CN203089352U - Guide device for setting needle on vertebral column posterior without rays - Google Patents

Abstract

The utility model discloses a guide device for setting a needle on vertebral column posterior without rays. The guide device comprises a positioning frame among spines, a slide scale and an angle change-over lever. The guide device for setting the needle on the vertebral column posterior without the rays has the advantages that (1) operation is simple, mastering is easy, doctor acceptability is good; (2) a needle setting effect is reliable; (3) price is low; (4) ray exposure of patients and medical workers can be reduced obviously; (5) in a small incision minimally invasive needle setting operation, protrusions in small thorn shape on a base can be guaranteed to be accurately positioned between two spines outside the skin even if supraspinal ligaments are not exposed, the guide device is suitable for minimally invasive operations and incision operations, and the application range is wide.

Description

A guide device for radiographic screw placement in posterior spinal column

technical field

The utility model relates to a guide device for placing nails in the posterior spine without radiation, which belongs to the field of medical instruments.

Background technique

Pedicle screw technology has developed rapidly since its advent in the 1980s, and has been widely used in the surgical treatment of spinal degeneration, spondylolisthesis, spinal stenosis, vertebral fractures, deformities, bone metastases, and spinal instability. . At present, pedicle screws are one of the most widely used internal fixation devices in spinal surgery, but in actual operation, the process of screw placement requires repeated perspectives, especially in small incisions or percutaneous minimally invasive screw placement , the number of perspectives is significantly increased. At present, the damage of repeated low-dose radiation exposure to patients and medical staff is not yet clear, but it is the consensus of all spine surgeons to reduce the radiation exposure of patients and medical staff during spinal surgery.

At present, the positioning of intraoperative nails depends on the X-ray machine. Intraoperative operation requires repeated fluoroscopy and adjustment. The amount of radiation during small incision nail placement requires repeated fluoroscopy, which significantly prolongs the radiation exposure of patients and medical staff, and prolongs the operation. Time, and intraoperative fluoroscopy also increases the probability of surgical incision infection. Although the latest robotic system does not require fluoroscopy during the nail placement process, it requires pre-embedded positioning metal needles and CT scanning. The patient's radiation exposure has not been reduced, and additionally increases the pain of positioning needle placement. . In addition, robots are expensive, and currently only a few hospitals in the world use them, so they cannot be popularized.

Utility model content

Purpose of the utility model: The purpose of the utility model is to provide an accurate, fast and convenient guide device for nail placement when performing posterior spinal screw placement operations. This device can be used for placement without or with the assistance of a very small amount of radiation. Nail operation, significantly reducing the radiation exposure of patients and medical staff.

Technical solution: a guide device for spinal posterior radiographic nail placement according to the utility model, including an interspinous process positioning frame, a sliding scale and an angle conversion rod;

The positioning frame between spinous processes includes a plate base, a C-shaped handle, an upper splint and a lower splint, the sides of the upper splint and the lower splint are respectively fixedly connected to the two ends of the C-shaped handle, and the upper splint It is parallel to the lower splint, and the opposite surface is respectively provided with an upper chute and a lower chute along its length direction. Slide between them, and the bottom end of the lower splint is fixedly connected with the plate-shaped base through the connecting column;

The outer surface of the sliding ruler is provided with an angle dial, and the center of the angle dial is provided with a circular hole, and a runner is provided in the circular hole, and a pointer pointing to the angle dial is provided on the runner, so A through hole with a square cross section is opened in the runner, the axis of the tube through hole overlaps with the axis of the circular hole, the symmetry axis of the pointer overlaps with the symmetry axis of the outer end surface of the through hole and is perpendicular to one side of the outer end surface ;

The angle conversion rod includes a square metal rod and a tubular member that match the through hole, and one end of the metal rod is inserted into the through hole so that the rotation of the metal rod is consistent with the rotation of the pointer and can slide in the through hole, The other end of the metal rod is connected to the tubular member, and the tubular member can rotate around the other end of the metal rod through the connecting piece. The axis of the metal rod passes through the axis of the tubular member, and the metal rod is provided with a reminder The inner diameter of the tubular member is equal to the diameter of the pedicle screw-opening cone, and finally guides the screw-setting angle of the open-circuit cone through the tubular structure.

The lower splint is fixedly connected to the plate-shaped base through the connecting column, so that the base has a double-sided valgus-shaped design, which is convenient for intraoperative placement, especially can be easily inserted into the subcutaneous area.

The handle is a C-shaped structure connecting the upper and lower splints, and the middle part is the gripping part, which is mainly for the convenience of holding during the operation, and the C-shaped design can avoid the interference of the connecting structure between the upper and lower splints on the angle conversion rod. Affects the sliding of the slider.

To further improve the above technical solution, the other end of the metal rod has a through hole along its width direction, and the tubular member is connected to the through hole through two hinges on its side wall, and the hinge is engraved with a symbol for prompting rotation. Tip scale for angles.

To further improve the above technical solution, the lower surface of the plate-shaped base is provided with a nail-like protrusion, which is convenient to be fixed on the supraspinous ligament; If you hit this site, the protrusions on the base will anchor to the supraspinous ligament.

Specific operations during the operation: Before operation, the sagittal and lateral lumbar MRI films of the patient were measured, and the angle between the ideal screw placement angle and the vertical line of the supraspinous ligament and the projection of the pedicle on the anterior lumbar spine were measured. After the distance between the margin and the midpoint of the spinous process:

In the first step, after the surgical exposure is completed and the pedicle needle insertion point is preliminarily determined, the positioning frame of the guide device is fixed between the vertebral body of the nail insertion segment and the spinous process of the previous vertebral segment, that is, hold it by hand Hold the handle and use a hammer to lightly tap the columnar protrusion on the top of the positioning frame, and then the positioning frame will be stably fixed on the spinous process through the nail-shaped protrusion.

In the second step, the assistant holds the C-shaped handle to stabilize the positioning frame, and the operator correctly places the angle conversion rod, that is, keeps the tubular member roughly parallel to the pointer, and inserts the metal rod into the square hole when the pointer is at zero degrees. The open-circuit cone passes through the tubular structure, and then adjusts the direction of the open-circuit cone by properly rotating the tubular member (because the pointer and the tubular member are linked, so the pointer will generally deviate from zero) and adjusts the distance between the tubular member and the sliding scale, so that the open-circuit cone Place the distal end at the position of the proposed pin point, move the sliding scale so that the pointer points to the zero degree in the middle of the angle dial, at this time, the direction of the pointer is consistent with the direction of the open cone, and the direction of the base and supraspinous ligament is Consistent, when the pointer points to 0°, it indicates that the pointer and the base are vertical, that is, the opening cone and the supraspinous ligament are vertical, according to the ideal screw placement angle measured before operation and the vertical line of the supraspinous ligament Then move the sliding scale appropriately to adjust the angle of head deviation and tail deviation.

The third step is to keep the camber angle of the control tubular member at 0°, observe the scale on the angle conversion rod, and then compare the distance between the outer edge of the pedicle projection and the center of the spinous process on the preoperative lumbar anteroposterior film, which can be further determined Whether the selection of the pointer point is appropriate, if it is significantly shorter than the preoperative measurement, it indicates that there is a risk of entering the spinal canal. After the needle placement point is determined, the camber angle can be properly controlled and the open-circuit cone can be tapped.

Compared with the prior art, the utility model has the beneficial effects as follows: (1) simple operation, easy to master, and good acceptance by doctors; (2) reliable nail placement effect; (3) cheap price; and radiation exposure of medical staff; (5) In the operation of minimally invasive nail placement through small incisions, even if the supraspinous ligament is not exposed, the small spine-like protrusions at the base can still ensure that they can be accurately positioned between the two spinous processes across the skin, It is feasible for both minimally invasive and open surgery, and has a wide range of applications.

Description of drawings

Fig. 1 is the structural representation of the utility model.

Detailed ways

The technical solutions of the utility model are described in detail below, but the protection scope of the utility model is not limited to the embodiments.

Embodiment 1: As shown in Figure 1, a guiding device for radiographically placed nails in the posterior spinal column, including an interspinous process positioning frame, a sliding scale 1, and an angle conversion rod;

The positioning frame between the spinous processes comprises a plate-like base 2, a C-shaped handle 3, an upper splint 4 and a lower splint 5, and the sides of the upper splint 4 and the lower splint 5 are connected to the two end surfaces of the C-shaped handle 3 respectively. Fixedly connected, the upper splint 4 and the lower splint 5 are parallel to each other, and an upper chute and a lower chute are respectively opened on the opposite surface along its length direction, and the upper and lower sides of the sliding scale 1 are respectively arranged on the upper chute and the lower chute. groove, and can slide between the upper splint 4 and the lower splint 5, the bottom end of the lower splint 5 is fixedly connected with the plate-shaped base 2 through the connecting column 6, and the lower surface of the plate-shaped base 2 is provided with a nail-shaped Protrusion, the top surface of the upper splint 4 is provided with a columnar protrusion 7;

The outer surface of described sliding ruler 2 is provided with angle dial 8, and the center of described angle dial 8 has circular hole, is provided with runner in described circular hole, and described runner can be moved by the annular groove of side wall. Rotatingly engaged around the circular hole, a pointer 9 is fixed on the side wall of the runner close to the outer end surface, and a through hole with a square cross section is opened in the runner, the axis of the through hole is in line with the circle The axes of the holes overlap, and the symmetry axis of the pointer 9 overlaps with the symmetry axis of the outer end surface of the through hole and is perpendicular to one side of the outer end surface;

The angle conversion lever includes a square metal rod 10 matching the through hole and a tubular member 11 connected to one end of the metal rod 10, and the other end of the metal rod 10 is inserted into the through hole, so that the rotation of the metal rod 10 and The rotation of the pointer 9 remains consistent and can slide back and forth in the through hole to adjust the distance between the tubular member 11 and the sliding scale 2. One end of the metal rod 10 has a through hole along its width direction, and the tubular member 11 passes through the Two hinges 12 on its side wall are connected with the through hole, the axis of the metal rod 10 passes through the axis of the tubular member 11, and the tubular member 11 can rotate around the other end of the metal rod 10 to adjust the tubular The camber angle of the member 11, the hinge 12 is engraved with a prompt scale for prompting the rotation angle, that is, there are scales for prompting 10°, 15°, and 20°, and the metal rod 10 is engraved with a scale, which can prompt the far The precise distance between the shaft center of the end tubular member 11 and the sliding scale 2, the inner diameter of the tubular member 11 is equal to the diameter of the open-circuit cone for pedicle screw placement.

As stated above, although the invention has been shown and described with reference to certain preferred embodiments, this should not be construed as limiting the invention itself. Various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the appended claims.

Claims (3)

1. A guiding device for spinal posterior spine without radiation, comprising a positioning frame between spinous processes, a sliding scale and an angle conversion rod; The positioning frame between spinous processes includes a plate base, a C-shaped handle, an upper splint and a lower splint, the sides of the upper splint and the lower splint are respectively fixedly connected to the two ends of the C-shaped handle, and the upper splint It is parallel to the lower splint, and an upper chute and a lower chute are respectively opened on the opposite surface along its length direction. Sliding between the splints, the bottom end of the lower splint is fixedly connected with the plate-shaped base through the connecting column; The outer surface of the sliding ruler is provided with an angle dial, and the center of the angle dial is provided with a circular hole, and a runner is provided in the circular hole, and a pointer pointing to the angle dial is provided on the runner, so A through hole with a square cross-section is opened in the runner, the axis of the through hole overlaps with the axis of the circular hole, the symmetry axis of the pointer overlaps with the symmetry axis of the outer end surface of the through hole and is perpendicular to one side of the outer end surface; The angle conversion rod includes a square metal rod and a tubular member that match the through hole, one end of the metal rod is inserted into the through hole, and the other end of the metal rod is connected to the tubular member, and the tubular member can be wound around through the connector. The other end of the metal rod rotates, the axis of the metal rod passes through the axis of the tubular member, and the metal rod is provided with a scale indicating the distance between the axis of the tubular member and the sliding scale. The diameters of the opening cones for pedicle screw placement are equal. 2. The guide device for spinal posterior radiographic nail placement according to claim 1, characterized in that, the other end of the metal rod has a through hole along its width direction, and the tubular member passes through two sides of its side wall. A hinge is connected with the through hole, and the hinge is engraved with a prompt scale for prompting the rotation angle. 3 . The guiding device for radiographic nail placement in the posterior spinal column according to claim 1 , wherein the lower surface of the plate-shaped base is provided with a nail-shaped protrusion, and the top surface of the upper splint is provided with a column-shaped protrusion. 4 .