CN101049257A - 骨锚固装置 - Google Patents

骨锚固装置 Download PDF

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CN101049257A
CN101049257A CNA200710091622XA CN200710091622A CN101049257A CN 101049257 A CN101049257 A CN 101049257A CN A200710091622X A CNA200710091622X A CN A200710091622XA CN 200710091622 A CN200710091622 A CN 200710091622A CN 101049257 A CN101049257 A CN 101049257A
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bone anchoring
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威尔弗里德·马蒂斯
卢茨·比德尔曼
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Biedermann Technologies GmbH and Co KG
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Abstract

一种骨锚固装置，包括：骨锚固元件(2)，其具有待锚固于骨中的轴杆(3)和头部(4)；接收部件(5；500)，其用于接收待连接到骨锚固元件(2)的杆(100)，所述杆具有纵向轴线(L)；所述接收部件(5；500)形成为一体件并且包括：具有第一孔轴线(9)的第一开孔(8)、形状和尺寸制成为接收所述杆的凹槽(10)、具有第二孔轴线(13；130)的第二孔(12；120)，第二孔与第一孔(8)相通并且尺寸制成为接收头部(4)，轴杆(3)的一部分延伸穿过第二孔(12；120)，其中第二孔轴线(13；130)与由第一孔轴线(9)和所述杆的纵向轴线(L)限定的平面的夹角为大约90°；和压力元件(20)，其作用在头部(4)，以锁定所述头部相对于接收部件的位置。

Description

骨锚固装置
技术领域
本发明涉及一种骨锚固装置，尤其是一种可用于在骶骨间区域稳定脊椎的骨锚固装置。
背景技术
在骶骨间区域稳定脊椎在一定因素上需要将待与脊椎稳定杆连接的骨螺钉横向地旋拧在骨中。
US6,981,973公开了一种矮外形的脊椎对准/固定装置，其包括位于开槽连接单元中的半球形头部椎弓根螺钉，并且一旦将杆插入开槽连接单元中其就可通过单个内部锁定螺母锁定，开槽连接单元被设计成允许椎弓根螺钉调整角度达到90°。所述螺母具有被设计为与所述杆接合的接合部分。通过压在头部上的杆的作用锁定螺钉头部。用相对于连接单元以90°角对准的螺钉将所述装置锚固在骨盆骨(ileumbone)中。
US 2005/0159750 A1公开了一种骨锚固装置，其包括骨锚固件和接收部件以用于接收脊椎杆。骨锚固件可在接收部件中调整以使骨锚固件的纵向轴线相对于接收部件成0°到90°角，所述接收部件位于包含脊椎杆纵向轴线的平面内。该锚固装置的主要应用为颈椎稳定，在颈椎稳定中，必须枢转骨锚固件离开对准位置以避免由于它们非常接近带来的干涉。
US 2005/0154391 A1公开了一种骨锚固装置，其包括骨锚固件和用于接收脊椎杆的接收部件。接收部件具有第一部分和连接到骨锚固件的第二部分。第二部分可移动地连接到第一部分。可调整骨锚固件以使骨锚固件的纵向轴线相对于接收部件成0°到90°角。
US 6,736,820公开了一种骨螺钉，其具有带螺纹部分和头部的螺钉部件以及用于接收待连接到骨螺钉中的杆的接收部件。该接收部件具有：第一开孔；用以接收所述杆的基本为U形的横截面；和在相对端上的、带用于头部的座的第二孔。为了使螺钉部件可以在至少一侧枢转一个增大的角度，界定第二孔自由端的边缘具有非对称结构。
US 2003/0055426 A1公开了一种偏置角度骨固定装置，其包括锚固元件和具有与第一纵向轴线共轴的第一孔以及与第二纵向轴线共轴的第二孔的连接元件，其中所述第一和第二纵向轴线彼此横向。连接元件还包括杆接收开口以用于接收脊椎杆。
发明内容
本发明的目的在于提供一种改进的骨锚固装置，其允许骨锚固元件横向地固定在骨中，例如相对于接收部件以至少90°的角度固定在骨中，所述接收部件位于垂直于适用于脊椎骶骨间区域的脊椎杆的纵向轴线的平面内。
该目的通过根据权利要求1的骨锚固装置实现。在从属权利要求中给出了本发明的进一步改进。
根据本发明的骨锚固装置的骨锚固元件是小型的，带有少数部件，并提供了可靠的安装。
接收部件的底部和接触骨锚固元件头部的压力元件表面优选具有对应于头部表面的球形部分的球形表面。这提供了平衡的夹持力以夹紧该头部。因此，可减小施加到头部的夹持力。
骨锚固装置还具有以下优点：它允许相对于接收部件以大于90°的角度定位螺钉。
结合附图，参考下面实施例的详细描述，本发明的其它特征和优点将变得明显且最好理解。
附图说明
图1示出了骨锚固装置第一实施例的分解透视图。
图2示出了在装配完成状态下图1的骨锚固装置的截面图。
图3示出了在装配完成状态下图1的骨锚固装置的侧视图。
图4示出了包括根据本发明的骨锚固装置的脊椎稳定系统的顶视图。
图5示出了根据第二实施例的骨锚固装置的分解横截面图。
图6a到6c示出了根据图5的骨锚固装置的不同装配步骤的横截面图。
图7示出了在装配完成状态下根据图5的骨锚固装置的侧视图。
图8示出了在装配完成状态下根据图5的骨锚固装置旋转180°后的侧视图。
图9是根据第三实施例的骨锚固装置的截面图。
图10是示出了根据第三实施例的骨锚固装置的后部侧视图。
图11是第三实施例的骨锚固元件的透视图。
具体实施方式
图1到3中示出的根据第一实施例的骨锚固装置1包括：螺钉部件2，其具有螺纹杆3和优选为球截形形状的头部4；以及接收部件5，其用于接收待与螺钉部件连接的杆100。头部4在其自由端具有凹槽4′以用于与拧入工具接合。接收部件5具有第一端6和相对的第二端7以及第一孔8，第一孔8通向第一端6并且限定第一孔轴线9。接收部件5还具有限定两条自由腿的U形凹槽10以用于接收杆100于其间。在这些腿处设置内螺纹11。
所述接收部件还包括具有第二孔轴线13的第二孔12。第二孔12与第一孔8相通并且通向接收部件5横向侧面，位于第一端6和第二端7之间。
第二孔轴线13与第一孔轴线9以大约90°±12°的角度α相交，所述角度α优选略小于90°，例如85°。从接收部件5的底部测量角度α。第二孔12的直径小于头部4的最大直径而大于螺钉部件2的螺纹杆3的直径。邻近接收部件5外壁，第二孔12包括沿直径外壁方向逐渐增大的部分14。例如该直径可以朝外壁变宽的圆锥形段形状逐渐增大。在第二端7，接收部件5于底部设置座15，头部4的一部分可置于座中。优选地，座15具有适应于头部4的球形外表面的球形形状。
此外，接收部件5包括具有第三孔轴线17的第三孔16，第三孔16与第一孔8相通且通向接收部件5侧面，位于第一端6和第二端7之间，该第三孔16与第二孔12相对。优选地，第三孔轴线17与第二孔12的第二孔轴线13共轴。第三孔17的直径大于头部4的最大直径并因此大于螺纹杆3的直径。由于第三孔16与第一孔8相通，所以它也与第二孔12相通。
骨锚固装置1还包括压力元件20，该压力元件20具有基本为圆柱形的外表面，并且该外表面的最大直径小于第一孔8的内径，使得压力元件20可在第一孔8内移动。压力元件20在其面向第二端7的一侧包括球形凹槽21，该球形凹槽21的形状适应于头部4的球形表面。压力元件在其相对侧包括圆柱形凹槽，该圆柱形凹槽的形状和尺寸制成为当插入所述杆100时接收所述杆的一部分。此外，在具有球形凹槽21的端部，在圆柱形凹槽22的圆柱轴线的相对两侧上，压力元件20包括切去部分23以用于当通过压力元件20部分地包围螺钉部件的头部4时允许螺纹杆3枢转。如图3中可看到的，所述切去部分23具有的尺寸使得即使骨锚固装置处于装配完成状态，也允许接近螺钉部件头部4的凹槽4。
所述骨锚固装置还包括锁定螺钉25，其具有与接收部件的内螺纹11配合的外螺纹。
压力元件20的尺寸制成为使得在装配完成状态下，当螺钉部件2插入接收部件5，杆100插入压力元件以及锁定螺钉25未紧固时，压力元件20的圆柱形凹槽22底部突出在接收部件5的U形凹槽底部上方。
首先，通过引导螺纹杆3穿过第三孔16以及与第三孔16相通的第二孔12，直到头部4置于座15中，来装配所述骨锚固装置。然后，移动压力元件20以通过其球形凹槽21接合球截形头部4的一部分。在外科手术使用之前，可以这种方式预装配所述骨锚固装置。
使用中，首先，通过将头部的凹槽4′与穿过第三孔16的拧入工具接合，从而将与接收部件5和压力元件20预装配在一起的螺钉部件2拧入骨中。第一孔轴线9与螺钉部件2的纵向轴线夹角可以大约至少为α±10°，所述角度取决于第二孔12的直径尺寸以及具有逐渐增大直径的部分14的尺寸。类似地，螺钉部件2的纵向轴线与垂直于第一孔轴线9且垂直于杆100的纵向轴线L的轴线的夹角可以为±10°。因此，在围绕第二孔轴线13的圆锥内，可以在±10°的角度范围内枢转螺钉部件2，所述角度范围取决于第二孔12和部分14的尺寸。
一旦插入杆100并且调整了螺钉部件2和接收部件5之间的角位置，就拧入锁定螺钉25，该锁定螺钉25按压在杆100上以固定所述杆，并且同时经由所述杆按压在压力元件20上，以将锁定螺钉部件2的头部锁定就位。
图4示出了脊椎骶骨间区域中稳定系统的骨锚固装置的应用。多个已知的锚固装置101每一个都连接于杆100。稳定系统的杆100延伸到骶骨50的区域中。根据本发明的骨锚固装置1用于骶骨间固定。为此，螺钉部件2必须以大约90°的角度从包括杆纵向轴线L和第一孔轴线9的平面延伸。螺钉部件2可绕第二孔轴线在上述±10°的角度范围内枢转。
图5到8示出了骨锚固装置的第二实施例。第二实施例的骨锚固装置与第一实施例的骨锚固装置的不同之处在于接收部件的第二和第三孔的结构。所有其它部件都与第一实施例相同并且与第一实施例中采用相同的附图标记。不再重复对这些相同部件的描述。接收部件500包括与第一孔8相通的第二孔120，并且该第二孔限定第二孔轴线130。如第一实施例中，第二孔120通向接收部件500的横向侧面并且第二孔轴线130以大约90°的角度从由杆100的纵向轴线和第一孔轴线9限定的平面延伸。第二孔120的直径大于螺钉部件2头部4的最大直径，以便可通过第二孔120将螺钉部件2的头部4引入接收部件500中，直到头部4置于在接收部件500底部上的座15中。在第二孔120相对一侧上，设置第三孔160，其与第一孔8相通且限定第三孔轴线170。第三孔轴线170优选与第二孔轴线130共轴。第三孔160通向所述横向侧面并且具有至少可引导拧入工具以接合头部4的凹槽4′的直径，而该直径小于所述头部的最大直径以使螺钉部件不可经由第三孔160掉出。因为第三孔160不仅与第一孔相通，而且与第二孔120相通。
如图6a和6b所示地预装配骨锚固装置1，其中通过其头部4引导螺钉部件2穿过第二孔120直到头部4置于座15中。然后，使用中，通过引导拧入工具将螺钉部件2拧入骨中，该拧入工具穿过第三孔160与头部的凹槽4′接合。之后，调整螺钉部件相对于接收部件500的角位置，插入杆并且通过拧入螺钉25来锁定所述装置。
在可选的用途中，螺钉部件2可拧入骨中并且接收部件500可稍后通过引导螺钉部件头部穿过第二孔120进入接收部件500来连接到螺钉部件2。
图9到11示出了根据第三实施例的骨锚固装置。所述骨锚固装置与根据第一实施例的骨锚固装置的不同之处仅在于骨锚固元件的设计。接收部件5是相同的。所述骨锚固元件200包括螺纹杆3和头部400。头部在其与螺纹杆3相对的一侧包括六边形的突起401以用于接合可被引导穿过第三孔16的工具。这具有以下优点：头部可被制不带凹槽的实心球和球截形。所述突起可具有适于接合工具的任何形状。在又一修改中，所述突起本身具有用于接合工具的凹槽。
本发明是可以修改的，例如，在第二实施例的情形中，当首先将螺钉部件2拧入骨中且之后连接到接收部件500时，可以省略第三孔160。第二孔的尺寸可改变以允许在增大的或减小的角度范围内相对于接收部件枢转骨螺钉部件。在压力元件处的切去部分23可以省略，只要可以通过工具接近螺钉部件的头部。可替换地，仅仅设置一个切去部分。
为了预装配，可以通过弯边孔(crimp bores)来连接压力元件20与接收部件。
所述座15不是必须具有球形形状，其可以具有另一形状或者是平的。对于封闭机构，除了那些使用单个锁定螺钉的机构外，其它机构是可以的。例如，由杆锁定螺钉和类似螺母的头部锁定元件组成的锁定装置是可以的。在本实例中，压力元件具有突出在杆上方的直立的腿，从而可以独立于杆而向下压压力元件。
所述轴线不是必须带有螺纹的而可具有允许保持在骨中的任何形状和结构。压力元件也可为平面圆盘形状。

Claims (17)

1、一种骨锚固装置，包括：
骨锚固元件(2；200)，其具有待锚固于骨中的轴杆(3)和头部(4；400)；
接收部件(5；500)，其用于接收待连接到骨锚固元件(2)的杆(100)，所述杆具有纵向轴线(L)；
所述接收部件(5；500)形成为一体件并且包括：具有第一孔轴线(9)的第一开孔(8)、形状和尺寸制成为接收所述杆的凹槽(10)、具有第二孔轴线(13；130)的第二孔(12；120)，第二孔与第一孔(8)相通并且尺寸制成为接收头部(4)，轴杆(3)的一部分延伸穿过第二孔(12；120)，其中第二孔轴线(13；130)与由第一孔轴线(9)和所述杆的纵向轴线(L)限定的平面的夹角为大约90°；和
压力元件(20)，其作用在头部(4；400)上，以锁定所述头部相对于接收部件的位置。
2、根据权利要求1所述的骨锚固装置，其中第一孔轴线(13；130)与第二孔轴线(17；170)彼此相交。
3、根据权利要求1或2所述的骨锚固装置，其中当骨锚固元件位于接收部件内时允许骨锚固元件枢转。
4、根据权利要求1到3之一所述的骨锚固装置，其中第二孔(12；120)包括直径朝接收部件外壁逐渐增大的部分(14)，以便当骨锚固元件(2)位于接收部件内时允许骨锚固元件枢转。
5、根据权利要求1到4之一所述的骨锚固装置，其中接收部件包括第三孔(16；160)，所述第三孔(16；160)与第二孔(13；130)相通且布置在接收部件的与第二孔相对的一侧上。
6、根据权利要求5所述的骨锚固装置，其中第二孔轴线(13；130)与第三孔轴线(17；170)基本共轴。
7、根据权利要求1到6之一所述的骨锚固装置，其中第二孔(12)的直径小于头部(4)的最大直径。
8、根据权利要求1到7之一所述的骨锚固装置，其中第三孔(16)的直径大于头部(4；400)的最大直径。
9、根据权利要求1到6之一所述的骨锚固装置，其中第二孔(120)的直径大于头部(4；400)的最大直径。
10、根据权利要求9所述的骨锚固装置，其中第三孔(160)的直径小于头部(4；400)的最大直径。
11、根据权利要求1到10所述的骨锚固装置，其中第二孔轴线(13；130)与所述平面之间的角度为90°±12°。
12、根据权利要求3到11之一所述的骨锚固装置，其中在围绕第二孔轴线(13；130)的圆锥内，锚固元件可以在±10°的角度内枢转。
13、根据权利要求1到12之一所述的骨锚固装置，其中所述凹槽(10)基本为U形。
14、根据权利要求1到13之一所述的骨锚固装置，其中接收部件包括用于头部(4)的座(15)，所述座是第二孔表面的一部分。
15、根据权利要求1到13所述的骨锚固装置，其中所述座具有与头部(4)的球形表面相对应的球形表面部分。
16、根据权利要求1到15所述的骨锚固装置，其中压力元件(20)具有与头部(4；400)的球形表面相对应的球形表面部分。
17、根据权利要求1到16之一所述的骨锚固装置，其中头部(400)在其与所述轴杆相对的一端包括突起(401)，以用于与工具接合。
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