CN1076850A - 骶骨植入装置 - Google Patents
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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
- A61B17/7041—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
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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
- A61B17/7055—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant connected to sacrum, pelvis or skull
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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
- A61B17/7049—Connectors, not bearing on the vertebrae, for linking longitudinal elements together
Abstract
一种骶骨植入装置包括固定于腰骶连接处附近
的骶骨两侧的第一和第二骶骨板。骶骨板包括至少
一个椎弓根斜向安装装置以将骶骨板刚性地固定于
骶骨。第一和第二杆件沿脊柱腰部向上延伸。一个
或更多的连接件将杆件系在一起。待固定的最上方
骶骨用专门的错开固定板和椎弓根螺钉连接至植入
装置。需要时也可使用常规的椎骨钩。中间椎骨由
一直连接板和椎弓根螺钉连接至植入装置。
Description
本发明涉及骶骨植入器械,更具体地涉及一种将稳定器具固定到骶骨和胺椎的改进的植入装置。
脊柱融合,特别是腰部和骶部的脊柱融合,常常用来矫正和稳定脊柱曲线,以防止再发生脊柱弯曲,并且使由于椎间盘变性、关节疾病、后柱缺陷、脊柱骨折以及其他衰弱性问题而产生的躯干虚弱之处得到稳定。
脊柱植入装置常常用来在密实的脊柱融合进行时暂时稳定住腰椎和骶椎。
有几种暂时的稳定装置目前正在使用。所有这些都可以胜任,但仍有可改进的地方。比如,需要开发一种植入装置,用来将最上方的腰椎(L1)与植入物相连而不影响次最上方的椎骨的运动。另外,也需要植入装置可实现更牢固的骶骨固定、用于多段固定时更容易并且容易用于脊柱变形。而且,必须开发更好的植入装置以将装置的底座刚性地连系在骶骨上。
本发明提供了一种骶骨植入装置,它可刚性地将植入装置的底座固定在骶骨上,同时安装方便,设计灵活。而且,本装置提供了用来将植入装置的上部固定到比如L-1骶骨的器械,而不影响次最上方骶骨(T-12)和任何其间的骶骨。本发明的骶骨植入装置包括用来安装在靠近腰骶接合处的骶骨两侧上的第一和第二骶骨板。每个骶骨板至少有一用来刚性地将每个骶骨板固定到骶骨的椎弓根斜向安装装置。此植入装置也包括沿向上并基本与各自骶骨板成平行关系地延伸的第一和第二杆件。杆件位于矢状平面的两侧。还有将杆件刚性固定在各骶骨板的机构。至少采用一个连接件用来将骶骨板上方某一位置的杆件相互刚性连接起来。最后,采用一具有一横向部和一中间部的上固定板来将要融合的最上方椎骨固定到植入装置。一椎弓根螺钉固定到并穿过椎弓根。固定板的横向部刚性地固定到椎弓根螺钉。固定板的中间部向上错开一足够距离以避开次最上方椎骨的下关节突。以这种方式,次最上方椎骨可在暂时稳定期间以正常方式相对于待融合椎骨而移动。更可取地,还用一横向固定板用于中间椎骨的椎弓根固定。
在本发明的另一方面,提供了一种专门的椎弓根螺钉用来将错开的横向固定板连接到椎骨。螺钉包括一拧入椎骨的第一螺纹部、一小头部和从小头部突出的一第二螺纹部。第二螺纹部可接纳一螺母。小头部直径大于第二螺纹部并有一在一与螺钉轴线基本正交的平面内的面向上的肩部。在使用时,肩部与固定板的前表面配合,而螺母拧合在第二螺纹部上并向下抵靠在板的后表面上以将板和螺钉固定在一起。
通过参考下面结合附图的描述,更容易欣赏和理解本发明的上述各方面及许多伴随的优点。
图1是本发明脊柱植入装置施用于腰脊时的等角视图;
图2是根据本发明构成的右侧骶骨板的等角视图;
图3是图2所示骶骨板的平面图(位于骶骨平面);
图4是沿图3中线4-4的横剖图;
图5是沿图3中线5-5的横剖图;
图6和图7是与骶骨板一起使用的固定螺钉的立体图;
图8是根据本发明构成的错开的固定板的平面图;
图9是与图8固定板一起使用的椎弓根螺钉的立体图;
图10是图9固定板和螺钉的分解等角视图,图中示出它们与本发明使用的固定杆件和紧固装置相结合。
图11是一直的固定板的平面图;
图12是骶骨上部的放大脊椎视图,显示了根据本发明植入的骶骨板;
图13是沿图1中线13-13穿过骶骨剖切并在本发明骶骨植入装置处向内看去的放大剖视图;
图14是根据本发明植入的椎弓根螺钉和错开的固定板沿图1线14-14剖切并从向内方向看去的放大剖视图;
图15是图14所示的错开的固定板从右向左的侧视图;
图16是图2和图3的骶骨板的第二实施例的平面图(在骶骨平面内);
图17是沿图16线17-17的横剖图。
参看图1,本发明的脊柱植入装置20固定在腰部脊柱上,总体用22表示。植入装置包括一对骶骨板24和26,它们固定在靠近腰骶连接处的骶骨28。一对固定杆件30和32在矢平面的两侧沿向上方向从骶骨板后部延伸到腰椎L5、L4、L3、L2和L1。杆件30和32终止于椎骨L1的上部附近。常规的紧固件34和36分别将杆件30和32牢固地固定到骶骨板24和26。
在杆件的上端,一对错开的固定板40和42将杆件上端固定到L1椎骨。在此位置下方,一对常规的下方钩件44和46抓住L1椎骨的下部以使其相对于杆件30和32而固定。在中间位置,采用一直的固定板48将椎骨L3固定到杆件30和32。紧靠在骶骨板的上方,一连接件50使杆件30和32相对固定。本技术领域内普通熟练人员很容易明白可根据需要采用一个或更多的连接件50、直的固定板48以及钩件44。
根据本发明构成并采用的植入装置20为腰部脊柱提供了一种刚性稳定装置。此装置刚性地将骶骨连接于一个或更多的腰椎。而且,错开的固定板40和42允许植入装置的上部刚性地固定于最上方腰椎L1而不与次最上方椎骨T12的下突接触。以这种方式,T12椎骨可在腰部脊柱稳定的同时以正常方式移动。
现请参看图2、3、4和5,图示了右边的骶骨板。右边的骶骨板和左边的骶骨板是对称的,因此,只详细描述右边的板。右边的骶骨板26有一具有一后表面和一前表面的底座60。板的前表面设计用来与腰骶连接处附近的骶骨后表面紧密接触。在位置上,底座60基本位于一与腰骶连接处附近的骶骨部分基本相切的平面内。为了描述,此平面称为骶骨平面或脊柱平面。
U形法兰62从底座60的中间部分向后延伸。法兰62的中间表面有一沿上下方向的槽64以接纳固定杆件32。采用一常规的杆件夹68用来牢固地且刚性地将杆件32固定于法兰62上的槽64内。骶骨板26的横向部分有三个孔,它们从底座60的后表面沿基本向前的方向延伸。这些孔是椎弓板孔70、横向孔72和斜向孔74。孔70、72和74虽然沿向前方向延伸,但不与骶骨平面正交。
椎弓根孔70有一圆柱形部分80,其轴线83沿一与中间方向错开的前内方向延伸,此方向最好与正交于骶骨平面的直线成15度角。埋头孔81位于圆柱形部分80的后部并露出于骶骨板的后表面。此角度可在0度至20度之间变化,这取决于要固定的具体骶骨构造。然而,应当明白延伸穿过此孔的螺钉延伸穿过骶骨的椎弓根且必须总是位于椎弓根内。已经发现在取向上15度角适用最广。在本实施例中,轴线82相当于与骶骨平面垂直的平面在上下方向上是不倾斜的。然而它可向上倾斜,这样骶骨终板,而不是前皮层,就能与螺钉端部拧合了。
横向孔72有一圆柱形部分84,其轴线86沿一前外方向延伸,此方向最好与正交于骶骨平面的直线在横向上错开30度。如果需要,一个普通熟练人员也可将此横向角度从30度改变直到45度。最好轴线86相对于骶骨板在上下方向上不倾斜。然而,根据骶骨构造,从骶骨平面内看,轴线可向上从0度变到15度。一埋头孔85位于圆柱形部分25的后部并露出骶骨板的后部面。
斜向孔74也有一圆柱形部分88,其轴线90也在横向和向下方向错开。当在骶骨平面内看时,首先,轴线90最好与横向直线错开45度,但也能在30度至60度之间变化。其次,在横向上,轴线90最好与正交于骶骨平面的直线错开30度,但同样也可在30至50度之间变化。埋头孔89位于圆柱形部分88后部,且也露出骶骨板的后表面。
现请参看图6,和骶骨板一起使用的椎弓根螺钉94有独特的构造。它有一较下的螺纹部96、一较上的扩张头部98和紧挨在头部98下面的圆柱形部分100。头部也有一六角插口102,这样螺钉就能旋入钻在椎弓根里的洞。较下的螺纹部96上的与骨头拧合的螺纹是常规形式的。圆柱形部分100有一直径稍小于椎弓根孔70的圆柱形部分80的直径。这些直径选择成,当圆柱形部分100在圆柱形部分80里时,螺钉94可以旋转和往复移动。然而,间隙为可使螺钉相对于轴线82不能成一角度或卡住。较上的扩张部分98的构造为当螺钉完全拧入骶骨时可与埋头孔81相配。
参看图7,在横向孔72和斜向孔74里都采用了同样的螺钉106。螺钉106也有一较下的螺纹部108、一扩张头部110和一圆柱形部分112。圆柱形部分112相对于圆柱形部分84和88的尺寸为可允许转动和往复运动但不能成一角度。扩张头部110的构造为当螺钉完全拧入骶骨时可与埋头孔85主89相配。
现请参看图8和图10,错开的固定板40包括一中间部122和一横向部124。图8中的固定板用于固定装置的左侧上。一与板40对称的相似的固定板用于右侧,然而没有图示。横向部124有一在安装后沿前后方向延伸的孔126。中部122沿向下方向与横向部124错开。中间部122有一横向狭槽127。中间部122的前表面有多个槽128,这些槽128沿上下方向延伸且与狭槽127正交。这些槽128的直径等于固定杆件30。一常规的杆夹式紧固件58用来将固定板40固定到固定杆件30。
一专门的椎弓根129与错开的固定板一起使用。参看图9,椎弓根螺钉包括一下螺纹部130、一小头部132和一上螺纹部134。上螺纹部134有一沿轴向延伸入其上端的六角插口136。小头部的直径大于上螺纹部件134,且其上端终止于一位于正交于螺钉轴线的平面内的肩部138。现请参看图10,椎弓根螺钉129由孔126接纳,此孔的尺寸刚好稍大于上螺纹部134,这样椎弓根螺钉就能相对于错开的固定板40往复移动,但当与孔126拧合时不能相对于螺钉轴线成一角度。一常规的螺母140拧到椎弓根螺钉129的上部134上而使肩部138抵靠固定于固定板的前表面,同时螺母140抵靠着后表面,从样将椎弓根螺钉129和固定板刚性地相互锁定。
图11显示了一直的固定板48。直的固定板48在结构上与错开的固定板40相似,但它不错开。它有一类似的孔144用来接纳与螺钉129相似的椎弓根螺钉,还有一横向狭槽146和用来将板48固定到固定杆件的杆件配合槽148。
参看图12和图13,在使用时,骶骨板24和26固定于腰骶连接处附近的骶骨28。既是希望的也是必要的,可以使骶骨的前表面成为光滑的以成相互抵靠地接纳骶骨板24和26的前表面。用在骶骨板的椎弓根孔内的椎弓根螺钉94和94′拧入由外科医生开入骶骨椎弓根的适当的孔内。椎弓根螺钉向下贴靠,这样扩张头部就牢固地位于各板的埋头孔内。6至10in./1b范围的扭力可用来贴紧螺钉。医生也可制作进入骶骨的适当的孔使之与横向孔72和72′以及斜向孔74和74′对准。螺钉106塞过右边板的横向和斜向孔72和74以及左边板的孔72′和74′。所有螺钉106向下贴靠以使扩张头部贴紧地位于骶骨板前表面的埋头孔内。同样地,6至10in./lb的扭力也适于将螺钉贴靠进板内。
采用这种方式,每个骶骨板的所用三个螺钉相互分散开。结果这些螺钉就不容易从骨内的孔中拉出。沿一个螺钉的轴线方向的力会被部分地分配到其他两个螺钉所承受的骨上。因此,无法沿单个螺钉轴线方向施加全部的力,从而单个螺钉以任何方式都不会从其孔中剪断。这种结构比已有技术有显著的优点,同时骶骨每侧的骶骨板都能独立地布置。比如,可设计螺钉位置以实现骶骨邻近部分的固定,而这部分具有最强壮的骨。斜向螺钉设计成邻近并平行于S1孔,从而避免对S1神经的损伤。中间螺钉向中间倾斜以便双经皮质固定;同叶避开直接在S1椎弓根前方的神经血管结构。横向螺钉设计用来进行明显的神经血管结构侧边的双经皮质固定。
现请参看图14和15,显示了由常规紧固件58固定到固定杆件30和32的错开的固定板40和42。椎弓根螺钉129拧入L1椎骨的左右椎弓根150、152内的合适的孔内。螺母140拧在椎弓根螺钉129的上部并拧紧抵靠着固定板40的前表面。从而收紧紧固件58以将板的另一端固定到固定杆件30和32。以此方式,可将腰部脊柱的植入装置的上端固定到L1椎骨而不影响次最上方椎骨。
现请参看图16和17,显示了本发明右边的骶骨板150的第二实施例。左边的骶骨板在构造上与右边的骶骨板对称,因此只详细描述右边的骶骨板。骶骨板150有一具有后表面和前表面的底座152。板的前表面设计成可与腰骶连接处附近的骶骨后表面紧密接触。在位置上,底座152位于一与腰骶连接处附近的骶骨部分基本相切的平面内。
U形法兰154的构造与图2中的法兰64相同。法兰154的内侧表面有一沿上下方向的槽156以接纳如图2所示的由常规杆件夹68保持在位地固定杆件32。骶骨板150的横向部有两个从底座152的后表面以基本向前的方向延伸的孔。这些孔就是椎弓根孔158和斜向孔160。孔158和160虽然沿向前方向延伸,但不与骶骨平板正交。
椎弓根孔有一圆柱形部分162,其轴线164沿着与中间方向错开的向下向内方向延伸,此方向最好与正交于骶骨平面的直线成15度角。一埋头孔166位于圆柱形部分162的后部且露出骶骨板的后表面。轴线164的角度可在0和20度之间变化,这取决于待固定的具体骶骨构造。然而,应当明白穿过此开口而进入骶骨椎弓根的螺钉总是位于椎弓根内。在骶骨根150的本实施例中,轴线164相对于正交于骶骨板的平面在上下方向上是不倾斜的。然而,轴线可向上倾斜,这样垂直终板而不是前皮层就能与螺钉端部拧合了。
斜向孔160也有一圆柱形部分166,其轴线168在横向和向下方向上错开。当在骶骨平面内看时,首先,轴线168最好与横向直线错开45度,但也可在30至60度之间变化。其次,在横向上轴线168最好与正交于骶骨平面的直线错开30度,但同样也可以在30至45度之间变化。一埋头孔170位于圆柱形部分166的后部且也露出骶骨板的后表面。
骶骨板152是为那些腰骶连接处太小而无法接纳图2和3中所示的骶骨板26的病人而设计的。由于骶骨板150只有椎弓根孔和斜向孔,本发明的骶骨植入装置就可适合于体架较小的病人了。
上面已结合较佳实施例描述了本发明。然而,普遍熟练人员不偏离这里的上位概念也能完成各种变换、等同替代以及其他改变方式。因此,本专利只由权利要求书限定。
Claims (24)
1、一种骶骨植入装置,其特征在于,包括:
用来安装在腰骶连接处附近的所述骶骨两侧上的第一和第二分开的骶骨板,每个骶骨板有至少一个用来将各个所述骶骨板独立地安装于所述骶骨的相对两侧部的椎弓根斜向安装装置,
位于所述腰脊中线两侧从各所述骶骨板向上基本平行延伸的第一和第二杆件,以及用来将所述杆件刚性地固定到所述骶骨板上的装置,
至少一个用来将所述骶骨板上方的所述杆件相互连接的连接件,以及
一刚性地连接于至少一个所述杆件的错开的上固定板,一固定于脊椎椎弓根并穿入其中的椎弓根螺钉,以及将所述椎弓根刚性地固定于所述错开的固定板的装置;
每个所述的椎弓根斜向安装装置包括一固定螺钉,固定螺钉有一螺纹部、一头部和一靠近所述头部的圆柱段,所述骶骨板包括对应于所述椎弓根斜向安装装置的圆柱形孔,每个所述的孔的直径稍大于所述各固定螺钉上的各圆柱段的直径以使所述螺钉能在所述孔内旋转和往复运动但基本没有所述螺钉相对于所述板的成角度的运动,所述椎弓根安装装置的所述圆柱形孔的轴线从所述骶骨板向前内方向延伸,所述椎弓根安装装置的所述圆柱形孔位于所述斜向安装装置的圆柱形孔的中央。
2、如权利要求1所述的骶骨植入装置,其特征在于,所述椎弓根安装装置的所述轴线方向互相对于所述骶骨板正交线向内成一0度至20度范围的角度。
3、如权利要求2所述的骶骨植入装置,其特征在于,所述椎弓根安装装置的轴线方向为相对于骶骨板正交线向内成一约15度的角度。
4、如权利要求1所述的骶骨植入装置,其特征在于,所述斜向安装装置的圆柱形孔的轴线沿一相对于所述骶骨板沿一横向的、向前向下的方向延伸。
5、一种用于骶骨植入装置的骶骨板,其特征在于,包括:
一具有后表面和前表面的板,所述前表面的结构为可抵靠于靠近所述腰骶连接处的骶骨后表面定位,所述骶骨板具有用来与一固定杆件连接的装置,所述骶骨也有一椎弓根斜向安装装置用来将所述骶骨板刚性地固定于所述骶骨位于矢平面侧向的某一位置,每个所述椎弓根斜向安装装置包括一圆柱形孔,所述椎弓根安装装置的所述圆柱形孔的轴线沿一相对于所述骶骨板成向内向前的方向延伸,所述椎弓根安装装置的圆柱形孔位于所述斜向安装装置的圆柱形孔中央。
6、如权利要求5所述的骶骨板,其特征在于,所述椎弓根安装装置的所述轴线沿一与所述骶骨板正交线成一约0度至20度的向内方向延伸。
7、如权利要求6所述的骶骨板,其特征在于,所述椎弓根安装装置的所述轴线沿一与所述骶骨正交线成一约15度的向内方向延伸。
8、如权利要求5所述的骶骨板,其特征在于,所述斜向安装装置的圆柱形孔的轴线沿一相对于所述骶骨板沿一横向的、向前向下的方向延伸。
9、如权利要求8所述的骶骨板,其特征在于,从所述骶骨平面内观看时,所述斜向安装装置的所述轴线沿相对于一位于所述骶骨平面内的横向线成一约30度至60度的角度的向下方向错开,并沿一相对于所述骶骨平面的正交线成一约30度至约45度的横向方向错开。
10、如权利要求9所述的骶骨板,其特征在于,所述轴线相对于所述骶骨平面内的横向线向下错开约45度,并相对于骶骨平面正交线成一约30度角向侧向延伸。
11、一种骶骨植入装置,其特征在于,包括:
用来安装在腰骶连接处附近的所述骶骨两侧上的第一和第二骶骨板,每个骶骨板有至少一个用来将各个所述骶骨板安装于所述骶骨的两侧部的椎弓根斜向安装装置,
位于所述腰脊中线两侧从各所述骶骨板向上基本平行延伸的第一和第二杆件,以及用来将所述杆件刚性地固定到所述骶骨板上的装置;
至少一个用来将所述骶骨板上方的所述杆件相互连接的连接件,
一刚性地连接于至少一个所述杆件的错开的一固定板,一固定于脊椎椎弓根并穿入其中的椎弓根螺钉,以及将所述椎弓根刚性地固定于所述错开的固定板的装置,所述错开的固定板有一中间部和一向上错开的成一体的横向部,中间部位于相对于待固定的椎骨的椎弓根上面。
12、如权利要求11所述的装置,其特征在于,所述错开板的中间部有一横向狭槽,其下侧有多个沿上下方向的狭槽以接收与邻近椎弓根固定螺钉成多个横向距离处的所述杆件。
13、一种骶骨植入装置,其特征在于,包括:
用来安装在腰骶连接处附近的所述骶骨两侧上的第一和第二分开的骶骨板,每个骶骨板有至少一个用来将各个所述骶骨板安装于所述骶骨的两侧部的椎弓根斜向安装装置,
位于所述腰脊中线两侧从各所述骶骨板向上基本平行延伸的第一和第二杆件,以及用来将所述杆件刚性地固定到所述骶骨板上的装置,
至少一个用来将所述骶骨上方的所述杆件相互连接的连接件,
一刚性地连接于至少一个所述杆件的错开的上固定板,一固定于脊椎椎弓根并穿入其中的椎弓根螺钉,以及将所述椎弓根刚性地固定于所述错开的固定板的装置,以及
一用来将一中间椎骨固定于所述杆件之一的直固定板,所述直固定板有一中间部和一成一体的横向部,所述横向部有一孔用来接纳一椎弓根固定螺钉,所述中间部在其前侧有多个上下方向的狭槽用来接纳一与邻近椎弓根固定螺钉成多个横向距离的杆件。
14、一种骶骨植入装置,其特征在于,包括:用来安装在腰骶连接处附近的所述板两侧上的第一和第二的骶骨板,每个所述骶骨板有用来与一固定杆件相连的装置,每个所述骶骨板还有至少一个用来将各个所述骶骨板安装于所述骶骨的两侧部的椎弓根斜向安装装置,每个所述的椎弓根斜向安装装置包括一固定螺钉,固定螺钉有一螺纹部、一头部和一靠近所述头部的圆柱段,所述骶骨板包括对应于所述椎弓根斜向安装装置的圆柱形孔,每个所述的孔的直径稍大于所述各固定螺钉上的圆柱段的直径以使所述螺钉能在所述孔内旋转和往复运动但基本没有所述螺钉相对于所述板的成角度的运动,所述斜向安装装置的所述圆柱形孔轴线沿一相对于所述骶骨板成一横向的、向前向下的方向延伸,所述斜向安装装置的轴线当在所述骶骨平面内观看时沿一相对于一骶骨平面内的横向线成一约30度至约60度的角度的向下方向错开,并且沿一相对于骶骨平面正交线成一约30度至45度的角度的横向方向错开。
15、如权利要求14所述的装置,其特征在于,所述斜向安装装置的所述轴线相对于骶骨平面内的横向线向下错开约45度的角度,并且相对于骶骨平面正交线横向错开约30度的角度。
16、一种用于骶骨植入装置的骶骨板,其特征在于,包括:
一具有后表面和前表面的板,所述前表面的结构为可抵靠于靠近所述腰骶连接处的骶骨后表面定位,所述骶骨板具有用来与一固定杆件连接的装置,所述骶骨板也有至少一个椎弓根斜向安装装置用来将所述骶骨板刚性地固定于所述骶骨位于矢平面侧向的某一位置,每个所述椎弓根斜向安装装置包括一固定螺钉,此固定螺钉有一下螺纹部、一头部和一位于所述头部和所述螺纹部中间的圆柱段,所述板包括对应于每个所述椎弓根斜向安装装置的圆柱形孔,每个所述孔的直径稍大于各个圆柱段直径以使所述圆柱段能在所述孔内旋转和往复运动但基本没有所述螺钉相对于所述板成一角度的运动,所述斜向安装装置的所述圆柱形孔的轴线沿一相对于所述骶骨板成横向的、向前向下的方向延伸,当在所述骶骨平面内观看时,所述轴线沿一相对于一所述骶骨平面内的横向线成约30度至约60度的向下方向错开并沿一相对于所述骶骨平面的正交线成一约30度至45度的横向方向错开。
17、如权利要求16所述的骶骨板,其特征在于,所述斜向安装装置的所述轴线相对于骶骨平面内的横向线向下错开约45度角度并相对于骶骨平面正交线横向错开约30度角。
18、一种骶骨植入装置,其特征在于,包括:
用来安装在腰骶连接处附近的所述骶骨两侧上的第一和第二骶骨板,每个骶骨板有至少一个用来将各个所述骶骨板安装于所述骶骨板的两侧部的椎弓根斜向安装装置,
位于所述腰脊中线两侧从各所述骶骨板向上基本平行延伸的第一和第二杆件,以及用来将所述杆件刚性地固定到所述骶骨上的装置,
至少一个用来将所述骶骨板上方的所述杆件相互连接的连接件;
一刚性地连接于至少一个所述杆件的错开的上固定板,一固定于脊椎椎弓根并穿入其中的椎弓根螺钉,以及将所述椎弓根刚性地固定于所述错开的固定板的装置,所述错开的固定板有一中间部和一向上错开的成一体的横向部,中间部位于相对于待固定的椎骨为次上椎骨的下突下,错开部可位于待固定骶骨的椎弓根上面。
19、如权利要求18所述的装置,其特征在于,所述错开板的中间部有一横向狭槽,其前侧有多个上下方向的狭槽用来接纳与邻近椎弓根固定螺钉成多个距离的所述杆件。
20、一种骶骨植入装置,其特征在于,包括:
用来安装在腰骶连接处附近的所述骶骨两侧上的第一和第二骶骨板,每个骶骨板有至少一个用来将各个所述骶骨板安装于所述骶骨的两侧部的椎弓根斜向安装装置,
位于所述腰脊中线两侧从各所述骶骨板向上基本平行延伸的第一和第二杆件,以及用来将所述杆件刚性地固定到所述骶骨板上的装置;
至少一个用来将所述骶骨板上方的所述杆件相互连接的连接件,
一刚性地连接于至少一个所述杆件的错开的上固定板,一固定于脊椎椎弓根并穿入其中的椎弓根螺钉,以及将所述椎弓根刚性地固定于所述错开的固定板的装置,以及
一用来将一中间椎骨固定于所述杆件中的一个的直固定板,所述直固定板有一中间部和一成一体的横向部,所述横向部有一孔用来接纳一椎弓根固定螺钉,所述中间部在其前侧有多个上下方向的狭槽用来接纳一与邻近椎弓根固定螺钉成多个横向距离的杆件。
21、一种椎弓根固定螺钉,其特征在于,包括:
一螺纹部,
一位于所述用来拧入骨内的螺纹部的小头部,以及
一位于所述小头部上面用来接纳一螺母的第二螺纹部,所述小头部的直径大于所述第二螺纹部,所述小头部具有一位于与所述螺钉轴线正交的平面内的肩部,此肩部面向上朝着所述螺纹部。
22、如权利要求21所述的螺钉,其特征在于,它与一固定板相结合,所述固定板有一中间部用来连接一固定杆件和一横向部,横向部穿有一孔,其尺寸为可接纳所述螺纹部,所述固定板有一前表面和一后表面,所述肩部适于与所述前表面接触,拧合于所述第二螺纹部上的螺母适于抵靠着所述固定板的后表面。
23、一种与一骶骨植入装置结合使用的固定板,其特征在于,所述固定板包括:
一中间部和一横向部,所述横向部内有一孔用来接纳椎弓根固定螺钉的一部分,所述板有一前侧和一后侧,所述中间部内有横向狭槽,构成狭槽所述板的所述前表面有多个前后方向的槽,所述槽用来接纳固定杆。
24、如权利要求23所述的固定板,其特征在于,所述板的所述横向部相对于所述中间部向上错开。
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- 1992-12-18 CA CA002129011A patent/CA2129011A1/en not_active Abandoned
- 1992-12-18 AU AU33327/93A patent/AU663918B2/en not_active Ceased
- 1992-12-18 NZ NZ246497A patent/NZ246497A/en unknown
- 1992-12-18 EP EP93901929A patent/EP0624081A4/en not_active Withdrawn
- 1992-12-18 KR KR1019940702583A patent/KR950700040A/ko not_active IP Right Cessation
- 1992-12-18 BR BR9207070A patent/BR9207070A/pt active Search and Examination
- 1992-12-18 WO PCT/US1992/011113 patent/WO1993014721A1/en not_active Application Discontinuation
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1993
- 1993-01-26 MX MX9300405A patent/MX9300405A/es not_active Application Discontinuation
- 1993-01-28 CN CN93101270A patent/CN1076850A/zh active Pending
- 1993-08-13 US US08/929,660 patent/US6197028B1/en not_active Expired - Lifetime
-
1994
- 1994-07-27 FI FI943521A patent/FI943521A/fi not_active Application Discontinuation
- 1994-07-27 NO NO942793A patent/NO942793L/no unknown
- 1994-07-27 KR KR94702583A patent/KR0147459B1/ko active
-
1997
- 1997-10-17 AU AU41897/97A patent/AU4189797A/en not_active Abandoned
- 1997-12-10 KR KR97709254A patent/KR0147537B1/ko not_active IP Right Cessation
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CN104968302A (zh) * | 2012-11-12 | 2015-10-07 | 德普伊新特斯产品公司 | 椎间干扰植入物和仪器 |
US10278742B2 (en) | 2012-11-12 | 2019-05-07 | DePuy Synthes Products, Inc. | Interbody interference implant and instrumentation |
CN105232133A (zh) * | 2015-09-07 | 2016-01-13 | 徐兆万 | 颈椎前路椎弓根钉板固定系统 |
CN107080605A (zh) * | 2017-01-13 | 2017-08-22 | 王金成 | 3d打印个体化定制骶骨重建板的方法及骶骨重建板 |
CN109259904A (zh) * | 2018-10-09 | 2019-01-25 | 上海市第人民医院 | 一种全骶骨假体 |
Also Published As
Publication number | Publication date |
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KR950700040A (ko) | 1995-01-16 |
AU663918B2 (en) | 1995-10-26 |
JP2549824B2 (ja) | 1996-10-30 |
FI943521A0 (fi) | 1994-07-27 |
US5300073A (en) | 1994-04-05 |
JPH07500760A (ja) | 1995-01-26 |
US6197028B1 (en) | 2001-03-06 |
WO1993014721A1 (en) | 1993-08-05 |
KR0147459B1 (en) | 1998-08-01 |
AU3332793A (en) | 1993-09-01 |
BR9207070A (pt) | 1995-12-05 |
NZ246497A (en) | 1997-03-24 |
EP0624081A1 (en) | 1994-11-17 |
EP0624081A4 (en) | 1995-01-25 |
NO942793D0 (no) | 1994-07-27 |
CA2129011A1 (en) | 1993-08-05 |
NO942793L (no) | 1994-09-21 |
AU4189797A (en) | 1998-01-22 |
KR0147537B1 (en) | 1998-08-01 |
MX9300405A (es) | 1994-07-29 |
FI943521A (fi) | 1994-07-27 |
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