阅读说明：本技术 一种脊柱全内镜下椎间融合系统 (Intervertebral fusion system under full scope of backbone ) 是由 姚益奇 姚柏艇 卓清山 张鹏云 于 2021-08-11 设计创作，主要内容包括：本发明公开了一种脊柱全内镜下椎间融合系统,包括椎间融合器、手柄器械、骨水泥注射组件和骨泥注射组件。本发明的椎间融合器在骨水泥注射组件远端处导丝的作用下盘成预设形状,经骨水泥注射组件往融合器内灌注骨水泥,骨水泥固化后稳定支撑椎间隙,经骨泥注射组件灌注骨泥,填充剩余椎间隙空腔,达到术后融合的效果。本发明的脊柱全内镜下椎间融合系统可行脊柱内镜通道内全程可视化手术操作,手术更安全,微创化的脊柱内镜下手术,手术更微创,减少神经牵拉与骚扰,降低术后神经并发症风险,减少术中出血,提高患者预后效果,缩短了手术时间。(The invention discloses a spine full-endoscopic interbody fusion system, which comprises an interbody fusion cage, a handle instrument, a bone cement injection assembly and a bone cement injection assembly. The intervertebral fusion cage is coiled into a preset shape under the action of the guide wire at the far end of the bone cement injection assembly, bone cement is poured into the fusion cage through the bone cement injection assembly, intervertebral spaces are stably supported after the bone cement is solidified, bone cement is poured through the bone cement injection assembly, and the residual intervertebral space cavities are filled, so that the effect of postoperative fusion is achieved. The spinal full-endoscopic interbody fusion system can be used for performing full-process visual operation in a spinal endoscopic channel, is safer to operate, is minimally invasive in spinal endoscopic operation, is minimally invasive in operation, reduces nerve traction and disturbance, reduces postoperative nerve complication risks, reduces intraoperative hemorrhage, improves the prognosis effect of a patient, and shortens the operation time.)

1. The full-endoscopic intervertebral fusion system for the spine is characterized by comprising a foldable fusion cage main body (1), a handle instrument (2), a bone cement injection assembly (3) and a bone cement injection assembly (4); the fusion device body (1) comprises a distal head (11), a balloon (12) and a proximal head (13);

fuse ware main part (1) dish into default shape under the effect of guide wire (31) at bone cement injection subassembly (3) distal end, inject bone cement into in fuse ware main part (1), stably support intervertebral space after solidifying.

2. The spinal endoendoscopic interbody fusion system according to claim 1, wherein said guide wire (31) has elastic memory deformability and is able to return to a predetermined shape after being straightened.

3. The spinal endoendoscopic intervertebral fusion system according to claim 2, wherein the guide wire (31) can guide the balloon (12) to a preset shape.

4. The spinal column full-endoscopic intervertebral fusion system according to claim 1, wherein the bone cement injection assembly (3) further comprises an outer bone cement tube (32), an inner bone cement tube (33), a handle connector I (34), a limiting block III (35) and a bone cement injection connector (36); the distal end of the bone cement outer tube (32) is connected with the proximal end of the guide wire (31); the side walls of the bone cement outer pipe (32) and the bone cement inner pipe (33) are both provided with channels.

5. The system of claim 4, wherein the guide wire (31) and the outer tube of bone cement (32) are coated with a smooth membrane that does not react with the bone cement.

6. The spinal endoscopically total intervertebral fusion system according to claim 4, characterized in that after the bone cement assembly (3) is removed, a complete cavity channel is left in the fusion cage body (1), which channel transports bone cement into the middle cavity of the fusion cage body (1).

7. The spinal full-endoscopic interbody fusion system according to claim 1, wherein the cage body (1) has a cross-section with two narrow sides and a wider top and bottom.

8. The spinal endoscopically total intervertebral fusion system according to claim 1, wherein the balloon (12) can be attached to irregular shapes on a cartilage final plate during bone cement filling injection, and the anti-displacement capability of the fusion device body (1) is greatly enhanced after the bone cement is solidified.

9. The spinal endoscopic interbody fusion system according to claim 1, wherein the proximal end of the proximal head (13) is a slot structure and is engaged with a slot on the distal end of the inner tube (252) of the handle device (2) for connection and release of the fusion device body (1) and the handle device (2).

10. The spinal endoscopically total intervertebral fusion system as claimed in claim 1, wherein the proximal end of the distal tip (11) and the distal end of the guide wire (31) are of a matched step structure, so as to prevent relative slippage of the fusion body (1) and the guide wire (31) when the fusion body (1) is released into the intervertebral disc.

Technical Field

The invention relates to the field of medical instruments, in particular to a spine full-endoscopic intervertebral fusion system.

Background

Degenerative spinal diseases and structural damage are important causes of pain in the neck, shoulders, waist and legs, and impaired or even lost sensory and motor functions. In the last 50 s, Cloward first proposed posterior lumbar fusion (PLIF), a technique developed as one of the basic surgical procedures for spinal surgery today. Badgy and Kuslich designed an interbody fusion Cage (Cage) suitable for use in humans in 1986, the BAK system. Since then, the interbody bone-grafting fusion technology has been greatly developed, and becomes a basic operation mode for treating spinal degenerative diseases and structural injuries.

The principle of the interbody fusion cage is that after the interbody fusion cage is implanted, the muscle, the fibrous ring and the anterior and posterior longitudinal ligaments of the fusion segment are in a continuous tension state by the distraction force, so that the fusion segment and the fusion cage achieve three-dimensional super-static fixation. And secondly, the intervertebral fusion cage recovers the stress and the stability of the front and middle columns of the spine, recovers and maintains the inherent physiological bulge of the spine, enlarges intervertebral foramen and relieves the pressure of the dural sac and nerve roots by recovering the height of the intervertebral space. The hollow structure of the intervertebral fusion cage provides a good mechanical environment for the fusion of the cancellous bone therein, thereby achieving the purpose of interface permanent fusion.

The existing conventional fusion cage is generally in a series of blocks with fixed shapes, such as box-type structures, adapts to different vertebral body gaps by depending on a series of height models, and cannot be completely matched with the vertebral body gaps of patients; in order to achieve a good supporting effect, the supporting surface needs to be as large as possible and large in size during design, so that an implanted channel is large, the injury of a patient is large, the postoperative recovery is slow, and the patient can suffer from both physiological pain and psychological pain. Although a common minimally invasive surgery can reduce wound incisions and narrow an access channel of the fusion cage, the fusion cage can only be changed in the height direction or in the width direction in the aspect of a mechanical structure, the height lifting and the vertebral body contact area cannot be compatible, the bone grafting space is limited by the mechanical structure, the fusion effect is affected, the surgery effect is poor, secondary surgery may be needed, and heavier burden is brought to a patient.

Disclosure of Invention

The invention aims to solve the problems of a fusion cage in the prior art and provides a spinal full-endoscopic intervertebral fusion system.

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

the invention provides a spine full-endoscopic interbody fusion system, which comprises a foldable fusion cage main body, a handle instrument, a bone cement injection assembly and a bone cement injection assembly, wherein the bone cement injection assembly is arranged on the folding fusion cage main body; the cage body comprises a distal head, a balloon and a proximal head;

the fusion cage main body is coiled into a preset shape under the action of a guide wire at the far end of the bone cement injection assembly, bone cement is injected into the fusion cage main body, and after solidification, intervertebral space is stably supported.

Furthermore, the guide wire has elastic memory deformation capacity and can be restored to a preset shape after being straightened.

Further, the guidewire may guide the balloon into a preset shape.

Furthermore, the bone cement injection assembly also comprises a bone cement outer tube, a bone cement inner tube, a handle connector I, a limiting block III and a bone cement injection connector; the far end of the bone cement outer tube is connected with the near end of the guide wire; and the side walls of the bone cement outer pipe and the bone cement inner pipe are both provided with channels.

Further, the guide wire and the bone cement outer tube are coated with a smooth film which is not reacted with the bone cement.

Further, after the bone cement component is removed, a complete cavity channel is reserved in the fusion cage body, and bone cement is conveyed into the middle cavity of the fusion cage body through the channel.

Further, the cross section of the fusion cage main body is in a shape that two sides are narrow and the top and the bottom are wide.

Further, the balloon can be attached to the irregular shape on the cartilage final plate during bone cement filling and injection, and the anti-displacement capacity of the fusion cage body is greatly enhanced after the bone cement is solidified.

Furthermore, the near end of the near end head is a clamping groove structure and is matched with a clamping groove on the far end of the inner tube of the handle instrument, and the fusion cage is used for connecting and releasing the fusion cage main body and the handle instrument.

Further, the proximal end of the distal head and the distal end of the guide wire are of a matched step structure, so that relative sliding of the fusion device body and the guide wire is prevented when the fusion device body is released into the intervertebral disc.

Compared with the prior art, the invention has the following advantages:

the fusion cage main body of the intervertebral fusion system under the spine full-endoscope is coiled into a circle in advance under the action of the guide wire, then bone cement is injected for solidification, and the special-shaped saccule can increase the later bone cement implantation amount, so that the contact area of the fusion cage and a cartilage end plate is increased, and the fusion effect is improved; in addition, under the combined action of the balloon and the guide wire, the amorphous bone cement is solidified into a pre-designed form, so that good mechanical support is achieved, and the fusion effect is ensured.

The fusion device of the spinal full-endoscopic interbody fusion system can pass through an operation working channel with the diameter of 5mm or less, so that the wound of a vertebral body fusion operation is smaller.

The filling material of the intervertebral fusion system under the full endoscope of the spine is bone cement and bone mud, and the bone cement can provide good mechanical support after being solidified in the intervertebral disc; in addition, the mode of injecting the bone cement and the bone mud is adopted, so that the operation can be reduced, and the operation time is shortened.

Drawings

FIG. 1 is a general schematic view of an intervertebral fusion system under a spinal full-scope endoscope according to the present invention when the fusion device is constrained;

FIG. 2 is a general schematic view of the spinal full-endoscopic interbody fusion system of the present invention with the cage unlocked;

FIG. 3 is a general schematic view of the spinal total endoscopic interbody fusion system of the present invention with the cage disengaged from the handle instrument;

FIG. 4 is a schematic structural diagram of a cage body of the spinal full-endoscopic interbody fusion system according to the present invention;

FIG. 5 is a schematic view in half section of a handle instrument of the spinal full-endoscopic interbody fusion system of the present invention;

FIG. 6 is an exploded view of the handle instrument of the spinal full-endoscopic interbody fusion system of the present invention;

FIG. 7 is a schematic half-sectional view of a bone cement injection assembly of the spinal total endoscopic interbody fusion system of the present invention;

FIG. 8 is a schematic view of the distal end of the bone cement injection assembly of the spinal total endoscopic interbody fusion system of the present invention in a natural state;

FIG. 9 is an exploded view of the bone cement injection assembly of the spinal total endoscopic interbody fusion system of the present invention;

FIG. 10 is a schematic structural view of a cement tube of the spinal full-endoscopic interbody fusion system of the present invention;

FIG. 11 is a schematic structural view of a bone cement injection assembly of the spinal full-endoscopic interbody fusion system of the present invention;

FIG. 12 is a schematic half-sectional view of a bone cement injection assembly of the spinal total endoscopic interbody fusion system of the present invention;

FIG. 13 is a schematic view of the intervertebral fusion system under the spinal full-scope of the invention in the intervertebral disc.

Detailed Description

The present invention will be described in detail and specifically with reference to the following examples to facilitate better understanding of the present invention, but the following examples do not limit the scope of the present invention.

The proximal end of the invention refers to the end close to the operator, and the distal end refers to the end far away from the operator.

Examples

The embodiment provides a spine full-endoscopic intervertebral fusion system, which comprises a fusion cage main body 1, a handle instrument 2, a bone cement injection assembly 3 and a bone cement injection assembly 4, and is shown in figures 1-3 and 11.

Referring to fig. 4, the fusion cage body 1 comprises a balloon 12 and a stent 121 covered by the balloon 12, and the balloon 12 can be folded to meet the requirement of minimally invasive implantation of the fusion cage; the stent 121 is pre-shaped into an approximately elliptical shape and is wrapped in the balloon 12; a far end head 11 and a near end head 13 are fixed in the closed mouths at the two ends of the saccule 12, and a film is attached to the outer side of the closed mouths at the two ends of the saccule 12 in the fixing method, so that the saccule 12 is respectively fixed with the small bosses of the far end head 11 and the near end head 13;

referring to fig. 1-3 and 5-6, the above-described handle instrument 2 includes a handle upper cover 21, a handle lower cover 22, a stopper ii 23, an injection assembly connector 24, and a fusion device grip release member 25. The fusion cage grabbing and releasing part 25 comprises an outer pipe 251, an inner pipe 252, a pull head 253 and a limiting block I254. The inner tube 252 is fixedly connected with a limiting block II 23, and the limiting block II 23 and the injection assembly connector 24 are respectively clamped in ribs of the handle upper cover 21 and the handle lower cover 22; the distal end of inner tube 252 is removably coupled to proximal head 13 and the proximal end of inner tube 252 is fixedly coupled to injection assembly coupling head 24. The outer pipe 251, the pull head 253 and the limiting block I254 are sleeved outside the inner pipe 252, and the outer pipe 251 moves relative to the inner pipe 252 by pulling the pull head 253; the limiting block I is close to the far ends of the handle upper cover 21 and the handle lower cover 22, and a notch is formed in the side face of the limiting block I254 and can be stripped from the inner tube 252.

Referring to fig. 1-3, in three states of the operation of the instrument, the outer tube 251 sleeved outside the inner tube 252 can be pulled to move and retract in the direction away from the fusion device body 1 by pulling the pull head 253, the fusion device body 1 is released from the bound state, and when the proximal end face of the pull head 253 abuts against the end face of the limiting block i 254, the fusion device body 1 is completely released (as shown in fig. 2); then the limiting block I254 is peeled off from the inner tube 252, and after the limiting block I254 is removed, the pull head 253 is continuously withdrawn, so that the fusion device body 1 is completely separated (as shown in fig. 3).

Referring to fig. 7-10, the bone cement injection assembly 3 includes a guide wire 31 passing through the fusion cage body 1, an outer bone cement tube 32, an inner bone cement tube 33 sleeved in the outer bone cement tube 32, a handle connector i 34, a stopper iii 35, and a bone cement injection connector 36. The guide wire 31 includes a guide wire 311, an expanding tube 312, and a developing ring 313. The expanding tube 312 is made of a soft polymer material and is wrapped outside the ni-ti wire, so as to occupy the volume of the bone cement and leave a space for subsequent bone cement injection. The developing rings 313 are coated at two ends of the guide wire and used for observing the molding state of the fusion cage body 1 in the developing process. In addition, the guide wire 31 and the bone cement outer tube 32 are coated with a layer of PTFE film, so that the bone cement injection assembly 3 can be conveniently withdrawn.

The far end of the handle connector I34 is detachably connected with the injection assembly connector 24; the outer wall of the proximal end of the bone cement outer tube 32 is fixedly connected with a limiting block III 35 arranged in the handle connector I34, the proximal end of the bone cement inner tube 33 is fixedly connected with a bone cement injection connector 36, and the bone cement injection connector 36 can rotate and is sleeved in the handle connector 34, so that the bone cement inner tube 33 can rotate relative to the bone cement outer tube 32. The limit block III 35 is sleeved in the handle connector I34, and the near end of the bone cement outer tube 32 is fixedly connected with the limit block III 35. The boss on the stopper III 35 is matched with the gap at the near end of the injection assembly joint 24, and the bone cement outer tube 32 cannot be driven to rotate when the bone cement injection joint 36 is rotated, so that the positions of the bone cement outer tube 32 and the guide wire 31 are stable, and the rotation of the bone cement outer tube and the guide wire is limited. The hole of the proximal end face of the distal tip 11 is a stepped hole and can be fitted with a step at the distal end of the guide wire 31, and when the slider 253 is retracted, the stepped faces are in contact with each other, preventing slippage of the fusion cage body 1.

Referring to fig. 10 and 9, the outer cement tube 32 and the inner cement tube 33 are provided with bone cement through holes on their wall surfaces near the distal ends. The handle connector 34 and the bone cement injection connector 36 are further provided with marking lines, the bone cement injection connector 36 is rotated, when the two marking lines are aligned, bone cement through holes which are respectively arranged on the bone cement outer tube 32 and the bone cement inner tube 33 and are close to the far-end wall surface are overlapped, bone cement can be smoothly injected into the balloon 12, and the bone cement injection connector 36 is rotated again after injection is completed, so that a bone cement injection channel is sealed.

Referring to fig. 7 and 13, the development rings 313 are provided at both ends of the guide wire 31. As shown in fig. 8, the guide wire 31 is in a natural state, and the developing rings 313 provided at both ends of the guide wire 31 function to determine whether or not the fusion cage body 1 forms a closed loop in the intervertebral disc.

Referring to fig. 11-12, the spinal total endoscopic intervertebral fusion system of the present invention further includes an insertable bone cement injection assembly 4, wherein the bone cement injection assembly 4 includes a bone cement tube 41, a handle connector ii 42 and a bone cement injection connector 43; the near end of the bone cement pipe 41 is fixedly connected with the bone cement injection connector 43, the far end of the bone cement injection connector is of a boss structure and is limited in the handle connector II 42, and the far end of the handle connector II 42 is detachably connected with the injection assembly connector 24. After the bone cement injection assembly 3 is removed, the bone cement injection assembly 4 is inserted into the injection assembly connector 24, and then the bone cement is injected.

Application examples

The operation principle of the intervertebral fusion system under the spine full endoscope of the invention is as follows:

firstly, after the intervertebral disc is treated in an operation, when the fusion device body 1 is in a bound state (shown in figure 1), the fusion device body is sent to the opening of the intervertebral disc through a working channel of an endoscope, one hand pulls a pull head 253, the other hand holds a handle device 2 and simultaneously slowly pushes the handle device 2, the fusion device body 1 is released from the bound state and is placed in the intervertebral disc, and the fusion device body 1 forms a ring shape (shown in figure 11) due to the loss of the bound of an outer tube 251; meanwhile, whether the annular fusion cage is formed in place is judged according to the relative position of the developing ring 313 through CT shooting;

step two, rotating the bone cement injection joint 36 according to the marking lines arranged on the handle connector I34 and the bone cement injection joint 36, so that when the two marking lines are aligned, bone cement through holes which are respectively arranged on the bone cement outer tube 32 and the bone cement inner tube 33 and are close to the far-end wall surface are superposed, and connecting a matched bone cement injection instrument through the bone cement injection joint 36 to inject bone cement into the balloon 12; after injection is finished, the bone cement injection connector 36 is rotated again to seal a bone cement injection channel, after the bone cement is solidified, the handle connector I34 is loosened to withdraw the whole bone cement injection assembly 3, and a channel is left in the fusion cage main body 1 after the bone cement injection assembly 3 is withdrawn;

step three, inserting the bone cement injection assembly 4, enabling the far end of the bone cement pipe 41 to be located at the near end of the channel left in the step two, connecting the bone cement injection assembly 4 with the handle instrument 2 through the handle connector II 42 and the injection assembly connector 24; the bone cement injection joint 43 is connected to a matching bone cement injection instrument, and bone cement is injected into the fusion cage main body 1 (the passage left in the second step), and flows along the passage toward the center of the fusion cage main body 1. After injection is completed, the handle connector 42 is loosened, and the bone cement injection assembly 4 is removed;

and step four, peeling the limiting block I254 from the outer tube 252, continuously withdrawing the pull head 253, completing separation of the fusion device body 1 from the rest parts (as shown in fig. 3), and completing implantation of the ring fusion device.

While the invention has been described with reference to a preferred embodiment, it will be understood by those skilled in the art that various changes in form and detail may be made therein without departing from the spirit and scope of the invention.