CN209661772U - A minimally invasive extracutaneous pedicle screw navigation device combined with fluoroscopy - Google Patents

Abstract

The utility model, which belongs to, is related to the field of medical instrument technology, it is related to minimally invasive pedicle screw navigation device outside a kind of skin of combination perspective, the navigation device by N >=3 monomer template group at, lateral Fluoroscopy location needle guide hole is the perforation of horizontal two sides, is respectively arranged on template left side and template right side；Minimally invasive positioning needle guide hole and spinous process positioning needle guide hole may be selected as upper and lower surfaces perforation, be respectively arranged on template upper surface and template lower surface；It is two groups that minimally invasive positioning needle guide hole, which may be selected, is located at spinous process and positions needle guide hole two sides；Longitudinal Fluoroscopy location needle guide hole is front and rear sides perforation, is respectively arranged on the center of template leading flank and template trailing flank.The utility model is fully seated in vitro, assists improving its accuracy by perspective, and template is integral by Kirschner wire connection and improves its stability, appropriate in sagittal plain to be adjusted, and is suitble to different positions；The radiation exposure of medical worker and patient are reduced simultaneously, and there is preferable replicability.

Description

A minimally invasive extracutaneous pedicle screw navigation device combined with fluoroscopy

technical field

The utility model belongs to the technical field of medical instruments, in particular to an extracutaneous minimally invasive pedicle screw navigation device combined with perspective.

Background technique

Thoracolumbar compression and burst fractures are common types of spinal fractures, and the posterior pedicle fixation system is the first choice for dealing with such injuries. Due to the large trauma of traditional open nail placement surgery, the wide range of tissue incision, and the long-term stretching of surrounding tissues during the operation, which affects the postoperative functional recovery of patients, so in recent years, with the development of minimally invasive spinal surgery, through Skin pedicle screw fixation technology has been paid more and more attention. The determination of the pedicle screw entry point and the direction of the screw path during operation is the key to this technology. Pedicle screw placement under continuous fluoroscopy is often required in root surgery, resulting in increased radiation doses for medical staff and patients, which can lead to leukemia and skin cancer for a long time. Although the method of pedicle screw placement with bare hands and limited touch can reduce fluoroscopy, it prolongs time. The operation time is longer, and it is more difficult to meet the consistency of the entry point and direction of the screws on both sides of the same vertebra, which affects the reduction effect.

In addition, the existing individualized templates outside the skin are individually designed based on the external shape of the skin, but the soft tissue of the skin moves a lot and is affected by the receptor position, and is not easy to fix, which obviously affects the accuracy of positioning.

Contents of the invention

In order to solve the above technical problems, the utility model provides an extracutaneous minimally invasive pedicle screw navigation device combined with fluoroscopy, so that the implantation of percutaneous pedicle screws in minimally invasive spinal surgery is accurate, and at the same time reduces the radiation of patients and medical staff .

A kind of extracutaneous minimally invasive pedicle screw navigation device combined with fluoroscopy in the utility model that solves the above technical problems is characterized in that: the navigation device is composed of a single template with N>=3, and the single template There are horizontal fluoroscopy positioning needle guide holes, optional minimally invasive positioning needle guide holes, spinous process positioning needle guide holes and longitudinal fluoroscopy positioning needle guide holes. The horizontal fluoroscopy positioning needle guide holes are horizontally connected on both sides and are respectively located on the left side of the template. and the right side of the template; the minimally invasive positioning needle guide hole and the spinous process positioning needle guide hole can be selected to connect the upper and lower surfaces, and are respectively set on the upper surface of the template and the lower surface of the template; the guide holes of the minimally invasive positioning needle can be selected into two groups , located on both sides of the spinous process positioning needle guide hole; the longitudinal perspective positioning needle guide hole runs through the front and rear sides, and is respectively set at the center of the front side of the template and the back side of the template.

The monomer template is a cuboid.

Two groups of guide holes for the optional minimally invasive positioning needles are located symmetrically on both sides of the spinous process positioning needle guide holes.

The spinous process positioning needle guide holes are divided into two groups, which are staggered and distributed in the center of the upper and lower surfaces of the template.

The number of selectable minimally invasive positioning needle guide holes is >20, preferably the number of selectable minimally invasive positioning needle guide holes=90.

The diameter of the guide hole of the optional minimally invasive positioning pin is 2.1 mm, and the detachable extracutaneous minimally invasive pedicle screw navigation device is designed as a plurality of guide plate devices according to the inclination angle of the guide hole of the optional minimally invasive positioning pin , the inclination angles are 4°, 6°, 8°, 10°, 12° or 14° respectively.

The extracutaneous navigation template in the utility model is a general-purpose template, and various models such as 4°, 6°, 8°, 10°, 12°, 14° and other types of inclination angles of the guide hole of the minimally invasive positioning needle can be selected, which are suitable for absolutely Most thoracolumbar fractures and bone diseases require percutaneous pedicle surgery.

The upper surface of the monomer template is provided with a degree mark.

The single template is 14-16mm thick.

The diameters of the guide holes of the transverse fluoroscopy positioning needle, the spinous process positioning needle and the longitudinal fluoroscopy positioning needle are 2.1 mm.

There is one guide hole for the horizontal fluoroscopy positioning needle, and three guide holes for the longitudinal fluoroscopy positioning needle.

In the utility model, the guide hole of the horizontal perspective positioning needle is used to pass through the horizontal perspective guide needle, the guide hole of the minimally invasive positioning needle can be selected to pass through the positioning guide needle, and the guide hole of the spinous process positioning needle is used to pass through the spinous process perspective positioning needle and the guide hole of the longitudinal perspective positioning pin are used to pass through the longitudinal perspective guide pin, and the longitudinal perspective guide pin connects the single templates to form a whole.

In the utility model, the edge of the monomer template can also be passivated to avoid crushing the skin.

In this utility model, the individualized extracutaneous minimally invasive pedicle screw navigation device combined with perspective assistance solves the problem that the template changes with the movement of the skin through intraoperative perspective-assisted positioning, and also increases the spinous process perspective fixed on the spinous process Position the needle to prevent movement.

The device in the utility model is completely placed outside the body, and its accuracy is improved through fluoroscopy. The single template can be connected as a whole through Kirschner wires to improve its stability, and it can also be properly adjusted on the sagittal position, suitable for different position; at the same time, it reduces the radiation exposure of medical staff and patients, and the bed is also smaller, which has better scalability.

The template in the utility model is a general-purpose navigation template, which is suitable for the vast majority of patients with thoracolumbar fractures and bone diseases who need percutaneous pedicle puncture for surgery. Multiple vertebral pedicles, thus not only reducing trauma to patients.

Description of drawings

Fig. 1 is the structural representation of navigation device in the utility model

Fig. 2 is the schematic diagram of monomer formwork in the utility model

Figure 3 and Figure 4 are schematic diagrams of the combination of the navigation device and the thoracolumbar vertebrae in the utility model

Figure 5 is a schematic diagram of the combination of the positioning guide pin and the thoracolumbar vertebrae in the utility model

The specific marks in the figure are as follows: 1. Horizontal fluoroscopy positioning needle guide hole, 2. Optional minimally invasive positioning needle guide hole 3. Spinous process positioning needle guide hole, 4. Degree mark, 5. Longitudinal fluoroscopy positioning needle guide hole, 6. Monolithic template, 7. Upper and lower surfaces of the template, 8. Front and rear sides of the template, 9. Left and right sides of the template, 10. Kirschner wires, 11. Thoracolumbar vertebrae, 12. Normal vertebral bodies, 13. Affected vertebrae, 14. Skin , 15. Longitudinal fluoroscopy guide pin, 16. Transverse fluoroscopy guide pin, 17. Positioning guide pin

Detailed ways

The utility model is described further below with specific embodiment:

Example 1

An extracutaneous minimally invasive pedicle screw navigation device combined with fluoroscopy. The navigation device is composed of three single templates. Spinous process positioning needle guide hole, degree mark and longitudinal fluoroscopy positioning needle guide hole, horizontal fluoroscopy positioning needle guide hole are horizontally connected on both sides, respectively set on the left side of the template and the right side of the template; minimally invasive positioning needle guide hole can be selected The guide holes of the spinous process positioning needles are connected through the upper and lower surfaces, and are respectively set on the upper surface of the template and the lower surface of the template; two groups of minimally invasive positioning needle guide holes can be selected, located on both sides of the spinous process positioning needle guide holes; longitudinal perspective positioning needles The guide holes run through the front and rear sides, and are respectively arranged at the center positions of the front side of the formwork and the rear side of the formwork.

Horizontal fluoroscopy positioning needle guide hole is used to pass through the horizontal fluoroscopy guide needle, optional minimally invasive positioning needle guide hole is used to pass through the positioning guide needle, spinous process positioning needle guide hole is used to pass through the spinous process fluoroscopy positioning needle and longitudinal fluoroscopy positioning The needle guide hole is used to pass through the longitudinal perspective guide pin, and the longitudinal perspective guide pin connects the single templates into a whole.

The spinous process positioning needle guide holes are divided into two groups, with 9 holes in each group, which are staggered and distributed in the center of the upper and lower surfaces of the template. The number of minimally invasive positioning needle guide holes can be selected to be more than 20, and the thickness of the single template is 14mm, which can reduce the number of fluoroscopy positioning, and can be directly adjusted in different channels, which is more convenient for intraoperative operation.

The diameter of the guide hole of the horizontal fluoroscopy positioning needle, the guide hole of the spinous process positioning needle and the guide hole of the longitudinal fluoroscopy positioning needle is 2.1 mm, which can just pass through a 2 mm diameter Kirschner wire. The spinous process is superficial and low in the pedicle. Can be fixed with Kirschner wires to prevent displacement.

In the utility model, combined with the fluoroscopy-assisted individualized extracutaneous device, the intraoperative fluoroscopy-assisted positioning solves the problem that the template changes with the movement of the skin, and also adds a positioning pin fixed on the spinous process to prevent movement.

The device in the utility model enables accurate placement and easy fixation of the percutaneous tissue, and is completely placed outside the skin. No incision is required during the operation. In addition, the spinous process positioning needle is designed to enhance the positioning effect.

Example 2

An extracutaneous minimally invasive pedicle screw navigation device combined with fluoroscopy. The navigation device is composed of 4 single templates. Spinous process positioning needle guide hole, degree mark and longitudinal fluoroscopy positioning needle guide hole, horizontal fluoroscopy positioning needle guide hole are horizontally connected on both sides, respectively set on the left side of the template and the right side of the template; minimally invasive positioning needle guide hole can be selected The guide holes of the spinous process positioning needles are connected through the upper and lower surfaces, and are respectively set on the upper surface of the template and the lower surface of the template; two groups of minimally invasive positioning needle guide holes can be selected, located on both sides of the spinous process positioning needle guide holes; longitudinal perspective positioning needles The guide holes run through the front and rear sides, and are respectively arranged at the center positions of the front side of the formwork and the rear side of the formwork.

There are two groups of guide holes for minimally invasive positioning needles, and 90 circular holes can be selected for each group, which are symmetrically located on both sides of the guide holes of the spinous process positioning needles; the guide holes for the spinous process positioning needles are two Each group of 9 holes is staggered and distributed in the center of the upper and lower surfaces of the monomer template. The thickness of the template is 14mm, which can reduce the number of fluoroscopy positioning, and can be directly adjusted in different channels, which is more convenient for intraoperative operation.

The diameter of the guide hole of the horizontal fluoroscopy positioning needle, the guide hole of the spinous process positioning needle and the guide hole of the longitudinal fluoroscopy positioning needle is 2.1 mm, which can just pass through a 2 mm diameter Kirschner wire. The spinous process is superficial and low in the pedicle. Can be fixed with Kirschner wires to prevent displacement.

The detachable extracutaneous minimally invasive pedicle screw navigation device is designed as multiple guide plate devices according to the inclination angle of the guide hole of the minimally invasive positioning needle, and the inclination angles are 4°, 6°, 8°, 10°, 12° ° or 14°, which can meet the surgical requirements of different patients with different vertebral bodies, and has generalizability. The degree mark is set on the upper surface of the single template, and the edge of the single template can also be passivated to avoid crushing the skin.

Intraoperative process of the utility model navigation device:

The intraoperative internal fixation was the long-arm single-core pedicle screw system (Beijing Fule Technology Development Co., Ltd., China). After general anesthesia, the patient was placed in a prone position with the abdomen suspended. Use a C-arm X-ray machine to take standard anteroposterior photographs centered on the injured vertebra, and confirm that the spinous process is located at the center of the projection line connecting the left and right pedicles. The body surface marks the injured vertebra and the upper edge of the adjacent craniocaudal vertebral body, the line connecting the spinous processes of each vertebra, and the line connecting the left and right pedicle projections. Multiple Kirschner wires with a diameter of 2mm were selected and inserted into the guide holes of the above-mentioned templates respectively, and a shorter 2mm diameter Kirschner wire was driven into the spinous process and fixed with a surgical adhesive film.

Based on the above-mentioned anteroposterior radiographs, select a roughly suitable guide hole on the monomer template, and then percutaneously drive in a 2mm diameter Kirschner wire to reach the bone, then perform anteroposterior and lateral radiographs, and select the adjacent guide hole according to the X-ray film Adjust and position the Kirschner wire until the inserted Kirschner wire is adjusted to the positive position and reaches the edge of the pedicle projection, and the lateral position is parallel to the upper endplate of the vertebral body (same as the preoperative design), and then continue to drive the Kirschner wire to make it When the needle tip laterally reaches the posterior wall of the vertebral body, it is positioned anteriorly on the medial side of the pedicle projection, and continues to penetrate into the Klinefelter sign to enter the anterior 1/3 of the vertebral body. Insert expansion sleeves and protective sleeves step by step along the positioning Kirschner wires in turn, expand the screw path along the positioning Kirschner wires with a hollow wire tap, and select long-arm single-core pedicle screws of appropriate diameter and length along the positioning Kirschner wires. Screw into the vertebral body, and the length of the screw used for the injured vertebra is slightly shorter. Properly adjust the angle of the operating table, and reset the injured vertebra through posture. Then insert the screw tail cap, properly propel and reset the vertebral body and lock it, break off the screw tail, and the operation is completed.

The above descriptions are only preferred embodiments of the present utility model, and are not intended to limit the present utility model. Any modifications, equivalent replacements and improvements made within the spirit and principles of the present utility model shall be included in this utility model. within the scope of protection of utility models.

Claims (8)

1. An extracutaneous minimally invasive pedicle screw navigation device combined with fluoroscopy, characterized in that: the navigation device is composed of N>=3 monomer templates, and the monomer template (6) is provided with lateral perspective positioning Needle guide hole (1), optional minimally invasive positioning needle guide hole (2), spinous process positioning needle guide hole (3) and longitudinal fluoroscopy positioning needle guide hole (5), horizontal fluoroscopy positioning needle guide hole (1) is horizontal Both sides are connected, respectively set on the left side of the template (9-1) and the right side of the template (9-2); the minimally invasive positioning needle guide hole (2) and the spinous process positioning needle guide hole (3) can be selected as the upper and lower The two surfaces are connected, respectively set on the upper surface of the template (7-1) and the lower surface of the template (7-2); the minimally invasive positioning needle guide hole (2) can be selected into two groups, located at the spinous process positioning needle guide hole (3) Both sides; longitudinal perspective positioning needle guide holes (5) are through the front and rear sides, and are respectively located at the center of the front side of the template (8-1) and the back side of the template (8-2); the spinous process positioning needle guide holes (3) Two groups, staggered and distributed in the center of the upper and lower surfaces of the template; the number of optional minimally invasive positioning needle guide holes (2) = 90. 2. The extracutaneous minimally invasive pedicle screw navigation device combined with fluoroscopy according to claim 1, characterized in that: the single template (6) is a cuboid. 3. A fluoroscopy-integrated extracutaneous minimally invasive pedicle screw navigation device according to claim 1 or 2, characterized in that: the two groups of selectable minimally invasive positioning needle guide holes (2) are symmetrically located on the spinous process Locate both sides of the needle guide hole (3). 4. The extracutaneous minimally invasive pedicle screw navigation device combined with fluoroscopy according to claim 3, characterized in that: the diameter of the optional minimally invasive positioning needle guide hole (2) is 2.1mm, and the inclination angles are respectively 4°, 6°, 8°, 10°, 12° or 14°. 5 . The extracutaneous minimally invasive pedicle screw navigation device combined with fluoroscopy according to claim 1 , characterized in that: the upper surface of the single template ( 6 ) is provided with a degree mark ( 4 ). 6 . The extracutaneous minimally invasive pedicle screw navigation device combined with fluoroscopy according to claim 1 , characterized in that: the thickness of the single template ( 6 ) is 14-16 mm. 7. The extracutaneous minimally invasive pedicle screw navigation device combined with fluoroscopy according to claim 1, characterized in that: the horizontal fluoroscopy positioning needle guide hole (1), the spinous process positioning needle guide hole (3) And the aperture of the longitudinal perspective positioning pin guide hole (5) is 2.1mm. 8. The extracutaneous minimally invasive pedicle screw navigation device combined with fluoroscopy according to claim 1, characterized in that: there is one guide hole (1) for the horizontal fluoroscopy positioning needle, and one longitudinal fluoroscopy positioning needle guide hole (5) is 3.