CN212261501U

CN212261501U - Vertebral pedicle channel screw three-dimensional guider

Info

Publication number: CN212261501U
Application number: CN202021674159.9U
Authority: CN
Inventors: 邓迎生
Original assignee: Individual
Current assignee: Individual
Priority date: 2020-08-12
Filing date: 2020-08-12
Publication date: 2021-01-01
Anticipated expiration: 2030-08-12

Abstract

The utility model discloses a three-dimensional director of pedicle of vertebral arch passageway screw, including base, the three-dimensional distance adjusting member of setting on the base and set up the angle adjusting member at the three-dimensional distance adjusting member other end. The utility model discloses simple structure, the operation of being convenient for, adjust into nail direction through angle adjusting member, the rethread three-dimensional distance adjusting member makes angle adjusting member aim at into the nail point, can once only the accurate nail direction of advancing of confirming, it can not accurately confirm effectively to have avoided the main knife doctor to advance the nail direction and cause the way opener to wear out pedicle of vertebral arch cortex bone, or the direction of adjusting the way opener repeatedly causes pedicle of vertebral arch screw to control power and descends, the success of spinal pedicle of vertebral arch screw internal fixation operation has been ensured, make things convenient for the operation of main knife doctor, there is very strong practicality, and fix a position accurately, be applicable to the normal patient of vertebra form, be particularly useful for the patient of vertebra deformity, for example, the spinous process lower edge is not sharp, the spinous process fuses and can't utilize.

Description

Vertebral pedicle channel screw three-dimensional guider

Technical Field

The utility model belongs to the field of orthopedic surgery instruments, concretely relates to pedicle of vertebral arch passageway screw three-dimensional director.

Background

The spine pedicle of vertebral arch channel screw internal fixation operation is the basic technology of modern spine surgery, and the vertebral arch channel screw passes through the narrow pedicle of vertebral arch channel of the vertebral arch to fix the spine based on the anatomical characteristics of the vertebral arch. The vertebral body belongs to an irregular bone, the anatomy and the complexity are realized, the pedicle of vertebral arch channel not only has an external inclination angle relative to the sagittal plane of a human body, but also has a pitching inclination angle relative to the cross section of the human body, the internal and external diameters and the upper and lower diameters of the pedicle of vertebral arch are narrow, particularly, the narrowest part of the pedicle of vertebral arch channel is less than 5mm in the cervical vertebra and the upper thoracic vertebra, the external inclination angle and the pitching inclination angle have slight deviation, the bone cortex of the pedicle of vertebral arch can be broken through by the open circuit device, the precision required by scientific research cannot be achieved (the screw is accurately positioned and can be successfully placed once), the adjustment difficulty in the operation is very high, the failure of screw. Therefore, the requirement of the internal fixation operation of the vertebral pedicle channel screw on the screw feeding direction of the spinal vertebral pedicle channel screw is extremely high, whether the screw feeding direction of the vertebral pedicle channel screw can be accurately determined becomes one of key factors for determining the success or failure of the operation on the premise of accurately positioning the screw feeding point in the operation process, the determination of the screw feeding direction needs to determine the central axis of the vertebral pedicle channel on the vertebra through a pitching inclination angle (an included angle between the central axis of the vertebral pedicle channel and the central cross section of the vertebral body on a CT sagittal plane or a lateral X-ray plate) and an internal inclination angle (an included angle between the central axis of the vertebral pedicle channel and the central axis of the vertebral body on a CT transverse plane, which cannot be.

At present, the direction of screw feeding in the spinal pedicle channel screw internal fixation operation is determined, after the position of a screw feeding point is determined, an operator generally uses a ground plane as reference, and estimates the direction of a channel opener after the angle adjustment of two planes according to a pitching inclination angle and a inwards inclination angle measured by preoperative data by experience and feeling, and the angle is used as the direction of the screw feeding. However, due to the fact that two variables for controlling the nail feeding direction of the pitching inclination angle and the inwards inclination angle exist at the same time, the nail feeding direction cannot be accurately determined due to the fact that the determination of the pitching inclination angle and the inwards inclination angle both depend on the subjective judgment of a doctor. In the operation of a patient with spinous process fusion deformity, the pitching inclination angle can not eliminate the influence by using a method of using a perpendicular line of a central axis of the vertebral pedicle to an included angle of a lower edge of the spinous process, although a probe can be inserted after a channel is drilled, and measurement, judgment and adjustment can be carried out through lateral position X-ray perspective of the vertebral column, the success at one time cannot be ensured, and once deviation exists, the adjustment is difficult; and the camber angle can not be measured through X-ray fluoroscopy, and can only be judged by the hand feeling and experience of an operator. Meanwhile, the upper and lower diameters and the inner and outer diameters of the pedicle channel are very narrow (the inner and outer diameters are smaller), especially in the cervical vertebra and the upper thoracic vertebra, the narrowest part of the pedicle channel is less than 5mm, so that even under the condition that a screw feeding point is accurate, pedicle channel screws can penetrate out of cortical bone from any positions of the upper and lower walls, the inner side wall, the outer side wall and the like of the pedicle, and further damage the surrounding important tissues; at present, a device capable of simultaneously and accurately determining the camber angle and the pitching inclination angle of the central axis of the pedicle channel on the vertebra under the condition of spinous process fusion deformity and the like is lacked, and is used for solving the problems.

SUMMERY OF THE UTILITY MODEL

The utility model aims at providing a pedicle of vertebral arch passageway screw three-dimensional director, after confirming the entering nail point position, if can't use pedicle of vertebral arch passageway axis plumb-spinous process lower edge contained angle protractor to find out the vertical plane of pedicle of vertebral arch passageway axis when compensating the every single move inclination, adjust the camber angle through camber angle adjusting element, the every single move inclination is according to the angle of predetermineeing of measurement before the art, rethread three-dimensional distance adjusting element makes the guide pin that inserts in the guide block aim at entering the nail point, spinal column side position X line perspective adjustment every single move inclination to the optimum position, thereby reach the purpose that still can accurate location enter the nail direction under the extreme condition of no reference sign such as spinous process fusion deformity, solved pedicle of vertebral arch nail and advanced the direction inaccurate and worn out the problem of important tissue around the cortical bone injury.

The utility model discloses the technical scheme who adopts:

the utility model provides a pedicle of vertebral arch passageway screw three-dimensional director which characterized in that: the three-dimensional distance adjusting device comprises a base, a three-dimensional distance adjusting component arranged on the base and an angle adjusting component arranged at the other end of the three-dimensional distance adjusting component;

the base comprises a door-shaped plate and a sagittal sleeve arranged at the other end of the door-shaped plate, the door-shaped plate can be clamped and fixed on the spinous process, the sagittal sleeve is used for being in sliding connection with the three-dimensional distance adjusting component, and a reference needle is longitudinally arranged at the top of the door-shaped plate and provides a reference for adjusting the nail feeding direction;

the three-dimensional distance adjusting component comprises a sagittal slide bar arranged in the sagittal sleeve, a transverse slide bar arranged above the sagittal slide bar, a transverse sleeve sleeved on the transverse slide bar, a longitudinal slide bar arranged on the transverse sleeve, and a longitudinal sleeve sleeved on the longitudinal slide bar, wherein the sagittal sleeve, the transverse sleeve and the longitudinal sleeve are provided with positioning components;

the angle adjustment component, including setting up the horizontal arc scale bar in horizontal arc cover, set up the vertical arc cover in horizontal arc scale bar one end, set up the vertical arc scale bar in vertical arc cover and set up the guide block in vertical arc scale bar one end, horizontal arc scale bar slides in order to adjust the dip angle size inside and outside horizontal arc cover, vertical arc scale bar slides from top to bottom in vertical arc cover is in order to adjust the pitch angle size, thereby reach the purpose of accurate control nail feeding direction, set up locking member on horizontal arc cover and the vertical arc cover, run through on the guide block and set up the guiding hole, the guiding hole is used for passing the ware of opening the road.

Furthermore, a clamping groove is formed in the top end of the door-shaped plate, a T-shaped clamping block is arranged in the clamping groove, a reference hole is formed in the T-shaped clamping block, a reference needle is arranged in the reference hole, a concave groove is formed in the inner side wall of the top of the door-shaped plate, a convex plate is arranged between the concave grooves, a needle groove used for the reference needle to penetrate through is formed in the convex plate, one half of the reference needle is inserted into the spinous process, in order to use the reference needle as a reference, the nail penetrating direction is convenient to determine, the rear end of the reference needle penetrates through the needle groove of the convex plate and is inserted into the reference hole of the T-shaped clamping block, and a base is convenient to install or detach on or.

Furthermore, the side wall of the bottom of the door-shaped plate is provided with a fixing hole, a fixing needle is arranged in the fixing hole, the fixing needle penetrates through the fixing hole to nail the base on the spinous process, and the base is prevented from moving in the operation process.

Further, the positioning component comprises positioning sliding grooves formed in the sagittal sleeve, the transverse sleeve and the longitudinal sleeve, and positioning bolts penetrating through the positioning sliding grooves and connected with the sagittal sliding rod, the transverse sliding rod and the longitudinal sliding rod in a threaded mode.

Furthermore, the connecting rod perpendicularly connected with the middle of the transverse sliding rod is perpendicularly arranged at the top end of the sagittal sliding rod, rectangular sliding grooves capable of penetrating through the connecting rod are formed in the transverse sleeve and the vertical sleeve, and the adjusting range of the angle adjusting component is effectively enlarged.

Furthermore, a guide sleeve is arranged in the guide hole, the purpose is to increase the guide distance to enable the guide to be more accurate, and a locking component is arranged on the guide block and used for locking the guide sleeve in the guide hole.

Further, the locking member includes a locking threaded bore and a locking stud disposed within the threaded bore.

The utility model has the advantages that:

1. the utility model has simple structure and convenient operation;

2. the utility model can accurately determine the direction of the screw feeding at one time by adjusting the direction of the screw feeding through the angle adjusting component and aligning the angle adjusting component to the screw feeding point through the three-dimensional distance adjusting component, thereby effectively avoiding that the main knife doctor can not accurately determine the direction of the screw feeding to cause the opener to penetrate out the vertebral pedicle cortical bone or repeatedly adjust the direction of the opener to cause the control force of the vertebral pedicle screw to be reduced, and ensuring the success of the internal fixation operation of the vertebral pedicle screw of the spine;

3. the angle adjusting component in the utility model can slide inside and outside the transverse arc-shaped sleeve pipe through the transverse arc-shaped scale rod to adjust the size of the internal inclination angle, and the longitudinal arc-shaped scale rod can slide up and down in the longitudinal arc-shaped sleeve pipe to adjust the size of the pitching inclination angle, thereby achieving the purpose of accurately controlling the nail feeding direction;

4. the three-dimensional distance adjusting component of the utility model can adjust the vertical, horizontal and vertical positions of the angle adjusting component through the sagittal slide bar, the horizontal slide bar and the vertical slide bar respectively in the sagittal sleeve, the horizontal sleeve and the vertical sleeve, thereby being convenient for the doctor to operate, having strong practicability and accurate positioning;

5. the utility model discloses an insert the benchmark needle on spinous process to the benchmark needle is for referring to, and the nail direction of advancing is confirmed through every single move inclination and inclination, even patient's position changes and also can not exert an influence to the operation.

6. The utility model is suitable for the patients with normal vertebra shape; the method is particularly suitable for patients with vertebral malformation, such as patients with non-aligned spinous lower edge, spinous fusion and the like who can not use the spinous lower edge as a reference standard.

Drawings

Fig. 1 is a schematic structural view of the present invention;

fig. 2 is a schematic structural view of the base of the present invention;

fig. 3 is an exploded view of the base of the present invention;

fig. 4 is a schematic structural view of a three-dimensional distance adjustment member according to the present invention;

fig. 5 is a schematic structural view of the angle adjustment member of the present invention;

fig. 6 is a schematic view of the usage state of the present invention.

In the figure: 1. a base; 2. a door profile; 3. a vector slide bar; 4. a three-dimensional distance adjusting member; 5. a transverse sliding bar; 6. a transverse cannula; 7. a longitudinal slide bar; 8. a longitudinal sleeve; 9. a transverse arc-shaped sleeve; 10. an angle adjusting member; 11. a transverse arc-shaped scale bar; 12. a longitudinal arcuate sleeve; 13. a longitudinal arc-shaped scale bar; 14. a guide block; 15. a guide sleeve; 16. a convex plate; 17. a T-shaped fixture block; 18. a sagittal cannula; 19. a fixing pin; 20. a needle groove; 21. a reference hole; 22. a reference pin; 23. a card slot; 24. a concave groove; 25. opening a road device; 26. transverse process; 27. the superior articular process; 28. a vertebral body; 29. a vertebral foramen; 30. a pedicle of a vertebral arch; 31. a spinous process.

Detailed Description

It should be noted that, in the present application, the embodiments and features of the embodiments may be combined with each other without conflict, and the present invention will be described in detail with reference to the accompanying drawings and embodiments.

As shown in fig. 1, 2, 3, 4 and 5, the three-dimensional guide for a pedicle screw provided by the present invention comprises a base 1, a three-dimensional distance adjusting member 4 disposed on the base 1, and an angle adjusting member 10 disposed at the other end of the three-dimensional distance adjusting member 4;

the base 1 comprises a door-shaped plate 2 and a sagittal sleeve 18 arranged at the other end of the door-shaped plate 2, the door-shaped plate 2 can be clamped and fixed on spinous processes, the sagittal sleeve 18 is used for being in sliding connection with the three-dimensional distance adjusting component 4, the top end of the door-shaped plate 2 is provided with a clamping groove, a T-shaped clamping block 17 is arranged in the clamping groove, a reference hole 21 is arranged on the T-shaped clamping block 17, a reference needle 22 is arranged in the reference hole 21, the diameter of the reference needle 22 is 2mm, a concave groove 24 is arranged on the inner side wall of the top of the door-shaped plate 2, a convex plate 16 is arranged between the concave grooves 24, the convex surface length of the convex plate 16 has various specifications, a needle groove 20 for the reference needle 22 to pass through is arranged on the convex plate 16, half of the reference needle 22 is inserted into the spinous processes, in order to use the reference needle 22 as a reference to conveniently determine the nail feeding direction, the rear end of the reference needle, the bottom side wall of the door-shaped plate 2 is provided with a fixing hole, a fixing needle 19 is arranged in the fixing hole, the fixing needle 19 penetrates through the fixing hole to nail the base 2 on the spinous process, and the base 1 is prevented from moving in position in the operation process;

the three-dimensional positioning component 4 comprises a sagittal slide bar 3 arranged in a sagittal sleeve 18, a transverse slide bar 5 arranged above the sagittal slide bar 3, a transverse sleeve 6 sleeved on the transverse slide bar 5, a longitudinal slide bar 7 arranged on the transverse sleeve 6, and a longitudinal sleeve 8 sleeved on the longitudinal slide bar 7, wherein the sagittal sleeve 18, the transverse sleeve 6 and the longitudinal sleeve 8 are provided with positioning components, and each positioning component comprises a positioning chute arranged on the sagittal sleeve 18, the transverse sleeve 6 and the longitudinal sleeve 8, and a positioning bolt penetrating through the positioning chute and connected with the sagittal slide bar 3, the transverse slide bar 5 and the longitudinal slide bar 7; the sagittal slide bar 3, the transverse slide bar 5 and the longitudinal slide bar 7 respectively slide in the sagittal sleeve 18, the transverse sleeve 6 and the longitudinal sleeve 8 to adjust the position of the angle adjusting member 10, and the position of the angle adjusting member 10 is fixed by a positioning member, so that the angle adjusting member 10 is aligned to a nail feeding point, a connecting rod vertically connected with the middle part of the transverse slide bar 5 is vertically arranged at the top end of the sagittal slide bar 3, rectangular sliding grooves capable of passing through the connecting rod are respectively formed in the transverse sleeve 6 and the sagittal sleeve 18, the position adjusting range of the angle adjusting member 10 is effectively increased, a transverse arc sleeve 9 is arranged below the longitudinal sleeve 8, and the transverse arc sleeve 9 is used for being in sliding connection with the three-dimensional distance adjusting member 4;

the angle adjusting component 10 comprises a transverse arc-shaped scale rod 11 arranged in a transverse arc-shaped sleeve 9, a longitudinal arc-shaped sleeve 12 arranged at one end of the transverse arc-shaped scale rod 11, a longitudinal arc-shaped scale rod 13 arranged in the longitudinal arc-shaped sleeve 12 and a guide block 14 arranged at one end of the longitudinal arc-shaped scale rod 13, wherein the transverse arc-shaped scale rod 11 slides inside and outside the transverse arc-shaped sleeve 9 to adjust the inner inclination angle, the longitudinal arc-shaped scale rod 13 slides up and down in the longitudinal arc-shaped sleeve 12 to adjust the pitch inclination angle, so that the aim of accurately controlling the nail feeding direction is fulfilled, locking components are arranged on the transverse arc-shaped sleeve 9 and the longitudinal arc-shaped sleeve 12, each locking component comprises a locking threaded hole and a locking stud arranged in the threaded hole, a guide hole is formed in the guide block 14 in a penetrating manner, a guide sleeve 15 is arranged in the guide hole, and the, the guide block 14 is provided with locking means for locking the guide sleeve 15 in the guide hole.

As shown in fig. 6, the vertebrae are composed of transverse processes 26, superior articular processes 27, vertebral bodies 28, vertebral foramen 29, pedicles 30 and spinous processes 31, and when the vertebrae are damaged or have spinal cord diseases, pedicle screws are implanted into adjacent vertebrae to fix the upper and lower vertebrae. Before use, marking the position of a nail feeding point on the vertebral arch plate; when the device is used, the front end of a reference needle 22 is drilled forwards in the sagittal plane of the spinous process 31, the inner inclination angle of the reference needle 22 and the central axis of the pedicle channel is determined according to preoperative CT measurement, the rear end of the reference needle 22 passes through a needle groove of the convex plate 16 and is inserted into a reference hole 21 of the T-shaped fixture block 17, the adjusting base 1 is parallel to the reference needle 22, and the fixing needle 19 passes through a fixing hole of the gate-shaped plate 2 and is fixed on the spinous process 31; adjusting a longitudinal arc-shaped scale rod 13 in a longitudinal arc-shaped sleeve 12 according to a pitch inclination angle measured by CT before operation to preset a pitch inclination angle, screwing a locking stud to fix the longitudinal arc-shaped scale rod 13, adjusting a transverse arc-shaped scale rod 11 in a transverse arc-shaped sleeve 9 according to an inner inclination angle of a reference needle 22 and a central axis of a pedicle channel, and screwing the locking stud to fix the transverse arc-shaped scale rod 11, so that a nail feeding direction with a pitch inclination angle to be determined and an accurate camber angle is obtained (the direction of a guide hole of a guide block is the preset nail feeding direction); the vertical, the transverse and the longitudinal positions of the angle adjusting member 10 are adjusted by sliding the sagittal slide bar 3, the transverse slide bar 5 and the longitudinal slide bar 7 on the sagittal sleeve 19, the transverse sleeve 6 and the longitudinal sleeve 8 respectively, and the sagittal sleeve 18, the transverse sleeve 6 and the longitudinal sleeve 8 are fixed by positioning bolts; finally, the guide sleeve 15 passes through the guide hole of the guide block 14 and is fixed in the guide hole by a locking stud, so that the tip of the guide pin in the guide hole is aligned to the nail feeding point; the spinal column side position X-ray perspective is carried out, the included angle between the guide pin in the guide hole and the central axis of the pedicle screw channel is known, the pitching inclination angle is adjusted until the included angle is 0 degree < - >, namely the guide pin is completely consistent with the central axis of the pedicle screw channel, the guide pin is taken out, and the channel opener 25 penetrates through the guide sleeve 15 to open a circuit from the screw feeding point along the screw feeding direction, so that the pedicle screw channel is obtained; after the pedicle screw passage is completed, the channel opener is taken out of the guide sleeve 15, the fixing needle 19 on the spinous process 31 is pulled out, the base 1 is withdrawn along the tail end of the reference needle 23, the reference needle 23 on the spinous process 31 is pulled out, and finally the detached part is sterilized for the next use.

The above disclosure is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the scope of the invention, therefore, the present invention is not limited by the appended claims.

Claims

1. The utility model provides a pedicle of vertebral arch passageway screw three-dimensional director which characterized in that: the three-dimensional distance adjusting device comprises a base, a three-dimensional distance adjusting component arranged on the base and an angle adjusting component arranged at the other end of the three-dimensional distance adjusting component;

the base comprises a door-shaped plate and a sagittal sleeve arranged at the other end of the door-shaped plate, and a reference needle is longitudinally arranged at the top of the door-shaped plate;

the three-dimensional distance adjusting component comprises a sagittal slide bar arranged in the sagittal sleeve, a transverse slide bar arranged above the sagittal slide bar, a transverse sleeve sleeved on the transverse slide bar, a longitudinal slide bar arranged on the transverse sleeve, and a longitudinal sleeve sleeved on the longitudinal slide bar, wherein the sagittal sleeve, the transverse sleeve and the longitudinal sleeve are provided with positioning components, and a transverse arc sleeve is arranged below the longitudinal sleeve;

the angle adjusting component comprises a transverse arc scale rod arranged in the transverse arc scale rod, a longitudinal arc scale rod arranged at one end of the transverse arc scale rod, a longitudinal arc scale rod arranged in the longitudinal arc scale rod and a guide block arranged at one end of the longitudinal arc scale rod, locking components are arranged on the transverse arc scale rod and the longitudinal arc scale rod, and guide holes are formed in the guide block in a penetrating mode.

2. The pedicle access screw three-dimensional guide of claim 1, wherein: the door-shaped plate top has been seted up the draw-in groove, sets up T shape fixture block in the draw-in groove, sets up the benchmark hole on the T shape fixture block, the benchmark needle is established downthehole at the benchmark, and door-shaped plate top inside wall is seted up concave groove, is provided with protruding template between the concave groove, sets up the needle groove that is used for the benchmark needle to pass on the protruding template.

3. The pedicle access screw three-dimensional guide of claim 1, wherein: the side wall of the bottom of the door-shaped plate is provided with a fixing hole, and a fixing needle is arranged in the fixing hole.

4. The pedicle access screw three-dimensional guide of claim 1, wherein: the positioning component comprises positioning sliding grooves formed in the sagittal sleeve, the transverse sleeve and the longitudinal sleeve and positioning bolts penetrating through the positioning sliding grooves and in threaded connection with the sagittal sliding rod, the transverse sliding rod and the longitudinal sliding rod.

5. The pedicle access screw three-dimensional guide of claim 1, wherein: the vector is to the perpendicular connecting rod that sets up in slide bar top and be connected perpendicularly in the middle part of the horizontal slide bar, all sets up the rectangle spout that can pass the connecting rod on horizontal sleeve pipe and the vertical sleeve pipe.

6. The pedicle access screw three-dimensional guide of claim 1, wherein: a guide sleeve is arranged in a guide hole of the guide block, and a locking component is arranged on the guide block.

7. The pedicle access screw three-dimensional guide of claim 1 or 6, wherein: the locking member includes a locking threaded bore and a locking stud disposed within the threaded bore.