WO2019073046A1 - Instrument permettant de relier une tige correctrice à une vis à os - Google Patents

Instrument permettant de relier une tige correctrice à une vis à os Download PDF

Info

Publication number
WO2019073046A1
WO2019073046A1 PCT/EP2018/077908 EP2018077908W WO2019073046A1 WO 2019073046 A1 WO2019073046 A1 WO 2019073046A1 EP 2018077908 W EP2018077908 W EP 2018077908W WO 2019073046 A1 WO2019073046 A1 WO 2019073046A1
Authority
WO
WIPO (PCT)
Prior art keywords
instrument according
clip
legs
leg
instrument
Prior art date
Application number
PCT/EP2018/077908
Other languages
German (de)
English (en)
Inventor
Frank Heuer
Original Assignee
Silony Medical International AG
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 Silony Medical International AG filed Critical Silony Medical International AG
Publication of WO2019073046A1 publication Critical patent/WO2019073046A1/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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7083—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
    • A61B17/7086—Rod reducers, i.e. devices providing a mechanical advantage to allow a user to force a rod into or onto an anchor head other than by means of a rod-to-bone anchor locking element; rod removers

Definitions

  • the invention relates to an instrument for connecting a correction rod with a bone screw, in particular a pedicle screw, with an axial longitudinal direction, a radial direction and a circumferential direction, with an outer first housing part, which has an approximately half-shell-shaped portion forming a first clip leg, and with an approximately half-shell-shaped outer second housing part, which forms a second clip leg, which extends on the first clip leg via a pivot joint about an orthogonal to the axial longitudinal direction Swivel axis is pivotally hinged, and with a the outer housing parts axially passing through and thus inner adjustment part, wherein a proximal end of the adjustment of the outside of the housing parts is manually actuated, and with a rod pressure member which is axially applied against the correction rod and with the
  • Setting member is axially coupled, but is rotatable relative to the adjusting member about the axial longitudinal direction, so that rotational movements of the adjusting member not on the
  • Clamp legs surround the rod pressure member shell-shaped and receive longitudinally displaceable and each having a distal end portion, with which they engage the bone screw, and wherein the second clip leg through
  • Finger pressure on its proximal end by the using surgeon in the release position is actuated.
  • Such an instrument is typically referred to as
  • Correction rod which should usually connect several bone screws, especially pedicle screws, with respect to a respective bone screw in the vom
  • Bone screw is fixed.
  • the bone screw has a shaft which can be introduced into the bone and a so-called fork head, which generally has two limbs, which forms a groove for receiving the correction rod.
  • a fastener in particular a grub screw, and optionally other components, in particular a pressure piece is inserted to the correction rod to fix after positioning against the clevis or the bone screw.
  • the clevis is brought into a desired orientation with respect to the shaft, before the components finally
  • Pivot pin formed, but the interlocking hinge portions extend in a plane.
  • Wall thickness of one of the joint areas which represents a significant gain of usable space that can be used elsewhere.
  • a female threaded portion is provided in the first housing part proximal to the approximately half-shell-shaped portion and the adjusting part has a male thread at a portion and thus in the female threaded portion at the outer first housing part can be screwed.
  • the female threaded portion of the first housing part proximal to the approximately half-shell-shaped portion
  • the puzzle-like interlocking hinge areas are preferably of wall areas of the respective
  • Clamp leg a tongue-shaped projection formed by a wall portion of the staple leg, and on the other staple leg to this projection is substantially complementary recess bounded by a wall portion of this staple leg. It should be noted that the orientation of the projection and the recess preferably but not necessarily in the
  • the projection and the complementary recess may also be inclined in the distal or proximal direction.
  • Pivot axis may in this case in the direction of receiving the bone screw for the correction rod, ie in the direction of the correction rod, or orthogonal thereto, as in WO 2016/150920 AI.
  • a radial wall thickness or radial extent of the pivot joint is less than the sum of wall thicknesses of the puzzle-like interlocking joint regions of the clip legs.
  • the radial wall thickness or radial extent of the pivot joint at most is great as the wall thickness of one of the puzzle-like interlocking joint areas of the clip legs.
  • Staple leg is formed and if on the other
  • Clamp leg is limited. This opens up a simple manufacture and reliability of the staple legs or the pivot joint between the staple legs.
  • this recess is formed or delimited by two web portions projecting from one edge of the one clip leg and to be strung together, which then surround the tongue-shaped projection when the pivot joint is formed.
  • Staple legs are inserted into each other. This means that the clip legs are each made separately from each other and then their joint areas in
  • Circumferential direction an angle of more than 180 °
  • Securing element in turn is held captive in a securing position on the staple legs, which can be achieved by the above measures.
  • the securing element in a substantially circumferentially extending recess or groove on the one or both clip legs
  • the securing element still performs a more extensive function. It is then proposed that the securing element is a spring element and
  • Staple legs is kept captive.
  • the subject of the invention is therefore also considered an instrument for forming a Access channel to a bone anchor, in particular a bone screw, having an axial longitudinal direction, a radial direction and a circumferential direction, with an outer first housing part, which has an approximately half-shell-shaped portion which forms a first staple leg, and with an approximately
  • half-shell-shaped outer second housing part which forms a second clip leg, which runs on the first clip leg via a pivot joint about an orthogonal to the axial longitudinal direction
  • Swivel axis is hinged pivotally, and wherein the
  • Clip legs each have a distal end portion
  • Swivel joint is formed by the two
  • Such an instrument can be used, for example, in minimally invasive surgery,
  • Figure 1 is a perspective view of
  • Instrument according to the invention in the fortified Condition on a bone screw with indicated correction rod in a first operating position
  • Figure 2 is a perspective view of
  • Figure 3 is a perspective view of
  • Instruments comprising i.a. a first and second clip legs;
  • Figure 5a is a side view of the components of Figure 4 in the joined state
  • Figure 6a is another perspective view of the
  • FIG. 6b shows internal components of the instrument
  • FIG. 6c shows the instrument according to FIG. 6a without setting part and bar pressure part
  • a) to c) is a longitudinal sectional view, a plan view and a detailed view of the instrument of Figure 1 to illustrate the drive connection
  • a) to c) is a longitudinal sectional view, a plan view and a detailed view of the instrument of Figure 1 to illustrate the drive connection
  • Figures 1-8 show a plurality of views of a first embodiment of an instrument 2 according to the invention for connecting a correction rod 4 with a
  • Bone screw 6 is an example of a so-called pedicle screw for spinal surgery, with a threaded shaft 8, the has at its proximal end a head 10, which in turn in the case exemplified polyaxially pivotable in a two leg 12 having
  • FIG. 4 illustrates an axial longitudinal direction A, a radial direction R and a circumferential direction U for this purpose.
  • the instrument according to the invention is a so-called reduction instrument for
  • the instrument 2 comprises a first outer housing part 18, which has a first approximately half-shell-shaped portion 20 which forms a first staple leg 22, and a second outer housing part 24, the second staple leg 26 forms.
  • the first and the second clip legs 22, 26 are pivotally connected to each other via a pivot joint 28 in a manner to be described in more detail.
  • the instrument 2 comprises an adjusting part 30 shown separately in FIGS.
  • the setting part 30 has, in the example and preferred illustrated case, an external thread 34 with which it can be screwed in relation to the first outer housing part 18 in a manner still to be described in detail. This results in an axial adjustment of the adjusting member 30 relative to the outer housing parts 18 and 24 at the same time.
  • the adjusting member 30 is connected to the bar pressure member 32nd axially coupled, but rotatable relative thereto, so that a longitudinal adjustment of the adjusting member 30 on the
  • Rod member 32 is transmitted, so that the rod pressure member 32 with distal end portions 36, the correction rod 4 in its intended mounting position on the
  • Bone screw 6 can bring.
  • the rod pressure member 32 is longitudinally displaceable between the two housing parts 18, 24 and staple legs 22, 26, however, rotationally fixed
  • the pivot joint 28 is preferably formed in that the two clip legs 22, 26 have puzzle-like articulated areas 38, 40. They are formed by respective wall regions 42, 44 of the clip legs 22, 26.
  • the hinge portions 38, 40 include a
  • tongue-shaped projection 46 for example in the first clip leg 22, and a complementary thereto
  • Recess 48 in the other clip leg 26 Recess 48 in the other clip leg 26.
  • the recess 48 of two projecting from an edge 50 of the second clip leg 26 and the projection 46 around each striving web portions 51, 52 is limited.
  • the free ends of these web portions 51, 52 at the same time form a
  • Stop limit 54, 56 for the pivotability of the clip legs 22, 26 to each other.
  • the two clip legs 22, 26 are preferably prefabricated and then joined together by the
  • Swivel joint 28 are positioned side by side and then inserted into each other in the direction of the pivot axis 58 like puzzle pieces.
  • a securing element 60 is provided in the form of a spring element 62, which is clipped onto the joined clip legs.
  • the securing element 60 itself is part-ring-shaped and held captive in the mounting situation illustrated in FIGS. 5a, 5b.
  • the clip legs 22, 26 has a circumferentially extending groove 64 which is wider in the axial direction A than the securing element 60.
  • the securing element 60 has a radially inwardly projecting projection 66 which in a recess 68 in the clip leg 26th intervenes. Due to the game lag in the axial
  • Staple legs 22, 26 is generated, which tries to pivot the distal end portions 72, 74 toward each other again. But it would also be possible for the Provision of separate spring means can be used.
  • the instrument 2 is opened and can be releasably fixed to the hintergreifbaren areas 16 of the clevis 14 of the bone screw 6.
  • an internally threaded portion 90 is provided proximal to the approximately half-shell-shaped portion 20, which is not formed directly by the first housing part 18, but on a transversely adjustable to the axial longitudinal support body 92nd
  • the internal thread portion 90 is also not continuous in the circumferential direction U, but it is only in a relatively small circumferential angle segment
  • the carrier body 92 is preferably formed sleeve-shaped and further included in the exemplary and preferred case in a guide body 94.
  • this guide body 94 is designed such that it is arranged radially outside the first housing part 18. It can be set with respect to the first housing part 18 immovable. He has in the example shown two spaced apart and in the circumferential direction U
  • Flange portions 96 is formed in the axial longitudinal direction extending bearing portion 98. Between the inside of the bearing portion 98 and an outer side 100 of the support body 92 are exemplified two
  • Compression spring 102 supported, which press the carrier body 92 radially inward in the position shown in the figures and in particular in Figure 7.
  • the carrier body 92 projects with its internally threaded portion 90 into the clear opening 104 of the first housing part 18.
  • the adjusting member 30 is in this position with its external thread 34 in the
  • Internal thread section 90 can be screwed. It also rotates with respect to the non-rotatably received between the housing parts bar pressure member 32 and moves it in the distal direction or in the opposite proximal direction.
  • Housing body 18 in the region of the support body 92 and the guide body 94 is not formed closed in the circumferential direction U, but is designed to be open, that the carrier body 92 with its internal thread portion 90 can pass radially inward into engagement with the external thread 34 of the setting part 30.
  • the carrier body 92 has, diametrically opposite the female threaded portion 90, a manual operating portion 108 in the form of a key having an ergonomically shaped depressor trough 110.
  • Setting part 30 passes, so that the adjusting member 30 in the axial longitudinal direction A with respect to the housing parts 18, 24 is displaceable. As a result, a quick release function can be realized. A significant advantage of this
  • the above-described embodiment further consists in the fact that also through this radial space can be saved. It can best be seen from FIG. 8c that in this way the nominal diameter of the external thread 34 of the adjusting part 30 can be extended to the inside diameter of the clear cross-sectional opening 104 of the housing part. This in turn allows a large inner diameter Di of the
  • Adjustment part 30 for the supply of more
  • Outer diameter (Dal) of a rotational coupling portion between the rod pressing member 32 and the adjusting member 30 is larger than an outer diameter (Da2) of one proximal thereto
  • Outside diameter (Dal) of a rotational coupling portion between the rod pressing member 32 and the adjusting member 30 is between 0.95 and 1.05 times the nominal diameter of the external thread of the adjusting member.
  • FIGS. 9a to c show another one

Abstract

La présente invention concerne un instrument (2) pour relier une tige correctrice (4) à une vis à os (6), en particulier une vis pédiculaire, avec une première partie de logement (18) située à l'extérieur présentant un segment (20) formant à peu près une demi-coque qui forme une première branche (22) et avec une seconde partie de logement (24) située à l'extérieur formant à peu près une demi-coque qui forme une seconde branche (26) qui est articulée de manière à pivoter sur la première branche (22) au moyen d'une articulation pivotante (28), autour d'un axe de pivotement (58) s'étendant orthogonalement à la direction longitudinale axiale (A), et avec une partie de réglage (30) et une partie (32) de pression sur la tige, et la seconde branche (26) pouvant être actionnée en position libérée par pression du doigt exercée sur son extrémité proximale (70) par le chirurgien utilisateur et l'articulation pivotante (28) étant conçue pour que les deux branches (22, 26) présentent des zones articulées (38, 40) venant en prise les unes dans les autres à la manière d'un puzzle.
PCT/EP2018/077908 2017-10-13 2018-10-12 Instrument permettant de relier une tige correctrice à une vis à os WO2019073046A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE102017123906.5 2017-10-13
DE102017123906.5A DE102017123906B4 (de) 2017-10-13 2017-10-13 Instrument zum Verbinden eines Korrekturstabs mit einer Knochenschraube
DE102017123907.3A DE102017123907A1 (de) 2017-10-13 2017-10-13 Instrument zum Verbinden eines Korrekturstabs mit einer Knochenschraube

Publications (1)

Publication Number Publication Date
WO2019073046A1 true WO2019073046A1 (fr) 2019-04-18

Family

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Family Applications (2)

Application Number Title Priority Date Filing Date
PCT/EP2018/077912 WO2019073048A1 (fr) 2017-10-13 2018-10-12 Instrument permettant de relier une tige correctrice à une vis à os
PCT/EP2018/077908 WO2019073046A1 (fr) 2017-10-13 2018-10-12 Instrument permettant de relier une tige correctrice à une vis à os

Family Applications Before (1)

Application Number Title Priority Date Filing Date
PCT/EP2018/077912 WO2019073048A1 (fr) 2017-10-13 2018-10-12 Instrument permettant de relier une tige correctrice à une vis à os

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DE (2) DE102017123906B4 (fr)
WO (2) WO2019073048A1 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113440235B (zh) * 2021-06-22 2023-02-24 浙江德康医疗器械有限公司 一种用于脊柱微创手术的压棒系统及方法

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120215266A1 (en) * 2011-02-22 2012-08-23 K2M, Inc. Single action anti-torque rod reducer
US20130144346A1 (en) * 2004-11-23 2013-06-06 Roger P. Jackson Modular polyaxial bone anchor with retainer having interconnected pieces
EP2792325A1 (fr) 2013-04-20 2014-10-22 Silony Medical International AG Instrument chirurgical
US9011449B1 (en) * 2011-04-05 2015-04-21 Scott Cochran Screw and rod fixation system
WO2016150920A1 (fr) 2015-03-24 2016-09-29 Silony Medical International AG Instrument permettant de relier une tige correctrice à une vis osseuse

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7842044B2 (en) * 2003-12-17 2010-11-30 Depuy Spine, Inc. Instruments and methods for bone anchor engagement and spinal rod reduction
US8685029B2 (en) * 2010-09-27 2014-04-01 DePuy Synthes Products, LLC Rod reduction instrument and methods of rod reduction
US9204909B2 (en) * 2011-07-13 2015-12-08 Warsaw Orthopedic, Inc. Spinal rod system and method
WO2015054205A1 (fr) * 2013-10-07 2015-04-16 K2M, Inc. Réducteur de tige
AU2014259592B2 (en) * 2013-11-15 2019-05-16 K2M, Inc. System for corrective spinal surgery and method of use
DE102016106608A1 (de) * 2016-04-11 2017-10-12 Aesculap Ag Instrument zum Führen eines Stabs in eine Implantataufnahme

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20130144346A1 (en) * 2004-11-23 2013-06-06 Roger P. Jackson Modular polyaxial bone anchor with retainer having interconnected pieces
US20120215266A1 (en) * 2011-02-22 2012-08-23 K2M, Inc. Single action anti-torque rod reducer
US9011449B1 (en) * 2011-04-05 2015-04-21 Scott Cochran Screw and rod fixation system
EP2792325A1 (fr) 2013-04-20 2014-10-22 Silony Medical International AG Instrument chirurgical
WO2016150920A1 (fr) 2015-03-24 2016-09-29 Silony Medical International AG Instrument permettant de relier une tige correctrice à une vis osseuse
DE102015205362A1 (de) 2015-03-24 2016-09-29 Silony Medical International AG Instrument zum Verbinden eines Korrekturstabs mit einer Knochenschraube

Also Published As

Publication number Publication date
DE102017123906A1 (de) 2019-04-18
WO2019073048A1 (fr) 2019-04-18
DE102017123906B4 (de) 2019-05-29
DE102017123907A1 (de) 2019-04-18

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