KR20040078018A - Translaminar Compression Screw - Google Patents

Abstract

PURPOSE: A translaminar compression screw is provided to reduce surgery time and benefit a patient by inserting a guide pin into the point closer to the defective or fracture part of the body of the patient. CONSTITUTION: A translaminar compression screw(100) comprises a rod(110); a screw portion(120) formed at the front end of the rod; a head portion(130) formed at the back end of the rod; and a guide hole(140) penetrating through the side surface of the compression screw from the front end surface of the screw portion in such a manner that the guide hole has a predetermined tilt angle with respect to the center axis of the compression screw, wherein the guide hole guides the compression screw to the fracture or defective part of the body of a patient. The compression screw moves such that the guide pin tightly contacting the fracture or defective part passes through the guide hole, to thereby permit the compression screw to be guided to the fracture or defective part of the body of the patient.

Description

The translaminar compression screw

The present invention relates to compression fixation screws for treating fractures or defects and for bonding joints. More specifically, the present invention relates to a screw for pressing and fixing a fracture or defect site of the spine and a posterior joint.

In general, fracture refers to a state in which a bone is partially or completely separated by the action of an external force. Fractures include traumatic fractures that occur when the external force is large and applied, persistent fractures or fatigue fractures caused by chronic pressure, and pathological fractures caused by pathological invasion.

The treatment of fractures involves fixing the fractures in place and immobilizing them until they become union. Surgery of the fracture is a method of bonding both ends to the wound by fixing with a steel wire, and the method of fixing a metal base with a screw.

In particular, femoral neck fractures, scaphoid fractures, and the like, the fracture site is placed in place, and using a high pressure screw or a compression screw to perform a strong press operation to fix. In the case of intertrochanteric fractures of the femur of the elderly with osteoporosis, bone cement is injected, and the fracture site is joined using a metal plate and a compression screw. For scaphoid fractures and other fractures, the fracture site is joined using a compression screw guided by a guide pin. In addition, various inserts are used in the treatment methods for various fractures.

In the case of the spine, a vertebral replacement hydraulic fixing device, intervertebral fusion prosthetic inserts, pedicle screws and rods are used, and a treatment method using various medical inserts and fixtures is being developed.

The human spine consists of 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 sacral vertebrae, 4 to 5 lumbar vertebrae, etc., and each vertebral group has its own unique form, making it easy to distinguish. Cervical vertebrae are generally thin and have large bore. In particular, the first cervical spine is different in shape, but lacks a vertebra, so it becomes almost annular shape is also called a pendulum. In addition, the shape of the second cervical spine is slightly different from the top of the vertebral tooth-like protrusions (dental projections) protrude in the shape of the end of the little finger, and the spine is called the axis because it rotates with the skull on this axis. A tooth is the shape of a vertebrae, and because of this spine, the axis is shaped like a person with a desk leg. The thoracic and lumbar vertebrae are generally larger and lower. The sacral vertebrae are fused with five sacrum, and the sacrum is small and there is no blame.

1 is a cross-sectional view illustrating the vertebra, and FIG. 2 is a plan view illustrating the vertebra.

Referring to FIGS. 1 and 2, the vertebra 1 includes a vertebral body 10, a spinous process behind the vertebral body 12, a transverse process 14 formed on both sides, and an upper and lower joints. Protuberance (16, 16 '), superior and inferior articular process, pedicle (18, pedicle) and narrow (19, pars interarticularis) connecting the anterior and posterior part of the spine, intervertebral disc (Intervertebral Disc) , Not shown). Intervertebral discs are composed of anulus fibrosus and nucleus pulposus, and their shape and size differ depending on their position.

When defects or fractures occur in the spinous process 12 or the isthmus 19 in the vertebrae 1 as described above, use compression fixing screws and washers guided by fine guide pins to join and fix the bone fragments. do. The compression fixing screw has a guide hole formed along the central axis of the compression fixing screw, and penetrates the bone fragment and passes through the bone fragment along the guide pin inserted into the fracture or defect site during surgery. Then, the washer is firmly pressed to fix the bone fragments.

However, when a defect or fracture occurs in the narrow part 19, the narrow part 19 is located directly behind the nerve, and thus it is not easy to insert the guide pin in advance, and the guide pin is inserted according to the fractured shape. Since the direction to be changed is difficult to insert the guide pin. That is, in the case of a defect 19 or a fracture, the guide pin should be inserted into the patient's body from the spinous process 12 away from the lesion for proper insertion of the compression fixing screw, and the insertion distance of the guide pin may be large depending on the fractured shape. Depends.

In addition, when the guide pin is inserted, a case may be bent in the interior of the back arch 20 (lamina). At this time, since the guide pin is not inserted as intended by the operator, the operation time becomes long, thereby increasing the risk of the patient. In addition, the guide pin is not inserted as intended by the operator can damage the spinal cord (spinal cord) and nerve roots (nerve root) extending inside the spine. If the spinal cord or nerve roots are damaged during the operation as described above may cause serious postoperative sequelae in the patient. In addition, bone fragments or soft tissues may be caught, leading to screw and guide pins, which may cause tissue damage.

An object of the present invention for solving the above problems is to provide a compression fixation screw for fixing fractures or defects and posterior joints to reduce the surgical burden due to the guide pin insertion error or excessive invasion of the guide pin.

1 is a cross-sectional view for explaining the vertebrae.

2 is a plan view for explaining the vertebrae.

Figure 3 is a perspective view for explaining the chute and pressure fixing screw according to an embodiment of the present invention.

4 is a front view of the chute and pressure fixing screw shown in FIG.

FIG. 5 is a side view of the chute and pressure fixing screw shown in FIG. 3. FIG.

6A and 6B are schematic cross-sectional views for explaining a state in which a buccal defect or fracture site of the vertebrae is fixed by using the compression fixing screw shown in FIG. 3.

7 is a schematic cross-sectional view for explaining a state of fixing a buccal defect or fracture site of the vertebrae using a conventional compression fixing screw.

8A and 8D are cross-sectional views and a plan view illustrating a state of fixing using the pressing fixing screw shown in FIG. 3 when both narrow portions are missing or fractured.

9A and 9B are schematic plan views for explaining a state where the spinal column stabilization stabilization procedure is performed using the pressure fixing screw shown in FIG. 3.

Explanation of symbols on the main parts of the drawings

1: vertebrae 19: buccal

100: pressure fixing screw 110: rod

120: screw 130: head

140: guide 150: washer

160: connector 170: self-tap

20a, 20b: guide pin

The present invention for achieving the above object, including a rod, a screw formed on the front end of the rod, and a head formed on the back end of the rod, for joining a fractured or missing site In the bladder barrel and the pressure fixing screw, the pressure fixing screw penetrates from the front end surface of the screw portion to the side of the pressure fixing screw and has a predetermined inclination angle with respect to the central axis of the pressure fixing screw. Or a guide hole for guiding to the missing part is formed, and the compression fixing screw is moved to the fracture or missing part by moving the pressure fixing screw so that the guide pin in close contact with the fracture or missing part passes through the guide hole. It provides a pressure fixation screw for fixing fractures or defects and posterior joints characterized in that the guide.

In addition, a washer for pressing and fixing the fracture or missing portion is integrally formed with the head, and when the plurality of pressing fixing screws are used to join the fracture or missing portion, A connecting hole for connecting is formed through the head in a direction perpendicular to the central axis. In addition, a screw portion is provided with a self tap for easily coupling the compression fixing screw to the fractured portion by applying a rotational force.

According to the present invention as described above, it is not necessary to insert the guide pin for guiding the pressure fixing screw in the missing or fractured portion. Since the guide hole has a predetermined inclination angle with respect to the central axis, the guide pin is brought into close contact with the missing or fractured portion at an appropriate angle and the pressure fixing screw is moved along the guide pin to properly adjust the insertion point and the insertion angle of the pressure fixing screw. Can shorten the insertion distance of the guide pin.

In particular, when a defect or fracture occurs in the buccal region of the spine, the guide pin is not inserted through the posterior arch so that a problem due to the bending of the guide pin does not occur, and the guide hole has a predetermined inclination angle with respect to the central axis of the pressure fixing screw. Therefore, the insertion distance of the guide pin can be shortened from the patient's skin to the site where the defect or fracture occurs, and even if the guide pin is properly inserted, it can prevent excessive invasion of the guide pin when the screw is inserted. In addition, since the washer is formed integrally with the pressure fixing screw, the operation time is shortened, and the cost required for the operation can be reduced.

In addition, when a plurality of compression fixing screws are inserted into the fracture or missing site, the compression fixing screws can be connected to each other, thereby more firmly bonding the fracture or missing site.

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

Figure 3 is a perspective view for explaining the vertebral barrel and pressure fixing screw according to an embodiment of the present invention, Figure 4 is a front view of the vertebral barrel and pressure fixing screw shown in Figure 3, Figure 5 is a vertebral passage shown in Figure 3 Side view of the pressure fixing screw.

3 to 5, the bladder barrel and the pressure fixing screw 100 may include a rod 110, a screw portion 120 formed at a front end of the rod 110, and a head portion formed at a rear end of the rod 110. 130.

The screw portion 120 is screwed to the fractured portion through the two-stage bone fragments. At this time, a guide pin (not shown) for guiding the pressure fixing screw 100 to the bone fragment and the fractured part is first inserted into the body of the patient, and a guide hole for moving the pressure fixing screw 100 along the guide pin ( 140 is formed from the front end surface 122 of the thread portion 120 to the side surface of the pressure fixing screw (100). That is, the guide pin passes through the guide hole 140 and guides the pressure fixing screw 100 to the bone piece to be joined. At this time, the guide pin is not inserted into the fractured or missing portion through the bone fragments, but only close to the exact point of the bone to be bonded to guide the pressure fixing screw 100 to the correct insertion point. This is to prevent the problem that the guide pin is bent inside the fracture or missing area when the guide pin is inserted into the fracture or missing site.

The guide hole 140 penetrates from the front end surface 122 of the thread portion 120 to the side portion of the pressure fixing screw 100, and has a predetermined inclination angle α with respect to the central axis 102 of the pressure fixing screw 100. Has This is to allow the guide pin to be inserted closer to the fracture site. When a portion formed laterally of the human body, such as a narrow part of the spine, is missing or fractured, the compression fixing screw 100 must be inserted from the side of the patient's body. The guide hole 140 having a predetermined inclination angle α with respect to the central axis 102 of the compression fixing screw 100 allows the compression fixing screw 100 to be inserted at a point closer to the missing or fractured narrow part. . In other words, the insertion distance of the guide pin is reduced. Therefore, a shorter operation distance can be ensured than when using a conventional compression fixing screw having a guide hole formed along the central axis of the compression fixing screw, thereby significantly reducing the operation time and the patient's risk.

The inclination angle α of the guide hole 140 may be variously changed. Since it may not be easy to insert the pressure fixing screw 100 according to the inclination angle α of the guide hole 140, it should be appropriately changed according to the length and diameter of the pressure fixing screw 100. In addition, the guide hole 140 may be formed from an edge portion as well as the center portion of the front end surface 122 of the threaded portion 120, which makes the inclination angle α of the guide hole 140 wider. For sake.

The head 130 may have various shapes. That is, according to the shape of the surgical tool may have a variety of shapes, such as hexagon, square, triangle, etc., which can be variously formed from the shape of the well-known bolt does not limit the scope of the present invention. In addition, as shown, one side of the head 130, the washer 150 for pressing the two-stage bone fragment is formed integrally with the head 130. The washer 150 is formed to face the screw 120 from the head 130, which reduces the number of medical members inserted into the human body in the surgery using the pressure fixing screw 100 for the convenience of surgery This is to shorten the operation time.

In addition, when a plurality of compression fixing screws 100 are used to join the fractured or missing portions to the head 130, the compression fixing screws 100 are connected to each other to more firmly fix the fractured or missing portions. The connecting hole 160 is formed to penetrate the head 130 in a direction perpendicular to the central axis 102 of the pressure fixing screw 100. That is, when the two or more compression fixing screws 100 are used in the fractured portion, the connection hole 160 may fix the compression fixing screws 100 to the fractured or missing portions more firmly. Are formed to connect them to each other by a wire.

On the other hand, when inserting the compression fixing screw 100 to the fracture or missing portion by applying a rotational force to the front end of the screw portion 120, the self-tap 170 for advancing the compression fixing screw 100 more easily tap) is formed.

As shown, the number of threads of the thread portion 120 is four, but the number of threads can be varied in various ways. The pressure fixing screw 100 is preferably made of titanium or titanium alloy, the total length is about 25 to 70mm. The length of the screw 120 is about 8mm, the diameter of the rod 110 is 3 to 3.5mm, the outer diameter of the screw 120 is 4 to 4.5mm, the thickness of the washer 150 is about 3 to 4mm, washer It is preferable that the diameter is about 6-8 mm. The diameter of the guide hole 140 is preferably about 1mm, which may be changed accordingly because the diameter of the guide pin is about 0.5 to 1mm. The design dimensions of the pressure fixing screw 100 as described above may be changed in various ways depending on the surgical site.

6A and 6B are schematic cross-sectional views for explaining a state in which a buccal defect or fracture site of the vertebrae is fixed by using the compression fixing screw shown in FIG. 3, and FIG. It is a schematic sectional drawing for demonstrating the state which fixes a buccal defect or a fracture site | part.

6A to 7, the vertebra 1 includes the vertebral body 10, the spinous process 12 at the rear of the vertebral body, the transverse protrusions 14 formed on both sides, the upper and lower articular protrusions 16 and 16 ', and the spinal column. It consists of a pedicle 18 and the narrow 19 to connect the front and rear, the intervertebral disc is located between the vertebrae and vertebrae. 6A and 6B illustrate a case in which a defect or a fracture occurs in the buccal part 19, which is performed using the compression fixing screw 100 according to the embodiment of the present invention, and the compression screw according to the related art ( The procedure using 200) is shown in FIG.

When using the pressure fixing screw 100 according to an embodiment of the present invention, the guide hole 140 of the pressure fixing screw 100 is a predetermined angle of inclination with respect to the central axis 102 of the pressure fixing screw 100 ( Since α) is inserted, the insertion direction of the guide pin 20a is different from the insertion direction of the pressure fixing screw 100 that must be inserted through the missing or fractured narrow portion 19. Thus, the guide pin 20a should not be inserted through the missing or fractured narrowing 19. That is, the guide pin 20a merely serves to guide the pressure fixing screw 100 to the correct insertion point and is not inserted through the missing or fractured buccal portion 19. Therefore, the problem that may occur due to the improper insertion of the conventional guide pin 20b into the defective or fractured area is basically eliminated.

In the conventional pressing screw 200, since the guide hole is formed along the central axis, the insertion direction of the guide pin 20b and the insertion direction of the conventional pressing screw 200 are the same. In addition, a problem may arise that the guide pin 20b is bent while penetrating the blame.

6A to 7, when using the pressure fixing screw 100 according to an embodiment of the present invention, the guide pin 20a can be inserted at a point closer to the missing or fractured narrowed part 19. It can be seen. The insertion point of the guide pin 20a may be appropriately changed according to the guide hole inclination angle α of the pressure fixing screw 100 and the state of the missing or fractured narrow portion 19 and the size of the pressure fixing screw 100. .

8A and 8D are cross-sectional views and a plan view illustrating a state of fixing using the pressing fixing screw shown in FIG. 3 when both narrow portions are missing or fractured.

8A and 8D, two compression screws 100 may be used to firmly fix both narrow portions 19 at the same time, and the two compression fixing screws 100 may be secured through the connection hole 160. Connection can be made using wires, making the fixation more robust.

9A and 9B are schematic plan views for explaining a state where the spinal column stabilization stabilization procedure is performed using the pressure fixing screw shown in FIG. 3.

9A and 9B show a state in which two vertebrae are fixed by using a compression fixing screw in the correction and stabilization surgery of the modified spinal column.

Referring to FIG. 9A, two pressure fixing screws 100 are inserted through the facet joints 17 alternately in opposite directions from both sides of the spinous process 12, respectively. That is, the pressure fixing screw 100 is coupled through the upper and lower joint protrusions 16 and 16 'of the upper and lower vertebrae 1 and 2 coupled to each other.

9B, two compression fixing screws 100 are coupled to penetrate the upper and lower joint protrusions 16 and 16 ′, respectively. That is, the back joint 17 is fixed by using the pressure fixing screw 100 to correct the deformed spinal column.

Such a procedure may be performed as a secondary procedure after performing a spinal column correction primarily using a cage or a pedicle screw, or may perform spinal column correction using only a compression fixing screw when the degree of deformation of the spinal column is light. At this time, the two pressing fixing screws can be connected to each other by a wire through each connection hole, it is possible to more securely fix the spinal column.

According to the present invention as described above, the guide hole of the pressure fixing screw penetrates from the front end surface of the screw portion to the side of the pressure fixing screw, and has a predetermined inclination angle with respect to the central axis of the pressure screw. Therefore, when a portion formed laterally of the human body, such as a narrow portion of the vertebrae, is missing or fractured, the guide pin may be inserted at a point closer to the defective or fractured portion. Thus, the operation time can be shortened, and the risk of the patient and the postoperative sequelae can be reduced.

In addition, since the guide pin only serves to guide the compression screw to the missing or fractured site, the problem of improper insertion of the guide pin is basically eliminated. The connection hole formed in the head can ensure a more firm joint when a large number of compression screws are used, and the washer formed integrally with the head can facilitate the operation and consequently reduce the surgical burden on the operator and patient. have.

Although described above with reference to a preferred embodiment of the present invention, those skilled in the art will be variously modified and changed within the scope of the invention without departing from the spirit and scope of the invention described in the claims below I can understand that you can.

Claims (6)

In the rod and pressure fixing screw comprising a screw formed at the front end of the rod, and a head formed at the back end of the rod, for joining fractures or defects and posterior joint fixation , Penetrates from the front end surface of the screw portion to the side of the compression fixation screw and has a predetermined inclination angle with respect to the central axis of the compression fixation screw, and moves the compression fixation screw to the fracture or missing and posterior joint fixation portion; Guide holes are formed to guide, The compression fixing screw is guided to the fracture or defect and the posterior joint fixing site by moving the compression fixing screw so that the guide pin in close contact with the fracture or defect and the posterior joint fixing site passes through the guide hole. Passing pressure fixing screw. According to claim 1, wherein the head is formed integrally with the bladder passage pressing screw is characterized in that it further comprises a washer for pressing the fracture or defect and the posterior joint fixing site. The method of claim 1, wherein when a plurality of compression screws are used to join the fracture or defect and the posterior joint fixing portion, a connection hole for connecting the compression screws to each other passes through the head at right angles to the central axis. The blame passage press fixing screw which is formed. The method of claim 1, wherein a self-tap for coupling the compression fixing screw to the fracture or defect and the posterior joint fixing portion by applying a rotational force is formed in the screw section, the pass through the compression screw . In the post-pass compression screw for joining fractures, defects and posterior joint fixation, comprising a rod, a screw formed at the front end of the rod, and a head formed at the back end of the rod. , When a plurality of compression fixing screws are used to join the fracture or defect and the posterior joint fixing portion, a connection hole for connecting the compression fixing screws to each other penetrates the head in a direction perpendicular to the central axis of the compression fixing screw. Formed, It is formed integrally with the head, and running through the bladder pressure fixing screw, characterized in that it comprises a washer for pressing and fixing the fracture or defect and the posterior joint fixing. The screw portion of claim 5, wherein a self tap is formed on the screw portion for applying the rotational force to couple the compression fixing screw to the fracture or defect and the posterior joint fixation portion. Penetrates from the front end surface of the screw portion to the side of the compression fixation screw and has a predetermined inclination angle with respect to the central axis of the compression fixation screw, and moves the compression fixation screw to the fracture or missing and posterior joint fixation portion; Guide holes are formed to guide, The compression fixing screw is guided to the fracture or defect and the posterior joint fixing site by moving the compression fixing screw so that the guide pin in close contact with the fracture or defect and the posterior joint fixing site passes through the guide hole. Passing pressure fixing screw.