DE20004812U1 - Endoscopic expanding pliers - Google Patents

Endoscopic expanding pliers

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Publication number
DE20004812U1
DE20004812U1 DE20004812U DE20004812U DE20004812U1 DE 20004812 U1 DE20004812 U1 DE 20004812U1 DE 20004812 U DE20004812 U DE 20004812U DE 20004812 U DE20004812 U DE 20004812U DE 20004812 U1 DE20004812 U1 DE 20004812U1
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forceps
spreading
endoscopic
thoracic
treatment
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025—Joint distractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/2804—Surgical forceps with two or more pivotal connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00261—Discectomy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025—Joint distractors
    • A61B2017/0256—Joint distractors for the spine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4635—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive surgery

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Description

Endoskopische SpreizzangeEndoscopic spreading forceps

Die Erfindung betrifft eine endoskopische Spreizzange zur Behandlung instabiler Läsionen der Brust- und Lendenwirbelsäule.The invention relates to an endoscopic spreading forceps for the treatment of unstable lesions of the thoracic and lumbar spine.

Die kombinierte dorso-ventrale Stabilisierung ist eines von verschiedenen Standardverfahren zur Behandlung instabiler Läsionen der Brust- und Lendenwirbelsäule. Zu den instabilen Läsionen gehören instabile Verletzungen, die hauptsächlich den thorakolumbalen Übergang (11. /12. Brustwirbelkörper sowie 1.12. Lendenwirbelkörper) betreffen, instabile Fehlstellungen nach Verletzungen mit oder ohne ausreichende Behandlung und Tumoren. Das Verfahren sieht zunächst die Stabilisierung des betroffenen Abschnitts mit einem von hinten angebrachten Implantat vor, wobei im deutschsprachigen Raum fast ausschließlich ein innerer Spanner (Fixateur interne) verwendet wird. Danach wird in einem zweiten Operationsschritt die Tragfähigkeit der vorderen Säule wiederhergestellt: Dieses geschiehtCombined dorsoventral stabilization is one of several standard procedures for treating unstable lesions of the thoracic and lumbar spine. Unstable lesions include unstable injuries that primarily affect the thoracolumbar transition (11th/12th thoracic vertebrae and 1.12th lumbar vertebrae), unstable misalignments after injuries with or without adequate treatment, and tumors. The procedure initially involves stabilizing the affected section with an implant attached from behind, with an internal tensioner (internal fixator) being used almost exclusively in German-speaking countries. The load-bearing capacity of the anterior column is then restored in a second surgical step: This is done

1. mit einem massiven Knochenspan, der aus dem Beckenkamm des Patienten entnommen wird. Der Vorteil dieses Verfahrens besteht darin, daß bei der Verwendung eines Beckenkammspanes dieser über einen minimal - invasiven Zugangsweg eingesetzt werden kann. Als nachteilig erweist sich, daß die Entnahme von Beckenkammspänen bei den Patienten häufig zu bleibenden Schmerzen oder funktionellen Beeinträchtigungen fuhrt und die Implantanthöhe der Größe des Defektes nicht angepaßt werden kann.1. with a solid bone chip taken from the patient's iliac crest. The advantage of this procedure is that when an iliac crest chip is used, it can be inserted via a minimally invasive access route. The disadvantage is that the removal of iliac crest chips often leads to permanent pain or functional impairments in the patient and the implant height cannot be adjusted to the size of the defect.

2. durch den Einsatz eines druckfesten Dauerimplantats, wie beispielsweise Synex™. Der Vorteil dieses Implantates besteht darin, daß es zunächst in minimaler Höhe in den Defekt zwischen zwei benachbarten Wirbelkörpem eingesetzt und anschließend mit einer speziellen Spreizzange auf die gewünschte Höhe aufgespreizt wird. Ein „Ratschenmechanismus" hält die erzielte Höhe des Implantates, so daß es unter „expansiver Vorspannung" den Defekt zwischen den Wirbelkörpern überbrückt. Ein weiterer Vorteil von Synex™ gegenüber anderen Implantaten besteht darin, daß die Implantathöhe der Größe des Defektes angepaßt werden kann, und daß das Implantat im Gegensatz zu starren Implantaten unter „Vorspannung" eingesetzt wird. Der Nachteil dieses Verfahrens ist, daß für den Einsatz der bisherigen Spreizzange ein offener chirurgischer Zugang erforderlich ist.2. by using a pressure-resistant permanent implant, such as Synex™. The advantage of this implant is that it is initially inserted into the defect between two adjacent vertebral bodies at a minimal height and then spread to the desired height using special spreading pliers. A "ratchet mechanism" maintains the achieved height of the implant so that it bridges the defect between the vertebral bodies under "expansive pre-tension". Another advantage of Synex™ over other implants is that the implant height can be adjusted to the size of the defect and that, unlike rigid implants, the implant is inserted under "pre-tension". The disadvantage of this procedure is that an open surgical approach is required to use the spreading pliers used previously.

Ziel war es eine Spreizzange zu entwickeln, die ein minimal-invasives thorakoskopisches Vorgehen ermöglicht und den Einsatz von höhenvariablen Dauerimplantaten (Synex™) erlaubt.The aim was to develop a spreading forceps that enables a minimally invasive thoracoscopic procedure and allows the use of height-variable permanent implants (Synex™).

Diese Problem wird mit den in Schutzanspruch 1 aufgeführten MerkmalenThis problem is solved with the features listed in claim 1

• Minimierung des Zangenkopfes in seinen Abmaßen• Minimization of the pliers head in its dimensions

• Runde und genügend lange Ausfuhrung des Zangenschaftes.• Round and sufficiently long design of the pliers shaft.

• Standardisierung / Flexibilisierung der Aufnahme• Standardization / flexibilization of recording

• Einbau von arretierbaren Quergriffen• Installation of lockable cross handles

• Einbau eines Zangengriffes.• Installation of a pliers handle.

• Einbau einer Kraftunterstützungsbaugruppe• Installation of a power assist assembly

• Einbau einer Arretierschraube, gelöst.• Installation of a locking screw, loosened.

Mit der Erfindung wird erreicht, daß durchThe invention achieves that by

die minimierten Abmaße des Zangenkopfes in Breite und Höhe (Fig. 1) dieser durch einen minimal - invasiven Zugang eingeführt werden kann.The minimized dimensions of the forceps head in width and height (Fig. 1) mean that it can be inserted through a minimally invasive approach.

die Längenreduzierung des Zangenkopfes dieser ausschließlich innerhalb der Körperhöhle aufspreizt und nicht im Durchtritt durch die Brustkorbwand (Fig. 2)the reduction in the length of the forceps head means that it only spreads within the body cavity and not when passing through the chest wall (Fig. 2)

die Ausführung des Schaftes der Spreizzange durch runde Werkstoffe (Fig. 3), dieser im Zugang frei gedreht werden kann um die Implantatposition zu korrigieren.the design of the shaft of the spreading forceps using round materials (Fig. 3), which can be freely rotated in the access to correct the implant position.

die vorgesehene Schaftlänge der Einsatz bei jeder Brustkorbgröße von Erwachsenen möglich istthe intended shaft length allows use with any adult chest size

Fixierspitzen (Fig. 3) bzw. deren Austauschmöglichkeit druckfeste Dauerimplantate, wie beispielsweise Synex™ aufgenommen, positioniert und gespreizt werden können.Fixation tips (Fig. 3) or their exchangeability allow pressure-resistant permanent implants such as Synex™ to be picked up, positioned and spread.

Die arretierbaren Quergriffe (Fig.4) ein genaues Positionieren und sicheres Halten ermöglicht wird.The lockable cross handles (Fig.4) enable precise positioning and secure holding.

die Ausbildung des Zangengriffes (Fig.3) ein rasches und sicheres aufspreizen möglich ist.The design of the pincer grip (Fig.3) enables quick and safe spreading.

das Einbringen eine Gewindemechanismusses (Fig. 3) ein stufenloses Aufspreizen mit erhöhter Kraft durch Ausnutzen der Hebelwirkung über das Gewinde möglich ist.The introduction of a threaded mechanism (Fig. 3) enables continuous spreading with increased force by utilizing the leverage effect via the thread.

den Einbau einer Arretierschraube (Fig. 3) die jeweilige Spreizstellung der Zange gehalten werden kann.The respective spreading position of the pliers can be held by installing a locking screw (Fig. 3).

Arbeitsablaufworkflow

Der Patient wird auf der rechten Körperseite gelagert (für Höhe Brustwirbelkörper 9 bis Lendenwirbelkörper 2), Intubationsnarkose mit Doppellumentubus. Nach dem sterilen Abwaschen und Abdecken werden 4 endoskopische (thorakoskopische) Zugänge in den Zwischenrippenräumen angelegt, Trokare in die 3 Zugänge für Videooptik, Retraktor und Saugrohr eingesetzt und der betroffene Wirbelsäulenabschnitt dargestellt. Aus dem vorhandenen Defekt wird unter Einschluß des Bandscheibenraumes und dem zerstörten Anteil eines Wirbelkörpers ein quaderförmiger „Schacht" von der linken Seite herausgearbeitet. Dieses operative Vorgehen ist standardisiert und von Beisse, Potulski et al. ausführlich beschrieben .The patient is placed on the right side of the body (at the level of thoracic vertebra 9 to lumbar vertebra 2), intubation anesthesia with a double lumen tube. After sterile washing and draping, 4 endoscopic (thoracoscopic) accesses are created in the intercostal spaces, trocars are inserted into the 3 accesses for video optics, retractor and suction tube and the affected section of the spine is exposed. A cuboid-shaped "shaft" is carved out of the existing defect from the left side, including the intervertebral disc space and the destroyed part of a vertebral body. This surgical procedure is standardized and described in detail by Beisse, Potulski et al.

In diesen Defekt wird dann Synex™, wie in der Original-Operationsanleitung des Herstellers beschrieben, eingesetzt. Der Unterschied beim Einsatz von Synex™ besteht also darin, daß die neue, für diesen Zweck entwickelte Zange verwendet wird. Ohne dieses Instrument wäre es notwendig, den kleinen, endoskopischen Zugang soweit zu vergrößern, bis ein genügendes Aufspreizen der Original-Spreizzange möglich ist. Die Zugangsgröße entspräche dann eher der des „offenen" chirurgischen Zuganges, mit dem die Vorteile der minimal-invasiven Technik entfielen.Synex™ is then inserted into this defect, as described in the manufacturer's original operating instructions. The difference when using Synex™ is that the new forceps developed for this purpose are used. Without this instrument, it would be necessary to enlarge the small endoscopic access until the original spreading forceps could be spread sufficiently. The access size would then correspond more to that of the "open" surgical access, which would eliminate the advantages of the minimally invasive technique.

Funktionsweise der endoskopischen Spreizzange:How the endoscopic spreading forceps work:

Das Dauerimplantat wird in min. Stellung (Fig. 1) zwischen den Fixierspitzen (Pos. 5) eingebracht und durch Formschluß und Anlegen einer Vorspannung, ausgelöst über den Zangengriff, gehalten. Durch den minimal-invasiven Zugang wird das Dauerimplantat mit der endoskopischen Spreizzange an den betroffenen Wirbelsäulenabschnitt verbracht und mit Hilfe der ausgeklappten Quergriffe (Fig. 4) positioniert. Mittels des Zangengriffes und der Arretiermutter (Pos.l 1) wird über die Schubstange (Pos. 7), den Scherenmechanismus (Pos.2), der Aufnahme (Pos.4) und den Fixierspitzen die erforderliche Kraft zum Aufspreizen des Dauerimplantates eingeleitet. Die Arretiermutter (Pos. 11) bewirkt, daß das Implantat in jeder beliebigen Auszugsstellung gehalten werden kann. Nachdem die erforderliche Spreizposition erreicht ist, wird über das Lösen der Arretiennutter und dem Entlasten des Zangengriffes der Formschluß zwischen dem Dauerimplantat und der Zange gelöst. Das Dauerimplantat verbleibt in einer fixen Rastposition, und die Zange kann, nachdem sie in die min. Stellung zurückversetzt wurde, entnommen werden.The permanent implant is inserted in the minimum position (Fig. 1) between the fixation tips (item 5) and held in place by positive locking and the application of pre-tension, triggered by the forceps handle. The permanent implant is brought to the affected section of the spine using the endoscopic spreading forceps through the minimally invasive access and positioned using the unfolded cross handles (Fig. 4). The force required to spread the permanent implant is introduced via the push rod (item 7), the scissor mechanism (item 2), the holder (item 4) and the fixation tips using the forceps handle and the locking nut (item 11). The locking nut (item 11) ensures that the implant can be held in any extension position. Once the required spreading position has been reached, the positive connection between the permanent implant and the forceps is released by loosening the locking nut and releasing the forceps handle. The permanent implant remains in a fixed locking position and the forceps can be removed after they have been returned to the minimum position.

Liste der BauteileList of components (Fig. 1+2)(Fig. 1+2) 1. Zangenkopf1. Pliers head (Fig. 1+2+3)(Fig. 1+2+3) 2. Scherenmechanismus2. Scissor mechanism (Fig.3)(Fig.3) 3. Bodenstück3. Base piece (Fig.3)(Fig.3) 4. Aufnahme4. Recording (Fig.3+4)(Fig.3+4) 5. Fixierspitzen5. Fixing tips (Fig.3)(Fig.3) 6. Schaft6. Shaft (Fig.3)(Fig.3) 7. Schubstange7. Push rod (Fig.4)(Fig.4) 8. Quergriff8. Cross handle (Fig.3)(Fig.3) 9. Zangengriff9. Pincer grip (Fig.3)(Fig.3) 10. Gewindestange10. Threaded rod (Fig.3)(Fig.3) 11. Arretiermutter11. Locking nut

Fig. 1 Zangenkopf mit Scherenmechanismus /min. gespreizte VersionFig. 1 Pliers head with scissor mechanism /min. spread version

Fig. 2 Zangenkopf mit Scherenmechanismus / max. gespreizte VersionFig. 2 Pliers head with scissor mechanism / max. spread version

Fig. 3 Endoskopische Spreizzange / SeitenansichtFig. 3 Endoscopic spreading forceps / side view

Fig. 4 Endoskopische Spreizzange / Draufsicht mit ausgeschwenkten QuergriffenFig. 4 Endoscopic spreading forceps / top view with swivelled cross handles

Claims (10)

1. Endoskopische Spreizzange zur Behandlung instabiler Läsionen der Brust- und Lendenwirbelsäule, dadurch gekennzeichnet, daß sämtliche Bauteile aus physiologisch einwandfreiem Werkstoff bestehen (Fig. 3) 1. Endoscopic spreading forceps for the treatment of unstable lesions of the thoracic and lumbar spine, characterized in that all components are made of physiologically sound material ( Fig. 3) 2. Endoskopische Spreizzange zur Behandlung instabiler Läsionen der Brust- und Lendenwirbelsäule nach Schutzanspruch 1, deren Zangenkopf in Höhe und Breite so reduziert ist (Fig. 1 + 2), daß dieser mit seinen Aufnahmen, an denen die Fixierstücke befestigt sind in kleinster Ausdehnung durch einen minimal-invasiven Zugang in den Brustkorb eingeführt werden kann. 2. Endoscopic spreading forceps for the treatment of unstable lesions of the thoracic and lumbar spine according to claim 1, the forceps head of which is reduced in height and width ( Fig. 1 + 2) so that it can be introduced into the thorax with its receptacles to which the fixation pieces are attached in the smallest possible extent through a minimally invasive access. 3. Endoskopische Spreizzange zur Behandlung instabiler Läsionen der Brust- und Lendenwirbelsäule nach Schutzanspruch 1, deren Zangenkopf in der Länge so reduziert ist (Fig. 2), daß dieser ausschließlich innerhalb der Körperhöhle aufspreizt und nicht im Durchtritt durch die Brustkorbwand. 3. Endoscopic spreading forceps for the treatment of unstable lesions of the thoracic and lumbar spine according to claim 1, the forceps head of which is reduced in length ( Fig. 2) so that it spreads exclusively within the body cavity and not by passing through the chest wall. 4. Endoskopische Spreizzange zur Behandlung instabiler Läsionen der Brust- und Lendenwirbelsäule nach Schutzanspruch 1, deren Zangenschaft rund ausgeführt ist (Fig. 3) und dadurch im Zugang frei bewegt werden kann um die Implantatposition zu korrigieren. 4. Endoscopic spreading forceps for the treatment of unstable lesions of the thoracic and lumbar spine according to claim 1, the forceps shaft of which is round ( Fig. 3) and can therefore be moved freely in the access in order to correct the implant position. 5. Endoskopische Spreizzange zur Behandlung instabiler Läsionen der Brust - und Lendenwirbelsäule nach Schutzanspruch 1, deren Zangenschaft genügend lang ausgeführt ist (Fig. 3), um dadurch den Einsatz bei jeder Brustkorbgröße von Erwachsenen erlaubt. 5. Endoscopic spreading forceps for the treatment of unstable lesions of the thoracic and lumbar spine according to claim 1, the forceps shaft of which is sufficiently long ( Fig. 3) to allow use with any adult chest size. 6. Endoskopische Spreizzange zur Behandlung instabiler Läsionen der Brust- und Lendenwirbelsäule nach Schutzanspruch 1, deren seitlich angeordneten, schwenk- und arrentierbaren Quergriffe ein sicheres Halten, auch durch eine zweite Person, und genaues Positionieren ermöglichen (Fig. 4). 6. Endoscopic spreading forceps for the treatment of unstable lesions of the thoracic and lumbar spine according to claim 1, the laterally arranged, pivotable and lockable cross handles of which enable secure holding, even by a second person, and precise positioning ( Fig. 4). 7. Endoskopische Spreizzange zur Behandlung instabiler Läsionen der Brust- und Lendenwirbelsäule nach Schutzanspruch 1, deren Zangengriff so ausgebildet ist (Fig. 3), daß sie über die Schubstange und den Scherenmechanismus ein rasches und sicheres aufspreizen ermöglicht. 7. Endoscopic spreading forceps for the treatment of unstable lesions of the thoracic and lumbar spine according to claim 1, the forceps handle of which is designed in such a way ( Fig. 3) that it enables rapid and safe spreading via the push rod and the scissor mechanism. 8. Endoskopische Spreizzange zur Behandlung instabiler Läsionen der Brust- und Lendenwirbelsäule nach Schutzanspruch 1, an deren Zangengriff eine Gewindestange vorgesehen ist (Fig. 3), die ein stufenloses Aufspreizen der Zange mit erhöhter Kraft durch Einsatz der Hebelwirkung (Gewindesteigung) ermöglicht. 8. Endoscopic spreading forceps for the treatment of unstable lesions of the thoracic and lumbar spine according to claim 1, on the forceps handle of which a threaded rod is provided ( Fig. 3), which enables a continuous spreading of the forceps with increased force by using the leverage effect (thread pitch). 9. Endoskopische Spreizzange zur Behandlung instabiler Läsionen der Brust- und Lendenwirbelsäule nach Schutzanspruch 1, mit deren Arretiermutter (Fig. 3) die jeweilige Spreizstellung der Zange gehalten werden kann. 9. Endoscopic spreading forceps for the treatment of unstable lesions of the thoracic and lumbar spine according to claim 1, with whose locking nut ( Fig. 3) the respective spreading position of the forceps can be held. 10. Endoskopische Spreizzange zur Behandlung instabiler Läsionen der Brust- und Lendenwirbelsäule nach Schutzanspruch 1, bei der durch die Austauschmöglichkeit der Fixierspitzen eine Anpassung an verschiedene Dauerimplantate möglich ist. 10. Endoscopic spreading forceps for the treatment of unstable lesions of the thoracic and lumbar spine according to claim 1, in which adaptation to various permanent implants is possible due to the possibility of exchanging the fixation tips.
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Cited By (190)

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WO2003002012A1 (en) * 2001-06-29 2003-01-09 Sdgi Holdings, Inc. Fluoroscopic locator and registration device
WO2003003951A1 (en) * 2001-07-02 2003-01-16 Surgicraft Limited Collapsible and expandable instrument for insertion in a dorsal vertebra
EP1306064A1 (en) * 2001-10-29 2003-05-02 Waldemar Link (GmbH & Co.) Instrument for inserting an intervertebral prosthesis
WO2003037230A2 (en) * 2001-10-29 2003-05-08 Waldemar Link (Gmbh & Co.) Instrumentation for insertion of an inter-vertebral prosthesis
WO2003092507A2 (en) * 2002-05-06 2003-11-13 Sdgi Holdings, Inc. Instrumentation and methods for preparation of an intervertebral space
WO2004000166A2 (en) * 2002-06-25 2003-12-31 Sdgi Holdings, Inc. Minimally invasive expanding spacer
WO2004002353A2 (en) * 2002-06-26 2004-01-08 Sdgi Holdings, Inc. Fluoroscopic locator and registration device
US7070598B2 (en) 2002-06-25 2006-07-04 Sdgi Holdings, Inc. Minimally invasive expanding spacer and method
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