Lumbar vertebral plate windowing equipment and surgical method

Abstract

The invention relates to the technical field of medical equipment, in particular to lumbar vertebral plate windowing equipment and an operation method.The lumbar vertebral plate windowing equipment comprises a drill bit and further comprises a transmission cylinder and an elastic supporting piece, one end of the transmission cylinder is open and is of a hollow structure, and the drill bit is embedded into the transmission cylinder and movably connected with the transmission cylinder and can move in the transmission cylinder in the axial direction of the drill bit; an insertion hole is formed in the closed end of the transmission cylinder, an insertion rod matched with the insertion hole is fixedly connected to the end of the drill bit, and the end, back to the drill bit, of the insertion rod extends in the axial direction of the drill bit to be inserted into the insertion hole and is in single-degree-of-freedom sliding fit in the axial direction of the drill bit; one end of the elastic supporting piece abuts against the inserting rod, and the other end of the elastic supporting piece abuts against the plane, opposite to the opening, of the inserting hole. The problem that in the prior art, after a drill bit is disengaged from the surface of the articular process, the risk that the drill bit rotates to grind the spinal cord or nerve root exists is solved.

Description

Technical Field

[0001] The present invention relates to the technical field of medical equipment, and in particular to a lumbar vertebral plate window opening device and an operation method. Background Art

[0002] Lumbar disc herniation is a common degenerative spinal disease in clinical practice. In severe cases, it can compress nerve roots or spinal cord, causing pain, numbness and even functional impairment. Currently, surgical resection of the protruding disc is an effective means of treating the disease, among which lumbar lamina fenestration (Laminotomy) is one of the classic procedures. This operation requires grinding or cutting part of the upper and lower articular processes and lamina to form a notch "bone window" on the outer contour of the articular process or lamina to expose the protruding part of the intervertebral disc, and then remove the tissue that compresses the nerves. Among them, the articular process is an important stabilizing structure of the posterior column of the lumbar spine. Excessive grinding (especially bilateral articular process resection) may increase the risk of postoperative segmental instability and even induce long-term lumbar spondylolisthesis.

[0003] Prior art typically relies on doctors manually holding a drill or ultrasonic scalpel against the surface of the lumbar vertebral articular process to perform grinding. However, due to the complex anatomical structure of the lumbar spine and the confined operating space, the drill bit can accidentally slip off the articular process during high-speed rotation or continue to deviate toward the spinal cord or nerve roots after grinding through. This poses a risk of the drill bit grinding the spinal cord or nerve roots, causing irreversible nerve damage and even leading to serious medical accidents such as paraplegia. Summary of the Invention

[0004] In view of this, the purpose of the present invention is to provide a lumbar vertebral lamina window opening device and surgical method to solve the problem of the risk of the drill bit rotating and grinding the spinal cord or nerve roots after the drill bit is separated from the contact with the surface of the articular process in the prior art.

[0005] The present invention is achieved through the following technical solutions:

[0006] A lumbar vertebral lamina window opening device includes a drill bit, a transmission cylinder with a hollow structure and an elastic support member, wherein the drill bit is embedded in the transmission cylinder and movably connected to the transmission cylinder, and the drill bit can move along the drill bit axis in the transmission cylinder;

[0007] A socket is provided in the closed end of the transmission cylinder, and a plug rod adapted to the socket is fixedly connected to the end of the drill bit. The end of the plug rod facing away from the drill bit extends along the axial direction of the drill bit and is plugged into the socket, and slides in a single degree of freedom along the axial direction of the drill bit;

[0008] The elastic support member is embedded in the jack, one end of the elastic support member abuts against the insertion rod, and the other end abuts against a plane of the jack facing away from the opening;

[0009] The drill bit can be in the following two states in the transmission tube:

[0010] State 1: The drill bit is completely retracted into the transmission cylinder, the insertion rod is inserted into the insertion hole, the transmission cylinder and the drill bit are linked through the plug-in structure, the elastic support is in a compressed state, and the drill bit rotates synchronously with the transmission cylinder;

[0011] State 2: The drill bit partially extends out of the transmission cylinder, the insertion rod is separated from the socket, the elastic support member stretches naturally, and the drill bit and the transmission cylinder are released from linkage and can rotate relative to each other.

[0012] Furthermore, a slider is provided in the closed end of the transmission cylinder, and the slider is slidably engaged with the inner wall of the transmission cylinder along the axial direction of the drill bit in a single degree of freedom;

[0013] The jack is arranged on the end surface of the slider facing the drill bit, and an adjusting portion for driving the slider to slide in the transmission cylinder is arranged between the slider and the transmission cylinder.

[0014] Furthermore, a circular hole extending along the axial direction of the drill bit is provided on the end face of the insertion rod facing away from the drill bit, and a guide rod is provided in the circular hole. The outer circular surface of one end of the guide rod is in contact with the inner circular surface of the circular hole, and the other end protrudes from the outside of the circular hole and is inserted into the socket and fixedly connected to the plane facing away from the opening of the socket.

[0015] Furthermore, the elastic support member is a compression spring, which is sleeved outside the guide rod and extends spirally along the axial direction of the guide rod. One end of the compression spring abuts against the end face of the insertion rod, and the other end abuts against a plane facing away from the opening of the jack.

[0016] Furthermore, the adjustment part includes a screw rod extending axially toward the drill bit, one end of the screw rod passes through the side wall of the slider and is connected by a threaded fit, and the other end passes through the end wall of the closed end of the transmission cylinder and extends out of the transmission cylinder, and rotates with the transmission cylinder.

[0017] Furthermore, a cavity is provided in the end wall of the closed end of the transmission cylinder, and two meshing bevel gear rings are provided in the cavity, one of the bevel gear rings is coaxially fixedly connected to the screw rod, and the other bevel gear ring is coaxially fixedly connected to the control rod;

[0018] One end of the control rod penetrates the transmission cylinder along the radial direction of the drill bit and extends to the outside of the side wall of the transmission cylinder, and is rotatably matched with the end wall of the closed end of the transmission cylinder.

[0019] Furthermore, a strip-shaped hole extending axially toward the drill bit is formed on the side wall of the transmission cylinder, and a marking strip adapted to the strip-shaped hole is fixedly connected to the side wall of the slider;

[0020] The marking strip is disposed on a side facing away from the slider and passes through the strip hole and extends out of the transmission cylinder;

[0021] The outer wall of the transmission cylinder is engraved with scale lines evenly arranged along the axial direction of the drill bit, and the scale lines are located on the movement track of the marking bar.

[0022] Furthermore, a rotating sleeve is provided outside the open end of the transmission cylinder, one end of the rotating sleeve is inserted into the open end of the transmission cylinder and rotates coaxially, and the other end is sleeved outside the drill bit, and the drill bit and the inner wall of the rotating sleeve slide together in a single degree of freedom along the axial direction of the drill bit.

[0023] Furthermore, a cutting strip is fixedly connected to the outer circumferential surface of the rotating sleeve, and the cutting strip extends axially toward the rotating sleeve.

[0024] A lumbar lamina fenestration surgical method includes using the above-mentioned lumbar lamina fenestration device, and the surgical steps are as follows:

[0025] S1. Preoperative positioning: Determine the disc herniation segment and fenestration location through imaging examinations, and mark the fenestration range of the lamina;

[0026] S2. Equipment Adjustment: Rotate the control lever to drive the screw through the two bevel gear rings. Adjust the axial position of the slider in the drive barrel to set the initial extension length of the drill bit to 5-8mm. Then, coaxially secure the closed end of the drive barrel to the output shaft of the electric drill.

[0027] S3. Safety lock: Use a handheld electric drill to place the drill bit against the lamina surface. Apply 3-5N of axial pressure to deform the elastic support member. Fully insert the rod into the socket to achieve rigid linkage between the drill bit and the drive cylinder.

[0028] S4. Window opening operation: It is divided into the following two stages:

[0029] In the first stage, the electric drill is started at high gear to make the transmission barrel drive the drill bit to rotate at high speed, quickly grinding the lamina. The "electric pulse flushing pump" is used to flush and remove debris. The grinding thickness is visually observed. When the remaining grinding thickness is less than 1.5 mm, the grinding is stopped.

[0030] In the second stage, repeat step 2 and adjust the initial extension length of the drill bit to 2-3mm. Reduce the axial pressure applied by the elastic support to the drill bit in the second state to 1-2N. Start the electric drill at low speed to rotate the drill bit at low speed. Slowly grind the lamina until the drill bit wears through the lamina. The axial resistance applied by the lamina to the drill bit disappears. The elastic support extends and pushes the rod out of the socket. The drill bit extends 1-2mm from the transmission cylinder, and the drill bit and the transmission cylinder are disconnected.

[0031] S5. Nerve protection: When the drill is disengaged, the rotational power is lost and the speed automatically drops to below 1000 rpm, preventing the drill from continuing to rotate and further damaging nerve tissue.

[0032] S6. Expand the window: Repeat steps S3-S5, gradually enlarging the bone window to a diameter of 8-10 mm.

[0033] S7. Disc management: Use microsurgical instruments to remove the protruding disc tissue through the bone window, preserving the normal nucleus pulposus.

[0034] S8. Surgical field management: Use bipolar electrocoagulation to stop bleeding, flush the surgical field with saline, and close the incision layer by layer.

[0035] The beneficial effects of the present invention are:

[0036] The lumbar vertebral lamina window opening device and surgical method utilize a transmission cylinder as a transmission structure between a drill bit and an external power device. By plugging a rod on the drill bit into a socket on the transmission cylinder, the transmission cylinder and the drill bit are linked. When the transmission cylinder rotates, it can drive the drill bit to rotate and perform grinding work.

[0037] At the same time, the drill bit is slidably connected to the transmission cylinder, and an elastic support is used to provide the drill bit with elastic support along the axial direction of the drill bit, so that after the drill bit wears through the vertebral plate during the grinding process, the axial resistance applied by the vertebral plate to the drill bit disappears, the elastic support extends and pushes the insertion rod out of the socket, and the drill bit extends from the transmission cylinder, so that the drill bit and the transmission cylinder are disconnected, eliminating the power source required for the rotation of the drill bit, slowing down the rotation of the drill bit, or even stopping the rotation, thereby reducing the risk of the drill bit grinding the spinal cord or nerve roots.

[0038] Other advantages, objects, and features of the present invention will be described in part in the following description and, in part, will be apparent to those skilled in the art upon examination of the following description or may be learned from practice of the present invention. The objects and other advantages of the present invention may be realized and obtained through the following description. BRIEF DESCRIPTION OF THE DRAWINGS

[0039] Figure 1 A schematic diagram of the three-dimensional structure of an embodiment of the present invention;

[0040] Figure 2 An exploded view of an embodiment of the present invention;

[0041] Figure 3 Schematic diagram of the planar structure of an embodiment of the present invention;

[0042] Figure 4 for Figure 3 Sectional view of AA (state 1);

[0043] Figure 5 for Figure 3 Sectional view of AA (state 2);

[0044] Figure 6 for Figure 3 Cross-sectional view of the middle BB;

[0045] Figure 7 for Figure 3 Cross-sectional view of CC;

[0046] Figure 8 for Figure 3 Cross-sectional view of the middle DD;

[0047] Figure 9 for Figure 3 Cross-sectional view of EE;

[0048] Figure 10 Schematic diagram of the three-dimensional structure of the rotating sleeve in an embodiment of the present invention;

[0049] Figure 11 Schematic diagram of the three-dimensional structure of the drill bit in an embodiment of the present invention;

[0050] Figure 12 Schematic diagram of the three-dimensional structure of the transmission cylinder in an embodiment of the present invention;

[0051] Figure 13 Schematic diagram of the three-dimensional structure of the slider in an embodiment of the present invention;

[0052] Figure 14 Schematic diagram of the three-dimensional structure of the screw rod in an embodiment of the present invention;

[0053] Figure 15 Schematic diagram of the three-dimensional structure of the joystick in an embodiment of the present invention.

[0054] In the figure: 1. Drill bit; 11. Insert rod; 111. Round hole; 2. Transmission cylinder; 21. Bar hole; 22. Scale line; 23. Rotating sleeve; 231. Cutting strip; 3. Slider; 31. Insert hole; 32. Guide rod; 33. Marking strip; 4. Compression spring; 5. Screw rod; 6. Bevel gear ring; 7. Control lever. DETAILED DESCRIPTION

[0055] To make the objectives, technical solutions, and advantages of the embodiments of the present invention more clear, the technical solutions of the embodiments of the present invention will be clearly and completely described below in conjunction with the accompanying drawings of the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Generally, the components of the embodiments of the present invention described and shown in the drawings herein can be arranged and designed in various different configurations.

[0056] Therefore, the following detailed description of the embodiments of the present invention provided in the accompanying drawings is not intended to limit the scope of the invention as claimed, but rather merely represents selected embodiments of the present invention. All other embodiments derived by persons of ordinary skill in the art based on the embodiments of the present invention without creative effort shall fall within the scope of protection of the present invention.

[0057] It should be noted that similar reference numerals and letters denote similar items in the following drawings, and therefore, once an item is defined in one drawing, it does not need to be further defined or explained in subsequent drawings.

[0058] In the above description of the present invention, it should be noted that the terms "one side," "the other side," and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the accompanying drawings, or the orientations or positional relationships in which the inventive product is typically placed when in use. These terms are intended solely to facilitate the description of the present invention and simplify the description, and are not intended to indicate or imply that the devices or components referred to must have, be constructed, or operate in a specific orientation. Therefore, they should not be construed as limitations on the present invention. Furthermore, the terms "first," "second," and the like are used solely for distinction and should not be construed as indicating or implying relative importance.

[0059] Furthermore, the term "identical" and similar terms do not necessarily require that the components be absolutely identical; slight variations are permitted. The term "perpendicular" simply refers to the positional relationship between components being more perpendicular than "parallel," not that the structure must be perfectly vertical; rather, it can be slightly tilted.

[0060] See also Figure 1-15 The present invention provides a technical solution: a lumbar vertebral lamina window opening device, comprising a drill bit 1, a transmission cylinder 2 with a hollow structure and an elastic support member, wherein the drill bit 1 is embedded in the transmission cylinder 2 and movably connected to the transmission cylinder 2, and the drill bit 1 can move axially within the transmission cylinder 2;

[0061] A socket 31 is provided in the closed end of the transmission cylinder 2, and an insert rod 11 adapted to the socket 31 is fixedly connected to the end of the drill bit 1. The end of the insert rod 11 facing away from the drill bit 1 extends along the axial direction of the drill bit 1 and is inserted into the socket 31, and slides in a single degree of freedom along the axial direction of the drill bit 1;

[0062] The elastic support member is embedded in the insertion hole 31, with one end of the elastic support member abutting against the insertion rod 11, and the other end abutting against a plane of the insertion hole 31 facing away from the opening;

[0063] The drill bit 1 can be in the following two states in the transmission tube 2:

[0064] State 1 (such as Figure 4 As shown in FIG3 , the drill bit 1 is completely retracted into the transmission cylinder 2, the insertion rod 11 is inserted into the insertion hole 31, the transmission cylinder 2 and the drill bit 1 are linked by the plug-in structure, the elastic support member is in a compressed state, and the drill bit 1 rotates synchronously with the transmission cylinder 2;

[0065] State 2 (such as Figure 5 As shown in FIG5 , the drill bit 1 partially extends out of the transmission cylinder 2, the insertion rod 11 is separated from the insertion hole 31, the elastic support member naturally stretches, and the drill bit 1 and the transmission cylinder 2 are released from the linkage and can rotate relative to each other.

[0066] In this solution, a transmission cylinder 2 is used as the transmission structure between the drill bit 1 and the external power device. By plugging the insertion rod 11 on the drill bit 1 into the socket 31 on the transmission cylinder 2, the transmission cylinder 2 and the drill bit 1 are linked. When the transmission cylinder 2 rotates, it can drive the drill bit 1 to rotate and perform the grinding work. At the same time, the drill bit 1 and the transmission cylinder 2 are slidably connected, and an elastic support member is used to provide elastic support to the drill bit 1 along the axial direction of the drill bit 1. After the drill bit 1 wears through the vertebral plate during the grinding process, the axial resistance applied by the vertebral plate to the drill bit 1 disappears, and the elastic support member stretches to push the insertion rod 11 out of the socket 31, and the drill bit 1 extends from the transmission cylinder 2, so that the drill bit 1 and the transmission cylinder 2 are disconnected, eliminating the power source required for the rotation of the drill bit 1, causing the rotation of the drill bit 1 to slow down or even stop, thereby reducing the risk of the drill bit 1 grinding the spinal cord or nerve roots.

[0067] The closed end of the drive tube 2 is equipped with a connector (similar in shape to the connector end of a twist drill 1 for connecting to an electric drill) for connection to an external power source, such as a hand drill. The centerline of the connector is aligned with the axis of the drill bit 1. The end face of the drill bit 1 facing away from the drive tube 2 is provided with a sharp cutting strip 231 for cutting the vertebral lamina to create holes and windows in the lamina. Alternatively, the end face of the drill bit 1 is provided with a diamond coating to grind the lamina to create holes and windows. Drill bits 1 for creating bone windows are well-established in the prior art, and the structure of the cutting / grinding end and the cutting / grinding principles will not be elaborated upon here.

[0068] The interior of the transmission barrel 2 can be configured as a circular hole 111, and the drill bit 1 is shaped like a circular shaft, so that the outer surface of the drill bit 1 abuts the inner surface of the transmission barrel 2, allowing the drill bit 1 to both slide axially within the transmission barrel 2 and rotate relative to the transmission barrel 2. The insertion rod 11 is prismatic, and the insertion hole 31 is compatible with the insertion rod 11. When the insertion rod 11 is inserted into the insertion hole 31 (state 1), the drill bit 1 and the transmission barrel 2 are linked. When the insertion rod 11 slides out of the insertion hole 31 (state 2), the linkage between the drill bit 1 and the transmission barrel 2 is eliminated.

[0069] In addition, a pressure sensor can be set on the elastic support member and directly embedded in the elastic support member (such as between spring coils) or fixed at its end. The pressure sensor is used to sense the elastic force changes of the elastic support member, and an external warning light or warning sound is connected (such as wirelessly (Bluetooth / Wi-Fi) or wiredly connected to an external display / alarm device) to warn medical staff visually or aurally.

[0070] When using:

[0071] First, insert the drill bit 1 into the transmission tube 2, ensuring that the insertion rod 11 is aligned with the insertion hole 31, check the preload force of the elastic support, and ensure that the drill bit 1 is in the second state when it is not under pressure (the insertion rod 11 is out of the insertion hole 31, and the drill bit 1 can rotate freely). Securely connect the connector at the closed end of the transmission tube 2 to the external power equipment (such as an orthopedic electric drill) to ensure that the center lines are coaxial;

[0072] Secondly, the target vertebral lamina segment is located by a C-arm X-ray machine, a small incision is made to expose the surgical field of view, the drill bit 1 is vertically aligned with the vertebral lamina window position, the bone surface is lightly touched, and axial pressure is applied to retract the drill bit 1 into the transmission tube 2. The rod 11 is inserted into the socket 31 to enter the linkage state. The elastic support member applies axial support force to the drill bit 1, the electric drill is started, and the transmission tube 2 drives the drill bit 1 to rotate to start grinding the vertebral lamina.

[0073] Then, when the lamina is penetrated, the axial resistance exerted by the lamina on the drill bit 1 drops sharply, bone debris decreases, the elastic support member stretches, the insertion rod 11 disengages the socket 31, and the drill bit 1 stops rotating and idles until it stops. Simultaneously, the pressure sensor transmits the pressure change data to the controller, which then issues a command to an external warning device (such as a warning light or sound), causing it to emit a corresponding warning message (such as a change in light or sound), assisting medical staff in controlling the grinding depth and reducing the risk of the drill bit 1 grinding the spinal cord or nerve roots.

[0074] In this embodiment, a slider 3 is provided in the closed end of the transmission cylinder 2, and the slider 3 is slidably engaged with the inner wall of the transmission cylinder 2 along the axial direction of the drill bit 1 with a single degree of freedom;

[0075] The insertion hole 31 is provided on the end surface of the slider 3 facing the drill bit 1 , and an adjustment portion for driving the slider 3 to slide in the transmission cylinder 2 is provided between the slider 3 and the transmission cylinder 2 .

[0076] In this scheme, if Figure 13 As shown, the slider 3 has a prismatic shape, and the interior of the transmission cylinder 2 is adapted to fit the slider 3, which can restrict the slider 3 from rotating within the transmission cylinder 2 about the axis of the drill bit 1, thereby achieving the purpose of sliding the slider 3 in a single degree of freedom along the axial direction of the drill bit 1 within the transmission cylinder 2. Alternatively, if the interior of the transmission cylinder 2 is a circular hole, the slider 3 is cylindrical, a limiting protrusion is provided on the outer circumference of the slider 3, and a sliding groove extending along the axial direction of the drill bit 1 is provided on the inner wall of the transmission cylinder 2. By embedding the limiting protrusion in the sliding groove, the slider 3 can be restricted from rotating within the transmission cylinder 2, achieving the purpose of sliding in a single degree of freedom.

[0077] Among them, the socket 31 is set in the slider 3. By sliding the slider 3 and the transmission tube 2, the position of the slider 3 and the elastic support member in the socket 31 in the transmission tube 2 can be adjusted. Since the drill bit 1 can slide axially along the drill bit 1 in the transmission tube 2, the extension length of the drill bit 1 (initial extension length) can be adjusted by adjusting the position of the slider 3. When in state 2, the deformation of the elastic support member changes, so that the elastic force value (axial pressure applied to the drill bit 1) changes. Therefore, the axial pressure on the drill bit 1 during bone grinding can be adjusted by adjusting the position of the slider 3 in the transmission tube 2. This reduces the excessive pressure when the vertebral plate is about to be ground through, directly compressing the bone, causing bone fragments to squeeze and damage the spinal cord / nerve roots, or when the vertebral plate is ground through, the elastic support member has an excessively large rebound force, pushing the drill bit 1 to move quickly over a long distance, directly impacting and damaging the spinal cord / nerve roots, thereby protecting the spinal cord / nerve roots.

[0078] In this embodiment, a circular hole 111 is provided on the end surface of the insertion rod 11 facing away from the drill bit 1, and extends along the axial direction of the drill bit 1. A guide rod 32 is provided in the circular hole 111. The outer circular surface of one end of the guide rod 32 is in contact with the inner circular surface of the circular hole 111, and the other end protrudes from the outside of the circular hole 111 and is inserted into the insertion hole 31 and is fixedly connected to the plane of the insertion hole 31 facing away from the opening.

[0079] In this scheme, if Figure 2 、 4 As shown in Figures 5 and 6, the guide rod 32 is inserted into the circular hole 111 to guide the sliding of the insertion rod 11 relative to the slider 3. After the insertion rod 11 slides out of the insertion hole 31, the guide rod 32 provides a lateral support to the top end of the insertion rod 11 (when the transmission cylinder 2 is placed vertically), and the transmission cylinder 2 provides a lateral support to the drill bit 1, so that the insertion rod 11 is not easy to tilt or deviate, thereby improving the overall structural stability of the device and facilitating the secondary insertion of the insertion rod 11 into the insertion hole 31.

[0080] Moreover, the outer surface of the guide rod 32 is in contact with the inner surface of the circular hole 111 . After the insertion rod 11 slides out of the insertion hole 31 , the guide rod 32 can rotate in the circular hole 111 , and the corresponding drill bit 1 can rotate relative to the slider 3 .

[0081] In this embodiment, the elastic support member is a compression spring 4, which is sleeved outside the guide rod 32 and spirally extends along the axial direction of the guide rod 32. One end of the compression spring 4 abuts against the end face of the insertion rod 11, and the other end abuts against a plane facing away from the opening of the insertion hole 31.

[0082] In this solution, when the slider 3 is fixed in position, the compression spring 4 acts as an elastic support for the drill bit 1, applying axial pressure to the drill bit 1. The compression spring 4 is embedded in the socket 31 and is sleeved outside the guide rod 32, which can limit the space for the compression spring 4 to move laterally (along the radial direction of the drill bit 1), reducing the risk of the compression spring 4 being squeezed and twisted to cause plastic deformation and damage. By limiting the space for the compression spring 4 to move laterally, the compression spring 4 can be stably expanded and contracted in the axial direction, providing axial pressure to the drill bit 1. Figure 4 、 5 shown.

[0083] In addition, to ensure that the drill bit 1 can be safely removed after grinding through the vertebral lamina, excessive ejection can be avoided to cause nerve damage or vertebral lamina damage.

[0084] Set the ejection distance (initial extension length) to 1.0-2.0 mm (preferably 1.5 mm) to ensure that the drill bit 1 only extends slightly after disengaging from the drive cylinder 2 to avoid touching deep nerves.

[0085] The elastic coefficient of the compression spring 4 is set to 0.5-1.0 N / mm (preferably 0.8 N / mm) to provide a mild elastic force.

[0086] In this embodiment: the adjustment part includes a screw rod 5 extending axially toward the drill bit 1, one end of the screw rod 5 passes through the side wall of the slider 3 and is connected by a threaded connection, and the other end passes through the end wall of the closed end of the transmission cylinder 2 and extends out of the transmission cylinder 2, and rotates with the transmission cylinder 2.

[0087] In this solution, pins can be inserted into the holes at both ends of the end wall of the transmission cylinder 2, or limit blocks can be welded. The pins / limit blocks can be pressed against the inner and outer planes of the end wall of the transmission cylinder 2 to limit the axial movement of the screw rod 5.

[0088] Under the condition of limiting the axial movement of the screw rod 5, the screw rod 5 is connected to the slider 3 through threaded cooperation. It is only necessary to control the screw rod 5 to rotate at one end outside the closed end of the transmission cylinder 2. The external thread on the screw rod 5 can apply axial thrust to the slider 3, so that the slider 3 slides in the transmission cylinder 2. The height of the slider 3 is adjusted (when the transmission cylinder 2 is placed vertically) to adjust the initial extension length of the drill bit 1.

[0089] In addition, since the screw rod 5 passes through the side wall of the slider 3 (to be inserted into the socket 31), the axis of the screw rod 5 is not colinear with the axis of the drill bit 1. The screw rod 5 can serve as a limiting structure for the slider 3, limiting the rotation of the slider 3 around the axis of the drill bit 1, so that the slider 3 can only slide in a single degree of freedom along the axis of the drill bit 1 in the transmission cylinder 2.

[0090] In this embodiment, a cavity is provided in the end wall of the closed end of the transmission cylinder 2, and two meshing bevel gear rings 6 are provided in the cavity. One of the bevel gear rings 6 is coaxially fixedly connected to the screw rod 5, and the other bevel gear ring 6 is coaxially fixedly connected to the control rod 7.

[0091] One end of the control rod 7 penetrates the transmission cylinder 2 along the radial direction of the drill bit 1 and extends to the outside of the side wall of the transmission cylinder 2, and is rotatably engaged with the end wall of the closed end of the transmission cylinder 2.

[0092] In this scheme, if Figure 2 、 12 As shown, the top end of the screw rod 5 is inserted into the cavity, and the control point is transferred from the closed end of the transmission cylinder 2 to the radial side of the transmission cylinder 2 through two bevel gear rings 6 and the control rod 7. Since the closed end of the transmission cylinder 2 needs to be connected to a driving device such as an electric drill, its operating space is small, while there is no obstruction around the radial side of the transmission cylinder 2, and the operating space is large, which is convenient for controlling and debugging the position of the slider 3.

[0093] In this embodiment, a strip-shaped hole 21 extending axially toward the drill bit 1 is formed on the side wall of the transmission cylinder 2, and a marking strip 33 adapted to the strip-shaped hole 21 is fixedly connected to the side wall of the slider 3;

[0094] The marking strip 33 is located on a side facing away from the slider 3 and passes through the strip hole 21 and extends out of the transmission cylinder 2;

[0095] The outer wall of the transmission cylinder 2 is engraved with scale lines 22 evenly distributed along the axial direction of the drill bit 1 , and the scale lines 22 are located on the movement trajectory of the marking strip 33 .

[0096] In this scheme, if Figure 1 As shown, the scale line 22 can be used to indicate the value of the initial extension length of the drill bit 1 at the position corresponding to the marking bar 33. By sliding the marking bar 33 to the position corresponding to the scale line 22, the initial extension length of the drill bit 1 can be quickly adjusted without the need to use measuring equipment (ruler, laser rangefinder, etc.) for frequent measurement and adjustment.

[0097] Alternatively, the scale line 22 is used to indicate the pressure value applied by the compression spring 4 to the drill bit 1 in state two. The elastic force value of the compression spring 4 in state two can be converted based on the initial extension length and the elastic force coefficient of the compression spring 4, and intuitively represented by the scale line 22, eliminating the step of converting the elastic force value (axial pressure applied to the drill bit 1) during the process of adjusting the position of the slider 3.

[0098] In this embodiment: a rotating sleeve 23 is provided outside the open end of the transmission cylinder 2, one end of the rotating sleeve 23 is inserted into the open end of the transmission cylinder 2 and rotates coaxially, and the other end is sleeved outside the drill bit 1, and the drill bit 1 and the inner wall of the rotating sleeve 23 slide together along the axial direction of the drill bit 1 with a single degree of freedom.

[0099] In this scheme, if Figure 10 、 12As shown, an annular groove coaxial with the axis of the drill bit 1 is provided on the inner wall of the open end of the transmission cylinder 2, and the two ends of the rotating sleeve 23 are open and hollow. An annular protrusion is provided on the outer wall of the top end of the rotating sleeve 23. The annular protrusion is embedded in the annular groove and rotates in cooperation, which can limit the axial movement of the rotating sleeve 23 relative to the transmission cylinder 2 and can only rotate relative to the transmission cylinder 2.

[0100] When the insertion rod 11 is in a prismatic shape, the top opening of the rotating sleeve 23 is adapted to the insertion rod 11, and the top end of the insertion rod 11 (the end facing away from the drill bit 1) extends from the top opening of the rotating sleeve 23 and is inserted into the transmission cylinder 2. The middle part of the insertion rod 11 slides with the top opening of the rotating sleeve 23, so that the insertion rod 11 (drill bit 1) can only slide axially on the rotating sleeve 23, that is, when the drill bit 1 rotates, the rotating sleeve 23 rotates synchronously, and when the drill bit 1 stops rotating, the rotating sleeve 23 stops rotating synchronously.

[0101] The outer shape of the rotary sleeve 23 can be set to be cylindrical or conical. By coating the outer surface of the rotary sleeve 23 with diamond, the rotary sleeve 23 can follow the drill bit 1 to grind bone.

[0102] The rotating sleeve 23 is cylindrical in shape and has a straight wall structure that can reduce the risk of accidental side slippage and maintain the stability of the bone window diameter through parallel expansion;

[0103] The outer shape of the rotating sleeve 23 is conical, and the outer size gradually decreases from the end facing the transmission cylinder 2 to the end facing away from the transmission cylinder 2. When the rotating sleeve 23 rotates, the surgical site is expanded gradually to form a funnel-shaped surgical field.

[0104] In this embodiment, a cutting strip 231 is fixedly connected to the outer circumferential surface of the rotating sleeve 23 , and the cutting strip 231 extends axially toward the rotating sleeve 23 .

[0105] In this embodiment, the cutting strips 231 extend in a spiral shape along the axial direction of the rotating sleeve 23 on the outer surface of the rotating sleeve 23 , and multiple cutting strips 231 are evenly arranged along the circumference of the rotating sleeve 23 . The cutting strips 231 are made of cemented carbide.

[0106] A longitudinal chip removal groove (extending spirally along the axial direction of the rotating sleeve 23) is formed on the outer side wall of the rotating sleeve 23 to prevent bone chips from accumulating and affecting the field of vision.

[0107] A lumbar lamina fenestration surgical method includes using the above-mentioned lumbar lamina fenestration device, and the surgical steps are as follows:

[0108] S1. Preoperative positioning: Determine the disc herniation segment and fenestration location through imaging examinations, and mark the fenestration range of the lamina;

[0109] S2. Equipment Adjustment: Rotate the control lever 7, which drives the screw 5 through the two bevel gear rings 6. Adjust the axial position of the slider 3 within the drive cylinder 2. Set the initial extension length of the drill bit 1 to 5-8 mm. Then, coaxially secure the closed end of the drive cylinder 2 to the output shaft of the electric drill.

[0110] S3 safety lock: handheld electric drill will drill bit 1 against the surface of the lamina, apply 3-5N axial pressure to deform the elastic support member, the rod 11 is fully inserted into the jack 31, to achieve the drill bit 1 and the drive tube 2 rigid linkage;

[0111] S4. Window opening operation: It is divided into the following two stages:

[0112] In the first stage, the electric drill is started at high gear (15,000-20,000 rpm) to rotate the drive barrel 2 and the drill bit 1 at high speed, and the lamina is quickly ground. The electric pulse flushing pump is used to flush and remove debris. The grinding thickness is visually observed. When the remaining grinding thickness is less than 1.5 mm, the grinding is stopped.

[0113] In the second stage, step 2 is repeated, and the initial extension length of the drill bit 1 is adjusted to 2-3 mm. The axial pressure applied by the elastic support to the drill bit 1 in the second state is reduced to 1-2 N. The electric drill is started at a low speed (5000-8000 rpm) to rotate the drill bit 1 at a low speed, and the lamina is slowly ground until the drill bit 1 wears through the lamina. The axial resistance applied by the lamina to the drill bit 1 disappears, and the elastic support extends to push the insertion rod 11 out of the insertion hole 31. The drill bit 1 extends 1-2 mm from the transmission cylinder 2, and the drill bit 1 and the transmission cylinder 2 are disconnected.

[0114] S5. Nerve protection: After the drill bit 1 is disengaged, the rotational power is lost and the speed automatically drops to below 1000 rpm, preventing the drill bit 1 from continuing to rotate and further damaging nerve tissue.

[0115] S6. Expand the fenestration: Repeat steps S3-S5, gradually enlarging the bone window to a diameter of 8-10 mm.

[0116] S7. Disc management: Use microsurgical instruments to remove the protruding disc tissue through the bone window, preserving the normal nucleus pulposus.

[0117] S8. Surgical field management: Use bipolar electrocoagulation to stop bleeding, flush the surgical field with saline, and close the incision layer by layer.

[0118] Finally, it should be noted that the above embodiments are only used to illustrate the technical solutions of the present invention and are not limiting. Although the present invention has been described in detail with reference to the preferred embodiments, those skilled in the art should understand that the technical solutions of the present invention may be modified or replaced by equivalents without departing from the purpose and scope of the technical solutions of the present invention, which should all be included in the scope of the claims of the present invention.

Claims

1. A lumbar vertebral lamina fenestration device, comprising a drill bit (1), characterized in that: It also includes a transmission cylinder (2) with a hollow structure and an elastic support member, wherein the drill bit (1) is embedded in the transmission cylinder (2) and movably connected to the transmission cylinder (2), and the drill bit (1) can move in the transmission cylinder (2) along the axial direction of the drill bit (1); A socket (31) is provided in the closed end of the transmission cylinder (2); an insert rod (11) adapted to the socket (31) is fixedly connected to the end of the drill bit (1); one end of the insert rod (11) facing away from the drill bit (1) extends along the axial direction of the drill bit (1) and is inserted into the socket (31), and is slidably fitted in a single degree of freedom along the axial direction of the drill bit (1); The elastic support member is embedded in the insertion hole (31), one end of the elastic support member abuts against the insertion rod (11), and the other end abuts against a plane of the insertion hole (31) facing away from the opening; The drill bit (1) can be in the following two states in the transmission tube (2): State 1: The drill bit (1) is completely retracted into the transmission cylinder (2), the insertion rod (11) is inserted into the insertion hole (31), the transmission cylinder (2) and the drill bit (1) are linked by the plug-in structure, the elastic support member is in a compressed state, and the drill bit (1) rotates synchronously with the transmission cylinder (2); State 2: The drill bit (1) partially extends out of the transmission cylinder (2), the insertion rod (11) is separated from the insertion hole (31), the elastic support member stretches naturally, and the drill bit (1) and the transmission cylinder (2) are released from linkage and can rotate relative to each other.

2. The lumbar lamina fenestration device according to claim 1, characterized in that: A slider (3) is provided in the closed end of the transmission cylinder (2), and the slider (3) and the inner wall of the transmission cylinder (2) are slidably matched along the axial direction of the drill bit (1) with a single degree of freedom. The jack (31) is arranged on the end surface of the slider (3) facing the drill bit (1), and an adjusting portion for driving the slider (3) to slide in the transmission cylinder (2) is arranged between the slider (3) and the transmission cylinder (2).

3. The lumbar lamina fenestration device according to claim 2, characterized in that: A circular hole (111) extending along the axial direction of the drill bit (1) is provided on the end surface of the insertion rod (11) facing away from the drill bit (1), and a guide rod (32) is provided in the circular hole (111). The outer circular surface of one end of the guide rod (32) is in contact with the inner circular surface of the circular hole (111), and the other end protrudes from the outside of the circular hole (111) and is inserted into the insertion hole (31) and fixedly connected with the plane of the insertion hole (31) facing away from the opening.

4. The lumbar lamina fenestration device according to claim 3, characterized in that: The elastic support member is a compression spring (4), which is sleeved outside the guide rod (32) and spirally extends along the axial direction of the guide rod (32). One end of the compression spring (4) abuts against the end surface of the insertion rod (11), and the other end abuts against a plane of the insertion hole (31) facing away from the opening.

5. The lumbar lamina fenestration device according to claim 2, characterized in that: The adjusting portion comprises a screw rod (5) extending axially toward the drill bit (1); one end of the screw rod (5) penetrates the side wall of the slider (3) and is connected by a threaded fit; the other end penetrates the end wall of the closed end of the transmission cylinder (2), extends out of the transmission cylinder (2), and rotates in conjunction with the transmission cylinder (2).

6. The lumbar lamina fenestration device according to claim 5, characterized in that: A cavity is provided in the end wall of the closed end of the transmission cylinder (2), and two meshing bevel gear rings (6) are provided in the cavity, one of the bevel gear rings (6) is coaxially fixedly connected to the screw rod (5), and a control rod (7) is coaxially fixedly connected to the other bevel gear ring (6); One end of the control rod (7) penetrates the transmission cylinder (2) along the radial direction of the drill bit (1) and extends to the outside of the side wall of the transmission cylinder (2), and is rotatably matched with the end wall of the closed end of the transmission cylinder (2).

7. The lumbar lamina fenestration device according to claim 2, characterized in that: A strip-shaped hole (21) extending axially toward the drill bit (1) is formed on the side wall of the transmission cylinder (2), and a marking strip (33) adapted to the strip-shaped hole (21) is fixedly connected to the side wall of the slider (3); The marking strip (33) extends through the strip hole (21) on one side facing away from the slider (3) and extends out of the transmission cylinder (2); The outer wall of the transmission cylinder (2) is engraved with scale lines (22) evenly distributed along the axial direction of the drill bit (1), and the scale lines (22) are located on the movement trajectory of the marking strip (33).

8. The lumbar lamina fenestration device according to claim 1, characterized in that: A rotating sleeve (23) is provided outside the open end of the transmission cylinder (2); one end of the rotating sleeve (23) is inserted into the open end of the transmission cylinder (2) and rotates coaxially; the other end is sleeved outside the drill bit (1); the drill bit (1) and the inner wall of the rotating sleeve (23) slide in a single degree of freedom along the axial direction of the drill bit (1).

9. The lumbar lamina fenestration device according to claim 8, characterized in that: A cutting strip (231) is fixedly connected to the outer circumferential surface of the rotating sleeve (23), and the cutting strip (231) extends axially toward the rotating sleeve (23).

10. A lumbar lamina fenestration surgical method, comprising using the lumbar lamina fenestration device of claim 6, characterized in that: The surgical steps are as follows: S1. Preoperative positioning: Determine the disc herniation segment and fenestration location through imaging examinations, and mark the fenestration range of the lamina; S2. Equipment adjustment: Rotate the control lever to drive the screw (5) through the two bevel gear rings (6), adjust the axial position of the slider (3) in the transmission tube (2), set the initial extension length of the drill bit (1) to 5-8mm, and then coaxially fix the closed end of the transmission tube (2) to the output shaft of the electric drill; S3. Safety lock: The handheld electric drill is placed in contact with the drill bit (1) on the surface of the lamina, and an axial pressure of 3-5N is applied to deform the elastic support member. The rod (11) is fully inserted into the jack (31), thereby achieving rigid linkage between the drill bit (1) and the drive cylinder (2); S4. Window opening operation: It is divided into the following two stages: In the first stage, the electric drill is started at high gear to make the transmission barrel (2) drive the drill bit (1) to rotate at high speed, and the lamina is quickly ground. The electric pulse flushing pump is used to flush and remove debris, and the grinding thickness is visually observed. When the remaining grinding thickness is less than 1.5 mm, the grinding is stopped; In the second stage, step 2 is repeated to adjust the initial extension length of the drill bit (1) to 2-3 mm, reduce the axial pressure applied by the elastic support member to the drill bit (1) in the second state to 1-2 N, start the electric drill at a low speed to rotate the drill bit (1) at a low speed, and slowly grind the vertebral plate until the drill bit (1) wears through the vertebral plate. The axial resistance applied by the vertebral plate to the drill bit (1) disappears, the elastic support member stretches to push the insertion rod (11) out of the socket (31), and the drill bit (1) extends 1-2 mm from the transmission cylinder (2). The drill bit (1) and the transmission cylinder (2) are disengaged. S5. Nerve protection: After the drill bit (1) is disengaged from the linkage, the rotational power disappears and the rotation speed automatically drops to below 1000 rpm, reducing the drill bit (1) from continuing to rotate deeply to damage the nerve tissue; S6. Expand the window: Repeat steps S3-S5, gradually enlarging the bone window to a diameter of 8-10 mm. S7. Intervertebral disc treatment: Use micro-shell instruments to remove the protruding intervertebral disc tissue through the bone window, preserving the normal nucleus pulposus; S8. Surgical field management: Use bipolar electrocoagulation to stop bleeding, flush the surgical field with saline, and close the incision layer by layer.

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