CN118203400B - Traction resetting device - Google Patents
Traction resetting device Download PDFInfo
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- CN118203400B CN118203400B CN202410620920.7A CN202410620920A CN118203400B CN 118203400 B CN118203400 B CN 118203400B CN 202410620920 A CN202410620920 A CN 202410620920A CN 118203400 B CN118203400 B CN 118203400B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8866—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices for gripping or pushing bones, e.g. approximators
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B2017/681—Alignment, compression, or distraction mechanisms
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Abstract
本发明属于医用器械技术领域，特别涉及一种引导头和牵拉复位装置；其中，引导头括连接部和预弯曲部；预弯曲部呈“J”字形结构，预弯曲部在变形后能够逐渐恢复原状；连接部设置在预弯曲部的尾端，用于连接钛缆。本发明提供的引导头中的预弯曲部在变形后能够自动的逐渐恢复至初始形状，在手术过程中，术者可以向预弯曲部施加外力使其变直，然后将引导头的头端依次由后弓下缘、后弓前缘以及后弓上缘的路径穿过后弓与脊髓之间的间隙，在穿插的过程中，预弯曲部会逐渐恢复至预弯曲的形状，使得该引导头的头端始终保持与后弓紧贴的状态，避免引导头碰触脊髓的情况发生，以降低该引导头压迫脊髓的风险和手术难度，直至预弯曲部的头端从上缘穿出。
The present invention belongs to the technical field of medical instruments, and particularly relates to a guide head and a traction and resetting device; wherein the guide head includes a connecting portion and a pre-bending portion; the pre-bending portion is in a "J"-shaped structure, and the pre-bending portion can gradually return to its original shape after deformation; the connecting portion is arranged at the tail end of the pre-bending portion, and is used to connect a titanium cable. The pre-bending portion in the guide head provided by the present invention can automatically and gradually return to its initial shape after deformation. During the operation, the surgeon can apply external force to the pre-bending portion to make it straight, and then pass the head end of the guide head through the gap between the posterior arch and the spinal cord in sequence along the path of the lower edge of the posterior arch, the front edge of the posterior arch, and the upper edge of the posterior arch. During the insertion process, the pre-bending portion will gradually return to the pre-bending shape, so that the head end of the guide head always remains in a state of being in close contact with the posterior arch, avoiding the occurrence of the guide head touching the spinal cord, so as to reduce the risk of the guide head compressing the spinal cord and the difficulty of the operation, until the head end of the pre-bending portion passes through the upper edge.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a guide head and a traction resetting device.
Background
About 10% -15% of cervical vertebra injuries are combined with odontoid process fracture, and most of odontoid process fracture is not accompanied with spinal cord injury, so symptoms are not obvious, missing diagnosis is often caused, and the fracture cannot heal and evolves into old fracture. The persistent existence of the old fracture causes the instability of the atlantoaxial, gradually causes the dislocation of the atlantoaxial difficult to restore and the compression of cervical spinal marrow with different degrees, and can endanger life when serious. Therefore, old odontoid fracture with atlantoaxial dislocation should be actively treated with surgery to relieve compression and simultaneously reestablish stability.
The cantilever beam supporting cable traction reduction fixation fusion is an operation mode for treating old odontoid process fracture with atlantoaxial dislocation, and has good intraoperative reduction capability for atlantoaxial dislocation. One of the core operation steps of the method is to separate the upper and lower edges of the posterior atlas arch, pass through the anterior edge of the posterior atlas arch by using hook-shaped stripper, pass through the posterior atlas arch by using a pre-bent shapable metal guide wire, and connect a titanium cable at the rear end of the guide wire, so that the posterior atlas arch can be suspended on a U-shaped arm; when the guide wire passes through the rear arch, the guide wire is closer to the spinal cord, so that the risk is higher, and high requirements are put on the bending degree of the guide wire and the operation technology of an operator.
The distance between the front edge of the posterior arch of the atlas and the cervical spinal cord is relatively close, and the clearance between the front edge of the posterior arch of the atlas and the cervical spinal cord is relatively small. Ideally, the guide wire should be bent into a semi-circular arc with a proper radius, and the operator holds the head end slightly behind, and carefully starts the guide wire from the lower edge of the rear arch, passes through the front edge and finally passes out from the upper edge through the action of rotation (rotation along the circumferential direction of the rear arch), so that the whole penetration path clings to the rear arch and is completely positioned in the gap between the rear arch and the spinal cord. On the one hand, the proper bending degree of the guide wire is critical, and if the guide wire is not sufficiently bent and has overlarge radius, the guide wire can irritate the spinal cord and cause further damage when passing through the rear arch; if the bending is excessive and the radius is too small, the patient can not pass through the rear arch easily, and the purpose of operation can not be achieved; on the other hand, if the skill level of the operator is insufficient, the guide wire cannot be clung to the rear arch when rotating, and the guide wire can press the spinal cord, so that the spinal cord is stimulated and damaged. In addition, the shape and thickness of the atlas posterior arch are different from person to person, so that the most appropriate bending degree and rotation angle can be obtained by repeated attempts in the operation, and the risk of accidental injury to a patient in the attempt process is high.
Therefore, the invention provides a traction resetting device capable of effectively reducing the penetration risk, which is a technical problem to be solved by the person skilled in the art.
Disclosure of Invention
The invention provides a guide head, which aims to solve the technical problems that the guide wire in the prior art has higher technical difficulty when passing through a gap between a rear arch and a spinal cord, and the risk of accidental injury to a patient in the operation process is higher.
The invention is realized by the following scheme:
a guide head comprising a connecting portion and a pre-bending portion;
the pre-bending part is in a J-shaped structure, and can gradually recover the original shape after being deformed;
The connecting part is arranged at the tail end of the pre-bending part and is used for connecting a titanium cable.
In order to better implement the present invention, a further optimization is made in the above structure, the pre-bent portion being made of a memory alloy.
In addition, the invention also provides a traction resetting device which comprises a titanium cable and the guide head;
The connecting part in the guide head is connected with the end part of the titanium cable; and applying an external force to the pre-bend Qu Bushi in the guide head to straighten the pre-bend part, extending one end of the pre-bend Qu Bu away from the connecting part from the lower edge of the rear arch into a gap between the rear arch and the spinal cord, and gradually restoring the pre-bend part to enable the concave side of the pre-bend part to be tightly attached to the rear arch until one end of the pre-bend Qu Bu away from the connecting part is penetrated out from the upper edge of the rear arch.
In order to better realize the invention, the structure is further optimized, and a positioning part for positioning the bending direction of the pre-bending part is arranged at one end of the titanium cable away from the connecting part.
In order to better realize the invention, in the structure, the positioning part is a positioning plane, the positioning plane is arranged on the circumferential side wall of the titanium cable, and the positioning plane is perpendicular to the plane where the pre-bending part is arranged.
In order to better realize the invention, the structure is further optimized, and the positioning part comprises a positioning groove and a positioning plate;
The positioning groove is formed in the titanium cable, and the extending direction of the positioning groove is parallel to the axis of the titanium cable;
The middle part of locating plate is provided with the perforation, perforation department be provided with the location arch of constant head tank matching, works as the locating plate passes through the perforation cover is established on the titanium cable, just the location arch card is established in the constant head tank, the locating plate with the plane at the bending portion in advance is perpendicular.
Compared with the prior art, the invention has the following beneficial effects:
the pre-bending part in the guide head can automatically and gradually restore to the initial shape after deformation, in the operation process, an operator can apply external force to the pre-bending part Qu Bushi to straighten the pre-bending part, then the head end of the guide head sequentially passes through a gap between the rear arch and the spinal cord from the paths of the lower edge of the rear arch, the front edge of the rear arch and the upper edge of the rear arch, in the penetration process, the pre-bending part can gradually restore to the pre-bending shape, so that the head end of the guide head always keeps a state of being clung to the rear arch, and the condition that the guide head touches the spinal cord is avoided, so that the risk of the guide head pressing the spinal cord and the operation difficulty are reduced, and the head end of the pre-bending part passes out from the upper edge.
Drawings
In order to more clearly illustrate the embodiments of the invention or the technical solutions in the prior art, the drawings that are required in the embodiments or the description of the prior art will be briefly described, it being obvious that the drawings in the following description are only some embodiments of the invention, and that other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
FIG. 1 is a schematic view of a guide head according to the present invention;
FIG. 2 is a schematic diagram of a traction reduction device according to the present invention;
FIG. 3 is a top view of FIG. 2;
Fig. 4 is a schematic view of a traction reduction device according to the present invention in use.
In the figure:
1. A pre-bending portion;
2. A connection part;
3. A titanium cable;
4. And a positioning part.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the technical solutions of the present invention will be described in detail below. It will be apparent that the described embodiments are only some, but not all, embodiments of the invention. All other embodiments, based on the examples herein, which are within the scope of the invention as defined by the claims, will be within the scope of the invention as defined by the claims.
In the description of the present invention, it is to be noted that, unless otherwise indicated, the meaning of "plurality" means two or more; the terms "upper", "lower", "left", "right", "inner", "outer", "front", "rear", "head", "tail", etc., refer to an orientation or positional relationship based on that shown in the drawings, and are merely for convenience in describing the present invention and simplifying the description, and do not indicate or imply that the apparatus or elements referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore should not be construed as limiting the present invention. Furthermore, the terms "first," "second," "third," and the like are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
In the description of the present invention, it should also be noted that, unless explicitly specified and limited otherwise, the terms "mounted", "connected" and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected or integrally connected; can be mechanically or electrically connected; can be directly connected or indirectly connected through an intermediate medium. The specific meaning of the above terms in the present invention can be understood as appropriate by those of ordinary skill in the art.
Examples
A guide head comprising a connecting portion 2 and a pre-bent portion 1, see fig. 1; wherein,
The pre-bending part 1 is in a J-shaped structure, and the pre-bending part 1 can gradually recover to be in an original shape after being deformed (the J-shaped structure);
the connecting part 2 is arranged at the tail end of the pre-bending part 1 and is used for connecting the titanium cable 3, and the connecting part 2 and the pre-bending part 1 are integrated into a whole.
The pre-bending part 1 in the guide head can automatically and gradually restore to the initial shape after deformation, in the operation process, an operator can apply external force to the pre-bending part 1 to straighten the pre-bending part, then the head end of the guide head sequentially passes through a gap between the rear arch and the spinal cord from the paths of the lower edge of the rear arch, the front edge of the rear arch and the upper edge of the rear arch, in the insertion process, the pre-bending part 1 can gradually restore to the pre-bending shape, the operator only needs to slowly send the pre-bending part 1 into the gap between the rear arch and the spinal cord, the head end of the guide head can always keep a state of being clung to the rear arch and pass out from the upper edge of the rear arch, the condition that the guide head touches the spinal cord is avoided, and the risk of the guide head pressing the spinal cord and the operation difficulty are reduced; when the head end of the pre-bending part 1 passes out from the upper edge of the rear arch, an operator can clamp the head end of the pre-bending part 1 by using an instrument, and pull and guide the titanium cable 3 connected to the connecting part 2 to pass through the rear arch, so that the atlas rear arch can be suspended on the U-shaped arm.
It should be noted that, the pre-bending portion 1 is made of a memory alloy, so that the pre-bending portion 1 can automatically return to an original state after being deformed under stress, so that the head end of the pre-bending portion 1 in the guiding head can be clung to the rear arch when penetrating the gap between the rear arch and the spinal cord, the spinal cord is prevented from being pressed by the pre-bending portion 1, and the risk of traction, reduction, fixation and fusion of the cantilever beam supporting cable is effectively reduced.
Examples
A traction reduction device comprising a titanium cable 3 and a guide head as described in example 1, see fig. 2 and 3; wherein,
The connecting part 2 in the guide head is connected with the end part of the titanium cable 3, and is fixedly connected in a welding way; the pre-bending part 1 in the guide head is applied with an external force to straighten the pre-bending part 1, one end of the pre-bending part 1 far away from the connecting part 2 is extended into a gap between the rear arch and the spinal cord from the lower edge of the rear arch, the pre-bending part 1 gradually returns to the original state, the concave side (inwards bent side) of the pre-bending part 1 is tightly attached to the rear arch until one end (head end) of the pre-bending part 1 far away from the connecting part 2 is penetrated out from the upper edge of the rear arch.
In the operation process, an operator can apply external force to the pre-bending part 1 in the guiding head to straighten the pre-bending part, and penetrate the head end of the pre-bending part 1 from the lower edge of the atlas to the upper edge of the bone surface, in the penetrating process, the pre-bending part 1 gradually recovers to the pre-bending (initial state) shape, so that the head end of the pre-bending part 1 can always keep a close state with the posterior arch, see fig. 4, until the head end of the pre-bending part 1 penetrates out from the upper edge of the posterior arch, namely, after the head end of the pre-bending part 1 is seen from the upper edge of the atlas, the head end of the pre-bending part 1 is clamped by an instrument and is slowly pulled out for standby, and the other traction and reduction device is pulled through the posterior arch of the contralateral atlas in the same way.
The test bar is pre-bent into an inverted U shape, the top end is just flush with the upper edge of the atlas posterior arch, and the width of the test bar is suitable for placing two sides into the tail end groove of a C2/3 side block screw (which is driven in front of the insertion guide head). And trimming the connecting rod according to the length of the test mould rod and pre-bending the connecting rod into an inverted U-shaped connecting rod with the same size and shape. C2/3 screws are put into the pre-bent U-shaped connecting rod and nuts are screwed down, so that a cantilever beam capable of providing a lifting force point is formed.
The traction and reduction device sleeved on the posterior arch of the atlas passes through the cantilever beam, passes through the tail end locker, is sleeved with a special cable lifting and tightening device on two sides, slowly lifts and draws the titanium cable 3 in the traction and reduction device to reposition the atlas dislocation at a point in a left-right alternating manner, the posterior arch is close to the cantilever Liang Gongshi, and the lifting amplitude of the traction and reduction device is readjusted under X-ray machine perspective according to the reposition degree. Finally, after the reduction of the atlas dislocation is satisfied, the locker clamps and locks the cable tail end fixing clamp, and redundant cables are cut off, so that the fixation of the atlas posterior arch is completed.
In this embodiment, the whole process of the traction, reduction and fixation fusion of the cantilever beam support cable is not described, and only the penetration and fixation modes of the traction, reduction and fixation device in the traction, reduction and fixation fusion process of the cantilever beam support cable are described, and other preparation work and ending work are identical to those of the traction, reduction and fixation fusion of the cantilever beam support cable in the prior art.
This tractive resetting means when using, can avoid the compression spinal cord of pre-bending portion 1 to the effectual reduction cantilever beam supports the risk of fixed fusion art that resets of cable tractive, simultaneously, reduced the cantilever beam and supported the degree of difficulty of fixed fusion art that resets of cable tractive, make operation process simpler, safe.
Preferably, the shape of the pre-bending part 1 can be customized individually according to the size data of the posterior arch of the atlas of the patient, so that the fitting degree of the pre-bending part 1 and the posterior arch is ensured to the maximum extent, the operation can be performed more smoothly, and the operation risk is reduced.
The shape of the pre-bent portion 1 is customized as follows:
Three-dimensional modeling is carried out on the atlas posterior arch of a patient through cervical vertebra CT before operation, then the position where the pre-bending part 1 is to be inserted in the operation is planned, and a molding die is designed according to the section shape of the atlas posterior arch at the position;
The shaping mold is a U-shaped groove, the width of the groove is equal to the bending diameter of the pre-bending part 1, the groove bottom wall is flat, the shape of the inner side wall is the same as the profile of the section of the rear arch, the shape of the outer side wall is similar to the profile of the section and is amplified to a certain extent, so that a gap is not reserved between the pre-bending part 1 and the inner side wall of the shaping mold when the pre-bending part 1 is pressed into the groove of the shaping mold;
printing a U-shaped groove by using a 3D printing technology, pressing the pre-bending part 1 into the groove of the molding die, heating the U-shaped groove and the pre-bending part 1 together to a high temperature and maintaining for a certain time to shape the pre-bending part 1, cooling, taking out the pre-bending part 1, and completing the shaping of the pre-bending part 1.
Optimally, one end of the titanium cable 3 far away from the connecting part 2 is provided with a positioning part 4 for positioning the bending direction of the pre-bending part 1, so that an operator can know the bending direction of the pre-bending part 1 through the position of the positioning part 4 in the operation process, and the operation is simpler and smoother.
Preferably, the positioning portion 4 is a positioning plane, the positioning plane is disposed on a circumferential side wall of the titanium cable 3, and the positioning plane is perpendicular to the plane of the pre-bending portion 1.
During the operation, the operator can touch the positioning plane with a finger to determine the bending direction of the pre-bending part 1, so that the operation can be performed more smoothly.
In addition, the present embodiment also provides another structure of the positioning portion 4, the positioning portion 4 including a positioning groove and a positioning plate; wherein,
The positioning groove is formed in the titanium cable 3, and the extending direction of the positioning groove is parallel to the axis of the titanium cable 3;
the middle part of the positioning plate is provided with a perforation, a positioning bulge matched with the positioning groove is arranged at the perforation, and when the positioning plate is sleeved on the titanium cable 3 through the perforation and the positioning bulge is clamped in the positioning groove, the positioning plate is vertical to the plane where the pre-bending part 1 is arranged;
When the traction resetting device is inserted, an operator can determine the bending direction of the pre-bending part 1 through the positioning plate so as to enable the operation to be carried out more smoothly, and after the insertion is completed, the operator can take down the positioning plate from the titanium cable 3 so as to be convenient for carrying out subsequent positioning and fixing work.
Preferably, the positioning plate is provided with a positioning mark, and the positioning mark is located on one surface of the positioning plate facing the bending direction of the pre-bending portion 1, so that an operator can more conveniently know the bending direction of the pre-bending portion 1.
The foregoing is merely illustrative of the present invention, and the present invention is not limited thereto, and any person skilled in the art will readily recognize that variations or substitutions are within the scope of the present invention. Therefore, the protection scope of the present invention shall be subject to the protection scope of the claims.
Claims (4)
1. A traction reduction device, characterized in that: comprises a titanium cable (3) and a guide head;
The guide head comprises a connecting part (2) and a pre-bending part (1); the pre-bending part (1) is in a J-shaped structure, and the pre-bending part (1) can be gradually restored to the original state after being deformed; the connecting part (2) is arranged at the tail end of the pre-bending part (1) and is used for connecting a titanium cable (3); the pre-bending part (1) is made of memory alloy;
The connecting part (2) is connected with the end part of the titanium cable (3); external force is applied to the pre-bending part (1) to straighten the pre-bending part (1), one end of the pre-bending part (1) away from the connecting part (2) stretches into a gap between the atlas posterior arch and the spinal cord from the lower edge of the atlas posterior arch, the pre-bending part (1) gradually returns to the original state, the concave side of the pre-bending part (1) is tightly attached to the atlas posterior arch, and one end of the pre-bending part (1) away from the connecting part (2) can be penetrated out from the upper edge of the posterior arch.
2. The pull-reset device of claim 1 wherein: one end of the titanium cable (3) far away from the connecting part (2) is provided with a positioning part (4) for positioning the bending direction of the pre-bending part (1).
3. The pull-reset device of claim 2, wherein: the positioning part (4) is a positioning plane, the positioning plane is arranged on the circumferential side wall of the titanium cable (3), and the positioning plane is perpendicular to the plane where the pre-bending part (1) is located.
4. The pull-reset device of claim 2, wherein: the positioning part (4) comprises a positioning groove and a positioning plate;
The positioning groove is formed in the titanium cable (3), and the extending direction of the positioning groove is parallel to the axis of the titanium cable (3);
A perforation is arranged in the middle of the positioning plate, and a positioning protrusion matched with the positioning groove is arranged at the perforation; when the locating plate is sleeved on the titanium cable (3) through the through hole and the locating protrusion is clamped in the locating groove, the locating plate is perpendicular to the plane where the pre-bending part (1) is located.
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| CN202410620920.7A CN118203400B (en) | 2024-05-20 | 2024-05-20 | Traction resetting device |
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| CN106691626A (en) * | 2015-11-16 | 2017-05-24 | 先健科技(深圳)有限公司 | Lung volume reduction elastic implant and lung volume reduction instrument |
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| CN118203400A (en) | 2024-06-18 |
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