CN115670618A - 螺杆塔和杆复位工具 - Google Patents

螺杆塔和杆复位工具 Download PDF

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CN115670618A
CN115670618A CN202210866879.2A CN202210866879A CN115670618A CN 115670618 A CN115670618 A CN 115670618A CN 202210866879 A CN202210866879 A CN 202210866879A CN 115670618 A CN115670618 A CN 115670618A
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screw
sleeve
screw tower
threaded
tower
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M·贝克特尔
C·艾伦
N·R·克劳福德
T·卡洛韦
S·张
N·约翰逊
J·福赛斯
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Globus Medical Inc
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Globus Medical Inc
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Abstract

本发明涉及一种螺杆塔和杆复位工具。该系统包括螺杆塔、器械和外壳。该器械包括可纵向延伸穿过该螺杆塔的驱动轴，以及安装在该驱动轴的近侧部分上的螺纹套筒。该外壳包括可联接到该螺杆塔的一个或多个保持构件，以及可螺纹联接到该螺纹套筒的螺纹按钮。该螺纹套筒可围绕纵向轴线旋转，以相对于该螺杆塔纵向推动该驱动轴。

Description

螺杆塔和杆复位工具
技术领域
本申请实施例大体上涉及脊柱固定装置，更特定地来说，涉及一种螺杆塔和杆复位工具。
背景技术
脊柱固定装置可以锚定到脊椎的特定部分。此类脊柱固定装置可包括例如可联接到脊椎的柄部分，以及具有接收元件的头部部分。固定杆可穿过接收元件就位，并通过拧紧头部部分而锁定就位。虽然已知的脊柱固定系统已经证明是有效的，但是一些杆复位器使用起来可能是困难的、累人的和/或耗时的。
发明内容
根据本文描述的本发明概念的一些示例，可以提供一种系统来提供杆复位工具。该系统包括螺杆塔、器械和外壳。该器械包括可纵向延伸穿过螺杆塔的驱动轴，以及安装在驱动轴的近侧部分上的螺纹套筒。外壳包括可联接到螺杆塔的一个或多个保持构件，以及可螺纹联接到螺纹套筒的螺纹按钮。螺纹套筒可围绕纵向轴线旋转，以相对于螺杆塔纵向推动驱动轴。
根据本文描述的本发明概念的其他示例，可以提供一种方法来提供杆复位工具。该方法包括：使驱动轴纵向延伸穿过螺杆塔；将螺纹套筒安装在驱动轴的近侧部分上；使用一个或多个保持构件将外壳联接到螺杆塔；以及使用螺纹按钮将外壳螺纹联接到螺纹套筒，使得螺纹套筒可围绕纵向轴线旋转以相对于螺杆塔纵向推动驱动轴。
提供该概述以便以简化形式介绍将在以下详细描述中进一步描述的本发明概念的选择。在阅读以下详细描述和附图之后，根据本发明主题的示例的其他方法和相关系统、以及对应方法和计算机程序产品对于本领域的技术人员而言将显而易见或将变得显而易见。该概述不旨在识别所要求保护的主题的关键特征或必要特征，也不旨在用于帮助确定所要求保护的主题的范围。
附图说明
为了进一步理解本公开而包括在内的并且构成本申请的一部分的附图示出了本发明概念的某些非限制性示例。在附图中：
图1是示例性螺杆塔的侧视图；
图2是图1所示的螺杆塔的前视图；
图3是图1所示的螺杆塔的剖视图；
图4是图1所示的螺杆塔的分解透视图；
图5是另一个示例性螺杆塔的剖视图；
图6是图5所示的螺杆塔的分解透视图；
图7是可与螺杆塔(诸如图1或图5所示的螺杆塔)一起使用的示例性器械的侧视图；
图8是图7所示的器械的分解透视图；
图9是可与螺杆塔(诸如图1或图5所示的螺杆塔)一起使用的另一个示例性器械的剖视图；
图10是图9所示的器械的远侧端部视图；
图11是示例性螺杆塔(诸如图1或图5所示的螺杆塔)的近侧端部视图；
图12是可与螺杆塔(诸如图1或图5所示的螺杆塔)和/或器械(诸如图7或图9所示的器械)一起使用的示例性外壳的部分透明侧视图；
图13是图12所示的外壳的部分透明的前视图；
图14是图12所示的外壳的部分透明的分解透视图；
图15是可用于跟踪一个或多个对象(诸如图1或图5所示的螺杆塔，图7或图9所示的器械和/或图12所示的外壳)的示例跟踪系统的框图；
图16是可被跟踪的示例性对象的透视图，包括示例性跟踪标记；
图17是图16所示的处于部分重叠布置的对象的透视图；
图18是图16所示的处于示例性使用布置的对象的透视图；
图19是可被跟踪的另一个示例性对象的透视图，包括示例性跟踪标记；
图20是可用于跟踪一个或多个对象(诸如图1或图5所示的螺杆塔，图7或图9所示的器械和/或图12所示的外壳)的示例计算系统的框图；
图21是第一阶段中的示例性跟踪阵列和配备有导航阵列的杆的示意图，在该第一阶段中跟踪阵列联接到第一螺杆塔并且配备有导航阵列的杆延伸穿过第一螺杆塔；
图22是图21所示的第二阶段中的跟踪阵列和配备有导航阵列的杆的示意图，在该第二阶段中跟踪阵列联接到第二螺杆塔并且配备有导航阵列的杆延伸穿过第一螺杆塔和第二螺杆塔；
图23是用于定位一个或多个对象(诸如图21和图22所示的配备有导航阵列的杆)的示例性视觉辅助的示意图；
图24是根据本发明主题的一个示例的提供杆复位工具的示例性方法的流程图；
图25是包括椎弓根螺钉、螺杆塔(诸如图1或图5所示的螺杆塔)、器械(诸如图7或图9所示的器械)以及外壳(诸如图12所示的外壳)的组件的前视图；
图26是图25所示的组件的侧视图；并且
图27是图25所示的组件的透视图。
附图未必按比例绘制，描绘了所选择的示例并且不旨在限制本公开的范围。尽管本公开的各种示例的具体特征可以在一些附图中示出而不在其他附图中示出，但这仅是为了方便。参考附图阅读以下详细描述，在不同的附图中类似的元件具有类似的附图标记。
具体实施方式
本公开涉及医疗装置，并且更具体地涉及螺杆塔和杆复位工具。本文所述的示例包括螺杆塔、器械和外壳。该器械包括可纵向延伸穿过螺杆塔的驱动轴，以及安装在驱动轴的近侧部分上的螺纹套筒。外壳包括可联接到螺杆塔的一个或多个保持构件，以及可螺纹联接到螺纹套筒的螺纹按钮。螺纹套筒可围绕纵向轴线旋转，以相对于螺杆塔纵向推动驱动轴。本文描述的示例使得能够以有效的、用户友好的和/或高效的方式附连螺杆塔，复位固定杆，和/或插入锁定帽。虽然本文描述的示例是相对于椎弓根螺钉来描述的，但是本领域的普通技术人员将理解和认识到，示例性系统和方法可以与其他类型的紧固机构一起使用。
现在转向附图，图1至图4示出了可用于保持或接合螺钉(例如，椎弓根螺钉)以经由微创切口植入螺钉的示例性螺杆塔100。螺杆塔100可包括例如细长管，该细长管限定用于在远侧端部104处接收螺杆的远侧开口102，用于在近侧端部108处接收一个或多个器械、杆、植入物等的近侧开口106，以及在它们之间纵向(例如，沿着Y轴)延伸的通道110。
在一些示例中，螺杆塔100包括尺寸、形状和/或构型被设计成接合螺钉的一部分的外套筒120。例如，外套筒120可包括第一壁122以及与第一壁122相对的第二壁124，使得螺钉的头部特征(例如，郁金香形件的唇缘)可横向地定位在其间。在一些示例中，第一壁122和/或第二壁124可以是悬臂式的，使得外套筒120可以使用悬臂卡扣配合接合联接到螺钉。例如，当沿近侧方向(例如，沿负Y方向)朝向外套筒120的远侧端部104推动螺钉的头部特征时，第一壁122和/或第二壁124可偏转或展开以允许头部特征在其间沿近侧方向移动，并且当头部特征离开第一壁122和/或第二壁124的部分126(例如，脊或唇缘)时返回或卡扣回到中性构型，使得第一壁122和/或第二壁124的部分126被设置在由螺钉的头部特征限定的底切和/或开口中。另选地，外套筒120可以使用提供快速、稳健和可靠连接的任何布置或机构接合或联接到螺钉。例如，在一些示例中，外套筒120可选择性地旋转以通过将第一壁122和/或第二壁124的部分126定位在由螺钉的头部特征限定的底切或开口中来将螺杆塔100联接到螺钉，并且/或者通过将第一壁122和/或第二壁124的部分126与由螺钉的头部特征限定的底切或开口间隔开而将螺杆塔100与螺杆解除联接。
如图3和图4所示，螺杆塔100可包括与外套筒120同轴的内套筒130。在一些示例中，内套筒130的尺寸、形状和/或构型可被设计成在其远侧端部104处接合联接到外套管120的螺钉的一部分，以相对于螺杆塔100“锁定”或刚性地固定螺钉就位。例如，当内套筒130沿远侧方向(例如，沿正Y方向)移动或推动，而外套筒120联接到螺钉时，头部特征可纵向地夹紧在内套筒130的配合部分132(例如，凸片或突起)与第一壁122和/或第二壁124的部分126之间。在一些示例中，内套筒130的配合部分132可以包括一个或多个配合特征，这些配合特征的尺寸、形状和/或构型被设计成接收在螺钉头部处的一个或多个凹入特征和/或开口中。附加地或另选地，内套筒130的配合部分132可包括一个或多个配合特征，这些配合特征的尺寸、形状和/或构型被设计成在螺钉的头部处接收一个或多个凸片和/或突起。
在一些示例中，内螺母134可用于相对于外套筒120纵向地移动或推动内套筒130。如图3和图4所示，螺母134可螺纹联接到外套筒120，使得螺母134可围绕纵向轴线沿第一方向(例如，顺时针方向)旋转以沿远侧方向移动和/或沿与第一方向相反的第二方向(例如，逆时针方向)移动以沿近侧方向(例如，沿负Y方向)移动。在一些示例中，保持夹或环136可用于将内套筒130联接到螺母134，使得防止或限制内套筒130和螺母134相对于彼此纵向移动，同时相对于彼此自由旋转。以这种方式，螺母134可选择性地旋转以相对于外套筒120纵向平移内套筒130。例如，可以保持外套筒120和内套筒130的相对取向，以确保螺杆塔100包括限定在其中的一个或多个纵向通道138。例如，如图2、图3和图4所示，可在外套筒120的第一壁122和第二壁124之间周向地限定通道138(例如，沿着外套筒120的圆周)。限定在外套筒120中的通道138可以与限定在内套筒130中的通道138对准，以允许一个或多个杆横向延伸穿过螺杆塔100。在一些示例中，通道138可以在外套筒120和/或内套筒130的远侧端部104处开放，使得一个或多个横向延伸的杆可以被接收在螺杆塔100的远侧端部104处并且朝近侧(例如，沿负Y方向)平移穿过通道138。
螺杆塔100可包括一个或多个控制特征140，用于控制外套筒120和内套筒130之间的相对移动。在一些示例中，控制特征140可以限制外套筒120与内套筒130之间的可允许移动的量或程度。例如，控制特征140可包括限定在外套筒120中的一个或多个开口142，限定在内套筒130中的一个或多个纵向狭槽144，以及可延伸穿过开口142和/或纵向狭槽144的一个或多个销146。开口142的尺寸、形状和/或构型可被设计成使得当销146延伸穿过其中时，外套筒120被限制或防止相对于销146旋转地(例如，围绕Y轴)或纵向地(例如，沿着Y轴)移动。纵向狭槽144的尺寸、形状和/或构型可被设计成使得当销146延伸穿过其中时，内套筒130被限制或防止相对于销146旋转地(例如，围绕Y轴)移动，同时相对于销146纵向地(例如，沿着Y轴)自由地移动纵向狭槽144的长度。对于另一个示例，控制特征140可包括限定在外套筒120中的一个或多个纵向狭槽148以及内套筒130的一个或多个凸片和/或突起150，该凸片和/或突起被构造成径向向外延伸穿过纵向狭槽148。纵向狭槽148的尺寸、形状和/或构型可被设计成使得当突起150延伸穿过其中时，外套筒120被限制或防止相对于突起150旋转地(例如，围绕Y轴)移动，同时相对于突起150纵向地(例如，沿着Y轴)自由地移动纵向狭槽148的长度。
在一些示例中，控制特征140可以选择性地脱离以允许外套筒120和内套筒130之间的相对移动。例如，销146可以从限定在外套筒120中的开口142和限定在内套筒130中的纵向狭槽144中取出或移除，使得限定开口142和/或纵向狭槽144的壁在外套筒120和/或内套筒130移动时不接合销146。对于另一个示例，外套筒120的第一壁122和/或第二壁124可偏转或展开，使得内套筒130的远侧部分处的突起150从外套筒120的远侧部分处的纵向狭槽148中取出或移除，并且因此在外套筒120和/或内套筒130移动时不接合第一壁122和/或第二壁124。对于又一个示例，内套筒130的近侧部分处的突起150被径向向内移动或推动，使得突起150从外套筒120的近侧部分处的纵向狭槽148中取出或移除，并且因此在外套筒120和/或内套筒130移动时不接合第一壁122和/或第二壁124。在一些示例中，可以使用单独的工具来选择性地脱离一个或多个控制特征140，以允许螺杆塔100至少部分地拆卸(例如，用于消毒和/或清洁)。
图5和图6示出了另一个示例性螺杆塔160，其可用于保持或接合螺钉以经由微创切口植入螺钉。如从图3和图4与图5和图6的比较可以理解，图5和图6所示的螺杆塔160基本上类似于图3和图4所示的螺杆塔100，不同之处在于螺杆塔160包括具有可压缩凸缘166的内螺母164(例如，内螺母134)。可压缩凸缘166被构造成接合内套筒130的内表面接合，使得防止或限制内套筒130和螺母164相对于彼此纵向移动，同时相对于彼此自由旋转。以这种方式，图5和图6所示的螺母164可选择性地旋转以相对于外套筒120纵向平移内套筒130。如图5和图6所示，螺母164可螺纹联接到外套筒120，使得螺母164可围绕纵向轴线沿第一方向(例如，顺时针方向)旋转以沿远侧方向移动和/或沿与第一方向相反的第二方向(例如，逆时针方向)移动或推动内套筒130以沿近侧方向(例如，沿负Y方向)移动或推动内套筒130。
图7和图8示出可用于复位杆和/或将锁定帽插入螺钉上的器械200。螺钉可以包括或联接到郁金香形件，杆可以定位在该郁金香形件上，并且锁定帽可用于将杆固定在郁金香形件内。器械200可以在近侧端部108和远侧端部104之间纵向延伸并且/或者与螺杆塔100一起使用(在图1至图4中示出)。在一些示例中，器械200包括驱动轴或内轴210，其尺寸、形状和/或构型被设计成推动或驱动沿远侧方向(例如，沿正Y方向)横向延伸穿过螺杆塔100的纵向通道138的杆。例如，可通过使内轴210延伸穿过螺杆塔100的通道110以将内轴210的远侧端部104定位在杆处或杆附近并沿远侧方向移动或推动内轴210来推动或驱动杆。
如图7和图8所示，帽推动器212可安装在内轴210的远处部分上或联接到该远侧部分。帽推动器212的尺寸、形状和/或构型可被设计成接合锁定帽并向锁定帽提供力，使得锁定帽可联接到郁金香形件(例如，用于将杆固定在其中)。在一些示例中，器械200可包括指示杆的位置的指示器或与其一起使用，以确保在将锁定帽联接到郁金香形件之前使杆复位。
在一些示例中，内轴210和帽推动器212可被构造成分别同时接合杆和锁定帽。例如，内轴210可延伸穿过锁定帽中的开口以直接接触杆，并且内轴210的远侧端部104可与帽推动器212的远侧端部104纵向间隔开或偏离，使得内轴210和帽推动器212被构造成分别接触杆和锁定帽。在一些示例中，器械200可以包括一个或多个偏置构件214(例如，弹簧)，该偏置构件吸收或减轻在杆复位期间(例如，由帽推动器)施加到锁定帽上的力。偏置构件214可容纳在例如联接到内轴210的隐藏帽216中。隐藏帽216可包括开口，该开口的尺寸、形状和/或构型被设计成允许内轴210和帽推动器212纵向延伸穿过其中。在一些示例中，保持环218可定位在内轴210的远侧部分处以便于将锁定帽保持到器械200。保持环218可以例如经由摩擦配合联接到内轴210的远侧部分。
如图7和图8所示，器械200可包括安装在内轴210的近侧部分上或联接到其的螺纹套筒220。内轴210独立于螺纹套筒220自由旋转和/或平移。螺纹套筒220的尺寸、形状和/或构型可被设计成接合内轴210的肩部222，以用于沿远侧方向(例如，沿正Y方向)移动或推动内轴210。在一些示例中，垫圈224可以纵向地定位在内轴210与螺纹套筒220之间，以便于减小摩擦和/或分布施加在其间的力。
驱动螺母230可联接到螺纹套筒220的远侧端部104，用于旋转螺纹套筒220。驱动螺母230可推动螺纹套筒220以围绕纵向轴线旋转。联接机构232可用于将驱动螺母230联接到螺纹套筒。联接机构232可以是但不限于组装螺钉。
图9和图10示出可用于复位杆和/或将锁定帽插入螺钉上的另一个示例性器械240。如从图7和图8与图9和图10的比较可以理解，图9和图10所示的器械240基本上类似于图7和图8所示的器械200，不同之处在于，如图10所示，器械240的内轴250在其径向外表面处包括一个或多个键控特征252。键控特征252可被构造成接合螺杆塔(例如，螺杆塔100或160)的径向内表面。例如，如图11所示，螺杆塔100可包括与器械240的键控特征252互补的一个或多个键控特征254。以这种方式，当内轴250延伸穿过螺杆塔100的通道110时，键控特征252和254可彼此接合。键控特征252和254通过与螺杆塔100配合而提供抗旋转特性。这继而限制或防止驱动螺母230的交叉螺纹(例如，在重的复位负载下)。
图12至图14示出了可用于选择性地移动和/或定位螺杆塔100和/或器械200的选择性螺纹接合外壳300。在一些示例中，外壳300包括尺寸、形状和/或构型被设计成接收螺杆塔100的近侧端部108的开口。外壳300可以包括一个或多个保持构件或塔夹310，这些保持构件或塔夹被构造成选择性地接合或夹紧到螺杆塔100的近侧部分。在一些示例中，每个塔夹310可围绕相应杆312枢转以在接合位置与脱离位置之间移动，在该接合位置，塔夹310的一部分(例如，脊或唇缘)接合螺杆塔100的外表面以便于防止或限制螺杆塔100和外壳300相对于彼此纵向移动，在该脱离位置，塔夹310的部分与螺杆塔100间隔开，使得螺杆塔100和外壳300相对于彼此自由地纵向移动。
外壳300可包括螺纹按钮320，该螺纹按钮被构造成与器械200的螺纹套筒220接合或配合。螺纹按钮320可以包括例如开口322，该开口的尺寸、形状和/或构型被设计成接收穿过其中的螺纹套筒220。在一些示例中，开口322可以至少部分地由螺纹壁324限定。以这种方式，可以通过在外壳300刚性地固定到螺杆塔100(例如，经由塔夹310)并且螺纹联接到器械200(例如，经由螺纹套筒220)的同时选择性地旋转螺纹套筒220来实现杆复位的驱动力。
在一些示例中，螺纹按钮320可以横向地移动跨过外壳300以允许可变复位。例如，沿第一横向方向(例如，径向向外)移动螺纹按钮320可使得螺纹壁324接合螺纹套筒220的外表面，使得螺纹套筒220可通过沿第一方向(例如，顺时针方向)围绕纵向轴线旋转而沿远侧方向移动并且/或者通过沿与第一方向相反的第二方向(例如，逆时针方向)围绕纵向轴线旋转而沿近侧方向移动。另一方面，沿第二横向方向(例如，径向向内)移动螺纹按钮320可使得螺纹壁324与螺纹套筒220间隔开，使得器械200和外壳300相对于彼此自由移动(例如，用于快速调整)。
如图14所示，外壳300可包括一个或多个偏置构件328(例如弹簧)，该偏置构件将塔夹310和/或螺纹按钮320推向接合位置，从而经由螺纹套筒220的旋转来支撑或促进机械螺纹复位。附加地或另选地，按钮销326可定位成防止或限制螺纹按钮320沿第二横向方向(例如，朝向脱离位置)移动。此外，为了便于防止或限制螺纹按钮320在重的复位负载期间沿第二横向方向移动，螺纹按钮320的近侧部分可以包括浅凸缘，该浅凸缘被构造成当施加重的复位负载时接合或卡在外壳300的外表面上。在一些示例中，螺纹壁324可以包括方形螺纹轮廓，该方形螺纹轮廓便于增加轴向力(例如，用于杆复位)和/或减小螺纹壁324与螺纹套筒220的外表面之间的摩擦(例如，当螺纹按钮320沿横向方向移动时)。
外壳300可以在器械200插入外壳300之前夹在螺杆塔100上，或者在器械200已经至少部分地延伸穿过外壳300的情况下夹在螺杆塔100上。在一些示例中，外壳300可以包括或者联接到反扭矩器械、压缩机/牵引器器械和/或其他塔操纵器械。
图15示出了示例性跟踪系统400，其可用于跟踪一个或多个对象，诸如螺杆塔100、器械200和/或外壳300。系统400包括一个或多个位置传感器410，其可以被定位和/或取向成具有到手术区域的直接视线。在一些示例中，位置传感器410可定位在支架上，该支架被构造成以期望位置和/或取向移动、取向和支撑位置传感器410。位置传感器410可以包括被构造成扫描给定测量体积并检测来自多个跟踪标记420的光和/或其他电磁波以便确定跟踪标记420在给定测量体积中的位置的任何合适的相机(例如，红外相机、双焦相机、立体摄影测量相机等)。
在一些示例中，跟踪标记420可以安装或以其他方式固定到在外科手术期间要跟踪的对象(例如，螺杆塔100、器械200、外壳300)。此类对象可以包括但不限于机器人(例如，在端部执行器处)、外科工具和/或直接固定到患者的患者跟踪装置。在一些示例中，可以随时间推移检测来自跟踪标记420的电磁波，以便监视一个或多个标记对象(例如，具有联接到其的跟踪标记420的对象)的位置和/或移动。
跟踪标记420可用作可在三个维度中跟踪的唯一标识符(例如，使用立体摄影测量)。跟踪标记420可以包括由电信号激活以发射光和/或其他电磁波的有源跟踪标记(例如，红外光发光二极管(LED))，和/或反射由位置传感器410或其他合适设备上的照明器发射的光和/或其他电磁波的无源跟踪标记(例如，回射标记)。在一些示例中，跟踪标记420可以包括反射标记、不透射线标记和/或光学标记。跟踪标记420可以具有适当的形状，包括球形、椭球形、圆柱形、立方形、立方体形等。
计算机430可以接收和处理来自位置传感器410的信息，以便使用显示器432和/或扬声器434向用户呈现信息。在一些示例中，计算机430可以包括与输入接口电路442(也称为输入接口)，输出接口电路444(也称为输出接口)和/或存储器电路446(也称为存储器)联接的处理器电路440(也称为处理器)。存储器446可以包括计算机可读程序代码，其在由处理器440执行时使得处理器440执行根据本文公开的实施方案的操作。根据其他示例，处理器440可以包括存储器，使得不需要单独的存储器电路(例如，存储器446)。
处理器440可以通过输入接口442接收输入，并且/或者通过输出接口444提供输出。例如，处理器440可以通过输入接口442从位置传感器410接收与一个或多个跟踪标记420相关联的位置传感器数据，并且/或者通过输入接口442使用显示器432和/或扬声器434向用户呈现位置信息。在一些示例中，标记对象的位置和/或取向可以相对于患者解剖结构的三维图像呈现给用户。
图16至图18示出了标记有示例性第一条纹群集502的示例性第一对象500以及标记有示例性第二条纹群集512的示例性第二对象510。在一些示例中，计算机430可被构造成通过区分条纹间间隔(例如，群集的条纹之间的纵向间隔)来辨别跟踪标记420(例如，第一条纹群集502，第二条纹群集512)。例如，第一条纹群集502具有第一条纹间间隔，并且第二条纹群集512具有大于第一条纹间间隔的第二条纹间间隔。
每个对象可以在多个位置处被标记。例如，第一条纹群集502存在于第一对象500的两个不同位置中，而第二条纹群集512存在于第二对象510的两个不同位置中。在一些示例中，计算机430可被构造成通过区分标记类型和群集间间隔(例如，群集之间的纵向间隔)来辨别对象(例如，第一对象500，第二对象510)。例如，第一对象500具有第一群集间间隔，并且第二对象510具有大于第一群集间间隔的第二群集间间隔。
第一条纹群集502和第二条纹群集512可各自被构造成唯一地标识相应对象(例如，分别为第一对象500和第二对象510)。例如，计算机430可被构造成基于第一条纹群集502识别第一对象500并且/或者基于第二条纹群集512识别第二对象510。
当针对跟踪标记420搜索所跟踪的帧时，计算机430可将所跟踪的帧与条纹群集(例如，第一条纹群集502，第二条纹群集512)的几何模型进行比较，将条纹群集视为唯一标记。因为计算机430正在以跨越预先确定纵向长度的预先确定数目(例如，五个)的序列搜索与包括预先确定直径的圆柱形状和预先确定曲率的条纹的多个参数的匹配，所以即使对象的一部分如图17所示被部分地阻挡，计算机430也可找到匹配并定位其中心。也就是说，不同的条纹间间隔和/或群集间间隔允许计算机430容易地辨别跟踪标记420和/或对象，同时还找到准确的位置。例如，在如图17所示的第二对象510上，与几何模型的比较可以考虑可见条纹的曲率，并确定跟踪标记420的可见部分表示跟踪标记420的右半部分。以这种方式，本文描述的示例性方法可以允许不同的元件彼此区分，尽管非常接近或部分重叠。
在一些示例中，多个可跟踪对象(例如，第一对象500和第二对象510)可用于形成动态参考库(DRB)，该动态参考库附接到患者和/或用作与其他跟踪对象相关的参考。为了使对象成为导航元件，可以以独特的方式对其进行成形或标记。在一个实施方案中，对象可在其轴上涂有对比鲜明的(例如，黑色和白色)条纹，或者在直径上有轻微的变化，使得截面升高或凹陷并且表现为条纹，其中条纹之间的间隔是一致的量。例如，条纹之间的间隔在一个元件中可以是1毫米(mm)，并且在另一个元件中可以是2mm。条纹的区段或组可具有预先确定数量的总条纹，使得计算机430可定位条纹群集的精确纵向位置，从而提供沿着元件的轴并垂直于该轴的精度。如果位置传感器410同时跟踪多个元件，则不同的条纹间隔允许计算机430区分元件。换句话说，条纹的频率可以从其他跟踪标记420中识别跟踪标记420，并且条纹群集可以提供跟踪标记420的坐标。
图19示出了具有不同厚度的条纹522的对象520，在条纹522的群集之间的单个条纹524，以及暗对象520相对于白色或银色条纹522和524(例如，回射带)的对比度。在一些实施方案中，对象520的唯一标识可以是条纹频率和/或条纹厚度的函数。附加地或另选地，群集之间的条纹524可以有助于改善跟踪精度和/或定位稳健性。图19中所示的颜色配置可有助于增加手术环境中的对比度，同时在视觉上将对象520与背景分开。将诸如红色、绿色和/或蓝色之类的局部颜色施加到对象520还可以向外科医生和/或系统提供附加反馈。本描述的示例性方法具有编码更多信息并且与现有的离散和连续线性条形码设计原理兼容的优点。另外，示例性方法允许植入的硬件(例如，螺杆塔100、器械200、外壳300)用作导航阵列，从而允许在放置时作为附加螺钉顺序地转移配准并维持更好的准确度。
图20示出了被构造成执行一个或多个计算操作的示例计算系统600。虽然本文参考作为计算机430(在图15中示出)和/或与计算机430一起使用的计算系统600示出并描述了本公开的一些示例，但是本公开的各方面可与执行指令以实现与计算系统600相关联的操作和功能的任何计算系统(例如，位置传感器410)一起操作。计算系统600仅示出了用于执行一个或多个计算操作的计算环境的一个示例，并且不旨在关于本发明的使用范围或功能提出任何限制。
在一些示例中，计算系统600包括系统存储器610(例如，计算机存储介质)和联接到系统存储器610的处理器620。处理器620可以包括一个或多个处理单元(例如，在多核构型中)。虽然处理器620被示为与系统存储器610分开，但是本公开的示例预期系统存储器610可以在处理器620上，诸如在一些嵌入式系统中。
系统存储器610存储与一个或多个用户、跟踪对象、位置传感器410和/或跟踪标记420相关联的数据和计算机可执行指令，并且处理器620被编程或构造成执行用于使用例如计算机430来实现本发明的各方面的计算机可执行指令。系统存储器610包括允许处理器620存储和/或检索诸如计算机可执行指令和其他数据之类的信息的一个或多个计算机可读介质。
作为示例而非限制，计算机可读介质可包括计算机存储介质和通信介质。计算机存储介质是有形的并且与通信介质互斥。例如，系统存储器610可以包括易失性和/或非易失性存储器形式的计算机存储介质，诸如只读存储器(ROM)或随机存取存储器(RAM)、电可擦除可编程只读存储器(EEPROM)、固态存储器(SSS)、闪速存储器、硬盘、软盘、压缩盘(CD)、数字多功能盘(DVD)、磁带、或可用于存储可由处理器620访问的期望信息的任何其他介质。计算机存储介质以硬件实现并且不包括载波和传播信号。也就是说，用于本公开目的的计算机存储介质本身不是信号。
用户或操作者可以通过联接到处理器620的一个或多个输入设备630将命令和其他输入输入到计算系统600中。输入设备630被构造成接收信息。示例性输入设备630包括但不限于指向设备(例如，鼠标、轨迹球、触摸板、操纵杆)、键盘、游戏手柄、控制器、麦克风、相机、陀螺仪、加速度计、位置检测器以及电子数字化器(例如，在触摸屏上)。诸如文本、图像、视频、音频等的信息可以经由联接到处理器620的一个或多个输出设备640呈现给用户。输出设备640被构造成传送信息。例如，输出设备640包括但不限于监视器、投影仪、打印机、扬声器、振动部件。在一些示例中，输出设备640与输入设备630(例如，电容触摸屏面板、包括振动部件的控制器)集成。
一个或多个网络部件650可用于使用一个或多个逻辑连接在联网环境中操作计算系统600。逻辑连接包括例如局域网、广域网和互联网。网络部件650允许处理器620例如向一个或多个远程设备(诸如另一计算系统或者一个或多个远程计算机存储介质)传送信息和/或从其接收信息。网络部件650可以包括网络适配器，诸如有线或无线网络适配器或无线数据收发器。
本文所述的示例有助于减少手术(例如，矫形脊柱和神经外科手术)期间的软组织损伤的量，这可导致较少疼痛，较快恢复时间和/或较低感染可能性。例如，图21示出了经皮螺钉。
图21和图22示出了横向延伸跨过一个或多个螺钉712(例如，椎弓根螺钉的郁金香形件)的上部部分以及联接到螺钉712的上部部分的一个或多个螺杆塔(例如，螺杆塔100或160)的示例跟踪阵列700和配备有导航阵列的杆710。如图21所示，跟踪阵列700可以在第一阶段联接到第一螺杆塔714。一旦杆710延伸穿过第一螺杆塔714，跟踪阵列700可与第一螺杆塔714解除联接，并且在第二阶段联接到第二螺杆塔716，如图22所示。
跟踪阵列700和杆710各自包括多个标记720，这些标记可以在第一阶段和第二阶段期间被跟踪(例如，使用位置传感器410)以使得能够确定杆710和第一螺杆塔714的相对位置(例如，使用计算机430)。以这种方式，可以使用来自跟踪系统400的反馈使杆710延伸穿过第一螺杆塔714和第二螺杆塔716。例如，如图23所示，显示器432可以通过示出到第一螺杆塔714或第二螺杆塔716的距离722以及杆710相对于限定在第一螺杆塔714或第二螺杆塔716中的开口(例如，纵向通道138)的对准724来帮助定位杆710。尽管图21至图22示出了跟踪阵列700和杆710，其各自包括多个臂和在每个臂的端部部分处的球形标记，但是跟踪阵列700和/或杆710可以包括用于跟踪杆710、螺钉712、第一螺杆塔714和/或第二螺杆塔716的一个或多个跟踪标记420。
图24示出了提供杆复位工具的示例性方法800。如图21和图22所示，杆710可横向延伸跨过螺钉712的上部部分和联接到螺钉712的上部部分的螺杆塔(例如，螺杆塔100或160)。如图25至图27所示，螺杆塔100可以刚性地和/或稳健地联接到螺钉712以允许螺钉操作或压缩/牵引。在一些示例中，驱动轴(例如，内轴210)在操作810处纵向延伸穿过螺杆塔100。例如，驱动轴的远侧端部104可被插入到螺杆塔100的近侧开口106中并且沿远侧方向移动。在操作820处，螺纹套筒220可安装在驱动轴的近侧部分上以形成器械200。
在操作830处，可以使用一个或多个保持构件(例如，塔夹310)将外壳300联接到螺杆塔100。在操作840处，可以使用螺纹按钮320将外壳300螺纹连接到螺纹套筒220。螺纹套筒220可围绕纵向轴线旋转，以相对于螺杆塔100纵向推动驱动轴。驱动轴能够突出穿过锁定帽，允许器械200实现杆复位，而不在锁定帽上施加额外的力，由此减轻对锁定帽和/或郁金香形件的过早损坏的可能性。在一些示例中，螺杆塔100、器械200和/或外壳300可以被标记并用作用于插入互连杆的定位和/或引导装置。
前面提到的示例允许快速和稳健地连接到接骨螺钉和郁金香形件，并且还允许在小占地面积内连接复位器械。内部可变复位不仅稳健，而且确实保持螺杆塔的外径细长，从而使切口尺寸最小化。以下器械还可以与其他器械一起起作用以允许其他技术相关步骤，包括但不限于：杆测量、棒通过、杆复位、锁定帽附接和上紧、压缩和牵引。以下实施方案代表可用于将椎弓根螺钉保持到基于塔的器械的方法；基于管的装置允许杆通过、杆复位、以及在螺钉植入之后的锁定帽递送和上紧。复位实施方案可允许自由移动复位，随后是机械辅助复位，以通过允许在所有微创螺钉器械系统中不可能实现的某些内部部件的特定取向或间歇功能来节省时间。另外，使用来自其他当前可用的Globus系统的器械的潜在能力可以减少手术室中所需的装置的数量，可以简化程序，并且由于潜在的更简化的技术还可以减少手术室时间。
本书面描述使用示例来公开本公开的各方面，并且还使本领域技术人员能够实践这些方面，包括制造或使用上述系统以及执行或进行上述方法。已经根据各种示例及其相关联的操作描述了本公开的各方面，显而易见的是，在不脱离如所附权利要求中限定的本公开的范围的情况下，修改和变化是可能的。也就是说，本公开的各方面不限于本文描述的特定示例，并且以上描述中包含的以及附图中示出的所有内容应被解释为说明性的而非限制性的。例如，在不脱离本公开的范围的情况下，本文描述的示例可以结合其他示例和应用来实现和利用，或者应用于其他示例和应用。因此，本公开的各方面不旨在限于以上描述和/或附图，而是符合与本文公开的原理和特征一致的最宽范围。
应当理解，本公开在其应用中不限于本文的描述中所述或附图中所示的构造细节和/或部件布置。例如，根据本公开的原理，本文描述的和/或在附图中示出的任何特征可以与本文描述的和/或在附图中示出的任何其他特征结合来参考和/或要求保护。本领域的技术人员将认识到，本文提供的示例具有许多有用的另选形式并且落入本公开的范围。
本公开的教导内容可以在其他实施方案中使用和实践，并且以各种方式实践或执行。例如，本文描述的系统的部件和/或方法的操作可与本文描述的其他部件和/或操作独立地和分开地使用。此外，本文描述的方法可以包括比所公开的那些操作更多或更少的操作，并且本文描述的操作的执行或进行的顺序不是必需的，除非另有说明。也就是说，除非另外指明，否则可以以任何顺序执行或进行操作，并且预期在另一操作之前、与另一操作同时或在另一操作之后执行或进行特定操作在本公开的范围内。此外，流程图和/或框图的给定框的功能可以被分成多个框，并且/或者流程图和/或框图的两个或更多个框的功能可以被至少部分地集成。此外，尽管图示中的一些图示包括通信路径上的箭头以示出主通信方向，但是应当理解，通信可以在与所描绘的箭头相反的方向上发生。
从前面的描述中应当清楚，本文描述的一个或多个框图可以表示体现本公开的原理的说明性电路的概念图，并且各种示例可以以硬件和/或作为存储在非暂态机器可读存储介质上的计算机程序指令来实现。计算机程序指令可以被提供给通用计算机电路、专用计算机电路和/或其他可编程数据处理电路的处理器以产生机器，使得经由处理器执行的指令变换并控制晶体管、存储在存储器位置中的值以及此类电路内的其他硬件部件以执行本文详细描述的操作，包括与流程图和/或框图的框相关联的功能/动作，并且由此创建用于执行此类操作的装置(功能)和/或结构。本领域的技术人员将了解，任何流程图、序列图、状态转变图、伪代码等表示可基本上在机器可读存储介质中表示并且因此由计算机或处理器执行的各种过程，无论此类计算机或处理器是否明确示出。
除非另有限定，否则本文所使用的所有术语(包括技术术语和科学术语)具有与本发明构思所属领域的普通技术人员通常理解的含义相同的含义。还应当理解，诸如在常用词典中定义的那些术语应当被解释为具有与它们在本说明书的上下文和相关领域中的含义一致的含义，并且不应当以理想化或过于正式的意义来解释，除非本文明确地如此定义。
在介绍本公开或其示例的各方面时，冠词“一”、“一个”、“该”和“所述”旨在表示存在一个或多个元件，除非上下文另外明确指出。对本公开的“实施方案”或“示例”的参考不旨在被解释为排除另外结合了所述特征的附加实施方案或示例的存在。短语“以下中的一项或多项：A、B和C”意指“A中的至少一项和/或B中的至少一项和/或C中的至少一项”。术语“和/或”包括一个或多个相关联的所列项的任何和所有组合。应当理解，尽管本文可以使用序数术语(例如，“第一”、“第二”、“第三”等)来描述各种元件/操作，但是这些元件/操作不应当受到这些术语的限制。这些术语仅用于将一个元件/操作与另一个元件/操作区分开。因此，在不脱离发明构思的教导内容的情况下，在一些实施方案中的第一元件/操作可以在其他实施方案中被称为第二元件/操作。此外，如本文所用，源自拉丁语短语“exempligratia”的常见缩写“e.g.”可以用于引入或指定先前提及项的一个或多个一般示例，并且不旨在限制此类项。源自拉丁语短语“id est”的常见缩写“i.e.”可以用于从更一般的叙述指定特定项。
此外，应当理解，本文所用的措词和术语是出于描述的目的，不应该被视为限制。本文中术语“包含”、“包括”或“具有”以及它们的变型的使用意指包括此后列出的项目以及它们的等同物以及附加项目。除非另有规定或限制，否则术语“安装”、“连接”、“支撑”和“联接”以及它们的变型被广泛使用，并且包括直接和间接的安装、连接、支撑和联接。此外，“连接”和“联接”不限于物理或机械连接或联接。此外，当元件被称为“连接”、“联接”或“响应”以及它们的变型到另一个元件时，该元件可以直接连接、联接或响应于其他元件或者可以存在居间元件。相反，当元件被称为“直接连接”、“直接联接”或“直接响应”以及它们的变型到另一个元件时，不存在居间元件。此外，如本文所用，“连接”、“联接”、“响应”或它们的变型可以包括无线联接、连接或响应。
本发明的专利范围由权利要求限定，并且可以包括本领域技术人员想到的其他示例。如果此类其他示例具有与权利要求的字面语言没有不同的结构要素，或者如果它们包括与权利要求的字面语言无实质差异的等同结构要素，则这些其他示例旨在处于权利要求的范围内。

Claims (10)

1.一种系统，包括：
螺杆塔；
器械，所述器械包括能够纵向延伸穿过所述螺杆塔的驱动轴，以及安装在所述驱动轴的近侧部分上的螺纹套筒；以及
外壳，所述外壳包括能够联接到所述螺杆塔的一个或多个保持构件，以及能够螺纹联接到所述螺纹套筒的螺纹按钮，其中所述螺纹套筒能够围绕纵向轴线旋转以相对于所述螺杆塔纵向推动所述驱动轴。
2.根据权利要求1所述的系统，其中所述螺杆塔包括限定开口的外套筒，限定纵向狭槽的内套筒，以及能够延伸穿过所述开口和所述纵向狭槽的销。
3.根据权利要求1所述的系统，其中所述螺杆塔包括外套筒和内套筒，所述外套筒包括壁和限定在所述壁中的纵向狭槽，所述内套筒包括被构造成径向向外延伸穿过所述纵向狭槽的突起，所述壁被构造成偏转以使得所述突起从所述纵向狭槽移除。
4.根据权利要求1所述的系统，其中所述螺杆塔包括外套筒和内套筒，所述外套筒限定纵向狭槽，所述内套筒包括被构造成径向向外延伸穿过所述纵向狭槽的突起，所述突起被构造成径向向内移动以使得所述突起从所述纵向狭槽移除。
5.根据权利要求1所述的系统，其中所述螺杆塔包括内套筒和内螺母，所述内螺母被构造成沿着所述纵向轴线移动所述内套筒。
6.根据权利要求1所述的系统，其中所述螺杆塔包括外套筒、内套筒和内螺母，所述内螺母螺纹联接到所述外套筒，所述内螺母能够围绕所述纵向轴线选择性地旋转以相对于所述外套筒沿着所述纵向轴线平移所述内套筒。
7.根据权利要求1所述的系统，其中所述螺杆塔包括内套筒，所述内套筒包括被构造成接合螺钉的头部特征的配合部分。
8.根据权利要求1所述的系统，其中所述器械包括帽推动器以及位于所述帽推动器和所述驱动轴之间的偏置构件。
9.根据权利要求1所述的系统，其中所述器械包括安装在所述驱动轴的远侧部分上的帽推动器，以及限定开口的隐藏帽，所述帽推动器和所述驱动轴延伸穿过所述开口。
10.根据权利要求1所述的系统，其中所述螺纹按钮能够在接合位置和脱离位置之间移动，在所述接合位置，所述螺纹按钮联接到所述螺纹套筒，在所述脱离位置，所述螺纹按钮与所述螺纹套筒间隔开。
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