防松动稚弓根螺钉 Pedicle screw loosening prevention of juvenile
发明领域 Field of the Invention
本发明涉及一种骨科专用脊柱内固定器械，即防松动推弓根螺钉。 The present invention relates to an in special orthopedic spinal fixation devices, i.e. loosening prevention push pedicle screw. 所述螺钉包括拧入式螺芯，撑开式螺芯，以及前段部分可以被撑开的空心稚弓根螺钉。 The screw includes a screw-threaded core, core spiro distraction, and may be stretched in the front part of the hollow juvenile pedicle screw. 其中通过向所述空心推弓根螺钉中拧入不同形状螺芯而 Wherein said hollow push through the pedicle screws are screwed into the threaded core and different shapes
使打入脊柱推体中的推弓根螺钉前段被撑开，导致形状发生改变；同时改善局部骨密度、骨强度，从而避免推弓根螺钉松动及脱出。 So that pushing into the push pedicle screw anterior spinal body is softened, leading to change shape; while improving local bone density, bone strength, in order to avoid pushing pedicle screw loosening and extrusion.
技术背景 technical background
近年来，脊柱内固定系统的研发得到了很大发展， 一大批新型脊柱内固定系统如脊柱通用系统（以下简称为USS) (A0/ASIF组织在其原有脊柱内固定系统基础上改进形成的新型组合式脊柱通用系统）等的涌现， 使脊柱外科得到了长足发展。 In recent years, the development of spinal fixation system has been great development, improve internal fixation system on the basis of a large number of new spinal fixation system such as spina common system (hereinafter referred to as USS) (A0 / ASIF organization in their original form of the spine General new combined spinal system) such as the emergence of the spine surgery has made considerable progress. 但目前临床应用的推弓根螺钉不具有防松动功能。 But the push pedicle screw clinical application does not have anti-loosening function. 如USS的Schanz钉在经稚弓^jf直入推体后，其形状未发生改变， 存在松动、退钉等风险。 The USS Schanz nail after the juveniles arch ^ jf push straight into the body, its shape is not changed, there is a loose nail back other risks. 尤其在面对骨质疏松患者时，现有的推弓根螺钉易产生松动与脱出，导致手术失败。 In particular, in the face of osteoporosis, a conventional push pedicle screw loosening and easy to prolapse, resulting in operation failure. 而目前仅有的预防措施是推体内注射骨水泥。 At present, the only preventive measure is pushed in vivo injection of bone cement. 因此，需要一种有效、捧作性强的防松动推弓根螺钉有效解决这一问题。 Therefore, the need for an effective, hailed as a strong anti-push pedicle screw loosening effectively solve this problem.
为了克服现有临床应用的推弓根螺钉所不具备的防松动功能，本发明提供了一种防松动推弓根螺钉，其中包括拧入式螺芯、撑开式螺芯和前部可以被撑开的空心推弓根螺钉，其中通过使推弓根螺钉前端因拧入适当的螺芯而被撑开，例如是呈伞状撑开，从而避免推弓根螺钉松动及脱出。 In order to overcome the conventional push pedicle screws do not have clinical application of anti-loosening function, the present invention provides a push bar preventing loosening of screws, including screw-threaded core, the core and the softened spiro front portion may be distraction hollow push pedicle screw, by which the front end of the push bar because of screws screwed into an appropriate threaded core is softened, for example, umbrella-shaped distraction, so as to avoid the push pedicle screw loosening and extrusion. 本发明涉及一种防松动推弓根螺钉，其中包括拧入式和撑开式螺芯， 以及前部可以被撑开的推弓根螺钉。 The present invention relates to a push bar preventing loosening of screws, including screw-type and distraction threaded core, and a front portion may be spanned by the push of screws. 具体的，所述前部可以被撑开的推弓根螺钉为空心推弓根螺钉。 Specifically, the front portion may be spanned by the push of screws a hollow push pedicle screw. 为了保证所述空心稚弓根螺钉具有良好弹性模量及顺应性，所述螺钉的管壁的厚度应当具有适当范围（例如优选0. lO. 5mm),以便于在柠入适当螺芯后被撑开，特别是呈伞状撑开，同时应保证空心螺钉的机械强度。 In order to ensure that the pedicle screw has a hollow juvenile modulus and good compliance, the wall thickness of the screw should have an appropriate range (e.g., preferably 0. lO. 5mm), in order to screw into a suitable die after citraconic distraction, in particular umbrella-shaped distraction, and should ensure the mechanical strength of the hollow screw. 为了方便所述空心推弓根螺钉柠入脊推的推体，所述空心推弓根螺钉的后段，优选地自末端起至螺钉全长的约1/16-约1/4处，可以为例如外六角型。 In order to facilitate pushing of the hollow spine pedicle screws into citraconic push pushing body, said hollow section being pushed by the pedicle screw, preferably at the terminus up from about 1/16 to about 1/4 of the entire length of the screw, can be for example, an outer hexagon. 在本发明中，所述空心推弓根螺钉还带有外螺紋，在其前段部分还带有，例如长度为自前端起全长的约1/16-约1/2部分，优选自前端起全长的约1/16-约1/3部分,优选自前端起全长的约1/16-约1/4部分， 优选自前端起全长的约1/16-约1/6部分，优选自前端起全长的约1/16 -约1/8部分，优选自前端起全长的约1/16-约1/10部分，优选自前端起全长的约1/16-约1/12部分，的至少两条，优选三条、四条、五条、 六条、七条、八条、十条、十二条或更多的贯穿整个螺钉管壁的缝隙。 In the present invention, the hollow push pedicle screw further having an external thread, further having at its front part, for example starting from the distal end of a length of about 1/16 of the full-length portion of about 1/2, preferably starting from the distal end about 1/16 to about 1/3 of the total length, starting from the distal end preferably from about 1/16 to about 1/4 of the entire length of the section, starting from the distal end preferably from about 1/16 to about 1/6 of the entire length of the section, preferably from about 1/16 of the entire length from the front end - about 1/8 portion, starting from the distal end preferably from about 1/16 to about 1/10 of the entire length of the section, preferably from the distal end of the full length from about 1/16 to about 1 / 12 portion, at least two, preferably three, four, five, six, seven, eight, ten, twelve or more slits through the entire wall of the screw. 空心推弓根螺钉的内径在前段缝隙出现处由末端向前端方向逐渐变细，例如，沿抛面呈直线均匀逐渐变细；或者空心推弓根螺钉的内径在前段缝隙出现处逐渐变细，抛面呈曲率很小的弧线。 Hollow push pedicle screw inner diameter at a gap appears in the pre-stage tapered in the distal direction from the terminal, e.g., a straight line along a parabolic-section tapers uniformly; or the inner diameter of the hollow push pedicle screw tapers at the front stage to gaps, Parabolic-section small curvature arc. 相应的，所述空心推弓根螺钉的管壁逐渐增厚，内壁抛面呈曲率很小的弧线或直线逐渐增厚。 Accordingly, the hollow push pedicle screw progressively thicker wall, the inner wall of a small linear or parabolic-section curvature is gradually thicker. 除带有缝隙的部分外，所述空心推弓根螺钉的其余部分均带有内螺紋，以方便不同螺芯的柠入及取出。 In addition to the slot portion with the remainder of the hollow push citraconic pedicle screws are internally threaded to facilitate threaded core and different extraction. 为了便于所述空心推弓根螺钉的拧入和取出，所述空心堆弓根螺钉的尾部可以有例如外六角形或十字形的螺扣。 In order to facilitate pushing of the hollow screw is screwed into the pedicle and removed, the stack hollow pedicle screws, for example, the tail may have a hexagonal outer cross-shaped or screw fastener. 在本发明中，所述螺芯包括一种拧入式螺芯和一种撑开式螺芯。 In the present invention, the core comprises one helical screw-threaded core and one distraction spiro core. 其中所述柠入式螺芯形状与空心推弓根螺钉内径完全吻合，其前段部分例如长度为自前端起全长的1/16-1/2部分，优选自前端起全长的1/16 -1/3部分，优选自前端起全长的1/16-1/4部分，优选自前端起全长的1/16-1/6部分，优选自前端起全长的1/16-1/8部分，优选自前端起全长的1/16-1/10部分，优选自前端起全长的1/16-1/12部分直径逐渐变细，不带有外螺紋，恰好与空心推弓根螺钉前段变细之内径吻合。 Citraconic wherein said core into the shape of a hollow spiro push bar fully consistent internal diameter of screws which front part from the distal end of a length of, for example, from 1 / 16-1 / 2 part of the full-length, preferably the entire length from the front end from 1/16 -1/3 section, starting from the distal end preferably 1 / 16-1 / 4 part of the full-length, starting from the distal end preferably 1 / 16-1 / 6 portion of the full-length, preferably the entire length from the front end from 1 / 16-1 / 8 part, preferably from the distal end from 1 / 16-1 / 10 portion of the full length, starting from the distal end preferably 1 / 16-1 / 12 portion of tapering diameter throughout its length, is not externally threaded, hollow push coincided with pedicle screw inner diameter of the pre-stage tapered fit. 所述柠入式螺钉的其余部分均带有外螺紋，其外螺紋与空心推弓根螺钉的内螺紋相互配合，以实现螺芯拧入及取出。 The rest of the formula citraconic are externally threaded screw, an outer thread and the internal thread of the hollow push pedicle screws cooperate to achieve and screwing the threaded core removed. 将所述拧入式螺芯拧入空心推弓根螺钉后，可以增加空心推弓根螺钉的机械强度，并避免骨组织通过其前部的缝隙进入空心推弓根螺钉，方便所述推弓根螺钉经推弓根植入推体。 After the screw-threaded into the hollow threaded core push pedicle screw may be hollow to increase the mechanical strength of the push pedicle screw, and to avoid bone tissue pedicle screw into the hollow push through the slit front portion thereof, to facilitate the push bar pedicle screw root implant body by pushing push. 在本发明中，所述撑开式螺芯在其前段部分，例如长度为自前端起全长的1/16-1/2部分，优选自前端起全长的1/16-1/3部分，优选自前端起全长的1/16 - 1/4部分，优选自前端起全长的1/16-1/6部分， 优选自前端起全长的1/16-1/8部分，优选自前端起全长的1/16-1/10 部分，优选自前端起全长的1/16-1/12部分不带有外螺紋，不带外螺紋的部分之长度与空心推弓根螺钉前段变细的部分相对应。 In the present invention, the core is softened spiro leading portion thereof, for example, starting from the distal end of a length of 1 / 16-1 / 2 part of the full-length, starting from the distal end preferably 1 / 16-1 / 3 of the full-length portion , preferably from 1/16 of the entire length from the front end - part 1/4, 1 / 16-1 / 6 starting from the distal end portion is preferably full length, 1 / 16-1 / 8 from the distal end portion is preferably from full length, preferably the length of the hollow portion of the push pedicle screw 1 / 16-1 / 10 starting from the distal end portion of the entire length, 1 / 16-1 / 12 from the entire length from the distal end portion is preferably not provided with an external thread, without external thread pre-stage tapered portion, respectively. 与柠入式螺芯不同的是，撑开式螺芯其前段部分的直径不是逐渐均匀变细，而是保持相同直径，直至最前端变为抛面曲率很大的弧形。 And citraconic the spiro core except that the diameter of the front part of the core is not softened spiro gradually tapers uniformly, but remains the same diameter, until a leading end becomes large curvature parabolic arc. 这一特点使得撑开式螺芯前段部分直径例如长度为自前端起全长的1/16 -1/2部分，优选自前端起全长的1/16-1/3部分，优选自前端起全长的1/16-1/4部分，优选自前端起全长的1/16-1/6部分，优选自前端起全长的1/16-1/8部分，优选自前端起全长的1/16-1/10部分，优选自前端起全长的1/16-1/12部分,总是大于空心推弓根螺钉前段相应的内径。 This feature makes the pre-stage portion of the expansion type core diameter of, for example, a length from the distal end portion from the entire length of 1/16 -1/2, preferably starting from the front end 1 / 16-1 / 3 of the full-length portion, preferably starting from the distal end 1 / 16-1 / 4 part of the full-length, starting from the distal end preferably 1 / 16-1 / 6 portion of the full-length, starting from the distal end preferably 1 / 16-1 / 8 for full-length, preferably the entire length from the front end from 1 / 16-1 / 10 portion, starting from the distal end preferably 1 / 16-1 / 12 portion of the entire length of the hollow push bar is always greater than the inner diameter of the screw root of the corresponding front stage. 除上述部分外，所述撑开式螺芯的其余部分的直径与空心推弓根螺钉内径完全吻合，也带有与所述空心推弓禪螺钉内螺紋相配合的外螺紋，用于增加狞入所述撑开式螺芯时撑开空心推弓根螺钉的力量。 In addition to the above portion, the diameter of the hollow inner diameter of the push pedicle screw distraction remainder of the core is fully consistent spiro, also provided with an external thread within said hollow push bar Zen cooperating screw threads for increasing hunting when the expansion into the hollow core of the expansion spiro pedicle screw pushing force. 同时，为了便于所述撑开式螺芯的柠入和取出，所述螺芯尾部可以有例如内六角形或十字形的螺扣。 Meanwhile, in order to facilitate the spreading spiro citraconic into the core and removed, the tail can be threaded core, for example, the cross-shaped or hexagonal screw fastener. 当定位明确，向稚体中柠入本发明所述推弓根螺钉时，需要将空心的推弓根螺钉与拧入式螺芯配套柠入，避免骨组织进入空心稚弓根螺钉, 同时增加空心推弓根螺钉的机械强度。 When the clear positioning, citraconic the present invention is to push the body juvenile pedicle screws, the pedicle screw is necessary to push the hollow screw-threaded core into the supporting citraconic avoid bone tissue into the hollow juveniles pedicle screw, while increasing hollow push pedicle screw mechanical strength. 当带有拧入式螺芯的所述推弓根螺钉前端拧入稚体放置妥当后，取出拧入式螺芯，拧入撑开式螺芯。 When the screw-threaded core with the front end of the push pedicle screws screwed into the body after the juveniles placed properly, remove the screw-threaded core, core spiro screwed distraction. 由于撑开式螺芯前段部分的直径较空心稚弓根螺钉前段部分所对应的内径粗，同时由于空心推弓根螺钉前段存在多条贯通的纵向缝隙，管壁逐渐增厚，故在柠入撑开式螺芯时，推弓根螺钉前段部分被逐渐撑开，例如呈伞状撑开，形状发生改变，同时造成局部周围骨密度及强度增加。 Since the diameter of the front part than hollow core distraction spiro juvenile pedicle screw corresponding to the inner diameter of the front part of the thick, hollow push bar and because the presence of the root gap through a plurality of longitudinal anterior screw, gradually thickened wall, so in the lemon when softened spiro core push pedicle screw is progressively stretched front part, e.g. umbrella-shaped distraction, change shape, while resulting in increased bone density and strength of the local surroundings. 因此，本发明稚弓根螺钉不易松动及脱出。 Thus, juvenile pedicle screw of the present invention is easy to loose and prolapse. 为了达到本发明的设计要求，本发明所述推弓根螺钉以及螺芯的材料可以是钬合金，这是因为钛合金具有理想的弹性模量、良好的组织相容性及抗疲劳性，能够在人体内长期存留。 In order to meet the design requirements of the present invention, the material and the pedicle screw threaded core of the present invention may be a push Holmium alloys, titanium alloys having desirable because the modulus of elasticity, compatibility and good fatigue resistance organization, can be long-term retention in the human body. 本领域普通技术人员也知晓， 只要具有理想的弹性模量，良好的组织相容性及抗疲劳性的材料均可用于制备本发明所述的推弓根螺钉以及螺芯。 Those of ordinary skill in the art are also known, as long as having desirable modulus of elasticity, good tissue compatibility and fatigue resistance of the material can be used to push pedicle screw and the threaded core was prepared according to the present invention. 本发明的有益效果是：通过使推弓根螺钉前段部分在推体内被撑开， 造成其周围骨密度及强度增加，同时由于外在形状的改变，增加了生物力学强度，因此不易松动及脱出。 Advantageous effects of the invention are: by pushing pedicle screw body front part push the softened, resulting in increased bone density and strength around the same time due to external changes in the shape, to increase the bio-mechanical strength, and thus easy to loose prolapse . 同时结构简单，操作方便。 Meanwhile simple structure, convenient operation. 附图说明下面结合附图及实施例对本发明作进一步说明。 BRIEF DESCRIPTION OF THE DRAWINGS Examples and embodiments of the present invention will be further described. 图1空心推弓根螺钉的透视图及剖面示意图，其中1为空心推弓根螺钉前段部分贯通管壁的缝隙部分；2为空心推弓根螺钉的外螺紋部分；3为空心推弓根螺钉末端的外六角形螺扣部分；4为空心堆弓根螺钉管壁部分；5为空心推弓根螺钉前段部分增厚的管壁部分；6为空心推弓根螺钉前段部分，其内径逐渐变细，抛面可以为直线或曲率很小的弧线；7为空心推弓根螺钉其余部分的内螺紋。 FIG hollow push pedicle screws 1 a perspective view and a sectional view, wherein a gap is partially hollow push pedicle screws through the wall of the front part; 2 as a hollow externally threaded portion pushes pedicle screw; 3 of screws a hollow push bar hexagonal outer end portion of the screw fastener; 4 pedicle screws a hollow pile wall section; 5 pedicle screws a hollow front part push the thickened wall portions; 6 pedicle screws pushing a hollow leading portion, an inner diameter gradually increases fine, may be linear or parabolic curvature is small; 7 as a hollow internally threaded push the rest of the pedicle screw. 图2拧入式螺芯的透视图，其中8为拧入式螺芯尾部的内六角形螺扣部分；9为拧入式螺芯的外螺统部分；10为拧入式螺芯前段部分， 其直径逐渐变细。 A perspective view of FIG. 2 is screwed-in threaded core, where the hexagonal screw 8 is screwed into the stud portions spiro core tail; spiro system 9 outer portion of the screw-threaded core; front part 10 is screw-threaded core which is tapered. 图3撑开式螺芯的透视图，其中11为撑开式螺芯尾部内六角形螺扣部分；12为撑开式螺芯的外螺紋部分；13为撑开式螺芯的前段部分， 其直径无明显变化，最前端抛面逐渐变为曲率很大的弧线。 3 a perspective view of the core of FIG spiro distraction, wherein the hexagonal inner core 11 is a distraction spiro spiro buckle tail portion; externally threaded portion 12 of the core spiro distraction; 13 anterior portion of distraction spiro core, no significant change in diameter, most distal parabolic curvature gradually becomes large arc. 图4 所述防松动稚弓根螺钉内固定系统示意图，图4 (a)为空心推弓根螺钉和拧入式螺芯组合的透视图；图4 (b)为空心推弓根螺钉和拧入式螺芯组合的剖面图，其中拧入式螺芯16与空心稚弓根螺钉15紧密配合；图4 (c)为空心推弓根螺钉和撑开式螺芯组合的剖面图，其中在带有柠入式螺芯16的推弓根螺钉15柠入推体后，取出柠入式螺芯16, 将撑开式螺芯17拧入空心推弓根螺钉15,由于所述撑开式螺芯17前端直径较拧入式螺芯粗，使得空心推弓根螺钉15的前段被撑开，得到撑开后的捋入式螺芯与空心推弓根螺钉组合18。 FIG 4 rattle juvenile pedicle screw system schematic, perspective view of a hollow screw and push pedicle screw-threaded core combination of FIG. 4 (A); FIG. 4 (b) is a pedicle screw and a hollow push screwed spiro sectional view of the core composition, wherein the screw-threaded core 16 and the hollow juvenile pedicle screws 15 mate; FIG. 4 (c) is a sectional view of a hollow push pedicle screw and a distraction screw type core composition, wherein the after the pedicle screws 15 citraconic pushed into the body with a push-in screw citraconic core 16, citraconic taken into spiro core 16, the core 17 is softened spiro screwed into the hollow push pedicle screw 15, since the spreading of formula threaded core diameter than the distal end 17 screwed into the core of the crude spiro, pedicle screw such that the hollow push the front section 15 is stretched to obtain a stroke-in of the hollow threaded core after distraction pedicle screw assembly 18 pushed. 图五（a)现有技术公开的推弓根螺钉狞入推体示意图；（b)本发明防松动推弓根螺钉拧入推体示意图，其中，本发明所述防松动推弓根螺钉由于其前段在推体中19被撑开，不易松动、脱出。 Push pedicle screw loosening (b) of the present invention, the anti-loosening pushing the push of screws screwed into the body of a schematic diagram, wherein the present invention, since the anti; Figure V (a) disclosed in the prior art pedicle screw push hunting schematic pushed into the body front section 19 which is pushed in the expansion body, is not easy to loose, prolapse. 具体实施方式如图4所示：当经推弓根拧入推弓根螺钉时，将空心推弓根螺钉15与拧入式螺芯16配套拧入，避免骨组织进入空心推弓根螺钉，同时增加空心推弓根螺钉机械强度，避免空心螺钉前段断裂或发生其它意外。 DETAILED DESCRIPTION Figure 4: When pushed by the push bar is screwed into the pedicle of screws, the pedicle screw 15 pushing the hollow screw-threaded core and support 16 screwed into the bone tissue avoiding to push hollow pedicle screw, hollow push bar while increasing the mechanical strength of screws, to avoid breakage or hollow screw anterior other accidents occur. 当螺钉捋入稚体放置妥当后，取出拧入式螺芯16，柠人撑开式螺芯17, 由于撑开式螺芯前段直径较空心推弓根螺钉前段内径粗，其管壁逐渐增厚，同时由于空心推弓根螺钉前段存在多条贯通管壁的纵向缝隙，故在拧入撑开式螺芯时，螺钉前段被逐渐呈伞状撑开，形状发生改变。 When the screw stroke juvenile body placed properly, screw-threaded core extraction 16, citraconic human distraction spiro core 17, since the expansion front stage spiro diameter than hollow core push pedicle screw crude anterior inner diameter which is gradually increased wall thick, and because the presence of the hollow push pedicle plurality of longitudinal slots through the wall of the anterior screw, so that when the screw is screwed into the expansion core type, the pre-stage screw is progressively stretched umbrella shaped, the shape change. 如图5所示：本发明推弓根螺钉同现有推弓根螺钉相比，在推体内19前端形状发生改变，同时可造成空心推弓根螺钉前段局部骨质强度及密度增加。 5: push pedicle screw of the present invention compared with the conventional push pedicle screw, a change in shape of the front end of the push body 19, and can result in the hollow push pedicle screw to increase local bone strength and density of the pre-stage. 因此，本发明推弓根螺钉不易松动及脱出。 Accordingly, the present invention is easy to loose the push pedicle screw and extrusion.