WO2011091718A1 - 一种自动延长并防旋转的脊柱侧弯矫形系统 - Google Patents

一种自动延长并防旋转的脊柱侧弯矫形系统 Download PDF

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Publication number
WO2011091718A1
WO2011091718A1 PCT/CN2011/000136 CN2011000136W WO2011091718A1 WO 2011091718 A1 WO2011091718 A1 WO 2011091718A1 CN 2011000136 W CN2011000136 W CN 2011000136W WO 2011091718 A1 WO2011091718 A1 WO 2011091718A1
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WO
WIPO (PCT)
Prior art keywords
sleeve
rod
rotation
insertion rod
scoliosis
Prior art date
Application number
PCT/CN2011/000136
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English (en)
French (fr)
Inventor
赵胜
卫小春
李凯
Original Assignee
Zhao Sheng
Wei Xiaochun
Li Kai
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Publication date
Application filed by Zhao Sheng, Wei Xiaochun, Li Kai filed Critical Zhao Sheng
Priority to US13/576,207 priority Critical patent/US9301784B2/en
Publication of WO2011091718A1 publication Critical patent/WO2011091718A1/zh

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7025—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a sliding joint
    • 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
    • A61B17/7049—Connectors, not bearing on the vertebrae, for linking longitudinal elements together
    • A61B17/705—Connectors, not bearing on the vertebrae, for linking longitudinal elements together for linking adjacent ends of longitudinal elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/701—Longitudinal elements with a non-circular, e.g. rectangular, cross-section
    • 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
    • A61B17/7011—Longitudinal element being non-straight, e.g. curved, angled or branched

Definitions

  • the present invention relates to an internal fixation device for scoliosis treatment, and more particularly to a scoliosis system that automatically extends and prevents rotation.
  • BACKGROUND OF THE INVENTION A significant proportion of adolescents with severe scoliosis require surgical correction.
  • pedicle screw-orthotic rod systems are often used for surgical treatment, but the existing fixation techniques have the following disadvantages and problems.
  • Chinese Patent 200510086711.6 discloses a growth rod system.
  • the orthopedic rod is a unitary structure and is slidably connected with a plurality of pedicle screws.
  • the pedicle screw and the orthopedic rod are not locked and can slide relative to each other, so the growth of the spine is not restricted by the orthopedic rod;
  • This system can correct lateral and angular deformities, but because there is no locking between the pedicle screw and the orthopedic rod, the pedicle screw will rotate with the orthopedic rod as the axis, which greatly affects the stability of the nail rod system to the spine.
  • the orthopedic effect is worse than other nail rod systems, especially the rotation of the vertebral body has no fixed effect, and the occurrence of rotational deformity cannot be effectively avoided.
  • the patient should undergo an operation every six months or so, expose the orthopedic rod fixed on the spine, loosen the growth valve fixing screw, and adjust the internal fixation length.
  • the surgical incision is adjusted to be more than 25 cm, and the internal fixation regulation portion of the spine is exposed, and the patient has a large pain, high cost, and is likely to cause complications such as infection.
  • Many patients are reluctant to undergo frequent surgery, which causes the growth valve to be unable to adjust in time, affecting the development of the spine. It can be said that frequent surgical adjustment is an important drawback of this technique.
  • the growth valve structure has a large length.
  • multiple vertebral bodies must be separated to allow pedicle screw fixation.
  • the normal spine is in the process of continuous growth, and the internal fixation needs to be slowly extended rather than periodically extended. Therefore, the growth valve system does not meet the physiological needs of spine growth, and the range of single adjustment is limited, so the adjustment is frequent.
  • the purpose of the present invention is to break through the bottleneck of the prior art, that is, to solve the existing spinal orthopedic device or to adjust with the growth of the spine, or to adjust or affect the orthopedic effect, or to cause great pain to the patient,
  • a correctable side curve, prevent rotation can be extended with growth without surgery, and can be fixed in short segments without the need to deliberately extend the spacing of the pedicle screws, and does not affect the local scoliosis orthopedic system.
  • An automatically extended and anti-rotation scoliosis system comprising a pedicle screw and a plurality of orthopedic rods locked with a pedicle screw, wherein the orthopedic rod comprises a sleeve and an insertable sleeve
  • the insertion rod has the same inner wall of the sleeve and the insertion rod and has a clearance fit therebetween.
  • the mating surface of the insertion rod and the sleeve is provided with a positioning mechanism for restricting the rotation of the insertion rod relative to the sleeve.
  • a set of sleeve and insertion rod combinations are placed between adjacent pedicle screws.
  • the positioning mechanism is composed of a positioning platform on the insertion rod and a corresponding platform on the inner wall of the sleeve, or a positioning boss on the insertion rod and a corresponding groove on the inner wall of the sleeve.
  • the insertion rod and the inner wall of the sleeve are matched contoured structures, such as polygonal or elliptical.
  • the sleeve is composed of a sleeve structure section and a rod section on one side, or a sleeve section on both sides and a rod section in the middle.
  • the insertion rod is composed of an end rod section and an end insertion rod structure section, or an intermediate rod section and an insertion rod structure section at both ends.
  • the sleeve and the insertion rod are integrally connected, including one end sleeve structure section connected by the rod section and one end insertion rod structure section.
  • a sleeve composed of one side sleeve structure section and one side rod section and an end rod rod section and an end insertion rod structure section constitute an insertion rod for the end of the orthopedic rod
  • the various basic structures of the sleeve and the insertion rod are combined with one another to form a component that can be combined with each other.
  • the structure can be made of different lengths and can be made into various types of sleeves and insertion rods, which can be used to form orthopedic rods of different lengths for patients of different ages and different surgical methods.
  • the sleeve structure and the insertion rod structure to be inserted into the sleeve are not pre-bent, and other areas can be pre-bent to accommodate spinal deformities.
  • the method of use of the invention is basically the same as the conventional conventional orthopedic nail rod system, that is, an orthopedic rod of a suitable size is combined, the pre-bending is adapted to the spinal deformity, and then connected with the pedicle screw, but not locked, and the rotating rod is corrected by 90°. Malformation, and then the orthopedic rod and the pedicle screw are locked, and the pedicle screw is integrated with the orthopedic rod.
  • the orthopedic rod is composed of a plurality of segments
  • the sleeve and the insertion rod structure at the joints of the joints do not rotate, so that they have rotational stability and are elongated in the longitudinal direction, and can be extended with growth without being restricted.
  • a plurality of sleeves can provide greater elongation and are not easily pulled out with growth.
  • a group of pedicle screws are generally used for every 3-4 vertebral bodies.
  • the length of the sleeve can be 1-1.5 vertebral bodies, so that the pedicle screws can be placed according to conventional methods, which can be avoided.
  • the pedicle screw spacing is deliberately extended to accommodate the extension device, which not only ensures the orthopedic effect, but also avoids excessive stress and causes broken bars and broken nails.
  • the linear structure of the orthopedic rod is limited to the sleeve, and the length of each sleeve is small, which has little influence on the local curvature of the spine. Compared with the existing growth valve system, it is not easy to cause the flat back deformity of the local spine.
  • the present invention has the following beneficial effects over the prior art:
  • pedicle screws can be placed in the usual way, to avoid excessive stress caused by broken rods, broken nails.
  • Figure 1 is a schematic diagram of the orthopedic system before the rotating rod
  • Figure 2 is a schematic diagram of the orthopedic system after the rotating rod orthopedics
  • Figure 3 is a schematic diagram of a single pedicle screw and orthopedic rod before the rotating rod
  • Figure 4 is a schematic diagram of a single pedicle screw and orthopedic rod after rotary bar orthosis
  • Figure 5 is a schematic view of the orthopedic rod
  • Figure 6 is a schematic cross-sectional view of the orthopedic rod
  • Figure 7 is a schematic cross-sectional view of Embodiment 1 of an orthopedic rod
  • Figure 8 is a schematic cross-sectional view of the embodiment 2 of the orthopedic rod
  • Figure 9 is a schematic cross-sectional view of the embodiment 3 of the orthopedic rod
  • Figure 10 is a schematic cross-sectional view showing the fourth embodiment of the orthopedic rod
  • Figure 11 is a schematic view of a structure of the sleeve
  • Figure 12 is a schematic view of another structure of the sleeve
  • Figure 13 is a schematic view of the structure of the insertion rod
  • Figure 14 is another schematic view of the insertion rod
  • Figure 15 is a schematic view of the structure of the insertion rod and the sleeve of the unitary structure
  • an automatically extended and anti-rotation scoliosis system comprising a pedicle screw 1 and an orthopedic rod 2 locked to the pedicle screw 1, as shown in Figures 1, 2, 3, and 4.
  • the orthopedic rod 2 comprises a sleeve 2.1 and an insertion rod 2.2 which can be inserted into the sleeve 2.1, and the inner wall of the sleeve 2.1 is inserted.
  • the input rod 2.2 is isomorphous with a clearance fit therebetween, and the insertion rod 2.2 and the sleeve 2.1 are provided with a positioning mechanism for restricting the rotation of the insertion rod relative to the sleeve.
  • a set of sleeves and insertion rods are placed between two adjacent pedicle screws 1
  • the positioning mechanism is composed of a positioning platform on the insertion rod 2.2 and a corresponding platform on the inner wall of the sleeve 2.1, as shown in Fig. 7, or by a positioning boss on the insertion rod 2.2 and a corresponding groove on the inner wall of the sleeve 2.1.
  • Composition as shown in Figure 8.
  • the insertion rod 2.2 and the sleeve 2.1 are matched contoured structures, such as polygonal or elliptical, etc., as shown in Figs.
  • the sleeve 2.1 consists of a side sleeve structure section 2.3 and a side rod section 2.4 for the end of the orthopedic rod, as shown in Fig. 12, or by the sleeve structure section 2.3 on both sides and the middle rod Segment 2.4 consists of Figure 11.
  • the insertion rod 2.2 is composed of an end rod section 2.4 and an end insertion rod structure section 2.5 for the end of the orthopedic rod, as shown in Fig. 14, or consists of an intermediate rod section 2.4 and an insertion rod structure section 2.5 at both ends. , as shown in Figure 13.
  • the sleeve and the insertion rod are integrally connected, including one end sleeve structure section 2.3 connected by the rod section 2.4 and one end insertion rod structure section 2.5, as shown in FIG.
  • the various basic structures of the sleeve and the insertion rod are combined with one another to form a component that can be combined with each other.
  • the components can be constructed in different lengths and can be made into a variety of different types of sleeves and insertion rods, which can be used to form orthopedic rods of different lengths for patients of different ages and different surgical methods.
  • the sleeve structure and the insertion rod structure to be inserted into the sleeve are not pre-bent, and other areas can be pre-bent to accommodate spinal deformities.
  • the method of use of the invention is basically the same as the conventional conventional orthopedic nail rod system, that is, combining the correct size of the correction, the shape bar, the pre-bending to adapt to the spinal deformity, and then connecting with the pedicle screw, but not locking, the rotation rod 90° correction
  • the lateral curvature is deformed, and then the orthopedic rod is locked with the pedicle screw, and the pedicle screw is integrated with the orthopedic rod.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
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Description

一种自动延长并防旋转的脊柱侧弯矫形系统
技术领域 本发明属于脊柱侧弯治疗用内固定装置， 具体涉及一种自动延长并防旋转 的脊柱侧弯矫形系统。 背景技术 青少年严重脊柱侧弯患者有相当比例需手术矫正， 目前多采用椎弓根钉-矫 形棒系统进行手术治疗， 但是现有固定技术存在以下缺点和问题。
1、 大多数椎弓根钉矫形棒系统将脊柱侧弯矫形固定后， 形状长度即无法调 整。 虽然侧弯得到了有效纠正， 但是由于患者多为青少年， 脊柱不断生长发育， 内固定对固定节段的限制导致脊柱发育停滞， 引起曲轴现象 （即固定节段周围 脊柱生长扭曲变形） ， 患者生长发育受到严重影响。 如果早期去除钉棒系统， 可能导致脊柱侧弯的复发。 临床需要可随生长发育延长的椎弓根钉 -矫形棒内固 定系统。
2、 中国专利 200510086711.6公开了一种生长棒系统。其矫形棒为一整体结 构， 与多个椎弓根钉滑动连接， 此系统中椎弓根钉与矫形棒之间并不锁定， 可 相对滑动， 因此脊柱生长不受矫形棒的限制； 这样虽然这一系统可纠正侧方和 成角畸形， 但是由于椎弓根钉与矫形棒之间没有锁定， 椎弓根钉会以矫形棒为 轴旋转， 大大影响了钉棒系统对脊柱作用的稳定性， 矫形效果较其他钉棒系统 差， 尤其是对椎体的旋转无固定作用， 无法有效避免旋转畸形的发生。
3、 现有技术中也有为了同时解决生长延长与防旋转问题而设计的生长阔系 统 （如 ISOLA固定装置） ， 采用类似传统钉棒系统的结构， 矫形棒与椎弓根钉
1
确认本 锁定， 但是在矫形棒上加用一个可手动延长的生长阀。 这一设计是目前最先进 的侧弯矫形系统。 此设计防旋转效果好， 既达到了普通钉棒系统纠正侧有的劫 能， 具有旋转稳定性， 且能部分满足内固定系统随生长发育延长的需要 但是 这一设计仍存在如下严重不足， 大大影响了治疗效果， 给患者带来巨大痛苦。
a、 由于需要手动延长， 患者每半年左右要接受一次手术， 暴露固定于脊柱 上的矫形棒， 松开生长阀固定螺丝， 调整内固定长度。 以常用的 ISOLA装置为 例， 调节手术切口要 25厘米以上， 暴露固定于脊柱的内固定调节部分， 患者痛 苦大， 费用高， 易引起感染等并发症。 许多患者因不愿接受频繁手术， 导致生 长阀不能及时调节， 影响脊柱发育。 可以说频繁的手术调节是这一技术的重要 缺陷。
b、 为保证有效的延长长度， 生长阀结构长度较大。 为放置生长阔， 必须间 隔多个椎体才可进行椎弓根钉固定。 但是间隔越多， 跨度越大， 矫形效果越差， 并且可造成生长阀上下椎弓根钉处应力过大， 易引起断钉、 断棒。
c、正常脊柱处于不断生长过程中， 需要内固定缓慢延长， 而不是定期延长。 因此生长阀系统不符合脊柱生长的生理需要， 且单次调整范围很有限， 因而调 整频繁。
d、 过长的直线型生长阀影响脊柱形态， 可造成部分脊柱的 "平背"畸形。 为改进这一系统， 中国专利 200510011913.4对生长阀系统进行改进,加装齿 条和驱动齿轮装置。 这些装置可在较小的切口内暴露， 旋转驱动齿轮可使整个 矫形棒延长。 此法縮小了手术切口， 减少了手术创伤， 但是仍然无法避免每半 年手术一次的窘境。 同时驱动齿轮等装置有明显的缝隙。 纤维结缔组织可长入 其中， 造成机械结构的失效， 为手术带来风险。 综上所述， 临床急需一种既能 纠正侧弯， 同时可防止旋转， 植入后无需手术即可随生长发育而自然延长， 且 可短节段固定， 多节段延长不影响局部脊柱形态的内固定系统。
发明内容
本发 的目的在于突破现有技术的瓶颈， 也即为了解决现有的脊柱矫形装 置或者不能随脊柱生长而调整， 或者能调整却影响矫形效果， 或者给患者带来 较大痛苦的问题， 提供一种可纠正侧弯， 防止旋转， 无需手术即可随生长发育 延长， 且可短节段固定， 无需刻意延长椎弓根钉间距， 不影响局部脊柱形态的 脊柱侧弯矫形系统。
本发明采用如下的技术方案实现：
一种自动延长并防旋转的脊柱侧弯矫形系统， 其包括椎弓根钉以及若干与 椎弓根钉锁定的矫形棒， 其特征在于所述的矫形棒包括套筒和可插入套筒之内 的插入杆， 套筒内壁与插入杆同形且二者之间为间隙配合， 插入杆和套筒的配 合面上设有限制插入杆相对套筒转动的定位机构。 相邻两个椎弓根钉之间设置 一组套筒和插入杆组合。
所述的定位机构由插入杆上的定位平台和套筒内壁上对应的平台构成， 或 者由插入杆上的定位凸台和套筒内壁上对应的凹槽构成。 或者插入杆以及套筒 内壁为相配合的异形结构， 如多边形或椭圆形等等。
所述的套筒由一侧套筒结构段和一侧棒杆段组成， 或者由两侧的套筒结构 段和中间的棒杆段组成。 所述的插入杆由一端棒杆段和一端插入杆结构段组成， 或者由中间的棒杆段和两端的插入杆结构段组成。 或者套筒和插入杆连接为一 体， 包括由棒杆段连接的一端套筒结构段和一端插入杆结构段。 一侧套筒结构 段和一侧棒杆段组成的套筒和一端棒杆段和一端插入杆结构段组成插入杆是用 于矫形棒末端的
套筒和插入杆的各种基本结构相互组合， 形成可相互组合的部件。 各部件 结构可采用不同长度， 制成各种不同型号的套筒和插入杆， 进而可组成不同长 度的矫形棒， 用于不同年龄阶段、 不同手术方式的患者。 套筒结构及将要插入 套筒的插入杆结构不可预弯， 其他区域可进行预弯， 以适应脊柱畸形。
本发明使用方法与现有常规矫形钉棒系统基本相同， 即组合合适规格的矫 形棒， 预弯适应脊柱畸形， 然后与椎弓根钉连接， 但暂不锁死， 转棒 90°矫正侧 弯畸形， 然后再将矫形棒与椎弓根钉锁定， 椎弓根钉与矫形棒连为一体。
矫形棒虽由多节组成， 但是各节连接处的套筒、 插入杆结构不会发生旋转 活动， 因此其具有旋转稳定性， 并在纵向具有延长性， 可随生长而延长， 不受 限制。 并且多个套筒可提供较大的延长性， 不易随生长而拔出。
传统钉棒系统中，一般每 3-4个椎体打椎弓根钉一组，可选用套筒长度可为 1-1.5个椎体长,这样椎弓根钉可按常规方法安置， 可避免使用现有生长阀系统 时， 为安置延长装置而刻意延长椎弓根钉间距， 这样既可保证矫形效果， 又避 免应力过于集中造成断棒、 断钉。
此矫形棒直线结构仅限于套筒处， 每处套筒处长度都很小， 对局部脊柱曲 度影响小， 与现有的生长阀系统相比， 不易造成局部脊柱的平背畸形。
综上， 本发明相对现有技术具有如下有益效果：
1、 突破了脊柱内固定系统的稳定性与自动延长性不可同时获得的难题， 既 可保证矫正脊柱侧弯所需的侧方稳定性和防旋转功能， 同吋具有沿脊柱生长方 向的自动延长性。
2、 保证了短期手术效果和长期疗效， 突破了脊柱侧弯非融合手术 不能一 次完成的技术偏见， 大大减少了患者痛苦， 为脊柱侧弯的治疗带来突破。
3、 椎弓根钉可按常规方法安置， 避免应力过于集中造成断棒、 断钉。
4、 套筒处长度都很小， 不易造成局部脊柱的平背畸形。 附图说明
图 1为转棒前矫形系统示意图
图 2为转棒矫形后矫形系统示意图
图 3为转棒前单节椎弓根钉和矫形棒示意图
图 4为转棒矫形后单节椎弓根钉和矫形棒示意图
图 5为矫形棒的示意图
图 6为矫形棒的剖面示意图
图 7为矫形棒的实施例 1的剖面示意图
图 8为矫形棒的实施例 2的剖面示意图
图 9为矫形棒的实施例 3的剖面示意图
图 10为矫形棒的实施例 4的剖面示意图
图 11为套筒的一种结构示意图
图 12为套筒的另一种结构示意图
图 13为插入杆的一种结构示意图
图 14为插入杆的另一种结构示意图
图 15为一体结构的插入杆和套筒结构示意图
图中： 1-椎弓根钉， 2-矫形棒， 2.1-套筒， 2.2-插入杆， 2.3-套筒结构段， 2.4- 棒杆段， 2.5-插入杆结构段。
具体实施方式
结合附图对本发明的具体实施方式作进一步说明。
一种自动延长并防旋转的脊柱侧弯矫形系统， 其包括椎弓根钉 1 以及与椎 弓根钉 1锁定的矫形棒 2， 如图 1、 图 2、 图 3、 图 4。 如图 5、 图 6所示， 所述 的矫形棒 2包括套筒 2.1和可插入套筒 2.1之内的插入杆 2.2，套筒 2.1内壁与插 入杆 2.2同形且二者之间为间隙配合， 插入杆 2.2和套筒 2.1上设有限制插入杆 相对套筒转动的定位机构。 相邻两个椎弓根钉 1 之间设置一组套筒和插入杆组 合
所述的定位机构由插入杆 2.2上的定位平台和套筒 2.1内壁上对应的平台构 成， 如图 7所示， 或者由插入杆 2.2上的定位凸台和套筒 2.1内壁上对应的凹槽 构成， 如图 8所示。 或者插入杆 2.2以及套筒 2.1为相配合的异形结构， 如多边 形或椭圆形等等， 如图 9、 图 10所示。
所述的套筒 2.1由一侧套筒结构段 2.3和一侧棒杆段 2.4组成， 用于矫形棒 末端， 如图 12所示， 或者由两侧的套筒结构段 2.3和中间的棒杆段 2.4组成， 如图 11所示。所述的插入杆 2.2由一端棒杆段 2.4和一端插入杆结构段 2.5组成， 用于矫形棒末端， 如图 14所示， 或者由中间的棒杆段 2.4和两端的插入杆结构 段 2.5组成， 如图 13所示。 或者套筒和插入杆连接为一体， 包括由棒杆段 2.4 连接的一端套筒结构段 2.3和一端插入杆结构段 2.5， 如图 15所示。
套筒和插入杆的各种基本结构相互组合， 形成可相互组合的部件。 各部件 结构可采用不同长度， 制成各种不同型号的套筒和插入杆， 进而可组成不同长 度的矫形棒， 用于不同年龄阶段、 不同手术方式的患者。 套筒结构及将要插入 套筒的插入杆结构不可预弯， 其他区域可进行预弯， 以适应脊柱畸形。
本发明使用方法与现有常规矫形钉棒系统基本相同， 即组合合适规格的矫, 形棒， 预弯适应脊柱畸形， 然后与椎弓根钉连接， 但暂不锁死， 转棒 90°矫正侧 弯畸形， 然后再将矫形棒与椎弓根钉锁定， 椎弓根钉与矫形棒连为一体。

Claims

权 利 要 求
1、 一种自动延长并防旋转的脊柱侧弯矫形系统， 其包括椎弓根钉 （1 ) 以 及若干与椎弓根钉 （1 ) 锁定的矫形棒 （2) ， 其特征在于所述的矫形棒 （2) 包 括套筒 （2.1 ) 和可插入套筒 （2.1 ) 之内的插入杆 （2.2) ， 套筒 （2.1 ) 内壁与 插入杆（2.2) 同形且二者之间为间隙配合， 插入杆（2.2)和套筒（2.1 ) 的配合 面上设有限制插入杆 （2.2) 相对套筒 （2.1 ) 转动的定位机构。
2、 根据权利要求 1所述的一种自动延长并防旋转的脊柱侧弯矫形系统， 其 特征在于所述的定位机构由插入杆 （2.2) 上的定位平台和套筒 （2.1 ) 内壁上对 应的平台构成。
3、 根据权利要求 1所述的一种自动延长并防旋转的脊柱侧弯矫形系统， 其 特征在于所述的定位机构由插入杆 （2.2) 上的定位凸台和套筒 （2.1 ) 内壁上对 应的凹槽构成。
4、 根据权利要求 1所述的一种自动延长并防旋转的脊柱侧弯矫形系统， 其 特征在于所述的定位机构为相配合的异形结构的插入杆 （2.2) 以及套筒 （2.1 )。
5、 根据权利要求 1或 2或 3或 4所述的一种自动延长并防旋转的脊柱侧弯 矫形系统， 其特征在于相邻两个椎弓根钉（1 )之间设置一组套筒（2.1 )和插入 杆 （2.2) 组合。
6、 根据权利要求 5所述的一种自动延长并防旋转的脊柱侧弯矫形系统， 其 特征在于所述的套筒（2.1 ) 由一侧套筒结构段（2.3 )和一侧棒杆段（2.4)组成。
7、 根据权利要求 5所述的一种自动延长并防旋转的脊柱侧弯矫形系统， 其 特征在于所述的套筒 （2.1 ) 由两侧的套筒结构段 （2.3 ) 和中间的棒杆段 （2.4) 组成。
8、 根据权利要求 5所述的一种自动延长并防旋转的脊柱侧弯矫形系统^寒 特征在于所述的插入杆 （2.2) 由一端棒杆段 （2.4) 和一端插入杆结构段 (2:5 ) 组成。
9、 根据权利要求 5所述的一种自动延长并防旋转的脊柱侧弯矫形系统， 其' 特征在于所述的插入杆（2.2)由中间的棒杆段（2.4)和两端的插入杆结构段（2.5 ) 组成。
10、 根据权利要求 5 所述的一种自动延长并防旋转的脊柱侧弯矫形系统， 其特征在于所述的套筒和插入杆连接为一体， 包括由棒杆段 （2.4) 连接的一端 套筒结构段 （2.3 ) 和一端插入杆结构段 （2.5 )。
PCT/CN2011/000136 2010-01-31 2011-01-28 一种自动延长并防旋转的脊柱侧弯矫形系统 WO2011091718A1 (zh)

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