Limit pressure individuation adjusts cavity elasticity passageway screw circuit breaker
Technical Field
The invention belongs to the field of orthopedic surgery instruments, relates to a channel screw circuit breaker, and particularly relates to a hollow elastic channel screw circuit breaker with individualized adjustment of extreme pressure.
Background
The opening device is a necessary tool for carrying out the internal fixation operation of the vertebral pedicle screw of the spine and is used for opening a screw channel which can be driven into the vertebral pedicle screw in cancellous bone; in the process of opening the nail path by using the opener, a doctor needs to carefully control the opening depth, force and direction, and position and adjust the opening depth and direction by adopting a C-shaped arm X-ray machine for fluoroscopy for many times in the operation process.
At present, when the existing pedicle screw is placed with a screw, the used open circuit device is made of solid hard material, and the prior art has the following defects:
1. the existing circuit breaker is not easy to adjust the direction of a nail path when in use;
2. the existing circuit breaker can not accurately control the propelling force, the circuit breaker can not advance when the force is insufficient, and cortex lycii can be broken through when the force is too large, so that the safety of a patient is damaged;
3. because the hardness difference of cortical bone and cancellous bone of each individual is very large, the propulsive force must be accurately adjusted in time according to the bone hardness of different patients, so that the use of the existing channel opener requires a doctor to strictly control the propulsive force, the propulsive force requires the orthopaedics doctor to learn and grope for a long time to realize certain hand feeling, the iatrogenic injury of the patients is very easy to cause in the learning and groping processes, all in all, the existing channel opener is extremely inconvenient to use, has extremely high technical requirements on the doctor, and increases the learning difficulty and the operation risk of the doctor;
4. the existing circuit breaker is not easy to detect whether the open rod breaks through the cortex lycii in time;
5. the existing opener is easy to break through the inner side wall, the outer side wall or the front wall of the vertebral pedicle when the nail feeding point and the angle are deviated and anatomical deformity or anatomical variation exists, so that the injury of the spinal cord, the nerve, the blood vessel or the viscera, even the consequence endangering the life is caused;
6. the existing circuit breaker can not extract a bone sample from the front end of a nail channel or inject a medicament into the front end of the channel;
7. the existing opener also lacks protective control on the propelling force and direction of opening of various channel screws such as sacroiliac joint screws, femoral neck hollow nails, acetabulum anterior column screws, acetabulum posterior column screws and the like.
Disclosure of Invention
According to the limit pressure individualized adjustment hollow elastic channel screw circuit breaker provided by the invention, the limit pressure of the circuit breaker rod is accurately adjusted through the pressure adjustment component, and the probe probes whether the top end of the circuit breaker rod breaks through cortical bone, so that the problems that the limit pressure of the circuit breaker cannot be accurately controlled and the condition of the top end of the circuit breaker rod cannot be probed are solved.
The technical scheme adopted by the invention is as follows:
limit pressure individuation adjusts cavity elasticity passageway screw circuit breaker, includes:
the handle is internally provided with a hollow cavity along the axial direction, the side wall of the handle is provided with axially symmetrical adjusting grooves from bottom to top, the top end of the handle is provided with a limiting opening, and the open circuit rod extends out of the limiting opening and is limited to move forwards continuously;
a pressure regulating member including a hollow conduit, a regulating member, and a spring; the hollow guide pipe is arranged in the hollow cavity of the handle, one end of the adjusting piece is connected with the hollow guide pipe, and the other end of the adjusting piece extends outwards from the adjusting groove to the outer side of the handle; the spring is coiled on the outer surface of the hollow guide pipe, the bottom of the spring is connected with the adjusting piece, the hollow guide pipe can limit the left and right bending of the spring, the adjusting piece slides back and forth along the hollow guide pipe, the spring is compressed to generate elasticity, and the spring generates pressure on the open circuit rod, so that the aim of adjusting the limit pressure of the spring on the open circuit rod is fulfilled;
the open circuit rod is of a long strip tubular structure, and the interior of the open circuit rod is designed to be hollow; the open circuit rod is arranged above the hollow catheter and extends upwards from the hollow cavity of the handle to the position above the handle; a conduit channel matched with the outer diameter of the hollow conduit is formed in the lower inner part of the open circuit rod, and the open circuit rod can slide back and forth along the hollow conduit through the conduit channel;
and the probe penetrates through the hollow catheter and the inside of the open circuit rod from the lower part of the handle and is used for probing whether the top end of the open circuit rod breaks through cortical bone.
Furthermore, the lower part of the hollow cavity is designed into a cylindrical cavity, the upper part of the hollow cavity is designed into a prismatic cavity, the lower part of the open circuit rod is designed into a prismatic structure matched with the prismatic cavity, the prismatic structure is limited to rotate in the prismatic cavity and only can slide, and when the prismatic structure retracts into the cylindrical cavity, the prismatic structure can rotate freely.
Furthermore, the digital scales are arranged on the handle along the direction of the adjusting groove, so that the pressure of the spring on the open circuit rod can be observed conveniently.
Furthermore, the adjusting part comprises a sliding block and an adjusting bolt, one end of the sliding block is connected with the hollow guide pipe, the other end of the sliding block can move up and down along the adjusting groove to adjust the initial length of the spring, and the adjusting bolt is used for locking the sliding block on the handle.
Further, the top end of the spring abuts against the bottom of the open circuit rod.
Further, the sliders are distributed in axial symmetry.
Further, the limiting opening at the top end of the handle is a tubular opening, the outer diameter of the middle of the open circuit rod is matched with the inner diameter of the tubular opening, the middle of the open circuit rod is supported by the tubular opening, and the open circuit rod can be prevented from shaking left and right when in use.
Furthermore, the top end of the open circuit rod is designed to be in a bevel point-shaped structure, so that the top end of the open circuit rod can be inserted into cancellous bone.
Furthermore, the outer surface of the open circuit rod is provided with a depth scale mark for measuring the depth of the open nail channel.
Furthermore, a conduit channel matched with the outer diameter of the hollow conduit is arranged in the lower inner part of the open circuit rod, and a probe channel matched with the outer diameter of the probe is arranged in the upper inner part of the open circuit rod; the inside of the hollow catheter is provided with a probe channel matched with the outer diameter of the probe.
The invention has the beneficial effects that:
1. the invention has simple structure, convenient use and easy operation;
2. if the probe adopts a handle-free long probe, the channel opener can be used for keeping the probe in the nail channel and replacing instruments such as channel openers or hollow drills with different diameters, and a needle tube can be inserted to extract a bone sample or inject a medicament to the front end of the channel;
3. when the nail path adjusting device is used, the direction of the nail path can be adjusted by rotating the handle and changing the opening direction of the top end of the open circuit rod;
4. the pressure at the top end of the open circuit rod is adjusted by the pressure adjusting component, so that the proper individualized propulsion force limit can be accurately adjusted according to the bone of different people, and the top end of the open circuit rod is prevented from breaking through cortical bone, so that the aim of protecting the safety of a patient is fulfilled;
5. the invention has good protective control on the propulsion force and direction of various open-circuit channel screws such as sacroiliac joint screws, femoral neck hollow screws, acetabulum anterior column screws, acetabulum posterior column screws and the like;
6. the invention adopts the all stainless steel material, is convenient for disinfection and use, and can not generate scraps in the using process;
7. the invention arranges the digital scale on the handle, which is beneficial to accurately controlling the use pressure.
Drawings
FIG. 1 is a schematic cross-sectional view of a handle and pressure adjustment member of the present invention;
FIG. 2 is a schematic cross-sectional view of the open bar of the present invention;
FIG. 3 is a schematic cross-sectional view of the present invention;
FIG. 4 is a schematic structural view of the present invention;
FIG. 5 is a view of the present invention in use in an open vertebral circuit;
fig. 6 is a diagram showing the open pelvic bone using state of the present invention.
In the figure: 1. a handle; 2. a cylindrical cavity; 3. an adjustment groove; 4. a prismatic cavity; 5. a tubular opening; 6. a hollow conduit; 7. a spring; 8. a slider; 9. adjusting the bolt; 10. a probe channel; 11. an open lever; 12. a prismatic structure; 13. a conduit channel; 14. the middle part of the open circuit rod; 15. a bevel pointed structure; 16. A probe; 17. depth scale lines; 18. digital scales; 19. the superior articular process; 20. a vertebral body; 21. a pedicle of a vertebral arch; 22. transverse process; 23. a vertebral foramen; 24. a spinous process; 25. a vertebral arch plate; 26. ischial tuberosity; 27. closing the pores; 28. an acetabulum; 29. a pubic comb; 30. the iliac fossa; 31. a hip bone; 32. a sacrum; 33. the coccyx.
Detailed Description
In order to better understand the technical content of the invention, specific embodiments are provided below, and the invention is further described with reference to the accompanying drawings.
As shown in fig. 1, 2, 3 and 4, in the limiting pressure individualized adjustment hollow elastic channel screw open-circuit device provided by the invention, a hollow cavity is axially arranged inside a handle 1, the lower part of the hollow cavity is designed to be a cylindrical cavity 2, the upper part of the hollow cavity is designed to be a prismatic cavity 4, an axisymmetric adjustment groove 3 is arranged on the side wall from bottom to top, a digital scale 18 is arranged on the handle 1 along the direction of the adjustment groove 3, so that the pressure of a spring 7 on an open-circuit rod 11 can be observed conveniently, a limit opening is arranged at the top end of the handle 1, the limit opening at the top end of the handle 1 is a tubular opening 5, the open-circuit rod 11 extends out of the tubular opening 5 and is limited to move forwards continuously, the outer diameter of the middle part 14 of the open-circuit rod is matched with the inner diameter of the tubular opening 5, and the. The pressure regulating member comprises a hollow conduit 6, a regulating member and a spring 7; the hollow guide pipe 5 is arranged in a hollow cavity of the handle 1, a probe channel 10 matched with the outer diameter of a probe 16 is formed in the hollow guide pipe 6, one end of an adjusting piece is connected with the hollow guide pipe 6, the other end of the adjusting piece extends outwards from the adjusting groove 3 to the outer side of the handle 1, the adjusting piece comprises sliding blocks 8 and adjusting bolts 9, the sliding blocks 8 are distributed in an axial symmetry mode, one end of each sliding block 8 is connected with the hollow guide pipe 6, the other end of each sliding block 8 can move up and down along the adjusting groove 3, and the adjusting bolts 9 are used for locking the sliding blocks 8; the spring 7 is coiled on the outer surface of the hollow guide pipe 6, the bottom of the spring 7 is connected with the adjusting part, the hollow guide pipe 6 can limit the spring 7 to bend left and right, the adjusting part moves back and forth along the hollow guide pipe 6, the spring 7 is compressed to generate elasticity, and the spring 7 generates pressure on the open circuit rod 11, so that the aim of adjusting the limit pressure of the spring 7 on the open circuit rod 11 is fulfilled. The open circuit rod 11 is in a strip tubular structure, the lower part of the open circuit rod 11 is designed to be in a prismatic structure 12 matched with the prismatic cavity 4, the prismatic structure 12 is limited to rotate in the prismatic cavity 4 and only can slide, when the prismatic structure 12 retracts into the cylindrical cavity 2, the prismatic structure 12 can rotate freely, and the interior of the open circuit rod 11 is designed to be hollow; the open circuit rod 11 is arranged above the hollow catheter 6 and extends upwards from the hollow cavity of the handle 1 to the upper part of the handle 1; the lower inner part of the open circuit rod 11 is provided with a conduit channel 13 matched with the outer diameter of the hollow conduit 6, the open circuit rod 11 can slide back and forth along the hollow conduit 6 by the conduit channel 13, the upper inner part is provided with a probe channel 10 matched with the outer diameter of a probe 16, the top end of the open circuit rod 11 is designed to be a bevel tip-shaped structure 15, the top end of the open circuit rod 11 can be inserted into cancellous bone, and the outer surface of the open circuit rod 11 is provided with a depth scale mark 17 for measuring the depth of an open nail channel. A probe 16 is passed through the hollow catheter 6 and the inside of the open rod 11 from below the handle 1 to investigate whether the tip of the open rod 11 breaks through cortical bone.
The use mode of the invention is as follows:
the pressure limit of the circuit breaker is divided into various specifications; firstly, a pointed cone is used for opening at a nail feeding point, the diameter of the opening is slightly larger than the outer diameter of the open circuit rod 11, and the outer diameter of the open circuit rod 11 has various specifications; when the pressure adjusting component is used, the adjusting bolt 9 is moved to a digital scale 18 where required pressure is located, the direction of the open circuit rod 11 is determined, the top end of the open circuit rod 11 is inserted into cancellous bone from an opening, and the open circuit device is pushed to be pushed by force continuously while rotating back and forth along the direction slowly; if the pressure applied to the open-circuit rod 11 by the spring 7 in the pressure adjusting member is smaller than the resistance of the spongy bone to the open-circuit rod 11 at the position, the open-circuit rod 11 cannot move forwards in the spongy bone, and meanwhile, under the pushing of manpower, the prismatic structure 12 at the lower part of the open-circuit rod 11 retracts from the prismatic cavity 4 into the cylindrical cavity 2, and the prismatic structure 12 can rotate freely in the cylindrical cavity 2; namely, when the handle 1 is rotated, the open circuit rod 11 is in place and is not moved, at this time, the limit pressure to the open circuit rod 11 is increased by adjusting the spring 7 in the pressure adjusting member, the prismatic structure 12 returns to the prismatic cavity 4 again, the open circuit rod 11 slowly advances along the advancing direction of the nail path at a constant speed, the resistance corresponding to the digital scale 18 when the opener just can advance in the cancellous bone is the clinical hardness F of the cancellous bone of the part of the patient, the proper pressure is selected between F and 1.3F as the limit pressure, which are all safe ranges, the adjusting bolt 9 is adjusted to the digital scale 18 corresponding to the limit pressure, and the handle 1 is pushed by the same pushing force as the pressure of the spring 7 provided in the pressure adjusting member; on the premise of smooth advancing in cancellous bone, if resistance suddenly increases during advancing, the probe 16 can be inserted into the probe channel 10 from the hollow conduit 6 at the bottom end of the handle 1, and can extend out from the inclined-plane pointed structure 15 through the probe channel 10 in the open-circuit rod 11, so that whether the front part of the top end and each side surface of the open-circuit rod 11 are hard cortical bone or not can be detected; if the side wall is hard cortical bone, the propelling direction can be adjusted by rotating the handle 1, changing the angle and the like until the open circuit rod 11 can be smoothly propelled; at this time, the depth scale line 17 on the outer surface of the open rod 11 is observed to judge whether the nail path depth meets the requirement, and if the nail path depth meets the requirement and the front part is hard cortical bone, the nail path establishment is completed.
As shown in fig. 5, the vertebrae are composed of a superior articular process 19, a vertebral body 20, a pedicle 21, a transverse process 22, a vertebral foramen 23, a spinous process 24 and a lamina 25, and when the vertebrae are damaged, pedicle screws are implanted into two adjacent vertebrae to fix the upper and lower vertebrae. Before opening the vertebral canal, a pointed cone is firstly used for opening at a vertebral arch plate 25 between a transverse process 22 and a spinous process 24, an opening rod 11 starts to open the canal from the opening and enters a vertebral body 20 through an upper articular process 19 and a vertebral pedicle 21, and a probe 16 is used for probing whether the tip of the opening rod 11 reaches the cortical bone of the vertebral body 20 or not, and the opening is completed when the tip reaches the cortical bone of the vertebral body 20.
As shown in fig. 6, the pelvis is composed of ischial tuberosity 26, obturator foramen 27, acetabulum 28, pubic comb 29, iliac fossa 30, hipbone 31, sacrum 32 and coccyx 33, and the pubic comb 29 is a thin bone which is easily broken by external force, so that internal fixation surgery is required for treatment. Before opening the pelvic bone, the anterior and medial sides of the pubic comb 29 are opened by the spine, the opening rod 11 is opened from the opening, advanced along the pubic comb 29, through the medial side of the acetabulum 28 and into the interior of the anterior column of the acetabulum, and the probe 16 is used for probing whether the top end of the opening rod 11 reaches the cortical bone of the iliac fossa 30, and the opening is completed when the top end reaches the cortical bone.
The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents, improvements and the like that fall within the spirit and principle of the present invention are intended to be included therein.