CN100409820C - Bio-flexible spinal fixation apparatus with shape memory alloy - Google Patents

Bio-flexible spinal fixation apparatus with shape memory alloy Download PDF

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Publication number
CN100409820C
CN100409820C CNB2005100908101A CN200510090810A CN100409820C CN 100409820 C CN100409820 C CN 100409820C CN B2005100908101 A CNB2005100908101 A CN B2005100908101A CN 200510090810 A CN200510090810 A CN 200510090810A CN 100409820 C CN100409820 C CN 100409820C
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China
Prior art keywords
screw
spinal fixation
fixation system
longitudinal rod
head
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Expired - Fee Related
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CNB2005100908101A
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Chinese (zh)
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CN1751663A (en
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朴庆佑
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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
    • A61B17/7032—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
    • 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
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7026—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a part that is flexible due to its form
    • A61B17/7028—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a part that is flexible due to its form the flexible part being a coil spring
    • 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
    • A61B17/7052—Connectors, not bearing on the vertebrae, for linking longitudinal elements together of variable angle or length
    • 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
    • A61B2017/00867—Material properties shape memory effect

Abstract

The present invention relates to a spinal fixation apparatus having a segment flexible rod for connecting pedicle screws and a transverse link for spacing out the rods, which are made from a shape memory alloy, thereby easily and simply connecting the rods and the pedicle screws. According to the present invention, it can easily and simply fit the rods to the misaligned pedicle screw, even if it may be a failure of alignment of the pedicle screws in surgery. Also, it can easily set up the transverse link on a pair of the longitudinal rods, even if the longitudinal rods are declined or are not in parallel.

Description

The bio-flexible spinal fixation system of belt shape memorial alloy
Technical field
The present invention relates to a kind of spinal fixation system, it can be corrected and fixing injured human spinal column; More unique is, it also relates to a kind of spinal fixation system of being convenient to carry out spinal operation, it can elongate longitudinal rod and transverse link by flexible longitudinal rod of the nodular made from marmem and transverse link, to adapt to the fixing of difform injured spinal column neatly.
Background technology
In general, vertebra is made up of 24 bones (except that sacral).They interconnect by joint piece, and also have disc between the joint piece.Because adopt this structure, vertebra makes the people can keep certain posture, and can absorb certain impulsive force.Because vertebra is also very important for motion, it can protect all internals to avoid external impact.But the vertebrae of spinal column also can come to harm or sprains because of factors such as external environment condition, long incorrect posture and plastic operations, thus the nervous system in the pressing spine and bring out serious backache.
After a certain position of spinal column comes to harm, because the injury of spinal column is subjected to the compressing at other adjacent on spinal column position, articuli intervertebrales compressing and unstable easily inducing neural root pain, patient can't be engaged in the comings and goings of daily life, and this spinal lesion need be treated by surgical operation.
As shown in Figure 1, comprise some pedicle screws 200 in traditional spinal fixation system, they are inserted in the vertebrae of injured or distortion by pedicle of vertebral arch respectively, wherein each pedicle screw 200 has a head of screw 201 at its top, a U type bar groove 201a is arranged on the head of screw 201, the inner surface of head of screw is shaped on female thread 201b, is shaped on screw thread 202 below thread head 201, makes in the pedicle screw 200 energy implantation vertebra bones.There is a pair of longitudinal rod 250 to be positioned at the both sides of spinal column, is connected on the pedicle screw 200, move to prevent vertebrae.Also have plurality of fixed screw 300, each screw all has external screw thread, and its upper surface has a driving hole, and they are inserted among the bar groove 201a on the head of screw 201 of pedicle screw 200, move to prevent longitudinal rod.Transverse link 400 is used for fixing longitudinal rod 250.
Hereinafter with reference to accompanying drawing, the longitudinal rod and the pedicle screw of traditional spinal fixation system are done with simple description.
As shown in Figure 2, in the threaded portion 202 implanted vertebral bodies 500 of pedicle screw 200.Then longitudinal rod 250 is inserted among the bar groove 201a.In this case, hold-down screw 300 is screwed among the female thread 201b of bar groove 201a.
In addition, hold-down screw 300 is screwed onto among the bar groove 201a, be by being inserted among the groove 300a, tightens at its top with spanner then and realizes.Therefore, in the bar groove 201a of pedicle screw 200, the top of longitudinal rod 250 is pushed down in the bottom surface of hold-down screw 300.
Because this installation method, longitudinal rod 250 will inevitably be tightened on the pedicle screw 200, to correct stiff or injured vertebral body 500.The two ends of transverse link 400 are fixed on a pair of longitudinal rod 250, between the longitudinal rod 250 that transverse link 400 can be fixed on be connected with pedicle screw 200.When patient need do reverse to the left or to the right movable, transverse link 400 can prevent that longitudinal rod 250 from rotating and moving.
In above-mentioned traditional spinal fixation system, longitudinal rod 250 is critical pieces of correcting vertebra.Therefore, when longitudinal rod and vertebrae merged inseparably, its material or performance (as elasticity) were very big to the human influence.Owing to adopt medical titanium alloy to make, longitudinal rod 250 itself be do not have elastic.Because merging, spinal segment and longitudinal rod correct vertebral body, therefore it is difficult to make the lumbar vertebra line to keep normal, vertebrae is after inner and longitudinal rod merge, weight will concentrate on epimere or hypomere, therefore in several years, can cause that also other spinal stenosis or lumbar instability are fixed after vertebrae merges, more dangerous is after lumbar vertebra is impacted, longitudinal rod can rupture and stay in the vertebrae, thereby brings some problems.
The purpose that longitudinal rod is set in the traditional spinal fixation device is the spinal curve wire shaped that keeps correct, and irrelevant with everyone concrete spinal column shape.Be difficult to realize the standardization of every kind of product like this and make different shape, thereby increase product cost.In addition, because everyone spinal column shape is different mutually, and longitudinal rod is straight, and when being connected to pedicle screw on the longitudinal rod, the structure of longitudinal rod also can produce a series of problems.Therefore, by the physical property decision of longitudinal rod,, be difficult to straight-bar is installed on the pedicle screw if pedicle screw is not fixed between each section equably.Therefore, the operator must be according to the inclined position pedicle screw of longitudinal rod, to adjust the distance and the direction of pedicle screw.In addition, the operator also must adjust the angle of pedicle screw head with the fountain type screw, and above-mentioned fountain type screw can rotate freely head around screw in predetermined angular range, so that connect above-mentioned longitudinal rod.Need to guarantee accuracy owing to use traditional spinal fixing device to undergo surgery, therefore the operator must determine to install the position of pedicle screw accurately, on vertebrae, burrow, also will spend a large amount of time makes longitudinal rod according to the curve shape of patient's vertebrae, has therefore caused a burden to the surgeon.In order to solve the problem of traditional spinal fixing device, there is polytype elasticity longitudinal rod at present.
Wherein Korean Patent 0,338, No. 006 utility model discloses a kind of elasticity longitudinal rod that is used for connecting pedicle screw, as shown in Figure 3, this longitudinal rod divides 603 to form by the body of rod 601 with at the body of rod 601 middle elastic joint parts of making, the elasticity longitudinal rod has all kinds, for example semicircle is ring-like, spiral spring type, less than the bar type of body of rod diameter, or the like.
The all flexible coupling part of the longitudinal rod of the above-mentioned type makes the body of rod can be crooked.This structure makes in the preset range of longitudinal rod between the pedicle of vertebral arch joint has flowability.But the elastic joint part branch causes mobile on a large scale, and therefore this longitudinal rod structure has been lost the basic function of spine correcting.Because longitudinal rod must support and be connected spinal column segment, and each section of the body of rod of said structure is detachable,, thereby can not realize reliably connecting between each section of spinal column so that they can move in certain elastic range.Owing to be difficult to longitudinal rod is connected on the pedicle screw, therefore when pedicle screw off-straight scope, the structure of longitudinal rod also can have problems.
Figure 4 shows that traditional being used for prevents that pedicle of vertebral arch from producing the perspective view of the transverse link of minute movement.Described transverse link 400 is by forming with the lower part: the fixed cover 410 and the movable sleeve 420 that are hooked in longitudinal rod 250 two ends respectively; Be supported on the spacer bar 430 on the longitudinal rod 250; And be connected, make spacer bar 430 to be fixed on hold-down screw 440 on the longitudinal rod 250 with fixed cover 410 and movable sleeve 420.Described fixed cover 410 and movable sleeve 420 are respectively equipped with semicircular hook- type position 410a and 420a, the supported hole 410b that is inserted in longitudinal rod 250 two ends and the 420b that is connected on the longitudinal rod 250, screw hole 410c and the 420c that is used to insert hold-down screw 440.
Hook-type position 410a on the fixed cover 410 is hooked on the longitudinal rod 250, and the end with spacer bar 430 inserts among the supported hole 410b then.The hook-type position 420a of movable sleeve 420 is hooked on the longitudinal rod 250, and the other end with spacer bar 430 inserts among the supported hole 420b then.Hold-down screw 440 is screwed in respectively among screw hole 410c and the 420c, makes longitudinal rod 250 be fastened on the below of spacer bar 430 reliably.
In the structure of transverse link 400, the internal diameter of hook-type position 410a almost with the equal diameters of longitudinal rod 250, if have bar to tilt in the longitudinal rod 250 or they between be not parallel to each other mutually, transverse link 400 just can not be yielded to this inclination or the imbalance of longitudinal rod 250.If longitudinal rod 250 tilts or be uneven, the supported hole 410a of fixed cover 410 and movable sleeve 420 and 420a also can be uneven, thereby cause spacer bar 430 can't insert among supported hole 410b and the 420b.If force spacer bar 430 is fixed among supported hole 410b and the 420b, the position of movable sleeve 420 will be twisted, and the hook-type position 420a of longitudinal rod 250 and movable sleeve 420 is thrown off.In these cases, even hold-down screw 440 still is screwed in the screw hole, still can't reliably spacer bar 430 be supported on the longitudinal rod 250.Because transverse link 400 has this problem, surgical operation just needs the cost long time.Even when being difficult to transverse link 400 is installed, omit transverse link 400, thereby cause the defective of performing the operation.
Summary of the invention
The technical problem underlying that the present invention will solve provides a kind of spinal fixation system, and it has enough intensity and correct spinal column in the process that elastic force is recovered, and makes this spinal fixation system to being had adaptability by corrigent spinal segment.
Another technical problem that will solve of the present invention provides a kind of U type bar, and it is made by marmem.This U type bar among the present invention can carry out spinal correction operation simply and easily, and part is few, can directly implant in the selected vertebrae and does not need to use pedicle screw.
In addition, another technical problem that will solve of the present invention provides the method for attachment between a kind of pedicle screw simply and easily and the longitudinal rod, even pedicle screw has deflection slightly during operation, also can solve, and longitudinal rod and transverse link are to adopt the marmem that can produce distortion at a certain temperature to make by the change of every longitudinal rod and transverse link shape and length.
For solving technical problem of the present invention, adopt following technical scheme: spinal fixation system of the present invention comprises: some pedicle screws, a head of screw is arranged at the top of each screw, head of screw below is shaped on screw thread and is used in the implantation vertebra nut, a mount pad is arranged on its head of screw, at least one bar groove is arranged in the mount pad bottom surface; The a pair of longitudinal rod that is connected with pedicle screw is used for preventing that vertebra from moving, and wherein longitudinal rod is provided with a stretch section and is installed in the bar groove on the mount pad; At least one transverse link, its straight-bar position is provided with stretch section, and extend from the two ends at straight-bar position at the hook-type position, and fixedly longitudinal rod is right rigidly; Plurality of fixed screw, each screw all are inserted in the mount pad on the head of screw rigidly, move to prevent longitudinal rod, and wherein longitudinal rod and transverse link all adopt the marmem that can produce distortion under predetermined temperature to make.
The bending two ends of longitudinal rod of the present invention becomes hook-type, also be shaped on the outer surface of head of screw at least one be positioned at the bar groove below holddown groove, an end of every longitudinal rod can be fixed in the holddown groove.The present invention also comprises some screw head caps, is installed on the pedicle screw head.Longitudinal rod of the present invention and transverse link are martensitic state under+10 ℃ and following temperature, approximately+35 ℃ and be austenitic state under the above temperature.The stretch section of longitudinal rod of the present invention and straight bar part have one section to be spring-like or waveform.Described straight bar part has one section for plate shaped, and the cross section of described straight bar part is circular.Also have a notch on the described pedicle screw outer surface, its transverse link is a serpentine, and the transverse link of S type is inserted in the notch of pedicle screw.Be shaped on female thread on the inner surface of mount pad on the head of screw of the present invention, be screwed in externally threaded hold-down screw on the female thread of head of screw mount pad, make the hold-down screw can fastening reliably longitudinal rod.
According to a side of the present invention, can provide by the spinal fixation system of forming with the lower part: some pedicle screws, a head of screw is arranged at the top of each screw, and head of screw below is shaped on screw thread and is used for being shaped on first bar groove on the bottom surface of head of screw in the implantation vertebra nut; Some screw head caps are used for hiding the pedicle screw head, are shaped on second bar groove on the inner surface of screw head cap; The a pair of a pair of longitudinal rod that is surrounded by second bar groove on first bar groove on the head of screw and the screw head cap is used for preventing that vertebra from moving, and a stretch section is wherein arranged on the longitudinal rod; At least one transverse link, its straight-bar position is provided with a stretch section, and extend from the two ends at straight-bar position at its hook-type position, and fixedly longitudinal rod is right rigidly; The plurality of fixed part, each fixture is fastened on the screw head cap on the pedicle screw head, it is inserted in the mount pad on the pedicle screw head, prevents that longitudinal rod from moving, and longitudinal rod and transverse link all adopt the marmem that can produce distortion under predetermined temperature to make.A screw thread nest is arranged on the head of screw of the present invention, and fixture is fixed on the screw head cap on the head of screw by the screw thread nest.
According to another side of the present invention, can provide by the spinal fixation system of forming with the lower part: some pedicle screws, a head of screw is arranged at the top of each screw, head of screw below is shaped on screw thread and is used in the implantation vertebra nut, a mount pad is arranged on the head of screw, two parallel bar grooves are arranged on the bottom surface of mount pad; The a pair of longitudinal rod that is connected on the pedicle screw is used for preventing that vertebra from moving, and wherein longitudinal rod adopts the marmem that can produce distortion under predetermined temperature to make, and longitudinal rod comprises with lower member: 1) with the Centered straight-bar of head of screw; 2) stretch section on the straight-bar; 3) support bar, its sweep extend from the two ends of straight-bar and along the outer surface bending of head of screw, its straight line portion extends from the two ends of sweep, be inserted in the bar groove, also have the plurality of fixed screw, each hold-down screw is inserted in the mount pad of pedicle screw head, is used for preventing that longitudinal rod from moving.Described longitudinal rod is approximately+10 ℃ and be martensitic state under the following temperature, and approximately+35 ℃ and be austenitic state under the above temperature, the stretch section of described longitudinal rod adopts the helical spring shape.Spinal fixation system of the present invention also comprises the screw head cap on some pedicle screw heads.Support bar of the present invention is staggered relatively.
According to another side of the present invention, can provide by the spinal fixation system of forming with the lower part: some pedicle screws, a head of screw is arranged at the top of each screw, and head of screw below is shaped on screw thread and is used at least one cannelure being arranged in the implantation vertebra nut on the outer surface of head of screw; The a pair of longitudinal rod that is connected on the pedicle screw, be used for preventing that vertebra from moving, straight-bar and head of screw center-aligned on every longitudinal rod, on the straight-bar flexible section, support ring is wrapped in the cannelure on the head of screw, and wherein longitudinal rod adopts and can produce the marmem that is out of shape make under predetermined temperature.Described longitudinal rod is approximately+10 ℃ and be martensitic state under the following temperature, approximately+35 ℃ and be austenitic state under the above temperature.The stretch section of described longitudinal rod is a waveform.Described support ring is staggered relatively.
According to another side of the present invention, can provide by the spinal fixation system of forming with the lower part: some pedicle screws, a head of screw is arranged at the top of each screw, head of screw below is shaped on screw thread and is used for the means of vertical screws hole passing the lateral aperture of head of screw body and be used for mounting fixing parts being arranged in the implantation vertebra bone pedicle of vertebral arch on the head of screw; The a pair of longitudinal rod that is connected on the pedicle screw, be used for preventing that vertebra from moving, wherein longitudinal rod is provided with straight-bar, and its hook-type position is extended from the two ends of straight-bar and be crooked, be inserted in then in the lateral aperture, wherein longitudinal rod adopts the marmem that can produce distortion under predetermined temperature to make; The plurality of fixed part is used for preventing that longitudinal rod from moving by the perpendicular screwed hole of head of screw.Described longitudinal rod is approximately+10 ℃ and be martensitic state under the following temperature, approximately+35 ℃ and be austenitic state under the above temperature.
According to another side of the present invention, can provide by the spinal fixation system of forming with the lower part: some pedicle screws, a head of screw is arranged at the top of each screw, head of screw below is shaped on screw thread and is used in the implantation vertebra nut, a mount pad is arranged on the head of screw, two parallel bar grooves are arranged on the bottom surface of mount pad; The a pair of longitudinal rod that is connected on the pedicle screw is used for preventing that vertebra from moving, and every longitudinal rod all is " U " shape, and adopts the marmem that can produce distortion under predetermined temperature to make; Plurality of fixed part, each fixture all are inserted in the mount pad on the pedicle screw head, are used for preventing that longitudinal rod from moving.Described longitudinal rod is approximately+10 ℃ and be martensitic state under the following temperature, approximately+35 ℃ and be austenitic state under the above temperature.
According to another side of the present invention, can provide by the spinal fixation system of forming with the lower part: at least one pedicle screw, a head of screw is arranged at its top, head of screw below is shaped on screw thread and is used in the implantation vertebra nut, a mount pad is arranged on the head of screw, two parallel slots are arranged on the bottom surface of mount pad; The a pair of U type bar that is connected on the pedicle screw is used for preventing that vertebra from moving, and in the direct implantation vertebra nut of a side of every U type bar, opposite side is inserted in the slot; There is at least one fixture to be inserted in the mount pad on the pedicle screw head, is used for preventing that longitudinal rod from moving.Spinal fixation system of the present invention also comprises an intermediate connecting rod, in the slot on the two ends insertion head of screw mount pad of intermediate connecting rod, is connected on the pedicle screw in placed in-line mode.Described spinal fixation system also comprises the screw head cap that is installed on the pedicle screw head.On the described U type bar first bridge piece is arranged, be used for selected vertebrae and adjacent vertebrae scleroseptum are opened, a stretch section is arranged on this first bridge piece, in the direct implantation vertebra nut of nail portion, first connecting rod extends from an end of first bridge piece, wherein nail portion to extension, the length of first connecting rod should be shorter than the degree of depth of head of screw mount pad under the end of first bridge piece.One second bridge piece is arranged on the described intermediate connecting rod, be used for pedicle screw is separated, a stretch section is arranged on second bridge piece, second connecting rod extends from the two ends of second bridge piece, and the length of second connecting rod is less than the degree of depth of head of screw mount pad.Described U type bar and intermediate connecting rod adopt the marmem that can produce distortion under predetermined temperature to make, described U type bar and intermediate connecting rod are approximately+10 ℃ and be martensitic state under the following temperature, under about 35 ℃ and above temperature is austenitic state, and the stretch section of described U type bar and intermediate connecting rod adopt the helical spring shape.Be shaped on some dentations district on the outer surface of nail of the present invention portion, be used for anti-non-magnetic shim portion to throw off from the vertebra nut.
According to another side of the present invention, can provide by the spinal fixation system of forming with the lower part: at least one U type bar, on the every U type bar bridge piece is arranged, be used for separating selected vertebrae and adjacent ridge vertebra, a stretch section is arranged on the bridge piece, in its nail portion implantation vertebra nut, nail portion extends downwards from the two ends of bridge piece, and wherein longitudinal rod adopts the marmem that can produce distortion under predetermined temperature to make.On the outer surface of described nail portion some dentations district is arranged, be used for anti-non-magnetic shim portion to deviate from from the vertebra nut.The stretch section of described U type bar and intermediate connecting rod are helical spring shape or waveform.
According to another side of the present invention, can provide by the spinal fixation system of forming with the lower part: some pedicle screws have a head of screw on the screw; The longitudinal rod of a pair of connection pedicle screw, longitudinal rod is first kind of structure in first humidity province, be second kind of structure in second humidity province, second kind of structure is the shape memory of marmem, longitudinal rod can provide certain working place when being first kind of structure, make the longitudinal rod with shape memory tighter than the longitudinal rod of first kind of structure, head is provided with the fixedly fixture of the end of longitudinal rod, with fixing longitudinal rod reliably.
According to another side of the present invention, a kind of spinal fixation system is by forming with the lower part: first row and the secondary series pedicle screw of arranged vertical, basically be parallel to each other, first row and secondary series pedicle screw comprise respectively with the lower part: a) be fixed on the some pedicle screws on the human spine, each pedicle screw comprises with the lower part: the head of screw that 1) some installation positions are arranged; 2) be used for the external screw thread made on the shank in the implantation vertebra bone; B) be listed as first row and the secondary series longitudinal rod that is connected with the secondary series pedicle screw with first respectively, first row and secondary series longitudinal rod comprise some nodular bars respectively, one end of every nodular bar is fixed therein in the installed part reliably, and the nodular bar adopts marmem to make.Have one elastic stretch section is provided on the described nodular bar, described nodular bar is approximately+10 ℃ and be martensitic state under the following temperature, approximately+35 ℃ and be austenitic state under the above temperature.Spinal fixation system of the present invention comprises that also at least one is used for connecting the transverse link of nodular bar.
Description of drawings
Consider the following specific embodiment in conjunction with the following drawings, will more be clear that technical problem that other will solve of the present invention and benefit:
Fig. 1 is the perspective view of traditional spinal fixation device.
Fig. 2 is the traditional spinal fixation device perspective view that is used for lumbar spine.
Fig. 3 is various forms of traditional longitudinal rod plane graphs.
Fig. 4 is the traditional transverse link perspective view that is used for longitudinal rod.
Fig. 5 is the spinal fixation system perspective view of first embodiment of the invention.
Fig. 6 is the perspective view of spinal fixation system assembly shown in Figure 5.
Fig. 7 is the profile of cutting open along the A-A line among Fig. 6.
Fig. 8 is the plane graph of another kind of form longitudinal rod in the first embodiment of the invention.
Fig. 9 is the profile of pedicle screw in the first embodiment of the invention.
Figure 10 is the plane graph that longitudinal rod and pedicle screw shown in Figure 9 are connected in series.
Figure 11 is the transverse link perspective view that is used for longitudinal rod in the first embodiment of the invention.
Figure 12 is the front view that connects between transverse link and the longitudinal rod.
Figure 13 a is the perspective view of another kind of form longitudinal rod.
Figure 13 b is the plane graph of another kind of form longitudinal rod.
Figure 14 be transverse link with the pedicle screw head between the perspective view that is connected.
Figure 15 is the spinal fixation system front view of second embodiment of the invention.
Figure 16 is the spinal fixation system perspective view of third embodiment of the invention.
Figure 17 is the plane graph that longitudinal rod and pedicle screw head shown in Figure 16 are connected in series.
Figure 18 is the spinal fixation system perspective view of four embodiment of the invention.
Figure 19 is the perspective view that longitudinal rod and pedicle screw head shown in Figure 180 are connected in series.
Figure 20 is the plane graph of spinal fixation system assembly shown in Figure 180.
Figure 21 is the spinal fixation system perspective view of fifth embodiment of the invention.
Figure 22 a and 22b are the spinal fixation system perspective views of sixth embodiment of the invention.
Figure 23 is the spinal fixation system perspective view of seventh embodiment of the invention.
Figure 24 is a U type bar perspective view in the seventh embodiment of the invention.
Figure 25 is a pedicle screw plane graph in the seventh embodiment of the invention.
Figure 26 is the perspective view that U type bar and pedicle screw head shown in Figure 23 are connected in series.
Figure 27 is the spinal fixation system perspective view of eighth embodiment of the invention.
Figure 28 is the U type bar perspective view of another kind of form.
1. 2. 3. 11. 11a.11b. 12. 13. 14. 15. 16.17. 17a. 17b. 18. 20.21. 22. 23. 24. 25.31. 32. 33. 35. 36.40. 41. 41a. 41b. 42.42a. 43. 44. 44a. 44b.45. 50. 51. 52. 53.53a. 53b. 60. 61. 61a.62. 62a. 70. 71. 72. 73.80. 81. 81a. 81b. 82. 83.90. 91. 92. 100. ( U ) 101. 102. 110. 110a.110b. 111. 111a. 112. 113.120.U ( ) 121. 122. 123.125. 126. 130. 130a. 130b.131. 140. 141. 142.146. 150.U 152. 153. 154.155. 200. 201. 201a. 201b.202. 250. 300. 300a. 400.410. 410a. 410b. 410c. 420.420a. 420b. 420c. 430.440. 500. 601. 603.
The specific embodiment
Hereinafter with reference to accompanying drawing the present invention is done with detailed argumentation.Spinal fixation system among the present invention adopts longitudinal rod and the transverse link of being made by marmem, can correct injured spinal column like a cork.Especially specifically, longitudinal rod and transverse link adopt nitinol (Nitinol) to make, and have super-elastic property.
Discuss first embodiment in detail hereinafter with reference to Fig. 5 to Figure 14.
In first embodiment of the present invention, spinal fixation system comprises with the lower part: the some pedicle screws 1 in the implant patient vertebrae; The a pair of longitudinal rod 2 that is positioned at the spinal column both sides and is connected to prevent that vertebra from moving with pedicle screw; The some transverse links 3 that separate longitudinal rod 2.
Referring now to Fig. 5 to Fig. 7,, a head of screw 11 is arranged at the top of pedicle screw 1, and there is screw thread 13 below of head of screw, is used in the implantation vertebra bone.A mount pad 11a is arranged on the head of screw 11, be used for installing longitudinal rod 2, at least one bar groove 12 is arranged on the bottom surface of mount pad 11a.The diameter of bar groove 12 conforms to the diameter of longitudinal rod 2.Longitudinal rod 2 has the body of rod 15 of a bending, is hook-type at its two ends, and longitudinal rod 2 has a stretch section 16 at the middle part of the body of rod 15, be used for producing elastic force, acts on the supraspinal impulsive force of patient with resistance.Stretch section 16 adopts helical spring to make the equal diameters of the helical spring diameter and the body of rod 15.As shown in Figure 8, the another kind of form of stretch section 16 is a waveform.The bar footpath is big in 2 to 7 millimeters scope, can adjust by each 0.5 millimeter.
When pedicle screw 1 with spinal fusion together the time, stretch section 16 plays cushioning effect between spinal segment.That is to say when patient bends over or twists waist, or impact force action is arranged when its waist, the stimulation that stretch section 16 produces in the time of can alleviating patient activity or be subjected to external impact.
Hold-down screw 17 is inserted in the mount pad on the head of screw 11 of pedicle screw 1, is used for preventing that longitudinal rod 2 from moving.External screw thread 17a is arranged on the hold-down screw 17, be used for fastening reliably longitudinal rod 2, the recessed portion 17b of a hexagonal section is arranged at the top of head of screw 11, hold-down screw 17 can be inserted among the mount pad 11a of head of screw 11.The length of hold-down screw 17 should enough be lacked, and should not stretch out from the upper surface of the mount pad 11a of head of screw 11.On the mount pad 11a of head of screw 11 female thread 11b is arranged also, be used for cooperating with the external screw thread 17a of hold-down screw 17.
A longitudinal rod holddown groove 14 is arranged on the head of screw 11 of pedicle screw 1, be used for an end of fastening longitudinal rod 2.Longitudinal rod 2 is inserted among the mount pad 11a, and when rod end tightly was inserted in the longitudinal rod holddown groove 14, it was inserted in the bar groove 12.Longitudinal rod holddown groove 14 is identical with the diameter of longitudinal rod 2, and perhaps the diameter of longitudinal rod holddown groove 14 is a bit larger tham the diameter of longitudinal rod 2.
Screw head cap 18 can be enclosed within the top of head of screw 11, to eliminate the hold-down screw 17 fixing variations that just do not producing.Because screw head cap 18 provides supplemental support, can improve the bed knife of longitudinal rod, so can be used as the auxiliary rod of fixed bar and so on.Screw head cap 18 increases as required, and is optional.
As shown in Figure 9, can hold two bar grooves 12 and 12 ' and two longitudinal rod holddown groove 14 and 14 ' on the head of screw 11 of pedicle screw 1.As shown in figure 10, according to said structure, in longitudinal rod 2 and 2 ' insertion rod groove 12 and 12 ', the longitudinal rod 2 and need not to use other connector of can connecting fixedly.
First embodiment of the present invention is limited in the said structure scope.For example, longitudinal rod can adopt the straight-bar shape, also can adopt the right angle rod-shape perpendicular to body of rod two ends.In this remodeling longitudinal rod, have only a bar groove on the structure of pedicle screw 1 and do not have longitudinal rod holddown groove 14.In addition, it can also be used for the pedicle screw of different structure, thereby adapts to the remodeling longitudinal rod.In addition, remodeling longitudinal rod 2 adopts hold-down screw 17 to be fixed on reliably among the mount pad 11a of head of screw 11.
Hereinafter with reference to Figure 11 and Figure 12, discuss transverse link 3 in detail.
Transverse link 3 is a rectangular plate shape, and length in 20 to 80 millimeters scope, can be adjusted by each 2 millimeters greatly, comprises a straight-bar position 31 and extends two also crooked hook-type positions 32 at the two ends at straight-bar position 31 respectively.As shown in figure 12, transverse link 3 is caught longitudinal rod 2 and 2 ' by hook-type position 32, thereby longitudinal rod 2 and 2 ' is separated.Here, though the length of the transverse link 3 of plate shape can guarantee external force act on make on longitudinal rod 2 and 2 ' longitudinal rod 2 and 2 ' distortion, also can keep the interval between longitudinal rod 2 and 2 '.
Figure 13 a is different with the transverse link among Figure 11 with the transverse link shown in Figure 13 b, that is, stretch section 33 is positioned at the middle part at straight-bar position 31.A helical spring (shown in Figure 13 a) is arranged on the stretch section 33 or be waveform (shown in Figure 13 b), the stretch section 33 of transverse link 3 can the power of Absorption on longitudinal rod 2.
Figure 14 shows that S type transverse link 3, it is different from transverse link shown in Figure 11.S type transverse link 3 comprises a crooked position 36 and extends and two crooked hook-type positions 32 from the both ends horizontal of crooked position 36, is used for fixing the head of screw 11 of pedicle screw 1.A notch 35 is arranged on the circumference of the head of screw 11 of pedicle screw 1, be used for the hook-type position 32 of S type transverse link 3 is inserted in head of screw 11.
Above-mentioned longitudinal rod 2 in the first embodiment of the invention and 2 ' and transverse link 3 all adopt the marmem that can produce distortion at a certain temperature to make.Longitudinal rod 2 and 2 ' and transverse link 3 have a kind of like this temperature characterisitic: they are martensitic state in+10 ℃ and following temperature range, temperature is an austenitic state during greater than+35 ℃, and returns to the original form of being remembered.Particularly unique is, the shape after distortion below+26 ℃ can remain unchanged, when heat treatment temperature reach+35 ℃ the time, recover institute's memorized shape gradually.
The two ends of shape-memory material and the hook-type of middle part and stretch section be respectively after the molding, at heat treatment under 650 ℃ to 750 ℃ the temperature about one hour, can obtain longitudinal rod 2 and 2 ' and transverse link 3.Like this, longitudinal rod 2 and 2 ' and transverse link 3 just had the characteristic of distortion at a certain temperature.
Below will discuss the process of installing in detail according to first embodiment of the invention.
Pedicle screw 1 is by in the predetermined angle and the implanted selected vertebra nut of the degree of depth.At this moment, do not consider the layout of screw, they do not have complete matching usually.Longitudinal rod 2 is out of shape under+10 ℃ and following temperature, to prolong the stretch section 16 of longitudinal rod 2, make longitudinal rod 2 be convenient to insert among the mount pad 11a on the head of screw 11 of pedicle screw 1, and then among the mount pad 11a with longitudinal rod 2 insertion head of screws 11, longitudinal rod 2 is fixed on some screws 1.Then, the end of hook-type longitudinal rod 2 is inserted in the longitudinal rod holddown groove 14, the straight bar part (body of rod 15) with strained longitudinal rod 2 inserts in the bar groove of making on the mount pad 11a bottom surface of head of screw 11 12 simultaneously.External screw thread 17a with hold-down screw 17 is screwed in downwards among the mount pad 11a of head of screw 11 with spanner, thereby hold-down screw 17 is fixed among the female thread 11b of mount pad 11a tightly.Longitudinal rod 2 screw 17 that is fixed compresses, and is rigidly fixed in reliably on the pedicle screw 1.
After longitudinal rod 2 installations, with the operation thermal source be higher than+35 ℃ temperature heat-treats longitudinal rod 2, and the stretch section 16 that is elongated on the longitudinal rod 2 is shunk, and returns to the original form of being remembered in the process of austenite phase transformation.At this moment, when longitudinal rod 2 returned to the original form of being remembered, the end of hook-type longitudinal rod was rigidly fixed in the longitudinal rod holddown groove 14 of head of screw 11.Like this, the two ends of longitudinal rod 2 are fixed in the longitudinal rod holddown groove 14 on the head of screw 11 and can separate.According to above argumentation, although arranging mutually, pedicle screw not very neat, longitudinal rod can be connected on the pedicle screw 1 simply and easily, because longitudinal rod 2 can be towards pedicle screw 1 free bend.In addition, after the spinal fusion, when patient's bending or distortion back, longitudinal rod 2 can also make by the super-elasticity effect of stretch section 16 to produce between the spinal segment and move.
In the installation process of longitudinal rod 2, when being installed in longitudinal rod 2 and 2 ' in the bar groove 12 respectively, use be the pedicle screw 1 that has two bar grooves 12 and 12 '.That is to say that longitudinal rod 2 and 2 ' alternately is fixed on the bar groove 12 and 12 ' that is arranged on the mount pad 11a respectively, as shown in figure 10.So, if employing does not then need the connector that uses other to be used to be connected in series with the pedicle screw 1 of two bar grooves 12 and 12 '.
Below will discuss the installation process of transverse link 3 in detail.After being installed to longitudinal rod 2 and 2 ' on the pedicle screw 1, transverse link 3 being attached on a pair of longitudinal rod 2, thereby two longitudinal rods 2 are separated.The installation of transverse link 3 is adopted and the identical method of above-mentioned longitudinal rod installation process.That is to say, transverse link 3 is out of shape under 10 ℃ and following temperature, to elongate straight-bar position 31 or to widen distance between the hook-type position 32.The hook-type position 32 of distortion on the transverse link 3 is inserted in the outer surface of longitudinal rod 2.If adopt S type transverse link, then insert in the notch 35 of head of screw 11.After transverse link 3 installations, will make it be transformed into austenite, thereby return to the original form of being remembered, transverse link 3 is rigidly fixed on the longitudinal rod by under the temperature more than+35 ℃, heat-treating.If adopt S type transverse link 3, it will be fixed on the notch 35 of pedicle screw 1.
So, if adopt the transverse link 3 of said structure, even longitudinal rod 2 is not parallel to each other mutually with 2 ', also can be like a cork fixing longitudinal rod 2.
Hereinafter with reference to Figure 15, discuss second embodiment of the present invention in detail, the part of reference number representative is identical with first embodiment of the invention.
In second embodiment, be shaped on a pair of first bar groove 21 and 21 ' on the head of screw 11 of pedicle screw 1, longitudinal rod 2 is fixed on screw top, be shaped on female thread 23 with the predetermined degree of depth on the inner surface of head of screw 11.In addition, be shaped on a pair of longitudinal rod insertion groove 22 and 22 ' respectively in the below of bar groove 21 and 21 ', longitudinal rod insertion groove 22 and 22 ' lays respectively on the axis of bar groove 21 and 21 '.
The top of head of screw 11 is provided with screw head cap 20, have a pair of on the screw head cap 20 and the first bar groove 21 and 21 ' the corresponding second bar groove 24 and 24 ', hold-down screw 25 is screwed on the female thread 23 that passes screw head cap 20, and head of screw 11 is fixed on the screw head cap 20 reliably.The first bar groove 21 and 21 ' and the second bar groove 24 conform to 2 ' with longitudinal rod 2 with 24 ' diameter.Longitudinal rod insertion groove 22 is identical or big slightly with the diameter of longitudinal rod 2 with 22 ' diameter.
If have only a bar groove in the first bar groove 21 and 21 ', two female threads can be positioned at the both sides of the first bar groove.If two bar grooves have, then a female thread can be set at the middle part of the first bar groove 21 and 21 '.This figure is depicted as a pair of first bar groove 21 and 21 '.These two bar grooves need alternately be fixed on two longitudinal rods 2 and 2 ' on the first bar groove 21 and 21 ' in placed in-line mode.
Discuss the 3rd to eight embodiment of the present invention in detail hereinafter with reference to Figure 16 to 28.
In these embodiments, longitudinal rod, U type bar and intermediate connecting rod all adopt under+10 ℃ and following temperature to morphology of martensite, make for austenite form and the marmem that can return to the original form of being remembered under temperature more than+35 ℃.Marmem among these embodiment need be through the first distortion under+10 ℃ and following temperature.Shape after distortion under the temperature below+26 ℃ remains unchanged.Be heated to+35 ℃ after shape recover.
Discuss the 3rd embodiment of the present invention in detail hereinafter with reference to Figure 16 and Figure 17.
In this embodiment, adopted some pedicle screws 40, a head of screw is arranged at its top, a mount pad 41a is arranged on the head of screw, two parallel bar grooves 42 and 42 ' are arranged on the bottom surface of mount pad 41a, below head of screw, be shaped on screw thread 43, be used in the implantation vertebra nut.Two parallel bar grooves 42 on the mount pad 41a are used for being connected longitudinal rod 50 and pedicle screw 40 with 42 ', and need not to use other connector.Here, bar groove 42 and 42 ' diameter equal the diameter of longitudinal rod 50.
Hold-down screw 44 is inserted among the mount pad 41a on the head of screw 41 of pedicle screw 40, is used for preventing that longitudinal rod 50 from moving.For fastening longitudinal rod 50 reliably, an external screw thread 44a is arranged on the hold-down screw 44, it is hexagonal recessed portion 44b that cross section is arranged on the mount pad 41a of head of screw 41.The length of hold-down screw 44 should enough be lacked, and can not stretch out from the upper surface of the mount pad 41a of head of screw 41.On the mount pad 41a of head of screw 41 female thread 41b is arranged, be used for cooperating with the external screw thread 44a of hold-down screw 44.
Screw head cap 45 can be enclosed within the top of head of screw 41, to eliminate the hold-down screw 44 fixing variations that just do not producing.Screw head cap 45 adopts auxiliary bar fixture, plays supplemental support, to improve the bed knife of bar.
A pair of longitudinal rod 50 is arranged in this embodiment, straight-bar 51 is positioned on the centrage of head of screw 41, be shaped on stretch section 52 at the middle part of straight-bar 51 to produce elastic force, the supraspinal impulsive force of Absorption patient Yu, also has a support bar 53, extend from the two ends of straight-bar 51, be fixed in the bar groove in bar groove 42 and 42 '.The diameter of longitudinal rod 50 in 2 to 7 millimeters scope, can be adjusted by each 0.5 millimeter greatly.Stretch section 52 is similar to a helical spring, and helical spring diameter equates with straight-bar 51.Stretch section 52 also can adopt waveform.
A straight line portion 53a is arranged on the support bar 53, can be installed in the bar groove in bar groove 42a and 42 ', sweep 53b extends from the two ends of straight-bar 51, along the outer surface bending of head of screw 41.The straight bar part 51 of longitudinal rod 50 keeps on the centrage of head of screw 41 by the shape of support bar 53.
On same head of screw 41, two support bars 53 are staggered relatively.Though do not indicate on the drawing, two support bars 53 can be made opposite shape.That is, the sweep 53b position opposite of support bar 53 and along the outer surface bending of head of screw 41 can alternately be connected longitudinal rod 50 on the pedicle screw 40 with series system in this way.
Referring to Figure 17, the support bar 53 with longitudinal rod 50 both sides is installed in bar groove 42 and 42 ' respectively.In addition, the female thread 41b of the mount pad 41a on hold-down screw 44 and the head of screw 41 matches, and is rigidly fixed on the longitudinal rod 50.
Hereinafter with reference to Figure 18 to Figure 20, discuss the 4th embodiment of the present invention in detail.
Referring now to Figure 18,, it only is made up of some pedicle screws 60 and a longitudinal rod 70.Pedicle screw 60 comprises the head of screw 61 at its top and the screw thread 62 of head of screw below.Head of screw 61 has last first and second cannelure 62a and the 62a ', is formed on its outer surface.
Longitudinal rod 70 comprises two straight bar parts 71 and 71 ', be positioned on the centrage of head of screw 61 of pedicle screw 60, it between two straight bar parts 71 and 71 ' corrugated stretch section 72, support ring 73 and 73 ' extends from the two ends of straight-bar position 71 and 71 ' respectively, is inserted among the first and second cannelure 61a and the 61a '.The support ring 73 of longitudinal rod 70 is opposite with 73 ' shape, though do not indicate among the figure, support ring 73 and 73 ' can be staggered relatively on same head of screw 61.
Referring now to Figure 19 and Figure 20,, adopt above support ring 73 and 73 ' that longitudinal rod 70 alternately is connected with series system on the cannelure 61a and 61a ' on the head of screw 61 of pedicle screw 60.
Discuss the 5th embodiment of the present invention in detail hereinafter with reference to Figure 21.
Referring now to Figure 21,, among the 5th embodiment some pedicle screws 80 are arranged, a head of screw 81 is arranged at its top, be cylinder, the below of head of screw 81 is shaped on screw thread 82.An opening 81a is arranged on the head of screw 81, and level is passed cylinder, can hold the two ends of longitudinal rod 90, and the top of head of screw 81 also has a screwed hole 81b, perpendicular to opening 81a.The screwed hole 81b of head of screw 81 cooperates with bolt 83, is used for fastening longitudinal rod 90.A straight bar part 91 is arranged on the longitudinal rod 90 and, insert among the opening 81a from the hook portion 92 and 92 ' of the straight bar part rounded extension in 91 two ends.Straight-bar 91 can be provided with a stretch section at the middle part of longitudinal rod 90.
Below will discuss the installation process of longitudinal rod 90 in detail.
In this embodiment, longitudinal rod 90 is installed in the pedicle screw 80, and the circular hook portion 92 that makes longitudinal rod 90 becomes straight-bar under+10 ℃ and following temperature.On the other hand, straight-bar shape hook portion 92 on the longitudinal rod 90 is inserted among the opening 81a, then, under the temperature more than+35 ℃ longitudinal rod 90 is heat-treated, make the hook portion 92 of distortion on the longitudinal rod 90 return to the original form of being remembered, be rigidly fixed on the head of screw 81.After inserting longitudinal rod 90 in the pedicle screws 80, bolt 83 cooperates with screwed hole 81b on the head of screw 81, and longitudinal rod 90 is fastened on the pedicle screw 80.
Hereinafter with reference to Figure 22 a, 22b, discuss the 6th embodiment of the present invention in detail.
In the 6th embodiment, be installed to some pedicle screws 40 in the vertebra nut after, longitudinal rod 100 need only be installed on the pedicle screw 40 and get final product, simplified connection work.
Referring now to Figure 22 a,,, therefore will no longer be elaborated to pedicle screw because the structure of pedicle screw 40 is identical with above-mentioned the 3rd embodiment.The part of reference number representative is identical with third embodiment of the invention.
Longitudinal rod 100 among the 6th embodiment is made " U " shape.After inserting pedicle screw 40 in the vertebra nuts, U type bar 100 is installed in the bar groove 42 and 42 ' on the head of screw 41.Hold-down screw 44 is screwed on the mount pad 41a of head of screw 41, longitudinal rod 100 is fixed on the pedicle screw 40, thereby finish the connection work of longitudinal rod 100.If not alignment of pedicle screw 40, U type bar 100 can produce distortion, to adapt to the pedicle screw 40 that does not have alignment.Like this, the longitudinal rod after the distortion 100 can be placed in the bar groove 42 and 42 ' of mount pad 41a on the head of screw 41 easily.Longitudinal rod 100 after the distortion returns to the original form that longitudinal rod 100 is remembered, thereby corrects the position of the pedicle screw 40 that does not have alignment.
Can replace U type bar 100 with the straight-bar type longitudinal rod 101 and 101 ' shown in Figure 22 b.Straight-bar type longitudinal rod 101 and 101 ' middle part are provided with a stretch section 102.Straight-bar type longitudinal rod 101 and 101 ' alternately is fixed on respectively in the bar groove 42 and 42 ' on the mount pad 41a of position.Therefore, if adopt the straight-bar type longitudinal rod 101 and 101 ' of band stretch section 102, then do not need to use other connector to carry out this being connected in series.
Discuss the 7th embodiment of the present invention in detail hereinafter with reference to Figure 23 to Figure 26.
Referring now to Figure 23 to Figure 25,, the 7th embodiment has a pedicle screw 110, a pair of U type bar 120 and an intermediate connecting rod 140 at least.
Referring now to Figure 25,, a head of screw 111 is arranged at the top of pedicle screw 110, and the below of head of screw 111 is shaped on screw thread 113, is used in the implantation vertebra nut, wherein on the head of screw 111 mount pad 111a is arranged, be shaped on first and second slots 112 and 112 ' in the bottom surface of mount pad 111a.
Longitudinal rod 120 adopts the U-shaped structure, is used for preventing that vertebra from moving.In the direct implantation vertebra nut of one side of U type bar 120, in the slot in the opposite side insertion slot 112 and 112 '.
Adopt intermediate connecting rod 140, respectively its two ends are inserted in the slot 112 and 112 ' of head of screw 111, thereby U type bar 120 is connected in series in the pedicle screw 110.
Referring to Figure 24, first bridge piece 121 is arranged on the U type bar 120, be used for selected vertebrae and adjacent vertebrae scleroseptum are opened, a stretch section 126 is arranged at the middle part of first bridge piece 121, nail portion 122 extends downwards from an end of first bridge piece 121, directly in the implantation vertebra nut, 123 other ends from first bridge piece 121 of first connecting rod extend downwards, are fixed in the pedicle screw 110.The length of first connecting rod 123 should be shorter than the degree of depth of mount pad 111a on the head of screw 111, and first connecting rod 123 can be inserted in the slot 112 of pedicle screw 110.One section dentation district 125 is arranged in the nail portion 122, be used for anti-non-magnetic shim portion 122 and throw off from the vertebra nut.Dentation district 125 can adopt electric spark machine tool processing.The diameter of U type bar 120 in 2 to 7 millimeters scope, can be adjusted by each 0.5 millimeter greatly.After spinal column merged fully, U type bar 120 just can not thrown off from vertebra, because dentation district 125 has imbedded in the vertebra.
According to this embodiment of the invention, can be connected with 110 pairs of three adjacent vertebraes of two U type bars 120 and a pedicle screw.
Second bridge piece 141 is arranged on the intermediate connecting rod 140, pedicle screw 110 is separated, a stretch section 146 is arranged at the middle part of second bridge piece 141, second connecting rod 142 extends downwards from the two ends of second bridge piece 141, wherein the degree of depth that is shorter in length than mount pad 111a on the head of screw 111 of second connecting rod 142.Its reason is should leave certain amount to be used for inserting fixtures such as hold-down screw.
The first connecting rod 123 and the second connecting rod 142 of U type bar 120 are substantially the same.In being connected in series, a bar in the second connecting rod 142 extends from the two ends of middle connecting rod 140, insert in the slot 112 on the head of screw 111 of pedicle screw 110, another root bar then inserts in the slot 112 ' of head of screw 111 ' of adjacent pedicle screw 110 '.
Stretch section 126,146 can adopt helical spring or wave spare to make.The diameter of each stretch section 126,146 is identical with first, second bridge piece 121,141 basically.
In this embodiment, have at least the mount pad 111a on the head of screw 111 of a hold-down screw 130 and pedicle screw 110 to cooperate, be used for preventing that U type bar 120 from moving.Equally, in this embodiment, have at least a screw head cap 131 to be enclosed within on the head of screw 111.Screw head cap 131 is used for improving the bed knife of U type bar 120, and need not adopt other rod members such as fixture.
Below will discuss the process that U type bar 120 is installed in detail between first to the 6th vertebra.
Referring to Figure 23 and Figure 26, first and second pedicle screws 110 and 110 ' are implanted respectively in the second and the 3rd center spine vertebra.The first connecting rod 123 of the one U type bar 120 is inserted in the slot in the slot 112,112 ' of first pedicle screw 110, another root connecting rod (123 ') of the 2nd U type bar 120 ' is inserted the slot 112 of second pedicle screw 110 ' " in.
First, second U type bar 120,120 ' nail portion 122,122 ' are implanted respectively in first vertebrae and the 4th vertebrae.Respectively two second connecting rods 142 of intermediate connecting rod 140 both sides are inserted first, second pedicle screw 110,110 ' slot 112 ', 112 " in.
U type bar 120,120 ' and intermediate connecting rod 140 installations after, the external screw thread 130a of hold-down screw 130 is cooperated with mount pad 110a on the screw 110, with spanner hold-down screw 130 is screwed on the female thread 110b of mount pad 110a then.Thus one, U type bar 120 and intermediate connecting rod 140 screw 130 that is fixed is simultaneously pushed down, and U type bar 120 and intermediate connecting rod 140 are rigidly fixed in the pedicle screw 110 reliably.Although pedicle screw 110,110 ' does not have complete matching, U type bar 120 can be connected on the pedicle screw 110 simply and easily.Can also further realize this purpose by making U type bar 120 and intermediate connecting rod 140 distortion.
The slot 112,112 ' that first, second U type bar 120,120 ' first connecting rod 123,123 ' are inserted head of screw 111 before, U type bar 120 will be in certain phase transition temperature (+10 ℃ and following) distortion down, in this case, an end of a U type bar 120 is connected on the slot 112 of head of screw 111 ideally.Then, in the hole of first, second U type bar of distortion back 120,120 ' nail portion 122,122 ' implanted vertebrae.In addition, first, second U type bar 120 of distortion, 120 ' first connecting rod 123,123 ' are inserted on the slot 112,112 ' of head of screw 111.At last, pedicle screw 110,110 ', U type bar 120,120 ' and intermediate connecting rod 140 between finished the longitudinal rod connection.
Then, use the scalpel of band thermal source, U type bar 120 and intermediate connecting rod 140 are heat-treated at shape recovery temperature point (+35 ℃ and more than).The stretch section 126 and 146 that is elongated returns to the original form of being remembered, and changes austenitic state into.In the original form process of remembering returning to, first, second connecting rod 123,142, U type bar 120 and intermediate connecting rod 140 are rigidly secured in the slot 112,112 ' of screw 110.
In this embodiment, on U type bar 120 and intermediate connecting rod 140, be shaped on stretch section 126,146 respectively, after the spinal fusion, when patient's bending or distortion back, because the super-elasticity effect of stretch section allows to produce between the spinal segment mobile.
In the said structure of the 7th embodiment, first, second U type bar 120,120 ' adopts symmetrical structure, so just needs four pedicle screws, although also need all these screws in traditional spinal fixation system.But only need two pedicle screws in the present invention, so in this embodiment, the decreased number of pedicle screw.Need to prove especially, correct two vertebraes if desired, can only not need other pedicle screw, can carry out the rectification work of vertebra with a U type bar 120.Correct three vertebraes if desired, then only need a pedicle screw.
Following with reference to Figure 27 and Figure 28, discuss the 8th embodiment of the present invention in detail.
In this embodiment, in the pedicle of vertebral arch of U type bar 150 direct implantation vertebras, and without any need for pedicle screw.And have at least a U type bar 150 to be positioned at the both sides of spinal column.A bridge piece 152 is arranged on the U type bar 150, be used for selected vertebrae and adjacent vertebrae scleroseptum are opened, nail portion 153 extends downwards from the two ends of bridge piece 152, in the implantation vertebra nut, is shaped on a stretch section 154 on the bridge piece 152.Stretch section 154 adopts helical spring (seeing Figure 27), wave spare or S type spare to make (seeing Figure 28).In addition, one section dentation district 155 is arranged in the nail portion 153, it can prevent that non-magnetic shim portion 153 throws off from the vertebra nut.Dentation district 125 can adopt electric spark machine tool processing.
Although being shown as schematically of these most preferred embodiments of the present invention, the people with professional technique under the condition that does not depart from the invention scope revealed in the claim and spirit, can carry out various improvement, interpolation and employing succedaneum still as can be seen.
In of the present invention first to the 8th embodiment, longitudinal rod and transverse link adopt the nitinol (Nitinol) with hyperelastic shape memory to make.Therefore, although pedicle screw not alignment in operation, the present invention still can implementation structure connection between longitudinal rod and pedicle screw simply and easily, and at vertebra and/or implant on the point and do not produce extra power.
In addition, in the present invention, longitudinal rod and transverse link are provided with stretch section in optional scope.Slight moving after allowing spinal segment to merge, the stretch section on the longitudinal rod arranged.Like this, because longitudinal rod and transverse link have super-elasticity, can the power of peptizaiton on the spinal segment that has merged.Therefore, the burden on the lumbar vertebra has alleviated.In addition, if use spinal fixation system of the present invention, it reduces the effect that produces complication between epimere and the hypomere in addition.

Claims (43)

1. the bio-flexible spinal fixation system of a belt shape memorial alloy, it is characterized in that comprising: some pedicle screws, a head of screw is arranged at the top of each screw, the below of head of screw is shaped on the screw thread in the implantation vertebra nut, a mount pad is wherein arranged on the head of screw, have a bar groove on the bottom surface of mount pad at least; A pair ofly be connected to pedicle screw and prevent the longitudinal rod that vertebra moves, a stretch section is wherein arranged on the longitudinal rod, longitudinal rod is installed in the bar groove of mount pad; At least one transverse link, its straight bar part have a stretch section, and hook portion is extended from the two ends of straight bar part, rigidly fixing longitudinal rod; Some interior hold-down screws to prevent that longitudinal rod from moving of mount pad that are inserted in head of screw rigidly, wherein longitudinal rod and transverse link adopt the marmem that can produce distortion under predetermined temperature to make.
2. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1, the bending two ends that it is characterized in that longitudinal rod becomes hook-type, also be shaped on the holddown groove that at least one end that makes every longitudinal rod can be fixed therein on the outer surface of head of screw, this holddown groove is positioned at the below of bar groove.
3. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1 is characterized in that spinal fixation system also comprises some screw head caps that are installed in the pedicle screw head.
4. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1, it is characterized in that in the spinal fixation system, longitudinal rod and transverse link are martensitic state under+10 ℃ and following temperature, are austenitic state under+35 ℃ and above temperature.
5. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1 is characterized in that in the spinal fixation system, and the stretch section of the stretch section of longitudinal rod and transverse link straight bar part is a spring-like.
6. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1 is characterized in that in the spinal fixation system, and the stretch section of the stretch section of longitudinal rod and transverse link straight bar part is a waveform.
7. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1 is characterized in that in the spinal fixation system, and straight bar part has one section for plate shaped.
8. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1 is characterized in that in the spinal fixation system, and the cross section of straight bar part is circular.
9. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1, it is characterized in that in the spinal fixation system, also have a notch on the pedicle screw outer surface, its transverse link is a serpentine, and the transverse link of S type is inserted in the notch of pedicle screw.
10. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1, it is characterized in that in the spinal fixation system, be shaped on female thread on the inner surface of mount pad on the head of screw, be screwed in externally threaded hold-down screw on the female thread of head of screw mount pad, hold-down screw can fastening reliably longitudinal rod.
11. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1 is characterized in that the bar groove on the head of screw mount pad bottom surface is the first bar groove; On the inner surface of some screw head caps of covering pedicle screw head one second bar groove is arranged; Described a pair of longitudinal rod is surrounded to prevent that vertebra from moving by the second bar groove of first bar groove of head of screw and screw head cap, each hold-down screw all is fastened on the screw head cap on the pedicle screw head, be inserted in the mount pad of pedicle screw head, prevent that longitudinal rod from moving.
12. the bio-flexible spinal fixation system according to claim 1 or 11 described belt shape memorial alloys is characterized in that in the spinal fixation system, and a screw thread nest is arranged on the head of screw, hold-down screw is fixed on the screw head cap on the head of screw by the screw thread nest.
13. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1 is characterized in that: two parallel bar grooves are arranged on the bottom surface of described mount pad; Described longitudinal rod comprises with the lower part: 1) straight-bar, align with the centrage of head of screw, 2) the described stretch section on the longitudinal rod is arranged on the straight-bar, 3) support bar, its sweep extends from the two ends of straight-bar, along the outer surface bending of head of screw, its straight line portion extends from the two ends of sweep, is inserted in the bar groove.
14. bio-flexible spinal fixation system according to claim 1 or 13 described belt shape memorial alloys, it is characterized in that in the spinal fixation system, longitudinal rod is a martensitic state under+10 ℃ and following temperature, is austenitic state under+35 ℃ and above temperature.
15. the bio-flexible spinal fixation system according to claim 1 or 13 described belt shape memorial alloys is characterized in that in the spinal fixation system, the stretch section of longitudinal rod adopts the helical spring shape.
16. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 13 is characterized in that spinal fixation system also comprises some screw head caps that are installed on the pedicle screw head.
17. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 13 is characterized in that in the spinal fixation system, support bar is staggered relatively.
18. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1 is characterized in that having a cannelure at least on the outer surface of head of screw; On described each root longitudinal rod a straight bar part is arranged all, align with the centrage of head of screw, the described stretch section on the longitudinal rod is arranged on this straight bar part; Described longitudinal rod also comprises support ring, and the sweep of this support ring extends from the two ends of straight bar part, along the outer surface bending of head of screw, is coiled on the cannelure of head of screw.
19. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 18 is characterized in that in the spinal fixation system, longitudinal rod is a martensitic state under+10 ℃ and following temperature, is austenitic state under+35 ℃ and above temperature.
20. the bio-flexible spinal fixation system according to claim 1 or 18 described belt shape memorial alloys is characterized in that in the spinal fixation system that the stretch section of longitudinal rod is a waveform.
21. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 18 is characterized in that in the spinal fixation system that described support ring is staggered relatively.
22. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1, it is characterized in that: in spinal fixation system, described hold-down screw is not set, mount pad and bar groove are not set on head of screw yet, and are substituted: have a lateral aperture that passes the head of screw body and one to be used for the perpendicular screwed hole of mounting fixing parts on the head of screw with following the setting; A straight bar part is arranged on the longitudinal rod, and the hook portion of longitudinal rod is extended from the two ends of the straight bar part of longitudinal rod and is crooked, inserts in the lateral aperture; The plurality of fixed part prevents that by the perpendicular screwed hole on the head of screw longitudinal rod from moving.
23. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 22 is characterized in that in the spinal fixation system, longitudinal rod is a martensitic state under+10 ℃ and following temperature, is austenitic state under+35 ℃ and above temperature.
24. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1 is characterized in that on the bottom surface of described mount pad two bar grooves being arranged; Every longitudinal rod all adopts " U " shape.
25. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 24 is characterized in that in the spinal fixation system, longitudinal rod is a martensitic state under+10 ℃ and following temperature, is austenitic state under+35 ℃ and above temperature.
26. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1 is characterized in that on the bottom surface of described mount pad two parallel slots being arranged; This longitudinal rod is a U type bar, and in the direct implantation vertebra nut of a side of every U type bar, opposite side inserts in one of them slot; At least one hold-down screw inserts in the mount pad on the pedicle screw head, moves to prevent longitudinal rod.
27. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 26, it is characterized in that spinal fixation system also comprises an intermediate connecting rod, in the slot on the two ends insertion head of screw mount pad of intermediate connecting rod, be connected on the pedicle screw in placed in-line mode.
28., it is characterized in that spinal fixation system also comprises the screw head cap that is installed on the pedicle screw head according to the bio-flexible spinal fixation system of claim 1 or 26 described belt shape memorial alloys.
29. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 26, it is characterized in that in the spinal fixation system, have on the U type bar will be selected vertebrae and first bridge piece opened of adjacent vertebrae scleroseptum, there is a stretch section to be positioned on this first bridge piece on the described U type bar, in the direct implantation vertebra nut of nail portion, first connecting rod extends from an end of first bridge piece, wherein nail portion under the other end of first bridge piece to extension, the degree of depth that is shorter in length than the head of screw mount pad of first connecting rod.
30. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 27, it is characterized in that in the spinal fixation system, second bridge piece that pedicle screw is separated is arranged on the intermediate connecting rod, a stretch section is arranged on second bridge piece, second connecting rod extends from the two ends of second bridge piece, and the length of second connecting rod is less than the degree of depth of head of screw mount pad.
31. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 27 is characterized in that in the spinal fixation system, U type bar and intermediate connecting rod adopt the marmem that can produce distortion under predetermined temperature to make.
32. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 27, it is characterized in that in the spinal fixation system, U type bar and intermediate connecting rod are martensitic state under+10 ℃ and following temperature, are austenitic state under 35 ℃ and above temperature.
33. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 29 is characterized in that in the spinal fixation system, is shaped on anti-non-magnetic shim portion on the outer surface of nail portion from some dentations district that the vertebra nut is thrown off.
34. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 27 is characterized in that in the spinal fixation system, the stretch section of U type bar and intermediate connecting rod adopt the helical spring shape.
35. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 24, it is characterized in that having on the every U type bar bridge piece and the stretch section that selected vertebrae and adjacent vertebrae scleroseptum are opened, bridge piece is provided with nail portion, in this nail portion implantation vertebra nut, nail portion extends downwards from the two ends of bridge piece.
36. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 35 is characterized in that in the spinal fixation system, anti-non-magnetic shim portion is arranged from some dentations district that the vertebra nut is deviate from the outer surface of nail portion.
37. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 35 is characterized in that in the spinal fixation system, the stretch section of U type bar is the helical spring shape.
38. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 35 is characterized in that in the spinal fixation system, the stretch section of U type bar is a waveform.
39. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1, it is characterized in that described longitudinal rod is first kind of structure in first humidity province, in second humidity province, be second kind of structure, second kind of structure is marmem institute memorized shape, longitudinal rod provides the working place under first kind of structure, make the longitudinal rod with institute's shape memory tighter than first kind of structure; Screw head has reliably the fixedly hold-down screw of longitudinal rod, and the end of longitudinal rod is fixed on the hold-down screw.
40. the bio-flexible spinal fixation system of belt shape memorial alloy according to claim 1, it is characterized in that comprising: first row and the secondary series pedicle screw of arranged vertical, two row screws are parallel to each other basically, first row and secondary series pedicle screw comprise with the lower part: the pedicle screw on some vertebraes that are inserted in human spinal column, each pedicle screw comprises with the lower part: 1) head of screw of some installed parts is arranged, 2) shank is shaped on the external screw thread in the implantation vertebra; First row are connected with the secondary series pedicle screw with first row respectively with the secondary series longitudinal rod, every longitudinal rod of first row and secondary series longitudinal rod is some nodular bars, one end of every nodular bar is fixed therein on the installed part reliably, and the nodular bar adopts marmem to make.
41., it is characterized in that transverse link is used for connecting the nodular bar according to the bio-flexible spinal fixation system of the described belt shape memorial alloy of claim 40.
42. the bio-flexible spinal fixation system according to the described belt shape memorial alloy of claim 40 is characterized in that in the spinal fixation system, a stretch section is arranged, so that elasticity to be provided on the nodular bar.
43. the bio-flexible spinal fixation system according to the described belt shape memorial alloy of claim 41 is characterized in that in the spinal fixation system, the nodular bar is a martensitic state under+10 ℃ and following temperature, is austenitic state under+35 ℃ and above temperature.
CNB2005100908101A 2004-09-22 2005-08-16 Bio-flexible spinal fixation apparatus with shape memory alloy Expired - Fee Related CN100409820C (en)

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