CN2045272U - Ct guide brain stereo-orientation apparatus for skull pore-drilling - Google Patents

Abstract

The utility model belongs to a medical instrument, in particular to a CT guide brain stereo-orientation apparatus for skull pore-drilling, which comprises a fixing bed frame, a rotary guide tool and a skull guiders. The fine hole drilling technique can be applied on skull by using the CT guide brain stereo-orientation apparatus for skull pore-drilling, which makes the scalp be drilled without knife edge, the pain of the sick is reduced, the operative procedure is simplified, and the operation time is shortened. Further more, the CT guide brain stereo-orientation apparatus for skull pore-drilling has the advantages of simple structure and convenient operation, which can be used for the clinical diagnosis and the therapy of the pathological changes of the pars encephalica in neurosurgery.

Description

The utility model belongs to a medical device, in particular to a brain stereotaxic instrument.

Brain stereotaxy is a new technology developed in the past forty years. Since its inception, it has been used in neurosurgery. In the early 1970s, computerized tomography (CT) came out and was used clinically, which opened up a broad prospect for the application of traditional stereotaxic technology. CT can clearly display the shape, location and size of intracranial anatomical structures and lesions, and provide accurate three-dimensional data. The combination of stereotaxic surgery and this new neuroimaging technology makes directional surgery more accurate, effective, safe and rapid, greatly improves the success rate of surgery, and expands the scope of application. The application of CT-guided stereotaxy requires a brain stereotaxic instrument suitable for CT scanners. According to foreign literature reports, the CT-guided stereotaxic instruments currently used in the world include Leksell directional system, Patil directional system, Bennetl stereotaxic instrument, Montagno stereotaxic instrument, B·R·W directional system, etc., which use Cartesian coordinates, The principles of cylindrical coordinates and spherical coordinates are complex in structure, bulky, and cumbersome in data calculations. Most of them require expensive equipment, and surgical operations need to drill bone holes in the skull.

The purpose of the utility model is to provide a CT-guided micro-hole drilling craniocerebral stereotaxic instrument with simple structure, convenient operation, accurate positioning, simple data calculation, and little damage to the human body, and a positioning head frame used in conjunction with the orienting instrument. .

The utility model is achieved in that it consists of a disk with a central axis, and there are at least three fixed bases formed by fixed arms fixed with the disk as a whole around the disk. The base, the vertical ruler The rotary guide instrument composed of a level ruler, a C-shaped arm and a vernier thereon and a cranial drill guide composed of a proximal club, a distal club and a double-ball splint connecting the two are composed of three parts.

The specific structure of the said fixed base frame of the utility model is: it is made of a disc with a central shaft, and its central shaft protrudes from an end face of the disc, and an annular groove is arranged on the central shaft. There are at least three fixed arms that are fixed as a whole around the disk. The front end of the fixed arm has a pointed screw that is threadedly connected with the fixed arm, and the rear end of the fixed arm is processed with a positioning hole. The fixed arm can be three, and its shape is arcuate, is convenient to make the included angle screw of fixed arm front end be fixed on the patient's skull like this. The best fixation method with three fixed arms is: one forearm, two original arms, the angle between the two rear arms is 60-80°, the angle between the forearm and the adjacent rear arm should be equal, Constituting the disk of this fixed base frame, also be fixed with an angle disk on that end face that its central axis protrudes, and angle is 360 °, and its O angle line passes the center of circle of forearm positioning hole, to facilitate positioning. Angle discs can also be engraved directly on the disc.

The orientation instrument of the utility model is constituted as follows: it has a truncated circular base, the lower end surface of the base has a central hole which is slidingly matched with the central axis of the fixed base frame, and the side has an annular groove corresponding to the central axis of the fixed base frame. Cooperating screws make the base and the fixed base frame connected as a whole. One end of the vertical ruler with scale is fixed on the upper end surface of the base, perpendicular to the end surface of the base, a vernier sliding on it is installed on the vertical ruler, and a horizontal ruler perpendicular to the vertical ruler is fixedly connected to the vernier. , there is also a scale on the level. A horizontal sliding vernier is also housed on the level, and the horizontal sliding vernier is connected with the C-shaped arm through the shaft sleeve structure, and the C-shaped arm can rotate 360° around the connecting shaft. The C-shaped arm is a part arc of a specific circle, and a vernier is also arranged on the C-shaped arm. There is a hole pointing to the center of the circle where the C-shaped arm is located on the vernier, and the double-clamp biopsy needle passes through this hole during sampling. There is a scale line on the base at the intersection of the vertical plane where the center line of the level bar is located and the base, and this scale line is the O scale starting line for the rotation of the rotary pilot instrument. After the rotary guide instrument is installed. When the vernier on the vertical ruler is on the O scale line of the vertical ruler, the center of the circle where the C-arm is located should be on the plane where the dial is located. When the horizontal vernier is on the 0 scale line of the spirit level, the center line connecting the C-arm bushing coincides with the center axis on the fixed base frame. To facilitate operation.

The cranial drill guide of the present utility model is constituted like this: it has near-end club and far-end club, and these two clubs all have one end as sphere, and this sphere is clamped screw respectively through double-ball splint. Hold on both ends of the double ball splint. The other end of the club at the proximal end is plate-shaped, with a connecting hole on it, through which the connecting screw and the positioning hole on the fixing base are connected as a whole with the fixing base. The other end of the distal club is a guide ball splint, in which the guide ball with a central hole is clamped. There is a guide ball fixing screw on the top of the guide ball splint to position the guide ball and define a fine hole for cranial drilling. position and direction.

The using method of this CT thin-hole drilling craniocerebral stereotaxic instrument is: earlier fixed base frame is fixed on the cranium of patient's head by the tip screw of its fixed arm front end, then goes to CT room to do X-ray scan. During scanning, the patient's head should be fixed on the CT bed through a fixed base frame fixed on the patient's head. When fixing, it should be ensured that the 0-180° line and the 90-270° line on the angle plate of the fixed base frame are parallel to the x and y axes on the CT respectively, and the axis of the central axis on the fixed base frame is parallel to the Z-axis of the CT scanner. That is, when scanning, ensure that each scanning plane is parallel to the plane where the angle disc is located. Then scan with the plane where the angle disc is located as the reference plane. When scanning, it is necessary to record the distance between each scanning plane and the reference plane, and print the positions of the 0-180° line and the 90-270° line on the scanning film. Since the patient's lesion is determined according to the scan film, after the patient's lesion is determined, the patient is allowed to enter the operating room, and the rotary steerer is installed. The side screws on the base of the rotator guide the rotator in place. According to the distance from the lesion to the intersection of the 0-180° line and the 90-270° line, the distance can be determined on the level with its horizontal vernier. According to the distance from the lesion to the plane of the angle disc, the vertical distance can be determined by the vernier on the vertical ruler. At this time, the lesion is located at the center of the circle where the C-arm is located. Use the C-arm and the vernier on the C-arm to find the best point for drilling, which should be in a non-vital area of the brain. To fix the cranial drill guide, pass the connection hole on the proximal ball rod of the cranial drill guide through the screw and the positioning hole on the fixed base frame, connect it to the fixed base frame, and connect the guide ball on the distal ball rod The direction of the hole on the guide hole on the C-shaped arm is consistent with the direction of the hole on the vernier on the C-shaped arm, and then the proximal club and the fixed base frame are fixed by the connecting screws. Secure the two clubs through the screws on the double ball cleat. Then the guide ball is clamped by the screw at the end of the guide ball splint, and then the C-shaped arm is removed, and a small-hole cranial drill is used to drill a hole in the skull according to the direction of the guide hole. After the hole is drilled, the C-arm is moved back, and the guide hole on the C-arm vernier and the radius of the circle where the C-arm is located can be used for sampling and testing with a biopsy needle. Diagnose and treat lesions based on test results.

In order to make the fixation between the fixed base frame and the CT bed more convenient, the 0-180° line and the 90-270° line on the angle plate can be displayed on the X-ray scanning film by using signs, and the plane where the angle plate is located can be displayed. The distances from each scanning plane are displayed on the X-ray scanning film, and the utility model also provides a fixed head frame which is used in conjunction with the CT fine-hole drilling craniocerebral stereotaxic instrument. This fixed head frame is made up like this: it comprises a hood that is made of tetrahedron, octahedron or dodecahedron, on the hood one end is fixed with bottom surface, and the central axis of fixing base frame is processed on this bottom surface Slip-fit circular holes and positioning holes corresponding to the positioning holes on the fixed base frame. Positioning strips are respectively fixed on the upper and lower sides of the hood. On a certain section, the connecting line of the upper and lower positioning strips should coincide with the 0-180° line on the angle plate. The ground on the left and right sides of the hood is also fixed with positioning strips, and the connection line of the left and right side positioning strips on a certain section should coincide with the 90-270 ° line on the angle plate. The side of the hood is also fixed with a measuring rod at a certain angle with the positioning bar. The optimal angle between the positioning bar and the measuring rod is 45°, so that each scanning plane can be calculated using the principle of the right-angled three shapes at 45° distance from the datum. The lower side of the head cover is fixed with a fixed support frame fixedly connected with the CT bed. There is a round hole and an oval hole on it, which are combined with the insertion rod at the head of the CT bed. There is a disc-shaped screw below the round hole for fixing.

The utility model can precisely locate the lesion of the patient, therefore, its application can replace the method of trepanning the skull widely used in the world with the method of drilling the skull with fine holes, and its advantage is that the patient's skull has no large wound, so the damage is small . Solved the problem of less invasive biopsy and treatment. Secondly, the diameter of the bone hole drilled by the fine-hole cranial drill is generally only 3mm, so the loss of cerebrospinal fluid can be avoided, thereby solving the problem of brain displacement due to the loss of too much cerebrospinal fluid due to the trepanation of the skull hole, and it can also improve the efficiency of stereotaxic surgery. accuracy. The orientation instrument has a simple structure and is convenient to operate, and can be applied without processing by an electronic computer, which greatly speeds up the operation speed and reduces the pain of the patient.

Fig. 1 is a structural diagram of a CT-guided fine hole drilling cranial stereotaxic instrument;

Fig. 2 is A-A sectional view of Fig. 1;

Fig. 3 is a structural diagram of an orienting head frame;

Fig. 4 is the B direction view of Fig. 3;

Fig. 5 is a CT scan film after installing the directional head frame.

In the figure, 1 is the tip screw; 2 is the fixed base frame; 3 is the vertical ruler; 4 is the vernier of the vertical ruler; 5 is the vernier of the horizontal ruler; 6 is the horizontal ruler; 7 is the C-shaped arm; Screw; 10 is the proximal club; 11 is the clamping screw; 12 is the guide ball clamping screw; 13 is the double ball splint; 14 is the positioning hole; 15 is the angle plate; 16 is the far-end club; 17 is the guide ball ; 18 is a C-shaped arm cursor; 19 is a rotation guide instrument base; 20 is a fixed arm; 21 is a positioning hood connection support frame; 22 is a lower side positioning bar, and 23 is a hood; 24 is a right positioning bar; 25 26 is an upper side positioning bar; 27 is a positioning hole; 28 is a round hole that slides with the central axis on the fixed base frame; 29 is a left side positioning bar.

Describe below in conjunction with accompanying drawing, fixed pedestal (2) is formed by stamping of steel plate, also can machining manufacture, the fixed arm (20) that stamps on it with steel plate can be stamped out together. If it is machined and processed, the central axis on it can be processed together with the disk. The angle plate (15) on the fixed base frame (2) can be fixed on the disc of the fixed base frame (2) by bonding, and the angle can also be directly engraved on the disc of the fixed base frame (2). The connection between the base (19) and the vertical ruler (3) is a screw connection. The vertical ruler (3) and the horizontal ruler (6) are made of tool steel, and the accuracy of the scale on it can preferably reach 0.02mm. more precise positioning. The connection between the vertical cursor (4) and the level ruler (6) is a fixed connection by means of screws or welding. When connecting, the perpendicularity between the level ruler (6) and the vertical ruler (3) must be ensured. The C-shaped vernier ruler (7) ) should be an arc of a particular circle. The hood (23) of the fixed head frame is made of transparent materials, such as plexiglass or plastic bonding, and can also be injection molded. The positioning strips (22), (24), (26), (29) and measuring rods (25) on the hood (23) are made of plexiglass or plastic, and can be glued on the hood (23), or directly Made into one with hood (23). Support frame (21) on it can be made into one with hood (23), also can make separately, and then it is fixed on the hood (23) with bonding or screw and gets final product. The a-a line and b-b line in Fig. 5 are the lines coincident with the 0-180° line and the 90-270° line of the angle plate respectively, and the intersection point of the two lines is the center of the central axis on the fixed base frame (2) , the distance between the center axis of the lesion fixing base frame (2) and the angle of the angle disc (19) where the lesion is located can be accurately measured according to the dot. Utilize the distance between the measuring rod and the positioning bar on the negative film of Fig. 5 and utilize the principle of a right triangle to calculate the distance between the plane where the dial is located and the scan chart. Using the above measurement and calculation data, the directional instrument can be used to accurately locate the lesion, drill holes, take samples, and then carry out laboratory tests.

Claims (6)

1, CT guiding micro-hole drilling craniocerebral stereotaxic apparatus, it is characterized in that: it is caused by a disc with central axis and at least three fixed arms (10 ) constitutes a fixed base frame (2); consists of a base (19), a vertical ruler (3), a horizontal ruler (5), a C-shaped arm (7) and a vernier (4), (5), (18) The rotation guide instrument and the cranial drill guide composed of the near-end club (10), the distal club (16) and the double-ball splint (13) connecting the two clubs into one form are composed of three parts. 2. The CT-guided fine-hole drilling craniocerebral stereotaxic instrument according to claim 1, characterized in that: the specific structure of the fixed base frame (2) is that it consists of a disc with a central axis, Its central shaft protrudes from an end face of the disc, and an annular groove is arranged on the central shaft, and there are at least three fixed arms (20) fixed with the disc around the disc, the fixed arms (20) The front end has a pointy screw (1) threaded with the fixed arm, and the rear end of the fixed arm (20) has a positioning hole (14); an angle plate is also fixed on the disc of the fixed base (2) (15). 3. The CT-guided fine-hole drilling craniocerebral stereotaxic instrument according to claim 1 is characterized in that the specific structure of said rotary steering instrument is that it has a frustum-shaped base (19), the base (19) The lower end surface has a central hole that slides with the central shaft on the fixed base frame (2), and the side of the base (19) has a screw that matches the annular groove on the central shaft of the fixed base frame (2); One end of the vertical ruler (3) with scale is just vertically fixed on the upper end face of the base (19), and a vernier (4) sliding thereon is housed on the vertical ruler (3), and a vernier (4) is fixedly connected with a vertical The horizontal ruler (6) perpendicular to the chi (3) has a scale on the horizontal ruler (6), and a vernier (5) is also installed on the horizontal ruler (6), and the vernier (5) is connected to the C-shaped arm through the shaft sleeve structure (7) connected as a whole, the C-shaped arm is a part of the arc of a certain circle, and it can rotate 360° around its connecting axis; A scale line is arranged on the seat (19), and this scale line is the O scale starting line that the rotary steerer instrument rotates. 4. The CT-guided fine-hole drill cranial stereotaxic instrument according to claim 1, characterized in that: said cranial drill guide is constructed in such a way that it has a proximal ball rod (10) and a distal end Club (16), these two clubs all have one end to be sphere, and this spheroid is respectively clamped on the two ends of double-ball splint (13) by the screw (11) in the middle of double-ball splint (13), near end The other end of club (10) is plate-shaped, has a connecting hole on it, through this connecting hole, connecting screw (9) and positioning hole (14) on the fixed base frame (2) and fixed base frame (2) The other end of the far-end club (16) is a guide ball splint, the guide ball (17) with a central hole is clamped in it, and the top of the guide ball splint is equipped with a guide ball (17) for positioning screw (12). 5. The CT-guided fine-hole drilling craniocerebral stereotaxic instrument according to claim 2, characterized in that: there are three fixed arms (20) on the fixed base frame (2), which are bow-shaped and divided into one forearm, There are two rear arms, the angle between the two rear arms is 60-80°, and the angle between the forearm and the adjacent rear arm is equal. 6. The CT-guided fine-hole drilling craniocerebral stereotaxic instrument according to claim 1, characterized in that: the structure of the directional head frame used in conjunction with the directional instrument is that it includes a hood (23), a hood (23) One end face is fixed with a bottom surface, and a garden hole (28) that is slidably matched with the central axis of the fixed base frame is processed on this bottom surface, and a positioning hole (27) corresponding to the positioning hole (14) on the fixed base frame; The upper and lower sides of the cover (23) are respectively fixed with positioning bars (26), (22), and the left and right sides of the head cover (23) are respectively fixed with positioning bars (29), (24); A measuring rod (25) which forms a certain angle with the positioning bar is also fixed on the top, and the optimum angle between the positioning bar and the measuring rod is 45°; Support frame (21).

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