An expandable and height-adjustable curette

Abstract

The present invention provides an expandable and height-adjustable curette, which includes an expandable cutter head, an inner tube, and a pull rod disposed inside the inner tube; it also includes a handle structure, which includes a pressing handle and a main handle; the pressing handle drives the expandable cutter head to adjust the height through the pull rod; a height stroke limit protection structure, which includes a spring, an inner limit block, an outer limit block, and an indicating block sequentially sleeved on the second fixing column at the distal end of the pressing handle; the indicating block drives the inner limit block to rotate to control the pressing height of the pressing handle. The curette provided by the present invention can pass through a surgical working channel with a diameter of less than 7 mm to meet the requirements of minimally invasive surgery. The cutter head can be expanded and height-adjusted to meet the needs of patients with different intervertebral disc sizes and heights, reducing the specifications of surgical instruments and simplifying the surgery. It is also provided with a height stroke limit protection device, which protects patients with relatively low intervertebral disc heights while meeting the requirements of different intervertebral disc heights, and eliminates the risks brought by misoperations, ensuring the safety of surgical operations.

Description

Technical Field

[0001] The present invention relates to the field of spinal intervertebral fusion surgical instruments, and in particular to an expandable height-adjustable curette. Background Art

[0002] Spinal fusion surgery has achieved good results in treating cervical and lumbar pain and cervical and lumbar instability. It is a routine procedure for treating degenerative disc disease, spondylolisthesis, and segmental spinal instability. In order to achieve an acceptable spinal fusion surgery, it is necessary to use disc processing tools to process / remove the existing disc before fusion device implantation.

[0003] With the development of medicine, fusion surgery under minimally invasive channels is developing rapidly, but the development of corresponding surgical instruments is obviously lagging behind, making some minimally invasive surgeries time-consuming or inconvenient to operate. Most of the existing conventional operating instruments are fixed structures, and their processing tools cannot pass through the minimally invasive working channel. Even if they can enter the intervertebral space through the minimally invasive channel, the processing efficiency is low, it is difficult to clean, and the electric processing tools are not safe.

[0004] Patent CN107714140A discloses an adjustable intervertebral curette. Before the intervertebral nucleus pulposus and cartilage endplate are removed, the scraping structure of the intervertebral curette is in a contracted state, and its transverse diameter is in a minimum state, so that the intervertebral curette can be inserted into the intervertebral space through a small incision or a channel such as a poroscope; after the intervertebral curette is inserted into the intervertebral space, the scraping structure is in an expanded state by controlling the adjustment structure, thereby increasing the contact area between the scraping structure and the intervertebral disc and / or the vertebral cartilage endplate, and increasing the amount of tissue scraped in a single time, which is very suitable for scraping the intervertebral nucleus pulposus and cartilage endplate under a small incision or channel. However, since the scraping structure is made of elastic material, there is a risk of deformation when the scraping structure is rotated in the expanded state to scrape the intervertebral disc tissue, which affects the effectiveness and safety of the intervertebral disc treatment. At the same time, the elastic material cannot expand the intervertebral space after expansion; there is no expansion height mark on the instrument, and it is impossible to clearly adjust the expansion height of different specifications to adapt to intervertebral discs of different sizes and heights.

[0005] Patent CN107708584A discloses a discectomy tool. This invention uses electric drive, which is safe to use. It solves the problem of low removal efficiency due to the small blade head of manual drive. It also uses a rotatable, flexible transmission shaft to adjust the bend to increase the disc treatment area. However, this invention cannot be adjusted in height, and has poor treatment effect on the vertebral cartilage endplate.

[0006] Therefore, a technology is provided to perform more convenient intervertebral disc scraping, vertebral end plate scraping, and even localized intrabone tumor scraping, distraction and reduction of compression bone fractures, etc. in a small incision or channel. It has the advantages of easy operation, multiple adjustments, safe implementation, and high resection efficiency. Summary of the Invention

[0007] In order to solve the problem that the development of the intervertebral disc treatment tools supporting minimally invasive fusion surgery in the prior art lags behind, conventional treatment tools cannot pass through the minimally invasive working channel, and the treatment tools that can match the minimally invasive working channel cannot balance in terms of treatment efficiency, treatment effect, operation simplicity and safety, which affects the intervertebral disc removal effect and finally affects the fusion effect, the present invention provides a dilatable and height-adjustable curette.

[0008] To achieve the above object, the present invention adopts the following technical solutions:

[0009] A dilatable and height-adjustable curette includes a dilatable cutter head, an inner tube, and a pull rod disposed inside the inner tube; wherein the proximal ends of the dilatable cutter head are respectively pin-connected to the distal end of the inner tube and the distal end of the pull rod, and the curette further includes:

[0010] A handle structure, which includes a pressing handle and a main handle; the pressing handle drives the dilatable cutter head to adjust the height through the pull rod;

[0011] A height stroke limit protection structure, which includes a spring, an inner limit block, an outer limit block, and an indicating block sequentially sleeved on the second fixing column at the distal end of the pressing handle; the outer limit block is fixedly connected to the main handle, and the spring supports the inner limit block to cooperate with the outer limit block for limiting; the indicating block drives the inner limit block to rotate to control the pressing height of the pressing handle, thereby limiting the maximum height adjustment height of the cutter head.

[0012] Preferably, it further includes a cutter head expansion driving structure, which includes an outer tube sleeved outside the dilatable cutter head and the inner tube; by pulling the outer tube to move relative to the dilatable cutter head, the expansion and contraction of the dilatable cutter head are controlled.

[0013] Preferably, the cutter head expansion driving structure includes:

[0014] A limit block is sleeved on the proximal end of the outer tube, and the inner circular edge of the proximal end of the limit block extends a plurality of non-connected arc-shaped parts along the outer surface of the outer tube, and the proximal ends of the arc-shaped parts are connected to the distal end of the main handle by screws;

[0015] A slider sleeved outside the inner tube, and part of the external thread on the outer surface of the slider extends out of the gap between the two arc-shaped parts, and the distal end of the slider is connected to the proximal end of the outer tube;

[0016] A threaded rotating block is sleeved outside the arc-shaped part, and by rotating the rotating block, the slider slides relative to the arc-shaped part and drives the outer tube to move relative to the dilatable cutter head.

[0017] Further, the distal end of the slider is welded and cooperated with the proximal end of the outer tube.

[0018] Furthermore, the limiting block and the main handle cooperate to enable the rotating block to only rotate and the slider to only slide.

[0019] Preferably, the expandable cutter head includes a main cutter head and a sub-cutter head, and the sub-cutter head is fixed to both sides of the main cutter head through fixing pins; further, the main cutter head is connected to the pull rod and the inner tube pin.

[0020] Preferably, the sub-cutter head is made of an expandable material; further, the material of the sub-cutter head is a shape memory metal.

[0021] Preferably, key groove structures are respectively provided on the main cutter head and the sub-cutter head and are matched with each other.

[0022] Preferably, rotate the rotating block until the expandable cutter head is wrapped in the outer tube, set a proximal marking line on the outer surface of the outer tube, and mark the corresponding position of the edge of the distal end of the limiting block on the outer tube at this time; rotate the rotating block until the expandable cutter head is fully expanded, set a distal marking line on the outer surface of the outer tube, and mark the corresponding position of the edge of the distal end of the limiting block on the outer tube at this time.

[0023] Preferably, a connecting portion extends from the inner circular edge of the inner limiting block, passes through the outer limiting block and is fixedly connected to the indicating block; further, the connecting portion is cylindrical.

[0024] Preferably, an outer gear is provided on the outer surface of the inner limiting block and is engaged with an inner gear provided in the outer limiting block; the spring supports the inner limiting block and the outer limiting block to be limited by the cooperation of the outer gear and the inner gear.

[0025] Preferably, the outer diameter of the outer tube < 7 mm.

[0026] Preferably, spring pieces are respectively fixed to the inner sides of the main handle and the pressing handle through screws.

[0027] Preferably, the pressing handle and the main handle are connected by the cooperation of the first fixing column at the distal end of the pressing handle and a screw; the proximal end of the inner tube is fixedly connected to the distal end of the main handle through a screw, and the proximal end of the pull rod is connected to the distal end of the pressing handle.

[0028] Preferably, the proximal end of the inner tube is fixedly connected to the distal end of the main handle through a screw.

[0029] Adopting the above technical solutions, the present invention has the following technical effects compared with the prior art:

[0030] 1) The curette provided by the present invention can pass through a surgical working channel with a diameter of less than 7 mm, meeting the requirements of minimally invasive surgery. The extremely small access allows for a wide range of tool adaptability and causes little harm to patients.

[0031] 2) The cutter head can be expanded and adjusted in height, meeting the needs of patients with different disc sizes and heights, reducing the specifications of surgical instruments, and simplifying the surgery.

[0032] 3) The main cutter head and the secondary cutter head are provided with a matching keyway structure, which can provide a certain degree of stiffness when scraping the cartilage endplate while ensuring the requirements of axial deformation.

[0033] 4) The present invention is provided with a height travel limit protection structure, which protects patients with relatively low disc heights while meeting the requirements of different disc heights, eliminates the risks brought by misoperations, and ensures the safety of surgical operations.

[0034] 5) The secondary cutter head is made of an expandable material, and the treatment area after the cutter head is expanded is more than twice that before expansion, ensuring that the instrument can be minimally invasively implanted and has a strong disc treatment ability, improving the efficiency of the surgery.

[0035] 6) On the basis of ensuring minimally invasive implantation, treatment efficiency, and treatment effect, this disc treatment tool is fully manually operated during use, ensuring the safety of surgical operations. BRIEF DESCRIPTION OF THE DRAWINGS

[0036] Figure 1 Schematic diagram of an expandable height-adjustable curette according to the present invention;

[0037] Figure 2 Schematic diagram of the working principle of an expandable height-adjustable curette according to the present invention;

[0038] Figure 3 Schematic diagram of the contraction method of the expandable cutter head according to the present invention;

[0039] Figure 4 Schematic diagram of the structure of the expandable cutter head according to the present invention;

[0040] Figure 5 Schematic diagram of the driving principle of the expandable cutter head according to the present invention;

[0041] Figure 6 Schematic diagram of the height adjustment principle of the expandable cutter head according to the present invention;

[0042] Figure 7 First perspective structure schematic diagram of the height travel limit protection structure according to the present invention;

[0043] Figure 8 Second perspective structure schematic diagram of the height travel limit protection structure according to the present invention;

[0044] Explanation of the marks in the figure:

[0045] 1 - Expanding cutter head, 2 - Cutter head expansion drive structure, 3 - Handle structure, 4 - Height stroke limit protection structure, 5 - Main cutter head, 6 - Sub - cutter head, 7 - Limit block, 8 - Rotary block, 9 - Slide block, 10 - Outer tube, 11 - Press handle, 12 - Main handle, 13 - Spring piece, 14 - Indicator block, 15 - Outer limit block, 16 - Inner limit block, 17 - Spring, 18 - Pull rod, 19 - Inner tube, 20 - First fixing column, 21 - Second fixing column, 22 - Concave part, 23 - Protruding part, 24 - Arc part. Detailed implementation mode

[0046] The present invention will be introduced in detail and specifically through specific embodiments to better understand the present invention. However, the following embodiments do not limit the scope of the present invention.

[0047] In the present invention, the proximal end refers to the end close to the surgical operator, and the distal end refers to the end far from the surgical operator.

[0048] Embodiment 1

[0049] In this embodiment, as Figure 1-8 shown in, a kind of expandable and height - adjustable curette is provided, which includes an expandable cutter head 1, an inner tube 19 and a pull rod 18 arranged in the inner tube 19; wherein the proximal end of the expandable cutter head 1 is respectively pin - connected with the distal end of the inner tube 19 and the distal end of the pull rod 18. The curette further includes:

[0050] A handle structure 3, which includes a press handle 11 and a main handle 12; the press handle 11 drives the expandable cutter head 1 to adjust the height through the pull rod 18;

[0051] A height stroke limit protection structure 4, which includes a spring 17, an inner limit block 16, an outer limit block 15 and an indicator block 14 sleeved in sequence on the second fixing column 21 at the distal end of the press handle 11; the outer limit block 15 is fixedly connected with the main handle 12, and the spring 17 supports the inner limit block 16 to cooperate with the outer limit block 15 for limiting; the indicator block 14 drives the inner limit block 16 to rotate to control the pressing height of the press handle.

[0052] In this embodiment, as Figure 7-8 shown, in the normal matching state, the spring 17 is compressed, and under the elastic force, the gear of the inner limit block 16 cooperates with the outer limit block 15. In this state, the indicator block 14 and the inner limit block 16 cannot rotate; when the height needs to be adjusted, the indicator block 14 is pressed, the cooperation between the inner limit block 15 and the outer limit block 16 is released. At this time, the indicator block 14 and the inner limit block 16 can rotate. By rotating the indicator block 14 to drive the limit block 16 to rotate, the distance from the protruding part of the inner limit block 16 to the edge of the concave part of the press handle 11 changes, changing the maximum pressing angle of the press handle 11 and controlling the lifting height of the expandable cutter head 1.

[0053] Further preferably, as Figure 7-8 shown in Figure 7-8 , an outer gear is provided on the outer surface of the inner limiting block 16 and is engaged with an inner gear provided inside the outer limiting block 15; the spring 17 supports the inner limiting block 16 and the outer limiting block 15 is limited by the engagement of the outer gear and the inner gear.

[0054] In this embodiment, as Figure 3-4 shown in Figure 3-4 , the expandable cutter head 1 includes a main cutter head 5 and a sub-cutter head 6, and the sub-cutter head 6 is fixed to both sides of the main cutter head 5 through fixing pins; further, the main cutter head 5 is pin-connected to the pull rod 18 and the inner tube 19; preferably, the sub-cutter head 6 is made of an expandable material; further, the material of the sub-cutter head 6 is a shape memory metal.

[0055] Further preferably, key groove structures are respectively provided on the main cutter head 5 and the sub-cutter head 6, which can provide a certain rigidity when scraping the cartilage endplate while meeting the requirements of axial deformation; as Figure 3-5 shown in Figure 3-5 , the outer tube 10 can move back and forth under the action of the expansion driving structure 2. Under the action of the outer tube 10, the sub-cutter head 6 can be deformed under the guiding action of the notch of the main cutter head 5, and the notch also improves the rigidity of the cutter head when scraping the cartilage endplate.

[0056] In this embodiment, as Figure 5 shown in Figure 5 , it further includes a cutter head expansion driving structure 2, which includes an outer tube 10 sleeved outside the expandable cutter head 1 and the inner tube 19; by pulling the outer tube 10 to move relative to the expandable cutter head 1, the expansion and contraction of the expandable cutter head 1 are controlled.

[0057] Further preferably, as Figure 5 shown in Figure 5 , the cutter head expansion driving structure 2 includes:

[0058] A limiting block 7 is sleeved on the proximal end of the outer tube 10. The inner circular edge of the proximal end of the limiting block 7 extends a plurality of non-connected arc-shaped parts 24 along the outer surface of the outer tube 10, and the proximal ends of the arc-shaped parts 24 are connected to the distal end of the main handle 12 by screws;

[0059] A slider 9 sleeved outside the inner tube 19, and part of the external thread on the outer surface of the slider 9 extends out of the gap between the two arc-shaped parts 24, and the distal end of the slider 9 is connected to the proximal end of the outer tube 10;

[0060] A rotary block 8 with internal threads is sleeved outside the arc-shaped parts 24. By rotating the rotary block 8, the slider 9 slides relative to the arc-shaped parts 24 and drives the outer tube 10 to move relative to the expandable cutter head 1.

[0061] Even further, asFigure 2 Among them, there are two arc portions, and the external threads on the outer surface of the slider 9 extend out of the gaps between the two arc portions and are engaged with the internal threads in the rotating block 8; preferably, the distal end of the slider 9 is welded and engaged with the proximal end of the outer tube 10.

[0062] In this embodiment, as Figure 1 Among them, rotate the rotating block 8 until the expandable cutter head 1 is wrapped in the outer tube 10, and set a proximal marking line on the outer surface of the outer tube 10 to mark the corresponding position of the edge of the distal end of the limiting block 7 on the outer tube 10 at this time; rotate the rotating block 8 until the expandable cutter head 1 is fully expanded, and set a distal marking line on the outer surface of the outer tube 10 to mark the corresponding position of the edge of the distal end of the limiting block 7 on the outer tube 10 at this time.

[0063] In this embodiment, as Figure 1-2 Among them, the limiting block 7 and the main handle 12 cooperate to make the rotating block 8 can only rotate and the slider 9 can only slide.

[0064] In this embodiment, as Figure 7-8 Among them, a cylinder extends out from the inner circular edge of the inner limiting block 16, passes through the outer limiting block 15 and is fixedly connected with the indicating block 14.

[0065] In this embodiment, the outer diameter of the outer tube 10 is < 7 mm.

[0066] In this embodiment, as Figure 1-2 Among them, spring pieces 13 are respectively fixed on the inner sides of the main handle 12 and the pressing handle 11 by screws.

[0067] In this embodiment, as Figure 1-2 Among them, the pressing handle 11 and the main handle 12 are connected by cooperation of the first fixing column 20 at the distal end of the pressing handle 11 and a screw; the proximal end of the inner tube 19 is fixedly connected with the distal end of the main handle 12 by a screw, and the proximal end of the pull rod 18 is connected with the distal end of the pressing handle 11.

[0068] Embodiment 2

[0069] This embodiment provides a specific use method of the expandable and height-adjustable curette provided in Embodiment 1.

[0070] In minimally invasive fusion surgery, after placing the working trocar, use a nucleus pulposus forceps to fenestrate the intervertebral disc, simply remove the nucleus pulposus and process it with a reamer. Then apply the expandable and height-adjustable curette provided in Embodiment 1, including the following steps:

[0071] (1) According to the preoperative intervertebral disc height assessment result of the patient, adjust the height travel limit protection structure 4. Press the indicating block 14 to release the limit between the inner limit block 16 and the outer limit block 15. Rotate the indicating block 14 to align with the maximum intervertebral disc height of the patient on the main handle 12, and then release the pressure on the indicating block 14. The inner limit block 16 cooperates with the outer limit block 15 for limiting under the action of the spring 17;

[0072] (2) Rotate the rotating block 8 to drive the outer tube 10 to move distally through the slider 9, compressing the secondary cutter head 6 to deform, so that the expandable cutter head 1 can pass through the working sleeve until the proximal marking line of the outer tube 10 aligns with the lower end face of the limit block 7; then insert the distal end of the curette into the working sleeve. After the expandable cutter head 1 enters the intervertebral disc position, rotate the rotating block 8 in the reverse direction, and the slider 9 drives the outer tube 10 to move proximally until the distal marking line of the outer tube 10 aligns with the lower end face of the limit block 7, and the secondary cutter head 6 returns to its original shape; while scraping the cartilage endplate back and forth, adjust the force of pressing the pressure handle 11 in real time according to the force feedback, so that the expandable cutter head 1 fits the cartilage endplate in real time until the treatment of the cartilage endplate is completed, and then treat the other side of the cartilage endplate in the same way.

[0073] The specific embodiments of the present invention have been described in detail above, but they are only examples, and the present invention is not limited to the specific embodiments described above. For those skilled in the art, any equivalent modifications and substitutions made to the present invention are also within the scope of the present invention. Therefore, all equivalent changes and modifications made without departing from the spirit and scope of the present invention should be covered within the scope of the present invention.

Claims

1. An expandable and height-adjustable curette, characterized in that, It includes an expandable cutter head (1), an inner tube (19), and a pull rod (18) disposed within the inner tube (19); wherein the proximal ends of the expandable cutter head (1) are respectively pin-connected to the distal end of the inner tube (19) and the distal end of the pull rod (18), and the curette further includes: A handle structure (3), which includes a pressing handle (11) and a main handle (12); the pressing handle (11) drives the expandable cutter head (1) to move up through the pull rod (18). A height travel limit protection structure (4), which includes a spring (17), an inner limit block (16), an outer limit block (15), and an indicating block (14) sequentially sleeved on a second fixed column (21) at the distal end of the pressing handle (11); the outer limit block (15) is fixedly connected to the main handle (12), and the spring (17) supports the inner limit block (16) to cooperate with the outer limit block (15) for limiting; the indicating block (14) drives the inner limit block (16) to rotate to control the pressing height of the pressing handle.

2. The expandable and height-adjustable curette according to claim 1, wherein, It further includes a cutter head expansion driving structure (2), which includes an outer tube (10), and the outer tube (10) is sleeved outside the expandable cutter head (1) and the inner tube (19); by pulling the outer tube (10) to move relative to the expandable cutter head (1), the expansion and contraction of the expandable cutter head (1) are controlled.

3. The expandable and height-adjustable curette according to claim 2, wherein, The cutter head expansion driving structure (2) includes: A limit block (7) is sleeved on the proximal end of the outer tube (10), and the inner circular edge of the proximal end of the limit block (7) extends a plurality of non-connected arc-shaped parts (24) along the outer surface of the outer tube (10), and the proximal ends of the arc-shaped parts (24) are connected to the distal end of the main handle (12) by screws. A slider (9) sleeved outside the inner tube (19), and a part of the external thread on the outer surface of the slider (9) extends out of the gap between the two arc-shaped parts (24), and the distal end of the slider (9) is connected to the proximal end of the outer tube (10). A threaded rotating block (8) is sleeved outside the arc-shaped parts (24), and by rotating the rotating block (8), the slider (9) slides relative to the arc-shaped parts (24) and drives the outer tube (10) to move relative to the expandable cutter head (1).

4. The expandable and height-adjustable curette according to claim 3, characterized in that, Rotate the rotating block (8) until the expandable cutter head (1) is wrapped in the outer tube (10), and set a proximal marking line on the outer surface of the outer tube (10) to mark the corresponding position of the edge of the distal end of the limit block (7) on the outer tube (10) at this time; rotate the rotating block (8) until the expandable cutter head (1) is fully expanded, and set a distal marking line on the outer surface of the outer tube (10) to mark the corresponding position of the edge of the distal end of the limit block (7) on the outer tube (10) at this time.

5. The expandable and height-adjustable curette according to claim 1, wherein, The expandable cutter head (1) includes a main cutter head (5) and a sub-cutter head (6), and the sub-cutter head (6) is fixed to both sides of the main cutter head (5) by fixing pins.

6. The expandable and height-adjustable curette according to claim 5, wherein The main cutter head (5) and the sub-cutter head (6) are respectively provided with matching keyway structures; the sub-cutter head (6) is made of an expandable material.

7. The expandable and height-adjustable curette according to claim 1, characterized in that, A connecting portion extends from the inner circular edge of the inner limiting block (16) along the second fixing post (21), and the connecting portion passes through the outer limiting block (15) and is fixedly connected to the indicating block (14).

8. The expandable and height-adjustable curette according to claim 1, wherein, The pressing handle (11) and the main handle (12) are connected by cooperation of a first fixing post (20) at the distal end of the pressing handle (11) and a screw; the proximal end of the inner tube (19) is fixedly connected to the distal end of the main handle (12) by a screw, and the proximal end of the pull rod (18) is connected to the distal end of the pressing handle (11).

9. The expandable and height-adjustable curette according to claim 1, characterized in that, An outer gear is provided on the outer surface of the inner limiting block (16) and is matched with an inner gear provided in the outer limiting block (15); the spring (17) supports the inner limiting block (16) and the outer limiting block (15) to be limited by the cooperation of the outer gear and the inner gear.

10. The expandable and height-adjustable curette according to claim 1, characterized in that, Spring pieces (13) are respectively fixed to the inner sides of the main handle (12) and the pressing handle (11) by screws.

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