CN108236492B - Nail rod correction bracket assembly for scoliosis - Google Patents
Nail rod correction bracket assembly for scoliosis Download PDFInfo
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- CN108236492B CN108236492B CN201611215482.8A CN201611215482A CN108236492B CN 108236492 B CN108236492 B CN 108236492B CN 201611215482 A CN201611215482 A CN 201611215482A CN 108236492 B CN108236492 B CN 108236492B
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- nail
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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
- 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
- A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
- A61B17/7005—Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit in the screw or hook heads
-
- 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
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
- A61B17/7064—Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
-
- 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
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
-
- 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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8605—Heads, i.e. proximal ends projecting from bone
- A61B17/861—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver
- A61B17/862—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver at the periphery of the screw 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8695—Washers
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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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
-
- 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
Abstract
The invention discloses a nail rod correcting bracket assembly for scoliosis, which comprises a concave side nail rod correcting bracket and a convex side nail rod correcting bracket, wherein the concave side nail rod correcting bracket and the convex side nail rod correcting bracket both comprise longitudinal connecting rods, the middle position (the concave side of a top vertebra) of the longitudinal connecting rod of the concave side nail rod correcting bracket is fixedly connected with a fixed pedicle screw, the middle position (the convex sides of the top vertebra and upper and lower centrums) of the longitudinal connecting rod of the convex side nail rod correcting bracket is fixedly connected with three fixed pedicle screws, and the positions, close to two ends, of the longitudinal connecting rods of the concave side nail rod correcting bracket and the convex side nail rod correcting bracket are respectively connected with more than one sliding pedicle screw in a sliding manner. The nail rod correction support assembly is simple in structure, good in correction effect, capable of maintaining the correction effect, capable of keeping spinal growth, small in minimally invasive operation wound and capable of reducing the incidence rate of complications such as spontaneous fusion and infection.
Description
Technical Field
The invention relates to the technical field of medical instruments for orthopedic surgery, in particular to a nail-bar correcting support assembly for scoliosis.
Background
Scoliosis refers to scoliosis and rotational deformity of the spine, and is classified into infant type (0-3 years old), juvenile type (4-10 years old) and juvenile type (more than 10 years old), which seriously affect physical and mental health of children. Adolescent patients with severe scoliosis may undergo orthopedic fusion procedures, which have relatively little effect on spinal development and cardiopulmonary involvement. With the increase of age, the spine deformity is very serious when children grow to adolescence, the operation difficulty is large, the wound is large, and the complications are many. The spinal deformity in the childhood period has good flexibility and is easy to correct. For children with scoliosis and low ages, the development of the spine and the thorax of the children is obviously influenced by orthopedic fusion surgery, so that the proportion of the trunk and the lower limbs is disordered and the children are difficult to accept. Spinal fusion surgery can also affect cardiac and pulmonary development and function in smaller children. The mobility and function of the spine after operation are necessarily affected by degeneration of the adjacent segments of the fused spine, particularly the lumbar segment, kyphosis of the adjacent segments, low back pain, endophytic-related complications and delayed infection, so that scholars at home and abroad try to treat scoliosis of children of low age by using methods without fusing the spine.
Currently, clinical non-fusion scoliosis surgery mainly includes three major types: (1) spinal growth rod technology; (2) vertical extensible titanium rib technology (VEPTR); (3) anterior vertebral body staple technology. Wherein, the former two are non-fusion technologies, the latter are non-complete fusion technologies, and the latter two are rarely used clinically at present due to unsatisfactory clinical curative effect. At present, the most widely applied technology for treating children scoliosis at home and abroad is the growth rod technology. The clinical curative effect of the spine fusion technology for treating the scoliosis of the mature population is satisfactory, but the spine fusion technology for treating the scoliosis of the growing children can cause a plurality of problems and fails, and the main problem is that the continuous development and aggravation of the postoperative scoliosis cannot be controlled, and the phenomenon of 'crankshaft' occurs. In addition, premature fusion causes the upper body of the infant patient to be short and small, influences the development of the heart and lung functions, and is unacceptable for people. The double-rod growing rod technology which is popularized and applied at home at present is considered as a good method once, but the defects of the double-rod growing rod technology are reported in recent years at home and abroad: (1) repeated surgery is required (on average once every 6 months); (2) breaking the rod and unhooking (or pulling out the upper screw); (3) a convex back deformity appears behind the upper junction; (4) a distraction failure; (5) complications such as spontaneous fusion are common; (6) higher infection rate, etc. The recurrence and aggravation of deformity and the distraction failure after correction are common. Three general reasons for failure are: (1) the capability of asymmetric growth regulation and control is not available, the distraction can be realized only by repeated operation, and the distraction can be realized when the growth capability of the convex side of the scoliosis exceeds the distraction force of the concave side. The adult scoliosis treatment only needs to be corrected by mechanical force, and the children scoliosis correction system can provide satisfactory correction effect immediately during operation, and also needs to regulate and control the asymmetric stress at two sides of a scoliosis vertebral body formed by the remaining scoliosis after the operation and the asymmetric growth caused by the asymmetric stress, reverse the effect of the Hueter-Volkman law, namely generate tensile stress at the concave side to promote the growth of the vertebral body end plate at the concave side of the spine, generate compressive stress at the convex side to inhibit the growth of the semi-vertebral body end plate at the convex side, thereby reducing the loss of scoliosis correction or further correcting the scoliosis by self during the growth period of the children after the operation; (2) after the correction operation, the rod is fixed by the upper pedicle screw and the lower pedicle screw, so that a 'bolt pulling' effect is formed on the concave side of the lateral bend, and the growth regulation and control capability of the rod is limited. At present, in a pedicle screw system correcting device for treating scoliosis of children, the upper end and the lower end of a concave side of the scoliosis are pulled by screw bolts after operation, when the concave side is corrected by using distraction force, the upper end and the lower end of the screw bolt are screwed to fix a distraction rod, otherwise, the screw bolt can be retracted. In the initial stage of opening, the concave side vertebral body is under the action of tensile stress, and the concave side of the vertebral body generates compressive stress again along with the growth of the vertebral body and the bolt pulling of the nail rod in the process of time, so that the asymmetric stress is increased on two sides of the immature vertebral body, and the scoliosis of the children is aggravated in turn. Theoretically, to overcome "bolting" a continuous distraction force must be applied to the concave side, however, current growing rod technology does not meet this requirement and relies on repeated surgical distraction corrections (every 6 months), which is certainly harsh to children. More and more users find that the support is more and more difficult after 2 years, and finally the support is completely immobile. (3) The existing correction devices at home and abroad can not provide enough correction stress at the top vertebra part of lateral curvature. Biomechanical studies have demonstrated that longitudinal loading of scoliosis is primarily concentrated in the apical vertebrae and their adjacent superior and inferior vertebral body segments. However, the correction force of the growth rod is mainly concentrated on the upper vertebra and the lower vertebra, so that sufficient correction stress cannot be provided for the top vertebra, the top vertebra is not fixed by pedicle screws, when the growth force of the vertebral end plate on the convex side of the lateral curvature of the vertebral column exceeds the opening correction force of the vertebral body on the concave side, the top vertebra cannot be opened, and the high-force opening can also induce the backward convex deformity of the junction area above the upper vertebral part. The "magnetic control rod" (MCGR) recently studied abroad, which is extended in vitro by magnetic force every 4 months, is the same as the orthopedic principle of the two-rod growing rod. Its advantages are no damage to child caused by multiple operations, no immediate correction of lateral bending, easy separation of screw, breaking of screw, pulling out screw from top, no movement of screw, and convex back deformation of near-end joint.
In summary, the existing non-fusion technique for scoliosis at home and abroad has the following four problems: (1) the asymmetric growth of the lateral bending spine cannot be regulated and controlled, and the lateral bending of the sick children cannot be corrected immediately during the operation. (2) The pedicle screw 'tie-pulling' phenomenon exists on the concave side after operation, the vertebral body can not grow and extend freely along the direction of the correction rod, the correction can not be maintained and not lost or less lost in the whole growth and development period of children, even the scoliosis can not be shaped, the vertebral body is further corrected by self, and the fusion operation is needed to be performed again after the vertebral body is mature. (3) The two ends of the growth rod are only fixed on pedicle screws of upper and lower end vertebrae of the scoliosis in vivo, the top vertebra and the upper and lower adjacent vertebrae are not fixed by pedicle screws, which is a fatal defect, and the side thrust applied to the concave side by the correction rod to the top vertebra and the effect of pressurizing and fixing the convex side of the top vertebra to inhibit the growth of the end plate are lacked. (4) Three incisions of 6-10 cm are required to be cut in the operation of installing the growing rod, the pedicle screw feeding point is exposed, the screw is placed, bone grafting around the pedicle screw is improved in stability, the operation wound is still large, and some patients have complications such as infection and spontaneous fusion.
Disclosure of Invention
The invention aims to solve the technical problem of overcoming the defects in the prior art and provides the nail rod correction support assembly for scoliosis, which has the advantages of simple structure, good correction effect and small wound and can reduce the incidence rate of complications such as spontaneous fusion, infection and the like.
In order to solve the technical problems, the invention adopts the following technical scheme:
the utility model provides a nail stick and correct bracket component for scoliosis, corrects support and protruding side nail stick and correct the support including concave side nail stick, concave side nail stick is corrected support and protruding side nail stick and is corrected the support and all including indulging even stick, concave side nail stick is corrected the support and is indulged the intermediate position department fixedly connected with a fixed pedicle screw of stick, protruding side nail stick is corrected the support indulge the three fixed pedicle screw of intermediate position department fixedly connected with of stick, concave side nail stick is corrected the position department that the stick of indulging of support and protruding side nail stick correction support is close to both ends and is connected with more than one slip pedicle screw with the sliding mode respectively.
Preferably, the fixed pedicle screw and the sliding pedicle screw each comprise a screw body, a screw seat, two breakable long arms, a screw plug and a cap, the screw body is connected with the screw seat, the screw body is solid or hollow, the two breakable long arms are oppositely and fixedly connected on the screw seat to form a U-shaped structure for embedding the longitudinally connected rod, the two breakable long arms are respectively provided with a concave notch which divides the breakable long arms into the breakable arms and the short arms, the short arms are connected between the breakable arms and the screw seat, the inner surfaces of the two breakable long arms are provided with internal threads extending from the breakable arms to the short arms, the screw plug comprises a threaded part and an arc-shaped pressure pad, the outer surface of the threaded part is provided with external threads matched with the inner surfaces of the internal threads of the breakable long arms, one end of the threaded part is provided with a holding hole, the other end of the threaded part is movably connected with the arc-shaped pressure pad, the arc-shaped pad is provided with an arc-shaped groove matched with the arc-shaped surface of the longitudinally connected rod, the outer surfaces of the short arms of the two breakable long arms are provided with external threads, the cap is used for being sleeved at one end, close to the concave cutting mark, of the short arms of the two breakable long arms and provided with internal threads matched with the external threads of the short arms, and the cap is provided with a cap holding hole.
Preferably, the cap is in a barrel shape, and a smooth section for guiding the short arm sleeved with the cap is arranged at an opening of the barrel-shaped cap; the screwing direction of the cap is opposite to that of the screw plug.
In the rod straightening support assembly, the arc-shaped cushion block is preferably rotatably mounted on the threaded portion through a rivet.
Above-mentioned bracket component is corrected to nail stick, preferred, the arc cushion includes cushion body and two protruding feet of interval connection on the cushion body, and the arc wall is located between two protruding feet.
Preferably, the pedicle screw is a fixed shaft pedicle screw or a movable shaft pedicle screw, a screw body of the fixed shaft pedicle screw is fixedly connected with the screw seat, the screw body is solid or hollow, and the hollow screw body is provided with a guide wire through hole along the axial direction; the nail body of the pedicle screw of the movable shaft is fixedly connected with a ball head, the ball head is movably connected with a nail seat, a ball head pressure pad pressed on the ball head is arranged in the nail seat, a longitudinal connecting rod is embedded into a U-shaped structure of the two breakable long arms, the nail body is solid or hollow, and the hollow nail body is provided with a guide wire through hole along the axial direction.
Preferably, the two short arms or the ball head pressure pads of the pedicle screw are provided with two supporting platforms corresponding to the two convex feet respectively, and the length of the two convex feet is configured to abut against the two supporting platforms so that the arc-shaped cushion block does not press the longitudinal connecting rod, or a space is reserved between the two supporting platforms so that the arc-shaped cushion block presses the longitudinal connecting rod.
Preferably, the cushion block body is provided with at least one rotation stopping shoulder which is matched with the U-shaped structure of the pedicle screw to stop the arc cushion block from rotating.
Preferably, in the concave side nail-bar correcting support, the fixed pedicle screws are arranged on the concave side of the top vertebra of the lateral curvature spine, the sliding pedicle screws at one end of the longitudinal connecting bar are arranged on the concave side of the upper end vertebra of the lateral curvature spine or the concave side of the adjacent vertebral body of the upper end vertebra, and the sliding pedicle screws at the other end of the longitudinal connecting bar are arranged on the concave side of the lower end vertebra of the lateral curvature spine or the concave side of the adjacent vertebral body of the lower end vertebra.
The convex side nail rod correction support frame is preferably, in the convex side nail rod correction support frame, one fixed pedicle screw is arranged on the convex side of the top vertebra of the lateral curvature spine, the other two fixed pedicle screws are arranged on the convex sides of the two vertebral bodies on the upper side and the lower side of the top vertebra, the sliding pedicle screw at one end of the longitudinal connecting rod is arranged on the convex side of the upper end vertebra of the lateral curvature spine or the convex side of the adjacent cone of the upper end vertebra, and the sliding pedicle screw at the other end of the longitudinal connecting rod is arranged on the convex side of the lower end vertebra of the lateral curvature spine or the convex side of the adjacent cone of the lower end vertebra.
Compared with the prior art, the invention has the advantages that: when the nail rod correcting support component is used for correcting the lateral curvature spine, the fixed pedicle screws of the longitudinal connecting rod of the concave lateral nail rod correcting support are arranged on the concave side of the top vertebra of the lateral curvature spine, and the sliding pedicle screws at the two ends of the longitudinal connecting rod are respectively arranged on the concave sides of the upper end vertebra, the lower end vertebra and other vertebral bodies of the lateral curvature spine. One fixed pedicle screw of the convex side screw rod correction bracket is arranged on the convex side of the top vertebra of the lateral bending spine, the other two fixed pedicle screws are arranged on the convex sides of two adjacent vertebral bodies on the two sides of the top vertebra, and the sliding pedicle screws at the two ends of the longitudinal connecting rod are respectively arranged on the convex sides of the upper end vertebra, the lower end vertebra and other vertebral bodies of the lateral bending spine. Each sliding pedicle screw can be matched with the longitudinal connecting rod to adjust the free growth of the lateral bending spine, three fixed pedicle screws fixed on the convex side of the top vertebra and two adjacent vertebral bodies can pressurize the convex side top vertebra and inhibit the growth of the end plate on the convex side of the top vertebra, the lateral bending of the spine can be effectively corrected by adopting the nail rod correcting bracket assembly, the self regulating and controlling capability of the lateral bending spine can be started to adjust the asymmetric growth of the lateral bending spine, the bolting and pulling effect of the pedicle screw on the concave side of the lateral bending spine is eliminated, and the concave side of the lateral bending spine can grow and extend freely.
Drawings
Fig. 1 is a schematic sectional view of a fixed shaft pedicle screw.
Fig. 2 is a schematic sectional structure view of a movable shaft pedicle screw.
Fig. 3 is a schematic structural view of a nail body and a ball head of the pedicle screw of the movable shaft.
Fig. 4 is a schematic sectional structure view of the plug screw.
Fig. 5 is a schematic perspective view of the screw plug.
Fig. 6 is a schematic perspective view of the cap.
Fig. 7 is a schematic cross-sectional structure of the cap.
Fig. 8 is a schematic perspective view of the one-way fixation pedicle screw and the longitudinal rod.
FIG. 9 is a schematic cross-sectional view of a single-direction pedicle screw and a longitudinal rod.
Fig. 10 is a schematic perspective view of the one-way sliding pedicle screw and the longitudinal rod.
FIG. 11 is a schematic cross-sectional view of a one-way sliding pedicle screw in combination with a longitudinal rod.
Fig. 12 is a schematic perspective view of the universal pedicle screw and the longitudinal rod.
FIG. 13 is a schematic cross-sectional view of the universal pedicle screw and the rod.
FIG. 14 is a perspective view of the universal sliding pedicle screw and the longitudinal rod.
FIG. 15 is a schematic cross-sectional view of a universal sliding pedicle screw in combination with a longitudinal rod.
FIG. 16 is a schematic view of the structure of a longitudinally connecting rod.
Fig. 17 is a schematic view of the position of the center pin in the example of the center pin.
Fig. 18 is a top view of the nail rod correcting bracket for correcting the lateral curvature of the spine in the nail placing example.
Fig. 19 is a side view of the nail rod correcting bracket for correcting the lateral curvature of the spine in the nail placing example.
FIG. 20 is a schematic sectional view of a ball pressure pad of a pedicle screw with a movable shaft.
Illustration of the drawings:
1. pedicle screws; 10. a nail body; 11. a nail seat; 12. the long arm can be broken; 121. breaking the arm; 122. a short arm; 13. a plug screw; 131. a threaded portion; 132. an arc-shaped cushion block; 1321. an arc-shaped slot; 1322. a cushion block body; 1323. a convex foot; 1324. a rotation stopping shoulder; 14. a U-shaped structure; 15. a ball head; 16. a ball head pressure pad; 17. holding the plug hole; 18. concave cutting marks; 19. capping; 191. a cap holding hole; 120. a support table; 2. longitudinally connecting rods; 20. a rod body; 21. a connecting head.
Detailed Description
The invention is described in further detail below with reference to the figures and specific examples.
As shown in fig. 17 to 19, the rod-nailing correction bracket for scoliosis of the present embodiment includes a concave side rod-nailing correction bracket and a convex side rod-nailing correction bracket, both the concave side rod-nailing correction bracket and the convex side rod-nailing correction bracket include a longitudinal rod 2, a fixed pedicle screw 1 is fixedly connected to the middle position of the longitudinal rod 2 of the concave side rod-nailing correction bracket, three fixed pedicle screws 1 are fixedly connected to the middle position of the longitudinal rod 2 of the convex side rod-nailing correction bracket, and two sliding pedicle screws 1 are respectively connected to the positions of the longitudinal rod 2 of the concave side rod-nailing correction bracket and the convex side rod-nailing correction bracket near to the two ends. In other embodiments, the longitudinal rod 2 of the concave side screw rod correcting bracket and the convex side screw rod correcting bracket near the two ends can be respectively connected with more than two sliding pedicle screws 1 in a sliding way.
When the nail rod correcting bracket component is used for correcting the lateral curvature spine, the fixed pedicle screws 1 of the longitudinal connecting rod 2 of the concave lateral nail rod correcting bracket are arranged on the concave side of the apical vertebra of the lateral curvature spine, and the sliding pedicle screws 1 at the two ends of the longitudinal connecting rod 2 are respectively arranged on the concave side of the upper end vertebra (or the concave side of the adjacent cone of the upper end vertebra) and the concave side of the lower end vertebra (or the concave side of the adjacent cone of the lower end vertebra) of the lateral curvature spine. One fixed pedicle screw 1 of the convex side screw rod correction bracket is arranged on the convex side of the top vertebra of the lateral curvature spine, the other two fixed pedicle screws 1 are arranged on the convex sides of two adjacent vertebral bodies on the two sides of the top vertebra, and the sliding pedicle screws 1 at the two ends of the longitudinal connecting rod 2 are respectively arranged on the convex side of the upper end vertebra (or the convex side of the adjacent cone of the upper end vertebra) and the convex side of the lower end vertebra (or the convex side of the adjacent cone of the lower end vertebra) of the lateral curvature spine. Each sliding pedicle screw 1 can be matched with the longitudinal connecting rod 2 to adjust the free growth of the lateral bending spine, three fixed pedicle screws 1 fixed on the convex side of the apical vertebra and two adjacent vertebral bodies can pressurize the convex side apical vertebra and inhibit the growth of the convex side end plate of the apical vertebra, the lateral bending of the spine can be effectively corrected by adopting the nail rod correcting bracket component, the self regulation and control capability of the lateral bending spine can be started to adjust the asymmetric growth of the lateral bending spine, the bolting and pulling effect of the pedicle screws on the concave side of the lateral bending spine is eliminated, and the concave side of the lateral bending spine can grow and extend freely.
As shown in fig. 1 to 5, the pedicle screw 1 in the concave side pedicle screw straightening bracket and the convex side pedicle screw straightening bracket comprises a screw body 10, a screw seat 11, two breakable long arms 12, a screw plug 13 and a cap 19, wherein the screw body 10 is connected with the screw seat 11, the two breakable long arms 12 are oppositely and fixedly connected with the screw seat 11 to form a U-shaped structure 14, the U-shaped structure 14 is used for embedding the longitudinal connecting rod 2, the screw plug 13 is used for screwing into the U-shaped structures 14 of the two breakable long arms 12 to press or not press the longitudinal connecting rod 2, when the screw plug 13 presses the longitudinal connecting rod 2, the longitudinal connecting rod 2 is relatively fixed with the pedicle screw 1, when the screw plug 13 does not press the longitudinal connecting rod 2, the longitudinal connecting rod 2 can slide relative to the pedicle screw 1, and the fixed pedicle screw 1 and the sliding screw 1 of the embodiment are different in whether the screw plug 13 presses the longitudinal connecting rod 2 or not. The nail body 10 is solid or hollow, the hollow nail body 10 is provided with a guide wire through hole along the axial direction, and the nail body 10 is provided with threads. The nail seat 11 is in a short cylindrical shape, and the two breakable long arms 12 are fixedly connected with the nail seat 11.
The positions, close to the nail seat 11, of the two breakable long arms 12 are provided with concave notches 18, the concave notches 18 divide the two breakable long arms 12 into a broken arm 121 and a short arm 122, the short arm 122 is fixedly connected with the nail seat 11, the broken arm 121 can be broken at the concave notches 18, and then the broken arm 121 is removed. The inner surfaces of the two breakable long arms 12 of the pedicle screw 1 are provided with internal threads extending from the broken arm 121 to the short arm 122, and the ends of the two short arms 122 close to the concave notch 18 are provided with external threads. The screw plug 13 comprises a threaded portion 131 and an arc-shaped pad 132, the outer surface of the threaded portion 131 has an external thread matching with the internal thread of the inner surface of the breakable long arm 12, one end of the threaded portion 131 has a holding plug hole 17, the holding plug hole 17 is a polygonal hole, the other end of the threaded portion 131 is movably connected with the arc-shaped pad 132, the threaded portion 131 and the arc-shaped pad 132 can rotate relatively, and preferably, the arc-shaped pad 132 is rotatably mounted on the threaded portion 131 through a rivet. The arc cushion block 132 is provided with an arc groove 1321 matched with the arc surface of the longitudinal connecting rod 2, so that the arc cushion block 132 has good pressing effect when pressing the longitudinal connecting rod 2, and can play a good guiding role when not pressing the longitudinal connecting rod 2. The tail parts of the two breakable long arms 12, which are far away from the nail seat 11, are also provided with smooth sections, and when the screw plug 13 is inserted along the space between the breakable long arms 12, the smooth sections play a role in guiding the screw plug 13.
As shown in fig. 6 and 7, the cap 19 is cylindrical, the inner wall of the cap 19 has an internal thread matching the external thread of the short arm 122, and the opening of the cap 19 has a smooth section, so that the cap 19 can be guided when the cap 19 is sleeved on the end of the short arm 122 close to the concave notch 18 and screwed in. The bottom of the cap 19 is provided with a cap holding hole 191, and the cap holding hole 191 is a polygonal hole. When the screw plug 13 is screwed into the two breakable long arms 12 of the pedicle screw 1 and the screw cap 19 is screwed and sleeved at one end of the two short arms 122 of the pedicle screw 1 corresponding to the concave notch 18 after passing through the concave notch 18 and only matching with the internal threads of the short arms 122, the two broken arms 121 of the pedicle screw 1 can be broken and removed, the cap 19 is screwed and sleeved at one end of the two short arms 122 of the pedicle screw 1 corresponding to the concave notch 18, the cap 19 clasps the two short arms 122 of the pedicle screw 1 and compresses the screw plug 13, the screw plug 13 can be effectively prevented from being loosened and withdrawn, and particularly under the condition that the pedicle screw 1 can slide along the longitudinal connecting rod 2, the cap 19 can play a good role in preventing the loosening and withdrawing. Preferably, the screwing direction of the cap 19 is opposite to the screwing direction of the screw plug 13, that is, the screw rotation direction of the cap 19 is opposite to the screw rotation direction of the screw plug 13, so as to further prevent the screw plug 13 from being loosened and withdrawn.
When the pedicle screw 1 is matched and connected with the longitudinal connecting rod 2, the pedicle screw 1 can be set into a one-way fixed pedicle screw 1, a one-way sliding pedicle screw 1, a universal fixed pedicle screw 1 and a universal sliding pedicle screw 1 according to requirements. The one-way fixed pedicle screw 1 and the one-way sliding pedicle screw 1 adopt a fixed shaft pedicle screw 1, a screw body 10 of the fixed shaft pedicle screw 1 is fixedly connected with a screw seat 11, the screw body 10 is solid or hollow, and the hollow screw body 10 is provided with a guide wire through hole along the axial direction. Because the nail body 10 is fixedly connected with the nail seat 11, the nail body 10 can not move relative to the nail seat 11, and therefore the one-way pedicle screw 1 is formed. The one-way fixed pedicle screw 1 and the one-way sliding pedicle screw 1 are different in that a plug 13 of the one-way fixed pedicle screw 1 compresses the longitudinal connecting rod 2 as shown in fig. 8 and 9, the plug 13 of the one-way sliding pedicle screw 1 is close to the longitudinal connecting rod 2 but does not compress the longitudinal connecting rod 2 as shown in fig. 10 and 11, and the one-way sliding pedicle screw 1 and the longitudinal connecting rod 2 can relatively slide along the arrangement direction of the longitudinal connecting rod 2.
The universal fixed pedicle screw 1 and the universal sliding pedicle screw 1 both adopt a movable shaft pedicle screw 1, a screw seat 11 of the movable shaft pedicle screw 1 is of a hollow structure, a ball head 15 and a ball head pressure pad 16 are arranged in the screw seat, a screw body 10 is fixedly connected with the ball head 15, the ball head pressure pad 16 is pressed on the ball head 15, a longitudinal connecting rod 2 is embedded into a U-shaped structure 14 of two breakable long arms 12 and is directly pressed on the ball head pressure pad 16, the screw body 10 is solid or hollow, the hollow screw body 10 is provided with a guide wire through hole along the axial direction, and a polygonal groove is formed in the ball head 15. When the nail body 10 is hollow, the ball head pressure pad 16 is also hollow. The universal fixed pedicle screw 1 and the universal sliding pedicle screw 1 are different in that as shown in fig. 12 and 13, a longitudinal connecting rod 2 is tightly pressed by a plug 13 of the universal fixed pedicle screw 1, a ball head 15 is tightly pressed by the longitudinal connecting rod 2, so that a screw body 10 is fixed, as shown in fig. 14 and 15, the longitudinal connecting rod 2 is not tightly pressed by the plug 13 of the universal sliding pedicle screw 1, the ball head 15 is not tightly pressed by the longitudinal connecting rod 2, the two convex feet 1323 of the plug 13 are pressed against a supporting platform 120 of a ball head pressure pad 16, the ball head pressure pad 16 is tightly pressed, the ball head 15 is tightly pressed by the ball head pressure pad 16, the screw body 10 is fixed, and the universal sliding pedicle screw 1 and the longitudinal connecting rod 2 can relatively slide along the arrangement direction of the longitudinal connecting rod 2.
In this embodiment, as shown in fig. 4 and 5, the arc-shaped spacer 132 includes a spacer body 1322 and two protruding legs 1323 connected to the spacer body 1322 at intervals, and the arc-shaped slot 1321 is disposed between the two protruding legs 1323.
Two supporting platforms 120 (see fig. 20) are arranged on the inner sides of the two short arms 122 of the pedicle screw 1 or the ball head pressure pad 16, the two supporting platforms 120 correspond to the positions of the two convex feet 1323 respectively, the length of the two convex feet 1323 is configured to be abutted against the two supporting platforms 120 so that the arc-shaped cushion block 132 does not press the longitudinal connecting rod 2, or a space is reserved between the two convex feet 1323 and the two supporting platforms 120 so that the arc-shaped cushion block presses the longitudinal connecting rod 2. The arc cushion block 132 with the convex feet 1323 with different lengths is adopted to realize the compression or non-compression of the longitudinal connecting rod 2, the screw plug 13 only needs to be screwed in the two cases, the position of the screw plug 13 does not need to be adjusted, and the operation is greatly facilitated.
Further, two rotation stopping shoulders 1324 which are matched with the U-shaped structure 14 of the pedicle screw 1 to prevent the arc-shaped cushion block 132 from rotating are arranged on the cushion block body 1322, the two rotation stopping shoulders 1324 are symmetrically arranged, and the rotation stopping shoulders 1324 are matched with the U-shaped structure 14 to play a role in guiding, so that the arc-shaped groove 1321 is just aligned to the outer surface of the longitudinally-connected rod 2 in a clamping manner.
Compared with the fixed shaft pedicle screw used in the existing open surgery, the smooth section at the tail end of the breakable long arm 12 plays a role in guiding the screw plug 13, so that the screw plug 13 can be conveniently screwed in; the pedicle screw 1 is provided with a short cylindrical screw seat 11, and the screw seat 11 plays a role in controlling the direction of the pedicle screw 1 when sliding in the screw placing guide sleeve; the nail body 10 is solid or hollow, the solid action force of the nail body 10 is stronger than that of the hollow action force, the hollow nail body 10 can be screwed in along the guide wire, and the nail placing accuracy is high; preferably, in order to better break the breakable long arms 12 of the pedicle screw 1, concave notches 18 are provided at one ends of the two breakable long arms 12 of the pedicle screw 1 close to the screw seat 11, and the weak points of the concave notches 18 can break the breakable long arms 12. After the two broken arms 121 of the pedicle screw 1 are broken off and removed, the cap 19 can cover and tightly screw one end of the short arm 122 of the pedicle screw 1 corresponding to the concave notch 18, tightly hold the two short arms 122 of the pedicle screw 1 and compress the plug screw 13, so as to prevent the plug screw 13 from loosening and withdrawing. The longitudinal rod 2 is compressed by the screw plug 13 of the one-way fixed pedicle screw 1 and the universal fixed pedicle screw 1, and is used for the side-bending top vertebra of the vertebral column and the convex side fixing rods of the upper and lower adjacent vertebrae, so that side thrust is generated on the concave side, the rotation is removed, the correction is facilitated, and meanwhile, the top vertebra is pressurized on the convex side and the growth is inhibited. The one-way sliding pedicle screw 1 and the screw plug 13 of the universal sliding pedicle screw 1 are close to the longitudinal rod 2 but do not compress the longitudinal rod 2, can slide along the longitudinal rod 2 and are used for fixing the upper and lower end vertebrae of the scoliosis and the pedicles of other vertebral bodies except for the apical vertebrae, and along with growth, the pedicle screw 1 for fixing the vertebral bodies can slide along the longitudinal rod 2 to adjust the free growth of the scoliosis.
As shown in fig. 16, the longitudinal rod 2 in the nail rod straightening support comprises a rod body 20 and connecting heads 21 at two ends of the rod body 20. The rod 20 is cylindrical, and the connecting head 21 is polygonal and protrudes out of both ends of the rod 20. The size of the connecting head 21 is smaller than that of the rod body 20. The rod 20 may be embedded in the U-shaped structure 14 of the pedicle screw 1 to form a rod-and-nail fixation structure. The longitudinal connecting rod 2 can be cut into required length according to actual requirements, or can be bent into required radian, and the cut longitudinal connecting rod 2 must be kept with a connector 21 at one end for being inserted into the transverse hole of the rod holder.
With idiopathic chest lumbar lateral curvature (lumbar thoracic cavity)12Upper end of the thoracic region9Lower end of lumbar vertebra3) For example, as shown in FIG. 19, the line A indicates the chest12The pedicle of vertebral arch, B line, is designated as the chest9The vertebral pedicle and the C line are indicated by the waist3The pedicle of vertebral arch, D line, is indicated by the chest11The pedicle of vertebral arch, designated by E line, is the waist1A pedicle of a vertebral arch. The nail placing condition is as follows: chest12Bilateral and thoracic part11Convex side and waist1The convex side is respectively provided with a one-way fixed pedicle screw 1, a chest9Two sides and waist3The two sides are respectively provided with a one-way sliding pedicle screw 1. When the rod penetrating is difficult by all the one-way screws, the universal fixed pedicle screw 1 and the universal sliding pedicle screw 1 are respectively the alternatives of the one-way fixed pedicle screw 1 and the one-way sliding pedicle screw 1. The schematic view of the nail rod correcting bracket after correcting the scoliosis is shown in figures 18 and 19.
The above description is only a preferred embodiment of the present invention, and the protection scope of the present invention is not limited to the above-described embodiments. Modifications and variations that may occur to those skilled in the art without departing from the spirit and scope of the invention are to be considered as within the scope of the invention.
Claims (9)
1. A bracket component is corrected to nail stick for scoliosis which characterized in that: the correcting bracket comprises a concave side nail rod correcting bracket and a convex side nail rod correcting bracket, wherein the concave side nail rod correcting bracket and the convex side nail rod correcting bracket both comprise longitudinal connecting rods, the middle position of the longitudinal connecting rod of the concave side nail rod correcting bracket is fixedly connected with a fixed pedicle screw, the middle position of the longitudinal connecting rod of the convex side nail rod correcting bracket is fixedly connected with three fixed pedicle screws, and the positions, close to the two ends, of the longitudinal connecting rod of the concave side nail rod correcting bracket and the longitudinal connecting rod of the convex side nail rod correcting bracket are respectively connected with more than one sliding pedicle screw in a sliding manner; the fixed pedicle screw and the sliding pedicle screw both comprise a screw body, a screw seat, two breakable long arms, a screw plug and a cap, wherein the screw body is connected with the screw seat, the screw body is solid or hollow, the two breakable long arms are oppositely and fixedly connected on the screw seat to form a U-shaped structure for embedding a longitudinal connecting rod, the two breakable long arms are respectively provided with a concave notch which divides the breakable long arms into a breakable arm and a short arm, the short arms are connected between the breakable arm and the screw seat, the inner surfaces of the two breakable long arms are provided with inner threads extending from the breakable arm to the short arms, the screw plug comprises a screw thread part and an arc-shaped pressure pad, the outer surface of the screw thread part is provided with outer threads matched with the inner threads of the inner surfaces of the breakable long arms, one end of the screw thread part is provided with a holding hole, the other end of the screw thread part is movably connected with the arc-shaped pressure pad, the arc-shaped pad is provided with an arc-shaped groove matched with the arc-shaped surface of the longitudinal connecting rod, the outer surfaces of the short arms of the two breakable long arms are provided with outer threads, the cap is used for being sleeved at one end, close to the concave notch, of the short arm of each of the two breakable long arms and is provided with an internal thread matched with the external thread of the short arm, and the cap is provided with a cap holding hole.
2. The rod straightening bracket assembly according to claim 1, wherein: the cap is in a barrel shape, and a smooth section for guiding the short arm sleeved with the cap is arranged at the opening of the barrel-shaped cap; the screwing direction of the cap is opposite to that of the screw plug.
3. The rod straightening bracket assembly according to claim 1, wherein: the arc-shaped cushion block is rotatably mounted on the threaded portion through a rivet.
4. The rod straightening bracket assembly according to claim 1, wherein: the arc cushion block comprises a cushion block body and two convex feet connected to the cushion block body at intervals, and the arc-shaped groove is arranged between the two convex feet.
5. The rod straightening bracket assembly according to claim 4, wherein: the pedicle screw is a fixed shaft pedicle screw or a movable shaft pedicle screw, a screw body of the fixed shaft pedicle screw is fixedly connected with a screw seat, the screw body is solid or hollow, and the hollow screw body is provided with a guide wire through hole along the axial direction; the nail body of the pedicle screw of the movable shaft is fixedly connected with a ball head, the ball head is movably connected with a nail seat, a ball head pressure pad pressed on the ball head is arranged in the nail seat, a longitudinal connecting rod is embedded into a U-shaped structure of the two breakable long arms, the nail body is solid or hollow, and the hollow nail body is provided with a guide wire through hole along the axial direction.
6. The rod straightening bracket assembly according to claim 5, wherein: two short arms or ball head pressure pads of the pedicle screw are provided with two supporting platforms corresponding to the two convex feet respectively, the length of the two convex feet is configured to be abutted against the two supporting platforms so that the arc-shaped cushion block does not press the longitudinal connecting rod, or a space is reserved between the two supporting platforms so that the arc-shaped cushion block presses the longitudinal connecting rod.
7. The rod straightening bracket assembly according to claim 4, wherein: the cushion block body is provided with at least one rotation stopping convex shoulder which is matched with the U-shaped structure of the pedicle screw to stop the arc cushion block from rotating.
8. The nail bar straightening support assembly according to any one of claims 1 to 7, wherein: in the concave side nail rod correcting support, a fixed pedicle screw is arranged on the concave side of the top vertebra of the lateral bending spine, a sliding pedicle screw at one end of a longitudinal connecting rod is arranged on the concave side of the upper end vertebra of the lateral bending spine or the concave side of the adjacent vertebral body of the upper end vertebra, and a sliding pedicle screw at the other end of the longitudinal connecting rod is arranged on the concave side of the lower end vertebra of the lateral bending spine or the concave side of the adjacent vertebral body of the lower end vertebra.
9. The nail bar straightening support assembly according to any one of claims 1 to 7, wherein: in the convex side nail rod correcting support, one fixed pedicle screw is arranged on the convex side of the top vertebra of the lateral curvature spine, the other two fixed pedicle screws are arranged on the convex sides of the two vertebral bodies on the upper side and the lower side of the top vertebra, the sliding pedicle screw at one end of the longitudinal connecting rod is arranged on the convex side of the upper end vertebra of the lateral curvature spine or the convex side of the adjacent cone of the upper end vertebra, and the sliding pedicle screw at the other end of the longitudinal connecting rod is arranged on the convex side of the lower end vertebra of the lateral curvature spine or the convex side of the adjacent cone of the lower end vertebra.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201611215482.8A CN108236492B (en) | 2016-12-26 | 2016-12-26 | Nail rod correction bracket assembly for scoliosis |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201611215482.8A CN108236492B (en) | 2016-12-26 | 2016-12-26 | Nail rod correction bracket assembly for scoliosis |
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| CN108236492A CN108236492A (en) | 2018-07-03 |
| CN108236492B true CN108236492B (en) | 2022-04-12 |
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Families Citing this family (3)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN112022318B (en) * | 2020-09-22 | 2022-05-13 | 常州集硕医疗器械有限公司 | Spinal deformity growth fixing system and method |
| CN112370136B (en) * | 2020-10-20 | 2022-06-21 | 广东施泰宝医疗科技有限公司 | Sliding groove vertebral pedicle screw internal fixing system |
| CN113768598B (en) * | 2021-09-17 | 2024-03-22 | 湖北省中医院 | Human bone deformity morphology repair system |
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| EP1819286A2 (en) * | 2004-10-26 | 2007-08-22 | U.S. Spinal Technologies, LLC | Bone fixation implant system and method |
| CN201192374Y (en) * | 2005-12-20 | 2009-02-11 | 贺新宁 | Pedicle of vertebral arch hollow corpus vertebrae bone grafting device |
| CN101785695A (en) * | 2010-01-31 | 2010-07-28 | 赵胜 | Automatic-extending and anti-revolving scoliosis correcting system |
| CN102247201A (en) * | 2011-08-12 | 2011-11-23 | 贺新宁 | Percutaneous minimally invasive pedicle screw/rod internal fixation system |
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| EP1819286A2 (en) * | 2004-10-26 | 2007-08-22 | U.S. Spinal Technologies, LLC | Bone fixation implant system and method |
| CN1745723A (en) * | 2005-10-26 | 2006-03-15 | 王岩 | Non-blending spinal side bending corrector |
| CN201192374Y (en) * | 2005-12-20 | 2009-02-11 | 贺新宁 | Pedicle of vertebral arch hollow corpus vertebrae bone grafting device |
| CN101785695A (en) * | 2010-01-31 | 2010-07-28 | 赵胜 | Automatic-extending and anti-revolving scoliosis correcting system |
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