Retractor for surgical applications in spinal fusion procedures on a spine

Abstract

The invention relates to a retractor (1) for surgical applications in spinal fusion procedures on a spine, the retractor comprising: a handle portion (2) for actuation; a central portion (3) that is arranged on the handle portion and has a longitudinal axis; and a tool portion (4) mounted directly on the central portion (3) for supporting spinal tissue, wherein the tool portion (4) comprises a first arm portion (41) which can be brought into contact with nerve tissue of the spine and which extends at a first angle (α1) in a first direction relative to the longitudinal axis of the central portion (3), and a second arm portion (42) which can be brought into contact with dural tissue of the spine and which extends at a second angle (α2) in a second direction opposite to the first direction relative to the longitudinal axis of the central portion (3).

Description

[0001]

[0002] Refractor for surgical applications in spinal fusion

[0003] The invention relates to a refractor for surgical applications in spinal fusion according to the independent claim.

[0004] The invention lies in the technical field of surgical instruments for spinal surgery, with the help of which access to the surgical field is kept open or even made possible in the first place.

[0005] The spinal canal is a cylindrical space in the center of the vertebral column, running axially (vertically in humans, horizontally in domestic animals). Within this space lie the spinal cord and the nerve bundle of the cauda equina, protected by the spinal cord. Diseases of the segmental bony structure can lead to changes such as bony outgrowths (spondylophytes, spondylosis), ligament thickening, and osteoarthritis of the facet joints (spondylarthrosis), which can result in narrowing of the spinal canal (spinal stenosis). These disease-related changes in the shape and position of the bony structures affect the spinal nerves exiting the spinal canal at each segment. Any movement, especially in cases of lumbosacral instability, can lead to progressive narrowing of the spinal canal and painful irritation of the nerves exiting it.

[0006] Over the course of a person's life, the joints undergo progressive degeneration. This particularly affects the small vertebral joints. Considerable scientific research has already been undertaken to explain the underlying causes. That degeneration is a factor is undisputed. The fact remains that, regardless of the specific causes, the joints and their components change to such an extent that it ultimately leads to misalignments and therapy-resistant spinal pain, significantly impacting quality of life.

[0007] Spinal surgeries have therefore increased significantly in recent years and require a very long operating time. The complexity of procedures within spinal surgery is also developing rapidly. This development includes technical innovations that continually present surgeons with new challenges.

[0008] Surgical treatment of spinal fusion takes some time. This is primarily due to the fact that, despite good development, the surgical instruments used only partially fulfill their function intraoperatively.

[0009] During spinal fusion surgery, a refractor and a dissector are among the instruments used. The assistant holds the dural sac with the intraspinal refractor, also known as a "Love hook." With the other hand, the assistant uses the dissector to pull the nerve root cranially. This allows the surgeon easy access to the disc space, which can then be cleared and a spacer inserted.

[0010] The assistant then already has an instrument in each hand and cannot hold any other instruments or otherwise assist the surgeon. This represents a major disadvantage of the surgical instruments currently in use.

[0011] The invention aims to provide a refractor that overcomes the disadvantages of the prior art and enables simplified handling by the assistant. This objective is achieved by a refractor for surgical applications in spinal fusion with the features of independent claim 1. Advantageous embodiments are the subject of the dependent claims.

[0012] The invention comprises a retractor for surgical applications in spinal fusion, comprising a handle section for actuation with a central section having a longitudinal axis arranged thereon, and a tool section arranged directly on the central section for supporting spinal tissue, wherein the tool section comprises a first leg section that can be brought into contact with nerve tissue of the spine and which extends at a first angle in a first direction to the longitudinal axis of the central section, and a second leg section that can be brought into contact with dural tissue of the spine and which extends at a second angle in a second direction opposite to the first direction to the longitudinal axis of the central section, so that an operating area on the spine can be opened between the first and the second leg section.wherein the first leg section has an angled first end section at the open end, and the second leg section has an angled second end section at the open end, and a flat surface of the second leg section is a surface that widens with respect to the longitudinal axis of the central section. This allows the assistant to hold the surgical field open with only one instrument, thus freeing up another hand for other instruments or maneuvers.

[0013] One advantageous feature is that the third and fourth angles are different, and the height of the first and second end sections differs relative to the longitudinal axis of the middle section. This allows the retractor to be precisely positioned and held against the spinal tissue. It is particularly beneficial if the first and second end sections each have a notch. This ensures the retractor is securely positioned and held against the spinal tissue, preventing slippage or twisting during surgery.

[0014] According to a preferred design, the tool section between the first and the leg section has an outwardly directed radius. This prevents damage to surrounding spinal tissues by the retractor and thus ensures the greatest possible medical and biological compatibility of the surgical procedure while avoiding undesirable side effects.

[0015] Advantageously, the radius lies in a range between 3 mm and 9 mm, preferably in a range between 4 mm and 7 mm, and particularly in a range between 5 mm and 6 mm. This enables optimal power transmission.

[0016] It has proven advantageous if an angle is formed between the first and second leg segments, and this angle lies in a range between 25° and 60°, preferably in a range between 35° and 50°, and particularly in a range between 40° and 45°. This allows the assistant to optimally access and keep the surgical field open, thus enabling the surgeon to work precisely.

[0017] An advantageous aspect is that the first leg section has a length Li in a range between 5 mm and 20 mm, preferably in a range between 7 mm and 15 mm, particularly in a range between 10 mm and 12 mm, and the second leg section has a length L2 in a range between 10 mm and 30 mm, preferably in a range between 15 mm and 25 mm, particularly in a range between 18 mm and 22 mm. This enables optimal force transmission and thus prevents slippage or twisting of the retractor during the operation.

[0018] It is particularly advantageous if the retractor is made from a single piece of metal. This allows the surgical instrument to be manufactured very cost-effectively. It is also particularly advantageous if the handle section is flattened and has one or more recesses for the insertion of a finger. This allows the assistant to hold the retractor securely without it slipping out of their hand.

[0019] Advantageously, a procedure for using a retractor for surgical applications in spinal fusion comprises the steps of: a. providing a retractor; b. supporting spinal nerve tissue by means of a first leg section of a tool segment; c. supporting spinal dural tissue by means of a second leg section of the tool segment; d. retracting the retractor obliquely cranially so that the first and second leg sections span an area between the spinal nerve tissue and the spinal dural tissue; e. removing a tissue structure of the spine; f. releasing the first and second leg sections from the spinal nerve tissue and dural tissue, respectively; and g. removing the retractor from the surgical site on the spine.

[0020] This allows the assistant to create access to the surgical field with an instrument and to keep the surgical field open with this instrument, so that, for example, the suction device can also be held by the assistant in their second free hand to ensure visibility for the procedures on the intervertebral disc compartment.

[0021] The invention will now be explained in more detail with reference to a drawing. The drawing shows:

[0022] Fig. 1 is a schematic representation of a retractor according to the invention for surgical applications in spinal fusion; Fig. 2 is a schematic detail representation of the tool section of a retractor according to the invention with two leg sections; and

[0023] Fig. 3 shows a conventional retractor for surgical procedures on a spine according to the state of the art.

[0024] Fig. 1 shows a retractor 1 according to the invention for surgical applications in spinal fusion, comprising a handle section 2 for actuation with a central section 3 having a longitudinal axis arranged thereon, and a tool section 4 arranged directly on the central section 3 for supporting tissue of a spine, wherein the tool section 4 comprises a first leg section 41 which can be brought into contact with nerve tissue of the spine and which extends in a first angle α in a first direction to the longitudinal axis of the central section 3, and a second leg section 42 which can be brought into contact with dural tissue of the spine and which extends in a second angle α in a second direction opposite to the longitudinal axis of the central section 3, so that an operating area on the spine can be opened between the first and the second leg sections 41, 42.wherein the first leg section 41 has a first end section 41 1 angled at a third angle 4>i at the open end and the second leg section 42 has a first end section 41 1 angled at a fourth angle at the open end , <f>2 angled second

[0025] End section 421 has a flat surface of the second

[0026] Leg section 42 is a surface that widens in relation to the longitudinal axis of the middle section 3.

[0027] The first and second end sections 41 1 , 421 each have a notch. For example, the notch is arc-shaped.

[0028] The handle section 2 is flattened and has one or more recesses 21 for the engagement of a finger. The retractor 1 is formed in one piece. For example, the first and second leg sections 41, 42 each have an outwardly facing and an inwardly facing flat surface.

[0029] A method for using a refractor for surgical applications in spinal fusion comprises the steps of: a. providing a refractor 1; b. supporting spinal nerve tissue by means of a first leg section 41 of a tool section 4; c. supporting spinal dural tissue by means of a second leg section 42 of the tool section 4; d. drawing the refractor 1 obliquely cranially so that the first and second leg sections 41, 42 span an area between the spinal nerve tissue and the spinal dural tissue; e. removing a tissue structure of the spine; f. releasing the first and second leg sections 41, 42 from the spinal nerve tissue and dural tissue, respectively; and g. removing the refractor 1 from a surgical site on the spine.

[0030] Fig. 2 shows a schematic detail of the tool section 4 of a refractor 1 according to the invention with two leg sections 41, 42. It can be seen that the third angle 41 and the fourth angle 42 are different from each other and that the height of the first and second end sections 411, 421 is different with respect to the longitudinal axis of the central section 3.

[0031] The tool section 4 has an outwardly directed radius R between the first and the leg sections 41, 42. The radius R lies in a range between 3 mm and 9 mm, preferably in a range between 4 mm and 7 mm, and particularly in a range between 5 mm and 6 mm.

[0032] An angle β is formed between the first and second leg sections 41, 42 and the angle β lies in a range between 25° and 60°, preferably in a range between 35° and 50°, particularly in a range between 40° and 45°.

[0033] The first leg section 41 has a length Li in a range between 5mm and 20mm, preferably in a range between 7mm and 15mm, particularly in a range between 10mm and 12mm, and the second leg section 42 has a length L2 in a range between 10mm and 30mm, preferably in a range between 15mm and 25mm, particularly in a range between 18mm and 22mm.

[0034] Fig. 3 shows a conventional, prior art intraspinal refractor 1 for surgical applications in spinal fusion. Such hooks are used in various forms: blunt and rounded, in different shapes and sizes, they serve to retract delicate tissues and organs.< / f>

Claims

Claims 1. Retractor (1) for surgical applications in spinal fusion, comprising a handle section (2) for actuation with a central section (3) having a longitudinal axis arranged thereon, and a tool section (4) arranged directly on the central section (3) for supporting tissue of a spine, wherein the tool section (4) comprises a first leg section (41) which can be brought into contact with nerve tissue of the spine and extends at a first angle (ai) in a first direction to the longitudinal axis of the central section (3), and a second leg section (42) which can be brought into contact with dural tissue of the spine and extends at a second angle (02) in a second direction opposite to the longitudinal axis of the central section (3), such that an operating area on the spine can be opened between the first and the second leg sections (41, 42).wherein the first leg section (41 ) has a first end section (411 ) angled at a third angle (4>i) at the open end and the second leg section (42) has a second end section (421 ) angled at a fourth angle (< 2) at the open end and a flat surface of the second leg section (42) is a surface that widens with respect to the longitudinal axis of the middle section (3).

2. Retractor (1 ) according to claim 1 , wherein the third angle (4>i) and the fourth angle (< 2) are different from each other and the height of the first and second end section (411 , 421 ) is different with respect to the longitudinal axis of the middle section (3).

3. Retractor (1) according to one of the preceding claims, wherein the first and second end section (411, 421) each have a notch.

4. Retractor (1 ) according to one of the preceding claims, wherein the tool section (4) between the first and the leg section (41 , 42) has an outwardly directed radius (R).

5. Retractor (1 ) according to one of the preceding claims, wherein the radius (R) is in a range between 3mm and 9mm, preferably in a range between 4mm and 7mm, particularly in a range between 5mm and 6mm.

6. Retractor (1 ) according to one of the preceding claims, wherein an angle (β) is formed between the first and the second leg section (41 , 42) and the angle (β) is in a range between 25° and 60°, preferably in a range between 35° and 50°, particularly in a range between 40° and 45°.

7. Retractor (1) according to one of the preceding claims, wherein the first leg section (41) has a length Li in a range between 5mm and 20mm, preferably in a range between 7mm and 15mm, particularly in a range between 10mm and 12mm, and the second leg section (42) has a length L2 in a range between 10mm and 30mm, preferably in a range between 15mm and 25mm, particularly in a range between 18mm and 22mm.

8. Retractor (1 ) according to one of the preceding claims, wherein the retractor (1 ) is formed in one piece.

9. Retractor (1) according to one of the preceding claims, wherein the handle section (2) is flattened and has one or more recesses (21) for the engagement of one finger each.

10. A method for using a retractor for surgical applications in spinal fusion according to any one of the preceding claims, comprising the steps of: a. providing a retractor (1); b. supporting spinal nerve tissue by means of a first leg section (41) of a tool section (4); c. supporting spinal dural tissue by means of a second leg section (42) of the tool section (4); d. pulling the retractor (1) obliquely cranially such that the first and second leg sections (41, 42) span an area between the spinal nerve tissue and the spinal dural tissue; e. removing a tissue structure of the spine; f. releasing the first and second leg sections (41, 42) respectively from the spinal nerve tissue and the spinal dural tissue; and g. removing the retractor (1) from a surgical area on the spine.

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