Visual spine endoscope fusion channel device

Abstract

The utility model discloses a visual spine endoscope fusion channel device, which relates to the field of medical equipment and comprises a soft tissue expansion rod, a sleeve, a first fusion channel and a second fusion channel. When the second fusion channel is used, two arc-shaped blocking faces are fixed to the two sides of the end, located in the body of the patient, of the second fusion channel respectively, and the blocking faces are used for separating and blocking the neurodural mater and the export nerve root to the outer side of the second fusion channel. The soft tissue expansion rod, the sleeve, the first fusion channel and the second fusion channel which are designed to be of an oval structure are different from an existing coaxial endoscope system, in the operation process, the area of an incision formed in the body of a patient is smaller, and the operation space is larger; under the direct view of an endoscope camera system, conventional operation tools such as vertebral plate forceps are used for biting and removing bone tissues such as vertebral plates and zygopophysis for windowing, so that the operation time is greatly shortened, the situation that channels with different sizes are replaced for multiple times is avoided, and multiple injuries to soft tissues of a patient caused by repeated replacement of the channels are avoided. The replacement frequency is reduced, and the surgical operation time is shortened.

Description

Technical Field

[0001] The utility model relates to the field of medical equipment, in particular to a visual spinal endoscope fusion channel device. Background Art

[0002] Degenerative spinal diseases are common and frequently occurring diseases among the middle-aged and elderly population, especially degenerative diseases of the cervical and lumbar spine. Lumbar degenerative diseases include lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis, lumbar instability, etc. In recent years, the incidence rate has been increasing year by year, and is showing a trend of becoming younger. Spinal fusion surgery is safe, effective, and reliable for the treatment of lumbar degenerative diseases, and has become a common method for treating such diseases. Intervertebral fusion cage placement is an emerging method of vertebral fusion, which aims to relieve nerve compression, restore intervertebral foramen height and normal physiological curvature of the spine. After surgery, it can provide early anterior column stability, create good biomechanical conditions for intervertebral osteogenesis, and significantly improve the intervertebral fusion rate. The key core of spinal fusion surgery is the placement of an intervertebral fusion cage. The placement of the fusion cage is divided into conventional open surgery and minimally invasive endoscopic surgery.

[0003] Minimally invasive spinal surgery is an inevitable trend now and in the future. After early development, endoscopic spinal interbody fusion has become a trend. Its advantages, such as minimal trauma, minimal bleeding, short incisions, and rapid postoperative recovery, are rapidly replacing conventional open spinal fusion. However, existing endoscopic spinal systems have shortcomings during surgery: frequent changes in channel sizes, initial decompression performed in a small channel, small channels and instruments, and lengthy procedures. Utility Model Content

[0004] The purpose of the present invention is to design a visual spinal endoscopic fusion channel device in order to solve the above problems.

[0005] The utility model achieves the above-mentioned purpose through the following technical solutions:

[0006] Visual spinal endoscopic fusion channel device, including:

[0007] Soft tissue expansion rod; the first end of the soft tissue expansion rod is a blunt tip, and the soft tissue expansion rod is a hollow structure;

[0008] At least two sleeves; the sizes of the sleeves are different, the soft tissue expansion rod and the sleeve are used for early soft tissue stripping of the bone surface, and the size of the soft tissue expansion rod is smaller than the size of the sleeve;

[0009] First fusion channel;

[0010] The second fusion channel; when the second fusion channel is in use, two arc-shaped blocking surfaces are fixed on both sides of one end located inside the patient's body. The blocking surfaces are used to separate the dura mater and the exit nerve roots and block them on the outside of the second fusion channel. The cross-sections of the soft tissue expansion rod, sleeve, first fusion channel and second fusion channel are all elliptical structures.

[0011] The beneficial effects of the present invention are as follows: the elliptical structure of the soft tissue expansion rod, sleeve, first fusion channel and second fusion channel is different from the currently used coaxial endoscope system. During surgery, the incision area on the patient is smaller, but the operating space is larger. Under the direct vision of the endoscopic camera system, conventional surgical tools such as vertebral lamina forceps are used to bite off the vertebral lamina, articular process and other bone tissue windows, greatly shortening the operation time and avoiding the need to repeatedly change channels of different sizes, thereby avoiding repeated damage to the patient's soft tissue. Reducing the number of changes further shortens the operation time. BRIEF DESCRIPTION OF THE DRAWINGS

[0012] Figure 1 This is a schematic diagram of a soft tissue expansion rod in the visual spinal endoscopic fusion channel device of the present invention;

[0013] Figure 2 This is a schematic diagram of the sleeve in the visual spinal endoscopic fusion channel device of the present invention;

[0014] Figure 3 This is a schematic diagram of the first fusion channel in the visual spinal endoscopic fusion channel device of the present invention;

[0015] Figure 4 This is a schematic diagram of the second fusion channel in the visual spinal endoscopic fusion channel device of the present invention;

[0016] Figure 5 This is a schematic diagram of the blocking surface in the visual spinal endoscopic fusion channel device of the present invention;

[0017] Figure 6 This is a schematic diagram of the tail cap in the visual spinal endoscopic fusion channel device of the present invention;

[0018] Figure 7 is a cross-sectional schematic diagram of an endoscope placed in the first fusion channel or the second fusion channel;

[0019] The corresponding figures are as follows:

[0020] 1-soft tissue expansion rod, 2-blunt tip, 3-sleeve, 4-first fusion channel, 5-second fusion channel, 6-blocking surface, 7-tail cap, 8-handle, 9-round hole, 10-endoscope. DETAILED DESCRIPTION

[0021] To make the objectives, technical solutions, and advantages of the embodiments of the present invention more apparent, the technical solutions in the embodiments of the present invention will be described clearly and completely below in conjunction with the accompanying drawings of the embodiments of the present invention. It should be understood that the described embodiments are only a portion of the embodiments of the present invention, not all of them. Generally, the components of the embodiments of the present invention described and illustrated in the drawings herein may be arranged and designed in a variety of different configurations.

[0022] Therefore, the following detailed description of the embodiments of the present invention provided in the accompanying drawings is not intended to limit the scope of the claimed invention, but rather merely represents selected embodiments of the present invention. All other embodiments derived by persons of ordinary skill in the art based on the embodiments of the present invention without creative effort are also within the scope of protection of the present invention.

[0023] It should be noted that similar reference numerals and letters denote similar items in the following drawings, and therefore, once an item is defined in one drawing, it does not need to be further defined or explained in subsequent drawings.

[0024] In the description of the present utility model, it should be understood that the terms "upper", "lower", "inside", "outside", "left", "right", etc. indicate directions or positional relationships based on the directions or positional relationships shown in the accompanying drawings, or are directions or positional relationships in which the utility model product is usually placed when in use, or are directions or positional relationships commonly understood by those skilled in the art. These directions or positional relationships are only for the convenience of describing the present utility model and simplifying the description, and do not indicate or imply that the device or component referred to must have a specific direction, be constructed and operated in a specific direction, and therefore should not be understood as a limitation on the present utility model.

[0025] Furthermore, the terms “first”, “second”, etc. are merely used for distinguishing descriptions and should not be understood as indicating or implying relative importance.

[0026] It should also be noted that, in the description of this utility model, unless otherwise expressly specified or limited, terms such as "disposed" and "connected" should be understood in a broad sense. For example, "connected" can mean a fixed connection, a detachable connection, or an integral connection; it can be a mechanical connection or an electrical connection; it can be a direct connection or an indirect connection through an intermediate medium, or it can be the internal communication between two components. For those skilled in the art, the specific meanings of the above terms in this utility model can be understood according to specific circumstances.

[0027] The specific implementation of the present invention is described in detail below with reference to the accompanying drawings.

[0028] like Figures 1-6 As shown, the visual spinal endoscopic fusion channel device includes:

[0029] Soft tissue expansion rod 1; the first end of the soft tissue expansion rod 1 is a blunt tip 2, and the soft tissue expansion rod 1 is a hollow structure;

[0030] At least two sleeves 3; the sizes of the sleeves 3 are different. The soft tissue expansion rod 1 and the sleeve 3 are used for early soft tissue stripping of the bone surface. The size of the soft tissue expansion rod 1 is smaller than that of the sleeve 3;

[0031] First fusion channel 4;

[0032] The second fusion channel 5; when the second fusion channel 5 is in use, two arc-shaped blocking surfaces 6 are fixed on both sides of one end located inside the patient's body. The blocking surfaces 6 are used to separate the dura mater and the exit nerve roots and block them on the outside of the second fusion channel 5. The cross-sections of the soft tissue expansion rod 1, the sleeve 3, the first fusion channel 4 and the second fusion channel 5 are all elliptical structures.

[0033] The two arc-shaped blocking surfaces 6 have different lengths.

[0034] The visual spinal endoscope 10 fusion channel device also includes a tail cap 7, the cross-section of the tail cap 7 is an elliptical structure, a circular hole 9 is provided in the center of the tail cap 7, the outer wall size of the first end of the tail cap 7 is not larger than the inner wall size of the second fusion channel 5 and the first fusion channel 4, and the outer wall size of the second end of the tail cap 7 is not smaller than the inner wall size of the second fusion channel 5 and the first fusion channel 4.

[0035] The first fusion channel 4 and the second fusion channel 5 are both provided with handles 8 on both sides of one end located outside the patient's body when in use. The two handles 8 provided on the same fusion channel have different lengths.

[0036] The first fusion channel 4 is a flat straight structure.

[0037] The surgical procedure of the utility model visual spinal endoscopic fusion channel device is as follows:

[0038] During the operation, the patient is placed in a prone position, and a skin incision of about 2.3 cm long is made 1.5 cm (posterior approach) or 5 cm (lateral posterior approach) beside the spinous process. The soft tissue expansion rod 1 and all sleeves 3 are implanted into the patient's incision in ascending order. The soft tissue expansion rod 1 can be used for preliminary soft tissue stripping on the bone surface, and then inserted into the first fusion channel 4. The soft tissue expansion rod 1 and all sleeves 3 are taken out; then the tail cap 7 is installed on the first fusion channel 4, and the outer wall of the first end of the tail cap 7 is located inside the inner wall of the first fusion channel 4. The endoscope 10 is inserted through the circular hole 9 of the tail cap 7; the vertebral plate and articular process joint are exposed by dissection under the endoscope 10; after the dissection is completed, the tail cap 7 is removed, and the endoscope 10 is placed on the side of the first fusion channel 4 close to the long handle 8, as shown in FIG. Figure 7 As shown; under direct vision of the endoscope 10 camera system

[0039] Use tools such as lamina forceps to gnaw off the lamina, articular processes, and other bone tissue to create a window (an endoscopic 10-centimeter trephine can also be used to create the window); after the window is created, use tools such as nerve probes and nerve retractors to dissect and retract the nerve roots to expose the intervertebral disc;

[0040] A soft tissue expansion rod 1 and all sleeves 3 are implanted in the first fusion channel 4, and then the first fusion channel 4 is replaced with the second fusion channel 5. At this time, the two arc-shaped blocking surfaces 6 of the second fusion channel 5 separate the nerve dura mater and the exit nerve root and block them at the outer wall of the second fusion channel 5 respectively; the expansion rod and all sleeves 3 are taken out, and the endoscope 10 is inserted; the endoscope 10 camera system (or conventional surgery) is used to process the intervertebral space to a satisfactory state with tools such as reamer, curette, and end plate processor; after the trial mold is selected, a suitable fusion device is selected, and after the bone tissue is implanted in the intervertebral space, the height of the fusion device is placed along the long axis of the second fusion channel 5 into the processed intervertebral space. The entire insertion process is monitored by the endoscope 10 camera system, so the insertion depth of the fusion device is completely controllable under direct vision. After re-verification under direct vision that there is no abnormality, the endoscope 10 and the second fusion channel 5 are taken out, and the operation can be completed.

[0041] The surgical procedure of the current coaxial endoscope 10 system is as follows:

[0042] The currently used coaxial endoscope 10 system operates with the patient in the prone position. A skin incision approximately 1.1 cm long is made lateral to the spinous process, 1.5 cm (posterior approach) or 5 cm (lateral posterior approach). Soft tissue expanders (levels 1-4) are progressively inserted, followed by a U-shaped cannula (a circular tube with an inner diameter of 1 cm). Finally, a 7.3 mm outer diameter hollow endoscope 10 (equipped with a 4.3 mm inner diameter operating channel) and an 8.5 mm inner diameter trephine are inserted for the procedure. Due to the 4.3 mm diameter limitation, the operating instruments are all approximately 4 mm in diameter, making them small, inefficient, and time-consuming.

[0043] After completing the above-mentioned lamina fenestration operation, operations within the spinal canal are still performed within the limitation of 1 cm in diameter of the U-shaped cannula, including decompression of the spinal canal, removal of the intervertebral disc, and treatment of the intervertebral space. However, there are still disadvantages such as small tools, low efficiency, and long time. After completing the above-mentioned operations, remove the endoscope 10 and the U-shaped cannula, extend the incision to about 2.2 cm in length, insert multiple soft tissue expansion rods in sequence, and finally blindly insert a tube with an outer diameter of about 2 cm close to the expansion rod. Then insert the endoscope 10 into the tube, confirm that the nerves and other parts are pulled apart, remove the endoscope 10, and implant bone into the intervertebral space and hammer in a blind test state. Perform C-arm X-ray fluoroscopy to confirm the size and depth of the test mold, remove the test mold, and then perform a blind test hammer to implant the intervertebral fusion device. Perform another C-arm X-ray fluoroscopy to confirm whether the depth and position of the fusion device are appropriate. If not satisfied, perform another blind test hammer adjustment. Perform another C-arm X-ray fluoroscopy to confirm. Finally, endoscope 10 is inserted to observe whether there are any fallen or loose bone graft fragments. The bone fragments are removed with forceps, and the nerves, dura mater, and other important tissues are examined for compression. The depth of the intervertebral fusion cage is checked. The operation is complete.

[0044] As can be seen from the above, the advantages of this structure are:

[0045] This utility model utilizes conventional surgical tools, such as lamina forceps, to gnaw and create fenestrations of bone tissue, such as the lamina and articular processes, under direct visualization by an endoscope camera system. Conventional surgical tools are bulky, requiring more tissue to be removed each time, significantly shortening the surgical time. This eliminates the need for multiple changes of channels, which can damage the patient's soft tissue. This reduces the number of changes and further shortens the surgical procedure.

[0046] The present invention utilizes an endoscope 10 throughout the entire fusion device insertion process. Protected by the tongue-shaped blocking surface of the second fusion channel 5, vital tissues such as nerve roots and the dura mater are completely blocked from view outside the second fusion channel 5. Furthermore, the long axis of the second fusion channel 5 allows direct visualization of the real-time position of these vital tissues. During device insertion, the positions of vital nerves and the dura mater are constantly monitored, completely eliminating the risk of nerve and dura mater damage. This prevents the serious consequences of paralysis in patients after nerve damage, ensuring surgical safety.

[0047] Under full direct visualization through the endoscope 10, the present invention allows for flexible adjustment of the fusion device insertion depth to achieve the desired insertion depth. No intraoperative X-ray fluoroscopy is required. This ensures precise placement of the fusion device while minimizing X-ray exposure for both the surgeon and patient, reducing X-ray harm to both. This also reduces X-ray exposure time for the surgeon, shortens surgical time, and increases safety.

[0048] The present invention avoids the drawbacks of existing endoscope systems, such as small operating channels, small tools, and inflexibility, in the process of treating vertebral lamina, articular processes, and intervertebral spaces. Suitable conventional surgical tools can be used, greatly improving surgical efficiency, shortening operative time, and significantly reducing anesthesia and surgical risks, thus benefiting the operator's occupational safety and the patient's health.

[0049] The technical solution of the present invention is not limited to the above-mentioned specific embodiments. Any technical deformation made according to the technical solution of the present invention falls within the protection scope of the present invention.

Claims

1. Visual spinal endoscopic fusion channel device, characterized in that: include: soft tissue expansion rods; The first end of the soft tissue expansion rod is a blunt tip, and the soft tissue expansion rod is a hollow structure; At least two sleeves; the sizes of the sleeves are different, the soft tissue expansion rod and the sleeve are used for early soft tissue stripping of the bone surface, and the size of the soft tissue expansion rod is smaller than the size of the sleeve; First fusion channel; The second fusion channel; when the second fusion channel is in use, two arc-shaped blocking surfaces are fixed on both sides of one end located inside the patient's body. The blocking surfaces are used to separate the dura mater and the exit nerve roots and block them on the outside of the second fusion channel. The cross-sections of the soft tissue expansion rod, sleeve, first fusion channel and second fusion channel are all elliptical structures.

2. The visual spinal endoscope fusion channel device according to claim 1, characterized in that: The two arc-shaped blocking surfaces have different lengths.

3. The visual spinal endoscope fusion channel device according to claim 1, characterized in that: The visual spinal endoscope fusion channel device also includes a tail cap, the cross-section of the tail cap is an elliptical structure, a circular hole is provided in the center of the tail cap, the outer wall size of the first end of the tail cap is not larger than the inner wall size of the second fusion channel and the first fusion channel, and the outer wall size of the second end of the tail cap is not smaller than the inner wall size of the second fusion channel and the first fusion channel.

4. The visual spinal endoscope fusion channel device according to claim 1, characterized in that: The first fusion channel and the second fusion channel are both provided with handles on both sides of one end located outside the patient's body when in use, and the two handles provided on the same fusion channel have different lengths.

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