TW201524453A - Rod insertion device - Google Patents

Abstract

A rod insertion device (1, 1') for inserting a spinal stabilization rod (95) into at least two bone anchors (901, 901'), wherein the rod inserting device comprises: a first tubular rod guide (6) configured to guide the spinal stabilization rod (95) therethrough, and a holding device (3, 3') configured to hold the rod guide (6), an adapter (2) configured to be connected to an extension (9), which is configured to be mounted to a receiving part (90) of the bone anchor (901), and configured to movably support the holding device (3, 3'); wherein, when the adapter (2) is connected to said extension (9), the holding device is arranged to move and pivot the rod guide (6) to allow a front portion (64) of the rod guide (6) to be positioned proximal to a rod channel of the receiving part (90); wherein the holding device (3, 3') includes a clamping portion (5, 5') arranged to clamp a portion (61) of the rod guide (6), and to allow releasing the portion (61) of the rod guide (6) at least in a state wherein the front portion (64) of the rod guide is positioned proximal to the rod channel of a first receiving part (90) of a first bone anchor (901), wherein an orientation of the rod guide (6) in the released state may be polyaxially (1030c, 1032) corrected in respect of a second receiving part (90') of a second bone anchor (901').

Description

Inserting a spinal stabilization rod into a rod insertion device for at least two bone anchors

The present invention relates to a rod insertion device for inserting a spinal stabilization rod into at least two bone holders, wherein the device comprises a tubular rod guide that constitutes a guiding spinal stabilization member; a retaining device that forms a retaining rod guide; and an engagement The member is connected to the extension member and can be fixed to the accommodating member of the bone anchor.

It is technically known to treat spinal fractures, arthrodesis, scoliosis, etc., using bone anchors for two or more vertebrae, stabilizing the spine, and connecting them with rigid or dynamic flexible stabilizers, such as Each vertebra defines its predetermined relative position and motion tolerance. In operation, a bone anchor is selectively supplied to the vertebra, and a stabilizer bar is inserted to connect the bone anchors. A number of methods and apparatus have been developed for inserting rods into individual rod slots provided in the holder.

US 2013/0096637 A1 discloses an apparatus having a main body holding a curved rod holder that is tubular and houses a rod that can be advanced through a slot of an individual spinal implant. In the extension of the main body, there is a function of the engaging member to connect to the post of the receiving member mounted to the spinal implant. A keyway is provided on the post and extension to ensure that the main body achieves a predetermined position relative to the bone anchor. In operation, the handle is used to advance the rod holder and the rods contained therein through the soft tissue until it is near the predetermined position of the spinal implant slot. Therefore, a set of bearings is provided in the main body to guide the rod holder.

US 2002/0161368 A1 discloses a mounting instrument for a connecting element, wherein the support arms are each connected to a holder extension mounted on a yoke of two adjacent bone fasteners. An inserter for the lever member is provided as a pivoting arm that can be pivotally pivoted about an axis provided by the support arm. Thus, by the pivoting of the inserter, the rods are inserted into individual passages of adjacent fixtures.

US 8,105,362 B2 discloses a rod insertion system. Extenders mounted on individual nail heads are provided with extender heads that are aligned with one another using a rod-like alignment member. The alignment member is slidably coupled to a pair of arms secured to the curved conduit. The curved conduit retains the insert member and can Use the rod to insert the probe to push the spinal rod through the individual passages of the spike.

US 7,918,878 B2 discloses a minimally invasive surgery (MIS) system in which an inserter forming a straight rod is held by a guide. The inserter is provided with a connecting member at the tip end. The guide member is coupled to the robot assembly extending from the bone holder, and the guide member has an opening through which the inserter can be guided to position the connecting member into the passage of the two adjacent bone anchors. Curved position. The opening can be opened to release the inserter.

It is an object of the present invention to improve a system and method for inserting a rod into a rod slot of at least two bone anchors with minimally invasive surgery (MIS). More specifically, the object is to simplify the rod insertion process and thus increase the flexibility of the operator.

This object is solved by the rod insertion device requested in the first application of the scope of the patent application. Further gist and specific examples will be apparent from the scope of the patent application.

According to a specific example, the rod insertion device is provided with a tubular rod guide, which constitutes a holding means for holding the rod guide, and an engaging member which is connected to the extension member and which can be attached to the holder of the bone holder. The engagement member constitutes a movable support support device. Thus, the engagement member allows the retention device and the rod guide to move and pivot in a predetermined path, wherein the rod guide front portion reaches a rod slot of the first receiver member proximate the first bone anchor, the extension member can be mounted thereto.

The clamping device is configured to entrain one of the rod guides to ensure a coordinated movement of the retaining device and the rod guide. This has the advantage that the clamping device also constitutes a release of the rod guide in the above state, wherein the rod guide has been brought to the front where it enters the soft tissue under MIS conditions, in the vicinity of the rod groove of the receiving member. This release provides a rod guide orientation that can be corrected in multiple axes. In other words, the rod guide can be rotated in this state or can be pivoted.

According to a particular embodiment, two distinct states in which the rod guide is released from the retaining device can be achieved. The configuration of the clamping portion can be separated from the rod guide to achieve complete release. In this state, the rod guide is separated from the retaining device, but substantially maintains its position and orientation such that the front portion is in proximity to the receiving member because it is already in the soft tissue when the application is released. This can be achieved, for example, by the fact that the gripping portion is arranged in a plurality of different components connected via the first locking arrangement, allowing the individual components to be separated and thus can be removed.

Other release states are implemented using a second locking arrangement provided at the clamping portion. A partial release can be achieved here, meaning that some of the rod guides are still held by the clamping portion, but the rod guides are reoriented because it can be multi-axis. A special case is the connection between the rod guide and the clamping portion to be clamped, It is also feasible to set the ball joint or turn the head mechanism, but other mechanisms for achieving multi-axis reorientation are also possible.

In this state, the rod guide is still safely held, but the orientation has been corrected slightly.

However, only a specific example of one of the above two release states may be achieved.

Another particular embodiment of the invention is directed to a dedicated support structure provided with an adapter whereby the movement guide retains the rod guide front to a position adjacent the receiver rod slot. The support structure provides a preliminary translation of the rod guide, essentially a linear motion, followed by a smooth over-to-pivoting, such as introducing a curved guide rod closer to the bone anchor involved, further reducing patient injury. Thus, the implementation of the support structure can be slid within the groove, for example by means of a cam-like structure, such as a pin, although other mechanisms can be used, using rods connected via hinges, joints and axes of rotation.

1,1'‧‧‧ insertion device

2‧‧‧Joint parts

3,3'‧‧‧ Keeping device

4‧‧‧ base

5,5'‧‧‧ gripping department

6‧‧‧ rod guide

7‧‧‧handle

8‧‧‧Cutting parts

9‧‧‧Extensions

22‧‧‧ side wall

23a, 23b, 23a', 23b'‧‧‧ groove

43a, 43b, 43a', 43b'‧‧‧ pin

51,52,51',52'‧‧‧ bracket

53,53'‧‧‧First lock configuration

54,54'‧‧‧second lock configuration

58,59‧‧‧ hemispherical recess

61‧‧‧Spherical Sphere

62‧‧‧ cavity

64‧‧‧ front

81‧‧‧ cutting tip

90,90'‧‧‧ accommodating parts

95‧‧‧Spine stabilization rod

531,532,533,534‧‧‧ lag screws

535‧‧‧ recess

541‧‧‧Instruction pin

901,901'‧‧‧ bone anchor

1 is an overview of an extension member attached to a bone holder accommodating member in a first specific example; FIG. 2 is an exploded perspective view of the joint member shown in FIG. 1; and FIG. 3 is a second view; A plan view of the joint member shown in FIG. 4; a cross-sectional view of the joint member along the AA plane shown in FIG. 3; and a cross-sectional view of the joint member along the BB plane shown in FIG. 4; 2 is a plan view of the retaining plate used for the joint member; FIG. 7 is a cross-sectional view of the retaining plate shown in FIG. 6 along the CC plane; and FIG. 8 is a retaining device and a rod guide of the rod inserting device shown in FIG. Figure 9 is an exploded view of the assembly shown in Figure 8; Figure 10 is a plan view of the assembly shown in Figure 8; and Figure 11 is a second locking arrangement detail along the DD plane shown in Figure 10. Fig. 12 is a cross-sectional view of the first locking arrangement detail along the EE plane shown in Fig. 10; Fig. 13 is a perspective view of the left bracket shown in Figs. 8 and 9; Figure 13, but from another point of view; Figure 15 and Figure 13, but from another point of view; Figure 16 is a sectional view, top view and through view of the pin of the second locking arrangement shown in Figure 9. Figure 17 is an enlarged view of the rod guide clamping portion shown in Figure 1; Figure 18 is a side view of the cutting member accommodated in the rod guide shown in Figure 1; Figure 19 is an enlarged view of the tip of the cutting member shown in Figure 18; Figure 20 is a side view of the rod guide shown in Figure 1 together with the handle; Figure 21 is the same as Figure 20, but is a plan view; 20 or 21 is a side sectional view of the rod guide; FIG. 23 is a first step of the first embodiment of the rod insertion device; and FIG. 24 is a second step of the first embodiment of the rod insertion device. Fig. 25 is a view showing a third step of the use method of the rod insertion device of the first specific example; Fig. 26 is a view showing a fourth step of the use method of the rod insertion device of the first specific example; and Fig. 27 is a view showing the use of the rod insertion device of the first specific example; The fifth step of the method; the figure 28 shows the sixth step of the method of using the rod insertion device of the first specific example; the figure 29 shows the seventh step of the method of using the rod insertion device of the first specific example; and the figure 30 shows the first example of the rod The eighth insertion step of the first embodiment of the rod insertion device is shown in the eighth step; the third step is shown in the first embodiment; the third step is shown in the third embodiment; a specific example of a rod insertion device Method eleventh step; Fig. 34 shows a twelfth step of the first embodiment of the rod insertion device; and Fig. 35 is a second embodiment of the present invention, the rod insertion device is applied to the extension of the bone holder An overview of the parts; Fig. 36 is an exploded view of the rod insertion device shown in Fig. 35, without the joint and the inner cutter.

Specific examples are described below with reference to the accompanying drawings.

A first specific example of the rod insertion device of the present invention will be described with reference to Figs. 1 to 22, and the corresponding use method of the rod insertion device of the first specific example will be described with reference to Figs. 23 to 34.

An overview of the rod insertion device 1 of the first specific example is shown in Fig. 1. The main components of the rod insertion device 1 are the joint member 2, the holding device 3 including the base portion 4 and the grip portion 5, the rod guide 6 having the handle 7, and the detachable inner cutter member 8. The rod insertion device 1 of this specific example is applied to a series of extension members 9, 9', 9", and each extension member is mounted to an individual accommodating member 90 of the bone anchor 901 (the cadre of the bone anchor is not seen in the specific example, Because it is completely in the bone material of the individual foot of the vertebra 100).

It should be noted that the extension member 9 in this specific example is not considered to be an assembly of the rod insertion device. However, according to other specific examples, the extension member 9 can be an assembly of the rod insertion device. An extension device, such as an extension 9, is primarily used to assemble the assembly to the bone holder and to facilitate final fixation, but is otherwise used to define the mounting position of the bone holder relative to the engagement member, i.e., relative to the rod insertion device 1.

The above-described components of the insertion device will be described in more detail below with reference to Figures 2 through 22, the function of which can be referred to the method steps shown in Figures 23 to 34.

The joint member 2 and its detailed components are as shown in Figures 2 to 7. The engaging member 2 comprises a cubic body 21 having substantially flat side walls 22 and rounded edges, and the cubic body 21 has a bore 281 slidably accommodating one of the extensions 9, 9' or 9" shown in Fig. 1. A flat portion 283 is formed in the bore 281 for guiding the individual flat portions 92, 92', 92" of the extension. With the flat portion 283, the engagement member 2 attached to the extension member 9 can be prevented from rotating, and when assembled, the orientation of the lever insertion device 1 is predetermined with respect to the bone anchor 901.

At the upper end of the bore 281, an opening 24 is formed toward the top surface of the engaging member 2 to allow access to the bore. A small shoulder 282 (see Fig. 4) serves as a support for the engagement member 2 relative to the upper end of the extension member 9.

In the method of using the lever inserting device 1 shown in Figs. 23 and 24, the first two steps of attaching the engaging member 2 to the extension member 9 are shown. Here, the engaging member 2 is slid (see numeral 1023) the distal end of the extension member 9. In Fig. 24, the number of 1024 is used to secure the joint 2 to the top of the extension 9 using the retaining plate 25. The warranty plate 25 is detailed in Figures 6 and 7. The securing plate 25 includes a plate portion 255 that is slidable into the slot 29 of the engaging member 2. The plate-type operating portion 251 allows the retaining plate to be pushed into the slot 29 against the force of the spring 26, and is attached to the nose portion 253 (see Fig. 6) to bear against the face portion 284 in the opening 28 (see Fig. 5).

The inner nearly circular recess 254 formed in the plate portion 255 can be introduced through the top of the extension member 9 when sliding upward in the bore 281 of the engaging member 2. For this purpose, the borrowing member 27 can be introduced into the hole 270 formed in the top surface of the engaging member 2 to hold the retaining plate 25 in position. Thus, the tip end of the pin member 27 comes into engagement with the recess 252 formed by the plate portion 255 of the retaining plate 25 (see Fig. 6). Once the top of the extension member 9 hits the shoulder 282 at the upper end of the cavity 281, a portion of the circular recess 91 formed in the upper portion of the extension member 9, that is, faces the securing plate 25, so that the retaining plate 25 can be forced into the top by the spring 26. The recess 91 of the extension member 9, i.e., latches into the recess 91, thereby securing and securing the engaging member to the extension member 9.

As shown in FIG. 2, the engaging member 2 includes a groove on the opposite side 22 thereof. 23a, 23a', 23b, 23b'. As described below, each of the grooves forms an assembly of the support structure to support the base 4 of the retaining device 3, as shown in FIG. In the assembled state of the engaging member 2, the flat side surfaces 22 of the grooves are formed to define a line orientation across the bone holder 901 and the extension members 9, 9', 9".

Figures 8-10 show the retaining device 3 and the stem guide 6 with the handle 7, the retaining device 3 comprising a base 4, in the shape of a U, comprising a main wall 24 and two side walls 41, 42 attached to the engaging member 2, i.e. at the side wall 22 surrounded by. The side wall 41 shown on the right side of the figure contains two pin members 43a, 43b at the distal end, and the right side wall 42 includes pin members 43a', 43b' at the distal end. The design and shape of the pins can be nested into the individual grooves 23a, 23b, 23a', 23b' of the engaging member 2, respectively.

Figure 25 shows the third step of the lever insertion device 1 in which the base 4 can be attached to the engaging member 2 (see numeral 1025), and the pin members 43a, 43b, 43a', 43b' respectively enter the recess 23a from the top direction. , 23b, 23a', 23b' can be at the top.

In the fourth step of the use of the rod insertion device 1, the pin of the base slides smoothly in the groove of the side wall 22 of the engaging member 2, wherein the upper portions 231a and 231b of the individual grooves contain a slightly curved but nearly close The linear shape, thereby causing the vertical movement of the holding device and the rod guide 6 to be almost translated (see number 1026). Thus, the arrangement of the holding device 3 and the rod guide 6 held by the clamping portion 5 is such that the rod guiding front portion 64 is oriented substantially in the extension member 9 and perpendicular to the skin surface of the patient (not shown), and the following can be utilized. The tip 81 of the cutting member 8 projecting from the front portion 64 is effectively cut. In addition, the translational motion 1026 allows the soft tissue to be cut at a location proximate to the bone anchor 901 and the extension 9.

In the fifth step of the method shown in Fig. 27, the cutting edge 811 of the tip 81 has entered soft tissue (not shown), and the pins 43a, 43b, 43a', 43b' have entered the bottom of the elliptical curved groove. 232a, 232b, the holding device 3 and the rod guide 6 are pivoted 1027. The pivoting curvature is almost equivalent to the curvature of the tubular stem guide 6. Thus, the rod guide 6 is introduced at the skin surface and small incision points of the soft tissue, ensuring the well-known advantages of minimally invasive surgery (MIS).

As with the sixth step of the method illustrated in Fig. 28, the front portion 64 of the stem guide 6 has reached or reached a position adjacent the receiving member 90 and in which a rod groove (not shown) is formed. At this stage, the pin members 43a, 43b of the base portion 4 also have the end points of the individual tracks in the grooves 23a, 23b, etc., where a stop portion can be provided to indicate and impart a tactile response to the operator, indicating that the end position has been reached. . At this stage, the cutting member 8, as detailed in Figures 18 and 19, can be removed by the handle 84. The inner cutter 8 is formed of a curved rod member whose tip end 81 has a cutting edge 811 and an intermediate stopper 83, ensuring that when inserted, Only the tip 81 projects from the front portion 64 of the stem guide 6. The curvature of the cutting member 8 corresponds to the curvature of the curved tube portion 60 of the stem guide 6.

Next, the holding portion 5 of the holding device 3 will be described with reference to Figs. The clamping portion includes two brackets 51, 52 that are pivotally coupled to the hinges 45 provided at the intermediate wall portion 44 of the base 4. In this particular embodiment, the hinges are formed by upper and lower apertures 46, 47 formed in the main projections of the main wall 44 and the bolts 48 into which the bolts 48 can be inserted. The brackets 51, 52 include respective apertures 56, 57 at the ends that are aligned with the apertures 46, 47 of the main wall. The brackets 51, 52 are pivotable about each other about the hinge 45 and away from each other.

The left bracket 51 includes a partial hemispherical recess 58 and the right bracket 52 also includes partial hemispherical recesses 59 that are aligned with each other and are substantially the same size and radius when the brackets 51, 52 are against each other with their flat end faces. At 511,521, the hemispherical recesses 58, 59 form a substantially spherical interior space leaving a small opening in the upper and lower sides, allowing the rod guide 6 to extend through, as described in detail. As can be seen from Fig. 8 and Fig. 1 to Fig. 1, the spherical inner space constitutes a spherical spherical portion 61 accommodating the rod guide 6. Here, the spherical spherical portion 61 dimension may be slightly larger than, for example, the hemispherical concave portion 58, 59, and when the first locking configuration 53 is tightened, the clamping function may be achieved. However, the dimensions between the spherical space and the spherical portion 61 may also be uniform. See Figure 12 for details of the first locking configuration.

More specifically, the first locking arrangement includes a hinged support member 531 disposed on the right side bracket 52 and formed in a single piece with the threaded stem portion 532. The threaded stem 532 can be threaded with the female thread 533 formed by the nut 534. When the ball portion 61 of the rod guide 6 is clamped, the lag screw assembly 531, 534 is formed together, that is, pivoted around the hinge member 531, and the trunk portion 532 is inserted into the recess 535 formed at the end of the left bracket 51, wherein the nut 534 can be Pull in the buckle groove 536 for a secure connection, see Figure 12 for details.

As can be seen in Figure 31 below, the first locking arrangement 53 allows the brackets 51, 52 to be completely removed from the spherical ball 61 by the pivoting brackets.

The clamping device 5 of this specific example contains a second locking device 54, as seen in Figures 9, 11, and 16.

As seen in detail in Fig. 11, the second locking arrangement 54 can be used to position and orient the spherical spherical portion 61 of the rod guide 6 within the inner spherical space defined by the hemispherical recesses 58, 59 of the brackets 51, 52, respectively. For this purpose, the locking arrangement includes a nut 544 with a latch 541 attached thereto, such as a snap-on or threaded type (not shown), as seen in Figure 16. The latch 541 is generally cylindrical, shoulder 547 and except at the distal end of the nose 544. The coil spring 543 can be engaged with the cylindrical portion of the latch pin 541, against the shoulder portion 547 of one side, and the inner ring shoulder portion 546 formed by the slit cavity 514 provided in the left bracket 51. As a result, as shown in Fig. 11, the latch pin 541 is urged toward the hemispherical concave portion 58 by the coil spring 543, and if the spherical spherical portion 61 of the rod guide 6 is inserted, the cavity hole 62 formed therein is entered.

Therefore, the nose portion 548 provided at the distal end of the latch pin 541 is designed to be snapped into the individual recess 621 formed in the cavity 62 if the latch is in a particular orientation.

As can be seen from the 14th or 15th view, the pin member 542 that is inserted into the individual hole 545 of the latch pin 541 and protrudes from both ends of the hole 545 can be latched into the recess 512 located away from the hemispherical recess 58 or near the hemisphere. The recess 513 of the recess 58 is inside. The recesses 512, 513 define two different index positions of the latch 541, wherein when the pin 542 is latched into the recess 512, the distal end of the latch 541 (at the nose 548) does not protrude into the hemispherical recess 58 and the pin When the 542 is latched into the recess 513, the distal end protrudes into the hemispherical recess 58 or is fixed in the cavity 62 of the spherical ball portion 61 of the rod guide 6. Since the latch 541 is forced into the inner spherical space defined by the recesses 58, 59, the operator must pull the nut 544 outward to change the locked or released state relative to the spherical ball 61.

The rod guide 6 together with the handle 7 overview, as shown in Figures 20-22. The handle 7 of this specific example can be disengaged from the rod guide by means of the button 71. The rod guide 6 includes a curved tube portion 60 having an internal bore 67 having a diameter comparable to that of the stabilizing rod 95 and a front portion 64 defining an outlet of the tube. The spherical ball portion 61 is provided at the upper portion of the rod guide 6, from which the bent portion extends. The bent pipe portion is buckled into the annular extension 63 provided at the lower portion of the spherical spherical portion 61. The inner bore 67 extends through the spherical bulb 61 up to the opening 65, defining the inlet of the stabilizing rod, formed within the rod guide assembly 66 for attachment to the handle 7.

Turning back to the method of using the rod insertion device 1, FIG. 29 shows a seventh step in which the arc-shaped or curved spinal stabilization member 95 is inserted and advanced (see number 1029) tubular rod guide after the inner cutter 8 is removed. An inlet aperture 65 is formed in the rear assembly 66 of 6. The tubular rod guide 6 details are shown in Figures 20-22. The spinal stabilization member 95 is advanced in this step until its tip exits the inner bore 67 of the curved member portion 60 of the front portion 64 of the stem guide 6.

This case is shown in Fig. 30, which is the eighth step of the method of using the rod insertion device 1. The operator may choose to accommodate the orientation of the spinal stabilization member 95 and the rod guide 6 as the spinal stabilization member 95 is further advanced (number 1029) into and through the rod slot of the receiving member 90. Therefore, the nut 544 of the second locking arrangement 54 is pulled out and rotated (number 1030b) so as to be spherical from the rod guide 6. The cavity 62 of the bulb 61 retracts the latch 541. Since the spherical ball portion 61 is still held by the lag screw of the first locking arrangement 53, the nut 534 of the lag screw can also be slightly rotated to reduce the pulling force (see numeral 1030a). As a result, the rod guide is fixed by the second locking arrangement 54, and is released due to the clamping of the first locking arrangement 53, and the spherical ball portion 61 is still contained in the spherical inner space formed by the recesses 58 and 59. As a result, the spherical spherical portion 61 functions like a ball joint, allowing multi-axis pivoting (see numeral 1030c) and correction of the rod guide 6 in the 3D dimension in the spherical inner space.

The annular extension 63 on one side of the spherical bulb 61 and the assembly 66 on the other side of the spherical bulb 61 allow for a sufficient degree of pivoting, as seen in Fig. 11.

Fig. 31 shows the ninth step of the method of using the rod insertion device 1. The spinal stabilization member 95 continues to advance (number 1029) with its tip entering the rod slot of the second receiver 90' of the second bone anchor 901. The operator occasionally applies a greater degree of reorientation with a greater degree of control over the continued advancement of the spinal stabilization member 95. For this purpose, the lag screw (assembly 531-534 shown in Figure 9) is finally unscrewed and the lag screw is released from the recess 535 and the groove 536. Therefore, the brackets 51 and 52 can be pivoted (consuming 1031) and moved apart from each other, and the spherical inner space formed by the recesses 58, 59 releases the rod guide.

Since the retaining portion is no longer needed, the base 4 together with the clamping portion 5 can be pushed up, with the pin members 43a, 43b, 43a', 43b' sliding through the individual grooves 23a, 23b, 23a', 23b', thus from the engaging member 2 Remove. In this case, as in the tenth step of the method of using the rod insertion device shown in Fig. 32, the operator can control the continued advancement 1029 as long as the operator applies the force on the rod guide 6 via the handle 7. For example, the spinal stabilization bar 95 continues to advance through the third receiving member 90", which in this particular embodiment may not be aligned with the first and second receiving members 90, 90'.

As in the eleventh step of the method shown in Fig. 33, the handle 7 together with the rod guide 6 can be removed from the end of the rod member 95 after being brought into full position. Performing a further step (not shown) provides a fixing screw or the like, and fixing the spinal stabilization member 95 in the rod groove through the inner cavity of the extension member 9, 9', 9" toward the receiving member, the unused end The portion 95a can be disassembled by being separated from the insertion rod member 95 (number number 1034a) at a predetermined breaking point 96. As shown in Fig. 34, the twelfth step of the method, the unused rod end 95a, can be used. The soft tissue is withdrawn (see number 1034b). At this stage, the joint 2 is also removed from the first extension 9.

The first and second locking arrangements of the first embodiment of the gripping portion 5 are preferably convenient for releasing the two different states of the stem guide 6 from the gripping portion 5. The operator selects the rod guide to be clamped and fixed depending on the situation. The predetermined insertion path is released by a portion of the shaft that is reoriented, and is fully released from the retaining device, and brought to a position to selectively control the spinal stabilization member to advance through the rod slot. Therefore, the multi-axis correction is applied with less effort and the rod insertion method is simplified. On the other hand, the safe insertion can be improved because the operator has full control over the insertion process.

The second embodiment will be described with reference to Figures 35 and 36. The same components as those in the first specific example are denoted by the same reference numerals and will not be described again. The main difference between the rod insertion device 1' of the second specific example and the first specific example lies in the grip portion 5'. Here, the first and second brackets 51' and 52' are not provided as pivoting members, but can be moved or slid in opposite directions toward and away from each other.

Therefore, the first bracket 51' is provided with a protruding pin 537 which can be inserted into the individual hole of the second bracket 52'. Due to the slit 538, the locking plate 536 is inserted, and the connection between the locking brackets 51', 52' is equivalent to the function of the first locking arrangement 53' inserted into the slot 536a, so when the locking plate 536 is unlocked, the locking plate 536 is unlocked. The recess 539 is combined with the slit 538.

The function of the second locking configuration 54' is similar to the first specific example.

In use, the annular seat 83 of the inner cutter 8 ensures the locked position of the locking plate 536, see Fig. 18. Because the locking plate 536 has an upper flange, it is latched to the annular support 83. Since the cutting edge 811 is used to cut the soft tissue through the cutting edge 81, the handle 7 can be used to remove the soft tissue. Thus, with the support removed, the locking plate 536 can be further slid into the slot 536a such that the lug 537 can be released from the second bracket 52' (the slit 538 is disengaged from the recess 539). The rod guide 6 and the spinal stabilization member 95 continue to push into the soft tissue, which can be performed manually, as the current route is undefined.

The components of the above specific examples are made of materials, such as stainless steel, titanium, nickel and/or titanium alloy, or plastic materials, depending on durability and rigidity, and ensure biocompatibility.

The stabilizer bar 95 can also be made of biocompatible metal or plastic. In a specific example, the curvature of the rod corresponds to the rod guide.

The present invention also provides a set including the above-described rod inserter in which two or more rod guides are provided, and the curved radii of the curved tube portions 60 are different from each other. The corresponding rods have an appropriate curvature and are also selected as needed.

The above specific examples may have several modifications, and do not violate the scope defined by the scope of the patent application.

For example, the rod guide can be clamped, locked, and retained in the nip by the lag screw or other securing mechanism other than the indicator pin.

In addition, the support structure defined as a pair of recessed grooves and inner slide pins can be modified with a hinge mechanism and/or a single axis of rotation to facilitate pivoting of the retaining device and the rod guide.

Also, components such as the handle 7 or the inner cutter 8 may be omitted.

Furthermore, the bone holder and the extension of the rod insertion device of the present invention can be of various types, wherein the bone anchor can be embodied as a multi-axis bone anchor or an integral bone anchor, and the shape of the rod groove And design, various types known in the art can be selected.

1‧‧‧Insert device

2‧‧‧Joint parts

3‧‧‧ Keeping device

4‧‧‧ base

5‧‧‧Clamping Department

6‧‧‧ rod guide

7‧‧‧handle

8‧‧‧Cutting parts

9,9',9"‧‧‧Extensions

51,52‧‧‧ bracket

53‧‧‧First lock configuration

54‧‧‧Second lock configuration

64‧‧‧ front

83‧‧‧ ring seat

84‧‧‧handle

90‧‧‧ accommodating parts

92", 92'''‧‧‧ Flat

100‧‧‧ vertebrae

901‧‧‧Bone holder

Claims (16)

A rod insertion device (1, 1') for inserting a spinal stabilization member (95) into at least two bone anchors (901, 901'), the rod insertion device comprising: a first tubular rod guide (6), Constituting to guide the spinal stabilization member (95) through; a retaining device (3, 3') configured to hold the stem guide (6); a joint member (2) configured to be coupled to an extension member (9), The latter constitutes a receiving member (90) mounted to a bone holder (901) and is configured to movably support the holding device (3, 3'); wherein when the engaging member (2) is attached to the extension member (9) The retaining device is configured to move and pivot the stem guide (6), permitting a front portion (64) of the stem guide (6) to be positioned adjacent one of the slots of the receiving member (90); wherein the retaining The device (3, 3') includes a gripping portion (5, 5') configured to grip a portion (61) of the stem guide (6) and located at least at the front portion (64) of the stem guide Adjacent to the slot state of a first receiving member (90) of a first bone anchor (901), the portion (61) of the rod guide (6) is allowed to be released, wherein the rod guide (6) is The orientation of the release state can be second accommodated by one of the second bone anchors (901') (90 ') in a multi-axis (1030c, 1032) are corrected. A rod insertion device according to claim 1, wherein the tubular rod guide (6) has a curved shape. A rod insertion device according to claim 1 or 2, wherein the holding portion (5, 5') of the holding device (3, 3') is configured to release the rod guide (6) to be clamped to two At least one of the different states (61), wherein: (i) the portion (61) to which the rod guide is to be clamped can be completely removed from the clamping portion (5, 5'); and/or (ii) The portion (61) to which the rod guide is to be gripped is movable (1030a, 1030b) in the grip portion (5, 5'). A rod insertion device according to any one of claims 1 to 3, wherein the clamping portion (5, 5') comprises an inner spherical space; the rod guide to be held by the clamping portion (6) The portion is formed by a spherical ball portion (61) that is snapped into the inner spherical space of the clamping portion to allow the orientation of the rod guide to be multi-axis corrected in a ball joint manner. For example, the rod insertion device of claim 4, wherein: The clamping portion includes a pair of brackets (51, 52; 51', 52') and a first locking arrangement (53, 53'), each bracket including a hollow hemispherical recess (58, 59); When the brackets are locked with each other by the first locking configuration, the hemispherical recesses are aligned with each other and closed to form the inner spherical space; and wherein when the first locking configuration (53, 53') is unlocked, the hemisphere The recesses are separated from each other and open to the inner spherical space. The rod insertion device of claim 5, wherein the first locking arrangement (53) comprises: a lag screw (531, 532, 533, 534) pivotally supported by one of the brackets and configured to be latched in One of the other brackets corresponds to the inside of the recess (535). The rod insertion device of claim 5 or 6, wherein the two brackets (51, 52) are: pivotally supported at a base (4) of the holding device (3); and/or Sliding in opposite directions toward each other and oppositely; to open and close the inner spherical space, respectively. A rod insertion device according to any one of claims 5 to 7, wherein the clamping portion (5, 5') comprises a second locking arrangement (54, 54') constituting a spherical spherical portion (61) It is fixed in the inner spherical space, and the spherical spherical portion (61) is held therein. The rod insertion device of claim 8, wherein the second locking arrangement (54, 54') comprises: an indicator pin (541) that is releasably inserted into the spherical ball portion (61) Within the bore (62), the indicator pin defines the spherical ball (61) of the stem guide (6) to be secured within the inner spherical space of the grip. A rod inserting device according to any one of claims 1 to 9 further comprising a cutting member (8) comprising a cutting tip (81), the cutting member being inserted into the rod guide (6) for cutting Entering a route within a soft tissue, using the front portion (64) to enter the vicinity of the accommodating member. A rod insertion device according to any one of claims 1 to 10, further comprising a handle (7) attached to the rod guide (6) to allow the holder to move and pivot. A rod insertion device according to any one of claims 1 to 11, wherein the engagement member (2) further comprises a support structure for supporting the holding device in an active manner, wherein the support structure defines the Keep one of the devices moving. The rod insertion device of claim 12, wherein the support structure is formed by a side wall (22) of the joint member (2) and a set of at least two grooves (23a.23b, 23a', 23b') Provided, individual pin members (43a, 43b, 43a', 43b') projecting from the base (4) of one of the holding devices (3, 3') are slidable therein. The rod insertion device of claim 13, wherein the groove (23a.23b, 23a', 23b') is formed by the pin (43a, 43b) of the base (4) of the holding device , 43a', 43b') forcing the holding device (3, 3') to hold the rod guide (6), first moving substantially linearly parallel to the extension member (9), and then along a curved path toward the first The first receiving member (90) of a bone anchor (901) is pivoted. A rod insertion device according to any one of claims 1 to 14 further comprising at least one second tubular rod guide having a different curvature than the first tubular rod guide to facilitate the stabilization of the rod inserter of different curvatures. A rod insertion device according to any one of claims 1 to 15 further includes the extension member (9), the joint member (2) being detachably coupled thereto.