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CN108577955B - Lumbar vertebra side front approach self-locking type interbody fusion fixing device - Google Patents

Lumbar vertebra side front approach self-locking type interbody fusion fixing device Download PDF

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Publication number
CN108577955B
CN108577955B CN201810284057.7A CN201810284057A CN108577955B CN 108577955 B CN108577955 B CN 108577955B CN 201810284057 A CN201810284057 A CN 201810284057A CN 108577955 B CN108577955 B CN 108577955B
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China
Prior art keywords
interbody fusion
locking
self
lumbar
angle bead
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CN201810284057.7A
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CN108577955A (en
Inventor
邝磊
陈小敏
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Second Xiangya Hospital of Central South University
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Individual
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
    • A61B17/7074Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
    • A61B2017/7073Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant with intervertebral connecting element crossing an imaginary spinal median surface
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30721Accessories
    • A61F2/30749Fixation appliances for connecting prostheses to the body

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

Abstract

The invention discloses a lumbar side front approach self-locking type interbody fusion fixing device which comprises a fixing piece and an operation channel matched with the fixing piece, wherein the fixing piece comprises an interbody fusion device and a self-locking nail, a plurality of positioning holes are formed in the interbody fusion device, the interbody fusion device is connected with the self-locking nail through the positioning holes, the operation channel comprises a plurality of fasteners, corner protectors, protective edges, illumination devices and image pick-up devices, the fasteners are connected with the corner protectors, the protective edges are arranged between the adjacent corner protectors, channel main bodies are arranged between the adjacent protective edges and the protective edges in a surrounding mode, the illumination devices are connected with the corner protectors, and the image pick-up devices are connected with the protective edges. The invention has the beneficial effects that: 1. the operation field is increased and the operation time is shortened; 2. is convenient to install, operate and use; 3. the use is safe and reliable and the pressure is directly reduced; 4. the operation wound is small and the complication incidence is reduced.

Description

Lumbar vertebra side front approach self-locking type interbody fusion fixing device
Technical Field
The invention relates to the technical field of medical appliances, in particular to a self-locking intervertebral fusion fixing device for a lumbar side front approach.
Background
Currently, posterior approaches such as posterior interbody fusion (PLIF) and foraminal access fusion (TLIF) have been widely used in lumbar surgery. Lumbar fusion requires assistance with internal fixation to achieve its stability, however, these internal fixation methods also damage the posterior group muscles and joints of the spine, thereby increasing surgical trauma, leading to increased degeneration and long-term back pain. In addition, the operation space at the rear is limited, in order to avoid nerve traction injury, the area of the fusion cage is small, so that the intervertebral height is not recovered well, the contact area is small, the intervertebral bodies are not fused easily, and the operation effect is affected.
Anterior Lumbar Interbody Fusion (ALIF) is another method of treating adjacent segment degeneration, recurrent disc herniation, and prosthetic joints, allowing for greater range of decompression and better treatment of the endplates, allowing for convenient placement of large-area fusion cage, and facilitating increased fusion opportunities. In addition, the anterior operation is also beneficial to restoring the height of the intervertebral space. In addition, ALIF avoids post-spinal muscle injury, but because large blood vessels and abdominal organs are often blocked right in front of the surgical space, the surgical site is often required to be operated for a long time, which tends to cause large blood vessel injury, urethral injury, intestinal perforation, incision hernia, intestinal obstruction and retrograde ejaculation, wherein severe large blood vessel injury may lead to death.
For this reason, lateral access to the very lateral interbody fusion (XLIF) has been developed, which greatly reduces the disturbance to the aorta and vena cava, with a lower probability of occurrence of great vessel injury, however, this approach requires to pass through the psoas major, which would damage the lumbar plexus and walk in it, with a higher probability of post-operative leg numbness, pain and weakness. In 1997, mel described for the first time that fusion was performed through the gap between the large blood vessel and the psoas muscle into the disc without passing through the technique of minimally invasive lumbar surgery of the psoas muscle, with less invasion of the psoas muscle and psoas nerve than XLIF. Named oblique approach interbody fusion (OLIF). However, neither XLIF nor OLIF can remove the protruding disc under direct vision, like ALIF, and only indirect decompression can be achieved by distracting the intervertebral space. Therefore, the application range is narrow. And is affected by the ribs and pelvis, often only in the L3/4, L4/5 segments. Because most of the prior XLIF/OLIF lacks a self-locking fusion device, the post-operation needs to be supplemented with the internal fixation of the posterior pedicle screw for sufficient stability, which increases the operation wound and the cost.
For the problems in the related art, no effective solution has been proposed at present.
Disclosure of Invention
Aiming at the technical problems in the related art, the invention provides the self-locking intervertebral fusion fixing device for the lumbar side front approach, which can increase the operation field of view and shorten the operation time, is convenient to install, operate and use, is safe and reliable to use, can directly decompress, and has small operation wound and reduced complication incidence rate.
In order to achieve the technical purpose, the technical scheme of the invention is realized as follows:
the utility model provides a lumbar vertebra side place ahead way self-locking type interbody fusion fixing device, includes interbody fusion fixer and fuses fixer matched with operation passageway with interbody, interbody fusion fixer includes interbody fusion ware and auto-lock nail, be equipped with a plurality of locating holes on the interbody fusion ware, interbody fusion ware is connected with auto-lock nail through the locating hole, operation passageway includes a plurality of fasteners, angle bead, safe edge, lighting device and camera device, be connected with the angle bead on the fastener, install the safe edge between the adjacent angle bead, enclose jointly between a plurality of adjacent safe edges and the angle bead and establish into the passageway main part, lighting device is connected with the angle bead, camera device is connected with the safe edge.
Further, a boss is arranged on the positioning hole.
Further, an included angle is formed between the central axis of the interbody fusion cage and the central axis of the vertebral body.
Further, the opposite guard edges are respectively provided with a pipeline for cleaning.
Further, the lighting system comprises a lighting device, the lighting device is connected with the lamp cap through a plurality of first wires, the camera shooting system comprises a camera shooting device, and the camera shooting device is connected with the camera through a second wire.
Further, the front end of the guard edge is arc-shaped.
Further, the cross section of the channel body is square.
The invention has the beneficial effects that:
1. the operation field is increased and the operation time is shortened;
2. is convenient to install, operate and use;
3. the use is safe and reliable and the pressure is directly reduced;
4. the operation wound is small and the complication incidence is reduced.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings that are needed in the embodiments will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
Figure 1 is a schematic view of a lumbar lateral anterior approach self-locking interbody fusion fixation device in accordance with an embodiment of the present invention;
FIG. 2 is one of the schematic structural views of an interbody cage according to an embodiment of the present invention;
FIG. 3 is a top view of an interbody cage according to an embodiment of the present invention;
FIG. 4 is a cross-sectional view of FIG. 3;
FIG. 5 is a second schematic view of an intervertebral cage according to an embodiment of the present invention;
FIG. 6 is a schematic view of a surgical channel according to an embodiment of the present invention;
fig. 7 is a cross-sectional view of a channel body according to an embodiment of the present invention.
In the figure: 1. an intervertebral fusion fixator; 11. an intervertebral fusion device; 111. positioning holes; 1111. a boss; 12. self-locking nails; 13. an included angle; 2. a surgical tunnel; 21. corner protection; 22. edge protection; 223. a front end; 23. a fastener; 24. a lighting device; 241. a lamp base; 242. a first wire; 25. an image pickup device; 251. a camera; 252. a second wire; 26. a channel body.
Detailed Description
The following description of the embodiments of the present invention will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present invention, but not all embodiments. All other embodiments, which are derived by a person skilled in the art based on the embodiments of the invention, fall within the scope of protection of the invention.
As shown in fig. 1-7, the self-locking type intervertebral fusion fixing device for the lumbar side front approach according to the embodiment of the invention comprises an intervertebral fusion fixing device 1 and an operation channel 2 matched with the intervertebral fusion fixing device 1, wherein the intervertebral fusion fixing device 1 comprises an intervertebral fusion device 11 and a self-locking nail 12, a plurality of positioning holes 111 matched with the self-locking nail 12 are formed in the intervertebral fusion device 11, the intervertebral fusion device 11 is connected with the self-locking nail 12 through the positioning holes 111, the self-locking nail 12 is fixed on an upper vertebral body and a lower vertebral body through the positioning holes 111, the operation channel 2 comprises a plurality of fasteners 23, corner protectors 21, corner protectors 22, an illumination device and a camera device, the fasteners 23 are fixing nails, the corner protectors 21 are connected with the fasteners 23, the corner protectors 22 are arranged between the adjacent corner protectors 21, a channel main body 26 is jointly arranged between a plurality of adjacent corner protectors 22 and the corner protectors 21, the illumination device is connected with the corner protectors 22, and the camera device is connected with the corner protectors 22, and the operation channel 2 of the intervertebral fusion fixing device 1 is required to be operated in the operation channel 2; the lower 2 fasteners 23 are fixed on the vertebral body, after the intervertebral disc is partially removed, the intervertebral space can be expanded by means of conventional instruments (an expanding device, expanding forceps, a drag hook and the like), the upper 2 fasteners 23 are fixed, and then the protective angle 21 and the protective edge 22 are assembled for fixation.
In one embodiment of the present invention, the positioning hole 111 is provided with a boss 1111, and the boss 1111 prevents the self-locking nail 12 from being separated from the interbody fusion cage 11.
In one embodiment of the invention, an included angle 13 is formed between the central axis of the interbody fusion cage 11 and the central axis of the vertebral body, and the included angle 13 is 20-50 degrees, so that the injury of posterior muscles is avoided, the large blood vessel is prevented from being pulled greatly, and the invasion of lumbar muscles and lumbar plexus nerves is reduced.
In one embodiment of the present invention, the opposite guard edges 22 are each provided with a conduit 221 for cleaning.
In one embodiment of the present invention, the lighting device 24 is connected to the lamp cap 241 by a plurality of first wires 242, the first wires 242 being settable, the lamp cap 241 extending from the corner protector 21 into the illuminated channel body 26 without fixation; the camera device 25 is connected with the camera 251 through a second lead 252, the second lead 252 can be shaped without fixing, and the camera 251 can be inserted into the channel main body 26 for shooting through the camera hole 222 by arranging the camera hole 222 on part of the protection edge.
In one embodiment of the invention, the leading end 223 of the guard is arcuate to match the curvature of the leading edge of the vertebral body, allowing the channel body 26 to conform more closely to the curvature of the leading edge of the vertebral body, preventing other structures from entering under the surgical channel and within the space of the vertebral body to block vision and manipulation.
In one embodiment of the present invention, the cross-section of the channel body 26 is square, which matches the shape and operative range of the interbody cage 11, thereby not only increasing the operative field and shortening the operative time, but also facilitating installation and minimizing surgical trauma.
In order to facilitate understanding of the above technical solutions of the present invention, the following describes the above technical solutions of the present invention in detail by a specific usage manner.
When the lumbar lateral anterior approach self-locking type interbody fusion fixing device is specifically used, firstly, a lateral muscle is separated layer by layer in a cut at the outer edge of rectus abdominis muscle in a blunt way, a great peritoneal blood vessel is pushed inwards, the outer side of the great lumbar muscle and the sympathetic nerve are blocked on the outer side, then an operation channel 2 is installed, firstly, the lower 2 fasteners 23 are fixed on a vertebral body, after a part of intervertebral discs are removed, the intervertebral space is expanded by means of conventional instruments (a spreader, a spreader clamp, a drag hook and the like), then the upper 2 fasteners 23 are fixed, and then a corner protector 21 and a protective edge 22 are fixed; the lamp cap 241 is inserted into the illuminating channel main body 26 from four corners of the channel main body 26, the camera 251 is inserted into the channel main body 26 through the camera hole 222, under the assistance of the lighting device and the camera device, the conventional instrument (test mould or spreader, etc.) is used for directly decompressing, the interbody fusion cage 11 is arranged at the center position between the centrum along the direction forming an included angle of 20-50 degrees with the central axis of the centrum, the self-locking nail 12 is fixed on the upper and lower centrum through the positioning hole 111 on the interbody fusion cage 11, the fatigue and the accidental injury caused by pulling the blood vessel by the long-term human hand are avoided by utilizing the operation channel 2, the thorough decompression is realized under the assistance of the lighting device and the camera device, the curative effect is ensured, and the invasion to the lumbar muscle and the lumbar plexus nerve is greatly reduced; the two lateral surfaces of the interbody fusion cage 11 are uniformly distributed in the final position, so that the spine is prevented from bending to one side after fusion.
In summary, by means of the technical scheme of the invention, the surgical field is increased and the surgical time is shortened; is convenient to install, operate and use; the use is safe and reliable and the pressure is directly reduced; the operation wound is small and the complication incidence rate is reduced; promote intervertebral fusion.
The foregoing description of the preferred embodiments of the invention is not intended to be limiting, but rather is intended to cover all modifications, equivalents, alternatives, and improvements that fall within the spirit and scope of the invention.

Claims (7)

1. The utility model provides a lumbar vertebra side place ahead way is from locking-type interbody fusion fixing device, its characterized in that includes interbody fusion fixer (1) and fuses fixer (1) matched with operation passageway (2) with the interbody, interbody fusion fixer (1) includes interbody fusion ware (11) and auto-lock nail (12), be equipped with a plurality of locating holes (111) on interbody fusion ware (11), interbody fusion ware (11) are connected with auto-lock nail (12) through locating holes (111), operation passageway (2) include a plurality of fastener (23), angle bead (21), edge guard (22), lighting device (24) and camera device (25), be connected with angle bead (21) on fastener (23), install edge guard (22) between a plurality of adjacent angle bead (21), enclose jointly between a plurality of adjacent angle bead (22) and angle bead (21) and establish into passageway main part (26), lighting device is connected with angle bead (21), camera device is connected with angle bead (22).
2. The lumbar lateral anterior approach self-locking interbody fusion fixation device of claim 1, wherein the positioning hole (111) is provided with a boss (1111).
3. The lumbar lateral anterior approach self-locking type interbody fusion fixation device of claim 1, wherein an included angle (13) is formed between a central axis of the interbody fusion cage (11) and a central axis of the vertebral body.
4. The lumbar lateral anterior approach self-locking interbody fusion fixation device of claim 1, wherein the opposing guard edges (22) are each provided with a conduit (221) for cleaning.
5. The lumbar lateral anterior approach self-locking interbody fusion fixation device of claim 4, wherein the illumination device (24) is connected to the lamp head (241) through a plurality of first wires (242), and the camera device (25) is connected to the camera (251) through a second wire (252).
6. The lumbar lateral anterior approach self-locking interbody fusion fixation device of claim 1, wherein the anterior end (223) of the guard is arcuate.
7. The lumbar lateral anterior approach self-locking interbody fusion fixation device of any of claims 1-6, wherein the channel body (26) is square in cross-section.
CN201810284057.7A 2018-04-02 2018-04-02 Lumbar vertebra side front approach self-locking type interbody fusion fixing device Active CN108577955B (en)

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CN108577955B true CN108577955B (en) 2024-03-29

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Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109953840A (en) * 2019-04-04 2019-07-02 山东新华联合骨科器材股份有限公司 Zero incisura anterior cervical interbody fusion cage of 3D printing
CN112773578B (en) * 2021-02-09 2022-08-16 北京爱康宜诚医疗器材有限公司 Lumbar vertebra fusion cage

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2012040152A1 (en) * 2010-09-20 2012-03-29 Jeffrey Kleiner Fusion cage with combined biological delivery system
CN104771251A (en) * 2015-02-06 2015-07-15 潘滔 Memory alloy auto-distraction locking interbody fusion cage and application method thereof
CN105287059A (en) * 2014-07-30 2016-02-03 上海祥尧医疗器械有限公司 Interbody fusion cage and implantation device thereof
CN107397526A (en) * 2016-05-18 2017-11-28 泰库德株式会社 rigid spinal endoscope
CN208864453U (en) * 2018-04-02 2019-05-17 陈小敏 A kind of fixed device of lumbar vertebrae side anterior lateral cervical approach self-locking intervertebral fusion

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2012040152A1 (en) * 2010-09-20 2012-03-29 Jeffrey Kleiner Fusion cage with combined biological delivery system
CN105287059A (en) * 2014-07-30 2016-02-03 上海祥尧医疗器械有限公司 Interbody fusion cage and implantation device thereof
CN104771251A (en) * 2015-02-06 2015-07-15 潘滔 Memory alloy auto-distraction locking interbody fusion cage and application method thereof
CN107397526A (en) * 2016-05-18 2017-11-28 泰库德株式会社 rigid spinal endoscope
CN208864453U (en) * 2018-04-02 2019-05-17 陈小敏 A kind of fixed device of lumbar vertebrae side anterior lateral cervical approach self-locking intervertebral fusion

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