WO2014040515A1 - Vis de pédicule ayant un cran et vis de pédicule formant un élément de poussée et procédé - Google Patents

Vis de pédicule ayant un cran et vis de pédicule formant un élément de poussée et procédé Download PDF

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Publication number
WO2014040515A1
WO2014040515A1 PCT/CN2013/083032 CN2013083032W WO2014040515A1 WO 2014040515 A1 WO2014040515 A1 WO 2014040515A1 CN 2013083032 W CN2013083032 W CN 2013083032W WO 2014040515 A1 WO2014040515 A1 WO 2014040515A1
Authority
WO
WIPO (PCT)
Prior art keywords
barb
pedicle screw
head
pusher
hole
Prior art date
Application number
PCT/CN2013/083032
Other languages
English (en)
Chinese (zh)
Inventor
田芳
高耀平
林忠
陈伟
Original Assignee
上海微创骨科医疗科技有限公司
苏州海欧斯医疗器械有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 上海微创骨科医疗科技有限公司, 苏州海欧斯医疗器械有限公司 filed Critical 上海微创骨科医疗科技有限公司
Publication of WO2014040515A1 publication Critical patent/WO2014040515A1/fr

Links

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
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/866—Material or manufacture
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8685—Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B2017/8655—Pins or screws or threaded wires; nuts therefor with special features for locking in the bone

Definitions

  • the present invention relates to the field of orthopedic implants, and in particular to the field of spinal surgery, such as implants for the treatment or repair of spinal diseases in patients. Background technique
  • Known post-spindle surgery nail rod systems generally consist of a pedicle screw, a connecting rod, a cross-linker, and a lock nut.
  • the spinal column to be treated within the frame is stabilized by assembling a nail rod system into a fixed frame with the vertebral body.
  • the pedicle screw implanted in the vertebral body plays a key role.
  • Current pedicle screw fixation technology enables safe and robust short-segment spinal fixation. This technique has been widely used in spinal surgery. However, this technique has a problem of complications caused by internal fixation failure such as screw loosening and screw fracture.
  • the device consists of a hollow pedicle screw, an intermediate body and a connector, the hollow pedicle screw being provided with a through hole, ie comprising a hollow internal hole, as an injection path for injecting bone cement, and the hollow vertebral arch
  • the root screw also has an externally threaded screw, and the head portion of the screw is provided with a plurality of side holes for orienting the bone cement into the pedicle.
  • Chinese invention patent application CN200780014263.6 proposes a surgical fastener having a mechanical and bone fixation device. The surgical fasteners combine fixed mechanical and osteogenic devices to maximize in vivo stability and long term performance.
  • the fastener includes a head and a stem, and the fastener has a bore and includes a passage leading to one or more openings along the stem.
  • the bone void filling material is delivered to the rod via the channel and delivered to the outside of the rod via the opening to improve the anchoring effect.
  • Xiamen Dabo Yingjing Medical Devices Co., Ltd. has developed a minimally invasive spinal system, as shown in Figures 1A-1B. This technique injects bone cement from the inner hole of the pedicle screw to enhance the pull-out resistance of the screw.
  • bone cement is not absorbed in the human body and cannot be biodegraded.
  • the bone cement will exotherm when it polymerizes, resulting in necrosis of the surrounding cancellous bone and release of toxins.
  • the above disadvantages have limited the application of bone cement. Summary of the invention
  • a pedicle screw comprising a head having an internal thread and a screw having an external thread.
  • the pedicle screw also has an elastically expandable barb, extending within the screw along the axis of the pedicle screw with a non-penetrating lumen open to the head and having one or more lumens on the screw The through holes are connected, and the barbs are snap-fitted into the through holes and protrude from the through holes.
  • the pedicle screw of the present invention is designed to have a barbed structure.
  • the through hole extends obliquely with respect to the axis of the pedicle screw.
  • the barb is V-shaped, and the two branches of the V-shape are respectively One of the holes protrudes.
  • there is a pusher head in the interior cavity and the barbs are snap-fitted to the pusher head in a clamping manner.
  • a pusher for forming a pedicle screw for attaching an elastically expandable barb to a pedicle screw.
  • the pusher includes a push rod in a longitudinal direction and a push head that is detachably engaged with the push rod, and the inverted head can be fitted to the push head.
  • the pusher of the present invention is capable of easily mounting the barbs on the pedicle screws.
  • the push rod is provided with a ball head at one end, and the push head is provided with a matching ball socket at one end engaged with the push rod.
  • the barb is V-shaped, and the push head is provided with a through hole for the barb to pass through at the opposite end of the end engaged with the push rod, and the inverted pin rides in a clamping manner due to its elasticity. On the hole.
  • a method of forming a pedicle screw using a pusher for attaching a barb to a pedicle screw comprises the steps of: fitting a inverted file to the push head; after implanting the pedicle screw into the vertebral body, inserting the pusher together with the barb down the inner cavity to reach the through hole, at the through hole, The inherent elasticity of the barb causes the inverted bar to automatically open into the through hole; lift the pusher upward to make the barb further open and snap into the through hole and protrude from the through hole; continue to lift the pusher upwards
  • the pusher head is separated from the pusher; the pusher is removed from the inner cavity and the pusher head is retained in the inner cavity.
  • the step of fitting the barb to the push head comprises: causing the barb to ride over the through hole of the push head in a clamping manner due to the elasticity of the barb.
  • FIGS. 1A and 1B are schematic views of a prior art pedicle screw.
  • FIG. 2 is a perspective view of a barbed pedicle screw of the present invention.
  • Figures 3A-3B are side elevational views, respectively, of a spur-removing pedicle screw of the present invention and a pusher inserted into a pedicle screw mounted with a barb.
  • Fig. 4 is a schematic view of the pusher of the present invention
  • Fig. 4A is an enlarged view of a portion A of the circle in Fig. 4
  • Fig. 4B is a schematic view of the barb of the present invention.
  • Figure 5 is a schematic view of the push barper of the present invention
  • Figure 5A is a circle of Figure 5.
  • Figures 6A-6C show schematic views of the process of installing a barb using a pusher.
  • Figure 7 shows the removal of the pusher after the barb has been installed on the pedicle screw.
  • FIG. 2 shows a perspective view of a pedicle screw mounted after barbs.
  • Pedicle screw included A head 1 having an internal thread and a screw 3 having an external thread.
  • a non-penetrating inner cavity 7 having an end open toward the head is extended in the screw 3 along the axis of the pedicle screw, and a plurality of through holes communicating with the inner cavity ⁇ are provided on the screw 3 so as to be inclined with respect to the axis. 6, as shown in Figure 3A-3B.
  • the barb 2 is an elastically expandable V-shaped configuration that fits in the through hole 6 and protrudes from the through hole 6 in a snap-fit manner.
  • FIG. 4 shows a view of the pusher 10 of the present invention.
  • the pusher 10 is composed of a push rod 4 and a push head 5, and the push rod 4 is provided with a ball head 9 at one end, and the push head 5 is provided with a matching ball socket (not shown) at one end joined to the push rod 4.
  • the ball 9 is provided with a slot 1 1 so that the ball 9 is shrunk when squeezed. Due to the configuration of the ball head 9, the ball head 9 can be detached from the ball socket under a certain force, thereby separating the push rod 4 from the push head 5. Further, as shown in Fig.
  • the push head 5 is provided at the opposite end of the end joined to the push rod 4 with a through hole 8 through which the barbs 2 pass.
  • the invention is not limited to the configuration in which the slot 11 is opened on the ball head 9.
  • the ball head 9 does not have to be slotted, but the ball socket of the push head 5 can be configured to be elastic, and under certain force, the ball socket is elastically opened to enable the ball head 9 to be detached from the ball socket.
  • the installation process of Barb 2 is as follows. The ball 9 on the push rod 4 is inserted into the socket of the push head 5 to constitute the pusher 10, as shown in FIG. The V-shaped barb 2 shown in FIG. 4B is passed through the through hole 8 in the push head 5.
  • the inverted jaw 2 rides in a clamping manner across the through hole 8 of the push head 5, as shown in Fig. 5-5A.
  • the pedicle screw is first implanted into the vertebral body, and the pusher 10 together with the barb 2 is inserted down the lumen 7 of the pedicle screw to the through hole 6, as shown in Fig. 3B.
  • the V-shaped barb 2 is automatically opened due to its inherent elasticity, and enters the through hole 6, as shown in Fig. 6A.
  • the pusher 10 is slowly lifted upward, the V-shaped barb will pass out of the through hole 6 and snap onto the through hole 6, as shown in Figs. 6B-6C.
  • the pusher 10 is continuously lifted upward, and the pusher 4 is separated from the pusher head 5 as shown in FIG. Finally, the push rod 4 is taken out of the inner chamber 7, and the push head 5 is left in the inner chamber 7. In this way, a V-shaped barb installation is completed. In the same way, a second V-shaped barb can be installed. Usually the installation of 2 V-shaped inverted rakes can achieve the desired anchoring effect.
  • the solution of the present invention is simple in construction and easy to install and disassemble. Moreover, the invention can be implemented on the basis of conventional pedicle screws. Specifically, a non-penetrating inner cavity is machined along the axis on the common pedicle screw, and a few oblique holes are made in the screw. At the time of surgery, the pedicle screw is first screwed into the vertebral body, and the V-shaped barb is attached using the pusher of the present invention.
  • the modified pedicle screw implanted in the vertebral body has increased pull-out force and radial stability, and also has a good anchoring effect on the stability of the implant in patients with bone loss. .

Abstract

L'invention concerne une vis de pédicule ayant des crans (2) et une vis de pédicule formant un élément de poussée et un procédé, la vis de pédicule comprenant une tête (1) ayant des filetages internes et une tige filetée (3) ayant des filetages externes ; une lumière non traversante (7) ayant une ouverture d'extrémité sur la tête (1) s'étend le long de l'axe de la vis de pédicule dans la tige filetée (3) ; la tige filetée (3) comprend un ou plusieurs trous traversants (6) sur celle-ci en communication avec la lumière (7) ; les crans élastiques et extensibles (2) peuvent se plier dans les trous traversants (6) et s'étendre en dehors des trous traversants (6). La vis de pédicule ayant des crans (2) a une structure simple, est facile à installer et accroît la force anti-retrait et la stabilité radiale de la vis de pédicule, permettant ainsi d'améliorer l'effet d'ancrage d'un implant dans un patient avec une faible densité minérale d'os vertébral.
PCT/CN2013/083032 2012-09-17 2013-09-06 Vis de pédicule ayant un cran et vis de pédicule formant un élément de poussée et procédé WO2014040515A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN201210345780.4A CN103654936B (zh) 2012-09-17 2012-09-17 形成具有倒刺的椎弓根螺钉的推送器和方法
CN201210345780.4 2012-09-17

Publications (1)

Publication Number Publication Date
WO2014040515A1 true WO2014040515A1 (fr) 2014-03-20

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PCT/CN2013/083032 WO2014040515A1 (fr) 2012-09-17 2013-09-06 Vis de pédicule ayant un cran et vis de pédicule formant un élément de poussée et procédé

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CN (1) CN103654936B (fr)
WO (1) WO2014040515A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN106691570A (zh) * 2017-01-22 2017-05-24 北京爱康宜诚医疗器材有限公司 螺钉
CN110418613A (zh) * 2017-03-16 2019-11-05 坎努弗洛公司 用于将片状材料固定到目标组织的系统和方法
WO2022136558A1 (fr) * 2020-12-22 2022-06-30 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Vis excentrique à os chirurgicale modulaire

Families Citing this family (4)

* Cited by examiner, † Cited by third party
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EP3445263B1 (fr) * 2016-04-20 2023-03-29 Dignity Health Systèmes pour ensemble vis pédiculaire
CN107661140A (zh) * 2017-11-28 2018-02-06 广东工业大学 一种弹性倒钩医用骨螺钉
CN108013923A (zh) * 2017-12-01 2018-05-11 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 一种锚片强化骨螺钉
CN108324356A (zh) * 2018-02-07 2018-07-27 中国人民解放军第二军医大学第二附属医院 前路颈椎骨水泥椎弓螺钉钉板固定系统

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CN2538291Y (zh) * 2002-04-23 2003-03-05 周烈超 倒剌锁定加压髓内针
US20040153075A1 (en) * 2001-07-10 2004-08-05 Roger Gregory James Surgical fixation device
CN101023881A (zh) * 2006-02-23 2007-08-29 比德曼莫泰赫有限公司 骨固定装置
CN200991298Y (zh) * 2006-11-23 2007-12-19 喻恒锋 倒卡内锁加压髓内钉
CN101669837A (zh) * 2009-09-28 2010-03-17 雷伟 一种医用椎弓根翻修螺钉组件
CN102525628A (zh) * 2012-01-04 2012-07-04 张建林 一种全内锁定型带锁髓内钉

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US8636783B2 (en) * 2006-12-29 2014-01-28 Zimmer Spine, Inc. Spinal stabilization systems and methods
KR100872529B1 (ko) * 2007-05-31 2008-12-08 주식회사 지에스메디칼 척추경 나사못 모듈

Patent Citations (6)

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Publication number Priority date Publication date Assignee Title
US20040153075A1 (en) * 2001-07-10 2004-08-05 Roger Gregory James Surgical fixation device
CN2538291Y (zh) * 2002-04-23 2003-03-05 周烈超 倒剌锁定加压髓内针
CN101023881A (zh) * 2006-02-23 2007-08-29 比德曼莫泰赫有限公司 骨固定装置
CN200991298Y (zh) * 2006-11-23 2007-12-19 喻恒锋 倒卡内锁加压髓内钉
CN101669837A (zh) * 2009-09-28 2010-03-17 雷伟 一种医用椎弓根翻修螺钉组件
CN102525628A (zh) * 2012-01-04 2012-07-04 张建林 一种全内锁定型带锁髓内钉

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN106691570A (zh) * 2017-01-22 2017-05-24 北京爱康宜诚医疗器材有限公司 螺钉
CN110418613A (zh) * 2017-03-16 2019-11-05 坎努弗洛公司 用于将片状材料固定到目标组织的系统和方法
WO2022136558A1 (fr) * 2020-12-22 2022-06-30 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Vis excentrique à os chirurgicale modulaire

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Publication number Publication date
CN103654936B (zh) 2016-05-25
CN103654936A (zh) 2014-03-26

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