CN203252716U - Operating device for carrying out vertebroplasty through unilateral vertebral pedicle - Google Patents
Operating device for carrying out vertebroplasty through unilateral vertebral pedicle Download PDFInfo
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- CN203252716U CN203252716U CN2013201997545U CN201320199754U CN203252716U CN 203252716 U CN203252716 U CN 203252716U CN 2013201997545 U CN2013201997545 U CN 2013201997545U CN 201320199754 U CN201320199754 U CN 201320199754U CN 203252716 U CN203252716 U CN 203252716U
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- bone cement
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- pilot sleeve
- vertebroplasty
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Abstract
The utility model discloses an operating device for carrying out vertebroplasty through a unilateral vertebral pedicle. The operating device for carrying out the vertebroplasty through the unilateral vertebral pedicle comprises a steerable guiding sleeve, a universal micro drill bit and a steerable bone cement injection channel. The operating device for carrying out the vertebroplasty through the unilateral vertebral pedicle is simple in operation, easy to master and high in acceptability of doctors. When the operating device for carrying out the vertebroplasty through the unilateral vertebral pedicle is used, the portion where a sacculus is opened and bone cement is injected can be located in the center of the position with two thirds of the length of a vertebral body away from the front end of the vertebral body, and an ill vertebra can be supported firmly and stably. Compared with existing vertebroplasty, the position of injection of the bone cement is closer to the center of the vertebral body, and is far away from the edge of the vertebral body, the probability of seepage of the bone cement is reduced, and due to the fact that unilateral puncture is carried out, the risk of a puncture channel entering a vertebral canal is reduced, and the risk of seepage of the bone cement in the vertebral canal is reduced. Due to the fact that the approach of an operation is changed from bilateral approaches into a unilateral approach, the time of the operation can be obviously reduced, injury to a patient can be reduced, and the frequency that the patient and medical staff are exposed to radial can be obviously reduced. Due to the fact the number of injection points of the bone cement in a bone is increased from one to more, the bone cement can evenly disperse in bone substances. The operating device for carrying out the vertebroplasty through the unilateral vertebral pedicle is wide in range of application, and is the same as the existing vertebroplasty in the range of application.
Description
Technical field
This utility model relates to a kind of operating means through one-sided pedicle of vertebral arch row vertebral body plastic operation, belongs to medical instruments field.
Background technology
Galibert in 1987 etc. have described first percutaneous vertebroplasty (percutaneous vertebroplasty, PVP) and have been used for the treatment of pain due to the Vertebral Hemangioma.This art formula enters in the pathological changes vertebral body with the puncture of bone biopsy needle percutaneous pedicle under the guiding of X line, in vertebral body, inject bone cement by puncture needle, increase vertebral body intensity, stable fracture, alleviating pain, be widely used in again subsequently the pain due to the molten bone malignant tumor of vertebral body and the osteoporotic fracture etc.Wong in 1998 etc. implement percutaneous balloon kyphoplasty (percutaneous kyphoplasty, PKP) first, originate from PVP in the design.What this Technology design thinking was different from PVP is before the injection bone cement, lift the soleplate that subsides with expansion of balloon catheter first, recovery subside height and the form of vertebral body, reduce the kyphosis deformity, in vertebral body, cause simultaneously a bone cavity, then the bone cement of the higher viscosity of low pressure injection in the cavity.
Through development these years, PVP and PKP technology obtain to use widely clinically at present, are widely used at present treating the treatment of the diseases such as Vertebral Metastases, myeloma and Osteoporotic Vertebral Compression Fractures.But still face some problems.At first being the problem that need to repeatedly have an X-rayed, secondly is the bone cement seepage.
Repeatedly have an X-rayed in the art except the unguarded repeatedly radiation exposure of client need, have simultaneously the operation doctor of protection to be under a kind of long-term low dose ray exposure.The risk of at present long-term low dose ray exposure is unknown, and stipulates that about personal dose's restriction individual irradiated annual dose equivalent should be lower than 5mSv (0.5rem) among the public in the radiation protection.When continuing to be subjected to radio exposure for a long time, the individual should not be higher than 1mSv (0.1rem) at the irradiated annual dose equivalent limit of annual whole body in life among the public.Wherein clear personal dose restriction is enforceable, must strictly observe.Personaldoselimit is the lower bound of unacceptable dosage range, rather than can allow the dosage upper limit accepted.Even individual suffered dosage does not surpass the corresponding dose equivalent limit of regulation, still must consider whether will further reduce dosage according to optimization criteria.The personaldoselimit of defined can not be as the standard or the design objective that reach satisfied protection, can only be as a kind of constraints with optimization criteria control irradiation.It is more few better that its essence refers to that exactly ray exposes, and it is best " not eat " ray.
The bone cement seepage can cause serious consequence, and epidural seepage, intervertebral foramina seepage can cause that serious nerve root is painful, often need decompression with alleviating pain; The intervertebral disc seepage can cause intervertebral disc degeneration, increases the risk of contiguous vertebral fracture; Venous plexus is leaked with the risk that causes pulmonary infarction, can cause patient's death when serious.
It is generally acknowledged at present the operation of carrying out vertebral body molding operation through one-sided pedicle of vertebral arch, can effectively reduce the time that ray exposes, simultaneously, because reduced the site of puncture for once, epidural seepage, intervertebral foramina seepage through the puncture position have also been reduced through one-sided operation simultaneously.But one-sided vertebral pedicle puncture carries out the vertebral body forming operation also faces a lot of problems, as in order to make piercing needle enter the front central part of vertebral body as far as possible, generally need to increase the outer dip angle of puncture, this has also increased puncture needle simultaneously and has entered the risk of canalis spinalis and injured nerve root and increased that the bone cement epidural is oozed out and the risk of bone cement thermal burn nerve root.At thoracic vertebra just round because the vertebral body form approaches, as long as entry point slightly biased outside, puncture relatively easily enters the front central part of vertebral body, so one-sided puncture is relatively feasible; And at lumbar vertebra because vertebral body is flat ellipse, so even increase the outer dip angle of puncture, enter before the vertebral body relatively difficulty of central part, operation easier is larger, often causes bone cement asymmetric disperse in vertebral body behind the injection bone cement.
On the theory, if the design operating walk way that can turn round in vertebral body punctures and sacculus can be placed in vertebral body front 1/3 boundary central part through one-sided pedicle of vertebral arch normal angled and expands, can effectively overcome the above problems.Because the injection site of bone cement is injected more near the central authorities of vertebral body than the bilateral bone cement, can increase the distance that bone cement is exuded to vertebral rim in addition, effectively reduce the seepage of bone cement.
The utility model content
The utility model purpose: the purpose of this utility model is to provide a kind of operating means through one-sided pedicle of vertebral arch row vertebral body plastic operation, it is designed with the operating sleeve that can guiding hose turns round in vertebral body, puncture and sacculus can be placed in vertebral body front 1/3 boundary central part through one-sided pedicle of vertebral arch normal angled and expand, can effectively reduce the exposure of ray and the seepage of bone cement.
Technical scheme: a kind of operating means through one-sided pedicle of vertebral arch row vertebral body plastic operation described in the utility model comprises pilot sleeve, bone drill and bone cement injection channel;
The top of described pilot sleeve is provided with conical nose, described conical nose has along its axis direction and holds the through hole that guide pin passes, the conical nose bottom surface of described pilot sleeve inboard is that arc is domatic, has oval foramen with the domatic relative position of arc on the sidewall of described pilot sleeve;
Described bone drill comprises push rod and Universal drill, and described Universal drill is by can being connected with push rod to the elastic bar that any direction curves, and described Universal drill enters pilot sleeve and can pass oval foramen under the domatic guiding of arc and enter Intrapyramidal precalculated position;
Described bone cement injection channel comprises the bone cement sprue bushing and is connected to the flexible pipe that can curve to any direction on its top, insert flexible polyethylene seal wire in the described flexible pipe, enter pilot sleeve and can under the domatic guiding of arc, pass oval foramen and enter Intrapyramidal precalculated position.
Further, the end of described pilot sleeve is fixed with handle, and described handle comprises link and turn to end, described pilot sleeve to run through in the link that is fixed on handle, described oval foramen towards with turn to extreme direction consistent.
Further, described elastic bar is helical spring.
Further, have three exhausting holes along its length direction on the sidewall of described flexible pipe, three exhausting holes are positioned near the flexible pipe remote location and along the circumferential direction are evenly distributed on the sidewall of flexible pipe, the part that described flexible pipe has through hole contains the material that stops ray, be convenient to fluoroscopy during operation positioning through hole position, the far-end of flexible pipe is blind end.
Further, the end of described bone cement sprue bushing is fixed with and pushes away handle, described bone cement sprue bushing runs through and is fixed on the central position that pushes away handle, described through hole towards vertical with the length direction that pushes away handle, described bone cement sprue bushing end stretches out the outer wall that pushes away shank portion and is provided with the screw thread that closely links to each other with bone cement injection device.
This utility model compared with prior art, its beneficial effect is: (1) is simple to operate, grasps easily, doctor's acceptance is good; (2) use this device that sacculus is strutted and position that bone cement injects is positioned at front 2/3 central part of vertebral body, make the vertebra of falling ill obtain the more support of firm stable; (3) compare with vertebral body plastic operation before, the injection position of bone cement is more near vertebral body central authorities, and the vertebral rim apart from each other, the probability of bone cement seepage reduces, simultaneously, because be one-sided puncture, reduce also that puncture channel enters the risk of canalis spinalis and the risk that reduces bone cement canalis spinalis seepage; (4) operative approach is changed into one-sidedly by bilateral, can obviously shorten operating time, reduces patient's damage, and the ray that can obviously reduce patient and medical personnel simultaneously exposes; (5) bone cement intraosseous injection point is expanded as multiple spot by a bit, so that bone cement disperse in sclerotin is more even; (6) scope of application is extensive, and the scope of application of existing vertebral body forming technique is identical.
Description of drawings
Fig. 1 is the structural representation of described pilot sleeve.
Fig. 2 is the structural representation of the taper bit of described pilot sleeve.
Fig. 3 is the structural representation of described bone drill.
Fig. 4 is the structural representation of described Universal drill.
Fig. 5 is the structural representation of described bone cement injection channel.
The specific embodiment
The below is elaborated to technical solutions of the utility model, but protection domain of the present utility model is not limited to described embodiment.
Embodiment 1:Shown in Fig. 1 to 5, a kind of operating means through one-sided pedicle of vertebral arch row vertebral body plastic operation comprises pilot sleeve 1, bone drill 2, sacculus dilator and bone cement injection channel 3;
The top of described pilot sleeve 1 is provided with conical nose 4, described conical nose 4 has along its axis direction and holds the through hole 5 that guide pin passes, the conical nose bottom surface of described pilot sleeve inboard is that arc is domatic 6, and position relative with arc domatic 6 on the sidewall of described pilot sleeve 1 has oval foramen 7; The end of described pilot sleeve 1 is fixed with handle 8, and described handle comprises link 9 and turn to end 10, and described pilot sleeve passes through 1 and fastens in the link 9 that fixes on handle, described oval foramen 7 towards consistent toward the directions that turn to end 10 with link 9.
Described bone drill 2 comprises push rod 11 and Universal drill 12, described Universal drill 12 is by can being connected with push rod 11 to the helical spring 13 that any direction curves, and described Universal drill 12 enters pilot sleeve 1 and can pass oval foramen 7 under the guiding of arc domatic 6 and enter Intrapyramidal precalculated position.
The seal wire of described sacculus dilator and 3 inside, bone cement injection channel is the polyethylene seal wire.
Described bone cement injection channel 3 comprises bone cement sprue bushing 14 and is connected to the flexible pipe 15 that can curve to any direction on its top, insert flexible polyethylene seal wire in the described flexible pipe 15, described flexible pipe 15 enters pilot sleeve 1 and can pass oval foramen 7 under the guiding of arc domatic 6 and enter Intrapyramidal precalculated position, have three exhausting holes along its length direction on the sidewall of described flexible pipe 15, three exhausting holes along the circumferential direction are evenly distributed on the sidewall of flexible pipe, and be positioned near the flexible pipe remote location, the part that described flexible pipe has through hole contains the material that stops ray, be convenient to fluoroscopy during operation positioning through hole position, the far-end of flexible pipe is blind end, the end of described bone cement sprue bushing 3 is fixed with and pushes away handle 16, described bone cement sprue bushing 3 runs through and is fixed on the central position that pushes away handle 16, described through hole towards vertical with the length direction that pushes away handle, described bone cement sprue bushing end stretches out the outer wall that pushes away shank portion and is provided with the screw thread that closely links to each other with bone cement injection device.
Concrete operating procedure is as follows:
1, the patient body position is the same with general vertebral body plastic operation operation, gets the ventricumbent position, the routine disinfection drape, and C arm X-ray machine is located the disease vertebra, determines that simultaneously the head of puncture inclines and the tail degree of tilt.
Lower and the present vertebral body plastic operation the same (using present puncture instrument) of 2, C arm X-ray machine guiding carries out the puncture of the one-sided pedicle of vertebral arch of disease vertebra, confirms to insert guide pin after puncture needle enters pedicle of vertebral arch and correct position.
3, insert the described pilot sleeve that can turn to along guide pin, keep the handle of pilot sleeve parallel with trunk, this moment, side position perspective can be observed the position of oval foramen on the sleeve, and C arm X-ray machine perspective is confirmed the degree of depth of pilot sleeve and the trailing edge whether oval foramen has surpassed vertebral body; Guide pin is extracted as the optimum position in 1/3 place then after generally surpassing the trailing edge of vertebral body fully and be centered close in the vertebral body lateral projection take oval foramen.
4, will be by handle with the pilot sleeve 90-degree rotation, so that the end that turns to of sleeve points to inboard and vertical with trunk, insert bone drill along pilot sleeve, electric drill changes over to, because the inclined design in the pilot sleeve, Universal drill is direction conversion along with the inclined-plane when arriving the inclined-plane, is 145 ° of angles along oval foramen and pilot sleeve and enters vertebral body.C arm X-ray machine normotopia and side position perspective monitoring Universal drill position simultaneously confirms that electric drill does not penetrate front 1/3 central part that has a common boundary that vertebral rim and position are arranged in vertebral body.
5, extract Universal drill after, insert sacculus dilator (wire guide of sacculus dilator inside is replaced by the polyethylene seal wire) to correct position, the row distraction reduction.
6, distraction reduction is inserted the described bone cement injection channel that can turn to after the polyethylene seal wire being extracted by sacculus after satisfied, inserts passage through pilot sleeve, and perspective cues far-end flexible pipe is inserted and extracted start injection bone cement behind the seal wire behind the tram.
7, the bone cement injection finishes to extract flexible pipe before bone cement solidifies, and makes flexible pipe be retracted into pilot sleeve, but not exclusively extracts, and the rotary steering sleeve is 90 ° simultaneously.Extract pilot sleeve after bone cement solidifies, operation finishes.
As mentioned above, although the specific preferred embodiment of reference has represented and has explained this utility model that it shall not be construed as the restriction to this utility model self.Under the spirit and scope prerequisite of the present utility model that does not break away from the claims definition, can make in the form and details various variations to it.
Claims (5)
1. the operating means through one-sided pedicle of vertebral arch row vertebral body plastic operation comprises pilot sleeve, bone drill and bone cement injection channel, it is characterized in that:
The top of described pilot sleeve is provided with conical nose, described conical nose has along its axis direction and holds the through hole that guide pin passes, the conical nose bottom surface of described pilot sleeve inboard is that arc is domatic, has oval foramen with the domatic relative position of arc on the sidewall of described pilot sleeve;
Described bone drill comprises push rod and Universal drill, and described Universal drill is by can being connected with push rod to the elastic bar that any direction curves, and described Universal drill enters pilot sleeve and can pass oval foramen under the domatic guiding of arc and enter Intrapyramidal precalculated position;
Described bone cement injection channel comprises the bone cement sprue bushing and is connected to the flexible pipe that can curve to any direction on its top, insert flexible polyethylene seal wire in the described flexible pipe, enter pilot sleeve and can under the domatic guiding of arc, pass oval foramen and enter Intrapyramidal precalculated position.
2. the operating means through one-sided pedicle of vertebral arch row vertebral body plastic operation according to claim 1, it is characterized in that, the end of described pilot sleeve is fixed with handle, described handle comprises link and turns to end, described pilot sleeve runs through in the link that is fixed on handle, described oval foramen towards consistent with the direction that turns to end.
3. the operating means through one-sided pedicle of vertebral arch row vertebral body plastic operation according to claim 1 is characterized in that, described elastic bar is helical spring.
4. the operating means through one-sided pedicle of vertebral arch row vertebral body plastic operation according to claim 1, it is characterized in that, have three exhausting holes along its length direction on the sidewall of described flexible pipe, three exhausting holes are positioned near the flexible pipe remote location and along the circumferential direction are evenly distributed on the sidewall of flexible pipe, the part that described flexible pipe has through hole is provided with the material that stops ray, be convenient to fluoroscopy during operation positioning through hole position, the far-end of described flexible pipe is blind end.
5. the operating means through one-sided pedicle of vertebral arch row vertebral body plastic operation according to claim 4, it is characterized in that, the end of described bone cement sprue bushing is fixed with and pushes away handle, described bone cement sprue bushing runs through and is fixed on the central position that pushes away handle, described through hole towards vertical with the length direction that pushes away handle, described bone cement sprue bushing end stretches out the outer wall that pushes away shank portion and is provided with the screw thread that closely links to each other with bone cement injection device.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2013201997545U CN203252716U (en) | 2013-04-19 | 2013-04-19 | Operating device for carrying out vertebroplasty through unilateral vertebral pedicle |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2013201997545U CN203252716U (en) | 2013-04-19 | 2013-04-19 | Operating device for carrying out vertebroplasty through unilateral vertebral pedicle |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN203252716U true CN203252716U (en) | 2013-10-30 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2013201997545U Expired - Fee Related CN203252716U (en) | 2013-04-19 | 2013-04-19 | Operating device for carrying out vertebroplasty through unilateral vertebral pedicle |
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| CN (1) | CN203252716U (en) |
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103251445A (en) * | 2013-04-19 | 2013-08-21 | 南京医科大学第一附属医院 | Device for operating vertebroplasty through unilateral vertebral pedicle |
| CN104173101A (en) * | 2014-09-11 | 2014-12-03 | 昆明医科大学第一附属医院 | Device for constructing dilator channel under unilateral pedicle admission passage condition |
| CN104546089A (en) * | 2015-01-09 | 2015-04-29 | 彭大勇 | Percutaneous puncture transverse balloon distraction percutaneous kyphoplasty surgical instrument |
| CN106473794A (en) * | 2016-12-02 | 2017-03-08 | 上海脊光医疗科技有限公司 | Micro-wound percutaneous vertebral pedicle puncture channel ultrasound points to real-time monitoring and alarming |
-
2013
- 2013-04-19 CN CN2013201997545U patent/CN203252716U/en not_active Expired - Fee Related
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103251445A (en) * | 2013-04-19 | 2013-08-21 | 南京医科大学第一附属医院 | Device for operating vertebroplasty through unilateral vertebral pedicle |
| WO2014169684A1 (en) * | 2013-04-19 | 2014-10-23 | 南京医科大学第一附属医院 | Operation device for unilateral pedicle vertebroplasty |
| CN104173101A (en) * | 2014-09-11 | 2014-12-03 | 昆明医科大学第一附属医院 | Device for constructing dilator channel under unilateral pedicle admission passage condition |
| CN104173101B (en) * | 2014-09-11 | 2017-01-11 | 昆明医科大学第一附属医院 | Device for constructing dilator channel under unilateral pedicle admission passage condition |
| CN104546089A (en) * | 2015-01-09 | 2015-04-29 | 彭大勇 | Percutaneous puncture transverse balloon distraction percutaneous kyphoplasty surgical instrument |
| CN106473794A (en) * | 2016-12-02 | 2017-03-08 | 上海脊光医疗科技有限公司 | Micro-wound percutaneous vertebral pedicle puncture channel ultrasound points to real-time monitoring and alarming |
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Legal Events
| Date | Code | Title | Description |
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| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| CF01 | Termination of patent right due to non-payment of annual fee |
Granted publication date: 20131030 Termination date: 20150419 |
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| EXPY | Termination of patent right or utility model |