Laminar Osteotomy Guard for Spinal Decompression
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Solution Overview
Problem
Current surgical methods for spinal stenosis, such as laminectomy and laminoplasty, are invasive and carry risks of damaging neuronal elements, particularly in the cervical and thoracic spine, where existing techniques are not accurately or safely applicable.
Innovation Solution
A device and method for performing laminar osteotomy and laminoplasty in the sagittal or oblique sagittal plane, using a guard to protect neuronal elements and guide bone division, with image guidance from CT, MRI, or fluoroscopy, allowing precise division and stabilization of the lamina to prevent anterior translation of divided posterior elements.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional open surgical procedures (laminectomy/laminoplasty) are used to decompress the spinal canal, then the spinal canal space is enlarged and pressure on neuronal elements is relieved, but the surgery is invasive with extensive recovery times, increased costs, and higher risks of complications
Solution Approach 1:
The procedure segments the lamina into divided portions through precise osteotomy, allowing the posterior elements to be separated and spread apart to create decompression space while maintaining control over each segment's position and orientation
Solution Approach 2:
A guard device is introduced as an intermediary between the cutting instrument and the neuronal elements. The guard protects the spinal cord and nerve roots during the osteotomy procedure, enabling safer minimally invasive surgery by preventing direct contact between surgical tools and vulnerable neural structures
2Volume of stationary object
If the lamina is divided and spread apart to enlarge the spinal canal, then more space is created for neuronal elements, but the divided posterior elements may translate anteriorly causing instability
Solution Approach 1:
The guard device is placed in position before the osteotomy is performed, establishing a protective barrier and guide for the cutting instrument. This preliminary positioning ensures that the division occurs at the correct location and orientation while protecting vulnerable structures throughout the procedure
Solution Approach 2:
The procedure changes the spatial parameters of the posterior elements by dividing the lamina and spreading the divided portions apart in the lateral direction, thereby increasing the transverse diameter of the spinal canal while maintaining vertical stability through the hinge mechanism
3Productivity
If existing techniques are used for cervical and thoracic spine stenosis, then decompression can be achieved, but the risk of damaging neuronal elements is high due to lack of accurate guidance
Solution Approach 1:
The procedure replaces traditional open mechanical exposure with a guided minimally invasive approach. Image guidance technology (fluoroscopy, CT, or MRI) substitutes for direct visual exposure, allowing precise navigation to the target lamina while the guard device provides mechanical protection during the cutting process
Solution Approach 2:
Image guidance provides real-time feedback during the procedure, allowing the surgeon to verify the position of the guard device and cutting instrument relative to the spinal anatomy. This feedback loop enables accurate positioning and immediate correction if misalignment is detected, enhancing safety
Data Source
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AI summary
This invention relates to a technique for performing laminar osteotomy (dividing of the spinal lamina, a posterior structure of vertebra). The term osteotomy is derived from os (bone), tomy (to cut or remove), and laminoplasty (the reshaping of the lamina). This technique can be performed with or without visual assistance such as cameras used with endoscopy, or image guidance such as fluoroscopy, computer tomography (CT) or magnetic resonance imaging (MRI).