KR100712312B1 - setting apparatus of stereotatic frame - Google Patents

Abstract

According to the present invention, the brain position positioning device is a base member, a table mounted to the base member to be lifted by the lifting means, a pair of guide members installed in parallel to be spaced apart from each other by a predetermined distance, At least one adjusting plate which is installed to be slidably installed along the guide member, and is rotatably and positionally fixed to the lifting member by a supporting means so as to be freely contacted or spaced from the side of the patient's head. And an indicator having a cerebral falsification frame coupled to the indicator by a coupling means, and a jaw supporting member installed to be liftable on the guide member and supporting the jaw of the patient.

Stereotactic Surgery, Gamma Knife, Brain Stereotactic, Treatment, Surgery.

Description

Brain setting position setting device {setting apparatus of stereotatic frame}

1 is an exploded perspective view of an apparatus for positioning brain brain position in accordance with the present invention;

Figure 2 is a side view of the brain vertebral position setting device according to the present invention,

3 is a front view of the brain falsification position setting device according to the present invention,

4 is an exploded perspective view of the fine gap adjusting means;

5 is a partial ablation perspective view showing a state in which the indicator shown in Figure 1 and the cerebrospinal fluid is coupled,

6 is a perspective view showing another embodiment of the support means,

Figure 7 is a partial ablation perspective view showing another embodiment of the cerebral wartler position setting device according to the present invention,

FIG. 8 is a side view of the cerebrospinalus position setting device shown in FIG. 7, illustrating a state for controlling the motors.

9 is a perspective view showing another embodiment of the elevating means for elevating the elevating member.

The present invention relates to a device for positioning the brain stereotactic position, and more specifically, to fix the head of the patient to the brain stereotactic frame so as to accurately treat the affected area during treatment using brain stereotactic surgery, gamma knife radiation surgery, radiation treatment devices, etc. It relates to the brain position positioning device.

Stereotactic surgery is a specially designed device for brain lesions to cut out the skull and cut small holes in the skull, using a needle-like instrument to obtain a highly effective and safe treatment method with less brain damage. Say. Stereotactic surgery involves fixing a stereotactic frame on the cranial head and confirming the target in the brain with radiographs (MRI, CT, cerebrovascular imaging, etc.), and three-dimensional orthogonality of the target's X, Y, and Z. By using an coordinate system, electrodes or probes are inserted into a desired target to obtain a surgical (stereotactic surgery) effect, or radiation is performed to perform stereotactic radiosurgery.

In general, cerebral warts are used in motor diseases (such as Parkinson's disease, hand and foot trembling, facial spasms and paralysis), and pain disorders (trigeminal neuralgia, post-hepes neuralgia, severe refractory), which are functional and stereotactic neurosurgery. Headaches), epilepsy (refractory convulsions), stiff (stiff) disorders, brain damage (cerebral palsy), neuroendocrine disorders (pituitary tumors, hyperhidrosis, etc.), behavioral disorders (refractory obsessive-compulsive disorder, depression, anxiety neurosis, Aggression diseases) and histological examination and removal (brain tumor, hematoma caused by bleeding, abscess, cyst) and radiosurgery (brain tumor, cerebrovascular malformation), which are fields of non-functional and stereotactic neurosurgery.

Meanwhile, in order to treat the brain disease, that is, brain disease in the functional and non-functional brain stereotactic surgery field, imaging of a computed tomography device (CT), magnetic resonance imaging device (MRI), angiography device (Angiography), etc. Stereotactic surgery planning and treatment based on the three-dimensional image obtained through the device can minimize the damage to the brain tissue, effectively remove the lesions, minimize the neurological disorder can be recovered early.

In order to secure the reference point of the Cartesian coordinate system in the above-described process, the brain stereotactic frame is attached to the head, and a radiographic reference point indicator (MR / CT / XR indicator) is combined on the brain stereotactic frame to perform radiography. At this time, the cerebral falsification frame and indicator should be accurately fixed to the center of the target (lesion) or to the position desired by the physician.

Meanwhile, Korean Utility Model Registration No. 0321453 discloses a frame for cerebral stereotactic radiation treatment. The disclosed frame is secured to a treatment table and includes a frame circle passing the patient's head therein, and a plurality of supports located within and within the frame circle, the patient's head being positioned therebetween and proximate and spaced apart from the patient's head. A bar holder mounted to the support bar and movable in the direction of movement of the support bar, the pin portion having a fixing pin for pressing the head to fix the head to the support bar, and driving the support bar to support the head. It has a structure including a support bar drive for adjusting the position.

And International Publication No. WO 1999/11176 discloses a technical configuration in which a radiopaque skull clamp is installed in an extension assembly of a table for fixing a patient's head.

In fixing the head of the patient using the radiotherapy frame or skull clamp mentioned in the above embodiments, it is relatively safe for treatment or imaging, and requires a relatively long time for fixing without pain to the patient. It is inconvenient for the patient to maintain a constant posture without moving his head for more than 20 minutes.

On the other hand, in order to fix the cerebral anomaly to the head as described above, the lesion is located in the center of the cerebral anomaly and the indicator based on the positional information of the lesion obtained from the radiographic image, so as to place the cerebral angioplasty or radiosurgery (for example, gamma knife) region. It is relatively difficult to allow the target (lesion) to be located. That is, in order to stereotactic lesions such as tumors in the brain it is necessary to precisely fix the brain stereotactic. Therefore, in order to fix the brain distortion, a specialist must spend a lot of time, a pair of personnel consisting of assistants and specialists to hold the brain distortion is necessary.

The present invention is to solve the problems as described above, to reduce the labor of the fixed brain brain to fix the head of the patient, and to reduce the effort of the patient does not move the head brain brain position setting device The purpose is to provide.

Another object of the present invention is to significantly reduce the movement of the patient's head due to pain when inserting the fixing pin in the patient's head to fix the brain stereotactic, the brain stereotactic to accurately fix the brain stereotactic position in the desired position To provide a positioning device.

Brain stabilization position setting device of the present invention for achieving the above object,

A base member, a table mounted on the base member so as to elevate by an elevating means, a pair of guide members installed in parallel on the table so as to be spaced apart from each other by a predetermined distance, and an elevating member slidably installed along the guide member Wow,

An indicator having at least two adjustment plates installed on the elevating member so as to be rotatable and fixed by a supporting means and surrounding the side of the patient's head;

Brain brain wand coupled to the indicator by the coupling means,

It is characterized in that provided with a bib member for supporting the jaw of the patient is installed to be elevated on the guide member.

In the present invention, at least one side of the guide member is further provided with fine adjustment means for finely adjusting the lifting member along the guide member. The support means is preferably further provided with a rotating portion to rotate the indicator member relative to the lifting member.

Hereinafter, a preferred embodiment according to the present invention will be described in detail.

The brain position positioning device according to the present invention can be used to fix all of the stereotactic frame (Stereotactic frame) for treating brain diseases, for example, using a device such as Lexel Gamma Knife (Leksell Gamma Knife) It can be used when fixing the cerebral wart to the head of the patient for the treatment of brain diseases, one embodiment is shown in Figures 1 to 3.

Referring to the drawings, the brain falsification position setting device 10 is a base member 11, a table 30 which is installed on the base member so as to be lifted by the lifting means 20, and spaced apart from each other at predetermined intervals. A pair of guide members 12 and 13 installed in parallel with each other, a lifting member 40 supported by the guide members 12 and 13 and slidably installed therein, and the lifting member 40. It is installed so as to be rotated and fixed by the support means 90, and is provided with an indicator (indicator) (50) having at least two sides covered with the head of the patient and corresponding to the head. And on the lower end side of the indicator 50 is provided with a brain stereotension 100 is coupled to and separated from the separate coupling means 60. In addition, the guide members 12 and 13 are provided to be liftable and have a bib member 70 for supporting the jaw of the patient, and at least one side of the guide member 12 and 13 is the lifting member ( Fine adjustment means 80 for fine-tuning and lifting 40 is provided.

Hereinafter, a detailed description will be given for each component of the brain position positioning device 10 according to the present invention configured as described above in detail.

The base member 11 supports the table 30. Casters 11a are provided on the lower surface of the base member 11, and the base member 11 is lifted to raise and lower the table 30. The drive section of the means 20 has a predetermined space portion 11b therein. And the base member 11 may be provided with an operating unit (11c) for operating the setting device, in this case, since the operation unit (11c) is mainly operated by the foot it is preferable to have a structure protruding while the operation buttons are spaced apart. Do.

The lifting means 20 for elevating the table 30 on which the guide members 12 and 13 are installed is inside the support members 21 and 22 which are foldable to the base member 11 as shown in FIG. 2. A lead screw 23 supported by the base member 11 and installed along the support members 21 and 22, and screwed to the lead screw 23 and supported by the table 30. The transfer member 24 supported by the support member 21 of the upper side, and the drive part 25 which drive the said lead screw 23 are provided. The driving unit 25 includes a driven gear 25a installed under the lead screw 23 and a driving gear 25c meshed with the driven gear 25a and driven by the motor 25b. Preferably, the motor 25b uses a geared motor. The lifting means of the table 30 with respect to the base member 11 is not limited to the above-described embodiment and may be any structure as long as the table can be raised and lowered to an arbitrary height. For example, it may be composed of a pinion rotated by an actuator or a motor made of a cylinder using pneumatic or hydraulic pressure, and a rack engaged therewith.

The table 30 supports the guide members 12 and 13, and includes an X and Y transfer unit 31 capable of lifting and moving in the X and Y axis directions. The X, Y transfer unit 31 may be made of a conventional X, Y table for the transfer in the X, Y direction. That is, the support panel 32 supported by the support member 21, the first guide rail 33 installed in the X-axis direction on the support panel 32, and the support panel 32 are provided. A second guide rail 34 for conveying the table 30 in the Y direction is provided. X and Y transfer unit for transferring the table 30 to the X, Y axis is not limited by the above-described embodiment may be made of a linear motor or an EL guide.

The elevating member 40 is slidably installed on the guide members 12 and 13, and sliders 41 and 42 slidably installed on the guide members 12 and 13, and And a connecting member 43 for connecting the sliders 41 and 42. The connecting member 43 suspends the indicator 50 on which the brain support frame 100 is supported by the supporting means. The connecting member 43 may be formed in the shape of a straight and crisscross.

  On the other hand, at least one side of each of the guide member 12, 13 is further provided with a fine adjustment means 80 that can finely adjust the lifting member along the guide member 12, 13, the fine adjustment means (80) As shown in FIG. 4, the threaded portion 81 is formed on the guide member 12 on the one side, and includes a fine adjustment lever 82 screwed to the threaded portion 81.

The indicator 50 is supported by the support member 90 so as to be rotatable and relatively movable by the support member 90 so that the indicator 50 covers the head of the patient. (53).

The indicator 50 has a plate-shaped upper frame 51 and adjustment plates 52 and 53 which are installed on both sides of the upper frame and correspond to both sides of the patient's head. The adjustment plates 52 and 53 are printed with scales (coordinates) for confirming the position of the affected part and confirming the fixed position of the cerebrospinal frame 100 by linking the location of the affected part with the cerebral wartler 100. The indicator 50 is not limited to the above-described embodiment, and may have a box shape in which a lower surface thereof is opened to cover the head of the patient.

And the indicator 50 is the brain stereotactic 100 is coupled by the coupling means (60). Coupling means 60 for coupling and separating the brain stereotactic 100 to the indicator 50 is a plurality of coupling holes 61 are formed on the upper surface of the brain stereotactic 100 as shown in Figure 5, Protrusions 62 coupled to the respective coupling holes 61 are formed at lower ends of the adjustment plates 52 and 53. In addition, through holes 63 and 64 are formed at the side surfaces of the adjustment plates 52 and 53, and gripping jaws 65 coupled to the through holes 63 and 64 and the brain crest 100 are held. The cerebral falsification frame 100 is fixed to the adjuster plates 52 and 53 by the clamp 68 having the hook 67 for the purpose of clamping. The coupling means 60 is not limited to the above-described embodiment and may be any structure as long as the coupling means 60 can fix the brain stereotension 100 with respect to the indicator 50. For example, using a bolt having a knob on the tab formed in the brain stereotactic 100 may be combined with the adjustment plate. In addition, the through holes 63 and 64 are preferably formed in a diagonal direction on the control plates corresponding to each other so as not to interfere with the guide members 12 and 13 when the clamps are coupled and separated.

The support means 90 is to support the indicator member 100 is fixed to the cerebral wart 100 with respect to the connecting member 43 to be able to move and rotate the position, one embodiment is shown in Figures 1 and 5.

Referring to the drawings, the support means 90 is formed with a first long hole 91 in the longitudinal direction in the connecting member 43, the upper frame 51 to be perpendicular to the first long hole 91. The second long hole 92 is formed. And the coupling member 93 is inserted through the second, the first hole 92, 91 from the lower surface side of the upper frame 51, and the coupling member 93 is screwed to the connection member 43 It has a fastening member 94 for supporting the indicator (50) for).

The support means is not limited to the above-described embodiment, and may be any structure as long as the support means can move the indicator in which the cerebral wartler is fixed in rotation and rotation and in the X and Y axis directions. For example, the support means may be ball joint coupled as shown in Figure 6, the support shaft (95a) of the ball joint (95) is structured to be transported along the first long hole 91 of the connecting member 43 Has At this time, the connecting member 43 is formed in a cross shape, it is preferable that the first long hole 91 is also formed in the cross shape accordingly. In another embodiment of the support means, as shown in FIG. 7, guide rails may be installed in the connecting member 43 in the X and Y axes, respectively, and the guide rail and the upper frame may be connected to a ball joint. . The support means is not limited to the above-described embodiment and may be any structure as long as it can move the indicator in the X and Y axis directions. For example, fine adjustment can be made with a manually operated lead screw.

The bib member 70 is installed on the guide members 12 and 13 to support the jaw of the patient for fixing the cerebral wartler 100, and the slider is transferred along each of the guide members 12 and 13. 72 and 72, a support bar 73 supported on the sliders 72 and 72 and bent to protrude to the front, and a bib 74 provided on the support bar 73. At least one side of the sliders 72, 72 is further provided with a stopper 75 defining this position with respect to the guide members 12, 13. The stopper 75 may be made of a bolt that is screwed to the slider 72 and whose end is in contact with the guide member 13.

On the other hand, Figures 7 to 9 is another embodiment of the brain position positioning device capable of automatic position control of the indicator 50 supported by the connecting member 43 based on the image coordinates of the affected part with respect to the patient's head An example is shown. In this embodiment, the same reference numerals as the above embodiment indicate the same components.

In the present embodiment, the position elevating member and the indicator 50 mounted on the elevating member and mounted with the cerebral falsification frame 100 may be automatically adjusted with respect to the head of the patient based on the image coordinates of the affected part.

As shown in FIGS. 7 and 8, the X-axis feeder 210 suspended in the connecting member 43 and the Y-axis feed control unit which are supported by the X-axis feed control unit 210 and feed the indicator in the Y-axis direction are shown. 220, the Z-axis feed control unit 230 is installed on the guide member 12 to convey the lifting member 40 in the Z-axis direction, and the indicatier can be rotated at a predetermined angle 3D of the affected part based on the image data photographed using a rotating means (not shown) and an imaging device such as CT, magnetic resonance imaging (MRI), angiography (Angiography), etc. It further includes a control means for controlling the X, Y, Z axis feed control unit (210, 220, 230) based on the position information coordinate value.

The X-axis feed control unit 210 is a guide formed in the longitudinal direction along the X-axis guide rail 211 and the X-axis guide rail 211 supported by the connecting member 43 by the support means 90 An X-axis conveying member 213 sliding along the groove 212 and installed in a Y-axis guide rail to be described later, and installed in the longitudinal direction of the X-axis guide rail 211, and the X-axis conveying member 213 and a screw are installed. The lead screw 214 is coupled, and the X-axis driving unit 215 rotates the lead screw 214 forward and backward. The X-axis driving unit 215 includes a worm wheel 215a coupled to the end of the lead screw 214, and a worm 215c meshed with the worm wheel 215a and driven by the motor 215b. In this case, it is preferable to use a stepping motor capable of rotation control, and the motor is preferably installed on a plate 216 extending to the side of the X-axis guide rail 211.

The Y-axis feed control unit 220 is substantially the same as the X-axis control feed unit. That is, the Y-axis feed control unit 220 is orthogonal to the X-axis guide rail 211 supported by the connecting member 43 and the Y guide rail 221 supported by the X-axis conveying member 213, and Along the guide groove 222 formed along the longitudinal direction along the Y-axis conveying member 223 is installed on the upper side of the indicator 50 and the Y-axis guide rail 221 is installed in the longitudinal direction of the Y-axis And a lead screw 224 screwed to the transfer member 223 and a Y-axis driving part 225 for forward and reverse rotation of the lead screw 224.

Herein, the X and Y axis feed control unit is not limited to the above-described embodiment, and any structure may be used as long as the indicator 50 can control the feed in the X and Y axis directions according to the set coordinates. For example, a linear motor can be used.

Meanwhile, the Z-axis feed control unit 230 rotates the Z-axis elevating member 231 and the Z-axis elevating member 231 which are engaged with the threaded portion 81 formed on the guide member 12, and rotates the slider. And a Z-axis driver 232 for elevating (42). The Z-axis driving portion includes a gear portion 232a formed on the outer circumferential surface of the Z-axis lifting member, a worm 232b engaged with the gear portion 232a, and a motor 232c for driving the worm. The motor 232c surrounds the guide member 12 and is installed in a housing 233 supporting the Z-axis transfer member 231 and the worm 232b.

The rotating means is not shown in the drawing, but any structure may be used as long as it can rotate the indicator supported by the support means 90 to the connecting member at a predetermined angle. For example, it may be composed of a worm wheel installed on a support shaft for supporting the indicator 50, a worm engaged with the worm wheel and a motor for driving the worm wheel. The rotating means is not limited to this, and any structure can be used as long as it can rotate the indicator based on the coordinate value of the control means.

The control means 240 may set the X, Y, Z axis feed control unit 210 (220 230) according to the coordinate value based on the image data of the affected part of the patient. have.

Referring to the operation of the brain position positioning device according to the invention configured as described above are as follows.

In order to fix the brain stereotactic frame 100 to the head of the patient with a brain disease, first fix the brain stereotactic frame 100 using the coupling means 60 to the indicator 50. In this process, the projections 62 and 62 installed at the lower ends of the adjustment plates 52 and 53 of the indicator 50 are coupled to the coupling holes 61 and 63 formed in the cerebral wartler 100. In addition, the locking jaw 65 of the clamp 68 is inserted into the through holes 63 and 64 formed in the adjustment plates 52 and 53, and the hook 67 is caught by the lower surface of the cerebral wart 100. Fix the brain stereotosis (100) against (50). As described above, when the coupling between the cerebral falsification frame 100 and the indicator 50 is completed, the suspension is suspended on the connecting member 43 by the support means 90.

In addition, the patient lifts the table 30 using the lifting means 20 so that the cerebral falsity 100 can be put on the head of the patient in a state of not being in a chair or a wheelchair. At this time, the lifting and lowering of the table 30 may be performed by lifting and lowering the transfer member screwed thereto by rotating the lead screw 23 forward and backward using the motor 25b. Since the table 30 is supported to be transportable in the X and Y directions, the position of the table 30 may be transferred in the front-back direction or the left-right direction so that the patient's jaw may be supported by the bib 74.

As described above, the patient's jaw is supported by the bib 74, and as shown in FIG. 7, the micro-adjusting means 80 is supported by the brain stereotosis 100 supported by the indicator 50 on the patient's head. By adjusting the height of the elevating member 40 by using the position of the brain stereotactic 100 in the vertical direction relative to the position of the affected area to be treated. Then, by using the support means 90, the indicator 50 mounted with the cerebral stereotension 100 is transferred to the front and rear or left and right directions so that the affected part located on the adjustment plates 52 and 53 is adjusted to the adjustment plate 52 and 53. To be located within the set coordinates printed on the.

In this process, the indicator of the conveyance or indicator 50 of the coupling member 93 is transported along the first long hole 91 formed in the connection member 43 and the second long hole 92 formed in the upper frame 51. It can be moved in the radial direction including front and rear left and right. Naturally, when the support means is connected by a ball joint, it is also possible to rotate at a predetermined angle with respect to the vertical direction.

Meanwhile, as shown in FIGS. 7 to 9, when the indicator 50 is controlled by the X, Y, and Z axis feed controllers 210, 220, 230, the image obtained by the photographing apparatus is used. The coordinate value of the location of the lesion is input to the data processor or received from the imaging apparatus or treatment planning apparatus, and based on the control of the respective motors of the X, Y, Z axis transfer control unit 210, 220, 230 to the The lead screws 214 and 224 are selectively driven to transfer the position of the indicator 50 in the X, Y and Z axial directions to set the cerebral wartler 100 relative to the affected part.

As described above, when the affected part of the patient is positioned at the set coordinates based on the pre-recorded image, the brain fixation frame 100 is fixed by inserting a fixing pin into the head of the patient.

When the fixation of the brain stereotactic frame 100 is completed as described above, when the indicator 50 and the brain stereotactic frame 100 that are coupled by the coupling unit 60 are separated, only the brain stereotactic frame is fixed to the head of the patient, or a stereotactic surgery device or gamma knife. Stereotactic surgery is used to treat lesions on the head.

As described above, the positional setting device of the cerebral falsification has the following effects.                     

first; In fixing the cerebrospinal to the head of the brain disease patient, the doctor can fix the cerebral wart within a short time without a separate assistant.

second; While the patient is sitting comfortably, the brain can be fixed to the desired position, and can reduce the pain caused by the fixation of the brain to the patient's head.

third; Since the brain head fixation can be accurately fixed to the position of the lesion in the brain by reducing the head movement when fixing the brain head fixation, it is possible to avoid re-correction procedure due to the position of the head fixation fixation during brain stereotactic surgery or gamma knife radiation surgery. Increase the accuracy of lesion treatment.

fourth; In the case of metastatic cancer, when a plurality of lesions in a patient's brain are scattered in a wide range, the accuracy of including the lesions in the range of cerebral stereosurgery can be increased.

Although the present invention has been described with reference to one embodiment illustrated in the drawings, this is merely exemplary, and it will be understood by those skilled in the art that various modifications and equivalent embodiments are possible.

Therefore, the true scope of protection of the present invention should be defined only by the appended claims.

Claims (11)

With a base member, A table mounted on the base member so as to be lifted and lowered by lifting means; A pair of guide members installed in parallel with the table to be spaced apart from each other by a predetermined interval, and a lifting member slidably installed along the guide member; It is installed on at least one side of the guide member to finely adjust the elevating member along the guide member, and a threaded portion is formed on at least one side of the guide member, and screwed to the screwed portion and moves along the guide member and is connected by the connecting member. Fine adjustment means having a fine adjustment lever for elevating the connected slider; An indicator installed at the connecting member so as to be rotatable and fixed by a supporting means, the indicator having at least one adjustment plate which covers the patient's head and is displayed with coordinates; A jaw support member installed on the guide member to be elevated and supporting the jaw of the patient; The indicator has a brain stabilization coupled to the coupling means, the coupling means has a plurality of coupling holes are formed on the upper surface of the brain stabilization and the lower end of the adjustment plate is formed with projections coupled to the respective coupling holes and the side of the adjustment plate A thoracic brain position positioning device, characterized in that the through hole is formed and made of a clamp having a locking jaw coupled to the through hole and a hook for gripping the cerebral falcon. delete delete delete The method of claim 1,  The support means has a first long hole is formed in the lifting member of the transfer member in the longitudinal direction, a second long hole orthogonal to the first long hole is formed in the upper frame of the indicator, the second from the lower surface side of the upper frame , 1, the coupling member is inserted into the hole, the cerebral falsification position setting device, characterized in that the coupling member and the screw made. The method of claim 1,  The table includes a support panel supported by a support member installed in the base member, a first guide rail installed in the X-axis direction on the support panel, and a second installed on the support panel to transfer the table in the Y direction. Brain stabilizing position setting device characterized in that it further comprises a conveying unit having a guide rail. The method of claim 1, An apparatus for positioning brain vertebrae position, characterized in that the adjustment plate marked with the coordinates of the indicator is installed on the upper frame supported by the support means so as to correspond to both sides of the patient's head. delete The method of claim 1, The bib member includes a slider transported along each of the guide members, a support bar supported by the slider and bent to protrude forward, and a bib installed on the support bar. delete delete

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