TWI798060B - percutaneous spinal guide - Google Patents

Abstract

The present invention relates to a guiding device for percutaneous spinal puncture, which includes a gripping part, a guiding tube for guiding a puncture needle, a pillar, a fixing part and an abutting part; wherein, the guiding tube is According to the spinal puncture path planned in advance by the computer, it points to the vertebrae to be operated. The pillar extends downward from the bottom end of the holding part. The fixing part is formed on the bottom end of the pillar and can be closely attached to the vertebrae to be operated. The lumbar plate is formed with a curved hook portion that can be matched with the lumbar plate on the edge of the fixed part, and the abutment piece is connected to the pillar to abut against the patient's back skin surface; by the above structure The guiding device of the present invention can accurately guide the bone puncture needle to percutaneously puncture the patient's back to reach the target vertebral segment to be treated, and improve the stability and accuracy of spinal surgery during drilling.

Description

percutaneous spinal guide

The present invention relates to a guiding device for percutaneous spinal puncture, in particular to a guiding device for percutaneous spinal puncture, which is used to assist doctors to correctly insert the puncture needle into the vertebral body along a preset path during minimally invasive surgery .

Osteoporosis, degeneration, or external forces may cause vertebral injury. For example, when the injury is severe, it is no longer possible to treat the patient with simple medicine or physical means, and the patient must be advised to undergo spinal surgery.

Traditional spine surgery will cause a large wound on the patient's body, so many factors need to be carefully considered, such as the amount of blood loss, whether the patient is suitable for general anesthesia, etc.; however, minimally invasive surgery produces relatively small wounds, bleeding Less amount, less muscle damage, can provide another more suitable treatment for patients. For example, percutaneous vertebroplasty (percutaneous vertebroplasty) is one of the minimally invasive procedures, which produces relatively small wounds. During the operation, the doctor uses a bone puncture needle to subcutaneously Pierce into the fractured vertebral body, and then pour bone cement into the vertebral body to achieve the purpose of strengthening the vertebral body and increase the stability of the patient's spine. In addition, percutaneous transpedicular bone screwing is also one of the common operations. For degenerative spondylopathy or spinal trauma, the vertebral screw can be passed through the vertebral arch to fix the vertebral screw inside the vertebral body , to assist the follow-up steel rod operation.

However, the shape of each vertebral segment of the human spine varies from person to person. How to provide individual auxiliary tools for patients during the operation to reduce surgical risks and improve the precision drilling of target vertebral segments? At the same time, taking into account the ease of operation for medical staff, improving customized appliances has become an important design topic for spinal surgery appliances.

The main purpose of the present invention is to provide a "guiding device for percutaneous spinal puncture", which can assist the doctor to follow a preset path and angle when operating the puncture needle during the minimally invasive operation of percutaneous spinal puncture. The needle is correctly inserted into the vertebral body to improve the stability and accuracy of the operation.

In order to achieve the above-mentioned purpose, the "guiding device for percutaneous spinal puncture" of the present invention includes: a gripping part; a guiding tube, which is connected to the outer wall of the gripping part through a plurality of connecting strips, wherein the guiding The tube forms a hollow channel, extending along the axial direction of the guide tube and the axial direction of the holding part respectively to form an included angle; a pillar extends coaxially downward from the bottom end of the holding part; a fixing part, It is formed at the bottom end of the pillar, the fixing part is a curved piece, and its bottom surface is used to closely adhere to the surface of the lumbar plate to be operated, and at least one hook part is formed on the edge of one side of the fixing part , the hook portion is used to engage the lumbar plate to be operated on in a matching manner; an abutment piece is connected to the outer wall surface of the pillar, and the abutment piece is used to abut against the patient's back skin surface.

The guide tube of the present invention is based on the optimal puncture path calculated by the computer software, which points to the pre-planned spinal drilling position, and can be used to guide the bone puncture needle to percutaneously puncture the patient's back to reach the target vertebral segment to be treated, improving the The stability and accuracy of drilling holes in cutaneous spine surgery.

The fixed part is customized according to the spine conditions of different patients. Its bottom surface can be closely attached to the surface of the spine to be treated, so that the guiding device can be firmly placed on the spine and improve the stability of the hand-held operation of the medical staff. , thereby reducing the safety concerns of spinal surgery.

1: Guide device for percutaneous spinal puncture

11: Grip

12: Guide tube

121: Connecting strip

122: hollow channel

123: through the entrance

124: wear exit

13: Pillars

14: fixed

141: curved hook

15: abutment sheet

20: guide ring

21: Connecting ribs

22: round hole

100: bone puncture needle

A: Diseased vertebrae

B: diseased vertebrae

Figures 1-3: The three-dimensional appearance views of the first embodiment of the "guide device for percutaneous spinal puncture" of the present invention at different viewing angles.

Fig. 4: A partial enlarged view of the fixing part of the first embodiment of the present invention.

Fig. 5: Schematic diagram of the application state of the first embodiment of the "guide device for percutaneous spinal puncture" shown in Figs. 1-4.

Fig. 6: A three-dimensional appearance view of the second embodiment of the "guide device for percutaneous spinal puncture" of the present invention.

Fig. 7: a schematic diagram of the application state of the second embodiment shown in Fig. 6 .

Fig. 8: A three-dimensional appearance view of the third embodiment of the "guide device for percutaneous spinal puncture" of the present invention.

Fig. 9: A partial enlarged view of the fixing part of the third embodiment of the present invention.

Fig. 10: A schematic diagram of the application state of the third embodiment shown in Fig. 8 .

The present invention relates to a drilling guide device 1 (hereinafter referred to as the guide device) for percutaneous puncture spinal surgery, which can assist doctors to inject artificial bone mud and bone nails into the diseased lumbar spine, and assist doctors to determine the location of the vertebral root. The drilling position, depth and direction of the (pedicle) can effectively guide the bone puncture needle to enter the spine accurately, thereby improving the safety and success rate of the operation.

Regarding the first embodiment of the guiding device 1 of the present invention, please refer to FIGS. Provide physicians with hand-held force when operating the guiding device 1; A guide tube 12 is located on one side of the gripping portion 11 at a distance from it. The guiding tube 12 is connected to one side of the gripping portion 11 through a plurality of connecting bars 121. In this embodiment There are two connecting strips 121 connected laterally to the outer wall of the gripping portion 11 and the guide tube 12, one of which is connected to the outer wall near the top of the gripping portion 11 and the guiding tube 12, and the other connecting strip 121 is connected to the top of the guiding tube 12. Adjacent to the outer wall surface of the handle portion 11 and the bottom end of the guide tube 12 . The center of the guide tube 12 forms a hollow channel 122 along the axial direction for insertion of the bone puncture needle, and the two ends of the hollow channel 122 are respectively used as a penetration port 123 and a penetration port 124; the guide tube 12 and the handle The holding parts 11 are arranged in a non-parallel arrangement. Specifically, after extending downward along the axial direction of the guide tube 12 and the axial direction of the holding part 11, a projected angle θ can be formed on the same plane. The projected angle θ Less than 90 degrees, so that the guide tube 12 is slightly inclined relative to the grip part 11, wherein the inclination angle of the guide tube 12 relative to the grip part 11 is determined according to the puncture paths planned for different patients; 13. It extends coaxially downward from the bottom surface of the holding part 11, wherein a fixing part 14 is formed at the end of the pillar 13, and the fixing part 14 is a curved piece whose bottom surface can be closely attached to the lumbar vertebrae On the surface of the lamina, as shown in Figure 4, a curved hook portion 141 is formed on the edge of the fixing portion 14 adjacent to the spinous process (spinous process), and the curved hook portion 141 can be matched and engaged with the The upper or lower edge of the lamina, in this embodiment, the hook portion 141 is used to engage with the lower edge of the lamina; a support piece 15 is connected to the outer wall of the pillar 13, adjacent to The bottom end of the holding part 11, wherein the bottom surface of the abutment piece 15 is a curved arc surface 151, the shape of the curved arc surface 151 can be matched and attached to the patient's back skin surface, so that the overall guiding device 1 can be more Balanced and stable placement on the vertebrae reduces the chance of shaking; preferably, the abutting plate 15 and the guide tube 12 are generally located on opposite sides of the pillar 13 respectively.

When making the guide device 1 above, it can be manufactured using additive manufacturing (3D printing) technology, and doctors can use known surgical planning software to calculate a safe puncture path suitable for the patient to puncture the spine from the outside. After the safe puncture path is determined, the inclination of the guide tube 12 relative to the grip portion 11 is determined. Oblique angle, distance apart, therefore can know the required length of two connecting strips 121; This strut 13 needs to have certain length so that the fixed part 14 of its bottom end can be attached to the diseased vertebral joint to be treated; 15 means that when the fixing part 14 is attached to the surface of the spine, the abutting piece 15 can just support the skin surface of the patient's back, providing a better balance effect for the overall guiding device 1 .

Please refer to shown in Figure 5, when the present invention is specifically applied to spinal surgery, the patient is lying prone on the operating table, and the doctor cuts an opening enough to insert the fixing part 14 on the patient's back and peels off the top of the spine. After the soft tissue is exposed, the diseased vertebral segment A to be treated is exposed, and the fixing part 14 of the guide device 1 is placed on the lamina of the diseased vertebral segment A through the opening, and the exposed abutting piece 15 is against the periphery of the opening surface of the back. Because the shape of the bottom surface of the fixing part 14 corresponds to the surface of the patient's lamina, the fixing part 14 can be closely attached to the pre-planned unique position, and the hook part 141 of the fixing part 14 can be engaged with the lesion The lower edge of the vertebral segment A completes the placement of the guiding device 1 .

After the guide device 1 is placed, the direction of the channel 122 in the center of the guide tube 12 is the preset puncture path. As shown in FIG. 5, the guide tube 12 is located on the upper back of the patient. The puncture needle 100 (such as a K-pin) is placed into the guide tube 12, and percutaneously punctures into the vertebral root of the diseased vertebral segment A according to the path pointed by the guide tube 12, so that the bone puncture needle 100 reaches the diseased vertebral segment A For subsequent treatment operations, such as injecting artificial bone paste or driving bone nails into the diseased vertebral segment.

Referring again to FIG. 6 and FIG. 7 , it is the second embodiment of the guiding device 1 of the present invention. The difference from the first embodiment is that the second embodiment further includes a guiding ring 20 . The guide ring 20 is connected to the outer wall of the bottom end of the pillar 13 through a connecting rib 21 and is coaxially aligned with the guide tube 12 . In other words, the guide ring 20 is also located on the pre-planned puncture path. A circular hole 22 is formed at the center of the guide ring 20 for the bone puncture needle 100 to pass through.

When the second embodiment is used in practice, as shown in FIG. 7 , the guide ring 20 is located at the position where the bone puncture needle 100 is intended to penetrate into the vertebral root. The feature of this embodiment is that the guide ring 20 strengthens the guiding and positioning function of the bone puncture needle 100 on the surface of the spinal segment, and reduces the slippage of the bone puncture needle 100 during the puncture process. The probability of dislocation can be improved, and the movement stability of the bone puncture needle 100 can be improved, especially when the bone puncture needle 100 needs to enter the patient's body for a relatively long distance, the guide ring 20 can further enhance the auxiliary effect.

Please also refer to Fig. 8, which is the third embodiment of the guiding device 1 of the present invention, and this guiding device 1 is designed to be applied to another adjacent diseased vertebra B; The structure is the same as that of the embodiment, including the gripping portion 11 , the guiding tube 12 , the pillar 13 , the fixing portion 14 , and the abutting piece 15 . However, special attention should be paid to the fact that the guide device 1 is designed for the diseased vertebra B, and should be adjusted and changed according to the puncture path of the diseased vertebra B, such as the position of the guide tube 12 relative to the gripping part 11. The relative spacing, included angle/length of the pillar 13/shape of the fixing portion 14/shape of the abutting piece 15 and angle relative to the pillar 13 are all different from the first embodiment.

Please refer to Fig. 9 and Fig. 10, in this third embodiment, the shape of the bottom surface of the fixing part 14 is corresponding to the surface of the lamina of the diseased vertebra B, and the edge of the fixing part 14 is formed The curved hook portion 141 is used to engage with the upper edge of the vertebral arch plate of the diseased vertebral segment B in a matching manner, which is different from the aforementioned first embodiment where it engages with the lower edge of the vertebral arch plate. Similarly, when the guiding device 1 of this embodiment is applied to surgery, its fixing part 14 is also placed on the lamina of the diseased vertebral segment B through the opening made on the back of the patient, and the exposed abutting piece 15 is supported on the back surface around the opening. Because the shape of the bottom surface of the fixing part 14 corresponds to the surface of the lamina of the diseased vertebral segment B, the fixing part 14 can be closely attached to the only pre-planned position, and the hook part 141 of the fixing part 14 can be engaged. On the upper edge of the diseased vertebra B, the placement of the guiding device 1 is completed.

To sum up, the guiding device for percutaneous spinal puncture provided by the present invention can point the guiding tube to the pre-planned drilling position, and guide the bone puncture needle to percutaneously puncture the back of the patient to reach the target vertebra to be treated accurately. Joint, improve the stability and accuracy of spinal surgery during drilling.

Furthermore, the structure of the present invention is relatively simple, and is suitable for customized planning and production according to the vertebral conditions of different patients, so that the guiding device can be accurately attached to the surface of the vertebral joints of the affected part of the patient, and conforms to Meet the patient's condition needs, reduce the shaking of the guide device, improve the stability of the hand-held operation of the medical staff, and thereby reduce the safety concerns of spinal surgery.

Although the present invention has been disclosed by using the above-mentioned preferred embodiments, it is not intended to limit the present invention. It is still within the scope of this invention for anyone skilled in the art to make various changes and modifications relative to the above-mentioned embodiments without departing from the spirit and scope of the present invention. The technical scope protected by the invention, therefore, the scope of protection of the present invention should be defined by the scope of the appended patent application.

1: Guiding device for percutaneous spinal puncture

11: Grip

12: Guide tube

121: Connecting strip

122: hollow channel

123: through the entrance

124: wear exit

13: Pillars

14: fixed

141: curved hook

15: abutment sheet

Claims (9)

A guiding device for percutaneous spinal puncture, comprising: a gripping portion; a guiding tube connected to the outer wall of the gripping portion through a plurality of connecting strips, wherein the guiding tube forms a hollow passage along the The axial direction of the guide tube and the axial direction of the holding part respectively extend to form an included angle; a pillar extends coaxially downward from the bottom end of the holding part; a fixing part is formed at the bottom end of the pillar , the fixing part is a curved piece, the bottom surface of which is used to closely adhere to the surface of the lamina to be operated, and at least one hook part is formed on the edge of one side of the fixing part, and the hook part is used for matching The lumbar plate to be operated is snapped together; an abutting sheet is connected to the outer wall of the post, and the abutting sheet is used to abut against the skin surface of the patient's back. The guiding device for percutaneous spinal puncture according to Claim 1, wherein the abutting piece and the guiding tube are respectively located on opposite sides of the pillar. The guiding device for percutaneous spinal puncture according to claim 2, wherein the bottom surface of the abutting plate is a curved arc surface, and the curved arc surface is correspondingly matched with the patient's back skin surface. The guiding device for percutaneous spinal puncture according to Claim 1, wherein the projected angle formed on the same plane between the axial direction of the guiding tube and the axial direction of the gripping portion is less than 90 degrees. The guiding device for percutaneous spinal puncture as described in Claim 1, wherein, the outer wall surface of the bottom end of the pillar is connected with a guiding ring, and the center of the guiding ring has a round hole, and the round hole is coaxial with the guiding tube align. The guiding device for percutaneous spinal puncture according to claim 1, wherein the hook portion is used to engage one of the upper edge or the lower edge of the lumbar plate to be operated on in a matched manner. The guiding device for percutaneous spinal puncture according to claim 1, wherein the hook portion is formed on the edge of the side of the fixing portion adjacent to the spinous process of the vertebral level to be operated. The guiding device for percutaneous spinal puncture according to Claim 1, wherein the hollow channel of the guiding tube is directed to the vertebral root of the vertebral segment to be operated. The guiding device for percutaneous spinal puncture as described in claim 1, wherein the plurality of connecting bars include two connecting bars, one of which connects the gripping part and the outer wall surface of the top end of the guiding tube, and the other connects The bar is connected between the holding portion and the outer wall surface of the bottom end of the guiding tube.

Images