Auxiliary positioning device for minimally invasive spine surgery

Abstract

The utility model relates to an auxiliary positioning device for a minimally invasive spine surgery, which is arranged on one side of an intraoperative scenograph and comprises a vertical support, a universal adjusting device is arranged at the top of the vertical support and connected with the auxiliary positioning device, and the universal adjusting device is connected with the auxiliary positioning device. The auxiliary positioning device comprises a guide plate, a plurality of guide holes are formed in the surface of the guide plate in an array mode, the axes of the guide holes are parallel, a first detachable positioning needle and a second detachable positioning needle are arranged in the guide holes in the two ends of the guide plate respectively, and the inner diameter of the guide holes is matched with the outer diameter of the puncture sleeve. Limiting bosses are arranged at one end of the first positioning needle, one end of the second positioning needle and one end of the puncture sleeve. According to the spine minimally invasive surgery positioning device, the positioning accuracy of a spine minimally invasive surgery can be remarkably improved, positioning of a coronal plane and a horizontal plane is achieved, and positioning errors caused by the fact that a perspective view is conical in the surgery can be eliminated by adopting the mode that positioning needles on the two sides of a body assist in positioning.

Description

Technical Field

[0001] The utility model belongs to the technical field of surgical auxiliary instruments, in particular to an auxiliary positioning device for minimally invasive spine surgery. Background Art

[0002] Minimally invasive surgery is the trend of future development. Minimally invasive spinal surgery has also achieved rapid development in recent years. Currently, many spinal diseases can be treated with minimally invasive methods, such as percutaneous pedicle screw fixation, vertebral tumor puncture biopsy, vertebroplasty (PVP), etc. The key to the success of minimally invasive spinal surgery is the accuracy of intraoperative guide needle positioning. However, even experienced clinicians may encounter problems such as inaccurate positioning of the guide needle after insertion and the need for repeated fluoroscopic adjustment of the guide needle.

[0003] Doctors and medical engineers have designed and manufactured various tools to improve the accuracy and efficiency of minimally invasive spinal surgery. The application of navigation and robots has greatly improved the accuracy of minimally invasive spinal surgery positioning. However, at present, navigation and robotic systems require more fluoroscopy during surgery to complete the identification and matching of the surgical area. In addition, since the fluoroscopy area of ​​the fluoroscopy instrument during surgery is not a parallel cylinder, but a cone, it is required that the doctor assisting the fluoroscopy is high, otherwise it is easy to cause identification and matching errors, and once the patient's position moves slightly, it will also cause positioning errors. In addition, the high price and complex operation greatly limit the clinical application. At present, the most commonly used clinical application is the locator placed on the surface of the back skin, such as a metal grid, but this positioning method ignores the soft tissue distance between the skin and the bony structure, and there will be large errors in the incision design and the positioning needle cohesion angle planning. In addition, since the human spine is "S" shaped when viewed from the side, the locator on the back cannot help the doctor confirm the angle of the puncture needle on the coronal plane. Therefore, the locator can only be inserted into the patient's body by experience and then adjusted by fluoroscopy. The positioning needle is inevitably in a poor position, and the surgical incision needs to be enlarged and the positioning needle needs to be adjusted repeatedly under fluoroscopy. Therefore, such a positioning method will significantly increase the radiation dose exposed to doctors and patients, leading to larger surgical incisions and damage caused by repeated insertion of positioning needles. In addition, inaccurate placement of positioning needles will lead to poor surgical results and the risk of surgical complications. Utility Model Content

[0004] The technical problem to be solved by the utility model is to provide an auxiliary positioning device for minimally invasive spinal surgery to accurately locate the surgical incision position and the angle direction of the guide needle.

[0005] The technical solution adopted by the utility model to solve its technical problems is: to provide an auxiliary positioning device for minimally invasive spinal surgery, which is arranged on one side of the fluoroscopy instrument during the operation, and includes a vertical support. A universal adjustment device is provided on the top of the vertical support. The universal adjustment device is connected to the auxiliary positioning device. The auxiliary positioning device includes a guide plate with a plurality of guide holes arranged in an array and with axes parallel to each other on the surface. A detachable first positioning needle and a second positioning needle are respectively provided in the guide holes at both ends of the guide plate. The inner diameter of the guide hole matches the outer diameter of the puncture sleeve. The first positioning needle, the second positioning needle and one end of the puncture sleeve are provided with a limiting boss.

[0006] Preferably, the first positioning needle, the second positioning needle and the puncture sleeve are of equal length, the second positioning needle is arranged on a side of the guide plate away from the universal adjustment device, and a tail cap is provided at the end of the second positioning needle.

[0007] Preferably, the guide plate surface is provided with 9 rows and 38 columns, with a total of 342 guide holes.

[0008] Preferably, a fixing device is provided on the universal adjustment device.

[0009] Preferably, the universal adjustment device comprises a height adjustment device, a horizontal rotation device is provided on the top of the height adjustment device, an angle adjustment device is provided at one end of the horizontal rotation device, and a terminal end of the angle adjustment device is connected to the guide plate.

[0010] Preferably, angle scale lines are provided on the surface of the angle adjustment device, and size scale lines are provided on the guide plate.

[0011] Beneficial Effects

[0012] The utility model can significantly improve the positioning accuracy of minimally invasive spinal surgery, realizes the positioning of the coronal plane and the horizontal plane, and adopts the method of auxiliary positioning by positioning needles on both sides of the body, which can eliminate the positioning error caused by the cone-shaped fluoroscopic field of view during the operation; in addition, when using the utility model, it is convenient to consider the condition of the soft tissue into the positioning system, which can accurately guide the position of the surgical incision, avoid the repeated expansion of the surgical incision due to inaccurate fluoroscopy, and avoid the radiation impact on the patient caused by repeated fluoroscopy. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] Figure 1 The present invention is a stereoscopic diagram of an auxiliary positioning device for minimally invasive spinal surgery.

[0014] Among them, 1-vertical support; 2-universal adjustment device; 201-height adjustment device; 202-horizontal rotation device; 203-angle adjustment device; 204-fixing device; 3-auxiliary positioning device; 301-first positioning needle; 302-puncture sleeve; 303-second positioning needle; 304-tail cap; 305-guide plate. DETAILED DESCRIPTION

[0015] The present invention is further described below in conjunction with specific embodiments. It should be understood that these embodiments are only used to illustrate the present invention and are not used to limit the scope of the present invention. In addition, it should be understood that after reading the content taught by the present invention, those skilled in the art can make various changes or modifications to the present invention, and these equivalent forms also fall within the scope defined by the claims attached to this application.

[0016] like Figure 1 As shown, the utility model provides an auxiliary positioning device for minimally invasive spinal surgery, which is arranged on one side of the intraoperative fluoroscopy instrument, and includes a vertical support 1. A universal adjustment device 2 is provided on the top of the vertical support 1. The universal adjustment device 2 is connected to an auxiliary positioning device 3. The auxiliary positioning device 3 includes a guide plate 305 with a plurality of guide holes arranged in an array and with axes parallel to each other on the surface. A detachable first positioning needle 301 and a second positioning needle 303 are respectively provided in the guide holes at both ends of the guide plate 305. The inner diameter of the guide hole matches the outer diameter of the puncture sleeve 302. The first positioning needle 301, the second positioning needle 303 and one end of the puncture sleeve 302 are provided with a limiting boss.

[0017] In a specific embodiment, the first positioning needle 301, the second positioning needle 303 and the puncture sleeve 302 are of equal length, the second positioning needle 303 is arranged on the side of the guide plate 305 away from the universal adjustment device 2, and the end of the second positioning needle 303 is provided with a tail cap 304. The tail cap 304 can be detachably mounted on the end of the second positioning needle 303 by means of threads or other forms, and is used to distinguish the first positioning needle 301 from the second positioning needle 303 in perspective.

[0018] The surface of the guide plate 305 is provided with 9 rows and 38 columns, a total of 342 guide holes. The more the number of guide holes and the smaller the spacing, the easier it is to quickly find the corresponding puncture position.

[0019] The universal adjustment device 2 is provided with a fixing device 204. If the universal adjustment device 2 has no damping, a fixing device 204 such as a knob can be provided thereon so as to lock the universal adjustment device 2 as a whole after the insertion angle is determined to prevent the position from being offset.

[0020] The universal adjustment device 2 includes a height adjustment device 201, a horizontal rotation device 202 is provided on the top of the height adjustment device 201, an angle adjustment device 203 is provided at one end of the horizontal rotation device 202, and the end of the angle adjustment device 203 is connected to the guide plate 305. The height adjustment device 201 is used to adjust the height position of the guide plate 305; the horizontal rotation device 202 can rotate around the central axis of the height adjustment device, so that the guide plate 305 can be rotated above the patient during surgery or turned away after surgery to prevent affecting the patient's transfer; the angle adjustment device 203 can rotate around the central axis of the horizontal rotation device 202, so as to adjust the angle between the guide plate 305 and the horizontal plane. In another embodiment, a universal joint can be directly used, such as a universal ball joint with damping that stops as it turns.

[0021] The surface of the angle adjustment device 203 is provided with angle scale lines, and the guide plate 305 is provided with size scale lines. The angle scale lines can be used to quickly adjust the angle with the horizontal plane, and the size scale lines can be used to quickly select the guide hole to be inserted or adjust the position of the vertical support 1.

[0022] The utility model comprises the following steps when used:

[0023] S1. Preoperative planning: Draw the midline (spinal midline) and puncture route on the patient's lying spine perspective view, measure the angle between the puncture needle and the midline and the vertical distance between the puncture point (located on the patient's skin surface) and the midline;

[0024] S2, setting the auxiliary puncture device: setting the angle between the angle adjustment device 203 in the universal adjustment device 2 and the horizontal plane according to the angle, so that the guide plate 305 is tilted above the patient to be punctured, and then placing the first positioning needle 301 and the second positioning needle 303 at both ends of the guide plate 305 at positions that do not touch the patient, and installing the tail cap 304 at the bottom of the second positioning needle 303;

[0025] S3, start the intraoperative fluoroscopy: control the intraoperative fluoroscopy to be parallel to the guide plate 305 and to perform fluoroscopy toward the patient, and then slightly adjust the universal adjustment device 2 according to the perspective view of the intraoperative fluoroscopy to make the first positioning needle 301 and the second positioning needle 303 coincide with the assumed puncture route;

[0026] S4, completing the positioning: selecting the guide hole in the same row as the positioning needle on the guide plate 305 and inserting the Kirschner wire, and ensuring that the distance between the skin puncture point and the midline of the patient's spine is the distance measured before the operation;

[0027] S5. Minimally invasive surgery: insert a Kirschner wire into the patient's vertebral lamina, confirm by fluoroscopy that the position of the Kirschner wire is on the planned puncture route, then insert the Kirschner wire as a guide needle into the puncture sleeve 302, and confirm by fluoroscopy that the puncture needle safely enters the vertebral body through the pedicle to successfully obtain the tissue inside the target vertebral body.

[0028] In S2, the first positioning pin 301 and the second positioning pin 303 are inserted into the guide holes in the same row and are prevented from falling by the limiting boss.

Claims

1. An auxiliary positioning device for minimally invasive spinal surgery, arranged on one side of a fluoroscopy instrument during surgery, characterized in that: The invention comprises a vertical support (1), wherein a universal adjustment device (2) is provided on the top of the vertical support (1), wherein the universal adjustment device (2) is connected to an auxiliary positioning device (3), wherein the auxiliary positioning device (3) comprises a guide plate (305) on the surface of which a plurality of guide holes are arranged in an array and whose axes are parallel to each other, wherein a detachable first positioning needle (301) and a second positioning needle (303) are respectively provided in the guide holes at both ends of the guide plate (305), wherein the inner diameter of the guide hole matches the outer diameter of the puncture sleeve (302), and a limiting boss is provided at one end of the first positioning needle (301), the second positioning needle (303) and the puncture sleeve (302).

2. The auxiliary positioning device for minimally invasive spinal surgery according to claim 1, characterized in that: The first positioning needle (301), the second positioning needle (303) and the puncture sleeve (302) are of equal length; the second positioning needle (303) is arranged on a side of the guide plate (305) away from the universal adjustment device (2); and a tail cap (304) is arranged at the end of the second positioning needle (303).

3. The auxiliary positioning device for minimally invasive spinal surgery according to claim 1, characterized in that: The surface of the guide plate (305) is provided with 9 rows and 38 columns, with a total of 342 guide holes.

4. The auxiliary positioning device for minimally invasive spinal surgery according to claim 1, characterized in that: The universal adjustment device (2) is provided with a fixing device (204).

5. The auxiliary positioning device for minimally invasive spinal surgery according to claim 1, characterized in that: The universal adjustment device (2) comprises a height adjustment device (201), a horizontal rotation device (202) is provided on the top of the height adjustment device (201), an angle adjustment device (203) is provided at one end of the horizontal rotation device (202), and the end of the angle adjustment device (203) is connected to the guide plate (305).

6. The auxiliary positioning device for minimally invasive spinal surgery according to claim 5, characterized in that: The surface of the angle adjustment device (203) is provided with angle scale lines, and the guide plate (305) is provided with size scale lines.

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