CN113693699A - 一种应用于骨质疏松的爪形椎弓根螺钉 - Google Patents
一种应用于骨质疏松的爪形椎弓根螺钉 Download PDFInfo
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Abstract
本发明公开应用于骨质疏松的爪形椎弓根螺钉,包括内螺塞和外螺钉;所述外螺钉包括外螺母和外螺杆,外螺母和外螺杆内部设置后贯穿的通孔,所述外螺杆外部依次设置有螺纹段、爪形段和锥形段,所述螺纹段内部设置有第一内螺纹,爪形段上设置有多个连通所述通孔的条形槽,爪形段内部为光滑段;所述锥形段内部设置有第二内螺纹;所述爪形段为可形变金属制成;所述内螺塞包括内螺母和内螺杆,所述内螺杆插入所述通孔,且所述内螺杆与所述有第一内螺纹、第二内螺纹螺纹连接;所述内螺杆与第二内螺纹互为反丝螺丝。本发明通过内螺塞增加螺钉与周围骨质的把持力,从而增强螺钉的抗拔出力。
Description
技术领域
本发明涉及骨质疏松手术器械技术领域,具体涉及一种应用于骨质疏松的爪形椎弓根螺钉。
背景技术
随着老年人预期寿命的延长,脊柱骨质疏松症的患者数量也在持续增长。由于这类患者骨质重塑能力的减弱,椎体骨质量的下降,导致脊柱容易出现压缩性骨折、退行性畸形和狭窄等,往往需要手术来干预。虽然椎弓根螺钉为骨质正常的患者提供坚强的固定,但在骨质疏松人群中,由于螺钉在疏松骨质中的把持力明显下降,因此往往存在术后螺钉拔出、松动及移位等风险。
研究者们已经尝试了使用骨水泥加强螺钉稳定性的方法来增强螺钉在疏松骨质内的把持力。诸多研究表明使用骨水泥加强后,其平均抗拔出强度可达普通椎弓根螺的150-250%。但是随着骨水泥强化螺钉使用数量的增加,与之相关的诸多并发症及风险也逐步浮现出来,其中最为常见的是骨水泥渗漏(文献报道的发生率最高可达26.2%)。此外,还存在发生包括骨水泥热损伤、肺栓塞及邻近椎体压缩性骨折等其他并发症的风险,而且其翻修较为困难。
为了避免使用骨水泥带来的各类并发症的风险,学者们又开始设计开发了一类替代以骨水泥加强螺钉把持力的新型螺钉——膨胀螺钉。这种螺钉置入椎体后,通过其位于椎体骨质内部分螺钉的膨胀,增加螺钉与周围骨质的接触面积,并通过压缩周围骨质来增加周围骨质的密度,从而显著增强螺钉的抗拔出力。早期报道的膨胀螺钉多为头端膨胀,近期有学者报道了一种新型膨胀螺钉(OsseoScrew脊柱内固定系统),该螺钉的膨胀部位靠近椎弓根,有利于增强其抗拔出强度。与普通椎弓根螺钉相比,该螺钉可增加约30%的抗拔出强度(在骨质疏松骨中可增加约50%的抗拔出强度),同时其刚度及屈服载荷与普通外径的椎弓根螺钉没有显著区别。
有研究显示膨胀螺钉增强其固定稳定性的效果类似于骨水泥,但是该螺钉在临床使用时发现仍有螺钉发生在椎弓根部断裂现象;其次,由于螺钉植入膨胀后,周围的骨质可以长入膨胀区域内部,导致后期如果需要进行翻修时,螺钉的取出将很困难且易导致较大的椎体骨质缺损,往往需要延长固定节段来维持固定的稳定性。
发明内容
为了避免使用骨水泥及膨胀螺钉带来的各类并发症的风险,本发明提供了一种应用于骨质疏松的爪形椎弓根螺钉,本发明设计爪型椎弓根喷涂螺钉,这种螺钉置入椎体后,通过其位于椎体骨质内部分螺钉的爪型结构,通过内螺塞增加螺钉与周围骨质的把持力,从而增强螺钉的抗拔出力。
为了实现上述目的,本发明提供了如下的技术方案。
一种应用于骨质疏松的爪形椎弓根螺钉,包括内螺塞和外螺钉;
所述外螺钉包括外螺母和外螺杆,外螺母和外螺杆内部设置后贯穿的通孔,所述外螺杆外部依次设置有螺纹段、爪形段和锥形段,所述螺纹段内部设置有第一内螺纹,爪形段上设置有多个连通所述通孔的条形槽,爪形段内部为光滑段;所述锥形段内部设置有第二内螺纹;所述爪形段为可形变金属制成;所述螺纹段上设置有第一外螺纹,第一内螺纹与第二内螺纹螺纹方向相反;第一外螺纹与第二内螺纹螺纹方向相同;
所述内螺塞包括内螺母和内螺杆,所述内螺杆插入所述通孔,所述内螺杆上设置有第二外螺纹,且所述内螺杆的第二外螺纹与所述有第一内螺纹连接,反向旋转作用下,所述第二外螺纹与第二内螺纹连接,挤压所述爪形段膨胀。
作为本发明的进一步改进,所述外螺杆为锥形结构,第一外螺纹由螺纹段向外螺母方向的螺距逐渐减小、螺纹直径逐渐减大。
作为本发明的进一步改进,所述第一外螺纹尾部具有羟基磷灰石喷涂层。
作为本发明的进一步改进,所述内螺母上设置有第二扳手操作槽。
作为本发明的进一步改进,所述内螺杆的长度等于外螺杆除去第二内螺纹之后的长度。
作为本发明的进一步改进,还包括操作工具,操作工具包括锁紧螺母和操作杆;
所述外螺母上设置有锁紧槽,外螺母内部设置有锁紧螺纹;
使用时,所述操作杆设置在所述锁紧槽内,并通过锁紧螺母与锁紧螺纹螺纹连接锁死操作杆。
作为本发明的进一步改进,所述锁紧螺母上设置有第一扳手操作槽。
作为本发明的进一步改进,所述操作杆与外螺钉轴向垂直。
作为本发明的进一步改进,所述爪形段的材料为纯钛,螺纹段材料为钛合金。
作为本发明的进一步改进,所述条形槽沿爪形段的轴向均匀设置在爪形段上。
与现有技术相比,本发明具有以下有益效果:
本发明提供了一种应用于骨质疏松的爪形椎弓根螺钉,本发明设计爪型椎弓根喷涂螺钉,这种螺钉置入椎体后,通过其位于椎体骨质内部分螺钉的爪型结构,通过内螺塞增加螺钉与周围骨质的把持力,从而增强螺钉的抗拔出力。
附图说明
在此描述的附图仅用于解释目的,而不意图以任何方式来限制本发明公开的范围。另外,图中的各部件的形状和比例尺寸等仅为示意性的,用于帮助对本发明的理解,并不是具体限定本发明各部件的形状和比例尺寸。在附图中:
图1为应用于骨质疏松的爪形椎弓根螺钉的示意图;
图2为应用于骨质疏松的爪形椎弓根螺钉的剖视图;
图3为应用于骨质疏松的爪形椎弓根螺钉的外螺钉剖视图;
图4为应用于骨质疏松的爪形椎弓根螺钉的爆炸图;
图5为应用于骨质疏松的爪形椎弓根螺钉的使用状态示意图。
具体实施方式
为了使本技术领域的人员更好地理解本发明中的技术方案,下面将结合本发明实施例中的附图,对本发明实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例仅仅是本发明一部分实施例,而不是全部的实施例。基于本发明中的实施例,本领域普通技术人员在没有做出创造性劳动的前提下所获得的所有其他实施例,都应当属于本发明保护的范围。
需要说明的是,当元件被称为“设置于”另一个元件,它可以直接在另一个元件上或者也可以存在居中的元件。当一个元件被认为是“连接”另一个元件,它可以是直接连接到另一个元件或者可能同时存在居中元件。本文所使用的术语“垂直的”、“水平的”、“左”、“右”以及类似的表述只是为了说明的目的,并不表示是唯一的实施例。
除非另有定义,本文所使用的所有的技术和科学术语与属于本发明的技术领域的技术人员通常理解的含义相同。本文中在本发明的说明书中所使用的术语只是为了描述具体的实施例的目的,不是旨在于限制本发明。本文所使用的术语“和/或”包括一个或多个相关的所列项目的任意的和所有的组合。
本发明提供一种应用于骨质疏松的爪形椎弓根螺钉,包括内螺塞100和外螺钉200;
所述外螺钉200包括外螺母210和外螺杆220,外螺母210和外螺杆220内部设置后贯穿的通孔,所述外螺杆220外部依次设置有螺纹段221、爪形段222和锥形段223,所述螺纹段221内部设置有第一内螺纹224,爪形段222上设置有多个连通所述通孔的条形槽226,爪形段222内部为光滑段;所述锥形段223内部设置有第二内螺纹227;所述爪形段222为可形变金属制成;所述螺纹段221上设置有第一外螺纹225,第一内螺纹224与第二内螺纹227螺纹方向相反;第一外螺纹225与第二内螺纹227螺纹方向相同;
所述内螺塞100包括内螺母110和内螺杆120,所述内螺杆120插入所述通孔,所述内螺杆120上设置有第二外螺纹121,且所述内螺杆120的第二外螺纹121与所述有第一内螺纹224连接,反向旋转作用下,所述第二外螺纹121与第二内螺纹227连接,挤压所述爪形段222膨胀。
原理为:反丝螺丝在螺钉往进拧的时候会向上运动,从而挤压使爪形段222膨胀。
作为优选地实施例,所述外螺杆220为锥形结构,第一外螺纹225由螺纹段221向外螺母210方向的螺距逐渐减小、螺纹直径逐渐减大。
优选地,所述第一外螺纹225尾部具有羟基磷灰石喷涂层228。
优选地,所述内螺杆120的长度等于外螺杆220除去第二内螺纹227之后的长度。这样的设计使得内螺塞100旋入外螺钉200之后,正好卡在第二内螺纹227顶部,再施加反向转转力时,内螺塞100与第二内螺纹227开始螺纹连接,使得爪形段222膨胀形成多个爪形结构。
进一步,所述内螺杆120伸出外螺杆220外部,内螺杆120下端部可以与体内骨质疏松部位固定。
还包括锁紧螺母400和操作杆300;
所述外螺母210上设置有锁紧槽211,外螺母210内部设置有锁紧螺纹212;
所述操作杆300设置在所述锁紧槽211,并通过锁紧螺母400与锁紧螺纹212螺纹连接锁死操作杆300。
所述锁紧螺母400上设置有第一扳手操作槽。用于使用工具将其旋入所述外螺母210内部与锁紧螺纹212进行螺纹连接。第一扳手操作槽优选内六方。
所述内螺母110上设置有第二扳手操作槽。用于使用工具将其旋入外螺钉200内部与对应的螺纹进行螺纹连接。第二扳手操作槽优选内六方。
作为优选实施例,外螺钉200的爪形段222的材料选择可变性的纯钛,螺纹段221材料选择钛合金。两端的材料不同,硬度不同,进而在后续作用力下爪形段222沿条形槽226分成多个部分进行膨胀,形成多个爪形结构。
作为优选实施例,所述条形槽226沿爪形段222的轴向均匀设置在爪形段222上。优选条形槽226设置三个,膨胀后形成类似四叶草的形状。
本发明应用于骨质疏松的爪形椎弓根螺钉(clawScrew螺钉)的结构及植入方式具体说明:
clawScrew螺钉由三部分组成,
第一部分是由外螺钉200具有内螺塞100结构,该内螺塞100负责撑开螺钉外部的爪形机械结构,增加螺钉在椎体内的把持力;
第二部分是在该外螺钉200尾部有2cm进行表面羟基磷灰石喷涂处理,这样增加骨长入减少螺钉的松动、移位及拔出;
第三部分是该外螺钉200设计为锥形结构,内轴部直径逐渐呈增粗状态,前端设计为内径设计为3mm,螺距5mm,每增加一圈,螺距减少0.1mm,内轴直径增加0.05mm。这样设计该螺钉内芯部呈现增粗趋势,减少螺钉植入后因金属疲劳导致的断裂。
植入方式:
采用常规技术制备椎弓根钉道,螺钉植入的后,由手术者使用专用的内螺塞扳手拧入螺塞,将内螺塞旋入至爪形段时,随着螺塞旋入后爪形段不断张开,螺钉外层之间的空隙逐渐被中心螺塞填充,在此过程中需要注意在透视下监视螺钉在椎体内的膨胀情况。
需要说明的是,在本发明的描述中,术语“第一”、“第二”等仅用于描述目的和区别类似的对象,两者之间并不存在先后顺序,也不能理解为指示或暗示相对重要性。此外,在本发明的描述中,除非另有说明,“多个”的含义是两个或两个以上。
应该理解,以上描述是为了进行图示说明而不是为了进行限制。通过阅读上述描述,在所提供的示例之外的许多实施例和许多应用对本领域技术人员来说都将是显而易见的。因此,本教导的范围不应该参照上述描述来确定,而是应该参照前述权利要求以及这些权利要求所拥有的等价物的全部范围来确定。出于全面之目的,所有文章和参考包括专利申请和公告的公开都通过参考结合在本文中。在前述权利要求中省略这里公开的主题的任何方面并不是为了放弃该主体内容,也不应该认为申请人没有将该主题考虑为所公开的发明主题的一部分。
Claims (10)
1.一种应用于骨质疏松的爪形椎弓根螺钉,其特征在于,包括内螺塞(100)和外螺钉(200);
所述外螺钉(200)包括外螺母(210)和外螺杆(220),外螺母(210)和外螺杆(220)内部设置后贯穿的通孔,所述外螺杆(220)外部依次设置有螺纹段(221)、爪形段(222)和锥形段(223),所述螺纹段(221)内部设置有第一内螺纹(224),爪形段(222)上设置有多个连通所述通孔的条形槽(226),爪形段(222)内部为光滑段;所述锥形段(223)内部设置有第二内螺纹(227);所述爪形段(222)为可形变金属制成;所述螺纹段(221)上设置有第一外螺纹(225),第一内螺纹(224)与第二内螺纹(227)螺纹方向相反;第一外螺纹(225)与第二内螺纹(227)螺纹方向相同;
所述内螺塞(100)包括内螺母(110)和内螺杆(120),所述内螺杆(120)插入所述通孔,所述内螺杆(120)上设置有第二外螺纹(121),且所述内螺杆(120)的第二外螺纹(121)与所述有第一内螺纹(224)连接,反向旋转作用下,所述第二外螺纹(121)与第二内螺纹(227)连接,挤压所述爪形段(222)膨胀。
2.根据权利要求1所述的应用于骨质疏松的爪形椎弓根螺钉,其特征在于,所述外螺杆(220)为锥形结构,第一外螺纹(225)由螺纹段(221)向外螺母(210)方向的螺距逐渐减小、螺纹直径逐渐减大。
3.根据权利要求1所述的应用于骨质疏松的爪形椎弓根螺钉,其特征在于,所述第一外螺纹(225)尾部具有羟基磷灰石喷涂层(228)。
4.根据权利要求(1)所述的应用于骨质疏松的爪形椎弓根螺钉,其特征在于,
所述内螺母(110)上设置有第二扳手操作槽。
5.根据权利要求1所述的应用于骨质疏松的爪形椎弓根螺钉,其特征在于,
所述内螺杆(120)的长度等于外螺杆(220)除去第二内螺纹(227)之后的长度。
6.根据权利要求1至5任一项所述的应用于骨质疏松的爪形椎弓根螺钉,其特征在于,
还包括操作工具,操作工具包括锁紧螺母(400)和操作杆(300);
所述外螺母(210)上设置有锁紧槽(211),外螺母(210)内部设置有锁紧螺纹(212);
使用时,所述操作杆(300)设置在所述锁紧槽(211)内,并通过锁紧螺母(400)与锁紧螺纹(212)螺纹连接锁死操作杆(300)。
7.根据权利要求6所述的应用于骨质疏松的爪形椎弓根螺钉,其特征在于,
所述锁紧螺母(400)上设置有第一扳手操作槽。
8.根据权利要求6所述的应用于骨质疏松的爪形椎弓根螺钉,其特征在于,
所述操作杆(300)与外螺钉(200)轴向垂直。
9.根据权利要求1所述的应用于骨质疏松的爪形椎弓根螺钉,其特征在于,
所述爪形段(222)的材料为纯钛,螺纹段(221)材料为钛合金。
10.根据权利要求1所述的应用于骨质疏松的爪形椎弓根螺钉,其特征在于,
所述条形槽(226)沿爪形段(222)的轴向均匀设置在爪形段(222)上。
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