Background technology
The tradition lumbar spinal fusion is as the main modus operandi of unstable spine illness due to the multiple factors such as treatment regression, wound, infection, tumor; Accepted widely by spinal surgeons; Yet the shortcoming of traditional lumbar spinal fusion is that large-area soft tissue is peeled off and long myotasis, and this can cause postoperative pain to increase the weight of; Prolong recovery time, and spinal function is impaired.Therefore, the assurance operation technique is reduced to the important development direction that minimum less invasive techniques becomes current field of spinal surgery with soft tissue injury simultaneously safely and effectively.
The vertebral column minimally invasive dilator that various ways is arranged on the market at present.Wherein typical pattern has two kinds, and a kind of is sleeve pipe dilator step by step, and a kind of is parallel dilator.
The sleeve pipe dilator is to utilize a series of sleeve pipes to wear successively step by step, enlarges the operative approach passage gradually.This series sleeve pipe has the sleeve pipe of a minimum, penetrate soft tissue after, second sleeve pipe that the reuse internal diameter is close with this cover external diameter of pipe wears, and then wears with next sleeve pipe, expands the approach channel sized so successively, until the size that reaches expection.This drawback that struts mode is to strut the limited size of passage, and can not adjust.
Parallel dilator is the combination of tooth bar, sliding seat and two drag hooks; Drag hook and tooth bar are connected as one, and another drag hook links to each other with sliding seat on the tooth bar, regulates sliding seat; Be the distance between expansible two drag hooks, thereby realize the size of expansion spinal column operative approach passage.This defective that struts mode is that drag hook penetrates difficulty of soft tissue, need do bigger otch; And strut and to realize parallel strutting, can't realize the soft-tissue expansion of dilator lower end, limited use in operation.
Therefore, how in Minimally Invasive Surgery, guaranteeing operation technique simultaneously safely and effectively, reduce soft tissue injury, is the present technical issues that need to address of those skilled in the art.
Summary of the invention
The purpose of this invention is to provide a kind of Minimally Invasive Surgery dilator, this dilator can effectively strut soft tissue, and can effectively improve the safety in the Minimally Invasive Surgery.Another object of the present invention provides a kind of Minimally Invasive Surgery device for spreading.
For realizing the foregoing invention purpose, the present invention provides a kind of Minimally Invasive Surgery dilator, comprises that mounting bracket, first struts pipe and second and struts pipe, comprises that also being located at said first struts the first adjusting bolt of managing the outside; The top and first nut of this first adjusting bolt are connected, and the bottom is provided with first drag hook that opening makes progress; Said first strut pipe the upper end periphery set up the connecting hole that the gib head that supplies said first drag hook wears; Said first to strut pipe hinged with said mounting bracket, and said second struts pipe is slidingly connected with said mounting bracket.
Preferably, also comprise the second adjusting bolt that is connected with said mounting bracket; The top and second nut of this second adjusting bolt are connected, and the bottom is provided with second drag hook that opening makes progress; Said second strut pipe the upper end periphery set up the connecting hole that the gib head that supplies said second drag hook wears; Said mounting bracket is provided with chute, said second strut pipe the top be provided with the rotating shaft that can in said chute, rotate and slide.
Preferably, said first regulates bolt is axially arranged with flat horizontal surface along it, and said mounting bracket is provided with said first and regulates the connecting hole that bolt cooperates.
Preferably, said mounting bracket comprises U type support, and at least one has tooth bar in two straight bar sections of this U type support, and said mounting bracket is provided with the ratchet that is connected with said tooth bar; Said first regulates the bending section that bolt is installed on said U type support, and said chute is located at said straight bar section.
Preferably, said mounting bracket also comprises the horizontal adjustment seat, and this horizontal adjustment seat has the connecting hole that supplies said straight bar section to penetrate, and said second regulates bolt is connected on the said horizontal adjustment seat.
Preferably, said first struts pipe and said second struts pipe and is semi-circular structure, the connection of two semicircle respective outer side edges, and on the joint face that both cooperatively interact, one have boss, and another person has the groove that cooperates with said boss.
Preferably, said first struts in two mating surfaces of pipe, and one have said boss, and another person has said groove.
The present invention also provides a kind of Minimally Invasive Surgery device for spreading; Comprise guide pin and step by step sleeve pipe strut assembly; It is characterized in that; Comprise also that like above-mentioned each described Minimally Invasive Surgery dilator first of this Minimally Invasive Surgery dilator struts pipe and said second and struts the size of managing after being connected and be slightly larger than the maximum casing size that said sleeve pipe step by step struts assembly.Minimally Invasive Surgery dilator provided by the present invention comprises that mounting bracket, first struts pipe and second and struts pipe, and different with prior art is that dilator provided by the present invention comprises that also being located at said first struts the first adjusting bolt of managing the outside; The top and first nut of this first adjusting bolt are connected, and the bottom is provided with first drag hook that opening makes progress; Said first strut pipe the upper end periphery set up the connecting hole that the gib head that supplies said first drag hook wears; Said first to strut pipe hinged with said mounting bracket, and said second struts pipe is slidingly connected with said mounting bracket.In Minimally Invasive Surgery, can be earlier strut pipe and second and strut pipe and stretch in the soft tissue first, make second to strut pipe and on mounting bracket, slide, make first to strut pipe and second and strut the distance increase between pipe, make soft-tissue expansion, open operation path.Simultaneously, can also regulate first nut, make first nut drive the first adjusting bolt and move up; And then drive the upper end that first drag hook pulling first struts pipe, make first strut pipe the upper end rotate around mounting bracket, the lower end expands outwardly; Thereby make the soft tissue depths, near intravital soft-tissue expansion; Further enlarged surgical field of view, for implant and kit through facilitating, improve operation safety.
A kind of preferred embodiment in, dilator provided by the present invention also comprise be connected with said mounting bracket second regulate bolt; The top and second nut of this second adjusting bolt are connected, and the bottom is provided with second drag hook that opening makes progress; Said second strut pipe the upper end periphery set up the connecting hole that the gib head that supplies said second drag hook wears; Said mounting bracket is provided with chute, said second strut pipe the top be provided with the rotating shaft that can in said chute, rotate and slide.When needs continue the expansion soft tissue, can regulate nut, make nut drive the second adjusting bolt and move up; And then drive the upper end that drag hook pulling second struts pipe, make second strut pipe the upper end rotate around said mounting bracket, the lower end expands outwardly; Thereby make the soft tissue depths, can expand to both direction near intravital soft tissue; Surgical field of view further enlarges, and it is more convenient to perform the operation, and safety is higher.
The present invention also provides a kind of Minimally Invasive Surgery device for spreading; This device for spreading comprises guide pin, sleeve pipe struts assembly and above-mentioned Minimally Invasive Surgery dilator step by step, and first the strutting pipe and said second and strut the size of managing after being connected and be slightly larger than the maximum casing size that said sleeve pipe step by step struts assembly of Minimally Invasive Surgery dilator.During Minimally Invasive Surgery; Earlier squeeze into a guide pin at the correct position of health; Use step by step sleeve pipe to strut assembly then and progressively expand the soft tissue passage; When reaching suitable dimension, bring into use the Minimally Invasive Surgery dilator again, first of closure state is strutted take out all sleeve pipes after pipe and second struts the pipe threading.Regulate first then and strut mutual edge distance mutually and the angle that pipe and second struts pipe, can further expand the soft tissue passage.Like this, the otch of operation can be very little, and is little to the damage of soft tissue, can reduce postoperative pain and patient's recovery time, further improves the operation safety reliability.
The specific embodiment
Core of the present invention provides a kind of Minimally Invasive Surgery dilator, and this dilator can effectively strut soft tissue, and can effectively improve the safety in the Minimally Invasive Surgery.Another core of the present invention provides a kind of Minimally Invasive Surgery device for spreading.
The upper and lower noun of locality that waits that this paper is related, the existing position of Minimally Invasive Surgery dilator is that benchmark defines during with operation; The inside and outside noun of locality that waits that this paper is related is that to strut the center that pipe and second struts pipe with first be that benchmark defines, away from the center be outside, near the center be in.The noun of locality that should be appreciated that among this paper to be adopted should not limit the protection domain of this patent.
In order to make those skilled in the art person understand the present invention program better, the present invention is done further detailed description below in conjunction with the accompanying drawing and the specific embodiment.
Please refer to Fig. 1 and Fig. 2, Fig. 1 is the perspective view of a kind of specific embodiment of Minimally Invasive Surgery dilator provided by the present invention; Fig. 2 is the cutaway view of Minimally Invasive Surgery dilator shown in Figure 1.
Minimally Invasive Surgery dilator provided by the present invention comprises that mounting bracket 3, first struts pipe 11 and second and struts pipe 21, and different with prior art is that dilator provided by the present invention comprises that also being located at first struts the first adjusting bolt 12 of managing 11 outsides; The top and first nut 13 of this first adjusting bolt 12 are connected, and the bottom is provided with first drag hook 14 that opening makes progress; First struts pipe 11 upper end periphery sets up the connecting hole that the gib head that supplies first drag hook 14 wears; First to strut pipe 11 hinged with mounting bracket 3, and second struts pipe 21 is slidingly connected with mounting bracket 3.
In Minimally Invasive Surgery; Can be earlier strut pipe 11 and second and strut pipe 21 and stretch in the soft tissue, make second to strut pipe 21 and on mounting bracket 3, slide, make first to strut the distance increase that pipe 11 and second struts 21 of pipes first; Make soft-tissue expansion, open operation path.Simultaneously, can also regulate first nut 13, make first nut 13 drive the first adjusting bolt 12 and move up; And then drive the upper end that first drag hook 14 pulling first struts pipe 11, make first strut pipe 11 the upper end around mounting bracket 3 rotations, the lower end expands outwardly; Thereby make the soft tissue depths, near intravital soft-tissue expansion; Further enlarged surgical field of view, for implant and kit through facilitating, improve operation safety.
Please refer to Fig. 3, Fig. 3 struts the perspective view of managing a kind of specific embodiment for provided by the present invention second.
In a kind of concrete embodiment, dilator provided by the present invention can also comprise the second adjusting bolt 22 that is connected with mounting bracket 3; The top and second nut 23 of this second adjusting bolt 22 are connected, and the bottom is provided with second drag hook 24 that opening makes progress; Second struts pipe 21 upper end periphery sets up the connecting hole that the gib head that supplies second drag hook 24 wears; Mounting bracket 3 is provided with chute 31, the second and struts pipe 21 top and be provided with the rotating shaft 211 that can in chute 31, rotate and slide.
When needs continue the expansion soft tissue, can regulate second nut 23, make second nut 23 drive the second adjusting bolt 22 and move up; And then drive the upper end that second drag hook 24 pulling second struts pipe 21, make second strut pipe 21 the upper end around mounting bracket 3 rotations, the lower end expands outwardly; Thereby make the soft tissue depths, can expand to both direction near intravital soft tissue; Surgical field of view further enlarges, and it is more convenient to perform the operation, and safety is higher.
Please refer to Fig. 4 and Fig. 5, Fig. 4 is the structural representation of a kind of specific embodiment of the first adjusting bolt provided by the present invention; Fig. 5 is the perspective view of the first adjusting bolt shown in Figure 4.
In a kind of concrete embodiment, provided by the present invention first regulates bolt 12 is axially arranged with flat horizontal surface along it, and mounting bracket 3 is provided with first and regulates the connecting hole that bolt 12 cooperates (specifically can with reference to figure 6).When the first adjusting bolt 12 is installed; Flat horizontal surface is cooperated with the relevant position of connecting hole; Make the first adjusting bolt 12 can pass connecting hole, can when rotary nut, can not drive first again and regulate bolt 12 rotations, the first adjusting bolt 12 can only be moved up and down; Can not rotate, thereby improve the motility and the reliability of regulating.
From Fig. 4 and Fig. 5, can find out; Flat horizontal surface can have one; Can have two or morely, as long as connecting hole can let first to regulate bolt 12 and pass through, and connecting hole can limit first and regulates bolt 12 and rotate during the nut rotation; Just can satisfy requirement of the present invention, the first such adjusting bolt 12 all should be within protection scope of the present invention.
Similar with the first adjusting bolt 12, second regulates bolt 22 also can have one, two or more flat horizontal surface, also should have on the mounting bracket 3 with second and regulate the connecting hole that bolt 22 cooperates, and gives unnecessary details no longer one by one at this.
Please refer to Fig. 6 and Fig. 7, Fig. 6 is the structural representation of a kind of specific embodiment of U type support provided by the present invention; Fig. 7 is the perspective view of U type support shown in Figure 6.
In further embodiment; Mounting bracket 3 provided by the present invention can comprise U type support 32; At least one has tooth bar 321 in two straight bar sections of this U type support 32, and chute 31 is located at straight bar section, and mounting bracket 3 is provided with the ratchet 34 that is connected with tooth bar 321; First regulates the bending section that bolt 12 is installed on U type support 32.Regulate first strut pipe 11 and second strut between the pipe 21 apart from the time, can regulate through tooth bar 321 and cooperating of ratchet 34, it is easy to adjust accurate, helps improving the controllability of the process of strutting.
As shown in the figure; The button 35 that the straight bar section that prevents to have tooth bar 321 is retreated can also be set on the mounting bracket 3; This button 35 cooperates with the straight bar section with tooth bar 321, and locked second struts pipe 21 in the operation, occurs second in preventing to perform the operation and struts the phenomenon that pipe 21 becomes flexible; Further improve the security reliability of operation, reduce operation risk.
Please refer to Fig. 8, Fig. 8 is the structural representation of a kind of specific embodiment of horizontal adjustment seat provided by the present invention.
Particularly, mounting bracket 3 can also comprise horizontal adjustment seat 33, and this horizontal adjustment seat 33 has the connecting hole that the straight bar section that supplies U type support 32 penetrates, and second regulates bolt 22 is connected on the horizontal adjustment seat 33, and ratchet 34 is located at horizontal adjustment seat 33.In conjunction with Fig. 6 and Fig. 7; Mounting bracket 3 provided by the present invention can comprise U type support 32 and the horizontal adjustment seat 33 that is connected with U type support 32; The bending section of U type support 32, straight bar section, horizontal adjustment seat 33, another straight bar section surround a space, and first struts pipe 11 and second struts and manage 21 and in this space, regulate.Simultaneously, the first adjusting bolt 12 and second is regulated bolt 22 and is connected on the bending section and horizontal adjustment seat 33 of U type support 32, and first stay pipe and second stay pipe are regulated along straight bar section.This is simple in structure, is easy to processing and manufacturing, can effectively reduce the production cost of Minimally Invasive Surgery dilator.
Obviously, above-mentioned mounting bracket 3 can have other structure, struts pipe 11 and second and struts and manage 21 horizontal adjustment and rotation adjusting is basic demand can realize first.
Please refer to Fig. 9 and Figure 10, Fig. 9 struts the cross sectional view of managing a kind of specific embodiment for provided by the present invention first; Figure 10 struts pipe and second and struts and manage the sketch map that is connected for provided by the present invention first.
In a kind of concrete embodiment, first struts pipe 11 and second struts pipe and 21 can be semi-circular structure, the connection of two semicircle respective outer side edges, and on the joint face that both cooperatively interact, one have boss 15, and another person has the groove that cooperates with boss 15.Like this, when dilator penetrated in soft tissue, first dilator and second dilator can be connected as a whole, make initially penetrate more simple, thereby guarantee operation safety.
Further, strut in two mating surfaces of pipe 11 first, one have boss, and another person has groove, and is with matching, and second struts in two mating surfaces of pipe 21, and one is groove, and another person is a boss.Therefore, first struts pipe 11 and second struts pipe 21 structure can to design ground identical, struts pipe 11 and second and struts and manage 21 production cost thereby reduce first.
Except above-mentioned Minimally Invasive Surgery dilator, the present invention also provides a kind of Minimally Invasive Surgery device for spreading that comprises above-mentioned Minimally Invasive Surgery dilator, and the structure of these other each several parts of Minimally Invasive Surgery device for spreading please refer to prior art, and this paper repeats no more.
Particularly; Above-mentioned Minimally Invasive Surgery device for spreading comprises guide pin, sleeve pipe struts assembly and above-mentioned Minimally Invasive Surgery dilator step by step, and first the strutting pipe 11 and second and strut and manage 21 sizes after being connected and be slightly larger than the maximum casing size that sleeve pipe step by step struts assembly of Minimally Invasive Surgery dilator.
During Minimally Invasive Surgery; Earlier squeeze into a guide pin at the correct position of health; Use step by step sleeve pipe to strut assembly then and progressively expand the soft tissue passage; When reaching suitable dimension, bring into use the Minimally Invasive Surgery dilator again, first of closure state is strutted take out all sleeve pipes after pipe 11 and second struts pipe 21 threadings.Regulate first then and strut mutual edge distance mutually and the angle that pipe 11 and second struts pipe 21, can further expand the soft tissue passage.Like this, the otch of operation can be very little, and is little to the damage of soft tissue, can reduce postoperative pain and patient's recovery time, further improves the operation safety reliability.
More than Minimally Invasive Surgery dilator provided by the present invention and device for spreading have been carried out detailed introduction.Used concrete example among this paper principle of the present invention and embodiment are set forth, the explanation of above embodiment just is used for helping to understand method of the present invention and core concept thereof.Should be pointed out that for those skilled in the art, under the prerequisite that does not break away from the principle of the invention, can also carry out some improvement and modification to the present invention, these improvement and modification also fall in the protection domain of claim of the present invention.