CN211985710U - Positioner used before and during thoracolumbar surgery - Google Patents

Abstract

The utility model relates to a positioner before chest lumbar vertebrae operation art, in the art, including the locating plate, still include: the spinous process positioning line is arranged along the central axis of the positioning plate, and two ends of the spinous process positioning line are fixedly connected with the positioning plate respectively; the longitudinal positioning lines are symmetrically distributed on two sides of the spinous process positioning line and are parallel to the spinous process positioning line; the positioning rod comprises a main rod and positioning wings vertically arranged at two ends of the main rod, and the main rod is rotatably embedded on the positioning plate; the transverse positioning lines are distributed on two sides of the main rod at equal intervals and are parallel to the main rod; and the positioning mark comprises a plurality of sliding positioning marks which are respectively arranged on the transverse positioning line between the longitudinal positioning line and the spinous process positioning line in a sliding manner, and a plurality of fixed positioning marks which are respectively arranged on the transverse positioning line between the longitudinal positioning line and the longitudinal frame in a fixed manner. The utility model discloses can be simultaneously to patient's pathological change segment section, pedicle of vertebral arch body surface projection and intervertebral disc, pedicle of vertebral arch side position orientation, improve the accuracy nature of location and practice thrift positioning time before the art and in the art.

Description

Positioner used before and during thoracolumbar surgery

Technical Field

The utility model belongs to the technical field of medical equipment, especially, relate to a positioner before chest lumbar vertebrae operation art, in the art can be before the art, position, the direction of locating position nail and decompression passageway in the art.

Background

With the progress of the aging of China's society and the change of the life style of Chinese people, the incidence of thoracolumbar related diseases is high and tends to be young, which becomes a persistent disease seriously affecting the labor capacity of human beings, and the thoracolumbar related diseases are still treated by surgery at present. In recent years, the development of related surgical techniques is rapid, and the intervertebral disc mirror, the intervertebral foramen mirror and the minimally invasive fusion technique are favored by operators and patients due to the advantages of minimally invasive and accurate technology, less bleeding during operation, quick recovery after operation and the like, and will become the development trend of future spinal surgery.

However, the application of these techniques often requires an accurate preoperative and intraoperative positioning and identification to ensure the smooth operation and save the operation time. Inaccurate positioning before and during surgery may result in missed and mis-cuts, prolonged surgery time, increased damage to normal tissue structures and increased risk of re-surgery. Accurate positioning has a significant impact on the success rate of minimally invasive spinal surgery. The minimally invasive spine surgery accurate positioning mark comprises the positioning of lesion segments, the vertebral pedicle body surface projection and the lateral position direction of intervertebral discs and vertebral pedicles, so that an operator can more smoothly and accurately complete the placement of a decompression fusion channel and the placement of vertebral pedicle screws. After the X-ray perspective positioning mark is finished, a small incision is adopted through the mark point, a decompression fusion channel and a pedicle screw which are expanded step by step are placed along the mark direction, the decompression fusion channel reaches the pathological intervertebral disc, and various minimally invasive instruments are used for finishing the whole operation.

At present, simple positioners such as a Kirschner wire, metal articles, a positioning plate and the like are clinically used for positioning, and a lesion segment, a vertebral pedicle body surface projection and a side position direction of an intervertebral disc and a vertebral pedicle cannot be quickly and accurately positioned. The minimally invasive spine surgery positioner needs to be capable of providing fast and accurate positioning before surgery, the positioner applied clinically at present can only obtain the pathological change segment and the pedicle body surface orthographic projection during the first perspective, and often needs to perform multiple perspectives to accurately position the orthographic and side wall body surface marks, although the positioner with a plurality of marks exists at present, the marks of the positioner cannot move, and therefore the target position (such as the very small pedicle projection) cannot be accurately calibrated when the marker pen is adopted for marking. In addition, for positioning of the intervertebral disc and the lateral direction of the vertebral pedicle, the direction is often required to be adjusted according to the experience of an operator or X-ray multiple fluoroscopy during the operation, the operation time is increased, the soft tissue injury of a patient is increased due to the multiple adjustment of the C-shaped arm, the operation channel and the internal fixing direction, and the operator and the patient are exposed to X-ray irradiation for multiple times. In summary, a positioner capable of obtaining accurate positioning marks (lesion segments, pedicle body surface projections and intervertebral disc and pedicle side position directions) through front side perspective during preoperative primary positioning is particularly important, preoperative positioning and intraoperative time can be shortened, pain of patients and operators is relieved, and complication incidence rate is reduced.

Through relevant literature and thoracolumbar anatomical analysis, we find that there is a certain rule in the space between the thoracolumbar vertebral bodies and the intervertebral discs. However, the height and shape of the vertebral body of a patient are greatly different due to the height and development condition of the patient, and the height and shape of the upper thoracic vertebra, the lower thoracic vertebra and the lumbar vertebra of the same patient are also obviously different, so that the adjustable positioner has higher requirement.

Through literature search, the heights of the thoracolumbar vertebral bodies of men are 20.43 +/-0.14 mm and 25.92 +/-0.16 mm respectively, and the heights of women are 20.08 +/-0.18 mm and 25.46 +/-0.18 mm respectively. The transverse diameter of the male is 32.49 +/-0.21 mm and 47.60 +/-0.28 mm respectively; the female is 32.14 mm plus or minus 0.28mm and 46.27 mm plus or minus 0.43mm respectively; gender differences were not statistically significant. Other relevant spine anatomy studies show that the height of the thoracic vertebrae and the width of the vertebral pedicle are gradually increased from the chest 1 to the chest 12 and from the chest 12 to the waist 5, so that the height of the upper and lower thoracic vertebrae and the thoracic and lumbar vertebrae and the transverse diameter of the vertebral pedicle are obviously different. The minimum pedicle height is 15.4mm (L3 mean) in lumbar spine, and L5 reaches the maximum, and can reach 22.7mm (L5 mean). The average anterior-posterior diameter, the upper-inferior meridian and the length of the thoracic vertebra foramen are respectively 9.51 +/-1.61, 15.08 +/-2.24 and 4.62 +/-1.03, and the average anterior-posterior diameter, the upper-inferior meridian and the length of the lumbar vertebra foramen are respectively 10.89 +/-1.20, 24.75 +/-2.24 and 8.68 +/-1.58. These all provide the reference basis of considerable value for the design and development of the positioner before and during the thoracolumbar surgery.

Therefore, based on the problems, the positioner before and during the thoracolumbar surgery is provided, which can simultaneously improve the accuracy of preoperative and intraoperative positioning and save the positioning time for the pathological change section, the pedicle body surface projection and the intervertebral disc and pedicle lateral position direction of a patient, and has important practical significance.

SUMMERY OF THE UTILITY MODEL

The utility model discloses a solve the problem that exists among the above-mentioned prior art, provide one kind can be simultaneously to patient's pathological change segment section, pedicle of vertebral arch body surface projection and intervertebral disc, pedicle of vertebral arch side position orientation, improve the accuracy nature of location and before the chest lumbar vertebrae operation preoperative, positioner in the art of practicing thrift positioning time before the art.

The utility model discloses a solve the technical scheme who takes of this problem and be:

the utility model provides a locator before chest lumbar vertebrae operation art, in art, is including being used for fixing a position chest lumbar vertebrae pathological change segment and the projected locating plate of pedicle of vertebral arch body surface normal position, the locating plate encloses the closed frame structure who establishes and form by two vertical frames, two horizontal frames, still includes:

the spinous process positioning line is superposed with the spinous process in actual operation, is used for positioning the position of the spinous process and the placement position of the positioner, is arranged along the central axis of the positioning plate, and is fixedly connected with the positioning plate at two ends respectively;

at least two longitudinal positioning lines are respectively and symmetrically distributed on two sides of the spinous process positioning line and are parallel to the spinous process positioning line, and two ends of the longitudinal positioning lines are respectively and fixedly connected with the positioning plate; preferably two longitudinal alignment lines

The positioning rod is used for positioning the lateral direction of the intervertebral disc and the vertebral pedicle, can position the lateral direction of the pathological intervertebral disc and the adjacent vertebral pedicle by rotation, comprises a main rod and positioning wings vertically arranged at two ends of the main rod, and the main rod is rotatably embedded on the positioning plate and is mutually vertical to the spinous process positioning line;

the number of the transverse positioning lines is 11-15, the transverse positioning lines are respectively distributed on two sides of the main rod at equal intervals and are parallel to the main rod, and two ends of the transverse positioning lines are respectively fixedly connected with the positioning plates; preferably 13 transverse positioning lines, wherein 6 transverse positioning lines are positioned at one side of the main rod, and 7 transverse positioning lines are positioned at the other side of the main rod;

and the positioning mark comprises a plurality of sliding positioning marks which are respectively arranged on the transverse positioning line between the longitudinal positioning line and the spinous process positioning line in a sliding manner, and a plurality of fixed positioning marks which are respectively arranged on the transverse positioning line between the longitudinal positioning line and the longitudinal frame in a fixed manner. The sliding positioning mark can transversely slide through the transverse positioning line to accurately position the projections of the pedicles and the intervertebral foramen on the body surface at two sides, and the fixed positioning mark can be used for positioning the upper side, the lower side, the left side, the right side and the left side.

Further preferably, the positioning plate is of a rectangular frame structure, the four corner ends of the positioning plate are of smooth arc structures, the positioning plate, the transverse positioning line, the longitudinal positioning line, the spinous process positioning line and the positioning mark are all made of soft high polymer materials which can be developed by X-rays or made of soft metal materials, the length of the longitudinal frame is 100-200mm, the preferred length is 150mm, the width of the transverse frame is 100-110mm, the preferred width is 106mm, wherein the soft metal can be but is not limited to metal aluminum, has good plasticity, can be better attached to the skin, and is convenient for closely attaching to the physiological radian of the thoracolumbar vertebra part of the back of a human body.

Further preferably, the transverse positioning lines and the longitudinal positioning lines are vertically distributed in a staggered manner, the spinous process positioning lines are arranged along the long axis of the positioning plate, the transverse positioning lines are distributed along the long axis of the positioning plate, the distance between two transverse positioning lines positioned at two sides of the positioning plate is 16mm-24mm, preferably 20mm, the distance between the other two adjacent transverse positioning lines is 8mm-12mm, preferably 10mm, and the length of each transverse positioning line is 100mm-110mm, preferably 106 mm. The number of the longitudinal positioning lines is preferably two, the distance between the longitudinal positioning lines and the spinous process positioning lines is 25mm-35mm, preferably 30mm, the width of the longitudinal positioning lines is 1.5-2 times of the average width of the vertebral body, and the distance between the two longitudinal positioning lines is 50mm-70mm, preferably 60 mm.

Further preferably, the shapes of the sliding positioning marks on different transverse positioning lines are not consistent. The various shapes may be, but are not limited to, square, diamond, triangle, hexagon, heart, circle, pentagram, downward arrow, and the like; and are respectively arranged on the first, third, fifth, sixth, seventh, ninth, eleventh and thirteenth transverse positioning lines. The number of the fixed positioning marks is three, and the fixed positioning marks are divided into two shapes, namely a hexagon shape and a trapezoid shape; the fixed positioning marks on the second transverse positioning line and the tenth transverse positioning line between the longitudinal positioning line and the longitudinal frame on the left side are hexagons, and the fixed positioning marks on the tenth transverse positioning line between the longitudinal positioning line and the longitudinal frame on the right side are trapezoids.

Preferably, the cross section of the transverse positioning line is in an inverted trapezoid shape or an I-shaped shape, the sliding positioning mark is arranged on the transverse positioning line in a sliding mode through a sliding groove formed in the back of the sliding positioning mark, and the shape of the sliding groove is matched with the shape of the cross section of the transverse positioning line.

Further preferably, the locating lever is a hard metal lever, the main lever of the locating lever is rotatably embedded in the locating plate through a buckle, the buckle is of an annular structure, the number of the buckle is two, and the buckle is fixedly connected to the longitudinal frame in a one-to-one correspondence mode. When the number of the transverse positioning lines is thirteen, the buckle is arranged on a longitudinal frame between the sixth transverse positioning line and the seventh transverse positioning line on the positioning plate, the main rod is rotatably inserted in the buckle, the positioning rod can rotate 360 degrees in the buckle along the long axis of the positioning rod, two ends of the main rod respectively extend out of a reversed L-shaped positioning wing, the length of the main rod is 350-500 mm, preferably 400mm,

preferably, the buckle is provided with at least two threaded holes along the radial direction of the buckle, and the threaded holes are provided with locking screws in a threaded mode.

Preferably, the positioning rod is of an integrated structure, the main rod is connected with the positioning wings through smooth arcs, the distance between the two positioning wings is 80-120 mm, preferably 100mm, and the cross section of the positioning rod is circular and has a diameter of 3 mm.

Preferably, the locating lever is the assembled structure, link to each other through the adapter sleeve between mobile jib and the location wing, be equipped with the horizontal passageway that supplies mobile jib cartridge, the vertical passageway that supplies the location wing cartridge in the adapter sleeve, the mobile jib is oval, or the rectangle with the cross-section of location wing, the shape of horizontal passageway, vertical passageway respectively with the mobile jib, the cross sectional shape phase-match of location wing, the annular rotation recess has been seted up to the part that the mobile jib is located buckle department.

Further preferably, the connecting sleeve has a "" L "" shape or a "" T "" shape.

The utility model has the advantages and positive effects that:

1. the utility model discloses a locating plate and locating lever combine together, can improve the accuracy nature of location and practice thrift positioning time before the art and in the art to patient's pathological change segment, pedicle of vertebral arch body surface projection and intervertebral disc, pedicle of vertebral arch side position orientation simultaneously.

2. The utility model discloses in, place the locating plate in the chest lumbar vertebrae position at patient back, the locating plate can closely laminate the physiological radian at the chest lumbar vertebrae position at human back, can avoid because of the positioning deviation that physiological curvature leads to, with the coincidence of spinous process location line and spinous process for the location of spinous process position and locator place the location of position, convenient operation.

3. The utility model discloses in, the locating plate is slick and sly arc structure for rectangular frame structure and four angular end departments, adopts the arc design, fish tail patient skin and art area surgical drape when avoiding using, improve the security of using.

4. The utility model discloses in, the locating lever spanes the lumbar vertebrae and relies on gravity to make the locating plate be fixed in the patient body surface for location intervertebral disc, pedicle of vertebral arch side position orientation still can fix a position the side position orientation of pathological change intervertebral disc and adjacent pedicle of vertebral arch through rotating the locating lever.

5. The utility model discloses in, the locator can obtain more accurate mark when the preoperative first location, shorten positioning time before the art, in backbone operations such as chest lumbar vertebrae fracture back way wicresoft resets internal fixation, vertebroplasty, kyphoplasty, can confirm backbone segment section, the body surface position of pedicle of vertebral arch and pedicle of vertebral arch screw side position direction fast and accurately, the use has first location just can obtain pinpointing, reduce perspective number of times, reduce characteristics such as soft tissue damage and easy operation in the art.

6. The utility model discloses in, the combination of horizontal positioning line, vertical positioning line, sliding location sign and fixed position sign can realize distinguishing the projected direction of body surface and the accurate location of body surface fast.

7. The utility model discloses in, different the last sliding location sign shape of transverse orientation line is inconsistent, and the projection of two side pedicle of vertebral arch of accurate positioning and intervertebral foramen in the body surface of transverse sliding of sliding location sign accessible on respective transverse orientation line, fixed position sign can be used to fix a position the upper and lower of this locator, and control the side other.

8. The utility model discloses in, the cross section of transverse orientation line is for falling trapezoidal, or I-shaped, and the shape of spout and the cross sectional shape phase-match of transverse orientation line on the sliding position sign can realize the slip of sliding position sign on the transverse orientation line, can prevent again that the sliding position sign from breaking away from on the transverse orientation line, and simple structure, practicality are strong.

9. The utility model discloses in, locking screw is installed to the screw thread on the screw hole, can lock the position of locating lever, convenient operation through the rotatory locking screw of instrument.

10. The utility model discloses in, when the locating lever was the assembled structure, the annular rotation recess had been seted up to the part that the mobile jib was located buckle department, not only can not hinder the locating lever in the buckle along 360 rotations of locating lever major axis, but also can prevent the mobile jib from the horizontal slip on the locating plate, plays the effect of mobile jib location.

11. The utility model discloses in, when the adapter sleeve is "T" shape, two location wings can be along with respective adapter sleeve horizontal slip on the mobile jib, adjust the interval between two location wings then for this locating lever is applicable to the patient of different sizes and uses, improves the practicality of using.

Drawings

The technical solution of the present invention will be described in further detail with reference to the accompanying drawings and examples, but it should be understood that these drawings are designed for illustrative purposes only and thus are not intended to limit the scope of the present invention. Furthermore, unless otherwise indicated, the drawings are intended to be illustrative of the structural configurations described herein and are not necessarily drawn to scale.

FIG. 1 is a schematic front view of a retainer according to embodiment 1;

FIG. 2 is a schematic view of the positioner in position on the chest, back or low back of a patient;

FIG. 3 is a schematic view in lateral perspective of FIG. 2;

FIG. 4 is a schematic diagram of a right side view of the positioner;

FIG. 5 is a front view of the positioning plate;

FIG. 6 is a schematic diagram of the right view of FIG. 5

FIG. 7 is a schematic right view of the structure of FIG. 5 taken along plane A-A;

FIG. 8 is an enlarged view of portion D of FIG. 7;

FIG. 9 is a schematic right side view taken along plane B-B of FIG. 5;

FIG. 10 is a left side view of the structure of FIG. 5 taken along the plane C-C;

FIG. 11 is a schematic diagram showing the structure of the positioner in the right view according to embodiment 2;

FIG. 12 is a schematic front view of the positioning rod of embodiment 3;

FIG. 13 is a schematic front view of the retainer of embodiment 4;

FIG. 14 is a front view of the positioning rod of FIG. 13;

fig. 15 is a schematic front view of the positioning rod when the connecting sleeve is T-shaped.

In the figure: 1. the positioning device comprises a positioning plate, 101, a longitudinal frame, 102, a transverse frame, 2, a spinous process positioning line, 3, a longitudinal positioning line, 4, a positioning rod, 401, a main rod, 402, a positioning wing, 403, a connecting sleeve, 5, a transverse positioning line, 6, a sliding positioning mark, 7, a fixed positioning mark, 8, a buckle, 9, a locking screw, 10, an annular rotating groove and 11, a sliding groove.

Detailed Description

First, it should be noted that the specific structures, features, advantages, etc. of the present invention will be described in detail below by way of example, but all the descriptions are only for illustrative purpose and should not be construed as forming any limitation to the present invention. Furthermore, any single feature described or implicit in any embodiment or any single feature shown or implicit in any drawing may still be combined or subtracted between any of the features (or equivalents thereof) to obtain still further embodiments of the invention that may not be directly mentioned herein. In addition, for the sake of simplicity, the same or similar features may be indicated in only one place in the same drawing.

In the present invention, unless otherwise expressly stated or limited, the terms "mounted," "disposed," "connected," "fixed," "screwed" and the like are to be construed broadly, e.g., as meaning fixedly connected, detachably connected, or integrally formed; can be mechanically or electrically connected; they may be directly connected or indirectly connected through an intermediate medium, and may be connected through the inside of two elements or in an interaction relationship between two elements, unless otherwise specifically defined, and the specific meaning of the above terms in the present invention will be understood by those skilled in the art according to specific situations. The present invention will be described in detail with reference to fig. 1 to 15.

Example 1

As shown in fig. 1-10, a positioner before and during thoracolumbar surgery comprises a positioning plate 1 for positioning thoracolumbar lesion segments and pedicle body surface orthographic projection, wherein the positioning plate 1 is a closed frame structure defined by two longitudinal frames 101 and two transverse frames 102, and further comprises:

the spinous process positioning line 2 is superposed with the spinous process in actual operation, is used for positioning the position of the spinous process and the placement position of the positioner, is arranged along the central axis of the positioning plate 1, and is fixedly connected with the positioning plate 1 at two ends;

at least two longitudinal positioning lines 3 are respectively and symmetrically distributed on two sides of the spinous process positioning line 2 and are parallel to the spinous process positioning line 2, and two ends of the longitudinal positioning lines are respectively and fixedly connected with the positioning plate 1; preferably, the two longitudinal positioning lines 3 are respectively distributed on the two sides of the spinous process positioning line 2 in a bilateral symmetry manner;

the positioning rod 4 is used for positioning the lateral direction of the intervertebral disc and the vertebral pedicle, can position the lateral direction of the pathological intervertebral disc and the adjacent vertebral pedicle by rotating, and comprises a main rod 401 and positioning wings 402 which are vertically arranged at two ends of the main rod 401, wherein the main rod 401 is rotatably embedded on the positioning plate 1 and is mutually vertical to the spinous process positioning line 2;

the number of the transverse positioning lines 5 is 11-15, the transverse positioning lines are respectively distributed on two sides of the main rod 401 at equal intervals and are parallel to the main rod 401, and two ends of the transverse positioning lines are respectively fixedly connected with the positioning plate 1; preferably, the number of the transverse positioning lines 5 is 13, wherein 6 transverse positioning lines 5 are positioned at one side of the main rod 401, and 7 transverse positioning lines 5 are positioned at the other side of the main rod 401;

the positioning mark comprises a plurality of sliding positioning marks 6 which are respectively arranged on the transverse positioning line 5 between the longitudinal positioning line 3 and the spinous process positioning line 2 in a sliding mode, and a plurality of fixed positioning marks 7 which are respectively arranged on the transverse positioning line 5 between the longitudinal positioning line 3 and the longitudinal frame 101 in a fixed mode. Preferably, 16 sliding positioning marks 6 are distributed between the two longitudinal positioning lines 3 and the spinous process positioning line 2, the sliding positioning marks 6 can slide between the left and right longitudinal positioning lines 3 and the spinous process positioning line 2 along the transverse positioning line 5, and the sliding positioning marks 6 can transversely slide through the transverse positioning line 5 to accurately position the projections of the bilateral pedicles and the intervertebral foramen on the body surface; preferably, two pieces of fixed positioning marks 7 are arranged between the left longitudinal positioning line 3 and the longitudinal frame 101 and are respectively fixed to the hexagram-shaped fixed positioning marks 7 on the second transverse positioning line and the tenth transverse positioning line 5, one piece of fixed positioning mark 7 is arranged between the right longitudinal positioning line 3 and the longitudinal frame 101, and the fixed positioning mark 7 can be used for positioning the upper side, the lower side, the left side, the right side and the left side of the trapezoidal fixed positioning mark 7 on the tenth positioning line.

The working principle is as follows: in the technical scheme, a positioning plate 1 is internally formed by interweaving a spinous process positioning line 2, two longitudinal positioning lines 3 and thirteen transverse positioning lines 5, the transverse positioning lines 5 and the longitudinal positioning lines 3 divide the positioning plate 1 into a plurality of unit lattices arranged in a matrix shape, in the actual operation, the positioning plate 1 is placed at the thoracolumbar vertebra part of the back of a patient, the positioning plate 1 can be tightly attached to the physiological radian of the thoracolumbar vertebra part of the back of the human body, the spinous process positioning lines 2 are superposed with the spinous processes for positioning the spinous process position and positioning the positioning device placing position, at the moment, a positioning rod 4 spans the lumbar vertebra and is fixed on the body surface of the patient by gravity for positioning the lateral direction of the vertebral pedicle, a pathological intervertebral disc and the lateral direction of the adjacent vertebral pedicle can be positioned by rotating the positioning rod 4, wherein the positioning plate 1 and the positioning rod 4 can be but are, portable and accomodate, in practical application, pedicle of vertebral arch and intervertebral disc side position projection can be fixed a position to locating lever 4, be used for fixing a position pathological change intervertebral disc, according to the relevant anatomical parameter of chest lumbar vertebrae, the last triangle-shaped slide orientation sign 6 of fifth transverse orientation line 5 can fix a position the superior cone pedicle of vertebral arch body surface projection of pathological change intervertebral disc, the hexagonal slide orientation sign 6 can fix a position intervertebral foramen body surface projection on the sixth transverse orientation line 5, the lower cone pedicle of vertebral arch body surface projection can be fixed a position to the slide orientation sign 6 of heart-shaped on the seventh transverse orientation line 5, be convenient for fuse the location of percutaneous nail placement operation through intervertebral foramen decompression. The positioning plate 1 and the positioning rod 4 are combined, so that the pathological change segment, the body surface projection of the vertebral pedicle and the lateral position direction of the intervertebral disc and the vertebral pedicle of a patient can be simultaneously positioned, the positioning accuracy before and during the operation is improved, the positioning time is saved, the positioner can obtain more accurate marks during the initial positioning before the operation, the positioning time before the operation is shortened, and the body surface positions of the vertebral column segment and the vertebral pedicle and the lateral position direction of a vertebral pedicle screw can be quickly and accurately determined in the spine operations such as thoracolumbar fracture posterior minimally invasive reduction internal fixation, vertebroplasty, kyphoplasty and the like; the intervertebral foramen position and the lateral direction of the decompression channel can be quickly and accurately positioned in the lumbar minimally invasive surgery; the use process has the characteristics of accurate positioning obtained by primary positioning, reduction of the number of fluoroscopy times, reduction of soft tissue injury in the operation, simplicity in operation and the like.

Furthermore, it can be considered in this embodiment that the positioning plate 1 is a rectangular frame structure and has smooth arc-shaped structures at the four corners, and adopts an arc-shaped design to avoid scratching the skin of the patient and the surgical drape during use, the positioning plate 1, the transverse positioning line 5, the longitudinal positioning line 3, the spinous process positioning line 2, and the positioning mark are all made of soft polymer material developable by X-ray or made of soft metal material, the length of the longitudinal frame 101 is 100 plus 200mm, preferably 150mm, the width of the transverse frame 102 is 100 plus 110mm, preferably 106mm, wherein the soft metal can be, but is not limited to, metal aluminum, has good plasticity, can be better attached to the skin, and is convenient for closely attaching to the physiological curvature of the thoracolumbar vertebra part of the back of the human body, and can have better attaching property when placed on the body surface during positioning, the positioning deviation caused by physiological curvature can be avoided.

Furthermore, it can be considered in this embodiment that the transverse positioning lines 5 and the longitudinal positioning lines 3 are vertically distributed in a staggered manner, the spinous process positioning line 2 is disposed along the long axis of the positioning plate 1, the transverse positioning lines 5 are distributed along the long axis of the positioning plate 1, the distance between two transverse positioning lines 5 located at two sides of the positioning rod 4 is 16mm to 24mm, preferably 20mm, the distance between the other two adjacent transverse positioning lines 5 is 8mm to 12mm, preferably 10mm, the length of the transverse positioning line 5 is 100mm to 200mm, preferably 100mm to 110mm, further preferably 106mm, the width is 2mm to 3mm, preferably 2.5 mm. The number of the longitudinal positioning lines 3 is preferably two, the distance between the longitudinal positioning lines 3 and the spinous process positioning lines 2 is 25mm-35mm, preferably 30mm, the width of the longitudinal positioning lines is 1.5-2 times of the average width of the vertebral body, and the distance between the two longitudinal positioning lines 3 is 50mm-70mm, preferably 60 mm.

Furthermore, it is also considered in this embodiment that the shapes of the sliding positioning marks 6 on the different lateral positioning lines 5 are not consistent. The various shapes may be, but are not limited to, square, diamond, triangle, hexagon, heart, circle, pentagram, downward arrow, and the like; and are respectively mounted on the first, third, fifth, sixth, seventh, ninth, eleventh and thirteenth transverse positioning lines 5. Preferably, but not limited to, the sliding position indicator 6 of the thirteenth transverse position line 5 is designed as a downward arrow, and the sliding position indicator 6 can also be used for referencing the positioner placing direction.

Furthermore, it can be considered in this embodiment that the number of the fixed positioning marks 7 is three, and the fixed positioning marks are divided into two shapes, namely a hexagon and a trapezoid; the fixed positioning marks 7 on the second and tenth transverse positioning lines 5 between the left longitudinal positioning line 3 and the longitudinal frame 101 are hexagons, and the fixed positioning marks 7 on the tenth transverse positioning line 5 between the right longitudinal positioning line 3 and the longitudinal frame 101 are trapezoids. The front sizes of the sliding positioning marks 6 and the fixed positioning marks are accommodated by a rectangle with a side length of 4mm, and the height of the positioning plate 1 is 1mm-2mm, preferably 1.5 mm.

It should be noted that, the combination of the transverse positioning line, the longitudinal positioning line, the sliding positioning mark and the fixed positioning mark can realize the fast distinguishing of the projection direction of the body surface and the accurate positioning of the body surface.

Furthermore, it can be considered in this embodiment that the cross section of the transverse positioning line 5 is an inverted trapezoid or an i-shape, the sliding positioning mark 6 is slidably disposed on the transverse positioning line 5 through a sliding slot 11 disposed on the back of the sliding positioning mark, and the shape of the sliding slot 11 matches with the cross section shape of the transverse positioning line 5. The sliding of the sliding positioning mark 6 on the transverse positioning line 5 can be realized, the sliding positioning mark 6 can be prevented from being separated from the transverse positioning line 5, the structure is simple, and the practicability is high. When the cross section of the transverse positioning line 5 is an inverted trapezoid, preferably, the two bottom sides are 2.5mm, 1.5mm and 1.5mm high, respectively.

Furthermore, it can be considered in this embodiment that the positioning rod 4 is a hard metal rod, the positioning rod is n-shaped, the main rod 401 of the positioning rod 4 is rotatably embedded in the positioning plate 1 through the buckle 8, the buckle 8 is an annular structure, and the number of the buckle 8 is two, and the two buckles are respectively and fixedly connected to the longitudinal frame 101 in a one-to-one correspondence manner. When the number of the transverse positioning lines 5 is thirteen, the buckle 8 is disposed on the longitudinal frame 101 between the sixth and seventh transverse positioning lines 5 on the positioning plate 1, the main rod 401 is rotatably inserted into the buckle 8, the positioning rod 4 can rotate 360 ° in the buckle 8 along the long axis of the positioning rod 4, two ends of the main rod 401 respectively extend out of a positioning wing 402 in a shape of "ji", the positioning rod 4 is used for positioning the lateral direction of the pathological intervertebral disc and the vertebral body by rotating when viewed from the lateral direction, as shown in fig. 3, the positioning wing 402 can rotate along the arrow direction along with the main rod 401, so as to position the lateral direction of the pathological intervertebral disc and the vertebral body, and the length of the main rod 401 is 350mm to 500mm, preferably 400 mm.

The specific operation process of this embodiment is as follows:

1. in chest lumbar vertebrae operation, the patient takes the prone position and places the locator in patient chest back or back (as fig. 2), through side during perspective (as fig. 3) the side position orientation of location fracture cone or pathological change intervertebral disc and do corresponding sign in health side, two location wings 402 of locating lever 4 overlap as far as possible during the perspective, this is the centrum nail advances to follow closely side position orientation, also can fix a position canalis spinalis decompression and fuse passageway side position orientation, it explains that, when two location wings 402 of locating lever 4 overlap as far as possible when perspective, can ensure that side position orientation is correct.

2. When the orthophoria is used for perspective, the positioning rod 4 is placed at the level of a fracture vertebra or a pathological change intervertebral disc, the pathological change cone and the spinous process of the adjacent cone are touched on the body surface to make marks and connect the marks, and the spinous process positioning line 2 on the positioning plate 1 is superposed with the marks; the direction of the identification line drawn by modulating the perspective of the C-shaped arm on the side of the body is consistent, so that more accurate perspective is facilitated, the positioning plate 1 is fixed on the body surface from top to bottom, and the middle part is attached to the body surface by the gravity of the positioning rod 4, so that accurate positioning is facilitated.

3. The left side and the right side of the patient can be positioned and the upper position and the lower position can be positioned through the fixed positioning mark 7 during the orthoscopic perspective, so that the adjustment of the C-shaped arm can be conveniently guided. 1-10, if a six-pointed star and a square or diamond shape are seen at the same time on the see-through screen, then it is determined to be the top left of the locator; if only the square or diamond is seen, it is the upper right of the positioner; if a hexagon star and a circular or pentagram star are seen, the left lower part of the positioner is seen; if the trapezoid, the circle or the five-pointed star is seen, the positioner is from the lower part; the C-arm is moved in the opposite direction to center the lesion in the perspective.

4. The distance between the pedicles of thoracic vertebrae from chest 1 to chest 12 is greatly different, the difference between thoracic vertebrae and lumbar vertebrae is greatly different, and individuation among patients also greatly differs; and precisely positioning the body surface projection of the pedicle screw feeding point by using the sliding positioning mark 6, and making a corresponding mark on the body surface, namely the body surface access point of the pedicle screw and the decompression fusion channel.

Example 2

As shown in fig. 11, embodiment 2 of the present invention is further modified from embodiment 1 so as to fully exert the technical advantages of the present invention, and this is exemplified below.

For example, at least two threaded holes are formed in the buckle 8 along the radial direction of the buckle, and the locking screws 9 are installed on the threaded holes in a threaded mode. Locating lever 4 can be 360 rotations of long axle along locating lever 4 in buckle 8, and locating lever 4 is used for the side position orientation through rotational positioning pathological change intervertebral disc, centrum when side position perspective, when needs locking locating lever 4 position, only need through the rotatory locking screw 9 of instrument can, the head of locking screw 9 supports locating lever 4 convenient operation.

Example 3

As shown in fig. 12, embodiment 3 of the present invention is further modified from embodiment 1 or 2 so that the technical advantages of the present invention can be fully exerted, and this will be exemplified below.

For example, the positioning rod 4 is an integral structure, the main rod 401 is connected with the positioning wings 402 through a smooth arc, an arc design is adopted, the skin of a patient and an operation area surgical drape are prevented from being scratched when the surgical drape is used, the distance between the two positioning wings 402 is 80mm-120mm, preferably 100mm, the cross section of the positioning rod 4 is circular, and the diameter of the positioning rod is 3 mm.

Example 4

As shown in fig. 13 to 15, embodiment 3 of the present invention is further modified from embodiment 1 or 2 so as to fully exert the technical advantages of the present invention, which will be exemplified below.

For example, the positioning rod 4 is an assembled structure, the main rod 401 and the positioning wings 402 are connected by a connecting sleeve 403, the assembling and disassembling are convenient, a transverse channel for the insertion of the main rod 401 and a longitudinal channel for the insertion of the positioning wings 402 are arranged in the connecting sleeve 403, the cross sections of the main rod 401 and the positioning wings 402 are in an oval shape or a rectangular shape, the shapes of the transverse channel and the longitudinal channel are respectively matched with the cross sections of the main rod 401 and the positioning wings 402, the oval shape or the rectangular shape of the cross section can prevent the positioning wings 402 and the connecting sleeve 403 from rotating on the main rod 401, so that the two positioning wings 402 and the main rod 401 are always on the same plane, when the lateral perspective is used (as shown in fig. 3), the lateral viewing direction of the fracture cone or the pathological intervertebral disc is positioned, and the corresponding mark is made on the body, when the lateral viewing direction is used, the two positioning wings 402 of the positioning rod 4 are, the lateral viewing direction of the spinal decompression fusion canal can also be positioned.

Furthermore, it is also considered in this embodiment that the main rod 401 is provided with an annular rotation groove 10 at the position of the buckle 8. The main rod 401 can rotate in the buckle 8 through the annular rotating groove 10, so that the positioning rod 4 cannot be prevented from rotating in the buckle 8 along the long axis of the positioning rod 4 by 360 degrees, and the main rod 401 can be prevented from sliding left and right on the positioning plate 1 to achieve the positioning effect of the main rod 401.

Further, it is also contemplated that the connection sleeve 403 has a "" L "" shape or a "T" shape. When the connecting sleeve 403 is "T" shaped, the main rod 401 can be inserted into the transverse channel of the connecting sleeve 403, the positioning wings 402 are inserted into the longitudinal channel, the transverse channel of the connecting sleeve 403 is a hollow channel structure, when the distance between two positioning wings 402 needs to be adjusted, then two positioning wings 402 can slide left and right on the main rod 401 along with the respective connecting sleeve 403, and then the distance between two positioning wings 402 is adjusted, so that the positioning rod 4 can be suitable for patients of different body types, and the practicability of use is improved.

It should be noted that, in order to realize that the positioning rod 4 is applicable to patients of different body types to use, the main rod of the positioning rod can be designed into a telescopic rod structure, and the length of the positioning rod can be adjusted according to patients of different body types.

To sum up, the utility model provides a can be simultaneously to patient's pathological change segment section, pedicle of vertebral arch body surface projection and intervertebral disc, pedicle of vertebral arch side position orientation, improve the accuracy nature of location and practice thrift positioning time's chest lumbar vertebrae operation before art, locator in the art.

The above embodiments are described in detail, but the above description is only for the preferred embodiments of the present invention, and should not be construed as limiting the scope of the present invention. All the equivalent changes and improvements made according to the application scope of the present invention should still fall within the patent coverage of the present invention.

Claims (10)

1. The utility model provides a locator before thoracolumbar surgery art, in art, is including being used for fixing a position thoracolumbar pathological change section and the projected locating plate of pedicle of vertebral arch body surface normal position, the locating plate is enclosed the closed frame structure who establishes and form, its characterized in that by two vertical frames, two horizontal frames: further comprising:

the spinous process positioning line is arranged along the central axis of the positioning plate, and two ends of the spinous process positioning line are fixedly connected with the positioning plate respectively;

at least two longitudinal positioning lines are respectively and symmetrically distributed on two sides of the spinous process positioning line and are parallel to the spinous process positioning line, and two ends of the longitudinal positioning lines are respectively and fixedly connected with the positioning plate;

the positioning rod comprises a main rod and positioning wings vertically arranged at two ends of the main rod, and the main rod is rotatably embedded on the positioning plate and is vertical to the spinous process positioning line;

the number of the transverse positioning lines is 11-15, the transverse positioning lines are respectively distributed on two sides of the main rod at equal intervals and are parallel to the main rod, and two ends of the transverse positioning lines are respectively fixedly connected with the positioning plates;

and the positioning mark comprises a plurality of sliding positioning marks which are respectively arranged on the transverse positioning line between the longitudinal positioning line and the spinous process positioning line in a sliding manner, and a plurality of fixed positioning marks which are respectively arranged on the transverse positioning line between the longitudinal positioning line and the longitudinal frame in a fixed manner.

2. The pre-and intra-operative positioner for thoracolumbar spine surgery of claim 1, wherein: the positioning plate is of a rectangular frame structure, the four corner ends of the positioning plate are of smooth arc structures, the positioning plate, the transverse positioning line, the longitudinal positioning line, the spinous process positioning line and the positioning mark are made of soft high polymer materials which can be developed by X-rays or made of soft metal materials, the length of the longitudinal frame is 100-plus-material 200mm, and the width of the transverse frame is 100-plus-material 110 mm.

3. The pre-and intra-operative positioner for thoracolumbar spine surgery of claim 2, wherein: the transverse positioning lines and the longitudinal positioning lines are vertically distributed in a staggered mode, the distance between the two transverse positioning lines on the two sides of each positioning rod is 16-24 mm, the distance between the other two adjacent transverse positioning lines is 8-12 mm, the length of each transverse positioning line is 100-110mm, and the distance between each longitudinal positioning line and each spinous process positioning line is 25-35 mm.

4. The pre-and intra-operative positioner for thoracolumbar spine surgery of claim 3, wherein: different sliding positioning marks on the transverse positioning lines are different in shape, the number of the fixed positioning marks is three, the fixed positioning marks are divided into two shapes, namely a hexagon star shape and a trapezoid shape.

5. The pre-and intra-operative positioner for thoracolumbar spine surgery of claim 4, wherein: the cross section of the transverse positioning line is in an inverted trapezoid shape or an I-shaped shape, the sliding positioning mark is arranged on the transverse positioning line in a sliding mode through a sliding groove formed in the back of the sliding positioning mark, and the shape of the sliding groove is matched with the shape of the cross section of the transverse positioning line.

6. The pre-and intra-operative positioner for thoracolumbar spine surgery of claim 2, wherein: the positioning rod is a hard metal rod, the main rod of the positioning rod is rotatably embedded in the positioning plate through a buckle, the buckle is of an annular structure, the number of the buckle is two, the two buckles are fixedly connected to the longitudinal frame in a one-to-one correspondence mode respectively, and the length of the main rod is 350-500 mm.

7. The pre-and intra-operative positioner for thoracolumbar spine surgery of claim 6, wherein: at least two threaded holes are formed in the buckle in a penetrating mode along the radial direction of the buckle, locking screws are installed on the threaded holes in a threaded mode, and the heads of the locking screws are abutted to the outer wall of the main rod.

8. The pre-and intra-operative positioner for thoracolumbar spine surgery according to claim 6 or 7, characterized in that: the positioning rod is of an integrated structure, the main rod is connected with the positioning wings through smooth arcs, the distance between the two positioning wings is 80-120 mm, and the cross section of the positioning rod is circular.

9. The pre-and intra-operative positioner for thoracolumbar spine surgery according to claim 6 or 7, characterized in that: the locating lever is assembled structure, link to each other through the adapter sleeve between mobile jib and the location wing, be equipped with the horizontal passageway that supplies the mobile jib cartridge, the vertical passageway that supplies the location wing cartridge in the adapter sleeve, the mobile jib is oval, or the rectangle with the cross-section of location wing, the shape of horizontal passageway, vertical passageway matches with the cross sectional shape of mobile jib, location wing respectively, the annular rotation recess has been seted up to the part that the mobile jib is located buckle department.

10. The pre-and intra-operative positioner for thoracolumbar spine surgery of claim 9, wherein: the connecting sleeve is L-shaped or T-shaped.

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