CN101011289B - 带有间接形状适配部的摩擦螺杆连接装置 - Google Patents

带有间接形状适配部的摩擦螺杆连接装置 Download PDF

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CN101011289B
CN101011289B CN2006101495327A CN200610149532A CN101011289B CN 101011289 B CN101011289 B CN 101011289B CN 2006101495327 A CN2006101495327 A CN 2006101495327A CN 200610149532 A CN200610149532 A CN 200610149532A CN 101011289 B CN101011289 B CN 101011289B
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S·弗洛伊迪格
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
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    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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    • A—HUMAN NECESSITIES
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    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor

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Abstract

本发明涉及一种带有间接形状适配部的摩擦螺杆连接装置，即用于脊柱弹性固定的脊椎植入件，其中弹性杆(2)通过垫片(3)和夹紧件(4)摩擦锚定在椎弓根螺钉(1)的插槽中，所述的摩擦连接由间接形状适配部(5a，5b，6a，6b)额外支持。这种连接装置能将光滑的塑料弹性杆连接到骨头上或者椎弓根螺钉上，从而将其用于腰椎动力固定手术时，就能持续稳定地传递期望的作用力。本发明用于外科手术中具有容易操作，安全可靠的优点。

Description

带有间接形状适配部的摩擦螺杆连接装置
技术领域
本发明涉及一种用于脊柱的动力固定系统，其能在不进行脊柱融合手术的情况下将脊柱固定。技术方案是采用一种新的方法将弹性连接件连接到骨骼或者椎弓根螺钉(pedicle screw)上。
背景技术
根据现有技术，有多种配合金属杆使用的螺杆/螺钉连接件，其主要用在融合手术(脊柱融合)中。因为用于支承和固定脊柱节段的弹性部件不多，并且其不能使脊柱节段融合，所以能将弹性连接件固定到椎弓根螺钉上的装置也并不多。
原则上，不必要求那些适用于金属杆的螺杆/螺钉连接件也同样能适用于弹性连接件，因为弹性相是用塑料制造的，举例来说就是用塑料做的杆件有很多属性和用与塑料相比更硬的金属来做的杆件不相同。所以，塑料弹性杆不能被简单地通过摩擦连接装置(或压紧装置)来持续夹紧，因为它们的塑变通常会减小夹持力。所以，在连接方面就要求连接件除了要能使用摩擦式夹紧以外，例如还要通过局部弹性或塑性变形获得形状适配。
在下面的描述中，将列举公知的螺杆/螺钉连接件，并说明它们相对于本发明的不足之处。
虽然如下所述的发明的专有特征能在接触区域实现增高的压力并且因此在杆件表面发生局部的弹性或塑性形变，但在弹性杆是由塑性材料制成的情况下仍有不足之处：WO 95/01132(
Figure G2006101495327D00011
等)专利申请中所采用的方案是借助在固定螺丝内的球形件；DE 4234118 A1(Harms等)专利申请中所采用的方案是借助空的固定螺丝的边缘；US 5,005,562(Cotrel)专利中所采用的是在固定螺丝上的环形齿廓；WO 03/015648A1(McKinley)专利申请中所采用的是在帽形固定螺丝下面的齿。
在US 6,117,137(Halm等)专利中公开了螺丝头内的下部杆插口处开有槽，但这也只能提供针对纵向位移的附加支承。而且这些槽的对侧没有匹配的互补结构。
在EP 0689798 B1(Sebastian Bueno等)专利中公开了一个相对于圆形杆件呈非全等形(“蛋形”)的插槽，其能增加金属杆件的夹持力。由于这种形状在对侧不匹配，由于存在塑变和张力减少的危险，所以其不适用于塑料弹性杆。
在EP 1364622B1(Freudiger)专利和EP 1527742A1(Freudiger)中都公开了在几何上互相匹配的形适锚定，因此其适合用于将塑料制成的弹性杆连接到椎弓根螺丝上。但是这种开槽表面的定位需要非常精确的插入，以防止搭挂。另外，这种开槽表面不允许无间断定位。
在US 6,478,797B1(Paul)专利和US 2003/0125742A1(Yuan等)专利申请中都公开了当从上部插入时用于环绕夹持金属杆的垫片。但是两者都没有公开在夹持区域设有通过充分的形状适配而适用于塑料弹性杆的表面结构。
在FR 2739548(Huitema)专利申请中公开了一种连接在金属杆周向部分的开槽连接结构。它是一种压入所述杆件中的带槽衬套，由于可能导致堵塞，所以这些衬套不适用于塑料弹性杆。
发明内容
所以本发明的任务就是使一种具有连续平滑表面的塑料弹性杆能持久可靠地连接并固定在骨骼或者椎弓根螺钉上，在此过程中传递相邻脊椎间的张力、压力以及剪切力和扭力。
解决该任务的方案具有以下特征：所述连接件是由一个直接摩擦(压紧)连接件和一个间接形状适配连接件组合而成。所述间接形状适配是通过塑料连接件局部的弹性变形或者塑性变形(例如，塑变)来实现的。理想的是，在预计的张力下形状适配部分的膨胀大于塑料弹性杆件的收缩。理想的是，凸出尺寸和凹陷尺寸相等或者几乎相等，这样在塑变结束后塑料弹性杆在连接区域处的体积能近似地恢复到初始值。理想的是，螺钉和杆件的接触表面形成一个罩，这样能防止杆件材料的意外脱落以及由此连带杆件位置的意外改变。
所以，本发明的目的就是提供一种带有间接形状适配部分的摩擦螺丝/杆件连接件。这种连接件能将光滑的塑料弹性杆连接到骨头上或者椎弓根螺钉上，从而将其用于腰椎动力固定手术时，就能持续稳定地传递期望的作用力。将其结合摩擦连接件使用还有一个好处就是利用连接件的形状适配部分的可靠性能简单地连续定位。但是形状适配只能利用弹性塑料的塑变属性在连接时产生。因此本发明用于外科手术中具有容易操作，安全可靠的优点。
附图说明
下面，本发明通过示出了示范性实施例的附图得到了更为详细的图示。在这些附图中，示意性地示出了以下内容：
图1a中的圆形截面表示没有受到载荷作用，椭圆形截面表示受到载荷作用。
图1b中的正方形截面表示没有受到载荷作用，矩形截面表示受到载荷作用。
图1c中的三角形截面表示没有受到载荷作用，底边较宽的三角形截面表示受到载荷作用。
图2中示出了一个位于带有垫片3和夹紧件4的椎弓根螺钉1的插槽内的圆形连接件2。
图3是图2的侧视图。
图4是图2的剖视图，其示出了连接件沿着插槽5a，5b，6a，6b中局部变形了的横截面。
图5也是图2的剖视图，其示出了连接件2在螺钉1和垫片3上插槽中发生销形变形8，9的横截面。
图6a示出了一个用于反压装置的带有示范性插槽10的垫片3。
图6b是图6a的顶视图。
图6c是类似于图6b的顶视图，其采用了另一种侧向导槽7。
图7a是一种改进型垫片的透视图。
图7b是图7a中垫片的底部视图。
具体实施方式
在图1a中，例如，一个圆形截面在受到两个相反的作用力后变成了一种新的形状，即椭圆形。
在图1b中，例如，一个正方形截面在受到两个相反的作用力后变成了一种新的形状，即矩形。
在图1c中，例如，一个三角截面在受到两个相反的作用力后变成了一种新的形状，即，底角更尖锐的另一三角形。
图2示出了一个在椎弓根螺钉1的插槽内的示范性圆形杆件2，其中椎弓根螺钉通过一块垫片3由作为夹紧件的的螺母4夹紧。
图3是图2中同一零件的侧视图。
图4是图2的剖视图，其中接触区域的一部分或多部分特别是从作为示范性连接件的示范性圆杆2的起始横截面发生变形，即，例如，隆起的肋部附着在螺钉1的底部5a处以及垫片3的顶部5b处。这里，例如连接件通过由侧向导槽7导向的垫片3被作为示范性夹紧件的螺母4压迫。为了容纳因此发生位移的材料，在螺钉1和垫片3的左侧6a和右侧6b形成了对应的凹槽，所述凹槽6a，6b能允许发生位移的材料流入到其内，由此能产生形状适配的效果。
图5示出了图2的一个剖视图，其中图4中的隆起5a，5b缩小成一个或多个位于螺钉1上的锥形销部8，或一个或多个位于侧向导槽7上的垫片3上的锥形销部9。这里，所述锥形销部8，9碰撞弹性塑料，由此产生形状适配。
图6a示出了一个带有示范性侧向导槽7和用于安装反冲支承零件10的插槽的垫片3的侧视图。
图6b是图6a的顶视图。
图6c是图6a的另一个顶视图，其示出了替换性的侧向导槽7。
垫片的另一种改进型如图7a和7b所示。垫片30与前述垫片的不同之处在于，在其面向连接件2的两侧上分别形成了多个沿垂直于连接件2的纵向轴线方向延伸的肋部31。实施例示出了三条相互平行并且彼此间距相等的凸肋31。然而，肋的数量可以根据需要增减。间距也可以改变。
在螺钉1的插槽内也可以设置与垫片30内的肋相对应的若干凸肋，所述凸肋沿垂直于连接件2纵向轴线的方向延伸。设置这些肋可以改善连接件2表面上的载荷分布。
螺钉的插槽中肋的数量和垫片上肋的数量可以彼此不相同。

Claims (12)

1.一种脊椎植入件，其由连接件(2)和多个骨头螺钉(1)组成，其中每一螺钉上都具有用于容纳所述连接件的插槽、被侧向导引的垫片(3)和一个夹紧件(4)，从而连接件(2)通过夹紧件(4)被摩擦夹紧在螺钉头内的插槽和垫片(3)之间，其特征在于，连接件由能够变形的塑料制成，并且在螺钉头上的插槽的下部区域(5a)和垫片上的插槽的上部区域(5b)内，插槽的轮廓从连接件的轮廓处发生偏离。
2.如权利要求1所述的脊椎植入件，其特征在于，插槽的轮廓还从位于螺钉头和垫片上的插槽的侧向区域(6a，6b)内的连接件的轮廓处发生偏离。
3.如权利要求1所述的脊椎植入件，其特征在于，插槽的轮廓从连接件的轮廓的偏离位于与连接件的纵向轴线垂直的一个或多个部分内，并在相同平面或不同平面内。
4.如权利要求1-3任一所述的脊椎植入件，其特征在于，从所述轮廓的偏离是隆起(5a，5b)或者凹陷(6a，6b)。
5.如权利要求1-3任一所述的脊椎植入件，其特征在于，上下方向的偏离是隆起(5a，5b)，侧向的偏离是凹陷(6a，6b)。
6.如权利要求1-3任一所述的脊椎植入件，其特征在于，插槽的轮廓从连接件的轮廓的偏离是肋型(5a，5b，6a，6b)或销形(8，9)。
7.如权利要求1-3任一所述的脊椎植入件，其特征在于，连接件(2)是一种杆件。
8.如权利要求7所述的脊椎植入件，其特征在于，杆件是圆的。
9.如权利要求1-3任一所述的脊椎植入件，其特征在于，连接件(2)是用弹性塑料制成的。
10.如权利要求9所述的脊椎植入件，其特征在于，连接件(2)用聚碳酸酯氨基甲酸酯制成。
11.如权利要求1-3所述的脊椎植入件，其特征在于，夹紧件(4)是一种螺母。
12.如权利要求1-3所述的脊椎植入件，其特征在于，所述垫片(3)包括一个用于一个保持元件的插槽(10)。
CN2006101495327A 2005-08-29 2006-08-29 带有间接形状适配部的摩擦螺杆连接装置 Expired - Fee Related CN101011289B (zh)

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US60/738,695 2005-11-21

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US20070093820A1 (en) 2007-04-26
TW200718390A (en) 2007-05-16
EP1759646A1 (de) 2007-03-07
US8282672B2 (en) 2012-10-09
CN101011289A (zh) 2007-08-08
KR101280008B1 (ko) 2013-06-28
ES2312071T3 (es) 2009-02-16
JP4813293B2 (ja) 2011-11-09
EP1759646B1 (de) 2008-07-30
CH705709B1 (de) 2013-05-15
US20130079824A1 (en) 2013-03-28
KR20070026058A (ko) 2007-03-08
EP1759646B2 (de) 2011-03-16
ES2312071T5 (es) 2011-07-20
TWI436755B (zh) 2014-05-11
JP2007061615A (ja) 2007-03-15

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