TWI379660B - Dynamic stabilization device for bones or vertebrae - Google Patents
Dynamic stabilization device for bones or vertebrae Download PDFInfo
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- TWI379660B TWI379660B TW095146969A TW95146969A TWI379660B TW I379660 B TWI379660 B TW I379660B TW 095146969 A TW095146969 A TW 095146969A TW 95146969 A TW95146969 A TW 95146969A TW I379660 B TWI379660 B TW I379660B
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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
- A61B17/7002—Longitudinal elements, e.g. rods
- A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
- A61B17/7022—Tethers, i.e. longitudinal elements capable of transmitting tension only, e.g. straps, sutures or cables
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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
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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
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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
- A61B17/74—Devices for the head or neck or trochanter of the femur
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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
- A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
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- Orthopedic Medicine & Surgery (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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Description
13.79660 九、發明說明: 【發明所屬之技術領域】 -本發明係關於錄或脊椎骨之動態穩定裝置 彈性環連接。彈性環容許在二骨絡固 ΐίίΐΐί 供二骨骼或脊椎骨之動態穩定。 ΕΡ 〇 669 109 B1號揭示一種穩定裝置,包括至少二單轴 =,固定於婦脊椎骨’並_帶連接,在各脊椎骨間傳 ^拉力。抗壓縮的支持體,包·釘間之 預力方式繫止於骨釘。如有二以上之骨釘=縮:穩 疋裝,在手術當中不易處理,而裝置之調節可能性有限。心、 js冰P 1 364 622八2號記載一種動態穩定裝置,包括骨釘和 f ^生桿’由彈料性材料製成。在相鄰脊椎骨間可達成的系 梏生ί能’是由桿的材料形狀和特性所決定。若有複數脊 。此外,容納組件和骨釘轴係單軸連接。如3 限制軸與桿相對位置調節之可能性。 叉耳號揭示一種脊柱穩定系統,具有交 呈^不月3器’加設脊柱運動限制,交又聯結構件 呈見不叼形式,尤其是包含彈性帶。 的组示一種脊柱拘限裝置,是人造絞股 件内界定之溝,附設於脊椎體的一組塊 之成長,用來處理if ^擇性拘限在脊柱凸曲面側一部份 【發明内容】 目的之解决疋利用申請專利範園第】項之動態穩定裝 5 置,步發展列於申請專利範圍附屬項。 環,有點是提供模組系統’包括若干無端 不同的彈按相鄰運動節穩定之要求,使用 相對於莖部之定^件為錄釘’可更佳調節釘頭 小。因此,動固定元件莖部之力量減到最 之效能。’―疋襄置具有改進使用壽命,以及更具平衡 下,點和優點’參見附圖所示具體例詳述如 【實施方式】 絡固定元件置之第—具體例,包括至少二骨 紋,可固定於骨莖部2,有骨路螺 件3有凹部4,I端彈^至/2甘之谷納組件3。容納組 元件11·。今右保同_从衣5插入其内,以連接二骨骼固定 元件U,之容納組,把無端彈性環5固定於骨路固定 由第巧3圖可見,骨路固技件1在莖部2之 頭部二有凹部8、在莖部2相反側,球形 以及第包Π端9,與第—端對立之第二端1〇, 與縱軸線11細,從目f接之縱㈣1卜設有腔孔12 接開口 U設有球形i H ΐ直徑比腔孔12直徑小。鄰 需為球形段,可呈另—形狀頭部7底座。此段14不 ^ Η,,-ν 狀例如錐形斜縮狀。 〜内組件3内之凹部呈υ形,在第—端9開始按第二 1379660 端10方向延伸’至離第二端預定距離處。利用u形凹部4 形成二自由股部15,16,朝第一端9延伸。容納組件3鄰接第 一端9,包括股部15,16上之陰螺紋17。 骨骼固定元件又包括第一施壓元件18,呈圓筒形構造, 其外徑只比腔孔12内徑梢小,使第一施壓元件18可引進入 容納組件3之腔孔12内,並在轴向運動。施壓元件18在朝 向第一端1〇之下側,包括球形凹部19,其半徑相當於骨釘 球形頭部7之半徑。在第一施壓元件18的相反側,具有圓筒 形凹部20 ’橫越縱軸線η延伸。選擇此凹部2〇的侧向直 徑,使呈圓形截面的環5,可插入凹部20内。選擇此圓筒形 凹部20的深度,使環插入並朝u形凹部4底加壓的組合狀 態下,第一施壓元件18對頭部7施壓。球形凹部2〇的深 度,以環5直徑大約一半為佳。 第一施壓元件18又有共軸腔孔21,可導經旋入工具。 骨骼固定元件又包括第二施壓元件22,呈圓筒形構造, 其外徑相當於第一施壓元件之外徑,以便可在腔孔12内滑 動。第二施壓元件22在朝向第一施壓元件18之側向,具有 圓筒形凹部23。圓筒形凹部23直徑使環5可套入,而其深 度為環5直徑之半或以下。此外,第二施壓元件22亦包括共 軸腔孔24。在第2圖所示組合狀態,第一施壓元件18和第 二施壓元件22,包圍環5。特別在第2和3圖内可見,第一 施壓元件18和第二施壓元件22插入容納組件3内,使得圓 筒形凹部20和23之導向,相當於u形凹部4之導向。第一 把壓元件之上緣20a銜接第二施壓元件之下緣23a。因此,環 5夾在第一施壓元件18和第二施壓元件22之間。 在圖示具體例中,保固元件6形成内螺釘,可旋入股部 15,16之間。内螺釘在朝向容納組件3的側面,有凸部25, 套^第二施壓元件22的共軸腔孔24内。在第2圖所示組合 狀態,凸部25碰到環5。陰螺紋和内螺釘之合作螺紋,可有 7 ,何已知螺紋形狀H平面敎和負角度螺紋的優點 疋,可防止股部15,16張開。 第 容納組件3和施壓元件18可利用分別設在容納組件3和 施壓元件18兩側的縮孔32,33,加以寬鬆預組合。 鈦 ,路固定裝置是由生理相容性材料製成,諸如不錄鋼或 或適合骨針之任何其他材料。 靡,1二L圖所示’環5係無端,有實質上長方形輪 ^ 長側W ’和二對立鋪36,36.。短側的長 二凹ί 4 t L的直㈣A,使短側可插人容納組件3的U m ^長度相當於二固定元件在操作現場的容 環5以彈料性材料製成為佳,諸如生理相 ί ΐ 物以聚賴、聚魏或peek為本之聚合 °可完全或部份屈曲 性尤其疋長侧35,%具有屈曲性。為 直徑可度,諸如不同長度和/或不同 使用時,至少有二骨骼固定震置固 骨碎片或二脊椎骨。骨路固定I署& 動〜、穩疋之一 納組件3内,以連接容納組件3 〇 L二固疋兀件之容 插入各容納!且件内,包圍環5。二施壓元件22 件的股部之間。在此情況下,内螺,内螺釘,入^組 緊時,可施壓於第二施壓元件22,接土“ = 円螺釘% 件18上,對骨釘頭部7施壓,把=在第一施壓元 置。環5雖插人於祕力H請碩補擔其角度位 裝置所需動態性能,藉選擇具有適當尺寸和剛性之環5 1379660 即可容易調節。若選用的環具高度屈曲 若選=5具有高度剛性,亦可傳輸_力 '】。拉。 亦可將環以預應力方式插入。 心Ϊ二ί體例如第4至6圖所示。第二具體例*第-且f ^不=在於容許插人二或以上之環,以連接二固J 2 St圖所示例中,三個固定元件 性帶巧51連接,例如以便财脊柱之二運動節。-紙,為彈 炉-第^具體例和第—具體例—致之組件,明樣參考數笨 部 4°,類=
叫仙,彼此相鄰,其方式是二環筒形段 =,Γ同内在第:施壓元件18,與第—具體例‘二S 件22,把朝向第一施壓元件侧面的單一圓筒; :域το 的圓筒形凹部23a,23b,以覆蓋和包圍二^,51和改成分開 辨/ =上,.㈣固定元件之固定和環之插人,均鱼第-罝 =t圖所 =。若有三個胁固找置要連接4骨路固定 ίί,連接 式4™各運動節所需適 則定位在鍊各端的骨釘容^件右,定, 即*^易處置,因外科醫師只要選擇適了 入ί納組;内’加以固定即可。甚至可用習知多軸骨 :備二施壓讀可肆應接受環,而環本身必須“ 在又-具體例中,可加彈料性阻尼 環的至少-長側’在環具較大屈曲程度時(圖可維未持= 間之距離。 ,發明可以修#。環不必有卿斷面,可呈橢圓形 形斷面’或另—形狀之斷面。環可在側面全長, 开/,、όΓ^全長變化斷面。此外,外形不必為圖示之長方 “:if圓形,或其他形狀。環可呈高度屈曲性或難能屈 々表面不需光滑,可加以結構化。 圖表示無端彈性環之第二具體例。環500包括第- S7f閉環段5°2 ’利用直段5。3連接。環_ ΪΪ,’ 料性材料製成。在修飾例中,只有直段503有 Ρ方磨耗。才 1%段501和502剛性。環500亦可有強化結構以 -+ίί9ίσ1°圖中,表示第1至4圖所示環5,5。,51之進 ,550包括二末端段551,552和中央段553,由二 貝1 ^ ’利用套筒554拉在一起。結果,環55〇類似 ,所不環500,有二閉環末端段5〇1 5〇2。套 性材料製成。 *』由弹枓 環不需緊密失在第—和第二施壓元件之間,亦 鬆弛保持在第-和第二施壓元件之間。在又_修飾中^ =或第二施壓元件的圓筒形凹部可財凸部,宜橫 卷Ϊ部可壓在環的表面’使得環的材料流動,因: 產生形式套接。對於内螺釘而言,所有已知修飾均可用。t 亦包含使用外環或螺帽。 此 在上述具體例中,螺釘是從頂部引進入容納组件3內 螺針亦可從容納組件之底部引進,只要容納組件g造 μ在又一修掷中’容納組件3和莖部2係硬性連 早軸螺釘。在此情況下,第-施壓元件可省略。在又 : 中,第二施壓^。 修鄉 在又一修飾中,凹部4,4〇 側向側面。 ’ 開口不向容納組件2,而是向 而是可以骨鉤或 本發明不限於螺釘做為骨關定元件, 任何其他骨骼固定元件實施。 【圖式簡單說明】 ,1圖為動態穩定裝置第一具體例之透視圖; 第2圖為動態穩定裝置第一具體例的骨骼固定元件連同 插入彈性環之斷面圖; 第3圖為第2圖骨骼固定元件之分解透視圖; 第4圖為動態穩定裝置之第二具體例; 第5圖為骨骼固定元件第二具體例連同插入彈性環之斷 面圖; 第6圖為動態穩定裝置第二具體例的骨骼固定元件不含 彈性環之分解圖; 第7圖為彈性環之修飾例; 第8圖為彈性環第二具體例之透視圖; 第9圖為彈性環第二具體例修飾例之透視圖; 第1〇圖為第9圖彈性環沿A-A線在環的縱轴線l垂直 方向延伸平面之斷面圖。 1379660
【主要元件符號說明】 UMM 骨骼固定元件 2 莖部 3 頭部 4,40 凹部 5,50,51連接元件 6 保固元件 7 球形頭部 8 凹部 9 第一端 10 第二端 11 縱軸線 12 腔孔 13 開口 14 球形段 15,16 股部 17 陰螺紋 18,18' 第一施壓元件 19 球形凹部 20,23 圓筒形凹部 21,24 共軸腔孔 22,22' 第二施壓元件 20a,20b,23a,23b 圓筒形凹部 25 凸部 32,33 縮孔 35,35' 長側 36,36' 短側 37 強化或保護性結構 41 凹部底 41a,41b圓筒形段 501,502 閉環末端段 500,550 環 503 直段 551,552末端段 553 中央段 554 套筒 12
Claims (1)
1379660 申請專利範圍: 1.一種骨骼或脊椎骨之動態穩定裝置,包括: 至少二骨骼固定元件(1; r ; 1”); 接 至少一連接元件(5 ; 50 ; 51),把骨骼固定元件加以連 , 骨骼固定元件具有要固定於骨骼或脊椎骨内之莖部 (2) ’以及要與連接元件(5 ; 5〇 ; 51)連接之頭部 其中連接元件(5 ; 5〇 ; 51)至少部份彈性,。牵二 環段; 节夕 四又其中頭部(3; 3,)包括凹部(4 ;4〇),有開口可供 壤段,和保固元件(6),可供環段固保於凹部内者。" (5 圍第1項之祕狱裝置,其中連接元件 D ,51)係無端環,以彈料性材料製成為佳者。 3.如申請專利範圍第丄或2項之動態穩 虫;仙)有内壁,包括陰螺紋⑼,而保固元以中: 螺釘,可旋入凹部(4 ; 4〇)内者。 〒…貝i為 件申請專利範圍第1項之動態穩定裝置,其中在伴固元 =6)和環段間設有施壓元件(22 I (6)之作動,對環段施壓者。 丄由保固兀件 其中凹部 其中凹部 其中莖部 其中莖部 5. 如申請專利範圍第i項之動態穩定 ^ )形狀可容納單一環段者。 6. 如申請專利範圍第!項之動態穩定裝 )形狀可容納至少二環段者。 7‘如申請專利範圍第丄項之動態穩定裝 和頭部係硬性連接者。 8. 如申請專利範圍第i項之動態穩定 U)和頭部(3; 3,)係樞動連接者。 复 ⑺具有球形頭心 9. 如申請專利範圍第8項之動態穩定裝置 有第或9項之_定裝置,其中設 凹部(4 ; 40)内之環)和第二施屢元件(22 ; 22,),包圍 件嫩由侧元 其中第一施 其中環段之 髮=二對球,部二動施 =裝置 斷面係實質Γίίϊ®第1項之動態穩定裝置 件項之動態穩定裝置,其中連接元 1”)者。 非應力狀態連接於二骨骼固定元件(1 ; (4==:項之動態穩定裝置,其中凹部 κ 〇P伤伸入衣蚊之内部空間者。 件係忿^^:項之動態穩定裝置心連接元 株位1料纖圍第1項之動態获裝置,其中連接元 以及ί 二;具5^ 1379660 七、指定代表圖: 圖。 莖部 凹部 保固元件 (一) 本案指定代表圖為:第(1 ) (二) 本代表圖之元件符號簡單說明: 1,1' 骨骼固定元件 2 3 頭部 4 5 連接元件 6
八、本案若有化學式時,請揭示最能顯示發明特徵的化學 式:
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-
2005
- 2005-12-23 DE DE602005012980T patent/DE602005012980D1/de active Active
- 2005-12-23 ES ES09002445T patent/ES2371701T3/es active Active
- 2005-12-23 ES ES05028284T patent/ES2323008T3/es active Active
- 2005-12-23 EP EP05028284A patent/EP1800614B1/en not_active Not-in-force
- 2005-12-23 EP EP09002445A patent/EP2055251B1/en not_active Not-in-force
-
2006
- 2006-12-13 CN CN2006101684511A patent/CN1985771B/zh not_active Expired - Fee Related
- 2006-12-15 TW TW095146969A patent/TWI379660B/zh not_active IP Right Cessation
- 2006-12-20 KR KR1020060130629A patent/KR101277771B1/ko not_active IP Right Cessation
- 2006-12-20 JP JP2006342950A patent/JP5260869B2/ja not_active Expired - Fee Related
- 2006-12-21 US US11/645,325 patent/US8192468B2/en not_active Expired - Fee Related
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2012
- 2012-05-22 US US13/477,834 patent/US8979902B2/en not_active Expired - Fee Related
Also Published As
Publication number | Publication date |
---|---|
ES2371701T3 (es) | 2012-01-09 |
US20070225708A1 (en) | 2007-09-27 |
US8979902B2 (en) | 2015-03-17 |
EP1800614A1 (en) | 2007-06-27 |
CN1985771B (zh) | 2013-10-02 |
DE602005012980D1 (de) | 2009-04-09 |
JP5260869B2 (ja) | 2013-08-14 |
KR101277771B1 (ko) | 2013-06-24 |
TW200726430A (en) | 2007-07-16 |
EP2055251A1 (en) | 2009-05-06 |
ES2323008T3 (es) | 2009-07-03 |
US8192468B2 (en) | 2012-06-05 |
US20120283779A1 (en) | 2012-11-08 |
CN1985771A (zh) | 2007-06-27 |
EP1800614B1 (en) | 2009-02-25 |
JP2007167658A (ja) | 2007-07-05 |
KR20070066892A (ko) | 2007-06-27 |
EP2055251B1 (en) | 2011-08-17 |
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