CN114305608B - Angulation puncture ware and percutaneous unilateral pedicle's centrum fusion system thereof - Google Patents
Angulation puncture ware and percutaneous unilateral pedicle's centrum fusion system thereof Download PDFInfo
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- CN114305608B CN114305608B CN202111604938.0A CN202111604938A CN114305608B CN 114305608 B CN114305608 B CN 114305608B CN 202111604938 A CN202111604938 A CN 202111604938A CN 114305608 B CN114305608 B CN 114305608B
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
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Abstract
The invention discloses an angulation puncture outfit and a percutaneous unilateral pedicle centrum fusion system thereof, wherein the angulation puncture outfit comprises a handle component, a sheath core component and a sliding block component; the sliding block assembly is arranged in the handle assembly, the sliding block assembly comprises a sliding block and a sliding block support, the sheath core assembly penetrates through the sliding block support and is fixed with the sliding block support, and the sliding block is slidably sleeved in the middle of the sliding block support; the external thread of the sliding block passes through the sliding groove of the sliding groove piece to be matched with the internal thread of the inner surface of the sleeve. According to the angulation puncture outfit provided by the invention, when the angulation puncture outfit is used for puncturing harder tissues, the bone hammer can be used for knocking and opening the cavity, the cavity opening puncture capability is stronger, and the operation is simpler, more convenient and labor-saving. Based on the minimally invasive centrum fusion system provided by the angulation puncture outfit, the vertebral pedicle on the single side of the vertebral body can be punctured for multiple times and is combined with the bone cement injection function, a radial channel filled with bone cement is provided, and after the bone cement is solidified, the whole fusion of three segments of vertebral bodies is completed.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to an angulation puncture outfit and a percutaneous unilateral pedicle centrum fusion system thereof.
Background
Along with the acceleration of the current social life rhythm and the increasing trend of aging, the incidence of spinal diseases is also increased year by year, and various spinal degenerative diseases, thoracolumbar spondylolisthesis, lateral curvature and other diseases seriously affect the life of people. Conventional spinal fixation fusion procedures typically employ a spinal rod system, a spinal plate system, or an implant that is simultaneously engaged with an interbody fusion cage. Such surgery is costly, traumatic and has long post-operative recovery time, and elderly patients with poor bone conditions often have difficulty tolerating and are unable to perform surgical treatment.
In recent years, percutaneous bent angle vertebroplasty (PCVP) instruments are increasingly developed and mature, the operation mode is that percutaneous is performed through pedicle puncture to enter a vertebral body, and the bent angle shape design of an open cavity instrument can be utilized to puncture the opposite side of the vertebral body, so that the effect of single-side puncture and double-side puncture can be achieved.
The following two devices for percutaneous transpedicular fusion are provided by those skilled in the art:
patent CN107530095a provides a device for percutaneous pedicle fusion comprising at least two straight pedicle cannulas, at least one guide sheath, a flexible cannulated drill bit, an injection device, and a closure device (9). The device has the following defects:
(1) Is only arranged in the intervertebral space for fusion of the upper vertebral body and the lower vertebral body, and cannot be arranged in single or multiple vertebral bodies and multiple intervertebral spaces;
(2) At least two straight pedicle cannulas are respectively arranged on the upper vertebra and/or the lower vertebra of the spinal level, at least two passages are needed for the at least two straight pedicle cannulas, and at least two skin incisions are needed to be formed on the body surface;
(3) The guide sheath and the flexible cannula type drill bit are separately designed into two independent instruments, the flexible cannula type drill bit is driven by a driving system, so that the back and forth rotary movement driving of the cannula type drill bit can be realized, the slotting process is quick, the reaction time is short, no process feedback is generated, the blind chisel is performed under the minimally invasive non-visual field direct vision, excessive puncture is caused, scraps are generated, physiological saline solution is required to be injected and pumped for cleaning, and incomplete cleaning is caused by limited channel diameter and number;
(4) The injection device is connected to a straight pedicle cannula to inject the implant into the intervertebral space; the straight cannula is arranged on the vertebra, the intervertebral space is beside the vertebra, a bending channel is needed to pass through when the implant is injected into the intervertebral space from the straight cannula, the channel is generated by slotting of the flexible cannula type drill, the flexible cannula type drill is arranged in the guide sheath, the guide sheath is arranged in the straight cannula, and the flexible cannula type drill has no expansion structure, so that the diameter of the bending channel of the slotting of the flexible cannula type drill is smaller than the inner diameter of the straight cannula, the granular suspension implant prepared by the autologous bone is blocked when the implant passes through the area of the bending channel from the straight cannula to the inner diameter, the filling is not smooth, in addition, the implant in the patent is a human autologous iliac crest bone, a bone taking channel is needed to be taken from the autologous iliac crest bone during operation, the traditional operation minimally invasive concept is not needed, in addition, the bone taking channel is damaged due to the structural integrity of the bone taking, chronic injury is caused after the operation bone taking, and secondary wound is caused by continuous pain during rehabilitation;
(5) The closing device is screwed into the hole leaving space after the straight pedicle cannula is withdrawn, and the closing device is a pedicle screw of the spinal fixation device, so that the connecting rod can be placed and fixed, namely, the operation using the instrument still needs to be assisted by using the pedicle screw, the operation time can be prolonged, the anesthesia time length can be increased, and meanwhile, the pedicle screw for closing can be charged, and the economic burden of a patient can be increased.
Patent CN112043466a discloses a transpedicular interbody fusion system, including pjncture needle subassembly, protective sleeve subassembly, conveyer pipe subassembly and sheath core subassembly, the sheath core can be dismantled with the conveyer pipe and be connected, and the sheath core head end is crooked, then the conveyer pipe head end is crooked, and the slider is fixed in the conveyer pipe, and sheath core and conveyer pipe can be dismantled and be connected. The puncture principle is as follows: continuously rotating the handle, driving the sliding block to move back and forth by the matched screw threads, driving the conveying pipe to move back and forth, bending the end of the conveying pipe head, bending the end of the sheath core, and moving the sheath core back and forth, namely, applying force to puncture the internal tissues of the vertebral body by rotating the handle. The device has the following defects:
(1) If hard tissues such as vertebral endplates are encountered, the handle is rotated, the sliding block is driven to move through the matched threads, the sliding block drives the conveying pipe to move, the conveying pipe drives the sheath core, so that insufficient force can be applied, and a channel is difficult to puncture the hard tissues;
(2) When the conveying pipe and the head end of the sheath core need to move relatively, the inner force consumption of the mutually misplaced bending sections is overcome, and the head end puncture force is insufficient;
(3) The puncture assembly and the protective sleeve are fixedly connected, so that the puncture assembly and the protective sleeve are integrated and have no activity.
Therefore, the existing scheme has insufficient puncture force when the surgical instrument is applied to the puncture of two adjacent vertebral bodies and the intervertebral space, and is difficult to realize the function of puncturing and opening the channel for multiple times. The minimally invasive vertebral fusion system through the vertebral pedicle is stronger in cavity opening puncture capability, simpler, more convenient and labor-saving to operate, and can perform multiple punctures through the unilateral vertebral pedicle of the vertebral body at the home position and combine the bone cement injection function.
Disclosure of Invention
In order to achieve the technical aim, the invention provides an angulation puncture outfit and a percutaneous unilateral pedicle centrum fusion system thereof.
In a first aspect, the present invention provides an angled spike comprising:
the handle assembly comprises an outer tube, a chute piece, a sleeve, a rotary handle and a grab handle, which are sleeved in sequence from inside to outside; the proximal end of the outer tube is fixed with the far end of the grab handle, the far end of the chute piece is fixed with the far end of the grab handle, the far end of the sleeve is axially limited and circumferentially fixed with the far end of the grab handle in a rotatable manner, and the proximal end of the sleeve is detachably and fixedly connected with the rotary handle;
the sheath core assembly comprises a sheath core, a nose cutting edge, a sheath core bending part, a reinforcing pipe and a sheath core handle;
the sliding block assembly comprises a sliding block and a sliding block support; the sliding block assembly is arranged in the sliding groove piece, a through hole is formed in the central shaft direction of the sliding block support, the sheath core assembly penetrates through the through hole, and the outer surface of the sheath core assembly is fixed with the inner surface of the through hole; the sliding block support is dumbbell-shaped, and the sliding block is slidably sleeved in the middle of the sliding block support; the external thread of the sliding block passes through the sliding groove of the sliding groove piece to be matched with the internal thread of the inner surface of the sleeve.
Preferably, the proximal end of the sheath core passes through the outer tube, the chute and the rotation handle in sequence; the sheath core is provided with a sheath core bending part at the distal end; the sheath core is sleeved with the reinforcing tube, the distal end of the reinforcing tube is provided with a bending section, the distal end of the reinforcing tube is fixedly connected with the cutting edge of the head part, and the proximal end of the reinforcing tube is fixedly connected with the sheath core handle; the distal end of the sheath core abuts against the nose cutting edge, and the proximal end of the sheath core abuts against the sheath core handle.
Preferably, the distal end of the reinforcing tube is cut in a circumferential direction leaving an uncut section to form a curved section.
Preferably, the internal thread and the external thread are trapezoidal threads.
Preferably, the radius of the sheath core curvature is 15-35mm.
Preferably, the outer surface of the sleeve is provided with a first bulge, the inner side wall of the sleeve, which is sleeved with the rotary handle, is provided with a first groove, and the first bulge is mutually matched with the first groove, so that the rotary handle is fixedly connected with the circumferential limiting axis of the sleeve in a sliding manner.
In a second aspect, the present invention provides a percutaneous unilateral pedicle fusion system comprising a penetrator, an angulation penetrator as described above, a conveyor and a filler.
In a third aspect, the present invention provides a percutaneous unilateral pedicle vertebral fusion method, which adopts the percutaneous unilateral pedicle vertebral fusion system, and specifically comprises the following steps:
a1, establishing a puncture channel;
step A2, establishing radial channels penetrating three vertebral bodies:
and A3, filling the radial channels with bone cement.
Preferably, the step A2 specifically comprises:
step A21: penetrating the lower vertebral body along the penetration channel by using the angulation puncture outfit, sequentially penetrating through the lower end plate of the lower vertebral body and the lower intervertebral space, and entering the lower vertebral body through the upper end plate of the lower vertebral body;
step A22: adjusting the depth and the deflection angle of the angulation puncture outfit entering the pedicle of vertebral arch, repeating the step A21 for a plurality of times, and then retracting the angulation puncture outfit;
step A23: sequentially puncturing upper end plates of the home vertebral bodies, upper intervertebral space and lower end plates of the upper vertebral bodies by using an angulation puncture outfit, and entering the upper vertebral bodies;
step A24: and (3) adjusting the depth and the deflection angle of the angulation puncture outfit entering the pedicle of vertebral arch, repeating the step A23 for a plurality of times, and then retracting the angulation puncture outfit.
Step A25: puncturing the home vertebral body by using an angulation puncture outfit;
step A26: and (3) adjusting the depth and the deflection angle of the angulation puncture outfit entering the pedicle of vertebral arch, repeating the step A25 for a plurality of times, and withdrawing the angulation puncture outfit.
Preferably, the puncture passes through the lower endplate of the lower vertebral body and the lower intervertebral space, and the puncture passes through the midline of the lower intervertebral space and the midline of the lower vertebral body in the process of entering the lower vertebral body; the puncture passes through the upper endplate of the upper vertebral body and the upper intervertebral space, and the puncture passes through the midline of the upper intervertebral space and the midline of the upper vertebral body in the process of entering the upper vertebral body; the vertebral body is penetrated transversely, and the puncture passes through the midline of the vertebral body.
Compared with the prior art, the invention has the following technical effects:
(1) The invention provides a minimally invasive vertebral fusion system through vertebral pedicle, which has stronger cavity opening and puncture capability, is simpler and more convenient and labor-saving to operate, can puncture multiple times through the unilateral vertebral pedicle of a local vertebral body and combines the bone cement injection function.
(2) Based on PCVP operation approach and puncture mode, the invention sequentially punctures the percutaneous unilateral vertebral pedicle into the lower vertebral body, the lower intervertebral space, the home vertebral body, the upper intervertebral space and the upper vertebral body, establishes a radial channel and injects bone cement in the channel, thereby effectively correcting and fixing two adjacent vertebral bodies, and treating and relieving pain and discomfort.
(3) According to the angulation puncture outfit provided by the invention, when the angulation puncture outfit is used for puncturing harder tissues, a bone hammer can be used for knocking a sheath core handle of the angulation puncture outfit, the angulation puncture outfit is transmitted to the cutting edge of the head part of the sheath core assembly, the hard tissues are broken through in a moving way, if the hard tissues are further broken through, the rotating handle is rotated, the steps are repeated, and the hard tissues can be broken through the knocking step by step; in the knocking process, force feedback exists when the hammer knocks, the firmness degree of the tissues is felt, the subsequent operation is guided, the process can be gradually performed, and the operation safety is improved.
(4) The fusion method provided by the invention can strengthen the three-section vertebral body and complete the integral fusion of the three-section vertebral body only through the unilateral pedicle of the home-position vertebral body. The incision wound is small, and only a puncture channel below 5mm is needed.
(5) The multi-channel bone cement column and the bone cement dispersed among the loose bones can be used for effectively fixing and reinforcing the adjacent three vertebrae without additional internal fixation spinal nail rod or bone grafting fusion process, and the surgical minimally invasive bone cement column and bone grafting fusion device is small in operation, simple to operate and quick in postoperative recovery. On the premise of achieving the same treatment purpose, fewer configuration resources, simpler operation process, less operation cost and less operation wound are used for benefiting doctor patients.
Drawings
FIG. 1 is a schematic view of an angled spike of the present invention;
FIG. 2 is a cross-sectional view of an angled spike of the present invention;
FIG. 3 is a schematic view of the structure of the puncture outfit;
FIG. 4 is a schematic view of a conveyor;
FIG. 5 is a schematic structural view of the filler;
FIG. 6 is a schematic front view of a radial channel formed by the penetration of an angled spike;
FIG. 7 is a rear schematic view of a radial channel formed by the penetration of an angled penetrator;
FIG. 8 is a left side schematic view of a radial channel formed by the penetration of an angled penetrator;
FIG. 9 is a right side schematic view of a radial channel formed by the penetration of an angled penetrator;
the reference symbols in the drawings indicate the description:
1-handle assembly, 11-outer tube, 12-grab handle, 13-rotating handle, 14-sleeve, 15-slide, 16-mount, 2-sheath-core assembly, 21-sheath-core, 22-nose edge, 23-sheath-core bend, 24-reinforcement tube, 25-sheath-core handle, 3-slide assembly, 31-slide, 32-slide mount.
Detailed Description
The present invention will be described in detail and in detail by way of the following examples, which are not intended to limit the scope of the invention, for better understanding of the invention. In the following description, the direction approaching the operator is the proximal end, and the direction away from the operator is the distal end.
Example 1
Referring to fig. 1 and 2, the present embodiment provides an angled spike comprising a handle assembly 1, a sheath-core assembly 2 and a slider assembly 3.
Specifically, the handle assembly 1 includes an outer tube 11, a grip 12, a rotatable handle 13, a sleeve 14, and a chute member 15. The chute member 15, the sleeve 14, the rotary handle 13 and the grab handle 12 are sleeved in sequence from inside to outside.
The proximal end of the outer tube 11 is fixed with the distal end of the grab handle 12, the distal end of the chute member 15 is fixed with the distal end of the grab handle 12, the chute member 15 is sleeved in the grab handle 12, and the wall surface of the chute member 15 is provided with a chute.
The far end of the sleeve 14 and the far end of the grab handle 12 are axially limited and circumferentially rotatably fixed, and the sleeve 14 is sleeved between the chute piece 15 and the grab handle 12; the sleeve 14 is internally threaded, preferably in the form of a stepped thread, so that the thread turns can transmit a sufficient force.
The distal end of the rotary handle 13 is interposed between the proximal end of the grip 12 and the proximal end of the sleeve 14, and the proximal end of the sleeve 14 is detachably and fixedly connected to the rotary handle 13. The rotary handle 13 is T-shaped, the central axis of the rotary handle 13 is provided with a through hole, and the sheath core assembly 2 passes through the through hole and is fixedly connected with the sheath core handle 25.
In a preferred embodiment, the outer surface of the sleeve 14 is provided with a first protrusion, and the inner side wall of the rotary handle 13, which is arranged outside the sleeve 14, is provided with a first groove, and the first protrusion and the first groove are mutually matched, so that the rotary handle 13 can rotate with the sleeve 14 when rotating.
In a preferred embodiment, the outer wall surface of the distal end of the sleeve 14 is provided with a second protrusion, the inner side wall of the grip 12 sleeved outside the sleeve 14 is provided with a second groove, the second protrusion and the second groove are mutually matched, the outer wall surface of the distal end of the chute member 15, which is positioned at the position outside the sleeve 14, is provided with a third protrusion, the distal end of the second groove in the grip 12 is provided with a third groove with a deeper depth, and when the third protrusion and the third groove are mutually matched, the third protrusion of the chute member 15 fixes the second protrusion of the sleeve 14 in the second groove, so that the axial limiting circumferential rotatable fixation of the sleeve 14 and the grip 12 is realized.
In another more preferred embodiment, a circle of second protrusions is arranged on the outer wall surface of the distal end of the sleeve 14, a circle of second grooves are arranged on the inner side wall of the handle 12 sleeved outside the sleeve 14, the second protrusions are mutually matched with the second grooves, a circle of third protrusions are arranged on the outer wall surface of the part, located outside the sleeve 14, of the distal end of the sliding groove piece 15, the outer edge diameter of each third protrusion is larger than that of each second protrusion, a fixing cavity is formed in the hollow part of the distal end of the second groove in the handle 12, the diameter of each fixing cavity is larger than or equal to that of each third protrusion, threads are arranged on the inner surface of each fixing cavity and are matched with the outer threads of the corresponding fixing piece 16, after the fixing piece 16 is combined with the sleeve 14, the third protrusions are fixed on the proximal end of the fixing cavity, and meanwhile, the third protrusions of the sliding groove piece 15 fix the second protrusions of the sleeve 14 in the second grooves, and the axial limiting and circumferential rotatable fixing of the sleeve 14 and the handle 12 are achieved. The fixing member 16 has a through hole formed in the central axis thereof, and the proximal end of the outer tube 11 is inserted into and fixed to the through hole.
Specifically, the sheath-core assembly 2 includes a sheath core 21, a nose cutting edge 22, a sheath-core bend 23, a reinforcing tube 24, and a sheath-core shank 25. The proximal end of the sheath-core assembly 2 passes through the handle assembly 1 and the slider assembly 3 within the handle assembly 1.
The proximal end of the sheath core 21 passes through the outer tube 11, the chute 15 and the rotation handle 13 in order, the distal end of the sheath core 21 abuts against the nose cutting edge 22, and the proximal end of the sheath core 21 abuts against the sheath core handle 25. The distal end of the sheath core 21 is provided with a sheath core bending part 23, and the radius of the sheath core bending part 23 is 15-35mm.
The sheath core 21 is sleeved with the reinforcing tube 24, the distal end of the reinforcing tube 24 is cut by laser to form a curved section, preferably, the specific cutting mode is circumferential cutting, and the uncut section is remained, namely, the uncut section is not cut in a whole circle, so that the reinforcing tube 24 can be smoothly attached to the curved portion 23 of the sheath core, and the torsion resistance of the curved portion 23 of the sheath core can be enhanced. The proximal end of the reinforcing tube 24 is fixedly connected with the sheath core handle 25, the distal end of the reinforcing tube 24 is fixedly connected with the nose cutting edge 22, and the nose cutting edge 22 is used for puncturing tissues to open cavities.
In a specific use, since the distal end of the reinforcing tube 24 is fixedly connected to the nose cutting edge 22, the proximal end of the reinforcing tube 24 is fixedly connected to the sheath core handle 25, the distal end of the sheath core 22 abuts against the nose cutting edge 22, and the proximal end of the sheath core 22 abuts against the sheath core handle 25, when a distally directed striking force is applied to the sheath core handle 25, the force can be transmitted from the sheath core handle 25 to the nose cutting edge 22 through the reinforcing tube 24 and the sheath core 22, and the striking force is used to break through harder tissue for tunneling treatment.
Specifically, the slider assembly 3 includes a slider 31 and a slider holder 32. The slider assembly 3 is arranged in the slide slot means 15.
The sliding block support 32 is dumbbell-shaped, one side, close to the sliding groove of the sliding groove piece 15, of the two ends of the sliding block support 32 is clamped in the sliding groove, and meanwhile, the part protruding out of the sliding groove is subjected to plane treatment, so that the sliding block support 32 can slide in the sliding groove relatively, and is not limited by the sleeve 14.
The sliding block 31 is sleeved on a bar in the middle of the sliding block support 32, and a gap is reserved between the distal end face and the proximal end face of the sliding block 31 and the two ends of the sliding block support 32; so that the slider 31 can move back and forth on the bar of the slider holder 32.
The sliding block support 32 is provided with a through hole along the central axis direction, the sheath core assembly 2 passes through the through hole, and the outer surface of the sheath core assembly 2 is fixed with the inner surface of the through hole. In a specific embodiment, the through-hole of the shoe support 31 is fixedly connected to the outer surface of the reinforcing tube 24.
The external thread of the outer surface of the slider 31 passes through the sliding groove of the sliding groove piece 15 and is matched with the internal thread of the sleeve 14. Preferably, the external thread is also a trapezoidal thread. When the sleeve 14 rotates, the slider 31 can only move forward and backward due to the limitation of the circumferential direction of the chute.
Example 2
The embodiment provides a specific use method of the angulation puncture outfit in the embodiment 1, which specifically comprises the following steps:
step S1, preparation work: cutting an incision of 5mm on the skin, puncturing a pedicle channel by using a puncture outfit, withdrawing a puncture outfit needle core, reserving a puncture outfit needle tube, and penetrating a home position vertebral body along the puncture outfit needle tube channel by using an angulation puncture outfit;
step S2, starting puncturing: when the rotating handle 13 drives the sleeve 14 to rotate, the sliding block 31 can abut against the far end of the sliding block support 32 due to the fact that the external threads on the outer surface of the sliding block 31 are matched with the internal threads of the sleeve 14, the sliding block moves far end along the sliding groove of the sliding groove piece 15, when the sliding block 31 continues to move far end, the sliding block 31 can abut against the sliding block support 32 to move far end, the sliding block support 31 is fixedly connected with the reinforcing tube 24, the sliding block support 31 can abut against the reinforcing tube 24 to move far end, the reinforcing tube 24 carries the sheath core handle 25 to move far end, the sheath core handle 25 abuts against the sheath core 21 to move far end, and the sheath core 21 and the reinforcing tube 24 abut against the head cutting edge 22 to pierce far end;
step S3, encountering hard tissue puncture: at this time, the sliding block 31 is abutted against the distal end of the sliding block support 32, a larger gap is reserved between the sliding block 31 and the proximal end of the sliding block support 32, a knocking force is applied to the sheath core handle 25, and the knocking force is transmitted to the nose cutting edge 22 through the sheath core handle 25, the sheath core 21 and the reinforcing tube 24, so that the nose cutting edge 22 is further exposed out of the outer tube 11 and penetrates into a cavity towards the distal end, at the same time, the sheath core handle 25 moves towards the distal end with the reinforcing tube 24, the reinforcing tube 24 moves towards the distal end with the sliding block support 32, and the sliding block 31 cannot move when the sliding block 14 is not rotated due to the threaded fit of the sliding block 31 and the sleeve 14, the sliding block support 32 slides towards the distal end relative to the sliding block 31, and when the rear end of the sliding block support 32 is abutted against the sliding block 31, the nose cutting edge 22 cannot be further exposed out of the outer tube 11 for penetration, and the distal movement of the sheath core assembly 3 is stopped;
step S4, further hard tissue puncture: if the hard tissue is not completely broken through after the step S3 is finished, and if the hard tissue is still required to be broken through, the rotary handle 13 rotates along with the sleeve 14, and the sliding block 31 moves distally due to the threaded fit, so that the sliding block 31 is attached to the distal end of the sliding block support 32 again, a larger gap is left between the sliding block 31 and the rear end of the sliding block support 32 again, the striking force can be applied to the sheath core handle 25 again, the distal hard tissue is broken through in a bone hammer striking mode, and the hard tissue in the vertebral body can be gradually broken through only by repeating the stepping process, so that a through channel is opened.
In the knocking process, force feedback is generated when the bone hammer is applied and knocked, the force feedback is matched with the routine operation experience of doctors, and the hardness of the tissues can be identified through the force feedback to guide the subsequent operation.
Example 3
The present embodiment provides a percutaneous unilateral pedicle fusion system comprising a penetrator (as shown in fig. 3), an angulation penetrator (as shown in fig. 1-2), a conveyor (as shown in fig. 4), and an obturator (as shown in fig. 5) of embodiment 1.
Example 4
The present embodiment provides a percutaneous unilateral pedicle vertebral fusion method, which adopts the percutaneous unilateral pedicle vertebral fusion system as in embodiment 3, and specifically comprises the following steps:
step A1, establishing a puncture channel: a 5mm incision is made on the skin, a puncture outfit is used for puncturing the pedicle of vertebral pedicle of the home position to form a channel, a puncture outfit needle core is withdrawn, and a puncture outfit needle tube is reserved to form a puncture channel;
step A2, establishing radial channels penetrating three vertebral bodies (as shown in figures 5-9):
step A21: penetrating the home position vertebral body along a needle tube channel of the puncture outfit by using the angulation puncture outfit, sequentially penetrating through a lower endplate of the home position vertebral body and a lower intervertebral space, entering the lower vertebral body through an upper endplate of the lower vertebral body, and penetrating across the central line of the lower vertebral body;
step A22: adjusting the depth and the deflection angle of the angulation puncture outfit entering the pedicle of vertebral arch, repeating the step A21 for a plurality of times, and then retracting the angulation puncture outfit;
step A23: sequentially puncturing upper end plates of the home vertebral bodies, upper intervertebral space, lower end plates of the upper vertebral bodies, entering the upper vertebral bodies and crossing the central line of the upper vertebral bodies by using an angulation puncture outfit;
step A24: adjusting the depth and the deflection angle of the angulation puncture outfit entering the pedicle of vertebral arch, repeating the step A23 for a plurality of times, and then retracting the angulation puncture outfit;
step A25: puncturing the centrum by using an angulation puncture outfit, and puncturing the centrum midline;
step A26: and (3) adjusting the depth and the deflection angle of the angulation puncture outfit entering the pedicle of vertebral arch, repeating the step A25 for a plurality of times, and withdrawing the angulation puncture outfit.
Step A3, filling radial channels with bone cement: the conveyor is used for entering the home position vertebral body along a puncture channel formed by a needle tube of the puncture device, reaching the root of the pedicle of the home position vertebral body, not entering the home position vertebral body, the filler which is preloaded with bone cement is used for connecting a conveyor interface, the bone cement is filled in a pressurizing mode, enters the home position vertebral body along the conveyor channel, and fills the lower position vertebral body, the lower position vertebral gap, the upper position vertebral gap and the home position vertebral body along a radial channel.
After the bone cement is solidified, the lower vertebral body, the lower intervertebral space, the home vertebral body, the upper intervertebral space and the upper vertebral body are fused into a whole.
In a preferred embodiment, the penetration is through the inferior endplate of the inferior vertebral body, the inferior intervertebral space, the superior endplate of the inferior vertebral body, and the penetration is over the midline of the inferior intervertebral space and the midline of the inferior vertebral body during the penetration into the inferior vertebral body; the puncture passes through the upper endplate of the upper vertebral body and the upper intervertebral space, and the puncture passes through the midline of the upper intervertebral space and the midline of the upper vertebral body in the process of entering the upper vertebral body.
Because the radial channels all cross the central lines of the lower vertebral body, the lower intervertebral space, the home vertebral body, the upper intervertebral space and the upper vertebral body, bone cement can permeate to the opposite sides of the lower vertebral body, the lower intervertebral space, the home vertebral body, the upper intervertebral space and the upper vertebral body to form radial channels which penetrate through the side and the opposite side of the lower vertebral body, the side and the opposite side of the lower intervertebral space, the side and the opposite side of the home vertebral body, the side and the opposite side of the upper intervertebral space and the side and the opposite side of the upper vertebral body, and the channel starting points are all positioned at the root of the pedicle of vertebral arch at one side of the home vertebral body. After the bone cement is solidified, the whole reinforcement of the lower vertebral body, the lower intervertebral space, the home vertebral body, the upper intervertebral space and the upper vertebral body is achieved.
In summary, the fusion method can not only strengthen three segments of vertebral bodies, but also complete the integral fusion of the three segments of vertebral bodies by only passing through the unilateral pedicle of the vertebral body. The minimally invasive vertebral fusion system through the pedicle has small incision wound and only needs a puncture channel below 5mm. In addition, the bone cement dispersed between the multichannel bone cement column and the loose bone can be effectively fixed and reinforced to adjacent three vertebrae, an additional internal fixation spine nail rod or bone grafting fusion process is not needed, and the surgical minimally invasive bone grafting device is small in operation, simple to operate and quick in postoperative recovery. On the premise of achieving the same treatment purpose, fewer configuration resources, simpler operation process, less operation cost and less operation wound are used for benefiting doctor patients.
The above description of the specific embodiments of the present invention has been given by way of example only, and the present invention is not limited to the above described specific embodiments. Any equivalent modifications and substitutions for the present invention will occur to those skilled in the art, and are also within the scope of the present invention. Accordingly, equivalent changes and modifications are intended to be included within the scope of the present invention without departing from the spirit and scope thereof.
Claims (8)
1. An angulation puncture outfit, comprising:
the handle assembly (1) comprises an outer tube (11), and further comprises a chute piece (15), a sleeve (14), a rotary handle (13) and a grab handle (12) which are sleeved in sequence from inside to outside; the proximal end of the outer tube (11) is fixed with the distal end of the grab handle (12), the distal end of the chute piece (15) is fixed with the distal end of the grab handle (12), the distal end of the sleeve (14) is axially limited and circumferentially rotatably fixed with the distal end of the grab handle (12), and the proximal end of the sleeve (14) is detachably and fixedly connected with the rotary handle (13);
a sheath core assembly (2) comprising a sheath core (21), a nose cutting edge (22), a sheath core bending part (23), a reinforcing tube (24) and a sheath core handle (25); the proximal end of the sheath core (21) sequentially passes through the outer tube (11), the chute piece (15) and the rotary handle (13); a sheath core bending part (23) is arranged at the distal end of the sheath core (21); the sheath core (21) is sleeved with the reinforcing tube (24), the distal end of the reinforcing tube (24) is provided with a bending section, the distal end of the reinforcing tube (24) is fixedly connected with the nose cutting edge (22), and the proximal end of the reinforcing tube (24) is fixedly connected with the sheath core handle (25); the distal end of the sheath core (21) abuts against the nose cutting edge (22), and the proximal end of the sheath core (21) abuts against the sheath core handle (25);
the sliding block assembly (3) comprises a sliding block (31) and a sliding block support (32); the sliding block assembly (3) is arranged in the sliding groove piece (15), a through hole is formed in the central shaft direction of the sliding block support (32), the sheath core assembly (2) penetrates through the through hole, and the outer surface of the sheath core assembly (2) is fixed with the inner surface of the through hole; the sliding block support (32) is dumbbell-shaped, and the sliding block (31) is slidably sleeved in the middle of the sliding block support (32); the external thread of the sliding block (31) passes through the sliding groove of the sliding groove piece (15) to be matched with the internal thread of the inner surface of the sleeve (14); the internal thread and the external thread are ladder-shaped threads.
2. The angled spike of claim 1 wherein the distal end of the stiffening tube (24) is cut in a circumferential direction leaving an uncut section to form a curved section.
3. The angled spike of claim 1 wherein the radius of the sheath core curvature (23) is 15-35mm.
4. The angulation puncture outfit according to claim 1, wherein the outer surface of the sleeve (14) is provided with a first bulge, the inner side wall of the rotary handle (13) sleeved outside the sleeve (14) is provided with a first groove, and the first bulge and the first groove are mutually matched, so that the rotary handle (13) and the sleeve (14) are fixedly connected in a sliding way along a circumferential limiting axis.
5. A percutaneous unilateral pedicle fusion system comprising a penetrator, an angulation penetrator as claimed in any one of claims 1-4, a delivery device and a filler.
6. The percutaneous unilateral pedicle fusion system of claim 5, wherein the specific use step comprises the steps of:
a1, establishing a puncture channel;
a2, establishing radial channels penetrating through three vertebral bodies;
and A3, filling the radial channels with bone cement.
7. The percutaneous unilateral pedicle fusion system of claim 6, wherein step A2 is specifically configured to:
step A21: penetrating the lower vertebral body along the penetration channel by using the angulation puncture outfit, sequentially penetrating through the lower end plate of the lower vertebral body and the lower intervertebral space, and entering the lower vertebral body through the upper end plate of the lower vertebral body;
step A22: adjusting the depth and the deflection angle of the angulation puncture outfit entering the pedicle of vertebral arch, repeating the step A21 for a plurality of times, and then retracting the angulation puncture outfit;
step A23: sequentially puncturing upper end plates of the home vertebral bodies, upper intervertebral space and lower end plates of the upper vertebral bodies by using an angulation puncture outfit, and entering the upper vertebral bodies;
step A24: adjusting the depth and the deflection angle of the angulation puncture outfit entering the pedicle of vertebral arch, repeating the step A23 for a plurality of times, and then retracting the angulation puncture outfit;
step A25: puncturing the home vertebral body by using an angulation puncture outfit;
step A26: and (3) adjusting the depth and the deflection angle of the angulation puncture outfit entering the pedicle of vertebral arch, repeating the step A25 for a plurality of times, and withdrawing the angulation puncture outfit.
8. The percutaneous unilateral pedicle fusion system of claim 7, wherein the penetration is through the inferior endplate of the inferior vertebral body, the inferior intervertebral space, the superior endplate of the inferior vertebral body, and the penetration is through the midline of the inferior intervertebral space and the midline of the inferior vertebral body; the puncture passes through the upper endplate of the upper vertebral body and the upper intervertebral space, and the puncture passes through the midline of the upper intervertebral space and the midline of the upper vertebral body in the process of entering the upper vertebral body; the vertebral body is penetrated transversely, and the puncture passes through the midline of the vertebral body.
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| CN202111604938.0A CN114305608B (en) | 2021-12-24 | 2021-12-24 | Angulation puncture ware and percutaneous unilateral pedicle's centrum fusion system thereof |
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