CN205831900U - A kind of Pedicle Screw Placement in Lower Cervical enters to follow closely guiding die plate - Google Patents
A kind of Pedicle Screw Placement in Lower Cervical enters to follow closely guiding die plate Download PDFInfo
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- CN205831900U CN205831900U CN201620319347.7U CN201620319347U CN205831900U CN 205831900 U CN205831900 U CN 205831900U CN 201620319347 U CN201620319347 U CN 201620319347U CN 205831900 U CN205831900 U CN 205831900U
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- die plate
- guiding die
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- spinous process
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Abstract
A kind of Pedicle Screw Placement in Lower Cervical enters to follow closely guiding die plate, and guiding die plate plate face is the profiling binding face in the spinous process region on single-unit cervical vertebra；Dorsal part at guiding die plate binding face is provided with handle, the spinous process bump pad in corresponding spinous process region, runs through handle and guiding die plate offers limiting through hole, and the spacing tailpin of movable loading in limiting through hole, the tip of spacing tailpin is embedding thrusts spinous process bump pad；The pedicle of vertebral arch of corresponding both sides, spinous process region, the dorsal part of guiding die plate binding face protrusion respectively, boss is offered hollow approach through hole, movable loading sleeve in hollow approach through hole；Described sleeve is medical resin sleeve.This device fitting area is abundant, and laminating is stable, and effectively in prevention operation, guiding die plate rocks relative to vertebral plate, all can guarantee that the accuracy into nail for different patients, reduces difficulty and the risk of operation of operation；Medical resin sleeve is high with the compatible degree of tissue, can realize that bilateral or pleurocentrum guiding are entered nail and guide, simple and reliable for structure, easy to use.
Description
Technical field
This utility model relates to surgical medical instrument field, particularly relates to Pedicle Screw Placement in Lower Cervical and enters to follow closely guider.
Background technology
In treatment spondylolishesis reset, corrective procedure, pedicle of vertebral arch location technology is the most reliable spinal column fixed form.
Owing to pedicle screw can play three-dimensional fixation, having the advantages such as mechanical strength is high, fixing, its clinical practice is more and more wider
General.But only depth desired is inserted and reached to nail along the long axis channel of dissection of pedicle of vertebral arch, could obtain preferable effect.Spinal column
Vertebral body surrounding anatomical structures is complicated, and front and big blood vessel, internal organs are adjacent, are canalis spinalis inside pedicle of vertebral arch, and lower section is nerve root institute shape
Become narrow space in, make pedicle screw insert difficulty and danger increases the most accordingly.Therefore, pedicle screw inner position
Technology is difficult to popularize in clinic, and how safety and precise determines is inserted pedicle screw, and always basis and clinical research is extremely closed
The problem of note.
At present, the conventional method that vertebral arch is followed closely into nail specifically includes that (1) anatomic landmark point method；(2) vertebral lamina fenestration method；(3)X
Line diascopy；(4) computer navigation method.Wherein:
(1) although various anatomic points notation entry point, entering to follow closely angle slightly difference, but its common ground is pedicle screw
Entry point, enter to follow closely direction and mainly judged by the experience of patient, the feel and the pedicle of vertebral arch probe that rely primarily on patient are opposed
Ordering the exploration of passage to ensure accurately inserting of pedicle screw, require higher to doctor, degree of accuracy is difficult to ensure that；
(2) vertebral lamina fenestration inevitably increases operating time and intraoperative blood loss；
(3) operating time of X-ray examination householder method is longer, and the x-ray radiation amount of patient and medical personnel is relatively big, to its body
Bulk damage is bigger；
(4) computer navigation method gradually obtains application in fixing in pedicle of lumbar vertebral arch screw in recent years, utilizes patient
Real-time pedicle of vertebral arch image information carrys out guided operation, reduces operation risk, reduces doctors and patients' double time sending out contact ray, has
The biggest advantage.But navigator is expensive, operating complex, patient's learning time is long, and clinical universal right existence asks
Topic.
Along with the progress of 3D printing technique, in medical domain people trial, direction engineering is combined with 3D printing technique
Mode, utilizes the equipment such as CT or nuclear magnetic resonance, NMR (MRI) to gather the shape data at the positions such as human organ, skeleton, joint, rebuilds three
Dimension word model, then utilizes 3D printing type manufacture teaching and referential model of performing the operation, and is usually used in helping to manufacture artificial limb
Or carry out surgical repair.
But, existing enter to follow closely guider and deposit after placement without fixed structure, operation process shake easily with respect to human body
Dynamic, cause the error into nail direction, and guider can produce chip when with the friction of pedicle screw, introduces human body group
Knitting rear harmful, additionally guider volume is relatively big, and therefore operation suits face relatively greatly, and the most also device adhibition is bad
Deng series of problems.
Utility model content
Technical problem to be solved in the utility model is to provide a kind of Pedicle Screw Placement in Lower Cervical to enter to follow closely guiding die plate.Should
Guiding die plate can effectively be fitted in the cervical vertebra of human body, has laminating fixed structure, it is ensured that guiding die plate in operation process
Will not rock by cervical vertebra relatively, it is possible to achieve bilateral or pleurocentrum guiding are entered nail and guides, and simple and reliable for structure, use
Convenient, effectively personalized pedicle screws can be provided to enter nail for different patients and guide duct, it is ensured that enter the accuracy of nail, reduce
The difficulty of operation, has control to control operation cost and the risk of operation.
This utility model is achieved through the following technical solutions:
A kind of Pedicle Screw Placement in Lower Cervical enters to follow closely guiding die plate, it is characterised in that:
Guiding die plate knee-piece in wave shape shape, its plate face is the profiling binding face in the spinous process region on single-unit cervical vertebra, is fitted in
On spinous process region；
Dorsal part at guiding die plate binding face is provided with handle, the spinous process bump pad in corresponding spinous process region, runs through handle and leads
Offering at least one place's limiting through hole to template, the spacing tailpin of movable loading in limiting through hole, the tip of spacing tailpin is embedding thrusts spine
Prominent bump pad, keeps the bonding position in guiding die plate and spinous process region to immobilize；
The pedicle of vertebral arch of corresponding both sides, spinous process region, the dorsal part of guiding die plate binding face protrusion respectively, boss is offered
Hollow approach through hole, movable loading sleeve in hollow approach through hole, sleeve circumferentially can relatively rotate in hollow approach through hole,
Sleeve head end is concordant with guiding die plate binding face or is positioned at inside guiding die plate, and tail end exposes to guiding die plate dorsal part；
Described sleeve hardness is to have the sleeve of good biocompatibility.
When the guiding die plate of thin board type enables guiding die plate stress, waveform binding face elastic fit is in the vertebra portion of human body
Position；Be opened in the thickening boss of guiding die plate dorsal part for installing the hollow approach through hole of sleeve, by longer hollow enter
Road through hole and sleeve with the use of, it is possible to pedicle screw is played the best to effect；Sleeve is movably arranged on hollow
In approach through hole, pedicle screw activity passes sleeve, by sleeve position on guiding die plate, angle-determining pedicle of vertebral arch screw
The entry point of nail and nail direction, road, it is possible to determined the entrance degree of depth of pedicle screw by length sleeve, it is ensured that enter nail
Accuracy, reduces difficulty and the risk of operation of operation；Due to sleeve material hardness relative to pedicle screw and guiding die plate relatively
Low, and three is matched in clearance, therefore in operation process, even if between pedicle screw and sleeve, sleeve and guiding module
Phase mutual friction between plate, a little chip of generation also can be sleeve chip, and bush material has good biocompatibility, can promote
Enter the adhesion growth of human tissue cell, human body will not be caused bigger burden；Employing has good biocompatibility material sleeve
Cylinder and other relative low price but the composite construction of the guiding die plate of the poor material of biocompatibility rather than guiding module
What plate entirety employing price was high has good biocompatibility material, can effectively reduce the cost of device, reduces and performs the operation into
This, alleviate patient's burden economically；Operation is directed to template is spacing to be fixed on spinous process region, operation by spacing tailpin
Taking out spacing tailpin after end, spacing tailpin can effectively prevent guiding die plate in operation process from rocking relative to vertebral plate, makes guiding
Template is more preferable with human vertebra stickiness, more stable, it is to avoid enter to follow closely the error in direction.
Further, described handle is the "eight" shape of hollow, and its root relatively opened is fixed on guiding die plate, phase
To shrink head connect as one, junction is corresponding with spinous process bump pad position, "eight" shape handle open go-and-retum every
It is fixed on the two ends of guiding die plate, shrinks two ends and link together, it is simple to patient exerts a force force uniform to guiding die plate, passes through art
Person's joystick, adjustable guiding die plate and human spine's bonding position and the stability of raising laminating.This kind of handle is applicable to
The adult cervical spondylopathy patient that most of cervical vertebra disfigurations are little.After decompression or during sham operated, it is directed to template laminating and places
On corresponding Vertebral laminectomy, pedicle screw passes through the axially directed nail road on the sleeve in hollow approach through hole in vertebra side
Hole on block.Having limiting through hole on guide plate handle, limiting through hole avoids patient's force application location, from the linkage section of handle towards leading
Offering to template, limiting through hole guide and limit tailpin is squeezed in spinous process, make guiding die plate and human vertebra stickiness more preferably, more steady
Fixed.
Further, described handle is in " T " font, and its crosspiece two ends are fixed on guiding die plate, relatively lead in the middle part of crosspiece
To template evagination, the evagination crosspiece of " T " font handle plays to be strengthened guiding die plate intensity and supports the perpendicular section effect of stress.Should
Handle be applicable to some cervical spondylosis than more serious or cervical vertebra is less, be unfavorable for arrange "eight" shape handle adult patient or
Person child.Limiting through hole avoids patient's force application location, offers towards guiding die plate from the handle section of erecting, limiting through hole guide and limit tail
Stylus printer enters in spinous process, makes guiding die plate more preferable with human vertebra stickiness, more stable.No matter splayed handle and yi word pattern handle
All meet ergonomics, facilitate patient to use.
Further, the most protruding first flange on described sleeve revealed section, when sleeve loads hollow approach through hole, the
One flange activity covers exposing on port at hollow approach through hole.First flange is used for limiting sleeve and loads hollow approach through hole
Length, make sleeve head end concordant with guiding die plate binding face or be positioned at inside guiding die plate, tail end exposes to guiding die plate
Dorsal part, facilitates patient to use.
Further, the most protruding second flange on described sleeve tail end, formed between the first flange and the second flange
One ring annular groove.Annular groove is Handheld Division, facilitates patient to take and installs elongated sleeve, meets ergonomics.
Further, described sleeve loads between load segment external diameter and the hollow approach through hole internal diameter of hollow approach through hole
Diameter ratio is 0.8～1, is guaranteeing while nail accuracy, it is ensured that sleeve can be circumferentially in hollow approach through hole
Relatively rotate, reduce friction between the two, it is to avoid produce too much friction chip.
Further, described guiding die plate accounts for the 0.5～1 of spinous process region surface with the binding face in spinous process region, it is ensured that lead
To laminating between template and spinous process region fully, it is ensured that the stability of laminating.
Further, described limiting through hole is at interval is offered 1～6.More spacing tailpin can preferably ensure
The stickiness of guiding die plate, but bigger injury, therefore limiting through hole number can be caused in spinous process region by too much spacing tailpin
Amount is usually no more than 6, is optimal with about 2.
Further, described sleeve is medical resin sleeve, titanium alloy sleeve, vitallium sleeve, ceramic material, high
Molecularly Imprinted Polymer material sleeve or other is similar, have that good biocompatibility material is one-body molded to be prepared from, subtracts
Few operation damage to patient.
The beneficial effects of the utility model are:
1, the profiling thin-walled binding face of guiding die plate when stress can elastic fit at the vertebra position of human body, binding face
Long-pending abundant, laminating is stable；
2, the fixed structure of spacing tailpin can effectively prevent guiding die plate in operation process from rocking relative to vertebral plate, makes guiding
Template is more preferable with human vertebra stickiness, more stable, it is to avoid enter to follow closely the error in direction；
3, guiding die plate generates according to the individual spinous process region shape of different patients, it is possible to provide personalization for pedicle screws
Enter nail and guide duct, it is ensured that enter the accuracy of nail, reduce difficulty and the risk of operation of operation；
The medical property material sleeve 4, with good biocompatibility is high with the biocompatibility of human tissue cell, even if
In operation process, friction produces a small amount of chip, human body also will not cause bigger burden, and adopt without guiding die plate entirety
With the material with good biocompatibility that cost is the highest, effectively control operation cost；
5, multiple handle is selected flexibly, is suitable for different patients；
6, two hollow approach through holes are opened on the thickening boss of guiding die plate dorsal part, coordinate long sleeve to use, can protect
Demonstrate,prove to pedicle screw spacing that fully guidance quality is good, and can realize bilateral or pleurocentrum guidings are entered nail guiding,
Simple and reliable for structure, easy to use.
Accompanying drawing explanation
Fig. 1 is the three-dimensional fit structure schematic diagram of a kind of preferred structure of this device and spinous process region
Fig. 2 is the three-dimensional fit structure schematic diagram of this device another kind preferred structure and spinous process region
Fig. 3 is the fit structure schematic diagram of sleeve and guiding die plate
In Fig. 1～3: 1 is guiding die plate, 101 is hollow approach through hole, and 102 is boss, and 2 is sleeve, and 201 is first convex
Edge, 202 is the second flange, and 203 is annular groove, and 3 is pedicle screw, and 4 is spinous process region, and 6 is handle, and 7 is limiting through hole.
Detailed description of the invention
The utility model is described in further detail below in conjunction with the accompanying drawings.
As shown in Fig. 1～2, guiding die plate 1 knee-piece in wave shape shape, its plate face is the imitative of the spinous process region 4 on single-unit cervical vertebra
Shape binding face, is fitted on spinous process region 4, the binding face in guiding die plate 1 and spinous process region 4 account for surface, spinous process region 4 0.5～
1。
The pedicle of vertebral arch of corresponding both sides, spinous process region 4, the dorsal part of guiding die plate 1 binding face protrusion 102 respectively, on boss
Offer hollow approach through hole 101.
Dorsal part at guiding die plate 1 binding face is additionally provided with handle 6, the spinous process bump pad in corresponding spinous process region 4, runs through handle
6 and guiding die plate 1 offer limiting through hole 7 at, movable in limiting through hole 7 load spacing tailpin, the embedding thorn in tip of spacing tailpin
Enter spinous process bump pad, keep the bonding position in guiding die plate 1 and spinous process region 4 to immobilize.
In Fig. 1, the handle 6 "eight" shape in hollow, its root relatively opened is fixed on guiding die plate 1, relatively receives
The head of contracting is connected as one by crosspiece, connects crosspiece forward and backward corresponding with spinous process bump pad position, and limiting through hole 7 is from handle 6
Linkage section offer towards guiding die plate 1.
In Fig. 2, handle 6 is in " T " font, and its crosspiece two ends are fixed on guiding die plate 1, in being oppositely oriented mould in the middle part of crosspiece
The arc block shape of the dorsal part evagination of plate 1 binding face, the limiting through hole 7 thickening part from perpendicular section free end offers towards guiding die plate 1,
Avoid the hand griping position of patient.
Loading sleeve 2 as it is shown on figure 3, movable in hollow approach through hole 101, sleeve 2 loads the dress of hollow approach through hole 101
Diameter ratio between the section of entering external diameter and hollow approach through hole 101 internal diameter is 0.8～1, and sleeve 2 can be in hollow approach through hole 101
Circumferentially relatively rotating, sleeve 2 head end is concordant with guiding die plate 1 binding face or is positioned at guiding die plate 1 inside, and tail end exposes to
Guiding die plate 1 dorsal part.The most protruding first flange 201 on sleeve 2 revealed section, when sleeve 2 loads hollow approach through hole 101,
First flange 201 is movable covers exposing on port at hollow approach through hole 101；On sleeve 2 tail end, circumferentially projection second is convex
Edge 202, forms a ring annular groove 203 between the first flange 201 and the second flange 202, makes to load hollow approach in sleeve 2 and leads to
Spacing and patient in hole 101 is hand-held.Sleeve 2 is medical resin sleeve.
Preparing above-mentioned Pedicle Screw Placement in Lower Cervical and enter to follow closely the method that guiding die plate can use 3D to print, it concretely comprises the following steps:
The first step, sets up 3-D geometric model: gather CT or the MRI data of corrective surgery region vertebra, data preserved
For DICOM format or the two-dimensional image data of other form and after importing MIMICS or other image processing software, use filtering,
Noise reduction means carries out image pre-treatment, arranges Gray-scale value further according to joint profile, reconstructs the three of corrective surgery region vertebra
Dimension module, and save as STL formatted file；
Second step, determines pedicle screw road: imported by the vertebra threedimensional model of above-mentioned reconstruct in three-dimensional software, position one
Series of X Y parallel reference face so that reference plane are vertical with pedicle of vertebral arch outline direction, extracts pedicle of vertebral arch and reference plane respectively
Intersecting outlines line, fits to cylinder passage, is sleeve and enters paths, and determines cylinder passage central coordinate of circle, thus really
Determine the entry point of vertebral arch nail, enter the degree of depth and nail direction, road；
3rd step, generates guiding die plate: in Slodworks or other three-dimensional software, skeleton model is carried out grid excellent
Changing, extract bone surface grid, reserve migration generates the guiding die plate 1 of suitable thickness after increasing, then with the above-mentioned vertebral arch determined
Root screw road is reversed matching, generates hollow approach through hole 101 and the sleeve 2 matched with it, and generates handle and spacing
Through hole 7, obtains guiding die plate model；
4th step, 3D printing and making model: the guiding die plate model of above-mentioned 3rd step of printing and making, and produce weight simultaneously
The corrective surgery region vertebra threedimensional model of structure, it is simple to doctor carries out preoperative planning, it is ensured that guiding die plate enters with pedicle screw
The accuracy in nail direction.
Claims (9)
1. a Pedicle Screw Placement in Lower Cervical enters to follow closely guiding die plate, it is characterised in that:
Guiding die plate (1) knee-piece in wave shape shape, its plate face is the profiling binding face in the spinous process region (4) on single-unit cervical vertebra, laminating
On spinous process region (4)；
Dorsal part at guiding die plate (1) binding face is provided with handle (6), the spinous process bump pad of corresponding spinous process region (4), runs through handle
(6) and guiding die plate (1) offers at least one place's limiting through hole (7), movable in limiting through hole (7) spacing tailpin, spacing tail are loaded
The embedding spinous process bump pad that thrusts in the tip of pin, keeps the bonding position of guiding die plate (1) and spinous process region (4) to immobilize；
The pedicle of vertebral arch of corresponding spinous process region (4) both sides, the dorsal part of guiding die plate (1) binding face protrusion (102), boss respectively
On offer hollow approach through hole (101), movable in hollow approach through hole (101) load sleeve (2), sleeve (2) can hollow enter
Road through hole circumferentially relatively rotates in (101), and sleeve (2) head end is concordant with guiding die plate (1) binding face or is positioned at guiding module
Plate (1) is internal, and tail end exposes to guiding die plate (1) dorsal part；
Described sleeve (2) is the sleeve with biocompatibility.
Pedicle Screw Placement in Lower Cervical the most according to claim 1 enters to follow closely guiding die plate, it is characterised in that: described handle (6) in
The "eight" shape of hollow, its root relatively opened is fixed on guiding die plate (1), and the head of relative constriction connects as one,
Junction is corresponding with spinous process bump pad position, and limiting through hole (7) is offered towards guiding die plate (1) from the linkage section of handle (6).
Pedicle Screw Placement in Lower Cervical the most according to claim 1 enters to follow closely guiding die plate, it is characterised in that: described handle (6) in
" T " font, its crosspiece two ends are fixed on guiding die plate (1), are oppositely oriented template (1) evagination, limiting through hole (7) in the middle part of crosspiece
Offer towards guiding die plate (1) from perpendicular section.
Pedicle Screw Placement in Lower Cervical the most according to claim 1 enters to follow closely guiding die plate, it is characterised in that: described sleeve (2) is outward
The most protruding first flange (201) in dew section, when sleeve (2) loads hollow approach through hole (101), the first flange (201) is lived
Dynamic covering exposing on port in hollow approach through hole (101).
Pedicle Screw Placement in Lower Cervical the most according to claim 4 enters to follow closely guiding die plate, it is characterised in that: described sleeve (2) tail
On end, the most protruding second flange (202), forms a ring annular groove between the first flange (201) and the second flange (202)
(203)。
Pedicle Screw Placement in Lower Cervical the most according to claim 1 enters to follow closely guiding die plate, it is characterised in that: described sleeve (2) fills
The diameter ratio entered between load segment external diameter and hollow approach through hole (101) internal diameter of hollow approach through hole (101) is 0.8～1.
Pedicle Screw Placement in Lower Cervical the most according to claim 1 enters to follow closely guiding die plate, it is characterised in that: described guiding die plate
(1) binding face with spinous process region (4) accounts for the 0.5～1 of spinous process region (4) surface.
Pedicle Screw Placement in Lower Cervical the most according to claim 1 enters to follow closely guiding die plate, it is characterised in that: described sleeve (2) is
Medical resin sleeve, titanium alloy sleeve, vitallium sleeve, ceramic material or high molecular polymer material sleeve.
Pedicle Screw Placement in Lower Cervical the most according to claim 1 enters to follow closely guiding die plate, it is characterised in that: described limiting through hole
(7) for being spaced at 1～6 offered.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201620319347.7U CN205831900U (en) | 2016-04-15 | 2016-04-15 | A kind of Pedicle Screw Placement in Lower Cervical enters to follow closely guiding die plate |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201620319347.7U CN205831900U (en) | 2016-04-15 | 2016-04-15 | A kind of Pedicle Screw Placement in Lower Cervical enters to follow closely guiding die plate |
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| Publication Number | Publication Date |
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| CN205831900U true CN205831900U (en) | 2016-12-28 |
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105852956A (en) * | 2016-04-15 | 2016-08-17 | 上海瑞博医疗科技有限公司 | Cervical pedicle screw feeding guiding formwork and preparation method thereof |
| CN107320174A (en) * | 2017-07-03 | 2017-11-07 | 苏州昕健医疗技术有限公司 | The pedicle for cervical vertebra arch guide plate of customization |
| CN107977971A (en) * | 2017-11-09 | 2018-05-01 | 哈尔滨理工大学 | The method of vertebra positioning based on convolutional neural networks |
| CN109247986A (en) * | 2018-11-21 | 2019-01-22 | 南方医科大学珠江医院 | Assist the fixing means and device of the atlantoaxial dislocation of endless all reset |
-
2016
- 2016-04-15 CN CN201620319347.7U patent/CN205831900U/en active Active
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105852956A (en) * | 2016-04-15 | 2016-08-17 | 上海瑞博医疗科技有限公司 | Cervical pedicle screw feeding guiding formwork and preparation method thereof |
| CN107320174A (en) * | 2017-07-03 | 2017-11-07 | 苏州昕健医疗技术有限公司 | The pedicle for cervical vertebra arch guide plate of customization |
| CN107977971A (en) * | 2017-11-09 | 2018-05-01 | 哈尔滨理工大学 | The method of vertebra positioning based on convolutional neural networks |
| CN109247986A (en) * | 2018-11-21 | 2019-01-22 | 南方医科大学珠江医院 | Assist the fixing means and device of the atlantoaxial dislocation of endless all reset |
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