CN116898641A - Assembly for intervertebral fusion - Google Patents

Assembly for intervertebral fusion Download PDF

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Publication number
CN116898641A
CN116898641A CN202310718676.3A CN202310718676A CN116898641A CN 116898641 A CN116898641 A CN 116898641A CN 202310718676 A CN202310718676 A CN 202310718676A CN 116898641 A CN116898641 A CN 116898641A
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CN
China
Prior art keywords
shaped
fusion
clamp
shaped track
bullet
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Pending
Application number
CN202310718676.3A
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Chinese (zh)
Inventor
吴浩
赵兴华
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Xuanwu Hospital
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Xuanwu Hospital
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Priority to CN202310718676.3A priority Critical patent/CN116898641A/en
Publication of CN116898641A publication Critical patent/CN116898641A/en
Pending legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7083—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4687—Mechanical guides for implantation instruments

Abstract

The invention relates to an assembly for intervertebral fusion operation, comprising: fusion device and channel clamp; the fusion device consists of a U-shaped track part and a bullet-shaped hollow fusion body part; the inner walls of the two sides of the U-shaped track part are provided with first internal threads distributed along the length direction of the U-shaped track part; the outer surface of the bullet-shaped hollow fusion body part is provided with a plurality of through holes at intervals and external threads matched with the first internal threads of the U-shaped track part; the channel clamp comprises a track cylinder and a handle; the track cylinder is formed by buckling two identical semicircle cylinders, a clamp head extends out of the far end of each semicircle cylinder along the axial direction of the semicircle cylinder, and the handle is fixedly connected with the track cylinder to control the opening and closing of the two semicircle cylinders and the clamp heads thereof; the two clamp heads are used for clamping the outer walls at two sides of the U-shaped track part of the fusion device, and the two clamp heads clamp the outer walls at two sides of the U-shaped track part and simultaneously the far-end cylinder opening of the track cylinder formed by buckling the two semicircular cylinders is opposite to and abutted against the open end of the U-shaped track part. The component can avoid taking out bones additionally, and has high placement accuracy and safety.

Description

Assembly for intervertebral fusion
Technical Field
The invention relates to a surgical instrument, in particular to an imbedding assembly used in spinal fusion fixation of spinal surgery. .
Background
Currently, in spinal surgery, when an unstable lesion appears in the spine of a patient or the stability of the spine is damaged by operation, such as fracture, lumbar vertebra slippage, discectomy, vertebral body excision and the like, internal fixation of spinal fusion is generally performed on the patient, so that two or more vertebral body growth of a lesion segment are integrated into a whole. The purpose of this surgery is to restore spinal biomechanical stability, height between vertebrae, reduce relative motion between vertebrae, thereby avoiding nerve compression and lesion progression, and alleviating pain, restoring erectile function, etc. The intervertebral fusion operation mainly comprises 3 steps, namely, firstly, cutting off intervertebral discs and carrying out internal fixation and nailing; secondly, taking the self ilium from another incision and grinding for later use; third, the fusion cage is filled with crushed bone and placed into the intervertebral space. Generally, the vertebral body needs about one year to achieve complete osseous fusion, and if the fusion fails, secondary operation treatment is needed, and the patient suffers great pain. Thus, clinicians have been struggling with how to increase fusion rate, shorten fusion time, restore intervertebral height, and alleviate patient symptoms.
The advent of intervertebral fusion devices has revolutionized the enhancement of fusion rates and improved surgical outcomes. The method has two main effects, namely, the intervertebral height is restored, and the fusion rate is improved. At present, the structural design and the material use of the fusion device are also continuously improved, and the aim of reducing the displacement and the sedimentation of the fusion device is to further improve the fusion rate and obtain the treatment effect.
The quantity and material of the bone graft are also critical to the fusion rate, and the bone graft material with the best effect is the cancellous bone of the patient, and the bone is taken by making an ilium incision in the operation in clinical practice. Has the advantages of fast bone tissue growth and high fusion rate, but has the defect of needing secondary operation, and increasing pain and wound area for patients. In addition, there are broken bones of spinous processes or partial vertebral plates which are bitten by an operation, but there are limited numbers and less cancellous bone components, and effects are general. At present, the artificial bone is widely used for replacing the self ilium, but the bone fusion effect is relatively poor according to the literature report.
In the prior art, patent documents CN105342680A, CN110314020A and CN115553986A and the like both disclose self-tapping intervertebral fusion devices and implantation instruments and methods which can be used in spinal surgery. However, there are limitations of each of them, for example, CN105342680A, CN110314020a is an integral structure of the screw and the fusion device, although the risk of displacement of the fusion device is reduced, the joint still needs to be fully loosened before implantation, meanwhile, the fusion device is involved to be loosened together when the screw is loosened, the unnecessary risk is increased, while the risk of displacement of the pure fusion device is reduced, but the risk of instability of the integral structure is increased, meanwhile, the self-iliac tissue needs to be taken during bone grafting, and the wound and a certain risk are increased for the patient due to secondary operation; CN115553986a is a structure of adding fixing screws on the fusion cage, but has no relation with pedicles or other fixing screws, simply increasing the stability of the fusion cage. Therefore, although the risk of settlement and displacement is reduced to a certain extent, the risk of additional operation is increased, more damage is easily caused, and the self-body ilium bone grafting is also needed.
Therefore, how to develop a novel surgical assembly for intervertebral fusion, which can improve the implantation accuracy and safety, the fusion rate and the subsidence rate, and simultaneously avoid the pain of a patient caused by taking bones through secondary operation, is a problem worthy of thinking of clinicians.
Disclosure of Invention
Aiming at the problems in the prior art, the invention aims to provide a novel surgical assembly for intervertebral fusion implantation, which not only has a self-tapping and self-stabilizing fusion device, but also has an implantation clamp which is highly adaptive to the fusion device, can obtain cancellous bone for fusion in situ, avoids additional bone taking or other bone supplementing, and has high implantation accuracy and safety.
The above object of the present invention is achieved by the following technical solutions:
there is provided an intervertebral fusion implant assembly comprising: fusion device and channel clamp;
the fusion device consists of a U-shaped track part and a bullet-shaped hollow fusion body part; the inner walls of the two sides of the U-shaped track part are provided with first internal threads distributed along the length direction of the U-shaped track part; the outer diameter of the bullet-shaped hollow fusion body part is larger than the height of a conventional intervertebral space and is matched with the space between the inner walls at two sides of the U-shaped track part, and a plurality of through holes and external threads matched with the first internal threads of the U-shaped track part are arranged on the outer surface of the bullet-shaped hollow fusion body part at intervals;
the channel clamp comprises a track cylinder and a handle; the track cylinders are formed by buckling two identical semicircle cylinders, a clamp head extends out of the far end of each semicircle cylinder along the axial direction of the semicircle cylinder, and the handle is fixedly connected with the track cylinders and used for controlling the opening and closing of the two semicircle cylinders and the clamp heads thereof; the two clamp heads are used for clamping the outer walls at two sides of the U-shaped track part of the fusion device, and the two clamp heads clamp the outer walls at two sides of the U-shaped track part, and simultaneously, the far-end cylinder opening of the track cylinder formed by buckling the two semicircular cylinders is opposite to and abutted against the open end of the U-shaped track part;
the channel clamp is used for: on one hand, the U-shaped track part of the fusion device is clamped by the two forceps heads and is placed into the intervertebral space of the affected part; on the other hand, the bullet-shaped hollow fusion body part is guided by the track cylinder to be aligned with the first internal thread of the U-shaped track part and accurately screwed into the interior and the intervertebral space of the U-shaped track part.
The handle of the channel forceps is preferably formed by pivoting two rigid handles; each rigid handle is fixedly connected with one semi-cylinder. The pivotal connection position of the two rigid handles is not particularly limited, and the handle structure which can be used for realizing the opening or tight buckling of the two semi-cylinders by rotating the two rigid handles around the pivotal connection shaft at different positions of the end parts or the non-end parts of the rigid handles can be used for the invention.
In a preferred scheme of the invention, in order to fix the state of the handle, the two semicircular cylinders are kept tightly buckled, and matched buckles are respectively arranged at positions, far away from the pivot point, of the two rigid handles.
In a more preferable scheme of the invention, in order to facilitate opening the rail barrel in the buckling state, a spring piece is fixedly connected between the two rigid handles of the handle, and the spring piece is used for applying pressure to the two rigid handles to enable the two rigid handles to be relatively far away.
In the scheme of the invention, the specific shape of the handle of the channel forceps is not particularly limited, and can be a straight handle or a crank, or can be any shape conforming to the ergonomic design.
In a preferred scheme of the invention, in order to enable the bullet-shaped hollow fusion body to smoothly enter the U-shaped track part of the fusion device from the track cylinder of the channel clamp, the distal end of the track cylinder of the channel clamp is provided with second internal threads, namely the distal end of each semi-cylinder is respectively provided with second internal threads, and two parts of the second internal threads form integral second internal threads after the two semi-cylinders are buckled; the second internal thread is consistent with the first internal thread in specification, and when the channel pliers clamp the U-shaped track part of the fusion device, the second internal thread is connected with the first internal thread end to end. Therefore, after the bullet-shaped hollow fusion body part of the fusion device enters the track cylinder, the bullet-shaped hollow fusion body part of the fusion device can be firstly screwed with the second internal thread to form a screw joint after the screw driver is unscrewed, and then gradually transits to form the screw joint with the first internal thread, namely, the bullet-shaped hollow fusion body part is screwed into the U-shaped track part.
In the assembly, the forceps head of the channel forceps clamps the U-shaped track part of the fusion device and the track cylinder of the U-shaped track part is abutted with the tail part of the U-shaped track part, so that a safe and stable imbedding structure is formed, a longer guide channel is obtained, and the bullet-shaped hollow fusion body can safely, accurately and stably attack the intervertebral space along the correct direction and angle. The U-shaped track part of the fusion device is used as a basis for the bullet-shaped hollow fusion body part to attack the intervertebral space, and the shape of the U-shaped track part of the fusion device needs to be in line with the structural characteristics of the intervertebral space as much as possible. The U-shaped track part provided by the invention is provided with a closed front end, a middle section and an open rear end, wherein the outer surface of the closed front end is relatively smooth, and the middle section and the open rear end are parallel to each other. In the operation, the closed front end firstly enters the intervertebral space and is finally fixed in the intervertebral space, so that the bullet-shaped hollow fusion body part screwed in later can be limited, and the deep screw-in injury and the tissue in front of the spinal column (particularly spinal cord) are avoided; the two sides of the middle section with the first internal threads, which are parallel to each other, can play a role in guiding and fixing the bullet-shaped hollow fusion body which enters later, the open rear end can be matched with the forceps head and the track cylinder of the channel forceps, the U-shaped track part is placed into the intervertebral space under the stable forceps, and the bullet-shaped hollow fusion body and the U-shaped track part can smoothly establish a threaded connection. The overall dimension of the U-shaped track part should not exceed the dimension of the intervertebral space, and the material can be selected from various rigid materials acceptable for spinal surgery and meeting implantation requirements.
In a preferred scheme, in order to enable the U-shaped track part of the fusion device to be better matched with the forceps heads of the rail guide forceps, grooves distributed along the length direction of the U-shaped track part are respectively formed in the outer side walls of the two sides of the U-shaped track part, and the pair of forceps heads of the channel forceps are of long strip shapes capable of being embedded into the grooves. In a further preferred scheme, an anti-slip rough surface layer is arranged at the bottom of each groove and the inner surface of each clamp head and used for increasing the contact friction force between the rail guide clamp and the U-shaped rail part.
In the preferred scheme, in order to enhance the stability of the U-shaped track part after being implanted into the intervertebral space, anti-slip teeth are arranged on the contact surfaces of the U-shaped track part and the upper and lower vertebral bodies.
In the assembly of the invention, the shape of the inner wall of the U-shaped track part of the fusion device is not particularly limited, and the inner wall of the U-shaped track part can be a plane or an arc surface with an arc center positioned in the U-shape.
In order to enable the bullet-shaped hollow fusion body to smoothly transition from the inside of the channel clamp to the inside of the U-shaped track part, in a preferable scheme of the invention, the inner walls at two sides of the U-shaped track part are two sections of cambered surfaces in the same cylindrical surface, and the inner diameter of a track cylinder of the channel clamp is consistent with the diameter of the cylindrical surface at which the two side surfaces of the U-shaped track part are positioned. In another preferable scheme of the invention, the inner walls at two sides of the U-shaped track part are plane surfaces, and the space between the U-shaped track part and the inner wall of the track cylinder of the channel clamp is consistent.
In order to improve the bone fusion efficiency of the operation, broken bones are required to be generated as much as possible in the process that the bullet-shaped hollow fusion body part of the fusion device is tapped into the intervertebral space, so that the external threads of the bullet-shaped hollow fusion body part are required to be exposed out of the U-shaped track part more, and in a more preferable scheme of the invention, the inner walls at two sides of the U-shaped track part are two sections of cambered surfaces in the same cylindrical surface, the inner diameter of a track cylinder of the channel clamp is consistent with the diameter of the cylindrical surface at which the two side surfaces of the U-shaped track part are positioned, and the two sections of cambered surfaces at the two sides of the U-shaped track part respectively occupy less than 1/4 of the cylindrical surface. Therefore, when the bullet-shaped hollow fusion body part is screwed into the U-shaped track part, the overlapping area of the two sides of the U-shaped track part and the bullet-shaped hollow fusion body part is smaller, at least half of the outer surface of the fusion body part is not shielded by the U-shaped track part, the fusion body part is exposed outside the U-shaped track part, and sharp external threads on the surface of the fusion body part can be fully utilized to cut the upper and lower vertebral bodies to form broken bones.
In the assembly of the invention, the bullet-shaped hollow fusion body of the fusion device is provided with sharp external threads, and the height of the external threads is preferably not less than 1mm for better cutting of the vertebral body.
In the assembly, the specification of the bullet-shaped hollow fusion body part can be adjusted in a certain range according to the requirement, but the bullet-shaped hollow fusion body part is always required to be matched with the inner diameter or the inner wall spacing of the U-shaped track part.
In the assembly, the through holes on the outer surface of the bullet-shaped hollow fusion body part of the fusion device are used for enabling broken bones generated by screwing into an intervertebral space to enter the inner cavity of the bullet-shaped hollow fusion body part, so that the fusion device is used for postoperative bone fusion, and bone extraction operation on other parts of a patient can be avoided. In order to further improve the efficiency of the broken bones entering the inner cavity of the fusion body in the screwing process, in the preferred scheme, a plurality of through holes on the outer surface of the bullet-shaped hollow fusion body of the fusion device are all strip-shaped through holes, and the trend of the through holes is crossed with the external threads; in a more preferred scheme, the plurality of strip-shaped through holes are distributed at intervals in a spiral manner on the warhead-shaped hollow fusion body. In the further preferred assembly, in order to further increase the broken bone quantity generated in the screwing process of the fusion device, a knife edge is arranged on each through hole of the bullet-shaped hollow fusion body, the edge of the knife edge is divided into front and rear parts according to the rotation direction, and the edge of the knife edge is low in front and high in rear, namely, the front edge and the rear edge of the knife edge have height difference.
In the assembly, the bullet-shaped hollow fusion body part of the fusion device can be provided with a semi-closed tail end, the end face of the tail end is provided with a recess, and the shape of the recess is matched with that of the head end of a conventional screwdriver. In the preferred scheme, the concave center is also provided with a through hole for additionally filling broken bones into the inner cavity of the bullet-shaped hollow fusion body part so as to make up for the defect of bone falling quantity and further increase the fusion rate.
Compared with the prior art, the beneficial effects of the component for intervertebral fusion implantation disclosed by the invention are mainly shown in the following aspects:
(1) the component for intervertebral fusion implantation can realize bone grafting free: because the fusion body part of the component for intervertebral fusion is provided with the through hole and the sharp external thread, and most of the external thread is exposed outside the U-shaped track part, the external thread can be in large-area contact with the vertebral body when the fusion body part is tapped between the vertebral bodies, the sharp external thread can generate a large amount of broken bones through friction and cutting, the broken bones from the upper vertebral plate and the lower vertebral plate can fall into the inner cavity of the fusion body part along with the spiral rotation of the fusion body part through the through hole of the fusion body part, excessive broken bones are prevented from falling out of the fusion device under the cooperation of the U-shaped track part, and finally the broken bone quantity basically used for bone fusion can be obtained in the inner cavity of the fusion body part. Therefore, the special ilium extraction operation can be avoided from being additionally carried out on the patient, and the pain of the patient is reduced. And in theory, the in-situ cancellous bone of the spine has higher efficiency than the self-iliac fusion, and in-situ tissues are easier to grow. In addition, when the design of the tail part of the fusion body part is carried out, if redundant broken bones are generated in the operation, the bone fracture can be implanted from the tail end through hole of the fusion body part, the defect of bone fracture quantity is overcome, and the fusion rate is further increased.
(2) Spiral osteotomy knife edge design of fusion body: and a bone grafting-free structural foundation. The screw hollow-out position is low before and high after the process, and broken bones of the upper and lower centrum parts fall into the screw in the rotating process, so that the advancing resistance is reduced.
(3) The fusion body part with the spiral appearance has self-tapping power and self-stabilizing effect: at present, the fusion device is basically square or bullet-shaped, the vertebral body needs to be firstly spread during implantation, the implantation power is basically knock-in, and the stability is mainly provided by the anti-skid structures on the upper surface and the lower surface. Because the anchoring or embedding depth is insufficient without embedding the inside of the vertebral body, the stabilizing effect is limited, and the fusion rate is affected. The self-tapping and self-stabilizing functional effect is achieved by arranging the self-tapping external threads on the fusion body. Specifically, the external thread firstly ensures that the external thread has self-tapping power, and on the basis, under the cooperation of the internal thread of the U-shaped track part, the fusion body part with the external thread can self-tap the upper and lower vertebral plates and reach the ideal position forwards; and secondly, a deeper thread knife edge with the depth not less than 1mm can be embedded into the vertebral body, so that more firm anchoring stability is provided, the fusion cage is prevented from shifting, and the overall stability is further enhanced after the fusion cage is combined with the U-shaped track part. The upper surface and the lower surface of the U-shaped track part are also provided with anti-slip toothed structures, so that the self-stabilizing effect can be further improved.
(4) The effect of expanding the intervertebral to restore the intervertebral height is obvious: the fusion body part has a slightly wider outer diameter than the intervertebral space, and can prop up the intervertebral space while rotating into the intervertebral space, so that the expanding effect is more obvious compared with the existing fusion device.
(5) The anti-sedimentation function is enhanced: in the invention, the fusion body part can form a cylindrical contact surface which is attached with the upper and lower vertebral bodies after entering, namely, a certain self-adaption is formed, and the contact area of the vertebral bodies and the fusion device is further increased after the U-shaped track part is combined, so that the local pressure can be reduced, and the anti-sedimentation function is improved.
(6) The implantation process is safer: in the invention, the closed front end of the U-shaped track part can ensure the safety of the placement of the fusion body part, and can avoid the screw part from entering too deeply to accidentally injure the tissues in front of the spine. Meanwhile, the channel clamp can ensure the implantation process of the fusion device to be accurate.
(7) The application range is wide: the component of the invention is the combination of the fusion device and the special imbedding channel forceps thereof, the application range of the combination is wider, and the combination can be suitable for various open and minimally invasive channel type spinal fusion operations.
In a word, the assembly for intervertebral fusion operation can improve the rate of spinal operation fusion, reduce the subsidence and displacement of the fusion cage and avoid the pain of patients for independently taking own ilium bones.
Drawings
FIG. 1 is a schematic view of the overall structure of an intervertebral fusion implant assembly of the present invention.
FIG. 2 is a schematic view of the structure of the assembly of the present invention in a clamped state.
Fig. 3 is a schematic view of the assembly of the present invention in a relaxed open configuration of the access clamp.
Fig. 4 is a schematic view of the overall construction of the cage of the assembly of the present invention.
Fig. 5 is a schematic view of a spinal fusion cage prior to deployment using the assembly of the present invention.
FIG. 6 is a schematic view of the assembly of the present invention after insertion of the cage.
The reference numerals are explained as follows:
10-U-shaped track portion; 11-internal threads; 12-grooves; 13-rough surface; 14-anti-slip teeth; 20-bullet-shaped hollow fusion body; 21-external threads; 22-through holes; 23-tail end; 24-recessing; 25-tail through holes; 30-channel forceps; 100-track cylinder; 101-a semi-cylinder; 102-clamp heads; 103-second internal threads; 200-handle; 201-a rigid handle; 202-a buckle; 203-a spring piece; 300-screwdriver.
Detailed Description
The technical scheme of the present invention will be described in detail below with reference to the accompanying drawings, but the technical scheme of the present invention is not limited to the specific embodiments described.
The invention provides an assembly for intervertebral fusion operation implantation, which has an integral structure comprising a fusion device and a channel clamp;
as shown in fig. 1-3, the channel clamp includes a track cylinder 100 and a handle 200. The track cylinder 100 is formed by buckling two identical semi-cylinders 101, and a clamp head 102 extends from the distal end of each semi-cylinder 101 along the axial direction thereof. The handle 200 is formed by pivoting two rigid handles 201; each rigid handle 201 is fixedly connected to one of said half cylinders 101. The two rigid handles 201 may be other shapes and structures that are suitable for gripping and may be pivotally connected, may be a straight shank or a crank, may be any shape that is ergonomically designed, and the pivotal connection between them is not particularly limited, and may be any handle structure that can be used in the present invention by adjusting the distance between the two semi-cylinders 101 by rotating the two rigid handles 201 about the pivotal axis at different positions, either at the end or not, of the rigid handles. The distal end of the track cylinder 100 is further provided with a second internal thread 103, that is, the distal end of each semi-cylinder 101 is respectively provided with a second internal thread 103, and the second internal threads 103 of the two parts form an integral second internal thread 103 after the two semi-cylinders 101 are buckled. The two rigid handles 201 are respectively provided with matched buckles 202 at positions far away from the pivot points, and are used for fixing the state of the handle 200 so that the two semicircular cylinders 101 fixedly connected with the handles are tightly buckled. A spring piece 203 is fixedly connected between the two rigid handles 201, and is used for applying pressure to the two rigid handles 201 to enable the two rigid handles 201 to be relatively far away so as to open the track cylinder 100 in the buckling state.
As shown in fig. 1 and 4, the fusion device comprises a U-shaped track portion 10 and a bullet-shaped hollow fusion body portion 20. The inner surface of the U-shaped track part 10 and the outer surface of the bullet-shaped hollow fusion body part 20 are matched with each other in shape, and the bullet-shaped hollow fusion body part 20 can enter the U-shaped track part 10 in a spiral mode to form a spiral connection. When the device is used for spinal fusion, the U-shaped track part 10 is used for being implanted into an affected intervertebral space, the bullet-shaped hollow fusion body part 20 is used for being screwed into the U-shaped track 10 part which enters the intervertebral space, the bullet-shaped hollow fusion body part 20 can attack upper and lower vertebral bodies while being screwed into the U-shaped track part 10, and finally, the U-shaped track part 10, the bullet-shaped hollow fusion body part 20 and the upper and lower vertebral bodies form a fixed structure together.
As shown in fig. 1 and 4, the U-shaped rail portion 10 has a closed front end with a relatively rounded outer surface, a middle section parallel to each other, and an open rear end. The inner walls of the two sides of the middle section of the U-shaped track part 10 are two sections of cambered surfaces in the same cylindrical surface, and first internal threads 11 distributed along the length direction of the cambered surfaces are arranged on the cambered surfaces; the areas of the two sections of cambered surfaces respectively occupy less than 1/4 of the cylindrical surface. The outer side walls of the two sides of the middle section of the U-shaped track part 10 are respectively provided with grooves 12 distributed along the length direction. The upper and lower surfaces of the U-shaped track portion 10 are respectively provided with anti-slip teeth 14 for increasing friction between the U-shaped track portion 10 and the upper and lower lamina surfaces.
The overall gauge of the bullet-shaped hollow fusion body 20 can be adjusted within a certain range as required, but the outer diameter is larger than the conventional intervertebral space height and always needs to be matched with the inner diameter or the inner wall spacing of the U-shaped track portion 10. As shown in fig. 4, the bullet-shaped hollow fusion body 20 has a self-tapping structure, i.e., has a tip with a gradually decreasing outer diameter from the near to the far, and the outer surface is provided with a sharp external thread 21 which mates with the first internal thread 11 of the U-shaped track portion, and the external thread 21 continues all the way to the tip. The height of the external thread 21 is preferably not less than 1mm, more preferably 1 to 4mm; the external threads 21 have equal widths and different intervals of 0.2-2 mm. The outer surface of the bullet-shaped hollow fusion body 20 is also provided with a plurality of through holes 22 at intervals, which are used for enabling broken bones generated by the bullet-shaped hollow fusion body 20 to attack the intervertebral space to enter the inner cavity of the bullet-shaped hollow fusion body 20 for postoperative bone fusion, thereby avoiding bone taking operation on other parts of a patient. In order to further improve the efficiency of the broken bones entering the inner cavity of the bullet-shaped hollow fusion body 20 in the screwing process, in a preferred scheme, a plurality of through holes 22 are all strip-shaped through holes on the bullet-shaped hollow fusion body 20, and the trend of the through holes is crossed with the external threads 21. More preferably, the plurality of strip-shaped through holes 22 are spirally spaced on the bullet-shaped hollow fusion body 20. In a further preferred embodiment, in order to further increase the broken bone quantity generated during the screwing process of the fusion device, a knife edge is arranged at each through hole edge on the bullet-shaped hollow fusion body, the knife edge is divided into front and rear parts according to the rotation direction, and the edge of the knife edge is low in front and high in rear, namely, the front edge and the rear edge of the knife edge have height differences. The bullet-shaped hollow fusion body 20 is further provided with a semi-closed tail end 23, and the end surface of the tail end 23 is provided with a recess 24, and the shape of the recess 24 is matched with that of a head end of a conventional screwdriver, for example, the hollow fusion body can be a regular hexagon recess. In the preferred embodiment, the center of the recess 24 is further provided with a tail through hole 25 for additionally filling broken bones into the inner cavity of the bullet-shaped hollow fusion body 20 so as to compensate for the shortage of bone falling amount and further increase the fusion rate.
As shown in fig. 1, a handle 200 is fixedly connected with the track cylinder 100 and is used for controlling the opening and closing of the two semi-cylinders 101 and the clamp heads 102 thereof; the two clamp heads 102 clamp the U-shaped track part 10 of the fusion device through the grooves 12 embedded in the outer walls of the two sides of the U-shaped track part 10, and the clamp heads 102 clamp the U-shaped track part, and simultaneously, the cylinder mouth at the far end of the track cylinder 100 formed by buckling the two semicircular cylinders 101 is opposite to and abutted against the open end of the U-shaped track part 10. In a further preferred embodiment, as shown in fig. 4, the bottom of each recess 12 and the inner side of the binding clip 102 are further provided with a roughened surface 13 for increasing the friction of them against each other.
The channel clamp of the assembly of the present invention has the function of clamping the U-shaped rail portion 10 of the fusion cage by the two clamp heads 102 and placing it into the affected intervertebral space on the one hand, and guiding the bullet-shaped hollow fusion body portion 20 to align with the first internal thread 11 of the U-shaped rail portion 10 by the rail barrel 100 on the other hand, so that the bullet-shaped hollow fusion body portion 20 is accurately screwed into the interior of the U-shaped rail portion 10 and the intervertebral space under the screwing action of the screwdriver 300.
The specific specifications of each part of the assembly can be adjusted within the following range according to requirements:
(1) the height (thickness) of the U-shaped rail portion 10 may be in the range of 4-12mm; the outer diameter of the U-shaped track portion 10 may range from 8-26mm; the horizontal length of the U-shaped track section 10 may range from 16-28mm;
(2) the outer diameter of the bullet-shaped hollow fusion body 20 may range from 6-18mm; the inner diameter of the bullet-shaped hollow fusion body 20 may range from 4-14mm; the bullet-shaped hollow fusion body 20 may be 14-26mm in length.
(3) The inside diameter of the channel clamp rail cylinder 100 is not smaller than the inside diameter of the U-shaped rail portion 10.
In each component of the component, the material of the fusion device is in accordance with the standard of medical implants, and various materials such as PEEK, titanium alloy, ceramics and the like can be used according to the requirement of the use strength.
The assembly of the invention can be used for minimally invasive or open surgery of various lumbar vertebrae, such as ALIF, OLIF, PLIF, TLIF and the like.
When the assembly of the present invention is used in an interbody fusion procedure, the procedure is generally as follows: prior to implantation, the intervertebral space is first surgically exposed; a pair of U-shaped rail portions 10 and bullet-shaped hollow fusion body portions 20 of appropriate size are then selected according to the size of the intervertebral space; clamping the groove 12 on the side of the U-shaped track part 10 by using the clamp head 102 of the channel clamp, then opening a hole from the tail part of the track cylinder 100 of the channel clamp to load the bullet-shaped hollow fusion body part 20, and screwing the bullet-shaped hollow fusion body 20 into the U-shaped track part 10 for about 1-2 circles by using a screwdriver 300 to generate connection; then the U-shaped track part 10 is sent into the intervertebral space, and a hammer can be used for properly knocking the tail part of the track cylinder 100 of the channel clamp, so that the U-shaped track part 10 completely enters (the state after the completion of the step is shown in fig. 5), and at the moment, part of the head part of the bullet-shaped hollow fusion body part 20 also enters the intervertebral space; finally, the bullet-shaped hollow fusion body 20 in the track cylinder 100 of the channel clamp is gradually screwed into the U-shaped track portion 10 by using the opener 300. After the bullet-shaped hollow fusion body 20 is completely screwed out of the track cylinder 100 of the channel clamp and enters the U-shaped track part 10, confirming whether the position is correct under perspective, and after confirming that the position is correct, loosening the handle 200 of the channel clamp to release the U-shaped track part 10 and withdrawing the channel clamp, thereby completing the placement and obtaining the fixing structure shown in fig. 6.
In the above operation, the closed front end of the U-shaped track portion 10 firstly enters the intervertebral space and is finally fixed in the intervertebral space, so that the bullet-shaped hollow fusion body portion 20 screwed in later can be limited, and the deep injury and spinal cord caused by the screwing in of the bullet-shaped hollow fusion body portion are avoided; the two sides of the middle section with the first internal threads 11 which are parallel to each other can play a role in guiding and fixing the bullet-shaped hollow fusion body 20 which enters later, the rear end of the open outer wall with the groove 12 can be fully matched with the pliers head 102 of the track pliers, and the bullet-shaped hollow fusion body 20 and the U-shaped track 10 can smoothly establish a threaded connection. When the bullet-shaped hollow fusion body portion 20 is screwed into the U-shaped track portion 10, the overlapping area between the two sides of the U-shaped track portion 10 and the bullet-shaped hollow fusion body portion 20 is small, at least half of the outer surface of the bullet-shaped hollow fusion body portion 20 is not shielded by the U-shaped track portion 10 and is exposed outside the U-shaped track portion 10, so that sharp external threads on the surface of the bullet-shaped hollow fusion body portion 20 can be fully utilized to cut the upper and lower vertebral bodies, and broken bones can be generated as much as possible. The generated broken bones fully enter the inner cavity of the bullet-shaped hollow fusion body 20 through the through holes 22 on the bullet-shaped hollow fusion body 20, so that the inner cavity of the bullet-shaped hollow fusion body 20 can accumulate enough broken bones from the vertebral bodies, the bone fusion rate after fixation can be effectively improved, bone extraction operation is not needed to be carried out on a patient, and the pain of the patient is greatly relieved.

Claims (10)

1. An assembly for intervertebral fusion operation, which is characterized by comprising a fusion device and a channel clamp;
the fusion device consists of a U-shaped track part and a bullet-shaped hollow fusion body part; the inner walls of the two sides of the U-shaped track part are provided with first internal threads distributed along the length direction of the U-shaped track part; the outer diameter of the bullet-shaped hollow fusion body part is larger than the height of a conventional intervertebral space and is matched with the space between the inner walls at two sides of the U-shaped track part, and a plurality of through holes and external threads matched with the first internal threads of the U-shaped track part are arranged on the outer surface of the bullet-shaped hollow fusion body part at intervals;
the channel clamp comprises a track cylinder and a handle; the track cylinders are formed by buckling two identical semicircle cylinders, a clamp head extends out of the far end of each semicircle cylinder along the axial direction of the semicircle cylinder, and the handle is fixedly connected with the track cylinders and used for controlling the opening and closing of the two semicircle cylinders and the clamp heads thereof; the two clamp heads are used for clamping the outer walls at two sides of the U-shaped track part of the fusion device, and the two clamp heads clamp the outer walls at two sides of the U-shaped track part and simultaneously the far-end cylinder opening of the track cylinder formed by buckling the two semicircular cylinders is opposite to and abutted against the open end of the U-shaped track part.
2. The assembly of claim 1, wherein: the handles of the channel forceps are formed by pivoting two rigid handles; each rigid handle is fixedly connected with one semi-cylinder.
3. An assembly as claimed in claim 2, wherein: the two rigid handles are respectively provided with matched buckles at positions far away from the pivot point.
4. An assembly according to any one of claims 2 or 3, wherein: a spring piece is fixedly connected between the two rigid handles of the handle and is used for applying pressure to the two rigid handles to enable the two rigid handles to be relatively far away.
5. An assembly according to any one of claims 1-3, wherein: the distal end of the track cylinder of the channel clamp is provided with a second internal thread, namely the distal end of each semi-cylinder is respectively provided with a second internal thread, and two parts of the second internal threads form an integral second internal thread after the two semi-cylinders are buckled; the second internal thread is consistent with the first internal thread in specification, and when the channel pliers clamp the U-shaped track part of the fusion device, the second internal thread is connected with the first internal thread end to end.
6. An assembly according to any one of claims 1-3, wherein: the outer side walls of the two sides of the U-shaped track part are respectively provided with grooves distributed along the length direction of the U-shaped track part, and the pair of forceps heads of the channel forceps are long strip-shaped which can be embedded into the grooves; in a further preferred scheme, an anti-slip rough surface layer is arranged at the bottom of each groove and the inner surface of each clamp head and used for increasing the contact friction force between the rail guide clamp and the U-shaped rail part.
7. An assembly according to any one of claims 1-3, wherein: the contact surfaces of the U-shaped track part and the upper and lower vertebral bodies are provided with anti-slip teeth.
8. An assembly according to any one of claims 1-3, wherein: the inner walls of the two sides of the U-shaped track part are two sections of cambered surfaces in the same cylindrical surface, and the inner diameter of the track cylinder of the channel clamp is consistent with the diameter of the cylindrical surface where the two sides of the U-shaped track part are positioned; preferably, two sections of cambered surfaces on the inner walls of two sides of the U-shaped track part respectively occupy less than 1/4 of the cylindrical surface.
9. An assembly according to any one of claims 1-3, wherein: the through holes on the outer surface of the bullet-shaped hollow fusion body part of the fusion device are all strip-shaped through holes, and the trend of the through holes is crossed with the external threads; in a preferred scheme, the plurality of strip-shaped through holes are spirally and alternately distributed on the warhead-shaped hollow fusion body; preferably, each through hole edge on the bullet-shaped hollow fusion body is provided with a knife edge, the knife edge is divided into front and rear according to the rotation direction, and the edge of the knife edge is low in front and high in rear, namely, the front edge and the rear edge of the knife edge have height difference.
10. An assembly according to any one of claims 1-3, wherein: the bullet-shaped hollow fusion body part of the fusion device is provided with a semi-closed tail end, the end face of the tail end is provided with a recess, and the shape of the recess is matched with that of the head end of a conventional screwdriver; in the preferred scheme, the concave center is also provided with a through hole for additionally filling broken bones into the inner cavity of the bullet-shaped hollow fusion body part so as to make up for the defect of bone falling quantity and further increase the fusion rate.
CN202310718676.3A 2023-06-16 2023-06-16 Assembly for intervertebral fusion Pending CN116898641A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN202310718676.3A CN116898641A (en) 2023-06-16 2023-06-16 Assembly for intervertebral fusion

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202310718676.3A CN116898641A (en) 2023-06-16 2023-06-16 Assembly for intervertebral fusion

Publications (1)

Publication Number Publication Date
CN116898641A true CN116898641A (en) 2023-10-20

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Family Applications (1)

Application Number Title Priority Date Filing Date
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Country Status (1)

Country Link
CN (1) CN116898641A (en)

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