Arc-shaped lumbar puncture trocar for treating lumbar disc herniation through low-temperature plasma nucleus pulposus ablation

Abstract

The invention provides an arc-shaped lumbar puncture trocar for treating lumbar disc herniation through low-temperature plasma nucleus pulposus ablation. A needle outer tube is integrally formed by a tube front section, a tube middle section and a tube rear section, and a penetrating type working channel is formed in the center of the needle outer tube; the front end of the pipe arc-shaped section extends to be connected with the pipe parallel section, and the rear end of the pipe arc-shaped section extends to be connected with the pipe middle section; a tube inclined surface is arranged on the front surface of the arc-shaped recess at the front end of the tube parallel section and extends towards the tube back surface to form a needle tip; the far end of the tube slope is designed into a sharp triangle, and the near end of the tube slope is designed into an ellipse; the needle handle is arranged at the rear section of the tube, the syringe connector is arranged at the tail of the needle handle, and the working channel starts from the syringe connector to the tube slope. According to the invention, the design is reasonable, the operation is safe, the needle tip can bypass the zygopophysis to accurately reach the target spot of the lumbar disc protrusion, the soft low-temperature plasma cutter head is placed through the trocar to realize ablation, the compression of the protrusion on the adjacent nerve root and dural sac is relieved, and the clinical symptoms are eliminated.

Description

Technical Field

[0001] The invention relates to medical equipment, in particular to an arc-shaped lumbar puncture trocar for treating lumbar disc herniation by low-temperature plasma nucleus pulposus ablation. Background Art

[0002] Lumbar disc herniation is a common and frequently occurring disease that seriously impacts human health. Numerous treatment options are currently available, including acupuncture, massage, physical therapy, acupotomy, surgery, and interventional therapy. Each of these treatments has its pros and cons. In terms of overall efficacy, surgery offers the most definite benefits, but its drawbacks include significant trauma and high risk.

[0003] With the advancement of science and technology and people's increasing demands for health, minimally invasive interventional treatments are gaining increasing recognition from experts and patients for their minimal trauma, excellent efficacy, and minimal side effects. Among the many minimally invasive interventional treatment techniques, low-temperature plasma nucleus pulposus ablation has been a rapidly developing new technology in recent years.

[0004] Low-temperature plasma ablation for lumbar disc herniation generally adopts a lateral approach. The needle insertion point is selected on the affected side of the responsible intervertebral disc, 8-10 cm away from the midpoint of the spinous process. After local anesthesia, under the guidance of a C-arm X-ray machine, a specific cannula is punctured to the middle and posterior 1 / 3 of the herniated intervertebral disc (anteroposterior position) or the center slightly to the affected side (anteroposterior position). Then, the low-temperature plasma blade is inserted from the cannula and connected to the main unit to complete the ablation treatment.

[0005] See Figure 1 Under the guidance of C-arm X-ray machine, a special trocar is inserted through the skin to a specific position in the herniated intervertebral disc. The plasma cutter is inserted through the trocar and the power of appropriate intensity is selected to ablate and vaporize the nucleus pulposus tissue of the intervertebral disc in a certain range around the working section of the plasma cutter, thereby reducing the pressure in the intervertebral disc and alleviating the pressure and stimulation of the herniated intervertebral disc tissue on the dura mater and nerve roots, thereby alleviating the symptoms (see Figure 2 ).

[0006] This technology is simple to operate, minimally invasive, highly safe, does not damage the vertebral structure, and does not injure extravertebral muscle fascia and other tissues. It has certain clinical efficacy, but there are the following problems during use: 1. The target location of the intervertebral disc herniation is mainly concentrated on the inner side of the facet joints on both sides and near the posterior edge of the intervertebral disc. Since conventional trocars are straight, it is difficult for the needle tip of the straight trocar to directly reach the target location of the intervertebral disc herniation due to the obstruction of the facet joints (unless it is a very lateral herniation, but very lateral herniation is rare in clinical practice). It can only reach the middle and posterior 1 / 3 of the corresponding intervertebral disc. In this way, the low-temperature plasma blade inserted into the working channel of the trocar can only reach this place, and reduce the pressure in the disc by ablating and removing part of the normal tissue in the intervertebral disc, thereby indirectly reducing the stimulation and compression of the protruding intervertebral disc on the adjacent dura mater and nerve roots to relieve symptoms.

[0007] 2. Since the conventional straight puncture trocar mentioned above cannot directly reach the target position of the herniated disc and cannot directly ablate the herniated disc tissue, although it has a certain therapeutic effect, the clinical efficacy is often limited, especially if the herniated disc tissue is large or the herniation has a long course and has hardened, the pressure reduction in the disc cannot significantly relieve the stimulation and compression of the herniated disc tissue on the adjacent dura mater and nerve roots. The therapeutic effect for these patients is very poor.

[0008] Therefore, a special curved lumbar puncture trocar is needed clinically. After puncturing into the human body, the needle tip of the trocar can bypass the articular process and enter the spinal canal in a direction parallel to the posterior edge of the intervertebral disc, directly reaching the target point of the intervertebral disc herniation, ensuring that the low-temperature plasma blade inserted from the trocar can accurately reach the target point, thereby achieving precise ablation of the target point of the intervertebral disc herniation.

[0009] The invention patent published under patent number 2022111977984 relates to a "painful puncture trocar and needle outer tube." The needle has a certain curvature and is claimed to be able to adjust the puncture path and smoothly glide across the bone surface during puncture. However, according to the content of the announcement, the needle cannot achieve the technical purpose of "precise target ablation of low-temperature plasma blades to treat lumbar disc herniation." The reasons are as follows: 1. Patent No. 2022111977984, published in

[0006] , states: The advantage of the invention is that it provides a painful puncture trocar and a needle outer tube, the bending angle of which is adjustable. The trocar used in low-temperature plasma ablation for the treatment of lumbar disc herniation is a straight tube made of metal with a diameter of 1.4mm and a certain strength and hardness. Because the traditional trocar is straight, it cannot bypass the obstruction of the small articular process and accurately puncture the herniated disc. If the traditional straight tube is changed to a fixed curvature arc tube, and the puncture point is designed through calculation with reference to the actual anatomical imaging parameters of the patient's body, there is no need to adjust the bending angle during the puncture process, and the needle tip can bypass the articular process and puncture the herniated disc (this has been confirmed in clinical practice).

[0010] It can be seen that the puncture needle with adjustable bending angle disclosed in Patent No. 2022111977984 is meaningless for this treatment.

[0011] 2. Patent No. 2022111977984's specification states in

[0016] that the front section of the outer tube of the needle comprises a tube extension section, a tube arc section, and a tube bevel, wherein the tube arc section is integrally formed at the front portion of the tube extension section, and the tube bevel is disposed at the top end of the tube arc section... It can be seen that the distal end section of the trocar disclosed in Patent No. 2022111977984 is arc-shaped.

[0012] Since all the herniated intervertebral disc tissues are located near the posterior edge of the intervertebral disc, which is nearly straight, the trocar must advance in a straight line parallel to the posterior edge of the intervertebral disc after entering from the outer opening of the neural foramen to the inner opening. The distal end of the puncture needle announced in Patent No. 2022111977984 is arc-shaped. Thus, when the puncture needle enters the spinal canal from the lateral approach, it is difficult for the needle tip to advance in a straight line parallel to the posterior edge of the intervertebral disc, making it difficult to accurately reach the herniated intervertebral disc tissue. Instead, the needle tip bends and moves backward after continuing to insert the needle, which can easily damage the dura mater sac in the spinal canal, damage the cauda equina, and may cause cerebrospinal fluid leakage.

[0013] It can be seen that the arc-shaped structure design of the trocar of Patent No. 2022111977984 cannot meet the requirements of this operation.

[0014] 3. Patent No. 2022111977984, specification

[0011] states: The advantage of this invention patent is to provide a painful puncture trocar and a needle outer tube, wherein the needle tip is a blunt, rounded shape... Page 14 of the specification Figure 2 A The tube inclined surface 1131 is arc-shaped.

[0015] It can be seen that the purpose of the needle design of Patent No. 2022111977984 is to slide over the bone surface encountered during the advancement process so as to flip and change the direction of the puncture needle, so its needle must have a blunt and rounded shape. However, this blunt needle design can only be successfully inserted into the human body when the puncture needle is thin. The diameter of the matching puncture cannula needle for low-temperature plasma ablation is about 1.4mm. If the blunt and rounded needle structure of Patent No. 2022111977984 is used, it is obviously difficult to successfully complete the operation of inserting into the human body. Because the puncture process will be particularly laborious and difficult, especially after entering the inner opening of the neural foramen, the blunt and rounded needle tip will find it difficult to break through the tough fiber ring outside the intervertebral disc tissue.

[0016] It can be seen that the blunt, rounded needle design of Patent No. 2022111977984 cannot meet the requirements of this surgery.

[0017] 4. Patent No. 2022111977984, specification

[0018] states: The arcuate tube segment includes an arcuate front face and an arcuate back face, the tube bevel is located at the top of the arcuate back face, the tube bevel includes a tube bevel top face and a tube bevel end face, the tube bevel extends obliquely from the tube bevel top face toward the tube bevel end face, and the tube bevel end face is connected to the arcuate back face... As can be seen, the outer tube needle hole outlet of the trocar disclosed in Patent No. 2022111977984 has the beveled surface located on the back of the arcuate segment, and this opening orientation is one of the important features of Patent No. 2022111977984. Because Patent No. 2022111977984 is designed to slide over the bone surface by flipping the needle when the needle tip encounters the bone surface, this operation would not be completed if the beveled surface of the tube was located on the back of the arcuate segment.

[0018] The puncture trocar used for low-temperature plasma ablation is relatively thick, with a diameter of approximately 1.4mm. It enters the human body through a lateral approach. If the trocar structure disclosed in Patent No. 2022111977984 is used, the tube bevel is located on the curved back side of the tube. In this way, the needle tip on the curved back side will have a larger cross-sectional plane. During puncture, the curved back side penetrates downward, and the trocar passes through the human tissue in a manner equivalent to a blunt penetration. This is especially true in the lower back, where the skin and fascia are relatively dense and the muscle tissue is abundant. The puncture will face great resistance, causing significant damage to the human tissue passed through, especially the muscle fiber tissue, resulting in more bleeding and greater pain for the patient. In addition, after entering the spinal canal, coupled with the blunt and rounded design of the needle tip, it will be more difficult for the puncture needle to penetrate the dense fibrous ring outside the intervertebral disc tissue and enter the intervertebral disc (this has also been confirmed in clinical practice).

[0019] It can be seen that the inclined opening direction design of the cannula needle tube published in Patent No. 2022111977984 cannot meet the requirements of this operation.

[0020] 5. The puncture trocar described in the specification of Patent No. 2022111977984 does not include a needle handle structure, page 14 Figure 1 The needle tail is a regular square shape... It can be seen that the puncture cannula needle used for low-temperature plasma ablation is relatively thick, with a diameter of about 1.4mm, and the curved front is facing downward. It enters the human body from the side approach. After the curved puncture needle enters the human body, it is possible to change the direction of travel and rotate. If the puncture direction and rotation angle are not discovered and corrected in time, it will bring risks to the puncture process. The direction and rotation angle of the puncture needle that has entered the body cannot be directly observed, but can be judged by referring to the structure of the needle tail exposed outside. The needle tail published in Patent No. 2022111977984 is a regular square shape with poor direction recognition. This is obviously not conducive to timely observation, grasping and correction of the puncture direction and rotation angle of the puncture needle in the body by referring to the needle tail. It can be seen that the needle tail design of the trocar published in Patent No. 2022111977984 is also difficult to meet the requirements of this operation.

[0021] 6. In the specification of patent No. 2022111977984,

[0016] shows that the end of the front section of the needle outer tube is a curved section,

[0036] shows that the needle outer tube is made of iron and aluminum, and has predetermined strength and toughness...

[0017] shows that it also includes a needle inner core, and the needle inner core includes a core front section, and the core front section includes a core extension section, a core curved section, and a core inclined surface;

[0026] shows that the needle inner core is installed inside the needle outer tube when in use, and

[0070] shows that the needle inner core 20 is made of stainless steel and is relatively hard, but the needle outer tube 10 is softer than the needle inner core 20, and the degree of bending of the needle outer tube 10 can be changed by applying external force to the needle outer tube 10.

[0022] As can be seen, the outer tube and needle core designed in Patent No. 2022111977984 must be used in conjunction. The core principle is to use a harder curved needle core to change the curvature of the relatively soft front section of the outer tube. During use, the hard curved needle core must first be inserted from the needle end of the outer tube, then advance along the outer tube working channel through the rear and middle sections of the outer tube, until it reaches the outer tube extension section, the curved section, and the bevel. Common sense and experience show that the needle outer tube announced in Patent No. 2022111977984 is made of iron and aluminum, not plastic. Its softness must be limited, and it must retain a certain hardness and strength. The middle and rear sections of the extended section are both straight structures. After the curved front section of the stainless steel hard needle core is inserted into the working channel from the needle tail hole of the needle outer tube, the straight rear and middle sections of the tube are first entered. Can the curved stainless steel hard needle core easily pass through the straight needle outer tube made of iron and aluminum, which still has a certain hardness and strength? Even if it can be done, it will definitely be difficult, because when the curved stainless steel hard needle core passes through the straight needle outer tube, the needle core is not easy to deform, so the needle outer tube must have a process of changing shape, and there will be very large resistance during insertion; if it can be barely completed before insertion into the human body, then after the puncture needle penetrates the human body and reaches the designated position, how to easily pull out the hard curved needle core will be a very big problem, because when the hard curved needle core is pulled out, the entire needle outer tube will face the process of changing shape, and the removal process will be very strenuous. How to ensure that the needle tip does not shake or change position during the strenuous needle removal process will be a very big problem.

[0023] Therefore, the content disclosed in Patent No. 2022111977984 is difficult to achieve clinical application in practice.

[0024] In summary, the trocar structure disclosed in Patent No. 2022111977984 does not meet the actual surgical requirements of low-temperature plasma nucleus pulposus ablation for the treatment of lumbar disc herniation at all, and the implementation method based on the principle described therein cannot adapt to the actual surgical requirements through any deformation and modification. Summary of the Invention

[0025] The purpose of the present invention is to provide a curved lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation. Using this trocar from the side approach, the needle tip of the trocar can bypass the facet joint process and safely puncture the target point of the herniated intervertebral disc. The plasma cutter head is then inserted from the working channel of the trocar to achieve direct and precise target ablation of the herniated intervertebral disc tissue, thereby improving the clinical efficacy.

[0026] The second purpose of the present invention is to provide a curved lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation treatment of lumbar disc herniation, which only includes an outer tube of the needle and does not require a core needle.

[0027] The third purpose of the present invention is to provide an arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation. The trocar is made of metal material, has a certain hardness, strength and toughness, and is not easy to deform or break.

[0028] The fourth purpose of the present invention is to provide an arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation. The trocar has a fixed curvature. When in use, the arc design can be used to change the direction of the needle tip so that the trocar tip can bypass the obstruction of the articular process and enter the spinal canal.

[0029] The fifth purpose of the present invention is to provide an arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation. When in use, after the trocar needle tip bypasses the articular process and enters the spinal canal, the puncture needle can run parallel to the posterior edge of the intervertebral disc to reach the site of the intervertebral disc herniation without causing damage to the adjacent dura mater and cauda equina in the spinal canal.

[0030] The sixth purpose of the present invention is to provide an arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation, which can smoothly puncture into the relatively thick skin, fascia, muscles and dense fiber ring around the disc herniation on the waist and back to reach the disc herniation.

[0031] The seventh purpose of the present invention is to provide a curved lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation, which can observe, control and adjust the direction of the trocar needle tip in real time during the insertion process into the human body, thereby ensuring the safety and accuracy of the puncture process.

[0032] The eighth purpose of the present invention is to provide a curved lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation, which is not easy to slip in the operator's hand during puncture.

[0033] The ninth purpose of the present invention is to provide an arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation, inserting a soft low-temperature plasma blade into the herniated disc through the working channel of the trocar to achieve precise target ablation of the herniated disc and cure the disease.

[0034] The tenth purpose of the present invention is to provide an arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation. By slightly pressing, lifting or rotating the trocar handle, the depth and rotation direction of the needle tip can be appropriately adjusted to achieve multi-target ablation of the intervertebral disc herniation, and it can also have a good therapeutic effect on larger intervertebral disc herniations.

[0035] The eleventh object of the present invention is to provide a curved lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation, and to inject collagenase, ozone, anti-inflammatory drugs and other drugs into the disc herniation through the working channel of the trocar to further improve the therapeutic effect.

[0036] The technical solution of the present invention is: an arc-shaped lumbar puncture cannula needle for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation, which only includes an outer tube of the needle, and the front section, middle section and rear section of the tube are integrally formed to form the outer tube of the needle, and a through-type working channel is provided in the center of the outer tube of the needle; the middle section and the rear section of the tube are straight sections, the front section of the tube is composed of a parallel section of the tube and an arc-shaped section of the tube, the parallel section of the tube is integrally formed at the front end of the arc-shaped section of the tube, and the rear end of the arc-shaped section of the tube extends to connect the middle section of the tube; the middle section of the tube extends backward to form the rear section of the tube, and a needle handle is provided at the end of the rear section of the tube; the concave side of the arc-shaped section of the tube is the arc-shaped front side, and the convex side of the arc-shaped section of the tube is the arc-shaped back side; a tube bevel is provided on the arc-shaped front side of the front end of the parallel section of the tube from near to far, and the tube bevel extends to the back side of the tube to form a needle tip.

[0037] A further design is that the tube bevel includes a distal end of the tube bevel and a proximal end of the tube bevel; the proximal end of the tube bevel is located on the arc-shaped front side of the parallel section of the tube, the distal end of the tube bevel is located on the top of the arc-shaped back side of the parallel section of the tube, and the distal end of the tube bevel extends into a needle tip at the top of the parallel section of the tube.

[0038] A further design is that the distal end of the tube bevel is designed to be a sharp triangle, and the proximal end of the tube bevel is designed to be an ellipse.

[0039] A further design is that the acute angle of the distal end of the tube bevel is designed to be 15°-45°, preferably the acute angle of the distal end of the tube bevel is designed to be 30°; the length of the tube bevel is 1.5mm-2.5mm, preferably the length of the tube bevel is designed to be 2.0mm; the inclination angle of the tube bevel is designed to be 10°-45°, preferably the inclination angle of the tube bevel is designed to be 30°.

[0040] A further design is that the parallel section of the tube is straight, and the length of the parallel section of the tube is 0.5-1.5 cm, preferably the length of the parallel section of the tube is 1 cm.

[0041] A further design is that the arc section of the tube is integrally formed at the rear end of the parallel section of the tube, and the arc section of the tube is arc-shaped and has a length of 1.5cm-2.5cm; preferably, the length of the arc section of the tube is designed to be 2cm, and the arc section of the tube is a 30° arc section with a radius of 4cm.

[0042] A further design is that the middle section of the tube is straight and has a length of 8-15 cm. Preferably, the length of the middle section of the tube is designed to be 13 cm.

[0043] A further design is that the rear section of the tube is composed of a tube connecting section and a needle handle, the needle handle is integrally formed at the rear end of the tube connecting section, and the tube connecting section is connected to the rear end of the middle section of the tube.

[0044] A further design is that the tube connecting section is a cylindrical structure, the diameter of the cylindrical structure is 1.9mm-2.3mm, preferably the diameter of the cylindrical structure is designed to be 2mm; the length of the cylindrical structure is 1cm-2cm, preferably the length of the cylindrical structure is designed to be 1.5cm.

[0045] A further design is that the needle handle is a flat rectangular parallelepiped structure, and the coronal plane of the needle handle rectangular parallelepiped structure is perpendicular to the sagittal plane of the arc section of the front section of the tube.

[0046] A further design is that a syringe interface is designed at the tail of the needle handle; the working channel starts from the syringe interface at the tail of the needle handle and ends at the tube bevel of the front section of the tube.

[0047] A further design is that the surface of the needle handle is designed with anti-slip patterns.

[0048] A further design is that a depth marking line is designed on the surface of the outer tube of the needle to facilitate observation and control of the needle insertion depth.

[0049] During the operation: the patient is in prone position and a lateral approach is used, i.e. the insertion point is determined 8-13 cm away from the midline of the spine at the plane of the responsible intervertebral disc. The specific insertion point should be calculated based on the actual imaging anatomical parameters of each patient combined with the parameters of the puncture needle; after successful local anesthesia, under the guidance of C-arm X-ray fluoroscopy, the curved back of the arc-shaped lumbar puncture cannula is downward, and the distal end of the tube bevel, i.e. the needle tip, is close to the insertion point. At an angle of about 45° (this direction roughly points to the lateral edge of the facet articular process of the corresponding vertebra), the cannula is percutaneously punctured downward to the subcutaneous tissue, lumbar muscle and fascia layer... until the posterior edge of the safety triangle of the neural foramen lateral to the facet articular process; due to the design of the opening direction, angle and proximal and distal shape of the tube bevel, the puncture process is smooth and safe; when the needle tip reaches the posterior edge of the neural foramen lateral to the facet articular process, due to the displacement and the design of the curved section of the tube front section, the tube front section at this time The parallel section of the tube is already parallel to the posterior edge of the intervertebral disc. If the needle is continued to be inserted, the parallel section of the front section of the tube will bypass the obstruction of the facet joint and enter the spinal canal in a horizontal direction parallel to the posterior edge of the intervertebral disc. The inclined design of the cannula needle tube ensures that the puncture needle can smoothly pierce the denser fiber ring after entering the spinal canal until the needle tip reaches the target of the intervertebral disc herniation; the oblate rectangular needle handle is conducive to real-time observation and adjustment of the angle and direction of the arc-shaped lumbar puncture cannula needle tip during the puncture process, ensuring the safety and accuracy of the puncture process; the anti-slip grooves of the needle handle are conducive to preventing the cannula needle from sliding; after the needle tip reaches the ideal position, the soft low-temperature plasma blade is inserted through the syringe interface at the tail of the needle handle to achieve direct and precise ablation of the lumbar disc herniation target; after the ablation is completed, the low-temperature plasma blade is pulled out, and collagenase, ozone, anti-inflammatory drugs, etc. are injected through the syringe interface at the tail of the needle handle to further improve the therapeutic effect. BRIEF DESCRIPTION OF THE DRAWINGS

[0050] Figure 1 This is a schematic diagram of the lateral approach puncture through the safety triangle; Figure 2 Schematic diagram of the treatment of lumbar disc herniation by reducing intradiscal pressure using conventional straight trocar-guided low-temperature plasma nucleus pulposus ablation. Figure 3 This is a schematic diagram of treating lumbar disc herniation by using the arc-shaped lumbar puncture trocar of the present invention to perform low-temperature plasma target ablation under the guidance of puncture to relieve the direct compression of the protruding intervertebral disc on the nerve root; Figure 4 A schematic front view (side view) of the curved lumbar puncture trocar of the present invention; Figure 5 for Figure 4 A front view schematic diagram of Figure 6 for Figure 4 Schematic diagram of the rear view; Figure 7 for Figure 4 A front view schematic diagram of the tube slope; Figure 8 for Figure 4 Schematic diagram of the back side of the tube bevel (needle tip); Figure 9 for Figure 4 A front view of the tail of the needle handle; Figure 10 for Figure 4 A schematic back view of the tail portion of the needle handle of the trocar; Figure 11 for Figure 4 Schematic diagram of the needle handle and the syringe interface at the tail; Figure 12 This is a picture of the curved back of the trocar for the lateral approach, which is inserted downward from a fixed point to the anterior edge of the outer opening of the neural foramen safety triangle below the facet articular process; Figure 13 The curved tip of the trocar bypasses the facet joint and moves parallel to the posterior edge of the intervertebral disc from the external opening of the neural foramen to the internal opening of the neural foramen and punctures the target site of the intervertebral disc herniation. Figure 14 A picture of a low-temperature plasma blade inserted into a trocar to precisely ablate the target site of a herniated intervertebral disc and relieve nerve compression; Figure 15 、 Figure 16 This is a photo of the parallel segment of the trocar parallel to the posterior edge of the intervertebral disc; Figure 17 、 Figure 18 This is a photo of the distal end of the tube bevel, where the needle tip reaches; Figure 19 、 Figure 20This is a photo of the tube obliquely passing through the target site of the intervertebral disc herniation; Figure 21 Photographs for multi-target treatment; In the figure: 1 tube front section, 2 tube middle section, 3 tube rear section, 4 working channel, 11 tube bevel, 12 tube parallel section, 13 tube arc section, 111 tube bevel distal end, 112 tube bevel proximal end, 131 arc front, 132 arc back, 31 connecting section, 32 needle handle, 321 syringe interface, 322 anti-slip pattern. DETAILED DESCRIPTION

[0051] The technical solution of the present invention is further described below with reference to the accompanying drawings, which should not be construed as limiting the technical solution, and all improvements based thereon fall within the scope of protection of the present invention.

[0052] In this embodiment, the patient takes a prone position, and the direction of the patient's chest and abdomen is defined as the front, the direction of the back is defined as the back, the direction close to the midline of the spine is defined as the inside, and the direction away from the midline of the spine is defined as the outside, for the convenience of explanation.

[0053] like Figure 4 、 Figure 5 、 Figure 6 As shown, a curved lumbar puncture trocar needle is used for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation, which only includes an outer tube of the needle. The front section 1, the middle section 2, and the rear section 3 are integrally formed to form the outer tube of the needle, and a through-type working channel 4 is provided in the center of the outer tube of the needle; the middle section 2 and the rear section 3 are straight sections, the front section 1 is composed of an arcuate section 13 and a parallel section 12, the parallel section 12 is integrally formed at the front end of the arcuate section 13, and the rear end of the arcuate section 13 extends to connect with the middle section 2; the concave side of the arcuate section 13 is an arcuate front side 131, and the convex side of the arcuate section 13 is an arcuate back side 132; a tube bevel 11 is provided on the arcuate front side of the front end of the parallel section 12 from near to far, and the tube bevel 11 extends toward the back end of the tube to form a needle tip.

[0054] like Figure 7 、 Figure 8 As shown, the tube bevel 11 includes a tube bevel distal end 111 and a tube bevel proximal end 112; the tube bevel proximal end 112 is located on the arc-shaped front side of the tube parallel section 12, and the tube bevel distal end 111 is located at the top of the arc-shaped back side of the tube parallel section 12, and the tube bevel distal end 111 extends into a needle tip at the top of the tube parallel section 12; the tube bevel distal end 111 is designed to be a sharp triangle, and the tube bevel proximal end 112 is designed to be elliptical.

[0055] The acute angle of the distal end 111 of the tube bevel is between 15° and 45°, and preferably, the acute angle of the distal end 111 of the tube bevel is designed to be 30°.

[0056] The length of the tube slope 11 is 1.5 mm to 2.5 mm, preferably 2 mm. The inclination angle of the tube slope 11 is 10° to 45°, preferably 30°.

[0057] Figure 4 、 Figure 5 The arc section 13 of the tube is arc-shaped and is integrally connected to the rear end of the parallel section 12 of the tube. The length of the arc section 13 of the tube is 1.5cm-2.5cm; preferably, the length of the arc section 13 of the tube is designed to be 2cm, and the arc section 13 of the tube is designed to be a 30º arc section with a radius of 4cm.

[0058] like Figure 4 、 Figure 5 As shown, the middle section 2 of the tube is connected between the rear end of the arc section 13 of the front section 1 and the rear section 3 of the tube. The middle section 2 of the tube is a straight structure with a length of 8-15 cm. Preferably, the length of the middle section of the tube is designed to be 13 cm.

[0059] like Figure 9 、 Figure 10 As shown, the rear section 3 of the tube is a straight structure, and the rear section 3 of the tube is composed of a tube connecting section 31 and a needle handle 32. The needle handle 32 is integrally formed at the rear end of the tube connecting section 31, and the tube connecting section 31 is connected to the rear end of the middle section 2 of the tube.

[0060] The tube connecting section 31 is a cylindrical structure with a diameter of 1.9 mm to 2.3 mm, preferably 2 mm; and a length of 1 cm to 2 cm, preferably 1.5 cm.

[0061] The needle handle 32 is in the shape of a flat cuboid, and the coronal plane of the needle handle cuboid structure is perpendicular to the sagittal plane of the arc-shaped section 13 of the front tube section 1 .

[0062] A syringe interface 321 is provided at the end of the needle handle 32 , and the working channel 4 starts from the syringe interface 321 at the end of the needle handle 32 and ends at the tube bevel 11 of the tube front section 1 .

[0063] The surface of the needle handle 32 is designed with anti-slip patterns 322 .

[0064] Wherein, a depth marking line is designed on the surface of the outer tube of the needle.

[0065] like Figure 3 、 Figure 12 ,to Figure 21 As shown, the process of using the curved lumbar trocar for low-temperature plasma nucleus pulposus ablation to treat lumbar disc herniation is as follows: (1) The patient lies prone with a pillow of appropriate height under the abdomen. The intervertebral space about 8-13 cm away from the midline of the spine is set as the needle insertion point. The precise location of the needle insertion point should be calculated based on the lumbar CT imaging parameters of different patients combined with the fixed parameters of the trocar. Practice has shown that as long as the needle insertion point is calculated accurately, the arc-shaped puncture needle tip can bypass the articular process and accurately puncture the target site of the intervertebral disc herniation. (2) Local anesthesia (3) With the curved back of the trocar facing downward, under the guidance of the C-arm X-ray machine, the distal end 111 of the bevel of the front section 1, i.e., the needle tip, is directed at an angle of about 45° from the insertion point (this direction roughly points to the lateral edge of the facet joint of the corresponding vertebra), and penetrates the skin, subcutaneous tissue, fascia, and waist and back muscles downward in the human body until the lateral edge of the facet joint; refer to the direction of the needle handle 32 to observe and adjust the direction and angle of the needle tip in real time to ensure that the needle tip enters the front edge of the outer opening of the safety triangle of the neural foramen (such as Figure 12 Because of the displacement relationship, the parallel section 12 of the trocar is now parallel to the posterior edge of the intervertebral disc and can be determined by C-type X-ray fluoroscopy (see Figure 15 、 Figure 16 ); (4) Due to the presence of the curved tube section 13, the direction of travel of the distal end 111 of the tube bevel is changed. At this time, the parallel tube section 12 is almost parallel to the posterior edge of the intervertebral disc. If the needle is slowly inserted, the parallel tube section 12 and the distal end 111 of the tube bevel can bypass the facet joint process and move in the direction parallel to the posterior edge of the intervertebral disc in front of the facet joint process and enter the neural foramen. At this time, you will feel that the distal end 111 of the tube bevel touches a tough structure and there is a certain resistance to needle insertion. This is the annulus fibrosus outside the intervertebral disc. With a slight setback, the distal end 111 of the bevel can break through the annulus fibrosus and reach the protrusion of the intervertebral disc. Figure 13 At this time, the position of the distal end 111 of the tube bevel, that is, the needle tip, is determined by C-type X-ray fluoroscopy (see Figure 17 、 Figure 18 ); (5) The tube bevel 11 is designed on the side of the curved front 131 of the tube, ensuring that the back of the needle tip has a smaller cross-section; the distal end 111 of the tube bevel is designed to be a 30° triangle, which ensures the sharpness of the needle tip; thus, when the curved back 132 of the trocar is facing downward and the front end 111 of the tube bevel, i.e., the needle tip, is inserted into the human body in an inward and downward direction, the trocar can smoothly and fluidly pierce the relatively thick skin, fascia and muscle tissue of the waist and back, as well as the dense fiber ring wrapped around the intervertebral disc tissue; (6) Continue to insert the needle according to the position, size and shape of the protrusion, and slightly change the direction of the needle tip by pressing, lifting or swinging the needle handle 32, so as to puncture the needle tip to the optimal target position; (7) The depth marking line set on the surface of the trocar helps as a reference for the needle insertion depth; (8) Perform air and water injection tests through the syringe port 321 at the end of the needle handle to confirm that the trocar is not in the dural sac; insert the soft low-temperature plasma cutter head 5 from the syringe port 321 of the trocar into the working channel 4, and pass it through the tube bevel 11 to the target site of the intervertebral disc herniation, and confirm it by C-type X-ray fluoroscopy (see Figure 19 、 Figure 20 ); (9) Connect the blade to the main unit and perform precise ablation on the target of the intervertebral disc protrusion after safety testing to relieve the pressure of the protrusion on the adjacent nerve roots and dural sac (see Figure 14 By properly adjusting the position and angle of the puncture needle tip, it is possible to treat both central and lateral protrusions. If the protrusion is large, multi-target treatment can be performed, that is, one puncture can achieve two or even multiple target treatments, further improving the efficacy. Figure 21 As shown; (10) After the ablation is completed, the low-temperature plasma blade 5 is pulled out, and the needle tip of the cannula needle is adjusted to an appropriate position. Appropriate drugs such as collagenase, ozone, and anti-inflammatory drugs can be injected into the target site of the intervertebral disc herniation from the syringe interface 321 at the needle handle end of the cannula needle to further increase the therapeutic effect.

Claims

1. A curved lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation for the treatment of lumbar disc herniation, characterized by: It only includes an outer needle tube, and the front section, middle section and rear section of the tube are integrally formed to form the outer needle tube, and a through-type working channel is arranged in the center of the outer needle tube; the middle section and rear section of the tube are straight sections, and the front section of the tube is composed of a parallel section and an arc section of the tube, and the parallel section is integrally formed at the front end of the arc section of the tube, and the rear end of the arc section of the tube extends to connect with the middle section of the tube; the concave side of the arc section of the tube is the arc front side, and the convex side of the arc section of the tube is the arc back side; a tube bevel is arranged on the arc front side of the front end of the parallel section of the tube from near to far, and the tube bevel extends to the back side of the tube to form a needle tip.

2. The arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation treatment of lumbar disc herniation according to claim 1 is characterized by: The tube bevel includes a distal end and a proximal end; the proximal end of the tube bevel is located on the arc-shaped front side of the parallel section of the tube, the distal end of the tube bevel is located at the top of the arc-shaped back side of the parallel section of the tube, and the distal end of the tube bevel extends into a needle tip at the top of the parallel section of the tube; the distal end of the tube bevel is designed to be a sharp triangle, and the proximal end of the tube bevel is designed to be an ellipse.

3. The arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation treatment of lumbar disc herniation according to claim 2 is characterized by: The acute angle of the distal end of the tube bevel is 15°-45°, the length of the tube bevel is 1.5mm-2.5mm, and the inclination angle of the tube bevel is designed to be 10°-45°.

4. The arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation treatment of lumbar disc herniation according to claim 3 is characterized by: Preferably, the acute angle of the distal end of the tube bevel is 30°, and preferably the tube bevel length is 2 mm; preferably, the inclination angle of the tube bevel is designed to be 30°.

5. The arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation treatment of lumbar disc herniation according to claim 1 is characterized by: The parallel section of the tube is straight, and the length of the parallel section of the tube is 0.5-1.5 cm.

6. The curved lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation treatment of lumbar disc herniation according to claim 1, characterized in that: The arc-shaped tube section is arc-shaped, and the length of the arc-shaped tube section is 1.5 cm-2.5 cm.

7. The arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation treatment of lumbar disc herniation according to claim 6, characterized in that: Preferably, the arc section of the tube is 2.0 cm long and is a 30° arc section of a circle with a radius of 4 cm.

8. The arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation treatment of lumbar disc herniation according to claim 1 is characterized by: The rear section of the tube is composed of a tube connecting section and a needle handle. The needle handle is integrally formed at the end of the tube connecting section, and the tube connecting section is connected to the middle section of the tube. The needle handle is in the shape of a flat rectangular parallelepiped. A syringe interface is provided at the end of the needle handle. The working channel starts from the syringe interface of the rear section of the tube and ends at the tube inclined surface of the front section of the tube. The coronal plane of the rectangular parallelepiped structure of the needle handle is perpendicular to the sagittal plane of the arc section of the front section of the tube.

9. The arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation treatment of lumbar disc herniation according to claim 8, characterized in that: The tube connecting section is a cylindrical structure with a diameter of 1.9 mm to 2.3 mm and a length of 1 cm to 2 cm.

10. The arc-shaped lumbar puncture trocar for low-temperature plasma nucleus pulposus ablation treatment of lumbar disc herniation according to claim 8, characterized in that: The surface of the needle handle is designed with anti-slip patterns.

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