Atlantoaxial lateral mass joint spreader device

Abstract

The utility model discloses an atlantoaxial lateral mass joint dilator device which comprises a transverse toothed plate, a transverse moving sleeve, a vertical rod, two movable arms and two distraction rods, the transverse moving sleeve is movably sleeved on the transverse toothed plate, one end of the transverse toothed plate is provided with a vertical through hole, the vertical rod is movably arranged in the vertical through hole in a penetrating mode, and the two movable arms are arranged on the two distraction rods. The two movable arms are movably connected with the lower end of the vertical rod and the lower end of the transverse moving sleeve respectively, and each movable arm is provided with an opening rod positioning hole and an observation hole. The distance between the two distraction rods in the horizontal direction and the distance between the distraction cones can be adjusted by adjusting the transverse moving sleeve along the transverse toothed plate, the two movable arms can rotate up and down and horizontally, so that the inclination angle of the distraction rods is adjusted, the distraction rods can move in the axial direction, and therefore the use length is adjusted. The atlantoaxial lateral mass joint dilator is high in flexibility, limited operation space can be used, a visual channel is reserved, and conditions are established for operation under an endoscope.

Description

TECHNICAL FIELD

[0001] The utility model relates to the field of medical apparatus and instruments, and particularly relates to a atlantoaxial lateral mass joint distractor device. BACKGROUND

[0002] The atlantoaxial vertebrae, including the atlas (the first cervical vertebra) and the axis (the second cervical vertebra), are the uppermost two vertebrae at the junction of the vertebral column and the skull. 50% of the range of left and right rotation of the head is achieved through the movement of the atlantoaxial joint, and 50% of the range of forward and backward flexion is achieved through the movement of the atlantooccipital joint. Clinically, the most common diseases in the atlantoaxial region include atlantoaxial dislocation caused by congenital developmental abnormalities and rheumatic immune diseases, and children's torticollis caused by atlantoaxial rotation fixation; at the same time, the atlantoaxial region is also the most common site of cervical spine fracture in the elderly. For patients with obvious clinical symptoms, surgery is currently the most effective and safe treatment method; even for some patients without obvious clinical symptoms, active follow-up and early intervention when necessary are also needed.

[0003] Atlantoaxial surgery is mainly divided into simple anterior approach, simple posterior approach, and anterior and posterior combined approach. For the treatment of atlantoaxial dislocation, the anterior approach has a high risk of infection, and the postoperative recovery period is greatly affected by the respiratory and swallowing functions of the patient, and the patient is in great pain; therefore, in recent years, more and more posterior direct reduction (lateral mass joint space release) is used in clinical practice to perform screw-rod or screw-plate system fixation, prevent atlantoaxial dislocation again, limit the rotation between the atlantoaxial vertebrae, and at the same time, autologous bone or allogeneic bone and other materials are filled into the lateral mass joint space of the atlantoaxial vertebrae to achieve bone graft fusion.

[0004] The ordinary posterior approach incision is incised from the midline, the suboccipital muscle group is stripped to expose the atlantoaxial lamina for surgery, and its disadvantages include destruction of the posterior nuchal ligament and muscle, and a high incidence of postoperative occipitocervical pain; intraoperative bleeding and postoperative drainage result in a large amount of blood loss. Open atlantoaxial internal fixation and fusion surgery generally uses a posterior midline approach, and the destroyed ligaments and muscles include the superficial nuchal ligament, the trapezius muscle, the semispinalis capitis muscle, the semispinalis cervicis muscle, the longissimus capitis muscle, the shortissimus capitis muscle, and the obliquus capitis muscle. Studies have shown that the destruction of the spinous process muscle attachment point of the axis is the main cause of axial pain after open atlantoaxial surgery. Literature reports that the incidence of neck pain, spasm, and dysfunction after open cervical spine surgery can reach 18% to 60%. In addition, there are reports that the longissimus capitis muscle and the shortissimus capitis muscle may exist between the dura mater, and the destruction and contraction of the occipital posterior extensor muscle tension band can cause occipitocervical pain. The suboccipital muscle group stripping operation can also cause postoperative occipital nerve numbness. Elliott et al. summarized the data of 1073 cases of open atlantoaxial fusion surgery and found that 7.7% of the patients had numbness in the C2 innervation area.

[0005] Literatures reported that the atlantoaxial approach through the muscle gap could protect the attachment points of the posterior muscles of the occipital cervical region, reduce postoperative occipital cervical pain and numbness, and protect the occipital cervical line. Since 2015, the Department of Orthopedics of the Third Hospital of Peking University has used microscopic minimally invasive surgery-posterior atlantoaxial lateral mass joint fusion (Mis-PALF) for the treatment of atlantoaxial dislocation, and the clinical results are good.

[0006] The operation technique of Mis-PALF under the microscope is essentially different from open surgery, and its advantages include:

[0007] (1) The light source is not easy to be blocked, which has obvious advantages over headlamps or surgical shadowless lamps, can reveal the structures in the narrow gap, and is beneficial to the treatment of the endplate of the lateral mass joint and the implantation of the fusion cage;

[0008] (2) The dura mater, nerves and blood vessels can be clearly distinguished, and the risk of intraoperative injury to the dura mater and blood vessels is greatly reduced;

[0009] (3) Under the magnified high-power field, the compression hemostasis and bipolar electrocoagulation after the venous plexus bleeds are more accurate;

[0010] (4) Under the naked eye, only the surgeon can see the deep surgical field;

[0011] (5) The display screen of the microscope can display the surgical process in real time, which is convenient for the cooperation of the assistants and nurses and clinical teaching.

[0012] However, compared with open incision, the operation space is limited, and if there is a lateral mass joint spacer for atlantoaxial joint, the efficiency and safety of minimally invasive atlantoaxial surgery can be greatly improved. Content of the utility model

[0013] In view of the defects of the prior art, the utility model provides a kind of lateral mass joint spacer for atlantoaxial joint device, and it is flexible, can be flexibly used in limited operation space, improve the efficiency and safety of minimally invasive atlantoaxial surgery.

[0014] To achieve the above object, the utility model is realized by the following technical scheme:

[0015] A kind of lateral mass joint spacer for atlantoaxial joint device, including transverse tooth plate, transverse movement sleeve, vertical rod, two movable arms, two expansion rods;

[0016] Transverse movement sleeve is movably sleeved on transverse tooth plate, and transverse movement sleeve can move along transverse tooth plate, and quick release mechanism is installed on transverse movement sleeve to quickly lock or quickly release transverse movement sleeve;

[0017] The transverse tooth plate is provided with a vertical through hole at one end, a vertical rod is movably arranged in the vertical through hole, and a first adjusting screw for positioning the vertical rod is arranged on the transverse tooth plate;

[0018] The lower end of the vertical rod and the lower end of the transverse moving sleeve are respectively inserted with a vertical rotating shaft, the vertical rod and the transverse moving sleeve are respectively provided with a second adjusting screw for locking the vertical rotating shaft, and the lower ends of the two vertical rotating shafts are respectively rotatably connected with the corresponding movable arm through a transverse rotating shaft;

[0019] The movable arm is provided with a splaying rod positioning hole and an observation hole, two splaying rods are respectively arranged in the two splaying rod positioning holes, and a third adjusting screw for positioning the splaying rod is arranged on the movable arm at a position corresponding to each splaying rod positioning hole;

[0020] The axial direction of the splaying rod positioning hole and the axial direction of the observation hole are the same, and are both perpendicular to the vertical rod and the transverse tooth plate.

[0021] Preferably, a positioning bead is arranged on the side wall of the observation hole, and a through pipe is arranged in the observation hole, and the positioning bead abuts against the through pipe to prevent the through pipe from falling off.

[0022] Preferably, a gear is arranged in the transverse moving sleeve, the gear is engaged with the teeth on the transverse tooth plate, one end of the gear is connected with a knob, and the transverse moving sleeve and the gear are synchronously moved along the transverse tooth plate by rotating the knob.

[0023] Preferably, one end of the gear is rotatably connected with the knob through a rotating shaft perpendicular to the axial direction of the gear, one end surface of the gear is provided with a plurality of positioning grooves for accommodating the positioning bead, and the positioning bead is arranged in the knob, and the positioning bead and the plurality of positioning grooves cooperate to make the knob have different states relative to the gear.

[0024] Preferably, one end of the knob is provided with an accommodating groove, one end of the gear is inserted into the accommodating groove and rotatably connected with the knob through a rotating shaft perpendicular to the axial direction of the gear, one end surface of the gear inserted into the accommodating groove is provided with three positioning grooves for accommodating the positioning bead, the positioning bead is arranged in the knob, and when the knob is rotated along the rotating shaft, the positioning bead cooperates with the three positioning grooves to determine three states of the knob, and the three positioning grooves correspond to upward folding, downward folding and horizontal state of the knob respectively.

[0025] Preferably, the quick release mechanism comprises a handle, a torsion spring and a positioning bead, the handle is rotatably arranged in the transverse moving sleeve and partially extends out of the transverse moving sleeve as a hand holding part, the handle is connected with the transverse moving sleeve through the torsion spring, the positioning bead is arranged on the handle, the transverse moving sleeve is provided with two arc-shaped positioning grooves and a circular positioning hole, the circular positioning hole is located between the two arc-shaped positioning grooves, and the handle has two stop portions;

[0026] When the positioning bead is located in the circular positioning hole, the two stop portions are separated from the transverse tooth plate, and the transverse moving sleeve can reciprocate along the transverse tooth plate.

[0027] When the positioning bead is located in one of the arc-shaped positioning grooves, the transverse moving sleeve can move in a single direction along the transverse tooth plate, and the two arc-shaped positioning grooves correspond to opposite two directions respectively.

[0028] The atlantoaxial lateral mass joint distractor device has the following advantages.

[0029] 1. By adjusting the transverse moving sleeve along the transverse tooth plate, the distance between the two distraction rods in the horizontal direction can be adjusted, the distance between the distracted vertebral bodies can be adjusted, the two movable arms can be rotated upward and downward and horizontally, so that the inclination angle of the distraction rod can be adjusted, the distraction rod can be moved axially to adjust the length, the atlantoaxial lateral mass joint distractor has high flexibility, can use limited operation space, and reserves a visual channel (observation hole), and establishes conditions for mirror operation.

[0030] 2. It can assist in distracting the atlantoaxial lateral mass joint.

[0031] 3. It is beneficial to atlantoaxial lateral mass joint release, bone grafting, cage placement and other operations.

[0032] 4. It can assist in distracting the channel muscle soft tissue in minimally invasive surgery.

[0033] 5. It optimizes the field of view, reduces the amount of bleeding, and increases the safety of the operation. BRIEF DESCRIPTION OF DRAWINGS

[0034] Figure 1 is a structural schematic view of the atlantoaxial lateral mass joint distractor device of the embodiment of the utility model;

[0035] Figure 2 is Figure 1 another angle view of the atlantoaxial lateral mass joint distractor device of

[0036] Figure 3 is Figure 1 a schematic view of the atlantoaxial lateral mass joint distractor device of

[0037] Figure 4 is Figure 1 another angle view of the atlantoaxial lateral mass joint distractor device of DETAILED DESCRIPTION

[0038] The utility model will be further described below in combination with the drawings and embodiments.

[0039] In the description of the utility model, it is understood that the terms "upper", "lower", "front", "rear", "left", "right", "top", "bottom", "inner", "outer" and the like indicate the orientation or positional relationship shown in the drawings, and are only for the convenience of describing the utility model and simplifying the description, and do not indicate or imply that the devices or elements referred to must have a particular orientation, be constructed and operated in a particular orientation, and therefore cannot be understood as limiting the utility model.

[0040] As shown in Figures 1 to 4 The utility model discloses a atlas lateral mass joint distractor device, including transverse tooth plate 1, transverse moving sleeve 2, vertical rod 3, two movable arms 4, two distraction rods 5, transverse moving sleeve 2 is movably sleeved on transverse tooth plate 1, gear 6 is installed in transverse moving sleeve 2, gear 6 is engaged with the tooth on transverse tooth plate 1, by rotating gear 6, transverse moving sleeve 2 can slip along transverse tooth plate 1.

[0041] One end of transverse tooth plate 1 is equipped with vertical through -hole, and vertical rod 3 is movably arranged in the vertical through -hole, and first adjusting screw 7 for positioning vertical rod 3 is installed on transverse tooth plate 1 (first adjusting screw 7 is connected by screw thread on transverse tooth plate 1, and one end of first adjusting screw 7 is abutted on vertical rod 3). The upper end of vertical rod 3 is provided with a latch, to avoid the vertical rod 3 from falling off the vertical through -hole.

[0042] Two movable arms 4 are movably connected with the lower end of vertical rod 3 and the lower end of transverse moving sleeve 2 respectively, a vertical pivot 8 is inserted on the lower end of vertical rod 3 and the lower end of transverse moving sleeve 2 respectively, a second adjusting screw 9 for locking vertical pivot 8 is arranged on vertical rod 3 and transverse moving sleeve 2 respectively (second adjusting screw 9 is connected by screw thread on vertical rod 3 or transverse moving sleeve, and one end of second adjusting screw 9 is abutted on vertical pivot 8), and the lower end of the two vertical pivots 8 is rotatably connected with the corresponding movable arm 4 through a transverse pivot 10. Each movable arm 4 can rotate around the transverse pivot 10, and the second adjusting screw 9 is loosened, and each movable arm 4 can rotate around the vertical pivot 8. In the specific structure, the vertical pivot is provided with an annular limiting groove, two pins 23 are horizontally arranged on the vertical rod and the transverse moving sleeve, the two pins 23 are clamped in the annular limiting groove of the corresponding vertical rod to avoid the vertical pivot from falling off, and the vertical pivot can also be rotated, and the second adjusting screw can lock the rotation of the vertical pivot.

[0043] The movable arm 4 is provided with a distraction rod positioning hole and an observation hole 11, the axis of the distraction rod positioning hole and the axis of the observation hole 11 are perpendicular to the vertical rod 3 and the transverse tooth plate 1. Two distraction rods 5 are respectively arranged in the two distraction rod positioning holes, and the movable arm 4 is provided with a third adjusting screw 14 for positioning the distraction rod 5 at a position corresponding to each distraction rod positioning hole (the third adjusting screw 14 is threadedly connected to the movable arm 4, and one end of the third adjusting screw 14 abuts against the distraction rod 5), and the distraction rod 5 in the distraction rod positioning hole can be locked or released by adjusting the third adjusting screw 14. The distraction rod 5 is detachable, which can reduce the storage volume of the atlantoaxial lateral mass joint distractor device. The distraction rod 5 of the embodiment can move along the axis, the length of the distraction rod 5 is set to be relatively large, one end of the distraction rod 5 is provided with a screw, and the lengthened distraction rod 5 is locked on the atlantoaxial joint through the screw, which is suitable for the deep anatomical structure of the atlantoaxial joint.

[0044] The side wall of the observation hole 11 is provided with a positioning bead 15, the observation hole 11 is a reserved visualization channel, a through pipe is arranged in the observation hole 11, the positioning bead 15 abuts against the through pipe to prevent the through pipe from falling and bruising the body, and the distance between the lens and the spine can be adjusted by inserting the lens into the through pipe, which is convenient for observation.

[0045] In order to facilitate the rotation of the gear 6, the gear 6 is connected with a knob 16 at one end, the gear 6 is driven to rotate by rotating the knob 16, and the sleeve 2 and the gear 6 move synchronously along the transverse tooth plate 1.

[0046] The lateral moving sleeve 2 is provided with a quick release mechanism for quick locking and quick releasing the lateral moving sleeve 2. The quick release mechanism comprises a handle 17, a torsion spring and a positioning bead 15. The handle 17 is pivotally mounted in the lateral moving sleeve 2 and partially extends out of the lateral moving sleeve 2 as a hand holding part. The handle 17 is connected to the lateral moving sleeve 2 by the torsion spring (the handle 17 and the lateral moving sleeve 2 are each provided with a hole 22 for fixing one end of the torsion spring). The handle 17 is provided with the positioning bead 15. The lateral moving sleeve 2 is provided with two arc-shaped positioning grooves 18 and a circular positioning hole 19. The circular positioning hole 19 is located between the two arc-shaped positioning grooves 18. The handle 17 has two stop portions 20. When the positioning bead 15 is located in the circular positioning hole 19, the two stop portions 20 are separated from the lateral tooth plate 1, and the lateral moving sleeve 2 can reciprocate along the lateral tooth plate 1. When the positioning bead 15 is located in one of the arc-shaped positioning grooves 18, the lateral moving sleeve 2 can move in one direction along the lateral tooth plate 1. The two arc-shaped positioning grooves 18 correspond to two opposite directions respectively. At this time, one of the stop portions 20 is inserted into the tooth gap of the lateral tooth plate 1, and the other stop portion 20 is separated from the lateral tooth plate 1. That is, when the positioning bead 15 is located in one of the arc-shaped positioning grooves 18, one of the stop portions 20 is inserted into the tooth gap of the lateral tooth plate 1, and the lateral moving sleeve 2 can only move in one direction, and the movement in the opposite direction is locked. When the positioning bead enters the other arc-shaped positioning groove 18, the other stop portion 20 is inserted into the tooth gap of the lateral tooth plate 1, and the lateral moving sleeve 2 can move in the opposite direction.

[0047] The lateral moving sleeve 2 can move, and the distance between the two distraction rods 5 in the horizontal direction can be adjusted, and the distance between the vertebrae can be adjusted. The two movable arms 4 can rotate up and down to adjust the angle of the distraction rods 5.

[0048] The knob 16 is rotatable relative to the gear 6, that is, the knob 16 is foldable. One end of the gear 6 is rotatably connected to the knob 16 through a rotating shaft perpendicular to the axial direction of the gear 6, and the surface of the one end of the gear 6 is provided with a plurality of positioning grooves 21 for accommodating positioning beads 15, and the knob 16 is provided with the positioning beads 15, and the positioning beads 15 are matched with the plurality of positioning grooves 21 to make the knob 16 have different states relative to the gear 6. In the embodiment, the one end of the knob 16 is provided with an accommodating groove, the one end of the gear 6 is inserted into the accommodating groove and rotatably connected to the knob 16 through the rotating shaft perpendicular to the axial direction of the gear 6, the surface of the one end of the gear 6 inserted into the accommodating groove is provided with three positioning grooves 21 for accommodating the positioning beads 15, the knob 16 is provided with the positioning beads 15, and when the knob 16 rotates along the rotating shaft, the positioning beads 15 are matched with the three positioning grooves 21 to determine three states of the knob 16, and the three positioning grooves 21 correspond to upward folding, downward folding and horizontal state of the knob 16 respectively. The rotating shaft of the knob 16 is perpendicular to the axial direction of the gear 6, so that the gear 6 can be rotated regardless of the state of the knob 16, for opening the intervertebral space, and the doctor can operate conveniently in a compact space. In other embodiments, the number of the positioning grooves 21 can be increased or decreased.

[0049] The above describes the embodiments only to illustrate the technical solutions of the present application, rather than limit them; although the present application has been described in detail with reference to the foregoing embodiments, those skilled in the art should understand that the technical solutions recorded in the foregoing embodiments can be modified, or some technical features can be replaced by equivalents; and these modifications or replacements do not make the corresponding technical solutions deviate from the spirit and scope of the technical solutions of the embodiments of the present application, therefore, all other embodiments obtained by those skilled in the art without creative labor fall within the protection scope of the present application.

Claims

1. An atlantoaxial lateral mass joint distractor device, comprising: It includes a transverse toothed plate, a transverse moving sleeve, a vertical rod, two movable arms, and two expansion rods; The transverse moving sleeve is movably fitted on the transverse toothed plate. The transverse moving sleeve can move along the transverse toothed plate. The transverse moving sleeve is equipped with a quick release mechanism to quickly lock or quickly release the transverse moving sleeve. A vertical through hole is provided at one end of the transverse toothed plate, and the vertical rod is movably inserted through the vertical through hole. A first adjusting screw for positioning the vertical rod is installed on the transverse toothed plate. Two movable arms are respectively movably connected to the lower end of the vertical rod and the lower end of the horizontal moving sleeve. A vertical rotating shaft is inserted into the lower end of the vertical rod and the lower end of the horizontal moving sleeve. A second adjusting screw for locking the vertical rotating shaft is provided on the vertical rod and the horizontal moving sleeve. The lower ends of the two vertical rotating shafts are rotatably connected to the corresponding movable arms through a horizontal rotating shaft. Each movable arm is provided with a positioning hole for the expansion rod and an observation hole. The two expansion rods are respectively placed in the two positioning holes for the expansion rods. The movable arm is provided with a third adjusting screw for positioning the expansion rods corresponding to the position of each positioning hole for the expansion rods. The axial direction of the positioning hole of the support rod is the same as that of the observation hole, both being perpendicular to the vertical rod and the transverse toothed plate.

2. The atlantoaxial lateral mass joint distractor device according to claim 1, wherein, A positioning bead is installed on the side wall of the observation hole, and a through tube is installed in the observation hole. The positioning bead holds the through tube in place to prevent it from falling out.

3. The atlantoaxial lateral mass joint distractor device according to claim 1, wherein, A gear is installed in the transverse moving sleeve. The gear meshes with the teeth on the transverse toothed plate. A knob is connected to one end of the gear. By rotating the knob, the transverse moving sleeve and the gear move synchronously along the transverse toothed plate.

4. The atlantoaxial lateral mass joint distractor device according to claim 3, wherein, One end of the gear is rotatably connected to the knob via a shaft perpendicular to the gear axis. The surface of one end of the gear is provided with multiple positioning grooves for accommodating positioning beads. Positioning beads are installed in the knob, and the positioning beads cooperate with the multiple positioning grooves to make the knob have different states relative to the gear.

5. The atlantoaxial pedicle joint distractor device according to claim 4, wherein, One end of the knob is provided with a receiving groove, and the other end of the gear is inserted into the receiving groove and rotated to connect the knob via a shaft perpendicular to the gear axis. The surface of the end of the gear inserted into the receiving groove is provided with three positioning grooves for accommodating positioning beads. Positioning beads are installed in the knob. When the knob rotates along the shaft, the positioning beads cooperate with the three positioning grooves to determine the three states of the knob. The three positioning grooves correspond to the knob being folded upward, folded downward, and in a horizontal state, respectively.

6. The atlantoaxial pedicle joint distractor device according to claim 1, wherein, The quick-release mechanism includes a handle, a torsion spring, and a positioning bead. The handle is rotatably mounted in the transverse moving sleeve and partially extends out of the transverse moving sleeve as a gripping part. The handle is connected to the transverse moving sleeve through the torsion spring. A positioning bead is installed on the handle. The transverse moving sleeve has two arc-shaped positioning grooves and one circular positioning hole. The circular positioning hole is located between the two arc-shaped positioning grooves. The handle has two stop parts. When the positioning bead is in the circular positioning hole, both stops are separated from the transverse toothed plate, and the transverse moving sleeve can move back and forth along the transverse toothed plate. When the positioning bead is located in one of the arc-shaped positioning grooves, the transverse moving sleeve can move in one direction along the transverse toothed plate. The two arc-shaped positioning grooves correspond to two opposite directions.

7. The atlantoaxial pedicle joint distractor device according to claim 1, wherein, The vertical shaft is equipped with an annular limiting groove, and two pins are horizontally set on both the vertical rod and the horizontal moving sleeve. The two pins are locked in the annular limiting groove of the corresponding vertical rod to prevent the vertical shaft from falling off.

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