Fixable half-tube nerve protection sheath under minimally invasive single-side double-channel spine endoscope

Abstract

The invention discloses a fixable half-tube nerve protection sheath under a minimally invasive spine single-side dual-channel endoscope, and provides a solution aiming at the problems that a traditional drag hook is easy to slip in a minimally invasive spine surgery and possibly causes mechanical injury to nerve roots or dural sacs. The device comprises a protective sheath part, a nervous tissue stripping drag hook part and a protective sheath fixing part. The protective sheath part guides the main sheath head and the side sheath head to the periphery of a spine to be operated through the hollow sheath body, and the main sheath head and the side sheath head form a specific included angle and are internally communicated. And the protective sheath fixing piece fixes the protective sheath on the spine skeleton by using a bone nail. The nervous tissue stripping drag hook piece controls the memory metal wire claw to stretch out and draw back by pulling the push wire, and grabbing and pulling of nervous tissue are achieved. The instrument can safely pull and protect nervous tissue in an operation, space is vacated for follow-up operation, damage to the nervous tissue is effectively avoided, and the operation safety and success rate are improved.

Description

TECHNICAL FIELD

[0001] The present application relates to the field of minimally invasive spine surgery nerve protection devices, and particularly relates to a unilateral double-channel endoscopic semi-pipe fixable nerve protection sheath. BACKGROUND

[0002] In the field of spine surgery, with the continuous progress of medical technology, minimally invasive surgery has gradually become the mainstream trend due to its small trauma, rapid recovery and other advantages, and techniques such as unilateral double-channel endoscopy (UBE) and single-port double-channel spine endoscopy (AUSS) are increasingly widely used. However, in the actual process of minimally invasive spine surgery, there is a difficult and critical problem, i.e., how to safely and effectively protect the nerve tissue during traction.

[0003] Traditional nerve tissue traction tools used in spine surgery are mostly simple retractor structures. Such retractors may be able to play a certain role in relatively open surgical fields and operating spaces, but their disadvantages are highlighted in the narrow operating space required for minimally invasive spine surgery. Due to space limitations, traditional retractors are difficult to stabilize and fix, and are extremely easy to slip during surgical operations. Once slipped, the sharp instrument head used in the operation, or the high-speed rotating burr, planer, etc., is extremely likely to directly contact the nerve root or dural sac, thereby causing irreversible mechanical damage, seriously affecting the postoperative recovery and nerve function of the patient, and even possibly causing serious sequelae to the patient, greatly increasing the risk of surgery.

[0004] In addition, due to factors such as material and design, the traditional retractor has a large stimulation to the nerve tissue when in contact with the nerve tissue, which may trigger a stress response of the nerve tissue, interfere with the normal progress of the operation, and is also not conducive to the postoperative recovery of the patient's nerve function. Therefore, developing an instrument that can safely and reliably protect the nerve tissue during minimally invasive spine surgery has become an important problem to be solved in the field of spine surgery. SUMMARY

[0005] In view of the defects in the above background art, a technical solution of a unilateral double-channel endoscopic semi-pipe fixable nerve protection sheath for minimally invasive spine surgery is provided.

[0006] The protection sheath includes a protection sheath member, a protection sheath fixing member arranged in the inner cavity main port of the protection sheath member, and a nerve tissue stripping retractor member arranged in the inner cavity side edge port of the protection sheath member. The protection sheath member includes a hollow sheath body, a main sheath head fixedly connected to the front end port position of the hollow sheath body, and a side sheath head fixedly connected to the front end side of the hollow sheath body. The nerve tissue stripping retractor piece comprises an outer sleeve fixedly embedded in the inner port of the side sheath head, an inner sleeve nested in the inner cavity of the outer sleeve, and a pulling and pushing wire penetrating through the outer sleeve, the inner sleeve, the hollow sheath body, and the side sheath head; wherein a plurality of memory metal wire claws for grabbing and pulling the nerve tissue are fixedly connected in a ring array on the front side end of the pulling and pushing wire, and a tapered cavity with a narrow rear end is arranged in the inner sleeve. The protection sheath fixing piece comprises a supporting ring fixedly embedded in the inner port of the main sheath head, and a bone nail rotatably arranged in the inner port of the supporting ring, and a hexagonal nut head is fixedly connected to the rear end of the bone nail.

[0007] In the above technical solution, preferably: the hollow sheath body is inserted into the human body through a minimally invasive incision of the spine, and the main sheath head and the side sheath head are located around the spine to be operated.

[0008] In the above technical solution, preferably: the inner space of the hollow sheath body, the main sheath head, and the side sheath head are mutually penetrated.

[0009] In the above technical solution, preferably: the main sheath head and the side sheath head have an included angle of 4-10°, and the front end port of the side sheath head is located around the nerve tissue to be pulled.

[0010] In the above technical solution, preferably: the segment of the pulling and pushing wire located at the rear side of the hollow sheath body has a knurled segment for the surgeon to grab and push forward or pull backward.

[0011] In the above technical solution, preferably: a plurality of support blocks are fixedly arranged in a ring array on the outer ring surface of the outer sleeve, and the outer side end of each support block is fixedly connected to the inner cavity side wall of the side sheath head.

[0012] In the above technical solution, preferably: a layer of biocompatible silica gel is fixedly covered on the outer surface of each memory metal wire claw, and the memory metal wire claws are gathered together in a hemispherical shape.

[0013] In the above technical solution, preferably: the diameter of the front port of the tapered cavity is larger than the diameter of the rear port, for pulling the pulling and pushing wire backward to drive the memory metal wire claws to be clamped into the inner port of the tapered cavity, so as to realize the mutual gathering and shrinking of the memory metal wire claws to grab and pull the nerve tissue.

[0014] In the above technical solution, preferably: a plurality of support blocks are fixedly arranged in a ring array on the outer ring surface of the supporting ring, and the outer side end of each support block is fixedly connected to the inner cavity side wall of the main sheath head.

[0015] In the technical scheme, preferably, the inner side surface of the inner sliding ring is fixedly connected with the non-threaded section of the bone nail, the rear end surface of the inner hexagonal nut head is provided with a hexagonal groove for rotating the bone nail, and the front section of the bone nail is screwed into a threaded positioning hole reserved on the vertebral bone.

[0016] According to the technical scheme, the present application provides a unilateral double-channel endoscopic semi-pipe nerve protection sheath for minimally invasive spine surgery, which has the following advantages: The technical scheme is applied to minimally invasive spine surgery and has the following advantages: the main sheath head and the side sheath head can accurately reach the surrounding of the spine to be operated, the specific angle and the internal space between the two provide a stable channel for the operation, the protection sheath fixing member fixes the protection sheath on the vertebral bone through the bone nail to avoid movement of the protection sheath during the operation and ensure the continuity of the operation, the nerve tissue stripping hook member is innovatively designed, the memory metal wire claw is controlled to extend and retract by the pulling and pushing wire, the memory metal wire claw is gathered into a hemisphere and covered with silicone, the stimulation is small when the nerve tissue is close, the nerve tissue can be reliably grabbed and pulled after the tapered chamber is contracted, the traditional hook is effectively solved in the narrow space, the sharp instrument or high-speed rotating tool cannot cause irreversible mechanical damage to the nerve root and dural sac, and the safety and success rate of the operation are improved. BRIEF DESCRIPTION OF DRAWINGS

[0017] In order to more clearly illustrate the technical scheme in the embodiments of the present application or the prior art, the following will briefly introduce and describe the drawings needed in the description of the embodiments of the present application or the prior art. Obviously, the drawings in the following description are only some embodiments of the present application, and those skilled in the art can obtain other drawings according to these drawings without creative labor.

[0018] Figure 1 It is a whole structure diagram of the minimally invasive nerve protection sheath for spine; Figure 2 It is a cutaway exploded view of the protection sheath; Figure 3 It is a schematic view of the nerve tissue stripping hook member inside the protection sheath; Figure 4 It is a schematic view of the limiting ring inside the nerve tissue stripping hook member; Figure 5 It is a schematic view of the protection sheath fixing member.

[0019] ATTACHMENT Figure 1 ATTACHMENT Figure 5 The corresponding relationship of the parts in the above-mentioned technical scheme is as follows: 1, protective sheath; 1-1, hollow sheath body; 1-2, main sheath head; 1-3, side sheath head; 2, nerve tissue stripping retractor; 2-1, outer sleeve; 2-2, support block; 2-3, inner sleeve; 2-4, memory wire claw; 2-5, tapered chamber; 3, protective sheath fixing part; 3-1, support ring; 3-2, support block; 3-3, inner sliding ring; 3-4, inner hexagonal nut head; 3-5, bone nail; 4, pulling and pushing wire. DETAILED DESCRIPTION

[0020] The technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application. Obviously, the following described embodiments are only a part of the embodiments of the present application, rather than all the embodiments. Based on the embodiments in the present application, all other embodiments obtained by those skilled in the art without creative labor fall within the scope of protection of the present application. In order to make the technical solutions and implementation modes of the present application clearer and more clearly explained and described, the following introduces the specific embodiments for implementing the technical solutions of the present application.

[0021] In the process of spinal minimally invasive surgery, such as UBE (unilateral double-channel endoscopic spinal surgery) or AUSS (unilateral double-channel spinal minimally invasive surgery), the traditional retractor is easy to slip in the narrow operating space, which may cause irreversible mechanical damage to the nerve root or dural sac by the sharp instrument head or high-speed rotating burr, planer, etc., and cause serious complications such as postoperative limb numbness, pain aggravation and even dysfunction. To solve this problem, the following is a specific embodiment of a spinal minimally invasive unilateral double-channel endoscopic semi-pipe nerve protection sheath.

[0022] The protective sheath mainly includes a protective sheath 1, a nerve tissue stripping retractor 2, and a protective sheath fixing part 3. The protective sheath 1 serves as the basis of the overall structure, including a hollow sheath body 1-1, a main sheath head 1-2, and a side sheath head 1-3. The hollow sheath body 1-1 is inserted into the human body through a spinal minimally invasive incision, the main sheath head 1-2 is fixedly connected to the front end port position of the hollow sheath body 1-1, and the side sheath head 1-3 is fixedly connected to the front end side of the hollow sheath body 1-1. The main sheath head 1-2 and the side sheath head 1-3 have an included angle of 4-10°, and the internal spaces of the hollow sheath body 1-1, the main sheath head 1-2, and the side sheath head 1-3 are mutually connected. This design allows the main sheath head 1-2 and the side sheath head 1-3 to smoothly reach the surrounding of the spine to be operated on, and the front end port of the side sheath head 1-3 can be accurately positioned around the nerve tissue to be pulled, providing a suitable space and position for subsequent operations.

[0023] The nerve tissue dissection hook 2 is embedded and fixed inside the port of the side sheath 1-3. It includes an outer sheath 2-1, an inner sheath 2-3, and a traction push wire 4. The outer sheath 2-1 is embedded and fixed inside the port of the side sheath 1-3. Multiple support blocks 2-2 are fixed in a ring array on its outer surface. The outer ends of the support blocks 2-2 are fixedly connected to the inner wall of the side sheath 1-3. Through these support blocks 2-2, the outer sheath 2-1 can be firmly fixed inside the side sheath 1-3, providing stable support for the installation and operation of subsequent components. The inner sheath 2-3 is nested inside the cavity of the outer sheath 2-1. It has a conical chamber 2-5 that is wider at the front and narrower at the back. The diameter of the front port of the conical chamber 2-5 is larger than the diameter of the rear port. This specially shaped chamber plays a key role in subsequent operations.

[0024] The traction push wire 4 passes through the outer sheath 2-1, the inner sheath 2-3, the hollow sheath 1-1, and the side sheath 1-3. Multiple shape memory metal claws 2-4 are fixedly connected in a ring array at the anterior end of the outer sheath 2-1. The outer surface of each shape memory metal claw 2-4 is covered with a layer of biocompatible silicone and they are clustered together in a hemispherical shape. During the surgical procedure, the surgeon grasps the section of the traction push wire 4 located behind the hollow sheath 1-1 with knurled edges and pushes it forward, causing the shape memory metal claws 2-4 to extend beyond the front end of the outer sheath 2-1. Due to the characteristics of the shape memory metal claws 2-4, they will naturally unfold, allowing them to be brought close to the nerve tissue to be pulled. Then, the traction push wire 4 is pulled backward, causing the shape memory metal claws 2-4 to move backward and eventually engage inside the conical chamber 2-5 of the inner sheath 2-3. During insertion, the cone-shaped chamber 2-5, which is wider at the front and narrower at the back, exerts a squeezing effect on the memory metal claws 2-4, causing them to come together and contract, thereby grasping and pulling the nerve tissue. This effectively avoids the problem of traditional retractors easily slipping out and reduces the risk of damage to the nerve tissue.

[0025] The protective sheath fixing component 3 includes a support ring 3-1 fixed inside the front end of the main sheath head 1-2. Multiple support blocks 3-2 are fixed in a ring array on the outer surface of the support ring 3-1. The outer ends of the support blocks 3-2 are fixedly connected to the inner wall of the main sheath head 1-2. Through these support blocks 3-2, the support ring 3-1 can be securely fixed inside the main sheath head 1-2. An inner sliding ring 3-3 is rotatably embedded inside the support ring 3-1. The inner surface of the inner sliding ring 3-3 is fixedly connected to the non-threaded section of the bone screw 3-5. The bone screw 3-5 is rotatably disposed inside the support ring 3-1, and a hexagonal nut head 3-4 is fixedly connected to the rear end of the bone screw 3-5. A hexagonal groove for rotating the bone screw 3-5 is provided on the rear end face of the hexagonal nut head 3-4. During the surgery, once the protective sheath 1 is in the appropriate position, a special tool is used to screw the bone nail 3-5 through the hexagonal groove on the rear end face of the internal hexagonal nut head 3-4. This screws the front part of the bone nail 3-5 into the pre-drilled threaded positioning hole on the vertebral bone, thereby fixing the protective sheath and preventing it from moving during the surgery, further ensuring the safety and stability of the surgery.

[0026] Through the coordinated work of the above components, this minimally invasive unilateral dual-channel endoscopic fixation semi-tube nerve protection sheath can be firmly fixed at the surgical site during the operation, effectively grasping and pulling nerve tissue, avoiding the problem of slippage of traditional retractors, greatly reducing the risk of mechanical damage to nerve roots or dural sac, and reducing the possibility of serious complications such as limb numbness, increased pain, or even functional impairment after surgery, providing a safer and more reliable guarantee for minimally invasive spinal surgery.

[0027] Based on the above-described preferred technical solution, the workflow of this technical solution is explained as follows: When performing minimally invasive spinal surgery, such as UBE or AUSS, the hollow sheath 1-1 of the protective sheath 1 is first inserted into the human body through a pre-opened minimally invasive spinal incision. During the insertion process, guided by the hollow sheath 1-1, the main sheath head 1-2 and the side sheath head 1-3 smoothly reach the periphery of the spine to be operated on. Since there is an angle of 4-10° between the main sheath head 1-2 and the side sheath head 1-3, and the front end of the side sheath head 1-3 is precisely located around the nerve tissue to be pulled, the position is prepared for subsequent operations. At the same time, the internal spaces of the hollow sheath 1-1, the main sheath head 1-2, and the side sheath head 1-3 are interconnected, ensuring the continuity of operation of each component. Next, the protective sheath is fixed. The support ring 3-1 in the protective sheath fixing component 3 is firmly fixed to the front end of the main sheath head 1-2 through multiple support blocks 3-2 fixed in a ring array on its outer surface. The inner sliding ring 3-3 is embedded in the support ring 3-1 and its inner surface is fixedly connected to the non-threaded section of the bone nail 3-5. The surgeon uses a special tool to screw the bone nail 3-5 through the hexagonal groove on the rear end face of the internal hexagonal nut head 3-4 fixed at the rear end of the bone nail 3-5, so that the front part of the bone nail 3-5 is screwed into the threaded positioning hole reserved on the vertebral bone, thus completing the fixation of the protective sheath and preventing it from moving during subsequent surgery. Then, the nerve tissue traction operation is carried out. The outer sheath 2-1 of the nerve tissue dissection hook 2 is securely embedded and fixed inside the side sheath 1-3 port by multiple support blocks 2-2 fixed in a ring array on its outer surface. The surgeon grasps the section of the traction push wire 4 located on the back side of the hollow sheath 1-1 and with a knurled section, and pushes the traction push wire 4 forward. The traction push wire 4 drives multiple memory metal claws 2-4 fixed in a ring array at the front end of the outer sheath 2-1 to extend out of the front end of the outer sheath 2-1. Since the memory metal claws 2-4 are gathered together in a hemispherical shape and the outer surface is covered with a layer of biocompatible silicone, they can be brought close to the nerve tissue to be pulled to minimize stimulation of the nerve tissue. Then, the pull wire 4 is pulled backward, and the memory metal claw 2-4 moves backward with the pull wire 4 and gets into the conical chamber 2-5 inside the inner tube 2-3 nested in the inner cavity of the outer tube 2-1. Because the diameter of the front port of the conical chamber 2-5 is larger than the diameter of the rear port, the conical chamber 2-5 exerts a squeezing effect on the memory metal claw 2-4 during the insertion process, causing the memory metal claw 2-4 to come together and contract, thereby grasping and pulling the nerve tissue to a suitable position, making room for subsequent surgical operations, and avoiding the situation where traditional retractors are prone to slipping in a narrow operating space, resulting in irreversible mechanical damage to the nerve root or dural sac caused by the sharp instrument tip or high-speed rotating drill, planer, etc.After traction of the nerve tissue, the core surgical procedure is performed. The surgeon utilizes the operating channel formed by the main sheath 1-2 and the side sheath 1-3, employing appropriate surgical instruments such as drills and planers to treat the diseased spinal tissue. Because the nerve tissue is safely tractioned and protected, damage to the nerve tissue can be effectively avoided during the procedure. After the surgical operation is completed, the traction wire 4 is pushed forward, causing the memory metal wire claw 2-4 to withdraw from and unfold from the conical chamber 2-5, releasing the tractioned nerve tissue. Then, using a special tool, the bone nail 3-5 is reverse-screwed through the hexagonal groove of the internal hexagonal nut head 3-4, unscrewing it from the pre-drilled threaded positioning hole on the vertebral bone, releasing the protective sheath. Finally, the protective sheath 1 is slowly withdrawn from the minimally invasive surgical incision, completing the entire minimally invasive spinal surgery procedure.

[0028] This invention is not limited to the preferred embodiments described above. Anyone should understand that structural changes made under the guidance of this invention, and any technical solutions that are the same as or similar to this invention, fall within the protection scope of this invention. Finally, it should be noted that the structures, proportions, sizes, etc., illustrated in the accompanying drawings are only for illustrative purposes to aid those skilled in the art and are not intended to limit the implementation of this application. Therefore, they have no substantial technical significance. Any modifications to the structure, changes in proportions, or adjustments to size, without affecting the effects and objectives of this application, should still fall within the scope of the technical content disclosed in this application.

Claims

1. A minimally invasive unilateral dual-channel endoscopic hemitube nerve protection sheath for spinal surgery, comprising a protective sheath component (1), characterized in that: The protective sheath (1) has a protective sheath fixing member (3) in the main port of its inner cavity, and a nerve tissue dissection hook member (2) is provided in the side port of its inner cavity. The protective sheath (1) includes a hollow sheath body (1-1), a main sheath head (1-2) fixedly connected to the front end port of the hollow sheath body (1-1), and a side sheath head (1-3) fixedly connected to the front side of the hollow sheath body (1-1). The nerve tissue stripping hook (2) includes an outer sleeve (2-1) embedded and fixed inside the port of the side sheath (1-3), an inner sleeve (2-3) nested in the inner cavity of the outer sleeve (2-1), and a traction push wire (4) that passes through the outer sleeve (2-1), the inner sleeve (2-3), the hollow sheath (1-1), and the side sheath (1-3); wherein, the traction push wire (4) is located on the front end of the outer sleeve (2-1) and is fixedly connected in a ring array with multiple memory metal wire claws (2-4) for grasping and pulling nerve tissue, and the inner sleeve (2-3) has a conical chamber (2-5) that is wider at the front and narrower at the back. The protective sheath fixing component (3) includes a support ring (3-1) fixed inside the front end of the main sheath head (1-2) and a bone nail (3-5) rotatably disposed inside the support ring (3-1), and the rear end of the bone nail (3-5) is fixedly connected to an internal hexagonal nut head (3-4).

2. The spinal minimally invasive unilateral dual-channel endoscopic fixation sheath for hemitube nerve protection according to claim 1, characterized in that: The hollow sheath (1-1) is inserted into the human body through a minimally invasive spinal incision, and the main sheath head (1-2) and the side sheath heads (1-3) are located around the spine to be operated on.

3. The spinal minimally invasive unilateral dual-channel endoscopic fixation sheath for hemitube nerve protection according to claim 1, characterized in that: The internal spaces of the hollow sheath (1-1), the main sheath (1-2), and the side sheath (1-3) are interconnected.

4. The spinal minimally invasive unilateral dual-channel endoscopic fixation hemitube nerve protection sheath according to claim 1, characterized in that: The main sheath (1-2) and the side sheath (1-3) have an angle of 4-10°, and the front end of the side sheath (1-3) is located around the nerve tissue to be stretched.

5. The spinal minimally invasive unilateral dual-channel endoscopic fixation sheath for hemitube nerve protection according to claim 1, characterized in that: The section of the traction push wire (4) located behind the hollow sheath (1-1) has a knurled section for surgical personnel to grasp and push forward or pull backward.

6. The spinal minimally invasive unilateral dual-channel endoscopic fixation sheath for hemitube nerve protection according to claim 1, characterized in that: Multiple support blocks (2-2) are fixed in a ring array on the outer surface of the outer sheath (2-1), and the outer ends of the support blocks (2-2) are fixedly connected to the inner wall of the side sheath (1-3).

7. A minimally invasive unilateral dual-channel endoscopic hemitube nerve protection sheath for spinal fixation according to claim 1, characterized in that: The outer surface of each of the memory metal claws (2-4) is covered with a layer of biocompatible silicone, and the memory metal claws (2-4) are gathered together to form a hemispherical shape.

8. The spinal minimally invasive unilateral dual-channel endoscopic fixation sheath for hemitube nerve protection according to claim 1, characterized in that: The diameter of the front port of the conical chamber (2-5) is larger than that of the rear port. This is used to pull the traction push wire (4) backward, which then drives the memory metal wire claw (2-4) to be inserted into the conical chamber (2-5), thereby enabling the memory metal wire claw (2-4) to come together and contract to grasp and pull the nerve tissue.

9. A minimally invasive unilateral dual-channel endoscopic hemitube nerve protection sheath for spinal fixation according to claim 1, characterized in that: The outer ring surface of the support ring (3-1) is fixed with a plurality of support blocks (3-2) in a ring array, and the outer ends of the support blocks (3-2) are respectively fixedly connected to the inner cavity sidewall of the main sheath (1-2).

10. A minimally invasive unilateral dual-channel endoscopic hemitube nerve protection sheath for spinal fixation according to claim 1, characterized in that: The support ring (3-1) is internally fitted with an inner sliding ring (3-3), the inner surface of which is fixedly connected to the non-threaded section of the bone screw (3-5). The rear end face of the internal hexagonal nut head (3-4) is provided with a hexagonal groove for rotating the bone screw (3-5). The front section of the bone screw (3-5) is screwed into the threaded positioning hole reserved on the vertebral bone.

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