Pedicle screw guide plate capable of being adjusted during operation

Abstract

The utility model belongs to the field of medical instruments, and relates to a pedicle screw guide plate capable of being adjusted during operation, which comprises a guide plate body crossing spinous processes, a positioning plate used for being attached to the vertebra surface is fixedly arranged at the end of the guide plate body, and a guide column parallel to the planned screw placement direction is arranged on the guide plate body. A guide groove is formed in the position, corresponding to the planned screw placement point, of the positioning plate. Through a semi-open positioning mode, positioning has certain degree of freedom and flexibility, secondary adjustment and positioning can be carried out in the operation, the accuracy of screw placement is improved, a guide plate can be conveniently taken out in the operation, meanwhile, the cost of consumables is saved, and the pedicle screw positioning device is suitable for positioning a pedicle screw in the internal fixation operation of the pedicle screw.

Description

Technical Field

[0001] The utility model belongs to the field of medical equipment and relates to a guide plate, in particular to a pedicle screw guide plate which can be adjusted during surgery. Background Art

[0002] Among surgical treatments for spinal disorders, pedicle screw technology has become the most commonly used internal fixation technique due to its excellent biomechanical properties. It is widely used to treat spinal fractures, deformity correction, tumors, infections, and other conditions. Pedicles are adjacent to vital organs, and precise screw placement not only provides effective biomechanical properties but also provides a crucial guarantee of safety.

[0003] To increase the accuracy of screw placement, currently more commonly used methods include freehand screw placement, 3D-printed guide-assisted screw placement, and computer navigation-assisted screw placement. Freehand screw placement is the most widely used, but multiple fluoroscopy procedures are required during the operation, which is time-consuming and increases the patient's exposure to X-rays. Its accuracy is closely related to the surgeon's surgical experience, and the surgical learning curve is relatively long. Computer-assisted navigation technology uses a computer system to simulate and design reasonable and accurate entry points and screw trajectories based on marker navigation positioning, guiding the surgeon to operate according to real-time image displays, thereby achieving precise screw placement. However, the system is expensive, the intraoperative installation time is long, and additional personnel are required to operate the system, which limits its development in grassroots hospitals. Regardless of the technology used, the hope is to improve the accuracy of screw placement, reduce the risk of screw placement, and ensure the effective fixation of pedicle screws.

[0004] 3D (three-dimensional) printing technology is a type of additive manufacturing. It uses computer-aided techniques to build three-dimensional shapes layer by layer based on discrete / stacking principles using different two-dimensional cross-sectional shapes. With the advancement of 3D printing technology, it has become increasingly widely used across various industries. In recent years, the development of 3D printing in the medical industry has enabled reverse modeling based on patient CT (computed tomography) and MRI (magnetic resonance imaging) imaging data, enabling the reconstruction of three-dimensional models of corresponding tissues, organs, or medical implants. This has significantly improved surgeons' medical planning and surgical execution methods, becoming a rapidly developing innovation in clinical medicine and being applied in many areas of surgery. For example, personalized 3D-printed navigation templates for pedicle screw fixation have become a hot topic in spinal surgery. 3D-printed navigation template-assisted screw placement is a technology designed to ensure precise screw placement, increase stability, and reduce surgical complications. Due to its low cost and the lack of specialized equipment and operating room instruments, it is currently attracting widespread clinical attention. The technique primarily involves preoperatively performing a thin-slice CT scan of the target spine. The CT data is then input into 3D modeling software to reconstruct the CT image of the target segment. A morphologically matching guide plate positioning surfaces are then created in the 3D processing software based on the position and course of the pedicles in various image sequences, including axial, sagittal, and coronal views. The insertion point and orientation are then determined, and the bony attachment surface of the guide plate is printed in a manner that closely matches the morphology of the lamina, facet joints, and transverse processes. A 3D model of the entire spine within the surgical area can be pre-printed to serve as a reference for intraoperative guide plate installation. After intraoperative exposure of the surgical segment, the soft tissue covering the bony structure is completely dissected to facilitate guide plate attachment. After the guide plate is securely attached to the lamina, the pedicles are punctured and the screw placement channel is prepared through pre-set guide holes. Once the positioning is correct, pedicle screws of appropriate length and diameter are inserted. This technology also enables personalized patient assessment and screw placement, effectively improving the success rate and reducing the risk of screw placement.

[0005] Chinese utility model patent publication number CN217828043U discloses a screw placement guide for spinal correction surgery. The guide has the following disadvantages:

[0006] (1) The guide cylinder is a closed structure, which makes the planned path completely dependent on the fitting effect. The Kirschner wire has only one insertion path. Once the path is found to be incorrect during the operation, flexible path adjustment and secondary adjustment are impossible;

[0007] (2) The two guide cylinders are set at an angle. When the Kirschner wire is inserted, the guide plate is positioned in the opposite direction by the Kirschner wire, making it difficult to remove;

[0008] (3) Once the Kirschner wire is positioned, it cannot be used after it is removed, which increases the cost of consumables during surgery. Utility Model Content

[0009] In order to solve the above deficiencies in the prior art, the present invention aims to provide a pedicle screw guide that can be adjusted intraoperatively, so as to achieve the purpose of secondary adjustment according to real-time conditions during surgery, easy removal of the guide plate and reduction of surgical consumables costs.

[0010] To achieve the above-mentioned purpose, the technical solution adopted by the present invention is as follows: a pedicle screw guide that can be adjusted during surgery, including a guide body that spans the spinous process, a positioning plate fixed to the end of the guide body for fitting with the vertebral surface, a guide column parallel to the planned screw placement direction is provided on the guide body, and a guide groove is provided on the positioning plate at a position corresponding to the planned screw placement point.

[0011] As a limitation of the present invention: the guide groove is arranged on the edge of the positioning plate, and the guide groove is an inwardly concave arc.

[0012] As a limitation of the present invention: the guide groove is arc-shaped, the center of the arc coincides with the planned pin placement point, the central angle of the arc of the guide groove is 180°, and the radius of the circle corresponding to the arc of the guide groove is greater than the radius of the placed positioning pin.

[0013] As a limitation of the present invention: an arc-shaped guide sleeve is fixedly provided at a position on the edge of the positioning plate corresponding to the planned nail placement point, and a guide groove is provided on the guide sleeve.

[0014] As a limitation of the present invention, the height of the guide sleeve is less than 4 mm.

[0015] As a limitation of the present invention: the guide plate body is in an inverted "U" shape, including two vertical poles along the height direction and a cross bar connecting the vertical poles, and there are two positioning plates, which are respectively fixed to the ends of the two vertical poles.

[0016] As a limitation of the present invention: reinforcing ribs are fixed at the bend where the vertical rod and the horizontal rod are connected.

[0017] As a limitation of the present invention: there are two guide columns, which are respectively fixed on the two upright poles.

[0018] Due to the adoption of the above technical solution, the present invention has the following beneficial effects compared with the prior art:

[0019] (1) The present invention confirms the nail placement point through the guide groove and the nail placement direction through the guide column. This semi-open positioning method has a certain degree of freedom and flexibility. Based on the positioning of the guide plate, it can be adjusted in combination with the experience and operating habits of the surgeon, which is more in line with the operating process and feel of traditional surgery. Once the path is found to be wrong during the operation, secondary adjustment and positioning can be performed, which shortens the time from skin incision to nail placement, reduces the number of fluoroscopy during the operation, improves the accuracy of nail placement, and reduces nail placement-related complications. At the same time, this open positioning method will not cause the guide plate to be positioned, which facilitates the removal of the guide plate during the operation.

[0020] (2) Due to the provision of a semi-open guide groove, the positioning needle can be directly inserted, eliminating the step of inserting the Kirschner wire. Since the positioning needle is reusable, the utility model also saves the cost of related consumables.

[0021] In summary, the present invention adopts a semi-open positioning method to provide a certain degree of freedom and flexibility in positioning. Secondary adjustment and positioning can be performed during the operation, which improves the accuracy of screw placement and facilitates the removal of the guide plate during the operation, while saving the cost of consumables. It is suitable for the positioning of pedicle screws during pedicle screw internal fixation surgery. BRIEF DESCRIPTION OF THE DRAWINGS

[0022] The present invention will be described in further detail below with reference to the accompanying drawings and specific embodiments.

[0023] Figure 1 This is a schematic diagram of the three-dimensional structure of Example 1 of the present utility model;

[0024] Figure 2 This is a schematic diagram of the three-dimensional structure of another angle of embodiment 1 of the present invention;

[0025] Figure 3 This is a schematic diagram of the use of Example 1 of the present utility model.

[0026] In the figure: 1-guide plate body, 11-vertical rod, 12-cross bar, 13-reinforcement rib, 2-positioning plate, 3-guide groove, 4-guide sleeve, 5-guide column, 6-spine, 7-positioning pin. DETAILED DESCRIPTION

[0027] The preferred embodiment of the present invention will be described below with reference to the accompanying drawings. It should be understood that the intraoperatively adjustable pedicle screw guide described herein is a preferred embodiment and is only used to illustrate and explain the present invention, and does not constitute a limitation of the present invention.

[0028] The directional terms or positional relationships such as "up", "down", "left" and "right" described in the present invention are based on the directional relationships in the drawings of the present invention specification and are only for the convenience of describing the present invention and simplifying the description. They do not indicate or imply that the device or element must have a specific orientation, be constructed and operated in a specific orientation, and therefore cannot be understood as a limitation on the content protected by the present invention.

[0029] This embodiment Figures 1 to 3 As shown, a pedicle screw guide that can be adjusted during surgery includes a guide body 1 that spans the spinous process, a positioning plate 2 fixed to the end of the guide body 1 for fitting with the vertebral surface, a guide column 5 parallel to the planned screw placement direction is provided on the guide body 1, and an inwardly concave guide groove 3 is provided on the positioning plate 2 at a position corresponding to the planned screw placement point.

[0030] Specifically, the guide plate body 1 is an inverted "U" shaped structure for fastening on the spinous process of the spine, including two vertical rods 11 along the height direction and a crossbar 12 for integrally connecting the vertical rods 11. The crossbar 12 is used to span the spinous process, and the vertical rods 11 extend to both sides of the spinous process respectively. The connection between the crossbar 12 and the vertical rods 11 is set at an angle, and a reinforcing rib 13 is set at the angle at the connection. Of course, the connection between the crossbar 12 and the vertical rods 11 can also be an arc-shaped transition. The ends of the vertical rods 11 are integrally provided with a positioning plate 2. There are two positioning plates 2, which are respectively fixed to the ends of the two vertical rods 11. Since the bone surface is an irregular plane, the side of the positioning plate 2 away from the vertical rods 11 is an irregular plane that matches the bone surface. Here, matching means that the surface of the positioning plate 2 away from the side of the vertical rods 11 is complementary to the bone surface, so that the positioning plate 2 can be completely fitted on the bone surface. During design, a bone surface with strong specificity can be selected as the fitting surface, and the setting position of the positioning plate 2 is adjusted accordingly. There is no restriction on the shape, size and number of the positioning plates 2 , as long as the guide plate body 1 can connect two or more positioning plates 2 into an integrated structure.

[0031] A guide groove 3 is provided on the positioning plate 2 at a position corresponding to the planned pin placement point. In this embodiment, the guide groove 3 is provided on the edge of the positioning plate 2. The guide groove 3 corresponding to the planned pin placement point means that the number of guide grooves 3 provided is equal to the planned number of pin placements, and the guide groove 3 is semicircular, that is, the central angle of the arc of the guide groove 3 is 180°, and the radius of the circle corresponding to the arc of the guide groove 3 is greater than the radius of the positioned positioning pin 7, and the center of the arc of the guide groove 3 coincides with the planned pin placement point. Furthermore, an arc-shaped guide sleeve 4 is fixed to the edge of the positioning plate 2 at a position corresponding to the planned pin placement point. The guide groove 3 is provided on the guide sleeve 4. The height of the guide sleeve 4 is less than 4 mm. While ensuring structural strength, the guide sleeve 4 is made as low as possible to avoid interference with the direction of the positioning pin 7. The guide sleeve 4 and the guide groove 3 together form a "half-pipe" structure. In this embodiment, there are two guide sleeves 4 and two guide grooves 3, and they are both provided in the same direction of human height, that is, above or below the human height. When multiple guide sleeves 4 and guide grooves 3 are provided, it is sufficient to ensure that all guide grooves 3 and guide sleeves 4 are in the same direction along the height direction of the human body. This arrangement can facilitate the later removal of the guide plate while ensuring that the guide grooves 3 have a certain positioning effect. Of course, the guide grooves 3 can also be provided independently or located at a non-edge portion of the positioning plate 2, as long as the guide grooves 3 do not uniquely restrict the nail placement path and direction.

[0032] The guide plate body 1 is provided with guide posts 5 parallel to the planned nail placement direction. In this embodiment, the guide posts 5 are integrally mounted with the guide plate body 1. The number of guide posts 5 provided equals the planned number of nail placements, and the orientation of the guide posts 5 is parallel to the placement direction of the corresponding nails. In this embodiment, two guide posts 5 are provided, each fixed to the two upright posts 11.

[0033] When using this embodiment, if Figure 3 As shown, the positioning plate 2 is fitted to the specific bone surface of the spine 6, and a positioning pin 7 of appropriate specifications is placed at the point corresponding to the center of the arc of the guide groove 3 and in a direction parallel to the guide column 5. Figure 3 The figure shows the insertion of a positioning pin 7 into one side of the guide body 1. After insertion, the surgeon can determine whether the position or direction of the positioning pin 7 needs to be adjusted based on the surgeon's experience. If necessary, a secondary adjustment is performed, and the position or direction of the positioning pin 7 is readjusted before continuing the operation. It should be noted that the intraoperatively adjustable pedicle screw guides in this embodiment are often arranged along the direction of the spine 6, and multiple guides are used in combination. A protruding identification symbol is integrally provided on the top of the crossbar 12 to distinguish and mark different sections of the guide body 1, thereby adapting different guide bodies 1 to different spinal segments.

Claims

1. A pedicle screw guide that can be adjusted during surgery, comprising a guide body that spans the spinous process, a positioning plate fixed to the end of the guide body for fitting with the vertebral surface, characterized in that: A guide column parallel to the planned nail placement direction is provided on the guide plate body, and a guide groove is provided on the positioning plate at a position corresponding to the planned nail placement point. The guide groove is arranged at the edge of the positioning plate, and the guide groove is an inwardly concave arc. The guide groove is a circular arc, and the center of the circular arc coincides with the planned nail placement point, and the radius of the circle corresponding to the arc of the guide groove is greater than the radius of the positioned positioning pin.

2. The pedicle screw guide plate adjustable during surgery according to claim 1, characterized in that: The central angle of the arc of the guide groove is 180°.

3. The pedicle screw guide plate adjustable during surgery according to claim 2, characterized in that: An arc-shaped guide sleeve is fixedly provided at a position on the edge of the positioning plate corresponding to the planned nail placement point, and a guide groove is provided on the guide sleeve.

4. The pedicle screw guide plate adjustable during surgery according to claim 3, characterized in that: The height of the guide sleeve is less than 4 mm.

5. The pedicle screw guide plate adjustable during surgery according to any one of claims 1 to 4, characterized in that: The guide plate body is in an inverted "U" shape, including two vertical poles along the height direction and a cross bar connecting the vertical poles. There are two positioning plates, which are respectively fixed to the ends of the two vertical poles.

6. The pedicle screw guide plate adjustable during surgery according to claim 5, characterized in that: The bending part where the vertical pole and the horizontal pole are connected is fixed with a reinforcing rib.

7. The pedicle screw guide plate adjustable during surgery according to claim 6, characterized in that: There are two guide columns, which are respectively fixed on the two upright poles.

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