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CN105534584A - 一种微动态椎弓根钉 - Google Patents

一种微动态椎弓根钉 Download PDF

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CN105534584A
CN105534584A CN201610113668.6A CN201610113668A CN105534584A CN 105534584 A CN105534584 A CN 105534584A CN 201610113668 A CN201610113668 A CN 201610113668A CN 105534584 A CN105534584 A CN 105534584A
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曾析非
何伟义
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    • 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
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A61B17/7064—Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
    • 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
    • A61B17/7049—Connectors, not bearing on the vertebrae, for linking longitudinal elements together
    • 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
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone
    • A61B17/861—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver
    • A61B17/8615—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver at the central region of the screw head
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone
    • A61B17/861—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver
    • A61B17/862—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver at the periphery of the screw head
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8685—Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
    • 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
    • A61B2017/564—Methods for bone or joint treatment

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Abstract

本发明涉及一种微动态椎弓根钉，提供了一种对现有在临床上使用的椎弓根钉进行改进的方案。这种椎弓根钉，包括连接器、螺塞、上压块、弹簧、下压块和球头钉，所述连接器为空心柱体，连接器一端为上开口，连接器另一端为下开口，所述螺塞安装在连接器上开口内，上压块、弹簧和下压块安装在连接器内部，上压块设置在弹簧上方，下压块设置在弹簧下方，所述弹簧竖直安装在上压块和下压块之间，所述球头钉设置在下压块下方。本发明利用弹簧的特性，对下压块产生可以变的压力，并使压力转化为阻尼作用在与下压块配合的球头钉，实现对球头钉的弹性约束。

Description

一种微动态椎弓根钉
技术领域
本发明涉及一种医疗器械，特别是一种脊椎内固定手术用的微动态椎弓根钉。
背景技术
椎弓根钉的应用，在近二十年来，逐步在国内流行起来，主要用途是在骨外科手术上，病人的腰椎间盘突出或腰椎管狭窄等疾病；手术时，先将坏死的腰椎间盘切除，填入融合物，再在相邻的腰椎中分别植入椎弓根钉，最后连接棒装入连接器，被连接器的螺塞固定，相邻的腰椎就被植入钉和矫形棒连接在一起。此手术的好处是可以在强制性固定的情况下，让相邻的椎间融合，从根本上解决其病变部位。但从此亦带来另一个问题：被固定的腰椎失去了活动能力，不能够前后伸展，加重了邻近的椎间盘承受的压力，一段时间后，又产生新的病变。
针对这个问题，人们提出了一种微动态椎弓根钉，通过对椎弓根钉连接器的结构进行改良，包括加入弹簧圈和改变连接器通孔形状，使得植入钉可以相对连接器所小幅度摆动。然而，这些微动态椎弓根钉连接器由于其结构的限制，一方面受安装位置限制，对加工精度要求高，生产难度大；另一方面又难以对摆动阻尼作定量选择，而且支撑质量不稳定。
发明内容
针对椎弓根钉的阻尼不能定量调节的问题，本发明提供了一种椎弓根钉的改进方案，其采用竖向设置的弹簧作为阻尼调节装置，解决此问题。
本发明解决其技术问题采用的技术方案是：一种微动态椎弓根钉，包括连接器、螺塞、上压块、弹簧、下压块和球头钉，所述连接器为空心柱体，连接器一端为上开口，连接器另一端为下开口，所述螺塞安装在连接器上开口内，上压块、弹簧和下压块安装在连接器内部，上压块设置在弹簧上方，下压块设置在弹簧下方，所述弹簧竖直安装在上压块和下压块之间，所述球头钉设置在下压块下方。
本发明解决其技术问题采用的技术方案进一步还包括：
进一步地，所述弹簧为柱状弹簧。
进一步地，所述上压块和下压块分别与连接器内部相配合，所述连接器内壁设有阻挡上压块的台阶位。
进一步地，所述弹簧有两个以上。
进一步地，所述所述弹簧数量为四条。
进一步地，所述弹簧呈圆周分布在上压块和下压块之间。
进一步地，所述弹簧数量为一条。
进一步地，所述上压块和/或下压块上设有盲孔，所述盲孔设在上压块和下压块相对的面上，所述弹簧安装在盲孔中。
进一步地，所述上压块和/或下压块上设有凸台，所述凸台设在上压块和下压块相对的面上，所述凸台卡入弹簧内。
本发明的有益效果是：本发明的连接器处于工作状态时，上压块支撑在连接器的内腔的台阶位上，同时通过柱状弹簧约束下压块，下压块与植入钉的球头作球面约束性配合；上压块和下压块之间多条弹簧柱同时作用，支撑呈现平稳状态；每条弹簧的预压缩量增加，所能承受的压力亦大大增加；此外只要改变弹簧的线径及线距，即可调整上下压块间的柔性约束的力度。
下面将结合附图和具体实施方式对本发明做进一步说明。
附图说明
图1为本发明实施例一的椎弓根钉的立体结构示意图；
图2为本发明实施例一的椎弓根钉的上压块仰视结构示意图；
图3为本发明实施例一的椎弓根钉A-A剖面示意图；
图4为本发明实施例一的微动态椎弓根钉上压块、弹簧和下压块的组合示意图；
图5为本发明实施例二的椎弓根钉的结构示意图；
图6为本发明实施例二的微动态椎弓根钉上压块、弹簧和下压块结构示意图；
1、螺塞，2、上压块，3、矫形棒，4、柱状弹簧，5、下压块，6、连接器，7、植入钉，21、上压块盲孔，51、下压块的盲孔，52、下压块的凸台，62、台阶位。
具体实施方式
下面结合附图对本发明做进一步说明：
如图1-4所示，本发明实施例一的椎弓根钉，包括螺塞1、连接器6、上压块2、柱状弹簧4和下压块5，本实施例中，弹簧4采用柱状弹簧，具体实施时，也可以采用常规技术中的其他可用的弹簧形式；为了使支撑更为平稳本实施例使用了四条柱状弹簧，具体实施中也可以因应具体支撑力量的需要增加或减少弹簧的数量。连接器6为空心柱体，连接器6的两端分别设有上开口和下开口，螺塞1安装在连接器6的上开口内，上开口内壁设有安装螺塞1的螺纹，上压块2、四条柱状弹簧4和下压块5安装在连接器6内部。连接器6内壁有台阶位62，台阶位62上方连接器的内径略大于下方的内径，该台阶位可以阻挡上压块2下压到过低位置。上压块2与台阶位62上方的连接器内部相配合，下压块5与台阶位62下方的连接器内壁相配合。上压块2和下压块5相接的底面上设有四个呈圆周分布的盲孔21，下压块5和上压块2相接的面上也对应设有四个盲孔51，四条柱状弹簧4安装在上压块2和下压块5之间，弹簧4的两端安装在上压块盲孔21和下压块的盲孔51之内。四条柱状弹簧4呈圆周分布在上压块2和下压块5之间，可以使支撑力度更加均匀。开设盲孔一方面可以固定弹簧位置，另一方面可以增加弹簧的可利用长度，使预压缩量增加，柔性约束力度的可调节范围也更大，具体实施时，可以根据需要的约束力度大小，选择盲孔是否开设，开设的数量、位置和深度。
连接器6上有一个U型槽，用于安装矫形棒3，U型槽采用常规的连接器中的安装矫形棒的U型槽结构。
使用时，椎弓根钉的球头钉7会预安装到连接器6内，球头钉7的球头卡接在连接器底部的下开口，钉体伸出连接器外，待植入椎体。上压块2、柱状弹簧4和下压块5安装在球头上方，下压块5的另一个底面为球面，与球头71配合。全部椎弓根钉植入椎体后，将矫形棒3安装到连接器6上，将螺塞1安装到连接器6的上开口内，拧紧，固定住矫形棒3。
本发明实施例二的椎弓根钉如图5、6所示，使用了一条柱状弹簧4，竖直安装在上压块2和下压块5之间，上压块2上设有盲孔21，下压块5上设有凸台52，盲孔21和凸台52的大小和形状与柱状弹簧4相配合，凸台52卡在弹簧4内，凸台52与上压块不接触。
使用时，椎弓根钉的球头钉7会预安装到连接器6内，球头钉7的球头卡接在连接器底部的下开口，钉体伸出连接器外，待植入椎体。上压块2、柱状弹簧4和下压块5安装在球头上方，下压块5的另一个底面为球面，与球头71配合。全部椎弓根钉植入椎体后，将矫形棒3安装到连接器6上，将螺塞1安装到连接器6的上开口内，拧紧，固定住矫形棒3。
以上实施例为本发明优选实施方式，其他凡其原理和基本结构与本实施例相同或近似的，均在本发明保护范围之内。

Claims (9)

1.一种微动态椎弓根钉，其特征在于，所述椎根弓钉包括连接器、螺塞、上压块、弹簧、下压块和球头钉，所述连接器为空心柱体，连接器一端为上开口，连接器另一端为下开口，所述螺塞安装在连接器上开口内，上压块、弹簧和下压块安装在连接器内部，上压块设置在弹簧上方，下压块设置在弹簧下方，所述弹簧竖直安装在上压块和下压块之间，所述球头钉设置在下压块下方。
2.如权利要求1所述的微动态椎弓根钉，其特征在于，所述弹簧为柱状弹簧。
3.如权利要求1所述的微动态椎弓根钉，其特征在于，所述连接器上压块和下压块分别与连接器内部相配合，所述连接器内壁设有阻挡上压块的台阶位。
4.如权利要求1所述的微动态椎弓根钉，其特征在于，所述弹簧设有两个以上。
5.如权利要求4所述的微动态椎弓根钉，其特征在于，所述弹簧数量为四条。
6.如权利要求4所述的微动态椎弓根钉，其特征在于，所述弹簧呈圆周分布在上压块和下压块之间。
7.如权利要求1所述的微动态椎弓根钉，其特征在于，所述弹簧数量为一条。
8.如权利要求1至7任一项所述的微动态椎弓根钉，其特征在于，所述上压块和/或下压块上设有盲孔，所述盲孔设在上压块和下压块相对的面上，所述弹簧安装在盲孔中。
9.如权利要求1至7任一项所述的微动态椎弓根钉，其特征在于，所述上压块和/或下压块上设有凸台，所述凸台设在上压块和下压块相对的面上，所述凸台卡入弹簧内。
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CN108186093A (zh) * 2018-01-25 2018-06-22 何伟义 一种能够产生切换功能的垫块
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CN205658962U (zh) * 2015-12-31 2016-10-26 曾析非 一种微动态椎弓根钉

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