CN103356275B - A kind of Micro-movement lumber pedicle screw elastic-fixation system - Google Patents
A kind of Micro-movement lumber pedicle screw elastic-fixation system Download PDFInfo
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- CN103356275B CN103356275B CN201210087982.3A CN201210087982A CN103356275B CN 103356275 B CN103356275 B CN 103356275B CN 201210087982 A CN201210087982 A CN 201210087982A CN 103356275 B CN103356275 B CN 103356275B
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Abstract
A kind of Micro-movement lumber pedicle screw elastic-fixation system, is made up of support stick and at least 2 pedicle nails, described support stick, is made up of the good spacing sheath pipe of the flexible rod and rigidity that can produce elastic deformation. The fine motion of appropriateness can be there is in flexible rod along with the motion of human body, and the good spacing sheath Guan Ze of rigidity limits the fine motion amplitude of flexible rod, so, just reached under the premise not sacrificing spinal column stability maintenance, increase load to share, reduce stress shielding and the clinical requirement of stress concentration.
Description
Technical field
The present invention relates to a kind of implanted surgical operating instrument pedicle of lumbar vertebral arch nail rod fixed system, particularly pedicle of lumbar vertebral arch nail rod elastic fixation system.
Background technology
Lumbar degenerative unstability be the commonly encountered diseases causing lumbago and skelalgia because of, lumbar spinal fusion is the chief surgical mode treating this kind of disease at present, whether fusion remains the goldstandard judging its curative effect, although traditional bilateral pedicle screw-rod commonly used at present fixes (being called for short bilateral flexible fastening), the post-operative fusion rate more than 90% can be obtained, but failing to correspondingly improve its general curative effect, curative effect percent dissatisfied is even as high as 35%. Cause curative effect cause of dissatisfaction and cause cesarean delivery adhesion cicatrix, paravertebral muscles extensively to peel off outside the Pass stretch injury has except with intraspinal tube operation technique the tractive of dural sac and nerve root being stimulated, rigidly fix at bilateral and in sections, also easily occur that osteoporosis, osteanabrosis, bone fusion mass decline and pseudoarticulation formation, and be easily caused broken nail and disconnected rod generation owing to stress concentrates on inside-fixture. Overwhelming majority load is born owing to tradition bilateral rigidly fixes, fixed-segment is shared load and is greatly reduced, thus producing stress-shielding effect, the load making neighbouring section intervertebral disc and Minor articulus changes, dmm increases, mobility increases, then the Adjacent segment degeneration of medium-long term generation after surgery, its incidence rate is up to 30%��45%, and range of fusion is more long, Adjacent segment degeneration incidence rate is more high, this wherein partly can produce corresponding clinical symptoms, it is therefore desirable to operative treatment again.
Desirable lumbar vertebra internal fixation method is under the premise not sacrificing spinal column stability maintenance, increases load and shares, and reduces stress shielding and stress is concentrated. Therefore, the pedicle screw-rod fixed system of prior art needs to improve, and to meet under the premise not sacrificing spinal column stability maintenance, increases load and shares, and reduces stress shielding and the clinical requirement of stress concentration.
Summary of the invention
It is an object of the invention to provide a kind of Micro-movement lumber pedicle screw elastic-fixation system, under the premise not sacrificing spinal column stability maintenance, load can have been increased and share, reduced stress shielding and stress is concentrated.
The one Micro-movement lumber pedicle screw elastic-fixation system of the present invention is achieved in that
A kind of Micro-movement lumber pedicle screw elastic-fixation system, is made up of support stick 2 and at least 2 pedicle nails 1, and pedicle nail 1 is arranged on support stick 2, it is characterised in that:
A. the support stick 2 of described Micro-movement lumber pedicle screw elastic-fixation system is containing flexible rod 21 and spacing sheath pipe 22;
B. described flexible rod 21 is that elastic deformation can occur under external force, when external force can return to again the elastomer of original form after releasing;
C. the described spacing sheath pipe 22 position-limit mechanism 201 containing sleeve 202 and the motion amplitude that flexible rod 21 can be limited; Described sleeve 202 is provided with position-limit mechanism 201;
D. described flexible rod 21 is fixed in the centre bore 203 of the sleeve 202 of spacing sheath pipe 22.
Further, described position-limit mechanism 201 is to be made up of the limited block 2011 cooperated for a pair and slotted eye 207.
The geometries such as described flexible rod 21 is medical elastic material manufacture, and the shape of the cross section of described flexible rod 21 is selected from: circular, oval, square, rectangle, the rectangle with circular arc.
Described flexible rod 21 is the latch plate that the stratiform stacked system that medical elastic plate of material manufactures is constituted.
The geometries such as the shape of the centre bore 203 of described sleeve 202 and flexible rod 21 match, and the shape of the cross section of described centre bore 203 is selected from: circular, oval, square, rectangle, the rectangle with circular arc.
Described flexible rod 21 is arranged in the centre bore 203 of sleeve; In the contiguous interval L2 of the limited block 2011 on the sleeve corresponding to described support stick, between flexible rod 21 and sleeve 202, it is provided with movement clearance ��; Sleeve corresponding to described support stick 2 is installed in the contiguous interval L1 of pedicle nail 1, be tight fit between flexible rod 21 and sleeve 202.
Further, it is provided with movement clearance �� less than 0.6mm between described flexible rod 21 and sleeve 202.
The sleeve 202 of described spacing sheath pipe at least contains the upper bush 204 cooperated a pair and lower sleeve 205 is constituted; Upper bush 204 and lower sleeve 205 are connected with flexible rod 21 by pin 206, upper bush 204 and lower sleeve 205 at the axial movement clearance H along spacing sheath pipe 22 less than 0.5mm.
The material manufacturing described Micro-movement lumber pedicle screw elastic-fixation system further is selected from: the medical metal materials such as medical titanium alloy, medical titanium nickel shape memory alloy, medical high elasticity beta Ti alloy, medical titanium zirconium-niobium alloy, medical titanium base amorphous alloy, medical niobio amorphous alloy, medical iron-based non-crystalline alloy, medical stainless steel.
The core of the technical scheme of the present invention is in that:
Constitute the support stick 2 of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention, be made up of the good spacing sheath pipe 22 of the flexible rod 21 and rigidity that can produce elastic deformation. The fine motion of appropriateness can be there is in flexible rod 21 along with the motion of human body, the good spacing sheath pipe 22 of rigidity then limits the fine motion amplitude of flexible rod 21, so, has just reached under the premise not sacrificing spinal column stability maintenance, increase load to share, reduce stress shielding and the clinical requirement of stress concentration.
In recent years, unilateral pedicle screw-rod technique for fixing is applied to clinic gradually, its purpose is while reducing wound, what is more important can reduce the rigidity of implants, its curative effect and stability are confirmed by clinical and biomechanics Research, but at present, what adopt is conventional vertebral pedicle nail rod, namely rigidly fixes system. The Micro-movement lumber pedicle screw elastic-fixation system of the present invention can be applied not only to lumbar vertebra bilateral flexible fastening, is more expected to and is applied to unilateral flexible fastening, thus fixing in realizing desirable lumbar vertebra.
Accompanying drawing explanation
Fig. 1 is the structural representation of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention.
Fig. 2 is the perspective view of the support stick of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention.
Fig. 3 is the perspective view of Fig. 2.
Fig. 4 is the front view of Fig. 2.
Fig. 5 is the side view of Fig. 2.
Fig. 6 is the A-A sectional view of Fig. 2.
Fig. 7 is the B-B sectional view of Fig. 2.
Fig. 8 is the partial enlarged drawing at the R place of Fig. 7.
Fig. 9 is the top view of Fig. 2.
Figure 10 is the Micro-movement lumber pedicle screw elastic-fixation system of a present invention structural representation when stretching.
Figure 11 is the Micro-movement lumber pedicle screw elastic-fixation system of the present invention structural representation when bent position.
Figure 12 is the structural representation of the Micro-movement lumber pedicle screw elastic-fixation system flexible rod of the present invention.
Figure 13 is the sectional view at C-C place.
Figure 14 is the structural representation of the cross section of the oval flexible rod of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention.
Figure 15 is the structural representation of the cross section of the square flexible rod of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention.
Figure 16 is the structural representation of the cross section of the rectangle flexible rod of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention.
Figure 17 is the structural representation of the cross section of the rectangle flexible rod with circular arc of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention.
Figure 18 is the structural representation of the cross section of the oval flexible rod of the layer structure of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention.
Figure 19 is the structural representation of the cross section of the stratiform rectangle flexible rod of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention.
Figure 20 is the structural representation of the cross section of the stratiform of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention rectangle flexible rod with circular arc.
Figure 21 is the structural representation of the laminated resilient rod of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention. In the present embodiment, flexible rod 21 is formed by stacking with 3 layers of medical elastic metallic plate 209. The flexible rod 21 of layer structure is fixed in the spacing sheath pipe 22 of support stick, and at the position near pedicle nail 1, flexible rod 21 and the spacing sheath pipe 22 of layer structure form tight fit. And elastic deformation area, namely near position-limit mechanism 201, between flexible rod 21 and the spacing sheath pipe 22 of layer structure, there is movement clearance ��, usual described movement clearance �� is less than 0.6mm.
Figure 22 is the structural representation containing the upper bush cooperated for a pair and the Micro-movement lumber pedicle screw elastic-fixation system of lower sleeve of the present invention. In the present embodiment, have employed the upper bush 204 cooperated a pair and lower sleeve 205 fixes the flexible rod 21 of support stick. Flexible rod 21 is the layer structure adopting 3 layers of medical elastic metallic plate to be formed by stacking. The upper end of the flexible rod 21 of layer structure is arranged in the centre bore 203 of sleeve of upper bush 204 by pin 206 and rivet hole 208; Equally, the lower end of the flexible rod 21 of layer structure is arranged in the centre bore 203 of sleeve of lower sleeve 205 by pin 206 and rivet hole 208. The gap formed between limited block 2011 and the limited block 2011 of lower sleeve 205 of upper bush 204 constitutes the slotted eye 207 of position-limit mechanism, and slotted eye 207 limits the range of movement of pedicle of lumbar vertebral arch nail rod elastic fixation system.
Figure 23 is the structural representation being provided with the Micro-movement lumber pedicle screw elastic-fixation system presetting angle of bend of the present invention. In the present embodiment, the support stick of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention has preset angle of bend ��. Angle of bend �� is the axis angle with vertical direction of support stick 2, and generally preset angle of bend �� is less than 5 �� so that the flexible rod 21 and the spacing sheath pipe 22 that constitute described support stick 2 have the physiologic radian adapted with human body lumbar vertebra. Gap between the limited block 2011 arranged on sleeve 202 constitutes the slotted eye 207 of position-limit mechanism, and the size of slotted eye 207 determines the range of movement of pedicle of lumbar vertebral arch nail rod elastic fixation system. The two ends of the flexible rod 21 of support stick 2 are separately fixed on sleeve 202, and the middle part of flexible rod 21 is arranged in the bushing core hole 203 of sleeve 202, and the external diameter at the middle part of flexible rod 21 is less than the internal diameter in bushing core hole 203. This structure makes the middle part of flexible rod 21 can carry out uniform elastic deformation in bushing core hole 203, avoids the concentration at slotted eye 207 place corresponding to position-limit mechanism to deform, thus improving the service life of flexible rod 21.
In above-mentioned figure: 1 is pedicle nail, 2 is support stick, 21 is the flexible rod of support stick, 22 is the spacing sheath pipe of support stick, 201 is position-limit mechanism, 202 is sleeve, 203 is the centre bore of sleeve, 204 is upper bush, 205 is lower sleeve, 206 is pin, 207 is the slotted eye of position-limit mechanism, 208 is rivet hole, 209 is medical elastic metallic plate, 2011 is the limited block on position-limit mechanism, L1 is the interval that pedicle nail is contiguous, L2 is the interval that position-limit mechanism is contiguous, L3 is the spacing gap of position-limit mechanism, H is the axially-movable gap between upper bush and lower sleeve, �� is the movement clearance between flexible rod and sleeve, d1 is the diameter that flexible rod corresponds to the interval L1 place connecting pedicle nail, d2 is the diameter that flexible rod corresponds at L2 place, elastic deformation interval, d3 is the internal diameter of the sleeve of spacing sheath pipe, �� is the angle of bend that support stick is preset.
Detailed description of the invention
Embodiment 1: the Micro-movement lumber pedicle screw elastic-fixation system of the present invention
Referring to figs. 1 to Figure 13, in the present embodiment, disclose the Micro-movement lumber pedicle screw elastic-fixation system of a kind of present invention. Described Micro-movement lumber pedicle screw elastic-fixation system is made up of support stick 2 and at least 2 pedicle nails 1, and pedicle nail 1 is arranged on support stick 2. Described support stick 2 is containing flexible rod 21 and spacing sheath pipe 22, and flexible rod 21 is that elastic deformation can occur under external force, when external force can return to again the elastomer of original form after releasing. The spacing sheath pipe 22 position-limit mechanism 201 containing sleeve 202 and the motion amplitude that can limit flexible rod 21, sleeve 202 is provided with position-limit mechanism 201, and flexible rod 21 is fixed in the centre bore 203 of the sleeve 202 of spacing sheath pipe 22.
Described flexible rod 21 adopts medical high elasticity beta Ti alloy manufacture or medical super elastic Ti base amorphous alloy manufacture. Described flexible rod 21 connects the diameter d1 at L1 place, pedicle nail interval corresponding to, and described flexible rod 21 is d2 at the diameter of elastic deformation interval L2. Described sleeve 202 adopts medical titanium nickel shape memory alloy manufacture, and the internal diameter of sleeve 202 is d3. Described flexible rod 21 is d3 corresponding to the diameter d1 connecting L1 place, pedicle nail interval slightly larger than the internal diameter of sleeve 202, shape interference tight fit. First at low temperatures, in the cold water of 0 DEG C��15 DEG C, the internal diameter d3 of sleeve 202 is suitably expanded, make its diameter d1 more than flexible rod 21, then it is placed in the hot water of 33 DEG C��37 DEG C, the internal diameter d3 of the sleeve 202 of medical titanium nickel shape memory alloy manufacture returns to original size, owing to the internal diameter d3 of described sleeve is less than the outside diameter d 1 of flexible rod, so sleeve 201 is corresponding to, with flexible rod 21, the interval L1 place formation tight fit being connected pedicle nail. Described flexible rod 21 is fixed with sleeve 202, constitutes support stick 2.
Correspond to the region of the contiguous interval L2 of position-limit mechanism, i.e. elastic deformation area L2 place at sleeve 202, be provided with slotted eye 207. It is respectively provided with locating piece 2011 that locating piece 2011,2 cooperates between the top and bottom of described slotted eye 207 and slotted eye 207 together constitutes position-limit mechanism 201. When body forward bends, the flexible rod 21 also bend forward of support stick 2, the slotted eye 207 on right side progressively closes, and upper and lower locating piece contacts with each other, and plays the effect that position in the wrong is spacing, with reference to Figure 11. Equally, when health stretches backward, the slotted eye 207 in left side progressively closes, and upper and lower locating piece contacts with each other, and plays the effect that position is spacing of stretching, with reference to Figure 10.
Due at support stick 2 corresponding to there is gap delta between internal diameter d3 and the outside diameter d 2 of flexible rod 21 of the sleeve 202 of elastic deformation interval L2, both the appropriate fine motion of flexible rod 21, bending had been ensure that, there is again certain position-limiting action so that flexible rod 21 can not hyperkinesia and bending. The existence of described gap delta and described position-limit mechanism 201 and combined effect, both ensure that the flexible rod 21 of the Micro-movement lumber pedicle screw elastic-fixation system of the present invention can carry out the fine motion of appropriateness, bending, serve again spacing effect, so, just reach under the premise not sacrificing spinal column stability maintenance, increase load to share, the clinical requirement that power is blocked by minimizing and stress is concentrated.
In addition, when adopting the Micro-movement lumber pedicle screw elastic-fixation system of Ti-Ni marmem manufacture invention, by Technology for Heating Processing of shaping, the flexible rod 21 and spacing sheath pipe 22 that constitute described support stick 2 can also be designed with the physiologic radian adapted with human body lumbar vertebra, generally preset angle of bend �� is less than 5 ��, with reference to Figure 23.
The material of the Micro-movement lumber pedicle screw elastic-fixation system manufacturing the present invention is also selected from: the medical metal materials such as medical titanium alloy, medical titanium nickel shape memory alloy, medical high elasticity beta Ti alloy, medical titanium zirconium-niobium alloy, medical titanium base amorphous alloy, medical niobio amorphous alloy, medical iron-based non-crystalline alloy, medical stainless steel.
Embodiment 2: the Micro-movement lumber pedicle screw elastic-fixation system of the layer structure of the present invention
With reference to Figure 22, and Figure 18, Figure 19, Figure 20. In the present embodiment, its basic structure is identical with embodiment 1, and its difference is in that:
The sleeve 202 of described support stick 2 is made up of upper bush 204 and lower sleeve 205. The upper end of described flexible rod 21 is fixed on upper bush 204 by pin 206, and the lower end of described flexible rod 21 is fixed on lower sleeve 205 by pin 206; Slotted eye 207 between the locating piece of the locating piece 2011 on upper bush 204, the locating piece 2011 on lower sleeve 205 and upper and lower sleeve together constitutes position-limit mechanism 201.
Described flexible rod 21 is the latch plate structure being layered the layer structure that superposition manufactures by medical elastic plate of material. The harden top and bottom of flexible rod 21 of structure of laminated spring are respectively provided with rivet hole 208. The diameter of rivet hole 208 is slightly larger than the diameter of the pin 206 for riveting so that described flexible rod 21 can do suitable axially-movable around pin 206. Namely the gap H of axially-movable is the difference between the diameter of rivet hole 208 and the diameter of pin 206, and generally, described gap H is less than 0.5mm.
The present embodiment hardens the flexible rod 21 of structure owing to have employed laminated spring, not only makes the Micro-movement lumber pedicle screw elastic-fixation system of the present invention stretch position and the better anti-fatigue performance of Qu Weiyou; And, axially, namely upper and lower is to, it is also possible to suitably fine motion, can meet better under the premise not sacrificing spinal column stability maintenance, increase load and share, and reduces stress shielding and clinical requirement that stress is concentrated.
It should be noted that structure disclosed and illustrated herein can replace by the structure that other effect is identical, the embodiment that the present invention introduces simultaneously not realizes the exclusive architecture of the present invention. Although the preferred embodiments of the present invention is introduced in this article and is illustrated; but it is only illustrate that those skilled in the art are clear from these embodiments; those skilled in the art can make countless change, improvement and replacements; without departing from the present invention; therefore, protection scope of the present invention should be limited according to the spirit and scope of appending claims of the present invention.
Claims (9)
1. a Micro-movement lumber pedicle screw elastic-fixation system, is made up of support stick (2) and at least 2 pedicle nails (1), and pedicle nail (1) is arranged on support stick (2), it is characterised in that:
A. the support stick (2) of described Micro-movement lumber pedicle screw elastic-fixation system is containing flexible rod (21) and spacing sheath pipe (22);
B. described flexible rod (21) is that elastic deformation can occur under external force, when external force can return to again the elastomer of original form after releasing;
C. the described spacing sheath pipe (22) position-limit mechanism (201) containing sleeve (202) and the motion amplitude that flexible rod (21) can be limited; Described sleeve (202) is provided with position-limit mechanism (201);
D. described flexible rod (21) is fixed in the centre bore (203) of the sleeve (202) of spacing sheath pipe (22).
2. Micro-movement lumber pedicle screw elastic-fixation system according to claim 1, it is characterised in that described position-limit mechanism (201) is to be made up of the limited block (2011) cooperated for a pair and slotted eye (207).
3. Micro-movement lumber pedicle screw elastic-fixation system according to claim 1, it is characterized in that described flexible rod (21) is medical elastic material manufacture, the shape of the cross section of described flexible rod (21) is selected from: circular, oval, square, rectangle, with the rectangle of circular arc.
4. Micro-movement lumber pedicle screw elastic-fixation system according to claim 1, it is characterised in that described flexible rod (21) is the latch plate that the stratiform stacked system that medical elastic plate of material manufactures is constituted.
5. Micro-movement lumber pedicle screw elastic-fixation system according to claim 1, it is characterized in that the shape of the centre bore of described sleeve (202) (203) and flexible rod (21) match, the shape of the cross section of described centre bore (203) is selected from: circular, oval, square, rectangle, with the rectangle of circular arc.
6. Micro-movement lumber pedicle screw elastic-fixation system according to claim 1, it is characterised in that described flexible rod (21) is arranged in the centre bore (203) of sleeve; In contiguous interval (L2) of the limited block (2011) on the sleeve corresponding to described support stick, between flexible rod (21) and sleeve (202), it is provided with movement clearance ��; Sleeve corresponding to described support stick (2) is installed in contiguous interval (L1) of pedicle nail (1), be tight fit between flexible rod (21) and sleeve (202).
7. Micro-movement lumber pedicle screw elastic-fixation system according to claim 1, it is characterised in that be provided with movement clearance �� less than 0.6mm between described flexible rod (21) and sleeve (202).
8. Micro-movement lumber pedicle screw elastic-fixation system according to claim 1, it is characterised in that the sleeve (202) of described spacing sheath pipe at least contains the upper bush (204) cooperated a pair and lower sleeve (205) is constituted; Upper bush (204) and lower sleeve (205) are connected with flexible rod (21) by pin (206), upper bush (204) and lower sleeve (205) at the axial movement clearance H along spacing sheath pipe (22) less than 0.5mm.
9. Micro-movement lumber pedicle screw elastic-fixation system according to claim 1, it is characterised in that the material manufacturing described Micro-movement lumber pedicle screw elastic-fixation system is selected from: medical titanium alloy, medical titanium nickel shape memory alloy, medical high elasticity beta Ti alloy, medical titanium zirconium-niobium alloy, medical titanium base amorphous alloy, medical niobio amorphous alloy, medical iron-based non-crystalline alloy, medical stainless steel.
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| CN201210087982.3A CN103356275B (en) | 2012-03-29 | 2012-03-29 | A kind of Micro-movement lumber pedicle screw elastic-fixation system |
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| CN201210087982.3A CN103356275B (en) | 2012-03-29 | 2012-03-29 | A kind of Micro-movement lumber pedicle screw elastic-fixation system |
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| CN103356275A (en) | 2013-10-23 |
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