CN112807065A - Lumbar interbody fusion system under spinal endoscope and use method thereof - Google Patents

Abstract

The invention discloses a lumbar interbody fusion system under a spinal endoscope and a use method thereof, and the lumbar interbody fusion system comprises a working channel, a soft tissue expander, a spinal endoscope and a bone grafting pressurizer, and further comprises a channel type fusion device complex; the channel-type fusion cage complex comprises a fusion cage body and a connecting channel; the invention designs a lumbar interbody fusion system under a spinal endoscope and a use method thereof, which integrate a fusion cage with a working channel and can realize visual operation for placing the fusion cage, thereby effectively improving the operation safety, simultaneously improving the bone grafting amount in the fusion cage and greatly improving the fusion rate.

Description

Lumbar interbody fusion system under spinal endoscope and use method thereof

Technical Field

The invention relates to the field of medical instruments, in particular to a lumbar interbody fusion system under a spinal endoscope and a using method thereof.

Background

The lumbar degenerative disease is a common disease and frequently encountered disease in clinic, is an important root cause of low back pain and sciatic nerve pain, and seriously threatens the health of human beings. Clinical treatment methods for patients with lumbar degenerative diseases include conservative treatment and surgical treatment. A large number of patients are treated by surgery each year for degenerative diseases of the lumbar spine. The traditional open surgery has large wound, much bleeding, great interference on spinal biomechanics, more postoperative complications, long hospitalization time and postoperative rehabilitation time and high cost.

Conservative treatment is generally adopted for patients with initial onset, light age, short course of disease and obvious alleviation of symptoms after lying in bed, while the conservative treatment is ineffective, the symptoms are recurrent and progressively aggravated, and the imaging examination indicates that patients with intervertebral disc protrusion, spinal stenosis and nerve compression need surgical treatment. The paravertebral muscle that traditional operation mode need be peeled off, partial or open the vertebral lamina entirely, and this type of art formula has destroyed the normal structure of backbone back post, and operation time is long, it is many to bleed, has increased postoperative paravertebral muscle and has lost the innervation, atrophy adhesion, function reduction, the painful discomfort of back and the unstable risk of lumbar vertebrae, and postoperative bed time is long, and some patients are because of the regional nerve adhesion of operation and the sick side of complication and or healthy side low limbs radiation pain.

In order to reduce the damage to the body, shorten the hospitalization time and reduce the hospitalization cost of the traditional operation mode, the minimally invasive technology for treating the lumbar degenerative disease is rapidly developed in recent years, for example, the intraspinal injection collagenase, ozone, radiofrequency ablation, MED intervertebral disc, YESS and TESSYS technologies and the like, especially the percutaneous spinal endoscopy technology, are more and more favored by the majority of spinal surgeons and patients due to small trauma, fast recovery, good curative effect, low cost and the like.

Yeung proposed a method for removing nucleus pulposus of intervertebral disc from inside to outside through a safe trigone on the posterolateral side of intervertebral disc under direct vision of endoscope (YESS technology), which became the earliest Percutaneous Endoscopic approach to intervertebral foramen for lumbar Discectomy (PETD), and laid the foundation for the development of modern Percutaneous lumbar Endoscopic technology. It is suitable for patients with discogenic lumbago and extreme lateral type disc herniation, but is not available for disc herniation protruding into the vertebral canal. In 2003, Hoogland professor adopts a foramen approach endoscope to excise the protruded intervertebral disc tissue from outside to inside under direct vision, and simultaneously can explore an epidural space, a lateral crypt, a foramen outlet nerve root and a spinal canal internal nerve root, which is called TESSYS technology. The technique obviously expands the operation indications (including lateral central type, intervertebral hole type and pole lateral type intervertebral disc protrusion) of the posterolateral approach endoscope. In recent years, the spinal endoscope technology in China is rapidly developed, the indications of the spinal endoscope technology are obviously expanded, besides the simple nucleus pulposus extirpation, infectious diseases such as lumbar spinal stenosis and lumbar tuberculosis, palliative treatment of lumbar tumor and the like can be successfully completed under the microscope, and satisfactory curative effects are achieved.

In recent years, with the development of spine minimally invasive technology, particularly spine endoscope technology, a plurality of operations can be completed under an endoscope, and the spine minimally invasive spine endoscope has the advantages of small operation trauma, less bleeding, no damage to a spine stable structure, quick postoperative recovery, low cost and the like. Although the application of the spine endoscopy technology is wider and wider along with the development of the technology and the improvement and optimization of instruments, the spine endoscopy technology cannot be ideally completed at present for the diseases such as waist and leg pain caused by lumbar instability, for example, lumbar spondylolisthesis, lumbar degenerative lateral bending, postoperative recurrence of huge lumbar disc herniation and the like which need lumbar fusion. The reason is mainly that the size of the intervertebral fusion cage which is commonly used in clinic at present is larger, and the intervertebral fusion cage can not be directly implanted into the intervertebral space from the working channel of the spinal endoscope.

In view of the current problems of spinal endoscopy in lumbar fusion, various solutions have been proposed by many scholars.

One of them is the adjustable intervertebral fusion device; the intervertebral fusion cage is designed into an adjustable fusion cage with the height capable of being properly changed. It can be spread from 7mm-10mm to 10-13 mm. During the lumbar fusion operation, after the intervertebral space is decompressed under the mirror and treated, autologous bones or allogeneic bones are implanted into the cavity space in the middle of the interbody fusion cage, then the interbody fusion cage with the autologous bones is implanted into the intervertebral space from a backbone endoscope working channel (the diameter is 10-12mm), then screws in the interbody fusion cage are screwed, the height of the interbody fusion cage is gradually increased in the screwing process until the height of the intervertebral space, and the implantation of the interbody fusion cage is completed. Although the fusion cage is skillfully implanted into the intervertebral space through the working channel of the spinal endoscope, in the opening process, the internal original bone grafting amount of the fusion cage is insufficient due to the enlarged internal space of the fusion cage in the opening process, so that the fusion rate is influenced. In addition, such a cage is not visible during implantation, risking damage to the nervous tissue. Also have the student directly implant intervertebral space (suppress the bone grafting) with autologous bone or allogeneic bone granule through working channel, implant intervertebral space with the bone piece more easily like this, but its bone grafting does not have a supporting role, and the bone grafting piece easily absorbs, shifts oppression nerve, and postoperative causes shortcomings such as root nature symptom, is not extensively promoted.

In view of the above, there is a need to design a spinal endoscopic lumbar interbody fusion system and a method for using the same that overcomes the above-mentioned technical problems.

Disclosure of Invention

The invention designs a lumbar interbody fusion system under a spinal endoscope and a use method thereof, which integrate a fusion cage with a working channel and can realize visual operation for placing the fusion cage, thereby effectively improving the operation safety, simultaneously improving the bone grafting amount in the fusion cage and greatly improving the fusion rate.

In order to achieve the above purpose, the present invention mainly provides the following technical solutions:

a lumbar interbody fusion system under a spinal endoscope comprises a working channel, a soft tissue expander, a spinal endoscope and a bone grafting pressurizer; also includes a channeled cage complex;

the channel-type fusion cage complex comprises a fusion cage body and a connecting channel;

the fusion cage body is cylindrical and consists of an outer cylinder body arranged in the middle, a tongue-shaped plate I arranged at the front end of the outer cylinder body and an annular boss arranged at the rear end of the outer cylinder body, wherein external threads are arranged on the outer wall of the annular boss;

the outer wall of the outer cylinder body is symmetrically provided with a plane and an arc surface, the plane is in a grid shape and is two sides which are contacted with the vertebral body end plate; the cambered surface is an arc-shaped polished surface, and the first tongue-shaped plate is arranged at the front end of the arc-shaped polished surface at one end;

the connecting channel is hollow and cylindrical, the inner wall of the front end of the connecting channel is provided with an internal thread screwed with the external thread, and the outer wall of the rear end of the connecting channel is vertically provided with a first handle.

As a preferable technical scheme, the fusion cage body is made of titanium alloy or PEEK material;

the length of the fusion cage body is 22/26mm, and the inner diameter and the outer diameter of the fusion cage body are 8/10mm, 9/11mm, 10/12mm or 11/13 mm.

As a preferable technical scheme, the length of the connecting channel is 100/150mm, and the inner diameter and the outer diameter of the connecting channel are 8/10mm, 9/11mm, 10/12mm or 11/13mm respectively.

As a preferred technical scheme, the working channel comprises a first working channel and a second working channel;

the first working channel is cylindrical, the front end of the first working channel is provided with a tongue-shaped plate II, and the outer wall of the rear end of the first working channel is vertically provided with a handle II;

the working channel II is cylindrical, and the outer wall of the rear end of the working channel II is vertically provided with a handle III.

As a preferred technical scheme, the first handle, the second handle and the third handle are all rectangular plate-shaped, and the bottom ends of the first handle, the second handle and the third handle are respectively and integrally connected with the outer walls of the rear ends of the connecting channel, the first working channel and the second working channel;

and non-slip pads are attached to the outer walls of the first handle, the second handle and the third handle.

As a preferable technical scheme, the length of the first working channel is 110-175mm, and the inner/outer diameter is 8/10mm, 9/11mm, 10/12mm or 11/13 mm;

the length of the second working channel is 120-170mm, and the inner/outer diameter is 8/9.8 mm;

and when the difference between the inner diameters of the spinal endoscope and the channel type fusion device complex is larger, the working channel II is placed between the spinal endoscope and the channel type fusion device complex.

As a preferred technical scheme, the soft tissue dilator is in a hollow pipeline shape, and the length of the soft tissue dilator is 190 mm; the outer diameter is 7.5mm, 8.5mm, 9.5mm, 10.5mm, and the inner diameter is 1 mm.

As a preferred technical solution, the method further comprises:

the sealing cap is annular and is sleeved at the tail end of the connecting channel;

the sealing cap is made of rubber materials.

As a preferred technical scheme, the spinal endoscope adopts an endoscope with the outer diameter of 7.8mm, the working channel in the endoscope is 5.3mm, the visual angle is 25-30 degrees, and the visual angle is 65-75 degrees.

A use method of a lumbar interbody fusion system under a spinal endoscope comprises the following steps:

1) inserting a soft tissue dilator into the superficial layer of the ligamentum flavum in the intervertebral disc space, placing the soft tissue dilator into a first working channel, performing an under-mirror operation, sequentially performing nerve decompression, nucleus pulposus enucleation and endplate treatment, and finally measuring the intervertebral disc space height;

2) placing the soft tissue dilator again, selecting a channel type fusion device complex with a proper model according to the intervertebral space height, guiding the channel type fusion device complex to enter an operation area, and taking out the soft tissue dilator;

3) inserting a spinal endoscope into a channel type fusion cage compound body with a sealing cap, rotating under the endoscope according to conditions, rotating the channel type fusion cage compound body clockwise, poking away nerve tissues by using a tongue-shaped plate I in front of the fusion cage, and placing the fusion cage into a treated intervertebral space; wherein the grid sample plane is contacted with the upper end plate and the lower end plate, after the depth of the fusion cage is checked by fluoroscopy to be satisfactory, the spinal endoscope is pulled out, and a proper amount of autogenous bone or allogeneic bone is implanted into the fusion cage along the connecting channel;

4) after the bone grafting pressurizer is used for pressurizing, the endoscope is placed into the connecting channel again to check the bone grafting condition, and the connecting channel is rotated anticlockwise to separate from the fusion cage after satisfaction, and the connecting channel is taken out;

5) replacing the first working channel, and performing endoscopic examination on the nerve root decompression condition and the position of the fusion cage again; the pedicle screw is implanted percutaneously, the titanium rod is connected with the corresponding pedicle screw, and after the nut is fixed, the operation is finished.

Compared with the prior art, the invention has the following beneficial effects:

according to the lumbar interbody fusion system under the spinal endoscope, the connecting channel and the fusion cage of the spinal endoscope are designed into a complex body, and the complex body has the functions of a working channel and the fusion cage;

according to the lumbar interbody fusion system under the spinal endoscope, the implantation process of the fusion cage is changed from invisible implantation to visible implantation, so that the safety of the fusion cage during implantation is greatly improved, and the risk of nerve injury is reduced;

according to the lumbar interbody fusion system under the spinal endoscope, bone grafting particles are firstly placed into the fusion cage and then are implanted into the intervertebral space, so that the bone grafting particles are firstly implanted into the fusion cage and then are implanted into the granular bone through the channel, and the bone grafting pressurizer can increase the bone grafting amount and the contact between the bone grafting and the final plate after being pressed, so that the bone grafting fusion is facilitated;

according to the lumbar interbody fusion system under the spinal endoscope, the inner space of the fusion cage of the channel type fusion cage complex is obviously increased, so that more bone grafts can be accommodated, and as the front end of the fusion cage is of an open design, part of bone graft particles can be allowed to enter the front half part of the intervertebral space through the opening at the front end of the fusion cage, so that the bone graft fusion rate is improved;

according to the lumbar interbody fusion system under the spinal endoscope, the outer two surfaces of the fusion cage are designed into planes, so that the contact area between the fusion cage and the end plate can be enlarged, and the fusion rate is improved;

compared with the pressing bone grafting, the lumbar interbody fusion system under the spinal endoscope can provide the supporting function for the interbody and improve the fusion rate;

the use method of the lumbar interbody fusion system under the spinal endoscope is simple in operation process and easy to operate.

The foregoing is a summary of the present invention, and in order to provide a clear understanding of the technical means of the present invention and to enable the same to be carried into effect in accordance with the present specification, the following detailed description of the preferred embodiments of the present invention is provided in conjunction with the accompanying drawings.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts.

FIG. 1 is a schematic structural diagram of a lumbar interbody fusion system under a spinal endoscope according to the present invention;

FIG. 2 is a schematic diagram of the configuration of the channeled cage complex of the present invention;

FIG. 3 is another schematic view of the channeled cage complex of the present invention;

FIG. 4 is a schematic structural view of the cage body of the present invention;

FIG. 5 is a schematic view of the structure of the connecting passage of the present invention;

FIG. 6 is a schematic structural diagram of a first working channel of the present invention;

FIG. 7 is a schematic structural view of the soft tissue dilator of the present invention;

FIG. 8 is a schematic structural view of the bone grafting punch of the present invention;

FIG. 9 is a schematic representation of the working channel one and soft tissue dilator of the present invention in use;

FIG. 10 is a schematic structural view of a second working channel of the present invention;

FIG. 11 is a schematic structural view of another embodiment of the intra-spinal lumbar interbody fusion system of the present invention;

description of reference numerals:

10. workingchannel 11, working channel I12 and working channel II

111. A tongue-shaped plate II 112, ahandle II 121 and a handle III

20. Soft tissue dilator

30. Spinal endoscope

40. Channel-typefusion cage complex 41,fusion cage body 42, and connection channel

411.Outer cylinder 412, tongue-shapedplate 413 and annular boss

414.External thread 4111,plane 4112, and arc surface

421.Internal thread 422, handle one

50. Non-slip mat

60. Sealing cap

70. Bone grafting pressing device

Detailed Description

To further illustrate the technical means and effects of the present invention for achieving the predetermined objects, the following detailed description will be given of specific embodiments, structures, features and effects of the lumbar interbody fusion system under spinal endoscopy and the method for using the same according to the present invention, with reference to the accompanying drawings and preferred embodiments.

As shown in fig. 1-9, the present invention relates to a spine endoscopic lumbar interbody fusion system, which comprises a workingchannel 10, asoft tissue dilator 20, aspine endoscope 30 and abone grafting presser 70; also included are channeledcage complexes 40;

the tunnel-type cage complex 40 includes acage body 41 and a connectingtunnel 42;

thefusion cage body 41 is cylindrical, and comprises anouter cylinder 411 arranged in the middle, a tongue-shapedplate 412 arranged at the front end of the outer cylinder, and anannular boss 413 arranged at the rear end of the outer cylinder, wherein the outer wall of theannular boss 413 is provided with anexternal thread 414;

aplane 4111 and anarc surface 4112 are symmetrically arranged on the outer wall of theouter cylinder 411, theplane 4111 is in a grid shape and is two surfaces which are in contact with a vertebral body end plate; thecambered surface 4112 is an arc-shaped polished surface, and the tongue-shaped plate I412 is arranged at the front end of the arc-shaped polished surface at one end;

the connectingchannel 42 is hollow and cylindrical, the inner wall of the front end of the connecting channel is provided with aninternal thread 421 screwed with theexternal thread 414, and the outer wall of the rear end of the connecting channel is vertically provided with afirst handle 422.

The invention relates to a lumbar interbody fusion system under a spinal endoscope, which adopts a channel typefusion cage complex 40, wherein the channel typefusion cage complex 40 and the channel type fusion cage complex are detachably connected; the shortcoming improvement design to fuse the ware under original mirror, will fuse the ware and fuse rather than workingchannel 10 as an organic whole, even if place the ware under the mirror to whole journey is visual, improves the operation security, can improve again and fuse the ware and plant bone volume, improves and fuses the rate.

The fusion cage is designed like a cylinder, two corresponding surfaces which are contacted with a vertebral body end plate are grating-like planes 4111 made of metal, theplane 4111 is a tangent plane of the cylindrical fusion cage at the position, and two sides of theplane 4111 are in smooth arc shape with the fusion cage, so that the fusion cage is in surface-surface contact with the end plate under the condition that the height of the fusion cage is not reduced, bone grafting particles in the fusion cage can be in full contact with the bone tissue of the end plate, the bone grafting particles can be in favor of bone fusion, and the end plate can be prevented from collapsing; the other twocorresponding arc surfaces 4112 are polished surfaces, when the fusion cage is implanted into an intervertebral space, one of the two arc surfaces may contact with nerves, and the polishing design can prevent nerve damage.

The front of the fusion device is designed into a slightly-reduced cone shape, so that the fusion device can be inserted into an intervertebral space conveniently, the tongue-shaped plate I412 at the front end adopts a tongue-shaped design, the tongue-shaped plate I412 is arranged at the front end of one of the arc-shaped polished surfaces of the fusion device, the function of the tongue-shaped plate I412 is the same as that of the tongue-shaped plate II 111 in front of the working channel I11, the tongue-shaped plate I and the tongue-shaped plate II are used for retracting and separating nerve tissues and are equivalent to nerve drag hooks in the operation; the rear end of the cage is provided withexternal threads 414 which are connected to the connectingchannel 42.

The connectingchannel 42 is hollow cylindrical and is detachably screwed with the fusion device through threads; the connectingchannel 42 here can be of any length and type.

The utility model provides a lumbar vertebrae interbody fusion system under backbone scope, its shortcoming to fusion cage under original mirror improves the design, fuses ware and workingchannel 10 and fuses as an organic whole, even if place the fusion cage under the mirror to whole journey is visual, improves the operation security, can improve again and plant bone volume in the fusion cage, improves and fuses the rate.

In order to meet the requirements of different operators, thefusion cage body 41 comprises a plurality of models with different specifications; as shown in fig. 2-4, in the lumbar interbody fusion system under a spinal endoscope of the present invention, thefusion cage body 41 is made of titanium alloy or PEEK material; the length of thefusion cage body 41 is 22/26mm, and the inner and outer diameters are 8/10mm, 9/11mm, 10/12mm or 11/13 mm.

In order to match with thefusion cage bodies 41 with different specifications, the connectingchannel 42 also comprises a plurality of groups of different specifications and can be matched with thefusion cage bodies 41; as shown in figure 1, the connectingchannel 42 of the spinal endoscopic lumbar interbody fusion system of the present invention has a length of 100/150mm, and inner/outer diameters thereof are 8/10mm, 9/11mm, 10/12mm or 11/13mm, respectively.

As shown in fig. 6 and 10, the workingchannel 10 of the present invention includes a first workingchannel 11 and a second workingchannel 12; the first workingchannel 11 is cylindrical, the front end of the first working channel is provided with a tongue-shaped plate II 111, and the outer wall of the rear end of the first working channel is vertically provided with ahandle II 112; the second workingchannel 12 is cylindrical, and the outer wall of the rear end of the second working channel is vertically provided with athird handle 121.

As shown in fig. 6 and 10, in the spinal endoscopic lumbar interbody fusion system of the present invention, the length of the first workingchannel 11 is 110-175mm, and the inner/outer diameter is 8/10mm, 9/11mm, 10/12mm or 11/13 mm; the length of the second workingchannel 12 is 120-170mm, and the inner/outer diameter is 8/9.8 mm; when the difference between the inner diameters of thespinal endoscope 30 and the channel typefusion device complex 40 is larger, the second workingchannel 12 is placed between thespinal endoscope 30 and the channel typefusion device complex 40.

The lumbar interbody fusion system under the spinal endoscope of the embodiment of the application needs to be explained, wherein the working channel I11 is one of products used clinically at present, the front end of the working channel I is tongue-shaped, which is beneficial to retracting or separating nerve tissues by rotating the workingchannel 10 in an operation, and the rear end of the channel is a metal handle integrated with the channel;

as another example, as shown in FIGS. 10 and 11, the working channel two 12 is similar in design to the working channel one 11, differing only in its size and its tongue-type design without a leading end; the use of the second workingchannel 12 has certain conditions: when the inner diameters of thespinal endoscope 30 and the channel type fusiondevice compound body 40 are different greatly, such as when two types of fusion devices with inner/outer diameters of 10/12mm and 11/13mm are applied, because the difference between the inner diameter (7.8mm) of the endoscope and the inner diameter (10 mm and 11mm) of the fusiondevice connecting channel 42 compound body is larger, soft tissue can enter between the inner diameter and the outer diameter and the inner diameter, so that the operation is influenced, at the moment, the working channel II 12 without tongue-shaped design can be placed between the endoscope and the connectingchannel 42 fusion device compound body, so that the operation is matched more, and the operation is facilitated.

As shown in fig. 1 and 10, in the intra-spinal-endoscopic lumbar interbody fusion system of the present invention, thefirst handle 422, thesecond handle 112, and thethird handle 121 are all rectangular plates, and the bottom ends thereof are respectively connected with the outer walls of the rear ends of the connectingchannel 42, the first workingchannel 11, and the second workingchannel 12; theanti-slip pad 50 is attached to the outer walls of thefirst handle 422, thesecond handle 112 and thethird handle 121.

It should be noted that thefirst handle 422, thesecond handle 112 and thethird handle 121 are designed to facilitate the operation.

As shown in fig. 7, in the lumbar interbody fusion system under spinal endoscope of the present invention, thesoft tissue dilator 20 is in the shape of a hollow tube, and the length thereof is 190 mm; the outer diameter is 7.5mm, 8.5mm, 9.5mm and 10.5mm, and the inner diameter is 1 mm; thesoft tissue expander 20 is used in conjunction therewith.

As shown in fig. 3, the lumbar interbody fusion system under spinal endoscopy of the present invention further includes:

the sealingcap 60 is annular, and the sealingcap 60 is sleeved at the tail end of the connectingchannel 42; the sealingcap 60 is made of rubber.

The diameter of the sealingcap 60 matches with the connectingchannel 42, and the sealing cap is made of rubber and is used for sealing the tail end of the channel, preventing water in the channel from flowing out and increasing water pressure in the channel.

As shown in figure 1, thespinal endoscope 30 is an endoscope with an outer diameter of 7.8mm, a workingchannel 10 in the endoscope is 5.3mm, an image angle of 25-30 degrees and a field angle of 65-75 degrees.

The invention discloses a using method of a lumbar interbody fusion system under a spinal endoscope, which comprises the following steps:

1) inserting thesoft tissue dilator 20 into the superficial layer of the ligamentum flavum in the intervertebral disc space, placing the working channel I11 along thesoft tissue dilator 20, performing an under-mirror operation, sequentially performing nerve decompression, nucleus pulposus removal and endplate treatment, and finally measuring the intervertebral disc space height;

2) placing thesoft tissue dilator 20 again, selecting a channel typefusion device complex 40 with a proper model according to the intervertebral space height, guiding the channel typefusion device complex 40 to enter an operation area, and taking out thesoft tissue dilator 20;

3) inserting aspinal endoscope 30 into the channel type fusioncage compound body 40 with the sealingcap 60, rotating the channel type fusioncage compound body 40 clockwise under the endoscope according to conditions, poking away nerve tissues by using a tongue plate I412 in front of the fusion cage, and placing the fusion cage into a treated intervertebral space; wherein the grid-like plane 4111 is in contact with the upper and lower end plates, after the depth of the fusion cage is checked by fluoroscopy to be satisfactory, thespinal endoscope 30 is pulled out, and a proper amount of autogenous bone or allogeneic bone is implanted into the fusion cage along the connectingchannel 42;

4) after thebone grafting presser 70 is used for pressing, the endoscope is put into the connectingchannel 42 again to check the bone grafting condition, and after the bone grafting condition is satisfied, the endoscope rotates anticlockwise to separate the connectingchannel 42 from the fusion cage, and the connectingchannel 42 is taken out;

5) replacing the first workingchannel 11, and performing endoscopic examination on the nerve root decompression condition and the position of the fusion cage again; the pedicle screw is implanted percutaneously, the titanium rod is connected with the corresponding pedicle screw, and after the nut is fixed, the operation is finished.

The invention designs thespinal endoscope 30 channel and the fusion cage into a complex, the fusion cage has the functions of the workingchannel 10 and the fusion cage, and the original invisible implantation is changed into the visualization when the fusion cage is implanted, thereby greatly improving the safety when the fusion cage is implanted.

Bone grafting particles are firstly placed into the fusion cage and then are implanted into the intervertebral space, the bone grafting particles are placed into the fusion cage after the bone grafting particles are implanted into the fusion cage, and the bone grafting amount and the contact between the bone graft and an end plate can be increased after the bone graft is pressed by a bone graft pressing device, so that the bone graft fusion is facilitated;

the channel typefusion cage body 41 has a larger internal space, so that more bone grafts can be accommodated, the foremost end of the fusion cage is in an opening-like design, when bone graft particles are placed, part of the bone graft particles can enter the anterior half part of the intervertebral space through the opening of the fusion cage, so that the bone graft amount can be further increased, and the bone graft fusion rate can be theoretically improved; the outer two surfaces of the fusion device are designed into grid-like planes 4111, so that the contact area between the fusion device and an end plate can be enlarged, and the fusion rate is improved.

As shown in fig. 8, thebone grafting presser 70 used herein is selected to have a length of 250mm and a diameter of 5.0mm, and has a handle at the rear end thereof; thebone grafting presser 70 is used for pressing bone grafting particles in the fusion cage through the inner diameter of the spinal endoscope.

It will be evident to those skilled in the art that the invention is not limited to the details of the foregoing illustrative embodiments, and that the present invention may be embodied in other specific forms without departing from the spirit or essential attributes thereof.

Claims (10)

1. The utility model provides a lumbar vertebrae interbody fusion system under backbone scope, includes working channel, soft tissue expander, backbone scope and bone grafting depressor, its characterized in that: also includes a channeled cage complex;

the channel-type fusion cage complex comprises a fusion cage body and a connecting channel;

the fusion cage body is cylindrical and consists of an outer cylinder body arranged in the middle, a tongue-shaped plate I arranged at the front end of the outer cylinder body and an annular boss arranged at the rear end of the outer cylinder body, wherein external threads are arranged on the outer wall of the annular boss;

the outer wall of the outer cylinder body is symmetrically provided with a plane and an arc surface, the plane is in a grid shape and is two sides which are contacted with the vertebral body end plate; the cambered surface is an arc-shaped polished surface, and the first tongue-shaped plate is arranged at the front end of the arc-shaped polished surface at one end;

the connecting channel is hollow and cylindrical, the inner wall of the front end of the connecting channel is provided with an internal thread screwed with the external thread, and the outer wall of the rear end of the connecting channel is vertically provided with a first handle.

2. The system of claim 1, wherein the system comprises:

the fusion cage body is made of titanium alloy or PEEK material;

the length of the fusion cage body is 22/26mm, and the inner diameter and the outer diameter of the fusion cage body are 8/10mm, 9/11mm, 10/12mm or 11/13 mm.

3. The system of claim 1, wherein the system comprises:

the length of the connecting channel is 100/150mm, and the inner diameter and the outer diameter of the connecting channel are 8/10mm, 9/11mm, 10/12mm or 11/13mm respectively.

4. The system of claim 1, wherein the system comprises:

the working channel comprises a first working channel and a second working channel;

the first working channel is cylindrical, the front end of the first working channel is provided with a tongue-shaped plate II, and the outer wall of the rear end of the first working channel is vertically provided with a handle II;

the working channel II is cylindrical, and the outer wall of the rear end of the working channel II is vertically provided with a handle III.

5. The system of claim 4, wherein the system comprises:

the first handle, the second handle and the third handle are all rectangular plate-shaped, and the bottom ends of the first handle, the second handle and the third handle are respectively and integrally connected with the outer walls of the rear ends of the connecting channel, the first working channel and the second working channel;

and non-slip pads are attached to the outer walls of the first handle, the second handle and the third handle.

6. The system of claim 5, wherein the system comprises:

the length of the first working channel is 110-175mm, and the inner/outer diameter is 8/10mm, 9/11mm, 10/12mm or 11/13 mm;

the length of the second working channel is 120-170mm, and the inner/outer diameter is 8/9.8 mm;

and when the difference between the inner diameters of the spinal endoscope and the channel type fusion device complex is larger, the working channel II is placed between the spinal endoscope and the channel type fusion device complex.

7. The system of claim 1, wherein the system comprises:

the soft tissue dilator is in a hollow pipeline shape, and the length of the soft tissue dilator is 190 mm; the outer diameter is 7.5mm, 8.5mm, 9.5mm, 10.5mm, and the inner diameter is 1 mm.

8. The system of claim 1, further comprising:

the sealing cap is annular and is sleeved at the tail end of the connecting channel;

the sealing cap is made of rubber materials.

9. The system of claim 1, wherein the system comprises:

the spinal endoscope is an endoscope with the outer diameter of 7.8mm, the working channel in the endoscope of 5.3mm, the visual angle of 25-30 degrees and the field angle of 65-75 degrees.

10. The use method of the lumbar interbody fusion system under the spinal endoscope is characterized by comprising the following steps:

1) inserting a soft tissue dilator into the superficial layer of the ligamentum flavum in the intervertebral disc space, placing the soft tissue dilator into a first working channel, performing an under-mirror operation, sequentially performing nerve decompression, nucleus pulposus enucleation and endplate treatment, and finally measuring the intervertebral disc space height;

2) placing the soft tissue dilator again, selecting a channel type fusion device complex with a proper model according to the intervertebral space height, guiding the channel type fusion device complex to enter an operation area, and taking out the soft tissue dilator;

3) inserting a spinal endoscope into a channel type fusion cage compound body with a sealing cap, rotating under the endoscope according to conditions, rotating the channel type fusion cage compound body clockwise, poking away nerve tissues by using a tongue-shaped plate I in front of the fusion cage, and placing the fusion cage into a treated intervertebral space; wherein the grid sample plane is contacted with the upper end plate and the lower end plate, after the depth of the fusion cage is checked by fluoroscopy to be satisfactory, the spinal endoscope is pulled out, and a proper amount of autogenous bone or allogeneic bone is implanted into the fusion cage along the connecting channel;

4) after the bone grafting pressurizer is used for pressurizing, the endoscope is placed into the connecting channel again to check the bone grafting condition, and the connecting channel is rotated anticlockwise to separate from the fusion cage after satisfaction, and the connecting channel is taken out;

5) replacing the first working channel, and performing endoscopic examination on the nerve root decompression condition and the position of the fusion cage again; the pedicle screw is implanted percutaneously, the titanium rod is connected with the corresponding pedicle screw, and after the nut is fixed, the operation is finished.

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