CN110141343A

CN110141343A - A kind of improvement of internal suspension type dynamic support pedicle screws

Info

Publication number: CN110141343A
Application number: CN201910494045.1A
Authority: CN
Inventors: 何静; 何伟义
Original assignee: Individual
Current assignee: Individual
Priority date: 2019-06-08
Filing date: 2019-06-08
Publication date: 2019-08-20

Abstract

The present application relates to a kind of to the implantation material for being applied to arrive used in Orthopeadic Surgery and neurosurgery, i.e. a kind of improvement of internal suspension type dynamic support pedicle nail, particularly as being by the head of traditional original button, it is suspended on pin, it can not make rotation adjustment relative to nail seat, it is improved to for pin being placed on the header planes of button, it can be while reducing incisura, in the course of surgery, can to by pedicle nail after being implanted into patient centrum, when issuable deviation, nail seat can be made to make the rotation relative to button around its axis, to increase the chance of correction, significantly reduce the technical requirements to operator.

Description

A kind of improvement of internal suspension type dynamic support pedicle screws

Technical field

The present application relates to a kind of applied to the implantation material arrived used in Orthopeadic Surgery and neurosurgery, particularly as A kind of improvement to the interior suspension type dynamic support pedicle screws for meeting " on-fixed fusion " theory so that it is this clinically Start the technical issues of pedicle nail being applied is showed, obtain repairing and improves.

Background technique

Currently, to the traditional scheme for the treatment of disc herniation and spinal canal stenosis, being in Orthopeadic Surgery and field of neurosurgery Theoretical according to " rigidly fixing fusion " for being referred to as " gold law " and matching used pedicle nail, including uniaxial follow closely and universal Nail, collectively termed as " fixing glue "；And with clinical medical development, a new academic school is derived, i.e., " on-fixed melts Close " it is theoretical, meet this theoretical pedicle nail gradually received by art circle, is then referred to as " dynamic is followed closely "；In numerous forms " dynamic follow closely " in, have " the outer suspension type " and on this basis improved " interior suspension type " of relatively early stage, such as Granted publication It number is CN 201085680Y, entitled " bearing pin type spine follow closely stick fixing glue " and Patent No. ZL 2,015 2 1144089.5, Entitled " a kind of interior suspension type dynamic support pedicle nail ", although it is this kind of it is typical outer/or interior suspension pedicle nail can present The superior function of dynamic nail, but also in use, find its existing place that denounced, it may be assumed that since rivet nut is by pin Constraint, can only put around the axis of pin, and the U-shaped opening in adjacent nail seat, it is necessary to each other to just, can be convenient for pitman Connection；And on clinical operation, because severe or operator the level of environment is limited, in the vertebra that rivet nut implantation patient is adjacent When body, inevitably generates and the error that ＂ trains off nail ＂ is known as by art circle；In the case, operator often makees nail seat suitable Or rotation counterclockwise, in the hope of the U-shaped opening in adjacent nail seat each other to just, so that pitman is smoothly placed in；In this way Corrective measure so that the rivet nut also synchronous rotary constrained by pin, if precession clockwise, most probably it is perverse wear centrum and it is perverse in not Blood vessel that can be perverse and neural line etc；If rotation is moved back counterclockwise, necessarily lead screw way and return pine, be easy to cause and " taken off because following closely pine Fall the malpractice of ＂；And such structure type, " incisura " are higher.

The issuable malpractice when adjusting the relative angular position of adjacent nail seat how is avoided, is reduced to operation The technical requirements of operator, so that simple and practical " dynamic " function of interior suspension type dynamic support pedicle screws be allowed to obtain sufficiently Embodiment, while trying hard to reduce its incisura, this is that clinically, for the clinical effectiveness for improving such dynamic nail, and there is an urgent need to solve Technical problem certainly.

Summary of the invention

" under the premise of the function of ensuring to maintain dynamic nail, adjacent nail seat is solved to such pedicle nail for industry Angle adjustment is difficult, and reduces its incisura as far as possible " clinically technical problem in the urgent need to address, the present patent application mention for this The improved technical solution for having gone out internal suspension type dynamic support pedicle screws is exactly by traditional interior suspension type dynamic support vertebra The upper half of rivet nut in root bow nail (hereinafter referred to as " tradition nail "), (being commonly called as bulb) be passed through by pin through type, or by Pin suspension type is supported on the fixed position of nail seat, so, the rivet nut can only be swung around the axis of pin, and can not be around nail The axis rotation of seat；It is modified to are as follows: the pin is only placed on the plane of the upper half of the rivet nut；In the nail seat To the common of the outer surface of the incomplete concave sphere and pin of lower end and under the constraint of clearance fit, the rivet nut both may be used To swing under the common constraint of the two, mutual relative rotation can also be made around the axis of the nail seat, thus, in hand When art carries out, very easily the U-shaped opening in adjacent nail seat can be appropriately adjusted, so as to avoid again to the nail Body is readjusted, and issuable perverse wears centrum or screw way returns the malpractices such as pine.

Further, the head of the rivet nut is not to swing by the pin of tradition nail, but rely on the nail seat Outer surface from the incomplete concave sphere and pin to lower end it is common constraint and swing or rotate, so, the rivet nut Plane can reduce at a distance from its centre of sphere, and be placed in the inserting end of the pin above this plane, also can be avoided and hold U-shaped opening through slot in the nail seat taken over the baton in succession generates interference, so, effectively reduce the incisura height of whole nail.

Further, since the plane on the rivet nut bulb reduces, so as to provide biggish plane for setting Set the blind hole being used cooperatively with dedicated driver；So that: when rivet nut is implanted into patient centrum, due to above rivet nut and accessible It blocks, (at this point, not being placed in pitman and plug screw, this is common sense clinically), operator directly can be placed in blind hole with driver In, the rivet nut is operated, to provide operational convenience and accuracy；And then avoid operation with traditional nail When, because the blind hole position on ailhead is small, and often go that pin, then band moving nail body is driven to rotate and rotate and plant by rotation nail seat Enter centrum, the position deviation for the adjacent tradition nail that generated position of related features accumulation is directed at.

Further, it in bulb plane, along rivet nut vertical axis, passes through in blind hole, processes a through-hole and one Several vertical with through-hole or inclined lateral through-holes of shunt being connected to of group；Due to above rivet nut and it is accessible block, operation behaviour Author, the density degree of the centrum sclerotin of visual patient may be selected to use dedicated tool, auxiliary injected or be not injected into through-hole Fixed liquid (being commonly called as bone cement), to increase surgical medical effect, and the structure of tradition nail is limited, be can not or more difficult tool There is this for the option of operation.

Further, the plug screw and pitman in tradition nail are continued to use, to save R & D Cost, it is often more important that, energy Enough compatible tradition nails and other kinds of pedicle nail, have uniformity and convenience.

Beneficial effect

The improved pedicle nail of this internal suspension type dynamic support pedicle screws shown in the present patent application, The beneficial effect of (referred to as " this nail ") is exactly the improvement by the correlation to the bulb on the pin and rivet nut in tradition nail This technical solution, solve the technical issues of most being denounced by clinical use person in tradition nail, the polishing short slab of traditional nail, together When also reduce incisura, additionally provide the available property using injection bone cement, reach clinically required technical effect, With stronger practicability, and great social benefit can be generated.

Detailed description of the invention

Hereinafter, in conjunction with attached drawing and specific embodiment, further explanation explanation is made to the present patent application；

Fig. 1 is the X-Y scheme of the present patent application (this nail)；

Fig. 2 is the explosive decomposition effect picture of this nail；

Fig. 3 is the structure chart of traditional outer/inner suspension type dynamic nail；

Fig. 4 is the function contrast effect figure of tradition nail and this nail；

Fig. 5 is the comparison diagram of tradition nail and the main improvement of this nail；

Fig. 6 is the two-dimensional structure figure and incisura comparison diagram of tradition nail and this nail；

Fig. 7 is the schematic diagram in this nail " bone cement " channel；

Wherein:

Plug screw 1；Pitman 2；Nail seat 3；Pin 4；Rivet nut 5；

Nail seat internal screw thread 31；U-shaped opening through slot 32；Nail seat under shed 33；Nail seat inner cavity spherical surface 34；

Pin pilot hole 35；Nail seat holding holes 36；Rivet nut head 51；Rivet nut tail portion 52；

Plane 53 on rivet nut head；Driver blind hole 54；Through-hole 55 on rivet nut axis；Side through hole 56.

Specific embodiment

In order to be easier to understand improvement of this nail to tradition nail, attached drawing is first passed through, brief introduction is clinically used at present The characteristics of tradition nail: two embodiments on the left of Fig. 3 with " outer suspension type " tradition nail shown in centre for relatively early stage (are detailed in The listed patent No. above)；And shown in the right side Fig. 3, then it is more advanced " a kind of interior suspension type dynamic support pedicle nail "；This Two tradition nail is mainly characterized by, and pin directly passes through rivet nut, and rivet nut can only be swung around the axis of pin；Either as schemed Direct puncture formula shown in the suspension type of two embodiments shown in 6 left sides or the centre Fig. 6, still nail seat is limited by pin, nothing Method and rivet nut make opposite rotation；Which results in operators when needing to adjust the position of adjacent nail seat, increases A possibility that malpractice occurs.

It is shown in FIG. 1, it is exactly the X-Y scheme of this nail, in conjunction with the explosive decomposition on the installation diagram in left side and right side shown in Fig. 2 Effect picture, so that it may see this nail to the improvements of tradition nail: the pin 4 of this nail is assemblied in the nail seat 3, In the pin pilot hole 35 vertical with U-shaped opening through slot 32, and the interior intracavitary of nail seat 3 is protruded into, is placed in the plane 53 of the rivet nut 5 On；And the pin of tradition nail and the matching relationship on rivet nut head, it is determined that rivet nut may only be swung around the axis of pin, and It cannot relatively rotate, as shown in the left side Fig. 5.

This nail is placed in the inner cavity of the nail seat 3, then in assembly and in use, first by the rivet nut 5 by the pin 4 It is symmetrically placed in the pin pilot hole 35 of nail seat 3, and fixes；Plane 53 on 5 head of rivet nut, with the centre of sphere away from From will lead to the size of the area of plane 53, it is contemplated that blind hole 54 and/or axis through bore 55 are set in this plane 53, with And it is found: in the development process of this nail when plane 53 was reduced to the ball of bulb with factors such as the inserting ends of the pin 3 When the heart, the incisura of this nail is most ideal, but its state swung is impacted；And when its plane 53 is higher than 0.5 ~ 1mm of the centre of sphere, institute The inserting end for stating pin is 1.5 ~ 2mm, then can take into account the use function of each structure.

Due to the cylindrical surface of the pin 4 and the constraint to the rivet nut head 51 jointly of inner cavity spherical surface 34 of the nail seat In clearance fit, so, when needing to be implanted into the rivet nut 5, operator can directly use driver, and insertion driver is with blind In hole 54, directly rivet nut 5 is operated, is avoided in implantation tradition nail, needs to rotate the nail seat and goes to drive nail indirectly Body and the tolerance build-up generated；And when causing angle to be deviated when adjacent nail seat 3 is not good enough because operating, the institute on the left of Fig. 4 Show, pitman 2 can not U-shaped opening through slot 32 to just adjacent nail seat when (as indicated with an arrow, pitman 2 and nail seat 3 are dry Relate to), also only need the nail seat 3 of this nail of simple rotation to adjust, it is entirely avoided tradition nail needs unitary rotation to adjust；

Improvement from shown in fig. 5 nail to tradition nail again: left side is the Local map of tradition nail, is clearly showed, pin and nail Seat is at rigid connection, and pin passes through the centre of sphere on rivet nut head, so, rivet nut can only be swung around the axis of pin, and can not It rotates around the axis of nail seat；And can be clearly shown on the right side of Fig. 5, the pin 4 does not hinder the rivet nut 5 around around Z--- Z axis rotates, (as shown on the right side of Fig. 4) and rotation, can solve tradition nail in clinical operation and most be denounced by industry Short slab；

After error angle by adjusting the nail seat 3, so that it may smoothly be placed in the pitman 2, then use dedicated tool, press from both sides Nail seat holding holes 36 are hold, to stablize nail seat 3, are recycled after locking the plug screw 1 with the screw thread pair of nail seat internal screw thread 31, phase This adjacent nail is connected and finishes, in this case, from the rivet nut tail portion 52 that nail seat under shed 33 stretches out, together with what is be implanted into The centrum of patient can make the pendulum of appropriate angle under the common constraint of the pin 4 and nail seat inner cavity spherical surface 34 around A-A axis Dynamic --- -- is most basic here it is what is dynamically followed closely, referred to as " non-fused fixation " function.

From the two-dimentional comparison diagram of tradition nail shown in fig. 6 and this nail it is clear that due to traditional pin and ball followed closely The structural relation of head, incisura (term can be simply considered that, be the height of the nail seat) is higher, surveys as H=17.5mm；And it passes through It crosses after this nail improves its feature, the plane 53 on rivet nut head is lowered, and the inserting end of the pin 4, just may be used The neutral position in the inner cavity of 32 lower section of U-shaped opening through slot in the nail seat 3 is taken full advantage of, then U-shaped opening through slot 32 Also it can reduce simultaneously, in the identical situation of specification of the pitman 2 and plug screw 1, the incisura h of this nail, less than 14mm, The height h reduced reach 3.5mm or more, this just significantly reduce patient to implantation foreign matter bad feeling, in clinical medicine, As one of the important parameter of items research and development, there is splendid clinical effectiveness.

Shown in Fig. 7, since the plane 53 in the rivet nut 5 of this nail decreases than tradition nail, biggish plane face Product provides possibility for biggish driver blind hole 54 is arranged, this is also that this nail is more corresponding more convenient for using than tradition nail In place of driver is operated；In addition, also being provided convenience to process through-hole 55 on a rivet nut axis in the rivet nut 5； Operator can choose whether to inject bone cement according to the specific needs of patient, and one group of several side through hole 56 is then Bone cement provides shunting.

In conclusion the technical solution that the present patent application is proposed, that is, be mainly to the pin and rivet nut in tradition nail Opposed configuration improves, it will be able under the premise of ensuring the good using effect of dynamic nail, solve in tradition nail at present, most It is denounced by clinically operator, is also to be easiest to cause the technology of the angular deviation of the adjacent nail seat of adjustment of malpractice difficult Topic, while also largely reducing in clinical medicine and incisura problem that patient relatively emphasizes, more begin trying in the recent period The new disciplines of injection bone cement provide alternative；Accordingly, it can be seen that the developer of the present patent application is in clinic Using the effect of tradition nail, have conducted a thorough research analysis, and the specifically demonstration and comparison of data, it is creative with it is novel Property；Clinically also achieve the practicability clinical effectiveness of " easy to operate, accident prevention, can infuse bone cement at undercut mark ".

Moreover, above-described embodiment is the present patent application preferred embodiment, and other implementations of exhaustive the present patent application Example, therefore, as long as any modifications, equivalent replacements, and improvements made by the description and the appended drawings content with the present patent application etc., It should be included within the protection scope of the present patent application.

Claims

1. a kind of improvement of internal suspension type dynamic support pedicle nail, by plug screw, pitman, nail seat, pin and rivet nut institute group At, it is characterised in that:

The lower half of the rivet nut is one with externally threaded spike body, for being implanted into lesion centrum；The upper half of the rivet nut Portion is an incomplete orbicule, and is equipped with a plane perpendicular to rivet nut axis on this orbicule, this plane central is set There is the blind hole used for driver；

The cylindrical body that the pin is two one group, is placed in the hole perpendicular to the axis of the nail seat, and symmetrically stretch Enter the inner cavity of nail seat, and inserting end is placed on the plane of the rivet nut upper half；

The nail seat is a hollow cylindrical body, a U-shaped opening through slot is equipped on perpendicular to its axis, is used to be placed in and straight Connect the bearing pitman；It is symmetrical for assembling the logical of the pin equipped with one with U-shaped opening through slot at vertical direction Hole.

2. the improvement of internal suspension type dynamic support pedicle nail according to claim 1, it is characterised in that: the nail seat U-shaped opening through slot on, equipped with the internal screw thread matched with plug screw；In the hollow cavity of nail seat to lower end, be equipped in imperfect Spherical surface and lower to opening, Internal Spherical Surface is matched with the upper half of the rivet nut, and the lower half of rivet nut opening downwards from nail seat Mouth is stretched out and is implanted into the centrum of people.

3. the improvement of internal suspension type dynamic support pedicle nail according to claim 1, it is characterised in that: the plug screw With pitman, traditional original structure form is continued to use, it may be assumed that the plug screw is equipped with the external screw thread matched with the nail seat, and in spiral shell Plug center is equipped with the matching hole used for driver；The pitman is cylindrical body, and the U-shaped of the nail seat is pressed on by the plug screw The bottom of opening through slot, for being connected with adjacent nail seat.

4. the improvement of internal suspension type dynamic support pedicle nail according to claim 1, it is characterised in that: the rivet nut The upper half orbicule on plane, above its centre of sphere be no more than 1.5mm.

5. the improvement of internal suspension type dynamic support pedicle nail according to claim 4, it is characterised in that: the rivet nut The upper half orbicule on plane, cross its centre of sphere and the axis perpendicular to rivet nut.

6. the improvement of internal suspension type dynamic support pedicle nail according to claim 1, it is characterised in that: the rivet nut On plane on, equipped with/or be not provided with the vertical through hole and several lateral through-holes of an axis direction along rivet nut, in hand The fixative of auxiliary is poured into art.

7. the improvement of internal suspension type dynamic support pedicle nail according to claim 1, it is characterised in that: after assembly The pin is in the inserting end of the nail seat inner cavity, and together with the incomplete concave sphere of the nail seat inner cavity, common implementing is to described The constraint of the upper half of rivet nut, and this constraint are gap constraint.

8. the improvement of internal suspension type dynamic support pedicle nail according to claim 1, it is characterised in that: in the nail After body and pin are successively assemblied in nail seat inner cavity, the pin is fixed in the hole of the nail seat matched, can anti-non-magnetic shim Body abjection；And in the nail seat outer cylinder, it is provided with a pair of of blind hole for clamping the nail seat.