CN104382642A - Pedicle screw path infusion device and pedicle screw path local reinforcing assembly - Google Patents
Pedicle screw path infusion device and pedicle screw path local reinforcing assembly Download PDFInfo
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- CN104382642A CN104382642A CN201410625607.9A CN201410625607A CN104382642A CN 104382642 A CN104382642 A CN 104382642A CN 201410625607 A CN201410625607 A CN 201410625607A CN 104382642 A CN104382642 A CN 104382642A
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- side opening
- pedicle screw
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- infusion
- screw
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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
-
- 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
-
- 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
-
- 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
- A61B17/8825—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by syringe details
-
- 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8847—Equipment for handling bone cement or other fluid fillers for removing cement from a bone cavity
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Medical Informatics (AREA)
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- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
The invention provides a pedicle screw path infusion device and a pedicle screw path local reinforcing assembly. The pedicle screw path infusion device comprises a side hole sheath of which the surface is smooth, wherein an infusion channel is formed in the middle part of the side hole sheath along the own axis; the far end of the side hole sheath is enclosed; an opening which is communicated with the infusion channel is formed in the near end of the side hole sheath; the side wall of the side hole sheath is provided with a plurality of side holes which are communicated with the infusion channel; each side hole is distributed spirally along the axis of the side hole sheath from the far end to the near end. The invention further relates to a pedicle screw path local reinforcing assembly. The side hole sheath is provided with the side holes which are distributed spirally; after the side hole sheath is placed into a screw path, a bone cement biological material can flow into the screw path from the infusion channel and the side holes, and the periphery of the circumferential wall of the screw path corresponding to the side holes is reinforced locally, so that the full contact of the screw and bone is ensured, the mechanical strength between the screw and a screw path interface is enhanced, and the aim of reinforcing a pedicle screw is fulfilled.
Description
Technical field
The present invention relates to medical instruments field, particularly a kind of pedicle screw trajectory infusion device and pedicle of vertebral arch local strengthening screw assembly.
Background technology
At present, trans-pedicle spinal fixation technique has become spinal surgery routine techniques.Pedicle screw can be rescued deformity of spine by mode three-dimensionals such as traction, pressurization, rotations and be carried out spinal stabilization reconstruction.Can the key of pedicle screw stability maintenance depends on obtain enough " sclerotin-screw " interface holds, and, till this hold will last till the Bony union reaching firm between Fusion levels.But in clinical position, osteoporosis often causes pedicle screw crystallized ability to decline, and screw loosening is deviate from, thus causes operative failure.How to solve the problem that pedicle screw constant intensity declines under osteoporosis condition, also day by day become the thorny problem of puzzlement spinal surgery doctor.
For solving the problem, Chinese scholars has carried out a large amount of correlational studyes, mainly concentrates on the improvement of screw designs and strengthening two aspects in nail road.But increasing screw diameter has the danger causing pedicle of vertebral arch to be burst apart causing fracture of vertebral pedicle, increase screw length and then may destroy vertebral body front pillar, cause internal organs and blood vessel injury, cause serious postoperative complication.In strengthening nail road, main employing fills the method for bone cement class material to following closely total length in road clinically at present, there is more problem in the method: 1. after following closely road total length filled type perfusion bone cement, close adhesion between bone cement class material and screw total length, after bone cement solidification, screw takes out very difficulty, even if screw out screw reluctantly also can cause following closely bony defects a large amount of around road, even injure pedicle of vertebral arch root and nervous tissue, produce serious complication; 2. what is more important, traditional filling type is filled bone cement and can be caused occurring bone cement interlayer between sclerotin and screw, form the secondary interface of " screw-bone cement-sclerotin ", be difficult between interface form good Integrated implant effect, affect the long-term stability of postoperative screw, finally must cause screw loosening, there is very big potential safety hazard in clinical practice; 3. lack suitable bone cement device for casting, careless when pouring into bone cement, part bone cement may be caused to flow in canalis spinalis, cause serious nerve injury complication; 4. also have more common traditional pedicle screw duct strengthening to be developed by vertebroplasty, mostly its sclerotin strengthened is osteoporotic pyramidal portion, does not advocate to strengthen pedicle of vertebral arch position sclerotin.
At present, also there is scholar to invent and use a kind of pedicle screw, in screw, cavity is set, after screw is screwed into nail road, bone cement class biomaterial to inject in cavity and flow on sclerotin from the side opening that screw is arranged, although this screw is easy and simple to handle, also certain strengthening effect is possessed, but possess larger limitation, its reason is: when the not good row overhaul technology of pedicle screw implantation site or other factors cause needing to take out pedicle screw, the bone cement flowed out from hole is connected with the bone cement in nail road, the danger destroying vertebral body sclerotin in the process screwing out screw increases greatly, be not easy to the taking-up of screw after cement augmentation.
Summary of the invention
In order to overcome above-mentioned technical problem, the object of the present invention is to provide a kind of pedicle screw trajectory infusion device improving mechanical strength between screw and nail interface, road.
The technical solution adopted in the present invention is:
A kind of pedicle screw trajectory infusion device, comprise the side opening sheath of surface smoothing, infusion channel is provided with along own axes in the middle part of described side opening sheath, the far-end of described side opening sheath is closed, near-end is provided with the opening being communicated with infusion channel, the sidewall of described side opening sheath is provided with the side opening of some connection infusion channel, and described each side opening is distributed to near-end along side opening sheath axis in the shape of a spiral by far-end.
As the further improvement of technique scheme, the diameter of described side opening is proximally successively decreased by far-end.
As the further improvement of technique scheme, described side opening is distally 0.25mm to the diameter decrement of near-end, and the diameter of described infusion channel is 2mm.
As the further improvement of technique scheme, every 90 ° of the circumference along described side opening sheath is provided with a side opening.
As the further improvement of technique scheme, described side opening sheath near-end is connected to Injection Section, and described Injection Section is provided with the hand-hole of connection opening, and the diameter of described hand-hole is greater than the internal diameter of infusion channel.
As the further improvement of technique scheme, described Injection Section comprises the flank perpendicular to side opening sheath axis, the formation grip part, periphery of described flank, and described flank forms location division towards the end face of side opening sheath.
The present invention also provides a kind of pedicle screw trajectory local strengthening assembly of effective raising clinical efficacy, and its technical scheme adopted is:
A kind of pedicle screw trajectory local strengthening assembly, for pedicle screw trajectory local strengthening, comprising:
Infusion device, injects bone cement class biomaterial to carry out local strengthening to described pedicle screw trajectory;
Injection device, enters infusion device by bone cement class biomaterial injection and arrives pedicle screw trajectory by infusion device;
As the further improvement of technique scheme, described injection device comprises:
Syringe-type syringe, injects bone cement class biomaterial from opening part to infusion channel;
Push rod, described push rod mates with infusion channel, for releasing bone cement class biomaterial residual in infusion channel.
The invention has the beneficial effects as follows: side opening sheath of the present invention is provided with the side opening of spiral distribution, after nail road inserted by side opening sheath, bone cement class biomaterial can flow into by infusion channel and side opening the nail road perisporium making to correspond to side opening position and carry out local strengthening, and the surface smoothing of side opening sheath, be easy to after sclerotin around local strengthening nail road take out in nail road, common pedicle screw is screwed into after taking-up, ensure to still have part fully to contact with surrounding sclerotin while screw contacts with the bone cement class material of local strengthening, at once the mechanical strength between screw and nail interface, road is improved after pedicle screw, the Integrated implant that can be further nail-bone interface long term offers an opportunity thus reaches the fixing object of strengthening pedicle screw at a specified future date, after injecting cement augmentation simultaneously, compared to the hollow side opening screw existed at present, the interface formed between pedicle screw and bone cement is present in screw surface, and there is not the bone cement structure be communicated with inside and outside screw, therefore does not have too much influence when screwing out screw to the destruction of vertebral body sclerotin.
Accompanying drawing explanation
Below in conjunction with drawings and embodiments, the present invention is further described.
Fig. 1 is the structural representation of side opening sheath;
Fig. 2 is side opening Qiao Yuding road connection status schematic diagram;
Fig. 3 is bone cement class biomaterial infusion view;
Fig. 4 is that bone cement class biomaterial injects nail road schematic diagram;
Fig. 5 is that push rod releases residual bone cement class biomaterial view;
Fig. 6 is pedicle screw and nail road connection status schematic diagram.
Detailed description of the invention
Pedicle screw trajectory infusion device as shown in Figure 1, comprises the side opening sheath 1 of surface smoothing, and side opening sheath 1 is the cylindrical-shaped structure of hollow, and its hollow space is the infusion channel 2 along own axes.The far-end of side opening sheath 1 is blunt round tip and closes, and near-end is provided with the opening being communicated with infusion channel 2.The sidewall of side opening sheath 1 is provided with the side opening 3 of some connection infusion channel 2, and each side opening 3 is distributed to near-end along side opening sheath 1 axis in the shape of a spiral by far-end.
Preferably, the diameter of side opening 3 is proximally successively decreased by far-end, and under the prerequisite that injection pressure reduces, side opening 3 relatively far away equally still can flow out more bone cement, ensures that bone cement flows out relatively uniform amount by different far and near side opening 3.
Preferably, every 90 ° of the circumference along side opening sheath 1 is provided with a side opening 3, and namely namely every half-twist has a side opening 3 from far near, and always have 4 such side openings 3, its quantity is moderate, meets the requirement of local strengthening in nail road.Side opening 3 is distally 0.25mm to the diameter decrement of near-end, distalmost end be the first side opening, the first side opening diameter is 2.25mm, be followed successively by 2mm, 1.75mm, 1.5mm afterwards, and the diameter of infusion channel 2 is 2mm.
Preferably, side opening sheath 1 near-end is connected to Injection Section, the hand-hole 4 of connection opening is provided with in the middle part of Injection Section, this hand-hole 4 is through hole, its diameter is greater than the internal diameter of infusion channel 2, have in infusion channel 2 when ensureing bone cement injection and have enough pressure, meeting hand-hole 4 can form good connection with syringe-type syringe 7 head simultaneously.
Preferably, Injection Section comprises the flank 5 perpendicular to side opening sheath 1 axis, the external diameter of flank 5 is greater than the external diameter of side opening sheath 1, make the formation grip part, periphery of flank 5, be convenient to holding when injecting, flank 5 forms location division towards the end face of side opening sheath 1, is convenient to side opening sheath 1 and inserts the location of angle and the grasp of placed-depth.
The present embodiment also provides a kind of pedicle screw trajectory local strengthening assembly, for pedicle screw trajectory local strengthening, except above-mentioned infusion device, also comprises injection device and pedicle screw 6.
Injection device is used for bone cement class biomaterial injection enter infusion device and arrive pedicle screw trajectory by infusion device, and it comprises syringe-type syringe 7 and push rod 8.
Syringe injector injects bone cement class biomaterial from opening part to infusion channel 2; Push rod 8 diameter 2mm, mates with infusion channel 2, for releasing bone cement class biomaterial residual in infusion channel 2.
Pedicle screw 6 is screw conventional in operation, for being screwed into nail road after infusion device takes out.
Pedicle screw trajectory local strengthening assembly using method in the present embodiment is as follows:
1) hand drill conventional preparation nail road in vertebral body is used in advance;
2) after confirmation nail position, road is good, modulation can strengthen the bone cement class biomaterial of nail road perisporium, and by its suction syringe-type syringe 7;
3) as shown in Figure 2, side opening sheath 1 is entered to nail trace interpolation;
4) as shown in Figure 3 and Figure 4, connecting needle cartridge type syringe 7 in hand-hole 4, gradually the bone cement class biomaterial of certain volume is pushed in side opening sheath 1, its side opening 3 along side opening sheath 1 is made to flow out in nail road, under a certain pressure, the bone cement material flowed out distributes twist along in the sclerotin of pedicle screw trajectory around side opening 3, and distribution is in the middle part of vertebral body and pedicle of vertebral arch veutro portion;
5) as shown in Figure 5, remove syringe-type syringe 7 and connect, in side opening sheath 1, insert push rod 8, the bone cement remained in sheath is injected completely to sheath outside sclerotin, to the Formation rule strengthening of screw nail road;
6) before bone cement does not solidify, side opening sheath 1 and push rod 8 is extracted;
7) as shown in Figure 6, before bone cement sclerosis, the common pedicle screw 6 of respective diameters is screwed into along this nail road through local strengthening process, after determining that pedicle screw 6 position is good, inner fixing device is installed, can completes.
Hold due to screw depends on the boundary strength of sclerotin around screw thread and screw thread, therefore, when strengthening material is after side opening is strengthened nail road perisporium, interface mechanics intensity can be improved to a certain extent, and then increase screw hold, reach the object that strengthening screw is fixing.In conventional art, cement augmentation mainly concentrates on front end or the nail road total length of screw, the former does not strengthen the sclerotin at pedicle of vertebral arch position, and the latter Ze Yin follows closely road total length perfusion bone cement, add it and leak out to the risk that canalis spinalis causes serious complications.By side opening sheath, achieve the local strengthening of part vertebral body to osteoporosis centrum and part pedicle of vertebral arch, remain again the interface of nail-bone contact simultaneously, stablizing by interfacial structure, the firmly screw stability achieving screw stability at once and obtained by Integrated implant long term, improves the hold near, at a specified future date inserting pedicle screw.
The present embodiment one carries out local strengthening by pedicle of vertebral arch local strengthening screw assembly to nail road perisporium, while guarantee screw fully contacts with sclerotin, improves the mechanical strength between screw and nail interface, road, reach the object that strengthening pedicle screw is fixing; Two is the local distribution of bone cement in nail road perisporium sclerotin, strengthening, avoid and retain and affect long-time stability and bone cement because bone cement wraps up secondary interface that screw brings completely and improperly may be leaked to the problems such as intraspinal tube hot injury is neural because pouring into, effective raising clinical efficacy, reduces operative failure incidence rate.Phase nail road total length is as compared with the past strengthened or pyramidal portion strengthening, apparatus of the present invention had both enhanced vertebral body position, enhance again the pedicle of vertebral arch position of vertebral body, simultaneously, while raising pedicle screw constant intensity, reduce postoperative pedicle screw and take out destruction to vertebral body and pedicle of vertebral arch sclerotin, reduce screw and take out impact on spinal stability.
In addition, for needing after surgery by the situation that pedicle screw takes out, the interface formed between screw and bone cement after the present embodiment injection cement augmentation is present in screw surface, does not have too much influence when screwing out screw to the destruction of vertebral body sclerotin.
The above is the preferred embodiment of the present invention, and it does not form limiting the scope of the invention.
Claims (8)
1. a pedicle screw trajectory infusion device, it is characterized in that: the side opening sheath (1) comprising surface smoothing, described side opening sheath (1) middle part is provided with infusion channel (2) along own axes, the far-end of described side opening sheath (1) is closed, near-end is provided with the opening being communicated with infusion channel (2), the sidewall of described side opening sheath (1) is provided with the side opening (3) of some connection infusion channel (2), and described each side opening (3) is distributed to near-end along side opening sheath (1) axis in the shape of a spiral by far-end.
2. pedicle screw trajectory infusion device according to claim 1, is characterized in that: the diameter of described side opening (3) is proximally successively decreased by far-end.
3. pedicle screw trajectory infusion device according to claim 2, is characterized in that: described side opening (3) is distally 0.25mm to the diameter decrement of near-end, and the diameter of described infusion channel (2) is 2mm.
4. the pedicle screw trajectory infusion device according to claim 1 or 2 or 3, is characterized in that: every 90 ° of the circumference along described side opening sheath (1) is provided with a side opening (3).
5. the pedicle screw trajectory infusion device according to claim 1 or 2 or 3, it is characterized in that: described side opening sheath (1) near-end is connected to Injection Section, described Injection Section is provided with the hand-hole (4) of connection opening, and the diameter of described hand-hole (4) is greater than the internal diameter of infusion channel (2).
6. pedicle screw trajectory infusion device according to claim 5, it is characterized in that: described Injection Section comprises the flank (5) perpendicular to side opening sheath (1) axis, the formation grip part, periphery of described flank (5), described flank (5) forms location division towards the end face of side opening sheath (1).
7. a pedicle screw trajectory local strengthening assembly, for pedicle screw trajectory local strengthening, is characterized in that, comprising:
Infusion device described in any one of claim 1 to 6, injects bone cement class biomaterial to carry out local strengthening to described pedicle screw trajectory;
Injection device, enters infusion device by bone cement class biomaterial injection and arrives pedicle screw trajectory by infusion device.
8. pedicle screw trajectory infusion device according to claim 7, is characterized in that, described injection device comprises:
Syringe-type syringe (7), injects bone cement class biomaterial from opening part to infusion channel (2);
Push rod (8), described push rod (8) mates with infusion channel (2), for releasing bone cement class biomaterial residual in infusion channel (2).
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CN201410625607.9A CN104382642A (en) | 2014-11-06 | 2014-11-06 | Pedicle screw path infusion device and pedicle screw path local reinforcing assembly |
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CN201410625607.9A CN104382642A (en) | 2014-11-06 | 2014-11-06 | Pedicle screw path infusion device and pedicle screw path local reinforcing assembly |
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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CN112741677A (en) * | 2020-12-30 | 2021-05-04 | 北京铸正机器人有限公司 | Bone cement injection device |
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2014
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CN112741677A (en) * | 2020-12-30 | 2021-05-04 | 北京铸正机器人有限公司 | Bone cement injection device |
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Application publication date: 20150304 |