CN2439264Y - Internal fixation device for lumber spondy-lolisthesis reposition - Google Patents

Abstract

The utility model relates to an internal fixation device for lumber slippage reposition, which is composed of a hexagonal connection screw rod, a straight head self-tapping screw nail, an oblique head self-tapping screw nail and a screw cap, wherein, the hexagonal connection screw rod is a whole rod, one end is hexagonal, and the other end is a round head with an opening. The straight head self-tapping screw nail is sheathed in the opening of the hexagonal connection screw rod and is fixed by the screw cap. The oblique head self-tapping screw nail is provided with a hexagonal borehole jack on one hexagonal end of the hexagonal connection screw rod. A bracing sleeve barrel is arranged between the two screw nails and is cooperated with the hexagonal connection screw rod. The utility model is an internal fixation device for lumber slippage reposition, which has the advantages of simple structure, convenient operation and firm connection. In addition, the utility model is suitable for different slippage degrees.

Description

The lumbar spondylolisthesis inner fixer that resets

This utility model relates to a kind of medical apparatus and instruments, is specifically related to a kind of orthopaedics with the inner fixer that resets of the lumbar spondylolisthesis in the implant into body.

On modern age Osteopathic Medicine history, the appearance of pedicle screw, the shortcoming of all technology before having overcome, the new era of having started the spondylolisthesis treatment.Dick in 1987 have reported the severe centrum olisthe of use " FI " treatment 3～4 degree; Adopt two-step method, at first insert the Schanz nail at waist 4 and sacrum 1 pedicle of vertebral arch percutaneous, skin connects " FI " bar outward, slowly resets 10 days; In second step, the way of escape is cut, and waist 4Schanz nail is moved on to waist 5 pedicles of vertebral arch, and it is fixing further to reset, capable simultaneously unisegmental intervertebral fusion.Hou Shuxun etc. are after the pedicle of vertebral arch form of having measured thoracic vertebra and lumbar vertebra under the compatriots, the Dick apparatus has been carried out improvement design, keeping on original basis that vertically struts function, by increasing suspention hook fixed reset screw, and as the capable Retracting repositioning of fulcrum, increased the diameter of thread that the screw that resets enters the vertebral body part simultaneously, to improve the resistance to plucking output capacity of screw.Clinical practice 45 routine lumbar spondylolisthesis patients, average slippage rate 48.3% (32.6%～78.5%), reset rate 83.8% (65%～100%).But cooperate back brace early ambulation, no complication takes place.

The mid-80, Edwards and other scholar propose the progressively reduced method of spondylolysis, use when its main method is 1: three kind of corrective force (strut pull up behind power, waist 5 vertebral bodys, sacrum osteocampsia power); 2: 2 of rumpbones fixing (sacrum 1, sacrum 2); 3: viscoelastic stress loose; 4: the recovery of dissecting sequence is so that bone grafting.Edwards has reported the spondylolishesis of 18 examples, 2～4 degree, uses Edwards spinal adjustments system, 12～59 years old age, and average 25 years old, 2 years follow up a case by regular visits to, slip angle is average 33 ° before the art, and postoperative on average is remedied in 4 °.The trunk height on average recovers 32mm, and complication obviously reduces, and 1 example infects for the bone place, and 1 example does not merge.Point out that simultaneously an experienced spinal surgeons is used this cover apparatus, the correction of slip angle answers 80～90%, and remaining slippage should not merged within 10～15% within 1～2 degree, and serious nervous lesion does not take place.1985, Gaines and Nichols at first reported 16 routine patients, used preceding road waist 5 vertebral resections, and way of escape excision vertebral plate and pedicle of vertebral arch shorten spinal column, merged between row waist 4 sacrums 1 vertebral body, and Ha Shi rod or pedicle inner fixer are fixed.Kyphosis and trunk height do not recover as a result, and temporary nerve injury appears in nearly 50% case, and nonvolatil function of nervous system appears in about 37% case partly to be damaged, and 2 years follow up a case by regular visits to has 30% do not merge.

Through clinical practice for many years, spondylolysis has had significant progress at aspects such as the cause of disease, treatments.At present, for the spondylolysis of 1～4 degree, adopt disposable bone grafting or TFC (the Threaded fusion cage) intervertebral fusion of resetting of the way of escape, good curative effect can be finished and have to most cases.The spondylolysiss of 5 degree, first waist 5 vertebral resections that adopt, the second stage of way of escape bone grafting internal fixation that resets. Waist 4,5 nerve root decompression completely in the art can be improved clinical symptoms preferably.But in our clinical experiment, adopt apparatus reset fixing after, when way of escape bone grafting or TFC make intervertebral fusion, because it is fixing that the slippage vertebral body is resetted by inner fixer, intervertebral space can not be strutted, and can only rely on inner fixer to strut intervertebral space, could implant TFC, and strut apart from being difficult for and grasp, narrow then TFC is difficult for implanting, and wide then easy generation is not merged.In addition, because present inner fixer volume is bigger, when implementing TFC technology or bone grafting, operating apparatus is subjected to the obstruction of inner fixer, and part patient can not vertically enter intervertebral space, and tiltedly the side enters, also promptly can only implant one piece of TFC, if insert two pieces of TFC or both sides intervertebral fusion simultaneously, then easily pass vertebral body, and the anxiety of other anatomical structure of damage vertebral body the place ahead is arranged.From biomechanics, it is then smaller to resist LS shear stress, and these problems await further solution.

The purpose of this utility model is exactly in order to overcome the deficiency of prior art, for people provide a kind of simple in structure, more convenient to operate, be suitable for different slippage degree (2～4 degree, slip angle 5 degree in 30 °), connect the more firm lumbar spondylolisthesis inner fixer that resets.The purpose of this utility model realizes by following proposal.

The lumbar spondylolisthesis of the present utility model inner fixer that resets, by six side's connecting screw rods (1), straight peen tapping screw (2), plagiocephaly tapping screw (3), nut (5) is formed, six side's connecting screw rods (1) are whole bars, the one end is a hexagon, the other end is for there being the round end of opening (6), straight peen tapping screw (2) is inserted in the opening (6) of six side's connecting screw rods (1), and fixing with nut (5), plagiocephaly tapping screw (3) has hex hole (7) and is enclosed within the hexagonal end of six side's connecting screw rods, has one to strut sleeve (4) and six side's connecting screw rods (1) employing threaded engagement between two screws.

In the such scheme, the opening (6) of six side's connecting screw rods (1) is half oval openings of outside oblique 10～30 degree, and this open side is half vertical half splayed configuration.

In the such scheme, the thread segment on straight peen wherein and the plagiocephaly tapping screw (2) is taper.

In the such scheme, the hex hole (7) on the plagiocephaly tapping screw (3) is respectively left or to rotation 10 degree openings, the plagiocephaly angle of inclination of plagiocephaly tapping screw is preferably 10～20 degree.

In the such scheme, the centrage of half oval opening (6) of six side's connecting screw rods (1) is preferably 20～22mm from the distance of the screw thread other end, and the round end diameter is preferably 12～14mm.

In the such scheme, the length that struts sleeve (4) is preferably 13～15mm, and diameter is 10～11mm.

In the such scheme, the opening (6) of six side's connecting screw rods (1) is preferably outwards half oval opening of oblique 10 degree.

In the such scheme, side half splay gradient is preferably 30～40 degree.

In the such scheme, described nut (5) is the hemispherical nut, and the radius of hemispherical nut is identical with the concave size of the round end of six side's connecting screw rods (1), and driving fit so well prevents to become flexible.

The reset biomechanics comparative study of inner fixer of the lumbar spondylolisthesis of waist sacral reduction of spondylolisthesis inner fixer and prior art shows that this inner fixer structure is strong, and anti-axial compression, resistance to lateral bending, anti-rotation are all strong than other inner fixer, better reduction.Can make things convenient for the implantation of intervertebral bone grafting and TFC, after implant is implanted, have automatic pressurization simultaneously simultaneously.The present invention is mainly used in 2～4 degree, slip angle 5 degree lumbar spondylolisthesiss in 30 °, be a kind of simple in structure, more convenient to operate, be suitable for different slippage degree, connect the more firm lumbar spondylolisthesis inner fixer that resets.Further describe the technical solution of the utility model below by the embodiment accompanying drawing, but this utility model is not limited only to described embodiment.

Fig. 1 is an overall structure sketch map of the present utility model.

Among the figure: 1, six side's connecting screw rods; 2, straight peen tapping screw; 3, plagiocephaly tapping screw; 4, strut sleeve; 5, spheric nut; 6. opening; 7. hex hole.

Fig. 2 six side's connecting screw rod structural representations.

Fig. 3 straight peen tapping screw structural representation.

Fig. 4 plagiocephaly tapping screw structural representation.

Fig. 5 struts the sleeve sketch map.

As shown in the figure: waist sacral reduction of spondylolisthesis inner fixer of the present utility model, by six side's connecting screw rods (1), straight peen tapping screw (2), plagiocephaly tapping screw (3), nut (5) is formed, six side's connecting screw rods (1) are straight whole bars, the one end is a hexagon, the other end is for there being the round end of half oval opening (6), straight peen tapping screw (2) is inserted in the half oval opening (6) of six side's connecting screw rods (1), and it is fixing with nut (5), plagiocephaly tapping screw (3) has hex hole (7) and is enclosed within the hexagonal end of six side's connecting screw rods (1), have one to strut sleeve (4) and six side's connecting screw rods (1) employing threaded engagement between two screws, thread segment on straight peen wherein and the plagiocephaly tapping screw (2) is taper, hex hole (7) on the plagiocephaly tapping screw (3) is spent openings left or to rotation 10 respectively, and half oval opening (6) of six side's connecting screw rods (1) is half vertical half splayed configuration openings of oblique 10 degree.Nut (5) is the hemispherical nut, and the radius of hemispherical nut is identical with the concave size of the round end of six side's connecting screw rods (1), and driving fit so well prevents to become flexible.

Implant two pairs of straight peens and plagiocephaly tapping screw in the slippage respectively during operation, (waist 5 in the pedicle of vertebral arch of hypocentrum, sacrum 1), left-right symmetric, totally four pedicle screws, wherein the plagiocephaly tapping screw is respectively left and to two of 10 ° of right rotations, implant sacrum 1 pedicle of vertebral arch, confirm through the X sheet in the art, after screw position is correct, hexagonal bar one end of six side's connecting screw rods (1) is inserted among the hex hole (7) of plagiocephaly tapping screw (3), half oval opening (6) of the other end puts straight peen tapping screw (2), tighten hemispherical nut (5), the slippage vertebral body was resetted, turn and strut sleeve (4), can strut the intervertebral space of slippage vertebral body, be convenient to reset and implement bone grafting or other fusion methods (as TFC).Therefore, simple to operate, really fixing, the bone grafting healing is fast, can not influence operation because of the implantation of inner fixer during bone grafting, and back loss angle and rotation can not occur resetting.The present invention is because six side's connecting screw rods (1) one end is a hexagon, plagiocephaly tapping screw (3) adopts hexagon to cooperate with six side's connecting screw rods (1), can prevent the rotation of this screw on connecting screw rod, and strut sleeve (4) owing to adopted, turn this sleeve, straight peen and plagiocephaly tapping screw can be strutted again, the slippage vertebral body can be resetted well.In addition, half oval opening (6) of six side's connecting screw rods (1) adopts the opening of oblique 10 degree, be convenient to reset being connected of back and straight peen tapping screw, be difficult for skidding off after also being convenient to simultaneously connect, the lumbar spondylolisthesis that the side half splayed opening of half oval opening (6) is convenient to different slippage degree resets, can be used for 2～4 slippage and slip angle at 30 ° with 5 interior degree slippage lumbar spondylolisthesiss.The hex hole (7) that rotates 10 degree to the left or to the right on the plagiocephaly tapping screw (3) can be eliminated the angle (TSA) between waist and the sacrum pedicle of vertebral arch, makes the more driving fit and firm of connection of inner fixer.The vertebra screw thread of plagiocephaly and straight peen tapping screw can make screw stubborn more tight more in the process of being screwed into, and it is fixing more firm to make.

Claims (9)

1. the lumbar spondylolisthesis inner fixer that resets, by six side's connecting screw rods (1), straight peen tapping screw (2), plagiocephaly tapping screw (3), nut (5) is formed, it is characterized in that six side's connecting screw rods (1) are straight whole bars, the one end is a hexagon, the other end is for there being the round end of opening (6), straight peen tapping screw (2) is inserted in the opening (6) of six side's connecting screw rods (1), and fixing with nut (5), plagiocephaly tapping screw (3) has hex hole (7) and is enclosed within the hexagonal end of six side's connecting screw rods, has one to strut sleeve (4) and six side's connecting screw rods (1) employing threaded engagement between two screws.

2. the lumbar spondylolisthesis according to claim 1 inner fixer that resets, the opening (6) that it is characterized in that described six side's connecting screw rods (1) are outside half oval openings of oblique 10～30 degree, and this open side is half vertical half splayed configuration.

3. the lumbar spondylolisthesis according to claim 1 inner fixer that resets is characterized in that the thread segment on described straight peen tapping screw (2) and the plagiocephaly tapping screw (3) is taper.

4. the lumbar spondylolisthesis according to claim 1 inner fixer that resets is characterized in that hex hole (7) on the described plagiocephaly tapping screw (3) is respectively left or to rotation 10 degree openings, the plagiocephaly angle of inclination of plagiocephaly tapping screw is preferably 10～20 degree.

5. the lumbar spondylolisthesis according to claim 2 inner fixer that resets is characterized in that the centrage of half oval opening (6) of described six side's connecting screw rods (1) is preferably 20～22mm from the distance of the screw thread other end, and the round end diameter is preferably 12～14mm.

6. the lumbar spondylolisthesis according to claim 1 inner fixer that resets is characterized in that the described length that struts sleeve (4) is preferably 13～15mm, and diameter is 10～11mm.

7. the lumbar spondylolisthesis according to claim 2 inner fixer that resets is characterized in that the opening (6) of described six side's connecting screw rods (1) is preferably outwards half oval openings of oblique 10 degree.

8. the lumbar spondylolisthesis according to claim 2 inner fixer that resets is characterized in that described side half splay gradient is preferably 30～40 degree.

9. the lumbar spondylolisthesis according to claim 1 inner fixer that resets is characterized in that described nut (5) is the hemispherical nut, and the radius of hemispherical nut is identical with the concave size of the round end of six side's connecting screw rods (1).

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