CN111419366A - Pedicle screw-rod system capable of changing rigidity into flexibility into rigidity - Google Patents
Pedicle screw-rod system capable of changing rigidity into flexibility into rigidity Download PDFInfo
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- CN111419366A CN111419366A CN202010261459.2A CN202010261459A CN111419366A CN 111419366 A CN111419366 A CN 111419366A CN 202010261459 A CN202010261459 A CN 202010261459A CN 111419366 A CN111419366 A CN 111419366A
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
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- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7071—Implants for expanding or repairing the vertebral arch or wedged between laminae or pedicles; Tools therefor
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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
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- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8605—Heads, i.e. proximal ends projecting from bone
- A61B17/861—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver
- A61B17/8615—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver at the central region of the screw head
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- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
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- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
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- A—HUMAN NECESSITIES
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- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B2017/8655—Pins or screws or threaded wires; nuts therefor with special features for locking in the bone
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
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Abstract
The invention relates to a vertebral pedicle screw-rod system which can be rigid or flexible and can be changed from flexible to rigid fixation, in particular to a dynamic vertebral pedicle screw which is characterized in that a screw seat is connected with a screw body through a cylindrical spring, and a connecting rod is laterally arranged beside the screw seat and consists of the screw seat, the screw body, a hook frame, the connecting rod, a screw plug and an inner core type stopper made of rigid degradable materials; the screw seat is shaped like a cylindrical hollow nut with a thin upper part and a thick lower part and a middle arc transition, the screw seat is connected with the connecting rod through a hook frame which is sleeved on one side of the outer edge of the screw seat and is provided with a hook rod arm extending to the side, the hook rod frame which is semicircular below the hook rod arm and the arc transition below the outer side of the screw seat jointly enclose the connecting rod, and when a screw plug with an upper cover is screwed into an inner screw hole arranged at the upper end of the screw seat, the upper cover of the screw plug can press the hook frame downwards; after the inner core type limiter is screwed into the inner cavity of the cylindrical spring, the swinging between the nail body and the nail seat is prevented, the nail body can be opened or pressurized at a neutral position, and the screw plug is fastened to form a rigidly fixed static nail; after the retainer degrades, the nail and rod system will turn into a non-rigid fixation.
Description
Technical Field
The invention relates to a medical instrument, in particular to a pedicle screw and rod fixing system for internal fixation of a spine.
Background
Currently, pedicle screw and rod fixation systems used in the fields of bone surgery and neurosurgery are mainly divided into two main categories, one is a static pedicle screw which causes a fixed segment to lose any movement, and the fixation is called rigid fixation for short; the other is a dynamic pedicle screw which can make a fixed segment do proper bending and stretching activities, and is called as a dynamic screw for short, and the fixed segment is fixed in a non-rigid way.
The rigid fixation is stronger, which is beneficial to fracture healing and interbody fusion, but the over-strong fixation can lead the fixed segment to generate stress shielding, thus causing the disuse osteoporosis of the vertebra; furthermore, the inner fixing device can generate the phenomena of fatigue fracture, looseness and other protection failures due to the fact that the inner fixing device is excessively dependent on the long-term protection of the inner fixing object; once the loose spine loses the effective support of the pedicle screw, the injury such as osteoporosis fracture and the like can be more easily caused; it is therefore often clinically necessary to intentionally surgically remove the internal fixation device after the bone has healed.
In addition, some injuries need to support the spine by using the pedicle screw rod system in the early operation stage, so that the pressure on the vertebral body and the intervertebral is reduced, the stability of the spine is enhanced along with the healing of an incision, and a fixed segment is expected to have certain flexion and extension activities, namely the fixing strength of the pedicle screw rod system is expected to be reduced, and the degeneration caused by the stress concentration of the adjacent segment is prevented.
In order to prevent adjacent sections from degeneration, a non-rigid fixed dynamic screw is delivered, as the pedicle screw is mostly not fixed in situ, in the operation process, after implantation of all pedicle screws and installation of a connecting rod are completed, a distractor or a clamping device is often used for distracting or clamping a screw seat of the pedicle screw to drive a screw body in rigid connection with the screw seat to pick up a vertebral body fixed by the pedicle screw, so that adjacent vertebral bodies and intervertebral spaces are opened or closed to a required position, all screw plugs are screwed down to maintain the position and the spine stability of the fixed section, however, the dynamic screw in a hinged state between the screw body and the screw seat is only acted on the screw seat by soft tissue resistance such as intervertebral disc and ligament due to the fact that the front end of the screw body cannot synchronously move in parallel with the screw seat, but temporarily stays in situ, so that the coaxial relation between the screw seat and the screw body is damaged, only when the distraction or continuous action of the distraction or the clamping force exerted by the tool is acted, the swing of the screw body and the screw seat reaches the designed limit value, the swing angle of the screw body is only damaged, namely, the swing angle of the screw body and the screw seat is seriously influenced by the two dynamic screw body swing angles, namely, the swing of the swing angle is seriously influenced by the two dynamic screw body, namely, the swing angle of the swing, the swing of the screw body is seriously influenced by the swing, the swing angle is more than the swing, the swing of the swing angle, the screw body is seriously influenced by the swing angle, the screw.
The nail body and the nail seat can not synchronously move in the same direction in real time, so that adjacent intervertebral discs are gradually expanded along with the gradual distance between the nail seats, and a forward angulation trend consistent with that between the nail bodies gradually appears, so that forward flexion fixation is caused; and the adjacent intervertebral parts are compressed along with the gradual approaching of the nail seats, and simultaneously, the trend of backward angulation consistent with the nail bodies gradually appears, so that the backward extension fixation is caused.
However, there is no dynamic nail that can temporarily limit the dynamically connected nail body and nail seat to be relatively fixed in the distraction or compression direction for operation during operation, and there is no pedicle screw-rod fixation system that can provide strong rigid fixation at the early stage of fixation and then automatically convert into non-rigid fixation with relatively weak fixation strength.
In addition, due to various cases of injuries and diseases, which type of pedicle screws are needed before operation is difficult to be determined, even if a definite operation plan before operation is corrected according to what is seen in the operation, the dynamic screws or the static screws prepared before operation are not suitable for being used again, so that a whole set of static screws or dynamic screws and operation tools thereof are required to be prepared as backup before operation, and the investment and consumption of marketing enterprises and hospitals on human, financial and material resources are increased; sometimes, in order to reduce consumption, for the rare cases, some operations in some hospitals do not carry out backup, and once backup is needed in the operations, the cost of sacrificing medical quality, such as sacrificing fixed quality, increasing the time of waiting instruments in the operations, prolonging the time of the whole operations, and the like, is inevitably generated; at the moment, the pedicle screws which can realize dynamic and static consideration and static-dynamic conversion to meet the requirement of one screw for three purposes can be mutually used as emergency backups to solve the clinical urgency.
In addition, the lower the height of the pedicle screw exposed out of the bone, namely the lower the 'incisure', the less the adverse stimulation to the human body, and most of the existing pedicle screws are 'middle-positioned' type nails which are tightly connected with the screw seat and the screw body into a whole by directly extruding the connecting rod by the screw plug, so the increased incisure on the axis of the screw plug because of the superposition of the connecting rod on the axis of the screw plug can not be reduced; the side-mounted pedicle screw with the application number of 201910494053.6, namely the externally-arranged spring type pedicle screw with the screw plug and the connecting rod arranged in parallel, can greatly reduce cutting marks and thoroughly solve the problem of wire explosion, but has no screw tool interface at the upper end of the screw seat, and is difficult in nail implantation operation.
Disclosure of Invention
In order to meet the requirements of three purposes of one nail, explosion-proof wire, low incisura, easy installation and the like expected in clinic, the invention designs a pedicle screw rod system which can be rigid and flexible and can be changed from flexible to rigid fixation, wherein the pedicle screw rod system comprises a pedicle screw, a connecting rod and a screw plug; the pedicle screw comprises a screw seat and a screw body, a flexible connecting part is arranged between the screw seat and the screw body, and the screw seat and the screw body can relatively swing by taking the flexible connecting part as a turning point; the flexible connecting part is also connected with a degradable stopper used for preventing the nail seat and the nail body from swinging mutually, and along with the gradual degradation of the degradable stopper, the fixing mode of the pedicle screw-rod system is gradually changed from rigid fixing of initial fixing into a non-rigid fixing mode.
The flexible connecting part comprises a spring, preferably a cylindrical spring, one end of the spring is connected with the nail seat, and the other end of the spring is connected with the nail body.
The degradable stopper is a core type stopper which can be screwed into the inner cavity of the spring to prevent the nail body and the nail seat from swinging mutually, the outer surface of the stopper is an external thread matched with the thread shape of the inner wall of the spring, the center of the upper end surface of the degradable stopper is provided with a first screwdriver interface, the center of the lower end of the stopper is provided with a bulge matched with a blind hole in the upper end of the nail body along the axial direction, and further, the stopper is of a rigid structure.
The nail seat is of a cylindrical hollow nut structure with a thin upper part and a thick lower part, a high upper part and a low lower part and is in transition by an arc surface, and the radian radius of the arc transition surface at the outer edge of the nail seat is consistent with the radius of the connecting rod;
an opening in the upper part of the inner cavity of the nail seat is provided with an internal thread matched with the screw plug, the upper end surface of the nail seat is also provided with a second screwdriver connector, and the second screwdriver connector is a notch formed in the peripheral wall of the nail seat in an axial symmetry manner, preferably a cross-shaped notch;
the lower part of the inner cavity of the nail seat is provided with an axial through hole matched with the flexible connecting part in size and shape.
The hook frame comprises a lantern ring and a barb-shaped rod pressing arm which is arranged on the side edge of the lantern ring and extends outwards, and the lantern ring and the rod pressing arm are of an integrated structure; the inner cavity of the hook frame sleeve ring is matched with the outer edge of the nail seat, the sleeve ring is sleeved on the outer edge of the nail seat, and the lower edge of the press rod arm is a press rod cambered surface with the radius consistent with that of the connecting rod; furthermore, the pressing rod cambered surface is intersected with the inner cavity of the lantern ring to form a lantern ring gap.
Furthermore, after the hook frame is sleeved with the nail seat, the semicircular press rod cambered surface of the press rod frame and the arc transition surface at the outer edge of the nail seat jointly form a tunnel for accommodating the connecting rod, so that the connecting rod is positioned outside the nail seat; at the moment, the connecting rod is placed in the tunnel, and the screw plug is screwed into the internal thread at the upper end of the nail seat, so that the connecting rod can be limited from falling off, and the instant synchronous equidirectional distraction or compression operation of the supported nail seats is carried out on adjacent vertebras; the screw plug is screwed down, so that the connecting rod can be forced to pass through the lantern ring notch to fasten the nail seat while the connecting rod is fastened;
the nail body is a cylindrical or conical threaded nail screwed into the spine, the upper end of the nail body is free of a nail head, the upper end face is a plane, and a round blind hole is formed in the center of the nail body along the axial direction; the edge of the upper end face of the nail body is also provided with an adaptive groove matched with the shape of the lower end of the spring.
The upper end of the spring is in threaded connection with an axially arranged internal thread-shaped through hole at the lower end of the nail seat and is permanently and mechanically fixed, and the lower end of the spring is in adaptive connection with an adaptive groove at the upper end of the nail body and is permanently and mechanically fixed.
Preferably, the nail body, the nail seat and the spring connected between the nail body and the nail seat, and the flexible body and the rigid body in the connecting rod and the connection between the flexible body and the rigid body are integrally manufactured in an additive manufacturing mode.
Furthermore, the plug screw includes the upper cover, and plug screw upper cover center is equipped with the screw utensil interface three, and the plug screw lower part is the external screw thread that matches with the nail seat upper end internal thread.
Further, the degradable stopper is made of a degradable biological material such as magnesium metal, magnesium alloy, magnesium-polylactic acid composite, zinc and the like, and is preferably made of a magnesium metal/polylactic acid composite material with a magnesium metal inner core with higher elastic modulus and higher degradation speed and a polylactic acid surface layer with lower elastic modulus and lower degradation speed.
Furthermore, the limiter can also be made of non-degradable titanium, titanium alloy and other materials.
When the inner core type limiter is abandoned, the pedicle screw can be used as a dynamic screw; when the inner core type limiter made of non-degradable materials is used, the pedicle screw can be used as a fixing screw; when the inner core type limiter made of degradable materials is used, along with the gradual degradation of the degradable inner core type limiter, the fixing mode of the pedicle screw-rod system is gradually changed from the initial rigid fixing mode to the non-rigid fixing mode, and the invention aims of gradually changing from the fixed screw to the dynamic screw can be achieved by the pedicle screw; therefore, the invention is a multifunctional pedicle screw-rod fixing system which can be used for three purposes by one screw.
The invention adopts a side-mounted structure, and simultaneously realizes the aims of 'explosion-proof wire' and 'low notch'.
Compared with the prior art, the invention has the advantages that the upper end of the nail seat is not provided with a screwdriver interface, the nail planting operation is difficult, only one side of the nail seat is provided with an arc surface for connecting a connecting rod, the nail seat is difficult to rotate to a proper position, and the application number is 201910494053.6 application named as 'an explosion-proof wire external spring type pedicle nail'.
Advantageous effects
The invention adopts a side-mounted pedicle screw structure, and realizes the aims of 'explosion-proof wire' and 'low notch'; the inner core type limiter made of degradable hard biological materials is used as a limiting device of the dynamic pedicle screw, so that the dynamic pedicle screw is convenient to implant into a body and expand or compress, firm static fixation can be realized at the initial stage of fixation, the limiting device can be gradually converted into dynamic fixation which allows a fixed segment to move moderately in the gradual degradation process, and the fixed segment is in a neutral position state during implantation and after expansion or pressurization, so that the dynamic pedicle screw can have mobility in the forward bending and backward stretching directions after degradation of the limiting device, the dynamic fixation effect of a dynamic pedicle screw-rod system can be guaranteed to the maximum extent, and the multipurpose of one screw with three purposes can be realized.
Drawings
To better illustrate the features and embodiments disclosed in the present application, the following description is made with reference to the accompanying drawings, in which:
FIG. 1 is a two-dimensional view and a shape effect view of the present invention;
FIG. 2 is an exploded schematic view of the present application;
FIG. 3 is a schematic view of the nail seat and hook frame of the present invention together restraining the connecting rod;
FIG. 4 is a schematic diagram of the two purposes of the invention, dynamic and static;
FIG. 5 is a schematic diagram comparing the "low notch" and "explosion proof wire" of the present application;
fig. 6 is a schematic diagram of the solution of the present invention to solve the difficulty of installing the connecting rod.
Wherein the numbering is as follows:
a plug screw 1; a plug screw external thread 11; a plug screw driver interface III 12; a screw upper cover 13;
and a limiter 3: an inner core type stopper 3 e; the upper end of the limiter is provided with a first screwdriver interface 32; an inner core limiter external thread 33; a stopper lower end projection 34;
a nail seat 4; internal threads 45 at the upper end of the nail seat; a second screwdriver interface 46 at the upper end of the nail seat; nail seat outer cylindrical surface 47; nail seat holding rod arc surface 48; an internal thread-shaped through hole 49 is axially arranged at the lower end of the nail seat;
a nail body 5; a nail body tail 51; a spring 55; a spring top end 551; a spring lumen 552; a spring lower end 553; a blind hole 56 at the upper end of the nail body; a nail body fitting groove 57;
a hook frame 7; hook frame collar 71; a collar inner wall 711; a collar notch 712; hook frame press bar arm 72; a rod pressing frame 73;
notch comparison h; resulting in a plug lateral component force F of the "blow".
Detailed Description
In order to make the technical problems, technical solutions and beneficial effects solved by the present invention more clearly apparent, the present invention is further described in detail below with reference to the following embodiments; it should be understood that in the description of the present application, the terms "left and right", "up and down", etc., indicate orientations or positional relationships based on those shown in the drawings, and are only for convenience of describing the present application, and do not require that the present application be constructed and operated in a particular orientation, and thus should not be construed as limiting the present application.
The invention is composed of a pedicle screw formed by combining a screw seat and a screw body, an attached hook frame, a connecting rod, a screw plug and a limiter.
The lower end of the nail seat 4 is connected with the upper end of the nail body 5 through a cylindrical spring 55, the nail seat 4 is shaped like a hollow round nut, the appearance of the nail seat is cylindrical with a thin upper part and a thick lower part, a high upper part and a low lower part, and the nail seat is in a circular arc transition shape, the circular arc transition shape is also a nail seat holding rod cambered surface 48, and the radian radius of the circular arc transition shape is consistent with that of the connecting rod 2; an opening at the upper part of the inner cavity of the nail seat is provided with an internal thread matched with the screw plug 1, and the lower part of the inner cavity of the nail seat is provided with an axially arranged internal thread-shaped through hole 49 matched with the external size and shape of the cylindrical spring 55; the upper end face of the nail seat 4 is provided with a screwdriver connector 46, and the screwdriver connector is a notch formed in the circumferential wall of the nail seat symmetrically through the axis, and preferably 2 crossed notches are formed.
The nail body 5 is a cylindrical or conical threaded nail screwed into the spine, the upper end of the nail body is free of a nail head, the upper end face is a plane, a round blind hole 56 is formed in the center of the nail body along the axial direction, and the blind hole can be cylindrical, conical or circular truncated cone; the edge of the upper end face of the nail body 5 is also provided with an adaptive groove 57 matched with the shape of the lower end of the spring 55.
The spring 55 is a cylindrical spring with enough rigidity, the upper end of the spring is in threaded connection with the axially arranged internal thread-shaped through hole 49 at the lower end of the nail seat and is permanently and mechanically fixed, and the lower end of the spring 55 is in adaptive connection with the adaptive groove 57 at the upper end of the nail body and is permanently and mechanically fixed.
Preferably, the nail seat, the nail body and the spring connected between the nail seat and the nail body are manufactured in a 3D printing and integrated forming mode.
The hook frame 7 is a sleeve ring 71 sleeved on the outer edge of the nail seat 4, and an inner cavity 711 of the sleeve ring is matched with the outer edge of the nail seat 4; one side edge of the lantern ring is provided with a barb-shaped press rod arm 72 which extends outwards, the lantern ring 71 and the press rod arm 72 are of an integrated structure, the lower edge of the press rod arm is an approximately semicircular press rod frame 73 with the radius consistent with that of the connecting rod 2, and preferably, the press rod frame 73 is intersected with the lantern ring inner cavity 711 to form a lantern ring notch 712; after the hook frame 7 is sleeved with the nail seat 4, the small semicircular arc surface of the pressing rod frame 73 and the nail seat holding rod arc surface 48 jointly form a tunnel which just accommodates the connecting rod 2, at the moment, the connecting rod 2 is placed into the tunnel, the screw plug 1 is screwed into the internal thread at the upper end of the nail seat 4, so that the connecting rod 2 can be limited to be separated, the screw plug 1 is screwed, and the connecting rod 2 can be forced to fasten the nail seat 4 through the lantern ring notch 712 while the connecting rod 2 is fastened.
The whole connecting rod 2 except the two ends is cylindrical, and can be straight or bent to form a radian.
The screw plug 1 is provided with an upper cover 13, the center of the upper cover of the screw plug is provided with a screwdriver connector 12, and the lower part of the screw plug 1 is provided with an external thread 11 matched with an internal thread 45 at the upper end of the screw seat.
The stopper 3 is a degradable inner core type stopper which can be screwed into the inner cavity 552 of the spring 55, the outer surface of the stopper 3 is an external thread 33 matched with the thread shape of the inner wall of the spring 55, the center of the upper end surface of the stopper 3 is provided with a screwdriver interface 32, the center of the lower end of the stopper 3 is provided with a bulge 34 matched with the blind hole 56 at the upper end of the nail body along the axial direction, and the bulge 34 is cylindrical, conical, truncated cone-shaped or hemispherical; the degradable inner core type stopper is preferably made of a magnesium metal/polylactic acid composite material which takes magnesium metal with higher elastic modulus and higher degradation speed as an inner core and takes polylactic acid with lower elastic modulus and lower degradation speed as a surface layer.
The structure and combination and function of the invention can be clearly shown by the figures 1 and 2, the figure 1 shows the two-dimensional drawing and the outline drawing of the invention, the figure 2 shows the explosion effect drawing of the invention, the two drawings can show that the pedicle screw of the invention is formed by connecting and permanently fixing the upper end 551 and the lower end 553 of the spring 55 with the screw seat 4 and the screw body 5 respectively, and the axes of the three parts are coincident, the screw body 5 and the screw seat 4 can swing to all directions by taking the spring 55 as a turning point; when the inner core type stopper 3e is screwed into the spring cavity 552, the lower end bulge 34 of the stopper is inserted into the blind hole 56 at the upper end of the nail body, thereby preventing the spring 55 from bending, and enabling the pedicle nail to be rigid connection in a neutral state with the nail body 5 and the nail seat 4 coaxial, so as to facilitate the nail implantation operation; during operation, after all the pedicle screws are implanted into the spine, the connecting rod 2 is arranged on one side of the screw seat 4, the hook frame 7 is sleeved into the outer cylindrical surface 47 of the screw seat, the external thread 11 at the lower end of the screw plug 1 is screwed into the internal thread 45 of the screw seat, the connecting rod 2 is hooked and restrained on the screw seat 4 by the rod pressing frame 73, the spine can be easily expanded or pressurized by means of the pedicle screws which are connected in a rigid neutral position, and the angulation of a fixed segment caused by the forced angulation of the screw body 5 and the screw seat 4 is avoided; after the expansion and the pressurization are completed, when the screw plug 1 is screwed, the rod pressing frame 73 of the hook frame 7 and the nail seat rod cambered surface 48 lock the connecting rod 2 together through the downward pressure of the screw plug upper cover 13.
FIG. 3 is a two-dimensional view of the assembly of the present invention and a three-dimensional view of the nail holder and hook frame, respectively, further illustrating the construction and relationship of the components involved; the shape of the driver interface 46 at the upper end of the nail holder is clearly shown in fig. 3, and the use of the driver interface 46 at the upper end of the nail holder allows the pedicle screws to be screwed into the spine without the addition of the inner core type stopper 3e, which is an important optimization improvement of the patent application No. 201910494053.6.
Because the external spring type dynamic nail is characterized in that after the spring 7 is connected with the nail seat 5 and the nail body 4, a section of spring between the two can still do bending movement to generate the function of the dynamic nail, so that the whole pedicle nail can be in a static state or a dynamic state only by controlling the movement of the section of spring.
The structure and the limiting mechanism of the limiter are further illustrated by the attached fig. 4, as shown in fig. 4, the limiter is an inner core type limiter 3e, the outer surface of the limiter is processed into a cylindrical body with a thread 33 matched with the inner cavity 552 of the spring 55, the upper end surface of the limiter is provided with a screwdriver interface 32 for a screwdriver function, and the lower end of the limiter is provided with a protrusion 34; when the inner core type stopper 3e is not inserted into the inner cavity 552 of the spring 55, the screw body 5 and the implanted human vertebral body can swing at a certain angle relative to the screw plug 1, the hook frame 7, the connecting rod 2 and the screw seat 4 which are already connected together, as shown in fig. 4a, the pedicle screw of the present invention exhibits the function of a dynamic screw; when the inner core type limiter 3e is screwed into the inner cavity 552 of the spring 55 by using the inner core external thread 33 on the outer surface thereof by using the screwdriver, the lower end protrusion 34 of the inner core type limiter is then screwed into the upper end blind hole 56 of the nail body matched with the inner core type limiter, so that the spring 55 cannot be bent, the nail seat 4 and the nail body 5 become coaxial rigidity in an immediate neutral state, and the nail body 5 cannot swing relative to the nail seat 4 to become a 'static nail', as shown in fig. 4 b; if the inner core type stopper 3e is made of non-degradable material, it will be always stuck in the inner cavity 552 of the spring 55, and the whole pedicle screw will always be a "static screw"; since the inner core type stopper 3e of the present invention is made of degradable material, when it is gradually degraded, becomes smaller and softer and finally absorbed with time, the pedicle screw also gradually changes the static screw which initially performs rigid fixation into a dynamic screw which performs non-rigid fixation, i.e. the combination shown in fig. 4b returns to the combination shown in fig. 4a, thereby achieving the purpose of "the fixation screw is formed at the initial stage of operation and then gradually changed into the dynamic screw".
The beneficial effects of the invention will be further described with reference to fig. 5 and 6, as shown in fig. 5, the pedicle screw disclosed in the present application adopts a structural form of "connecting rod side-mounted", and the height of incisal tracks is effectively reduced by moving the connecting rod 2 to one side of the screw seat 4; the incisure height of the currently popular 'connective bar mid-positioned' dynamic nail shown in the middle of figure 5 is about 18mm, while the incisure of the invention application shown in the left side of figure 5 is only about 12mm, the reduced incisure h reaches about 6mm, and the incisure data can greatly reduce the adverse stimulation of the implant to the paraspinal muscles and improve the postoperative experience of patients.
As can be seen from the effect diagram of the typical "connecting rod middle-positioned" pedicle screw on the right side of fig. 5, when the screw plug downwards presses the connecting rod by using the internal thread on the screw seat, the working principle of the thread inevitably generates a lateral component force F which props open the through groove of the U-shaped opening on the screw seat towards two sides, thereby causing the screw plug to loosen, and further causing a medical accident of "rod loosening and rod breaking" seriously; in the multipurpose pedicle screw disclosed by the invention, because the connecting rod 2 is arranged on the side, the whole screw seat 4 is in a circular tube shape almost without weak points except the narrow and shallow screwdriver connector 46 at the upper end, and the hook frame 7 is sleeved on the outer cylindrical surface 47 of the screw seat in an encircling manner, the screw seat 4 cannot be propped open towards two sides no matter how much downward pressure is applied by the upper cover 13 of the screw, so that the clinical purpose of 'explosion-proof wire' is achieved.
The right drawing of fig. 6 is a nail seat effect drawing of the invention patent with the application number 201910494053.6 named as 'external spring type pedicle screw of an explosion-proof wire', the upper end of which has no screwdriver interface and is difficult to plant nails, in addition, only one side of the nail seat is provided with an arc surface for connecting a connecting rod, the nail seat is difficult to rotate to a proper position during operation, and the installation is difficult; on the contrary, the left drawing of fig. 6 shows the present invention, the nail seat 4 has the screwdriver interface 46 for facilitating nail implantation, and the outer edge of the whole nail seat is surrounded by a circle of arc surface with uniform shape, so that the nail seat 4 can be installed smoothly no matter what angle the nail seat 4 rotates.
The above embodiments are preferred embodiments of the present invention, and are not exhaustive of other embodiments of the present invention, and therefore, any modifications, equivalents, improvements, etc. made by using the contents of the specification and drawings of the present invention should be included in the scope of the present invention.
Claims (10)
1. A vertebral pedicle screw rod system capable of changing rigidity and flexibility from flexibility to rigidity is characterized by comprising a vertebral pedicle screw, a connecting rod and a screw plug; the pedicle screw comprises a screw seat and a screw body, a flexible connecting part is arranged between the screw seat and the screw body, and the screw seat and the screw body can relatively swing by taking the flexible connecting part as a turning point; the flexible connecting part is also connected with a degradable stopper used for preventing the nail seat and the nail body from swinging mutually, and along with the gradual degradation of the degradable stopper, the fixing mode of the pedicle screw-rod system is gradually changed from rigid fixing of initial fixing into a non-rigid fixing mode.
2. A pedicle screw and rod system capable of rigid and flexible transition from flexible to rigid fixation according to claim 1, wherein the flexible connecting part comprises a spring, one end of the spring is connected with the screw seat, and the other end of the spring is connected with the screw body.
3. A pedicle screw and rod system capable of changing rigid and flexible into rigid fixation according to claim 2, wherein the outer surface of the degradable stopper is an external thread matched with the thread shape of the inner wall of the spring, a first screwdriver interface is arranged in the center of the upper end surface of the degradable stopper, and a bulge matched with the blind hole in the upper end of the screw body is axially arranged in the center of the lower end of the stopper.
4. A pedicle screw and rod system capable of rigid and flexible change from flexible to rigid fixation according to claim 1, wherein the screw seat is a cylindrical structure with thin upper part and thick lower part, high upper part and low lower part and is transited by a circular arc surface, and the radian radius of the circular arc transition surface at the outer edge of the screw seat is consistent with the radius of the connecting rod;
the upper end surface of the nail seat is also provided with a second screwdriver connector which is a notch symmetrically arranged on the peripheral wall of the nail seat through the axial center;
the lower part of the inner cavity of the nail seat is provided with an axial through hole matched with the flexible connecting part in size and shape.
5. A pedicle screw and rod system capable of changing rigid and flexible into rigid fixation according to claim 4, further comprising a hook frame for fastening the connecting rod, wherein the hook frame comprises a lantern ring and a barb-shaped rod pressing arm arranged on the side edge of the lantern ring and extending outwards, and the lantern ring and the rod pressing arm are of an integrated structure; the inner cavity of the hook frame sleeve ring is matched with the outer edge of the nail seat, the sleeve ring is sleeved on the outer edge of the nail seat, and the lower edge of the press rod arm is a press rod cambered surface with the radius consistent with that of the connecting rod;
after the hook frame and the nail seat are sleeved, the semicircular pressing rod cambered surface of the pressing rod frame and the arc transition surface of the outer edge of the nail seat jointly form a tunnel for accommodating the connecting rod, so that the connecting rod is located on the outer side of the nail seat.
The pressing rod cambered surface is intersected with the inner cavity of the lantern ring to form a lantern ring gap.
6. A pedicle screw and rod system capable of changing rigidity from flexibility to rigidity according to claim 2, wherein the upper end of the screw body is free of a screw head, the upper end surface is a plane, and the center of the screw body is provided with a round blind hole along the axial direction; the edge of the upper end face of the nail body is also provided with an adaptive groove matched with the shape of the lower end of the spring.
7. A pedicle screw and rod system capable of changing from flexible to rigid fixation according to claim 4 or 6, wherein the upper end of the spring is screwed with the axially arranged internally threaded through hole at the lower end of the screw seat and permanently mechanically fixed, and the lower end of the spring is permanently mechanically fixed after being matched and connected with the matching groove at the upper end of the screw body.
8. A pedicle screw and rod system capable of changing from rigid to flexible to rigid fixation according to claim 2, wherein the screw body, the screw seat and the spring connected therebetween, and the flexible body and the rigid body in the connecting rod and the connection therebetween are manufactured in an integrated manner by additive manufacturing.
9. A pedicle screw-rod system capable of changing rigidity from flexibility to rigidity according to claim 1, wherein the screw plug comprises an upper cover, a third screwdriver connector is arranged in the center of the upper cover of the screw plug, and the lower part of the screw plug is provided with external threads matched with the internal threads at the upper end of the screw seat.
10. A pedicle screw and rod system capable of changing rigidity from flexibility to rigidity according to claim 1, wherein the degradable stopper is made of degradable biological material, magnesium metal with higher elastic modulus and faster degradation speed is used as an inner core, and polylactic acid with lower elastic modulus and slower degradation speed is used as a magnesium metal/polylactic acid composite material of a surface layer.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010261459.2A CN111419366A (en) | 2020-04-03 | 2020-04-03 | Pedicle screw-rod system capable of changing rigidity into flexibility into rigidity |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010261459.2A CN111419366A (en) | 2020-04-03 | 2020-04-03 | Pedicle screw-rod system capable of changing rigidity into flexibility into rigidity |
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| CN111419366A true CN111419366A (en) | 2020-07-17 |
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| CN202010261459.2A Pending CN111419366A (en) | 2020-04-03 | 2020-04-03 | Pedicle screw-rod system capable of changing rigidity into flexibility into rigidity |
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