KR100850322B1 - Apparatus for percutaneous pedicle screw fixation - Google Patents

Abstract

Patients in need of fixation of the spine are provided with a spinal fixation device inserted through minimally invasive surgery to fix the spine. The vertebral fixation tooth fixing the spine of the patient according to the present invention is a pedicle screw inserted into the pedicle or sacrum of the vertebra at a predetermined angle and depth, and the spinal rod and the pedicle screw fixing the pedicle screw in connection with the pedicle screw. It is fastened to have a rod guide portion and the shape of the tube to guide the spinal rod, a protective member for receiving the rod guide portion to prevent damage from the outside during the procedure and the coupling screw coupled to the pedicle screw to fix the spinal rod Includes a wrench and a wrench portion inserted into the rod guide portion to rotate the pedicle screw.

Spine, pedicle screw, fixing device, rod, rod guide part, rod inserter

Description

Spinal Fixation Device {Apparatus for percutaneous pedicle screw fixation}

1 is an exploded perspective view of the spinal column fixing device according to an embodiment of the present invention.

Figure 2a is a perspective view of the pedicle screw nail of the spinal column fixing device according to an embodiment of the present invention.

FIG. 2B is a cross-sectional view of IIb-IIb 'of FIG. 2A.

Figure 3 is a perspective view showing a coupling state of the rod guide portion and pedicle screw of the spinal fixing device according to an embodiment of the present invention.

Figure 4 is a cross-sectional view of the coupling of the spinal column fixing device according to an embodiment of the present invention.

Figure 5 is a perspective view of a rod inserter used when performing a spinal fixation device according to an embodiment of the present invention.

Figure 6 is a side cross-sectional view of a pedicle screw according to another embodiment of the present invention.

7a to 7o are explanatory views of the use of the spinal fixation apparatus according to the embodiment of the present invention.

 (Explanation of symbols for the main parts of the drawing)

10: spinal fixing device 100: the first rod guide portion

110, 220: n-type groove 120: fastening protrusion

140: through hole 150: protective member

200: second rod guide portion 210: interference prevention groove

300: pedicle screw 310: screw

312: hexagonal groove 314: through hole

320: head portion 322: u-shaped groove

324: female thread 326: fastening groove

350: coupling part 400: wrench part

410: rotating member 414: spline

420: hexagon wrench 430: handle

500: spinal rod 600: rod inserter

610: head 630: linkage

The present invention relates to a spinal fixation device, and more particularly, to a spinal fixation device that is inserted through a minimal invasive surgery (Minimal Invasive Surgery) to a patient in need of fixing the spine.

In general, in the treatment of diseases related to the spine, indirect treatment methods through physical therapy and direct treatment methods for correcting and fixing the spine are performed by attaching a separate fixing device to the damaged spine. In other words, if the spinal disease is mild, physical therapy is performed, but when the disease is severe in the cervical spine, thoracic spine, lumbar spine, sacrum, and intervertebral discs, the spine is treated with a separate spinal fixation device. The configuration of the vertebral fixation device that is usually performed is a pedicle screw (sacral) screw and vertebrae inserted at a predetermined angle and depth into the pedicle or sacrum of the vertebra so that the damaged vertebral portion can be fixed in a normal state without movement. It consists of a spinal rod located on one side and a fixing cap or coupling portion for fastening the spinal rod and the pedicle screw nail.

On the other hand, the spine is composed of 32 to 35 vertebrae (vertebrae) and intervertebral disks (intervertebral disks) between the vertebrae, forming the props of the trunk, connecting the upper skull and the lower pelvis. The vertebrae are called seven cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 sacral vertebrae, and 3 to 5 coccygeal vertebrae. In adults, five sacral spines are fused into one sacrum, and three to five lumbar vertebrae become one coccyx. The characteristic vertebrae consist of one vertebral body, two pedicles, two laminas, a spinous process at the back, and two transverse processes on both sides. ) And articular process. For the treatment of the injured spine, the pedicle screw is first inserted into the pedicle or sacrum of the vertebra in the proper direction and position, and then the vertebral column is corrected using the spinal rod and the spinal rod is fixed using the fixing cap or the joint. And fix the fixing screw to complete the treatment.

In the treatment method using the spinal fixation device as described above, it is important to fix the vertebral portion corrected in a normal arrangement for a certain period of time without movement, and when using the direct treatment method to fix and fix the spine with the fixing device, In the case of open surgery, in which the affected area is dissected more than the longitudinal length of the spinal fixation device, the wound area becomes large and the affected area becomes large. There is a problem that large surgical marks on the affected area. Essentially, the activity of the vertebral muscles, particularly the erector spinae, is directly related to the posture of the trunk and pelvis, and to the function of the trunk muscles and to low back disorders. . In particular, the degeneration of adjacent nodes after the procedure suggests that the poor outcome after spinal surgery is associated with deformed and distorted posture. In the case of incision, the incision of these muscles and the cutting / removal of the nerve tissue are performed, which may result in a negative surgical result due to the absence of torso muscle activity after the operation, and the increased load and the pressure applied to the intervertebral discs. Increase shear stress. This can lead to disc degeneration.

The present invention has been made to improve the above problems, the object of the present invention is to provide a spinal fixing device that is easy to perform the procedure when inserted into the affected part of the patient through minimally invasive surgery.

Technical problems of the present invention are not limited to the technical problems mentioned above, and other technical problems not mentioned will be clearly understood by those skilled in the art from the following description.

In accordance with an embodiment of the present invention for achieving the above technical problem, the vertebral fixation window fixing the spine of the patient by connecting the pedicle screw and the pedicle screw inserted into the pedicle or sacrum at a predetermined angle and depth. It is fastened to the spinal rod and the pedicle screw nail to secure the rod guide portion and the shape of the tube, the protective member and the pedicle screw nail to accommodate the rod guide portion to prevent damage from the outside during the procedure It is coupled to secure the spinal rod and the coupling portion is inserted into the rod guide portion includes a wrench portion for rotating the pedicle screw.

Specific details of other embodiments are included in the detailed description and the drawings.

Advantages and features of the present invention and methods for achieving them will be apparent with reference to the embodiments described below in detail with the accompanying drawings. However, the present invention is not limited to the embodiments disclosed below, but can be implemented in various different forms, and only the embodiments make the disclosure of the present invention complete, and the general knowledge in the art to which the present invention belongs. It is provided to fully inform the person having the scope of the invention, which is defined only by the scope of the claims. Like reference numerals refer to like elements throughout.

Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the accompanying drawings.

1 is an exploded perspective view of the spinal column fixing device 10 according to an embodiment of the present invention. As shown in FIG. 1, the spinal column fixing device 10 includes a first rod guide part 100 in which an n-type groove 110 is formed and a second rod guide part having an upper side opened by an interference prevention groove 210. 200, the pedicle screw nail 300 is coupled to each of the rod guide portion 100, 200, the protective member 150 for receiving the rod guide portion 100, 200, respectively, the first rod guide portion 100 Is fastened to the wrench portion 400 for rotating the pedicle screw nail 300, the spinal rod 500 and the pedicle screw nail 300, respectively connected to the upper end of the pedicle screw screw 300 It may be composed of a fastening portion 350 for fixing the spinal rod 500.

The first rod guide portion 100 has a plurality of fastening protrusions 120 are formed at the lower end, the n-shaped groove 110 formed in the body of the first rod guide portion 100 is extended to the lower side along the vertical line to the lower side Open wealth. In addition, the male screw unit 130 is provided at the upper side to be fastened to the wrench unit 400, and a through hole 140 may be formed to accommodate the wrench unit 400.

Similarly to the first rod guide part 100, the second rod guide part 200 has the same formation of the fastening protrusion 120 and the through hole 140, but the upper side of the second rod guide part 200 to avoid interference of the rod inserter 600 to be described later. It is preferable that the interference prevention groove 210 formed to open is additionally provided. In addition, an n-type groove 220 is formed at the bottom of the interference preventing groove 210 to open the lower side.

Figure 2a is a perspective view of the pedicle screw 300 of the spinal fixation device 10 according to an embodiment of the present invention, Figure 2b is a sectional view IIb-IIb 'of Figure 2a.

As shown in Figure 2a and Figure 2b, the pedicle screw nail 300 may be composed of a screw portion 310 is inserted into the vertebra at the lower side and a head 320 provided on the upper portion of the screw portion 310. . The head portion 320 is formed with a u-shaped groove 322 into which the spinal rod 500 is inserted, and a female thread portion 324 is formed inside the u-shaped groove 322 to form a thread. Preferably, the u-shaped groove 322 may form a chamfer at a predetermined angle to help smooth insertion of the spinal rod 500.

In addition, the top of the head 320, the pedicle screw nail 300 is provided with a fastening groove 326 so as to correspond to the fastening protrusion 120 is fastened with the rod guide portion (100, 200), the bottom of the u-shaped groove (322) In the hexagonal groove 312 is formed integrally with the screw 310 is located. In the present embodiment, the hexagonal grooves 312 are described based on the use, but since the hexagonal grooves 312 may be configured as a polygon, such as a triangle or a square, the scope of the present invention is not limited thereto.

The u-shaped groove 322 formed in the pedicle screw nail 300 should be positioned to face each other so that the spinal rod 500 is inserted. Therefore, when the screw part 310 and the head part 320 are formed as separate components and the hexagonal grooves 312 are turned to tighten the screw part 310, the head part 320 is formed along the thread part 310. It is preferable not to rotate.

In addition, the screw portion 310 is a through hole penetrating the upper and lower ends to allow the guide wire portion (w) to pass through the pedicle screw 300 when inserting the pedicle screw nail 300 into the pedicle ( 314 may be formed.

Figure 3 is a perspective view showing a coupling state of the rod guide portion (100, 200) and pedicle screw 300 of the spinal column fixing device 10 according to an embodiment of the present invention. As shown in FIG. 3, the fastening protrusions 120 formed at the ends of the rod guide parts 100 and 200 are seated in the fastening grooves 326 formed in the head part 320 of the pedicle screw nail 300, thereby forming the spine. The u-shaped groove 322 of the screw thread 300 and the n-type grooves 110 and 220 of the rod guide parts 100 and 200 are aligned in a vertical line. Here, the coupling method of the fastening protrusion 120 and the fastening groove 326, that is, the fastening means of the pedicle screw nail 300 and the rod guide parts 100 and 200 are not limited thereto because there are various methods such as screw fastening.

4 is a cross-sectional view of the coupling of the spinal fixation device 10 according to an embodiment of the present invention. As shown in Figure 4, the rod guide portion 100, 200 and the pedicle screw nail 300, the protective member 150, which serves to prevent damage to various muscles and organs during the procedure in the state coupled to the rod guide Coupled to the outer portion (100, 200), the wrench portion 400 is inserted along the through-hole 140 of the rod guide portion (100, 200). At this time, the wrench unit 400 is firmly fastened with the first rod guide unit 100 and a pivot member 410 is provided to safely insert the pedicle screw nail 300 into the vertebrae. A female screw portion 412 may be formed at the inner side of the distal end of the rotation member 410 to correspond to the male screw portion 130 of the first rod guide portion 100. A spline 414 may be formed along one outer circumferential surface of the rotating member 410 to facilitate fastening of the male screw part 130 and the female screw part 412.

In addition, the hexagonal wrench 420 is formed at the distal end of the wrench unit 400 and coupled as described above, so that the hexagonal wrench 420 of the wrench unit 400 is inserted into the hexagonal groove 312 of the pedicle screw 300. When the handle 430 provided in the wrench part 400 is turned, the screw part 310 of the pedicle screw nail 300 is returned to form a screw thread in the vertebrae.

5 is a perspective view of the rod inserter 600 used when performing the spinal fixation device 10 according to an embodiment of the present invention.

As shown in FIG. 5, the rod inserter 600 includes a head 610, which may include a spinal rod 500, a handle 620 configured to facilitate an operator's operation, and the handle 620. It may be configured to include a linking portion 630 for connecting the head 610. Linkage 630 is formed extending from the head 610 is bent to one side of the handle 620 is formed. The handle 620 may have a space 640 to prevent interference with the first rod guide part 100. How to use the rod inserter 600 will be described later as described when using the spinal fixing device 10 according to the present invention.

6 is a side cross-sectional view of a pedicle screw 300 'according to another embodiment of the present invention. Another embodiment of the pedicle screw 300 'will be described only with reference to FIG. 5 compared with the above embodiment.

The pedicle screw 300 'has a head 320 to be the same as the embodiment, the upper end of the screw portion 310 is formed of a spherical coupling portion 315 is rotatably connected to the head 320 and the head It is connected to the lower end of the part 320. Accordingly, the thread 310 and the head 320 may be aligned in different axial directions, and can provide a wider movement of the patient.

A method of using the spinal column fixing device 10 according to the present invention having the above configuration will be described in detail below. 7a to 7o are explanatory views of the use of the spinal fixation apparatus according to the embodiment of the present invention.

As shown in Figure 7a to 7o, the operator invades the guide wire (w) in the desired position, inserting the guide wire (w) in the through hole 314 formed in the pedicle screw (300) pedicle screw Place 300 on the top of the spine 1 desired by the operator along the guide wire (w) (Fig. 7a).

Thereafter, the guide wire w is removed and the first rod guide part 100 is coupled to the pedicle screw nail 300. Here, the fastening protrusion 120 formed at the end of the first rod guide portion 100 is seated in the fastening groove 326 formed in the head portion 320 of the pedicle screw nail 300, u of the pedicle screw nail 300 The groove 322 and the n-shaped groove 110 of the first rod guide part 100 coincide with each other in a vertical line (FIG. 7B). Next, the protection member 150 is inserted into the outside of the first rod guide part 100 (FIG. 7C). Protective member 150 is installed to prevent secondary infection during the procedure, to prevent damage to muscles and blood vessels.

Thereafter, the end of the wrench part 400 is inserted into the through hole 140 of the first rod guide part 100 to insert the hexagon wrench 420 of the wrench part 400 into the hexagonal groove of the pedicle screw 300. 312). At this time, by rotating the spline 414 of the rotating member 410 by hand, the female screw portion 412 of the rotating member 4100 and the male screw portion 130 of the first rod guide portion 100 are fastened. The first rod guide part 100 is integrated. This prevents the wrench part 400 from escaping from the first rod guide part 100 when the operator rotates the wrench part 400 to fix the pedicle screw nail 300 to the vertebrae 1, and the operator Serves to minimize the incidence of misoperation that can be generated by applying a predetermined force to the handle 430 of the wrench unit 400. When the wrench unit 400 and the first rod guide unit 100 are integrated, the operator rotates the handle of the wrench unit 400 by hand with a predetermined force, and at the same time, the hexagon wrench 420 formed at the end rotates together. And the pedicle screw nail 300 is rotated. At this time, if the force is further increased in the insertion direction of the pedicle screw nail 300, the screw thread formed in the screw portion 310 is inserted to form a tab (Tap) on the vertebrae (1). In this case, the head 320 of the pedicle screw 300 is positioned to be buried inside the skin 2, and the first rod guide part 100 is preferably positioned to have a predetermined height outside the skin 2 ( 7d).

When the pedicle screw nail 300 is inserted into and fixed to the vertebra 1 as desired by the operator, the first rod guide part 100 and the wrench part (by rotating the rotating member 410 of the wrench part 400 on the contrary) 400). Then, the pedicle screw 300 is inserted into the vertebrae 1 by a predetermined depth, and the first rod guide part 100 is in a state of rising to a predetermined height above the skin 2 (FIG. 7E).

Thereafter, the operator of another adjacent vertebrae 1 invades the guide wire w at the desired position, and inserts the guide wire w into the through hole 314 formed in the pedicle screw 300. The pedicle screw nail 300 is positioned along the guide wire (w) on the vertebral bone 1 desired by the operator (FIG. 7F).

Thereafter, the guide wire (w) is removed and the second rod guide portion 200 is coupled to the pedicle screw nail 300. The fastening protrusion 120 formed at the end of the second rod guide portion 200 is seated in the fastening groove 326 formed in the head portion 320 of the pedicle screw nail 300, u of the pedicle screw nail 300 The n-type groove 220 and the interference preventing groove 210 of the mold groove 322 and the second rod guide portion 200 are aligned in a vertical line (FIG. 7G). Thereafter, the protective member 150 is coupled to the second rod guide portion 200, and the pedicle screw nail 300 is fixed and inserted into the vertebrae 1 using the wrench portion 400 in the same manner as described above. (FIG. 7H). At this time, the head portion 320 of the two pedicle screw nail 300 is preferably located on the vertical line looking at the u-shaped groove 322.

The pedicle screw nails 300 fixed to the two vertebrae 1 are not the head 320 protruding to the outside of the skin 2, but the first rod guide portion 100 and the second rod guide portion ( 200 becomes a shape which protrudes by the predetermined height outward of the skin 2 (FIG. 7I).

Thereafter, the head 610 of the rod inserter 600 having the spinal rod 500 passes through the interference preventing groove 210 of the second rod guide portion 200 (FIG. 7J). Lifting the rod inserter 600 in the direction of the arrow to insert the spinal rod 500 provided in the 600 into the u-shaped groove 322 of the pedicle screw nail 300 is fastened to the second rod guide portion 200 Raise to achieve a predetermined angle (Fig. 7k).

Thereafter, when the rod inserter 600 is further lifted in the direction of the arrow to make it vertical, the rod inserter 600 is a star because the upper portion of the second rod guide part 200 is opened by the interference preventing groove 210. The spine rod 500 provided in the rod inserter 600 passes through the second rod guide portion 200 without any other interference, and is inserted into each pedicle screw 300 at the minimum surgical site (FIG. 7L). ).

Then, to secure the spinal rod 500, the coupling part 350 is inserted through the rod guide parts 100 and 200 to the head 320 of the pedicle screw 300 (FIG. 7m). Thereafter, the coupling screw 350 is fastened to the female screw 324 of the head screw 320 of the pedicle screw nail 300 to firmly fix the spinal rod 500 that links the two pedicle screw nails 300 ( 7n). Removing the rod guide parts 100 and 200 coupled to the upper part of the fastened fastening part 350, and suturing the minimally incised surgical part is completed the mounting of the spinal fixing device (Fig. 7o).

Although embodiments of the present invention have been described above with reference to the accompanying drawings, those skilled in the art to which the present invention pertains may implement the present invention in other specific forms without changing the technical spirit or essential features thereof. I can understand that. Therefore, it should be understood that the embodiments described above are exemplary in all respects and not restrictive.

As described above, according to the spinal fixation apparatus according to the present invention, the insertion of the spinal rod is possible by the minimally invasive surgery, and thus the operation is easy and simple, thereby reducing the burden on the operator and the patient.

In addition, it can be used semi-permanently as a separate removable mechanism has the advantage that can be expected to reduce the cost.

Claims (11)

In the spinal fixation device to fix the spine of the patient, Pedicle screws inserted into the pedicle or sacrum of the vertebrae; A spinal rod fixing the pedicle screw nail in association; A rod guide part coupled to the pedicle screw nail to guide the spinal rod; A protective member having a pipe shape and accommodating the rod guide part to prevent damage by the outside during the procedure; A fastening portion coupled to the pedicle screw and fixing the spinal rod; And a wrench portion inserted into the rod guide portion to rotate the pedicle screw. The method of claim 1, wherein the pedicle screw, A head part having a plurality of fastening grooves formed at one side thereof; And It is formed so as to be rotatable with the head portion, the spinal fixing device including a screw portion which is positioned to the lower end of the head portion is inserted into the pedicle and fixed. The method of claim 2, wherein the head portion, A u-shaped groove formed through the end of one side to open the upper part to accommodate the spinal rod; And And a female screw portion formed in the u-shaped groove to be fastened to the coupling portion. The fastening groove is a spinal fixing device formed on each end of the u-shaped groove. The method of claim 2, wherein the screw portion, A through hole penetrating the upper and lower ends; And And a polygonal groove formed on an upper surface of the head and positioned on a bottom surface of the u-shaped groove. The method of claim 4, wherein the screw portion, Spinal fixing device comprising a spherical coupling portion is formed so that the upper end is rotatable with the inside of the head portion. The method of claim 2, wherein the rod guide portion, An n-type groove which penetrates from one side to the lower end of the lower end and is opened at the bottom; Spinal fixing device is formed on each end of the n-type groove further comprises a plurality of fastening projections that are fastened to the fastening groove. The method of claim 6, wherein the rod guide portion, A first rod guide portion having a male screw portion formed thereon; And And a second rod guide part having an interference preventing groove for opening the upper end through the terminal from the upper end to the upper end of the n-type groove. The method of claim 7, wherein the wrench unit, A wrench formed at an end and inserted into the polygonal groove of the pedicle screw to rotate the pedicle screw; A handle part integrally formed at an end formed vertically extended from the wrench and configured to facilitate rotation of the wrench; And Spinal fixing device including a rotating member is formed so as to enable individual rotation between the handle portion and the wrench. The method of claim 8, wherein the rotating member, Splines formed on one side to facilitate rotation; And And a female screw portion formed along an inner circumferential surface of the first rod guide portion to be engaged with the male screw portion. The method of claim 1, Further comprising a rod inserter used to insert the spinal rod into the pedicle screw nail, the rod inserter, A head portion formed to provide the spinal rod; A linking portion that is bent from the head and extends in a direction perpendicular to the spinal rod; And Is formed on the distal end of the linkage, spinal fixing device including a handle is formed in the space portion to prevent the interference of the rod guide portion. delete

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