RU43146U1 - DEVICE FOR OSTEOSYNTHESIS OF THE SPINE - Google Patents

Abstract

The utility model is aimed at simplifying the manipulation of a damaged vertebra (fractures, spondylitis) with significant destruction of the vertebral body and reliable stabilization of the spine.

The specified technical result is achieved in that in a device for osteosynthesis of the spine containing support plates connected by screw rods and threaded rods having a working part inserted into the vertebra and free ends attached to the plates, threaded rods inserted into the vertebra with a destroyed body have a shortened the working part, which is 1/3 of the working part of the threaded rods inserted into adjacent intact vertebrae.

Description

The utility model relates to medicine, namely to the treatment of the spine with significant destruction of the vertebral body (fractures, spondylitis).

A device is known for extra-focal spinal osteosynthesis (Pat. RF No. 2115381), including supporting elements in the form of arched plates with longitudinal slots, threaded rods fixed perpendicular to the plane of the arched plate, which are interconnected by brackets and longitudinal screw rods in two parallel planes.

However, a device with the same threaded rods is used in the treatment of vertebral displacement, as well as with minor damage to the vertebral body (with fractures or partial damage to the vertebral body with tuberculosis). When manipulating a threaded rod inserted into the vertebra with significant destruction of the body, the point of application of force on the threaded rod changes. With great effort required to reposition the displaced vertebra, the rods break, the reliability of the fixation of the vertebra in the achieved position decreases. In addition, difficulties arise when removing the destroyed vertebral body.

The technical task is to simplify manipulation of the vertebra with a destroyed body and ensuring reliable stabilization, is solved as follows.

In the device for osteosynthesis of the spine, containing support plates with longitudinal slots connected by screw rods located in two parallel planes and threaded rods having a working part inserted into the vertebra and free ends attached to the plates, according to the invention, threaded rods inserted into the vertebra with shattered body made with shortened

the working part, which is 1/3 of the working part of the threaded rods inserted into adjacent intact vertebrae.

In clinical trials, it was proved that with a shortened working part of the threaded rods inserted into the vertebra with a destroyed body, a targeted dosage effect on the displaced vertebra is more effective when it is repaired, it is easier to keep the vertebra in a predetermined position when removing the damaged vertebral body and to securely fix the vertebral segment in achieved position. The size of the working part of the threaded rods inserted into the vertebra with a destroyed body equal to 1/3 of the working part of the threaded rods inserted into adjacent unbroken vertebrae is selected taking into account the anatomical size of the leg of the vertebral arch, which is approximately 1/3 of the pediculocorporeal size of the vertebra.

Thus, the use of the claimed device simplifies the manipulation of the vertebra with significant destruction of the body and reliably stabilize it until a bone block is formed.

Figure 1 presents a General view of the device for osteosynthesis of the spine with significant destruction of the vertebral body.

The device consists of supporting arcuate plates 1 with longitudinal slots. The plates are interconnected via brackets with screw rods 2 located in two parallel planes, while the central rod consists of two parts connected by a hinge. In the longitudinal slots of the support plates 1, through threaded washers (convex and concave), threaded rods 3 for adjacent intact (overlying and underlying) vertebrae and threaded rods 4 with a shortened working part for the vertebra with a damaged body (damaged due to fracture or injured) are attached perpendicular to the plates ) The shortened working part of the threaded rod 4 is 1/3 of the working part of the threaded rod 3. Working

the threaded part has a diameter of 4 mm, the shank with a metric thread has a diameter of 6 mm.

A device for osteosynthesis of the spine is used as follows.

Threaded rods 3 are introduced transpedicularly into the bodies of the overlying and underlying vertebrae with respect to the damaged (affected) one. A threaded rod 4 is introduced into the vertebra with a destroyed body in the region of the arch leg 4. The free ends of the threaded rods are fixed on the supporting plates 1 with the help of expansion washers and nuts. Support plates are interconnected via brackets with screw rods 2.

Using screw rods, the support plates are moved relative to each other, adjusting the position of the vertebrae. The position of the vertebrae is controlled using an X-ray apparatus with an image intensifier tube and visually according to the level of location of the support plates. The device is effective in spinal osteosynthesis with significant destruction of the vertebral bodies: in case of fractures, fracture-dislocations, and spondylitis (tuberculosis, osteomyelitis).

Example. Patient J., The diagnosis of a fracture of the LIII vertebra with significant destruction of the body.

Figure 2 presents the radiographs of the patient J. - before surgery, Figure 3 - produced spinal osteosynthesis, Figure 4 - treatment outcome.

Spinal osteosynthesis was performed. Threaded rods are transpedicularly introduced into the bodies of the overlying and underlying vertebrae. Threaded rods with a shortened working part within the leg of the arch were introduced into the third vertebra. Fixed displacement of the third vertebra. On day 3, the patient is raised to her feet. Spinal correction achieved. After 4 months, fusion of the LIII vertebra was achieved. The device is dismantled. There are no complaints. There is no loss of achieved vertebral correction.

Example. Patient A., The diagnosis of tuberculous spondylitis of the bodies of the LI-II spine.

Spinal osteosynthesis and correction of spinal deformity by the proposed device have been performed. Two threaded rods with a shortened working part are introduced into the destroyed vertebra within the leg of the arch. At the same time, anti-tuberculosis therapy was carried out. Spinal deformity is eliminated, walking is allowed from 3 days. After 5 months, a bone block was reached. No vertebral destruction. The device is dismantled. There are no complaints. Discharged home.

Figure 5 presents the radiographs of patient A. - before surgery, Fig.6 - produced spinal osteosynthesis, Fig.7 - treatment outcome, vertebral displacement eliminated, bone block. There is no loss of achieved vertebral correction.

Thus, the proposed device simplifies the dosage correction of displacement of the vertebrae with significant damage to the vertebral body with reliable stabilization of the vertebrae until the bone block is reached, which generally increases the efficiency of the device.

Claims (1)

A device for spinal osteosynthesis comprising support plates with longitudinal slots connected by screw rods located in two parallel planes and threaded rods having a working part inserted into the vertebra and free ends fixed to the plates, characterized in that the threaded rods inserted into the vertebra with a destroyed body, made with a shortened working part, which is 1/3 of the working part of the threaded rods inserted into adjacent intact vertebrae.