技术领域technical field
本发明涉及医疗领域，尤其涉及一种脊柱手术辅助装置。The invention relates to the medical field, in particular to an auxiliary device for spinal surgery.
背景技术Background technique
脊柱手术需要进行精确定位，因为病变往往位于椎管内部，定位不准不仅难以发现病变，更需要打开更多不必要的脊柱节段，易致脊柱稳定性丧失。Spinal surgery requires precise positioning, because lesions are often located inside the spinal canal. Inaccurate positioning not only makes it difficult to find lesions, but also requires opening more unnecessary spinal segments, which can easily lead to loss of spinal stability.
在行脊柱后路手术时，尤其是胸段及胸腰段手术，常因确定病变节段困难而反复透视，不仅给患者带来更多放射性损伤，影响手术进程，甚至发生定位错误、脊髓神经损伤等并发症。而对于没有术中X线透视的手术室，，椎体更只能靠术前通过体表触摸或者体表贴标记物后行X线检查定位，但上述方法定位有失精准，常因解剖变异或皮肤移位致定位错误，最终给患者带来额外的脊柱骨性乃至脊髓神经损伤等并发症。During posterior spinal surgery, especially thoracic and thoracolumbar surgery, repeated fluoroscopy is often required due to the difficulty in determining the lesion segment, which not only brings more radiation damage to the patient, affects the operation process, and even causes positioning errors, spinal nerves, etc. Complications such as injury. For the operating room without intraoperative X-ray fluoroscopy, the vertebral body can only be positioned by X-ray inspection after the body surface is touched or the body surface is pasted with markers before the operation. Or skin displacement leads to positioning errors, which will eventually bring additional complications such as spinal bone and even spinal nerve injury to the patient.
柱传统脊柱定位方法有很多，各有其局限性：(1)髂前上棘定位法对体形肥胖或退变导致棘突间隙不清者容易导致判断错误，而且该定位方法依赖于医生的经验。(2)肋骨定位法对术前X线片及术中透视的清晰度要求较高。肠内气体及粪便影可影响对T12肋骨的判断。另外，由于脊柱可能存在先天变异，如肋骨缺如、骶椎腰化、腰椎骶化等容易导致定位错误。(3)皮肤标记物定位法是临床较为常用的胸椎定位方法。但由于术中体位与摄片体位不一致或皮肤移动致皮肤记号与骨性棘突对应位置发生移动而使定位不十分准确，尤其对肥胖的患者，误差更大。(4)克氏针定位法是临床上最常用的脊柱定位方法。因透视视野只能包括3-4个椎体，C型臂X线机影像增强器装置、克氏针距离椎体较远。平移C型臂X线机透视近端椎体时由于透视球管中心的移动，连续透视影像中同一克氏针在同一椎体上的投影会发生位移，越往近端移动，误差越大，需反复透视定位方能确定病变节段。There are many traditional spine positioning methods, and each has its own limitations: (1) The positioning method of the anterior superior iliac spine is likely to lead to misjudgment for obese or degenerated patients with unclear spinous process gaps, and this positioning method relies on the experience of doctors . (2) The rib positioning method has higher requirements on the clarity of preoperative X-ray films and intraoperative fluoroscopy. Intestinal gas and feces can affect the judgment of T12 ribs. In addition, because there may be congenital variations in the spine, such as the absence of ribs, lumbar lumbar sacralization, and lumbar sacralization, it is easy to cause positioning errors. (3) The skin marker localization method is a commonly used clinical thoracic vertebra localization method. However, due to the inconsistency between the intraoperative body position and the photographic body position or the movement of the skin, the corresponding position of the skin mark and the bony spinous process is shifted, so the positioning is not very accurate, especially for obese patients, the error is even greater. (4) The Kirschner wire positioning method is the most commonly used clinical spine positioning method. Because the fluoroscopy field of view can only include 3-4 vertebral bodies, the image intensifier device and Kirschner wire of the C-arm X-ray machine are far away from the vertebral bodies. When translating the C-arm X-ray machine to see through the proximal vertebral body, due to the movement of the center of the fluoroscopy tube, the projection of the same Kirschner wire on the same vertebral body in the continuous fluoroscopy images will be displaced. The more you move to the proximal end, the greater the error. Repeated fluoroscopy positioning is required to determine the lesion segment.
发明内容Contents of the invention
发明的目的：为了提供一种功能更好的脊柱手术辅助装置，具体目的见具体实施部分的多个实质技术效果。Purpose of the invention: In order to provide a spinal surgery assisting device with better functions, the specific purpose is shown in the multiple substantive technical effects in the specific implementation part.
为了达到如上目的，本发明采取如下技术方案：In order to achieve the above object, the present invention takes the following technical solutions:
一种脊柱手术辅助装置，其特征在于，包含套筒，所述套筒包含中空的筒状结构，还包含能穿过筒状结构的插针，所述插针包含突起的插针端部，所述筒状结构中还能穿入定位钉，所述定位钉包含尖顶、中间带螺纹的体部和非尖顶一端的凹陷，还包含能和该凹陷嵌合的安装手柄，所述安装手柄包含手柄转柄和旋转头，所述旋转头包含突起，所述旋转头和定位钉的凹陷能够契合。An auxiliary device for spinal surgery, characterized in that it includes a sleeve, the sleeve includes a hollow cylindrical structure, and also includes a pin that can pass through the cylindrical structure, and the pin includes a protruding pin end, A positioning nail can also be inserted into the cylindrical structure, and the positioning nail includes a pointed top, a threaded body in the middle, and a depression at one end of the non-pointed top, and also includes an installation handle that can fit into the depression, and the installation handle includes A handle turns a handle and a swivel head, the swivel head includes a protrusion, and the swivel head can fit into the recess of the positioning nail.
本发明进一步技术方案在于，所述套筒包含两个边翅片。A further technical solution of the present invention is that the sleeve includes two side fins.
本发明进一步技术方案在于，所述旋转头包含的突起为磁性材料，所述定位钉能够和该磁性材料吸引。A further technical solution of the present invention lies in that the protrusion included in the rotating head is made of magnetic material, and the positioning nail can be attracted to the magnetic material.
本发明进一步技术方案在于，所述凹陷为方形槽或者是十字槽。The further technical solution of the present invention is that the depression is a square groove or a cross groove.
采用如上技术方案的本发明，相对于现有技术有如下有益效果：能够准确定位，使用方便安全，创伤小，容易恢复，不容易引发并发症。Compared with the prior art, the present invention adopting the above technical solution has the following beneficial effects: accurate positioning, convenient and safe use, less trauma, easy recovery, and less likely to cause complications.
附图说明Description of drawings
为了进一步说明本发明，下面结合附图进一步进行说明：In order to further illustrate the present invention, further describe below in conjunction with accompanying drawing:
图1为穿刺部分的结构示意图；Fig. 1 is the structural representation of puncture part;
图2为套筒截面结构示意图；Fig. 2 is a schematic diagram of the cross-sectional structure of the sleeve;
图3为定位钉及旋转手柄位于套筒内时的结构示意图；Fig. 3 is a structural schematic diagram when the positioning nail and the rotating handle are located in the sleeve;
图4为定位钉的结构示意图；Fig. 4 is the structural representation of positioning pin;
图5为固定好定位钉于脊椎棘突上的结构示意图；Fig. 5 is a schematic structural view of fixing the positioning nail on the spinous process of the spine;
其中：1.套筒；2.边翅片；3.插针；4.插针端部；5.脊椎的棘突；6.定位钉；7.手柄转柄；8.旋转头。Among them: 1. Sleeve; 2. Side fin; 3. Pin; 4. End of pin; 5. Spinous process of spine;
具体实施方式Detailed ways
下面结合附图对本发明的实施例进行说明，实施例不构成对本发明的限制：Embodiment of the present invention is described below in conjunction with accompanying drawing, embodiment does not constitute limitation of the present invention:
一种脊柱手术辅助装置，其特征在于，包含套筒1，所述套筒包含中空的筒状结构，还包含能穿过筒状结构的插针3，所述插针包含突起的插针端部4，所述筒状结构中还能穿入定位钉6，所述定位钉6包含尖顶、中间带螺纹的体部和非尖顶一端和非尖顶一侧的凹陷，还包含能和该凹陷嵌合的安装手柄，所述安装手柄包含手柄转柄7和旋转头8，所述旋转头8包含突起，所述旋转头8和定位钉6的凹陷能够契合。本处的技术方案所起到的实质的技术效果及其实现过程为如下：X线下初步体表定位目标节段脊椎棘突，局部麻醉，然后使用插针穿过套筒1，穿透皮肤、肌肉到达脊椎骨的棘突，拔出插针，留下套筒；随后将安装手柄上8的凸起和定位钉6的凹陷嵌合好后一起插入套筒1，用安装手柄转柄7旋转将定位钉6旋入棘突内部；撤出套筒和安装手柄，完成过程。通过X射线再次定位定位钉6所在椎体节段，完成精确定位，手术完成后，取出定位钉即可。定位准确。An auxiliary device for spinal surgery, characterized in that it includes a sleeve 1, the sleeve includes a hollow cylindrical structure, and also includes a pin 3 that can pass through the cylindrical structure, and the pin includes a protruding pin end part 4, the positioning nail 6 can also be penetrated into the cylindrical structure, and the positioning nail 6 includes a pointed top, a threaded body in the middle, a non-pointed end and a depression on the non-pointed side, and can be embedded with the concave Fitted installation handle, the installation handle includes a handle handle 7 and a swivel head 8, the swivel head 8 includes a protrusion, and the swivel head 8 and the depression of the positioning nail 6 can fit. The actual technical effect and the realization process of the technical solution here are as follows: under the X-ray, initially locate the spinous process of the target segment on the body surface, perform local anesthesia, and then use the insertion needle to pass through the sleeve 1 and penetrate the skin 1. When the muscle reaches the spinous process of the spine, pull out the pin and leave the sleeve; then fit the protrusion 8 on the installation handle and the depression of the positioning nail 6 into the sleeve 1 together, and rotate it with the installation handle 7 Screw the positioning pin 6 into the inside of the spinous process; withdraw the sleeve and install the handle to complete the process. The vertebral body segment where the positioning nail 6 is located is repositioned by X-ray to complete precise positioning. After the operation is completed, the positioning nail can be taken out. Positioning accuracy.
经过对90例胸腰段椎管内肿瘤病例，术前或术中分别采用本专利(定位钉)定位法，以及临床最常用的皮肤标记定位法和克氏针定位法进行定位(每组各30例)，发现本专利能有效进行脊柱节段定位，且定位准确率高，30例中无1例错误定位，而选择皮肤标记定位法的30人中定位错误的有9例，克氏针定位法的30人中定位错误的有4例。选择本专利定位法定位的患者需接受透视的次数也明显低于其他传统定位方法：本专利定位法平均每人需接受照射2次；皮肤标记定位法和克氏针定位法平均每人需接受透视3.1次和3.76次。同时，由于本专利定位次数少，缩短了手术时间，减少了术中操作，故而显著降低了感染率，30例中仅有1例感染；而皮肤标记定位法和克氏针定位法30人中的感染人数分别为3人和4人。所以本专利较其他传统方法具有定位准确，患者接受放射性照射次数少，感染几率低的优势，明显减轻了患者痛苦。After 90 cases of intraspinal tumor cases in the thoracolumbar segment, this patent (positioning nail) positioning method, and the most commonly used clinical skin marking positioning method and Kirschner wire positioning method were used for positioning before or during the operation (each group each 30 cases), it was found that this patent can effectively locate the spinal segment, and the positioning accuracy rate is high. There is no wrong positioning in 30 cases, and there are 9 cases of wrong positioning in the 30 people who choose the skin marking positioning method. Kirschner wire There are 4 cases of wrong positioning among 30 people in the positioning method. Patients who choose this patented positioning method need to receive fluoroscopy times are also significantly lower than other traditional positioning methods: this patented positioning method requires an average of 2 irradiations per patient; skin marking positioning method and Kirschner wire positioning method require an average of Perspective 3.1 times and 3.76 times. At the same time, due to the less number of positioning times in this patent, the operation time is shortened, and the intraoperative operation is reduced, so the infection rate is significantly reduced, and only 1 infection occurs in 30 cases; The number of infected people was 3 and 4 respectively. Therefore, compared with other traditional methods, this patent has the advantages of accurate positioning, fewer times of radiation exposure for patients, and lower chance of infection, which obviously reduces the suffering of patients.
传统定位方法说明：Description of traditional positioning methods:
1.皮肤标记物定位法：术前在棘突或棘突间皮肤上放置金属标记物。如回形针等，在放射科行胸腰椎正位X线片检查后做皮肤表面记号。术中根据皮肤表面记号进行切口及椎体的选择。术中如发现定位失败，则采用C型臂X线机进行侧方透视，从骶椎依次向上透视至所需节段。1. Skin marker positioning method: metal markers are placed on the skin between spinous processes or between spinous processes before surgery. Such as paper clips, etc., after the radiology department performs the thoracolumbar anteroposterior X-ray examination, make skin surface marks. During the operation, the incision and vertebral body were selected according to the marks on the skin surface. If positioning failure is found during the operation, a C-arm X-ray machine is used for lateral fluoroscopy, from the sacral vertebra upward to the required segment.
2.克氏针定位法：术前在放射科行胸腰椎正位X片检查了解椎体有无变异，术中在躯干侧方平行垂直插数根不同粗细的克氏针应用C型臂X线机进行侧方透视，从骶椎根据克氏针与椎体的关系依次向上透视至所需节段。2. Kirschner wire positioning method: Before the operation, take an anteroposterior X-ray of the thoracolumbar spine in the radiology department to find out whether there is any variation in the vertebral body. The thread machine performs lateral perspective, from the sacrum to the required segment upwards in sequence according to the relationship between the Kirschner wire and the vertebral body.
所述定位钉6的尖顶后方包含带螺纹的体部。本处的技术方案所起到的实质的技术效果及其实现过程如下，没有螺纹难以固定于棘突，有了螺纹后旋进去更方便。The dowel 6 comprises a threaded body behind the apex. The substantive technical effect and the realization process of the technical solution here are as follows, it is difficult to be fixed on the spinous process without the thread, and it is more convenient to screw in after having the thread.
所述套筒1包含两个边翅片2。翅片能够帮助固定和旋转操作。Said sleeve 1 comprises two side fins 2 . Fins assist in both stationary and rotational operations.
所述旋转头8包含的突起为磁性材料，所述定位钉6能够和该磁性材料吸引。本处的技术方案所起到的实质的技术效果及其实现过程如下，能直接吸引着定位钉6进行操作。The protrusion contained in the rotating head 8 is a magnetic material, and the positioning nail 6 can be attracted to the magnetic material. The substantive technical effect and the realization process of the technical solution here are as follows, which can directly attract the positioning nail 6 for operation.
所述定位钉6固定入棘突后能实现精确定位，不会偏移。After the positioning nail 6 is fixed into the spinous process, precise positioning can be realized without deviation.
定位钉6从右往左包含尖顶段，中部为带螺纹的体部，右部为带凹陷的平滑段，结合图4。The positioning nail 6 includes a sharp top section from right to left, the middle part is a threaded body, and the right part is a concave smooth section, as shown in FIG. 4 .
需要说明的是，本专利提供的多个方案包含本身的基本方案，相互独立，并不相互制约，但是其也可以在不冲突的情况下相互组合，达到多个效果共同实现。It should be noted that the multiple solutions provided by this patent include their own basic solutions, which are independent of each other and do not restrict each other. However, they can also be combined without conflict to achieve multiple effects together.
以上显示和描述了本发明的基本原理、主要特征和本发明的优点。本领域的技术人员应该了解本发明不受上述实施例的限制，上述实施例和说明书中描述的只是说明本发明的原理，在不脱离本发明精神和范围的前提下，本发明还会有各种变化和改进，这些变化和改进都落入要求保护的范围内。The basic principles, main features and advantages of the present invention have been shown and described above. Those skilled in the art should understand that the present invention is not limited by the above-mentioned embodiments, and what described in the above-mentioned embodiments and the description only illustrates the principle of the present invention, and the present invention also has various aspects without departing from the spirit and scope of the present invention. Variations and improvements all fall within the scope of the claimed protection.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201410515033.XACN104257420A (en) | 2014-09-30 | 2014-09-30 | Spinal operation assisting device |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201410515033.XACN104257420A (en) | 2014-09-30 | 2014-09-30 | Spinal operation assisting device |
| Publication Number | Publication Date |
|---|---|
| CN104257420Atrue CN104257420A (en) | 2015-01-07 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201410515033.XAPendingCN104257420A (en) | 2014-09-30 | 2014-09-30 | Spinal operation assisting device |
| Country | Link |
|---|---|
| CN (1) | CN104257420A (en) |
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| Date | Code | Title | Description |
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| C06 | Publication | ||
| PB01 | Publication | ||
| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| RJ01 | Rejection of invention patent application after publication | ||
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