CN101426440A - 椎弓根螺钉脊柱棒连接器装置 - Google Patents

椎弓根螺钉脊柱棒连接器装置 Download PDF

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CN101426440A
CN101426440A CNA2007800141830A CN200780014183A CN101426440A CN 101426440 A CN101426440 A CN 101426440A CN A2007800141830 A CNA2007800141830 A CN A2007800141830A CN 200780014183 A CN200780014183 A CN 200780014183A CN 101426440 A CN101426440 A CN 101426440A
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spinal rod
pedicle screw
shape thing
connector arrangement
contract shape
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E·H·桑德斯
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Warsaw Orthopedic Inc
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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
    • 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
    • A61B17/7041—Screws or hooks combined with longitudinal elements which do not contact vertebrae with single longitudinal rod offset laterally from single row of screws or hooks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, 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
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor

Abstract

本发明提供了一种椎弓根螺钉脊柱棒连接器装置，其包括在主体中有一个用于安放所插入的椎弓根螺钉头部的开口。与主体连接的托架形成侧向约束。桥状物与主体连接，且在主体之上延伸。在桥状物和托架之间提供了脊柱棒接受槽。连接器装置也有契状物，该契状物与椎弓根螺钉轴向偏移，所述椎弓根螺钉可通过用桥状物安放的固定螺钉向下移动。契状物向该椎弓根螺钉头部施加锁模力，且对脊柱棒施加总体侧向锁模力。

Description

椎弓根螺钉脊柱棒连接器装置
发明领域
发明背景
脊椎外科医师常用脊椎融合来处理脊椎异常，脊椎融合是用椎弓根螺钉连接到脊柱上的伸长的脊柱棒来被增添的。这样的“棒组合器”一般包括一个或两个脊柱棒，和多个插入通过椎弓根并且进入其各自椎体中的多个螺钉。螺钉被提供具有连接器，用于将脊柱棒耦合到螺钉上。脊柱棒沿着脊柱的纵轴延伸，通过它们的连接器耦合到多个螺钉上。棒的对准影响驱使病人的脊椎适合更适当的形状。
发明内容
本发明提供了椎弓根螺钉脊柱棒连接器装置，在一个优选的实施方案中，包括有一个主体，该主体有一个开口，开口用于安放插入的椎弓根螺钉的头部。与主体连接的托架(bracket)构成侧向约束。有一个桥状物与主体连接并且延伸通过主体。在桥状物和托架之间提供了接受脊柱棒的槽(slot)。连接器装置也有一个契状物(wedge)，该契状物从椎弓根螺钉轴向偏移，该椎弓根螺钉可通过用桥状物安放的固定螺钉向下运动。契状物给椎弓根螺钉头部施加锁模力(locking force)，对脊柱棒施加总体侧向锁模力。
在下面的附图和本发明的详细说明中，将对本发明进一步说明，这样本发明的其它特征对于本技术领域的普通技术人员将更加明显。
附图说明
图1是根据本发明的椎弓根螺钉脊柱棒连接器装置的一个优选实施方案的透视图。
图2是在图1所示的连接器装置中所使用的椎弓根螺钉的透视图。
图3是在图1所示的连接器装置的部分部件的透视图。
图3A是在图3中所示的连接器装置的放大的剖视图，说明了图3中所示的固定螺钉和契状物之连接的进一步细节。
图4是与图3类似的视图，显示一个替代性优选实施方案的连接器装置。
图5是与图3A类似的视图，显示另一个替代性的优选的实施方案的连接器装置。
图6、7和8是在图1中所示的实施方案的另外的替代性的优选的连接器装置的剖面视图。
发明详述
参考图1-3和3A，提供了根据本发明的一个优选实施方案的椎弓根螺钉脊柱棒连接器装置7。装置7包括主体10。典型地，主体10是用钛或其它合适的材料制造的。主体的底端部分12是平面的，具有经过机械加工的的边。主体的底端部分12有一个开口14。开口14有一个坡形板边16。开口14允许插入椎弓根螺钉18。
典型地，椎弓根螺钉18被插入到病人的脊柱的一个椎弓根中。椎弓根螺钉18有一个大部分有螺纹的杆20，该轴与圆锥的、球形的、或者半球形的头部22连接在一起。
两个平行的有距离的侧板26与主体的底端部分12固定地连接在一起。通常，侧板26和底端部分12用一片固体材料机械加工而成或者模制而成。桥状物28与侧板26完整地连接在一起并且延伸通过侧板26。侧板26的前部形成双重托架30。典型地，托架30有一个弯曲的啮合面34，该啮合面与脊柱棒32的圆柱状表面一致，与脊柱棒32单点或者连续地接触。桥状物28和托架30之间的空间形成接受脊柱棒的槽36。
桥状物28有一个孔40，该孔40至少部分地有螺纹。固定螺钉42通过螺纹方式插入到孔40中。固定螺钉42沿着其顶部表面有一个凹陷，形成六角头扭转驱动表面44，用于接受Allen扳手(没有给出)。契状物48位于固定螺钉42的下面。契状物48的位置从椎弓根螺钉18的轴43轴向偏移。如图3所示，契状物48的横截面为梯形，有一个通常扁平的脊柱棒接触表面50，和一个相对的通常扁平的螺钉头接触表面52。契状物48是用金属的、通常是坚硬的材料制作的，如钛或其它合适的材料。
固定螺钉的扭转驱动表面44有一个底板58。孔隙59与底板58交叉。与契状物48连接的是支柱60，该支柱60延伸通过孔隙59，并且进入到扭转驱动表面44中。支柱60的宽度比孔隙59的宽度明显地小，这样有助于契状物48相对固定螺钉42的侧向运动，并且允许固定螺钉42相对于契状物48自由地旋转。所述支柱的端61通过用型铁弄弯曲而变形，以便相对于孔隙59扩大端61。支柱的端61的扩大可以用固定螺钉42捕获契状物48。端61与底板58将典型地具有至少微笑的空隙，以确保契状物48相对于固定螺钉42有前述的相对运动。
在手术中，主体10、固定螺钉42和契状物48在递送到手术室之前被组合在一起。在外科手术过程中，外科医生将头部椎弓根螺钉18插入到主体10的开口14中。然后椎弓根螺钉18的杆20通过螺纹方式插入到病人脊柱的脊椎基座中。接着将脊柱棒32放置在脊柱棒接受槽36中，与托架30毗邻。契状物48并列脊柱棒32和螺钉头部22。固定螺钉42被旋转，导致契状物48向下运动。契状物48的向下运动引起契状物48与脊柱棒32沿着接触表面50发生线接触。上述提及的作用导致托架30作为侧向约束作用于脊柱棒32。从而，契状物48和托架30一起作用，侧向锁住脊柱棒32。同时契状物48向下运动使契状物48的接触表面52用基本上向下的分力，给螺钉头22施加了针对开口14的坡形板边16的锁模力。椎弓根螺钉轴43与主体的底端部分12的不垂直对准，通过螺钉头22与开放的坡形板边16的枢轴运动来补偿。轴43的位置与脊柱棒32的中心线33的侧向偏差由固定螺钉42穿透深度补偿，所述固定螺钉42被要求可引起契状物48锁住椎弓根螺钉18和脊柱棒32。契状物48也可相对于固定螺钉42侧向微小地移动，以补偿耐受差异。契状物48的接触表面50与脊柱棒32的线接触，确保契状物48是不能旋转的。
典型地，在许多应用中，接触表面50与脊柱棒32的线接触，是与脊柱棒的轴向中心线33平行。接触表面50与棒32的线接触也与两个托架30之间的所划的线平行，它们与脊柱棒32的点接触或线接触。对于逐渐变细的脊柱棒的应用，托架30接触点或接触线的构形，和接触表面50的接触线可被修饰到非平行，以容纳这样的逐渐变细的脊柱棒。此外，如果期望，可修饰接触表面50，以便提供与脊柱棒32的一次接触或多次接触。
图4提供了根据本发明的一个备选的优选实施方案的椎弓根螺钉脊柱棒连接器装置107。图4的组件与先前在图1-3中描述的那些组件基本上相同，除了契状物102的形状为一个对称的锥形物。在固定螺钉42扭矩转动的过程中，契状物102可微小地旋转。另外，脊柱棒32可与契状物102点接触。在另一个没有示出的实施方案中，锥形契状物可与固定螺钉整体形成。
图5提供了根据本发明的一个备选的优选实施方案的椎弓根螺钉脊柱棒连接器装置117。在连接器装置117中，契状物120用聚合材料制作，与金属契状物相比，所述聚合材料通常是软的、且可变形的。契状物120有一个具有支柱124，带有可变形的端125。支柱124插入到孔隙59中导致端125径向收缩，然后向外延伸，以连接契状物120和固定螺钉42。
图6提出了根据本发明的一个备选的优选实施方案椎的弓根螺钉脊柱棒连接器装置137。在连接器装置137中，契状物140与主体144的最末端142相邻放置。契状物140也与脊柱棒32相邻。连接器装置137也有安放固定螺钉42的桥状物145。固定螺钉42的向下运动使契状物140沿着倾斜的对准壁147被对准。对准壁147与桥状物145和主体的下边部分148连接。也提供了托架150，与椎弓根螺钉头22相邻。与托架150相邻的是聚合椎弓根螺钉缓冲器152。契状物140向下移动给脊柱棒32施加了侧向锁模力。脊柱棒32给螺钉头22施加了侧向锁模力，这样通过缓冲器152针对托架150锁住了螺钉头22。典型地，螺钉头22上的锁模力将额外地有一个垂直向上的分力，这是由于棒轴向中心线33是在螺钉头的径向中心23下面的这个事实。
图7提出了根据本发明的一个备选的优选实施方案的椎弓根螺钉脊柱棒连接器装置177。安置177与图6中所示基本上相同，除了对准壁180是垂直的，且没有倾斜。此外，在某种程度上可修饰契状物174。
图8提出了根据本发明的一个备选的优选实施方案的椎弓根螺钉脊柱棒连接器装置187。安置187与图6中所示基本上相同，除了脊柱棒32和螺钉头22的部分已经被互换，这导致契状物149与螺钉头22相邻。契状物149也与主体的最末端191临近。托架192侧向限制脊柱棒32。
尽管已经公开了本发明的优选实施方案，但应该理解到，只是通过实施例的方式进行了描述，可以做各种修改，而不背离本发明的精神和范围，本发明的精神和范围如下述权利要求中所包括的。

Claims (20)

1.一种椎弓根螺钉脊柱棒连接器装置，其包括：
一个主体，该主体有一个开口，用于安放所插入的椎弓根螺钉的头部；
一个托架，该托架与所述主体连接，形成侧向约束；
一个桥状物，该桥状物在所述主体之上延伸、且与所述主体连接，所述桥状物在其本身和所述托架之间形成一个脊柱棒接受槽；和
一个契状物，该契状物从所述椎弓根螺钉轴向偏移，所述椎弓根螺钉可通过用所述桥状物安放的固定螺钉向下移动，所述契状物给所述椎弓根螺钉头部施加锁模力，给所述脊柱棒施加总体侧向锁模力。
2.如权利要求1所述的椎弓根螺钉脊柱棒连接器装置，其中所述椎弓根螺钉上的所述锁模力有一个向下的分力。
3.如权利要求1所述的椎弓根螺钉脊柱棒连接器装置，其中所述契状物是不能旋转的。
4.如权利要求1所述的椎弓根螺钉脊柱棒连接器装置，其中所述契状物与支柱连接，所述支柱延伸通过所述固定螺钉中的孔隙，所述支柱有一个相对于所述孔隙扩大的端。
5.如权利要求1所述的椎弓根螺钉脊柱棒连接器装置，其中所述契状物并列于所述脊柱棒和所述椎弓根螺钉的所述头部。
6.如权利要求1所述的椎弓根螺钉脊柱棒连接器装置，其中所述契状物与所述主体的最末端总体上相邻。
7.如权利要求6所述的椎弓根螺钉脊柱棒连接器装置，其中所述契状物也与所述椎弓根螺钉相邻。
8.如权利要求6所述的椎弓根螺钉脊柱棒连接器装置，其中所述契状物也与所述脊柱棒相邻。
9.如权利要求6所述的椎弓根螺钉脊柱棒连接器装置，其中所述契状物通过对准壁被对准。
10.如权利要求1所述的椎弓根螺钉脊柱棒连接器装置，其中所述契状物用通常坚硬的材料形成。
11.如权利要求1所述的椎弓根螺钉脊柱棒连接器装置，其中所述契状物用聚合材料形成
12.如权利要求1所述的椎弓根螺钉脊柱棒连接器装置，其中所述契状物形成为对称的锥形物。
13.如权利要求1所述的椎弓根螺钉脊柱棒连接器装置，其中所述契状物相对于所述固定螺钉有侧向移动。
14.一种椎弓根螺钉脊柱棒连接器装置，其包括：
一个主体，该主体有一个总体上的平面部分，该平面部分有一个开口，用于安放所插入的椎弓根螺钉的总体上的球形头部；
一个托架，该托架与所述主体连接，形成侧向约束；
一个桥状物，该桥状物在所述主体之上延伸、且与所述主体连接，所述桥状物在其本身和所述托架之间形成一个脊柱棒接受槽；和
一个不能旋转的契状物，该契状物并列于所述椎弓根螺钉和所述棒，所述契状物可通过用所述桥状物安放的固定螺钉向下移动，对着所述托架，所述契状物给所述椎弓根螺钉头部施加向下的锁模力、并且给所述脊柱棒施加侧向锁模力。
15.如权利要求14所述的椎弓根螺钉脊柱棒连接器装置，其中一个侧壁连接所述主体的平面部分和所述桥状物，并且所述侧壁也有一个形成所述托架的部分。
16.如权利要求15所述的椎弓根螺钉脊柱棒连接器装置，其中有两个侧壁，这两个侧壁通常被平行间隔开，以提供平行的有间隔的托架。
17.如权利要求16所述的椎弓根螺钉脊柱棒连接器装置，其中所述契状物有一个扁平的接触表面，该接触表面与所述脊柱棒线接触。
18.如权利要求17所述的椎弓根螺钉脊柱棒连接器装置，其中与所述脊柱棒接触的所述契状物线，是平行于：与所述脊柱棒接触的所述托架点的连接线。
19.如权利要求17所述的椎弓根螺钉脊柱棒连接器装置，其中与所述脊柱棒接触的所述契状物线，是不平行于：与所述脊柱棒接触的所述托架点的连接线。
20.一种椎弓根螺钉脊柱棒连接器装置，其包括：
一个通常是平面的主体，该主体有一个带有逐渐变细的边缘的开口，用于安放所插入的椎弓根螺钉的总体上的球形头部；
两个平行的有间隔的托架，由与所述平面主体接触的侧壁形成，所述托架提供侧向约束；
一个桥状物，该桥状物在所述侧壁之上延伸且与所述侧壁连接，所述桥状物在其本身和所述托架之间形成一个脊柱棒接受槽；和
一个不能旋转的契状物，该契状物并列所述椎弓根螺钉和所述棒，所述契状物具有一个通常是扁平的接触表面，该接触表面与所述脊柱棒接触，所述契状物可通过用桥状物安放的固定螺钉向下移动，所述契状物针对所述托架，给所述椎弓根螺钉头部施加向下的锁模力，给所述脊柱棒施加侧向锁模力。
CNA2007800141830A 2006-04-11 2007-03-22 椎弓根螺钉脊柱棒连接器装置 Pending CN101426440A (zh)

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