Spinal cord administration device

Abstract

A spinal cord administration device 1 comprises: a retractor 20 that is attached to an incised opening 91 in a patient back part 9 and widens the opening 91; a manipulator 40 that holds an administration device 30 for administering a drug to the spinal cord of the patient through the opening 91 such that an administration position with respect to the patient can be adjusted; and a holder 50 that holds the manipulator 40 such that a relative position with respect to the retractor 20 can be changed.

Description

Device for spinal administration

[0001] The present invention relates to a device for spinal administration.

[0002] There is known a device for spinal administration comprising a trocar attached to an incision in a patient's back to expand the incision, and a manipulator fixedly attached to the trocar and holding an injection assembly for injecting a drug into the patient's spinal cord through the incision in an adjustable manner with respect to the administration position for the patient (see, for example, Patent Document 1).

[0003] Japanese Patent Application Laid-Open No. 2022-516746

[0004] In the device for spinal administration of Patent Document 1, since the manipulator is fixedly attached to the trocar, the position of the manipulator cannot be changed with respect to the trocar. As a result, when attempting to administer a drug to a plurality of locations of a patient's spinal cord, if the amount of movement exceeds the position adjustment margin of the injection assembly by the manipulator, it is necessary to once remove the trocar from the patient and reattach it to the desired position. As a result, the device for spinal administration is attached to the patient a plurality of times, and since it takes time to attach and detach the device for spinal administration, the work and surgical time required for administration increase and the burden on the patient also increases.

[0005] An object of the present invention is to provide a device for spinal administration that can reduce the burden on the patient and the doctor when administering a drug to a plurality of locations of the patient's spinal cord. [[ID=十七]]

[0006] One aspect of the present invention provides a device for spinal administration comprising: a trocar attached to an incision in a patient's back to expand the incision; a manipulator holding an injector for injecting a drug into the patient's spinal cord through the incision in an adjustable manner with respect to the administration position for the patient; and a holder holding the manipulator in a manner capable of changing the relative position with respect to the trocar.

[0007] According to the present invention, the position of the injector can be roughly changed by changing the mounting position of the manipulator relative to the retractor while the retractor remains attached to the patient's back, and then the position of the injector can be finely adjusted by operating the manipulator. Moreover, since the position of the manipulator relative to the retractor can be changed without removing the retractor from the patient, the approximate position of the injector can be easily changed. Therefore, even when administering drugs to multiple locations in the spinal cord, for example, the trouble of removing the retractor can be eliminated, thus reducing the time required to adjust the position of the spinal cord administration device and reducing the burden on the patient and the physician.

[0008] Furthermore, this spinal administration device is attached to the patient's back via a manipulator and holder, and is immobile from relative displacement by a retractor. Therefore, the administration device can follow the movement of the patient's back, which fluctuates with respiration, allowing for stable drug delivery to the patient's spinal cord.

[0009] A perspective view of a spinal administration device according to one embodiment of the present invention. A plan view of a spinal administration device according to one embodiment of the present invention. A side view of a spinal administration device according to one embodiment of the present invention. A side view of a spinal administration device with the manipulator in a prepared position. A perspective view of the manipulator alone. A bottom view of the manipulator alone. A partially enlarged cross-sectional view along line VII-VII in Figure 2. A side view showing a first modified example of the spinal administration device. A side view showing a second modified example of the spinal administration device.

[0010] A spinal cord administration device according to one embodiment of the present invention is a device for administering drugs such as pharmaceuticals and regenerative medicine products to a patient's spinal cord. In this specification, the drug is not particularly limited as long as it can be administered to the patient's spinal cord by the administration device, and may be in any form of liquid, solid, or suspension. The active ingredient of the drug is not particularly limited and can be a chemical substance, an antibody, a protein such as an enzyme, a nucleic acid, a cell, a neurotrophic factor, a vector, cerebrospinal fluid, etc. Examples of drugs include drugs containing cells such as pluripotent stem cell-derived neural trunk / progenitor cells, mesenchymal stem cells, or hematopoietic stem cells as active ingredients, or drugs administered to the patient's spinal cord such as chondroitinase ABC or semaphorin 3A inhibitors. In this specification, the spinal cord includes the spinal cord parenchyma and the intramedullary cavity, and in this embodiment, the spinal cord refers to the spinal cord parenchyma.

[0011] A spinal administration device according to one embodiment of the present invention will be described with reference to the drawings. The spinal administration device 1 is used by being placed on the back of a patient in a prone position. In this specification, "front," "back," "left," and "right" refer to the head direction, foot direction, left direction, and right direction of the patient in which the spinal administration device 1 is placed. The front-to-back direction may also be referred to as the patient's body length direction, and the left-to-right direction as the patient's body width direction. The abdominal and back directions of the patient in a prone position, which are perpendicular to the body length and body width directions, are referred to as the downward and upward directions.

[0012] As shown in Figure 1, the spinal cord administration device 1 includes a retractor 20 that is attached to a cut-open opening 91 on the patient's back 9 to widen the opening 91, a manipulator 40 that holds the injector 30, which administers the drug to the patient's spinal cord through the opening 91, in an adjustable position relative to the patient, and a holder 50 that holds the manipulator 40 in an adjustable position relative to the retractor 20.

[0013] As shown in Figure 1, the retractor 20 has a pair of left and right frame members 21 extending along the length of the body, a cross member 22 connecting the pair of left and right frame members 21 at one end in the length of the body, and a pair of left and right claw portions 23 extending downward from the pair of left and right frame members 21 at the other end in the length of the body.

[0014] In this embodiment, the left end of the cross member 22 is fixed to the left frame member 21. The right end of the cross member 22 penetrates the right frame member 21 in the width direction. The right frame member 21 is movable in the width direction relative to the cross member 22. The cross member 22 has a plurality of recesses 22a at its rear edge that are arranged in the width direction and recessed toward the front. The right frame member 21 penetrates the right frame member 21 in the vertical direction and is rotatable, and has an engaging portion 21a that engages with the plurality of recesses 22a.

[0015] When the engaging portion 21a is rotated, the widthwise position of the recess 22a into which the engaging portion 21a engages moves. This adjusts the widthwise position of the right frame member 21 relative to the left frame member 21, that is, the distance between the pair of left and right claw portions 23 (claw distance). The pair of left and right claw portions 23 are inserted along the opening 91 of the patient's administration site with the claw distance narrowed, and are used to widen the opening 91 and expose the target administration site by widening the claw distance.

[0016] As shown in Figure 2, the left and right frame members 21 have a plurality of positioning portions 24 arranged side by side in a first direction (in this specification, the body length direction) in an in-plane direction parallel to the body length direction and body width direction of the patient 9. More specifically, the plurality of positioning portions 24 are a plurality of grooves arranged side by side on the upper surface of the left and right frame members 21 and recessed downwards. In other words, each of the plurality of positioning portions 24 is a groove extending in a second direction (in this specification, the body width direction) perpendicular to the first direction. In this embodiment, each positioning portion 24 has a semicircular cross-section when viewed in the body width direction (see Figure 3).

[0017] As shown in Figure 3, the multiple positioning parts 24 are arranged at regular intervals in the longitudinal direction, and the pitch W1 of adjacent positioning parts 24 is, for example, 5 mm. In this embodiment, the adjustment range in the longitudinal direction of the manipulator 40 is determined by the multiple positioning parts 24, and since there are, for example, 34 of them, the adjustment range in the longitudinal direction of the manipulator 40 is 5 mm to 170 mm, preferably 5 mm to 115 mm, specifically about 100 mm. In this embodiment, the multiple positioning parts 24 are separate from the left and right pair of frame members 21 and are formed on elongated plate members 25 fixed to the upper surfaces of the left and right pair of frame members 21, but the multiple positioning parts 24 may also be provided directly on the upper surfaces of the left and right pair of frame members 21.

[0018] As shown in Figure 2, each of the multiple positioning parts 24 is assigned an identifier 26. In this embodiment, the identifier is an alphanumeric character attached to the bottom of the groove 24a of each positioning part 24, but is not limited to this. The identifier 26 may be provided on the side surface of each positioning part 24 as shown in Figure 3, in a view in the width direction.

[0019] As shown in Figure 3, in this embodiment, the manipulator 40 is mounted on the wound retractor 20. The manipulator 40 has a main body 41, a holding part 42 for holding the dispenser 30, a first movable element 43, a second movable element 44, and a third movable element 45 for adjusting the width, length, and vertical positions of the dispenser 30, respectively, and a moving mechanism 46 for moving the piston of the dispenser 30. In this embodiment, the dispenser 30 is a syringe having a cylinder 31 in which the drug is contained, a piston 32 that moves inside the cylinder 31, and a needle 33 that communicates with the tip (lower end) of the cylinder 31 and extends downward. The moving mechanism 46 is a mechanism for moving the piston 32 so that the drug is discharged from the cylinder 31.

[0020] The manipulator 40 can be changed to at least two positions: a basic position (Figure 3) in which the axis of the injector 30 held by the manipulator 40 extends in the vertical direction, and a preparation position (Figure 4) in which the axis of the injector 30 extends in the front-back direction. In the basic position, the injector 30 held by the manipulator 40 extends in a direction perpendicular to the pair of left and right frame members 21. In the preparation position, the injector 30 held by the manipulator 40 extends in a direction parallel to the pair of left and right frame members 21. The manipulator 40 is placed on the retractor 20 in either the basic position or the preparation position.

[0021] As shown in Figure 5, the main body portion 41 has a lower frame portion 41d that is parallel to the body length direction and body width direction in the basic posture, a rear frame portion 41e that is perpendicular to the lower frame portion 41d and parallel to the vertical direction and body width direction, a front frame portion 41f that faces the rear frame portion 41e, and an upper frame portion 41g that connects the upper ends of the rear frame portion 41e and the front frame portion 41f.

[0022] The main body 41 further includes detachable first positioning parts 41a and 41b for positioning the manipulator 40 in a basic position relative to the retractor 20, and detachable second positioning parts 41b and 41c for holding the manipulator 40 in a ready position.

[0023] The first positioning portions 41a and 41b are elongated members extending outward in the width direction from the front and rear ends of the lower frame portion 41d. The first positioning portions 41a and 41b have a front positioning portion 41a located at the front end and a rear positioning portion 41b located at the rear end. The second positioning portions 41b and 41c are elongated members extending outward in the width direction from the lower and upper ends of the rear frame portion 41e. The second positioning portions 41b and 41c have a lower positioning portion 41b located at the lower end and an upper positioning portion 41c located at the upper end. In this embodiment, the first positioning portion 41b at the rear end and the second positioning portion 41b at the lower end are used interchangeably.

[0024] As shown in Figure 3, each of the positioning portions 41a, 41b, and 41c is fitted into the positioning portion (groove) 24 in a vertical direction perpendicular to the width direction and the length direction of the body. The first positioning portions 41a, 41b and the second positioning portions 41b, 41c are each positioned by two locations on the plurality of positioning portions 24.

[0025] More specifically, in the reference position, the front positioning portion 41a is positioned on the first positioning portion 25a, and the rear positioning portion 41b is positioned on the second positioning portion 25b, which is located behind the first positioning portion 25a. As shown in Figure 4, in the preparation position, the lower positioning portion 41b is positioned on the third positioning portion 25c, and the upper positioning portion 41c is positioned on the fourth positioning portion 25d, which is located behind the third positioning portion 25c. The second positioning portion 25b and the third positioning portion 25c may be in the same position, or they may be positioned in positions offset from each other.

[0026] As shown in Figure 6, the lower frame portion 41d has a space S1 that penetrates vertically through its center. A first movable element 43 is positioned in space S1. The first movable element 43 adjusts the position of the dispensing device 30 in the width direction. The first movable element 43 is attached to the lower frame portion 41d so as to be movable in the width direction.

[0027] In this embodiment, the first movable element 43 is attached to the lower frame 41d so as to be movable in the width direction by engaging protrusions projecting forward and backward from the front and rear surfaces, respectively, with rails extending in the width direction provided on the inner surfaces of the front and rear frame portions of the lower frame 41d. The range of movement of the first movable element 43 in the width direction relative to the lower frame 41d is, for example, 10 mm.

[0028] The first movable element 43 is fitted with a first operator 43a that can be rotated manually, and a screw shaft 43b that is coupled to the first operator 43a and extends parallel to the width direction of the body. The first movable element 43 is screwed onto the screw shaft 43b and moves in the width direction of the body when the first operator 43a is rotated.

[0029] The first mobile element 43 has a space S2 that penetrates its center vertically. The second mobile element 44 is located in space S2. The second mobile element 44 adjusts the position of the administration device 30 in the longitudinal direction. The second mobile element 44 is attached to the first mobile element 43 so as to be movable in the longitudinal direction.

[0030] In this embodiment, the second movable element 44 has a vertical portion that extends vertically and is positioned in space S2, and a front-rear portion 44b (see Figure 3) that extends forward from the upper end of the vertical portion 44a. The second movable element 44 is movable in the longitudinal direction relative to the first movable element 43 by engaging protrusions protruding from both sides of the vertical portion 44a with rail portions extending in the longitudinal direction provided on both sides of the first movable element 43. The range of movement of the second movable element 44 in the longitudinal direction relative to the first movable element 43 is, for example, 10 mm.

[0031] The second movable element 44 is fitted with a second operator 44c that can be rotated manually, and a screw shaft 44d that is coupled to the second operator 44c and extends parallel to the length of the element. The second movable element 44 is screwed onto the screw shaft 44d and moves in the length of the element when the second operator 44c is rotated.

[0032] As shown in Figure 7, the front-rear portion 44b of the second movable element 44 passes through a space S3 that penetrates the center of the front frame portion 41f in the front-rear direction, and the front end portion 44e is located in front of the front frame portion 41f. A third movable element 45 is positioned at the front end portion 44e of the second movable element 44. The third movable element 45 adjusts the vertical position of the dispensing device 30.

[0033] In this embodiment, the third movable element 45 is a rectangular frame member (hereinafter also referred to as the "frame body") that surrounds the front end portion 44e from above and below and in the width direction, and is elongated in the vertical direction. The frame body 45 has a lower frame 45c that is located below the front end portion 44e of the second movable element 44 and extends in the width direction, an upper frame 45d that is opposite to the upper frame 45c, and a pair of left and right side frames 45e that connect the widthwise side edges of the lower frame 45c and the upper frame 45d vertically. The third movable element 45 has a space S4 that penetrates its center in the front-rear direction, and the space S4 is formed between the lower frame 45c, the upper frame 45d, and the pair of left and right side frames 45e. The front end portion 44e is located in the space S4. The third movable element 45 is mounted so as to be movable in the vertical direction relative to the front end portion 44e. The third movable element 45 is movable vertically relative to the second movable element 44 by engaging protrusions protruding from both sides of its front end 44e with vertically extending rail portions provided on the inner surfaces of the side frames 45e on both sides in the width direction of the body. The vertical movement range of the third movable element 45 relative to the second movable element 44 is, for example, 40 mm, 70 mm, 80 mm, 90 mm, or 100 mm.

[0034] The third movable element 45 is fitted with a third operator 45a that can be rotated manually, and a screw shaft 45b that is coupled to the third operator 45a and extends parallel to the length of the element. The third movable element 45 is screwed onto the screw shaft 45b and moves vertically when the third operator 45a is rotated. In this embodiment, when the third movable element 45 is located at the upper end of its vertical movement range, the third operator 45a is positioned on the upper surface of the upper frame 45d.

[0035] The third movable element 45 is provided with a holding portion 42 for holding the dispensing device 30. The holding portion 42 has a first holding portion 42a extending forward from the middle of the upper and lower frames of the third movable element 45, and a second holding portion 42b extending forward from the lower frame of the third movable element 45.

[0036] The first holding portion 42a has a rear support portion that surrounds the cylinder 31 from the rear at the upper end of the cylinder 31, and a front support portion that is positioned opposite to the front of the rear support portion. The front support portion is connected to the rear support portion via a hinge portion on one side in the width direction of the body (see Figure 6). The upper end of the cylinder 31 on which the rear support portion is placed is sandwiched between the rear support portion and the front support portion when the front support portion is rotated and fixed to the rear support portion with screws or the like on the other side in the width direction of the front support portion. The second holding portion 42b holds the cylinder 31 so as to surround the middle part between the upper end portion 31a and the lower end portion 31b from the rear.

[0037] A guide section 47 for guiding the movement mechanism 46 is fixed to the third movable element 45. The guide section 47 is a frame member that is elongated in the vertical direction. The guide section 47 has an upper frame 47a, a lower frame 47b, and side frames 47c. The upper frame 47a of the guide section 47 is positioned above the upper frame 45c of the third movable element 45. The lower frame 47b of the guide section 47 is composed of a first holding section 42a. The side frames 47c of the guide section 47 connect the upper frame 47a and the lower frame 47b at both ends in the width direction of the body. The guide section 47 is provided between the side frames 47c of the guide section 47 and the side frames 45e of the third movable element 45, and is fixed to the third movable element 45 by a connecting wall 47d that connects these side frames 47c and 45e.

[0038] The moving mechanism 46 includes an operator 46a that can be rotated manually, a screw shaft 46b that is coupled to the operator 46a and extends parallel to the axis of the cylinder 31, and a moving body 46c that is screwed onto the screw shaft 46b and contacts the piston 32 from the opposite side of the connection or extrusion direction, and moves the piston 32 in the extrusion direction when the operator 46a is rotated.

[0039] In this embodiment, the guide portion 47 has a space S5 in its central part that penetrates in the front-rear direction. A movable body 46c is arranged in the space S5. The movable body 46c is mounted so as to be movable in the vertical direction relative to the guide portion 47. The movable body 46c is movable in the vertical direction relative to the guide portion 47 by the engagement of protrusions protruding from both sides of the movable body 46 with vertically extending rail portions provided on the inner surfaces of both side frames 47c. Since the guide portion 47 is fixed to the third movable element 45, it can also be said that the movable body 46c is movable in the vertical direction relative to the third movable element 45. The vertical range of movement of the movable body 46c relative to the third movable element 45 is preferably greater than or equal to the range of movement of the piston 32 of the dispenser 30, for example, 32.5 mm, 41 mm, or 60 mm.

[0040] The upper end of the piston 32 is in contact with the lower surface of the movable body 46c. As the movable body 46c moves vertically, the piston 32 is moved in the pushing direction, causing the chemical inside the cylinder to protrude from the cylinder.

[0041] The first mobile element 43, the second mobile element 44, the third mobile element 45, and the mobile body 46c are each made of polyetheretherketone (PEEK) resin, and their movable parts are lubrication-free.

[0042] As shown in Figure 3, the retainer 50 connects the retractor 20 and the manipulator 40. The retainer 50 is an arm member that can be changed between a deformable mode and a fixed mode that cannot be changed. The retainer 50 only needs to be movable to an intended location and fixed in an intended location, and can be made of, for example, a flexible arm.

[0043] The retainer 50 has a bellows-shaped body 51 having a wire 51c that is inserted into the hollow space from the tip 51a to the base 51b and has its tip fixed, a fixing part 52 that is fixed to the manipulator 40 at the tip 51a, a retractor-side fixing part 53 that is fixed to the rear end of the retractor 20 at the base 51b, and an adjustment part 54 that is attached to the base 51b and allows the body 51 to be fixed or deformed by pulling or loosening the wire 51c.

[0044] Next, the method of using the spinal administration device 1 will be described.

[0045] As shown in FIG. 1, the dissector 20 is attached to the incised opening 91 on the patient's back 9 and fixed to the patient's back 9. The frame member 21 on the right side of the dissector 20 is separated from the frame member 21 on the left side to widen the opening 91. As shown in FIG. 4, the manipulator 40 is temporarily placed on the dissector 20 in the preparation posture. In the state of the preparation posture, the holder 50 is connected to the dissector 20. At this time, a simulation rod imitating the dispenser 30 is held by the holding part 42 of the manipulator 40.

[0046] In order to confirm the position of the manipulator 40, the manipulator 40 in the preparation posture shown in FIG. 4 is rotated 90 degrees clockwise (centered on a straight line extending in the body width direction) in a side view (arrow A1 in FIG. 4) to the reference posture shown in FIG. 3. At this time, the front, rear, left, and right positions of the manipulator 40 with respect to the dissector 20 are roughly adjusted so that the tip of the simulation rod is located at the administration site. More specifically, the positions of the first positioning parts 41a and 41b are arranged in the positioning part 24 to adjust the position of the manipulator 40. After adjusting the position of the manipulator 40, the identifier of the second positioning part 25b where the rear positioning part 41b is arranged is recorded (see the enlarged view of FIG. 2). In this embodiment, the identifier "3" is recorded.

[0047] Thereafter, the manipulator 40 in the reference posture shown in FIG. 3 is rotated 90 degrees counterclockwise (centered on a straight line extending in the body width direction) in a side view (arrow A2 in FIG. 3) to return to the preparation posture of FIG. 4, and the simulation rod is removed from the holding part 42. A dispenser (microsyringe) 30 filled with a drug is set in the holding part 42, and the manipulator 40 is rotated 90 degrees clockwise in a side view to the reference posture. At this time, by setting the rear positioning part 41b in the second positioning part 25b with the recorded identifier "3", the manipulator 40 is arranged at the target administration site. By operating the adjustment part 54 of the holder 50 to change the main body 51 of the holder 50 to a fixed mode, the manipulator 40 is fixed to the dissector 20.

[0048] Rotate the first operator 43a and the second operator 44c of the manipulator 40 that is roughly positioned, and adjust the front, rear, left, and right positions of the injector 30 so that the needle 33 of the injector 30 is directly above the administration site.

[0049] After the adjustment of the front, rear, left, and right positions of the injector 30 is completed, rotate the third operator 45a to insert the needle 33 into the spinal cord. Rotate the administration dial (operator 46a of the moving mechanism 46) to push down the piston 32, and slowly administer the drug in the cylinder 31 to the spinal cord.

[0050] After the administration is completed, rotate the third operator 45a to remove the needle 33 from the spinal cord. After the needle 33 is removed from the spinal cord, operate the adjustment part 54 of the holder 50 to loosen the main body 51 from the fixed mode to the deformed mode, and rotate the manipulator 40 counterclockwise by 90 degrees in a side view to return to the preparation posture. The spinal cord administration is completed by removing the injector 30 from the manipulator 40.

[0051] When administering drugs to multiple locations of the spinal cord, without detaching the dissector 20 from the patient, change the position of the manipulator 40 relative to the dissector 20, change the approximate position of the injector 30, and finely adjust the manipulator 40 as described above to administer the drug in the cylinder to the spinal cord.

[0052] According to the spinal cord administration device 1 according to the present embodiment, the following effects can be obtained.

[0053] The spinal cord administration device 1 in the present embodiment includes a dissector 20 that is attached to the incised opening 91 of the patient's back 9 and expands the opening 91, an injector 30 that administers a drug to the patient's spinal cord through the opening 91, a manipulator 40 that holds the administration position with respect to the patient so as to be adjustable, and a holder 50 that holds the manipulator 40 so that the relative position with respect to the dissector can be changed.

[0054] According to the present invention, the position of the injector 30 can be roughly changed by changing the mounting position of the manipulator 40 relative to the retractor 20 while the retractor 20 remains attached to the patient's back, and then the position of the injector 30 can be finely adjusted by operating the manipulator 40. Moreover, since the position of the manipulator 40 relative to the retractor 20 can be changed without removing the retractor 20 from the patient, the approximate position of the injector 30 can be easily changed. Therefore, even when administering drugs to multiple locations in the spinal cord, for example, the effort of removing the retractor 20 can be eliminated, thus reducing the time required to adjust the position of the spinal cord administration device 1 and reducing the burden on the patient.

[0055] Furthermore, in this spinal administration device 1, the injector 30 is attached to the patient's back via a manipulator 40 and a holder 50, and is immobile relative to the patient's back by a retractor 20. Therefore, the injector 30 can follow the movement of the patient's back, which fluctuates with the patient's breathing, thus enabling stable administration of the drug to the patient's spinal cord.

[0056] The manipulator 40 is placed on the retractor 20.

[0057] With this configuration, the position of the injector 30 can be easily changed by changing the mounting position of the manipulator 40 relative to the retractor 20 while the retractor 20 remains attached to the patient's back. In addition, since the manipulator 40 is mounted on the retractor 20, the distance between the manipulator 40 and the spinal cord is kept constant, making it easy to adjust the height of the injector 30 during subsequent administrations.

[0058] The retainer 50 connects the retractor 20 and the manipulator 40, and is an arm member that can be changed between a deformable mode and a fixed mode that cannot be deformed.

[0059] With this configuration, the arm member can hold the manipulator in the desired position.

[0060] The retractor 20 has a plurality of positioning parts 24 arranged in a first direction (in this embodiment, the body length direction) in an in-plane direction parallel to the patient's body length direction and body width direction, and the manipulator 40 has positioned parts 41a, 41b, 41c which are positioned by one of the plurality of positioning parts 24.

[0061] With this configuration, the position of the manipulator 40 can be easily changed in a first direction relative to the retractor 20 by positioning the positioned parts 41a, 41b, and 41c of the manipulator 40 to one of the multiple positioning parts 24 of the retractor 20.

[0062] Each of the multiple positioning portions 24 is a groove extending in a second direction (in this embodiment, the width direction) perpendicular to the first direction in the in-plane direction, and the positioned portions 41a, 41b, and 41c are elongated members extending in the second direction and are fitted into the groove 24 in a third direction (in this embodiment, the vertical direction) perpendicular to the first and second directions.

[0063] With this configuration, the elongated member can be slid in a second direction relative to the groove, so the manipulator can be easily repositioned in a second direction relative to the retractor.

[0064] Each of the multiple positioning units 24 is assigned an identifier 26.

[0065] With this configuration, by checking the identifier 26 of the positioning unit 24 used for positioning while the manipulator 40 is placed on the retractor 20, it is easy to reproduce the position of the manipulator 40 relative to the retractor 20 by using the identifier 26 as a guide, even if the position of the manipulator 40 relative to the retractor 20 is changed. For example, after aligning the manipulator 40 with the spinal cord using a dummy injector (simulation rod), and then moving the manipulator 40 away from the retractor 20 and replacing the dummy injector with a drug injector 30, it is easy to reproduce the position of the manipulator 40 relative to the retractor 20 by relying on the identifier 26. In addition, when moving the manipulator 40 a large distance in the first direction to perform multiple injections, the identifier 26 can be used to measure the distance to be moved and / or as a guide for the distance to be moved.

[0066] The manipulator 40 has a moving mechanism 46 that moves the piston 32 in the extrusion direction (up and down direction) to discharge the drug from the cylinder 31 of a syringe, which has a cylinder 31 in which a drug is contained and a piston 32 that moves inside the cylinder 31. The moving mechanism 46 has an operator 46a that can be rotated manually, a screw shaft 46b that is coupled to the operator 46a and extends parallel to the axis of the cylinder 31, and a moving body 46c that is screwed onto the screw shaft 46b and contacts the piston 32 from the opposite side of the direction of extrusion or connection to the piston 32, and moves the piston 32 in the extrusion direction when the operator 46a is rotated.

[0067] With this configuration, the piston 32 can be moved by manually rotating the operator 46a, thereby administering the drug from the syringe 30 to the spinal cord. In other words, the amount and speed of drug administration can be easily adjusted by the amount and speed of operation of the operator 46a. This simplifies the device configuration and makes operation easy, as it eliminates the need for administration speed control by an electric injection system.

[0068] Furthermore, if the dispensing device 30 is a syringe having a cylinder 31, there is no need to supply the dispensing device 30 with the drug from an external drug supply source, and there is no need to provide an external drug supply route from the external drug supply source to the dispensing device 30. As a result, dead volume caused by the external drug supply route is eliminated, and the increase in drug usage due to the external drug supply route can be suppressed. For example, if the drug is expensive, the cost related to drug administration can be suppressed by reducing drug waste, thus making the present invention more favorable to implement.

[0069] The manipulator 40 includes a first movable element 43 that is movable in a first direction in an in-plane direction parallel to the patient's body length and body width, a second movable element 44 that is movable relative to the first movable element 43 in a second direction perpendicular to the first direction in the in-plane direction, and a third movable element 45 that is movable relative to the first movable element 43 and the second movable element 44 in a third direction perpendicular to the first and second directions, respectively.

[0070] With this configuration, the position of the dispensing device 30 can be finely adjusted in three mutually orthogonal directions using the manipulator 40.

[0071] The manipulator 40 has a first movable element 43, a second movable element 44, and a third movable element 45, all made of PEEK resin, and each of its movable parts is lubrication-free.

[0072] With this configuration, the first movable element 43, the second movable element 44, and the third movable element 45 are made of PEEK resin, which reduces the weight of the manipulator 40. Furthermore, since each movable part is lubrication-free, it can be autoclaved.

[0073] In this embodiment, a configuration in which the manipulator 40 is mounted on the retractor 20 has been described, but the invention is not limited to this configuration. As shown in the first modified example in Figure 8, the manipulator 40 may be spaced apart from the retractor 20.

[0074] With this configuration, the position of the injector 30 can be easily changed by changing the position of the manipulator 40 relative to the retractor 20 while the retractor 20 remains attached to the patient's back. Furthermore, since the manipulator 40 is not mounted on the retractor 20, it can be rotated around any axis, not just in translational directions such as front / back, up / down, or left / right, thus improving the degree of freedom in changing its position relative to the retractor 20. For example, by removing the first positioning parts 41a and 41b, the injector 30 can be moved to a deeper administration position.

[0075] In this embodiment, the upper frame 47a of the guide section 47 is positioned above the upper frame 45c of the third movable element 45, and the operator 46a is positioned above the third operator 45a. However, the embodiment is not limited to this configuration. For example, as shown in the second modified example in Figure 9, the upper frame 145d of the third movable element 145 and the upper frame 47a of the guide section 47 may be positioned at the same height, and the third operator 145a may be positioned at the same height as the operator 46a.

[0076] As the height of the upper frame 145d of the frame body 145 increases, the vertical distance in the space S14 of the frame body 145 is expanded, making it easier to widen the vertical movement range of the third movable element 145. As a result, the vertical movement range L1 of the dispensing device 30 can be expanded.

[0077] In the second modified example, the frame body 145 and the guide portion 47 have side wall portions 147d that connect the frame body 145 and the guide portion 47 on both sides in the width direction, and upper wall portions 147e and lower wall portions 147f that connect the frame body 145 and the guide portion 47 at the upper and lower ends. An elongated elliptical side wall opening 147g is provided in the center of the side wall portion 147d in the vertical and front-rear directions, penetrating the side wall portion 147d in the width direction. A rectangular upper wall opening 147h is provided in the center of the upper wall portion 147e in the front-rear and width directions, penetrating the upper wall portion 147e in the vertical direction. By providing these side wall openings 147g and upper wall openings 147h, the weight increase of the manipulator 40 is suppressed.

[0078] In this embodiment, each positioning part 24 has been described as having a semi-circular cross-section when viewed in the width direction of the body, but it is not limited to this, and the cross-section when viewed in the width direction of the body may be rectangular.

[0079] In this embodiment, a configuration has been described in which each positioning portion 24 and each positioned portion 41a, 41b, 41c are elongated members that fit into grooves, but this is not limited to this configuration. The positioning portion 24 and the positioned portions 41a, 41b, 41c can be positioned in the longitudinal direction of both, and for example, the positioned portion may be a protrusion or the like.

[0080] In this embodiment, the first movable element 43, the second movable element 44, the third movable element 45, and the movable body 46c are described as being made of poly PEEK resin, but the invention is not limited to this, and any autoclavable material is acceptable, and they may be made of fluororesin such as polytetrafluoroethylene (PTFE).

[0081] In this embodiment, an example in which the retainer 50 is composed of a flexible arm has been described, but the retainer 50 only needs to have a configuration that can maintain the relative position of the manipulator 40 with respect to the retractor 20. For example, it may be a flexible arm that constitutes a brain retractor, or it may be composed of a device called an indirect fixator or a lock arm in addition to a flexible arm.

[0082] In this embodiment, the first, second, and third directions are the body length direction, body width direction, and vertical direction, respectively, and a configuration has been described in which each movable element moves in the first and second in-plane directions. However, each movable element may also be able to move in directions intersecting the first and second in-plane directions.

[0083] In this embodiment, the movable body 46c has been described as being in contact with the piston 32, but the movable body 46c may also be connected to the piston 32.

[0084] In this embodiment, an example has been described in which the injector 30 is a syringe and is directly attached to the holding part 42 of the spinal administration device 1. However, the invention is not limited to this, and the injector 30 may be a needle assembly connected to an electric pump system or the like.

[0085] Furthermore, the spinal administration device of this disclosure is not limited to the configuration of the embodiments described above, and various modifications are possible.

[0086] [Note] This disclosure includes the following aspects.

[0087] [Aspect 1] A spinal administration device comprising: a retractor attached to a cut-open opening in the patient's back to widen the opening; a manipulator that holds an injector for administering a drug to the patient's spinal cord through the opening in an adjustable position relative to the patient; and a holder that holds the manipulator in an adjustable position relative to the retractor.

[0088] [Aspect 2] The spinal administration device according to aspect 1, wherein the manipulator is mounted on the retractor.

[0089] [Aspect 3] The spinal administration device according to aspect 1 or 2, wherein the manipulator is spaced apart from the retractor.

[0090] [Aspect 4] The spinal cord administration device according to any one of aspects 1 to 3, wherein the retainer is an arm member that connects the retractor and the manipulator and can be changed between a deformable configuration and a fixed configuration that cannot be deformed.

[0091] [Aspect 5] The spinal administration device according to aspect 2, wherein the retractor has a plurality of positioning parts arranged in a first direction in an in-plane direction parallel to the length and width of the patient's body, and the manipulator has a positioned part that is positioned by one of the plurality of positioning parts.

[0092] [Aspect 6] The spinal cord administration device according to aspect 5, wherein each of the plurality of positioning portions is a groove extending in a second direction perpendicular to the first direction in the in-plane direction, and the positioned portion is an elongated member extending in the second direction, which is fitted into the groove in a third direction perpendicular to the first and second directions.

[0093] [Aspect 7] The spinal administration device according to aspect 5 or 6, wherein each of the plurality of positioning parts is assigned an identifier.

[0094] [Aspect 8] The spinal administration device according to any one of aspects 1 to 7, wherein the manipulator has a moving mechanism that moves the piston in the extrusion direction to discharge the drug from the cylinder of a syringe having a cylinder containing the drug and a piston moving within the cylinder, the moving mechanism having an operator that can be rotated manually, a screw shaft coupled to the operator and extending parallel to the axis of the cylinder, and a moving body that is screwed onto the screw shaft and is connected to the piston or in contact with it from the opposite side of the extrusion direction, and moves the piston in the extrusion direction when the operator is rotated.

[0095] [Aspect 9] The spinal administration device according to any one of aspects 1 to 8, wherein the manipulator has a first movable element that is movable in a first direction in an in-plane direction parallel to the length and width of the patient's body, a second movable element that is movable relative to the first movable element in a second direction perpendicular to the first direction in the in-plane direction, and a third movable element that is movable relative to the first and second movable elements in a third direction perpendicular to the first and second directions, respectively.

[0096] [Aspect 10] The spinal cord administration device according to aspect 9, wherein the manipulator has a first mobile element, a second mobile element, and a third mobile element, each made of PEEK resin, and each movable part is lubrication-free.

[0097] 9 Patient's back 91 Opening 20 Retractor 30 Injector 40 Manipulator 50 Holder 1 Spinal administration device 24 Multiple positioning parts 41a First positioned part (front positioned part) 41b First positioned part (rear positioned part) 26 Identifier 31 Cylinder 32 Piston 46 Moving mechanism 46a Operator 46b Screw shaft 46c Moving body 43 First moving part 44 Second moving part 45 Third moving part

Claims

1. A spinal administration device comprising: a retractor attached to a cut-out opening in the patient's back to widen the opening; a manipulator that holds an injector for administering a drug to the patient's spinal cord through the opening in an adjustable position relative to the patient; and a holder that holds the manipulator in an adjustable position relative to the retractor.

2. The spinal administration device according to claim 1, wherein the manipulator is mounted on the retractor.

3. The spinal administration device according to claim 1 or 2, wherein the manipulator is spaced apart from the retractor.

4. The spinal cord administration device according to any one of claims 1 to 3, wherein the retainer is an arm member that connects the retractor and the manipulator and can be changed between a deformable configuration and a fixed configuration that cannot be deformed.

5. The spinal administration device according to claim 2, wherein the retractor has a plurality of positioning parts arranged in a first direction in an in-plane direction parallel to the length and width directions of the patient's body, and the manipulator has a positioned part that is positioned by one of the plurality of positioning parts.

6. The spinal cord administration device according to claim 5, wherein each of the plurality of positioning portions is a groove extending in a second direction perpendicular to the first direction in the in-plane direction, and the positioned portion is an elongated member extending in the second direction, which is fitted into the groove in a third direction perpendicular to the first and second directions.

7. The spinal delivery device according to claim 5 or 6, wherein each of the plurality of positioning parts is assigned an identifier.

8. The spinal administration device according to any one of claims 1 to 7, wherein the manipulator has a moving mechanism that moves the piston in the extrusion direction to cause the drug to be discharged from the cylinder of a syringe having a cylinder containing the drug and a piston moving within the cylinder, the moving mechanism comprising: an operator that can be rotated manually; a screw shaft coupled to the operator and extending parallel to the axis of the cylinder; and a moving body screwed onto the screw shaft and connected to the piston or in contact with it from the opposite side of the extrusion direction, and moves the piston in the extrusion direction when the operator is rotated.

9. The spinal administration device according to any one of claims 1 to 8, wherein the manipulator has a first movable element that is movable in a first direction in an in-plane direction parallel to the length and width of the patient's body, a second movable element that is movable relative to the first movable element in a second direction perpendicular to the first direction in the in-plane direction, and a third movable element that is movable relative to the first and second movable elements in a third direction perpendicular to the first and second directions, respectively.

10. The spinal cord administration device according to claim 9, wherein the manipulator has a first movable element, a second movable element, and a third movable element, each made of PEEK resin, and each movable part is lubrication-free.

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