CN106264702A - Spine minimally invasive positioning system and application thereof in spine minimally invasive positioning - Google Patents

Abstract

The invention discloses a spinal minimally invasive positioning system and its application. It includes: a base; a z-axis guide rod arranged on the base; a z-axis scale; a first scale and a first vernier extending along the x-axis; a second scale and a second vernier extending along the y-axis; To the first angle disc of the second vernier, which extends in the xz plane and has a scale; the first rotating member, which is connected to the second vernier and can rotate along the central axis parallel to the y-axis; the second angle disc, which is perpendicular to the The first angle plate extends in the plane and has a scale; the second rotating part rotates along the second rotation axis perpendicular to the second angle plate; the indicator needle can rotate with the second rotating part and is used to mark the rotation angle; Needle holder holding puncture needle. The spinal minimally invasive positioning system avoids important tissue damage caused by inaccurate puncture positions during minimally invasive surgery, reduces the risk of surgery for patients, and thus makes the positioning of spinal minimally invasive surgery more accurate.

Description

Spinal minimally invasive positioning system and its application in spinal minimally invasive positioning

technical field

The invention relates to the technical field of minimally invasive surgery, in particular to a spinal minimally invasive positioning system and its application in spinal minimally invasive positioning.

Background technique

Minimally invasive surgery is the application of advanced tools (such as computers, special puncture guide needles, special retractors and imaging equipment) to complete traditional operations through special surgical approaches, so as to achieve the least tissue damage to patients, the lightest The psychological impact, the fastest recovery and the best surgical results.

Minimally invasive spinal surgery is a surgical method for the treatment of various spinal diseases (such as osteoporotic compression fractures, spinal traumatic fractures, lumbar disc herniation, lumbar spinal stenosis, etc.) that has emerged in recent years. Small size, short operation time, good postoperative effect and many other advantages. But there are also disadvantages. One of the keys to this operation is accurate positioning, including skin incision, surgical path, and location of the lesion. If the positioning is not accurate, it may cause more serious damage, such as damage to important surrounding nerves and blood vessels. The previous methods of positioning various body surface landmarks and metal markers are not accurate enough, and multiple perspectives are required during the operation; it not only increases the operation time, but also exposes medical staff and patients to X-ray radiation for many times, and suffers from more conventional X-ray radiation. X-ray irradiation with several times or even dozens of times the dose of surgery.

Minimally invasive spinal surgery is the future direction of development, and one of the main operations is percutaneous screw fixation. At present, the existing internal fixation technology is either cut open under direct vision or completed under continuous X-ray fluoroscopy, which causes great harm to patients or medical staff. Existing locators, sights, and guides cannot achieve accurate goals. At present, only computer-aided navigation systems can solve this problem, and surgical navigation systems are complex in structure, expensive (about 4 million/set), and have a learning curve. long, and the accuracy needs to be improved.

Another minimally invasive technique in spinal surgery is endoscopic spinal surgery, which is used to treat lumbar disc herniation, etc. However, in this operation, the surgical instrument must be directly punctured through the skin and accurately reach the "safe triangle working area", so that the resection of the herniated lumbar intervertebral disc can be safely and smoothly performed under the endoscope. The accuracy of puncture positioning determines whether the entire operation is successful or not, and is even the key to determining the success or failure of the operation. The entire puncture process is carried out under the fluoroscopy monitoring of a C-arm X-ray machine. The longer the puncture time and the more times, it means that the X-ray exposure of the operator and the patient will increase significantly.

Contents of the invention

The purpose of the present invention is to provide a spinal minimally invasive positioning system and its application in spinal minimally invasive positioning, so as to make the positioning of spinal minimally invasive surgery more accurate, shorten the operation time, and avoid excessive exposure to radiation.

In order to solve the above problems, according to one aspect of the present invention, a spinal minimally invasive positioning system is provided, which is used to position the puncture needle to a predetermined puncture position, comprising: a base; a z-axis guide rod arranged on the base along the z-axis direction on the z-axis scale used to identify the position of the z-axis; a first scale extending along the x-axis direction and a first vernier capable of sliding along the first scale, the first scale is connected to the z-axis guide rod and Able to move in the z-axis direction along the z-axis guide rod; a second scale extending along the y-axis direction and a second vernier capable of sliding along the second scale, the second scale is connected to the first vernier and can follow the first The vernier moves; a first angle disc fixedly connected to the second vernier, which extends in the x-z plane and has a scale for identifying the angle; a first rotating member, which is connected to the second vernier and can move along with the second vernier The first central axis of rotation parallel to the y-axis rotates; the second angle plate fixedly connected to the first rotating member extends in a plane perpendicular to the first angle plate and has a scale for indicating the angle; the second rotating member, It is connected with the first rotating member so as to be able to rotate along the second rotating axis perpendicular to the second angle plate; the indicator needle connected with the second rotating member, which can rotate with the second rotating member, is arranged adjacent to the second angle plate , to identify the rotation angle of the second rotating member relative to the second angle plate; a needle holder, which is connected to the second rotating member and used to hold the puncture needle.

Further, the second angle disk is arranged adjacent to the first angle disk, so that the projection of the second angle disk on the first angle disk can be used to identify the rotation angle of the first rotating member relative to the first angle disk.

Further, the first angle plate is made of transparent or translucent material; optionally, the second angle plate is made of transparent or translucent material.

Further, the second rotating member is integrally formed with the needle holder.

Further, the second vernier includes a protrusion extending along the x-axis direction, and the first angle disc and the first rotating member are arranged at the protrusion so that the first rotating member is away from the second scale; optionally, The first rotating member includes a connecting shaft connected to the first angle disc and a block sheathed on the connecting shaft.

Further, it also includes an x-axis guide rod extending along the x-axis direction, the first end of the x-axis guide rod is movably fixed on the z-axis guide rod and can move along the z-axis guide rod; the first end of the x-axis guide rod The two ends are connected to the first scale through a connecting block; optionally, a scale is provided on the x-axis wire rod.

Further, the base is configured to be detachably connected to an operating table for puncturing.

Further, the base includes a y-axis guide rod extending along the y-axis direction, wherein the z-axis guide rod is slidably connected to the y-axis guide rod; optionally, the y-axis guide rod is provided with a scale.

Further, the z-axis scale is formed on the surface of the z-axis guide rod, or the z-axis scale is independent of the z-axis guide rod and arranged on the base (20).

According to another aspect of the present invention, there is provided an application of a minimally invasive spinal positioning system in minimally invasive spinal positioning, comprising the following steps: providing any one of the above-mentioned minimally invasive spinal positioning systems; shooting the first x along the x-axis direction light picture, record the first position information of the first puncture point on the bone surface and the second puncture point inside the bone in the y-z plane; take the second x-ray picture along the y-axis direction, record the first puncture point on the bone surface The second position information of a puncture point and the second puncture point located inside the bone in the x-z plane; determine the direction and angle to be positioned according to the first position information and the second position information; adjust the spinal minimally invasive positioning system so that the puncture needle and The direction and angle of positioning are consistent.

Beneficial effects of the present invention: The spinal minimally invasive positioning system of the present invention is based on two points to determine a straight line, and the position of the point in space can be expressed by the principle of three-dimensional coordinates. The use of this minimally invasive spine positioning system can avoid important tissue damage caused by inaccurate puncture and drilling positions during minimally invasive surgery, or inaccurate internal fixation positions that lead to fixation instability and failure, reducing the risk of surgery for patients. As a result, the positioning of spinal minimally invasive surgery is more accurate, the radiation of medical staff is reduced, and the operation time is shortened. The market prospect is immeasurable.

According to the following detailed description of specific embodiments of the present invention in conjunction with the accompanying drawings, those skilled in the art will be more aware of the above and other objects, advantages and features of the present invention.

Description of drawings

Hereinafter, some specific embodiments of the present invention will be described in detail by way of illustration and not limitation with reference to the accompanying drawings. The same reference numerals in the drawings designate the same or similar parts or parts. Those skilled in the art will appreciate that the drawings are not necessarily drawn to scale. In the attached picture:

Fig. 1 is a schematic structural view of a spinal minimally invasive positioning system according to an embodiment of the present invention;

Fig. 2 is the partial structural enlarged view of the spinal minimally invasive positioning system in Fig. 1; And

Fig. 3 is a structural schematic diagram of a first angle plate and a second angle plate according to an embodiment of the present invention.

detailed description

As shown in Figures 1-2, the present invention provides a spinal minimally invasive positioning system for positioning the puncture needle 10 to a predetermined puncture position, the structure of which includes a base 20 and a z slidably sleeved on the base 20 Shaft guide rod 30 , first scale 40 , second scale 50 , first angle plate 60 and second angle plate 70 .

Specifically, as shown in FIG. 1 , the base 20 includes two fixing clips 21 for fixing the base 20 and a y-axis guide rod 22 extending along the y-axis direction, so that the base 20 can be set to be detachably connected to the Operating table for puncture. The y-axis guide rod 22 is located between the two fastening clips 21 . A vertical guide seat 23 is sleeved on the y-axis guide rod 22 , and the z-axis guide rod 30 is slidably connected to the y-axis guide rod 22 through the vertical guide seat 23 . The z-axis guide rod 30 can be adjusted through the vertical guide seat 23 , so that the z-axis guide rod 30 can slide freely on the horizontal coarse adjustment guide rod 22 . Preferably, a scale is provided on the y-axis guide rod 22 .

In order to mark the moving distance in the z-axis direction, the minimally invasive spine positioning system further includes a z-axis scale 301 for marking the z-axis position. In one embodiment of the present invention, as shown in FIG. 2 , the z-axis scale 301 is independent from the z-axis guide bar 30 and parallel to them. Both the z-axis scale 301 and the z-axis guide rod 30 are set on the horizontal coarse adjustment guide rod 22 , and the z-axis scale 301 can be sleeved and fixed on the horizontal coarse adjustment guide rod 22 by screws. In an unshown embodiment of the present invention, the z-axis scale 301 may also be formed on the surface of the z-axis guide rod 30 , that is, a scale is provided on the surface of the z-axis guide rod 30 .

As shown in FIG. 1 , an x-axis guide rod 401 extending along the x-axis direction is provided on the z-axis guide rod 30 . Wherein, the first end of the x-axis guide rod 401 is movably fixed on the z-axis guide rod 30 and can move in the z-axis direction along the z-axis guide rod 30, and the second end of the x-axis guide rod 401 passes through the connecting block 402 is connected with the first scale 40 . Preferably, a scale can be set on the x-axis guiding rod 401 . In other embodiments of the present invention, when the first scale 40 is long enough, the first scale 40 can also be directly connected to the z-axis guide rod 30, so that the x-axis guide rod 401 can no longer be provided, Reduced process flow.

As shown in Figures 1 and 2, one end of the first scale 40 extends along the x-axis direction, and the other end is connected to the z-axis guide bar 30 by a fastener, and can move along the z-axis guide bar 30 in the z-axis direction. move up. In one embodiment, the fasteners may be bolts. A first cursor 41 that can slide along the first scale 40 may be provided. The first vernier 41 may have a through hole (not shown in the figure), and the second scale 50 is connected to the first vernier 41 and can move with the first vernier 41 . Specifically, the second scale 50 is sleeved in the through hole of the first vernier 41 and fixed thereon. The second scale 50 extends along the y-axis direction perpendicular to the x-axis direction, and also has a second cursor 51 that can slide along it.

In a preferred embodiment of the present invention, the spinal minimally invasive positioning system further includes first rotating parts 71 , 80 . The first rotating member 71 , 80 is connected to the second cursor 51 and can rotate relative to the second cursor 51 along a first central rotation axis parallel to the y-axis. Specifically, the second cursor 51 includes a protrusion (not shown in the figure) extending along the x-axis direction, and the first angle disc 60 and the first rotating parts 71, 80 are arranged at the protrusion, so that the first The rotating member is away from the second scale 50 to avoid affecting the second scale 50 . The first rotating parts 71 and 80 include a connecting shaft 80 connected to the first angle disc 60 and a block body 71 sleeved on the connecting shaft 80 . In a typical embodiment of the present invention, the connecting shaft 80 is fixed on the second vernier 51 by bolts, and the block 71 sleeved on the connecting shaft 80 can rotate around the connecting shaft 80 . In another typical embodiment of the present invention, the connecting shaft 80 is fixedly connected with the block body 71 sleeved thereon, and does not rotate relative to it, and the connecting shaft 80 can be fixed on the second vernier 51 through adjustment. The bolt is thus rotated.

The first angle disc 60 may be fixedly connected to the protrusion of the second vernier 51 through a support located below it, and the first angle disc 60 extends in the x-z plane and has a scale for marking the angle. The second angle plate 70 is fixedly connected to the block 71 of the first rotating member 71 , 80 , and the second angle plate 70 extends in a plane perpendicular to the first angle plate 60 and has a scale for indicating the angle.

Preferably, the second angle disk 70 is arranged adjacent to the first angle disk 60 , so that the projection of the second angle disk 70 on the first angle disk 60 can be used to identify the first rotating member 71 , 80 relative to the first angle disk 60 of rotation angle. Fig. 3 is a structural schematic diagram of the first angle disk and the second angle disk, from which the angle indication can be clearly read. Wherein, the first angle disk 60 can be made of transparent or translucent material, so that even on the back of the first angle disk 60 , the indication of the angle indicated by the projection of the second angle disk 70 on it can still be seen. In one embodiment of the present invention, the second angle disc 70 can also be made of transparent or translucent material, so that the positions of the first angle disc 60 and the second angle disc 70 can be clearly read in any orientation or angle. Indication, improve work efficiency.

In a preferred embodiment of the present invention, as shown in FIG. 2 , the spinal minimally invasive positioning system further includes a second rotating member 92 . The second rotating member 92 is connected with the first rotating member 71 , 80 so as to be able to rotate along a second rotating axis perpendicular to the second angle plate 70 . The indicator needle 93 is connected with the second rotating member 92 and can rotate with the second rotating member 92 . In a preferred embodiment of the present invention, as shown in FIG. 2 , the indicator needle 93 is arranged adjacent to the second angle dial 70 to more clearly identify the rotation angle of the second rotating member 92 relative to the second angle dial 70 .

As shown in FIG. 2 , the spinal minimally invasive positioning system further includes a needle holder 91 connected to the second rotating member 92 and used for holding the puncture needle 10 . Specifically, the needle holder 91 is disposed in the circular through hole of the second rotating member 92 . In one embodiment, the second rotating member 92 and the needle holder 91 may be integrally formed. In other embodiments, the second rotating member 92 and the needle holder 91 may also be connected through threads.

According to another aspect of the present invention, there is also provided an application of a spinal minimally invasive positioning system in spinal minimally invasive positioning, which includes the following steps: firstly, providing any one of the aforementioned spinal minimally invasive positioning systems. When the patient is lying on the operating bed or operating table, determine the three-dimensional direction in the minimally invasive spinal positioning system, then take the first X-ray picture along the x-axis direction, and record the first puncture point on the surface of the bone and the puncture point inside the bone First position information of the second puncture point in the y-z plane; then take a second x-ray picture along the y-axis direction, and record the first puncture point on the bone surface and the second puncture point inside the bone in the x-z plane second position information; determine the direction and angle to be positioned according to the first position information and the second position information; and adjust the spinal minimally invasive positioning system so that the puncture needle 10 is consistent with the positioned direction and angle.

So far, those skilled in the art should appreciate that, although a number of exemplary embodiments of the present invention have been shown and described in detail herein, without departing from the spirit and scope of the present invention, the disclosed embodiments of the present invention can still be used. Many other variations or modifications consistent with the principles of the invention are directly identified or derived from the content. Accordingly, the scope of the present invention should be understood and deemed to cover all such other variations or modifications.

Claims (10)

1. A spinal minimally invasive positioning system for positioning the puncture needle (10) to a predetermined puncture position, comprising: base (20); a z-axis guide rod (30), arranged on the base (20) along the z-axis direction; A z-axis scale (301) for identifying the position of the z-axis; A first scale (40) extending along the x-axis direction and a first vernier (41) capable of sliding along the first scale (40), the first scale (40) is connected to the The z-axis guide rod (30) can move in the z-axis direction along the z-axis guide rod (30); A second scale (50) extending along the y-axis direction and a second vernier (51) capable of sliding along the second scale (50), the second scale (50) being connected to the first vernier (41) and can move with the first cursor (41); a first angle disc (60) fixedly connected to said second vernier (51), which extends in the x-z plane and has a scale for marking the angle; a first rotating member (71, 80) connected to said second vernier (51) and capable of rotating relative to said second vernier (51) along a first central rotational axis parallel to the y-axis; a second angle plate (70) fixedly connected to said first rotating member (71, 80), which extends in a plane perpendicular to said first angle plate (60) and has a scale for indicating the angle; a second rotating member (92), which is connected to the first rotating member (71, 80) so as to be able to rotate along a second rotating axis perpendicular to the second angle plate (70); The indicator needle (93) connected with the second rotating member (92) can rotate with the second rotating member (92) and is arranged adjacent to the second angle plate (70) to identify the The rotation angle of the second rotating member (92) relative to the second angle plate (70); and A needle holder (91) connected to said second rotating member (92) for holding said puncture needle (10). 2. The spinal minimally invasive positioning system according to claim 1, characterized in that, the second angle disc (70) is arranged adjacent to the first angle disc (60), so that the second angle disc (70) ) on the first angle disk (60) can be used to identify the rotation angle of the first rotating member (71, 80) relative to the first angle disk (60). 3. The spinal minimally invasive positioning system according to any one of claims 1-2, characterized in that, the first angle disc (60) is made of transparent or translucent material; The two-angle disc (70) is made of transparent or translucent material. 4. The spinal minimally invasive positioning system according to any one of claims 1-3, characterized in that, The second rotating member (92) is integrally formed with the needle holder (91). 5. The spinal minimally invasive positioning system according to any one of claims 1-4, characterized in that, The second vernier (51) includes a protrusion extending along the x-axis direction, the first angle disc (60) and the first rotating member (71, 80) are arranged at the protrusion, so that the first rotating member (71, 80) is away from the second scale (50); Optionally, the first rotating member (71, 80) includes a connecting shaft (80) connected to the first angle disc (60) and a block (71) sleeved on the connecting shaft (80). 6. The spinal minimally invasive positioning system according to any one of claims 1-5, further comprising an x-axis guide rod (401) extending along the x-axis direction, the x-axis guide rod (401) The first end is movably fixed on the z-axis guide rod (30) and can move along the z-axis guide rod (30); the second end of the x-axis guide rod (401) passes through the connecting block ( 402) being connected with the first scale (40); Optionally, a scale is provided on the x-axis wire rod (401). 7. The spinal minimally invasive positioning system according to any one of claims 1-6, characterized in that the base (20) is configured to be detachably connected to an operating table for puncturing. 8. The spinal minimally invasive positioning system according to any one of claims 1-7, characterized in that, said base (20) comprises a y-axis guide rod (22) extending along the y-axis direction, said z An axis guide rod (30) is slidably connected to the y-axis guide rod (22); optionally, the y-axis guide rod (22) is provided with a scale. 9. The spinal minimally invasive positioning system according to any one of claims 1-8, characterized in that, The z-axis scale (301) is formed on the surface of the z-axis guide rod (30), or The z-axis scale (301) is independent from the z-axis guide rod (30), and is arranged on the base (20). 10. The application of a spinal minimally invasive positioning system in spinal minimally invasive positioning, comprising the following steps: The minimally invasive spinal positioning system according to any one of claims 1-9 is provided; Take the first x-ray picture along the x-axis direction, record the first position information of the first puncture point on the bone surface and the second puncture point inside the bone in the y-z plane; take the second x-ray picture along the y-axis direction , recording the second position information of the first puncture point on the bone surface and the second puncture point inside the bone in the x-z plane; determining a direction and an angle to be positioned according to the first position information and the second position information; and The minimally invasive spinal column positioning system is adjusted to make the puncture needle (10) consistent with the positioning direction and angle.