CN103976779B - Foramen intervertebrale lens lancing system - Google Patents

Abstract

The invention relates to a medical device, and discloses an intervertebral foramen mirror puncture system. In the present invention, it includes a primary casing, a secondary casing, an open-circuit cone, an anchor needle and a trephine; the cone head of the open-circuit cone has a protective shoulder, and the head end of the anchor needle has a self-tapping thread and the head end of the anchor needle is Blunt, the blunt design of the anchor needle makes it less likely to cause injury when approaching the nerve after penetrating the articular process, and its self-tapping thread design makes the adjustment of the bone tract much easier; the trephine is used to enter the spinal canal along the anchor needle Cutting the articular process laterally at an angle widens the bone canal to the diameter required for placement of the endoscope. In the present invention, the endoscopic intervertebral foramina puncture system significantly simplifies the puncture process of lumbar intervertebral foramina endoscopic surgery, is reliable and easy to operate, improves the safety and success rate of the operation, and greatly reduces the radiation exposure of the operator and the patient.

Description

transforaminal puncture system

technical field

The present invention relates to a medical device, in particular to a transvertebral foramen mirror puncture system.

Background technique

As we all know, intervertebral disc herniation is a common disease that brings great pain to patients. Treat this disease. Traditional operations include laminectomy, fenestration, and posterior laminectomy, decompression, spinal canal decompression, and pedicle screw fixation. The surgical trauma is large, the bleeding is high, and the postoperative recovery time is long, especially after spinal internal fixation. Adjacent lumbar vertebrae are prone to complications such as accelerated degeneration, which brings new discomfort to patients. Among them, internal fixation is to fix the lumbar spine with instruments such as screws.

Chinese Patent No. 201020186910.0 discloses a "Minimally Invasive Cervical Intervertebral Disc Surgery System", which improves the tools for cervical percutaneous puncture and interventional treatment. Drilling, 2-stage dilation into the intervertebral disc, has the advantage of being minimally invasive, with low complications and quick recovery.

And this kind of interventional treatment is carried out under the guidance of X-ray images. After using tools to puncture into the cervical intervertebral disc, use the working cannula as a channel, and then put radio frequency and other operating tools through this channel, without using an endoscope, that is, The operation of the intervertebral disc is performed under blind vision, and doctors often need to puncture the lesion safely and accurately during the medical treatment process. Repeated fluoroscopy positioning increases the amount of X-ray damage to the patient and the doctor, and inaccurate positioning will affect the treatment effect; meanwhile, the structural design of the parts is not suitable for intervertebral disc surgery.

At present, endoscopic transforaminal surgery is the minimally invasive treatment of lumbar disc herniation with the least trauma to patients and the best effect among similar operations, and is known as "green ecological surgery". The intervertebral foramina technique uses the physiological structure of the intervertebral foramen to percutaneously puncture the lumbar spine, and after the important bony component of the intervertebral foramen—the superior articular process is worn away and shaped, the working tube is placed into the spinal canal, and the endoscope and Surgical instruments directly enter the spinal canal through the working pipeline to treat diseased tissues. The protruding nucleus pulposus, nerve root, dural sac and proliferating bone tissue can be clearly seen under the direct vision of the endoscope. Then use various grasping forceps to remove the protruding tissue, remove the hyperplastic bone and calcified tissue under the microscope, and repair the damaged intervertebral disc annulus fibrosus with radiofrequency electrodes.

In particular, TESSYS minimally invasive transforaminal endoscopic technique is increasingly favored by physicians due to its characteristics of less trauma, quick recovery and good curative effect. TESSYS technology includes 3 levels of puncture, each level of equipment includes a guide rod, a cannula, and a trephine. First insert the guide rod, then put the same level of cannula on the guide rod, and then put the same level of trephine behind the cannula Cut and grind the articular process; then replace the puncture tool with a larger level along the cut hole, and repeat in turn until the third level trephine cuts and grinds the articular process, and an endoscopic sleeve with a corresponding diameter is inserted along the bone canal. Complete the piercing operation. Using multi-stage bone sawing operation, step by step expansion of bone sawing can reduce the possibility of nerve damage.

However, the puncture steps of this technique are relatively cumbersome, each operation needs to be confirmed by fluoroscopy, and the corresponding radiation exposure is relatively large. More importantly, the TESSYS technology uses guide rods, catheter compression and articular process, trepanation along the catheter insertion, close to the articular process to grind and cut the articular process bone, thereby forming a bone tunnel. Due to repeated operations in different stages, the grinding and cutting bone tunnel and its trajectory are likely to deviate during the process, which makes the position of the final endoscopic cannula deviate and affects the operation.

Contents of the invention

The purpose of the present invention is to provide a transforaminal endoscopic puncture system, which simplifies the puncture process of the lumbar intervertebral foramina endoscopic surgery, is reliable and easy to operate, improves the safety and success rate of the operation, and reduces the radiation exposure of the operator and the patient .

In order to solve the above technical problems, the embodiment of the present invention discloses a transforaminal endoscopic puncture system, which includes a primary sleeve, a secondary sleeve, an opening cone, an anchor needle, and a trephine;

Both the primary and secondary cannula are hollow, and the primary cannula is used to insert along the guide wire until the articular process to form a soft tissue channel;

The inner diameter of the second-level sleeve is the same as the outer diameter of the first-level sleeve, and is used to insert along the first-level sleeve to expand the soft tissue channel;

The diameter of the open-circuit cone is the same as the inner diameter of the secondary casing, and it is used to insert a bone hole on the articular process from the secondary casing along the soft tissue channel to the articular process. The cone head of the open-circuit cone has a protective shoulder to avoid bone the hole is too deep;

The diameter of the anchor pin is the same as that of the opening cone. The head end of the anchor pin has a self-tapping thread and the head end of the anchor pin is blunt. It is used to pull out the opening cone and insert it into the bone hole of the articular process along the secondary sleeve And penetrate the articular process along the angle of entering the spinal canal to reach the spinal canal to form a bone tunnel;

The inner diameter of the trephine is the same as the outer diameter of the secondary cannula, which is used to fit on the secondary cannula to reach the articular process, and cut the articular process from the side along the angle at which the anchor needle enters the spinal canal, and will enter the spinal canal at one time. The bone canal is enlarged to the diameter required to place the endoscope, the trephine tip has safety teeth and the tip of the trephine is blunt to push the nerve away to avoid injury.

Compared with the prior art, the embodiment of the present invention has the main difference and its effects in that:

The intervertebral foramina endoscopic puncture system of the present invention significantly simplifies the puncture process of the lumbar intervertebral foramina endoscopic surgery, is reliable and easy to operate, improves the safety and success rate of the operation, and greatly reduces the radiation exposure of the operator and the patient. The cone head of the open-circuit cone has a protective shoulder, which can prevent the bone hole from being too deep on the articular process, which is safe and reliable; the head of the anchor needle is designed with self-tapping threads, and does not need to be tapped when entering the articular process, so as to avoid directly penetrating the joint Injured nerves or broken joints, and fluoroscopy reveals that the trajectory of the anchor needle entering the spinal canal is not good, you can twist it out in the opposite direction at any time and adjust the angle, which makes the adjustment of the bone canal much easier. The blunt design of the anchor needle makes it penetrate When approaching the nerve behind the articular process, it is not easy to cause damage; only one-level trepanation is used to directly expand the bone channel to the diameter where the endoscope needs to be placed, which simplifies the process of cutting and grinding the articular process, reduces X-ray exposure, and avoids multiple sawing processes. The deviation of the bone channel is generated uniformly, the reliability and accuracy of cutting and grinding are improved, and the success rate of endoscopic cannula placement is improved.

The intervertebral foramenoscopic puncture system of the present invention significantly simplifies the puncture process of lumbar intervertebral foramenoscopic surgery, is reliable and easy to operate, and greatly reduces the radiation exposure of operators and patients.

Furthermore, the outer wall of the needle tube of the puncture needle is provided with a scale, and the insertion depth of the puncture needle can be displayed through the scale on the needle tube, which is convenient for observing the puncture depth, and can avoid damage caused by the displacement of the needle tip during use.

Furthermore, the head of the first-stage cannula is conical, which is beneficial for cutting soft tissue and forming an initial soft tissue channel.

Further, by adjusting the position of the open-circuit cone on the articular process, the extension line of the open-circuit cone in the direction of the spinal canal can be adjusted in anteroposterior and lateral perspectives, and the trajectory of the bone canal formed by subsequent operations can be correctly established to ensure that the endoscopic cannula enters the vertebral canal. Tube.

Furthermore, the head of the opening cone is designed in a triangular pyramid shape, which is beneficial to the formation of bone holes.

Furthermore, the teeth of the trepan saw are wavy and relatively shallow, which can easily push the nerve away and avoid damage.

Description of drawings

Fig. 1 is a structural schematic diagram of a first-level sleeve of a transforaminal endoscopic puncture system in the first embodiment of the present invention;

Fig. 2 is a schematic structural view of a secondary sleeve of a transforaminal endoscopic puncture system in the first embodiment of the present invention;

3 is a schematic structural view of an open-circuit cone of an intervertebral foramen mirror puncture system in the first embodiment of the present invention;

Fig. 4 is a structural schematic diagram of an anchor needle of a transforaminal endoscopic puncture system in the first embodiment of the present invention;

Fig. 5 is a structural schematic diagram of a trephine of a transforaminal endoscopic puncture system according to the first embodiment of the present invention.

detailed description

In the following description, many technical details are proposed in order to enable readers to better understand the application. However, those skilled in the art can understand that without these technical details and various changes and modifications based on the following implementation modes, the technical solution claimed in each claim of the present application can be realized.

In order to make the purpose, technical solution and advantages of the present invention clearer, the following will further describe the implementation of the present invention in detail in conjunction with the accompanying drawings.

Endoscopic transforaminal surgery mainly includes two steps: percutaneous puncture, endoscopic working cannula placement into the spinal canal, and endoscopic operation.

The first embodiment of the present invention relates to a transvertebral foramen endoscopic puncture system, which includes a primary casing, a secondary casing, an opening cone, an anchor needle and a trephine. Fig. 1 to Fig. 5 are respectively the structural schematic diagrams of the first-level sleeve, the second-level sleeve, the open-circuit cone, the anchor needle and the trephine in the intervertebral foramen endoscopic puncture system. The above 5 instruments are the necessary instruments for the simplified puncture of transforaminal endoscope. The puncture needle and endoscopic cannula required by this puncture system are the same as those of other techniques, so they are not described.

Specifically, FIG. 1 shows a schematic structural diagram of a primary bushing, and FIG. 2 shows a schematic structural diagram of a secondary bushing.

Both the first-level cannula and the second-level cannula are hollow, and the first-level cannula is used to insert along the guide wire until the articular process to form a soft tissue channel. Wherein, it can be understood that the guide wire is introduced to the bone surface of the articular process along the puncture needle after the puncture needle percutaneously punctures the articular process.

The inner diameter of the second-level sleeve is the same as the outer diameter of the first-level sleeve, and is used for inserting along the first-level sleeve to expand the soft tissue channel.

Preferably, the outer diameter of the primary cannula is 3 mm, the outer diameter of the second cannula is 6.3 mm, and the heads of the first and second cannula are conical, which is conducive to cutting soft tissue and forming an initial soft tissue channel.

The two-stage cannula expands the soft tissue to form the soft tissue channel required by the subsequent working pipeline and simplifies the soft expansion steps. In addition, it can be understood that in other embodiments of the present invention, the outer diameters of the primary casing and the secondary casing can also adopt other sizes, and the heads of the primary casing and the secondary casing can also adopt other effective dimensions. It is beneficial to cut the shape of soft tissue, but not limited thereto.

Figure 3 is a schematic diagram of the structure of the open-circuit cone. The diameter of the open-circuit cone is the same as the inner diameter of the secondary casing, and it is used to insert a bone hole on the articular process from the secondary casing along the soft tissue channel to open the circuit. The cone head of the cone has a protective shoulder, and as shown in Figure 3, the diameter of the cone head of the open circuit cone is smaller than the diameter of the rest of the open circuit cone, thereby forming a protective shoulder. The protective shoulder can avoid too deep bone holes made on the articular process, and is not easy to slip and is safe and reliable.

Preferably, when the open-circuit cone makes a bone hole on the articular process, the ideal position of the open-circuit cone on the articular process is that the extension line of the open-circuit cone is located on the posterior wall of the vertebral body on the lateral X-ray perspective, and is located on the pedicle of the anterior position The connection line of the inner edge. By adjusting the position of the open-circuit cone on the articular process, the extension line of the open-circuit cone in the direction of entering the spinal canal can be adjusted during anteroposterior and lateral fluoroscopy, and the trajectory of the bone tunnel formed by subsequent operations can be correctly established to ensure that the endoscopic cannula enters the spinal canal.

Preferably, the head of the opening cone is in the shape of a triangular pyramid, as shown in the section A in FIG. 3 , and the angle between the three edges of the head of the opening cone is 120 degrees. The head of the open-circuit cone is designed in a triangular pyramid shape, which is beneficial to the formation of bone holes.

Fig. 4 is a schematic structural diagram of the anchor pin. The diameter of the anchor pin is the same as that of the open-circuit cone. The head end of the anchor pin has a self-tapping thread and the head end of the anchor pin is blunt. The self-tapping thread is shown in the A-direction section in Fig. 4 Show. The anchor needle is used to pull out the opening cone and insert it into the bone hole of the articular process along the secondary cannula, and penetrate the articular process along the angle of entering the spinal canal to reach the spinal canal to form a bone tunnel.

The head of the anchor needle is designed with self-tapping thread, no need to tap when entering the articular process, avoiding direct penetration of the articular process to damage the nerve or break the joint, and when the fluoroscopy finds that the anchor needle enters the spinal canal poorly, it can be unscrewed in the opposite direction at any time After adjusting the angle, the adjustment of the bone canal is much easier. The blunt design of the anchor needle makes it less likely to cause damage when it penetrates the articular process and approaches the nerve.

Figure 5 is a structural schematic diagram of a trephine. The inner diameter of the trephine is the same as the outer diameter of the secondary sleeve, which is used to cover the secondary sleeve to reach the articular process, and cut the joint from the side along the angle at which the anchor needle enters the spinal canal One-time expansion of the bone channel into the spinal canal to the diameter required to place the endoscope. The head end of the trepanation saw has safety serrations and the head end of the trepanation saw is blunt, which is used to push the nerve away to avoid injury.

It is understandable that only one-level trepanation is used to directly expand the bone channel to the diameter of the endoscope at one time, which simplifies the process of articular process cutting and grinding, reduces X-ray exposure, and avoids bone channels that cannot be highly uniform due to multiple sawing processes The deviation can improve the reliability and accuracy of cutting and grinding, and at the same time improve the success rate of endoscopic cannula placement.

In addition, it can be understood that the outer diameter of the trepanation saw reaches 7.5 mm due to one bone sawing, which is equivalent to the diameter of the last trepanation saw of other techniques, so when it is close to the spinal canal and the nerve root, the teeth of the trepanation saw are likely to damage the nerve , so the new ring saw adopts the design of safe saw teeth. Preferably, the saw teeth of the ring saw are wavy and relatively shallow, as shown in the I-direction section in Figure 5, the saw tooth depth is only 0.5mm, and the saw tooth width is 2mm. It is found in clinical use that , the new trephine pushes away soft tissues such as nerves when they are close to them, rather than damaging them.

The transforaminal endoscopic surgery mentioned above mainly includes the steps of percutaneous puncture, endoscopic cannula placement into the spinal canal, and endoscopic operation. The intervertebral foramen mirror puncture system of the present invention is to first puncture and expand the skin of the lumbar spine with tools, and after reaching the upper articular process of the lumbar spine, open a hole on the bone surface with an open-circuit vertebra, and then drill a hole in the bone with an anchor needle. Go directly to the ventral side of the articular process, that is, enter the spinal canal, and then use a trephine to expand the drill hole so that the hole can accommodate the endoscope, and then start the operation under the surgical microscope.

The intervertebral foramina endoscopic puncture system of the present invention significantly simplifies the puncture process of the lumbar intervertebral foramina endoscopic surgery, is reliable and easy to operate, improves the safety and success rate of the operation, and greatly reduces the radiation exposure of the operator and the patient.

Preferably, the transforaminal endoscopic puncture system further includes a puncture needle, and the puncture needle includes a needle tube, a needle handle and a needle core. The front end of the needle tube is a tip, the outer wall of the needle tube is provided with scales, the rear end of the needle tube is connected with a needle handle, and the needle core is passed through the needle tube through the needle handle. After the puncture needle percutaneously punctures the articular process, the needle core is pulled out and the guide wire is introduced. In addition, it can be understood that the guide wire enters the bone surface of the articular process along the needle tube of the puncture needle.

There is a scale on the outer wall of the needle tube of the puncture needle, and the insertion depth of the puncture needle can be displayed through the scale on the needle tube, which is convenient for observing the puncture depth and can avoid damage caused by needle tip displacement during use.

In addition, it can be understood that in order to ensure that the puncture needle reaches the correct position, it is necessary to confirm the position through fluoroscopy.

Preferably, the intervertebral foramen endoscopic puncture system further includes an endoscopic sleeve, which is inserted along the secondary sleeve after the trephine is pulled out, for inserting the endoscope.

Specifically, when using the transforaminal mirror puncture system of the present embodiment to perform transforaminal surgery, the specific steps are as follows:

1. The puncture needle is percutaneously punctured on the upper articular process of the lumbar spine, and the position is confirmed by fluoroscopy.

2. Enter the guide wire along the puncture needle until the bone surface of the articular process. An 8mm incision was made on the skin with a sharp knife.

3. The first-level cannula (that is, the first-level cannula) is placed along the guide wire until the articular process. Grade I cannula has a diameter of 3 mm and a conical head, which is beneficial for cutting soft tissue and forming the initial soft tissue channel.

4. The outer diameter of the second-level cannula (that is, the second-level cannula) is 6.3 mm, and the inner diameter is the same as that of the first-level cannula. The former is inserted along the latter to further expand the soft tissue passage.

5. Pull out the grade I casing and leave the grade II casing. Insert the opening cone into the grade II cannula to reach the surface of the facet bone. Here, the position of the opening cone on the articular process is confirmed fluoroscopically. The head of the open-circuit cone is 6 mm long, and its head enters the articular process after light tapping. At this time, the positive and lateral fluoroscopy is performed again, and the trajectory of the open-circuit cone entering the intervertebral foramen is imaginary along the head of the open-circuit cone on the fluoroscopy image. If it is not satisfactory, establish the angle to be adjusted.

The function of the opening cone is mainly to open a bone hole on the articular process, so that the subsequent anchor needle can enter. At the same time, the position of the opening cone on the articular process can form an imaginary extension line on the anteroposterior perspective. The ideal position should be: the lateral position is located on the posterior wall of the vertebral body, and at this time, it is just located on the medial edge of the pedicle in the anterior view. connection. The extension line is the track of the bone tunnel formed by the subsequent operation, that is, the track of the inner-diameter cannula entering the spinal canal at last. Whether the trajectory is correctly established or not determines the success or failure of catheterization.

6. Pull out the opening cone, and insert the anchor pin with the same outer diameter into the bone hole of the articular process along the second-level cannula. At this time, according to the trajectory of entering the spinal canal set in the previous step, screw in the anchor pin. The head of the anchor needle is designed as a self-tapping thread, the length is 10mm (the thickness of the articular process is generally about 10mm), and the head end is not sharp. The above two design can maximize the safety of the anchor needle penetrating the articular process and reaching the spinal canal. At the same time, due to the design of the self-tapping thread on the head of the anchor needle, there is no need to tap when entering the articular process, and the patient does not feel pain when being tapped. After pulling it out forcefully, select a point and re-knock it in, but only need to unscrew it in the opposite direction, adjust the angle and continue to screw it in.

The above-mentioned design of the anchor needle makes the operation of establishing the feeding track easier and more controllable.

7. Insert the new trepanation saw into the second-grade casing, the inner diameter of the new-type trepanation is the same as the outer diameter of the second-grade casing, and reach the facet bone surface. At this time, the anchor pin has been fixed in the articular process with the correct trajectory of the tube insertion, and the angle of the anchor pin determines the angle at which the trephine cuts the articular process, as well as the trajectory of the tube insertion.

The outer diameter of the novel ring saw is again the same as the endoscope of the inner diameter sleeve. In this step, the requirements for trepanation are: one trepanation operation forms the bone tunnel for the tube, rather than multiple cycles of other techniques to expand step by step; due to one-time bone sawing, the outer diameter of the trepanation reaches 7.5mm, It is equivalent to the diameter of the last trepanation saw in other technologies, so when it is close to the spinal canal and the nerve root, the teeth of the trepanation are very likely to damage the nerve. The new trepanation adopts a safe sawtooth design, and the depth of the sawtooth is only 0.5mm, and its The sawtooth width is 2mm. It has been found in clinical use that the new trephine can push away soft tissues such as nerves, rather than damage them.

8. Pull out the trephine after the trepanation is finished, keep the grade II cannula in place, insert the endoscopic cannula along the cannula, and end the puncture operation.

Endoscopic transforaminal surgery mainly includes two steps: percutaneous puncture, endoscopic cannula placement into the spinal canal, and endoscopic operation. The advantages of the present invention are reflected in:

1. Simplify the percutaneous puncture process, reduce operating steps, and reduce radiation exposure.

2. Simplify the cutting and grinding process of the articular process, improve the reliability and accuracy of cutting and grinding, and improve the success rate of endoscopic cannula placement.

It should be noted that in the claims and description of this patent, relative terms such as first and second are only used to distinguish one entity or operation from another entity or operation, and do not necessarily require or Any such actual relationship or order between such entities or operations is implied. Furthermore, the term "comprises", "comprises" or any other variation thereof is intended to cover a non-exclusive inclusion such that a process, method, article, or apparatus comprising a set of elements includes not only those elements, but also includes elements not expressly listed. other elements of or also include elements inherent in such a process, method, article, or device. Without further limitations, an element defined by the statement "comprising a" does not exclude the presence of additional identical elements in the process, method, article or apparatus comprising said element.

Although the present invention has been illustrated and described with reference to certain preferred embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the present invention. The spirit and scope of the invention.

Claims (7)

1. An intervertebral foramen mirror puncture system is characterized in that it comprises a first-level sleeve pipe, a second-level sleeve pipe, an opening cone, an anchor needle and a trephine; Both the first-level sleeve and the second-level sleeve are hollow, and the first-level sleeve is used to be inserted along the guide wire until the articular process to form a soft tissue channel; The inner diameter of the second-level sleeve is the same as the outer diameter of the first-level sleeve, and is used to insert along the first-level sleeve to expand the soft tissue channel; The diameter of the opening cone is the same as the inner diameter of the secondary casing, and is used to insert a bone hole on the articular process after being inserted from the secondary casing along the soft tissue channel to the articular process. The cone head of the opening cone has a protective shoulder to prevent the bone hole from being too deep; The diameter of the anchor pin is the same as that of the opening cone, the head end of the anchor pin has a self-tapping thread and the head end of the anchor pin is blunt, and is used to insert the articular process along the secondary sleeve after pulling out the opening cone. Penetrate the articular process along the angle of entering the spinal canal to reach the spinal canal to form the bone tunnel; The inner diameter of the trepan saw is the same as the outer diameter of the secondary casing, and is used to be placed on the secondary casing to reach the articular process, and cut the articular process from the side along the angle at which the anchor needle enters the spinal canal, once The bone tunnel into the spinal canal is permanently enlarged to the diameter required to place the endoscope. The head end of the trephine has safety serrations and the head end of the trephine is blunt for pushing away the nerves to avoid damage. 2. The intervertebral foramen mirror puncture system according to claim 1, further comprising a puncture needle, the puncture needle comprising a needle tube, a needle handle and a needle core; the front end of the needle tube is a tip, and the outer wall of the needle tube is provided with a scale , the rear end of the needle tube is connected with a needle handle, and the needle core is pierced in the needle tube through the needle handle; after the puncture needle percutaneously punctures the articular process, the needle core is pulled out and introduced into the guide wire. 3. The intervertebral foramen endoscopic puncture system according to claim 1, further comprising an endoscopic sleeve, which is inserted along the secondary sleeve after the trephine is pulled out, For placing endoscopes. 4. The transforaminal endoscopic puncture system according to claim 1, wherein the outer diameter of the first-level sleeve is 3 mm, the outer diameter of the second-level sleeve is 6.3 mm, and the outer diameter of the first-level sleeve is 6.3 mm. The heads of the tube and the secondary casing are conical. 5. The intervertebral foramina endoscopic puncture system according to claim 1, characterized in that, when the opening cone opens a bone hole on the articular process, the position of the opening cone on the articular process is located in the lateral position of the vertebral body Posterior wall, anteriorly located at the line connecting the medial borders of the pedicles. 6. The transforaminal endoscopic puncture system according to claim 1, characterized in that, the head of the opening cone is in the shape of a triangular pyramid. 7. The intervertebral foramen mirror puncture system according to claim 1, characterized in that, the teeth of the trephine are wave-shaped, the depth of the teeth is 0.5 mm, and the width of the teeth is 2 mm.