CN101031248A - 多轴连接系统 - Google Patents
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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
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
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- 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
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- 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
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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
- 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
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- 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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
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- 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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B2017/8655—Pins or screws or threaded wires; nuts therefor with special features for locking in the bone
Abstract
在本发明的一个实施方式中,提供了一种为脊柱固定而相对于一个杆连接紧固元件(例如,椎弓根螺钉)的系统。该系统可允许紧固元件和杆之间的多轴运动。另外,该系统可允许紧固元件和杆之间的角度关系保持在期望的方向上。为描述和主张本发明的目的,术语“杆”意指任何长形结构。这种长形结构可以是实心的或者是中空的,并可具有任何期望的截面(例如,圆形、椭圆形、方形、矩形)。另外,为描述和主张本发明的目的,术语“干涉配合”意指两个或者多个部件之间的物理接触。
Description
技术领域
在本发明的一个实施方式中,提供了一种相对于杆连接一个紧固元件(例如椎弓根螺钉)以实现脊柱固定的系统。该系统可允许紧固元件和杆之间的多轴运动。另外,该系统可允许紧固元件和杆之间的角度关系保持在预定的朝向上。
为了描述和主张本发明的目的,术语“杆”意指任何长形结构。这种长形结构可以是实心的或者中空的,并且可具有任何期望的横截面(例如,圆形、椭圆形、方形、矩形)。
另外,为了描述和主张本发明的目的,术语“干涉配合”意指两个或者更多部件之间的物理接触。
背景技术
提出了为实现脊柱固定而将紧固元件(例如椎弓根螺钉)连接到长形支持件(例如杆)上的多种系统。示例包括在以下美国专利中描述的系统。
美国专利5,466,237涉及一种可变锁定的稳定锚固设备支座和螺钉。更具体地,该专利涉及设置成与稳定杆一起用于脊柱内部固定的骨界面锚固设备。锚固设备具有支座,该支座容纳稳定杆并容置将支座固定到骨上的接骨螺钉。压紧构件与稳定杆外部的支座配合、并且能被绷紧而引起作用在稳定杆上的压力。稳定杆支承在接骨螺钉的圆形表面上而形成支座和接骨螺钉之间的配合面。随后,可以锁定支座与接骨螺钉的相对位置。
美国专利5,474,555涉及一种脊柱植入系统。更具体地,该专利涉及用于脊柱内部固定的装置。该装置包括有一个组件,所述组件具有至少两个锚固设备和一个长形的稳定装置。每一个锚固设备都有把锚固设备保持在骨上的装置,并且包括容置稳定装置的容置装置以及通过配合螺纹的相互作用而导致稳定装置上的压力施加到容置装置内来与所述容置装置配合的紧固装置。
美国专利5,669,911涉及一种多轴椎弓根螺钉。更具体地,该专利涉及与杆植入装置一起使用的多轴整形设备。该设备包括具有弯曲头部的螺钉、布置在其周围的锁环、和具有线性锥形插座的容置构件,螺钉及锁环嵌入该容置构件内。锁环是开槽的并且是锥形的,并且具有半球形的内部容积,螺钉头部初始多轴地保持在该内部容积内。容置装置具有形成于其内以用于容置杆的横向槽、以及在其底部具有线性锥形腔的轴向孔。套环从顶部沿着孔向下插入以固定在腔内,接着螺钉穿过孔的底部向上插入并且进入到套环内。当在腔内朝下压套环时,腔的线性锥度提供了作用在锁环上的径向朝内的力。这种径向朝内的力引起锁环挤压锁紧螺钉头部,在其中以给定的角度锁住两者。杆在横槽内抵靠套环顶部的放置、以及杆在槽内随后的向下锁紧提供了抵靠锁环的向下的力,这又将螺钉锁定在给定的角度中。
美国专利5,879,350涉及一种多轴接骨螺钉组件。更具体地,该专利涉及包括有具有部分球形头部的接骨螺钉的多轴接骨螺钉组件。接骨螺钉头部的上表面是截平的,其中限定有一个容置工具的凹口。组件包括容置构件,该容置构件包括一个中心孔,该中心孔限定有锥形凹口以容置支承接骨螺钉头部的收缩夹头部。容置构件的孔也限定了与凹口相通并构造成在其中容置脊柱杆的槽。槽的一部分设置有螺纹,以容置杆上的定位螺纹。组件也包括有放置在杆和接骨螺钉头部之间的收缩夹头部。夹头部限定了容置接骨螺钉头部的部分球形凹口,并且包括大致包绕螺钉头部的可偏转指形件。当定位螺钉被固紧在容置构件内时,定位螺钉将杆压紧在夹头部上,这将夹头部压入容置构件的锥形凹口,因而抵靠接骨螺钉头部偏转指形件。
美国专利6,063,090涉及用于将纵向支撑件连接到椎弓根螺钉的设备。更具体地,该专利涉及通过具有容纳纵向支撑件的槽的容纳头部将纵向支撑件连接到椎弓根螺钉的设备,其中可以从顶部开口或者闭合的容纳头部中自由选择或者混合以侧面开口的容纳头部。例如,顶部开口的容纳头部便于纵向支撑件的插入,而侧面开口便于侧面校正。椎弓根螺钉和容纳头部通过容纳头部内的锥形夹块和椎弓根螺钉上的球形头部相连接。该专利允许在椎弓根螺钉插入骨内后使椎弓根螺钉接合在容纳头部内。
美国专利6,582,436涉及将纵向支撑件连接到接骨锚钉的设备。更具体地,该专利涉及将纵向支撑件连接到圆头部接骨锚钉的设备。该设备包括一个本体,该本体限定一个用于容置接骨锚钉圆头部的腔和用于容置纵向支撑件的第一槽。此外,第一套管可在该本体上滑动而压紧所述的腔,第二套管可在该本体上滑动而逆着第一套管偏置纵向支撑件,并且一个紧固件与本体操作上相联而朝第一套管偏置第二套管。紧固件施加在第二套管上的力被传递到位于在与中心轴线垂直的平面内的第一套管上。优选地,纵向支撑件在第一和第二接触点或区上接触第一套管,并且套管之一包括至少一个延伸部分,以在至少另一个接触点或区处接触另一个套管。
美国专利6,660,004涉及一种多轴接骨螺钉组件。更具体地,该专利涉及底部装载的多轴接骨锚钉装置。装置包括容置构件、冠状构件、接骨锚钉和保持构件。容置构件限定有可构成同一开口的一个部分的上部开口和下部开口、槽、和凹槽。冠状构件和接骨锚钉被装载入容置构件的下部开口,且保持构件绕着接骨锚钉配合并配合入容置构件的凹槽内。接骨锚钉可相对于容置构件多轴定位。一长形构件放置在容置构件的槽内、接触冠状部件,而一压紧构件通过上部开口而施加。压紧构件在长形构件上压下,长形构件压下冠状构件并且将接骨锚钉锁定在冠状部件和保持部件之间。
美国专利6,740,086涉及螺钉和杆的固定组件和设备。更具体地,该专利涉及用于固定螺钉和可选地固定杆的螺钉和杆的固定组件。该螺钉和杆的固定组件包括螺钉、固定机构、大致圆形的环、杆安置机构以及锁死机构。该发明也设置有用于固定螺钉的固定机构,其中该固定机构还包括有内表面壁,所述内表面壁具有夹紧部分和非夹紧部分。此外,该发明设置有大致圆形的环,以引导并为螺钉头部提供机械力和摩擦力。另外,该发明设置有杆安置机构,该机构操作上接合螺钉头部并且包括至少一个柔性部分,该柔性部分可压紧在其中的杆的一个部分上。最后,该发明设置有用于接合杆和杆安置机构的锁定机构。锁定机构包括偏转机构,以在锁定机构进一步接合杆安置机构的至少一个柔性部分时逆抵靠和绕着杆偏转杆安置机构的至少一个柔性部分。
附图说明
图1示出了根据本发明一个实施方式的紧固组件的立体分解图;
图2示出了根据图1实施方式的部分装配的紧固组件的横截面视图(为了清楚起见,该图没有包括图1中的杆或者压紧构件);
图3示出了根据本发明另一实施方式的紧固组件的立体分解图;
图4示出了根据图3实施方式的部分装配的紧固组件的横截面视图(为了清楚起见,该图没有包括图3中的杆或者压紧构件);
图5示出了根据本发明另一实施方式的紧固组件的侧视图;
图6示出了根据本发明另一实施方式的紧固组件的侧视图;以及
图7示出了根据本发明一个实施方式的紧固件的侧视图;
在已经揭示的那些优点和改进中,通过下文的描述、同时结合附图,本发明的其它目地和优点将会变得明显。附图组成本说明书的一个部分,并包括本发明的说明性实施方式,并且说明其不同的目的和特征。
具体实施方式
在此对本发明的详细实施方式进行描述;但可以理解的是,所描述的实施方式只是对可以多种形式实施的发明的一个示例。另外,与本发明各个实施方式结合地给出的每一个例子都用于说明而不用于限制。此外,图不必要按比例,一些特征可以被放大以示出特定部件的细节。因此,这里揭示的特定的结构和功能细节不认为是限制性的,而仅仅是作为代表性的原理,以教导本领域内的技术人员以各种方式来实施本发明。
现在参见图1和2,其示出了本发明的第一实施方式。正如这些图中所观察到的,紧固组件100可与相对于患者的脊柱安装一个杆101结合地使用(当然,一个或者多个这样的紧固组件可与一个或者多个杆一起使用)。更具体地,紧固组件100可包括紧固件103,该紧固件103的第一端具有头部103A、第二端具有骨连接元件103B(骨连接元件103B可适于附连在脊柱上、脊柱内和/或附连到脊柱)。此外,头部103A可包括至少一个位于其上的变形元件103C。
在一个例子中(该例子是用来说明的而不是限制的),头部103A的至少一部分可以是球形的。在另一个例子中(该例子是用来说明的而不是限制的),紧固件103可以是接骨螺钉,且骨连接元件103B可以包括螺纹。在另一个例子中(该例子是用来说明的而不是限制的),紧固件103可以是管状接骨螺钉(参见图2的管103D)。在另一个例子中(该例子是用来说明的而不是限制的),变形元件103C可以大致上环绕管103D(例如,在管103D离开头部103A处)。在另一个例子中(该例子是用来说明的而不是限制的),变形元件103C可以是从头部103A突出的大致圆形的环。在另一个例子中(该例子是用来说明的而不是限制的),变形元件103C(和/或紧固件103的任意其它部分(例如,头部103A或者整个紧固件103))可以包括这样的材料:(a)比形成杆101的材料软;(b)比形成杆101的材料硬;(c)与形成杆101的材料具有基本相同的硬度(例如,与形成杆101的材料相同)。
还是参见图1和2,可见紧固组件100可以包括本体105。本体105可具有第一端和第二端,其中用于容置杆101的杆容置槽105A邻近本体105的第一端设置,而紧固件头部容置腔105B邻近本体105的第二端设置(正如在这些图中观察到的,紧固件头部容置腔105B可朝本体105的第二端逐渐变细,而杆容置槽105A和紧固件头部容置腔105B可操作上相连(例如,本体105内的一个孔可以连接杆容置槽105A和紧固件头部容置腔105B))。
此外,紧固组件100可包括保持环107。该保持环107的尺寸可在头部103A设置于紧固件头部容置腔105B内时至少部分包绕头部103A地配合。在一个例子中(该例子是用来说明的而不是限制的),保持环107可如图所示地具有“开口环”设计。
更进一步地,当杆101设置在杆容置槽105A内时,压紧元件109可与本体105配合而推动杆101,使其与变形元件103C的至少一部分接触。当朝紧固件头部容置腔105B的逐渐变细端(也就是缩窄端)推压头部103A时,杆101和变形元件103C之间的这种接触将使变形元件103变形。此动作的作用是固定所述紧固件103与杆101相互之间的角度关系。
更具体地,可以至少部分地由于下述因素来固定所述紧固件103相对于杆101的角度关系:(a)在头部103A外表面的至少一部分和保持环107内表面的至少一部分之间的干涉配合(由径向压紧引起);(b)在保持环107外表面的至少一部分和紧固件头部容置腔105B内表面的至少一部分之间的干涉配合(由径向压紧引起);和/或(c)在杆101外表面的至少一部分和变形元件103C之间的干涉配合。
在一个例子中(该例子是用来说明的而不是限制的),压紧元件109可具有与本体105的互补螺纹配合的螺纹。在另一个例子中(该例子是用来说明的而不是限制的),压紧元件109可具有与本体105的互补内螺纹配合的外螺纹(例如,压紧元件109可以是定位螺钉)。在另一个例子中(该例子是用来说明的而不是限制的),压紧元件109可具有与本体105的互补外螺纹配合的内螺纹(例如,压紧元件109可以是螺母)。在另一个例子中(该例子是用来说明的而不是限制的),压紧元件109可具有一个或者多个凹痕、突出和/或用于承受来自驱动工具的扭矩的驱动面(例如,参见图1的凹形六角结构)。
现在将结合对示例安装过程的描述来参考图1和2所示的元件。这种示例安装过程可适用于本发明紧固组件的这种实施方式,当然,这是用来说明而不是限制的。
更具体地,一个导丝可以首先被附连到脊柱的椎弓根上。接着,导丝的自由端可穿过紧固件103(经过管103D)。接着,紧固件103(例如椎弓根螺钉)可插入(例如拧入)脊柱的椎弓根。注意,这种椎弓根螺钉可自攻入钻进椎弓根内的孔中、或者钻进椎弓根内的孔可预先地攻出螺纹。还要注意,这种椎弓根螺钉可通过任何期望工具(例如,通过杆容置槽105A和紧固件头部容置腔105B施加扭矩的手动或者电动驱动器)驱动入骨内。
在一个例子中(该例子是用来说明的而不是限制的),这种椎弓根螺钉可通过扭矩施加工具驱动进骨内,该扭矩施加工具接合头部103A上的一个或者多个凹痕、突出和/或驱动面(例如,参见图1中头部103A的四个扇形凹口)。
在一个例子中(该例子是用来说明的而不是限制的),紧固件103可以自攻入骨内。接着,本体/保持环组件(例如,包括保持环107已经设置在紧固件头部容置腔105B内的紧固本体105)可放置(或者“卡合”)到紧固件103上。
在这个方面,当本体105随后被按到头部103A上时,保持环107压靠在紧固件头部容置腔105B的后壁上(参见图2的105C),并且保持环107能够朝外自由膨胀以使得头部103A可以通过。一旦头部103A挤过保持环107的底部,则头部103A保持锁定(因为当保持环由头部103A朝前拉向紧固件头部容置腔105B的逐渐变细(即缩窄)端时,保持环107没有膨胀的空间)。
接着,杆101可放置入杆容置槽105A内(杆101与变形元件103C接触)。
最后,当压紧元件109(例如定位螺钉)拧入本体105内时,压紧元件109将部件夹紧在固定位置上(也就是说,压紧元件109将杆101压紧在变形元件103C上(并且,取决于杆101、变形元件103C和头部103A的尺寸和形状,压紧在头部103A的一个部分上))。注意,在这种夹紧过程中,变形元件103C变形(例如,以形成与引起变形的该部分杆101互补的一个表面)并且结果是锁定(例如,杆101和紧固件103之间的角度关系)得以改善。还要注意,相信变形元件103C在使诸如管状椎弓根螺钉的管状紧固件牢固锁死的方面是特别有用的(相信管(没有使用根据本发明的变形元件)有可能会弱化锁定多轴可调度的能力)。
在另一个例子中(该例子是用来说明的而不是限制的),紧固件103不是自攻入骨内然后在其上放置本体/保持环组件,而是如上所述地锁固在本体/保持环组件内,然后,整个的本体/保持环/紧固组件可附连到骨上(例如,通过使用例如手动或者电动驱动器的驱动工具来驱动椎弓根螺钉而穿过设置在本体105内、位于杆容置槽105A和紧固件头部容置腔105B之间的孔)。
现在参见图3和4,其示出本发明的另一个实施方式。此实施方式与图1和2中示出的实施方式相似,在这方面,相同的元件将以相同的标号指示(这种相似的元件将不再详细描述)。注意,这些图3和4的实施方式与图1和2的实施方式之间的主要差别是在这种实施方式中紧固组件200不使用保持环107。
更具体地,紧固组件200可再次与相对于患者的脊柱安装杆101结合地使用(当然,一个或者多个这样的紧固组件可以与一个或者多个杆一起使用)。此外,紧固组件200可以包括紧固件103(其具有头部103A,骨连接元件103B和至少一个变形元件103C)。
仍然参照图3和4,可见紧固组件200可还包括本体105’(本体105’可具有第一端和第二端,其中用于容纳杆101的杆容置槽105A’邻近本体105’的第一端设置,而紧固件头部容置腔105B’邻近本体105’的第二端设置)。正如在这些图中所观察到的,紧固件头部容置腔105B’可朝本体105’的第二端逐渐变细,且一个孔可设置成穿过本体105’而连接杆容置槽105A’和紧固件头部容置腔105B’。
注意,紧固件头部容置腔105B’的逐渐变细(即缩窄)端可以制成足够小以禁止头部103A从其中通过(而杆容置槽105A’和本体105’内将杆容置槽105A’连接到紧固件头部容置腔105B’的孔可制成得足够大以允许头部103A从其中通过)。
在这一点上,紧固组件200可通过把紧固件103插过本体105A’而安装,使得头部103A搁置在紧固件头部容置腔105B’中(见图4)。如前面所述(例如,一导丝可用于引导紧固件103,且或者自攻接骨螺钉可驱进骨的一个孔内、或可在骨内设置预先攻出螺纹的孔。),紧固件然后103可以插入(例如,进入脊柱的椎弓根)。
最后,当杆101设置在杆容置槽105A’内时,压紧元件109可与本体105’配合以将杆101推入到与变形元件103C的至少一部分接触,从而使变形元件103C变形、同时朝紧固件容置腔105B的逐渐变细端(即缩窄端)推压头部103A。此动作将固定所述紧固件103与杆101相互之间的角度关系(紧固件103相对于杆101的角度关系可至少部分地由于以下原因而固定:(a)在头部103A外表面的至少一部分和紧固件头部容置腔105B’内表面的至少一部分之间的干涉配合(由径向压紧引起);和/或(b)在杆101外表面的至少一部分和变形元件103C之间的干涉配合。
现在参见图5和6,其示出紧固组件本体的两个另外的实施方式。在这方面,注意,图1和2中的本体105具有朝上的用于容置杆101的杆容置槽105A。同样地,图3和4中的本体105’具有朝上的用于容置杆101的杆容置槽105A’。相反,图5中可以看到,本体500包括朝向侧面的用于容纳杆101的杆容置槽501(杆101、紧固件103、压紧元件109和保持环107以虚线示出,与前面所详细描述的元件基本上相同)。此外,从图6观察到,本体600包括用于容置杆101的“隧道型”杆容置槽601(杆101、紧固件103、压紧元件109和保持环107以虚线示出,与前面所详细描述的元件基本上相同)。注意,图5和6中的这些实施方式可与上述相同地操作(例如,本体可包括锥形的腔以利于设置在其中的部件之间的干涉配合)。
现在参见图7,其示出用于和本发明一起使用的另一个紧固件的实施方式。注意,此处示出的紧固件700为接骨螺钉,尽管当然可使用其它类型的骨附连机构(例如,一端有钩的杆)。无论如何,可以观察到在这种实施方式中设置有底切701(底切701可例如通过修平接骨螺钉头部的底部(参见701A)和/或通过缩窄接骨螺钉轴杆的一部分(参见701B)而形成)。通过使用这样的底切701,在紧固件700从紧固组件本体延伸的区域处,紧固件700可以提供增加的间隙(其中这种增加的间隙可以转化为紧固件700所能获得的相对于紧固件本体和/或杆的最大角度的增加)。
尽管已经描述了本发明的许多实施方式,可以理解,这些实施方式只是说明性的而不是限制性的,对于本技术领域内的普通技术人员而言,许多修改是显而易见的。例如,本发明可以放置在任意期望的脊柱高度上。此外,本发明可以与后期的脊柱杆植入结合地使用。更进一步地,本发明所提供的可控角度可位于任意的期望平面内。此外,杆可以轴向固定及旋转固定。此外,这里描述的任意元件可设置成任意期望的尺寸(例如,这里描述的任意元件可以设置成任意期望的自定义尺寸、或者这里描述的任意元件可设置成从一“族”尺寸中选择的任意尺寸,例如是小的、中等的、和大的尺寸)。为了给出更具体的例子(该例子是用来说明的而不是限制的),接骨螺钉可以设置有期望的螺距、螺纹外直径、螺杆外直径,螺杆外直径与螺纹外直径的比值和/或长度,且本体元件可以设置有任何期望的内直径、外直径和/或长度。此外,压紧元件可具有“断裂”结构,以在施加有预期的扭矩值时从压紧元件的安装部分分离。此外,一个或者多个紧固组件的部件可以由以下材料中的任一种制成:(a)任意生物相容的材料(可处理该生物相容材料以允许骨的内生或者禁止骨的内生——这取决于医生的要求);(b)塑料;(c)纤维;(d)高分子材料;(e)金属(例如钛的纯金属和/或例如Ti-Al-Nb、Ti-6Al-4V、不锈钢的合金);(f)所述材料的任何组合。此外,例如在微创过程中使用导丝以将紧固件导引经过管可以是有用的。此外,接骨螺钉可适于放置在松质骨内。此外,紧固件可以不使用螺纹,而是用钩子附连到骨上。此外,紧固件头部的外表面、杆的外表面、保持环的外表面、保持环的内表面、和/或本体的内表面(例如,上述部件之间的任何界面处)可具有一个或者多个增加界面处的摩擦的结构。例如,任何上述的部件可具有:粗糙化的或者处理过(例如,通过喷砂或者滚花处理)的表面、螺纹表面、有槽表面、有脊表面、带有突出的表面、和/或带有凹痕的表面。此外,变形元件的变形可取决于:(a)变形元件使用的材料;(b)杆使用的材料;(c)杆在接触变形元件的区域中的几何形状;(d)变形元件的几何形状;(e)由杆施加在变形元件上的载荷的方向;和/或(f)由杆施加在变形元件上的载荷的大小。此外,对于每个杆,最少可使用两个紧固组件(例如,为了稳定的目的)。此外,这里描述的任何步骤可以任何期望的顺序进行。
Claims (40)
1.一种脊柱固定系统,包括:
至少一个杆;
至少一个在第一端具有头部的螺钉,其中所述螺钉头部包括至少一个位于该头部上的变形元件;
至少一个本体,其中所述本体具有第一端和第二端,其中杆容置槽邻近所述本体的第一端设置,其中螺钉头部容置腔邻近所述本体的第二端设置,其中所述螺钉头部容置腔朝该本体第二端逐渐变细,并且其中所述杆容置槽和螺钉头部容置腔操作上连接;和
压紧元件,当所述杆设置在所述杆容置槽内时,所述压紧元件与本体配合而将所述杆推至与所述螺钉头部的变形元件的至少一部分接触以使该变形元件变形,同时朝所述螺钉头部容置腔的逐渐变细端推压该螺钉头部以固定所述螺钉与杆相互之间的角度关系。
2.如权利要求1所述的脊柱固定系统,其中所述螺钉与杆相互之间的角度关系至少部分地因为下述因素而固定:(a)所述螺钉头部外表面的至少一部分和螺钉头部容置腔内表面的至少一部分之间的干涉配合;和(b)所述杆外表面的至少一部分和变形元件之间的干涉配合。
3.如权利要求1所述的脊柱固定系统,还包括保持环,该保持环的尺寸使得当所述螺钉头部设置在螺钉头部容置腔内时,该保持环至少部分包绕所述螺钉头部地配合。
4.如权利要求3所述的脊柱固定系统,其中所述螺钉与杆相互之间的角度关系至少部分地因为下述因素而固定:(a)所述螺钉头部外表面的至少一部分和所述保持环内表面的至少一部分之间的干涉配合;(b)所述保持环外表面的至少一部分和所述螺钉头部容置腔内表面的至少一部分之间的干涉配合;和(c)所述杆外表面的至少一部分和所述变形元件之间的干涉配合。
5.如权利要求1所述的脊柱固定系统,其中所述螺钉是接骨螺钉。
6.如权利要求5所述的脊柱固定系统,其中所述接骨螺钉构造成拧入脊柱的椎弓根部分。
7.如权利要求5所述的脊柱固定系统,其中所述接骨螺钉是管状接骨螺钉。
8.如权利要求7所述的脊柱固定系统,其中所述变形元件大致环绕所述接骨螺钉中的管。
9.如权利要求8所述的脊柱固定系统,其中所述变形元件是从所述接骨螺钉头部突出的大致呈圆形的环。
10.如权利要求1所述的脊柱固定系统,其中所述变形元件包括从下述组中选择的材料,所述组包括:(a)比形成所述杆的材料软的材料;(b)比形成所述杆的材料硬的材料;和(c)与形成所述杆的材料硬度大致相同的材料。
11.如权利要求1所述的脊柱固定系统,其中所述杆容置槽和螺钉头部容置腔操作上相连以允许工具从其中插入穿过、从而向所述螺钉施加扭矩。
12.如权利要求11所述的脊柱固定系统,其中所述螺钉头部是至少部分球形的。
13.如权利要求11所述的脊柱固定系统,其中所述螺钉头部包括至少一个扭矩接收结构以用于从工具接收扭矩。
14.如权利要求13所述的脊柱固定系统,其中所述扭矩接收结构选自下述组,所述组包括:(a)至少一个凹痕;(b)至少一个突出;和(c)至少一个驱动面。
15.如权利要求1所述的脊柱固定系统,其中所述杆具有大致圆形的截面。
16.如权利要求1所述的脊柱固定系统,其中所述压紧元件具有与本体的互补螺纹配合的螺纹。
17.如权利要求16所述的脊柱固定系统,其中所述压紧元件具有与本体的互补内螺纹配合的外螺纹。
18.一种与相对于患者的脊柱固定杆结合地使用的紧固组件,包括:
至少一个紧固件,该紧固件具有位于第一端的头部以及位于第二端的骨连接元件,其中所述紧固件的头部包括至少一个位于其上的变形元件,且所述紧固件的骨连接元件适于连接到患者的脊柱;
至少一个本体,其中所述本体具有第一端和第二端,其中用于容置所述杆的杆容置槽邻近所述本体的第一端设置,其中紧固件头部容置腔邻近所述本体的第二端设置,其中所述紧固件头部容置腔朝该本体第二端逐渐变细,并且其中所述杆容置槽和紧固件头部容置腔操作上连接;和
压紧元件,当所述杆设置在所述杆容置槽内时,所述压紧元件与本体配合而将所述杆推至与所述紧固件头部的变形元件的至少一部分接触以使该变形元件变形,同时朝所述紧固件头部容置腔的逐渐变细端推压该紧固件头部以固定所述紧固件与杆相互之间的角度关系。
19.如权利要求18所述的紧固组件,其中所述紧固件与杆相互之间的角度关系至少部分地因为下述因素而固定:(a)所述紧固件头部外表面的至少一部分和紧固件头部容置腔内表面的至少一部分之间的干涉配合;和(b)所述杆外表面的至少一部分和变形元件之间的干涉配合。
20.如权利要求18所述的紧固组件,还包括保持环,该保持环的尺寸使得当所述紧固件头部设置在紧固件头部容置腔内时,该保持环至少部分包绕所述紧固件头部地配合。
21.如权利要求20所述的紧固组件,其中所述紧固件与杆相互之间的角度关系至少部分地因为下述因素而固定:(a)所述紧固件头部外表面的至少一部分和所述保持环内表面的至少一部分之间的干涉配合;(b)所述保持环外表面的至少一部分和所述紧固件头部容置腔内表面的至少一部分之间的干涉配合;和(c)所述杆外表面的至少一部分和所述变形元件之间的干涉配合。
22.如权利要求18所述的紧固组件,其中所述紧固件的骨连接元件选自(a)螺纹;和(b)钩。
23.如权利要求22所述的紧固组件,其中所述紧固件构造成连接到脊柱的椎弓根部分。
24.如权利要求23所述的紧固组件,其中所述紧固件是管状接骨螺钉。
25.如权利要求24所述的紧固组件,其中所述变形元件大致环绕所述接骨螺钉中的管。
26.如权利要求25所述的紧固组件,其中所述变形元件是从所述接骨螺钉头部突出的大致呈圆形的环。
27.如权利要求18所述的紧固组件,其中所述变形元件包括选自下述组中的材料,所述组包括:(a)比形成所述杆的材料软的材料;(b)比形成所述杆的材料硬的材料;和(c)与形成所述杆的材料硬度大致相同的材料。
28.如权利要求18所述的紧固组件,其中所述杆容置槽和紧固件头部容置腔操作上相连以允许工具从其中插入穿过、从而向所述紧固件施加扭矩。
29.如权利要求28所述的紧固组件,其中所述紧固件头部是至少部分球形的。
30.如权利要求28所述的紧固组件,其中所述紧固件头部包括至少一个扭矩接收结构以用于从工具接收扭矩。
31.如权利要求30所述的紧固组件,其中所述扭矩接收结构选自下述组,所述组包括:(a)至少一个凹痕;(b)至少一个突出;和(c)至少一个驱动面。
32.如权利要求18所述的紧固组件,其中所述杆具有大致圆形的截面。
33.如权利要求18所述的紧固组件,其中所述压紧元件具有与本体的互补螺纹配合的螺纹。
34.如权利要求33所述的紧固组件,其中所述压紧元件具有与本体的互补内螺纹配合的外螺纹。
35.一种与相对于患者的脊柱将杆固定在本体构件中结合地使用的管状紧固件,包括:
位于第一端的头部以及位于第二端的骨连接元件,其中所述头部包括至少一个位于其上的变形元件,且所述骨连接元件适于连接到患者的脊柱;
其中所述变形元件大致包绕所述紧固件的管;以及
其中所述变形元件在由杆施加于其上的压力的作用下变形。
36.如权利要求35所述的紧固件,其中所述紧固件的骨连接元件选自(a)螺纹;和(b)钩。
37.如权利要求36所述的紧固件,其中所述紧固件构造成连接到脊柱的椎弓根部分。
38.如权利要求37所述的紧固件,其中所述紧固件是接骨螺钉。
39.如权利要求35所述的紧固件,其中所述变形元件是从所述紧固件头部突出的大致呈圆形的环。
40.如权利要求39所述的紧固件,其中所述变形元件包括选自下述组中的材料,所述组包括:(a)比形成所述杆的材料软的材料;(b)比形成所述杆的材料硬的材料;(c)与形成所述杆的材料硬度大致相同的材料。
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US10/928,955 US20060058788A1 (en) | 2004-08-27 | 2004-08-27 | Multi-axial connection system |
US10/928,955 | 2004-08-27 |
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EP (1) | EP1799135B1 (zh) |
CN (1) | CN101031248A (zh) |
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BR (1) | BRPI0515238A (zh) |
CA (1) | CA2579023A1 (zh) |
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US20100256681A1 (en) | 2010-10-07 |
US8709051B2 (en) | 2014-04-29 |
US9375236B2 (en) | 2016-06-28 |
WO2006026242A3 (en) | 2007-01-25 |
MX2007002394A (es) | 2007-08-23 |
WO2006026242A2 (en) | 2006-03-09 |
EP1799135A2 (en) | 2007-06-27 |
CA2579023A1 (en) | 2006-03-09 |
US20060058788A1 (en) | 2006-03-16 |
AU2005280286B2 (en) | 2009-09-24 |
EP1799135A4 (en) | 2009-06-17 |
AU2005280286A1 (en) | 2006-03-09 |
ES2532122T3 (es) | 2015-03-24 |
US20140228897A1 (en) | 2014-08-14 |
EP1799135B1 (en) | 2015-03-04 |
BRPI0515238A (pt) | 2008-07-22 |
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