CN1935093A - 骨锚固装置 - Google Patents

骨锚固装置 Download PDF

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CN1935093A
CN1935093A CNA2006101375679A CN200610137567A CN1935093A CN 1935093 A CN1935093 A CN 1935093A CN A2006101375679 A CNA2006101375679 A CN A2006101375679A CN 200610137567 A CN200610137567 A CN 200610137567A CN 1935093 A CN1935093 A CN 1935093A
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head
anchor pole
anchoring device
bone anchoring
receiving portion
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CN1935093B (zh
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W·马蒂斯
L·比德曼
J·哈姆斯
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Biedermann Technologies GmbH and Co KG
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    • 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
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    • 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
    • A61B17/7085—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements for insertion of a longitudinal element down one or more hollow screw or hook extensions, i.e. at least a part of the element within an extension has a component of movement parallel to the extension's axis
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
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Abstract

一种骨锚固装置，包括：锚固元件，其包括锚于骨或椎骨内的锚杆(14)和头部(15)，所述头部具有带球截形部分(16)的外表面，其中所述锚杆(14)和所述头部(15)是分离的部件；接纳部分(1)，其包括第一端(2)、与第一端相对的第二端(3)、穿过所述两端的纵向轴线(4)、与纵向轴线同轴的孔(5)、与第二端(3)邻近的用于接纳所述头部的球截形部分(16)的第一区域(7)；和对所述头部(15)施压以将所述头部锁定在接纳部分内的元件(17；20；21)；其中，所述头部具有中空的内部(25)以接纳所述锚杆的自由端部(22)，并且所述头部和所述端部形成为使得在没有锁定所述头部时通过所述头部弹性地卡住所述端部。

Description

骨锚固装置
技术领域
本发明涉及骨锚固装置，该装置包括具有锚于骨内的锚杆和外表面呈球截形部分的头部的锚固元件、接纳所述头部的接纳部分和对所述头部施加压力的元件，其中所述锚杆部和所述头部是分离部件。
背景技术
从US6,835,196 B2已知这种类型的骨锚固装置。锚固元件的锚杆具有被头部中相应的孔所接纳的圆柱形端部，所述头部具有弹性弯曲边缘以便当对该头部施加压力时卡住所述锚杆的端部。在另一实施例中，锚杆的端部具有与头部内接纳所述端部的孔的内螺纹相配合的外螺纹。利用这种骨锚固装置，可以首先旋入该锚杆，如果必要的话调节该锚杆的长度，接着将它与包含头部的接纳部分连接。
US6,074,391公开了一种包括骨螺钉的骨锚固装置，该骨螺钉具有带螺纹的锚杆，该锚杆带有形成该锚杆自由端的球形部分。该骨锚固装置进一步包括在其内侧上具有向下会聚的锥形环形表面的接纳部。在该接纳部上所设的开槽支架包围所述球形部分并具有与接纳部的锥形表面相配的外锥形表面。支架内的多个狭槽允许当对所述支架施加压力时卡住锚杆的球形部分。
WO94/00066公开了一种人造骨固定装置，包括具有锥形头部的固定组件、设计成用于固定在骨中的邻近的锚固组件以及带有接纳锥形头部的锥形孔以便在内部卡住具有球截形孔的连接组件的球截形开槽夹具组件。该夹具组件具有带有呈球截形部分的外表面。通过将锥形头部拉入夹具组件内使得夹具组件展开以压靠连接组件的球截形孔来实现在连接组件内的固定组件的固定。
US6,063,090公开了一种用于杆和椎弓根螺钉的连接装置，该连接装置允许首先将带有球形头部的螺钉元件旋入骨中，其后将保持头扣合连接到球形头部上的杆。为了相对于保持头固定螺钉元件的角位，通过锥形弹簧卡盘卡住该球形头部。
发明内容
本发明的一个目的是提供一种具有将头和锚杆作为分离部件的骨锚固装置，这种分离部件便于该装置的预先装配并且当发生螺钉最终紧固到杆上时另外提供增强的固定。
通过根据权利要求1的骨锚固装置解决该目的。在从属权利要求中给出进一步的改进。
根据本发明的骨锚固元件具有这样的优点，即根据在手术期间或者手术之前特定情形的需要，它允许将不同大小的锚杆与分离头部和接纳部分结合起来。
利用根据本发明的骨锚固元件，可以首先将锚杆入骨中中，其后将包括球截形头部的接纳部分安装到锚杆上。由于锚杆的端部的锥体形状和头部的相配凹槽，即使该头部还没有锁定在其最终的多轴位置也可实现相对于锚杆的头部的预先固定。
如果锚杆的端部和头部凹槽的锥角是在大约2°到10°的确定范围内，则可以在球截形头部和锚杆之间实现自锁连接，该自锁连接确保头部不会无意地从锚杆上掉落或分离。
所述骨锚固装置进一步具有的优点在于由于不需要外部环圈或螺母所以它是很紧凑的。
附图说明
本发明进一步的特征和优点将从结合附图的实施例的描述中变得很明显。
图1显示了根据本发明一个实施例的骨锚固装置的截面图。
图2显示了根据图1的骨锚固装置的分解图。
图3显示了骨锚固元件头部的透视图，该骨锚固元件是根据图1的骨锚固装置的一部分。
图4显示了图1到3的骨锚固元件的头部和锚杆的端部的示意性剖面图。
图5a到c显示了所述锚固元件的锚杆的变形。
图6显示了连接到锚杆的头部的变形的示意性剖面图。
图7显示了用于图6的头部的一种工具的示意性侧视图。
图8a到8d显示了在原位置去除根据图1到4的头部和接纳部分连同工具的示意性步骤。
图9显示了用于根据图8a到8d步骤的工具的底视图。
具体实施方式
如图1到3所示，骨锚固装置包括接纳部分1，其基本上呈圆柱形并具有第一端2和与第一端相对的第二端3。该两个端部垂直于纵向轴线4。与纵向轴线4同轴地设置有同轴孔5，其从第一端2延伸到距第二端3的预定距离处。在第二端3处设有一开口6，其直径小于孔5的直径。该同轴孔5朝向开口6渐缩。在实施例中显示它以球状部分7的形式渐缩。
接纳部分1进一步具有U-形凹槽8，其从第一端2开始朝着第二端3的方向延伸到距所述第二端3的预定距离处。通过U-形凹槽，形成朝向第一端2终止的两个自由腿部9、10。与第一端2邻近，所述接纳部分1包括在所述腿部9、10处的内螺纹11。
骨锚固元件13包括带有骨螺纹的锚杆14和形成为分离部件并以图1所示的装配状态连接到锚杆的头部15。头部15具有球截形外表面部分16。头部15这部分的半径是这样的，即使得当在接纳部分1中接纳头部15时，通过与第二端3处的开口6邻近的球形部分7支撑头部15的球形外表面16或者通过开口6的边缘支撑头部15的球形外表面16使得头部15的部分15a从开口6中伸出来。如果没有在头部15上施加压力，则类似于球和球窝接合，在球形区域7中可枢转地保持头部15。
进一步，设置有压力元件17，其具有圆柱形结构，该圆柱形结构的外径仅比孔5的内径稍小以允许压力元件引入到接纳部分1的孔5中并可沿轴向移动。在其面向第二端3的下侧，压力元件17包括一球形凹槽18，该凹槽的半径对应于头部15的球形部分16的半径。在压力元件17的相对侧具有U-形凹槽19，其相对于纵向轴线4横向延伸。该U-形凹槽的横向直径选择为使得在接纳部分内接纳的杆20可被插入凹槽19并在其中被横向引导。球形凹槽19的深度选择为使得在装配状态下当把杆插入并压靠在U-形凹槽的底部时，压力元件17对头部15施加压力。
所述骨锚固装置进一步包括内螺钉21，可将其旋入腿部9、10之间以固定杆20并经由压力元件17对头部15施加压力。内螺纹11和内部螺钉21的对应的螺纹可以是任何已知的螺纹形式。然而，平螺纹和负角螺纹带来腿部9、10不会发生张开的优点，该优点可不必使用外螺母或圈环。
现在描述锚杆14和头部15的细节。锚杆14包括在头部15中所接纳的端部22。端部22具有朝直径为ds的自由端23变宽的截锥形状。优选地，锚杆的锥形端部22的锥角α选择为使得当锚杆连接到头部时能实现自锁连接。特别是在图2和3中所见的，头部15具有扁平的球体轮廓并在其面向第一端2的端部包括一孔24，该孔与接纳部分的纵向轴线4同轴并具有比锥形端部22的自由端23的最大直径ds稍大的直径。孔24允许引导穿过锥形端部22的外端23使得当完全插入锥形端部22时，如图1所示锥形端部22从头部15伸出。在其朝向接纳部分的第二端3的一侧，头部15具有形如中空的截锥形凹槽25，其尺寸使得当将锚杆插入到头部15中时，与锚杆的锥形端部22的尺寸相匹配。锥形凹槽25的角α’优选对应于端部22的角α或比角α更大。由凹槽25形成的下开口26具有直径db，该直径小于锚杆的锥形端部22的自由端23的最大直径ds。
如图2和3中所示，头部15具有多个纵向狭缝27，其开口在面向锚杆的端部22的端部并等距离地布置在圆周方向上。狭缝27具有足够的大小以允许凹槽25展开到使下开口26变宽允许锥形端部22插入并在其插入后弹性卡住该端部的程度。
如图4中所示，为了便于插入到头部15，锥形端部的自由端23可以具有倒角28。倒角28可以是弯曲的以便与压力元件17的凹槽18的曲率匹配。锥形凹槽25还可延伸贯穿整个头部15。
优选地，头部15中凹槽25的锥角α对应于端部22的锥角并被选择成当将锥形端部22插入到头部凹槽25中时实现自锁连接。一旦建立自锁连接，需要额外的力将该锥形端部从凹槽25中去除，该力大于将锥形端部插入到凹槽25中所必须的力。实现自锁效果的锥角优选在大约2°到10°之间，更优选为4°。
在第一操作模式中，选择合适的锚杆14并将其端部22连接到头部15。通过倒角28便于将锥形端部22穿过下开口26引入头部15中。通过插入端部22，将下开口26变宽并且由于狭缝27将锥形凹槽25展开以便允许整个锥形端部22的引入。如果角α选择为使得当将锚杆引入到头部中时建立自锁连接，则一旦将其插入到头部，该头部不会无意地掉落或移除。
接着，将包括已安装了头部15的锚杆14的骨锚固元件13通过引导带螺纹的锚杆14穿过接纳部分的开口6直到头部15抵靠在开口6的边缘而从笫一端2引入接纳部1中。其后，引入压力元件7并将该带螺纹的锚杆施入骨中。接着，相对于锚固元件13调整接纳部分1的角位并插入杆20。接着通过旋入内部螺钉21来固定该杆。内部螺钉21对压着压力元件17的杆20施加压力。压力元件17构成用于锚杆的端部22的自由端23的拱座。如此，将头部15压靠在球形区域7或开口6的边缘上使得由于狭缝27开口6的边缘挤压头部以卡住锚杆的端部22。另外，压力元件17压在端部22的自由端23上，因而将锥形端部22压入头部的锥形凹槽25中，由此实现头和锚杆之间的牢固连接，同时将头部锁在旋转位置中。
上述骨锚固装置的多个部件优选用身体相容性材料构成，象例如钛。
在第二操作模式中，首先将带螺纹的锚杆14旋入骨或椎骨中。为了这一目的，锚杆14在其自由端具有用于螺丝起子的已知的接合能力，例如六边形凹槽30，如图1所示。接着将接纳部分1和松弛的预装配头部15以及压力元件17一起压在从骨中伸出的锚杆14的锥形端部22上。为了实现该装配，需要一定的压力将头部15扣合到锥形端部上，即由于狭缝的作用头部15展开并咬合到锥形端部22上。将头部放置在锚杆上所需的压力取决于锥角和/或狭缝所提供的弹性。在这一状态中，虽然通过头部将锚杆卡住，但是该头部仍可在接纳部分内枢转。紧接着，插入杆20并相对于头部15调整接纳部分1的角位。其后，将内螺钉旋入腿部9、10之间直到它压在杆20上，杆20从而对头部15施压。
由于通过压力元件对头部15所施加的压力，将开槽的头部15牢固地连接或卡到锚杆上，防止其移动并同时将头部15锁在它的旋转位置。
如果必要，如图8a到8d和9中所示，在原处用工具将接纳部分1连同头部15从锚杆上分离开。首先，如图8a中所示去除内部螺钉和杆。在这一状态中，在接纳部分1中释放头部15但它仍卡位锚杆的端部22。紧接着，如图8b中所示使用工具100将头部15推入接纳部分1使得它不再从接纳部分的下开口6中伸出。
工具100包括纵向棒101，两个臂102、103从其上沿垂直方向延伸。将其中一个臂固定在距棒101的自由端104的一定距离处，使得棒的一部分105伸到臂103之上以便于抓握。在实施例中当工具使用时显示它为上臂103。另一个臂102可滑动地安装在纵向棒101上并能在另一端106的端部和朝着上臂103的方向上所希望的位置之间可变地固定以便在两臂之间改变距离。至少下臂102制成叉子形状以便能够包围锚杆14。当下臂102位于棒的端部106时，两臂间的距离大于接纳部分1的高度。
使用中，将该工具应用到接纳部分并使得下臂102位于接纳部分的端部(如图8b中所示)。接着，移动下臂102并压靠在接纳部分1的第二末端3，这样相对于头部15移动接纳部分1直到头部15完全在接纳部分中(如图8c中所示)。在这一状态中，头部的空间变宽使得当将工具连同接纳部分和头部一起从锚杆中拽离时，锚杆的端部22能被拉出(如图8d中所示)。
变化是可以的。例如，状替下臂上臂103是可滑动的。无需将可滑动臂固定在棒上而是可手动地将其压靠在接纳部分上。
端部22、头部15和接纳部分1的尺寸选择为使得在手术期间克服端部22和头部15之间的摩擦力所需要的力是可容许的。
图5a到5c显示了锚杆14的变化。图5a中锚杆14的直径d小于锥形部分22的最小直径。图5b中锚杆14的直径d大于锥形端部22的最小直径。图5c中锚杆包括邻近尖端141的螺纹部分140和不带骨螺纹的部分142。在所有变化中锥形端部22成形为使得其可被头部15的凹槽25接纳。
图6显示了头部变化的示意图。头部15′具有形如图1到4中所示实施例中的截锥凹槽25。然而同轴孔24′具有比锚杆的锥形端部的端23的直径小的直径。这样，凹槽25的上壁形成用于端部22的环形拱座28。孔24′的直径大小正好使它为旋入工具提供接近端部22的入口。为了允许在原位置将头部15连同接纳部分1从锚杆14上分离，头部具有接合装置用于接合工具，该工具保持头部使得当将接纳部分1从锚杆上拽离时，头部不会脱离开口6。图7显示了由手柄31和从手柄延伸并具有螺纹端部33的棒32所构成的工具30的例子。在这一情况下，孔24′包括用于接合螺纹端部33的内螺纹。在使用中，去除内部螺钉21和杆从而减轻头部15上的压力后，通过将螺纹尖端33旋入螺纹孔24′中，工具30抓住头部同时手动地将接钠部分从锚杆上拽离。用这种方式，锚杆的端部22从头部15中脱离。本发明并不限于上面描述的实施例。进一步的变化是能够想到的。例如，本发明并不限于具有螺纹锚杆的锚固元件。而是也可应用到由钩组成的锚固元件。在这种情况下，钩的自由端具有锥形端部22。
此外，锚杆14的形状和直径可以改变，并且骨螺纹的长度也可以改变。例如，其中锚杆具有无螺纹部分的图5c的变化也可应用到图5a或5b所示的锚杆上。
锥形端部22和中空截锥形凹槽25的锥角可选择为使得不存在自锁效果。在这种情况下，头部15上狭缝26的数量和形状必须选择为使得可以将头部15咬合到锥形端部22上。
代替头部15上的一些狭缝，可以仅有一个狭缝，该狭缝沿纵向在头部的整个壁上延伸。还有可能的是，除了图3中所示的狭缝外还有一个这样的连续狭缝。还可提供另外的狭缝，其朝向与下开口26相对的端部开口。进一步，还可以使形如中空截锥形凹槽25延伸穿过头部15，这样省略了孔24或24′。
在进一步的变化中，头部用具备弹性的材料，例如合适的塑性材料制成。在这种情况下，狭缝可以省略。
还可以改变接纳部分。只要开口6足够小以至于头部15不会掉落，球形部分7的半径可大于头部的半径。可以用其它形状，例如锥形的部分代替球形部分7。
进一步，压力元件17可具有不同的形状。压力元件的纵向长度可正好是当插入杆时通过突出于杆之上的U形凹槽19来形成腿部。在这种情况下，可以通过将内螺母旋入腿部9、10之间经由压力元件单独固定头部15以及通过将内螺钉旋入该螺母来单独固定杆。
接纳部分可以是骨平面的一部分。在这种情况下，接纳部分没有U形凹槽并且通过例如单独的内螺钉来产生头部15上的压力。

Claims (10)

1、一种骨锚固装置，包括：
锚固元件，其包括锚于骨或椎骨内的锚杆(14)和头部(15)，所述头部具有带球截形部分(16)的外表面，其中所述锚杆(14)和所述头部(15)是分离的部件；
接纳部分(1)，其包括第一端(2)、与第一端相对的第二端(3)、穿过所述两端的纵向轴线(4)、与纵向轴线同轴的孔(5)、与第二端(3)邻近的用于接纳所述头部的球截形部分(16)的第一区域(7)；和
对所述头部(15)施压以将所述头部锁定在接纳部分内的元件(17；20；21)；
其中，所述头部具有中空的内部(25)以接纳所述锚杆的自由端部(22)，并且所述头部和所述端部形成为使得在没有锁定所述头部时通过所述头部弹性地卡住所述端部。
2、如权利要求1的骨锚固装置，其中，所述端部(22)是锥形形状的且直径朝着自由端(23)增大，并且所述中空内部(25)具有匹配的形状。
3、如权利要求2的骨锚固装置，其中，所述锥形形状是截锥形。
4、如权利要求2或3的骨锚固装置，其中，锥角选择为使得在头部和端部之间发生自锁。
5、如权利要求4的骨锚固装置，其中，所述角在大约2到10°之间。
6、如权利要求1到5之一的骨锚固装置，其中头部(15)包括面向锚杆的端部(22)的类似弹簧的弯曲边缘。
7、如权利要求1到6之一的骨锚固装置，其中，头部(15)包括一个或多个狭缝(27)，该狭缝基本平行于头部的旋转轴线定向并在面向所述锚杆(14)的端部(22)的一侧开口。
8、如权利要求1到7之一的骨锚固装置，其中，所述头部的接纳锚杆端部的中空内部形成用于端部(22)的自由端(23)的拱座(28)。
9、如权利要求1到7之一的骨锚固装置，其中，中空的内部成形为中空的截锥形并从头部的一端延伸到相对端。
10、如权利要求1到9之一的骨锚固装置，其中，所述接纳部分(1)具有从第一端(2)沿着第二端(3)的方向延伸的U形凹槽(8)，其形成沟槽以接纳杆。
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US20120143264A1 (en) 2012-06-07
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US20090326587A1 (en) 2009-12-31
US8034089B2 (en) 2011-10-11
CN1935093B (zh) 2010-12-08
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US20070055240A1 (en) 2007-03-08

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