CN1965769B - 骨锚固装置 - Google Patents

骨锚固装置 Download PDF

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CN1965769B
CN1965769B CN2006101416575A CN200610141657A CN1965769B CN 1965769 B CN1965769 B CN 1965769B CN 2006101416575 A CN2006101416575 A CN 2006101416575A CN 200610141657 A CN200610141657 A CN 200610141657A CN 1965769 B CN1965769 B CN 1965769B
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receptacle
anchoring element
cylinder
bone
longitudinal axis
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L·比德曼
W·马蒂斯
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Biedermann Technologies GmbH and Co KG
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    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
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Abstract

提供了一种骨锚固装置，其包括用于接纳杆的接纳部(1)，所述接纳部具有与纵向轴线(4)共轴线的第一孔(5)和第二孔(6)；锚固元件，所述锚固元件具有用于插入到骨头中的第一端部(14)和可定位在第二孔(6)中的第二端部(15)，所述锚固元件(13)可相对于所述接纳部(1)绕所述纵向轴线(4)在有限的角度范围内运动，所述角度位于单个平面(P)内；以及固定元件(30)，所述固定元件与所述接纳部(1)配合以相对于所述接纳部(1)锁定所述锚固元件(13)；所述锚固元件(13)可绕横向于所述纵向轴线(4)的一个旋转轴线相对于所述接纳部枢转。

Description

骨锚固装置
技术领域
本发明涉及骨锚固装置，其包括要锚固在骨头中的锚固元件以及用于接纳要连接至锚固元件的杆的接纳部，其中，接纳部具有与纵向轴线共轴线的第一孔和第二孔，锚固元件具有用于插入到骨头中的第一端部和可定位在第二孔内的第二端部，并且锚固元件可绕接纳部的纵向轴线相对于接纳部在有限的角度范围内移动。锚固元件可绕横向于接纳部的纵向轴线的单个旋转轴线相对于接纳部枢转。因此，锚固元件可在单个平面内相对于接纳部调节。
背景技术
US 5,005,562公开了一种骨锚固装置，其具有要锚固在骨头中的带螺纹的轴或钩以及与所述轴整体形成的头部，该头部具有用于接纳杆的U形凹部。这种所谓的单轴骨锚固装置具有很高的抗负载能力。但是，将头部的位置调节到解剖状态的可能性受到限制。
US 5,443,467公开了一种骨锚固装置，其包括用于接纳杆的接纳部和骨锚固元件，该骨锚固元件具有带螺纹的轴和可枢转地容纳在接纳部中的球形头部。利用这种所谓的多轴线骨锚固元件，锚固构件可以绕接纳部的纵向轴线沿围绕该纵向轴线360°的范围内的反向枢转±25°的范围。因此，即使在将骨锚固构件的带螺纹的部分拧进到骨头中，也可以相对于锚固元件调节接纳部的方向。在接纳部的方向已经调节到解剖状态并且杆已经插入到接纳部中之后，将骨锚固装置锁紧。
对于某些临床应用，例如在颈椎骨区域中的应用，由于颈椎骨的尺寸小，相比较大的胸椎和腰椎区域，向一个具体侧的枢转程度必需更大。US 6,736,820B2公开了一种骨螺钉，其具有带螺纹部分的螺钉构件和可枢转地容纳在用于接纳杆的接纳部中的头部。螺钉构件可以以扩大的角度枢转到至少一侧。这是通过使接纳部的边缘具有不对称构造实现的。但是，该螺钉构件仍然可以绕它的螺钉轴线沿360°的角度范围中所有方向枢转。
图17所示的康标后动力学系统(Cosmic posterior dynamicsystem)公开了一种骨锚固装置，包括接纳杆101的接纳部100和骨螺钉102，其中骨螺钉绕横向销105形成的枢转轴线103可枢转地被保持在接纳部中，横向销垂直于接纳部的纵向轴线104并垂直于杆。因此，骨螺钉可以在包含接纳部的纵向轴线的单个平面内枢转。骨螺钉相对于接纳部的位置不能被锁住，因此，骨螺钉和接纳部总是可相对于彼此移动。
发明内容
本发明的目的是提供一种可调节的骨锚固装置，其具有改善的抗负载能力，并且易于操作，能安全地锁住骨螺钉的角向位置。
上述目的通过根据本发明的骨锚固装置实现。
具体地，根据本发明的一种骨锚固装置包括：用于接纳杆的接纳部，所述接纳部具有与纵向轴线共轴线的第一孔和第二孔；锚固元件，所述锚固元件具有用于插入到骨头中的第一端部和能定位在第二孔中的第二端部，所述第二端部形成头部，所述锚固元件能相对于所述接纳部绕所述纵向轴线在有限的角度范围内运动，所述角度位于单个平面内；以及固定元件，所述固定元件与所述接纳部配合以相对于所述接纳部锁定所述锚固元件，其特征在于：设置有具有第一圆柱缺形凹部的压力元件以相对于所述接纳部锁定所述锚固元件的角度位置，所述第一圆柱缺形凹部的尺寸确定成使得杆安装到所述第一圆柱缺形凹部中，其中通过所述头部与所述压力元件之间的压配合连接将所述锚固元件在锁定之前的运动限制到所述单个平面。
优选地，所述单个平面包括所述纵向轴线。
优选地，所述锚固元件相对于所述接纳部在所述单个平面内的运动角度相对于所述纵向轴线对称。
优选地，所述头部能在所述第二孔中在单个平面内枢转。
优选地，所述头部镜像对称并具有圆柱形引导表面，并且所述压力元件包括第二圆柱缺形凹部，所述压力元件的第二圆柱缺形凹部与所述头部的圆柱形引导表面配合。
优选地，所述头部的圆柱形引导表面的圆柱轴线垂直于所述锚固元件的纵向轴线，并且所述压力元件的第二圆柱缺形凹部的圆柱轴线垂直于所述压力元件的第一圆柱缺形凹部的圆柱轴线。
优选地，所述锚固元件在所述接纳部中的角向运动的锁定通过摩擦力实现。
优选地，所述接纳部的内表面相对于绕所述纵向轴线的旋转大体对称。
优选地，所述锚固元件能绕横向于所述接纳部的纵向轴线的单个旋转轴线相对于所述接纳部枢转。
根据本发明的骨锚固装置结合了单轴线骨锚固装置和多轴线骨锚固装置的优点。它允许在单个平面，优选地包含接纳部的纵向轴线的平面内进行单平面调节。锚固元件可绕横向于接纳部的纵向轴线的一个旋转轴线相对于接纳部枢转。因此，例如可以仅在单个平面内相对于骨锚固元件调节接纳部的位置。该平面例如可以平行于在使用中通常处于径向面内的杆延伸，同时防止沿横向于杆的方向的横向运动。可选地，该平面可横向于杆延伸或者在另一限定方向上延伸。因此，整个锚固装置更加稳定。
接纳部可以成形为类似已知的用于多轴线骨锚固装置的接纳部。因此，可以根据外科手术中的实际需要预组装想要的骨锚固装置，或者多轴线装置或单平面装置，这样可以降低用于库存骨锚固装置的费用。
本发明的其他特征和优点通过参考下面结合附图所进行的详细描述将更加清楚并能更好地理解。
附图说明
图1示出根据本发明的实施例的骨锚固装置的分解透视图；
图2示出处于组装好的状态下的图1的骨锚固装置沿杆的纵向轴线的剖面的剖视图；
图3示出骨锚固装置的骨锚固元件的透视图；
图4示出图3的骨锚固元件的俯视图；
图5示出图3的骨锚固元件的局部侧视图；
图6示出图3的骨锚固元件旋转90°的局部侧视图；
图7示出骨锚固装置的压力元件的俯视图；
图8示出骨锚固装置的压力元件的侧视图；
图9示出骨锚固装置的压力元件从下面看到的透视图；
图10示出图9的压力元件的另一透视图；
图11示出骨锚固装置的压力元件的仰视图；
图12示出压力元件的另一实施例的侧视图；
图13示出图12的压力元件的透视图；
图14a)和14b)示出处于两个不同角向位置中的骨锚固元件和压力元件一起的侧视图；
图15示出骨锚固元件与压力元件一起的透视图；
图16示出与杆一起的根据本发明的骨锚固元件；和
图17示出已知的康标后动力学系统。
具体实施方式
如图1和2所示，骨锚固装置包括接纳部1，该接纳部为大体圆筒形并具有第一端部2和与第一端部相反的第二端部3。两个端部垂直于纵向轴线4延伸。与纵向轴线4共轴线地设有孔5，该孔从第一端部2延伸到离第二端部3预定距离。在第二端部3处设有开口6，其直径小于孔5的直径。在可以是例如球形或圆锥形形状的部分7中，共轴线的孔5向着开口6变小。
接纳部1还包括U形凹部8，其起始于第一端部2并沿第二端部3的方向延伸到离所述第二端部3预定距离。借助于U形凹部8形成了两个自由的支腿9、10，其向着第一端部2延伸。靠近第一端部2，接纳部1在所述支腿9、10上包括内螺纹。U形凹部8起到接纳杆12的作用，多个骨锚固装置通过该杆连接。
骨锚固装置还包括骨锚固元件13，该骨锚固元件包括带有骨螺纹的轴14以及位于轴一端处的头部15。如图3-6所示，头部15具有两个部分16a、16b，其彼此相对并具有球形外表面，且球形的中心M位于头部15的中心。在相对的球形表面16a、16b之间，头部15包括两个圆柱形表面17a、17b，且圆柱轴线C垂直于骨锚固元件13的纵向轴线L并延伸经过头部的中心M。在与螺纹部分14相反的一侧上，头部15包括平坦表面18。用于与拧入工具接合的凹部19设在平坦表面18中。圆柱形表面17a和17b的圆柱半径小于球形表面16a、16b的半径。螺纹部分14的半径小于接纳部的开口6的半径，使得锚固元件13可以从第一端部2插入到接纳部1中，其间螺纹部分14被引导通过下部开口6直到球形表面16a、16b与接纳部1的锥形部分7相接触。
从图1和7到15可以看出，骨锚固装置还包括用于作用在头部并限制头部15在接纳部1中的枢转运动的压力元件20。压力元件20为大体圆柱形并包括第一端部21和第二端部22。压力元件20的外直径稍小于接纳部1的孔5的内直径，使得压力元件20可以被插入到接纳部1中并可以在孔5内滑动。靠近第一端部21，压力元件20包括圆柱缺形凹部23，其尺寸如此确定使得杆12安装到该凹部23中。靠近第二端部22，压力元件20包括第二圆柱缺形凹部24，其圆柱轴线垂直于第一圆柱缺形凹部23的圆柱轴线。
第二圆柱缺形凹部24的圆柱缺的半径与头部15的圆柱形表面17a、17b的半径大体一致。第二圆柱缺形凹部24的宽度W与头部15的圆柱形表面17a、17b的宽度一致，使得当锚固元件13以及压力元件被插入到接纳部1时，圆柱缺形凹部24至少部分地包住表面17a、17b。靠近第二端部22，压力元件20还包括两个相对的球形凹部25a、25b，其在第二圆柱缺形凹部24两侧延伸并且其直径例如等于或大于头部15的相对的球形表面16a、16b的直径，使得头部15的球形表面16a、16b不被压力元件20包住。
此外，压力元件20在其外表面上包括束缚孔(crimp bores)26，该束缚孔优选地彼此相对地定位在具有凹部25a、25b的侧部处并分别与接纳部1中的支腿上对应的束缚孔27配合。束缚孔26、27起到将压力元件20宽松地预组装在接纳部内使得压力元件20不会掉出来的作用。这样，也可以预先限定锚固元件相对于接纳部的枢转平面。
另外，压力元件20具有用于允许拧入工具进入到头部15中的凹部19的共轴线孔28。
在图12和13中示出了压力元件的变型实施例。压力元件20′与图7到10的压力元件的不同之处在于第二圆柱形凹部24′相对于第一圆柱形凹部23按下述方式对准，即，它们的圆柱轴线平行。其结果是锚固元件的枢转运动的旋转轴线与使用图7-12所示的压力元件相比旋转了90°。
如图1和2所示，骨锚固装置还包括内螺钉30，该内螺钉能拧在支腿9、10之间以固定杆12并通过杆12将压力施加到头部15上。
整个装置由不会引起排斥的材料例如钛制成。
使用中，首先将锚固元件13通过引导带螺纹的轴14通过位于接纳部的第二端部3处的开口6直到头部15抵靠在靠近开口6的部分7上而插入到接纳部1中。然后，将压力元件20以其第二端部22面向头部的方式插入到接纳部1中并由配合的束缚孔26、27宽松地保持在合适位置，在该位置中，压力元件的凹部23与接纳部1的凹部8共轴线。头部15的圆柱形表面17a、17b至少部分地被压力元件的凹部24的圆柱形表面包住。按这种方式预组装后，将锚固元件13拧入到骨头中。
在这种状态下，锚固元件13仍然可相对于接纳部1枢转，但是枢转的角度范围受到限制并且位于平面P内，该平面P包含接纳部的纵向轴线4并形成接纳部1的镜像对称平面。在该实施例中，平面P是图2所示的剖视图的剖切平面。通过仅由表面17a、17b与第二圆柱缺形凹部24的配合而使压力元件20作用在头部15上但不对头部15施加压力实现在单个平面内的枢转，该配合允许绕圆柱轴线C的枢转运动但阻止沿其它方向的枢转。因此，当该装置在使用时，可以在径向面中即沿着杆12调节接纳部相对于锚固元件13的位置，而阻止在装置使用时沿横向方向即横向于杆12的调节。在调节接纳部1的位置之后，将杆12插入并将内螺钉30拧入到支腿9、10之间并拧紧以在杆上施加压力，而杆自身在压力元件20上施加压力。压力元件20然后在头部15上施加压力以将其锁定在它的最终位置。从而通过头部15和压力元件的圆柱形表面的压配合来阻止锚固元件13绕纵向轴线4旋转，而通过作用在头部15和压力元件20之间的摩擦力实现对头部在单个平面内的角向运动的锁定。
在图16中示出了两个骨锚固装置50、50′，其通过杆12连接。第一锚固装置50包括如图7到11所示的压力元件20。锚固元件13的旋转轴线垂直于杆的轴线A，这样允许在接纳部1的纵向轴线4和杆的轴线A所限定的平面内进行调节。第二锚固元件50′包括如图12和13所示的压力元件20′。锚固元件13的旋转轴线平行于杆的轴线A，这样允许在垂直于杆的轴线A并包括接纳部的纵向轴线4的单个平面内调节锚固元件13。
从图14a、14b、15和16可以看出，根据本发明的骨锚固装置允许在单个平面内进行调节，或者换言之，允许绕单个旋转轴线旋转。因此，锚固元件以单平面的方式连接至接纳部。这种骨锚固装置比允许绕纵向轴线在360°的范围内枢转的多轴线骨锚固装置更稳定。它具有改善的抗负载能力并允许足够用于具体的临床应用的接纳部的位置调节。通过选择适当的压力元件，可以组装能够根据实际的解剖需要相对于杆在想要的平面内调节的骨锚固装置。
本发明不限于上面所示的实施例。变型是可以想象得到的。压力元件的第一和第二圆柱形凹部的两个圆柱轴线相对于彼此的任何取向都是可以的。
压力元件的圆柱缺形凹部23可以省掉。这意味着：压力元件的第一端部21可以具有平坦表面。在这种情况下，压力元件可以这样定向在接纳部内，即第二圆柱缺形凹部沿任意所需方向定向。
头部15的表面16a、16b不必具有球形形状。它们可以是平坦的。
锚固元件可以在其中枢转的所述单个平面不是必须包含纵向轴线。它也可以平行于纵向轴线延伸。
接纳部可以在开口6处具有非对称的边缘，以便在纵向轴线一侧上能具有比另一侧上更大的枢转角度。枢转角度的这种非对称也可以通过其它手段实现。
在所示实施例中，压力通过杆12施加在压力元件20上，压力元件20自身挤压头部。但是，也可以将头部通过压力元件20的锁定与杆12的锁定分离。为此，压力元件20中的凹部23包括向上延伸的支腿，该支腿延伸到所插入的杆12的上方，使得它可以通过分离的内螺钉分离地挤压在这些支腿上，该内螺钉包围挤压在杆上的内螺钉30。
在另一变型中，可以有这样一种构造，其中头部从第二端部3插入到接纳部1中。在这种情况下，开口6必须足够大以将头部引入，并且必须提供防止头部掉出来的装置。
在又一变型中，接纳部的下部开口6设有与锚固元件的轴14的螺纹配合的螺纹。在这种情况下，锚固元件13的带螺纹的轴14可以被拧入到开口中并进而拧入到骨头中。带螺纹的轴的直径可以和第一孔5的直径一样大。
除了带螺纹的轴14外，其他的骨锚固装置如钉子或钩也是可以的。
骨锚固装置不必在用在外科手术中之前预组装。它也可以在手术期间组装。

Claims (8)

1.一种骨锚固装置，包括：
用于接纳杆的接纳部(1)，所述接纳部具有与纵向轴线(4)共轴线的第一孔(5)和第二孔(6)；
锚固元件(13)，所述锚固元件具有用于插入到骨头中的第一端部(14)和能定位在第二孔(6)中的第二端部，所述第二端部形成头部(15)，所述锚固元件(13)能相对于所述接纳部(1)绕所述纵向轴线(4)在有限的角度范围内运动，所述角度位于单个平面(P)内；以及
固定元件(30)，所述固定元件与所述接纳部(1)配合以相对于所述接纳部(1)锁定所述锚固元件(13)，
其特征在于：设置有具有第一圆柱缺形凹部(23)的压力元件(20)以相对于所述接纳部(1)锁定所述锚固元件(13)的角度位置，所述第一圆柱缺形凹部(23)的尺寸确定成使得杆(12)安装到所述第一圆柱缺形凹部(23)中，其中通过所述头部(15)与所述压力元件(20)之间的压配合连接将所述锚固元件(13)在锁定之前的运动限制到所述单个平面；所述头部(15)镜像对称并具有圆柱形引导表面(17a，17b)，并且所述压力元件(20)包括第二圆柱缺形凹部(24)，第二圆柱缺形凹部(24)与所述头部(15)的圆柱形引导表面(17a，17b)配合。
2.如权利要求1所述的骨锚固装置，其特征在于：所述单个平面包括所述纵向轴线(4)。
3.如权利要求1或2所述的骨锚固装置，其特征在于：所述锚固元件(13)相对于所述接纳部(1)在所述单个平面(P)内的运动角度相对于所述纵向轴线(4)对称。
4.如权利要求1或2所述的骨锚固装置，其特征在于：所述头部(15)能在所述第二孔(6)中在单个平面(P)内枢转。
5.如权利要求1或2所述的骨锚固装置，其特征在于：所述头部(15)的圆柱形引导表面(17a，17b)的圆柱轴线垂直于所述锚固元件(13)的纵向轴线(L)，并且所述压力元件(20)的第二圆柱缺形凹部(24)的圆柱轴线垂直于所述压力元件(20)的第一圆柱缺形凹部(23)的圆柱轴线。
6.如权利要求1或2所述的骨锚固装置，其特征在于：所述锚固元件(13)在所述接纳部中的角向运动的锁定通过摩擦力实现。
7.如权利要求1或2所述的骨锚固装置，其特征在于：所述接纳部(1)的内表面相对于绕所述纵向轴线(4)的旋转大体对称。
8.如权利要求1或2所述的骨锚固装置，其特征在于：所述锚固元件(13)能绕横向于所述接纳部的纵向轴线(4)的单个旋转轴线相对于所述接纳部(1)枢转。
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CN1965769A (zh) 2007-05-23
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US8048133B2 (en) 2011-11-01
US20120109224A1 (en) 2012-05-03
US9078715B2 (en) 2015-07-14
DE602005009202D1 (de) 2008-10-02
US8506611B2 (en) 2013-08-13
US20100318135A1 (en) 2010-12-16
US20070161996A1 (en) 2007-07-12
KR20070040720A (ko) 2007-04-17
JP2007105472A (ja) 2007-04-26
US7749258B2 (en) 2010-07-06
US20140058463A1 (en) 2014-02-27
KR101267581B1 (ko) 2013-05-23
TWI379657B (en) 2012-12-21
TW200722030A (en) 2007-06-16
EP1774919A1 (en) 2007-04-18
EP1774919B1 (en) 2008-08-20

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