CN115337090A - 顶部加载式快锁构建物 - Google Patents

顶部加载式快锁构建物 Download PDF

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CN115337090A
CN115337090A CN202210510456.7A CN202210510456A CN115337090A CN 115337090 A CN115337090 A CN 115337090A CN 202210510456 A CN202210510456 A CN 202210510456A CN 115337090 A CN115337090 A CN 115337090A
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implant
receiver
rod
size
shape
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C·伊塔利艾
W·雷扎切
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Warsaw Orthopedic Inc
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Warsaw Orthopedic Inc
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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
    • A61B17/70—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
    • A—HUMAN NECESSITIES
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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
    • A61B17/70—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
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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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
    • A61B17/70—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
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A61B17/7008—Longitudinal elements, e.g. rods with a cross-section which varies along its length with parts of, or attached to, the longitudinal elements, bearing against an outside of the screw or hook heads, e.g. nuts on threaded rods
    • 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
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    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7014—Longitudinal elements, e.g. rods with means for adjusting the distance between two screws or hooks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7038—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other to a different extent in different directions, e.g. within one plane only
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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
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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
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
    • A61B17/8685—Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
    • 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
    • A61B2017/564—Methods for bone or joint treatment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter

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  • Health & Medical Sciences (AREA)
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Abstract

一种顶部加载式快锁构建物。所公开的脊柱植入物可以包括在水平方向上延伸的杆件和具有在水平方向上延伸的第一通道和在竖直方向上延伸的第一螺纹通道的第一植入物接收器，仅举例而言。此外，所述植入物可以包括第二植入物接收器，所述第二植入物接收器具有在水平方向上延伸的第二通道和在竖直方向上延伸的第二螺纹通道，仅举例而言。所述植入物可以包括具有与所述第一螺纹通道的尺寸和形状相对应的尺寸和形状的第一定位螺钉和具有与所述第二螺纹通道的尺寸和形状相对应的尺寸和形状的第二定位螺钉，仅举例而言。在一些实施例中，所述杆件可以在水平方向上延伸穿过所述第一和第二通道，并且可以被所述第一和第二通道限制在竖直方向上的移动，仅举例而言。

Description

顶部加载式快锁构建物
相关申请的交叉引用
此申请通过引用方式并入2017年1月25日提交的名称为“脊柱植入系统和使用方法(Spinal Implant System and Methods of Use)”的第10,335,201号美国专利；2017年9月12日提交的名称为“脊柱植入系统和使用方法(Spinal Implant System and Methodsof Use)”的第10,653,455号美国专利；2002年7月1日提交的名称为“杆件复位器械和方法(Rod Reducer Instruments and Methods)”的第6,790,209号美国专利；2021年2月4日提交的名称为“用于锁定骨科螺钉的器械(Instrument for locking Orthopedic Screws)”的第17/167,258号美国申请；以及2021年2月3日提交的名称为“组合定位螺钉折断和突片折断器械(Combination Set Screw Breakoff and Tab Breaker Instrument)”的第17/104,897号美国申请。每个申请的全部内容通过引用方式并入本文。
技术领域
本发明总体涉及用于治疗肌肉骨骼病症的医疗装置，并且更具体地涉及用于治疗脊柱的脊柱植入系统和方法。
背景技术
脊柱病理学和病症，诸如，脊柱侧凸、脊柱后凸以及其它曲度异常、退行性椎间盘疾病、椎间盘突出、骨质疏松症、腰椎滑脱、狭窄、肿瘤和骨折，可能由包括创伤、疾病和由损伤和老化引起的退行性病况的因素引起。脊柱病症通常导致包括畸形、疼痛、神经损伤以及部分或完全丧失活动能力的症状。
非外科手术治疗，诸如，药物治疗、康复和锻炼，可能是有效的，然而，可能不能缓解与这些病症相关的症状。这些脊柱病症的外科手术治疗包括矫正、融合、固定、椎间盘切除术、椎板切除术以及可植入式假体。作为这些外科手术治疗的一部分，脊柱构建物，诸如，椎骨杆，常常用于为治疗区域提供稳定性。在发生愈合时，杆件将应力从受损或有缺陷的区域转移，以恢复正确的准直度且总体上支撑椎骨构件。在外科手术治疗期间，可以将一个或多个杆件、脊柱构建物以及接骨紧固件递送到外科手术部位。杆件可以通过一个脊柱构建物和/或多个脊柱构建物独立地附接到两个或更多个椎骨构件的外部。本发明描述优于这些现有技术的改进。
发明内容
本发明的技术总体涉及顶部加载式脊柱构建物。在各种实施例中，顶部加载式脊柱构建物可以包括两个植入物接收器，它们可以分别支撑杆件并连接到一对接骨螺钉。一些实施例可以可选地预先组装，以便于快速安装和/或易于安装。
在一方面，本发明提供了一种植入物。所述植入物可以包括在横向方向上延伸的杆件和具有第一通道的第一植入物接收器，所述第一通道在横向方向上延伸穿过所述第一植入物接收器的第一侧壁和第二侧壁，仅举例而言。在各种实施例中，所述第一植入物接收器可以具有在纵向方向上延伸的第一螺纹通道，仅举例而言。此外，所述植入物可以包括第二植入物接收器，所述第二植入物接收器具有在横向方向上延伸穿过所述第二植入物接收器的第三侧壁和第四侧壁的第二通道，仅举例而言。此外，所述第二植入物接收器可以具有在纵向方向上延伸的第二螺纹通道，仅举例而言。在各种实施例中，所述植入物可以包括第一定位螺钉(set screw)，所述第一定位螺钉具有沿所述第一定位螺钉的外圆周表面延伸的第一外螺纹样式并且具有与所述第一螺纹通道的尺寸和形状相对应的尺寸和形状，仅举例而言。在各种实施例中，所述植入物可以包括第二定位螺钉，所述第二定位螺钉具有沿所述第二定位螺钉的外圆周表面延伸的第二外螺纹样式并且具有与所述第二螺纹通道的尺寸和形状相对应的尺寸和形状，仅举例而言。在一些实施例中，所述杆件可以在横向方向上延伸穿过所述第一和第二通道，并且可以被所述第一和第二通道限制在纵向方向上的移动，仅举例而言。
在另一方面，本发明提供了一种安装脊柱植入物的方法。所述方法可以包括提供预先组装的植入物的步骤，所述植入物包括在横向方向上延伸的杆件和第一植入物接收器，所述第一植入物接收器具有在横向方向上延伸穿过所述第一植入物接收器的第一侧壁和第二侧壁的第一通道，仅举例而言。在各种实施例中，所述第一植入物接收器可以具有在纵向方向上延伸的第一螺纹通道和用于联接到第一接骨螺钉的第一基部，仅举例而言。在各种实施例中，第二植入物接收器可以具有在横向方向上延伸穿过所述第二植入物接收器的第三侧壁和第四侧壁的第二通道，仅举例而言。在各种实施例中，所述第二植入物接收器可以具有在纵向方向上延伸的第二螺纹通道和用于联接到第二接骨螺钉的第二基部，仅举例而言。在各种实施例中，可以提供第一定位螺钉，所述第一定位螺钉具有沿所述第一定位螺钉的外圆周表面延伸的第一外螺纹样式并且具有与所述第一螺纹通道的尺寸和形状相对应的尺寸和形状。另外，在各种实施例中，可以提供第二定位螺钉，所述第二定位螺钉具有沿所述第二定位螺钉的外圆周表面延伸的第二外螺纹样式并且具有与所述第二螺纹通道的尺寸和形状相对应的尺寸和形状。在一些实施例中，所述杆件可以在横向方向上延伸穿过所述第一和第二通道，并且可以被所述第一和第二通道限制在纵向方向上的移动，仅举例而言。所述方法还可以包括将第一和第二接骨螺钉固定到患者身上和将预先组装的脊柱植入物固定到所述第一和第二接骨螺钉的步骤，仅举例而言。
在以下的附图和具体实施方式中阐述本发明的一个或多个方面的细节。本发明中所述的技术的其它特征、目的以及优点将根据具体实施方式和附图以及权利要求书而变得显而易见。
附图说明
图1是脊柱植入系统的立体图。
图2是脊柱植入系统的侧视图。
图3A是与所公开的脊柱植入系统一起使用的接收器的侧视图。
图3B是与所公开的脊柱植入系统一起使用的接收器的俯视图。
图4是脊柱植入系统的侧视分解零件图。
图5是脊柱植入系统的立体分解零件图。
图6是接收器和用于连接到接骨螺钉的各种部件的立体分解零件图。
图7是脊柱植入系统的侧视截面图。
图8是与所公开的脊柱植入系统一起使用的杆件的立体图。
图9是脊柱植入系统的预先组装的部分在牢固地联接到一对接骨螺钉之前的侧视图。
图10是脊柱植入系统的预先组装的部分在牢固地联接到一对接骨螺钉之后的侧视图。
图11是所公开的脊柱植入物实施例的示例性使用方法的流程图。
具体实施方式
本发明的实施例总体涉及，例如，脊柱稳定系统，并且更具体地涉及顶部加载式脊柱构建物。在一些实施例中，顶部加载式脊柱构建物可以包括两个植入物接收器，它们可以分别支撑杆件并连接到一对接骨螺钉。在一些实施例中，所述两个植入物接收器和杆件可以可选地预先组装，以便于快速安装和/或易于安装到所述一对接骨螺钉。下面参考附图来描述装置和方法的实施例。
以下讨论省略或仅简要描述与医疗植入物、安装工具及相关外科手术技术相关的某些部件、特征以及功能，这些对于本领域普通技术人员来说是显而易见的。应注意的是，参考附图详细描述了各个实施例，其中在可能的情况下，相似的附图标记在若干视图中表示相似的零件和组合件。对各个实施例的参考并不限制所附权利要求书的范围，因为这些实施例是本文描述的发明构思的示例。此外，在本说明书中阐述的任何示例旨在是非限制性的，并且仅阐述适用于所附权利要求书的许多可能实施例中的一些实施例。而且，除非上下文或其他陈述另有明确说明，否则本文描述的特定特征可以在各种可能的组合和排列中的每一种组合和排列中与其它描述的特征结合使用。
如本文所用，“相同”、“相等”、“平面”、“共面”、“平行”、“垂直”等术语旨在涵盖完全相同的含义，同时还包括可能发生的变化，例如，由于制造工艺而产生的变化。术语“基本上”可以在本文中用于强调这种含义，特别是当所描述的实施例具有相同或几乎相同的功能或特性时，上下文或其他陈述另有明确说明时除外。
总体上参考图1至图10，公开了各种脊柱植入系统100。脊柱植入系统100的部件可由适合于医疗应用的生物上可接受的材料制成，包括金属、合成聚合物、陶瓷和骨材料，和/或其复合物。举例而言，脊柱植入系统100的部件可以单独地或共同地由以下材料制成：诸如，不锈钢合金、商业纯钛、钛合金、5级钛、超弹性钛合金、钴-铬合金、超弹性金属合金(例如，镍钛诺(Nitinol)、超弹塑性金属，诸如，GUM
Figure BDA0003637561800000041
)、陶瓷及其复合物，诸如，磷酸钙(例如，SKELITETM)、热塑性塑料，诸如，聚芳基醚酮(PAEK)(包括聚醚醚酮(PEEK)、聚醚酮酮(PEKK)和聚醚酮(PEK))、碳-PEEK复合物、PEEK-BaSO4聚合橡胶、聚对苯二甲酸乙二醇酯(PET)、织物、硅酮、聚氨基甲酸酯、硅酮-聚氨基甲酸酯共聚物、聚合橡胶、聚烯烃橡胶、水凝胶、半刚性和刚性材料、弹性体、橡胶、热塑性弹性体、热固性弹性体、弹性体复合物、刚性聚合物(包括聚亚苯基、聚酰胺、聚酰亚胺、聚醚酰亚胺、聚乙烯、环氧树脂)、骨材料(包括自体移植物、同种异体移植物、异种移植物或转基因皮质骨和/或皮髓质骨)和组织生长或分化因子、部分可再吸收的材料(诸如，举例而言，金属与钙基陶瓷的复合物、PEEK与钙基陶瓷的复合物、PEEK与可再吸收的聚合物的复合物)、完全可再吸收的材料(诸如，举例而言，钙基陶瓷，诸如，磷酸钙、磷酸三钙(TCP)、羟基磷灰石(HA)-TCP、硫酸钙)，或其它可再吸收的聚合物，诸如，聚酮(polyaetide)、聚乙交酯、聚酪氨酸碳酸酯、聚己内酯(polycaroplaetohe)，及其组合。
脊柱植入系统100的各个部件可以具有包括上述材料在内的材料复合物，以实现各种期望的特性，诸如，强度、刚性、弹性、顺从性、生物力学性能、耐久性以及射线可透性或成像优先性。脊柱植入系统100的部件还可以个别地或共同地由非均质材料(诸如，举例而言，两种或更多种上述材料的组合)制成。脊柱植入系统100的部件可以一体成型地形成，一体地连接或包括紧固元件和/或器械，如本文所述。
图1是脊柱植入系统100的立体图，且图2是脊柱植入系统100的侧视图。脊柱植入系统100可以包括第一植入物接收器20和第二植入物接收器20。在示例性实施例中，第一和第二植入物接收器20是相同类型的植入物接收器。然而，在其他实施例中，第一和第二植入物接收器20可以基本上相同，和或彼此相似。第一和第二植入物接收器20可以各自包括用于接收杆件40的通道22，仅举例而言。此外，第一和第二植入物接收器20可以分别包括第一和第二定位螺钉50。定位螺钉50可以在图2中标记为X方向的竖直方向上上下移动，以将杆件40固定在通道22内，仅举例而言。在各种实施例中，定位螺钉50可以是具有折断部分52的折断式定位螺钉(参见图2)，仅举例而言。在其他实施例中，定位螺钉50可以是没有折断部分的实心定位螺钉，仅举例而言。
在示例性实施例中，每个通道22可以包括延伸穿过植入物接收器20的侧面的孔口。在示例性实施例中，通道22在植入物接收器20的上端23处封闭，使得杆件40在两个维度上被限制在通道22内。在各种实施例中，实心上端23设置在通道22上方。例如，在各种实施例中，通道22可以在竖直方向(在图2中标记为X方向)和横向方向(在图2中标记为Z方向)上限制杆件40，但仍允许其在水平方向(在图2中标记为Y方向)上有一定滑动。例如，通道22的周界在竖直方向和横向方向上被封闭。例如，如图2所示，杆件40在竖直方向和横向方向上被通道22限制，但可以允许其在水平方向上移动。然而，如图8所示，一些实施例可以使用具有封闭端盖46的替代杆件45，封闭端盖46可以限制杆件45在水平方向上移动太远而滑出通道22，仅举例而言。
图3A是植入物接收器20的侧视图，且图3B是与所公开的脊柱植入系统100一起使用的接收器的俯视图。在示例性图示中，植入物接收器20可以包括用于可旋转地支撑和接收定位螺钉50的螺纹通道24，仅举例而言。螺纹通道24可以在竖直方向上延伸并且限定竖直轴线A-A，定位螺钉50在旋转时，可以沿竖直轴线A-A向上和向下移动。此外，植入物接收器20可以包括用于接收杆件40的通道22，仅举例而言。通道22可以在水平方向上延伸并且限定水平轴线B-B，杆件40可以与此水平轴线同轴对齐，仅举例而言。在示例性实施例中，在如图3A所示的侧视立体图中观察时，通道22的形状像椭圆形。在其他实施例中，通道22的形状像圆形或方形，仅举例而言。在各种实施例中，通道22可以具有与杆件40的尺寸和形状大体对应的尺寸和形状，仅举例而言。在各种实施例中，杆件40的侧视横截面可以呈类椭圆形，与通道22的尺寸和形状大体对应，仅举例而言。
图4是脊椎植入系统100的侧视分解零件图，且图5是脊柱植入系统100的立体分解零件图。在示例性图示中，示出了定位螺钉50可以具有外螺纹样式51，此外螺纹样式51具有定时(timing)和/或螺距，包括与螺纹通道24的螺纹25的定时和/或螺距大体对应的尺寸和形状，仅举例而言。此外，定位螺钉50可以包括用于联接到驱动器(图未示)以使定位螺钉50旋转的驱动端53，仅举例而言。驱动端53可以呈任何形状，例如，内六角形、六角形、梅花形等。在操作中，最终使用者可以通过在驱动端53处使定位螺钉50旋转以使定位螺钉50沿着竖直轴线A-A向下推进并且将杆件40固定在通道22的下壁上将杆件40固定在第一和第二植入物接收器20的通道22内并牢固地拧紧定位螺钉50，仅举例而言。
图6是与所公开的脊柱植入系统100一起使用的植入物接收器20的立体分解零件图。在示例性图示中，示出了植入物接收器20可以包括具有下腔的基部21，此下腔被配置为牢固地联接到接骨螺钉10并且将冠部2支撑在接骨螺钉10的头部11上方的位置，仅举例而言。冠部2可以包括具有与杆件40的弯曲表面的下部相对应的尺寸和形状的弯曲支撑表面3，仅举例而言。因此，冠部2可以通过直接接触杆件40的下侧而从杆件40下方支撑杆件40。另外，杆件40可以向下压在通道22的下表面上。脊柱植入系统100还可以包括上环8和下环9。上环8和下环9可以呈C形，并且被配置为将接骨螺钉10的头部11牢固地联接在基部21的下腔内，仅举例而言。植入物接收器20如何通过基部21的内腔牢固地连接到接骨螺钉10的其他示例在名称为“脊柱植入系统和使用方法(Spinal Implant System and Methods ofUse)”的第10,335,201号美国专利、名称为“脊柱植入系统和使用方法(Spinal ImplantSystem and Methods of Use)”的第10,653,455号美国专利，以及名称为“用于锁定骨科螺钉的器械(Instrument for locking Orthopedic Screws)”的第17/167,258号美国申请中的每一篇文献中详细地公开，这些申请的全部内容通过引用并入本文。
图7是脊柱植入系统100的侧视截面图。在示例性图示中，第一和第二植入物接收器20牢固地联接到单轴接骨螺钉10。例如，外科医生可以通过，例如，用于锁定骨科螺钉的器械将每个植入物接收器20向下推靠在接骨螺钉10上而最初将第一和第二植入物接收器20联接到相应的接骨螺钉10。在一些实施例中，外科医生可以同时向下推动每个植入物接收器20，而在其他实施例中，外科医生可以依次向下推动每个植入物接收器20。例如，外科手术器械可以向下推动植入物接收器20，使得上环8和下环9围绕接骨螺钉10的头部11安置并嵌套在基部21的对应腔室8a、9a内并由其固位，仅举例而言。在将上环8和下环9安置在对应的腔室8a、9a中时，植入物接收器20可以固定到接骨螺钉10。尽管本文的讨论和图示是在单轴接骨螺钉的背景下进行的，但可以设想，在一些实施例中，第一和第二接骨螺钉10中的至少一个可以被配置为多轴螺钉、矢状角螺钉、椎弓根螺钉、单轴螺钉、单平面螺钉、固定螺钉、锚钉、组织穿透螺钉、常规螺钉、扩张螺钉。在一些实施例中，接骨螺钉10可以与楔形件、锚固件、按钮、夹子、卡扣、摩擦配件、压缩配件、扩张铆钉、U字钉、钉子、粘合剂、柱、连接器、固定板和/或柱一起使用，在此仅列出几个可能的示例性配置。24
图8是与所公开的脊柱植入系统100一起使用的杆件的立体图。杆件45的至少一个优点可以是端盖46防止杆件45滑出第一和第二接收器20和/或与第一和第二接收器20分离，仅举例而言。此外，通过利用杆件45，脊柱植入系统100或其至少一部分可以在外科手术开始之前预先组装。然而，其他系统可以预先组装并且依赖于杆件40，而不是杆件45，仅举例而言。递送预先组装的脊柱植入系统100的另一个优点是外科医生可以相对快速地将预先组装的脊柱植入系统100固定到患者的一对相邻椎骨上，仅举例而言。
图9和图10是预先组装的脊柱植入物60的侧视图。如图9所示，杆件40固定在第一和第二植入物接收器20的通道22内，仅举例而言。如上所述，在一些实施例中，杆件40可以代替杆件45。由于第一和第二定位螺钉50向下推压杆件40，杆件40可以牢固地在通道22内固位。例如，第一和第二定位螺钉50可以在螺纹通道24内旋转，使得它们在竖直方向上向下移动并且对杆件40提供压缩力，使得杆件40与通道22的侧部和冠部2的弯曲的支撑表面3直接接触，仅举例而言。在示例性实施例中，脊柱构建物100的上部50被预先组装，并且定位螺钉50已用手指拧紧。如图10所示，外科医生等最终使用者可以向下推动第一和第二植入物接收器20，使得每个接骨螺钉10的头部11牢固地联接到对应的植入物接收器20，仅举例而言。
图11是安装预先组装的脊柱植入物60的方法200的示例性流程图。以下对方法200的讨论可以包括参考如上文针对上下文解释的脊柱植入系统100的部件、特征以及功能，然而，下文公开的方法不限于上文公开的特定脊柱植入系统100实施例。在步骤202，可以提供脊柱植入系统，例如，脊柱植入系统100的上部50等。在步骤204，可以将第一接骨螺钉10或紧固件和第二接骨螺钉10或紧固件固定到患者的解剖结构，例如，可以将一对接骨螺钉10固定到患者的相邻椎骨。在步骤206，可将预先组装的脊柱植入物固定到第一和第二接骨螺钉10。例如，如图10所示，通过向下推动第一和第二植入物接收器20，第一和第二植入物接收器20被固定到第一和第二接骨螺钉10。例如，如上所述，可以通过向下推动植入物接收器20并将各种锁定环8、9围绕接骨螺钉10的头部11安置在植入物接收器20的各种接收腔室8a、9a内而将每个植入物接收器20固定到对应的接骨螺钉10。在一些实施例中，第一和第二植入物接收器20可以通过，例如，类似于名称为“杆件复位器械和方法(Rod ReducerInstruments and Methods)”的第6,790,209号美国专利中描述的杆件复位器械的一对复位器械，同时固定到第一和第二接骨螺钉，上述专利的全部内容整体并入本文。在步骤208，可以通过充分拧紧第一和第二定位螺钉50将杆件40(或杆件45)固定在最终位置。例如，第一和第二定位螺钉50可以由驱动器械驱动旋转并沿竖直轴线A-A向下推进，使得它们与杆件40直接接触并通过压缩力使杆件40在适当位置固位。在步骤210，可以折断第一和第二定位螺钉50中的每一个的折断部分，例如，可以通过折断器械，诸如，举例而言，名称为“组合定位螺钉折断和突片折断器械(Combination Set Screw Breakoff and Tab BreakerInstrument)”的第17/104,897号美国申请中公开的器械，将折断部分52折断。
应当理解的是，本文所公开的各个方面可以以不同的组合而非说明书和附图中具体呈现的组合而组合。例如，除非上下文另有明确指示，否则来自一个实施例的特征、功能以及部件可以与另一实施例组合，反之亦然。类似地，除非上下文另有明确指示，否则可以省略特征、功能以及部件。还应理解的是，视示例而定，本文中所描述的过程或方法中的任一个的某些动作或事件可以不同序列执行，可以被添加、合并或完全省略(例如，所有描述的动作或事件对于执行这些技术可能不是必需的)。
除非本文另有明确定义，否则所有术语都将被赋予其最广泛的可能解释，包括说明书中暗示的含义以及本领域技术人员理解的和/或在字典、论文等中定义的含义。还必须应注意的是，如在说明书和所附权利要求中所使用的，除非另有说明，否则单数形式“一/一个(a/an)”和“所述(the)”包括复数指代物，并且术语“包括(comprises和/或comprising)”在本说明书中使用时，指定所述特征、元件和/或部件的存在，但不排除一个或多个其它特征、步骤、操作、元件、部件和/或它们的组的存在或添加。

Claims (15)

1.一种植入物，包括：
杆件，在横向方向上延伸；
第一植入物接收器，具有第一杆件接收通道，所述第一杆件接收通道在横向方向上延伸穿过所述第一植入物接收器的第一侧壁和第二侧壁，所述第一植入物接收器具有在纵向方向上延伸的第一螺纹通道；
第二植入物接收器，具有在横向方向上延伸穿过所述第二植入物接收器的第三侧壁和第四侧壁的第二杆件接收通道，所述第二植入物接收器具有在纵向方向上延伸的第二螺纹通道；
第一定位螺钉，具有沿所述第一定位螺钉的外圆周表面延伸的第一外螺纹样式并且具有与所述第一螺纹通道的尺寸和形状相对应的尺寸和形状；以及
第二定位螺钉，具有沿所述第二定位螺钉的外圆周表面延伸的第二外螺纹样式并且具有与所述第二螺纹通道的尺寸和形状相对应的尺寸和形状，
其中，当组装所述植入物时，所述杆件在横向方向上延伸穿过所述第一和第二杆件接收通道并且被所述第一和第二杆件接收通道限制在纵向方向上的移动。
2.根据权利要求1所述的植入物，其中：
所述第一植入物接收器包括用于联接到第一接骨螺钉的第一基部，且
所述第二植入物接收器包括用于联接到第二接骨螺钉的第二基部。
3.根据权利要求2所述的植入物，包括：
第一冠部，具有弯曲表面，所述弯曲表面的尺寸和形状与所述杆件的下侧相对应，所述第一冠部定位在所述第一基部内并且位于所述第一接骨螺钉上方；和
第二冠部，具有弯曲表面，所述弯曲表面的尺寸和形状与所述杆件的下侧相对应，所述第二冠部定位在所述第二基部内并且位于所述第一接骨螺钉上方。
4.根据权利要求3所述的植入物，其中，所述第一基部和所述第二基部中的至少一个被配置为用于与单轴接骨螺钉配合。
5.根据权利要求4所述的植入物，其中，在俯视图中，所述杆件在横向方向上延伸，使得所述杆件直接定向在所述第一接骨螺钉和所述第二接骨螺钉上方。
6.根据权利要求1所述的植入物，其中：
所述第一植入物接收器的实心第一上表面设置在所述第一杆件接收通道上方，并且
所述第二植入物接收器的实心第二上表面设置在所述第二杆件接收通道上方。
7.根据权利要求1所述的植入物，其中
所述第一杆件接收通道的周界被封闭，并且
所述第二杆件接收通道的周界被封闭。
8.根据权利要求1所述的植入物，其中，所述植入物是预先组装的。
9.根据权利要求1所述的植入物，其中，所述杆件包括第一端盖和第二端盖。
10.根据权利要求9所述的植入物，其中，所述第一端盖的尺寸大于所述第一杆件接收通道的尺寸，并且所述第二端盖的尺寸大于所述第二杆件接收通道的尺寸。
11.根据权利要求1所述的植入物，其中，在截面图中，所述杆件包括椭圆形。
12.根据权利要求11所述的植入物，其中，所述第一杆件接收通道和所述第二杆件接收通道分别包括形状像椭圆形的开口。
13.根据权利要求1所述的植入物，其中，在截面图中，所述杆件包括圆形。
14.根据权利要求13所述的植入物，其中，所述第一杆件接收通道和所述第二杆件接收通道分别包括形状像圆形的开口。
15.根据权利要求1所述的植入物，其中，所述第一和第二定位螺钉是折断式定位螺钉。
CN202210510456.7A 2021-05-12 2022-05-11 顶部加载式快锁构建物 Pending CN115337090A (zh)

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