CN111904574A

CN111904574A - Posterior atlantoaxial reposition fixing system

Info

Publication number: CN111904574A
Application number: CN202010939545.4A
Authority: CN
Inventors: 郝定均; 张海平; 郝尹泽
Original assignee: Individual
Current assignee: Individual
Priority date: 2020-09-07
Filing date: 2020-09-07
Publication date: 2020-11-10
Also published as: NL2027527B1

Abstract

The invention discloses a posterior atlantoaxial resetting and fixing system, which comprises an atlas screw, a clamping ring sleeve, an atlas plate and an adjusting bolt; the atlas plate comprises two main plates, one end of each main plate is an arc-shaped surface, and the other end of each main plate is a plane; through holes are formed in the plane ends of the two main boards, and the arc surfaces of the two main boards are in up-down contact and can be connected in a sliding manner; the atlas screw passes through the through hole; the atlas screw is provided with a through central hole along the axial direction. The system can directly use the guide wire to penetrate through the atlas screw for positioning and fixing, so that the nail track is quickly and accurately found.

Description

Posterior atlantoaxial reposition fixing system

Technical Field

The invention relates to the field of medical instruments, in particular to a posterior atlantoaxial reposition and fixation system.

Background

Atlas blowout fractures are often caused by car accidents and high bruise, and are difficult to treat. The cervical and occipital fusion or atlantoaxial fusion is usually adopted for treatment, but the above method can cause the patient to lose most of the cervical vertebra movement function. At present, the atlas single vertebral level peg fixation method is emerging for treating the atlas bursting fracture, so that the physiological activity function of the upper cervical vertebra is reserved, but the fixation method easily causes the expansion of the front fracture in the process of posterior clasping and resetting, so that the fracture cannot be healed.

Chinese patent CN204744370U discloses a posterior atlantoaxial reposition fixator, which comprises a left fixing piece, a right fixing piece and universal screws, wherein the left fixing piece and the right fixing piece are respectively a cross bar which is arranged up and down and is parallel and an oblique bar used for connecting the cross bar which is arranged up and down, the cross bar on the upper part of the left fixing piece is provided with a key groove, the cross bar on the upper part of the right fixing piece is a bulge with a locking screw, and the bulge is in matched connection with the key groove; the inclined rods of the left fixing piece and the right fixing piece are provided with pressurizing reset holes for fixing the horizontal forceps, and the cross rods at the lower parts of the left fixing piece and the right fixing piece are fixed through universal screws and atlas lateral masses. The mobility loss caused by the adoption of the cervical pillow fusion or the atlantoaxial fusion is avoided, and the problem that the physiological reduction of the burst fracture cannot be realized by the fixation of the single vertebral segment with the nail rod at present is solved.

However, clinical applications found problems with current posterior atlantoaxial reduction fixation implant: 1. when the screw and the plate are implanted into an integrated structure, the atlas nail channel and the peripheral venous plexus oozing blood obviously cover the prepared nail channel, the field definition is obviously reduced, and the nail channel is difficult to find; 2. the addition of the rear square plate has obvious visual field blocking disadvantage for searching the screw path in front. 3. When the screw is implanted, the implantation direction of the screw is difficult to be completely kept on the same axis with the original nail path, the screw is easy to deviate from the original nail path in the operation, the small lateral block is damaged, the screw cannot be placed, the neck pillow fusion is carried out by adjusting the operation scheme, the rotation of the head of a patient and the mobility of the head stretching forwards and backwards are lost, and the daily life of the patient is affected.

Disclosure of Invention

In order to solve the problem that the atlas nail channel is difficult to find in the atlas bursting fracture operation, the invention provides a posterior atlas resetting and fixing system, which can directly use a preset guide wire to design an atlas screw as a hollow screw and implant, fix and reset along the guide wire, so that the nail channel finding and the implantation are quick and accurate.

In order to achieve the purpose, the invention adopts the following technical scheme:

the posterior atlas resetting and fixing system comprises an atlas screw, a clamping ring sleeve, an atlas plate and an adjusting bolt;

the atlas plate comprises two main plates, one end of each main plate is an arc-shaped surface, and the other end of each main plate is a plane; through holes are formed in the plane ends of the two main boards, and the arc surfaces of the two main boards are in up-down contact and can be connected in a sliding manner;

the atlas screw passes through the through hole; the atlas screw is provided with a through central hole along the axial direction.

Optionally, a clamping ring sleeve and a limiting pin are further arranged in the through hole; the snap ring sleeve is provided with a notch; the limiting pin is arranged on the side wall of the through hole, and the limiting pin is arranged in the notch of the clamping ring sleeve; the inner wall of the clamping ring sleeve is provided with threads; the screw head of the atlas screw is in threaded connection with the snap ring sleeve.

Optionally, the bottom of the snap ring sleeve and the bottom of the through hole form a ball-and-socket structure.

Optionally, the outer wall of the snap ring sleeve is provided with threads.

Optionally, the screw head outer wall has a thread; the screw rod of the atlas screw penetrates through the clamping ring sleeve, the screw head is arranged in the clamping ring sleeve, and the screw head and the clamping ring sleeve can be in threaded connection.

Optionally, the screw head is in an inverted trapezoidal round platform structure; the inner cavity of the clamping ring sleeve is of a trapezoidal round platform structure matched with the inverted trapezoidal round platform structure.

Optionally, the snap ring is sleeved in the through hole, and the top of the snap ring does not exceed the upper surface of the main board.

Optionally, the arc-shaped surface end of one main board is provided with a sliding groove, the arc-shaped surface end of the other main board is provided with a threaded hole, and the adjusting bolt penetrates through the sliding groove in one main board and is fixed with the threaded hole in the other main board.

Optionally, the upper and lower contacting parts of the arc surfaces of the two main boards are tooth-shaped structures which are meshed up and down.

Optionally, both of said tooth formations are helical teeth.

Compared with the prior art, the invention has the following beneficial technical effects:

the posterior atlas resetting and fixing system of the invention sets the atlas screw clinically used at present as a hollow atlas screw, and the hollow atlas screw only needs to be gradually screwed along the guide wire directly through the guide wire preset to the nail channel in the operation, so that the operation can be performed quickly and accurately no matter whether the visual field is blocked or not, thereby ensuring that the direction of the screw is consistent with that of the original nail channel, solving the problem that the nail channel is difficult to find due to unclear visual field, greatly reducing the probability of damaging the spinal cord and the vertebral artery by sliding inwards and outwards when the screw is implanted, and greatly shortening the operation time. After the atlas screw is implanted into the nail channel and fixed, the guide wire is directly pulled out along the central hole, and the clamping ring sleeve is connected with the through hole to fix the atlas screw so as to ensure that the atlas screw cannot slide backwards.

Furthermore, the bottom of the clamping ring sleeve and the bottom of the through hole form a ball socket structure. Can adapt to the nail paths in different directions and is also beneficial to the reduction of the side mass of the atlas and the front and back arch fractures which are burst and close to the midline.

Furthermore, the rear part of the atlas plate is arranged into an upper dentate structure and a lower dentate structure, so that the rear occlusion in the resetting process is facilitated, the sliding to two sides after the resetting is reduced, and the resetting capability is enhanced; and after the position is fixed, locking can be realized, and sliding is not easy to occur.

Drawings

FIG. 1 is a schematic view of a posterior atlantoaxial reposition fixation system;

FIG. 2 is a vertical cross-sectional view of a posterior atlantoaxial reposition fixation system;

FIG. 3 is an enlarged view of a portion of FIG. 2;

FIG. 4 is a cross-sectional view taken along line A-A of FIG. 3;

FIG. 5 is a first surgical view of a posterior atlantoaxial reposition fixation system;

FIG. 6 is a second schematic view of a posterior atlantoaxial reposition fixation system;

FIG. 7 is a third schematic view of a posterior atlantoaxial reposition fixation system;

FIG. 8 is a fourth schematic view of a posterior atlantoaxial reposition fixation system;

wherein 100 is an atlas screw; 200 is a snap ring sleeve; 300 is an atlas plate; 400 is an adjusting bolt; 500 is a guide wire; 600 is a limit pin; 101 is a screw head; 102 is a screw rod; 103 is a central hole; 301 is a main board; 302 is a through hole; 303 is a chute; 304 are tooth-like structures.

Detailed Description

In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings needed to be used in the description of the embodiments will be briefly introduced below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings based on these drawings without creative efforts.

In order to make the objects, technical solutions and advantages of the present invention more apparent, the following description of the embodiments of the present invention with reference to the accompanying drawings and examples is given by way of illustration and not limitation.

As shown in fig. 1 to 4, a posterior atlas reduction fixation system of the present invention includes an atlas screw 100, a collar 200, an atlas plate 300, and an adjusting bolt 400; the atlas plate 300 is provided with an atlas screw 100 and a cuff 200 at both ends.

The atlantoaxial plate 300 comprises two main plates 301, wherein one end of each main plate 301 is an arc-shaped surface, and the other end of each main plate 301 is a plane; through holes 302 are formed in the plane ends of the two main boards 301, and the arc surfaces of the two main boards 301 are in up-down contact and can be connected in a sliding manner;

the atlas screw 100 passes through the through hole 302; the atlas screw 100 is provided with a through central hole 103 in the axial direction.

In order to limit and fix the atlas screw 100, a clamping ring sleeve 200 and a limiting pin 600 are also arranged in the through hole 302; the snap ring sleeve 200 is provided with a notch; the limiting pin 600 is arranged on the side wall of the through hole 302, and the limiting pin 600 is arranged in the notch of the snap ring sleeve 200; the inner wall of the snap ring sleeve 200 is provided with threads; the screw head 101 of the atlas screw 100 is in threaded connection with the snap ring sleeve 200.

In order to allow for the partial adjustment and the tightening and resetting before the locking screw, the bottom of the snap ring sleeve 200 and the bottom of the through hole 302 form a ball-and-socket structure. This allows the atlas screw 100 to be perturbed about the snap ring collar 200 as a fulcrum prior to tightening.

In order to reduce the disturbance amplitude, the outer wall of the snap ring sleeve 200 is provided with threads. Increasing a certain friction force.

Specifically, the outer wall of the screw head 101 is provided with threads; the screw rod 102 of the atlas screw 100 passes through the snap ring 200, the screw head 101 is arranged in the snap ring 200, and the screw head 101 and the snap ring 200 can be connected in a threaded manner.

Preferably, the screw head 101 is in an inverted trapezoidal truncated cone structure; the inner cavity of the snap ring sleeve 200 is a trapezoidal circular truncated cone structure matched with the inverted trapezoidal circular truncated cone structure. This also makes the screw head 101 with the ring clamp 200 in the process of screwing in, more and more squeeze ring clamp 200, because the effect of spacer pin 600, ring clamp 200 can not rotate, so extensive region vertebra screw 100 just more and more tight, ring clamp 200 finally tightly contacts with the through-hole 302 inner wall tightly, makes through-hole 302, ring clamp 200 and screw head 101 form an organic whole structure, reduces the not hard up in the follow-up operation.

Wherein, the snap ring sleeve 200 is a spring element.

Specifically, the atlas plate 300 comprises two main plates 301, wherein one end of each main plate 301 is an arc-shaped surface, and the other end of each main plate 301 is a plane; the arc-shaped surface of one main board 301 is provided with a sliding groove 303, the arc-shaped surface of the other main board 301 is provided with a threaded hole, the other ends of the two main boards 301 are provided with through holes 302, the arc-shaped surfaces of the two main boards 301 are in up-and-down contact, and the adjusting bolt 400 penetrates through the sliding groove 30 on the one main board 301 and the threaded hole on the other main board 301 to be fixed.

When the distance between the two main boards 301 needs to be adjusted, the adjusting bolts 400 are loosened to adjust the horizontal positions of the two main boards 301, and then the adjusting bolts 400 are fixed and locked. This adjustable configuration helps accommodate atlas blowout fracture surgery in different patients.

As the preferred embodiment of the invention, the connection part of the two main plates 301 is the dentate structure 305 which is engaged up and down, the back of the atlas plate is set into the dentate structure which is engaged up and down, which is beneficial to the engagement of the back in the process of restoration, reduces the slippage to both sides again after restoration, and strengthens the restoration ability; preferably, the tooth-like structure is helical teeth.

The atlas screw 100 comprises a screw head 101 and a screw rod 102, the screw head 101 and the screw rod 102 are both provided with a central hole 103, the screw head 101 is arranged at the end part of the screw rod 102, and the atlas screw 100 is arranged in the through hole 302 and is fixed with the side wall of the through hole 302 through the threaded connection of the clamping ring sleeve 200.

To ensure that the surgical device does not protrude too much, collar 200 is an insert nut, and collar 200 is placed in through hole 302 with the top not exceeding the flat top. The screw head 101 is an internal hexagonal screw head.

As the preferred embodiment of the invention, the atlas screw is designed into the hollow screw with the diameter of 3.5-4.0mm, the guide wire with the diameter of 1.0mm is placed into the screw channel after the screw channel is prepared, and the screw is gradually screwed along the guide wire, so that the direction of the screw is consistent with that of the original screw channel, and the problem that the screw channel is difficult to find due to unclear vision is solved.

As a preferred embodiment of the present invention, the bottom of the collar 200 and the bottom of the through hole 302 form a ball and socket structure, so that the atlas screw 100 can orbit along the through hole 302 before being tightened. The spherical-fossa structure is designed between the screw and the atlas plate, which is favorable for the burst atlas lateral mass to approach to the midline for resetting.

As shown in fig. 5 to 8, the actual operation method of the present invention is as follows:

s100, exposing the posterior arch of the atlas through operation, and preparing atlas vertebral pedicle or lateral mass screw nail channels on two sides by using an open cone and a tap; inserting a guide wire 500 into the nail path respectively;

s200, movably connecting one ends of two main plates 301 through adjusting bolts 400 to form an atlantoaxial plate 300; the guide wire 500 is inserted into the central hole 103 of the atlas screw 100, and the atlas screw 300 only needs to slide gradually along the guide wire and be screwed gradually, so that the nail path searching and fixing can be realized.

S300, clasping the adjusting bolts 400 on the two sides by using clasping forceps, and locking the middle screw and the adjusting bolts 400 on the two sides by sliding the two atlantoaxial plates 300 along the transverse direction, so that the contact extrusion of the atlantoaxial plate and the posterior atlantoaxial is realized, and the purpose of clasping and resetting the posterior atlantoaxial plate after the operation is promoted.

S400, after the atlas screw is fixed, the guide wire 500 is pulled out along the central hole 103, the clamping ring sleeve 200 is screwed with the through hole 302,

s500, the atlas screw 300 and the adjusting screw 400 are all internal hexagonal screw heads. The wrench used for the operation can pass the guide wire 500 because of the hollow wrench.

The above-described embodiments are merely illustrative of implementations of the invention that enable persons skilled in the art to make or use the invention, and the description is not limiting. Therefore, the present invention should not be limited to the embodiments shown herein, and all additions and equivalents made to the technical features of the present invention are intended to fall within the scope of the present application.

Claims

1. The posterior atlas resetting and fixing system is characterized by comprising an atlas screw (100), a clamping ring sleeve (200), an atlas plate (300) and an adjusting bolt (400);

the atlantoaxial plate (300) comprises two main plates (301), one end of each main plate (301) is an arc-shaped surface, and the other end of each main plate is a plane; through holes (302) are formed in the plane ends of the two main boards (301), and the arc surfaces of the two main boards (301) are in up-down contact and are in sliding connection;

the atlas screw (100) passes through the through hole (302); the atlas screw (100) is provided with a through central hole (103) along the axial direction.

2. The posterior atlantoaxial reposition fixation system of claim 1, wherein a snap ring sleeve (200) and a stop pin (600) are further disposed in the through hole (302); the snap ring sleeve (200) is provided with a notch; the limiting pin (600) is arranged on the side wall of the through hole (302), and the limiting pin (600) is arranged in the notch of the clamping ring sleeve (200); the inner wall of the snap ring sleeve (200) is provided with threads; the atlas screw (100) is in threaded connection with the clamping ring sleeve (200) through the screw head (101).

3. The posterior atlantoaxial reduction fixation system of claim 2, wherein the bottom of the snap ring sleeve (200) forms a ball and socket structure with the bottom of the through hole (302).

4. The posterior atlantoaxial reduction fixation system of claim 2, characterized in that the outer wall of the collar (200) is provided with threads.

5. The posterior atlantoaxial reduction fixation system of claim 2, characterized in that the outer wall of the screw head (101) is threaded; the screw rod (102) of the atlas screw (100) penetrates through the clamping ring sleeve (200), the screw head (101) is arranged in the clamping ring sleeve (200), and the screw head (101) and the clamping ring sleeve (200) can be in threaded connection.

6. The posterior atlantoaxial reduction fixation system of claim 2, wherein the screw head (101) is of an inverted trapezoidal truncated cone structure; the inner cavity of the clamping ring sleeve (200) is of a trapezoidal circular truncated cone structure matched with the inverted trapezoidal circular truncated cone structure.

7. The posterior atlantoaxial reduction fixation system of claim 2, wherein the snap ring sleeve (200) is placed within the through hole (302) without the top exceeding the upper surface of the main plate (301).

8. The posterior atlantoaxial reposition and fixation system according to any one of claims 1 to 7, wherein the curved surface end of one main plate (301) is provided with a sliding slot (303), the curved surface end of the other main plate (301) is provided with a threaded hole, and the adjusting bolt (400) passes through the sliding slot (303) on one main plate (301) and is fixed with the threaded hole on the other main plate (301).

9. The posterior atlantoaxial reposition fixation system of any one of claims 1 to 7, wherein the upper and lower contact of the arc surfaces of the two main plates (301) are dentations (305) that engage up and down.

10. The posterior atlantoaxial reduction fixation system of claim 9, wherein two of the dentations are oblique teeth.