process, the X ray monitor detects the position relation of puncture guide pin 2 and pedicle of vertebral arch waist central point.
By length relation and the scale location of puncture guide pin 2 with cannulated threaded brill 1, piercing process as the telltale mark that puncture puts in place, is penetrated the X ray transmiting time with reference to boring body 6 scale 60 and radioscopies when having significantly reduced puncture.
After the puncture step is finished, second is exactly to implant and the treatment step, in conjunction with shown in Figure 7 and carry out: take out cannulated threaded and bore 1 according to the order of e, f, g, h, i, j, working column 4 is inserted pedicle of vertebral arch inside, also in the passage of promptly setting up in formerly the puncture procedure step, then the expansible reset cradle of vertebral body 20 is inserted working column 4 after moulding, working column 4 supports into the vertebral body trailing edge, directly the expansible reset cradle 20 of vertebral body is implanted in the vertebral body spongy bone along working column 4 with implanting push rod 5.When pushing, according to the relative stroke of amount of moving between " 0 " the scale position 410 on depthkeeping scale 52 and the working column 4 implanted on the push rod 5, and the location mark card outer sleeve of considering simultaneously to be fixed in the integumentary musculature 3 judges that with the scale side-play amount of 4 of working columns implantation push rod 5 enters the intravital degree of depth, when arriving at the vertebral body trailing edge, can directly the expansible reset cradle 20 of vertebral body cone in the working column 4 be pushed in the vertebral body.
Since the breach 19 on the non-lipostomous of " C " tee section of expansible reset cradle 20 ends of vertebral body can with lordosis labelling 500 couplings of implanting on push rod 5 free ends 50, therefore can push away labelling 100 on the handle 10 and concern with 500 prepositions of lordosis labelling and recognize the direction that respectively supports lobe 16 and terminal plate of vertebral body after the expansible reset cradle 20 of vertebral body is implanted in the vertebral bodys by implanting push rod 5.
The last expansible reset cradle 20 of vertebral body is stayed in the vertebral body, takes out the location mark card outer sleeve 3 of implanting push rod 5 and being positioned at Musclar layer, EO.After implant procedure finishes, can further treat suffering from vertebra, pour into as material: intrusion pipe 21 and perfusion push rod 22 can carry out deciding the material perfusion of volume to the cavity of implanting expansible reset cradle 20 generations of Intrapyramidal vertebral body.When specific design, the volume of the expansible reset cradle 20 of the volume of intrusion pipe 21 and vertebral body is suitable, more convenient clinical manipulation, especially when the perfusion bone cement, needn't gradation fill bone cement and the gradation perfusion, reduced because fill bone cement and the time difference of injecting have reduced the operate miss that this time bone cement may harden and bring.Certainly if do not implant the expansible reset cradle 20 of vertebral body in the process, then dabbling packing material dosage can be controlled by scale intrusion pipe 21 and that pour into 22 of push rods.
Adopt present embodiment to carry out the vertebral plasty operation, operating process is simple relatively, convenient; Reduced the infringement of Clinical X sensitivity of film number of times and X ray to patient and patient.Suffering from the transfer passage of setting up one " advance and go out " between vertebra and back body surface through aforesaid puncture, implantation step, can directly inject packing materials such as bone cement, reaching suffering from the solid therapeutic purposes of perfusion, filling or glue of vertebra with filling apparatus.Spinal lesion for the need drain is suffered from vertebra, according to the drainage treatment principle of inflammation abscess, can insert the subcutaneous drainage catheter that has sieve aperture, and the vertebral body abscess is carried out drain and treatment of drug perfusion; The spinal lesion vertebral body of tumor, available radio frequencies electrothermal therapy pipe or utilization have the pipeline of sieve aperture to carry out the local thermotherapy or the chemotherapy of tumor, reach the purpose of percutaneous minimally-invasive treatment.
What deserves to be mentioned is the human body vertebral body according to different ethnic groups, the bodily form, especially for the tall and big human body of physique, in the auxiliary device of this utility model percutaneous vertebral body Minimally Invasive Surgery, the caliber of each parts can corresponding expansion 0.5mm; The expansion of caliber is more convenient for operating, and especially the implantation of the expansible reset cradle of vertebral body is carried.
Claims (7)
1. the auxiliary device of a percutaneous vertebral body Minimally Invasive Surgery comprises that cannulated threaded is bored (1), puncture guide pin (2), the location mark blocks outer sleeve (3), working column (4) and implants push rod (5); It is characterized in that:
The drill bit that described cannulated threaded is bored (1) has the helical form burr, bores body (6) and is marked with scale (60), bores WEILIAN and is connected to handle (7), and cannulated threaded is bored (1) integral body and had axial central duct (8); Puncture guide pin (2) and central duct (8) coupling;
Described location mark card outer sleeve (3) is enclosed within cannulated threaded and bores outside (1); The one end flushes with drill end, and the other end flushes with " 0 " scale position (600) on boring body (6) scale (60);
Described working column (4) is a hollow tube body, can insert in the location mark card outer sleeve (3), and body one end is connected with sleeve pipe handle (9); The other end is free end (40), and tube wall is marked with scale (41), and " 0 " scale position (410) is identical with the length of aforementioned location mark card outer sleeve (3) to the distance between body free end (40);
Described implantation push rod (5) can place in the working column (4), but and the axial and circumferential activity, the one end is connected with and pushes away handle (10), the other end is free end (50); Also have the axial centre duct (51) that is complementary with aforementioned puncture guide pin (2) in this implantation push rod (5), and its outer wall is marked with depthkeeping scale (52).
2. the auxiliary device of percutaneous vertebral body Minimally Invasive Surgery according to claim 1, it is characterized in that also being connected with on the described handle (7) a detachable arc holder handle (11), be provided with in the arc holder handle (11) and can embed and fixed draw-in groove (110) for puncture guide pin (2) tail end.
3. the auxiliary device of percutaneous vertebral body Minimally Invasive Surgery according to claim 1 is characterized in that described location mark card outer sleeve (3) is provided with radial screens screw rod (12),
4. the auxiliary device of percutaneous vertebral body Minimally Invasive Surgery according to claim 3 is characterized in that described screens screw rod (12) is fixed in the location mark card outer sleeve (3) and may be stuck in cannulated threaded to bore on the brill body (6) of (1).
5. the auxiliary device of percutaneous vertebral body Minimally Invasive Surgery according to claim 1, the top that it is characterized in that described implantation push rod (5) free end (50) is provided with a lordosis labelling (500), be provided with labelling (100) and push away handle (10), angle between described labelling (100) and the lordosis labelling (500) and direction position relation are determined.
6. the auxiliary device of percutaneous vertebral body Minimally Invasive Surgery according to claim 5 is characterized in that between described labelling (100) and the lordosis labelling (500) parallel to each other or orthogonal.
7. the auxiliary device of percutaneous vertebral body Minimally Invasive Surgery according to claim 1 is characterized in that the auxiliary device of this percutaneous vertebral body Minimally Invasive Surgery also comprises intrusion pipe (21) and perfusion push rod (22); Intrusion pipe (21) is a hollow tube body, can insert in the aforementioned working column (4), and perfusion push rod (22) can be inserted in the intrusion pipe (21), and with the internal diameter of intrusion pipe (21) coupling; The end of perfusion push rod (22) is connected with injects handle (23), and perfusion push rod (22) shaft is marked with scale (220).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNU2008200065222U CN201147351Y (en) | 2007-07-06 | 2008-02-05 | Auxiliary device of percutaneous vertebrae minimal invasive surgery |
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN200720072262.4 | 2007-07-06 | ||
| CN200720072262 | 2007-07-06 | ||
| CNU2008200065222U CN201147351Y (en) | 2007-07-06 | 2008-02-05 | Auxiliary device of percutaneous vertebrae minimal invasive surgery |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN201147351Y true CN201147351Y (en) | 2008-11-12 |
Family
ID=40115121
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNU2008200065222U Expired - Fee Related CN201147351Y (en) | 2007-07-06 | 2008-02-05 | Auxiliary device of percutaneous vertebrae minimal invasive surgery |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN201147351Y (en) |
Cited By (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101984924A (en) * | 2010-10-30 | 2011-03-16 | 赵斌 | Adjustable kyphotic forming device |
| CN102144939A (en) * | 2011-04-23 | 2011-08-10 | 杨宗夫 | Thoracoscope surgery cannula |
| CN102284089A (en) * | 2010-11-30 | 2011-12-21 | 俞晓立 | Drainage operation instrument |
| CN102933162A (en) * | 2010-06-04 | 2013-02-13 | 脊柱工艺公司 | Instruments for mini-invasive spinal column surgery and uses thereof |
| TWI407937B (en) * | 2010-04-26 | 2013-09-11 | Wen Ling Yeh | A ligament surgery assist device |
| CN103356278A (en) * | 2013-07-19 | 2013-10-23 | 贺石生 | Intradermal positioning device for lumbar vertebra minimally invasive surgery |
| CN105496503A (en) * | 2015-12-31 | 2016-04-20 | 苑振峰 | Instrument for safely manufacturing posterior cruciate ligament tibia tunnel |
| CN105708517A (en) * | 2016-04-19 | 2016-06-29 | 苏州瑞华医院有限公司 | Hollow trephine provided with push rod |
| CN106725717A (en) * | 2017-01-13 | 2017-05-31 | 蒋毅 | The full vertebral column minimally invasive bone drill of location type and full vertebral column minimally invasive approach shaping jig |
| CN113499125A (en) * | 2021-06-25 | 2021-10-15 | 南京航空航天大学 | Auxiliary electrode implantation system and electrode implantation method capable of adjusting needle insertion depth for organism |
-
2008
- 2008-02-05 CN CNU2008200065222U patent/CN201147351Y/en not_active Expired - Fee Related
Cited By (13)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| TWI407937B (en) * | 2010-04-26 | 2013-09-11 | Wen Ling Yeh | A ligament surgery assist device |
| CN102933162A (en) * | 2010-06-04 | 2013-02-13 | 脊柱工艺公司 | Instruments for mini-invasive spinal column surgery and uses thereof |
| CN101984924A (en) * | 2010-10-30 | 2011-03-16 | 赵斌 | Adjustable kyphotic forming device |
| CN102284089A (en) * | 2010-11-30 | 2011-12-21 | 俞晓立 | Drainage operation instrument |
| CN102144939A (en) * | 2011-04-23 | 2011-08-10 | 杨宗夫 | Thoracoscope surgery cannula |
| CN102144939B (en) * | 2011-04-23 | 2013-01-30 | 杨宗夫 | Thoracoscope surgery cannula |
| CN103356278A (en) * | 2013-07-19 | 2013-10-23 | 贺石生 | Intradermal positioning device for lumbar vertebra minimally invasive surgery |
| CN105496503A (en) * | 2015-12-31 | 2016-04-20 | 苑振峰 | Instrument for safely manufacturing posterior cruciate ligament tibia tunnel |
| CN105496503B (en) * | 2015-12-31 | 2018-02-27 | 苑振峰 | A kind of safety makes the apparatus of posterior cruciate ligament of knee tibial tunnel |
| CN105708517A (en) * | 2016-04-19 | 2016-06-29 | 苏州瑞华医院有限公司 | Hollow trephine provided with push rod |
| CN106725717A (en) * | 2017-01-13 | 2017-05-31 | 蒋毅 | The full vertebral column minimally invasive bone drill of location type and full vertebral column minimally invasive approach shaping jig |
| CN113499125A (en) * | 2021-06-25 | 2021-10-15 | 南京航空航天大学 | Auxiliary electrode implantation system and electrode implantation method capable of adjusting needle insertion depth for organism |
| CN113499125B (en) * | 2021-06-25 | 2023-02-10 | 南京航空航天大学 | Auxiliary electrode implantation system and electrode implantation method capable of adjusting needle insertion depth for organism |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CN201147351Y (en) | Auxiliary device of percutaneous vertebrae minimal invasive surgery | |
| CN100522091C (en) | Systems and methods for reducing fractured bone using a fracture reduction cannula | |
| CN100434046C (en) | Nickel titanium temperature memory alloy centrum compression fracture orthopedic repositor and device | |
| EP1653869B1 (en) | Device for delivering medicine to bone | |
| US8062270B2 (en) | Method and device for delivering medicine to bone | |
| EP1257212B1 (en) | Apparatus for providing anterior trans-sacral access to spinal vertebrae | |
| CN100444808C (en) | Systems and methods for treating vertebral bodies | |
| US20130012951A1 (en) | Systems and methods for treating a spine through a single vertebral body insertion point | |
| CN103987332A (en) | Bone tamp and methods of use | |
| AU2002225837A1 (en) | Systems and methods for reducing fractured bone using a fracture reduction cannula | |
| CN101208053A (en) | Minimally invasive actuable bone fixation devices, system and method of using the same | |
| CN103976779B (en) | Foramen intervertebrale lens lancing system | |
| US20220401114A1 (en) | Methods, systems, and devices for diagnosing and treating intervertebral disc degeneration | |
| CN102499740B (en) | Centrum balloon dilation forming system | |
| US20030236527A1 (en) | Multi-slot guide for bone-setting operation for a femoral neck fracture | |
| CN206621411U (en) | A kind of dissection locking for Complex Acetabular is oriented to steel plate | |
| CN103126750A (en) | Multifunctional medical treatment material in-vivo implantation device | |
| US20110282348A1 (en) | Device for fixation of bone, and device set comprising the same | |
| CN105250056A (en) | Internal fixing system for minimally invasive lumbosacral vertebrae one-way axial fusion with spine | |
| US20110264099A1 (en) | Multi-directional cement delivery system | |
| CN106175905A (en) | A kind of dissection for Complex Acetabular locks and guides steel plate | |
| CN203468723U (en) | Combined type percutaneous zygopophysis pedicle screw internal fixation system | |
| CN103431901B (en) | Combined type percutaneous zygopophysis pedicle screw internal fixation system |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| CF01 | Termination of patent right due to non-payment of annual fee | ||
| CF01 | Termination of patent right due to non-payment of annual fee |
Granted publication date: 20081112 Termination date: 20170205 |