JP3691565B2 - Spinal external fixator - Google Patents

Spinal external fixator Download PDF

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Publication number
JP3691565B2
JP3691565B2 JP00096596A JP96596A JP3691565B2 JP 3691565 B2 JP3691565 B2 JP 3691565B2 JP 00096596 A JP00096596 A JP 00096596A JP 96596 A JP96596 A JP 96596A JP 3691565 B2 JP3691565 B2 JP 3691565B2
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external fixator
spinal
connection pin
screw
head
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JPH09187465A (en
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▲高▼秀 黒川
薫 伊藤
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▲高▼秀 黒川
薫 伊藤
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7058—Plates mounted on top of bone anchor heads or shoulders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7049—Connectors, not bearing on the vertebrae, for linking longitudinal elements together
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A61B17/8635—Tips of screws

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Neurology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Description

【０００１】
【発明の属する技術分野】
本発明は湾曲、変形した人体の脊椎または脊椎動物の脊椎を矯正する脊椎創外固定器に関する。
【０００２】
【従来の技術】
脊椎の湾曲、変形の矯正治療は、手術によるか、創内に埋入させた脊椎創外固定器で行っている。
【０００３】
【発明が解決しようとする課題】
しかし、脊椎創外固定器による矯正治療は、脊椎に固定した固定ねじ相互の位置を後日調整する必要がある。しかし創内に固定した脊椎創外固定器ではこの調整を行う度に再手術する必要があり、この手術に伴う患者の肉体的苦痛に伴う負担が大きい等の不具合がある。
本発明はかかる不具合のない脊椎創外固定器を得ることを課題とする。
【０００４】
【課題を解決するための手段】
前記課題を解決する第１の手段は、請求項１記載のとおり、複数の椎体にそれぞれ固定して創内に埋入させる左右一対の固定ねじと、該固定ねじの頭部に接続して一部を創外に突出させる接続ピンと、各接続ピン相互の間隔を創外で調節可能に固定する固定具とから成る脊椎創外固定器において、上記固定ねじはその頭部に連通する細孔を備え、接続ピンは該細孔に挿着される針状突起を有すると共に、上記固定具には接続ピンと対応する位置にスリット溝が複数施されていることを特徴し、かかる構成を備えることで、各接続ピン相互の間隔の調節を創外から行うことができる。
【０００５】
また、第２の手段は、請求項２記載のとおり、請求項１の手段において、上記接続ピンは、その先端部に雄ねじ部を備え、固定ねじは、その頭部に、頂面から該接続ピンの雄ねじ部を螺合させる雌ねじ部を備えることを特徴とし、かかる構成を備えることで、該固定ねじへの接続ピンの接続を創外から簡単に行うことが出来る。
【０００６】
【発明の実施の形態】
本発明の実施の形態を図示するものに付き説明する。
図１〜図４で１は脊椎、２は椎体、２ａは横突起、２ｂは乳頭突起、Ｂは背中の表面を示す。
３は本発明の脊椎創外固定器を示し、該脊椎創外固定器３は、複数の椎体２のそれぞれ螺合して創内に埋込まれる左右一対の固定ねじ４と、該固定ねじ４の頭部４ａに接続して一部を創外に突出させる接続ピン５と、各接続ピン５相互の間隔を創外で調節可能に固定する固定具６とで構成される。
【０００７】
これを更に詳細に説明すると、固定ねじ４は、その頭部４ａに軸線方向に沿う窪みを備え、その内周面にねじを施して雌ねじ部４ｂとし、該固定ねじ４を各椎体２に螺合した後該雌ねじ部４ｂに、接続ピン５の雄ねじ部５ａを螺合させて固定ねじ４に接続ピン５を接続させる。接続ピン５には図６で示すように針状突起５ｂが設けられている。
【０００８】
なお、該固定ねじ４の中心には、その長さ方向に伸び且つ雌ねじ部４ｂと連通する細孔４ｃを備え、雌ねじ部４ｂへの雄ねじ部５ａの螺合に先だって、接続ピン５の先端中心から突出する前記針状突起５ｂが該細孔４ｃに挿着され、これが案内となって、雌ねじ部４ｂへの雄ねじ部５ａの螺合をし易くした。
【０００９】
なお、固定ねじ４と接続ピン５との間にはパッキンを介在させて、該雌ねじ部４ｂ内に体液等が侵入しないようにした。
【００１０】
この実施の形態の固定具６は、図５に示すように接続ピン５と対応する位置に多数の十字状のスリット溝Ａ−１を施した金属板Ａで構成した。
【００１１】
またこの固定具６に固定する接続ピン５は、その頭部に膨大部５ｃと該膨大部５ｃから突出するねじ部５ｄとを備え、該ねじ部５ｄを板材Ａのスリット溝Ａ−１に挿着した後該ねじ部５ｄに施したナット５ｅによって、板材Ａに接続ピン５を締付け固定させるようにした。
【００１２】
かくすることで、調節を必要とするナット５ｅを緩めた後、該十字状のスリット溝Ａ−１に沿って該接続ピン５を移動させれば、創外で簡単に各ピン５の相互の位置を調節でき、その後ナット５ｅを締めれば、各接続ピン５は相互の位置を調節された状態で固定具６に固定出来る。
【００１３】
図７に示す固定具６は、脊椎１の長さ方向に沿う２本のロッドＣ，Ｃで構成し、各ロッドＣに脊椎１のそれぞれの側に設けた接続ピン５を頭部で結着固定させるようにした。
【００１４】
これを更に説明すると、ロッドＣ，Ｃは、周面にローレット等の滑り止めを施した金属杆からなり、接続ピン５は、図８に示すごとく、その頭部に該ロッドＣが嵌まり込む凹部５ｆを備えるとともに、該凹部５ｆを施した部分の外周にねじ５ｇを施し、該ねじ５ｇ部にナット５ｈを施してナット５ｈを締めることで、ロッドＣの適宜位置に接続ピン５を結着固定できるようにした。
【００１５】
本発明の脊椎創外固定器による治療は、手術によって脊椎１を露出させ、椎体２の横突起２ａと乳頭突起２ｂとの間に図２に示すように固定ねじ４をねじ込み固定する。このとき固定ねじ４に接続ピン５を接続する。そしてこの手術と同時に、または一旦縫合した後、後日各接続ピン５を創外で固定具６に固定させる。
【００１６】
そして、各接続ピン５相互の間隔を調節する必要があるときは、創外から簡単に該固定具６への固定位置を調節することができる。
【００１７】
また、固定ねじ４と、この固定ねじ４の頭部に接続して一部を創外に突出させる接続ピン５を用い、各接続ピンを創外で固定具６に固定させるようにしたことで、別の接続ピン並びに固定具を別のものと簡単に交換出来、また脊椎の湾曲、変形脊椎の湾曲が完治したところで、該接続ピン５から外側のみを取り除くことで、大きな手術をすることなく脊椎創外固定器を外すことができる。
【００１８】
【発明の効果】
以上のように、請求項１の発明においては、各接続ピン相互の間隔を創外で調節できるので、各接続ピン相互の間隔を調整するための手術をする必要がなくなって、矯正治療に伴う患者の肉体的負担を軽減出来る。また請求項２の発明においては、各接続ピンを簡単に固定ピンに接続できる。
【図面の簡単な説明】
【図１】 本発明の実施の形態の１例を示す側面図
【図２】 図１の要部拡大図
【図３】 固定ねじの斜視図
【図４】 固定ねじの截断側面図
【図５】 固定具の１例を示す平面図
【図６】 接続ピンの斜視図
【図７】 本発明の他の実施の形態を示す正面図
【図８】 図７に使用する接続ピンの斜視図
【符号の説明】
２ 椎体 ４ 固定ねじ ４ａ 頭部
４ｂ 雌ねじ部 ５ 接続ピン ５ａ 雄ねじ部
６ 固定具[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a spinal external fixator that corrects a curved or deformed human spine or vertebrate spine.
[0002]
[Prior art]
Corrective treatment for spinal curvature and deformation is performed by surgery or using an external spinal fixator implanted in the wound.
[0003]
[Problems to be solved by the invention]
However, in the orthodontic treatment with the spinal external fixator, the positions of the fixation screws fixed to the spine need to be adjusted at a later date. However, the spinal external fixator fixed in the wound needs to be re-operated every time this adjustment is performed, and there is a problem such as a heavy burden caused by the physical pain of the patient.
An object of the present invention is to obtain a spinal external fixator free from such defects.
[0004]
[Means for Solving the Problems]
The first means for solving the above-mentioned problem is as described in claim 1, wherein a pair of left and right fixing screws fixed to a plurality of vertebral bodies and embedded in the wound are connected to the heads of the fixing screws. A spinal external fixator comprising a connection pin for projecting a part of the wound externally and a fixture for fixing the interval between the connection pins so as to be adjustable externally, wherein the fixing screw is a pore communicating with the head. The connecting pin has a needle-like projection inserted into the pore, and the fixture is provided with a plurality of slit grooves at positions corresponding to the connecting pin. Thus, the interval between the connection pins can be adjusted from the outside.
[0005]
Further, according to claim 2, the second means is the means according to claim 1, wherein the connection pin has a male screw portion at a tip thereof, and a fixing screw is connected to the head from the top surface. It is characterized by including a female thread part for screwing the male thread part of the pin, and by providing such a configuration, the connection pin can be easily connected to the fixing screw from the outside.
[0006]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
1-4, 1 is the spine, 2 is the vertebral body, 2a is the transverse process, 2b is the papillary process, and B is the surface of the back.
3 shows a spinal external fixator according to the present invention. The spinal external fixator 3 includes a pair of left and right fixing screws 4 that are screwed into a plurality of vertebral bodies 2 and embedded in the wound, and the fixing screws. 4, connecting pins 5 that are connected to the head 4 a and projecting a part of the connecting pins 5 to the outside of the wound, and fixtures 6 that fix the distance between the connecting pins 5 so as to be adjustable outside the wound.
[0007]
This will be described in more detail. The fixing screw 4 has a recess along the axial direction in its head 4a, and a screw is applied to its inner peripheral surface to form a female screw portion 4b. The fixing screw 4 is attached to each vertebral body 2. After screwing, the male screw portion 5a of the connecting pin 5 is screwed into the female screw portion 4b, and the connecting pin 5 is connected to the fixing screw 4. The connection pin 5 is provided with a needle-like protrusion 5b as shown in FIG.
[0008]
The center of the fixing screw 4 is provided with a pore 4c extending in the length direction and communicating with the female screw portion 4b. The needle-like protrusions 5b protruding from the hole 4c were inserted into the pores 4c, which served as guides to facilitate the screwing of the male screw part 5a to the female screw part 4b.
[ 0009 ]
Incidentally, with intervening packings between the fixing screw 4 and the connecting pin 5, the body fluid or the like is prevented from entering the female screw portion 4b.
[0010]
As shown in FIG. 5, the fixture 6 of this embodiment is composed of a metal plate A provided with a number of cross-shaped slit grooves A- 1 at positions corresponding to the connection pins 5.
[0011]
Further, the connection pin 5 to be fixed to the fixture 6 has a bulged portion 5c at its head and a screw portion 5d protruding from the bulged portion 5c, and the screw portion 5d is inserted into the slit groove A-1 of the plate A. After the attachment, the connection pin 5 is fastened and fixed to the plate A by a nut 5e applied to the screw portion 5d.
[0012]
In this way, after loosening the nut 5e that needs to be adjusted, if the connecting pin 5 is moved along the cross-shaped slit groove A-1, the mutual connection between the pins 5 can be easily performed outside the wound. If the position can be adjusted and then the nut 5e is tightened, the connection pins 5 can be fixed to the fixture 6 with their positions adjusted.
[0013]
The fixing tool 6 shown in FIG. 7 is composed of two rods C and C along the length direction of the spine 1, and connecting pins 5 provided on the respective sides of the spine 1 are attached to the rods C at the head. I tried to fix it.
[0014]
This will be further explained. The rods C and C are made of a metal rod having a slip surface such as a knurled surface, and the connecting pin 5 is fitted into the head thereof as shown in FIG. A recess 5f is provided, and a screw 5g is applied to the outer periphery of the portion provided with the recess 5f, a nut 5h is applied to the screw 5g, and the nut 5h is tightened, so that the connection pin 5 is attached to an appropriate position of the rod C. I was able to fix.
[0015]
In the treatment with the spinal external fixator of the present invention, the spine 1 is exposed by surgery, and a fixing screw 4 is screwed and fixed between the transverse process 2a and the papillary process 2b of the vertebral body 2 as shown in FIG. At this time, the connection pin 5 is connected to the fixing screw 4. Then, at the same time as this operation or once once sutured, each connection pin 5 is fixed to the fixture 6 outside the wound at a later date.
[0016]
And when it is necessary to adjust the space | interval between each connection pin 5, the fixing position to this fixing tool 6 can be adjusted easily from outside.
[0017]
In addition, by using the fixing screw 4 and the connecting pin 5 that is connected to the head of the fixing screw 4 and partially protrudes outside the wound, each connecting pin is fixed to the fixture 6 outside the wound. Another connecting pin and fixture can be easily exchanged for another, and when the curvature of the spine and the curvature of the deformed spine are completely cured, only the outside is removed from the connecting pin 5 without major surgery. The spinal external fixator can be removed.
[0018]
【The invention's effect】
As described above, according to the first aspect of the present invention, since the distance between the connection pins can be adjusted outside the wound, it is not necessary to perform an operation for adjusting the distance between the connection pins, and the correction treatment is accompanied. The physical burden on the patient can be reduced. In the invention of claim 2, each connection pin can be easily connected to the fixed pin.
[Brief description of the drawings]
1 is a side view showing an example of an embodiment of the present invention. FIG. 2 is an enlarged view of a main part of FIG. 1. FIG. 3 is a perspective view of a fixing screw . swash view of the connection pins used in the front view [Figure 8] Figure 7 illustrates another embodiment of a swash plan view the present invention; FIG plan view showing an example of the fixture 6 connecting pin Figure [Explanation of symbols]
2 vertebral body 4 fixing screw 4a head 4b female screw part 5 connection pin 5a male screw part 6 fixing tool

Claims (2)

複数の椎体にそれぞれ固定して創内に埋入させる左右一対の固定ねじと、該固定ねじの頭部に接続して一部を創外に突出させる接続ピンと、各接続ピン相互の間隔を創外で調節可能に固定する固定具とから成る脊椎創外固定器において、上記固定ねじはその頭部に連通する細孔を備え、接続ピンは該細孔に挿着される針状突起を有すると共に、上記固定具には接続ピンと対応する位置にスリット溝が複数施されていることを特徴とする脊椎創外固定器。A pair of left and right fixing screws that are respectively fixed to a plurality of vertebral bodies and embedded in the wound, a connection pin that is connected to the head of the fixing screw and projects a part to the outside of the wound, and a distance between each connection pin In the spinal external fixator comprising a fixing device that can be adjusted externally, the fixing screw has a pore communicating with its head, and the connecting pin has a needle-like projection inserted into the pore. A spinal external fixator having a plurality of slit grooves at positions corresponding to the connecting pins . 上記接続ピンは、その先端部に雄ねじ部を備え、固定ねじは、その頭部に、頂面から該接続ピンの雄ねじ部を螺合させる雌ねじ部を備えることを特徴とする請求項１記載の脊椎創外固定器。  The said connection pin is provided with the external thread part in the front-end | tip part, and the fixing screw is provided with the internal thread part which screw-fits the external thread part of this connection pin from the top surface to the head. Spinal external fixator.
JP00096596A 1996-01-08 1996-01-08 Spinal external fixator Expired - Lifetime JP3691565B2 (en)

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JP00096596A JP3691565B2 (en) 1996-01-08 1996-01-08 Spinal external fixator

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Application Number Priority Date Filing Date Title
JP00096596A JP3691565B2 (en) 1996-01-08 1996-01-08 Spinal external fixator

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JPH09187465A JPH09187465A (en) 1997-07-22
JP3691565B2 true JP3691565B2 (en) 2005-09-07

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CN104546107A (en) * 2015-02-05 2015-04-29 刘立峰 Percutaneous locking screw

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