JP2013138820A - Diamond bar for endoscope surgical bone elimination instrument - Google Patents

Diamond bar for endoscope surgical bone elimination instrument Download PDF

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JP2013138820A
JP2013138820A JP2012012462A JP2012012462A JP2013138820A JP 2013138820 A JP2013138820 A JP 2013138820A JP 2012012462 A JP2012012462 A JP 2012012462A JP 2012012462 A JP2012012462 A JP 2012012462A JP 2013138820 A JP2013138820 A JP 2013138820A
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bar
bone
cutting
instrument
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JP5952004B2 (en
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Shu Nakamura
周 中村
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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
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B2017/320004—Surgical cutting instruments abrasive

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  • Life Sciences & Earth Sciences (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
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Abstract

PROBLEM TO BE SOLVED: To provide an instrument wherein elimination capability is held even if pressing a diamond bar for a rotary bone elimination instrument in the axial direction, and which is safe even if the instrument is used for a nerve operation.SOLUTION: This diamond bar includes a concavity 9 conically cut out in a small range having the tip rotational axis center of a spherical bar as the center. By applying abrasive grain fixing working onto the whole surface of the bar 8 including the concavity surface, it is solved that the tip rotational axis center having lowest cutting capability comes to the forefront of the cutting, so that the cutting becomes rapid. When advancing bone elimination, a bone abuts on the rotational axis center, too, but the bone having remained in the shape of the concavity portion without being cut is weak on a structure because it is a small projection shape, and is easily scraped.

Description

本発明は、内視鏡下脊椎手術等において使用する回転式骨削除器具のサージカルバーに関するものである。  The present invention relates to a surgical bar for a rotary bone removal instrument used in endoscopic spinal surgery or the like.

脊椎手術において回転式の骨削除器具のバーには、刃のあるカッティングバー（図１）と、刃がなく微小な凹凸が表面にあるダイヤモンドバー（図２）の主に二種類がある。カッティングバーは、骨削除能力が高いが、刃により神経を損傷する危険がある。ダイヤモンドバーは刃がないので神経に触れても巻き込まなければ安全だが、骨削除能力は低い。ダイヤモンドバーは砥粒を表面に固着させたもので、砥石と同じように軟性のものはほとんど切削せず硬性のものだけ切削できるので、神経近くの骨を削除する脊髄手術にはもっぱらダイヤモンドバーが用いられる。  There are mainly two types of bars for rotary bone removal instruments in spinal surgery: a cutting bar with a blade (FIG. 1) and a diamond bar without a blade and a minute unevenness on the surface (FIG. 2). The cutting bar has a high ability to remove bone, but there is a risk of damaging the nerve by the blade. The diamond bar has no blades, so it is safe if you don't get involved even if you touch your nerves, but its ability to remove bones is low. A diamond bar is made of abrasive grains fixed to the surface. Like a grindstone, it can cut only hard ones without cutting soft ones, so diamond bars are exclusively used for spinal surgery to remove bones near nerves. Used.

図３のように、ダイヤモンドバーは先端回転軸中心（図２の１、図３の２）はコマの軸と同じで擦過運動がほとんどないため、そこが最も削除能力が低い。通常はダイヤモンドバーを骨面に対して先端回転軸中心をはずして、すこし斜めにあてて、横方向に往復運動をしながら削る。  As shown in FIG. 3, the diamond bar has the lowest center of rotation (1 in FIG. 2 and 2 in FIG. 3), which is the same as the axis of the frame and has almost no rubbing motion. Usually, the diamond bar is scraped while reciprocating in the lateral direction, with the center of the rotation axis of the tip removed from the bone surface, slightly tilted.

図４のように、侵襲を少なくするため小径の外筒３を用いて内視鏡下に手術を行う内視鏡下脊椎手術が行われるようになってきたが、可視領域が非常に狭く、そこに挿入する骨削除器具４の横方向（図４の５）の動きもかなり制限されるため、骨削除器具も骨にあてて、軸方向（図４の６）に押し付けるような削り方になる。すると、最も削除能力が低い先端回転軸中心領域が骨削除最前線となり骨削除速度が非常に下がってしまう。  As shown in FIG. 4, endoscopic spine surgery has been performed in which surgery is performed under an endoscope using a small-diameter outer tube 3 to reduce invasion, but the visible region is very narrow, Since the movement in the lateral direction (5 in FIG. 4) of the bone removing device 4 to be inserted there is also considerably limited, the bone removing device is also applied to the bone and is sharpened so as to press in the axial direction (6 in FIG. 4). Become. Then, the tip rotation axis center region having the lowest deletion capability becomes the bone deletion front and the bone deletion speed is greatly reduced.

内視鏡下脊椎手術における骨削除器具でより迅速かつ安全性を保つことを目的とする。  The purpose is to maintain a quicker and safer bone removal device in endoscopic spine surgery.

従来の脊椎手術で用いるダイヤモンドバーは球形や、楕円球や、球と円柱を足したマッチ棒ような形をしている。これは、骨の奥に神経があり、骨を部分的に貫いたとしても安全なように、バーの先端側を尖らせず、ほぼ球形の凸曲面である。砥粒の凹凸は微小なので、削る対象が硬性であって、それに擦る運動による摩擦力で削ることになる。ダイヤモンドバーの先端の回転軸中心は、コマの軸のように摩擦力が生じないため、切削能力が最も小さい。図５のように非常に硬い平面にダイヤモンドバーを垂直にあてると、最も切削能力が低い先端回転軸中心がその平面にあたり、ほとんど削れない。ダイヤモンドバーを垂直のまま平行移動しても先端回転中心軸のみがあたりながら移動することになるので削れない。内視鏡下脊椎手術の場合は前述のように、このような状況になってしまい、骨削除が迅速にできない。  Diamond bars used in conventional spinal surgery have a spherical shape, an elliptical sphere, or a match rod with a sphere and a cylinder. This is a substantially spherical convex curved surface without the pointed end of the bar so that it is safe even if there is a nerve behind the bone and partially penetrates the bone. Since the unevenness of the abrasive grains is minute, the object to be cut is hard, and is cut by the frictional force generated by the rubbing motion. The center of rotation of the diamond bar has the smallest cutting ability because no frictional force is generated like the top axis. When the diamond bar is placed vertically on a very hard plane as shown in FIG. 5, the center of the tip rotation axis having the lowest cutting ability hits the plane and is hardly scraped. Even if the diamond bar is translated in a vertical direction, only the tip rotation center axis moves while hitting, so it cannot be cut. In the case of endoscopic spine surgery, as described above, this situation occurs, and bone removal cannot be performed quickly.

ダイヤモンドバーの球の直径を小さくすれば骨にあたる面積が小さくなるので押し当てる圧力が上がるため削りやすくなるが、骨を貫いたときには一気にバーの直径全体を削り落としてバーをその奥に押し出してしまう。奥には神経があるので、貫くと非常に危険である。バーの先端を尖らせても同様に危険である。バーの直径を大きくすれば、その一部分が骨を貫いたとしてもその他の部分がストッパーとなり奥に押し出してしまうことはなく、貫いた部分も奥への突出がわずかであるため安全である。小圧力で短時間あたるだけなら神経は軟性であるので、切削されることはない。しかし、バーの直径が大きくなると、骨面に押し当てる圧力が下がり、さらに先端回転軸中心の骨削除能の低い部分の面積が大きくなり、削る速度が落ちてしまう。  If you reduce the diameter of the diamond bar sphere, the area that hits the bone will be smaller, so it will be easier to cut because the pressing pressure will increase, but when you penetrate the bone, the entire diameter of the bar will be scraped away and the bar will be pushed out to the back . There is a nerve in the back, so it is very dangerous to penetrate. It is equally dangerous to sharpen the bar tip. If the diameter of the bar is increased, even if one part penetrates the bone, the other part becomes a stopper and is not pushed out to the back, and the penetrated part is safe because the protrusion to the back is slight. If only a short pressure is applied for a short time, the nerve is soft and will not be cut. However, as the diameter of the bar increases, the pressure applied to the bone surface decreases, and the area of the portion having a low bone-removing ability at the center of the distal end rotation axis increases, and the cutting speed decreases.

本発明の回転式骨削除器具のバーは、類球形でその先端回転軸中心からその近傍までの小範囲に円錐形に欠切された陥凹があり、その陥凹部分表面も含めバー全体の表面に砥粒固着加工が施されている。The bar of the rotary bone removing device of the present invention has a spherical shape and has a concavity notched in a small range from the center of the tip rotation axis to the vicinity thereof, and the entire bar including the surface of the concave portion is also included. Abrasive fixing process is applied to the surface.

最も切削能力が低い先端回転軸中心が切削の最前線に来ることが解消され、切削が迅速になる。骨削除を進めていくと回転軸中心部にも骨があたることになるが、陥凹部分の形に削り残った骨は、小突起状であるため構造上弱く、容易に削られる。  The center of the tip rotation axis having the lowest cutting ability is eliminated from being at the forefront of cutting, and the cutting becomes quicker. As the bone removal progresses, the bone also hits the central part of the rotation axis. However, the bone left in the shape of the recessed portion is a small protrusion and is weak in structure and easily cut.

骨を貫く時、突出した部分がなく、また他の部分がストッパーになるため奥のものを傷つける危険が少ない。垂直にあてて貫いた場合は、点ではなく、陥凹部分全体の面積を持って抜けるため、押す抵抗の変化が急激であるためその瞬間がわかりやすいので、より安全である。  When penetrating the bone, there is no protruding part, and other parts become stoppers, so there is little risk of damaging the back. When penetrating vertically, it passes through the entire area of the recessed portion, not a point, so the change in pressing resistance is abrupt and the moment is easy to understand, so it is safer.

本発明の実施形態１を図６〜８を用いて説明する。図６は回転軸を含んだ平面による断面図で、図７はその先端部拡大図で、図８はバーの下面図である。シャフト７につながるバー８は球形でその先端回転軸中心を頂点とする円錐形の陥凹（図６の９、図７の１０、図８の１１）がある。陥凹した部分を含めて、全体の表面に砥粒が固着されている。  A first embodiment of the present invention will be described with reference to FIGS. FIG. 6 is a cross-sectional view of a plane including the rotation axis, FIG. 7 is an enlarged view of the tip, and FIG. 8 is a bottom view of the bar. The bar 8 connected to the shaft 7 is spherical and has conical depressions (9 in FIG. 6, 10 in FIG. 7, and 11 in FIG. 8) whose apex is the center of the tip rotation axis. Abrasive grains are fixed to the entire surface including the recessed portion.

本発明の実施形態２を図９を用いて説明する。図９はバーの下面図である。バーの先端回転軸中心を頂点とする円錐形の陥凹１２とそれに連続するように欠削された小排粉溝１３がある。その他は実施形態１と同様である。  A second embodiment of the present invention will be described with reference to FIG. FIG. 9 is a bottom view of the bar. There is a conical recess 12 having the center of the rotational axis of the tip of the bar as an apex, and a small dust groove 13 that is continuously cut out. Others are the same as in the first embodiment.

本発明の実施形態３を図１０を用いて説明する。図１０はバーの側面図である。バーの先端回転軸中心を頂点とする円錐形の陥凹１４とそこから上方へ貫通している貫通孔１５がある。その他は実施形態１と同様である。  Embodiment 3 of the present invention will be described with reference to FIG. FIG. 10 is a side view of the bar. There is a conical recess 14 having a vertex at the rotation axis of the tip of the bar and a through hole 15 penetrating upward therefrom. Others are the same as in the first embodiment.

既存カッティングバーの側面図である。It is a side view of the existing cutting bar. 既存ダイヤモンドバーの側面図である。It is a side view of the existing diamond bar. バーの下面の回転時動態図である。It is a dynamic diagram at the time of rotation of the lower surface of a bar. 外筒に骨削除器具を挿入した状態の斜側面図である。It is an oblique side view of the state which inserted the bone removal instrument in the outer cylinder. 既存ダイヤモンドバーが平面に接地した状態の側断面図である。It is a sectional side view in the state where the existing diamond bar was grounded to the plane. 当発明のバーの実施形態１の側断面図である。It is side sectional drawing of Embodiment 1 of the bar | burr of this invention. 当発明のバーの実施形態１の側断面の先端部拡大図である。It is a front-end | tip part enlarged view of the side cross section of Embodiment 1 of the bar | burr of this invention. 当発明のバーの実施形態１の下面図である。It is a bottom view of Embodiment 1 of the bar of the present invention. 当発明のバーの実施形態２の下面図である。It is a bottom view of Embodiment 2 of the bar of the present invention. 当発明のバーの実施形態３の側面図である。It is a side view of Embodiment 3 of the bar | burr of this invention.

１，２ 先端回転軸中心
７ シャフト
８ バー
９、１０、１１，１２，１４ 陥凹
１３ 排粉溝
１５ 貫通孔1, 2 Tip rotation axis center 7 Shaft 8 Bar 9, 10, 11, 12, 14 Recess 13 Drainage groove 15 Through hole

Claims (4)

回転式骨削除器具のバーにおいて、少なくとも先端側に類球形の曲表面を持ち、
その先端回転軸中心からその近傍までの小範囲に陥凹があり、
その陥凹の表面も含めてバー表面に微小な凹凸加工処理が施されていること
を特徴とする回転式骨削除器具のバー。In the bar of the rotary bone removal device, at least the tip side has a similar curved surface,
There is a depression in a small range from the center of the tip rotation axis to the vicinity,
A bar for a rotary bone removal device, characterized in that the surface of the bar, including the surface of the recess, has been subjected to minute uneven processing. 前記の陥凹は、類円錐形に欠切された形状であること
を特徴とする請求項１に記載の回転式骨削除器具のバー。The bar of the rotary bone removing device according to claim 1, wherein the recess has a shape cut out in a conical shape. 前記の陥凹は、類円錐形に切削され、さらにその類円錐形に連続する小欠削が追加された形状であること
を特徴とする請求項１に記載の回転式骨削除器具のバー。2. The bar of the rotary bone removing device according to claim 1, wherein the recess has a shape obtained by cutting into a conical shape and further adding a small notch continuous to the conical shape. 前記の陥凹は、類円錐形に切削され、さらにその陥凹に貫通孔が追加された形状であること
を特徴とする請求項１に記載の回転式骨削除器具のバー。The bar of the rotary bone removing device according to claim 1, wherein the recess is cut into a conical shape and a through hole is added to the recess.
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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11806024B2 (en) 2021-06-24 2023-11-07 Nakanishi Inc. Surgical bur

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH04208148A (en) * 1990-11-30 1992-07-29 Katsumi Takahashi Rotary cutting tool for surgical operation
JP3001002U (en) * 1993-02-15 1994-08-16 シーメンス アクチエンゲゼルシヤフト A tool capable of rotary motion suitable for high-speed drive
JPH1043193A (en) * 1996-08-07 1998-02-17 Urawa Kogyo Kk Cutter for bone cutting
JP2006109917A (en) * 2004-10-12 2006-04-27 Dentech:Kk Rotating work tool

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH04208148A (en) * 1990-11-30 1992-07-29 Katsumi Takahashi Rotary cutting tool for surgical operation
JP3001002U (en) * 1993-02-15 1994-08-16 シーメンス アクチエンゲゼルシヤフト A tool capable of rotary motion suitable for high-speed drive
JPH1043193A (en) * 1996-08-07 1998-02-17 Urawa Kogyo Kk Cutter for bone cutting
JP2006109917A (en) * 2004-10-12 2006-04-27 Dentech:Kk Rotating work tool

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11806024B2 (en) 2021-06-24 2023-11-07 Nakanishi Inc. Surgical bur

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