TWI439251B - 骨骼固定裝置 - Google Patents

骨骼固定裝置 Download PDF

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TWI439251B
TWI439251B TW098109434A TW98109434A TWI439251B TW I439251 B TWI439251 B TW I439251B TW 098109434 A TW098109434 A TW 098109434A TW 98109434 A TW98109434 A TW 98109434A TW I439251 B TWI439251 B TW I439251B
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sleeve
bone fixation
rod
fixation device
slit
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TW098109434A
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TW200940025A (en
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Lutz Biedermann
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Biedermann Technologies Gmbh
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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
    • 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
    • A61B17/7005—Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit in the screw or hook heads
    • 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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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Neurology (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Description

骨骼固定裝置
本發明係關於骨骼或椎骨動態穩定用之骨骼固定裝置。
EP 1,759,646 A1揭示一種椎骨動態穩定用之脊椎植入體，使用撓性桿，利用充填件和夾持元件，夾持於梗釘之容納件內。梗釘是所謂單軸式梗釘。
EP 1,795,134 A1揭示一種使用撓性桿之多軸式螺釘。加壓元件和充填件彼此之間夾持撓性桿，使撓性桿的材料沿軸縱軸線的流動減到最少。
已知骨骼固定裝置特別適合使用撓性桿。
本發明之目的，在於提供一種骨骼或椎骨動態穩定用之骨骼固定裝置，使用撓性桿，具有簡化之設計。
此目的是以申請專利範圍第1項之骨骼固定裝置解決。本發明進一步發展列於申請專利範圍附屬項。
骨骼固定裝置得以使用撓性桿，連同已知必然不能特別適於夾持撓性桿之單軸式或多軸式螺釘。撓性桿之夾持係利用固設元件(例如固定螺釘)達成。
使用金屬桿之已知單軸式或多軸式螺釘，可以升級使用撓性桿。
夾持撓性桿之套筒有不同維度，得以使用具有同一容納件之不同直徑的桿。
本發明其他特點和優點，由具體例之詳細說明連同附圖，即可明白。
參見附圖，第1至3圖表示包括單軸式梗釘和桿之骨骼固定裝置1第一具體例。骨骼固定裝置1包括骨骼固定元件2、撓性桿3、套筒4和固設元件5。骨骼固定元件2包括固定於骨骼或椎骨內所用螺紋軸6，和基本上圓筒形之容納件7，有共軸腔孔11和形成二自由股部9和10之基本上U形凹部8。自由股部9,10設有陰螺紋12。在第一具體例中，容納件7和螺紋軸8由單件製成。螺紋軸8相對於容納件7之角度位置固定，實施為共軸式，故設有單軸式螺釘。固設元件5為固定螺釘，旋入股部9,10之間。
桿3呈一般圓形截面，部份或全部撓性。例如桿可由生理相容性塑膠材料，例如彈料性材料製成。材料可為聚胺酯或聚碳酸酯胺酯(PCU)為基質之聚合物。
特別由第1至4圖可見，套筒4呈實質上圓筒形，其外徑D尺寸可套入容納件7之U形凹部8內。內徑d比桿3之直徑DR 稍大，故套筒可套於桿外。另外，桿的內徑d尺寸可等於或稍小於桿的直徑，使套筒可以預力方式套在桿外。套筒4長度L至少等於容納件7直徑，使套筒插入容納件7內時，置於U形凹部底。
套筒4又包括細縫15，從第一端延伸至第二端。細縫15寬度尺寸是，在套筒4包圍桿3時，不會有壓力作用於套筒上，細縫開口，有第一寬度。經由固設元件於壓於套筒4時，套筒被壓縮，細縫有第二寬度，比第一寬度小。套筒4由較桿的材料不具撓性之材料製成。例如，套筒4為生理相容性金屬製成，像不銹鋼或鈦，或硬質聚合物製成，像充填碳之PEEK或其他合成材料。細縫15對套筒4賦予彈性，使套筒4可以壓縮，減少細縫寬度。細縫15亦得以使套筒4套在桿上。
在套筒4內壁，設有複數沿周延伸之肋條狀凸部16。如具體例所示，肋條狀凸部圓滑，以免傷及桿表面。
特別由第3圖可見，在組裝狀態中，套筒4在容納件7內桿上定向是，讓細縫15面向容納件的股部9,10之一，即實質上對螺釘軸線垂直。
使用時，把至少二骨骼固定元件2旋入相鄰椎骨或骨骼組件。然後，撓性桿3設置套筒4，距離在相當於骨骼固定元件2之距離。桿3和複數套筒可預組裝，或在手術之際套在桿外。套筒4在不受壓力時，可沿桿軸線移動。因此，外科醫師可調節套筒在桿上之位置。
然後，桿連同套筒插入各骨骼固定元件之容納件內，並把固設螺釘5旋入股部之間。固設螺釘旋緊時，施壓於套筒，如第3圖所示，因而壓縮套筒4，減少細縫15寬度。桿3的材料開始流動，容許肋條狀凸部16壓在桿上，提供桿3和套筒4內壁間之形式套合連接。不影響桿之整體結構。同時，套筒4壓住U形凹部底，使桿牢靠保持在容納件7內。
茲參見第6至8圖說明第二具體例。第二具體例之骨骼固定裝置1'包括多軸式骨骼螺釘，包括骨骼固定元件20'，有螺紋軸21和球形截面狀之頭部22。頭部22在背離螺紋軸21之側面有凹部23，容許骨骼固定元件旋入。
骨骼固定裝置1'又包括容納件24，有第一端25及其對立之第二端26，和從第二端26延伸至第一端25之共軸腔孔27，如第8圖所示，朝第二端25斜縮，提供頭部22之底座。容納件24又有實質上U形凹部28，具有容納桿3用之凹溝。利用U形凹部28形成二自由股部29,30，包括陰螺紋31，與固設元件5嚙合。
設有加壓元件32，呈一般圓筒形構造，其外徑只比腔孔27內徑稍大，使加壓元件32可引進入容納件內，在其間按軸向活動。加壓元件32在其朝第二端25之下側，包括球形凹部33，半徑相當於骨骼固定元件之球形頭部22半徑。加壓元件在相反側有圓筒形凹部34，橫越共軸腔孔27之軸線延伸。此凹部側向直徑尺寸，使桿3連同套筒4可插入凹部內，在其內導引。圓筒形凹部34深度尺寸，使得桿3連同套筒4插入並以固設螺釘5壓下之組裝狀態時，加壓元件34即對頭部22施壓。此外，加壓元件32具有共軸腔孔35，供導引工具貫穿其間。
使用時，骨骼固定裝置可預組裝，其方式是令骨骼固定元件20樞動保持在容納件24內，把加壓元件32插入，故圓筒形凹部34即與容納件之U形凹部28共軸。把至少二骨骼固定元件旋入相鄰椎骨或骨骼組件內，再把套在其上的桿3連同套筒4，插入U形凹部內。套筒4定向一如第一具體例，使細縫15在側面定向。當固設螺釘5插入容納件內旋緊時，對套筒施壓，因而壓縮套筒，夾持桿。剩餘壓力經套筒轉移至加壓元件，從而施壓於骨骼固定元件之頭部22，把頭部固設在與容納件24之原先所調節角位關係。一如第一具體例，套筒內壁之肋條狀凸部16導致撓性桿3和套筒4間之部份形式套合連接，把桿牢牢夾持，防止桿材料在沿桿軸線方向流動。
具體例可構想若干修飾例。肋條狀凸部可改設其他形狀。例如凸部可為複數小球形凸部，或呈其他形狀。亦可用凸部和凹部之組合。
套筒內壁可以用粗糙表面，以增進撓性桿之夾持。凸部可另設或改設粗糙表面。
套筒4之壁厚和內徑可以變化，故不同直徑之不同桿，可置入預定尺寸之容納件內。
上述多軸式螺釘，即頂部負荷型多軸式螺釘，可以改用其他類多軸式螺釘，諸如底部負荷型多軸式螺釘。單一固設螺釘5可改用任何其他固設元件，包含二件式固設元件、外螺母等。螺紋軸可以改用其他種類之軸，像鈎件、有開口之套管軸、有倒鈎元件之軸等。
桿可設想任何其他類型之連接元件，例如使用彈料環圈，把二骨骼固定元件加以撓性連接。
1,1'．．．骨骼固定裝置
2,,20,20'．．．骨骼固定元件
3．．．撓性桿
4．．．套筒
5．．．固設元件
6,21．．．螺紋軸
7,24．．．容納件
8,28．．．U形凹部
9,10,29,30．．．自由股部
11,27,35．．．共軸腔孔
12,31．．．陰螺紋
15．．．細縫
DR ．．．桿直徑
D．．．外徑
D．．．內徑
L．．．套筒長度
16．．．肋條狀凸部
22．．．球形頭部
23．．．凹部
25．．．容納件第一端
26．．．容納件第二端
32．．．加壓元件
33．．．球形凹部
34．．．圓筒形凹部
第1圖為骨骼固定裝置第一具體例之透視立面圖；
第2圖為第1圖骨骼固定裝置之組裝狀態；
第3圖為骨骼固定裝置組裝狀態取自垂直於桿縱向軸線之斷面圖；
第4圖為套筒之透視圖；
第5圖為套筒取自A-A線之斷面圖；
第6圖為骨骼固定裝置第二具體例之透視立面圖；
第7圖為第6圖骨骼固定裝置組裝狀態之透視圖；
第8圖為第7圖骨骼固定裝置取自垂直於桿軸線的平面之斷面圖。
1．．．骨骼固定裝置
2．．．骨骼固定元件
3．．．撓性桿
4．．．套筒
5．．．固設元件
6．．．螺紋軸
7．．．容納件
8．．．U形凹部
9,10．．．自由股部
11．．．共軸腔孔
12．．．陰螺紋
15．．．細縫
DR ．．．桿直徑

Claims (9)

  1. 一種骨骼固定裝置，包括：一骨骼固定段(6,21)，供固定於一骨骼或一椎骨內；一容納件(7,24)，供容納一桿件(3)；一桿件(3)；一固設元件(5)，把該桿件(3)固設於該容納件(7,24)內；其中設有一套筒(4)，包圍該容納件內之該桿件(3)；其中該套筒(4)包括一細縫(15)，其寬度從一端延伸貫穿其壁至相反端，當該套筒(4)包圍該桿件(3)，且利用該固設元件(5)對該套筒(4)施以壓力時，該細縫(15)之寬度即減小，其中該桿件(3)係至少部份由可撓性之彈料性材料製成，而該套筒(4)製作材料係可撓性遜於該桿件(3)材料；其中該套筒(4)內壁包括一凸部(16)；且其中該凸部(16)形狀為沿周肋條者。
  2. 如申請專利範圍第1項之骨骼固定裝置，其中該套筒(4)內徑比該桿件(3)之外徑稍大者。
  3. 如申請專利範圍第1或2項之骨骼固定裝置，其中該套筒(4)係金屬或另一硬質材料製成者。
  4. 如申請專利範圍第1或2項之骨骼固定裝置，其中該容納件(7,24)係實質上圓筒形，並包括一U形凹部(8,28)，形成二自由股部(9,10；29,30)者。
  5. 如申請專利範圍第1或2項之骨骼固定裝置，其中該固設元件(5)係一鎖定螺釘者。
  6. 如申請專利範圍第1或2項之骨骼固定裝置，其中該骨骼固定段(6)和該容納件(7)係單軸式連接者。
  7. 如申請專利範圍第1或2項之骨骼固定裝置，其中該骨骼固定段(21)和該容納件(24)係樞動式連接者。
  8. 如申請專利範圍第1或2項之骨骼固定裝置，其中該細 縫(15)係在該固設元件(5)所施壓力方向之垂直方向開口者。
  9. 如申請專利範圍第1或2項之骨骼固定裝置，其中該套筒之內表面包括一表面粗糙者。
TW098109434A 2008-03-28 2009-03-24 骨骼固定裝置 TWI439251B (zh)

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Application Number Priority Date Filing Date Title
US4047608P 2008-03-28 2008-03-28
EP08005981.9A EP2105101B2 (en) 2008-03-28 2008-03-28 Bone anchoring device

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TW200940025A TW200940025A (en) 2009-10-01
TWI439251B true TWI439251B (zh) 2014-06-01

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US (1) US20090248088A1 (zh)
EP (1) EP2105101B2 (zh)
JP (1) JP5737829B2 (zh)
CN (1) CN101543424B (zh)
DE (1) DE602008002815D1 (zh)
ES (1) ES2353033T5 (zh)
TW (1) TWI439251B (zh)

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EP2105101A1 (en) 2009-09-30
US20090248088A1 (en) 2009-10-01
JP5737829B2 (ja) 2015-06-17
CN101543424B (zh) 2013-06-19
ES2353033T3 (es) 2011-02-24
CN101543424A (zh) 2009-09-30
TW200940025A (en) 2009-10-01

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