CN105596077A - Universal screw-setting device for pedicle screw - Google Patents

Universal screw-setting device for pedicle screw Download PDF

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Publication number
CN105596077A
CN105596077A CN201610082225.5A CN201610082225A CN105596077A CN 105596077 A CN105596077 A CN 105596077A CN 201610082225 A CN201610082225 A CN 201610082225A CN 105596077 A CN105596077 A CN 105596077A
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CN
China
Prior art keywords
puncture
screw
guide
needle
end
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CN201610082225.5A
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Chinese (zh)
Inventor
贺新宁
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贺新宁
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Priority to CN201610082225.5A priority Critical patent/CN105596077A/en
Publication of CN105596077A publication Critical patent/CN105596077A/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3415Trocars; Puncturing needles for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3468Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3472Trocars; Puncturing needles for bones, e.g. intraosseus injections
    • 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
    • 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
    • A61B2017/564Methods for bone or joint treatment
    • 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
    • A61B2017/90Guides therefor

Abstract

The invention provides a universal screw-setting device for a pedicle screw. The universal screw-setting device for the pedicle screw comprises a puncture cone, a guide needle, an expanding core, a screw-setting guide sleeve, a hollow flat file, a hollow screw tap and a nailing device, wherein the puncture cone comprises a puncture sleeve and a puncture cone needle; the puncture sleeve is a hollow pipe; the front end of the puncture sleeve is tapered; an expanded holding part is arranged at the rear end of the puncture needle; the hollow core of the holding part is expanded and is provided with an inner thread region; the puncture cone needle is needle-like; the front end of the puncture cone needle is tapered; the tail end is expanded and is provided with an outer thread; the puncture cone needle is inserted into the puncture sleeve; after the outer thread at the tail end of the puncture cone needle is matched and identical with the inner thread at the rear end of the puncture sleeve, the tapered tip at the front end of the puncture cone needle is exposed out of the front end of the puncture sleeve and is identical with the taper shape of the front end of the puncture sleeve; a scale is arranged on the surface of the puncture sleeve; the guide needle is needle-like and is used for being inserted into a vertebral pedicle inlet through the puncture sleeve to determine the screw-setting position; and the scale is arranged on the surface of the guide needle. According to the universal screw-setting device for the pedicle screw, the hollow or solid pedicle screw can be accurately set into a vertebral pedicle and a vertebral body.

Description

一种椎弓根螺钉的通用置钉装置 Universal apparatus for pedicle screws pedicle screw

技术领域 FIELD

[0001]本发明涉及骨科手术医疗器械领域,具体涉及一种椎弓根螺钉的通用置钉装置。 [0001] The present invention relates to the field of orthopedic medical devices, particularly relates to a universal device for screw placement of pedicle screws.

背景技术 Background technique

[0002]椎弓根螺钉技术具有三柱固定优势,是一种非常成熟的脊柱外科技术,已被广泛应用。 [0002] Pedicle screw fixation technique has the advantages of the three columns, is a very mature spinal surgical techniques, has been widely used. 传统方法是采用后路切口开放式手术,需广泛剥离椎旁肌、韧带等结构,容易导致椎旁肌丧失神经支配,患者易遗留腰背疼痛,僵硬等后遗症。 The traditional method is to use the posterior open surgical incision, extensive dissection required paraspinal muscles, ligaments and other structures, easily lead to loss of innervation paravertebral muscles, patients tend to left back pain, stiffness and other sequelae. 且该手术创伤大、出血多,住院时间长,增加了病人痛苦和经济负担。 And the surgical trauma, bleeding, long hospital stay, increased patient suffering and economic burden. 近几年来经皮微创椎弓根螺钉技术应用于临床,创伤小,失血少,恢复快,并取得了一定疗效。 In recent years, minimally invasive percutaneous pedicle screw technique used in clinical, less trauma, less blood loss, faster recovery, and achieved a certain effect. 目前经皮椎弓根钉系统及相应的微创手术器械大都采用空心活动轴椎弓根钉,预设棒的长度和弧度,然而空心椎弓根螺钉的强度比实心椎弓根螺钉的强度降低30 %,活动轴椎弓根螺钉比固定轴椎弓根螺钉的复位能力差,尚无对实心固定轴椎弓根钉进行置钉的相应装置,难以对实心固定轴椎弓根螺钉置钉位置准确控制,使得置钉精度较低,难度大。 Currently percutaneous pedicle screw system and the corresponding use of minimally invasive surgical instrument mostly hollow movable shaft pedicle screw, and a predetermined arc length of the rod, however, reduce the strength of the pedicle screw hollow specific strength solid pedicle screw 30%, the difference between the reset capability of the screw shaft pedicle screw pedicle activity than the fixed shaft, there is no solid fixed shaft of the pedicle screw means for opposing the respective nail, it is difficult to solid fixed shaft pedicle screw placement position precise control, so that the lower screw placement accuracy difficult.

发明内容 SUMMARY

[0003]本发明要解决的技术问题是克服现有技术存在的不足,提供一种操作简单方便、置钉精准、可用于空心固定轴或活动轴椎弓根螺钉和实心固定轴或活动轴椎弓根螺钉置钉的椎弓根螺钉的通用置钉装置。 [0003] The present invention is to solve the technical problem to overcome the disadvantages of the prior art, to provide easy, precise operating a pedicle screw, a hollow fixed shaft can be used for pedicle screw and the movable shaft or the fixed shaft or a solid shaft activity vertebral Generalized Markup staple means of a pedicle screw of pedicle screw placement.

[0004]为解决上述技术问题,本发明采用以下技术方案: [0004] To solve the above problems, the present invention employs the following technical solution:

[0005] —种椎弓根螺钉的通用置钉装置,包括穿刺锥、导针、扩张芯、置钉导向套筒、空心平突锉、空心丝攻和上钉器,所述穿刺锥包括穿刺套管和穿刺锥针,穿刺套管为空心管,穿刺套管的前端为锥形,穿刺套管的后端设有膨大的手握部,手握部内空心扩大并设有内螺纹,穿刺锥针为针状,穿刺锥针的前端为锥形,穿刺锥针的尾端膨大并设有外螺纹,穿刺锥针插入穿刺套管中,当穿刺锥针尾端的外螺纹与穿刺套管后端的内螺纹匹配吻合后穿刺锥针前端的锥形尖露出穿刺套管前端并与穿刺套管前端的锥形吻合,穿刺套管表面有刻度;所述的导针为针状,用于经穿刺套管插入椎弓根入口中确定置钉位置,导针表面有刻度。 [0005] - Generalized Markup staple means species of the pedicle screw, comprising a piercing cone, the guide pin, the core expanded, pedicle screw guide sleeve, projecting hollow flat file, and tapping on the hollow staple, said puncturing comprises puncturing cone and a piercing needle cannula cone, hollow tube of the puncture cannula, the puncture cannula distal end is tapered, the rear end of the sleeve is provided with a grip portion puncture dilated, expanded and provided with a hollow internal thread grip portion, the piercing cone acicular needle tip of the puncture needle is tapered cone, the cone tail puncture needle and inflated with an external thread, puncturing the insertion puncture needle cannula tapered, the rear end of the sleeve when the outer thread puncture trailing end of the awl after stapling matching tapered internal threads distal tip of the puncture needle cone end of the pin is exposed and punctured with the tapered distal anastomosis puncture cannula, the puncture cannula with a graduated surface; said needle guide a needle, for piercing through the cover an inlet tube is inserted into the pedicle screw placement location is determined, the surface of the guide pin with scale.

[0006] 上述的通用置钉装置,优选的,还包括导丝,所述导丝为细长的丝,其直径小于等于导针直径,长度大于导针的长度。 [0006] The general pedicle screw device, preferably, further comprising a guide wire, the guide wire is an elongated wire having a diameter smaller than a diameter equal to the guide pin, guide pin of length greater than the length.

[0007] 上述的通用置钉装置,优选的,所述扩张芯包括沿轴线上具有导针通孔的圆柱体,圆柱体的外径与椎弓根螺钉的钉座外径相同;圆柱体的一端呈圆锥形,另一端为手持部。 [0007] The general pedicle screw means, preferably of the expandable core pin comprises a cylinder having a through hole on the guide along an axis, the outer diameter of the same anvil cylinder the outer diameter of the pedicle screw; cylinder conical end, the other end of the hand-held portion.

[0008]上述的通用置钉装置,优选的,所述置钉导向套筒包括沿轴线上具有椎弓根螺钉通孔的圆筒体,圆筒体的一端为环形锯齿状,另一端固定连接有第一手持横柄,圆筒体的长度小于扩张芯的圆柱体的长度,圆筒体的长度大于椎弓根螺钉的钉体、钉座和可折断长臂的总长度。 [0008] The general pedicle screw means, preferably of the screw placement guide sleeve comprises a cylindrical body having at one end a through hole on the pedicle screw along the axis of the annular toothed cylinder, and the other end fixedly connected a first cross-holding handle, length, length of the cylindrical body, the cylindrical body is less than the expansion of the core is greater than the pedicle screw cylinder body staples, the anvil body and the total length of the long arm breakable.

[0009] 上述的通用置钉装置,优选的,所述的空心平突锉包括沿轴线上具有导针通孔的锉杆,锉杆的外径与椎弓根螺钉的钉体外径相同,锉杆的一端固定连接有锉头,另一端固定连接第二手持横柄,锉头端面设有磨齿,周缘设有钻花样螺纹;所述空心丝攻包括沿轴线上具有导针通孔的丝攻杆,丝攻杆的外径与椎弓根螺钉的钉体外径相同,丝攻杆的一端固定连接有丝攻头,另一端固定连接第三手持横柄,丝攻头的外周设有与椎弓根螺钉钉体匹配的螺纹齿道。 [0009] The general pedicle screw device, preferably, the projecting flat file comprising a hollow filing needle guide rod having a through hole along the axis of the same outer diameter as the staple body pedicle screw rod file, file the end of the rod is fixedly connected with a rasping head, the other end connected to the second cross-holding handle, with the head end surface grinding teeth file, the peripheral edge is provided with a threaded drill pattern; comprising tapping said hollow filaments having a guide pin through hole along the axis tapping rod with the same outer diameter as the staple member of the pedicle screw tapping rod, one end of the tapping rod is fixedly connected with a tapping head, and the other end fixedly connected to the third cross-holding shank, the outer periphery of the wire-tapping head is provided with vertebral pedicle screw nail thread tooth-matched channel.

[0010]上述的通用置钉装置,优选的,所述上钉器包括撑杆、固接于撑杆一端的塞头和固接于撑杆另一端的第四手持横柄,撑杆上套设有可转动的锁臂管,锁臂管靠近塞头的一端外表面具有与可折断长臂内表面内螺纹匹配的外螺纹,锁臂管的另一端固定连接有用于转动锁臂管的旋转帽,锁臂管上套设有螺钉导向环和旋转手柄,螺钉导向环位于靠近塞头一侦U,旋转手柄位于靠近第四手持横柄一侧,螺钉导向环的外径与椎弓根螺钉的钉座外径相同,锁臂管上还设有通过旋拧抵紧或松开撑杆的止转螺钉,所述上钉器还具有导丝通孔,导丝通孔沿撑杆轴向贯穿塞头、撑杆和第四手持横柄。 [0010] The general pedicle screw device, preferably, the upper strut includes a staple, fixed to an end of the strut and a fourth plug shank holding cross-brace fixed to the other end, the stay sleeved a lock arm rotatable tube, the outer end of the tube near the surface of the plug having a locking arm locking arm rotates the rotary cap tube and the inner breakable external thread matching a threaded inner surface of the long arm, the other end of the locking arm is fixedly connected to pipes for the locking arm is provided with a screw guide sleeve tube ring and the rotary handle, the screw guide ring located adjacent a plug investigation U, rotation of the handle located adjacent a fourth side of the handheld cross handle, the outer diameter of the screw and the guide ring pedicle screw nail the same as the outer diameter of the seat, also a rotation stop screw by screwing abutment tightened or loosened on the locking arm strut tube, on the staple guide wire further having a through hole, the guide wire through the through hole in the plug axial struts head, cross brace and fourth handheld handle.

[0011] 上述的通用置钉装置,优选的,所述塞头上还设有凸起,凸起用于插入活动轴椎弓根螺钉的球头中拧紧活动轴椎弓根螺钉的钉体,所述导丝通孔贯通所述凸起。 [0011] The general pedicle screw device, preferably, the plug head is also provided with a projection, the projection movable shaft for insertion into the pedicle screw ball head pedicle screw tightening staple movable shaft member, the said guidewire through hole penetrating said projection.

[0012]与现有技术相比,本发明的优点在于:本发明椎弓根螺钉的通用置钉装置,解决了现有技术中存在实心固定轴椎弓根螺钉置钉难及精确低的技术问题,其通用于空心固定轴或活动轴椎弓根螺钉和实心固定轴或活动轴椎弓根螺钉的精确置钉,具有操作灵活、简便、快捷、精准的优点。 [0012] Compared with the prior art, advantages of the present invention is: Generalized Markup staple pedicle screw device of the invention solves the difficult pedicle screw placement accuracy and low solid fixed shaft in the art exists in the prior art problem, which is common to the movable shaft or a hollow shaft fixed pedicle screw placement accuracy and a solid screw shaft or a movable shaft fixed pedicle screw, having a flexible operation, simple, fast, accurate advantages.

附图说明 BRIEF DESCRIPTION

[0013]图1为穿刺锥的结构示意图。 [0013] FIG. 1 is a schematic view of the piercing cone.

[0014]图2为穿刺锥的剖视结构示意图。 [0014] FIG. 2 is a schematic cross-sectional view of the structure of the piercing cone.

[0015]图3为导针的结构示意图。 [0015] FIG. 3 is a schematic structural diagram of guide pin.

[0016]图4为扩张芯的立体结构示意图。 [0016] FIG. 4 is a perspective schematic structural view of the expansion core.

[0017]图5为扩张芯的剖视结构示意图。 [0017] FIG. 5 is a schematic cross-sectional view of the expansion of the core structure.

[0018]图6为置钉导向套筒的结构示意图。 [0018] FIG. 6 is a schematic view of the screw placement guide sleeve.

[0019]图7为空心平突锉的结构示意图。 [0019] FIG. 7 is a schematic view of a hollow flat projecting burrs.

[0020]图8为空心丝攻的结构示意图。 [0020] FIG. 8 is a schematic view of a hollow wire tapping.

[0021 ]图9为不具有凸起的空心上钉器的结构示意图。 [0021] FIG. 9 is a schematic view of the staple hollow structure having no projection.

[0022]图10为具有凸起的空心上钉器的结构示意图。 [0022] FIG. 10 is a schematic structural diagram of a projection having a hollow staple.

[0023]图11为导丝的结构示意图。 [0023] FIG. 11 is a schematic structural diagram of the guidewire.

[0024]图12为固定轴椎弓根螺钉的结构示意图。 [0024] FIG. 12 is a schematic view of a fixed pedicle screw axis.

[0025]图13为活动轴椎弓根螺钉的结构示意图。 [0025] FIG. 13 is a schematic view of the movable shaft of the pedicle screw.

[0026]图14为活动轴椎弓根螺钉的钉体和球头结构的示意图。 [0026] FIG. 14 is a schematic view of the staple body and the movable shaft structure of a ball head of a pedicle screw.

[0027]图15为活动轴椎弓根螺钉的螺塞的结构示意图。 [0027] FIG. 15 is a schematic view of the movable shaft of the pedicle screw plug.

[0028]图16为活动轴椎弓根螺钉的球头压垫的结构示意图。 [0028] FIG. 16 is a schematic view of the movable shaft of the pedicle screw ball head pressure pad.

[0029]图例说明: [0029] Legend:

[0030] 1、椎弓根螺钉;10、钉体;11、钉座;12、可折断长臂;13、螺塞;14、U形结构;15、球头;16、球头压垫;17、持塞孔;18、凹切迹;3、穿刺锥;31、穿刺套管;32、穿刺锥针;33、手握部;4、导针;5、扩张芯;51、圆柱体;6、置钉导向套筒;61、圆筒体;62、第一手持横柄;7、上钉器;71、撑杆;7 2、塞头;73、第四手持横柄;74、锁臂管;75、旋转帽;76、螺钉导向环;77、旋转手柄;78、止转螺钉;79、凸起;9、导丝;100、空心平突锉;101、锉杆;102、第二手持横柄;103、锉头;200、空心丝攻;201、丝攻杆;202、第三手持横柄;203、丝攻头。 [0030] 1, pedicle screw; 10, the staple member; 11, anvil; 12, a long arm broken; 13, plugs; 14, U-shaped structure; 15 ball; 16, ball pressure pad; 17, holding plug hole; 18, concave notch; 3, puncture cone; 31, puncture tube; 32, a puncture awl; 33, holding unit; 4, guide pin; 5, expansion die; 51, a cylinder; 6, pedicle screw guide sleeve; 61, the cylindrical member; 62, a first lateral holding handle; 7, the staple; 71, struts; 72, plug; 73, fourth cross-holding shank; 74, tube locking arm ; 75, rotation of the cap; 76, the screw guide ring; 77, rotation of the handle; 78, detent screws; 79, projection; 9, guidewire; 100, projecting hollow flat file; 101, filing rod; 102, second hand cross-holding shank; 103, file header; 200, hollow fiber attack; 201, tapping rod; 202, a third cross-holding shank; 203, tapping head.

具体实施方式 Detailed ways

[0031]以下结合附图和具体实施例对本发明作进一步详细说明。 [0031] Further detailed description and specific embodiments of the present invention is made in conjunction with the following drawings.

[0032] 如图12至图16所示,椎弓根螺钉I包括钉体1、钉座11、两条可折断长臂12和螺塞13,钉体10与钉座11连接,两条可折断长臂12对立地固定连接于钉座11上形成U形结构14,U形结构14中用于嵌入纵连棒,螺塞13用于拧入两条可折断长臂12的U形结构14中压紧纵连棒。 [0032] As shown in FIGS. 12 to pedicle screw 16 includes a nail body I 1, anvil 11, the long arm 12 and two breakable plug 13, anvil 10 and the staple body 11 is connected, may be two breaking the long arm 12 is fixedly connected to the oppositely U-shaped structure 14 is formed on the anvil 11, a U-shaped structure 14 for inserting the rod longitudinally connected, plug 13 for screwing in two breakable long arm 12 of the U-shaped structure 14 a vertical rod connected in the pressing. 钉体10为实心或空心,空心钉体10沿轴向具有导针4通孔,钉体10上设有螺纹。 Staple member 10 is solid or hollow 10 in the axial direction, the hollow screw body has a guide pin through hole 4, the staple member 10 is provided with a thread.

[0033]两条可折断长臂12的内表面具有内螺纹,如图15所示,螺塞13的外表面具有与可折断长臂12内表面内螺纹匹配的外螺纹,螺塞13的一端具有持塞孔17,两条可折断长臂12远离钉座11的尾部还设有光滑段,当螺塞13沿可折断长臂12之间插入时,光滑段对螺塞13起导向作用。 [0033] The two breakable inner surface of the long arm 12 having an internally threaded, as shown, the outer surface of the plug 13 has an external thread and the inner surface of the long arm breakable matching threads 12 in FIG. 15, one end 13 of the plug a plug having a holding hole 17, two breakable tail long arm 12 away from the staple holder 11 is also provided with a smooth section 13 when the plug 12 along the break between the long arm can be inserted from the guide 13 smooth section of the plug.

[0034]椎弓根螺钉I可根据需要设置成固定轴椎弓根螺钉I和/或活动轴椎弓根螺钉1,钉体10为实心或空心,空心钉体10沿轴向具有导针4通孔。 [0034] I pedicle screw may be set to a fixed pedicle screw shaft I and / or necessary movable shaft pedicle screw 1, the staple 10 is solid or hollow body, the hollow screw body has a guide pin 10 in the axial direction 4 through-hole. 例如,固定轴椎弓根螺钉I的结构如图1所示,由于钉体10与钉座11固定连接,使得钉体10不能相对钉座11运动,因此形成固定轴椎弓根螺钉I。 For example, a pedicle screw fixed shaft structure I is shown in Figure 1, since the staple 10 and the anvil 11 is fixedly connected, so that the staple member 10 incapable of relative motion of the staple holder 11, thus forming a fixed pedicle screw shaft I. 钉座11为短圆柱形,两条可折断长臂12与钉座11固定连接。 11 is a short cylindrical anvil, two breakable long arm 12 and the staple holder 11 is fixedly connected.

[0035]活动轴椎弓根螺钉I的结构如图2所示,钉座11为空心结构,内置有球头15和球头压垫16。 [0035] The movable shaft structure I pedicle screw shown in Figure 2, the staple holder 11 is a hollow structure, built-in ball 15 and the ball head pressure pad 16. 其中钉体10与球头15固定连接,球头压垫16位于钉座11的中空结构内,并压在球头15上。 Wherein the staple body 10 is fixedly connected to the ball head 15, the anvil 16 located in the hollow structure of the ball head pressure pad 11, and pressed against the ball head 15. 球头压垫16也为中空结构,如图16所示,使得纵连棒可嵌入U形结构14中并压在球头压垫16上。 Ball head pressure pad 16 is also a hollow structure, as shown in Figure 16, so that even the vertical rods may be embedded in the U-shaped structure 14 is pressed against the ball head and the pressure pad 16. 球头15上有多边形凹槽,如图14所示。 Ball head has a polygonal recess 15, as shown in FIG. 球头15与钉座11之间活动连接。 Ball head 15 is connected between the movable anvil 11. 在U形结构14中纵连棒的压力作用下,钉体10和钉座11的位置被固定。 In the U-shaped structure in vertical and 14 bar pressure, the position of the staple body 10 and the staple holder 11 is fixed. 活动轴椎弓根螺钉I中由于球头15与钉座11活动连接,使得钉体1在各个方向有一定活动度,利于三节椎体以上的固定。 I pedicle screw movable shaft due to the ball head 15 is connected to the anvil 11 activity, such that the staple 1 has a certain activity in all directions, three or more vertebrae facilitate fixing.

[0036]与普通固定轴椎弓根螺钉I相比,固定轴和活动轴椎弓根螺钉I有短圆柱形钉座U,可折断长臂12尾端的光滑段对螺塞13起导向作用,便于拧入螺塞13;同时钉座11对椎弓根螺钉I在置钉导向套筒6内的滑动时起方向控制作用;钉体10为实心或空心,钉体10实心较空心作用力强,空心钉体10可沿导丝9拧入,置钉准确率高。 [0036] I compared with the conventional screw pedicle fixed shaft, fixed shaft and the movable shaft pedicle screw has a short cylindrical anvil I U, breakable plug 13 serves as a guide for a smooth tail end segment 12 of the long arm, facilitates screwing plug 13; also plays the role of controlling the direction of the slide anvil 11 pairs of opposing pedicle screws I within the staple guide sleeve 6; staple solid or hollow body 10, the staple member 10 than the hollow solid strong effect , the hollow screw 9 can be screwed into the body 10 along the guide wire, high accuracy pedicle screw.

[0037]优选情况下,为更好的折断椎弓根螺钉I的长臂,椎弓根螺钉I的两条可折断长臂12上靠近钉座11的一端处设有凹切迹18。 The [0037] Preferably, for better breaking the long arm of the pedicle screw I, two pedicle screws may break I anvil 11 near one end of the notch 18 is provided with a recess 12 on the long arm. 凹切迹18处较破弱,可将可折断长臂12在此处折断。 Recessed notch 18 at the relatively weak breaking, breaking the long arm 12 can be broken here.

[0038]本发明椎弓根螺钉的通用置钉装置,包括穿刺锥3、导针4、扩张芯5、置钉导向套筒 [0038] Generalized Markup staple device of the present invention, a pedicle screw, comprising a piercing cone 3, the guide pin 4, the expansion die 5, pedicle screw guide sleeve

6、空心平突锉100、空心丝攻200和上钉器7,其中,穿刺锥3和导针4用于确定置钉位置。 6, hollow protrusions flat file 100, 200 and the upper hollow tapping staple 7, wherein the puncture needle 4 and the guide cone 3 for determining the position of the pedicle screw. 如图1和图2所示,穿刺锥3包括穿刺套管31和穿刺锥针32。 As shown in FIG. 1 and 2, a cone 3 comprises a piercing cannula 31 piercing the puncture needle 32 cone. 穿刺套管31为空心管,前端为锥形,后端设有膨大的手握部33,手握部33内空心扩大并设有内螺纹,穿刺锥针32为针状,穿刺锥针32的前端也为锥形,穿刺锥针32的尾端膨大并设有外螺纹,穿刺锥针32插入穿刺套管31中,当穿刺锥针32尾端的外螺纹与穿刺套管31后端的内螺纹匹配吻合后穿刺锥针32前端的锥形尖露出穿刺套管31前端并与穿刺套管31前端的锥形吻合。 Puncture cannula 31 is a hollow tube, a tapered distal end, a rear end of the grip portion 33 is provided with enlarged, hollow enlarged grip portion 33 and has an internal thread, the taper needle 32 is a needle puncture, the puncture needle 32 of the cone , a tapered distal end, the trailing end of the puncture needle cone 32 and externally threaded enlargement, the puncture needle 32 is inserted into the tapered puncture cannula 31, when the rear end of the internal thread 31 matching external thread 32 and the trailing end of the puncture cannula puncture awl anastomosis puncture needle 32 distal tapered conical distal tip 31 is exposed and punctured with the puncture cannula the tip of the conical sleeve 31 coincide. 穿刺套管31表面有刻度,可测定穿刺锥3的插入深度。 Surface 31 has a scale puncture cannula, the insertion depth can be determined puncturing cone 3.

[0039]如图3所示,导针4为针状,用于从穿刺套管31中拔出穿刺锥针32后再插入,确定置钉位置。 [0039] As shown in FIG 3, a needle guide pin 4, for extracting from the puncture awl 31 32 before inserting the puncture cannula, opposite the staple position is determined. 导针4的表面有刻度。 Surface of the guide pin 4 is provided with a scale. 导针4从穿刺套管31中插入至椎体中部后,拔出穿刺套管31,留置导针4。 After the guide needle 4 is inserted from the puncture tube 31 to the middle of the vertebral body, pull out the puncture tube 31, indwelling guide pin 4.

[0040] 本实施例中,还包括导丝9,如图11所示,导丝9为细长的丝,其直径小于等于导针4直径,长度大于导针4的长度。 [0040] In this embodiment, further comprising a guidewire 9, 11, the guidewire 9 is an elongated wire having a diameter smaller than a diameter equal to the guide pin 4, the guide length greater than the length of the needle 4.

[0041]本实施例中,扩张芯5包括沿轴线上具有导针4通孔的圆柱体51,如图4和图5所示。 [0041] In this embodiment, the expansion die 5 comprises a cylindrical body 51 having a through hole 4 along the axis of the guide pin, as shown in Figures 4 and 5. 圆柱体51的外径与椎弓根螺钉I的钉座11外径相同。 The outer diameter of the cylinder 11 and the outer diameter of the pedicle screw anvil 51 I of the same. 圆柱体51的一端呈圆锥形,另一端为手持部。 The conical end of the cylinder 51, the other end of the hand-held portion. 扩张芯5沿导针4旋入,一次性扩张肌肉通道,头端抵达椎弓根入口骨面。 Expansion of the core 5 along the guide pin 4 is screwed into the disposable muscle expansion channel, the inlet head end arrive pedicle bone surface. 由于微创切口1.5cm已切开皮肤,深筋膜,因此扩张芯5很容易扩张开肌间隙,与传统逐级扩张相比,操作简单,快捷省时。 Since a minimally invasive incision skin incision was 1.5cm deep fascia, thus easily expanding die 5 is pushed open gap muscle, compared with the conventional stepwise expansion, easy operation, quick-saving.

[0042]本实施例中,置钉导向套筒6包括沿轴线上具有椎弓根螺钉I通孔的圆筒体61,如图6所示。 [0042] In this embodiment, screw placement guide sleeve 61 having a cylindrical body 6 I pedicle screw including a through hole along an axis, as shown in FIG. 圆筒体61的一端为环形锯齿状,另一端固定连接有第一手持横柄62,扩张芯5沿导针4插入,再置钉导向套筒6沿扩张芯5插入,因此圆筒体61的内径与扩张芯5的外径、以及与椎弓根螺钉I钉座11的外径三者相等。 One end of cylindrical body 61 is an annular serrated, and the other end fixedly connected with a first lateral holding handle 62, the expansion of the core 5 along the guide pin 4 is inserted, and then set the guide sleeve 6 in the expansion nail 5 is inserted into the core, the cylindrical body 61 so inner diameter of the outer diameter of the expansion core 5, and three outer diameter equal to the pedicle screw 11 I anvil.

[0043]圆筒体61的长度比扩张芯5的长度短,置钉导向套筒6沿扩张芯5插入,扩张芯5的尾端手持部露出置钉导向套筒6的尾部外,操作者手握置钉导向套筒6的第一手持横柄62并下滑使置钉导向套筒6的环形锯齿尖刺在椎板、关节突骨面,压紧置钉导向套筒6的第一手持横柄62,以保持置钉导向套筒6的环形锯齿不移动,然后拔出扩张芯5,保留置钉导向套筒6和导针4,此时导针4入骨点处于置钉导向套筒6的环形锯齿中心点。 [0043] The expansion ratio of the length of the core 61 of a short length cylindrical member 5, screw placement guide die 5 is inserted into the expansion sleeve 6 along the expansion core holding portion 5 is exposed tail tip opposite the staple guide sleeve 6, the operator pedicle screws holding the guide sleeve 6, a first holding lever 62 and a cross-fell so that screw placement guide sleeve 6 in an annular sawtooth spikes lamina, facet bone surface, opposing the staple guide pressing the first sleeve 6 is held horizontal handle 62, to maintain the screw placement guide sleeve annular serrations 6 does not move, and then pull out the expansion die 5, pedicle screw to retain the guide sleeve 6 and the guide pin 4, the guide needle 4 at this time point is the bone screw placement guide sleeve 6 circular saw-tooth center point. 圆筒体61的长度大于椎弓根螺钉I的钉体10、钉座11和可折断长臂12的总长度。 10, anvil 11 and the long arm can break the total length greater than the length of the cylindrical body 61 of the pedicle screw I nail body 12. 因此,当椎弓根螺钉I插入置钉导向套筒6中,椎弓根螺钉I的钉体10尖恰好平齐置钉导向套筒6的环形锯齿时,椎弓根螺钉I的两条可折断长臂12没入圆筒体61。 Therefore, when a pedicle screw is inserted into opposing I staple guide sleeve 6, the spike body 10 is exactly flush with the pedicle screw I opposed serrated annular staple guide sleeve 6, two pedicle screw can I breaking the long arm 12 into the cylinder body 61 no.

[0044]用穿刺锥3将导针4换成导丝9,空心椎弓根螺钉I可沿导丝9经置钉导向套筒6插入并拧入椎体。 [0044] 9, I pedicle screw may be hollow sleeve 9 along the guide wire 6 is inserted through the screw placement guide of the puncture needle guide cone 3 4 into the guidewire and screwed into the vertebral body. 实心椎弓根螺钉I沿置钉导向套筒6同轴插入时,也可实现准确定位,解决了现有技术中只能空心螺钉中插入导丝9才能准确定位的技术问题。 When I along opposing pedicle screws solid staple guide sleeve 6 is inserted coaxially, accurate positioning can be achieved, the prior art can solve the technical problems hollow screw inserted in the guidewire 9 to accurate positioning. 因此本发明准确完成实心和空心椎弓根螺钉I置钉。 Thus, the present invention is to accurately complete the solid and hollow screw placement I pedicle screw.

[0045] 开放手术中发现,由于关节突凹凸不平,有时椎弓根螺钉I钉体10尖端难以插入小的椎弓根入口,拧钉时皮质容易蹦裂、移位。 [0045] found in open surgery, since the facet irregularities, sometimes I pedicle screw tip 10 is difficult to insert the staple body inlet small pedicle cortical readily crack when tightening the staple jump shift. 本发明的空心平突锉100用于锉平导针4入骨口的骨皮质,并钻入椎弓根内几毫米,制造有大小有深度的椎弓根骨性入口。 Projecting hollow flat file 100 of the present invention is a flat file for cortical bone bone guide pin 4 of the mouth, and drill pedicle few millimeters, manufactured with the pedicle bone depth size of the inlet.

[0046] 如图7所示,空心平突锉100为T形结构,包括沿轴线上具有导针4通孔的锉杆101,锉杆101的一端固定连接有锉头103,另一端固定连接第二手持横柄102。 [0046] 7, hollow flat file 100 is T-shaped projection structure, comprising filing rod 101 has a guide pin 4 along the axis of the through hole, an end of file rod 101 is fixedly connected with a rasping head 103, and the other end fixedly connected The second cross-held handle 102. 锉头103端面设有磨齿,周缘设有钻花样齿轮螺纹。 Filing head 103 is provided with end surface teeth grinding, drilling patterns periphery with a threaded gear. 空心平突锉100沿导针4插入椎弓根入口,因此空心平突锉100内径稍大于导针4,其锉杆101的外径小于椎弓根螺钉I钉体10的外径。 Flat file hollow projection 100 along the guide pin 4 is inserted into the pedicle entry, and therefore the inner diameter of the hollow projecting flat file 100 is slightly larger than the guide pin 4, the outer diameter of which is smaller than the outer diameter of the filing rod 101 I pedicle screw nail body 10.

[0047] 本实施例中,空心丝攻200用于对置钉位置进行攻丝,方便椎弓根螺钉I的置入。 [0047] In this embodiment, hollow fiber tap for tapping 200 opposed stapling position, to facilitate placement of pedicle screws in I. 如图8所示,空心丝攻200为T形结构,包括沿轴线上具有导针4通孔的丝攻杆201,丝攻杆201的一端固定连接有丝攻头203,另一端固定连接第三手持横柄202。 8, 200 is a hollow tapping T-shaped configuration, comprising a tapping rod with the guide pin 4 along the axis of the through hole 201, one end of the tapping rod 201 is fixedly connected with a tapping head 203, fixedly connected to the other end of three hand-held horizontal handle 202. 丝攻头203的外周设有与椎弓根螺钉I钉体10匹配的螺纹齿道。 The outer periphery of tapping head 203 is provided with teeth mating threads 10 and pedicle screw channel I nail body. 空心丝攻200沿导针4插入椎弓根入口,因此空心丝攻200的内径稍大于导针4,其丝攻杆201的外径与椎弓根螺钉I钉体10的外径相同。 Tapping hollow fiber 200 along the guide pin 4 is inserted into the pedicle entry, so the inner diameter of the hollow tapping 200 is slightly larger than the guide pin 4, which tapping rod 201 of the pedicle screw and the outer diameter of the same outer diameter I staple body 10. 丝攻头203的螺纹齿道与椎弓根螺钉I钉体10的螺纹相吻合。 Thread tapping head 203 teeth pedicle screw threaded channel I nail body 10 coincide. 空心丝攻200沿导针4对椎弓根椎体部进行攻丝,对于具有自攻能力的椎弓根螺钉I则无需采用空心丝攻200进行攻丝。 200 along the guide wire tapping hollow needle 4 tapping portion vertebral pedicle, for pedicle screw having a self-tapping capability I is no need for the use of hollow tapping tapping 200.

[0048]本实施例中,空心上钉器7的结构如图9所示,包括撑杆71和分别位于撑杆71两端的塞头72和第四手持横柄73。 [0048] In this embodiment, the structure shown in FIG. 7 is a staple on the hollow 9, including struts 71 and 71 are located at both ends of the strut 72 and the fourth plug 73 held horizontal shank. 撑杆71上套设有可转动的锁臂管74,锁臂管74靠近塞头72的一端外表面具有与可折断长臂12内表面内螺纹匹配的外螺纹,锁臂管74的另一端固定连接有旋转帽75,用于转动锁臂管74,旋转帽75上有锁紧螺帽。 Sleeve 71 is provided on the struts of the locking arm 74 rotatable tube, the other end of the locking arm 74 of the outer tube end plug 72 has an outer surface with a threaded inner surface 12 of the long arm breaking matching threads, the tube 74 near the locking arm rotation of the cap 75 is fixedly connected, for rotating the locking arm tube 74, rotation of the cap 75 with a locking nut. 当锁臂管74旋转到位锁紧椎弓根螺钉I时,锁紧螺帽锁住旋转帽75,防止锁臂管74退出,锁臂管74上套设有螺钉导向环76和旋转手柄77,其中,螺钉导向环76位于靠近塞头72—侧,旋转手柄77位于靠近第四手持横柄73—侧。 When the locking arm 74 is rotated into place locking tube pedicle screws I, rotating locking nut to lock the cap 75 to prevent the locking arm exit tube 74, tube 74 on the locking arm is provided with a screw guide sleeve 76 and the rotary ring 77 of the handle, wherein the screw guide ring 76 located adjacent 72- plug side, rotation of the handle 77 is located close to a fourth lateral shank 73- hand side. 螺钉导向环76和旋转手柄77套在锁臂管74上,可各自独立旋转。 The guide ring 76 and a screw 77 fitted over the rotary handle locking arm tube 74, can be independently rotated. 此外,锁臂管74上还设有通过旋拧抵紧或松开撑杆71的止转螺钉78,上钉器7还具有导丝9通孔,导丝9通孔沿撑杆71轴向贯穿塞头72、撑杆71和第四手持横柄73。 Further, the locking arm 74 is also a tube through screwing or loosening the struts 71 tightly against rotation stop screw 78, the staple 7 also has a through hole 9 guidewire, the guidewire through hole 9 along the axial struts 71 through plug 72, horizontal struts 71 and the fourth holding handle 73.

[0049]塞头72直接插在椎弓根螺钉I的U形结构14底部,转动旋转帽75使锁臂管74的外螺纹与椎弓根螺钉I可折断长臂12内表面的内螺纹咬合紧,从而将椎弓根螺钉I固定在空心上钉器7上。 [0049] The plug 72 is inserted directly at the bottom of the U-shaped structure I, the pedicle screw 14, rotation of the cap 75 causes rotation of the locking arm 74 of the outer tube and the pedicle screw thread I breakable internal thread 12 engaging the surface of the long arm tight, so that the pedicle screw fixation nail I in the hollow 7. 螺钉导向环76的外径与椎弓根螺钉I钉座11外径以及置钉导向套筒6的内径相等。 The outer diameter of the screw guide ring pedicle screw and the outer diameter of the staple holder I 11 and 76 equal to the inner sleeve opposite the staple guide 6. 当与空心上钉器7连接的椎弓根螺钉I沿置钉导向套筒6插入时,螺钉导向环76也进入置钉导向套筒6中,并与置钉导向套筒6的内壁吻合。 When connected to the pedicle screw 7 of the hollow screw opposite direction I staple guide sleeve 6 is inserted, the guide ring 76 also screw into the screw placement guide sleeve 6, and the opposite inner wall of the guide sleeve 6 staple anastomosis. 因此,在置钉导向套筒6的中前端有椎弓根螺钉I的钉座11,后端有螺钉导向环76,使得椎弓根螺钉I在置钉导向套筒6中滑行时确保钉体10的尖端对准置钉导向套筒6的中心点位置,从而保证实心椎弓根螺钉I的钉体10的尖端准确插入椎弓根骨性入口。 Thus, the staple in the distal end of the guide sleeve 6 opposite the staple holder 11 I pedicle screw, the screw rear end guide ring 76, so that the pedicle screw to ensure that the staple body I during taxi screw placement guide sleeve 6 nail tip 10 is aligned opposite the center point of the guide sleeve 6, thereby ensuring that the tip of the nail solid I pedicle screw body 10 is inserted into the pedicle bone inlet accurately. 置钉导向套筒6的环形锯齿刺在椎板、关节突皮质骨上,保持中心点位置不转动,当钉体10的尖端插入椎弓根骨性入口后,置钉导向套筒6可随上钉器7方向改变,使椎弓根螺钉I朝向更确切的方向拧入,类似于开放置钉。 Opposed annular serrations barbed staple guide sleeve 6 in the lamina, facet cortical bone, holding the position of the center point is not rotated, when the tip of the nail body 10 is inserted into the pedicle bone inlet, screw placement guide sleeve 6 may vary 7 changes direction on the nail, so that I toward the pedicle screw screwed more precise directions, similar to open pedicle screw.

[0050]当椎弓根螺钉I为活动轴椎弓根螺钉I时,由于钉座11与钉体10为活动连接,仅采用塞头72无法完成活动轴椎弓根螺钉I的上钉操作。 [0050] When the pedicle screw is movable shaft I I pedicle screw, since the anvil 11 and the staple body 10 is movably connected staple operation using only the plug 72 can not complete the activities of I-axis pedicle screw. 因此,上钉器7还具有另一种优选实施方式,如图10所示,所述上钉器7的塞头72上还设有凸起79,用于插入活动轴椎弓根螺钉I的球头15的凹槽中,直接拧活动轴椎弓根螺钉I的钉体10,同时,上述导丝9通孔贯通凸起79。 Thus, the staple unit 7 also has a further preferred embodiment, shown in Figure 10, the staple 7 is the plug 72 is also provided with a projection 79 for insertion of the movable shaft pedicle screws I grooved ball head 15, the pedicle screw is screwed directly movable shaft screw member 10 I, while the guidewire through hole 9 through the projection 79. [0051 ]以胸腰椎椎体骨折为例,本发明椎弓根螺钉的通用置钉装置的工作过程如下: [0051] In thoracic vertebral fractures, for example, the pedicle screw means of pedicle screws during operation of the general purpose of the present invention are as follows:

[0052] 1、麻醉成功后,患者取俯卧位,腹部悬空。 [0052] 1, after the success of anesthesia, the patient prone, abdominal vacant.

[0053] 2、C臂X光机透视定位,标记伤椎及上下椎的椎弓根体表投影,用穿刺锥3于椎弓根体表投影外缘旁开经皮穿入,针尖达椎弓根骨性投影“眼睛”外上缘2点或10点处穿破皮质层,缓慢钻入达椎体中部,拔出穿刺锥针32,经穿刺套管31插入导针4达椎体中部,拔出穿刺套管31,保留导针4,同法于其他椎弓根内经皮插入导针4,正侧位透视确认导针4位置恰当。 2, ray fluoroscopy [0053] C arm X, and the vertical marker vertebral pedicle of vertebral surface projection, the puncture opening cone 3 beside the outer edge of the surface projection of the pedicle percutaneous penetration, the tip of the vertebral projection Gengu bow "eyes" at the outer edge of the 2-point or 10-point perforation cortical layers, slowly penetrate into the middle of the vertebral body, pull puncture awl 32, the puncture needle cannula 31 into the guide 4 of the middle vertebral , pull out the puncture cannula 31 to retain the guide pin 4, the same method percutaneous insertion guide pin 4, and lateral fluoroscopy to confirm proper location of the guide pin 4 on the other pedicle.

[0054] 3、以导针4为中心做1.5厘米的纵向皮肤切口,并切开深筋膜,用扩张芯5沿导针4一次性扩大通道,置钉导向套筒6沿扩张芯5插入,操作者手持第一手持横柄62压紧,使置钉导向套筒6前端的环形锯齿尖刺入椎板、关节突的表面皮质,固定置钉导向套筒6保持位置不移动,拔出扩张芯5,保留置钉导向套筒6和导针4。 [0054] 3, 4 is a guide pin to make the central 1.5 cm longitudinal skin incision, cut and deep fascia, with the expansion of expandable core passage 5 along the guide pin 4 disposable, screw placement guide along expandable sleeve 6 of the core 5 is inserted , the operator holds the handle 62 of the first cross-held pressed against the front end of screw placement guide sleeve 6 into the annular serrations spikes lamina, facet surface of the cortical, pedicle screws fixed to the holding position of the guide sleeve 6 is not moved, removed expansion core 5, pedicle screw to retain the guide sleeve 6 and the guide pin 4.

[0055] 4、用空心平突锉100沿导针4插入,磨平导针4入口骨皮质,并钻入少许深度,拔出空心平突锉100,用空心丝攻200沿导针4对椎弓根钉道进行攻丝,拔出导针4。 [0055] 4, hollow flat file projections 100 along the guide pin 4 is inserted, the guide needle 4 is polished inlet cortical bone, and drill little depth, pull tab hollow flat file 100, hollow tapping 200 along the guide pin 4 pairs tapping pedicle screw path, the guide needle 4 is pulled out.

[0056] 5、空心上钉器7与椎弓根螺钉I连接后,沿置钉导向套筒6插入,钉体10的尖端准确插入椎弓根入口,旋转空心上钉器7,拧入椎弓根螺钉I ο同样方法置入其余椎弓根螺钉I,必要时伤椎可置入单侧或双侧螺钉。 [0056] 5, with a hollow staple pedicle screw 7 is connected after I, pedicle screws along the guide sleeve 6 is inserted, the tip of the nail body 10 is inserted into the pedicle inlet accurately, on a rotary hollow screw 7 is screwed into the vertebral I ο pedicle screws inserted in the same manner to rest pedicle screws I, vertebral screws can be placed one or both sides, if necessary.

[0057]另一方法置空心椎弓根螺钉I是,用穿刺锥3的穿刺套管31沿导针4插入椎体内,拔出导针4保留穿刺套管31,将导丝9沿穿刺套管31孔插入椎体,拔出穿刺套管31,保留导丝9,空心椎弓根螺钉I与空心上钉器7连接后沿导丝9插入,并拧入空心椎弓根螺钉I至椎体内。 [0057] Another method of opposing pedicle screws I is hollow, with 3 puncture puncture cone sleeve 31 along the guide pin 4 is inserted into the vertebral body, pull out the needle 4 Reserved puncture cannula guide 31, the guide wire 9 along the puncture cannula 31 is inserted into the vertebral body hole, pull puncture tube 31, to retain the guidewire 9, I hollow pedicle screws and the hollow 7 is connected after the staple along the guide wire 9 is inserted and screwed into the hollow pedicle screw to I Posterior.

[0058]本发明的通用置钉装置具有以下优点: [0058] Generalized Markup staple device of the present invention has the following advantages:

[0059] 1、本发明由于将穿刺锥针32的前端设置为锥形,使其具有自锥能力,且由于穿刺套管31为空心管,其前端形成齿尖,既起锯齿作用又起固定作用,在操作时当穿刺锥针32进入皮质骨之后,退出穿刺锥针32,穿刺套管31齿尖刺入皮质骨使其不易位移,确保导针4的插入。 [0059] 1, according to the present invention, since the front end of the puncture needle bevel 32 is tapered so as to have the ability to self-cone, and since the puncture tube 31 is a hollow tube, its front end prongs, acting both as a sawtooth fixed underway after acting, in operation when the puncture needle 32 into the cortical bone of the cone and exit cone puncture needle 32, the teeth 31 puncture cannula into the cortical bone spikes it easy displacement, ensuring the insertion guide needle 4. 穿刺锥3穿刺时,穿刺锥3中穿刺锥针32和穿刺套管31均有锥进骨质中的作用,而现有技术中的穿刺套针,由于其穿刺套筒前端为圆形,不是锥形,其自身没有锥破皮质能力,只有穿刺针有锥进骨质中的作用,仅靠穿刺针锥孔,但穿刺针直径比穿刺套管小,穿刺针锥孔后穿刺套管圆头进入费力困难,特别是较硬的皮质骨,所以其作用仅限于用来穿刺插入导针。 3 puncture puncture cone, cone puncture needle 3 puncture cone 32 and the sleeve 31 are puncturing coning effect of the bone, while the prior art trocar puncture, since the front end of the sleeve which is circular puncture, not tapered, the taper itself is not broken cortex capacity, only the role of the puncture needle into the bone of a cone, needle cone alone, but smaller than the diameter of the puncture needle puncture cannula, the puncture needle after the puncture tube round cone into the laborious difficult, especially harder cortical bone, so that their only to the puncture needle inserted into the guide. 在实际操作中,当穿刺针刺破皮质后退出时,穿刺套管容易位移,会导致插导针时位置容易发生变化;本发明的穿刺锥3还具有二个作用:其一调整导针4方向,操作中当导针4插入后X线透视发现导针入点正确而方向不正确时,用穿刺锥3的穿刺套管31经导针4插入,其锯齿锥入骨皮质少许并刺入骨质,导针4退出于骨面,但并不完全从穿刺套管31内退出,调整穿刺套管31方向,再回插该导针4,完成了导针4方向的调整。 In practice, when the puncture needle after breaking the cortical exit puncture cannula easily displaced when inserting the guide pin will cause the position is likely to change; puncture cone 3 of the invention further has two functions: First adjust the guide needle 4 direction, the operation when the guide needle 4 is inserted into the X-ray guide needle point and the correct orientation is found incorrect, the guide 31 through the puncture needle 4 is inserted into the puncture cannula cone 3, serrated cone penetration into the bone and cortical bone little quality, the guide pin 4 on the exit surface of the bone, but not completely withdrawn from the puncture tube 31, 31 to adjust the direction of the puncture cannula, the return guide pin 4 is inserted, to complete the adjustment of the guide pin 4 directions. 其二转换导丝9作用,导针4位置准确后,由于导针4较粗,一般空心椎弓根通孔较细,所以要转换成细长的导丝9。 Second, the role of converting the guidewire 9, the position of the guide pin 4 accurately, since the thick guide pin 4, is generally hollow pedicle fine through holes, so to be converted into an elongated guidewire 9. 再用穿刺套管31沿导针4插入,其锯齿锥进骨质内并固定,抽出导针4,再将导丝9沿穿刺套管31插入骨质中原导针的孔道中,再将空心椎弓根钉和空心上钉器7沿导丝9拧入,保证了导针4换导丝9而位置不变。 Then puncture cannula 4 is inserted along the guide pin 31, which is secured within serrations coning and bone, extracting the guide pin 4, the guide pin 31 is inserted into the bone tunnel and then Central guidewire 9 along the puncture cannula, the hollow and then the pedicle screw 7 and a hollow screw screwed along the guide wire 9, to ensure that the guide pin 4 and a position transducer guidewire 9 unchanged.

[0060] 2、扩张芯5和置钉导向套筒6结构和使用方法均与现有技术中的经皮微创椎弓根钉棒内固定系统中所用扩张芯5和置钉导向套筒6不同。 [0060] 2, 5, and expansion of the core 6 opposite the staple guide sleeve structure and method of use are the prior art percutaneous minimally invasive pedicle screw fixation systems 5 and the expansion of the core 6 with a screw placement guide sleeve different. 结构不同:现有技术中的扩张芯设置有手柄,而本发明扩张芯5无需设置手柄且长度比置钉导向套筒6长,长出部分即成为手持部,现有技术中的置钉导向套筒设置有与置钉导向套筒6横柄平行的两个U形槽,而现置钉导向套筒6无需设置两个U形槽,手柄与套筒入口相平。 Different structures: the expansion of the core in the prior art is provided with a handle, and the expansion core 5 of the present invention without a handle and a staple length longer than the opposing guide sleeve 6, i.e., becomes part of a handheld unit grow, prior art screw placement guide the sleeve is provided with two opposed U-shaped staple guide groove and the bushing 6 parallel to the transverse shank, the screw placement guide sleeve 6 is now no need to provide two U-shaped groove, flush handle and the sleeve inlet.

[0061]使用方法不同:现有技术中的使用方法是,扩张芯沿导针插入扩开软组织通道后退出,置钉导向套筒再沿扩张芯插入套合使扩张芯横柄嵌入置钉导向套筒的U形槽中,组合成一体,再经扩张芯通孔沿导针插入,扩张芯抵触骨面后,下压置钉导向套筒手柄,使其继续下插入,其齿尖刺到骨面,再上拉横柄拔出扩张芯。 Different [0061] Use: Use the prior art is that the expansion of the core along the guide pin is inserted into expansion after opening the soft tissue channel exit, screw placement guide sleeve and then along the expansion core insert nested so that the expansion core cross handle embedded opposed staple guide sleeve U-shaped groove of the cylinder, combined into one, and then the expansion of the core along the guide pin is inserted into the through-hole, the expansion of the core conflict bone surface, under the pressure screw placement guide sleeve lever to continue to the next insert, the tooth to the bone spikes surface, and then pull the pull-handle lateral expansion of the core. 本发明的使用方法是:扩张芯5沿导针4插入扩开软组织,抵触到骨面后,置钉导向套筒6直接沿扩张芯5插入,其齿尖刺到骨面,握住扩张芯5手持部拔出扩张芯5。 Using the method of the present invention are: the expansion of the core 5 along the guide pin 4 is inserted into flared soft tissue to the bone surface after the conflict, screw placement guide sleeve 6 is inserted directly in the expansion of the core 5, the tooth to the bone surface spikes, a core holding expansion 5 hand pulled out the expansion of the core 5. 显然,与现有技术中的使用方法相比,具有操作简便、快捷的优点。 Obviously, compared with the prior art method of use is simple, quick advantages. 与现有技术中其它套筒类装置相比,套筒前端设置的齿,除可以起到在置空心钉过程中阻隔并保护软组织的作用外该齿尖刺在皮质上,还可确保置钉导向套筒6远端无移位,确保导针进入点位于中心位置,当空心钉经置钉导向套筒6插入时,确保钉尖进入导针入点。 Compared with other prior art sleeve type arrangement, the teeth of the front end of the sleeve, in addition to the barrier and can play a protective role of the soft tissues of the outer teeth in the spikes in the process of the hollow screw opposite cortical, pedicle screws also ensure the distal end of the guide sleeve 6 no shift, to ensure that the entry point of the guide pin in the center position, when the hollow screw through screw placement guide sleeve 6 is inserted, ensure the nail tip into the needle guide point.

[0062] 3、上钉器7与现有技术中的经皮微创椎弓根钉棒内固定系统中的上钉器结构和作用都不相同。 [0062] 3, the staple 7 and the prior art percutaneous minimally invasive nail on the structure and function within the pedicle screw fixation systems are not the same. 现有技术中的上钉器的撑杆为实心,只能置实心椎弓根钉,旋转帽上无锁紧螺帽,拧椎弓根钉时容易退出,松动。 On the nail of the prior art solid struts, it can only be set solid pedicle screw, the rotation of the cap without lock nut, when tightening easy exit pedicle screw loosening. 本发明中的上钉器7的撑杆71为空心,既可置空心钉也可置实心钉,旋转帽75上有锁紧螺帽,锁紧螺帽锁紧旋转帽75同时锁紧了锁臂管74,拧椎弓根钉时不退出,无松动,操作安全稳定。 In the present invention the nail is hollow struts 717, it can also be placed opposite the hollow screw nails solid, the rotary cap 75 has a lock nut, rotation of the locking cap locking nut 75 while locking the lock arm tube 74, without exiting the pedicle screw when tightening, no loosening, safe and stable operation.

[0063]以采用本发明通用置钉装置完成的518例胸腰椎骨折微创手术的数据分析来看,其中置钉共3115枚,准确率达98.3%,且与现有开放手术相比具有手术时间短、出血少、住院时间短等优点,具体对比数据如下: [0063] In 518 cases the data were analyzed using thoracolumbar fracture minimally invasive surgical apparatus of the present invention Generalized Markup staple finished view, wherein the pedicle screw co-3115, 98.3% accuracy rate, and having a conventional open surgery as compared to surgery time is short, less bleeding, shorter hospital stay, particularly comparative data as follows:

[0064] 手术时间:开放手术为60〜180分钟,平均91分钟;米用本发明的微创手术为30〜70分钟,平均52分钟。 [0064] The operation time: 60~180 minutes of open surgery, average 91 minutes; m with minimally invasive surgery of the present invention is 30~70 minutes, mean 52 minutes.

[0065] 出血量:开放手术为100〜600ml,平均260ml;采用本发明的微创手术为15〜30ml,平均25ml 0 [0065] The amount of bleeding: open surgery 100~600ml, 260 ml of an average; the present invention is minimally invasive surgery 15~30ml, average 25ml 0

[0066] 住院时间:开放手术为15〜21天,平均14天;采用本发明的微创手术为6〜14天,平均9天。 [0066] hospitalization time: open surgery 15~21 days, an average of 14 days; minimally invasive surgery according to the present invention is 6~14 days, an average of 9 days.

[0067]以上所述仅是本发明的优选实施方式,本发明的保护范围并不仅局限于上述实施例。 [0067] The above are only preferred embodiments of the present invention, the scope of the present invention is not limited to the above embodiments. 对于本技术领域的技术人员来说,在不脱离本发明技术构思前提下所得到的改进和变换也应视为本发明的保护范围。 For the person skilled in the art, without departing from the technical concept of the present invention under the premise that the resulting modifications and changes should be regarded as the protection scope of the present invention.

Claims (7)

1.一种椎弓根螺钉的通用置钉装置,包括穿刺锥、导针、扩张芯、置钉导向套筒、空心平突锉、空心丝攻和上钉器,其特征在于:所述穿刺锥包括穿刺套管和穿刺锥针,穿刺套管为空心管,穿刺套管的前端为锥形,穿刺套管的后端设有膨大的手握部,手握部内空心扩大并设有内螺纹,穿刺锥针为针状,穿刺锥针的前端为锥形,穿刺锥针的尾端膨大并设有外螺纹,穿刺锥针插入穿刺套管中,当穿刺锥针尾端的外螺纹与穿刺套管后端的内螺纹匹配吻合后穿刺锥针前端的锥形尖露出穿刺套管前端并与穿刺套管前端的锥形吻合,穿刺套管表面有刻度;所述的导针为针状,用于经穿刺套管插入椎弓根入口中确定置钉位置,导针表面有刻度。 A pedicle screw placement apparatus common screws, cone comprises a piercing, the guide pin, the core expanded, pedicle screw guide sleeve, projecting hollow flat file, and tapping on the hollow fiber staple, characterized in that: said piercing puncture cannula comprising a cone and a tapered needle puncture, the puncture cannula is a hollow tube, the distal end of the puncture cannula is tapered, the rear end of the sleeve is provided with a grip portion puncture dilated, expanded and provided with a hollow internal thread grip portion , a needle puncture needle cone tip of the puncture needle is tapered cone, the cone tail puncture needle and inflated with an external thread, puncturing the insertion puncture needle cannula cone, the cone when the puncture needle puncturing the tail end of the male screw and sleeve after the rear end of the inner tube coincide thread matching tapered distal tip of the puncture needle cone end of the pin is exposed and punctured with the tapered distal anastomosis puncture cannula, the puncture cannula with a graduated surface; said needle guide a needle, for puncture cannula is inserted through the inlet pedicle screw placement location is determined, the surface of the guide pin with scale.
2.根据权利要求1所述的通用置钉装置,其特征在于:还包括导丝,所述导丝为细长的丝,其直径小于等于导针直径,长度大于导针的长度。 2. Generalized Markup staple apparatus according to claim 1, characterized in that: further comprising a guide wire, the guide wire is an elongated wire having a diameter smaller than a diameter equal to the guide pin, guide pin of length greater than the length.
3.根据权利要求1所述的通用置钉装置,其特征在于:所述扩张芯包括沿轴线上具有导针通孔的圆柱体,圆柱体的外径与椎弓根螺钉的钉座外径相同;圆柱体的一端呈圆锥形,另一$而为手持部。 The apparatus according to General pedicle screws claim 1, wherein: said expandable core includes a cylindrical body having a through hole on the guide pin along the axis, the outer diameter of the cylindrical anvil outer diameter of the pedicle screw same; the conical end of the cylinder, while the other is a hand held unit $.
4.根据权利要求1所述的通用置钉装置,其特征在于:所述置钉导向套筒包括沿轴线上具有椎弓根螺钉通孔的圆筒体,圆筒体的一端为环形锯齿状,另一端固定连接有第一手持横柄,圆筒体的长度小于扩张芯的圆柱体的长度,圆筒体的长度大于椎弓根螺钉的钉体、钉座和可折断长臂的总长度。 The apparatus according to General pedicle screws claim 1, wherein: said guide sleeve includes a staple opposite end of the cylindrical body having a through hole on the pedicle screw along the axis of the cylindrical body is an annular serrated , and the other end fixedly connected with a first cross-holding handle, a cylindrical length of less than the length of the expansion of the core cylinder, the cylindrical body is greater than pedicle screw nail body, the total length of the anvil and the long arm can break.
5.根据权利要求1所述的通用置钉装置,其特征在于:所述的空心平突锉包括沿轴线上具有导针通孔的锉杆,锉杆的外径与椎弓根螺钉的钉体外径相同,锉杆的一端固定连接有锉头,另一端固定连接第二手持横柄,锉头端面设有磨齿,周缘设有钻花样螺纹;所述空心丝攻包括沿轴线上具有导针通孔的丝攻杆,丝攻杆的外径与椎弓根螺钉的钉体外径相同,丝攻杆的一端固定连接有丝攻头,另一端固定连接第三手持横柄,丝攻头的外周设有与椎弓根螺钉钉体匹配的螺纹齿道。 The apparatus according to General pedicle screws claimed in claim 1, wherein: said flat projecting hollow stem having a file comprises a file on a guide pin through hole along the axis, the outer diameter of the rod and the pedicle screw nail file the same outside diameter, one end of the rod is fixedly connected with a file header file, the other end connected to the second cross-holding handle, with the head end surface grinding teeth file, the peripheral edge is provided with a threaded drill pattern; tapping the hollow along the axis includes an upper guide tapping rod pin through-holes, outer diameter same as the outer diameter of the staple wire tapping pedicle screw rod, one end of the tapping rod is fixedly connected with a tapping head, and the other end fixedly connected to the third cross-holding handle, tapping head an outer periphery provided with a pedicle screw nail thread tooth-matched channel.
6.根据权利要求1所述的通用置钉装置,其特征在于:所述上钉器包括撑杆、固接于撑杆一端的塞头和固接于撑杆另一端的第四手持横柄,撑杆上套设有可转动的锁臂管,锁臂管靠近塞头的一端外表面具有与可折断长臂内表面内螺纹匹配的外螺纹,锁臂管的另一端固定连接有用于转动锁臂管的旋转帽,锁臂管上套设有螺钉导向环和旋转手柄,螺钉导向环位于靠近塞头一侧,旋转手柄位于靠近第四手持横柄一侧,螺钉导向环的外径与椎弓根螺钉的钉座外径相同,锁臂管上还设有通过旋拧抵紧或松开撑杆的止转螺钉,所述上钉器还具有导丝通孔,导丝通孔沿撑杆轴向贯穿塞头、撑杆和第四手持横柄。 The apparatus according to General pedicle screws claim 1, wherein: said staple comprising a strut, the strut fixed to an end of the plug and fixed to the fourth lateral shank strut holding the other end, upper strut tube sleeve is provided with a rotatable locking arm, the outer end of the tube near the surface of the plug having a locking arm breakable external thread matching inner thread of the inner surface of the long arm, the other end of the locking arm is fixedly connected with a pipe for the rotary latch rotary cap tube arm, the locking arm is provided with a screw guide sleeve tube ring and the rotary handle, the screw guide ring located adjacent a side of the plug head, rotation of the handle located adjacent a fourth side of the handheld cross handle, the outer diameter of the screw and the vertebral arch of the guide ring the same as the outer diameter of the anvil body of screws, and the locking arm tube further abutment provided by screwing tightened or loosened screw detent struts, the upper staple guide wire further having a through hole, the through hole along the guide wire struts axially through the plug, the cross-struts and holding the fourth handle.
7.根据权利要求6所述的通用置钉装置,其特征在于:所述塞头上还设有凸起,凸起用于插入活动轴椎弓根螺钉的球头中拧紧活动轴椎弓根螺钉的钉体,所述导丝通孔贯通所述凸起。 7. Generalized Markup staple device of claim 6, wherein: said plug head is also provided with a projection, the projection movable shaft for insertion into the pedicle screw ball head pedicle screw tightening movable shaft nail body, the guide wire through the protrusion through holes.
CN201610082225.5A 2016-02-06 2016-02-06 Universal screw-setting device for pedicle screw CN105596077A (en)

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