JP2000350731A - Device for correcting thoracic vertebrae - Google Patents

Abstract

PROBLEM TO BE SOLVED: To shorten time of a correcting operation for the vertebrae (TB), to reduce a physical burden for a patient, and to reduce amounts of bleeding and a rate of bacterium infection. SOLUTION: This correcting device comprises a main rod 1 arranged in parallel to an axis of TB outside the human body, a central draw rod 3 for TB, whose shaft length is adjustable, in which a base part is mounted to the main rod 1 by a joint member 8, so that a tip part is oriented to TB, a plurality of side draw rods 4 for TB, whose shaft length is adjustable, in which base parts are mounted on both sides of the central draw bar 3 for TB of the main rod 1 by a joint member 10 in such a way that an interval to the central draw rod 3 can be adjusted, so that a rotation adjustable tip part is oriented to TB, and a vertebra fixture holding member 6 for TB formed in a reversed T shape in which a support arm 13 to support the vertebra fixture is protruded from a lower end of a connecting part 12 to both sides, and is mounted to tips of the central draw rod 3 for TB and the side draw rods 4 for TB by the connecting part 12 in such a way that oscillation can be adjusted, so that both ends of the support arm 13 can alternately be connected or separated to TB. By this, this device can be installed to TB through each vertebra fixture.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a spine corrector for correcting spinal deformities such as scoliosis into a proper spine shape.

[0002]

2. Description of the Related Art Spinal deformities such as scoliosis are complicated three-dimensional deformations in which left and right lateral bending, longitudinal bending, and torsion are combined. Surgery to correct this to an appropriate spine shape has been performed, but in the conventional surgical methods, there were many cases using the rookie method or the derotation method, but the former rookie method was deformed. It is a surgical method of expanding a pair of vertebral body fixtures such as a vertebral body clamp member attached to the concave side of the spine part using an expansion device called a spreader, the operation time is short, Although there are advantages such as a low bacterial infection rate and a small amount of bleeding, there is a problem that three-dimensional correction cannot be performed at all.

[0003] On the other hand, in the latter rotation method, one-sided correction rod, which has been bent into an appropriate shape in advance, is locally attached to a deformed spine at a location where deformation is small, and this is performed. Rotate the rod while applying force to attach the non-attached part to the spine when it comes along the spine, and then attach and fix the opposite bending rod, which has been bent to the appropriate shape, to the spine Although it is a surgical method, three-dimensional correction is possible for the time being, but the correction state is uniquely determined by the bending shape of the rod, so it is easy to apply excessive force locally and the hook etc. may come off and the spinal cord may be abnormal. It was a drawback that the correction limit was low and the desired correction state could not be achieved in many cases. In addition, since two rods are usually used to correct the spine, one rod corrects and fixes it, and the other corrects and fixes it. Was made longer.

[0004]

SUMMARY OF THE INVENTION The present invention has been made to solve such problems, and an object of the present invention is to avoid duplication of surgical procedures in this kind of operation. Therefore, it is an object of the present invention to shorten the operation time, thereby reducing the physical burden on the patient and reducing the amount of bleeding and the bacterial infection rate.

[0005]

The present invention has the following configuration to achieve the above object. That is, the invention of claim 1 according to the present invention is characterized in that the main rod 1 is disposed outside the human body in parallel with the axis of the spine, and the base is connected to the thoracic vertebra 16 by the joint rod 8 so that the tip is directed toward the thoracic vertebra 16. The center extension rod 3 for the thoracic vertebra attached to the thoracic vertebra is adjustable in axial length, and the base is connected to the thoracic vertebra 16 by the joint member 10 so that the tip of the vertebra can be adjusted to rotate around the axis. A plurality of thoracic spine laterally extending rods 4 having adjustable axial lengths attached to both sides of the centrally extending centrally extending rod 3 so as to adjust the distance from the centrally elongated rod 3, and a vertebral body clamp The support arm 13 for supporting the vertebral body fixture 11 such as a member is formed in a substantially inverted T-shape formed by projecting from the lower end portion of the connection portion 12 on both sides, and both ends of the support arm portion 13 are provided. Connection part 1 so that the part can be alternately moved toward and away from the thoracic vertebra 16.
2 and a thoracic vertebral body fixing tool holding member 6 attached to the distal ends of the thoracic vertebra center extending rod 3 and the thoracic lateral extension rod 4 so as to be swingably adjustable. A spinal corrector that is mounted via a body fixture 11.

According to a second aspect of the present invention, there is provided a main rod 1 arranged outside the human body in parallel to the axis of the spine.
And two branch rods 2 attached to the main rod 1 by a joint member 9 and arranged in parallel on both sides with respect to the main rod 1, and a lumbar vertebra 1
A plurality of lumbar extension rods 5 whose bases are attached to each branch rod 2 so as to be adjustable so as to adjust the distance between the lumbar vertebrae and the vertebral body clamp members so as to be directed to 7; A supporting arm 15 for supporting the vertebral body fixing tool 11 such as the one shown in FIG.
The extension 14 for the lumbar vertebra is formed by the connecting portion 14 so that the support arm 15 can rotate about an axis orthogonal to the branch rod 2 and the extension lumbar for the lumbar vertebra 5 facing the lumbar vertebra 17.
And a lumbar vertebral body fixture holding member 7 attached to the distal end of the vertebra so as to be swingably adjustable, and is attached to the lumbar portion via each vertebral body fixture 11. It is.

According to a third aspect of the present invention, there is provided a main rod 1 disposed outside the human body in parallel to the axis of the spine.
And two branch rods 2 attached to the main rod 1 by the joint member 9 and arranged in parallel on both sides with respect to the main rod 1, and a base member connected to the thoracic vertebra 16 so that the distal end thereof is directed to the thoracic vertebra 16. A center extension rod 3 for the thoracic vertebra attached to the main rod 1 by 8 and having an adjustable axial length, and a joint base 10 at the base so that the distal end that can be rotated around the axis is directed to the thoracic vertebra 16. Center extension rod 3 for thoracic spine of main rod 1
A plurality of laterally extending rods 4 for the thoracic vertebrae, the lengths of which can be adjusted, which are attached to both sides of the body so as to adjust the distance between the centrally extending rods 3 and the vertebral bodies such as vertebral body clamp members Tool 11
Is formed in a substantially inverted T-shape formed by projecting a supporting arm 13 for supporting the connector from a lower end portion of the connecting portion 12 to both sides.
The connecting portion 12 allows the center extending rod 3 for the thoracic vertebra to be stably moved toward and away from the thoracic vertebra 16 at both ends of the supporting arm 13.
And a vertebral body vertebral body fixing member holding member 6 attached to the tip of the laterally extending rod body 4 for the thoracic vertebra so as to be swingable.
The base is connected to each of the branch rods 2 by the joint member 10 so that the tip that can be rotated around the axis is directed toward the lumbar vertebra 17.
A plurality of elongated lumbar extension rods 5 having adjustable axial lengths, which are attached to each other so as to be adjustable to each other, and a support arm for supporting a vertebral body fixture 11 such as a vertebral body clamp member. 1
5 is formed in a substantially L-shape that bends and continues to the lower end portion of the connecting portion 14, and the supporting arm portion 15 faces the lumbar vertebra and rotates about an axis orthogonal to the branch rod 2 and the lumbar extension rod 5. And a lumbar vertebral body fixture holding member 7 attached to the distal end of the lumbar extension rod 5 by a connecting portion 14 so as to be swingably adjustable. A spinal corrector that is mounted via a fixing tool 11.

[0008] According to such a spine corrector according to the present invention, basically, the spine correction can be completed first by the spine corrector, and then the spine correction rod is corrected in that state. It is possible to attach to. Therefore, the operation procedure does not overlap, and the operation can be shortened. This point is described below with reference to FIGS. 1 and 2, which show the movement (degrees of freedom) of the functional spinal unit (FSU), that is, the relationship between the load applied to the FSU and the resulting displacement. FIG. 2 is a conceptual diagram showing a state of spinal deformity.

In FIG. 1, a horizontal direction (X-axis), an axial direction (Y-axis), and a front-rear direction (Z-axis) with respect to the human body relative to the spine.
In each axis, the main motion is mo
ment (M) rotation (rotation); ± MX, ±
MY and ± MZ are generated, and translation (translation); ± FX, ± FY and ± FZ are generated by the load of force (F). Assuming that a spine having such a degree of freedom deforms, as shown in FIG. 2, the distance (l) between two posterior elements of the apex is the distance (L) between anterior elements of the same vertebra. It is accompanied by a shorter or longer rotation (twist). Therefore, correcting this deformation is not easy.

In the spine corrector according to the present invention, each vertebral body fixing device such as a vertebral body clamp member or a pedicle screw fixed to a predetermined position of the spine against the three-dimensional deformation of the spine as described above. 11, the spinal corrector is mounted in the deformed state, and then the target corrective state is corrected without applying excessive force to the target corrective state using a predetermined surgical jig. Then, the correction rod is attached to the spine to complete the fixation, and then the spine corrector is removed from the spine.
In the case of this correction operation, the joint member 10, for example, the elbow-type joint member 10 is slid on the basis of the thoracic vertebral center extending rod 3 to adjust the interval between the thoracic vertebra lateral extension rods 4. By sliding the member 10 to adjust the distance between the extension bars 5 for the lumbar spine, the translation (± FY) of the lateral extension bars 4 for the thoracic spine and the extension bars 5 for the lumbar spine can be adjusted. By adjusting the axial length of the central stretch bar 3, the lateral stretch bar 4 for the thoracic spine, and the stretch bar 5 for the lumbar spine, the translation (± FZ) of each stretch bar 3, 4, 5 can be adjusted. It is.

Further, the joint member 9 such as the T-shaped joint member 9 and the elbow-shaped joint member 10 are connected to the main rod 1 and the branch rod 2.
, The translation (± FX) can be adjusted with respect to the thoracic vertebra center extension rod 3, the thoracic vertebra lateral extension rod 4, and the lumbar extension rod 5 and the respective extension rods 3 can be adjusted. ,
The rotation (± MZ) of the center stretch bar 3 for the thoracic spine, the lateral stretch bar 4 for the thoracic spine, and the stretch bar 5 for the lumbar spine can be adjusted by rotating the tip portions 4 and 5 around the axis. . Further, by pivotally adjusting the vertebral body fixing tool holding member 6 for the thoracic vertebra, the rotation (± M
Y) Adjustment is possible, and by pivotally adjusting the lumbar vertebral body fixture holding member 7, rotation (± MX) adjustment with respect to the lumbar extension rod 5 is possible.

As described above, the spine corrector according to the present invention includes:
rotation; ± MX, ± MY, ± MZ, translat
ion (translation); ± FX, ± FY, ± FZ correction degrees of freedom are provided, making correction operations easy and reliable.
Therefore, it is possible to easily mount and fix the correction rod on the spine.

[0013]

DESCRIPTION OF THE PREFERRED EMBODIMENTS Preferred embodiments of the present invention will be specifically described below with reference to the accompanying drawings. FIGS. 3 to 5 show a front view, a plan view, and a left side view of the spine corrector according to the embodiment of the present invention. FIG. 6 shows a vertebral body fixation in the spine corrector shown in FIG. A side view of the tool part is shown.

The spine corrector according to the present invention shown in FIGS. 3 to 6 is a corrector capable of simultaneously correcting the thoracic spine and the lumbar spine, that is, the corrector according to the third embodiment. However, it goes without saying that the present invention encompasses both those dedicated to the thoracic spine and those dedicated to the lumbar spine. The spine corrector shown in FIGS. 3 to 6 includes a main rod 1, two branch rods 2, a central extension rod 3 for the thoracic spine (hereinafter abbreviated as extension rod 3), and two lateral thoracic vertebrae. Stretched rods 4 (hereinafter abbreviated as stretched rods 4), four lumbar vertebrae stretched rods 5 (hereinafter abbreviated as stretched rods 5), three attached to each stretched rod 3, 4 Thoracic vertebral body fixing member holding member 6 (hereinafter, abbreviated as holding member 6), and four lumbar vertebral body fixing member holding members 7 (hereinafter, abbreviated as holding members) attached to each elongated rod 5.
The holding member 7 is abbreviated as a component member.

The main rod 1 is made of a metal rod. In this example, the joint rod 8 is coaxially extended to a joint portion of the joint member 8 such as a T-shaped joint member 8 by screwing. It is located outside and near the spine and parallel to the spine axis. In addition to this example, the main rod 1 made of one piece
May be inserted through the through hole of the T-shaped joint member 8 and fixed to the T-shaped joint member 8 with a fastening nut. On the other hand, the branch rod 2 is made of a metal rod like the main rod 1 and has a base end bent at a right angle and a screw threaded on its outer periphery, and is attached to the end of the main rod 1. The T-shaped joint member 9 is extended in parallel with the main rod 1 at both side positions.

The elongated rods 3, 4, and 5 have basically the same structure, and are formed as rods whose axial length can be adjusted to be shorter or longer. For example, a core member 18 of a round rod and the core member 18 are slid. A sheath member 19 which is receivably received therein.
The core member 18 can be immovably fixed at an arbitrary length by being tightened with a tightening nut 20 screwed to the end of the core member 18. The elongated rod 3 is inserted into the T-shaped joint member 8 with the core member 18 serving as a base, and is fixed to the T-shaped joint member 8 by screwing with a nut 21.
The sheath member 19 is attached so as to be orthogonally crosswise to the main rod 1, and is provided so that the distal end of the sheath member 19 faces the thoracic vertebra 16 (see FIG. 7). Since the elongated rod 3 forms the central skeleton of the present spinal corrector, it extends above the main rod 1 so as to be easily grasped by an operator, but is not necessarily limited to such a structure. Not something. On the other hand, the end portions of the core member 18 serving as the base are screwed into the screw holes of the elbow-type joint member 10, and the elongated rod bodies 4 and 5 are screwed together with the nut 21 to be attached to the main rod 1 or the branch rod 2. It is attached in a T-shape, and is provided so that the distal end of the sheath member 19 faces the thoracic spine 16.

The holding member 6 is a member for holding the vertebral body fixture 11 such as the vertebral body clamping member shown in FIG.
A substantially inverted T-shaped member comprising a U-shaped connecting portion 12 to be mounted on the distal end portion and a supporting arm portion 13 protruding in an upper arm shape on both sides from the lower end portion of the connecting portion 12. Formed. At both ends of the support arm 13, an oval mounting hole 23 for inserting the mounting shaft of the vertebral body fixture 11 is formed. A shaft hole for connecting the shaft and a circular hole 22 along an arc centered on the shaft hole are provided. As shown in FIG.
As shown in (1), the connecting portion 12 is connected to the distal end of the sheath member 19 via a shaft 24 parallel to the main rod 1 passing through the shaft hole, and a pin passing through the arc hole 22 is inserted into the sheath member 19. As a result, the support arm is attached to the distal end of the extension rod body 3, 4, and is provided so as to be swingable about the shaft 24 in a range of, for example, ± 30 ° = 60 ° determined by the arc hole 22. Both ends of the portion 13 can be alternately moved toward and away from the thoracic vertebra 16.

The holding member 7 is attached to the distal end of the elongated rod 5 to hold the vertebral body fixture 11 like the holding member 6, and is mounted on the distal end of the sheath member 19.
It is formed into a substantially L-shaped member including a connecting portion 14 of a character shape and a supporting arm portion 15 bent and connected to a lower end portion of the connecting portion 14. The supporting arm 15 has the supporting arm 13
An oval mounting hole 23 for inserting the mounting shaft of the vertebral body fixing tool 11 is formed in the same manner as that of the connecting part 12, while the connecting part 14 has a shaft hole and an arc like the connecting part 12. Hole 22
Is provided. The holding member 7 connects the connecting portion 14 to the distal end portion of the sheath member 19 via a shaft 25 parallel to the branch rod 2 and the extending rod 5 passing through the shaft hole, and forms an arc hole 22.
Is inserted into the sheath member 19 by being inserted into the sheath member 19, and is attached to the distal end portion of the elongated rod body 5 and swings around the shaft 25 in a range of, for example, ± 30 ° = 60 ° determined by the arc hole 22. The support arm 15 is provided so as to be adjustable and the lumbar spine 1
7 so as to be able to move in the spinal axis direction.

The procedure of correction by the spine corrector having such a structure will be described with reference to FIG. Vertebral body fixture 1
Thoracic vertebra 16 and lumbar vertebra 17 in a patient to undergo spinal correction
(See FIG. 7A).
In this state, the corresponding vertebral body fixtures 11 are respectively supported and fixed to the support arm 13 of the holding member 6 and the support arm 15 of the holding member 7 as illustrated in FIG. As a result, the spine corrector is attached to the thoracic vertebra and the lumbar vertebra through the vertebral body fixtures 11 before the correction.

The main rod 1 and the bifurcated rod 2 are immovably held so as to be substantially parallel to the expected axis of the vertebra after correction, and then the intended correction is performed using a predetermined surgical jig. Correction without applying excessive force to the condition. In this correction, as described above, rotation (rotation); ±
MX, ± MY, ± MZ, translation (translation); ± F
Since the spine corrector has the degrees of freedom of correction of X, ± FY, and ± FZ, the correction operation can be performed easily and reliably. The state of the corrected spine at this time is as shown in FIG. Under this straightening condition, the straightening rod 26
(See FIG. 7 (c)) is attached to the spine via the vertebral body fixture 11 to complete the fixation. Thereafter, the spine corrector is removed from the spine, and the corrective operation using the spine corrector is completed.

[0021]

The present invention is embodied in the form described above and has the following effects.

The present invention is directed to a thoracic vertebral center bar, a plurality of thoracic spinal bars, a plurality of lumbar vertebral bars, and a thoracic vertebral body fixture attached to each of the vertebral bars. By adjusting the component members of the holding member and the lumbar vertebral body fixation member, the spine can be corrected in any direction having six degrees of freedom, and thus the spine which is as ideal as possible is possible. The shape can be corrected, and as a result, there is an advantage that the satisfaction of the patient is high and the correction loss after the operation is low.

In addition, since the operation using the correction device and the fixing operation using the correction rod are performed separately, the operation procedure is less likely to be duplicated, the operation time is reduced, the amount of bleeding is reduced, and the bacterial infection rate is reduced. Is expected to decrease, and the reliability of the operation is improved.

[Brief description of the drawings]

FIG. 1 is a diagram showing the movement (degree of freedom) of a functional spine unit (FSU).

FIG. 2 is a conceptual diagram showing a state of spinal deformity.

FIG. 3 is a front view of the spine corrector according to the embodiment of the present invention.

FIG. 4 is a plan view corresponding to FIG.

FIG. 5 is a left side view corresponding to FIG. 3;

FIG. 6 is a side view of a vertebral body fixing part of the spinal orthosis shown in FIG. 3;

7 is an explanatory view of a procedure of a spine correction method using the spine corrector shown in FIG. 3;

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Main rod 2 ... Branch rod 3 ... Central extension rod for thoracic vertebra 4 ... Lateral extension rod for thoracic vertebra 5 ... Extension rod for lumbar vertebra 6 ... Retaining member for vertebral vertebral body 7 ... Lumbar vertebral body fixing tool Holding member 8: T-shaped joint member 9: T-shaped joint member 10: Elbow-shaped joint member 11: Vertebral body fixture 12: Connection part 13 ...
Supporting arm 14 ... Connecting part 15 ... Supporting arm 16 ...
Thoracic spine 17 ... lumbar spine 18 ... heart member 19 ...
Sheath member 20 ... Tightening nut 21 ... Nut 22 ...
Arc hole 23 ... Mounting hole 24 ... Shaft 25 ...
Shaft 26: Straightening rod

Claims (3)

[Claims] The length of a main rod disposed outside the human body parallel to the axis of the spine and the base attached to the main rod by a joint member so that the distal end is directed to the thoracic vertebra can be adjusted. A centrally stretched rod for the thoracic spine, and a centrally stretched rod on both sides sandwiching the centrally elongated rod for the thoracic vertebra of the main rod by a joint member so that the tip that can be rotated around the axis is directed toward the thoracic vertebra; A plurality of thoracic spine laterally extending rods whose axial length is adjustable so that the distance between them can be adjusted,
A support arm for supporting a vertebral body fixture such as a vertebral body clamp member is formed in a substantially inverted T-shape protruding from both sides from a lower end portion of the connection portion, and both end portions of the support arm portion Vertebral body fixation device for thoracic vertebrae, which is swingably attached to the distal ends of the central extension rods for the thoracic vertebra and the lateral extension rods for the thoracic vertebra by the connection portions so that the vertebrae can be alternately moved toward and away from the thoracic vertebra A spine corrector, which is attached to the thoracic spine portion via each of the vertebral body fixing devices. 2. A main rod disposed outside the human body in parallel to the axis of the spine, and two branch rods attached to the main rod by joint members and disposed in parallel to both sides of the main rod. And a plurality of rods whose base lengths are attached to each of the branch rods so that the distance between them can be adjusted by a mold joint member so that the tip end that can be rotated around the axis is directed to the lumbar spine, and whose axial length is adjustable. And a support arm for supporting a vertebral body fixture such as a vertebral body clamp member is formed into a substantially L-shape which is bent and connected to a lower end portion of the connection portion. A lumbar vertebra, which is swingably adjustable to the distal end of the lumbar extension rod by the connection portion so that the portion can rotate around an axis orthogonal to the branch rod and the lumbar extension rod facing the lumbar spine. And a vertebral body fixture holding member for the lumbar spine. A spinal corrector, which is mounted via each vertebral body fixture. 3. A main rod disposed outside the human body in parallel with the axis of the spine, and two branch rods attached to the main rod by joint members and disposed in parallel on both sides of the main rod. A centrally extending rod for the thoracic spine, the base of which is attached to the main rod by a joint member such that the distal end is directed to the thoracic vertebra, the axial length of which is adjustable; A plurality of bases, whose bases are attached to both sides of the main extension rod body for the thoracic spine by a joint member so as to be oriented so as to adjust the distance between the extension rod and the central extension rod body, are adjustable. A laterally extending bar for the thoracic spine and a support arm for supporting a vertebral body fixture such as a vertebral body clamp member are formed in a substantially inverted T-shape formed by protruding from the lower end of the connecting portion to both sides. And the ends of the support arm can be staggered toward and away from the thoracic spine. And a vertebral body vertebral body fixing member holding member which is attached to the distal end of the thoracic vertebral center extending rod and the thoracic spine laterally extending rod so as to be swingably adjustable by the connection portion, A plurality of stretch bars for lumbar vertebrae, the length of which is adjustable, the base length of which is adjustable by adjusting the distance between the divergence rods to each of the branch rods by a joint member such that the possible tip points toward the lumbar vertebra, A support arm for supporting a vertebral body fixture such as a vertebral body clamp member is formed in a substantially L-shape which is bent and connected to the lower end of the connection portion, and the support arm branches off facing the lumbar spine. A lumbar spine vertebral body fixture holding member, which is pivotally attached to the distal end of the lumbar extension rod by the connection portion so as to be rotatable about an axis perpendicular to the rod and the lumbar extension rod; Wherein each of the vertebral body fasteners Spinal orthosis, characterized in that mounted over.