WO2019062070A1 - 一种可调节双槽脊柱内固定装置以及骨螺钉 - Google Patents

一种可调节双槽脊柱内固定装置以及骨螺钉 Download PDF

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Publication number
WO2019062070A1
WO2019062070A1 PCT/CN2018/082550 CN2018082550W WO2019062070A1 WO 2019062070 A1 WO2019062070 A1 WO 2019062070A1 CN 2018082550 W CN2018082550 W CN 2018082550W WO 2019062070 A1 WO2019062070 A1 WO 2019062070A1
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Prior art keywords
base
connecting rod
groove
slot
shaped groove
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PCT/CN2018/082550
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English (en)
French (fr)
Inventor
朱泽章
邱勇
刘明岩
刘瑞锋
Original Assignee
上海三友医疗器械股份有限公司
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.)
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Publication date
Priority claimed from CN201710892210.XA external-priority patent/CN109549696B/zh
Priority claimed from CN201721255595.0U external-priority patent/CN208625834U/zh
Application filed by 上海三友医疗器械股份有限公司 filed Critical 上海三友医疗器械股份有限公司
Priority to JP2019526609A priority Critical patent/JP6795225B2/ja
Priority to US16/482,712 priority patent/US11684393B2/en
Priority to EP18849453.8A priority patent/EP3689279B1/en
Priority to KR1020207010680A priority patent/KR102365489B1/ko
Priority to AU2018330957A priority patent/AU2018330957B9/en
Publication of WO2019062070A1 publication Critical patent/WO2019062070A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • 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
    • 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
    • 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
    • A61B17/7034—Screws or hooks with U-shaped head or back through which longitudinal rods pass characterised by a lateral opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7038—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other to a different extent in different directions, e.g. within one plane only
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/704—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other the longitudinal element passing through a ball-joint in the screw head
    • 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
    • A61B17/7041—Screws or hooks combined with longitudinal elements which do not contact vertebrae with single longitudinal rod offset laterally from single row of screws or hooks
    • 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
    • A61B17/7044—Screws or hooks combined with longitudinal elements which do not contact vertebrae also having plates, staples or washers bearing on the vertebrae
    • 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
    • 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
    • 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

Definitions

  • the present invention relates to a spinal internal fixation medical device, and more particularly to an adjustable double-slot spinal fixation device and a bone screw.
  • the commonly used spinal internal fixation devices include various pedicle screws that are used in conjunction with the nail rods and other ancillary instruments.
  • single-slot pedicle screws single-slot nails
  • double-slot pedicle screws referred to as double-slot nails
  • the single groove nail is commonly used for spinal degenerative diseases, spondylolisthesis, tumors, fractures and the like.
  • the double-slot nail is suitable for osteotomy, composite fixation of the lumbosacral bone and revision surgery.
  • osteotomy is needed, the osteotomy operation space can be ensured, the risk of spinal cord injury can be effectively reduced, and the orthopedic effect can be achieved.
  • the nail rod in one groove realizes the fixation of the lumbosacral bone
  • the nail rod in the other groove realizes the fixation of the lumbosacral bone.
  • the technical problem to be solved by the present invention is to provide an adjustable double-slot spinal internal fixation device for reducing the number of times of bending of the nail rod and ensuring its service life, thereby overcoming the defects of the prior art.
  • an adjustable double-slot spinal internal fixation device comprising a first base, a second base and a connecting rod, the first base and the second base are respectively opened from the top to the bottom a U-shaped groove, an inner wall of the U-shaped groove is provided with an internal thread, the connecting rod is disposed in a horizontal direction, the second base is provided with a long groove in a horizontal direction, and one end of the connecting rod is disposed at the first base The other end is disposed in a long slot of the second base, the connecting rod is swingable in the long slot, and the first base and the second base are relatively rotatable on the connecting rod.
  • the U-shaped groove on the second base is in communication with the long groove
  • the U-shaped groove of the second base is provided with a pressing block
  • the bottom surface of the pressing block is provided with a limiting protrusion
  • An annular groove is formed in the connecting rod, and the connecting rod penetrates into the groove bottom of the U-shaped groove through a long groove, and the limiting protrusion on the pressing block cooperates with the annular groove on the connecting rod .
  • the U-shaped groove on the second base is in communication with the long groove, and the U-shaped groove of the first base and the second base are respectively provided with the same pressing block, and the bottom surface of the pressing block A limiting protrusion is disposed, and two ends of the connecting rod are respectively provided with an annular groove, one end of the connecting rod penetrates into the groove bottom of the U-shaped groove of the first base, and the other end penetrates into the second base through the long groove
  • the bottom of the groove of the U-shaped groove, the limiting protrusion on the pressing block cooperates with the annular groove on the connecting rod.
  • the invention also provides a bone screw with the internal fixation device which is convenient and flexible.
  • the specific technical solution is that the first base 1 and/or the second base are provided with a screw rod.
  • the first base and/or the second base are provided with a ball socket, and one end of the screw rod is provided with a ball head, and the ball head cooperates with the ball socket.
  • the first base and/or the second base are provided with a threaded hole, and the screw rod is threadedly engaged with the threaded hole.
  • the two bases of the internal fixing device of the invention can be relatively rotated and relatively oscillated, and the position of the nail rod is adjusted according to the position of the nail rod, thereby reducing the number of bending rods on the nail rod, thereby reducing the stress of the nail rod caused by the bending rod. Concentration or scratching to ensure the service life of the nail rod and avoid premature failure.
  • the surgical efficiency can be effectively improved, the doctor's surgical operation is greatly facilitated, and the labor intensity and workload of the doctor are effectively reduced.
  • Figure 1 is a schematic view of the internal fixation device of the present invention.
  • Figure 2 is a first structural split view of the internal fixture of the present invention.
  • FIG 3 is a schematic top view of the first base and the second base in the present invention.
  • Figure 4 is a front elevational view of the second base of the present invention.
  • Figure 5 is a cross-sectional view taken along line A-A of Figure 4.
  • Figure 6 is a structural view of a pressing block in the present invention.
  • Figure 7 is a schematic view showing the structure of the pressing block and the connecting rod in the present invention.
  • Figure 8 is a schematic view showing the second structure of the internal fixing device of the present invention.
  • Figure 9 is a split view of Figure 8.
  • Figure 10 is a first structural view of the internal fixing device of the present invention with a break port.
  • Figure 11 is a schematic view showing the second structure of the internal fixing device with a broken opening according to the present invention.
  • Figure 12 is a schematic view showing the first structure of the bone screw of the present invention.
  • Figure 13 is a cross-sectional view of Figure 12 .
  • Figure 14 is a schematic view showing the second structure of the bone screw of the present invention.
  • Figure 15 is a schematic view showing the third structure of the bone screw of the present invention.
  • Figure 16 is a schematic view showing the use of the internal fixation device of the present invention.
  • Figure 17 is a schematic view showing the use of a bone screw with an internal fixation device of the present invention.
  • the present invention is an adjustable double-slot spinal internal fixation device comprising a first base 1, a second base 2 and a connecting rod 3, and the first base 1 and the second base 2 are upwardly Lower U-shaped grooves 4 are respectively formed, and the inner wall of the U-shaped groove 4 is provided with internal threads, and the connecting rods 3 are disposed in the horizontal direction.
  • the second base 2 has a long slot 21 in the horizontal direction.
  • One end of the connecting rod 3 is disposed on the first base 1 and the other end is disposed in the long slot 21 of the second base 2, the connecting rod 3 can swing in the long groove 21, that is, the first base 1 and the second base 2 can swing relative to each other in the horizontal direction as shown in FIG. 3; the first base 1 and the second base 2 can also be connected to the rod 3 Relative rotation.
  • the width of the long groove 21 on the second base 2 is the left and right direction in FIG. 4, and the specific structure of the long groove 21 is as shown in FIG. 5, and the both end portions are large mouth portions having a large width.
  • the middle portion is a small mouth portion 212 having a small width, and the small mouth portion 212 in the middle can effectively limit the position of the connecting rod 3 at the time of swinging, and is equivalent to swinging around the small small mouth portion 212 to ensure the first base 1 when swinging. And the stability of the second base 2 used.
  • Embodiment 1 is a diagrammatic representation of Embodiment 1:
  • the annular groove 31 of the connecting rod 3 can be seen through the U-shaped groove 4, and the pressing block 5 is placed in the U shape.
  • the limiting protrusion 51 can be inserted into the annular groove 31 for limiting, so that the connecting rod 3 can be rotated relative to the pressing block 5, that is, the second base 2 can surround the connecting rod 3. Free rotation, thereby achieving relative rotation of the first base 1 and the second base 2.
  • the pressing block 5 rotates in synchronization with the connecting rod 3; (2) the pressing block 5 is an elastic material, and when the connecting rod 3 rotates, the pressing block 5 generates an elastic shape to become a swing providing condition of the connecting rod 3.
  • the pressing block 5 is an inverted U-shaped structure that is adapted to the shape of the connecting rod 3.
  • the two ends are respectively provided with an inner plate 52 and an outer plate 53, and the inner plate 52 is provided.
  • the shape of the inner plate 52 toward the side of the connecting rod 3 is adapted to the outer wall of the connecting rod 3.
  • the two inner plates 52 are first expanded outward and then received inward.
  • the gap 54 provides a deformation space for the expansion and adduction of the inner panel 52.
  • the second structure of the present invention is that one end of the connecting rod 3 is rotatably disposed on the first base 1 and the other end is rotatably disposed on the second base 2, that is, A base 1 and a second base 2 are rotatably coupled to the connecting rod 3.
  • the specific implementation structure is the same as the first structure described above, that is, the U-shaped slot 4 on the second base 2 communicates with the long slot 21, and the U-shaped slot 4 of the first base 1 and the second base 2
  • the bottom surface of the pressing block 5 is provided with a limiting protrusion 51, and the two ends of the connecting rod 3 respectively have an annular groove 31, one end of the connecting rod 3
  • the bottom of the U-shaped groove 4 of the first base 1 is inserted into the bottom of the groove of the U-shaped groove 4 of the second base 2 through the long groove 21, and the limiting protrusion 51 on the pressing block 5 is The annular groove 31 on the connecting rod 3 is fitted.
  • the two ends of the connecting rod 3 are respectively inserted into the first base 1 and the second base 2, and the annular groove 31 can be seen through the two U-shaped grooves 4, and the two pressing blocks 5 are respectively respectively
  • the limiting protrusions 51 on the two pressing blocks 5 respectively enter the annular groove 31 for limiting
  • the connecting rod 3 can freely rotate relative to the two bases, thereby achieving the first The relative rotation of the base 1 and the second base 2.
  • the position between the two bases in this embodiment is also restricted by the limit projections 51 and the annular grooves 31, and depending on the distance between the two annular grooves 31, a plurality of models can be produced.
  • the swinging fit structure of the connecting rod 3 and the second base 2 in this embodiment is the same as that in the first embodiment.
  • the two side walls of the U-shaped groove 4 of the first base 1 and/or the two side walls of the U-shaped groove 4 of the second base 2 are broken. Mouth 41.
  • the fracture opening 41 can be broken as needed to meet the surgical needs of different situations.
  • a specific structure is shown in FIG. 10, wherein the height of the first base 1 is greater than the height of the second base 2, and the fracture opening 41 is opened on both side walls of the U-shaped groove 4 of the first base 1; the fracture is not broken.
  • the U-shaped groove 4 on the first base 1 can increase the setting range of the nail bar in the U-shaped groove 4; breaking the broken opening 41 can make the heights of the first base 1 and the second base 2 the same.
  • FIG. 11 Another specific structure is shown in FIG. 11 , wherein the first base 1 and the second base 2 have the same height, and the fracture openings 41 are respectively formed on the two side walls of the U-shaped groove 4 , and the structural principle and the use method are as shown in FIG. 10 . the same.
  • the first base 1 has a through hole 11 communicating with the bottom surface at the bottom of the slot of the U-shaped slot 4, and a ball is disposed in the through hole 11.
  • the socket of the screw rod 6 is provided with a ball head 61.
  • the screw rod 6 penetrates the through hole 11 from the U-shaped groove 4.
  • the ball head 61 is engaged with the ball socket, it is installed in position, and then the pressure head 8 is placed into a U shape.
  • the groove 4, the indenter 8 is also an inverted U-shaped structure, and the lower part has two pressing portions, and the pressing portion can be pressed against the ball head 61 to limit the position of the ball head, that is, the first base 1 and the screw rod 6 Universal cooperation.
  • FIG. 16 a schematic view of the use of the internal fixing device of the present invention, in conjunction with FIGS. 1-7 and 16, a nail rod 7 is respectively mounted on the first base 1 and the second base 2, and the two nail rods 7 are simultaneously Cooperating with other bone screws, the first base 1 and the second base 2 are not connected to the vertebra 10, and are in a suspended state, because the first base 1 and the second base 2 are relatively rotatable and relatively swingable, so that they can be bent In the case of the dowel 7 , the two studs 7 are guided to play a guiding role.
  • the bone screw of the present invention with the internal fixation device is used, as shown in FIG. 17, wherein the second base 2 is provided with a screw 6, which is combined with FIG. - Figure 7, Figure 12, Figure 17, the screw rod 6 on the second base 2 is screwed into the vertebra 10 to achieve overall positioning, and the first base 1 and the second base 2 are respectively mounted with a nail rod 7, two nail rods 7
  • the bone screw of the present invention plays a role of guiding the two nail rods 7 at the same time as the positioning.
  • the adjustable double-slot spinal internal fixation device and the bone screw of the invention can solve the problem that the bending rod of the nail rod is excessive, the operation is time-consuming and laborious, and the operation efficiency can be effectively improved. Therefore, the present invention effectively overcomes some practical problems in the prior art and has high utilization value and use significance.

Abstract

一种可调节双槽脊柱内固定装置，包括第一底座（1）、第二底座（2）和连接棒（3），第一底座（1）和第二底座（2）从上向下分别开有U形槽（4），U形槽（4）的内壁设有内螺纹，连接棒（3）沿水平方向设置，第二底座（2）沿水平方向开有长槽（21），连接棒（3）的一端穿设在第一底座（1）上，另一端穿设在第二底座（2）的长槽（21）中，连接棒（3）能够在长槽（21）中摆动，第一底座（1）和第二底座（2）能够在连接棒（3）上相对转动，内固定装置减少了因弯棒造成的钉棒应力集中或划痕，保证钉棒的使用寿命。一种带有内固定装置的骨螺钉，第一底座（1）和/或第二底座（2）设有螺钉杆（6），骨螺钉使用方便、灵活。

Description

一种可调节双槽脊柱内固定装置以及骨螺钉 技术领域
本发明涉及脊柱内固定医疗器械，尤其涉及一种可调节双槽脊柱内固定装置以及骨螺钉。
背景技术
脊柱内固定技术是目前脊柱疾病广泛使用的手术技术，早期内固定手术均采用较为简单的方式，比如用银丝固定颈椎的颈椎骨融合术等。脊柱内固定的技术发展主要是为了满足脊柱矫形的需要，比如经前路或后路脊柱侧凸畸形的矫正、脊柱畸形的多阶段复位等。脊柱内固定技术的一个飞跃是经椎弓根螺钉技术的出现，目前经椎弓根螺钉固定技术已经成为脊柱内固定技术的核心技术。
现在常用的脊柱内固定装置包括各种椎弓根螺钉，其配合钉棒及其他一些辅助器械使用。目前，已经使用的包括单槽椎弓根螺钉(简称单槽钉)和双槽椎弓根螺钉(简称双槽钉)。
所述单槽钉常用于脊柱退行性病变、滑脱、肿瘤、骨折等手术。所述双槽钉适合截骨手术、腰骶髂骨的复合固定和翻修手术。在需要截骨时，可确保截骨操作空间稳定，有效降低脊髓损伤风险，实现矫形效果。复合固定时，一个槽中的钉棒实现腰骶骨固定，另一个槽中的钉棒实现腰髂骨固定。
上述双槽钉可以在手术时提供很大的方便性，但还是存在一些无法解决的问题，例如将两个钉棒安装在双槽钉上时，钉棒必须要平行固定，这就增加了折棒弯棒的次数和可能性。在业内公知的，为了起到矫正效果，钉棒的刚度较大，而不同病人的实际情况不同，临时弯棒耗费时间，容易出现反复弯棒仍然无法满足使用要求的情况，这就会导致钉棒应力集中或划痕，使用寿命收到很大影响，容易失效。
发明内容
本发明要解决的技术问题在于提供一种减少钉棒的弯棒次数，保证其使用寿命的可调节双槽脊柱内固定装置，以克服现有技术上的缺陷。
为了解决上述技术问题，本发明采用如下技术方案：一种可调节双槽脊柱内固定装置，包括第一底座、第二底座和连接棒，第一底座和第二底座从上向下分别开有U形槽，所述U形槽的内壁设有内螺纹，所述连接棒沿水平方向设置，所述第二底座沿水平方向开有长槽，所述连接棒的一端穿设在第一底座上，另一端穿设在第二底座的长槽中，所述连接棒能够在所述长槽中摆动，所述第一底座和第二底座能够在连接棒上相对转动。
优选地，所述连接棒的一端固定穿设在第一底座上，另一端可以转动的穿设在第二底座上。
进一步地，第二底座上的U形槽和所述长槽相连通，所述第二底座的U形槽中设有压紧块，所述压紧块的底面设有限位凸起，所述连接棒上开有环形凹槽，所述连接棒通过长槽穿入所述U形槽的槽底，所述压紧块上的限位凸起与所述连接棒上的环形凹槽相配合。
优选地，所述连接棒的一端可转动的穿设在第一底座上，另一端可转动的穿设在第二底座上。
进一步地，第二底座上的U形槽和所述长槽相连通，所述第一底座和第二底座的U形槽中分别设有结构相同的压紧块，所述压紧块的底面设有限位凸起，所述连接棒的两端分别开有环形凹槽，所述连接棒的一端穿入第一底座的U形槽的槽底，另一端通过长槽穿入第二底座的U形槽的槽底，所述压紧块上的限位凸起与连接棒上的环形凹槽相配合。
优选地，所述第一底座的U形槽的两个侧壁上和/或第二底座的U形槽的两个侧壁上开有折断口。
本发明还提供一种使用方便、灵活的带有所述内固定装置的骨螺钉，具体技术方案为：第一底座1和/或第二底座设有螺钉杆。
优选地，所述第一底座和/或第二底座开有球窝，所述螺钉杆的一端设有球头，所述球头与球窝相配合。
优选地，所述第一底座和/或第二底座开有螺纹孔，所述螺钉杆与螺纹孔螺纹配合。
如上所述，本发明一种可调节双槽脊柱内固定装置以及骨螺钉，具有以下有益效果：
本发明内固定装置的两个底座可以相对转动、相对摆动，根据钉棒调节位置，起到过渡导向作用，进而减少对钉棒的弯棒次数，也就减少了因弯棒造成的钉棒应力集中或划痕，保证钉棒的使用寿命，避免过早实现失效。此外，因为在实际使用时能够有效减小弯棒次数，所以可以有效提高手术效率，为医生的手术操作带来极大方便，有效减小医生的劳动强度和工作量。
本发明带有内固定装置的骨螺钉使用方便、灵活，工作效果好。
附图说明
图1为本发明内固定装置的示意图。
图2为本发明内固定装置的第一种结构拆分图。
图3为本发明中第一底座和第二底座的俯视摆动示意图。
图4为本发明中第二底座的主视图。
图5为图4中A-A处剖视图。
图6为本发明中压紧块的结构图。
图7为本发明中压紧块和连接棒的结构原理示意图。
图8为本发明内固定装置的第二种结构示意图。
图9为图8的拆分图。
图10为本发明内固定装置带有折断口的第一种结构示意图。
图11为本发明内固定装置带有折断口的第二种结构示意图。
图12为本发明骨螺钉的第一种结构示意图。
图13为图12的剖视图。
图14为本发明骨螺钉的第二种结构示意图。
图15为本发明骨螺钉的第三种结构示意图。
图16为本发明内固定装置的使用示意图。
图17为本发明带有内固定装置的骨螺钉使用示意图。
图中：
1     第一底座                2     第二底座
3     连接棒                  4     U形槽
5     压紧块                  31    环形凹槽
51    限位凸起                21    长槽
52    内板                    53    外板
54    间隙                    6     螺钉杆
7     钉棒                    8     压头
61    球头                    11    通孔
10    椎骨                    211   大口部
212   小口部                  41    折断口
具体实施方式
说明书附图所绘示的结构、比例、大小等，均仅用以配合说明书所揭示的内容，以供熟悉此技术的人士了解与阅读，并非用以限定本发明可实施的限定条件，故不具技术上的实质意义，任何结构的修饰、比例关系的改变或大小的调整，在不影响本发明所能产生的功效及所能达成的目的下，均应落在本发明所揭示的技术内容所能涵盖的范围内。同时，本说明书中所引用的如“上”、“下”、“前”、“后”、“中间”等用语，亦仅为便于叙述的明了，而非用以限 定本发明可实施的范围，其相对关系的改变或调整，在无实质变更技术内容下，当亦视为本发明可实施的范畴。
在脊柱外科手术中，有些位置不方便植入骨螺钉，但是又需要通过钉棒实现位置矫正或过渡，本内固定装置就是应用在这些位置，其能够为脊椎手术提供方便。
如图1-图5所示，本发明为一种可调节双槽脊柱内固定装置，包括第一底座1、第二底座2和连接棒3，第一底座1和第二底座2从上向下分别开有U形槽4，所述U形槽4的内壁设有内螺纹，所述连接棒3沿水平方向设置。所述第二底座2沿水平方向开有长槽21，所述连接棒3的一端穿设在第一底座1上，另一端穿设在第二底座2的长槽21中，所述连接棒3能够在所述长槽21中摆动，即第一底座1和第二底座2可以如图3所示在水平方向相对摆动；所述第一底座1和第二底座2还能够在连接棒3上相对转动。
本发明的结构原理是：因为第一底座1和第二底座2通过连接棒3连接形成整体结构，使用时，医用的钉棒分别放置在两个底座的U形槽4中，然后使用压紧帽与U形槽4上的内螺纹配合将钉棒分别压紧在U形槽4中。因为两个底座可以相对转动和相对摆动，进而可以带着钉棒灵活地调整位置，钉棒自身不会多次弯折，减少应力集中和划痕，使得钉棒的失效机会减少，保证使用寿命。
结合图2-图5，本发明中第二底座2上的长槽21宽度即图4中的左右方向，长槽21的具体结构如图5所示，两端部分是宽度较大的大口部211，中间部分是宽度较小的小口部212，通过中间的小口部212能够有效限制连接棒3在摆动时的位置，相当于以中间的小口部212为中心摆动，保证摆动时第一底座1和第二底座2使用的稳定性。
实施例一：
本发明的第一种结构是连接棒3的一端固定穿设在第一底座1上，另一端可以转动的穿设在第二底座2上，从而实现两个底座的相对转动。具体实施结构是：参考图2-图7，所述U形槽4和所述长槽21相连通，所述第二底座2的U形槽4中设有压紧块5，所述压紧块5的底面设有限位凸起51，所述连接棒3上开有环形凹槽31，所述连接棒3通过长槽21穿入所述U形槽4的槽底，所述压紧块5上的限位凸起51与所述连接棒3上的环形凹槽31相配合。即在使用时，当连接棒3的端部插入第二底座2的长槽21中时，通过U形槽4能够看到连接棒3的环形凹槽31，将压紧块5放入U形槽4中时，能够让限位凸起51进入到所述环形凹槽31中进行限位，进而实现连接棒3能相对压紧块5转动，也就是第二底座2能够绕着连接棒3自由转动，从而实现第一底座1和第二底座2的相对转动。本实施例中的限位凸起51和环形凹槽31配合后能够限制第二底座2在连接棒3上的位置，第一底座1和第二底 座2之间的距离是确定的，即在生产加工时，可以根据环形凹槽31的位置确定两个底座的间距，得到多个型号的产品。此外，为了实现连接棒3与第二底座2的相对摆动，可以有以下几种方式实现：(1)所述压紧块5能够相对第二底座2独立在水平面内转动，连接棒3摆动时压紧块5与连接棒3同步转动；(2)所述压紧块5为弹性材料，当连接棒3转动时，压紧块5产生弹性形变为连接棒3的摆动提供条件。在本实施例中，如图6所示，所述压紧块5是与连接棒3形状相适配的倒U形结构，其两端分别设有内板52和外板53，内板52和外板53之间有间隙54，内板52能够产生弹性形变，所述限位凸起51设置在内板52上。所述内板52朝向连接棒3一侧的形状与连接棒3外壁相适配，在将压紧块5压在连接棒3上时，两个内板52先向外扩再向内收，以便于有效贴靠在连接棒3上，所述间隙54为内板52的外扩和内收提供形变空间。当连接棒3相对第二底座2摆动时，压紧块5相对于连接棒3不动，压紧块5随着连接棒3的摆动以小口部212为中心转动。
实施例二：
结合图7-图9，本发明的第二种结构是所述连接棒3的一端可转动的穿设在第一底座1上，另一端可转动的穿设在第二底座2上，即第一底座1和第二底座2均可转动的与连接棒3配合。具体实施结构与上述第一种结构的原理相同，即：第二底座2上的U形槽4和所述长槽21相连通，所述第一底座1和第二底座2的U形槽4中分别设有结构相同的压紧块5，所述压紧块5的底面设有限位凸起51，所述连接棒3的两端分别开有环形凹槽31，所述连接棒3的一端穿入第一底座1的U形槽4的槽底，另一端通过长槽21穿入第二底座2的U形槽4的槽底，所述压紧块5上的限位凸起51与连接棒3上的环形凹槽31相配合。即在使用时，连接棒3的两端分别插入第一底座1和第二底座2，通过两个U形槽4能够看到所述环形凹槽31，将两个所述压紧块5分别放入U形槽4中时，两个压紧块5上的限位凸起51分别进入到一个环形凹槽31中进行限位，连接棒3可以相对两个底座自由转动，从而实现第一底座1和第二底座2的相对转动。本实施例中的两个底座之间的位置也是通过限位凸起51和环形凹槽31限制的，根据两个环形凹槽31之间距离的不同，也可以生产出多个型号的产品。本实施例中连接棒3与第二底座2的摆动配合结构与实施例一相同。
如图10和图11所示，本发明中所述第一底座1的U形槽4的两个侧壁上和/或第二底座2的U形槽4的两个侧壁上开有折断口41。折断口41可以根据需要进行折断，进而满足不同情况的手术需要。一种具体结构如图10所示，其中第一底座1的高度大于第二底座2的高度，在第一底座1的U形槽4两个侧壁开设折断口41；不折断所述折断口41时，第一底座1上的U形槽4可以提高钉棒在U形槽4中的设置范围；折断所述折断口41则能让第一底 座1和第二底座2的高度相同。另一种具体结构如图11所示，其中第一底座1和第二底座2高度相同，并且分别在U形槽4的两个侧壁开设折断口41，结构原理和使用方法与如图10相同。
结合图1、图12和图13，本发明还公开一种带有所述内固定装置的骨螺钉，第一底座1和/或第二底座2设有螺钉杆6。即第一底座1和第二底座2上可以分别穿设有一个螺钉杆6，也可以是第一底座1和第二底座2的其中之一设置螺钉杆6。
结合图12和如图13，本骨螺钉的一种具体结构是：所述第一底座1在所述U形槽4的槽底开有与底面连通的通孔11，通孔11中设置球窝，螺钉杆6的一端设置球头61，螺钉杆6从U形槽4穿入所述通孔11，当球头61与球窝配合好时安装到位，然后将压头8放入U形槽4，所述压头8也为倒U形结构，其下部有两个压紧部，压紧部能够压靠在球头61上限制球头的位置，即第一底座1与螺钉杆6万向配合。
本骨螺钉的另一种具体结构是：所述第一底座1和/或第二底座2的底部开有螺纹孔，所述螺钉杆6与螺纹孔螺纹配合，即相对固定配合。此外，螺钉杆6可以焊接在第一底座1和/或第二底座2上。
图14和图15分别为带有折断口41的两种骨螺钉结构示意图。
如图16所示，为本发明内固定装置的使用示意图，结合图1-图7、图16，第一底座1和第二底座2上分别安装有钉棒7，两个钉棒7还同时与其他骨螺钉配合，第一底座1和第二底座2与椎骨10没有连接关系，处于悬空状态，因为第一底座1和第二底座2是可以相对转动和相对摆动的，因此可以在不弯折钉棒7的情况下实现两个钉棒7导向，起到过渡导向作用。
在脊柱外科手术中，对于可以植入骨螺钉的位置，则使用本发明带有所述内固定装置的骨螺钉，如图17所示，其中第二底座2上设有螺钉6，结合图1-图7、图12、图17，第二底座2上的螺钉杆6旋入椎骨10，实现整体定位，第一底座1和第二底座2上分别安装有钉棒7，两个钉棒7还同时与其他骨螺钉配合，本发明的骨螺钉在实现定位的同时，对两个所述钉棒7起到过渡导向作用。
综上所述，本发明的一种可调节双槽脊柱内固定装置以及骨螺钉，能够解决钉棒弯棒过多、操作费时费力的问题，能有效提高手术效率。所以，本发明有效克服了现有技术中的一些实际问题从而有很高的利用价值和使用意义。
上述实施方式仅例示性说明本发明的原理及其功效，而非用于限制本发明。本发明还有许多方面可以在不违背总体思想的前提下进行改进，对于熟悉此技术的人士皆可在不违背本 发明的精神及范畴下，可对上述实施例进行修饰或改变。因此，举凡所属技术领域中具有通常知识者在未脱离本发明所揭示的精神与技术思想下所完成的一切等效修饰或改变，仍应由本发明的权利要求所涵盖。

Claims (9)

  1. 一种可调节双槽脊柱内固定装置，其特征在于：包括第一底座(1)、第二底座(2)和连接棒(3)，第一底座(1)和第二底座(2)从上向下分别开有U形槽(4)，所述U形槽(4)的内壁设有内螺纹，所述连接棒(3)沿水平方向设置，所述第二底座(2)沿水平方向开有长槽(21)，所述连接棒(3)的一端穿设在第一底座(1)上，另一端穿设在第二底座(2)的长槽(21)中，所述连接棒(3)能够在所述长槽(21)中摆动，所述第一底座(1)和第二底座(2)能够在连接棒(3)上相对转动。
  2. 根据权利要求1所述的一种可调节双槽脊柱内固定装置，其特征在于：所述连接棒(3)的一端固定穿设在第一底座(1)上，另一端可以转动的穿设在第二底座(2)上。
  3. 根据权利要求2所述的一种可调节双槽脊柱内固定装置，其特征在于：第二底座(2)上的U形槽(4)和所述长槽(21)相连通，所述第二底座(2)的U形槽(4)中设有压紧块(5)，所述压紧块(5)的底面设有限位凸起(51)，所述连接棒(3)上开有环形凹槽(31)，所述连接棒(3)通过长槽(21)穿入所述U形槽(4)的槽底，所述压紧块(5)上的限位凸起(51)与所述连接棒(3)上的环形凹槽(31)相配合。
  4. 根据权利要求1所述的一种可调节双槽脊柱内固定装置，其特征在于：所述连接棒(3)的一端可转动的穿设在第一底座(1)上，另一端可转动的穿设在第二底座(2)上。
  5. 根据权利要求4所述的一种可调节双槽脊柱内固定装置，其特征在于：第二底座(2)上的U形槽(4)和所述长槽(21)相连通，所述第一底座(1)和第二底座(2)的U形槽(4)中分别设有结构相同的压紧块(5)，所述压紧块(5)的底面设有限位凸起(51)，所述连接棒(3)的两端分别开有环形凹槽(31)，所述连接棒(3)的一端穿入第一底座(1)的U形槽(4)的槽底，另一端通过长槽(21)穿入第二底座(2)的U形槽(4)的槽底，所述压紧块(5)上的限位凸起(51)与连接棒(3)上的环形凹槽(31)相配合。
  6. 根据权利要求1所述的一种可调节双槽脊柱内固定装置，其特征在于：所述第一底座(1)的U形槽(4)的两个侧壁上和/或第二底座(2)的U形槽(4)的两个侧壁上开有折断口(41)。
  7. 一种骨螺钉，其特征在于：带有权利要求1所述的内固定装置，第一底座(1)和/或第二 底座(2)上设有螺钉杆(6)。
  8. 根据权利要求7所述的骨螺钉，其特征在于：所述第一底座(1)和/或第二底座(2)开有球窝，所述螺钉杆(6)的一端设有球头，所述球头与球窝相配合。
  9. 根据权利要求7所述的骨螺钉，其特征在于：所述第一底座(1)和/或第二底座(2)开有螺纹孔，所述螺钉杆(6)与螺纹孔螺纹配合。
PCT/CN2018/082550 2017-09-27 2018-04-10 一种可调节双槽脊柱内固定装置以及骨螺钉 WO2019062070A1 (zh)

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JP2019526609A JP6795225B2 (ja) 2017-09-27 2018-04-10 調節可能な二溝式脊柱内部固定装置及び骨スクリュー
US16/482,712 US11684393B2 (en) 2017-09-27 2018-04-10 Adjustable double-slot internal spinal fixation apparatus and bone screw
EP18849453.8A EP3689279B1 (en) 2017-09-27 2018-04-10 Adjustable double-slot spinal internal fixing device and bone screw
KR1020207010680A KR102365489B1 (ko) 2017-09-27 2018-04-10 조절가능한 이중 슬롯 척추 내부 고정장치 및 골나사
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