CN111278373B - 用于动态植入物的滑刀的固定和穿刺的引导装置 - Google Patents
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Abstract
本专利申请涉及医学领域,更具体地涉及用于治疗骨或关节的手术物品和特别适于它们的装置的领域,其理想化了用于固定脊柱植入物的柔性刀的引导装置;现有技术公认将植入装置固定至患者的椎骨,包括椎弓根钩和螺钉,其缺点是当应用于椎骨时,除了不稳定和设计不佳的引导装置之外,缺乏对椎弓根螺钉的角度的选择;为了解决问题,开发了本专利申请的对象,其包括用于穿刺构成平台(13)和(14)的柔性刀(1)的引导装置,所述平台(13)和(14)具有箱形侧,柔性刀组(3)在所述箱形侧交叉并滑动,并且另一侧具有孔(16),用于将其固定到双中间连接器(5),连接器承载椎弓根螺钉(7);所述柔性刀组(3)由两个刀(4)形成,所述两个刀(4)重叠并设置有纵向开口(9),两个刀通过所述纵向开口(9)借助于固定装置(11)相互连接,这允许两个刀在彼此上滑动。
Description
技术领域
本发明专利涉及一种用于固定柔性的、滑动的和动态的刀以选择性地稳定和校正脊柱变形和不稳定的引导装置,属于医学领域,更具体地涉及用于治疗骨或关节的手术物品和特别适于它们的装置的领域。
研发本申请的对象,从而试图在骨折、椎骨变形、退行性疾病、脊柱肿瘤等典型问题的情况下帮助脊柱的康复,同时允许患者在其康复期间以更大的舒适度或以确定的能力保持辅助的脊柱移动性。
因此,本发明涉及一种用于固定柔性刀和部件的引导装置,该部件除了能够在柔性刀上移动它们的固定点之外,还能够允许以各种角度放置将所述刀固定在椎骨上的椎弓根螺钉。这样,即使在植入之后,也可以移位刀上的固定点而不需要改变脊椎骨上的固定点。
背景技术
在骨折、椎骨变形、退行性疾病、脊柱肿瘤等典型问题的情况下帮助脊柱康复的现有技术中已知的植入物基本上包括杆,该杆通过椎弓根螺钉刚性地固定到每个椎骨或椎骨组,其方式为使得在矫正变形之后,根据刚性杆的预建模和定位使脊柱保持对齐。
现有技术中的关注点
传统植入物的缺点是手术脊柱的节段可能丧失其移动性和自然柔性,从而限制患者躯干的运动,并且作为这种移动性丧失的结果,在中长期,邻近固定的脊柱节段经历椎间盘和小面关节的退化,引起早期骨关节炎、脊柱疼痛和巨大不适。
传统脊柱植入程序的另一个重要缺点是未成熟(发育中)患者的脊柱生长和脊柱发育的丧失。
除了允许脊柱在未被***阻挡的平面中移动和允许未成熟脊柱生长(经历生长);这种新的柔性植入物***可应用于脊柱,而不破坏或去除脊柱的解剖结构,如脊柱内韧带、棘上韧带、黄韧带、棘突和髋臼间关节,即,植入物被植入并保持手术节段的椎骨结构完整。
发明内容
为了解决问题,在该领域具有经验的发明人创建并开发了所述对象,即用于选择性地稳定和校正脊柱变形和不稳定的“用于动态植入物的滑刀的固定和穿刺的引导装置”。
本发明涉及包括用于柔性刀的固定头组的项目。
柔性刀组由两个重叠的刀组成,两个重叠的刀一个在另一个上滑动,以便根据需要缩回或伸出。
所述刀组通过多个椎弓根螺钉固定到患者的脊柱,所述多个椎弓根螺钉具有用于穿刺刀的引导装置,所述刀在端部沿着其延伸部定位,并且植入在相应椎骨中的特定点处。
本发明涉及用于将刀组件固定到脊柱的***,该***包括头部,该头部由安装在滑动支撑件上的双轴承组成,该滑动支撑件除了使椎弓根螺钉在柔性刀中的固定点移位之外,还能够以各种角度放置椎弓根螺钉。这样,即使在植入之后,也可以移位刀上的固定点而不需要改变脊椎骨上的固定点。
为了执行新的柔性植入技术,创新被理解为包括可植入部件的四个部分或类型的项目。
第1部分:椎弓根螺钉。
通过椎弓根螺钉附接到椎骨的固定(锚定)植入物,其头部的特征在于在骨表面的外部仅保留3或4毫米,并且具有中心孔以接纳用于固定适配到椎弓根螺钉的头部中的双中间连接器的小螺钉。
第2部分:双中间连接器。
双中间连接器是回旋镖形的并且具有两个侧部。一个侧部具有用于椎弓根螺钉的插口,另一侧部具有待附接到刀平台的多轴螺杆。
第3部分:刀平台。
刀平台具有轨道,柔性滑刀组将穿过该轨道。平台具有两个侧部。一个箱状侧部,其中柔性刀组将通过并且滑动,并且另一个侧部具有用于与该双中间连接器固定的孔。
对于每个椎骨,提供锚定到每个椎弓根的两个刀平台,即,一个平台连接到右椎弓根并且另一个平台连接到同一椎骨的左椎弓根。
这样,在右侧上操作的节段将为平台提供柔性滑动刀组,而在左侧上操作的节段将为平台提供通过连接到左侧上的椎弓根的平台的另一组刀。
在组装***的每一侧上,根据所操作的脊柱节段,在每一端将具有终端平台和多个滑动平台。
第4部分:滑动刀。
植入物是成组的两个或更多个柔性刀,所述柔性刀在平台内在它们自身之间滑动。
这样的刀组以这样的方式安装在***作的脊柱的两侧,即靠近棘突的左右,使得对于脊柱的每一侧,至少一组两个滑动刀连接到平台,平台又连接到椎弓根螺钉。
组装特性
在配备有该***的椎骨节段的每一侧,将会是:
刀仅在一端连接到近端终端平台,近端终端平台连接到近端终端椎骨。
另一刀也仅在一端附接到远端终端平台,远端终端平台附接到远端终端椎骨。
在每个***中,每个刀仅在一端固定,使得它们可以一起滑动。因此,刀的内缘在它们之间自由滑动并且在滑动平台内松动。
重要的是,滑动刀组允许***作的脊柱节段的缩短和伸长,并且还由于柔性,它们允许***作的脊柱节段的弯曲、伸展和旋转的角运动,这是重要的。
利用该***的组件,在滑动平台内滑动并运行的柔性滑刀组通过双中间连接器依次锚定到椎弓根螺钉,允许矫正诸如脊柱侧凸的椎骨变形,保持脊柱在***允许的自由平面内的运动,并且当应用于未成熟患者(儿童和青少年)时允许脊柱生长。
该***可用来通过调节和部分阻断刀间的滑动来治疗脊柱后凸、骨折、肿瘤和由退行性脊柱疾病引起的不稳定性。
因此,本专利设计成获得一种假体,其具有尽可能少的部件,方便地构造和布置成允许柔性的、滑动的和动态的植入***选择性稳定和校正脊柱变形和不稳定,以不匹配的效率和多功能性执行其功能,而没有上述缺点。
附图说明
为了更好地理解什么构成了在此要求保护的“用于动态植入物的滑刀的固定和穿刺的引导装置”,提供了附图,其中可以看到:
图1是用于选择性稳定和校正脊柱变形和不稳定的两个柔性的、滑动的和动态的植入物的侧透视图,一个左一个右。
图2是用于选择性稳定和校正脊柱变形和不稳定的两个柔性的、滑动的和动态的植入物的仰视图,一个左一个右。
图3是用于选择性稳定和校正脊柱变形和不稳定的两个柔性的、滑动的和动态的植入物的主视图,一个左一个右。
图4是直的滑动杆的分解透视图,其包括用于选择性稳定和校正脊柱变形和不稳定的柔性的、滑动的和动态的植入物。
图5是直的滑动杆的透视图,其包括用于选择性稳定和校正脊柱变形和不稳定的柔性的、滑动的和动态的植入物。
图6是由终端支撑件、球接头、双轴承和椎弓根螺钉形成的套件的分解图。
图7是具有球接头的双轴承的透视图。
图8是具有球接头的双轴承的分解透视图。
图9是终端支撑件的后透视图。
图10是终端支撑件的前透视图。
图11是终端支撑件的主视图。
图12是滑动支撑件的前透视图。
图13是集成所述植入***的双轴承组的透视图,其中可以在左栏中从顶部到底部看到:双腰椎轴承,其椎弓根螺钉在垂直方向上突出;腰椎轴承,其螺钉突出5度;以及腰椎轴承,其螺钉突出15度。右栏中:胸腔轴承,其螺钉在垂直方向上突出;胸腔轴承,其螺钉突出5度;以及双胸腔轴承,其螺钉突出15度。
具体实施方式
根据上述附图,本专利的对象“用于动态植入物的滑刀的固定和穿刺的引导装置”由用于穿刺柔性刀(1)的引导装置组成,用于姿势矫正和/或脊柱治疗,包括与健康脊柱等效的所有角度的自然活动。
所述柔性刀(4)集成铰接的脊椎假体(2),该铰接的脊椎假体由两个刀组(3)组成,两个刀组被安装在手术过的脊柱的两侧上。
所述刀组(3)包括两个重叠的薄刀(4),这两个重叠的薄刀能够在纵向上彼此滑动并且定位在两个终端平台(13)和多个滑动平台(14)的导轨上,而每个端部通过螺钉(17)固定到相应的终端平台(13)上。
所述终端平台(13)和滑动件(14)集成用于穿刺柔性刀(1)的引导装置,所述引导装置还包括形状类似于回旋镖的双中间连接器(5),所述双中间连接器(5)具有多轴螺杆(6)和椎弓根螺钉(7)。
所述椎弓根螺钉(7)附接至患者的每个椎骨的相对于待植入的椎骨延伸部的骨区域,并且多轴螺杆(6)相对于椎弓根螺钉(7)向相反侧突出。所述椎弓根螺钉(7)在骨表面之外并且具有中心孔(27),该中心孔接纳小螺钉(26),该小螺钉固定该双中间连接器(5),该双中间连接器适配在所述椎弓根螺钉(7)的头部中。
更具体地,刀组(3)由两个相同的薄的刚性刀(4)组成,所述刀具有长形的几何形状并且具有圆化的边缘,即没有尖锐的边缘并且具有椭圆形的纵向开口(9),该纵向开口占据其长度的大约一半,具有倾斜的边缘(10)。
所述刀(4)通过两个紧固件(11)重叠和接合,两个紧固件适配在于刀(4)中提供的每个纵向开口(9)中并且使用螺钉(12)固定到另一个刀(4)的端部。
所述紧固件(11)是具有圆形较小侧部的扁平矩形元件,扁平矩形元件适配到纵向开口(9)的倾斜边缘(10)中并且允许刀(4)彼此纵向滑动。还有两个通孔,通孔在所述紧固件(11)的中线具有纵向对齐的截头圆锥形轮廓。
两个终端平台(13)附接到每端的一个刀组(3)和沿着其长度的多个滑动平台(14)。
所述终端平台(13)由中空四边形元件构成并且在其整个下表面和上表面中开口,在其上表面中设置有螺纹圆孔(15)并且设置有从左侧突出的孔(16)。
在直线结构的每一端,终端平台(13)通过螺钉(17)附接,该螺钉(17)***并螺纹连接到螺纹圆孔(15)中,该螺纹圆孔(15)穿过设置在刀(4)的区域中的圆孔(29)并接触终端平台(13)的底面。
滑动平台(14)具有与终端平台(13)相同的构型,但没有螺纹圆孔,即,该滑动平台由中空的四边形元件组成并且在其整个下表面和上表面上是开口的,该滑动平台呈包括轨道(18)的盒子的形式,柔性刀组(3)在该轨道上经过并且滑动,并且在相对侧上具有用于附接到双中间连接器的孔(16)。
滑动平台(14)联接到刀组(3)上并且沿着其长度定位在与椎弓根螺钉将附接至其上的对应椎骨一致的位置中。
每个平台(13)和(14)接纳双中间连接器(5),该双中间连接器包括呈回旋镖形式的整体式件,该整体式件配备有两个通孔(19)和(20),该通孔(19)位于较高壁(21)侧部,其中多轴螺杆(6)被联接,多轴螺杆由圆柱形杆(23)组成,圆柱形杆的下端具有球体(24),螺纹区域(25)位于球体之前。另一个孔(20)在一个侧部接纳椎弓根螺钉(7)并且在另一侧部上接纳固定螺钉(26),该固定螺钉被拧入椎弓根螺钉(7)的头部中的同心孔(27)中,以便将其附接到设置在孔(20)中的内凸缘(8)上。所述内凸缘(8)负责对该椎弓根螺钉(7)的角度进行定向,并且因此提供了多个双中间连接器(5),双中间连接器的内凸缘角度(8)针对它们在刀组(3)中所占据的不同位置而变化。
多轴螺杆(6)的圆柱形杆(23)穿过双中间连接件(5)的孔(19)和平台(13)或(14)的孔(16),并通过螺母(28)固定,螺母(28)拧入螺纹区域(25)。
可以看出,双中间连接器(5)的内凸缘(8)具有不同的角度,使得相应的椎弓根螺钉(7)处于用于将植入物附接到相应椎骨的合适角度,并且因此每种类型的双中间连接器(5)具有特定位置。
上终端平台(13)固定到待植入的椎骨延伸部的第一对应上椎骨,下终端平台(13)固定到该延伸部的最后下椎骨,并且滑动平台(14)固定到包含在所述范围内的椎骨。
植入物是成组的两个或更多个柔性刀,所述柔性刀在平台内在它们自身之间滑动。
可以肯定的是,当实施本发明时,可以引入关于某些结构和形式细节的修改,而不意味着背离在权利要求框架中清楚证实的基本原理,因此应当理解,所使用的术语是出于描述而非限制的目的而选择的。
Claims (7)
1.一种用于动态植入物的滑刀的固定和穿刺的引导装置,由用于穿刺柔性刀(1)以进行姿势矫正和/或脊柱治疗的引导装置组成,其特征在于,所述引导装置包括接纳双中间连接器(5)的终端平台(13)和滑动平台(14),所述连接器(5)包括呈回旋镖形式的零件,所述零件配备有第一通孔(19)和第二通孔(20),所述第一通孔(19)位于较高壁(21)侧部,在所述较高壁(21)处联接有由圆柱形杆(23)组成的多轴螺杆(6),所述圆柱形杆(23)的下端具有球体(24),螺纹区域(25)位于所述球体(24)之前,第二通孔(20)在一侧接纳椎弓根螺钉(7)并且在另一侧上接纳固定螺钉(26),所述固定螺钉(26)被拧入椎弓根螺钉(7)的头部中的同心孔(27)中,以便将其固定在内凸缘(8)上,所述内凸缘被提供在第二通孔(20)中,所述内凸缘(8)负责对椎弓根螺钉(7)的角度进行定向并且因此提供了多个双中间连接器(5),所述双中间连接器的内凸缘角度(8)针对其在刀组(3)中占据的不同位置而变化。
2.根据权利要求1所述的一种用于动态植入物的滑刀的固定和穿刺的引导装置,其特征在于,所述椎弓根螺钉(7)在骨表面之外并且具有同心孔(27)以接纳固定螺钉(26),所述固定螺钉(26)附接所述双中间连接器(5),所述双中间连接器(5)适配于所述椎弓根螺钉(7)的头部。
3.根据权利要求1所述的一种用于动态植入物的滑刀的固定和穿刺的引导装置,其特征在于,终端平台(13)和滑动平台(14)集成引导装置,所述引导装置用于穿刺柔性刀(1)并且保持节段的椎骨结构完整无损。
4.根据权利要求1所述的一种用于动态植入物的滑刀的固定和穿刺的引导装置,其特征在于,所述双中间连接器(5)具有回旋镖形状并且具有两个侧部,所述两个侧部中的一个侧部具有用于椎弓根螺钉(7)的配件,并且另一个侧部具有用于附接到刀(4)的多轴螺杆(6)。
5.根据权利要求1所述的一种用于动态植入物的滑刀的固定和穿刺的引导装置,其特征在于,柔性刀(4)在其长度上具有引导件(1)。
6.根据权利要求1所述的一种用于动态植入物的滑刀的固定和穿刺的引导装置,其特征在于,所述刀的终端平台(13)和滑动平台(14)具有导轨(18),刀组(3)将在所述导轨(18)上滑动,而终端平台(13)和滑动平台(14)具有两个侧部,一个侧部呈箱形,其中柔性刀组(3)将通过并滑动,而另一个侧部具有用于附接到双中间连接器(5)的孔(16)。
7.根据权利要求1所述的一种用于动态植入物的滑刀的固定和穿刺的引导装置,其特征在于,植入物是成组的两个或更多个柔性刀(4),所述柔性刀在滑动平台(14)内在它们自身之间滑动。
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JP7104150B2 (ja) | 2022-07-20 |
EP3701892A1 (en) | 2020-09-02 |
KR20200080240A (ko) | 2020-07-06 |
EP3701892A4 (en) | 2021-07-14 |
CN111278373A (zh) | 2020-06-12 |
WO2019079863A1 (pt) | 2019-05-02 |
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