CN1124447A - 一种尤其适用于脊柱固定的固定装置 - Google Patents

一种尤其适用于脊柱固定的固定装置 Download PDF

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CN1124447A
CN1124447A CN95190204A CN95190204A CN1124447A CN 1124447 A CN1124447 A CN 1124447A CN 95190204 A CN95190204 A CN 95190204A CN 95190204 A CN95190204 A CN 95190204A CN 1124447 A CN1124447 A CN 1124447A
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screw
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circular port
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鲁茨·比德曼
于尔根·哈姆斯
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Biedermann Motech GmbH and Co KG
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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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
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    • F16B39/00—Locking of screws, bolts or nuts
    • F16B39/22—Locking of screws, bolts or nuts in which the locking takes place during screwing down or tightening
    • F16B39/28—Locking of screws, bolts or nuts in which the locking takes place during screwing down or tightening by special members on, or shape of, the nut or bolt
    • F16B39/32—Locking by means of a pawl or pawl-like tongue
    • 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
    • A61B17/7059—Cortical plates
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones

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Abstract

一种尤其适用于固定脊柱的固定装置，它具一个固定板(1)，该固定板带有第一端(12)和与之相对着的第二端(13)，每一端各自有至少一个孔(14)用来容纳骨螺钉，骨螺钉通过一个锁定机构(15)确保其避免在第二转向转动。锁定机构具有与所旋入的螺钉实现啮合的带弹性的构件(30、31、32)，它构成固定板的一部分，并且沿第一转向转动螺钉时该带弹性的构件可从在固定板内的凹槽(35)内的锁定位置偏转开。

Description

一种尤其适用于脊柱固定的固定装置
本发明涉及一种固定装置，它尤其适用于按照本发明权利要求1的前序部分的固定脊柱的固定装置。
当脊柱的两节椎骨尤其在颈椎段要相互连接时，需应用固定装置。传统的固定装置由一个固定板组成，它借助至少两个旋入要连接的椎骨内的骨螺钉来被固定。
特别在颈椎段，由于头部的运动存在这样的倾向，即螺钉易被松动、旋转甚至脱落，这样就无法保证椎骨的稳固连接。
本发明的目的是提供一种固定装置，它可确保螺钉避免松开的转动。
通过权利要求1所述的一种固定装置可达到此目的。
该固定装置具有以下优点：可确保螺钉避免其所不希望的旋出，以至每个螺钉都保持紧固状态，并且不需要额外设置避免螺钉旋出的锁定装置。因此通常的螺丝保险方法，如借助带弹簧的齿锁垫片、盖舌及类似构件可以放弃，它们在对脊柱手术时操作不便。
具有优点的其它设计将在从属权利要求中给出。
下面将参照图对一实施例进行说明，附图中：
图1示出固定板的俯视图；
图2是图1中沿A—A线截面的放大图；
图3是图1中局部B的放大图；
图4是一骨螺钉的侧视图；
图5是图4中骨螺钉头部的俯视图；
图6是描述骨螺钉在最终紧固前旋入时的状态的一个截面图；
图7是描述骨螺钉最终紧固状态的一个截面图。
如图1所示，该固定装置有一个基本呈矩形的固定板1、在后面的叙述中，D代表板的沿矩形长度方向延伸的中心线；C代表与D垂直的沿矩形横向延伸的中心线。
其固定板1的形状是这样的，它的拐角10呈圆形，它的两长边11对称地朝着中心线D弯曲。
该板具有第一端12和与之相对着的第二端13，其每端都各自带有两个容纳骨螺钉的孔14。孔14呈两两对称于中心线C和中心线D设置。
如图3所示，每个孔14都做成长形孔，其长形孔的长轴平行于中心线D延伸，每个长形孔都与一个其直径等于长形孔短轴直径的圆形孔重叠，使圆形孔的中点M落在长形孔的长轴上，并朝中心线G方向偏离长形孔的中点。圆形孔带有一埋头孔16其形状与骨螺钉头适配，对此内容后面还将叙述。
从图1可以看出，板1在每个孔的靠中心线C一侧都有一个锁定机构15用于锁定骨螺钉2。
锁定机构15被做成有弹性的构件，它是固定板1的一部分并在板平面之内，它可从固定板1上直接切削而成，并能沿固定板平面方向在固定板内切削后形成的凹槽35内偏转。
如图3所示，锁定机构有一曲桥段30，其一端切入固定板1内。在朝曲率中心一侧，一直桥段31与曲桥段的另一端相连成一尖角，直桥段31的自由端弯曲并转向曲桥段30的方向。从固定板的切入点看，曲桥段30的曲率是一左向曲率。从由曲桥段30和直桥段31所构成的锁定机构15的顶点17到圆形孔中心点M的距离小于圆形孔的半径，这就是说顶点17略突出于圆形孔内，这一点也可从图2清楚地看到。
直桥段31沿圆形孔的径向延伸并与曲桥段30在顶点17处围成一大约60°的夹角。锁定机构15是有弹性的并能在固定板1的凹槽35内从上面所述的不受力位置(图3中实线)向曲桥段30的曲率中心方向偏转(图3中虚线)。曲桥段的背向曲率中心一侧与板体60邻接。在虚线所示的偏转位置，从锁定机构的顶点17到圆形孔中心点M的间隔大于或等于圆形孔周围的埋头孔16的外半径。
该固定装置还有如图4所示的骨螺钉2用于固定板1的固定。骨螺钉2具有螺钉头20和螺杆21。螺钉头20在与螺杆相连的一侧有一几乎呈截球形的边缘，其截面中心落在背向螺杆一侧并在螺杆的长轴上。螺钉头的直径等于或略小于圆形孔的埋头孔16的直径，螺钉头20的球拱形边缘上有槽齿23，锁定机构15与其啮合从而达到锁定。
从图5可以看出，槽齿被做成如下形式：每个齿均由指向螺钉头轴向的第一齿面51和与这一方向组成一尖角的第二齿面52组成。第二齿面的布置是这样确定的：如把顺时针方向看作第一转向，其第二齿面对第一转向而言处在第一齿面前。在螺钉旋入状态下，其螺钉头20处在圆形孔的埋头孔16内，而锁定机构15的直桥段31紧贴槽齿23的第一齿面51，并构成锁定。
在螺钉头20背面螺杆21一侧的中央有一六角形内孔用于插入螺钉扳手使螺钉2旋转。
固定板1和骨螺钉2采用人体亲和性金属，尤其是钛来制造。
参照图1至图5，锁定机构的工作原理如下：沿第一转向即顺时针方向旋入螺钉，当螺钉头20一到达埋头孔16的区域内，第二齿面52就沿锁定机构15的曲桥段30滑动使锁定机构偏转，使直桥段31从它被第一齿面51的锁定位置被推开，从而使螺钉头滑动。此时，从锁定机构的顶点17到圆形孔的中心点M的间隔大于圆形孔的半径。每当第二齿面52滑过后，有弹性的锁定机构15又卡入前面所述的锁定位置。
在试图使螺钉旋出的沿与第一转向相反的第二转向的转动中，槽齿的第一齿面51被压着所紧贴的锁定机构的直桥段31，而锁定机构的顶点17被紧夹在槽齿中，以至如不借助其它辅助工具将锁定机构偏转到虚线所示的位置的话，螺钉不可能旋出。
下面参照图6和图7对固定板1的固定加以说明。
图6示出带孔14的固定板的局部截面图和螺钉在最终紧固前的状态。螺钉大约处在长形孔的长轴中点上，接着螺杆21被继续旋入直至螺钉头20碰到非埋头孔的长形孔边缘的上边18。
继续沿第一转向旋入时，螺钉头20将从上边18被推开并进入与长形孔重叠的圆形孔的形状适合的埋头孔16中，此时骨螺钉2的头部20在圆形孔中，因此分别与固定板的第一端和第二端用螺钉固定的椎骨被相互压上。图7给出了固定板1与骨螺钉2完全紧固状态下的截面图。
长形孔的横向直径、即也是处在埋头孔16中心的孔的直径是与螺钉2的杆相关，以使螺钉2象图6所示的那样在孔轴周围15°角内的任何方向旋入。如图4和图7所示，沿轴向，齿面几乎布满整个钉头高度上，因此对于倾斜旋入的螺钉同样能以上面所述的形式实现锁定。

Claims (15)

1.一种尤其适用于固定脊柱的固定装置，具有一个固定板(1)，该固定板带有第一端(12)和与之相对的第二端(13)，其每一端至少有一个孔(14)用来容纳骨螺钉(2)，骨螺钉有一螺杆(21)，其第一转向为旋入；第二转向为旋出，其特征是，具有一个锁定机构(15，23)用于锁定骨螺钉以避免所不希望的沿第二转向的转动。
2.按照权利要求1所述的固定装置，其特征是，所述的机构(15)具有一个与所旋入的骨螺钉啮合的有弹性的构件(30、31、32)。
3.按照权利要求2所述的固定装置，其特征是，所述的骨螺钉(2)具有与螺杆(21)相毗连的螺钉头(20)，螺钉头周边带有槽齿，所述的有弹性的构件与其啮合用于锁定。
4.按照权利要求3所述的固定装置，其特征是，所述的槽齿(23)被做成如下形式：第一齿面(51)指向螺钉头(20)的径向；第二齿面(52)与该径向形成一尖角，并且就第一转向而言第二齿面处在第一齿面之前。
5.按照权利要求3或4所述的固定装置，其特征是，所述的孔(14)为一长形孔，其长轴分别指在两端(12，13)上，该长孔与一等同直径的圆形孔重叠，圆形孔带有一埋头孔(16)用于与螺钉头(20)适配，使圆形孔的中心点(M)落在长形孔的长轴上并偏离长形孔中心点的方向的另一端。
6.按照权利要求2至5中任一项所述的固定装置，其特征是，所述的有弹性的构件(30、31、32)由固定板(1)的一部分组成并处在其平面之内。
7.按照权利要求6所述的固定装置，其特征是，所述的有弹性的构件具有与一固定板(1)相连的曲桥段(30)和一在曲率中心一侧的与曲桥段相接并与其组成一尖角的直桥段(31)，该直桥段带有一向曲桥段方向弯转的自由尾端，从与固定板的接触点观察，曲桥形段是向左弯曲的。
8.按照权利要求6或7所述的固定装置，其特征是，所述的带弹性的构件在固定板(1)的凹槽(35)内可向曲桥形段的曲率中心方向偏转。
9.按照权利要求8所述的固定装置，其特征是，所述的带有弹性的构件被做成如下形式：当它在不受力状态下由曲桥形段(30)和直桥形段(17)所组成的尖顶(17)到圆形孔中心点的间距小于该圆形孔的半径。
10.按照权利要求8或9所述的固定装置，其特征是，所述的带弹性的构件被造成如下形式：当它在偏转位置时，顶点(17)到圆形孔中民点的间距大于或等于圆形孔周围埋头孔(16)的外半径。
11.按照权利要求3至10中任一项所述的固定装置，其特征是，骨螺钉(2)的钉头(20)具有一基本呈截球形的边缘，其球截面的中心点位于背向螺杆(21)的一侧。
12.按照权利要求11所述的固定装置，其特征是，圆形孔的埋头孔(16)与螺钉头(20)的形状相适配。
13.按照权利要求1至12中任一项所述的固定装置，其特征是，在所述的固定板(1)的第一端(12)和第二端(13)各自有两个孔(14)。
14.按照权利要求1至13一项所述的固定装置，其特征是，所述的固定板(1)，锁定机构(15)和骨螺钉(2)都采用人体亲和性金属尤其是钛来制造。
15.按照权利要求3至14中任一项所述的固定装置，其特征是，所述的骨螺钉(2)在其螺钉头(20)的背向螺杆一侧有一内孔(55)用来插入螺钉扳手使螺钉转动。
CN95190204A 1994-03-22 1995-03-01 一种尤其适用于脊柱固定的固定装置 Pending CN1124447A (zh)

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CN100486540C (zh) * 2004-06-17 2009-05-13 华沙整形外科股份有限公司 使螺钉保持在板中的方法和器械
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DE4409833A1 (de) 1995-10-05
WO1995025474A1 (de) 1995-09-28
CA2163243A1 (en) 1995-09-28
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ATE193431T1 (de) 2000-06-15
EP0699057A1 (de) 1996-03-06

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