JP5957166B2 - Osteotomy flea for percutaneous endoscopy - Google Patents

Description

  The present invention relates to an osteotomy blade (bone flea) used when performing bone resection in percutaneous endoscopic surgery.

  An axial sectional view of the neck is shown in FIG. A cervical spinal canal 2 is located deep in the vertebral arch 1, and a spinal cord 3 runs there. An intervertebral hole 5 is located deep in the facet joint 4, and a nerve root 6 passes therethrough. The right side of FIG. 1 is normal, but the left side has a foramen stenosis. Cervical spondylotic radiculopathy is a disease in which nerve roots are compressed by the narrowing of the intervertebral foramen and cause neurological symptoms.

  The posterior decompression (intervertebral foramen enlargement), which is a common surgical treatment for cervical spondylotic radiculopathy, is a part of the vertebral arch 1 or intervertebral joint 4 such as the lattice plane 7 in FIG. This is a treatment method that expands the intervertebral foramen by excision.

  In the subsequent decompression, as a minimally invasive surgery, the perforation of the intervertebral foramen is performed using a percutaneous endoscope (percutaneous endoscopic cerebral foramen plastoplasty; PECF). Percutaneous endoscopic surgery is one of the endoscopic operations. It is a long cylindrical outer tube with a diameter of 7 to 8 mm and a length of about 170 mm. An operation in which a tube and a light source are integrated is inserted, and an elongated instrument is inserted into the remaining space of 3 to 4 mm in diameter. An endoscope is placed in a very narrow space, but a good visual field can be secured by flowing perfusion water. PECF is a very minimally invasive method, but it has various limitations because only thin instruments can be inserted.

  Since PECF has a thin outer cylinder, there is a restriction on the size of the instrument that can be used, and the strength and power of the bone removal instrument are not sufficient. As shown in FIG. 2, the distance between the deep bone cortex 8 of the facet joint and the nerve root 6 is small, and only there is a thin film (not shown). As it goes, there is a risk of damaging the nerve when the bar penetrates the deep cortical bone 8 in the final stage of bone removal. The deep bone cortex 8 of the facet joint is hard, but the power of the surgical bar is insufficient, so it is necessary to strongly press the surgical bar against the bone or reduce the diameter of the bar. In that case, the surgical bar is likely to be pushed deeply into the deep part at the moment of passing through the bone, which is more dangerous. There is already an elongated bone flea 10 that can also be used in a percutaneous endoscope, but if this instrument has penetrated the bone as well, there is a risk of damaging the nerve root behind it.

  In endoscopic surgery using a thicker external tube than percutaneous endoscopes, Kerison Ronjur or sharp blades can be used, but percutaneous endoscopes are small enough to have sufficient strength to excise bone. There are no large-sized percutaneous endoscopic endoscopes or sharps.

  Therefore, the bone flea of the present invention is intended to enable safe and quick osteotomy in a bone flea that can be used for a percutaneous endoscope during PECF.

  The tip of the elongated cylindrical shaft part is a flat chisel, and has a raised stopper in the middle of the blade part, and the height of the stopper is a protrusion that does not exceed the tangent to the surface of the shaft part. A bone flea for a percutaneous endoscope having a handle on the proximal side.

  The blade portion is a portion that gradually decreases in thickness toward the tip, and normally there is no ridge on the blade portion, but in the present invention, a shaft is provided by providing a stopper on the blade portion instead of the shaft portion. It is also possible to insert into a long and thin outer cylinder that can be inserted at the edge.

  By providing the protrusions on the blade portion instead of the shaft portion, the stopper can be disposed at a slight position from the tip. Since the distance from the stopper to the blade tip is small, it is possible to prevent fleas from penetrating deeply, prevent damage to deep nerves, and perform surgery safely. There is a handle on the hand side, making it easy to twist the bone flea. In actual use, instead of hitting the bone flea until it penetrates the bone, twist it with the handle when the bone flea blade enters the bone It is safer to break the bone by adding.

  An embodiment of the present invention will be described with reference to FIGS. 3 is an overall front view, FIG. 4a is a front side view, FIG. 4b is a front side view, and FIG. 5 is a proximal side view. The main structure includes a shaft portion 11, a blade portion 12 and a stopper 13 at the tip thereof, and a handle 14 on the hand side.

  A blade portion 12 is provided at the distal end side of the elongated cylindrical shaft portion 11, and the distal end has a flat chisel shape. There is a stopper 13 that is raised in the middle of the blade portion 12, that is, in a portion where the thickness decreases substantially continuously, and the height of the stopper 13 is a protrusion that does not exceed the tangent line W on the surface of the shaft portion 11. On the hand side, there is a handle 14 that is wider than the shaft portion.

It is an axial sectional view of a cervical vertebra. It is a sectional side view at the time of bone deletion. 1 is an overall front view of an embodiment of the present invention. (A) The front end side front view of embodiment of this invention, (b) The front end side side view. It is a hand side view of an embodiment of the present invention.

11 Shaft portion 12 Blade portion 13 Stopper 14 Handle

Claims (3)

A cylindrical or polygonal long shaft shaped shaft,
On the tip side of the shaft portion, a blade portion that gradually decreases in thickness toward the tip,
In the middle of the blade part , a stopper raised so as not to exceed the tangent line of the shaft part surface,
An endoscopic bone chisel comprising a handle having a width larger than that of the shaft portion on a proximal side of the shaft portion. The endoscopic bone flea according to claim 1, wherein the stopper protrudes from a position 1 to 5 mm from the tip. The bone flea for an endoscope according to claim 1 or 2, wherein a tip of the blade portion has a flat chisel shape.

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