CN104013457A - 棘间万向稳定器 - Google Patents
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- 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
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
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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
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7047—Clamps comprising opposed elements which grasp one vertebra between them
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- 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
- A61B17/7056—Hooks with specially-designed bone-contacting part
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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
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
- A61B17/7067—Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor
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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
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
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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
- A61B2017/564—Methods for bone or joint treatment
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Abstract
本发明涉及一种棘间万向稳定器,属医疗器械的人体内置入物技术领域。它由上固定板、下固定板和弹性结构组成,上固定板和下固定板通过弹性结构连接,上、下固定板的中间制作有开口,开口底部制作有防脱钩,两侧制作有半圆形螺孔和竖齿,上固定板、下固定板和弹性结构之间为镂空孔结构。该棘间万向稳定器通过多个互相垂直的U形变形结构或弹簧连接,实现手术节段在矢状位上的前屈、后伸、左右侧弯与旋转等各方向的弹性活动。具有结构简单、应力分散、植入方便、固定牢固可靠、能万向弹性活动、能避免材料与棘突的撞击等优点。解决了目前使用的各种动态棘突间内固定物不能保留脊柱在各方向上的活动,且结构复杂,操作困难,使用不耐久的问题。
Description
技术领域
本发明涉及一种棘间万向稳定器,属医疗器械的人体内置入物技术领域。
背景技术
目前,脊柱融合技术在治疗下腰痛和腰椎不稳方面取得了较好的疗效,融合率达90%以上。但有研究表明,其临床疗效并未达到期望值;而且坚强内固定和脊柱融合术存在加速邻近节段退变、内固定失败、术后假关节形成等并发症的可能。鉴于此,腰椎动态固定正在成为近年来治疗退行性腰椎疾病比较热门的一种技术,有人工全椎间盘置换、人工髓核置换、经椎弓根动态固定、棘突间动态固定以及小关节成形装置等5种类型。其中棘突间动态固定创伤最小,安全性最高,操作最简单,并发症轻微,即使失败也不影响其进一步的手术治疗,因而发展迅速。虽然棘突间内固定系统的植入在不牺牲脊柱即刻稳定性的前提下将其动态固定,术后可分散坚固内固定的负荷传导,避免应力遮挡,棘间产生的撑开力可在手术节段产生相对的后凸,使内折的黄韧带反向张开以减少其对椎管的侵入,增大椎管容积,还可恢复椎间隙高度,增加椎管及椎间孔的面积、卸载后方纤维环的负荷,减少相应节段小关节载荷。术后患者恢复迅速,复发率低,疼痛等症状缓解显著,可早期下床活动、恢复日常生活等诸多优点,但现有的棘突间动态内固定器尚存在不少缺陷,有的只能提供某一方向上的活动(如Coflex只能提供矢状位的伸屈),有的应力易集中于某处导致假体断裂,有的假体与棘突高度相近致术中需牺牲棘上韧带,有的假体与棘突撞击导致磨损反应,有的联接复杂(如棘板间万向动态稳定器),还有的固定器体积过大致术中创伤大、术后体内占位多、安装困难(如棘间万向动态稳定器),或有的利用捆绑带长期固定易松弛等问题,难以保证很低的并发症与很好的远期效果。
发明内容
本发明的目的在于,针对现有技术的不足,提供一种上下固定板之间通过多个互相垂直的U形变形结构或弹簧连接,利用固定板材料的弹性回缩而固定于棘突,还可根据需要在固定板与棘突骨之间采用锁定螺钉加强固定,具有万向活动性能,植入方便、固定可靠、应力分散,能保留棘上韧带、对骨质切除少、能安于棘突根部、能用于腰骶角过大、棘突过矮或棘间距过小病例的棘间万向稳定器。
本发明是通过如下技术方案来实现上述目的的:
该棘间万向稳定器由上固定板、下固定板和弹性结构组成,上固定板和下固定板通过弹性结构连接,其特征在于,上固定板和下固定板的中间分别制作有开口,开口的底部制作有防脱钩,开口内的两侧分别制作有半圆形螺孔,开口内的两端制作有竖齿;所述的弹性结构为U形变形结构或弹簧结构,所述的U形变形结构由多个U形连接而成, U形中有U形开口向上的垂直U形,还有 U形开口向外侧的水平U形;所述的弹簧结构由弹簧制成;上固定板、下固定板和弹性结构之间为镂空孔结构。
本发明与现有技术相比的有益效果在于:
该棘间万向稳定器的外层金属板中部通过多个互相垂直的U形变形结构或弹簧连接,固定板利用弹性回缩而固定于棘突,必要时还可在固定板与棘突骨质之间加用螺孔锁定,可实现棘间弹性撑开与脊柱左右侧屈,通过外层金属板本身的弹性和U形变形结构或弹簧连接,以及内外层空心弧形部份弹性的共同作用,实现脊柱手术节段在矢状位上的伸、屈、旋转的弹性稳定,还能实现手术节段各方向运动及多方位活动综合作用所形成环转的动态稳定。具有结构简单、应力分散、植入方便、固定牢固可靠、抗金属疲劳强、磨损小、能万向弹性活动、可用于腰骶角过大、棘突过矮或棘间距过小的病例,且能避免材料与材料或材料与棘突之间的撞击等优点。解决了目前使用的各种动态棘突间内固定物不能保留脊柱在各方向上的活动及对各方向的活动进行弹性限制,以及未能充分实现棘间弹性承载或出现材料与棘突、材料与材料的撞击;且结构复杂、操作复杂、损伤大,使用不耐久的问题。
附图说明
图1为棘间万向稳定器为U形变形结构的主视结构示意图;
图2为棘间万向稳定器为U形变形结构的左视结构示意图;
图3为棘间万向稳定器为U形变形结构的一面制作成弧形的左视结构示意图;
图4为棘间万向稳定器为弹簧结构的主视结构示意图;
图5为棘间万向稳定器为弹簧结构的左视结构示意图;
图6为棘间万向稳定器为弹簧结构的一面制作成弧形的左视结构示意图。
图中:1、上固定板,2、下固定板,3、垂直U形,4、水平U形,5、防脱钩,6、半圆形螺孔,7、竖齿,8、镂空孔,9、弹簧。
具体实施方式
该棘间万向稳定器由上固定板1、下固定板2和弹性结构组成,上固定板1和下固定板2通过弹性结构连接,上固定板1和下固定板2的中间分别制作有开口,开口的底部制作有防脱钩5,开口内的两侧分别制作有半圆形螺孔6,开口内的两端制作有竖齿7;所述的弹性结构分为U形变形结构或弹簧结构两种,所述的U形变形结构一般由3个U形连接而成,也可以是3个以上的U形连接而成, U形中有U形开口向上的垂直U形3,还有 U形开口向外侧的水平U形4;所述的弹簧结构由弹簧9制成,通过弹簧9直接与上固定板1和下固定板2弹性连接。上固定板1、下固定板2和弹性结构之间为镂空孔8的结构。该棘间万向稳定器可以制作成两面为平面结构的,也可以有一面制作成弧形面的结构。(参见附图1~6)。
该棘间万向稳定器植入退变性腰椎疾患病人的人体时,可切开棘上韧带,切除棘间韧带,牵开上下棘突以加大棘间距,试模成功后,用撑开器插入镂空孔8的内面向外撑开,将棘间万向动态稳定器嵌入棘间,取出撑开器,利用固定板材料的弹性回缩而使固定板固定于上、下棘突,便完成安装;若固定欠妥当,则还可通过上固定板1和下固定板2开口内两侧的半圆形螺孔6和锁定螺钉加强固定,开口底部的防脱钩5,则钩在棘突上,防止上固定板1和下固定板2向后滑脱,为了防止防脱钩5钩的不牢固,可对棘突进行适当修整。同时,开口内的半圆形螺孔6上部的竖齿7也钩在棘突上,使棘间万向稳定器进一步固定。将棘间万向稳定器与棘突之间固定妥当后,最后缝合棘上韧带,完成安装。该棘间万向稳定器通过弹性结构和镂空孔8的变形,能实现棘间弹性撑开与脊柱左右侧屈,实现手术节段在矢状位上的前屈、后伸、左右侧弯与旋转等各方向的弹性活动;其手术时间短,术中损伤小,术后身体恢复快。
以上所述只是该发明的具体实施方式,上述举例说明不对本发明的实质内容构成限制,所属技术领域的普通技术人员在阅读了本说明书后可以对上述的具体实施方式做修改或变形,而不背离本发明的实质和范围。
Claims (1)
1.一种棘间万向稳定器,它由上固定板(1)、下固定板(2)和弹性结构组成,上固定板(1)和下固定板(2)通过弹性结构连接,其特征在于,上固定板(1)和下固定板(2)的中间分别制作有开口,开口的底部制作有防脱钩(5),开口内的两侧分别制作有半圆形螺孔(6),开口内的两端制作有竖齿(7);所述的弹性结构为U形变形结构或弹簧结构,所述的U形变形结构由多个U形连接而成, U形中有U形开口向上的垂直U形(3),还有 U形开口向外侧的水平U形(4);所述的弹簧结构由弹簧(9)制成;上固定板(1)、下固定板(2)和弹性结构之间为镂空孔(8)的结构。
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CN201520426702.6U CN204708959U (zh) | 2014-06-19 | 2015-06-19 | 棘间稳定器 |
CN201510342952.6A CN104873258B (zh) | 2014-06-19 | 2015-06-19 | 棘间稳定器 |
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Cited By (2)
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CN104921793A (zh) * | 2015-07-08 | 2015-09-23 | 李照文 | 组配式棘间万向稳定器 |
WO2016201695A1 (zh) * | 2015-06-19 | 2016-12-22 | 李照文 | 棘间稳定器 |
Families Citing this family (7)
Publication number | Priority date | Publication date | Assignee | Title |
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CN104013457A (zh) * | 2014-06-19 | 2014-09-03 | 李照文 | 棘间万向稳定器 |
CN106214238A (zh) * | 2016-08-15 | 2016-12-14 | 李照文 | 棘间动态固定器 |
JP6771554B2 (ja) | 2015-10-21 | 2020-10-21 | 佰奥達生物科技(武漢)股▲ふん▼有限公司 | 棘間ユニバーサル動的ホルダー |
CN105193524B (zh) * | 2015-10-21 | 2017-07-21 | 李照文 | 棘板间稳定器 |
CN105919699A (zh) * | 2016-04-08 | 2016-09-07 | 李照文 | 棘板间稳定器 |
CN106108997A (zh) * | 2016-08-26 | 2016-11-16 | 常州好利医疗科技有限公司 | 椎板下撑开活动器 |
CN107753150B (zh) * | 2017-12-05 | 2024-04-09 | 运怡(北京)医疗器械有限公司 | 一种翻修型带袢固定板 |
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FR2892616B1 (fr) * | 2005-11-02 | 2009-01-09 | Spinevision Sa | Implant chirurgical intervertebral comprenant un element viscoelastique |
CN201275131Y (zh) * | 2007-04-10 | 2009-07-22 | 王黎明 | 镍钛形状记忆合金非融合性棘突间固定器 |
TW200920306A (en) * | 2007-11-13 | 2009-05-16 | Topasia Internat Technology Inc | Spacing stabilizing structure for spinous process |
WO2010085809A1 (en) * | 2009-01-26 | 2010-07-29 | Life Spine, Inc. | Flexible and static interspinous/inter-laminar spinal spacers |
CN201920880U (zh) * | 2010-12-10 | 2011-08-10 | 上海凯利泰医疗科技股份有限公司 | 弹开式棘突撑开装置 |
CN102697544A (zh) * | 2011-03-28 | 2012-10-03 | 上海微创骨科医疗科技有限公司 | 棘突间动态稳定装置 |
CN102512232B (zh) * | 2012-01-10 | 2013-07-24 | 李照文 | 棘间万向动态稳定器 |
CN103705296A (zh) * | 2014-01-17 | 2014-04-09 | 李照文 | 棘板间万向动态稳定器 |
CN104013457A (zh) * | 2014-06-19 | 2014-09-03 | 李照文 | 棘间万向稳定器 |
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- 2014-06-19 CN CN201410275255.9A patent/CN104013457A/zh active Pending
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- 2015-06-19 CN CN201520426702.6U patent/CN204708959U/zh not_active Withdrawn - After Issue
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Cited By (3)
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WO2016201695A1 (zh) * | 2015-06-19 | 2016-12-22 | 李照文 | 棘间稳定器 |
CN104921793A (zh) * | 2015-07-08 | 2015-09-23 | 李照文 | 组配式棘间万向稳定器 |
CN104921793B (zh) * | 2015-07-08 | 2017-06-16 | 李照文 | 组配式棘间万向稳定器 |
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CN104873258A (zh) | 2015-09-02 |
CN204708959U (zh) | 2015-10-21 |
CN104873258B (zh) | 2017-08-25 |
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