Medical drilling device and medical drilling system

Abstract

The invention relates to a medical drilling device comprising a tubular drill head with a longitudinal channel extending coaxially to a longitudinal axis of the drill head, wherein the drilling device comprises at its proximal end a drilling device coupling section for being coupled torsionally fixed to a handle or a drill machine, wherein the drill head has a proximal end and a distal end, wherein the drilling device comprises a stylet with a distal stylet section and a proximal stylet section, wherein the distal stylet section is configured for inserting and closing the longitudinal channel of the drill head in its entire or substantially entire length in a drilling position, and wherein the drill head comprises in the region of its proximal end a drill head coupling section which together with the proximal stylet section configures the drilling device coupling section. Furthermore, an improved medical drilling system is presented.

Description

TECHNICAL FIELD

[0001] The invention relates to a medical drilling device comprising a tubular drill head with a longitudinal channel extending coaxially to a longitudinal axis of the drill head, wherein the drilling device comprises at its proximal end a drilling device coupling section for being coupled torsionally fixed to a handle or a drill machine, wherein the drill head has a distal end and a proximal end.

[0002] Further, the invention relates to a medical drilling system comprising at least one medical drilling device. BACKGROUND

[0003] Nowadays many operations in spinal surgery are performed in a minimally invasive manner. Especially pedicle screws are used as part of a spinal stabilization system, which are placed into the cortical layer of the vertebral region of a pedicle channel. It is known that the cortex is opened with a drill head. In the pre-drilled cortex, after removal of the drill head, a K-wire or a drill wire, subsequently called K-wire, is placed, via which then the pedicle screw can be directed to the vertebra in order to anchor the pedicle screw in the vertebra in the desired manner. The problem in this behavior is that the entry point in the cortex after removal of the drill head hits the K-wire, since for this there is no guiding device for the K-wire. Furthermore, the minimally invasive procedure is virtually invisible. Also the medical drilling device of the type described at the outset with the tubular drill head does not help for this, since the bone is pressed into the longitudinal channel while drilling, so that the K-wire cannot be placed directly through the drill head. Therefore, the tubular drill head must also be removed first in order to then place the K-wire in a second step after removal of the drill head. SUMMARY

[0004] Therefore, it is the task of the invention to improve the medical drilling device and the medical drilling system of the type described at the outset in such a way that especially its handling is simplified.

[0005] This task is solved according to the invention in a medical drilling device of the type described at the outset by the fact that the drilling device comprises a stylet with a distal stylet section and a proximal stylet section, the distal stylet section being configured for inserting and closing the longitudinal channel of the drill head in its entire or substantially entire length in the drilling position, and the drill head comprises in the region of its proximal end a drill head coupling section, which together with the proximal stylet section configures the drilling device coupling section.

[0006] The proposed improved medical drilling device enables, inter alia, the opening of a bone in a minimally invasive procedure, wherein the drill bit does not have to be removed for the placement of a K-wire. Rather, it is sufficient here to remove the stylet from the longitudinal channel. The stylet, which fills the longitudinal channel completely or almost completely in a form-fitting manner, prevents bone material from penetrating into the longitudinal channel. After removal of the stylet, the longitudinal channel of the drill bit is then completely free of bone material, so that the drill bit itself can serve as a guide device for the K-wire in order to place it in the bone, for example a vertebra, in a defined manner, i.e. in a defined position and with a defined orientation. The stylet thus forms, inter alia, a closure element in the form of a plug for the longitudinal channel in order to prevent bone material or other tissue that can penetrate into the longitudinal channel during drilling from clogging it. As mentioned, the drill bit thus does not have to be removed before the placement of the K-wire, as in the conventional known methods, but serves itself as a guide device for the K-wire. In this way, the finding of the entry site at the bone is simplified when placing the K-wire and thus also the handling of the drilling device. This improves the quality of the surgical procedure, inter alia. Furthermore, the operating time can be reduced, inter alia, also in this way.

[0007] It is expedient if the drilling device coupling section is rotationally asymmetrically configured with respect to the longitudinal axis. In this way, the drilling device can be coupled in a defined manner with a handle or drill, for example a drill chuck or a coupling device thereof. An anti-rotation coupling between the handle or drill and the drilling device can be realized in a simple manner, inter alia.

[0008] It is advantageous if the drill bit coupling section has at least one drill bit driving surface and the proximal stylet section has at least one stylet driving surface and the at least one drill bit driving surface and the at least one stylet driving surface abut or approximately abut each other in the drilling position. The mentioned surfaces can enable, inter alia, that the drill bit engages with the stylet in the region of the drilling device coupling section in such a way that the stylet is rotated in conjunction when the drill bit is rotated, when the surfaces extend parallel to the longitudinal axis. In other words, the drill bit and the stylet rotate together in this way. The proximal stylet section and the drill bit coupling section form a driving element with each other in order to transmit a torque to the respective other component, more precisely, inter alia, depending on which component the torque is introduced from the handle or drill.

[0009] A good coupling and guidance of the stylet and the drill bit can be achieved, inter alia, if the drill bit coupling section has two drill bit driving surfaces and the proximal stylet section has two stylet driving surfaces. The two driving surfaces can be configured, inter alia, respectively in pairs parallel to each other. For example, the two stylet driving surfaces can point away from each other in opposite directions and the two drill bit driving surfaces can point towards each other. It is clear that such an orientation or alignment of the driving surfaces can also be realized in reverse.

[0010] Preferably, the longitudinal channel has an elliptical cross-section. In particular, the cross-section can be circular. An elliptical cross-section has the additional advantage that the stylet is forced to rotate along with the rotary drill bit. A circular cross-section is advantageous because a circular K-wire can be guided through the longitudinal channel in a defined manner and likewise twisted therein.

[0011] It is expedient for the distal stylet section to have a cross-section which corresponds to the cross-section of the longitudinal channel. It is thereby possible, inter alia, for the distal stylet section to fill the longitudinal channel in a form-fitting manner. In this way, the intrusion of bone material into the longitudinal channel can be prevented in a simple and reliable manner.

[0012] Advantageously, a tip is configured at the distal end of the distal stylet section. With such a tip, the drilling device can be simply positioned at the bone. In particular, the sliding of the tip of the drill bit can thereby be avoided in a simple and reliable manner.

[0013] According to a further preferred embodiment, it can be provided that the distal end of the distal stylet section reaches or protrudes beyond the distal end of the stylet channel in the drilling position. In both cases, it can be ensured, inter alia, that the longitudinal channel is sufficiently closed distally in order to prevent, in the case of a drill hole-like opening of the bone, inter alia, the intrusion of bone tissue. If the distal stylet section protrudes beyond the distal end of the longitudinal channel, it can be used, for example, to position the drill bit at the bone. Preferably, the distal end of the distal stylet section is configured in the form of a tip for this purpose.

[0014] The medical drilling device can be configured in a simple manner when the drill device coupling section is configured mirror-symmetrically to a mirror plane containing the longitudinal axis. In particular, a drill device coupling section which is not circular in cross-section can thereby be configured.

[0015] Furthermore, the design of the medical drilling device can be simplified when the drill bit coupling section and the proximal stylet section are each configured mirror-symmetrically to a mirror plane. In other words, the proximal stylet section and the drill bit coupling section can be transformed into one another by the mirror plane itself. Such a design enables, inter alia, the configuration of a drill bit coupling section with a slot for accommodating the proximal stylet section. The slot is then preferably likewise configured mirror-symmetrically to the mirror plane.

[0016] In order to reliably transmit a torque from the drill bit coupling section to the proximal stylet section or vice versa, it is expedient for the at least one stylet driving surface and the at least one drill bit driving surface to run parallel to the mirror plane.

[0017] In order for the stylet to rotate along with the drill bit when drilling, it is expedient for the stylet and the drill bit to be torsionally joined to one another. The rotation of the drill bit then results in a forced rotation of the stylet.

[0018] According to a further preferred embodiment provision can be made for the stylet to be brought into the drilling position from a detached position, in which the stylet and the drill are detached from one another, by introducing the distal stylet section into the longitudinal channel from the proximal end thereof. This design enables the coupling of the stylet to the drill in a simple manner, in particular. This is advantageous, in particular, when a plurality of pedicle screws are to be placed during a surgical procedure in the manner described at the outset. After placement of the K-wire, the tubular drill can be removed. The stylet can then be coupled to the drill again in the manner described in order to close the longitudinal channel of the drill. In this way, only one drill with a matching stylet is required for such a coupling at least in theory, so that only one drilling device is required as a result.

[0019] It is expedient for a depth stop for the stylet to be arranged or configured at the drill for limiting the depth of introduction of the distal stylet section into the longitudinal channel. In this way, it can be ensured, in particular, that the stylet fills the longitudinal channel in the desired manner. For this purpose, the user has only to introduce the stylet into the longitudinal channel until the depth stop. If the stylet cannot be moved further in the distal direction relative to the drill, the stylet has reached the desired position.

[0020] The drilling device can be configured in a simple manner when the depth stop comprises a stop face of the drill which points in the proximal direction. The proximal stylet section rests against this stop face in the drilling position in the distal direction.

[0021] Preferably, the stop face extends transversely, in particular perpendicularly, to the longitudinal axis. In this way, the depth stop can be realized in a simple manner.

[0022] It is advantageous for the stop face to adjoin the proximal introduction opening of the longitudinal channel and to at least partially, in particular completely, enclose this introduction opening. Such a design enables the distal stylet section to be configured only in correspondence with the longitudinal channel in order to fill the longitudinal channel in the drilling position. The proximal stylet section can then form only a part of the drilling device coupling section in this case. Furthermore, it can be possible in this simple manner to prevent deformation, in particular buckling, of the distal stylet section relative to the proximal stylet section.

[0023] It is advantageous for the drill coupling section to comprise a coupling slit which extends parallel to the longitudinal axis and for the proximal stylet section to be coupled into the coupling slit in the drilling position. This design enables a simple and defined relative positioning of the proximal stylet section and the drill coupling section, in particular. The proximal stylet section can be guided through the drill coupling section on both sides, in particular.

[0024] It is expedient for the joint seam to have two seam faces which point towards one another and which form two drill bit driving faces. In particular, the two seam faces can be parallel to one another and parallel to the mirror plane described above. The mirror plane can in this case comprise the longitudinal axis or run parallel thereto.

[0025] Furthermore, the rotationally asymmetric drill device joint section can be configured in a simple manner, in particular by the drill device joint section having a joint face which extends parallel to the longitudinal axis and transversely, in particular perpendicularly, to the at least one drill bit driving face. For example, the joint face can be configured as part of a drill device joint section which is otherwise rotationally symmetrical.

[0026] It is expedient for the joint face to be flat or substantially flat and to comprise at least two joint face sections, at least one of which is formed by a side face of the drill bit joint section and at least one other of which is formed by a side face of the proximal stylet section. In this way, it is possible, in particular, to transmit torque not only to the drill bit but also simultaneously to the stylet when the drill device joint section is jointed to a handle for a drill device or drill rig. In this way, it is possible, in particular, to avoid the proximal stylet section and the distal stylet section from becoming entangled relative to one another.

[0027] When the drill device joint section has a rotationally symmetrical basic shape and a flat portion which extends in lateral direction parallel to the longitudinal axis, the joint face can be configured in a simple manner.

[0028] Preferably, the flat portion comprises the joint face. Such a design makes it possible, in particular, to achieve a simple and reliable, for example torque-proof, joining of the drill device to the handle or drill rig.

[0029] According to a further preferred embodiment, it can be provided that the drill bit joint section and the proximal stylet section are each configured rotationally asymmetrically about the longitudinal axis. In this way, the two mentioned sections can each be configured as a driving element with respect to the other section in order to transmit torque in a simple manner.

[0030] It can furthermore be advantageous for at least one joint element to be arranged or configured at the drill device joint section for predefining the axial position of the drill device and the handle or drill rig relative to one another. The at least one joint element makes it possible, in particular, to block relative movement between the drill device and the handle or drill rig in axial direction in the jointed position.

[0031] When the at least one joint element is configured pointing in radial direction, the handle or drill rig can be jointed to the drill device in a simple manner. For example, the at least one joint element can be configured in the form of a recess pointing in radial direction, for example in the form of an annular groove or a section of an annular groove about the longitudinal axis.

[0032] When the at least one coupling element is configured in the form of a coupling protrusion or a coupling receptacle, the coupling of the drilling device and the handle or the drill can be further simplified. Such a coupling element can be engaged in a force-fitting and / or form-fitting manner with a corresponding coupling element at the handle or at the drill.

[0033] It is expedient for the at least one coupling element to be configured at least partially encircling the longitudinal axis. For example, it is possible to configure such an annular groove which extends over an angle of less than 360° of the circumference with respect to the longitudinal axis. In particular when a coupling face is configured as described above at the drilling device coupling section, whereby the drilling device coupling section obtains a non-circular cross section, it is not necessary for the at least one coupling element to extend over the entire circumference with respect to the longitudinal axis, but only over a part of the circumference, for example only over an angle of 180° or 270°.

[0034] Preferably, the at least one coupling element is interrupted by a flat. In other words, there is thus no coupling element in the region of the flat. In other words, this can be achieved, for example, in that the flat is dimensioned such that, in the case of an originally rotationally symmetrical drilling device coupling section with a coupling element encircling, more precisely completely encircling, with respect to the longitudinal axis, the coupling element is completely removed in the region of the flat.

[0035] It can furthermore be advantageous for at least one manipulation element to be arranged or configured at the proximal stylet section. Such a manipulation element can be used, inter alia, for engaging with a finger or a corresponding pulling element in order to move the stylet in the proximal or distal direction relative to the drill bit. It is conceivable, inter alia, for a pulling element corresponding to the at least one manipulation element to be provided at the drill chuck of the handle or the drill, which can be engaged or disengaged with the at least one manipulation element in order to move the stylet relative to the drill bit in the distal direction or, in particular, in the proximal direction as described. In particular when the drill bit with the stylet accommodated in the longitudinal channel is inserted in a bone, the stylet can thus be pulled out of the drill bit in the proximal direction in a simple manner.

[0036] Preferably, the manipulation element is configured in the form of a manipulation recess or a manipulation protrusion. For example, the manipulation element can be formed by a portion of the at least one coupling element, which is configured at the proximal stylet section. This further simplifies the structure of the drilling device, inter alia.

[0037] In order to be able to apply a force acting in the proximal or distal direction to the stylet in a simple manner, it is expedient for the at least one manipulation element to be configured pointing in the radial direction with respect to the longitudinal axis. For example, the at least one manipulation element can be configured as a portion of a groove encircling with respect to the longitudinal axis at the drilling device coupling section.

[0038] The handling of the drilling device can be further simplified when the drilling device has an end face which extends transversely, in particular perpendicularly, to the longitudinal axis in the drilling position. In particular, this can indicate whether the stylet is engaged with the drill bit in the desired manner, i.e. in particular whether the longitudinal channel of the drill bit is filled with the distal stylet section.

[0039] It is furthermore expedient that the proximal stylet section defines a proximal stylet end face, the drill bit coupling section defines a proximal drill bit end face and the end face is formed partly by the stylet end face and partly by the drill bit end face. In particular, it can then be directly recognizable to the user whether the stylet and the drill bit are engaged in the desired manner. The end face can thereby serve as a type of optical display for the user.

[0040] In order that a sufficiently stable drilling device can be configured, it is expedient that the drill bit is configured from a metal material. In particular, it can be configured from stainless steel or titanium.

[0041] It is furthermore expedient that the stylet is configured from a metal material or from plastic. A stylet composed of plastic can in particular be manufactured cost-effectively. A stylet composed of a metal material can in particular better conduct the heat generated when drilling than a drill bit.

[0042] Expediently, the drilling device is configured from at least one sterilizable material. In particular, it can be configured from only one sterilizable material. For example, the stylet and the drill bit can be configured from the same material.

[0043] The task set at the outset is furthermore solved according to the application in a drilling system of the type described at the outset, in that the medical drilling device is configured in the form of one of the above-described expedient embodiments of a drilling device and the drilling system comprises a handle and / or a drill for torque-proof coupling with the medical drilling device.

[0044] With the handle or the drill, the drilling device can be handled in the desired manner, in particular in order to drill open a bone, for example for the placement of a K-wire as a guide device for a pedicle screw. The drilling system can furthermore comprise a plurality of drilling devices which differ from one another in terms of form and size. For example, the drilling system can comprise different drill bit types, for example a twist drill, a ring drill (sometimes also referred to as a stepped drill bit), a boring drill, a center drill or a countersink drill.

[0045] Suitably, the drilling system comprises at least one K-wire. Such a K-wire in the sense of the present application is a drill wire. The concept is thus used synonymously. In particular, it can also comprise a plurality of K-wires, for example with different diameters and lengths. The K-wire can be arranged as described through the longitudinal channel into the bone opened with the drilling device after removal of the stylet. To this end it must be sufficiently long to allow the pull-out of the drill. After pull-out of the drill through the K-wire in proximal direction, the tubular pedicle screw can then be moved through the K-wire in distal direction and directed to the bone and screwed therein. Preferably, the K-wire is longer than the drill in order to ensure the guided pull-out.

[0046] In a simple manner, the handle or the drill can be coupled with the drilling device when the handle and / or the drill comprises a coupling device for a force-fit and / or form-fit coupling with the drilling device coupling section in the coupling position.

[0047] Preferably, the coupling device can be brought from the coupling position into a release position in which the coupling device is disengaged from the drilling device coupling section. In the release position, the drilling device is then simply and reliably removed from the handle or from the drill.

[0048] It can furthermore be advantageous if the coupling device comprises a pulling element for engaging with the at least one handling element when the coupling device occupies the release position. As already mentioned above, the stylet can thus be removed from the drill in a simple and reliable manner. To this end, then only the coupling device must be transferred into the release position and the pulling element must engage with the at least one handling element. If the handle or the drill are pulled away from the drilling device in the described position, they are also coupled with the stylet, however disengaged from the drill, so that they pull the stylet out of the longitudinal channel of the drill in the case of a pull-back in proximal direction. BRIEF DESCRIPTION OF DRAWINGS

[0049] The following description of preferred embodiments of the present application is made in conjunction with the drawings. In which:

[0050] Figure 1 A schematic perspective overall view of a drilling system in the case of a drilling-type opening of a vertebra is shown;

[0051] Figure 2 A partial cutaway side view of the drilling system in Figure 1 is shown;

[0052] Figure 3 A partial interrupted view of an embodiment of the drilling device in the drilling position is shown;

[0053] Figure 4 A partial interrupted exploded view of the arrangement in Figure 3 is shown;

[0054] Figure 5 a longitudinal section view of the arrangement in Figure 3 enlarged view of the proximal end and the distal end of the drilling device in a drilling device;

[0055] Figure 6 a longitudinal section view of the arrangement in Figure 5

[0056] Figure 7 a similar view as in Figure 3 of another embodiment of a drilling device;

[0057] Figure 8 a similar view as in Figure 7 of a drilling device in Figure 4

[0058] Figure 9 enlarged view of the proximal end of the drilling device in Figure 7

[0059] Figure 10 a longitudinal section view of the arrangement in Figure 9

[0060] Figure 11 schematic view in the situation of the placement of the drilling device at a bone;

[0061] Figure 12 schematic partial cut view of a drilling device driven into a pedicle;

[0062] Figure 13 schematic view as in Figure 11 of a drill bit with the drill bit remaining in the pedicle after removal of the stylet and insertion of a k-wire through the longitudinal channel of the drill bit into the pedicle; and

[0063] Figure 14 schematic view as in Figure 12 after removal of the drill bit via the k-wire and introduction of a pedicle screw into the pedicle via the k-wire. DETAILED DESCRIPTION

[0064] An embodiment of a medical drilling system, generally designated with reference numeral 10, is schematically presented in Figure 1 It comprises a drilling device 12 and a handle 14 for coupling with the drilling device 12, especially torsionally.

[0065] The drilling device 12 comprises a tubular drill bit 16 with a longitudinal channel 20 extending coaxially with a longitudinal axis 18 of the drill bit 16. The drilling device 12 comprises at a proximal end a drilling device coupling section 22 for torsionally coupling with the handle 14 or a drill machine, not presented in the figures.

[0066] ​​​​The drill head 16 has a proximal end 24 and a distal end 26. The distal end 26 is provided with a plurality of cutting edges 28 which are suitable for cutting bone, among other things.

[0067] The drill device 12 furthermore comprises a stylet 30 with a distal stylet section 32 and a proximal stylet section 34. The distal stylet section 32 is configured in the manner of an elongate rod and defines a circular cross section.

[0068] At a distal end 36 of the distal stylet section 32, a tip 38 is configured.

[0069] The drill head 16 has a drill head shank 40 which expands in the manner of a single step in the outer diameter in a transition region 42 from the distal end 26 in the proximal direction. In this way, a distal shank section 44 and a proximal shank section 46 are defined between which the transition region 42 is configured.

[0070] In the proximal direction, a cylinder 48 is coupled to the proximal shank section 46. From a proximal end face 50 of the cylinder 48, a cylindrical stop body 52 is configured upright in the proximal direction. The stop body 52 has a slightly smaller outer diameter than the cylinder 48, so that an annular face 54 is configured at the cylinder which points in the proximal direction. An end face 56 of the stop body 52 which points in the proximal direction defines a stop face 58.

[0071] From the stop face 58, a drill head coupling section 60 is configured upright in the proximal direction. In this way, the drill head 16 has the drill head coupling section 60 in the region of its proximal end 24. The drill head coupling section 60 forms the drill device coupling section 22 together with the proximal stylet section 34.

[0072] The distal stylet section 32 is configured for insertion and closure of the longitudinal channel 18 of the drill head 16 in the drill hole position over its entire length, which is illustrated schematically in Figures 1 to 3 and is presented in 5 and 6.

[0073] The cross section of the distal stylet section 32 perpendicular to the longitudinal axis 18 corresponds to the cross section of the longitudinal channel 20, so that the distal stylet section 32 fills the longitudinal channel 20 form-fittingly. In the drill hole position, the distal end 36 of the distal stylet section 32 reaches the distal end 26 of the longitudinal channel 20 or extends slightly beyond the distal end 26.

[0074] The longitudinal channel 20 has a circular cross section. In an alternative embodiment, the longitudinal channel 20 can also have an elliptical or other non-circular cross section.

[0075] The stop body 52 forms with the stop face 58 a depth stop 62 for the stylet 30 for limiting the introduction depth of the distal stylet section 32 into the longitudinal channel 20. The proximal stylet section 34 abuts in the drilling position distally at the stop face 58 of the drill bit 16 in the proximal direction, as this can be well recognized in Figure 5 and 6 .

[0076] The stop face 58 extends transversely, i.e. perpendicular to the longitudinal axis 18. The stop face 58 adjoins the introduction opening 64 of the longitudinal channel 20 proximally. As can be well recognized in Figure 5 , the stop face 58 at least partially, i.e. completely, surrounds the introduction opening 64.

[0077] The proximal stylet section 34 is supplemented in the area of the section 66 by the drill bit coupling section 60 to a straight cylinder which in the drilling position extends proximally beyond the stop body 52.

[0078] The drilling device coupling section 22 extends from a distally directed end face 68 of the proximal stylet section 34 up to a proximal end face 70 of the drilling device coupling section 22. The end face 70 extends transversely, i.e. perpendicular to the longitudinal axis 18.

[0079] The proximal end face 70 is formed in the drilling position by a proximal stylet end face 72 of the proximal stylet section 34 and a proximal drill bit end face 74. In this way, the end face 68 is formed partially by the stylet end face 72 and partially by the drill bit end face 74.

[0080] The drilling device coupling section 22 has a cylindrical basic shape which, however, comprises a non-circular cross section by virtue of a configured flat 76, more precisely in a coupling area 78 which is coupled to the proximal side of the section 66 and reaches the end face 70. The flat 76 is configured laterally and extends parallel to the longitudinal axis 18. The flat 76 thus defines a coupling face 80 at the drilling device coupling section 22 which likewise extends parallel to the longitudinal axis 18.

[0081] The coupling face 80 is configured flat with the exception of a short transition area 82 and comprises two coupling face sections 84, 86, namely a first coupling face section 84 which is formed by a side face 88 of the drill bit coupling section 60 and a second coupling face section 86 which is formed by a side face 90 of the proximal stylet section 34.

[0082] By virtue of the configuration of the flat 76, the drilling device coupling section 22 is configured rotationally asymmetrically with respect to the longitudinal axis 18.

[0083] The drill bit coupling section 60 is so configured that it defines a drill bit driving face 92. The proximal stylet section 34 defines a stylet driving face 94. In the drilling position, the drill bit driving face 92 and the stylet driving face 94 abut against each other, as this can be well recognized in Figure 5 and 6 .

[0084] The drilling device coupling section 22 is configured mirror-symmetrically to a mirror plane 96 containing the longitudinal axis 18. The drill bit driving face 92 and the stylet driving face 94 extend parallel to the mirror plane 96.

[0085] By the described design of the proximal stylet section 34 and the drill bit coupling section 60, the stylet 30 and the drill bit 16 are torsionally joined to each other in the drilling position.

[0086] In this embodiment, not only the drill bit coupling section 60 but also the proximal stylet section 34 is respectively itself configured rotationally asymmetrically about the longitudinal axis 18.

[0087] At the drilling device coupling section 22, furthermore, a coupling element 98 is configured for presetting the axial position of the drilling device 12 and the handle 14 relative to each other. The coupling element 98 is configured pointing in radial direction about the longitudinal axis 18.

[0088] The coupling element 98 is configured in the form of a coupling receptacle 100 in the case of the embodiment of the drilling device 12 according to Figures 1 to 6 . The coupling receptacle 100 partially encloses the longitudinal axis 18. When no flat 76 is provided in the drilling device coupling section 22, the coupling receptacle 100 has the form of an annular groove 102. In other words, this annular groove 102 and thus the coupling element 98 is interrupted by the flat 76.

[0089] The coupling element 98 is partially configured at the proximal stylet section 34 and partially at the drill bit coupling section 60.

[0090] At the proximal stylet section 34, furthermore, a manipulation element 104 is configured. It has the form of a manipulation recess 106. The manipulation element 104 is configured pointing in radial direction about the longitudinal axis 18.

[0091] In the embodiment according to Figures 1 to 6 , the manipulation element 104 is formed by a portion of the coupling element 98, which extends along a peripheral face 108 of the proximal stylet section 34 outside about the longitudinal axis 18.

[0092] The exemplarily presented handle 14 comprises at its proximal end a spherical knob 110 to which a holding region 112 is coupled distally, which has grooves 114 running parallel to the longitudinal axis 18. The grooves 114 are arranged uniformly distributed over the circumference of the holding region 112.

[0093] The distal end region of the handle 14 forms a coupling device 116. This is configured in the form of a quick coupling, with a coupling sleeve 120 which is movable on a shank 118 of the handle 14. The coupling device 116 enables the coupling of the handle 14 to the drilling device 12 in a coupled position.

[0094] The coupling sleeve 120 is movable in the proximal direction against the action of a spring 122. If the moved-back coupling sleeve 120 is released, the spring 122 acts such that the coupling sleeve 120 moves automatically in the distal direction.

[0095] At the shank 118, a plurality of balls 126 are held which are inserted in radial interruptions 124 thereof. The balls 126 are pressed in the direction towards the longitudinal axis 18 and slightly protrude beyond an inner wall face 128 of a coupling receptacle 130 which is configured coaxially to the longitudinal axis 18 in the shank 118 in the coupled position in which the spring 122 holds the coupling sleeve 120 in its most distal position.

[0096] At the coupling sleeve 120, a recess 134 is configured in the form of an annular groove which points in the direction towards the longitudinal axis 18 at an inner wall face 132 which points in the direction towards the longitudinal axis 18. The recess is so deep that the balls 126 can sink into the recess 134, so that they then release the coupling receptacle 130.

[0097] Furthermore, the coupling receptacle 130 has an internally rotationally asymmetric cross section which extends transversely to the longitudinal axis 18, which cross section matches the cross section of the drilling device coupling section 22, so that this can be form-fittingly accommodated in the coupling receptacle 130. By the described design, the drilling device coupling section 22 and the handle 14 are torsionally joined to one another.

[0098] In order to couple the drilling device 12 to the handle 14, the drilling device coupling section 22 is introduced into the handle 14 with the proximal end face 70 forwards into the distally open coupling receptacle 130 of the shank 118. The balls 126 block the path for the drilling device coupling section 22 at this point. If the coupling sleeve 120 is moved at this point in the direction towards the holding region 112 against the action of the spring 122, the balls 126 can sink into the recess 34 as described and the drilling device coupling section 22 is moved further in the proximal direction, more precisely to such an extent that the coupling receptacle 100 is opposite the balls 126. If the coupling sleeve 120 is released at this point, the spring 122 moves the coupling sleeve 120 in the distal direction relative to the holding region 112, whereby the balls 126 are prevented from movement in the radial direction away from the longitudinal axis 18. Figure 2 The coupled position is shown in which the handle 14 is force-fittingly and form-fittingly coupled with its coupling device 116 to the drilling device coupling section 22.

[0099] The coupling device 116 can alternatively also be constructed in a similar manner at the drilling rig, so that the drilling device 12 can also be coupled to the drilling rig accordingly.

[0100] As described, the coupling device 116 can be brought from the coupled position into a decoupled position in which the coupling device is disengaged from the drilling device coupling section 22. The decoupled position is not represented in the figures, but is described above. In the decoupled position the coupling sleeve 120 is thus moved against the action of the spring 122 in the direction of the holding region 112, so that the ball 126 sinks into the recess 134 and releases the drilling device coupling section 22.

[0101] Optionally, the coupling device 116 can comprise a pulling element for engagement with the handling element 104, more precisely when the coupling device 116 occupies the decoupled position. If the pulling element is thus engaged only into the handling element 104 constructed at the proximal stylet section 34, the drilling device 12 can be disassembled into its components by means of the handle 14. When the handle 14 is pulled away in the proximal direction, the stylet 30 is pulled out of the longitudinal channel 20 in the proximal direction when the pulling element is engaged into the handling element 104.

[0102] In Figures 7 to 10 , a second embodiment of the drilling device 12 is represented schematically. According to Figures 7 to 10 , the embodiment of the drilling device 12 differs from the drilling device 12 according to Figures 1 to 6 only by the design of the drilling device coupling section 22. For the description the same reference signs are thus subsequently used for identical or functionally similar components.

[0103] In this embodiment, the drill head coupling section 60 is constructed mirror-symmetrically to the mirror plane 96 and thus comprises two sections 136 and 138 which are separated from one another by a coupling slit 140 which extends parallel to the longitudinal axis 18, i.e. is spaced apart. The coupling slit 140 has two slit faces 142 which are directed towards one another, which form the drill head driving face 92.

[0104] The proximal stylet section 34 is constructed in this embodiment mirror-symmetrically with respect to the mirror plane 96 itself and engages in the drilling position so far into the coupling slit 140 that the proximal stylet section fills the coupling slit. The drilling position is represented schematically in Figure 7 , 9 and 10.

[0105] The outer contour of the drilling device coupling section 22 is identical to the outer contour of the drilling device coupling section 22 of the embodiment according to Figures 1 to 6 .

[0106] By the slotted design of the drill bit coupling section 60, the drill bit coupling section has two drill bit driving faces 92 which extend parallel to the longitudinal axis 18 and which run parallel to each other and point towards each other. The proximal stylet section 34 accordingly has two stylet driving faces 94. The stylet driving faces point away from each other in opposite directions and likewise run parallel to each other and parallel to the longitudinal axis 18. As can be well recognized in Figure 10 , the drill bit driving faces 92 and the stylet driving faces 94 abut against each other in the drilling position.

[0107] The stop face 58 extends between the drill bit driving faces 92 which point towards each other and is formed by the end face 56 of the stop body 52.

[0108] Also in this embodiment, the handling element 104 is configured in the form of a handling recess 106, more precisely as a part of the coupling element 98.

[0109] The coupling face 80 is formed in the embodiment of Figures 7 to 10 by two first coupling face sections 84 at sections 136 and 138 of the drill bit coupling section 60 and by one second coupling face section 86 at the proximal stylet section 34.

[0110] Correspondingly, also the proximal end face 70 is formed by three parts, namely the proximal stylet end face 72 which is arranged between the two proximal drill bit end faces 74 in the drilling position.

[0111] The functional principle of the drilling device 12 according to the embodiment of Figures 7 to 10 corresponds in full to the functional principle of the drilling device 12 according to the embodiment of Figures 1 to 6 , so that reference is made to the above description.

[0112] In the described embodiment, the drill bit 16 is configured from a metal material. The stylet 30 is likewise configured from a metal material.

[0113] In an alternative embodiment, the stylet 30 is configured from a plastic.

[0114] The drilling device 12 is configured in all embodiments from at least one sterilizable material. It can also be configured from only one sterilizable material, for example a sterilizable metal material. If, for example, the stylet 30 is configured from a plastic and the drill bit 16 is configured from a metal material, the drilling device 12 is configured from two sterilizable materials.

[0115] The use of the drilling system 10 is schematically combined with Figure 11 and 14In the following, a brief explanation is given according to possible applications. For example, in spinal surgery not only pedicle screws exist. For the cervical spine, for example, also lateral mass screws exist. The procedure described subsequently is not a limitation of the field of use of the drilling device 12 in connection with the use of pedicle screws 150.

[0116] In a first step, the drilling device 12 is introduced into the body of a patient with its distal end 26 through a minimally invasive access. Figure 11 and 12 The procedures are shown schematically, wherein neither the handle 13 nor a correspondingly suitable drill machine is presented for overview reasons.

[0117] The drill bit 16 with the stylet 30 is anchored in the pedicle 146 of the vertebra 144. During drilling, the stylet 30 prevents bone material from entering into the longitudinal channel 20 and clogging it.

[0118] In a next step, the stylet 30 is pulled out of the longitudinal channel 20 of the drill bit 16. The drill bit 16 remains, however, in the vertebra 144.

[0119] After the stylet 30 has released the longitudinal channel 20, a K-wire 148 included by the drilling system 10 can be introduced into the longitudinal channel 20 through the proximal introduction opening 64 and anchored in the vertebra 144. The drill bit 16 serves as a guiding device for the K-wire 148 here.

[0120] If the K-wire 148 is anchored, as this is schematically presented in Figure 13 in a next step, the drill bit 16 can be removed from the vertebra 144, wherein the K-wire 148 remains in the vertebra 144.

[0121] The K-wire 148 serves now for guiding a tubular pedicle screw 150. This can then be screwed into the pedicle 146 in the usual manner with a shank 154 provided with an external thread 152.

[0122] If the pedicle screw 150 is sufficiently anchored in the vertebra 144, the K-wire 148 is removed. The pedicle screw 150 can now be driven further into the vertebra 144, if necessary.

[0123] The head 156 of the pedicle screw 150 is configured for accommodating a rod-like connecting element, not presented in the figures, which can be clamped in the head 156 with a fixation screw, not presented in the figures.

[0124] After the first pedicle screw 150 has been arranged in the manner described, the stylet 30 can be brought into the drilling position from the detached position (in which the stylet 30 and the drill bit 16 are completely disengaged) by introducing the distal stylet section 32 into the longitudinal channel 20 from its proximal end. It is thus possible to anchor a plurality of pedicle screws 150 in the vertebrae 144 in the manner described above during a surgical procedure using only the unique drilling device 12.

[0125] List of reference signs

[0126] 10 drilling system

[0127] 12 drilling device

[0128] 13 handle

[0129] 16 drill bit

[0130] 18 longitudinal axis

[0131] 20 longitudinal channel

[0132] 22 drilling device coupling section

[0133] 24 proximal end

[0134] 26 distal end

[0135] 28 cutting edge

[0136] 30 stylet

[0137] 32 distal stylet section

[0138] 34 proximal stylet section

[0139] 36 distal end

[0140] 38 tip

[0141] 40 drill bit handle

[0142] 42 transition region

[0143] 44 distal handle section

[0144] 45 proximal handle section

[0145] 48 cylinder

[0146] 50 end face

[0147] 52 stop body

[0148] 54 annular face

[0149] 56 end face

[0150] 58 stop face

[0151] 60 drill coupling section

[0152] 62 depth stop

[0153] 64 lead-in opening

[0154] 66 section

[0155] 68 end face

[0156] 70 proximal end face

[0157] 72 proximal stylet end face

[0158] 74 proximal drill end face

[0159] 76 flat

[0160] 78 coupling region

[0161] 80 coupling face

[0162] 82 transition region

[0163] 84 first coupling face section

[0164] 86 second coupling face section

[0165] 88 side face

[0166] 90 side face

[0167] 92 drill driving face

[0168] 94 stylet driving face

[0169] 96 mirror

[0170] 98 coupling element

[0171] 100 coupling accommodation

[0172] 102 annular groove

[0173] 104 handling element

[0174] 106 handling recess

[0175] 108 peripheral face

[0176] 110 spherical knob

[0177] 112 holding region

[0178] 114 slot

[0179] 116 coupling device

[0180] 118 handle

[0181] 120 coupling sleeve

[0182] 122 spring

[0183] 124 interruption

[0184] 126 ball

[0185] 128 wall surface

[0186] 130 coupling accommodation

[0187] 132 wall surface

[0188] 134 recess

[0189] 136 section

[0190] 138 section

[0191] 140 coupling slit

[0192] 142 slit surface

[0193] 144 vertebra

[0194] 146 pedicle

[0195] 148 k-wire

[0196] 150 pedicle screw

[0197] 152 external thread

[0198] 154 handle

[0199] 156 head

Claims

1. A medical drilling device (12) comprising a tubular drill head (16) with a longitudinal channel (20) extending coaxially to a longitudinal axis (18) of the drill head (16), wherein the drilling device (12) comprises at a proximal end a drilling device coupling section (22) for torque-proof coupling with a handle (14) or a drill machine, wherein the drill head (16) has a proximal end (24) and a distal end (26), characterized in that, The drilling device (12) comprises a stylet (30) with a distal stylet section (32) and a proximal stylet section (34), the distal stylet section (32) being configured for insertion into and closing a longitudinal channel (20) of the drill head (16) over its entire or substantially entire length in the drilling position, and the drill head (16) comprising a drill head coupling section (60) in the region of its proximal end (24), which together with the proximal stylet section (34) configures the drilling device coupling section (22).

2. The medical drilling device according to claim 1, characterized in that The drilling device coupling section (22) is rotationally asymmetrically configured with respect to the longitudinal axis (18).

3. The medical drilling device according to claim 1 or 2, characterized in that The drill head coupling section (60) has at least one drill head driving face (92), the proximal stylet section (34) has at least one stylet driving face (94), and the at least one drill head driving face (92) and the at least one stylet driving face (94) abut or substantially abut one another in the drilling position.

4. The medical drilling device according to claim 1 or 2, characterized in that The distal stylet section (32) has a cross section which corresponds to the cross section of the longitudinal channel (20).

5. The medical drilling device according to claim 1 or 2, characterized in that The drilling device coupling section (22) is mirror-symmetrically configured with respect to a mirror plane (96) which contains the longitudinal axis (18).

6. The medical drilling device according to claim 5, characterized in that The drill head coupling section (60) has at least one drill head driving face (92), wherein the proximal stylet section (34) has at least one stylet driving face (94), wherein the at least one drill head driving face (92) and the at least one stylet driving face (94) abut or substantially abut one another in the drilling position, and wherein the at least one stylet driving face (94) and the at least one drill head driving face (92) run parallel to the mirror plane (96).

7. The medical drilling device according to claim 1 or 2, characterized in that The stylet (30) and the drill head (16) are torsionally joined to one another in the drilling position.

8. The medical drilling device according to claim 1 or 2, characterized in that A depth stop (62) for the stylet (30) is arranged or configured at the drill head (16) for limiting the depth of introduction of the distal stylet section (32) into the longitudinal channel (20).

9. The medical drilling device according to claim 8, characterized in that The depth stop (62) comprises a stop face (58) of the drill head (16) which points in a proximal direction, against which the proximal stylet section (34) abuts distally in the drilling position.

10. The medical drilling device according to claim 1 or 2, characterized in that The drill head coupling section (60) comprises a coupling slit (140) which extends parallel to the longitudinal axis (18), and the proximal stylet section (34) engages into the coupling slit (140) in the drilling position.

11. The medical drilling device according to claim 1 or 2, characterized in that The drill head coupling section (60) has at least one drill head driving face (92), the proximal stylet section (34) has at least one stylet driving face (94), the at least one drill head driving face (92) and the at least one stylet driving face (94) abut or substantially abut each other in the drilling position, and the drilling device coupling section (22) has a coupling face (80) which extends parallel to the longitudinal axis (18) and transversely to the at least one drill head driving face (92).

12. The medical drilling device according to claim 11, characterized in that The coupling face (80) is flat or substantially flat in design and comprises at least two coupling face sections (84, 86), at least one of the at least two coupling face sections (84, 86) being formed by a lateral face (88) of the drill head coupling section (60) and at least one other of the at least two coupling face sections (84, 86) being formed by a lateral face (88) of the proximal stylet section (34).

13. The medical drilling device according to claim 1 or 2, characterized in that The drilling device coupling section (22) has a rotationally symmetrical basic shape and a lateral flat (76) which extends parallel to the longitudinal axis (18).

14. The medical drilling device according to claim 1 or 2, characterized in that, The drill head coupling section (60) and the proximal stylet section (34) are each rotationally asymmetrically designed in relation to the longitudinal axis (18) as such.

15. The medical drilling device according to claim 1 or 2, characterized in that At least one coupling element (98) is arranged or designed at the drilling device coupling section (22) for predefining the axial position of the drilling device (12) and the handle (14) or drill rig relative to each other.

16. The medical drilling device according to claim 1 or 2, characterized in that At least one actuating element (104) is arranged or designed at the proximal stylet section (34).

17. A medical drilling system (10) comprising at least one medical drilling device (12) according to any one of the preceding claims 1 to 16 and / or a handle and / or a drill rig for being coupled to the medical drilling device (12) in a torque-proof manner.

18. The medical drilling system according to claim 17, a) comprising at least one K-wire (148) and / or b) the handle (14) and / or drill rig comprises a coupling device (116) for being coupled to the drilling device coupling section (22) in a force- and / or form-fitting manner in a coupled position.

19. The medical drilling system of claim 17, wherein, The handle (14) and / or drill rig comprises a coupling device (116) for being coupled to the drilling device coupling section (22) in a force- and / or form-fitting manner in a coupled position, and the coupling device (116) is movable from the coupled position into a released position in which the coupling device is disengaged from the drilling device coupling section (22).

20. The medical drilling system of claim 19, wherein, The coupling device (116) comprises a pulling element for being engaged with the at least one actuating element (104) when the coupling device (116) occupies the released position.

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