CN201286725Y

CN201286725Y - Percutaneous lumbar intervertebral foramina enlargement shaper

Info

Publication number: CN201286725Y
Application number: CNU2008201111656U
Authority: CN
Inventors: 李振宙
Original assignee: Individual
Current assignee: Individual
Priority date: 2008-04-22
Filing date: 2008-04-22
Publication date: 2009-08-12
Anticipated expiration: 2018-04-22

Abstract

A percutaneous enlarging plasty apparatus for intervertebral foramen of lumbar vertebra comprises a guide wire (Figure 1), a soft tissue expander (Figure 2), a duck bill-shaped expanding casing (Figure 3), a duck bill-shaped protective casing (Figure 4), trepans with different diameters (Figure 5), and a sideway rear diskoscope working casing (Figure 6). After gradual expansion of soft tissue with the duck bill-shaped expanding casing, the superior articular process of lumbar vertebra on the front part of the duck bill-shaped protective casing is excised with the trepans inside the duck bill-shaped protective casing, so that the sideway rear diskoscope working casing can directly enter the vertebral canal to pointedly excise the protrudent intervertebral disc tissue.

Description

Percutaneous waist intervertebral foramina enlarges the shaping apparatus

Technical field

This utility model relates to a kind of percutaneous waist intervertebral foramina and enlarges the shaping apparatus.After aperture enlarged between lumbar vertebra, the working column of rear flank road MED can directly enter in the canalis spinalis, the outstanding disc tissue of specific aim excision.

Background technology

Prolapse of lumbar intervertebral disc is commonly encountered diseases, frequently-occurring disease, and its symptom mainly comprises lumbago and lower limb radiating pain, the horse hair syndrome can occur when serious, has a strong impact on patient's work and social life ability.

1934, through capable full laminectomy for decompression of lumbar vertebral posterior or part vertebrae plate resection decompression by fenestration, the operation of extracing outstanding intervertebral disc became the standard treatments of prolapse of lumbar intervertebral disc.But need the denervate fibrous ring of root veutro of part to make apparatus enter in the intervertebral disc nucleus pulposus in the excision dish in the art, postoperative is left over a fibrous ring passage; Zygapophysial joints inboard 1/3 is also often cut simultaneously, lumbar stability suffers destruction to a certain degree, this sections regression aggravation of postoperative, fibrous ring, cartilage endplate, residual nucleus pulposus all may strip off, and deviate from canalis spinalis pressuring neural root by the fibrous ring passage that stays in the operation, promptly " intervertebral disk hernia recurrence " incidence rate surpasses 10%, because adhesion is serious in the canalis spinalis, often the revision procedure difficulty is big, and complication is many.

Otch is bigger in the Lumbar Fusion operation, paraspinal muscle is peeled off more extensive, canalis spinalis rear vertebral plate and side zygapophysial joints excision extension are more extensive, the peeling off of nervous tissue in the canalis spinalis, tractive are more, need bone-graft fusion and apparatus to fix simultaneously, apparatus complication of thereupon bringing and bone grafting related complication also obviously increase.Extensively peel off paravertebral muscles during the Lumbar Fusion operation, make its denervation, acceleration regression, the intervertebral disk hernia of the contiguous lumbar vertebra motion segment in Lumbar Fusion operation back.

The treatment of the Minimally Invasive Surgery of prolapse of lumbar intervertebral disc have damage little, recover fast, spinal motion segment stability destroyed characteristics such as little.As percutaneous lumbar intervertebral disc laser vaporization decompression, radio-frequency (RF) ablation, IDET, chemonucleolysis, percutaneous lumbar intervertebral disc are cut automatically and are inhaled art etc. and be the intervertebral disc internal therapy, mainly finish decompression in the intervertebral disc, can't outthrust and emersion object directly be handled, so the indication limitation, effect is limited.

Disc removal art (Microendoscopic Discectomy under the micro-scope, MED) although can directly extract the disc tissue of giving prominence to or deviating from the canalis spinalis, but its operation process is similar to open surgery, identical to intraspinal operation with open surgery, still need just can appear outthrust, so the risk of nerve root injury and adhesion is identical with open surgery by tractive nerve root and dural sac.

Percutaneous intervertebral foramina approach scope descends outstanding or deviates from the disc tissue enucleation, by lumbar vertebra rear flank road percutaneous puncture to the waist intervertebral foramina, enlarge urethroptasty by the capable intervertebral foramina of instruments such as side opening laser, tiny balls abrasive drilling or trepan, make intervertebral aperture mirror working column directly enter in the canalis spinalis, direct view under endoscope exposes disc tissue outstanding or that deviate from, directly extracts and causes the pressure thing.Owing to do not need tractive nerve root and dural sac in the operation process, all operation techniques all carry out in working column, so nervous tissue in the canalis spinalis is not had harassing and wrecking, auxiliary utilization bipolar radio frequency electricity can effectively stop blooding with fixed attention, can prevent adhesion in the postoperative canalis spinalis, operation more can guarantee the safety of whole surgery process under the local anaesthesia, so this technology has favorable application prospect.But the poor controllability of laser and tiny balls abrasive drilling, the probability of nerve root injury is higher; External intervertebral foramina trepan system operates outside the MED working column, and surrounding soft tissue and nerve root are lacked protection, poor stability.

The present domestic percutaneous intervertebral foramina plastic operation of not carrying out as yet more lacks safety percutaneous intervertebral foramina good, that be fit to the state human body type and enlarges the apparatus that is shaped.

Summary of the invention

In order to overcome the deficiency that domestic and international existing percutaneous intervertebral foramina enlarges the safety aspect of shaping apparatus, this utility model provides a kind of suitable state human body type, and safer, effective percutaneous waist intervertebral foramina enlarges the serial apparatus that is shaped.

The technical solution of the utility model is as follows:

Percutaneous waist intervertebral foramina enlarges the serial apparatus that is shaped and comprises: seal wire (Fig. 1), soft tissue expander (Fig. 2), duckbill expanded casing (Fig. 3), duckbill protective casing (Fig. 4), trepan (Fig. 5), rear flank road MED working column (Fig. 6).Trepan has different diameters, and duckbill protective casing diameter is greater than the trepan diameter.

Percutaneous inserts " duckbill " cannula system that enlarges step by step to the waist intervertebral foramina, and outside protective casing, superior articular process's veutro of the next lumbar vertebra that needs are excised partly moves in the sleeve pipe, the dorsal part of " duckbilled sheet " outlet nerve root retaining.The trepan system cut-out articular process sclerotin of utilization different-diameter enlarges waist intervertebral foramina lower part in protective casing.

The beneficial effects of the utility model are, can be safely, effectively waist intervertebral foramina the latter half is carried out percutaneous and enlarge, and rear flank road MED working column is entered in the canalis spinalis, outstanding disc tissue is effectively excised.Provide prolapse of lumbar intervertebral disc the most perfect Minimally Invasive Surgery method.

Description of drawings

Below in conjunction with drawings and Examples this utility model is further specified.

Fig. 1 is a seal wire.

Fig. 2 is a soft tissue expander.

Fig. 3 is the duckbill expanded casing.

Fig. 4 is the duckbill protective casing.

Fig. 5 is a trepan.

Fig. 6 is a rear flank road MED working column.

Fig. 7 is that percutaneous waist intervertebral foramina enlarges a kind of sketch map under the shaping devices work state.

The specific embodiment

1, the proceeds posterolateral percutaneous punctures seal wire (Fig. 1) to intervertebral disc plane, intervertebral foramina lower part.

2, import soft tissue expander (Fig. 2) to intervertebral foramina along seal wire (Fig. 1).

3, import the duckbill expanded casing (Fig. 3) that increases step by step along soft tissue expander (Fig. 2).

4, keep duckbill protective casing (Fig. 4).Superior articular process's sclerotin of visible the next lumbar vertebra under the scope.

5, import trepan (Fig. 5) in duckbill protective casing (Fig. 4), cut-out superior articular process sclerotin enlarges intervertebral foramina.

6, intervertebral foramina is extended.

7, along in the duckbill protective casing (Fig. 4), the intervertebral foramina through enlarging is presented to the working column (Fig. 6) of rear flank road MED in the canalis spinalis.The visible down outstanding nucleus pulposus of scope.

8, behind the cut-out nucleus pulposus, nerve root can drop to working column the place ahead, visible nerve root under the scope.

9, rotation duckbill sleeve pipe is pulled to the sleeve pipe dorsal part with nerve root.Visible nerve root disappears under the scope.

10, continue the outstanding disc tissue of excision residue.

11, behind the outstanding nucleus pulposus of excision, scope is the completeness of monitoring nucleus pulposus excision down.

12, rotate duckbill protective casing (Fig. 4) again, nerve root drops to sleeve pipe the place ahead again.See under the scope that nerve root thoroughly reduces pressure.

Claims

Between this percutaneous lumbar vertebra the hole enlarge the shaping apparatus by: seal wire, soft tissue expander, duckbill expanded casing, duckbill protective casing, trepan, rear flank road MED working column are formed; it is characterized in that trepan has different diameters, duckbill protective casing diameter is greater than the trepan diameter.