CN1192749C - 多轴向骨钉组件及骨固定装置 - Google Patents

多轴向骨钉组件及骨固定装置 Download PDF

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CN1192749C
CN1192749C CNB008122474A CN00812247A CN1192749C CN 1192749 C CN1192749 C CN 1192749C CN B008122474 A CNB008122474 A CN B008122474A CN 00812247 A CN00812247 A CN 00812247A CN 1192749 C CN1192749 C CN 1192749C
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head
bone anchor
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CN1371258A (zh
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B·T·巴克
J·S·扬
C·斯夸尔斯
D·布伦菲尔德
C·约翰逊
D·J·布坎南
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Warsaw Orthopedic Inc
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SDGI Holdings 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
    • 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
    • A61B17/70—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
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00858—Material properties high friction, non-slip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter

Abstract

揭示了一种底部装载的多轴向骨锚装置。该装置包含有接受件(30)、冠状件(70)、骨锚(50)和保持件(90)。接受件(30)限定可构成同一个开口(32)的一部分的上部开口(31a)和下部开口(31b)、通道(45)和沟槽(41)。冠状件(70)和骨锚(50)被装入到接受件(30)的下部开口(31b)中，并且保持件(90)环绕骨锚(50)装配到接受件(30)的沟槽(41)中。骨锚(50)能够相对于接受件(30)多轴向定位。一细长件(R)放置在接受件(30)的通道(45)内，与冠状件(70)相接触，并且一压缩件(120)经上部开口(31a)施加。该压缩件(120)向下紧压在细长件(R)上，该细长件又向下紧压在冠状件(70)上，并将骨锚(50)锁定在冠状件(70)与保持件(30)之间。

Description

多轴向骨钉组件及骨固定装置
技术领域
本发明涉及骨接合术和其它矫形外科手术中所用的装置和植入物。具体地讲，本发明设想了一种能够实现相对于沿着骨组织延伸的细长件的、多角度取向的底部装载的骨锚组件。
背景技术
已开发了用于矫正并使骨头、尤其是长骨和脊柱的损坏或畸形稳定的几种技术和系统。在一种系统中，诸如可弯曲杆之类的细长件沿着骨头的长度纵向安置。在脊柱应用中，该杆最好弯曲，以便与位于正被执行的特殊区域中的脊柱的正常曲率相对应。例如，该杆可弯曲，以便形成用于脊柱的胸区的正常脊柱后凸曲率，或者用于腰区的脊柱前凸曲率。根据此类系统，该杆沿着脊柱的长度藉由多个固定件接合在各个椎骨上。可提供各种各样的固定件，它们被构成为可接合椎骨及其它骨头的特定部分。例如，其中一种固定件系被构成为可接合椎骨板的钩子。另一种被广泛采用的固定件系可拧入到椎骨或其它骨头的各个部位中的螺钉。
在利用可弯曲杆的典型的脊柱手术中，将该杆放置在脊柱或棘状突起的相对两侧上。将多个骨钉拧入到若干椎骨体的一部分内，且极频繁地拧入到这些椎骨的蒂之中。将诸杆固定到这些骨钉上，以便向脊柱施加矫正和稳定力。
杆型脊柱固定系统的一种例子系由Medtronic Sofamor Danek有限公司销售的TSRH脊柱系统。该TSRH系统包括诸细长杆和各种各样的钩子、螺钉和螺栓，它们均被做成可在整个脊柱范围形成弧形分段(segmental)结构。在TSRH系统的一个方面，脊柱杆藉由眼螺栓连接在各种椎骨固定件上。在这种结构中，固定件与脊柱杆相接合，并横向接近该杆。在TSRH系统的另一个方面中，变角螺钉藉由眼螺栓与脊柱杆相接合。该变角螺钉允许骨钉在与脊柱杆的平面相平行的一个平面内枢转。有关该变角螺钉的细节可从为本发明的受让人所拥有的美国专利5,261,909号(Sutterlin等人)中找到。TSRH系统所实现的一个目标是，外科医生可向位于适当解剖位置中的脊柱施加诸如脊柱钩或骨钉之类的椎骨固定件。该TSRH系统还可使外科医生易于将弯曲的脊柱杆接合到用于最终拧紧的各个固定件上。
另一种杆型固定系统系由Medtronic Sofamor Danek有限公司销售的Cotrel-Dubosset/CD脊柱系统。象TSRH系统一样，该CD系统提供用于细长杆与脊柱之间接合的各种各样的固定件。在CD系统的一个方面中，这些固定件自身包括限定有其中容纳脊柱杆的槽的本体。该槽包含有一螺孔，螺纹销栓啮合到该螺孔中，以便将杆夹置在固定件的本体中。该CD系统包括具有这种“后开(open-back)”结构的钩子和骨钉。有关该技术的细节可在美国专利5,005,562号(Cotrel)中找到。CD系统的这个特点的一个好处在于，固定件设置在细长杆的正下方。这样有助于减小植入物结构的总体积，并可将对周围组织的损伤降至最小。
另一方面，CD系统的这些固定件只能绕脊柱杆枢转，以便实现相对于杆的变角定位。虽然这种范围有限的相对角度定位可为众多脊柱病理学所接受，但许多其它的病例则要求骨钉有更灵活的取向，例如相对于脊柱杆取向。这个问题的某些方面可由’909号专利中所述的TSRH系统的变角螺钉来解决。然而，仍然需要一种能相对于脊柱杆在多个平面内角度取向的骨钉。最好该骨钉能相对于脊柱杆进行多种三维取向。此类骨钉已被称之为复轴向或多轴向骨钉。
其他人已提出了用多种复轴向骨钉设计来解决这个问题。例如，在美国专利5,466,237号(Byrd等人)中揭示了一种骨钉，该骨钉在其顶上具有一球形凸起。一外螺纹接受件支撑该骨钉和位于球形凸起的顶上的脊柱杆。将一外部螺母拧紧在接受件上，以便将脊柱杆紧压在球形凸起上，从而允许骨钉相对于杆进行多种角度取向。虽然这种特殊的方法采用了最少的构件，但骨钉骨钉到杆上却不够牢固。换句话说，骨钉上的小球形凸起与脊柱杆之间的接合或骨钉容易在器械受到脊柱的高载荷时、尤其在腰区中断裂。
在美国专利4,946,458号(Harms等人)中所示的另一种方法中，球形头部的骨钉支撑在接受件分离的两个半部之中。这两个半部的底部藉由保持环保持在一起。接受件两个半部的顶部藉由拧紧在螺纹脊柱杆上的螺母环绕骨钉来压缩。在另一种由Harms等人在美国专利5,207,678号中所采用的方法中，接受件绕骨钉的局部球形头部可挠曲地连接。位于接受件的相对两侧上的诸圆锥形螺母被拧紧在穿过接受件的螺纹杆上。由于圆锥形螺母朝着彼此刻有螺纹，因而接受件环绕骨钉可挠曲地压缩，以便将该骨钉夹置在其变角位置中。两个Harms等人的专利中的系统的一个害处在于，脊柱杆必须刻有螺纹，以便接受压缩螺母。已知的是，螺纹杆往往会使杆在面对剧烈的脊柱负载时变弱。此外，’458和’678号专利中的骨钉设计需要多种部件，并且要完成骨钉的固定还相当复杂。
为本发明的受让人所拥有的美国专利5,797,911号(Sherman等人)中所示的另一种方法在于，提供一种U形保持件，顶上设有冠状件的固固定件通过该保持件的顶部装载。该保持件容纳通道中的、位于冠状件上方的杆和位于杆上方的压缩件。该压缩件紧压在杆和冠状件上，以便将紧固件以相对于杆的任何三维角度顶着保持件锁定。这种方法已被证实对解决上述问题是十分有效的。然而，它不允许底部装载紧固件。另外，为了容纳其它的结构件，该保持件的体积也略微庞大。
美国专利5,733,285号(Errico等人)中还揭示了另一种方法，其中保持件在其底部处设有一锥形的夹头(colletted)部分，骨紧固件的头部就插入在该部分中。设有一套筒，该套筒环绕夹头部分向下滑动，以使夹头部分环绕固紧固件的头部变形锁定。这种装置被认为体积较为庞大，且难以操纵所给的外部滑动锁定机构。它还取决于外部套筒的装配和夹头的相对强度及其用于固紧固件头部的牢固锁定的弯曲和变形部分。
发明内容
因此，鉴于上述问题，本发明的第一个目的在于提供一种多轴向骨锚组件，它易于牢固地接合任何结构、即光滑、粗糙、滚花或均匀刻有螺纹的细长件，它能改善骨锚的角度，提高强度，并减小用于使骨锚以多种角度取向中的任何一种取向与细长件相接合的诸构件的尺寸(包括外形轮廓和体积)。
本发明的第二个目的在于提供一种骨固定装置。
本发明的第三个目的在于提供一种用于容纳和保持多轴向骨锚系统的诸构件的装置。
根据上述目的，本发明第一方面在于提供一种用于与细长件相接合的骨锚组件，包括：接受件，该接受件限定有：各自具有相应的最小宽度的开口上部和开口下部，被构成为可容纳细长件、且与开口上部和开口下部相通的通道，以及环绕开口下部的一部分的沟槽；可移动地安置在开口下部内的冠状件，该冠状件包含有顶表面和下表面；骨接锚，该骨接锚具有被构成为可与骨头相接合的下部和具有一宽度的头部，该头部的宽度小于开口下部的最小宽度，该头部可移动地安置在开口下部内、接近冠状件的下表面，以及限定一小于头部的宽度的孔的保持件，该保持件至少局部容纳在接受件的沟槽中、且环绕骨锚置于头部下方，其中，保持件可防止头部从开口下部中移出。
本发明的第二个方面在于提供一种骨固定装置，包括：被构成为用于接近且沿着至少一根骨头的长度放置的细长件；限定自顶端贯穿至底端的一开口的接受件，该开口具有位于底端的下孔和位于顶端的上孔，该接受件还限定环绕开口的一部分的沟槽，该沟槽接近下孔，该接受件还包括与开口和上孔相通的通道，该通道被构成为其中可容纳细长件；可通过下孔插入、且安置在开口中的冠状件，该冠状件具有下表面和与细长件相接触的相对的顶表面；具有被构成为用于接合骨头的下部和具有一宽度尺寸的头部的骨锚，该头部可通过下孔且接近冠状件插入到接受件的开口之中；限定一其宽度尺寸小于头部的宽度尺寸的孔的保持件，该保持件环绕骨锚的一部分设置，并且保持件的至少一部分容纳在沟槽的至少一部分内；以及接近上孔接合在开口内的压缩件，该压缩件可将细长件紧压在冠状件上，从而将紧固件的头部固定在冠状件与保持件之间。
本技术领域中的那些普通技术人员将从以下说明中对本发明的附加实施例、例子、优点和目的一目了然。
附图说明
图1是本发明多轴向骨钉锚组件的一种实施例的侧视图。
图2是图1所示本发明实施例的分解图。
图3a是图2所示本发明实施例的接受件的一种实施例的侧视图。
图3b是图3a所示接受件的实施例的前视图。
图3c是沿着图3a中的线3c-3c进行剖切、且沿着箭头方向所看到的图3a所示接受件的实施例的剖视图。
图3d是沿着图3a中的线3d-3d进行剖切、且沿着箭头方向所看到的图3a所示接受件的实施例的剖视图。
图4a是图2所示本发明实施例所用的骨锚的一种实施例的侧视图。
图4b是沿着图4a中的线4b-4b进行剖切、且沿着箭头方向所看到的图4a所示骨锚的实施例的剖视图。
图4c是图4a所示骨锚的实施例的头部的一种实施例的放大图。
图5a是图2所示本发明实施例所用的冠状件的一种实施例的俯视图。
图5b是沿着图5a中的线5b-5b进行剖切、且沿着箭头方向所看到的图5a所示冠状件的实施例的剖视图。
图5c是图2所示本发明实施例所用的冠状件的另一种实施例的、类似于图5b的剖视图。
图6a是图2所示本发明实施例所用的保持件的一种实施例的俯视图。
图6b是沿着图6a中的线6b-6b进行剖切、且沿着箭头方向所看到的图6a所示保持件的实施例的剖视图。
图7是图1所示本发明实施例的放大剖视图。
具体实施方式
为了促进对本发明原理的理解，以下将参见附图中所示的实施例，并采用特定的语言来描述该实施例。然而要理解的是，本发明的范围并不会由此而受到限制，本发明相关技术领域中的任何一名熟练技术人员通常能设想该图示装置中的变化和其它的变型、以及如本文中所示的本发明原理的其它应用等。
请总的参阅图1和2，图中示出了本发明多轴向骨锚组件20的一种实施例。在该图示实施例中，组件20包含有接受件30、骨锚50、冠状件70和保持件90。本发明的组件20被设计成可与诸如脊柱杆、条或其它矫形结构(将在下文中作进一步描述)之类的细长件R(图7)一起使用。
现在请总的参阅图3a-3d，图中示出了本发明接受件30的一种实施例。该接受件30限定一开口上部31a和一开口下部31b，在图示实施例中，这两个部分构成自顶端34中的上孔33延伸穿过接受件30至底端36中的下孔35的单个开口32。在一特定实施例中，该开口32的开口下部31b包含有由腔壁39所限定的腔室38。或者，开口上部31a和下部31b可具有多种构造，诸如各自具有一个或多个不同直径的部分。
开口32由处于接受件30的顶端34的斜切或圆角边缘40a所局部包围，并由处于接受件30的底端36的斜切或圆角边缘40b所包围。接受件30接近底端36限定一沟槽41和环绕开口32的相关突起41a。在图示实施例中，虽然看到的是，沟槽41仅仅环绕开口32的直径局部延伸，但该沟槽41是环绕开口32的整个直径延伸的。沟槽41具有沟槽深度A(图7)和沟槽直径B(图3a)。
图示实施例中的接受件30包含有一对垂直分支42、43，开口32延伸通过这对分支。该分支42、43还横过开口32限定一U形通道45，该通道与开口32的上部31a和下部31b相通，并且容纳细长件R(图7)。在图示实施例中，在分支42、43中形成有内螺纹44，并且该分支42、43设有允许外科医生用适当的工具(未图示)来紧夹住接受件30的缺口或孔46。一特定实施例中的内螺纹44系反转角形螺纹，即该螺纹中的前向点向下且朝着接受件30，如1998年11月9日提交的共有的美国专利申请09/188,825号中所揭示的，在此援引该其内容以作参考。较佳地，接受件30的顶部47(包含有分支42、43)要比接受件30的底部48来得窄，从而减小接受件30的体积和外形轮廓。
现在请总的参阅图4a-4c，图中示出了本发明所用的骨锚50的一种实施例。该图示的骨锚50系一种骨钉，在其一种实施例中，它基本上类似于美国专利5,885,286号中所揭示的骨钉，在此援引其内容以作参考。骨锚50包含有锚接部52和头部54。该锚接部52包含有至少一条螺纹56，该螺纹可为一种格状(cancellous)自攻螺纹。在图示实施例中，头部54呈局部球体状，当然也可采用另外的曲形和其它的结构。在一种具体实施例中，头部54包含有用于改善与冠状件70(下文中将作描述)的接合的一系列脊部58。头部54可具有诸如粗糙或滚花之类的其它的可增加摩擦的表面构造。另外，头部54包含有一工具接合印痕(print)60，工具(未图示)可与该印痕接合，以便将锚接部52拧入到骨头中。在图示实施例中，该工具接合印痕60系一种内部印痕，当然也可采用外部印痕，并且它可具有多种结构中的任何一种结构，诸如六角形、六叶形或其它已知的传递转矩的结构。
在本发明的范围之中可设想骨锚50的其它实施例。例如，骨锚50可为一种骨接钩而不是螺钉。在该实施例中，锚接部52将被构成为一种钩子而不是具有螺纹56的细长部分。
骨锚50的头部54的形状和尺寸被做成可至少装配在开口32的下部31b和接受件30的腔室38之中。具体地讲，头部54的宽度要小于开口下部31b和腔室38的宽度。如下文中更详细地描述的那样，骨锚50被插入到接受件30中，其中头部通过接受件30的底端36进入到开口下部31b和腔室38中。
现在请参阅图5a-5b，图中示出了本发明冠状件70的一种实施例。在该实施例中，冠状件70呈圆盘形，它具有带斜角边缘74的顶表面72和下表面78。该下表面78被构成为可容纳骨锚50的头部54，因此图示实施例中的下表面78呈局部球体状。或者或另外，冠状件70的下表面可具有一种或多种其它的形状，诸如斜角或锥形下表面78’(图5c)。下表面78可设有用于配合骨锚50的头部54的增加摩擦或接合的表面构造(例如，粗糙或滚花)。
图示实施例中的冠状件70还包含有孔80。该孔80被设置成可通过冠状件70接近骨锚50的头部54、具体地讲为工具接合印痕60。该冠状件70的尺寸和形状被做成可装配在开口32的下部31b和接受件30的腔室38之中。该冠状件70的外部尺寸较佳地略小于腔室38和开口32的下部31b的内部尺寸，这样冠状件70就能在腔室38和开口32中滑动和转动。另外，在图示实施例中，冠状件70的外部尺寸要大于开口上部31a的内部尺寸，这样冠状件70就不会移入到开口上部31a中去。
现在请参阅图6a-6b，图中示出了本发明的保持件90的一种实施例。在图示实施例中，该保持件90采用限定一间隙91的C形簧片或夹片的形式。保持件90包含有顶表面92和底表面94。在图示实施例中，保持件90还包含有基本包围孔102的内表面96、98、100。在一种特定实施例中，内表面96构成其半径大致等同于骨锚50的头部54的半径的球体的一部分，内表面98呈圆柱形，并且内表面100呈圆锥形并向外倾斜，以便允许骨锚50更大范围的角度定位。在其它的实施例中，可有一个或多个内表面来包围孔102，这些表面可呈圆柱形、圆锥形、球形或其它适当的结构。孔102的直径要小于骨锚50的头部54的直径和冠状件70的直径。
保持件90具有卸载或自然外径D，即当保持件90不处于任何收缩(间隙闭合)或膨胀(间隙张开)应力下时所测得的直径。在一种实施例中，保持件90的直径D要小于沟槽41的沟槽直径B。另外，保持件90具有在整个保持件90上基本恒定的体宽W。保持件90的体宽W要大于沟槽41的沟槽深度A。
请总的参阅图1、2和7，组件20的组装如下：将骨锚50、冠状件70和保持件90个别或大致在一个步骤中通过底端36插入到接受件30中。例如，可首先插入冠状件70，然后插入骨锚50，最后插入保持件90。在一种特定实施例中，在将骨锚50插入到接受件30中之前，先将保持件90环绕骨锚50装配在头部54的正下方。通过将骨锚50的锚接部52经保持件90的孔插入、并将保持件90朝着头部54移过锚接部52可将保持件90环绕骨锚50放置。或者，可将保持件90的间隙91紧压在头部54下方的骨锚50的颈部(shank)上，以便间隙90膨胀而使骨锚50放置到保持件90的孔102中，于是，保持件90恢复其原有尺寸和形状。通过将冠状件70放置在骨锚50的头部54的顶上、以使冠状件70的下表面78邻接头部54，并且如上所述将骨锚50和保持件90装配在一起，可将骨锚50、冠状件70和保持件90同时插入到接受件30中。
冠状件70保持可滑动且可转动地定位在开口32的下部31b和/或接受件30的腔室38内，并且骨锚50相对于冠状件70和接受件30保持多轴向移动。将保持件90向上压入到开口32的下部31b内。当保持件90紧压在接受件30的斜切边缘40b上时，保持件90收缩而使间隙91变小，直到保持件90的外径与开口32的下部31b的直径相同为止。保持件90沿着开口32进一步前进至沟槽41内，这样保持件90就装配到沟槽41的至少一部分中。
如上所述，在一种特定实施例中，沟槽41的沟槽直径B小于自然(即卸载)状态中的保持件90的外径D。于是，当保持件90位于沟槽41内时，保持件90紧压在沟槽41的壁上。或者，沟槽41的沟槽直径B的尺寸可等于或略大于保持件90的自然外径D。在这种情况下，保持件90的底表面94就搁置在沟槽41的突起41a上，从而将保持件90保持在沟槽41内。沟槽41的沟槽深度A小于保持件90的体宽W，这样当保持件90装配在沟槽41中时，保持件90的一部分就会伸入到开口32的开口下部31b中。
当保持环90位于沟槽41内时，骨锚50和冠状件70保持在接受件30的开口32之中。冠状件70由骨锚50的头部54所支撑，并且头部54由保持件90的内表面96所支撑。保持件90由接受件30的沟槽41和/或突起41a所保持，由此当保持环90位于沟槽41内时，骨锚50和冠状件70就不会通过保持环90而移出到接受件30之外。
较佳地，在进行外科手术之前先组装该组件20(如上所述)。在使用图示实施例中的组件20的过程中，将该组件20的骨锚50拧入到骨头(未图示)的一适当准备的孔之中。要理解的是，在本发明的另一种实施例中，例如，在骨锚50是一种骨钩的情况下，可不必在骨头上钻个孔并拧入骨锚。将螺纹锚接部52插入到该孔中，并且一适当的螺旋工具通过冠状件70的孔80与工具接合印痕60一起使用，并将骨锚50拧入到骨头中。当已将骨锚50拧入到骨头中至所需深度时，定位接受件30，以便开口32与骨锚50形成所需的角度，如图1所示。在图示实施例中，介于骨锚50与开口32之间的角度θ可为任何方向中的直至30度的任何值。可看到的是，可以几种方式来改变骨锚50相对于开口32的最大角度：例如，通过使头部54下方的骨锚50的部分变薄、通过提供斜切边缘40b的更陡峭的角度、以及/或者通过将沟槽41设置成尽可能地接近接受件30的底端36。
如上所述，接受件30可如外科医生所希望的那样相对于骨锚50倾斜。诸如脊柱杆、连接件或其它矫形外科植入物之类的细长件R与组件20相连。该细长件R放置在接受件30的通道45内，并与冠状件70的顶表面72相接触。诸如定位螺钉或螺纹销栓之类的压缩件120被拧入到接受件30的螺纹44之中，并向下直至细长件R上。在一种实施例中，该压缩件120系具有用于施加转矩的外螺纹122和印痕124的定位螺钉或销栓，而在一种特定实施例中，则是一种断开定位螺钉，如美国专利5,885,286(Sherman等人)中所揭示的，在此援引其内容以作参考。在另一种实施例中，螺纹122系反转角形螺纹，如1998年11月9日提交的美国专利申请09/188,825号中所揭示的，在此援引该其内容以作参考，该螺纹与上述接受件30的螺纹44的反转角形实施例相一致。或者，在接受件30刻有外螺纹的情况下，压缩件120可为一种内螺纹螺母。
当拧紧压缩件120时，细长件R向下紧压在冠状件70上，它将冠状件70向下推动到骨锚50的头部54上。由此，头部54夹置于保持件90与冠状件70之间。在其中头部包含有脊部58的本发明的实施例中，脊部58被压入到冠状件70的下表面78中。这样，骨锚50相对于细长件R和组件20的其余部分被锁入到所需的角度位置中。
或者，可在外科手术过程中组装组件20。在保持环90已定位在头部54下方的情况下，将骨锚50插入到骨头中去。将冠状件70放置在骨锚50的顶上或者接受件30的开口32中。然后，将接受件30向下紧压在骨锚50的头部54上，压制保持环90使其收缩以进入开口32，并如上所述设置在沟槽41中。在以此方式组装组件20之后，将细长件装入到接受件30中，并如前所述的那样锁定。
用于本发明的较佳的材料包括不锈钢和钛。要意识到的是，任何强健的生物相容材料可用于完成骨接合术和本发明的其它的矫形外科手术目的。在一种特定实施例中，冠状件70可由略软于用于骨锚50的头部54的脊部58的材料的材料所制成。这种结构将使脊部58在组件20的锁定期间能更容易地穿入到冠状件70的内表面78之中，从而在脊部58与冠状件70之间提供更坚固的接合。在另一种特定实施例中，冠状件70可由略软于用于细长件R的材料的材料所制成。这种结构将使冠状件70的顶表面72在组件20的锁定期间能变形至细长件R的形状，还能使植入物更为牢固的锁定。
虽然在附图和上述描述中已图示并详细描述了本发明，但这仅仅是用作图示说明用的，而并不能看作是对本发明特征的限定，要理解的是，已示出和描述的仅仅是较佳的实施例，而所有落在本发明精神实质范围内的变化和变形均应受到保护。

Claims (38)

1.一种用于与细长件相接合的骨锚组件，包括：
接受件，所述接受件限定有：各自具有相应的最小宽度的开口上部和开口下部，被构成为可容纳所述细长件、且与所述开口上部和所述开口下部相通的通道，以及环绕所述开口下部的一部分的沟槽；
可移动地安置在所述开口下部内的冠状件，所述冠状件包含有顶表面和下表面；
骨接锚，所述骨接锚具有被构成为可与骨头相接合的下部和具有一宽度的头部，所述头部的所述宽度小于所述开口下部的所述最小宽度，所述头部可移动地安置在所述开口下部内、接近所述冠状件的所述下表面，以及
限定一小于所述头部的所述宽度的孔的保持件，所述保持件至少局部容纳在所述接受件的所述沟槽中、且环绕所述骨锚置于所述头部下方，
其中，所述保持件可防止所述头部从所述开口下部中移出。
2.如权利要求1所述的组件，其特征在于，所述开口上部和所述开口下部构成贯穿所述接受件的单个开口的至少一部分。
3.如权利要求2所述的组件，其特征在于，所述接受件包含有限定所述开口上部和所述通道的两个分支。
4.如权利要求3所述的组件，其特征在于，所述分支包含有内螺纹。
5.如权利要求4所述的组件，其特征在于，还包含有与所述内螺纹螺纹连接的压缩件。
6.如权利要求2所述的组件，其特征在于，所述接受件限定构成所述开口下部的至少一部分的腔室，并且所述冠状件可移动地安置在所述腔室之中。
7.如权利要求6所述的组件，其特征在于，所述骨锚系骨钉。
8.如权利要求7所述的组件，其特征在于，所述骨钉的所述头部呈至少局部球形。
9.如权利要求8所述的组件，其特征在于，所述骨钉的所述头部包含有脊部。
10.如权利要求8所述的组件，其特征在于，所述冠状件的所述下表面呈至少局部球形。
11.如权利要求10所述的组件，其特征在于，所述冠状件的所述下表面包含有粗糙部分。
12.如权利要求6所述的组件，其特征在于，所述冠状件的宽度大于所述接受件的所述开口上部。
13.如权利要求12所述的组件，其特征在于，所述骨锚的所述头部包含有工具接合印痕。
14.如权利要求13所述的组件，其特征在于，所述冠状件限定一贯穿所述顶表面的孔，通过该孔可接近所述骨锚的所述头部。
15.如权利要求12所述的组件，其特征在于，所述保持件系C形件。
16.如权利要求15所述的组件，其特征在于，所述保持件具有卸载外径，所述接受件具有沟槽直径，所述保持件的所述卸载外径大于所述接受件的所述沟槽直径。
17.如权利要求16所述的组件，其特征在于，所述保持件具有体宽，所述沟槽具有沟槽深度，所述体宽大于所述沟槽深度。
18.如权利要求17所述的组件，其特征在于，所述保持件包含有用于接合所述骨锚的所述头部的内凹表面。
19.如权利要求18所述的组件，其特征在于，所述内凹表面构成球体的一部分。
20.如权利要求2所述的组件，其特征在于，所述冠状件的所述下表面成斜角。
21.如权利要求2所述的组件，其特征在于，所述冠状件的所述下表面是凹入的。
22.如权利要求2所述的组件，其特征在于，所述冠状件的宽度大于所述接受件的所述开口上部。
23.如权利要求22所述的组件，其特征在于，所述冠状件限定一贯穿所述顶表面的孔，通过该孔可接近所述骨锚的所述头部。
24.如权利要求2所述的组件，其特征在于，所述保持件系C形件。
25.如权利要求24所述的组件，其特征在于，所述保持件具有卸载外径，所述接受件具有沟槽直径，所述保持件的所述卸载外径大于所述接受件的所述沟槽直径。
26.如权利要求24所述的组件，其特征在于，所述保持件具有体宽，所述沟槽具有沟槽深度，所述体宽大于所述沟槽深度。
27.如权利要求26所述的组件，其特征在于，所述保持件包含有用于接合所述骨锚的所述头部的内凹表面。
28.如权利要求27所述的组件，其特征在于，所述内凹表面构成球体的一部分。
29.一种骨固定装置，包括：
被构成为用于接近且沿着至少一根骨头的长度放置的细长件；
限定自顶端贯穿至底端的一开口的接受件，所述开口具有位于所述底端的下孔和位于所述顶端的上孔，所述接受件还限定环绕所述开口的一部分的沟槽，所述沟槽接近所述下孔，所述接受件还包括与所述开口和所述上孔相通的通道，所述通道被构成为其中可容纳所述细长件；
可通过所述下孔插入、且安置在所述开口中的冠状件，所述冠状件具有下表面和与所述细长件相接触的相对的顶表面；
具有被构成为用于接合骨头的下部和具有一宽度尺寸的头部的骨锚，所述头部可通过所述下孔且接近所述冠状件插入到所述接受件的所述开口之中；
限定一其宽度尺寸小于所述头部的宽度尺寸的孔的保持件，所述保持件环绕所述骨锚的一部分设置，并且所述保持件的至少一部分容纳在所述沟槽的至少一部分内；以及
接近所述上孔接合在所述开口内的压缩件，所述压缩件可将所述细长件紧压在所述冠状件上，从而将所述紧固件的所述头部固定在所述冠状件与所述保持件之间。
30.如权利要求29所述的装置，其特征在于，所述细长件系脊柱杆。
31.如权利要求29所述的装置，其特征在于，所述细长件系C形件。
32.如权利要求31所述的装置，其特征在于，所述保持件具有卸载外径，所述接受件具有沟槽直径，所述保持件的所述卸载外径大于所述接受件的所述沟槽直径。
33.如权利要求32所述的装置，其特征在于，所述保持件具有体宽，所述沟槽具有沟槽深度，所述体宽大于所述沟槽深度。
34.如权利要求33所述的装置，其特征在于，所述保持件包含有用于接合所述骨锚的所述头部的内凹表面。
35.如权利要求34所述的装置，其特征在于，所述内凹表面构成球体的一部分。
36.如权利要求29所述的装置，其特征在于，所述冠状件限定一贯穿所述顶表面的孔，通过该孔可接近所述骨锚的所述头部。
37.如权利要求29所述的装置，其特征在于，所述骨锚的所述头部呈至少局部球形。
38.如权利要求37所述的装置，其特征在于，所述冠状件的所述下表面呈至少局部球形。
CNB008122474A 1999-09-01 2000-08-29 多轴向骨钉组件及骨固定装置 Expired - Lifetime CN1192749C (zh)

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US20100198270A1 (en) 2010-08-05
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