CN102940523A - Assembly for reinforcing injectable vertebral pedicle screw - Google Patents

Assembly for reinforcing injectable vertebral pedicle screw Download PDF

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Publication number
CN102940523A
CN102940523A CN2012104833956A CN201210483395A CN102940523A CN 102940523 A CN102940523 A CN 102940523A CN 2012104833956 A CN2012104833956 A CN 2012104833956A CN 201210483395 A CN201210483395 A CN 201210483395A CN 102940523 A CN102940523 A CN 102940523A
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China
Prior art keywords
screw
side opening
injectable
thread
afterbody
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Granted
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CN2012104833956A
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Chinese (zh)
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CN102940523B (en
Inventor
刘达
潘显明
张波
谢庆云
张译
廖冬发
龚凯
屈波
蒋凯
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Western Theater General Hospital of PLA
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Chengdu Military General Hospital of PLA
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Priority to CN201210483395.6A priority Critical patent/CN102940523B/en
Publication of CN102940523A publication Critical patent/CN102940523A/en
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Abstract

The invention discloses an assembly for reinforcing an injectable vertebral pedicle screw. The assembly is composed of a side hole screw, an injecting device and an inner bolt which are matched with one another for usage; the side hole screw is made of medical titanium alloy materials and composed of a side hole screw thread section, a side-hole-free thread section and a tail portion, the side hole screw is provided with a center hollow cavity which penetrates through the full length of the screw, the side hole thread section is provided with a side hole which is communicated with the center hollow cavity along the direction of a thread, and the tail portion is a U-shaped groove; the injection device is made of medical polymer materials and composed of an injection end, an injection pipe cavity and a piston, the injection end is matched with the tail portion of the side hole screw, the injection pipe cavity is a cylindrical pipe cavity, and the piston is formed by connecting a rod portion and a handle portion; and the inner bolt is made of medical titanium alloys and composed of a front end cone and a rear end cylinder. According to the assembly, under the condition of bone rarefaction, internal fixation stability can be improved when the screw is initially placed, risks that the vertebral pedicle screw is loosened are reduced, internal fixation stability and reliability of the spine can be enhanced, and operation failure occurrence rates can be reduced.

Description

A kind of injectable vertebral pedicle strengthening screw assembly
Technical field
The invention belongs to medical auxiliary apparatus, relate to the pedicle screw that uses in the internal fixation of spine, be particularly related to a kind of injectable vertebral pedicle strengthening screw assembly, be mainly used in improving the stability of internal fixation of spine under the osteoporosis condition, fixing failed risk in reducing.
Background technology
At present, trans-pedicle spinal fixation technique has become routine techniques of spinal surgery.Pedicle screw can be rescued deformity of spine and carry out the spinal stabilization reconstruction by mode three-dimensionals such as traction, pressurization, rotations.Can the key of pedicle screw stability depends on obtain enough " sclerotin-screw " interface holds, and this hold will last till till the bone fusion that reaches firm between vertebral body.But in clinical position, osteoporosis often causes the pedicle screw crystallized ability to descend, and screw loosening is deviate from, thereby causes operative failure.Along with extensively carrying out of internal fixation of spine operation, it is also more and more that the postoperative that many reasons causes is overhauled case.The stability of internal fixation of spine under the Effective Raise osteoporosis condition how has become puzzlement spinal surgery doctor's thorny problem.In addition, because patient's operating technology is unskilled, operation process is difficult to reach once put and follows closely successfully, again inserts after often screw need being back-outed in the art, and this also makes the hold of screw decline to a great extent.
For addressing the above problem, Chinese scholars has been carried out a large amount of correlational studyes, mainly concentrates on to improve screw designs and strengthen two aspects of processing, nail road.At the design aspect that improves screw, increasing screw diameter has the danger that causes fracture of vertebral pedicle, uses long spiro nail and then may destroy the vertebral body front pillar, can cause internal organs and blood vessel injury.Because the restriction of vertebral body and pedicle of vertebral arch anatomical structure, the effect that improves the screw constant intensity by improving screw designs is very restricted.Mainly adopt clinically to the method for nail road sclerotin perfusion on every side bone cement at present, namely be screwed into forward direction at screw and follow closely direct injection bone cement in the road, and then be screwed into screw.But there is following point in the method:
1, the finite capacity in nail road, the dosage that injects bone cement is limited, and there is certain limitation in the effect of strengthening screw stability;
2, in traditional intensifying method, bone cement is evenly distributed in the sclerotin around the screw relatively, and tight parcel screw easily causes the considerable damage of sclerotin around getting in the nail process, brings difficulty and risk for the taking-up of screw and secondary Pin nail;
3, what is more important, in the process that screw is screwed into, in the sclerotin around bone cement is entered by the screw extruding, it flows and distributes uncontrolled, seepage, pressuring nerve etc. easily occur, especially when the small fracture of pedicle of vertebral arch place Cortical histogenesis and when undiscovered, bone cement easily is pressed into canalis spinalis when being screwed into screw, compressing spinal cord and nerve.In case seepage in the generation canalis spinalis can not solve the problem that intraspinal pressure is compeled although in time take out screw.Even carefully detect dosage and the pressure of nail road, attention control injection material in the art, can not avoid the generation of seepage fully, brought huge challenge therefore for patient's operation, limited clinical extensively quoting.
Summary of the invention
Defective or deficiency for above-mentioned prior art existence, the object of the invention is to, a kind of injectable vertebral pedicle strengthening screw assembly is proposed, the stability of fixing in this injectable vertebral pedicle strengthening screw can significantly improve under the osteoporosis condition, reduce the incidence rate that pedicle screw is loosening even deviate from, can increase the stability of spinal column, can reduce simultaneously the complication such as bone cement seepage in traditional intensifying method, nerve compression, significantly improve clinical therapeutic efficacy, reduce operation risk.
In order to realize above-mentioned task, the present invention takes following technical solution:
A kind of injectable vertebral pedicle strengthening screw assembly is characterized in that this Injectable pediculus arcus vertebrae screw assembly is comprised of side opening screw, injection device and interior bolt, is used in conjunction with each other;
Described side opening screw is made by the medical titanium alloy material, the side opening screw is by the side opening thread segment, be formed by connecting without side opening thread segment and afterbody, the side opening screw has a central cavity, connect the side opening thread segment, without side opening thread segment and afterbody, the side opening thread segment be the identical cylinder of diameter without the side opening thread segment, both outer surfaces are provided with continuous and highly identical the first external screw thread, on the side opening thread segment from nail tip, whenever rotate to an angle along the screw thread rotation direction, between adjacent thread, be provided with successively the side opening that communicates with central cavity, central cavity has a circular open at afterbody, and afterbody is one " U " type groove, and its inwall has the first female thread;
Described injection device is made by medical macromolecular materials, has certain mechanical strength, formed by dispensing end, injection tube chamber and piston, dispensing end comprises injection head and connecting portion, the diameter of injection head and central cavity are complementary at the circular open of afterbody, and the outer surface of connecting portion is provided with the second external screw thread, are complementary with the first female thread of afterbody inwall, the injection tube chamber is a cylindrical tube chamber, and piston is formed by connecting by bar section and handle portion;
Described interior bolt is made by the medical titanium alloy material, is comprised of the cone of front end and the cylinder of rear end.
Injectable pediculus arcus vertebrae screw assembly of the present invention, have four distinguishing features: detect the nail road behind (1) preparation nail road good, not tapping nail road, directly be screwed into Injectable pediculus arcus vertebrae screw, first through having an X-rayed the position of determining screw, if find that the position is not good, before the injection bone cement, adjust in addition the chance of screw position, can reduce the risk that causes the bone cement seepage because screw position is not good and adjust the risk that interior stability maintenance that screw causes descends; (2) compare with traditional method, this invention can increase the metering of towards periphery sclerotin injection bone cement, and the stability of screw further is provided; (3) through have an X-rayed determine that the injectable screw position is good after, connect again injection device, under perspective by screw towards periphery sclerotin slowly inject in the process of bone cement, in case can stop immediately injection when finding to have the seepage tendency, the operation leeway of avoiding the bone cement seepage is arranged; (4) bone cement flows peripherad sclerotin by the side opening of screw, being distributed in around the screw of limitation, avoid the tight parcel of bone cement to screw, especially at the pedicle of vertebral arch position, also reduced when screw takes out the destruction to vertebral body and pedicle of vertebral arch when improving screw stability.
Description of drawings
Fig. 1 is the structural representation of side opening screw;
Fig. 2 is the structural representation of injection device;
Fig. 3 is the structural representation of interior bolt;
Fig. 4 is the structural representation of side opening thread segment;
The schematic diagram that Fig. 5 injection device is connected with the side opening screw;
Fig. 6 is the schematic diagram that interior bolt inserts the side opening screw;
Fig. 7 uses operation chart of the present invention; Wherein (a) preparation nail road (b) is screwed into the side opening screw, (c) connects injection device, (d) injection bone cement, (e) bolt in the insertion.
The specific embodiment
Below in conjunction with accompanying drawing the present invention is described in further detail.
Shown in accompanying drawing 1~7, injectable vertebral pedicle strengthening screw assembly of the present invention is comprised of side opening screw 1, injection device 2 and interior bolt 3, is used in conjunction with each other;
Described side opening screw 1 is made by the medical titanium alloy material, side opening screw 1 is by side opening thread segment A, be formed by connecting without side opening thread segment B and afterbody C, side opening screw 1 has a central cavity 11, connect side opening thread segment A, without side opening thread segment B and afterbody C, side opening thread segment A be the identical cylinder of diameter without side opening thread segment B, both outer surfaces are provided with continuous and highly identical the first external screw thread 12, side opening thread segment A is upper from nail tip, whenever rotate to an angle along the screw thread rotation direction, between adjacent thread, be provided with successively the side opening 13 that communicates with central cavity 11, central cavity 11 has a circular open 14 at afterbody C, afterbody C is one " U " type groove 15, and its inwall has the first female thread 16;
D outer diameter 1 and the inside diameter D 2 of side opening screw 1 are respectively 6.5mm and 4.5mm, and the height H 1 of the first external screw thread 12 is 1.0mm, and the first external screw thread 12 is tapping screw thread, avoid descending because of the screw stability that tapping nail road causes.
The length L 1 of side opening thread segment A is 2.5cm, approximate the length of screw 1 in lumbar vertebra, the length L 2 without side opening thread segment B of screw 1 is 2.0cm, approximate the length of screw 1 in pedicle of lumbar vertebral arch, make like this position of side opening 13 all be positioned at vertebral body, so that bone cement concentrates in the vertebral body, and avoid bone cement in the seepage at pedicle of vertebral arch place.
Central cavity 11 runs through the side opening thread segment A of screw 1, without side opening thread segment B and afterbody C, the diameter D3 of central cavity 11 is 1.5mm, the too small central lumen 11 that easily causes of diameter D3 is meticulous, resistance and the difficulty of injection bone cement have been increased, the excessive central lumen 11 that easily causes of diameter D3 is excessively thick, and it is thin to cause the screw side thickness to be spent, and has reduced the mechanical strength of screw self.
Upper whenever the rotating to an angle along hand of spiral from nail tip of side opening thread segment A prepares side opening 13, side opening 13 is all between two adjacent the first external screw threads 12, and communicate with central lumen 11, the diameter D4 of side opening 13 is 1.5mm approximately, diameter D4 is too small, the bone cement towards periphery resistance that flows of sclerotin and the pressure of injection have been increased, diameter D4 is excessive, can destroy the first external screw thread 12, affect the mechanical strength of screw self, the longitudinal axis of side opening 12 all tilts to the afterbody of side opening screw 1, is about 60 ° with the angulation α of side opening screw 1 longitudinal axis, can make the distributional class around screw of bone cement be similar to " agnail ", can prevent screw loosening, withdraw from.
Can hold hold-down bars in " U " type groove 15 on the afterbody C, the first female thread 16 of " U " type groove 15 inwalls is complementary with lock nut, is convenient to keep the stability of whole nail-stick system.
Described injection device 2 is made by medical macromolecular materials, has certain mechanical strength, can bear certain injection pressure, injection device 2 is by dispensing end E, injection tube chamber F and piston G form, dispensing end E comprises injection head 21 and connecting portion 22, the diameter of injection head 21 and central cavity 11 are complementary at the circular open 14 of afterbody C, the outer surface of connecting portion 22 is provided with the second external screw thread 23, be complementary with the first female thread 16 of afterbody C inwall, injection device 2 and side opening screw 1 are combined closely, guarantee the continuous conduction of injection bone cement course pressure, prevent that bone cement is from revealing between the two.
The injection tube chamber F of injection device 2 is a cylindrical tube chamber 24, and wall thickness can bear the pressure when injecting greater than 1.5mm, preventing from injecting tube chamber F breaks, hold injectable bone cement in the cylindrical tube chamber 24, its volume is about 3.0-4.0ml, can satisfy the needed bone cement dosage of strengthening screw.
The piston G of injection device 2 is formed by connecting by bar section 25 and handle portion 26, and the diameter of bar section 25 and handle portion 26 is about 1.5cm all, has enough self mechanical strengths, can feed to vasopressing injection in the screw.
Described interior bolt 3 is made by medical titanium alloy, it is comprised of the cone 31 of front end and the cylinder 32 of rear end, the length L 3 of cone 31 is 0.5cm approximately, the profile of circular cone is convenient to the central cavity 11 that interior bolt 3 inserts side opening screw 1, the length L 4 of cylinder 32 is 4.0cm approximately, and the D outer diameter 5 of interior bolt 3 is 1.5mm approximately, and interior bolt 3 is complementary with the central cavity 11 of side opening screw 1, be convenient to the central cavity close contact of interior bolt 3 and side opening screw 1, increase self mechanical strength of side opening screw 1.
Use operation of the present invention as shown in Figure 7: at first (Fig. 7 a) in preparation nail road to the vertebral body for pedicle, good through confirming nail position, road, detect the nail road without breakage after, side opening screw 1 pedicle is screwed into (Fig. 7 b) in the vertebral body, through have an X-rayed determine that side opening screw 1 position is good after, the dispensing end E of injection device 2 is connected with the afterbody C of side opening screw 1, guarantee that injection head 21 enters central cavity 11 fully at the circular open 14 of afterbody C, and the second external screw thread 23 and first female thread 16 of " U " type groove 15 inwalls of connecting portion 22 are tightened (Fig. 7 c), then under perspective, bone cement is slowly injected vertebral body (Fig. 7 d), take off injection device 2, interior bolt 3 is inserted the central cavity 11 (Fig. 7 e) of side opening screw 1.
Insert all the other side opening screws and finish the injection of bone cement by same method, again interior fixing and bone cement position to be determined good after, auxiliary hold-down bars is put into " U " type groove 15 of the afterbody C of side opening screw 1, clamping screw is screwed into " U " type groove 15 and with the locking of the first female thread 16, get final product complete operation.

Claims (9)

1. an injectable vertebral pedicle strengthening screw assembly is characterized in that, this Injectable pediculus arcus vertebrae screw assembly is comprised of side opening screw (1), injection device (2) and interior bolt (3), is used in conjunction with each other;
Described side opening screw (1) is made by the medical titanium alloy material, side opening screw (1) is by side opening thread segment (A), be formed by connecting without side opening thread segment (B) and afterbody (C), side opening screw (1) has a central cavity (11), connect side opening thread segment (A), without side opening thread segment (B) and afterbody (C), side opening thread segment (A) be the identical cylinder of diameter without side opening thread segment (B), both outer surfaces are provided with continuous and highly identical the first external screw thread (12), side opening thread segment (A) is upper from nail tip, whenever rotate to an angle along the screw thread rotation direction, between adjacent thread, be provided with successively the side opening (13) that communicates with central cavity (11), central cavity (11) has a circular open (14) at afterbody (C), afterbody (C) is one " U " type groove (15), and its inwall has the first female thread (16);
Described injection device (2) is made by medical macromolecular materials, injection device (2) is by dispensing end (E), injection tube chamber (F) and piston (G) form, dispensing end (E) comprises injection head (21) and connecting portion (22), the diameter of injection head (21) and central cavity (11) are complementary at the circular open (14) of afterbody (C), the outer surface of connecting portion (22) is provided with the second external screw thread (23), be complementary with first female thread (16) of afterbody (C) inwall, injection tube chamber (F) is a cylindrical tube chamber (24), and piston (G) is formed by connecting by bar section (25) and handle portion (26);
Described interior bolt (3) is made by the medical titanium alloy material, is comprised of the cone (31) of front end and the cylinder (32) of rear end.
2. injectable vertebral pedicle strengthening screw assembly as claimed in claim 1, it is characterized in that, external diameter (D1) and the internal diameter (D2) of described side opening screw (1) are respectively 6.5mm and 4.5mm, the height (H1) of the first external screw thread (12) is 1.0mm, and the first external screw thread (12) is tapping screw thread.
3. injectable vertebral pedicle strengthening screw assembly as claimed in claim 1, it is characterized in that, the length (L1) of described side opening thread segment (A) is 2.5cm, approximate the length of side opening screw (1) in lumbar vertebra, the length without side opening thread segment (B) of side opening screw (1) (L2) is 2.0cm, approximates the length of side opening screw (1) in pedicle of lumbar vertebral arch.
4. injectable vertebral pedicle strengthening screw assembly as claimed in claim 1, it is characterized in that, described central cavity (11) runs through the side opening thread segment (A) of side opening screw (1), without side opening thread segment (B) and afterbody (C), the diameter (D3) of central cavity (11) is 1.5mm.
5. injectable vertebral pedicle strengthening screw assembly as claimed in claim 1, it is characterized in that, upper whenever the rotating to an angle along hand of spiral from nail tip of described side opening thread segment (A) prepares side opening (13), side opening (13) all is positioned between adjacent two the first external screw threads (12), and communicate with central lumen (11), the diameter (D4) of side opening (13) is 1.5mm approximately, the longitudinal axis of side opening (13) all tilts to the afterbody of side opening screw (1), is about 60 ° with the angulation α of side opening screw (1) longitudinal axis.
6. injectable vertebral pedicle strengthening screw assembly as claimed in claim 1, it is characterized in that, can hold hold-down bars in " U " type groove (15) on the described afterbody (C), first female thread (16) of " U " type groove (15) inwall is complementary with lock nut.
7. injectable vertebral pedicle strengthening screw assembly as claimed in claim 1, it is characterized in that, the injection tube chamber (F) of described injection device (2) is a cylindrical tube chamber (24), wall thickness is greater than holding bone cement in the cylindrical tube chamber of 1.5mm (24), and its volume is about 3.0-4.0ml.
8. injectable vertebral pedicle strengthening screw assembly as claimed in claim 1, it is characterized in that, the piston (G) of described injection device (2) is formed by connecting by bar section (25) and handle portion (26), and the diameter of bar section (25) and handle portion (26) is about 1.5cm all.
9. injectable vertebral pedicle strengthening screw assembly as claimed in claim 1, it is characterized in that, described interior bolt (3) is comprised of cone (31) and cylinder (32), the length (L3) of cone (31) is 0.5cm approximately, the length (L4) of cylinder (32) is 4.0cm approximately, the external diameter (D5) of interior bolt (3) is 1.5mm approximately, and interior bolt (3) is complementary with the central cavity (11) of side opening screw (1).
CN201210483395.6A 2012-11-26 2012-11-26 Assembly for reinforcing injectable vertebral pedicle screw Active CN102940523B (en)

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Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104107085A (en) * 2013-04-17 2014-10-22 上海市同济医院 Member connecting rod with accurate and slow drug-dosage releasing function
CN104287819A (en) * 2014-10-09 2015-01-21 中国人民解放军第四军医大学 Medical pedicle screw component with telescopic double thread and capable of resisting pullout
CN105559871A (en) * 2016-02-22 2016-05-11 苏州博习医疗科技有限公司 Intramedullary nail fixing device
CN105852950A (en) * 2016-04-19 2016-08-17 青岛大学附属医院 Hollow screw structure and usage thereof
CN106994038A (en) * 2017-05-23 2017-08-01 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 One kind remedies fixing device for vertebral arch pedicle of vertebral column broken wall
CN107280756A (en) * 2017-07-21 2017-10-24 西安康拓医疗技术有限公司 A kind of medical cranial Bone nail structure
CN109124748A (en) * 2017-06-28 2019-01-04 北京形梦信息技术有限公司 A kind of spongious screw
CN111603346A (en) * 2020-05-28 2020-09-01 上海长征医院 Novel spinal surgery device based on mixed reality technology
CN111839707A (en) * 2020-06-30 2020-10-30 陈丹华 Bone cement propeller of vertebroplasty system

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CN201346237Y (en) * 2009-01-14 2009-11-18 杨惠林 Pourable screw for pedicle of vertebral arch
CN201346238Y (en) * 2009-01-14 2009-11-18 王志荣 Pouring device used for pourable screw for pedicle of vertebral arch
US20100042167A1 (en) * 2008-08-13 2010-02-18 Nebosky Paul S Orthopaedic screws
CN101669837A (en) * 2009-09-28 2010-03-17 雷伟 Medical vertebral arch pedicle renovating screw assembly
CN203029370U (en) * 2012-11-26 2013-07-03 中国人民解放军***总医院 Injectable vertebral pedicle strengthening screw component

Patent Citations (5)

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US20100042167A1 (en) * 2008-08-13 2010-02-18 Nebosky Paul S Orthopaedic screws
CN201346237Y (en) * 2009-01-14 2009-11-18 杨惠林 Pourable screw for pedicle of vertebral arch
CN201346238Y (en) * 2009-01-14 2009-11-18 王志荣 Pouring device used for pourable screw for pedicle of vertebral arch
CN101669837A (en) * 2009-09-28 2010-03-17 雷伟 Medical vertebral arch pedicle renovating screw assembly
CN203029370U (en) * 2012-11-26 2013-07-03 中国人民解放军***总医院 Injectable vertebral pedicle strengthening screw component

Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104107085B (en) * 2013-04-17 2016-03-23 上海市同济医院 A kind of component connecting rod with the accurate slow-release function of drug dose
CN104107085A (en) * 2013-04-17 2014-10-22 上海市同济医院 Member connecting rod with accurate and slow drug-dosage releasing function
CN104287819A (en) * 2014-10-09 2015-01-21 中国人民解放军第四军医大学 Medical pedicle screw component with telescopic double thread and capable of resisting pullout
WO2016054951A1 (en) * 2014-10-09 2016-04-14 中国人民解放军第四军医大学 Telescopic double-threaded pull-out resistant pedicle screw assembly for medical use
CN105559871B (en) * 2016-02-22 2018-03-06 苏州博习医疗科技有限公司 Intramedullary nail fixation device
CN105559871A (en) * 2016-02-22 2016-05-11 苏州博习医疗科技有限公司 Intramedullary nail fixing device
CN105852950B (en) * 2016-04-19 2018-09-14 青岛大学附属医院 A kind of hollow screw structure and its application method
CN105852950A (en) * 2016-04-19 2016-08-17 青岛大学附属医院 Hollow screw structure and usage thereof
CN106994038A (en) * 2017-05-23 2017-08-01 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 One kind remedies fixing device for vertebral arch pedicle of vertebral column broken wall
CN106994038B (en) * 2017-05-23 2024-03-26 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 Be used for broken wall of backbone pedicle of vertebral arch to remedy fixing device
CN109124748A (en) * 2017-06-28 2019-01-04 北京形梦信息技术有限公司 A kind of spongious screw
CN107280756A (en) * 2017-07-21 2017-10-24 西安康拓医疗技术有限公司 A kind of medical cranial Bone nail structure
CN111603346A (en) * 2020-05-28 2020-09-01 上海长征医院 Novel spinal surgery device based on mixed reality technology
CN111839707A (en) * 2020-06-30 2020-10-30 陈丹华 Bone cement propeller of vertebroplasty system
CN111839707B (en) * 2020-06-30 2021-07-20 陈丹华 Bone cement propeller of vertebroplasty system

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