阅读说明：本技术 一种可调式寰椎螺钉定位导向装置 (Adjustable atlas screw positioning and guiding device ) 是由 张海平 郝定均 闫亮 姜永宏 王彪 于 2020-08-28 设计创作，主要内容包括：本发明公开了一种可调式寰椎螺钉定位导向装置,包括定位板、主杆、导向器和手柄；所述定位板与主杆端部连接,主杆末端部连接手柄；所述导向器可拆卸安装在所述主杆侧壁上,导向器上具有用于磨钻头穿过的导向孔；所述定位板包括曲型的定位板本体,定位板本体上具有第一凸起、第一凹槽和第二凸起；第一凸起为延伸出定位板本体端部形成的弯折部,第一凸起、第二凸起与定位板本体连接形成用于卡紧寰椎侧块内壁的曲面；第一凹槽设置在定位板本体两侧；所述导向器的导向孔与第一凹槽位置相对。该装置能够实现螺钉手术前的高速磨钻快速打磨定位及手术中螺钉的准确导向及精准置钉提供技术保障。(The invention discloses an adjustable atlas screw positioning and guiding device, which comprises a positioning plate, a main rod, a guider and a handle, wherein the main rod is fixedly connected with the positioning plate; the positioning plate is connected with the end part of the main rod, and the tail end part of the main rod is connected with the handle; the guide device is detachably arranged on the side wall of the main rod, and a guide hole for a grinding drill to pass through is formed in the guide device; the positioning plate comprises a curved positioning plate body, and a first bulge, a first groove and a second bulge are arranged on the positioning plate body; the first bulge is a bent part formed by extending out of the end part of the positioning plate body, and the first bulge and the second bulge are connected with the positioning plate body to form a curved surface for clamping the inner wall of the atlas lateral mass; the first grooves are arranged on two sides of the positioning plate body; the guide hole of the guide is opposite to the first groove. The device can realize that the high-speed abrasive drilling before the screw operation polishes the location fast and the accurate direction and the accurate nail of putting of screw provide technical guarantee in the operation.)

1. An adjustable atlas screw positioning and guiding device is characterized by comprising a positioning plate (103), a main rod (102), a guider (108) and a handle (101); the positioning plate (103) is connected with the end part of the main rod (102), and the tail end part of the main rod (102) is connected with the handle (101); the guide (108) is detachably arranged on the side wall of the main rod (102), and the guide (108) is provided with a guide hole (117) for a grinding bit to pass through;

the positioning plate (103) comprises a curved positioning plate body, and a first bulge (105), a first groove (106) and a second bulge (115) are formed on the positioning plate body; the first bulge (105) is a bent part formed by extending out of the end part of the positioning plate body, and the first bulge (105) and the second bulge (115) are connected with the positioning plate body to form a curved surface for clamping the inner wall of the atlas side block; the first grooves (106) are arranged on two sides of the positioning plate body.

2. The adjustable atlas screw positioning and guiding device according to claim 1, wherein the positioning plate (103) is fixed with the end of the main rod (102) through a rotating screw (107), and the positioning plate (103) is provided with a limiting device for clamping with the end of the main rod (102) in two directions.

3. The adjustable atlas screw positioning guide of claim 1, wherein the guide (108) includes a positioning head (109), a base (110), and a T-head (111); the guide hole (117) is arranged on the positioning head (109), the positioning head (109) is arranged on the base (110), and the T-shaped head (111) is arranged at the lower part of the base (110);

a T-shaped groove (104) is axially formed in the main rod (102), and a T-shaped head (111) of the guider (108) is connected with the T-shaped groove (104) in a sliding fit mode.

4. The adjustable atlas screw positioning guide of claim 3, wherein the T-shaped slot (104) has an entrance slot at one end, the entrance slot having a width greater than the width of the T-shaped head (111); the other end of the T-shaped groove (104) is provided with a locking groove.

5. The adjustable atlas screw positioning guide of claim 3, wherein the positioning head (109) is rotationally connected with the base (110) at an angle of-20 ° to +20 °.

6. The adjustable atlas screw positioning and guiding device according to claim 3, wherein the bottom of the positioning head (109) is provided with a fan-shaped block (114), the base (110) is provided with a fan-shaped groove (113), and the center of the fan-shaped block (114) is arranged in the fan-shaped groove (113) through the rotating shaft (112); the central angle of the fan-shaped block (114) is smaller than that of the fan-shaped groove (113).

7. The adjustable atlas screw positioning guide of claim 3, wherein one side of the positioning head (109) is provided with a second groove (116), the second groove (116) being in line with the direction of the pedicle.

8. The adjustable atlas screw positioning guide of claim 1, wherein two T-slots (104) are symmetrically disposed on the lateral wall of the primary rod (102).

9. The adjustable atlas screw positioning guide of claim 1, wherein the guide holes (117) on the guide (108) are of a shallow funnel configuration.

10. The adjustable atlas screw positioning guide of claim 1, wherein the primary rod (102) is a bendable rod, and a button on the handle (101) that controls bending of the primary rod (102) is provided.

Technical Field

The invention relates to the field of medical instruments, in particular to an adjustable atlas screw positioning and guiding device.

Background

The invention patent of China, CN107496016A, discloses a field operations atlas pedicle screw guider, which is composed of a main body sleeve and a positioning bracket. The main part sleeve pipe is the cylinder of front end radius angle, and the main part sleeve pipe is equipped with the centre bore that runs through the sheathed tube, and main part sleeve pipe front end is equipped with circular brill mouth, the connecting rod on the main part sleeve pipe face fixedly connected with locating support. The positioning bracket is composed of a connecting rod, a supporting rod and a positioning rod. The connecting rod is a cylindrical rod, the head of the connecting rod is fixedly connected with the pipe surface of the main sleeve, and the tail of the connecting rod is connected with the upper end of the supporting rod. The support rod is a cylindrical rod, and the lower end of the support rod is connected with the tail part of the positioning rod. The locating lever is a cylindrical rod, and a locating point is arranged at the front end of the locating lever.

However, clinical verification shows that the guide device has the risks of sliding upwards, outwards and inwards in the operation to damage vertebral artery and spinal cord in vertebral canal, especially the risk that the distance between atlas screws cannot be adjusted, and pedicle screws cannot be placed when the pedicle medullary cavity is small and has developmental deformity, and lateral mass screws cannot be placed.

The patent of the invention in China, CN106333741A, discloses an atlas pedicle screw guider, which comprises a guide arm part, a straight frame, a through hole and guide grooves, wherein the through hole is arranged in the middle part of the straight frame, the guide grooves are arranged on the left side and the right side of the through hole, the through hole is opposite to a posterior nodule of the atlas, a through threaded hole is arranged on the upper end surface of the through hole, and two strip-shaped through holes are symmetrically arranged on the upper end surfaces of the two guide grooves; a positioning part which is penetrated and installed in the through hole and is provided with an anchoring unit fixedly installed on the rear node and an adjusting and fixing unit for adjusting and fixing the anchoring unit; the guide cylinder part comprises two guide pin guide cylinders which are respectively penetrated and installed in the two guide grooves and can move left and right and front in the grooves, and the guide pin guide cylinders are fixed in the guide grooves according to implantation points for the nail path guide pins to pass through; and a fastening portion. Wherein, the first half of guide pin guide cylinder is provided with along axial extension and with fastener assorted T-slot, the latter half is provided with the guide pin passageway that is used for the nail way guide pin to pass.

The guider of the invention is premised on fixing the positioning part on the posterior tuberosity of the atlas and then adjusting the anchoring unit, however, in the clinical work of the inventor, most of atlas nails are required for traumatic atlas fracture, when the atlas is fractured, the tuberosity and the posterior arch are often fractured at the back, the positioning part can not be fixed, the invention can be effective only for degeneration or congenital atlantoaxial dislocation, and the application range of the invention is limited.

Disclosure of Invention

In order to solve the defect of inaccurate atlas screw positioning and expand the application range of the atlas screw positioning, the invention provides an adjustable atlas screw positioning and guiding device, which can realize the high-speed abrasive drilling and quick grinding positioning before screw operation, and provide technical support for accurate guiding and accurate screw placing of screws in the operation.

In order to achieve the purpose, the invention adopts the following technical scheme:

an adjustable atlas screw positioning and guiding device comprises a positioning plate, a main rod, a guider and a handle; the positioning plate is connected with the end part of the main rod, and the tail end part of the main rod is connected with the handle; the guide device is detachably arranged on the side wall of the main rod, and a guide hole for a grinding drill to pass through is formed in the guide device;

the positioning plate comprises a curved positioning plate body, and a first bulge, a first groove and a second bulge are arranged on the positioning plate body; the first bulge is a bent part formed by extending out of the end part of the positioning plate body, and the first bulge and the second bulge are connected with the positioning plate body to form a curved surface for clamping the inner wall of the atlas lateral mass; the first grooves are arranged on two sides of the positioning plate body.

Optionally, the locating plate is fixed with the end of the main rod through a rotating screw, and a limiting device used for being clamped with the end of the main rod in two directions is arranged on the locating plate.

Optionally, the T-shaped head is arranged on the base, and the T-shaped head is arranged at the lower part of the base;

a T-shaped groove is axially formed in the main rod, and a T-shaped head of the guider is connected with the T-shaped groove in a sliding fit mode.

Optionally, an inlet slot is arranged at one end of the T-shaped slot, and the width of the inlet slot is greater than that of the T-shaped head; the other end of the T-shaped groove is provided with a locking groove.

Optionally, the positioning head is rotatably connected with the base, and the rotation angle is-20 to +20 degrees.

Optionally, the bottom of the positioning head is provided with a sector, the base is provided with a sector groove, and the center of the sector is arranged in the sector groove through a rotating shaft; the central angle of the fan-shaped block is smaller than that of the fan-shaped groove.

Optionally, a second groove is formed in one side of the positioning head, and the direction of the second groove is consistent with that of the pedicle of vertebral arch.

Optionally, the side wall of the main rod is symmetrically provided with two T-shaped grooves.

Optionally, the guide hole on the guide is of a shallow funnel structure.

Optionally, the main rod is a flexible rod, and the handle is provided with a button for controlling the bending of the main rod.

Compared with the prior art, the invention has the following beneficial technical effects:

according to the adjustable atlas screw positioning and guiding device, the first bulge used for clamping the inner wall of the atlas lateral mass is arranged on the positioning plate of the device, so that the position of the guider is accurately fixed when the guider is used, and the problem of slippage is avoided. In addition, the guide device can realize rapid tapping guide by tapping the hollow circle of the guide device to prepare the nail path, so that the device can realize rapid polishing and positioning before screw operation and accurate guide of the screw in the operation.

Drawings

FIG. 1 is a schematic view of an adjustable atlas screw positioning guide;

FIG. 2 is a first schematic view of an adjustable atlas screw guide;

FIG. 3 is a schematic view of an adjustable atlas screw guide assembly II;

FIG. 4 is a first schematic view of the guide;

FIG. 5 is a second schematic view of the guide;

FIG. 6 is a top view of the base;

FIG. 7 is a view of the adjustable atlas screw positioning and guiding device in use;

wherein 100 is a positioning guide device; 101 is a handle; 102 is a main rod; 103 is a positioning plate; 104 is a T-shaped groove; 105 is a first projection; 106 is a first groove; 107 is a rotating screw; 108 is a guider; 109 is a positioning head; 110 is a base; 111 is a T-shaped head; 112 is a rotating shaft; 113 is a fan-shaped groove; 114 is a sector; 115 is a second projection; 116 is a second groove; 117 is a guide hole; 200 is atlas posterior arch; 300 is the inner wall of the lateral mass.

Detailed Description

In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings needed to be used in the description of the embodiments will be briefly introduced below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings based on these drawings without creative efforts.

In order to make the objects, technical solutions and advantages of the present invention more apparent, the following description of the embodiments of the present invention with reference to the accompanying drawings and examples is given by way of illustration and not limitation.

As shown in fig. 1 to 4, the adjustable atlas screw positioning and guiding device comprises a positioning plate 103, a main rod 102, a guide 108 and a handle 101; the positioning plate 103 is connected with the main rod 102, and the tail end of the main rod 102 is connected with the handle 101. The guide 108 is movably disposed on the main shaft 102.

The positioning plate 103 comprises a curved positioning plate body, and a first protrusion 105A, a first groove 106B and a second protrusion 115C are arranged on the positioning plate body. The first protrusion 105A is a bent portion formed by extending the end of the positioning plate body for tightly clamping the inner wall of the atlas lateral mass, so as to reduce the damage of the positioning plate 103 to the outside and upper vertebral artery caused by the outward movement of the positioning plate during the operation of the upper guide hole 117 in the operation.

The first groove 106B is used for positioning the pin placing point of the lateral mass screw, and two sides of the positioning plate body are respectively provided with a first groove 106.

As a preferred embodiment, as shown in fig. 3, the positioning plate 103 can be disassembled and assembled after being rotated 180 degrees, specifically, the positioning plate 103 is fixed with the end of the main rod 102 by rotating the screw 107, after the rotating screw 107 is loosened, the limiting device is used for fixing after being rotated 180 degrees, and the universal use of the left and right sides of the atlas lateral mass can be realized.

As shown in fig. 4 and 5, the guide 108 is movably disposed on the main rod 102, and specifically, the guide 108 includes a positioning head 109, a base 110 and a T-shaped head 111; the positioning head 109 is provided with a guide hole 117, the positioning head 109 is arranged on the base 110, and the T-shaped head 111 is arranged at the lower part of the base 110.

The main rod 102 is provided with a T-shaped groove 104, and a T-shaped head 111 of the guide 108 is connected with the T-shaped groove 104 in a matching manner. Preferably, the main rod 102 is provided with two T-shaped grooves 104.

First, the guide 108 is capable of moving axially along the main rod 102, and when orbiting axially to the end of the main rod 102, the head of the guide 108 may be disposed at the point of the first groove 106B. The second is that after the head of the guide 108 is separated from the first groove 106B and moves backwards to a specified position along the axial direction, the guide 108 can rotate along one side of the main rod 102, and after the guide 108 rotates, the head of the guide 108 is not in line with the positioning plate 103, so that the normal operation of the polishing process is not affected.

In a preferred embodiment, the positioning head 109 is rotatably connected to the base 110 at an angle of-20 ° to-20 °. In the operation process, the positioning head 109 can rotate in a small angle, so that the positioning head is tightly attached to the atlas posterior arch, the abrasive drill can adjust and polish in a small angle when extending into the guide hole 117 of the positioning head 109, and the polishing range is expanded.

Specifically, as shown in fig. 6, a sector 114 is disposed at the bottom of the positioning head 109, a sector 113 is disposed on the base 110, and the sector 114 is disposed in the sector 113 through the rotating shaft 112. Wherein the central angle of the sector block 114 is smaller than that of the sector groove 113.

One side of the positioning head 109 is provided with a second groove 116, the direction of the second groove 116 is consistent with that of the pedicle of vertebral arch, and the second groove 116 is clamped on the pedicle of vertebral arch for secondary limiting during operation.

If the lateral mass screw is to be prepared, the upper guider 108 can be removed, and the leather is directly polished through the first groove 106B to prepare the lateral mass screw channel through hole opening.

The guide hole 117 on the guider 108 is of a shallow funnel structure, the diameter is 3.5-4.0 mm, and the length is 5mm, so that the high-speed abrasive drill can be slightly adjusted upwards, downwards, leftwards and rightwards to polish through the funnel so as to remove the cortex preparation nail way.

As shown in FIG. 7, when the present invention is used for surgery, the specific surgical procedure is as follows:

conventionally exposing the posterior arch of the atlas and two lateral masses, probing the vertebral canal and the inner wall of the lateral mass, clamping the point A (a first bulge 105) of the positioning plate 103 on the inner wall of the right lateral mass, installing a guide 108, pushing down the head end of the guide 108, adjusting the guide 108 to be positioned above the lateral mass of the posterior arch of the atlas, polishing the cortex of the posterior arch by using a high-speed abrasive drill, seeing the medullary cavity at the position of the posterior arch, and replacing the vertebra to prepare the nail way. After the preparation of the right-side nail path is completed, the screws at the bottom of the positioning plate 103 are loosened, the positioning plate 103 is rotated by 180 degrees clockwise, the point A (the first bulge 105) continues to clamp the inner wall of the left-side lateral block, the guide 108 is adjusted, and the left-side nail path is prepared in the same way.

If the vertebral pedicle is small and has no medullary cavity in the operation or the fracture can not be placed in the preparation nail channel, after the guider 108 is removed, the hand drill is directly placed at the point B to polish the cortex of the lateral mass, and then the lateral mass nail channel is prepared by replacing the hand drill.

The above-described embodiments are merely illustrative of implementations of the invention that enable persons skilled in the art to make or use the invention, and the description is not limiting. Therefore, the present invention should not be limited to the embodiments shown herein, and all additions and equivalents made to the technical features of the present invention are intended to fall within the scope of the present application.