DE202023102723U1 - cutter - Google Patents

Abstract

A milling cutter, characterized in that the milling cutter comprises a rod and a handle connected to each other, the rod comprising a hollow internal cavity, and a working end provided at the front end of the rod; that the working end comprises an annular serration at the front end and an annular stepped platform located within the internal cavity.

Description

technical field

The present invention relates to a novel burr for endoscopic spinal fusion surgery and belongs to the field of medical instruments.

State of the art

With the rapid development of endoscopic technology, the use of endoscopy in the treatment of spinal surgical indications has continued to gain popularity.

Against the background of an aging population, the incidence of spinal diseases due to bone hyperplasia, hypertrophy of the ligamenta flava, herniated discs, loss of height of the intervertebral discs and lumbar spondylolisthesis has increased significantly. In particular, in the case of spinal instability such as lumbar spondylolisthesis, only open surgery can be performed in the prior art, severely damaging the patient's muscles, fascia and bone tissue, so that the patient's postoperative recovery time is long and consumes too many medical resources. In existing clinics, minimally invasive surgical approaches such as posterior lumbar interbody fusion (PLIF) are being introduced. It thus helps the surgeon to perform fusion surgery using endoscopes and other devices (Endo PLIF) based on common access methods and anatomical knowledge to achieve a minimally invasive endoscopic fusion surgery.

In minimally invasive fusion surgery, treatment of fibrous rings and posterior vertebral marginal osteophytes is a mandatory step and is usually performed by the surgeon using instruments such as biopsy forceps and bone chisels along with gelatinous forceps. Performing with a biopsy forceps is simple but inefficient and can only treat soft tissue. It is not possible to treat calcified fibrous rings, osteophytes of the posterior edge of the vertebral body, etc. And there is some risk of damaging the dura mater of the nerve. However, using a bone chisel in combination with gelatinous forceps is also inefficient and difficult to use. This results in a tedious and time-consuming surgical procedure, which causes considerable suffering to the patients.

It is for this reason that this patent application is submitted.

Disclosure of Invention

The burr described in the present application was designed to address the above deficiencies in the prior art and to propose a novel chisel cutting special tool to achieve rapid and complete cutting and treatment of soft tissue and hyperplastic bone tissue while achieving forward feed hole machining , effectively improving the efficiency of the operation and shortening the operation time, reducing patient pain. Several treatment options are covered as part of the clinical spinal fusion procedure.

In order to achieve the above design objectives, the milling cutter comprises a rod and a handle connected to each other, the rod comprising a hollow internal cavity, and a working end provided at the front end of the rod; in that the working end comprises annular teeth at the front end and an annular stepped platform located within the internal cavity.

It is further contemplated that the rod and handle can be attached and detached by internal and external thread rotation.

Furthermore, it is envisaged that the handle is designed as a hollow, rubber-coated spherical structure, the cross-section and volume of which is significantly larger than the external dimensions of the rod.

Furthermore, it is envisaged that the outer circumference of the rod is provided with a scale which can be measured in millimeters and that a limiter is movably fitted onto the rod.

It is further envisaged that the limiter would comprise a shackle looped around the perimeter of the rod and an adjustment knob inserted through the shackle and threadable in and out of the shackle.

1. 1. Die vorliegende Anmeldung erfüllt die klinischen Anforderungen an eine minimalinvasive, visuelle und sichere Operation. Die vorliegende Anmeldung besitzt ein hohes Maß an Anwendbarkeit für endoskopische Fusionsoperationen und Anschlussbehandlung mit breiter Kompatibilität. Dadurch wird die Effizienz der Operation insgesamt erheblich verbessert und der Zeitbedarf reduziert, die Reizung der Nerven und der Dura mater im Wirbelkanal des Patienten und die Schmerzen des Patienten werden verringert.
2. 2. Die vorliegende Anmeldung in Verbindung mit dem Wirbelsäulenendoskop und verschiedenen Arbeitshülsen ermöglicht es dem Chirurgen, die Operationsinstrumente präzise in die Operationsposition einzuführen. Durch Drehen des Griffs werden die bogenförmigen Sägezähne angetrieben, um den Faserring effizient und schnell zu resezieren. Gleichzeitig wird das Gewebe nach vorne geschoben, um den Faserring zu komprimieren und schnell wegzuschneiden. Anschließend mit der Gallertkernzange wird der durchgetrennte Faserring herausgeklemmt, wodurch die Effizienz und Genauigkeit der Operation erheblich verbessert und die Schmerzen des Patienten minimiert werden.
3. 3. Mit der vorliegenden Anmeldung kann sowohl Weich- als auch Knochengewebe behandelt werden, wodurch die Größe der Einschnitte des Patienten effektiv reduziert, die Schmerzen des Patienten verringert und die postoperative Genesung erleichtert werden.
4. 4. Die vorliegende Anmeldung kann flexibel in Kombination mit einem Endoskop verwendet werden, um den Arbeitsvorgang für den Arzt zu vereinfachen und eignet sich besser für den klinischen Einsatz und die Förderung der bestehenden Wirbelsäulenfusionschirurgie und kann auch auf andere endoskopische Operationen ausgedehnt werden.
5. 5. Die vorliegende Anmeldung hat eine sinnvolle Struktur, der Griff ist universell einsetzbar und in der Herstellung kostengünstiger, was die Operationskosten und die Patientenbelastung entsprechend reduziert.

In summary, the milling cutter proposed in the present application has the following advantages:

1. 1. The present application meets the clinical requirements for a minimally invasive, visual and safe operation. The present application has a high degree of applicability for endoscopic fusion surgery and follow-up treatment with broad compatibility. This greatly improves the overall efficiency of the operation and reduces the time required, the irritation of the nerves and the Dura mater in the patient's spinal canal and the patient's pain is reduced.
2. 2. The present application in connection with the spinal endoscope and various working sleeves enables the surgeon to introduce the surgical instruments precisely into the surgical position. Rotating the handle drives the arcuate saw teeth to efficiently and quickly resect the fibrous ring. At the same time, the tissue is pushed forward to compress and quickly cut away the fibrous ring. The severed fibrous ring is then pinched out with the gelatinous core forceps, which greatly improves the efficiency and accuracy of the operation and minimizes the patient's pain.
3. 3. The present application can treat both soft and bone tissue, effectively reducing the size of patient's incisions, reducing patient's pain and facilitating postoperative recovery.
4. 4. The present application can be flexibly used in combination with an endoscope to simplify the doctor's work process, and is more suitable for clinical use and promotion of the existing spinal fusion surgery, and can also be extended to other endoscopic operations.
5. 5. The present application has a reasonable structure, the handle is universal and less expensive to manufacture, which correspondingly reduces the operation cost and patient burden.

character list

• 1 zeigt eine schematische Darstellung der menschlichen Wirbelsäule;
• 2 zeigt ein Funktionsschema eines endoskopischen Fräsers nach dem Stand der Technik;
• 3 zeigt eine schematische strukturelle Darstellung des Fräsers gemäß der vorliegenden Anmeldung;
• 4 zeigt eine schematische Darstellung des Arbeitsendes;
• 5 und 6 sind schematische Diagramme des Prozesses der Verwendung des Fräsers zum Resezieren von Gewebe.

The design of the present application is explained in more detail in connection with the following drawings:

• 1 shows a schematic representation of the human spine;
• 2 shows a functional diagram of an endoscopic milling cutter according to the prior art;
• 3 Fig. 12 shows a schematic structural representation of the milling cutter according to the present application;
• 4 shows a schematic representation of the working end;
• 5 and 6 are schematic diagrams of the process of using the burr to resect tissue.

Embodiments of the invention

Further advantages and features of the present application emerge from the following description, in which the exemplary embodiments are described in detail with reference to the accompanying drawings.

In the embodiment 1 as in FIG 1 and 2 1, in performing the prior surgeries for resecting the inner annulus of the vertebral body 10 or the hyperplastic bone tissue of the trailing edge of the vertebral body of the spine, an endoscopic reamer 40 is used in conjunction with a spinal endoscope 20 and a working sleeve 30, but this can only involve rotary cutting of tissue and the roots of the tissue are still glued together, so the tissue cannot be completely removed, making it difficult to remove the tissue that has been cut away from the body. This leads to less efficient clinical operations.

As in 3 until 6 As illustrated, the present application proposes a novel burr for spinal surgery, comprising a rod 1 and a handle 2 connected to each other.

Here, the outer dimension of the rod 1 must not be too large in order to minimize the surgical incision. The rod 1 has an internal cavity and a working end 3 is provided at the front end of the rod 1 to enable annular tissue incisions to be made using spinal endoscopes, various working sleeves for receiving spinal endoscopes.

The handle 2 is formed as a hollow, rubber-coated spherical structure whose cross-section and volume is significantly larger than the outer dimension of the rod 1, allowing easy gripping and manipulation of the rod 1 to rotate to drive the working end 3 for chiseling various types of tissue.

The rod 1 and the handle 2 can be easily disassembled and assembled. The conventional connection structure is that the two parts can be attached and disassembled by internal and external thread rotation.

In order to enable easier assessment of the insertion depth of the rod 1 into the human body, the outer circumference of the rod 1 is provided with a scale which is measured in millimeters sen can be, and a limiter 4 is movably attached to the rod 1.

In order to improve the accuracy and the flexibility of adjusting the deep action of the rod 1 according to the scale, the limiter 4 comprises a shackle 41 looped around the outer circumference of the rod 1 and an adjustment handle 42 inserted through the shackle 41 and can be screwed in and out of the bracket 41 by means of a thread. When screwing to the inner limit position of the bracket 41, the front end of the adjustment handle 42 is pressed against the outer periphery of the rod 1 to position the bracket 41 by friction between the two.

The working end 3 has annular teeth 31 at the forward end and an annular stepped platform 32 located within the internal cavity. The annular serration 31 has a sharper edge and a cutting function. The annular stepped platform 32 serves to push the ring-cut tissue of any kind forward with the stroke of the rod 1, thus forming a through or round hole in the chiseled area, allowing penetration of the tissue into the working end 3 and the rod 1 prevents, but also facilitates the subsequent removal of the ring-cut tissue from the human body with other instruments (e.g. bone removal rod) so as not to disturb the subsequent surgical steps.

• Zunächst wird die zu operierende Stelle mit einem bildgebenden Instrument identifiziert, die Meißelschneide- und Räumtiefe präoperativ mittels CT gemessen und die Skalenposition des Begrenzers 4 auf der Stange 1 entsprechend eingestellt;
• Anschließend wird der Fräser in den Wirbelkörper eingeführt und gestoppt, wenn sich der Begrenzer 4 der Haut des Patienten nähert. Zu diesem Zeitpunkt dringt das Arbeitsende 3 allmählich tiefer in den Wirbelkörper bis zur operierenden Stelle ein;
• Darauffolgend führt der Griff 2 den Ringschnitt für das erkrankte Gewebe mittels des Arbeitsendes 3 aus. Dank der ringförmigen, abgestuften Plattform 32 im inneren Hohlraum des Arbeitsendes 3 hinterlässt während des Ringschnitts ein durchgehendes oder rundes Loch an der Operationsstelle, unabhängig davon, egal welche Art von Gewebe als Ganzes nach vorne geschoben wird;
• Schließlich wird das schnell durchgetrennte Gewebe 50 mit einer großen Zange aus dem Zwischenwirbelraum herausgenommen und der chirurgische Zweck wird dadurch erreicht. Zusammenfassend lässt sich sagen, dass die in Verbindung mit den beigefügten Zeichnungen beschriebenen Ausführungsbeispiele nur bevorzugte Ausführungsformen sind. Dem Fachmann ist es möglich, andere alternative Strukturen abzuleiten, die mit dem Gestaltungskonzept des Gebrauchsmusters übereinstimmen und die alle in den Schutzumfang der vorliegenden Anmeldung fallen sollten.

As in 5 and 6 shown, the operational procedure for using the milling cutter described in the present application is as follows:

• First, the site to be operated on is identified with an imaging instrument, the chisel cutting and clearing depth is measured preoperatively using CT, and the scale position of the limiter 4 on the rod 1 is adjusted accordingly;
• The burr is then inserted into the vertebral body and stopped when the limiter 4 approaches the patient's skin. At this time, the working end 3 gradually penetrates deeper into the vertebral body to the operating site;
• Subsequently, the handle 2 performs the ring incision for the diseased tissue by means of the working end 3. Thanks to the annular stepped platform 32 in the inner cavity of the working end 3, during the annular incision leaves a through or round hole at the surgical site, regardless of what type of tissue is pushed forward as a whole;
• Finally, the rapidly severed tissue 50 is extracted from the disc space with a large forceps, and the surgical purpose is thereby accomplished. In summary, it can be said that the exemplary embodiments described in connection with the accompanying drawings are only preferred embodiments. It is possible for those skilled in the art to derive other alternative structures that are consistent with the design concept of the utility model, all of which should fall within the scope of the present application.

Claims (5)

A milling cutter, characterized in that the milling cutter comprises a rod and a handle connected together, the rod comprising a hollow internal cavity, and a working end provided at the front end of the rod; that the working end comprises an annular serration at the front end and an annular stepped platform located within the internal cavity. cutter after claim 1 , characterized in that the rod and the handle can be attached and detached by internal and external thread rotation. cutter after claim 2 , characterized in that the handle is formed as a hollow, rubber-coated spherical structure, the cross section and volume of which is significantly larger than the outer dimension of the rod. cutter after one of the Claims 1 until 3 , characterized in that the outer circumference of the rod is provided with a scale which can be measured in millimeters and that a limiter is movably fitted on the rod. cutter after claim 4 characterized in that the limiter comprises a shackle looped around the outer periphery of the rod and an adjustment knob inserted through the shackle and threadable in and out of the shackle.

Images