WO2014117561A1 - 一种脊柱后路小切口椎旁肌间隙入路的暴露器械 - Google Patents

一种脊柱后路小切口椎旁肌间隙入路的暴露器械 Download PDF

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Publication number
WO2014117561A1
WO2014117561A1 PCT/CN2013/086967 CN2013086967W WO2014117561A1 WO 2014117561 A1 WO2014117561 A1 WO 2014117561A1 CN 2013086967 W CN2013086967 W CN 2013086967W WO 2014117561 A1 WO2014117561 A1 WO 2014117561A1
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Prior art keywords
handle
hook body
hook
exposure apparatus
small incision
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PCT/CN2013/086967
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English (en)
French (fr)
Inventor
曹晓建
李海俊
谢浩
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南京医科大学第一附属医院
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Application filed by 南京医科大学第一附属医院 filed Critical 南京医科大学第一附属医院
Priority to EP13873774.7A priority Critical patent/EP2952140B1/en
Priority to US14/764,473 priority patent/US9439638B2/en
Priority to ES13873774.7T priority patent/ES2694428T3/es
Publication of WO2014117561A1 publication Critical patent/WO2014117561A1/zh

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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
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0042—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00858—Material properties high friction, non-slip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025—Joint distractors
    • A61B2017/0256—Joint distractors for the spine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0807—Indication means

Definitions

  • the invention relates to an exposure device for a small incision paraspinal muscle gap approach in the posterior spinal column, which belongs to the field of medical instruments.
  • pedicle screw is one of the most widely used internal fixation instruments in spinal surgery.
  • the pedicle screw implantation methods mainly include: 1. Posterior midline incision and nailing, which is a traditional surgical method. It has a wide range of clinical applications and is widely accepted by most clinicians. Its main disadvantages are large surgical trauma, difficulty in exposing the pedicle to the needle point, more bleeding, longer recovery time after surgery, and more long-term muscle and multiple fractures.
  • minimally invasive spinal technique that is, minimally invasive nailing technology assisted by posterior channel, which performs spinal pedicle screw placement with special surgical instruments and instruments such as medical imaging, auxiliary channel expansion and microscopic endoscopy.
  • the best treatment effect is achieved with minimal damage.
  • the surgical incision is short, the trauma is small, the bleeding is less, the postoperative function is recovered quickly, and the incidence of postoperative low back pain is reduced.
  • it has been clinically applied for 30 years now. Because of the high price of its supporting equipment and the relatively flat learning curve, it has not been widely used and promoted. Especially in China, it is currently limited to the spine surgery of tertiary hospitals.
  • the inventor has improved the traditional minimally invasive posterior spinal technique, redesigning a simple and convenient, easier to grasp surgical procedure and surgical instruments with less trauma than conventional minimally invasive surgery, and a small incision paraspinal muscle in the posterior spinal column.
  • the exposed device of the gap approach is part of it.
  • the traditional posterior spinal minimally invasive laminectomy technique generally uses the Kirschner wire to penetrate the lamina and then cut the skin.
  • the dilator is expanded from small to large to a satisfactory size, and the perforating approach may deviate from the multifidus muscle and The longest muscle gap enters the multifidus muscle or the longest muscle, causing damage to the multifidus muscle and the longest muscle.
  • the process of expansion is actually tearing the local muscles, further aggravating the muscle damage.
  • the object of the present invention is to provide an accurate, rapid and convenient exposure device for performing a minimally invasive laminar decompression operation of the posterior vertebral artery, which can be used to separate the multi-cleft muscle and the longest under direct vision.
  • the gap between the muscles is easily and without damage to the decompression site of the lamina.
  • the present invention relates to an apparatus for exposing a paraspinal muscle gap approach with a small posterior spinal incision, including a spinous process side laminar hook and a lamina lateral pull hook for use therewith, the spinous process side laminar hook Composed of a first handle and a first hook body,
  • the first hook body is an L-shaped metal strip, one end of the first hook body is connected with the first handle, the other end is bent toward the first handle, and the end is horizontally disposed along the width of the first hook body.
  • the horizontal tooth member is located at a side of the first hook body adjacent to the first handle and at an obtuse angle with the end portion;
  • the outer laminar hook of the lamina is composed of a second handle and a second hook body
  • the second hook body is an L-shaped metal strip, and one end of the second hook body is connected to the second handle, and the other end is provided with a tongue-shaped protrusion that is bent away from the second handle.
  • the first hook body includes a first horizontal section and a first vertical section, and the angle between the first horizontal section and the first vertical section is 80 ⁇ 10 degrees, which satisfies a certain requirement for a surgical approach.
  • the angle of the abduction angle is 165 ⁇ 15 degrees between the first handle and the first horizontal section, and the first handle is located on the opposite side of the first horizontal section and the first vertical section, so as to facilitate the intraoperative lead
  • the handle is pulled to reduce the influence of the tissue around the incision on the hook placement; the other end of the first hook body is bent 10 ⁇ 10 degrees toward the first handle.
  • the second hook body includes a second horizontal section and a second vertical section, and the angle between the second horizontal section and the second vertical section is 100 ⁇ 10 degrees, which satisfies the surgical entry when the lamina is exposed.
  • the road needs to be abducted by 10° to 15°
  • the second handle and the second horizontal section have a folding angle of 165 ⁇ 15 degrees
  • the second handle is located at the opposite of the second horizontal section and the second vertical section.
  • the side is convenient for holding during the intraoperative pulling, and reducing the influence of the tissue around the incision on the hooking; the tongue-like protrusion of the other end of the second hooking body is bent 10 ⁇ 5 degrees away from the second handle.
  • the connecting ends of the first handle and the second handle are in a flat structure of a fish mouth, which avoids the pressing of the tissue by the inoperative hook, and is more advantageous for the surgical operation;
  • the first hook body and the second pull body The thickness is 2 ⁇ 1 mm, and the width is 25 ⁇ 5 mm; the length of the first horizontal section and the second horizontal section are both 100 ⁇ 50 mm.
  • the length of the first vertical segment is 40 ⁇ 10 or 60 ⁇ 10 mm
  • the length of the other end of the first hook body bent toward the first handle is 10 ⁇ 5 mm
  • the length of the horizontal tooth It is 5 ⁇ 2mm, which can effectively pull the multi-cleft muscle back to the inside and lift it up. It completely exposes the lamina and facilitates the operation. The local damage to the muscle is small.
  • the length of the second vertical segment is 55 ⁇ 10 or 75 ⁇ 10 mm
  • the other end of the second hook body is provided with two tongue-like protrusions having a length of 5 ⁇ 2 mm, which are placed in the lamina during operation.
  • the outer edge can serve to expose the lamina, while the double tongues make the contact between the hook and the lamina more stable, and the local exposure operation is simple and labor-saving.
  • the outer surfaces of the grip portions of the first handle and the second handle are engraved with intersecting pinstripes for easy intraoperative grasping.
  • the invention has the following beneficial effects: (1) The roughening treatment of the two handles is convenient for the operator to hold, and the fish mouth-like design of the handle connecting end avoids the compression damage of the tissue by the inoperative hook; the handle and the hook The use of the folding angle can make the grip of the handle upturned, reducing the influence of the tissue around the incision on the hook placement; (2) The two hooks facilitate the accurate separation of the multifidus muscle under direct vision when the posterior approach of the spine is small incision The longest muscle gap, exposing the lamina, avoiding muscle damage inside the muscles, Reduce intraoperative hemorrhage; (3) The unique horizontal odontoid structure of the laminar side pull hook makes the pull hook pull the medial side of the multi-cleft muscle in the operation while pulling up, so it can not only pull the multi-cleft muscle exposed vertebra The role of the plate can prevent the multi-cleft muscle from being pressed between the spinous process and the hook, and protect the multi-crack muscle from damage; (4) Two tongue-like
  • the outer edge can expose the local part of the lamina, and the double tongue-like protrusion makes the contact between the hook and the lamina more stable, and the local exposure operation is simple and labor-saving;
  • the invention according to the characteristics of the local surgical approach muscle and the characteristics of the local bone structure The design, after completing the anatomy of the surgical approach, accurately placing the hook, the design of the spinous process side hook 80 ⁇ 10 ° angle, the angle of the outer side of the laminar hook 100 ⁇ 10 ° can form a partial abduction 10 ° -15 The tunnel space of ° meets the needs of local surgical operations.
  • FIG. 1 is a schematic view showing the structure of a spinous process side laminar hook according to the present invention.
  • FIG. 2 is a schematic view showing the structure of the outer laminating hook of the lamina according to the present invention.
  • Example 1 As shown in Figures 1 and 2, an apparatus for exposing the paraspinal muscle space of the posterior spinal approach with a small incision, including a spinous process side laminar hook and a laminar outer hook for use therewith.
  • the spinous process side lamina hook is composed of a first handle 1 and a first hook body, the first hook body is an L-shaped metal strip, including a first horizontal section 2 and a first vertical section 3, the first The angle between the horizontal section 2 and the first vertical section 3 is 80 degrees, one end of the first hook body is connected with the first handle 1, and the first handle 1 and the first horizontal section 2 have a 165 degree angle.
  • the first handle 1 is located on a side of the first horizontal section 2 opposite to the first vertical section 3, and the other end of the first hook body is bent toward the first handle 1, and the bending length is 10 mm, and the bending is performed.
  • the degree is 10 degrees, and the end portion is provided with a horizontal tooth member 4 in the width direction of the first hook body, and the horizontal tooth member 4 is located at the other end of the first hook body near the side of the first handle 1 and at the end portion
  • the angle is an obtuse angle, parallel to the first horizontal section 2, and the length of the teeth of the horizontal tooth member 4 is 5 mm.
  • the laminar outer hook is composed of a second handle 5 and a second hook body, the second hook body is an L-shaped metal strip, and the second hook body includes a second horizontal section 6 and a second vertical section 7
  • the angle between the second horizontal section 6 and the second vertical section 7 is 100 degrees, one end of the second hook body is connected with the second handle 5, and between the second handle 5 and the second horizontal section 6
  • the second handle 5 is located on a side opposite to the second vertical section 7 , and the other end of the second hook body is bent in a direction away from the second handle 5 .
  • a tongue-like projection 8 having a length of 5 mm is bent 10 degrees away from the second handle 5.
  • the connecting ends of the first handle 1 and the second handle 5 are both in the shape of a fish mouth, the first handle 1 and the second hand
  • the handles 5 are each 120 mm long, wherein the gripping ends are 100 mm, each of which is a cylinder of 20 mm in diameter, and the outer surface of the grip portion is engraved with intersecting pinstrips; the thickness of the first hook body and the second hook body are both 2 mm.
  • the width of the first horizontal section 2 and the second horizontal section 6 are both 100 mm, the length of the first vertical section 3 is 40 or 60 mm, and the length of the second vertical section 7 is 55 mm. Or 75mm.

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Abstract

一种脊柱后路小切口椎旁肌间隙入路的暴露器械，包括棘突侧椎板拉钩和与其配合使用的椎板外侧拉钩。使用该器械可以直视下分离多裂肌和最长肌的间隙，可以轻易无损伤地到达椎板外缘部位，暴露小关节、钝性分离多裂肌和椎板，正确放置拉钩后可在局部形成外展10°到15°的手术操作隧道空间。拉钩的角度和结构设计使得在牵拉局部肌肉、保证充分的手术空间的同时，有效保护局部软组织，避免组织的损伤。

Description

一种脊柱后路小切口椎旁肌间隙入路的暴露器械 技术领域
本发明涉及一种脊柱后路小切口椎旁肌间隙入路的暴露器械， 属于医疗器械领域。
背景技术
椎弓根螺钉技术自上世纪 80 年代问世以来发展迅速， 已经广泛应用于脊柱退行性变、 椎 体滑脱、 椎管狭窄、 椎体骨折、 畸形、 骨转移瘤、 脊柱失稳等疾患的手术治疗。 目前， 椎弓 根螺钉是脊柱外科手术中应用最为广泛的内固定器械之一， 椎弓根螺钉植入方法主要有： 1、 经后路正中切开置钉术， 其为传统手术方式， 目前临床应用广泛， 为大多数临床医师广泛接 受， 其主要缺点是手术创伤较大， 椎弓根进针点暴露困难， 出血较多， 术后病人恢复时间较 长， 多合并最长肌和多裂肌的萎缩， 韧带破坏致不稳定， 远期部分患者留有腰痛。 2、 脊柱 微创技术， 即后路通道辅助下微创置钉技术， 其借助医学影像、 辅助通道扩张及显微内窥镜 等特殊手术器械和仪器进行脊柱椎弓根螺钉置入的操作， 以最小的损伤达到最佳的治疗效果, 较传统方法手术切口短、 创伤小、 出血少、 术后功能恢复快， 降低术后腰背部疼痛的发生率。 但目前从其发明， 临床应用至今快 30 年， 因为其配套器械的价格昂贵及学习曲线相对平缓， 其并未得到广泛的应用和推广， 特别是国内目前仅限于三级医院脊柱外科开展。
目前临床需要一种和微创一样手术切口短、 创伤更小、 出血少、 术后功能恢复快但价格便 宜， 简单有效， 容易掌握的新的微创技术。 发明人对传统的脊柱后路微创技术进行了改良， 重新设计了一套简单方便， 更容易掌握， 创伤较传统微创更小的手术方式和手术器械， 而脊 柱后路小切口椎旁肌间隙入路的暴露器械就是其中的一部分。
传统脊柱后路微创椎板减压技术一般采用克氏针穿剌定位椎板后切开皮肤， 使用扩张器由 小到大依次扩张至满意大小， 其穿剌入路可能偏离多裂肌和最长肌的间隙而进入多裂肌或者 最长肌中， 造成多裂肌和最长肌肉的损伤， 同时其扩张的过程其实是对局部肌肉撕拉， 进一 步加重肌肉的损伤。
发明内容
发明目的： 本发明的目的是在进行脊椎后路微创椎板减压操作时， 提供一种可以辅助准确、 快速、 方便的暴露装置， 使用该装置可以直视下分离多裂肌和最长肌的间隙， 轻易无损伤的 到达椎板减压部位。
技术方案： 本发明所述的一种脊柱后路小切口椎旁肌间隙入路的暴露器械， 包括棘突侧椎 板拉钩和与其配合使用的椎板外侧拉钩， 所述棘突侧椎板拉钩由第一手柄和第一拉钩体构成， 所述第一拉钩体为呈 L型金属条， 所述第一拉钩体的一端与第一手柄连接， 另一端向靠近第 一手柄方向弯折， 端部沿第一拉钩体宽度方向设有水平齿部件， 所述水平齿部件位于所述第 一拉钩体的另一端靠近第一手柄的一侧且与端部的夹角为钝角； 所述椎板外侧拉钩由第二手 柄和第二拉钩体构成， 所述第二拉钩体为呈 L型的金属条， 所述第二拉钩体的一端与第二手 柄连接， 另一端设有向远离第二手柄方向折弯的舌状凸起。
进一步完善上述技术方案， 所述第一拉钩体包括第一水平段和第一垂直段， 所述第一水平 段与第一垂直段的夹角为 80±10 度， 满足手术入路需要一定的外展角度的需要， 所述第一 手柄与第一水平段之间呈 165±15度的折角， 所述第一手柄位于第一水平段与第一垂直段相 对的一侧， 便于术中牵拉时握持， 减少切口周围组织对拉钩放置的影响； 所述第一拉钩体的 另一端向靠近第一手柄方向弯折 10± 10度。
进一步完善上述技术方案， 所述第二拉钩体包括第二水平段和第二垂直段， 所述第二水平 段和第二垂直段的夹角为 100±10度， 满足椎板暴露时手术入路需要外展 10° 到 15° 的需 要， 所述第二手柄与第二水平段之间呈 165±15度的折角， 所述第二手柄位于第二水平段与 第二垂直段相对的一侧， 便于术中牵拉时握持， 减少切口周围组织对拉钩放置的影响； 所述 第二拉钩体的另一端的舌状凸起向远离第二手柄方向弯折 10±5度。
进一步地， 所述第一手柄和第二手柄的连接端均呈鱼嘴状的扁平结构， 避免术中拉钩对组 织的压迫， 更有利于手术操作； 所述第一拉钩体与第二拉钩体厚度均为 2±lmm， 宽度均为 25±5mm; 所述第一水平段和第二水平段的长度均为 100±50mm。
进一步地， 所述第一垂直段的长度为 40±10 或 60±10mm， 所述第一拉钩体的另一端向 靠近第一手柄方向弯折的长度为 10±5mm， 所述水平齿的长度为 5±2mm， 可以有效的将多 裂肌向内侧牵开后且上提， 完全暴露椎板且利于手术操作， 局部对肌肉的损伤较小。
进一步地， 所述第二垂直段的长度为 55 ±10 或 75±10mm， 所述第二拉钩体的另一端设 有两个长度为 5 ±2mm的舌状凸起， 术中顶在椎板的外缘可以起到暴露椎板局部， 同时双舌 状突起使得拉钩和椎板的接触更加稳定， 局部暴露操作简单省力。
进一步地， 所述第一手柄和第二手柄的握持部的外表面上刻有交叉的细条纹， 便于术中握 持。
本发明与现有技术相比， 其有益效果是： （1) 两个手柄的糙化处理方便术者握持， 手柄连 接端鱼嘴样设计避免术中拉钩对组织的压迫损伤； 手柄和拉钩间采用折角可使得手柄握持部 位上翘， 减少切口周围组织对拉钩放置的影响； （2) 两个拉钩方便在脊柱后路椎旁小切口入 路时在直视下准确分离多裂肌和最长肌的间隙， 暴露椎板， 避免进入肌群内部致肌肉损伤， 减少术中出血； （3 ) 椎板侧拉钩独特水平齿突结构设计使得拉钩在术中对多裂肌向内侧牵拉 同时又可以向上提拉， 所以既可以起到牵拉多裂肌暴露椎板的作用， 又可以避免多裂肌受压 于棘突和拉钩之间， 保护多裂肌不受损伤； （4 ) 与椎板外缘接触部位采用两舌状突起， 术中 顶在椎板的外缘可以暴露椎板局部， 同时双舌状突起使得拉钩和椎板的接触更加稳定， 局部 暴露操作简单省力； （5 ) 本发明根据局部手术入路肌肉的特点以及局部骨性结构的特点而设 计， 在完成手术入路的解剖， 准确放置拉钩后， 棘突侧拉钩 80 ± 10 ° 角度的设计， 椎板外 侧拉钩 100 ± 10° 的角度设计可以在局部形成一个外展 10 ° -15 ° 的隧道空间， 符合局部手 术操作的需要。
附图说明
图 1为本发明所述棘突侧椎板拉钩的结构示意图。
图 2为本发明所述椎板外侧拉钩的结构示意图。
具体实施方式
下面对本发明技术方案进行详细说明， 但是本发明的保护范围不局限于所述实施例。
实施例 1 : 如图 1和 2所示， 一种脊柱后路小切口椎旁肌间隙入路的暴露器械， 包括棘突 侧椎板拉钩和与其配合使用的椎板外侧拉钩。
所述棘突侧椎板拉钩由第一手柄 1和第一拉钩体构成， 所述第一拉钩体为呈 L型金属条， 包括第一水平段 2和第一垂直段 3， 所述第一水平段 2与第一垂直段 3 的夹角为 80度， 所 述第一拉钩体的一端与第一手柄 1连接， 所述第一手柄 1与第一水平段 2之间呈 165度的折 角， 所述第一手柄 1位于第一水平段 2与第一垂直段 3相对的一侧， 所述第一拉钩体另一端 向靠近第一手柄 1 方向弯折， 弯折长度为 10mm， 弯折度数为 10度， 端部沿第一拉钩体宽 度方向设有水平齿部件 4， 所述水平齿部件 4位于所述第一拉钩体的另一端靠近第一手柄 1 的一侧且与端部的夹角为钝角、 与第一水平段 2 平行， 所述水平齿部件 4 的齿的长度为 5mm
所述椎板外侧拉钩由第二手柄 5和第二拉钩体构成， 所述第二拉钩体为呈 L型的金属条， 所述第二拉钩体包括第二水平段 6和第二垂直段 7， 所述第二水平段 6和第二垂直段 7的夹 角为 100度， 所述第二拉钩体的一端与第二手柄 5连接， 所述第二手柄 5与第二水平段 6之 间呈 165度的折角， 所述第二手柄 5位于第二水平段 6与第二垂直段 7相对的一侧， 所述第 二拉钩体的另一端设有一对向远离第二手柄 5方向弯折的长度为 5mm的舌状凸起 8， 其向 远离第二手柄 5方向弯折 10度。
所述第一手柄 1和第二手柄 5的连接端均呈鱼嘴状的扁平结构， 所述第一手柄 1和第二手 柄 5均长 120mm， 其中握持部长 100mm, 均为直径 20mm圆柱体， 所述握持部的外表面上 刻有交叉的细条纹； 所述第一拉钩体与第二拉钩体厚度均为 2mm， 宽度均为 25mm; 所述第 一水平段 2和第二水平段 6的长度均为 100mm, 所述第一垂直段 3的长度为 40或 60mm， 所述第二垂直段 7的长度为 55或 75mm。
如上所述， 尽管参照特定的优选实施例已经表示和表述了本发明， 但其不得解释为对本发 明自身的限制。 在不脱离所附权利要求定义的本发明的精神和范围前提下， 可对其在形式上 和细节上作出各种变化。

Claims

WO 2014/117561 +Τ1 ^,, _^ _ι PCT/CN2013/086967 权 禾1 J 要 求 书
1. 一种脊柱后路小切口椎旁肌间隙入路的暴露器械， 其特征在于， 包括棘突侧椎板拉钩和 与其配合使用的椎板外侧拉钩， 所述棘突侧椎板拉钩由第一手柄和第一拉钩体构成， 所述第 一拉钩体为呈 L型金属条， 所述第一拉钩体的一端与第一手柄连接， 另一端向靠近第一手柄 方向弯折， 端部沿第一拉钩体宽度方向设有水平齿部件， 所述水平齿部件位于所述第一拉钩 体的另一端靠近第一手柄的一侧且与端部的夹角为钝角； 所述椎板外侧拉钩由第二手柄和第 二拉钩体构成， 所述第二拉钩体为呈 L型的金属条， 所述第二拉钩体的一端与第二手柄连接， 另一端设有向远离第二手柄方向弯折的舌状凸起。
2.根据权利要求 1 所述的脊柱后路小切口椎旁肌间隙入路的暴露器械， 其特征在于， 所述 第一拉钩体包括第一水平段和第一垂直段， 所述第一水平段与第一垂直段的夹角为 80 ± 10 度， 所述第一手柄与第一水平段之间呈 165 ± 15度的折角， 所述第一手柄位于第一水平段与 第一垂直段相对的一侧， 所述第一拉钩体的另一端向靠近第一手柄方向弯折 10± 10度。
3.根据权利要求 1 所述的脊柱后路小切口椎旁肌间隙入路的暴露器械， 其特征在于， 所述 第二拉钩体包括第二水平段和第二垂直段， 所述第二水平段和第二垂直段的夹角为 100± 10 度， 所述第二手柄与第二水平段之间呈 165 ± 15度的折角， 所述第二手柄位于第二水平段与 第二垂直段相对的一侧， 所述第二拉钩体的另一端的舌状凸起向远离第二手柄方向弯折 10 ± 5度。
4.根据权利要求 2或 3所述的脊柱后路小切口椎旁肌间隙入路的暴露器械， 其特征在于， 所述第一手柄和第二手柄的连接端均呈鱼嘴状的扁平结构， 所述第一拉钩体与第二拉钩体厚 度均为 2 ± lmm， 宽度均为 25 ± 10mm; 所述第一水平段和第二水平段的长度均为 100士 50mm。
5.根据权利要求 4所述的脊柱后路小切口椎旁肌间隙入路的暴露器械， 其特征在于， 所述 第一垂直段的长度为 40 ± 10或 60 ± 10mm， 所述第一拉钩体的另一端向靠近第一手柄方向 弯折的长度为 10± 5mm， 所述水平齿部件的齿的长度为 5 ±2mm。
6.根据权利要求 4所述的脊柱后路小切口椎旁肌间隙入路的暴露器械， 其特征在于， 所述 第二垂直段的长度为 55 ± 10或 75 ± 10mm， 所述第二拉钩体的另一端设有两个长度为 5士 2mm的舌状凸起。
7.根据权利要求 4所述的脊柱后路小切口椎旁肌间隙入路的暴露器械， 其特征在于， 所述 第一手柄和第二手柄的握持部的外表面上刻有交叉的细条纹。
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