CN111493989A

CN111493989A - System for fixing adjacent vertebral bodies through crossed cables

Info

Publication number: CN111493989A
Application number: CN202010443215.6A
Authority: CN
Inventors: 郝晓艳
Original assignee: Individual
Current assignee: Individual
Priority date: 2020-05-22
Filing date: 2020-05-22
Publication date: 2020-08-07

Abstract

The invention discloses a system for fixing adjacent vertebral bodies through crossed cables, which comprises a system for fixing the adjacent vertebral bodies through combination of nails and the crossed cables, a system for fixing the adjacent vertebral bodies through combination of nail plates and the crossed cables, and a system for fixing the adjacent vertebral bodies through combination of nail hooks and the crossed cables; the system for fixing the adjacent vertebral bodies by combining the nail and the crossed cable and the system for fixing the adjacent vertebral bodies by combining the nail plate and the crossed cable are used for fixing the implanted bone in the lateral approach intervertebral space; the system for fixing the adjacent vertebral bodies by combining the nail hooks and the crossed cables is used for fixing the adjacent vertebral bodies in the posterior lumbar; the invention can effectively limit the relative movement between the vertebral bodies without stress shielding and can avoid the rapid degeneration of the adjacent intervertebral discs due to stress concentration; the system can limit the relative movement between the vertebral bodies in the early stage to provide a stable environment for fusion, and the system can be made of absorbable materials, can be absorbed by the human body in the later stage, does not leave foreign matters in the body and has a good long-term effect; has better long-term effect and can reduce the operation cost.

Description

System for fixing adjacent vertebral bodies through crossed cables

Technical Field

The invention relates to a system for fixing adjacent vertebral bodies through crossed cables, and belongs to the technical field of surgical instruments.

Background

At present, when fixing adjacent vertebral bodies, two modes of posterior vertebral body fixing and lateral approach fixing are generally adopted:

the posterior vertebral body is fixed by a nail-rod system, and the biggest problem of the fixing mode is that the adjacent intervertebral discs can be rapidly degenerated due to stress concentration; in addition, there are also several kinds of non-rigid fixation or elastic fixation, but they are often expensive and do not solve the problem completely.

The side approach is fixed, intervertebral fusion is generally carried out after the intervertebral disc is removed, strong fixation between vertebral bodies is often carried out, but the strong fixation can cause stress shielding to generate local osteoporosis, side effect is generated to the fusion, and metal fixtures are left in the body.

In view of the above, the prior art obviously has inconvenience and disadvantages in practical use, and therefore, there is a need to develop a novel system for fixing adjacent vertebral bodies by crossing cables to solve the disadvantages of the prior art.

Disclosure of Invention

Aiming at the defects, the invention provides a system for fixing adjacent vertebral bodies through crossed cables, which can effectively limit the relative movement between the vertebral bodies, has no stress shielding and can avoid the rapid degeneration of the adjacent intervertebral discs due to stress concentration; the system can limit the relative movement between the vertebral bodies in the early stage to provide a stable environment for fusion, can select an absorbable material according to the materials required by the operation, can be absorbed by the human body in the later stage, does not leave traces, does not leave foreign matters in the body, and has better long-term effect; the operation cost can be reduced.

In order to solve the technical problems, the invention adopts the following technical scheme:

a system for fixing adjacent vertebral bodies through crossed cables comprises a system for fixing the adjacent vertebral bodies through combination of nails and the crossed cables, a system for fixing the adjacent vertebral bodies through combination of nail plates and the crossed cables, and a system for fixing the adjacent vertebral bodies through combination of nail hooks and the crossed cables; the system for fixing the adjacent vertebral bodies by combining the nail and the crossed cable and the system for fixing the adjacent vertebral bodies by combining the nail plate and the crossed cable are used for fixing the implanted bone in the lateral approach intervertebral space; the system for fixing the adjacent vertebral bodies by combining the nail hook and the crossed cable is used for fixing the adjacent vertebral bodies in the posterior lumbar vertebra.

Further, the nail and cross cable combination fixes the system of the adjacent vertebral bodies, which comprises a lateral nail and a cross cable; the quantity of side road nail is four, and the top of side road nail is provided with the hemicycle body that is used for the threading respectively.

Furthermore, the system for fixing the adjacent vertebral bodies by combining the nail plates and the crossed cables comprises the crossed cables and two side road plates, the side road plates are respectively fixed on the surfaces of the upper vertebral body and the lower vertebral body which are adjacent through screws, two bulges are respectively arranged at the edges of the two side road plates close to the middle vertebral gap, and threading holes A are respectively arranged in the bulges; two threading holes A of the upper side circuit board are respectively used for penetrating and fixing the upper ends of the crossed cables, and two threading holes A of the lower side circuit board are respectively used for penetrating and fixing the lower ends of the crossed cables.

Furthermore, the cross cable and the side board are made of absorbable materials or non-absorbable materials.

Furthermore, vertical cables penetrate through holes A of the lateral board close to the front edge of the spine.

Furthermore, the system for fixing the adjacent vertebral bodies by combining the nail hook and the crossed cable comprises the crossed cable, the transverse convex hook and the pedicle nail, wherein the top end and the bottom end of the crossed cable are respectively fixedly arranged in the two transverse convex hooks which are arranged up and down in a penetrating manner.

Furthermore, one end of the transverse protruding hook is a round rod body, the other end of the transverse protruding hook is a plate hook body, the round rod body and the plate hook body are integrally arranged, a threading hole B is formed in the round rod body, the round rod body is matched with the U-shaped opening of the pedicle screw, and the round rod body is arranged in the U-shaped opening of the pedicle screw in a penetrating mode and fixed through a looseness-proof nut; the number of the pedicle screws on the same side of the vertebral body is two, and the two pedicle screws are respectively driven into the two vertebral bodies which are adjacent up and down.

Furthermore, the plate hook body is in a plate hook shape, and the shape of the inner surface of the plate hook body is matched with the shape of the transverse convex surface of the vertebral body; the tail end of the plate hook body, which is far away from the round rod body, is provided with a threading hole C.

Furthermore, the cross cable, the transverse protruding hook and the pedicle screw are all made of absorbable materials or non-absorbable materials.

Furthermore, the system for fixing adjacent vertebral bodies by combining the nail hooks and the crossed cables further comprises a cushion block, the cushion block is matched with the transverse projecting hook at the upper part to fix the L5S 1 intervertebral disc, a circular shaft is arranged on the cushion block, the cushion block is matched and combined with a U-shaped opening of the sacral nail through the circular shaft, the bottom shape of the cushion block is matched with the bone in front of the sacral nail, and a threading hole D is formed above the cushion block.

After the technical scheme is adopted, compared with the prior art, the invention has the following advantages:

1. for patients who do not need to be fused, the invention belongs to non-strong fixation, can limit the accelerated degeneration of the target intervertebral disc due to over-activity and can also avoid the rapid degeneration of adjacent intervertebral discs due to stress concentration; for the patient needing to be fused, the invention can select absorbable materials, limit the relative motion between the vertebral bodies in the early stage to provide a stable environment for the fusion, and the nail, the nail plate, the nail hook, the flexible cable and the like in the later stage can be absorbed by the human body without leaving traces or foreign matters in the body, so the long-term effect is better;

2. the nail, the nail plate, the nail hook and the flexible cable are combined to be used as a fixing device, the maximum advantage is that stress concentration is avoided, the self-buffering property is achieved, and in addition, whether an absorbable material is adopted or not can be selected according to the length of fixing time;

3. the cross cable has the advantages that effective fixation can be formed in multiple directions;

4. except for the side path nail and the crossed cable fixing system, the pedicle nails and the sacrum nails in other fixing systems are not under the action of direct stress, except for eliminating stress concentration through cable buffering, the transverse protruding hooks, the cushion blocks and the side path plates help the pedicle nails to share traction stress, so that even for patients with osteoporosis, looseness can not be caused generally;

5. the operation of the invention is simple when the operation is carried out, and for the spine surgeon, the fixing equipment has lower manufacturing cost and can reduce the cost of the whole operation; the invention has simple structure, excellent effect and certain creativity, and can be widely applied and popularized.

The present invention will be described in detail below with reference to the accompanying drawings and examples.

Drawings

FIG. 1 is a schematic view of a system for anchoring adjacent vertebral bodies with a staple and cross-cable combination according to the present invention;

FIG. 2 is a schematic view of the construction of the side rail of the present invention;

FIG. 3 is a schematic view of a system for securing adjacent vertebral bodies using a combination of a nail plate and a cross cable according to the present invention;

FIG. 4 is another schematic view of the system for fixation of adjacent vertebral bodies with a staple plate and cross-cable combination of the present invention;

FIG. 5 is a schematic view of a system for securing adjacent vertebral bodies with a staple and cross-cable combination according to the present invention;

FIG. 6 is a front view of the structure of the transverse projecting hook of the present invention;

FIG. 7 is a top view of the cross hook of the present invention;

FIG. 8 is a schematic view of the construction of the spacer of the present invention;

in the figure, 1-crossed cable, 2-lateral nail, 21-hemicycle, 3-centrum, 31-transverse process, 4-lateral board, 41-bulge, 42-threading hole A, 5-vertical cable, 6-transverse projecting hook, 61-round rod body, 62-board hook body, 63-threading hole B, 64-threading hole C, 7-pedicle nail, 8-cushion block, 81-threading hole D, 82-shaft and 9-sacral nail.

Detailed Description

In order to more clearly understand the technical features, objects, and effects of the present invention, embodiments of the present invention will now be described with reference to the accompanying drawings.

EXAMPLE 1A System for securing adjacent vertebral bodies by a combination of staples and crossed cables

As shown collectively in fig. 1 and 2, the present invention provides a system for fixation of adjacent vertebral bodies by a combination of staples and cross cables, which can be used for fixation after bone grafting of a lateral approach intervertebral space; the system comprises a lateral spike 2 and a cross cable 1; the number of the side road nails 2 is four, two side road nails 2 are fixed in the upper vertebral body 3, two side road nails are fixed in the lower vertebral body 3, the top parts of the side road nails 2 are respectively provided with a semi-ring body 21, and the semi-ring bodies 21 are used for penetrating and fixing the end parts of the crossed cables 1; the cross cable 1 comprises two cables which penetrate through the half ring body 21 to form cross fixation.

The cross cable 1 and the side road nail 2 are made of absorbable materials or non-absorbable materials.

The specific implementation manner of this embodiment:

when in operation, the side path nail 2 with the half-ring body 21 is screwed into the vertebral bodies 3 at the upper part and the lower part, and the cable is fixed on the half-ring body 21 of the side path nail 2 after being crossed.

EXAMPLE 2A System for securing adjacent vertebral bodies by a combination of pegboard and cross-cables

As shown in FIG. 3, the present invention provides a system for fixation of adjacent vertebral bodies by a combination of nail plates and cross cables, which can be used for fixation after bone grafting of a lateral approach intervertebral space; the system comprises a cross cable 1 and a side road board 4; the cross cable 1 comprises two cables; the number of the side road boards 4 is two, the side road boards 4 are respectively fixed on the surfaces of two adjacent vertebral bodies 3 up and down through screws, two bulges 41 are respectively arranged at the edges of the upper side road board 4 and the lower side road board 4 close to the middle intervertebral space, and threading holes A42 are respectively arranged in the bulges 41; the two threading holes a42 of the upper side road plate 4 are respectively used for threading and fixing the upper ends of the cross cables 1, and the two threading holes a42 of the lower side road plate 4 are respectively used for threading and fixing the lower ends of the cross cables 1.

The advantage of the cross cable 1 in this embodiment is that both cables can act in synergy, but also individually.

In practical application, as shown in fig. 4, in order to prevent the anterior intervertebral space from opening when the spine extends backwards, a vertical cable 5 can be added into the holes A42 of the two lateral plates 4 near the anterior edge of the spine to prevent the anterior intervertebral space from opening.

The cross cable 1 and the side plates 4 in this embodiment can be made of absorbable or non-absorbable materials.

The specific implementation manner of this embodiment:

the intervertebral disc is treated in the way of side approach, put into Cage, respectively bore two fixed orificess under the cooperation of template director at the position that upper and lower centrum 3 is close to the intervertebral space, put two side way boards 4 and fix firmly with the screw, cross the threading hole A42 that penetrates the cable correspondence, adjust the waist bridge, let patient's backbone normal position be upright state, see through when necessary, tighten up the cable, make the cable possess certain tension can, combine together two disconnected ends of cable with special cable locking apparatus.

EXAMPLE 3A System for fixation of adjacent vertebral bodies by means of a combination of staples and crossed cables

As shown collectively in fig. 5, 6 and 7, the present invention provides a system for fixation of adjacent vertebral bodies by a combination of staples and cross cables, which can be used for fixation after bone grafting of the posterior lumbar intervertebral space; the system includes a cross-cable 1, a transverse process hook 6 and a pedicle screw 7.

The cross cable 1 comprises two cables, and the top ends and the bottom ends of the two cables are respectively fixedly penetrated in the two vertically arranged transverse projecting hooks 6; one end of the transverse protruding hook 6 is a round rod body 61, the other end of the transverse protruding hook is a plate hook body 62, the round rod body 61 and the plate hook body 62 are integrally arranged, a threading hole B63 is formed in the round rod body 61, the round rod body 61 is matched with the U-shaped opening of the pedicle screw 7, and the round rod body 61 is arranged in the U-shaped opening of the pedicle screw 7 in a penetrating mode and fixed through a looseness-proof nut; the number of the pedicle screws 7 is two on the same side of the vertebral bodies 3, and the two pedicle screws 7 are respectively driven into the two vertebral bodies 3 which are adjacent up and down;

the plate hook body 62 is in a plate hook shape, and the shape of the inner surface of the plate hook body 62 is matched with the surface shape of the transverse process 31 of the vertebral body 3; the end of the plate hook body 62 far away from the round rod body 61 is provided with a threading hole C64.

When the plate hook body 62 is installed, the upper plate hook body 62 is lapped on the transverse projection 31, the plate hook opening is arranged downwards, the lower plate hook body 62 penetrates through the lower part of the transverse projection 31, and the plate hook opening is arranged upwards; the inner surface of the hook body 62 conforms to the surface shape of the transverse projection 31 to increase the contact area with the transverse projection 31.

The relevant position of transverse process 31 is first exposed prior to installation of transverse process hook 6 and the bone facets are treated to increase the conformity of the bone facets of transverse process 31 with the inner face of plate hook body 62. In the plate hook 62 for the non-intervertebral fusion operation requiring long-term fixation, the portion in contact with the transverse process 31 may be designed as a microporous surface, which is expected to have bone ingrowth for a long time, and thus be more stable.

As shown in figure 8, when L5S 1 intervertebral disc fixation is carried out, as L5S 1 is special and the lower end of a cross cable 1 is not easy to install, the invention also comprises a cushion block 8, the cushion block 8 is matched with a transverse convex hook 6 at the upper part to realize the fixation of the L5S 1 intervertebral disc, a round shaft 82 is arranged on the cushion block 8, the round shaft 82 is matched and combined with a U-shaped opening of a sacral nail 9, the bottom shape of the cushion block 8 is matched with the bone in front of the sacral nail 9, the cushion block 8 is locked with the sacral nail 9 and is supported by the bone in front of the sacral nail 9, the load of the sacral nail 9 is greatly reduced, a threading hole D81 is arranged above the cushion block 8, the threading hole D81 corresponds to the threading hole B in front of the transverse convex hook 6 of L5, the two holes are connected by a single cable, and the joint is tightened to finish the fixation of the L5S 1 intervertebral disc.

In the embodiment, the transverse process 31 is used for assisting the fixation besides the fixation point of the pedicle screw 7, so that stress concentration at a certain point is avoided, and the pedicle screw is very stable when being pulled. The connecting points of the transverse protruding hook 6 and the cross cable 1 are both positioned on the same side of the pedicle screw 7, and no matter which cable is pulled, the transverse protruding hook 31 does not allow the compound body of the pedicle screw 7 and the transverse protruding hook 6 to rotate around the pedicle screw 7 as an axis due to stress. When the system is used for the operation of intervertebral space fusion, the cross cable 1, the transverse process hook 6 and the pedicle screw 7 can be made of absorbable materials according to the operation requirement.

The specific implementation manner of this embodiment:

after the intervertebral space and the spinal canal are treated in a posterior way, the pressure reduction or the Cage is placed, 4 pedicle screws 7 with proper length are driven in, soft tissues are stripped at the root parts of the corresponding transverse processes 31, the stripping range is about 1 cm, muscles near the channels of the crossed cables 1 are cut off, the pain caused by the traction of the cables after the operation is avoided, the edges of the transverse processes 31 are treated by a sander, the transverse processes are matched with the inner surfaces of the plate hook bodies 62, the plate hook bodies 62 at the upper parts are lapped on the transverse processes 31, the plate hook openings are arranged downwards, the plate hook bodies 62 at the lower parts penetrate through the lower surfaces of the transverse processes 31, the plate hook openings are arranged upwards, the round rod bodies 61 are placed in U-shaped openings of the pedicle screws 7 under the condition that the plate hook bodies 62 are maximally attached to the transverse processes 31 and are screwed down by anti-loosening nuts, the spinal column is straightened to avoid lateral bending, the cables are tightened, the tension is slightly larger to avoid the excessive relaxation of the standing position in the future, the two sides are consistent, the cables are combined together by a locker, and for L5S 1 patients, the sacrum stress is obvious, the front bone stress is fixed by the lower hook bodies 62 and the single.

The fixing of the cable in the invention can adopt a metal ring with teeth on the inner surface, a half pipe, a mode of extrusion by special instruments and the like, and the fixing of the cable does not belong to the innovation point of the invention, so the details are not described.

The foregoing is illustrative of the best mode of the invention and details not described herein are within the common general knowledge of a person of ordinary skill in the art. The scope of the present invention is defined by the appended claims, and any equivalent modifications based on the technical teaching of the present invention are also within the scope of the present invention.

Claims

1. A system for securing adjacent vertebral bodies by crossing cables, comprising: the system comprises a system for fixing adjacent vertebral bodies by combining nails and crossed cables, a system for fixing adjacent vertebral bodies by combining nail plates and crossed cables, and a system for fixing adjacent vertebral bodies by combining nail hooks and crossed cables; the system for fixing the adjacent vertebral bodies by combining the nail and the crossed cable and the system for fixing the adjacent vertebral bodies by combining the nail plate and the crossed cable are used for fixing the implanted bone in the lateral approach intervertebral space; the system for fixing the adjacent vertebral bodies by combining the nail hook and the crossed cable is used for fixing the adjacent vertebral bodies in the posterior lumbar vertebra.

2. A system for anchoring adjacent vertebral bodies via a cross-cable as in claim 1, wherein: the system for fixing adjacent vertebral bodies by combining the nail and the crossed cable comprises a lateral nail (2) and the crossed cable (1); the number of the side road nails (2) is four, and the top parts of the side road nails (2) are respectively provided with a semi-ring body (21) for threading.

3. A system for anchoring adjacent vertebral bodies via a cross-cable as in claim 1, wherein: the system for fixing the adjacent vertebral bodies by combining the nail plates and the crossed cables comprises two side channel plates (4) and the crossed cables (1), wherein the number of the side channel plates (4) is two, the side channel plates (4) are respectively fixed on the surfaces of the upper vertebral body and the lower vertebral body (3) which are adjacent through screws, two bulges (41) are respectively arranged at the edges of the two side channel plates (4) close to the middle vertebral gap, and threading holes A (42) are respectively arranged in the bulges (41); two threading holes A (42) of the upper side circuit board (4) are respectively used for threading and fixing the upper ends of the crossed cables (1), and two threading holes A (42) of the lower side circuit board (4) are respectively used for threading and fixing the lower ends of the crossed cables (1).

4. A system for anchoring adjacent vertebral bodies via a cross-cable as in claim 3, wherein: the cross cable (1) and the side circuit board (4) are made of absorbable materials or non-absorbable materials.

5. A system for anchoring adjacent vertebral bodies via crossing cables according to claim 4, wherein: vertical cables (5) penetrate through holes of the side circuit board (4) close to the threading holes A (42) of the front edge of the spine.

6. A system for anchoring adjacent vertebral bodies via a cross-cable as in claim 1, wherein: the system for fixing the adjacent vertebral bodies by combining the nail hook and the cross cable comprises the cross cable (1), the transverse convex hook (6) and the pedicle nail (7), wherein the top end and the bottom end of the cross cable (1) are respectively fixed in the two vertically arranged transverse convex hooks (6) in a penetrating manner.

7. A system for anchoring adjacent vertebral bodies via a cross-cable as in claim 6, wherein: one end of the transverse protruding hook (6) is a round rod body (61), the other end of the transverse protruding hook is a plate hook body (62), the round rod body (61) and the plate hook body (62) are integrally arranged, a threading hole B (63) is formed in the round rod body (61), the round rod body (61) is matched with a U-shaped opening of the pedicle screw (7), and the round rod body (61) penetrates through the U-shaped opening of the pedicle screw (7) and is fixed through a looseness-proof nut; the number of the pedicle screws (7) on the same side of the vertebral body (3) is two, and the two pedicle screws (7) are respectively driven into the two vertebral bodies (3) which are adjacent up and down.

8. A system for anchoring adjacent vertebral bodies via a cross-cable as in claim 7, wherein: the plate hook body (62) is in a plate hook shape, and the shape of the inner surface of the plate hook body (62) is matched with the shape of the surface of a transverse process (41) of the vertebral body (3); the tail end of the plate hook body (62) far away from the round rod body (61) is provided with a threading hole C (64).

9. A system for anchoring adjacent vertebral bodies via a cross-cable as in claim 8, wherein: the cross cable (1), the transverse projecting hook (6) and the pedicle screw (7) are all made of absorbable materials or non-absorbable materials.

10. The system for fixing the adjacent vertebral bodies through the crossed cable is characterized in that the system for fixing the adjacent vertebral bodies through the combination of the nail hook and the crossed cable further comprises a cushion block (8), the cushion block (8) is matched with the transverse protruding hook (6) at the upper part to realize the fixation of L5S 1 intervertebral discs, a round shaft (82) is arranged on the cushion block (8), the cushion block (8) is matched and combined with a U-shaped opening of the sacral nail (9) through the round shaft (82), the bottom shape of the cushion block (8) is matched with the bone in front of the sacral nail (9), and a threading hole D (81) is arranged above the cushion block (8).