KR20210038064A - Patient Specific Cervical Fixation Guiding System - Google Patents

Patient Specific Cervical Fixation Guiding System Download PDF

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KR20210038064A
KR20210038064A KR1020190120721A KR20190120721A KR20210038064A KR 20210038064 A KR20210038064 A KR 20210038064A KR 1020190120721 A KR1020190120721 A KR 1020190120721A KR 20190120721 A KR20190120721 A KR 20190120721A KR 20210038064 A KR20210038064 A KR 20210038064A
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cervical
patient
guide
cervical spine
screw
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김호정
임권묵
우수헌
정효복
박태현
정현우
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(주)메디쎄이
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1757—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the spine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1703—Guides or aligning means for drills, mills, pins or wires using imaging means, e.g. by X-rays
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A61B17/7064—Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7071—Implants for expanding or repairing the vertebral arch or wedged between laminae or pedicles; Tools therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8866—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices for gripping or pushing bones, e.g. approximators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/90—Guides therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/568—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor produced with shape and dimensions specific for an individual patient
    • A61B2017/90—

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  • Orthopedic Medicine & Surgery (AREA)
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Abstract

The present invention relates to a patient-specific cervical fusion surgery guide system, and to a target guide that guides the insertion direction of a screw during cervical spine surgery and a traction guide that pulls the cervical spine to maintain correct alignment. By fixing interspine of cervical vertebrae with plates surrounding the same at both sides based on sagittal plane, the correct alignment of the cervical vertebrae during cervical fusion surgery is maintained, and with a target guide system designed by computer simulation allows a screw to be inserted in the correct position of the cervical pedicle, thereby improving the accuracy and convenience of surgery and minimizing side effects.

Description

환자맞춤형 경추 유합술 가이드 시스템{Patient Specific Cervical Fixation Guiding System}Patient Specific Cervical Fixation Guiding System}

본 발명은 환자맞춤형 경추 유합술 가이드 시스템에 관한 것으로서, 경추 수술 시 스크류의 삽입 방향을 안내하는 타겟 가이드와 경추가 올바른 정렬을 유지하도록 견인하는 견인 가이드에 관한 것이다.The present invention relates to a patient-specific cervical spine fusion guide system, and relates to a target guide for guiding an insertion direction of a screw during cervical spine surgery and a traction guide for traction to maintain correct alignment of the cervical spine.

일반적으로 척추는 통상 24개(천추골 제외)의 뼈로 이루어져 있으며, 이것은 관절 마디로 연결되어 있고, 각 관절의 사이에는 인체가 움직이거나 관절이 작동할때마다 그에 따른 충격을 흡수하고, 하중을 지지하기 위한 디스크가 위치하고 있다.In general, the spine is usually composed of 24 bones (excluding sacral vertebrae), which are connected by joint nodes, and between each joint, each time the human body moves or the joint operates, it absorbs the corresponding shock and supports the load. There is a disk for playing.

이러한 구성에 의해 척추는 완충작용을 하면서 인간의 자세를 지탱해줄 뿐만 아니라, 운동의 토대가 되며 내장의 모든 기관을 보호하는 중요한 기능을 한다.By this configuration, the spine acts as a buffer and supports the human posture, as well as the foundation for movement and an important function to protect all internal organs.

그러나, 척추가 외부의 인위적인 요인, 퇴행성 또는 비정상적인 자세가 오랫동안 지속됨에 따라 척추가 손상되거나 틀어질 경우 척추관을 통과하는 신경을 압박함으로써 심한 통증을 유발하게 된다.However, when the spine is damaged or twisted due to external artificial factors, degenerative or abnormal postures persisting for a long time, severe pain is caused by compressing the nerves passing through the spinal canal.

즉, 척추의 일부가 손상된 환자는 개인생활에 필요한 활동을 할 수 없고, 손상 정도가 심하지 않은 경우에도 척추의 손상된 부분이 다른 인접한 부분에 눌려지거나 닿게 되어 통증을 유발하게 된다.That is, a patient with a part of the spine injured cannot perform activities necessary for personal life, and even if the degree of damage is not severe, the damaged part of the spine is pressed or touched by other adjacent parts, causing pain.

이러한 손상된 척추를 치료하는 수술적 방법으로는 척추의 후방을 스크류(Pedicle Screw)로 고정하여 인접 분절의 적절한 간격을 유지시키고 신경 압박의 원인을 제거하는 척추 유합술이 시행된다. 이러한 수술적 치료에서 스크류는 척추의 후방 페디클 엔트리 포인트에서 페디클에 정확하게 삽입되어야 한다.As a surgical method to treat such a damaged spine, spinal fusion is performed in which the posterior of the spine is fixed with a pedicle screw to maintain proper spacing between adjacent segments and eliminate the cause of nerve compression. In this surgical treatment, the screw must be accurately inserted into the pedicle at the posterior pedicle entry point of the spine.

특히 경추(Cervical)의 경우 페디클 영역이 좁고 제한적인 특징으로 스크류 삽입 시 위치 선정이 매우 중요하며, 특히 척추가 완전히 발달되지 않은 소아환자의 경우에는 성인에 비해 더욱 주의를 요한다. 스크류가 잘못된 위치로 삽입될 경우 주변 신경 및 조직에 영향을 주어 심각한 부작용을 초래할 수 있는 문제점이 있다.In particular, in the case of the cervical spine (Cervical), the pedicle area is narrow and limited, so it is very important to select the position when inserting the screw. In particular, the pediatric patient whose spine is not fully developed requires more attention than adults. If the screw is inserted into the wrong position, there is a problem that may cause serious side effects by affecting the surrounding nerves and tissues.

본 발명은 상기 문제점을 해결하기 위해 고안된 것으로서, 경추에 안착하여 구비된 삽입관을 통해 스크류의 삽입 경로를 안내할 수 있는 타겟 가이드와 경추의 극돌기를 고정하여, 스크류가 삽입되는 동안 경추를 올바른 정렬상태로 유지시킬 수 있는 견인 가이드의 제공을 그 목적으로 한다.The present invention is devised to solve the above problem, by fixing the spinous process of the cervical vertebrae and a target guide that can guide the insertion path of the screw through an insertion tube provided to seat on the cervical vertebrae, correct alignment of the cervical vertebrae while the screw is inserted Its purpose is to provide a traction guide that can be kept in a state.

상기 목적 달성을 위해 본 발명은, 환자의 의료영상에 기반하여 형성된 경추 안착부와, 상기 경추 안착부와 연결되어 스크류를 삽입할 수 있게 구비된 스크류 삽입관과 상기 경추 안착부 및 상기 스크류 삽입관을 연결시켜주는 슬리브부로 형성되는 타겟 가이드 시스템, 복수 개의 결합홀이 형성된 경추의 극돌기를 시상면을 기준으로 양쪽에서 감싸 고정할 수 있는 플레이트, 상기 플레이트의 일측 단면은 고정력을 높일 수 있는 스파이크를 구비한 것을 특징으로 하는 견인 가이드 시스템을 포함하는 환자맞춤형 경추 유합술 가이드 시스템을 기술적 요지로 한다.In order to achieve the above object, the present invention provides a cervical vertebrae seating portion formed based on a medical image of a patient, and a screw insertion tube connected to the cervical spine seating portion to insert a screw, and the cervical vertebral seating portion and the screw insertion pipe A target guide system formed as a sleeve that connects the plate, a plate that can wrap and fix the spinous processes of the cervical spine with a plurality of coupling holes on both sides of the sagittal plane, and a spike that can increase the fixing force on one side of the plate. A patient-specific cervical spine fusion guide system including a traction guide system, characterized in that one, is a technical gist.

본 발명은 경추의 극돌기를 시상면을 기준으로 양쪽에서 감싸는 플레이트로 고정하여 경추 유합술을 시행하는 동안 경추가 올바른 정렬을 유지하도록 하며, 컴퓨터 시뮬레이션에 의해 설계된 타겟 가이드 시스템으로 경추 페디클의 정확한 위치에 스크류가 삽입될 수 있도록 하여 수술의 정확성과 편리성을 향상시키고 부작용을 최소화하는 효과가 있다. The present invention fixes the spinous processes of the cervical spine with a plate that wraps around the sagittal plane on both sides to maintain the correct alignment of the cervical spine while performing cervical fusion, and is a target guide system designed by computer simulation to accurately position the cervical pedicle. By allowing the screw to be inserted, there is an effect of improving the accuracy and convenience of surgery and minimizing side effects.

도 1~4 - 본 발명에 따른 환자맞춤형 경추 유합술 가이드 시스템의 실시 예.
도 5 - 본 발명에 따른 타겟 가이드의 상측 사시도.
도 6 - 본 발명에 따른 견인 가이드의 사시도.1-4-An embodiment of a patient-customized cervical spine fusion guide system according to the present invention.
Figure 5-An upper perspective view of the target guide according to the present invention.
6-a perspective view of a traction guide according to the invention.

본 발명은 환자맞춤형 경추 유합술 가이드 시스템에 관한 것으로서, 경추 수술 시 스크류의 삽입 방향을 안내하는 타겟 가이드와 경추가 올바른 정렬을 유지하도록 견인하는 견인 가이드에 관한 것이다.The present invention relates to a patient-specific cervical spine fusion guide system, and relates to a target guide for guiding the insertion direction of a screw during cervical spine surgery and a traction guide for traction to maintain correct alignment of the cervical spine.

이하에서는 첨부된 도면을 참조하여 본 발명에 대해 상세히 설명하고자 한다. 도 1에서 도4는 본 발명에 따른 환자맞춤형 경추 유합술 가이드 시스템의 실시 예이고, 도5는 타겟 가이드는 상측 사시도이며, 도6은 견인 가이드의 사시도를 나타낸 것이다.Hereinafter, the present invention will be described in detail with reference to the accompanying drawings. 1 to 4 is an embodiment of a patient-specific cervical spine fusion guide system according to the present invention, FIG. 5 is an upper perspective view of a target guide, and FIG. 6 is a perspective view of a traction guide.

도시된 바와 같이 본 발명에 따른 환자맞춤형 경추 유합술 가이드 시스템은, 경추 뼈(100)에 안착되어 페디클 스크류(400)의 올바른 삽입 경로를 안내하는 타겟 가이드(200)와, 경추의 극돌기(110)를 인체 시상면(sagittal plane)을 기준으로 양쪽에서 고정시켜 경추의 올바른 정렬을 유도하는 견인가이드(300)을 포함하는 것을 특징으로 한다.As shown, the patient-customized cervical spine fusion guide system according to the present invention includes a target guide 200 that is seated on the cervical spine bone 100 to guide the correct insertion path of the pedicle screw 400, and the spinous process 110 of the cervical spine. It characterized in that it comprises a traction guide 300 for inducing correct alignment of the cervical vertebrae by fixing on both sides with respect to the sagittal plane of the human body.

상기 타겟 가이드(200)에 있어서, 상기 페디클 스크류(400)의 경로를 안내하는 스크류 삽입관(210) 및 환자의 의료영상을 기반으로 설계되어 환자의 경추 뼈(100)에 정확히 안착시킬 수 있는 안착부(230), 상기 스크류 삽입관(210) 및 상기 안착부(230)와 연결되어 위치를 고정시키는 슬리브부(220)를 포함하는 타겟 가이드(200)를 포함하는 것을 특징으로 한다.In the target guide 200, it is designed based on a screw insertion tube 210 guiding the path of the pedicle screw 400 and a medical image of the patient, so that it can be accurately seated on the cervical spine bone 100 of the patient. It characterized in that it comprises a target guide 200 including a seating portion 230, the screw insertion tube 210, and a sleeve portion 220 connected to the seating portion 230 to fix the position.

상기 견인 가이드(300)에 있어서, 복수개의 스파이크부(310)와 복수개의 결합홀(320)이 형성된 것을 특징으로 한다.In the traction guide 300, a plurality of spike portions 310 and a plurality of coupling holes 320 are formed.

상기 견인 가이드(300)는 두 개가 한쌍으로 구성되어 경추의 극돌기(110)를 감싸 고정하는 것을 특징으로 한다.The traction guide 300 is characterized in that the two are configured as a pair to wrap and fix the spinous protrusions 110 of the cervical vertebrae.

상기 견인가이드(300)의 일측단면에 형성된 복수개의 스파이크부(310)는 경추의 극돌기(110)를 양쪽으로 감싸 고정하면서 위치가 이탈하지 않도록 뼈를 고정하는 역할을 하며, 상기 견인 가이드(300)에 형성된 복수개의 결합홀(320)은 볼트와 너트의 조합으로 한쌍의 상기 견인 가이드를 고정할 수 있음을 특징으로 한다.The plurality of spike portions 310 formed on one side end surface of the traction guide 300 serve to fix the bone so that the position does not deviate while surrounding and fixing the spinous protrusions 110 of the cervical vertebrae, and the traction guide 300 A plurality of coupling holes 320 formed in is characterized in that it is possible to fix the pair of traction guides by a combination of a bolt and a nut.

100 : 경추 110 : 경추 극돌기
200 : 타겟 가이드 210 : 스크류 삽입관
220 : 슬리브부 230 : 안착부
300 : 견인 가이드 310 : 스파이크부
320 : 결합홀 400 : 페디클 스크류100: cervical vertebrae 110: cervical spinous processes
200: target guide 210: screw insertion tube
220: sleeve part 230: seating part
300: traction guide 310: spike portion
320: coupling hole 400: pedicle screw

Claims (4)

경추 뼈에 안착되어 고정되는 안착부,
페디클 스크류를 삽입할 수 있는 스크류 삽입관,
상기 안착부와 상기 스크류 삽입관을 연결하여 유지시키는 슬리브부로 형성되는 타겟 가이드;와
복수 개의 스파이크 부,
복수 개의 결합홀이 형성된 견인 가이드;를 포함하는 환자맞춤형 경추 유합술 가이드 시스템.A seating part that is seated and fixed on the cervical spine
Screw insertion tube into which pedicle screw can be inserted,
A target guide formed of a sleeve portion connecting and holding the seating portion and the screw insertion tube; and
A plurality of spike parts,
A traction guide having a plurality of coupling holes formed; patient-customized cervical spine fusion guide system including. 제 1항에 있어서, 상기 타겟 가이드의 상기 안착부는 CT, MRI 등 환자의 의료영상에 기반하여 환자맞춤형으로 제작되는 것을 특징으로 하는 환자맞춤형 경추 유합술 가이드 시스템.The patient-specific cervical spine fusion guide system according to claim 1, wherein the seating part of the target guide is manufactured to be patient-specific based on a patient's medical image such as CT and MRI. 제 1항에 있어서, 상기 타겟 가이드는 2개가 한쌍으로 제작되어 사용되는 것을 특징으로 하는 환자맞춤형 경추 유합술 가이드 시스템.The patient-specific cervical spine fusion guide system according to claim 1, wherein two target guides are manufactured and used as a pair. 제 1과 제3 항에 있어서, 상기 타겟 가이드의 상기 결합홀은 볼트와 너트의 조합으로 고정되는 것을 특징으로 하는 환자맞춤형 경추 유합술 가이드 시스템.

4. The patient-specific cervical spine fusion guide system according to claim 1 and 3, wherein the coupling hole of the target guide is fixed by a combination of a bolt and a nut.
KR1020190120721A 2019-09-30 2019-09-30 Patient Specific Cervical Fixation Guiding System KR20210038064A (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113693697A (en) * 2021-07-22 2021-11-26 首都医科大学宣武医院 Bone block lifting system, bone block lifting auxiliary instrument and vertebral body fixing plate
CN115394146A (en) * 2022-09-22 2022-11-25 中国中医科学院望京医院(中国中医科学院骨伤科研究所) Human cervical vertebra simulation device for rotary handle method training and teaching robot

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113693697A (en) * 2021-07-22 2021-11-26 首都医科大学宣武医院 Bone block lifting system, bone block lifting auxiliary instrument and vertebral body fixing plate
CN113693697B (en) * 2021-07-22 2024-04-30 首都医科大学宣武医院 Bone block lifting system, bone block lifting auxiliary instrument and vertebral body fixing plate
CN115394146A (en) * 2022-09-22 2022-11-25 中国中医科学院望京医院(中国中医科学院骨伤科研究所) Human cervical vertebra simulation device for rotary handle method training and teaching robot
CN115394146B (en) * 2022-09-22 2023-12-01 中国中医科学院望京医院(中国中医科学院骨伤科研究所) Human cervical vertebra simulation device and teaching robot for training by rotary handle method

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