Grinding instrument and grinding method for unilateral double-channel endoscopic surgery of the spine

Abstract

The application relates to the technical field of medical devices, and provides a grinding device and a grinding method for unilateral double-channel endoscopic surgery of a spine, wherein the grinding device comprises a shell, a grinding head and a micro ultrasonic probe; the shell is suitable for being placed into a working channel of unilateral double-channel endoscope; a cavity is formed in the inside of the shell; a first through hole and a second through hole are arranged at the end of the shell; the first through hole and the second through hole are arranged side by side; the grinding head is arranged in the cavity and passes through the first through hole, and is used for grinding the lamina of the spine; and the micro ultrasonic probe is arranged in the cavity and faces the second through hole, and is used for ultrasonic scanning and imaging of the lamina subjected to the grinding operation. The application can not only synchronously display the grinding image of the bone tissue, but also synchronously display the grinding depth and the real-time position of the grinding head, can provide accurate monitoring and real-time navigation in operation, and improves the safety of the grinding operation.

Description

Technical Field

[0001] This invention relates to the field of medical device technology, and in particular to a grinding instrument and grinding method for unilateral dual-channel endoscopic surgery of the spine. Background Technology

[0002] With the increasing aging of the population, the incidence of degenerative spinal diseases is rising year by year, and clinical treatment has gradually shifted from traditional open surgery to minimally invasive surgery. Unilateral dual-channel spinal endoscopy (UBE) has been widely used in the treatment of spinal diseases such as lumbar disc herniation and lumbar spinal stenosis due to its advantages such as small incisions (usually two 5-8mm incisions), less soft tissue damage, and faster postoperative recovery.

[0003] However, UBE surgery still faces many technical bottlenecks in clinical application. During the operation, the user cannot clearly see the real-time position of the grinding head through the endoscope of the observation channel, cannot control the grinding depth, and cannot quantify the thickness of the cortical and cancellous bone of the vertebral lamina during the operation. The remaining bone volume cannot be judged in real time, and it is difficult to distinguish the relative positions between the cortical bone, cancellous bone and dural sac / spinal cord. It is very easy to cause spinal cord or dural sac damage due to excessive grinding, which can lead to serious complications such as lower limb paralysis in severe cases. Summary of the Invention

[0004] This invention provides a grinding instrument and grinding method for unilateral dual-channel endoscopic surgery of the spine, which solves the problem that existing grinding instruments cannot accurately control the grinding depth, make it difficult to quantify the degree of bone tissue removal, and cause over-grinding.

[0005] To solve the above-mentioned technical problems, this application is implemented as follows: In a first aspect, the present invention provides a grinding instrument for unilateral dual-channel endoscopic surgery of the spine, comprising: The housing is adapted to accommodate the working channel of a single-sided dual-channel endoscope. The interior of the housing forms a cavity. The ends of the housing are provided with a first through hole and a second through hole, which are arranged side by side. A grinding head is disposed in the cavity and passes through the first through hole, and is used to perform grinding operations on the vertebral lamina of the spine; A miniature ultrasonic probe is disposed within the cavity and oriented toward the second through hole, for ultrasonic scanning and imaging of the lamina undergoing grinding.

[0006] A grinding instrument for unilateral dual-channel endoscopic surgery of the spine, provided by the present invention, further includes: an acoustic cover plate; The acoustically transparent cover plate is embedded in the second through hole; the miniature ultrasonic probe is positioned facing the acoustically transparent cover plate.

[0007] According to the present invention, a grinding instrument for unilateral dual-channel endoscopic surgery of the spine is provided, wherein the first through hole is located at the center of the end of the housing, and the second through hole is located on the side of the center, and the second through hole is a strip-shaped hole; The length of the strip hole is L and the width is W, satisfying: 8mm≤L≤12mm, 4mm≤W≤6mm; And / or, the thickness of the sound-permeable cover is h, satisfying: 0.1mm≤h≤0.3mm.

[0008] According to the present invention, a grinding instrument for unilateral dual-channel endoscopic surgery of the spine is provided, wherein the acoustic cover plate is made of medical polyurethane, TPU or ultrasonic film.

[0009] According to the present invention, a grinding instrument for unilateral dual-channel endoscopic surgery of the spine is provided, wherein the housing is cylindrical, and the outer diameter of the cross-section of the housing is D1, satisfying: 8mm≤D1≤12mm; And / or, the material of the housing is medical-grade stainless steel or titanium alloy; And / or, the inner wall of the housing is provided with an anti-adhesion coating.

[0010] According to the present invention, a grinding instrument for unilateral dual-channel endoscopic surgery of the spine is provided, wherein the grinding head is either a power grinding head or an ultrasonic grinding head; When the grinding head is a power grinding head, the grinding head is telescopically inserted through the first through hole; In the case where the grinding head is an ultrasonic grinding head, the grinding head is disposed in the cavity and is oriented toward the first through hole.

[0011] According to the present invention, a grinding instrument for unilateral dual-channel endoscopic surgery of the spine is provided, wherein when the grinding head is a power grinding head, the outer diameter of the grinding head is D2, which satisfies: 2mm≤D2≤5mm; Alternatively, if the grinding head is an ultrasonic grinding head, the rotational speed of the ultrasonic grinding head is 5000 to 30000 r / min.

[0012] According to the present invention, a grinding instrument for unilateral dual-channel endoscopic surgery of the spine is provided, wherein the ultrasonic frequency of the miniature ultrasonic probe is 10-20MHz and the scanning angle is 60°-90°.

[0013] According to the present invention, a grinding instrument for unilateral dual-channel endoscopic surgery of the spine is provided, wherein the length of the miniature ultrasound probe is less than or equal to 15 mm and the width is less than or equal to 4 mm.

[0014] Secondly, the present invention provides a grinding method based on a grinding instrument for unilateral dual-channel endoscopic surgery of the spine, comprising: Acquire ultrasound images from the miniature ultrasound probe and perform real-time imaging; Semi-automatic registration is performed based on MRI / CT images and ultrasound images acquired by the miniature ultrasound probe to plan the grinding path and safety threshold. Different bone tissues are identified based on the ultrasound images, and the remaining thickness of the bone tissue and the safe distance of the grinding head are calculated in real time. The grinding operation is performed based on the ultrasonic image, remaining thickness, and safety distance.

[0015] The grinding instrument and method for unilateral dual-channel endoscopic surgery of the spine provided by this invention integrates a grinding head and a miniature ultrasonic probe on the housing. When the grinding head performs grinding operations on bone tissue, it can simultaneously perform ultrasonic scanning and imaging of the bone tissue. It can not only display the grinding image of the bone tissue at the same time, but also display the grinding depth and the real-time position of the grinding head at the same time. It can provide precise monitoring and real-time navigation during the operation, and improve the safety of the grinding operation. Attached Figure Description

[0016] To more clearly illustrate the technical solutions in this invention or the prior art, the drawings used in the description of the embodiments or the prior art will be briefly introduced below. Obviously, the drawings described below are some embodiments of this invention. For those skilled in the art, other drawings can be obtained from these drawings without creative effort.

[0017] Figure 1 This is a front view of the grinding instrument for unilateral dual-channel endoscopic surgery of the spine provided by the present invention.

[0018] Figure 2 This is a cross-sectional view of the grinding instrument for unilateral dual-channel endoscopic surgery of the spine provided by the present invention.

[0019] Figure 3 This is a schematic diagram of the four-layer structure of the vertebra provided by the present invention.

[0020] Figure 4 This is the original ultrasound image of the vertebra provided by the present invention.

[0021] Figure 5 This is an image of the elastic modulus of a vertebra provided by the present invention.

[0022] Figure 6 This is a flowchart of a grinding method based on a grinding instrument for unilateral dual-channel endoscopic surgery of the spine, provided by the present invention.

[0023] Figure label: 1. Shell; 11. First through hole; 12. Second through hole; 2. Grinding head; 3. Miniature ultrasonic probe; 4. Acoustic cover plate; 101. Lateral cortical bone; 102. Cancellous bone; 103. Medial cortical bone; 104. Dural sac; 200. UBE channel. Detailed Implementation

[0024] To make the objectives, technical solutions, and advantages of this invention clearer, the technical solutions of this invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some, not all, of the embodiments of this invention. All other embodiments obtained by those skilled in the art based on the embodiments of this invention without creative effort are within the scope of protection of this invention.

[0025] In the description of the embodiments of the present invention, it should be noted that the terms "center," "longitudinal," "lateral," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," and "outer," etc., indicate the orientation or positional relationship based on the orientation or positional relationship shown in the accompanying drawings. They are only for the purpose of clarifying the embodiments of the present invention and simplifying the description, and do not indicate or imply that the device or element referred to must have a specific orientation, or be constructed and operated in a specific orientation. Therefore, they should not be construed as limitations on the embodiments of the present invention. In addition, the terms "first," "second," and "third" are used for descriptive purposes only and should not be construed as indicating or implying relative importance.

[0026] In the description of the embodiments of the present invention, it should be noted that, unless otherwise explicitly specified and limited, the terms "connected" and "linked" should be interpreted broadly. For example, they can refer to a fixed connection, a detachable connection, or an integral connection; they can refer to a mechanical connection or an electrical connection; they can refer to a direct connection or an indirect connection through an intermediate medium. Those skilled in the art can understand the specific meaning of the above terms in the embodiments of the present invention according to the specific circumstances.

[0027] In embodiments of the present invention, unless otherwise explicitly specified and limited, "above" or "below" the second feature can mean that the first feature is in direct contact with the second feature, or that the first feature is in indirect contact with the second feature through an intermediate medium. Furthermore, "above," "over," and "on top" of the second feature can mean that the first feature is directly above or diagonally above the second feature, or simply indicates that the first feature is at a higher horizontal level than the second feature. "Below," "below," and "under" the second feature can mean that the first feature is directly below or diagonally below the second feature, or simply indicates that the first feature is at a lower horizontal level than the second feature.

[0028] In the description of this specification, the references to terms such as "one embodiment," "some embodiments," "example," "specific example," or "some examples," etc., refer to specific features, structures, materials, or characteristics described in connection with that embodiment or example, which are included in at least one embodiment or example of the present invention. In this specification, the illustrative expressions of the above terms do not necessarily refer to the same embodiment or example. Furthermore, the specific features, structures, materials, or characteristics described may be combined in any suitable manner in one or more embodiments or examples. Moreover, without contradiction, those skilled in the art can combine and integrate the different embodiments or examples described in this specification, as well as the features of different embodiments or examples.

[0029] The following is combined Figures 1 to 6 The present invention provides a detailed description of the grinding instrument and grinding method for unilateral dual-channel endoscopic surgery of the spine through specific embodiments and application scenarios.

[0030] Firstly, such as Figure 1 and Figure 2 As shown, this embodiment provides a grinding instrument for unilateral dual-channel endoscopic surgery of the spine, including: a housing 1, a grinding head 2, and a miniature ultrasonic probe 3.

[0031] The housing 1 is adapted to be inserted into the working channel of a unilateral dual-channel endoscopic surgery. The interior of the housing 1 forms a cavity. The end of the housing 1 is provided with a first through hole 11 and a second through hole 12, which are arranged side by side. The grinding head 2 is located in the cavity and passes through the first through hole 11, and is used to grind the vertebral lamina of the spine.

[0032] The miniature ultrasonic probe 3 is located inside the cavity and is positioned toward the second through hole 12, and is used to perform ultrasonic scanning and imaging on the lamina undergoing grinding.

[0033] Understandably, unilateral biportal endoscopic surgery of the spine (UBE) involves two channels: an observation channel and a working channel. The observation channel is typically used for inserting the endoscope for imaging observation, while the working channel is typically used for inserting grinding instruments to grind bone tissue. Existing imaging equipment such as CT or MRI are used to provide image support for preoperative planning or postoperative evaluation. The endoscope in the observation channel observes the grinding instruments through the other channel. Because it is not possible to provide real-time images during the operation, the user can only rely on experience to judge the grinding position and control the grinding depth, and cannot quantify the grinding depth.

[0034] In this embodiment, the grinding head 2 and the miniature ultrasonic probe 3 are integrated into the cavity of the housing 1, and the housing 1 is placed inside the working channel. The miniature ultrasonic probe 3 adopts a miniaturized design, is small in size, and can be placed in the working channel of the UBE.

[0035] The housing 1 is placed into the working channel, with its end facing the bone tissue of the vertebral lamina. In this embodiment, a first through hole 11 and a second through hole 12 are provided at the end of the housing 1. A grinding head 2 and a miniature ultrasonic probe 3 are arranged side by side inside the housing 1, with the grinding head 2 facing the first through hole 11 and the miniature ultrasonic probe 3 facing the second through hole 12.

[0036] The grinding head 2 can perform grinding operations on the bone tissue of the vertebral lamina through the first through-hole 11. The miniature ultrasound probe 3 is located inside the housing 1 and is flush with the end of the housing 1 to avoid friction with the tissues around the vertebral lamina during the operation. Furthermore, the probe end of the miniature ultrasound probe 3 faces the second through-hole 12, and the ultrasound scanning area faces the bone tissue of the vertebral lamina. The end of the miniature ultrasound probe 3 facing away from the grinding head 2 is connected to a transmission line for transmitting ultrasound signals. The miniature ultrasound probe 3 emits ultrasound towards the vertebral lamina to scan bone tissue, such as cortical bone, cancellous bone 102, dural sac 104, or spinal cord, and receives the echoes, which are transmitted to the imaging terminal via the transmission line. The imaging terminal can analyze and process the echoes, calculate the remaining cortical bone thickness, the amount of remaining cancellous bone 102, and the safe distance from the dural sac 104 in real time, and display the relevant data on the screen in real time.

[0037] Since both the grinding head 2 and the miniature ultrasonic probe 3 are integrated in the inner cavity, the user can move or rotate the housing 1 to simultaneously adjust the position or angle of the grinding head 2 and the miniature ultrasonic probe 3 in the working channel, ensuring that the miniature ultrasonic probe 3 can perform real-time scanning as the grinding head 2 moves, so as to obtain real-time information of the grinding head 2.

[0038] During surgery, users can observe the real-time relative position of the grinding head 2 and the bone tissue on the screen, as well as the real-time grinding depth, while performing the grinding operation. This not only allows for real-time quantification of cortical bone thickness and the amount of remaining cancellous bone 102, accurately assessing the degree of bone tissue removal, but also enables precise control of the grinding depth by judging the real-time position of the grinding head 2. This ensures that the actual grinding depth and position accurately match the preoperative assessment, guaranteeing the safety and precision of the grinding operation.

[0039] The grinding instrument for unilateral dual-channel endoscopic surgery of the spine provided by the present invention integrates a grinding head 2 and a miniature ultrasonic probe 3 on the housing 1. When the grinding head 2 performs grinding operations on bone tissue, it can simultaneously perform ultrasonic scanning and imaging of bone tissue. It can not only display the grinding image of bone tissue simultaneously, but also display the grinding depth and the real-time position of the grinding head 2 simultaneously, providing precise monitoring and real-time navigation during the operation, thus improving the safety of the grinding operation.

[0040] like Figure 2 As shown, the grinding instrument for unilateral dual-channel endoscopic surgery of the spine in this embodiment also includes: an acoustic cover plate 4.

[0041] The acoustic cover plate 4 is embedded in the second through hole 12; the miniature ultrasonic probe 3 is positioned facing the acoustic cover plate 4.

[0042] Understandably, grinding will generate debris, affecting the imaging quality of the endoscope within the observation channel and interfering with the ultrasound signal of the miniature ultrasound probe 3, thus impacting ultrasound imaging quality. In this embodiment, an acoustically transparent cover plate 4 is embedded at the second through-hole 12, facing the bone tissue of the vertebral lamina. This ensures high penetration of the ultrasound signal while preventing grinding debris from entering the housing 1 through the second through-hole 12. Furthermore, the acoustically transparent cover plate 4 can also form good acoustic coupling with the irrigation fluid during UBE surgery, eliminating the need for additional ultrasound coupling agent and ensuring the normal operation of the miniature ultrasound probe 3, thus simplifying the surgical procedure.

[0043] like Figure 2 As shown, in this embodiment, the first through hole 11 is located at the center of the end of the housing 1, and the second through hole 12 is located on the side of the center. The second through hole 12 is a strip-shaped hole.

[0044] The length of the strip hole is L and the width is W, satisfying: 8mm≤L≤12mm, 4mm≤W≤6mm.

[0045] Understandably, to ensure sufficient power for the grinding head 2 and stable, non-shaking grinding, the first through hole 11 for mounting the grinding head 2 in this embodiment is located at the center of the end of the housing 1. The second through hole 12 is located beside the first through hole 11 and is used to mount the miniature ultrasonic probe 3. The fixed relative positions of the first through hole 11 and the second through hole 12 ensure the fixed relative positions of the miniature ultrasonic probe 3 and the grinding head 2, thereby enabling synchronous detection of the grinding depth and image of the grinding head 2.

[0046] Specifically, the second through hole 12 is a strip-shaped hole, which can maximize the ultrasonic scanning range of the micro ultrasonic probe 3, so that the working range of the grinding head 2 can be ultrasonically scanned.

[0047] Because the miniature ultrasonic probe 3 is small in size, the length and width of the strip hole need to meet certain requirements to satisfy the scanning range of the miniature ultrasonic probe 3.

[0048] Specifically, the length L of the slot can be 8mm, 10mm, or 12mm. The width W of the slot can be 4mm, 5mm, or 6mm.

[0049] The thickness of the sound-permeable cover plate 4 in this embodiment is h, which satisfies: 0.1mm≤h≤0.3mm.

[0050] Understandably, in order to ensure the high penetration of ultrasonic signals and the resolution of imaging by the acoustic cover plate 4, the thickness of the acoustic cover plate 4 needs to meet a certain range, which requires both sufficient structural strength and the ability to penetrate ultrasonic signals.

[0051] Specifically, the thickness h of the sound-permeable cover plate 4 can be 0.1mm, 0.2mm, or 0.3mm.

[0052] like Figure 2 As shown, the sound-permeable cover plate 4 in this embodiment is made of medical polyurethane, TPU or ultrasonic film.

[0053] Understandably, medical-grade polyurethane has extremely low acoustic attenuation, minimal interference with ultrasound images, acoustic impedance close to that of human soft tissue, high sound energy transmittance, and low imaging distortion. TPU (Thermoplastic Polyurethane) offers good acoustic properties, precisely matches acoustic impedance to soft tissue, has high elasticity, and is easy to process. Ultrasonic films offer good acoustic and mechanical properties at a lower cost.

[0054] like Figure 2 As shown, the shell 1 in this embodiment is cylindrical, and the outer diameter of the cross-section of the shell 1 is D1, which satisfies: 8mm≤D1≤12mm.

[0055] Understandably, the cylindrical shell 1 is compatible with the working channel, ensuring that it can be smoothly inserted into the channel. The shell 1 has a circular cross-section, which allows it to move back and forth within the working channel and accommodates minor angular adjustments. The outer diameter D1 of the shell 1's cross-section needs to meet certain requirements.

[0056] Specifically, the outer diameter D1 of the cross-section of the shell 1 can be 8mm, 10mm, or 12mm.

[0057] like Figure 2 As shown, the shell 1 in this embodiment is made of medical stainless steel or titanium alloy.

[0058] Understandably, medical-grade stainless steel is durable, reliable, and cost-effective. Titanium alloys have a self-generating oxide film on their surface, are extremely stable, have almost no ion precipitation, and have an elastic modulus close to that of bone, allowing for more precise handling, reducing stress shielding, and exhibiting extremely strong corrosion resistance, all contributing to safety and durability.

[0059] The inner wall of the housing 1 in this embodiment is provided with an anti-adhesion coating.

[0060] Understandably, in order to reduce the amount of grinding debris and rinsing fluid remaining on the inner wall of the housing 1, this embodiment provides an anti-adhesion coating on the inner wall of the housing 1. The anti-adhesion coating has a smooth surface, preventing grinding debris and rinsing fluid from remaining on the inner wall of the housing 1 due to friction, thus ensuring the cleanliness of the inner wall of the housing 1.

[0061] like Figure 1 As shown, the grinding head 2 in this embodiment is either a power grinding head or an ultrasonic grinding head.

[0062] When the grinding head 2 is a powered grinding head, the grinding head 2 is telescopically inserted through the first through hole 11.

[0063] In the case where the grinding head 2 is an ultrasonic grinding head, the grinding head 2 is disposed in the cavity and is positioned toward the first through hole 11.

[0064] It is understood that the grinding head 2 in this embodiment can be a power grinding head or an ultrasonic grinding head.

[0065] In the case where the grinding head 2 is a power grinding head, this embodiment also includes a drive motor, which is also housed within the housing 1. The output end of the drive motor is connected to the power grinding head for driving its rotation. The power grinding head is retractably inserted through the first through hole 11. When grinding bone tissue is required, the power grinding head extends out of the first through hole 11. If no grinding operation is needed, or if the position and angle of the housing 1 within the working channel need to be adjusted, the power grinding head retracts into the cavity. In this embodiment, the power grinding head is a high-speed drill. Specifically, the high-speed drill uses a medical-grade diamond coating or tungsten steel to ensure its hardness.

[0066] When the grinding head 2 is an ultrasonic grinding head, the grinding head 2 is located in the cavity and is positioned toward the first through hole 11, so that the ultrasonic waves emitted by the grinding head 2 can act on the bone tissue through the first through hole 11.

[0067] like Figure 2 As shown, when the grinding head 2 is a power grinding head, the outer diameter of the grinding head 2 in this embodiment is D2, which satisfies: 2mm≤D2≤5mm.

[0068] Understandably, the required outer diameter of the grinding head 2 varies depending on the specific grinding requirements. Due to the size limitations of the working channel, the outer diameter D2 of the grinding head 2 in this embodiment also needs to meet certain range requirements.

[0069] Specifically, the outer diameter D2 of the grinding head 2 can be 2mm, 3.5mm, or 5mm.

[0070] like Figure 2 As shown, when the grinding head 2 is an ultrasonic grinding head, the rotational speed of the ultrasonic grinding head in this embodiment is 5000 to 30000 r / min.

[0071] Understandably, in order to adapt to the grinding needs of different bone tissues, the rotation speed of the ultrasonic grinding head in this embodiment needs to meet a certain range to satisfy the differentiated grinding needs of cortical bone and cancellous bone 102.

[0072] Specifically, the rotational speed of the ultrasonic grinding head can be 5000 r / min, 17500 r / min, or 30000 r / min.

[0073] The ultrasonic frequency of the miniature ultrasonic probe 3 in this embodiment is 10-20 MHz, and the scanning angle is 60°-90°.

[0074] It is understood that the ultrasound frequency and scanning angle of the miniature ultrasound probe 3 in this embodiment need to meet certain ranges to ensure that the complete bone tissue layers covering the lamina, cancellous bone 102, dural sac 104 or spinal cord are covered, and that ultrasound signals are emitted outward and echoes are received.

[0075] Specifically, the ultrasonic frequency of the miniature ultrasonic probe 3 can be 10MHz, 15MHz, or 20MHz. The scanning angle can be 60°, 75°, or 90°.

[0076] In this embodiment, the length of the miniature ultrasonic probe 3 is less than or equal to 15 mm, and the width is less than or equal to 4 mm.

[0077] It is understandable that, in order to house the miniature ultrasonic probe 3 within the housing 1 and meet the size limitations of the working channel, the length and width of the miniature ultrasonic probe 3 in this embodiment are both limited to a maximum size.

[0078] Specifically, the length of the miniature ultrasonic probe 3 can be 15mm, 13mm, or 10mm. The width of the miniature ultrasonic probe 3 can be 4mm, 3mm, or 2mm.

[0079] Secondly, such as Figure 6As shown, this embodiment provides a grinding method based on a grinding instrument for unilateral dual-channel endoscopic surgery of the spine, including the following steps: Step 611: Acquire the ultrasound image obtained by the miniature ultrasound probe 3 and perform real-time imaging.

[0080] Step 612: Perform semi-automatic registration based on MRI / CT images and ultrasound images acquired by miniature ultrasound probe 3 to plan the grinding path and safety threshold.

[0081] Step 613: Identify different bone tissues based on ultrasound images, and calculate the remaining thickness of bone tissue and the safe distance of grinding head 2 in real time.

[0082] Step 614: Based on the ultrasonic image, remaining thickness, and safety distance, perform the grinding operation.

[0083] Understandably, prior to surgery, the grinding instruments used for unilateral dual-channel endoscopic surgery of the spine are placed into the UBE working channel, so that the front end of the housing 1 is close to the vertebral lamina bone surface. The miniature ultrasound probe 3 built into the housing 1 can acquire ultrasound images of the bone tissue in real time.

[0084] The MRI / CT images acquired before surgery are semi-automatically registered with the ultrasound images acquired in real time by the miniature ultrasound probe 3 during surgery to plan the grinding path of the grinding head 2. The grinding path includes the travel route of the housing 1, the travel distance, and the adjustment of the angle of the housing 1 toward the bone tissue. Then, the safety threshold of the grinding head 2 is planned. The safety threshold refers to the threshold of the remaining bone thickness after grinding the bone tissue, and the safety distance threshold from the dura mater 104, to avoid excessive cutting of the bone tissue. The remaining bone thickness threshold is usually 1-2 mm, and the safety distance threshold from the dura mater 104 is usually 2-3 mm, prompting the user to stop grinding or adjust the operating force.

[0085] Specifically, in clinical applications, such as Figure 3 As shown, the vertebra comprises four layers: lateral cortical bone 101, cancellous bone 102, medial cortical bone 103, and dural sac 104 or spinal cord. Lateral cortical bone 101 and medial cortical bone 103 are hyperechoic, while cancellous bone 102 is hypoechoic. The UBE channel 200 is positioned perpendicular to the four layers.

[0086] Based on the synchronous display of ultrasound images and the indication of remaining bone thickness and the safe distance from the dural sac 104, bone tissue grinding operations can be performed, and the grinding depth and safe threshold can be indicated simultaneously to avoid damage to the vertebrae caused by excessive grinding.

[0087] This embodiment also includes a real-time imaging and navigation software system, which can dynamically enhance the raw echo signal of the miniature ultrasound probe 3, simultaneously display the distance between the drill bit, bone, and dura mater, and support the display of a color graph of the elastic modulus. Figure 4 It is the original ultrasound image. Figure 5 This is a graph of the elastic modulus.

[0088] Specifically, the real-time imaging and navigation software system incorporates a real-time identification algorithm for cortical bone / cancellous bone 102 / dural sac 104, which utilizes the echo differences and characteristic textures of different bone tissues to achieve automatic identification and calculate the remaining bone thickness and the safe distance from the dural sac 104.

[0089] Furthermore, the real-time imaging and navigation software system is equipped with a safety threshold warning mechanism, which automatically issues an audible and visual warning signal when the grinding operation approaches the preset safety threshold.

[0090] The real-time imaging and navigation software system in this embodiment runs on a medical computer workstation and is connected to the miniature ultrasound probe 3 and the grinding head 2 via a data transmission line. It supports the simultaneous display of raw ultrasound images and elastic modulus color images. The elastic modulus color image uses red, yellow, and blue to mark cortical bone 102, cancellous bone 102, and dural sac 104, respectively, to visually present the distribution range of different tissues.

[0091] Finally, it should be noted that the above embodiments are only used to illustrate the technical solutions of the present invention, and not to limit them; although the present invention has been described in detail with reference to the foregoing embodiments, those skilled in the art should understand that modifications can still be made to the technical solutions described in the foregoing embodiments, or equivalent substitutions can be made to some of the technical features; and these modifications or substitutions do not cause the essence of the corresponding technical solutions to deviate from the spirit and scope of the technical solutions of the embodiments of the present invention.

Claims

1. A grinding instrument for unilateral dual-channel endoscopic surgery of the spine, characterized in that, include: The housing is adapted to accommodate the working channel of a single-sided dual-channel endoscope. The interior of the housing forms a cavity. The ends of the housing are provided with a first through hole and a second through hole, which are arranged side by side. A grinding head is disposed in the cavity and passes through the first through hole, and is used to perform grinding operations on the vertebral lamina of the spine; A miniature ultrasonic probe is disposed within the cavity and oriented toward the second through hole, for ultrasonic scanning and imaging of the lamina undergoing grinding.

2. The grinding instrument for unilateral dual-channel endoscopic surgery of the spine according to claim 1, characterized in that, Also includes: Sound-permeable cover plate; The acoustically transparent cover plate is embedded in the second through hole; the miniature ultrasonic probe is positioned facing the acoustically transparent cover plate.

3. The grinding instrument for unilateral dual-channel endoscopic surgery of the spine according to claim 2, characterized in that, The first through hole is located at the center of the end of the housing, and the second through hole is located on the side of the center. The second through hole is a strip-shaped hole. The length of the strip hole is L and the width is W, satisfying: 8mm≤L≤12mm, 4mm≤W≤6mm; And / or, the thickness of the sound-permeable cover is h, satisfying: 0.1mm≤h≤0.3mm.

4. The grinding instrument for unilateral dual-channel endoscopic surgery of the spine according to claim 2, characterized in that, The sound-permeable cover is made of medical-grade polyurethane, TPU, or ultrasonic film.

5. The grinding instrument for unilateral dual-channel endoscopic surgery of the spine according to claim 1, characterized in that, The shell is cylindrical, and the outer diameter of the cross-section of the shell is D1, satisfying: 8mm≤D1≤12mm; And / or, the material of the housing is medical-grade stainless steel or titanium alloy; And / or, the inner wall of the housing is provided with an anti-adhesion coating.

6. The grinding instrument for unilateral dual-channel endoscopic surgery of the spine according to claim 1, characterized in that, The grinding head can be either a power grinding head or an ultrasonic grinding head; When the grinding head is a power grinding head, the grinding head is telescopically inserted through the first through hole; In the case where the grinding head is an ultrasonic grinding head, the grinding head is disposed in the cavity and is oriented toward the first through hole.

7. The grinding instrument for unilateral dual-channel endoscopic surgery of the spine according to claim 6, characterized in that, When the grinding head is a power grinding head, the outer diameter of the grinding head is D2, which satisfies: 2mm≤D2≤5mm; Alternatively, if the grinding head is an ultrasonic grinding head, the rotational speed of the ultrasonic grinding head is 5000 to 30000 r / min.

8. The grinding instrument for unilateral dual-channel endoscopic surgery of the spine according to claim 1, characterized in that, The ultrasonic frequency of the miniature ultrasonic probe is 10-20 MHz, and the scanning angle is 60°-90°.

9. The grinding instrument for unilateral dual-channel endoscopic surgery of the spine according to claim 1, characterized in that, The length of the miniature ultrasonic probe is less than or equal to 15 mm, and the width is less than or equal to 4 mm.

10. A grinding method based on the grinding instrument for unilateral dual-channel endoscopic surgery of the spine according to any one of claims 1 to 9, characterized in that, include: Acquire ultrasound images from the miniature ultrasound probe and perform real-time imaging; Semi-automatic registration is performed based on MRI / CT images and ultrasound images acquired by the miniature ultrasound probe to plan the grinding path and safety threshold. Different bone tissues are identified based on the ultrasound images, and the remaining thickness of the bone tissue and the safe distance of the grinding head are calculated in real time. The grinding operation is performed based on the ultrasonic image, remaining thickness, and safety distance.

Images