The method of selective catheterization

 

(57) Abstract:

The invention relates to neurosurgery, in particular to selective catheterization of the spinal canal and intervertebral holes and local endolyumbalnye pharmacophobia in the treatment of diseases of the nervous system affecting etiology, and can also be used for intravascular manipulations for the dosed administration of medication directly into the lesion. When catheterization produce tougher outer conductor, the promotion of it and the vertebral canal to the lesion epidural catheter, with nested inside the inner conductor. Before attachment to the catheter distal portion of the inner conductor set corresponding to the location of the affected area deviation from the axis of the conductor and return to its original position. The catheter with the wire moving through the outer conductor and the vertebral canal before the adoption of the inner conductor, and with him and a catheter into the affected area previously specified deviations, and when catheterization carry out the lateral deviation of the distal portion. The method allows to avoid damage to the epidural bag at the puncture and catheterization, to avoid slouching the x drugs injected epidurally. 2 Il.

The invention relates to neurosurgery, in particular to selective catherization the spinal canal and intervertebral holes and local endolyumbalnye pharmacophobia in the treatment of diseases of the nervous system affecting etiology, and can also be used for intravascular manipulations for the dosed administration of medication directly into the lesion.

Diseases of the nervous system affecting etiology, in particular sciatica, are in the overall structure of diseases of the peripheral nervous system up to 80%, are associated with prolonged disability and often lead to disability. It is therefore evident that the search and improve the methods of treatment of this pathology sufficient relevant.

With the development of new medical technologies has developed a wide variety of methods of treatment of these diseases, and more recently, minimally invasive, which improves the quality of life of patients. The abundance of different ways indicates that one of them is not sufficiently effective and versatile and has its positive and negative sides.

There is a method of treatment of vertebr is NCCI lower sacral foramen and the introduction of large amounts of drugs through a needle and syringe (B. K. The novels. Treatment of radiculitis epidural injection of medicinal substances. HP: Medicine, 1971, S. 59 - 5).

There is also known a method of multiple precision needle injection drug mixtures through a needle and syringe directly into the area of irritation of the spine under the control of the computer tomograph (David J. Allison, H. Peterson, A. Hemmigway Interventinal Radiology The NICER Year Book 1994, p. 236), which applies only when formiranih lesions.

The closest attainable goals is the way catheterization of the patent of the Russian Federation 2074010, MKI 6 A 61 M 25/08, publ. 27.02.97, bull. N 6, which allows for the manipulation of multiple wires at the proximal section of the inner conductor to provide a deviation managed the distal section of the catheter 360oaround the axis of the tool to advance the catheter through curved sections of vessels and branches.

The objective of the proposed technical solution is to provide a method for selective catheterization at the location of the area of the lesion in the spinal canal and intervertebral holes, which avoids damage to the dural SAC at the puncture and catheterization, to avoid accidental introduction of medical prepare.

The problem is solved by introducing a rigid outer conductor, the path to the affected area epidural catheter before the catheter into the affected area a predefined deviation. With the catheter in advance include inner conductor with extra soft distal part, which before attachment set corresponding to the location of the affected area deviation from the axis of the conductor and return to its original position. After that, the catheter with the wire moving through the outer conductor and the spinal diseased vertebral holes. Further rotation of the proximal part of the inner conductor to move its distal part, with the possibility of penetration of the catheter into besprovodnikovy hole to a predetermined depth.

Introduction external hard conductor through the lower sacral hole and use the walls of the spinal canal as a continuation of the outer conductor when promoting soft epidural catheter inserted in his inner conductor with extra soft distal part gives an opportunity to hold the catheter through the lower sacral foramen at the level of any of the affected spinal segment.

What pervoe deviation from 0 to 360ocorresponding to a pre-identified location of the affected area, and return to its original position, allows a precise move the catheter to the affected area, located in mesozonal the hole, to improve the quality of life of the patient.

The set of features is new and allows, firstly, to reduce tissue injury that is caused by only one puncture of the spinal canal, to reduce the volume and the dose of the drugs, thereby avoiding General toxic effect of drugs, eliminate damage to the dural SAC and roots, in many cases, to avoid open surgery, to reduce the treatment time, improve the patient's quality of life.

The essence of the method is illustrated by drawings, where Fig. 1 shows a diagram of a selective catheterization of the spinal canal, Fig. 2 - scheme catheterization intervertebral holes.

In Fig. 1 and 2 the outer conductor 1, an epidural catheter 2, the inner conductor 3.

The inventive method is carried out as follows. When the location of the zones in the vertebral canal rigid outer conductor 1 is used to puncture the lower sacral foramen to the spinal canal, the walls to the Oia soft epidural catheter 2 with nested inside the inner conductor 3 (Fig. 1). At the location of the affected area in the intervertebral foramen (Fig. 2) super soft distal portion of the inner conductor 3 specify the lateral and axial deviation from the 0oup to 360ofrom the axis of the conductor corresponding to the detected location of the affected area, and return to its original position. After that, the inner conductor 3 is put into the catheter 2 and the catheter is in the rigid outer conductor 1. Hard outer conductor 1 is introduced into the lower sacral opening up the spinal canal and move it along the catheter with the inner conductor 3 to the affected vertebral hole, then rotate the proximal part of the inner conductor 3 is moved to its distal portion of the catheter. With this movement of the distal portion of the inner guide catheter, getting into the area of the intervertebral foramen, loses a support on the wall of the spinal canal and takes a previously given deviation from the 0oup to 360ofrom the axis of the inner conductor, penetrating into the intervertebral hole to a predetermined depth.

The method of selective catheterization by introducing a rigid outer conductor, the path to the affected area epidural catheter before the catheter in the area paratenic with extra soft distal part, which the attachment is set corresponding to the location of the affected area deviation from the axis of the conductor and return to its original position, after which the inner conductor together with the catheter is moved through the outer conductor and the spinal canal to the affected vertebral hole and rotation of the proximal part of the inner conductor to move its distal part, with the possibility of penetration of the catheter into the intervertebral hole to a predetermined depth.

 

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11 cl, 4 dwg

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