CN109171933A - A kind of screw steel plate system for spinous process of axis - Google Patents

A kind of screw steel plate system for spinous process of axis Download PDF

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Publication number
CN109171933A
CN109171933A CN201811184646.4A CN201811184646A CN109171933A CN 109171933 A CN109171933 A CN 109171933A CN 201811184646 A CN201811184646 A CN 201811184646A CN 109171933 A CN109171933 A CN 109171933A
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CN
China
Prior art keywords
screw
spinous process
steel plate
hole
plate body
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
CN201811184646.4A
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Chinese (zh)
Inventor
刘观燚
徐顶立
马维虎
周雷杰
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
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Individual
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Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to CN201811184646.4A priority Critical patent/CN109171933A/en
Publication of CN109171933A publication Critical patent/CN109171933A/en
Pending legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8004Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8605Heads, i.e. proximal ends projecting from bone
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/864Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated

Abstract

The present invention relates to a kind of screw steel plate systems for spinous process of axis, including spinous process screw, isthmus screw and spinous process steel plate, the spinous process steel plate includes the first plate body to match with the anatomical structure of spinous process side and the second plate body for matching with the anatomical structure of vertebral plate, the first through hole for spinous process screw insertion is offered on above-mentioned first plate body, and the second through-hole for the insertion of isthmus screw is offered on the second plate body.Compared with prior art, the corresponding position for the spinous process of axis that the present invention can enable the spinous process steel plate be firmly secured to, while being avoided that spinous process screw is placed in canalis spinalis, a possibility that invading spinal cord is farthest reduced, and be avoided that isthmus screw invades vertebral artery.As it can be seen that the screw steel plate system in the present invention can effectively avoid the infringement to dentata normal function on the basis of strong fix spinous process of axis fracture, to effectively improve the safety and reliability of surgical procedure.

Description

A kind of screw steel plate system for spinous process of axis
Technical field
The present invention relates to medical instruments field more particularly to a kind of screw steel plate systems for spinous process of axis.
Background technique
Currently, clinically used dentata technique for fixing includes through C1-2Joint screw, axis arch root screw and vertebral plate spiral shell Nail, the above technology have the risk of damage vertebral artery.Wherein, since screw wears four layers of cortex bone fixation of articulatio atlantoepistrophica, Margerl Coronary sinus retroperfusion provides strong fixation, but coronary sinus retroperfusion has the risk of very high technical requirements and vertebral artery injuries. Pedicle screw equally has a higher technical requirements, the angle of pedicle of vertebral arch, diameter, vertebral artery and foramen transversarium position there may be Variation, good screw screw way must avoid canalis spinalis and foramen transversarium, in some cases, since axis arch root is too small or vertebra is dynamic The arteries and veins position anatomical factors such as interior, " high position rides " partially, may should not use axis arch root screw fix.Dentata Translaminar screw It is fixed to be also applied to clinic, but the report that Jea etc. and Wang have axis laminar screw arranging to enter the generation of canalis spinalis complication.
Dentata anatomical structure is unique, and spinous process is maximum in cervical vertebra, the average width of part basal part in research CT measurement spinous process Degree is (20.7 ± 1.3) mm, this, can be clinically as a kind of new pivot to provide possibility through the fixation of spinous process of axis screw Vertebra Posterior fixation method supplement uses.Since spinous process screw is located at the rear structure of C2, screw way avoids foramen transversarium completely, so this Technology is almost without the risk of vertebral artery injuries, however it is exactly screw that spinous process of axis screw, which fixes a clearly disadvantageous place, Veutro cortex may be broken through and enter canalis spinalis infringement neck marrow, this technical risk of spinous process of axis screw limits this technology in clinic It is universal.
Summary of the invention
It is a kind of safe and reliable for dentata spine the technical problem to be solved by the present invention is to be provided for the prior art Prominent screw steel plate system.
The technical scheme of the invention to solve the technical problem is: a kind of screw steel plate system for spinous process of axis System, which is characterized in that including spinous process screw, isthmus screw and spinous process steel plate, which includes the solution with spinous process side The second plate body learning the first plate body for matching of structure and matching with the anatomical structure of vertebral plate is cutd open, is opened on above-mentioned first plate body Equipped with the first through hole being inserted into for spinous process screw, and the second through-hole for the insertion of isthmus screw is offered on the second plate body, use Under state, from dentata cross section as it can be seen that above-mentioned first through hole is opposite with the spinous process substrate of side where spinous process steel plate, above-mentioned spinous process spiral shell The central axes of nail and the angle of horizontal direction are 5 °~10 °, and the tip of spinous process screw is pierced by from the spinous process substrate of the other side, on State the second through-hole and C2/C3The top of zygapophysial joint is opposite, and the central axes of isthmus screw and the angle of vertical direction are 25 ° ~30 °.
Vertebral artery, second through-hole and C are invaded to further avoid isthmus screw2/C3The top 5mm of zygapophysial joint Place is opposite, i.e., the entry point of isthmus screw is in C2/C3The top 5mm of zygapophysial joint, in this way energy during isthmus screw enters It is farthest avoided to invade vertebral artery.
For improve the present invention in spinous process steel plate applicability, make it is suitable for more with different spinous process of axis forms Angle formed by body, plane where first plate body and the second plate body place plane is 125 °~135 °.
To reduce the cuing open from range of spinous process steel plate and spinous process side and vertebral plate, enable the first plate body and the second plate body more preferably Ground is attached respectively on spinous process side and vertebral plate, and first plate body is bonded spinous process side and vertebral plate with the intersection of the second plate body Intersection and in smooth transition.
To keep spinous process steel plate internal structure firm, so as to more preferably firmly fix the corresponding position of spinous process, the spinous process steel Plate is integrated.
Screw steel plate system in surgical procedure in the present invention needs to be combined with other surgical instruments, for convenience of using, institute It states spinous process screw and isthmus screw includes head and the bar portion for connecting with other surgical instruments.
Preferably, the diameter of the bar portion of the spinous process screw and isthmus screw is 3.5mm~4.0mm, further, spine The length of the bar portion of prominent screw is 22mm~24mm, and the length of the bar portion of the isthmus screw is 16mm~18mm, so as to protect Depth of needle needed for demonstrate,proving spinous process screw and isthmus screw.
Preferably, the first through hole and the second through-hole are locking made of being overlapped as pressurization hole slot and threaded bore portion Pressurization hole increases the flexibility fixed in art, promotes treatment effect so as to carry out preferably fixed to knochenbruch face and/or pressurize Fruit is conducive to post-operative recovery.
Further, it is preferable that formed by plane where the central axis of the threaded bore portion of the first through hole and the first plate body Angle is 85 °~90 °, and central axis and the plane angulation where the second plate body of the threaded bore portion of second through-hole are 65 °~70 ° so that spinous process screw into nail direction and the angle of horizontal direction be 5 °~10 °, isthmus screw into nail side It is 25 °~30 ° to the angle with vertical direction.
Compared with the prior art, the advantages of the present invention are as follows: the first plate body and the anatomical structure of spinous process side match, The anatomical structure of second plate body and vertebral plate matches, and first be inserted into for spinous process screw is offered on above-mentioned first plate body Through-hole offers the second through-hole for the insertion of isthmus screw on the second plate body, so as to be firmly secured to the spinous process steel plate The corresponding position of spinous process of axis.Meanwhile under use state, from dentata cross section as it can be seen where above-mentioned first through hole and spinous process steel plate The spinous process substrate of side is opposite, and the central axes of above-mentioned spinous process screw and the angle of horizontal direction are 5 °~10 °, and the point of spinous process screw End be pierced by from other side spinous process substrate, thus be avoided that spinous process screw be placed in canalis spinalis, farthest reduce invade spinal cord can Energy property, while above-mentioned second through-hole and C2/C3The top of zygapophysial joint is opposite, and the central axes of isthmus screw and vertical direction Angle be 25 °~30 °, thus be avoided that isthmus screw invade vertebral artery.As it can be seen that the screw steel plate system in the present invention is steady Admittedly the infringement to dentata normal function can be effectively avoided, to effectively improve operation on the basis of fixed spinous process of axis fracture The safety and reliability of process.
Detailed description of the invention
Fig. 1 is the dentata schematic cross-sectional view in the embodiment of the present invention under screw steel plate system use state;
Fig. 2 is the structural schematic diagram of screw in the embodiment of the present invention.
Specific embodiment
The present invention will be described in further detail below with reference to the embodiments of the drawings.
As illustrated in fig. 1 and 2, a kind of screw steel plate system for spinous process of axis, including spinous process screw 51, isthmus screw 52 And spinous process steel plate 3, the setting position for both the central axes of spinous process screw 51 and isthmus screw 52 being respectively adopted in Fig. 1 to indicate It sets.Above-mentioned spinous process steel plate 3 includes the first plate body 31 and the second plate body 32, wherein the anatomy knot of the first plate body 31 and spinous process side Structure matches, and the anatomical structure of the second plate body 32 and vertebral plate matches.For improve the present invention in spinous process steel plate 3 applicability, Make that it is suitable for more with the individual of different spinous process of axis forms, above-mentioned first plate body, 31 place plane and the second plate body 32 Angle α formed by the plane of place is 125 °~135 °, in addition, to reduce the cuing open from model of spinous process steel plate 3 and spinous process side and vertebral plate It encloses, the first plate body 31 and the second plate body 32 is preferably attached on spinous process side and vertebral plate respectively, above-mentioned first plate body 31 are bonded the intersection of spinous process side and vertebral plate with the intersection of the second plate body 32 and are in smooth transition.Preferably, the present embodiment In, spinous process steel plate 3 is integrated, and so as to keep 3 internal structure of spinous process steel plate firm, then more preferably can firmly fix spinous process Corresponding position.
Further, the first through hole 41 being inserted into for spinous process screw 51, and the second plate body are offered on above-mentioned first plate body 31 The second through-hole 42 being inserted into for isthmus screw 52 is offered on 32.In the present embodiment, above-mentioned first through hole 41 and the second through-hole 42 Be one, each through-hole be as pressurization hole slot and threaded bore portion it is overlapping made of locking compress hole, so as to knochenbruch face into Row is preferable fixed and/or pressurizes, and increases flexibility fixed in art, promotes therapeutic effect, is conducive to post-operative recovery.Into one Step, the central axis and 31 place plane angulation γ of the first plate body of the threaded bore portion of above-mentioned first through hole 41 for 85 °~ 90 °, the central axis and 32 place plane angulation ε of the second plate body of the threaded bore portion of above-mentioned second through-hole 42 be 65 °~ 70 °, so that spinous process screw 51 (is preferably in the present embodiment for 5 °~10 ° into the angle β of nail direction and horizontal direction 5 °), isthmus screw 52 into the angle δ of nail direction and vertical direction be 25 °~30 ° (in the present embodiment be preferably 30 °).
Specifically, in a state of use, from dentata cross section as it can be seen that above-mentioned first through hole 41 and 3 place side of spinous process steel plate Spinous process substrate it is opposite (i.e. the entry point of spinous process screw 51 is spinous process substrate), the central axes and level side of above-mentioned spinous process screw 51 To angle β be 5 °~10 ° (in the present embodiment be preferably 5 °), and the tip of spinous process screw 51 is worn from the spinous process substrate of the other side Out, above-mentioned second through-hole 42 and C2/C3(i.e. 52 entry point of isthmus screw is C for the top of zygapophysial joint2/C3Zygapophysial joint Top) relatively, and the angle δ of the central axes of isthmus screw 52 and vertical direction (is preferably in the present embodiment for 25 °~30 ° 30°)。
The first plate body 31 and the anatomical structure of spinous process side match in the present invention in this way, the second plate body 32 and vertebral plate Anatomical structure matches, and the first through hole 41 being inserted into for spinous process screw 51 is offered on above-mentioned first plate body 31, and second The second through-hole 42 being inserted into for isthmus screw 52 is offered on plate body 32, so that the spinous process steel plate 3 be enable to be firmly secured to pivot The corresponding position of vertebra spinous process.Meanwhile under use state, from dentata cross section as it can be seen that above-mentioned first through hole 41 and 3 institute of spinous process steel plate Spinous process substrate in side is opposite, and the central axes of above-mentioned spinous process screw 51 and the angle β of horizontal direction are 5 °~10 °, and spinous process spiral shell The tip of nail 51 is pierced by from the spinous process substrate of the other side, to be avoided that spinous process screw 51 is placed in canalis spinalis, is farthest reduced A possibility that invading spinal cord 1, while above-mentioned second through-hole 42 and C2/C3The top of zygapophysial joint is opposite, and isthmus screw 52 The angle δ of central axes and vertical direction is 25 °~30 °, to be avoided that isthmus screw 52 invades vertebral artery 2.As it can be seen that of the invention In 3 system of screw steel plate on the basis of firm fixed spinous process of axis fracture, can effectively avoid to dentata normal function Infringement, to effectively improve the safety and reliability of surgical procedure.Preferably, the second through-hole 42 and C2/C3Zygapophysial joint Opposite at the 5mm of top, i.e., the entry point of isthmus screw 52 is in C2/C3The top 5mm of zygapophysial joint, in this way in isthmus screw It can be farthest avoided to invade vertebral artery 2 during 52 entrance.
In the present embodiment, above-mentioned spinous process screw 51 and isthmus screw 52 include the head for connecting with other surgical instruments Portion 501 and bar portion 502 increase so that screw steel plate system and other surgical instruments in surgical procedure in the present invention be facilitated to be combined Add operability.Preferably, the diameter of the bar portion 502 of each above-mentioned spinous process screw 51 and isthmus screw 52 be 3.5mm~ 4.0mm, further, the length of the bar portion 502 of spinous process screw 51 are 22mm~24mm, the bar portion 502 of above-mentioned isthmus screw 52 Length is 16mm~18mm, thus depth of needle needed for can guarantee spinous process screw 51 and isthmus screw 52.
The above above-mentioned specific embodiment has carried out further in detail the purpose of the present invention, technical scheme and beneficial effects It describes in detail bright, it should be understood that above are only specific embodiments of the present invention above, is not intended to restrict the invention, it is all Within the spirit and principles in the present invention, any modification, equivalent substitution, improvement and etc. done should be included in guarantor of the invention Within the scope of shield.

Claims (10)

1. a kind of screw steel plate system for spinous process of axis, which is characterized in that including spinous process screw (51), isthmus screw (52) And spinous process steel plate (3), the spinous process steel plate (3) include the first plate body (31) to match with the anatomical structure of spinous process side and The second plate body (32) to match with the anatomical structure of vertebral plate is offered for spinous process screw (51) on above-mentioned first plate body (31) The first through hole (41) of insertion, and the second through-hole (42) for isthmus screw (52) insertion is offered on the second plate body (32),
Under use state, from dentata cross section as it can be seen that the spinous process substrate of side where above-mentioned first through hole (41) and spinous process steel plate (3) Relatively, the central axes of above-mentioned spinous process screw (51) and the angle of horizontal direction are 5 °~10 °, and the tip of spinous process screw (51) from The spinous process substrate of the other side is pierced by, above-mentioned second through-hole (42) and C2/C3The top of zygapophysial joint is opposite, and isthmus screw (52) angle of central axes and vertical direction is 25 °~30 °.
2. screw steel plate system as described in claim 1, which is characterized in that second through-hole (42) and C2/C3Joint tip out It is opposite at the top 5mm of section.
3. screw steel plate system as described in claim 1, which is characterized in that plane and second where first plate body (31) Angle formed by plane where plate body (32) is 125 °~135 °.
4. screw steel plate system as claimed in claim 3, which is characterized in that first plate body (31) and the second plate body (32) Intersection fitting spinous process side and vertebral plate intersection and in smooth transition.
5. screw steel plate system as described in claim 3 or 4, which is characterized in that the spinous process steel plate (3) is integrated.
6. screw steel plate system as claimed in any one of claims 1 to 3, which is characterized in that each spinous process screw (51) and Isthmus screw (52) includes the head (501) and bar portion (502) for connecting with other surgical instruments.
7. screw steel plate system as claimed in claim 6, which is characterized in that each spinous process screw (51) and isthmus screw (52) diameter of bar portion (502) is 3.5mm~4.0mm.
8. screw steel plate system as claimed in claim 6, which is characterized in that the bar portion (502) of the spinous process screw (51) Length is 22mm~24mm, and the length of the bar portion (502) of the isthmus screw (52) is 16mm~18mm.
9. screw steel plate system as claimed in any one of claims 1 to 3, which is characterized in that the first through hole (41) and Two through-holes (42) are locking compress hole made of being overlapped as pressurization hole slot and threaded bore portion.
10. screw steel plate system as claimed in claim 9, which is characterized in that the threaded bore portion of the first through hole (41) Plane angulation where central axis and the first plate body (31) is 85 °~90 °, the threaded bore portion of second through-hole (42) Plane angulation where central axis and the second plate body (32) is 65 °~70 °.
CN201811184646.4A 2018-10-11 2018-10-11 A kind of screw steel plate system for spinous process of axis Pending CN109171933A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN201811184646.4A CN109171933A (en) 2018-10-11 2018-10-11 A kind of screw steel plate system for spinous process of axis

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN201811184646.4A CN109171933A (en) 2018-10-11 2018-10-11 A kind of screw steel plate system for spinous process of axis

Publications (1)

Publication Number Publication Date
CN109171933A true CN109171933A (en) 2019-01-11

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102551868A (en) * 2012-01-10 2012-07-11 刘观燚 Posterior cervical spine single open door side block spinous process steel plate
CN202665673U (en) * 2012-06-13 2013-01-16 常州华森医疗器械有限公司 Laminoplasty steel plate
CN105596070A (en) * 2016-01-22 2016-05-25 赵海生 Fixing system for cervical posterior open-door expansive laminoplasty
CN106725788A (en) * 2016-12-27 2017-05-31 中国人民解放军第二军医大学第二附属医院 A kind of wing plate with curved surface internal fixation system for spondylolysis and spondylolithesis of the lumbar spine
CN209611279U (en) * 2018-10-11 2019-11-12 刘观燚 A kind of screw steel plate system for spinous process of axis

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102551868A (en) * 2012-01-10 2012-07-11 刘观燚 Posterior cervical spine single open door side block spinous process steel plate
CN202665673U (en) * 2012-06-13 2013-01-16 常州华森医疗器械有限公司 Laminoplasty steel plate
CN105596070A (en) * 2016-01-22 2016-05-25 赵海生 Fixing system for cervical posterior open-door expansive laminoplasty
CN106725788A (en) * 2016-12-27 2017-05-31 中国人民解放军第二军医大学第二附属医院 A kind of wing plate with curved surface internal fixation system for spondylolysis and spondylolithesis of the lumbar spine
CN209611279U (en) * 2018-10-11 2019-11-12 刘观燚 A kind of screw steel plate system for spinous process of axis

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