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Pedicle screw path infusion device and pedicle screw path local reinforcing assembly

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Publication number
CN104382642A
CN104382642A CN 201410625607 CN201410625607A CN104382642A CN 104382642 A CN104382642 A CN 104382642A CN 201410625607 CN201410625607 CN 201410625607 CN 201410625607 A CN201410625607 A CN 201410625607A CN 104382642 A CN104382642 A CN 104382642A
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CN
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Prior art keywords
side
screw
path
hole
sheath
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CN 201410625607
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Chinese (zh)
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付索超
夏虹
吴增晖
马向阳
尹庆水
雷伟
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广州军区广州总医院
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7074Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802Equipment for handling bone cement or other fluid fillers
    • A61B17/8805Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802Equipment for handling bone cement or other fluid fillers
    • A61B17/8805Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8825Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by syringe details
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802Equipment for handling bone cement or other fluid fillers
    • A61B17/8847Equipment for handling bone cement or other fluid fillers for removing cement from a bone cavity

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

一种椎弓根钉道输注器及椎弓根钉道局部强化组件 One kind of pedicle screw path infusion pedicle screw assembly local reinforcing channel

技术领域 FIELD

[0001] 本发明涉及医疗器械领域,特别是一种椎弓根钉道输注器及椎弓根局部强化螺钉组件。 [0001] The present invention relates to the field of medical devices, particularly to a pedicle screw path strengthening local infusion pedicle screw assembly.

背景技术 Background technique

[0002]目前,经椎弓根内固定技术已经成为脊柱外科一项常规技术。 [0002] Currently, the pedicle screw fixation of spinal surgery technology has become a routine technique. 椎弓根螺钉可以通过牵引、加压、旋转等方式三维矫治脊柱畸形和进行脊柱稳定重建。 Pedicle screws by pulling, pressure, rotation, etc., and a three-dimensional correction of spinal deformities for spinal reconstruction. 椎弓根螺钉固定稳定性的关键取决于能否获得足够的“骨质一螺钉”界面把持力,而且,这种把持力要持续到融合节段间达到坚固的骨性融合为止。 The key depends on the stability of pedicle screw fixation can get enough "a bone screw" screen holding force, and that this holding force to continue to achieve solid fusion segments between the bony fusion so far. 但在临床工作中,骨质疏松常导致椎弓根螺钉固定能力下降,螺钉松动脱出,从而导致手术失败。 However, in clinical practice, often lead to a decline osteoporosis pedicle screw fixation ability, extrusion screw loose, causing operation failure. 如何解决骨质疏松条件下椎弓根螺钉固定强度下降的问题,也日益成为困扰脊柱外科医师的棘手问题。 How to solve the problem of osteoporosis under conditions of pedicle screw fixation strength decrease, also increasingly become a thorny problem for spine surgeons.

[0003] 为解决上述问题,国内外学者进行了大量的相关研究,主要集中在螺钉设计的改进和钉道的强化两个方面。 [0003] To solve the above problems, domestic and foreign scholars have done a lot of research, mainly focused on two aspects to strengthen and improve the design of the screw channel of the screw. 但是,增加螺钉直径有导致椎弓根崩裂引起椎弓根骨折的危险,增加螺钉长度则可能破坏椎体前柱,引起内脏及血管损伤,导致严重的手术并发症。 However, increasing the lead to pedicle screw diameter dangerous crack caused pedicle fractures, increasing the length of the screws may destroy the anterior vertebral column, causing damage to internal organs and blood vessels, leading to serious complications. 在强化钉道方面,目前临床上主要采用向钉道内全长填充骨水泥类材料的方法,该方法存在较多问题:1.钉道全长填充式灌注骨水泥后,骨水泥类材料与螺钉全长之间紧密粘合,骨水泥固化后螺钉取出极为困难,即使勉强旋出螺钉也会导致钉道周围大量的骨质缺损,甚至伤及椎弓根根部及神经组织,产生严重的并发症;2.更为重要的是,传统的灌注式填充骨水泥会导致骨质和螺钉之间出现骨水泥夹层,形成“螺钉一骨水泥一骨质”的二次界面,界面之间难以形成良好的骨整合效果,影响术后螺钉的长期稳定,最终必然导致螺钉松动,临床应用存在极大安全隐患;3.缺少合适的骨水泥灌注装置,在灌注骨水泥时不慎,可能导致部分骨水泥流入椎管中,导致严重的神经损伤并发症;4.还有比较常见的传统的椎弓根螺钉钉道强化由椎体成形术发展而来,其所 In strengthening the screw channel, is currently used mainly in clinical method of filling a bone cement-based material to the entire length of the screw channel, the method many problems: 1. After the entire length of the screw channel of formula perfusion bone cement, cement-based material with the screw tight adhesion between the total length, the bone cement after curing is extremely difficult to remove the screws, even if reluctantly unscrew the screw also causes the screw channel surrounding a large number of bone defects, even hurt roots and nerve tissue pedicle, serious complications ; 2. more importantly, conventional impregnated-type filling bone cement can lead to bone cement occurs between the interlayer and the screw is formed "a bone screw and a bone cement" secondary interface, it is difficult to form a good interface between the osseointegration effect, the impact of long-term stability after the screws, eventually will inevitably lead screw loose, there is a big security risk clinical application; 3. lack of suitable bone cement perfusion device inadvertently when filling bone cement, bone cement may cause some flows into the spinal canal, resulting in severe neurological damage complications; 4. there are more common traditional pedicle screw pilot reinforced molded from vertebroplasty evolved, they 化的骨质多是骨质疏松的椎体部分,未主张对椎弓根部位骨质进行强化。 A plurality of vertebral bone portion osteoporosis unclaimed intensive pedicle bone site.

[0004]目前,也有学者发明并使用一种椎弓根螺钉,在螺钉内设置空腔,在螺钉拧入钉道后,骨水泥类生物材料注入空腔内并从螺钉上设置的侧孔流至骨质上,这种螺钉虽然操作简便,也具备一定的强化效果,但是具备较大的局限性,其原因在于:在椎弓根螺钉置入位置不佳行翻修术或其他因素导致需要取出椎弓根螺钉时,从孔中流出的骨水泥与钉道内的骨水泥连成一体,在旋出螺钉的过程中破坏椎体骨质的危险性大大增加,不便于骨水泥强化后螺钉的取出。 [0004] Currently, some scholars invention is the use of a pedicle screw, a screw disposed within the cavity, the screw is screwed into the screw channel, the bone cement biomaterial injection hole side from the cavity and provided on the screw stream to the bone, though such a simple screw, also have some reinforcing effect, but have serious limitations, the reason is: poor location row revision surgery or other factors lead to pedicle screw placement in the need to remove when the pedicle screw, the bone cement within the bone cement integral with the staple channel flowing from the wells, the vertebral bone damage greatly increased risk during the unscrewing of the screw, it is not easy to screw the bone cement reinforced extraction .

发明内容 SUMMARY

[0005] 为了克服上述技术问题,本发明的目的在于提供一种提高螺钉与钉道界面之间力学强度的椎弓根钉道输注器。 [0005] To overcome the above technical problems, an object of the present invention is to provide an improved mechanical strength of the interface between the screw and the screw channel is channel infusion pedicle screw.

[0006] 本发明所采用的技术方案是: [0006] The technical proposal of the present invention is:

一种椎弓根钉道输注器,包括表面平滑的侧孔鞘,所述侧孔鞘中部沿自身轴线设有输注通道,所述侧孔鞘的远端封闭,近端设有连通输注通道的开口,所述侧孔鞘的侧壁设有若干连通输注通道的侧孔,所述各侧孔沿侧孔鞘轴线由远端至近端呈螺旋状分布。 One kind of channel infusion pedicle screw, comprising a flat surface side of the hole of the sheath, the middle sheath side hole provided along its axis infusion passage, the distal end of the sheath side hole is closed, in communication with the proximal end of the output opening of the injection channel, a sidewall of the sheath side hole provided with a plurality of lateral holes communicating the infusion channel, said side hole along the axis of the sheath side hole proximal to the distal end of a spiral distribution.

[0007] 作为上述技术方案的进一步改进,所述侧孔的直径由远端向近端递减。 [0007] As an improvement to the above technical scheme, the side hole diameter decreasing from the distal end toward the proximal end.

[0008] 作为上述技术方案的进一步改进,所述侧孔从远端至近端的直径递减量为0.25mm,所述输注通道的直径为2mm。 [0008] As a further improvement to the foregoing technical solution, the decrement from the side hole diameter of the distal to the proximal end is 0.25mm, the diameter of said infusion channel is 2mm.

[0009] 作为上述技术方案的进一步改进,沿所述侧孔鞘的周向每90°设有一个侧孔。 [0009] As a further improvement to the foregoing technical solution, the sheath side hole along said peripheral side provided with a hole to each of 90 °.

[0010] 作为上述技术方案的进一步改进,所述侧孔鞘近端接有注入段,所述注入段设有连接开口的注入孔,所述注入孔的直径大于输注通道的内径。 [0010] As a further improvement to the foregoing technical solution, the inner diameter of the sheath side hole terminating near an injection section, the injection section is provided with an opening connected to the injection hole of the injection hole is larger than the diameter of the infusion passage.

[0011] 作为上述技术方案的进一步改进,所述注入段包括垂直于侧孔鞘轴线的侧翼,所述侧翼的外周形成握持部,所述侧翼朝向侧孔鞘的端面形成定位部。 [0011] As a further improvement to the foregoing technical solution, the injection section comprises a flank perpendicular to the axis of the sheath side hole formed in the outer periphery of the flanking gripping portion, said side end surface side toward the positioning hole formed in sheath portion.

[0012] 本发明还提供一种有效提高临床疗效的椎弓根钉道局部强化组件,其采用的技术方案是: [0012] The present invention further provides an efficient improve the clinical efficacy of topical pedicle screw channel enhancement element, which is used in the technical solutions:

一种椎弓根钉道局部强化组件,用于对椎弓根钉道局部强化,包括: One kind of local reinforcing component pedicle screw path for topical strengthen the pedicle screw path, comprising:

输注器,对所述椎弓根钉道注入骨水泥类生物材料以进行局部强化; Infusion, the bone cement injecting the biomaterial pedicle screw path for the local enhancement;

注射装置,将骨水泥类生物材料注射入输注器并通过输注器到达椎弓根钉道; The injection device, the bone cement injected into the infusion biomaterial and to the pedicle screw path through the infusion set;

作为上述技术方案的进一步改进,所述注射装置包括: As a further improvement of the above-described aspect, the injection device comprises:

针筒式注射器,从开口处对输注通道注入骨水泥类生物材料; Syringe barrel, from the opening of the bone cement injection of biomaterials infusion channel;

推杆,所述推杆与输注通道匹配,用于推出输注通道内残留的骨水泥类生物材料。 A push rod channel matching the infusion, the introduction of bone cement for biological material remaining in the infusion passage.

[0013] 本发明的有益效果是:本发明的侧孔鞘设置了螺旋状分布的侧孔,在侧孔鞘置入钉道后,骨水泥类生物材料可以由输注通道和侧孔流入使对应于侧孔位置的钉道周壁进行局部强化,而侧孔鞘的表面平滑,局部强化钉道周围骨质后易于从钉道内取出,取出后拧入普通的椎弓根螺钉,保证螺钉与局部强化的骨水泥类物质接触的同时仍有部分同周围骨质充分接触,植入螺钉后即刻提高螺钉与钉道界面之间的力学强度,远期可为进一步的钉-骨界面的骨整合提供机会从而达到远期强化椎弓根螺钉固定的目的;同时注射骨水泥强化后,相比于目前存在的空心侧孔螺钉,椎弓根螺钉与骨水泥之间形成的界面存在于螺钉表面,而不存在连通螺钉内外的骨水泥结构,故当旋出螺钉时对椎体骨质的破坏没有太大的影响。 [0013] Advantageous effects of the present invention are: the present invention, the sheath side hole provided with a spiral side holes distributed in the sheath side hole into the screw channel, the bone cement may flow from the biological material passage and infusion side holes so hole position corresponds to the side peripheral wall of the screw channel locally strengthened, while the surface smoothness of the sheath side hole, after intensive local bone surrounding the screw channel easily removed from the screw channel, the pedicle screw is screwed into the ordinary after removing the screws to ensure that the local while strengthening bone cement material still in contact with the surrounding bone full contact portion, and an immediate mechanical strength between the screw and the staple channel interface screws after implantation, the forward staple can be further - provide a bone interface osseointegration the opportunity to achieve long-term strengthening pedicle screw fixing purposes; after simultaneous injection of bone cement reinforced, as compared to the interface between the hollow side of the screw hole, the pedicle screw and the existing bone cement present in the surface of the screw is formed, and cement structure communicating inside and outside of the screw does not exist, so when unscrewing the screw has no significant effect on vertebral bone destruction.

附图说明 BRIEF DESCRIPTION

[0014] 下面结合附图和实施方式对本发明进一步说明。 [0014] The present invention is further described below in conjunction with accompanying drawings and embodiments.

[0015] 图1是侧孔鞘的结构示意图; [0015] FIG. 1 is a schematic view of the sheath side hole;

图2是侧孔鞘与钉道连接状态示意图; FIG 2 is a schematic view of the sheath side hole and the screw channel connection state;

图3是骨水泥类生物材料输注状态示意图; 3 is a schematic infusion of bone cement biomaterial state;

图4是骨水泥类生物材料注入钉道示意图; FIG 4 is a schematic view of bone cement biomaterial injection screw channel;

图5是推杆推出残留骨水泥类生物材料状态示意图; FIG 5 is a schematic view of the push rod Release residual cement-based biomaterial state;

图6是椎弓根螺钉与钉道连接状态示意图。 FIG 6 is a schematic view of a pedicle screw with a screw channel connection state.

具体实施方式 detailed description

[0016] 如图1所示的椎弓根钉道输注器,包括表面平滑的侧孔鞘1,侧孔鞘I为中空的圆柱状结构,其中空部分为沿自身轴线的输注通道2。 [0016] channel infusion pedicle screw shown in Figure 1, comprises a flat surface side of the hole of the sheath 1, the sheath side hole I a hollow cylindrical structure, wherein the hollow portion along its axis infusion channel 2 . 侧孔鞘I的远端为钝圆形尖部并封闭,近端设有连通输注通道2的开口。 The distal end of the sheath side hole I is blunt and rounded tip portion is closed, the communication with the proximal end of the infusion passage opening 2. 侧孔鞘I的侧壁设有若干连通输注通道2的侧孔3,各侧孔3沿侧孔鞘I轴线由远端至近端呈螺旋状分布。 I sidewall of the sheath side hole provided with a plurality of infusion side holes communicating passage 3 2, side holes 3 along the axis of the sheath I from the distal to proximal side holes in a spiral distribution.

[0017] 优选的,侧孔3的直径由远端向近端递减,在注射压力减少的前提下相对较远的侧孔3同样仍能流出较多的骨水泥,保证骨水泥由不同远近的侧孔3流出相对均匀的量。 [0017] Preferably, the diameter of the side hole 3 is decreased from a distal end toward the proximal end, the injection pressure is reduced at a relatively far from the premise of the same side of the hole 3 flowing still more bone cement, the bone cement by a different distance to ensure that the side hole 3 flowing relatively uniform amount.

[0018] 优选的,沿侧孔鞘I的周向每90°设有一个侧孔3,即由远至近每旋转90°即有一个侧孔3,总共有4个这样的侧孔3,其数量适中,符合钉道内局部强化的要求。 [0018] Preferably, along the periphery of the slots of the sheath I is provided to each of 90 ° a side hole 3, i.e. from far to near 90 ° for each rotation i.e., a side hole 3, a total of four such side hole 3, moderate amount, in line with the requirements of local reinforcing screw channel. 侧孔3从远端至近端的直径递减量为0.25mm,最远端的为第一侧孔,第一侧孔直径为2.25mm,之后依次为2mm、1.75mm、1.5mm,而输注通道2的直径为2mm。 The quantity of decreasing diameter from the distal end to the proximal end of the side hole is 0.25mm, the distal-most side of the first hole, a first side holes having a diameter of 2.25mm, followed after 2mm, 1.75mm, 1.5mm, and an infusion passage 2 the diameter of 2mm.

[0019] 优选的,侧孔鞘I近端接有注入段,注入段中部设有连接开口的注入孔4,该注入孔4为通孔,其直径大于输注通道2的内径,保证骨水泥注入时有输注通道2内有足够的压力,同时满足注入孔4能够与针筒式注射器7头部形成良好的连接。 [0019] Preferably, the sheath side hole injection I nearly terminated by a segment, the center section is provided with injection openings of the injection hole 4 connected to the injection hole 4 is a through hole, a diameter larger than the inner diameter of the infusion channel 2 to ensure that the bone cement infusion channel when there is a sufficient injection pressure in the 2, 4 meet the injection hole can be formed with good connection 7 a syringe injector head.

[0020] 优选的,注入段包括垂直于侧孔鞘I轴线的侧翼5,侧翼5的外径大于侧孔鞘I的外径,使得侧翼5的外周形成握持部,便于注射时的把持,侧翼5朝向侧孔鞘I的端面形成定位部,便于侧孔鞘I置入角度的定位和置入深度的掌握。 [0020] Preferably, the injection section comprises flaps perpendicular to the side of the sheath 5 I axis of the bore, an outer diameter larger than the outer diameter of the flank 5 of the sheath side hole of I, such that an outer circumferential-side holding portion 5 is formed, to facilitate gripping during injection, 5 toward the flank face side positioning hole forming portion I of the sheath, the sheath side hole to facilitate positioning angle I and inserted into the depth of the master.

[0021] 本实施例还提供一种椎弓根钉道局部强化组件,用于对椎弓根钉道局部强化,除了上述的输注器外,还包括注射装置和椎弓根螺钉6。 [0021] The present embodiment further provides a pedicle screw path local reinforcing component for strengthening local pedicle screw path, in addition to the infusion, further comprising a pedicle screw and an injection device 6.

[0022] 注射装置用于将骨水泥类生物材料注射入输注器并通过输注器到达椎弓根钉道,其包括针筒式注射器7和推杆8。 [0022] An injection device for injecting bone cement into the biomaterial and to the infusion pedicle screw path by infusion, comprising a syringe plunger of the syringe 7 and 8.

[0023] 针筒注射器从开口处对输注通道2注入骨水泥类生物材料;推杆8直径2_,与输注通道2匹配,用于推出输注通道2内残留的骨水泥类生物材料。 [0023] infusion of the syringe barrel 2 is injected from the opening of the channel-based bone cement biomaterial; 2_ diameter of the push rod 8, and matching an infusion channel 2, Release 2 for the remaining infusion the bone cement passage biomaterial.

[0024] 椎弓根螺钉6为手术中常用的螺钉,用于在输注器取出后拧入钉道。 [0024] pedicle screw 6 surgical screws commonly used for the infusion taken screwed screw channel.

[0025] 本实施例中的椎弓根钉道局部强化组件使用方法如下: [0025] The present embodiment pedicle screw assembly using the local reinforcing channel as follows:

O预先使用手钻在椎体内常规制备钉道; O in advance using a conventional hand drill within the vertebral body prepared staple channel;

2)当确认钉道位置良好后,调制可强化钉道周壁的骨水泥类生物材料,并将其抽入针筒式注射器7内; 2) When the confirmation good staple track position, modulation may strengthen bone cement biomaterial staple passage peripheral wall, and is drawn into the syringe barrel 7;

3)如图2所示,向钉道内插入侧孔鞘I ; 3) As shown in FIG 2, is inserted into the sheath side hole into the screw channel I;

4)如图3和图4所示,在注入孔4中连接针筒式注射器7,逐渐将一定体积的骨水泥类生物材料推入侧孔鞘I内,使其沿侧孔鞘I的侧孔3流出至钉道内,在一定压力下,流出的骨水泥材料沿椎弓根钉道在侧孔3周围的骨质内呈螺旋形分布,分布范围在椎体中部及椎弓根腹侧部; 4) As shown in FIG. 3 and FIG. 4, a syringe connected to the injector 7 in the injection hole 4, and gradually a volume of biomaterial bone cement is pushed into the side hole I sheath, the sheath side hole along its side I of holes into the screw channel 3 flows, under pressure, flows along the bone cement pedicle screw path within the spirally shaped distribution around the side of the bone hole 3, and the distribution in the middle of the vertebral pedicle ventral portion ;

5)如图5所示,解除针筒式注射器7连接,向侧孔鞘I内插入推杆8,将残存于鞘内的骨水泥完全推注至鞘外周围骨质,对螺钉钉道形成规律性强化; 5) 5, 7 connected to syringe barrel is released, I inserted laterally push rod sheath hole 8, remaining in the fully pushed intrathecal injection of bone cement to the bone around the outer sheath, forming screw pilot regularity strengthening;

6)在骨水泥未凝固前,拔出侧孔鞘I及推杆8 ; 6) Before unset cement, pulled out of the sheath side hole and the push rod 8 I;

7)如图6所示,骨水泥硬化前,将相应直径的普通椎弓根螺钉6沿此经局部强化处理的钉道拧入,确定椎弓根螺钉6位置良好后,安装内固定装置,即可完成。 7) shown in FIG. 6, the front hardened cement, the respective diameters of 6 common pedicle screw along the screw channel via local reinforcing screwing process, well after determining pedicle screw 6 position, the mounting fixture, to complete.

[0026] 由于螺钉的把持力取决于螺钉螺纹与螺纹周围骨质的界面强度,因此,当强化材料经侧孔对钉道周壁进行强化后,可在一定程度上提高界面力学强度,进而增加螺钉把持力,达到强化螺钉固定的目的。 [0026] Since the gripping force is dependent on the screw threads of the screw thread interfacial strength of the surrounding bone, thus strengthening through the side hole when the screw channel circumferential wall material intensive, mechanical strength of the interface can be improved to some extent, thus increasing the screw gripping force, to strengthen the fixing screws purposes. 传统技术中骨水泥强化主要集中在螺钉的前端或是钉道全长,前者没有对椎弓根部位的骨质进行强化,而后者则因钉道全长灌注骨水泥,增加了其渗漏至椎管导致严重手术并发症的风险。 Cement enhancing conventional art mainly in the front end or the entire length of the screw channel of the screw, the former does not temper the pedicle bone site, and the entire length of the latter due to the screw channel filling bone cement, which increases the leakage to spinal resulting in serious risk of surgical complications. 通过侧孔鞘,实现了对骨质疏松椎体的部分椎体和部分椎弓根的局部强化,同时又保留了钉-骨接触的界面,通过界面结构的稳定,实现了即刻的螺钉稳定性及远期通过骨整合获得的牢固的螺钉稳定性,提高置入椎弓根螺钉的近、远期把持力。 Hole through the side sheath, to achieve a partial strengthening of the vertebral body portion and a portion of osteoporotic vertebral pedicle, while retaining the staple - bone contact interface, by stabilizing the interface structure, the stability of the screw to achieve the immediate long-term stability and solidity of the screw obtained by the osseointegration, pedicle screw improve short and long term gripping force.

[0027] 本实施例一是通过椎弓根局部强化螺钉组件对钉道周壁进行局部强化,在保证螺钉与骨质充分接触的同时,提高螺钉与钉道界面之间的力学强度,达到强化椎弓根螺钉固定的目的;二是骨水泥在钉道周壁骨质中的局部分布、强化,避免了因骨水泥完全包裹螺钉所带来的二次界面存留影响长期稳定性、以及骨水泥因灌注不当可能泄露到椎管内热损伤神经等问题,有效的提高临床疗效,减少手术失败发生率。 [0027] One embodiment according to the present embodiment of the peripheral wall of the screw channel is locally reinforced by reinforcing pedicle screw assembly topical, ensuring sufficient contact with the bone screw, while improving the mechanical strength between the screw and the screw channel interface, to strengthen the vertebral the object of the pedicle screws; second local distribution of bone cement in the screw channel in the peripheral wall of bone strengthening avoided completely surrounded by bone cement screw retention caused by the secondary interface affect long-term stability, and by filling the bone cement improper disclosure of heat damage to the spinal nerves and other issues, effectively improve the clinical efficacy and reduce the incidence of surgical failure. 相较之以往的钉道全长强化或椎体部分强化,本发明装置既强化了椎体部位,又强化了椎体的椎弓根部位,同时,在提高椎弓根螺钉固定强度的同时,减少术后椎弓根螺钉取出对椎体和椎弓根骨质的破坏,降低螺钉取出对脊柱稳定性的影响。 Compared to the conventional full-length staple channel vertebral portions of the reinforcing or strengthening, the present invention means not only to strengthen the vertebral site, and a reinforced portion of the pedicle of the vertebral body, while, at the same time improving the fixing strength of the pedicle screw, reduce postoperative vertebral pedicle screw and remove the damage to the pedicle bone, reducing the impact on the stability of the spinal screw removed.

[0028] 另外,针对需要在术后将椎弓根螺钉取出的情况,本实施例注射骨水泥强化后螺钉与骨水泥之间形成的界面存在于螺钉表面,当旋出螺钉时对椎体骨质的破坏没有太大的影响。 After the interface [0028] Further, if necessary after surgery for pedicle screw removed, the present embodiment the injection of bone cement is formed between the screw and the reinforcing embodiment is present in the cement surface of the screw, the screw when unscrewed vertebral bone It does not affect the quality of much of the destruction.

[0029] 以上所述只是本发明优选的实施方式,其并不构成对本发明保护范围的限制。 [0029] The above are only preferred embodiments of the present invention, which do not limit the scope of the present invention.

Claims (8)

1.一种椎弓根钉道输注器,其特征在于:包括表面平滑的侧孔鞘(I),所述侧孔鞘(I)中部沿自身轴线设有输注通道(2),所述侧孔鞘(I)的远端封闭,近端设有连通输注通道(2)的开口,所述侧孔鞘⑴的侧壁设有若干连通输注通道(2)的侧孔(3),所述各侧孔(3)沿侧孔鞘(I)轴线由远端至近端呈螺旋状分布。 A pedicle screw infusion channel, wherein: a surface smoothness of the sheath side hole (I), the sheath side hole (I) is provided with an infusion passage along its central axis (2), the said distal end of the sheath side hole (I) is closed, the communication with the proximal end of the infusion channel (2) opening of a sidewall of the sheath side hole provided with a plurality of communication ⑴ infusion channel (2) a side hole (3 ), each of said side hole (3) along the side hole of the sheath (I) from the distal to proximal axis spiral profile.
2.根据权利要求1所述的椎弓根钉道输注器,其特征在于:所述侧孔(3)的直径由远端向近端递减。 The pedicle screw channel infusion according to claim 1, wherein: the diameter of the side hole (3) is decreased from the distal end toward the proximal end.
3.根据权利要求2所述的椎弓根钉道输注器,其特征在于:所述侧孔(3)从远端至近端的直径递减量为0.25_,所述输注通道(2)的直径为2_。 The infusion of the pedicle screw channel of claim 2, wherein: said side hole (3) decrement in diameter from distal to proximal to 0.25_, said infusion channel (2) 2_ diameter.
4.根据权利要求1或2或3所述的椎弓根钉道输注器,其特征在于:沿所述侧孔鞘(I)的周向每90°设有一个侧孔(3)。 The pedicle screw infusion channel 1, 2 or claim 3, wherein: along the sheath side hole (I) is provided with a circumferential side opening (3) to each of 90 °.
5.根据权利要求1或2或3所述的椎弓根钉道输注器,其特征在于:所述侧孔鞘(I)近端接有注入段,所述注入段设有连接开口的注入孔(4),所述注入孔(4)的直径大于输注通道(2)的内径。 The pedicle screw infusion channel 1, 2 or claim 3, wherein: said sheath side hole (I) terminating near an injection period, the injection section is provided with a connecting opening the diameter of the injection hole (4), said injection hole (4) is greater than the infusion channel (2) inner diameter.
6.根据权利要求5所述的椎弓根钉道输注器,其特征在于:所述注入段包括垂直于侧孔鞘(I)轴线的侧翼(5),所述侧翼(5)的外周形成握持部,所述侧翼(5)朝向侧孔鞘(I)的端面形成定位部。 The injection section comprises an outer circumferential side aperture flanking sheath (I) perpendicular to the axis (5), said flaps (5): The pedicle screw according to claim 5, wherein the infusion channel, wherein forming a grip portion, said side (5) toward the sheath side hole (I) formed in the end surface of the positioning portion.
7.一种椎弓根钉道局部强化组件,用于对椎弓根钉道局部强化,其特征在于,包括: 权利要求1至6任一项所述的输注器,对所述椎弓根钉道注入骨水泥类生物材料以进行局部强化; 注射装置,将骨水泥类生物材料注射入输注器并通过输注器到达椎弓根钉道。 A pedicle screw assembly to strengthen local channel for topical strengthen the pedicle screw channel, characterized by comprising: any one of claims 1 to 6, claim infusion, the arch nails bone cement injection channel based biomaterial local enhancement; injection means, the bone cement injected into the infusion biomaterial and to the pedicle screw path through the infusion.
8.根据权利要求7所述的椎弓根钉道输注器,其特征在于,所述注射装置包括: 针筒式注射器(7),从开口处对输注通道(2)注入骨水泥类生物材料; 推杆(8),所述推杆(8)与输注通道(2)匹配,用于推出输注通道(2)内残留的骨水泥类生物材料。 Pedicle screw according to claim 7 of the infusion channel, wherein said injection device comprising: a syringe barrel (7), from the opening of the injection of bone cement infusion channel (2) biological material; pusher (8), said push rod (8) with an infusion channel (2) matches for the introduction of the infusion channel (2) remaining in the bone cement biomaterial.
CN 201410625607 2014-11-06 2014-11-06 Pedicle screw path infusion device and pedicle screw path local reinforcing assembly CN104382642A (en)

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