JPH07108303B2 - Barhole button for skull valve fixation - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a cranial valve fixing barhole used for fixing a cranial flap cut out during craniotomy in the field of neurosurgery and repairing the craniotomy after the procedure. It's about buttons.

[0002]

2. Description of the Related Art Conventionally, when treating a brain tumor, an intracranial hematoma, or the like in the area of neurosurgery, a cranial bone of a patient (Krunke) is cut off as a bone valve to form a craniotomy. There is a case where a surgical operation is performed on the brain tissue from the scalp, and in these cases and when the skull is opened in the treatment of a head injury or a fracture, as shown in FIG. 10, first, the scalp 1 is incised to remove the skull 2. It is exposed, and at a desired craniotomy position of the skull 2, as shown in FIG. 10 and FIG.
By forming an incision between the perforations 3, 3, ... With a bone cutting wire saw or a clanitome (both not shown), the bone valve 4 at the desired position is excised and craniotomy. It is general to obtain the part 5 and further incis the internal dura 6 to perform an operation on the brain tissue 7.

When repairing the craniotomy 5 of the skull 2 after the operation on the brain tissue 7 is performed as described above, the craniotomy 5 is closed by the bone valve 4 and fixed. A barhole cap is used for this purpose, but as shown in FIG. 12, the conventional barhole cap 10 is composed of a large-diameter umbrella portion 10a and a small-diameter shaft portion 10b.

When closing the craniotomy 5 after the operation, for example, the bone flap 4 shown in FIG. 10 is sewn to the craniotomy 5 with a suture and a wire at one position, and in this state, the bone flap 4 is closed. And craniotomy 5
The shaft portion 10b of the bar hole cap 10 is inserted into the marks of the perforations 3, 3 ,.

In the case of closing the open head 5 as described above, the marks of the perforations 3, 3, ... In the vicinity of the sutured portion and the marks of the perforations 3, 3, .. Since the diameters of the holes 3, 3, ... Are slightly different due to the relationship of the bone cutting groove 8 generated as shown in FIG. 10 at the time of cutting with the wire cutting wire saw or the like, the shaft portion of the bar hole cap 10 is 10b
Is smaller than the diameter of the perforations 3, 3, ... Generated at the time of craniotomy, while the diameter of the umbrella portion 10a of the bar hole cap 10 is generally larger than the diameter of the perforations 3, 3 ,. is there.

[0006]

However, in the conventional barhole cap 10 described above, the diameter of the shaft portion 10b is smaller than the diameter of the perforations 3, 3, ... Perforations that occur when heading 3,
Only the effect of covering the marks of 3, ...
There is a problem in that it is difficult to fix the bone to the craniotomy 5 and to obtain the action of promoting the bone fusion of the bone flap 4 to the skull 2.

The present invention has been made in view of the above circumstances, and can reliably fix the bone flap to the craniotomy after the craniotomy of the skull, and promote the bone fusion of the bone flap to the skull. An object of the present invention is to provide a barhole button for fixing a skull valve that can be used.

[0008]

In order to achieve the above object, the present invention forms a perforation at a predetermined position of a skull, and the perforation is performed.
A bone flap cut through the hole and cut off from the skull,
Located in the opening formed in the skull by excision of the valve
Perforated part formed in the skull when fixing
And a living body inserted between the perforated portion formed in the bone flap and
In the skull valve fixing bar hall button formed by a material having excellent affinity diameter peripheral surface of the burr hole buttons, over the top surface opposing the bottom surface of the insertion side Do that bottom surface to the drilling It is formed with a tapered surface that increases
Thus, the barhole button has a truncated cone shape .

In order to achieve the above object, the present invention provides
It was made of apatite or calcium phosphate. In order to further achieve the above object, the present invention provides
A through hole is formed at the center in the radial direction from the bottom surface to the top surface.
It has been configured. To achieve the above objectives
In the present invention, the radial direction is measured from the peripheral surface from the bottom surface to the top surface.
The cutout portion is formed to reach the central portion.

[0010]

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

FIG. 1 is an explanatory view showing a schematic structure of a cranial valve fixing barhole button according to one embodiment of the present invention, and FIG. 2 is a craniotomy of a cranial bone using the cranial valve fixing barhole button of FIG. FIG. 3 is a plan view showing a state of being fixed to the portion, and FIG. 3 is a sectional view taken along the line EE of FIG.

As shown in FIG. 1, the barhole button 20 of this embodiment is made of, for example, calcium phosphate, apatite, or the like, which has excellent biocompatibility and osteointegration, and its top surface 20a has a large diameter. Bottom 20b
It has a substantially truncated cone shape formed by the tapered surface and with a small diameter peripheral surface.

Using this barhole button 20, FIG.
When the craniotomy 5 (opening) of the skull 2 as shown in FIG. 2 is closed with the bone valve 4 to restore the original skull shape, first, the bone valve 4 is craniotomy as shown in FIGS. 2 and 3. 5, and in this state, the barhole button 20 is fitted from the bottom surface 20b side thereof to the marks of the perforations 3, 3, ... Formed between the bone valve 4 and the craniotomy 5.

After the barhole buttons 20 have been fitted into the marks of all the perforations 3, 3, ... As described above, the barhole buttons 20, 20, ... ... is further deeply fitted into the marks of the perforations 3, 3, ... And as shown in FIG. 3, the space between the bone valve 4 and the craniotomy 5 is caulked by the bar hole buttons 20, 20 ,. The scalp 1 is sutured by filling the bone cutting groove 8 between the bone valve 4 and the craniotomy 5 with bone scraping (not shown) that occurs during cutting with the above-described wire cutting wire saw.

As a result, the bone flap 4 extends in the extension of the skull 2.
The hole is fixed immovably in the direction and is firmly fixed to the craniotomy 5, and the barhole button 20 is formed of ceramics having excellent biocompatibility and osteointegration, and the perforations 3, 3, 3. Bone fusion of the bone valve 4 to the craniotomy 5 via the barhole button 20 in the trace portion, and craniotomy 5 of the bone valve 4 in the bone incision groove 8 part.
Bone fusion is promoted, and the period for repairing the skull shape before surgery is shortened. Further, the protrusion amount of the barhole button 20 on the surface of the skull 2 can be suppressed to a small value, which is preferable in terms of appearance.

Here, the fixed state of the barhole button 20 when the barhole button 20 is fitted into the perforation 3 formed by the clanitome is shown in FIG.
This will be described in detail with reference to (a) to (c). As shown in FIG. 4 (a), when a perforation 3 is formed at a desired position of the skull 2 using a clanitome 30 having two blades 30a and 30b having different diameters, the cross section of the perforation 3 has A step 3a as shown in FIG. 4B is generated depending on the difference in diameter between the two blades 30a and 30b.

Therefore, when the barhole button 20 is fitted into the hole 3 having the step 3a, the peripheral surface portion of the top surface 20a of the barhole button 20, that is, the most as shown in FIG. 4C. The large-diameter peripheral surface portion is caulked in the large-diameter portion 3b of the perforation 3, and the peripheral surface portion near the bottom surface 20b of the barhole button 20, that is, the peripheral surface portion having a relatively small diameter is in the perforation 3. The barhole button 20 is firmly fitted into the perforation 3 by being crimped at the small-diameter portion 3c, so that the bone valve 4 is firmly fixed to the open head 5.

By the way, in the step of fitting the barhole button 20 into the perforation 3 as described above, the barhole button 20 is provided in several perforations 3 as shown in FIG.
Is fitted, the interval of the bone incision groove 8 in that portion widens, which reduces the diameter of the perforation 3 in which the barhole button 20 is not fitted and the interval of the bone incision groove 8 in the perforation 3 portion. Then, it is assumed that the barhole button 20 cannot be fitted into the hole 3.
Therefore, in this case, as a supplement to the barhole button 20 having a substantially truncated cone shape, a barhole button 40 having a square pillar shape having a substantially square plane as shown in FIG. 6A may be used. Good.

The bar-hole button 4 having the shape of a square pole.
When 0 is used, the corner portion of the bar hole button 40 is appropriately cut as shown in FIG. 6 (a) according to the diameter of the hole 3 having a smaller diameter, and the bar is pressed in that state. The hole button 40 is fitted into the hole 3 as shown in FIG. 6 (b). As a result, the bone valve 4 can be fixed to the craniotomy 5 at the portion of the perforation 3 regardless of the diameter of the perforation 3. When the perforation 3 is formed by the clanitome 30, the bottom surface of the bar hole button 40 whose corners are cut has a step 3 of the perforation 3 as shown in FIG. 6C.
Since the bar hole button 40 comes into contact with the portion a, it is possible to prevent the bar hole button 40 from falling off the hole 3 and entering the inside of the skull 2.

Two holes 41, 41 as shown in FIG. 7A may be formed in the barhole button 40 so that the tip of a tool such as tweezers can be inserted therein. With this structure, as shown in FIG. 7B, the bar hole button 40 fitted in the hole 3 is formed.
Is rotated by tweezers 50 or the like, and the portion of the barhole button 40 having the longest diagonal length is fitted into the portion of the hole 3 having the smallest diameter so that the barhole button 40 can be fitted into the hole 3. It becomes possible to become stronger.

In this embodiment, the barhole button 2 is used.
Although 0 is formed of ceramics such as calcium phosphate or apatite which is excellent in biocompatibility or osteointegration, it may be formed of metal such as titanium, zirconium or alumina which is excellent in biocompatibility. The barhole button 40 is preferably made of the same material as the barhole button 20.

By the way, FIGS. 8 and 9 show a schematic structure of a skull valve fixing barhole button according to another embodiment of the present invention. First, the barhole button 20 shown in FIG. A through hole 20c is formed in the center in the radial direction extending to the bottom surface 20b, while the bar hole button 20 shown in FIG. 9 has a peripheral surface extending from the top surface 20a to the bottom surface 20b.
Flat, substantially U-shaped cutout portions 20d extending radially from central is
It is form form.

As a result, after closing the craniotomy 5 of the skull 2 with the bone valve 4, the barhole button 2 shown in FIGS.
By inserting a catheter (not shown) into the through hole 20c and the cutout portion 20d of 0, for example, bleeding in the skull 2 can be sucked and discharged to the outside.

[0024]

Effects of the Invention According to the skull valve fixing bar hall button of the present invention as described above, the ceiling facing the peripheral surface of the burr hole buttons, the bottom surface of the insertion side Do that bottom surface to the drilling It is formed with a tapered surface whose diameter increases toward the surface.
As a result, since the barhole button has a truncated cone shape , a hole is formed at a predetermined position of the skull, and
The bone flap cut from the skull and cut from the skull,
To fix in the opening formed in the skull by resection
Hit the bone valve immovably in the direction of extension of the skull
However, it can be firmly fixed to the opening of the skull , and thus bone fusion to the opening of the bone valve can be promoted.

Further, as described above, according to the skull valve fixing barhole button of the present invention, since the skull valve fixing barhole button is made of apatite or calcium phosphate, the bar of the bone valve in the perforated portion is formed. Bone fusion to the skull via the hole button can be facilitated. Further, as described above,
According to the burrhole button for fixing the skull valve, the barhoe is
Through hole in the radial center from the bottom to the top of the button
And the barhole button
A notch from the top surface to the bottom surface from the peripheral surface to the radial center
Since the part is formed, the bar hole button
Even after fixing the bone flap to the opening of the skull with
Insert the catheter into the skull through the through hole and cutout.
Enter and suck and discharge eg bleeding inside the skull to the outside
be able to.

[Brief description of drawings]

FIG. 1 is an explanatory diagram showing a schematic configuration of a skull valve fixing barhole button according to an embodiment of the present invention.

FIG. 2 is a plan view showing a state where a bone valve is fixed to the craniotomy of the skull by using the skull valve fixing barhole button of FIG.

3 is a cross-sectional view taken along the line EE of FIG.

FIG. 4 shows the perforations formed by the klaniotome.
FIG. 4 (a) is an explanatory view showing the work of forming a perforation by the craniotome, and FIG. 4 (b) shows the shape of the perforation by the craniotome. Explanatory drawing, FIG. 4 (c) is FIG.
It is explanatory drawing which shows the fixed state when the barhole button for skull valve fixing of FIG. 1 was fitted in the perforation shown to (b).

FIG. 5 is a plan view showing a state of the bone valve with respect to the craniotomy when the skull valve fixing barhole button of FIG. 1 is fitted into a part of the perforations.

6A and 6B show a square columnar barhole button used as an auxiliary to the skull valve fixing barhole button of FIG. 1, and FIG. 6A is an explanatory view showing its shape and usage. 6B and 6C are explanatory views showing a state in which the barhole button shown in FIG. 6A is fitted into the hole.

FIG. 7 shows a modified example of the barhole button shown in FIG. 6A, FIG. 7A is a perspective view thereof, and FIG. 7B is a use of the barhole button shown in FIG. 7A. It is explanatory drawing which shows a method.

FIG. 8 is an explanatory view showing a schematic configuration of a skull valve fixing barhole button according to another embodiment of the present invention.

FIG. 9 is an explanatory view showing a schematic configuration of a skull valve fixing barhole button according to another embodiment of the present invention.

FIG. 10 is an explanatory diagram illustrating a general craniotomy procedure.

FIG. 11 is a cross-sectional view taken along the line Loro of FIG.

FIG. 12 is an explanatory diagram showing a schematic configuration of a conventional barhole cap.

[Explanation of symbols]

 2 Skull 3 Perforation 4 Bone flap (cranial flap) 5 Craniotomy 20 Barhole button 20a Top 20b Bottom

Claims (4)

[Claims] 1. A perforation is formed at a predetermined position of a skull ,
A bone flap cut from the perforation and excised from the skull,
Located in the opening formed in the skull by excision of the bone flap
When fixing and fixing, perforated part formed in the skull
Minute and a perforated part formed in the bone flap,
Facing in the skull valve fixing bar hall button formed by a material having excellent body affinity, the peripheral surface of the burr hole buttons, the bottom surface from the bottom surface and the insertion side into the perforations <br/> ing The bar-hole button for fixing a skull valve, characterized in that the bar-hole button is formed into a truncated cone shape so that the diameter increases toward the top surface . 2. The cranial flap valve-fixing barhole button according to claim 1, which is formed of apatite or calcium phosphate. 3. Radial direction from the bottom surface to the top surface
A through hole is formed in the center, The skull valve fixation according to claim 1 or 2, characterized in that
Barhole button. 4. Diameter from the peripheral surface from the bottom surface to the top surface
A cutout is formed to reach the center of the direction, The skull valve fixation according to claim 1 or 2, characterized in that
Barhole button.