CN213606814U

CN213606814U - Spinous process midline-nail feeding point distance measurer

Info

Publication number: CN213606814U
Application number: CN202021672856.0U
Authority: CN
Inventors: 邓迎生
Original assignee: Individual
Current assignee: Individual
Priority date: 2020-08-12
Filing date: 2020-08-12
Publication date: 2021-07-06
Anticipated expiration: 2030-08-12

Abstract

The utility model discloses a spinous process central line-nail feeding point distance measurer, including deciding the slider, slide the setting in the measuring part of deciding the slider both sides and with measuring part sliding connection's extensible member. The utility model discloses simple structure, high durability and convenient use, the reference benchmark as with the benchmark needle of fixed slider, measure spinous process central line-advance the nail point distance through the measuring part, and support the vertical support plate of extensible member and confirm and mark the vertical line of the nail point of advancing of crossing on the vertebral arch board, the horizontal transverse line at nail point place is confirmed to methods such as data such as reunion three-dimensional CT and osseous dissection sign and intraoperative perspective, and then pinpoint the nail point of advancing, avoided making the pedicle screw wear out the pedicle of vertebral arch and harm the spinal cord because of advancing the nail point and confirming the mistake, nerve root, the risk of important tissue such as vertebra artery, do not receive the influence that the vertebra has anatomical difference and multiple deformity, be favorable to the accurate position of measuring spinous process central line-advance the nail point distance and location nail point of advancing.

Description

Spinous process midline-nail feeding point distance measurer

Technical Field

The utility model belongs to the field of orthopedic surgery instruments, relates to an auxiliary device of spinal pedicle screw internal fixation operation, concretely relates to spinous process central line-point of advance distance caliber.

Background

The spine pedicle screw internal fixation operation is a basic technology of modern spine surgery, and a spine is fixed by passing a pedicle screw through a narrow pedicle channel based on the anatomical characteristics of a pedicle; the requirement of the spinal pedicle screw internal fixation operation on the screw feeding point is extremely high (for example, the error of the cervical pedicle screw cannot exceed 1mm), so whether the screw feeding point of the pedicle screw can be accurately determined in the operation process becomes one of the key factors for success and failure of the operation.

The correct selection of the nail feeding point is the first step of successful pedicle nail placement, and is mainly determined by bony anatomical landmarks in the operation. The cervical vertebra is the part with the greatest technical difficulty and the greatest risk in the implantation of the vertebral pedicle screw of the spine, the positioning of the screw feeding point of the cervical vertebra is commonly performed by a Magerl method and a Roy-Camille method, the outer edge of a side block and an upper articular process are used as reference standards, and the positioning of the upper and lower positions (namely the horizontal position) of the screw feeding point can be determined by X-ray perspective of a C arm in the operation; but the distance between the inner side and the outer side of the nail feeding point is positioned, the distance cannot be determined by means of perspective due to the existence of the internal inclination angle and the pitching inclination angle, if the distance is too far inward, the spinal cord is easily injured, and if the distance is too far outward, the vertebral artery is easily injured, so that the distance between the inner side and the outer side of the nail feeding point is very critical and difficult to determine; the positioning difficulty and risk of the screw feeding point of the thoracic vertebra (particularly the upper thoracic vertebra) are high, the equal lines of the upper height and the lower height of the transverse process root are mostly used as horizontal marking lines, the outer edge line of the articular process is used as a longitudinal reference line to estimate the screw feeding point of the pedicle screw, and the positioning of the distance between the inner side and the outer side of the pedicle screw has the similar inner inclination angle and pitching inclination angle with the cervical vertebra and is difficult to accurately determine; the pedicle of the lumbar vertebra is relatively thick, the operation risk is relatively low, and the positioning of the nail feeding point is mostly determined by taking a bisector of the upper and lower heights of the root of the transverse process as a horizontal marking line and taking an outer margin line of the articular process as a longitudinal reference line and combining the position of the mastoid process. However, the vertebral body, the vertebral pedicle and the accessory of the vertebral column belong to irregular bones, the position has obvious anatomical difference and various deformities (such as hemivertebras, fusion of spinous processes, scoliosis, kyphosis, gooseneck deformity and the like), and the positions of the screw feeding points on the left side and the right side are possibly different, so that the screw feeding point of the vertebral pedicle screw cannot be accurately determined only by bony anatomical marks, and the risk that the vertebral pedicle screw penetrates out of the vertebral pedicle to damage important tissues such as spinal cord, nerve roots, vertebral artery and the like exists, and a device capable of accurately positioning the screw feeding point at the internal and external distances is lacked at present.

SUMMERY OF THE UTILITY MODEL

The utility model aims at providing a spinous process central line-advance a nail point distance measurement ware, through survey piece and extensible member confirm the perpendicular line of advancing the nail point on the vertebral arch board, combine data such as three-dimensional CT and bony nature anatomical landmarks to confirm the point of advancing the nail again, solved only to rely on bony nature anatomical landmarks can not accurately confirm the problem that pedicle of vertebral arch screw advances the nail point.

The utility model discloses the technical scheme who adopts:

a spinous process midline-nail feeding point distance measurer is characterized in that: the device comprises a fixed sliding block, measuring parts arranged on two sides of the fixed sliding block in a sliding manner and a telescopic part connected with the measuring parts in a sliding manner;

the fixed sliding block is longitudinally provided with a reference hole, a reference needle is arranged in the reference hole, the reference needle is used as a reference for measurement, and the fixed sliding block is fixed on the midline of the spinous process;

the measuring part comprises transverse sliding rulers arranged at two ends of a fixed sliding block in a sliding mode and a connecting block arranged at one end of each transverse sliding ruler, the transverse sliding rulers slide left and right at two ends of the fixed sliding block to measure the distance between the center line of the spinous process and a nail feeding point, a limiting member is arranged between the fixed sliding block and each transverse sliding ruler and used for limiting the transverse sliding rulers on the fixed sliding blocks, scale marks are arranged on the outer surfaces of the transverse sliding rulers to facilitate observation of the sliding distance of the transverse sliding rulers, a longitudinal sliding groove is formed in the connecting block, and a locking member is arranged on the longitudinal sliding groove and used for locking a telescopic part in;

the telescopic piece comprises a longitudinal sliding rod arranged in a longitudinal sliding groove in a sliding mode and a vertical abutting plate arranged at one end of the longitudinal sliding rod, the longitudinal sliding rod slides back and forth in the longitudinal sliding groove to vertically abut the vertical abutting plate against a nail feeding point on a vertebral arch plate, the longitudinal sliding rod is locked in the longitudinal sliding groove through a locking component, a longitudinal line of the nail feeding point is drawn on the vertebral arch plate of a vertebra by an electric knife along the vertical abutting plate (namely, the horizontal distance from the middle line of the spinous process to the outer side to the nail feeding point is determined), and finally, a horizontal transverse line where the nail feeding point is located is determined by combining three-dimensional CT (computed tomography) and other data, bony dissection signs, intraoperative perspective and other methods, so that the nail feeding point is accurately located.

Furthermore, the fixed sliding block comprises a vertical slot and a T-shaped inserting block arranged in the slot, and the reference hole is formed in the T-shaped inserting block, so that a longer reference hole is obtained, a steel needle is guided, and shaking in the operation process is avoided.

Further, the limiting component comprises a transverse sliding groove arranged on the transverse sliding ruler and a limiting bolt penetrating through the transverse sliding groove and connected with two ends of the thread of the fixed sliding block, the limiting bolt limits the transverse sliding ruler to slide left and right at two ends of the fixed sliding block, and when the limiting bolt is tightened, the transverse sliding ruler can be fixed and locked at two ends of the sliding block.

Further, the locking member includes a locking hole and a locking bolt threadedly coupled to the locking hole.

Furthermore, two vertical sliding grooves which are vertically arranged and are parallel to each other are formed in the connecting block, the number of the vertical sliding rods is two, the two vertical sliding rods are correspondingly arranged in the vertical sliding grooves, and the vertical abutting plate connected with one end of each vertical sliding rod is always in the vertical direction.

Furthermore, a longitudinal fixing hole is formed in the upper end of the vertical abutting plate, a longitudinal fixing needle is arranged in the longitudinal fixing hole, a transverse fixing hole is formed below the longitudinal fixing hole, and a transverse fixing needle is arranged in the transverse fixing hole and used for temporarily fixing the vertical abutting plate on a vertebra.

Furthermore, the lower part of the vertical abutting plate is provided with an L-shaped notch, and the L-shaped notch is used for abutting against a vertebral arch plate of a vertebra and plays a supporting role for the vertical abutting plate.

The utility model has the advantages that:

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

2. the utility model discloses regard as the reference benchmark with the benchmark needle (inserting on the spinous process midline) of fixed slider, measure spinous process central line-advance nail point distance through the measuring part, and support the vertical butt plate of extensible member on the vertebral arch board confirm and mark out advance the longitudinal line of nail point (for the human body), combine data such as three-dimensional CT and bony dissection sign and intraoperative perspective etc. method confirm advance horizontal transverse line that the nail point locates again, and then pinpoint advance the nail point, avoided because advance the nail point confirm mistake make the pedicle screw wear out of the pedicle of vertebral arch and injure the risk of important tissue such as spinal cord, nerve root, vertebral artery;

3. the utility model discloses an insert the benchmark needle on the spinous process central line as the reference benchmark, do not receive the influence that the vertebra exists anatomical difference and multiple deformity, compare more objectively with the outer fringe and the last articular process of side piece as the reference benchmark, be favorable to accurate measurement spinous process central line-advance the position of nailing point distance and location advance the nailing point.

Drawings

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

fig. 2 is a schematic view of the usage state of the present invention.

In the figure: 1. a fixed sliding block; 2. a T-shaped insert block; 3. a reference hole; 4. a transverse slide rule; 5. a reference pin; 6. connecting blocks; 7. scale lines; a threaded hole; 8. a transverse chute; 9. a restraining bolt; 10. a longitudinal slide bar; 11. a vertical resisting plate; 12. a transverse fixing pin; 13. a longitudinal fixation pin; 14. locking the bolt; 15. transverse process; 16. a vertebral arch plate; 17. the superior articular process; 18. a pedicle of a vertebral arch; 19. a vertebral foramen; 20. a vertebral body; 21. 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, the utility model provides a spinous process midline-nail feeding point distance measurer, which comprises a fixed slide block 1, measuring parts arranged at two sides of the fixed slide block 1 in a sliding way, and a telescopic part connected with the measuring parts in a sliding way;

the fixed sliding block 1 comprises a slot longitudinally formed and a T-shaped inserting block 2 arranged in the slot, a datum hole 3 is formed in the T-shaped inserting block 2, a datum pin 5 is arranged in the datum hole 3, the datum hole 3 plays a guiding role for the datum pin 5, shaking in the operation process is avoided, the datum pin 5 is used as a reference datum for measurement, and the fixed sliding block 1 is fixed at the center line of the spinous process;

the measuring part comprises transverse sliding rulers 4 arranged at two ends of a fixed sliding block 1 in a sliding way and a connecting block 6 arranged at one end of the transverse sliding rulers 4, the transverse sliding rulers 4 slide left and right at two ends of the fixed sliding block 1 to measure the distance between the center line of the spinous process and a nail feeding point, a limiting member is arranged between the fixed sliding block 1 and the transverse sliding rulers 4, the limiting member comprises a transverse sliding groove 8 arranged on the transverse sliding rulers 4 and a limiting bolt 9 penetrating through the transverse sliding groove 8 and connected with two ends of the thread of the fixed sliding block 1, the limiting bolt 9 limits the transverse sliding rulers 4 to slide left and right at two ends of the fixed sliding block 1, when the limiting bolt 9 is screwed down, the transverse sliding rulers 4 can be fixed and locked at two ends of the sliding blocks, the outer surface of the transverse sliding rulers 4 is provided with scale marks 7 to facilitate observation of the sliding distance of the transverse sliding rulers 4, the locking member comprises a locking hole and a locking bolt 14 in threaded connection with the locking hole and is used for locking the telescopic piece in the longitudinal sliding groove;

the telescopic piece comprises longitudinal slide bars 10 arranged in a longitudinal sliding groove in a sliding manner and vertical resisting plates 11 arranged at one ends of the longitudinal slide bars 10, the number of the longitudinal slide bars 10 is two, the longitudinal slide bars are correspondingly arranged in the longitudinal sliding groove, in order to ensure that the vertical resisting plates 11 connected with one ends of the longitudinal slide bars 10 are always in the vertical direction, the upper ends of the vertical resisting plates 11 are provided with longitudinal fixing holes, longitudinal fixing needles 13 are arranged in the longitudinal fixing holes, transverse fixing holes are arranged below the longitudinal fixing holes, transverse fixing needles 12 are arranged in the transverse fixing holes and used for temporarily fixing the vertical resisting plates 11 on vertebrae, the lower parts of the vertical resisting plates 11 are provided with L-shaped gaps, the L-shaped gaps are used for abutting against vertebral arch plates of the vertebrae, the vertical resisting plates 11 are supported, the longitudinal slide bars 10 slide back and forth in the longitudinal sliding groove to vertically abut against nail feeding points on the vertebral arch plates, and the longitudinal slide bars 10 are locked in the longitudinal sliding groove through locking bolts 14, then drawing a perpendicular line passing through the nail feeding point on the vertebral arch plate of the vertebra along the vertical supporting plate 11 by using the electric knife, and finally determining the nail feeding point by combining the data of three-dimensional CT and the like and the bony anatomical mark.

As shown in fig. 2, the principle of the present invention is as follows:

taking cervical vertebra as an example, the vertebra consists of transverse processes 15, vertebral laminas 16, upper articular processes 17, lower articular processes, vertebral pedicle 18, vertebral foramen 19, vertebral bodies 20 and spinous processes 21, when the vertebra is damaged, vertebral pedicle screws need to be implanted into two adjacent vertebrae to fix the upper vertebra and the lower vertebra, a screw feeding point needs to be determined firstly during operation, then an open circuit device is used for opening the circuit, and finally the vertebral pedicle screws are placed and fixed to the vertebra. When the nail feeding point is determined, a reference needle 5 is inserted into the center of the spinous process 21 (namely on the spinous process midline) through a reference hole 3 on an insertion block 2, a fixed sliding block 1 is fixed at the center of the spinous process, the spinous process midline is taken as a measurement starting point, the distance from the spinous process midline to the nail feeding point is calculated according to data such as three-dimensional CT before operation, transverse sliding rulers 4 on two sides of the fixed sliding block 1 are slid, scale marks 7 are observed at the same time, when the sliding distance of the transverse sliding rulers 4 on two sides is equal to the distance from the spinous process midline to the nail feeding point, the sliding is stopped, a limiting bolt 9 is screwed down, and the transverse sliding rulers 4 are fixed on the fixed sliding block 1; then, the longitudinal sliding rod 10 slides towards the direction of the vertebral arch plate 16, after the vertical abutting plate 11 abuts against the vertebral arch plate 16, the longitudinal sliding rod 10 is fixed in the longitudinal sliding groove through the locking bolt 8, then the longitudinal fixing pin 13 and the transverse fixing pin 12 respectively penetrate through the longitudinal fixing hole and the transverse fixing hole to temporarily fix the vertical abutting plate 11 on the vertebra, and at the moment, a vertical line passing through a fixed point is drawn on the vertebral arch plate 16 along the vertical abutting plate 11 by using an electrotome; after drawing the vertical line, firstly pulling out the longitudinal fixing needle 13 and the transverse fixing needle 12 from the vertebra, and dismounting the whole spinous process midline-nail feeding point distance measurer; and finally, calculating the up-down distance from the articular process 17 or the inferior articular process to the nail feeding point according to the data of the preoperative three-dimensional CT and the like, and finding and marking the nail feeding point on the drawn vertical line.

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. A spinous process midline-nail feeding point distance measurer is characterized in that: the device comprises a fixed sliding block, measuring parts arranged on two sides of the fixed sliding block in a sliding manner and a telescopic part connected with the measuring parts in a sliding manner;

the fixed sliding block is longitudinally provided with a reference hole, and a reference needle is arranged in the reference hole;

the measuring part comprises a transverse sliding ruler and a connecting block, the transverse sliding ruler is arranged at two ends of a fixed sliding block in a sliding mode, the connecting block is arranged at one end of the transverse sliding ruler, a limiting component is arranged between the fixed sliding block and the transverse sliding ruler, scale marks are arranged on the outer surface of the transverse sliding ruler, a longitudinal sliding groove is formed in the connecting block, and a locking component is arranged on the longitudinal sliding groove;

the telescopic piece comprises a longitudinal sliding rod arranged in the longitudinal sliding groove in a sliding mode and a vertical abutting plate arranged at one end of the longitudinal sliding rod.

2. The spinous process midline-approach point distance measurement device of claim 1, wherein: the fixed sliding block comprises a slot vertically formed and a T-shaped inserting block arranged in the slot, and the reference hole is longitudinally formed in the T-shaped inserting block.

3. The spinous process midline-approach point distance measurement device of claim 1, wherein: the limiting component comprises a transverse sliding groove arranged on the transverse sliding ruler and a limiting bolt which penetrates through the transverse sliding groove and is in threaded connection with the fixed sliding block.

4. The spinous process midline-approach point distance measurement device of claim 1, wherein: the locking member includes a locking hole and a locking bolt threadedly coupled to the fixing hole.

5. The spinous process midline-approach point distance measurement device of claim 1, wherein: two longitudinal sliding grooves which are parallel to each other are formed in the connecting block, and the number of the longitudinal sliding rods is two and the longitudinal sliding rods are correspondingly arranged in the longitudinal sliding grooves.

6. The spinous process midline-approach point distance measurement device of claim 1, wherein: vertical fixing holes are formed in the upper ends of the vertical supporting plates, vertical fixing needles are arranged in the vertical fixing holes, transverse fixing holes are formed below the vertical fixing holes, and transverse fixing needles are arranged in the transverse fixing holes.

7. The spinous process midline-approach point distance measurement device of claim 1, wherein: and an L-shaped notch is formed in the lower part of the vertical abutting plate.