CN107440776A - A kind of inner fixing device of the new lag screw joint pedicle screw treatment Hangman fracture of the way of escape - Google Patents
A kind of inner fixing device of the new lag screw joint pedicle screw treatment Hangman fracture of the way of escape Download PDFInfo
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- CN107440776A CN107440776A CN201710594669.1A CN201710594669A CN107440776A CN 107440776 A CN107440776 A CN 107440776A CN 201710594669 A CN201710594669 A CN 201710594669A CN 107440776 A CN107440776 A CN 107440776A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
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Abstract
The invention discloses a kind of inner fixing device of the new lag screw joint pedicle screw treatment Hangman fracture of way of escape, the inner fixing device includes lag screw, two universal nuts of convex surface outer-hexagonal, cobra pitman, pedicle screw and horizontal company, the lag screw is double thread structure end to end, it includes end thread, middle core and tailing screw flight, the form that tailing screw flight is connected through a screw thread is equipped with two single universal nuts of convex surface outer-hexagonal, the convex surface of two single universal nuts of convex surface outer-hexagonal is oppositely arranged, the cobra pitman is housed between them simultaneously, one end of the cobra pitman is provided with bi-concave hole, the other end connects the pedicle screw, the horizontal company is housed on the cobra pitman between pedicle screw and lag screw.The present invention overcome current each art formula fracture of vertebral pedicle can not perfect anatomical reduction or operation the problems such as leaving cervical spine instabily the defects of, it is possible to achieve axis arch root more preferably anatomical reduction.
Description
Technical field
The present invention relates to a kind of interior fixed dress of the new lag screw joint pedicle screw treatment Hangman fracture of way of escape
Put, belong to technical field of medical instruments.
Background technology
Hangman fractures, and is slipped before also known as traumatic dentata, is obtained with being found, studying with death by hanging criminal first
Name, is nowadays common in various traffic accidents, Falling Injury, diving accident and some antagonism injurys gained in sports, as suffered from traffic accident
Person brakes suddenly in car, and when forehead rigid collision objects in front or lower jaw are answered back to, cervical vertebra hyperextension, axial load act on dentata
The narrow portion of pedicle of vertebral arch, axis arch root receive the stress longitudinally transmitted and are broken, and occur together Cervical cord injuries more, and the death rate is high.
According to incompletely statistics, slipped in whole fracture-dislocation of cervical spine, before traumatic dentata and account for 4%~7%.For being survived after wound
Hangman fracture patients, due to fracture cause intervertebral unstability or neural compression of spinal cord to compel, current most scholars tend to
Operation in early stage, however, preceding road resets C2-3 Intervertebral disc fusions Interal fixation, way of escape C2 pedicle of vertebral arch C3 lateral mass is followed closely in rod admittedly
Determine art, Occipital-cervical fusion, way of escape axis arch root screw fix, the pedicle of vertebral arch lag screw minimal invasion ligamentopexis of novel C 2,
External NSA technologies are currently used six kinds of art formulas.
Anterior approach cuts off damaged spinal disc with impaired section sequence is directly recovered, and rebuilds segmental stabilization and prevents
Only the advantages that long term complication caused by malunion, but the dissection of preceding road is complicated, easy damaged arteria carotis and sublingual god
Through mandibular blocks influence operation technique in addition, this to indirect treatment of fracturing, it is impossible to fracture is well resetted, fracture be present
Disunion risk.
Way of escape C2 pedicle of vertebral arch C3 lateral mass follow closely rod internal fixation, although formed an internal fixation system, make cervical stability with
Balance is improved, but makes the reduction of the fracture very limited, and the once reset of only usual pedicle screw, reset effect is owed
It is good.
Occipital-cervical fusion does not have to clinically now substantially, due to upper cervical spine major part loss of activity after its fixation, unless
Hangman fracture merges upper cervical spine shakiness or merges complicated upper cervical spine injury, and this operation can not fracture very well to Hangman
Reset.
Way of escape axis arch root lag screw technique for fixing is gradually promoted clinical, and this art formula has that wound is small, fracture
At once stablize, can farthest retain the advantages of adjacent segment physiological function in position.But way of escape dentata pedicle screw is to fracture
Reset response it is limited, may after surgery long term there is Segmental instability, and to cut out rate higher for screw.And for oblique fracture
（Fracture line and screw way direction out of plumb）, the pressurization of screw may result in fracture site dislocation, and the displacement of horizontal position makes vertebra
Pipe anteroposterior diameter diminishes, and is likely to result in the compressing of spinal cord or even damages.
The newest pedicle of vertebral arch lag screw minimal invasion ligamentopexis of novel C 2, has operating time short, intraoperative hemorrhage is few, postoperative
Recover the advantages that fast, but this novel screw makes the reduction of the fracture limited（Second of pressurization can only at most make fracture end close to 2.3mm）,
It is poor that obvious fracture effect is separated for displacement, oblique fracture is resetted poor, and this screw individually resets, and does not connect and is
System, the stability and balance of cervical vertebra are poor, can not be solved for the compound fracture of joint atlas or C3 fracture.
External nearest new NSA technologies, although foring metastable systems stabilisation, main problem is still
It is limited to reduction of the fracture effect, and this technology needs to cut off most of spinous process of axis and supraspinal ligament and interspinal ligaments, destroys
Rear complex, makes the less stable of rear pillar, and post-operative recovery is slower, and has the concurrent of postoperative prolonged cervical pain
Disease, and can not solve to merge the compound fracture for closing on vertebral fracture.
More than operation exist operating difficulty is larger, easy damaged important blood vessels nerve, fracture can not perfect anatomical reduction, lose
The problems such as staying cervical spine instabily, thus for possess it is a set of can make fracture anatomical reduction, and can makes the stability of cervical vertebra after reset
And the new internal fixation system for the treatment of Hangman fracture that balance greatly improves is particularly important.
The content of the invention
It is an object of the invention to provide a kind of internal fixing system for cervical posterior approach, specially a kind of new lag screw connection of the way of escape
Close the new inner fixing device of pedicle screw, secondary the resets Hangman of nut combined by lag screw and fractured, joint C1 or
C3 pedicle screws composition nail rod solid internal fixation system, can overcome current each art formula fracture of vertebral pedicle can not perfect anatomical reduction
Or the defects of operation the problems such as leaving cervical spine instabily, it is possible to achieve axis arch root more preferably anatomical reduction, while by drawing
The innovative transformation of power screw, greatly reduce the possibility that C2 lag screws pass cortex of bone, and C1, C3 vertebra is being used in combination
After pedicle screw and novel glasses snake pitman form nail rod solid internal fixation system, stabilization between cervical vertebral body and balance can be with
It is effectively restored and maintains, possesses the originality in scientific research and wide potential applicability in clinical practice.
The present invention adopts the technical scheme that：A kind of new lag screw joint pedicle screw treatment Hangman of the way of escape
The inner fixing device of fracture, the inner fixing device include lag screw, the universal nut of the first single convex surface outer-hexagonal, second single convex surface
The universal nut of outer-hexagonal, cobra pitman, pedicle screw and horizontal company, the new lag screw are double thread knot end to end
Structure, it includes end thread, middle core and tailing screw flight, and the form that the tailing screw flight is connected through a screw thread is single convex equipped with first
The universal nut of face outer-hexagonal, second single universal nut of convex surface outer-hexagonal, the universal nut of the first single convex surface outer-hexagonal and second
The convex surface of single universal nut of convex surface outer-hexagonal is oppositely arranged, while on the universal nut of the first single convex surface outer-hexagonal and second single convex surface
The cobra pitman is housed between the universal nut of outer-hexagonal, one end of the cobra pitman is provided with bi-concave hole,
Cobra pitman is sleeved on the afterbody of lag screw and universal with described first single convex surface outer-hexagonal by the bi-concave hole
Nut and second single universal nut slidable connection of convex surface outer-hexagonal, the other end of the cobra pitman connect the vertebral arch
Root screw, the horizontal company is housed on the cobra pitman between pedicle screw and new lag screw.
As the preferred of this programme, the tailing screw flight of the new lag screw is finer and closely woven than end thread.
As the preferred of this programme, the end thread diameter of the new lag screw is slightly larger than tailing screw flight diameter.
As the preferred of this programme, the tail cap portion of the new lag screw is hexagon.
As the preferred of this programme, the concave curvature radius of the bi-concave hole of the cobra pitman is slightly larger than first
The nut convex radius of the universal nut of single convex surface outer-hexagonal and second single universal nut of convex surface outer-hexagonal.
The present invention has the following advantages compared with prior art：
The present invention is upper in shape, construction and its combination, is different from current prior art, is specially:
1st, new lag screw head end screw thread is roomy, and the head end diameter of thread is slightly larger than threads, beneficial to holding sclerotin, middle-end core
Diameter is smaller will not to hold sclerotin, and fracture line both ends are pressurizeed when being screwed in beneficial to the universal nut in single convex surface, and tail end is hexagon, is passed through
Specific purpose tool is held.
2nd, the universal nut of single convex surface outer-hexagonal, cobra pitman cause for some for the design of a bi-concave hole
Oblique fracture（That is the direction out of plumb of fracture line and fixing screws）, can also make universal nut and novel glasses snake pitman concave surface
Match.
3rd, the most important point of the present invention：To the secondary reset of fracture site, pressed reduction of fracture can be made unrestricted, make bone
Folding obtains perfect anatomical reduction, and equally can be with anatomical reduction for oblique fracture.It is by new pulling force to reset for the first time
Screw resets, and it is to enter fracture both ends by the loaded reset to vertebral plate by single convex universal nut of outer-hexagonal that second, which resets,
One step is close.
Brief description of the drawings
Fig. 1 is the overall structure diagram of the present invention.
Fig. 2 is new lag screw structural representation.
Fig. 3 is the universal nut of single convex surface outer-hexagonal and cobra pitman side view.
In figure：1- end threads, core in 2-, 3- tailing screw flights, the single universal nuts of convex surface outer-hexagonal of 4- first, 5- second
Single universal nut of convex surface outer-hexagonal, 6- tail caps portion, the horizontal companies of 7-, 8- pedicle screw afterbodys, 9- cobra pitmans, 10- vertebral arch
Root screw.
Embodiment
The present invention is described in detail with specific embodiment below in conjunction with the accompanying drawings.
As shown in Figure 1 to Figure 3, a kind of new lag screw joint pedicle screw treatment Hangman fracture of way of escape is interior
Fixing device, the inner fixing device include new lag screw, the universal nut 4 of the first single convex surface outer-hexagonal, outside second single convex surface
The universal nut 5 of hexagonal, cobra pitman 9, pedicle screw 10 and horizontal company 7, the new lag screw are double thread end to end
Structure, it includes end thread 1, middle core 2 and tailing screw flight 3, and the form that the tailing screw flight 3 is connected through a screw thread is equipped with the
The universal nut 4 of one single convex surface outer-hexagonal, second single universal nut 5 of convex surface outer-hexagonal, first single universal spiral shell of convex surface outer-hexagonal
The convex surface of 4 and second single universal nut 5 of convex surface outer-hexagonal of mother is oppositely arranged, while in first single universal nut 4 of convex surface outer-hexagonal
And second be equipped with the cobra pitman 9, one end of the cobra pitman 9 between single universal nut 5 of convex surface outer-hexagonal
Provided with bi-concave hole, cobra pitman 9 by the bi-concave hole be sleeved on new lag screw afterbody and with it is described
First single universal universal slidable connection of nut 5 of single convex surface outer-hexagonal of nut 4 and second of convex surface outer-hexagonal, the cobra connection
The other end of rod 9 connects the pedicle screw 10, the cobra connection between pedicle screw 10 and new lag screw
The horizontal company 7 is housed on rod 9.
In the present invention, the tailing screw flight 3 of the new lag screw is finer and closely woven than end thread 1.The new lag screw
The diameter of end thread 1 be slightly larger than the diameter of tailing screw flight 3.The tail cap portion 6 of the lag screw is hexagon.The cobra connects
Take over the baton 9 bi-concave hole concave curvature radius slightly larger than outside first single universal 4 and second single convex surface of nut of convex surface outer-hexagonal
The nut convex radius of the universal nut 5 of hexagonal.
The present invention can also be carried out in manipulation under direct-view under three-dimensional navigation auxiliary, led in specific operation application
Cross C2 pedicles of vertebral arch and insert new lag screw, insert screw and be inserted in first single universal nut of convex surface outer-hexagonal after afterbody, rotate
After nut is tightened up, cobra pitman is inserted in, then is pressed into the universal nut of the second single convex surface outer-hexagonal and tightens, C1 or C3 pedicles of vertebral arch
Screw is conventional Pedicle Screw Placement in Lower Cervical, and ordinary operation is inserted, and press-in pitman routinely places horizontal company after tightening up tail cap.
The basic principles, principal features and advantages of the present invention have been shown and described above.One of ordinary skill in the art
It should be appreciated that above-described embodiment protection domain that the invention is not limited in any way, all to be obtained using modes such as equivalent substitutions
The technical scheme obtained, falls within protection scope of the present invention.
Part that the present invention does not relate to is same as the prior art or can be realized using prior art.
Claims (5)
1. a kind of inner fixing device of the new lag screw joint pedicle screw treatment Hangmang fracture of the way of escape, its feature exist
Include new lag screw, first single universal nut of convex surface outer-hexagonal in the inner fixing device（4）, second single convex surface outer-hexagonal ten thousand
To nut（5）, cobra pitman（9）, pedicle screw（10）With horizontal company（7）, the lag screw is double thread knot end to end
Structure, it includes end thread（1）, middle core（2）And tailing screw flight（3）, the tailing screw flight（3）The form being connected through a screw thread
Equipped with first single universal nut of convex surface outer-hexagonal（4）, second single universal nut of convex surface outer-hexagonal（5）, outside first single convex surface
The universal nut of hexagonal（4）With second single universal nut of convex surface outer-hexagonal（5）Convex surface be oppositely arranged, while outside first single convex surface
The universal nut of hexagonal（4）With second single universal nut of convex surface outer-hexagonal（5）Between the cobra pitman is housed（9）, it is described
Cobra pitman（9）One end be provided with bi-concave hole, cobra pitman（9）Pulling force is sleeved on by the bi-concave hole
The afterbody of screw and with described first single universal nut of convex surface outer-hexagonal（4）With second single universal nut of convex surface outer-hexagonal（5）Can
It is slidably connected, the cobra pitman（9）The other end connect the pedicle screw（10）, in pedicle screw（10）With
Cobra pitman between new lag screw（9）It is upper that the horizontal company is housed（7）.
2. the new lag screw joint pedicle screw treatment Hangman fracture of a kind of way of escape according to claim 1
Inner fixing device, it is characterised in that the tailing screw flight of the new lag screw（3）Compare end thread（1）It is fine and closely woven.
3. the new lag screw joint pedicle screw treatment Hangman fracture of a kind of way of escape according to claim 1
Inner fixing device, it is characterised in that the end thread of the lag screw（1）Diameter is slightly larger than tailing screw flight（3）Diameter.
4. the new lag screw joint pedicle screw treatment Hangman fracture of a kind of way of escape according to claim 1
Inner fixing device, it is characterised in that the tail cap portion of the new lag screw（6）For hexagon.
5. the new lag screw joint pedicle screw treatment Hangman fracture of a kind of way of escape according to claim 1
Inner fixing device, it is characterised in that the cobra pitman（9）Bi-concave hole concave curvature radius be slightly larger than first
Single universal nut of convex surface outer-hexagonal（4）With second single universal nut of convex surface outer-hexagonal（5）Nut convex radius.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710594669.1A CN107440776B (en) | 2017-07-20 | 2017-07-20 | Internal fixing device for treating Hangman fracture by combining posterior lag screw with pedicle screw |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710594669.1A CN107440776B (en) | 2017-07-20 | 2017-07-20 | Internal fixing device for treating Hangman fracture by combining posterior lag screw with pedicle screw |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN107440776A true CN107440776A (en) | 2017-12-08 |
| CN107440776B CN107440776B (en) | 2020-07-14 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201710594669.1A Active CN107440776B (en) | 2017-07-20 | 2017-07-20 | Internal fixing device for treating Hangman fracture by combining posterior lag screw with pedicle screw |
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Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2147840Y (en) * | 1993-05-24 | 1993-12-01 | 邹德威 | Angle screw two-way reversal nut orthopedic device for orthopedics department |
| CN2305176Y (en) * | 1997-09-12 | 1999-01-27 | 邢台矿务局总医院 | Fixer for pediculus arcus vertebrae of cervical vertebrae |
| CN2398981Y (en) * | 1999-12-15 | 2000-10-04 | 邹德威 | Reduction fixed bone orthopedic appts. |
| CN1380043A (en) * | 2002-05-23 | 2002-11-20 | 霍新明 | Internal fixation steel plate for department of orthopedics |
| CN2848152Y (en) * | 2005-08-25 | 2006-12-20 | 李全修 | Pulling pressurization screw |
| US20110307013A1 (en) * | 2010-06-10 | 2011-12-15 | Spartek Medical, Inc. | Adaptive spinal rod and methods for stabilization of the spine |
-
2017
- 2017-07-20 CN CN201710594669.1A patent/CN107440776B/en active Active
Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2147840Y (en) * | 1993-05-24 | 1993-12-01 | 邹德威 | Angle screw two-way reversal nut orthopedic device for orthopedics department |
| CN2305176Y (en) * | 1997-09-12 | 1999-01-27 | 邢台矿务局总医院 | Fixer for pediculus arcus vertebrae of cervical vertebrae |
| CN2398981Y (en) * | 1999-12-15 | 2000-10-04 | 邹德威 | Reduction fixed bone orthopedic appts. |
| CN1380043A (en) * | 2002-05-23 | 2002-11-20 | 霍新明 | Internal fixation steel plate for department of orthopedics |
| CN2848152Y (en) * | 2005-08-25 | 2006-12-20 | 李全修 | Pulling pressurization screw |
| US20110307013A1 (en) * | 2010-06-10 | 2011-12-15 | Spartek Medical, Inc. | Adaptive spinal rod and methods for stabilization of the spine |
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| Publication number | Publication date |
|---|---|
| CN107440776B (en) | 2020-07-14 |
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Effective date of registration: 20230410 Address after: No. 9 Nanliu Street, Dawenkou Industrial Park, Tai'an City, Shandong Province, 271000 Patentee after: Shandong Kangsheng Medical Device Co.,Ltd. Address before: 210001 No. 68, Qinhuai, Nanjing District, Jiangsu, Changle Road Patentee before: NANJING FIRST Hospital |