CN109925045B - Vertebral pedicle fixing, positioning and guiding system for spine - Google Patents
Vertebral pedicle fixing, positioning and guiding system for spine Download PDFInfo
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- CN109925045B CN109925045B CN201910097879.9A CN201910097879A CN109925045B CN 109925045 B CN109925045 B CN 109925045B CN 201910097879 A CN201910097879 A CN 201910097879A CN 109925045 B CN109925045 B CN 109925045B
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Abstract
According to the vertebral pedicle fixing, positioning and guiding system of the spine, which is related by the invention, the positioning and guiding device and the center management device are mutually communicated and connected through the sensor, the positioning and guiding device is connected with the opener, the tap and the nail feeder for internal fixation surgery, the center management device obtains and records the real-time three-dimensional coordinate of the sensor, calculates the three-dimensional coordinate to obtain the correct open circuit direction and open circuit distance, and guides the internal fixation mechanism to operate according to the open circuit direction and the open circuit distance, so that the vertebral pedicle fixing, positioning and guiding system of the spine can rapidly and accurately guide the internal fixation surgery instrument to rapidly and accurately perform the fixation operation of the vertebral pedicle of the spine without the need of the internal fixation surgery instrument, and is simple in operation and convenient to carry.
Description
Technical Field
The invention belongs to the field of medical treatment, and particularly relates to a vertebral pedicle fixing, positioning and guiding system.
Background
Currently, the pedicle screw is one of the most widely used internal fixation instruments in spinal surgery, and the successful and safe implantation of the pedicle screw is the key to ensure the success of the surgery.
The current pedicle internal fixation has some difficulties which plague the operating physician as follows: 1) because the outer diameter of the operative track opening instrument is only about 1/3 times the outer diameter of the matched tapping instrument and the matched nailing instrument. 2) Because of the bone condition of the patient, the operation experience of the operating doctor and the sudden condition in the operation, the open circuit phenomenon often occurs in the internal fixation operation of the vertebral pedicle, namely, a plurality of opened nail paths exist in one opening of the nail path, and only one of the nail paths is the required correct nail path. 3) The bone of human body is brittle but not hard. These three reasons often cause the deviation of the internal fixation screw from the correct track during the surgical procedure, which in turn may cause serious damage to the nerve and vascular structures causing potential problems such as dysesthesia, nerve damage, bleeding and destruction of the original structure. Some navigation techniques have been used for surgery to assist in real time, and many research activities are underway to seek various alternatives to avoid pedicle screw misplacement. Existing methods available for navigation include intraoperative fluoroscopy, computer-assisted surgery (CAS), ultrasound image guided pedicle screw insertion, and non-imaging navigation, among others. The methods provide a new method and a new idea for open circuit and access in navigation, but the existing devices in the current market have the problems of great radiation, threat to the health of workers, complex system and program operation, long time consumption, difficulty in carrying and the like, and bring certain limit to the further development of access navigation.
Disclosure of Invention
The present invention has been made to solve the above problems, and an object of the present invention is to provide a vertebral pedicle fixing, positioning and guiding system for positioning and guiding a vertebral pedicle fixing device, the vertebral pedicle fixing device including a channel opener, a screw tap and a screw driver, the system including: the positioning guide device is used for correspondingly connecting the circuit breaker, the screw tap and the screw feeding device with the sensor to form a circuit opening mechanism, a screw tap mechanism and a screw feeding mechanism; the central management device is in communication connection with the positioning guide device; wherein, location guider includes: the initial position correcting plate comprises an initial position correcting plate, and a circuit breaker part, a nail feeding part and a screw tapping part which are arranged on the initial position correcting plate; the screw driver comprises a first sensor, a second sensor, a first screw driver, a second sensor, a screw tap and a screw driver, wherein the first sensor is arranged on the screw driver; the system comprises a first sensor, a second sensor, a third sensor, a first sensor, a second sensor, a third sensor and a fourth sensor, wherein the first sensor is used for collecting coordinates of an instant space position point where the first sensor is located, the second sensor is used for collecting coordinates of an instant space position point where the second sensor is located, the third sensor is used for collecting coordinates of an instant space position point where the third sensor is located, the instant space position point of the first sensor is taken as a space point A, the coordinates of the space point A are open-circuit coordinates, the instant space position point of the second sensor is taken as a space point B, the coordinates of the space point B are nail coordinates, the instant space position point of the third sensor is taken as a space point C, the coordinates of the space point C are tapping coordinates, a straight line where the space point A and the space point B are located is called a space line AB; the contained angle between space line AB and the space line BC is less than or equal to 1/100 degrees, space point A and space point B's distance, and space point B and space point C's distance equals predetermined length, and central management device includes: the communication part is used for receiving the open circuit coordinates, the nail installing coordinates and the screw tap coordinates; the instrument calibration part is used for performing calibration operation on the open-circuit mechanism, the screw feeding mechanism and the screw tapping mechanism according to the included angle between the space line AB and the space line BC, the distance between the space point A and the space point B and the distance between the space point B and the space point C; a screen storage unit that stores a management screen including: the device comprises a control key area, a position display area and a data display area, wherein the control key area comprises a plurality of keys for operation; a screen display unit for displaying a management screen; the data calling part is used for calling an open circuit coordinate, a nail installing coordinate and a screw tap coordinate; a data generation unit for generating an open-circuit data string, a staple data string, and a tap data string; a data adding part for adding the open-circuit coordinates into the open-circuit data string, adding the nail-on coordinates into the nail-on data string, and adding the tap coordinates into the tap data string; a data update unit for updating the open-circuit data string, the staple data string, and the tap data string; a data deleting section for deleting the open-circuit data string; the data operation part is used for calculating the open circuit coordinates, the nail feeding coordinates and the screw tap coordinates of two different time points to obtain corresponding calculation result values; a data storage section for storing the calculation result value as a reference result value; the data judgment part compares the reference result value with the calculation result value to obtain a corresponding judgment result value; and a control part which is respectively connected with the above-mentioned every part and is used for controlling the above-mentioned every part to execute correspondent function according to the operation of correspondent key-press zone. The control key area comprises a router-in selection key used for generating an open-circuit data string, a screw-on data string and a screw-on data string, an initialization key used for selecting the type and the position of a vertebra fixed by a pedicle surgery, a recording key used for respectively obtaining an open-circuit coordinate, a screw-on coordinate and a screw-on coordinate, a marking key used for updating and storing the open-circuit data string and an exit key used for deleting the open-circuit data string which is not updated and maintained.
In the spinal pedicle fixing, positioning and guiding system provided by the invention, the system can also have the following characteristics: wherein, the central management device is any one of a desktop computer, a notebook computer and a tablet computer.
In the spinal pedicle fixing, positioning and guiding system provided by the invention, the system can also have the following characteristics: the center management device comprises a sound prompt part which is used for sending out buzzing sounds with different frequencies according to different judgment result values.
In the spinal pedicle fixing, positioning and guiding system provided by the invention, the system can also have the following characteristics: the control key area comprises a prompt tone switch key for selectively turning on or off a prompt buzzing sound emitted by the sound prompt part.
In the spinal pedicle fixing, positioning and guiding system provided by the invention, the system can also have the following characteristics: the positioning guide device and the central management device are in communication connection through a wired network or a wireless network.
In the spinal pedicle fixing, positioning and guiding system provided by the invention, the system can also have the following characteristics: the wired network adopts any one of twisted-pair wires, coaxial cables and optical fibers as a transmission medium, and the wireless network adopts any one of the technologies of Bluetooth, WIFI, 3G, 4G, zigbee and EnOcean.
In the spinal pedicle fixing, positioning and guiding system provided by the invention, the system can also have the following characteristics: wherein, the distance between the positioning guide device and the central management device is within 10 meters.
Action and Effect of the invention
According to the vertebral pedicle fixing, positioning and guiding system of the spine, which is related by the invention, the positioning and guiding device and the center management device are mutually communicated and connected through the sensor, the positioning and guiding device is connected with the opener, the tap and the nail feeder for internal fixation surgery, the center management device obtains and records the real-time three-dimensional coordinate of the sensor, calculates the three-dimensional coordinate to obtain the correct open circuit direction and open circuit distance, and guides the internal fixation mechanism to operate according to the open circuit direction and the open circuit distance, so that the vertebral pedicle fixing, positioning and guiding system of the spine can rapidly and accurately guide the internal fixation surgery instrument to rapidly and accurately perform the fixation operation of the vertebral pedicle of the spine without the need of the internal fixation surgery instrument, and is simple in operation and convenient to carry.
Drawings
FIG. 1 is an illustrative schematic view of a spinal pedicle fixation positioning guide system in an embodiment of the invention;
FIG. 2 is a schematic view of a positioning guide according to an embodiment of the present invention;
FIG. 3 is a schematic structural diagram of an initial position correction plate in an embodiment of the present invention;
figure 4 is an exploded view of the opener portion of the positioning guide in an embodiment of the invention;
FIG. 5 is an exploded view of the tacker portion of the positioning guide in an embodiment of the present invention;
FIG. 6 is an exploded view of the tap portion of the positioning guide in an embodiment of the present invention;
FIG. 7 is a side cross-sectional view of a tap holder of the positioning guide in an embodiment of the present invention;
FIG. 8 is a bottom view of a tap clasp of a positioning guide in an embodiment of the present invention;
fig. 9 is a block diagram showing the configuration of a central management apparatus in the embodiment of the present invention;
FIG. 10 is a diagram illustrating an example of a management screen according to the present invention;
FIG. 11 is a first diagram illustrating a control key area according to an embodiment of the present invention;
FIG. 12 is a second exemplary diagram of a control key area in accordance with an embodiment of the present invention; and
FIG. 13 is a system flow diagram of a spinal pedicle fixation positioning guide system in an embodiment of the invention.
Detailed Description
In order to make the technical means, the creation characteristics, the achievement purposes and the efficacy of the invention easy to understand, the following embodiments are specifically described with reference to the attached drawings.
As shown in fig. 1, a vertebral pedicle fixation positioning and guiding system 100 is used for positioning and guiding a vertebral pedicle fixation instrument, which includes a channel opener T1, a tap machine T3 and a nail-applying machine T2, and is characterized by comprising:
as shown in fig. 2, the positioning guide 10 is used to connect the circuit breaker T1, the tap T3, and the tacker T2 to the sensors, respectively, to form the opening mechanism 14A, the tap mechanism 12A, and the tacker mechanism 13A. The device comprises an initial position correction plate 11, and a opener part 14, a tacker part 13 and a tap part 12 which are arranged on the initial position correction plate 11.
As shown in fig. 3, the initial position correction plate 11 has an opener placing position 111, a tacker placing position 112, and a tap placing position 113;
the opener placing position 11, the tacker placing position 12 and the tap placing position 13 may be groove structures or through hole structures. In the present embodiment, the opener placing position 11, the tacker placing position 12, and the tap placing position 13 are sequentially provided from left to right, and are preferably rectangular through holes penetrating the upper and lower end surfaces of the initial position correction plate 10.
As shown in fig. 4, the breaker portion 14 has a rectangular parallelepiped shape, is detachably provided at the breaker placement position 111, and is connected to the rod-shaped breaker T1 to form the opening mechanism 14A. The sensor ring clamp assembly comprises a first sensor ring clamp assembly 141, an upper opener gasket 142, a lower opener gasket 1433 and a first connecting bolt 144 which are sequentially connected from top to bottom.
The first sensor ring clamping assembly 141 is arranged at the upper part of the disconnector part 14 and comprises a square first sensor 1411 and a first sensor ring clamping 1412, the first sensor ring clamping 1412 is in a rectangular parallelepiped bottomless cylinder shape, the first sensor 1411 is fixed in the first sensor ring clamping 1412 through adjustable fastening screws on four side surfaces, in the embodiment, the first sensor 1411 is preferably an LPMS-B2 nine-axis Bluetooth attitude sensor with a switch and a communication state indicator lamp, the working temperature is-20 ℃ -60 ℃, and the sensor can be charged and can be continuously used for 8 hours in a full-power state.
The upper spacer 142 of the circuit breaker is a rectangular metal flat plate and is arranged adjacent to the first sensor ring clamping assembly 141, and four corners of the upper spacer 142 of the circuit breaker are connected with the first sensor ring clamping assembly 141 through the first connecting bolts 144 and are matched with each other.
The lower spacer 143 of the circuit breaker is plate-shaped and is arranged adjacent to the upper spacer 142 of the circuit breaker, four corners of the lower spacer 143 of the circuit breaker are connected with the upper spacer 142 of the circuit breaker through first connecting bolts 144 and are matched with each other, a first through groove 145 with a V-shaped cross section is arranged in the middle of the upper end surface of the lower spacer 143 of the circuit breaker, and a notch of the first through groove 145 faces the upper spacer 142 of the circuit breaker. The arrangement mode of the slots enables the first through slot 145 and the upper spacer 142 of the circuit breaker to jointly form a through hole of the circuit breaker, namely, a through hole of the circuit breaker penetrating through two corresponding side surfaces of the circuit breaker part 14 is formed between the upper spacer 142 of the circuit breaker and the lower spacer 143 of the circuit breaker, the axis of the through hole of the circuit breaker is perpendicular to the height direction of the circuit breaker part 14, the size of the gap between the upper spacer 142 of the circuit breaker and the lower spacer 143 of the circuit breaker can be adjusted by adjusting the first connecting bolt 144, so that the size of the through hole of the circuit breaker is changed, the circuit breaker T1 penetrating through the through hole of the circuit breaker can be clamped and fixed to form the opening mechanism 14A, and the head of the circuit breaker T1 is the head of.
A first protrusion 146 having a trapezoidal cross section is provided on the bottom surface of the lower spacer 143 corresponding to the first through groove 145, and the area of the upper end surface of the first protrusion 146 is smaller than that of the lower end surface. The first protrusion 146 has the same rectangular shape as the opener placement site 111 when viewed from directly below and upward from the opener lower pad 143. The first protrusion 146 is fitted into the opener placing site 111 such that the opener portion 14 is horizontally fitted onto the opener placing site 111.
As shown in fig. 5, the tacker portion 13 is rectangular, detachably disposed on the opener placing position 112, and is used to connect with the rod-shaped tacker T2 to form a tacker mechanism 13A, which includes a second sensor ring clip assembly 131, a tacker upper spacer 132, a tacker lower spacer 133, and a second connecting bolt 134, which are sequentially connected from top to bottom.
The second sensor ring clamp assembly 131 is arranged at the upper part of the upper nailing device part 13 and comprises a square second sensor 1311 and a second sensor ring clamp 1312, the second sensor ring clamp 1312 is in a shape of a cuboid bottomless cylinder, the second sensor 1311 is fixed in the second sensor ring clamp 1312 through adjustable fastening screws on four side faces, in the embodiment, the second sensor 1311 is preferably an LPMS-B2 nine-axis Bluetooth attitude sensor with a switch and a communication state indicator lamp, the working temperature is-20 ℃ -60 ℃, the sensor can be charged, and the sensor can be continuously used for 8 hours in a full-power state.
The nail feeding device upper gasket 132 is a cuboid and is arranged adjacent to the second sensor ring clamping component 131, and four corners of the nail feeding device upper gasket 132 are connected with the second sensor ring clamping component 131 through the second connecting bolts 134 and are matched with each other. The middle part of terminal surface is provided with the second and leads to groove 136 under last nail ware upper shim 132, and the bottom surface that the groove 136 was led to the second is led to groove 136 everywhere the area of cross section all the same.
The shape of the lower nail puller gasket 133 is plate-shaped, the lower nail puller gasket 132 is arranged adjacent to the upper nail puller gasket 132, a third through groove 138 is arranged in the middle of the upper end face of the lower nail puller gasket 133, the bottom surface of the third through groove 138 is an arc surface, and the arc surface is identical to the shape and size of the bottom surface of the second through groove 136. The four corners of the upper tacker lower pad 133 are connected to and matched with the upper tacker upper pad 132 by the second connecting bolts 134.
The notch of the third through groove 138 and the notch of the second through groove 136 are oppositely arranged and matched with each other, the second through groove 136 and the third through groove 138 jointly form a nail driver through hole, namely, a nail driver through hole penetrating through two corresponding side surfaces of the nail driver part 13 is formed between the upper nail driver gasket 132 and the lower nail driver gasket 133, the axis of the nail driver through hole is vertical to the height direction of the nail driver part 13, and the gap between the upper nail driver gasket 132 and the lower nail driver gasket 133 can be adjusted by adjusting the second connecting bolt 134 so that the size of the nail driver through hole is changed. And the nail feeding device T2 passing through the through hole of the nail feeding device can be clamped and fixed to form the nail feeding mechanism 13A, and the head of the nail feeding device T2 is the head of the nail feeding mechanism 13A.
A circular arc-shaped second protrusion 137 is arranged on the bottom surface of the upper tacker lower spacer 133 at a position corresponding to the third through groove 138, and the shape of the second protrusion 137 is the same as that of the third through groove 138.
The second projection 137 has the same rectangular shape as the tacker location 112 when viewed from directly below and upward from the tacker lower pad 133. The second projection 137 is fitted into the tacker placing location 112 so that the tacker portion 13 is horizontally fitted onto the tacker placing location 112.
As shown in fig. 6, the tap portion 12 is a rectangular parallelepiped, is detachably provided at the opener placement position 113, is used to be connected to the rod-shaped tap T3 to form a tap mechanism, is detachably provided at the tap placement position 113, and includes a tap clasper 1412 and a third sensor 1411 provided at an upper portion of the tap clasper 1412.
The tapping device clamp 1212 is rectangular, and the upper end surface has a flat-bottom square recess 12121, and the bottom surface of the square recess 12121 is parallel to the horizontal plane. The tap holder 1212 secures the square third sensor 1211 within the square recess 12121 via four adjustable set screws located on the upper four sides of the tap holder 1212. In this embodiment, the third sensor 1211 is preferably a nine-axis LPMS-B2 Bluetooth attitude sensor having a switch and a communication status indicator, and has an operating temperature of-20 deg.C-60 deg.C, and is rechargeable and can be used continuously for 8 hours in a full power state.
The screw tap holder 1212 is provided with a screw tap through hole 12122 penetrating two corresponding sides of the screw tap portion 12, the screw tap through hole 12122 is arranged below the square recess 12121, and the axis of the screw tap through hole 12122 is perpendicular to the height direction of the screw tap portion 12. A slot 12124 extends from the edge of the tap bore 12122 in a direction parallel to the bottom surface of the square recess 12121, and the slot 12124 divides one side of the tap holder 1212 into two free ends, an upper free end B at the upper portion of the slot 12124 and a lower free end a at the lower portion of the slot 12124.
As shown in fig. 7 and 8, two corners of the lower free end a close to the screw holder 1212 are respectively provided with a threaded through hole 12126, two corners of the upper free end B close to the screw holder 1212 are respectively provided with a threaded blind hole 12125, the threaded blind holes 12125 correspond to the threaded through holes 12126, when the adjusting screw 122 is screwed into the threaded through hole 12126 and the threaded blind holes 12125, the width of the slit 12124 can be adjusted by adjusting the depth of the adjusting screw screwed into the threaded blind hole 12125, so that the size of the screw holder through hole 12122 is changed, the screw holder T3 passing through the screw holder through hole can be clamped and fixed to form the nailing device 12A, and the head of the screw holder T3 is the head of the tapping device 12A.
The middle of the bottom surface of the screw tap holder 1212 is provided with a third protrusion 12123, and the third protrusion 12123 is rectangular and has a length direction that is consistent with the axial direction of the screw tap through hole 12122.
The third protrusion 12123 has the same rectangular shape as the tap placement location 113 when viewed from directly below and up the tap holder 1212. The third protrusion 12123 engages the tap placement location 113 such that the tap portion 12 engages horizontally on the tap placement location 113.
In the present embodiment, when the first sensor 1411, the second sensor 1311, and the third sensor 1211 are turned on, the corresponding communication status indicator lamp is in the first flashing state, and when the communication connection with the central management device 20 is completed, the communication status indicator lamp is in the second flashing state.
The instantaneous spatial position point of the first sensor 1411 is taken as a spatial point a, the coordinate of the spatial point a is an open-circuit coordinate, the instantaneous spatial position point of the second sensor 1311 is taken as a spatial point B, the coordinate of the spatial point B is an upper nail coordinate, the instantaneous spatial position point of the third sensor 1211 is taken as a spatial point C, the coordinate of the spatial point C is a tap coordinate, a straight line where the spatial point a and the spatial point B are located is referred to as a spatial line AB, and a straight line where the spatial point B and the spatial point C are located is referred to as a spatial line BC.
The included angle between space line AB and space line BC is less than or equal to 1/100 degrees, the distance between space point a and space point B, and the distance between space point B and space point C is equal to the predetermined length, in this embodiment, space line AB coincides with space line BC, and the distance between space point a and space point B, the distance between space point B and space point C are both 1 cm.
The center management device 20 is operated by a device operator, is in communication connection with the positioning guide device 10, and is configured to obtain and record coordinates of spatial position points of the opener T1, the tap T3, and the tacker T2 connected to the positioning guide device 10, calculate the coordinates of the spatial position points to obtain an internal fixed tunnel parameter, and guide the operation of the tap T3 and the tacker T2 according to the internal fixed tunnel parameter, where the center management device 20 is any one of a desktop computer, a notebook computer, and a tablet computer, and in this embodiment, the center management device 20 is a notebook computer.
The positioning guide device 10 and the central management device 20 are connected in communication by a wired network 30 or a wireless network 30. The wired network 30 uses any one of a twisted pair, a coaxial cable, and an optical fiber as a transmission medium, the wireless network 30 uses any one of technologies of bluetooth, WIFI, 3G, 4G, zigbee, and EnOcean, in this embodiment, the positioning guide device 10 and the central management device 20 are communicatively connected by using the bluetooth wireless network 30.
The distance between the positioning guide device 10 and the central management device 20 is within 10 meters.
The positioning guide 10 is communicatively connected to the center management device 20, and when the opening mechanism 14A, the nailing mechanism 13A, and the tapping mechanism 12A are recognized by the center management device 20 through the calibration operation, the communication unit 202 receives the opening coordinates, the nailing coordinates, and the tapping coordinates, and thereby completes the communication connection with the opening mechanism 14A, the nailing mechanism 13A, and the tapping mechanism 12A, and at this time, the opening mechanism 14A, the nailing mechanism 13A, and the tapping mechanism 12A are detached from the initial position correction plate 11, respectively.
As shown in fig. 9, the center management device 20 includes a communication unit 202, a data calling unit 206, a data calculation unit 209, an instrument correction unit 201, a data addition unit 213, a data update unit 214, a data generation unit 207, a data deletion unit 208, a data storage unit 210, a data determination unit 211, an audio presentation unit 204, a screen storage unit 205, a screen display unit 203, and a control unit 212 connected to each of the above units.
A communication section 202 for receiving the open coordinates, the nail-on coordinates, and the tap coordinates;
a data calling part 206 for calling the open coordinates, the nail-on coordinates, and the tap coordinates received by the communication part 202;
a data calculation unit 209 for calculating the open-circuit coordinates, the nail-loading coordinates, and the tap coordinates of two different time points to obtain corresponding calculation result values;
an instrument calibration part 201, which calibrates the open-circuit mechanism 14A, the nailing mechanism 13A and the tapping mechanism 12A according to an included angle between the space line AB and the space line BC, a distance between the space point a and the space point B and a distance between the space point B and the space point C, if the included angle between the space line AB and the space line BC is smaller than or equal to 1/100 degrees and the distance between the space point a and the space point B and the distance between the space point B and the space point C are both predetermined lengths, the calibration is passed, the central management device 20 is in communication connection with the open-circuit mechanism 14A, the nailing mechanism 13A and the tapping mechanism 12A, otherwise, the central management device 20 is in communication connection with the open-circuit mechanism 14A, the nailing mechanism 13A and the tapping mechanism 12A, in this embodiment, the distance between the space point a and the space point B and the distance between the space point B and the space point C are both 1 cm;
a data generation unit 207 for generating an open data string, a staple data string, and a tap data string;
a data adding section 213 for adding the open-circuit coordinates to the open-circuit data string, adding the nail-on coordinates to the nail-on data string, and adding the tap coordinates to the tap data string;
a data update unit 214 for updating the open data string, the staple data string, and the tap data string;
a data deleting unit 208 for deleting the open-circuit data string;
a data storage section 210 for storing the calculation result value as a reference result value;
a sound prompt part 204 for sending out beeps with different frequencies according to different judgment result values, including normal state prompt beeps and abnormal state prompt beeps;
the screen storage unit 205 stores a management screen including a control key region C, a position display region V, and a data display region D as shown in fig. 10.
The control key region C includes a plurality of keys, and performs corresponding processing on the open-circuit coordinates, the screw-up coordinates, and the tap coordinates by operating the plurality of keys, so as to drive the center management device 20 to perform corresponding operations according to the movement conditions of the open-circuit mechanism 14A, the screw-up mechanism 13A, and the tap mechanism 12A. The device comprises a router selection key used for generating an open-circuit data string, a screw-on data string and a screw tap data string, an initialization key used for selecting the type and the position of the pedicle of vertebral arch to be fixed, a recording key used for respectively obtaining an open-circuit coordinate, a screw-on coordinate and a screw tap coordinate, a marking key used for updating and storing the open-circuit data string, an exit key used for deleting the open-circuit data string which is not updated and stored, and a prompt tone switch key used for selecting to turn on or turn off prompt buzzing sound sent by a sound prompt part.
The position display area V graphically displays the positions of the open circuit coordinates, the staple coordinates and the tap coordinates, and comprises a position target image V1, the position target image V1 is formed by a plurality of concentric circles, the diameters of the concentric circles are in an arithmetic progression from small to large, and the position target image V1 displays graphical marks of the open circuit coordinates, the staple coordinates and the tap coordinates.
The data display area D is used for displaying values of the open circuit coordinates, the nail feeding coordinates and the screw tap coordinates and is divided into two sides located in the position display area V.
A screen display unit 203 for displaying a management screen having functions of: displaying a graphic mark of the open circuit coordinate, the nail feeding coordinate and the screw tap coordinate in a position display area V, displaying values of the open circuit coordinate, the nail feeding coordinate and the screw tap coordinate in a position data display area D, and correspondingly processing the open circuit coordinate, the nail feeding coordinate and the screw tap coordinate through a plurality of keys in a control key area C;
in the position display region V, the multiple loop initial state of the position target map image V1 is displayed in red. After the positioning guide 10 and the center management device 20 are communicatively connected, graphic marks P1, P2, P3 respectively representing the spatial positions of the open coordinates, the staple coordinates, and the tap coordinates appear in the position target map image V1. In the present embodiment, the open-circuit coordinate graphic mark P1, the nail-up coordinate graphic mark P2, and the tap coordinate graphic marks are green dots, red dots, and yellow dots, respectively.
When the router selection key is pressed, a pull-down menu appears below, the pull-down menu comprises a 'router' option card, a 'tacker' option card and a 'tapper' option card, and when the 'router' option card is selected, an open-circuit data string is generated in the data generation part 207. When the "tacker" tab is selected, a piece of staple data string will be generated in the data generation section 207. When the "tap" tab is selected, a tap data string is generated in the data generation section 207.
The initialization key is used for selecting the type and the position of the pedicle of vertebral arch to be internally fixed and writing the relevant information of the pedicle of vertebral arch into an open-circuit data string, a screw-on data string and a screw-on data string. This key surface displays "initialize". After pressing this key, as shown in fig. 11, two rows of three keys arranged in a matrix and an input box are displayed at the key, which are pedicle type selection keys of pedicle types to be operated, located at the upper left corner of the matrix, respectively, and when pressing this key, a pull-down menu appears below, which is: tab "C", representing cervical spine; tab "T" for thoracic vertebrae, tab "L" for lumbar vertebrae, tab "S" for sacral vertebrae; a pedicle position selection key located at the upper right corner of the matrix, wherein after a corresponding pedicle type is selected from the pedicle type selection keys, the key is pressed down, a pull-down menu appears below, the pull-down menu comprises sequential position serial numbers which are displayed from '1' and represent the selected pedicle type, and the determination of the sequential position serial numbers is based on the common general knowledge in the field; the left and right sides of the pedicle of vertebral arch located in the lower left corner of the matrix select a key, and when the key is pressed, a pull-down menu appears below, which is: the tab with the L-shaped display surface represents the left side, the key with the R-shaped display surface represents the right side (the human pedicle of a vertebral arch is butterfly-shaped and divided into the left side and the right side according to the common knowledge in the field), and the type of the vertebral pedicle, the sequential position of the vertebral pedicle and the internal fixation operation position of the vertebral pedicle which are subjected to internal fixation operation after the corresponding tab is selected by the three keys are determined; the input box located at the lower right corner of the matrix is a remark input box for manually inputting remarks. Three pieces of information data of the type, the position and the operation implementation position of the internal fixation pedicle of vertebral arch are added into an open circuit data string or a screw-on data string or a screw tapping data string. In this embodiment, the key combination shown in fig. 12 indicates that the operation of the tacker is ready to be performed on the right side of the 5 th thoracic vertebra.
The recording key is used for acquiring an open-circuit coordinate, a nail-loading coordinate and a screw tap coordinate, and specifically comprises the following steps: recording key surface initial display "record", when the open mechanism 14A is operated, after pressing this key, the display of the key surface will become "end", at the same time, the control section 212 controls the open coordinates acquired by the data calling section 206 as first open coordinates and adds the open data string by the data adding section 212, when pressing the key again, the display of the key surface will become "record", at the same time, the control section 202 controls the open coordinates acquired by the data calling section 206 as second open coordinates and adds the open data string by the data adding section 212, and controls the data operation section 209 to calculate the first open coordinates and the second open coordinates in the open data string to obtain an open travel direction as an open calculation result value, the open travel direction being a direction of a straight line where the first open coordinates and the second open coordinates are located; when the staple feeding mechanism 13A is operated and pressed, the display of the key surface becomes "end", meanwhile, the control part 212 controls the staple feeding coordinate acquired by the data calling part 206 as a first staple feeding coordinate and adds a staple feeding data string through the data adding part 212, and in the continuous operation process of the staple feeding mechanism 13A, the control part 212 calculates the first staple feeding coordinate and the second staple feeding coordinate through the data calculating part 209 to obtain the staple feeding direction as a staple feeding calculation result value, the staple feeding direction is the direction of a straight line where the first staple feeding coordinate and the second staple feeding coordinate are located, when the record key is pressed again, the display of the key surface becomes "record", and meanwhile, the control part 202 controls the data calling part 206 not to acquire a new staple feeding coordinate; when the tapping mechanism 12A is operated, the display of the key surface becomes "end" after being pressed, and at the same time, the control section 212 controls the tap coordinates acquired by the data calling section 206 as first tap coordinates and adds a tap data string by the data adding section 212, and in the continuous operation of the tapping mechanism 12A, the instant tap coordinates acquired by the data calling section 206 are taken as second tap coordinates, and the control section 212 calculates the first tap coordinates and the second tap coordinates by the data calculating section 209 to obtain the tap advancing direction as a tap calculation result value, the tap advancing direction being the direction of the straight line where the first tap coordinates and the second tap coordinates are located, and when the record key is pressed again, the display of the key surface becomes "record", and at the same time, the control section 202 controls the data calling section 206 not to acquire new tap coordinates any more.
The marking key is used for marking the distance between the open circuit advancing direction and the open circuit obtained by the obtaining operation, and specifically comprises the following steps: when the open mechanism 14A presses the key by the acquisition operation, the data update section 214 replaces the first open coordinates and the second open coordinates in the open data string with the open travel direction and the open travel distance, and stores the new open data string in the data storage section 210, and at this time, the pattern mark P1 is covered with a blue dot in the position target map image V1. And taking the open circuit calculation result value as a reference result value.
When the exit key surface displays "exit" and is pressed, the control unit 212 controls the data deleting unit 208 to delete the open data string that is not subjected to the marking operation.
A data determining part 211, which compares the reference result value with the calculation result value to obtain a corresponding determination result value, specifically, the data determining part compares the tap calculation result value with the reference result value, and when the reference result value is equal to the tap calculation result value, the determination result value is "2"; when the values are not equal, judging that the result value is '1'; comparing the nail feeding calculation result value with the reference result value, and judging that the result value is '2' when the nail feeding calculation result value is equal to the reference result value; when the values are not equal, judging that the result value is '1';
when the judgment result value is "2", the multiple-loop display of the position target map image V1 will be changed from red to green, and the corresponding graphic mark P2 or graphic mark P3 coincides with the graphic mark P1; when the determination result value is "1", the sound presentation unit produces an abnormal state presentation beep, and when the determination result value is "1", the sound presentation unit produces a normal state presentation beep and displays a multiple loop line of the position target map image V1 in red.
The alert tone switch button is used to select on or off of an alert buzzer sound issued by the center management apparatus 20. And
and a control unit 212 connected to each unit for controlling each unit to perform a corresponding function according to an operation of the device operator in the control key region.
As shown in fig. 13, the operation process S100 of the spinal pedicle positioning and guiding system 100 includes the following steps:
step S1, connecting the open-circuit device T1, the screw feeder T2 and the screw tap T3 with the positioning guide device 10 to obtain an open-circuit mechanism 14A, a tapping mechanism 12A and a screw feeding mechanism 13A;
step S2, placing the positioning guide device 10 right in front of the screen of the central management device 20, opening each sensor and executing calibration operation;
step S3, after the calibration operation is completed, obtaining the instant coordinate of the first sensor 1411 corresponding to the open-circuit mechanism 14A and taking the instant coordinate as the open-circuit coordinate, obtaining the instant coordinate of the second sensor 1311 corresponding to the nailing mechanism 13A and taking the instant coordinate as the nailing coordinate, obtaining the instant coordinate of the third sensor 1211 corresponding to the tapping mechanism 12A and taking the instant coordinate as the tapping coordinate, and taking the open-circuit mechanism 14A, the nailing mechanism 13A and the tapping mechanism 12A down from the initial position correction plate 11;
step S4, determining a nail inserting point on the surface of the pedicle needing internal fixation, operating the opening mechanism 14A to ensure that the head of the opening mechanism 14A is aligned with the nail inserting point, and keeping the opening mechanism 14A still;
step S5, selecting "open circuit" for the enter circuit button in the control function button area C, and the control unit 212 generating one open circuit data string by the control data generation unit 207;
step S6, pressing the record button, the control part 212 takes the open coordinates obtained by the control data calling part 206 as the first open coordinates, and adds the open initial coordinates to the open data string through the data adding part 213;
step S7, the open-circuit mechanism 14A is used for open-circuit operation, namely, an open-circuit pore canal for placing a fixing screw in the pedicle of vertebral arch is opened towards the inside of the pedicle of vertebral arch by taking the screw-in point as an entrance, and the open-circuit mechanism 14A is kept still after the open-circuit operation is finished;
step S8, pressing the record key again, the control part 212 adding the open-circuit coordinates obtained by the control data calling part 206 as the second open-circuit coordinates into the open-circuit data string through the data adding part 213, and obtaining the open-circuit proceeding direction and the open-circuit proceeding distance according to the first open-circuit coordinates and the second open-circuit coordinates;
step S9, the control unit 212 controls the data update unit 214 to replace the first open coordinates and the second open coordinates in the open data string with the open travel direction and the open travel distance, stores the open data string in the data storage unit 210, and sets the open mechanism 14A to one side with the open travel direction as a reference result value;
step S10, operating the tapping mechanism 12A to tap the open-circuit pore canal, enabling the head of the tapping mechanism 12A to align with the nail-in-place point, and enabling the data calling part 206 to use the obtained tapping coordinate as the tapping starting point coordinate;
step S11, manually slightly rotating the tapping mechanism 12A to slightly change the direction and distance of the head of the tapping mechanism 12A, and the data call unit 206 sets the acquired tapping coordinates as tapping changing coordinates;
step S12, the data calculation part 209 calculates the coordinates of the starting point of the tap and the coordinates of the variation of the tap to obtain the initial direction of the tap;
step S13, the data judgment part 211 judges whether the initial direction of the tap is consistent with the reference result value, if not, the step S14 is executed, if so, the step S15 is executed;
step S14, the sound prompt part 204 sends out abnormal state prompt buzzing sound, and then the step S11 is proceeded;
step S15, the sound prompt part 204 sends out a normal state prompt buzzing sound, the multiple ring line display of the position target graph image V1 changes from red to green, a 'screw tap' is selected for the router key in the control function key area C, and the data generation part generates a screw tap data string;
step S16 is a step of pressing the record button, the control section 212 setting the tap coordinates acquired by the control data calling section 206 from the communication section 202 as first tap coordinates, and adding the first tap coordinates to the tap data string in the data generation section 207;
step S17, tapping the open pore passage by using the tapping mechanism 12A, wherein the data calling part 206 takes the obtained tap coordinates as second tap coordinates in the tapping process;
in step S18, the data calculation unit 209 calculates the second tap coordinates and the first tap coordinates to obtain the tap advancing direction and the tap advancing distance, and uses the tap advancing direction as the tap calculation result value;
step S19, the data judgment part 211 judges whether the tap calculation result value is consistent with the reference result value, if not, the step S20 is executed, and if so, the step S21 is executed;
step S20, in the open-circuit duct, slightly rotating the tap mechanism to change the second tap coordinate, and the data arithmetic section 209 performing arithmetic operation on the second tap coordinate and the first tap coordinate to obtain the adjusted tap advancing direction as a new tap calculation result value, and then returning to step S19;
step S21, monitoring whether the graphic mark P1 and the graphic mark P2 are overlapped in the position target map image V1, if the graphic mark P1 and the graphic mark P2 are overlapped, indicating that the tap travel distance is consistent with the open-circuit travel distance, and entering step S22, if the graphic mark P2 is not overlapped, entering step S17;
step S22, pressing the recording key again to complete the tapping operation to obtain a tapping hole channel, and taking out the tapping mechanism 12A to place one side;
step S23, attaching an internal fixing screw to the head of the nailing mechanism 13A, operating the nailing mechanism 13A to make the head of the nailing mechanism 13A align with the nailing point, and using the acquired nailing coordinate as the nailing starting point coordinate by the data calling part 206;
step S24, manually slightly rotating the nailing mechanism 13A to make the head of the nailing mechanism 13A generate slight direction change and distance change, and the data calling part 206 takes the acquired nailing coordinate as a nailing change coordinate;
step S25, the data operation part 209 calculates the initial direction of the staple feeding by the coordinates of the start point of the staple feeding and the coordinates of the variation of the staple feeding;
step S26, the data judgment part 211 judges whether the initial nailing direction is consistent with the reference result value, if not, the step S27 is proceeded, if so, the step S28 is proceeded;
step S27, the sound prompt part 204 sends out abnormal state prompt buzzing sound, and then the step S24 is proceeded;
step S28, the sound prompt part 204 sends out normal state prompt buzzing sound and the multiple ring line display of the position target graph image V1 changes from red to green, the button of the router is selected to be 'nailing device' in the control function button area C, and the data generation part generates a nailing data string;
step S29 is that the recording key is pressed, the control section 212 takes the staple attaching coordinates acquired from the communication section 202 by the control data calling section 206 as first staple attaching coordinates, and adds the first staple attaching coordinates to the staple attaching data string in the data generating section 207;
step S30, the nailing mechanism 13A is used for nailing the tapping hole channel, and in the nailing process, the data calling part 206 takes the acquired nailing coordinate as a second nailing coordinate;
in step S31, the data arithmetic unit 209 calculates the second staple feeding coordinate and the first staple feeding coordinate to obtain the staple feeding direction and the staple feeding distance, and uses the staple feeding direction as the staple feeding calculation result value;
step S32, the data judgment part 211 judges whether the nail feeding calculation result value is consistent with the reference result value, if not, the step S33 is proceeded, if so, the step S34 is proceeded;
step S33, slightly rotating the upper nail mechanism 13A in the screw hole channel to change the second upper nail coordinate, and the data operation part 209 calculates the second upper nail coordinate and the first upper nail coordinate to obtain the adjusted upper nail advancing direction as a new upper nail calculation result value, and then returning to the step S32;
step S34, monitoring whether the graphic mark P1 and the graphic mark P3 are overlapped in the position target map image V1, if the graphic mark P1 and the graphic mark P3 are overlapped, indicating that the tap travel distance is consistent with the open-circuit travel distance, and entering step S35, if the graphic mark P3 is not overlapped, entering step S30;
step S35, pressing the recording key again to finish the nailing operation;
effects and effects of the embodiments
According to the vertebral pedicle fixing, positioning and guiding system of the spine related to the embodiment, the positioning and guiding device and the center management device are in communication connection through the sensor, the positioning and guiding device is connected with the opening device, the tapping device and the nailing device for internal fixation surgery, the center management device obtains and records the real-time three-dimensional coordinate of the sensor, calculates the three-dimensional coordinate to obtain the correct opening direction and opening distance, and guides the internal fixation mechanism to operate according to the opening direction and the opening distance, so that the vertebral pedicle fixing, positioning and guiding system of the spine does not need to be capable of quickly and accurately guiding the internal fixation surgery instrument to quickly and accurately perform the vertebral pedicle surgery fixing operation, and is simple to operate and convenient to carry.
The above embodiments are preferred examples of the present invention, and are not intended to limit the scope of the present invention.
Claims (7)
1. The utility model provides a fixed location guidance system of backbone pedicle of vertebral arch for through fixing the apparatus location and direction to the backbone pedicle of vertebral arch, the fixed apparatus of backbone pedicle of vertebral arch includes circuit breaker, screw tap ware and goes up the nail ware, its characterized in that includes:
the positioning guide device is used for correspondingly connecting the circuit breaker, the screw tap and the screw feeding device with a sensor to form a circuit opening mechanism, a screw tap mechanism and a screw feeding mechanism; and
the central management device is in communication connection with the positioning guide device;
wherein, the positioning and guiding device comprises:
the initial position correcting plate comprises an initial position correcting plate, and a circuit breaker part, a nail feeding part and a screw tapping part which are arranged on the initial position correcting plate;
the tapping device comprises a tapping device body, a first sensor, a second sensor, a third sensor, a first screw driver, a second screw driver, a third sensor, a third screw driver, a first screw driver, a second screw driver, a third screw driver and a third screw driver, wherein the first sensor is arranged on the tapping device body;
the first sensor is used for collecting the coordinates of the instant space position point where the first sensor is located, the second sensor is used for collecting the coordinates of the instant space position point where the second sensor is located, the third sensor is used for collecting the coordinates of the instant space position point where the third sensor is located,
taking the instant space position point of the first sensor as a space point A, taking the coordinate of the space point A as an open-circuit coordinate, taking the instant space position point of the second sensor as a space point B, taking the coordinate of the space point B as an upper nail coordinate, taking the instant space position point of the third sensor as a space point C, taking the coordinate of the space point C as a tapping coordinate, taking the straight line where the space point A and the space point B are located as a space line AB, and taking the straight line where the space point B and the space point C are located as a space line BC;
an included angle between the space line AB and the space line BC is less than or equal to 1/100 degrees, a distance between the space point A and the space point B, and a distance between the space point B and the space point C are equal to a predetermined length,
the center management device includes:
a communication part for receiving the open circuit coordinates, the nail-feeding coordinates and the tap coordinates;
the instrument calibration part is used for performing calibration operation on the open-circuit mechanism, the nailing mechanism and the tapping mechanism according to an included angle between the space line AB and the space line BC, the distance between the space point A and the space point B, and the distance between the space point B and the space point C;
a screen storage unit that stores a management screen including: the device comprises a control key area, a position display area and a data display area, wherein the control key area comprises a plurality of keys for operation;
a screen display unit for displaying the management screen;
the data calling part is used for calling the open circuit coordinates, the nail installing coordinates and the screw tap coordinates;
a data generation unit for generating an open-circuit data string, a staple data string, and a tap data string;
a data adding section for adding the open-circuit coordinates to the open-circuit data string, adding the upper-pin coordinates to the upper-pin data string, and adding the tap coordinates to the tap data string;
a data update unit configured to update the open-circuit data string, the screw-up data string, and the tap data string;
a data deleting unit configured to delete the open-circuit data string;
the data operation part is used for calculating the open circuit coordinates, the nail feeding coordinates and the screw tap coordinates of two different time points to obtain corresponding calculation result values;
a data storage section for storing the calculation result value as a reference result value;
the data judgment part is used for comparing the reference result value with the calculation result value to obtain a corresponding judgment result value; and
a control part connected with each part for controlling each part to execute corresponding functions according to the operation of the corresponding keys by the control key area,
the control key area comprises a router-in selection key used for generating the open-circuit data string, the screw-on data string and the tap data string, an initialization key used for selecting the type and the position of vertebra fixed in a pedicle surgery, a recording key used for respectively acquiring the open-circuit coordinate, the screw-on coordinate and the tap coordinate, a marking key used for updating and storing the open-circuit data string and an exit key used for deleting the open-circuit data string which is not updated and maintained.
2. The spinal pedicle fixation positioning guide system as claimed in claim 1, wherein:
the central management device is any one of a desktop computer, a notebook computer and a tablet computer.
3. The spinal pedicle fixation positioning guide system as claimed in claim 1, wherein:
the center management device comprises a sound prompt part which is used for sending out buzzing sounds with different frequencies according to different judgment result values.
4. The spinal pedicle fixation positioning guide system as claimed in claim 3, wherein:
the control key area comprises a prompt tone switch key for selectively turning on or off the buzzing sound emitted by the sound prompt part.
5. The spinal pedicle fixation positioning guide system as claimed in claim 1, wherein:
the positioning guide device and the central management device are in communication connection through a wired network or a wireless network.
6. The spinal pedicle fixation positioning guide system as claimed in claim 5, wherein:
wherein, the wired network adopts any one of twisted pair, coaxial cable and optical fiber as transmission medium,
the wireless network adopts any one technology of Bluetooth, WIFI, 3G, 4G, zigbee and EnOcean.
7. The spinal pedicle fixation positioning guide system as claimed in claim 5 or 6, wherein:
wherein, the distance between the positioning guide device and the central management device is within 10 meters.
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| CN201910097879.9A CN109925045B (en) | 2019-01-31 | 2019-01-31 | Vertebral pedicle fixing, positioning and guiding system for spine |
| PCT/CN2019/095388 WO2020155562A1 (en) | 2019-01-31 | 2019-07-10 | Positioning guiding device, and positioning guiding system for vertebral pedicle fixation |
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