CN114366273A - Pedicle of vertebral arch mouth gag for spinal surgery - Google Patents

Pedicle of vertebral arch mouth gag for spinal surgery Download PDF

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Publication number
CN114366273A
CN114366273A CN202111571187.7A CN202111571187A CN114366273A CN 114366273 A CN114366273 A CN 114366273A CN 202111571187 A CN202111571187 A CN 202111571187A CN 114366273 A CN114366273 A CN 114366273A
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CN
China
Prior art keywords
sheath
kirschner wire
pedicle
channel
handle
Prior art date
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Pending
Application number
CN202111571187.7A
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Chinese (zh)
Inventor
贺石生
倪海键
冯超博
王翔
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Shanghai Tenth Peoples Hospital
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Shanghai Tenth Peoples Hospital
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Priority to CN202111571187.7A priority Critical patent/CN114366273A/en
Publication of CN114366273A publication Critical patent/CN114366273A/en
Pending legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8897—Guide wires or guide pins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1637—Hollow drills or saws producing a curved cut, e.g. cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1671—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the spine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Biomedical Technology (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Neurology (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Surgical Instruments (AREA)

Abstract

The application provides a pedicle of vertebral arch mouth gag for spinal surgery, includes: sheath, handle and kirschner wire; the lower end of the sheath is provided with a pyramid part, the sheath is provided with a hollow channel along the central line, and the upper end and the lower end of the channel respectively penetrate through the upper end surface of the sheath and the lower end of the pyramid part; in the application, a sharp corner at the lower end of the Kirschner wire and a pyramid part at the lower end of the outer sheath can form a tip structure, in the puncturing process, the strength difference between the peripheral cortical bone and the middle cancellous bone of the pedicle is utilized, the tip structure can automatically adjust the track to the cancellous bone area under the action of the cortical bone of the pedicle, so that the opening can be safely and quickly realized and a correct nail channel can be constructed, the outer sheath is hollow, the Kirschner wire can be placed in the outer sheath to replace the traditional Kirschner wire positioning method, and a guide wire can be directly placed in the outer sheath for placing nails after the opening is successful, so that the operation steps in the prior art can be simplified, and the number of times of perspective and the operation time can be efficiently reduced; meanwhile, the structure is simple and optimized, the use is convenient, the nail path can be effectively constructed, and the operation efficiency is improved.

Description

Pedicle of vertebral arch mouth gag for spinal surgery
Technical Field
The invention relates to the technical field of medical equipment, in particular to a pedicle of vertebral arch mouth gag for spinal surgery.
Background
With the ever-increasing depth of the idea of minimally invasive spinal surgery, more and more spinal surgeons are using minimally invasive surgery as the preferred treatment strategy. In minimally invasive spine surgery, percutaneous pedicle screw implantation can ensure the mechanical property of the spine and effectively stabilize the curvature of the spine, so that the minimally invasive spine surgery is more and more extensive in application.
In the process of percutaneous minimally invasive spine surgery, a doctor needs to construct a channel for the placement of a pedicle screw through surgical instruments such as a puncture needle, a guide wire, tapping and the like. Because the relevant anatomical structures cannot be directly viewed, the puncture needle is used by depending on the experience of an operator and X-ray images to a great extent, multiple times of perspective repeated adjustment are often needed in the process that the puncture needle needs to be placed along a correct nail path, and because the bone around the articular process is irregular, even if the skill adjustment is carried out by depending on the experience of the operator and multiple times of perspective, the situation that the position cannot be adjusted to a satisfactory position or even the nail needs to be cut open still exists for patients with spinal degeneration and hyperosteogeny. In the process of constructing the nail path, for example, the lateral slippage or the change of the abduction angle of the instrument is easy to occur, so that the constructed nail path deviates from a normal track and risks of nerve and blood vessel damage and the like occur, and the nail path needs to be repeatedly subjected to fluoroscopy and slowly enter. Therefore, the problems of excessive radiation exposure, low operation efficiency and the like exist in the current percutaneous pedicle screw implantation operation.
Therefore, there is a need to provide a new mouth gag structure with guiding function and a technical solution for realizing safe and efficient nail path arrangement.
Disclosure of Invention
The invention provides a vertebral pedicle mouth gag for spinal surgery, and aims to solve the problems of complexity, excessive radiation exposure and low operation efficiency of the existing percutaneous vertebral pedicle screw implantation process.
The technical scheme adopted by the invention is as follows: a pedicle opener for spinal surgery, comprising: sheath, handle and kirschner wire; the lower end of the sheath is provided with a pyramid part, the sheath is provided with a hollow channel along the central line, and the upper end and the lower end of the channel respectively penetrate through the upper end surface of the sheath and the lower end of the pyramid part;
the handle comprises an upper structure and a lower structure which are detachably connected;
the lower structure of the handle is fixed on the upper end wall surface of the outer sheath;
the upper structure of the handle is fixedly connected with the upper end of the Kirschner wire; the Kirschner wire is detachably mounted in the channel of the sheath, the upper end of the Kirschner wire is close to the upper structure of the handle and is in threaded connection with the channel of the sheath, and the sharp corner at the lower end of the Kirschner wire extends to the outside of the pyramid part along the channel.
Further, the diameter of the channel of the outer sheath is the same as the diameter of the k-wire.
Further, the kirschner wire is provided with a thread part at the upper end and close to the upper structure of the handle, and the thread part is used for being in threaded connection with the channel of the outer sheath.
Further, the upper end of the channel is provided with an internal thread matched with the threaded part.
Further, the inclination of the side wall of the pyramid part corresponds to the inclination of the side surface of the lower tip angle of the Kirschner wire.
The invention has the beneficial effects that:
in the application, a sharp corner at the lower end of the Kirschner wire and a pyramid part at the lower end of the outer sheath can form a tip structure, in the puncturing process, the strength difference between the peripheral cortical bone and the middle cancellous bone of the pedicle is utilized, the tip structure can automatically adjust the track to the cancellous bone area under the action of the cortical bone of the pedicle, so that the opening can be safely and quickly realized and a correct nail channel can be constructed, the outer sheath is hollow, the Kirschner wire can be placed in the outer sheath to replace the traditional Kirschner wire positioning method, and a guide wire can be directly placed in the outer sheath for placing nails after the opening is successful, so that the operation steps in the prior art can be simplified, and the number of times of perspective and the operation time can be efficiently reduced; meanwhile, the structure is simple and optimized, the use is convenient, the nail path can be effectively constructed, and the operation efficiency is improved.
Drawings
The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the invention without limiting the invention. In the drawings:
FIG. 1 is a schematic structural diagram of an embodiment of the present invention;
FIG. 2 is a cross-sectional view of one embodiment of the present invention;
fig. 3 is a schematic structural view of a handle and a k-wire according to an embodiment of the present invention.
Reference is made to the accompanying drawings in which: 1. a handle; 2. an outer sheath; 21. a pyramid part; 3. a Kirschner wire; 31. a threaded portion.
Detailed Description
The following detailed description of embodiments of the invention refers to the accompanying drawings. It should be understood that the detailed description and specific examples, while indicating the present invention, are given by way of illustration and explanation only, not limitation.
The invention provides a vertebral pedicle mouth gag for spinal surgery, and aims to solve the problems of complexity, excessive radiation exposure and low operation efficiency of the existing percutaneous vertebral pedicle screw implantation process.
Referring to fig. 1 to 3, to achieve the object, the present invention provides a pedicle opener for spinal surgery, comprising: sheath 2, handle 1 and kirschner wire 3; wherein, the lower end of the sheath 2 gradually shrinks towards the center line to form a pyramid part 21, and the pyramid part 21 is of a multi-pyramid structure; a hollow channel is arranged in the sheath 2, the channel is arranged along the central line of the sheath 2, the upper end of the channel penetrates through the upper end surface of the sheath 2, and the lower end of the channel penetrates through the lower part of the pyramid part 21, so that an opening is formed at the lower end of the pyramid part 21;
the handle 1 comprises an upper structure and a lower structure, the upper structure and the lower structure are both hemispherical structures and are detachably arranged between the upper structure and the lower structure, and the lower structure of the handle 1 is fixed on the upper end wall surface of the outer sheath 2; the upper structure of the handle 1 is fixedly connected with the upper end of the Kirschner wire 3, and the upper structure and the Kirschner wire have the same central line; after mounting the k-wire 3 into the channel of the sheath 2, the upper structure of the handle 1 will abut at the upper end face of the lower structure (see figure 1), meanwhile, the kirschner wire 3 is in threaded connection with the channel of the sheath 2 at the upper end and close to the upper structure of the handle 1, so that the kirschner wire 3 is stably arranged in the sheath 2, and, after the k-wire 3 is mounted in the passage of the sheath 2, the lower tip of the k-wire 3 projects outside the pyramid part 21 along the passage, and the pyramid part 21 forms the tip structure of the mouth gag, specifically, the side surface gradient of the lower end sharp corner of the kirschner wire 3 corresponds to the side wall gradient of the pyramid part 21, so that after the kirschner wire 3 is installed on the sheath 2, the side of the lower tip angle thereof corresponds to the side of the pyramid part 21, so that both sides are on the same slope (see fig. 2), thereby constituting a tip structure of the mouth gag by which the opening can be safely and rapidly performed and the staple passage can be constructed.
In addition, this application simple structure optimizes, and convenient to use can construct the nail way effectively and improve user's work efficiency.
In one embodiment, the diameter of the channel is the same as the diameter of the rod part of the kirschner wire 3, so that the channel corresponds to the structure of the kirschner wire 3, and the lower tip angle of the kirschner wire 3 can cling to the pyramid part 21 structure after extending out of the channel, so as to prevent the structure from generating a gap and affecting the use, and the channel can limit the position of the kirschner wire 3, so that the straight line movement of the kirschner wire 3 is kept, and the subsequent opening of the kirschner wire 3 can be facilitated.
In one embodiment, the kirschner wire 3 is provided at the upper end thereof, near the upper structure of the handle 1, with a threaded portion 31, the outer diameter of which threaded portion 31 is slightly larger than the diameter of the shaft portion below the kirschner wire 3, while the upper end of the channel of the sheath 2 is provided with an internal thread for cooperating with the threaded portion 31, thereby achieving a threaded connection of the kirschner wire 3 with the channel of the sheath 2, and thus allowing a more stable mounting of the kirschner wire 3 in the sheath 2.
The specific working process of the application is as follows: the general advancing direction of the mouth gag is determined on the basis of positioning the built-in Kirschner wire 3 of the mouth gag near the pedicle entry point outside the articular process and then clearly determining the position of the tip of the mouth gag through perspective. Then, an external force acts on the handle 1 to drive the sheath 2 and the built-in Kirschner wire 3 to rotate, and the joint process cortical bone is penetrated through by rotation and advancing, so that a nail path is constructed in the vertebral pedicle cancellous bone, wherein due to the difference of the mechanical strength of the vertebral pedicle cortical bone and the cancellous bone, the tip structure of the mouth gag slides to the fragile cancellous bone when approaching the cortical bone in the process of going deep, so that the tip structure can automatically adjust the track to the cancellous bone region, namely the central region of the vertebral pedicle, and the opening can be safely and quickly realized and the correct nail path can be constructed; after the tip structure of the mouth gag completely enters the vertebral pedicle, the handle 1 and the built-in Kirschner wire 3 can be detached, a guide wire is placed in a channel of the outer sheath 2 and lightly knocked to enter a vertebral body through the vertebral pedicle, then the outer sheath 2 is detached, a screw channel is expanded through a tap, and a vertebral pedicle screw is placed along the guide wire.
Compared with the prior art, in the application, a sharp corner at the lower end of the Kirschner wire 3 and a pyramid part 21 at the lower end of the outer sheath 2 can form a tip structure, in the puncturing process, the strength difference between the peripheral cortical bone and the middle cancellous bone of the pedicle is utilized, the tip structure can automatically adjust the track to the cancellous bone area under the action of the cortical bone of the pedicle, so that the opening can be safely and quickly realized and the correct nail track can be constructed, the outer sheath 2 is hollow, the Kirschner wire 3 can be placed in the tip structure to replace the traditional positioning method of the Kirschner wire 3, and after the opening is successful, a guide wire can be directly placed in and nails can be placed in parallel, so that the operation steps in the prior art can be simplified, and the number of perspective times and the operation time can be efficiently reduced; meanwhile, the structure is simple and optimized, the use is convenient, the nail path can be effectively constructed, and the operation efficiency is improved.
Any combination of the various embodiments of the present invention should be considered as disclosed in the present invention, unless the inventive concept is contrary to the present invention; within the scope of the technical idea of the invention, any combination of various simple modifications and different embodiments of the technical solution without departing from the inventive idea of the present invention shall fall within the protection scope of the present invention.

Claims (5)

1. A pedicle opener for spinal surgery, comprising: sheath, handle and kirschner wire; the lower end of the sheath is provided with a pyramid part, the sheath is provided with a hollow channel along the central line, and the upper end and the lower end of the channel respectively penetrate through the upper end surface of the sheath and the lower end of the pyramid part;
the handle comprises an upper structure and a lower structure which are detachably connected;
the lower structure of the handle is fixed on the upper end wall surface of the outer sheath;
the upper structure of the handle is fixedly connected with the upper end of the Kirschner wire; the Kirschner wire is detachably mounted in the channel of the sheath, the upper end of the Kirschner wire is close to the upper structure of the handle and is in threaded connection with the channel of the sheath, and the sharp corner at the lower end of the Kirschner wire extends to the outside of the pyramid part along the channel.
2. A pedicle opener as claimed in claim 1, in which: the diameter of the channel of the sheath is the same as the diameter of the K-wire.
3. A pedicle opener as claimed in claim 1, in which: the kirschner wire is provided with a thread part at the upper end and close to the upper structure of the handle, and the thread part is used for being in threaded connection with the channel of the sheath.
4. A pedicle opener as claimed in claim 3, wherein: the upper end of the channel is provided with an internal thread matched with the thread part.
5. The pedicle opener of claim 1 or 2, wherein: the inclination of the side wall of the pyramid part corresponds to the inclination of the side surface of the sharp corner at the lower end of the Kirschner wire.
CN202111571187.7A 2021-12-21 2021-12-21 Pedicle of vertebral arch mouth gag for spinal surgery Pending CN114366273A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN202111571187.7A CN114366273A (en) 2021-12-21 2021-12-21 Pedicle of vertebral arch mouth gag for spinal surgery

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202111571187.7A CN114366273A (en) 2021-12-21 2021-12-21 Pedicle of vertebral arch mouth gag for spinal surgery

Publications (1)

Publication Number Publication Date
CN114366273A true CN114366273A (en) 2022-04-19

Family

ID=81139539

Family Applications (1)

Application Number Title Priority Date Filing Date
CN202111571187.7A Pending CN114366273A (en) 2021-12-21 2021-12-21 Pedicle of vertebral arch mouth gag for spinal surgery

Country Status (1)

Country Link
CN (1) CN114366273A (en)

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