KR100545059B1 - Spine spacer - Google Patents

Abstract

The present invention relates to a medical device for maintaining a constant spacing between spinous processes by placing a spacer between spinous processes respectively present on adjacent vertebrae.

Spinal expander according to the present invention has a tapered shape, the first fixing portion is provided with a fixing protrusion for preventing the movement of the spinal expander in the direction of the insertion direction, and the glass to secure a predetermined distance by inserting the spinal expander And a second holding part provided with a gap holding part having a long axis and a short axis on a cross section, and a fixing protrusion for preventing the spinal dilator from moving backward in the inserted direction after the spinal dilator is fixed.

According to the present invention, there is no need to remove the interultra ligament and the size of the muscle incision can be minimized, thereby reducing the physical burden on the patient undergoing the procedure.

Spine, spinous process, interspinous ligament, yellow ligament, spinal nerve, spinal stenosis, guide wire, spinal dilator

Description

Spinal dilator {Spine spacer}

1 is a cross-sectional view of the spine.

Figure 2 is a view showing a method for operating a U-shaped cushion.

Figure 3 illustrates an insertion method for performing a spinal nerve dilator.

Figure 4a is a perspective view showing a dilator according to an embodiment of the present invention.

Figure 4b is a view showing the projection direction of the spinous process.

Figure 5 is a cross-sectional view of the dilator for the spine of Figure 4a.

6A illustrates a process of infiltrating a guide wire into a target point.

Figure 6b is a view after removing the medical needle from the guide wire.

6C is a view for explaining a process of inserting a ballpoint pen-shaped member until immediately before a target point.

6D illustrates a process of inserting a cylindrical member until immediately before the target point.

6E illustrates a process of inserting a cutting member.

Figure 6f is a view showing after creating a crack gap with a cutting member.

Figure 6g is a view showing the process of inserting the spinal dilator between the spinous process.

Figure 6h is a view showing a process for extending the spacing between spinous processes by orthogonal rotation of the spinal dilator.

Figure 7 looks at the shape of the spinal expander installed in the back direction.

(Symbol description of main part of drawing)

10: second fixing portion 11: second fixing protrusion

12: rear end surface of the second fixing part 20: gap holding part

21: spinous process support part 30: first fixing part

31: first fixing projection 32: shear surface of the first fixing portion

40: through hole 100: spinal expander

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to spinal spacers, more particularly for medical use to maintain a constant spacing between spinous processes by placing spacers between spinous processes existing on adjacent vertebrae. It is about a mechanism.

1 is a cross-sectional view of the spine. A number of spinous processes 3 are located on the back of the human body, and the vertebral body 8 is located on the opposite side. The spinal nerve 1 is located in the space between the spinous process 3 and the vertebral body 8, and the interspinous ligament 7 and the yellow ligament 6 are located between each spinous process 3. Then, the superficial ligaments 5 and the skin 20 exist from the spinous process 3 toward the back of the human body.

As the human body ages, the above-described degenerative change occurs in the spine, and as shown by the dotted line A, the gap between the spinous processes 3 becomes close, and the ligamentum flavum 6 loses its elasticity and becomes thick. It protrudes forward like a dotted line B. Compression of the spinous process 3 or the yellow ligament 6 by the above-described change in the spinal nerve 1 or the spinous nerve (not shown) connected to the spinal nerve 1 is called spinal stenosis.

Treatment of spinal stenosis includes treatment with drugs, physical therapy, surgery. Among these, surgical treatment is used when it is not treated by other treatment methods, and it removes bones and tissues compressing the nerves and fixes the spine with screws in preparation for instability of the spine. Generally known. However, the above-described surgical method requires extensive removal of bone and tissue, so general anesthesia is required, and a long operation time and a long recovery period after surgery are required. Therefore, elderly people who have weak energy often do not operate, there is a problem that often occurs when complications and other reasons do not obtain a satisfactory effect, there was a problem that costs a lot of surgery.

As a solution to this problem, a U-type cushion insert for lumbar spinous process has been proposed. As shown in Figure 2, just beneath the skin there is a spine and spinous process, this method is to remove the ligaments between the spinous process between this is a method of fixing by inserting a U-shaped cushioning device, which is a nerve dilator. This method reduces the nerve compression by removing the ligaments and dilating the nerve pores by maintaining the intervals of the spinous process. To insert such a U-shaped cushion, it is necessary to cut the muscle about 5 cm.

The U-shaped cushioning machine has a configuration in which the fixing plates 65 protrude outward from both ends of the U-shaped holding member 63. The U-shaped cushion is disposed between the spinous processes 3, each of which the retaining member 63 is present on the adjacent spine, and the fixing plate 65 provided on the retaining member 63 engages with the sides of the spinous processes 3; Has a configuration.

As another solution to the above problem, a method such as that disclosed in Registration Utility Model No. 307633 (hereinafter referred to as '307633') may be used. As shown in FIG. 3, the spinal nerve dilator 70 is inserted between the adjacent spinous processes 20. The spinal nerve dilator 70 is configured to include a body 71 and the bending member 72.

Thus, the L-shaped spinal nerve dilator 70 is inserted into the human body through the cut skin, and is inserted between the adjacent spinous processes 3 with the bending member 72 in the direction of the arrow. Thereby, the space | interval of the spinous processus 3 which narrowed the space | interval by spinal stenosis becomes wider. In order to keep the spinal nerve dilator 70 sandwiched between the spinous processes 3, the bending member 72 is bent upwardly. Then, the spinal nerve hole dilator 70 is U-shaped, the main body 71 is installed so as not to be separated between the spinous processes (3).

The U-shaped cushion technique described above, or 307633 or similar conventional techniques eliminates the interultra ligaments between the spinous processes to insert a mechanism for maintaining the spacing between the spinous processes. In addition, in order to insert the instrument, the muscle must be incised to a considerable size (about 5 cm). Therefore, the work for the procedure becomes cumbersome, and the patient is burdened with considerable time and physical burden.

In addition, particularly devices that require coupling bolts, nuts, and the like, such as spinal nerve dilators, the separated components are mechanically coupled so that the coupling site may be compromised after considerable time. In addition, there is a limitation in terms of the material because it is necessary to use a rigid material, such as a metal material in the structure. Similarly, in the case of a U-shaped cushion machine, it is difficult to use a malleable, ductile metal because it must use a material with elasticity.

Therefore, it is necessary to create a spinal dilator that can be easily performed without a great physical burden on the patient, its structure and shape are simple, and the constraints of the materials used are small.

The present invention was devised in consideration of the above-described needs, and an object of the present invention is to provide a vertebral dilator which can be installed between the spinous processes with only minimal muscle dissection without removing the interultra ligament.

In addition, it is an object of the present invention to provide a spinal dilator that can be simply manufactured integrally without the need to be combined by the coupling means, it can be installed in the correct position in the body by a simple procedure.

In order to achieve the above object, the spinal dilator according to the present invention has a tapered shape at an angle to the front end so that the spinal dilator can be inserted into the cracks of tissues and interultra ligaments in the body, the spine A first fixing part provided with a first fixing protrusion for preventing the dilator from moving backward in the inserted direction after being rotated and fixed; It has a short axis on the cross section to facilitate insertion of the spinal dilator, and has a long axis in the vertical direction and the short axis on the cross section so as to secure a predetermined interval in the spinous process period when the spinal dilator is rotated. Spacing part; And a second fixing part provided with a second fixing protrusion for preventing the spinal dilator from moving backward in the inserted direction after the spinal expander is rotated and fixed.

The spinal dilator preferably further includes a through-hole penetrating the vertebral dilator to the end to move the spinal dilator along a guide wire for guiding a target point from outside the body.

It is preferable that the second fixing portion has a semicircular shape having a substantially rounded shape at its rear end.

It is preferable that the cross section of the space keeping part is substantially elliptical.

The gap maintaining part preferably includes a spinous process support part having a shape in which both ends of the long axis are cut in a direction perpendicular to the long axis in the cross section in order to prevent the fixed state from being released after the spinal dilator is rotated and fixed.

The gap maintaining part has a shape in which the both ends of the long axis are cut in a direction perpendicular to the long axis in the cross section so as to be slightly moved toward the center of the cross section in order to prevent the fixed state from being released after the spinal dilator is rotated and fixed. It is preferable to include a spinous process support.

The length of the major axis direction of the gap holding part has a value between 7 mm and 15 mm, and the size of the major axis direction of the first fixing part and the second fixing part has a value obtained by adding 4 mm to 6 mm to the value.

The crack gap preferably has a value of 5 mm to 7 mm smaller than the size of the first fixing part in the major axis direction.

The spinal dilator is preferably made of any one material of jade, elvan, amethyst, silicone, synthetic rubber, or synthetic fibers.

It is preferable that the first fixing part, the gap holding part, and the second fixing part are integrally manufactured without being coupled.

Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the accompanying drawings. Advantages and features of the present invention and methods for achieving them will be apparent with reference to the embodiments described below in detail with the accompanying drawings. However, the present invention is not limited to the embodiments disclosed below, but may be implemented in various forms. It is provided to fully convey the scope of the invention to those skilled in the art, and the present invention is defined only by the scope of the claims. Like reference numerals refer to like elements throughout.

Figure 4a is a perspective view of the spinal dilator 100 in accordance with an embodiment of the present invention. The spinal dilator 100 includes a first fixing part 30, a second fixing part 10, a gap maintaining part 20 connecting them, and a through hole 40. Spinal dilator 100 is inserted between the spinous process (3), it can extend the interval of the spinous process (3) by fixing the rotation. To this end, the two axes in the cross section of the spinal expander 100 are divided into short and long axes, respectively, as shown in FIG. 5 (b), and the spinous processus protrusions are inserted when the spinal expander 100 is inserted between the spinous processes 3. Direction (shown in Fig. 4b, hereinafter) and the long axis are inserted in parallel, and after insertion, by rotating at right angles, the projection direction of the spinous process and the long axis are perpendicular to extend the distance between the spinous processes (3). have.

In the following description, the long axis means the long axis of the cross section shown in FIG. 5 (b), and the short axis means the short axis of the cross section shown in FIG. 5 (b).

The first fixing part 30 is a front end portion 32 having a tapered shape so that the vertebral dilator 100 can penetrate the cracks of tissues and interultra ligaments 7 in the body along the medical guide wire. And a protrusion having a protrusion shape so as to prevent the spinal expander 100 from moving backward in the inserted direction in contact with the first side surface (52 of FIG. 7) of the spinous process during rotational fixation of the spinal expander 100. 1 includes a fixing protrusion (31). The front end portion 32 has a predetermined taper angle. The smaller the taper angle, the easier it is to penetrate into the crack gap, but the first fixing portion 30 should be enlarged in the longitudinal direction of the spinal dilator 100. In the opposite case, it is difficult to penetrate the crack. Therefore, the taper angle should be appropriately sized to satisfy both.

The second fixing portion 10 abuts against the second side of the spinous process protrusion (51 in FIG. 7) during rotational fixation of the spinal expander 100 so as to prevent the spinal expander 100 from moving backward in the inserted direction. And a second fixing protrusion 11 having a protrusion shape. The rear end 12 of the second fixing portion 10 does not need to form a taper angle unlike the front end portion 32 of the first fixing portion 30. Therefore, it may be any shape, but it is preferable to have a substantially round semicircular shape in consideration of handleability and stability.

The gap maintaining part 21 connects the first fixing part 30 and the second fixing part 10, and when the spinal dilator 100 is rotated between the adjacent spinous processes 3, the lower end of the upper spinous process ( 53) of FIG. 7 and the upper end of the lower spinous process protrusion (54 of FIG. 7) are extended and maintained at predetermined intervals. In addition, the gap holding part 21 is a spinous process support part having a shape in which both ends of the long axis are cut in a direction perpendicular to the long axis in a cross section having an ellipse in order to prevent the fixed state from being released due to the pressure between the spinous processes 3 after the rotation is fixed. 21).

The through hole 40 has a front end 32 of the first fixing part 30 and a rear end 12 of the second fixing part 10 so that the spinal expander 100 can move along the guide wire. It is a cylindrical hole through). The size of the hole is sufficient to accommodate the guide wire.

Although the size of the spinal dilator 100 may be maintained between the spinous processes 3 depending on the patient or the degree of symptoms, the spacing between the spinous process support members 21, that is, the long axis direction of the spacing holding part 20 is approximately. It is preferable that the size of about 7mm to 15mm, the size of the long axis direction of the first fixing part 30, and the size of the long axis direction of the second fixing part 10 is about 4mm to 6mm in the interval between the spinous process support 21. It is preferable to add the degree. And, the size of the short axis direction of the spinal dilator 100 can be made differently in accordance with the interval between the narrowed spinous process 3 of the patient.

As a result, the spinal dilator 100 according to the present invention requires a slightly larger muscle incision than the size of the cross section to be inserted, so the procedure can be performed with only a much smaller incision than the prior art requiring a 5 cm muscle incision. It becomes possible.

On the other hand, the spinal expander 100 can be manufactured using a variety of materials because it is made integrally without a connecting portion. In general, the spinal dilator 100 is to be inserted into the human body should not cause side effects in the human body, and also should be enough to support the load applied between the spinous processes (3). Therefore, a material with high hardness, such as titanium, ceramic, bone cement, or polymethyl methacrylate, can be used.

However, although a material having a high hardness may be used as described above, a material such as silicone, synthetic rubber, synthetic fiber, or the like having some elasticity may be used without limitation. Furthermore, it would be more beneficial to use materials that could benefit the patient's physical health, such as jade, octane, amethyst, and the like, which are known to have a generally beneficial effect on the human body.

5 is a cross-sectional view of the vertebrae dilator 100 of FIG. 4A, wherein (a) is a longitudinal section cut along a major axis along the through hole 40 direction, and (b) is A in (a). -A 'cut cross section. Although the spinous process support part 21 is illustrated as having a straight shape in (b), the spinous process support part 21 is not limited thereto and may have another shape to be easily coupled and supported according to the shape of the bottom or top of the spinous process. For example, as in (c) it may have a form slightly entered in the center direction.

6A to 6H are detailed views illustrating a process of placing the spinal dilator 100 in the spine of a patient. First, the patient is anesthetized, and a predetermined position of the interultra ligament 7 existing between the spinous processes 3 into which the medical needle 51 with the guide wire 52 joined to the tip is inserted. (Hereinafter referred to as 'target point') (see FIG. 6A). The predetermined position may be sufficient as long as it can be inserted into the dilator 100 for the spine, but a position about the middle of the interultra ligament 7 may be preferable.

Next, the medical needle 51 is removed leaving only the guide wire 52 passing through the predetermined position of the interultra ligament 7 (see FIG. 6B). The guide wire 52 may be fixed to the end passing through the interultra ligament 7, for example, near the posterior joint (not shown), but may be left as it is without passing through the interultra ligament 7.

Then, along the guide wire 52 provided above, a ballpoint pen-shaped member 53 is inserted until just before the target point (see Fig. 6C). A cylindrical member 54 is inserted along the periphery of the ballpoint pen-shaped member 53 until immediately before the target point (see FIG. 6D). After removing the ball pen-shaped member 53 leaving only the cylindrical member 54, the medical cutting member 55 having a blade 56 is inserted along the space inside the cylindrical member 54. (See FIG. 6E). The size of the blade should be determined to be somewhat smaller than the size of the long axis of the first fixing portion 30 of the spinal expander 100, and 5mm to 7mm smaller than the size of the long axis of the first fixing portion 30. It would be advisable to use the size.

By inserting the blade 56, the interstitial ligament 7 is formed with a crack gap 57 long in a direction parallel to the spinous process. The crack gap 57 is about the same size as the blade 56. After creating the crack gap 57, the cylindrical member 54 and the cutting member 55 are removed, leaving only the guide wire 52 (see FIG. 6F).

Next, the guide wire 52 is inserted into the through hole 40 of the spinal expander 100, and according to the direction in which the guide wire 52 guides, the first fixing part 30 of the spinal expander 100. ) Is inserted until it passes through the crack gap 57 (see Fig. 6g). In this case, the spinal dilator 100 is inserted in a direction parallel to the spinous processes 3, that is, in a direction parallel to the crack gap 57.

Finally, when the first fixing part 30 passes through the crack gap 57, the interval between the spinous processes 3 is extended by rotating the spinal expander 100 at right angles to the axis of the through hole 40 (FIG. 6h). As such, when the spacing between the spinous processes 3 is widened, the yellow ligaments 6, which are thickened as shown and press the spinal nerve 1, are thinned. In addition, the pressing of the disk 4 is alleviated, and thus the degree to which the disk 4 presses the spinal nerve 1 can be alleviated.

7 is a view illustrating the shape of the spinal dilator installed in the back. The spinal dilator 100 is fixed between the spinous processes 3, and the first fixing protrusion 31 of the first fixing part 30 is caught by the first side 52 of the spinous processes 3. The second fixing protrusion 11 of the second fixing part 10 is locked to the second side surface 51 of the spinous processes 3 so that the movement in the longitudinal direction is fixed. In addition, the spinous process support part 21 of the gap holding part 20 is pressed between the lower end 53 of the upper spinous process protrusion and the upper end 54 of the lower spinous process to fix the movement in the long axis or short axis direction of the cross section.

Although embodiments of the present invention have been described above with reference to the accompanying drawings, those skilled in the art to which the present invention pertains may implement the present invention in other specific forms without changing the technical spirit or essential features thereof. I can understand that. Therefore, it should be understood that the embodiments described above are exemplary in all respects and not restrictive.

According to the present invention, there is no need to remove the interultra ligament and the size of the muscle incision can be minimized, thereby reducing the physical burden on the patient undergoing the procedure.

In addition, according to the present invention, the procedure can be made easily and there is an advantage that can be installed in the spine expander in the correct position.

And according to the present invention, the process of manufacturing a dilator for the spine can be made simple and has the advantage of reducing the manufacturing cost.

In addition, according to the present invention, there is also an advantage to reduce the limitation of the material used to produce a spinal expander using a variety of materials.

Claims (10)

In the spinal dilator is inserted between the spinous process existing on each adjacent spine to maintain a constant distance between the spinous process, The spinal dilator has a tapered shape having a predetermined angle at the front end so that the spinal dilator can be inserted into the cracks of tissues and interultra ligaments of the body, and prevents the spinal dilator from moving backward in the inserted direction after rotation is fixed. A first fixing part provided with a first fixing protrusion; It has a short axis on the cross section to facilitate insertion of the spinal dilator, and has a long axis in the vertical direction and the short axis on the cross section so as to secure a predetermined interval in the spinous process period when the spinal dilator is rotated. Spacing part; And And a second fixing part provided with a second fixing protrusion for preventing the spinal expander from moving backward in the inserted direction after the spinal expander is rotationally fixed. The method of claim 1, A spinal dilator further comprising a through-hole penetrating the vertebral dilator to its end to move the spinal dilator along a guide wire guiding a target point from outside the body. The method of claim 1, wherein the second fixing portion A spinal dilator, characterized in that the shape of the rear end has a substantially round semicircle shape. The spinal dilator of claim 1, wherein the cross section is substantially elliptical. The method of claim 1, wherein the interval maintaining unit And a spinous process support having a shape in which both ends of the long axis are cut in a direction perpendicular to the long axis in the cross section, in order to prevent the fixed state from being released after the spinal expander is rotationally fixed. The method of claim 1, wherein the interval maintaining unit In order to prevent the fixation state from being released after the spinal dilator is rotated and fixed, the spinous process includes a spinous process support part having a shape in which both ends of the long axis are cut in a direction perpendicular to the long axis in the transverse section and slightly in the center direction of the cross section. Spinal dilator, characterized in that. The method of claim 1, The major axis of the interval holding portion has a value between 7 mm and 15 mm, and the major axis of the first fixing part and the second fixing part has a value of 4 mm to 6 mm. Spinal dilator. The method of claim 7, wherein The size of the crack is a spinal expander, characterized in that it has a value of 5mm to 7mm smaller than the size of the long axis direction of the first fixing portion. The method of claim 1, wherein the spinal dilator Spinal expander, characterized in that made of any one of silicone, synthetic rubber, synthetic fibers, jade, ganban stone, or amethyst. The spinal expander according to claim 1, wherein the first fixing part, the spacing part, and the second fixing part are integrally manufactured without being coupled.

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