CN213641138U

CN213641138U - Adjustable fixing plate system for lateral thoracolumbar vertebra

Info

Publication number: CN213641138U
Application number: CN202022549592.6U
Authority: CN
Inventors: 杨小卫; 郝定均; 王晓东; 贺宝荣; 闫亮; 刘团江
Original assignee: Xian Honghui Hospital
Current assignee: Xian Honghui Hospital
Priority date: 2020-11-06
Filing date: 2020-11-06
Publication date: 2021-07-09
Anticipated expiration: 2030-11-06

Abstract

The utility model belongs to the technical field of medical instruments, and particularly discloses a thoracolumbar lateral adjustable fixing plate system, which comprises a locking plate, a sliding plate, a vertebral body screw and a locking screw, wherein the locking plate and the sliding plate are both arc plates; the inner end of the locking plate is provided with a fixing hole, and the outer end of the locking plate is provided with a screw hole for implanting a vertebral body screw; the inner end of the sliding plate is provided with a long hole, and the outer end of the sliding plate is provided with a screw hole; the locking plate is connected with the sliding plate through a locking screw, and a vertebral body screw is implanted at the position of a vertebral body of a patient close to an end plate through a screw hole. Because the length is adjustable, the centrum screw can be ensured to be selectively implanted into adjacent end plate sclerotin, the end plate is prevented from being damaged, the screw has strong holding force, and the screw is suitable for reconstructing the thoracolumbar stability of normal or osteoporosis patients; the locking plate and the sliding plate correspond to the radian of the side wall of the vertebral body along the transverse radian, can be attached to the curved surface on the side of the vertebral body better, and simultaneously wrap the intervertebral implant or the bone grafting material to play a role in preventing displacement and falling.

Description

Adjustable fixing plate system for lateral thoracolumbar vertebra

Technical Field

The utility model belongs to the technical field of medical instrument, a chest lumbar vertebrae side adjustable fixed plate system is related to.

Background

The oblique lateral approach of the thoracolumbar vertebra is a commonly used operation approach for spinal surgery, and provides an effective operation treatment approach for solving the diseases such as infection, tumor, fracture nonunion and the like represented by thoracolumbar tuberculosis. As a technical improvement of the approach, in recent years, minimally invasive oblique lateral approach lumbar interbody fusion (OLIF) brings a new choice for treating lumbar diseases due to advantages of small trauma, less bleeding, large intervertebral bone grafting area, less complications and the like.

The mechanical stability of the spine needs to be reconstructed after the tissues such as sclerotin, focus, intervertebral disc and the like are removed in the approach operation, and the common fixing mode is an anterior nail rod system or a posterior nail rod fixing mode for changing the posture. However, when the position of the post-installation nail rod is changed and the operation is performed, turning over is easy to cause displacement of the internal plants or bone grafting materials, and the operation risk and time are increased; the front nail rod is cut too high, which affects the surrounding thoracic or abdominal organs; the installation is complicated and the matching with the adjacent vertebral body is poor; does not have the convenience of reconstructing the physiological curvature of the thoracolumbar vertebra. The locking type fusion cage special for OLIF operation passes through the upper endplate and the lower endplate by screws to realize fixation, and complications such as endplate collapse, screw looseness, internal fixation displacement and the like are often caused by the fact that the end plates are damaged by the screws, insufficient holding force and the like when common vertebral body osteoporosis occurs.

SUMMERY OF THE UTILITY MODEL

In order to overcome the defect that above-mentioned prior art exists, the utility model aims to provide an adjustable fixed plate system in chest lumbar vertebrae side shortens the back and puts into from chest lumbar vertebrae side and readjusts suitable length, has solved loaded down with trivial details and operation complication and the anterior path little incision that the nail was put to the back and has realized the problem that intervertebral mechanics rebuild the difficulty.

The utility model discloses a realize through following technical scheme:

a thoracolumbar lateral adjustable fixing plate system comprises a locking plate, a sliding plate, a vertebral body screw and a locking screw, wherein the locking plate and the sliding plate are arc-shaped plates, and each arc-shaped plate is provided with a radian along the longitudinal direction, and the radian corresponds to the local physiological curvature of the thoracolumbar; the arc-shaped plate has a radian along the transverse direction, and the radian corresponds to the radian of the side wall of the vertebral body;

the inner end of the locking plate is provided with a fixing hole, and the outer end of the locking plate is provided with a screw hole for mounting a vertebral body screw;

the inner end of the sliding plate is provided with a long hole, and the outer end of the sliding plate is provided with a screw hole for mounting a centrum screw;

when the sliding plate is used, the sliding plate is placed on the locking plate, the locking screws penetrate through the elongated holes and the fixing holes, and the locking plate is connected with the sliding plate through the locking screws; the vertebral body screw is implanted in the position of the vertebral body of a patient close to the end plate through the screw hole.

Furthermore, the tail end of the centrum screw is embedded in the screw hole and is flush with the upper surfaces of the locking plate and the sliding plate.

Further, step surfaces are prefabricated at the inner ends of the locking plate and the sliding plate, and the radian and the length of the two step surfaces are the same; when the locking plate and the sliding plate are connected, the two step surfaces are overlapped.

Furthermore, the locking plate, the sliding plate, the vertebral body screw and the locking screw are all made of titanium alloy materials.

Further, the locking screw is a flange screw.

Furthermore, the number of the screw holes at the outer ends of the locking plate and the sliding plate is 1-2.

Further, the length between the two outer ends of the locking plate and the sliding plate is 20-70 mm.

Further, the length of the vertebral body screw is 30-45 mm.

Further, the width of lockplate and sliding plate is 20 ~ 30mm, and thickness is 5 ~ 10 mm.

Further, the arc plate has a longitudinal radian of 5-15 degrees and a transverse radian of 2-10 degrees.

Compared with the prior art, the utility model discloses following profitable technological effect has:

the utility model discloses a chest lumbar vertebrae side adjustable fixation plate system, including lockplate, sliding plate, centrum screw and locking screw, it has rectangular hole to open on the sliding plate, and it has the fixed orifices to open on the lockplate, and during the use, the sliding plate is placed on the lockplate, and locking screw runs through rectangular hole and fixed orifices, and lockplate and sliding plate pass through the locking screw connection, and the centrum screw passes through the screw hole and implants patient's centrum and is close the end plate position. The locking screw penetrates through the long hole to realize the overlapping sliding between the locking plate and the sliding plate, so that the length can be adjusted; the reconstruction of the stability and the physiological curvature of the lumbar vertebra is realized under the single lateral minimally invasive incision, the risk of the turning-over posterior operation is avoided, and the operation time is prolonged; the locking plate and the sliding plate can be assembled in vitro, then the length of the locking plate and the sliding plate is shortened, and the locking plate and the sliding plate are implanted in vivo, the direction and the length of the locking plate and the sliding plate are adjusted according to the fixed length and the reconstructed physiological curvature, the locking plate and the sliding plate are easy to install and are suitable for fixation in an operation under an inclined outer channel with a small opening; because the length is adjustable, the centrum screw can be ensured to be selectively implanted into the sclerotin under the end plate, the end plate is prevented from being damaged, the screw has strong holding force, and the screw is suitable for the osteoporosis patient to reconstruct the thoracolumbar stability; the locking plate and the sliding plate have certain radian along the longitudinal direction, namely the length direction, and the radian corresponds to the local physiological curvature of the thoracolumbar spine, so that the reconstruction of the thoracic lumbar spine physiological curvature can be assisted; the locking plate and the sliding plate have certain radian along the transverse direction, namely the width direction, the radian corresponds to the radian of the side wall of the vertebral body, the locking plate and the sliding plate can be attached to the curved surface on the side of the vertebral body better, and meanwhile, the locking plate and the sliding plate wrap intervertebral implants or bone grafting materials to prevent displacement and falling. In addition, the curvature of the locking and fixation plates along the longitudinal axis of the spine and the locking screws facilitate vertebral body reduction in a lateral anterior lumbar spondylolisthesis procedure. The utility model relates to a scheme is ingenious unique, simple structure, and is compatible strong, is applicable to through the operation under the oblique outside approach of chest lumbar vertebrae open and the minimal access passageway, including chest lumbar vertebrae infection, tumour, fracture nonunion, deformity etc. especially be favorable to the reconstruction of stability in the OLIF operation treatment lumbar vertebrae degenerative disease art.

Furthermore, the vertebral body screw can be screwed in and embedded into the screw hole, so that the cutting trace of the screw is reduced, and the surrounding organs of the internal plant are protected from being stimulated and interfered.

Furthermore, step surfaces are prefabricated at the inner ends of the locking plate and the sliding plate, when the locking plate and the sliding plate are connected, the two step surfaces are overlapped, the step surfaces are designed to reduce the thickness of the overlapped part, the thickness of the fixing plate system can be integrally reduced, and the size of the whole device is reduced.

Drawings

FIG. 1 is a schematic structural view of a thoracolumbar lateral adjustable fixing plate system of the present invention in a shortened state;

FIG. 2 is a schematic structural view of the thoracolumbar lateral adjustable fixing plate system of the present invention in an extended state;

FIG. 3 is a top view of FIG. 2;

fig. 4 is a bottom view of fig. 2.

Wherein: the locking plate is 1, the sliding plate is 2, the centrum screw is 3, the locking screw is 4, the step surface is 5, the long hole is 6, and the fixing hole is 7.

Detailed Description

The present invention will be described in further detail with reference to the accompanying drawings:

as shown in fig. 1-4, the utility model discloses a thoracolumbar lateral adjustable fixing plate system, which comprises a locking plate 1, a sliding plate 2, a vertebral body screw 3 and a locking screw 4, wherein the locking plate 1 and the sliding plate 2 are both arc plates, and the arc plates have a radian along the longitudinal direction, and the radian corresponds to the local physiological curvature of the thoracolumbar; the arc-shaped plate has a radian along the transverse direction, and the radian corresponds to the radian of the side wall of the vertebral body; the inner end of the locking plate 1 is provided with a fixing hole 7, and the outer end is provided with a screw hole for mounting a vertebral body screw 3; the inner end of the sliding plate 2 is provided with a long hole 6, and the outer end is provided with a screw hole for mounting a vertebral body screw 3; when in use, the sliding plate 2 is placed on the locking plate 1, the locking screw 4 penetrates through the elongated hole 6 and the fixing hole 7, and the locking plate 1 and the sliding plate 2 are connected through the locking screw 4; the vertebral body screw 3 is implanted in the position of the vertebral body of a patient close to the end plate through the screw hole.

Preferably, the tail end of the centrum screw 3 is embedded in the screw hole and is flush with the upper surfaces of the locking plate 1 and the sliding plate 2. After being screwed in, the vertebral body screw 3 compresses the locking plate 1 and the sliding plate 2, can be embedded in the plate to reduce the incision of the internal plant and protect the internal organs around the internal plant from stimulation interference. The vertebral screws 3 are selectively implanted in the bone adjacent the endplates of the vertebral bodies to increase the holding force without damaging the endplates. The existing OLIF fixing mode is mainly that a posterior nail rod is fixed, the posture is changed, the approach of the operation is changed, and the loosening risk of the implant in the anterior path and the operation time are increased; in addition, the anterior screw of the OLIF fusion cage with the locking nail needs to penetrate through the upper endplate and the lower endplate, so that the structure of the endplates is damaged, and intervertebral collapse or screw looseness is easily caused by patients suffering from osteoporosis.

Preferably, as shown in fig. 2, step surfaces 5 are prefabricated at the inner ends of the locking plate 1 and the sliding plate 2, and the radian and the length of the two step surfaces 5 are the same; when the locking plate 1 and the sliding plate 2 are connected, the two step surfaces 5 are overlapped. The step surface 5 is designed to reduce the thickness of the overlapped part, so that the thickness of the fixing plate system can be integrally reduced, the volume of the whole device is reduced, after all, the internal space is limited, and the influence of the internal plant on the surrounding visceral organs is smaller and better.

Generally, the locking plate 1, the sliding plate 2, the vertebral body screw 3 and the locking screw 4 are all made of titanium alloy material.

The locking screws 4 are flange screws, and the flange screws penetrate through the strip holes 6 to realize overlapping sliding between the locking plate 1 and the sliding plate 2, so that length adjustment is realized.

The tail part of the vertebral body screw 3 is of an inner hexagonal structure and is matched with a corresponding screwdriver to be screwed into the screw. The tail part of the middle locking screw 4 is an outer hexagonal nut which is matched with a corresponding sleeve tool to be locked.

The number of the screw holes at the outer ends of the locking plate 1 and the sliding plate 2 is 1-2, and single or double centrum screws 3 are selected to be used at the head end and the tail end according to needs.

The length between the two outer ends of the locking plate 1 and the sliding plate 2 is 20-70 mm. The length of the locking plate 1 and the sliding plate 2 is 20-60 mm in the shortened state, and the length of the locking plate 1 and the sliding plate 2 is 30-70 mm in the extended state.

The length of the vertebral body screw 3 is 30-45 mm. The width of the locking plate 1 and the sliding plate 2 is 20-30 mm, and the thickness is 5-10 mm.

Preferably, the radian of the arc plate along the longitudinal direction is 5-15 degrees, and the assembled radian of the head and tail sides of the back edge of the vertebral column can assist in reconstructing the physiological curvature of the thoracolumbar and can even realize the reduction of the centrum slippage by utilizing the arc plate. The fixing plate system has 2-10 degrees of radian along the horizontal direction, namely the horizontal direction parallel to the vertebral end plate, and the radian is fitted to the side curved surface of the vertebral body, can be better attached to the side curved surface of the vertebral body, and simultaneously wraps the intervertebral implant or the bone grafting material to play a role in preventing displacement and falling.

Taking the OLIF operation for oblique lateral intervertebral decompression fusion for lumbar 4/5 spondylolisthesis as an example, a special channel is placed in front of the left psoas major or the operation field is exposed by a special draw hook after positioning. The intervertebral cage is implanted with a corresponding size of bone graft material from the side of the waist 4/5 using tools to treat the nucleus pulposus and the cartilaginous endplates of the intervertebral space. The fixed plate with the corresponding length is selected after the length between end plates needing to be fixed between the lumbar 4/5 vertebral bodies is measured, the assembled fixed plate system is implanted into the body through a channel after the lumbar lordosis direction is consistent correspondingly well in the shortened state, 2-4 vertebral body screws 3 on the head side and the tail side are placed and locked, an operator cooperates with a surgical instrument or a manipulation to push the spinous process behind the lumbar of an operation area to recover the lumbar lordosis, the lumbar is reset, the locking screw 4 in the middle of locking in the reset state rebuilds the lumbar physiological lordosis and the sequence alignment and realizes the mechanical fixation. The position of the vertebral body screw 3 is preferably in the bone near the end plate, which ensures a high holding force of the vertebral body screw 3. The operation type solves the problems of decompression between lumbar vertebrae and internal fixation operation of bone grafting fusion by a simple oblique lateral minimally invasive approach by means of a telescopic fixing plate system, simplifies OLIF operation procedures and reduces operation complications.

In a similar way, the fixing plate system can be used for the surgical treatment of diseases such as multi-section or single-section thoracolumbar degeneration, trauma, infection, tumor and the like.

The embodiments of the present invention have been described in detail with reference to the accompanying drawings, but the present invention is not limited to the above embodiments, and various changes can be made without departing from the spirit of the present invention within the knowledge of those skilled in the art, and all such changes are within the scope of the present invention.

Claims

1. The thoracolumbar lateral adjustable fixing plate system is characterized by comprising a locking plate (1), a sliding plate (2), a vertebral body screw (3) and a locking screw (4), wherein the locking plate (1) and the sliding plate (2) are arc-shaped plates, each arc-shaped plate has a radian along the longitudinal direction, and the radian corresponds to the local physiological curvature of the thoracolumbar; the arc-shaped plate has a radian along the transverse direction, and the radian corresponds to the radian of the side wall of the vertebral body;

the inner end of the locking plate (1) is provided with a fixing hole (7), and the outer end is provided with a screw hole for mounting a vertebral body screw (3);

the inner end of the sliding plate (2) is provided with a long hole (6), and the outer end is provided with a screw hole for mounting a vertebral body screw (3);

when the locking device is used, the sliding plate (2) is placed on the locking plate (1), the locking screw (4) penetrates through the elongated hole (6) and the fixing hole (7), and the locking plate (1) is connected with the sliding plate (2) through the locking screw (4); the vertebral body screw (3) is implanted in the position of the vertebral body of a patient close to the end plate through the screw hole.

2. The thoracolumbar lateral adjustable fixing plate system according to claim 1, characterized in that the tail end of the vertebral body screw (3) is embedded in the screw hole and is flush with the upper surfaces of the locking plate (1) and the sliding plate (2).

3. The thoracolumbar lateral adjustable fixing plate system according to claim 1, characterized in that the inner ends of the locking plate (1) and the sliding plate (2) are both prefabricated with step surfaces (5), and the radian and length of the two step surfaces (5) are the same; when the locking plate (1) is connected with the sliding plate (2), the two step surfaces (5) are overlapped.

4. The thoracolumbar lateral adjustable fixing plate system according to claim 1, characterized in that the locking plate (1), the sliding plate (2), the vertebral body screw (3) and the locking screw (4) are made of titanium alloy material.

5. The lateral adjustable fixing plate system of thoracolumbar spine according to claim 1, characterized in that the locking screws (4) are flange screws.

6. The lateral adjustable fixing plate system for thoracolumbar vertebrae according to claim 1, wherein the number of screw holes at the outer ends of the locking plate (1) and the sliding plate (2) is 1-2.

7. The lateral adjustable fixing plate system for thoracolumbar vertebrae according to claim 1, wherein the length between the two outer ends of the locking plate (1) and the sliding plate (2) is 20-70 mm.

8. The thoracolumbar lateral adjustable fixation plate system of claim 1, wherein the length of the vertebral body screw (3) is 30-45 mm.

9. The lateral adjustable fixing plate system for thoracolumbar vertebrae according to claim 1, characterized in that the width of the locking plate (1) and the sliding plate (2) is 20-30 mm and the thickness is 5-10 mm.

10. The thoracolumbar lateral adjustable fixation plate system of claim 1, wherein the arc of the curved plate is 5 ° to 15 ° in the longitudinal direction and 2 ° to 10 ° in the transverse direction.