KR101434333B1 - Rod reducer for minimally invasive surgery system - Google Patents

Abstract

The present invention relates to a rod reducer for fastening a set screw to a rod-receiving portion of a rod-receiving portion of a calibration screw during a minimally invasive surgery while pressing a rod downwardly and having a set screw mounting portion at a lower end thereof; An inner member slidably provided in the outer member and having a lower end drawn out from the outer member at a lower end to be in contact with the rod; And a fastening sleeve for lowering the inner member while being fastened to the third external device holding the calibration screw so that the rod is pressed by the lower end withdrawing portion of the inner member; And a rotation handle for rotating the outer member such that the set screw is screwed to the rod receiving portion of the calibration screw.

Description

{Rod reducer for minimally invasive surgery system}

The present invention relates to a working tower, a rod inserter, a rod reducer, and a tension compressor used in a spinal minimally invasive surgical system.

Generally, the vertebrae are usually composed of 24 bones (except sacrum and submucosa), which not only help maintain posture, but also serve as the basis of exercise and play an important role in protecting the internal organs.

In addition, to absorb the impact on the spine, a joint called the disk, which acts as a buffer between each vertebrae, is located, and the spinal nerve passes through the vertebrae and extends to the vertebrae.

Due to the structure of the vertebrae, if the abnormal posture is maintained for a long time, or if a degenerative disease caused by aging or an external shock, the disk of the vertebral bone node may be damaged and the spinal disc disease may occur. In particular, this spinal disc disease causes pain due to compression of the spinal nerve.

In order to treat such a spinal disc disease, the practitioner usually performs the following operation.

The practitioner removes the damaged part of the disk to prevent the injured portion of the vertebrae from being pushed or pressed, and inserts a piece of bone into an artificial auxiliary material (for example, a cage) made of a hollow metal or plastic material, Next, surgery is performed to correct the position of the vertebrae in the upper and lower parts of the damaged disc. Further, in order to correct the position of the vertebrae, the practitioner fixes the corrective screws to the vertebrae of the upper and lower parts of the damaged disk, connects the connected correction screws with a rod, corrects the positions of the vertebrae , And a method of tightly tightening the rod and the calibration screw with the set screw can be used. Therefore, bone fusion is normally performed between the vertebrae where the position is corrected.

Minimally Invasive Surgery techniques have been recently developed to minimize the area of invasion during spinal surgery because of the large size of the invasive site, which slows the patient 's recovery and reduces the satisfaction of the wound.

Korean Registered Patent Application No. 10-0942226, filed by the present applicant and applicable to such minimally invasive surgery, discloses a rod holder and a spinal minimally invasive surgical system using the rod holder.

This conventional technique not only guides the rod 20 by being inserted into the skin of the patient (the skin of the patient penetrating through a separate penetrating device (not shown)), as shown in Figs. 1A and 1B A rod holder 60 serving to grip the pedicle screw 10 and a rod holder 30 serving to insert the rod 20 into the incision 61a of the rod guide 60, A rod pusher 70 that presses the rod 20 as far as possible downward to abut the bottom of the receiving groove 11 of the pedicle screw 10 and a spacer adjuster 95).

However, in the conventional rod guide 60, the grip portion 61b of the inner body 61 is completely inserted into the outer sleeve 650 by the rod pressing portion 65a protruding from the end of the outer sleeve 65 So that the degree of spreading of the grip portion 61b in the state before being pulled is minimized in order to compensate for the reduction of the gripping force due to the portion that is not brought in. Thus, It may be inconvenient for the threaded screw 10 to be held against the grasping portion 61b. Further, since a separate rod guide separator (not shown) is used for smooth separation from the spinal screw 10, which is forcedly held by the grip portion 61b of the rod guide 60 after the operation, the configuration may be complicated .

In addition, since the conventional rod holder 30 is configured to be operated in a two-step loading manner, its configuration may be complicated, and a separate operation for raising or lowering the loading section 35 and a button section 37 must be operated The operation method can be troublesome.

Further, the conventional rod pusher 70 does not have a function of fastening the set screw (not shown) to the pedicle screw 10, that is, the structure in which the pressing operation of the rod 20 can not be performed simultaneously with the set screw fastening Therefore, there is a fear that tissue may be caught between the rod 20 and the set screw when the set screw is tightened. Also, since the conventional rod pusher 70 is an external type located outside the rod guide 60, not a cannulated type inserted into the hollow portion of the rod guide 60, there is a fear of interference with the peripheral members.

In addition, the conventional spacer 95 (FIG. 1B) may have a limit in adjusting the distance between the pedicle screws 10 because the cylindrical rod 95d corresponding to the pivot is thin. In addition, when the rod guide 60 is held, the rod guide 60 may move in the longitudinal direction of the cylindrical rod 95d. Reference numeral 95a denotes a grip portion for gripping the rod guide 60, and 95b and 95c are grips for gripping the grip portion.

An object of the present invention is to provide a worktool which is easy to use and which can easily mount a calibration screw by improving a conventional rod guide and easily remove a calibration screw without a separate separator.

Another object of the present invention is to provide a rod inserter which is simple in construction and easy to operate by improving the conventional rod holder.

Another object of the present invention is to improve a conventional rod pusher so that a set screw can be fastened to a calibration screw while pressing a rod so that a structure can be prevented from being caught between a rod and a set screw, The present invention also provides a load reducer which can minimize the interference with peripheral members.

It is another object of the present invention to provide a method of manufacturing a tension member capable of improving a space adjuster and enlarging a range of adjustment for tension and compression between the calibration screws and reducing the length of the member, Compressor.

In order to accomplish the above object, a work tower according to an embodiment of the present invention is a work tower that grasps a calibration screw and serves as a work platform of other external devices. An inner tube slidably installed inside the outer tube; A driving sleeve rotatably connected to the outer tube and screwed to the inner tube to move the inner tube upward and downward along the longitudinal direction when rotated; And a screw holder provided at a lower end of the inner tube and opened by self-elasticity to receive the head portion of the calibration screw when drawn out of the outer tube, and contracted to tighten the head portion when the outer tube is pulled.

A rod inserter according to an embodiment of the present invention is a rod inserter for grasping a rod to seat the rod on a rod receiving portion of at least two calibration screws, A movable bar slidably mounted on the fixed bar; A control knob rotatably connected to the fixing bar and screwed to the moving bar to adjust a moving distance of the moving bar through rotation; And a rod holder provided between one end of the fixed bar and one end of the movable bar and holding the rod according to the movement of the movable bar.

The rod reducer according to an embodiment of the present invention is a rod reducer for fastening a set screw to the rod receiving portion while pressing down the rod seated on the rod receiving portion of the calibration screw, ; An inner member slidably provided in the outer member and having a lower end drawn out from the outer member at a lower end to be in contact with the rod; And a fastening sleeve for lowering the inner member while being fastened to the third external device holding the calibration screw so that the rod is pressed by the lower end withdrawing portion of the inner member; And a rotation handle for rotating the outer member such that the set screw is screwed to the rod receiving portion of the calibration screw.

A tension compressor according to an embodiment of the present invention is a tension compressor that stretches or narrows and compresses between first and second calibration screws at the lower ends of first and second operation towers, A central axis located between the working towers; A tower pressurizing unit provided at one end of the central shaft and pressing the first and second operation towers so that the first and second operation towers are tilted with respect to the central axis; And a tower pedestal rotatably provided at the other end of the central axis to prevent the first and second operation tows from moving in the longitudinal direction of the central axis.

According to the operation tower of the first embodiment of the present invention, the calibration screw can be easily mounted as compared with the conventional rod guide, and the calibration screw can be easily removed without using a separate separator.

According to the rod inserter according to the second embodiment of the present invention, the configuration is simple and easy to operate as compared with the conventional rod holder.

The rod reducer according to the third embodiment of the present invention is configured so that the rod can be fastened to the calibration screw while pressing the rod unlike the conventional rod pusher, thereby preventing the tissue from being caught between the rod and the set screw, It is possible to minimize the interference with the peripheral members by constituting a type which is inserted into other members.

According to the tension compressor of the fourth embodiment of the present invention, compared with the conventional gap adjuster, the interval adjustment range for tension and compression between the calibration screws can be made larger, and the member located on the center axis can be moved You can block the concerns you may have.

FIGS. 1A and 1B are perspective views showing respective devices constituting a conventional minimally invasive surgery system for vertebrae.
2 is a perspective view showing a work tower according to a first embodiment of the present invention.
Fig. 3 is a cross-sectional view showing the operation tower of Fig. 2 being branched. Fig.
4 is a longitudinal sectional view showing a state in which the grip portion is drawn in the state of FIG. 3;
5 is a cross-sectional view showing an inner surface of an outer tube of the work tower of Fig. 2;
FIG. 6 is a cross-sectional view of the operation tower of FIG. 3 taken along line VI-VI.
7 is a perspective view illustrating a rod inserter according to a second embodiment of the present invention.
Figure 8 is a front view of the rod inserter of Figure 7;
FIG. 9 is a cross-sectional view of the rod inserter of FIG. 8 taken along line IX-IX.
10 is a plan view of the portion "A" in Fig.
FIG. 11 is a cross-sectional view taken along the line XI-XI of the rod inserter of FIG. 8. FIG.
12 is a cross-sectional view taken along the line XII-XII of the rod inserter of FIG.
Figs. 13A and 13B are views showing the state before and after the rod inserter of Fig. 7 grasps the rod center portion.
14 is a schematic perspective view showing a state in which a rod is inserted into a rod guide groove of a work tower in a state where the rod inserter of Fig. 7 grasps the rod center portion.
Figs. 15A and 15B are views showing the state before and after the rod inserter of Fig. 7 grasps the rod end. Fig.
16 is a schematic perspective view showing a state in which a rod is inserted into a rod guide groove of a work tower in a state where the rod inserter of Fig. 7 grasps the rod end portion.
17 is a front view showing a rod inserter according to a modification of the second embodiment of the present invention.
18 is a perspective view showing the rod holder of the rod inserter of Fig.
FIG. 19 is a perspective view showing a state in which a cover is mounted on the rod inserter of FIG. 17;
Figure 20 is a front view of the rod inserter of Figure 19;
FIG. 21 is a cutaway view of the recess of the rod inserter of FIG. 20; FIG.
22 is a perspective view showing a state in which a rod is mounted on the rod inserter of Fig.
23 is a perspective view showing a state in which a rod is mounted on the rod inserter of Fig.
24 is a perspective view showing a state in which the cover of the rod inserter is moved to the clip side and the clip is locked in the state of Fig.
25 is a perspective view showing a state in which the rod is rotated while the movement bar is moved to the clip side by rotation of the adjustment knob in the state of FIG.
26 is a perspective view of a load reducer according to a third embodiment of the present invention.
Fig. 27 is a longitudinal sectional view of the load reducer of Fig. 26; Fig.
28 is a schematic cross-sectional view showing a state in which the rod is pressed by the lower end drawing portion of the inner member while the fastening sleeve is rotated;
29 is a schematic sectional view showing a state in which the set screw is fastened to the rod inserting portion of the calibration screw while the rotation handle is rotated while being pressed.
30 is a perspective view showing a tension compressor according to a fourth embodiment of the present invention.
31 is a plan view of the tension compressor of Fig. 30;
32 is a front view of the tension compressor of Fig. 30;
Fig. 33 is a cross-sectional view of the tension compressor of Fig. 31 taken along line XXXIII-XXXIII.
Fig. 34 is a perspective view showing in detail a screw rod or the like of the tension compressor of Fig. 32; Fig.
Fig. 35 is a perspective view of the tension compressor of Fig. 30 viewed from above; Fig.
36A and 36B are schematic views showing the state of use of the tensile compressors, which are respectively a tensile state and a compressed state.

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings, which will be readily apparent to those skilled in the art to which the present invention pertains. The present invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein.

FIG. 2 is a perspective view showing a work tower according to a first embodiment of the present invention, FIG. 3 is a sectional view showing the work tower of FIG. 2 being branched, and FIG. 4 is a cross- Fig.

FIG. 5 is a cross-sectional view illustrating the inner surface of the outer surface of the worktable of FIG. 2, and FIG. 6 is a cross-sectional view of the worktable of FIG. 3 taken along line VI-VI.

A working tower 100 according to a first embodiment of the present invention is configured to hold a correction screw 10 as shown in Figures 2 to 4 and to hold other external devices For example, a working tower serving as a work table for a load inserter (300 in FIG. 7 or 500 in FIG. 7), a load reducer (700 in FIG. 27) or a tension compressor a pipe, an interior pipe, a driving sleeve 130, and a screw holder 140.

The outer tube 110 is a tubular member forming the outer side of the operation tower 100. Specifically, the lower half of the outer tube 110 has a branched shape divided into first and second outer branch branches 110a and 110b, and the first and second outer branch branches 110a and 110b, A first rod guide groove 111 may be formed.

The inner tube 120 is provided inside the outer tube 110 so as to be slidable in the longitudinal direction thereof. Specifically, the lower half of the inner tube 120 is branched into the first and second inner branch portions 120a and 120b and is divided into the first and second inner branch portions 120a and 120b. The second rod guide groove 121 may be formed to correspond to the first rod guide groove 111 described above. The rod 20 can be smoothly moved to the rod receiving portion 11 of the calibration screw 10 through the first rod guide groove 111 and the second rod guide groove 121 described above. For reference, the rod 20 can be inserted into the first and second rod guide grooves 111 and 121 while being held by a rod inserter (300 of FIG. 7) to be described later.

An external device fastening female thread 123 (hereinafter, referred to as "first female thread ") is provided on the outer circumference of the inner tube 120 for fastening the first external device (e.g., a rod reducer Quot;) may be formed. For example, the inner circumferential surface of the fastening sleeve (730 in Fig. 27) of the load reducer (700 in Fig. 27) and the outer circumferential surface of the inner tube 120 can be screwed together via the first female screw 123. 27) of the load reducer (700 in Fig. 27), the first female screw is formed at an upper portion (upper portion with reference to Fig. 2) than the female screw 122 for fastening the sleeve to be described later. The reducer (700 in Fig. 27) can be smoothly fastened to the first female screw 123 without interfering with the sleeve fastening female screw 122.

The driving sleeve 130 is a member rotated to move the inner tube 120 up and down (up and down with reference to FIG. 2) along its longitudinal direction. The driving sleeve 130 is rotatably connected to the outer tube 110, do. The male screw 131 may be formed on the inner circumferential surface of the upper end of the driving sleeve 130 and the male screw 131 may be formed on the outer circumferential surface of the inner pipe 120 to correspond to the male screw 131. [ ) (Hereinafter referred to as "second female screw"). Accordingly, when the drive sleeve 130 is rotated in the forward or reverse direction while the male screw 131 and the second female screw 122 are screwed together, the inner tube 120 is moved upward or downward.

The second female screw 122 may be spaced apart from the first female screw 123 by a predetermined distance. That is, a threadless section 124 having no thread is formed between the second female screw 122 and the first female screw 123. The reason why the screw portion 124 is formed is that the screw holder 140 is pulled in and out by a method of pulling or pressing the inner tube 120 without rotating the driving sleeve 130. As a result, the time required for the rotation can be significantly reduced by pulling or pushing, thereby shortening the operation time. A more detailed description of the manner of pulling or pressing the inner tube 120 will be given in the description of the use state to be described later.

The screw holder 140 is provided at the lower end of the inner tube 120 and is opened by its own elasticity to receive the head portion 12 of the calibration screw 10 when it is pulled out of the outer tube 110, The head portion 12 is contracted so as to be able to tighten. For example, the screw holder 140 may include first and second holding arms 140a and 140b, respectively, provided at the ends of the first and second inward branch branches 120a and 120b. The first and second holding arms 140a and 140b may be formed with fasteners 141 to be fastened to the head portion 12 of the calibration screw 10. For example, when the fastening groove 13 is formed in the head portion 12 of the calibration screw 10, the fastening tool 141 may be a fastening protrusion. On the contrary, if not shown, if a fastening protrusion (not shown) is formed on the head portion 12 of the calibration screw 10, the first and second holding arms 140a and 140b are provided with fastening protrusions (Not shown) may be formed.

When the first and second holding arms 140a and 140b are pulled out of the outer tube 110 and opened by self-elasticity, the distance therebetween is set larger than the outer diameter of the head portion 12 of the calibration screw 10 . Therefore, when the operation tower 100 according to the first embodiment of the present invention is used for minimally invasive surgery for vertebra, the calibration screw 10 can be inserted into the first and second holding arms 140a and 140b without separate interference, The operation time of the operator can be shortened.

2 and 3, a second external device (for example, a tower pressurizing unit 920 of FIG. 31) of a tension compressor (700 of FIG. 31) to be described later is provided on the outer peripheral surface of the outer tube 110 An external device insertion groove 113 into which a fixing protrusion (see 922 in FIG. 31) can be inserted can be formed.

5 and 6, the inner tube 120 and the outer tube 110 can be slid up and down without being rotated left and right by the tube guide 150. [ For example, the tube guide 150 is formed on the inner surfaces of the first and second outer branch branches 110a and 110b and has an inner guide groove 112a for guiding the first and second inner branch branches 120a and 120b, (151).

5 and 6, the first and second holding arms 140a and 140b can be seated on the inner surfaces of the end portions of the first and second outer branch portions 110a and 110b, respectively, The holding arm seating groove 161 may be formed and the holding arm seating groove 161 may be connected to the inner tube guiding groove 151.

3 and 4, the use state of the operation tower 100 according to the first embodiment of the present invention will be described in detail.

First, when the male screw 131 of the drive sleeve 130 is positioned in the minus thread section 124 between the first female screw 123 and the second female screw 122, the user (or auxiliary device) The screw holder 140 can be pulled out from the outer tube 110 by pulling or pressing. For reference, when the operation tower 100 according to the first embodiment of the present invention is used for minimally invasive surgery for spine, the user may be an operator.

3, when the user (or auxiliary device) presses the inner tube 120, the inner tube 120 is moved downward and the second female screw 122 of the inner tube 120 is driven And is caught by the lower end of the sleeve 130. At this time, the screw holder 140 is completely drawn out from the outer tube 110.

4, when the user (or auxiliary device) pulls the inner tube 120, the inner tube 120 is moved upward and the second female screw 122 of the inner tube 120 is moved to the driving sleeve 130 of the male screw 131. Thereafter, when the user (or auxiliary device) rotates the drive sleeve 130 and the male screw 131 of the drive sleeve 130 is fastened to the second female screw 122 of the inner tube 120, (110).

Hereinafter, a rod inserter according to a second embodiment of the present invention will be described in detail with reference to FIGS. 7 to 12. FIG.

FIG. 7 is a perspective view of a rod inserter according to a second embodiment of the present invention, FIG. 8 is a front view of the rod inserter of FIG. 7, and FIG. 9 is a cross- Fig.

Fig. 10 is a plan view of the "A" part of Fig. 8, Fig. 11 is a sectional view taken along the line XI-XI in Fig. 8 and Fig. 12 is a cross- Fig.

The rod inserter 300 according to the second embodiment of the present invention is constructed such that the rod 20 is held by the rod holding portion 11 of at least two calibration screws 10 The rod inserter is a rod inserter that rests on a rod accommodating part of the main body 200. As shown in FIGS. 7 to 12, a fixed bar 310, a moving bar 320, An adjusting knob 330, and a rod holder 340.

The fixing bar 310 is a bar-shaped fixing member fixed relative to the moving bar 320, and supports the moving bar 320 in a manner slidable in the longitudinal direction thereof. In addition, a fixed handle may be provided on the outer surface of the fixing bar 310 so that the user can easily grasp the rod inserter 300. One end of the fixing bar 310 indicates the left end of the fixing bar 310 with reference to Fig. 7 and the other end of the fixing bar 310 indicates the right end of the fixing bar 310 with reference to Fig.

The movable bar 320 is a bar-shaped movable member that is relatively movably provided with respect to the fixed bar 310 and is provided on the fixed bar 310 so as to be slidable along the longitudinal direction thereof. One end of the movable bar 320 indicates the left end of the movable bar 320 with reference to FIG. 7, and the other end indicates the right end of the movable bar with reference to FIG.

The adjustment knob 330 is rotatably connected to the fixing bar 310 and screwed to the moving bar 320 by adjusting the moving distance of the moving bar 320 through rotation. A movable clearance portion 370 may be formed between the adjustment knob 330 and the other end of the movable bar 320 so that the movable bar 320 can advance sufficiently to the adjustment knob 330 side. Therefore, the movable bar 320 can be moved to the side of the adjustment knob 330 sufficiently through the moving clearance portion 370, so that the holding force of the rod holder 340 can be increased.

7 and 8, the rod holder 340 is provided between one end of the fixing bar 310 and one end of the moving bar 320 and is provided with a rod (not shown) 20). For example, the rod holder 340 may include a hook 341 provided at one end of the moving bar 320 and a rod supporting portion 342 provided at one end of the fixing bar 310. The rod support 342 may also have an arcuate contact surface 342a that grips the center of the rod 20 with the hook 341 when the hook 341 is moved toward the adjustment knob 330. The process of grasping the center of the rod 20 by the rod holder 340 will be described in the description of the use state to be described later.

10, the rod holder 340 includes a first holding groove 343 formed at the end of the rod supporting portion 342 and a second holding groove 343 formed at the end of the hook 341, And a second holding groove 344 for holding the end of the rod 20 together with the groove 343. [ The process of grasping the end of the rod 20 by the rod holder 340 will be described in the description of the use state to be described later.

Meanwhile, while the user sequentially inserts the rod 20 into the rod guide groove (111 in FIG. 4) of the operation tower (100 in FIG. 4) and the rod accommodation portion 11 of the calibration screw (10) The moving bar 320 and the fixing bar 310 are formed in a shape bent by the first and second bent portions B1 and B2 so as to prevent interference with the first and second bending portions B1 and B2, can do.

In this case, the fixing handle 350 and the rod holder 340 can be respectively positioned on a straight line lying parallel to each other such that the moving bar 320 is smoothly moved in the longitudinal direction thereof. A structure in which the movable bar 320 is slid with respect to the fixed bar 310 in a state having the first and second bent portions B1 and B2 will be described with reference to Figs. 8, 11 and 12 .

As shown in FIGS. 8 and 11, the movable bar 320 and the fixed bar 310 can be slid from each other by the rail structure (see FIG. 11) from the rod holder 340 to the first bent portion B1 Can be combined. 12 and FIG. 12, the insertion structure (see FIG. 12) in which the movement bar 320 is slidably inserted into the fixed bar 310 from the second bent portion B2 to the adjustment knob 330 Lt; / RTI > As shown in FIG. 8, the movable bar 320 and the fixed bar 310 may be spaced apart from each other between the first bent portion B1 and the second bent portion B2. The movable bar 320 can be slidably disposed along the longitudinal direction of the fixed bar 310 through such a rail structure (see FIG. 11), an insertion structure (see FIG. 12), and a spacing structure.

9, the movement bar 320 may be connected to the fixed bar 310 through the first movement restriction unit 360 to limit the movement distance of the movement bar 320. [ For example, the first movement restricting unit 360 may include a stop pin 361 and a movement restricting groove 362. A stop pin 361 is provided across the fixing bar 310. The movement restricting groove 362 is formed in the movement bar 320 and is a long groove having one end and the other end which is inserted into the stop pin 361 in accordance with the movement of the movement bar 320.

Hereinafter, the use state of the rod inserter according to the second embodiment of the present invention will be described in detail with reference to FIGS. 13A to 16. FIG.

13A and 13B are views showing the state before and after the rod inserter 300 of Fig. 7 grasps the center portion of the rod 20, and Fig. 14 is a view showing the rod inserter 300 of Fig. 20) is inserted into a rod guide groove (111 in Fig. 4) of a working tower (100 in Fig. 4) while gripping a central portion of the rod (20).

15A and 15B are views showing the state before and after the rod inserter 300 of Fig. 7 grasps the end of the rod 20, and Fig. 16 is a view showing the rod inserter 300 of Fig. 20) is inserted into the rod guide groove (111 in Fig. 4) of the operation tower (100 in Fig. 4) while gripping the end of the rod 20

As an example of grasping the center portion of the rod 20, after the center portion of the rod 20 is positioned across the rod holder 340 as shown in Fig. 13A, when the user rotates the adjustment knob 330 in the forward direction The center of the rod 20 is gripped by the hook 341 and the rod supporter 342 as shown in FIG. 13B when the movable bar 320 is moved to the side of the adjustment knob 330 as much as possible. For reference, when the rod inserter 300 according to the second embodiment of the present invention is used for spinal minimally invasive surgery, the user may be an operator.

14, in a state where the rod inserter 300 is positioned between the first and second operation towers 100a and 100b, the rod inserter 300 is connected to the rod inserter 300, One end of the rod 20 is first inserted into the rod guide groove 111 of the first operation tower 100a and then the other end of the rod 20 is rotated to the second operation tower 100b while the rod inserter 300 is rotated. Into the rod guide groove (111) The rod 20 is then lowered to the rod inserter 300 to seat both ends of the rod 20 on the rod receiving portion 11 of the first and second calibration screws 10a and 10b. Finally, when the operation through the rod inducer (700 in FIG. 27) to be described later is completed, the adjustment knob 330 is rotated in the reverse direction to release the grasp of the rod 20.

15A, after the end of the rod 20 is positioned toward the square of the rod holder 340, the user rotates the adjustment knob 330 in a direction The ends of the rod 20 can be grasped by the first and second holding grooves 343 and 344 as shown in Figure 15B by rotating the movable bar 320 to the side of the adjustment knob 330 as much as possible. do.

16, in a state in which the rod inserter 300 is positioned in the direction opposite to the direction of the first operation tower 100a toward the second operation tower 100b, One end of the rod 20 is sequentially inserted into the rod guide grooves 111 of the first operation tower 100a and the rod guide grooves 111 of the second operation tower 100b. The rod 20 is then lowered to the rod inserter 300 to seat both ends of the rod 20 on the rod receiving portion 11 of the first and second calibration screws 10a and 10b. Finally, when the operation through the rod inducer (700 in FIG. 27) to be described later is completed, the adjustment knob 330 is rotated in the reverse direction to release the grasp of the rod 20.

Hereinafter, a rod inserter according to a modification of the second embodiment of the present invention will be described in detail with reference to Figs. 17 to 21. Fig.

17 is a front view showing a rod inserter according to a modification of the second embodiment of the present invention, Fig. 18 is a perspective view showing the rod holder of the rod inserter of Fig. 17, and Fig. 19 is a perspective view showing the rod inserter of Fig. Fig. 6 is a perspective view showing a state in which the cover is mounted.

FIG. 20 is a front view of the rod inserter of FIG. 19, and FIG. 21 is a cutaway view of the recess of the rod inserter of FIG.

A rod inserter 500 according to a modification of the second embodiment of the present invention is configured such that the configuration of the rod holder 510 is changed as shown in Figs. And the first multi-stage regulating unit 530 and the second movement restricting unit 540 are further added to the second embodiment of the present invention, Only the rod holder 510, the cover 520, the first multi-stage regulating unit 530 and the second movement limiting unit 540 will be described below. The same constituent elements as those of the second embodiment of the present invention are given the same reference numerals.

The rod holder 510 includes a knuckle 511, a rod holder bracket 512, and a clip 513, as shown in Figs. 17 and 18 do.

One end of the knuckle 511 is rotatably provided at one end of the movement bar 320 and the other end of the knuckle 511 is connected to the rod holder bracket 511. The knuckle 511 is rotatably connected to the member, (Not shown). Here, one end of the knuckle 511 indicates the right end of the knuckle 511 with reference to FIG. 17, and the other end of the knuckle 511 indicates the left end of the knuckle 511 with reference to FIG.

The rod holder bracket 512 has a shape bent by fixing the clip 513. One end of the rod holder bracket 512 is rotatably provided at the other end of the knuckle 511, And the other end is rotatably provided at one end of the fixing bar 310. One end of the rod holder bracket 512 indicates the right end of the rod holder bracket 512 with reference to Fig. 17 and the other end of the rod holder bracket 512 indicates the left end of the rod holder bracket 512 And the above-described bent shape is a shape in which the other end of the rod holder 510 is bent up substantially on the basis of FIG.

The clip 513 is fixed to the rod holder bracket 512 and grasps the end of the rod 20. 18, the clip 513 may have an arc shape, and both ends of the clip 513 may be set by self-elasticity so that the end of the rod 20 is smoothly fitted into the clip 513. [ It can be positioned in a gap-wise state. A fastener 513a for gripping the end of the rod 20 may be formed on the inner surface of the clip 513. [ For example, when a fastening groove (20a in FIG. 22) is formed at the end of the rod 20, the fastening hole 513a may be a fastening protrusion. As another example, although not shown, a locking groove (not shown) may be formed on the inner surface of the clip 513 when a fastening protrusion (not shown) is formed at the end of the rod 20.

As the rod holder 510 has these components, when the movable bar 320 moves toward the knuckle 511, the rod holder bracket 512 and the clip 513 are moved by the knuckle 511 to the fixed bar The rod 20 held by the clip 513 can be rotated together with the rotation of one end of the rod 513. A more detailed description thereof will be given in the description of the use state to be described later.

Further, as shown in FIGS. 19 to 21, the cover 520 may be provided on the outer surface of the movable bar 320 so as to be slidable in the longitudinal direction thereof. Particularly, the cover 520 includes a cover body 521 surrounding the fixing bar 310, and a cover body 521. The cover body 520 is provided at one end of the cover body 521 and covers the clip 513 when the cover 520 is moved in the direction toward the clip 513. [ And a clip locking portion 522 for preventing the clip 513 from spreading. The clip 513 is completely gripped by the clip lock portion 522 of the cover 520 so that the clip 513 can be opened to prevent the rod 20 gripped by the clip 513 from being pulled out .

When the movable bar 320 is moved toward the clip 513 side after the clip 513 is locked by the clip lock portion 522, the rod 20 is rotated smoothly without being disturbed by the clip lock portion 522 , And the clip locking portion 522 may be provided with a rod passage groove 522a.

The cover 520 may further include a cover knob 523 provided at the other end of the cover body 521 and pushing or pulling the cover 520 so that the user can easily push or pull the cover 520 have.

21, the cover 520 can be connected to the fixed bar 310 via the first multi-stage adjustment unit 530 to give the user a feeling of movement when the cover 520 is slid, have. For example, the first multi-stage regulating unit 530 includes a first ball 531 elastically supported by the fixing bar 310 and a plurality of first balls 531 formed on the cover body 521 so as to be engaged with the first ball 531 in multiple stages. And may include first locking grooves 532 of the first locking groove 532. Accordingly, when the first ball 531 is positioned or disengaged from the first engaging groove 532, a sound of "ticking" is produced and the sound is provided to the user, so that the sense of operation can be maximized.

20 and 21, the cover 520 may be connected to the fixed bar 310 via the second movement limiting unit 540 to limit the movement distance of the cover 520 . For example, the second movement restricting unit 540 may be provided with at least one slot 541 formed along the longitudinal direction of the cover 520, and at least one slot 541, And at least one stop protrusion 542 provided on the inner circumferential surface.

Hereinafter, the use state of the rod inserter 500 according to a modification of the second embodiment of the present invention will be described in detail with reference to FIGS. 22 to 25. FIG.

22 is a perspective view showing a state in which the rod 20 is mounted on the rod inserter 500 of Fig. 19, and Fig. 23 is a view showing a state in which the rod 20 is mounted on the rod inserter 500 of Fig. Fig.

24 is a perspective view showing a state in which the cover 520 of the rod inserter 500 is moved to the clip 513 side and the clip 513 is locked in the state of Fig. 23, and Fig. 25 is a perspective view Is a perspective view showing a state in which the rod 20 is rotated while the moving bar 320 is moved toward the clip 513 by the rotation of the rod 330.

22, when the user moves the clip locking portion 522 of the cover 520 upward in the drawing to expose the clip 513 of the rod holder 510 to the outside, the clip 513 Is spread by the self-elasticity in the direction of the arrow 1 in the set interval. Thereafter, the user inserts the end of the rod 20 into the clip 513 in the direction of arrow 2, and the end of the rod 20 is positioned on the clip 513, as shown in Fig. At this time, the fastening protrusion 513a of the clip 513 is loosely fastened to the fastening groove 20a of the end of the rod 20. For reference, when the rod inserter 500 according to the modification of the second embodiment of the present invention is used for spinal minimally invasive surgery, the user may be the practitioner.

24, when the user moves the clip locking portion 522 of the cover 520 in the downward direction in the figure, the clip 513 is tightened by the clip locking portion 522, 20 are completely mounted to the clip 513. [

17, 18, and 25, when the user rotates the adjustment knob 330 in the direction of the arrow, the movement bar 320 pushes the knuckle 511 while moving downward in the drawing, The rod 20 held by the clip 513 is rotated together with the rod holder bracket 512 and the clip 513 being rotated with respect to one end of the fixing bar 310 by the push knuckle 511, The movable bar 320 is bent.

The user can move the rod inserter 500 from the first operation tower 100a (see 100a in Fig. 16) to the second operation tower 320 (See 100b in Fig. 16) (see Fig. 16). Thereafter, when the rod 20 is bent in the state shown in Fig. 25, the rod 20 is pushed by the rod guide groove (see 111 in Fig. 16) of the first operation tower (see 100a in Fig. 16) (See reference numeral 111 in Fig. 16) of the guide grooves 100a and 100b. The user then descends the rod 20 to the rod inserter 500 to seat both ends of the rod 20 on the rod receiving portion 11 of the first and second calibration screws 10a and 10b . Finally, when the operation through the rod inserter 500 to be described later is completed, the user moves the clip lock portion 522 upward in the drawing to release the grip of the rod 20. Here, when the clip locking portion 522 is moved upward, the clip 513 is opened by its own elasticity, and the holding of the rod 20 is released.

Hereinafter, the load reducer according to the third embodiment of the present invention will be described in detail with reference to FIGS. 26 and 27. FIG.

FIG. 26 is a perspective view of a load reducer according to a third embodiment of the present invention, and FIG. 27 is a longitudinal sectional view of the rod reducer of FIG. 26.

The rod reducer according to the third embodiment of the present invention is a rod reducer according to the third embodiment of the present invention in which the rod (20 in Fig. 28) that is seated in the rod accommodating portion (11 in Fig. 28) 29, the rod reducer for tightening the set screw (S in Fig. 29) to the rod receiving portion (11 in Fig. 29) An interior member 720, a coupling sleeve 730, and a rotation handle 740. As shown in FIG.

The outer member 710 has a tubular shape, and at its lower end, a set screw mounting portion 711 capable of mounting a set screw (S in Fig. 28) is formed.

The inner member 720 has a rod shape and is slidably provided inside the outer member 710 and has a lower end portion drawn out from the outer member at its lower end so as to be in contact with the rod 721).

The fastening sleeve 730 can be moved downwardly while the inner member 720 is being fastened to the third external device OS (e.g., the operation tower 100 (Fig. 4)) holding the calibration screw 10 20 of the inner member 720 is pressed by the lower end withdrawing portion 721 of the inner member 720. [ Here, when the third external device OS is tubular like the operation tower 100, the outer member 710 may be inserted into the third external device OS (see FIG. 28) ).

The rotary handle 740 rotates the outer member 710 such that the set screw (S in Fig. 29) is screwed to the rod receiving portion (11 in Fig. 29) of the calibration screw 710).

Furthermore, the inner circumferential surface of the fastening sleeve 730 may have a structure in which the inner peripheral surface of the fastening sleeve 730 is screwed to the outer peripheral surface of the third external device (OS in Fig. 28). That is, as shown in Fig. 27, a male screw 732 for external equipment (hereinafter referred to as "second male screw") may be formed on the inner peripheral surface of the fastening sleeve 730. For example, when the third external device OS is a working tower (100 in Fig. 4), the second male screw 732 can be screwed into the first female screw (123 in Fig. 4) of the working tower 100 have.

27, the fastening sleeve 730 may be connected to the outer member 710 and the inner member 720 by a connecting unit 750. [ For example, the connecting unit 750 includes a through hole 751 penetrating the inner member 720, a connecting pin 752 inserted into the through hole 751, A sliding hole 753 formed in the member 710 so as to allow the outer member 710 to move downward, a mounting groove 754 formed in the inner circumferential surface of the coupling sleeve 730 along the circumferential direction, And a rotary ring 755 rotatably mounted in the groove 754 and formed with first and second insertion holes 755a and 755b for inserting both ends of the connection pin 752. [

While the set screw S is fastened to the rod receiving portion 11 of the calibration screw 10, the lower end drawing portion 721 of the inner member 720 can be completely drawn into the inside of the outer member 710 The length of the sliding hole 753 may be set to be longer than the length of the lower end withdrawing portion 721 of the inner member 720 with respect to the longitudinal direction of the outer member 710. [

Before the set screw (S in Fig. 29) is fastened to the rod receiving portion (11 in Fig. 29) of the calibration screw (10 in Fig. 29), the lower end withdrawing portion 721 of the inner member 720 is connected to the outer member 710 The inner member 720 may be resiliently supported on the outer member 710. [ For example, the inner member 720 and the outer member 710 may be resiliently supported together by a fastening sleeve 730 and a rotating handle 740, respectively, and a fastening sleeve 730 and a rotating handle 740 may be provided.

Hereinafter, the use state of the load reducer 700 according to the third embodiment of the present invention will be described in detail with reference to FIGS. 28 and 29. FIG.

28 is a schematic sectional view showing a state in which the rod 20 is pressed by the lower end withdrawing portion 721 of the inner member 720 while the fastening sleeve 730 is rotated.

29 is a schematic sectional view showing a state in which the set screw S is fastened to the rod insertion portion 11 of the calibration screw 10 while the rotation handle 740 is rotated while being pressed.

First, the user inserts the load reducer 700 into the third external device OS. For reference, when the rod reducer 700 according to the third embodiment of the present invention is used for minimally invasive surgery for the spine, the user may be an operator.

28, when the user rotates the fastening sleeve 730, the fastening sleeve 730 is smoothly rotated by the rotating ring 755 and at the same time the second external thread 732 of the fastening sleeve 730 Is screwed to the first female screw (see 123 in Fig. 4) of the third external device OS (for example, the operation tower 100 (Fig. 4)), so that the fastening sleeve 730 moves downward. At this time, the outer member 710 and the inner member 720 constrained together by the coupling sleeve 730 are simultaneously moved downward by the connection pin 752. [

When the rod 20 is brought into contact with the bottom surface of the rod accommodation portion 11 of the calibration screw 10 by the lower end withdrawal portion 721 of the inner member 720, The rotation of the rotary shaft 730 is stopped and the rotary screw 740 is pressed downward and turned in the forward direction to screw the set screw S into the rod housing portion 11 of the calibration screw 10. At this time, the inner member 720 is fixed together with the fastening sleeve 730, and only the outer member 710 is moved downward through the sliding hole 753. That is, the inner member 720 gradually enters the outer member 710 while the outer member 710 is gradually moved downward.

Accordingly, since the pressing operation of the rod 20 is performed simultaneously with the fastening of the set screw S, it is possible to prevent the tissue from being caught between the rod 20 and the set screw S.

Hereinafter, a tension compressor according to a fourth embodiment of the present invention will be described in detail with reference to FIGS. 30 to 35. FIG.

FIG. 30 is a perspective view of a tension compressor according to a fourth embodiment of the present invention, FIG. 31 is a plan view of the tension compressor of FIG. 30, and FIG. 32 is a front view of the tension compressor of FIG.

FIG. 33 is a cross-sectional view cut along the line XXXIII-XXXIII of FIG. 31, FIG. 34 is a perspective view showing a screw rod or the like of the tension compressor of FIG. 32 in detail, and FIG. 35 is a cross- It is a perspective view.

The compression-distraction tool 900 according to the fourth embodiment of the present invention is a compression-distraction tool according to the fourth embodiment of the present invention. The compression-distraction tool 900 according to the fourth embodiment of the present invention includes first and second working towers 100a, 100b, A tensile compressing device that stretches or narrows and compresses between two calibration screws (10a in Fig. 36A) (10a in Fig. 36A) is used as a tensile compressing device in which a central axis 910 (pivot) A pressurizing unit 920 (tower compressing unit), and a tower supporter 930 (tower supporter).

The central axis 910 has a cylindrical shape and is positioned substantially vertically between the first and second operation towers 100a and 100b (see Figs. 36A and 36B).

The tower pressurizing unit 920 is provided at one end of the center shaft 910 and includes first and second operation towers 100a and 100b such that the first and second operation towers 100a and 100b are inclined with respect to the center axis 910. [ ) 100b. Here, one end of the central axis 910 refers to the upper end of the central axis 910 with reference to Fig.

The tower base 930 is rotatably installed at the other end of the center shaft 910 to prevent the first and second operation towers 100a and 100b from sliding in the longitudinal direction of the center shaft 910. Here, the other end of the central axis 910 points to the lower end of the central axis 910 with reference to Fig.

The tension compressor 900 according to the fourth embodiment of the present invention further includes a control knob 930 for rotating the tower pedestal 930 so that the tower pedestal 930 can be inserted between the first and second operation towers 100a, (940). For example, the adjustment handle 940 is fixed to the tower pedestal 930 and may be rotatably mounted on the center shaft 910.

33, the adjustment knob 940 is connected to the center shaft 910 through the second multi-stage adjustment unit 950 so as to give the user a feeling of movement when the adjustment knob 940 is rotated . For example, the second multi-stage regulating unit 950 includes a second ball 951 elastically supported on the center shaft 910, and a second ball 951 formed on the outer peripheral surface of the regulating knob 940 so that the second ball 951 is engaged with the multi- And a plurality of second latching grooves 952, Therefore, when the second ball 951 is positioned or disengaged from the second engaging groove 952, a sound of "ticking " is produced and the sound is provided to the user, so that the sense of operation can be maximized.

It is also possible to place the tower pedestal 930 substantially parallel to the first and second operation towers 100a and 100b so that the tower pedestal 930 is smoothly inserted into the first and second operation towers 100a and 100b Or to place the tower pedestal 930 substantially perpendicular to the first and second operation towers 100a and 100b so that the tower pedestal 930 supports the first and second operation towers 100a and 100b And the plurality of second latching grooves 952 may be formed at intervals of 90 degrees.

32, 34 and 35, the tower pressurizing unit 920 includes a connecting bracket 921 vertically provided at one end of the center shaft 910, a connecting bracket 921, A fixing protrusion 922 fitted to an external device insertion groove 113 of FIG. 4 of the first operation tower 100a and a pressing body 922 provided on the connection bracket 921 so as to be spaced apart from the central axis 910, A screw nut 924 rotatably provided on the pressing body 923 and a pressing nut 925 threadedly engaged with the screw rod 924 and a pressing nut 925 provided on the pressing nut 925, A pressing projection 926 located on one side of the second working tower 100b so as to be able to pull the pressing nut 925 and a pressing rod 928 rotatably provided on the outside of the pressing body 923, And a driving handle 927 (a driving handle) that rotates the handle 924. Accordingly, when the user rotates the drive handle 927 in the forward direction or the reverse direction, the screw nut 924 is rotated in the forward or reverse direction so that the pressing nut 925 moves in the left or right direction in the drawing. Accordingly, the pressing projection 926 provided on the pressing nut 925 also moves and holds the first and second operation towers 100a and 100b together with the fixing projection 922 firmly.

30 and 35, the pressing body 923 is positioned vertically to the center shaft 910 and the connecting bracket 921, respectively, and the first and second operation towers 100a and 100b (See Fig. 36A).

31, in order to minimize the interference with the first operation tower 100a or the second operation tower 100b while the user rotates the drive handle 927, both ends of the pressure body 923 May have a shape bent in a direction different from a direction toward the first and second operation towers 100a and 100b

32, 34, and 35, both end portions of the screw rod 924 are pressed against each other at the opposite end portions of the pressing body 924 so as to smoothly rotate the screw rod 924 when both ends of the pressing body 923 are bent. Can be connected to both ends of the body 923 by first and second universal joints 971 and 972, respectively.

The tower pressurizing unit 920 further includes first and second auxiliary shafts 928 and 929 rotatably provided at both outer ends of the pressurizing body 923 and the drive handle 927 includes a first Or the second auxiliary shaft 928 or 929 so that the screw rod 924 can be rotated. Therefore, regardless of whether the center shaft 910 is positioned above or below the pressing body 923, the right-handed user can continue to use the right hand, and the left-handed user can continue to use the outer hand.

Hereinafter, the use state of the tension compressor 900 according to the fourth embodiment of the present invention will be described in detail with reference to FIGS. 36A and 36B.

36A and 36B are schematic views showing the state of use of the tension compressor 900, which are a tensile state and a compressed state, respectively.

First, the user rotates the adjustment knob 940 to position the tower pedestal 930 substantially parallel to the first and second operation towers 100a and 100b. For reference, when the tension compressor 900 according to the fourth embodiment of the present invention is used for minimally invasive surgery for spine, the user may be a practitioner.

Then, when the user desires to stretch between the first and second calibration screws 10a and 10b at the lower ends of the first and second operation towers 100a and 100b, the center shaft 910 After the tower pedestal 930 is inserted between the first and second operation towers 100a and 100b such that the tower pedestal 930 is positioned below the pressurizing body 923, , The first and second calibration screws 10a and 10b are stretched while being stretched.

On the other hand, if the user wishes to narrow the gap between the first and second calibration screws 10a and 10b at the lower ends of the first and second operation towers 100a and 100b, After the tower pedestal 930 is inserted between the first and second operation towers 100a and 100b so as to be positioned above the pressure body 923, The first and second calibration screws 10a and 10b are compressed while being narrowed.

10: calibration screw 11: rod compartment
12: head part 13: fastening groove
20: Load S: Set screw
SP: Spine Bone 100: Operation Tower
110: Appearance 120: Inner tube
130: drive sleeve 140: screw holder
300, 500: Rod inserter 310: Fixed bar
320: Movement bar 330: Adjustment knob
340, 510: rod holder 341: hook
342: rod support portion 343: first holding arm
344: second holding arm 511: knuckle
512: Rod holder bracket 513: Clip
700: rod reducer 710: outer member
711: Set screw mounting portion 720: Inner member
721: lower drawer 730: fastening sleeve
740: rotation handle 900: tension compressor
910: center shaft 920: tower pressurizing unit
930: Tower stand

Claims (6)

A load reducer for tightening a set screw to the rod receiving portion while pressing down the rod seated on the rod receiving portion of the calibration screw during the minimally invasive surgery,
A tubular outer member having a set screw mounting portion formed at a lower end thereof;
An inner member slidably provided in the outer member and having a lower end drawn out from the outer member at a lower end to be in contact with the rod; And
A fastening sleeve for lowering the inner member while being fastened to the third external device holding the calibration screw so that the rod is pressed by the lower end withdrawing portion of the inner member; And
And a rotation handle for rotating the outer member so that the set screw is screwed to the rod housing portion of the calibration screw
A load reducer. The method of claim 1,
Wherein the third external device has a tubular shape, the outer member is inserted into the third external device, and the inner peripheral surface of the fastening sleeve is screwed to the outer peripheral surface of the third external device. 3. The method of claim 2,
The fastening sleeve being connected to the outer member and the inner member by a connecting unit,
The connecting unit includes: a through hole penetrating the inner member; A connection pin inserted into the through hole; A sliding hole formed in the outer member such that both ends of the connecting pin are inserted and the outer member is formed to be movable downward; A mounting groove formed on an inner circumferential surface of the fastening sleeve along a circumferential direction; And a rotating ring rotatably mounted in the mounting groove, the rotating ring being formed with first and second insertion holes for respectively inserting both ends of the connecting pin. 4. The method of claim 3,
And the length of the sliding hole is longer than the length of the lower end drawing portion of the inner member with respect to the longitudinal direction of the outer member. 4. The method of claim 3,
Wherein the inner member is elastically supported on the outer member so that the lower draw-out portion of the inner member is pulled out from the outer member before the set screw is fastened to the rod housing portion of the calibration screw. The method of claim 5,
Wherein the inner member and the outer member are resiliently held together by the fastening sleeve and the rotary handle, respectively, and an elastic body is provided between the fastening sleeve and the rotary handle for the elastic support.

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