CA2289629C - Device for connecting a longitudinal support with a pedicle screw - Google Patents
Device for connecting a longitudinal support with a pedicle screw Download PDFInfo
- Publication number
- CA2289629C CA2289629C CA002289629A CA2289629A CA2289629C CA 2289629 C CA2289629 C CA 2289629C CA 002289629 A CA002289629 A CA 002289629A CA 2289629 A CA2289629 A CA 2289629A CA 2289629 C CA2289629 C CA 2289629C
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- CA
- Canada
- Prior art keywords
- connector
- spring chuck
- connecting member
- longitudinal rod
- anchoring element
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
- A61B17/7034—Screws or hooks with U-shaped head or back through which longitudinal rods pass characterised by a lateral opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
- A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Neurology (AREA)
- Surgery (AREA)
- Molecular Biology (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Medicines Containing Material From Animals Or Micro-Organisms (AREA)
- Prostheses (AREA)
- Clamps And Clips (AREA)
- Mutual Connection Of Rods And Tubes (AREA)
Abstract
The invention relates to a device for connecting a rod to a bone anchoring element. The device includes a connecting member having upper and lower ends, a bore hole with a central axis, and a through hole positioned perpendicular to the central axis. The device has a tensioning member insertable in the upper end of the connecting member for securing the anchoring element to the connector at a surgeon selected angle. A radially compressible spring chuck is arranged within the connecting member and has a cavity for receiving the head of the anchoring element. An insert slides into the bore hole of the connecting member and has a recess with a shape complementary to the outer surface of the chuck. The chuck is axially supported in the bore hole in such a fashion that radial movement of the chuck is not affected.
Description
DEVICE FOR THE CONNECTION OF A LONGITUDINAL ROD WITH A
I'EDICLE SCREW
The invention relates to a device for the connection of a longitudinal rod with a bone-anchoring element.
From prior art pedicle screws to the fixation of vertebral column are known which show the advantage that the longitudinal rod may be inserted afterwards from topside and the angle between pedicle screw and longitudinal rod is variably adjustable. Such pedicle screwy are known among others from the patents EP-B
0 330 881 SHERMAN and EP-B 0 441 729 VIGNAUD. The disadvantage of these known pedicle screws is that in spite of the degree of freedom between pedicle screw and longitudinal rod the latter must often be bent three dimensionally because of the anatomical conditions.
In case of other pedicle screws as for instance according to the DE-C 195 09 HARMS this disadvantage has been eliminated. Thanks to the spatial movability of the screw head respective to the screw part the longitudinal rod must be bent up to three pedicle screws per longitudinal rod only in one plane when mounted.
The disadvantages of this known pedicle screw consist therein that the head part and the threaded part are nolr apt to be separated, the head part and the longitudinal rod are not apt to be fastened separately with respect to the threaded part, the reachable solidity is low because of the one-sided alignment of the longitudinal slots in the pressure element according to the DE-C 195 09 and it is difficult to remobilise the head part once it is fastened. The separability of the head part and the threaded part is a necessity to use different head parts according to the need and that the view is not impeded through the head part during the screwing in of the screw part into the bone. A separate fastening of the head part and the longitudinal rod and a high solidity between head part and threaded part enable the application of distraction and compression without a loss of angle between the pedicle screw and the longitudinal rod and the conservation of the anatomical bending of the stabilized vertebral segments.
Remobilization is especially important in case of explantation or new adjustment of the fixation.
A further such connection device is disclosed in WO 97/02786 ERRICO which allows in a simple manner to connect a pedicle screw or more generally a bone-anchoring element with a longitudinal rod and which permits a great freedom regarding the angle between thE: two elements. In case of this known connection device the disadvantage consists therein that the spring chuck is part of the connection element and therefore consists of the same material impairing the choice and pairing of the material with the bone screw to improve the solidity.
Here, the invention shall offer remedy. The object of the invention lies therein to provide a device for the connection of a longitudinal rod with a pedicle screw having the following qualities:
- simple handling;
- screwing in the threaded part of the device even without the connection part;
- possible later snap-on of the connection part;
- depending on the situation and the preference of the surgeon the free choice of or combination of sidewardly open, upwardly open or dosed connection parts.
For instance an upwardly open connection part facilitates the insertion of the longitudinal rod while a sideward opening enables sideward corrections and thanks to the possibility of the aideward removing of the connection part each pedicle screw may any time be fastened at the longitudinal rod or be removed again without the necessity of de~mounting the whole fixation system.
The invention provides a vertebral fixation system connector for connecting a longitudinal rod with a bone-anchoring element, the connector comprising a connecting member having upper and lower ends, a bore hole through the lower end with a central axis, and a through hole running transversely to the central axis for receiving a longitudinal rod, and a tensioning member configured and 2a dimensioned for insertion in the upper end of the connecting member for securing a bone-anchoring element, having a head and a shaft, to the connector at a surgeon-selected angle. The connector also comprises a radially-compressible spring chuck arranged within the connecting member, coaxial with the central axis and having an upper end and a lower end that includes a cavity for receiving the head of the bone-anchoring element, and an insert slidable in the bore hole of the connecting member and having a recess complementary in shape to an outer surface of the radially compressible spring chuck. The spring chuck is axially supported in the bore hole without impeding radial movement of the spring chuck therein.
The invention also provides a vertebral fixation system comprising a longitudinal rod, a bone anchoring element, and a connector for connecting the rod to the bone-anchoring element. Th~~ connector comprises a connecting member having upper and lower ends, a bore hole through the lower end with a central axis, and a through hole running transversely to the central axis for receiving the longitudinal rod, and a tensioning member configured and dimensioned for insertion in the upper end of the connecting member for securing a bone-anchoring element, having a head and a shaft, to the connector at a surgeon-selected angle. The connector also comprises a radially-compressible spring chuck arranged within the connecting member, coaxial with the central axis and having an upper end and a louver end that includes a cavity for receiving the head of the bone-anchoring element, and an insert slidable in the bore hole of the connecting member and having a recess complementary in shape to an outer surface of the radially compressible spring chuck:. The spring chuck is axially supported in the bore hole without impeding radial movement of the spring chuck therein.
The device according to the invention consists of a connection part accepting the longitudinal rod wherein a pediclE~ screw having a preferably spherical head may . CA 02289629 1999-11-09 afterwards be snapped-on and fastened. The connection part may be simply snapped-on in the desired number and variant onto the pedicle screws already implanted in the vertebral bodies so that a primary connection between longitudinal rod and pedicle screw is produced. Via the screw-in of the tension means into the fixation device the longitudinal rod is axially and rotatively fastened and simultaneously the device is fastened at a stable angle. Thereby the adjusting screw serving as a tension means presses on the longitudinal rod inserted in the device, this one presses on hollow cylinder which encompasses a hollow truncated cone which is alternatingly slotted and radially not fastened and which is itself compressed because of its sonically shaped outer surface and wedging the preferably spherical head of the pedicle screw.
The device according to the invention such offers the advantage compared to the known devices that the pedicle screws are not only fastenable exactly perpendicularly to the longitudinal rod but allows an angle of up to ~ 25° and because of the distance between the rotating center of the connection part and the axis of the longitudinal rod sideward deviations between longitudinal rod and pedicle screw may be compensated to a certain degree depending on the thickness of the longitudinal rod having an amount of between 4 to 10 mm. This qualities enable the application of longitudinal rods standardizedly prebent at the production site what causes serious difficulties by the mounting of conventional systems. A further advantage of a variant of the device according to the invention consists therein that depending on the embodiment of the hollow cylinder and the tension means respectively on the embodiment of the device the longitudinal rod and the preferably spherical head of the bone screw may be fastened separately.
The angular stability may be improved such that the head of the screw consists of a relatively hard material (e.g. Titanium-Aluminium-Niobium-alloy) and the alternately slotted hollow truncated cone consists of a relatively soft material (e.g.
Titanium in its soft state).
Another possibility for the improvement of the angular stability consists therein to provide the preferably spherical head of the pedicle screw and/or the complementary cavity in the hollow truncated cone with a three dimensional structure e.g. in the shape of grooves.
Therewith the structure attached at the head of the screw consisting of a relatively hard material is pressed into the relatively soft material of the hollow truncated cone.
A change of the hardness of the materials is possible at least in the contact area, too. The difference of hardness may also be obtained through different cold forming or different crystallization of the same material and whereby the harder material is preferably highly trained steel 1.4441 and the soft material is hot treated steel 1.4441. Apart from this the difference of hardness may be obtained via surface treatment as coating or ion implantation.
To be able to screw in the pedicle screws into the bone they are provided at the spherical head preferably with a hexagon socket. If the head apt to be snapped-on is also drilled through optionally only the pedicle screw or the whole device may be screwed in at once. The latter has the advantage above all that at any time the device may be farther screwed in or screwed reverse to obtain a compensation in height.
A further embodiment of the invention consists therein that the angles of the cones of the spring chuck and of the insert compressing the spring chuck are different and form a not self locking cone joining.
Other embodiments of the device according to the invention enable a subsequent insertion of the longitudinal rod from the side or from above. Through the screw in of the tension screw into the fixation device simultaneously the longitudinal rod is fastened axially and rotatively within the device and the device is fastened at a stable angle. Thereby the tension screw presses onto the longitudinal rod inserted in the device, this one presses onto the insert of the fixation device and this insert wedges the springable contact studs of the spring chuck via a preferably conical shaped inner surface and a corresponding likewise conical shaped outer surface of the spring chuck on the preferably spherical head of the pedicle screw.
The invention and further embodiments of the invention are discussed in more detail in the following section by means of the partially schematic representations of several embodiments.
The figures show:
Fig. 1 a longitudinal cut through the connection part of a variant of the device according to the invention together with a longitudinal rod and a pedicle screw having a spherical head;
Fig. 2 a perspectival representation of a variant of the device according to the invention;
Fig. 3 a longitudinal cut through a modified device according to the invention having qualities as disclosed in fig. 1 but with the difference that the longitudinal rod is accepted via a sidewardly open channel in the connectionpart;
Fig. 4 a longitudinal cut through a modified device according to the invention having qualities as disclosed in fig. 1 but with the difference that the longitudinal rod is accepted in an oval channel in the connection part;
Fig. 5 a perspectival representation of a variant of the device according to the invention;
Fig. 6 a perspectival representation of a further variant of the device according to the invention;
Fig. 7 a perspectival representation of a further variant of the device according to the invention;
Fig. 8 a perspectival representation of a further variant of the device according to the invention; and Fig. 9 a perspectival representation of a further variant of the device according to the invention.
The variant of the device according to the invention shown in fig. 1 essentially consists of a hollow cylindrical sleeve 10 which is provided with a channel 11 open towards the upper end 28 for the acceptance of the longitudinal rod 1. If required the channel 11 may also be open towards the side (fig. 3) or be formed as an oval bore hole (fig. 4). At the tower end 29 of the sleeve 10 a preferably ring shaped channel 17 is provided wherein the flange 18 of the spring chuck 7 inserted in the bore hole 6 of the sleeve 10 is attachable. Such the spring chuck 7 is fastened against displacement along the central axis 4 of the sleeve 10 but not radially fastened. The spring chuck 7 is provided in its inside with a cavity 15 preferably shaped as a hollow sphere. Slots, wherefrom alternately a first number run into the upper base area 8 and another number run into the lower base area 13 of the spring chuck 7 enable a homogeneous expansion and compression of the spring chuck 7. Thanks to the radial freedom of the spring chuck 7 in the channel 17 the head 5 of the pedicle screw 2 may at any time be snapped into respectively out of the spring chuck 7 as long as the device is not fastened through tightening the tension screw 23. Outside the spring chuck 7 is shaped tapering sonically towards its upper end 8. A hollow cylindrical insert 9 which is shaped complementarily conical to the cone at the spring chuck 7 at its lower end may slide within the bore hole 6 of the sleeve 10 and depending on the effect of force radially compress the spring chuck 7 via the conical joining 14 and therewith fasten the head 5 of the pedicle screw 2 being inside of the cavity 15. This connection is also loosenable what is facilitated through the attachment of a shoulder 16 in the insert 9. Longitudinal rod 1 and pedicle screw 2 are fastened by means of a tension screw 23 which is screwed in coaxially into an insert screw 21 being at the upper end 28 of the sleeve 10. The tension screw 23 presses when being tightened onto the longitudinal rod 1 which itself presses onto the insert 9 and therewith causes the closure of the spring chuck 7 through pushing into one another the cones 14.
The function of the insert screw consists therein to alter the thread 19 in the sleeve 10 interrupted by the channel 11 into a closed thread wherein the tension screw 23 may run unhindered.
Since the through hole 11 according to the variant of the device according to the invention shown in fig. 1 is formed as a channel open at the upper end 28 of the sleeve 10 and thus the sleeve 10 is weakened at this part a swivel ring 22 is mounted that prevents the widening of the sleeve 10 when the tension screw 23 is tightened.
A further variant of the device according to the invention is shown in fig. 2.
The main difference between the embodiment according to fig. 1 and the one according to fig. 2 consists in the sideward dislocation of the channel 52 to the acceptance of the longitudinal rod 1 with respect to the bore hole 6 with the central axis 4. Thus it is possible to separately fasten the longitudinal rod 1 and the pedicle screw 2. From the lower end 29 of the connection part 30 a bone anchoring element 40 may be inserted and be fastened analogously to the variant shown in fig. 1 by means of a spring chuck 7, an insert 9 and a tension means 50. Thereby the tension means 50 according to the variant shown in fig. 2 presses directly onto the insert 9. A
channel 52 running transversely to the central axis 4 without contacting the bore hole 6 which may again be optionally sidewardly open, open towards the upper end 28 or be realized as a bore hole serves to the acceptance of the longitudinal rod 1.
The fastening of the longitudinal rod 1 is done by means of a separate screw 51.
The variant of the device according to the invention shown in fig. 3 differentiates from the variant shown in fig. 1 only by that means that the sidewardly open through opening 2fi in the sleeve 10 accepts the longitudinal rod 1. The insert 9 is lower at this side, too. Thus, the longitudinal rod 1 may be subsequently inserted into the device as in case of the variant shown in fig. 1.
The variant of the device according to the invention shown in fig. 4 differentiates from the variant shown in fig. 1 only by that means that a closed oval through opening 27 within the sleeve 10 accepts the longitudinal rod 1.
The variant of the device according to the invention shown in fig. 5 differentiates from the variant shown in fig. 1 only by that means that a nut 42 is employed as a tension means 50. Thereto the sleeve 10 is provided with an exterior thread 41 whereon the nut 42 is screwed. When tightened the nut 42 presses onto the longitudinal rod 1 which itself presses onto the insert 9 by what means the spring chuck 7 is radially compressed and such the head 5 of the pedicle screw 2 and the longitudinal rod 1 are simultaneously fastened. A collapse of the channel 11 may be prevented by forming the thread 41 as buttress thread or by inserting a cylindrical element 47 into the bore hole 6.
In fig. 6 another variant of the device according to the invention is shown.
This one differentiates from the variant shown in fig. 1 only by that means that a locking screw 43 serves as a tension means 50. The widening of the channel 11 is prevented by forming the thread 19 as a buttress thread.
Also the variant shown in fig. 7 differentiates from the variant shown in fig.
1 only through the construction of the tension means 50. The sleeve 10 is provided with an exterior thread 41 whereon the threaded sleeve 44 is screwed. The fastening of the longitudinal rod 1 and pedicle screw 2 happens by means of a tension screw 23 which is screwed into the threaded sleeve 44. The threaded sleeve 44 thus has the same function as the threaded insert 21 shown in fig. 1. Thanks to the threaded sleeve 44 inserted between the slotted thread 41 and the tension screw 23 the tension screw 23 runs within an uninterrupted thread.
Also another variant of the device according to the invention is shown in fig.
8. This variant accentuates by that means that the longitudinal rod 1 and the pedicle screw 2 may be fastened separately. To this purpose the sleeve 10 is provided at its upper end 28 with an interior thread 19 and an exterior thread 41. The channel 12 of the insert 9 is shaped such that the longitudinal rod 1 always lies on the lower edge of the through opening 11 during its fastening by means of the nut 42. When the tension screw 23 which presses directly on the insert 9 extending over the longitudinal rod 1 is tightened the spring chuck 7 is compressed thus fastening the pedicle screw 2.
Furthermore, the variant of the device according to the invention shown in fig. 9 enables a separate fastening of the longitudinal rod 1 and the pedicle screw 2. The trough opening 11 and the channel 12 are shaped such that the longitudinal rod always lies on the channel 12 when fastened. The longitudinal rod 1 is fastened by means of a stud bolt 45 which is screwed into an interior thread 46 in the insert 9. The tension screw 23 serves to fasten the pedicle screw 2 whereby the tension screw 23 presses onto the insert 9 whereby this one is sliding over the spring chuck 7 thus radially compressing it. The widening of the channel 11 may also be prevented either by shaping the threads 19 and 46 as buttress threads or by using a sleeve 22 as shown in fig. 1.
I'EDICLE SCREW
The invention relates to a device for the connection of a longitudinal rod with a bone-anchoring element.
From prior art pedicle screws to the fixation of vertebral column are known which show the advantage that the longitudinal rod may be inserted afterwards from topside and the angle between pedicle screw and longitudinal rod is variably adjustable. Such pedicle screwy are known among others from the patents EP-B
0 330 881 SHERMAN and EP-B 0 441 729 VIGNAUD. The disadvantage of these known pedicle screws is that in spite of the degree of freedom between pedicle screw and longitudinal rod the latter must often be bent three dimensionally because of the anatomical conditions.
In case of other pedicle screws as for instance according to the DE-C 195 09 HARMS this disadvantage has been eliminated. Thanks to the spatial movability of the screw head respective to the screw part the longitudinal rod must be bent up to three pedicle screws per longitudinal rod only in one plane when mounted.
The disadvantages of this known pedicle screw consist therein that the head part and the threaded part are nolr apt to be separated, the head part and the longitudinal rod are not apt to be fastened separately with respect to the threaded part, the reachable solidity is low because of the one-sided alignment of the longitudinal slots in the pressure element according to the DE-C 195 09 and it is difficult to remobilise the head part once it is fastened. The separability of the head part and the threaded part is a necessity to use different head parts according to the need and that the view is not impeded through the head part during the screwing in of the screw part into the bone. A separate fastening of the head part and the longitudinal rod and a high solidity between head part and threaded part enable the application of distraction and compression without a loss of angle between the pedicle screw and the longitudinal rod and the conservation of the anatomical bending of the stabilized vertebral segments.
Remobilization is especially important in case of explantation or new adjustment of the fixation.
A further such connection device is disclosed in WO 97/02786 ERRICO which allows in a simple manner to connect a pedicle screw or more generally a bone-anchoring element with a longitudinal rod and which permits a great freedom regarding the angle between thE: two elements. In case of this known connection device the disadvantage consists therein that the spring chuck is part of the connection element and therefore consists of the same material impairing the choice and pairing of the material with the bone screw to improve the solidity.
Here, the invention shall offer remedy. The object of the invention lies therein to provide a device for the connection of a longitudinal rod with a pedicle screw having the following qualities:
- simple handling;
- screwing in the threaded part of the device even without the connection part;
- possible later snap-on of the connection part;
- depending on the situation and the preference of the surgeon the free choice of or combination of sidewardly open, upwardly open or dosed connection parts.
For instance an upwardly open connection part facilitates the insertion of the longitudinal rod while a sideward opening enables sideward corrections and thanks to the possibility of the aideward removing of the connection part each pedicle screw may any time be fastened at the longitudinal rod or be removed again without the necessity of de~mounting the whole fixation system.
The invention provides a vertebral fixation system connector for connecting a longitudinal rod with a bone-anchoring element, the connector comprising a connecting member having upper and lower ends, a bore hole through the lower end with a central axis, and a through hole running transversely to the central axis for receiving a longitudinal rod, and a tensioning member configured and 2a dimensioned for insertion in the upper end of the connecting member for securing a bone-anchoring element, having a head and a shaft, to the connector at a surgeon-selected angle. The connector also comprises a radially-compressible spring chuck arranged within the connecting member, coaxial with the central axis and having an upper end and a lower end that includes a cavity for receiving the head of the bone-anchoring element, and an insert slidable in the bore hole of the connecting member and having a recess complementary in shape to an outer surface of the radially compressible spring chuck. The spring chuck is axially supported in the bore hole without impeding radial movement of the spring chuck therein.
The invention also provides a vertebral fixation system comprising a longitudinal rod, a bone anchoring element, and a connector for connecting the rod to the bone-anchoring element. Th~~ connector comprises a connecting member having upper and lower ends, a bore hole through the lower end with a central axis, and a through hole running transversely to the central axis for receiving the longitudinal rod, and a tensioning member configured and dimensioned for insertion in the upper end of the connecting member for securing a bone-anchoring element, having a head and a shaft, to the connector at a surgeon-selected angle. The connector also comprises a radially-compressible spring chuck arranged within the connecting member, coaxial with the central axis and having an upper end and a louver end that includes a cavity for receiving the head of the bone-anchoring element, and an insert slidable in the bore hole of the connecting member and having a recess complementary in shape to an outer surface of the radially compressible spring chuck:. The spring chuck is axially supported in the bore hole without impeding radial movement of the spring chuck therein.
The device according to the invention consists of a connection part accepting the longitudinal rod wherein a pediclE~ screw having a preferably spherical head may . CA 02289629 1999-11-09 afterwards be snapped-on and fastened. The connection part may be simply snapped-on in the desired number and variant onto the pedicle screws already implanted in the vertebral bodies so that a primary connection between longitudinal rod and pedicle screw is produced. Via the screw-in of the tension means into the fixation device the longitudinal rod is axially and rotatively fastened and simultaneously the device is fastened at a stable angle. Thereby the adjusting screw serving as a tension means presses on the longitudinal rod inserted in the device, this one presses on hollow cylinder which encompasses a hollow truncated cone which is alternatingly slotted and radially not fastened and which is itself compressed because of its sonically shaped outer surface and wedging the preferably spherical head of the pedicle screw.
The device according to the invention such offers the advantage compared to the known devices that the pedicle screws are not only fastenable exactly perpendicularly to the longitudinal rod but allows an angle of up to ~ 25° and because of the distance between the rotating center of the connection part and the axis of the longitudinal rod sideward deviations between longitudinal rod and pedicle screw may be compensated to a certain degree depending on the thickness of the longitudinal rod having an amount of between 4 to 10 mm. This qualities enable the application of longitudinal rods standardizedly prebent at the production site what causes serious difficulties by the mounting of conventional systems. A further advantage of a variant of the device according to the invention consists therein that depending on the embodiment of the hollow cylinder and the tension means respectively on the embodiment of the device the longitudinal rod and the preferably spherical head of the bone screw may be fastened separately.
The angular stability may be improved such that the head of the screw consists of a relatively hard material (e.g. Titanium-Aluminium-Niobium-alloy) and the alternately slotted hollow truncated cone consists of a relatively soft material (e.g.
Titanium in its soft state).
Another possibility for the improvement of the angular stability consists therein to provide the preferably spherical head of the pedicle screw and/or the complementary cavity in the hollow truncated cone with a three dimensional structure e.g. in the shape of grooves.
Therewith the structure attached at the head of the screw consisting of a relatively hard material is pressed into the relatively soft material of the hollow truncated cone.
A change of the hardness of the materials is possible at least in the contact area, too. The difference of hardness may also be obtained through different cold forming or different crystallization of the same material and whereby the harder material is preferably highly trained steel 1.4441 and the soft material is hot treated steel 1.4441. Apart from this the difference of hardness may be obtained via surface treatment as coating or ion implantation.
To be able to screw in the pedicle screws into the bone they are provided at the spherical head preferably with a hexagon socket. If the head apt to be snapped-on is also drilled through optionally only the pedicle screw or the whole device may be screwed in at once. The latter has the advantage above all that at any time the device may be farther screwed in or screwed reverse to obtain a compensation in height.
A further embodiment of the invention consists therein that the angles of the cones of the spring chuck and of the insert compressing the spring chuck are different and form a not self locking cone joining.
Other embodiments of the device according to the invention enable a subsequent insertion of the longitudinal rod from the side or from above. Through the screw in of the tension screw into the fixation device simultaneously the longitudinal rod is fastened axially and rotatively within the device and the device is fastened at a stable angle. Thereby the tension screw presses onto the longitudinal rod inserted in the device, this one presses onto the insert of the fixation device and this insert wedges the springable contact studs of the spring chuck via a preferably conical shaped inner surface and a corresponding likewise conical shaped outer surface of the spring chuck on the preferably spherical head of the pedicle screw.
The invention and further embodiments of the invention are discussed in more detail in the following section by means of the partially schematic representations of several embodiments.
The figures show:
Fig. 1 a longitudinal cut through the connection part of a variant of the device according to the invention together with a longitudinal rod and a pedicle screw having a spherical head;
Fig. 2 a perspectival representation of a variant of the device according to the invention;
Fig. 3 a longitudinal cut through a modified device according to the invention having qualities as disclosed in fig. 1 but with the difference that the longitudinal rod is accepted via a sidewardly open channel in the connectionpart;
Fig. 4 a longitudinal cut through a modified device according to the invention having qualities as disclosed in fig. 1 but with the difference that the longitudinal rod is accepted in an oval channel in the connection part;
Fig. 5 a perspectival representation of a variant of the device according to the invention;
Fig. 6 a perspectival representation of a further variant of the device according to the invention;
Fig. 7 a perspectival representation of a further variant of the device according to the invention;
Fig. 8 a perspectival representation of a further variant of the device according to the invention; and Fig. 9 a perspectival representation of a further variant of the device according to the invention.
The variant of the device according to the invention shown in fig. 1 essentially consists of a hollow cylindrical sleeve 10 which is provided with a channel 11 open towards the upper end 28 for the acceptance of the longitudinal rod 1. If required the channel 11 may also be open towards the side (fig. 3) or be formed as an oval bore hole (fig. 4). At the tower end 29 of the sleeve 10 a preferably ring shaped channel 17 is provided wherein the flange 18 of the spring chuck 7 inserted in the bore hole 6 of the sleeve 10 is attachable. Such the spring chuck 7 is fastened against displacement along the central axis 4 of the sleeve 10 but not radially fastened. The spring chuck 7 is provided in its inside with a cavity 15 preferably shaped as a hollow sphere. Slots, wherefrom alternately a first number run into the upper base area 8 and another number run into the lower base area 13 of the spring chuck 7 enable a homogeneous expansion and compression of the spring chuck 7. Thanks to the radial freedom of the spring chuck 7 in the channel 17 the head 5 of the pedicle screw 2 may at any time be snapped into respectively out of the spring chuck 7 as long as the device is not fastened through tightening the tension screw 23. Outside the spring chuck 7 is shaped tapering sonically towards its upper end 8. A hollow cylindrical insert 9 which is shaped complementarily conical to the cone at the spring chuck 7 at its lower end may slide within the bore hole 6 of the sleeve 10 and depending on the effect of force radially compress the spring chuck 7 via the conical joining 14 and therewith fasten the head 5 of the pedicle screw 2 being inside of the cavity 15. This connection is also loosenable what is facilitated through the attachment of a shoulder 16 in the insert 9. Longitudinal rod 1 and pedicle screw 2 are fastened by means of a tension screw 23 which is screwed in coaxially into an insert screw 21 being at the upper end 28 of the sleeve 10. The tension screw 23 presses when being tightened onto the longitudinal rod 1 which itself presses onto the insert 9 and therewith causes the closure of the spring chuck 7 through pushing into one another the cones 14.
The function of the insert screw consists therein to alter the thread 19 in the sleeve 10 interrupted by the channel 11 into a closed thread wherein the tension screw 23 may run unhindered.
Since the through hole 11 according to the variant of the device according to the invention shown in fig. 1 is formed as a channel open at the upper end 28 of the sleeve 10 and thus the sleeve 10 is weakened at this part a swivel ring 22 is mounted that prevents the widening of the sleeve 10 when the tension screw 23 is tightened.
A further variant of the device according to the invention is shown in fig. 2.
The main difference between the embodiment according to fig. 1 and the one according to fig. 2 consists in the sideward dislocation of the channel 52 to the acceptance of the longitudinal rod 1 with respect to the bore hole 6 with the central axis 4. Thus it is possible to separately fasten the longitudinal rod 1 and the pedicle screw 2. From the lower end 29 of the connection part 30 a bone anchoring element 40 may be inserted and be fastened analogously to the variant shown in fig. 1 by means of a spring chuck 7, an insert 9 and a tension means 50. Thereby the tension means 50 according to the variant shown in fig. 2 presses directly onto the insert 9. A
channel 52 running transversely to the central axis 4 without contacting the bore hole 6 which may again be optionally sidewardly open, open towards the upper end 28 or be realized as a bore hole serves to the acceptance of the longitudinal rod 1.
The fastening of the longitudinal rod 1 is done by means of a separate screw 51.
The variant of the device according to the invention shown in fig. 3 differentiates from the variant shown in fig. 1 only by that means that the sidewardly open through opening 2fi in the sleeve 10 accepts the longitudinal rod 1. The insert 9 is lower at this side, too. Thus, the longitudinal rod 1 may be subsequently inserted into the device as in case of the variant shown in fig. 1.
The variant of the device according to the invention shown in fig. 4 differentiates from the variant shown in fig. 1 only by that means that a closed oval through opening 27 within the sleeve 10 accepts the longitudinal rod 1.
The variant of the device according to the invention shown in fig. 5 differentiates from the variant shown in fig. 1 only by that means that a nut 42 is employed as a tension means 50. Thereto the sleeve 10 is provided with an exterior thread 41 whereon the nut 42 is screwed. When tightened the nut 42 presses onto the longitudinal rod 1 which itself presses onto the insert 9 by what means the spring chuck 7 is radially compressed and such the head 5 of the pedicle screw 2 and the longitudinal rod 1 are simultaneously fastened. A collapse of the channel 11 may be prevented by forming the thread 41 as buttress thread or by inserting a cylindrical element 47 into the bore hole 6.
In fig. 6 another variant of the device according to the invention is shown.
This one differentiates from the variant shown in fig. 1 only by that means that a locking screw 43 serves as a tension means 50. The widening of the channel 11 is prevented by forming the thread 19 as a buttress thread.
Also the variant shown in fig. 7 differentiates from the variant shown in fig.
1 only through the construction of the tension means 50. The sleeve 10 is provided with an exterior thread 41 whereon the threaded sleeve 44 is screwed. The fastening of the longitudinal rod 1 and pedicle screw 2 happens by means of a tension screw 23 which is screwed into the threaded sleeve 44. The threaded sleeve 44 thus has the same function as the threaded insert 21 shown in fig. 1. Thanks to the threaded sleeve 44 inserted between the slotted thread 41 and the tension screw 23 the tension screw 23 runs within an uninterrupted thread.
Also another variant of the device according to the invention is shown in fig.
8. This variant accentuates by that means that the longitudinal rod 1 and the pedicle screw 2 may be fastened separately. To this purpose the sleeve 10 is provided at its upper end 28 with an interior thread 19 and an exterior thread 41. The channel 12 of the insert 9 is shaped such that the longitudinal rod 1 always lies on the lower edge of the through opening 11 during its fastening by means of the nut 42. When the tension screw 23 which presses directly on the insert 9 extending over the longitudinal rod 1 is tightened the spring chuck 7 is compressed thus fastening the pedicle screw 2.
Furthermore, the variant of the device according to the invention shown in fig. 9 enables a separate fastening of the longitudinal rod 1 and the pedicle screw 2. The trough opening 11 and the channel 12 are shaped such that the longitudinal rod always lies on the channel 12 when fastened. The longitudinal rod 1 is fastened by means of a stud bolt 45 which is screwed into an interior thread 46 in the insert 9. The tension screw 23 serves to fasten the pedicle screw 2 whereby the tension screw 23 presses onto the insert 9 whereby this one is sliding over the spring chuck 7 thus radially compressing it. The widening of the channel 11 may also be prevented either by shaping the threads 19 and 46 as buttress threads or by using a sleeve 22 as shown in fig. 1.
Claims (29)
1. A vertebral fixation system connector for connecting a longitudinal rod with a bone-anchoring element, the connector comprising:
a connecting member having upper and lower ends, a bore hole through the lower end with a central axis, and a through hole running transversely to the central axis for receiving a longitudinal rod;
a tensioning member configured and dimensioned for insertion in the upper end of the connecting member for securing a bone-anchoring element, having a head and a shaft, to the connector at a surgeon-selected angle;
a radially-compressible spring chuck arranged within the connecting member, coaxial with the central axis and having an upper end and a lower end that includes a cavity for receiving the head of the bone-anchoring element; and an insert slidable in the bore hole of the connecting member and having a recess complementary in shape to an outer surface of the radially compressible spring chuck;
wherein the spring chuck is axially supported in the bore hole without impeding radial movement of the spring chuck therein.
a connecting member having upper and lower ends, a bore hole through the lower end with a central axis, and a through hole running transversely to the central axis for receiving a longitudinal rod;
a tensioning member configured and dimensioned for insertion in the upper end of the connecting member for securing a bone-anchoring element, having a head and a shaft, to the connector at a surgeon-selected angle;
a radially-compressible spring chuck arranged within the connecting member, coaxial with the central axis and having an upper end and a lower end that includes a cavity for receiving the head of the bone-anchoring element; and an insert slidable in the bore hole of the connecting member and having a recess complementary in shape to an outer surface of the radially compressible spring chuck;
wherein the spring chuck is axially supported in the bore hole without impeding radial movement of the spring chuck therein.
2. The connector of claim 1, wherein the connecting member has a shoulder for supporting the spring chuck in the bore hole.
3. The connector of claim 2, wherein the shoulder has a ring groove.
4. The connector of claim 1, 2 or 3, wherein the connecting member is a cylindrical sleeve.
5. The connector of any one of claims 1 to 4, wherein the outer surface of the spring chuck and the recess of the insert each have a conical shape.
6. The connector of claim 5, wherein both the outer surface of the spring chuck and the recess have conical angles of at least about 10°, with the angles differing by less than about 1°.
7. The connector of claim 5, wherein both the outer surface of the spring chuck and the recess have conical angles of at least about 10°, with the angles differing by between about 4° wind 6°.
8. The connector of any one of claims 1 to 7, wherein a sidewall of the connecting device has an opening for receiving the longitudinal rod.
9. The connector of any one of claims 1 to 8, wherein the through hole has an oval shape.
10. The connector of any one of claims 1 to 9, wherein the tensioning member includes an insert screw having an external thread, and wherein the upper end of the connecting member has an internal thread.
11. The connector of claim 10, wherein the internal thread and external thread are buttress threads.
12. The connector of any one of claims 1 to 11, wherein the recess is convexly shaped in an area of contact between the insert and the spring chuck.
13. The connector of any one of claims 1 to 12, wherein the upper end of the insert has a ridge for compressing against the spring chuck.
14. The connector of any one of claims 1 to 13, wherein the insert has a cylindrical shape.
15. The connector of any one of claims 1 to 13, wherein a cross-section of the insert has a polygonal shape.
16. The connector of any one of claims 1 to 15, wherein the bore hole and the through hole are connected to each other.
17. The connector of any one of claims 1 to 16, wherein the tensioning member provides for simultaneous fixation of the longitudinal rod and the head of the bone anchoring element.
18. The connector of any one of claims 1 to 16, wherein the tensioning member is configured and dimensioned to press on the longitudinal rod.
19. The connector of claim 18, wherein the tensioning member comprises a nut, and the upper end of the connecting member has an external thread for threadably receiving the nut.
20. The connector of claim 18, wherein the tensioning member comprises a locking screw and the upper end of the connecting member has an internal thread for threadably receiving the locking screw.
21. The connector of any one of claims 1 to 20, wherein at least a portion of the insert has an internal thread, and wherein a stud bolt having a shaft with an external thread is threadably received by the insert to press on the longitudinal rod.
22. The connector of any one of claims 1 to 21, wherein the cavity of the spring chuck has a spherical shape.
23. The connector of any one of claims 1 to 22, wherein the spring chuck has a plurality of slots for allowing the radial movement of the spring chuck, with at least one of the slots extending from the upper end of the spring chuck.
24. A vertebral fixation system comprising:
a longitudinal rod;
a bone anchoring element; and a connector for connecting the rod to the bone-anchoring element, said connector comprising:
a connecting member having upper and lower ends, a bore hole through the lower end with a central axis, and a through hole running transversely to the central axis for receiving the longitudinal rod;
a tensioning member configured and dimensioned for insertion in the upper end of the connecting member for securing a bone-anchoring element, having a head and a shaft, to the connector at a surgeon-selected angle;
a radially-compressible spring chuck arranged within the connecting member, coaxial with the central axis and having an upper end and a lower end that includes a cavity for receiving the head of the bone anchoring element; and an insert slidable in the bore hole of the connecting member and having a recess complementary in shape to an outer surface of the radially compressible spring chuck:
wherein the spring chuck is axially supported in the bore hole without impeding radial movement of the spring chuck therein.
a longitudinal rod;
a bone anchoring element; and a connector for connecting the rod to the bone-anchoring element, said connector comprising:
a connecting member having upper and lower ends, a bore hole through the lower end with a central axis, and a through hole running transversely to the central axis for receiving the longitudinal rod;
a tensioning member configured and dimensioned for insertion in the upper end of the connecting member for securing a bone-anchoring element, having a head and a shaft, to the connector at a surgeon-selected angle;
a radially-compressible spring chuck arranged within the connecting member, coaxial with the central axis and having an upper end and a lower end that includes a cavity for receiving the head of the bone anchoring element; and an insert slidable in the bore hole of the connecting member and having a recess complementary in shape to an outer surface of the radially compressible spring chuck:
wherein the spring chuck is axially supported in the bore hole without impeding radial movement of the spring chuck therein.
25. The system of claim 24, wherein the bone-anchoring element is a pedicle screw.
26. The system of claim 24 or 25, wherein the bone-anchoring element has a turned groove below the head.
27. The system of claim 24, 25 or 26, wherein the spring chuck and the head of the bone-anchoring element have different hardnesses in an area of contact between the head and the spring chuck.
28. The connector of claim 27, wherein the harder material is an alloy of Titanium, Aluminum, and Niobium, and the softer material is commercially pure titanium.
29. The connector of claim 27, wherein the head and the spring chuck are made of the same material and the difference in hardness is obtained by surface treatment processing of the material.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE19720782A DE19720782B4 (en) | 1997-05-17 | 1997-05-17 | Device for connecting a side member to a pedicle screw |
| DE19720782.0 | 1997-05-17 | ||
| PCT/CH1997/000236 WO1998052482A1 (en) | 1997-05-17 | 1997-06-16 | Device for connecting a longitudinal support with a pedicle screw |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2289629A1 CA2289629A1 (en) | 1998-11-26 |
| CA2289629C true CA2289629C (en) | 2005-11-15 |
Family
ID=7829799
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002289629A Expired - Fee Related CA2289629C (en) | 1997-05-17 | 1997-06-16 | Device for connecting a longitudinal support with a pedicle screw |
Country Status (15)
| Country | Link |
|---|---|
| EP (1) | EP0984730B1 (en) |
| JP (1) | JP4072201B2 (en) |
| KR (1) | KR100509375B1 (en) |
| CN (1) | CN1146365C (en) |
| AT (1) | ATE245947T1 (en) |
| AU (1) | AU723894B2 (en) |
| CA (1) | CA2289629C (en) |
| DE (2) | DE19720782B4 (en) |
| DK (1) | DK0984730T3 (en) |
| ES (1) | ES2203807T3 (en) |
| HK (1) | HK1023710A1 (en) |
| PT (1) | PT984730E (en) |
| TW (1) | TW409048B (en) |
| WO (1) | WO1998052482A1 (en) |
| ZA (1) | ZA984064B (en) |
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| US9320546B2 (en) | 2008-09-29 | 2016-04-26 | DePuy Synthes Products, Inc. | Polyaxial bottom-loading screw and rod assembly |
| US9326796B2 (en) | 2008-11-03 | 2016-05-03 | DePuy Synthes Products, Inc. | Uni-planer bone fixation assembly |
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-
1997
- 1997-05-17 DE DE19720782A patent/DE19720782B4/en not_active Expired - Fee Related
- 1997-06-16 EP EP97924848A patent/EP0984730B1/en not_active Expired - Lifetime
- 1997-06-16 ES ES97924848T patent/ES2203807T3/en not_active Expired - Lifetime
- 1997-06-16 CN CNB97182195XA patent/CN1146365C/en not_active Expired - Fee Related
- 1997-06-16 CA CA002289629A patent/CA2289629C/en not_active Expired - Fee Related
- 1997-06-16 PT PT97924848T patent/PT984730E/en unknown
- 1997-06-16 DK DK97924848T patent/DK0984730T3/en active
- 1997-06-16 DE DE59710520T patent/DE59710520D1/en not_active Expired - Lifetime
- 1997-06-16 WO PCT/CH1997/000236 patent/WO1998052482A1/en active IP Right Grant
- 1997-06-16 KR KR10-1999-7010676A patent/KR100509375B1/en not_active IP Right Cessation
- 1997-06-16 JP JP54975098A patent/JP4072201B2/en not_active Expired - Fee Related
- 1997-06-16 AT AT97924848T patent/ATE245947T1/en not_active IP Right Cessation
- 1997-06-16 AU AU30223/97A patent/AU723894B2/en not_active Ceased
-
1998
- 1998-05-12 TW TW087107283A patent/TW409048B/en not_active IP Right Cessation
- 1998-05-14 ZA ZA984064A patent/ZA984064B/en unknown
-
2000
- 2000-04-20 HK HK00102399A patent/HK1023710A1/en not_active IP Right Cessation
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9320546B2 (en) | 2008-09-29 | 2016-04-26 | DePuy Synthes Products, Inc. | Polyaxial bottom-loading screw and rod assembly |
| US9326796B2 (en) | 2008-11-03 | 2016-05-03 | DePuy Synthes Products, Inc. | Uni-planer bone fixation assembly |
Also Published As
| Publication number | Publication date |
|---|---|
| AU723894B2 (en) | 2000-09-07 |
| EP0984730A1 (en) | 2000-03-15 |
| CN1146365C (en) | 2004-04-21 |
| TW409048B (en) | 2000-10-21 |
| CN1254266A (en) | 2000-05-24 |
| AU3022397A (en) | 1998-12-11 |
| ZA984064B (en) | 1998-11-24 |
| JP2001525707A (en) | 2001-12-11 |
| CA2289629A1 (en) | 1998-11-26 |
| DE19720782B4 (en) | 2004-12-09 |
| EP0984730B1 (en) | 2003-07-30 |
| ES2203807T3 (en) | 2004-04-16 |
| HK1023710A1 (en) | 2000-09-22 |
| DE19720782A1 (en) | 1998-11-19 |
| KR20010012715A (en) | 2001-02-26 |
| WO1998052482A1 (en) | 1998-11-26 |
| JP4072201B2 (en) | 2008-04-09 |
| DK0984730T3 (en) | 2003-11-10 |
| ATE245947T1 (en) | 2003-08-15 |
| KR100509375B1 (en) | 2005-08-22 |
| DE59710520D1 (en) | 2003-09-04 |
| PT984730E (en) | 2003-12-31 |
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| EEER | Examination request | ||
| MKLA | Lapsed |
Effective date: 20160616 |