Vertebral column minimally invasive positioning system and its application in vertebral column minimally invasive positioningTechnical field
The present invention relates to minimally invasive surgical techniques fields, more particularly, to a kind of vertebral column minimally invasive positioning system and its in ridgeApplication in the minimally invasive positioning of column.
Background technique
Micro-wound surgical operation is using advanced tool (such as computer, special puncture guide pin, special drag hook and imageEquipment), traditional operation is completed by special operative approach, and least tissue damage, most light is generated to patient to reachPsychological impact, most fast rehabilitation and best surgical effect.
Minimally invasive spine surgical is the various spinal diseases for the treatment of (such as the osteoporotic compression fracture, ridge of rising in recent yearsColumn traumatic fractue, the protrasion of the lumbar intervertebral disci, lumbar spinal stenosis etc.) operation method, it have notch is small, wound is small, handMultiple advantages such as the art time is short, postoperative effect is good.But also have disadvantage, a key of the operation be accurately positioned, includingSkin incision, operation pathway and position where lesion etc..If position inaccurate, it is possible to cause more serious damage, such asImportant nerve, blood vessel etc. around damage.The methods of the various body surface symbols positioning of the past, metal marker positioning positioning are not quasi- enoughReally, it needs repeatedly to have an X-rayed in surgical procedure；Not only operating time is increased, but also medical staff and patient is made repeatedly to be exposed to x-ray spokeIt penetrates down, by the x-ray bombardment compared with routine operation several times or even dozens of times dosage.
Minimally invasive procedure is developing direction from now on, and the main operation of one of them is fixed in percutaneous screw.At presentIt is completed under existing Internal fixation technology or incision direct-view or in the case where x-ray is continuously had an X-rayed, patient or medical worker is causedGreat damage.Existing locator, sighting device, guider cannot reach accurate purpose, only have the computer aided manufacturing assistant director of a film or play at presentBoat system can solve this problem, and structure is complicated for operation guiding system, and expensive (about 4,000,000/set), learning curve is long,Accuracy is also to be improved.
An other minimally invasive spinal surgery technology is spinal endoscopes operation, for treating protrasion of the lumbar intervertebral disci etc..ButThe operation must make the percutaneous Direct perforantes of surgical instrument, accurately arrive at " triangle of safety workspace ", could be in Microendoscopic safetySuccessfully carry out the resection operation of lumbar disc herniation.Needle localization it is accurate whether, whether determining entire operation smoothly, veryTo be the key that determine operation success or failure.Entire puncture process is carried out under the perspective monitoring of C-arm X-ray machine, and the puncture time gets overLength, number are more, it is meant that the x-ray exposed amount of patient and patient obviously increase.
Summary of the invention
The purpose of the present invention is intended to provide a kind of vertebral column minimally invasive positioning system and its application in vertebral column minimally invasive positioning, fromAnd make the positioning of minimally invasive spine surgical more accurate, operating time is shortened, while it is sudden and violent too much to also avoid medical staffIt is exposed under radiation.
To solve the above-mentioned problems, according to an aspect of the invention, there is provided a kind of vertebral column minimally invasive positioning system, is used forPuncture needle is positioned to scheduled puncture position, comprising: pedestal；Z-axis guide rod, is set on the base along the z-axis direction；For markingKnow the z-axis scale of z-axis position；The first graduated scale extended along the x-axis direction and the first trip that can be slided along the first graduated scaleMark, the first graduated scale are connected to z-axis guide rod and can move in the z-axis direction along z-axis guide rod；Extend along the y-axis directionSecond graduated scale and the second vernier that can be slided along the second graduated scale, the second graduated scale be connected to the first vernier and can be withFirst vernier is mobile；It is fixedly attached to the first angle disk of the second vernier, extend in x-z-plane and is had for identifying angleThe scale of degree；First rotating member, is connected to the second vernier and can be relative to the second vernier along first center parallel with y-axisPivot axis；It is fixedly attached to the second angle disk of the first rotating member, is prolonged in the plane perpendicular to first angle diskIt stretches and there is the scale for indicating angle；Second rotating member, connecting into the first rotating member can be along perpendicular to second jiaoThe second rotation axis of scale rotates；The indicator connecting with the second rotating member can be rotated with the second rotating member, and adjacentIt is bordering on second angle disk arrangement, to identify rotational angle of second rotating member relative to second angle disk；Needle holder, connectionTo the second rotating member and for keeping puncture needle.
Further, second angle disk is arranged adjacent to first angle disk, so that second angle disk is on first angle diskProjection can be used in identifying rotational angle of first rotating member relative to first angle disk.
Further, first angle disk is made of transparent or semitransparent material；Optionally, second angle disk is by transparent or halfTransparent material is made.
Further, the second rotating member and needle holder are formed as an entirety.
Further, the second vernier includes a protrusion extended along the x-axis direction, first angle disk and the first rotating member clothIt sets at protrusion, so that the first rotating member is far from the second graduated scale；Optionally, the first rotating member includes and first angle diskThe connecting shaft of connection and the block being set in connecting shaft.
It further, further include the x-axis guide rod extended along the x-axis direction, the first end of x-axis guide rod is movably fixedIt can move on z-axis guide rod and along z-axis guide rod；The second end of x-axis guide rod is connected by link block and the first graduated scaleIt connects；Optionally, x-axis conductor rod is equipped with scale.
Further, pedestal is arranged to be detachably connectable to the station for being punctured.
Further, pedestal includes a y-axis guide rod extended along the y-axis direction, wherein z-axis guide rod slideably connectsIt is connected to y-axis guide rod；Optionally, y-axis guide rod is equipped with scale.
Further, z-axis scale is formed in z-axis guide rod surface or z-axis scale are set independently of z-axis guide rodIt sets on pedestal (20).
According to another aspect of the present invention, a kind of vertebral column minimally invasive positioning system answering in vertebral column minimally invasive positioning is providedWith, comprising the following steps: any of the above-described kind of vertebral column minimally invasive positioning system is provided；The first x light picture, note are shot along the x-axis directionRecord is located at the first point of puncture in bone surface and believes positioned at first position of second point of puncture in y-z plane of inside boneBreath；Shoot the 2nd x light picture along the y-axis direction, record is located at the first point of puncture in bone surface and positioned at the of inside boneSecond location information of two points of puncture in x-z-plane；It is determined according to first location information and second location information to be positionedDirection and angle；Adjustment vertebral column minimally invasive positioning system makes puncture needle consistent with the direction of positioning and angle.
Beneficial effects of the present invention: vertebral column minimally invasive positioning system of the invention be straight line is determined according to two o'clock, andIt the position put in space can be made of the principle that three-dimensional coordinate is expressed.Using the vertebral column minimally invasive positioning system, can to avoidPosition inaccuracy when drilling is punctured in minimal invasive surgical procedures and vital tissue damage or interior fixed position is caused inaccurately to cause admittedlyPhenomena such as fixed shakiness, failure, the risk of patients surgery is reduced, so that the positioning of minimally invasive spine surgical is more accurate, is subtractedThe radiation of few medical staff, shortens operating time, market prospects are beyond measure.
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 brighterThe above and other objects, advantages and features of the present invention.
Detailed description of the invention
Some specific embodiments of the present invention is described in detail by way of example and not limitation with reference to the accompanying drawings hereinafter.Identical appended drawing reference denotes same or similar part or part in attached drawing.It should be appreciated by those skilled in the art that theseWhat attached drawing was not necessarily drawn to scale.In attached drawing:
Fig. 1 is the structural schematic diagram according to the vertebral column minimally invasive positioning system of an embodiment of the present invention；
Fig. 2 is the part-structure enlarged drawing of the vertebral column minimally invasive positioning system in Fig. 1；And
Fig. 3 is a kind of first angle disk of embodiment according to the present invention and the structural schematic diagram of second angle disk.
Specific embodiment
As shown in Figs. 1-2, the present invention provides a kind of for positioning puncture needle 10 to the backbone of scheduled puncture positionMinimally invasive positioning system, structure include pedestal 20 and the z-axis guide rod 30 being slidably sleeved on pedestal 20, the first scaleRuler 40, the second graduated scale 50, first angle disk 60 and second angle disk 70.
Specifically, as shown in Figure 1, pedestal 20 includes two fixing clamps 21 for firm banking 20 and along the y-axis direction prolongsThe y-axis guide rod 22 stretched, such pedestal 20 can be set to the station that can be detachably connectable to for being punctured.Y-axis guide rod 22 is located between two fixing clamps 21.It is arranged on y-axis guide rod 22 and is vertically directed seat 23, z-axis guide rod 30Y-axis guide rod 22 is slidably attached to by being vertically directed seat 23.Z-axis guiding can be adjusted and then being vertically directed seat 23Bar 30, so that z-axis guide rod 30 can freely slide on horizontal coarse adjustment guide rod 22.Preferably, on y-axis guide rod 22Equipped with scale.
In order to indicate the distance moved on z-axis direction, which further includes for identifying z-axis positionZ-axis scale 301.In one embodiment of the invention, as shown in Fig. 2, the z-axis scale 301 is independently of z-axis guide rod 30, andIt is parallel to each other with it.Z-axis scale 301 and z-axis guide rod 30 are arranged on horizontal coarse adjustment guide rod 22, and z-axis scale 301 canTo be to be arranged and be fixed by screws on horizontal coarse adjustment guide rod 22.In a unshowned embodiment of the invention, z-axis markRuler 301 is also possible to be formed in the surface of z-axis guide rod 30, i.e., is provided with scale on the surface of z-axis guide rod 30.
As shown in Figure 1, being equipped with the x-axis guide rod 401 extended along the x-axis direction on z-axis guide rod 30.Wherein, x-axis is oriented toThe first end of bar 401 is movably fixed on z-axis guide rod 30 and can move in the z-axis direction along z-axis guide rod 30, xThe second end of axis guide rod 401 is connect by link block 402 with the first graduated scale 40.It preferably, can be on x-axis conductor rod 401Equipped with scale.It in other embodiments of the invention, can also be straight by the first graduated scale 40 when the first 40 long enough of graduated scaleIt is connected to z-axis guide rod 30 in succession, can thus not have to that x-axis guide rod 401 is arranged again, reduce process flow.
As depicted in figs. 1 and 2, one end of the first graduated scale 40 extends along the x-axis direction, and the other end is connected to by fastenerOn z-axis guide rod 30, and it can be moved in the z-axis direction along z-axis guide rod 30.In one embodiment, fastener can beBolt.The first vernier 41 that can be slid along can be equipped on the first graduated scale 40.First vernier 41 can have through-hole(not indicating in figure), the second graduated scale 50 are connected to the first vernier 41 and can be mobile with the first vernier 41.Specifically, secondGraduated scale 50 is set in the through-hole of the first vernier 41 and is fixed thereon.Second graduated scale 50 is along the y-axis vertical with x-axis directionDirection extends, and also equally is provided with the second vernier 51 that can be slid along thereon.
In a preferred embodiment of the invention, which further includes the first rotating member 71,80.TheOne rotating member 71,80 is connected to the second vernier 51 and can be relative to the second vernier 51 along first center rotating parallel with y-axisAxis rotation.Specifically, the second vernier 51 includes a protrusion (not shown) extended along the x-axis direction, first angle disk60 and first rotating member 71,80 be arranged at protrusion so that the first rotating member is avoided far from the second graduated scale 50 to secondGraduated scale 50 impacts.First rotating member 71,80 includes the connecting shaft 80 connecting with first angle disk 60 and the company of being set inBlock 71 in spindle 80.In a kind of exemplary embodiments of the invention, connecting shaft 80 is bolted on the second vernier 51On, the block 71 being set in connecting shaft 80 can be rotated around connecting shaft 80.In another exemplary embodiments of the invention,Connecting shaft 80 is to be fixedly connected, and do not relatively rotate with block 71 on it is arranged, and connecting shaft 80 can pass through adjustingThe bolt being fixed on the second vernier 51 is to be rotated.
First angle disk 60, which can be, to be fixedly attached on the protrusion of the second vernier 51 by the support being disposed below,And first angle disk 60 extends in x-z-plane and has the scale for identifying angle.Second angle disk 70 is fixedly connectedTo the block 71 of the first rotating member 71,80, and second angle disk 70 extends simultaneously in the plane perpendicular to first angle disk 60With for indicating the scale of angle.
Preferably, second angle disk 70 is arranged adjacent to first angle disk 60, so that second angle disk 70 is in first angleProjection on disk 60 can be used in identifying rotational angle of first rotating member 71,80 relative to first angle disk 60.Fig. 3 is firstThe structural schematic diagram of angle scale and second angle disk can clearly read angle registration from above.Wherein, first angle disk 60 canTo be made of transparent or semitransparent material, accordingly even when at the back side of first angle disk 60 still it can also be seen that second angle diskThe registration of angle indicated by 70 projection on it.In one embodiment of the invention, second angle disk 70 can also be by saturatingBright or trnaslucent materials is made, and can clearly read first angle disk 60 and with orientation in office or angle in this wayThe registration of two angle scales 70, improves work efficiency.
In a preferred embodiment of the invention, as shown in Fig. 2, the vertebral column minimally invasive positioning system further includes the second rotationPart 92.Second rotating member 92 and the first rotating member 71,80 connect into can be along the second rotation axis perpendicular to second angle disk 70Line rotation.Indicator 93 connect with the second rotating member 92 and can rotate with the second rotating member 92.Preferably at of the invention oneIn embodiment, as shown in Fig. 2, indicator 93 is arranged adjacent to second angle disk 70, more clearly to identify the second rotating member 92Rotational angle relative to second angle disk 70.
As shown in Fig. 2, vertebral column minimally invasive positioning system further includes being connected to the second rotating member 92 and for keeping puncture needle 10Needle holder 91.Specifically, needle holder 91 is arranged in the circular through hole of the second rotating member 92.In one embodiment,Second rotating member 92 can be formed as an entirety with needle holder 91.In other embodiments, the second rotating member 92 is pressed from both sides with needleHolder 91 can also be connected through a screw thread.
According to another aspect of the present invention, a kind of vertebral column minimally invasive positioning system answering in vertebral column minimally invasive positioning is additionally providedWith, comprising the following steps: firstly, providing any of the above-described kind of vertebral column minimally invasive positioning system.When patient lies in the operating bed or graspsWhen making on platform, the three-dimensional in vertebral column minimally invasive positioning system is determined, shoot the first x light picture along the x-axis direction later, record positionIn the first point of puncture in bone surface and positioned at first location information of second point of puncture in y-z plane of inside bone；It shoots the 2nd x light picture along the y-axis direction again, records the first point of puncture being located in bone surface and positioned at the second of inside boneSecond location information of the point of puncture in x-z-plane；Side to be positioned is determined according to first location information and second location informationTo and angle；And adjustment vertebral column minimally invasive positioning system makes puncture needle 10 consistent with the direction of positioning and angle.
So far, although those skilled in the art will appreciate that present invention has been shown and described in detail herein multiple showsExample property embodiment still without departing from the spirit and scope of the present invention, still can according to the present disclosure directlyDetermine or deduce out many other variations or modifications consistent with the principles of the invention.Therefore, the scope of the present invention is understood that and recognizesIt is set to and covers all such other variations or modifications.