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CN119498922B - Intervertebral foramen rapid prototyping apparatus suit - Google Patents

Intervertebral foramen rapid prototyping apparatus suit

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Publication number
CN119498922B
CN119498922BCN202411516831.4ACN202411516831ACN119498922BCN 119498922 BCN119498922 BCN 119498922BCN 202411516831 ACN202411516831 ACN 202411516831ACN 119498922 BCN119498922 BCN 119498922B
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CN
China
Prior art keywords
articular process
intervertebral foramen
duck tongue
superior articular
ring saw
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CN202411516831.4A
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Chinese (zh)
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CN119498922A (en
Inventor
周跃
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Zhou Yue
Original Assignee
Shanghai Chenji Medical Equipment Co ltd
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Application filed by Shanghai Chenji Medical Equipment Co ltdfiledCriticalShanghai Chenji Medical Equipment Co ltd
Priority to CN202411516831.4ApriorityCriticalpatent/CN119498922B/en
Publication of CN119498922ApublicationCriticalpatent/CN119498922A/en
Application grantedgrantedCritical
Publication of CN119498922BpublicationCriticalpatent/CN119498922B/en
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Abstract

Translated fromChinese

本申请涉及一种椎间孔快速成型器械套装,用于下位椎骨上关节突腹侧的椎间孔扩孔成型,所述套装包括:鸭舌棒,其头部经椎间孔伸入椎管中,并与上关节突的腹侧偏心抵接;固定针,沿鸭舌棒的轴向贯穿所述鸭舌棒的中孔,并旋转拧入上关节突;保护鞘,沿鸭舌棒外侧滑入椎间孔中,并顶开周围的神经元;环锯,外套于所述鸭舌棒外侧,并介于鸭舌棒与保护鞘之间,且沿鸭舌棒的轴向进给,并旋转切削且穿透上关节突,一步分离出与所述固定针相螺纹紧固的骨块,所述固定针反向带走所述骨块以扩大所述椎间孔,孔镜经由椎间孔探入椎管观察。从而,实现椎间孔扩孔的一步成型,同时避免周围神经元损伤。

The present application relates to an intervertebral foramen rapid prototyping instrument set, which is used for the intervertebral foramen expansion and molding of the ventral side of the superior articular process of the inferior vertebra, and the set includes: a duck tongue rod, the head of which extends into the spinal canal through the intervertebral foramen and abuts eccentrically with the ventral side of the superior articular process; a fixing needle, which penetrates the middle hole of the duck tongue rod along the axial direction of the duck tongue rod and is rotated and screwed into the superior articular process; a protective sheath, which slides into the intervertebral foramen along the outer side of the duck tongue rod and pushes open the surrounding neurons; a trephine, which is sheathed on the outer side of the duck tongue rod and is between the duck tongue rod and the protective sheath, and is fed along the axial direction of the duck tongue rod, and is rotated to cut and penetrate the superior articular process, and the bone block threadedly fastened with the fixing needle is separated in one step, and the fixing needle reversely takes away the bone block to expand the intervertebral foramen, and the trephoscope is inserted into the spinal canal through the intervertebral foramen for observation. Thus, the one-step molding of intervertebral foramen expansion is achieved, while avoiding damage to surrounding neurons.

Description

Intervertebral foramen rapid prototyping apparatus suit
Technical Field
The application relates to surgical instruments, in particular to an intervertebral foramen rapid prototyping instrument set.
Background
The intervertebral foramen mirror operation is a minimally invasive therapy for the lumbar disc herniation, which has small trauma, small risk, quick recovery and good curative effect for patients with lumbar disc herniation. When in the operation of the intervertebral foraminiferous mirror, the hypertrophic ligamentum flavum, the protruding nucleus pulposus, the pressed nerve root, the dura mater sac and the proliferated bone tissues can be clearly seen under the assistance of the foraminiferous mirror (endoscope). The pore mirror needs to enter the vertebral canal for observation through the intervertebral foramen, but the aperture of the intervertebral foramen is smaller, and the intervertebral foramen reaming molding is needed first. The traditional method is to utilize concentric coaxial trephine to ream in stages, take out bone blocks in times, finish reaming and forming work in multiple steps, and has low efficiency and long time. And neurons are distributed among the vertebrae, so that the fault tolerance rate for misoperation is extremely low. Therefore, it is necessary to provide an orthopedic surgical instrument set capable of cutting a large number of bone fragments at a time, further directly completing reaming and forming of intervertebral foramen in one step, and simultaneously avoiding damage to peripheral neurons during operation.
Disclosure of Invention
The application aims to provide an orthopedic surgical instrument set which can cut a large number of bone blocks at one time, further directly finish reaming and forming of intervertebral foramen, and avoid damaging peripheral neurons in the operation process.
According to an aspect of the present application, there is provided an intervertebral foramen rapid prototyping apparatus kit for the reaming of an intervertebral foramen on the ventral side of the superior articular process of an inferior vertebra, the kit comprising:
the head of the duck tongue rod extends into the vertebral canal through the intervertebral foramen and is in eccentric abutting connection with the ventral side of the upper articular process;
a fixing needle which penetrates through the middle hole of the duck tongue rod along the axial direction of the duck tongue rod and is rotationally screwed into the upper joint protrusion;
a protective sheath which slides into the intervertebral foramen along the outer side of the duck tongue rod and pushes up the peripheral nerve cells;
The trepan is sleeved outside the duck tongue rod, is arranged between the duck tongue rod and the protective sheath, is fed along the axial direction of the duck tongue rod, rotates to cut and penetrate through the upper articular process, separates out bone blocks screwed with the fixing needle in one step, and reversely takes away the bone blocks by the fixing needle to enlarge the intervertebral foramen, and the pore mirror is inserted into the vertebral canal for observation through the intervertebral foramen.
More preferably, the duck tongue bar comprises:
the rod body extends along the axial direction, and the axle center penetrates through the middle hole;
the head is integrally formed at one end of the rod body, the head deviates from the axis of the rod body when seen in the axial direction, and the head deviating from the axis is abutted with the abdomen side of the upper articular process when seen in the vertical axial direction.
More preferably, the head comprises:
the tongue root is connected with the rod body and is positioned against the abdomen side of the upper articular process when being observed along the vertical axial direction;
The tongue tip is connected with the tongue root and is positioned at one side of the tongue root far away from the rod body, and the tongue tip stretches into the vertebral canal through the intervertebral foramen and pushes up neurons in the vertebral canal.
More preferably, when the trephine rotates to cut the upper articular process, the trephine rotates relative to the upper articular process and further rotates relative to the fixing needle, and after the trephine penetrates through the upper articular process to separate out the bone block, the trephine drives the bone block to rotate and further rotates relative to the fixing needle.
More preferably, when the trephine rotates to cut the upper articular process, the duck tongue stick is static relative to the upper articular process, and the trephine rotates relative to the duck tongue stick;
after the trephine penetrates the upper articular process to separate out the bone blocks, the trephine drives the bone blocks to rotate relative to the upper articular process under the action of friction force, the bone blocks drive the duck tongue bars which are abutted with the trephine and the fixing needles which are mutually connected with the trephine to rotate,
When the fixed needle is observed to rotate along with the trephine, the bone block separation step is judged to be completed, the feeding of the trephine is immediately stopped, and the trephine is prevented from extending into the vertebral canal to damage neurons.
More preferably, one end of the fixing needle screwed into the bone block is marked as a front end, the other end is marked as a rear end, and the rear end is provided with a first phase mark;
And when the trephine rotates to cut the upper articular process, observing whether the first phase mark rotates or not to judge whether the bone block separation step is finished or not, and if yes, immediately stopping rotating the trephine.
More preferably, the head further comprises:
A back surface contacting with the inner wall of the trepan;
And the front surface is abutted with the upper articular process and positioned, the contact position of the front surface and the upper articular process is deviated from the axis of the rod body, and the axis of the rod body is deviated from the area surrounded by the back surface and the front surface.
More preferably, the other end of the rod body opposite to the head is marked as a tail, and a second phase mark is formed on a symmetrical line perpendicular to the front surface of the tail when the tail is observed along the axial direction;
When the duck tongue rod is abutted to the ventral side of the upper articular process for positioning, whether the front surface is abutted to the upper articular process or not is judged through the second phase mark, and the damage to neurons outside a target area when the trepan is sleeved into the duck tongue rod is avoided.
More preferably, the protective sheath comprises:
The shape of the sliding groove is adapted to the shape of the outer wall of the trepan and forms an open opening,
And when the trephine is sleeved into the duck tongue rod along the axial direction, the trephine is positioned between the chute and the duck tongue rod.
More preferably, one end of the trephine cutting upper articular process is provided with a trephine, and the other end of the trephine cutting upper articular process is movably connected with a trephine handle;
the fixed needle is screwed into one end of the upper articular process to form a threaded drill bit, the other end of the fixed needle is movably connected with a fixed needle handle, one end of the fixed needle handle is connected with the fixed needle, and the other end of the fixed needle handle extends unidirectionally and linearly.
The application has the following beneficial effects:
The duck tongue rod with the eccentric shaft structure is abutted against the ventral side of the upper joint protrusion for positioning, and then the trepan is used for rotary cutting around the outer side of the duck tongue rod, so that the rapid reaming and forming of the intervertebral foramen are realized in one step. The fixing needle is fastened with the upper articular process thread, so that the trephine is convenient for stably cutting the bone block during cutting, and after the cutting is completed, the fixing needle reversely takes away the bone block, so that the bone block is prevented from entering the vertebral canal, and neurons in the vertebral canal are prevented from being damaged. Thereby, the one-step molding of the reaming of the intervertebral foramen is realized, and the damage of peripheral neurons is avoided.
Drawings
In order to more clearly illustrate the embodiments of the application or the technical solutions in the prior art, the drawings which are used in the description of the embodiments or the prior art will be briefly described, it being obvious that the drawings in the description below are only some embodiments of the application, and that other drawings can be obtained from them without inventive effort for a person skilled in the art.
FIG. 1 is a schematic perspective view of a combination state of a kit according to an embodiment of the application;
FIG. 2 is a perspective view showing a separated state of a kit according to an embodiment of the present application;
FIG. 3 is a schematic view of an exploded assembly according to an embodiment of the present application;
FIG. 4 is a front view of a combination of a duck tongue, a retaining pin and a trepan according to one embodiment of the present application;
FIG. 5 is a cross-sectional view taken at A-A of FIG. 4;
FIG. 6 is a cross-sectional view taken at B-B of FIG. 4;
fig. 7 is a schematic perspective view of a duck tongue bar according to an embodiment of the application;
FIG. 8 is a schematic perspective view of the structure of FIG. 7, as seen in the axial direction;
Fig. 9 is a schematic diagram showing a three-dimensional state that a duck tongue head extends into a vertebral canal through an intervertebral foramen and is in eccentric abutment with the ventral aspect of an upper articular process according to an embodiment of the present application;
Fig. 10 is a schematic view illustrating the principle that the head of a duck tongue stick according to an embodiment of the present application extends into a vertebral canal through an intervertebral foramen and is eccentrically abutted against an upper articular process;
FIG. 11 is a schematic view showing a state that a fixing needle according to an embodiment of the present application penetrates through a middle hole of a duck tongue rod along an axial direction of the duck tongue rod and is rotated to be screwed into an upper articular process;
FIG. 12 is a schematic view showing a state in which a protective sheath according to an embodiment of the present application is slid into an intervertebral foramen along the outside of a duck tongue and pushes up peripheral neurons;
fig. 13 is a schematic view showing a state that the trepan is sleeved outside the duck tongue and is arranged between the duck tongue and the protective sheath according to an embodiment of the application;
FIG. 14 is a schematic view showing a state that a trepan according to an embodiment of the present application is fed along the axial direction of a duck bill bar and rotated to cut an upper articular process;
FIG. 15 is a schematic view showing a state that a trepan penetrates an upper articular process and a bone block screwed with the fixing needle is separated in one step according to an embodiment of the present application;
FIG. 16 is a schematic view showing the fixation needle reversed carrying away bone fragments to form an enlarged intervertebral foramen according to one embodiment of the present application;
FIG. 17 is a schematic view showing the view of a foramen mirror according to an embodiment of the present application as it is advanced into a spinal canal through an enlarged intervertebral foramen;
The reference numerals are 100, the suit, 10, the duck tongue stick, F1, the axial direction, 200, the superior articular process, 20, the fixing needle, 11, the middle hole, 30, the circular saw, 12, the outer side, 210, the bone block, 300, the hole mirror, 400, the intervertebral hole, 13, the stick body, 14, the head, 21, the front end, 22, the rear end, 141, the back surface, 31, the inner wall, 142, the front surface, 143, the tongue root, 144, the tongue tip, T, the axis, 40, the protective sheath, 32, the outer wall, 41, the sliding groove, 411, the open opening, 42, the handle, 33, the circular teeth, 34, the circular saw handle, 211, the screw drill, 221, the positioning needle handle, 500, the vertebral canal, 600 and the neuron.
Detailed Description
In order that the application may be readily understood, a more complete description of the application will be rendered by reference to the appended drawings. The drawings illustrate preferred embodiments of the application. This application may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete.
It should be noted that the present embodiment relates to some anatomical terms. Hereinafter, inferior vertebrae refer to the vertebrae in the spine that are inferior, generally including the lumbar and sacral vertebrae, with the lumbar vertebrae being an example herein. The superior articular process is an anatomical structure on the vertebra (vertebrae). Each vertebra has two superior articular processes located in the posterior portion of the vertebral arch. The ventral side refers to the side of the front of the body or organ or near the abdomen. It is opposite the back side, which refers to the direction of the back or back of the body. For humans and other vertically walking animals, the ventral side is the front of the body, such as the chest and abdomen. The intervertebral foramen refers to the hole formed between each pair of adjacent vertebrae in the spine, located on the left and right sides of the spine. The spinal canal refers to a longitudinal canal formed by a stack of vertebrae surrounding and protecting the spinal cord and spinal nerve roots. The arch portion (posterior structure) of each vertebra forms part of the spinal canal, and when multiple vertebrae are connected together, the holes align to form a continuous channel throughout the spinal column.
Referring to fig. 1 to 17, an apparatus kit 100 for rapid prototyping of an intervertebral foramen 400 for reaming and prototyping of an intervertebral foramen 400 on the ventral side of an upper articular process 200 of a lower vertebra is provided in an embodiment of the present application, wherein the kit 100 comprises a duck tongue bar 10, a fixing needle 20, a trepan 30 and a protective sheath 40.
The use of the rapid prototyping instrument set 100 for the intervertebral foramen 400 will be understood with reference to fig. 10-17.
Specifically, referring to fig. 10 and 1-9, the axial direction of the duck tongue 10 is denoted as F1 and may be understood as being either forward or reverse. In fig. 10, the left direction is the forward direction, the right direction is the reverse direction, and the forward direction corresponds to the feeding direction of the trepan 30. The head 14 of the duck tongue bar 10 is smaller in volume than the bar body 13, and the head 14 extends into the vertebral canal 500 through the intervertebral foramen 400 and is in eccentric abutment with the ventral side of the superior articular process 200. Specifically, the tongue tip 144 of the head 14 protrudes into the vertebral canal 500, and pushes up the neuron 600, and the tongue root 143 of the head 14 abuts against the ventral side of the upper articular process 200, and as shown in fig. 10, the position corresponding to the tongue root 143 of the head 14 abuts against the lower end of the upper articular process 200.
The eccentric abutment refers to that the position where the head 14 abuts against the lower end of the upper articular process 200 deviates from the axis T of the duck tongue bar 10, which is mainly different from the positioning member of the structure other than the duck tongue bar 10. In this embodiment, the tongue root 143 of the duck tongue bar 10 abuts against the upper articular process 200, the trepan 30 is sleeved on the outer side 12 of the duck tongue bar 10, and the cutting is performed around the duck tongue bar 10 in a rotating manner, and the cutting action area corresponds to the area from the front 142 of the tongue root 143 of the duck tongue bar 10 to the outer wall 32 of the trepan 30. The eccentric abutting can be understood that the duck tongue bar 10 can be matched with the trepan 30 to obtain a better positioning effect and a large enough cutting area, so that one-time cutting can be supported to meet the size requirement of the expansion of the intervertebral foramen 400, multiple steps are not needed, and the rapid and safe expansion molding of the intervertebral foramen 400 is realized.
Referring to fig. 11 and 1-9, the fixing needle 20 penetrates the central hole 11 of the duck tongue 10 in the axial direction F1 of the duck tongue 10 and is screwed into the upper articular process 200. Specifically, the duck tongue 10 has a central hole 11 penetrating along the axis T, and the tongue root 143 of the duck tongue 10 is positioned in contact with the upper articular process 200, and then the fixing needle 20 penetrates along the central hole 11 of the duck tongue 10, is screwed into the upper articular process 200, and is fixed to the upper articular process 200.
Referring to fig. 12 and fig. 1 to 9, the protective sheath 40 is in an open groove structure, the protective sheath 40 slides into the intervertebral foramen 400 along the outer side 12 of the duck tongue bar 10 and pushes up the peripheral neurons 600, the protective sheath 40 has the function of avoiding the neurons 600 from being accidentally injured in the process of entering the intervertebral foramen 400 by the trepan 30 in the subsequent step, and the protective sheath 40 pushes up the neurons 600 in order to avoid damaging the neurons 600 by the annular teeth 33 of the trepan 30.
The protecting sheath 40 not only protects the neuron 600, but also plays a role in guiding the entrance of the hole scope 300 in the following process of the entrance of the hole scope 300, so that the doctor can not find the position where the intervertebral foramen 400 enters after the duck tongue 10 exits along with the bone block 210.
Referring to fig. 13 and fig. 1-9, the trepan 30 is sleeved on the outer side 12 of the duck tongue bar 10 and between the duck tongue bar 10 and the protective sheath 40, so as to avoid the trepan 30 touching the neuron 600 inside the intervertebral foramen 400 and outside the intervertebral foramen 400 during the process of entering the intervertebral foramen 400 along the duck tongue bar 10. It should be noted that fig. 13 illustrates the neurons 600 only outside the foramen 400, and in practice, the neurons 600 are distributed in both the foramen 400, outside the foramen 400, and in the spinal canal 500, see the illustration of fig. 9.
Referring to fig. 14 and 1-9, trepan 30 is fed in the axial direction F1 of duck bill bar 10 and rotationally cuts upper articular process 200. The purpose of cutting the superior articular process 200 is to enlarge the foramen 400 so that the foramen 400 passes into the spinal canal 500 after the foramen mirror 300 has been enlarged. The trepan 30 feeds along the axial direction F1 of the duck tongue 10, the protective sheath 40 pushes against the lateral neurons 600, and the tips 144 of the duck tongue 10 push against the anterior neurons 600.
Referring to fig. 15 and 1-9, trepan 30 penetrates superior articular process 200 to separate bone pieces 210 that are threadably secured to fixation needle 20 in a single step. Bone pieces 210 are separated from superior articular processes 200, but remain in a fixed relationship with respect to fixation needle 20, and duck tongue 10 remains in a relatively abutting relationship with bone pieces 210. At this point, the task of the trepan 30 cutting the upper articular process 200 is complete. In operation, there are two dangerous points at this time, one is that the doctor does not know in time that the cutting has been completed, and continues to feed the trephine 30, resulting in the trephine 30 accidentally injuring the neurons 600 in the spinal canal 500. Secondly, the separated bone pieces 210 are subjected to the force pushing into the vertebral canal 500, which can also cause serious medical accidents if the bone pieces 210 run into the vertebral canal 500. In this embodiment, first, the following is performed. Since the fixing needle 20 is fixed to the bone block 210, when the bone block 210 has not been separated from the upper articular process 200, the fixing needle 20 is fixed to the upper articular process 200, and after the bone block 210 is separated from the upper articular process 200, the fixing needle 20 is fixed to the bone block 210 only. After the bone block 210 is separated from the superior articular process 200, the bone block 210 rotates along with the rotation of the trepan 30 under the action of friction force, and the rotation of the bone block 210 drives the rotation of the fixing needle 20, so that whether the cutting of the bone block 210 is completed can be judged by observing whether the fixing needle 20 rotates, and if so, the feeding of the trepan 30 should be stopped immediately. Second, since the fixing needle 20 is fixed to the bone block 210 in the present embodiment, the bone block 210 is prevented from entering the vertebral canal 500, and even if it enters, it is also possible to withdraw the bone block 210 along with the fixing needle 20, thereby preventing accidents caused by the separated bone block 210 entering the vertebral canal 500.
Referring to fig. 16 and also to fig. 1-9, fixation needle 20 is reversed to remove bone pieces 210 to form enlarged intervertebral foramen 400. Reversing refers to the direction opposite to the feed of the trepan 30, which in fig. 16 corresponds to taking the bone pieces 210 to the right, along with the bone pieces 210, as well as the fixation needle 20, trepan 30 and duck tongue bar 10. Leaving only the protective sheath 40 still within the intervertebral foramen 400 to guide a subsequent foramen mirror 300 or other surgical instrument through the intervertebral foramen 400 into the spinal canal 500.
Referring to fig. 17 and 1-9, the foramen mirror 300 is viewed through the enlarged intervertebral foramen 400 into the spinal canal 500, it being understood that other situations may be implemented where instruments are required to access the intervertebral foramen 400 and the spinal canal 500, as appropriate. The protective sheath 40 serves primarily as a guide to prevent other tissues of the body from flooding the foramen 400, resulting in the physician not being able to locate the foramen 400 where reaming has just been completed.
The duck tongue bar 10 adopts an eccentric shaft design, and is matched with the trepan 30, the trepan 30 is sleeved on the outer side 12 of the duck tongue bar 10, and the trepan 30 is arranged outside, so that the duck tongue bar 10 is arranged inside, the specifications of the trepan 30 can flexibly adopt a large-size aperture, and a taper hole with a larger aperture can be formed at one time.
Specifically, the fixing needle 20 penetrates the hole 11 in the duck bill bar 10 and is screwed into the upper articular process 200 in the axial direction F1. The center of the duck tongue bar 10 is provided with a central hole 11 penetrating along the axial direction F1, and a fixing needle 20 penetrates through the central hole 11 along the axial direction F1 and is screwed into the upper articular process 200 to be fixed with the upper articular process 200.
Because neurons 600 are distributed inside and outside the intervertebral foramen 400, it is desirable to avoid touching the cut neurons 600 and also to avoid the cut bone pieces 210 from entering the intervertebral foramen 400 along the axial direction F1. The fixing needle 20 plays three roles, namely, fixing the bone block 210 to facilitate the stable cutting of the trepan 30, reversely carrying the bone block 210 fixed with the fixing needle away from the human body after the cutting is completed to avoid the bone block 210 from sliding into the vertebral canal 500 carelessly, and facilitating the observation of whether the cutting step of the trepan 30 is completed.
Specifically, the trepan 30 is sleeved on the outer side 12 of the duck tongue 10, and the upper articular process 200 is cut by rotating around the outer side 12. Here, the duck tongue bar 10 has a positioning function, so that the trepan 30 sleeved on the outer side 12 of the duck tongue bar 10 can stably perform rotary cutting in a target area, and also has a rotating shaft function, the trepan 30 is sleeved on the outer side 12 of the duck tongue bar 10, and the inner wall 31 of the trepan 30 is in sliding contact with the outer side 12 of the duck tongue bar 10.
Specifically, the trepan 30 is fed through the superior articular process 200 in the axial direction F1 to separate out the bone pieces 210 screwed with the fixing needles 20 in one step, and the fixing needles 20 reversely carry away the bone pieces 210 to finish reaming. The foramen mirror 300 passes through the enlarged intervertebral foramen 400 into the spinal canal 500. The trepan 30 is fed in the axial direction F1 while rotating and cutting until penetrating the superior articular process 200.
When the trepan 30 cuts, the duck tongue bar 10 is always kept in the abutting positioning position. Because the fixing needle 20 is screwed into the upper articular process 200, and the fixing needle 20 passes through the middle hole 11 of the duck tongue bar 10 and then is fixed with the upper articular process 200, the fixing needle 20 is equivalent to limiting the duck tongue bar 10 to a certain extent, and the situation that the abutting position of the duck tongue bar 10 and the upper articular process 200 is randomly deviated in the forced cutting process of the circular saw 30 during cutting is avoided.
Because the trephine 30 is arranged on the outer side 12, the duck tongue stick 10 is arranged on the inner side, a doctor can select the trephine 30 with proper aperture size according to the condition of the patient during operation, and reaming of the intervertebral foramen 400 is finished on the upper articular process 200 at one time, so that the trephine 30 with different aperture sizes is prevented from being replaced for multiple times to finish reaming molding step by step.
After the trepan 30 completes cutting, the fixing needle 20 is withdrawn in the reverse direction of feeding of the trepan 30, and simultaneously takes away the fixed bone block 210 with the fixing needle, thereby completing reaming molding.
Preferably, when the trepan 30 rotates to cut the upper articular process 200, the trepan 30 rotates relative to the upper articular process 200 and thus relative to the fixing needle 20, and after the trepan 30 penetrates the upper articular process 200 to separate the bone pieces 210, the trepan 30 drives the bone pieces 210 to rotate and thus to be stationary relative to the fixing needle 20.
Since the trepan 30 rotates to cut the upper articular process 200, the trepan 30 rotates relative to the upper articular process 200, and the upper articular process 200 is fixed to the fixing needle 20, the trepan 30 rotates relative to the fixing needle 20. After trepan 30 penetrates superior articular process 200 to separate bone pieces 210, it is a separate individual from bone pieces 210 that remain in contact with inner wall 31 of trepan 30 and separate from superior articular process 200. If the trepan 30 continues to rotate, the separated bone pieces 210 will follow the trepan 30 under the action of friction force, and at this time, since the separated bone pieces 210 are still fixed with the fixing needle 20, the bone pieces 210 rotate with the trepan 30, which corresponds to the fixing needle 20 rotating with the trepan 30, and thus the fixing needle 20 is relatively stationary with the trepan 30. By determining whether the stationary needle 20 rotates with the trephine 30, it can be determined whether the trephine 30 penetrates the superior articular process 200. Thereby preventing the trepan 30 from extending into the intervertebral foramen 400 to compress or cut the neuron 600.
More preferably, the duck tongue bar 10 comprises a body 13 and a head 14.
Specifically, the rod 13 extends in the axial direction F1, and the center of the shaft T penetrates the center hole 11. The rod 13 is cylindrical, and the middle hole 11 penetrates through the center of the rod 13. The rod 13 has a ring-shaped cross section, and the fixing needle 20 is inserted through the middle hole 11 to be fixed with the upper articular process 200. The head 14 is integrally formed at one end of the rod 13, and the head 14 is offset from the axis T of the rod 13 as viewed in the axial direction F1.
Specifically, the trepan 30 is sleeved on the outer side 12 of the rod 13, and when the trepan 30 rotates to cut the upper articular process 200, the head 14 is stationary relative to the upper articular process 200, the trepan 30 rotates relative to the rod 13, and the rod 13 is stationary relative to the head 14 and further stationary relative to the upper articular process 200. After the trepan 30 penetrates the superior articular process 200 to separate the bone pieces 210, the trepan 30 drives the bone pieces 210 to rotate, and the bone pieces 210 drive the head 14 and the fixing needle 20 to rotate, wherein when the fixing needle 20 is observed to rotate along with the trepan 30, the step of separating the bone pieces 210 is judged to be completed, and the rotary trepan 30 is immediately stopped, so that the head 14 is prevented from losing a positioning position along with the rotation of the bone pieces 210.
More preferably, the fixation needle 20 is threaded into the bone block 210 at one end, denoted as front end 21, and at the other end denoted as rear end 22, said front end 21 being provided with a first phase indication. When the trepan 30 rotates to cut the upper articular process 200, it is observed whether the first phase mark is rotated to determine whether the bone block 210 separation step is completed, and if so, the rotation of the trepan 30 is stopped immediately.
Specifically, the front end 21 of the fixation needle 20 is screwed into and fixed to the superior articular process 200, and the rear end 22 is provided with a first phase mark for observing the cutting process. The trepan 30 rotates on the outer side 12 of the duck tongue 10, progressively cutting the upper articular process 200. During this process, the fixation needle 20 is always fixed to the bone block 210 and the trephine 30 is rotated relative to the superior articular process 200 and the fixation needle 20. When the trepan 30 penetrates the superior articular process 200 and the bone pieces 210 are completely cut, the bone pieces 210 separate from the overall articular process 200 as a single piece. As the trepan 30 continues to rotate, the bone pieces 210 will also rotate under the friction of the inner wall 31 of the trepan 30. If the rear end 22 of the fixation needle 20 (i.e., the end provided with the first phase indication) is observed to begin to rotate with the trepan 30, it is indicated that the bone pieces 210 have separated and are rotating following the trepan 30. This means that the cutting operation of the trephine 30 has been completed, at which point the rotation of the trephine 30 needs to be stopped immediately to avoid that the trephine 30 continues to cut deep, accidentally injuring the neurons 600 in the intervertebral foramen 400.
The first phase mark may be a notch formed on the tail, a color mark coated on the tail, or other components for other marking functions. In this embodiment, the handle 42 of the fixed needle 20 is used as the first phase marker.
More preferably, the head 14 includes a tongue base 143 and a tongue tip 144. The tongue 143 is connected to the rod 13, and the tongue 143 is positioned in contact with the ventral side of the upper articular process 200 when viewed in the vertical axis F1. The tongue tip 144 is connected to the tongue root 143 and is located on a side of the tongue root 143 away from the stick body 13, and the tongue tip 144 extends into the vertebral canal 500 through the intervertebral foramen 400 and pushes against the neuron 600 in the vertebral canal 500.
More preferably, the head 14 includes a back 141 and a front 142.
Specifically, the back surface 141 is a surface that contacts the inner wall 31 of the trepan 30. The front surface 142 is a surface positioned in contact with one side of the upper articular process 200 in the vertical axial direction F1. Referring to fig. 6, the front surface 142 contacts the upper articular process 200 at a position offset from the axis T of the rod 13, and the rod 13 has an axis offset from the area surrounded by the rear surface 141 and the front surface 142, as viewed in the axial direction F1.
Specifically, the back surface 141 is the surface of the duck tongue 10 that contacts the inner wall 31 of the trepan 30. The sliding contact between the back surface 141 and the trephine 30 allows the trephine 30 to rotate stably about the duck tongue bar 10 during cutting. The front surface 142 is a position where the duck tongue 10 abuts against one side of the upper articular process 200 in a direction perpendicular to the axial direction F1, for stably positioning the upper articular process 200 during cutting. The axial direction F1 is a direction along the central axis of the duck tongue 10. The front face 142 of the duck tongue 10 is positioned in contact with the upper articular process 200, as viewed in the axial direction F1, offset from the axis T of the body 13. That is, the front face 142 is not perfectly aligned with the center of the rod 13, but is eccentrically contacted with one side of the upper articular process 200.
More preferably, the end of the body 13 opposite the head 14 is denoted as the tail. The tail is formed with a second phase mark on a line of symmetry perpendicular to the front face 142, as viewed along the axial direction F1. When the duck tongue bar 10 is abutted against one side of the upper joint protrusion 200, whether the front face 142 is abutted against one side of the upper joint protrusion 200 is judged by the second phase mark, so that the damage to the neuron 600 outside the target area when the trepan 30 is sleeved into the duck tongue bar 10 is avoided.
The second phase mark may be a score formed in the tail, a color mark applied to the tail, or other means for other marking purposes. In this embodiment, a colored score is used as the second phase mark (not shown).
Specifically, the head 14 is the side of the duck tongue 10 that contacts and positions the upper articular process 200. The tail has a second phase mark for providing visual assistance during surgery to ensure proper positioning of the duck tongue 10. In operation, the duck tongue bar 10 needs to be accurately positioned in abutment with the side of the upper articular process 200. To ensure that the front face 142 of the duck tongue 10 remains in proper contact with the upper articular process 200 throughout the process, the second phase mark may be used as a reference point to assist the physician in determining whether the orientation of the duck tongue 10 is correct.
When the trepan 30 is nested into the duck tongue bar 10 for cutting, if the direction of the duck tongue bar 10 is not aligned, the trepan 30 may deviate from the target area and cut to an area outside the upper articular process 200. The second phase mark is designed to avoid this, ensuring correct orientation by simple visual confirmation.
More preferably, the protective sheath 40 includes a chute 41 and a handle 42.
Specifically, the chute 41 is shaped to conform to the shape of the outer wall 32 of the trepan 30 and forms an open opening 411. The handle 42 is connected to the chute 41 and is located on a side facing away from the open opening 411, and when extending into the intervertebral foramen 400, the open opening 411 is oriented in the same direction as the second phase mark, as seen in the axial direction F1.
The second phase mark indicates where the front face 142 of the duck tongue 10 is in contact with the upper articular process 200. The orientation of the open opening 411 in accordance with this indicator ensures that the protective sheath 40 is inserted in a direction consistent with the positioning of the intervertebral foramen 400 without creating additional pressure or damage to the peripheral nerve or bone structure.
More preferably, the trepan 30 has teeth 33 formed at one end of the upper articular process 200, and a trepan handle 34 movably connected to the other end. The front end 21 of the fixed needle 20 is provided with a threaded drill bit 211, the rear end 22 is movably connected with a positioning needle handle 221, one end of the positioning needle handle 221 is connected with the fixed needle 20, and the other end of the positioning needle handle extends unidirectionally and linearly to play a role of a first phase mark.
Specifically, the positioning of the ring tooth 33 at the end of the ring saw 30 where the upper articular process 200 is cut is a critical part of the cutting function of the ring saw 30. The other end of the trepan 30 is movably connected to a trepan handle 34 to allow a physician to conveniently control the rotational cutting of the trepan 30. The head 14 of the fixation needle 20 is provided with a threaded drill bit 211 so that the fixation needle 20 can be screwed into the superior articular process 200, in firm connection with the bone pieces 210.
Therefore, the duck tongue bar 10 with the eccentric shaft structure is abutted against the abdomen side of the upper joint protrusion 200 for positioning, and then the trepan 30 is used for rotary cutting around the outer side 12 of the duck tongue bar 10, so that the rapid reaming and forming of the intervertebral foramen 400 is realized in one step. And the fixing needle 20 is fastened with the upper articular process 200 through threads, so that the trephine 30 is convenient to stably cut the bone block 210 during cutting, and after the cutting is completed, the fixing needle 20 reversely takes away the bone block 210, so that the bone block 210 is prevented from entering the vertebral canal 500, and the neurons 600 in the vertebral canal 500 are prevented from being damaged. Thus, one-step formation of the reaming of the intervertebral foramen 400 is achieved while avoiding damage to the peripheral neurons 600.
The above embodiments represent only a few embodiments of the present application, which are described in more detail and are not to be construed as limiting the scope of the claims. It should be noted that it will be apparent to those skilled in the art that various modifications and improvements can be made without departing from the spirit of the application, which are within the scope of the application.

Claims (10)

Translated fromChinese
1.一种椎间孔快速成型器械套装,用于下位椎骨的上关节突腹侧的椎间孔扩孔成型,其特征在于,所述套装包括:1. An intervertebral foramen rapid prototyping instrument kit, used for the intervertebral foramen expansion and prototyping of the ventral side of the superior articular process of the inferior vertebra, characterized in that the kit comprises:鸭舌棒,其头部经椎间孔伸入椎管中,并与上关节突的腹侧偏心抵接;The head of the duck tongue stick extends into the spinal canal through the intervertebral foramen and abuts eccentrically against the ventral side of the superior articular process;固定针,沿鸭舌棒的轴向贯穿所述鸭舌棒的中孔,并旋转拧入上关节突;A fixing needle is inserted through the middle hole of the duck tongue stick along the axial direction of the duck tongue stick and is rotated and screwed into the superior articular process;保护鞘,沿鸭舌棒外侧滑入椎间孔中,并顶开周围的神经元;The protective sheath slides along the outside of the duck tongue bar into the intervertebral foramen and pushes open the surrounding neurons;环锯,外套于所述鸭舌棒外侧,并介于鸭舌棒与保护鞘之间,且沿鸭舌棒的轴向进给,并旋转切削且穿透上关节突,一步分离出与所述固定针相螺纹紧固的骨块,所述固定针反向带走所述骨块以扩大所述椎间孔,孔镜经由椎间孔探入椎管观察。The ring saw is sleeved on the outside of the duck tongue stick and is between the duck tongue stick and the protective sheath. It is fed along the axial direction of the duck tongue stick, and rotates to cut and penetrate the superior articular process, separating the bone block threadedly fastened to the fixing pin in one step. The fixing pin takes away the bone block in the reverse direction to expand the intervertebral foramen, and the endoscope is inserted into the spinal canal through the intervertebral foramen for observation.2.根据权利要求1所述的椎间孔快速成型器械套装,其特征在于,所述鸭舌棒包括:2. The intervertebral foramen rapid prototyping instrument set according to claim 1, characterized in that the duck tongue bar comprises:棒体,沿轴向延伸,且轴心贯穿形成所述中孔;The rod body extends in the axial direction, and the axis passes through to form the central hole;头部,一体成型于所述棒体的一端,且沿轴向观察,所述头部偏离所述棒体的轴心;沿垂直轴向观察,偏离轴心的头部与上关节突的腹侧相抵接定位。The head is integrally formed at one end of the rod body, and when viewed along the axial direction, the head deviates from the axis of the rod body; when viewed along the vertical axis, the head deviating from the axis is positioned in contact with the ventral side of the superior articular process.3.根据权利要求2所述的椎间孔快速成型器械套装,其特征在于,所述头部包括:3. The intervertebral foramen rapid prototyping instrument kit according to claim 2, wherein the head comprises:舌根,与所述棒体相连,沿垂直轴向观察,所述舌根与上关节突的腹侧相抵接定位;The tongue root is connected to the rod body, and when viewed along the vertical axis, the tongue root is in contact with the ventral side of the superior articular process;舌尖,与所述舌根相连,且位于所述舌根远离棒体的一侧,所述舌尖经椎间孔伸入椎管中,并顶开椎管内的神经元。The tongue tip is connected to the tongue root and is located at a side of the tongue root away from the rod body. The tongue tip extends into the spinal canal through the intervertebral foramen and pushes open the neurons in the spinal canal.4.根据权利要求1所述的椎间孔快速成型器械套装,其特征在于,4. The intervertebral foramen rapid prototyping instrument kit according to claim 1, characterized in that:环锯旋转切削上关节突时,环锯与上关节突相对转动,进而与固定针相对转动;环锯穿透上关节突分离出骨块后,环锯带动骨块转动,进而与固定针相对静止。When the ring saw rotates to cut the superior articular process, the ring saw rotates relative to the superior articular process and then rotates relative to the fixing pin; after the ring saw penetrates the superior articular process to separate the bone block, the ring saw drives the bone block to rotate and then remains relatively still with the fixing pin.5.根据权利要求4所述的椎间孔快速成型器械套装,其特征在于,5. The intervertebral foramen rapid prototyping instrument kit according to claim 4, characterized in that:环锯旋转切削上关节突时,鸭舌棒相对上关节突静止,环锯相对鸭舌棒转动;When the ring saw rotates to cut the superior articular process, the duck tongue stick is stationary relative to the superior articular process, and the ring saw rotates relative to the duck tongue stick;环锯穿透上关节突分离出骨块后,环锯在摩擦力作用下带动骨块相对上关节突转动,骨块带动与之相抵接的鸭舌棒和与之相固定针转动,其中,After the ring saw penetrates the superior articular process and separates the bone block, the ring saw drives the bone block to rotate relative to the superior articular process under the action of friction, and the bone block drives the duck tongue stick and the fixed needle abutting against it to rotate, wherein,当观察到固定针随环锯转动时,判定骨块分离步骤完成,立即停止进给环锯,避免环锯伸入椎管损伤神经元。When the fixation needle is observed to rotate with the ring saw, the bone block separation step is determined to be completed, and the feeding of the ring saw is immediately stopped to prevent the ring saw from extending into the spinal canal and damaging neurons.6.根据权利要求1所述的椎间孔快速成型器械套装,其特征在于,6. The intervertebral foramen rapid prototyping instrument kit according to claim 1, characterized in that:固定针拧入骨块的一端记为前端,另一端记为后端,所述后端设有第一相位标识;One end of the fixing needle screwed into the bone block is marked as the front end, and the other end is marked as the rear end, and the rear end is provided with a first phase mark;环锯旋转切削上关节突时,观察所述第一相位标识是否转动,以判定骨块分离步骤是否完成,若是,则立即停止旋转环锯。When the ring saw is rotated to cut the superior articular process, observe whether the first phase mark rotates to determine whether the bone block separation step is completed. If so, stop rotating the ring saw immediately.7.根据权利要求2所述的椎间孔快速成型器械套装,其特征在于,所述头部还包括:7. The intervertebral foramen rapid prototyping instrument kit according to claim 2, wherein the head further comprises:背面,与环锯的内壁相接触的面;The back side, the side in contact with the inner wall of the trephine;正面,与上关节突相抵接定位的面,沿轴向观察,所述正面与上关节突相接触的位置偏离所述棒体的轴心,棒体的轴线偏离所述背面与所述正面围成的区域。The front side is the side that abuts against the superior articular process. When viewed axially, the position where the front side contacts the superior articular process deviates from the axis of the rod body, and the axis of the rod body deviates from the area enclosed by the back side and the front side.8.根据权利要求7所述的椎间孔快速成型器械套装,其特征在于,8. The intervertebral foramen rapid prototyping instrument kit according to claim 7, characterized in that:棒体与头部相对的另一端记为尾部,沿轴向观察,所述尾部在垂直所述正面的对称线上形成有第二相位标识;The other end of the rod body opposite to the head is marked as a tail, and when viewed along the axial direction, the tail forms a second phase mark on a symmetry line perpendicular to the front side;鸭舌棒与上关节突的腹侧抵接定位时,通过所述第二相位标识判定是否为正面与上关节突相抵接,避免环锯套入鸭舌棒时损伤目标区域外的神经元。When the duck tongue stick is in contact with the ventral side of the superior articular process, the second phase mark is used to determine whether the front side is in contact with the superior articular process, so as to avoid damaging neurons outside the target area when the ring saw is inserted into the duck tongue stick.9.根据权利要求1所述的椎间孔快速成型器械套装,其特征在于,所述保护鞘包括:9. The intervertebral foramen rapid prototyping instrument kit according to claim 1, wherein the protective sheath comprises:滑槽,形状与环锯的外壁形状相适应,且形成开放式开口,The shape of the slide is adapted to the outer wall shape of the ring saw and forms an open opening.手柄,与所述滑槽相连,且位于背离所述开放式开口的一面;所述环锯沿轴向套入所述鸭舌棒时,环锯位于滑槽与鸭舌棒之间。The handle is connected to the slide groove and is located on the side away from the open opening; when the ring saw is axially inserted into the duck tongue stick, the ring saw is located between the slide groove and the duck tongue stick.10.根据权利要求1所述的椎间孔快速成型器械套装,其特征在于,10. The intervertebral foramen rapid prototyping instrument kit according to claim 1, characterized in that:所述环锯切削上关节突的一端形成有环齿,另一端活动连接有环锯手柄;One end of the trephine for cutting the superior articular process is formed with a ring tooth, and the other end is movably connected with a trephine handle;所述固定针拧入上关节突的一端形成有螺纹钻头,另一端活动连接有固定针手柄,所述固定针手柄的一端与所述固定针相连,另一端单向线性地延伸。One end of the fixing needle screwed into the superior articular process is formed with a threaded drill bit, and the other end is movably connected with a fixing needle handle, one end of the fixing needle handle is connected to the fixing needle, and the other end extends linearly in one direction.
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