CN203252731U - Personalized fixing auxiliary device in lumbar vertebra - Google Patents

Abstract

The utility model relates to a personalized fixing auxiliary device in the lumbar vertebra. The device comprises guide holes, sleeves and a connecting body. The number of the guide holes is two, the number of the sleeves is two, the sleeves are located in the guide holes, and the connecting body is connected with the guide holes on two sides. The personalized fixing auxiliary device in the lumbar vertebra is used for accurate implantation of a pedicle screw, and is convenient and easy to use.

Description

A personalized lumbar internal fixation auxiliary device

technical field

The invention relates to the field of medical devices, in particular to a personalized auxiliary device for internal fixation of the lumbar spine, and the auxiliary device is used for accurate implantation of pedicle screws. the

Background technique

Biomechanical experiments have proved that the stability of the screw-rod system and the ideal clinical efficacy can only be guaranteed if the screw is accurately placed along the only anatomical long-axis channel of the pedicle and reaches the ideal depth [LAW M, TENCERAF, ANDERSON P A.Caudo- cephalad loading of pedicle screws: mechanisms of loosening and methods of augmentation. Spine, 1993, 18(16): 2438-2443], this uniqueness increases the difficulty of the operation. In order to improve the accuracy of pedicle screw placement, scholars at home and abroad have conducted many related studies on the position, angle, and depth of screw insertion. Such studies have made physicians realize that the large variability in the shape of the pedicle itself is one of the most important reasons why the error rate of screw placement is always unsatisfactory. the

Trend analysis found that the distance between the pedicles, the width of the pedicles, and the cross-sectional angle of the pedicles showed a significant increasing trend from the high position to the low position of the lumbar spine. The larger the abduction angle, the greater the weight and power transmission of the entire spine. On the other hand, the sagittal diameter of the vertebral foramen and the sagittal angle of the pedicle gradually decrease with the downward movement of the vertebral body, which is considered to be related to the structure and function of the human spinal cord and the physiological curvature of the spine. the

At the same time, the study also found that L5 is significantly different from the other 4 segments in most indicators, that is, the morphological structure of L5 is significantly different from other lumbar vertebrae. The pre- and post-operative evaluation has important reference value. the

The specific morphological structure of the lumbar spine varies not only in different positions of the spine of the same individual, but also in different populations of lumbar spine. Therefore, when performing the pedicle screw technique, it is necessary to consider the difference in the structure of the patient's lumbar spine and choose a guide template suitable for him, so as to achieve the purpose of better treatment of the patient. Therefore, it is not difficult for us to conclude that in the field of spine-related diseases, personalized treatment is an important method to reduce surgical complications and improve curative effect. the

2002，31(4)：368-371]。通过部分椎板切除直视下进行椎弓根螺钉置入可提高置钉的准确性和安全性用。但该法同样对术者的经验要求较高，同时椎板开窗不可避免地会增加手术时间及术中出血量。X线透视辅助法存在手术操作时间长，患者及手术者术中受X线辐射量较大等不足，且因椎体骨骼外形复杂、X线透视角度不同及伪影的存在，具有很高的假阳性率和假阴性率，Weinstein[WEINSTEIN J N，SPRATT KF，SPENGLER D，et al.Spinal pedicle fixation：reliability and validity of roentgenogram-based assessment and surgical factors on successful screw placement.Spine，1988，13(9)：1012-1018]对解剖标本椎弓根螺钉置入的精确性进行研究分析，发现有21％的穿破椎弓根皮质。说明此种置钉方法实际上很难提高一次置钉成功率。  Currently, the commonly used screw placement methods mainly include: anatomical landmark method, lamina fenestration method, X-ray fluoroscopy-assisted method, computer-aided navigation method, etc. Although various anatomical landmark point methods have different nail entry points and angles. But what they have in common is that the entry point and direction of the pedicle screw are mainly judged by the operator's experience, and the pedicle screw is ensured mainly by the operator's feel and the pedicle probe's detection of the opposite screw channel. Accurate screw placement, related research reports, the screw misplacement rate of the anatomical landmark method is about 20%-30% [SCHULZE C J, MUNZINGER E, WEBER U. Clinical relevance of accuracy of pedicle screw placement. A computed tomographic-supported analysis.Spine, 1998, 23(20): 2215-20], the misplacement rate of thoracic pedicle screws can even be as high as 40% [REICHLE E, SELLENSCHLOH K, MORLOCK M, et al.Placement of pedicle screws using different navigation systems.A laboratory trial with12spinal preparations.DER

2002, 31(4): 368-371]. Pedicle screw placement under direct vision through partial laminectomy can improve the accuracy and safety of screw placement. However, this method also requires high experience of the operator, and at the same time, lamina fenestration will inevitably increase the operation time and intraoperative blood loss. The X-ray fluoroscopy-assisted method has the disadvantages of long operation time, large amount of X-ray radiation to the patient and the operator during the operation, and because of the complex shape of the vertebral body, different X-ray perspective angles and the existence of artifacts, it has a high risk. False positive rate and false negative rate, Weinstein [WEINSTEIN J N, SPRATT KF, SPENGLER D, et al. Spinal pedicle fixation: reliability and validity of roentgenogram-based assessment and surgical factors on successful screw placement. Spine, 1988, 13(9) : 1012-1018] The accuracy of pedicle screw placement in anatomical specimens was analyzed and found that 21% of the pedicle cortex was penetrated. It shows that this method of nail placement is actually difficult to improve the success rate of nail placement at one time.

In recent years, the computer-aided navigation method has gradually been applied in the internal fixation of lumbar pedicle screws. This method allows the operator to use the patient's real-time pedicle imaging information to guide the operation in real time. It is prospective and real-time. The technique of guiding pedicle screw placement has achieved great success. Relevant reports have shown that the misplacement rate of screw placement using computer-aided navigation technology can be significantly reduced, reducing the risk of nerve damage and reducing the time for both doctors and patients to be exposed to radiation. , which has incomparable advantages over other methods. However, the positioning and navigation equipment for spinal pedicles is expensive, requires high equipment, takes a long learning period, and is prone to errors when registering on the surface of the vertebral body. The method of placing nails with other advantages. the

Contents of the invention

In order to reduce the error rate of pedicle screw implantation caused by differences in vertebral body anatomy, the invention discloses a personalized lumbar internal fixation auxiliary device. the

The above-mentioned personalized lumbar internal fixation auxiliary device includes: a guide hole, a casing, and a connecting body. There are two guiding holes and two casings, wherein the casing is located in the guiding hole, and the connecting body connects the guiding holes on both sides. The casing is of multiple specifications, and its outer diameter has the same length, and its inner diameter has various sizes according to requirements, among which the inner diameter is preferably 0.5-20 mm. The surface of the connecting body is a structure that can complementarily connect with the surface of the posterior vertebral plate and the spinous process of the vertebral body. the

The material of the personalized lumbar internal fixation auxiliary device is metal titanium or photosensitive resin, wherein metal titanium is preferred. the

The personalized lumbar internal fixation auxiliary device prepared by the present invention has the following beneficial effects:

1) The accuracy rate of screw placement, screw acceptance rate and surgical safety are high;

2) The average operation time is shortened, the efficiency is improved, and the risk of exposure infection is reduced;

3) The device described in the operation is convenient and simple to use. It only needs to fit the device closely to the corresponding anatomical structure to complete the accurate positioning and orientation of the operation area, and it can be operated safely by those who lack internal fixation experience;

4) The personalized lumbar internal fixation auxiliary device will not cause positioning failure due to body position changes during the operation and relative displacement between adjacent vertebral bodies. The patient's body position can be changed arbitrarily during the operation to avoid the navigation from affecting its accuracy when the patient's body position changes. sex;

5) It can also be used for patients with degeneration, deformity and hyperplasia of bony structures, and patients who have difficulty in locating anatomical landmarks;

6) It does not require other computer navigation systems and other equipment, and does not occupy a corresponding special space in the operating room; it is convenient for disinfection, as long as the personalized lumbar internal fixation auxiliary device is brought into the operating room and sterilized with ethylene oxide before the operation. the

Description of drawings

Fig. 1 overall schematic diagram of a personalized lumbar internal fixation auxiliary device;

Fig. 2 Schematic diagram of matching of personalized lumbar internal fixation auxiliary device and vertebrae during use. the

Detailed ways

The present invention will be further described below in conjunction with the accompanying drawings. The following examples are only preferred implementations of the present invention, and are not limitations of the present invention. the

As shown in Figure 1, the personalized lumbar internal fixation auxiliary device of the present invention includes: a guide hole 1, a connecting body 2, and a sleeve 3, the guide hole 1 is two, the sleeve 3 is two, and the connecting body is connected Pilot holes on both sides. the

Among them, the casing is multi-standard, and its outer diameter is the same as the length of the guide hole; the inner diameter of the casing has various sizes according to the requirements, and the inner diameter of the casing is preferably 0.5-20mm; when used, the casing is inserted into the guide hole. In the hole, replace the cannula of different specifications according to the operation needs. the

The surface of the connecting body is a structure that can complementarily connect with the surface of the posterior vertebral plate and the spinous process of the vertebral body. the

Claims (4)

1. A personalized lumbar internal fixation auxiliary device, characterized in that, the personalized lumbar internal fixation auxiliary device comprises: a guide hole, a sleeve, and a connector; wherein the sleeve is located in the guide hole, and the connector connects both sides pilot hole. the 2. The personalized lumbar internal fixation auxiliary device according to claim 1, characterized in that: the sleeve has various specifications, the outer diameter of the sleeve is the same in length, and the inner diameter is 0.5-20mm. the 3. The personalized lumbar internal fixation auxiliary device according to claim 1, characterized in that, the surface of the connecting body is a structure that can complementarily connect with the surface of the posterior lamina and spinous process of the vertebral body. the 4. The personalized lumbar internal fixation auxiliary device according to any one of claims 1-3, characterized in that, the material of the device is metal titanium or photosensitive resin. the

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