Side rear linkage spine minimally invasive puncture guiding system

Abstract

The present application belongs to the field of orthopedic surgical instruments, and particularly relates to a side-rear linkage spinal minimally invasive puncture guiding system. The guiding system has a fixed end and a guiding end, and an arc-shaped guide rail structure is used to connect the fixed end and the guiding end. A sliding arm at the fixed end is perpendicular to a tangent of the arc-shaped guide rail, and a guiding sleeve is arranged at the guiding end and is also perpendicular to the tangent of the arc-shaped guide rail. In this way, during the sliding of the arc-shaped guide rail, the directions of the fixed end and the guiding end will continuously point to the center of the circle. Therefore, when a puncture direction is known, the fixed end is connected to the known puncture direction, and the guiding end can maintain real-time guiding to the target center of the circle. The use of the guiding system for assisting surgery can reduce the puncture difficulty and frequency.

Description

Technical Field

[0001] This invention belongs to the field of orthopedic surgical instruments, specifically a lateral and posterior linkage spinal minimally invasive puncture guidance system. Background Technology

[0002] Minimally invasive spinal surgery typically uses percutaneous puncture to reach the lesion site, minimizing damage to soft tissues such as skin and muscles. However, current puncture methods often require repeated fluoroscopic positioning to determine the puncture location and angle. In cases requiring multiple punctures within the same surgery, the fluoroscopic positioning process must be repeated for each puncture, especially when the directions of multiple punctures are inconsistent.

[0003] Multiple fluoroscopy sessions and repeated punctures can cause unnecessary health hazards to patients. Since the target points for multiple punctures are often related to anatomical structures, it's possible to locate sites for other puncture directions using known anatomical structures after completing one puncture. Currently, there are no auxiliary guiding devices that can reduce the difficulty of other punctures by utilizing known puncture directions and locations. Summary of the Invention

[0004] To increase puncture accuracy and improve puncture safety, this invention provides a posterolateral spinal puncture guidance system that uses known puncture locations and directions to guide punctures in other directions and at different locations.

[0005] The present invention specifically adopts the following technical solution:

[0006] A posterolateral linkage minimally invasive spinal puncture guidance system is characterized by comprising a guide rail and a fixed end and a guiding end disposed on the guide rail. The fixed end includes a sliding arm and a first puncture instrument connected thereto. The guiding end is provided with a guide sleeve, in which a second puncture instrument can be inserted. The fixed end and the guiding end are located at the same center. When the puncture direction of the fixed end is known, the orientation of the guiding end is determined according to the correspondence between the fixed end and the guiding end.

[0007] Furthermore, the guide end can be replaced with guide sleeves of different diameters to adapt to different puncture needs, and guide sleeves of different depths can limit the puncture depth.

[0008] Furthermore, the guide rail is an arc-shaped guide rail or a right-angled guide rail.

[0009] Furthermore, the sliding arm and guide rail are provided with scales and locking structures, which are used for positioning and locking the guide end when the guide rail slides.

[0010] Furthermore, the fixed end can be connected to the bed body via a serpentine arm, and a connecting crossbar is provided between the fixed ends of multiple puncture guide systems to improve the stability of the system during use.

[0011] Furthermore, the first puncture instrument includes an intramedullary nail with a cortical bone thread at the posterior end and a cancellous bone thread at the anterior end; the intramedullary nail has an opening on its anterior side for injecting bone cement into the vertebral body.

[0012] Furthermore, the first puncture instrument also includes an intramedullary nail screwdriver and an intramedullary nail handle, wherein the intramedullary nail screwdriver is connected to the rear end of the vertebral arch intramedullary nail, and the intramedullary nail handle is located on the intramedullary nail screwdriver.

[0013] Furthermore, a spacer is installed at the tail of the intramedullary nail to prevent the nail from sinking into the bone.

[0014] Furthermore, the second puncture instrument includes an artificial pedicle, the size of which is smaller at the insertion end than at the connection end; the artificial pedicle is hollow in the middle for inserting the intramedullary nail; the surface of the artificial pedicle in contact with the bone has anti-slip textures, and its interior has a loose, porous structure. The hollow structure is cylindrical, and its inner diameter is adapted to the size of the intramedullary nail.

[0015] Furthermore, the second puncture instrument also includes an artificial pedicle holder, which is connected to the connection port of the artificial pedicle connection end.

[0016] Alternatively, in this application, a guide rail can be omitted, and a fixed guide can be used directly, so that the puncture angle is a fixed value, which can meet some requirements.

[0017] The present invention has the following beneficial effects:

[0018] In this guidance system, both the fixed end and the guiding end point towards the center of the circle. When a puncture direction is known, the fixed end connects to the puncture instrument with that direction. Based on the puncture angle between the fixed and guiding ends, the guiding end maintains real-time guidance towards the target center. This technique reduces the number of fluoroscopic procedures, increases puncture accuracy, improves puncture safety, and makes the surgery more quantitative and digital. Attached Figure Description

[0019] Figure 1 This is a schematic diagram of the intramedullary nail structure in the vertebral arch of the present invention;

[0020] Figure 2 This is a schematic diagram of the intramedullary nail screwdriver structure in this invention;

[0021] Figure 3 This is a schematic diagram of the intramedullary nail handle structure in this invention;

[0022] Figure 4 This is a schematic diagram of the structure of a puncture instrument in this invention;

[0023] Figure 5 This is a schematic diagram of the artificial pedicle structure in this invention;

[0024] Figure 6 This is a schematic diagram of the artificial pedicle retainer structure in this invention;

[0025] Figure 7 This is a schematic diagram illustrating the process of using the artificial pedicle and the intramedullary nail in this invention.

[0026] Figure 8 This is a schematic diagram of a certain embodiment of the present invention;

[0027] Figure 9 A schematic diagram of the structure of multiple puncture guidance systems under the same vertebral body;

[0028] Figure 10 This is a schematic diagram of a puncture procedure according to the present invention (internal to external).

[0029] Numbers in the diagram:

[0030] 10. Guide rail;

[0031] 20. Fixed end;

[0032] 201. First puncture instrument;

[0033] 2011, Intramedullary nail for vertebral arch; 2011a, Opening;

[0034] 2012, Intramedullary nail screwdriver;

[0035] 2013, Intramedullary nail handle;

[0036] 202. Sliding arm;

[0037] 30. Bootloader;

[0038] 301. Guide sleeve;

[0039] 302. Second puncture instrument;

[0040] 3021, Artificial pedicle; 3021a, Insertion end; 3021b, Connecting end; 3021bb, Connecting port; 3021c, Hollow structure;

[0041] 3022. Artificial pedicle screw retainer;

[0042] 303. Connecting crossbar. Detailed Implementation

[0043] The following specific examples illustrate the implementation of the present invention. Those skilled in the art can easily understand other advantages and effects of the present invention from the content disclosed in this specification. The present invention can also be implemented or applied through other different specific embodiments, and various details in this specification can be modified or changed based on different viewpoints and applications without departing from the spirit of the present invention. It should be noted that the illustrations provided in the following embodiments are only schematic representations of the basic concept of the present invention. Unless otherwise specified, the following embodiments and features can be combined with each other.

[0044] Please see Figures 1 to 6 As shown in the figure, an instrument for pedicle lengthening and fixation puncture is provided. It mainly includes an intramedullary nail 2011 and an artificial pedicle 3021, wherein the artificial pedicle 3021 uses cylindrical bone fusion materials (titanium, PEEK material, hydroxyapatite, allogeneic bone, etc.) as the artificial pedicle. Figure 7 This demonstrates the process of using the artificial pedicle 3021 in conjunction with the intramedullary nail 2011. Before implantation, the pedicle is cut off using a tool and stretched and extended. The artificial pedicle 3021 is then inserted from the side of the pedicle using a holding tool to keep the pedicle in an extended state.

[0045] The 2011 vertebral nail is a hollow structure (3021c) implanted percutaneously. It has a lateral opening (2011a) at the anterior end for injecting bone cement into the vertebral body to enhance fixation. The threads of the 2011 vertebral nail can be denser at the posterior end (cortical bone threads) and sparser at the anterior end (cancellous bone threads), which, after insertion, can apply pressure to the pedicle fragments to promote fusion. Alternatively, the 2011 vertebral nail can have a conical structure with a larger diameter at the posterior end and a smaller diameter at the anterior end to increase hold on the posterior bone after insertion. A shim can be designed at the tail end of the 2011 vertebral nail to prevent the screw from embedding into the bone.

[0046] The puncture instruments also include an intramedullary nail screwdriver 2012 and an intramedullary nail handle 2013, which are detachably connected. The end of the intramedullary nail screwdriver 2012 is connected to the front end of the intramedullary nail 2011. The intramedullary nail handle 2013 is designed in a T-shape to facilitate slow screwing in by the operator during surgery.

[0047] The artificial pedicle 3021 is a hollow cylindrical structure through which the intramedullary nail 2011 passes. The artificial pedicle 3021 has a porous internal structure to facilitate bone ingrowth; the surface in contact with the bone has anti-slip grooves to prevent slippage. The hollow structure 3021c of the artificial pedicle 3021 can be pre-filled with a bone-inducing material, such as BMP, to promote bone healing.

[0048] The artificial pedicle 3021 holder is used to implant the artificial pedicle 3021 into the space between the vertebral body and the anterior bone. In this embodiment, the end of the artificial pedicle with the smaller diameter is the insertion end 3021a, and the end connected to the holder is the connecting end 3021b. The connecting end 3021b is provided with a connecting port 3021bb, which engages with the protruding structure at the front end of the holder.

[0049] Please see Figure 8 The posterolateral linkage minimally invasive spinal puncture guidance system can precisely guide the position and direction of punctures in other directions using a known puncture location and direction. It includes a guide rail 10 and a fixed end 20 and a guiding end 30 mounted on the guide rail 10. The guide rail 10 can be arc-shaped or right-angled. The fixed end 20 includes a sliding arm 202 and puncture instruments connected to the sliding arm 202. The guiding end 30 includes a sleeve mounted on the guide rail 10 and various instruments for puncture within the sleeve. Both the sliding arm 202 and the sleeve are perpendicular to the tangent of the guide rail 10. The fixed end 20 and the guiding end 30 are located at the same center. When the puncture location and direction of the fixed end 20 are known, pushing the sleeve causes the guide rail 10 to move slowly, adjusting the angle between the fixed end 20 and the guiding end 30. When a preset angle is reached, the orientation of the subsequent puncture can be determined.

[0050] Specifically, the guide end can be fitted with guide sleeves of various diameters, and the puncture depth can be limited by the different depths of the sleeves. A graduated scale and locking structure are provided between the sliding arm 202 and the guide rail 10. When the scale on the sliding arm 202 coincides with the scale on the sliding guide rail 10, guidance stops, and the position is locked, thus determining the orientation for the next puncture. The puncture instruments connected to the sliding arm 202 mainly include the pedicle screw 2011, and the puncture tools installed in the sleeve mainly include the artificial pedicle screw 3021 and a holder.

[0051] Alternatively, the lateral-posterior linkage minimally invasive spinal puncture guidance system can eliminate the need for an arc-shaped guide track and directly use a fixed guide, thus fixing the puncture angle and meeting some requirements.

[0052] Figure 9To guide the use of the puncture guidance system, under X-ray fluoroscopy guidance, the correct puncture position and direction are located using the puncture tool of the pedicle screw 2011. A guidewire is inserted, and the pedicle screw 2011 is screwed in along the guidewire until its tip reaches the location where the pedicle needs to be severed. The intramedullary nail handle 2013 is removed, and the sliding arm 202 and guide rail 10 are installed. The puncture angle is adjusted to ensure that the lateral puncture angle avoids abdominal organs. The sliding arm 202 has indicator points, and the guide rail 10 has angle graduations to display the angle between the fixed end and the guide end. The guide rail 10 is adjusted so that the angle between the guide end 30 and the fixed end 20 is 90°, at which point the lateral puncture instrument is perpendicular to the pedicle to be severed. An dilator is inserted at the guide end, followed by the spinal endoscope, and the pedicle is severed under endoscopic guidance. Artificial pedicle 3021 is implanted into the space between the vertebral body and the anterior bone using artificial pedicle holder 3022. Intramedullary nail 2011 is screwed into the hollow structure 3021c and driven into the vertebral body. Bone cement is injected into the vertebral body through the lateral opening 2011a of the intramedullary nail to improve the fixation effect.

[0053] like Figure 10 As shown, two puncture guidance systems are installed on the same vertebra. A connecting crossbar 303 can be installed between the fixed ends 20 of the guidance systems to increase stability. Alternatively, the fixed ends 20 can be connected to the bed frame via a serpentine arm to achieve the same effect.

Claims

1. A posterolateral linkage minimally invasive spinal puncture guidance system, characterized in that, It includes a guide rail and a fixed end and a guide end disposed on the guide rail. The fixed end includes a sliding arm and a first puncture instrument connected thereto. The guide end is provided with a guide sleeve, into which a second puncture instrument can be inserted. The fixed end and the guide end are located on an arc with the same center. When the puncture direction of the fixed end is known, the orientation of the guide end is determined according to the correspondence between the fixed end and the guide end. The first puncture instrument includes an intramedullary nail with a cortical bone thread at the posterior end and a cancellous bone thread at the anterior end; the intramedullary nail has an opening on its anterior side for injecting bone cement into the vertebral body; the first puncture instrument also includes an intramedullary nail screwdriver and an intramedullary nail handle, the intramedullary nail screwdriver being connected to the rear end of the intramedullary nail, and the intramedullary nail handle being located on the intramedullary nail screwdriver; The second puncture instrument includes an artificial pedicle, the size of which is smaller at the insertion end than at the connection end; The artificial pedicle is hollow in the middle for inserting the intramedullary nail; the surface of the artificial pedicle in contact with the bone is provided with anti-slip texture, and the interior of the artificial pedicle has a loose and porous structure; the second puncture instrument also includes an artificial pedicle holder, which is connected to the connection port of the artificial pedicle connection end.

2. The posterolateral linkage spinal minimally invasive puncture guidance system according to claim 1, characterized in that, The guide rail is an arc-shaped guide rail.

3. The posterolateral linkage spinal minimally invasive puncture guidance system according to claim 1, characterized in that, The sliding arm and guide rail are equipped with scales and locking structures, which are used for positioning and locking the guide end when the guide rail slides.

4. The posterolateral linkage spinal minimally invasive puncture guidance system according to claim 1, characterized in that, The fixed end can be connected to the bed body via a serpentine arm.

5. The posterolateral linkage spinal minimally invasive puncture guidance system according to claim 1, characterized in that, A connecting crossbar is provided between the fixed ends of multiple puncture guidance systems to improve the stability when multiple systems are in use.

6. The posterolateral linkage spinal minimally invasive puncture guidance system according to claim 1, characterized in that, The tail end of the intramedullary nail is fitted with a pad to prevent the nail from sinking into the bone.

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