CN200994767Y - A distraction device for minimally invasive lumbar surgery - Google Patents

Abstract

The utility model relates to a distraction device for minimally invasive lumbar surgery, which comprises a bearing mechanism with an annular guide rail; a plurality of sliding seat mechanisms movably arranged on the annular guide rail; at least two outer muscle hooking mechanisms respectively assembled on the two adjacent sliding seat mechanisms; an inner muscle hooking mechanism arranged on one of the sliding seat mechanisms; and a nerve hooking mechanism arranged on the other sliding seat mechanism. Therefore, the sliding seat mechanism on the bearing mechanism can be used for matching with at least two outer side muscle hooking mechanisms, an inner side muscle hooking mechanism and a nerve hooking mechanism, so that the minimally invasive lumbar vertebra operation is performed with small wound and less tissue damage, the nerve tissue can be safely protected to avoid repeated artificial fingering, the muscle can be hooked open under the condition of not cutting off the tendon, and a clear and wide operation visual field is formed.

Description

Translated fromChinese

微创腰椎手术的撑开装置A distraction device for minimally invasive lumbar surgery

技术领域technical field

本实用新型有关于一种微创腰椎手术的撑开装置，尤指一种可于施行微创腰椎手术时达到伤口小、组织破坏少，且可安全保护神经组织以避免反复的人为拨弄，并可于不切断肌腱的情况下将肌肉勾开，形成清楚且广范的手术视野的微创腰椎手术的撑开装置。The utility model relates to a distraction device for minimally invasive lumbar spine surgery, especially a device that can achieve small wounds and less tissue damage during minimally invasive lumbar spine surgery, and can safely protect nerve tissue from repeated human fiddles. It is a distraction device for minimally invasive lumbar spine surgery that can pull apart muscles without cutting off tendons to form a clear and wide surgical field of view.

背景技术Background technique

腰椎病变如椎管狭窄或椎间盘突出等(Herniated disc)，经常会造成严重的坐骨神经痛(Sciatica)、跛行或神经病变，此类患者部分的确需要进行手术治疗，然而漫长的复原期及复健常导致患者犹豫是否欲进一步施行手术，因为传统的手术路径(如图1及图2所示)是经由背部的正中线，切开筋膜(Fascia)及棘上韧带(Supraspinous ligament)，再将脊椎4旁的肌肉41以工具42沿着骨膜拨离，并以勾具43勾向二侧固定；如此一来，许多附着于脊椎4上的肌腱必须切断，而传统的椎板切除术(laminectomy)又必须将椎棘及棘间韧带(Interspinous ligament)切除以达到使神经减压的目的，因此造成患者部分椎骨及肌肉肌腱受到破坏，以致有下列缺点产生：Lumbar spine lesions such as spinal stenosis or herniated disc often cause severe sciatica, claudication or neuropathy. Some of these patients do need surgical treatment, but the long recovery period and rehabilitation often lead to The patient hesitated whether to perform further surgery, because the traditional surgical approach (as shown in Figure 1 and Figure 2) is through the midline of the back, incision of the fascia and supraspinous ligament, and then thespine 4 Theadjacent muscles 41 are pulled away along the periosteum withtools 42 and fixed to both sides withhooks 43; in this way, many tendons attached to thespine 4 must be cut off, and the traditional laminectomy (laminectomy) The vertebral spine and interspinous ligament (Interspinous ligament) must be resected to achieve the purpose of decompression of the nerve, thus causing damage to some vertebrae and muscle tendons of the patient, resulting in the following disadvantages:

1.完成肌肉缝合的手术后，肌肉及肌腱无法贴复回解剖前的原来位置，不符合人体背部肌肉运动的自然生理。1. After the muscle suturing operation is completed, the muscles and tendons cannot be pasted back to their original positions before dissection, which is not in line with the natural physiology of human back muscle movement.

2.死空间(dead space)过大，易造成手术后的粘黏(epidural fibrosis)，以致术后效果大打折扣。2. If the dead space is too large, it is easy to cause epidural fibrosis after surgery, so that the postoperative effect is greatly reduced.

3.棘上韧带、椎棘及棘间韧带遭到切除，易造成术后脊柱(spinal column)的不稳定。3. The supraspinous ligament, vertebral spine and interspinous ligament are resected, which can easily cause postoperative spinal column instability.

由于上述传统手术存有诸多缺点，因此便有使伤口小及组织破坏少的微创手术应运而生，目前所使用的微创手术(如图3所示)，一般称为内视镜手术，该内视镜手术的方式是以一直径约2cm的套筒5穿过脊椎51旁的肌肉52，再于该套筒5内穿设微型摄影机53，进而将视野传达投射至显示器屏幕上(图中未示)，通过工具55置于套筒5内来施行手术，如此，可改善上述现有结构的缺点，达到伤口小及组织破坏少的优点。Due to the many shortcomings of the above-mentioned traditional surgery, minimally invasive surgery with small wounds and less tissue damage has emerged. The currently used minimally invasive surgery (as shown in Figure 3) is generally called endoscopic surgery. The method of this endoscopic operation is that a sleeve 5 with a diameter of about 2 cm passes through themuscle 52 next to thespine 51, and then amicro camera 53 is installed in the sleeve 5, and then the visual field is transmitted and projected onto the display screen (Fig. Not shown in the middle), the operation is performed by placing thetool 55 in the sleeve 5, so that the shortcomings of the above-mentioned existing structure can be improved, and the advantages of small wound and less tissue damage can be achieved.

但就该微创手术而言，当套筒5穿过脊椎51旁的肌肉52而落设于所需的位置时，常会因该套筒5的一端缘受制于脊椎51的形廓而造成干涉阻碍，使套筒5的端缘卡到脊椎51，且手术进行时，医疗人员仅能从直径约2cm的套筒5内得到有限的手术视野，而该套筒5内又同时穿设有手术所需的工具55，因而造成手术进行时，存有太多的视野死角，不但无法对神经产生减压，对医疗人员而言，也必须经过长时间的训练才能以此方式施行所需的微创手术。However, as far as this minimally invasive operation is concerned, when the sleeve 5 passes through themuscle 52 next to thevertebra 51 and is placed at the desired position, it often causes interference because one end edge of the sleeve 5 is constrained by the shape of thespine 51. Obstacles, so that the end edge of the sleeve 5 is stuck to thespine 51, and when the operation is in progress, the medical staff can only get a limited surgical field of view from the sleeve 5 with a diameter of about 2 cm, and the sleeve 5 is also pierced with a surgical needle. The requiredtools 55, thus causing too many blind spots in the field of vision during the operation, not only cannot decompress the nerves, but for medical personnel, it is necessary to undergo long-term training before performing the required microscopic surgery. invasive surgery.

实用新型内容Utility model content

本实用新型的主要目的在于解决上述缺陷、避免缺陷存在而提供一种微创腰椎手术的撑开装置，可通过承载机构上的滑座机构配合至少二外侧肌肉勾拉机构、一内侧肌肉勾拉机构及一神经勾拉机构移动至所需的位置及高度，而于施行微创腰椎手术时达到伤口小、组织破坏少，且可安全保护神经组织以避免反复的人为拨弄，并可于不切断肌腱的情况下将肌肉勾开，形成清楚且广范的手术视野。The main purpose of this utility model is to solve the above-mentioned defects, avoid the existence of defects and provide a distraction device for minimally invasive lumbar surgery, which can cooperate with at least two outer muscle hook-pull mechanisms and one inner muscle hook-pull mechanism through the sliding seat mechanism on the bearing mechanism. The mechanism and a nerve hooking mechanism can be moved to the required position and height, so that the minimally invasive lumbar spine surgery can achieve small wounds and less tissue damage, and can safely protect the nerve tissue from repeated manual manipulation, and can be performed without cutting In the case of tendons, the muscles are hooked apart to form a clear and wide surgical field of view.

为达上述的目的，本实用新型所提供的微创腰椎手术的撑开装置，包含有一具有环形导轨的承载机构；多数活动设置于环形导轨上的滑座机构；至少二分别组装于相邻两滑座机构上的外侧肌肉勾拉机构；一设置于其中一滑座机构上的内侧肌肉勾拉机构；及一设置于另一滑座机构上的神经勾拉机构。In order to achieve the above-mentioned purpose, the distraction device for minimally invasive lumbar spine surgery provided by the utility model includes a bearing mechanism with an annular guide rail; most of the sliding seat mechanisms are movably arranged on the annular guide rail; An outer muscle hooking mechanism on the sliding seat mechanism; an inner muscle hooking mechanism arranged on one of the sliding seat mechanisms; and a nerve hooking mechanism arranged on the other sliding seat mechanism.

综上所述，本实用新型的效果是显著的：本实用新型的微创腰椎手术的撑开装置可有效改善现有结构的种种缺点，可利用承载机构上的滑座机构配合至少二外侧肌肉勾拉机构、一内侧肌肉勾拉机构及一神经勾拉机构，而于施行微创腰椎手术时达到伤口小、组织破坏少，且可安全保护神经组织以避免反复的人为拨弄，并可于不切断肌腱的情况下将肌肉勾开，形成清楚且广围的手术视野。To sum up, the effect of the utility model is remarkable: the distraction device of the minimally invasive lumbar spine surgery of the utility model can effectively improve various shortcomings of the existing structure, and the sliding seat mechanism on the bearing mechanism can be used to cooperate with at least two lateral muscles A hook-and-pull mechanism, a inner muscle hook-and-pull mechanism, and a nerve hook-pull mechanism can achieve small wounds and less tissue damage during minimally invasive lumbar spine surgery, and can safely protect nerve tissues from repeated manual manipulation, and can be used in different When the tendon is severed, the muscle is pulled apart to form a clear and wide surgical field of view.

附图说明Description of drawings

图1、2 为传统手术的施行示意图。Figures 1 and 2 are schematic diagrams of traditional operations.

图3    为目前微创手术的施行示意图。Figure 3 is a schematic diagram of the implementation of the current minimally invasive surgery.

图4    为本实用新型的立体外观示意图。Figure 4 is a schematic diagram of the three-dimensional appearance of the utility model.

图5    为本实用新型滑座机构的外观立体图。Figure 5 is a perspective view of the appearance of the sliding seat mechanism of the present utility model.

图6    为本实用新型滑座机构的立体分解图。Figure 6 is a three-dimensional exploded view of the sliding seat mechanism of the utility model.

图7    为本实用新型滑座机构的侧视图。Fig. 7 is a side view of the sliding seat mechanism of the present utility model.

图8    为本实用新型滑座机构的前视图。Fig. 8 is the front view of the sliding seat mechanism of the present utility model.

图9    为本实用新型外侧肌肉勾拉机构的外观立体图。Fig. 9 is a perspective view of the appearance of the outer muscle hooking mechanism of the present utility model.

图10   为本实用新型外侧肌肉勾拉机构的立体分解图。Fig. 10 is a three-dimensional exploded view of the outer muscle hooking mechanism of the present utility model.

图10A  为图10的连接单元的分解示意图。Figure 10A is an exploded schematic view of the connecting unit of Figure 10.

图11   为图10的连接单元的部份剖视图。Fig. 11 is a partial sectional view of the connection unit of Fig. 10.

图12   为本实用新型内侧肌肉勾拉机构的外观立体图。Figure 12 is a perspective view of the appearance of the inner muscle hooking mechanism of the present utility model.

图13   为本实用新型内侧肌肉勾拉机构的立体分解图。Fig. 13 is a three-dimensional exploded view of the inner muscle hooking mechanism of the present utility model.

图13A  为图13的连接单元的分解示意图。Figure 13A is an exploded schematic diagram of the connection unit of Figure 13.

图14   为本实用新型神经勾拉机构的外观立体图。Figure 14 is a perspective view of the appearance of the nerve hooking mechanism of the present invention.

图15   为本实用新型神经勾拉机构的立体分解图。Fig. 15 is a three-dimensional exploded view of the nerve hooking mechanism of the present invention.

图15A  为图15的连接单元的分解示意图。Figure 15A is an exploded schematic view of the connecting unit of Figure 15.

图16   为图15的连接单元的部份剖视图。Fig. 16 is a partial sectional view of the connection unit of Fig. 15.

元件标号对照Component designation comparison

现有部分existing part

4……脊椎                  41……肌肉4...spine 41...muscle

42……工具                 43……勾具42...Tools 43...Hooks

5……套筒                  51……脊椎5...sleeve 51...spine

52…肌肉                   53……微型摄影机52...muscle 53...miniature camera

55……工具55... tools

本实用新型部分The utility model part

6……承载机构              61……环形导轨6...Bearing mechanism 61...Ring guide rail

7……滑座机构              71……座体7...Sliding seat mechanism 71...Seat body

711……弹簧座              712……楔槽711...spring seat 712...wedge groove

713……C型孔               72……组接部713...C-type hole 72...Assembly part

721……切槽                73……凹槽721...grooving 73...groove

74……限制单元             741……止挡部74...Limiting unit 741...Stop

742……压掣部              743……枢轴742...Depressingpart 743...Pivot

744……凸块                745……第一弹簧744...Bump 745...First spring

746……扣爪                75……调整单元746...Claw claw 75...Adjusting unit

751……按压部              752……顶掣部751...Pressing part 752...Top catch part

753……压板                754……第二弹簧753...Pressplate 754...Second spring

755……圆柱755...Cylinder

81……外侧肌肉勾拉机构     811……支架81...Lateralmuscle hooking mechanism 811...Bracket

8111……锯齿面             8112……接合部8111...Serrated surface 8112...Joint part

812……连接单元            8121……连接部812...Connection unit 8121...Connection part

8122……万向接头           8123……套接部8122...Universal joint 8123...Socket

8124……弹簧               8125……枢杆8124...Spring 8125...Pivot

8126……顶持块             813……外侧肌肉勾8126...Holding block 813...Outside muscle hook

8131……杆体               8132……勾部8131...Rod Body 8132...Hook

82……内侧肌肉勾拉机构     821……支架82...Internalmuscle hooking mechanism 821...Bracket

8211……锯齿面                8212……接合部8211...Serrated surface 8212...Joint part

8213……枢轴                  822……连接单元8213……Pivot 822……Connection unit

8221……连接部                8222……套接部8221...Connecting part 8222...Socketing part

8223……按压件                8224……顶块8223...Pressing piece 8224...Top block

8225……弹性元件              8226……枢杆8225...Elastic element 8226...Pivot

823……内侧肌肉勾             8231……杆体823...Internal muscle hook 8231...Rod body

8232……勾部                  8233……齿条部8232...Hook part 8233...Rack part

83……神经勾拉机构            831……支架83...Nerve hook mechanism 831... Bracket

8311……锯齿面                8312……接合部8311...Serrated surface 8312...Joint part

832……连接单元               832a……第一枢轴832...Connection unit 832a...First pivot

832b…第二枢轴                832c…第三枢轴832b…second pivot 832c…third pivot

8321……连接部                8322……万向接头8321...Connecting part 8322...Universal joint

8323……套接部                8324……上座体8323...Socket part 8324...Upper seat body

8324a…前开孔                 8324b…后开孔8324a...front opening 8324b...rear opening

8325……下座体                8326……按压件8325...Lower seat body 8326...Pressing piece

8326a…弹簧                   8326b…突起8326a…spring 8326b…protrusion

8327……弹性顶持块            8328……齿面扇形块8327...Elastictop holding block 8328...Tooth surface fan-shaped block

833……神经勾                 8331……杆体833...Nerve hook 8331...Rod body

8332……勾部8332...Hook department

具体实施方式Detailed ways

请参阅图4～16，如各图所示：本实用新型是一种微创腰椎手术的撑开装置，其至少是由一承载机构6、多数滑座机构7、至少二外侧肌肉勾拉机构81、一内侧肌肉勾拉机构82及一神经勾拉机构83所构成。Please refer to Figures 4 to 16, as shown in each figure: the utility model is a distraction device for minimally invasive lumbar spine surgery, which is at least composed of a bearing mechanism 6, a plurality of slidingseat mechanisms 7, and at least two outermuscle hooking mechanisms 81. It is composed of a medialmuscle hooking mechanism 82 and anerve hooking mechanism 83.

其中承载机构6为一外径在10至30cm范围内的环状导轨61，在20cm左右效果最佳，可通过一支撑臂固设于手术台上(图中未示)。Wherein the carrying mechanism 6 is anannular guide rail 61 with an outer diameter in the range of 10 to 30 cm, the best effect is about 20 cm, and it can be fixed on the operating table (not shown) by a support arm.

滑座机构7具有一座体71，其上具有一呈一侧开口的框型(即呈ㄈ型开口状)组接部72(如图5～图8所示)，该组接部72可活动结合于承载机构6的环形导轨61上，使得滑座机构7可于环形导轨61上任意移动位置进而固定，另于座体71的二侧分别设有一止挡部741以使其间形成有一凹槽73，该凹槽73二侧分别活动跨设有一限制单元74，同时于该座体71上设置有一楔槽712，该楔槽712内设有一调整单元75；其中各限制单元74向上延伸二相对应的扣爪746，且以一枢轴743与座体71的止挡部741枢接，使该对扣爪746分别位于止挡部741的前后两侧，利用扣爪746上的凸块744对应凹槽73的一侧内突，以对凹槽73形成限制作用。同时，另各限制单元74向下延伸一外倾的压掣部742，并以一贯穿座体71的第一弹簧745两端分别支撑两压掣部742，使得枢接于座体71上的至少二限制单元74保持上方扣爪746的凸块744对应凹槽73的一侧内突以形成限制作用，而下方的压掣部742保持外张(如图8所示)；当相对按压压掣部742时，会使两限制单元74向上延伸的扣爪746对应凹槽73外张，以解除对凹槽73的限制作用。而调整单元75是由一按压部751、一由按压部751一端向上延伸的顶掣部752、一由按压部751横向延伸的压板753及一设置于座体71的弹簧座711内部与压板753间的第二弹簧754所构成。其中压板753设于座体71上的楔槽712内，并通过压板753末端有一圆柱755可嵌入楔槽712末端的C型孔713，以及楔槽712下方形成为下倾面空间，使得调整单元75的按压部751可向下按压，并使顶掣部752可向下移动；并由于第二弹簧754所提供的回复力，使得调整单元75的顶掣部752保持在上方顶掣位置，可参见图7所示。另外，座体71所形成的组接部72下方开设一切槽721，以供组接部72具有弹性，方便组合于环形导轨61上。The slidingseat mechanism 7 has aseat body 71, on which there is a frame-shaped (that is, a ㄈ-shaped opening) assembly part 72 (as shown in Figures 5 to 8), which is open on one side, and theassembly part 72 is movable. Combined with thecircular guide rail 61 of the carrying mechanism 6, theslide seat mechanism 7 can be moved at any position on thecircular guide rail 61 and then fixed. In addition, astopper 741 is provided on both sides of theseat body 71 so that a groove is formed therebetween 73, the two sides of thegroove 73 are respectively provided with a restricting unit 74, and at the same time, awedge groove 712 is arranged on theseat body 71, and an adjusting unit 75 is arranged in thewedge groove 712; wherein each restricting unit 74 extends upward for two phases The correspondingbuckle claws 746 are pivotally connected to thestop portion 741 of theseat body 71 with apivot 743, so that the pair ofbuckle claws 746 are respectively located on the front and rear sides of thestop portion 741, and theprotrusions 744 on thebuckle claws 746 are used to One side corresponding to thegroove 73 protrudes inward to form a restriction on thegroove 73 . Simultaneously, each restricting unit 74 extends downwards an outwardly tiltingpressing portion 742, and supports the twopressing portions 742 with afirst spring 745 penetrating through theseat body 71 at both ends, so that the twopressing portions 742 that are pivotally connected to theseat body 71 At least two limiting units 74 keep theprotrusion 744 of theupper claw 746 protruding inward on one side corresponding to thegroove 73 to form a limiting effect, while the lowerpressing part 742 keeps expanding (as shown in FIG. 8 ); When thecatch portion 742 is closed, theclaws 746 extending upward of the two limiting units 74 will expand outward corresponding to thegroove 73 , so as to release the restriction on thegroove 73 . The adjustment unit 75 is composed of apressing portion 751, atop catch portion 752 extending upward from one end of thepressing portion 751, apressing plate 753 extending laterally from thepressing portion 751, and a spring seat 711 inside theseat body 71 and thepressing plate 753. Thesecond spring 754 between them is formed. Wherein thepressure plate 753 is arranged in thewedge groove 712 on theseat body 71, and a cylinder 755 at the end of thepressure plate 753 can be inserted into the C-shaped hole 713 at the end of thewedge groove 712, and the downward slope space is formed under thewedge groove 712, so that the adjustment unit Thepressing part 751 of the adjustment unit 75 can be pressed downwards, and thetop catch part 752 can be moved downward; and due to the restoring force provided by thesecond spring 754, thetop catch part 752 of the adjustment unit 75 remains at the top push stop position, which can See Figure 7. In addition, aslot 721 is defined under the assemblingportion 72 formed by theseat body 71 , so that the assemblingportion 72 has elasticity and is conveniently assembled on thecircular guide rail 61 .

上述滑座机构7具有两主要功能，一是可于环形导轨61上位意移动位置进而固定；二是可快速组装各种不同功能的拉杆机构。The above-mentioned slidingseat mechanism 7 has two main functions, one is that it can be moved on thering guide rail 61 and then fixed; the other is that it can quickly assemble various pull rod mechanisms with different functions.

外侧肌肉勾拉机构81(如图9～11所示)，主要是由一支架811、一连接单元812及一外侧肌肉勾813所构成。至少二外侧肌肉勾拉机构81的主要功能是将多裂肌(Multifidus muscle)向外侧拉开，其中支架811穿过滑座结构7的凹槽73，并被扣爪746上的凸块744限制而不致脱落，并在支架811底部具有一与滑座机构7的按压部751上的顶掣部752相互干涉的锯齿面8111，支架811的末端形成一接合部8112，该连接单元812的连接部8121与支架811的接合部8112是通过一万向接头8122组接，使得连接单元812可相对支架作角度调整；且连接单元812的一端设有一套接部8123，可参见图10A及图11所示，该套接部8123顶端于连接单元812内设有一顶持块8126，该顶持块8126通过一弹簧8124向套接部8123推顶，并以一枢杆8125自连接单元812外部贯穿顶持块8126以限制移动，套接部8123内供外侧肌肉勾813的杆体8131穿过，并以顶持块8126抵压持住定位，另外侧肌肉勾813是由一与连接单元812套接的杆体8131及一设于杆体8131一端的勾部8132所构成。The outer muscle hook pulling mechanism 81 (as shown in FIGS. 9 to 11 ) is mainly composed of abracket 811 , a connectingunit 812 and anouter muscle hook 813 . The main function of at least two outermuscle hooking mechanisms 81 is to pull the multifidus muscle (Multifidus muscle) outward, wherein thebracket 811 passes through thegroove 73 of the slidingseat structure 7, and is restricted by theprotrusion 744 on theclaw 746 not fall off, and at the bottom of thebracket 811, there is aserrated surface 8111 that interferes with thetop catch portion 752 on thepressing portion 751 of theslide mechanism 7. The end of thebracket 811 forms a joint 8112, and the connecting portion of the connectingunit 812 Thejunction 8112 between the 8121 and thebracket 811 is assembled through a universal joint 8122, so that the angle of theconnection unit 812 can be adjusted relative to the bracket; and one end of theconnection unit 812 is provided with asocket 8123, which can be seen in Figure 10A and Figure 11 As shown, the top of thesocket part 8123 is provided with a holding block 8126 in the connectingunit 812, and the holding block 8126 is pushed to thesocket part 8123 by a spring 8124, and a pivot rod 8125 penetrates the top from the outside of the connectingunit 812. The holding block 8126 is used to limit the movement, and therod body 8131 of theouter muscle hook 813 passes through thesleeve part 8123, and is pressed and held by the holding block 8126. The otherside muscle hook 813 is socketed with the connectingunit 812 Therod body 8131 and ahook portion 8132 disposed at one end of therod body 8131 are formed.

内侧肌肉勾拉机构82(如图12及图13所示)，主要是由一支架821、一连接单元822及一内侧肌肉勾823所构成。内侧肌肉勾拉机构82可将位于手术视野范围内侧的多裂肌向上拉开，以增加其内侧的视野，如此对于椎管狭窄的病人，可减轻椎管中央处(central canal)的压迫，其中支架821穿过滑座结构7的凹槽73，并被扣爪746上的凸块744限制而不致脱落，并在支架821底部具有一与滑座结构7的按压部751上的顶掣部752相互干涉的锯齿面8211，支架821的末端形成一接合部8212，该连接单元822的连接部8221与支架821的接合部8212通过一枢轴8213组接，使得连接单元822可相对支架821具有水平自由度；且连接单元822的连接部8221直向连通有一套接部8222，且该连接部8221上以一枢杆8226活动设有一按压件8223，该按压件8223的一端具有一设于套接部8222中的顶块8224，且该按压件8223与连接部8221之间设置有一弹性元件8225，可参见图13A所示，一枢杆8226自连接单元822外部贯穿按压件8223，使按压件8223在未被按压时保持顶块8224向套接部8222推抵，使顶块8224抵压内侧肌肉勾823杆体8231的齿条部8233以持住定位；而按压按压件8223会使顶块8224对内侧肌肉勾823顶持解除，此一设计使得内侧肌肉勾823具有相对上提的功能。套接部8222内供内侧肌肉勾823的杆体8231穿过，并以顶块8224抵压持住定位但可上提，另内侧肌肉勾823是由一连接单元822套接的杆体8231及一设于杆体8231一端的勾部8232所构成，并于杆体8231的一面上设有齿条部8233。The inner muscle hooking mechanism 82 (as shown in FIGS. 12 and 13 ) is mainly composed of abracket 821 , a connectingunit 822 and aninner muscle hook 823 . The innermuscle hooking mechanism 82 can pull the multifidus muscle located on the inner side of the surgical field of view upwards to increase the visual field of the inner side, so that for patients with spinal canal stenosis, the compression of the central canal of the spinal canal can be relieved, wherein Thebracket 821 passes through thegroove 73 of the slidingseat structure 7, and is restricted by theprotrusion 744 on theclaw 746 so as not to fall off, and there is atop catch part 752 on thepressing part 751 of the slidingseat structure 7 at the bottom of thebracket 821 Theserrated surface 8211 interferes with each other, and the end of thebracket 821 forms a joint 8212. The joint 8221 of the connectingunit 822 and the joint 8212 of thebracket 821 are assembled through a pivot 8213, so that the connectingunit 822 can have a level relative to thebracket 821. degree of freedom; and the connecting portion 8221 of the connectingunit 822 is directly connected with a sleeve portion 8222, and a pivot 8226 is movable on the connecting portion 8221 to be provided with a pressing member 8223, and one end of the pressing member 8223 has a set on the socket The top block 8224 in the part 8222, and an elastic element 8225 is arranged between the pressing part 8223 and the connecting part 8221, as shown in FIG. When not being pressed, keep the top block 8224 pushed against the sleeve portion 8222, so that the top block 8224 presses against the rack portion 8233 of theinner muscle hook 823 rod body 8231 to hold the position; and pressing the pressing piece 8223 will make the top block 8224 to align Theinner muscle hook 823 is lifted, and this design enables theinner muscle hook 823 to have a relatively upward lifting function. The rod body 8231 of theinner muscle hook 823 passes through the sleeve part 8222, and is pressed and held by the top block 8224 but can be lifted up. The hook portion 8232 at one end of the rod body 8231 is formed, and a rack portion 8233 is provided on one side of the rod body 8231 .

神经勾拉机构83(如图14～图16所示)，主要是由一支架831、一连接单元832及一神经勾833所构成。神经勾拉机构83可将神经根一次勾开并予以定位，以避免神经反复拨弄，其中支架831穿过滑座结构7的凹槽73，并被扣爪746上的凸块744限制而不致脱落，并在支架831底部具有一与滑座结构7的按压部751上的顶掣部752相互干涉的锯齿面8311，支架831的末端形成一接合部8312，该连接单元832的连接部8321与支架831的接合部8312通过一万向接头8322组接，使得连接单元832可相对支架831作角度调整；且连接单元832的一端设有一套接部8323，可参见图15A及图16所示，该套接部8323顶端延伸出一上座体8324，而连接部8321则延伸出一下座体8325，上座体8324具有一与套接部8323顶端相通且以第一枢轴832a贯穿前开孔8324a，使得下座体8325前端套合于前开孔8324a内并为枢接，同时使下座体8325前端的弹性顶持块8327自前开孔8324a伸入套接部8323的顶端，以持住神经勾833的杆体8331；另下座体8325则配合第二枢轴832b组接一齿面扇形块8328，并使该齿面扇形块8328伸入上座体8324的后开孔8324b；而上座体8324的后开孔8324b内则以第三枢轴832c枢接一按压件8326，该按压件8326设有一弹簧8326a，使得按压件8326前缘的一突起8326b可扣入齿面扇形块8328内，可参见图16所示，而按压件8326的作用是在提供所组装的神经勾833于垂直面上有弯曲的功能，另神经勾833是由一与连接单元832套接的杆体8331及一设于杆体8331一端的勾部8332所构成。The nerve hook pulling mechanism 83 (as shown in FIGS. 14 to 16 ) is mainly composed of abracket 831 , a connectingunit 832 and anerve hook 833 . Thenerve hooking mechanism 83 can hook and position the nerve root at one time, so as to avoid repeated manipulation of the nerve. Thebracket 831 passes through thegroove 73 of the slidingseat structure 7, and is restricted by theprotrusion 744 on theclaw 746 so as not to fall off. , and at the bottom of thebracket 831, there is aserrated surface 8311 that interferes with thetop catch portion 752 on thepressing portion 751 of theslide structure 7, and a joint portion 8312 is formed at the end of thebracket 831, and the connectingportion 8321 of the connectingunit 832 is connected to the bracket The connecting part 8312 of 831 is connected by a universal joint 8322, so that the connectingunit 832 can be adjusted at an angle relative to thebracket 831; Anupper base body 8324 extends from the top of thesleeve part 8323, and alower base body 8325 extends from the connectingpart 8321. Theupper base body 8324 has afront opening 8324a that communicates with the top end of thesleeve part 8323 and passes through thefirst pivot 832a, so that The front end of thelower seat body 8325 fits in thefront opening 8324a and is pivotally connected. At the same time, theelastic holding block 8327 at the front end of thelower seat body 8325 extends from thefront opening 8324a into the top end of thesleeve part 8323 to hold thenerve hook 833 The rod body 8331 of thelower seat body 8325 is combined with thesecond pivot 832b to connect a toothsurface sector block 8328, and the toothsurface sector block 8328 extends into therear opening 8324b of theupper seat body 8324; and the rear of theupper seat body 8324 In theopening 8324b, apressing piece 8326 is pivotally connected with athird pivot 832c, and thepressing piece 8326 is provided with aspring 8326a, so that aprotrusion 8326b on the front edge of thepressing piece 8326 can be buckled into thetooth surface sector 8328, as shown in Fig. As shown in 16, the function of thepressing member 8326 is to provide the assemblednerve hook 833 with a bending function on the vertical plane, and thenerve hook 833 is composed of a rod body 8331 that is socketed with the connectingunit 832 and a rod body 8331. The hook portion 8332 at one end is formed.

上述所构成本实用新型的微创腰椎手术的撑开装置，于外侧肌肉勾拉机构81、内侧肌肉勾拉机构82及一神经勾拉机构83，每一拉杆机构的功能可归纳如下：The distraction device for minimally invasive lumbar surgery of the present invention constituted by the above-mentioned, in the outermuscle pull mechanism 81, the innermuscle pull mechanism 82 and anerve pull mechanism 83, the function of each pull mechanism can be summarized as follows:

1.外侧肌肉勾拉机构81具有持住功能(以顶持块8126达成)、半万向功能(以万向接头8122及连接部8121达成)。1. The outermuscle pulling mechanism 81 has a holding function (achieved by the holding block 8126) and a semi-universal function (achieved by the universal joint 8122 and the connecting part 8121).

2.内侧肌肉勾拉机构82具有上提功能(以按压件8223及顶块8224提供固定及止挡)、水平自由度(以接合部8212、枢轴8213及连接部8221枢接达成)。2. The innermuscle hooking mechanism 82 has the lifting function (fixed and stopped by the pressing piece 8223 and the top block 8224), and the horizontal degree of freedom (achieved by the joint 8212, the pivot 8213 and the connecting part 8221).

3.神经勾拉机构83具有持住功能(以弹性顶持块8327达成)、半万向功能(万向接头8322及连接部8321组接达成)、弯曲功能(由按压件8326及齿面扇形块8328达成)。3. Thenerve hooking mechanism 83 has a holding function (achieved by the elastic supporting block 8327), a semi-universal function (achieved by the assembly of the universal joint 8322 and the connecting part 8321), and a bending function (achieved by thepressing part 8326 and the tooth surface fan-shapedBlock 8328 is reached).

但以上所述，仅为本实用新型的较佳实施例而已，当不能以此限定本实用新型实施的范围；故凡依本实用新型权利要求书及说明书内容所作的简单的等效变化与修饰，皆应仍属本实用新型专利涵盖的范围内。But the above are only preferred embodiments of the present utility model, and should not limit the scope of the utility model implementation; therefore all simple equivalent changes and modifications made according to the claims of the utility model and the contents of the description , all should still belong to the scope that the utility model patent covers.

Claims (18)

Translated fromChinese

1.一种微创腰椎手术的撑开装置，其特征在于，至少包括有：1. A distraction device for minimally invasive lumbar surgery, characterized in that it at least includes:一承载机构，该承载机构具有一环形导轨；A carrying mechanism, the carrying mechanism has an annular guide rail;多数滑座机构，各滑座机构活动设置于上述承载机构的环形导轨上；Most of the sliding seat mechanisms, each sliding seat mechanism is movably arranged on the annular guide rail of the above-mentioned bearing mechanism;至少二外侧肌肉勾拉机构，分别组装于上述相邻的两滑座机构上；At least two outer muscle hooking mechanisms are respectively assembled on the above-mentioned two adjacent sliding seat mechanisms;一内侧肌肉勾拉机构，设置于上述其中一滑座机构上；An inner muscle hook-and-pull mechanism, which is set on one of the above-mentioned sliding seat mechanisms;一神经勾拉机构，设置于上述另一滑座机构上。A nerve hooking mechanism is arranged on the other sliding seat mechanism.2.如权利要求1所述的微创腰椎手术的撑开装置，其特征在于，该承载机构的环形导轨外径介于10至30cm的范围内。2 . The distraction device for minimally invasive lumbar surgery according to claim 1 , wherein the outer diameter of the annular guide rail of the bearing mechanism is within the range of 10 to 30 cm. 3 .3.如权利要求1所述的微创腰椎手术的撑开装置，其特征在于，该滑座机构具有一座体，其上具有一与环形导轨活动结合的组接部，且该座体的二侧分别设有一止挡部，二止挡部间形成有一凹槽，而各止挡部上活动跨接有限制单元，并于该座体上设置有一楔槽，该楔槽内设有一调整单元。3. The distraction device for minimally invasive lumbar surgery as claimed in claim 1, wherein the sliding seat mechanism has a base, on which there is an assembly part that is movably combined with the annular guide rail, and the two bases of the base There is a stop part on each side, a groove is formed between the two stop parts, and a restriction unit is movable across each stop part, and a wedge groove is arranged on the base body, and an adjustment unit is arranged in the wedge groove .4.如权利要求3所述的微创腰椎手术的撑开装置，其特征在于，该组接部呈一侧开口的框型，且该组接部下方开设一切槽，以供组接部具有弹性。4. The distraction device for minimally invasive lumbar surgery as claimed in claim 3, wherein the assembly part is a frame-shaped opening on one side, and a slot is provided below the assembly part for the assembly part to have elasticity.5.如权利要求3所述的微创腰椎手术的撑开装置，其特征在于，各限制单元向上延伸二相对应的扣爪，而二扣爪间以一枢轴与座体的止挡部枢接，并于扣爪对应凹槽的一侧分别具有一凸块，另各限制单元向下延伸一外倾的压掣部，并以一贯穿座体的第一弹簧两端分别支撑两压掣部。5. The distracting device for minimally invasive lumbar surgery as claimed in claim 3, wherein each restricting unit extends upwards with two corresponding claws, and a pivot and a stopper between the two claws are connected to the seat body It is pivotally connected, and has a protrusion on the side of the claw corresponding to the groove, and each restricting unit extends downwards with an outwardly inclined pressing part, and supports two pressing parts at both ends of a first spring penetrating through the seat body. click department.6.如权利要求3所述的微创腰椎手术的撑开装置，其特征在于，该调整单元是由一按压部、一由按压部一端向上延伸的顶掣部、一由按压部横向延伸且设于楔槽内的压板及一设置于座体的弹簧座内部与压板间的第二弹簧所构成，且该压板的末端具有一圆柱，通过该圆柱嵌入楔槽末端的C型孔。6. The distraction device for minimally invasive lumbar surgery as claimed in claim 3, wherein the adjustment unit is composed of a pressing part, a top catch part extending upward from one end of the pressing part, a laterally extending from the pressing part and The pressing plate located in the wedge groove and a second spring arranged between the spring seat of the seat body and the pressing plate are composed, and the end of the pressing plate has a cylinder through which the cylinder is inserted into the C-shaped hole at the end of the wedge groove.7.如权利要求1所述的微创腰椎手术的撑开装置，其特征在于，该外侧肌肉勾拉机构至少包括有一穿设于滑座机构上的支架、一与支架组接的连接单元及一设置于连接单元上的外侧肌肉勾。7. The distraction device for minimally invasive lumbar surgery as claimed in claim 1, wherein the outer muscle hooking mechanism at least includes a bracket that is passed through the slide mechanism, a connecting unit that is assembled with the bracket, and A lateral muscle hook arranged on the connection unit.8.如权利要求7所述的微创腰椎手术的撑开装置，其特征在于，该支架的底部具有一与滑座机构相互干涉的锯齿面，且末端形成一接合部。8 . The distraction device for minimally invasive lumbar surgery according to claim 7 , wherein the bottom of the bracket has a serrated surface that interferes with the slide mechanism, and the end forms a joint.9.如权利要求7所述的微创腰椎手术的撑开装置，其特征在于，该连接单元通过一万向接头与支架组接，且该连接单元的一端设有一套接部，该套接部内设有一顶持块，该顶持块通过一弹簧向套接部推顶，并以一枢杆自连接单元外部贯穿顶持块。9. The distraction device for minimally invasive lumbar surgery as claimed in claim 7, wherein the connection unit is assembled with the bracket through a universal joint, and one end of the connection unit is provided with a socket, and the socket A top holding block is arranged inside the part, and the top holding block is pushed toward the sleeve part by a spring, and a pivot bar penetrates the top holding block from the outside of the connecting unit.10.如权利要求7所述的微创腰椎手术的撑开装置，其特征在于，该外侧肌肉勾具有一与连接单元套接的杆体及一设于杆体一端的勾部。10 . The distraction device for minimally invasive lumbar surgery according to claim 7 , wherein the outer muscle hook has a rod body sleeved with the connecting unit and a hook portion disposed at one end of the rod body. 11 .11.如权利要求1所述的微创腰椎手术的撑开装置，其特征在于，该内侧肌肉勾拉机构至少包括有一穿设于滑座机构上的支架、一与支架组接的连接单元及一设置于连接单元上的内侧肌肉勾。11. The distraction device for minimally invasive lumbar surgery as claimed in claim 1, wherein the inner muscle hooking mechanism at least comprises a bracket pierced on the slide mechanism, a connecting unit assembled with the bracket, and An inner muscle hook arranged on the connection unit.12.如权利要求11所述的微创腰椎手术的撑开装置，其特征在于，该支架的底部具有一与滑座机构相互干涉的锯齿面，且末端形成一接合部。12 . The distraction device for minimally invasive lumbar surgery as claimed in claim 11 , wherein the bottom of the bracket has a serrated surface that interferes with the slide mechanism, and the end forms a joint. 13 .13.如权利要求11所述的微创腰椎手术的撑开装置，其特征在于，该连接单元以一连接部配合一枢轴与支架组接，且该连接部直向连通有一套接部，并于该连接部上以一枢杆活动设有一按压件，该按压件的一端具有一设于套接部中的顶块，且该按压件与连接部之间设置有一弹性元件。13. The distraction device for minimally invasive lumbar surgery as claimed in claim 11, wherein the connecting unit is assembled with the bracket by a connecting part matched with a pivot, and the connecting part is directly connected with a sleeve part, A pressing piece is movably provided on the connecting portion with a pivot rod, and one end of the pressing piece has a top block arranged in the sleeve portion, and an elastic element is arranged between the pressing piece and the connecting portion.14.如权利要求11所述的微创腰椎手术的撑开装置，其特征在于，该内侧肌肉勾具有一与连接单元套接的杆体及一设于杆体一端的勾部，并于杆体的一面上设有齿条部。14. The distraction device for minimally invasive lumbar surgery as claimed in claim 11, wherein the inner muscle hook has a rod body which is socketed with the connection unit and a hook part which is arranged at one end of the rod body, and is placed on one side of the rod body. A rack portion is provided on the top.15.如权利要求1所述的微创腰椎手术的撑开装置，其特征在于，该神经勾拉机构至少包括有一穿设于滑座机构上的支架、一与支架组接的连接单元及一设置于连接单元上的神经勾。15. The distraction device for minimally invasive lumbar surgery as claimed in claim 1, wherein the nerve hooking mechanism at least comprises a bracket pierced on the sliding seat mechanism, a connecting unit assembled with the bracket, and a Neural hooks set on the connection unit.16.如权利要求15所述的微创腰椎手术的撑开装置，其特征在于，该支架的底部具有一与滑座机构相互干涉的锯齿面，且末端形成一接合部。16 . The distraction device for minimally invasive lumbar surgery as claimed in claim 15 , wherein the bottom of the bracket has a serrated surface that interferes with the slide mechanism, and the end forms a joint. 16 .17.如权利要求15所述的微创腰椎手术的撑开装置，其特征在于，该连接单元以一具有万向接头的连接部与支架组接，且该连接单元的一端设有一套接部，该套接部顶端延伸出一上座体，该上座体具有一与套接部顶端相通且以第一枢轴贯穿的前开孔，而该连接部则延伸出一下座体，下座体前端枢接于前开孔内，且该下座体前端具有一自前开孔伸入套接部顶端的弹性顶持块，另该下座体上配合第二枢轴组接一伸入上座体后开孔的齿面扇形块，并于该上座体的后开孔内以第三枢轴枢接一按压件，该按压件设有一弹簧，该按压件前缘的一突起扣入齿面扇形块内。17. The distraction device for minimally invasive lumbar surgery as claimed in claim 15, wherein the connection unit is assembled with the bracket by a connection part having a universal joint, and one end of the connection unit is provided with a socket , the top end of the socket part extends an upper seat body, the upper seat body has a front opening that communicates with the top end of the socket part and penetrates through the first pivot, and the connecting part extends a lower seat body, the front end of the lower seat body It is pivotally connected in the front opening, and the front end of the lower base body has an elastic supporting block extending from the front opening into the top end of the sleeve part, and the second pivot is assembled on the lower base body and extends into the back of the upper base body. A tooth surface sector block with openings, and a pressing piece is pivotally connected with a third pivot in the rear opening of the upper base body. The pressing piece is provided with a spring, and a protrusion on the front edge of the pressing piece is buckled into the tooth surface sector block Inside.18.如权利要求15所述的微创腰椎手术的撑开装置，其特征在于，该神经勾具有一与连接单元套接的杆体及一设于杆体一端的勾部。18 . The distraction device for minimally invasive lumbar surgery according to claim 15 , wherein the nerve hook has a rod body sleeved with the connecting unit and a hook portion disposed at one end of the rod body. 19 .

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