WO2017082189A1 - Dispositif de perçage de trou profond - Google Patents

Dispositif de perçage de trou profond Download PDF

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Publication number
WO2017082189A1
WO2017082189A1 PCT/JP2016/082925 JP2016082925W WO2017082189A1 WO 2017082189 A1 WO2017082189 A1 WO 2017082189A1 JP 2016082925 W JP2016082925 W JP 2016082925W WO 2017082189 A1 WO2017082189 A1 WO 2017082189A1
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WO
WIPO (PCT)
Prior art keywords
long hole
guide shaft
drilling device
hole drilling
hole
Prior art date
Application number
PCT/JP2016/082925
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English (en)
Japanese (ja)
Inventor
利徳 玉田
Original Assignee
学校法人 川崎学園
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 学校法人 川崎学園 filed Critical 学校法人 川崎学園
Priority to JP2017550301A priority Critical patent/JP6772174B2/ja
Publication of WO2017082189A1 publication Critical patent/WO2017082189A1/fr

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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
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires

Definitions

  • the present invention relates to a long hole drilling device for drilling a long hole leading to an affected part in a bone in front of the affected part, and in particular, a long hole of a size capable of guiding an endoscope is provided in a tooth process of a second cervical vertebra. It is suitable for use in forming.
  • Various diseases can occur on the back side of the upper cervical vertebra such as the first cervical vertebra and the second cervical vertebra.
  • a tumor may occur on the back side of the upper cervical spine, and rheumatism may occur in a joint of synovial tissue on the back side of the upper cervical spine.
  • the surgeon needs to proceed with the surgery while skillfully avoiding the nerve (spinal cord) behind the affected area. For this reason, it becomes difficult for the surgeon to perform sufficient surgery on the affected area.
  • an object of the present invention is to provide a long hole drilling device for use in a surgical technique capable of smoothly and appropriately proceeding a less invasive cervical spine surgery.
  • the main aspect of the present invention relates to a long hole drilling device for drilling a long hole leading to an affected part in a bone before the affected part.
  • the long hole drilling device includes a drill guide having a tongue portion for abutting against a cylindrical portion and a site in the vicinity of the affected portion to define an inclination direction of the cylindrical portion, and being attachable / detachable to / from the cylindrical portion A guide shaft.
  • the guide shaft is formed with a plurality of pin guides for guiding a fixed pin inserted into the tubular drill in parallel to the central axis of the guide shaft.
  • a long hole drilling device by replacing the fixed pins with the plurality of pin guides provided on the guide shaft, a plurality of the bones in front of the affected area overlap each other at the same pitch as the pitch between the pin guides. Can be formed.
  • a long hole can be formed in the bone by leveling a boundary portion between the plurality of holes formed in the bone with a predetermined jig prepared separately.
  • the long hole drilling device since the holes are formed in the bone at a constant pitch, the finally formed long holes can always be arranged in substantially the same size. . Therefore, a long hole having a minimum size can be formed in the bone before the affected area. Moreover, the inclination of the cylinder part of a drill guide can be adjusted smoothly by making the tongue part of a drill guide contact
  • the long hole drilling device As described above, according to the long hole drilling device according to this aspect, it is possible to accurately form a long hole having a minimum size in the bone before the affected area.
  • the surgeon can observe the affected area satisfactorily with an endoscope or the like through the thus formed long hole, and can smoothly take measures for the affected area. In this operation, only the minimum required long hole is formed in the bone before the affected area, so that the burden on the patient can be significantly reduced as compared with the conventional surgical technique.
  • the long hole drilling device it is possible to smoothly and appropriately advance a less invasive cervical spine operation.
  • the plurality of pin guides may be configured to include a hole formed along the central axis of the guide shaft.
  • the hole since the hole is formed along the central axis, the surgeon can easily aim at the bone driving position when the fixing pin is driven into the bone through the hole.
  • the plurality of pin guides may be configured to include grooves formed on the outer surface of the guide shaft in parallel with the central axis.
  • the pin guide is constituted by the groove in this way, the fixing pin already driven into the bone can be fitted into the pin guide from the outer surface side of the guide shaft, and replacement of the fixing pin with respect to the guide shaft can be smoothly advanced.
  • the plurality of pin guides are arranged on the guide shaft so as to be arranged in a straight line. If it carries out like this, replacement
  • the long hole drilling device is suitable for use in drilling a long hole in the tooth process of the second cervical vertebra.
  • the tongue portion may be configured to include a loop-shaped frame body having a window portion at the center. If it carries out like this, the position shift of a drill guide can be prevented by fitting a window part in the protruding part of the vicinity of an affected part. Therefore, the drill guide can be positioned smoothly and with high accuracy.
  • the window portion is fitted into the front nodule of the first cervical vertebra, and the frame body is the front It may be configured to have a size for riding a nodule. If it carries out like this, the cylinder part of a drill guide can be correctly aimed at the predetermined position of a tooth process.
  • the window portion has a long shape in a direction in which the tongue portion extends. If it carries out like this, a drill guide can be shifted to the direction where a tongue part is extended in the state which fitted the window part to protruding parts, such as a front nodule. Therefore, a long hole that is long in the direction in which the tongue extends can be smoothly formed in the bone before the affected area.
  • FIG.1 (a) is a perspective view which shows the structure of the guide shaft and drill guide which concern on embodiment.
  • FIG.1 (b) is a perspective view which shows the structure of the tubular drill and fixing pin which concern on embodiment.
  • FIGS. 2A and 2B are side views showing configurations of a drill guide and a guide shaft, respectively, according to the embodiment.
  • FIG.2 (c) is a side view which shows the state with which the guide shaft was mounted
  • FIG.2 (d) is a side view which shows the state by which the guide shaft was mounted
  • FIG. 3A is a rear view of the guide shaft according to the embodiment.
  • FIG.3 (b) is sectional drawing of the trunk
  • FIG.3 (c) is a side view of the edge part of the guide shaft which concerns on embodiment.
  • 4 (a) and 4 (b) are diagrams showing a method of surgery using the long hole drilling device according to the embodiment, respectively.
  • FIGS. 5A and 5B are views showing a method of surgery using the long hole drilling device according to the embodiment, respectively.
  • FIGS. 6A and 6B are views showing a method of surgery using the long hole drilling device according to the embodiment, respectively.
  • FIGS. 7A and 7B are views showing a method of surgery using the long hole drilling device according to the embodiment, respectively.
  • FIGS. 8A and 8B are views showing a surgical method using the long hole drilling device according to the embodiment, respectively.
  • FIGS. 9A and 9B are views showing a method of surgery using the long hole drilling device according to the embodiment, respectively.
  • FIGS. 10A and 10B are views showing a surgical method using the long hole drilling device according to the embodiment, respectively.
  • Fig.11 (a) is a figure which shows the method of the surgery using the long hole drilling apparatus which concerns on embodiment.
  • FIGS. 11B and 11C are diagrams illustrating a process of forming a long hole by leveling two holes formed by the long hole drilling device according to the embodiment.
  • the long hole drilling device 1 in order to perform an operation on the affected part on the back side of the upper cervical vertebra, the long hole drilling device 1 is used to drill a long hole in the bone in front of the affected part, that is, the tooth process of the second cervical vertebra. Is used.
  • FIG. 1A is a perspective view showing the configuration of the guide shaft 20 and the drill guide 10 constituting the long hole drilling device 1
  • FIG. 1B shows the configuration of the tubular drill 30 and the fixing pins 40 and 50
  • FIG. 2A and 2B are side views showing the configurations of the drill guide 10 and the guide shaft 20, respectively.
  • FIG. 2C is a side view showing a state in which the guide shaft 20 is mounted on the drill guide 10.
  • FIG. 2D is a side view showing a state in which the guide shaft 20 is mounted on the drill guide 10 and two fixing pins 40 and 50 are mounted on the guide shaft 20.
  • the long hole drilling device 1 includes a drill guide 10 and a guide shaft 20.
  • the drill guide 10 includes a tube portion 11, a tongue portion 12, and a grip portion 13.
  • the cylinder part 11 has a cylindrical shape in which left and right are opened.
  • the cylindrical part 11 is formed with a circular hole 11a penetrating left and right.
  • the tongue 12 includes a loop-shaped frame (hereinafter referred to as “loop frame”) 12b having a window (hereinafter referred to as “loop window”) 12a.
  • the cross section of the loop frame 12b is circular.
  • the loop frame body 12b has a tip looped in an arc shape. In this way, the tip of the loop frame body 12b loops in an arc shape, and the loop frame body 12b has a circular cross section.
  • the frame body 12b is prevented from being caught by the tissue near the affected part and damaging the tissue.
  • the tongue portion 12 is inclined downward at a predetermined angle with respect to the central axis A0 of the cylindrical portion 11.
  • the tongue portion 12 is for abutting against a site in the vicinity of the affected area to define the inclination direction of the cylindrical portion 11.
  • the tongue 12 is mounted on the anterior nodule of the first cervical vertebra as described later, and at the same time the tongue 11 is directed to the portion of the second cervical vertebra at the back of the anterior nodule. Twelve inclination angles are set.
  • the loop window 12a has a size such that the loop frame body 12b rides on the anterior nodule by fitting into the anterior nodule of the first cervical vertebra.
  • the loop window 12a has a long shape in the direction in which the tongue 12 extends.
  • the grip portion 13 is formed so as to be slightly inclined with respect to the cylinder portion 11.
  • the hole 11 a at the right end of the tube portion 11 is inclined at the same angle as the tongue portion 12.
  • a tongue 12 extends downward from the right end of the tube 11.
  • the drill guide 10 is made of a metal material having high rigidity.
  • the guide shaft 20 includes a trunk portion 21 and a locking portion 22.
  • drum 21 has a rod shape with a circular cross section.
  • the diameter of the body portion 21 is slightly smaller than the diameter of the hole 11 a of the drill guide 10.
  • the diameter of the right end of the body portion 21 decreases toward the tip.
  • the locking part 22 has a cylindrical shape having a larger diameter than the body part 21.
  • the central axis of the locking part 22 and the central axis of the trunk part 21 are coincident.
  • a hole 21a serving as a pin guide for the fixing pin 40 is formed in the barrel portion 21 along the central axis A1.
  • the hole 21 a extends from the right end of the body portion 21 to the left end of the locking portion 22. That is, the hole 21a penetrates the guide shaft 20 from side to side.
  • grooves 21 b serving as pin guides for the fixing pins 40 and 50 are formed at positions symmetrical with respect to the central axis of the body portion 21.
  • the locking part 22 is formed with holes 22b connected to the grooves 21b.
  • the hole 22b extends in parallel to the central axis of the locking portion 22 and penetrates the locking portion 22 from side to side.
  • the guide shaft 20 is made of a highly rigid metal material.
  • the tubular drill 30 includes a body portion 31 and a hole 32.
  • the tubular drill 30 is used to make a hole in the bone before the affected area (in this embodiment, the tooth process of the second cervical vertebra).
  • the trunk portion 31 has a rod shape with a circular cross section.
  • the diameter of the body portion 31 is slightly smaller than the diameter of the hole 11 a of the drill guide 10.
  • a groove blade 31a for cutting bone is formed in the vicinity of the right end portion of the body portion 31, a groove blade 31a for cutting bone is formed.
  • the hole 32 has a circular shape, and extends from the right end of the trunk portion 31 to the left end along the central axis of the trunk portion 31. That is, the hole 32 penetrates the tubular drill 30 to the left and right.
  • the diameter of the hole 32 is substantially the same as the diameter of the hole 21 a of the guide shaft 20.
  • the fixing pins 40 and 50 are made of linear members having a circular cross section. As will be described later, the fixing pins 40 and 50 are driven into the bone when a hole is drilled in the bone in front of the affected area (the tooth process of the second cervical vertebra in this embodiment). The fixing pins 40 and 50 driven into the bone are used as support shafts of the tubular drill 30.
  • the fixing pins 40 and 50 have the same shape and size.
  • the diameters of the fixing pins 40 and 50 are slightly smaller than the diameter of the hole 21 a of the guide shaft 20 and slightly smaller than the diameter of the hole 32 of the tubular drill 30.
  • Each of the fixing pins 40 and 50 is made of a metal material having high rigidity.
  • the guide shaft 20 having the above configuration is attachable to and detachable from the drill guide 10.
  • the trunk portion 21 of the guide shaft 20 is inserted into the hole 11 a from the left side of the drill guide 10.
  • the guide shaft 20 is inserted until the locking portion 22 contacts the left end of the cylindrical portion 11.
  • Fixing pins 40 and 50 can be attached to the guide shaft 20.
  • the fixing pins 40, 50 are inserted into the hole 21a or the two grooves 21b of the guide shaft 20.
  • FIG. 2D shows a state in which the fixing pins 40 and 50 are inserted into the two grooves 21b.
  • FIG. 3A is a rear view of the guide shaft 20.
  • FIG. 3B is a cross-sectional view when the body portion 21 of the guide shaft 20 is cut along a plane perpendicular to the central axis of the body portion 21.
  • FIG. 3C is a side view of the end portion of the guide shaft 20.
  • the hole 21a penetrating the trunk portion 21 and the locking portion 22 and the two holes 22b formed in the locking portion 22 are arranged in a straight line.
  • the central axis of the hole 21a coincides with the central axis A1 of the trunk portion 21.
  • the central axis A2 of the two holes 22b is symmetrical with respect to the central axis A1. Therefore, the distance D2 between the hole 21a and the one hole 22b and the distance D3 between the hole 21a and the other hole 22b are the same.
  • the distance D1 between the two holes 22b is twice the distance D2 and twice the distance D3.
  • the outer circumferences of the two holes 22b are in contact with the outer circumference of the trunk portion 21.
  • the diameter of the hole 21a and the diameter of the two holes 22b are both D4.
  • the hole 21a and the two grooves 21b formed in the body portion 21 of the guide shaft 20 are arranged in a straight line.
  • the central axis of the hole 21a coincides with the central axis A1 of the trunk portion 21.
  • the cross section of the groove 21b has a shape in which a semicircular arc portion C1 is followed by a straight portion C2 having the same width as the diameter D4 of the arc portion C1.
  • the central axes A2 of the two holes 22b formed in the locking portion 22 in FIG. 3A pass through the centers of the two grooves 21b, respectively.
  • the diameter D4 is slightly larger than the diameter of the fixing pins 40 and 50.
  • the diameter of the end portion of the body portion 21 of the guide shaft 20 gradually decreases toward the tip.
  • the hole 21 a passes through the smallest diameter portion of the body portion 21.
  • the groove 21b extends partway along the inclined surface at the end of the body part 21. Since the end portion of the body portion 21 of the guide shaft 20 is an inclined surface in this way, the guide shaft 20 is inserted into the hole 11a of the drill guide 10 after the drill guide 10 is installed near the affected portion as will be described later. In this case, it is possible to prevent the end portion of the trunk portion 21 from being caught by the tissue in the vicinity of the affected area and damaging the tissue. Further, since the end portion of the body portion 21 has a small diameter due to the inclined surface, the guide shaft 20 can be smoothly inserted into the hole 11a of the drill guide 10 and workability can be improved.
  • FIG. 4 (a) to FIG. 11 (a) a step in which a hole is drilled in the bone (dental process of the second cervical vertebra) in front of the affected area by the long hole drilling device 1 having the above configuration.
  • the state of the cylindrical portion 11 of the drill guide 10 in each step is schematically shown on the left side of FIGS. 4 (a) to 10 (a).
  • 4A to 11A schematically show the relationship between the patient's upper cervical vertebra and the drill guide 10.
  • a state when the vicinity of the upper cervical vertebra of the patient facing upward is viewed from the left side of the patient is shown.
  • the left direction of these schematic views is the front of the patient.
  • B1 is an anterior nodule of the first cervical vertebra
  • B2 is an odontoid process of the second cervical vertebra
  • AP is the affected area.
  • the affected part AP is in the rear position of the anterior node B1 on the back side of the dental process B2.
  • the long hole drilling device 1 drills two holes in the tooth projection B2.
  • the two holes are formed obliquely from the front side of the upper cervical vertebra toward the tooth process B2.
  • the surgeon drills a hole while referring to a fluoroscopic image near the upper cervical vertebra of the patient.
  • the operator first makes a lateral skin incision on the right side of the patient's anterior neck, and peels the front of the vertebral body to the anterior nodule B1 using a technique. Thereafter, the operator grasps the grasping portion 13 (see FIG. 1A) of the drill guide 10 and moves the tongue portion 12 of the drill guide 10 to the anterior node B1 as shown in FIG. 4A. . Further, as shown in FIG. 4 (b), the operator fits the loop window 12a (see FIG. 1 (a)) of the tongue 12 into the front node B1, and the loop frame 12b (FIG. 1) of the tongue 12. (See (a)) on the previous nodule B1. In this state, the cylindrical part 11 of the drill guide 10 is directed to the vicinity of the tooth protrusion B2 immediately before the affected part AP.
  • the surgeon inserts the guide shaft 20 into the hole 11a of the drill guide 10 as shown in FIG.
  • the guide shaft 20 is inserted until the locking portion 22 comes into contact with the end portion of the cylindrical portion 11 as shown in FIG.
  • the operator inserts the fixing pin 40 into the hole 21a of the guide shaft 20 and drives the fixing pin 40 into the tooth projection B2.
  • the surgeon adjusts the position of the drill guide 10 while confirming a fluoroscopic image near the upper cervical vertebra of the patient so that the fixing pin 40 is driven into a predetermined position. Further, the operator adjusts the driving depth of the fixing pin 40 while confirming the fluoroscopic image so that the fixing pin 40 does not penetrate the tooth protrusion B2.
  • the operator pulls out the guide shaft 20 from the drill guide 10 as shown in FIG. Then, the operator passes the fixing pin 40 driven into the tooth protrusion B2 through the hole 32 of the tubular drill 30 and operates the tubular drill 30 using the fixing pin 40 as a support shaft. Thereby, as shown in FIG. 6B, the tooth protrusion B ⁇ b> 2 is dug by the tubular drill 30. At this time, the surgeon adjusts the progress of the tubular drill 30 while confirming a fluoroscopic image near the upper cervical vertebra of the patient so that the distal end of the tubular drill 30 stops on the back surface of the tooth projection B2.
  • the operator pulls out the tubular drill 30 from the drill guide 10 as shown in FIG. Thereby, the hole H1 is formed in the tooth projection B2.
  • the operator shifts the drill guide 10 downward as shown in FIG. 7B.
  • the drill guide 10 since the loop window 12a (see FIG. 1 (a)) of the tongue 12 of the drill guide 10 is fitted into the front node B1, the drill guide 10 has a loop frame 12b (see FIG. 1 (a)). It is moved downward without shaking as guided by the front nodule B1.
  • the drill guide 10 is moved downward to a position where the fixing pin 40 substantially contacts the inner surface of the hole 11a.
  • the fixing pin 40 protrudes from the opposite side of the drill guide 10 through the hole 11a of the drill guide 10 to the outside.
  • the operator inserts the fixing pin 40 protruding outside into the upper groove 21b of the guide shaft 20 and inserts the guide shaft 20 into the hole 11a of the drill guide 10 again as shown in FIG.
  • the operator inserts the second fixing pin 50 into the groove 21b on the lower side of the guide shaft 20, and drives the fixing pin 50 into the tooth projection B2.
  • the surgeon adjusts the position of the drill guide 10 while confirming a fluoroscopic image near the upper cervical vertebra of the patient so that the fixing pin 50 is driven into a predetermined position. Further, the operator adjusts the driving depth of the fixing pin 50 so that the fixing pin 50 does not penetrate the tooth projection B2 while checking the fluoroscopic image.
  • the operator pulls out the guide shaft 20 from the drill guide 10, and further pulls out the fixing pin 40 that is first driven into the tooth protrusion B2 from the tooth protrusion B2.
  • the surgeon shifts the drill guide 10 downward so that the remaining fixing pin 50 is positioned substantially at the center of the cylindrical portion 11. Also in this case, the drill guide 10 is moved downward without shaking so that the loop frame 12b (see FIG. 1 (a)) is guided to the front node B1.
  • the operator passes the fixing pin 50 driven into the tooth protrusion B2 through the hole 32 of the tubular drill 30, and operates the tubular drill 30 with the fixing pin 50 as a support shaft.
  • the lower side of the hole H1 of the tooth projection B2 is dug by the tubular drill 30.
  • the surgeon adjusts the progress of the tubular drill 30 while confirming a fluoroscopic image near the upper cervical vertebra of the patient so that the distal end of the tubular drill 30 stops on the back surface of the tooth projection B2.
  • the hole H2 is formed in the tooth projection B2.
  • the operator pulls out the tubular drill 30 from the drill guide 10 and pulls out the fixing pin 50 from the tooth projection B2. Further, the operator removes the drill guide 10 from the patient's upper cervical spine. After forming the hole H2 in the tooth protrusion B2 in this manner, the operator, as shown in FIG. 11A, separately prepares a boundary portion between the two holes H1 and H2 formed in the tooth protrusion B2. A long hole H3 is formed in the tooth projection B2 by leveling with a jig. Finally, the operator removes the bone remaining in the deepest part of each hole H1, H2, and exposes the affected part AP in the long hole H3. Thereby, formation of the long hole H3 with respect to the tooth projection B2 is completed.
  • FIG. 11 (b) is a diagram schematically showing the drilled state of the holes H1 and H2 in the tooth projection B2.
  • FIG. 11C is a diagram schematically illustrating a state after the holes H1 and H2 are leveled to form the long hole H3.
  • FIGS. 11B and 11C schematically show a state when the holes H1, H2 or the long hole H3 are viewed in the depth direction.
  • the distance between the central axis P1 of the hole H1 and the central axis P2 of the hole H2 matches the distance D1 between the two grooves 21b shown in FIG. 3 (b).
  • the two holes H1 and H2 partially overlap each other.
  • the boundary portion between the two holes H1 and H2 indicated by the alternate long and short dash line in FIG.
  • the bone remaining in the deepest part of the holes H1 and H2 is removed, and the affected part AP is exposed in the long hole H3.
  • the long hole H3 is formed in the tooth projection B2.
  • the holes H1 and H2 may be slightly widened.
  • the long hole H3 is slightly wider than the long hole H3 formed by leveling only the boundary portion as shown in FIG.
  • the surgeon inserts an endoscope into the long hole H3 and observes the affected part AP. Based on this observation, the surgeon takes measures for the affected area AP.
  • the operator removes the endoscope from the long hole H3 and further sutures the patient's front neck. Thus, the operation for the patient is completed.
  • the holes H1 and H2 are formed in the tooth projection B2 at a constant pitch (distance D1).
  • H3 can always be arranged to have substantially the same size. Therefore, it is possible to form a long hole H3 having a minimum size in the tooth protrusion B2 before the affected area AP.
  • the inclination of the cylinder part 11 of the drill guide 10 can be smoothly adjusted by riding the tongue part 12 of the drill guide 10 on the front nodule B1 near the affected part AP. Therefore, the fixing pins 40 and 50 can be accurately driven into the target position of the tooth projection B2 before the affected area AP, and the holes H1 and H2 can be accurately formed in the tooth protrusion B2 before the affected area AP.
  • the long hole drilling device 1 As described above, according to the long hole drilling device 1 according to the present embodiment, it is possible to accurately form the long hole H3 having a minimum size in the tooth protrusion B2 before the affected area AP.
  • the surgeon can observe the affected area AP satisfactorily with an endoscope or the like through the thus formed long hole H3, and can smoothly take measures for the affected area AP.
  • the burden on the patient can be significantly reduced as compared with the conventional surgical technique.
  • a less invasive cervical spine operation can be smoothly and appropriately advanced.
  • a hole 21a is formed along the central axis A1 of the guide shaft 20, and a fixing pin 40 is formed in the hole 21a. Inserted.
  • the surgeon aims at the driving position of the tooth protrusion B2 when the fixing pin 40 is driven into the tooth protrusion B2 by the hole 21a. It becomes easy.
  • two grooves 21b are formed on the outer surface of the trunk portion 21 of the guide shaft 20 in parallel with the central axis A1.
  • the fixing pins 40 and 50 are fitted into the groove 21b.
  • the fixing pin 40 already driven into the tooth projection B2 can be fitted into the groove 21b from the outer surface side of the guide shaft 20.
  • the replacement of the fixing pin 40 with respect to the guide shaft 20 can proceed smoothly.
  • the hole 21a and the two grooves 21b are arranged on the guide shaft 20 so as to be aligned in a straight line. . Accordingly, as described with reference to FIGS. 7B and 9B, the replacement of the fixing pin 40 and the driving of the fixing pin 50 can be advanced by shifting the drill guide 10 in one direction. .
  • the tongue 12 is constituted by a loop frame 12b having a loop window 12a at the center.
  • the position of the drill guide 10 can be prevented from being displaced by fitting the loop window 12a to the anterior node B1 of the first cervical vertebra. Therefore, the drill guide 10 can be positioned smoothly and with high accuracy.
  • the loop window 12a of the tongue 12 is fitted into the anterior node B1 of the first cervical vertebra and the loop frame 12b is mounted on the anterior node B1.
  • the cylinder part 11 of the drill guide 10 can be correctly directed to the predetermined position of the tooth projection B2.
  • the loop window 12a has a long shape in the direction in which the tongue 12 extends. For this reason, the drill guide 10 can be shifted in the direction in which the tongue portion 12 extends in a state where the loop window 12a is fitted to the front node B1. Therefore, the long hole H3 long in the direction in which the tongue portion 12 extends can be smoothly formed in the tooth protrusion B2 before the affected area AP.
  • the long hole drilling device 1 is It can be used not only for the affected part on the back side of the first cervical vertebra, but also for the affected part on the back side of the other cervical vertebra. Can be used. Furthermore, it can be used not only for cervical vertebrae but also for operations on other vertebrae such as lumbar vertebrae.
  • the pin guide provided in the guide shaft 20 is provided.
  • the number may be plural, and two pin guides may be provided on the guide shaft 20.
  • the hole 21a may be omitted and only the two grooves 21b may be provided in the guide shaft 20.
  • the fixing pin 40 is inserted into the upper groove 21b and driven into the tooth projection B2, for example.
  • the drill guide 10 is shifted upward, and the fixing pin 40 is positioned at the center of the hole 11 a of the drill guide 10.
  • two holes H1 and H2 are formed at the same pitch as the distance D1 in FIG.
  • the upper groove 21b may be omitted, and only the hole 21a and the lower groove 21b may be provided in the guide shaft 20.
  • the step of FIG. 7B is omitted, and in the steps of FIGS. 8A and 8B, the fixing pin 40 is inserted into the hole 21a.
  • the subsequent steps are the same as in the above embodiment.
  • the pitch of the holes H1 and H2 in FIG. 11B is a distance D3 (see FIG. 3B) that is half of the distance D1. Therefore, the length (dimension in the major axis direction) of the long hole H3 is shorter than that in the above embodiment.
  • the two grooves 21b are formed on the outer surface of the trunk portion 21 of the guide shaft 20, but one or both of the two grooves 21b may be replaced with holes.
  • the groove 21b since the fixing pin 40 can be fitted from the outer surface side of the body portion 21 as described above, the workability of replacing the fixing pin 40 is improved as compared with the hole.
  • the holes H1 and H2 are formed while the drill guide 10 is shifted in the extending direction of the tongue 12, the holes H1 and H2 are formed so as to be lined downward, but are drilled in the bone.
  • the direction in which the holes are aligned is not limited to this.
  • the drill guide 10 is rotated around the front node B1, and then the drill guide 10 is moved in the direction in which the tongue 12 extends to form the second hole H2. Good.
  • the holes H1 and H2 are drilled so as to be aligned in a direction inclined by a predetermined angle with respect to the alignment direction of the cervical vertebra.
  • the two holes H1 and H2 are formed in the tooth process B2 before the affected area AP.
  • the number of holes formed in the bone before the affected area is not limited to two.
  • the tubular drill 30 is removed from the drill guide 10 to leave the fixing pin 50, and then the steps of FIGS. 50 and a new fixing pin may be used to form a third eye hole in the tooth projection B2.
  • the length (dimension in the major axis direction) of the long hole H3 can be made longer than that in the above embodiment.
  • the shape and the like of the drill guide 10 and the guide shaft 20 can be changed as appropriate.
  • the cylindrical portion 11 of the drill guide 10 may have a square shape
  • the hole 11a may have a square shape.
  • the shape of the guide shaft 20 is also changed to a square shape.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Dentistry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un dispositif de perçage de trou profond (1) comprenant : un guide de perçage (10) comprenant une partie cylindre (11), et une partie languette (12) permettant de définir la direction d'inclinaison de la partie cylindre (11) en entrant en contact avec un site à proximité d'une zone affectée ; et une tige de guidage (20) pouvant être introduite à l'intérieur de la parte cylindre (11) et en être extraite. Une pluralité de guides de broche (trou (21a), rainure (21b)) destinée à guider une broche fixe (40, 50) insérée dans un foret tubulaire (30) est formée dans la tige de guidage (20) parallèle à l'axe central de la tige de guidage (20). Ainsi, un trou profond se prolongeant vers la zone affectée peut être percé dans un os, en avant de la zone affectée, au moyen du dispositif de perçage de trou profond (1).
PCT/JP2016/082925 2015-11-10 2016-11-07 Dispositif de perçage de trou profond WO2017082189A1 (fr)

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JP2017550301A JP6772174B2 (ja) 2015-11-10 2016-11-07 長孔穿設装置

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107998518A (zh) * 2017-12-08 2018-05-08 广州医科大学附属肿瘤医院 宫颈癌腔联合宫旁插植治疗的个体化辅助装置的制作方法
WO2020195730A1 (fr) * 2019-03-26 2020-10-01 オリンパス株式会社 Dispositif de guidage et procédé de formation de trous de fraise

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002528163A (ja) * 1998-10-28 2002-09-03 エスディージーアイ・ホールディングス・インコーポレーテッド 脊椎手術の方法及び装置
JP2008515580A (ja) * 2004-10-13 2008-05-15 バイオコンポジッツ・リミテッド ワイヤーを案内するための長手方向を通る孔を有するオブトラトール付きトロカール
US20130023891A1 (en) * 2011-07-22 2013-01-24 Sascha Berberich Device For Introducing Multiple Drilled Channels In A Bone
WO2014134584A1 (fr) * 2013-02-28 2014-09-04 Feibel Jonathan Systèmes, méthodes et appareils d'alésage d'éléments osseux
JP2015100450A (ja) * 2013-11-22 2015-06-04 タキロン株式会社 ドリルガイド

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002528163A (ja) * 1998-10-28 2002-09-03 エスディージーアイ・ホールディングス・インコーポレーテッド 脊椎手術の方法及び装置
JP2008515580A (ja) * 2004-10-13 2008-05-15 バイオコンポジッツ・リミテッド ワイヤーを案内するための長手方向を通る孔を有するオブトラトール付きトロカール
US20130023891A1 (en) * 2011-07-22 2013-01-24 Sascha Berberich Device For Introducing Multiple Drilled Channels In A Bone
WO2014134584A1 (fr) * 2013-02-28 2014-09-04 Feibel Jonathan Systèmes, méthodes et appareils d'alésage d'éléments osseux
JP2015100450A (ja) * 2013-11-22 2015-06-04 タキロン株式会社 ドリルガイド

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107998518A (zh) * 2017-12-08 2018-05-08 广州医科大学附属肿瘤医院 宫颈癌腔联合宫旁插植治疗的个体化辅助装置的制作方法
CN107998518B (zh) * 2017-12-08 2020-07-28 广州医科大学附属肿瘤医院 宫颈癌腔联合宫旁插植治疗的个体化辅助装置的制作方法
WO2020195730A1 (fr) * 2019-03-26 2020-10-01 オリンパス株式会社 Dispositif de guidage et procédé de formation de trous de fraise
JPWO2020195730A1 (fr) * 2019-03-26 2020-10-01
JPWO2020194536A1 (fr) * 2019-03-26 2020-10-01
WO2020194536A1 (fr) * 2019-03-26 2020-10-01 オリンパス株式会社 Dispositif de guidage
CN113613569A (zh) * 2019-03-26 2021-11-05 奥林巴斯株式会社 引导器件和骨孔形成方法

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