RU2299045C2 - Endoclamp plate for fixing cervical segment of the vertebral column - Google Patents

Abstract

FIELD: medical engineering.

SUBSTANCE: device has hollow case and pterygoid cast members with holes. Casing has technological openings produced on frontal surface for fixing bone plastic material. Teeth are available at end faces as obstacle hindering displacement. The technological opening for fixing bone plastic material has height corresponding to interbody defect height. The pterygoid cast member openings are united in groups of three each, one of which is threaded for receiving the blocking screw, and two openings have internal convergence for introducing screws. Oval transition zones are available between the casing and pterygoid cast members to allow entering into grooves produced in vertebral bodies.

EFFECT: high stability in connecting motor parts of the vertebral column segments; prevented undesirable extension, flexion and rotation movements.

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Description

The invention relates to medicine, namely to traumatology and orthopedics and can be used in the treatment of injuries and diseases of the cervical spine.

Known endofixer of the spine, made by a hollow body, in the form of an open hoop with teeth along the edges, having in shape a sectional shape of the vertebral body, and the teeth on opposite edges are slanted in mutually opposite directions (US No. 6231610 IPC A61F 2/44, 15/05 / 2001).

A disadvantage of the known spinal fixative is the lack of rigidity due to rupture of its external contour. This fixative is used only as an interbody, which limits its possibilities in case of damage to the end plates, vertebral bodies. Common features of the invention and the analogue are: the presence of a hollow body with holes and teeth at the ends.

Closest to the claimed is the endofixer described by George Samandouras, MD, FRCS, Masood Shafafy, FRCS, and Peter John Hamlyn, MD, // A New Anterior Cervical Instrumentation System Combining an Intradiscal Cage With an Integrated Plate // Spine Volume 26, Number 10, pp. 1188-1192, 2001, consisting of the interbody and wings of the plate, which are attached to the vertebral bodies by means of screws, which creates additional fixation. In the front part of the endofixer there is an oval port through which bone grafts are introduced into the cavity of the interbody part of the endofixer in the form of “crumbs”.

The endofixer has several disadvantages:

- two screws do not provide reliable flexion-rotational stability of the structure;

- through the oval port it is possible to introduce only bone grafts in the form of "crumbs";

- endofixer is intended only for insertion into the interbody gap of one motor segment.

The objective of the invention is the prevention of extensional-flexion-rotational movements, allowing to increase the stabilizing capabilities of the endofixer-plate on one or more motor segments of the spine.

When using the proposed endofixer-plate, there is a positive effect, which consists in the fact that the endofixer-plate provides rigid fixation, creates optimal conditions for bone fusion in a shorter time, eliminates the need for external immobilization.

When using the proposed endofixer-plate, the patient’s stay on the bed is reduced, the period of disability is reduced. Early activation improves the patient's quality of life.

The technical result is achieved due to the design features of the endofixer-plate, preventing extensional-flexion-rotational movements, thereby increasing the stabilizing capabilities on one or more motor segments of the spine.

The problem is solved due to the fact that the technological hole for the installation of osteoplastic material has a height corresponding to the height of the interbody defect, the holes in the pterygoid castings are made in three, one of which is threaded for the locking screw, and two holes are made with internal convergence for insertion there are screws in them, between the body and pterygoid ebbs there are oval transitions for entering the formed grooves in the vertebral bodies.

The drawing shows an endofixer-plate, consisting of a housing 1; pterygoid ebbs 2; holes for the introduction of screws 3; holes for introducing locking screws 4; oval transitions 5; H is the height of the technological hole in the housing.

Endofixer plate works as follows. Operational access to the bodies of the cervical vertebrae is typical. On the front edge of the sternocleidomastoid muscle. After dissection of the skin, fiber, superficial fascia, m.platisma, the pretracheal fascia is exposed. The place of passage of the neurovascular bundle is determined by palpation, medially departing from which the pretracheal fascia is dissected. The organs of the neck are diverted inwards, the neurovascular bundle outwards. After dissection of the prevertebral fascia, the front long muscles of the neck are exposed, which are bred to the sides, thereby exposing the vertebral bodies. After the surgical procedure, a bed for the endofixer is formed, in the bodies of adjacent vertebrae, using chisels and templates, grooves are formed for introducing oval transitions into them. Correction of deformation of the damaged segment achieved by traction and extension. The endofixer plate is selected according to the height of the defect formed. The hollow body of the endofixer-plate is installed in the formed defect, while the oval transitions enter the formed grooves of the vertebral bodies, determining the desired position of the endofixer-plate with a snug fit of the pterygoid ebb to adjacent vertebral bodies. After this, the extension and traction are eliminated. Four screws (two in each) are inserted through the holes in the pterygoid ebb parallel to the locking plates and with a convergence of 5 ° (two in each), which are pairwise blocked by two additional screws. The endofixer plate installed in this way firmly fixes the segments, eliminating the possibility of extension-flexion-rotational movements. Due to the fact that the front technological hole corresponds in height to the interbody, a bone graft of the required size is installed in it, which fills the hollow part of the endofixer-plate with a snug fit to the bodies of adjacent vertebrae. Thus, favorable conditions are provided for reparative regeneration and early bone fusion of vertebral bodies. The wound closes in layers. External immobilization is not used.

Claims (1)

An endofixer-plate for the cervical spine, containing a hollow body and pterygoid ebbs with holes, the body is made on the front surface with a technological hole for installing bone-plastic material, and at the ends with teeth to prevent displacement, characterized in that the technological hole for the installation of osteoplastic material has a height corresponding to the height of the interbody defect, the holes in the pterygoid ebb are three, one of which is threaded to block screw, and two holes are made with internal convergence for introducing screws into them, between the body and pterygoid ebbs there are oval transitions for entering the formed grooves in the vertebral bodies.