CN108236494A - For being placed in the ejector apparatus of scoliosis nail stick correction bracket - Google Patents
For being placed in the ejector apparatus of scoliosis nail stick correction bracket Download PDFInfo
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- CN108236494A CN108236494A CN201611215554.9A CN201611215554A CN108236494A CN 108236494 A CN108236494 A CN 108236494A CN 201611215554 A CN201611215554 A CN 201611215554A CN 108236494 A CN108236494 A CN 108236494A
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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
- A61B17/7074—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
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Abstract
The invention discloses a kind of for being placed in the ejector apparatus of scoliosis nail stick correction bracket, including ejector and fixed frame, ejector includes push-pull arm and the sleeve being connected on push-pull arm, sleeve is equipped with to be sheathed on the socket through-hole outside pedicle screw, push-pull arm includes intermediate connecting seat, connecting rod and adjusting rod, connecting rod and adjusting rod are connected respectively by that can lock universal joint with intermediate connecting seat, in in connecting rod, adjusting rod is connected to by the way that the force adjustment component of push-pull effort is adjusted on fixed frame sleeve connection.The ejector apparatus has the advantages that simple in structure, operation is easy to adjust, laborsaving, and applicability is good.
Description
Technical field
The present invention relates to bone surgery the field of medical instrument technology, and in particular to one kind is rectified for being placed in scoliosis nail stick
The ejector apparatus of Positive rack.
Background technology
Scoliosis refers to that the side of backbone is convex and rotation deformity, is divided into infantilism（0 ~ 3 year old）, Shao Erxing（4 ~ 10 years old）, it is green
Juvenile form（10 years old or more）, seriously affect the health and mental health of children.The puberty of severe scoliosis
Patient, can row orthopedic fusion art, performing the operation, it is relatively small that its vertebral column development and cardiopulmonary are influenced.With advancing age, juvenile
Develop to that adolescence deformity of spine is very serious, and operating difficulty is big the phase, wound is big, and complication is more.Juvenile's phase deformity of spine is soft
It is soft good, it is easy to correct.For scoliosis low age infant, orthopedic fusion, which is performed the operation, significantly affects the hair of children's backbone and thorax
It educates, causes trunk and lower limb out of proportion, it is difficult to which people is allowed to receive.For compared with small children, spinal fusion surgery can also influence the heart, lung
Development and function.Posterior spinal mobility of performing the operation and function are necessarily by fusion backbone adjacent segment especially waist section backbone regression, phase
The incidence of adjacent segment kyphosis deformity, low back pain, the relevant complication of implants and delayed infection is also higher, therefore state
Some inside and outside scholars have attempted to not merged the method treatment underage child scoliosis of backbone with some.
Clinically the non-fused operation of scoliosis mainly includes three categories at present：（1）Spinal growth stick technology；（2）Vertically
Titanium rib cage technology can be extended（VEPTR）；（3）Preceding road centrum staple technology.Wherein, the above two are non-fusion technology, the latter's right and wrong
Complete integration technology, since clinical efficacy is unsatisfied with, present clinic is rarely employed rear the two.Treat children's backbone both at home and abroad at present
Lateral bending it is most widely used be growing rod technology.Spinal fusion techniques treat crowd's scoliosis clinical efficacy satisfaction of reaching maturity,
But treat growing children scoliosis, it may appear that many problems and failure, most important problem are to be unable to control postoperative backbone
The development that continues of lateral bending aggravates, and " bent axle " phenomenon occurs.In addition, fusion too early causes infant upper body short and small and influences the heart, lung work(
It can develop, cannot also receive for people.The double stick growing rod technology that also promotes and applies at home at present was considered as once
Method, but report its deficiency one after another in recent years both at home and abroad：（1）It needs to perform the operation repeatedly（Average every 6 months primary）；（2）Disconnected stick takes off
Hook（Or top screw is extracted）；（3）There is kyphosis deformity after the intersection of top；（4）Strut failure；（5）Spontaneous fusion etc. is concurrent
Disease is common；（6）Higher infection rate etc..More common is that deformity recurrence aggravates and strut failure after correction.It is former to study carefully its failure
Because substantially there is three aspects：（1）Do not regulate and control the ability of asymmetric growth, operation repeatedly can only be leaned on to strut, it is convex when scoliosis
Side growth ability just supports motionless when being more than concave side distracting force.The scoliosis for the treatment of adult is corrected merely with mechanical force,
And children's scoliosis orthopedic system, other than it can provide satisfied rectification effect at once during operation, it is also necessary to can be for
The asymmetric stress for the lateral bending centrum both sides that remaining scoliosis is formed and the asymmetric growth thus caused carry out after operation
Regulation and control reverse Hueter-Volkman law effects --- and it can generate tensile stress in concave side and promote the life of backbone concave side terminal plate of vertebral body
It is long, and convex side generates compression, inhibits the growth of convex side hemivertebra soleplate, so as to reduce lateral bending during children growth after surgery
Correction loses or lateral bending degree is made further voluntarily to correct；（2）After corrective procedure, since upper and lower two pieces of pedicle screws consolidate stick
It is fixed, " bolt drawing " effect is formed in the concave side of lateral bending, limits the ability of its regulation and control growth.At present, in treatment children's scoliosis
In pedicle screw system apparatus for correcting, the postoperative upper and lower side in scoliosis concave side is all held by screw bolt, when concave side uses
After distracting force correction, it is necessary to upper and lower side screw-driving be strutted stick with fixation, otherwise it will be retracted.Distracted initial rank
Section, concave side centrum are acted on by tensile stress, and the bolt of the growth of centrum and nail stick is drawn as time goes by, will necessarily be occurred in the later stage
Centrum concave side generates compression again, increases asymmetric stress to immature centrum both sides, can aggravate children's ridge again in turn
Column lateral bending.Theoretically, need to be to concave side using lasting distracting force in order to overcome " bolt drawing ", however growing rod technology is not achieved at present
This requirement needs to strut correction by operation repeatedly（Every 6 months primary）, this is undoubtedly children cruel.It is and more next
More users has found that rear distraction in 2 years is increasingly difficult to, and supports completely to the end motionless.（3）Domestic and international existing apparatus for correcting cannot
Enough correction stress is provided at the top vertebra position of lateral bending.The longitudinal load that biomechanics Research is proved scoliosis mainly collects
In in top vertebra and its neighbouring upper hypocentrum segment.However the corrective force of growing rod is concentrated mainly on upper and lower side vertebra, it can not be to top
Vertebra position provides enough correction stress, and top vertebra does not have pedicle screw to fix, when the convex pleurocentrum soleplate growing power of scoliosis
During more than concave side pyramidal support corrective force, just support it is motionless, it is powerful support to open can also induce junctional area above the vertebra position of upper end
Kyphosis deformity." the magnetic force control rod " of latest research（MCGR）, it is as the orthopedic principle of double stick growing rod, every 4
The moon is extended in vitro with magnetic force.Its advantages of be can to avoid the Repeated Operation wound to children, but it there is also given birth to double stick
All shortcomings of long stick, cannot equally correct lateral bending at once, be susceptible to the disconnected stick of de- nail, top screw is extracted, supports motionless, proximal end
The problems such as kyphosis deformity of engaging portion.
In conclusion at present both at home and abroad scoliosis non-fusion technology there are the problem of have a following four in terms of：（1）It cannot
Regulate and control the asymmetric growth of scoliotic spine, cannot at once correct the lateral bending of sick child when operation.（2）It is postoperative that in concave side, there are vertebras
Pedicle screw " bolt drawing " phenomenon, it is impossible to centrum be allowed to extend along the direction free growth of correction stick, in the entire growth and development of children
Phase cannot maintain correction not lose or lose less or even scoliosis cannot be allowed moulding, further voluntarily correct, and also be needed after ripe
Fusion is done again.（3）The pedicle of vertebral arch screw that growing rod both ends are only fixed on scoliosis upper and lower side vertebra in vivo nails on, and pushes up vertebra
And its defects of neighbouring upper hypocentrum is without nail pedicle fix, this is fatal, lack correction stick and push concave side to what top vertebra applied
Side-thrust and the fixed effect for inhibiting soleplate growth of pressurizeing is carried out to top vertebra convex side.（4）Installation growing rod operation need to cut three 6
The notch of ~ 10cm appears screw entrance point and puts nail, and bone grafting increases the stability of screw, operation wound around pedicle screw
Still big, there are the complication such as infection, spontaneous fusion in some patientss.
Invention content
The technical problem to be solved in the present invention is to overcome the shortcomings of the prior art, provides a kind of simple in structure, operation
It is easy to adjust, laborsaving, the good ejector apparatus for being used to be placed in scoliosis nail stick correction bracket of applicability.
In order to solve the above technical problems, the present invention uses following technical scheme：
A kind of ejector apparatus for being used to be placed in scoliosis nail stick correction bracket, including ejector and fixed frame, the ejector
Including push-pull arm and the sleeve being connected on push-pull arm, the sleeve is equipped with to be connected for being sheathed on the set outside pedicle screw
Hole, the push-pull arm include intermediate connecting seat, connecting rod and adjusting rod, and connecting rod and adjusting rod are respectively by that can lock Universal connector
Head is connected with intermediate connecting seat, and in connecting rod, adjusting rod is connected to sleeve connection by the way that the force adjustment component of push-pull effort is adjusted
On fixed frame.
Above-mentioned ejector apparatus, it is preferred that the one end open of the socket through-hole is equipped with to be fastened in vertical connecting bar
The slot of falling U, the width for the slot of falling U are greater than or equal to the diameter of the vertical connecting bar of nail stick correction bracket.
Above-mentioned ejector apparatus, it is preferred that the fixed frame includes frame and the mounting assembly for installing fixed frame,
Frame has two to four for fixing the installing frame side of ejector, and each installing frame side is used to be caught in adjusting rod equipped with several
Card slot, several card slots are along installing frame side arranged for interval；The adjusting part includes third adjusting nut and the 4th adjusting nut, adjusts
Pole is screw rod, and adjusting rod is arranged in card slot, and third adjusting nut and the 4th adjusting nut thread fitting are installed in adjusting rod
On, and third adjusting nut and the 4th adjusting nut are divided into the both sides on installing frame side.
Above-mentioned ejector apparatus, it is preferred that the mounting assembly includes at least two support fixed mechanisms, and each support is fixed
Mechanism includes strut and for being fastened in the U-shaped folder block on operating table, and one end of the strut is connect with frame, the other end and U
Type fixture block connects, and thread fitting is connected with by screwing abutting or unclamping the lock-screw of operating table on U-shaped folder block.
Above-mentioned ejector apparatus, it is preferred that between the third adjusting nut and installing frame side and the 4th adjusting nut
Gasket is equipped between installing frame side.
Above-mentioned ejector apparatus, it is preferred that universal joint can be locked and include ballhead and lock nut, lock nut is connected to centre and connects
On joint chair, spherical cavity is equipped between lock nut and intermediate connecting seat, ballhead is installed in spherical cavity, lock nut and intermediate connecting seat spiral shell
Line connects and can be affixed by screwing compression or release ballhead, connecting rod or adjusting rod and ballhead.
Above-mentioned ejector apparatus, it is preferred that the axis of the sleeve and the axis of connecting rod are misaligned.
Compared with prior art, the advantage of the invention is that：The present invention follows closely stick correction bracket for being placed in scoliosis
Ejector apparatus can push centrum to be drawn close to midspinal line, to realize correction with the epicentral pedicle screw cooperation of merging vertebra
Lateral bending.And its connecting rod and adjusting rod are connected respectively by that can lock universal joint with intermediate connecting seat, can adjust operating force
Line, applicability are good.The ejector apparatus have many advantages, such as it is simple in structure, operation it is easy to adjust, laborsaving.
Description of the drawings
Fig. 1 is the schematic cross-sectional view of fixing axle pedicle screw.
Fig. 2 is the schematic cross-sectional view of movable axis pedicle screw.
Fig. 3 is the rivet nut of movable axis pedicle screw and the structure diagram of bulb.
Fig. 4 is the schematic cross-sectional view of plug screw.
Fig. 5 is the dimensional structure diagram of plug screw.
Fig. 6 is the dimensional structure diagram of block.
Fig. 7 is the schematic cross-sectional view of block.
Fig. 8 is unidirectional fixed pedicle screw and the dimensional structure diagram of vertical connecting bar cooperation.
Fig. 9 is unidirectional fixed pedicle screw and the schematic cross-sectional view of vertical connecting bar cooperation.
Figure 10 is the unidirectional dimensional structure diagram slided pedicle screw and coordinated with vertical connecting bar.
Figure 11 is the unidirectional schematic cross-sectional view slided pedicle screw and coordinated with vertical connecting bar.
Figure 12 is universal fixed pedicle screw and the dimensional structure diagram of vertical connecting bar cooperation.
Figure 13 is universal fixed pedicle screw and the schematic cross-sectional view of vertical connecting bar cooperation.
Figure 14 is universal slip pedicle screw and the dimensional structure diagram of vertical connecting bar cooperation.
Figure 15 is universal slip pedicle screw and the schematic cross-sectional view of vertical connecting bar cooperation.
Figure 16 is the structure diagram of vertical connecting bar.
Figure 17 is the front view structure view of ejector.
Figure 18 is the broken section structure diagram of ejector.
Figure 19 is the dimensional structure diagram that ejector is mounted in the card slot on installing frame side.
Figure 20 is the dimensional structure diagram that fixed frame is mounted on operating table.
Figure 21 is to put the schematic diagram that nail position is put in nail example.
Figure 22 is to put to follow closely the overlooking the structure diagram after stick correction bracket corrects scoliotic spine in nail example.
Figure 23 is to put to follow closely the side structure schematic view after stick correction bracket corrects scoliotic spine in nail example.
Figure 24 is the schematic cross-sectional view of the bulb pressure pad of movable axis pedicle screw.
Marginal data：
1st, pedicle screw；10th, rivet nut；11st, nail seat；12nd, it is broken long-armed；121st, break arm；122nd, galianconism；13rd, plug screw；131、
Threaded portion；132nd, arc cushion block；1321st, arc groove；1322nd, cushion block body；1323rd, convex foot；1324th, rotation stop convex shoulder；14th, U-shaped
Structure；15th, bulb；16th, bulb pressure pad；17th, consent is held；18th, recessing mark；19th, block；191st, cap aperture is held；120th, supporting station；2、
Vertical connecting bar；20th, barred body；21st, connector；1000th, ejector；1001st, sleeve；10011st, the slot of falling U；1002nd, push-pull arm；10021、
Connecting rod；10022nd, intermediate connecting seat；10023rd, adjusting rod；10024th, third adjusting nut；10025th, the 4th adjusting nut；
10026th, ballhead；10027th, lock nut；1100th, fixed frame；1101st, frame；11011st, installing frame side；11012nd, card slot；1102、
Support fixed mechanism；11021st, strut；11022nd, U-shaped folder block；11023rd, lock-screw.
Specific embodiment
The present invention is described in further detail below in conjunction with the drawings and specific embodiments.
As shown in Figure 17 to Figure 20, the present embodiment is used to be placed in the ejector apparatus of scoliosis nail stick correction bracket, including
Ejector 1000 and fixed frame 1100, ejector 1000 include push-pull arm 1002 and the sleeve being connected on push-pull arm 1002
1001, sleeve 1001 is equipped with for being sheathed on the socket through-hole outside pedicle screw 1, and push-pull arm 1002 includes intermediate connecting seat
10022nd, connecting rod 10021 and adjusting rod 10023, connecting rod 10021 and adjusting rod 10023 are respectively by that can lock universal joint
It is connected with intermediate connecting seat 10022, sleeve 1001 is connected in connecting rod 10021, and adjusting rod 10023 is by being adjusted push-pull effort
Force adjustment component be connected on fixed frame 1100.
The ejector apparatus can push centrum to be drawn close to midspinal line with the epicentral cooperation of pedicle screw 1 of merging vertebra,
Lateral bending is corrected to realize.Its connecting rod 10021 and adjusting rod 10023 are respectively by that can lock universal joint and intermediate connecting seat
10022 are connected, and can adjust the operation line of force, and applicability is good, and can be by connecting rod 10021 and adjusting rod 10023 after adjusting
Locking makes connecting rod 10021 and adjusting rod 10023 are fixedly connected with intermediate connecting seat 10022.The ejector apparatus has structure letter
It is single, operate the advantages that easy to adjust, laborsaving.
In the present embodiment, the one end open of through-hole is socketed equipped with the slot of falling U 10011 for being fastened in vertical connecting bar 2, should be fallen
U-type groove 10011 is two symmetrical grooves being opened on 1001 annular sidewall of cylindrical sleeve, the width of the slot of falling U 10011 be more than or
Equal to the diameter of the vertical connecting bar 2 of nail stick correction bracket, the length of inverted U slot 10011 accounts for about 2/3rds of 1001 length of sleeve
To 3/4ths, the inverted U slot 10011 of pedicle screw 1 and sleeve 1001 is passed through conducive to vertical connecting bar 2.
In the present embodiment, fixed frame 1100 includes frame 1101 and the mounting assembly for installing fixed frame 1101, frame
Frame 1101 has two for fixing the installing frame side 11011 of ejector 1000, and two installing frame sides 11011 are arranged at intervals and phase
Mutually parallel, each installing frame side 11011 is equipped with several card slots 11012 for being used to be caught in adjusting rod 10023, several card slots 11012
Along 11011 arranged for interval of installing frame side；Adjusting part includes 10024 and the 4th adjusting nut 10025 of third adjusting nut, adjusts
Bar 10023 is screw rod, and adjusting rod 10023 is arranged in card slot 11012,10024 and the 4th adjusting nut of third adjusting nut
10025 thread fittings are installed on adjusting rod 10023, and 10024 and the 4th adjusting nut 10025 of third adjusting nut is divided into
The both sides on installing frame side 11011.Third adjusting nut 10024 and the 4th adjusting nut 10025 are adjusted, adjusting rod can be forced
10023 move along card slot 11012, and then adjust push-pull effort.
In the present embodiment, mounting assembly includes four support fixed mechanisms 1102, each that fixed mechanism 1102 is supported to include branch
Bar 11021 and for being fastened in the U-shaped folder block 11022 on operating table, one end of strut 11021 is connect with frame 1101, another
End is connect with U-shaped folder block 11022, and thread fitting is connected with by screwing abutting or unclamping the lock of operating table on U-shaped folder block 11022
Tight screw 11023.Four support fixed mechanisms 1102 are separately fixed on the two sides of operating table two-by-two, can be by frame 1101
The solid and reliable surface for being fixed on operating table, the structure of the support fixed mechanism 1102 is simple, is dismounted easily.
In the present embodiment, between third adjusting nut 10024 and installing frame side 11011 and the 4th adjusting nut 10025
Gasket is equipped between installing frame side 11011.
In the present embodiment, universal joint can be locked and include ballhead 10026 and lock nut 10027, during lock nut 10027 is connected to
Between on connecting seat 10022, be equipped with spherical cavity between lock nut 10027 and intermediate connecting seat 10022, ballhead 10026 is installed in ball
Shape intracavitary, lock nut 10027 are threadedly coupled with intermediate connecting seat 10022 and can be by screwing compression or unclamping ballhead 10026, even
Extension bar 10021 or adjusting rod 10023 and ballhead 10026 are affixed.Lock nut 10027 has for connecting rod 10021 or adjusting rod
10023 through-holes passed through.
In the present embodiment, the axis and the axis of connecting rod 10021 of sleeve 1001 are misaligned.
As shown in Figures 1 to 5, the pedicle screw 1 followed closely in stick correction bracket can be rolled over including rivet nut 10, nail seat 11, two
Disconnected long-armed 12, plug screw 13 and block 19, rivet nut 10 are connect with nail seat 11, and two broken long-armed 12 are contrario fixedly connected on nail
U-shaped structure 14 is formed on seat 11, for embedded vertical connecting bar 2 in U-shaped structure 14, plug screw 13 is for being screwed into two broken long-armed 12
U-shaped structure 14 in compress or do not compress vertical connecting bar 2, when plug screw 13 compresses vertical connecting bar 2, indulge connecting bar 2 and 1 phase of pedicle screw
To fixation, when plug screw 13 does not compress vertical connecting bar 2, indulge connecting bar 2 and opposite with pedicle screw 1 can slide.Rivet nut 10 to be solid or
Hollow, hollow rivet nut 10 has seal wire through-hole in an axial direction, and rivet nut 10 is equipped with screw thread.Nail seat 11 is short cylindrical shape, and two can roll over
Disconnected long-armed 12 are fixedly connected with nail seat 11.
Recessing mark 18 is equipped at the position of nail seat 11 on two broken long-armed 12, recessing mark 18 is broken by two
Long-armed 12 points are fixedly connected for disconnected arm 121 and galianconism 122, galianconism 122 with nail seat 11, and disconnected arm 121 can be rolled at recessing mark 18
It is disconnected, and then disconnected arm 121 is removed.There is two broken long-armed 12 inner surfaces of pedicle screw 1 arm 121 of autotomying to extend to
The internal thread of galianconism 122, two galianconism 122 have external screw thread close to 18 end of recessing mark.Plug screw 13 includes threaded portion 131 and arc cushion block
132, the outer surface of threaded portion 131 has and the broken long-armed matched external screw thread of 12 inner surface internal thread, one end of plug screw 13
With consent 17 is held, consent 17 is held as polygonal hole, the other end of threaded portion 131 is flexibly connected with arc cushion block 132, threaded portion
131 and arc cushion block 132 can relatively rotate, it is preferred that arc cushion block 132 is rotatably mounted in threaded portion by rivet
On 131.Arc cushion block 132 is equipped with the matched arc groove 1321 of curved surfaces with vertical connecting bar 2, is compressing arc cushion block 132
Its compression effect is good during vertical connecting bar 2, when not compressing vertical connecting bar 2, can play good guiding role.Two broken long-armed
12 tail portions far from nail seat 11 are additionally provided with smooth section, and when plug screw 13 is inserted into along between broken long-armed 12, smooth section is to plug screw
13 play the guiding role.
As shown in Figure 6 and Figure 7, block 19 is barrel-shaped, and inner wall has the internal thread to match with 122 external screw thread of galianconism, lid
19 opening of cap has smooth section, and when block 19 is sleeved on galianconism 122 close to 18 one end of recessing mark and is screwed into, guiding is played to block 19
Effect.19 bottom of block, which has, holds cap aperture 191, holds cap aperture 191 as polygonal hole.When plug screw 13 is screwed into 1 all right one way or the other folding of pedicle screw
In disconnected long-armed 12, be threaded through recessing mark 18 only screw-internal thread fit with galianconism 122 when, 1 liang of disconnected arm 121 of pedicle screw can be fractureed
And remove, block 19 is screwed and is set in one end that 1 two galianconism 122 of pedicle screw correspond to recessing mark 18, block 19 is held tightly
Two galianconism 122 of pedicle screw 1 simultaneously compress plug screw 13, can effectively prevent the loosening of plug screw 13 and exit, especially in pedicle of vertebral arch
In the case that screw 1 can be slided along vertical connecting bar 2, block 19 can play the role of anti-loosening well exit.Preferably, block 19
Screw direction and plug screw 13 screws direction on the contrary, namely the rotation direction of thread of block 19 and the rotation direction of thread of plug screw 13
On the contrary, further the anti-loosening of plug screw 13 is exited.
Pedicle screw 1 can be arranged as required into unidirectional fixed pedicle screw 1, list when being connected with vertical connecting bar 2
To slip pedicle screw 1, universal fixed pedicle screw 1 and universal 1 four kinds of pedicle screw of slip.Wherein, it is unidirectional fixed
Pedicle screw 1 and the unidirectional pedicle screw 1 that slides are using fixing axle pedicle screw 1, the rivet nut of fixing axle pedicle screw 1
10 are fixedly connected with nail seat 11, and rivet nut 10 is solid or hollow, and hollow rivet nut 10 has seal wire through-hole in an axial direction.Due to rivet nut 10
It is fixedly connected with nail seat 11 so that rivet nut 10 cannot be moved with respect to nail seat 11, therefore form unidirectional pedicle screw 1.It is unidirectional solid
Determining pedicle screw 1 and unidirectional slip pedicle screw 1, difference lies in as shown in Figure 8 and Figure 9, unidirectionally fix pedicle of vertebral arch screw
The plug screw 13 of nail 1 compresses vertical connecting bar 2, and as shown in Figure 10 and Figure 11, the unidirectional plug screw 13 for sliding pedicle screw 1 connects close to vertical
Stick 2 but vertical connecting bar 2 is not compressed, the unidirectional pedicle screw 1 and vertical connecting bar 2 of sliding can be slided along vertical 2 arranged direction of connecting bar is opposite.
Universal fixed pedicle screw 1 and universal slip pedicle screw 1 are using movable axis pedicle screw 1, activity
The nail seat 11 of axis pedicle screw 1 is hollow-core construction, is built-in with bulb 15 and bulb pressure pad 16, and rivet nut 10 is fixed with bulb 15 to be connected
It connects, bulb pressure pad 16 is pressed on bulb 15, and vertical connecting bar 2 is embedded in two broken long-armed 12 U-shaped structures 14 and directly bears against
On bulb pressure pad 16, rivet nut 10 is solid or hollow, and hollow rivet nut 10 has seal wire through-hole in an axial direction, has polygon on bulb 15
Groove.When rivet nut 10 is hollow, bulb pressure pad 16 is also hollow structure.Universal fixed pedicle screw 1 and universal slip vertebral arch
Root screw 1 difference lies in, as shown in Figure 12 and Figure 13, the plug screw 13 of universal fixed pedicle screw 1 compresses vertical connecting bar 2,
The compression of bulb 15 fixes rivet nut 10 by vertical connecting bar 2, as shown in Figure 14 and Figure 15, the universal plug screw 13 for sliding pedicle screw 1
Vertical connecting bar 2 is not compressed, vertical connecting bar 2 does not compress bulb 15 yet, and the convex foot 1323 of 13 liang of plug screw is pressed on the bearing of bulb pressure pad 16
On platform 120, bulb pressure pad 16 is compressed, bulb pressure pad 16 compresses bulb 15, and rivet nut 10 is fixed, universal slip 1 He of pedicle screw
Vertical connecting bar 2 can be slided along vertical 2 arranged direction of connecting bar is opposite.
In the present embodiment, as shown in Figure 4 and Figure 5, arc cushion block 132 includes cushion block body 1322 and interval is connected to cushion block
Two convex feet 1323 on ontology 1322, arc groove 1321 are set between two convex feet 1323.
The inside of two galianconism 122 of pedicle screw 1 or bulb pressure pad 16 set that there are two supporting stations 120（Referring to Figure 24）,
Two supporting stations 120 are corresponding with the position of two convex feet 1323 respectively, and the length of two convex feet 1323 is configured to and two branch
Cushion cap 120 offsets so that arc cushion block 132 does not compress is stayed between vertical connecting bar 2 or two convex feet 1323 and two supporting stations 120
There is spacing so that arc cushion block compresses vertical connecting bar 2.Pressure can be realized using the arc cushion block 132 with the convex foot 1323 of different length
Tightly or vertical connecting bar 2 is not compressed, both of which need to only tighten plug screw 13, the position without adjusting plug screw 13, big generous
Operation.
Further, there are two being set in cushion block body 1322 arc-shaped pad is prevented with the cooperation of the U-shaped structure 14 of pedicle screw 1
The rotation stop convex shoulder 1324 that block 132 rotates, two rotation stop convex shoulders 1324 are symmetrical set, and rotation stop convex shoulder 1324 is matched with U-shaped structure 14
Guiding role is closed, arc groove 1321 is made just to be directed at the outer surface for being fastened in vertical connecting bar 2.
Compared with the fixing axle pedicle nail that current open surgery uses, the smooth section of broken long-armed 12 tail end is to plug screw
13 play the guiding role, convenient for being screwed into plug screw 13；Pedicle screw 1 has short cylindrical shape nail seat 11, and nail seat 11 exists to pedicle screw 1
Play direction controlling when putting the slip in nail pilot sleeve；Rivet nut 10 is solid or hollow, the solid more hollow effect of rivet nut 10
Power is strong, and hollow rivet nut 10 can be screwed into along seal wire, and it is high to put nail accuracy rate；Under preferable case, for the pedicle screw 1 that preferably fractures
Broken long-armed 12, recessing mark 18 is equipped with close to the at one end of nail seat 11 on two broken long-armed 12 of pedicle screw 1,
It is weaker at recessing mark 18, broken long-armed 12 can be fractureed here.Two disconnected arms 121 of pedicle screw 1 fracture and remove
Afterwards, block 19 can cover 1 galianconism 122 of pedicle screw and correspond to one end of recessing mark 18 and screw, and it is 1 liang short to hold pedicle screw tightly
Arm 122 simultaneously compresses plug screw 13, and the anti-loosening of plug screw 13 is exited.Unidirectional fixed pedicle screw 1 and universal fixed pedicle screw 1
Plug screw 13 compresses vertical connecting bar 2, and for scoliosis top vertebra and its convex side hold-down bars of upper and lower adjacent vertebra, side-thrust is generated to concave side,
It goes to rotate, conducive to orthopedic, while pressurize in convex side to top vertebra and inhibit to grow.It is unidirectional to slide pedicle screw 1 and universal slip
The plug screw 13 of pedicle screw 1 is close to vertical connecting bar 2 but does not compress vertical connecting bar 2, can be slided along vertical connecting bar 2, for scoliosis
Upper and lower side vertebra and other centrum pedicles of vertebral arch in addition to vertebra is pushed up are fixed, and with growth, the pedicle screw 1 of fixed centrum can be along vertical
Connecting bar 2 is slided, and adjusts the free growth of scoliotic spine.
As shown in figure 16, the vertical connecting bar 2 followed closely in stick correction bracket includes barred body 20 and the connector positioned at 20 both ends of barred body
21.Barred body 20 is cylinder, and connector 21 is polygon, protrudes the both ends of barred body 20.The size of connector 21 is less than barred body 20
Size.Barred body 20 can be embedded in the U-shaped structure 14 of pedicle screw 1, so as to form nail stick fixed structure.Vertical connecting bar 2 can root
Required length is cut into according to actual needs or bends to required radian, and the vertical connecting bar 2 after being tailored must retain the company of one end
Connector 21 is held for being inserted into the horizontal shape hole of stick device.
Ejector apparatus main function is that scoliosis is corrected in art, and each centrum is made to be located on coronal-plane after correction
On one line, maintain to carry out wearing stick under correction state, if no ejector apparatus resets scoliosis under general anesthesia, warp
Mini-incision carries out wearing stick extremely difficult.After each pedicle screw 1 of embedded with minimal invasion Design, fixed frame 1100 is fixed on
Operating table entangles the sleeve 1001 of first ejector 1000 in the two-arm for pushing up the convex side pedicle screw 1 of vertebra, sleeve 1001
Openend is contradicted to bone face, then the adjusting rod 10023 of push-pull arm 1002 is embedded in the card slot 11012 on homonymy installing frame side 11011
In, 10024 and the 4th adjusting nut 10025 of third adjusting nut is located at 11011 card slot of installing frame side, 11012 both sides respectively,
Two adjusting nuts are tightened to card slot 11012, temporarily fixed ejector 1000 is on the installing frame side 11011 of fixed frame 1100；
Same operating method is by second and 1001 sets of pedicles of vertebral arch for staying in upper and lower side vertebra concave side of sleeve of third ejector 1000
In 1 two-arm of screw, the adjusting rod 10023 of push-pull arm 1002 is embedded in the card slot on the installing frame side 11011 of corresponding concave side
In 11012, temporarily fixed ejector 1000 is on the installing frame side 11011 of fixed frame 1100.Adjusting each 1001 direction of sleeve makes
U-shaped structure 14 between 1 two-arm of inverted U slot 10011 and pedicle screw is completely relatively logical, adjusts the direction of push-pull arm 1002, makes
Adjusting rod 10023 is perpendicular to the vertebral sagittal, because each centrum is there are different degrees of rotation, as long as each adjusting rod 10023
It tightens universal joint perpendicular to the mistake shape face of corresponding centrum and fixes connecting rod 10021 and adjusting rod 10023, make entirely to push away in direction
Apical organ 1000 is fixed, then rotates the nut of each adjusting rod 10023, and ejector 1000 is made to push respective pedicle screw 1 to ridge
Column center line is drawn close, and adjusting repeatedly makes centrum and convex side concave side pedicle of vertebral arch be located on straight line on coronal-plane, also corrects simultaneously
Rotation deformity, conducive to further wearing stick orthopedic fixation.Pedicle screw 1 is fixed on pedicle of vertebral arch, and active force is most strong, ejector
1000 sleeve 1001 entangle vertebral arch spiral shell screw 1 be conducive to it is orthopedic, universal joint is conveniently adjusted the direction of adjusting rod 10023, adjust
Bar 10023 vertically corresponds to the direction of the sagittal plane of centrum, and tightening universal joint makes ejector 1000 be fixed on an entirety, is conducive to
Adjusting ejection corpus vertebrae replacement is orthopedic, and adjusting rod 10023 is caught in the card slot 11012 on installing frame side 11011, is revolved by adjusting nut
Turn that pedicle screw 1 is pushed to draw close to midspinal line, resetting orthopedic power is powerful, rectifys conducive to the poor lateral bending of flexibility
Shape.
With idiopathic chest waist lateral bending（Push up vertebra chest12, upper end vertebra chest9, lower end vertebra waist3）For, as shown in figure 21, A lines in figure
Meaning is chest12Pedicle of vertebral arch, B lines meaning is chest9Pedicle of vertebral arch, C lines meaning is waist3Pedicle of vertebral arch, D lines meaning is chest11Vertebra
Nut, E lines meaning is waist1Pedicle of vertebral arch.Putting nail situation is：Chest12Bilateral, chest11Convex side, waist1Unidirectional fixed vertebra is put respectively in convex side
Pedicle screw 1, chest9Bilateral, waist3Bilateral puts unidirectional slip pedicle screw 1 respectively.When all with unidirectional nail wear stick it is difficult when,
Universal fixed pedicle screw 1 and universal slip pedicle screw 1 are respectively that unidirectional fixed pedicle screw 1 slides vertebra with unidirectional
Pedicle screw 1 it is alternative.
After the completion of the merging of pedicle screw 1, chest is entangled respectively with three ejectors 100012Convex side, chest9Concave side, waist3It is recessed
The pedicle screw 1 of side retracts other 1 mini-incision skin soft tissues of pedicle screw with incision tissue's retractor, appears vertebra
Two broken long-armed 12 of pedicle screw 1 and U-shaped structure 14.Chest12The push-pull arm 1002 of the ejector 1000 of convex side is mounted on
Fixed frame 1100 is located on the installing frame side 11011 of the convex side of backbone, chest9Concave side and waist3The push-pull arm of the ejector 1000 of concave side
1002 are located at mounted on fixed frame 1100 on the installing frame side 11011 of backbone concave side, adjust the push-pull arm of each ejector 1000
1002 line of forces, locking can lock universal joint.The third adjusting nut 10024 and the 4th that rotation adjusts each ejector 1000 is adjusted
Nut 10025 makes the sleeve 1001 of each ejector 1000 be drawn close to midspinal line, and correction backbone side deformity makes during each centrum is located at
On line.In other cases, multiple ejectors 1000 can be used to correct how curved backbone.
After completing ejection correction using ejector apparatus, vertical connecting bar 2 is placed in, then be screwed into plug screw 13 and block 19.Wherein, chest12
Bilateral, chest11Convex side, waist1In the fixation pedicle screw 1 of convex side, plug screw 13 and block 19 are tightened the vertical connecting bar 2 of compression；
Chest9, waist3In the pedicle screw 1 of bilateral, plug screw 13 does not compress vertical connecting bar 2, and unidirectional slip pedicle screw 1 can be along vertical connecting bar 2
It slides.Follow closely stick correction bracket by the schematic diagram after Rachiocampis correction as shown in Figure 22 and Figure 23.
The above is only the preferred embodiment of the present invention, and protection scope of the present invention is not limited merely to above-mentioned implementation
Example.To those of ordinary skill in the art, obtained improvement and change in the case where not departing from the technology of the present invention concept thereof
It changes and also should be regarded as protection scope of the present invention.
Claims (7)
1. a kind of ejector apparatus for being used to be placed in scoliosis nail stick correction bracket, it is characterised in that：Including ejector and fixation
Frame, the ejector include push-pull arm and the sleeve being connected on push-pull arm, and the sleeve is equipped with to be sheathed on nail stick correction
Set outside the pedicle screw of stent connects hole, and the push-pull arm includes intermediate connecting seat, connecting rod and adjusting rod, connecting rod
It is connected respectively by the way that universal joint can be locked with intermediate connecting seat with adjusting rod, in connecting rod, adjusting rod passes through sleeve connection
The force adjustment component of adjustable push-pull effort is connected on fixed frame.
2. ejector apparatus according to claim 1, it is characterised in that：The one end open of the socket through-hole is equipped with for card
The slot of falling U being placed in vertical connecting bar, the width for the slot of falling U are greater than or equal to the diameter of the vertical connecting bar of nail stick correction bracket.
3. ejector apparatus according to claim 1, it is characterised in that：The fixed frame includes frame and for installing fixation
The mounting assembly of frame, frame have two to four for fixing the installing frame side of ejector, and each installing frame side is equipped with several
For being caught in the card slot of adjusting rod, several card slots are along installing frame side arranged for interval；The adjusting part includes third adjusting nut
With the 4th adjusting nut, adjusting rod is screw rod, and adjusting rod is arranged in card slot, third adjusting nut and the 4th adjusting nut screw thread
It is with the installation of on adjusting rod, and third adjusting nut and the 4th adjusting nut are divided into the both sides on installing frame side.
4. ejector apparatus according to claim 3, it is characterised in that：The mounting assembly includes at least two supports and fixes
Mechanism, it is each that fixed mechanism is supported to include strut and for being fastened in the U-shaped folder block on operating table, one end of the strut and frame
Connection, the other end are connect with U-shaped folder block, and thread fitting is connected with by screwing abutting or unclamping the lock of operating table on U-shaped folder block
Tight screw.
5. ejector apparatus according to claim 3, it is characterised in that：Between the third adjusting nut and installing frame side with
And the 4th be equipped with gasket between adjusting nut and installing frame side.
6. ejector apparatus according to any one of claims 1 to 5, it is characterised in that：Universal joint can be locked and include spherical shape
Head and lock nut, lock nut are connected on intermediate connecting seat, are equipped with spherical cavity between lock nut and intermediate connecting seat, ballhead is installed in ball
Shape intracavitary, lock nut is threadedly coupled with intermediate connecting seat and can by screw compression or release ballhead, connecting rod or adjusting rod and
Ballhead is affixed.
7. ejector apparatus according to any one of claims 1 to 5, it is characterised in that：The axis and connecting rod of the sleeve
Axis it is misaligned.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201611215554.9A CN108236494B (en) | 2016-12-26 | 2016-12-26 | Pushing device for implanting scoliosis nail rod correcting bracket |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201611215554.9A CN108236494B (en) | 2016-12-26 | 2016-12-26 | Pushing device for implanting scoliosis nail rod correcting bracket |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN108236494A true CN108236494A (en) | 2018-07-03 |
| CN108236494B CN108236494B (en) | 2022-07-19 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201611215554.9A Active CN108236494B (en) | 2016-12-26 | 2016-12-26 | Pushing device for implanting scoliosis nail rod correcting bracket |
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| Country | Link |
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| CN (1) | CN108236494B (en) |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20050081865A1 (en) * | 2003-10-17 | 2005-04-21 | Labelle Hubert | Dynamic frame for prone surgical positioning |
| CN103800062A (en) * | 2014-02-27 | 2014-05-21 | 北京积水潭医院 | Surgical correcting device for spine malformation |
| CN103948424A (en) * | 2014-03-13 | 2014-07-30 | 山东冠龙医疗用品有限公司 | Dilated threaded fusion cage |
| CN105596072A (en) * | 2016-03-08 | 2016-05-25 | 中国人民解放军第二军医大学 | Vertebral malformation correcting instrument |
| CN106175909A (en) * | 2016-06-30 | 2016-12-07 | 陈春美 | Pedicle nail locating guide device |
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2016
- 2016-12-26 CN CN201611215554.9A patent/CN108236494B/en active Active
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20050081865A1 (en) * | 2003-10-17 | 2005-04-21 | Labelle Hubert | Dynamic frame for prone surgical positioning |
| CN103800062A (en) * | 2014-02-27 | 2014-05-21 | 北京积水潭医院 | Surgical correcting device for spine malformation |
| CN103948424A (en) * | 2014-03-13 | 2014-07-30 | 山东冠龙医疗用品有限公司 | Dilated threaded fusion cage |
| CN105596072A (en) * | 2016-03-08 | 2016-05-25 | 中国人民解放军第二军医大学 | Vertebral malformation correcting instrument |
| CN106175909A (en) * | 2016-06-30 | 2016-12-07 | 陈春美 | Pedicle nail locating guide device |
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| Publication number | Publication date |
|---|---|
| CN108236494B (en) | 2022-07-19 |
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