Patent ID: 12232779

DETAILED DESCRIPTION OF THE DISCLOSURE

Hereinafter, various exemplary embodiments will be described in more detail with reference to the accompanying drawings. Exemplary embodiments described in the present specification may be variously modified. A specific exemplary embodiment may be illustrated in the drawings and be described in detail in a detailed description. However, the specific exemplary embodiment illustrated in the accompanying drawings is provided only to allow various exemplary embodiments to be easily understood. Therefore, it should be understood that the spirit of the present invention is not limited by the specific exemplary embodiment illustrated in the accompanying drawings, but includes all the modifications, equivalents, and substitutions included in the spirit and the scope of the present invention.

Terms including ordinal numbers such as “first”, “second”, and the like, may be used to describe various components. However, these components are not limited by these terms. The terms are used only to distinguish one component from another component.

It should be further understood that terms “include” or “have” used in the present specification specify the presence of features, numerals, steps, operations, components, parts described in the present specification, or combinations thereof, but do not preclude the presence or addition of one or more other features, numerals, steps, operations, components, parts, or combinations thereof. It is to be understood that when one element is referred to as being “connected to” or “coupled to” another element, it may be connected directly to or coupled directly to another element or be connected to or coupled to another element, having the other element intervening therebetween. On the other hand, it should be understood that when one element is referred to as being “connected directly to” or “coupled directly to” another element, it may be connected to or coupled to another element without the other element interposed therebetween.

Meanwhile, a term “module” or “˜er/˜or” for components used in the present specification performs at least one function or operation. In addition, a “module” or a “˜er/˜or” may perform a function or an operation by hardware, software, or a combination of hardware and software. In addition, a plurality of “modules” or a plurality of “˜ers/˜ors” except for a “module” or a “˜er/˜or” performed by specific hardware or performed by at least one processor may be integrated into at least one module. Singular forms are intended to include plural forms unless the context clearly indicates otherwise.

Further, when it is decided that a detailed description for the known function or configuration related to the present invention may obscure the gist of the present invention, the detailed description therefor will be abbreviated or omitted.

FIG.2is a diagram schematically illustrating an apparatus for operation according to an exemplary embodiment of the present invention, andFIG.3is a diagram illustrating a bending part.

Referring toFIG.2, an apparatus100for operation according to an exemplary embodiment of the present invention includes a rod110, a rotating part120, and a bending part130.

The rod110, the rotating part120, and the bending part130are metal or plastic, such as stainless steel, and in addition, may include various materials that have strong corrosion resistance and are harmless to the human body.

The rod110is provided in a cylindrical shape having an accommodation space therein. A first driving force transmission unit and a second driving force transmission unit to be described later may be disposed in the accommodation space.

The rotating part120is rotatably connected to one end of the rod110. One end of the rod110may be provided with a shaft118, and the rotating part120may be rotatably coupled to the shaft118.

The rod110includes a first driving adjustment unit111for driving the rotating part120.

The first driving adjustment unit111may be rotatably connected to the rod110. Although not illustrated, the first driving adjustment unit111may be connected to the rod110in the form of a button. A first driving force transmission unit (not illustrated) is disposed between the first driving adjustment unit111and the rotating part120. The first driving force transmission unit includes power transmission elements (not illustrated) for connecting the first driving adjustment unit111and the rotating part120. The power transmission elements may include gears, belts, cams, wires, etc., used to transmit power, and combinations thereof.

In a structure in which the first driving adjustment unit111is rotatably connected to the rod110, when the first driving adjustment unit111is rotated, the rotating part120is rotated through the first driving force transmission unit. A rotation amount (angle) of the rotating part120is determined according to a rotation angle of the first driving adjustment unit111, so the rotation angle of the first driving adjustment unit111may be adjusted by adjusting the rotation amount (angle) of the rotating part120.

In the structure in which the first driving adjustment unit111is connected to the rod110in the form of a button, when the first driving adjustment unit111is pressed, the rotating part120is rotated through the first driving force transmission unit, so the rotation amount (angle) of the rotating part120may be adjusted through a process of pressurizing the first driving adjustment unit111or releasing a pressure applied to the first driving adjustment unit111.

In addition, although not illustrated, a structure in which the rotation angle of the rotating part120is adjusted by a rotation of a fully automatic motor (not illustrated) in a button type is also applicable.

When the rotating part120is rotated to a desired position, the rotating part120may be fixed to the rotated position by a locking device (not illustrated) or the like.

The bending part130is bendably connected to the rotating part120. The bending part130includes a plurality of links131, a plurality of adjustment wires133, and a switching wire135.

The plurality of links131may be in rolling contact with each other. Hereinafter, the link structure and connection relationship will be described in detail.

FIG.4is a diagram illustrating a link constituting the bending part,FIG.5is a diagram illustrating a lower portion of the link illustrated inFIG.4.FIG.6is a cross-sectional view taken along line I-I ofFIG.5,FIG.7is a diagram illustrating a state in which adjacent links may move relative to each other, andFIG.8is a diagram illustrating a state in which adjacent links are fixed to each other.

As illustrated inFIGS.4and5, the link131includes a link body131a, a convex portion131bformed on one side of the link body131a, and a concave portion131cformed on the other side of the link body131a.

The convex portion131bis formed in a hemispherical shape, and the concave portion131cis formed in a shape corresponding to the convex portion131b. Although not illustrated, the convex portion131bmay have an elliptical shape other than a hemispherical shape or other shapes capable of relative rotation with other concave portions131c, or may have a joint-type structure.

A plurality of first through holes134is formed at an edge of the link131. The plurality of first through holes134is disposed on an outer side of the concave portion131cin the radial direction of the link131.

The plurality of first through holes134is spaced apart from each other in a circumferential direction of the link131. The plurality of adjustment wires133each passes through the corresponding first through hole134to connect the plurality of links131.

A plurality of guide grooves136is formed in a portion corresponding to the first through hole134of the convex portion131bto allow the adjustment wires133to pass therethrough. The plurality of guide grooves136is provided in the number corresponding to the first through hole134. The plurality of guide grooves136is formed at positions corresponding to the first through holes134and is spaced apart from each other in the circumferential direction of the link131.

The link131includes a plurality of first locking protrusions136aformed at positions corresponding to the plurality of guide grooves136. The adjustment wires133may be fixed by being caught on the first locking protrusions136aof the link131located at the most distal end, respectively.

A plurality of elastic bodies132is disposed in the concave portion131calong the circumferential direction of the link body131a. The elastic body132is provided in a spherical shape, and is rotatably disposed in the concave portion131c, and at least a portion of the elastic body132protrudes from the concave portion131c. Although not illustrated, in addition to the elastic body, a rigid body having an appropriate frictional force on the surface is also applicable. For example, a rigid body having a metallic spherical shape may be applied instead of the elastic body132.

When an external force is applied to the elastic body132, the shape of the elastic body132is deformed and inserted into the concave portion131c.

The link131further includes a second through hole131dformed through the center thereof. The switching wire135extends through the second through hole131d.

The link131includes a second locking protrusion131e(refer toFIG.7) formed at a position corresponding to the second through hole131d. The switching wire135may be fixed by being caught on a second locking protrusion131eof the link131located at the most distal end.

As illustrated inFIG.6, a plurality of accommodation grooves138may be formed in the concave portion131cof the link131to accommodate the elastic body132.

A plurality of elastic bodies132is disposed in the plurality of accommodation grooves138, respectively. The plurality of elastic bodies132may be rotated while being accommodated in the plurality of accommodation grooves138, respectively, and at least a portion of the plurality of elastic bodies132may protrude toward the outer side of the concave portion131c.

A diameter d1of an inlet portion of the accommodation groove138may be smaller than a diameter d2of the elastic body132. Therefore, the spherical elastic body132accommodated in the accommodation groove138may not be separated from the accommodation groove138. Also, the spherical elastic body132may be inserted into the accommodation groove138through the inlet portion138aof the accommodation groove138while its volume is reduced due to its own elasticity.

As illustrated inFIGS.7and8, the plurality of links131constituting the bending part130is disposed to be in contact with each other. For convenience of explanation, two links disposed at the distal ends of the bending part130are illustrated inFIGS.7and8, and will be collectively referred to as a first link A and a second link B, respectively. That is, both the first link A and the second link B are included in the plurality of links131constituting the bending part130, and the second link B is a link located at the most distal end of the bending part130.

As illustrated inFIG.7, in a state (hereinafter, referred to as bending mode) in which adjacent links may move relative to each other, the convex portion131bof the first link A is spaced apart from the concave portion131cof the second link B by a predetermined distance G. In addition, in the bending mode, the convex portion131bof the first link A is disposed so as to be in contact with the elastic body132protruding from the concave portion131cof the second link B.

Accordingly, the first link A and the second link B may move relative to each other, and the bending part130may be bent by adjusting the tension of the adjustment wires133connecting the plurality of links131.

A pair of adjustment wires133spaced apart from each other 180° in the circumferential direction of the link131provide a degree of freedom for bending in two directions. In the present exemplary embodiment, since all four pairs of adjustment wires133pass through the links131and connect the links131, the bending part130has a degree of freedom for bending in 8 directions. The degree of freedom for bending can be adjusted through the number of adjustment wires133.

As illustrated inFIG.8, when a tension Tp is applied to the switching wire135, the convex portion131bof the first link A presses the elastic body132, and the pressed elastic body132is compressed to change its shape, and thus, completely inserted into the accommodation groove138. When the elastic body132is completely inserted into the accommodation groove138, the convex portion131bof the first link A is into contact with the concave portion131cof the second link B.

When the first link A and the second link B are in close contact with each other, the frictional force between the convex portion131bof the first link A and the concave portion131cof the second link B increases. As a result, the relative motion of the first link A and the second link B is restricted, and the first link A and the second link B are in a fixed state (hereinafter, referred to as a fixed mode). When the tension applied to the switching wire135in the fixed mode is released, the first link A and the second link B are switched to the bending mode while being spaced apart from each other, and the bending part130may be bent by adjusting the tension of the first wires133. In this way, in the fixed mode, it is possible to detach muscles around the spinous process and to prevent movement in other directions.

In the case of a structure in which a metallic rigid body (not illustrated) other than the elastic body132is inserted into the accommodation groove138, the relative movement of the first link A and the second link B may be restricted, and the first link A and the second link B may be fixed to each other due to the frictional force between the rigid body and the convex portion131bof the first link A while the rigid body and the convex portion131bof the first link A are in contact with each other.

The bending part130further includes a driving plate139that is rotated by being connected to the second driving force transmission unit to be described later. The driving plate139is disposed inside the rotating part120, and is rotatably connected to the rotating part120. The driving plate139has a circular cross-section. The cross-section of the driving plate139may have a polygonal shape other than a circular shape. In addition, the driving plate139may have various shapes such as a three-dimensional spherical shape or a polygonal shape.

The adjustment wires133are wound and fixed on the outer circumferential surface of the driving plate139.FIG.3illustrates only a pair of adjustment wires133aand133bfor convenience of explanation.

The pair of adjustment wires133aand133bconnects the plurality of links131. The pair of adjustment wires133aand133bincludes a first wire133aand a second wire133b.

The first wire133aincludes a first portion133aaand a second portion133ab.

One end of the first portion133aaof the first wire133amay be coupled to a portion of the outer circumferential surface of the driving plate139, and may be wound around the outer circumferential surface of the driving plate139or unwound from the outer circumferential surface of the driving plate139according to the rotation of the driving plate139.

The second portion133abof the first wire133apasses through the plurality of links131and connects the plurality of links131. As described above, one end of the second portion133abof the first wire133ais fixed to the second link B disposed at the last among the plurality of links131.

The second wire133bincludes a first portion133baand a second portion133bb.

One end of the first portion133baof the second wire133bmay be coupled to a portion of the outer circumferential surface of the driving plate139, and may be wound around the outer circumferential surface of the driving plate139or unwound from the outer circumferential surface of the driving plate139according to the rotation of the driving plate139.

The second portion133bbof the second wire133bpasses through the plurality of links131and connects the plurality of links131. As described above, one end of the second portion133bbof the second wire133bis fixed to the second link B disposed at the last among the plurality of links131.

The driving plate139described above is one exemplary embodiment for bending the bending part130, and it is possible to extend the adjustment wires133to the rod110without the driving plate139, and it is also possible to bend the bending part130by adjusting the tension of the adjustment wires133extending to the rod110.

The rod110includes a second driving adjustment unit112for driving the bending part130.

The second driving adjustment unit112may be rotatably connected to the rod110. Although not illustrated, the second driving adjustment unit112may be connected to the rod110in the form of the button. A second driving force transmission unit (not illustrated) is disposed between the second driving adjustment unit112and the bending part130. The second driving force transmission unit includes power transmission elements (not illustrated) for connecting between the second driving adjustment unit112and the bending part130. The power transmission elements may include gears, belts, cams, wires, etc. used to transmit power, and combinations thereof.

In the structure in which the second driving adjustment unit112is rotatably connected to the rod110, when the second driving adjustment unit112is rotated, the bending part130may be bent through the second driving force transmission unit. A bending amount (angle) of the bending part130is determined according to a rotation angle of the second driving adjustment unit112, and thus, the bending amount (angle) of the bending part130may be adjusted by adjusting the rotation angle of the second driving adjustment unit112.

In the structure in which the second driving adjustment unit112is connected to the rod110in the form of the button, when the second driving adjustment unit111is pressed, the bending part130is bent through the second driving force transmission unit, so the bending amount (angle) of the bending part130may be adjusted through a process of pressurizing the second driving adjustment unit112or releasing a pressure applied to the second driving adjustment unit112.

In addition, although not illustrated, a structure in which the rotation angle of the rotating part120is adjusted by a rotation of a fully automatic motor (not illustrated) in a button type is also applicable.

When the bending part130is bent at a desired position, the bending part130may be fixed at the bent position by a locking device (not illustrated) or the like.

In addition, the rod110includes a tension adjustment unit114for adjusting the tension of the switching wire135and a current adjustment unit116for supplying a current to the switching wire135or adjusting a current flowing in the switching wire135. The current adjustment unit116is electrically connected to a current generator (not illustrated) to be described later.

As illustrated inFIGS.7and8, a blade140provided with a hole140ais coupled to the second link B disposed at the last among the plurality of links131. The blade140may be provided in a polygonal shape with the hole140aand a spherical shape with the hole140a, and may be provided in various shapes such as a circular shape, an elliptical shape, and a polyhedron with holes in a two-dimensional plate shape.

The blade140is inserted and fixed to the second through hole131dof the second link B. The blade140may include a metal material through which a current may flow.

The blade140may be connected to the switching wire135. The switching wire135is configured to receive a current from a current generator or a surgical cauterizer (not illustrated) disposed inside or outside the rod110. When a current having a specific wavelength and frequency is generated by the current generator (not illustrated), the current is transmitted to the blade140through the switching wire135to cauterize the tissue around the blade140with thermal energy.

In addition to the switching wire135, the configuration through which the current flows may include all or at least a portion of the adjustment wire133, the bending part130, and all or at least a portion of the end link constituting the bending part130. In this case, all or at least a portion of the adjustment wire133and the bending part130should be provided with a conductive material such as metal.

The blade140is used to remove or deform a portion of soft tissue. Alternatively, the blade140may be used to combine tissues, or may be used to cut tissues by replacing a surgical knife or sharp tools.

The intensity of the current applied to the blade140may be precisely controlled so as to affect only the tissue of a specific region. This is because the blade140is to not only cut tissues by applying force, but also melt a living tissue or cause a living tissue to be stuck by heat generated by a surface contact current. Therefore, through the blade140, it is possible to easily perform surgery (e.g., detachment of a spinal muscle from a spinous process bone, etc.) and hemostasis even on soft tissue that is difficult to treat.

Although not illustrated, an endoscopic optical fiber, an imaging device (camera), or the like that can be bent to know a site where bleeding occurs during spinal endoscopic surgery and should be required hemostasis can be connected to the bending part130.

A strap T may be inserted into the hole140aformed in the blade140.

FIG.9is a diagram illustrating a state in which the rotating part is rotated.

Referring toFIG.9, in a state in which the rod110, the rotating part120, and the bending part130are aligned in a line, as described above, when the first driving adjustment unit111is rotated or pressed to operate, the driving force is transmitted to the rotating part120through the first driving force transmission unit.

When power is transmitted to the rotating part120through the first driving force transmission unit, the rotating part120may be rotated with respect to the shaft118. When the rotating part120is rotated with respect to the axis118, the rotating part120may form an inclination angle θ to the rod110. The inclination angle θ may have various values depending on various conditions (e.g., surgical environment such as a direction of a patient's incision hole, a shape of the rod, a length of the rod, a position of a patient's spinous process, etc.).

When the rotating part120is rotated, the bending part130may be rotated together with the rotating part120.

FIG.10is a diagram illustrating a state in which the bending part is bent.

A process in which the bending part130is bent will be described with reference toFIGS.3and9and10.

As described above, when the second driving adjustment unit112(refer toFIG.2) is rotated or is pressed to operate, the driving force is transmitted to the driving plate139of the bending part130through the second driving force transmission unit.

When the driving plate139is rotated in a clockwise direction c, the first part133aaof the first wire133aand the first part133baof the second wire133bare rotated while the first part133aaof the first wire133aand the first part133baof the second wire133bare fixed to a portion of the outer circumferential surface of the driving plate139. When the first portion133aaof the first wire133aand the first portion133baof the second wire133bare rotated in the clockwise direction c, the second portion133abof the first wire133amoves in the first direction a, and the second portion133bbof the second wire133bmoves in the second direction b opposite to the first direction a.

When the second portion133abof the first wire133amoves in the first direction a, one end of the second portion133abof the first wire133afixed to the second link B located at the most end of the bending part130pulls the second link B in the first direction a, and one end of the second link B is tilted towards the first direction a.

Since adjacent links are in rolling contact with each other, when one end of the second link B is tilted toward the first direction a, one end of the first link A in rolling contact with the second link B is also tilted.

When one end of the first link A is tilted, one end of the other link131in rolling contact with the first link A is also tilted, and one ends of the plurality of links131are generally tilted toward the first direction a through the above-described processes.

When the second portion133bbof the second wire133bmoves in the second direction b, and one ends of the plurality of links131are tilted toward the first direction a, the other ends of the plurality of links131are tilted toward the second direction b.

As one ends of the plurality of links131are tilted in the first direction a and the other ends of the plurality of links131are tilted in the second direction b, the bending part130is generally bent in the clockwise direction c.

The process in which the bending part130is bent in the clockwise direction c has been described above, but the same principle is also applied to the process in which the bending part130is bent in the counterclockwise direction. That is, when the driving plate139is rotated in the counterclockwise direction, the plurality of links131in rolling contact with each other are generally bent in the counterclockwise direction.

FIG.11is a diagram schematically illustrating a state before an apparatus for operation according to an exemplary embodiment of the present invention is inserted through a patient's incision hole,FIG.12is a diagram schematically illustrating a state in which the apparatus for operation according to an exemplary embodiment of the present invention wraps around a patient's spinous process, andFIG.13is a diagram schematically illustrating a state in which a strap wraps around spinous processes.

Referring toFIGS.11to13, the apparatus100for operation is configured to have a first shape in which the rotating part120and the bending part130are arranged substantially parallel to the rod110so that the rotating part120and the bending part130may be inserted into a body through an incision hole P, and a second shape in which the rotating part120is rotated with respect to the rod110or the bending part130is bent so that the bending part130wraps around spinous processes S1and S2in the body.

The apparatus100for operation may be fixed by a locking device (not illustrated) or the like in the first shape and the second shape.

In a state in which an interspinous spacer X is inserted between the spinous processes S1and S2, the rotating part120and the bending part130may be inserted into the periphery of the patient's spinous processes S1and S2through the patient's incision hole P in the first shape disposed substantially parallel to the rod110.

The rotating part120may be rotated to form an inclination angle θ to the rod110. In this case, the bending part130may be rotated together with the rotating part120.

In the state in which the rotating part120is rotated, the bending part130may be bent along the circumference of one S1of the spinous processes.

In the state in which the strap T is inserted into the hole140a, when the rotating part120is rotated with respect to the rod110and the bending part130is bent along the circumference of one S1of the spinous processes, the strap T wraps around one S1of the spinous processes. In the state in which the strap T wraps around one S1of the spinous processes, when the rod110is rotated with respect to a rotation axis R1, the strap T inserted into the hole140aof the blade140wraps around one S1of the spinous processes while the bent bending part130is rotated around one S1of the spinous processes.

In the state in which the rotating part120is not rotated with respect to the rod110, by bending the bending part130and rotating the rod110about the rotation axis R1, the strap T may wrap around one S1of the spinous processes. In addition, in the state of the rotation, it is possible to wrap around one of the spinous processes only by bending the bending part according to the surgical environment without the rotation about the rotation axis R1.

After the strap T wraps around one S1of the spinous processes, the strap T may be separated from the apparatus100for operation.

After the apparatus100for operation is disposed on the periphery of the other S2of the spinous processes, the strap T is inserted into the hole140a, in the state in which the strap T is inserted into the hole140a, the rotating part120is rotated with respect to the rod110, and when the bending part130is bent along the circumference of the other S2of the spinous processes, the strap T wraps around the other S2of the spinous processes. In this state, when the rod110is rotated with respect to the rotation axis R1, the strap T inserted into the hole140aof the protrusion wraps around the other S2of the spinous processes while the bent bending part130is rotated around the other one S2of the spinous processes.

In the state in which the rotating part120is not rotated with respect to the rod110, by bending the bending part130and rotating the rod110about the rotating shaft R1, the strap T may wrap around the other S2of the spinous processes. In addition, in the state of the rotation, it is possible to wrap around the other of the spinous processes only by bending the bending part according to the surgical environment without the rotation about the rotation axis R1.

After the interspinous spacer X is inserted between the spinous processes S1and S2, in the state in which the strap T wraps around the spinous processes S1and S2, one end of the strap T and the other end of the strap T may be fixed to each other by a coupling member190. The coupling member190may be, for example, a clip or a buckle.

The coupling member190is configured to apply the tension to both ends of the strap T to maintain the tensioned state of the strap T. Therefore, the interspinous spacer X is firmly fixed between the spinous processes S1and S2, and thus, the phenomenon that the interspinous spacer X is separated between the spinous processes is prevented. In addition, the stability of the corresponding vertebral segment including the spinous processes S1and S2is greatly improved.

In the above, the structure in which the apparatus100for operation includes the structure including the rod110, the rotating part120, and the bending part130has been illustrated and described as an example, but is not limited thereto.

For example, the apparatus100for operation may have the structure including only the rod110and the bending part130without the rotating part120. In this case, the bending part130is directly coupled to the rod110, and by bending the bending part130and manipulating the rod110, the strap T may wrap around the spinous processes.

FIG.14is a diagram schematically illustrating an apparatus for operation according to another exemplary embodiment of the present invention.

An apparatus200for operation according to another exemplary embodiment of the present invention includes a rod210, a rotating part220, a bending part230, and a guide part240. The rod210, the rotating part220, and the bending part230are the same as the apparatus100for operation according to an exemplary embodiment of the present invention described above, and therefore, a description thereof will be omitted.

The guide part240is provided in a shape of a hollow tube. The guide part240may be made of a hard and elastic material such as plastic or silicone, or may be made of a metal material and a joint part that needs to be rotated may be provided in the form of a mesh.

The rod210, the rotating part220, and the bending part230may be accommodated in the guide part240.

The rod210, the rotating part220, and the bending part230may be in contact with the inner surface of the guide part240while the rod210, the rotating part220, and the bending part230are accommodated in the guide part240.

The guide part240may include a first body242having both ends open, a second body244having both ends open, and a connection joint246connecting the first body242and the second body244.

The connection joint246may include a wrinkle part246aso that the second body244may be bent with respect to the first body242.

The first body242and the second body244prevent the rod210, the rotating part220, and the bending part230accommodated therein from moving or rotating in an unwanted direction in a patient's body, or prevents the shape of the bending part230from being deformed, thereby enabling stable operation.

The guide part240may be inserted into the periphery of the patient's spinous processes S1and S2(seeFIGS.11to13) through the patient's incision hole P (seeFIGS.11to13) while the first body242and the second body244are substantially aligned side by side

The rod210, the rotating part220, and the bending part230are guided to the periphery of the spinous processes S1and S2through the inside of the guide part240while the guide part240is inserted.

When the rotating part220is rotated or the bending part230is bent, an end of the bending part230may be disposed at a desired position while the second body244is bent with respect to the first body242by the wrinkle part246a. Thereafter, the process of winding the strap T around the spinous processes S1and S2to fix the interspinous spacer X between the spinous processes S1and S2is the same as described above.

Although not shown, a modified exemplary embodiment of the apparatus200for operation according to another exemplary embodiment of the present invention described above is also applicable.

For example, the guide part240described above includes the first body242, the wrinkle part246aconnected to the first body242, and power transmission wires (not illustrated) disposed on an inner surface or an inner wall of the first body242and the wrinkle part246ato rotate the wrinkle part246awith respect to the first body242or fix the wrinkle part246ain a state in which the wrinkle part246ais rotated.

In addition, in response to the guide part as described above, the apparatus for operation may include only the bending part and a driving unit for driving the bending part without the rotating part.

In such a structure, the apparatus for operation passes through the guide part240and enters the periphery of the spinous processes S1and S2to perform functions such as muscle detachment, cauterization, and winding of the strap T after spacer insertion.

In addition, before the apparatus for operation is inserted by passing through the guide part240, the guide part240may serve to guide the spacer X to the periphery of the spinous processes S1and S2through the inner side of the guide part240.

Although exemplary embodiments of the present invention have been illustrated and described, the present invention is not limited to the above-described specific exemplary embodiment, but may be variously modified by those skilled in the art to which the present invention pertains without departing from the spirit and scope of the present invention as claimed in the claims. In addition, such modifications should also be understood to fall within the scope of the present invention.