CN1812747A - Dynamic spine stabilizer - Google Patents
Dynamic spine stabilizer Download PDFInfo
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- CN1812747A CN1812747A CN 200480017893 CN200480017893A CN1812747A CN 1812747 A CN1812747 A CN 1812747A CN 200480017893 CN200480017893 CN 200480017893 CN 200480017893 A CN200480017893 A CN 200480017893A CN 1812747 A CN1812747 A CN 1812747A
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Abstract
A dynamic spine stabilizer moves under the control of spinal motion providing increased mechanical support within a central zone corresponding substantially to the neutral zone of the injured spine. The dynamic spine stabilizer includes a support assembly and a resistance assembly associated with the support assembly. The resistance assembly generates greater increase in mechanical force during movement within the central zone and lesser increase in mechanical force during movement beyond the central zone. A method for using the stabilizer is also disclosed.
Description
Technical field
The present invention relates to be used for the method and apparatus of spinal stabilization.More particularly, the present invention relates to be used for when spinal column property district motion therein, applying the method and apparatus of the mechanical resistance that increases progressively.
Background technology
Lumbago and backache is to make the industrialized society worries and spend one of maximum disease.Except that common cold, its diagnosis amount is all more than any other disease.Lumbago and backache in extensive range is from the interim violent anergy pain that can disappear in various degree chronic pain.The conservative treatment that can be used for lumbago and backache comprises: cold pack, physiotherapy, anesthetics, steroid and massotherapy.In case the patient has used up all conservative treatments, the scope of surgery selection scheme is performed the operation (micro discectomy) (a kind of less relatively operation is to alleviate the pressure to nerve root and spinal cord) to fusion (it eliminates spinal motion in pain level) from micro-lumbar discectomy exactly.
In the U.S., there are every year 200,000 patients of surpassing to carry out the waist fusion surgery.Though fusion is effective in about 70%, even but still there is adverse consequences in these successful operations, comprise that range of movement reduces and increase that this can quicken the degeneration of spine on those horizontal planes to the load transfer of the spine of adjacent level face.In addition, a considerable amount of back pain patient estimate to surpass 7,000,000 in the U.S., just stand chronic low back pain simply, can not be suitably or alleviate the risk of operation of their symptom effectively and do not emit.
New therapeutic device is referred to as exercise protection device, is just obtaining exploitation at present to address these restrictions.Some therapy likely is the form of (marrow) nucleus substitution art, (vertebra) dish replacement or facet (joint) replacement.Other exercise protection device provides the power type (dynamically) of damage and/or degenerated spine interior stable, and does not remove any spinal tissues.The main target of the method is that stabilizing spine is in case the pain that relieves the pain keeps nearly normal spinal function simultaneously.The main difference of this two type of motion protector is: the purpose of using displacement apparatus is the anatomical structure that displacement promotes the degenerated of motion, and the purpose of the interior stabilising arrangement of working power type (dynamically) is the spinal motion of stable and control abnormity.
More than ten years had proposed a kind of lumbago and backache hypothesis in the past, and dorsal column system is considered to by spinal column (vertebra, (intervertebral) dish and ligament), around the muscle of spinal column and help the neuromuscular control unit of stabilizing spine to constitute in the comings and goings of daily life in this hypothesis.Panjabi?MM.“The?stabilizing?system?of?the?spine.Part?I.Function，dysfunction，adaptation，and?enhancement.”J?Spinal?Disord?5(4)：383-389，1992a。An inference of this hypothesis is, when spinal column sustains damage or needs strong spinal muscle during regression.When with neutral posture (neutral posture) when standing, this is especially correct.Panjabi?MM.“The?stabilizing?system?of?the?spine.Part?II.Neutral?zone?and?instability?hypothesis.”J?Spinal?Disord?5(4)：390-397，1992b。In other words, back (disease) needs of patients has the muscular strength of enough fine coordinations, strengthens and the necessary muscle of locating of training, so that maximum protection can be provided when they stand with neutral posture.
Dynamic stabilization (non-fusion) device needs certain functional, so that impaired (having damage that mechanical integrity reduces or the regression) spinal column of auxiliary back (disease) patient.Specifically, these devices provide mechanical assistance must for impaired spinal column, especially in the neutral area that needs most it." neutral area " is meant the preceding lower area (toe-region) (referring to Fig. 1) of the moment-rotating curve of the zone of lower vertebral rigidity (stiffness) or spinal segments.Panjabi?MM，Goel?VK，Takata?K.1981?Volvo?Award?in?Biomechanics.“Physiological?Strains?in?Lumbar?spinal?Ligaments，an?in?VitroBiomechanical?Study.”Spine?7(3)：192-203，1982。The neutral area is normally defined around the core of the scope of neutral posture motion, and the soft tissue dough-making powder joint of spinal column provides minimum resistance to spinal motion herein.As shown in Figure 1, this notion shows with the load-displacement or the moment-rotating curve of the spinal column of not damaged and damage very visually.Notice that these curves are non-linear; That is to say that the spinal column mechanical performance changes with the amount of angle and/or rotation.If the curve of our imaginations on positive side and minus side is illustrated respectively in the spinal column behavior of case of bending and extended configuration, then represent vertebral rigidity at the slope of curve every bit so.As seen in Figure 1, the neutral area is the low stiffness region of range of movement.
Experiment shows that after spinal injury or owing to regression, neutral area and range of movement increase (referring to Fig. 1).Yet when being described as the percent of corresponding not damaged value, the neutral area is bigger than the degree that range of movement increases.This means that the neutral area is than better spinal injury of range of movement and instable tolerance.Clinical research finds that also the scope that motion increases is not relevant with lumbago and backache well.Therefore, unsettled spinal column especially needs in the neutral area to be stablized.Stabilising arrangement must be flexible in the power type so that with spinal motion, thereby make (vertebra) dish, face joint and ligament normally physiological movement and (bearing) for keeping its good equilibrium state necessary load.These devices also must adapt to the different physical characteristics of each patient and human body (anatomy), so that obtain ideal position by each patient.
Consider above-mentionedly, it will be apparent to one skilled in the art that needs a kind of spinal stabilization device that overcomes the shortcoming of prior-art devices.The present invention provides so a kind of apparatus and method for spinal stabilization.
Summary of the invention
Therefore, an object of the present invention is to provide a kind of method that is used for spinal stabilization.This method is to provide the mechanical assistant of resistance form to realize by the vertebra that power type (dynamically) regulator is fixed in spinal column and to the spine regions that connects the dynamic stabilization device.This resistance applies in the following manner: bigger mechanical assistant is provided when spinal column is therein around the property district, and provides less mechanical assistant during above its neutral area when rachiocamposis.
Another purpose of the present invention provides a kind of power type (dynamically) regulator, and this dynamic stabilization device moves under the control of spinal motion, thereby the mechanical support of increase is provided in the center that corresponds essentially to damage spinal column neutral area.This regulator comprises supporting component and the resistance assembly that links to each other with supporting component.This resistance assembly produces resistance, applies bigger resistance to moving in moving process in the center, then applies lower resistance to moving when (extended movement) moved in the expansion that surpasses its center in the regulator.
Another object of the present invention provides a kind of dynamic stabilization device, and this dynamic stabilization device comprises piston component and the resistance assembly that interrelates with piston component.This resistance assembly is made up of first spring and second spring, and piston component becomes definite shape and size, is used for resistance assembly is connected to main component (housing member).
According to the detailed description of hereinafter carrying out in conjunction with the accompanying drawings, other purpose and advantage of the present invention will be more clear, wherein description of drawings some specific embodiment of the present invention.
Description of drawings
Fig. 1 is the moment-rotating curve of spinal segments (not damaged and damage), and it shows the low vertebral rigidity in the neutral area.
Fig. 2 is the moment-rotating curve of the sketch of spinal segments together with spinal segments, and it shows the low vertebral rigidity in the neutral area.
Fig. 3 a be sketch of the present invention together with force-displacement curve, it shows provides the resistance that increases in the center of present dynamic spine stabilizer.
Fig. 3 b is a force-displacement curve, and it shows by spring replaces the variation that has realized scattergram.
Fig. 3 c is the dorsal view that is fixed with the spinal column of a pair of regulator thereon.
Fig. 3 d is the side view of the regulator of extended state.
Fig. 3 e is the side view of the regulator of compressive state.
Fig. 4 is the sketch of present dynamic spine stabilizer.
Fig. 5 is the sketch according to a kind of interchangeable specific embodiment of the present invention.
Fig. 6 is moment-rotating curve, and it illustrates that this regulator helps the mode of spinal stabilization.
Fig. 7 a and Fig. 7 b are respectively the free housing sketch map of this regulator and the sketch of representing the center of this regulator.
The specific embodiment
To disclose the detailed specific embodiment of the present invention here.Yet should understand that the disclosed specific embodiment only is an illustrative embodiments of the present invention, it can be implemented with different forms.Therefore, disclosed here details is not to be used for restriction, and only how to implement and/or use basis of the present invention as the basis of claim and as instruction those skilled in the art.
With reference to Fig. 2,3a-e and 4, it has disclosed the method and apparatus that is used for spinal stabilization.According to a kind of preferred embodiment of the present invention, realize that the method for spinal stabilization is: by internal motivation type (dynamically) spine stabilizer 10 being fixed between the adjacent vertebra 12,14 and the mechanical assistant of elastic resistance form being provided to the spine regions of connection dynamic spine stabilizer 10.Function as displacement applies elastic resistance, so that provide bigger mechanical assistant therein during the property district when spinal column, and less mechanical assistant is provided when rachiocamposis surpasses its neutral area.Though in whole description, all use the term elastomeric resistance, in the case of without departing from the spirit of the present invention, can adopt the resistance of other form.
Know as those skilled in the art, and the content of as above being gone back that " neutral area " is interpreted as being meant the preceding lower area (referring to Fig. 2) of the moment-rotating curve of the zone of lower vertebral rigidity or spinal segments.That is to say that the neutral area can be considered to be meant the relaxation area around the neutral resting position of spinal segments, has minimum resistance for intervertebral motion herein.The scope of neutral area is considered to have the importance of highly significant when determining spinal stability.Panjabi，MM.“The?stabilizing?system?of?the?spine.Part?II.Neutral?zone?and?instability?hypothesis.”J?Spinal?Disorders?1992；5(4)：390-397。
In fact, the inventor utilized " spheroid in the bowl " to describe the load displacement curve relevant with spinal stability do analogy in the past.According to this analogy, the shape of bowl is represented spinal stability.Bowl is deeply felt more and is shown more stable spine, and the shallow more spinal column of then representing of bowl is unstable more.The inventor supposed in the past that for the people who does not have spinal injury, it had normal neutral area (that part of range of movement that intervertebral motion is existed minimum drag) and normal range of movement, thereby does not have spinal pain.In this case, bowl is not too dark also not too shallow.Yet when damage betided anatomical structure, the neutral area of spinal column can increase, and spheroid can freely move on bigger distance.By this analogy, bowl should be more shallow and spheroid is more unstable, so pain is from the neutral area of this expansion.
Usually, utilize easily tolerance and surgical procedures well known to those skilled in the art, dynamic spine stabilizer 10 is connected in the vertebra 12,14 of spinal column with pedicle screw (pedicle nail) 16,18.According to the preferred specific embodiment, and know, come balance to put on the load (referring to Fig. 3 c) of spinal column with a pair of regulator that joins usually as those skilled in the art.Dynamic spine stabilizer 10 helps impaired (damage and/or degenerated) spinal column of back pain patient, and helps s/he to carry out daily routines.Dynamic spine stabilizer 10 is by to spinal motion, and especially the spinal motion around the neutral posture in the zone that is centered around the neutral area provides controlled resistance to carry out above-mentioned help.When spinal column regulator 10 when front curve (flexing) is stretched (referring to Fig. 3 d), and regulator 10 is compressed (referring to Fig. 3 e) when spine bends backward (stretching, extension).
The resistance to displacement that is provided by dynamic spine stabilizer 10 is non-linear, and heart district maximum therein, so that consistent with (patient) individual neutral area; That is to say that the center of regulator 10 provides high-caliber mechanical assistant on the support spinal column.When individuality was moved beyond the neutral area, the increase of resistance dropped to more moderate level.Therefore, when in the neutral area when mobile, the patient runs into the bigger resistance (or bigger resistance that increases progressively) to moving.
The center of dynamic spine stabilizer 10, that is, 10 pairs of spine stabilizers move the range of movement that maximum resistance is provided, and can be regulated when surgical operation to be fit to each patient's neutral area.Can before operation and in the operation, be regulated by the resistance that dynamic spine stabilizer 10 provides moving.This helps to adjust the mechanical performance of dynamic spine stabilizer 10 to be fit to the compromised spine of single patient.The length of dynamic spine stabilizer 10 also can be regulated in operation with the dissection that is fit to single patient and be organized structure, and reaches desirable spinal posture.Can after operation, carry out re-adjustment to dynamic spine stabilizer 10, in order to regulating its center, thereby satisfy the needs that the patient has changed by means of surgical operation.
Ball-and- socket joint 20,22 connects dynamic spine stabilizer 10 and pedicle screw 16,18.Dynamic spine stabilizer 10 is freely with being connected of pedicle screw 16,18, and unrestricted in rotation.Therefore, at first, spinal column can carry out all physiological movements crooked and that reverse, and secondly, dynamic spine stabilizer 10 and pedicle screw 16,18 are protected, in order to avoid be subjected to deleterious bending and rotatory force or moment.Though preferred embodiment according to the present invention has disclosed ball-and-socket joint, under the situation that does not depart from spirit of the present invention, can use other syndeton.
Because all there is ball-and- socket joint 20,22 in each end of 10 in the regulator, therefore there is not bending moment to be delivered to regulator 10 from spinal column.In addition, to recognize importantly that the only power that acts on regulator 10 is the caused power of power by its inner spring 30,32.These power only depend on stretching and the compression by the determined regulator 10 of spinal motion.In a word, spring force is only born in regulator 10.Irrelevant with epispinal heavy load (when carrying or lifting than heavy load as the people), the load that arrives regulator 10 only is the power of appearance regulator 10 in, and it is the result of spinal motion rather than the result of spinal load.Therefore, regulator 10 can be assisted spinal column uniquely and need not bear the high load capacity of spinal column, thereby obtains design alternative widely.
In this regulator 10, the loading of pedicle screw 16,18 also with the pedicle screw fixation device of prior art in be loaded with a great difference.Only load that regulator pedicle screw 16,18 bears is the power from regulator 10.This changes into the pure axial force in ball joint-screw interface.Compare with the pedicle screw emerging system of prior art, this mechanism can reduce to place the bending moment on the pedicle screw 16,18 widely.Because the cause of ball-and- socket joint 20,22, the bending moment in pedicle screw 16,18 are zero at ball-and- socket joint 20,22 places, and it is towards the end increase of pedicle screw 16,18.The zone of pedicle screw-bone interface, it often is failure site (failure site) in the pedicle screw fixation device of typical prior art, is the position that is subjected to stress minimum, therefore can not lose efficacy.In a word, when using together with the present invention, pedicle screw 16,18 bears significantly littler load than common pedicle screw and is under the significantly littler stress.
In Fig. 2, the moment-rotating curve of healthy spine has been shown in the structure with this regulator 10.This curve shows that the moving resistance that runs into is very low in the neutral area of healthy spine.Yet, as by the neutral area expansion proved, when spinal column is damaged, this curvilinear motion and spinal column become unstable (referring to Fig. 1).
According to preferred embodiment of the present invention, the people who suffers from spinal injury can obtain best treatment by the mechanical assistant that applies increase in the neutral area.When spinal column moves when exceeding the neutral area, the mechanical assistant that needs can descend and become more moderate.Especially, and with reference to Fig. 3 a, disclosed according to the present invention the support profile of imagination.
Three kinds of different scattergrams have been shown in Fig. 3 a.Disclosed scattergram only is exemplary, and support requirement possible in the neutral area has been described.Scattergram 1 representative needs bigger auxiliary individuality in the neutral area, so the center of regulator is increased, and high-caliber resistance is provided in bigger displacement range; Scattergram 2 representatives need less auxiliary individuality in the neutral area, so the center of regulator is more moderate, and the resistance of increase is provided in more limited displacement range; And the such situation of scattergram 3 representative: only need in the neutral area bigger a little auxiliary, the center that therefore can reduce the regulator with in addition littler displacement range the resistance of increase is provided.
Know that as those skilled in the art the mechanical assistance that needs and the scope of neutral area will be with individual different the variations.Yet basic principle of the present invention remains unchanged; That is, suffer unstable spine individual qualitatively, in the neutral area of individuality, need bigger mechanical assistance for those.This auxiliary be with providing of in the center of the neutral area of individuality and dynamic spine stabilizer 10, providing to moving bigger resistance form.
The dynamic spine stabilizer 10 of exploitation provides the mechanical assistant that meets disclosed support profile (assisting) according to the present invention.In addition, by means of the concentric spring design, this regulator 10 provides controllability.
More particularly, when spinal column left neutral posture on any physiology direction, dynamic spine stabilizer 10 provided auxiliary (help) with the form that increases mobile resistance (being provided by spring according to the preferred specific embodiment) for impaired spinal column.As mentioned above, the force-displacement relationship curve that is provided by dynamic spine stabilizer 10 according to the present invention is non-linear, around the center of the neutral area of spinal column and regulator 10, has bigger PR, and when individuality is moved beyond the neutral area, outside the center of dynamic spine stabilizer 10, has the PR that reduces (a) referring to Fig. 3.
With reference to Fig. 3 a, further show this regulator 10 and the relation curve between the power that applies between stretching and compression period.As mentioned above, the behavior of this regulator 10 is non-linear.Load-displacement curves has three districts: drawing zone, center and compressional zone.If K1 and K2 have defined the rigidity value in stretching and compressional zone respectively, design this regulator so and make that the high rigidity in the center is " K1+K2 ".With discussed in detail, it depends on the width of the preloading of regulator 10, center as hereinafter, and the width in high rigidity zone therefore can be regulated.
With reference to Fig. 4, disclosed according to dynamic spine stabilizer 10 of the present invention.This dynamic spine stabilizer 10 comprises the supporting component of housing 20 forms, and its middle shell 20 is made up of first housing member 22 and second housing member 24.By means of the external screw thread on the opening 26 that is formed on first housing member 22 be formed on female thread on the opening 28 of second housing member 24, telescopically (telescopically) connects first housing member 22 and second housing member 24.Like this, by being screwed into second housing member 24, first housing member 22 just can finish housing 20.Like this, and as hereinafter with discussed in detail, can easily regulate the relative distance between first housing member 22 and second housing member 24, so that regulate first spring 30 be included in the housing 20 and the compression of second spring 32.Though preferred embodiment according to the present invention has adopted spring, in the case of without departing from the spirit of the present invention, can adopt other elastic component.Piston component 34 is connected in first and second ball-and- socket joints 36,38 with first spring 30 and second spring 32.First and second ball-and- socket joints 36,38 itself are arranged to definite shape again and are designed for selectivity connect the pedicle screw 16,18 that stretches out from respective vertebrae 12,14.
By means of screw-threaded engagement member 40, first ball-and-socket joint 36 is fixed on the closing end 38 of first housing member 22, wherein the shape and size of screw-threaded engagement member 40 are suitable for engaging, and thread-shaped is formed in the opening 42, and opening 42 is formed in the closing end 38 of first housing member 22.Like this, the closing end 38 of closed basically first housing member 22 of first ball-and-socket joint 36.By rotating first ball-and-socket joint 36, can easily regulate the length of dynamic spine stabilizer 10 with the overlapping degree between the mesh component 40 of regulating first housing member 22 and first ball-and-socket joint 36.Know as those skilled in the art, though disclosed the screw-threaded engagement between the mesh component 40 of first housing member 22 and first ball-and-socket joint 36 according to preferred embodiment, under the situation that does not depart from spirit of the present invention, can adopt other connected structure.
The closing end 44 of second housing member 24 is equipped with protecting cover 46, is formed with opening 48 in protecting cover.With discussed in detail, 48 one-tenth definite shapes of opening and size are as the passage from the piston rod 50 of piston component 34 by this opening as hereinafter.
Piston component 34 comprises: piston rod 50; First and second springs 30,32; And maintenance bar (fixed bar, retaining rods) 52.Piston rod 50 comprises stop-nut 54 and in the enlarged head 56 of its first end 58.Enlarged head 56 is rigidly connected in piston rod 50, and comprises guide hole 60, by this guide hole, keeps bar 52 to extend in the work process of present dynamic spine stabilizer 10.Therefore, when first ball-and-socket joint 36 is shifted to and removed to second ball-and-socket joint 38, enlarged head 56 was along keeping bar 52 being directed.With discussed in detail, when extension (stretching) dynamic spine stabilizer 10 and when flexion moves spinal column, the enlarged head 56 and first spring 30 interact to produce resistance as hereinafter.
Stop-nut 54 is assembled on the piston rod 50, so that move freely with respect to piston rod.Yet, keep bar 52 to stop stop-nut 54 to move to first ball-and-socket joint 36, wherein keep bar 52 to support stop-nut 54 and stop stop-nut 54 to shift to first ball-and-socket joint 36.With discussed in detail, when compression power type spine stabilizer 10 and when extended configuration moves spinal column, the stop-nut 54 and second spring 32 interact to produce resistance as hereinafter.
As above institute's simple declaration, first and second springs 30,32 are accommodated in the housing 20.Especially, first spring 30 extends between the protecting cover 46 of the enlarged head 56 of piston rod 50 and second housing member 24.Second spring 32 extends between the stop-nut 54 of the far-end of the mesh component 64 of second ball-and-socket joint 38 and piston rod 50.The preload force that is applied by first and second springs 30,32 remains on resting position in the housing 20 with piston rod, so that piston rod can move between the stretching, extension of spinal column or flexion stage.
In use, when mobile vertebra 12,14 under flexion and when second ball-and-socket joint 38 draws back first ball-and-socket joint 36, piston rod 50 is pulled against the power that first spring 30 applies in housing 24.Specifically, the enlarged head 56 of piston rod 50 is shifted to the closing end 44 of second housing member 24.This motion causes the compression of first spring 30, thereby to the mobile generation resistance of spinal column.For second spring 32, this second spring 32 leaves from second ball-and-socket joint 38 with piston rod 50.When vertebra moved with flexion in the neutral area, the height of second spring 32 increased, thereby has reduced the power of strutting (distractiveforce), and had in fact increased the resistance of device to moving.By this mechanism, when spinal column in flexion when initial position moves, (promptly by the load that increases the load in the spring (that is first spring 30) or impel motion by minimizing, second spring 32), equal direct the strutting of resisting apparatus (distraction) of spring 30 and spring 32.
Yet, when spinal column is in extended configuration and second ball-and-socket joint 38 and shifts to first ball-and-socket joint 36, the mesh component 64 of second ball-and-socket joint 38 is shifted to stop-nut 54, and this stop-nut is held bar 52 and remains on the appropriate location when piston rod 50 is shifted to first ball-and-socket joint 36.This move causes the mesh component 64 that is contained in second ball-and-socket joint 38 and the compression of second spring 32 between the stop-nut 54, in order to the mobile generation resistance to dynamic spine stabilizer 10.For first spring 30, this first spring 30 is supported between protecting cover 46 and the enlarged head 56, and when vertebra moved under extended configuration in the neutral area, the height of second spring 30 can increase, thereby reduce compression stress, and in fact can increase the resistance of device moving.By this mechanism, when spinal column from initial position under extended configuration when mobile, (promptly by the load that increases the load in the spring (that is second spring 32) or impel motion by minimizing, first spring 30), all directly compressions of resisting apparatus of spring 32 and spring 30.
Disclosed as the present invention, based on the elastomeric spring 30,32 that uses two concentric locatings, present dynamic spine stabilizer 10 provides auxiliary (power) scattergram as shown in Figure 2.That is, when in the center in the regulator during mobile dynamic spine stabilizer 10,30,32 associated working of first and second springs are to provide bigger elastic force.Yet, in case the expansion of the displacement between first ball-and-socket joint 36 and second ball-and-socket joint 38 exceeds the center of regulator 10 and the neutral area of the spinal motion of (use) individuality, the PR that moves is then significantly reduced, and this is no longer need required assisting significantly in the neutral area because (use) is individual.This is to finish by the center that the disclosed device of this paper is set.The center of power displacement curve is the zone of curve, and it is illustrated in when two springs all work in the aforesaid device.When the motion of spinal column outside the neutral area and the elongation of relevant device or when being compressed in outside the center that sets, the spring of elongation reaches its drift.Understand that as those skilled in the art drift is the spring length when not applying power.In this mechanism, outside center (two springs all work with resisted movement herein): be spring 30 or be spring 32 at extended configuration in flexion to installing the resistance that mobile resistance only depends on a spring.
As above institute's simple declaration, dynamic spine stabilizer 10 is to regulate with respect to the rotation of second housing member 24 by first housing member 22.This athletic meeting changes the distance between first housing member 22 and second housing member 24 in some way, and it finally can change and places preloading on first and second springs 30,32.This variation that preloads has changed the resistance diagram of present dynamic spine stabilizer 10: to the increase that preloads (referring to the scattergram 1 of Fig. 3 a), the increase that preloads has enlarged the effective range of first and second springs, 30,32 complete coordinative roles from the scattergram 2 that is shown in Fig. 3 a.The center width of the regulator 10 of this increase is relevant with higher in larger scope rigidity at spinal motion.As what obviously see from 3 of the scattergrams of Fig. 3 a, this effect is also set up conversely.
Present dynamic spine stabilizer 10 is connected in the pedicle screw 16,18 that partly stretches out from the vertebra that needs to support.Between the setting stage, the size of the center of regulator can be regulated at each patient, as being judged by surgeon and/or being quantized by the unstability measuring device at the surgical operation of dynamic spine stabilizer 10.This adjustable feature of this dynamic spine stabilizer 10 illustration in addition in three illustrative scattergrams, these scattergrams are to produce (referring to Fig. 2 according to preferred embodiment of the present invention; The width of attention device center).
Before operation, can be with on the same group first and second elastomeric springs 30,32 of spring alternate power type spine stabilizer 10 not, qualitative to adapt to wider unstable spine.As indicated in Fig. 3 b, when with the curve ratio shown in the scattergram 2a of Fig. 3 b than the time, scattergram 2b shows the power displacement curve that is produced by more inflexible one group of spring.
In operation,, organize structure and desirable spinal posture so that adapt to different patients' dissection with lengthening regulator 10 by the length that the mesh component 40 that rotates first ball-and-socket joint 36 can be regulated dynamic spine stabilizer 10.Before operation, can change piston rod 50 to adapt to even the variation of wider anatomical tissue structure.
Routine tests its load-displacement relationship of present dynamic spine stabilizer 10.When applying pulling force, this dynamic spine stabilizer 10 shows the resistance that increases up to predetermined displacement, and the speed that then increases resistance reduces, and reaches its complete extended position up to device.When being compressed, this dynamic spine stabilizer 10 shows the resistance that increases up to predetermined displacement, and the speed that then increases resistance reduces, and reaches its complete compression position up to device.Therefore, this dynamic spine stabilizer 10 presents nonlinear load-displacement curves, has maximum resistance for the displacement around neutral posture.This specific character helps to make the load-displacement curves normalization of compromised spine.
In another specific embodiment of the design, with reference to Fig. 5, regulator 110 can be arranged with serial spring and be constructed.According to this specific embodiment, housing 120 is made up of first and second housing members 122,124, and these housing members have controllability with threads engage.First ball-and-socket joint 136 stretches out from first housing member 122.Second housing member 124 is provided with opening 148, by second end, 162 extensions of this opening piston rod 150.Second end 162 of piston rod 150 is connected on second ball-and-socket joint 138.Second ball-and-socket joint 138 is screwed onto on the piston rod 150.
Piston rod 150 is included in the enlarged head 156 of its first end 158.First and second springs 130,132 are separately fixed between the closing end 138,144 of the enlarged head 156 and first and second housing member 122,124.Like this, utilize the theory of mechanics identical with previous embodiment, regulator 10 can all provide resistance to launching and compressing.
Realize by rotating first housing member 122 for adjusting with respect to second housing member 124 according to the resistance diagram of this replaceable specific embodiment.The center of the high-drag that is provided by regulator 110 has been provided in the rotation of carrying out by this way.As previously mentioned, also can change one or two spring to change the slope of force-displacement curve respectively in two or three districts.
In order to explain that how regulator 10,110 assists impaired spinal column (neutral area of increase), now observes moment-rotating curve (Fig. 6).Fig. 6 shows four curves: 1. not damaged, 2. damage, 3. regulator, and 4. damage+regulators.These curves are respectively that intact spine, damage spinal column, independent regulator and regulator add the moment-rotating curve that damages spinal column.Notice that this curve is near intact curve.Thereby, the regulator that bigger resistance is provided around neutral posture mobile is suitable for compensating ideally the unstability of spinal column.
Except that above-mentioned dynamic spine stabilizer, it is contemplated that other auxiliary device.For example, can provide connecting device, be used to connect left stabilizer unit and right stabilizer unit, with pivot and lateral thrust aspect help to provide additional stability.This connecting device will be replenishing of dynamic spine stabilizer.On the single patient basis, when needs, can use it.In addition, can use the spinal stabilization measuring device.This measuring device will quantize the stability of each spinal level when surgical operation.This device will be connected to a pair of adjacent spine on undermined and unimpaired spinal level face (or spinal column osteomere) in operation, to measure the stability of each horizontal plane.Can be used for determining suitable adjusting with respect to the stability measurement of the adjacent not injured level of injured level to device.In addition, by with reference to the tabular data storehouse of normally not damaging spinal stability, can be used for device is regulated for the stability measurement that damages the spinal level face.This device will be simple and firm, so that provide information in the simplest as far as possible mode to surgeon under surgical condition.
For obtaining desirable power distribution curve, for depending on the basic physical law according to the selection of spring used in the present invention, the power that its domination is produced by spring.Especially, the power scattergram of more than describing and be shown in Fig. 3 a is that the unique design by this regulator realizes.
At first, all work under compression and extended state in this regulator, even two springs in the regulator all are compression-types.Secondly, the higher rigidity (K that provides by this regulator in the center
1+ K
2) be because existence preloads.When existence preloads, two springs are worked together.When the regulator was stretched or compressed, power in a spring increased and power in another spring reduces.When the power that reduces reaches null value, spring corresponding to this power no longer works, thereby, reduced stabilizer function, a kind of project analysis, it comprises the sketch that is shown among Fig. 7 a and the 7b, is described below (this analysis is particularly related to the specific embodiment that is disclosed among Fig. 5, though those skilled in the art will understand that it is applied in the method for all specific embodiment of disclosure according to the present invention).
F
0Be preloading in the regulator, it is introduced by the principal length that shortens aforesaid housing.
K
1And K
2Being the stiffness coefficient of compression spring, is effective between regulator stretching and compression period respectively.
F and D are respectively power and the displacement of regulator (vertebra) dish with respect to the main body of regulator.
The summation that acts on the power of (vertebra) dish must equal zero.Therefore,
F+ (F
0-DxK
2)-(F
0+ DxK
1)=0, and
F＝Dx(K
1+K
2)。
For center (CZ) width (referring to Fig. 3 a):
At tensile side CZ
TBe:
CZ
T＝F
0/K
2。
At compressed side CZ
CBe:
CZ
C＝F
0/K
1。
Know that as those skilled in the art the principle that constitutes basis of the present invention can be applied to other medical procedure.Therefore, in the case of without departing from the spirit of the present invention, these principles can be applied beyond spinal treatments.
Though illustrated and described the preferred specific embodiment; but should understand; disclosed content is not to be used to limit the present invention, but is used for covering all improvement in appended spirit of the present invention that claim limited and the protection domain and replaces structure.
Claims (24)
1. method that is used for spinal stabilization may further comprise the steps:
The dynamic stabilization device is fixed in the vertebra of spinal column;
The described spine regions that connects described regulator is provided the mechanical assistant of resistance form, wherein apply described resistance so that bigger mechanical assistant is provided when described spinal column is therein around the property district, and provides less mechanical assistant during above its neutral area when described rachiocamposis.
2. method according to claim 1, wherein pedicle screw is connected in described vertebra with described regulator.
3. method according to claim 1, wherein ball-and-socket joint is connected in described regulator with described pedicle screw.
4. method according to claim 1 is non-linear by the described resistance that described regulator provides wherein, and heart district maximum therein, so that corresponding to patient's described neutral area.
5. method according to claim 1 further comprises and regulates the step of described resistance with suitable patient's described neutral area.
6. method according to claim 5, wherein said regulating step carries out before operation.
7. method according to claim 5, wherein said regulating step carries out in operation.
8. method according to claim 5, wherein said regulating step carries out after operation.
9. dynamic stabilization device, described dynamic stabilization device move under the control of spinal motion, thereby the mechanical support of increase is provided in the center that corresponds essentially to damage spinal column neutral area, and described regulator comprises:
Supporting component;
The resistance assembly that links to each other with described supporting component, wherein said resistance assembly produces resistance, in described center, apply bigger resistance to moving in the moving process, then apply less resistance when the expansion outside described regulator surpasses its center is mobile moving.
10. regulator according to claim 9, wherein said resistance assembly further comprises into the piston component of definite shape and size, is used for described resistance assembly is connected in the adjacent vertebrae of spinal column.
11. regulator according to claim 10 further comprises the ball-and-socket joint that is fixed in described piston component, described ball-and-socket joint becomes definite shape and size, is used for optionally being connected to the pedicle screw that stretches out from several respective vertebrae.
12. regulator according to claim 9, wherein said resistance assembly comprise first spring and second spring.
13. regulator according to claim 12, wherein said first spring and described second spring are concentric.
14. regulator according to claim 12, wherein said first spring and described second spring are linear.
15. regulator according to claim 9, wherein said supporting component is made up of housing, first housing member and second housing member.
16. regulator according to claim 15, wherein said first housing member is connected with the described second housing member telescopically.
17. regulator according to claim 16, the relative distance between wherein said first housing member and described second housing member can easily be carried out adjusting, so that regulate preloading on the described resistance assembly.
18. a dynamic stabilization device comprises:
Piston component; And
With the resistance assembly that described piston component links to each other, wherein said resistance assembly is made up of first spring and second spring, and described piston component becomes definite shape and size, is used for described resistance assembly is connected to main component.
19. regulator according to claim 18 further comprises the ball-and-socket joint that is fixed in described piston component, described ball-and-socket joint becomes definite shape and size, is used for optionally being connected to the pedicle screw that stretches out from described main component.
20. regulator according to claim 18, wherein said first spring and described second spring are concentric.
21. regulator according to claim 18, wherein said first spring and described second spring are linear.
22. regulator according to claim 18 comprises that further described resistance assembly is supported on housing wherein, described housing is made up of first housing member and second housing member.
23. regulator according to claim 22, wherein said first housing member is connected with the described second housing member telescopically.
24. regulator according to claim 23, the relative distance between wherein said first housing member and described second housing member can easily be carried out adjusting, so that regulate preloading on described first and second springs.
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US46741403P | 2003-05-02 | 2003-05-02 | |
| US60/467,414 | 2003-05-02 | ||
| US60/506,724 | 2003-09-30 | ||
| US10/835,109 | 2004-04-30 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN1812747A true CN1812747A (en) | 2006-08-02 |
Family
ID=36845292
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 200480017893 Pending CN1812747A (en) | 2003-05-02 | 2004-04-30 | Dynamic spine stabilizer |
Country Status (2)
| Country | Link |
|---|---|
| CN (1) | CN1812747A (en) |
| ZA (1) | ZA200508821B (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105310758A (en) * | 2015-03-18 | 2016-02-10 | 周军 | Intervertebral disc stabilizer and method for applying same |
-
2004
- 2004-04-30 CN CN 200480017893 patent/CN1812747A/en active Pending
- 2004-04-30 ZA ZA200508821A patent/ZA200508821B/en unknown
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105310758A (en) * | 2015-03-18 | 2016-02-10 | 周军 | Intervertebral disc stabilizer and method for applying same |
| CN105310758B (en) * | 2015-03-18 | 2017-08-01 | 周军 | A kind of intervertebral disk stabilizer and its application method |
Also Published As
| Publication number | Publication date |
|---|---|
| ZA200508821B (en) | 2008-01-30 |
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