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WO2014117560A1 - Dispositif de positionnement de pédicule d'arc vertébral pour fixation de vis mini-invasive postérieure rachidienne - Google Patents

Dispositif de positionnement de pédicule d'arc vertébral pour fixation de vis mini-invasive postérieure rachidienne Download PDF

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Publication number
WO2014117560A1
WO2014117560A1 PCT/CN2013/086960 CN2013086960W WO2014117560A1 WO 2014117560 A1 WO2014117560 A1 WO 2014117560A1 CN 2013086960 W CN2013086960 W CN 2013086960W WO 2014117560 A1 WO2014117560 A1 WO 2014117560A1
Authority
WO
WIPO (PCT)
Prior art keywords
minimally invasive
positioner
metal ring
vertebral arch
pedicle
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/CN2013/086960
Other languages
English (en)
Chinese (zh)
Inventor
曹晓建
李海俊
谢浩
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Jiangsu Province Hospital
Original Assignee
Jiangsu Province Hospital
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Jiangsu Province Hospital filed Critical Jiangsu Province Hospital
Publication of WO2014117560A1 publication Critical patent/WO2014117560A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/04—Positioning of patients; Tiltable beds or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1757—Guides or aligning means for drills, mills, pins or wires specially adapted 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
    • 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 or setting implements
    • 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, e.g. stabilisers comprising fluid filler in an implant

Definitions

  • the invention relates to a pedicle locator for minimally invasive placement of the posterior spinal column, which belongs to the field of medical instruments.
  • pedicle screw technique has developed rapidly since its inception in the 1980s and has been widely used in the surgical treatment of spinal degeneration, vertebral spondylolisthesis, spinal stenosis, vertebral fracture, deformity, bone metastases and spinal instability. .
  • pedicle screws are one of the most widely used internal fixation devices in spinal surgery.
  • the pedicle screw implantation methods mainly include: 1.
  • the posterior median incision and nailing is a traditional surgical method. It is widely used in clinical practice and is widely accepted by most clinicians. The main disadvantage is that the surgical trauma is large.
  • minimally invasive spinal technique that is, minimally invasive nailing technology assisted by posterior channel, which performs spinal pedicle screw placement with special surgical instruments and instruments such as medical imaging, auxiliary channel expansion and microscopic endoscopy.
  • the best treatment effect is achieved with minimal damage.
  • the surgical incision is short, the trauma is small, the bleeding is less, the postoperative function is recovered quickly, and the incidence of postoperative low back pain is reduced.
  • Conventional posterior spinal minimally invasive nailing technique is more complicated and time-consuming in anterior pedicle positioning. It generally uses preoperative Kirschner wire to penetrate the pedicle and expand the approach after the pedicle, especially requiring repeated fluoroscopy. Patients and health care workers are additionally exposed to more rays; their dilation after perforation may deviate from the gap between the multifidus and the longissimus muscles and cause damage to the multifidus and longest muscles. At present, there is a need for a simple and effective, easy-to-master pedicle preoperative positioning technique and a less traumatic surgical approach.
  • the object of the present invention is to provide a positioning device capable of assisting accurate, rapid, and convenient projection of a pedicle surface, in view of the deficiencies of the prior art, and to provide accurate selection of small incisions for posterior nail placement. Positioning.
  • a pedicle locator for minimally invasive spinal posterior approach includes a pair of metal rings that cannot penetrate through the same perspective ray, and the metal rings are fixed by a connecting portion Connecting, the metal ring body is located at the same level In-plane, when the locator is placed laterally on the back of the patient for fluoroscopy, the projection of the bilateral pedicle is simultaneously positioned in the metal ring by fine adjustment of the locator.
  • Accurate positioning at the same time without the need for repeated fluoroscopy to position the pedicle in the center of the ring, the positioning is simple and fast, and can significantly reduce the number of X-ray exposure.
  • the metal ring body has an inner diameter of 26 mm, an outer diameter of 34 mm, and a thickness of 4 mm ; the connecting portion has a length of 4 mm, a width of 6 mm, and a thickness of 4 mm.
  • the distance between the two centers of the metal ring is based on the measurement of the distance between a large number of pedicles, and the distance between the two centers is 8 mm larger than the average distance measured by the pedicle, so that the pedicle is positioned behind the metal. Longitudinal incision of the center of the ring allows the surgical incision to be on the outside of the pedicle, providing space for the pedicle screw to require a 10° to 15° camber angle, making the surgical procedure more convenient.
  • the upper surface of the connecting portion is provided with a semicircular protrusion, and the protrusion has a through hole in a direction perpendicular to a line connecting the centers of the two metal ring bodies.
  • the semicircular projection has a diameter of 6 mm and the through hole has a diameter of 4 mm.
  • a plurality of locators are connected through a through hole through a through-hole to realize positioning of a plurality of segments.
  • the metal rod can be shaped according to the shape of the spinous process to coincide with the spinous process. Perform perspective.
  • the metal rod is a shapeable aluminum alloy rod with a diameter of 4 mm, and has three specifications according to the length: 100 mm, 200 mm and 300 mm.
  • the invention has the following beneficial effects: (1) The position of the pedicle can be accurately and easily positioned on the body surface, and the small incision can be accurately selected, and the same operation as the existing minimally invasive technique can be used. In the case of the length of the incision, the gap between the multifidus muscle and the longissimus muscle is separated by direct vision to reach the surgical site; (2) The percutaneous direct sputum is prevented from causing the surgical approach to damage the muscle within the muscle, and the vertebral arch can be easily reached. The nail placement and the lamina are surgically performed; (3) The operation is simple, convenient, quick and time-saving, and avoids excessive radiation exposure.
  • Figure 1 is a schematic view of the structure of the present invention.
  • metal ring body 1, connecting part; 3, semi-circular protrusion; 4, through hole.
  • a pedicle locator for posterior spinal minimally invasive nailing includes a pair of metal ring bodies 1 which are not penetrated by the same perspective ray, between the metal ring bodies 1
  • the metal ring body 1 is fixedly connected by the connecting portion 2, wherein the metal ring body 1 has an inner diameter of 26 mm, an outer diameter of 34 mm, and a thickness of 4 mm; the connecting portion 2 has a length of 4 mm, a width of 6 mm, and a thickness of 4 mm.
  • the upper surface of the connecting portion 2 is provided with a semicircular protrusion 3, and the protrusion 3 is provided with a through hole 4 in a direction perpendicular to a line connecting the centers of the two metal ring bodies 1, the semicircular protrusion 3
  • the diameter of the through hole 4 is 4 mm, and the projection of the bilateral pedicle is simultaneously positioned in the metal ring by fine adjustment of the positioner when the positioner is laterally placed on the back of the patient for front and rear perspective.
  • the metal rod can be shaped according to the shape of the spinous process to coincide with the spinous process.
  • the metal rod is a shapeable aluminum alloy rod having a diameter of 4 mm, and has three specifications depending on the length: 100 mm, 200 mm, and 300 mm.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Engineering & Computer Science (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Neurology (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne un dispositif de positionnement de pédicule d'arc vertébral pour fixation de vis mini-invasive postérieure rachidienne qui comprend une paire de corps annulaires du même métal (1) qui ne peuvent pas être pénétrés par des rayons radioscopiques, les corps annulaires métalliques (1) étant raccordés de façon fixe par l'intermédiaire d'une partie de raccordement (2) et les corps annulaires métalliques (1) étant situés sur un même plan. Lorsque le dispositif de positionnement est placé horizontalement sur le dos d'un patient pour radioscopie, les saillies de pédicules d'arc vertébral sur deux côtés sont simultanément positionnées dans les corps annulaires métalliques (1) par ajustement fin du dispositif de positionnement. Le dispositif de positionnement peut être utilisé pour positionner aisément et précisément les pédicules d'arc vertébral sur une surface corporelle et sélectionner précisément une petite incision chirurgicale. Par conséquent, une position d'opération chirurgicale peut être atteinte en séparant un espacement entre un muscle multifidus et un muscle longissimus sous observation directe dans une condition dans laquelle la longueur de l'incision chirurgicale reste la même que celle formée par une technique de chirurgie vertébrale mini-invasive antérieure, et une condition dans laquelle un muscle est endommagé par une approche chirurgicale parce qu'une ponction percutanée directe est évitée. Une position de fixation de vis sur les pédicules d'arc vertébral et un arc vertébral peuvent être aisément atteints pour effectuer des opérations de fixation de vis et de réduction de pression. Le dispositif de positionnement est simple et commode en utilisation, est économique, et évite une exposition excessive aux rayonnements.
PCT/CN2013/086960 2013-01-30 2013-11-12 Dispositif de positionnement de pédicule d'arc vertébral pour fixation de vis mini-invasive postérieure rachidienne Ceased WO2014117560A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN2013100355729A CN103169535A (zh) 2013-01-30 2013-01-30 一种脊柱后路微创置钉的椎弓根定位器
CN201310035572.9 2013-01-30

Publications (1)

Publication Number Publication Date
WO2014117560A1 true WO2014117560A1 (fr) 2014-08-07

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PCT/CN2013/086960 Ceased WO2014117560A1 (fr) 2013-01-30 2013-11-12 Dispositif de positionnement de pédicule d'arc vertébral pour fixation de vis mini-invasive postérieure rachidienne

Country Status (2)

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CN (1) CN103169535A (fr)
WO (1) WO2014117560A1 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103169535A (zh) * 2013-01-30 2013-06-26 南京医科大学第一附属医院 一种脊柱后路微创置钉的椎弓根定位器

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040186346A1 (en) * 1996-03-22 2004-09-23 Smith Maurice M. Devices and methods for percutaneous surgery
CN201160895Y (zh) * 2007-07-25 2008-12-10 林�建 脊柱穿刺引导器
CN101904757A (zh) * 2009-06-02 2010-12-08 张春霖 无框架脊柱导航手术机器人
CN202714861U (zh) * 2012-06-01 2013-02-06 上海中医药大学附属曙光医院 用于胸腰椎微创手术术前透视定位的金属网格
CN103169535A (zh) * 2013-01-30 2013-06-26 南京医科大学第一附属医院 一种脊柱后路微创置钉的椎弓根定位器
CN203059916U (zh) * 2013-01-30 2013-07-17 南京医科大学第一附属医院 一种脊柱后路微创置钉的椎弓根定位器
CN203138679U (zh) * 2012-12-04 2013-08-21 杨双石 一种脊椎三维体表定位器

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5088504A (en) * 1990-10-23 1992-02-18 National Upper Cervical Chiropractic Research Assn. Machine and method for measuring skeletal misalignments
CN201328877Y (zh) * 2009-01-20 2009-10-21 四川大学华西医院 胸腰椎前路螺钉导向器
US20120245587A1 (en) * 2011-03-25 2012-09-27 Jing-Jing Fang Method for spinal drilling operation and guiding assembly
CN202161402U (zh) * 2011-06-23 2012-03-14 姚剑飞 椎弓根螺钉定位架

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040186346A1 (en) * 1996-03-22 2004-09-23 Smith Maurice M. Devices and methods for percutaneous surgery
CN201160895Y (zh) * 2007-07-25 2008-12-10 林�建 脊柱穿刺引导器
CN101904757A (zh) * 2009-06-02 2010-12-08 张春霖 无框架脊柱导航手术机器人
CN202714861U (zh) * 2012-06-01 2013-02-06 上海中医药大学附属曙光医院 用于胸腰椎微创手术术前透视定位的金属网格
CN203138679U (zh) * 2012-12-04 2013-08-21 杨双石 一种脊椎三维体表定位器
CN103169535A (zh) * 2013-01-30 2013-06-26 南京医科大学第一附属医院 一种脊柱后路微创置钉的椎弓根定位器
CN203059916U (zh) * 2013-01-30 2013-07-17 南京医科大学第一附属医院 一种脊柱后路微创置钉的椎弓根定位器

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