RU88535U1 - DEVICE FOR MINIMALLY INVASIVE INSTALLATION OF IMPLANT - Google Patents

Abstract

A device for minimally invasive implant placement, including jaws interconnected by non-working ends, characterized in that it is equipped with a nozzle with an internal thread mounted for movement along the handle by means of a threaded connection between them, while a recess with a serrated notch is made on the working end of each jaw to fix the implant.

Description

Currently, the interest of neurosurgeons and orthopedic traumatologists in minimally invasive operations has sharply increased, the essence of which is to stabilize the damaged vertebra (s) in a less traumatic way, which is achieved by reducing the size of the surgical access by various methods. To restore normal anatomical relationships between damaged vertebrae and vertebrae, the integrity of which is not compromised, operating surgeons use biocompatible implants. Some of the implants are of standard sizes, but implants are used, the shape and dimensions of which the surgeon adapts intraoperatively depending on the groove formed. The installation of implants of the second type is difficult, since commercially manufactured instruments are not intended for manipulations with such implants in the surgical wound. Also a feature of minimally invasive operations is that all instruments must function in an operating wound, the dimensions of which do not exceed 8-10 cm.

The proposed utility model relates to medicine, namely to traumatology, orthopedics and neurosurgery, and can be used as a device for installing an implant in the formed groove during anterior spinal fusion performed by minimally invasive methods.

A device for installing the implant of FIGS. 1-2 is used for interbody fusion operation [prospectus of the company Medtronic Sofamor Danek Cornerstone SR Peek Cage], comprising two branches with a lock, characterized in that its working part is equipped with two bayonet protrusions intended for grasping the implant laterally.

The disadvantages of this device is that the device allows you to fix and install implants only a certain shape and size. Also, this device does not provide for a force effect on the implant, which in some cases is necessary for "rigid" fixation of the implant in the groove.

It is known "Device for restoring the height of the intervertebral gap and fixing the vertebrae and a tool for its installation" [RF patent No. 2210343].

The disadvantages of this device is that when the implant is inserted into the formed groove, the force impact on it is excluded, since this can lead to a “jamming” of the threaded working part of the device in the implant.

As a prototype of the selected invention, the "Spine retainer and device for its installation" [RF patent No. 2244527].

The essence of this invention is as follows: a device for installing a spinal retainer containing articulated jaws and a mechanism for moving them, which is a threaded rod pivotally connected to one of the jaws passing into the hole of the other jaw and equipped with a lamb, characterized in that the jaws are interconnected non-working ends, and the working ends are double-tooth forks made in the form of half rings, located by the planes of their arcs perpendicular to the plane of movement of the branches.

This device has the following disadvantages: the distance between the working ends of the jaw does not allow installation of the implant from minimally invasive access, the design of the device excludes force on the implant, dismantling the working parts of the device from the implant in some cases, with a significant depth of the surgical wound, is technically difficult.

The objective of the present invention is to expand the arsenal of devices for installing orthopedic implants when performing minimally invasive stabilizing operations on the spinal column.

The technical result is achieved due to the fact that the fixation of the implant is carried out by two branches, the degree of impact of the working parts of the branches on the implant is regulated by the pressure of the threaded pipe on the branches, which are interconnected by inoperative parts. The movement of the pipe is carried out by rotating it on a threaded connection with a handle towards the branches. The working part of the jaw contains a recess with a serrated notch in which the implant is fixed.

The problem is solved due to the fact that the proposed device makes it possible to fix the implant of various shapes and sizes, manipulate the implant and change its position in the surgical wound, perform a complete implant placement without additional tools, does not require the surgeon's static effort to hold the implant in the required position, eliminates the mobility of the implant when it is inserted into the prepared groove.

The invention is illustrated by graphic material, in which Fig. 1 shows a device for installing an implant "Cornerstone SR Peek Cage", Fig. 2 shows a diagram of a device for installing an implant "Cornerstone SR Peek Cage", in Fig. 3, the proposed device for installing an implant [5]. The device is a structure consisting of a handle [1], two branches [2], interconnected by non-working parts and a pipe [3] with a thread. The movement of the pipe along the handle is carried out by means of a threaded connection between them [4].

The device is used as follows: the implant is fixed by the working parts of the branches of the device until it is inserted into the surgical wound by displacing the threaded pipe with rotational movements around the axis towards the branches, which ensures that the working parts of the branches on the surface of the implant are closed towards each other. After installing the implant in the bone groove, the threaded tube weakens the effect on the branches by rotating it in the opposite direction, towards the handle of the device. If necessary, without loosening the fixation of the implant by the device, they “finish” the implant into the groove by force acting on the handle of the device, and then weaken the fixation of the implant and remove the device from the surgical wound.

An example of the practical use of the device. Patient B., 34 years old, 11/14/08 was admitted to the Design Bureau No. 2 of Tyumen on an emergency basis after falling from a height of 3 meters. As a result of the examination, a clinical diagnosis was made for this patient: Closed comminuted uncomplicated fracture of the body of the L III vertebra. After stabilization on November 18, 2008, the operation was performed - Anterior minimally invasive extraperitoneal fusion of L II-L III implant made of porous titanium nickelide. The course of the operation - after performing extraperitoneal access to the anterior - lateral surface of the L II-III vertebrae, a bone bed is formed for the installation of an interoperatively prepared implant. The implant is fixed in the proposed device with the working parts of the branches and inserted into the surgical wound. By manipulating the device, the implant is directed to the "entrance" into the groove and is installed in it until it "stops" and the force on the device handle implant is "rigidly" fixed in the groove. Then the fixation of the implant by the jaws of the device is weakened. The device is removed from the surgical wound. On the image intensifier tube, implant position is adequate. The surgical wound is sutured in layers.

The postoperative period was uneventful. The patient was discharged for outpatient treatment on 11/24/08 without external immobilization. I started light work 3 months after the operation.

The proposed device has been successfully tested at the clinical base of the Department of Traumatology, Orthopedics and VPH GOU VPO Tyumen State Medical Academy.

Claims (1)

A device for minimally invasive implant placement, including jaws interconnected by non-working ends, characterized in that it is equipped with a nozzle with an internal thread mounted for movement along the handle by means of a threaded connection between them, while a recess with a serrated notch is made on the working end of each jaw to fix the implant.