CN206214558U - Particle surface balloon dilatation catheter is used in PKP operations - Google Patents

Abstract

The utility model discloses a kind of PKP operations particle surface balloon dilatation catheter, it includes conduit, sacculus and seal wire, conduit（1）21 29.5cm long, conduit（1）Inner core placement seal wire（3）, seal wire（3）Afterbody have the female adapter of 9 10mm long（4）, female adapter（4）With threaded joint（5）Conduit（1）End connects, conduit（1）Top connection sacculus（2）, conduit（1）End 5cm scopes overstriking to 5mm external diameters, conduit（1）The fine duct of traveling draws the hickey of a 3cm long in 30o directions in the catheter wall communicated with sacculus at the 4cm of end（6）, hickey（6）It is connected with force (forcing) pump in PKP operation bags, standby hydraulic dilatation is used.The utility model simple structure, increase the frictional force and inlay resultant force of artificial bone, the sequential injection PKP early postoperations bone cement of bone cement and artificial bone interface, for all kinds of Thoracolumbar disk compressions of orthopaedics, blow-out fracture PKP Minimally Invasive Surgeries are used, reduce bone cement and the inside and outside displacement risk of centrum occurs.

Description

Particle surface balloon dilatation catheter is used in PKP operations

Technical field

The utility model is related to expander, and in particular to particle surface balloon dilatation catheter is used in a kind of PKP operations.

Background technology

At present, serious Thoracolumbar disk compression, blow-out fracture belong to the common wound of orthopaedics, often betide more serious Falling Injury, friendship Interpreter's event and sufferers of osteoporosis face.Simple vertebral fixity system fixed postcentrum and was internally formed eggshell sample cavity in the past, therefore Often there are the complication such as fixation failure, bone nonunion.The forward and backward approach wound of second operation is larger, high cost.At present, Frequently with pedicle screw systems joint pedicle centrum endoparticle bone grafting treatment thoracolumbar fracture, to reduce fixation failure etc. Complication, but limited by pedicle bone graft passage, it is difficult to accurately reach at centrum cavity, bone grafting amount is limited, and still has broken nail simultaneously Hair disease occurs, and the interior fixed operation risk that takes out is increased, and some patientss broken nail cannot take out.

Thoracolumbar disk osteoporotic compression fracture is clinical common diseases, at present frequently with different pathway vertebroplasties (Percutaneous vertebroplasty, PVP) and balloon kyphoplasty (Percutaneous Kyphoplasty, PKP) treatment, wherein PKP better reductions, more preferably, clinical practice is more extensive for curative effect.But there is bone water Mud still easy to leak, heat production injured nerve blood vessel, may be hindered vertebra stress concentration after treatment and caused injury and vertebra or adjacent section centrum easily fracture and cure Suffer from the larger grade of both sides' X-ray exposure not enough.Have using artificial bone, the sequential injection PKP treatments Thoracolumbar disk osteoporosis of bone cement Property compression fracture, reduce seepage relevant risk, mitigation hinder vertebra stress concentration, alleviate doctor and patient X-ray contact infringement.

In recent years, import balloon expandable, bone cement injection PKP arts treatment osteoporotic compressed fracture of thoracic vertebra and lumber vertebra just by Application is gradually generalized, the technology has the advantages that minimally invasive, rehabilitation is fast, but somewhat expensive（One 40,000 yuan of sacculus）, reset effect owe Ideal, indication is narrow, and late result is imprecise.Having bone cement to penetrate into canalis spinalis to blow-out fracture patient causes severe complication Danger, security is less than vertebral body enhancements such as Bone grafting across transpedicalar.Foreign countries still have using vertebral fixity system joint PKP Art treats compressed fracture of thoracic vertebra and lumber vertebra, then expense is costly（More than 100000）, it is difficult to popularize.Production domesticization PKP arts treatment at present The just gradually popularization and application of osteoporotic compressed fracture of thoracic vertebra and lumber vertebra.Using artificial bone, the sequential injection PKP treatments chest waist of bone cement Vertebra osteoporotic compression fracture, reduces seepage relevant risk, and mitigation is hindered vertebra stress concentration, alleviates doctor and patient X-ray Contact infringement.The technology is expected to rapid popularization, but Intraoperative expansion balloon surface is shiny surface design, to preventing PKP postoperative morning It is smaller that phase artificial bone is broken secondary bone cement translocation.PKP is postoperative hinder vertebra stress concentration cause injury vertebra centrum and neighbouring centrum it is easy Fracture again, have been reported that postoperative more than 2-3 patient injections bone cement block occurs gradually to increase to the complication such as displacement outside centrum.

The content of the invention

The purpose of this utility model is：A kind of PKP operations particle surface balloon dilatation catheter is designed, increases artificial bone, bone Cement injects the frictional force and inlay resultant force of PKP early postoperations bone cement and artificial bone interface by several times, is all kinds of Thoracolumbar disk pressures of orthopaedics Contracting, blow-out fracture PKP Minimally Invasive Surgeries are used, and are reduced bone cement and are occurred to shift risk outside centrum.

Technical solution of the present utility model is：PKP operations include conduit, sacculus with particle surface balloon dilatation catheter And seal wire, conduit 21-29.5cm long, the inner core placement seal wire of conduit, seal wire afterbody has the female adapter of 9-10mm long, interior spiral shell Line joint is connected with the catheter tip of threaded joint, the top of conduit connection sacculus, and the end 5cm scopes overstriking of conduit is extremely 5mm external diameters, the fine duct of traveling draws a 3cm's long in 30o directions in the catheter wall that conduit is communicated at the 4cm of end with sacculus Hickey, hickey is connected with force (forcing) pump in PKP operation bags, and standby hydraulic dilatation is used.

Wherein, conduit overall diameter has 2mm, 2.5mm, 3.0mm specification, the conduit diameter diminution treatment of sacculus portion.

Wherein, the diameter of sacculus is 10mm, 15mm, 20mm specification, apart from the head end 2mm of conduit, wall thickness 0.2- 1mm, bears pressure 5-30atm；There is floating-point particle on surface, and granular size is between 0.2-1.2mm, and grain spacing, particle is swollen Swollen radius 1-3mm.

During operation, local anaesthesia（With reference to Sauteralgyl intramuscular injection）Or take prone position under general anesthesia；Sterilization before using positioning rule according to Preoperative DR P-A Cephalomatrics/CT pieces measurement determines that sagittal plane is hindered vertebra bilateral and punctures entry point position and mark（Connected with posterior superior iliac spine upper limb Line be external object of reference upwards measurement away from hindering vertebra pedicle of vertebral arch window midpoint distance, along spinous process center line to two-sided measurement away from pedicle of vertebral arch outside window Upper quadrant distance selection bone entry point）, spread single after sterilization, 3mm to be opened by skin one 3mm longitudinal incisions are cut with sharp knife, arthroscope is visited After pin is inserted and detects articular process mastoid process processus paramastoideus ditch or crista lambdoidalis position through micro-incision（T12 ribs, L1 transverse process can be visited if necessary Vertebra is hindered in auxiliary confirmation）, puncture needle is placed in detects confirmation position, twist/hammers 3~5mm, and 1~2 positive side position perspective of C arms X-ray machine refers to Lead the accurate selection entry point of fine setting and puncture angle enters pin puncture（Selection is estimated with reference to preoperative CT pieces, DR lateral projections puncture inserting needle Angle, depth, puncture needle needle point is placed in the outer upper limb of pedicle of vertebral, general to use 10 o'clock of left side, 2 o'clock of right side position）, Stop piercing when paracentesis trocar front end reaches hinders before vertebra centrum rear wall 8~10mm at, extraction nook closing member inserts guide pin（Beyond set Pipe 20mm）；Extract paracentesis trocar, along guide pin put working column reaming, make working column front end be located at centrum rear wall front 5~ At 10mm, guide pin is extracted, slowly pierced finely working column is drilled through at up to before centrum 1/4（Deep 20~25mm is preferably limited, is arrived at Anterior margin of vertebral body cortex bone）, fine drilling is taken out, it is put into dilating sacculus to centrum front middle part as far as possible（Perspective is equal to the metal flag of sacculus 2 Beyond sleeve pipe）, compression pump injection contrast agent row balloon expandable（Pressure is typically in the range of between 6~15kpa, and old fracture can be extremely 25kpa）；When sacculus has been expanded up to anterior margin of vertebral body, soleplate or estimated reset effect, stop pressurization, suction out contrast agent, take out ball Capsule, first injects self-curable calcium phosphate/1.0~2ml of internal fixation, and be placed in centrum with this particle surface balloon dilatation catheter Rear portion quadratic extension, 1~3kpa of pressure takes out sacculus, after after artificial bone closely solidification, then by injection-type polymethyl methacrylate It is slowly pushed into centrum through sleeve pipe with PMMA push rod when being adjusted to the wire drawing phase（From front to back）, injection rate connects with balloon expandable volume Closely（2~5ml）, PMMA is in the range of vertebral rim for holding（C arm X-ray machines dynamic penetrating is observed）；In PMMA injections 30min closely The changes of vital signs such as observation blood pressure, correct in time；To slight bursting fracture and old fracture, operating method is identical.

The utility model has the advantages that：Simple structure, easy to operate, spongiosa bone interface in bone cement and artificial bone, centrum It is firmly combined with, is to use in the compression of all kinds of Thoracolumbar disks of orthopaedics, blow-out fracture PKP Minimally Invasive Surgeries, one is applied to fresh Thoracolumbar disk The injured centrum front compression of fracture is collapsed upon within the 2/3 of vertebral height and slight blow-out fracture impassivity compression symptom； Two are applied to old fracture and bone nonunion（Especially old people with osteoporosis）Without regular bed expectant treatment person.

Brief description of the drawings

Fig. 1 is PKP operation particle surface balloon dilatation catheter structural representations.

In figure：1 conduit, 2 sacculus, 3 seal wires, 4 female adapters, 5 nipples, 6 hickeys, 7 particles.

Specific embodiment

As shown in figure 1, PKP operations include conduit 1, sacculus 2 and seal wire 3 with particle surface balloon dilatation catheter, conduit 1 is grown 21-29.5cm, the inner core placement seal wire 3 of conduit 1, the afterbody of seal wire 3 has the female adapter 4 of 9-10mm long, female adapter 4 It is connected with the end of conduit 1 of threaded joint 5, the top of conduit 1 connection sacculus 2, the end 5cm scopes overstriking of conduit 1 to 5mm External diameter, the fine duct of traveling draws the spiral shell of a 3cm long in 30o directions in the catheter wall that conduit 1 is communicated at the 4cm of end with sacculus Line interface 6, hickey 6 is connected with force (forcing) pump in PKP operation bags, and standby hydraulic dilatation is used.

Wherein, the overall diameter of conduit 1 has 2mm, 2.5mm, 3.0mm specification, the conduit diameter diminution treatment of sacculus portion.

Wherein, the diameter of sacculus 2 is 10mm, 15mm, 20mm specification, apart from the head end 2mm of conduit, wall thickness 0.2- 1mm, bears pressure 5-30atm；There is floating-point particle 7 on surface, and the size of particle 7 is between 0.2-1.2mm, the spacing of particle 7, particle 7 expansion radius 1-3mm.

During operation, carry out according to the following steps：

（1）Local anaesthesia（With reference to Sauteralgyl intramuscular injection）Or general anesthesia；

（2）Numeral positioning skin penetrating point, mark；

（3）Sterile drape；

（4）Puncture, the accurate selection entry point of C arms X-ray machine perspective and puncture angle enter pin puncture, extract nook closing member, insert and lead Pin（Beyond sleeve pipe 20mm）；Paracentesis trocar is extracted, working column reaming is put along guide pin, after working column front end is located at centrum At 5~10mm of wall front, guide pin is extracted, slowly pierced finely working column is drilled through at up to before centrum 1/4（Preferably limit deep 20~ 25mm, to arriving at anterior margin of vertebral body cortex bone depth）, take out fine drilling；

（5）As far as possible dilating sacculus are put into centrum front middle part（Perspective to the metal flag of sacculus 2 exceeds sleeve pipe）, compression pump Injection contrast agent row balloon expandable（Pressure is typically in the range of between 6~15kpa, and old fracture can be to 25kpa）；When sacculus has expanded Open during up to anterior margin of vertebral body, soleplate or estimated reset effect, stop pressurization, suction out contrast agent, taking-up sacculus；

（6）Self-curable calcium phosphate/1.0~2ml of internal fixation is first injected, and with this novel particle surface balloon expandable Device is placed in centrum postmedian quadratic extension, and 1~3kpa of pressure can combine perspective and confirm the satisfaction of balloon expandable size；

（7）Balloon dilatation catheter is taken out, when external artificial bone closely solidifies, then by pre-prepd injection-type polymethyl Sour methyl esters is adjusted to be slowly pushed into centrum through sleeve pipe with push rod during the wire drawing phase（From front to back）, injection rate connects with balloon expandable volume Closely（2~5ml）, PMMA is in the range of vertebral rim for holding（C arm X-ray machines dynamic penetrating is observed）, in PMMA injections 30min closely The changes of vital signs such as observation blood pressure, correct in time.

Claims (3)

1. Particle surface balloon dilatation catheter is used in 1.PKP operations, it is characterized in that：It includes conduit（1）, sacculus（2）And seal wire（3）, lead Pipe（1）21-29.5cm long, conduit（1）Inner core placement seal wire（3）, seal wire（3）Afterbody have the female adapter of 9-10mm long （4）, female adapter（4）With threaded joint（5）Conduit（1）End connects, conduit（1）Top connection sacculus（2）, lead Pipe（1）End 5cm scopes overstriking to 5mm external diameters, conduit（1）Traveling in the catheter wall communicated with sacculus at the 4cm of end Fine duct draws the hickey of a 3cm long in 30o directions（6）, hickey（6）It is connected with force (forcing) pump in PKP operation bags, it is standby Hydraulic dilatation is used.
2. 2. particle surface balloon dilatation catheter is used in PKP operations according to claim 1, it is characterized in that：Conduit（1）Overall diameter has 2mm, 2.5mm, 3.0mm specification, the conduit diameter diminution treatment of sacculus portion.
3. 3. particle surface balloon dilatation catheter is used in PKP operations according to claim 1, it is characterized in that：Sacculus（2）Diameter it is big Small is 10mm, 15mm, 20mm specification, apart from the head end 2mm of conduit, wall thickness 0.2-1mm, bears pressure 5-30atm；Surface has floating Point particle（7）, particle（7）Size is between 0.2-1.2mm, particle（7）Spacing, particle（7）Expansion radius 1-3mm.