[go: up one dir, main page]

WO2010004613A1 - Appareil de fixation de vertèbre - Google Patents

Appareil de fixation de vertèbre Download PDF

Info

Publication number
WO2010004613A1
WO2010004613A1 PCT/JP2008/062303 JP2008062303W WO2010004613A1 WO 2010004613 A1 WO2010004613 A1 WO 2010004613A1 JP 2008062303 W JP2008062303 W JP 2008062303W WO 2010004613 A1 WO2010004613 A1 WO 2010004613A1
Authority
WO
WIPO (PCT)
Prior art keywords
rod
fixing
screw
peripheral surface
fixation device
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/JP2008/062303
Other languages
English (en)
Japanese (ja)
Inventor
貴博 村瀬
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Robert Reid Inc
Original Assignee
Robert Reid Inc
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 Robert Reid Inc filed Critical Robert Reid Inc
Priority to JP2010519578A priority Critical patent/JPWO2010004613A1/ja
Priority to PCT/JP2008/062303 priority patent/WO2010004613A1/fr
Publication of WO2010004613A1 publication Critical patent/WO2010004613A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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, e.g. 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
    • 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 or setting implements
    • 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, e.g. 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
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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, e.g. 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

Definitions

  • the present invention relates to a spinal fixation device for fixing a spine, particularly a cervical vertebra and a thoracic vertebra.
  • the spinal fixation device includes a main body portion to which a screw to be embedded in a vertebra is attached and fixed.
  • the rod is accommodated in a rod accommodating portion disposed on a portion of the main body portion on the skin side of the patient.
  • a fixing screw is screwed into a female screw portion to fix a rod accommodated in the rod accommodating portion (for example, see Patent Document 1).
  • the spinal fixation device having such a configuration can easily secure the surgical field of view of the doctor and can attach each member from the upper side to the patient's spine in a state where the patient is lying down. It is effective from the viewpoint. JP 2005-169071 A
  • the parts other than the screw of the spinal fixation device used for fixing the spine are in a state where they are not embedded in the vertebrae and remain subcutaneously, but when the part existing under the skin becomes thick, the subcutaneous nerves are compressed by the part and after the operation. The patient may feel pain more easily.
  • the subcutaneous nerve of the spinal fixation device is easily compressed by the portion existing under the skin.
  • a main object of the present invention is to provide a spinal fixation device that can make the portion existing under the skin thinner and make it difficult for the patient to feel pain after the operation.
  • a spinal fixation device that is fixedly connected to a rod to fix a spine, wherein the implant member is at least partially embedded in a vertebra constituting the spine, and the implant member is attached.
  • a rod fixing member comprising: a mounting portion to be mounted; a rod receiving portion in which the rod is disposed; and a mounting fixing portion to which a fixing member for fixing the rod disposed in the rod receiving portion is fixed.
  • the rod receiving portion has an inner peripheral surface portion formed in a shape along at least a part of the outer peripheral surface of the rod, and the fixing member has a shape along at least a part of the outer peripheral surface of the rod.
  • An outer peripheral surface portion formed on the rod fixing member, and the fixing member is attached and fixed to the mounting fixing portion of the rod fixing member. The outer peripheral surface of the inner peripheral surface portion and said fixing member is contacted spinal fixation device for fixing the rod is provided.
  • the fixing member is attached and fixed to the mounting fixing portion of the rod fixing member, instead of fixing the rod by fixing the fixing member to the rod receiving portion of the rod fixing member.
  • the rod can be fixed by contacting the outer peripheral surface of the rod receiving portion and the outer peripheral surface of the fixing member in contact with the outer peripheral surface of the rod arranged on the outer periphery. Therefore, by arranging the fixing member on the side of the rod arranged in the rod receiving portion, the portion existing under the spine fixation device can be thinned, and the patient can hardly feel pain after the operation. .
  • the implant member is attached to the attachment portion such that one end portion of the implant member that is not embedded in the vertebra faces the rod side, and the fixing member is attached and fixed to the attachment fixing portion. Accordingly, the rod may be fixed and the outer peripheral surface of the rod may be brought into contact with the one end of the embedded member to fix the embedded member to the attachment portion.
  • the fixing member is attached and fixed to the attachment fixing portion, so that the rod can be fixed and the outer peripheral surface of the rod is brought into contact with one end portion that is not embedded in the vertebra of the implantation member.
  • the embedded member can be fixed to the attachment portion. Therefore, even in a spinal fixation device in which the implant member is not fixed to the rod fix member before the rod is fixed, both the fixation of the rod and the fix to the attachment portion of the implant member are used as the attachment fix portion. This can be done by a single operation of attaching and fixing the fixing member, and the fixation of the rod by the spinal fixation device can be made easier.
  • the rod may be formed in a substantially cylindrical shape, and the inner peripheral surface portion and the outer peripheral surface portion may be formed to be curved in a substantially arc shape.
  • the contact area between the outer peripheral surface of the rod arranged in the rod receiving portion, the inner peripheral surface portion of the rod receiving portion and the outer peripheral surface portion of the fixing member is further increased, so that the rod can be fixed more appropriately. It can be carried out. In particular, even if a force in a twisting direction is applied to the rod disposed in the rod receiving portion, the rod can be made difficult to come out to the skin side.
  • the length of the inner peripheral surface portion in the direction along the rod circumferential direction with respect to the outer periphery of the rod is 1 ⁇ 2 or less, and the length of the inner peripheral surface portion and the outer peripheral surface portion in the direction along the rod circumferential direction. The sum may be larger than 1 ⁇ 2.
  • the rod since the length of the inner peripheral surface portion in the direction along the rod circumferential direction is 1 ⁇ 2 or less with respect to the outer periphery of the rod, the rod can be properly arranged with respect to the rod receiving portion.
  • the sum of the lengths in the direction along the rod circumferential direction of the inner peripheral surface portion and the outer peripheral surface portion is larger than 1/2 with respect to the outer periphery of the rod, the rod is prevented from being removed by the fixing member and the rod fixing member. Can be performed properly.
  • the tip of the rod receiving portion opposite to the embedded member is disposed on the skin side of the back of the human body with respect to the central axis of the rod, and is formed so as to protrude around the fixing member side. May be.
  • the tip of the rod receiving portion opposite to the embedded member is disposed on the skin side of the back of the human body with respect to the central axis of the rod and is formed so as to protrude around the fixing member side. Therefore, even if a twisting force is applied to the rod arranged in the rod receiving portion, the rod receiving portion can be made difficult to be pulled out to the skin side by the tip portion on the opposite side to the embedded member. .
  • the fixing member is attached and fixed to the mounting and fixing portion of the rod fixing member, so that the inner periphery of the rod receiving portion having a shape along the outer peripheral surface is formed on the outer peripheral surface of the rod disposed in the rod receiving portion.
  • the rod can be fixed by bringing the surface portion and the outer peripheral surface portion of the fixing member into contact with each other. Therefore, by arranging the fixing member on the side of the rod arranged in the rod receiving portion, the portion existing under the spine fixation device can be thinned, and the patient can hardly feel pain after the operation. .
  • FIG. 8 is a side view showing the spinal fixation device of FIG. 7. It is a figure which expands and shows a part of spinal fixation apparatus of FIG.
  • FIG. 1 is a perspective view showing a spinal fixation device 100 exemplified as a preferred embodiment to which the present invention is applied.
  • 2 and 3 are diagrams schematically showing a state in which the spinal fixation device 100 is attached from the third cervical vertebra C3 to the fifth cervical vertebra C5, and FIG. 2 is a diagram viewed from the back side.
  • FIG. 3 is a view seen from the side.
  • the spinal fixation device 100 attached to the cervical vertebra C1 to C7
  • the implantation direction of the screw 3 with respect to the cervical vertebra C3 to C5 is defined as the Z-axis direction.
  • a direction along the extending direction of C7 is a Y-axis direction, and a direction substantially orthogonal to the Z-axis direction and the Y-axis direction is an X-axis direction.
  • the spinal fixation device 100 has, for example, two cervical vertebrae C3 to C5 to be fixed to each of the third cervical vertebra C3 to the fifth cervical vertebra C5.
  • the two rods R which are fixed to each other and are substantially cylindrical, are arranged along the cervical vertebrae C3 to C5.
  • the spinal fixation device 100 includes a rod fixing member 2 to which the rod R is attached and fixed by screwing the fixing screw 1, and is attached and fixed to the rod fixing member 2, and the cervical vertebra C3 to C5
  • the screw 3 to be screwed into is provided.
  • FIG. 4 is an exploded perspective view showing the spinal fixation device 100.
  • FIG. 5 is a side view showing the spinal fixation device 100.
  • 6 is a cross-sectional view of the spinal fixation device 100 taken along line VI-VI in FIG.
  • the screw 3 is an implant member that is at least partially embedded in the cervical vertebra C3 to C5. Specifically, as shown in FIG. 4, the screw 3 is formed in an elongated shape along the Z-axis direction. A screw main body 31 to be screwed into C5 is provided, and a screw head 32 is formed continuously at the skin side end of the shaft portion 31a of the screw main body 31.
  • the shaft portion 31 a is formed to have a smaller diameter than the screw head portion 32 and the screw thread portion other than the shaft portion 31 a of the screw main body portion 31.
  • the screw head 32 is formed to have a larger diameter than the screw main body 31 and the shaft portion 31a, and is prevented from being removed in a state where the screw head 32 is attached to the screw attachment portion 21 of the rod fixing member 2 described later. .
  • a through hole 33 is formed in the approximate center of the screw 3 along the Z-axis direction.
  • the through-hole 33 is for inserting a needle-like member (not shown) for specifying the attachment position of the spinal fixation device 100 in the cervical vertebra C3 to C5.
  • the rod fixing member 2 includes a screw attaching portion 21 to which the screw 3 is attached, a rod receiving portion 22 in which the rod R is arranged, and a fixing screw 1 for fixing the rod R arranged in the rod receiving portion 22. And an attachment fixing portion 23 having a female screw portion 23a to be screwed.
  • the rod receiving portion 22 is formed continuously at one end of the mounting fixing portion 23 in the X-axis direction.
  • the rod receiving portion 22 includes an inner peripheral surface portion 22a that receives the rod R and arranges the rod R along the extending direction (Y-axis direction) of the cervical vertebrae C1 to C7.
  • the inner peripheral surface portion 22 a is formed in a substantially arc shape so as to be substantially equal to the curvature of the outer peripheral surface of the rod R.
  • the inner peripheral surface portion 22a is recessed toward the cervical vertebra C1 to C7 with respect to one end in the X-axis direction of the mounting and fixing portion 23, and the distal end portion of the inner peripheral surface portion 22a is in the X-axis direction of the mounting and fixing portion 23. It is curved so as to wrap around the back skin (opposite to the cervical vertebrae C1 to C7) rather than one end.
  • the length of the inner peripheral surface portion 22a in the direction along the rod circumferential direction is substantially a half of the outer circumference of the rod R.
  • the length of the inner peripheral surface portion 22a in the direction along the rod circumferential direction only needs to be 1 ⁇ 2 or less with respect to the outer periphery of the rod R, whereby the inner peripheral surface portion 22a on the mounting fixing portion 23 side is sufficient.
  • the distance (opening width) between the end and the tip 22b opposite to the mounting fixing portion 23 can be made equal to or less than the diameter of the rod R, and the rod R can be received and disposed in the rod receiving portion 22.
  • the distal end portion 22b of the rod receiving portion 22 opposite to the mounting fixing portion 23, that is, the distal end portion 22b of the rod receiving portion 22 opposite to the screw 3 is formed to protrude toward the mounting fixing portion 23 side.
  • the distal end portion 22 b of the rod receiving portion 22 is disposed on the skin side of the back of the human body with respect to the central axis of the rod R disposed on the rod receiving portion 22 and is fixed to the attachment fixing portion 23. In a state where the screw 1 is screwed, it is formed so as to protrude toward the fixing screw 1 side.
  • a screw mounting portion 21 is disposed on the inner peripheral surface portion 22 a of the rod receiving portion 22.
  • the screw attachment portion 21 includes a screw insertion hole 21 a that penetrates a substantially central portion in the Y-axis direction of the inner peripheral surface portion 22 a in the Z-axis direction.
  • the screw insertion hole 21a includes a notch 21b formed so that the tip 22b of the rod receiving portion 22 is seated at a predetermined depth outward in the X-axis direction (see FIG. 4). That is, the distal end portion 22b of the rod receiving portion 22 is disposed on the skin side of the back of the human body relative to the central axis of the rod R disposed on the rod receiving portion 22, and protrudes so as to wrap around the fixing screw 1 side. Since it is formed, the screw 3 can be easily inserted into the screw insertion hole 21a along the Z-axis direction by forming the notch portion 21b at the distal end portion 22b of the rod receiving portion 22.
  • the outer diameter of the end of the screw insertion hole 21a on the skin side on the back is substantially equal to or slightly larger than the outer diameter of the screw head 32. Further, the outer diameter of the end of the screw insertion hole 21a on the cervical vertebra C3 to C5 side is smaller than that of the screw main body 31.
  • the screw main body 31 is screwed into the screw insertion hole 21a by being rotated by a predetermined rotating means (not shown) such as the above. In this state, as shown in FIG. 6, the outer diameter of the end portion on the cervical vertebra C3 to C5 side of the screw insertion hole 21a is larger than the shaft portion 31a of the screw main body 31, and the screw head 32 The diameter is smaller than that.
  • the screwing amount of the screw main body portion 31 with respect to the screw insertion hole 21a is arranged in the rod receiving portion 22 in consideration of the screwing of the male screw portion 11 of the fixing screw 1 with respect to the female screw portion 23a of the mounting fixing portion 23 described later.
  • the degree of contact with the outer peripheral surface of the made rod R is set to a level that can be contacted (details will be described later).
  • the screw 3 causes the screw head (one end portion) 32 not embedded in the cervical vertebra C3 to C5 to face the rod R side. It is like that. Further, in this state, that is, in a state where the screw main body 31 is screwed into the screw insertion hole 21a, the screw 3 has a predetermined angle (for example, 15) with respect to the X-axis direction or the Y-axis direction about the axis in the Z-axis direction. (Degrees of rotation) is allowed. In FIG. 5, the range in which the screw 3 can be rotated is schematically represented by a two-dot chain line.
  • the screwing direction of the screw 3 with respect to the cervical vertebra C3 to C5 does not necessarily have to be substantially parallel to the Z-axis direction, and the screw 3 can be screwed in a direction shifted from the Z-axis direction.
  • the degree of freedom in the screwing direction can be increased.
  • the attachment fixing portion 23 is formed in a substantially rectangular parallelepiped shape, and a female screw portion 23a is formed in a substantially central portion thereof (see FIG. 4).
  • the female screw portion 23a is formed so as to sit on a predetermined depth along the Z-axis direction from the skin-side surface of the attachment fixing portion 23.
  • the fixing screw 1 is a fixing member for fixing the rod R arranged in the rod receiving portion 22.
  • the fixing screw 1 is a male screw portion screwed with the female screw portion 23 a of the rod fixing member 2. 11 and a screw head 12 formed continuously at the skin-side end of the male screw 11.
  • the outer peripheral surface portion 12a of the screw head 12 is formed to be curved in a substantially arc shape so as to be substantially equal to the curvature of the outer peripheral surface of the rod R. That is, the outer peripheral surface portion 12a is curved in an arc shape convex toward the axial center so as to gradually reduce the diameter as it becomes closer to the male screw portion 11 side along the Z-axis direction. Further, the outer peripheral surface portion 12a of the screw head portion 12 is substantially equal in radius to the inner peripheral surface portion 22a of the rod receiving portion 22 in a state where the fixing screw 1 is attached and fixed to the attachment fixing portion 23 of the rod fixing member 2. A part of the outer periphery of a substantially concentric circle is formed.
  • the length of the outer peripheral surface portion 12a in the direction along the rod circumferential direction is such that the sum of the length of the inner peripheral surface portion 22a of the rod receiving portion 22 in the direction along the rod circumferential direction is 1/2 with respect to the outer periphery of the rod R.
  • the outer peripheral surface portion 12 a of the screw head 12 contacts the outer peripheral surface of the rod R disposed in the rod receiving portion 22 in a state where the fixing screw 1 is attached and fixed to the mounting fixing portion 23 of the rod fixing member 2.
  • the rod R is prevented from being removed.
  • a rotating member attachment portion 12b to which a predetermined rotation member such as a screw driver for rotating the fixing screw 1 is attached is provided on the end surface of the screw head 12 opposite to the male screw portion 11.
  • Each part constituting the spinal fixation device 100 that is, the screw 3, the rod fixing member 2, and the fixing screw 1 is made of a medical material such as an alloy containing titanium or the like at a predetermined ratio, or stainless steel, for example.
  • the attachment position of the spinal fixation device 100 in the cervical vertebra C1 to C7 that is, the screwing position of the screw 3 that avoids nerves and the like of the cervical vertebra C1 to C7, the needle-like member is inserted into the cervical vertebra C1 to C7, Identify by confirming with.
  • the attachment positions of all the spinal fixation devices 100 may be specified in advance.
  • the attachment position may be specified for each spinal fixation device 100.
  • the screw 3 is screwed by a screw driver along any one of the needle-like members inserted into the cervical vertebra C3 to C5. Specifically, the screw 3 is rotated by a screw driver, the screw 3 is screwed into the screw insertion hole 21a of the rod fixing member 2, and the screw main body portion of the screw 3 screwed into the screw insertion hole 21a. The screw 3 is screwed into the cervical vertebrae C3 to C5 so that the needle-like member is inserted into the through-hole 33 of 31. Thereafter, the needle-like member in which the through hole 33 of the screw 3 is extrapolated is pulled out.
  • the screw body 31 of the screw 3 is screwed into a predetermined cervical vertebra (for example, cervical vertebra C3), and the screw head 32 is attached to the screw attachment portion 21 so as to face the rod R side. It will be in the state.
  • the rod fixing member 2 is rotatable with respect to the screw 3 by a predetermined angle (for example, about 15 °) about the axis in the extending direction of the screw 3. A certain degree of freedom in arrangement of the rod R is ensured.
  • the rod R is disposed inside the rod receiving portion 22 so that the outer peripheral surface of the rod R is brought into contact with the inner peripheral surface portion 22a of the rod receiving portion 22, and the rod R is extended in the extending direction of the cervical vertebra C1 to C7. Arrange along (Y-axis direction).
  • the male screw portion 11 of the fixing screw 1 is screwed into the female screw portion 23 a of the mounting fixing portion 23 of the rod fixing member 2.
  • the inner peripheral surface portion 22a of the rod receiving portion 22 and the outer peripheral surface portion 12a of the fixing screw 1 are brought into contact with the outer peripheral surface of the rod R arranged in the rod receiving portion 22, and the rod R is moved along the Z-axis direction to the cervical spine.
  • the rod R is fixed by being pushed toward the cervical spine C3, and the outer peripheral surface of the rod R is brought into contact with the screw head 32 of the screw 3 to fix the screw 3 to the screw mounting portion 21.
  • the rod R is arranged along the cervical vertebrae C1 to C7 by performing the above-described operation on each of the spinal fixation devices 100 and fixing the rod R.
  • the fixing screw is screwed into the rod accommodating portion to fix the rod R.
  • the fixing screw 1 is attached and fixed to the attachment fixing portion 23 of the rod fixing member 2, whereby the rod receiving portion 22 having a shape along the outer peripheral surface on the outer peripheral surface of the rod R arranged in the rod receiving portion 22.
  • the rod R can be fixed by bringing the inner peripheral surface portion 22a of the fixing screw 1 and the outer peripheral surface portion 12a of the fixing screw 1 into contact with each other.
  • the fixing screw 1 is attached and fixed to the attachment fixing portion 23, so that the rod R can be fixed and the outer peripheral surface of the rod R is not embedded in the cervical vertebra C3 to C5 of the screw 3.
  • the screw 3 can be fixed to the screw mounting portion 21 by contacting the portion 32. Therefore, even in the spinal fixation device 100 in which the screw 3 is not fixed to the rod fixing member 2 before fixing the rod R, both the fixation of the rod R and the screw 3 to the screw mounting portion 21 are performed.
  • the fixing screw 1 can be attached and fixed to the mounting and fixing portion 23 in one operation, and the fixation of the rod R by the spine fixing device 100 can be facilitated.
  • the fixing screw 1 can be arranged on the side of the rod R arranged in the rod receiving portion 22 and the rod R is fixed by screwing the fixing screw into the conventional rod housing portion.
  • the thickness in the Z-axis direction of the portion existing under the skin of the spinal fixation device 100 can be reduced, and the patient can hardly feel pain after the operation.
  • the spinal fixation device 100 according to the present invention has a longer length in the X-axis direction and the Y-axis direction than a conventional configuration in which a fixing screw is screwed into a rod housing portion to fix the rod.
  • the rod R is formed in a substantially cylindrical shape, and the inner peripheral surface portion 22a of the rod receiving portion 22 and the outer peripheral surface portion 12a of the fixing screw 1 are formed to be curved in a substantially arc shape.
  • the rod R can be fixed more appropriately by increasing the contact area between the outer peripheral surface of the rod R arranged on the inner surface 22a of the rod receiving portion 22 and the outer peripheral surface 12a of the fixing screw 1.
  • the rod R can be made difficult to come out to the skin side.
  • the rod R and the fixing screw are screwed in the configuration in which the fixing screw is screwed into the rod housing portion and the rod R is fixed as in the conventional case. Since the mountain portions are in contact with each other, when the neck is moved, an external force is applied to the fixing screw in contact with the rod R due to the twisting of the rod R, and the fixing screw is easily rotated (loosened). If the washer is arranged to suppress the loosening of the fixing screw, there arises a problem that the thickness in the Z-axis direction is further increased.
  • the rod R and the outer peripheral surface portion 12a are in contact with each other, not the male screw portion 11 of the fixing screw 1, the rod R is twisted by moving the neck. Even if an external force is applied to the fixing screw 1 due to the occurrence of stress, the rotation (loosening) of the fixing screw 1 is restricted by applying stress to the rod R side. Thereby, it becomes difficult for the fixing screw 1 to loosen, and it is possible to appropriately prevent the rod R from coming off (reversing).
  • FIG. 7 is a perspective view showing a spinal fixation device 200 of the first modification.
  • FIG. 8 is a side view showing the spinal fixation device 200 of Modification 1.
  • FIG. 9 is an enlarged view of a portion surrounded by the one-dot chain line A in FIG.
  • the spinal fixation device 200 of Modification 1 includes a rod contact member 4 through which the fixing screw 1 is inserted to contact the outer peripheral surface of the rod R, and the rod contact member 4.
  • the fixing screw 201 and the rod receiving portion 22 cooperate to fix the rod R.
  • the spinal fixation device 200 of Modification 1 has substantially the same configuration as the spinal fixation device 100 of the above-described embodiment except for the configuration including the rod abutting member 4 and the external shape of the fixing screw 201. Omitted.
  • the rod abutting member 4 is a plate-like member having a predetermined thickness in the Z-axis direction.
  • the rod-like member 41 includes an insertion hole (not shown) through which the fixing screw 201 is inserted, and the rod R.
  • a contact surface portion 42 formed in a shape along at least a part of the outer peripheral surface is provided. As shown in FIGS. 8 and 9, the contact surface portion 42 is formed continuously with one end in the X-axis direction of the plate-like portion 41, and has a substantially arc shape so as to be substantially equal to the curvature of the outer peripheral surface of the rod R. It is curved. Specifically, the contact surface portion 42 is formed to be curved so as to protrude a predetermined length from one end of the plate-like portion 41 in the X-axis direction toward the back skin side.
  • the screw head 12 of the fixing screw 201 has a smaller diameter than that of the fixing screw 1 of the above embodiment.
  • a portion 12c of the outer peripheral surface portion 12a of the screw head 12 is formed to be curved in a substantially arc shape so as to be substantially equal to the curvature of the outer peripheral surface of the rod R. That is, the cervical vertebra C3 to C5 side and the skin side of the part 12c of the outer peripheral surface part 12a of the screw head 12 have a curvature different from the curvature of the outer peripheral surface of the rod R (see FIG. 9).
  • the spinal fixation device 200 is configured to fix the rod R in substantially the same procedure as that of the spinal fixation device 100 of the above-described embodiment.
  • the procedure different from that of the spinal fixation device 100 of the above-described embodiment is particularly detailed. Explained.
  • the attachment position of the spinal fixation device 100 in the cervical vertebra C1 to C7 is specified by inserting a needle-like member into the cervical vertebra C1 to C7 and confirming by X-ray imaging or the like.
  • the screw 3 is screwed by a screw driver along any one of the needle-like members inserted into the cervical vertebra C3 to C5.
  • the screw body 31 of the screw 3 is screwed into the cervical vertebra C3 to C5, and the screw 3 is attached to the screw attachment 21 so that the screw head 32 faces the rod R side. .
  • the rod R is disposed inside the rod receiving portion 22 so that the outer peripheral surface of the rod R is brought into contact with the inner peripheral surface portion 22a of the rod receiving portion 22, and the rod R is extended in the extending direction of the cervical vertebra C1 to C7. Arrange along (Y-axis direction).
  • the spinal fixation device 200 of the first modification it is needless to say that the same effect as in the above embodiment can be obtained, and the contact surface portion 42 of the rod contact member 4 is applied to the outer peripheral surface of the rod R. Since the rod R is fixed by contact, the outer peripheral surface of the rod R arranged in the rod receiving portion 22, the inner peripheral surface portion 22a of the rod receiving portion 22, the portion 12c of the outer peripheral surface portion 12a of the fixing screw 201, and the rod contact The contact area with the contact surface portion 42 of the member 4 can be increased, and the rod R can be fixed more appropriately. A force in the twisting direction is applied to the rod R arranged on the rod receiving portion 22. Also, it is possible to make it difficult to remove the rod R to the skin side.
  • the rod R is exemplified by a columnar shape having substantially the same cross-sectional shape, but the outer shape of the rod R is not limited to this.
  • the outer shape of the rod R is other than a cylindrical shape, the outer peripheral surface of the inner peripheral surface portion 22a of the rod receiving portion 22 and the outer peripheral surface portion 12a of the fixing screw 1 are matched with the shape of the outer peripheral surface of the rod R. What is necessary is just to form in the shape which follows at least one part.
  • the fixing screw 1 is attached and fixed to the attachment fixing portion 23, whereby the rod R is fixed, and the screw R is prevented from being pulled out to the skin side by the rod R and attached and fixed to the screw attachment portion 21.
  • the attachment method of the screw 3 with respect to the screw attachment portion 21 is not limited to the one exemplified in the embodiment and the first modification.
  • the thing in which the screw 3 and the rod fixing member 2 were comprised by the separate member was illustrated, it is not restricted to this, The screw 3 and the rod fixing member 2 And may be configured integrally.
  • the distal end portion 22 b of the rod receiving portion 22 is disposed on the skin side of the back of the human body with respect to the central axis of the rod R disposed on the rod receiving portion 22, and the fixing screw 1 is provided on the attachment fixing portion 23.
  • the shape of the distal end portion 22b of the rod receiving portion 22 can be arbitrarily changed as appropriate, and the above-described embodiments and modifications are not necessarily required.
  • the shape as in Example 1 is not necessary.
  • a washer such as a plain washer or a spring washer may be inserted into the male screw portion 11 of the fixing screw 1 so that the washer is interposed between the fixing screw 1 and the rod fixing member 2.
  • the fixing screw 1 can be made more difficult to loosen, and the rod R can be fixed more firmly.
  • the spinal fixation devices 100 and 200 are illustrated as fixing the third cervical vertebra C3 to the fifth cervical vertebra C5, but may be other cervical vertebrae.
  • the spinal fixation device may fix a spine other than the cervical vertebrae C1 to C7, for example, a thoracic vertebra.
  • the fixing screw is not screwed into the rod receiving portion of the rod fixing member to fix the rod, but is fixed to the mounting fixing portion of the rod fixing member.
  • the inner peripheral surface portion of the rod receiving portion and the outer peripheral surface portion of the fixing screw in contact with the outer peripheral surface of the rod arranged in the rod receiving portion are fixed to fix the rod. can do.
  • the present invention can be particularly suitably used for a technique capable of thinning a portion existing under the skin in a spinal fixation device.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Neurology (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention porte sur un appareil de fixation de vertèbre qui a un élément enterré qui doit être au moins partiellement noyé dans une vertèbre, une partie d'installation sur laquelle l'élément noyé est installé, une partie de réception de tige dans laquelle une tige est déposée, et une partie d'installation et de fixation à laquelle un élément de fixation destiné à fixer la tige disposée dans la partie de réception de tige est installé et fixé. Grâce à l'installation et la fixation de l'élément de fixation à la partie d'installation et de fixation de l'élément de fixation de tige, la tige est fixée tandis que la partie de surface périphérique interne de la partie de réception de tige et la partie de surface périphérique externe de l'élément de fixation qui sont toutes deux formées le long de la surface périphérique externe de la tige disposée dans la partie de réception de tige sont en contact avec la surface périphérique externe de la tige.
PCT/JP2008/062303 2008-07-08 2008-07-08 Appareil de fixation de vertèbre Ceased WO2010004613A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
JP2010519578A JPWO2010004613A1 (ja) 2008-07-08 2008-07-08 脊椎固定装置
PCT/JP2008/062303 WO2010004613A1 (fr) 2008-07-08 2008-07-08 Appareil de fixation de vertèbre

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2008/062303 WO2010004613A1 (fr) 2008-07-08 2008-07-08 Appareil de fixation de vertèbre

Publications (1)

Publication Number Publication Date
WO2010004613A1 true WO2010004613A1 (fr) 2010-01-14

Family

ID=41506747

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2008/062303 Ceased WO2010004613A1 (fr) 2008-07-08 2008-07-08 Appareil de fixation de vertèbre

Country Status (2)

Country Link
JP (1) JPWO2010004613A1 (fr)
WO (1) WO2010004613A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2011119751A1 (fr) * 2010-03-23 2011-09-29 Scapa Flow, Llc Système de connecteurs cervicaux

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2827757A1 (fr) * 2001-07-27 2003-01-31 Sra Piece et dispositif pour materiel d'immobilisation relative de deux vertebres
US20050228382A1 (en) * 2004-04-12 2005-10-13 Marc Richelsoph Screw and rod fixation assembly and device

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2845269B1 (fr) * 2002-10-07 2005-06-24 Spine Next Sa Systeme de fixation a plaque
US7850716B2 (en) * 2006-02-17 2010-12-14 Warsaw Orthopedic, Inc. Adjustable interconnection device
US20070233062A1 (en) * 2006-04-04 2007-10-04 Amedica Corporation Pedicle screw system with offset stabilizer rod
US7789897B2 (en) * 2006-04-11 2010-09-07 Warsaw Orthopedic, Inc. Pedicle screw spinal rod connector arrangement

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2827757A1 (fr) * 2001-07-27 2003-01-31 Sra Piece et dispositif pour materiel d'immobilisation relative de deux vertebres
US20050228382A1 (en) * 2004-04-12 2005-10-13 Marc Richelsoph Screw and rod fixation assembly and device

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2011119751A1 (fr) * 2010-03-23 2011-09-29 Scapa Flow, Llc Système de connecteurs cervicaux
US10219842B2 (en) 2010-03-23 2019-03-05 Scapa Flow, Llc Cervical link system
US11123111B2 (en) 2010-03-23 2021-09-21 Scapa Flow, Llc Cervical link system

Also Published As

Publication number Publication date
JPWO2010004613A1 (ja) 2011-12-22

Similar Documents

Publication Publication Date Title
CA2343327C (fr) Systeme de fixation vertebrale a angle variable
JP6087356B2 (ja) 骨アンカー
JP4138255B2 (ja) 脊椎安定化装置
JP5612668B2 (ja) 最小限侵襲圧着のためのシステムおよび方法ならびに骨締結のためのケーブル
CN101588764B (zh) 骶骨重建固定装置
US8506609B2 (en) Receiving part for receiving a rod for coupling the rod to a bone anchoring element and a bone anchoring device with such a receiving part
US8475499B2 (en) Rod to rod connectors and methods of adjusting the length of a spinal rod construct
US20060149234A1 (en) Variable offset connectors and bone fixation methods
JP2011036666A (ja) ロッドを受けこのロッドを骨固定要素に結合するための受け部
KR101037206B1 (ko) 척추 임플란트 보조 나사못 및 그 삽입기구
JP2010525874A (ja) 脊椎固定システムのための装着システムおよびそれに関連した方法
CA2475200A1 (fr) Appareil et procede connecteur de vis pediculaire
JP2002518084A (ja) 脊柱ロッド固定装置
US20140012333A1 (en) Polyaxial screw with mechanical thread and its friction device
WO2011077511A1 (fr) Dispositif de fixation de colonne vertébrale, dispositif d'incorporation, dispositif de fixation d'élément d'incorporation, et système de fixation de colonne vertébrale
JP2017522133A (ja) 外科インプラント用多軸スクリュー
JP2013070998A (ja) 骨固定アセンブリ
JP2021069944A (ja) 椎弓板下バンドクランプ
US11147595B2 (en) Occipital plate with angled screw opening
WO2010004613A1 (fr) Appareil de fixation de vertèbre
US9763718B2 (en) Bone screw
KR20210080415A (ko) 자극 프로브 어셈블리 및 사용 방법
JP2013111260A (ja) 脊椎固定用手術器具
KR100980313B1 (ko) 척추교정용 로드
CN223081738U (zh) 一种骶髂关节髓内钉

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 08790940

Country of ref document: EP

Kind code of ref document: A1

WWE Wipo information: entry into national phase

Ref document number: 2010519578

Country of ref document: JP

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 08790940

Country of ref document: EP

Kind code of ref document: A1