WO2015007235A1

WO2015007235A1 - Intradermal positioning apparatus for lumbar vertebra minimally invasive surgery

Info

Publication number: WO2015007235A1
Application number: PCT/CN2014/082478
Authority: WO
Inventors: 贺石生
Original assignee: He Shisheng
Priority date: 2013-07-19
Filing date: 2014-07-18
Publication date: 2015-01-22
Also published as: CN103356278A

Abstract

An intradermal positioning apparatus for lumbar vertebra minimally invasive surgery consists of a positioning device (2) made of an X-ray transparent material and a plurality of kirschner wires (1). An intradermal part of the positioning device (2) is a sharp head, and an extradermal part of the positioning device is a flat head; a plurality of hollow channels is formed in the positioning device, and kirschner wires (1) used for positioning penetrate the hollow channels. The kirschner wires (1) are the commonly used kirschner wires in orthopedics surgery. The positioning device has the advantages of high positioning accuracy, short positioning time, less X-ray times, and low X-ray radiant quantity that a medical staff and a patient receive, thereby having popularization and application value in minimally invasive spine surgery.

Description

Intradermal localization device for lumbar spine minimally invasive surgery

[0001] The present invention belongs to the technical field of medical instruments, and in particular relates to an intradermal positioning device for minimally invasive surgery of the lumbar spine. Background technique

[0002] The advantage of spinal minimally invasive surgery is that the trauma is small, the bleeding is less, the operation does not need to extensively exfoliate the paraspinal muscles, and the damage to the posterior structure of the spine is minimal, which does not affect the stability of the spine. Accurate preoperative intraoperative positioning is very important for minimally invasive surgery of the spine. If the positioning is not accurate, it will inevitably cause unnecessary destruction of the structure behind the spine, thus increasing the damage. This is particularly evident in minimally invasive surgery of the spine. For example, the implantation of a percutaneous pedicle screw does not have any positioning device. The direction and depth of the needle can be clearly determined by repeated perspective. This method of relying solely on sensation is not accurate enough, and often requires extensive surgical experience, which can be completed with repeated fluoroscopy; it increases the operation time and exposes the medical staff and patients to X-ray radiation multiple times. Summary of the invention

[0003] In order to make the positioning of spinal minimally invasive surgery more accurate, shorten the operation time, and reduce the radiation of medical staff, we designed a intradermal positioning device for lumbar minimally invasive surgery and applied it to the clinic.

[0004] The intradermal positioning device for minimally invasive surgery of the lumbar spine is composed of a positioner 1 and a Kirschner wire 2, and the positioner 1 is a columnar structure, and one end has a pointed structure for intraoperative insertion. The intradermal portion, the other end is a flat head, and is used for the extracutaneous portion; a plurality of hollow channels are arranged in parallel in the positioner 1, and the hollow channel is used for the Kirschner wire 2 for intraoperative positioning.

[0005] In the present invention, the positioner 1 is made of an X-ray non-developing material (may be a polymer, wood, or the like which is not developed on the X-ray), and can be formed by stamping, molding, or Handmade.

In the present invention, the Kirschner wire 2 is a conventional Kirschner wire commonly used in orthopedic surgery.

[0007] The method for using the intradermal positioning device for minimally invasive surgery of the lumbar spine according to the present invention has the following specific steps: According to the pedicle position marked by the body surface, the fat and thinness of the patient and the head tilt angle of the vertebral body, a skin incision of 0.95-1.05 cm was cut at a distance of l-1.5 cm beside the surface of the pedicle screw of the body surface. After the stage is expanded, insert the positioner, then insert 3-4 pieces of Kirschner wire from each positioner, perform X-ray fluoroscopy of the positive side, select the appropriate K-wire for the positioning of the needle, and remove the remaining K-wires. Needle; if there is no suitable Kirschner wire, leave the K-wire needle closest to the desired position, then adjust the position by the positioner, and then select the appropriate K-wire for positioning.

[0008] The present invention can achieve the effects of dozens of fluoroscopys by only 1-2 intraoperative fluoroscopy, and has the characteristics of accurate positioning, shortening operation time, and reducing radiation of medical personnel. DRAWINGS

1 is a front structural view of the present invention.

2 is a side view showing the structure of the present invention.

[0011] FIG. 3 is a schematic view of a cut in a desired surgical portion.

4 is a use state diagram of the present invention.

[0013] FIG. 5 is a simulation diagram of the Kirschner needle driving into the positioner (position is appropriate).

[0014] FIG. 6 is an effect diagram of a suitable position.

[0015] FIG. 7 is a simulation diagram of the Kirschner needle driving into the positioner (inappropriate position).

Figure 8 shows the effect of the position being unsatisfactory and the adjusted position is suitable.

[0016] Reference numerals in the figure: 1 is a Kirschner wire, and 2 is a positioner. detailed description

[0017] The invention is further illustrated by the following examples.

[0018] Embodiment 1: As shown in FIG. 1-2, wherein the inside of the locator 1 is divided into a pointed end, the outer part of the skin is divided into a flat head, and a plurality of hollow channels are provided, which are worn by the Kirschner wire 2 for intraoperative positioning. In. As shown in Figure 3-8, (this part is better described in conjunction with the figure). According to the pedicle position marked by the body surface, the fatness of the patient and the tilt angle of the vertebral body, the position of the pedicle screw in the body surface is marked. Cut a skin incision around l-1.5cm and cut a lcm or so

(Figure 3), insert the intradermal positioning device after expansion (Fig. 4), and then insert 3-4 K-wires from each intradermal positioning device to perform X-ray fluoroscopy of the lateral position. Suitable Kirschner wire for positioning

(Fig. 5), remove the remaining Kirschner wires (Fig. 6). If there is no suitable K-wire, then the most close is left. The position of the Kirschner wire (Fig. 7), and then adjust the position by the intradermal positioning device and then select the appropriate Kirschner wire for positioning (Fig. 8).

[0019] The workflow of the present invention is as follows:

A: Inserting the intradermal positioning device after stepwise expansion;

B: 3-4 pieces of Kirschner wire are inserted into each intradermal positioning device to perform X-ray fluoroscopy of the positive side; C: K-wires are placed at appropriate positions for piercing and positioning;

D: the red mark in the figure is a suitable K-wire;

E: There is no suitable Kirschner wire, so the K-wire is the closest to the satisfactory position; F: Adjust the position by the intradermal positioning device and select the appropriate K-wire for positioning.

Example 2: The inventors have conducted relevant clinical studies on the positioner. For 121 patients with lumbar disc herniation complicated with lumbar instability and thoracolumbar fractures, the traditional method was compared with the new method. It was found that the traditional method was used to implant double percutaneous pedicle screws in patients with single segmental disease. The positioning time is 15.12± 4.69min, and the number of positioning times is 6.47 times. The new method using the positioner has a positioning time of 5.51 ± 1.32 min and a positioning time of 2.45.

Claims

Rights request

1. A intraoperative intradermal positioning device for minimally invasive surgery of the lumbar spine, comprising a positioner (1) and a Kirschner wire (2), characterized in that the positioner (1) is a columnar structure and one end is a pointed structure, The intradermal portion is inserted during the operation, and the other end is a flat head for the extracutaneous portion; a plurality of hollow channels are arranged in parallel in the positioner (1), and the hollow channel is used for the intra-operative positioning of the Kirschner wire (2) Penetrate.

2. The intraoperative intradermal positioning device for minimally invasive surgery of the lumbar spine according to claim 1, wherein the positioner 1 is made of X-ray non-developing material, and can be formed by die stamping, molding, or hand-made.

3. The intraoperative intradermal positioning device for minimally invasive surgery of the lumbar spine according to claim 1, wherein the Kirschner wire (2) is a common Kirschner wire commonly used in orthopedic surgery.

4. A method of using a intradermal positioning device for minimally invasive surgery of a lumbar spine according to claim 1, wherein the specific steps are as follows:

5厘米的处。 The pedicle of the pedicle of the body surface, the fat and thinness of the patient's body and the slanting angle of the vertebral body, in the surface of the pedicle screw marked 1-1. 5cm cut open a 0. 95-1. 05cm The skin incision is inserted into the positioner after being expanded step by step, and then 3-4 K-wires are inserted from each positioner to perform X-ray fluoroscopy of the positive side, and a suitable K-wire is selected for the positioning of the needle. Remove the remaining K-wires; if there is no suitable K-wire, leave the K-wire that is closest to the desired position, then adjust the position by the positioner and select the appropriate K-wire for positioning.