Ball centering multidirectional adjustable rotation radius offset-minimally invasive sacroiliac screw positioning guider
阅读说明:本技术 定球心多向可调旋转半径错距-微创骶髂螺钉定位导向器 (Ball centering multidirectional adjustable rotation radius offset-minimally invasive sacroiliac screw positioning guider ) 是由 邓迎生 邓喆尹 于 2019-10-30 设计创作,主要内容包括:本发明公开了一种定球心多向可调旋转半径错距-微创骶髂螺钉定位导向器,包括矩形主定位器、空心定位杆、横向弧形调节器、纵向弧形调节器和空心套筒,矩形主定位器包括定位器本体和设置在定位器本体前端的横向弧形套筒,空心定位杆的上部和下部均为圆筒状且下部直径小于上部直径,横向弧形调节器包括横向弧形刻度杆和设置在横向弧形刻度杆左端的纵向弧形套筒,纵向弧形调节器包括纵向弧形刻度杆和设置成在纵向弧形刻度杆后端的矩形导向块,空心套筒的上部为圆筒状,下部为锥状。本发明结构简单,成本低廉,使用方便,不需要多角度的X光反复透视,也勿需穿刺到骨内,定位准确、稳定性强,保证了导针和螺钉安全植入的一次性成功。(The invention discloses a fixed sphere center multidirectional adjustable rotation radius offset-minimally invasive sacroiliac screw positioning guider which comprises a rectangular main positioner, a hollow positioning rod, a transverse arc regulator, a longitudinal arc regulator and a hollow sleeve, wherein the rectangular main positioner comprises a positioner body and the transverse arc sleeve arranged at the front end of the positioner body, the upper part and the lower part of the hollow positioning rod are cylindrical, the diameter of the lower part of the hollow positioning rod is smaller than that of the upper part, the transverse arc regulator comprises a transverse arc scale rod and the longitudinal arc sleeve arranged at the left end of the transverse arc scale rod, the longitudinal arc regulator comprises a longitudinal arc scale rod and a rectangular guide block arranged at the rear end of the longitudinal arc scale rod, the upper part of the hollow sleeve is cylindrical, and the lower part of the hollow sleeve is conical. The invention has simple structure, low cost and convenient use, does not need multi-angle X-ray repeated fluoroscopy, does not need to puncture into the bone, has accurate positioning and strong stability, and ensures the one-time success of the safe implantation of the guide pin and the screw.)
1. The utility model provides a fixed ball center multidirectional adjustable turning radius offset-wicresoft sacroiliac screw location director which characterized in that: the device comprises a rectangular main positioner, a hollow positioning rod, a transverse arc regulator, a longitudinal arc regulator and a hollow sleeve;
the rectangular main positioner comprises a positioner body and a transverse arc-shaped sleeve arranged at the front end of the positioner body, the positioner body is provided with a sacrum positioning hole and an ilium fixing hole which are through up and down, and the sacrum positioning hole and the ilium fixing hole are both provided with locking members;
the upper part and the lower part of the hollow positioning rod are both cylindrical, the diameter of the lower part is smaller than that of the upper part, a detachably connected threaded guide pin is arranged in the hollow positioning rod, and the hollow positioning rod can be movably inserted into the sacrum positioning hole and can be locked by a locking component on the sacrum positioning hole;
the transverse arc regulator comprises a transverse arc scale rod and a longitudinal arc sleeve arranged at the left end of the transverse arc scale rod; the transverse arc-shaped scale rod penetrates through the transverse arc-shaped sleeve and can slide in the transverse arc-shaped sleeve;
the longitudinal arc-shaped adjuster comprises a longitudinal arc-shaped scale rod and a rectangular guide block arranged at the rear end of the longitudinal arc-shaped scale rod; the longitudinal arc-shaped scale rod penetrates through the longitudinal arc-shaped sleeve and can slide in the longitudinal arc-shaped sleeve;
the upper part of the hollow sleeve is cylindrical, the lower part of the hollow sleeve is conical, and the hollow sleeve is movably inserted into the rectangular guide block.
2. The centering multi-way adjustable radius of rotation offset-minimally invasive sacroiliac screw positioning guide as defined in claim 1, wherein: the sacrum positioning holes on the positioner body are positioned on the inner side of the ilium fixing holes, the number of the ilium fixing holes is four, the ilium fixing holes are longitudinally arranged, and only one sacrum positioning hole is arranged.
3. The centering multi-way adjustable radius of rotation offset-minimally invasive sacroiliac screw positioning guide as defined in claim 1, wherein: the locator body is also provided with a square connecting hole which is through from left to right, and the square connecting hole is provided with a locking component.
4. The centering multi-way adjustable radius of rotation offset-minimally invasive sacroiliac screw positioning guide as defined in claim 1, wherein: the radians of the transverse arc-shaped scale rod and the longitudinal arc-shaped scale rod are provided with various specifications for selection.
5. The centering multi-way adjustable radius of rotation offset-minimally invasive sacroiliac screw positioning guide as defined in claim 1, wherein: the inner surface of the cylindrical upper part of the hollow positioning rod is provided with threads, and the outer surface of the hollow positioning rod is provided with scales.
6. The centering multi-way adjustable radius of rotation offset-minimally invasive sacroiliac screw positioning guide as defined in claim 1, wherein: the plane of the transverse arc-shaped scale rod is vertical to the plane of the longitudinal arc-shaped scale rod; and the horizontal arc-shaped scale rod and the longitudinal arc-shaped scale rod have the same rotating radius and the common sphere center.
7. The centering multi-way adjustable radius of rotation offset-minimally invasive sacroiliac screw positioning guide as defined in claim 1, wherein: still include offside fixing device, offside fixing device includes fixed block and screw thread nail, and the fixed block divide into haplopore fixed block and diplopore fixed block, is equipped with about on the haplopore fixed block penetrating square connecting hole and upper and lower penetrating ilium fixed orifices, all is equipped with locking member on square connecting hole and ilium fixed orifices, controls penetrating and two front and back penetrating square connecting holes about being equipped with on the diplopore fixed block, is equipped with locking member on controlling penetrating, front and back penetrating two square connecting holes.
8. The centering multi-way adjustable radius of rotation offset-minimally invasive sacroiliac screw positioning guide as defined in claim 7, wherein: the single-hole fixing blocks are two, the double-hole fixing blocks are one, the threaded nails are two, and the threaded nails can penetrate through the ilium fixing holes in the single-hole fixing blocks, drill into the opposite ilium and are locked by the locking members in the ilium fixing holes.
9. The centering multi-way adjustable radius of rotation offset-minimally invasive sacroiliac screw positioning guide as defined in claim 1, wherein: still include horizontal square connecting rod and vertical square connecting rod, the one end of horizontal square connecting rod is connected with the square connecting hole on the locator body, the other end passes the square connecting hole of first haplopore fixed block and the penetrating square connecting hole of controlling of diplopore fixed block is connected, and by the locking member locking on the three square connecting hole, vertical square connecting rod one end is connected with the penetrating square connecting hole around the diplopore fixed block, the other end is connected with the square connecting hole of second haplopore fixed block, and by the locking member locking on two square connecting holes.
10. The centering multi-way adjustable radius of rotation offset-minimally invasive sacroiliac screw positioning guide as defined in claim 1, wherein: the locking member is divided into a locking hole and a locking bolt detachably connected with the locking hole.
Technical Field
The invention belongs to the technical field of medical instruments, and relates to a minimally invasive sacroiliac screw positioning guider with a fixed sphere center, multidirectional adjustable rotation radius and offset distance.
Background
The injury of the posterior pelvic ring such as the dislocation of the sacroiliac joint and the fracture around the sacroiliac joint can cause the rotational instability and the vertical instability of the pelvis, and the superior method for realizing the fixation of the posterior pelvic ring is to implant sacroiliac screws in a patient body. In recent years, both clinical and biomechanical studies of pelvic fixation have demonstrated: the sacroiliac screw enters from the posterior lateral aspect of the ilium ala, passes through the sacroiliac joint and enters the middle upper part of the
The technical difficulty of the sacroiliac joint screw is the implantation of a guide pin and a screw, the implantation of the prior sacroiliac joint screw is mostly finished by bare hands under the perspective of a C-arm X-ray machine, and the sacroiliac joint screw has the following defects: 1. in the process of nail placement, multi-angle X-ray repeated perspective is needed, the positioning is inaccurate, the stability is poor, and if a satisfactory fixed position cannot be achieved after multiple attempts, the fixed holding force is greatly reduced due to the damage of the guide pin to the bone structure. 2. Since the screw is fixed across the joint and needs to pass through 3 layers of cortical bone, accurate positioning of the point of insertion is extremely difficult. 3. The sacrum is anatomically tilted backwards, the sacroiliac screw has a certain angle in the transverse plane and the sagittal plane, and the individual difference is large, so the running direction of the screw is difficult to be accurately determined. 4. The length of the screw is preferably such that it does not break through the cortical bone of the contralateral sacrum, which is difficult to determine accurately by fluoroscopy. 5. The anterior part of the screw is adjacent to the iliac vessels, the posterior part of the screw is the cauda equina nerve in the vertebral canal, and the upper part of the screw is the intervertebral disc, so that the screw has slight deviation, not only can not achieve effective fixation, but also is easy to damage important nerves and vessels, and even endangers life. In summary, the insertion of the screw lacks objective criteria in determining the point of insertion, the direction of travel, the length of the screw, etc., and is not possible to succeed at one time, thus being technically very difficult and challenging.
In the existing sacroiliac screw guiding device, a pedicle screw guiding needle must be firstly drilled into a sacral 1 vertebral body, and then the guiding needle of the sacroiliac screw is drilled into the sacroiliac screw in a point-to-point aiming mode through a connecting rod with the radian of pi/2. The device improves the accuracy and the safety of nail placement to a certain extent, but has the following defects: 1. the guide pin of the
In the prior art, a sighting device which only depends on anatomical marks of lumbar vertebrae and pelvis, has no obvious damage to vertebral pedicle, has low technical threshold, can randomly adjust the angle according to individual difference of patients, is simple and convenient to operate and can accurately place the sacroiliac screw guide pin at one time is lacked.
Disclosure of Invention
The invention aims to provide a sphere centering multidirectional adjustable rotation radius offset-minimally invasive sacroiliac screw positioning guider, which combines a rectangular main positioner, a transverse arc regulator and a longitudinal arc regulator, can realize the functions of determining a screw feeding point according to different patient conditions, regulating the inserting direction of sacroiliac screws and accurately inserting the sacroiliac screws at one time and solves the problems in the prior art. The top of the transverse arc-shaped sleeve is downwards inclined so as to adjust the circle center of the longitudinal arc-shaped adjuster to be a virtual rotation sphere center O point in a matching way, so that a doctor can adjust the scales on the transverse and longitudinal arc-shaped scale rods inserted into the transverse and longitudinal arc-shaped slide ways according to different disease conditions of a patient so as to determine the inserting direction of the sacroiliac screw.
In order to achieve the purpose, the technical scheme adopted by the invention is as follows:
a ball centering multidirectional adjustable rotation radius offset-minimally invasive sacroiliac screw positioning guider comprises a rectangular main positioner, a hollow positioning rod, a transverse arc adjuster, a longitudinal arc adjuster and a hollow sleeve;
the rectangular main positioner comprises a positioner body and a transverse arc-shaped sleeve arranged at the front end of the positioner body. The rectangular main positioner is fixed on the ilium through the ilium fixing holes, and the sacrum positioning holes and the ilium fixing holes are provided with locking members. The connecting block is arranged at the connecting position of the positioner body and the transverse arc sleeve, and the top of the transverse arc sleeve connected with the connecting block is inclined downwards. The transverse arc-shaped sleeve is provided with a left and right transparent transverse arc-shaped slide way, the top of the transverse arc-shaped slide way is parallel to the top of the transverse arc-shaped sleeve, and the transverse arc-shaped slide way is provided with a locking component.
The upper part and the lower part of the hollow positioning rod are both cylindrical, the diameter of the lower part of the hollow positioning rod is smaller than that of the upper part of the hollow positioning rod, a detachable connected threaded guide pin is arranged in the hollow positioning rod, the top of the threaded guide pin is a cylinder, threads are arranged below the cylinder and on the outer side of the guide pin, and the hollow positioning rod can be movably inserted into the sacrum positioning hole and can be locked by a locking component on the sacrum positioning hole. The hollow positioning rod is matched with the thread guide pin to be inserted into a sacrum positioning hole on the positioner body to penetrate into the skin, the tip end of the hollow positioning rod is tightly attached to the outer side of an upper articular process of a first sacrum, which is sunken on the cortical bone surface (the point where the hollow positioning rod is tightly attached is A point) or the bone surface of other key anatomical marks, and the thread guide pin can be screwed into the sacrum to stabilize the hollow positioning rod and can also not be screwed into the sacrum. Avoiding cumbersome and risky procedures that must rely on pedicle screws of the sacrum as a reference. A virtual straight line which is parallel to the sagittal plane and vertically enters the sacrum downwards is made through the point A, the point O (the point O is the virtual rotating sphere center) is selected at a certain distance below the point A on the virtual straight line, the distance from the point A to the point O is the offset distance, and the offset distance can be set by adjusting the scale on the hollow positioning rod inserted into the sacrum positioning hole during the operation. And in turn, the precise location of the virtual sphere of rotation O point (also the point through which the sacroiliac screw and guide pin must pass) within the sacrum.
The horizontal arc regulator comprises a horizontal arc scale rod and a longitudinal arc sleeve arranged at the left end of the horizontal arc scale rod. Be equipped with L type connecting rod crouches in horizontal arc scale rod and the telescopic junction of vertical arc, L type connecting rod crouches includes stock and quarter butt, and the stock is parallel with vertical arc scale rod, and the end of stock is connected with the front end of the bottom of horizontal arc scale rod, and the quarter butt is parallel with horizontal arc scale rod, and the end and the telescopic top of vertical arc of quarter butt are connected. Be equipped with the scale on horizontal arc scale rod, be equipped with the front and back penetrating vertical arc slide on vertical arc sleeve, be equipped with locking member on the vertical arc slide, horizontal arc scale rod passes horizontal arc sleeve and horizontal arc scale rod can slide in horizontal arc sleeve, can freely adjust the scale on the horizontal arc scale rod of the horizontal arc slide of inserting horizontal arc sleeve according to patient's anatomical structure and different state of an illness in order to match the contained angle of sacroiliac screw and human sagittal plane on the cross section, and make the extension line of sacroiliac screw nail way pass through virtual rotatory centre of sphere O point to the interior inclination of accurate definite sacroiliac screw.
The longitudinal arc regulator comprises a longitudinal arc scale rod and a rectangular guide block arranged at the rear end of the longitudinal arc scale rod, scales are arranged on the longitudinal arc scale rod, an opening sliding chute which is through from left to right and is opened downwards is arranged on the rectangular guide block, a locking member is arranged on the opening sliding chute, the longitudinal arc scale rod penetrates through the longitudinal arc sleeve, the longitudinal arc scale rod can slide in the longitudinal arc sleeve, the scales on the longitudinal arc scale rod inserted into the longitudinal arc sliding chute of the longitudinal arc sleeve can be freely adjusted according to the anatomical structure and different disease conditions of a patient to match the included angle between a sacroiliac screw and the plane above the sacrum on the coronal plane, and the extension line of the sacroiliac screw nail path passes through a virtual rotation sphere center O point, so that the inclination angle of the cephalic side or the caudal side of the sacroiliac screw can be accurately determined, and the imbedding direction of the sacr. The downward inclination of the top of the transverse arc-shaped sleeve is used for matching with the adjustment of the circle center of the longitudinal arc-shaped adjuster to a virtual rotation sphere center O point, so that a doctor can adjust the scales on the transverse arc-shaped scale rod and the longitudinal arc-shaped scale rod which are inserted into the transverse arc-shaped slide way and the longitudinal arc-shaped slide way according to different disease conditions of a patient so as to determine the embedding direction of the sacroiliac screw.
The upper part of the hollow sleeve is cylindrical, the lower part of the hollow sleeve is conical, and the hollow sleeve is movably inserted into the opening sliding groove of the rectangular guide block and can be locked by the locking component on the opening sliding groove. The hollow sleeve is used for being inserted into the opening sliding groove to reach the rear outer side of the ilium wing to play a role in positioning and guiding, and the extension line of the insertion direction of the hollow sleeve passes through the O point of the rotating sphere center.
The further technical scheme is that the sacrum positioning holes in the positioner body are positioned on the inner side of the ilium fixing holes, the number of the ilium fixing holes is four, the ilium fixing holes are longitudinally arranged, and only one sacrum positioning hole is arranged. The four iliac fixation holes are designed to allow the use of iliac fixation holes in different positions depending on the patient's condition, and one sacral locating hole is designed to allow the use of cortical bone or other critical anatomical landmarks recessed outside the superior articular process of the first sacrum as a reference point for location.
The technical scheme is that the locator body is further provided with a left square connecting hole and a right square connecting hole which are through, and the square connecting holes are provided with locking components.
The technical scheme is that the radian of the transverse and longitudinal arc-shaped scale rods has various specifications to be selected.
The technical scheme is that the inner surface of the cylindrical upper part of the hollow positioning rod is provided with threads, and the outer surface of the hollow positioning rod is provided with scales.
The technical scheme is that the plane of the transverse arc-shaped scale rod is vertical to the plane of the longitudinal arc-shaped scale rod; and the horizontal arc-shaped scale rod and the longitudinal arc-shaped scale rod have the same rotating radius and the common sphere center.
Further technical scheme is, still include offside fixing device, offside fixing device includes fixed block and screw thread nail, and the fixed block divide into haplopore fixed block and diplopore fixed block, is equipped with on the haplopore fixed block about penetrating square connecting hole and upper and lower penetrating ilium fixed orifices, all is equipped with locking member on square connecting hole and ilium fixed orifices, is equipped with about penetrating and two square connecting holes penetrating around with on the diplopore fixed block, is equipped with locking member on controlling penetrating, two square connecting holes penetrating around.
The further technical scheme is that the number of the single-hole fixing blocks is two, the number of the double-hole fixing blocks is one, and the number of the threaded nails is two. The screw can pass the ilium fixed orifices on the haplopore fixed block and drill into on the contralateral ilium and be locked by the locking member of ilium fixed orifices, play the effect of fixed contralateral fixing device.
The technical scheme is that the positioner comprises a positioner body, and is characterized by further comprising a transverse square connecting rod and a longitudinal square connecting rod, wherein one end of the transverse square connecting rod is connected with a square connecting hole in the positioner body, the other end of the transverse square connecting rod penetrates through the square connecting hole in the first single-hole fixing block to be connected with left and right through square connecting holes in the double-hole fixing block and is locked by a locking component in the three square connecting holes, one end of the longitudinal square connecting rod is connected with the front and back through square connecting holes in the double-hole fixing block, the other end of the longitudinal square connecting rod is connected with the square connecting hole in. The transverse and longitudinal square connecting rods are used for connecting the positioner body and the opposite side fixing device, and the function of stabilizing the rectangular main positioner is achieved.
The further technical scheme is that the locking component is divided into a locking hole and a locking bolt detachably connected with the locking hole.
Compared with the prior art, the invention has the beneficial effects that:
1. the invention has simple structure, low cost and convenient use.
2. The invention does not need multi-angle X-ray repeated fluoroscopy and does not need to puncture into the bone, has accurate positioning and strong stability, and ensures the one-time success of the safe implantation of the guide pin and the screw.
3. The hollow positioning rod is matched with the thread guide pin to penetrate into skin, the tip end of the hollow positioning rod is tightly attached to the outer side of the upper articular process of the first sacrum and is sunken on cortical bone or the surface of bone of other key anatomical marks, and the thread guide pin can be screwed into the sacrum to stabilize the hollow positioning rod and can also not be screwed into the sacrum. Avoiding cumbersome and risky procedures that must rely on pedicle screws of the sacrum as a reference.
4. The use of the transverse arc adjuster enables a doctor to freely adjust the scales on the transverse arc scale rod inserted into the transverse arc slide way according to the anatomical structure and different disease conditions of a patient so as to match the included angle between the sacroiliac screw and the sagittal plane of a human body on the transverse section and enable the extension line of the sacroiliac screw nail track to pass through the virtual rotation sphere center O point, so that the internal inclination angle of the sacroiliac screw can be accurately determined.
5. The use of the longitudinal arc adjuster allows the surgeon to freely adjust the scale on the longitudinal arc scale rod inserted into the longitudinal arc slide according to the anatomy and different conditions of the patient to match the angle between the sacroiliac screw and the plane above the sacrum on the coronal plane and to pass the extension line of the sacroiliac screw trajectory through the virtual rotation sphere center O point, so as to accurately determine the cephalad or caudal tilt angle of the sacroiliac screw and determine the direction of insertion of the sacroiliac screw.
6. The top of the transverse arc-shaped sleeve is downwards inclined so as to adjust the circle center of the longitudinal arc-shaped adjuster to be a virtual rotation sphere center O point in a matching way, so that a doctor can adjust the scales on the transverse and longitudinal arc-shaped scale rods inserted into the transverse and longitudinal arc-shaped slide ways according to different disease conditions of a patient so as to determine the inserting direction of the sacroiliac screw.
Drawings
FIG. 1 is a schematic view of the combination structure of the rectangular main positioner, the transverse arc adjuster and the longitudinal arc adjuster.
FIG. 2 is a schematic structural diagram of a rectangular primary locator according to the present invention.
FIG. 3 is a left side view of the rectangular primary retainer of the present invention.
Fig. 4 is a schematic view of the lateral arc adjuster of the present invention.
Fig. 5 is a schematic view of the longitudinal arc adjuster of the present invention.
Fig. 6 is a schematic structural view of the contralateral fixation device of the present invention.
FIG. 7 is a schematic structural diagram of the hollow sleeve, the hollow positioning rod and the threaded guide pin according to the present invention.
Fig. 8 is a state diagram of the present invention in use.
Fig. 9 is a partially enlarged view of region B in fig. 8.
In the figure: 1. a locator body; 2. a sacral locating hole; 3. a hollow positioning rod; 4. a threaded guide pin; 5. an ilium fixation hole; 6. a threaded nail; 7. connecting blocks; 8. a locking hole; 9. a transverse arcuate sleeve; 10. a transverse arc-shaped scale bar; 11. locking the bolt; 12. a hollow sleeve; 13. an open chute; 14. a rectangular guide block; 15. a longitudinal arc-shaped scale bar; 16. a longitudinal arcuate sleeve; 17. a longitudinal arcuate chute; 18. the ilium; 19. a sacrum; 20. a transverse arc-shaped slideway; 21. a square connecting hole; 22. a transverse square connecting rod; 23. a double-hole fixing block; 24. a single-hole fixing block; 25. a longitudinal square connecting rod.
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 to 9, the sphere centering multidirectional adjustable turning radius offset-minimally invasive sacroiliac screw positioning guider provided by the invention comprises a rectangular main positioner, a
the rectangular main positioner comprises a
The upper portion and the lower part of hollow locating
The transverse arc adjuster comprises a transverse
The longitudinal arc regulator comprises a longitudinal
The upper part of the
The fixing device comprises a fixing block and a threaded
Still include horizontal
The working principle of the invention is as follows:
before an operation, a patient is in a prone position, the upper surface of a
In the operation process, puncture is carried out in a vertical horizontal plane, a
Since the rotation offset (i.e. the distance from the rotation center O to the cortical surface at a point) and the included angle α between the nail track and the sagittal plane are determined before the operation, the transverse arc-shaped graduated
And (3) continuously opening the way by using the opener, selecting a proper limit resistance gear, and enabling the opener to advance in the
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.
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