CN103054623B - Foramen reaming tool used during transforaminal approach surgery under spinal endoscope - Google Patents

Foramen reaming tool used during transforaminal approach surgery under spinal endoscope Download PDF

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Publication number
CN103054623B
CN103054623B CN201310014298.7A CN201310014298A CN103054623B CN 103054623 B CN103054623 B CN 103054623B CN 201310014298 A CN201310014298 A CN 201310014298A CN 103054623 B CN103054623 B CN 103054623B
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bone
drill
cone
bone drill
protection sleeve
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CN103054623A (en
Inventor
袁健东
穆小静
刘扬波
张纯武
陈雷
白一冰
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First Affiliated Hospital of Wenzhou Medical University
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First Affiliated Hospital of Wenzhou Medical University
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Abstract

The invention discloses a foramen reaming tool used during a transforaminal approach surgery under a spinal endoscope. The foramen reaming tool comprises at least one bone awl, at least one bone awl protective sleeve, a plurality of bone drills and at least one bone drill protective sleeve; each bone awl comprises a bone awl rod, a rotating handle and an awl head, the rotating handle is arranged at the tail end of the bone awl rod in a connected manner, the awl head is fixedly arranged at the head end of the bone awl rod, the bone awls include a first bone awl, and an awl head of the first bone awl is in the shape of a triangular pyramid; each bone drill comprises a bone drill rod, a rotating handle and a drill bit, the rotating handle is arranged at the tail end of the bone drill rod in a connected manner, the drill bit is fixedly arranged at the head end of the bone drill rod, and a through wire guide hole is arranged in the axial center of the bone drill; and the multiple bone drills at least include first bone drills and large-diameter bone drills, and outer diameters of the drill bits of the first bone drills and the large-diameter bone drills are sequentially increased. The foramen reaming tool has the advantages of reasonable design, capability of improving surgical safety, and the like.

Description

Intervertebral foramina reaming tool under spinal column scope in transforaminal approach operation
Technical field
The present invention relates to medical surgical instrument, specifically refer to the intervertebral foramina reaming tool in transforaminal approach operation under a kind of spinal column scope.
Background technology
Lumbar Intervertebral (pressuring nerve after intervertebral disk hernia, pressuring nerve be disc tissue, for soft tissue), (hyperosteogeny causes neural channel relative narrowness to cause Waisting cupola shape to lumbar spinal stenosis, pressuring nerve be bone tissue, for sclerous tissues) be common disease, long-standing problem patient.Current Therapeutic Method, mostly adopts open surgery, i.e. posterior lumbar spinal surgery, cut skin, peel off muscle, excision lumbar vertebra vertebral plate, by the outstanding disc tissue of pressuring nerve or osseous tissue excision (decompression) of hypertrophy, its operation wound is large, and patient recovery times is long.Along with the progress of less invasive techniques, occurred transforaminal approach operative treatment lumbar disc disease under spinal column scope, its operation wound is little, uses local anaesthesia, achieves enormous benefits.This operation needs the otch at skin lumbar vertebra side incision of skin one 8mm, Needle localization is to superior articular process of lumbar vertebra, puncture needle needs to be close to superior articular process's wall, then seal wire is inserted, then use ring to crouch cut-out superior articular process of lumbar vertebra, so just establish and enter the passage that lumbar vertebral canal carries out operation technique, then insert work sleeve, then in work sleeve, insert spinal column scope, under direct-view, carry out the excision of the excision of Lumbar intervertebral disc protrusion and the bone tissue of hypertrophy.
But the technological difficulties of this operation are Needle localization accurately, puncture needle must be close to superior articular process's wall, this difficult problem makes clinician in order to the time of the accurate at substantial that punctures, experience the X-ray examination location of tens times, huge injury is caused to patient and doctor, and, use ring to crouch and excise superior articular process, easily accidental injury is caused to crouch important soft tissue such as nerve, the blood vessel of surrounding of ring, and bring the severe complications such as lower limb muscles paralysis, massive hemorrhage, be therefore necessary that designing some operation tools improves this technology.
Summary of the invention
The object of the invention is the shortcoming and defect existed to overcome prior art, and a kind of intervertebral foramina reaming tool that can improve under the spinal column scope of the safety of spinal column endoscopic surgery in transforaminal approach operation is provided.
For achieving the above object, technical scheme of the present invention includes at least one bone cone, at least one bone cone protection sleeve, multiple bone drill and at least one bone drill protection sleeve;
Described each root bone cone includes and bores bar portion by bone, interlock is arranged at bone and bores the turning handle of bar portion tail end and be fixedly installed on the conehead that bone bores bar size end, and include the first bone cone in described bone cone, the conehead of this first bone cone is Rhizoma Sparganii taper;
Described bone cone protection sleeve comprises bone cone hollow cylinder and is fixedly installed on the bone cone protection sleeve hand part of bone cone hollow cylinder upper end, the inner bone taper via-hole being axially provided with bone cone fairlead and joining of bone cone protection sleeve;
Each described root bone drill has included bone rod portion, interlock is arranged at the turning handle of bone rod portion tail end, and be fixedly installed on the drill bit of bone drill bar size end, and the shaft core position of each root bone drill is provided with through thread eye, described many bone drills at least include outside diameter to be had little of the first large bone drill and large footpath bone drill, the drill bit of the first described bone drill comprises the positioning pluging rod being positioned at axial top, adjoining in the blunt ring portion of the first taper of positioning pluging rod tail end, and it is adjoining in the first one-way spiral drill lip portion of the blunt ring portion tail end of the first taper, the conehead external diameter that external diameter and the bone of described positioning pluging rod are bored is close and coordinates, the drill bit of described large footpath bone drill includes the blunt ring portion of large footpath taper that is positioned at axial top and adjoining in the one-way spiral drill lip portion, large footpath of large footpath taper blunt ring portion tail end,
Described bone drill protection sleeve comprises bone drill hollow cylinder and is affectedly bashful portion with the bone drill protection sleeve being fixedly installed on bone drill hollow cylinder upper end, the inner bone drill through hole being axially provided with bone drill fairlead and joining of bone drill protection sleeve.
By the instrument of this setting, carry out the intervertebral foramina perforate operation in transforaminal approach operation under spinal column scope, the first bone cone is utilized to output hole, hole in patient superior articular process position, then the first bone drill is inserted, being located inserted link navigates in hole, hole, carry out first order perforate, and then insert large footpath bone drill and expand perforate step by step, pit hole is expanded, and get out duct, and then set up operation path, because superior articular process's sclerotin of human body is hard, the instrument of this setting is adopted to expand mode perforate step by step, doctor is when operating, the relatively good control of strength of its manipulation bone drill, not only reduce operating difficulty, and be conducive to carrying out conservative control manipulation to the bit depth of bone drill, the operation non-controllable risk that effective anti-stop operation bone drill strength is suddenlyd change and brought.In addition, this setting, the drill bit of each root bone drill is provided with the blunt ring portion of taper, when holing, can not cause cutting, drastically increase operation safety to the nerve of suffering from around this superior articular process.Thread eye in the present embodiment bone drill is used for when inserting bone drill, first located by seal wire, and then insert bone drill from thread eye position, withdraw from seal wire again, the insertion making bone drill each is all accurately reliable, this seal wire is the metallic rod of band flexible, is the common tool of transforaminal approach operation under existing spinal column scope.
Further setting is that described bone cone also includes the second bone cone, and the conehead of this second bone cone is the screw conic with one-way spiral cone sword.By this setting, can bore the hole, hole outputed suitably expand the first bone, the strength making surgical manipulate bone cone more steadily and accurately.
Further setting is that described bone cone also includes bone cone of removing obstacles, and this conehead of removing obstacles bone cone is hemisphere shape.By this setting, by the first bone cone or the second bone cone, the GUSUIPIAN when excavating hole, hole pushes deep to, is conducive to the accurate location of the positioning pluging rod of the first follow-up bone drill, to realize the accurate of perforate direction.
Further setting is that bone drill also includes at least one piece central diameter bone drill of outside diameter between the first bone drill and large footpath bone drill, and the drill bit of this central diameter bone drill comprises the blunt ring portion of central diameter taper that is positioned at axial top and adjoining in the central diameter one-way spiral drill lip portion of the blunt ring portion tail end of central diameter taper.By this setting, utilize this central diameter bone drill to carry out the expansion of perforate step by step, make surgical manipulate the strength of bone cone more steadily with accurate.
Further setting also includes bone rod portion locking piece, the bone rod portion of each described root bone drill is provided with distance scale line, described bone rod portion locking piece includes the anchor ear ring with bone rod portion anchor ear adaptation, this anchor ear ring is provided with and embeds adaptive breach with bone rod portion, and this anchor ear ring is arranged the clamping screw run through inside and outside anchor ear ring.By this setting, when perforate operation, calculate in conjunction with the degree of depth of X-ray examination in art to perforate, and utilize the bone rod portion locking piece of this setting the drilling depth of bone drill to be limited, improve the safety of bone drill boring.
Further setting is that the tail end of described each root bone cone and each root bone drill is provided with interlock plug, described turning handle includes axial shaft bar and is fixedly installed on the stressed handle of rotation of axial shaft bar upper end, described axial shaft Gan Nei center is provided with axially through handle seal wire perforation, and the lower end of this axial shaft bar is provided with the interlock jack of the inserting that to link with the plug that links.Described interlock plug is positive hexagon prism, and described interlock jack is inner hexagonal hole.This setting, general both the turning handle corresponding to bone cone and bone drill is arranged to, thus decrease the quantity of operation tool, the carrying out of more convenient operation.
Further setting is described turning handle is T-shaped handle, and its center, upper surface of rotating stressed handle is provided with and perpendicularly with axial shaft bar knocks face.By this setting, when the first bone cone carries out offering hole, hole, what little hammer can be utilized to knock this turning handle knocks face, the triangular pyramid conehead of the first bone cone is knocked in the superior articular process of patient, contributes to the carrying out of accurate location to position of opening and convenient operation.
Further setting also includes bone cone protection sleeve locking piece, this bone cone protection sleeve locking piece includes the upper locking member and lower locking piece that mutual screw thread is fixedly connected with, the center of this upper locking member is provided with through hole, the periphery projection that the inner side of this upper locking member goes up through hole is relatively provided with multi-disc and embraces lobe, and the head end of this armful of lobe is provided with arcwall; The center of described lower locking piece is provided with the lower through-hole corresponding with upper through hole, and the periphery projection of the relative lower through-hole in inner side of this lower locking piece is provided with embraces lobe cover, is provided with the conical cavity with the arcwall press fit of embracing lobe in this armful of lobe cover.Pass through, this setting, utilize the opposed helical of upper locking member and lower locking piece to rotate; make an armful lobe cover constantly compressing embrace a lobe and hold action tightly, and then bone is bored protective sleeve locking, make bone cone when operation; doctor arrest bone cone protective sleeve carry out rotations bone bore time, more effectively control strength.
It is blunt nosed that further setting is that the head end of described bone drill hollow cylinder is provided with oblique arc.By this setting, contribute to protecting the nerve around patient superior articular process and soft tissue.
In sum, the present invention has reasonable in design, and improves the advantages such as the safety of having performed the operation.
Below in conjunction with specification drawings and specific embodiments, the present invention is described further.
Accompanying drawing explanation
The structural representation of Fig. 1 embodiment of the present invention bone cone;
The structural representation of Fig. 2 embodiment of the present invention bone drill;
Fig. 3 is the I portion enlarged drawing of Fig. 2;
What Fig. 4 embodiment of the present invention first bone cone and turning handle, bone bored that protection sleeve and bone bore protection sleeve locking piece coordinates schematic diagram;
Fig. 5 is the STRUCTURE DECOMPOSITION figure of Fig. 3;
The STRUCTURE DECOMPOSITION axonometric chart 1 of Fig. 6 embodiment of the present invention bone cone protection sleeve locking piece;
The STRUCTURE DECOMPOSITION axonometric chart 2 of Fig. 7 embodiment of the present invention bone cone protection sleeve locking piece;
Fig. 8 embodiment of the present invention central diameter bone drill coordinates schematic diagram with turning handle, bone drill protection sleeve and bone drill protection sleeve;
Fig. 9 is the exploded view of Fig. 7;
Figure 10 is the II portion enlarged drawing of Fig. 8.
Figure 11 embodiment of the present invention turning handle axonometric chart 1;
Figure 12 embodiment of the present invention turning handle axonometric chart 2.
Detailed description of the invention
Below by embodiment, the present invention is specifically described; only be used to further illustrate the present invention; can not be interpreted as limiting the scope of the present invention, the technician in this field can make some nonessential improvement and adjustment according to the content of foregoing invention to the present invention.
The specific embodiment of the present invention as shown in figs. 1-12, includes 3 bone cones, 1, bone cone protection sleeve 3,4 bone drill 4 and a bone drill protection sleeve 5;
Described each root bone cone includes and bores bar portion 14 by bone, interlock is arranged at bone and bores the turning handle 2 of bar portion tail end and be fixedly installed on the conehead that bone bores bar size end, include the first bone cone 11 in described bone cone, the conehead of this first bone cone 11 is Rhizoma Sparganii taper 111; Described bone cone also includes the second bone cone 12, and the conehead of this second bone cone is the screw conic 121 with one-way spiral cone sword, and described bone cone also includes bone cone 13 of removing obstacles, and this conehead of removing obstacles bone cone is hemisphere shape 131.The external diameter of the conehead of this first bone of the present embodiment cone 11, second bone cone 12 and bone cone 13 of removing obstacles is preferably 2.5mm, 3.0mm, 2.5mm.
In addition, the bone cone protection sleeve 3 described in the present embodiment comprises bone cone hollow cylinder 31 and is fixedly installed on the bone cone protection sleeve hand part 32 of bone cone hollow cylinder upper end, the inner bone taper via-hole 33 being axially provided with bone cone fairlead and joining of bone cone protection sleeve; Arrange this bone cone protection sleeve 3 when carrying out bone cone rotation operation, doctor is affectedly bashful this bone cone protection sleeve 3, carries out rotations bone cone, rotate manipulation of having an effect more stable with freely.
In addition, each described root bone drill has included bone rod portion 45, interlock is arranged at the turning handle 2 of bone rod portion tail end, and be fixedly installed on the drill bit of bone drill bar size end, and the shaft core position of each root bone drill is provided with through thread eye 46, described many bone drills at least include outside diameter to be had little of the first large bone drill 41 and large footpath bone drill 44, the drill bit of the first described bone drill 41 comprises the positioning pluging rod 411 being positioned at axial top, adjoining in the blunt ring portion 412 of the first taper of positioning pluging rod tail end, and it is adjoining in the first one-way spiral drill lip portion 413 of the first taper blunt ring portion 412 tail end, external diameter and first bone of described positioning pluging rod 411 bore 11 or second the bone conehead external diameter of boring 12 be close and coordinate, the drill bit of described large footpath bone drill 44 includes the blunt ring portion of large footpath taper 441 that is positioned at axial top and adjoining in the one-way spiral drill lip portion, large footpath 442 of large footpath taper blunt ring portion tail end, in addition, bone drill also includes the 2 piece central diameter bone drills 42 of outside diameter between the first bone drill and large footpath bone drill, the rotary head external diameter of these two central diameter bone drills has little of large, and the structure of the drill bit of this central diameter bone drill is the blunt ring portion of central diameter taper 421 that comprises and be positioned at axial top and adjoining in the central diameter one-way spiral drill lip portion 422 of the blunt ring portion tail end of central diameter taper.The outside diameter of this first bone drill of the present embodiment 41, two central diameter bone cones 42 and large footpath bone drill 44 is preferably 4mm, 6mm, 7mm, 8mm respectively.
In addition, the bone drill protection sleeve 5 described in the present embodiment comprises bone drill hollow cylinder 51 and is affectedly bashful portion 52 with the bone drill protection sleeve being fixedly installed on bone drill hollow cylinder upper end, the inner bone drill through hole 53 being axially provided with bone drill fairlead and joining of bone drill protection sleeve.
In order to make the drilling depth of bone drill precisely controlled, the present embodiment also includes bone rod portion locking piece 6, the bone rod portion of each described root bone drill is provided with distance scale line 47, described bone rod portion locking piece 6 includes the anchor ear ring 61 with bone rod portion anchor ear adaptation, this anchor ear ring 61 is provided with and embeds adaptive breach 611 with bone rod portion, and this anchor ear ring is arranged the clamping screw 612 run through inside and outside anchor ear ring.
In addition, each root bone cone described in the present embodiment and the tail end of each root bone drill are provided with interlock plug, described turning handle 2 includes axial shaft bar 21 and is fixedly installed on the stressed handle 22 of rotation of axial shaft bar upper end, described axial shaft Gan21Nei center is provided with axially through handle seal wire perforation 211, and the lower end of this axial shaft bar is provided with the interlock jack of the inserting that to link with the plug that links, described interlock plug is positive hexagon prism, and described interlock jack is inner hexagonal hole 212.Described turning handle 2 is T-shaped handle, and its center, upper surface of rotating stressed handle 22 is provided with the knock face 221 perpendicular with axial shaft bar 21.
The present embodiment also includes bone cone protection sleeve locking piece 7, this bone cone protection sleeve locking piece 7 includes the upper locking member 71 and lower locking piece 72 that mutual screw thread is fixedly connected with, the center of this upper locking member is provided with through hole 711, the periphery projection that the inner side of this upper locking member goes up through hole is relatively provided with multi-disc and embraces lobe 712, and the head end of this armful of lobe is provided with arcwall 7121; The center of described lower locking piece 72 is provided with the lower through-hole 721 corresponding with upper through hole, the periphery projection of the relative lower through-hole in inner side of this lower locking piece 72 is provided with embraces lobe cover 722, is provided with the conical cavity 7221 with the arcwall press fit of embracing lobe in this armful of lobe cover 722.
In addition, in order to protect nerve around superior articular process and soft tissue, the head end of described bone drill hollow cylinder 5 is provided with oblique arc blunt nosed 511.

Claims (9)

1. the intervertebral foramina reaming tool under spinal column scope in transforaminal approach operation, is characterized in that: include at least one bone cone, at least one bone cone protection sleeve, multiple bone drill and at least one bone drill protection sleeve;
Described each root bone cone includes and bores bar portion by bone, interlock is arranged at bone and bores the turning handle of bar portion tail end and be fixedly installed on the conehead that bone bores bar size end, and include the first bone cone in described bone cone, the conehead of this first bone cone is Rhizoma Sparganii taper;
Described bone cone protection sleeve comprises bone cone hollow cylinder and is fixedly installed on the bone cone protection sleeve hand part of bone cone hollow cylinder upper end, the inner bone taper via-hole being axially provided with bone cone fairlead and joining of bone cone protection sleeve;
Each described root bone drill has included bone rod portion, interlock is arranged at the turning handle of bone rod portion tail end, and be fixedly installed on the drill bit of bone drill bar size end, and the shaft core position of each root bone drill is provided with through thread eye, described many bone drills at least include the first ascending bone drill of outside diameter and large footpath bone drill, the drill bit of the first described bone drill comprises the positioning pluging rod being positioned at axial top, adjoining in the blunt ring portion of the first taper of positioning pluging rod tail end, and it is adjoining in the first one-way spiral drill lip portion of the blunt ring portion tail end of the first taper, the conehead external diameter that external diameter and the bone of described positioning pluging rod are bored is close and coordinates, the drill bit of described large footpath bone drill includes the blunt ring portion of large footpath taper that is positioned at axial top and adjoining in the one-way spiral drill lip portion, large footpath of large footpath taper blunt ring portion tail end,
Described bone drill protection sleeve comprises bone drill hollow cylinder and is affectedly bashful portion with the bone drill protection sleeve being fixedly installed on bone drill hollow cylinder upper end, the inner bone drill through hole being axially provided with bone drill fairlead and joining of bone drill protection sleeve;
It is blunt nosed that the head end of described bone drill hollow cylinder is provided with oblique arc.
2. the intervertebral foramina reaming tool under a kind of spinal column scope according to claim 1 in transforaminal approach operation, is characterized in that: described bone cone also includes the second bone cone, and the conehead of this second bone cone is the screw conic with one-way spiral cone sword.
3. the intervertebral foramina reaming tool under a kind of spinal column scope according to claim 1 and 2 in transforaminal approach operation, is characterized in that: described bone cone also includes bone cone of removing obstacles, and this conehead of removing obstacles bone cone is hemisphere shape.
4. the intervertebral foramina reaming tool under a kind of spinal column scope according to claim 1 in transforaminal approach operation, it is characterized in that: bone drill also includes at least one piece central diameter bone drill of outside diameter between the first bone drill and large footpath bone drill, the drill bit of this central diameter bone drill comprises the blunt ring portion of central diameter taper that is positioned at axial top and adjoining in the central diameter one-way spiral drill lip portion of the blunt ring portion tail end of central diameter taper.
5. the intervertebral foramina reaming tool under a kind of spinal column scope according to claim 1 in transforaminal approach operation, it is characterized in that: also include bone rod portion locking piece, the bone rod portion of each described root bone drill is provided with distance scale line, described bone rod portion locking piece includes the anchor ear ring with bone rod portion anchor ear adaptation, this anchor ear ring is provided with and embeds adaptive breach with bone rod portion, and this anchor ear ring is arranged the clamping screw run through inside and outside anchor ear ring.
6. the intervertebral foramina reaming tool under a kind of spinal column scope according to claim 1 in transforaminal approach operation, it is characterized in that: described each root bone cone and the tail end of each root bone drill are provided with interlock plug, described turning handle includes axial shaft bar and is fixedly installed on the stressed handle of rotation of axial shaft bar upper end, described axial shaft Gan Nei center is provided with axially through handle seal wire perforation, and the lower end of this axial shaft bar is provided with the interlock jack of the inserting that to link with the plug that links.
7. the intervertebral foramina reaming tool under a kind of spinal column scope according to claim 6 in transforaminal approach operation, it is characterized in that: described interlock plug is positive hexagon prism, described interlock jack is inner hexagonal hole.
8. the intervertebral foramina reaming tool under a kind of spinal column scope according to claim 7 in transforaminal approach operation, it is characterized in that: described turning handle is T-shaped handle, and its center, upper surface of rotating stressed handle is provided with and perpendicularly with axial shaft bar knocks face.
9. the intervertebral foramina reaming tool under a kind of spinal column scope according to claim 1 in transforaminal approach operation, it is characterized in that: also include bone cone protection sleeve locking piece, this bone cone protection sleeve locking piece includes the upper locking member and lower locking piece that mutual screw thread is fixedly connected with, the center of this upper locking member is provided with through hole, the periphery projection that the inner side of this upper locking member goes up through hole is relatively provided with multi-disc and embraces lobe, and the head end of this armful of lobe is provided with arcwall; The center of described lower locking piece is provided with the lower through-hole corresponding with upper through hole, and the periphery projection of the relative lower through-hole in inner side of this lower locking piece is provided with embraces lobe cover, is provided with the conical cavity with the arcwall press fit of embracing lobe in this armful of lobe cover.
CN201310014298.7A 2013-01-15 2013-01-15 Foramen reaming tool used during transforaminal approach surgery under spinal endoscope Active CN103054623B (en)

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