Anterior cervical flexible eccentric minimally invasive channel system

Abstract

The present invention relates to the field of medical devices, and specifically to a flexible eccentric minimally invasive channel system for anterior cervical approach, wherein a semi-circular esophageal protection hook is formed by a semi-circular segment, an arc-shaped gradient segment, and a horizontal extension segment, wherein the semi-circular segment is 50 mm long, and the bottom is 2 mm upwardly tilted outward to form a hook, and the two sides are cylindrical with a diameter of 1.5 mm, and the horizontal extension segment is 100 mm long; the flexible expandable sheet is 20 mm high, and the two sides are symmetrical 6 mm rigid structures, and the middle is connected by a 10 mm elastic protective pad edge, which is used to protect the outer blood vessels and nerves, and can be pressed down to facilitate operation in the window; the edge is semi-circular, with an inner diameter of 1.6 mm, and is used to insert the esophageal hook cylinder, and a locking screw hole is provided on the edge, which is used to lock after opening. When the present invention is applied, it has the characteristics of small surgical trauma, fast recovery, and truly achieves the characteristics of accurate and minimally invasive anterior cervical surgery, and reaches the requirements of the CADF gold standard for anterior cervical surgery.

Description

Technical Field

[0001] The present invention relates to the field of medical devices, and in particular to an anterior cervical flexible eccentric minimally invasive channel system. Background Art

[0002] Endoscopic cervical surgery has a history of more than 20 years. In 1989, Tajima first reported percutaneous cervical discectomy. In 1993, Gastambide reported central discectomy under image guidance. Since then, Algara, Herman, Bonati, Sieber, Hellinger and others have successively reported laser-assisted surgery for cervical disc herniation. Aweife1's research report in 1994 clearly pointed out that holmium laser is the safest and most effective for soft tissue ablation, which can minimize thermal damage to surrounding soft tissue. As an alternative technology to laser, the study of high-frequency low-temperature radiofrequency ablation of soft tissue around 2000 has promoted the development of cervical endoscopic surgery with its excellent performance in hemostasis, contraction or ablation of soft tissue in endoscopic cervical surgery. Of course, the most important thing is the breakthrough in endoscope production technology. The 0° and 25° angle optical systems provide good surgical field illumination and a wide field of view. The 4mm-7mm diameter endoscope allows the anterior cervical intervertebral space to accommodate such a slender endoscope and its working cannula, making the anterior cervical minimally invasive treatment of the cervical spine bright. However, due to the complexity of the anterior cervical anatomical structure, the importance of the tissue structure, and the difficulty of establishing the anterior cervical minimally invasive working channel, the progress of the anterior cervical minimally invasive treatment of the cervical spine has been slow. Although the posterior cervical KeyHole technology has made progress in the posterior cervical treatment. However, the anterior and posterior cervical surgery have their own advantages and disadvantages, so the anterior cervical surgery cannot be completely abandoned. The traditional anterior cervical open surgery has a clear surgical field, thorough decompression, and simple fusion and fixation operations. It is particularly suitable for multi-segment lesions. The high excellent rate of anterior cervical surgery is a recognized fact in the medical community. However, the anterior cervical open surgery still has corresponding complications, such as scars at the surgical site of the neck, limited neck movement, nerve damage, loosening and falling of internal fixation, esophageal injury, and postoperative neck traction syndrome. The development of surgery will be minimally invasive, intelligent and precise. The difficulty in applying minimally invasive technology of the anterior cervical spine is the establishment of a working channel. It is applied to the rigid working channel of the posterior lumbar and cervical spine. Due to the complexity of the anterior cervical anatomical structure and the importance of tissues and organs, it is obviously impossible to use a rigid method to establish an anterior cervical working channel.

[0003] There are currently three techniques for anterior cervical surgery: the first is percutaneous cervical discectomy, which mainly includes percutaneous cervical disc resection, percutaneous laser vaporization cervical disc decompression, and percutaneous plasma ablation discoplasty; under the guidance of imaging equipment, a 3-4 working channel is used for percutaneous puncture to the lesion gap, and the nucleus pulposus tissue that compresses the nerves is removed by cutting, laser vaporization, and plasma ablation to achieve the purpose of treating the disease; the second is endoscopic cervical discectomy, which uses 4-7mm in the anterior part of the neck, along the anterior sternocleidomastoid muscle, blood vessels and esophageal tracheal sheath to the front of the vertebra, insert a working cannula for expansion, insert an endoscope, and perform surgical removal The decompression of nucleus pulposus tissue mainly includes the expansion sleeve of rigid channel in the anterior cervical approach, and the decompression of nucleus pulposus is performed. Due to the difficulty of positioning and puncture, the damage of the anterior cervical tissue structure is very likely to occur, and it is rarely used clinically. The third is the conventional anterior cervical open surgery, with an anterior cervical transverse incision of about 10 cm in length, which gradually exposes the anterior cervical blood vessels, nerves, trachea and esophagus, reaches the front of the vertebra, decompresses the anterior cervical space, and supports bone graft fixation (ACDF). It has become the gold standard for the treatment of cervical disc herniation and cervical spondylosis, and there are also corresponding complications such as scars at the surgical site of the neck, limited neck movement, nerve damage, loosening and falling of internal fixation, esophageal injury, postoperative cervical traction syndrome and other complications. There is also anterior cervical artificial disc replacement, which is less clinically used due to problems such as prosthesis fatigue and heterotopic ossification.

[0004] In summary, percutaneous puncture for discectomy is prone to damage to the anterior cervical tissue structure, the working channel is small, the operation is relatively blind, the discectomy is not thorough, the intervertebral stability problem is not solved, and there are many recurrence cases. It is high-risk to perform it by feel alone. Whether it is suffocation caused by early swelling or paralysis caused by delayed hematoma, it is disastrous for both doctors and patients.

[0005] The nucleus pulposus tissue is removed under endoscopy, and the working channel is a rigid dilation tube, which increases the chance of damaging the anterior cervical blood vessels, nerves and esophagus, and still does not solve the problem of vertebral stability.

[0006] The complication rate associated with the above two minimally invasive techniques can reach 11% (Sclafani JA, Kim CW. Complications associated with the imitial learning curve of minimally invasive spine surgery: a systematic review [J]. Clin Orthop Relat, 2014, 472 (6): 1711-1717).

[0007] Although anterior cervical open surgery is the gold standard for anterior cervical treatment, it is very traumatic, has many postoperative complications, and is more likely to cause damage to the esophagus due to preplaced objects. It does not meet the current goals of surgical development: minimally invasive, precise, and intelligent requirements.

[0008] It can be seen that at present, there are difficulties in puncture during anterior cervical spine surgery. The rigid expansion channel is not suitable for the anterior cervical spine and is easy to damage the cervical tissue structure. Open surgery causes great damage and many complications. No matter which technology is used, it cannot achieve the clinical effect of lesion clearance, fusion and stability under non-invasive conditions. Summary of the invention

[0009] In order to solve the above problems, the present invention provides an anterior cervical flexible eccentric minimally invasive channel system.

[0010] To achieve the above-mentioned purpose, the technical solution adopted by the present invention is: a flexible eccentric minimally invasive channel system for anterior cervical approach, characterized in that it includes a semi-annular esophageal protection hook, a flexible expandable sheet, an auxiliary bedside fixed serpentine hose, a universal dilator and a matching cold light source system, wherein the semi-annular esophageal protection hook is integrally formed by a semi-ring segment, an arc-shaped gradient segment and a horizontal extension segment, the semi-ring segment is 50 mm long, the bottom is 2 mm outwardly tilted to form a hook, the two sides are esophageal hook cylinders with a diameter of 1.5 mm, and the horizontal extension segment is 100 mm long; the flexible expandable sheet is 20 mm high, the two sides are symmetrical 6 mm rigid structures, and the middle is connected by a 10 mm elastic protection pad edge, which is used to protect the outer blood vessels and nerves, and can be pressed down to facilitate operation in the window; the edge is a semi-ring with an inner diameter of 1.6 mm, which is used to insert the esophageal hook cylinder, and a locking screw hole is provided on the edge for locking after dilating.

[0011] Furthermore, the semi-ring segment is 50 mm long, has an outer diameter of 19 mm, an inner diameter of 16 mm, and a wall thickness of 1.5 mm.

[0012] Furthermore, the radius of the connection between the arc-shaped gradual section and the horizontal extension section is 25 mm.

[0013] Furthermore, the vertical height of the semi-annular esophagus protection retractor is 76.5 mm.

[0014] Furthermore, the thickness of the symmetrical 6 mm steel structure is 1.5 mm.

[0015] The present invention has the following effects: simple exposure under direct vision, reducing the damage to the anterior cervical tissue structure to zero, the inner esophagus and trachea can be protected after the channel is placed, the outer flexible structure can protect the blood vessels and nerves, and the outer eccentric structure designed according to the anterior cervical anatomical structure can be pressed down to make the operation window field of view larger, just like an open window, which can be operated under direct vision or with an endoscope. The window can easily insert an intervertebral fusion device, anterior cervical lateral single-hole self-locking steel plate, small surgical trauma, fast recovery, truly achieving accurate and minimally invasive anterior cervical surgery, and meeting the requirements of the CADF gold standard for anterior cervical surgery. It has the following characteristics: 1. Simple operation; 2. Flexible expansion does not produce compression damage to the anterior cervical tissues and organs; 3. The damage to the cervical tissue separation is small, avoiding the risk of damage to the esophagus, recurrent laryngeal nerve, and blood vessels, and fast recovery after surgery; 4. After the channel is established, all surgical operations are under the fiber ring; 5. It fills the gap in minimally invasive treatment of the anterior cervical route. BRIEF DESCRIPTION OF THE DRAWINGS

[0016] Figure 1 It is a schematic diagram of the three-dimensional structure of the semi-annular esophageal protection retractor in an embodiment of the present invention.

[0017] Figure 2 It is a front view of the semi-annular esophagus protection retractor in an embodiment of the present invention.

[0018] Figure 3 It is a rear view of the semi-annular esophageal protection retractor in the embodiment of the present invention.

[0019] Figure 4 It is a side view of the semi-annular esophagus protection retractor in an embodiment of the present invention.

[0020] Figure 5 Schematic diagram of the structure of the flexible expandable sheet in an embodiment of the present invention. DETAILED DESCRIPTION

[0021] The present invention is described in detail below in conjunction with specific embodiments. The following embodiments will help those skilled in the art to further understand the present invention, but are not intended to limit the present invention in any form. It should be noted that, for those of ordinary skill in the art, several variations and improvements may be made without departing from the concept of the present invention. These all belong to the protection scope of the present invention.

[0022] like Figure 1-Figure 4As shown, an embodiment of the present invention provides an anterior cervical flexible eccentric minimally invasive channel system, including a semi-circular esophageal protection hook, a flexible expandable sheet, an auxiliary bedside fixed serpentine hose, a universal opener and a matching cold light source system, wherein the semi-circular esophageal protection hook 1 is formed by a semi-circular segment, an arc-shaped gradient segment, and a horizontal extension segment in one piece, the semi-circular segment is 50 mm long, and the bottom is 2 mm upwardly tilted outward to form a hook, with esophageal hook cylinders 2 with a diameter of 1.5 mm on both sides, and the horizontal extension section is 100 mm long; the flexible expandable sheet is 20 mm high, and the two sides are symmetrical 6 The esophageal retractor cylinder 2 is inserted into the esophageal retractor cylinder 2 with a semi-ring 5 having an inner diameter of 1.6 mm, and a locking screw hole 6 is provided on the edge for locking after expansion. Specifically, when the flexible expandable sheet and the semi-ring esophageal protection retractor are docked and expanded, the semi-ring and the esophageal retractor cylinder are locked by the screw in the locking hole; the semi-ring segment is 50 mm long, with an outer diameter of 19 mm, an inner diameter of 16 mm, and a wall thickness of 1.5 mm. The radius of the connection between the arc gradient segment and the horizontal extension segment is 25 mm. The vertical height of the semi-ring esophageal protection retractor is 76.5 mm, and the horizontal length is 134.5 mm. The thickness of the symmetrical 6 mm steel structure is 1.5 mm.

[0023] When this specific implementation is used, the responsible gap is determined based on the patient's symptoms, signs and physical and chemical examinations before the operation. After the surgical anesthesia is successful, the patient takes the supine position, the shoulders are routinely raised, the head is fixed, and a cushion is placed on the back of the neck. After the position is fixed, the common carotid artery and the neck blood vessels are marked by B-ultrasound, and the surgical gap is determined by X-ray fluoroscopy and marked with a marking pen. A transverse incision of about 1.5 cm long is made from the front edge of the sternocleidomastoid muscle to the midline, and the skin, subcutaneous tissue, and platysma muscle are cut to confirm the front edge of the sternocleidomastoid muscle. The gaps between C6 and C7 are entered from the lower edge of the omohyoid muscle and the sternocleidomastoid muscle, and the gaps between C5 and C6, C4 and C5 are entered from the upper edge of the omohyoid muscle and the sternocleidomastoid muscle. The gaps are separated from the anterior inner edge of the carotid sheath and the tracheoesophageal fascia to enter the front of the vertebra, and the small opening of the prevertebral fascia is separated from the anterior inner edge of the longus colli muscle to reach the anterior longitudinal ligament of the vertebral body. Place the esophageal protection retractor on the anterior longitudinal ligament under the prevertebral fascia, pull the esophagus and trachea to the midline, fix it to the bedside with a serpentine arm, insert the half ring of the flexible expandable sheet into the cylinder of the esophageal protection retractor to expand its inner diameter to more than 1.6 cm, and lock it to fix it. At this time, the flexible expandable sheet becomes a semicircle, forming a circular eccentric asymmetric channel with the esophageal retractor, and the anterior cervical blood vessels, nerves, trachea and esophagus are protected. The working channel is established, and the inner diameter of the working tube can reach 1.6 cm. Put in a light source, and check that there is no tissue structure at the bottom of the working tube, which is the inner edge of the longus colli muscle and the anterior ligament intervertebral disc fiber ring. Various operations can be performed, including space decompression, removal of nucleus pulposus tissue, cleaning of cartilage plates, treatment of osteophytes at the posterior edge of the vertebral body, embedding of a special fusion device, and fixation with a special single-hole small steel plate on the anterior and lateral sides.

[0024] This specific implementation can be applicable to cervical diseases such as cervical spondylosis, cervical fracture and dislocation, cervical spinal stenosis, etc. Those who need anterior cervical surgery can complete the surgery under the flexible expandable eccentric anterior cervical channel system. The operation is simple, the learning curve is short, the patient recovers quickly, the trauma is small, and the therapeutic effect can achieve the same effect as open surgery, truly achieving the goal of precise and micro treatment.

[0025] The above describes the specific embodiments of the present invention. It should be understood that the present invention is not limited to the above specific embodiments, and those skilled in the art can make various changes or modifications within the scope of the claims, which does not affect the essence of the present invention. In the absence of conflict, the embodiments of the present application and the features in the embodiments can be combined with each other arbitrarily.

Claims

1. Anterior cervical flexible eccentric minimally invasive channel system, characterized by: It includes a semi-circular esophageal protection hook, a flexible expandable sheet, an auxiliary bedside fixed serpentine hose, a universal opener and a matching cold light source system. The semi-circular esophageal protection hook is formed by a semi-circular segment, an arc-shaped gradient segment and a horizontal extension segment. The semi-circular segment is 50mm long, and the bottom is 2mm outward and upward to form a hook. The two sides are esophageal hook cylinders with a diameter of 1.5mm, and the horizontal extension section is 100mm long. The flexible expandable sheet is 20mm high, with symmetrical rigid structures on both sides and an elastic protective pad in the middle to protect the outer blood vessels and nerves, and can be pressed down to facilitate operation in the window. The edge is a semi-ring with an inner diameter of 1.6mm, which is used to insert the esophageal hook cylinder, and a locking screw hole is provided on the edge to lock it after opening. The semi-ring segment is 50 mm long, with an outer diameter of 19 mm, an inner diameter of 16 mm, and a wall thickness of 1.5 mm; The radius of the connection between the arc-shaped gradual section and the horizontal extension section is 25 mm.

2. The anterior cervical flexible eccentric minimally invasive channel system according to claim 1, characterized in that: The vertical height of the semi-circular esophageal protection retractor is 76.5mm.

3. The anterior cervical flexible eccentric minimally invasive channel system according to claim 1, characterized in that: The thickness of the symmetrical steel structure is 1.5 mm.

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