CN209678652U - Minimally invasive pedicle screw navigation device outside a kind of detachable skin of combination perspective - Google Patents
Minimally invasive pedicle screw navigation device outside a kind of detachable skin of combination perspective Download PDFInfo
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- CN209678652U CN209678652U CN201720937597.1U CN201720937597U CN209678652U CN 209678652 U CN209678652 U CN 209678652U CN 201720937597 U CN201720937597 U CN 201720937597U CN 209678652 U CN209678652 U CN 209678652U
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Abstract
The utility model belongs to the field of medical instrument technology, it is related to minimally invasive pedicle screw navigation device outside a kind of detachable skin of combination perspective, navigation device by N >=3 monomer template group at, monomer template is equipped with left horizontal company and right horizontal company, it is left horizontal to be provided with fixture block, it is right it is horizontal be provided with card slot, make left horizontal company when use in fixture block insertion card slot and right horizontal even form one;Template is additionally provided with lateral Fluoroscopy location needle guide hole, minimally invasive positioning needle guide hole, spinous process positioning needle guide hole and longitudinal Fluoroscopy location needle guide hole may be selected, lateral Fluoroscopy location needle guide hole to pass through laterally perspective guide pin, minimally invasive positioning needle guide hole may be selected longitudinal have an X-rayed guide pin to pass through to pass through spinous process Fluoroscopy location needle and longitudinal Fluoroscopy location needle guide hole to pass through positioning guide pin, spinous process positioning needle guide hole.The utility model is fully seated in vitro, can puncture multiple centrum nuts simultaneously, thus can not only reduce the wound of patient, can also reduce the radiation exposure of medical worker and patient.
Description
Technical field
The utility model belongs to minimally invasive vertebra outside the detachable skin of the field of medical instrument technology more particularly to a kind of combination perspective
Pedicle screw navigation device.
Background technique
Thoracolumbar disk vertebral compression and blow-out fracture are the common types of spine fracture, the fixed system in posterior Pedicle
System is the preferred measure for handling such damage.Because conventional open is set, tack operation wound is larger, tissue dissection range is relatively wide, operation
In can to surrounding tissue for a long time pull, and influence patient's postoperative function recovery, so recently as vertebral column minimally invasive surgery
Development, percutaneous cervical arc root screw technique for fixing are paid more and more attention, the determination of pedicle screw entry point and screw way direction in art
It is the key that this technology, but Thoracolumbar disk anatomical structure is more complicated and variation is big, in conventional percutaneous cervical arc root operation often
Underlying nail need to be continuously had an X-rayed, medical worker and patient radiation dose is caused to increase, will lead to leukaemia and cutaneum carcinoma for a long time
Occur, though the pedicle of vertebral arch of unarmed limited touch sets nail method and can reduce perspective, extends operating time, and be harder to meet same
The consistency of centrum bilateral Screw entrance point and direction, influences reset effect.
In addition the outer individuation template of the skin that currently exists, be using skin outside form as template Individual design,
But skin soft tissue activity is big, and receptor site etc. influences, and does not allow to be fixed easily, hence it is evident that influences the accuracy of positioning.
Summary of the invention
In order to solve the above-mentioned technical problem, the utility model provides minimally invasive pedicle of vertebral arch outside a kind of detachable skin of combination perspective
Screw navigation device makes in minimally invasive spine surgical percutaneous cervical arc root screw implantation accurate, while reducing patient and medical staff
Radiation.
It solves one of the utility model of the above technical problem and combines minimally invasive pedicle of vertebral arch screw outside the detachable skin of perspective
Follow closely guide plate arrangement, it is characterised in that: the navigation device is by N >=3 monomer template group at the monomer template is equipped with left horizontal company
With right horizontal company, left horizontal even one end is equipped with fixture block, it is right it is horizontal be even equipped with card slot in one end, fixture block, which is inserted into card slot, when use makes left horizontal company
With right horizontal even formation one;Guide plate is additionally provided with that lateral Fluoroscopy location needle guide hole, that minimally invasive positioning needle guide hole, spinous process may be selected is fixed
Position needle guide hole and longitudinal Fluoroscopy location needle guide hole, lateral Fluoroscopy location needle guide hole to pass through laterally perspective guide pin, can
Select minimally invasive positioning needle guide hole to pass through positioning guide pin, spinous process positioning needle guide hole to pass through spinous process Fluoroscopy location needle and
Longitudinal Fluoroscopy location needle guide hole is to pass through longitudinal perspective guide pin.
Lateral Fluoroscopy location needle guide hole is the perforation of horizontal two sides in prioritization scheme in the utility model, is respectively arranged on a left side
Horizontal even side and right horizontal even side;Minimally invasive positioning needle guide hole may be selected as upper and lower surfaces perforation, two groups, be located at left cross
Even and right horizontal connect on lower surface;Longitudinal Fluoroscopy location needle guide hole is front and rear sides perforation, before being located at left horizontal company and right horizontal company
On trailing flank;It is that upper and lower surfaces penetrate through that spinous process, which positions needle guide hole, two groups, one group positioned at it is left it is horizontal connect lower surface, another group
Positioned at fixture block upper and lower surface and right horizontal connect on the corresponding position in lower surface.
It is described may be selected minimally invasive two groups of positioning needle guide hole be symmetrically positioned in spinous process positioning needle guide hole two sides, spinous process pilot pin
Pilot hole is staggered parallelly distribute on, positioned at the center of guide plate upper and lower surface.
The quantity that minimally invasive positioning needle guide hole may be selected >=20, the quantity of minimally invasive positioning needle guide hole preferably may be selected
=90。
It is described that minimally invasive positioning needle guide hole diameter may be selected as 2.1mm, 2mm Kirschner wire can just be passed through, it is described
Minimally invasive pedicle screw navigation device is set according to the difference that minimally invasive positioning needle guide hole inclined angle may be selected outside detachable skin
Meter becomes multiple guide plate arrangements, and inclined angle is respectively 4 °, 6 °, 8 °, 10 °, 12 ° or 14 °.
The outer navigation template of skin in the utility model is universal template, and minimally invasive positioning needle guide hole inclined angle may be selected
There are the Multiple Types such as 4 °, 6 °, 8 °, 10 °, 12 °, 14 °, needs percutaneous puncture vertebra suitable for most thoracolumbar fractures, osteopathy
Nut implements the patient of operation.
The left horizontal company and the right horizontal surface that connects are respectively equipped with degree mark, and the navigation to indicate different inclined angles fills
It sets.
The guide plate thickness 14-16mm.
The aperture of the transverse direction Fluoroscopy location needle guide hole, spinous process positioning needle guide hole and longitudinal Fluoroscopy location needle guide hole
For 2.1mm.
The guide plate is cuboid.
The transverse direction Fluoroscopy location needle guide hole is 1, and longitudinal Fluoroscopy location needle guide hole is 3.
In the utility model template edge can also Passivation Treatment, to avoid skin is weighed wounded.
Template in the utility model is fully seated in vitro, assists improving its accuracy by perspective, template can lead to
It crosses various kinds Kirschner wire (pilot pin) connection and is integral its stability of raising, appropriate in sagittal plain can also be adjusted,
It is suitble to different positions;While the radiation exposure of medical worker and patient are reduced, also smaller on bed, having can preferably promote
Property.
Minimally invasive positioning needle guide hole may be selected described in the utility model and form inside tilt angle, to guarantee pedicle of vertebral arch
Screw being capable of introversion implantation.Because guide pin has an inside tilt angle after placing, if being integrally formed, it is not easy to take out
Guide plate arrangement.The utility model forms detachable, avoids after guide pin is placed and is not easy the problem of taking out, increases operational
Convenience;Independent navigation template is designed to the device of an entirety again, reduces the possibility that detachable navigation template teetertotters
Property, avoid the problem that screw into angle bad assurance when following closely, increases success rate in art.
Minimally invasive pedicle screw navigation device outside the individuation skin of perspective auxiliary is combined in the utility model, by saturating in art
Depending on auxiliary positioning, solve the problems, such as that template changes with skin is mobile, in addition also increase be fixed on spinous process spinous process perspective it is fixed
Position needle, prevents from moving.
Device in the utility model is fully seated in vitro, assists improving its accuracy by perspective, monomer template can
Its stability is improved to be integral by Kirschner wire connection, appropriate in sagittal plain can also be adjusted, be suitble to difference
Position;The radiation exposure of medical worker and patient are reduced simultaneously, and wound is also smaller, has preferable replicability.
Monomer template in the utility model is universal navigation template, is suitable for most thoracolumbar fractures, osteopathy
Percutaneous puncture pedicle of vertebral arch is needed to implement the patient of operation, the present apparatus guarantees the accurate of puncture by the way that X-ray examination is auxiliary, can wear simultaneously
Multiple centrum nuts are pierced, thus can not only reduce the wound of patient.
Detailed description of the invention
Fig. 1 is the structural schematic diagram of navigation device in the utility model
Fig. 2 is monomer template schematic diagram in the utility model
Fig. 3 and Fig. 4 is the combination schematic diagram of navigation device and Thoracolumbar disk bone in the utility model
Fig. 5 is the combination schematic diagram that guide pin and Thoracolumbar disk bone are positioned in the utility model
Wherein in figure be specifically identified it is as follows: 1. lateral Fluoroscopy location needle guide holes, 2., which may be selected minimally invasive pilot pin, leads
Needle guide hole is positioned to 3. spinous process of hole, 4, degree mark, 5. longitudinal Fluoroscopy location needle guide holes, 6. templates, above and below 7. templates
Surface, 8. template front and back sides, the left horizontal even side 9-1., the right horizontal even side 9-2., 10. left horizontal companies, 11. right horizontal companies, 12.
Fixture block, 13. card slots, 14. skins, 15. longitudinal perspective guide pins, 16. laterally have an X-rayed guide pin, 17. positioning guide pins, 18. spinous process perspective
Pilot pin, 19. normal vertebral bodies, 20. suffer from vertebra, 21. Thoracolumbar disk bones
Specific embodiment
The utility model is further described with specific embodiment below:
Embodiment 1
Minimally invasive pedicle screw navigation device outside a kind of detachable skin of combination perspective, navigation device by N=3 loose pattern
Board group is at monomer template is equipped with left horizontal company and right horizontal company, and left horizontal even one end is equipped with fixture block, is equipped with card slot in right horizontal even one end, makes
Make left horizontal company and right horizontal even formation one in used time fixture block insertion card slot;Guide plate is additionally provided with lateral Fluoroscopy location needle guide hole, can
Minimally invasive positioning needle guide hole, spinous process positioning needle guide hole and longitudinal Fluoroscopy location needle guide hole, lateral Fluoroscopy location needle is selected to lead
To hole to pass through lateral perspective guide pin, minimally invasive positioning needle guide hole may be selected to lead across positioning guide pin, spinous process pilot pin
To hole to pass through spinous process Fluoroscopy location needle and longitudinal Fluoroscopy location needle guide hole to pass through longitudinal perspective guide pin.
Lateral Fluoroscopy location needle guide hole is the perforation of horizontal two sides, is respectively arranged on left horizontal even side and right horizontal even side;It can
It selects minimally invasive positioning needle guide hole for upper and lower surfaces perforation, two groups, is located at left horizontal company and right horizontal connects on lower surface;It is vertical
It is front and rear sides perforation to Fluoroscopy location needle guide hole, is located in left horizontal company and right horizontal even front and back sides;Spinous process pilot pin guiding
Hole is upper and lower surfaces perforation, two groups, one group be located at it is left it is horizontal connect lower surface, another group is located at fixture block upper and lower surface and right horizontal company
Spinous process Fluoroscopy location needle is inserted on the corresponding position of upper and lower surface, when use with fixed and connect left horizontal company and right horizontal company.
It may be selected minimally invasive two groups of positioning needle guide hole and be symmetrically positioned in spinous process positioning needle guide hole two sides, spinous process pilot pin guiding
Hole is staggered parallelly distribute on, positioned at the center of guide plate upper and lower surface.
It is 2.1mm that minimally invasive positioning needle guide hole diameter, which may be selected, can just pass through 2mm Kirschner wire, the disassembly
Minimally invasive pedicle screw navigation device is designed to according to the difference that minimally invasive positioning needle guide hole inclined angle may be selected outside formula skin
For multiple guide plate arrangements, inclined angle is respectively 4 °, 6 °, 8 °, 10 °, 12 ° or 14 °.
The outer navigation template of skin is universal template (non-individualsization design), can satisfy the operation of different centrum difference patients
It is required that having generalization.
Quantity 60 of minimally invasive positioning needle guide hole may be selected.
The preoperative inclined angle that required operated level centrum pedicle of vertebral arch is measured by CT individuation, selects corresponding introversion degree
Skin outer guide plate directly adjusted in different ducts, in art in the case where keeping inclined angle constant more convenient for being grasped in art
Make.Minimally invasive positioning needle guide hole, spinous process positioning needle guide hole and longitudinal Fluoroscopy location may be selected in lateral Fluoroscopy location needle guide hole
The aperture of needle guide hole is 2.1mm, fits in through 2mm diameter Kirschner wire.Spinous process table is shallow, in pedicle of vertebral arch low level.Spine can be used
Prominent Fluoroscopy location needle fixation avoids shifting.Guide plate thickness 14-16mm, facilitates operation.
Embodiment 2
Minimally invasive pedicle screw navigation device outside a kind of detachable skin of combination perspective, navigation device by N=4 loose pattern
Board group is at monomer template is equipped with left horizontal company and right horizontal company, and left horizontal even one end is equipped with fixture block, is equipped with card slot in right horizontal even one end, makes
Make left horizontal company and right horizontal even formation one in used time fixture block insertion card slot;Guide plate is additionally provided with lateral Fluoroscopy location needle guide hole, can
Minimally invasive positioning needle guide hole, spinous process positioning needle guide hole and longitudinal Fluoroscopy location needle guide hole, lateral Fluoroscopy location needle is selected to lead
To hole to pass through lateral perspective guide pin, minimally invasive positioning needle guide hole may be selected to lead across positioning guide pin, spinous process pilot pin
To hole to pass through spinous process Fluoroscopy location needle and longitudinal Fluoroscopy location needle guide hole to pass through longitudinal perspective guide pin.
Lateral Fluoroscopy location needle guide hole is the perforation of horizontal two sides, is respectively arranged on left horizontal even side and right horizontal even side;It can
It selects minimally invasive positioning needle guide hole for upper and lower surfaces perforation, two groups, is located at left horizontal company and right horizontal connects on lower surface;It is vertical
It is front and rear sides perforation to Fluoroscopy location needle guide hole, is located in left horizontal company and right horizontal even front and back sides;Spinous process pilot pin guiding
Hole is upper and lower surfaces perforation, two groups, one group be located at it is left it is horizontal connect lower surface, another group is located at fixture block upper and lower surface and right horizontal company
Spinous process Fluoroscopy location needle is inserted on the corresponding position of upper and lower surface, when use with fixed and connect left horizontal company and right horizontal company.
May be selected it is minimally invasive positioning needle guide hole quantity=90, two groups 180, it is preoperative by CT individuation measure needed for
The inclined angle of operated level centrum pedicle screw selects the outer guide plate of the skin of corresponding degree, is keeping inclined angle not in art
In the case where change, directly adjusted in different ducts, more convenient for being operated in art.The outer navigation template of skin is that universal template is (non-
Individual design), it is 2.1mm that minimally invasive positioning needle guide hole diameter, which may be selected, can just pass through 2mm Kirschner wire, described
Minimally invasive pedicle screw navigation device is set according to the difference that minimally invasive positioning needle guide hole inclined angle may be selected outside detachable skin
Meter becomes multiple guide plate arrangements, and inclined angle is respectively 4 °, 6 °, 8 °, 10 °, 12 ° or 14 °, can satisfy different centrum differences and suffers from
The operation requirement of person, has generalization.
Lateral Fluoroscopy location needle guide hole is 1, and longitudinal Fluoroscopy location needle guide hole is 3, and spinous process positions needle guide hole
18, it is divided to two groups, every group 9, two groups of parallelly distribute ons that are staggered, positioned at the center of guide plate upper and lower surface.
The aperture of lateral Fluoroscopy location needle guide hole, spinous process positioning needle guide hole and longitudinal Fluoroscopy location needle guide hole is
2.1mm fits in through 2mm diameter Kirschner wire.Spinous process table is shallow, in pedicle of vertebral arch low level.It can be fixed with spinous process Fluoroscopy location needle
It avoids shifting.
Template upper surface be equipped with instruction block, and template edge can also Passivation Treatment, to avoid skin is weighed wounded.
Minimally invasive pedicle screw navigation device outside the detachable skin of perspective is combined in the utility model, it is auxiliary by fluoroscopy during operation
Positioning is helped, solves the problems, such as that template changes with skin is mobile, in addition also increases the pilot pin for being fixed on spinous process, prevent from moving
It is dynamic.
Device in the utility model makes percutaneously accurately to place and easily fix, and device is disposed entirely within outside skin, in art
When do not need notch placement, in addition design spinous process pilot pin reinforce locating effect.
Minimally invasive positioning needle guide hole may be selected described in the utility model and form inside tilt angle, to guarantee pedicle of vertebral arch
Screw being capable of introversion implantation.Because guide pin has an inside tilt angle, if being integrally formed, it is not easy to take out guide plate.
The utility model shape be designed to it is detachable, avoid be not easy take out guide plate the problem of, increase operational convenience;Again
Independent navigation template is designed to the device of an entirety, a possibility that detachable navigation template teetertotters is reduced, avoids spiral shell
The problem of following closely assurance bad into angle when following closely, increases success rate in art.
Process of the utility model navigation device in art:
Interior fixation is long-armed single pedicle screw system in art, and patient takes the prone position of hanging abdomen after general anesthesia.Make
Piece is taken the photograph as center standard normotopia with C-arm X-ray machine to hurt vertebra, confirmation spinous process is located at the centre bit of left and right sides pedicle of vertebral arch projection join line
It sets.Body surface marking hurts the line of vertebra and the adjacent upper limb of pleurocentrum end to end, the line of each centrum spinous process and the projection of left and right sides pedicle of vertebral arch.
It selects more pieces of diameter 2mm Kirschner wire to respectively penetrate in the Fluoroscopy location needle guide hole of above-mentioned each template, is placed by above-mentioned body surface symbol
Skin outer guide plate arrangement after X-ray examination confirmation, is driven into spinous process with shorter diameter 2mm Kirschner wire and is consolidated with sticky pad pasting of performing the operation
It is fixed.
By above-mentioned normotopia take the photograph piece on the basis of substantially suitable pilot hole is selected in template, be percutaneously successively driven into diameter 2mm
After Kirschner wire reaches sclerotin, piece is taken the photograph in row positive side position, pilot hole adjustment positioning Kirschner wire is closed on according to X-ray film selection, until being driven into
Kirschner wire be adjusted to normotopia and reach pedicle of vertebral arch projecting edge, it is parallel (identical as Design) that side position and centrum go up soleplate, after
Continuous to be driven into Kirschner wire, when its needlepoint side position being made to reach centrum rear wall, normotopia is located at pedicle of vertebral arch projection inside, continues to be driven into kernig sign
1/3 before into centrum.It is successively put into expansion sleeve and protection sleeve step by step along positioning Kirschner wire, with hollow screw tap along positioning kirschner
Needle expands screw way, and suitable diameter and the long-armed single pedicle screw of length is selected to be screwed into centrum along positioning Kirschner wire, hurts vertebra choosing
Screw length is slightly shorter.The angle of appropriate adjustment operating bed hurts vertebra etc. by Postural reduction.It is placed in screw tail cap again, suitably
Distraction reduction centrum is simultaneously locked, and is fractureed and is followed closely tail, and art finishes.
The above is only the preferred embodiment of the utility model only, is not intended to limit the utility model, all at this
Made any modifications, equivalent replacements, and improvements etc., should be included in the utility model within the spirit and principle of utility model
Protection scope within.
Claims (7)
1. minimally invasive pedicle screw navigation device outside a kind of detachable skin of combination perspective, including stencil body, it is characterised in that:
The navigation device by N >=3 monomer template group at, the monomer template (6) is equipped with left horizontal company (10) and right horizontal company (11),
Even one end is equipped with fixture block (12) for left horizontal company (10), is equipped with card slot (13) in right horizontal company (11) one end, fixture block (12) insertion when use
Left horizontal company (10) and right horizontal company (11) is set to form one in card slot (13);Template (6) is additionally provided with lateral Fluoroscopy location needle guide hole
(1), minimally invasive positioning needle guide hole (2), spinous process positioning needle guide hole (3) and longitudinal Fluoroscopy location needle guide hole (5) may be selected, it is horizontal
To Fluoroscopy location needle guide hole (1) to pass through lateral perspective guide pin (16), minimally invasive positioning needle guide hole (2) may be selected to wear
Positioning guide pin (17), spinous process positioning needle guide hole (3) are crossed to pass through spinous process Fluoroscopy location needle (18) and longitudinal Fluoroscopy location needle
Pilot hole (5) is to pass through longitudinal perspective guide pin (15);Quantity=90 that minimally invasive positioning needle guide hole (2) may be selected;Institute
State may be selected (2) two groups of minimally invasive positioning needle guide hole be symmetrically positioned in spinous process positioning needle guide hole (3) two sides, the spinous process pilot pin
Pilot hole (3) is staggered parallelly distribute on, and spinous process positions needle guide hole 18, is divided to two groups, every group 9;The template (6) is rectangular
Body.
2. minimally invasive pedicle screw navigation device outside a kind of detachable skin of combination perspective according to claim 1, special
Sign is: the transverse direction Fluoroscopy location needle guide hole (1) is the perforation of horizontal two sides, is respectively arranged on left horizontal even side (9-1) and right
It is horizontal to connect side (9-2);Minimally invasive positioning needle guide hole (2) may be selected as upper and lower surfaces perforation, be equipped with two groups, be located at left cross
Even on (10) and right horizontal company (11) upper and lower surface (7);Longitudinal Fluoroscopy location needle guide hole (5) is front and rear sides perforation, is located at a left side
On horizontal company (10) and right horizontal company (11) front and back sides (8);Spinous process positions needle guide hole (3) as upper and lower surfaces perforation, is equipped with two
Group, one group is located at left horizontal company (10) upper and lower surface, and another group is located at fixture block (12) upper and lower surface and right horizontal company (11) upper and lower surface
On corresponding position.
3. minimally invasive pedicle screw navigation device outside a kind of detachable skin of combination perspective according to claim 2, special
Sign is: described minimally invasive positioning needle guide hole (2) diameter may be selected is 2.1mm, minimally invasive pedicle of vertebral arch screw outside the detachable skin
Nail navigation device is configured to multiple guide plate arrangements according to the difference that minimally invasive positioning needle guide hole (2) inclined angle may be selected,
Inclined angle is respectively 4 °, 6 °, 8 °, 10 °, 12 ° or 14 °.
4. minimally invasive pedicle screw navigation device outside a kind of detachable skin of combination perspective according to claim 1, special
Sign is: the left horizontal company (10) and right horizontal company (11) upper surface are respectively equipped with degree mark (4).
5. minimally invasive pedicle screw navigation device outside a kind of detachable skin of combination perspective according to claim 1, special
Sign is: template (6) the thickness 14-16mm.
6. minimally invasive pedicle screw navigation device outside a kind of detachable skin of combination perspective according to claim 1, special
Sign is: the transverse direction Fluoroscopy location needle guide hole (1), spinous process positioning needle guide hole (3) and longitudinal Fluoroscopy location needle guide hole
(5) aperture is 2.1mm.
7. minimally invasive pedicle screw navigation device outside a kind of detachable skin of combination perspective according to claim 1, special
Sign is: the transverse direction Fluoroscopy location needle guide hole (1) is 1, and longitudinal Fluoroscopy location needle guide hole (5) is 3.
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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CN111529038A (en) * | 2020-04-16 | 2020-08-14 | 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 | Split type guide plate for spinal surgery |
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2017
- 2017-07-31 CN CN201720937597.1U patent/CN209678652U/en active Active
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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CN111529038A (en) * | 2020-04-16 | 2020-08-14 | 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 | Split type guide plate for spinal surgery |
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Effective date of registration: 20210312 Address after: No.19, tamulin street, Ziliujing District, Zigong City, Sichuan Province Patentee after: ZIGONG FOURTH PEOPLE'S HOSPITAL (ZIGONG EMERGENCY CENTER) Address before: 643000 No.2, tamulin street, Ziliujing District, Zigong City, Sichuan Province Patentee before: ZIGONG NO.4 PEOPLE'S Hospital Patentee before: Wu Chao |