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WO2011077511A1 - Dispositif de fixation de colonne vertébrale, dispositif d'incorporation, dispositif de fixation d'élément d'incorporation, et système de fixation de colonne vertébrale - Google Patents

Dispositif de fixation de colonne vertébrale, dispositif d'incorporation, dispositif de fixation d'élément d'incorporation, et système de fixation de colonne vertébrale Download PDF

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Publication number
WO2011077511A1
WO2011077511A1 PCT/JP2009/071272 JP2009071272W WO2011077511A1 WO 2011077511 A1 WO2011077511 A1 WO 2011077511A1 JP 2009071272 W JP2009071272 W JP 2009071272W WO 2011077511 A1 WO2011077511 A1 WO 2011077511A1
Authority
WO
WIPO (PCT)
Prior art keywords
fixing
screw
head
rod
main body
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/JP2009/071272
Other languages
English (en)
Japanese (ja)
Inventor
英雄 一青
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 PCT/JP2009/071272 priority Critical patent/WO2011077511A1/fr
Publication of WO2011077511A1 publication Critical patent/WO2011077511A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • A61B17/7082—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7083—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
    • A61B17/7086—Rod reducers, i.e. devices providing a mechanical advantage to allow a user to force a rod into or onto an anchor head other than by means of a rod-to-bone anchor locking element; rod removers
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7091—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges

Definitions

  • the present invention relates to a spinal fixation device for fixing a spine, an implantation device for embedding an implantation member of the spinal fixation device in the spine, and an implantation member for fixing the implantation member of the spinal fixation device to a head portion.
  • the present invention relates to a fixation device and a spinal fixation system.
  • a rod is attached and fixed to a spinal fixation device fixed to a vertebra as a surgical operation, and the rod is disposed along the spine.
  • a spinal fixation device fixed to a vertebra as a surgical operation
  • the rod is disposed along the spine.
  • a fixing screw is screwed into the female screw portion of the rod accommodating portion to fix the rod.
  • a rotation type device (for example, refer to Patent Document 1) in which a screw embedded in a vertebra is rotatably attached to and fixed to a main body part, or a screw and a main body part are integrally formed.
  • the rotation type spinal fixation device can rotate the main body with respect to the screw, the degree of freedom of attachment of the rod is high, and even if the attachment direction of the device to the vertebra is slightly deviated, It can be accommodated in the rod accommodating portion.
  • the screw and the main body portion are fixed, the fixed spinal fixation device can firmly fix the rod accommodated in the rod accommodating portion.
  • the distance between two spinal fixation devices fixed to one rod Therefore, it is necessary to prevent the implant device from being displaced and to fix, correct, and stabilize the spine.
  • the spine may be fixed, corrected, stabilized, etc. by fixing the two spinal fixation devices fixed to one rod so as to be separated from each other. At this time, in order to firmly fix the spinal fixation device and the rod, it is more preferable to use a fixed spinal fixation device.
  • the main object of the present invention is to use both a rotation type and a fixation type, and to properly fix, correct, and stabilize the spine, a spine fixation device, an implantation device, and an implantation device. It is an object of the present invention to provide a locking member fixing device and a spinal fixation system.
  • a spinal fixation device that is connected and fixed to a rod to fix a spine, and an implant member that is at least partially embedded in a vertebra constituting the spine, and a head portion that can fix the implant member and the rod;
  • the head portion includes an embedded member placement portion on which the embedded member is placed, and a rod fixing portion on which the rod is fixed, and a head portion body disposed on the embedded member placement portion.
  • a fixing member for fixing the embedded member to the head portion, and the fixing member is attached to the head portion main body to hold the embedded member, and the fixing member
  • the mounting state with respect to the head portion main body includes a first state in which the embedded member disposed in the embedded member disposition portion is held rotatably about a predetermined angle about an axis extending in a predetermined direction, and the embedded state. Retaining non-rotating member A second state and to switchably Configured spinal fixation device is provided that.
  • the mounting state of the fixing member that holds the embedded member by being attached to the head portion main body with respect to the head portion main body extends the embedded member arranged in the embedded member arranging portion in a predetermined direction.
  • the head portion of the fixing member is configured to be switchable between a first state that is rotatably held at a predetermined angle around a shaft to be rotated and a second state in which the embedded member is held unrotatable.
  • the degree of freedom of attachment of the rod can be further increased, and further, after attaching the rod, by using it as a fixation type spinal fixation device, It is possible to appropriately perform a treatment for bringing the distance between the two spinal fixation devices fixed to one rod closer to or away from each other, and to appropriately fix, correct and stabilize the spine.
  • it since it can be used as both a spinal and fixed spinal fixation device, it is not necessary to prepare a rotary and fixed spinal fixation device in accordance with the patient's spinal disease state. The cost of the spinal fixation device can be reduced as compared to the case where both a rotation type and a fixation type spine fixation device are prepared. Can be achieved.
  • the implant member placement portion is provided on the vertebra side of the head portion main body, and the fixing member supports one end portion of the implant member inserted through the through hole that is not embedded in the vertebra.
  • the fixing member having the insertion portion inserted into the through hole is attached to the head portion main body, so that the support portion supports the one end portion of the implantation member and The insert member may be held.
  • the fixing member having the through hole inserted into the through hole is attached to the head portion main body, so that the support portion supports the one end portion that is not embedded in the vertebra of the embedded member, and Since the member is held, the fixing member can be held in a state in which the embedded member inserted through the through hole is prevented from being detached by the support portion, and the fixing member is attached to the head portion main body in the first state. Switching to the second state can be performed appropriately.
  • the support portion may include an inner surface formed in a shape along at least a part of the outer surface of the one end portion of the embedded member.
  • the inner side surface of the support portion is formed in a shape along at least a part of the outer surface of the one end portion of the embedding member, so that the inner side surface of the support portion and the outer surface of the one end portion of the embedding member are By increasing the contact area, the supporting member can support the embedded member more appropriately.
  • the embedded member disposition portion may include an inner surface that contacts an outer surface of the one end portion of the embedded member.
  • the inner surface of the implant member placement portion contacts the outer surface of one end portion that is not embedded in the vertebra of the implant member, so that the inner surface of the implant member placement portion and the one end portion of the implant member are in contact with each other.
  • the supporting member can support the embedded member more appropriately.
  • the fixing member has a screwing portion that is screwed with a screwed portion formed on an outer surface of the head portion main body, and adjusts an amount of screwing between the screwing portion and the screwed portion.
  • the mounting state of the fixing member with respect to the head portion main body may be configured to be switchable between the first state and the second state.
  • the mounting state of the fixing member with respect to the head portion main body can be adjusted by adjusting the screwing amount between the screwed portion of the fixing member and the screwed portion formed on the outer surface of the head portion main body. Since it is configured to be switchable between the first state and the second state, it is a relatively simple operation of adjusting the screwing amount between the screwing portion of the fixing member and the screwed portion of the head portion main body.
  • the mounting state of the fixing member with respect to the head body can be appropriately switched between the first state and the second state.
  • An implanting device for embedding the implanting member provided in the spinal fixation device according to the present invention in the vertebra, wherein the head fixing member is fixedly attached to the rod fixing portion of the spinal fixation device, and the implantation
  • An implant member attaching member attached to one end of the member not embedded in the vertebra, and attaching the implant member attaching member to the one end of the implant member to embed the implant member in the vertebra
  • an embedding device configured to fix the relative position of the head portion with respect to the embedding member by attaching and fixing the head portion fixing member to the rod fixing portion.
  • the head fixing member is attached and fixed to the rod fixing portion when the implanting member attaching member of the implanting device is attached to one end portion of the implanting member and the implanting member is embedded in the vertebra.
  • the relative position of the head part with respect to the implant member is fixed, so that the rotation of the head part around the implant member embedded in the vertebra is restricted, and the implant member with respect to the vertebra is controlled. Embedding can be performed appropriately.
  • a positioning member for fixing a relative position between the head portion fixing member and the implanting member mounting member with respect to an embedding direction of the implanting member when the implanting member is embedded in the vertebra. May be.
  • the positioning member fixes the relative position of the head portion fixing member and the implant member mounting member with respect to the implant direction of the implant member.
  • the head fixing member can be moved following the implant member mounting member that moves in the embedding direction in accordance with the increase or decrease in the amount of the implant member embedded in the vertebra, and the implant member can be appropriately embedded in the vertebra. Can do.
  • a spinal fixation system comprising: a spinal fixation device according to the present invention; and an implanting device for implanting the implant member of the spinal fixation device into the vertebra.
  • a head portion fixing member that is fixedly attached to the rod fixing portion; and an implanting member attaching member that is attached to one end portion of the implanting member that is not embedded in the vertebra.
  • the head portion fixing member is attached and fixed to the rod fixing portion, so that the head portion is relative to the implantation member.
  • a spinal fixation system is provided that is configured to fix the correct position.
  • the head fixing member is attached and fixed to the rod fixing portion when the implanting member attaching member of the implanting device is attached to one end portion of the implanting member and the implanting member is embedded in the vertebra.
  • the relative position of the head part with respect to the implant member is fixed, so that the rotation of the head part around the implant member embedded in the vertebra is restricted, and the implant member with respect to the vertebra is controlled. Embedding can be performed appropriately.
  • An embedded member fixing device for fixing the embedded member included in the spinal fixation device according to the present invention to the head portion, wherein the embedded member is engaged with an engaged portion formed on an outer surface of the fixing member.
  • a first engagement member having one engagement portion
  • a second engagement member having a second engagement portion that engages with the rod fixed to the rod fixing portion of the head portion main body
  • the first engaging member engages the first engaging portion and the engaged portion and rotates in a predetermined direction, whereby the screwed portion formed on the outer surface of the head portion main body and the The amount of screwing with the screwed portion of the fixing member is adjustable, and the second engaging member of the second engaging member is engaged with the rod, so that the rotation of the head body in a predetermined direction is performed.
  • the first engaging member is engaged with the engaged portion of the fixing member in a predetermined direction. And the threaded portion of the fixing member is screwed into the threaded portion of the head portion main body so as to fix the embedded member to the head portion.
  • An embedded member securing device is provided.
  • the first engagement portion of the fixing member is in a state in which the second engagement portion of the second engagement member is engaged with the rod to restrict the rotation of the head body in the predetermined direction.
  • the screwing portion of the fixing member is screwed into the screwed portion of the head portion main body, and the embedded member is Since it is fixed to the head part, it is formed on the outer surface of the head part main body by engaging the first engaging part of the first engaging member and the engaged part of the fixing member and rotating in a predetermined direction.
  • the fixing member is rotated in a predetermined direction with the rotation of the head part main body being restricted.
  • the screwed portion of the fixing member can be properly screwed into the screwed portion of the head portion main body, and the embedded member can be properly fixed to the head portion.
  • the fixing member of the spinal fixation device is attached to the vertebra side with respect to the rod fixing portion of the head portion main body, and the first engaging member is configured such that the first engaging portion is the fixing member.
  • the rod arrangement opening further includes a rod arrangement opening in which the rod engaged with the second engagement portion of the second engagement member is arranged on the inner side in a state of being engaged with the engaged portion.
  • the opening for use is configured such that the first engagement portion in a state where the second engagement portion of the second engagement member engages the rod and restricts rotation of the head portion main body in a predetermined direction. You may comprise so that the rotation space of the predetermined direction of the said 1st engagement member engaged with the said to-be-engaged part of the member for fixation may be formed.
  • the first engagement portion is the fixing member in a state where the second engagement portion of the second engagement member engages the rod and restricts the rotation of the head body in the predetermined direction. Since the rotation space for the first engagement member engaged with the engaged portion to rotate in a predetermined direction is formed by the rod arrangement opening, the fixing member is more than the rod fixing portion of the head body. Even in the configuration attached to the vertebra side, the rod is arranged inside the rod arrangement opening, so that the first engagement in a state where the first engagement portion and the fixing member are engaged with each other.
  • the screwing portion of the fixing member can be properly screwed into the screwed portion of the head portion main body, and the head of the embedded member The fixing to the part can be performed appropriately.
  • a spinal fixation system comprising: a spinal fixation device according to the present invention; and an implantation member fixation device for fixing the implantation member of the spine fixation device to the head portion, wherein the implantation member fixation device is A first engaging member having a first engaging portion that engages with an engaged portion formed on an outer surface of the fixing member, and the rod fixed to the rod fixing portion of the head body. A second engagement member having a second engagement portion to be engaged, wherein the first engagement member engages the first engagement portion and the engaged portion and rotates in a predetermined direction.
  • the amount of screwing between the screwed portion formed on the outer surface of the head portion main body and the screwed portion of the fixing member can be adjusted, and the second engagement of the second engaging member can be adjusted.
  • the first engagement in a state in which the joint portion is engaged with the rod to restrict the rotation of the head body in a predetermined direction.
  • the screwing portion of the fixing member is engaged with the screwed portion of the head portion main body.
  • a spinal fixation system is provided that is threaded into a portion and configured to secure the implant member to the head portion.
  • the first engagement portion of the fixing member is in a state in which the second engagement portion of the second engagement member is engaged with the rod to restrict the rotation of the head body in the predetermined direction.
  • the screwing portion of the fixing member is screwed into the screwed portion of the head portion main body, and the embedded member is Since it is fixed to the head part, it is formed on the outer surface of the head part main body by engaging the first engaging part of the first engaging member and the engaged part of the fixing member and rotating in a predetermined direction.
  • the fixing member is rotated in a predetermined direction with the rotation of the head part main body being restricted.
  • the screwed portion of the fixing member can be properly screwed into the screwed portion of the head portion main body, and the embedded member can be properly fixed to the head portion.
  • the embedded member by setting the mounting state of the fixing member to the head portion main body to the first state, the embedded member can be used as a rotary spinal fixation device in which the embedded member is rotatable with respect to the head portion.
  • the fixing member when the fixing member is attached to the head portion main body in the second state, the fixing member can be used as a fixed spinal fixation device in which the embedded member cannot rotate with respect to the head portion.
  • the degree of freedom of attachment of the rod can be further increased, and further, after attaching the rod, by using it as a fixation type spinal fixation device, It is possible to appropriately perform a treatment for bringing the distance between the two spinal fixation devices fixed to one rod closer to or away from each other, and to appropriately fix, correct and stabilize the spine.
  • it since it can be used as both a spinal and fixed spinal fixation device, it is not necessary to prepare a rotary and fixed spinal fixation device in accordance with the patient's spinal disease state. The cost of the spinal fixation device can be reduced as compared to the case where both a rotation type and a fixation type spine fixation device are prepared. Can be achieved.
  • FIG. 2 is a cross-sectional view of the spinal fixation device taken along line II-II in FIG. 1.
  • FIG. 1 It is a perspective view which shows the implantation apparatus for implanting the screw which comprises the spinal fixation apparatus of FIG. 1 in a vertebra. It is a perspective view which shows the state which removed the spinal fixation apparatus from the implantation apparatus of FIG. It is a disassembled perspective view which shows the embedding apparatus of FIG. It is a perspective view which shows the screw fixing device for fixing the screw which comprises the spinal fixing device of FIG. 1 to a head part. It is a disassembled perspective view which shows the screw fixing apparatus of FIG. It is a figure for demonstrating the fixing method of the screw with respect to the head part using the screw fixing apparatus of FIG. It is a figure for demonstrating the fixing method of the screw 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.
  • the direction along the extending direction of the spine is defined as the Y-axis direction, and substantially perpendicular to the Y-axis direction.
  • One direction substantially parallel to the X-axis direction is taken as the X-axis direction, and one direction substantially perpendicular to the X-axis direction and the Y-axis direction is taken as the Z-axis direction.
  • the spinal fixation device 100 of the present embodiment is fixed to each of a plurality of vertebrae arranged in the Y-axis direction, for example, in order to fix, correct, and stabilize a spine such as a lumbar vertebra.
  • R2 is arranged along the spine, and the screw 1 is not rotatable with respect to the head portion 2 even as a rotation type device in which the screw 1 is configured to be rotatable with respect to the head portion 2. It can also be used as a fixed-type device constructed as described above.
  • the spinal fixation device 100 includes a screw 1 to be screwed into a vertebra and a fixing nut 22 to screw and fix the screw 1, and a fixing screw 23. And the head portion 2 to which the rod R is attached and fixed by being screwed.
  • FIG. 2 is a cross-sectional view of the spinal fixation device 100 taken along the line II-II in FIG. 3 is a front view showing a state in which the head portion main body 21, the screw 1 and the fixing nut 22 are assembled.
  • FIG. 4 shows the head portion main body 21, the screw 1 and the fixing nut 22 separated. It is a disassembled perspective view which shows a state.
  • FIG. 5 is an exploded perspective view showing a state in which the fixing screw 23 is separated from the assembled head unit main body 21, screw 1, and fixing nut 22.
  • the screw 1 is an implant member that is at least partially embedded in the vertebra. Specifically, as shown in FIG. 4 and the like, the screw 1 includes a screw body portion 11 that is formed in an elongated shape along an embedding direction (for example, the Z-axis direction) and is screwed into a vertebra. A screw head 12 is formed continuously from the skin side end (one end) of the portion 11.
  • the screw body 11 is formed to have a smaller diameter than the vertebra side opening of the fixing nut 22 of the head 2.
  • the screw head 12 is formed from a part obtained by cutting a sphere formed continuously with the screw main body 11 along a plane substantially orthogonal to the axial direction of the screw main body 11.
  • the attachment part 12a (refer FIG. 2 etc.) to which the embedding apparatus 200 (after-mentioned) for rotating the said screw 1 and embedding is attached is provided in the edge part by the side of the skin of the screw head 12.
  • the screw head 12 is formed to have a larger diameter than the vertebra side opening (described later) of the fixing nut 22 and is prevented from being pulled out while being attached to the head portion 2 as described later. Yes.
  • the head portion 2 includes a head portion main body 21 that can fix the rod R, and a fixing nut 22 that holds the screw 1 by being screwed into a male screw portion 212 of the head portion main body 21. And a fixing screw 23 for fixing the rod R by being screwed into the female screw portion 215 of the head portion main body 21.
  • the fixing nut 22 is a member for fixing the screw 1 arranged in the screw arrangement portion 211 provided on the vertebra side of the head portion main body 21 as a fixing member.
  • the fixing nut 22 has a through-hole 221 formed so as to penetrate in a direction substantially orthogonal to the rod R (Z-axis direction).
  • a female screw portion (screwed portion) 222 that is screwed with a male screw portion (threaded portion) 212 of the head portion main body 21 is formed at an end portion on the skin side of the fixing nut 22.
  • a support portion 223 that supports the screw head 12 of the screw 1 inserted through the fixing nut 22 is formed on the vertebra side from the portion 222.
  • the female screw portion 222 is formed on the inner peripheral surface of the skin-side end of the fixing nut 22.
  • the female screw portion 222 has a thread with a predetermined pitch and can be screwed with a screw thread formed on the outer peripheral surface of the male screw portion 212 of the head portion main body 21.
  • the support portion 223 includes an inner peripheral surface portion (inner side surface) 223 a formed in a shape along at least a part of the outer peripheral surface of the screw head (one end portion) 12 of the screw 1.
  • the inner peripheral surface portion 223 a has a shape that is gradually reduced in diameter with a curvature that is substantially equal to the curvature of the outer peripheral surface of the screw head 12. That is, the opening at the skin side end of the inner peripheral surface portion 223 a is formed to have a smaller diameter than the (spherical) diameter of the screw head 12.
  • the inner peripheral surface portion 223a is formed to be curved in a substantially arc shape with a curvature substantially equal to the curvature of the outer peripheral surface of the screw head 12 by gradually reducing the inner diameter toward the vertebra side. Further, the opening at the end portion on the vertebra side of the inner peripheral surface portion 223 a is formed to have a larger diameter than the diameter of the screw main body portion 11.
  • the screw 1 inserted through the through hole 221 of the fixing nut 22 is in a state in which the screw head 12 is locked to the inner peripheral surface portion 223 a of the support portion 223. That is, the fixing nut 22 with the screw 1 inserted through the through hole 221 is attached to the head portion main body 21, whereby the screw head 12 is supported by the support portion 223 and the screw 1 is held. At this time, in a state where the fixing nut 22 is not completely fixed to the head portion main body 21 (described later), the screw 1 is centered on an axis in the extending direction of the screw 1 (for example, the Z-axis direction). As shown in FIG.
  • the cross-sectional shape substantially orthogonal to the Z-axis direction of the outer peripheral surface portion 224 portion 224 of the fixing nut 22 is formed into a regular polygon shape having a predetermined number of corner portions, and a screw fixing device 300 (described later) is attached and fixed. It is like that.
  • the head main body 21 is formed with a screw arrangement portion 211 in which the screw head 12 is arranged at an end portion on the vertebra side, and the female nut of the fixing nut 22 is formed outside the screw arrangement portion 211.
  • a male screw portion 212 that is screwed with the screw portion 222 is formed.
  • the male thread portion 212 has a thread having a predetermined pitch and can be screwed with a thread formed on the inner peripheral surface of the female thread portion 222 of the fixing nut 22.
  • the screw placement portion 211 is formed in a concave shape that is recessed toward the skin side from the end portion on the vertebra side of the head portion main body 21. Moreover, the screw arrangement
  • positioning part 211 is equipped with the planar inner peripheral surface part (inner side surface) 211a inclined so that the internal diameter may gradually reduce in diameter toward the skin side.
  • the opening at the end on the vertebra side of the inner peripheral surface portion 211a is formed to be larger than the (spherical) diameter of the screw head 12, and the opening at the skin side end of the inner peripheral surface portion 211a is the screw head. The diameter is smaller than the (spherical) diameter of the portion 12.
  • the screw head 12 is placed in the screw placement portion 211.
  • the screw head 12 is placed on the screw placement portion 211.
  • the arranged screw 1 is held so as to be rotatable at a predetermined angle with respect to the X-axis direction and the Y-axis direction about the axis in the extending direction (for example, the Z-axis direction) of the screw 1 (first State) (see FIG. 3).
  • the screwing direction of the screw 1 with respect to the vertebra does not necessarily have to be substantially parallel to the Z-axis direction, and the screw 1 can be screwed in a direction shifted from the Z-axis direction.
  • the degree of freedom in direction can be increased.
  • the range which can rotate the screw 1 is typically represented by the dashed-two dotted line.
  • the fixing nut 22 adjusts the screwing amount of the female screw portion 222 and the male screw portion 212 of the head portion main body 21, thereby changing the mounting state of the fixing nut 22 to the head portion main body 21. It can be switched between the first state and the second state.
  • the head portion main body 21 includes a groove portion 213 that receives the rod R and arranges the rod R along the extending direction of the spine (Y-axis direction), and the groove portion 213.
  • a rod receiving portion 214 in which the rod R is arranged and a female screw portion 215 to be screwed with the male screw portion 231 of the fixing screw 23 for fixing the rod R arranged in the rod receiving portion 214 are formed.
  • the groove portion 213 is recessed to a predetermined depth so as to be cut out from the skin side end of the head portion main body 21 to the vertebra side, and is formed to extend in substantially the same direction as the longitudinal direction of the rod R. (See FIG. 5 etc.).
  • a rod receiving portion 214 is configured by a vertebra side portion of the groove portion 213, and this rod receiving portion 214 is formed continuously with an opening at an end portion on the skin side of the screw placement portion 211.
  • the inner side surface of the rod receiving portion 214 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.
  • female threads 215 are provided on the inner surfaces of both side walls in the X-axis direction of the groove 213.
  • the female screw portion 215 is formed so as to be seated at a predetermined depth from the inner surface of both side walls of the groove portion 213 outward in the X-axis direction.
  • the female screw portion 215 has a thread with a predetermined pitch, and can be screwed with a screw thread formed on the outer peripheral surface of the male screw portion 231 of the fixing screw 23.
  • an engagement hole 216 that engages with a part of a device (not shown) used for arranging the rod R with respect to the rod receiving portion 214.
  • a part of the device (not shown) is engaged with the engagement hole 216, and the rod R can be disposed on the rod receiving portion 214 by the lever principle.
  • a male screw portion 231 that is screwed with the female screw portion 215 of the head portion main body 21 is formed.
  • the male thread portion 231 has a thread having a predetermined pitch and can be screwed with a thread formed on the inner peripheral surface of the female thread portion 215 of the groove 213.
  • a rotation member attachment portion 232 to which a predetermined rotation member such as a screw driver for rotating the fixation screw 23 is attached is provided at the skin side end of the fixation screw 23.
  • the fixing screw 23 rotates in a predetermined direction in a state where the predetermined rotating member is attached to the rotating member attaching portion 232, so that the male screw portion 231 of the fixing screw 23 becomes the female screw portion 215 of the groove portion 213.
  • the surface on the vertebra side of the fixing screw 23 comes into contact with the surface facing the skin side of the outer peripheral surface of the rod R arranged in the rod receiving portion 214, and the rod R is fixed by the fixing screw 23.
  • the rod R is fixed to the head portion 2 by the rod receiving portion 214 and the fixing screw 23 (see FIG. 2 and the like).
  • the groove portion 213 (the rod receiving portion 214 and the female screw portion 215) of the head portion main body 21 and the fixing screw 23 constitute a rod fixing portion to which the rod R is fixed.
  • Each part constituting the spinal fixation device 100 that is, the screw 1, the head part main body 21, the fixing nut 22, and the fixing screw 23 are made of, for example, a medical material such as an alloy or titanium containing titanium or the like at a predetermined ratio. It is configured.
  • FIGS. 6 and 7 are perspective views showing the implanting device 200.
  • FIG. 7 shows the head unit body 21, the fixing nut 22 and the screw 1 of the spinal fixation device 100 removed from the implanting device 200.
  • FIG. It is a perspective view which shows a state.
  • FIG. 8 is an exploded perspective view showing the embedding device 200.
  • the implanting device 200 is a device for embedding the screw 1 of the spinal fixation device 100 into the vertebra, and constitutes a spinal fixation system together with the spinal fixation device 100. Further, as shown in FIGS. 6 to 8, the implanting device 200 is configured to be detachable from the head body 21 of the spinal fixation device 100. Specifically, the implanting device 200 is attached to the mounting portion 12a of the screw head 12. A screw attachment member 210 that is detachably attached; a head portion fixing member 220 that includes the screw attachment member 210 and is detachably attached and fixed to the female screw portion 215 (rod fixing portion) of the head portion main body 21; A positioning member 230 that fixes the relative positions of the head portion fixing member 220 and the screw mounting member 210 is provided.
  • the screw attachment member (embedding member attachment member) 210 is a member formed in a long shaft shape extending in a predetermined direction.
  • the screw attachment member Both end portions on the longitudinal direction side of 210 are formed so as to protrude from both end portions on the same direction side of the head portion fixing member 220.
  • a screw engagement portion 21a (see FIG. 7) that engages with the attachment portion 12a of the screw head 12 is provided at one end portion (tip portion) of the screw attachment member 210.
  • the screw engaging portion 21a has an outer shape that is substantially the same as the inner shape of the mounting portion 12a of the screw head 12, and can be inserted into and removed from the mounting portion 12a of the screw head 12 in a predetermined direction. It is configured. Then, the screw engagement portion 21a is inserted into the attachment portion 12a of the screw head 12 so that the screw engagement portion 21a and the attachment portion 12a are engaged, and the screw attachment member 210 is in a predetermined direction. With the rotation, the screw 1 is rotatable in the same direction as the rotation direction of the screw mounting member 210.
  • an engaged portion 21b (see FIG. 8) with which the positioning member 230 is engaged is provided on the end portion side of the screw mounting member 210 opposite to the screw engaging portion 21a.
  • the engaged portion 21 b is recessed by a predetermined depth from the surface of the screw mounting member 210 and is formed in an annular shape along the circumferential direction of the screw mounting member 210.
  • the head portion fixing member 220 is a cylindrical member that encloses the screw attachment member 210, and the head portion main body is provided at one end portion thereof, that is, at the end portion where the screw engagement portion 21 a of the screw attachment member 210 is provided.
  • a male threaded portion 22a is provided that is screwed into the female threaded portion 215.
  • the male screw portion 22 a has a screw thread having a predetermined pitch and can be screwed with a screw thread formed on the inner peripheral surface of the female screw portion 215 of the head portion main body 21.
  • the male screw portion 22a of the head portion fixing member 220 becomes the head portion main body 21.
  • the relative position of the head portion 2 with respect to the screw 1 is fixed by being screwed into the female screw portion 215 (rod fixing portion). That is, when the screw 1 is embedded in the vertebra, the head 2 is in a state of being rotatable with respect to the screw 1 by a predetermined angle about the axis in the embedding direction (for example, the Z-axis direction).
  • the relative position of the head portion 2 with respect to the screw 1 is fixed, and even if the screw 1 is rotated to be embedded in the vertebra, the screw Therefore, the rotation of the head portion 2 around 1 is restricted. Therefore, the screw 1 can be properly implanted into the vertebra.
  • a predetermined number (for example, two) of positioning members 230 are disposed on the end of the head portion fixing member 220 opposite to the male screw portion 22a.
  • the positioning member 230 is, for example, a plunger provided so as to protrude from the inner surface of the head portion fixing member 220 to the screw mounting member 210 side. Then, the engaged portion 21b of the screw mounting member 210 inserted into the head portion fixing member 220 and the positioning member 230 are engaged with each other, whereby the head in the embedding direction of the screw 1 (longitudinal direction of the screw mounting member 210). The relative positions of the part fixing member 220 and the screw mounting member 210 are fixed.
  • the head fixing member 220 can be moved by following the screw mounting member 210 that moves in the embedding direction according to the increase or decrease of the amount of the screw 1 embedded in the vertebra.
  • the insertion of the screw 1 into the vertebra using the insertion device 200 can be performed appropriately.
  • a spinal fixation device 100 is prepared in which a screw 1 is attached to a head portion 2 so as to be rotatable at a predetermined angle about an axis in the Z-axis direction, and a screw attachment member 210 is provided in the head portion fixing member 220.
  • the implanted device 200 in the inserted state is attached to the spinal fixation device 100.
  • the screw engagement portion 21a of the screw attachment member 210 is inserted into the attachment portion 12a of the screw head 12 to engage the screw engagement portion 21a and the attachment portion 12a, and the head portion main body 21.
  • the male screw portion 22 a of the head portion fixing member 220 is screwed into the female screw portion 215 to fix the head portion fixing member 220 to the head portion 2.
  • the screw 1 is screwed into the vertebrae by rotating the screw mounting member 210 into the screwing position of the screw 1 in the spine.
  • the head portion fixing member 220 is attached and fixed to the head portion 2, the relative position of the head portion 2 with respect to the screw 1 is fixed, and even if the screw 1 is rotated to be embedded in the vertebra, the screw The rotation of the head portion 2 around 1 can be restricted.
  • the relative positions of the head portion fixing member 220 and the screw mounting member 210 with respect to the screw 1 embedding direction are fixed, the screw mounting that moves in the embedding direction in accordance with the increase or decrease of the amount of screw 1 embedding with respect to the vertebra.
  • the head fixing member 220 can be moved following the member 210.
  • the screwing position of the screw 1 of the spine may be specified by inserting a needle-like member into the vertebra and confirming it by X-ray imaging or the like.
  • the engagement of the attachment portion 12a of the screw head 12 and the screw engagement portion 21a of the screw attachment member 210 is released, and the female screw portion 215 of the head portion main body 21 and the head portion are fixed.
  • the screwing with the male screw portion 22a of the member 220 is released, and the implanting device 200 is removed from the spinal fixation device 100.
  • the screw body 11 of the screw 1 is screwed into a predetermined vertebra, and the head 2 is centered on the axis in the extending direction (embedding direction) of the screw 1 with respect to the screw 1.
  • a predetermined angle (for example, about 15 °) is freely rotatable, and the degree of freedom of arrangement of the head portion 2 and the rod R is ensured to some extent.
  • FIG. 9 is a perspective view showing the screw fixing device 300
  • FIG. 10 is an exploded perspective view of the screw fixing device 300.
  • FIGS. 11 to 15 are diagrams for explaining a method of fixing the screw 1 to the head unit 2.
  • the screw fixing device 300 is a device for fixing the screw 1 of the spinal fixation device 100 to the head unit 2, and constitutes a spinal fixation system together with the spinal fixation device 100. Further, as shown in FIGS. 9 and 10, the screw fixing device 300 is configured to be detachable with respect to the head portion main body 21 of the spinal fixation device 100, specifically, disposed in the groove portion 213 of the head portion main body 21.
  • a rod engaging member 310 that engages with the rod R, and an engagement with the corner portion of the outer peripheral surface portion 224 portion 224 of the fixing nut 22 that includes the rod engaging member 310 and is screwed into the head portion main body 21. And a nut engaging member 320 to be provided.
  • the rod engaging member (second engaging member) 310 is a member formed in a long shaft shape extending in a predetermined direction, and is inserted into and removed from the nut engaging member 320 in a predetermined direction (longitudinal direction). It is configured freely.
  • a head portion arrangement portion 311 in which the head portion 2 in a state where the rod R is arranged in the rod receiving portion 214 is formed on one end portion (tip portion) of the rod engaging member 310.
  • the head portion arrangement portion 311 has a concave space that is open on the vertebra (rod R) side and has a larger diameter than the head portion 2. Further, the depth (height) of the head portion arranging portion 311 in the direction along the longitudinal direction of the rod engaging member 310 is a rod engaging portion 312 (described later) formed at the vertebra side end of the head portion arranging portion 311. ) And the rod R are engaged with each other so that the skin side end portion of the head portion 2 (fixing screw 23) does not come into contact with the skin side end portion of the head portion arrangement portion 311.
  • the rod engaging portion 312 is engaged with the rod R disposed in the rod receiving portion 214.
  • the end surface on the vertebra side of the rod engaging portion 312 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. Then, by moving the rod engaging member 310 in a predetermined direction (longitudinal direction) with respect to the nut engaging member 320, the rod engaging portion 312 and the rod R can be brought into an engaged state or can be released. It has become.
  • the state of the rod R engaged with the rod engaging portion 312 may be a state in which the fixing screw 23 is completely screwed into the head portion main body 21 and is completely fixed to the head portion 2.
  • the fixing screw 23 may be loosely screwed into the head portion 2 and the rod receiving portion of the groove portion 213 without the fixing screw 23 being screwed into the head portion main body 21. It may be in a state where it is only arranged in 214.
  • the nut engaging member (first engaging member) 320 is a cylindrical member that includes the rod engaging member 310, and is relative to the rod engaging member 310 disposed in the nut engaging member 320. It is configured to be rotatable around a longitudinal axis. Further, one end portion of the nut engaging member 320, that is, the end portion where the rod engaging portion 312 of the rod engaging member 310 is provided is a corner portion (covered) formed on the outer peripheral surface portion 224 of the fixing nut 22. A rod engaging portion (first engaging portion) 321 that engages with the engaging portion), and a rod arrangement opening in which the rod R that engages with the rod engaging portion 312 of the rod engaging member 310 is disposed inside. 322 are formed.
  • Two nut engaging portions 321 are provided side by side in the diameter direction substantially orthogonal to the longitudinal direction of the nut engaging member 320 so as to sandwich the fixing nut 22.
  • Each nut engaging portion 321 is provided on a protrusion 323 that protrudes inward from the inner surface of the nut engaging member 320 and has an inner surface so as to have a shape substantially equal to a corner of the outer peripheral surface portion 224 of the fixing nut 22.
  • the concave portion 323a is formed to be recessed in a predetermined shape.
  • the rod engaging member 310 inserted inside the nut engaging member 320 has the vertebra side end surface of the head portion arranging portion 311 in contact with the protruding portion 323, so that the rod engaging member 310 and the nut engaging member are arranged.
  • the relative position with respect to the insertion direction with 320 is fixed.
  • the nut engaging member 320 including the rod engaging member 310 is moved from the skin side to the vertebra side with respect to the spinal fixation device 100, so that the head portion arrangement portion 311 of the rod engaging member 310 has a head.
  • the concave surface portion 323a of the nut engaging portion 321 and the corner portion of the outer peripheral surface portion 224 of the fixing nut 22 are engaged.
  • the rod R in a state of being engaged with the rod engaging portion 312 of the rod engaging member 310 is arranged inside the rod arrangement opening 322.
  • the nut engaging member 320 is formed on the outer surface of the head portion main body 21 by rotating in a predetermined direction around the longitudinal axis while the nut engaging portion 321 and the fixing nut 22 are engaged.
  • the amount of screwing between the formed male screw portion 212 and the female screw portion 222 of the fixing nut 22 can be adjusted.
  • the rod arrangement opening 322 is formed continuously between the nut engaging portions 321 between the two nut engaging portions 321 and 321.
  • the rod arrangement opening 322 is formed so as to be cut out from the end of the nut engaging member 320 on the vertebra side to the skin side. Then, when adjusting the screwing amount between the male screw portion 212 formed on the outer surface of the head portion main body 21 and the female screw portion 222 of the fixing nut 22, the nut engaging portion 321 is formed by the rod arrangement opening 322.
  • a rotation space in a predetermined direction around the longitudinal axis of the nut engaging member 320 engaged with the fixing nut 22 is secured.
  • the rod R is arranged on the vertebra side (that is, the side where the screw fixing device 300 is inserted) from the fixing nut 22, but the rod R is arranged inside the rod arrangement opening 322. In a state where the nut engaging portion 321 and the fixing nut 22 are engaged, rotation in a predetermined direction around the longitudinal axis of the nut engaging member 320 is allowed.
  • the rotation in a predetermined direction around the longitudinal axis of the head portion main body 21 is regulated,
  • the nut engaging member 320 in which the concave surface portion 323a of the nut engaging portion 321 is engaged with the corner portion of the outer peripheral surface portion 224 of the fixing nut 22 rotates in a predetermined direction around the longitudinal axis.
  • the female screw portion 222 of 22 is screwed into the male screw portion 212 of the head portion main body 21.
  • the rod arrangement opening 322 causes the nut engagement portion 321 to rotate in a predetermined direction around the longitudinal axis of the nut engagement member 320 engaged with the corner portion of the outer peripheral surface portion 224 of the fixing nut 22.
  • a dynamic space is formed.
  • the screwing amount of the female screw portion 222 of the fixing nut 22 into the male screw portion 212 of the head portion main body 21 is increased, the outer peripheral surface of the screw head 12 comes into contact with the inner peripheral surface portion 211a of the screw placement portion 211.
  • the screw 1 is fixed to the head portion 2 so as not to rotate while maintaining a predetermined angle with respect to an axis in a predetermined direction (for example, the Z-axis direction) (second state).
  • a method of fixing the screw 1 using the screw fixing device 300 will be described with reference to FIGS.
  • a predetermined rotating member such as a screw driver is attached to the rotating member attaching portion 232 of the fixing screw 23 and the male screw portion of the fixing screw 23.
  • 231 is screwed into the female screw part 215 of the groove part 213.
  • the surface on the vertebra side of the fixing screw 23 comes into contact with the surface of the outer peripheral surface of the rod R arranged on the rod receiving portion 214 facing the skin side, and the rod R is fixed to the rod receiving portion 214 side by the fixing screw 23.
  • the rod R is fixed to the head portion 2 by the rod receiving portion 214 and the fixing screw 23. Note that the fixing of the rod R to the head portion 2 itself is not directly related to the fixing method of the screw 1 of the present invention, and a spinal fixation device 100 in which the rod R is fixed to the head portion 2 is prepared in advance. May be.
  • the nut engaging member 320 containing the rod engaging member 310 is vertebra side from the skin side with respect to the spinal fixation device 100 (direction of arrow in FIGS. 11 and 12).
  • the longitudinal axis of the rod engaging member 310 and the nut engaging member 320 is centered. It is preferable to determine the relative position in the rotational direction.
  • the rod engaging portion 312 and the outer peripheral surface of the rod R are engaged, and the concave portion 323a of the nut engaging portion 321 is engaged. And the corner portion of the outer peripheral surface portion 224 of the fixing nut 22 engage with each other.
  • the rod R in a state of being engaged with the rod engaging portion 312 of the rod engaging member 310 is arranged inside the rod arrangement opening 322.
  • the rod engaging portion 312 of the rod engaging member 310 is engaged with the rod R, whereby a predetermined direction centered on the longitudinal axis of the head portion main body 21 (for example, In a state where the rotation of the nut engaging portion 321 is restricted, the nut engaging member 320 in which the concave surface portion 323a of the nut engaging portion 321 is engaged with the corner portion of the outer peripheral surface portion 224 of the fixing nut 22 is centered on the longitudinal axis. It is rotated in a predetermined direction (for example, clockwise). As a result, the female screw portion 222 of the fixing nut 22 is screwed into the male screw portion 212 of the head portion main body 21.
  • a predetermined direction for example, clockwise
  • the nut engaging member 320 When the circumferential end of the nut engaging portion 321 of the rotating nut engaging member 320 comes into contact with the rod R (see FIG. 14), the nut engaging member 320 cannot be rotated any further. As shown in FIG. 15, the nut engaging member 320 including the rod engaging member 310 is moved from the vertebra side to the skin side (in the direction of the arrow in FIG. 15) with respect to the spinal fixation device 100, thereby The engagement between the concave surface portion 323a of 321 and the corner portion of the outer peripheral surface portion 224 of the fixing nut 22 is released.
  • the protruding portion 323 of the nut engaging member 320 is brought into contact with the end surface on the vertebra side of the head portion arranging portion 311 of the rod engaging member 310 and is locked.
  • the joint member 310 also moves.
  • the engagement between the rod engaging portion 312 and the outer peripheral surface of the rod R is also released.
  • the nut engaging member 320 is rotated by a predetermined amount with respect to the rod engaging member 310 in a direction opposite to the predetermined direction (for example, counterclockwise) around the longitudinal axis, thereby forming a concave surface of the nut engaging portion 321.
  • the amount of screwing of the female screw portion 222 of the fixing nut 22 into the male screw portion 212 of the head body 21 in the state where the portion 323a is engaged with the corner portion of the outer peripheral surface portion 224 of the fixing nut 22 is ensured.
  • the screw fixing device 300 and the spinal fixation device 100 are substantially in the same state as shown in FIG. 11, and thereafter, the same operation as that of FIGS.
  • the fixing nut 22 that holds the screw 1 by being attached to the head portion main body 21 is attached to the head portion main body 21 in the screw placement portion 211. Since the arranged screw 1 is configured to be switchable between a first state in which the screw 1 is rotatably held at a predetermined angle around the longitudinal axis and a second state in which the screw 1 is held unrotatable. By setting the mounting state of the fixing nut 22 to the head portion main body 21 to the first state, the screw 1 can be used as a rotary spinal fixation device 100 that can rotate with respect to the head portion 2.
  • both of the spinal fixation device 100 can be used as both the rotation type and the fixation type, it is not necessary to prepare the rotation type and the fixation type spine fixation device according to the state of the spine disease of the patient.
  • the operation time can be reduced and the operation time can be shortened.
  • when it is desired to release the fixation in the middle of the operation or when it is desired to temporarily fix the operation it is possible to easily switch between the rotating type and the fixed type, and the usability can be further improved.
  • the fixing nut 22 can be used as a fixed spine fixing device 100 from the beginning. The cost of the spinal fixation device 100 can be reduced as compared with the case where each device is prepared.
  • the fixing nut 22 in which the screw 1 is inserted into the through hole 221 is attached to the head portion main body 21, the screw head 12 of the screw 1 is supported and held by the support portion 223.
  • the fixing nut 22 can be held in a state in which the screw 1 inserted through the through hole 221 is prevented from being detached by the support portion 223.
  • the mounting state of the fixing nut 22 to the head portion main body 21 is adjusted.
  • the inner peripheral surface portion 223a of the support portion 223 is formed in a shape along at least a part of the outer surface of the screw head 12 of the screw 1, the inner peripheral surface portion 223a of the support portion 223 and the screw head of the screw 1 are formed.
  • the contact area with the outer surface of 12 can be made larger, and the support of the screw 1 by the support part 223 can be performed more appropriately.
  • the inner peripheral surface portion 211 a of the screw placement portion 211 is in contact with the outer surface of the screw head portion 12 of the screw 1, the contact between the inner peripheral surface portion 211 a of the screw placement portion 211 and the outer surface of the screw head portion 12 of the screw 1.
  • the area can be increased, and the support of the screw 1 by the support portion 223 can be performed more appropriately.
  • the head portion fixing member 220 is attached to the head portion main body 21. Since the relative position of the head part 2 with respect to the screw 1 is fixed by being fixed to the female screw part 215, the rotation of the head part 2 around the screw 1 embedded in the vertebra is restricted. Thus, the screw 1 can be properly implanted into the vertebra. Furthermore, when the screw 1 is embedded in the vertebra, the relative position between the head fixing member 220 and the screw mounting member 210 is fixed by the positioning member 230 with respect to the direction in which the screw 1 is embedded. The head fixing member 220 can be moved following the screw mounting member 210 that moves in the embedding direction according to the increase or decrease of the embedding amount, so that the screw 1 can be properly implanted into the vertebra.
  • the rod engaging portion 312 of the rod engaging member 310 is engaged with the rod R to restrict the rotation of the head portion main body 21 in a predetermined direction
  • the nut engaging member 320 having the nut engaging portion 321 engaged with the corner portion of the outer peripheral surface portion 224 of the fixing nut 22 is rotated in a predetermined direction
  • the female screw portion 222 of the fixing nut 22 is moved to the head portion main body 21. Since the screw 1 is fixed to the head portion 2 by being screwed into the male screw portion 212, the nut engaging portion 321 of the nut engaging member 320 and the corner portion of the outer peripheral surface portion 224 of the fixing nut 22 are engaged.
  • the nut engaging portion 321 is the outer periphery of the fixing nut 22. Since the rotation space for the nut engaging member 320 engaged with the corner portion of the surface portion 224 to rotate in a predetermined direction is formed by the rod arrangement opening 322, the fixing nut 22 is provided on the head portion main body 21. Even when the rod receiving portion 214 is mounted on the vertebra side, the rod R is arranged inside the rod arrangement opening 322 so that the nut engaging portion 321 and the fixing nut 22 are engaged.
  • the nut engaging member 320 is allowed to rotate around the axis in a predetermined direction, so that the female screw portion 222 of the fixing nut 22 is properly fitted to the male screw portion 212 of the head portion main body 21. Screwed in Can be fixed can be appropriately performed with respect to the head portion 2 of the screw 1.
  • the rod fixing portion to which the rod R is fixed is configured by the groove portion 213 (the rod receiving portion 214 and the female screw portion 215) of the head portion main body 21 and the fixing screw 23.
  • the present invention is not limited to this, and can be arbitrarily changed as appropriate.
  • the screw placement portion may be provided inside the head portion main body 21 and the screw 1 may be prevented from coming off only by the screw placement portion by inserting the screw 1 through the through hole of the screw placement portion.
  • the outer shape of the rod R is not limited to this.
  • the outer peripheral surface of the rod receiving portion 214 and the vertebra side surface of the fixing screw 23 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 mounting state of the fixing member that holds the embedded member by being attached to the head portion main body is arranged in the embedded member arranging portion.
  • the embedded member can be switched between a first state in which the embedded member is rotatably held at a predetermined angle around an axis extending in a predetermined direction and a second state in which the embedded member is held unrotatable. By doing so, it can be used as both a rotation type and a fixed type spine fixation device.
  • the present invention can be particularly suitably used for a technique capable of appropriately performing spinal fixation, correction, stabilization, and the like in the spinal fixation device 100.

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Abstract

La présente invention concerne un dispositif de fixation de colonne vertébrale apte à être utilisé à la fois en tant que type pouvant pivoter et en tant que type fixe, et qui réalise de manière appropriée la fixation, la correction, la stabilisation etc. d'une colonne vertébrale. Le dispositif de fixation de colonne vertébrale (100) est pourvu d'une vis (1) dont au moins une partie est incorporée dans une vertèbre qui forme une colonne vertébrale, ainsi que d'une tête (2) à laquelle la vis et une tige peuvent être fixées. La tête est pourvue d'un corps de tête (21) et d'un écrou de serrage (22) qui fixe à la tête la vis disposée dans une section de disposition de vis (211) du corps de tête. Lorsqu'il est monté sur le corps de tête, l'écrou de serrage maintient la vis. L'état de montage de l'écrou de serrage au corps de tête est conçu pour permettre le passage d'un premier état - selon lequel la vis disposée dans la section de disposition de vis est maintenue de manière à pouvoir pivoter selon un angle prédéfini autour d'un axe qui s'étend dans une direction prédéfinie - à un second état selon lequel la vis est maintenue de manière à ne pas pouvoir pivoter.
PCT/JP2009/071272 2009-12-22 2009-12-22 Dispositif de fixation de colonne vertébrale, dispositif d'incorporation, dispositif de fixation d'élément d'incorporation, et système de fixation de colonne vertébrale Ceased WO2011077511A1 (fr)

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Application Number Priority Date Filing Date Title
PCT/JP2009/071272 WO2011077511A1 (fr) 2009-12-22 2009-12-22 Dispositif de fixation de colonne vertébrale, dispositif d'incorporation, dispositif de fixation d'élément d'incorporation, et système de fixation de colonne vertébrale

Applications Claiming Priority (1)

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PCT/JP2009/071272 WO2011077511A1 (fr) 2009-12-22 2009-12-22 Dispositif de fixation de colonne vertébrale, dispositif d'incorporation, dispositif de fixation d'élément d'incorporation, et système de fixation de colonne vertébrale

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EP3536271A1 (fr) 2018-03-06 2019-09-11 Biedermann Technologies GmbH & Co. KG Dispositif d'ancrage osseux polyaxial et système d'un instrument et dispositif d'ancrage osseux polyaxial
US10463402B2 (en) 2016-07-13 2019-11-05 Medos International Sàrl Bone anchor assemblies and related instrumentation
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US10568667B2 (en) 2016-07-13 2020-02-25 Medos International Sàrl Bone anchor assemblies and related instrumentation
US10751090B2 (en) 2016-08-04 2020-08-25 Biedermann Technologies Gmbh & Co. Kg Polyaxial bone anchoring device and system including an instrument and a polyaxial bone anchoring device
US10874438B2 (en) 2016-07-13 2020-12-29 Medos International Sarl Bone anchor assemblies and related instrumentation
US11369418B2 (en) 2017-10-25 2022-06-28 Biedermann Technologies Gmbh & Co. Kg Polyaxial bone anchoring device
US12496099B2 (en) 2016-08-04 2025-12-16 Biedermann Technologies Gmbh & Co. Kg Polyaxial bone anchoring device and system including an instrument and a polyaxial bone anchoring device

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CN110226957A (zh) * 2018-03-06 2019-09-13 比德尔曼技术有限责任两合公司 多轴骨锚固装置以及多轴骨锚固装置和器械的系统
CN110226957B (zh) * 2018-03-06 2024-07-05 比德尔曼技术有限责任两合公司 多轴骨锚固装置以及多轴骨锚固装置和器械的系统
EP3536271A1 (fr) 2018-03-06 2019-09-11 Biedermann Technologies GmbH & Co. KG Dispositif d'ancrage osseux polyaxial et système d'un instrument et dispositif d'ancrage osseux polyaxial
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JP2019155089A (ja) * 2018-03-06 2019-09-19 ビーダーマン・テクノロジーズ・ゲゼルシャフト・ミット・ベシュレンクテル・ハフツング・ウント・コンパニー・コマンディートゲゼルシャフトＢｉｅｄｅｒｍａｎｎ Ｔｅｃｈｎｏｌｏｇｉｅｓ Ｇｍｂｈ ＆ Ｃｏ． Ｋｇ 多軸骨固着装置、および、器具と多軸骨固着装置とのシステム
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