CN107635493A - 可扩张多轴脊柱内固定系统 - Google Patents

可扩张多轴脊柱内固定系统 Download PDF

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CN107635493A
CN107635493A CN201680022348.8A CN201680022348A CN107635493A CN 107635493 A CN107635493 A CN 107635493A CN 201680022348 A CN201680022348 A CN 201680022348A CN 107635493 A CN107635493 A CN 107635493A
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rod
separated
internal fixation
fixation system
housing
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乌里·阿宁
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Apifix Ltd
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Apifix Ltd
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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
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A—HUMAN NECESSITIES
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    • 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
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    • 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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    • 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
    • A61B17/7049—Connectors, not bearing on the vertebrae, for linking longitudinal elements together
    • A61B17/7052—Connectors, not bearing on the vertebrae, for linking longitudinal elements together of variable angle or length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
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    • A61B17/7071—Implants for expanding or repairing the vertebral arch or wedged between laminae or pedicles; Tools therefor
    • A—HUMAN NECESSITIES
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    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • A61B17/7082—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws
    • A—HUMAN NECESSITIES
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    • 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
    • A61B2017/681—Alignment, compression, or distraction mechanisms

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Abstract

一种脊柱椎弓根螺钉系统，该脊柱椎弓根螺钉系统具有在螺钉(26)插入到椎弓根中之后被分开并经由多轴接头(22)维持运动的能力。

Description

可扩张多轴脊柱内固定系统
技术领域
本发明总体上涉及脊柱植入物和假体，并且特别地涉及被设计成可扩张并且在原位维持多轴运动的基于脊柱椎弓根螺钉的系统。
背景技术
脊柱侧凸正在影响很大部分的人群。当前外科治疗很多时候涉及使用被设计成放置在两块或更多块椎骨之间的基于椎间椎弓根螺钉的系统。
标准椎弓根螺钉系统的使用通常与脊柱融合相关联，而脊柱融合具有一些已知的负面影响。因此，具有能够防止或校正一些患者的侧凸的非融合系统是有价值的。
发明内容
本发明试图提供一种改进的基于脊柱椎弓根螺钉的系统，该基于脊柱椎弓根螺钉的系统能够在螺钉插入到两块椎骨的椎弓根之后扩张并且经由一个或更多个多轴接头而维持脊柱运动。
因此，根据本发明的非限制性实施例，提供一种脊柱内固定系统，该脊柱内固定系统包括：第一分开棒，该第一分开棒具有安装在其端部处的第一连接器；以及第二分开棒，该第二分开棒具有安装在其端部处的第二连接器，该两根棒均被布置成在壳体中移动，并且其中，所述连接器中的每一个连接器被安装在多轴接头上并且由紧固件固定，所述多轴接头中的每一个多轴接头被附接到椎弓根螺钉或者是椎弓根螺钉的一部分，并且其中，紧固件被顶着多轴接头的一部分拧紧，但不抑制多轴接头的多轴移动，使得即使在拧紧紧固件之后，连接器也不能够从多轴接头移走，但多轴接头始终能够自由地多轴移动。
根据本发明的实施例，第一分开棒和第二分开棒中的至少一根分开棒被分开紧固件固定在沿着壳体的任意期望位置处。
根据本发明的实施例，第一分开棒和第二分开棒中的至少一根分开棒在被分开紧固件锁定在位之前绕该至少一根分开棒的纵向轴线旋转。
根据本发明的实施例，分开棒中的至少一根分开棒至少部分带有螺纹，并且与壳体中的内螺纹配合。
根据本发明的实施例，分开棒中的两根分开棒均至少部分带有螺纹，并且与壳体中的内螺纹配合，并且其中，分开棒中的一根分开棒的螺纹是右旋的，并且另一分开棒的螺纹是左旋的。
根据本发明的实施例，壳体包括流体入口，用于通过该流体入口引入流体。
根据本发明的实施例，壳体包括偏压装置，该偏压装置可操作以在第一分开棒和第二分开棒中的至少一根分开棒上施加偏压力。
附图说明
将从结合附图做出的以下详细描述更全面地理解并领会本发明，其中：
图1是根据本发明的非限制性实施例构造和操作的脊柱内固定系统的简化图示，该脊柱内固定系统处于分开之前的初始收缩构造中；
图2是处于扩张/分开构造中的脊柱内固定系统的简化图示；
图3是处于其扩张/分开构造中的系统的简化剖视图；
图4是根据本发明的另一非限制性实施例构造和操作的脊柱内固定系统的简化图示，其中分开是使用螺纹元件来进行的；
图5是根据本发明的另一非限制性实施例构造和操作的脊柱内固定系统的简化图示，其中分开是使用液压力或气压力来进行的；并且
图6是根据本发明的另一非限制性实施例构造和操作的脊柱内固定系统的简化图示，其中分开是使用偏压元件来进行的。
具体实施方式
现参照示意了根据本发明的非限制性实施例构造和操作的脊柱内固定系统100的图1到图3。
该脊柱内固定系统10包括：第一分开棒12，第一分开棒12具有安装在其端部处的第一连接器14；以及第二分开棒16，第二分开棒16具有安装在其端部的第二连接器18。两根棒12和16被布置成在壳体20中移动(例如，平移或滑动)。两个连接器14和18每个可以包括安装在多轴接头22(其可以是，但不限于，球形头)上并由紧固件24(例如，螺母)固定的环。多轴接头22可以被附接到椎弓根螺钉26或者可以是椎弓根螺钉26的一部分。紧固件24被顶着多轴接头22的一部分(在图示中，上部)拧紧，但不抑制多轴接头的多轴移动。因此，即使在拧紧紧固件24之后，连接器14或18不能够从多轴接头移走，但多轴接头始终能够自由地多轴移动。
分开紧固件28和30可分别将第一分开棒12和第二分开棒16紧固在沿着壳体20的任意期望位置处。
在将椎弓根螺钉26插入到患者的椎骨中之后，能够通过使用分开器(未示出)或任意其它适当的装置来分开或扩张(该两个术语被可互换地使用)螺钉之间的距离。分开定向在图2中示出。在分开之后，分开紧固件28和30能够用于固定椎弓根螺钉之间的距离。
如在图1和图2中所看出，第一分开棒12和第二分开棒16可在被分开紧固件28和30锁定在位之前绕其相应的纵向轴线旋转。例如，可以使分开棒中的仅一根分开棒旋转，而不旋转另一根分开棒，或可以使两根分开棒都旋转。作为另一示例，可以使分开棒中的仅一根分开棒被分开，而不使另一根被分开，或可以使两根都被分开。不被分开的那根棒可被分开紧固件锁定在位，或者替代地，可保持解锁，在该情形中，该棒能够以平移和旋转的方式自由移动。
现参照示意了根据本发明的另一非限制性实施例构造和操作的脊柱内固定系统的图4，其中相同元件由相同附图标记表示。在该实施例中，分开棒42和44至少部分地带有螺纹并且与壳体20中的内螺纹46配合。分开可通过使棒相对于壳体旋转来进行，即，通过在壳体静止的情况下使棒旋转或通过在棒不旋转的情况下使壳体旋转，或者通过使棒和壳体两者旋转。在一个实施例中，棒42的螺纹43是右旋螺纹，而棒44的螺纹45是左旋螺纹。以该方式，使壳体在一个方向上旋转导致棒42和44在相反的方向上同时移动。在分开到椎弓根螺钉之间的期望距离之后，分开紧固件(未示出)可用于将该系统固定在期望位置处。
现参照示意了根据本发明的另一非限制性实施例构造和操作的脊柱内固定系统的图5，其中相同元件由相同附图标记表示。在此实施例中，分开是使用液压力或气压力来进行的。例如，壳体20可设有流体入口52，用于通过该流体入口52引入流体(例如，水、生理盐水、空气等)。流体压力作用在棒12和16上，并且增大棒12和16之间的距离。可设置密封环(未示出)以将流体密封在壳体20中。可在外科手术期间或在外科手术之后的任意时间点引入流体。
在一个实施例中，所述棒中的一根棒能够被固定到壳体，而另一根棒通过流体力(液压力或气压力)被分开。
现参照示意了根据本发明的另一非限制性实施例构造和操作的脊柱内固定系统的图6，其中相同元件由相同附图标记表示。在该实施例中，分开是使用设置在壳体中的偏压装置62(例如，螺旋弹簧或柔性带)来进行的。偏压装置62可由金属或弹性体材料制成。偏压装置62可将恒定的或变化的弹簧力施加在棒12和16上。
在一个实施例中，所述棒中的一根棒能够被固定到壳体，而另一根棒通过弹簧力被分开。

Claims (7)

1.一种脊柱内固定系统(10)，包括：
第一分开棒(12)，所述第一分开棒具有安装在其端部处的第一连接器(14)；以及
第二分开棒(16)，所述第二分开棒具有安装在其端部处的第二连接器(18)，所述棒(12、16)中的两根棒均被布置成在壳体(20)中移动，并且其中，所述连接器(14、18)中的每一个连接器被安装在多轴接头(22)上并且由紧固件(24)固定，所述多轴接头中的每个多轴接头被附接到椎弓根螺钉(26)或者是椎弓根螺钉(26)的一部分，并且其中，所述紧固件(24)被靠着所述多轴接头(22)的一部分拧紧，但不抑制所述多轴接头(22)的多轴移动，使得即使在拧紧所述紧固件(24)之后，所述连接器(14、18)不能从所述多轴接头(22)移走，但所述多轴接头(22)始终能够自由地多轴移动。
2.根据权利要求1所述的脊柱内固定系统(10)，其中，所述第一分开棒(12)和所述第二分开棒(16)中的至少一根分开棒通过分开紧固件(28、30)固定在沿着所述壳体(20)的任意期望位置处。
3.根据权利要求2所述的脊柱内固定系统(10)，其中，所述第一分开棒(12)和所述第二分开棒(16)中的至少一根分开棒在通过所述分开紧固件(28、30)锁定在位之前绕所述至少一根分开棒的纵向轴线旋转。
4.根据权利要求1所述的脊柱内固定系统(10)，其中，所述分开棒(42、44)中的至少一根分开棒至少部分带有螺纹，并且与所述壳体(20)中的内螺纹(46)配合。
5.根据权利要求1所述的脊柱内固定系统(10)，其中，所述分开棒(42、44)中的两根分开棒均至少部分带有螺纹，并且与所述壳体(20)中的内螺纹(46)配合，并且其中，所述分开棒(42、44)中的一根分开棒的螺纹是右旋的，而另一个分开棒(44、42)的螺纹是左旋的。
6.根据权利要求1所述的脊柱内固定系统(10)，其中，所述壳体(20)包括流体入口(52)，用于通过所述流体入口(52)引入流体。
7.根据权利要求1所述的脊柱内固定系统(10)，其中，所述壳体(20)包括偏压装置(62)，所述偏压装置(62)可操作以在所述第一分开棒(12)和所述第二分开棒(16)中的至少一根分开棒上施加偏压力。
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