CN1046846A - Adjustable Spinal Internal Fixator - Google Patents

Abstract

An adjustable internal spine fixing reductor, in particular to an adjustable internal spine fixing reductor which can stretch and push the spine to reduce and fix the fractured spine. The repositor is characterized in that at least one end of a spine steel plate provided with a plurality of screw holes for inserting the pedicle screws is connected with a screw rod, the screw rod is screwed with a pair of screw caps, a hole head is sleeved between the two screw caps for inserting the pedicle screws into the screw holes and enabling the screw rods to extend out of the holes and slightly swing up and down, and then an ejector is nested, so that a stretching device arranged at one end or two ends of the spine steel plate is formed; the nail hole can be screwed with a pushing lock which can push the fractured vertebra to reset.

Description

The invention relates to an adjustable spinal internal fixation resetter, especially an adjustable spinal internal fixation resetter which is suitable for the spine and can effectively fix, stretch and push the spine, so as to reset the fractured spine and stably fix the vertebrae.

For the vast majority of thoracic and lumbar spine fractures and dislocations, it is very important to apply Distractionforce to the spine to reset and reduce or avoid the compression of the spinal cord or nerve roots (Nerve roots). , It is also extremely important for the stability and fixation of the spine. For many years, the most commonly used and most effective spinal internal fixation device used to apply tension is Harrington's tension steel column (Harrington distraction rod) (as shown in Figures 13 and 14); The device is the spinal plate (Spinal plate) and the transvertebral foot screw on it (as shown in Figure 15), which have been used for many years. The two conventional devices are described as follows:

(1) Stretched steel column: its structure is shown in Figures 13 and 14. When it is installed on the spine K, although it can apply tension to the spine K ₁ to make it move (such as applying force and moving in the direction of arrow A) to reset (keep the affected vertebra K ₂ in its original position) and subtract the vertebra , spinal cord or nerve root (not shown), but because the spine K between the upper and lower hooks 102 and 103 on the steel column 101 lacks effective fixation, it is easy to cause the situation of shaking back and forth (shaking in the direction shown by arrows B and B'), and its upper and lower hooks 102, 103 are easy to slide away from the vertebra K ₁ through the lamina 43, which is its biggest disadvantage. Other relevant shortcomings and problems are briefly described as follows:

1. For more serious thoracolumbar vertebral fractures, it is often necessary to bind sublaminar wires (Sublaminar Wiring) (not shown) to enhance its stability. The injury, and its operation is extremely time-consuming and troublesome, and the spine still has the fear of slipping and shaking in the wire ring.

2. When the lower support hook 103 is placed on the sacral vertebra, its installation operation is extremely difficult, has many complications, and is prone to failure.

3. In most cases of thoracolumbar spine fractures, dislocations, and non-safety spinal nerve injuries, anterior-posterior force (Anterio-Posterior force) is required to reduce and reduce the compression of bone fragments on nerve tissue, such as this To exert this force on the steel column, the steel column 101 must be curved according to the radian of the spine (contoured), and then the steel column 101 is installed on the spine by the upper and lower hooks 102, 103, and the curved top is used to compress the fractured vertebra. Only later can it be achieved. But this method is time-consuming and troublesome, and the effect is poor, and it is also very difficult to tie between the anti-reverse rod 104 at the upper end of the steel column and the square rod end 13 at the lower end and the bracket hooks 102, 103, which has become its shortcoming. Moreover, this method is not easy to correctly apply the required front and rear force to the desired place, and may cause artificial nerve tissue damage by pressing the injured lamina into the spinal cord cavity; The force is all concentrated on the interface between the hamate and the bone, which can easily cause slipping of the upper and lower brackets 102, 103 and fracture intrusion.

4. The slippage rate of the upper hook 102 is very high, and the fracture collapse rate of the hamate interface is also high, and the hooks of the upper and lower hooks 102, 103 need to enter the spinal cavity, which may cause damage to the nerve tissue or dura mater. damage rupture.

(2) Spinal steel plate: As shown in Figure 15, a plurality of nail holes 202 are provided along the length direction on a curved lath body 201, and vertebral foot screws 203 can be inserted into these nail holes 202. A pair of spinal steel plates can be nailed into good vertebra K ₁ with screws 203 and fixed on the spine K to achieve the purpose of fixing the spine. The stability of this device is currently the best, and the possibility of causing nerve tissue damage during installation is small (according to Salliant's statistics of 375 transvertebral screw cases, the nerve damage is "zero"), but its biggest disadvantage is the lack of implantation. The design of the supporting tension means that the vertebra 4 cannot be stretched to make it reset, so that the affected vertebra 41 is compressed by the upper and lower vertebra 42, which greatly reduces the ability to restore the fracture and dislocation of the vertebra and the ability to decompress the nerves. This is also its shortcoming. . On the other hand, the hole diameter of the nail must be slightly larger, so the screw will inevitably shake, which will affect the stable fixation of the spine.

The main purpose of the present invention is to provide a novel structure adjustable internal fixation device for the spine, which is connected to at least one end of a spinal steel plate with a stretching device, and the stretching device has a screw rod connected to the end of the vertebral steel plate. A pair of upper and lower nuts are screwed on the screw rod, and a hole head and a vertebral screw on the hole head that can swing up and down moderately are set between the two nuts of the screw rod, and are fitted under the hole head A push-off piece that fits on the transvertebral foot screw outside the hole head with the nail hole of its upright side wall, and engages with the screw rod with the notch of its bottom wall; according to this structure, the screw on the screw rod can be easily The hole head is first pushed to the vicinity of the final position for preliminary stretching, and then the lower edge of the side wall nail hole of the ejector part in between pushes up the transvertebral screw to a position slightly higher than the vertical screw axis, And make it in a slightly upward tilted state, so that the vertebra fixed by the screw can be easily and easily further lifted to the predetermined stretching position and the vertebra will not be skewed, so it can be easily and easily performed. The spine is stretched and finer adjustments are possible. And because the transvertebral foot screws of the stretching device are slightly tilted upward, the spine is also slightly tilted back, so that it can match the natural curvature of the spine and facilitate the reduction and fixation of the fractured spine.

Another object of the present invention is to provide an adjustable internal fixation device for the spine, which forms the nail hole of the spine plate as a threaded hole, and installs a push screw with a head with an appropriate thickness and a screw rod in the nail hole. The pushing screw is unscrewed from one side of the corresponding vertebra to push the fractured vertebra in front, so that the fractured vertebra reaches the state of hyperextension (Hiperextension), and further resets the bone fragments that compress the nerve, so as to reduce the pressure on the nerve tissue. damage caused.

Yet another object of the present invention is to provide an adjustable internal fixator for the spine, which is tied to the other end of the spine plate and adjacent to the transvertebral foot screw for individual fixation, and is provided with a fastener with an eccentric head. Rotation of the eccentric head through an angle compresses the stem of the adjacent transpedicular screw, tightening the screw to prevent it from rocking, thereby more firmly immobilizing the spine.

Other purposes, features and effects of the present invention can be described in detail with reference to the embodiments of the present invention according to the accompanying drawings.

Fig. 1 is the exploded perspective view of an embodiment of the present invention;

Fig. 2 is a longitudinal sectional view of the hole head of the present invention;

Fig. 3 is a top view of the ejector of the present invention;

Fig. 4 is a side view schematic diagram when the present invention is installed on the spine and has not yet been stretched;

Fig. 5 is a schematic side view of the state where the present invention is installed on the spine for preliminary stretching;

Fig. 6 is a partial cross-sectional explanatory diagram showing the action of the ejector in Fig. 5;

Fig. 7 is a schematic side view of the present invention installed on the spine for final stretching;

Figure 8 is a partial sectional illustration of the action of the ejector in Figure 7;

Fig. 9 is a cross-sectional view of the installation state of the push screw of the present invention;

Figure 10 (a) (b) is an explanatory diagram showing the fastening action of the fastener of the present invention;

Fig. 11 is the front view on the spine after the present invention is installed;

Figure 12 is a side view of another embodiment of the present invention;

The structure of the first embodiment of the present invention is shown in Fig. 1 to Fig. 11, including: at least one end of the arc-shaped strip-shaped spine steel plate 11 provided with a plurality of threaded nail holes 111 is provided with a screw rod 12 at least one end of the reducer body 1; a pair of upper and lower nuts 3, 4 that can be screwed on the screw rod 12 for locking; a vertical through hole 51 and a side screw hole 52 inserted through the vertebral foot screw are provided, The hole head 5 that can be slidably set on the screw rod 12 between the two nuts 3 and 4 above; Rod 62 protrudes out of the hole and can slightly swing up and down through the transvertebral foot screw 6; the nail hole 73 lower hole edge 74 nested under the side of the hole head 5, has rib walls 71 on both sides, and can be used for its upright wall 72 Push the pusher 7 that extends out of the hole head 5 through the foot screw 6, and inserts the bottom wall 76 with the notch 75 between the bottom of the hole head 5 and the lower nut 4. The lower edge of the nail hole 74 is slightly higher than the lower hole edge 54 of the embedded nail hole 52 of the hole head 5; the push screw 8 with the head 82 that can be screwed into the nail hole 111 of the resetter body 1 by its rod portion 81; and at least A transvertebral foot screw 2 that can be inserted into the nail hole 111 of the reducer body 1 . Above-mentioned screw rod 12, hole head 5, transvertebral foot screw 6, ejector part 7, and upper and lower nuts 3, 4 constitute a stretching device.

As shown in Fig. 1, Fig. 2 and Fig. 6, the hole head 5 can be inserted into the insertion nail hole 52 on the other side from the through hole 55 on one side of the above-mentioned transvertebral foot screw 6, and the diameter of the nail hole 52 is slightly larger than The bar diameter of screw 6 makes screw 6 can be pivot point and its nail bar 62 can swing up and down in right amount with its semicircle head 61 and hole seat 53. And the hole head 5 can be sleeved on the screw rod 12 through its vertical through hole 51 .

As shown in Fig. 1, Fig. 3 and Fig. 5 to Fig. 9, the ejecting member 7 can be nested on the side of the hole head 5 through the space surrounded by the rib walls 71 on both sides, the upright wall 72 and the bottom wall 76. Downward, and make the nail hole 73 of the upright wall 72 cover the rod portion 62 of the transvertebral screw 6, because the lower hole edge 74 of the nail hole 73 is slightly higher than the lower hole edge 54 of the nail hole 52 of the hole head 5, Therefore, when the ejector member 7 is pushed up by the lower nut 4 (the action will be described in detail below), the ejector member 7 can push up the foot screw 6 through the lower hole edge 74 of the nail hole 73, And push the hole head 5 upwards with its bottom wall 76, when the push-off piece 7 and the hole head 5 reach the appropriate position and are fastened together by the upper and lower nuts 3,4, then the vertebral foot screw 6 is received The hole edge 74 of the nail hole of the ejector part is pushed upwards slightly upwards, thereby making it remain at a position slightly higher than the axis perpendicular to the screw rod 12 .

Have again, the nail hole 111 place of above-mentioned vertebral plate 11 is still screwed with a fastener 9 with eccentric round head 91 and screw rod 92, to fasten the adjacent transvertebral foot screw 2, thereby prevent it from being stuck in the nail hole. 111 to ensure the stable connection and support of the spine plate 11 and the screw 2 to the spine K ₁ . As shown in Fig. 4 and Fig. 10 (a), there is a gap "C" between the eccentric round head 91 and the adjacent transvertebral foot screw 2. When the fastener 9 is slightly unscrewed and the eccentric round head After 91 rotates an angle, then as shown in Figure 5 and Figure 10 (b), the outer peripheral surface of the large-diameter end 911 of the eccentric circle head 91 can be compressed on the rod portion of the adjacent transvertebral screw 2, thereby Prevent the screw 2 from loosening in the nail hole 111.

The function, action and surgical application of the present invention with the above-mentioned structure will be described in detail below.

(1) When the present invention is to be installed on the spine K during the operation, first, as shown in Figure 4, it is advisable to nest the hole head 5 and the pusher 7 together, and insert the transvertebral screw 6 into the hole Insert the head 5 into the nail hole 52, and make the nail rod 62 protrude out of the nail hole 73 of the pusher 7 at the same time, and then, screw the foot screw 6 into the uppermost position of the spine K to be fixed. On the vertebra K ₁ , the hole head 5 is fixed on the vertebra K ₁ under the slightly movable state of the ejector member 7.

(2) Subsequently, pre-screw the lower nut 4 on the screw 12 of the restorer body 1 to the lowest point of the screw 12, and adjust the length of the protruding end of the screw 12 so that the lower end of the spine plate 11 below the nail hole 111 is consistently aligned with the lowermost vertebra K ₁ to be fixed, so as to facilitate the smooth insertion of the lowest transvertebral foot screw 2, and the central part of the reducer body 1 is made to be adjacent to the fractured vertebra K ₂ in advance, and at the same time, the The push screw 8 is screw-mounted in the nail hole 111 slightly above the middle of the fractured vertebra K ₂ on the inner side of the spine plate 11, and the fastener 9 is screw-mounted in the lower part where the lower transvertebral foot screw 2 is to be inserted. The nail hole 111 is adjacent to the nail hole 111 .

(3) Next, as shown in Figure 4, pass the screw 12 of the resetter body 1 through the notch 75 of the ejector 7 and the vertical through hole 51 of the hole head 5, and then screw the lower transvertebral foot screw 2 Insert it into the vertebra _K1 below the fractured vertebra _K2 (at this time, it is advisable to slightly press the screw rod 12 to prevent it from tilting).

(4) Rotate the fastener 9 with a screwdriver so that the large-diameter end is adjusted to the eccentric round head 91 above the figure (as shown in Figure 4) and rotated at an angle, and the large-diameter end The outer peripheral surface is tightly pressed against the rod of the adjacent transpedicular screw, so that the screw is fixed at the nail hole 111 without loosening.

(5) Screw the upper nut 3 to the approximate position of the estimated final stretched state of the spine on the screw rod 12 (as shown in FIG. 4 ).

(6) Subsequently, as shown in Figure 5 and Figure 6, rotate the lower nut 3, and use the bottom wall 76 of the ejector 7 and the lower edge 74 of the nail hole to push up the hole head 5 and the insertion hole head 5 and The transvertebral screw 6 on the ejector 7; at this time, because the nail shank 62 of the transvertebral screw 6 is in the hole of the larger diameter inserting nail hole 52 of the hole head 5, and because of its nailed spine The resistance pulling force of K can tilt down moderately. At this time, the upper spine K ₁ system is in a downward tilting state, so that the hole head 5 is first pushed up to abut against the upper nut 3 without much effort. At this time, due to the rise of the hole head 5 and the screw 6, the appropriate amount of stretching of the spine K can be achieved, and the initial stretching of the spine K can be easily achieved. Therefore, the hole head 5 can be prevented from being difficult to push out and stretch because of being subjected to excessive resistance (or tension force) so that the edge of the skewed vertical through hole 51 clamps the thread of the screw rod 11.

(7) Next, as shown in Figure 7 and Figure 8, continue to turn the lower nut 4 upwards to restore the ejector 7 to the upright position, and lock the hole head 5 and the ejector 7 on the upper, Between the lower nuts 3 and 4. At this time, the lower hole edge 74 of the nail hole of the pusher 7 will push up the nail rod 62 of the vertebral foot screw 6 to reach a position slightly higher than the axis perpendicular to the screw rod 12, thereby nailing the upper vertebra. K ₁ is further lifted upwards, and kept in a slightly upward position to match the curvature of the spine K, so that the final spinal stretch can be easily achieved to reset the fractured spine K ₂ and achieve effective fixation of the spine K.

(8) Next, use X-ray fluoroscopy or computerized tomography to check the state of spinal stretching and the predetermined pushing amount of the fractured spine K ₂ , and adjust the stretching slightly if necessary. And push the fractured vertebra K ₂ in front by unscrewing the push screw 8 to reset it and prevent the bone fragments from compressing the nerve tissue, thereby completing the installation of the present invention.

In the actual operation application of the present invention, the spine plate with appropriate length, the appropriate amount of ejector pins and transvertebral foot screws can be used, and the present invention is installed in pairs on the spine for stretching, reduction, fixation and ejection Spine (shown in Figure 11).

Fig. 12 is a side view of the structure of the second embodiment of the present invention. In this embodiment, the above-mentioned stretching device of the present invention is provided at both ends of the spine steel plate 11, to replace the lower transvertebral spine alone in the previous embodiment. The fixing structure of the foot screw 2 is similar to the method of the previous example, that is, the two-hole head 5 and the transvertebral foot screw 6 on it are respectively nailed to the upper and lower vertebra K ₁ of the injured vertebra K ₂ , and then the After the restorer body 1A is installed with relevant components, after fully passing through the through hole 51 of one hole head 5 with its one end screw rod 12, the other end screw rod is passed back through the through hole 51 of the other hole head 5, and then according to The aforementioned method initially and finally stretches the spine K ₁ and pushes and folds the spine K ₂ . The structure of this example is equipped with stretching devices at both ends, so it can be used on patients as needed to stretch the spine for a greater distance. And because the upper and lower spine K ₁ can be raised outwards, the stretched spine can obtain a larger curvature to meet the needs.

If the stretching member on the screw rod of the present invention is applied to a commonly used Harrington distraction rod (Harrington distraction rod) (not shown), the stretching effect of the device can also be improved; moreover, if the present invention The nail holes of the spine steel plate are continuous nail holes (not shown) with several nail holes as a unit, and the distance between each nail hole is reduced to facilitate the selection.

The above is only a description of the specific embodiments of the present invention, but does not mean to limit the present invention. Various changes and modifications can be made without violating the spirit of the present invention.

The above-mentioned adjustable spinal internal fixator of the present invention can be properly adjusted to effectively stretch the spine so that the fractured spine reaches a state of hyperextension, thereby achieving the purpose of resetting the fractured or diseased spine and decompressing the compressed nerve tissue. At the same time, the spinal plate can be used to stabilize and safely fix the spine, so that the fractured vertebra will not shake, and then the fractured spine can be pushed up with the push screw to reduce the compression of the fracture fragments on the nerves. In particular, when the present invention is in use, it is stretched in sections by means of push-off parts and the like, so that the installation is easy and quick, and the spine can be kept from being skewed, which is more convenient for use. To sum up, the present invention has many excellent effects, thereby being able to solve the shortcomings of the spinal internal fixator for many years, which is incomparable to any existing fixator. The present invention provides great benefits for spinal treatment, and can benefit patients with spondylosis. It is a breakthrough invention in the medical field.

Claims (3)

1, a kind of adjustable inside fixing reset unit for vertebra, You Zhiyi be applicable to supraspinal can be effectively and support easily and the pushing and withstanding vertebra, the fracture vertebra is resetted and the adjustable inside fixing reset unit for vertebra of secure vertebra, be by: one be provided with along its length a plurality of for the vertebra steelplates of following closely the hole through vertebra foot screw plants; One device that supports that is connected with on this vertebra steelplate constitutes;

It is characterized in that: this support device system by: one is connected with in the screw rod of these vertebra steelplate one or both ends; One is provided with a vertical through hole, a side through hole, and an embedding plug pin bore be placed in hole head on this screw rod; One can by the side through hole be inserted in the hole head embedding plug pin bore place through vertebra foot screw; One is provided with a recess, is provided with a nail hole, and is provided with the ejector of two side rib walls between diapire and upstanding wall in upstanding wall in diapire, and this ejector coefficient can be nested in this hole side-lower, and can its nail hole lower edge pushing and withstanding pass in it through vertebra foot screw; And a pair of be screwed together on this screw rod, can compress on this face ejector bottom surface, crown, hole down that nut constitutes;

And this vertebra steelplate is to borrow its thread structure in its nail hole place and screw togather a pushing and withstanding screw with head and screw rod with the pushing and withstanding vertebra.

2, adjustable inside fixing reset unit for vertebra as claimed in claim 1, it is characterized in that, the intercalation nail bore dia of this hole head is slightly larger than this bar portion diameter through vertebra foot screw, this nail is distolateral within hole to have a large diameter semicircle orifice seat, and this screw can be embedded in this hole seat by its semicircle head, and make the extension bar portion of screw can be in right amount pivot is moving up and down; And, the nail bore dia of corresponding ejector also greater than pass in it through vertebra foot screw bar footpath, and intermarginal height under the bottom surface that intermarginal height is slightly larger than the hole head under the bottom surface of ejector and the nail hole and the nail hole.

3, adjustable inside fixing reset unit for vertebra as claimed in claim 1, it is characterized in that, place, this vertebra steelplate nail hole can screw togather a securing member with off-centre operation head and screw rod, thus can with the independent use at the place, contiguous nail hole on the vertebra steelplate give through vertebra foot screw fastening.

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