CN1539382A - Percutaneous prying instrument for vertebral body reduction and its pedicle puncture needle - Google Patents

Abstract

A percutaneous prying vertebral body reduction instrument, which has two pedicle puncture needles, an extension rod used to lengthen the pedicle puncture needles to increase the force arm, and a rod for positioning the two pedicle puncture needles. Connecting rod, two combined clamping heads connecting the pedicle puncture needle and the connecting rod; the length of the front part of the above-mentioned pedicle puncture needle is between 12 and 18 mm and is provided with threads, and the middle part of the pedicle puncture needle is a truncated cone shape. The present invention realizes percutaneous prying reduction of vertebral body compression fractures and partial burst fractures in clinical practice. Since the intervertebral joints with a complete structure behind the spine are used as the fulcrum of prying reduction to complete the reduction of the front compression fractured vertebral body, no need to consider on the instrument The setting of fulcrum, so the present invention is simple in structure, easy to operate. The head of the pedicle puncture needle is tapered, and the thread section is short. When the pedicle puncture needle is screwed into the pedicle, the thread section of the pedicle puncture needle enters the human body and is followed by a smooth section, and the needle body is from thin to Thick, so the screwing in of the pedicle puncture needle is easy, the resistance is small, and the damage to the surrounding soft tissue is small.

Description

Percutaneous prying instrument for vertebral body reduction and its pedicle puncture needle

technical field

The invention relates to a medical device, which is a vertebral body reset device.

Background technique

For vertebral compression fractures, the traditional treatment method is bed rest, which takes a long time to recover, and is prone to complications especially for the elderly. Vertebroplasty is a method of percutaneous injection of bone cement into the vertebral body. It was first used clinically in my country in 2000. Although percutaneous vertebroplasty can solve the pain caused by osteoporotic compression fractures and stabilize the vertebral body , so that patients get out of bed as soon as possible, but the existing kyphosis can not be resolved regrettably. In 1998, it was reported abroad that a cannula was introduced into the vertebral body, and an inflatable airbag bone tamping rod was inserted through the cannula to expand the collapsed vertebral body and produce a cavity. Then inject bone cement under a lower pressure. This technique is called kyphoplasty. The short-term clinical effect is satisfactory. In 2002, this aspect has been reported in China. However, due to the high cost of kyphoplasty, the operation method is complicated. , it is difficult to popularize and promote. The percutaneous prying vertebral body reduction operation that is being tested now, it resets the fractured vertebral body under prying, and then injects bone cement. This method is simple, economical, practical, and easy to popularize. For patients with complete vertebral body posterior wall and no neurological symptoms, patients with vertebral body burst fracture can also be reset by prying. Since percutaneous prying vertebral body reduction is a new method, there is currently no ready-made instrument suitable for this operation, but the pedicle puncture needle used in it can be used in the AO external fixation instrument currently used for spinal external fixation. Schanz screw (see Figure 11), the Schanz screw is a self-tapping screw, the front part of the needle body is a threaded section with a diameter of 5 mm and a length of 35 mm, the middle part is a thin needle body with a diameter of 5 mm and a length of 25 mm, and the rear part is a threaded segment with a diameter of 5 mm and a length of 25 mm. 6mm, 100mm long thick needle body. The Schanz screw is rotated into the human body. Since the thread part of the Schanz screw is long, the soft tissue around the Schanz screw is repeatedly cut by the thread during the puncture process, so that the soft tissue is entangled on the thread part of the Schan screw, which makes the advance resistance of the Schan screw very small. Large, with large soft tissue damage.

Contents of the invention

One object of the present invention is to provide a percutaneous prying vertebral body reduction instrument suitable for percutaneous prying vertebral body reduction and simple in structure; Pedicle puncture needle with less soft tissue damage.

In order to realize above-mentioned first object, the present invention has except having two pedicle puncture needles, the present invention also has:

an extension rod used to lengthen the pedicle puncture needle to increase the moment arm;

a connecting rod for positioning the two pedicle puncture needles;

Two combined clamping heads connecting the pedicle puncture needle and the connecting rod.

In addition, the instrument also has a handle that cooperates with the pedicle puncture needle and is transparent to X-rays.

The length of the front part of the pedicle puncture needle is between 12mm and 18mm and is provided with threads, and the middle part of the pedicle puncture needle is in the shape of a truncated cone.

The truncated conical taper of the pedicle puncture needle is between 1:45 and 1:30.

The front part of the above-mentioned pedicle puncture needle can be an extension of the middle part of the truncated cone, that is, an external thread is provided on the front part of the truncated cone; the front part of the pedicle puncture needle can also be cylindrical, that is, the front part of the cylindrical There are external threads on the part.

The rear part of the pedicle puncture needle is provided with a positioning plane and a positioning groove; the pedicle puncture needle has a scale line.

The combined clamping head has two L-shaped clamping heads, and the base of the clamping head is provided with an axial clamping hole matched with a pedicle puncture needle, and an axial opening groove communicated with the axial clamping hole And the radial bolt hole passing through the axial opening groove, the bolt hole is provided with bolts; the backs of the two clamping heads are pinned by pin shafts and can be used as 360° relative rotation with the pin shaft as the central axis.

The handle is provided with a jack and a head screw hole matched with the pedicle puncture needle, and the handle and the pedicle puncture needle are plugged in and fixed by the head screw; the material for making the handle is wood and plastic.

The extension rod is provided with an insertion hole matched with the pedicle puncture needle, and the upper half of the outer surface of the extension rod is knurled.

The outer surface of the connecting rod is knurled.

To achieve another object of the present invention, the length of the front part of the above-mentioned pedicle puncture needle is between 12-18 mm and is provided with threads, and the middle part of the pedicle puncture needle is in the shape of a truncated cone.

The taper of the truncated conical middle part of the pedicle puncture needle is between 1:45 and 1:30.

The front part of the above-mentioned pedicle puncture needle can be an extension of the middle part of the truncated cone, that is, an external thread is provided on the front part of the truncated cone; the front part of the above-mentioned pedicle puncture needle can also be cylindrical, that is, the External threads are provided on the front.

The rear part of the pedicle puncture needle is provided with a positioning plane and a positioning groove; the pedicle puncture needle has a scale line.

The present invention realizes percutaneous prying reduction of vertebral body compression fractures and partial burst fractures in clinical practice. Since the intervertebral joints with a complete structure behind the spine are used as the fulcrum of prying reduction to complete the reduction of the front compression fractured vertebral body, no need to consider on the instrument The setting of fulcrum, so the present invention is simple in structure, easy to operate. The head of the pedicle puncture needle is tapered, and the thread section is short. When the pedicle puncture needle is screwed into the pedicle, the thread section of the pedicle puncture needle enters the human body and is followed by a smooth section, and the needle body is a truncated cone. shape, transitioning slowly from thin to thick, so the pedicle puncture needle is easy to screw in, with low resistance and less damage to the surrounding soft tissue; the scale on the needle can indicate the depth of the needle insertion. The combined clamping head formed by the hinged connection of the two clamping heads can ensure the stable connection with the connecting rod when the directions of the two pedicle puncture needles are inconsistent. The handle is made of materials that can transmit X-rays. The doctor determines the position of the pedicle of the patient under the fluoroscopy of the C-arm X-ray machine. When the pedicle puncture needle is screwed into the pedicle, the X-rays can pass through the handle. Does not affect observation. The knurling of the outer surface of the connecting rod and the knurling of the upper section of the outer surface of the extension rod can not only increase the friction force connected with the corresponding parts or the friction force of the hand, but also increase the aesthetic feeling.

Description of drawings

Fig. 1 is the diagram of pedicle puncture needle;

Figure 2 is a diagram of the extension rod;

Fig. 3 is a connecting rod diagram;

Fig. 4 is a handle diagram;

Figure 5 is a schematic diagram of a combined clamping head;

Fig. 6 is a combination view of the handle and the pedicle puncture needle;

Fig. 7 is a combination view of the extension rod and the pedicle puncture needle;

Fig. 8 is a combination diagram of two pedicle puncture needles, a connecting rod and a combined clamping head;

Figure 9 is a top view of Figure 8;

Fig. 10 is a diagram of another embodiment of the pedicle puncture needle.

Fig. 11 is a diagram of a conventional pedicle puncture needle.

Detailed ways

Example 1

Referring to the accompanying drawings, the embodiment has two pedicle puncture needles 1, a handle 5, two extension rods 2, a connecting rod 3 and two combined clamping heads 4. Also equipped with fastening tools.

As shown in Figure 1, the total length of the pedicle puncture needle 1 is 153 mm, the middle part of the pedicle puncture needle 1 is in the shape of a truncated cone, the length L is 36 mm, the diameter D of the large end of the middle part of the truncated cone is 6 mm, and the diameter of the small end is d 5mm, the taper is 1:36. The rear part 1-3 is a cylinder with a diameter of 6mm. The length of the front part 1-1 of the pedicle puncture needle is 15 mm, and the front part 1-1 is an extension of the middle part of the truncated cone shape, and an external thread is processed on the front part of the truncated cone shape; Pyramidal or conical. The rear part of the pedicle puncture needle 1 has a scale line 1-3-1; a positioning plane 1-3-2 and a positioning groove 1-3-3 are also provided.

As shown in Figure 2 and Figure 7, the extension rod 2 is provided with an insertion hole 2-1 matched with the pedicle puncture needle 1, the extension rod 2 is inserted into the pedicle puncture needle 1, and the outer surface of the extension rod 2 Knurled top. The extension rod 2 lengthens the pedicle puncture needle 1, and increases the moment arm when the pedicle puncture needle 1 applies force.

As shown in Fig. 3, the connecting rod 3 is a round rod with knurling on the outer surface. The connecting rod 3 is positioned on the two pedicle puncture needles 1 .

See Figure 4 and Figure 6, the handle 5 is made of materials that can transmit X-rays, such as wood, plastic, etc., and the handle 5 is provided with a jack 5-1 and a stopper that match the pedicle puncture needle 1 The screw hole, the jack 5-1 is an incomplete round hole. The handle 5 is inserted into the pedicle puncture needle 1 , and the head screw 6 abuts in the positioning groove 1-12-3 of the pedicle puncture needle 1 to ensure the connection between the handle 5 and the pedicle puncture needle 1 .

See Figure 5, Figure 8 and Figure 9, the combined clamping head 4 has two L-shaped clamping heads 4-1 with basically the same structure, consisting of a base 4-11 and a back 4-12, the clamping head 4-1 The base 4-11 is provided with an axial clamping hole 4-11-1 matched with the pedicle puncture needle 1, and an axial opening groove 4-11-2 communicating with the axial clamping hole 4-11-1 And through the radial bolt hole 4-11-3 of the axial opening groove 4-11-2, the bolt hole 4-11-3 is provided with an inner hexagon bolt 4-2, and the back 4 of the two clamping heads 4-1 -12 is pinned by the pin shaft 4-3, and the pin shaft 4-3 can be integrated with one of the clamping heads, or it can be a separate pin shaft; the pin shaft 4-3 can be connected between the two clamping heads 4-1 Make 360° relative rotation for the central axis.

The combined clamping head 4 passes through one of the clamping holes 4-11-1 on the connecting rod 3, and the other clamping hole 4-11-1 is used to place the pedicle puncture needle 1 to connect the pedicle The effect of the puncture needle 1 and the connecting rod 3 is that after the bolts 4-2 in the two bolt holes 4-11-3 are tightened, the pedicle puncture needle 1 and the connecting rod 3 are all fixed with the clamping head 4-1.

The doctor fixes the position of the pedicle of the patient under the fluoroscopy of the C-arm X-ray machine, installs the handle 5 on the first pedicle puncture needle 1, screws the puncture needle 1 into the pedicle, reaches the vertebral body, and removes the handle 5. Install the handle 5 on the second pedicle puncture needle 1, screw the puncture needle 1 into the pedicle, reach the vertebral body, and remove the handle 5. Connect the two extension rods 2 to the two pedicle puncture needles 1 respectively. The doctor places the top of the extension rod 2 with his hand, and uses the intervertebral joint with a complete rear structure as the fulcrum for prying and resetting. Separation tension is generated in front of the vertebral body, reset under prying, loosely connect the connecting rod and pedicle puncture needle with the combined clamping head, and observe the satisfactory reset under the C-arm X-ray machine. The combined clamping head connected with the connecting rod and the pedicle puncture needle is locked with a fastening tool, that is, an Allen wrench, to fix the two puncture needles, maintain the position after the fracture is reduced, and inject bone cement into the vertebral body In the inner space, after 15 minutes, remove the reset fixation device, pull out the puncture needle, and you can go to the ground 3 days after the operation.

Example 2

Referring to Fig. 1, the total length of the pedicle puncture needle 1 is 160 mm, the middle part of the pedicle puncture needle 1 is in the shape of a truncated cone, the length L is 45 mm, the diameter D of the large end of the middle part of the truncated cone is 6 mm, and the diameter of the small end is d 5mm, the taper is 1:45. The rear part 1-3 is a cylinder with a diameter of 6mm. The front part 1-1 of the pedicle puncture needle is an extension of the middle part of the truncated cone, the length of the front part 1-1 is 15mm, and an external thread is processed on the front part of the truncated cone. All the other are identical with embodiment 1.

Example 3

As shown in Figure 20, the total length of the pedicle puncture needle 1 is 150 mm, the middle part of the pedicle puncture needle 1 is in the shape of a truncated cone, the length L is 30 mm, the diameter D of the large end of the middle part of the truncated cone is 6 mm, and the diameter of the small end is d 5mm, the taper is 1:30. The rear part 1-3 is a cylinder with a diameter of 6mm. The front part 1-1 of the pedicle puncture needle is a cylinder, the length of the front part 1-1 is 14 mm, and the front part 1-1 of the cylinder is processed with threads. All the other are identical with embodiment 1.

Example 4

Referring to Figure 20, the total length of the pedicle puncture needle 1 is 155 mm, the middle part of the pedicle puncture needle 1 is in the shape of a truncated cone, the length L is 36 mm, the diameter D of the large end of the middle part of the truncated cone is 6 mm, and the diameter of the small end is d 5mm, the taper is 1:36. The rear part 1-3 is a cylinder with a diameter of 6mm. The front part 1-1 of the pedicle puncture needle is a cylinder, the length of the front part 1-1 is 16 mm, and the front part 1-1 of the cylinder is processed with threads. All the other are identical with embodiment 1.

Claims (13)

1, a kind of percutaneous sled is dialled the vertebral body reduction instrument, has two pedicle of vertebral arch puncture needles (1), it is characterized in that this apparatus also has:

Two are used for pedicle of vertebral arch puncture needle (1) lengthening to increase the extension bar (2) of the arm of force;

One is used for the two localized pitmans of pedicle of vertebral arch puncture needle (1) (3);

Two connect the combination type clamping head (4) of pedicle of vertebral arch puncture needle (1) and pitman (3).

2, percutaneous according to claim 1 sled is dialled the vertebral body reduction instrument, it is characterized in that: this apparatus also has one and cooperates with pedicle of vertebral arch puncture needle (1) and can be through the handle (5) of x-ray.

3, percutaneous according to claim 1 and 2 sled is dialled the vertebral body reduction instrument, it is characterized in that: the length of pedicle of vertebral arch puncture needle front portion (1-1) is between 12～18mm and be provided with screw thread; The middle part of pedicle of vertebral arch puncture needle (1-2) is a circular cone shape.

4, percutaneous sled according to claim 3 is dialled the vertebral body reduction instrument, it is characterized in that: (1-2) tapering at the circular cone shape middle part of pedicle of vertebral arch puncture needle is between 1: 45～1: 30.

5, percutaneous sled according to claim 4 is dialled the vertebral body reduction instrument, and it is characterized in that: pedicle of vertebral arch puncture needle front portion (1-1) can be the extension at circular cone shape middle part, promptly is provided with external screw thread on the front portion of circular cone shape (1-1); Pedicle of vertebral arch puncture needle front portion (1-1) also can be cylindric, promptly is provided with external screw thread on columned front portion (1-1).

6, percutaneous sled according to claim 5 is dialled the vertebral body reduction instrument, and it is characterized in that: pedicle of vertebral arch puncture needle rear portion (1-3) is provided with plane of orientation (1-3-2) and locating slot (1-3-3); Has graduation mark (1-3-1) on the pedicle of vertebral arch puncture needle (1).

7, percutaneous sled according to claim 1 and 2 is dialled the vertebral body reduction instrument, it is characterized in that: combination type clamping head (4) has two L type clamping heads (4-1), the base (4-11) of clamping head (4-1) is provided with the axial clamping hole (4-11-1) that matches with pedicle of vertebral arch puncture needle (1), the shaft orientation opening groove (4-11-2) that communicates with axial clamping hole (4-11-1) and the radial bolts hole (4-11-3) of passing shaft orientation opening groove (4-11-2), is provided with bolt (4-2) in the bolt hole (4-11-3); The back (4-12) of two clamping heads (4-1) is by bearing pin (4-3) pin joint and can do to make 360 ° of central shaft with bearing pin (4-3) and relatively rotate.

8, percutaneous sled according to claim 2 is dialled the vertebral body reduction instrument, it is characterized in that: handle (5) is provided with the jack (5-1) that matches with pedicle of vertebral arch puncture needle (1) and ends a screw hole (5-2), be grafting between handle (5) and the pedicle of vertebral arch puncture needle (1), fixing by ending a screw (6), make the material of handle (5) and take wooden, plastics.

9, percutaneous sled according to claim 1 and 2 is dialled the vertebral body reduction instrument, and it is characterized in that: extension bar (2) is provided with the spliced eye (2-1) that matches with pedicle of vertebral arch puncture needle (1), the upper semisection annular knurl (2-2) of extension bar (2) outer surface; The outer surface annular knurl of pitman (3).

10, a kind of pedicle of vertebral arch puncture needle is characterized in that: the length of pedicle of vertebral arch puncture needle front portion (1-1) is between 12～18mm and be provided with screw thread, and pedicle of vertebral arch puncture needle middle part (1-2) is a circular cone shape.

11, pedicle of vertebral arch puncture needle according to claim 10 is characterized in that: the tapering at the circular cone shape middle part (1-2) of pedicle of vertebral arch puncture needle is between 1: 45～1: 30.

12, pedicle of vertebral arch puncture needle according to claim 11 is characterized in that: pedicle of vertebral arch puncture needle front portion (1-1) can be the extension at circular cone shape middle part, promptly is provided with external screw thread on the front portion of circular cone shape (1-1); Pedicle of vertebral arch puncture needle front portion (1-1) also can be cylindric, promptly is provided with external screw thread on columned front portion (1-1).

13, pedicle of vertebral arch puncture needle according to claim 12 is characterized in that: the rear portion of pedicle of vertebral arch puncture needle (1-3) is provided with plane of orientation (1-3-2) and locating slot (1-3-3); Has graduation mark (1-3-1) on the pedicle of vertebral arch puncture needle (1).

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