Thoracolumbar disk vertebroplasty Unipedicular approach positioning and guiding sting deviceTechnical field
This utility model relates to spinal surgery Thoracolumbar disk vertebroplasty Unipedicular approach positioning and guiding puncture technique, belongs to technical field of medical instruments.
Background technology
Vertebroplasty is the most frequently used Minimally Invasive Surgery of current spinal surgery, and have pain palliation efficacy definite, the advantages such as rehabilitation of patients after surgical treatment is fast, are widely used in the disease such as osteoporotic vertebral fracture, Vertebral Metastases.It is the most frequently used Puncture approach of Thoracolumbar disk vertebroplasty that the puncture of pedicle approach arrives vertebral body, conventionally adopts bilateral pedicle approach puncture technique.The feature of vertebroplasty is that the person of undergoing surgery mostly is weak and sickly patient or malignant tumor Bone tumour in late period patient at advanced age, and health general state is poor; Carry out under operation local anaesthesia, need under patient awoke's state to keep the prostrate long period; Whole operation process needs to complete under the Lookout assist of the image documentation equipments such as C-arm X-ray machine, and medical personnel and patient all have the radioactive exposure of more amount.
Traditional vertebroplasty localised puncture Shi doctor needs free-hand holding puncture needle, repeatedly locates, punctures, inserting needle under the fluoroscopic monitoring of C arc X-ray machine.In default of the lower spinal column bone mark exposed of open surgery direct-view, doctor needs through the even tens of secondary X line perspective of ten several with the position and the direction that adjust puncture needle, could the accurate inserting needle of pedicle.Therefore, conventional vertebroplasty pedicle approach localised puncture process Problems existing has: (1) the free-hand localised puncture difficulty of vertebroplasty is large, and surgical doctor is not easily grasped; (2) the bilateral pedicle puncturing operation time is long, advanced age or malignant tumor patients with terminal prostrate for a long time, occur the heart, lung, cerebral pathology risk high; (3) in art, patient and doctor are subject to iatrogenic X X-ray radiation quantity X comparatively greatly, and it is large that potential or build-up radiation damages probability; (4) the probability of the severe complications such as inaccurate initiation neural blood vessel damage of puncturing is high; (5) Computer navigation surgery equipment price costliness, the technical sophistication of newly-developed, operating difficulties, not easily popularizes.
Summary of the invention
The technical problem that this utility model solves is to provide a kind of spinal surgery Thoracolumbar disk vertebroplasty Unipedicular approach positioning and guiding sting device.
The technical solution of the utility model is: a kind of Thoracolumbar disk vertebroplasty Unipedicular approach positioning and guiding sting device, it is characterized in that, comprise cylinder, parallel end face is provided with at these cylindrical two ends, normal direction and the cylindrical axial angle of end face are 25 °-35 °, between these cylindrical two ends, be provided with the pilot hole of multiple irregular spacing distribution, the axis of this pilot hole is identical with cylindrical axis, and one of them pilot hole is located at cylindrical axle center.
Described cylindrical length is 60-100mm, and diameter is 20-40mm; The diameter of pilot hole is 2mm, and the number of pilot hole is 6-15.
Described cylindrical material is wooden or plastics.
Compared with prior art, tool has the following advantages this utility model:
1, precisely can complete the puncture of pedicle positioning and guiding, avoid neural blood vessel to damage, significantly improve the safety of operation technique.
2, the puncture of pedicle positioning and guiding can be completed fast, obviously shorten operating time, the number of times that the X line perspective at utmost reducing patient and doctor exposes.
3,1/3 can be arrived before targeted vertebral body central authorities through one-sided pedicle of vertebral arch localised puncture, and then complete through one-sided vertebral pedicle puncture vertebroplasty, with tradition compared with the bilateral vertebral pedicle puncture vertebroplasty, half operation high-value consumables and expense can be saved.
4, overall volume size is suitable, is easy to patient and holds and operation.
5, can keep farthest fitting with patient's lower back skin, when doctor operates there is natural activity in the head inclination angle of positioning and guiding sting device.
6, structure is simple, is easy to make, and sterilization is convenient, and cost is extremely low.
7, its pilot hole diameter is consistent with conventional Thoracolumbar disk vertebroplasty puncture needle inner core diameter, can support the use.
Accompanying drawing explanation
Fig. 1 is the perspective view of this utility model embodiment;
Fig. 2 is the side schematic view of this utility model embodiment;
Fig. 3 is the A-A sectional view of Fig. 2.
Detailed description of the invention
See Fig. 1-Fig. 3, a kind of Thoracolumbar disk vertebroplasty of this utility model Unipedicular approach positioning and guiding sting device, it is characterized in that, comprise cylinder 1, parallel end face 3 is provided with at these cylindrical two ends, the axial angle of splay of angle a(of the normal direction of end face 3 and the axis of cylinder 1) be 25 °-35 °, the pilot hole 2 of multiple irregular spacing distribution is provided with between the two ends of this cylinder 1, the axis of this pilot hole 2 is identical with the axis of cylinder 1, and one of them pilot hole 2 is located at the axle center of cylinder 1.
The length of described cylinder 1 is 60-100mm, and diameter is 20-40mm; The diameter of pilot hole 2 is 2mm, and the number of pilot hole 2 is 6-15.
As long as the length of cylinder 1 and diameter are conducive to the holding of operative doctor and many pieces of Kirschner wires lead.
The diameter of pilot hole 2 can not be 2.0mm, as long as supporting with certain specific vertebroplasty puncture instrument.
The material of described cylinder 1 is preferably wooden, also can be nonvisualized other materials under roentgen radiation x, as polyethylene, PEEK etc.
Can according to the difference of the Thoracolumbar disk region of anatomy, make a set of with axially different abduction angle a(as 25 °, 30 °, 35 °) this utility model, the individuation being more conducive to performing the operation is selected.
Above-mentioned embodiment is only for illustration of the utility model, and be not to restriction of the present utility model, the those of ordinary skill of relevant technical field, when not departing from this utility model spirit and scope, can also make various change and modification, therefore all equivalent technical schemes also should belong to category of the present utility model.
Using method of the present utility model is described as follows:
Unipedicular approach vertebra localization ultrasonic puncture in Thoracolumbar disk vertebroplasty art.Patient gets ventricumbent position, routine disinfection paving aseptic towel.In the capable local anesthesia of patient's lower back skin preoperative Primary Location point.Then position according to step below:
(1) first insert the Kirschner wire of one piece of 2.0mm diameter through centre pilot hole 2, operative doctor grips cylinder 1 makes it stand on patient's lower back, and Kirschner wire front tip and the preoperative anchor point of patient's lower back skin are coincided.
(2) the next abduction 30 ° perspective on first time C arc X-ray machine, according to pedicle of vertebral arch target point of puncture position (outside pedicle of vertebral arch 2 or 10 positions) relation with Kirschner wire tip location, behind the position of fine setting cylinder 1, Kirschner wire is driven into pedicle of vertebral arch cortical bone along placed channel and is about 2mm.
(3) the upper the next abduction 30 ° perspective of second time, judges the relation of kirschner needle point perspective position and target point of puncture position again.If kirschner tip position and target point of puncture position are departed from less, then get other one piece or two pieces of Kirschner wires other pilot holes insertions through central pilot hole 2 side.
(4) the next abduction 30 ° perspective on third time, after determining that the kirschner needle point perspective position after target point of puncture position and adjustment overlaps, is driven into pedicle of vertebral arch sclerotin 5mm by this piece of Kirschner wire along pilot hole 2.
(5) if determine that target point of puncture position does not still overlap with the kirschner needle point perspective position after adjustment, retain one piece of Kirschner wire closest to target point of puncture position, after taking out cylinder 1, exchange pilot hole 2, then cylinder 1 is inserted along this piece of Kirschner wire.
(6) increase perspective number of times, repeat above-mentioned steps, the kirschner needle point perspective position after finally determining target point of puncture position and adjusting coincides, and this piece of Kirschner wire is driven into pedicle of vertebral arch sclerotin 5mm along this pilot hole 2.
(7) position, side perspective, after determining the head inclination angle of targeted vertebral body pedicle of vertebral arch, operative doctor adjusts the head of cylinder 1 by appropriateness and to incline direction, and the accurate guiding completing Kirschner wire pedicle is driven into.
(8) final Kirschner wire arrives the accurate location of before vertebral body central authorities 1/3 through cylinder 1.