Retractor for posterior unilateral lumbar spine surgery

Abstract

The present invention provides a retractor for posterior lumbar unilateral approach surgery, belonging to the technical field of medical devices. It includes a frame, a main retractor, a locking clamp assembly, a plurality of narrow retractors and a mechanical arm; the frame is a rounded rectangular structure, the frame has four sides, a connecting rod is provided on the frame, the mechanical arm is fixedly connected to the connecting rod to stabilize the frame, the main retractor and the narrow retractor are evenly distributed on the frame frame, the narrow retractor is connected to the frame through the locking clamp assembly, the main retractor is connected to the frame through an adjustable connecting mechanism, the adjustable connecting mechanism includes a fixing part and an adjusting part, the adjusting part is connected below the main retractor, and the fixing part is arranged on the front side of the frame, which can make the surgical field fully displayed, the light is sufficient, and it is convenient for minimally invasive surgery.

Description

Technical Field

[0001] The invention belongs to the technical field of medical devices, and in particular relates to a retractor for posterior lumbar unilateral approach surgery. Background Art

[0002] At present, the main retractors used in posterior lumbar surgery are bilateral automatic main retractors, unilateral main retractors, posterior cranial fossa retractors, and horn retractors. With the deepening of the concept of minimally invasive surgery, unilateral approach and unilateral / bilateral decompression techniques can be used for some lumbar degenerative diseases. For unilateral approach surgery, the outer side of the surgical area is the paraspinal muscle, and the inner side is the spinous process and lumbar fascia. The use of bilateral automatic main retractors, posterior cranial fossa retractors, and horn retractors is not suitable for use because of the uneven force on both sides. The stability is relatively poor after the tissue is retracted, and the inner part of the retractor blocks the surgical field. The use of ordinary unilateral main retractors requires manpower to retract the paraspinal muscles, and the use of unilateral main retractors cannot retract the inner lumbar fascia and the upper and lower soft tissues of the surgical area, and the surgical field is not fully displayed. With the development of minimally invasive technology, the posterior lumbar unilateral approach technology has also been clinically applied to a certain extent. The unilateral approach is a minimally invasive surgery with a small incision, and it is difficult for ordinary surgical lights to illuminate the surgical field. Summary of the invention

[0003] The invention provides a lumbar spine posterior unilateral approach surgical retractor, which can fully display the surgical field and provide sufficient light, thus facilitating minimally invasive surgical operations.

[0004] The present invention solves the technical problem through the following technical solutions:

[0005] A retractor for posterior lumbar unilateral approach surgery, comprising a frame, a main retractor, a locking clamp assembly, a plurality of narrow retractors and a mechanical arm; the frame is a rounded rectangular structure, the frame has four sides, a connecting rod is provided on the frame, the mechanical arm is fixedly connected to the connecting rod to stabilize the frame, the main retractor and the narrow retractor are evenly distributed on the frame frame, the narrow retractor is connected to the frame through the locking clamp assembly, the main retractor is connected to the frame through an adjustable connecting mechanism, the adjustable connecting mechanism comprises a fixing member and an adjusting member, the adjusting member is connected below the main retractor, and the fixing member is arranged on the front side of the frame The fixing piece is cylindrical, and both ends of the fixing piece are fixed on the frame. A through hole is provided in the middle of the adjusting piece, and the adjusting piece is sleeved outside the fixing piece. A fastening screw hole is provided on the side wall of the adjusting piece, and the fastening screw hole connects the top of the main hook and the through hole in the middle of the adjusting piece. A locking screw is provided in the fastening screw hole, and the locking screw can be screwed inward along the fastening screw hole to resist the outer wall of the fixing piece; a first cone tip is provided at the bottom end of the main hook, and a second cone tip is provided at the bottom end of the narrow hook, and the first cone tip of the main hook faces the inside of the frame, and the second cone tip of the narrow hook faces the outside of the frame.

[0006] The above-mentioned retractor for posterior lumbar unilateral approach surgery has a main retractor hook provided with a bracket capable of adjusting the angle of a cold light source; the bracket comprises a plurality of locking buckles, a plurality of connecting rods and a cold light source sleeve, the connecting rods being connected and changing direction by locking buckles; the cold light source sleeve is fixed on the locking buckle at the end of the bracket, and the cold light source sleeve can fix a medical cold light source.

[0007] The above-mentioned retractor for posterior lumbar unilateral approach surgery, the connecting rod is L-shaped, the locking buckle includes two clips and a fastening bolt, the two sides of the clip are provided with a slot, the slot is arc-shaped, the center of the clip is provided with a clamping screw hole, the fastening bolt passes through the clamping screw hole to press the two clips together, the connecting rod is located in the slot between the two clips, the main retractor is provided with a screw hole, the fastening bolt passes through the clamping screw hole and the screw hole of the locking buckle located at the top of the bracket, so that the bracket is installed on the main retractor.

[0008] The above-mentioned retractor for posterior lumbar spine unilateral approach surgery has three narrow retractor hooks, which include a narrow hook body and a retractor handle. The narrow hook body is sheet-shaped and the retractor handle is cylindrical. The retractor handle is arranged at the control end of the narrow hook body, and the second cone tip is arranged at the working end of the narrow hook body.

[0009] The above-mentioned retractor for posterior lumbar spine unilateral approach surgery, the locking clamp assembly includes a pancake-shaped clamp block, a compression screw and a compression nut, the clamp blocks are, from bottom to top, a first clamp block, a second clamp block, a third clamp block and a fourth clamp block, the centers of the second clamp block, the third clamp block and the fourth clamp block are provided with a center hole, the bottom ends of the compression screw are connected to the center of the first clamp block and are perpendicular to each other, the compression screw passes through the center holes of the second clamp block, the third clamp block and the fourth clamp block from bottom to top, a compression spring is provided between the second clamp block and the third clamp block, the top of the compression screw is screwed with a compression nut, the top surface of the first clamp block is provided with a first columnar groove, the bottom surface of the second clamp block is provided with a second groove corresponding to the first groove, the first groove and the second groove can be buckled to clamp the frame, the top surface of the third clamp block and the bottom surface of the fourth clamp block are respectively provided with a third groove and a fourth groove, the third groove and the fourth groove can clamp the pull handle after buckling.

[0010] The above-mentioned retractor for posterior lumbar unilateral approach surgery has teeth parallel to the axial direction on the outer wall of the fixing part, and the inner wall of the through hole of the adjusting part has protrusions matching the teeth on the outer wall of the fixing part. The inner diameter of the adjusting part is larger than the outer diameter of the fixing part, and the adjusting part can rotate outside the fixing part.

[0011] In the above-mentioned retractor for posterior lumbar unilateral approach surgery, the top surface of the second clamping block and the bottom surface of the third clamping block are both provided with spring limiting grooves, the spring limiting grooves are located around the central hole, and the two ends of the compression spring are located in the spring limiting grooves.

[0012] Compared with the prior art, the frame of the present invention is provided with a mechanical arm, and the frame can be fixed to the operating table by the mechanical arm, so that the frame structure is more stable and the instability of human power is avoided.

[0013] The main retractor and three narrow retractors of the present invention can simultaneously pull the tissues around the surgical area to all sides, fully revealing the surgical field of view. The main retractor can pull the paraspinal muscles outward, and the three narrow retractors can pull the soft tissues in the other three directions to form a rectangular surgical field of view. The narrow retractors are fixed to the frame through a locking clamp group, and the pulling degree can be adjusted according to the situation during the operation to meet the actual operation requirements.

[0014] The first cone tip of the main retractor of the present invention can be fixed to the outside of the superior articular process, and the main retractor is fixed to the frame through an adjustable connecting mechanism, so that the main retractor is fixed more firmly and can save surgical assistants. The first cone tip and the second cone tip of the present invention are conical. In the unilateral approach unilateral decompression, the tip of the medial retractor can be embedded in the cortex on the opposite side of the spinous process after the soft tissue is pulled away by the medial retractor; in the unilateral approach contralateral sneak decompression, the root of the spinous process can be broken, the spinous process can be pulled to the opposite side, and the first cone tip of the main retractor can be embedded in the outer cortex of the opposite lamina; similarly, after the narrow retractor pulls the soft tissue away, the second cone tip can be embedded in the lamina or tissue in other directions. The handle is fixed to the frame, which can make the fixation more secure and avoid the displacement of the main retractor or the narrow retractor during the operation, resulting in unclear surgical field of view.

[0015] The bracket of the present invention can freely adjust the direction of the cold light source sleeve, so that the cold light source can accurately illuminate the operation area, making the surgical field of view clearer, solving the problem of insufficient light exposure in the small operation space of minimally invasive surgery, improving the convenience and safety of the surgery, and ensuring the smooth progress of the surgery. BRIEF DESCRIPTION OF THE DRAWINGS

[0016] Figure 1 It is a structural schematic diagram of the present invention;

[0017] Figure 2 A schematic diagram of the structure of the main puller;

[0018] Figure 3 It is a schematic diagram of the structure of a narrow pull hook;

[0019] Figure 4 It is a schematic diagram of the exploded structure of the locking clip assembly;

[0020] Figure 5 is a schematic diagram of the structure of the bracket;

[0021] Figure 6 It is a schematic diagram of the structure of the decomposed locking buckle;

[0022] Figure 7 The diagram of the main retractor in use.

[0023] The symbols in the figure represent:

[0024] 1. Frame, 2. Main draw hook, 3. Locking clamp assembly, 4. Narrow draw hook, 5. Connecting rod, 6. Screw mouth, 7. Bracket, 8. First cone tip, 9. Locking screw, 10. Fixing piece, 11. Narrow hook body, 12. Second cone tip, 13. Pull handle, 14. First clamp block, 15. Second clamp block, 16. Third clamp block, 17. Fourth clamp block, 18. Compression nut, 20. Adjustment piece, 22. First groove, 23. Compression screw, 24. Second groove, 26. Center hole, 27. Spring limit groove, 28. Third groove, 31. Fourth groove, 36. Compression spring, 37. Locking buckle, 38. Connecting rod, 43. Cold light source sleeve, 45. Clip, 46. Clamping screw hole, 47. Fastening bolt. DETAILED DESCRIPTION

[0025] The specific implementation of the present invention is further described in detail below in conjunction with the accompanying drawings and examples. The following examples are used to illustrate the present invention.

[0026] As attached Figure 1 To Attachment Figure 6 As shown, the present invention includes a frame 1, a main hook 2, a locking clamp assembly 3, a plurality of narrow hooks 4 and a mechanical arm; the frame 1 is a rounded rectangular structure, the frame 1 has four sides, a connecting rod 5 is provided on the frame, the mechanical arm is fixedly connected to the connecting rod 5 to stabilize the frame 1, the main hook 2 and the narrow hook 4 are evenly distributed on the frame 1 border, the narrow hook 4 is connected to the frame through the locking clamp assembly 3, the main hook 2 is connected to the frame 1 through an adjustable connecting mechanism, the adjustable connecting mechanism includes a fixing member 10 and an adjusting member 20, the adjusting member 20 is connected below the main hook 2, the fixing member 10 is arranged on the front side of the frame 1, and the fixing member 10 It is cylindrical, and both ends of the fixing member 10 are fixed on the frame 1. A through hole is provided in the middle of the adjusting member 20, and the adjusting member 20 is sleeved outside the fixing member 10. A fastening screw hole is provided on the side wall of the adjusting member 20, and the fastening screw hole connects the top of the main hook 2 and the through hole in the middle of the adjusting member 20. A locking screw 9 is provided in the fastening screw hole, and the locking screw 9 can be screwed inward along the fastening screw hole to resist the outer wall of the fixing member; a first cone tip 8 is provided at the bottom end of the main hook 2, and a second cone tip 12 is provided at the bottom end of the narrow hook 4, the first cone tip 8 of the main hook 2 faces the inside of the frame 1, and the second cone tip 12 of the narrow hook 4 faces the outside of the frame 1.

[0027] During the operation, the mechanical arm is first fixedly connected to the connecting rod 5 to stabilize the frame 1, the first cone tip of the main retractor 2 is clamped on the outer edge of the vertebral plate, the mechanical arm is adjusted to make the frame 1 horizontal, and the locking screw 9 is rotated to make the locking screw 9 abut against the outer wall of the fixing member 10, so that the main retractor 2 and the frame 1 can be fixed. At the same time, surgical assistants can be saved and the operation is simple.

[0028] See attached Figure 3 To Attachment Figure 6 Preferably, the narrow pull hook 4 is provided with three, and the narrow pull hook 4 includes a narrow hook body 11 and a pull handle 13, the narrow hook body 11 is sheet-shaped, and the pull handle 13 is cylindrical; the pull handle 13 is arranged at the control end of the narrow hook body 11, and the working end of the narrow hook body 11 is provided with a second cone tip 12. The locking clamp assembly 3 includes a pancake-shaped clamp block, a clamping screw 23 and a clamping nut 18, and the clamp blocks are, from bottom to top, a first clamp block 14, a second clamp block 15, a third clamp block 16 and a fourth clamp block 17, and the centers of the second clamp block 15, the third clamp block 16 and the fourth clamp block 17 are provided with a center hole 26, and the bottom end of the clamping screw 23 is connected to the center of the first clamp block 14 and is perpendicular to each other, and the clamping screw 23 passes through the center holes 26 of the second clamp block 15, the third clamp block 16 and the fourth clamp block 17 from bottom to top, and the second clamp block 1 A compression spring 36 is provided between the first clamp block 14 and the third clamp block 16, and the diameter of the compression spring is greater than the diameter of the center hole 26. A compression nut 18 is screwed on the top of the clamping screw 23. A columnar first groove 22 is provided on the top surface of the first clamp block 14, and a second groove 24 corresponding to the first groove 22 is provided on the bottom surface of the second clamp block 15. The first groove 22 and the second groove 24 can be buckled to clamp the frame. A third groove 28 and a fourth groove 31 are respectively provided on the top surface of the third clamp block 16 and the bottom surface of the fourth clamp block 17. The third groove 28 and the fourth groove 31 can be buckled to clamp the handle 13. When in use, first, the second clamp block 15, the compression spring 36, the third clamp block 16 and the fourth clamp block 17 are sequentially inserted into the compression screw 23, and then, the compression nut 18 is screwed onto the compression screw 23. Under the pressure of the compression spring 36, the first clamp block 14 and the second clamp block 15 are buckled, the third clamp block 16 and the fourth clamp block 17 are buckled, the first groove 22 and the second groove 24 are buckled to clamp the frame, and the third groove 28 and the fourth groove 31 are buckled to clamp the handle 13 of the narrow hook. According to actual needs, the position of the second cone tip 12 of the narrow hook can be adjusted by pulling the handle, thereby opening the incision. Then, the compression nut 18 is continuously rotated to make the first clamp block 14 and the second clamp block 15, the third clamp block 16 and the fourth clamp block 17 buckle and tighten, thereby fixing the position of the narrow hook. The front end of the narrow hook is arc-shaped, and the length of the narrow hook can be different specifications of 4-10cm.

[0029] See attached Figure 7During the operation, the first cone tip 8 of the main retractor 2 is inserted into the vertebral plate, and the tissue on the left side of the wound is blocked on the left side of the main retractor, thereby giving the main retractor a force to the right. Since the first cone tip 8 is inserted into the vertebral plate from left to right, the first cone tip 8 gives the main retractor 2 a force to the left, so that both the left and right sides of the main retractor are subjected to force, which helps to make the force between the main retractor and the vertebral plate more stable. Then, the soft tissue on the right side of the wound is pulled by three narrow retractors to form a stable surgical field of view within the frame, which can avoid the displacement of the narrow retractor and the main retractor caused by the pulling of the soft tissue during the operation, resulting in unclear surgical field of view. The pulling degree of the narrow retractor can be adjusted according to the situation during the operation, thereby adjusting the field of view, which can meet the operation requirements in the actual operation.

[0030] The main retractor 2 is provided with a bracket 7 with an adjustable cold light source angle; the bracket includes a plurality of locking buckles 37, a plurality of connecting rods 38 and a cold light source sleeve 43, and the connecting rods are connected and change direction through locking buckles; the cold light source sleeve is fixed on the card slot of the locking buckle at the end of the bracket 7, and the cold light source sleeves 43 and 44 can fix the medical cold light source. During the operation, the position of the locking buckle clamping the cold light source sleeve 43 can be adjusted by tightening the bolt 47 as needed, and the connection angle between the locking buckle and the connecting rod can be used to achieve steering, so that the cold light source can illuminate the surgical area, and the surgical field of view is clearer, which solves the problem of insufficient light exposure in the small field of view of minimally invasive surgery, improves the convenience and safety of the operation, and ensures the smooth progress of the operation.

[0031] Preferably, the connecting rods 38 and 40 are L-shaped, and the locking buckle includes two clips 45 and a fastening bolt 47. A slot is provided on both sides of the clip 45, and the slot is arc-shaped. A clamping screw hole 46 is provided in the center of the clip 45. The fastening bolt 47 passes through the clamping screw hole 46 to press the two clips 45 together. The connecting rod 38 is located in the slot between the two clips 45, and a screw hole 6 is provided on the main hook 2. The fastening bolt 47 passes through the clamping screw hole 46 of the locking buckle 37 located at the top of the bracket 7 and the screw hole 6, thereby installing the bracket 7 on the main hook 2.

[0032] In order to ensure the firmness and stability of the connection between the main retractor 2 and the frame 1, the outer wall of the fixing part 10 is provided with teeth parallel to the axial direction, the inner wall of the through hole of the adjusting part 20 is provided with protrusions matching the direction of the teeth on the outer wall of the fixing part, the inner diameter of the adjusting part 20 is larger than the outer diameter of the fixing part 10, and the adjusting part 20 can rotate outside the fixing part. Through the above arrangement, after tightening the locking screw 9, the locking screw 9 abuts against the outer wall of the fixing part 10, and the protrusion of the inner wall 21 of the adjusting part 20 on the opposite side of the locking screw 9 engages with the fixing part 10, thereby increasing the firmness of the connection between the adjusting part and the fixing part. By rotating the adjusting part 20, the main retractor can rotate with the fixing part 10 as the center, and the pulling angle of the main retractor can be adjusted so as to make fine adjustments during the actual operation.

[0033] The top surface of the second clamp block and the bottom surface of the third clamp block are both provided with spring limiting grooves, the spring limiting grooves match the parameters of the compression spring 36, the spring limiting grooves are located around the center hole 26, and the compression spring 36 is located in the spring limiting grooves. In this way, the compression spring 36 can be stabilized around the center hole 26, and the force of the compression spring 36 on the second clamp block and the third clamp block can be uniform, thereby improving stability.

[0034] The above is only a preferred embodiment of the present invention. It should be pointed out that for ordinary technicians in this technical field, several improvements and modifications can be made without departing from the technical principles of the present invention. These improvements and modifications should also be regarded as the scope of protection of the present invention.

Claims

1. A retractor for posterior lumbar spine unilateral approach surgery, characterized in that: The invention comprises a frame (1), a main retractor (2), a locking clamp assembly (3), a plurality of narrow retractor hooks (4) and a mechanical arm; the frame (1) is a rounded rectangular structure, the frame (1) has four sides, a connecting rod (5) is provided on the frame, the mechanical arm is fixedly connected to the connecting rod (5) to stabilize the frame (1), the main retractor hook (2) and the narrow retractor hook (4) are evenly distributed on the frame (1) border, the narrow retractor hook (4) is connected to the frame through the locking clamp assembly (3), the main retractor hook (2) is connected to the frame (1) through an adjustable connecting mechanism, the adjustable connecting mechanism comprises a fixing member (10) and an adjusting member (20), the adjusting member (20) is connected below the main retractor hook (2), the fixing member (10) is arranged on the front side of the frame (1), and the fixing member (10) is round. The fixing member (10) is columnar, with both ends of the fixing member (10) fixed on the frame (1), a through hole is provided in the middle of the adjusting member (20), the adjusting member (20) is sleeved outside the fixing member (10), a fastening screw hole is provided on the side wall of the adjusting member (20), the fastening screw hole communicates with the top of the main hook (2) and the through hole in the middle of the adjusting member (20), a locking screw (9) is provided in the fastening screw hole, and the locking screw (9) can be screwed inward along the fastening screw hole to resist the outer wall of the fixing member (10); the bottom end of the main hook (2) is provided with a first cone tip (8), and the bottom end of the narrow hook (4) is provided with a second cone tip (12), the first cone tip (8) of the main hook (2) faces the inside of the frame (1), and the second cone tip (12) of the narrow hook (4) faces the outside of the frame (1); The main retractor (2) is provided with a bracket (7) capable of adjusting the angle of the cold light source; the bracket comprises a plurality of locking buckles (37), a plurality of connecting rods (38) and a cold light source sleeve (43); the connecting rods (38) are connected and change direction via the locking buckles (37); the cold light source sleeve is fixed to the locking buckle (37) at the end of the bracket (7); and the cold light source sleeve (43) is capable of fixing a medical cold light source.

2. A retractor for posterior lumbar unilateral approach surgery according to claim 1, characterized in that: The connecting rod (38) is L-shaped, and the locking buckle (37) includes two clips (45) and a fastening bolt (47). The two sides of the clip (45) are provided with a slot, and the slot is arc-shaped. The center of the clip (45) is provided with a clamping screw hole (46). The fastening bolt (47) passes through the clamping screw hole (46) to press the two clips (45) together. The connecting rod (38) is located in the slot between the two clips (45). The main hook (2) is provided with a screw hole (6). The fastening bolt (47) passes through the clamping screw hole of the locking buckle (37) located at the top of the bracket (7) and the screw hole (6), so that the bracket (7) is installed on the main hook (2).

3. A retractor for posterior lumbar unilateral approach surgery according to claim 2, characterized in that: There are three narrow pull hooks (4), each of which comprises a narrow hook body (11) and a pull handle (13); the narrow hook body (11) is in the form of a sheet, and the pull handle (13) is in the form of a cylinder; the pull handle (13) is arranged at the control end of the narrow hook body (11), and the second cone tip (12) is arranged at the working end of the narrow hook body (11).

4. A retractor for posterior lumbar unilateral approach surgery according to claim 3, characterized in that: The locking clamp assembly (3) comprises a disc-shaped clamp block, a clamping screw (23) and a clamping nut (18), wherein the clamp blocks are, from bottom to top, a first clamp block (14), a second clamp block (15), a third clamp block (16) and a fourth clamp block (17), wherein the centers of the second clamp block (15), the third clamp block (16) and the fourth clamp block (17) are provided with a center hole (26), and the bottom end of the clamping screw (23) is connected to the center of the first clamp block (14) and is perpendicular to each other. The clamping screw (23) passes through the center holes (26) of the second clamping block (15), the third clamping block (16) and the fourth clamping block (17) from bottom to top in sequence; a compression spring (36) is provided between the second clamping block (15) and the third clamping block (16); a clamping nut (18) is screwed to the top of the clamping screw (23); a first columnar groove (22) is provided on the top surface of the first clamping block (14); a second groove (24) corresponding to the first groove (22) is provided on the bottom surface of the second clamping block (15); the first groove (22) and the second groove (24) are engaged to clamp the frame; a third groove (28) and a fourth groove (31) are provided on the top surface of the third clamping block (16) and the bottom surface of the fourth clamping block (17) respectively; the third groove (28) and the fourth groove (31) are engaged to clamp the handle (13).

5. A retractor for posterior lumbar unilateral approach surgery according to claim 4, characterized in that: The outer wall of the fixing member (10) is provided with teeth parallel to the axial direction, the inner wall of the through hole of the adjusting member (20) is provided with protrusions matching the teeth on the outer wall of the fixing member, the inner diameter of the adjusting member (20) is larger than the outer diameter of the fixing member (10), and the adjusting member (20) can rotate outside the fixing member (10).

6. A retractor for posterior lumbar spine unilateral approach surgery according to claim 5, characterized in that: The top surface of the second clamping block (15) and the bottom surface of the third clamping block (16) are both provided with spring limiting grooves (27), the spring limiting grooves (27) are located around the central hole (26), and the two ends of the compression spring (36) are located in the spring limiting grooves (27).

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