CN106963462A - External fixer for operation on vertebra - Google Patents
External fixer for operation on vertebra Download PDFInfo
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- CN106963462A CN106963462A CN201710178717.9A CN201710178717A CN106963462A CN 106963462 A CN106963462 A CN 106963462A CN 201710178717 A CN201710178717 A CN 201710178717A CN 106963462 A CN106963462 A CN 106963462A
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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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
- A61B17/66—Alignment, compression or distraction mechanisms
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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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6425—Devices extending alongside the bones to be positioned specially adapted to be fitted across a bone joint
-
- 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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6433—Devices extending alongside the bones to be positioned specially adapted for use on body parts other than limbs, e.g. trunk or head
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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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/645—Devices extending alongside the bones to be positioned comprising a framework
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
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- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
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Abstract
External fixer for operation on vertebra is provided, including：At least two pairs screws, each pair is configured to screw the pedicle of vertebral arch for being anchored to the adjacent of vertebra or the both sides on vertebra spaced apart respectively；At least two first coupling assemblies, extend between two screws being each connected in each pair screw and in a first direction, and be configured to adjust the angle between a pair of screws of the pedicle of vertebral arch for the both sides being anchored on same vertebra and distance in a first direction；Between two screws alignd in two the second coupling assemblies, the second direction vertical in first direction being each connected in two pairs of adjacent screws；And adjusting part, it is movably attached in a second direction between two adjacent the first coupling assemblies, to adjust distance between two adjacent first coupling assemblies in a second direction.Thus adjust the distance between screw on the pedicle of vertebral arch of same vertebra both sides and angle, and screw anchor to adjacent or interval vertebra vertical distance stretching is provided.
Description
Technical field
Embodiments of the invention are related to the external fixer for operation on vertebra, more particularly to a kind of for pedicle screw
Fixation and regulation external fixer.
Background technology
Spine fracture is relatively common damage in wound.Quality of life to patient causes to have a strong impact on.For without god
The treatment of spine fracture through symptom, has been used fixed in way of escape minimal invasion internal fixation operation, this way of escape minimal invasion
Operation has not only reached the effect of spinal fixation, also has the advantages that operation wound is small, otch is short, blood loss volume during the operation is few.But warp
The minimally invasive internal fixation operation of skin is relatively poor relative to conventional therapy fixed effect, and can not utilize by installing tranverse connecting rod
Mode realizes the horizontal connection on the pedicle of vertebral arch being fastened on the same vertebra of vertebra, and its stability is not enough.Meanwhile, it is no matter traditional
It is different degrees of that open operation or minimal invasion operation are all easily caused patient's vertebral height generation after being fixed in removing
Loss.Distraction osteogenesis theory refers to that under the stimulation of tensile stress human activin bone tissue regeneration potential reaches the mesh of Limb lengthening
's.It is widely used at present in the field such as oral cavity and limbs Cranial defect, infection of bone, achieves good effect.And due to lacking
Corresponding apparatus, the technology spinal injury domain variability without application.
The content of the invention
Prior art is eliminated at least one aspect solved the above problems at least in part, and reduction or at least part
Present in defect and deficiency, the embodiment of the present invention provides a kind of outer fixed dress being located at outside body for being used to be anchored to vertebra
Put, it is used for fixation and is such as fastened to supraspinal pedicle screw, is easy to implement the different pedicles of vertebral arch on same pedicle of vertebral arch
Lateral separation and angular adjustment between screw, and adjusted by stress between longitudinal centrum, it is theoretical and real using distraction osteogenesis
The purpose lost referring now to the height of sick vertebra for preventing the external fixer from being fixed after pedicle screw removal.
To realize the purpose of the present invention, The embodiment provides a kind of external fixer for operation on vertebra,
Including：At least two pairs screws, each pair screw is configured to be anchored to the adjacent of vertebra or vertebra spaced apart with screwing respectively
The pedicle of vertebral arch of both sides on bone；At least two first coupling assemblies, each first coupling assembly is connected in each pair screw
Two screws between and extend in a first direction, and be configured to adjust the vertebra for the both sides being anchored on same vertebra
Angle between a pair of screws of nut and distance in said first direction；Two the second coupling assemblies, it is each described
Second coupling assembly is connected in alignd in the second direction vertical with the first direction two in two pairs of adjacent screws
Between individual screw；And adjusting part, be movably attached in this second direction two adjacent the first coupling assemblies it
Between, to adjust the distance between described two adjacent first coupling assemblies in this second direction.
In one embodiment, each first coupling assembly includes：Horizontal connector, is being anchored on same vertebra
Extend in said first direction between a pair of screws of the pedicle of vertebral arch of both sides；And two the first fasteners, be configured to by
The two ends of the horizontal connector are movably coupled to this pair of screw respectively.
In one embodiment, each first fastener includes：Base portion, is formed with the base portion for the screw
The through hole passed through, and the base portion is configured to carry one end of the horizontal connector；First main part, from the base
Portion extends perpendicular to the axis of the through hole；And nut, be configured to from first main part at least with base portion phase
Anti- side screw with first main part into being screwed, the one end for the horizontal connector that base portion is carried
It is fixed to through on the screw of the through hole.
In one embodiment, at least one regulation extended along the first direction is formed in each horizontal connector
Hole, first main part movably passes through the adjustment hole, to adjust the pedicle of vertebral arch for the both sides being anchored on same vertebra
This pair of screw between angle and distance in said first direction.
In one embodiment, each second coupling assembly includes：First vertical connector, in this second direction
Extension；And second fastener, it is configured to the two ends of the described first vertical connector being respectively fixedly connected in a second direction
Between the threaded portion of two screws of alignment and first fastener.
In one embodiment, the two ends of the described first vertical connector are respectively fixedly connected in the spiral shell second fastener
Nail smooth nail rod on so that the threaded portion for two screws that second fastener can align in a second direction with
Pivoted between first fastener.
In one embodiment, each second fastener includes forming orthogonal cloth in the second main body, second main body
Two through holes put, the screw and the first vertical connector are each passed through two through holes.
In one embodiment, the two ends of the adjusting part extend through two adjacent transverse directions along the second direction
Connector, and be configured to adjust two adjacent horizontal connectors by way of screwing in this second direction
Distance.
In one embodiment, the adjusting part includes：Adjusting screw rod, the two ends of adjusting screw rod extend through described adjacent
Two horizontal connectors；And two pairs of regulation nut parts, each pair adjusting nut divided in the both sides of a horizontal connector
Be not screwed to one end of the adjusting screw rod, adjusted by screwing at least one pair of adjusting nut be anchored to the adjacent of vertebra or
The spacing between phase adjacency pair screw on the pedicle of vertebral arch of both sides on vertebra spaced apart.
In one embodiment, the adjusting part includes：Adjusting screw rod, the two ends of adjusting screw rod possess screw thread bar segment respectively
Run through described adjacent two horizontal connectors to screw, and the screw thread bar segment thread rotary orientation on the contrary, so as to pass through
Screw the adjusting screw rod to adjust the distance between horizontal connector of adjacent two, the adjacent of vertebra is anchored to adjust
Or the spacing between the phase adjacency pair screw on the pedicle of vertebral arch of the both sides on vertebra spaced apart.
In one embodiment, the spacing variation between the phase adjacency pair screw is less than or equal to described adjacent or is spaced apart
Vertebra on pedicle of vertebral arch between pitch.
In one embodiment, angle is between 0 degree to 180, preferably at 0 degree extremely between two screws in each pair screw
Between 150 degree, more preferably between 0 degree to 60 degree.
The external fixer for operation on vertebra of various embodiments of the present invention, at least possesses following beneficial effect：Energy
Enough screws to inserting pedicle of vertebral arch are corrected and fixed, can be by adjusting the length of vertical adjusting screw rod, to control vertebra
There is provided the tensile stress needed for distraction osteogenesis for the height of body leading edge.
Brief description of the drawings
The detailed description made by below with reference to accompanying drawing to the disclosure, above and other feature and advantage of the disclosure
It will be evident that, and can help to obtain to be fully understood by the disclosure.
Fig. 1 shows a kind of solid for being used to be anchored to the external fixer of vertebra of exemplary embodiment according to the present invention
Figure；
Fig. 2 shows the top view of external fixer as shown in Figure 1；
Fig. 3 shows the side view of external fixer as shown in Figure 1；
Fig. 4 (a) shows that being used in the external fixer shown in Fig. 1 fixes the schematic diagram of the screw of pedicle of vertebral arch；
Fig. 4 (b) shows the schematic diagram of the horizontal connector in the first coupling assembly shown in Fig. 1；
Fig. 4 (c) shows the schematic diagram of the first fastener in the first coupling assembly shown in Fig. 1, nut not shown in figure；
Fig. 4 (d) shows the schematic diagram of the second fastener in the second coupling assembly shown in Fig. 1；And
Fig. 4 (e) shows the schematic diagram of the adjusting screw rod in the external fixer shown in Fig. 1.
Embodiment
Below by embodiment, and with reference to accompanying drawing, technical scheme is described in further detail.In explanation
In book, same or analogous drawing reference numeral indicates same or analogous part.It is following referring to the drawings to embodiment of the present invention
Illustrate to be intended to explain the present general inventive concept of the present invention, and be not construed as a kind of limitation to the present invention.
In addition, in the following detailed description, for ease of explaining, elaborating many concrete details to provide to present disclosure
The comprehensive understanding of embodiment.It should be apparent, however, that one or more embodiments can also in the case of these no details
It is carried out.In other cases, known construction and device diagrammatically embodies to simplify accompanying drawing.
According to the present general inventive concept, there is provided a kind of external fixer for operation on vertebra, the external fixer
Including：At least two pairs screws, each pair screw is configured to be anchored to the adjacent of vertebra or vertebra spaced apart with screwing respectively
The pedicle of vertebral arch of both sides on bone；At least two first coupling assemblies, each first coupling assembly is connected in each pair screw
Two screws between and extend in a first direction, and be configured to adjust the vertebra for the both sides being anchored on same vertebra
Angle between a pair of screws of nut and distance in said first direction；Two the second coupling assemblies, it is each described
Second coupling assembly is connected in alignd in the second direction vertical with the first direction two in two pairs of adjacent screws
Between individual screw；And adjusting part, be movably attached in this second direction two adjacent the first coupling assemblies it
Between, to adjust the distance between described two adjacent first coupling assemblies in this second direction.
Fig. 1 shows a kind of solid for being used to be anchored to the external fixer of vertebra of exemplary embodiment according to the present invention
Figure.
In one embodiment of the disclosure, a kind of external fixer 1 for operation on vertebra is disclosed.As shown in figure 1,
In the illustrated embodiment, the external fixer 1 includes：(such as Fig. 1 shows two pairs at least two pairs screws for the sake of simplicity, only
Screw 2,2 '), each pair screw is configured to be anchored to screwing two on the adjacent of vertebra or vertebra spaced apart respectively
The pedicle of vertebral arch of side；At least two first coupling assemblies 3,3 ', be each connected between two screws in each pair screw and
Upwardly extended with the lateral first party of length direction of mutually reply screw, and be configured to adjust and be anchored on same vertebra
Angle between a pair of screws of the pedicle of vertebral arch of both sides and distance in said first direction；Two the second coupling assemblies 4,
4 ', each it is connected in alignd in the second direction vertical with the first direction two screws in two pairs of adjacent screws
Between；And adjusting part, the adjusting part is configured to be connected in the first adjacent coupling assembly in this second direction
Between 3,3 ', to adjust the distance between described two adjacent first coupling assemblies in this second direction.
Specifically, as an example, the screw 2,2 ' is usually screw-type pedicle of vertebral arch spicule, that is, possesses spiral vertically
The spicule of threaded portion.Compared to the Shi Shi that other types of fixed bone spicule such as spicule shank part is only smooth cylindrical needle body
For pin, Kirschner wire, screw-type spicule has to be firmly combined with bone area, and the axial stretching resistance of spicule is big, and it is excellent that inserting needle resistance is small etc.
Point, and be for example typically subdivided into including：Single hop screw needle, only has one section of screw thread on whole screw thread spicule；Or double sections of spiral shells
Line pin, possesses two sections of screw threads on whole screw thread spicule, and two sections of screw threads are for example arranged in the cortex of both sides and screw thread
Between polished rod then be located at ossis in.As an example, the screw 2,2 ' can be in single hop screw needle form, for example including：Axle
The Bonnel pins in the middle of needle body are arranged in threaded portion；Or the Schanz pins that axial thread portion is arranged close to syringe needle one end.In addition
Example in, the screw 2,2 ' then can using double section screw needles form, the screw thread of its step-by-step arrangement be able to ensure that holding
The more firm and more preferable reset effect of power.
Fig. 4 (a) shows that being used in the external fixer shown in Fig. 1 fixes the schematic diagram of the screw of pedicle of vertebral arch.
In an embodiment of the present invention, such as Fig. 1 and Fig. 4 (a) is best shown, for example with two pairs of staight needle type Schanz pins
2,2 ' as exemplary pedicle screw, and it is configured to above pedicle or outside is screwed into centrum, such as by meeting surgery
The material of implant material ISO5832 standards is made, such as stainless steel, titanium alloy, pure titanium.
Also, for example, the frame mounting described above 1 of the embodiment of the present disclosure is substantially in the both sides pedicle of vertebral arch of same vertebra
It is connected between the pedicle of vertebral arch of upper and adjacent or spaced apart vertebra with truss structure, especially because the vertebral arch of same vertebra
Coupled and between the pedicle of vertebral arch of adjacent or spaced apart vertebra by the first coupling assembly 3,3 ' between a pair of screws on root
Coupled between paired screw using the second coupling assembly 4,4 ' and adjusting part so that constrain each be screwed to same vertebra respectively
The one-movement-freedom-degree in a first direction of each pair screw 2,2 ' on the both sides pedicle of vertebral arch of bone and around first direction rotation from
By spending, and constrain due to the presence of the adjusting part spaced winding the of (but not cancelling) described at least two pairs paired screw
The free degree that two directions are rotated against, also due to first coupling assembly exist without limitation described at least two pairs into
To between screw one another along the one-movement-freedom-degree that second direction is closer to each other or remote.As shown in figure 1, in the example of the present invention
Property embodiment in, first direction be, for example, transverse to the direction of the screw 2,2 '；And second direction is and the first direction
Vertically, it is illustrated that be vertical.So as to which the adjusting part is configured to compress the first adjacent coupling assembly 3,3 ' from two ends
(for example, in center of the first coupling assembly 3,3 ') is to adjust between adjacent two pairs of screws 2,2 ' in this second direction
Distance, i.e., in vertical distance between adjacent two pairs of screws 2,2 ', so as to realize that each of which installs be fixed to adjacent
Or the distance between the spaced apart pedicle of vertebral arch of vertebra regulation.Thus, it is this distance regulation be, for example, by means of similar to
Fixed structure along the vertical direction of vertebra side mainly to come to perpendicular between paired screw outside conventional ilizarov
It is adjusted to distance, fixes to realize normal vertebra by the support of the frame mounting 1 during not only beneficial to patient recovering
Body height and intervertenral space and make to recover normal curvature between centrum, so as to keep the physiological bending of backbone, possess preferably negative
Weight and decompression ability, but need not possess the typical enclosed support around patient body of conventional ilizarov exterior fixing racks
Property form, and need only to the external use on rear side of vertebra can be in the outer of the embodiment of the present invention of " expansion-contraction " mode
Fixing device is distance between the pedicle of vertebral arch that can adjust adjacent or interval vertebra；And based on stretching fixed outside ilizarov
Skeletonization principle and " tension force-stress " rule, come the vertebra of adjacent or spaced apart vertebra being installed to the external fixer
Nut is applied with the axial stretching effect for meeting biomethanics requirement, such as by playing during the walking with load during patient recovers
Periodicity axial inching feature, to stimulate the centrum poroma of pedicle of vertebral arch slow but accurate contraposition lengthening and beneficial to suffering from
Person's early ambulant is without influenceing growth healing.
Fig. 2 shows the top view of external fixer as shown in Figure 1.And Fig. 4 (c) shows the first connection shown in Fig. 1
The schematic diagram of the first fastener in component, nut not shown in figure.
Referring to Fig. 1 and Fig. 2, in the illustrated embodiment, each first coupling assembly 3,3 ' includes：Horizontal connector
31,31 ', described first between a pair of screws of pedicle of vertebral arch of the horizontal connector in the both sides being anchored on same vertebra
Side is upwardly extended；And two the first fasteners 32,32 ', described two first fasteners 32,32 ' are configured to the horizontal stroke
This pair of screw is movably coupled to respectively to the two ends of connector 31,31 '.Thus, the mobile horizontal connector is passed through
Two ends, because the two ends of the horizontal connector have been attached to this pair of screw, consequently facilitating adjusting the angle between this pair of screw
With their distances along a first direction, and by being tensioned described two first fasteners 32,32 ', enable to adjusted
This pair of screw between the angle and distance along a first direction be kept.
As an example, first fastener 32,32 ' is arranged in the axial thread portion as shown in Fig. 4 (a) close to syringe needle
In the smooth shank portions of the Schanz pins of the staight needle type spicule form of one end arrangement rather than axial thread portion, in order to the axial spiral shell
The screw thread in line portion being made full use of and will not be worn due to the first the tightening maintenance of fastener 32,32 '.Also, specifically
As shown in Fig. 4 (c), for example, first fastener is, for example, purl fixture, including：Base portion 321,321 ', in the base portion
It is formed with the through hole 3211 passed through for the screw 2,2 ' in 321,321 ', 3211 ', and the base portion 321,321 ' is configured to
One end to carry the horizontal connector 31,31 '；With from the base portion perpendicular to the through hole 3211,3211 ' axis
And the first main part 322,322 ' of the extension extended；And nut, it is configured to from first main part 322,322 '
Side at least opposite with base portion screws, into being screwed, base portion 321,321 ' to be carried with first main part
One end of the horizontal connector is fixed to through on the screw of the through hole.And the example of the first main part 322,322 '
It is such as cylindrical, enabling for example in first main part 322,322 ' and base portion 321,321 ' opposite sides or described
The placement nut is screwed at the two ends of first main part with by first fastener (and the correspondingly horizontal connector
End) be firmly seated in along the direction with the axis vertical take-off of through hole 3211,3211 ' in the nail rod of the screw 2,2 ', by
This, eliminates entrance pedicle of vertebral arch of the screw 2,2 ' along screw length direction and the displacement exited from pedicle of vertebral arch.
Fig. 4 (b) shows the schematic diagram of the horizontal connector in the first coupling assembly shown in Fig. 1.
Referring to Fig. 1 and Fig. 2, in the illustrated embodiment, each horizontal connector 31,31 ' is for example configured to prolong
Long orifice plate, that is, possess at least one adjustment hole extended along the first direction, such as depicted in figs. 1 and 2 at two ends
Possess adjustment hole 311,311 ', for example, be arranged symmetrically, for accommodating corresponding first fastener 32,32 '.Specifically
Ground, with reference to Fig. 4 (b) and Fig. 4 (c) it is seen, for example, first main part of first fastener 32,32 ' is movably worn
The adjustment hole is crossed, angle between this pair of screw to adjust the pedicle of vertebral arch of both sides being anchored on same vertebra and in institute
State the distance on first direction.More specifically, as shown in Fig. 2 and Fig. 4 (b), in an exemplary embodiment of the present invention, the horizontal stroke
The orifice plate of extension is configured to connector 31,31 ', more specifically for example, straight orifice plate, and in the orifice plate of this extension
Two ends at, possess respectively along orifice plate length direction extend extension aperture i.e. adjustment hole 311,311 '.As an example, each
Adjustment hole 311,311 ' on orifice plate is arranged symmetrically relative to aperture plate center at its two ends, so that being just attached to same
For the regulation of the distance between each pair screw on the both sides pedicle of vertebral arch of one vertebra and angle, the regulation of any screw therein
Two screws in the regulating effect in another screw of opposite side, i.e. each pair screw are equivalent to each for its spacing walk-off angle
The regulation of degree is equivalent.In a kind of alternate embodiment of the present invention, the adjustment hole can also for example be set to only one
The long and narrow hole (being equally considered as by the adjustment hole 311,311 ' is communicating together and formed) being formed on orifice plate, the first fastening
First main part of part 32,32 ' is through the long and narrow hole and is movable within to adjust be anchored on same vertebra two
Angle between this pair of screw of the pedicle of vertebral arch of side and distance in said first direction, and first main part can
Further it is fixed on shown long and narrow hole to keep the angle and distance in a first direction by nut.
Specifically, for example, in the embodiment shown in Fig. 1 and 2, each first fastener 32,32 ' be configured to
In along the displaceable mode of the length direction of orifice plate through the adjustment hole and it is configured to screw and to push against ground tight
It is affixed to the part positioned at the adjacent of adjustment hole 311,311 ' of the orifice plate so that between two screws in each pair screw
Distance and angle adjustable.Specifically, as shown in Fig. 1,2 and Fig. 4 (b) and Fig. 4 (c), for example, two are in purl fixture form
The respective extension of the first fastener 32 (or 32 ') the first main part be positioned to be each passed through the orifice plate 31 (or
31 ') adjustment hole 311 (or 311 ') on, and then revolved using nut come the two ends respectively from first main part
Twist, so that distance and/or angle pair between each pair screw on the desired both sides pedicle of vertebral arch for being placed in same vertebra
At position in the adjustment hole 311 (or 311 ') answered so that nut is orthogonal with the length direction of the nail rod of screw 2,2 '
Direction on (be illustrated as in Fig. 1,2 vertical) first main part (then by whole first fastener 32 or 32 ') is compressed
On the outer surface adjacent with adjustment hole 311 (or 311 ') for being close proximity to the orifice plate 31 (or 31 '), thus screw edge is being realized
Two in each pair screw being fixed on the both sides pedicle of vertebral arch of same vertebra are defined while the maintenance for its length direction
The distance between screw and angle.Also, by adjusting the position that clamp nut is screwed in the adjustment hole of orifice plate, so that
The distance between two screws installed and be fixed on the both sides pedicle of vertebral arch of the same vertebra and angle are adjustable, spies
It is not that by trickle and stepless this regulation advantageously.And once fasten, then with being fixed outside conventional ilizarov
Similar mode eliminates angulation, lateral displacement and rotation, without circumferentially surrounding for conventional ilizarov exterior fixing racks
Formula structure.
Fig. 3 shows the side view of external fixer as shown in Figure 1.Fig. 4 (d) shows the second coupling assembly shown in Fig. 1
In the second fastener schematic diagram.
Referring to Fig. 1 and Fig. 2, in the illustrated embodiment, each second coupling assembly 4,4 ' includes：Described second
The first vertical connector 41,41 ' that side is upwardly extended；Second fastener 42,42 ', second fastener 42,42 ' is constructed
It is respectively fixedly connected into by the two ends of the described first vertical connector 41,41 ' to two screws 2 alignd in a second direction,
Between 2 ' threaded portion 21,21 ' and first fastener 32,32 '.More specifically, as shown in Fig. 3 and Fig. 4 (d), for example, often
Individual second fastener 42 (or 42 ') includes possessing into just in the second main body 421,421 ', second main body 421,421 '
Hand over two through holes 4211,4211 ' of arrangement；4212,4212 ', it is respectively used to pass through and for described for respective screws 2,2 '
First vertical connector 41 (or 41 ') passes through.So as to be attached to adjacent two pairs of the pedicle of vertebral arch of adjacent or spaced apart vertebra
Between the second fastener between screw, with two screws in each pair screw being attached on each pedicle of vertebral arch that illustrates before
Horizontal connector be collectively form entirety truss structure, with serve as the present invention frame assembly agent structure.
In a further embodiment, for example, the second fastener 42,42 ' is by the described first vertical connector 41,41 '
Two ends are respectively fixedly connected to the threaded portion 21,21 ' of two screws 2,2 ' alignd in a second direction and the described first fastening
Between part 32,32 ', in the smooth nail rod of the screw 2,2 ', so that second fastener 42,42 ' can also be
Pivot, be enable to adjacent what is anchored to screw between threaded portion 21,21 ' and first fastener 32,32 '
Or vertebra spaced apart is when carrying out stretching, realized by the pivot external fixer with similar to accordion around it
Draw direction simultaneously pivotably come realize with stretching as the outer fixed class of routine ilizarov, with stretching while adjusting institute
The leading edge angle stated between vertebra on second direction is i.e. vertical is to be adapted to the backbone normal physiological bending to be restored arrived.
In a kind of alternate embodiment, being used for for passing through that the screw 2,2 ' is passed through in second main body 421,421 '
Through hole 4211,4211 ' be configured to the tip of the threaded portion 21,21 ' towards screw 2,2 ' and in tapered so that working as institute
Screw 2,2 ' is stated through the through hole 4211,4211 ' of the second main body of second fastener 42,42 ' and then through described
The through hole 3211,3211 ' of first fastener and by the first fastener tighten it is fixed after, second fastener 42,42 ' and
Correspondingly second coupling assembly 4,4 ' is fixed on the screw alignd in a second direction at two ends, without occurring pivot
Turn.
In an embodiment of the present invention, for example as shown in figure 1, the two ends of the adjusting part are divided along the second direction
Guan Chuan be not adjacent two horizontal connectors 31,31 ', and it is configured to adjust described adjacent two by way of screwing
The distance of horizontal connector 31,31 ' in this second direction.
Fig. 4 (e) shows the schematic diagram of the adjusting screw rod in the external fixer shown in Fig. 1.
Referring to Fig. 1, Fig. 3 and Fig. 4 (e), in the illustrated embodiment, the adjusting part includes：Adjusting screw rod 5, regulation
The two ends of screw rod 5 extend through two adjacent horizontal connectors；And two pairs of regulation nut parts 6,6 ', each pair regulation
Nut is screwed to one end of the adjusting screw rod 5 respectively in the both sides of a horizontal connector, is adjusted by screwing at least one pair of
Section nut come adjust be anchored to the adjacent of vertebra or spaced apart vertebra on both sides pedicle of vertebral arch on phase adjacency pair screw it
Between spacing.For example, as illustrated, the single adjusting screw rod is arranged at the first main part institute by each first fastener
Between the adjustment hole run through.
In a further embodiment, the number of the adjusting screw rod is, for example, two or more.
Also, in further embodiment again, the adjusting screw rod is also for example relative to the first of each first fastener
The adjustment hole biasing that main part runs through is set.For example, one or more adjusting screw rods are located at each first fastener
The same side for the adjustment hole that first main part runs through.
Specifically, for example shown in Fig. 1 and Fig. 3, the orifice plate possesses the center screw of centrally located insertion, and described
Adjusting screw rod is configured to extend through the center screw of adjacent horizontal connector and is connected in adjacent horizontal connector
Between middle part, and it is constructed such that to screw between the middle part in this second direction, i.e., described adjusting screw rod
(it exemplarily can be illustrated as erecting in figure along second direction by means of the center screw on orifice plate between two orifice plates
To) screw in and screw out.
Also, and then as shown in figures 1 and 3, described external fixer also includes two pairs of regulation nut parts 6,6 ', institute
Two adjusting nut parts 6,6 ' are stated to be configured to be screwed to respectively and respectively press against one end of the adjusting screw rod 5
At both sides so that the spacing between two pairs of regulations nut part is variable.More specifically, as Fig. 3 is shown in further detail,
Each adjusting nut part 6 or 6 ' is substantially from correspondingly orifice plate respectively along second direction (it is vertical for being specifically illustrating) herein
The plane of both sides screws and clamps the component that the paired nut of the correspondence orifice plate is constituted, and thus enables that threadably to exist
The the described second vertical connector 5 in adjusting screw rod form for screwing in and screwing out in the center screw of the orifice plate is in the regulation
Nut part 6 or 6 ' place is fastened onto on orifice plate.By described two adjusting nut parts 6,6 ' by adjusting screw rod form
The second vertical connector 5 screws tensioning on orifice plate and fixes and screw release, so as to be achieved with adjusting screw rod
Adjacent or spaced apart vertebra pedicle of vertebral arch between spacing regulation, specifically for example similar to solid outside conventional ilizarov
Fixed " tension force-stress " formula stretching between the pedicle of vertebral arch of adjacent or spaced apart vertebra, consequently facilitating the centrum of vertebra
The growth and union of poroma, are in be fixed outside the conventional ilizarov for the formula that circumferentially surrounds in vitro without being embodied as in patient
Rack form.Simultaneously, additionally it is possible to ensure that anterior margin of vertebral body has certain mobility in original height.
Also, in a kind of alternate embodiment, the adjusting part includes adjusting screw rod 5, and the two ends of adjusting screw rod 5 are distinguished
Possess screw thread bar segment and run through described adjacent two horizontal connectors to screw, and the screw thread bar segment thread rotary orientation on the contrary,
So as to adjust the distance between horizontal connector of adjacent two by screwing the adjusting screw rod 5, to adjust anchoring
The spacing between phase adjacency pair screw on the pedicle of vertebral arch of both sides on to the adjacent of vertebra or vertebra spaced apart.This arrangement
Because adjusting screw rod 5 is provided at both ends with oppositely oriented screw thread bar segment, thus need not possess adjusting nut part, so as to simplify
Structure.
Also, as the development of the present exemplary embodiment, once by means of described two adjusting nut parts 6,6 ' or borrow
Help oppositely oriented tap bolt section will be fixed in described the second of adjusting screw rod form the vertical tensioning of connector 5 it is adjacent
On two orifice plates, then now for example referring back to Fig. 1 and Fig. 2, also by way of the second fastener between adjacent pairs of screw
Connection so that second direction such as diagram it is vertical on, not only beneficial to realized during treating anterior margin of vertebral body axial direction
Alignment, and also define adjustable pedicle of vertebral arch spacing and finished in the external fixer progress fastening every time to the present invention
Afterwards so that the pedicle of vertebral arch spacing is fixed, it is achieved thereby that the relative locking maintenance consolidated between pedicle of vertebral arch, and be easy to accord with
The mode for closing biomethanics requirement carries out axial pressure to promote stretching and bone growth and recover vertebral height and pedicle of vertebral arch
Normal physiological bending.
Also, as an example, such as Fig. 1 and Fig. 3 are best shown, the spacing variation between the phase adjacency pair screw is less than
Equal to the pitch between the pedicle of vertebral arch of adjacent or spaced apart vertebra.Thus, spacing becomes between this phase adjacency pair screw
Momentum essentially results in the variation of distance between the pedicle of vertebral arch of adjacent or spaced apart vertebra, and less than adjacent or be spaced apart
Vertebra pedicle of vertebral arch between normal pitch.
In addition, as an example, such as Fig. 1 and Fig. 2 are best shown, angle is between two screws in each pair screw 2,2 '
Between 0 degree to 180, preferably between 0 degree to 150 degree, more preferably between 0 degree to 60 degree.This is by means of horizontal connection
Part 31,31 ' and realize, and because the two paired screws being anchored on the both sides pedicle of vertebral arch of same vertebra are each screwed
The fact that be anchored to the both sides pedicle of vertebral arch of the vertebra and determine.
Thus, the cooperation and first due to the above-described horizontal fastener 32,32 ' of connector 31,31 ' and first are perpendicular
Cooperation and the second vertical connector 5 and described horizontal connection to connector 41,41 ' and second fastener 42,42 '
The cooperation of fitting 31,31 ', cause the exemplary external fixer of the invention realized on the both sides pedicle of vertebral arch of same vertebra and
Between the pedicle of vertebral arch of vertebra adjacent or spaced apart with purlin as fixed class outside the Ilizarov fixed in vitro for spicule
Frame structure is connected, thus be easy to during treating remove lateral displacement, angulation, rotate and realize anterior margin of vertebral body axially align and
Comprehensive controllability, and need not possess conventional ilizarov exterior fixing racks it is intrinsic in patient in vitro in circumferentially surrounding formula
Structure；And compared with conventional internally-fixed support, be prone to during overcoming recovery in cell reaction and stress shielding etc.
Fixture institute inherent shortcoming.Also, specifically, above-mentioned comprehensive controllability is, for example, to pass through technique effect and routine
The second vertical connector and its tune outside ilizarov in the similar exemplary embodiment of the present of fixed vertical rotary gemel
Save solid outside nut part and two the first vertical connectors and the second fastener, and technique effect and routine ilizarov
Horizontal connector and the first fastener in the similar exemplary embodiment of the present of fixed axial hinge realize, and also
The effect of the deformity such as orthotic joint flexing and bone varus can be similarly played with these hinges, but without conventional hinge
Chain and/or gimbal suspension, so that the external fixation system of three-dimensional adjustable and multiple corrective force is realized with simple structure,
This is repeated no more.
Also, in an exemplary embodiment of the present invention, as shown in figure 1, first fastener 32,32 ' and described the
Two fasteners 42,42 ' are can be removed with screw-fashion from the screw 2,2 ' so that described the of the external fixer
One coupling assembly 3,3 ', second coupling assembly 4,4 ' and the second vertical connector 5 can be with least two pairs spiral shells
Nail 2,2 ' departs from and removed.Thus, after after poroma completely healing, first fastener, the second fastener are unclamped by screwing
And the adjusting nut part for example for the described second vertical coupling arrangement, can by the present invention external fixer except
Other components beyond screw are removed from patient body, thus after avoiding removing outer fixation sick vertebra height loss, and
Avoid second operation to mitigate patient suffering when removing outer fixed.
In addition, based on above-mentioned example embodiment, the exemplary embodiment in other modifications and variations can be realized.
As an example, in alternative embodiments, the Schanz screws also for example with twin-core double thread, it can be provided
It is more broader than single thread Schanz screws be screwed into/enter to follow closely speed, and possess stronger resisting pull out forces and load bearing capacity.
Because the thread root of screw is due to stress Relatively centralized, it is easy to be broken herein.Thus, substituted as another
Embodiment, following form is fabricated to by Schanz screw-type spicules：Its thread segment overall diameter is constant, and inner core is tapered, and spiral shell
Line gradually becomes shallower as from the bottom to top, makes the intensity in whole nail portion and increases from nail tip to nail tail in uniform, it is to avoid produces stress concentration, subtract
Broken nail rate is lacked.
In another exemplary embodiment, it is in segmented thread form to be also set to screw, for example, possess positioned at front end
The first thread segment and rear end the second thread segment and non-threaded smooth section therebetween, be not only convenient in the first screw thread
Section screw penetrate pedicle of vertebral arch but it is convenient when the second thread segment is not yet inserted carry out angle modulated, and tightness can not influenceed
The risk of the fastening force reduction of non-threaded section in the middle of being reduced as far as possible in the case of energy.
In addition, on the fastening at the first and second fasteners, in order to further be easy to regulation in another embodiment,
Also for example on the horizontal connector and the first vertical connector in the first fastener and the second fastener extremely
At few one installation position, extraly set ball cup increases fastening with the first and/or second fastener of the accommodating ground
The angular adjustability of foregoing description external fixer.
The external fixer for operation on vertebra of various embodiments of the present invention, can enter to the screw for inserting pedicle of vertebral arch
Row correction and fixed, can by adjusting the length of vertical adjusting screw rod, come control the height of anterior margin of vertebral body there is provided stretching into
Tensile stress needed for bone.So, not only vertebral bone can be stimulated using the technology of Ilizarov external fixing racks is based essentially on
Scab grows, while can also ensure that anterior margin of vertebral body has certain mobility in original height.After poroma heals completely, then
Remove and be located at the external frame mounting of patient.Healing time can not only be shortened, fixed while can also avoid removing
The loss of sick vertebra height afterwards.Secondary cutting operation can be avoided when removing the frame mounting simultaneously, the pain of patient is significantly reduced
Bitter and financial burden.
Although with reference to accompanying drawing, the present invention is described, and the embodiment disclosed in accompanying drawing is intended to preferred to the present invention
Embodiment is illustrative, and it is not intended that limiting a kind of of the present invention.Dimension scale in accompanying drawing is only
Schematically, limitation of the present invention can not be interpreted as.
It will be understood to those skilled in the art that embodiment described above is all exemplary embodiment,
But protection scope of the present invention is not limited thereto, those skilled in the art can make improvements, in various embodiments
Described structure can carry out independent assortment in the case of the conflict in terms of not recurring structure or principle.
Although some embodiments of this present general inventive concept are shown and illustrated, any to be familiar with the general of this art
Logical technical staff will be understood that, in the case of without departing substantially from the principle of this present general inventive concept and spirit, can be easy to implement these
Example is made change and/or replaced, and these changes and/or replacement should be all included within the scope of the present invention.The present invention's
The protection domain that protection domain should be limited by appended claims and their equivalent is defined.
It should be noted that word " comprising " is not excluded for other element or steps, word "a" or "an" is not excluded for multiple.Separately
Outside, the scope that any element label of claim should not be construed as limiting the invention.
Claims (12)
1. a kind of external fixer (1) for operation on vertebra, it is characterised in that including：
At least two pairs screws (2,2 '), each pair screw is configured to be anchored to the adjacent of vertebra with screwing respectively or is spaced apart
Vertebra on both sides pedicle of vertebral arch；
At least two first coupling assemblies (3,3 '), each first coupling assembly is connected in two screws in each pair screw
Between and extend in a first direction, and be configured to adjust a pair of the pedicle of vertebral arch for the both sides being anchored on same vertebra
Angle between screw and distance in said first direction；
Two the second coupling assemblies (4,4 '), each second coupling assembly be connected in two pairs of adjacent screws with institute
State between two screws alignd in the vertical second direction of first direction；With
Adjusting part, is movably attached between two adjacent the first coupling assemblies, with institute in this second direction
State second party and be adjusted up the distance between described two adjacent first coupling assemblies.
2. external fixer according to claim 1, wherein, each first coupling assembly (3,3 ') includes：
Horizontal connector (31,31 '), described between a pair of screws of the pedicle of vertebral arch for the both sides being anchored on same vertebra
One side upwardly extends；And
Two the first fasteners (32,32 '), are configured to the two ends of the horizontal connector being movably coupled to this respectively
To screw.
3. external fixer according to claim 2, wherein, each first fastener (32,32 ') includes：
Base portion (321,321 '), is formed with the through hole passed through for the screw (2,2 ') in the base portion (321,321 ')
(3211,3211 '), and the base portion (321,321 ') is configured to carry the one of the horizontal connector (31,31 ')
End；
First main part (322,322 '), extends from the base portion perpendicular to the axis of the through hole；And
Nut, is configured to a sidespin opposite at least with base portion (321,321 ') from first main part (322,322 ')
Twist with first main part into being screwed, the one end for the horizontal connector that base portion (321,321 ') is carried
It is fixed to through on the screw of the through hole.
4. external fixer according to claim 3, wherein, formed at least in each horizontal connector (31,31 ')
One adjustment hole (311,311 ') along first direction extension, first main part movably passes through the regulation
Hole, angle between this pair of screw to adjust the pedicle of vertebral arch of both sides being anchored on same vertebra and in the first direction
On distance.
5. the external fixer according to any one of claim 2 to 4, wherein, each second coupling assembly (4,
4 ') include：
First vertical connector (41,41 '), extends in this second direction；And
Second fastener (42,42 '), is configured to the two ends of the described first vertical connector being respectively fixedly connected in second direction
Between the threaded portion (21,21 ') of two screws (2,2 ') of upper alignment and first fastener (32,32 ').
6. external fixer according to claim 5, wherein, second fastener (42,42 ') is vertical by described first
The two ends of connector (41,41 ') are respectively fixedly connected in the smooth nail rod of the screw (2,2 ') so that second fastener
The threaded portion (21,21 ') for two screws (2,2 ') that (42,42 ') can align in a second direction and described first tight
Pivoted between firmware (32,32 ').
7. external fixer according to claim 5, wherein, each second fastener (42,42 ') includes the second master
Two through holes (4211,4211 ' of quadrature arrangement are formed in body (421,421 '), second main body (421,421 ')；
4212,4212 '), the screw (2,2 ') and the first vertical connector (41,41 ') are each passed through two through holes.
8. external fixer according to claim 7, wherein, the two ends of the adjusting part are divided along the second direction
Guan Chuan be not adjacent two horizontal connectors, and it is configured to adjust described adjacent two laterally connection by way of screwing
The distance of fitting in this second direction.
9. external fixer according to claim 2, wherein,
The adjusting part includes：
Adjusting screw rod (5), the two ends of adjusting screw rod (5) extend through two adjacent horizontal connectors；And
Two pairs of regulation nut parts (6,6 '), each pair adjusting nut is screwed to described respectively in the both sides of a horizontal connector
One end of adjusting screw rod (5), adjusts what is be anchored to the adjacent of vertebra or be spaced apart by screwing at least one pair of adjusting nut
The spacing between phase adjacency pair screw on the pedicle of vertebral arch of both sides on vertebra.
10. external fixer according to claim 2, wherein,
The adjusting part includes：
Adjusting screw rod (5), the two ends of adjusting screw rod (5) possess screw thread bar segment and run through two adjacent transverse directions to screw respectively
Connector, and the screw thread bar segment thread rotary orientation on the contrary, so as to adjacent to adjust by screwing the adjusting screw rod (5)
The distance between two horizontal connectors, to adjust the vertebra for the both sides being anchored on the adjacent of vertebra or vertebra spaced apart
The spacing between phase adjacency pair screw on nut.
11. the external fixer according to claim 9 or 10, wherein, the spacing variation between the phase adjacency pair screw
Less than or equal to the pitch between the pedicle of vertebral arch on described adjacent or spaced apart vertebra.
12. external fixer according to claim 4, wherein, angle between two screws in each pair screw (2,2 ')
It is between 0 degree to 180, preferably between 0 degree to 150 degree, more preferably between 0 degree to 60 degree.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710178717.9A CN106963462A (en) | 2017-03-23 | 2017-03-23 | External fixer for operation on vertebra |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710178717.9A CN106963462A (en) | 2017-03-23 | 2017-03-23 | External fixer for operation on vertebra |
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| CN106963462A true CN106963462A (en) | 2017-07-21 |
Family
ID=59329801
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201710178717.9A Pending CN106963462A (en) | 2017-03-23 | 2017-03-23 | External fixer for operation on vertebra |
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| Country | Link |
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| CN (1) | CN106963462A (en) |
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108635029A (en) * | 2018-05-11 | 2018-10-12 | 王小华 | A kind of orthopaedics is for fixed fixed frame outside bone |
| CN110151282A (en) * | 2019-05-15 | 2019-08-23 | 赵华国 | Percutaneous fracture end is fixed temporarily and resetting apparatus and its operating method in a kind of art |
| CN112770685A (en) * | 2018-09-28 | 2021-05-07 | Pmu创新股份有限公司 | Medical positioning device |
| US11413070B2 (en) | 2021-11-22 | 2022-08-16 | New Standard Device, LLC | Locking clamp and external fixation horns |
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| CN110151282A (en) * | 2019-05-15 | 2019-08-23 | 赵华国 | Percutaneous fracture end is fixed temporarily and resetting apparatus and its operating method in a kind of art |
| US11413070B2 (en) | 2021-11-22 | 2022-08-16 | New Standard Device, LLC | Locking clamp and external fixation horns |
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