TWM618379U - Translaminar pedicle anchor suspension system and its anchor and related component-set - Google Patents

Abstract

A translaminar pedicle anchor suspension system (referred as T-PAS system) applicable to vertebral surgeries. The T-PAS system comprises: at least one anchor screw capable of being fixed to a pedicle of a lower vertebral segment, at least one suspension ligament having one end thereof fixed to the anchor screw, and at least one washer capable of fixing the other end of the suspension ligament to a contralateral side of a lamina of an upper vertebral segment. By using the suspension ligament to suspend the upper vertebral segment via a tunnel drilled on the lamina, not only the spine can be dynamically stabilized, but also the use of traditional bone screws and bone instrumented fusion can be avoided. This novel T-PAS system can: (1) reduce operation time; (2) reduce the risk of nerve damage; (3) reduce bleeding; (4) maintain vertebral mobility; (5) the waist feels natural after surgery; and (6) it can theoretically avoid the accelerated degeneration of adjacent segments caused by internal fixation and fusion, which will cause the need to have surgery again in the short term.

Description

Transvertebral pedicle pedicle anchor suspension system and its anchor and parts group

This creation is about a trans-laminar pedicle anchor suspension system, especially a trans-laminar pedicle anchor that suspends the lower vertebrae of the spine under the upper vertebra through suspension wires and anchors Suspension system and its anchors and parts group.

The human spine (Columna Vertebralis) is composed of 24 vertebrae (7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae), 1 sacrum (also known as sacrum) and 1 coccyx (also known as coccyx) It is connected by ligaments, joints and intervertebral discs. When one of the vertebrae is displaced, slipped, deformed, degenerated or damaged due to disease or trauma, it may cause mechanical injury or pathology of the spine; in addition to pain, it will cause further damage to other parts of the spine. When the symptoms of vertebrae displacement, spondylolisthesis, deformation, degeneration, or damage are severe and cannot be treated with conservative drugs or physical methods, surgical treatment is required. Common surgical treatment methods include: decompression, discectomy, laminectomy, bone fusion, and vertebral fixation.

Spinal surgery often requires the use of spinal fixators to fix and support the vertebrae at the surgical site. Currently, the conventional spinal fixator is to lock two bone nails on the adjacent upper and lower vertebrae respectively, and connect the two bone nails on the upper and lower vertebrae respectively by connecting rods extending up and down. To achieve the effect of supporting and fixing the adjacent upper and lower vertebrae. However, the currently known spinal fixators also have the following shortcomings:

1. At least four bone screws must be used. Since the upper and lower vertebrae need to be locked into two bone screws, at least four bone screws need to be locked in the patient's spine. The more bone nails needed, not only the longer the operation time and the higher the risk, but also the more serious the patient’s discomfort, which requires postoperative recovery. The longer it takes.

2. Connecting the upper and lower bone nails by connecting rods leads to reduced mobility after spinal surgery. Since today’s spinal fixators use rigid connecting rods to connect the upper and lower bone nails, the upper and lower vertebrae are "fixed" and "supported" by the connecting rods and bone nails; therefore, the device has a spine after surgery. The spine of the fixator can hardly bend, the patient's mobility is greatly reduced, and even cause chronic back pain and stiffness.

3. There are many components of the spinal fixator that protrude outside the vertebrae, causing discomfort and long-term pain for the patient. In order to allow the connecting rod to be combined on the top of the bone nail, the top of the bone nail of the conventional spinal fixator will include a joint part protruding 5-10mm outside the vertebra, so that the connecting rod with a diameter of 2-5mm can be installed and fixed on The top of the bone nail. Obviously, these bone nail tops and connecting rods protruding outside the vertebrae will definitely cause long-term discomfort and foreign body sensation to the patient, and even cause chronic back pain and stiffness.

For this reason, this creation discloses a translaminar pedicle anchor suspension system, which can solve the various deficiencies of the aforementioned conventional spinal fixators.

The main purpose of this creation is to provide a trans-laminar pedicle anchor suspension system, which fixes one end of the suspension line formed by the artificial ligament to the pedicle of the lower vertebra through the anchor, and the suspension line The other end is clamped to the lamina of the upper vertebra by a spacer, so that both the upper vertebra and the lower vertebra can be suspended by the suspension wire, which not only stabilizes the structural strength of the spine, but also more effectively Reduce the number of bone screws required for the operation, shorten the operation time, reduce the risk of nerve injury, reduce the amount of bleeding, maintain the vertebral mobility after the operation, avoid the accelerated degeneration of the adjacent joints caused by internal fixation and fusion, and reduce the foreign body and discomfort of the patient after the operation , Pain and stiffness, and speed up the time course of the patient's postoperative recovery.

Another purpose of this creation is to provide an anchor suitable for the translaminar pedicle anchor suspension system, which has an original oblique through hole structure. The anchor can not only fix one end of the suspension wire to the pedicle of the inferior vertebra, but also, through the design of the oblique through hole, the anchor can be rotated and locked in the operation of the pedicle to pull and adjust the suspension. The tension of the suspension wire. In addition, after the operation is completed, the top of the anchor will only slightly protrude, even flush with the surface of the pedicle, allowing the patient’s Foreign body sensation and discomfort are minimized.

Another purpose of this creation is to provide a set of parts suitable for the translaminar pedicle anchor suspension system, which includes what the doctor needs when performing the operation of the translaminar pedicle anchor suspension system. The tools and pre-assembled parts are used to facilitate and speed up the surgeon’s operation.

To achieve the above-mentioned purpose, this creation discloses a translaminar pedicle anchor suspension system (Translaminar Pedicle Anchor Suspension System; T-PAS system for short), which can be installed in at least one upper vertebra (Upper Vertebral Body). ) And a spine of the Lower Vertebral Body; the T-PAS system includes: at least one anchor (Anchor), at least one gasket (Washer), and at least one suspension wire (Suspension Wire) ). The anchor is fixed at a pedicle of the inferior vertebra. The spacer is located at a lamina (Lamina) of the superior vertebra. The suspension wire is connected between the anchor and the washer, and is respectively fixed to the pedicle of the lower vertebra and the lamina of the upper vertebra by the anchor and the washer; and, The suspension wire has a predetermined tension, and the lower vertebra can be suspended from the upper vertebra through the suspension wire.

In one embodiment, the upper vertebra and the lower vertebra each include: the vertebral plate and two pedicles which are respectively located on the left and right sides of the vertebral plate; and the vertebral plate of the upper vertebra A through hole (tunnel) penetrating through the left and right sides of the vertebral plate is provided.

In one embodiment, the number of the at least one anchor is two, which are respectively disposed at the two pedicles of the inferior vertebra; the number of the at least one spacer is two, which are respectively located on the upper vertebra At the left and right ends of the through hole of the vertebral plate; the number of the at least one suspension wire is two; one end of the suspension wire is the anchor fixed on the pedicle on the left side , The other end is from the left side of the vertebral plate of the superior vertebrae first through the through hole to the right and then combined with the spacer located at the right end of the through hole; the other end of the suspension wire is fixed at the The anchor on the pedicle on the right side and the other end of the vertebral plate of the superior vertebra pass through the through hole from the right side to the left before being combined with the washer at the left end of the through hole.

In one embodiment, the T-PAS system further includes a riveting plug placed in the through hole.

In one embodiment, the suspension wire is an artificial ligament; the anchor is a screw with an external thread; and a length of the spacer is greater than the aperture of the through hole.

In one embodiment, the anchor has a long and narrow cylinder extending along a central axis, an external thread provided on the outer surface of the cylinder, a fitting structure provided at a top end of the cylinder, and passing through the An oblique through hole of the cylinder; wherein the oblique through hole passes through the central axis, and the two ends of the through hole are respectively called the upper orifice and the lower orifice, the upper orifice and the cylinder The distance between the top ends of the column is smaller than the distance between the lower opening and the top end of the column; the oblique through hole allows the suspension wire to pass through, so that the anchor is hung on the suspension wire; the The sleeved structure can be combined with a screwdriver, and by operating the screwdriver, the anchor is driven to rotate around the central axis, and the anchor is locked and fixed at the pedicle.

In one embodiment, the external thread provided on the outer surface of the cylinder of the anchor includes a threaded portion with a smaller pitch and a threaded portion with a larger pitch; the threaded portion with a smaller pitch is arranged closer to the The top end of the column and the larger-spaced screw part are arranged at the top end farther from the column.

In one embodiment, the suspension wire is folded into a double-line side-by-side structure and has a closed head end at the double fold and an open tail end away from the double fold; the suspension wire is passed through the oblique through hole The method is to pass the closed end of the head of the suspension wire through the upper orifice into the oblique through hole, and then pull the closed end of the head of the suspension wire out of the oblique through hole from the lower opening. Outside the through hole, at the same time, the open end of the tail of the suspension wire remains exposed to the outside of the upper hole.

In one embodiment, the method of connecting the suspension wire to the gasket is to pull the closed end of the head of the suspension wire out of the oblique through hole from the lower hole of the anchor, and then first After the closed end of the head of the suspension wire passes through the through hole of the lamina of the superior vertebra, the closed end of the head of the suspension wire is placed on a rod of the washer; A pulling force is applied to the open end of the tail of the suspension wire, so that the washer can press against the outside of the through hole of the vertebral plate of the superior vertebra, so as to combine and fix the closed end of the head of the suspension wire The effect of the lamina on the upper vertebra.

In one embodiment, the method of fixing the anchor to the pedicle of the inferior vertebra is to pull the closed end of the head of the suspension wire out of the lower hole of the anchor to penetrate the obliquely After the hole is outside, first lock a part of the anchor into the pedicle of the inferior vertebra, so that the inferior orifice of the anchor is close to but still exposed on the outer surface of the pedicle of the inferior vertebra; At this time, first apply a pulling force from the open end of the tail of the suspension wire so that the suspension wire temporarily has a relatively small first Tension; Then, continue to lock the anchor into the pedicle of the inferior vertebra, so that the inferior orifice of the anchor is buried in the pedicle of the inferior vertebra, and the suspension wire is wound at the same time On the outer surface of the anchor and clamped between the outer surface of the anchor and the inside of the pedicle of the lower vertebra; except that the suspension wire can be combined and fixed at the pedicle of the lower vertebra, It is further possible to further pull the suspension wire and make the suspension wire reach and maintain a relatively large second tension; the second tension is the predetermined tension and is greater than the first tension.

To achieve the above-mentioned purpose, this creation also discloses a T-PAS system component set, which includes: at least one anchor, at least one washer, at least one suspension wire, a screwdriver, and a force gauge. The anchor can be fixed at a pedicle of the inferior vertebra. The spacer can be arranged at a lamina of the superior vertebra. The suspension wire can be used to connect the anchor and the washer, and the suspension wire is respectively fixed to the pedicle of the lower vertebra and the lamina of the upper vertebra by the anchor and the washer; In addition, the suspension wire has been assembled on the anchor nail in advance. A screwdriver can be combined with the anchor, and the anchor can be locked and fixed at the pedicle by operating the screwdriver. Tensiometer is used to measure the tension of the suspension wire.

10: Spine

11: Upper vertebra

12: Lower vertebra

111, 121: lamina

112, 113, 122, 123: pedicle

114: Through hole

20: T-PAS system

21, 41, 42, 43, 44, 45: anchor

211, 421, 431: cylinder

212, 432: Thread

2121, 2122: Thread part

213, 430: Top

214: fit structure

215, 411, 434, 435, 443, 453: through holes

2151, 2152, 4431, 4432: Orifice

22, 31, 32: Gasket

221, 321: pole

23: Suspended wire

231: closed end

231a, 231b, 231b’: the part of the suspension wire

2311, 2312: line segment

2319: Snap Point

232, 232a, 232b: open end

239: Knot

24: riveting sleeve

311: Through hole

312: end

322: Slot

422, 433: Counterbore

423: plug cover

441, 451: connecting rod fixing frame

442, 452: accommodating seat

50: Known spinal fixator

51: Anchor

52: connecting rod

90: central axis

91: Drilling tool

92: screwdriver

921: Grip

922: long pole

923: Screwdriver Tip

924: upper pylon

925: lower rack

93: Tensioner

94: hook

95: Scissors

96: Finger Push Filer

961: Grip

962: long pole

963: Cone-shaped file head

9631: Pointed Vertebral End

9632: Compressed end

Figures 1A and 1B are respectively a first perspective schematic diagram and a second perspective perspective schematic diagram of an embodiment of the creation of a translaminar pedicle anchor suspension system on two adjacent vertebral bodies of the spine.

Figures 2A and 2B are respectively a schematic top view and a schematic left side view of an embodiment of the creation of a translaminar pedicle anchor suspension system on two adjacent vertebral bodies of the spine.

Figures 3A to 3E are schematic diagrams of several steps of an embodiment of the process of installing the translaminar pedicle anchor suspension system on two adjacent vertebral bodies.

Figures 4A and 4B are respectively a three-dimensional schematic diagram and a schematic cross-sectional view of A-A of an embodiment of the anchor in the creation of a translaminar pedicle anchor suspension system.

Figure 5 is a schematic diagram of an embodiment of the method of creating a translaminar pedicle anchor suspension system in which the suspension wire is combined with the anchor.

Figure 6A and Figure 6B are respectively in the creation of the translaminar pedicle anchor suspension system. A schematic diagram of two steps of an embodiment of how the suspension wire is bonded to the gasket.

Fig. 7A and Fig. 7B are schematic diagrams showing two steps of an embodiment of the method of fixing the anchor to the pedicle of the lower vertebra in the creation of the translaminar pedicle anchor suspension system.

Figure 8 is a three-dimensional schematic diagram of another embodiment of the spacer in the creation of the translaminar pedicle anchor suspension system.

Fig. 9A and Fig. 9B are schematic diagrams of two steps of the method of bonding the suspension wire to the spacer as shown in Fig. 8 respectively.

Figure 10 is a three-dimensional schematic diagram of another embodiment of the spacer in the creation of the translaminar pedicle anchor suspension system.

Figure 11A is a schematic cross-sectional view of another embodiment of the anchor in the creation of a translaminar pedicle anchor suspension system.

Figure 11B is a schematic cross-sectional view of another embodiment of the anchor in the creation of a translaminar pedicle anchor suspension system.

Fig. 11C is a schematic cross-sectional view of another embodiment of the anchor in the creation of the translaminar pedicle anchor suspension system.

Figure 11D is a schematic cross-sectional view of yet another embodiment of the anchor in the creation of a translaminar pedicle anchor suspension system.

Figure 11E is a schematic cross-sectional view of yet another embodiment of the anchor in the creation of the translaminar pedicle anchor suspension system.

Figures 12A and 12B are respectively two schematic diagrams of another embodiment of the method of fixing the anchor to the pedicle of the lower vertebra in the creation of the translaminar pedicle anchor suspension system.

Figure 13A and Figure 13B are schematic diagrams of two embodiments of the created translaminar pedicle anchor suspension system used in conjunction with the conventional spinal fixator.

Figure 14 is a schematic diagram of an embodiment of the screwdriver in the component set of the translaminar pedicle anchor suspension system created.

Figure 15 is a schematic diagram of an embodiment of the finger pusher in the component set of the translaminar pedicle anchor suspension system created.

This creation is about a translaminar pedicle anchor suspension system (Translaminar Pedicle Anchor Suspension System; T-PAS system for short), which can be used in vertebral surgery. The parts used in the T-PAS system include: at least one anchor, a pedicle fixed to the lower vertebrae (Lower Vertebral Segment); and at least one artificial ligament (Suspension Ligament), used as a suspension wire, which One end is fixed to the anchor, and the other end is fixed to a lamina (Lamina) of the superior vertebra by a fixing means; and the suspension wire has a predetermined tension, which can connect the superior vertebra and the inferior vertebra. Both segment vertebrae are suspended by the suspension wire. The artificial ligament is drilled through the lamina to suspend the upper vertebrae, which not only dynamically stabilizes the spine, but also avoids the use of traditional bone nail fixation and bone fusion (Instrumented fusion). This innovative T-PAS system can: 1. shorten the operation time; 2. reduce the risk of nerve damage; 3. reduce bleeding; 4. maintain the mobility of the vertebrae; 5. feel natural in the waist after the operation; and 6. theoretically It can avoid the accelerated degeneration of adjacent segments (Acclerated Degeneration of Adjacent Segments) caused by internal fixation and fusion, which will cause the need to undergo surgery again in the short term. The indications and scope of application of the T-PAS system of this creation include (but are not limited to): single or multi-segment joint stenosis, lumbar spine stenosis, lumbar spondylolisthesis, etc. The T-PAS system of this invention can be applied to the patient's first operation to prevent stenosis of the junction, and it can also be used for the second operation of the stenosis of the junction.

In order to more clearly describe the translaminar pedicle anchor suspension system and its anchors and parts set proposed in this creation, the following will be described in detail with the drawings.

Please refer to Figure 1A, Figure 1B, Figure 2A and Figure 2B, respectively, which are the first of an embodiment of the creation of a translaminar pedicle anchor suspension system on two adjacent vertebral bodies of the spine Perspective three-dimensional schematic diagram, second perspective three-dimensional schematic diagram, top-view schematic diagram, and left-side schematic diagram.

The Translaminar Pedicle Anchor Suspension System (T-PAS system for short) created by this creation can be installed at least including an Upper Vertebral Body 11 (Upper Vertebral Body) and a lower vertebra 12 ( On a spine 10 (Spine) of Lower Vertebral Body). The upper vertebra 11 and the lower vertebra 12 respectively include: the vertebral plates 111, 121, and two pedicles 112, 113, 122, 123, which are located on the left and right sides of the vertebral plates 111, 121, respectively. In this embodiment, the T-PAS system 20 is set on the L4 and L5 vertebrae (Vertebra) of the lumbar spine (Lumbar Spine) of the spine 10 as an example for description, but it can also be set on vertebrae at different positions. Or it is used to connect and suspend a larger number of vertebrae (for example, three or more layers).

As shown in Figure 1A, Figure 1B, Figure 2A, and Figure 2B, the translaminar vertebra of this creation The pedestal anchor suspension system (T-PAS system) 20 includes at least one anchor 21 (Anchor), at least one washer 22 (Washer), and at least one suspension wire 23 (Suspension Wire). The anchor 21 is fixed to a pedicle 122 (Pedicle) of the inferior vertebra 12. The spacer 22 is located at a lamina 111 (Lamina) of the superior vertebra 11, and is usually fixed at a position where the lamina 111 has the greatest strength or thickness. An embodiment of the fixing means for fixing one end of the suspension wire 23 to a lamina of the superior vertebrae described in the present invention is achieved by the spacer 22. The suspension wire 23 is connected between the anchor 21 and the washer 22, and is fixed to the pedicle 122 and the upper segment of the inferior vertebra 12 by the anchor 21 and the washer 22, respectively The vertebral plate 111 of the vertebra 11; and, the suspension wire 23 has a predetermined tension, and the inferior vertebra 12 can be suspended under the upper vertebra 11 by the suspension wire 23.

In this embodiment, the vertebral plate 111 of the superior vertebra 11 is provided with a through hole 114 (tunnel) penetrating the left and right sides of the vertebral plate 111. The number of the at least one anchor 21 is two, which are respectively arranged at the two pedicles 122 and 123 of the inferior vertebra 12. The number of the at least one spacer 22 is two, which are respectively located at the left and right ends of the through hole 114 of the vertebral plate 111 of the superior vertebra 11. The number of the at least one suspension wire 23 is two; one end of the suspension wire 23 is fixed to the anchor 21 on the pedicle 122 on the left side, and the other end is formed by the upper vertebra 11 The left side of the vertebral plate 111 passes through the through hole 114 to the right and then is coupled to the washer 22 at the right end of the through hole 114; the other end of the suspension wire 23 is fixed to the vertebral arch on the right The anchor 21 on the root 123 and the other end are passed through the through hole 114 from the right side of the lamina 111 of the superior vertebra 11 to the left before being combined with the washer 22 at the left end of the through hole 114 .

In one embodiment, the T-PAS system 20 of the present invention further includes a hollow riveting sleeve 24 plugged in the through hole 114 and the suspension wire 23 passes through the riveting sleeve 24. Alternatively, the rivet sleeve 24 may not be provided, but a dagger or a finger-pushing file of the original creation can be used to round the inner surface and both ends of the through hole 114 on the vertebral plate 111 to avoid the vertebral plate. The sharp edge or surface of the through hole 111 cuts the suspension wire 23, or the edge of the through hole 114 is broken due to the high tension of the suspension wire 23.

In this embodiment, the suspension wire 23 is an artificial ligament; the anchor 21 is a screw (or bone nail) with an external thread; a length of the washer 22 is greater than the through hole Therefore, the aperture of 114 can be pressed against the outer surface of the through hole 114 of the vertebral plate 111, and will not fall into the through hole 114 due to the tension of the suspension wire 23. The material of the anchor 21 and the gasket 22 can be made of titanium alloy, ceramic, or other materials that will not cause allergies or rejection of the human body.

Please refer to Figure 3A to Figure 3E, respectively for the creation of translaminar pedicle anchors A schematic diagram of several steps of an embodiment process in which the suspension system is installed on two adjacent vertebral bodies.

As shown in Figure 3A, when the T-PAS system 20 of the present creation is to be installed on two adjacent vertebral bodies 11 and 12, a drilling tool 91 is used to drill a predetermined pedicle 122 on the left side of the lower vertebra 12 Deep pores. Then, the anchor 21 that has been pre-connected and assembled with the suspension wire 23 is locked in and fixed to the pedicle 122 by a screwdriver 92. At this time, the suspension wire 23 connected to the anchor 21 does not yet have tension but is in a relaxed state. Then, as shown in FIG. 3B, the suspension wire 23 is moved farther away from the end of the anchor 21, and passes through the through hole 114 of the vertebral plate 111 of the upper vertebra 11 from the left side of the vertebral plate 111 of the upper vertebra 11 to the right. (Or riveting sleeve 24) and protruding from the right side of the vertebral plate 111 of the superior vertebra 11, assembled on the washer 22. At this time, the washer 22 has not yet abutted against the surface of the vertebral plate 111, and the suspension wire 23 connected between the anchor 21 and the washer 22 is still in a relaxed state. Next, as shown in Figure 3C, by pulling the suspension wire 23 from the left side of the vertebral plate 111 to the left, the spacer 22 is pressed against the right side of the vertebral plate 111 of the upper vertebra 11, and a force device 93 is used to measure After the tension of the suspension wire 23 reaches a predetermined tension value, the end of the suspension wire 23 is fixed and the excess suspension wire 23 is removed. Then, repeat the same way as in Figure 3A to Figure 3C, as shown in Figure 3C, Figure 3D, and Figure 3E, the right pedicle 123 of the lower vertebra 12 is also locked in a pre-pierced suspension. The anchor 21 of the suspension wire 23 (as shown in Figure 3C), and the suspension wire 23 passes through the through hole 114 (or the rivet sleeve 24) of the vertebral plate 111 of the superior vertebra 11 from right to left, and then is combined with the vertebra Another gasket 22 on the left side of the plate 111 (as shown in Figure 3D), and after pulling the suspension wire 23 to reach the predetermined tension value, fix the end of the suspension wire 23 and remove the excess suspension wire 23 (as shown in Figure 3E). In this way, the setting of the T-PAS system 20 of the present creation in which the lower vertebra 12 is suspended under the upper vertebra 11 via the suspension wire 23 can be completed. The T-PAS system 20 created by this invention can suspend the lower vertebrae under the upper vertebra through suspension wires, which not only stabilizes the structural strength of the spine, but also reduces the number of bone screws required for surgery, shortens the operation time, and reduces the operation Risks, maintaining the necessary mobility of each vertebral body after the operation, reducing the foreign body, discomfort, pain and stiffness of the patient after the operation, and accelerating the time course of the patient's recovery after the operation.

In the above-mentioned embodiment, the installation of the anchor 21 and the suspension wire 23 on one side (left side) is completed first, and then the installation of the anchor 21 and the suspension wire 23 on the other side (right side) is started. However, in another embodiment of the present creation, the anchors 21 and suspension wires 23 on both sides can also be set simultaneously. Specifically, the two anchors 21 located on the left and right pedicles 122 and 123 of the lower vertebra 12 can also be locked in order to fix the left and right sides in the step of Figure 3A. Pedicles 122, 123; afterwards, the two suspension wires 23 connected to the two anchors 21 are in sequence in the steps of Figure 3B After passing through the through hole 114 (or riveting sleeve 24) of the vertebral plate 111 of the superior vertebra 11 and protruding from the other side of the vertebral plate 111 of the superior vertebra 11, it is assembled to the corresponding spacer 22 Afterwards, by pulling the two suspension wires 23 respectively, the two spacers 22 are respectively against the two opposite sides of the lamina 111 of the upper vertebra 11, and the tension of the two suspension wires 23 is measured by the tensioner 93 to reach a predetermined After the tension value, the ends of the two suspension wires 23 are fixed and the excess suspension wires 23 are removed; the inferior vertebra 12 can be suspended below the upper vertebra 11 via the suspension wires 23. The original creation of the T-PAS system 20 set up.

Please refer to Figure 4A and Figure 4B, which are respectively a three-dimensional schematic diagram and A-A cross-sectional schematic diagram of an embodiment of the anchor in the creation of the translaminar pedicle anchor suspension system. In one embodiment, the anchor 21 has a long and narrow cylinder 211 extending along a central axis 90, an external thread 212 disposed on the outer surface of the cylinder 211, and a top end 213 of the cylinder 211. A nesting structure 214 and an oblique through hole 215 penetrating the column 211. Wherein, the oblique through hole 215 passes through the central shaft 90, and the two ends of the through hole 215 are respectively called the upper orifice 2151 and the lower orifice 2152, the upper orifice 2151 and the column 211 The distance hb between the top ends 213 is smaller than the distance between the lower opening 2152 and the top end 213 of the column 211 (ha+hb), in other words, the distance between the two end openings 2151 and 2152 in the direction of the central axis 90 For ha. The oblique through hole 215 allows the suspension wire 23 to pass through, so that the anchor 21 is hung on the suspension wire 23. The sleeve structure 214 can be combined with the front end of the screwdriver 92, and by operating the screwdriver 92, the anchor 21 is driven to rotate around the central axis 90, and the anchor 21 is locked and fixed to the 122 pedicles. In this embodiment, the fitting structure 214 is an inner hexagonal recess, the outline and size of which correspond to the hexagonal bump on the front end of the screwdriver 92. The external thread 212 disposed on the outer surface of the cylinder 211 of the anchor 21 includes a threaded portion 2121 with a smaller pitch and a threaded portion 2122 with a larger pitch. The smaller pitch thread portion 2121 is disposed closer to the top end 213 of the column 211, and has a relatively low thread height and a smaller thread pitch; while the larger pitch thread portion 2122 is It is arranged at the top end 213 far away from the column 211 and has a relatively high thread height and a large thread pitch. In addition, the upper orifice 2151 and the lower orifice 2152 are both located closer to the top end 213 of the column 211, so the two orifices 2151 and 2152 are both located at the thread portion 2121 with a smaller pitch. In this creation, several kinds of anchors 21 of different sizes and specifications can be produced in advance to adapt to different spine sizes or structures of different patients. Generally speaking, the anchor 21 used in the T-PAS system 20 of the present invention is shown in Figure 4B. The outer diameter (diameter) d1 of the cylinder 211 is between 3.5mm-6.5mm and the total length H It is between 20mm-35mm. In this embodiment, the upper opening 2151 and the top end 213 of the column 211 The distance hb between the two holes 2151 and 2152 can be between 3mm and 7mm. The distance between the two orifices 2151 and 2152 in the direction of the central axis 90 is ha can be between 2mm and 4mm; the height of the thread portion 2121 with the smaller distance is h1 It can be between 5mm and 11mm, and the height h2 of the larger pitch thread portion 2122 can be between 14mm and 30mm.

In the embodiment shown in FIG. 4A and FIG. 4B, the reason why the external thread 212 of the anchor 21 is designed to be adjacent to the smaller pitch thread portion 2121 of the top end 213 of the column 211 and away from the top end 213 There are two main reasons for the larger pitch thread 2122: (1) The hardness and density of the bone at the pedicle 122 are relatively high from the surface, while the hardness and density of the bone deep inside is relatively low; (2) The area above the lower orifice 2152 of the anchor 21 (that is, the area between the lower orifice 2152 and the top end 213), when locked, the suspension wire 23 will be wound around the outer surface of the anchor 21 and locked into the vertebra. In the bones of the arch root 122. Therefore, the use of a smaller pitch screw portion 2121 with a smaller screw height near the top end 213 of the anchor 21 cylinder 211 can not only reduce the probability that the anchor 21 screw will damage the surface of the pedicle 122, and improve the lock The tightness greatly reduces the risk of scratches on the screw of the anchor 21 or damage to the suspension wire 23. However, in another embodiment, the external thread 212 of the anchor 21 can also be designed to maintain the same thread height and pitch no matter whether it is adjacent to the top end 213 or far away from the top end 213. In yet another embodiment, the external thread 212 of the anchor 21 can also be designed such that the height of the thread adjacent to the top end 213 is relatively low, but the pitch remains the same; relatively, it is located far away from the top end 213. The height of the screw thread is relatively high, but the spacing remains the same. This design can also reduce the probability of the anchor 21 screw thread destroying the surface of the pedicle 122, improve the tightness of the lock, and greatly reduce the anchor 21 screw thread The effect of scratching or destroying the risk of the suspension wire 23.

Please refer to Figure 5, which is a schematic diagram of an embodiment of the method of combining the suspension wire with the anchor in the creation of the translaminar pedicle anchor suspension system. In one of the embodiments of this creation, a middle section of the suspension wire 23 is folded into a double-line side-by-side structure and has a closed head 231 at the fold and an open tail away from the fold.端232. The way to pass the suspension wire 23 through the oblique through hole 215 is to pass the closed end 231 of the head of the suspension wire 23 into the oblique through hole 215 through the upper opening 2151, and then the suspension The closed end 231 of the head of the suspension wire 23 is pulled out of the oblique through hole 215 from the lower opening 2152, and at the same time, the open end 232 of the tail of the suspension wire 23 remains exposed to the outside of the upper opening 2151.

Please refer to Figure 6A and Figure 6B, which are schematic diagrams of one embodiment of the method of combining the suspension wire with the spacer in the creation of the translaminar pedicle anchor suspension system. Yu Ben In one of the created embodiments, the method of combining the suspension wire 23 with the spacer 22 is to first connect the closed end 231 of the head of the middle section of the suspension wire 23 from the lower hole of the anchor 21 The opening 2152 is pulled out of the oblique through hole. Afterwards, pass through the through hole 214 of the vertebral plate 111 of the superior vertebra 11 with a slender hook 94 from right to left, and hook the closed end 231 of the head of the suspension wire 23 on the left side of the vertebral plate 111, and then The elongated hook 94 together with the head closed end 231 of the suspension wire 23 is pulled right out of the through hole 114 of the vertebral plate 111, thereby pulling the head closed end 231 of the suspension wire 23 through the upper vertebra 11 The through hole 114 of the vertebral plate 111 (as shown in Fig. 6A). Then, the closed end 231 of the head of the suspension wire 23 is sleeved on a rod 221 of the washer 22. The way of nesting is to insert the left and right line segments 2311, 2312 of the closed end 231 of the suspension wire 23 into the washer 22 through the openings 222 and 223 on the left and right sides of the washer 22, so that the suspension wire 23 The closed end 231 of the head can cover the rod 221 in the middle of the gasket 22. After that, a pulling force is applied from the open end (not shown in this figure) of the suspension wire 23 on the left side of the vertebral plate 111, so that the washer 22 can resist the vertebral plate 111 of the superior vertebra 11 The outer surface of the right port of the through hole 214 achieves the effect of combining and fixing the head closed end 231 of the suspension wire 23 to the vertebral plate 111 of the superior vertebra 11 (as shown in FIG. 6B). In this embodiment, the shape of the gasket 22 is similar to an "H" structure, and its length L1 and width W1 are larger than the aperture Dh of the through hole 214 of the lamina 111, so it can be stuck outside the through hole 214 without falling Into the through hole 214. The aperture Dh of the through hole 214 of the lamina 111 can be between 1.5mm and 5mm, the length L1 of the spacer 22 can be between 6mm and 10mm, the width W1 can be between 6mm and 8mm, and the thickness T can be between Between 0.5mm-2mm. In this embodiment, the suspension wire 23 is a flat strip-shaped artificial ligament, and its width dw is preferably between 1.5 mm and 4 mm.

Please refer to FIG. 7A and FIG. 7B, which are schematic diagrams of an embodiment of the method of fixing the anchor to the pedicle of the lower vertebra in the creation of the translaminar pedicle anchor suspension system. In one of the embodiments of the present creation, the method of fixing the anchor 21 to the pedicle 122 of the inferior vertebra 12 is to connect the closed end 231 of the head of the middle section of the suspension wire 23 from After the lower hole 2152 of the anchor 21 is pulled out of the oblique through hole 215, a part of the column 211 of the anchor 21 (for example, the larger-spaced thread part) is locked into the lower vertebra 12 The pedicle 122 makes the lower orifice 2152 of the anchor 21 close to but still exposed on the outer surface of the pedicle 122 of the lower vertebra 12 (as shown in FIG. 7A). At this time, a pulling force is first applied from the open end 232 of the tail of the left end of the suspension wire 23 so that the suspension wire 23 temporarily has a relatively small first tension. The first tension must be less than the predetermined tension required by the suspension wire 23 when the T-PAS system is created to complete the installation. The tension value of the suspension wire 23 can be determined by During the process of locking the anchor 21, the tension meter 93 is operated to perform measurement. Then, when the screwdriver 92 is operated to continue to lock the anchor 21 into the pedicle 122 of the inferior vertebra 12, the inferior orifice 2152 of the anchor 21 is gradually embedded in the vertebra of the inferior vertebra 12. The inside of the pedicle 122, and at the same time, the suspension wire 23 is wound around the outer surface of the anchor 21 and sandwiched between the outer surface of the anchor 21 and the inside of the pedicle 122 of the lower vertebra 12 (Figure 7B), So that one end of the suspension wire 23 is clamped and fixed between the anchor 21 and the pedicle 122; at the same time, the other end of the suspension wire 23 is the other end of the vertebra 111 of the upper vertebra 11 fixed by the spacer 22 side. Thereby, in addition to connecting and fixing one end of the suspension wire 23 to the pedicle 122 of the inferior vertebra 12, the suspension wire 23 can be further pulled and the suspension wire 23 can reach and maintain a A relatively large second tension; the second tension is the predetermined tension and is greater than the first tension. When the tension of the suspension wire 23 measured by the tension meter 93 has reached the predetermined tension, scissors 95 or surgical knives can be used to cut off the excess suspension wire 23 (the open end 232 of the tail) that is still exposed outside the pedicle 122 . In the same way, the anchor on the other side is also locked into the pedicle 123 in the same manner and steps and provides a predetermined tension to the suspension wire. After the operation of locking the anchor 21 into the pedicle 122 is completed, the top end 213 of the anchor 21 will only slightly protrude, or even be flush with the surface of the pedicle 122. After the installation of the T-PAS system 20 of this creation is completed, only two anchors 21 need to be locked at the pedicle 122. Generally speaking, the tip 213 of the anchor 21 protrudes from the surface of the pedicle 122 at a different height. Will be higher than 5mm, the spacer 22 is also a thin sheet structure and close to the surface of the lamina, will not make the patient feel discomfort or foreign body sensation; in addition, the suspension line 23 composed of artificial ligaments will not cause discomfort or pain to the patient. Various deficiencies in conventional technologies have been improved.

The foregoing embodiment is only a preferred embodiment of the translaminar pedicle anchor suspension system of the present invention, and is not the only feasible embodiment. In this creation, the structure of the anchor and the spacer is not limited to the structure disclosed in the foregoing embodiments, but there are other implementable structures.

For example, please refer to Figure 8, Figure 9A and Figure 9B: Figure 8 is a three-dimensional schematic diagram of another embodiment of the spacer in the creation of a translaminar pedicle anchor suspension system; Figure 9A and Figure 9 9B is a schematic diagram of two steps of the method of connecting the suspension wire to the spacer as shown in FIG. 8 respectively. In this embodiment, the spacer 31 may be a thin and slender plate structure, which has a relatively small width W2 and a relatively long length L2; the width W2 is smaller than the aperture Dh of the through hole 114 of the vertebral plate 111 (W2<Dh ), the thickness of the spacer 31 is also smaller than the hole diameter Dh of the through hole, and the length L2 is greater than the hole diameter Dh of the through hole 114 of the lamina 111 (L2>Dh). Two or more through holes 311 are provided on the gasket 31, and the suspension wires 23 can be passed through these through holes 311 in sequence to achieve the purpose of bonding the suspension wires 23 to the gasket 31 Purpose. Next, as shown in FIG. 9A, the spacer 31 connected with the suspension wire 23 is aligned with the end 312 in the elongated direction to the through hole 114 of the vertebral plate 111, and the width W2 and thickness of the spacer 31 are both smaller than the through hole. Due to the characteristics of the diameter Dh of the hole 114, the spacer 31 together with the suspension wire 23 can be passed through the through hole 114 of the vertebral plate 111 to the other side of the vertebral plate. Afterwards, as shown in Figure 9B, by turning the spacer 31 at an angle and pulling the suspension wire 23 from the left side of the vertebral plate 111, the slender side of the spacer 31 with a length of L2 can be pressed against the right surface of the vertebral plate 111 To achieve the purpose of positioning one end of the suspension wire 23 at the right end of the through hole 114 of the vertebral plate 111 through the spacer 31.

Please refer to Figure 10, which is a three-dimensional schematic diagram of another embodiment of the spacer in the translaminar pedicle anchor suspension system. The structure of the gasket shown in this embodiment is almost the same as that of the gasket shown in FIG. 6A, and the method of use is similar. The only difference between the two is that the gasket 32 shown in FIG. Two rod portions 321, and an additional slot 322 is formed between the two rod portions 321. This structure allows the suspension wire to pass through the slot 322 back and forth and wind around the two rod portions 321 to be coupled to the gasket 32, providing a more stable and non-slip coupling effect.

Please refer to Figure 11A, which is a schematic cross-sectional view of another embodiment of the anchor in the creation of the translaminar pedicle anchor suspension system. The structure of the anchor 41 shown in this embodiment is substantially the same as that of the anchor 21 shown in FIG. 4A and FIG. The through hole 411 of the anchor 41 shown is a horizontal through hole 411, and the height of the two ends of the through hole 411 is the same; instead of the oblique through hole of the anchor 21 as shown in FIG. 4A and FIG. 4B 215 is oblique, and the heights of the apertures 2151 and 2152 at both ends are different.

Please refer to Figure 11B, which is a schematic cross-sectional view of another embodiment of the anchor in the creation of the translaminar pedicle anchor suspension system. In this embodiment, the column 421 of the anchor 42 is provided with a counterbore 422 extending from the top end in the direction of the central axis, and an internal thread is provided at the counterbore 422 adjacent to the top end. The closed end of the head of the suspension wire 23 can be inserted into the counterbore 422 from the top of the cylinder 421. Then, by rotating a plug cap 423 with external threads from the top of the cylinder 421 and locked into the counterbore 422, The closed end of the head of the suspension wire 23 is clamped and fixed between the plug cover 423 and the counterbore 422 at the top of the column 421 to achieve the purpose of combining and fixing the suspension wire 23 to the anchor 42. In this embodiment, since the suspension wire 23 passes through the through hole 114 of the vertebral plate 111 with its open end, the way to connect the suspension wire 23 to the washer 22 is to tie the suspension wire 23 to the washer 22 At least 5 knots 239 are required to ensure the stability of the connection.

Please refer to Figure 11C, which is part of the translaminar pedicle anchor suspension system in this creation A schematic cross-sectional view of a further embodiment of the anchor. In this embodiment, the anchor 43 also has a column 431 and a counterbore 433 extending downward from the top end 430 of the column 431 along the central axis. Two or more transverse through holes 434 and 435 are provided on the pillar 431 and penetrate the counterbore 433. When the suspension wire is inserted into the counterbore 433 from the top 430 of the column 431, the suspension cable located in the counterbore 433 can be pulled out of the column 431 from one of the through holes 434 and then inserted through the other through hole 435. The counterbore 433 can allow the suspension wire to be more firmly combined with the anchor. In addition, the thread height of the external thread 432 provided on the outer surface of the cylinder 431 is consistent with the pitch, and there is no difference between the smaller pitch thread portion or the larger pitch thread portion.

Please refer to Figure 11D, which is a schematic cross-sectional view of yet another embodiment of the anchor in the creation of the translaminar pedicle anchor suspension system. The structure of the anchor 44 shown in this embodiment is substantially the same as that of the anchor 21 shown in FIGS. 4A and 4B, and the method of use is similar. In the embodiment shown in Figure 11D, the anchor 44 also has a long and narrow cylinder extending along a central axis, an external thread provided on the outer surface of the cylinder, a fitting structure provided at the top of the cylinder, and a penetrating structure. An oblique through hole 443 of the column, and both ends of the oblique through hole 443 also have an upper orifice 4431 and a lower orifice 4432 with a height difference. The only difference between the two embodiments shown in FIG. 11D and FIG. 4A is that a U-shaped connecting rod fixing frame 441 is additionally provided at the top of the column of the anchor 44 shown in FIG. 11D. The connecting rod holder 441 has a accommodating seat 442 for accommodating a connecting rod (not shown in the figure), so that the T-PAS system of the present invention can be used with a conventional spinal fixator.

Please refer to Figure 11E, which is a schematic cross-sectional view of yet another embodiment of the anchor in the creation of the translaminar pedicle anchor suspension system. The structure of the anchor 45 shown in this embodiment is substantially the same as that of the anchor 44 shown in FIG. The only difference between the rod holder 451 and the accommodating seat 452 is that the through hole 453 of the anchor 45 shown in FIG. The height is the same; instead of the oblique through holes 215, 443 of the anchors 21, 44 as shown in Fig. 4A, Fig. 4B or Fig. 11D, the two end openings 2151, 2152, 4431, 4432 are oblique. The height is different.

The T-PAS system created by this invention can be used and pre-sterilized tools and pre-semi-assembled parts can be packaged into a part group for use when manufacturing or selling, so as to facilitate the surgeon to perform the operation. In one embodiment, the component set of the T-PAS system of the present creation may include: several anchors, several washers, several suspension wires, a screwdriver, and a force gauge. The anchor is used to be fixed to the pedicle of the lower vertebra. The spacer is the through hole of the lamina that is set in the upper vertebra Place. The suspension wire is used to connect the anchor and the spacer, and fix the suspension wire to the pedicle of the inferior vertebra and the lamina of the superior vertebra by the anchor and the spacer, respectively ; And, in this component group, the suspension wire has been pre-assembled on the anchor. A screwdriver is used to be combined with the anchor, and the anchor is locked into the pedicle of the lower vertebrae by operating the screwdriver. Tensiometer is used to measure the tension of the suspension wire. This component set can facilitate and speed up the process of surgeons performing surgery, thereby reducing the risk of surgery.

Please refer to Figure 12A and Figure 12B, which are schematic diagrams of another embodiment of the method of fixing the anchor to the pedicle of the lower vertebra in the creation of the translaminar pedicle anchor suspension system. In the T-PAS system of this creation, the method of fixing the anchor to the pedicle of the inferior vertebra can be used in addition to the embodiments disclosed in Figure 7A and Figure 7B and related text descriptions. Another embodiment shown in Twelve A and Figure Twelve B operates. In the embodiment shown in FIGS. 12A and 12B, the way to pass the suspension wire 23 through the oblique through hole 215 of the anchor 21 is to pass one end of the suspension wire 23 through the lower opening 2152 Enter the oblique through hole 215 and pull out the oblique through hole 215 from the upper hole 2151, so that the two ends 232a, 232b (open ends) of the suspension wire 23 extend out of the lower hole 2152 and the upper hole, respectively. Outside the orifice 2151. Wherein, the middle section of the suspension wire 23 and the closed end 231 of the head are both located at the part of the suspension wire 23 pulled out from the upper opening 2151. As shown in Figure 12A, the method of fixing the anchor 21 to the pedicle 122 of the lower vertebra is to use a screwdriver 92 to first lock a part of the anchor 21 into the lower vertebra. The pedicle 122, so that the lower orifice 2152 of the anchor and the open end 232a of the suspension wire 23 extending from the lower orifice 2152 are locked into and clamped on the outer surface of the anchor 21 and Between the inside of the pedicle 122 of the inferior vertebra, but at this time, the upper aperture 2151 of the anchor 21 and the parts 231a, 231b of the suspension wire 23 extending from the upper aperture 2151 are still exposed Outside the pedicle 122 of the lower vertebra. Next, the other open end 232b of the tail part of the suspension wire 23 that is still exposed to the outside is first drilled from the upper opening 2151 through the part 231a of the suspension wire 23 extending from the upper opening 2151, and then A pulling force is applied to the other open end 232b of the tail that is also exposed to the outside, so that the suspension wire temporarily has a relatively small first tension. That is, as shown in the lower right area B of FIG. 12A is a partial enlarged view of the upper opening 2151, so that the abutment points 2319 of the two parts 231a and 231b of the suspension wire 23 are stuck in the upper hole. The intersection of the mouth 2151 and the surface of the pedicle 122, and the part 231a of the suspension wire 23 is in contact with and presses on the other part 231b of the suspension wire 23. Then, as shown in Figure 12B, use a screwdriver 92 to continue to lock the anchor 21 into the pedicle 122 of the inferior vertebra, so that the The upper orifice 2151 of the anchor 21 is embedded in the pedicle 122 of the inferior vertebra, and at the same time, the portion 231a of the suspension wire 23 extending from the upper orifice 2151 is also exposed to the outside. The other part 231b' connected by an open end 232b of the tail is wound together on the outer surface of the anchor 21 and sandwiched between the outer surface of the anchor 21 and the inside of the pedicle 122 of the lower vertebra until it is under tension. The tension of the two parts 231a, 231b of the suspension wire 23 measured by the meter 93 reaches a relatively large second tension value. In addition to the two open ends 232a, 232b of the suspension wire 23 can be combined and fixed at the pedicle 122 of the inferior vertebra, the suspension wire 23 can be further pulled to make the suspension wire 23 reach the Maintain a relatively large second tension. The second tension is the predetermined tension and is greater than the first tension. After that, scissors 95 or other surgical tools are used to cut and remove the excess suspension wires from the two open ends 232a and 232b of the suspension wires 23. In an embodiment, when the other part 231b of the suspension wire 23 is drilled through the part 231a of the suspension wire 23 from the upper opening 2151 from below, the other part 231b of the suspension wire 23 may be additionally Wrap around the outer surface of the anchor 21 to ensure that when the anchor 21 is continuously locked into the pedicle 122 of the lower vertebra with a screwdriver 92, the other part 231b' will be wound together. And clamped between the outer surface of the anchor 21 and the inside of the pedicle 122 of the lower vertebra.

Please refer to Figure 13A and Figure 13B, which are schematic diagrams of two embodiments of the created translaminar pedicle anchor suspension system used in conjunction with the conventional spinal fixator. Even if the patient who wants to undergo surgery has previously had surgery and installed the conventional spinal fixator, but now there is a need for another spinal surgery, the T-PAS system of this creation can still be set up in the subsequent surgery Comes to work with the old spinal fixator. As shown in Figure 13A, generally speaking, a typical conventional spinal fixator 50 will include at least four anchors 51 and two connecting rods 52, wherein the vertebral arches on both sides of the upper and lower vertebrae An anchor 51 is screwed into the root respectively, and a connecting rod 52 is used to connect the two anchors 51 on the same side of the upper and lower vertebrae. Sometimes, a fixing plate (not shown in the figure) is added to the two connecting rods 52 or the four anchors 51 to enhance the fixing effect. In the embodiment shown in Fig. 13A, the T-PAS system of the present creation can select two anchors 21 of smaller size to be respectively locked in the vertebrae of the upper vertebra where the conventional spinal fixator 50 is installed. The anchor 51 of the pedicle is adjacent to the side. In addition, the two ends of the through hole of the vertebral plate of the upper vertebrae are respectively provided with spacers 22 of the original creation T-PAS system, and a suspension wire 23 with a predetermined tension is used to connect one side anchor through the through hole on the vertebral plate. The nail 21 and the spacer 22 located on the other side achieve this creation T-PAS system on the upper vertebrae and the upper vertebrae without affecting the function of the existing conventional spinal fixator 50. The effect of suspending both of them.

As shown in Figure 13B, another way of using the T-PAS system of this creation with the conventional spine fixator 50 is to use both the left and right conventional anchors located in the upper vertebra of the conventional spine fixator 50. Remove and replace with the anchor 44 ( Or 45). In addition, the two ends of the through hole of the vertebral plate of the upper vertebrae are respectively provided with spacers 22 of the original creation T-PAS system, and a suspension wire 23 with a predetermined tension is used to connect one side anchor through the through hole on the vertebral plate. Nail 44 (or 45) and gasket 22 on the other side. Since the anchor 44 (or 45) of the present creation located in the upper vertebrae also has a connecting rod fixing frame 441 (or 451) and a receiving seat 442 (or 452), the conventional spinal fixator 50 that was originally installed The connecting rod 52 can be directly combined and fixed to the anchor 44 (or 45) of the present invention. Therefore, the original T-PAS system can be installed on the upper vertebrae and the upper vertebrae for suspension without affecting the function of the existing conventional spinal fixator 50.

Please refer to Figure 14, which is a schematic diagram of an embodiment of the screwdriver in the component set of the translaminar pedicle anchor suspension system created. Since the T-PAS system in this creation uses a slender, soft and tough artificial ligament as the suspension wire, in order to avoid the suspension wire accidentally entangled with each other or entangled on the screwdriver when the anchor is locked during the operation, Therefore, this creation has created an innovative screwdriver 92 to overcome the aforementioned problems. As shown in FIG. 14, the screwdriver 92 includes a handle portion 921, a long rod portion 922, a head end 923, an upper hanger 924 and a lower hanger 925. The long rod portion 922 extends from one end of the grip portion 921 for a predetermined length along an axis. The screwdriver tip 923 is located at an end of the long rod portion 922 farther from the grip portion 921. The structure of the screwdriver tip 923 corresponds to the sleeve structure 214 of the anchor 21 of the present creation, and can be combined with the sleeve structure 214 of the anchor 21, so that when the grip portion 921 rotates, the screwdriver head The end 923 will also drive the anchor 21 to rotate. The upper pylon 924 and the lower pylon 925 are both installed on the long pole 922. Wherein, the lower hanger 925 is set on the long rod portion 922 and at a position corresponding to the upper hanger 924 across the axis; and the distance between the upper hanger 924 and the screwdriver tip 923 is greater than that of the lower hanger The distance between the frame 925 and the tip 923 of the screwdriver. In other words, the upper and lower hangers 924 and 925 are located on opposite sides of the long rod portion 922 and present a high and one low configuration. In addition, when the screwdriver tip 923 is coupled to the fitting structure 214 of the anchor 21, the position of the upper hanger 924 exactly corresponds to the position of the upper opening 2151 of the anchor 21, and the lower The position of the hanger 925 exactly corresponds to the position of the lower hole 2152 of the anchor 21. Therefore, when performing an operation, the doctor only needs to watch the upper and lower hangers 924, The position or rotation angle of 925 will know the current position or rotation angle of the upper and lower apertures 2151 and 2152 on the anchor 21 being locked by the screwdriver 92. In addition, the upper hanger 924 and the lower hanger 925 each have an elongated sheet, which is connected to the long rod by a number of protruding posts, and the upper and lower ends of the sheet are both in the axial direction. Slightly protruding from the lower convex column, in addition, the upper end of the sheet is also provided with a lower recess. The structural design of the upper and lower pylons can be used for the two ends of the suspension wire 23 extending from the upper and lower openings of the oblique through hole of the anchor to be wound and hung on the upper and lower suspenders respectively. On the protruding posts of the racks 924 and 925, the tail end of the suspension wire 23 is inserted into the recess at the upper end of the sheet, thereby avoiding the suspension wire 23 being entangled with each other or entangled on the screwdriver 92 when the screwdriver 92 is operated to lock the anchor 21 Case.

Please refer to Figure 15, which is a schematic diagram of an embodiment of the finger pusher in the component set of the translaminar pedicle anchor suspension system created. In this creation, a manual drill will be used to drill a through hole in the vertebral plate of the upper vertebra. Because the edge of the newly drilled port often has sharp edges or cracks, it is easy to scratch the suspension wire or crack due to the tension of the suspension wire; therefore, this creation has developed an original finger pusher 96 tool, Used to round the inner surface of the through hole and the edge of the hole. The finger pusher 96 includes a grip portion 961, a long shaft portion 962, and a conical file head 963. The long rod portion 962 extends a predetermined length from one end of the grip portion 961 along an axis. The vertebral file head 963 is located at an end of the long shaft portion 962 farther from the grip portion 961. The vertebral file head 963 has a cone-shaped structure and its protruding direction and the axial direction are both close to perpendicular. The surface of the vertebral file head 963 is a rough surface to provide the function of a file, and has a pointed end 9631 and a pressure end 9632. The tip size of the tip 9631 is smaller than the aperture of the through hole. The pressure end 9632 is located at the tail end of the vertebral file head 963, that is, the position connected to the long rod 962; the pressure end 9632 is designed as a slightly concave surface on the surface (tail end surface) away from the tip end 9631, Apply pressure to the vertebral file head 963 in such a way that it is convenient for the operator's fingers to press the end face of the compressed end 9632, while swinging the grip part 961 to prompt the grip part 961 to use the vertebral file head 963 as a pivot. Swing, so that the rough surface of the conical file head 963 can rub the edge of the through hole and the inner surface, so as to achieve the effect of rounding the inner surface of the hole and the edge of the orifice. In this embodiment, the long rod 962 also has a bent section and a parallel section, so that the front half and the back half of the long rod 962 are parallel but offset by a distance, allowing the operator to When using the finger to push the file 96, the front half of the long rod 962 is less likely to touch or block the lamina of the upper vertebra.

However, the above-mentioned embodiments should not be used to limit the applicable scope of this creation. The scope of protection of the creation shall be based on the technical spirit defined by the content of the patent application for this creation and the scope included in its equivalent changes. That is to say, all equal changes and modifications made in accordance with the scope of patent application for this creation will still not lose the essence of this creation, nor will it deviate from the spirit and scope of this creation, so it should be regarded as the further implementation status of this creation.

10: Spine

11: Upper vertebra

12: Lower vertebra

111, 121: lamina

112, 113, 122, 123: pedicle

114: Through hole

20: T-PAS system

21: Anchor

22: Gasket

23: Suspended wire

Claims (20)

A translaminar pedicle anchor suspension system can be set on a spine (Spine) including at least an upper vertebra (Upper Vertebral Segment) and a lower vertebra (Lower Vertebral Segment); the trans-laminar vertebra The pedicle anchor suspension system (Translaminar Pedicle Anchor Suspension System; T-PAS system for short) includes: at least one anchor (Anchor) that can be fixed to a pedicle of the lower vertebra; and , At least one suspension wire (Suspension Wire), one end of the suspension wire is combined with the anchor and can be fixed to the pedicle of the lower vertebra by the anchor, and the other end of the suspension wire can be borrowed It is fixed at a lamina (Lamina) of the upper vertebra by a fixing means; and the suspension wire has a predetermined tension, and both the upper vertebra and the lower vertebra can be suspended by the suspension wire Hang. For example, the translaminar pedicle anchor suspension system of claim 1, wherein: the upper vertebra and the lower vertebra respectively include: the vertebral plate and two pedicles which are respectively located on the vertebral plate Left and right sides; the vertebral plate of the superior vertebrae is provided with a tunnel that penetrates the left and right sides of the vertebral plate; the translaminar pedicle anchor suspension system further includes: At least one washer (Washer) can be provided at the through hole of the vertebral plate of the superior vertebra, and a length of the washer is greater than the aperture of the through hole; the fixing means is by hanging the The other end of the suspension wire passes through the through hole of the vertebral plate of the superior vertebrae and then is combined with the gasket. The length of the gasket is greater than the aperture of the through hole, and the suspension wire has the predetermined tension. The characteristic allows the other end of the suspension wire to be fixed at the through hole of the vertebral plate of the superior vertebra by the spacer. For example, the translaminar pedicle anchor suspension system of claim 2, wherein: the number of the at least one anchor is two, which are respectively arranged at the two pedicles of the lower vertebra; the at least one pad The number of pieces is two, which are respectively located at the left and right ends of the through hole of the vertebral plate of the superior vertebra; the number of the at least one suspension wire is two; one of the suspension wires is fixed at one end The anchor located on the left side of the pedicle, and the other end is from the left side of the vertebral plate of the superior vertebra through the through hole first to the right, and then combined with the spacer located at the right end of the through hole ; The other should be suspended One end of the wire is the anchor fixed on the pedicle on the right side, and the other end is the vertebral plate of the superior vertebrae passing through the through hole from the right side to the left, and then combined with the left end of the through hole. On the gasket. For example, the translaminar pedicle anchor suspension system of claim 2 further includes a rivet set plug placed in the through hole; wherein, the suspension wire is an artificial ligament; the anchor is an external Threaded screw (Screw). For example, the translaminar pedicle anchor suspension system of claim 2, wherein the method of connecting the suspension wire to the spacer is to connect a middle section of the suspension wire from the lamina of the upper vertebra After passing through the through hole to reach the other side of the vertebral plate, and making the middle section of the suspension line form a closed head end on the other side of the vertebral plate, the suspension line The closed end of the head is sleeved on a rod of the gasket located on the other side of the vertebral plate; wherein the two ends of the suspension wire farther from the closed end of the head are called open tail ends; After that, a pulling force is applied from at least one of the open ends of the tail of the suspension wire, so that the spacer can press against the outside of the through hole of the vertebral plate of the superior vertebra to reach the head of the suspension wire. The closed end of the part is combined with and fixed to the vertebral plate of the upper vertebra. For example, the translaminar pedicle anchor suspension system of claim 5, wherein the anchor has a long and narrow cylinder extending along a central axis, an external thread arranged on the outer surface of the cylinder, and is arranged on the cylinder A fitting structure at the top end of the, and an oblique through hole passing through the column; wherein the oblique through hole passes through the central axis, and the two ends of the through hole are respectively called upper orifices And a lower orifice, the distance between the upper orifice and the top end of the column is smaller than the distance between the lower orifice and the top end of the column; the oblique through hole allows the suspension wire to pass through, The anchor is hung on the suspension wire; the nesting structure can be combined with a screwdriver, and by operating the screwdriver to drive the anchor to rotate around the central axis, and then the anchor Locked in and fixed at the pedicle of the pedicle. For example, the translaminar pedicle anchor suspension system of claim 6, wherein the external thread provided on the outer surface of the cylinder of the anchor includes a threaded portion with a smaller pitch and a threaded portion with a larger pitch; The threaded portion with a smaller pitch is arranged closer to the top end of the column, and the threaded portion with a larger pitch is arranged at the top end farther from the column; and, the upper aperture and the The lower holes are all located at the threaded portion with a smaller pitch; wherein, a U-shaped connecting rod fixing frame is also provided at the top end of the column. For example, the translaminar pedicle anchor suspension system of claim 6, wherein the suspension wire is folded into a double-line side-by-side structure and has the closed end of the head at the double fold and the open tail away from the double fold The way to pass the suspension line through the oblique through hole is to pass the closed end of the head of the suspension line into the oblique through hole from the upper opening, and then put the head of the suspension line The closed end of the part is pulled out of the oblique through hole from the lower orifice, and at the same time, the open end of the tail of the suspension wire remains exposed to the outside of the upper orifice; the anchor is fixed to the lower vertebra The method of pedicle is to pull the closed end of the head of the suspension wire out of the oblique through hole from the lower orifice of the anchor, and then lock part of the anchor into the lower vertebrae. Of the pedicle, so that the lower orifice of the anchor is close to but still exposed on the outer surface of the pedicle of the lower vertebra; at this time, first apply a pulling force from the open end of the tail of the suspension wire so that The suspension wire temporarily has a relatively small first tension; then, the anchor is continued to be locked into the pedicle of the inferior vertebra, so that the inferior orifice of the anchor is embedded in the inferior vertebra Inside the pedicle, the suspension wire is wound around the outer surface of the anchor and clamped between the outer surface of the anchor and the inside of the pedicle of the lower vertebra; except that the suspension wire can be combined and fixed to the pedicle In addition to the pedicle of the lower vertebra, the suspension line can be further pulled and the suspension line can reach and maintain a relatively large second tension; the second tension is the predetermined tension and is greater than the The first tension. For example, the translaminar pedicle anchor suspension system of claim 6, wherein the way to pass the suspension wire through the oblique through hole is to pass one end of the suspension wire through the lower orifice into the oblique through hole And pull out the oblique through hole from the upper orifice, so that both ends of the suspension wire are located outside the lower orifice and the upper orifice; wherein, the middle section of the suspension wire and the head The closed ends of the upper part are all located at the part of the suspension wire pulled out from the upper orifice; the way to fix the anchor to the pedicle of the lower vertebra is to first lock part of the anchor into the The pedicle of the inferior vertebra, such that the lower orifice of the anchor and the open end of the tail of the suspension wire extending from the inferior orifice are locked in and clamped between the outer surface of the anchor and the Between the inside of the pedicle of the lower vertebra, but at this time, the upper orifice of the anchor and the part of the suspension wire extending from the upper orifice are still exposed to the pedicle of the lower vertebra. Root outside; then, the suspension wire is also exposed to the outside of the other open end of the tail from the upper orifice first drilled from below the portion of the suspension wire extending from the upper orifice, and then exposed A pulling force is applied to the other open end of the tail to make the suspension wire temporarily have a relatively small first tension; then, the anchor is continued to be locked into the pedicle of the lower vertebra, so that the anchor The upper orifice of the nail is buried inside the pedicle of the lower vertebra, At the same time, the part of the suspension wire extending from the upper orifice and the other open end of the tail that are also exposed to the outside are wound together on the outer surface of the anchor and sandwiched between the outer surface of the anchor and the lower section. The inside of the pedicle of the vertebrae; in addition to the suspension line can be combined and fixed at the pedicle of the lower vertebra, the suspension line can be further pulled and the suspension line can reach and maintain a relatively high Large second tension; the second tension is the predetermined tension and is greater than the first tension. An anchor, which can be applied to a translaminar pedicle anchor suspension system and can be locked to a pedicle of a vertebra; the anchor includes: a long and narrow cylinder extending along a central axis, An external thread arranged on the outer surface of the cylinder, a fitting structure arranged at a top end of the cylinder, and a through hole transversely penetrating the cylinder; wherein the through hole penetrates the central axis; the through hole The hole allows a suspension wire to pass through, so that the anchor is hung on the suspension wire; the nesting structure can be combined with a screwdriver, and the screwdriver is operated to drive the anchor to take the central axis as The shaft rotates to lock and fix the anchor on the pedicle and thereby also fix one end of the suspension wire on the pedicle. Such as the anchor of claim 10, wherein the through hole is an oblique through hole passing through the central axis: and the two ends of the oblique through hole are respectively called the upper orifice and the lower orifice. The distance between the aperture and the top end of the cylinder is smaller than the distance between the lower aperture and the top end of the cylinder; the external thread provided on the outer surface of the cylinder of the anchor includes a smaller pitch screw The thread portion and a larger-spacing thread portion; the smaller-spacing thread portion is arranged closer to the top end of the column, and the larger-spacing thread portion is arranged at the farther away from the column At the top; and, the upper orifice and the lower orifice are located in the smaller pitch thread portion. Such as the anchor of claim 11, wherein the suspension wire is folded into a double-line side-by-side structure and has a closed head end at the double fold and an open tail end away from the double fold; pass the suspension wire through the The oblique through hole method is to insert the closed end of the head of the suspension wire from the upper opening into the oblique through hole, and then pull the closed end of the head of the suspension wire from the lower opening. Out of the oblique through hole, at the same time, the open end of the tail of the suspension wire remains exposed outside the upper orifice; the method of fixing the anchor to the pedicle of the vertebra is to fix the suspension wire After the closed end of the head is pulled out of the oblique through hole from the lower hole of the anchor, a part of the anchor is first locked into the pedicle of the vertebra, so that the lower part of the anchor The orifice is close to but still exposed on the external surface of the pedicle; at this time, first apply a pulling force from the open end of the tail of the suspension wire so that the suspension wire temporarily has a relatively small first tension; Anchor continue Lock the pedicle so that the lower orifice of the anchor is buried inside the pedicle, and at the same time, the suspension wire is wound on the outer surface of the anchor and clamped between the outer surface of the anchor and the pedicle Inside the root; in addition to the suspension line can be combined and fixed at the pedicle, the suspension line can be further pulled and the suspension line can reach and maintain a relatively large second tension; the second tension Greater than the first tension. Such as the anchor of claim 11, wherein, both ends of the suspension wire are called tail open ends; the way to pass the suspension wire through the oblique through hole is to pass one end of the suspension wire through the lower opening Pass through the oblique through hole and pull out the oblique through hole from the upper hole, so that the two ends of the suspension wire are located outside the lower hole and the upper hole respectively; fix the anchor on the The method of the pedicle of the vertebrae is to first lock the anchor into the pedicle, so that the lower orifice of the anchor and the tail of the suspension wire extending from the lower orifice are open The ends are locked together and clamped between the outer surface of the anchor and the inside of the pedicle, but at this time the upper orifice of the anchor and the part of the suspension wire extending from the upper orifice are both It is also exposed to the outside of the pedicle; then, the other open end of the tail, which is also exposed to the outside, is drilled from the upper orifice through the portion of the suspension that extends from the upper orifice from below After that, a pulling force is applied to the other open end of the tail that is still exposed to the outside so that the suspension wire temporarily has a relatively small first tension; then, the anchor is continued to be locked into the pedicle to make the The upper orifice of the anchor is buried inside the pedicle, and at the same time, the part of the suspension wire extending from the upper orifice and the other open end of the tail that are also exposed to the outside are wrapped around the anchor The outer surface is clamped between the outer surface of the anchor and the inside of the pedicle; in addition to the suspension line can be combined and fixed at the pedicle, the suspension line can be further pulled and the suspension line can reach the parallel Maintain a relatively large second tension; the second tension is greater than the first tension. A component set of a translaminar pedicle anchor suspension system, the translaminar pedicle anchor suspension system is for installation at least including an upper vertebra (Upper Vertebral Segment) and a lower vertebra (Lower Vertebral) Segment) on a spine (Spine); the component set includes: at least one anchor (Anchor), which can be fixed to a pedicle (Pedicle) of the inferior vertebra; at least one washer (Washer), which can Is set at a lamina (Lamina) of the superior vertebra; at least one suspension wire (Suspension Wire) can be used to connect the anchor and the washer, and the anchor and the washer are used to suspend the The suspension wires are fixed to the pedicle and the upper of the lower vertebrae. The vertebral plate of the segmental vertebrae; and, the suspension wire has been pre-assembled on the anchor; and, a screwdriver can be combined with the anchor, and the anchor is locked in and fixed by operating the screwdriver At the pedicle. For example, the component set of claim 14, wherein the anchor includes: a long and narrow cylinder extending along a central axis, an external thread provided on the outer surface of the cylinder, and a set of fittings provided at a top end of the cylinder. Structure, and an oblique through hole passing through the column; wherein the oblique through hole passes through the central axis, and the two ends of the through hole are respectively called the upper orifice and the lower orifice, the upper hole The distance between the mouth and the top end of the column is smaller than the distance between the lower orifice and the top end of the column; Suspension line; the sleeved structure can be combined with the screwdriver, and by operating the screwdriver to drive the anchor to rotate around the central axis, and then lock the anchor in and fix the pedicle . For example, the component set of claim 15, wherein the external thread provided on the outer surface of the cylinder of the anchor includes a threaded portion with a smaller pitch and a threaded portion with a larger pitch; the threaded portion with a smaller pitch is provided At the top end closer to the column, and the larger-spaced threaded portion is disposed at the top end farther from the column; and the upper orifice and the lower orifice are both located at the smaller Spaced thread part; wherein, a U-shaped connecting rod fixing frame is also provided at the top end of the column. For example, the component set of claim 15, wherein the vertebral plate of the superior vertebra is provided with a tunnel penetrating the left and right sides of the vertebral plate; the suspension line is an artificial ligament (Artificial Ligament) The method of connecting the suspension wire to the spacer is to pass an intermediate section of the suspension wire from one side of the vertebral plate of the superior vertebra through the through hole to the other side of the vertebral plate, And make the middle section of the suspension wire form a closed head end on the other side of the vertebral plate, and then place the closed head end of the suspension wire on the other side of the vertebral plate A rod of the gasket on the side; wherein the two ends of the suspension wire farther from the closed end of the head are called the open tail end; then, a pull is applied from at least one of the open tail end of the suspension wire The force can make the spacer press against the outside of the through hole of the vertebral plate of the upper vertebra, achieving the effect of combining and fixing the closed end of the head of the suspension wire to the vertebral plate of the upper vertebra. For example, the component set of claim 17, wherein the suspension wire is folded into a double-line side-by-side structure and has the closed end of the head at the double fold and the open end of the tail far away from the double fold; pass the suspension wire through the The oblique through hole method is to insert the closed end of the head of the suspension wire into the oblique through hole through the upper hole, and then close the closed end of the head of the suspension wire The oblique through hole is pulled out from the lower hole, and at the same time, the open end of the tail of the suspension wire remains exposed to the outside of the upper hole. Such as the component set of claim 17, wherein the way to pass the suspension wire through the oblique through hole is to pass one end of the suspension wire through the lower hole into the oblique through hole and pull it out from the upper hole Outside the oblique through hole, the two ends of the suspension wire are respectively located outside the lower orifice and the upper orifice. For example, the component set of claim 15, wherein the screwdriver includes: a grip portion; a long rod portion extending from one end of the grip portion to a predetermined length along an axis; and a tip end located at the The long rod part is far away from an end of the grip part; the structure of the head end of the screwdriver can be combined with the fitting structure of the anchor, so that when the grip part rotates, the head end of the screwdriver will also drive the anchor to rotate ; An upper hanger, set on the long pole; and a lower hanger, set on the long pole and correspond to the upper hanger across the axis; and, the distance between the upper hanger and the tip of the screwdriver Greater than the distance between the lower hanger and the head end of the screwdriver; wherein, when the head end of the screwdriver is coupled to the fitting structure of the anchor, the position of the upper hanger corresponds to the upper hole of the anchor Position, and the position of the lower pylon corresponds to the position of the lower orifice of the anchor; wherein, the upper pylon and the lower pylon can extend from the oblique through hole of the anchor The suspension wire is wound and retracted.

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