JP2019165938A - Medical device - Google Patents

Abstract

To provide a medical device that appropriately supports a forward bent attitude of a patient himself/herself with a backbone rod, thus solving a drawback of prior arts that a backbone rod is fixed only on a backbone side by some member.SOLUTION: A medical device comprises: a backbone-side fixing member 2 to be fixed to a backbone support member 5 having a vertical prescribed length and fixed to a backbone side, or to be directly fixed to a backbone by bolts; a stationary-side gripping part 7 to contact either one side of vertical sides of some of ribs; and a moving-side gripping part 8 to contact the other side of the vertical sides of some of ribs. The medical device is formed of a rib-side fixing member 1 which is movable in a lengthwise direction with respect to the backbone-side fixing member 2.SELECTED DRAWING: Figure 1

Description

    The present invention relates to a medical device for spinal fixation.

Many types of spinal abnormalities often result from, but are not limited to, trauma, tumor, disc degeneration, and disease, and various spinal diseases such as scoliosis, degenerative disc disease For the treatment of disc herniation, spinal canal stenosis, or other malformations, a technique of immobilizing a portion of the spine is used, and for such procedures, two or more vertebrae are properly aligned and the spine Two or more vertebrae attached to the rod are permanently fixed by a connector (see Patent Document 1).
In addition, a connection support configuration is also known in which a pair of spine rods provided on both sides of the spine are connected by a pair of fixing members having grooves and screws (Patent Document 2).

JP 2005-503234 A JP 2017-221698 A

In each of the known examples, there is a problem that the spine rod cannot support the forward bending posture of the patient body satisfactorily because the spine rod is fixed only by the spine side by some member.
The present application provides a medical instrument that favorably supports the curvature of the spine by devising the configuration of the medical instrument and supporting the spine and ribs at two locations as fulcrums.

The invention of claim 1 is fixed to the spine support member 5 having a predetermined vertical length fixed to the spine S side, or to the spine side fixation member 2 fixed directly to the spine S side, A fixed-side gripping portion 7 that comes into contact with either the upper or lower side of the rib R and a moving-side gripping portion 8 that comes into contact with the upper or lower side of the rib are moved in the length direction with respect to the spine-side fixing member 2. This is a medical instrument constituted by a free rib-side fixing member 1.
According to a second aspect of the present invention, the fixed-side gripping portion 7 and the movable-side gripping portion 8 are formed in an arc shape whose tips are matched to the cross-sectional shape of the rib, and the fixed-side gripping portion 7 is fixed to the rib-side fixing member 1. The moving side gripping portion 8 is configured to be freely movable up and down with respect to the radius side fixing member 1, and the fixed side gripping portion 7 and the moving side gripping portion 8 are a linear shaft rod portion of the base portion and a circle at the tip end. The rib-side fixing member 1 is a long member extending in the lateral direction, and includes a rib fixing portion 12 and a rib fixing base portion continuous to the rib fixing portion 12. 13, and the rib fixing portion 12 is provided so that the fixed side gripping portion 7 is provided so as to protrude to either the upper or lower side, and the contact portion of the moving side holding portion 8 is protruded to the upper or lower side. Further, the groove portion 20 into which the shaft rod portion of the moving side gripping portion 8 is fitted and the shaft rod portion of the moving side gripping portion 8 fitted into the groove portion 20 are fixed. And a rib-side female screw hole 10 into which a gripping portion fixing screw 11 is screwed. The spine support member 5 is provided on either the left or right side or both sides of the spine S, and the rib-side fixing is performed. One or a plurality of fixtures K constituted by the member 1 and the spine side fixing member 2 are arranged side by side on the spine support member 5, or the spine support members 5 are provided on both left and right sides of the spine. Each spine support member 5 is provided with a plurality of the fixtures K arranged in the vertical direction, and the left and right fixtures K are medical devices provided at the same height position or shifted up and down.
According to a third aspect of the present invention, the fixed-side gripping portion 7 and the movable-side gripping portion 8 are formed in an arc shape whose tips are matched to the cross-sectional shape of the rib, and the fixed-side gripping portion 7 is fixed to the rib-side fixing member 1. The moving side gripping portion 8 is a medical instrument configured to be vertically movable with respect to the radius side fixing member 1.
According to a fourth aspect of the present invention, the fixed gripping portion 7 and the movable gripping portion 8 are formed to have a linear shaft rod portion at the base and an arcuate contact portion at the tip, and one of the contact portions. The part is a medical instrument formed to have the same diameter as the shaft bar part or a wider shape than the diameter of the shaft bar part.
According to a fifth aspect of the present invention, the abutment portion of the fixed-side gripping portion 7 is inclined in the plan view as it reaches the distal end with respect to the length direction of the radial-side fixing member 1 to fix the corresponding-side radial portion. A medical device having a configuration in which a plurality of types of different inclination angles with respect to the member 1 are provided from one side of the radial side fixing member 1 to the other side and selectively attached to the radial side fixing member 1 It is.
In the invention of claim 6, the radius side fixing member 1 is a long member extending in the lateral direction, and includes a radius fixing portion 12 and a radius fixing base portion 13 continuous to the radius fixing portion 12. The fixed side grip part 7 provided on the rib fixing part 12 so as to protrude either up or down, and the moving side grip so that the contact part of the moving side grip part 8 protrudes up or down on the other side. A rib side female screw hole 10 into which a groove portion 20 into which the shaft rod portion of the portion 8 is fitted and a gripping portion fixing screw 11 for fixing the shaft rod portion of the moving side holding portion 8 fitted into the groove portion 20 are screwed together. It is set as the medical device comprised with these.
In the invention of claim 7, a plurality of types of spine support members 5 having different diameters are prepared, and the grooves 42 of the spine fixing portion 40 are formed so as to correspond to the spine support members 5 having different diameters. A plurality of types of spine-side fixing members 2 having different sizes are prepared, and a medical device is configured to be attachable by selectively combining the spine-side fixing member 1 with the rib-side fixing member 1 as appropriate.
According to an eighth aspect of the present invention, the rib-side fixing member 1 includes a rib fixing part 12 and a rib fixing base part 13 continuous to the rib fixing part 12, and the rib fixing part 12 is on either the upper or lower side. The fixed gripping portion 7 provided so as to protrude from the groove portion 20 and the groove portion 20 into which the shaft rod portion of the movable gripping portion 8 is fitted so that the contact portion of the movable gripping portion 8 projects upward or downward. And a rib-side female screw hole 10 into which a gripping portion fixing screw 11 for fixing the shaft rod portion of the moving side gripping portion 8 fitted in the groove portion 20 is screwed. A plurality of types having different shapes of the portion 7 and the moving side gripping portion 8 are prepared, and the medical device is configured to be selectively attached to the radial side fixing member 1.
According to the ninth aspect of the present invention, the spine support member 5 is provided on either the left or right side or both sides of the spine S, and the fixture K constituted by the rib side fixing member 1 and the spine side fixing member 2 is used for the spine. One or more medical devices are arranged on the support member 5 in the vertical direction.
According to a tenth aspect of the present invention, the spine support members 5 are provided on both the left and right sides of the spine, and a plurality of the fixtures K are arranged vertically on each of the spine support members 5, and the left and right fixtures K have the same height. It is a medical device that is shifted in position or up and down.

In the first and second aspects of the present invention, the rib R and the spine S are constituted by the spine side fixing member 2 fixed to the spine S side and the rib side fixing member 1 fixed to the rib R side. The spine S can be supported at two locations, the load applied to the spine S can be dispersed, the spine S can be effectively deformed and bent, and the spine S Since the ribs R separated in the lateral direction can be supported, the load burden applied to the spine S can be further dispersed over a wide portion in the left-right direction, and in particular, the effect of correcting the forward bending posture can be improved.
Further, since the rib-side fixing member 1 is provided with the fixed-side gripping portion 7 and the movable-side gripping portion 8 that is movable with respect to the fixed-side gripping portion 7, the rib R can be fixed and supported favorably. The deformation of the spine S and the correction of the curvature can be effectively performed.
In the invention of claim 3, the fixed side gripping portion 7 and the movable side gripping portion 8 are formed in an arc shape whose tips are matched to the cross-sectional shape of the rib R, and the fixed side gripping portion 7 is fixed to the spine side fixing member 2. The movable gripping portion 8 is configured to be movable up and down with respect to the spine side fixing member 2, so that the rib R can be fixedly supported in accordance with the shape of the rib R, and the support strength of the rib R is improved. Thus, the overall support of the spine S can be strengthened.
In the invention of claim 4, the fixed side gripping portion 7 and the moving side gripping portion 8 are formed to have a linear shaft rod portion at the base and an arc-shaped contact portion at the tip, and a part of the contact portion Is formed to have the same diameter as the diameter of the shaft rod portion or a wide shape, so that any portion of the rib R can be fixedly supported, and the support strength of the rib R can be improved. The whole can be strengthened.
In the invention of claim 5, the abutting portion of the fixed-side gripping portion 7 is inclined as it reaches the distal end with respect to the length direction of the radial-side fixing member 1 in plan view, and the radial-side fixing member 1 of the abutting portion. A plurality of types of ribs with different inclination angles from one side to the other side in the length direction of the rib-side fixing member 1 are prepared and selectively attached to the rib-side fixing member 1. Even so, the support strength of the radius R can be improved and the support of the spine S can be strengthened in general.
In the invention of claim 6, the radius side fixing member 1 is a long member extending in the lateral direction, and includes a radius fixing portion 12 and a radius fixing base portion 13 continuous to the radius fixing portion 12. The fixed portion 12 has a fixed side grip portion 7 provided so as to protrude either up or down, and a shaft rod portion so that a contact portion of the movable side grip portion 8 protrudes either up or down. A groove portion 20 to be fitted and a rib side female screw hole 10 into which a grip portion fixing screw 11 for fixing the shaft rod portion of the moving side grip portion 8 fitted in the groove portion 20 is screwed are configured. Therefore, the spine S and the ribs R can be connected and supported with a simple configuration.
In the invention of claim 7, a plurality of types of spine support members 5 having different diameters are prepared, and the groove portions 42 of the spine fixing portion 40 are formed so as to correspond to the spine support members 5 having different diameters. A plurality of types of spine-side fixing members 2 having different sizes are prepared, and the rib-side fixing member 1 is configured to be appropriately combined and attached to the spine-side fixing member 2. The rib-side fixing member 1 can be attached to the supporting member 5 for the spine, and versatility can be improved.
In the invention of claim 8, a plurality of types having different shapes of the fixed side gripping portion 7 and the movable side gripping portion 8 are prepared and selectively attached to the radial side fixing member 1. Can be improved.
In the invention of claim 9, the spine support member 5 is provided on either the left or right side or both sides of the spine S, and the fixture K constituted by the rib side fixing member 1 and the spine side fixing member 2 is used to support the spine. Since one or a plurality of members 5 are arranged side by side in the vertical direction, the medical device of the present invention can be mounted in accordance with various vertebral bodies and ribs R of the spine S, and versatility is improved. Can do.
In the invention of claim 10, the spine support members 5 are provided on the left and right sides of the spine S, and a plurality of the fixtures K are arranged vertically on each spine support member 5, and the left and right fixtures K are at the same height. Since the position or the position is shifted up and down, the medical device of the present invention can be selected and attached even in various spine and rib states, and versatility can be improved.

The schematic diagram which attached the medical instrument to the skeleton. The schematic diagram of the cross section. The disassembled perspective view of a fixing tool. The perspective view of other embodiment of a holding part. The disassembled perspective view of other embodiment of a fixing tool. The disassembled perspective view of other embodiment of a fixing tool. The top view and rear view, and the rear view of other embodiment. The schematic diagram of the holding state of a holding part.

  One embodiment which can implement medical instrument T of the present invention is described using a drawing. In order to facilitate understanding, the length direction of the spine S (FIG. 1) is set to the vertical direction, the rib R is set to the horizontal direction, and this will be described as appropriate using directions such as front and rear, left and right. The configuration of the invention is not limited. In order to facilitate understanding, the backbone S, the rib R, and the bone body are referred to, but the configuration of the present invention is not limited by these names.

The medical instrument T of the present invention is configured by one or a plurality of fixing tools K, and the fixing tool K includes a rib side fixing member 1 fixed to the rib side and a spine side fixing member 2 fixed to the spine side. To do.
The spine side fixing member 2 only needs to be fixed to the spine side, and the fixing means is arbitrary. For example, the spine side fixing member 2 may be directly fixed to the spine side by the screw screw 3 or the like. It may be configured to be fixed to a longitudinal rod-shaped support member 5 for the spine that is fixed to the side in parallel with the spine by a screw screw 3 or the like.

Here, in the present embodiment, the spine support member 5 may be directly attached to the vertebral body of the spine S, or a predetermined intervention such as a bone screw screwed into the vertebral body. The spine support member 5 may be provided on one of the left and right sides of the spine S, and a pair of spine support members 5 may be provided on the left and right sides of the spine S. It may be provided.
In the pair of spine support members 5 of the present embodiment, the cross-sectional shapes thereof are substantially equal to each other, but the present invention is not limited to this.

When there is a spine support member 5 fixed to the spine side, the fixture K of the medical instrument T of the present invention includes the spine support member 5 in addition to the rib side fixation member 1 and the spine side fixation member 2. If there is no spine support member 5 fixed on the spine side, the rib side fixation member 1 and the spine side fixation member 2 are used.
In FIG. 1, the fixture K attached to the spine support member 5 is shown on the right side of the spine S, and an example of the fixture K not provided with the spine support member 5 on the left side of the spine S is shown. The number of K and the installation position are arbitrary and are not limited by these.
For example, in the lower part of the spine S in FIG. 1, a fixture K ′ having a spine fixing portion 40 described later is fixed to the spine (vertebrae / lumbar vertebra) S side, and the pair of spine support members 5 and the spine S side are connected. I support it.

The rib-side fixing member 1 has a fixed-side gripping portion 7 that comes into contact with either the upper or lower side of a part of the rib R of the rib cage S and the rib R, and the upper or lower side of the rib. The movable side gripping portion 8 is in contact with the spine side fixing member 2 so as to be movable in the length direction (FIG. 3).
The fixed-side gripping portion 7 and the movable-side gripping portion 8 are formed in an arc shape whose tips are matched to the cross-sectional shape of the rib, and the fixed-side gripping portion 7 is provided in a fixed state on the rib-side fixing member 1, 8 is configured to be vertically movable with respect to the rib side fixing member 1 (FIG. 3).

Specifically, the radius side fixing member 1 includes a radius side female screw hole 10 into which a grasping portion fixing screw 11 for fixing the moving side grasping portion 8 is screwed.
The rib side fixing member 1 is formed of a long member that is long in the left-right direction, and a rib fixing part 12 that can fix the ribs, and a rib fixing base part that extends continuously in the spine direction from the rib fixing part 12. Part 13.

  The rib fixing portion 12 includes the fixed-side gripping portion 7 and the moving-side gripping portion 8, and the moving-side gripping portion 8 is formed of a vertical member and is formed on one of the upper and lower sides. It is attached to the rib fixing portion 12 side so as to be movable, and is formed on either the upper or lower side of the linear movement side shaft rod portion (shaft rod portion) 14 and the upper or lower surface of the rib. And a moving contact portion 15 in contact therewith.

The moving side abutting portion 15 is formed in an arc shape so as to abut on either the upper or lower surface of the rib according to the cross-sectional shape of the rib. The moving-side abutting portion 15 may be formed in a wide shape whose tip is wider than the moving-side shaft rod portion 14 (FIG. 4).
In addition, the direction of the moving-side shaft rod portion 14 of the moving-side gripping portion 8 may be inclined to the left, middle, or right with respect to the rib fixing portion 12 in plan view.
The fixed-side gripping portion 7 is formed of a member in the vertical direction, and has a linear fixed-side shaft rod portion 16 fixed to a predetermined position of the rib-side fixing member 1 and a tip that contacts either one of the upper and lower surfaces of the rib. The fixed-side abutting portion 17 is provided.

The fixed-side contact portion 17 may be formed in a wide shape whose upper and lower intermediate portions are wider than the fixed-side shaft rod portion 16.
Further, the direction of the fixed-side contact portion 17 of the fixed-side gripping portion 7 may be inclined to the left, middle, or right in plan view.
Further, the rib-side fixing member 1 may be prepared in such a manner that a plurality of types having different shapes of the fixed-side gripping portion 7 and the moving-side gripping portion 8 of the rib fixing portion 12 are prepared and selectively attached to the spine-side fixing member 2. Good.
The rib-side fixing member 1 is based on the fact that the moving-side gripping portion 8 having the same shape as that of the fixing-side gripping portion 7 is attached to the rib-fixing portion 12, but has a shape different from the shape of the fixing-side gripping portion 7. The movable side gripping portion 8 may be selectively attached.

  The rib side fixing member 1 includes a groove portion 20 into which the moving side shaft rod portion 14 of the moving side gripping portion 8 is inserted and engaged, and a moving side shaft rod portion 14 of the moving side gripping portion 8 engaged with the groove portion 20. And a gripping portion fixing female screw hole 10 into which the gripping portion fixing screw 11 is screwed to fix the moving side gripping portion 8 with respect to the radius side fixing member 1 and allowing the movable side gripping portion 8 to move freely and vertically. It can be held.

  The groove portion 20 is formed so as to extend in a direction substantially perpendicular to the longitudinal direction of the radius side fixing member 1, that is, in a direction substantially the same as the longitudinal direction of the moving side gripping portion 8 attached to the radius side fixing member 1. A shaft rod member receiving portion 21 for supporting the moving side shaft rod portion 14 of the moving side gripping portion 8 engaged with the groove portion 20 is formed in the rib fixing portion 12 on the outer side of the groove portion 20. Has been.

  The shaft bar member receiving portion 21 is formed to have an inner peripheral surface formed so as to be along substantially half or more of the outer peripheral surface of the moving side shaft rod portion 14 of the moving side gripping portion 8. The configuration is such that the radial direction relative to the axial direction of the portion 14 is not lost.

  The holding part fixing screw hole 10 is formed so as to incline toward the center of the groove part 20 and penetrate the rib fixing part 12. Specifically, the grip portion fixing screw hole 10 is engaged with the groove portion 20 by the grip portion fixing screw 11 screwed into the grip portion fixing screw hole 10. The shaft-side member receiving portion is brought into contact with the outer peripheral surface of the moving-side shaft rod portion 14 of the moved-side gripping portion 8 and pressed against the shaft-side member receiving portion 21 side. The moving side shaft rod portion 14 of the moving side gripping portion 8 is formed so as to be able to be fixed in the inside 21.

In other words, when the gripping portion fixing screw 11 is screwed into the gripping portion fixing screw hole 10, the moving side shaft rod portion 14 of the moving side gripping portion 8 is connected to the gripping portion fixing screw 11 and the shaft rod member receiving portion 21. The shaft bar member receiving portion 21 is fixed in a state of being prevented from coming off by the inner peripheral surface.
The spine side fixing member 2 includes a spine side female screw hole 25 into which the screw screw 3 is screwed (FIG. 3).

  In this case, the screw screw 3 includes a fixing screw screw 3A having a nut portion 27 at the upper portion of the screw shaft portion 26, and a fitting groove into which the spine support member 5 is fitted at the upper portion of the screw shaft portion 26. Although a receiving screw screw 3B configured by bending or rotating a “U” -shaped rod receiving portion 29 having 28 is illustrated as an example, if it can be fixed to the spine S side via another intervening member Good.

  That is, the spine-side fixing member 2 of the left-side fixing tool K in FIG. 1 is configured to be directly fixed to the spine S side by a fixing screw 3A screwed into the spine-side female screw hole 25. The spine side fixing member 2 of the right fixture 1 of FIG. 1 has the spine support member 5 fitted in the fitting groove 28 of the rod receiving portion 29 of the receiving screw screw 3B to be screwed into the spine side female screw hole 25. The fixing member that fixes the spine support member 5 to the spine S side and the fixing member that fixes the spine support member 5 directly to the spine S side are combined. Alternatively, the spine support member 5 may be fixed to the spine S side via another intervening member.

  The spine-side fixing member 2 is configured to be movable in the left-right direction (lateral direction) relative to the rib-side fixing member 1. This moving configuration is arbitrary, but an insertion hole 35 is provided on one side of the rib side fixing member 1 and the spine side fixing member 2, and on either side of the rib side fixing member 1 and the spine side fixing member 2. Is provided with an insertion portion 36 to be inserted into the insertion hole 35, and the rib side fixing member 1 and the spine side fixing member 2 are fixed by a fixing screw 37.

FIG. 5 shows another embodiment of the fixture K, in which the spine side fixing member 2 is supported by the spine support member 5.
Specifically, the spine-side fixing member 2 includes a spine fixing portion 40 capable of fixing the spine support member 5 and a spine fixing base portion 41 formed continuously to the spine fixing portion 40.
In addition, you may employ | adopt the structure fixed to the spine S side with the receiving screw screw 3B among the fixing tools K of FIG.

  The spine fixing part 40 opens in a direction (longitudinal direction) substantially perpendicular to the longitudinal direction of the spine side fixing member 2, and a groove part 42 formed so as to be engageable with the spine support member 5. In order to fix the spine support member 5 engaged with 42, a spine side female screw hole 25 to which the spine side fixing screw 43 is screwed is provided.

  The groove portion 42 is formed so as to extend in a direction substantially perpendicular to the longitudinal direction of the spine side fixing member 2, that is, in a direction substantially the same as the longitudinal direction of the spine support member 5 attached to the spine side fixing member 2. A spine member receiving part 45 for supporting the spine support member 5 engaged with the groove part 42 is formed in the spine fixing part 40 on the outer side of the groove part 42.

  The spine side female screw hole 25 is formed so as to incline toward the center of the groove portion 42 and penetrate the spine fixing portion 40. Specifically, the spine side female screw hole 25 is engaged with the groove portion 42 at the distal end of the spine side fixing screw 43 by the spine side fixing screw 43 screwed into the spine side female screw hole 25. The spine support member 5 is brought into contact with the outer peripheral surface of the left spine support member 5 and pressed against the spine member receiving portion 45 so that the spine support member 5 is placed in the spine member receiving portion 45. It is formed so that it can be fixed.

FIG. 6 shows another embodiment, and the shape of each part of the rib fixing part 12 and the spine fixing part 40 is substantially the same as that of the second embodiment, but the shape of the rib fixing base part 13 and the spine fixing base part 41 is different. It is different in that it is formed by a so-called plate member.
In other words, the rib fixing base portion 13 and the spine fixing base portion 41 are overlapped in the front-rear direction, and the fastening fixing member 50 that fixes the rib fixing base portion 13 and the spine fixing base portion 41 is provided.

The configuration of the fastening and fixing member 50 is arbitrary, but a male screw portion 51 is provided in one of the rib fixing base portion 13 and the spine fixing base portion 41, and the insertion screw hole 52 through which the male screw portion 51 can move is provided in either one. The male screw portion 51 inserted through the insertion hole 52 is fixed with a fastening nut 53.
In this case, the rib-side fixing member 1 and the spine-side fixing member 2 are rotatable about the axial center of the male screw portion 51, and the position adjustment between the rib-side fixing member 1 and the spine-side fixing member 2 is performed by turning. Is possible.
Thus, the medical instrument T includes the rib-side fixing member 1 and the spine-side fixing member 2 to form the fixing tool K, but each of the rib-side fixing member 1 and the spine-side fixing member 2 is shaped. A plurality of different types may be prepared, and these may be selectively combined.
For example, in the rib-side fixing member 1, the orientation, shape, size, and the like of the fixed-side abutting portion 17 of the fixed-side gripping portion 7 of the radius fixing portion 12 and the moving-side abutting portion 15 of the moving-side gripping portion 8 are different. In addition, the spine side fixing member 2 is prepared to be directly attached to the spine S, and the spine support member 5 is attached to the spine support member 5. A plurality of types of spine side fixing members 2 having different sizes of the groove portions 42 of the spine fixing portion 40 so as to correspond to the support member 5 are prepared, and the rib side fixing member 1 and the spine side fixing member 2 are appropriately connected to each other. It is good also as a structure so that it can selectively combine.
As a result, the rib-side fixing member 1 of the present application can be attached to the spine support member 5 or the spine-side fixing member 2 manufactured by various manufacturers, and versatility can be improved.

The radial fixation member 1 of the present invention can be provided in a variety of different dimensions as required to accommodate the anatomy of the spine in the thoracic and lumbar portions of the spine.
While the invention has been illustrated and described in detail in the drawings and description, it is to be understood that the invention is merely illustrative and not restrictive of the invention, and that it is merely shown and illustrated in preferred embodiments. All changes and modifications within the spirit of this invention are protected by this invention.

(Operation of this embodiment)
A method for attaching the fixture K of the medical instrument T will be described.
First, the insertion portion 36 of the spine side fixing member 2 is inserted into the insertion hole 35 of the rib side fixing member 1, and this insertion portion 36 is prepared in a state where it is loosely fixed by the fixing screw 37.
In addition, the moving-side shaft rod portion 14 of the moving-side gripping portion 8 is inserted and engaged with the groove portion 20 of the rib-side fixing member 1 so that the moving-side shaft rod portion 14 is loosely fixed by the gripping portion fixing screw 11. Keep it.

The patient is lying on his or her back on the operating table. When the patient is incised from the back side and provided with the support member 5 for the spine, the support member 5 for the spine along the back side of the spine S is provided. Is assumed to be attached.
It is assumed that an incision is made in the vicinity of the joint between the spine S and the rib R of the patient on the operating table.

  The moving side in which the fixed side abutting portion 17 of the fixed side gripping portion 7 of the radius side fixing member 1 is brought into contact with either one of the upper and lower surfaces of the radius side, and then inserted into and engaged with the groove portion 20 of the radius side fixing member 1. The moving side shaft rod portion 14 of the gripping portion 8 is moved up and down to bring the moving side contact portion 15 of the moving side gripping portion 8 into contact with either the upper or lower side of the rib, and the rib R is fixed to the moving side gripping portion 8. It is set in a state of being sandwiched vertically by the side gripping portion 7.

Next, when the gripping portion fixing screw 11 screwed into the rib side female screw hole 10 of the rib side fixing member 1 is screwed in, the moving side shaft rod of the moving side gripping portion 8 is moved by the tip of the gripping portion fixing screw 11. The portion 14 is pressed toward the shaft rod member receiving portion 21, and the moving side shaft rod portion 14 of the moving side gripping portion 8 is fixed in the groove portion 20.
Thereby, the radius fixing | fixed part 12 of the radius side fixing member 1 is fixed to the radius R side.

Next, the spine-side fixing member 2 is moved with respect to the rib-side fixing member 1, the end of the spine-side fixing member 2 is fixed to the spine S side, and the attachment of the fixing tool K at one place is completed.
When the medical instrument T is constituted by this one fixing tool K, the mounting of the medical instrument T is completed with this, and when the fixing tool K is attached vertically and horizontally, the above installation work is performed. Repeatedly, a medical instrument T is obtained.

  In addition, the spine fixing | fixed part 40 of the edge part of the spine side fixing member 2 should just be fixed to the spine side, The fixing means is arbitrary, For example, the spine side fixing member 1 is spine directly by the screw screw 3 grade | etc.,. Although it may be fixed to the S side, in the configuration to be fixed to the vertical rod-shaped spine support member 5, the groove portion 42 of the spine fixation portion 40 of the spine side fixation member 2 is fitted to the spine support member 5, The spine support member 5 is pressed and fixed to the spine member receiving portion 45 by the spine side fixing screw 43.

When the spine support members 5 are provided on both the left and right sides of the spine, the above operation is repeated to fix the fixtures K on both sides of the spine.
In addition, there is a case where one fixing tool K is attached to the rib R and the spine S (supporting member 5 for the spine), or a plurality of the fixing tools K may be arranged side by side. Is repeated to obtain the medical device T.

Further, when the spine support members 5 are provided on both the left and right sides of the spine, a plurality of fixtures K are arranged vertically on each spine support member 5, and the left and right fixtures K are at the same height position or vertically. The medical instrument T may be shifted.
Even if the affected part is in the lower lumbar portion of the spine S, the fixture K attached to the rib R can assist the spine S in an auxiliary manner by attaching the fixture K to the rib R side. It can be expected and can improve the range of spinal fixation and the effect of the treatment.

In addition, fixation by the rib side fixing member 1 and the spine side fixing member 2 may be performed in the reverse order, and may be performed at substantially the same timing.
In this way, the connection support connection with one side of the spine, for example, the right rib, is completed with the medical instrument T, and the connection support connection with the other side, for example, the left rib, of the spine is completed in the same procedure.

Thereby, the medical instrument T can connect the spine side fixing member 2 fixed to the spine S side and the rib side fixing member 1 fixed to the rib R side, and the spine S can be connected to the longitudinal direction and the lateral direction. Can be corrected and supported, and the curvature of the spine can be corrected well.
That is, the medical instrument T of the present invention can support predetermined portions of the spine side fixing member 2 and the spine support member 5 fixed to the spine S side by the rib side fixing member 1 fixed to the rib R side, The support of the spine S and the curvature correction of the spine S are improved.
Further, the configuration of the fixture K of the medical instrument T is arbitrary, and the configurations shown in the drawings may be appropriately selected and combined.
That is, the medical instrument T includes the rib-side fixing member 1 and the spine-side fixing member 2 to form the fixing tool K, but each of the rib-side fixing member 1 and the spine-side fixing member 2 is shaped. A plurality of different types may be prepared, and these may be selectively combined.
For example, in the rib-side fixing member 1, the orientation, shape, size, and the like of the fixed-side abutting portion 17 of the fixed-side gripping portion 7 of the radius fixing portion 12 and the moving-side abutting portion 15 of the moving-side gripping portion 8 are different. In addition, the spine side fixing member 2 is prepared to be directly attached to the spine S, and the spine support member 5 is attached to the spine support member 5. A plurality of types of spine side fixing members 2 having different sizes of the groove portions 42 of the spine fixing portion 40 so as to correspond to the support member 5 are prepared, and the rib side fixing member 1 and the spine side fixing member 2 are appropriately connected to each other. Since it is configured so that it can be selectively combined, the rib side fixing member 1 of the present application can be attached to the spine support member 5 or the spine side fixing member 2 manufactured by various manufacturers. Can be improved.

  DESCRIPTION OF SYMBOLS 1 ... Radius side fixing member, 2 ... Spine side fixing member, 5 ... Spine support member, 7 ... Fixed side holding part, 8 ... Moving side holding part, 10 ... Gripping part fixing screw hole, 11 ... For holding part fixing Screws, 12 ... rib fixing part, 13 ... rib fixing base part, 14 ... moving side shaft bar part, 15 ... moving side contact part, 16 ... fixed side shaft bar part, 17 ... fixed side contact part, 20 ... groove part , 21 ... shaft rod member receiving part, 25 ... spine side female screw hole, 26 ... screw shaft part, 27 ... nut part, 28 ... fitting groove, 29 ... rod receiving part, 35 ... insertion hole, 36 ... insertion part, 37 ... fixing screw, 40 ... spine fixing part, 41 ... spine fixing base part, 42 ... groove part, 43 ... spine side fixing screw, 45 ... spine member receiving part, 50 ... fastening fixing member, 51 ... male screw part, 52 ... Insertion hole, 53 ... Fastening nut, K ... Fixing tool, T ... Medical instrument.

The invention of claim 1 includes a spine support member 5 having a predetermined vertical length fixed to the spine S side, and a spine side fixation member 2 constituting a part of a fixture K attached to the spine support member 5. A fixed-side gripping portion 7 that comes into contact with one of the upper and lower sides of a part of the ribs R, and a movable-side gripping portion 8 that comes into contact with either the upper and lower sides of the ribs R. lateral and a long rib-side fixing member 1 in the lateral direction to constitute a part of a movable fixture K to constitute the backbone-side fixing member 2 is fixed directly by a screw 3 in the spine S side Te The spine side fixing member 2 is provided with a spine side female screw hole 25 into which the screw 3 is screwed, and the screw 3 has a fitting groove 28 into which the spine support member 5 is fitted. The bone-side fixing member is formed by providing a rod receiving portion 29 having an upper portion so as to be bent or rotatable. A laterally long insertion hole 35 into which the laterally long insertion portion 36 provided in the bone side fixing member 2 can be movably inserted, and the insertion portion 36 are provided in a portion of the radial side fixing member 1 on the side. A fixing screw 37 to be fixed, and the fixing screw 37 can fix the rib-side fixing member 1 at a predetermined position in a direction intersecting the spine S with respect to the spine-side fixing member 2. 7 and the moving side gripping portion 8 are formed in a circular arc shape whose tip is matched to the cross-sectional shape of the rib, and the rib side fixing member 1 on the opposite side to the bone side fixing member 2 has a shaft rod of the moving side gripping portion 8. A groove portion 20 into which the portion 14 is fitted, and a rib side female screw hole 10 into which a gripping portion fixing screw 11 for fixing the shaft rod portion 14 of the moving side gripping portion 8 fitted in the groove portion 20 is screwed. The fixed side gripping part 7 and the movable side gripping part 8 are connected to the fixed side gripping part 7. One of the side gripping portions 8 is provided on the upper side of the radius side fixing member 1, and one of the fixed side gripping portion 7 and the moving side gripping portion 8 is provided on the lower side of the radius side fixing member 1. A configuration in which a space is provided between the tip of the contact portion 17 of the fixed-side gripping portion 7 and the tip of the contact portion 15 of the moving-side gripping portion 8 in a state of being engaged with both upper and lower sides of the rib R. This is a medical device.
According to a second aspect of the present invention, the fixed-side gripping portion 7 and the moving-side gripping portion 8 are formed to have a linear shaft rod portion at the base and an arc-shaped abutting portion at the tip. The part is a medical instrument formed to have the same diameter as the shaft bar part or a wider shape than the diameter of the shaft bar part.
According to a third aspect of the present invention, the abutment portion of the fixed-side gripping portion 7 is inclined in the plan view as it reaches the distal end with respect to the length direction of the radial-side fixing member 1 to fix the corresponding-side radial portion. A medical device having a configuration in which a plurality of types of different inclination angles with respect to the member 1 are provided from one side of the radial side fixing member 1 to the other side and selectively attached to the radial side fixing member 1 It is.
In the invention of claim 4, the spine support member 5 is prepared in a plurality of types having different diameters, and the grooves 42 of the spine fixing portion 40 are formed so as to correspond to the spine support members 5 having different diameters. A plurality of types of spine-side fixing members 2 having different sizes are prepared, and a medical device is configured to be attachable by selectively combining the spine-side fixing member 1 with the rib-side fixing member 1 as appropriate.
The invention of claim 5
A plurality of types of the fixed-side gripping portion 7 and the movable-side gripping portion 8 having different shapes are prepared, and the medical device is configured to be selectively attached to the radial side fixing member 1.
According to the sixth aspect of the present invention, the spine support member 5 is provided on either the left or right side or both sides of the spine S, and the fixture K constituted by the rib side fixing member 1 and the spine side fixing member 2 is used for the spine. One or more medical devices are arranged on the support member 5 in the vertical direction.
According to the seventh aspect of the present invention, the spine support members 5 are provided on both the left and right sides of the spine, and a plurality of the fixtures K are arranged in the vertical direction on each spine support member 5. It is a medical device that is shifted in position or up and down.

According to the first aspect of the present invention, the spine side fixing member 2 fixed to the spine S side and the rib side fixing member 1 fixed to the rib R side are used. The spine S can be supported, the load applied to the spine S can be dispersed, the spine S can be effectively deformed and bent, and the spine S can be separated laterally. Since the rib R can be supported, the load burden applied to the spine S can be further distributed over a wide portion in the left-right direction, and in particular, the effect of correcting the forward bending posture can be improved.
Further, since the rib-side fixing member 1 is provided with the fixed-side gripping portion 7 and the movable-side gripping portion 8 that is movable with respect to the fixed-side gripping portion 7, the rib R can be fixed and supported favorably. The deformation of the spine S and the correction of the curvature can be effectively performed.
In addition, since the fixed side gripping part 7 and the moving side gripping part 8 are formed in an arc shape that matches the cross-sectional shape of the radius R, the radius R can be fixedly supported according to the shape of the radius R, The support strength of the radius R can be improved, and thereby the overall support of the spine S can be strengthened.
In the invention of claim 2 , the fixed side gripping portion 7 and the moving side gripping portion 8 are formed to have a linear shaft rod portion at the base and an arc-shaped abutting portion at the tip, and a part of the abutting portion. Is formed to have the same diameter as the diameter of the shaft rod portion or a wide shape, so that any portion of the rib R can be fixedly supported, and the support strength of the rib R can be improved. The whole can be strengthened.
In the invention of claim 3 , the abutting portion of the fixed side gripping portion 7 is inclined as it reaches the tip with respect to the length direction of the radial side fixing member 1 in plan view, and the radial side fixing member 1 of the abutting portion is provided. A plurality of types of ribs with different inclination angles from one side to the other side in the length direction of the rib-side fixing member 1 are prepared and selectively attached to the rib-side fixing member 1. Even so, the support strength of the radius R can be improved and the support of the spine S can be strengthened in general.
In the invention of claim 4 , a plurality of types of spine support members 5 having different diameters are prepared, and the grooves 42 of the spine fixing portion 40 are formed so as to correspond to the spine support members 5 having different diameters. A plurality of types of spine-side fixing members 2 having different sizes are prepared, and the rib-side fixing member 1 is configured to be appropriately combined and attached to the spine-side fixing member 2. The rib-side fixing member 1 can be attached to the supporting member 5 for the spine, and versatility can be improved.
In the invention of claim 5, a plurality of types having different shapes of the fixed side gripping portion 7 and the moving side gripping portion 8 are prepared and selectively attached to the radius side fixing member 1. Can be improved.
In the invention of claim 6 , the spine support member 5 is provided on either the left or right side or both sides of the spine S, and the fixture K constituted by the rib side fixing member 1 and the spine side fixing member 2 is used to support the spine. Since one or a plurality of members 5 are arranged side by side in the vertical direction, the medical device of the present invention can be mounted in accordance with various vertebral bodies and ribs R of the spine S, and versatility is improved. Can do.
In the invention of claim 7 , the spine support members 5 are provided on the left and right sides of the spine S, and a plurality of the fixtures K are arranged in the vertical direction on each of the spine support members 5, and the left and right fixtures K have the same height. Since the position or the position is shifted up and down, the medical device of the present invention can be selected and attached even in various spine and rib states, and versatility can be improved.

The rib-side fixing member 1 has a fixed-side gripping portion 7 that comes into contact with either the upper or lower side of a part of the rib R of the rib cage S and the rib R, and the upper or lower side of the rib. The moving side gripping portion 8 is in contact with the spine side fixing member 2 so as to be movable in the lateral direction (FIG. 3).
The fixed-side gripping portion 7 and the movable-side gripping portion 8 are formed in an arc shape whose tips are matched to the cross-sectional shape of the rib, and the fixed-side gripping portion 7 is provided in a fixed state on the rib-side fixing member 1, 8 is configured to be vertically movable with respect to the rib side fixing member 1 (FIG. 3).

The invention of claim 1 includes a spine support member 5 having a predetermined vertical length fixed to the spine S side, and a spine side fixation member 2 constituting a part of a fixture K attached to the spine support member 5. A fixed-side gripping portion 7 that comes into contact with one of the upper and lower sides of a part of the ribs R, and a movable-side gripping portion 8 that comes into contact with either the upper and lower sides of the ribs R. And a laterally long rib-side fixing member 1 constituting a part of the fixing tool K that is movable in the lateral direction. The spine-side fixing member 2 is directly fixed to the spine S side by screws 3. The spine side fixing member 2 is provided with a spine side female screw hole 25 into which the screw 3 is screwed, and the screw 3 has a fitting groove 28 into which the spine support member 5 is fitted. the rod receiving portion 29 configured by providing the upper bendably or rotating with, the back bone side fixing part The said portion of the rib-side fixing member 1 of the 2 side, and a long insertion hole 35 in a lateral direction can be movably inserted into the back bone side fixing member 2 a long insertion portion 36 in the lateral direction provided in the insertion portion A fixing screw 37 for fixing 36, and the fixing screw 37 can fix the rib-side fixing member 1 at a predetermined position in a direction intersecting the spine 1S with respect to the spine-side fixing member 2; movable gripper 8 and the grip portion 7 is formed in an arc shape matching the tip cross-sectional shape of the rib, on the opposite side of the rib-side fixing member 1 and the back bone side fixing member 2, the movable gripping part 8 The rib portion female screw hole into which the groove portion 20 into which the shaft rod portion 14 is fitted and the gripping portion fixing screw 11 for fixing the shaft rod portion 14 of the moving side grasping portion 8 fitted in the groove portion 20 are screwed together. 10, and the fixed side gripping portion 7 and the movable side gripping portion 8 are fixed side gripping. 7 or the moving side gripping portion 8 protrudes above the radius side fixing member 1, and either the fixing side gripping portion 7 or the moving side gripping portion 8 protrudes below the radius side fixing member 1. A space is provided between the distal end of the abutting portion 17 of the fixed-side gripping portion 7 and the distal end of the abutting portion 15 of the moving-side gripping portion 8 in a state where the rib R is engaged with both the upper and lower sides of the rib R. This is a medical device having a configuration.
According to a second aspect of the present invention, the fixed-side gripping portion 7 and the moving-side gripping portion 8 are formed to have a linear shaft rod portion at the base and an arc-shaped abutting portion at the tip. The part is a medical instrument formed to have the same diameter as the shaft bar part or a wider shape than the diameter of the shaft bar part.
According to a third aspect of the present invention, the abutment portion of the fixed-side gripping portion 7 is inclined in the plan view as it reaches the distal end with respect to the length direction of the radial-side fixing member 1 to fix the corresponding-side radial portion. A medical device having a configuration in which a plurality of types of different inclination angles with respect to the member 1 are provided from one side of the radial side fixing member 1 to the other side and selectively attached to the radial side fixing member 1 It is.
In the invention of claim 4, the spine support member 5 is prepared in a plurality of types having different diameters, and the grooves 42 of the spine fixing portion 40 are formed so as to correspond to the spine support members 5 having different diameters. A plurality of types of spine-side fixing members 2 having different sizes are prepared, and a medical device is configured to be attachable by selectively combining the spine-side fixing member 1 with the rib-side fixing member 1 as appropriate.
The invention according to claim 5 is a medical instrument in which a plurality of types of the fixed-side gripping portion 7 and the movable-side gripping portion 8 having different shapes are prepared and selectively attached to the radial side fixing member 1. It is.
According to the sixth aspect of the present invention, the spine support member 5 is provided on either the left or right side or both sides of the spine S, and the fixture K constituted by the rib side fixing member 1 and the spine side fixing member 2 is used for the spine. One or more medical devices are arranged on the support member 5 in the vertical direction.
According to the seventh aspect of the present invention, the spine support members 5 are provided on both the left and right sides of the spine, and a plurality of the fixtures K are arranged in the vertical direction on each spine support member 5. It is a medical device that is shifted in position or up and down.

Claims (10)

  Either the spine-side fixing member 2 fixed on the spine S side and fixed to the spine support side 5 having a predetermined vertical length, or directly fixed on the spine S side, and some of the upper and lower sides of some ribs R A fixed-side gripping portion 7 that contacts the side and a movable-side gripping portion 8 that contacts either the upper or lower side of the rib, and the radial-side fixing member 1 that is movable in the longitudinal direction with respect to the spine-side fixing member 2 A medical device composed of   In Claim 1, the said fixed side holding part 7 and the movement side holding part 8 are formed in the circular arc shape which match | combined the front-end | tip with the cross-sectional shape of the rib, and the said fixed side holding part 7 is provided in the rib side fixing member 1 in the fixed state. The moving side gripping portion 8 is configured to be movable up and down with respect to the radial side fixing member 1, and the fixed side gripping portion 7 and the moving side gripping portion 8 have a linear shaft rod portion at the base and an arcuate shape at the tip. The rib-side fixing member 1 is a long member extending in the lateral direction, and includes a rib fixing portion 12 and a rib fixing base portion 13 continuous to the rib fixing portion 12. A fixed side gripping part 7 provided so as to protrude to either one of the upper and lower sides of the rib fixing part 12, and a contact part of the moving side holding part 8 to protrude to either the upper or lower side, The groove 20 in which the shaft rod portion of the moving side gripping portion 8 is fitted and the shaft rod portion of the moving side gripping portion 8 fitted in the groove portion 20 are fixed. And a rib-side female screw hole 10 into which a gripping portion fixing screw 11 is screwed. The spine support member 5 is provided on either the left or right side or both sides of the spine S, and the rib-side fixing is performed. One or a plurality of fixtures K constituted by the member 1 and the spine side fixing member 2 are arranged side by side on the spine support member 5, or the spine support members 5 are provided on both left and right sides of the spine. Each spine support member 5 is provided with a plurality of the fixtures K arranged in the vertical direction, and the right and left fixtures K are provided at the same height position or shifted up and down.   In Claim 1, the said fixed side holding part 7 and the movement side holding part 8 are formed in the circular arc shape which match | combined the front-end | tip with the cross-sectional shape of the rib, and the said fixed side holding part 7 is provided in the rib side fixing member 1 in the fixed state. The moving side grip 8 is a medical instrument configured to be movable up and down with respect to the radial side fixing member 1.   In claim 3, the fixed side gripping part 7 and the movable side gripping part 8 are formed to have a linear shaft rod part at the base and an arcuate contact part at the tip, and a part of the contact part is A medical device formed to have the same diameter as the shaft rod portion or a shape wider than the diameter of the shaft rod portion.   In Claim 4, the contact part of the said fixed side holding part 7 is made to incline toward the front-end | tip with respect to the length direction of the said rib side fixing member 1 in planar view, and the rib side fixing member 1 of the applicable contact part A medical instrument configured to prepare a plurality of different inclination angles with respect to the radial side fixing member 1 from one side to the other side in the length direction and selectively attach the radial side fixing member 1 to the radial side fixing member 1.   The rib fixing member 1 according to any one of claims 3 to 5, which is a long member extending in a lateral direction, and a rib fixing portion 12 and a rib continuous to the rib fixing portion 12. A fixed base portion 13, and a fixed side grip portion 7 provided on the rib fixing portion 12 so as to protrude to either the upper or lower side, and a contact portion of the movable side grip portion 8 on the upper or lower side. A groove 20 that fits the shaft rod portion of the moving side gripping portion 8 and a gripping portion fixing screw 11 that fixes the shaft rod portion of the moving side gripping portion 8 fitted in the groove portion 20 are screwed so as to protrude. A medical instrument configured to include a rib-side female screw hole 10.   The spine support member 5 according to any one of claims 1 to 6, wherein a plurality of types of spine support members 5 having different diameters are prepared so as to correspond to the spine support members 5 having different diameters. A plurality of types of spine side fixing members 2 having different sizes of the groove portions 42 of the spine fixing unit 40 are prepared, and the spine side fixing member 2 can be attached by selectively combining the rib side fixing members 1 appropriately. Instruments.   In any one of Claims 1-7, the said radius side fixing member 1 is equipped with the radius fixing | fixed part 12 and the radius fixing base part 13 continuing to this radius fixing | fixed part 12, and said radius fixing | fixed part 12, the fixed-side gripping portion 7 provided so as to protrude either up or down, and the axis of the moving-side gripping portion 8 so that the contact portion of the moving side gripping portion 8 protrudes up or down. A groove portion 20 into which the rod portion is fitted, and a rib side female screw hole 10 into which a grip portion fixing screw 11 for fixing the shaft rod portion of the moving side grip portion 8 fitted into the groove portion 20 is screwed are provided. A medical instrument having a configuration in which a plurality of types of the fixed-side gripping portion 7 and the movable-side gripping portion 8 having different shapes are prepared and selectively attached to the radial side fixing member 1.   9. The spine support member 5 according to claim 1, wherein the spine support member 5 is provided on either the left or right side or both sides of the spine S, and the rib side fixing member 1 and the spine side fixing are provided. A medical instrument configured such that one or a plurality of fixtures K constituted by the member 2 are vertically arranged on the backbone support member 5.   10. The spine support member 5 is provided on both left and right sides of the spine, and a plurality of the fixtures K are arranged in the vertical direction on each spine support member 5, and the left and right fixtures K are positioned at the same height or A medical device that is shifted up and down.

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