200908927 九、發明說明： 【發明所屬之技術領域】 尤指一種用於脊椎手 本發明係關於一種手術導引件 術中引導鑽頭鑽孔之導引件。 【先前技術】 脊椎之重要性’除在於其係人體骨骼的支架之外 =?，在於脊椎内另包覆有脊鏈。請參閱第十圖所示， 脊知疋人體神經的主軸，神經（91)係從脊椎 内部向外延伸而出’再向前方、左右以及上下延伸分佈丄 人體内’因此人體内之神經網路即是由㈣（9 2)作為 出發點而向外延伸。 … 脊隹（9 2 )可區分為頸椎節、胸椎節以及腰椎節， 神經（9 1 ) %是自脊髄通過各椎節間的間隙穿出，因此 -旦脊椎（92)任一椎節移位，就可能會壓迫到神經（9 1) ’間接影響到與神、經（91)連接的器官、肌肉 分泌腺體。 成脊椎（9 2 )移位之態樣，可能是因脊椎（9 2 ) :化造成椎節滑脫、受冑（如脫白或骨折）、感染或腫瘤 寺等病症所造成；目前對於脊椎（9 2 )移位之治療方式， 主要是藉由在脊椎（9 2 )椎節之椎足上植入—經蒂螺絲， 利用經蒂螺絲之硬性結構，可使移位的椎節固定，使各椎 么即間的連結更為穩固，令脊$ ( 9 2 )不再壓迫或磨損神 使病人可解除因脊椎（g 2 )壓迫或磨損神經所造 200908927 成之痛楚。 …、目別其中+術之做法，係由醫師判斷決定經蒂螺 絲的植入點以及植入方* 向，鑽孔後植入該經蒂螺絲；由於 脊椎（9 2)各椎節的形狀择田a ίέ ^ ^ 糸因人而異，因此如何能將經 帝螺絲準確地植入椎節 P上椎足的中心，全賴醫師之經驗與 技術，只要有分臺值至 ’和有可能造成患者終生癱瘓，故 *師…與技術對於手術之結果有著決定性的影響。 而目則另-種手術做法，請參閱第十一圖所示，主要 辅助固定架（1〇〇)來進行錯孔，該輔助固定架 (上〇cn係具有兩支撐腳（1〇1) (1〇2)，其各 定位筒（103)，該辅助固定架（ι〇〇)係設 :::V型刀狀支承㈣（參閱第十二圖）架設 、上，進仃手術時，醫師以輔助固定架 0)抵止於椎節的棘突與橫突上使其定位，接著， 、曾 （1 〇 4 )經由該定位筒（1 〇 3 )之 ^^引，而在椎節上鑽: L，惟此一做法雖可稍減少因醫師技 術之良狐所造成之丰科 丁 v 無差，但鑽孔時的定位穩定性仍嫌 不足。 W σ 對於現行脊椎手術中使用鑽頭鑽孔之定 位方式，尚有待進一步之改進方案。 【發明内容】 :提高脊椎椎足鑽孔手術之準確度與成功率，本發明 的在提i、種用於脊椎手術中引導鑽頭鑽孔之導 200908927 引件’其可輔助一鑽頭朝脊椎節的椎足中心軸方向鑽孔。 為達成前述目的所採取之主要技術手段，係當前述導 引件應用於頸椎節時，其包括： 一本體’其一側面係向内形成有一凹槽，該凹槽係供 本體設於—頸椎節（cervical vertebra)上，令該本體包 復椎弓板（lamina )、部分脊椎關節間部（pars ularis)的側表面以及側塊（丨atera| mass)，並 L開關節囊（】oint capsule )和黃韌帶（ligamentum flavum ) ’又該本體相對形成有凹槽之另側表面係形成有 一穿孔，該穿孔係向凹槽方向延伸並貫穿本體，以供容置 與引導—鑽頭以正確的方向在該頸椎節上鑽孔。 ...又為達成前述目的所採取之另一主要技術手段係當前 述導引件應用於胸椎節與腰椎節時，其包括： ' 側面係向内形成有一凹槽，該凹槽係供 本體設於-腰椎節或胸椎節上，令該本體係包覆該腰椎節 或胸椎節之椎弓板、部分脊椎關節㈣、乳突以及橫突的 基4亚避開關節囊和黃韌帶；又該本體相對形成有凹槽 =側表面係形成有一穿孔，該穿孔係向凹槽方向延伸並 貝牙本體’以供裳晉盘与丨道 撤1 ”腰始一谷置與引導-鑽頭以正確的方向在該胸椎 即或腰椎節上鑽孔。 才J用上述技術手段 始Λ昉 ^ 、音 段‘一…r催于術椎足螺絲 \ 4引件可有效辅助鑽頭準確地於脊椎上鑽孔， =-二:即毋需依靠醫師之經驗判斷鑽頭之植入位置盘 方向’而W提高脊椎手術之準確度與成 、 200908927 【實施方式】 本發明係有關於一種用於後位性脊椎手術（posterj〇r spinal surgery )椎足螺絲植入（pedic|e似⑽ implantation )之鑽孔導引件，其可有效導引鑽頭而準確 地於脊椎上鑽孔，如此一來，毋需依靠醫師之經驗判斷鑽 孔位置與方向，而得以提高手術之準辞度與成功率。 第一圖所示為根據本發明第一實施例之鑽孔導引件接 合於一腰椎節（1〇)Ji之立體示意圖。第三圖所示為根 據本發明第一實施例之鑽孔導引件與一腰椎節（丄〇 )之 :體示意圖。第四圖所示為根據本發明第一實施例之鑽孔 導引件之立體示意圖。第五圖所示為根據本發明第一實施 例之鑽孔Μ件接合於-腰椎節（1Q)上之剖示圖。 1 f先’請參閱第-、三圖所示，腰椎節（1〇)的構 造—般包含有：―椎體（11)，其外型係近似圓柱體；200908927 IX. Description of the invention: [Technical field to which the invention pertains] In particular, the invention relates to a guide for a spinal guide. [Prior Art] The importance of the spine is in addition to the scaffolding of the human skeleton, which is covered with a spine chain. As shown in the tenth figure, the spine knows the main axis of the human nerve. The nerve (91) extends outward from the inside of the spine and then 'extends forward, left and right, and up and down into the human body'. Therefore, the neural network in the human body. That is, it is extended from (4) (9 2) as a starting point. ... The ridge (9 2 ) can be divided into cervical vertebrae, thoracic vertebrae and lumbar vertebrae. The nerves (9 1 ) % are self-sacral through the interspinous space, so any vertebrae of the spine (92) Position, it may be oppressed to the nerve (9 1) 'indirectly affect the organs connected with God, the (91), muscle secretory glands. The aspect of the spine (9 2 ) displacement may be caused by the spine (9 2 ): the spondylolisthesis, the convulsion (such as whitening or fracture), the infection or the tumor temple; (9 2 ) The treatment of displacement, mainly by implanting the pedicle screw on the vertebrae of the vertebrae (92), using the pedicle screw, can make the displaced vertebrae fixed by using the rigid structure of the pedicle screw. The connection between the vertebrae is more stable, so that the ridge $(9 2) is no longer oppressed or worn, so that the patient can relieve the pain caused by the compression or wear of the spine (g 2 ). ..., to see the practice of + surgery, is determined by the physician to determine the implantation point of the pedicle screw and the implant side *, after drilling the pedicle screw; due to the shape of the vertebrae (92) a ίέ ^ ^ 糸 varies from person to person, so how to accurately implant the emperor screw into the center of the vertebral pedicle P on the vertebrae P, depends on the experience and technology of the physician, as long as there is a sub-value to 'and may cause the patient Lifelong sputum, so * division... and technology have a decisive influence on the outcome of the operation. For the other surgical procedure, please refer to the main auxiliary frame (1〇〇) for the wrong hole as shown in the eleventh figure. The auxiliary frame (the upper cn system has two supporting feet (1〇1) (1〇2), each of the positioning cylinders (103), the auxiliary fixing frame (ι) is equipped with:: V-shaped knife-shaped support (four) (refer to the twelfth figure) during erection, upper, and sacral surgery, The physician uses the auxiliary fixation frame 0) to abut the spinous process and the transverse process of the vertebral segment to position it, and then, (1 〇4) is guided through the positioning cylinder (1 〇 3 ), and in the vertebral section Drilling: L, but this method can slightly reduce the Fengke Ding v caused by the physician's technology, but the positioning stability during drilling is still insufficient. W σ There is still room for improvement in the use of drill bit drilling in current spine surgery. SUMMARY OF THE INVENTION: Improving the accuracy and success rate of spinal vertebral drilling surgery, the invention of the invention for guiding drill bit drilling in the spinal surgery 200908927, the lead piece 'which can assist a drill bit toward the vertebral section Drill holes in the direction of the central axis of the vertebra. The main technical means for achieving the foregoing purpose is when the guiding member is applied to the cervical vertebra, which comprises: a body having a groove formed inwardly on one side thereof, the groove being provided for the body to be placed on the cervical vertebra On the cervical vertebra, the body is covered with a lamina, a side surface of a part of the interparite (pars ularis), and a side block (丨atera| mass), and an L switch capsule () oint capsule And ligamentum flavum 'the other side of the body opposite to the grooved surface is formed with a perforation extending in the direction of the groove and extending through the body for receiving and guiding the drill bit in the correct direction Drill holes in the cervical vertebra. Another major technical means taken to achieve the aforementioned objectives is when the aforementioned guide member is applied to the thoracic vertebrae and the lumbar vertebrae, which includes: 'The side is formed with a groove inwardly, the groove is for the body Located on the lumbar vertebrae or thoracic vertebrae, the system covers the vertebral arch of the lumbar vertebra or thoracic vertebra, the part of the vertebrae (four), the mastoid and the transverse process of the base 4 and the ligament of the yellow ligament; The body is formed with a groove opposite to the side surface. The side surface is formed with a perforation, and the perforation extends in the direction of the groove and the body of the beak is removed for the skirt and the samp. The direction of the hole in the thoracic vertebrae or the lumbar vertebrae. Only J with the above technical means to start ^, the sound segment 'a...r urged the vertebral foot screw \ 4 lead can effectively assist the drill bit accurately drilled on the spine Hole, =- 2: It is necessary to rely on the experience of the physician to judge the direction of the implant position of the drill bit' and improve the accuracy of the spinal surgery. 200908927 [Embodiment] The present invention relates to a posterior vertebral spine. Surgery (posterj〇r spinal surgery) Implanted (pedic|elike (10) implantation) drill guide, which can effectively guide the drill bit and accurately drill the hole in the spine, so that it is necessary to rely on the experience of the physician to judge the position and direction of the drill, and It is possible to improve the accuracy and success rate of the operation. The first figure shows a perspective view of the drill guide according to the first embodiment of the present invention joined to a lumbar vertebra (1〇) Ji. The third figure shows A schematic view of a drill guide and a lumbar vertebra according to a first embodiment of the present invention. The fourth figure is a perspective view of a drill guide according to a first embodiment of the present invention. Figure 5 is a cross-sectional view showing the drilling element of the first embodiment of the present invention joined to the lumbar vertebra (1Q). 1 f first 'please refer to the first and third figures, the lumbar vertebrae (1〇) The structure generally consists of: - the vertebral body (11), the appearance of which is approximately cylindrical;
兩椎足（1 ?)，总ώ 乂 L .一丄2) 係自别述椎體（1 1)之一側垂直延伸 ，椎弓部，係具有-近似τ形的外觀，由前述兩椎 :向外延伸’而與椎體（11X間形成有一椎 子匕 t 1 U 1 ) > -ΐ*- j.a. ^ * ''人弓°卩的細部構造係包括兩個上關節突 兩個松突（transverse process) ( 1 4 )、 兩個下關節突（1 G、 J、兩個個乳突（mammillary pr〇cess) (16)¾及一棘突（I?)。 參閱第三鱼 一 Μ圖，根據本發明第一實施例之導引件主 要包括有：一本體（ ^ 2 0 )，其内側面上係形成有一凹槽 200908927 (2 1 )，而外側面則形成有一穿孔（2 2 )，其中該凹 槽（2 1 )係由本體（2 〇 )之内側面向内凹陷成型，該 凹槽（2 1 )係供本體（2 〇 )設於腰椎節（丄◦)上， 且令該本體（2 0 )包覆該腰椎節（丄〇 )之椎弓板（丨amina) (1 8 )、部分脊椎關節間部（pars jnterart丨cu|arjs) ( 1 9 )、乳冑（1 6 )以及橫突（1 4 ) 0基部，並避開如 第十圖所不之關節囊（j0jnt capsu|e) ( 9 3 )和黃韌帶 (Ngamentum flavum) ( 9 4 )。 參閱第三與五圖所示，該穿孔（2 2)係自本體（2 〇 )之外側面一位置向内延伸，且該穿孔（2 2)之成形 方向係自本體（2 0 )之外側面向内朝該椎足（丄2 )的 中心軸方向延伸，並於貫穿本體（2 〇 )後自凹槽（i 2 ) 内壁穿出。 爹閲弟五圖所*，進行手術日夺，醫師係先將本發明之 導引件以凹槽（1 2 ) ®向腰椎節（丄〇 )而接合在腰椎 節（1 0 )上’之後再將一鑽頭（3 〇 )穿入該穿孔（2 2)，藉由穿孔（22)之成形方向引導該鑽頭（3〇) 準確地朝椎足（12)之中心鑽孔；之後，再由醫師將緩 帝螺絲植入於椎足（1 2 )所鑽出之孔中。 由於每個人脊椎節的'細部幾何構造皆有或大或小之差 異，因此本發明導引件必須針對每個目標脊椎節客製化， 才能令本發明導引件與目標脊椎節緊密地結合。詳細言 Ϊ斷=本發明之導引件可以下列方法製作：f先利用; 私斷層掃目苗CT建構目標脊椎節之3…，接著根據前 200908927 =體20)於腰椎f(1〇)上之預定包覆區域的表 面特徵（surface features)建構本體（2Q)上凹槽 2)之3D輪廓，並進而建構客製化導引件 將其轉換成數百甚至數千個剖面圖、： ㈣jdP「〇t〇ty㈣瞻hine)，而製作出本發明之連 =機 以W述方法製成之導引件其凹槽 ^2 1 )内壁係形成 =不見則且連續之表面，且該不規則連續表面係與腰椎 即（10)之椎弓板（18)、部分脊椎關節間部（、 礼突（1 6 )以及橫突（i 4 )的基部的表 使本體（2 0 )可穩固地接合於該腰椎節（工〇 )目:配’ 避開關節囊（9 3 )和黃勃帶（9 4 )。 ’a :發明導引件於腰椎節（丄0) ±之預定包覆區域之 上邊界杈佳係延伸於椎弓板（丄8 ) 二 Γ y幻上緣以及上關節突 3 )的下、緣，但避開關節囊（9 3 )與黃動帶（9 :本發明導引件於腰椎節（丄〇 )上 =較佳係延伸於椎弓板(18)的下緣以及下關二 的上緣，但避開關節囊（9 3 )與黃勒帶（9 4 ). :::明導引件於腰椎節（1◦)上之預定包覆區域之側 『|車父佳係由該腰椎節（i ◦)之正面邊緣往側邊延伸 使侍該本體（2 〇 )包覆部分脊椎關節間部 之側表面之-小部分以及該橫突（14)綱上、下表) 面之一部分。 可以理解的是，該本體（2 〇 )卩為實心（如第五與 /、θ所不）或空心（如第八圖所示）；此外，本發明之導 200908927 引;牛可：：步設有—套筒"〇)(請參閱第三與五圖所 二:該…40)係匹配地置入於穿?L(22)内， 冋（4 0 )之前端外露於本體（2 〇 )表面；此套行 (4 0 )之作用係在於利用鑽頭（3 〇 )朝椎足（ 中心鑽孔的過程中，可保護該本體（2 0 )上的穿孔（2 2 )不致因施力方向有所偏差，而被鑽頭（3 〇 )鑽壞， 進而避免因穿孔（2(3)被鑽壞造成鑽孔方向歪斜。 又本發明的第二實施例，請參閱第六圖所示，係盘前 述第-實施例大致相同，不同之處在於該凹槽⑴，)、内 壁之凹凸表面上進一步形志右點斜曲认π / φ成有點針狀的凸點，因此該本體 2 0)之⑽（2 1’）㈣可提供更高的摩擦係數，令 本體（2 0 )可更為穩固地設於腰椎節（丄〇 )上。 此外，-般而s，口徑較大的鑽頭（3 〇 )較不易直 接鑽穿骨骼，&常見的解決方式，可先以小口徑鑽頭（6 〇 )在骨骼表面預先鑽開一小孔，之後再以大口徑鑽頭（3 0 )進行鑽孔，如此一來，由於骨骼表面已具有小孔，因 =可將大口徑鑽頭（3 0 )之一端置於該小孔上，使大口 杈鑽頭（3 0 )由小孔鑽入骨骼，如此將可較為容易鑽穿 骨骼；基於此一手術操作方式，以下說明本發明應用於小 口徑鑽頭的實施例。 請參閱第七與八圖所示，本發明之第三實施例係進一 步包含有一輔助導引片（50)，其係包括一手持部（5 1 )及一圓形套設塊（5 2 )，其中該手持部（51)係 為一狹長形的片狀體以方便使用者握持操作，且於手持部 10 200908927 (5 1 )—端的内側面上係形成該圓形套設塊（5 2 )， 又該套設塊（5 2 )的外徑係匹配該套筒（4 〇 )之内徑， 且其中心係、形成—與椎足（1 2 )的中心軸同向之通縫（5 …，該通縫（…）之直徑係小於該套筒（= 之内徑且貫通該手持部（5 1)。如此H套設部（5 2 )置於該套冑（4 〇 )内部時，一小口徑鑽頭（"） 可穿過該通縫（511)而對待手術的骨”位進行預先 雖然 件係利用 腰椎節之 引件亦適 第二 合於一頸 本發明第 〇)設於 椎節（8 9 )以及 第二圖中 面係形成 貫穿本體 在該頸椎 本發 包覆區域 弟 與第三實施例 之鑽孔導引 於胸椎節與 例之鑽孔導 孔導引件接 所示’根據 供本體（2 係包覆該頸 節間部（8 帶（未示於 )之另側表 方向延伸並 正確的方向 )上之預定 )的上緣以 則述本發明第 腰椎節（1 0 )來描述其構造，惟由 解剖構造接近，因此本發明前述實施 用於设計來接合於—胸椎節上。 圖所示為根據本發明第四實施例之鑽 椎節（8 0 )上之立體示意圖。如圖 四實施例之導引件之凹槽（2 i )係 頸椎節（8 0 )，令該本體（2 〇 ;、 〇 )之椎弓板（8 8 )、部分脊椎關 側塊（8 5 )，並避開關節囊和黃韋刃 )。又該本體相對形成有凹槽（21 有-穿孔（2 2 )，該穿孔係向凹槽 ，該穿孔係用以容置並引導一鑽頭以 節（8 0 )上鑽孔。 明第四實施例導引件於頸椎節（8 〇 之上邊界較佳係延伸於椎弓板（1 8 200908927 及上關節突（8 3 )的下缝 , 干於笛_回士、 ^ '、 ’但避開關節囊與黃韌帶（未 不於苐—圖中），本發明笛 弟四實施例導引件於頸椎節（8 〇)上之預定包覆區域之下诿 邊界較佳係延伸於椎弓板（1 8 )的下緣以及下關節突c 板（丄 ，大C未不於第二圖中）的 避開關節囊與黃韌帶（未示於楚_固山、 緣 於第—圖中），本發明第四實· 施例導引件於頸椎節（8 Ωμ — 一 ^ )上之預定包覆區域之本發明 弟四貫施例導引件於頸椎銪 側、…w 貝椎即（8 〇 )上之預定包覆區域之 側邊界係由該頸椎節（8 η w π工、* )之正面邊緣往側邊延伸2 m m， 使得該本體包覆側塊（8 〇 ο )之侧表面之一小部分。 由於C 3 - C 7頸椎節之解叫L技、分 鮮。構k接近’因此本發第 :施例之鑽孔導引件係適用於設計來接合力CW頸椎 卽。 此外，再請參㈣九圖所示，本發明之第五實施例係 :爾本體（20，），該兩本體⑴υ係分別設置 方:該，（8〇)的棘突（87)兩側，其間並以一跨 越棘穴（8 7 )的橋接部（2 3 )連接。 由上述可知，將本發明之鑽孔導引件應用於後位性脊 椎手術椎足螺絲植人時，可有效導引鑽頭而準確地於脊椎 =孔而不需如習知技術般由醫師以經驗判斷鑽孔之位 置^方向’如此—纟’即可大幅降低因人為判斷所造成的 失決，進而減少手術失誤造成患者癱瘓之機會。 此外’相對於習知輔助固定架（i 〇 〇 )以點狀支撐 亦P以V型刃狀支承（knife-edge)(參閱第十二圖） 架設在椎節的棘突與橫突上）架設在椎節上，本發明之鑽 12 200908927 孔導引件以面狀支撐方式接合在椎節上， 鑽孔時的定位穩定性。另外，必要時可：可有效增加 導引件與椎節間加入組織膠以進-步增加鑽：明之鑽孔 定性。 刀鑽孔時的定位穩 义惟本發明雖已為前述實施例中所揭露，但 w述實施例中所提及之内容，以配合每位 广、 骨：結構，因此在不脫離本發明之精神和範：内 何交化與修改，均屬於本發明之保護範圍。 綜上所述，本發明已且借顯荽Λ 專利要件，爰紐提Μ請㈣效以，並符合發明 【圖式簡單說明] 第-圖·係本發明之第一實施例接合於一腰椎節上之 立體示意圖。 第二圖：係本發明之第—實施例接合於一頸椎節上之 立體示意圖。 第一圖.係本發明之第一實施例與一腰椎節之立體示 意圖。 第四圖：係本發明之第一實施例的立體示意圖。 第五圖：係本發明之第一實施例接合於一腰椎節上之 剖示圖。 第六圖：係本發明之第二實施例設於一腰椎節上之俯 視暨部分剖面示意圖。 第七圖：係本發明之第三實施例設於—腰椎節上之分 13 200908927 解示意圖。 第八圖：係本發明之第三實施例設於一腰椎節上之俯 視暨部分剖面示意圖β ' 第九圖·係本發明之第四實施例設於一頸椎節上之俯 視圖。 ’ 第十圖：係部分脊椎骨與神經之示意圖。 第十一圖：係習用一利用辅助件進行脊椎手術之示意 圖。 弟十二圖.係第圖中輔λ, 丁孕《助件之v型刃狀支承架設 在椎節的棘突與橫突上之示意圖。 【主要元件符號說明】 (1 0 )腰椎節 (1 1 )椎體 (1 3 )上關節突 (1 5 )下關節突 (17)棘突 (1 9 )部分脊椎關節 (20) ( 2 0 ’）本體 (2 2 )穿孔 (3 0 )鑽頭 (5 0 )輔助導引片 (511)通缝 (6 0 )鑽頭 1 〇 1 )椎孔 1 2 )椎足 1 4 )橫突 1 6 )乳突 1 8 )椎弓板 部 (2 1 ) ( 2 1 ’）凹槽 2 3 )推移座 4 〇 )套筒 51)手持部 5 2 )套設部 14 200908927 (7 0 )胸椎節 (8 0 )頸椎節 (8 1 )椎體 (8 3 )上關節突 (8 5 )側塊 (8 8 )椎弓板 (9 1 )神經 (9 3 )關節囊 (1 0 0 )輔助固定 (10 1) (10 2 (1 0 3 )定位筒 (8 0 1 )椎孔 (8 2 )椎足 (8 4 )橫突 (8 7 )棘突 (9 2 )脊椎 (9 4 )黃韌帶 架 )支撐腳 (1 0 4 )鑽頭 15The two vertebrae (1?), total ώ 乂L. 丄2) are vertically extending from one side of the vertebral body (1 1), and the vertebral arch has an appearance of - approximately τ-shaped, from the aforementioned two vertebrae : Extending outwards and forming a vertebral 匕t 1 U 1 with the vertebral body (11X) > -ΐ*- ja ^ * ''The detailed structure of the human arch is composed of two upper articular processes. Transverse process (1 4), two inferior articular processes (1 G, J, two mastoids (mammillary pr〇cess) (16) 3⁄4 and one spinous process (I?). The guide member according to the first embodiment of the present invention mainly includes: a body (^ 2 0 ) having a groove 200908927 (2 1 ) formed on the inner side surface and a through hole formed on the outer side surface (2) 2), wherein the groove (2 1 ) is formed by inwardly facing the inner side of the body (2 〇), the groove (2 1 ) is provided on the lumbar vertebra (丄◦) for the body (2 〇), and The body (20) is wrapped around the lumbar vertebrae (丨amina) (1 8 ), part of the intervertebral joint (pars jnterart丨cu|arjs) (19), chyle ( 1 6 ) and the transverse process (1 4 ) 0 base, And avoid the joint capsule (j0jnt capsu|e) (9 3 ) and the yellow ligament (Ngamentum flavum) (9 4 ) as shown in the tenth figure. See the third and fifth figures, the perforation (2 2) Extending inwardly from a side of the body (2 〇), and the forming direction of the perforation (22) extends inward from the outer side of the body (20) toward the central axis of the vertebral foot (丄2), And passing through the inner wall of the groove (i 2 ) after passing through the body (2 〇). 爹 弟 五 五 * , , , , , , , , , , , , , , , 医师 医师 医师 医师 医师 医师 医师 医师 医师 医师 医师 医师 医师 医师 医师 医师 医师 医师After the lumbar vertebrae (丄〇) is engaged on the lumbar vertebrae (10), a drill bit (3 〇) is inserted into the perforation (2 2), and the drill bit is guided by the forming direction of the perforation (22) ( 3〇) Accurately drill holes in the center of the vertebral foot (12); afterwards, the physician will implant the sturdy screw into the hole drilled by the vertebral foot (1 2 ). Because of the 'detail geometry' of each person's vertebral section There are differences in the construction of large or small, so the guide of the present invention must be customized for each target vertebral node in order to make the guide of the present invention closely match the target vertebral section. In detail, the guide member of the present invention can be produced by the following method: f first use; private layer sweeping seedling CT constructs the target vertebral section 3..., then according to the previous 200908927 = body 20) in the lumbar vertebra f(1〇) The surface features of the predetermined cladding area construct a 3D profile of the groove 2) on the body (2Q) and, in turn, construct a customized guide to convert it into hundreds or even thousands of profiles: (4) jdP "〇t〇ty (4) looking at hine), and the guide member made by the method of the present invention has a groove ^2 1 ) the inner wall is formed = the surface is not visible and continuous, and the The regular continuous surface system and the base of the lumbar vertebrae (10), the vertebral arch (18), the part of the intervertebral joint (the pedicle (16), and the transverse process (i 4 ) make the body (20) stable. Jointly engaged in the lumbar vertebrae (work): with 'avoidance switch capsule (9 3) and yellow band (9 4). 'a: The invention guide is placed on the lumbar vertebrae (丄0) ± above the predetermined coverage area. The superior system extends over the vertebral arch (丄8). The upper edge of the illusion and the upper axon 3) Edge, but avoiding the switch capsule (9 3 ) and the yellow belt (9: the guide of the present invention on the lumbar vertebrae (丄〇) = preferably extending the lower edge of the vertebral arch (18) and the lower 2 The upper edge, but avoiding the switch capsule (9 3 ) and the yellow belt (9 4 ). ::: The guide is on the side of the predetermined covering area on the lumbar vertebrae (1◦) The front edge of the lumbar vertebrae (i ◦) extends to the side so that the body (2 〇) covers a small portion of the side surface of the intervertebral joint portion and the transverse process (14), the following table) One part of the face. It can be understood that the body (2 〇) 卩 is solid (such as the fifth and /, θ is not) or hollow (as shown in the eighth figure); in addition, the guide of the present invention 200908927 cited; cattle can:: step With the sleeve - "〇" (see paragraphs 3 and 5: the ... 40) is placed in the wearer L (22), the front end of the 冋 (4 0) is exposed on the body (2 〇) surface; the function of this set of lines (40) is to use the drill bit (3 〇) towards the vertebral foot (the hole in the body (20) can be protected during the center drilling process (2 2) The direction of the force is deviated, and it is drilled by the drill bit (3 〇), thereby avoiding the drilling direction being skewed due to the piercing (2 (3) being drilled. In addition, the second embodiment of the present invention, as shown in the sixth figure The first embodiment of the present invention is substantially the same, except that the groove (1), and the concave and convex surface of the inner wall are further shaped to have a right-pointed curved Φ / φ into a pin-like bump, so the body 2 0) (10) (2 1 ') (4) can provide a higher coefficient of friction, so that the body (20) can be more firmly placed on the lumbar vertebrae (丄〇). In addition, the larger diameter drill bit (3 〇) is less likely to drill through the bone directly. & A common solution is to pre-drill a small hole in the bone surface with a small diameter drill bit (6 〇). Then drill with a large diameter drill bit (30). As a result, since the bone surface has a small hole, one of the large diameter drill bits (30) can be placed on the small hole to make the large-mouth drill bit (30) drilling into the bone by the small hole, so that it is easier to drill through the bone; based on this surgical operation, the embodiment of the present invention applied to the small-diameter drill bit will be described below. Referring to the seventh and eighth embodiments, the third embodiment of the present invention further includes an auxiliary guiding piece (50) including a hand piece (5 1 ) and a circular sleeve (5 2 ). The hand-held portion (51) is an elongated sheet-like body for the user to hold the operation, and the circular sleeve is formed on the inner side of the end portion of the hand-held portion 10 200908927 (5 1 ) (5) 2), the outer diameter of the sleeve (52) matches the inner diameter of the sleeve (4 〇), and the center thereof forms a joint with the central axis of the vertebral foot (12) (5 ..., the diameter of the through slit (...) is smaller than the inner diameter of the sleeve (= and penetrates the hand portion (5 1). Thus the H sleeve portion (52) is placed in the sleeve (4 〇) Internally, a small-diameter drill bit (") can pass through the through-slit (511) and the bone to be treated in advance. Although the fitting uses the lumbar vertebrae, the fitting is also suitable for the second neck of the present invention. Provided in the vertebrae (89) and in the second figure, the facial system is formed through the body in the cervical spine, and the third embodiment is guided by the drill hole in the thoracic vertebrae. The drill guide hole guide is connected to the upper edge of the body according to the main body (2 is intended to cover the neck joint (the direction extending in the direction of the other side of the belt (not shown)) The construction of the lumbar vertebrae (10) of the present invention is described in terms of the anatomical structure, so that the foregoing embodiment of the present invention is designed to be joined to the thoracic vertebra. The figure shows a fourth embodiment according to the present invention. A perspective view of a drilled vertebra (80). As shown in the fourth embodiment, the groove (2 i ) of the guide member is a cervical vertebra (80), so that the body (2 〇;, 〇) a bow plate (8 8 ), a part of the spine closing side block (85), and avoiding the switch capsule and the yellow Wei blade. The body is oppositely formed with a groove (21 has - perforation (2 2 ), the perforation is oriented a groove for receiving and guiding a drill bit to drill holes in the section (80). The fourth embodiment guide member is on the cervical vertebra (the upper boundary of the 8 〇 preferably extends to the vertebral arch ( 1 8 200908927 and the lower joint of the upper articular process (8 3 ), dry in the flute _ _ 士, ^ ', 'but avoid the switch capsule and the yellow ligament (not in the 苐 - in the picture), The guide member of the fourth embodiment of the present invention has a guide member below the predetermined covering area on the cervical vertebra (8 〇), preferably extending from the lower edge of the vertebral arch (18) and the lower joint c-plate (丄, the large C is not in the second figure) avoiding the switch capsule and the ligamentum flavum (not shown in Chu_Gushan, from the first figure), the fourth embodiment of the present invention guide member in the cervical vertebra (4 Ωμ - a ^) on the predetermined cladding area of the present invention, the four-part embodiment of the guide member on the side of the cervical vertebrae, ... w bei vertebrae (8 〇) on the side of the predetermined coverage area of the boundary The front edge of the cervical vertebra (8 η w π, *) extends 2 mm to the side so that the body covers a small portion of the side surface of the side block (8 〇ο ). Because the C 3 - C 7 cervical vertebrae solution is called L technology, fresh. The configuration is close to the present invention. Therefore, the drill guide of the present embodiment is suitable for designing the joint force CW cervical vertebra. In addition, as shown in the figure (n) and IX, the fifth embodiment of the present invention is: the body (20), the two bodies (1) are respectively arranged on the sides: the (8) sides of the spinous processes (87) In the meantime, it is connected by a bridge (2 3 ) spanning the spine (8 7 ). It can be seen from the above that when the drill guide of the present invention is applied to the posterior vertebral vertebral screw implant, the drill bit can be effectively guided to accurately determine the spine = hole without the need of a physician as in the prior art. Experience to judge the location of the hole ^ direction 'so-纟' can greatly reduce the loss caused by human judgment, thereby reducing the chance of patients suffering from surgical errors. In addition, it is supported by a point-like support relative to a conventional auxiliary holder (i 〇〇) with a V-shaped knife-edge (see Figure 12) erected on the spinous processes and transverse processes of the vertebral segments. Mounted on the vertebra, the drill 12 200908927 hole guide of the present invention is joined to the vertebra in a planar support manner, and the positioning stability during drilling. In addition, if necessary: can effectively increase the introduction of tissue glue between the guide and the vertebral joint to further increase the drill: Ming drilling qualitative. Positioning stability when the knife is drilled. However, although the present invention has been disclosed in the foregoing embodiments, the contents mentioned in the embodiments are described to match each of the broad and bone: structures, and thus, without departing from the invention. Spirit and Fan: Internal and external communication and modification are all within the scope of protection of the present invention. In summary, the present invention has been utilized to disclose the patent requirements, the 爰 Μ Μ ( 四 四 四 四 四 四 四 四 四 四 四 四 四 四 四 符合 符合 符合 符合 符合 符合 符合 符合 符合 接合 接合 接合 接合 接合 接合 接合 接合 接合 接合 接合 接合 接合 接合 接合A three-dimensional diagram of the festival. Fig. 2 is a perspective view showing the first embodiment of the present invention joined to a cervical vertebra. The first figure is a perspective view of a first embodiment of the present invention and a lumbar vertebra. Fourth Figure: is a perspective view of a first embodiment of the present invention. Fig. 5 is a cross-sectional view showing the first embodiment of the present invention joined to a lumbar vertebra. Fig. 6 is a plan view and a partial cross-sectional view showing a second embodiment of the present invention which is disposed on a lumbar vertebra. Seventh figure: The third embodiment of the present invention is set on the lumbar vertebrae. Fig. 8 is a plan view and a partial cross-sectional view of a third embodiment of the present invention, which is disposed on a lumbar vertebrae. The ninth figure is a top view of a fourth embodiment of the present invention which is disposed on a cervical vertebra. ‘Tenth map: A schematic diagram of part of the vertebrae and nerves. Figure 11: Schematic diagram of a spine surgery using an aid. Twelve diagrams. In the figure, the auxiliary λ, Ding pregnancy, the v-shaped blade support of the aid is placed on the spinous processes and transverse processes of the vertebral segments. [Main component symbol description] (1 0) lumbar vertebrae (1 1) vertebral body (13) upper articular process (15) lower articular process (17) spinous process (19) partial spinal joint (20) (20 ') body (2 2 ) perforation (3 0 ) bit (5 0 ) auxiliary guide piece ( 511 ) through seam ( 6 0 ) bit 1 〇 1 ) vertebral hole 1 2 ) vertebral foot 1 4 ) transverse process 1 6 ) Mastoid 1 8 ) vertebral arch (2 1 ) ( 2 1 ') groove 2 3 ) slide seat 4 〇) sleeve 51) hand-held part 5 2 ) ferrule 14 200908927 (7 0 ) thoracic vertebrae (8 0) cervical vertebrae (8 1 ) vertebral body (8 3 ) upper articular process (8 5 ) side block (8 8 ) vertebral arch (9 1 ) nerve (9 3 ) joint capsule (1 0 0) auxiliary fixation (10 1) (10 2 (1 0 3 ) positioning tube (8 0 1 ) vertebral hole (8 2 ) vertebral foot (8 4 ) transverse process (8 7 ) spinous process (9 2 ) spine (9 4 ) ligamentum flavum Support foot (1 0 4) drill bit 15