201238556 六、發明說明： 【發明所屬之技術領域】 本發明係關於一種脊椎手術用之鑽孔導引裝置，尤指一 種預先規劃指引鑽孔操作方位的脊椎手術用之鑽孔導引裝 【先前技術】 脊椎之重要性，除在於其係人體骨骼的支架之外，最 重要的，在於脊椎内另包覆有脊髓。請參閱圖8所示，脊 髓是人體神經的主軸，神經40係從脊椎41内部向外延伸 而出，再向前方、左右以及上下延伸分佈於人體内，因此 人體内之神經網路即是由脊椎41作為出發點而向外延伸。 脊椎41可區分為頸椎節、胸椎節以及腰椎節，神經4〇 則是自脊髓通過各椎節間的空隙穿出，因此一旦脊椎41任 一椎節移位，就可能會壓迫到神經4〇,間接影響到與神經 40連接的器官、肌肉以及分泌腺體。 造成脊椎41移位之態樣，可能是因脊椎41退化造成 椎節滑脫、受傷（如脫ό或骨折）、感染或腫瘤等等病症所造 成’目前對於脊$41移位之治療方式，主要是藉由在脊椎 41椎節之椎足上植入一經蒂螺絲釘⑴扣邛地叫丨扣 ⑽w)’利用經蒂螺絲釘之剛性結構，可使移位的椎節歸位 再加以固定，使各椎節41間的相對位置不再壓迫或擠壓神 經，而使病人可解除因脊椎41 a迫或撥廢神經所造成之痛 楚。 然目前其中一手術之做法，係由醫師判斷決定經蒂螺 201238556 絲釘的進入點以及植入方向，鑽孔後植入該經蒂螺絲釘； 由於脊椎41各椎節的形狀係因人而異，因此如何能將經蒂 螺絲釘安全準確地植入手術椎節的椎足⑺⑼㈦勻避免插入 脊趙（spinaic〇「d)或脊神經（spjna丨nerves)，全賴醫師之經 驗與技術，只要有分毫偏差，極有可能造$患者、終生靡漢， 故醫師之經驗與技術對於手術之結果有著決定性的影響。 而目前另一種手術做法，請參閱圖9所示，主要採用 一輔助固定架50來進行鑽孔，該輔助固定架5〇係具有兩 支樓腳51、52，其各設有一定位冑53，該辅助固定架5〇 係設計成以V型刃狀支承（kn|fe_edge)，如圖1〇所示架 設在椎節的棘突與橫突上；進行手術時，醫師以輔助固定 架50抵止於椎節的棘突與橫突上使其定位，接著，醫師再 利用一鑽頭54經由該定位筒53之導引，而在椎節上鑽孔； 惟此一做法雖可稍減少因醫師技術之良窳所造成之手術誤 差’但鑽孔時的定位穩定性仍嫌不足。 由上述可知’對於現行脊椎手術中使用鑽頭鑽孔之定位 方式，尚有待進一步之改進方案。 【發明内容】 為提高脊椎椎足鑽孔手術之準確度與成功率，本發明 之主要目的在提供一種脊椎手術用之鑽孔導引裝置，提供 醫生以更方便方式操作鑽孔手術，並能輔助一鑽頭朝脊椎 節的椎足中心軸方向鑽孔。 欲達成上述目的所採取之主要技術手段，係令該脊椎 手術用之鑽孔導引裝置包含有： 201238556 一手持部，供手持用； 一跨部，择白主& '、目于得邛底面向下延伸，包含有二側支架 =卩其中—勾部係分別形成於二側支架的底端，又 -勾。p底面分別形成有匹配待手術椎節之椎板表面的椎板 表面曲面，並對應待手術椎節的椎板延伸-彎勾，勾設於 待手術椎節之椎板下緣，提供勾部更穩固的支撐點；及 ^至^導引件，各導引件係自跨部對應側支架之外壁 面往斜下延伸，並包含有一連接部及一環狀中空柱；其中 該=接部-端連接對應側支架之外側，其一端連接該環狀 中空柱’又該環狀中空柱的軸向穿孔係對準脊椎節的椎足 中心軸，供鑽頭穿經。 上述本發明係主要於一手持部底面形成有一跨部，供醫 生方便手抓該手持部，將該跨部分跨左右底端的勾部由身體 ，方分別全面貼附於欲進行鑽孔手術椎節，如頸椎節、腰椎 音卩或胸椎節4之椎板表面，並配合彎勾設計下壓時可更穩定 地固疋在手術推節上’又，該導引件的環狀中空柱形成有對 準頸椎節、腰椎節或胸椎節的椎足的轴向穿孔，可輔助醫生 準確地將鑽頭穿經其中，而鑽入該椎節部位之椎足中心，提 高脊椎手術之準確度與安全性。 【實施方式】 本發明係有關於一種用於後位性脊椎手術（p〇sterj〇r spinal surge⑺椎足螺絲釘植入（pedic|e sc_ imp丨antati〇n)之鑽孔導引件，其可有效導引k_pjn或鑽頭而 準確地於椎節上鑽孔，如此一來，可以協助術者決定椎足鑽 201238556 孔位置、深度與方向，而 ;付Μ徒局手術之安全性與 首先請參閱圖]及2所-一 注興成功率。 鑽孔導引裝置，其包含有： 锭月介椎手術用之 一手持部11，供手持用. ....^ 於本實施例中，該手持部1】 係為一扁矩形狀，並於甲間 固手持； 1位置形成有-穿孔12,方便穩 一跨部1 3 ’係自手持部1 1 支架⑶及二勾部132 .其φ底:向下延伸’包含有二側 廄i _ 131 、中一勾部132係分別形成於對 應支架131的底端，又二勾部 r 9Λ ^ ^ 4 ± Ί °Ρ 132底面分別對應待手術椎 郎20之椎板表面形成有椎 所示；又各勾部132對應t 3圖及圖3 子應待手術椎節的椎板延伸一 1 34 ’勾設於待手術椎節2〇之铪 之椎板下緣，提供勾部132更 穩固的支撐點，如圖4所示；及 至乂導引件14，各導引件，4係自跨部， 131之外壁面往斜下延伸， 胳文聲 Ψ並包含有一連接部141及一環 狀中空柱142;其中該連接部⑷-端連接對應側支架131 之外壁面，其-端連接該環狀中空柱142，又該環狀中空柱 142形成有一軸向穿孔143 ’對準脊椎節的椎足中心轴，供 安裝欽金屬環’以供手術中或鑽頭穿經；於本實施例 中，係包含有二導引件14，分別自對應支架131之外壁面 往斜下延伸。 上述本發明鑽孔導引裝置可用於固定在頸椎節、腰椎 節或胸椎節’輔助脊椎椎足鑽孔手術，當用於固定頸椎節 時，該跨部13的二勾部132之相對内面分別形成有匹配頸 ”（ee_al ve_「a)^卜側壁之外輪廊的表面以全面 6 201238556 貼附椎弓板（lamina) ’並避開關節囊（j〇jnt capsule)和黃勒 帶（丨igamentum flavum) 〇當用於固定在腰椎節、胸椎節或 頸椎節時，該跨部1 3的兩勾部彳32的相對内面則分別形成 有匹配腰椎節或胸椎節或頸椎節二外側壁之外輪廓的椎板 表面曲面，以全面貼附該腰椎節或胸椎節或頸椎節之椎弓 板（丨amina) ’並避開關節囊（j〇|nt capsu|e)和黃韌帶 (ligamentum flavum)。 請參閱圖5，係為本發明第二較佳實施例，其大多結構 與第一較佳實施例大致相同，惟該脊椎手術用之鑽孔導引 裝置包含有四導引件14,其中二導引件14的連接部141 一端係共同連接至該跨部13對應的支架131外側，並夾設 有-夾角；另二導引件14的連接部141 __端係共同連接至 ，跨部13另-支架131外側，同樣夾設有—夾角以提供 醫生對該待手術椎節部位鑽孔進人點的鑽孔定㈣，如圖6 及圖7所示。 由上述說明可知，本發明係主要於一手持部底面形成有 -跨部’供醫生方便手抓該手持部，將該跨部自由端的二側 向勾部分別全面貼附於欲進行毅鑽孔手術之頸椎節、腰椎 節或胸椎節外側面，配合f勾設計可更穩定地固定在手術部 位上，又該導引件的軸向固㈣形成有對準頸椎節、腰椎節 :胸椎節的椎足中心轴的轴向穿孔，特別適用於脊椎嚴重側 :，亦或適用於椎節退化部位以及無法進行椎節間相對運動 =之椎〇心軸’可辅助醫生準確地將k_pln_頭穿經其 ㈣節之椎足中心軸，提高脊椎手術之準確度 201238556 【圖式簡單說明】 圖1 .係本發明第一較佳實施例之仰視立體圖。 解圖 圖2.係本發明第—較佳實施例與待手術部位之立 〇 圖3 :係本發明坌 ^ 立b 月第—較佳實施例固定於待手術部位上之 1圖。 圖4 ··係圖3的剖面圖β 圖5係本發明第二較佳實施例之仰視立體圖。 解圖圖6·係本發明第二較佳實施例與待手術部位之立體分 圖7·係本發明第二較佳實施例固定於待手術部位上之 正解圖。 圖8:係係部分脊椎骨與神經之示意圖。 圖9:係習用-利用辅助件進行脊椎手術之示意圖。 圖10 .係圖9中輔助件之ν型刀狀支承架設在椎節的 棘突與橫突上之示意圖。 【主要元件符號說明】 10、10a脊椎鑽孔導 12穿孔 1 31側支架 133椎板表面曲面 14導引件 弓丨裝置11手持部 1 3跨部 1 32勾部 1 34 _ 勾 14<|連接部 8 201238556 142環狀中空柱 2 0待手術椎節 41脊椎 43黃韌帶 51、52支撐腳 54鑽頭 143軸向3 40神經 42關節囊 50輔助固 53定位筒 孔 定架 9201238556 VI. Description of the Invention: [Technical Field] The present invention relates to a drilling guide device for spinal surgery, and more particularly to a drilling guide for spinal surgery in which a drilling operation orientation is pre-planned. Technology] The importance of the spine, in addition to its support for the human skeleton, is the most important thing in the spine. Referring to FIG. 8, the spinal cord is the main axis of the human nerve. The nerve 40 extends outward from the inside of the spine 41, and then extends forward, left and right, and up and down in the human body. Therefore, the neural network in the human body is The spine 41 extends outward as a starting point. The spine 41 can be divided into a cervical vertebra, a thoracic vertebra, and a lumbar vertebra. The nerves 4 are penetrating from the spinal cord through the intervertebral space. Therefore, once any vertebra of the spine 41 is displaced, it may be pressed to the nerve. Indirectly affects organs, muscles, and secretory glands that are connected to nerve 40. The resulting dislocation of the spine 41 may be due to spondylolisthesis caused by spondylolisthesis, injury (such as dislocation or fracture), infection or tumor, etc. The current treatment for the ridge $41 shift, mainly By inserting a pedicle screw on the vertebral foot of the vertebra 41 vertebrae (1), the shackle is called a shackle (10) w) 'Using the rigid structure of the pedicle screw, the displaced vertebrae can be homing and fixed, so that each The relative position of the vertebral segments 41 no longer compresses or squeezes the nerves, so that the patient can relieve the pain caused by the nerves of the spine 41 a. However, at present, one of the surgical procedures is determined by the physician to determine the entry point and the implantation direction of the snail 201238556 stud, and the pedicle screw is implanted after drilling; since the shape of each vertebra of the spine 41 varies from person to person, How to safely and accurately implant the pedicle screw into the vertebral foot of the surgical vertebrae (7) (9) (7) evenly avoid insertion into the spine (spinaic〇 “d” or spinal nerve (spjna丨nerves), relying on the experience and technology of the physician, as long as there is a deviation, It is highly probable that the patient will be able to make a lifetime, and the experience and technique of the physician will have a decisive influence on the outcome of the operation. For another surgical procedure, please refer to Figure 9, which mainly uses an auxiliary fixture 50 for drilling. The auxiliary fixing frame 5 has two legs 51 and 52, each of which is provided with a positioning cymbal 53 which is designed to be supported by a V-shaped blade (kn|fe_edge), as shown in FIG. The sputum is erected on the spinous processes and transverse processes of the vertebral segments; when performing the operation, the physician positions the spinous processes and the transverse processes of the vertebral segments with the auxiliary fixation frame 50, and then the physician uses a drill bit 54 to Set The guide of the canister 53 and the drilling of the vertebral segments; however, this method can slightly reduce the surgical error caused by the good technique of the physician's technology, but the positioning stability during drilling is still insufficient. In order to improve the accuracy and success rate of spinal vertebral drilling, the main purpose of the present invention is to provide a spine surgery. The drilling guide device provides a doctor to operate the drilling operation in a more convenient manner, and can assist a drill bit to drill toward the central axis of the vertebral pedicle. The main technical means to achieve the above purpose is to make the spine The drilling guide for surgery includes: 201238556 a hand-held part for hand-held use; a cross-section, white master & ', the bottom of the bottom of the eye is extended downwards, including two side brackets = 卩 where - hook The minima is formed on the bottom end of the two side brackets, respectively, and the hook is formed. The bottom surface of the p surface is respectively formed with a surface of the lamina surface matching the surface of the lamina of the vertebral body to be operated, and corresponds to the lamina extension of the vertebral node to be operated. Stretch-bend hook, hooked on the lower edge of the lamina of the vertebral node to be operated, providing a more stable support point for the hook; and ^ to ^ guide member, each guide member is from the outer wall of the corresponding side bracket of the cross-section Extending obliquely downwards, and comprising a connecting portion and an annular hollow column; wherein the joint portion is connected to the outer side of the corresponding side bracket, one end of which is connected to the annular hollow column and the axial perforation of the annular hollow column Aligning the central axis of the vertebral pedicle with the vertebral pedicle for the drill bit to pass through. The above invention is mainly for forming a straddle portion on the bottom surface of a hand-held portion for the doctor to conveniently grasp the hand-held portion, and the hook portion of the straddle portion spans the left and right bottom ends The body and the body are fully attached to the lamina of the cervical vertebrae, such as the cervical vertebrae, lumbar vertebrae or thoracic vertebrae 4, and can be more stably fixed in the surgical knuckles when pressed with the curved hook design. Further, the annular hollow column of the guiding member is formed with an axial perforation of the vertebral foot of the cervical vertebra, the lumbar vertebra or the thoracic vertebra, which can assist the doctor to accurately pass the drill bit through the vertebral section. The site of the vertebral foot of the site improves the accuracy and safety of spinal surgery Sex. [Embodiment] The present invention relates to a drill guide for a posterior spinal surgery (p)sterj〇r spinal surge (7) pedic screw insertion (pedic|e sc_ imp丨antati〇n), which can be Effective guidance of k_pjn or drill bit to accurately drill holes in the vertebral segments, thus assisting the surgeon to determine the position, depth and direction of the hole of the vertebral foot drill 201238556, and the safety of the scorpion surgery is first and foremost Figure] and 2 - a success rate of drilling. The drilling guide device comprises: one hand-held portion 11 for ingot pericardial surgery for hand-held use. .... ^ In this embodiment, the The hand-held portion 1] is a flat rectangular shape and is held in the middle of the nail; the position 1 is formed with a perforation 12 to facilitate the stability of the span 1 3 ' from the hand-held portion 1 1 bracket (3) and the second hook portion 132. The bottom: the downward extension 'includes two sides 廄i _ 131 , the middle one hook portion 132 is formed at the bottom end of the corresponding bracket 131, and the second hook portion r 9 Λ ^ ^ 4 ± Ί ° Ρ 132 bottom surface respectively corresponds to the operation The surface of the lamina of the vertebral lang 20 is formed with the vertebrae; the hooks 132 correspond to the t 3 map and the lamina of the vertebral joint to be treated Stretching a 1 34 'hook at the lower edge of the lamina of the vertebral ganglion 2 ,, providing a more stable support point for the hook 132, as shown in Figure 4; and to the 乂 guide 14, each guide, 4 The outer wall of the 131 is extended obliquely downward, and has a connecting portion 141 and an annular hollow column 142; wherein the connecting portion (4)-end is connected to the outer wall surface of the corresponding side bracket 131, The end is connected to the annular hollow column 142, and the annular hollow column 142 is formed with an axial perforation 143' aligned with the central axis of the vertebral pedicle for the installation of a metal ring for surgery or drill bit penetration; In the embodiment, the two guiding members 14 are respectively disposed obliquely downward from the outer wall surface of the corresponding bracket 131. The above-mentioned drilling guiding device of the present invention can be used for fixing the cervical vertebra, lumbar vertebrae or thoracic vertebrae 'assisted vertebrae The foot drilling operation, when used for fixing the cervical vertebrae, the opposite inner faces of the two hook portions 132 of the span portion 13 are respectively formed with matching necks" (ee_al ve_"a) ^ the surface of the outer gallery of the side wall to be comprehensive 6 201238556 Attached to the lamella plate (lamina) and avoid the switch capsule (j〇jnt capsule) and丨igamentum flavum 用于 When used for fixation in the lumbar vertebrae, thoracic vertebrae or cervical vertebrae, the opposite inner faces of the two hooks 32 of the straddle 13 are respectively formed with matching lumbar vertebrae or thoracic vertebrae or cervical vertebrae The surface of the lamina surface outside the outer wall of the outer wall is fully attached to the lumbar vertebrae or the cervical vertebrae or the cervical vertebrae (丨amina) and avoids the switch capsule (j〇|nt capsu|e) and yellow Ligament (ligamentum flavum). Referring to FIG. 5, which is a second preferred embodiment of the present invention, most of the structures are substantially the same as those of the first preferred embodiment, but the drilling guide device for spinal surgery includes four guiding members 14, two of which One end of the connecting portion 141 of the guiding member 14 is commonly connected to the outer side of the corresponding bracket 131 of the span portion 13 and is provided with an angle; the connecting portions 141 __ of the other guiding members 14 are connected to each other, the cross portion 13 The other side of the bracket 131 is also provided with an angle to provide a drill hole for the drilled portion of the vertebral portion to be surgically drilled (four), as shown in Figs. 6 and 7. It can be seen from the above description that the present invention is mainly formed on the bottom surface of a hand-held portion with a - span portion for the doctor to conveniently grasp the hand-held portion, and the two lateral hook portions of the free end portion of the cross-section are completely attached to the hole for the purpose. The cervical vertebrae, lumbar vertebrae or thoracic vertebrae of the operation can be more stably fixed on the surgical site with the f-hook design, and the axial solid (4) of the guide is formed with the cervical vertebrae and the lumbar vertebrae: the thoracic vertebrae. The axial perforation of the central axis of the vertebral foot is especially suitable for the severe side of the spine: or for the degeneration of the vertebral joint and the inability to perform the relative motion of the intervertebral joint = the vertebral palpe of the vertebrae can assist the doctor to accurately wear the k_pln_ head Improving the accuracy of spinal surgery through the central axis of the vertebral foot of section (4) 201238556 [Schematic description of the drawings] Fig. 1 is a bottom perspective view of the first preferred embodiment of the present invention. Figure 2 is a perspective view of a preferred embodiment of the present invention and a site to be surgically viewed. Figure 3 is a view of the present invention attached to the site to be surgically. Fig. 4 is a cross-sectional view of Fig. 3, Fig. 5 is a bottom perspective view of a second preferred embodiment of the present invention. Figure 6 is a perspective view of a second preferred embodiment of the present invention and a site to be surgically. Figure 7 is a front view of the second preferred embodiment of the present invention attached to a site to be surgically treated. Figure 8: Schematic diagram of part of the spine and nerves of the system. Figure 9: Familiarization - a schematic diagram of spinal surgery with an aid. Fig. 10 is a schematic view showing the v-shaped knife-shaped support of the auxiliary member in Fig. 9 on the spinous processes and transverse processes of the vertebral segments. [Major component symbol description] 10, 10a spine drill guide 12 perforation 1 31 side bracket 133 lamina surface curved surface 14 guide bow device 11 hand 1 1 span 1 32 hook 1 34 _ hook 14 < | Department 8 201238556 142 annular hollow column 2 0 to be operated vertebral 41 vertebral 43 yellow ligament 51, 52 support foot 54 drill bit 143 axial 3 40 nerve 42 joint capsule 50 auxiliary solid 53 positioning cylinder hole fixing 9