JP4275198B2 - Device for fixing and correcting spinal correction devices outside the body to the spine - Google Patents

Device for fixing and correcting spinal correction devices outside the body to the spine Download PDF

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JP4275198B2
JP4275198B2 JP17125996A JP17125996A JP4275198B2 JP 4275198 B2 JP4275198 B2 JP 4275198B2 JP 17125996 A JP17125996 A JP 17125996A JP 17125996 A JP17125996 A JP 17125996A JP 4275198 B2 JP4275198 B2 JP 4275198B2
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vertebral body
shaft
correction means
screw
fixing device
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JPH1014934A (en
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原 宗 平 江
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Mizuho Ika Kogyo KK
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002Longitudinal elements, e.g. rods
    • A61B17/7004Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A61B17/7007Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7074Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • A61B17/7077Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
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  • Engineering & Computer Science (AREA)
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  • Orthopedics, Nursing, And Contraception (AREA)
  • Surgical Instruments (AREA)

Description

【0001】
【発明の属する技術分野】
本発明は、側弯症患者の椎体のねじれや曲りを矯正するための脊椎矯正装置を人体の外部から椎体に固定するために使用される脊椎矯正装置を体外で脊椎に固定および矯正する装置に関する。
【0002】
【従来の技術】
側弯症患者の背骨は、三次元のねじれとして突起して弓状に曲がっており、かかる側弯症患者の椎体のねじれや曲りを矯正するには、背骨を構成する椎体の前後方向の曲がりと左右方向の曲がりの両方を矯正することが必要である。
【0003】
側弯症患者の椎体のねじれや曲りを矯正する外科的治療方式には、椎体を横側(医学上では前方と称する)から矯正する前方治療方式と、椎体を後側から矯正する後方治療方式とがある。
【0004】
前方矯正装置として、複数の椎体プレートと、各椎体プレートの開口を通して椎体に螺入される椎体スクリューと、椎体に螺入された椎体スクリュー同士を連結するロッドと、椎体スクリューの頭部頂面に設けられた止めねじとから構成したものは、既に知られている。
【0005】
上記前方矯正装置を椎体に取付けるには、側弯症患者の胸部または腹部を、メス等を用いて大きく開き、脊椎の椎体を露出する状態とし、側弯症患者の椎体の側面に椎体プレートを配置し、この椎体プレートを椎体スクリューを介して椎体に固定し、隣り合う椎体に螺入された椎体スクリュー同士をロッドで連結することにより行なわれる。
【0006】
【発明が解決しようとする課題】
上記前方矯正装置は、側弯症患者の胸部または腹部をメス等を用いて大きく開かないと、側弯症患者へ取付けることができないので、取付けに際して、側弯症患者への負担が大きく、術後に皮膚縫合等の処置を必要とするだけでなく、側弯症患者の術後の回復に相当の期間が必要となる。
【0007】
本発明は上記した点を考慮してなされたもので、側弯症患者にシャフトの通る開口を設けるだけで、脊椎矯正装置を人体の外部から椎体に固定できる、脊椎矯正装置を体外で脊椎に固定および矯正する装置を提供することを目的とする。
【0008】
【課題を解決するための手段】
本発明の脊椎矯正装置を体外で脊椎に固定および矯正する装置は、先端に椎体固定具保持部を有するベースシャフトと基端部に椎体矯正手段受け部を有しベースシャフトに長手方向に連結するように取付けられたアウトリガーシャフトとを有する複数本のシャフトと、各シャフトのベースシャフトに設けられた椎体固定具保持部に取り付けられた椎体固定具と、各シャフトのアウトリガーシャフトに設けられた椎体矯正手段受け部に係着された椎体の位置を矯正する椎体矯正手段とを有し、各シャフトは、人体に設けた開口を通してベースシャフトの椎体固定具保持部に取り付けられた椎体固定具を脊椎の椎体に固定し、椎体矯正手段は、ねじロッドと一対のナットであり、各椎体矯正手段受け部の両側に配置されたナットにより各シャフトのアウトリガーシャフトの椎体矯正手段受け部に係着され、各シャフトにコンプレッション等を加えることでベースシャフトの椎体固定具保持部に取り付けられた椎体固定具を介して椎体の位置を矯正し、脊椎矯正装置のプレートまたはロッドを人体に設けた開口を通して位置を矯正した椎体に固定された椎体固定具に固定する。
【0009】
【発明の実施の形態】
以下本発明の実施の形態を図面を参照して説明する。
図1は本発明の脊椎矯正装置を体外で脊椎に固定および矯正する装置の使用状態を示す図である。
【0010】
本発明の脊椎矯正装置を体外で脊椎に固定および矯正する装置1は、5本のシャフト2,2…と、各シャフト2を互いに連結して、各シャフト2にコンプレッション力を加えるコンプレッションロッド3とから構成されている。ここでは、側弯症患者の処置すべき椎体31を5つとし、これに対応してシャフトを5本とした。
【0011】
各シャフト2は、先端部に椎体スクリュー保持部4を有するベースシャフト5と、コンプレッション手段受け部6を有するアウトリガーシャフト7から構成されている。アウトリガーシャフト7はベースシャフト5に長手方向に調節自在に取付けられている。
【0012】
上記ベースシャフト5は、図2に示すように、小径の筒状部8と大径の筒状部9を結合して構成されている。ベースシャフト5の小径筒状部8の先端部に凹部10aとこの凹部10aに連なる内面にねじ面10bが形成されている。ベースシャフト5に設けたねじ面10bに、図4に示す椎体スクリュー11または図5に示す椎体スクリュー12が螺合され、ねじ面10bが椎体スクリュー保持部4として作用する。また、ベースシャフト5の大径筒状部9の端部にねじ部13が形成されている。ベースシャフト5に設けたねじ部13にアウトリガーシャフト7が軸線方向に調節自在に螺合される。
【0013】
上記アウトリガーシャフト7は、図3(A)、(B)に示すように、先端部7aの内面に上記ベースシャフト5に設けたねじ部13に螺合するねじ面14を有する。また、アウトリガーシャフト7の基端部7bに端面に開口した長孔15が形成されている。そして、アウトリガーシャフト7に設けた長孔15にコンプレッションロッド3が挿入される。アウトリガーシャフト7に設けた長孔15の縁部にコンプレッションロッド3を固定することで、アウトリガーシャフト7に設けた長孔15の縁部がコンプレッション手段受け部として作用する。
【0014】
上記コンプレッションロッド3は、図1に示すように全長にわたってねじを設けたねじロッドであり、各シャフト2を両側から挟持するように5対のナット16,16が設けられている。このコンプレッションロッド3は、シャフト2にコンプレッション作用を与えるだけでなく、シャフト2にディストラクション作用やローテーション作用を与えることができる。
【0015】
一方、脊椎矯正装置は、図4ないし図6に示すように、側弯症患者の処置すべき椎体31のうちの両端側の椎体31に螺入される椎体スクリュー11と、中間に位置する椎体31に螺入される椎体スクリュー12と、各椎体スクリュー11および椎体スクリュー12を連結するプレート17とから構成されている。
【0016】
上記椎体スクリュー11は、図4に示すように、先端側から順にスクリュー部18とフランジ部19と6角ヘッド部20とねじ部21を有する。椎体スクリュー11に設けたねじ部21はベースシャフト5のねじ面10bに螺合する。
上記椎体スクリュー12は、図5に示すように、先端側から順にスクリュー部18とフランジ部19とねじ部21を有する。椎体スクリュー12は椎体スクリュー11と6角ヘッド部20の有無だけが異なっている。椎体スクリュー12に設けたねじ部21はベースシャフト5のねじ面10bに螺合する。
上記プレート17は、図6に示すように、両端を開口した長孔22,22と中間に位置する長孔23,23,23を有する。プレート17の両端側の長孔22,22に、側弯症患者の処置すべき椎体31のうちの両端側の椎体31に螺入される椎体スクリュー11の6角ヘッド部20が係合する。プレート17の中間に位置する長孔23,23,23に、中間に位置する椎体31に螺入される椎体スクリュー12のねじ部21が挿入される。
【0017】
つぎに、作用を説明する。
脊椎矯正装置の取付けに先だって、側弯症患者の処置すべき5つの椎体31に対応した部位にシャフト2の通る開口を設け、かつ、内視鏡を挿入するための開口を設ける。そして、5本のシャフト2のうちの端側に位置する2本のシャフト2、2のねじ面10bに椎体スクリュー11を螺合し、中間に位置する3本のシャフト2、2,2のねじ面10bに椎体スクリュー12を螺合する。
つぎに、中間に位置する3本のシャフト2をそれぞれ側弯症患者に設けた開口を通して挿入し、各シャフト2に設けた椎体スクリュー12を、内視鏡により映し出される映像により、対応する椎体31の所定位置に位置させる。
ついで、3本のシャフトのそれぞれを椎体スクリュー12を螺入する方向に回して、椎体スクリュー12を対応する椎体31にフランジ19が椎体31に当接する位置まで螺入する。これにより、椎体スクリュー12は、ねじ部21を突出した状態で対応する椎体31に螺結される。
【0018】
つぎに、端側に位置する2本のシャフト2をそれぞれ側弯症患者に設けた開口を通して挿入し、各シャフト2に設けた椎体スクリュー11を、内視鏡により映し出される映像により対応する椎体31の所定位置に位置させる。
ついで、2本のシャフトのそれぞれを椎体スクリュー11を螺入する方向に回して、椎体スクリュー11を対応する椎体31にフランジ19が椎体31に当接する位置まで螺入する。これにより、椎体スクリュー11は、6角ヘッド部20およびねじ部21を突出した状態で対応する椎体31に螺結される。
【0019】
つぎに、コンプレッションロッド3を5本のシャフト2の基端部に設けた長孔15に開口端から挿通し、各シャフト2の長孔15の縁部両側を一対のナット16,16により挟持することで、各シャフト2をコンプレッションロッド3に固定する。これにより、各シャフト2にコンプレッションが作用する。この場合、コンプレッション力は、両端側に位置するシャフト2に強く作用するので、好ましくは、中間に位置する3本のシャフト2に図示しない別のコンプレッション手段でコンプレッション力を加える。
シャフト2にコンプレッションが作用すると、コンプレッション力は、シャフト2および椎体スクリュー11,12を介して側弯症患者の椎体31に作用し、椎体31の位置を矯正する。この椎体31の位置矯正は、内視鏡により映し出される映像により確認される。
【0020】
椎体31の位置矯正が確認されたら、中間に位置する3本のシャフト2の長孔15の縁部を挟持する一対のナット16,16を緩め、シャフト2のアウトリガーシャフト7をベースシャフト5から外し、ベースシャフト5を緩める方向に回しながら、側弯症患者から抜き取る。
【0021】
つぎに、プレート17を、図示しない器具を用いて側弯症患者に設けた開口を通して挿入し、内視鏡により映し出される映像により、プレート17を椎体31に螺結された椎体スクリュー11,12の上に位置させる。そして、プレート17を椎体スクリュー11,12の方向に動かすことで、プレート17の中間に位置する長孔23,23,23を中間に位置する3つの椎体31に螺結された椎体スクリュー12のねじ部21を通す。この際、両端側に位置する長孔22に椎体31に螺結された椎体スクリュー11の6角ヘッド部20が係合する。これにより、プレート17は位置矯正された椎体31に整合した位置に置かれる。
【0022】
つぎに、ナットを嵌合した図示しないナットホルダーを、側弯症患者に設けた開口を通して挿入し、嵌合されたナットを3つの椎体31に螺結された椎体スクリュー12のねじ部21にそれぞれ螺着する。これにより、プレート17が3つの椎体スクリュー12に固定される。
【0023】
つぎに、両端に位置する2本のシャフト2の長孔15の縁部を挟持する一対のナット16,16を緩め、シャフト2のアウトリガーシャフト7をベースシャフト5から外し、ベースシャフト5を緩める方向に回しながら、側弯症患者から抜き取る。
【0024】
つぎに、ナットを嵌合した図示しないナットホルダーを、側弯症患者に設けた開口を通して挿入し、嵌合されたナットを2つの椎体31に螺結された椎体スクリュー11のねじ部21にそれぞれ螺着する。これにより、プレート17が2つの椎体スクリュー11に固定される。
これにより、脊椎矯正装置の取付けが終了する。
なお、上記実施の形態では、5本のシャフトを用いて説明したが、このシャフトの数は、処理すべき椎体31の数に対応して変動するものである。また、プレートはロッドであってもよい。
【0025】
以上述べたように本発明によれば、側弯症患者にシャフトの通る開口を設けるだけで、脊椎矯正装置を人体の外部から椎体に固定でき、脊椎矯正装置を介して椎体の位置を矯正できる。
【図面の簡単な説明】
【図1】 本発明による脊椎矯正装置を体外で脊椎に固定および矯正する装置を示す図。
【図2】 シャフトを構成するベースシャフトを一部を断面で示す図。
【図3】 シャフトを構成するアウトリガーシャフトを示す図。
【図4】 椎体スクリューの斜視図。
【図5】 椎体スクリューの斜視図。
【図6】 プレートの平面図。
【図7】 側弯症患者の腹部を切開した状態を示す図。
【符号の説明】
2 シャフト椎体プレート
3 コンプレッションロッド
4 椎体スクリュー保持部
5 ベースシャフト
6 コンプレッション手段受け部
7 アウトリガーシャフト
11 椎体スクリュー
12 椎体スクリュー
15 長孔
17 プレート
31 椎体
[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a device for fixing and correcting a spinal correction device used for fixing a spinal correction device for correcting torsion and bending of a vertebral body of a scoliosis patient to the vertebral body from the outside of a human body. About.
[0002]
[Prior art]
The scoliosis patient's spine protrudes as a three-dimensional twist and is bent in an arcuate shape. To correct the twisting and bending of the vertebral body of such a scoliosis patient, the vertebral body constituting the spine is bent in the longitudinal direction. It is necessary to correct both the right and left bends.
[0003]
Surgical treatment methods to correct vertebral body torsion and bending of scoliosis patients include an anterior treatment method in which the vertebral body is corrected from the lateral side (referred to as anterior in medicine) and a posterior direction in which the vertebral body is corrected from the rear side. There is a treatment system.
[0004]
As an anterior correction device, a plurality of vertebral body plates, a vertebral body screw that is screwed into the vertebral body through the opening of each vertebral body plate, a rod that connects the vertebral body screws threaded into the vertebral body, and a vertebral body The one constituted by a set screw provided on the top surface of the screw head is already known.
[0005]
To attach the anterior correction device to the vertebral body, the chest or abdomen of the scoliosis patient is opened widely with a scalpel or the like so that the vertebral body of the spine is exposed, and the vertebral body is placed on the side of the vertebral body of the scoliosis patient. A plate is arranged, this vertebral body plate is fixed to the vertebral body via a vertebral body screw, and vertebral body screws screwed into adjacent vertebral bodies are connected by a rod.
[0006]
[Problems to be solved by the invention]
Since the anterior correction device cannot be attached to a patient with scoliosis unless the chest or abdomen of the patient with scoliosis is wide open with a scalpel or the like, the burden on the patient with scoliosis is large at the time of attachment. In addition to requiring treatment such as suturing, a considerable period of time is required for postoperative recovery of patients with scoliosis.
[0007]
The present invention has been made in consideration of the above-described points, and the spinal correction device can be fixed to the vertebral body from the outside of the human body only by providing an opening through which the shaft passes in a patient with scoliosis. An object is to provide a device for fixing and straightening.
[0008]
[Means for Solving the Problems]
An apparatus for fixing and correcting a spinal correction device according to the present invention to a spine outside the body includes a base shaft having a vertebral body fixing member holding portion at a distal end and a vertebral body correction means receiving portion at a proximal end portion in a longitudinal direction on the base shaft. A plurality of shafts having an outrigger shaft attached so as to be connected, a vertebral body fixing device attached to a vertebral body fixing device provided on a base shaft of each shaft, and provided on an outrigger shaft of each shaft Vertebral body correction means for correcting the position of the vertebral body engaged with the received vertebral body correction means receiving portion, and each shaft is attached to the vertebral body fixing device holding portion of the base shaft through an opening provided in the human body was vertebral bodies fixture is fixed to the vertebral bodies of the spine, vertebral body straightening means is a screw rod and a pair of nuts, each shaft by a nut which is arranged on both sides of each vertebra correcting means receiving unit The position of the vertebral body is corrected via the vertebral body fixing device attached to the vertebral body fixing device holding part of the base shaft by being attached to the vertebral body correction means receiving part of the outrigger shaft and applying compression to each shaft. The plate or rod of the spinal correction device is fixed to the vertebral body fixing device fixed to the vertebral body whose position has been corrected through the opening provided in the human body.
[0009]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 is a view showing a use state of a device for fixing and correcting the spinal correction device of the present invention to the spine outside the body.
[0010]
The device 1 for fixing and correcting the spinal correction device of the present invention to the spine outside the body includes five shafts 2, 2..., A compression rod 3 that connects the shafts 2 to each other and applies a compression force to each shaft 2. It is composed of Here, five vertebral bodies 31 to be treated by a scoliosis patient are provided, and five shafts are provided correspondingly.
[0011]
Each shaft 2 includes a base shaft 5 having a vertebral body screw holding portion 4 at a distal end portion and an outrigger shaft 7 having a compression means receiving portion 6. The outrigger shaft 7 is attached to the base shaft 5 so as to be adjustable in the longitudinal direction.
[0012]
As shown in FIG. 2, the base shaft 5 is configured by connecting a small-diameter cylindrical portion 8 and a large-diameter cylindrical portion 9. A concave portion 10a is formed at the tip of the small-diameter cylindrical portion 8 of the base shaft 5, and a threaded surface 10b is formed on the inner surface continuous with the concave portion 10a. The vertebral body screw 11 shown in FIG. 4 or the vertebral body screw 12 shown in FIG. 5 is screwed onto the threaded surface 10 b provided on the base shaft 5, and the threaded surface 10 b acts as the vertebral body screw holding unit 4. Further, a screw portion 13 is formed at the end of the large-diameter cylindrical portion 9 of the base shaft 5. The outrigger shaft 7 is screwed to the screw portion 13 provided on the base shaft 5 so as to be adjustable in the axial direction.
[0013]
As shown in FIGS. 3A and 3B, the outrigger shaft 7 has a threaded surface 14 that is screwed into a threaded portion 13 provided on the base shaft 5 on the inner surface of the distal end portion 7 a. In addition, a long hole 15 opened in the end surface is formed in the base end portion 7 b of the outrigger shaft 7. Then, the compression rod 3 is inserted into the long hole 15 provided in the outrigger shaft 7. By fixing the compression rod 3 to the edge of the long hole 15 provided in the outrigger shaft 7, the edge of the long hole 15 provided in the outrigger shaft 7 acts as a compression means receiving portion.
[0014]
The compression rod 3 is a screw rod provided with a screw over its entire length as shown in FIG. 1, and five pairs of nuts 16 and 16 are provided so as to sandwich the shaft 2 from both sides. The compression rod 3 can give not only a compression action to the shaft 2 but also a distraction action and a rotation action to the shaft 2.
[0015]
On the other hand, as shown in FIGS. 4 to 6, the spinal correction device is positioned between the vertebral body screw 11 to be screwed into the vertebral bodies 31 on both ends of the vertebral bodies 31 to be treated by the scoliosis patient. The vertebral body screw 12 is screwed into the vertebral body 31 and the vertebral body screw 11 and the plate 17 connecting the vertebral body screw 12 are configured.
[0016]
As shown in FIG. 4, the vertebral body screw 11 includes a screw portion 18, a flange portion 19, a hexagonal head portion 20, and a screw portion 21 in order from the distal end side. The threaded portion 21 provided on the vertebral body screw 11 is screwed into the threaded surface 10 b of the base shaft 5.
As shown in FIG. 5, the vertebral body screw 12 includes a screw portion 18, a flange portion 19, and a screw portion 21 in order from the distal end side. The vertebral body screw 12 differs from the vertebral body screw 11 only in the presence or absence of the hexagonal head portion 20. The threaded portion 21 provided on the vertebral body screw 12 is screwed into the threaded surface 10 b of the base shaft 5.
As shown in FIG. 6, the plate 17 has long holes 22, 22 opened at both ends and long holes 23, 23, 23 located in the middle. The hexagonal head portions 20 of the vertebral body screws 11 to be screwed into the vertebral bodies 31 on both ends of the vertebral bodies 31 to be treated by the scoliosis patient are engaged with the long holes 22 and 22 on both ends of the plate 17. To do. The threaded portion 21 of the vertebral body screw 12 to be screwed into the vertebral body 31 located in the middle is inserted into the long holes 23, 23, 23 located in the middle of the plate 17.
[0017]
Next, the operation will be described.
Prior to the installation of the spinal correction device, an opening through which the shaft 2 passes is provided at a site corresponding to the five vertebral bodies 31 to be treated by a scoliosis patient, and an opening for inserting an endoscope is provided. Then, the vertebral body screw 11 is screwed onto the threaded surface 10b of the two shafts 2 and 2 located on the end side of the five shafts 2, and the three shafts 2, 2, and 2 located in the middle are connected. The vertebral body screw 12 is screwed onto the screw surface 10b.
Next, the three shafts 2 positioned in the middle are inserted through the openings provided in the scoliosis patient, and the vertebral body screws 12 provided in the respective shafts 2 are displayed on the corresponding vertebral bodies by an image projected by the endoscope. 31 is located at a predetermined position.
Next, each of the three shafts is rotated in the direction in which the vertebral body screw 12 is screwed, and the vertebral body screw 12 is screwed into the corresponding vertebral body 31 to a position where the flange 19 contacts the vertebral body 31. As a result, the vertebral body screw 12 is screwed to the corresponding vertebral body 31 with the threaded portion 21 protruding.
[0018]
Next, the two shafts 2 positioned on the end side are respectively inserted through the openings provided in the scoliosis patient, and the vertebral body screws 11 provided on the respective shafts 2 correspond to the vertebral bodies corresponding to the images projected by the endoscope. 31 is located at a predetermined position.
Next, each of the two shafts is rotated in the direction in which the vertebral body screw 11 is screwed, and the vertebral body screw 11 is screwed into the corresponding vertebral body 31 to a position where the flange 19 contacts the vertebral body 31. Thereby, the vertebral body screw 11 is screwed to the corresponding vertebral body 31 with the hexagonal head portion 20 and the screw portion 21 protruding.
[0019]
Next, the compression rod 3 is inserted into the long holes 15 provided at the base end portions of the five shafts 2 from the opening ends, and both sides of the edge portions of the long holes 15 of each shaft 2 are sandwiched by a pair of nuts 16 and 16. Thus, each shaft 2 is fixed to the compression rod 3. Thereby, a compression acts on each shaft 2. In this case, the compression force acts strongly on the shafts 2 positioned at both ends, and therefore, preferably, the compression force is applied to the three shafts 2 positioned in the middle by another compression means (not shown).
When the compression acts on the shaft 2, the compression force acts on the vertebral body 31 of the scoliosis patient via the shaft 2 and the vertebral body screws 11, 12 to correct the position of the vertebral body 31. The position correction of the vertebral body 31 is confirmed by an image projected by the endoscope.
[0020]
When the position correction of the vertebral body 31 is confirmed, the pair of nuts 16 and 16 holding the edges of the long holes 15 of the three shafts 2 positioned in the middle are loosened, and the outrigger shaft 7 of the shaft 2 is removed from the base shaft 5. Remove it from the patient with scoliosis while turning the base shaft 5 in the loosening direction.
[0021]
Next, the plate 17 is inserted through an opening provided in a scoliosis patient using an instrument (not shown), and the vertebral body screws 11 and 12 in which the plate 17 is screwed to the vertebral body 31 by an image projected by an endoscope. Position on top of. Then, by moving the plate 17 in the direction of the vertebral body screws 11, 12, the vertebral body screw screwed into the three vertebral bodies 31 positioned in the middle of the long holes 23, 23, 23 located in the middle of the plate 17 Twelve screw parts 21 are passed. At this time, the hexagonal head portion 20 of the vertebral body screw 11 screwed to the vertebral body 31 is engaged with the long holes 22 positioned on both ends. As a result, the plate 17 is placed at a position aligned with the position-corrected vertebral body 31.
[0022]
Next, a nut holder (not shown) fitted with a nut is inserted through an opening provided in a scoliosis patient, and the fitted nut is inserted into the screw portion 21 of the vertebral body screw 12 screwed to the three vertebral bodies 31. Screw each one. Thereby, the plate 17 is fixed to the three vertebral body screws 12.
[0023]
Next, the pair of nuts 16, 16 that sandwich the edge of the long hole 15 of the two shafts 2 positioned at both ends are loosened, the outrigger shaft 7 of the shaft 2 is removed from the base shaft 5, and the base shaft 5 is loosened Remove from the scoliosis patient.
[0024]
Next, a nut holder (not shown) fitted with a nut is inserted through an opening provided in a scoliosis patient, and the fitted nut is inserted into the screw portion 21 of the vertebral body screw 11 screwed to the two vertebral bodies 31. Screw each one. Thereby, the plate 17 is fixed to the two vertebral body screws 11.
Thereby, the attachment of the spinal correction device is completed.
In the above-described embodiment, the description has been made using five shafts. However, the number of shafts varies according to the number of vertebral bodies 31 to be processed. The plate may be a rod.
[0025]
As described above, according to the present invention, the spinal correction device can be fixed to the vertebral body from the outside of the human body only by providing an opening through which the shaft passes in a scoliosis patient, and the position of the vertebral body is corrected via the spinal correction device. it can.
[Brief description of the drawings]
FIG. 1 shows a device for fixing and correcting a spinal correction device according to the present invention to the spine outside the body.
FIG. 2 is a cross-sectional view showing a part of a base shaft constituting the shaft.
FIG. 3 is a view showing an outrigger shaft constituting the shaft.
FIG. 4 is a perspective view of a vertebral body screw.
FIG. 5 is a perspective view of a vertebral body screw.
FIG. 6 is a plan view of a plate.
FIG. 7 is a view showing a state in which the abdomen of a scoliosis patient is cut open.
[Explanation of symbols]
2 shaft vertebral body plate 3 compression rod 4 vertebral body screw holding portion 5 base shaft 6 compression means receiving portion 7 outrigger shaft 11 vertebral body screw 12 vertebral body screw 15 long hole 17 plate 31 vertebral body

Claims (1)

先端に椎体固定具保持部を有するベースシャフトと基端部に椎体矯正手段受け部を有しベースシャフトに長手方向に連結するように取付けられたアウトリガーシャフトとを有する少なくとも複数本のシャフトと、
各シャフトのベースシャフトに設けられた椎体固定具保持部に取り付けられた椎体固定具と、
各シャフトのアウトリガーシャフトに設けられた椎体矯正手段受け部に係着された椎体の位置を矯正する椎体矯正手段と
を有し、
前記複数本のシャフトは、両端側の位置する両端側シャフトと前記両端側シャフトの間にある少なくとも1本の中間シャフトとからなり、
各シャフトは、人体に設けた開口を通してベースシャフトの椎体固定具保持部に取り付けられた椎体固定具を脊椎の椎体に固定し、
椎体矯正手段は、ねじロッドと一対のナットを有し、
各々の前記椎体矯正手段受け部は、前記ねじロッドが挿入可能である前記アウトリガーシャフトの基端部に形成された長孔を有し、
前記長孔に前記ねじロッドが挿入され各々の前記椎体矯正手段受け部が前記ねじロッドに沿って位置移動可能な状態で各椎体矯正手段受け部の前記長孔を挟んだ両側に前記一対のナットの各々が配置され、
前記一対のナットは、椎体の位置を矯正するように各々の前記椎体矯正手段受け部を前記ねじロッドに沿って位置移動させた状態で各シャフトにコンプレッション等を加えるように前記アウトリガーシャフトの基端部を締め付け可能であり、
各シャフトにコンプレッション等を加えることでベースシャフトの椎体固定具保持部に取り付けられた椎体固定具を介して椎体の位置を矯正し、
脊椎矯正装置のプレートまたはロッドを人体に設けた開口を通して位置を矯正した椎体に固定された椎体固定具に固定する
ことを特徴とする脊椎矯正装置を体外で脊椎に固定および矯正する装置。
At least a plurality of shafts including a base shaft having a vertebral body fixing device holding portion at a distal end and an outrigger shaft having a vertebral body correction means receiving portion at a proximal end portion and attached to the base shaft in a longitudinal direction; ,
A vertebral body fixing device attached to a vertebral body fixing device holder provided on the base shaft of each shaft;
Vertebral body correction means for correcting the position of the vertebral body engaged with the vertebral body correction means receiving portion provided on the outrigger shaft of each shaft;
The plurality of shafts are composed of both end side shafts positioned on both end sides and at least one intermediate shaft between the both end side shafts,
Each shaft fixes the vertebral body fixing device attached to the vertebral body fixing device holding part of the base shaft through the opening provided in the human body to the vertebral body of the spine,
The vertebral body correction means has a screw rod and a pair of nuts ,
Each of the vertebral body correction means receiving portions has a long hole formed in a proximal end portion of the outrigger shaft into which the screw rod can be inserted,
The pair of the vertebral body correction means receiving portions on both sides of the long hole of each vertebral body correction means receiving portion while the screw rods are inserted into the long holes and the vertebral body correction means receiving portions are movable along the screw rods. Each of the nuts is arranged,
The pair of nuts are provided on the outrigger shaft so as to apply compression or the like to each shaft in a state where each of the vertebral body correction means receiving portions is moved along the screw rod so as to correct the position of the vertebral body . The base end can be tightened,
Correct the position of the vertebral body via the vertebral body fixing device attached to the vertebral body fixing device holding part of the base shaft by adding compression etc. to each shaft,
A device for fixing and correcting a spinal correction device to a spine outside the body, wherein the spine correction device is fixed to a vertebral body fixing member fixed to the vertebral body whose position has been corrected through an opening provided in a human body.
JP17125996A 1996-07-01 1996-07-01 Device for fixing and correcting spinal correction devices outside the body to the spine Expired - Lifetime JP4275198B2 (en)

Priority Applications (1)

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JP17125996A JP4275198B2 (en) 1996-07-01 1996-07-01 Device for fixing and correcting spinal correction devices outside the body to the spine

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP17125996A JP4275198B2 (en) 1996-07-01 1996-07-01 Device for fixing and correcting spinal correction devices outside the body to the spine

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JP4275198B2 true JP4275198B2 (en) 2009-06-10

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ES2318917B1 (en) * 2005-03-30 2010-02-04 Sdgi Holdings Inc. SYSTEM FOR THE THREE-DIMENSIONAL CORRECTION OF THE CURVATURE OF THE VERTEBRAL COLUMN IN PROBLEMS OF SCHOLIOSIS BY COPLANAR ALIGNMENT OF THE PEDICULAR SCREWS.
US8465529B2 (en) 2007-05-18 2013-06-18 Stryker Spine Apparatus and method for direct vertebral rotation
CN102293680B (en) 2010-06-24 2014-04-16 华沙整形外科股份有限公司 Coplanar straightening system

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