CN101636116A - The guidance system that is used for spinal fixation, instrument and device - Google Patents
The guidance system that is used for spinal fixation, instrument and device Download PDFInfo
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- CN101636116A CN101636116A CN200780046407A CN200780046407A CN101636116A CN 101636116 A CN101636116 A CN 101636116A CN 200780046407 A CN200780046407 A CN 200780046407A CN 200780046407 A CN200780046407 A CN 200780046407A CN 101636116 A CN101636116 A CN 101636116A
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Abstract
A kind of angle guidance system, first and second spinal fixation elements that are used for being relative to each other predetermined angle are connected to first and second positions of vertebra respectively, comprise: first and second leading arms that link together at first centring point, and first and second leading arms are constructed to rotate around the pivot by first centring point, so that relative to each other with described predetermined angle setting; With first, second guide pipe, two guide pipes pass the first and second slightness hole openings that are arranged on described first and second leading arms respectively, and form the X structure when passing described the one the second via openings.
Description
The cross reference of relevant common unauthorized application still
It is No.60/870 that the application requires in the serial number of December in 2006 submission on the 15th, 251, and exercise question is the rights and interests of the U.S. Provisional Application of " guidance system that is used for spinal fixation, instrument and device ", its content clearly is herein incorporated by the reference mode.
The application also is that the serial number of submitting on July 18th, 2007 is No.11/779526, and exercise question is the continuation of partial content of the U. S. application of " system and method for spinal fixation ", and its content is by clearly merging therewith with reference to mode.
Technical field
The present invention relates to a kind of system and method for spinal fixation, and specially refer to guidance system, insertion instrument and the device that is used for spinal fixation.
Background technology
As shown in Figure 1, the vertebra of human body is made up of vertebrae 30 (section) independently, and independently vertebrae interconnects and forms spinal column 29.As scheme as shown in IB and the 1C: each vertebrae 30 all has 32, three wing projections of diaphysis (vertebral body) (two transverse process 33,35 and a spinal 34) of column type, about little joint 46, vertebral plate 47, left and right sides pedicle of vertebral arch 48 and bone bow (neural arch) 36.Spinal bone 32 is folded mutually up and down, forms strong but does not lose flexible spinal column.The structure of bone bow 36 makes the space that they center on form a pipe, and promptly spinal canal 37.Spinal canal 37 holds spinal cord and shields with other neurons and to spinal cord and other neurons that held.Spinal dura mater 38 is protecting film of the inside full of liquid, covers on outside the interior object of canalis spinalis.Vertebra has enough pliabilities that health can be reversed and is crooked.But also enough strong, it can be played a protective role to spinal cord and other neurons.Vertebrae 30 is separated by intervertebral disc 40 and is supported, and intervertebral disc 40 is made up of hard sheet metal and elastic fiber.The disease of vertebra is because one or more independently vertebraes 30 and/or intervertebral disc 40 are undesired caused because of disease or wound.Under these pathological situations, the fusion of adjacent vertebrae assembly can be used for making the vertebra functional rehabilitation to normal, reaches steady statue, and the neuroprotective structure perhaps is used to alleviate patient's discomfort.
Exist the multiple spinal fixation system that is used for stabilizing spine, thereby realize that bone merges.The retaining element of most of utilizations of these fixed systems such as bar line or plate, this bar line or plate are connected to the into screw of vertebral body, surface of bone or pedicle of vertebral arch that is spirally connected.Because the outer surface of vertebral body is nonplanar typically, and the structure relative complex of vertebra, therefore importantly, when retaining element is inserted vertebra, these retaining elements (for example, bar, plate, line, nail and/or screw) are reasonably alignd.Unsuitable alignment may cause the inappropriate or unstable placement of retaining element and/or the separation of retaining element.Yet, in practice, realize and be maintained fixed the accurate location of element and guiding and be proved to be suitable difficulty.Because passing the alignment angles of a vertebral body or paired vertebral body is unique because of the fixture that individual variation produced of spinal curvature will and dissect physiology structure for each individuality, so this has further increased the weight of the complexity of this positioning difficulty.
Therefore, exist the guidance system of accurate placement of spinal fixation element and the demand of instrument.
Summary of the invention
The present invention relates to a kind of system and method that is used for spinal fixation, and specially refer to guidance system, insertion instrument and the device that is used for spinal fixation.
Generally, in one aspect, to be used for to be predetermined angle relative to each other be feature with the angle guidance system that first and second spinal fixation elements are connected to first and second positions of vertebrae respectively with a kind of in the present invention, the angle guidance system is included in first and second leading arms that first pivotal point is pivotally connected to one another, its shape can be rotated around the pivot by first pivotal point, with the one the second guide pipes by the one the second extended via openings, via openings is separately positioned on first and second leading arms, and forms an X structure when they stretch out the one the second via openings.
In the enforcement aspect this, can comprise one or more following listed features to the present invention.This system further comprises first and second leading lines, and it is set to insert the one the second guide pipes and enters first and second vertebral location.Pivot is perpendicular to the formed plane of first and second leading arms.This system can further comprise a protractor that is arranged between first and second leading arms, and this protractor can be used to measure and set predetermined angle.This system can further comprise an extensible vertical indicator, and this vertical indicator is used for indication and the vertical direction of vertebra centrage.This system can further comprise the Z-line indicator by first centring point, and this system can further comprise a slender bolt that is used for connecting first and second leading arms, and they are changeed with the controlled manner pivot axis, and angular spacing is ten/once.Elongated bolt is by respectively attached to the one the second guiding post-brachial first and second posts (post).This system can further comprise first and second handles that are installed in respectively on first and second guide pipes.This system can further comprise core drill, and this core drill is configured to be inserted into first and second leading lines and by first and second guide pipes, is used for holing in first and second vertebral location.This system can further comprise a plane (facet) access to plant, is used for expanding the leading line surrounding tissue and respectively first and second sleeve pipes is injected first and second vertebral location.The plane access to plant comprises a sleeve pipe, a packer, a switch release-push and a handle.Packer passes sleeve pipe and comprises a guide wire channel, is used for packer is enclosed within on the leading line.Discharging the packer switch pushes away packer forward and expands tissue around the leading line.After the tissue that packer is formed at expansion left sleeve pipe, packer can be removed.This system can further comprise screwdriver, and this screwdriver is configured to respectively first and second screws are fixed on first second vertebral location by first and second sleeve pipes.Described screwdriver comprises screw check cover and the handle that is provided with at screw check cover near-end, is arranged on the screw check element of screw check cover far-end and screw and unclamps and tighten switch.First and second positions can be little joint, pedicle of vertebral arch, processus transversus vertebrarum, pass internode, spinal meninges, vertebral body, rumpbone, lateral mass or occipital bone position.
Generally, according to another aspect of the present invention, feature of the present invention has been summarized the method that a kind of first and second spinal fixation elements that are used for being predetermined angle relative to each other are connected to first and second positions of vertebra respectively.This method comprises the primary importance of first leading line being inserted vertebra, then first leading arm in the angle guidance system is enclosed within on first leading line.The angle guidance system comprises first leading arm and second leading arm that connects with the first leading arm pivot, second leading arm be configured to first leading arm between become the angle of reservation.Next, second leading arm is arranged on first leading arm to become to subscribe the position of angle, then second leading line is passed the second position that second leading arm inserts vertebra.Next expand the tissue around first leading line and first retaining element inserted and be arranged on the vertebra primary importance, expand the tissue around second leading line then and second retaining element inserted and be arranged on second vertebral location.
Advantage of the present invention is following listed one or more.
This system can pass through micro-wound surgical operation, and a slice in the retaining element is implanted or shifted out in each permission.Retaining element location, angle has relative to each other reduced the demand of fluorescence imaging repeatedly, and this has reduced surgical operation time and patient's radioactive exposure.
Description of drawings
Figure 1A is the side view of people's vertebrae.
Figure 1B is the enlarged drawing of figure IA zone A.
Fig. 1 C is the axial cutaway view of lumbar vertebra.
Fig. 2 A is that two plane bolts that are used for fixing two little joints are provided with the direction sketch map.
Fig. 2 B is two sketch maps that are installed in two plane bolts on the adjacent vertebrae with respect to midvertebral line 80 bi-directional symmetrical.
Fig. 3 is the front perspective view of X-guiding position control system among the present invention.
Fig. 4 is the detail elevation view of X derived vector hornwork.
Fig. 5 is used for a K line is inserted the initial position sketch map of the X guidance system in the first little joint.
Fig. 6 is used for a K line is inserted the sketch map of falling the position of the X guidance system in the first little joint.
Fig. 7 is the sketch map of opening of X guidance system arm.
Fig. 8 is that vertical indicator launches sketch map in the X-guidance system.
Fig. 9 represents to use the X guidance system to find vertical direction.
Figure 10 is the sketch map that the angle between a vertical direction and the K line direction is enlarged twice.
Figure 11 is that the vertical indicator of X-guidance system is packed up sketch map.
Figure 12 is to use the sketch map of Z-line with X guidance system and patient's midvertebral line alignment.
Figure 13 is with the sketch map in the X-guidance system shown in second guide pipe insertion Fig. 3.
Figure 14 is for to insert the 2nd K-line second guide pipe and it is arranged on the sketch map in the second little joint.
Figure 15 is the rearview of the X guidance system shown in Fig. 3.
Figure 16 A is the vertical view of the X guidance system shown in Fig. 3.
Figure 16 B is the upward view of the X guidance system shown in Fig. 3.
Figure 17 is the X guidance system side perspective view shown in Fig. 3.
Figure 18 is the perspective view of Z line.
Figure 19 is the perspective view of Sleeve drill.
Figure 20 is the screwdriver device perspective view that has the additional screw gasket system.
Figure 21 A is the perspective view of the screwdriver device that shows among the Figure 20 that loosens under the Screw gasket system mode.
Figure 21 B is the perspective view of the screwdriver device that shows among the Figure 20 that tightens under the Screw gasket system mode.
Figure 22 A is the detail view of the Screw gasket system under the state that tightens that shows among the 21B.
Figure 22 B is the detail view of the Screw gasket system under the relaxation state that shows among the 21A.
Figure 23 A is the side view of plane Screw gasket.
Figure 23 B is the upward view of the plane Screw gasket among Figure 23 A.
Figure 24 is the cutaway view before the plane Screw gasket shown in Figure 23 A is loaded into the plane bolt.
Figure 25 A is the front perspective view of plane access to plant.
Figure 25 B is the side cross-sectional views of the plane access to plant that shows among Figure 25 A.
Figure 26 A is the sketch map that sealer inserts the handle of the plane access to plant that shows among Figure 25 A.
Figure 26 B be with casing pipe sleeve on sealer, and insert sketch map in the handle of the plane access to plant shown in Figure 25 A.
Figure 27 A is with the sketch map in the plane access to plant shown in K-line insertion Figure 25 A.
Figure 27 B is for inserting the sleeve pipe in the plane access to plant that shows among Figure 25 A the sketch map of bone.
Figure 27 C discharges the sketch map of sealer for the switch of plane access to plant shown in pulling Figure 25 A.
Figure 28 A is for inserting the sleeve pipe in the plane access to plant shown in Figure 25 A fully the sketch map in the bone.
Figure 28 B is for shifting out the sealer in the plane access to plant shown in Figure 25 A the sketch map of bone.
Figure 29 is the embodiment of multi-axle planar bolt among the present invention and gasket system.
Figure 30 is the plane bolt shown in Figure 29 and the side cross-sectional views of gasket system.
Figure 31 is another side cross-sectional views of plane bolt shown in Figure 29 and gasket system.
The specific embodiment
The present invention relates to a kind of system and method that is used for spinal fixation, particularly a kind of guidance system, insertion instrument and device that is used for spinal fixation.
As Fig. 2 A, shown in the 2B, spinal fixation element 82a, 82b are used to the first and second little joint 46a, and 46b is fixed together. Spinal fixation element 82a, 82b is inserted along direction 60,70 respectively, and angulation 65 between the direction 60,70.In most of the cases, direction 60,70 is symmetrically located at the left and right sides of midvertebral line 80, and midvertebral line 80 is perpendicular to the angular bisector 50 at angle 65.In the present embodiment, retaining element 82a, 82b are plane bolt and to stride the planar fashion setting, are used for connecting adjacent vertebra 30a, 30b.In the another one example, retaining element 82a, 82b can be staple, line or pin, and they can be by the face of striding, stride layer, stride the face pedicle of vertebral arch, stride pedicle of vertebral arch or connect adjacent or non-conterminous vertebra by other vertebral location.
Wicresoft's program of retaining element 82a, 82b is set, may further comprise the steps: respectively with leading line along direction 60,70 insert little joint 46a, 46b, the tissue of expansion leading line peripheral region, with the periphery of casing pipe sleeve at each leading line, boring or perforate on bone inserting bolt or the final position that is arranged on by the sleeve pipe inserting bolt and with it on little joint.
Leading line or Ke Shi draw point (being also referred to as the k-line) are elongated, and inflexible line utilizes this specific character to keep the position of GUSUIPIAN in orthopaedy or other forms of surgical operation.The K-line is that Martin Kirschner was incorporated in the surgical operation in 1909.They are aseptic, sharp-pointed, slick stainless pins, and are of different sizes.These lines can bore bone, so that GUSUIPIAN is remained on the appropriate location.Their quilts have been avoided the operation under the certain situation thus via placed (passing skin).In other cases, after operation, use the K-line, so that GUSUIPIAN is remained on the appropriate location.In some cases, the K-line comprises screw thread, is used for being screwed into bone.Typical k-line is to be placed under the guidance by Fluirescence observation, yet the fluoroscopy meeting increases operating time and patient is exposed under the ray.The invention provides a kind of guidance system that is used to insert the K-line, this system can reduce the use of fluoroscopy and reduce the time of performing the operation.
Shown in Fig. 3 and 4, be used for leading line 102a, 102b inserts the X guidance system 100 of patient's vertebral location, comprises the X guider 110 and the first and second guide duct device 130a, 130b.X guider 110 comprises the first and second arm 112a, 112b, and arm 112a, 112b can be around axle 113 rotations, as shown in Figure 5.Pivot 113 is perpendicular to arm 112a, the plane that 112b limits, and by centring point 114.The first and second arm 112a, 112b interconnects at centring point 114.The X-guider comprises that also is arranged on two pivot arm 112a, and the protractor 116 between the 112b, this protractor are used for measuring the angle 128 between two arms.The X guider also comprises extensible vertical indicator 118, and this indicator 118 is used for representing the direction perpendicular to vertebra centrage 80.As shown in Figure 4, vertical indicator 118 is in the closed position among this figure, and vertical indicator is shown in an open position in Fig. 8, and this indicator launches to measure the first arm and perpendicular to the angle between centrage 80 directions.As shown in figure 12, Z-line indicator 119 passes centring point 114, and can play the adjustment alignment effect.As shown in figure 15, two pivot arms connect by long spiro nail 120, and make they relatively the other side pivot, and with controllable mode around pivot 113 rotations, angular spacing is ten/once.Bolt 120 passes and is arranged at arm 112a respectively, two short column 122a at 112b rear portion, 122b.Two handle 124a, 124b is separately fixed at bolt 120 left and right end portions by screw thread, and is used at 125 direction adjusted bolts, thereby opens or closes the first and second arm 112a, the angle 126 between the 112b.Guide duct device 130a, 130b comprise and have handle 134a, 134b and elongated hollow pipe 132a mounted thereto, 132b.Leading line 102a, 102b pass handle 134a respectively, via openings on the 134b and elongated hollow pipe 132a, and 132b, and from elongated hollow tube 132a, the far-end 133a of 132b, 133b stretches out.Guide duct device 130a, 130b are inserted into and pass the opening 126a of through hole, and 126b also extends to the whole first and second arm 112a, and the length of 112b from through hole 126a, intersects to form the X-structure, as Figure 16 A, shown in the 16B at them mutually when stretching out among the 126b.
Show by the X guidance system shown in Fig. 3 among Fig. 5-Figure 14 and insert leading line 102a, the process of 102b.At first, the first guide duct device 130a inserted the vias 126a (Fig. 5) of the first arm 112a, next step, the first leading line 102a passes elongated hollow pipe 132a, and enters the first little joint (Fig. 6) of patient's vertebra under the supervision of Fluirescence observation.Next step, the second arm 112b of X-guider is rotated out (Fig. 7), and next, vertical indicator 118 is unfolded (Fig. 8) and is used to seek direction (Fig. 9) perpendicular to patient's midvertebral line 80.Measure the angle between the first arm and the vertical direction, subsequently, second arm is rotated to the set angle with respect to the first arm, and this angle is the twice (Figure 10) of angle between the first arm and the vertical direction.Second arm is based on a hypothesis with respect to the angle position between the first arm: promptly two little joint 46a and 46b are symmetrically arranged with respect to vertebra centrage 80.In most of skeleton structures, this imagination is valuable and the permission surgeon places second leading line by the help of X guidance system 100, and does not need to use cryptoscope for the second time.When this supposes that when untenable, the angle between the vertebra centrage and the second little joint can draw by the cryptoscope testing result first time, and second arm of X guidance system is configured to value of calculation.Next, vertical indicator is stowed in two and opens (Figure 11) between the arm and Z line be used to align X guidance system and patient's midvertebral line 80 (Figure 12), in case when the X guidance system with after patient's midvertebral line aligns, the second guide pipe 132b is inserted among the via openings 126b of the second arm 112b (Figure 13), next the second leading line 102b is inserted into guide pipe 132b and enters patient's the second little joint 46b (Figure 14), next, X guidance system 100 is removed after correctly having placed leading line 102a and 102b.In Minimally Invasive Surgery or open operation on vertebra, all can use X-guidance system 100.
In the subsequent step of spinal fixation operative procedure, on bone, make the position boring of labelling by leading line, tissue around the leading line is expanded, and pass sleeve pipe and insert flat bolt, and it is screwed into is directed to the wire tag place on the little joint, as shown in figure 19, Sleeve drill 140 is enclosed in leading line 102a, the outside of 102b, and the mark of on bone, making boring by leading line.With plane access to plant 200 tissue around the leading line is launched, shown in Figure 25 A and 25B.Plane access to plant 200 comprises sleeve pipe 202, sealer 204, and sealer release-push 206 and handle 210. sealers pass sleeve pipe, and comprise that guide wire channel 208, this passage can make sealer be enclosed within leading line 102a, outside the 102b.Switch 206 is used for pushing ahead sealer.When sealer is pushed ahead around leading line, the tissue around the leading line can be promoted and launches, online opens a passage on every side, is used for placing sleeve pipe 202.Shown in Figure 26 A, sealer 204 is inserted in the handle 210 of plane access to plant 200, shown in Figure 26 B, sleeve pipe 202 is enclosed within on the sealer 204, and injects in the handle 210 of plane access to plant 200.Shown in Figure 27 A, shown in K-line and Figure 27 B plane access to plant 200 is enclosed within on the K-line and and inserts in the bones sleeve pipe 202.Shown in Figure 27 C, the switch 206 of pulling plane access to plant 200 discharges sealer 204, and uses sealer to promote and expansion K-line tissue on every side.Shown in Figure 28 A,, the sleeve pipe of plane access to plant 200 is fully entered in the bone by being enclosed within the passage that the outer sealer of K-line is opened.What Figure 28 B showed is the sealer in the plane access to plant 200 to be removed from bone, and stay sleeve pipe 202 and k-line.In case when sleeve pipe 202 was placed on the mark of having been done by leading line on patient's vertebra, spinal fixation instrument and device were inserted into and arrive marked locations in the sleeve pipe.
As shown in figure 20, screwdriver device 300 is used for transmitting plane bolt device 160 and it is screwed in the bone by sleeve pipe 202.Bolt bottle opener device 300 comprises the lock screw socket and is arranged on the handle 320 of lock screw socket 310 near-ends.Handle 320 comprises removable T shape element 325, and this element provides an additional moment when bolt device 160 is screwed into bone.Shown in Figure 21 A and Figure 21 B, bolt device 160 is arranged on the far-end of lock screw socket 310, and can unclamp/tighten moving up and down of element 305 by bolt and pull down or install.Figure 22 A and 22B divide other to show the details that keeps and discharge the bolt washer device.
As shown in figure 29, plane bolt device 160 comprises that multishaft bolt 170 and packing ring 180. packing rings 180 are gone into and be locked in the top of bolt head 172 by hammer.As shown in figure 30, bolt 170 has the slender bodies 174 and the hemispheric head 172 of sleeve-shaped, and head 172 is gone into and be locked in opening 182 places of packing ring 180 by hammer.In one embodiment, the length of bolt 170 is 35mm, and diameter is 4.5mm.As shown in figure 31, before bolt head 172 was screwed into bone by screwdriver, bolt head can rotate around multiaxis in the opening 182 of packing ring 180.Described head 172 has hexagonal apertures, is used to admit the head of hexagon screwdriver.Shown in Figure 23 A and 23B, packing ring 180 has cylinder 180 and two toothrows 186,188, and described two toothrows can stretch out from the bottom of spacer ring body 184.As shown in figure 24, cylinder 184 has hemispherical opening 182, it is straight that the top 190 that this opening can hold hemispherical bolt head 172. openings 182 begins, it is locked in head in the opening to intramedullary expansion after bolt head 172 is put into opening, and can prevent that it from moving upward, as Figure 23 A and shown in Figure 30.The diameter of opening 182 bottoms is less than the diameter of hemispherical nose 172, and greater than the diameter that does not have the bolt part on the slender bolt body.So just can prevent that described head 172 from passing opening.Tooth 186 and 188 has alternative rectangle 192 and triangle 194 cross sections, and this structure can make packing ring pass and be grasped in the bone, and can prevent its rotation after it is screwed into bone.
What more than introduce is several embodiments of the present invention.It should be understood, however, that under prerequisite not can carry out various modifications, therefore, other embodiment are encompassed in the claim scope of enclosing departing from the spirit and scope of the present invention.
Claims (28)
1. angle guidance system, first and second spinal fixation elements that are used for being predetermined angle relative to each other are connected to first and second positions of vertebra respectively, comprising:
First and second leading arms that link together at first centring point,
And first and second leading arms are constructed to rotate around the pivot by first centring point, so that relative to each other with described predetermined angle setting;
With first, second guide pipe, two guide pipes pass the first and second slightness hole openings that are arranged on described first and second leading arms respectively, and form the X structure when passing described the one the second via openings.
2. system according to claim 1 further comprises: first and second leading lines, it is configured to pass described first and second guide pipes and inserts first and second vertebral location.
3. system according to claim 1 is characterized in that described pivot is perpendicular to the plane that is limited by first and second leading arms.
4. system according to claim 1 further comprises, is arranged on the protractor between first and second leading arms, and this protractor is used for measuring and being provided with described preset angle.
5. system according to claim 1 further comprises, is used to refer to the deployable vertical indicator perpendicular to the midvertebral line direction.
6. system according to claim 1 further comprises, passes the Z-line indicator of described first centring point.
7. system according to claim 1 further comprises, elongated bolt, it is used to connect described first and second leading arms, and allow they can around described pivot with controllable mode and with angular spacing be ten/ once rotated.
8. system according to claim 7 is characterized in that, described slender bolt passes first and second posts that are separately positioned on the first and second leading arm backs.
9. according to the system described in the claim 1, further comprise, be separately positioned on first and second handles on described first and second guide pipes.
10. system according to claim 2 further comprises a Sleeve drill, and it is configured to be enclosed on described first and second leading lines, and passes described first and second guide pipes, in described first and second spinal locations boring.
11. system according to claim 2 further comprises, a plane access to plant, and it is used for launching described leading line tissue on every side, and first and second sleeve pipes are inserted described first and second vertebral location respectively.
12. system according to claim 11, it is characterized in that, described plane access to plant comprises sleeve pipe, sealer, sealer release-push and handle, wherein, described sealer passes described sleeve pipe, and comprises guide wire channel, and it is enclosed within on the described leading line sealer, wherein unclamp described sealer release-push, pushing away described sealer forward can launch the tissue around the described leading line.
13. the system according to described in the claim 12 is characterized in that, described sealer is formed at when being deployed in described tissue behind the described sleeve pipe, and sealer is removed.
14. system according to claim 12 further comprises screwdriver, it is configured to pass respectively first and second sleeve pipes first and second bolts is placed on first and second vertebral location.
15. the system according to described in the claim 14 is characterized in that, described screwdriver comprises the lock screw socket, is arranged on the handle of described lock screw socket near-end, and the lock screw element and the screw that are arranged on lock screw socket far-end unclamp/tighten switch.
16. first and second spinal fixation elements that are used for becoming preset angle relative to each other are connected to the method for vertebra first and second positions respectively, comprising:
First leading line is inserted the described primary importance of described vertebra;
First leading arm of angle guidance system is inserted on described first leading line, wherein said angle guidance system comprises described first leading arm and second leading arm that is connected pivotly with described first leading arm, and described second leading arm is constructed to be the predetermined angle setting with respect to described first leading arm;
Be described predetermined angle place with respect to described first leading arm, setting described second leading arm;
Second leading line is inserted the described second position of described vertebra by described second leading arm;
Expand described first leading line tissue on every side, and described first retaining element is inserted and is connected to the described primary importance of described vertebra;
Expand described second leading line tissue on every side, and described second retaining element is inserted and be connected to described second vertebral location.
17. method according to claim 16 is characterized in that, described first and second positions comprise in little joint, pedicle of vertebral arch, processus transversus vertebrarum, pass internode, spinal meninges, vertebral body, rumpbone, lateral mass or the occipital bone position.
18. method according to claim 16, it is characterized in that, described angle guidance system further comprises and passes first and second guide pipes that are arranged on the first and second slightness hole openings on described first and second leading arms respectively, and form the X-structure from described first and second via openings when they pass.
19. method according to claim 18, it is characterized in that, described second leading arm is connected on described first leading arm pivotly at first centring point, and be configured around pivot rotation, and described pivot is perpendicular to the plane that is limited by described first and second leading arms by described first centring point.
20. method according to claim 18 is characterized in that, described angle guidance system further comprises: be arranged on the protractor between described first and second leading arms, this protractor is used for measuring and setting described preset angle.
21. method according to claim 18 is characterized in that, described angle guidance system further comprises: be used to refer to the deployable vertical indicator perpendicular to the midvertebral line direction.
22. method according to claim 18 is characterized in that, described angle guidance system further comprises: the Z-line indicator that passes described first centring point.
23. method according to claim 19, it is characterized in that, described angle guidance system further comprises: elongated bolt, be used to connect described first and second leading arms, and allow they can around described pivot with controllable mode and with angular spacing be ten/ once rotated.
24. method according to claim 18, further comprise, before inserting and described first and second retaining elements be set, in the boring of described first and second positions, and use Sleeve drill boring, described Sleeve drill is configured to and can be enclosed within respectively on described first and second leading lines, and passes described first and second guide pipes.
25. method according to claim 18, it is characterized in that, use the plane access to plant to carry out described tissue expander, this device comprises: sleeve pipe, sealer, sealer release-push and handle, and wherein said sealer passes described sleeve pipe, and comprises guide wire channel, and this passage is used for sealer is enclosed within described leading line, wherein unclamp described sealer release-push, pushing away described sealer forward can launch the tissue around the described leading line.
26. the method according to described in the claim 25 further comprises, in the time of after described tissue is deployed in described sleeve pipe, removes described sealer.
27. the method according to described in the claim 26 is characterized in that, uses screwdriver to finish described insertion and described first and second spinal fixation elements are set, this screwdriver is configured to pass described sleeve pipe.
28. method according to claim 27 is characterized in that, described screwdriver comprises the lock screw socket, is arranged on the handle of described lock screw socket near-end, and the lock screw element and the screw that are arranged on lock screw socket far-end unclamp/tighten switch.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US87025106P | 2006-12-15 | 2006-12-15 | |
| US60/870,251 | 2006-12-15 | ||
| US11/955,621 | 2007-12-13 |
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| Publication Number | Publication Date |
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| CN101636116A true CN101636116A (en) | 2010-01-27 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN200780046407A Pending CN101636116A (en) | 2006-12-15 | 2007-12-14 | The guidance system that is used for spinal fixation, instrument and device |
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| CN (1) | CN101636116A (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110074854A (en) * | 2018-01-26 | 2019-08-02 | 蛇牌股份公司 | Vertebra repositioning instrument and vertebra repositioning system |
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2007
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110074854A (en) * | 2018-01-26 | 2019-08-02 | 蛇牌股份公司 | Vertebra repositioning instrument and vertebra repositioning system |
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