RU208765U1 - Device for implantation of intervertebral disc endoprosthesis - Google Patents

Abstract

The utility model relates to medical technology and can be used in neurosurgery for the implantation of an Endocarbon intervertebral disc endoprosthesis. The device includes a handle-holder, which is represented by two parallel rods 1 and 2, inserted into the gripping working head, made whole in the form of two parallel spring plates and interconnected on one side, forming a mouth with holes for the rods. At the distal ends of each plate of the working head, two parallel pins are fixed, each of which enters the corresponding groove on the outer surface of the plates of the intervertebral disc prosthesis, rod 1 ends at the level of the mouth of the working head and is rigidly fixed in it, from its other end it is rigidly fixed to it hard platform-anvil. Rod 2 ends at the level of the edge of the working head, has a diameter smaller than the distance between the spring plates, the end of the rod is made oval to perform the function of a wedging tongue, in the proximal part it is bent in the form of a handle loop. The rods in the loop-handle area are interconnected by a coupling. The device expands the arsenal of technical means to ensure accurate positioning of the endoprosthesis in the intervertebral space and free removal of the device without displacement of the endoprosthesis.

Description

The utility model relates to medical technology and can be used in neurosurgery for the implantation of an Endocarbon intervertebral disc endoprosthesis.

Implantation of an endoprosthesis of the intervertebral disc is directly related to its further functioning. An implantation error can lead to improper functioning of the intervertebral disc endoprosthesis, which may lead to a lack of improvement in the patient's quality of life after surgery. To perform the correct implantation of the intervertebral disc endoprosthesis, visual control, the possibility of using a power mechanism during positioning, and the proper provision of easy release from the device for implantation without displacement of the endoprosthesis in the intervertebral space are of great importance.

The endoprosthesis Endocarbon comes with a tool for its installation (RF patent No. 2465870), which was chosen by us as a prototype. The device for holding the prosthesis of the intervertebral disc has the form of a handle-holder, the end of which is made in the form of two movable parts, at the ends of which four pins are fixed in pairs mutually parallel, each of which enters the corresponding groove on the outer surface of the plates of the prosthesis of the intervertebral disc, and in the body of the handle a thrust element is located that controls the mutual movement of its moving parts in a plane perpendicular to the outer surface of the mentioned plates

The device for implantation has the following disadvantages:

1. Insufficient visualization of the working field due to its overlapping with large parts, since the device is quite massive.

2. It is impossible to use inertial action for accurate positioning of the endoprosthesis in the dorsal-ventral direction, since the moving parts move in pairs in a plane perpendicular to the endoprosthesis through the thrust element, and the application of inertial forces can damage the rotary element. Without the use of inertial forces, it does not always allow a satisfactory placement of the endoprosthesis in the intervertebral space.

3. Migration of the endoprosthesis from the intervertebral space upon removal of the device for implantation. After the maximum dilution of the plates with pins, the prototype does not allow to freely separate the device from the endoprosthesis, which sometimes entails incorrect positioning, both in the dorsal-ventral and medial-lateral directions.

The task of the proposed utility model is to improve the device in order to eliminate the shortcomings of the prototype.

EFFECT: expanding the arsenal of technical means to ensure accurate positioning of the endoprosthesis in the intervertebral space and free removal of the device without displacement of the endoprosthesis.

The technical result is achieved by a device that includes a handle-holder, which is represented by two parallel rods 1 and 2, inserted into a gripping working head, made whole in the form of two parallel spring plates and interconnected on one side, forming a mouth with holes for the rods, on the distal At the ends of each plate of the working head, two parallel pins are fixed, each of which enters the corresponding groove on the outer surface of the plates of the intervertebral disc prosthesis, rod 1 ends at the level of the mouth of the working head and is rigidly fixed in it, from its other end, a thrust pad is rigidly fixed to it - anvil, rod 2 ends at the level of the edge of the working head, has a diameter smaller than the distance between the spring plates, the end of the rod is oval, to perform the function of a wedging tongue, in the proximal part it is bent in the form of a handle loop, the rods in the handle loop area are interconnected Mufto th.

Preferably, the working head plates are labeled with the letters "B" and "H" or the words "TOP" and "BOTTOM", defining the top and bottom of the implant device.

The proposed utility model is illustrated by graphic materials:

Fig. 1 - a photograph of the general view of the device (the loop-handle in the raised position, which corresponds to the horizontal location of the wedging tongue);

Fig. 2 - drawing of the working head with the internal arrangement of the rods.

Fig. 3 - photograph of the device with the endoprosthesis in two positions of the loop handle and the corresponding positions of the wedging tongue in the gripping working head.

Fig. 4 - intraoperative radiograph at the time of placement of the device for implantation with endoprosthesis Endocarbon in the intervertebral space.

Fig. 5 - intraoperative radiograph at the time of removal of the device for implantation of the endoprosthesis of the intervertebral disc Endocarbon: the position of the implant remained unchanged.

Fig. 6 - measurement of the maximum distance between the pins when wedging with a wedging tongue (side view).

The device for holding the endoprosthesis of the intervertebral disc (Fig. 1) consists of: a handle-holder, which is represented by two parallel rods (1, 2) inserted into a gripping working head (3), made whole in the form of two parallel spring plates and interconnected on the one hand, forming a mouth with holes for the rods. At the distal ends of each plate of the working head, two parallel pins (4, 5) are fixed, each of which enters the corresponding groove on the outer surface of the plates of the intervertebral disc prosthesis. Rod 1 (1) ends at the level of the mouth of the working head and is rigidly fixed in it (6), from its other end, a thrust platform-anvil (7) is rigidly fixed to it. Rod 2 (2) ends at the level of the edge of the working head, has a diameter smaller than the distance between the spring plates, the end of the rod is oval to perform the function of a wedging tongue, which allows to separate pairs of rods (4 and 5) at a distance of 4 mm. Rod 2 is bent in the proximal part in the form of a handle loop (8). Rods 1 and 2 in the loop-handle area are interconnected by a coupling (9).

The device is used as follows.

Before the start of the operation, the device for implantation of the intervertebral disc is brought into working position (wedging tongue in a vertical position, loop-handle in the plane of the plates). Next, the surgeon installs the pins (4,5) in the corresponding grooves of the endoprosthesis of the intervertebral disc and turns the loop-handle up or down by 90º, which corresponds to the horizontal location of the wedging tongue, thereby securing the endoprosthesis in the device (Figure 3). After that, the surgeon places the endoprosthesis clamped in the proposed device into the prepared intervertebral space. Performs its positioning under X-ray control, applying inertial force, if necessary, striking the hard anvil. After making sure that the required positioning of the endoprosthesis is achieved, the surgeon rotates the handle loop by 90º (the handle loop in the plane of the plates), which moves the wedging tongue to a vertical position and spreads the pins to a maximum distance of 4 mm. The distance between the pins located in pairs allows you to freely remove the device for implantation without migrating the installed endoprosthesis in the vertebral bed. The surgeon pulls towards himself and removes the device to hold the endoprosthesis.

Clinical example.

Patient A., aged 31. Complaints: severe pain in the neck radiating to the right arm, the area of the hand. Anamnesis: pain in the neck bothered for a long time (more than 1 year), courses of conservative therapy were carried out - with improvement. The present worsening marks about 2.5 months, conservative treatment has no significant effect. Visual analog scale of pain - 8 points. Examination data: clinical signs of C6 radiculopathy on the right, according to MRI - median-foraminal extrusion of the C5-C6 intervertebral disc with compression of the C6 root on the right. Conclusion: taking into account the complaints, medical history, results of imaging diagnostic methods, the patient was offered surgical treatment: microsurgical discectomy and arthroplasty at the C5-C6 level. During the operation, the proposed device was used, which held the endoprosthesis of the intervertebral disc of the cervical spine "Endocarbon" TU 9444-002-76751996-2009. Thanks to the proposed device for implantation of the endoprosthesis, a sufficient visualization of the area of installation of the endoprosthesis was obtained. An inertial mechanism was used for accurate positioning of the implant in the dorsal-ventral direction. Free removal of the device made it possible to avoid the migration of the endoprosthesis in the intervertebral space (Fig. 4 and 5). Result: there was a decrease in pain syndrome to 1 point according to the visual analogue scale of pain, no limitation of mobility in the cervical spine; X-ray control after surgery - the position of the endoprosthesis is satisfactory.

The proposed device for holding the endoprosthesis of the intervertebral disc makes it possible to achieve accurate positioning of the endoprosthesis in the intervertebral space, prevent clamping and displacement of the endoprosthesis when the device is removed, and also expand the visualization of the working field during implantation of the endoprosthesis.

Claims (2)

1. A device for implantation of an intervertebral disc endoprosthesis, including a handle-holder, which is represented by two parallel rods - the first and second, inserted into a gripping working head, made whole in the form of two parallel spring plates and connected to each other on one side, forming an orifice with holes for rods, at the distal ends of each plate of the working head, two parallel pins are fixed, each of which enters the corresponding groove on the outer surface of the plates of the intervertebral disc prosthesis, the first rod ends at the level of the mouth of the working head and is rigidly fixed in it, from its other end to a stop platform-anvil is rigidly fixed to it, the second rod ends at the level of the edge of the working head, has a diameter smaller than the distance between the springy plates, the end of the rod is made oval in the form of a tongue, and in the proximal part it is bent in the form of a loop-handle, while in a horizontal arrangement I am the tongue provides clamping of the endoprosthesis in the device, and when the tongue is in a vertical position, the device for implantation is removed without migration of the installed endoprosthesis, the rods in the loop-handle area are interconnected by a coupling. 2. The device according to claim. 1, characterized in that the plates of the working head are marked with the letters "B" and "H" or the words "TOP" and "BOTTOM", defining the upper and lower parts of the device for implantation.

Images