JP2017046926A - Insertion position indicator for spinal fusion perforator and guide device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an insertion position indicator capable of indicating a correct insertion position of a spinal fusion perforator at all times without moving, and to provide a perforator guide device using the insertion position indicator.SOLUTION: An insertion position indicator for a spinal fusion perforator includes a male screw part having a pointed end at a tip of a rod-shaped body. A guide device for a spinal fusion perforator includes: the insertion position indicator; and an arm plate which has a holder for the indicator in one end, the holder guiding the insertion position indicator to be inserted therethrough and operated rotatably, and which has a holder for the perforator in the other end, the holder guiding the spinal fusion perforator to be inserted therethrough toward the male screw part of the insertion position indicator.SELECTED DRAWING: Figure 4

Description

  The present invention relates to an insertion position indicating tool (hereinafter simply referred to as “perforator”) that forms a pilot hole for embedding a pedicle screw or the like. The present invention also relates to a guide device for the perforator.

  Conventionally, as an insertion position indicating tool for a spinal fusion perforator for forming a prepared hole for embedding a pedicle screw or the like, positioning is performed by inserting the pedicle base from the posterior side of the spine to the front side. Reference pins (for example, see Patent Document 1) and indicator needles that do not pierce bone tissue (for example, see Patent Document 2) have already been reported.

However, since the reference pin disclosed in Patent Document 1 is merely a needle-like body, it is pierced into the bone tissue, but its depth is usually only 2 to 3 mm, and its distal end portion. As a result, the correct insertion position and misalignment of the perforator occur. However, since the width of the area where the perforator can be inserted in spinal fusion is as narrow as 2 to 5 mm, the displacement of the insertion position increases the risk of damage to the adjacent vertebral arteries and spinal cord. It was the situation that was a pressure that could not be overlooked.
Further, since the pointing needle disclosed in Patent Document 2 does not pierce bone tissue in the first place, its ease of movement is greater than that of the reference pin disclosed in Patent Document 1, and damage to the vertebral artery and spinal cord. The actual situation is that the risk of this is even higher.

  Moreover, since the diameter of the tip of the conventional reference pin and indicator needle, which is the insertion target of the punch, is usually as small as 2 to 3 mm, there is a problem that it is difficult to visually recognize the correct position while observing with the naked eye. In fact, it took a great deal of skill to insert a perforator.

JP 2009-261485 A JP 2012-85998 A

The present invention has been made in view of the conventional problems and circumstances as described above, and provides an indicator that always indicates the correct insertion position of the perforator without moving, and in addition, the target site is visually recognized. It is an object to provide an easy-to-use indicator.
Furthermore, this invention makes it a subject to provide the punch guide apparatus using the said indicator.

  As a result of repeated various studies to solve the above problems, the present inventor is always correct because if the male screw portion is provided at the tip of the rod-shaped body, the indicator is screwed and fixed to the bone tissue and does not move. It is found that the insertion position of the punch can be shown, and if the protrusion is provided above the male screw part, the target site can be easily seen and also functions as a stopper at the time of insertion. completed.

  That is, the present invention solves the above-mentioned problem by an insertion position indicator for a spinal fusion instrument, wherein a male screw part having a sharp tip is formed at the tip of a rod-like body. .

  Further, the present invention provides the above object by using the insertion position indicating tool for a spinal fusion perforator, wherein a protrusion is formed at the boundary between the male screw portion and the non-male screw portion of the rod-shaped body. Is a solution.

  Furthermore, the present invention comprises the insertion position indicator; and an indicator holder part for inserting and guiding the insertion position indicator in a rotatable manner at one end, and a spinal fixation perforator at the other end. The above-mentioned problem is solved by a spinal fusion perforator guide device characterized by comprising: an arm plate having a perforator holder portion that is inserted and guided toward the male screw portion of the insertion position indicator. .

  If the male screw part is inserted into the bone tissue while rotating the rod-like body using the insertion position indicator of the present invention, the rod-like body is screwed and fixed to the bone tissue, so that the indicator moves. There is no. Therefore, it is possible to always indicate the correct insertion position of the punch.

  Moreover, if the insertion position indicator of the present invention in which the protruding portion is formed is used, the protruding portion can be easily visually recognized, so that the perforator can be accurately inserted with the protruding portion as a target. Moreover, since the protruding portion functions as a stopper when the rod-shaped body enters the bone tissue, it can be prevented that the protruding portion penetrates deeply into the non-male screw portion of the rod-shaped body above the male screw portion.

  Furthermore, if the perforator guide device of the present invention is used, an insertion position indicating tool in which the perforator is screwed and fixed to the bone tissue by using the holder portion for the perforator that is inserted and guided toward the tip of the insertion position indicating tool. Therefore, the perforator can be inserted more easily and accurately to form a pilot hole for embedding a pedicle screw or the like.

The perspective explanatory drawing of this invention insertion position indicator. Cross-sectional explanatory drawing which shows the example of the form of the protrusion part in this invention insertion position indicator. The principal part expansion explanatory drawing which shows the bending state of this invention insertion position indicator. Cross-sectional explanatory drawing of this invention punch guide device. The model explanatory drawing which shows the example of pedicle screw embedding using this invention perforator guide apparatus. The model explanatory drawing which shows the example of an outer lump screw embedding using this invention perforator guide apparatus. Schematic explanatory drawing which shows the example of pedicle screw embedding using this invention perforator guide apparatus.

  Embodiments of the present invention will be described below with reference to the drawings.

  FIG. 1 shows an example of an insertion position indicating tool 10 for a perforator according to the present invention, and a male screw portion 12 having a pointed end is formed at the tip of a rod-like body 11. The rod-like body 11 is made of a metal such as stainless steel, and preferably has a length of about 5 to 50 cm and a thickness of about 1 to 15 mm in diameter. The length of the male screw portion 12 is preferably 2 to 20 mm, and the thickness is preferably about 1 to 15 mm at the maximum diameter portion.

  A protruding portion 14 is formed at the boundary between the male screw portion 12 and the non-male screw portion 13 of the rod-shaped body 11. The projecting portion 14 may be a specific one as long as it is easy to visually recognize and functions as a stopper that prevents deep penetration of the bone tissue up to the portion of the non-male screw portion 13 above the male screw portion 12. Regardless of the form, it is a perforator that has a plurality of rod-like arms, for example, two or three rod-like arms as shown in FIG. It is preferable because it does not become an obstacle during the insertion operation. The protrusion length of the protrusion 14 is preferably about 3 to 4 mm from the viewpoint of easy visual recognition.

  A grip portion 15 having a diameter larger than that of the rod-shaped body 11 is formed at the base portion of the rod-shaped body 11, and the operation of screwing the male screw portion 12 into the bone tissue is performed by rotating the grip portion 15. It can be performed more smoothly.

For example, as shown in FIG. 3, the rod-shaped body 11 is formed between the male screw part 12 and the non-male screw part 13 (when the protrusion 14 is formed, the protrusion 14 and the non-male screw part 13 The male screw part 12 is screwed and fixed to the bone tissue, and then the non-male screw part 13 is appropriately bent so that the angle θ between the male screw part 12 and the tip is appropriately set. By adjusting and forming, the perforator can be inserted at a more accurate angle corresponding to the perforation site with the male screw portion 12 or the protrusion 14 as a target (the perforator guide device of the present invention to be described later). It is preferable because it is particularly effective when used to insert a punch.
The flexible mechanism between the male threaded portion 12 and the non-male threaded portion 13 is not particularly limited. For example, the connecting structure of the male threaded portion 12 and the non-male threaded portion 13 with the joint shaft 16 with a stopper interposed, or the male A joint mechanism such as a connection structure (not shown) using an upper spherical portion of the screw portion 12 and a lower hook-like portion of the non-male screw portion 13 that wraps around the upper spherical portion is used.

FIG. 4 shows an example of the punch guide device 20 according to the present invention, which is composed of the insertion position indicator 10 and the arm plate 21 described above.
The arm plate 21 is formed of a bent plate-like body. The arm plate 21 has an indicator holder 22 for inserting and guiding the insertion position indicator 10 so that the insertion position indicator 10 can be rotated, and a punch (not shown) at the other end. A holder for a punch that is inserted and guided toward the male screw portion 12 or the protruding portion 14 of the insertion position indicator 10 that is inserted through the indicator holder portion 22 and screwed and fixed to the bone tissue (in the direction of arrow A in the figure). The unit 23 is provided. The arm plate 21 includes an angle adjusting mechanism between the male screw portion 12 or the projecting portion 14 and the axial direction of the punch holder portion 23 (in the direction of arrow A in the figure), which corresponds to the punched portion. This is preferable because it can be inserted at a more accurate angle.
In addition, as a punch, what has drilling functions, such as a manual drill, an electric drill, an ultrasonic drill, is used suitably here, for example.

  Next, the usage example of the punch guide apparatus of this invention is demonstrated using FIGS.

  FIG. 5 shows an example of embedding a pedicle screw. First, the insertion position indicator 10 is inserted into the indicator holder 22 and the male screw 12 is partially excised from the bone (vertebral arch). Insert into the pedicle and fix with screws. Next, the perforator is inserted into the perforator holder portion 23 and inserted into the pedicle in the direction of arrow A in the drawing, that is, the direction of the male screw portion 12 fixed with screws, and a pilot hole for embedding the screw 30 is inserted. Is perforated (FIG. 5 (1)). Next, after removing the perforator from the perforator holder 23, the screw 30 is screwed into the prepared hole manually or with an electric screwdriver using the perforator holder 23, and the pedicle screw is embedded. (FIG. 5 (2)).

  FIG. 6 shows an example of embedding an outer mass screw, and a pilot hole for embedding the screw 30 is drilled in the same manner as in the above-described pedicle screw implantation except that the perforation site is replaced with the outer mass (FIG. 6). 6 (1)), and then screw the screw 30 into the pilot hole to embed the outer mass screw (FIG. 6 (2)).

  FIG. 7 shows an example in which a vertebral screw is embedded. A pilot hole for embedding a screw 30 is drilled in the same manner as in the above-described pedicle screw implantation except that the drilling site is replaced with a vertebral arch (see FIG. 7). 7 (1)), and then the pedicle screw is embedded by screwing the screw 30 into the prepared hole (FIG. 7 (2)).

DESCRIPTION OF SYMBOLS 10: Insertion position indicator 11: Rod-shaped body 12: Male thread part 13: Non-male thread part 14: Protrusion part 15: Grip part 16: Joint axis 20: Perforator guide device 21: Arm board 22: Holder part for indicator 23: Holder part for punch 30: Screw

Claims (5)

  An insertion position indicating tool for a spinal fusion puncture device, wherein a male screw portion having a pointed end is formed at the tip of a rod-shaped body.   The insertion position indicator according to claim 1, wherein a protruding portion is formed at a boundary portion between the male thread portion and the non-male thread portion of the rod-shaped body.   The insertion position indicator according to claim 1 or 2, wherein a grip portion having a diameter larger than that of the rod-shaped body is formed at a base portion of the rod-shaped body.   The insertion position indicator according to any one of claims 1 to 3, wherein the rod-shaped body is capable of bending and extending between a male screw part and a non-male screw part. An insertion position indicator according to any one of claims 1 to 4;
At one end is provided with an indicator holder part for inserting and guiding the insertion position indicator so that it can be rotated, and at the other end, a spinal fusion perforator is inserted and guided toward the male screw part of the insertion position indicator. An arm plate provided with a holder portion for perforating the punch;
A perforator guide device for spinal fusion, comprising:

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