CN2754574Y

CN2754574Y - Vertebral arch screw implanting guider

Info

Publication number: CN2754574Y
Application number: CN 200420057903
Authority: CN
Inventors: 方煌; 胡宁; 陈安民
Original assignee: Tongji Medical College of Huazhong University of Science and Technology
Current assignee: Tongji Medical College of Huazhong University of Science and Technology
Priority date: 2004-12-21
Filing date: 2004-12-21
Publication date: 2006-02-01
Anticipated expiration: 2014-12-21

Abstract

The utility model discloses a vertebral arch pedicle screw implanting guider which comprises a guide needle rod, wherein two regulating blocks are arranged and fixed on a rod body of the guide needle rod. A horizontal dial and a sagittal dial which are arranged mutually and vertically are respectively arranged on the two regulating blocks, and the two regulating blocks are respectively matched with the horizontal dial and the sagittal dial in the circular slide mode with the bottom end of the guide needle rod as a circle center. A positioning screw which is fixedly connected to the horizontal dial or the sagittal dial is respectively arranged on the two regulating blocks, and a guiding sleeve barrel is arranged on the rod body of the guide needle rod. The guider can specifically quantify the three-dimensional direction of a vertebral arch pedicle, enhances the accuracy of the implantation of the screw and has low cost and important clinical practical value.

Description

Pedicle screw is implanted guider

Technical field

This utility model relates to the medical assistance apparatus that cooperates pedicle screw to implant, and specifically refers to a kind of pedicle screw implantation guider.

Background technology

In the treatment of illness such as spinal trauma, deformity, regression, need to adopt cervical arc root screw internal fixing system to the pedicle of vertebral arch pedicle screw, fix three posts of spinal column.The worldwide popularization and application of segmental LOCATION OF PEDICLE SCREW FIXATION technology becomes one of the most frequently used internal fixation method of spinal surgery posterior approach.Many scholar's research the qualitative, quantitative of pedicle of vertebral arch dissect, the auxiliary pedicle screw implantation of technology such as image application, electrophysiology, but fracture of vertebral pedicle, wear out and complication such as nerve injury still higher.The pedicle screw implantation position has deviation slightly, not only influences its stability, and might cause the vital tissue organ injury that adjoins.

At present, most of hospitals still use conventional methods, and slowly implant pedicle screw with the feel of operator, or after inserting guide pin shooting X-ray film judgement position earlier, implant again.Owing to do not quantize the sagittal angle and the horizontal angle of pedicle of vertebral arch, the pedicle screw in being difficult to guarantee to perform the operation more than four pieces or four pieces is all correctly implanted.Use evoked electromyogram and monitor the pedicle screw implantation process in real time, its sensitivity is higher, but its monitoring effect of factor affecting such as loss of function behind the anaesthetic, chronic nerve root pressurized.And adopt the computer location and navigation technology to come additional screws to implant, and needing very high hardware-software condition, very high personnel's requirement, expensive cost also makes it be difficult in a short time apply.

Also there are some medical research personnel to develop relevant pedicle screw respectively both at home and abroad and implant guider.The position that has according to bone anatomical structures such as transverse process, rib judgement pedicle of vertebral arch lateral wall, the implantation of auxiliary thoracic pedicle screw; The design concept that has has only been considered pedicle of vertebral arch axis and the sagittal angle of vertebral body, i.e. direction on the single plane, and determine the three dimensions trend of pedicle of vertebral arch fully.

Summary of the invention

The purpose of this utility model will overcome above-mentioned existing in prior technology defective exactly, provide a kind of and can clearly quantize the three-dimensional of pedicle of vertebral arch, the accuracy that the raising screw is implanted, and pedicle screw with low cost, that be easy to promote is implanted guider.

For realizing this purpose, the designed pedicle screw of this utility model is implanted guider, include a guide pin bar, arranged in dislocation is fixed with two regulating blocks on the shaft of described guide pin bar, be separately installed with mutual vertically arranged horizontal circle and sagittal graduated disc on described two regulating blocks, it is that the center of circle is circular arc with described horizontal circle and sagittal graduated disc respectively and is slidingly matched that described two regulating blocks are decided pin mark with the bottom of guide pin bar, be respectively arranged with the dog screw of fixedly connected horizontal circle or sagittal graduated disc on described two regulating blocks, the shaft of described guide pin bar is provided with pilot sleeve.

Operation principle of the present utility model is such: its guide pin bar can be by means of being slidingly matched between two regulating blocks fixed thereon and horizontal circle and the sagittal graduated disc, is that the center of circle is done circular-arc motion respectively on two graduated discs with the nail point of deciding of its bottom.Horizontal circle can reflect guide pin bar and sagittal angle, corresponding to the angle between pedicle of vertebral arch axis and the vertebral body sagittal axis, i.e. TSA angle.The sagittal graduated disc can reflect the angle of guide pin bar and horizontal plane, corresponding to the angle between pedicle of vertebral arch axis and the vertebral body horizontal plane, i.e. SSA angle.Place pedicle of vertebral arch to enter the nail place nail point O that decides of guide pin bar bottom, regulate the direction in space of guide pin bar according to above-mentioned TSA angle and SSA angle, this moment, two intermediary 0 ° of calibration points of graduated disc were A, B at the planar upright projection point in fixed nail point O place, when ∠ AOB is the right angle, the direction of guide pin bar is that needed ideal advances to follow closely direction, thereby has quantized the three dimensions trend of pedicle of vertebral arch.

Advantage of the present utility model is: designed guider can clearly quantize the three-dimensional of pedicle of vertebral arch, promptly determines the angle of pedicle of vertebral arch axis and sagittal plane and horizontal plane simultaneously.It is tested in adult's spinal column specimen, and it is good that iconography and entity are observed the screw position that all confirms the guiding implantation, and the pedicle of vertebral arch wall does not all have obvious fracture or wears out phenomenon.It is applied to also further confirm its safety in the clinical spinal column way of escape LOCATION OF PEDICLE SCREW FIXATION operation.Therefore, this guider can be guaranteed pedicle screw according to correct space three-dimensional angle, implants breast section, breast waist section and the waist section of spinal column exactly, not limited by sections, has reduced the generation of by mistake planting with complication effectively.Simultaneously, this guide structure is simple and reliable, and is flexible and convenient to use, do not influence the actual operation operation, can significantly shorten operating time, and it is with low cost, is convenient to promote, and has important value for clinical application.

Description of drawings

Fig. 1 is the main TV structure sketch map that a kind of pedicle screw is implanted guider;

Fig. 2 is the left TV structure sketch map of Fig. 1;

Fig. 3 is that the guide pin bar among Fig. 1 is reflected in the TSA angle on the horizontal circle;

Fig. 4 is that the guide pin bar among Fig. 1 is reflected in the SSA angle on the sagittal graduated disc;

Fig. 5 is the fundamental diagram of guider shown in Figure 1.

The specific embodiment

Below in conjunction with the drawings and specific embodiments this utility model is described in further detail:

Pedicle screw shown in the figure is implanted guider, can adopt stainless steel material to process.It has the guide pin bar 5 of a square sectional, and arranged in dislocation is fixed with two and is on 2, two regulating blocks 2 of vertically arranged regulating block and is separately installed with mutual vertically arranged horizontal circle 1 and sagittal graduated disc 3 on the shaft of guide pin bar 5.It is that the center of circle is circular arc with described horizontal circle 1 and sagittal graduated disc 3 respectively and is slidingly matched that two regulating blocks 2 are decided pin mark O with the bottom of guide pin bar 5.Particularly, horizontal circle 1 and the curved chute structure of sagittal graduated disc 3 designs, two regulating blocks 2 are nested in the arc chute of horizontal circle 1 and sagittal graduated disc 3 by design perforation therebetween is accurate respectively, and are accurately errorless to guarantee TSA angle and SSA angle that two parts that mutual arc is slidingly matched are reflected.Be respectively arranged with the dog screw 4 of fixedly connected horizontal circle 1 or sagittal graduated disc 3 on two regulating blocks 2,, further guarantee the precision at TSA angle and SSA angle so that two parts that are slidingly matched of arc keep relative position to fix at last mutually.The shaft of described guide pin bar 5 is provided with three pilot sleeves 6, three pilot sleeves 6 are arranged in shaft upper end, middle part and the lower end of guide pin bar 5, so that give the pedicle screw thread tapper that passes therethrough guiding, guarantee that pedicle screw is according to correct three-dimensional perspective implantation.

When this utility model uses: at first, before operation, use multi-layer spiral CT the required fixed spinal segments of patient is carried out axial scan and the reorganization of many planars, three-dimensional reconstruction, measure angle (SSA angle) and pedicle of vertebral arch transverse diameter between angle (TSA angle), pedicle of vertebral arch axis and the vertebral body horizontal plane between pedicle of vertebral arch axis and the vertebral body sagittal axis, indulge directly and the bone-screw passage length.Secondly, regulate the deflection angle of guide pin bar 5 on horizontal circle 1, regulate the deflection angle of guide pin bar 5 on sagittal graduated disc 3 according to the pedicle of vertebral arch SSA angle of measuring again, determine the direction in space of guide pin bar 5 according to the pedicle of vertebral arch TSA angle of measuring.Then, 0 ° of scale place, centre at horizontal circle 1 and sagittal graduated disc 3 hangs up the gravity vertical line respectively, the entry point that nail point O places patient's pedicle of vertebral arch of deciding with guide pin bar 5 bottoms, two gravity vertical lines are A, B with the planar intersection point in fixed nail point O place, when ∠ AOB was the right angle, the direction in space of guide pin bar 5 was needed ideal orientation.At last, will pass three pilot sleeves 6 of pedicle screw thread tapper from guide pin bar 5, the screw intake channel that tapping is correct on pedicle of vertebral arch removes guider, screw is implanted pedicle of vertebral arch get final product.

Claims

1. a pedicle screw is implanted guider, include a guide pin bar (5), it is characterized in that: arranged in dislocation is fixed with two regulating blocks (2) on the shaft of described guide pin bar (5), be separately installed with mutual vertically arranged horizontal circle (1) and sagittal graduated disc (3) on described two regulating blocks (2), it is that the center of circle is circular arc with described horizontal circle (1) and sagittal graduated disc (3) respectively and is slidingly matched that described two regulating blocks (2) are decided pin mark (O) with the bottom of guide pin bar (5), be respectively arranged with the dog screw (4) of fixedly connected horizontal circle (1) or sagittal graduated disc (3) on described two regulating blocks (2), the shaft of described guide pin bar (5) is provided with pilot sleeve (6).

2. pedicle screw according to claim 1 is implanted guider, it is characterized in that: the curved chute structure of said horizontal circle (1) and sagittal graduated disc (3) design, said two regulating blocks (2) by design perforation therebetween respectively precision be nested in the arc chute of horizontal circle (1) and sagittal graduated disc (3).

3. pedicle screw according to claim 1 and 2 is implanted guider, it is characterized in that: shaft upper end, middle part and the lower end of said guide pin bar (5) are respectively arranged with a pilot sleeve (6).