CN1965770A - 骨锚固装置 - Google Patents

骨锚固装置 Download PDF

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CN1965770A
CN1965770A CNA2006101446551A CN200610144655A CN1965770A CN 1965770 A CN1965770 A CN 1965770A CN A2006101446551 A CNA2006101446551 A CN A2006101446551A CN 200610144655 A CN200610144655 A CN 200610144655A CN 1965770 A CN1965770 A CN 1965770A
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connection element
pressure elements
bone anchoring
anchoring device
pressure
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CN1965770B (zh
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卢茨·比德尔曼
威尔弗里德·马蒂斯
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Biedermann Technologies GmbH and Co KG
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    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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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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    • 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
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7031—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other made wholly or partly of flexible material
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass

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Abstract

提供了一种骨锚固装置，该骨锚固装置包括：骨锚固元件(1)，所述骨锚固元件包括要锚固在骨头或脊椎骨中的锚柄(2)和头部(4)；连接元件(20)，其用于连接至少两个锚固元件；接纳部(6)，所述接纳部具有接纳头部(4)的第一端部和包括用于接纳连接元件(20)的凹部(13)的第二端部，其中头部可在所述接纳部中枢转；第一压力元件(17)，所述第一压力元件在头部(4)上施加压力以将头部锁定在接纳部(6)中；第二压力元件(23)，所述第二压力元件在连接元件(20)上施加压力，以使连接元件按压抵靠第一压力元件(17)；其中，至少第一压力元件(17)或者第二压力元件(23)朝向连接元件(20)的表面的轮廓偏离连接元件的表面的轮廓。

Description

骨锚固装置
技术领域
本发明涉及一种骨锚固装置，该装置用于骨头的动态稳定，特别是脊柱的动态稳定。这种骨锚固装置包括可与弹性材料制成的挠性杆连接的骨锚固元件，并且允许骨锚固元件相对于杆多轴线地调节。
背景技术
DE 43 07 576 C1公开了一种与硬杆连接的多轴线骨螺钉，硬杆通常由金属制成。当弹性材料制成的挠性杆用于这样的骨螺钉时，由内部固定螺钉施加到杆上的压力会导致弹性材料的变形，这种变形会导致固定变松。
EP1 364 622 A2和EP 1 527 742 A1公开了包含骨螺钉和弹性材料制成的挠性杆的骨锚固装置。杆和骨螺钉的接纳部以及封闭元件在表面中具有几何对应的凸棱和凹槽以便获得形状合适的连接。在固定前，杆和骨螺钉的几何对应形状都必须对准。这使得调节困难且耗时。而且，骨螺钉的接纳部和轴要单轴线地连接，这进一步限制了轴相对杆调节轴的位置的可能性。
发明内容
本发明的目的是提供一种骨锚固装置，其能用于由弹性材料制成的挠性连接元件，并且允许多轴线地调节骨锚固元件相对于杆的位置同时安全锁定。
上述目的通过权利要求1所述的骨锚固装置实现。其他实施方式在从属权利要求中给出。
本骨锚固装置具有这样的优点，即，在封闭元件的上紧过程中，杆的弹性材料的变形使弹性杆和接纳部之间形状合适(form fit)地连接。这使杆的锁定得到改进，骨锚固元件相对杆的位置也得以确保。本骨锚固装置还有一个优点，即杆的材料在沿杆的纵轴线方向上的流动减到最少。
附图说明
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。
图1示出根据本发明的骨锚固元件的透视分解图；
图2示出处于组装好状态下的图1的骨锚固装置的截面图；
图3a示出从下面看到的下部压力元件的透视图；
图3b示出从上面看到的下部压力元件的透视图；
图3c示出下部压力元件的侧视图；
图4a示出从下面看到的骨锚固装置的上部压力元件的透视图；
图4b示出从顶部看到的上部压力元件的透视图；
图4c示出上部压力元件的侧视图；
图5示出下部压力元件的变型实施例的截面图。
具体实施方式
如图1和2所示，骨锚固装置包括骨螺钉形状的骨锚固元件1，该元件具有带骨螺纹的锚柄2、位于一端的尖部3以及位于另一端的球形头部4。用于与拧入工具接合的凹部5设在头部4的与锚柄相对一侧处。
骨锚固装置还包括接纳部6，该接纳部具有第一端部7和与第一端部相对的第二端部8以及与第一端部和第二端部形成的平面相交的纵向轴线9。与纵向轴线9共轴线地设有孔10，该孔从第一端部7延伸到离第二端部8预定距离。在第二端部8处设有开口11，其直径小于孔10的直径。临近开口10设有球形缺部12，其形成用于球形头部4的座部。
接纳部6还包括U型凹部13，其起始于第一端部7并沿第二端部8的方向延伸到离所述第二端部预定距离。通过U型凹部13形成了向着第一端部延伸的两个自由支腿14、15。临近第一端部7，接纳部6在所述自由支腿14、15处具有内螺纹16。
另外，还设有第一压力元件17，其具有圆柱形构造，外直径略小于孔10的内直径，以便第一压力元件17可以插入接纳部的孔10中并可沿轴方向移动。压力元件17朝向第二端部8的下侧部处包括球形凹部18，其半径与骨螺钉的球形头部4的半径相当(见图3a和5)。在相反一侧，第一压力元件17具有圆柱形凹部19，其横向于纵轴线9延伸。该凹部的横向直径尺寸被选择成使得带有圆形横截面的将被接纳部接纳的杆20能被插入凹部19中并横向引入。圆柱形凹部19的深度如此确定，即在组装状态中当杆被插入并压靠到U型凹部13的底部时，第一压力元件17在头部5上施加压力。而且深度优选地约为杆20的直径的一半。
从图1、3a和5中可以看出，第一压力元件17还包括共轴线孔21，此孔用于引导拧入工具穿入。在第一压力元件17的接纳杆20的表面上设有凸棱状的凸出部22，其沿横向于杆20的纵轴线L的方向延伸。可以设有多个这样的凸出部22，但单个凸出部也已足够。凸出部可以有结构化形状，其能够压在杆20的光滑表面上。从图5可以看出，还设有装配到共轴线孔21中的帽40，其朝向圆柱形凹部19封闭孔21。
如图4a到4c所示，骨锚固装置包括大体立方形的第二压力元件23，其具有大体正方形的第一端部24和第二端部25。第二压力元件的宽度要使得第二压力元件能够插入接纳部6的U型凹部13中。第二压力元件在相对的两侧包括外形如圆柱段的两个凸出部26，其装配到受限于内螺纹16的空间中以便在第二压力元件插入时沿内螺纹滑动。
第二压力元件23还具有从第二端部25沿向着第一端部24的方向延伸的圆柱形凹部27，其圆柱轴线垂直于圆柱形凸出部26的圆柱轴线。在第二端部侧，圆柱凸出部26包括较低边26a。圆柱形凹部27的直径与杆20的直径相当且其深度相当于或小于杆20直径的一半。与第一压力元件相似，设有一个或多个凸棱状的凸出部28，凸出部在相对的圆柱形凸出部26之间在凹部27的表面上圆周地延伸。凸出部28有结构化的形状，该形状使它们压在杆20的表面上。第二压力元件23还具有共轴线的孔29。
骨锚固装置还包括可拧入支腿14、15之间的内螺钉30。内螺钉30包括装配到第二压力元件23的孔29中的圆柱形凸出部31。内螺纹16和内螺钉30的配合螺纹可以具有任何众所周知的螺纹形状。不过平螺纹或者阴角螺纹可以带来不使支腿14、15张开的优点。
接纳部6和第一压力元件17在相对侧有包括对应的压接孔32、33，通过这些孔，螺钉1、接纳部6和第一压力元件17能够被宽松地预组装，使得第一压力元件17按其圆柱形凹部19与接纳部的U型凹部13共轴线地进行定向。
杆20由弹性材料制成，从而杆部分地或完全地可挠曲。优选地，杆由不会引起排斥的塑料材料制成，例如基于聚亚胺酯或PEEK的聚合体。杆优选地具有光滑的表面。骨锚固装置的其他部件由众所周知的不会引起排斥的材料制成，例如不锈钢或钛。
使用中，将预组装的骨锚固装置的骨螺钉1拧入骨头中。为了结构稳定，至少要将通过杆连接的两个骨锚固装置锚固到骨头中。接着，将帽40插入第一压力元件17a的共轴线孔21中，杆20插入支腿14和15之间。然后，将第二压力元件插入，使得第一和第二压力元件17和23从两侧环绕着杆20。调节好骨螺钉的角度位置后，将内螺钉拧入支腿之间直到内螺钉接触到第二压力元件23的第一端部24。当内螺钉30拧紧后，将第二压力元件23移向第一压力元件17直到较低边26a抵靠到上肩部17a为止。第一和第二压力元件17和23环绕的空间的横截面略小于杆20的横截面。这样，制成杆20的材料开始流动，使得凸出部22、28压到杆上，从而在杆20和第一第二压力元件17和23之间形成稳固的形状合适的连接而不损坏杆的整体结构。帽40防止杆20的材料进入共轴线孔21中。同时，通过第二压力元件23将第一压力元件17压到头部4上，从而通过旋转位置中的摩擦实现螺钉头部的锁定。考虑到纵向移动，优选地，凸出部22、28垂直于杆20的纵方向L地延伸，以保护杆20。
因为杆的锁定是通过将凸出部22、28压到杆的表面上而不损坏杆的整体结构来实现的，因而一些次要的调节是可能的。
上述实施例的变型是可能的。例如，只在两个压力元件中的一个，或者是第一或者是第二压力元件上设有凸棱状的凸出部22、28。与第一和第二压力元件表面具有凸棱状凸出部不同，可以在一个压力元件上设有凸出部而在另一个压力元件上设有相应的凹部。这样允许在凸出部压到杆的表面上时位移的材料可以进入相应的凹部从而形成形状合适的连接。可以在两个压力元件上都设有凸出部和凹部。有利地，凸出部和凹部的体积相似或者相同，以便材料流动结束后，杆在与接纳部的连接的区域中的体积与之前大致相同。这样，两个压力元件的接触面就像包住杆的罩子，从而防止材料不受控制地流动，从而维持杆的总长不变。这使杆安全地保持在适当的位置。凸出部和/或凹部不需要具有凸棱状结构，任何能达到所需形状合适的锁定功能的形状都是可以的。
杆不必具有圆形的横截面。它可以具有椭圆的、矩形的或者正方形的横截面。如果杆的硬度足够，帽40可以省掉。杆的弹性可以变化。杆可以具有高度挠性或者很难挠曲。杆的表面可以比较粗糙也可以是结构化的。
对于内螺钉30，所有已知的变型都可以采用。这也包括使用外环或螺帽。
在所述实施例中，骨锚固元件从顶部插入接纳部中。不过，如果接纳部的构造允许，骨锚固元件也可以从接纳部的底部插入。
骨锚固元件的头部和轴可以构造成可连接的分离部件。
本发明不限于用作骨锚固元件的螺钉，也可以用骨钩或其他骨锚固元件来实现。

Claims (13)

1.一种骨锚固装置，包括：
骨锚固元件(1)，所述骨锚固元件包括要锚固在骨头或脊椎骨中的锚柄(2)和头部(4)；
连接元件(20)，其用于连接至少两个锚固元件；
接纳部(6)，所述接纳部具有接纳头部(4)的第一端部和包括用于接纳连接元件(20)的凹部(13)的第二端部，其中头部可在所述接纳部中枢转；
第一压力元件(17)，所述第一压力元件在头部(4)上施加压力以将头部锁定在接纳部(6)中；
第二压力元件(23)，所述第二压力元件在连接元件(20)上施加压力，以使连接元件按压抵靠第一压力元件(17)；
其中，至少第一压力元件(17)或者第二压力元件(23)朝向连接元件(20)的表面的轮廓偏离连接元件的表面的轮廓。
2.如权利要求1所述的骨锚固装置，其特征在于，所述连接元件(20)由弹性材料制成。
3.如权利要求1或2所述的骨锚固装置，其特征在于，所述连接元件是杆。
4.如权利要求1到3之一所述的骨锚固装置，其特征在于，第一和第二压力元件(17，23)朝向连接元件(20)的表面偏离连接元件的表面的轮廓。
5.如权利要求1到4之一所述的骨锚固装置，其特征在于，所述轮廓偏离部是凸出部和/或凹部。
6.如权利要求1到5之一所述的骨锚固装置，其特征在于，所述轮廓偏离部具有凸棱状或销状结构。
7.如权利要求1到6之一所述的骨锚固装置，其特征在于，第一压力元件(17)包括接纳所述连接元件的凹部(19)，第二压力元件(23)包括朝向所述连接元件的凹部(27)，当压力施加到第二压力元件(23)上时，所述凹部形成包住连接元件(20)的罩状结构。
8.如权利要求1到7之一所述的骨锚固装置，其特征在于，所述罩状结构的横截面略小于所述连接元件(20)的横截面。
9.如权利要求1到8之一所述的骨锚固装置，其特征在于，设有封闭元件(30)，所述封闭元件封闭凹部(13)并对第二压力元件(23)施加压力。
10.根据权利要求1到9之一所述的骨锚固装置，其特征在于，第一压力元件(17)或者第二压力连接元件(20)的轮廓偏离部沿着垂直于所述连接元件的纵向的方向延伸。
11.根据权利要求1到10之一所述的骨锚固装置，其特征在于，凸出部和凹部的体积彼此大体相同。
12.根据权利要求1到11之一所述的骨锚固装置，其特征在于，第一压力元件(17)和第二压力元件(23)包括接触面(17a，26a)，通过所述接触面，第一压力元件(17)直接对第二压力元件(23)施加压力。
13.根据权利要求1到12之一所述的骨锚固装置，其特征在于，第一压力元件(17)朝向连接元件(20)的表面在凹部(13)上方延伸，以用于接纳处于组装好并拧紧状态下的接纳部(6)的连接元件。
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CN101347351B (zh) * 2007-07-20 2012-06-20 比德曼莫泰赫有限公司 骨锚固装置
CN102525621A (zh) * 2010-12-23 2012-07-04 比德尔曼技术有限责任两合公司 用于稳定椎骨或骨部分的稳定装置
CN102525621B (zh) * 2010-12-23 2015-07-22 比德尔曼技术有限责任两合公司 用于稳定椎骨或骨部分的稳定装置
CN104224299A (zh) * 2014-09-23 2014-12-24 江苏百易得医疗科技有限公司 骨结合可调式接骨板

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US7731749B2 (en) 2010-06-08
CN1965770B (zh) 2010-09-01
JP2007136196A (ja) 2007-06-07
DE602005008752D1 (de) 2008-09-18
US20100286731A1 (en) 2010-11-11
EP1795134B1 (en) 2008-08-06
US20070161999A1 (en) 2007-07-12
EP1795134A1 (en) 2007-06-13
JP5015557B2 (ja) 2012-08-29
KR20070052662A (ko) 2007-05-22
US9226778B2 (en) 2016-01-05
TWI419673B (zh) 2013-12-21
KR101306894B1 (ko) 2013-09-10
ES2313189T3 (es) 2009-03-01

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