CN107440776B - Internal fixing device for treating Hangman fracture by combining posterior lag screw with pedicle screw - Google Patents
Internal fixing device for treating Hangman fracture by combining posterior lag screw with pedicle screw Download PDFInfo
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- CN107440776B CN107440776B CN201710594669.1A CN201710594669A CN107440776B CN 107440776 B CN107440776 B CN 107440776B CN 201710594669 A CN201710594669 A CN 201710594669A CN 107440776 B CN107440776 B CN 107440776B
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- outer hexagonal
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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
Abstract
The invention discloses an internal fixing device for treating Hangman fracture by combining a posterior novel lag screw with a pedicle screw, which comprises a lag screw, two convex-surface outer hexagonal universal nuts, a cobra connecting rod, the pedicle screw and a transverse connection, wherein the lag screw is of a head-tail double-thread structure and comprises an end part thread, a middle core part and a tail part thread, the tail part thread is provided with the two single-convex-surface outer hexagonal universal nuts in a thread connection mode, the convex surfaces of the two single-convex-surface outer hexagonal universal nuts are oppositely arranged, the cobra connecting rod is arranged between the two single-convex-surface outer hexagonal universal nuts, one end of the cobra connecting rod is provided with a double-concave hole, the other end of the cobra connecting rod is connected with the pedicle screw, and the transverse connection is arranged on the cobra connecting rod between the pedicle screw. The invention overcomes the defects that the prior operative vertebral pedicle fracture can not be perfectly anatomically reduced or the cervical vertebra is left unstable after the operation, and the like, and can realize better anatomic reduction of the dentate vertebral pedicle.
Description
Technical Field
The invention relates to an internal fixing device for treating Hangman fracture by combining a posterior lag screw and a pedicle screw, belonging to the technical field of medical instruments.
Background
The Hangman fracture, also known as traumatic anterior spondylolisthesis, is named after being discovered and researched on strangling criminals, is commonly found in various traffic accidents, falling injuries, water-jumping accidents and some antagonistic sports injuries at present, such as sudden braking of a vehicle by a patient in an automobile accident, rigid collision of a forehead on an object in front or top collision of a lower jaw, hyperextension of cervical vertebra, axial load action on the narrow part of the pedicle of the vertebra dentata, fracture of the pedicle of the vertebra dentata under stress transmitted longitudinally, multiple cervical marrow injuries and extremely high mortality. According to incomplete statistics, traumatic anterior spondylolisthesis accounts for 4-7% of the total cervical fracture dislocation. For the Hangman fracture patients who survive after trauma, because fracture causes intervertebral instability or nerve spinal cord compression, most scholars tend to early operation treatment at present, however, anterior reduction C2-3 intervertebral bone grafting fusion steel plate fixation, posterior C2 vertebral pedicle C3 side block nail rod internal fixation, occipital cervical fusion, posterior axial vertebral pedicle screw fixation, novel C2 vertebral pedicle tension screw percutaneous minimally invasive fixation and foreign NSA technology are six common techniques at present.
The anterior surgery has the advantages of directly recovering the sequence of the damaged segment, cutting the damaged intervertebral disc, rebuilding the stability of the segment, preventing long-term complications caused by fracture malformation healing and the like, but the anterior anatomy is complex, the carotid artery and the hypoglossal nerve are easily damaged, in addition, the lower jawbone is shielded to influence the operation, the indirect treatment on the fracture cannot lead the fracture to be well restored, and the risk of fracture nonunion exists.
The posterior C2 pedicle C3 side block nail-rod internal fixation method forms an internal fixation system, improves the stability and balance of cervical vertebra, but has limited reduction of fracture, only one reduction of common pedicle screws is needed, and the reduction effect is not good.
Occipital cervical fusion is currently largely not used clinically because most of the activity of the upper cervical vertebra is lost after fixation unless the Hangman fracture is combined with instability of the upper cervical vertebra or complicated upper cervical vertebra injury, and the operation cannot perfectly reduce the Hangman fracture.
The posterior dentata pedicle lag screw fixing technology is gradually popularized in clinic, and the operation type has the advantages of small wound, immediate stability of fracture parts and capability of keeping physiological functions of adjacent segments to the maximum extent. However, the posterior dentata pedicle screw has limited reduction effect on the fracture, segmental instability may occur in the long term after operation, and the screw cutting rate is high. In addition, for oblique fractures (fracture lines are not perpendicular to the direction of the nail path), the compression of the screws may cause dislocation of the fracture ends, and the displacement of the horizontal position reduces the anteroposterior diameter of the vertebral canal, which may cause compression and even injury of the spinal cord.
The latest novel C2 pedicle of vertebral arch lag screw percutaneous minimal access fixation has the advantages of short operation time, less bleeding in the operation, quick postoperative recovery and the like, but the novel screw makes the fracture reduction limited (the second pressurization can only make the fracture end close to 2.3mm at most), has poor fracture effect obvious to the displacement separation, has poor reduction effect on oblique fracture, and the screw resets alone, has no connecting system, has poor stability and balance of cervical vertebra, and can not solve the combined fracture of the combined atlas or C3 fracture.
The most important problem of the recent foreign NSA technique is that although a relatively stable stabilization system is formed, the reduction of the fracture is limited, and most of the dentate spinous process, supraspinalis ligament and interspinous ligament need to be cut off, the posterior complex is damaged, the stability of the posterior column is poor, the postoperative recovery is slow, and complications of long-term postoperative cervical pain cannot be solved, and the complex fracture of adjacent vertebral body fractures cannot be solved.
The above operations all have the problems that the operation difficulty is higher, the important vascular nerve is easily damaged, the fracture can not be perfectly dissected and reset, the cervical vertebra is left unstably and the like, so that the system is particularly important for possessing a set of novel internal fixation system for treating the Hangman fracture, which can dissect and reset the fracture and greatly improve the stability and balance of the cervical vertebra after the reduction.
Disclosure of Invention
The invention aims to provide a posterior cervical vertebra internal fixation system, in particular to a novel internal fixation device combining a posterior lag screw and a pedicle screw, the Hangman fracture is reduced for the second time by combining the tension screw with the nut, the nail-rod three-dimensional internal fixing system is formed by combining the C1 or C3 pedicle screw, can overcome the defects that the prior operative vertebral pedicle fracture can not be perfectly anatomically reduced or the cervical vertebra is left unstable after the operation, and the like, can realize better anatomic reduction of the dentate vertebral pedicle, meanwhile, the possibility that the C2 lag screw penetrates out of cortical bone is greatly reduced through the innovative modification of the lag screw, and after the C1 and C3 pedicle screws are jointly used with the novel cobra connecting rod to form a nail-rod three-dimensional internal fixing system, the stability and balance between the cervical vertebrae can be effectively recovered and maintained, and the cervical vertebrae stabilization and balance chair has originality in scientific research and wide clinical application prospect.
The technical scheme adopted by the invention is as follows: the utility model provides an internal fixation device of back way lag screw combination pedicle of vertebral arch screw treatment Hangman fracture, this internal fixation device include lag screw, the outer hexagonal universal nut of first single convex surface, the outer hexagonal universal nut of the single convex surface of second, cobra connective bar, pedicle of vertebral arch screw and cross-linking, lag screw is head and the tail double thread structure, and it includes tip screw thread, well core and afterbody screw thread, the afterbody screw thread is equipped with the outer hexagonal universal nut of first single convex surface, the outer hexagonal universal nut of the single convex surface of second through threaded connection's form, the outer hexagonal universal nut of first single convex surface and the outer hexagonal universal nut of the single convex surface of second set up relatively, is equipped with simultaneously between the outer hexagonal universal nut of first single convex surface outer hexagonal universal nut of single convex surface and the outer hexagonal universal nut of single convex surface of second cobra connective bar, the one end of cobra connective bar is equipped with biconcave hole, the cobra connective bar through this biconcave hole suit at the afterbody of screw The nut is slidably connected with the second single convex outer hexagonal universal nut, the other end of the cobra connecting rod is connected with the pedicle screw, and the transverse connection is arranged on the cobra connecting rod between the pedicle screw and the lag screw.
Preferably, the lag screw has a finer thread at the tail than at the end.
Preferably, the diameter of the end thread of the lag screw is slightly larger than the diameter of the tail thread.
Preferably, the tail cap portion of the lag screw is hexagonal.
Preferably, the concave curvature radius of the double-concave hole of the cobra connecting rod is slightly larger than the nut convex curvature radius of the first single-convex outer hexagonal universal nut and the second single-convex outer hexagonal universal nut.
Compared with the prior art, the invention has the following advantages:
the shape, the structure and the combination of the invention are different from the prior art, and specifically comprise the following steps:
1. the novel tension screw head end screw thread is wide, the diameter of the head end screw thread is slightly larger than that of the tail end screw thread, the bone is favorably held, the diameter of the middle end core is smaller, the bone cannot be held, the pressurization of two ends of a fracture line is favorably realized when the single convex surface universal nut is screwed in, and the tail end is hexagonal and is held by a special tool.
2. The design that outer hexagonal universal nut of single convex surface, cobra connective bar are one end biconcave surface hole makes to some skew fractures (the fracture line is out of plumb with set screw's direction promptly), also enables universal nut and novel cobra connective bar concave surface identical.
3. The most important points of the invention are as follows: the fracture end is reduced for the second time, so that the fracture reduction pressurization is not limited, the fracture can be perfectly anatomically reduced, and the oblique fracture can be anatomically reduced. The first reduction is through novel lag screw reduction, and the second reduction is through the pressurization reduction to the vertebral plate through single protruding outer hexagonal universal nut, makes the fracture both ends further be close to.
Drawings
Fig. 1 is a schematic view of the overall structure of the present invention.
Fig. 2 is a structural schematic diagram of the novel tension screw.
FIG. 3 is a side view of a single convex outer hex universal nut and cobra connector bar.
In the figure: 1-end thread, 2-middle core part, 3-tail thread, 4-first single-convex surface outer hexagonal universal nut, 5-second single-convex surface outer hexagonal universal nut, 6-tail cap part, 7-transverse connection, 8-pedicle screw tail part, 9-cobra connecting rod and 10-pedicle screw.
Detailed Description
The invention is described in detail below with reference to the figures and specific embodiments.
As shown in fig. 1 to 3, an internal fixation device for treating Hangman fracture by combining a posterior lag screw with a pedicle screw comprises a lag screw, a first single-convex outer hexagonal universal nut 4, a second single-convex outer hexagonal universal nut 5, a cobra connecting rod 9, a pedicle screw 10 and a cross connection 7, wherein the lag screw is of a head-tail double-thread structure and comprises an end thread 1, a middle core part 2 and a tail thread 3, the tail thread 3 is provided with the first single-convex outer hexagonal universal nut 4 and the second single-convex outer hexagonal universal nut 5 in a threaded connection manner, the convex surfaces of the first single-convex outer hexagonal universal nut 4 and the second single-convex outer hexagonal universal nut 5 are oppositely arranged, and the cobra connecting rod 9 is arranged between the first single-convex outer hexagonal universal nut 4 and the second single-convex outer hexagonal universal nut 5, the one end of cobra connective bar 9 is equipped with the biconcave surface hole, cobra connective bar 9 through this biconcave surface hole suit at lag screw's afterbody and with but first single convex surface outer hexagonal universal nut 4 and the outer hexagonal universal nut 5 sliding connection of second single convex surface, the other end of cobra connective bar 9 is connected pedicle of vertebral arch screw 10 is equipped with on the cobra connective bar 9 between pedicle of vertebral arch screw 10 and lag screw violently even 7.
In the invention, the tail thread 3 of the lag screw is finer than the end thread 1. The lag screw has a slightly larger diameter at the end thread 1 than at the end thread 3. The tail cap part 6 of the lag screw is hexagonal. The concave surface curvature radius of the biconcave surface hole of the cobra connecting rod 9 is slightly larger than the nut convex surface curvature radius of the first single convex surface outer hexagonal universal nut 4 and the second single convex surface outer hexagonal universal nut 5.
When the invention is applied to a specific operation, the operation can be carried out under the assistance of three-dimensional navigation or under the direct vision manipulation, a lag screw is put in through the pedicle of vertebral arch C2, a first single-convex surface outer hexagonal universal nut is sleeved at the tail part after the lag screw is put in, a cobra connecting rod is sleeved after the nut is rotated and tightened, a second single-convex surface outer hexagonal universal nut is pressed in and tightened, the pedicle screw of vertebral arch C1 or C3 is a conventional pedicle screw of vertebral arch, the conventional insertion is carried out, and the transverse connection is carried out after the tail cap is tightened by pressing the connecting rod in.
The foregoing illustrates and describes the principles, general features, and advantages of the present invention. It should be understood by those skilled in the art that the above embodiments do not limit the scope of the present invention in any way, and all technical solutions obtained by using equivalent substitution methods fall within the scope of the present invention.
The parts not involved in the present invention are the same as or can be implemented using the prior art.
Claims (3)
1. An internal fixation device for treating Hangman fracture by combining posterior lag screw with pedicle screw, which is characterized in that the internal fixation device comprises lag screw, a first single convex surface outer hexagonal universal nut (4), a second single convex surface outer hexagonal universal nut (5), a cobra connecting rod (9), pedicle screw (10) and a transverse connection (7), the lag screw is of a head-tail double-thread structure and comprises end screw threads (1), a middle core part (2) and tail screw threads (3), the tail screw threads (3) are provided with the first single convex surface outer hexagonal universal nut (4) and the second single convex surface outer hexagonal nut (5) in a threaded connection mode, the convex surfaces of the first single convex surface outer hexagonal universal nut (4) and the second single convex surface outer hexagonal universal nut (5) are oppositely arranged, and the cobra connecting rod (9) is arranged between the first single convex surface outer hexagonal universal nut (4) and the second single convex surface outer hexagonal nut (5), one end of the cobra connecting rod (9) is provided with a biconcave surface hole, the cobra connecting rod (9) is sleeved at the tail part of the lag screw through the biconcave surface hole and is slidably connected with the first single-convex surface outer hexagonal universal nut (4) and the second single-convex surface outer hexagonal universal nut (5), the other end of the cobra connecting rod (9) is connected with the pedicle screw (10), and the cobra connecting rod (9) between the pedicle screw (10) and the lag screw is provided with the transverse connection (7); the tail thread (3) of the lag screw is finer than the end thread (1); and the diameter of the end thread (1) of the lag screw is slightly larger than that of the tail thread (3).
2. The internal fixation device for treating Hangman fracture by combining a posterior lag screw and a pedicle screw as claimed in claim 1, wherein the tail cap portion (6) of the lag screw is hexagonal.
3. The internal fixation device for treating Hangman fracture by combining the posterior lag screw and the pedicle screw as claimed in claim 1, wherein the radius of curvature of the concave surface of the double concave hole of the cobra connecting rod (9) is slightly larger than the radius of curvature of the convex surface of the nut of the first single-convex outer hexagonal universal nut (4) and the second single-convex outer hexagonal universal nut (5).
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 |
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| Publication Number | Publication Date |
|---|---|
| CN107440776A CN107440776A (en) | 2017-12-08 |
| CN107440776B true CN107440776B (en) | 2020-07-14 |
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| Application Number | Title | Priority Date | Filing Date |
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| 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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Family Cites Families (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. |
| CN1188086C (en) * | 2002-05-23 | 2005-02-09 | 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 |
| US8518085B2 (en) * | 2010-06-10 | 2013-08-27 | Spartek Medical, Inc. | Adaptive spinal rod and methods for stabilization of the spine |
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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 |