JPH05111496A - Cranium fixing device for medical purpose - Google Patents

Abstract

PURPOSE:To prevent the generation of a distortion between a pair of side plates of the device for fixing the patient's head at the time of a treatment, thereby preventing the degradation in the accuracy of a position and smoothing the movement of a movement adjusting mechanism at all times. CONSTITUTION:A cranium fixing plate 16 for fixing the patient's head is attachably and detachably mounted between a pair of the side plates 13 disposed in an opposite state and a movement adjusting mechanism 17 which three- dimensionally movably holds this cranium fixing frame 16 is disposed. A pair of the side plates 13 are mounted turnably in an arrow (a) direction to a pair of supporting arms 9 of a frame 8. A pair of the side plates 13 mentioned above are coupled by connecting members 15, 15. A frame shape is constituted by a pair of such side plates 13 and the connecting members 15.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical skull fixing device used to fix the head of a patient when treating an affected area such as a brain tumor or cerebral arteriovenous malformation (AVM).

[0002]

2. Description of the Related Art As a method for treating an affected area such as a brain tumor or an arteriovenous malformation, there is a method of irradiating the affected area with radiation, for example, high-energy X-rays.

When performing such treatment, X-ray CT is performed in advance.
Tomography of the head is performed by a scanner or MRI to confirm the position of the affected area, and the head of the patient lying on the bed is fixed by the skull fixing device to determine the position of the affected area by X-ray.
The irradiation center is made to coincide with the irradiation center, and in this state, the affected area is irradiated with X-rays emitted from the irradiation head of the X-ray irradiation apparatus.

By the way, the X-rays emitted from the irradiation head irradiate the affected area through the scalp, so that the normal tissue is also irradiated. At this time, since X-rays consume a lot of energy on the scalp side, there is a situation in which normal tissues on the scalp side are easily destroyed by the X-rays. Therefore, when performing this type of treatment, it is necessary to minimize the influence of X-rays on other than the affected area.

Further, there is a circumstance that an extremely small value (for example, ± 0.5 mm or less) is required as the error of the irradiation center.

Therefore, as an X-ray irradiation apparatus used for this type of treatment, an irradiation head for irradiating X-rays is rotatable about a predetermined irradiation center, and the irradiation head is at any rotation position. However, there is provided a device configured so that X-rays pass through the irradiation center.

In the cranial fixation device for fixing the head, the head is fixed at a predetermined position by the cranial fixation frame, and the affected part is aligned with the irradiation center of the X-ray irradiation device. It is considered that the head can be pivoted in the up-and-down direction intersecting with the pivotal direction of the irradiation head around the.

Thus, during X-ray irradiation, by appropriately rotating the irradiation head of the X-ray irradiation device and the skull fixing frame of the skull fixing device, the influence of X-rays on other than the affected area is minimized. Is possible.

[0009]

By the way, in the skull fixing device, for example, the skull fixing frame is detachably attached between the pair of side plates arranged in an opposed state and the skull fixing frame is moved in the three-dimensional direction. A configuration is possible in which a movement adjusting mechanism that holds the adjustment is provided, and the pair of side plates is attached to the frame so as to be vertically rotatable.

However, in such a structure, since the pair of side plates are connected by the rail of the movement adjusting mechanism, when the pair of side plates is rotated with respect to the frame, a twist is generated between the pair of side plates. Distortion is likely to occur,
As a result, the positional accuracy of the fixed position of the head may be deteriorated, or the movement of the movement adjustment mechanism may be hindered.

Therefore, an object of the present invention is to prevent distortion between the pair of side plates, thereby preventing a decrease in positional accuracy and, at the same time, allowing the movement adjusting mechanism to move smoothly at all times. To provide a fixing device.

[0012]

In order to achieve the above-mentioned object, the present invention has a skull fixing frame for detachably mounting a patient's head between a pair of side plates arranged in an opposed state. And a skull fixing device for medical treatment, in which a movement adjusting mechanism for holding the skull fixing frame so as to be movable and adjustable in a three-dimensional direction is provided, and the pair of side plates is rotatably attached to the frame, The side plates are connected by a connecting member, and the pair of side plates and the connecting member are formed into a frame shape.

[0013]

According to the above-mentioned means, the pair of side plates rotatably supported by the frame are connected by the connecting member, and the pair of side plates and the connecting member form a frame shape. Even if there is a situation in which the side plate is rotated with respect to the frame, twisting of the pair of side plates is restricted by the connecting member, and distortion between the pair of side plates is prevented.

[0014]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the present invention will be described below with reference to the drawings. First, in FIG. 2, an X-ray irradiator 1 as a radiation irradiator has a rotating arm 3 on a base 2, and the rotating arm 3 is rotatable on the base 2 about an axis 4 in the arrow A direction. Is attached to. The rotating arm 3 is provided with an irradiation head 5 which emits X-rays generated when an electron beam is applied to the X-ray plate at a high speed at one end, and also serves as a shield plate facing the irradiation head 5 at the other end. A balancer 6 is provided.

Thus, the irradiation head 5 of the X-ray irradiation device 1
Is rotatable about its irradiation center O.

Next, the skull fixing device 7 for fixing the patient's head will be described in detail. As shown in FIG. 1, the frame 8 of the skull fixing device 7 is provided with a pair of support arms 9 and 9 facing each other.

Origin rings 10, 10 are provided on the outer sides of the tip ends of both support arms 9, 9, and substantially fan-shaped support plates 11, 11 are fixedly attached on the inner side. An arc-shaped guide groove 12 centered on the center of the origin ring 10 is formed on the right side support plate 11 in FIG.

A pair of side plates 13 and 13 are arranged inside each of the support plates 11 and 11 so as to face each other.
Reference numerals 3 and 13 are rotatably supported by the support arms 9 and 9 about the origin rings 10 and 10, respectively.

Of the both side plates 13 and 13, the side plate 13 on the right side in FIG. 1 is a fixing screw 14 inserted into the guide groove 12.
Thus, it is fixed at a predetermined rotation position within the range of the guide groove 12.

The side plates 13 and 13 are firmly connected to each other by connecting members 15 and 15 on the front and rear sides, respectively, and the side plates 13 and 13 and the connecting members 15 and 15 are formed into a frame shape. There is.

An annular skull fixing frame 16 for fixing the patient's head is detachably attached between the side plates 13 and 13, and the skull fixing frame 16 is arranged in three-dimensional directions of X, Y and Z. Movement adjustment mechanism 1 for holding the movement adjustable
7 are arranged. The movement adjusting mechanism 17 is configured as follows.

A Z-axis rail 18 extending in the front-rear direction (Z direction) is provided at the lower inner surface of each of the side plates 13 and 13, and a Z-axis slider 19 is slidably provided on both Z-axis rails 18 ( Only the left side is shown in FIG. 1). Each Z-axis slider 19 is attached to the Z-axis rail 18 by a fixing screw (not shown).
It is designed to be fixed to.

Two X-axis rails 20 extending in the left-right direction (X-direction) are provided between both Z-axis sliders 19, and X-axis sliders 21 and 21 are slidably provided on both X-axis rails 20. There is. Each X-axis slider 21 is fixed to the X-axis rail 20 with a fixing screw 22.

Each X-axis slider 21 is integrally provided with a Y-axis rail portion 23 extending in the vertical direction.
A Y-axis slider 24 is slidably provided on the shaft rail portion 23. Each Y-axis slider 24 is fixed to the Y-axis rail portion 23 by a fixing screw 25.

A fixed U-shaped fixed frame holder 26 is mounted between the Y-axis sliders 24, 24, and the skull fixed frame 16 is detachably mounted on the fixed frame holder 26 by a fixing screw 27. It has become.

Thus, the skull fixing frame 16 attached to the fixing frame holder 26 can be moved and adjusted in the three-dimensional directions of X, Y, and Z through the movement adjusting mechanism 17, and both side plates 13 can be attached. Through the origin ring 10, it can be rotated in the direction of arrow a.

The skull fixing frame 16 is made of plastic with carbon fiber as a core material, and fixing pins 28 made of titanium are provided at four positions on the front side, and the fixing pins 28 are fixed to the head of the patient. It has become so. The fixed frame holder 26 is provided with three pairs of fixing screws 29 for attaching positioning markers (not shown).

The X-ray irradiation device 1 and the skull fixing device 7 are installed in a dedicated radiotherapy room.

Next, the operation of the above configuration will be described. First, the origin of the skull fixing device 7 and the irradiation center O of the X-ray irradiation device 1 are made to coincide with each other as follows.

The skull fixing frame 16 is attached to the fixing frame holder 26, and the X-axis, Y-axis and Z-axis sliders 21,
24 and 19 are set to the original position (0 point). After that, a board (not shown) is attached to the pair of attachment holes 26a, 26a formed on the origin axis of the fixed frame holder 26, and
A target plate having a through hole is attached to the substrate. Then, reference light is radiated from a reference light irradiator (for example, a laser irradiator) provided on the irradiation head 5 side of the X-ray irradiator 1 so as to coincide with the X-ray axis, and the reference light is transmitted through the target plate. The skull fixing device 7 is positioned with respect to the X-ray irradiator 1 by adjusting so as to pass through.

As a result, the origin of the skull fixing device 7 and the irradiation center O of the X-ray irradiation device 1 can be matched.

Then, the skull fixing frame 16 is attached to the head of the patient by the fixing pin 28, and the skull fixing frame 16 is connected to the fixing frame holder 26 provided on the bed of the X-ray CT scanner device, although not shown. The head is fixed to a fixed frame holder having a similar structure, and tomography of the head is performed in this state. At the time of this photographing, positioning markers are attached to the fixed frame holder at, for example, three positions.

The position of the affected area is calculated based on the tomographic image thus taken.

After the photographing, the patient with the skull fixing frame 16 attached is laid in a supine state, and the skull fixing frame 16 is fixed to the fixing frame holder 26 of the skull fixing device 7. In this state, the position of the affected part of the head does not always coincide with the origin of the skull fixing device 7.

Thereafter, based on the calculation result of the position of the affected area based on the tomographic image, the X-axis, Y-axis and Z-axis sliders 21, 24 and 19 are moved to move the skull fixing frame 16 in the three-dimensional direction. By moving, the position of the affected part is made to coincide with the origin of the skull fixing device 7. As a result, the position of the affected area on the head coincides with the irradiation center O of the X-ray irradiation apparatus 1.

In this way, the position of the affected area is fixed to the skull fixing device 7.
X-rays are radiated from the irradiation head 5 of the X-ray irradiator 1 toward the affected part of the head in a state where the origin and the irradiation center O of the X-ray irradiator 1 are matched.

At this time, in the skull fixing device 7, by rotating the skull fixing frame 16 about the origin ring 10, the head can be rotated in the direction of arrow A around the affected area, while X-ray irradiation is performed. In the apparatus 1, the irradiation head 5 can be rotated in the arrow A direction around the irradiation center O, that is, the affected area. Therefore, by combining these movements, it becomes possible to irradiate the affected area with X-rays from multiple directions. It is possible to avoid overlapping of the irradiation directions in the head as much as possible, and thereby it is possible to minimize the influence of X-rays on other than the affected area. Further, along with this, it becomes possible to irradiate the affected area with a sufficient amount of X-rays.

When the skull fixing frame 16 of the skull device 7 is rotated, the operator enters the treatment room and performs a rotation operation. However, in the case of irradiating X-rays, the doctor or the operator treats it. Go out of the room and watch it from the TV monitor or monitor window.

According to the above-described embodiment, the skull fixing frame 16
A pair of side plates 13 for holding the
13 is connected by the connecting members 15 and 15, and the pair of side plates 13 and the connecting member 15 form a frame shape. Therefore, the skull fixing frame 16 is rotated with respect to the frame 8 via the side plates 13 and 13. Even if there is a circumstance, the pair of side plates 13 is prevented from being twisted by the connecting member 15, and distortion is prevented from occurring between the pair of side plates 13. Along with this, it is possible to prevent deterioration of the positional accuracy of the skull fixing device 7, and it is possible to smoothly move the movement adjusting mechanism 17 at all times.

In the above embodiment, the pair of side plates 1
The fixing screw 14 is screwed into the right side plate 13 of the side plates 3 and 13, and the pair of side plates 13 and 13 is manually rotated along the guide groove 12.
13 may be configured to rotate via a gear or a ratchet, for example, based on a rotating operation of a knob.

In the above embodiment, the case where the skull fixing device 7 is combined with the X-ray irradiating device 1 is illustrated, but it may be combined with the device which irradiates cobalt as radiation.

[0042]

As is apparent from the above description, according to the present invention, a skull fixing frame for fixing the patient's head is detachably attached between a pair of side plates arranged in an opposed state. In the medical skull fixing device, which is provided with a movement adjusting mechanism for holding the skull fixing frame so that the skull fixing frame can be moved and adjusted in a three-dimensional direction, and the pair of side plates is rotatably attached to the frame, Since the side plates are connected by the connecting member and the pair of side plates and the connecting member are configured in a frame shape, it is possible to prevent distortion between the pair of side plates, thereby preventing a decrease in positional accuracy and moving. It has an excellent effect that the adjustment mechanism can be moved smoothly at all times.

[Brief description of drawings]

FIG. 1 is a perspective view of a main part showing an embodiment of the present invention.

FIG. 2 is a side view of a main part in a state of being combined with an X-ray irradiation device.

[Explanation of symbols]

1 is an X-ray irradiation device, 7 is a skull fixing device, 8 is a frame,
13 is a side plate, 15 is a connecting member, 16 is a skull fixing frame, 17
Is a movement adjusting mechanism, and 26 is a fixed frame holder.

Claims (1)

[Claims] 1. A pair of side plates arranged to face each other,
A skull fixing frame that fixes the patient's head is removably attached, and a movement adjusting mechanism that holds the skull fixing frame so that the skull fixing frame can be moved and adjusted in three dimensions is provided, and the pair of side plates can be rotated on the frame. Which is attached to the
A skull fixing device for medical use, characterized in that the pair of side plates are connected by a connecting member, and the pair of side plates and the connecting member are formed into a frame shape.