TWI379657B - Bone anchoring device - Google Patents
Bone anchoring device Download PDFInfo
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- TWI379657B TWI379657B TW095137002A TW95137002A TWI379657B TW I379657 B TWI379657 B TW I379657B TW 095137002 A TW095137002 A TW 095137002A TW 95137002 A TW95137002 A TW 95137002A TW I379657 B TWI379657 B TW I379657B
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- bone
- bone fixation
- head
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- fixation device
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8605—Heads, i.e. proximal ends projecting from bone
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
- A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
- A61B17/7038—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other to a different extent in different directions, e.g. within one plane only
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
- A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
Description
1379657 九、發明說明: 【發明所屬之技術領域】 本發明係關於一種骨骼固定裝 之固定元件,和接納桿用之接二置定:骨縣内 接納件有與縱轴線共軸之第— 於口疋兀件,其中 有插入骨顯之第-端,和可定^^第二腔孔’固定元件 2中^定元件可崎於__二 平面上調節。 ㈣固疋轉可相對於接納件在單- 【先前技術】 絡之,細定於骨 =抗性。然而’調節頭位置以應付解剖狀況之可能g 之接=,44/ΪΙ號揭示—種骨_定裝置,包括接納桿用 之骨絡固有螺紋轴及枢動保持在接納件内的球形頭部 ^ . 疋疋件。以此項所謂多軸骨骼固定元件,可令固定 範圍之方向,就接納件_線樞動-i所以,即使在骨絡固定構件的螺紋段旋人 ί 接納件相對於固定元件之定向’以接納 ί, 的節至解剖狀態,且桿插入接納件 =某些臨床應用上,例如在頸脊區域,由於頸脊尺寸 1特殊_的程度’必定比較大的胸脊和腰脊區 ,的5為大。us 6,736,82G Β2揭示—種骨釘,包含有螺纹 又之’丁:t件,和可樞動保持在接納桿的接納件内之頭部。釘 1379657
構件可以擴大角度拖動到至少一侧。此係對接納件之一邊設 備不對稱構造所完成。然而,釘構件仍然可繞其釘軸線以 360°角度範圍全方向樞動。 —第17圖所示Cosmic Posterior動態系統揭示一種骨骼固 ,裝置,包括接納件100、接納桿101和骨釘1〇2,其中骨釘 係繞樞動轴線1〇3搞動保持在接納件内,搞動軸線係以 垂直於接納件的縱轴線104且垂直於桿的橫銷1〇5所形成。 因此,骨釘可在含接納件縱軸線的單一平面樞動。骨釘相對
納件之位置不能鎖定’財釘和接婦可隨時彼此相對 運動。 【發明内容】 性,’在於提供—種f路㈣裝置,具有調節 位置。、何抵抗性,容易處置’且可安全鎖定骨釘在角度 半申請專利範圍第1或10項之骨路固定裝置解 决進一步發展列在申請專利範圍附屬項。 裝置骨”定裝置和多軸固定 垃細放Γ隹早千面進仃早平面調節,最好含有
平行延伸,使用時通常立置。此平面可例如與桿 側面運動。另外手==另,在桿的橫越方向 骨骼固定裝置因此更為穩定。—界定方向延伸。整個 接納元件可形成類似多軸 以,可預先組裝所需骨骼 裒$之已知接納件。所 要,無論多軸或單平面I置 π’按照手術上之實際需 置存量之穌。料面裝置均可,如降健持骨路固定裝 1379657 【實施方式】 為瞭i發明其他特點和優點,由參照關之詳細說明即可最 接納二 延伸。設有與縱轴線4共轴的腔孔5,從第H 離第二端3預從離處。在第二端3設有開 縮,該段可例如為球形或錐开f腔孔5有^又7朝開口 6斜 1又有u形凹部8,從第一端2開始,按第二端 2伸,離該第二端3預定距離處。利用 ==”,10 ’朝第-端2延伸。接納件i在鄰二! 細2 ’匕括在該股部9,1〇上之陰螺紋n ^ u形凹部 納桿12,藉此可連接若干骨骼固定裝置。 來接 骨路固定裝置又包括骨路固定元件13,含莖部14,有典 骼螺紋,-端有頭部15。如第3至6圖所示,頭部15J : 段16M6b,位於彼此對立,有球有: 於頭部15中心。頭部15在二對=f體中^ M位 包括二圓柱形表面17a,17b,盆之間, 元件―L,並延伸貫0穿 ?= ’包括平坦表面18。在平坦表:ι= 徑,較球形表面16a,16b的半徑為小。螺紋’ 納件的開口 6直徑小,故固定树^ 件⑶’螺紋^被導引通過下方^^二,^ 16^161?與接納件1的斜縮段7接觸為止。 /表面 由第1圖和第7至15圖可見,骨絡固 元件20,供作用於頭部15,並限制頭部15 ^ 極動。施壓元件20實質上為圓筒形,包括第$ 2二 7 1379657 端22。施壓元件20的外徑,比接納件1的腔孔5内徑稍 小’故施屢元件20可插入接納件1内,並在腔孔5内滑動。 施壓元件20在鄰接第一端21包括圓筒弓形凹部23,其大小 使桿12可套合於凹部23。施壓元件20鄰接第二端22包括 第二圓筒弓形凹部24,其圓筒軸線垂直於第一圓筒弓形凹 23之圓筒軸線。
第二圓筒弓形凹部24之圓筒弓形半徑,基本上相當於頭 部15的圓柱形表面I7a,17b之半徑。第二圓筒弓形凹部24 之寬度W,相當於頭部15的圓柱形表面17a l7b之寬度,當 固疋元件13和施壓元件插入接納件丨内時,使圓筒弓形凹部 24可至少部份覆蓋表面17a,17b。施壓元件2〇鄰接第二端u 又包括二對立球形凹部25a,25b,在第二圓筒弓形凹部24兩 側延伸,其直徑例如等於或大於頭部15的對立球形表面 16a,16b直徑,故由第12a、lib和13圖可見頭部15的球形 表面16a,16b不被施壓元件20所遮蓋》 ^
此外,施壓元件20包括在其外表的縮孔26,宜位在 凹部25a,25b之側面彼此對立,並分別與接納件1的股部上 之相對應縮孔27結合。縮孔26,27使施壓元件2〇可在接纳 件内鬆弛預先組裝,讓施壓元件20不致脫出。如此一來,亦 把固定元件相對於接納件的樞動平面預先界定。 再者,施壓元件20有共軸腔孔 於頭部15内之凹部19。 28,容許螺旋工具存取 第12和13圖表示施壓元件之修飾具體例。施壓元件 與第7至11圖所示施壓元件不同,在於第二圓筒形凹, 與第一圓筒形凹部23對準,使圓筒軸線平行。結果,_ 件樞動之轉動軸線,與使用第7至u _所示^壓 = 況相較,轉動90。。 干炙馉 如第1和2圖所示’骨路固定農置亦包括内釘% 股部9,K)之間螺合,把桿12 gj定,經桿12對頭部15旋^ 8 1379657 壓力。 整個裝置是由例如鈦等人體相容性材料製成。 使用上,首先將固定元件13插入接納件丨内,把螺紋莖 14導引通過接納件第二端3的開口 6,直至頭部15定置於g 接開口 6之·^又7。再將施壓元件20插入接納件1内,以其第 二端22朝向頭部,並利用合作的縮孔26,27鬆弛保持在一位 置’使施壓元件的凹部23與接納件i的凹部8共轴。頭部 15*之圓柱形表面17a l7b,至少部份以施壓元件的凹部24之 f筒形表面覆蓋。以此預組裝方式,把固定it件13螺旋入骨 路内。 Μ ’Λ定元件13仍餘對於接納件1樞動,然而 Ρ,並來杰圍有限位於包含接納件的縱轴線4之平面 第2 ^所-L件1的鏡像對稱平面。在具體例中,平面Ρ為 Ϊ元件之斷面平面。在單—平面樞動,是利用施 = 頭部15為之,不對頭部15施壓,只是令表
樞動\防止=圓1弓形凹部24合作’容許繞圓筒軸線C 另一方向樞動。所以,可在箭形平面(即襄 署/σ^ 12)調節接納件相對於固定元件13之付 置’而在侧向(即裝置使用中 之位 接納件1的位置調3 調節則受阻。隹 施壓元J 2t貝fm2 桿本身則對施盤元件20施壓。 王儿1卞山則對碩部15 王 利用頭部15的开,矣鎖疋在其最後位置。因此, 固定元件13 施塵元件的形式套合合作,防止 元件20間之摩擦力:在而^用:用於頭部15和施壓 第16圖矣-_ 建成碩°卩在早一平面角位運動之鎖定。 一骨路固定裝置'^50’50;/用桿12連接。第 元件13轉動袖線垂直 圖=不施壓元件20。固定 線4 和縣線
S 括第12和13圖所示施壓元件2〇,。骨骼固定元件13的轉動 軸線與桿軸線A平行,容許固定元件13在垂直於桿軸線A 並包含接納件縱軸線4的單一平面調節。 從第14a、14b、15、16圖可見,本發明骨骼固定裝置可 f單-平,調節,或易言之,繞-轉動軸線轉動。所以,固 2疋件以”方式連接納件。骨路固定裝置比可繞縱 36G°範關動的多軸骨制定褒置更穩定。具有改進 =抵抗性,容許躺件位置卿,足夠供特雜床應用。 ^用,當祕元件可組裝錄固定元件,按㈣際解剖需 要’在所需平面相對於桿調節。 ^發明不限於上述具體例,可加以修飾。施壓元件的第 ^和第二®筒形凹部之二關軸線,可彼此相對之任何定 第-圓λ弓形凹部23可以省略。意即施壓元件的 内定向,面。在此情況下,施壓元件可在接納件 白使第一圓清弓形凹部在任何所需方向對準。 頭部15的表面l6a,16b不需具有球 與縱==♦單—平面,不必包含縱4亦可 達成。 動角度的不對稱亦可利用其他機構 後者例:,壓力經由桿12施加於施壓元件20, 後者轭壓於頭部。然而,經由祐题/ ζυ i2 ^ ^ 23包括向上延伸之股部,在插人桿5凹部 由分開的_釘(包括對桿施壓 ’故可經 股部施壓。 〈叫釘3G),分別對此等 在進-步修飾中,可構造成把頭部從第二端3插入到接 必敎到夠引進頭部,而且 在另一修飾中,接納件的下開口 6設有螺纹, _ 嚙合。在此情況下’固定元件13的螺二定: 二=大 骨路内。螺紋莖的直徑可和第:腔 釘或Ξ螺紋114外’亦可構想任何其他骨顧定機構,諸如 亦可外科手術使用之前,可不需預先組裝, 【圖式簡單說明】 J1圖為本發明倾©定裝置之透視分解圖; 態之斷面if示第1圖骨細定|置沿桿縱轴線 ί 料制絲置的骨襲定元狀透視圖;
一段組裝狀 圖表示第1圖骨絡固^元件之俯視圖; ^圖表4 3圖骨制定元件之部份側視圖; 圖表示第3 g骨細定元件齡9(r之部份側視 ^ ^表示骨關定裝置的施觀件俯視圖; =圖表讨侧定裝置的麟元件側視圖; 圖表7F骨侧定裝置的施壓元件仰視透視圖; 。,表示第9圖施壓元件之另—透視圖; ^圖表示骨骼固定裝置的施壓元件仰視圖; 圖表示施壓元件另-具體例之側視圖; 圖表示第12圖施壓元件之透視圖; 11 1379657 第14a和14b圖表示骨骼固定元件連同施壓元件在二不 同角度位置之側視圖; 第15圖表示骨骼固定元件連同施壓元件之透視圖; 第16圖表示本發明二骨骼固定元件連同桿; 第17圖表示已知Cosmic Posterior動態系統。
【主要元件符號說明】 1,100 接納件 3,22 第二端 5 腔孔 7 腔孑L中的一段 9,10 自由股部 12 桿 14 莖部 16a, 16b 球形表面 18 平坦表面 20,20, 施壓元件 25a,25b球形凹部 28 腔孔 50,50, 骨骼固定裝置 C 圓柱軸線 W 寬度 A 桿軸線 102 骨釘 104 縱軸線 2,21 第一端 4 縱轴線 6 開口 8 U形凹部 11 陰螺紋 13 骨骼固定元件 15 頭部 17a,17b圓柱形表面 19 凹部 23,24,24’圓筒弓形凹部 26,27 縮孔 30 内釘 Μ 球體中心 L 縱軸線 Ρ 縱軸線之平面 101 接納桿 103 樞動軸線 105 橫銷
Claims (1)
1〇1年7月6日修正t il·^ 卜、申請專利範圍: 1·一種骨骼固定裝置,包括: 圍繞縱;角度範 (13)相對於接納件⑴鎖定, 把固疋兀件 部,以言i有施壓元件(20),具有形成容納桿之凹 鎖則’利用頭部(15)和施壓元件(20)門之 开Μ套合,接,限制骨路固定元件(13)於單一平牛面之 .如巾4專利範圍第丨項之骨㈣ 包含縱轴線(4)者。 Π八〒早一千面 3·如申請專利範圍第i力2項 固定元件⑼在平面(P)相對於接納=動^ J 就縱軸線⑷對稱者。 K連動角度係 圍第1或2項之骨路固定裝置,其中頭部 (^在早一平面(p),於第二腔孔(6)内槐動者。 5如申請專利範圍第!或2項之骨絡固定農置, (15)係鏡像對稱,並具有導引表面(ς: 件⑴的相配導引表面(24)合作者。 〃位於接納 6.如申請專利範圍第5項之骨骼固定裝置, :=;2:)。呈圓筒形,圓筒轴線係垂直於接卿 7·如申請專利範圍第1或2項之骨骼固定裴置,苴中骨 固定兀件(13)祕納件内角錢動,是彻摩擦力達成鎖定 1379657 者。 8. 如申請專利範圍第1或2項之骨骼固定裝置,其中接納 件(1)之内表面實質上相對於繞縱轴線轉動呈對稱者。 9. 如申請專利範圍第1或2項之骨骼固定裝置,其中: 固定元件(13)可繞橫越接納件縱轴線(4)的單一轉 動軸線,相對於接納件(1)樞動者。
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US72603205P | 2005-10-12 | 2005-10-12 | |
EP05022263A EP1774919B1 (en) | 2005-10-12 | 2005-10-12 | Poly-axial screw pivotable in a single plane |
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2005
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US20100318135A1 (en) | 2010-12-16 |
CN1965769B (zh) | 2012-11-21 |
DE602005009202D1 (de) | 2008-10-02 |
JP4994773B2 (ja) | 2012-08-08 |
JP2007105472A (ja) | 2007-04-26 |
KR101267581B1 (ko) | 2013-05-23 |
US8048133B2 (en) | 2011-11-01 |
US20140058463A1 (en) | 2014-02-27 |
US20120109224A1 (en) | 2012-05-03 |
KR20070040720A (ko) | 2007-04-17 |
CN1965769A (zh) | 2007-05-23 |
EP1774919B1 (en) | 2008-08-20 |
US20070161996A1 (en) | 2007-07-12 |
US7749258B2 (en) | 2010-07-06 |
US9078715B2 (en) | 2015-07-14 |
US8506611B2 (en) | 2013-08-13 |
ES2313182T3 (es) | 2009-03-01 |
EP1774919A1 (en) | 2007-04-18 |
TW200722030A (en) | 2007-06-16 |
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