CN112754634B - Intervertebral space elasticity distraction device - Google Patents
Intervertebral space elasticity distraction device Download PDFInfo
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- CN112754634B CN112754634B CN202110184459.1A CN202110184459A CN112754634B CN 112754634 B CN112754634 B CN 112754634B CN 202110184459 A CN202110184459 A CN 202110184459A CN 112754634 B CN112754634 B CN 112754634B
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- 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 ; Bone 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- 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 ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- 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 ; Bone 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
- A61B17/7065—Devices with changeable shape, e.g. collapsible or having retractable arms to aid implantation; Tools therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- 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 ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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
The invention provides an intervertebral space elastic distraction device, which comprises a pedicle screw and an elastic distraction mechanism for elastically distracting the pedicle screw, wherein the elastic distraction mechanism comprises a mandrel, a blind hole connector, a through hole connector and an elastic element; the blind hole connector and the through hole connector are respectively detachably connected with a pedicle screw; one end of the mandrel is provided with an elastic layer, the blind hole connector is sleeved on the elastic layer, and the blind hole connector can rotate around the axis of the mandrel; the through hole connector is assembled at the other end of the mandrel in a sliding mode; the elastic element is sleeved on the mandrel and used for driving the through-hole connector to slide along the direction far away from the blind hole connector. The invention can continuously open the intervertebral space, keep a certain height of the intervertebral space, has continuous traction and dynamic stabilization effects on the intervertebral space, and has the advantages of difficult loosening and fracture, difficult fracture, capability of avoiding acting force deviation and the like.
Description
Technical Field
The invention relates to the technical field of medical treatment, in particular to an intervertebral space elastic distraction device.
Background
The lumbar degenerative disease belongs to common diseases and frequently encountered diseases, and the further development of lumbar disc herniation caused by lumbar degenerative disease can cause diseases such as lumbar spinal stenosis, unstable lumbar vertebra and zygapophysis arthritis, thereby seriously affecting the health of people. At present, three types of treatment methods are mainly adopted for the disease, one type is conservative treatment, and comprises bed rest, traction, massage, acupuncture, physiotherapy, anti-inflammation and analgesia, traditional Chinese medicines and the like; the second type is interventional therapy, including chemonucleolysis, radio frequency ablation, laser, plasma, ozone ablation, and the like; the three types of surgery treatment comprise minimally invasive surgery treatment and open surgery treatment, the minimally invasive surgery comprises endoscopic discectomy of intervertebral disc nucleus pulposus, decompression fusion surgery and the like, and the open surgery comprises open surgery for discectomy of nucleus pulposus, decompression fusion surgery and the like. Remission is achieved by conservative treatment in about 85% of patients, and ultimately surgical treatment is required in about 15% of patients. The conservative treatment has the defects of uncertain curative effect, easy repeated attack and the like. The defects of large injury, multiple complications and the like in the surgical treatment are particularly related to the aspect of nerves, nerve adhesion is easy to generate after the operation, the consequences of the nerve injury are very serious, and patients are often difficult to accept interventional therapy and surgical treatment due to fear. Clinical practice proves that the curative effects of bed rest and traction treatment in the conservative treatment method are better, the bed rest reduces the pressure of the body weight on the intervertebral disc, and the traction treatment is realized by lumbar traction to widen the intervertebral space and reduce the pressure in the intervertebral disc so as to reduce the protruded nucleus pulposus of the intervertebral disc. In the lumbar dynamic stabilization system developed abroad in recent years, fusion is avoided, a lumbar active segment is reserved, adjacent disc degeneration is reduced, particularly, an interspinous process distraction device does not directly dissolve or excise nucleus pulposus of the disc, but indirectly decompresses nerve roots by distracting upper and lower spinous processes to distract nerve root holes, and a certain clinical curative effect is obtained, and the action mechanism of the lumbar dynamic stabilization system is similar to bed rest and traction treatment. The existing interspinous process strutting device can continuously strut the spinous process and the intervertebral foramen, mainly strut the spinous process of the spine by strutting only the back half part of the interspinous process, the acting force deviates, the stress of the spinous process is weak, and the strutting force is weak. The spinous processes are fine cancellous bones, and fracture and bone solubility looseness are easily caused after compression, so that the interspinous distraction device is easy to loosen and loses the distraction effect. However, the traction treatment adopted at present is transient traction, which can not be continuously carried out on intervertebral space, and intervertebral discs are stressed by weight after transient traction, and the traction force is not strong and the curative effect is limited. The lumbar traction and interspinous process distraction device indirectly reduces pressure, does not directly touch intervertebral discs and nerves, keeps spinal motion segments, avoids complications in the aspects of the intervertebral discs and the nerves caused by operations, and avoids adjacent segment degeneration.
The invention discloses an intervertebral space elastic internal fixing device (patent number: ZL 201510074540.9), which overcomes the defects of the prior art, provides continuous and stable traction force, widens the intervertebral space, relieves the intradiscal pressure, allows the protruded nucleus pulposus of the intervertebral disc to be contained, dynamically stabilizes the intervertebral space by semi-rigidity, provides a stable environment for repairing the intervertebral disc, delays the degeneration time of the intervertebral disc and reduces the degeneration of adjacent segments. The vertebral pedicle fixation has strong conduction acting force, is not easy to cause fracture and looseness, avoids acting force deviation, ensures that intervertebral space, spinal canal, zygapophyseal joint, joint capsule and intervertebral ligament all receive the function of distraction, has continuous fixing force and acting force, has lasting curative effect and high cure rate. However, it has been found that the elastic internal fixation device for intervertebral space has disadvantages, such as the inability to accurately grasp the traction force, the inability to maintain a stable intervertebral disc height, especially when the weight is heavy, the pressure applied to the elastic element exceeds its elastic deformation range, or the elastic element is stressed for a long time and deforms in fatigue, so that its elastic force is weakened, even lost, and the connecting rod is subjected to fatigue fracture.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provides an intervertebral space elastic distraction device.
The invention is realized by the following technical scheme:
the invention provides an intervertebral space elastic distraction device which comprises a pedicle screw and an elastic distraction structure for elastically distracting the pedicle screw. The elastic opening mechanism comprises a mandrel, a blind hole connector, a through hole connector and an elastic element; the blind hole connector and the through hole connector are respectively detachably connected with one pedicle screw; an elastic layer is arranged at one end of the mandrel, the blind hole connector is sleeved on the elastic layer and can rotate around the axis of the mandrel; the through hole connector is slidably assembled at the other end of the mandrel; the elastic element is sleeved on the mandrel and used for driving the through-hole connector to slide along the direction far away from the blind hole connector. The invention has the advantages of continuous and stable traction force, widening intervertebral space, reducing pressure in the disc, keeping the protruded nucleus pulposus of the intervertebral disc still, semi-rigid dynamic stabilization of the intervertebral space, providing stable environment for intervertebral disc repair, delaying the degeneration time of the intervertebral disc, transmitting acting force through the vertebral pedicle, being not easy to loosen, not easy to cause fracture, avoiding acting force deviation and the like, and also can accurately grasp the traction force, maintain the constant height of the intervertebral disc, maintain the elastic element in the elastic deformation range, prevent the elastic force from declining due to long-term compression of the elastic element, and prevent the fatigue fracture of the elastic element due to long-term stress.
As a further improvement of the invention:
the elastic element is an expansion spring, the expansion spring penetrates through the mandrel, and two ends of the expansion spring are fixedly connected with the blind hole connector and the through hole connector respectively. An annular cutting groove is formed at the fixed connection position of the open end of the blind hole connector and the elastic element. The annular cutting groove is likely to be subjected to fatigue fracture in the later period of concentrated stress so as to ensure that the telescopic spring is not fractured, and the other end of the telescopic spring is fixedly connected with the through hole connector.
The mandrel is of a cylindrical structure, one end of the mandrel is provided with a slotted hole, and the surface of the other end of the mandrel is provided with the elastic layer; a pin penetrates through the through hole connector, the pin penetrates through the slotted hole, and the through hole connector is limited in the sliding distance of the mandrel through the matching of the pin and the slotted hole.
The pin is cylindric, wear to establish a pair hole of through-hole connector respectively, the one end that the blind hole connector was kept away from to the dabber slotted hole and another pair hole of through-hole connector, and with through-hole connector fixed connection, at this moment, the pin wears to locate the dabber slotted hole and keeps away from the one end of blind hole connector, when the through-hole connector slides to the blind hole connector along the dabber, compress elastic element, simultaneously, the pin slides to the one end that is close to the blind hole connector along the dabber slotted hole, when the pin slides to the one end that is close to the blind hole connector along the dabber slotted hole and contradicts with the other end of dabber slotted hole, the through-hole connector slides and stops, elastic element is compressed and stops immediately.
The pedicle screw comprises a screw body, a screw seat and a thread locking cap, wherein the screw body is connected to one end of the screw seat, two breakable arms are arranged at the other end of the screw seat and are arranged at intervals to form a U-shaped groove, threads matched with the thread locking cap are arranged on the side walls of the two breakable arms facing the inside of the U-shaped groove, the inner surfaces of the tail ends of the two breakable arms are guide sections without threads, a blind hole connector or a through hole connector is arranged in the U-shaped groove, and the direction of the pin is parallel to the two breakable arms; the threaded locking cap is arranged in the U-shaped groove in a matched mode and used for pressing and fixing the blind hole connector or the through hole connector tightly pressed by the vertical pin.
The breakable arm is provided with a cutting groove which is easy to break; the threaded lock cap comprises a screw and a pressing block, the screw is provided with an insertion hole, and the pressing block is provided with a bulge inserted into the insertion hole; the through hole connector and the blind hole connector are cylindrical, and the pressing block is further provided with an arc-shaped opening which is attached to the arc-shaped outer walls of the through hole connector and the blind hole connector.
The nail body and nail seat fixed connection, the screw thread surface of the nail body sets up the spraying layer, the spraying layer is provided with the micropore that increases the nail body and controls power, does benefit to the bone and grows into.
The nail body is connected to the nail seat through a universal connecting mechanism; the universal connecting mechanism comprises a ball head arranged at the tail end of the nail body, the nail body is arranged in the nail seat in a penetrating manner from one end of a U-shaped groove, a pressure pad for pressing the ball head is arranged in the U-shaped groove, the pressure pad is arranged in the U-shaped groove and is fixedly pressed through a blind hole connector or a through hole connector, and the nail seat and the pressure pad are provided with hemispherical cavities matched with the ball head; the ball head is provided with a nail body hole, the pressure pad is provided with a through hole communicated with the nail body hole, and the nail body is of a solid structure or a hollow structure at the front part and a solid structure at the rear part.
Compared with the prior art, the invention has the advantages that: the elastic distraction device for the intervertebral space adopts a combined structure consisting of a mandrel, a pin, a through-hole connector, a blind hole connector and an elastic element, elastically distracts a pedicle screw, and the pedicle screw transmits acting force to an upper vertebral body and a lower vertebral body through the pedicle of vertebral arch to achieve the effect of continuously distracting the intervertebral space, restore the intervertebral disc, distract the nerve root canal to achieve the purpose of nerve decompression, distract and stabilize the zygapophyseal joints and the like. When standing or sitting, the weight pressure is transmitted to the elastic opening mechanism through the pedicle screw, the through hole connector compresses the elastic element, the pin slides to the blind hole connector along the central spindle slotted hole and slides to a certain distance, the pin props against the other end of the central spindle slotted hole, the through hole connector stops compressing the elastic element, the intervertebral space is compressed and maintains the height, at the moment, the weight force is transmitted to the centrum in three parts, one part is that the elastic force of the elastic element overcomes the gravity of the part of the body, the part is transmitted to the blind hole connector, and the part is transmitted to the centrum through the pedicle screw; the other part is that part of the body weight force is transmitted to a blind hole connector through a pin and a mandrel and is transmitted to a vertebral body through a pedicle screw; the gravity of the other part of the body is transmitted to the vertebral body through the intervertebral disc; the first two components are transmitted to the vertebral body through the pedicle screws, so that a certain height of the intervertebral disc is maintained, the weight pressure on the intervertebral disc is reduced, and a repaired physiological environment is created for the intervertebral disc. Meanwhile, the elastic element is prevented from being further pressed and maintained in a normal elastic force range, and the elastic element is prevented from losing the elastic force beyond the shaping range. When lying down, the elastic element does not bear the weight pressure, recovers the elastic force, performs the function of opening (traction) the intervertebral space, reduces the pressure in the intervertebral disc, is beneficial to the intervertebral disc to be accommodated and repaired, and simultaneously straightens the soft tissues of the shrunken annulus fibrosus, the posterior longitudinal ligament and the ligamentum flavum to ensure the decompression of the vertebral canal. The elastic layer end of the mandrel is embedded into the blind hole connector and is abutted against the blind end of the blind hole connector, the mandrel is embedded and connected with the blind hole connector, the blind hole connector is fixed by the pedicle screw, the mandrel is not fixed, the elastic mobility of the mandrel is weak when the mandrel is embedded into the blind hole connector, and fatigue fracture caused by stress concentration of the mandrel is prevented. One end of the telescopic spring is fixedly connected with the through hole connector, an annular cutting groove is formed in the joint of the other end of the telescopic spring and the blind hole connector, stress is concentrated by the annular cutting groove, and the telescopic spring is likely to be fatigue-fractured at the later stage of work so as to ensure that the telescopic spring is not fractured and continues to play a role.
Elasticity struts the mechanism and has axial elasticity and struts power, the elastic force and the semi-rigid steady force of 360 directions of level, has vertical distraction effect to intervertebral disc protrusion, spinal canal stenosis and waist retrogression shakiness, to the indirect decompression of nerve, to intervertebral dynamic stability, improves the microenvironment of intervertebral disc nucleus pulposus pressurized and hypoxemia, does benefit to intervertebral disc restoration, simultaneously, reduces and closes on the segment degeneration. The elastic force and the semi-rigid stabilizing force in the horizontal 360-degree direction overcome the abnormal movement of the lumbar vertebra, the effect of stabilizing the lumbar vertebra is achieved, and the occurrence of spinal stenosis is reduced. The elastic spreading force is controlled by precisely controlling the compression distance of the elastic element according to different body weights. A minimally invasive distraction pressurizer (patent No. ZL 201610082221.7) is used for accurately controlling the distance of distraction of the intervertebral space. Can be used for the treatment of thoracic and lumbar vertebra fracture, and has the effects of continuous reduction and dynamic fixation, and fracture healing. The intervertebral space elastic distraction device has strong traction force, is continuously stable, prevents fatigue fracture, is not easy to loosen, causes fracture, avoids acting force deviation, and has simple structure, good applicability and easy control and operation. Particularly, each pedicle screw is respectively fixed with the fixed lumbar into a whole, the elastic opening mechanism controls the abnormal movement of the lumbar in the horizontal 360-degree direction, the pedicle screws are elastically fixed in the vertical direction by the elastic opening mechanism, so that the parallelism and the vertical distance between the two lumbar can be effectively controlled, the poor parallelism caused by the simple opening from a certain point or part of the lumbar and the stress distribution influencing the opening of the intervertebral space are prevented, the intervertebral disc accommodation space is adjustable, and the adjustment of the three-dimensional space of the positions of the lumbar in a certain range is realized. The invention is mainly used for minimally invasive treatment of disc protection treatment of lumbar intervertebral disc protrusion, lumbar spinal stenosis, discogenic lumbago and the like and minimally invasive treatment of joint protrusion arthritis, degenerative lumbar instability, thoracolumbar fracture and other diseases.
Drawings
Fig. 1 is a schematic structural view of an elastic distraction mechanism in an intervertebral space elastic distraction device according to the invention.
FIG. 2 is a schematic cross-sectional view of an elastic distracting mechanism of an intervertebral space elastic distracting device of the present invention
Fig. 3 is a schematic structural view of an elastic element, a through-hole connector and a blind hole connector in the intervertebral space elastic distraction device.
Fig. 4 is a schematic cross-sectional view of an elastic member, a through-hole connector and a blind-hole connector in an intervertebral space elastic distraction device according to the invention.
Fig. 5 is a schematic structural view of a central spindle of an intervertebral space elastic distraction device according to the invention.
Fig. 6 is a schematic structural view of a pin in the intervertebral space elastic distraction device according to the invention.
Fig. 7 is a schematic structural view of a two-segment intervertebral space elastic distraction device.
Fig. 8 is a schematic cross-sectional view of a two-segment intervertebral space elastic distraction device.
Fig. 9 is a schematic view of the combination structure of the solid rod and the intervertebral space elastic distraction device.
Fig. 10 is a schematic structural view of a pedicle screw in an intervertebral space elastic distraction device according to the invention (the screw body is fixedly connected with the screw seat).
Fig. 11 is a schematic cross-sectional view of a screw cap of an intervertebral space elastic distraction device according to the invention.
Fig. 12 is a schematic structural view of a pedicle screw in an intervertebral space elastic distraction device (the screw body is connected with the screw seat in a universal way).
Fig. 13 is a schematic structural view of a nail body with a ball head in the intervertebral space elastic distraction device.
Fig. 14 is a schematic cross-sectional view of a pressure pad in an intervertebral space elastic distraction device according to the invention.
Fig. 15 is a schematic view of a split structure of a screw lock cap composed of a screw and a pressing block in the intervertebral space elastic distraction device of the invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is described in further detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
As shown in fig. 1 and 10, the present application provides an intervertebral space elastic distraction device, which includes a pedicle screw 2 and an elastic distraction mechanism 1 for elastically distracting the pedicle screw 2, where the elastic distraction mechanism 1 includes a mandrel 11, a pin 15, a blind hole connector 12, a through hole connector 13, and an elastic element 14 having two ends connected to the through hole connector 13 and the blind hole connector 12, respectively.
Referring also to fig. 2, the mandrel 11 has an elastic layer 112 on one end surface and a slot 111 on the other end. The 112 elastic layer is an elastic non-metal layer, and the elastic non-metal layer of the mandrel 11 is inserted into the blind hole of the blind hole connector 12 and is abutted against the blind end. During assembly, the elastic layer 112 of the mandrel 11 is sequentially inserted into the blind holes of the through-hole connector 13, the elastic element 14 and the blind-hole connector 12. The through-hole connector 13 is slidably mounted on the mandrel 11. The elastic element 14 is sleeved on the mandrel 11 and used for driving the through-hole connector 13 to slide along the direction away from the blind hole connector 12. The blind hole connector 12 and the through hole connector 13 are respectively detachably connected with a pedicle screw 2. The elastic expansion mechanism 1 further comprises a slot hole 111 penetrating through the mandrel 11, and a pin 15 used for fixing the through-hole connector 13 and capable of sliding in the slot hole 111 of the mandrel 11.
Referring to fig. 2 to 4, in the present embodiment, the elastic element 14 is a flexible spring, and may also be a cylindrical member made of an elastic material. The elastic element 14 is sleeved on the mandrel 11, and two ends of the elastic element 14 are respectively fixedly connected with the blind hole connector 12 and the through hole connector 13, wherein an annular cutting groove 16 is arranged at the joint of the elastic element 14 and the blind hole connector 12, and the annular cutting groove may be fatigue-fractured at the later stage of concentrated stress so as to ensure that the elastic element 14 is not fractured and keeps integrity and elasticity for a long time.
In this embodiment, the elastic distraction mechanism 1 further includes a connector 131, in which the front end of the blind hole connector 12 is bullet-shaped, and the tail end of the through hole connector 13 is polygonal and connected with the rod holder.
In this embodiment, the through-hole connector 13 is provided with two pair holes 133 penetrating through the slot 111 of the mandrel 11, one end of the elastic layer of the mandrel 11 is inserted into the blind hole of the blind hole connector 12 and abuts against the blind end, the mandrel 11 is connected with the blind hole connector 12 in an embedded manner, and the mandrel 11 has 360-degree elastic micromotion relative to the blind hole connector 12, so as to prevent fatigue fracture caused by stress concentration of the mandrel 11. As shown in fig. 2 and 5, the other end of the mandrel 11 is provided with a slot 111, and one end of the slot 111 away from the blind connector 12 is communicated with the pair of holes 133 of the through-hole connector 13.
As shown in fig. 2 and fig. 6, in the present embodiment, the pin 15 is cylindrical and is inserted through one pair of holes 133 of the through-hole connector 13, one end of the slotted hole 111 of the mandrel 11 away from the blind hole connector 12 and the other pair of holes 133 of the through-hole connector 13, and is fixedly connected to the through-hole connector 13, at this time, the pin 15 is inserted through one end of the slotted hole 111 of the mandrel 11 away from the blind hole connector 12, when the through-hole connector 13 slides along the mandrel 11 towards the blind hole connector 12, the elastic element 14 is pressed, and at the same time, the pin 15 slides along the slotted hole 111 of the mandrel 11 towards the end of the blind hole connector 12 close to the blind hole connector, and when the pin collides, the sliding of the through-hole connector 13 is stopped, and the elastic element 14 is compressed and then stopped, so as to ensure that the elastic element 14 is compressed within the elastic range.
As shown in fig. 10 and 11, in the present embodiment, the pedicle screw 2 includes a screw body 21, a screw seat 22 and a screw locking cap 23, the screw locking cap 23 has a locking cap holding hole, the screw body 21 may be a solid structure or a hollow structure, the screw body 21 is fixedly connected to one end of the screw seat 22, the other end of the screw seat 22 is provided with two breakable arms 221, the two breakable arms 221 are arranged at intervals to form a U-shaped groove 222, and the side walls of the two breakable arms 221 facing the inside of the U-shaped groove 222 are provided with threads engaged with the screw locking cap 23, the fixed connector 12 or the movable connector 13 is arranged in the U-shaped groove 222, and the screw locking cap 23 is arranged in the U-shaped groove 222 in a threaded manner and compresses the fixed connector 12 or the movable connector 13. Meanwhile, the cutting groove 223 is formed on the breakable arm 221 to make the breakable arm 221 easily broken, and the cutting groove 223 is formed on the outer wall of the breakable arm 221 at a position close to the nail seat 22.
In this embodiment, as shown in fig. 12, the inner surfaces of the tail ends of the two breakable arms 221 are guide sections 2211 without threads, and the length of the guide sections 2211 is 2 to 3 thread lengths. When the screw locking cap 23 is placed into the guide section 2211 without screw threads at the tail ends of the two breakable arms 221, the screw locking cap 23 can be in a coaxial state with the pedicle screw of the locking cap, i.e. completely matched with the opening edge of the screw threads, and can be smoothly and accurately screwed into the screw locking cap 23, thereby effectively avoiding damaging the pedicle screw and the screw threads of the screw locking cap 23.
In other embodiments, the nail body 21 may also be connected to the nail seat 22 in a universal connection manner, for example, a universal connection mechanism may be used for connection, as shown in fig. 13 and 14, the universal connection mechanism includes a ball 211 disposed at the tail end of the nail body 21, the nail body 21 is inserted into the nail seat 22 from one end of the U-shaped groove 222, a pressure pad 24 for pressing the ball 211 is disposed in the U-shaped groove 222, and the pressure pad 24 is pressed and fixed by the fixed connector 12 or the movable connector 13. Meanwhile, the pressure pad 24 is provided with an arc-shaped groove 242 corresponding to the fixed connector 12 or the movable connector 13 so as to ensure the firm and reliable pressing, and the nail seat 22 and the pressure pad 24 are provided with a semi-spherical cavity 243 corresponding to the ball head 211 so as to ensure the universal adjustment of the nail body 21. The ball head 211 is further provided with a nail body hole 212, and the pressure pad 24 is provided with a through hole 241 communicated with the nail body hole 212. The surface of the nail body is provided with a micropore spraying layer, so that the bone can grow in the nail body, and the holding force of the screw is increased.
In other embodiments, as shown in fig. 15, the screw locking cap 23 may also be composed of a screw 231 and a pressing block 232, wherein the screw 231 is provided with an insertion hole, the pressing block 232 is provided with a protrusion 2321, and the protrusion 2321 is inserted into the insertion hole of the screw 231; the press block 232 is also provided with an arcuate mouth 2322 which abuts the arcuate outer walls of the through-hole connector 13 and the blind-hole connector. The screw 231 is installed in the U-shaped groove 222 in a threaded manner, so that the pressing block 232 presses the through-hole connector 13 or the blind hole connector, the arc-shaped opening 2322 of the pressing block 232 is attached to the arc-shaped outer wall of the through-hole connector 13 or the blind hole connector 12, the arc-shaped opening 2322 enables the pressing block to be uniformly pressed, deformation of the through-hole connector 13 when the screw locking cap 23 is screwed to press the through-hole connector 13 is prevented, the core shaft 11 is pressed, and the through-hole connector 13 cannot slide on the core shaft 11.
In other embodiments, as shown in fig. 7-9, two pieces of intervertebral space spring distractor devices are combined for spring fixation of two segmental intervertebral spaces; the solid rod is combined with the intervertebral space elastic opening device and is used for elastic fixation of one segmental intervertebral space and fixation of other multiple segments.
The intervertebral space elastic distraction device is preferably made of a material which has good compatibility with human tissues, high elasticity and strength and similar elastic modulus with human bones.
The therapeutic principle of the intervertebral space elastic distraction device is to calculate the distraction height and the spring distraction force of the intervertebral space according to the weight and the height of the intervertebral space. Keep continuously retracting intervertebral disc space through strutting the power, improve the microenvironment of intraductal high pressure of intervertebral and hypoxemia, the intervertebral disc nucleus pulposus is still received in the intraductal decompression of dish, struts the indirect decompression of nerve root canal, and the dynamic stabilization backbone remains motion segment, resumes the stability of backbone, maintains intervertebral disc space height, prevents to narrow, promotes intervertebral disc restoration. Has continuous reduction and dynamic fixation effects on thoracolumbar fracture. The intervertebral space elastic distraction device can reduce the incidence of broken nails, broken rods and internal fixation looseness. The intervertebral space elastic distraction device can be used for placing a nail rod through percutaneous minimally invasive surgery.
The intervertebral space elastic distraction device can keep the intervertebral space in a relaxed state under anesthesia and a prone position when being installed, and is not influenced by the pressure of weight and the tension of soft tissues in a body. The pedicle screws 2 are implanted through percutaneous minimally invasive or open surgery, the elastic distraction mechanism 1 with proper length is selected according to the distance between the implanted upper and lower pedicle screws 2, the blind hole connector 12 and the through hole connector 13 are respectively embedded into the U-shaped grooves 222 of the upper and lower pedicle screws 2, the threaded locking caps 23 are respectively screwed to compress the blind hole connector 12, the threaded locking caps 23 are screwed to be close to but not screw the movable connector 13, and the elastic distraction mechanism is kept parallel to the force line of the vertebral column when being installed. Calculating the height of the distraction intervertebral space according to the body weight and the required distraction force, effectively propping the distance of the through-hole connector 12 sliding away from the blind hole connector 12 along the elastic distraction mechanism 1 by using a minimally invasive distraction pressurizer, screwing the threaded locking cap 23 to enable the pin 15 to be parallel to the sagittal plane, tightly pressing the through-hole connector 13 in the direction perpendicular to the pin 15, and enabling the through-hole connector 13 to slide along the mandrel 11. According to the principle of acting force and reacting force, the elastic force of the elastic element 14 makes the through-hole connector 12 and the blind-hole connector 13 separate from each other, so as to expand the intervertebral space. Another method for arranging the elastic distraction mechanism 1 is to fix the distance required by the elastic element 14 in vitro by using a rod holder, insert the blind hole connector 12 and the through hole connector 13 into the U-shaped grooves 222 of the upper pedicle screw 2 and the lower pedicle screw 2 respectively, screw the threaded locking cap 23 respectively to press the blind hole connector 12 and the through hole connector 13 tightly, loosen the rod holder and restore the elastic force of the spring. The elastic force of the elastic element 14 is the traction force that distracts the intervertebral space. When standing or sitting, the weight pressure is transmitted to the elastic distraction mechanism 1 through the pedicle screw, the through hole connector 13 compresses the elastic element 14, the pin 15 slides to the blind hole connector 12 along the slotted hole 111 of the mandrel 11 and slides for a certain distance, the pin 15 props against the other end of the slotted hole 111 of the mandrel 11, the through hole connector 13 stops compressing the elastic element 14, at the moment, the weight force is transmitted to the centrum in three parts, and one part is that the elastic force of the elastic element 14 overcomes the gravity of the part of the body, is transmitted to the blind hole connector 12 and is transmitted to the centrum through the pedicle screw; the other part is that part of the weight force is transmitted to the blind hole connector 12 through the pin 15 and the mandrel 11 and is transmitted to the vertebral body through the pedicle screw; the gravity of the other part of the body is transmitted to the vertebral body through the intervertebral disc; the first two components are transmitted to the vertebral body through the pedicle screws, so that a certain height of the intervertebral disc is maintained, the weight pressure on the intervertebral disc is reduced, and a repaired physiological environment is created for the intervertebral disc. Meanwhile, the elastic element 14 is prevented from being further pressed and maintained in the normal elastic force range, and the elastic element 14 is prevented from exceeding the shaping range and losing the elastic force. When lying on the back, the elastic element is not stressed by the weight pressure, recovers the elastic force, performs the opening (traction) function on the intervertebral space, and is beneficial to the accommodation and repair of the intervertebral disc. One end of the elastic layer 112 of the mandrel 11 is inserted into the blind hole connector 12 and is abutted and embedded with the blind end of the blind hole connector, when the pedicle screw fixes the blind hole connector 12, the mandrel 11 is not completely fixed, the mandrel 11 has 360-degree micro-motion, and the occurrence rate of fatigue fracture of the mandrel 11 due to stress concentration is reduced. The connection of the spring element 14 to the blind connector 12 is provided with an annular slot 16, which annular slot 16 may break due to fatigue later on due to stress concentrations to ensure that the spring element 14 does not break and remains intact and resilient for a long period of time. The elastic distraction mechanism 1 has longitudinal elastic distraction force, elastic force of 360 degrees in the horizontal direction and semi-rigid stabilizing force, has longitudinal distraction force to intervertebral disc protrusion, spinal stenosis and degenerative instability, achieves indirect decompression effect, promotes intervertebral disc repair, has longitudinal elastic dynamic stability, reduces adjacent segment degeneration, stabilizes lumbar vertebrae by the elastic force of 360 degrees in the horizontal direction and the semi-rigid stabilizing force, and overcomes abnormal movement of lumbar vertebrae.
The above description is only a preferred embodiment of the present invention, and the protection scope of the present invention is not limited to the above-described embodiments. Modifications and variations that may occur to those skilled in the art without departing from the spirit and scope of the invention are to be considered as within the scope of the invention.
Claims (8)
1. The utility model provides an intervertebral space elasticity distraction device, includes pedicle of vertebral arch screw and is used for elasticity to strut the elasticity of pedicle of vertebral arch screw and struts mechanism, its characterized in that: the elastic opening mechanism comprises a mandrel, a blind hole connector, a through hole connector and an elastic element; the blind hole connector and the through hole connector are respectively detachably connected with one pedicle screw;
an elastic layer is arranged at one end of the mandrel, the blind hole connector is sleeved on the elastic layer and can rotate around the axis of the mandrel; the through hole connector is slidably assembled at the other end of the mandrel; the elastic element is sleeved on the mandrel and used for driving the through-hole connector to slide along the direction far away from the blind hole connector;
the elastic element is an expansion spring, the expansion spring penetrates through the mandrel, and two ends of the expansion spring are fixedly connected with the blind hole connector and the through hole connector respectively;
an annular cutting groove is formed at the fixed connection position of the open end of the blind hole connector and the elastic element.
2. An intervertebral spring distractor device according to claim 1, wherein: the mandrel is of a cylindrical structure, one end of the mandrel is provided with a slotted hole, and the surface of the other end of the mandrel is provided with the elastic layer; a pin penetrates through the through hole connector, the pin penetrates through the slotted hole, and the through hole connector is limited in the sliding distance of the mandrel through the matching of the pin and the slotted hole.
3. An intervertebral spring distractor device according to claim 2, wherein: the through hole connector is in a circular tube shape, a tube cavity is called a through hole, one end of the through hole connector is a polygonal connector, the other end of the through hole connector is fixedly connected with the elastic element, and the through hole connector is provided with two pair holes penetrating through the pin.
4. An intervertebral spring distractor device as claimed in claim 3, wherein: the elastic layer of the mandrel inserted into one end of the blind hole connector is an elastic non-metal layer, and the elastic non-metal layer of the mandrel is inserted into the blind hole of the blind hole connector and is abutted against the blind end.
5. An intervertebral spring distractor device according to claim 2, wherein: the pedicle screw comprises a screw body, a screw seat and a thread locking cap, wherein the screw body is connected to one end of the screw seat, two breakable arms are arranged at the other end of the screw seat and are arranged at intervals to form a U-shaped groove, threads matched with the thread locking cap are arranged on the side walls of the two breakable arms facing the inside of the U-shaped groove, the inner surfaces of the tail ends of the two breakable arms are guide sections without threads, a blind hole connector or a through hole connector is arranged in the U-shaped groove, and the direction of the pin is parallel to the two breakable arms; the threaded locking cap is arranged in the U-shaped groove in a matched mode and used for pressing and fixing the blind hole connector or the through hole connector tightly pressed by the vertical pin.
6. An intervertebral spring distractor device according to claim 5, in which: each breakable arm is provided with a notch for easy breaking.
7. An intervertebral spring distractor device according to claim 6, in which: the nail body and nail seat fixed connection, the screw thread surface of the nail body sets up the spraying layer, the spraying layer is provided with the micropore that increases the nail body and controls power.
8. An intervertebral spring distractor device according to claim 6, in which: the nail body is connected to the nail seat through a universal connecting mechanism; the universal connecting mechanism comprises a ball head arranged at the tail end of the nail body, the nail body is arranged in the nail seat in a penetrating manner from one end of a U-shaped groove, a pressure pad for pressing the ball head is arranged in the U-shaped groove, the pressure pad is arranged in the U-shaped groove and is fixedly pressed through a blind hole connector or a through hole connector, and the nail seat and the pressure pad are provided with hemispherical cavities matched with the ball head; the ball head is provided with a nail body hole, the pressure pad is provided with a through hole communicated with the nail body hole, and the nail body is of a solid structure or a hollow structure at the front part and a solid structure at the rear part.
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