NL2027527B1 - Posterior atlas reduction and fixation system - Google Patents

Posterior atlas reduction and fixation system Download PDF

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Publication number
NL2027527B1
NL2027527B1 NL2027527A NL2027527A NL2027527B1 NL 2027527 B1 NL2027527 B1 NL 2027527B1 NL 2027527 A NL2027527 A NL 2027527A NL 2027527 A NL2027527 A NL 2027527A NL 2027527 B1 NL2027527 B1 NL 2027527B1
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Prior art keywords
atlas
screw
clamping ring
reduction
fixation system
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NL2027527A
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Dutch (nl)
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Hao Dingjun
Zhang Haiping
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Hao Dingjun
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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
    • A61B17/7059—Cortical plates
    • 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
    • A61B17/7055—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant connected to sacrum, pelvis or skull
    • 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
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7091—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8047—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers wherein the additional element surrounds the screw head in the plate hole
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Neurology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Neurosurgery (AREA)
  • Surgical Instruments (AREA)

Abstract

The present invention discloses a posterior atlas reduction and fixation system comprising an atlas screw, a clamping ring sleeve, an atlas plate and an adjusting bolt. the atlas plate comprises two main plates, wherein one end of each main plate is arc-shaped, and the other end is flat; the two main plates are provided with through holes on the flat ends, and arc-shaped surfaces of the two main plates are configured in an upper and lower contacting mode and in sliding connection; and the atlas screw penetrates through the through hole; the atlas screw is axially provided with a through central hole. According to the system disclosed by the present invention, the guide wire can be directly utilized to penetrate through the atlas screw for positioning and fixing, so that the screw channel can be quickly and accurately searched.

Description

POSTERIOR ATLAS REDUCTION AND FIXATION SYSTEM FIELD OF THE PRESENT DISCLOSURE
[0001] The present invention relates to the field of medical instruments, in particular to a posterior atlas reduction and fixation system.
BACKGROUND OF THE PRESENT DISCLOSURE
[0002] Atlas burst fractures are often caused by car accidents and high falls, which are complicated to deal with. In the past, cervical-occipital fusion or atlantoaxial fusion was usually used for treatment, but the above methods will cause the patient to lose most of the cervical spine mobility. At present, the use of atlas single segment screw rod fixation is emerging to treat atlas burst fractures, thereby preserving the physiological function of the upper cervical spine, but this fixation method is likely to cause the front fracture seam to open during the posterior tightening and reduction process, thereby causing the fracture to fail to heal.
[0003] The Chinese patent CN204744370U discloses a posterior atlas reduction fixer, which comprises a left fixing piece, a right fixing piece and a universal screw. The left fixing piece and the right fixing piece are both cross-bars provided parallel and up and down and oblique bars for connecting the cross-bars provided up and down; and a key groove is formed in the cross-bar at an upper part of the left fixing piece; a protrusion with a locking screw is provided on the cross-bar at an upper part of the right fixing piece, and the protrusion is matched and connected with the key groove; the oblique bars of the left fixing piece and the right fixing piece are provided with pressurized reset holes for fixing the horizontal pincers, and the cross-bars at the lower parts of the left fixing piece and the right fixing piece are fixed through the universal screw atlas lateral mass. The patent not only avoids the loss of mobility caused by cervical-occipital fusion or atlantoaxial fusion, but also solves the problem that the physiological reduction of the burst fracture cannot be realized by the conventional screw rod single segment fixation.
[0004] However, it is found in clinical application that the current posterior atlas reduction fixer has problems during the implantation: 1. when the screw and plate integrated structure is implanted, the prepared screw channel is obviously covered by the bleeding of the atlas screw channel and the surrounding venous plexus, obviously reducing the definition of the operation field, and making it difficult to find the screw channel; 2, in addition, the rear plate has obvious drawback of blocking the visual field when the front screw is searching for the screw channel; and 3. when the screw is implanted, the direction of implantation of the screw is difficult to keep the same axis with the original screw channel completely, and is easy to deviate from the original screw channel during operation to damage the small lateral mass, so that the screw cannot be placed in, and a surgical scheme needs to be adjusted for cervical-occipital fusion, which damages the activities of rotation and forward flexion and backward extension of the head of a patient, thereby affecting the daily life of the patient qualitatively.
SUMMARY OF THE PRESENT DISCLOSURE
[0005] In order to solve the problem of difficulty in finding an atlas screw channel in an atlas burst fracture operation, the present invention provides a posterior atlas reduction and fixation system which can directly utilize a preset guide wire to design an atlas screw as a hollow screw and perform implantation fixation and reduction along the guide wire, so that the finding of the screw channel and the implantation are rapid and accurate.
[0006] In order to achieve the above object, the present invention adopts the following technical scheme:
[0007] The posterior atlas reduction and fixation system comprises an atlas screw, a clamping ring sleeve, an atlas plate and an adjusting bolt;
[0008] the atlas plate comprises two main plates, wherein one end of each main plate is arc-shaped, and the other end is flat; the two main plates are provided with through holes on the flat ends, and arc-shaped surfaces of the two main plates are configured in an upper and lower contacting mode and in sliding connection; and
[0009] the atlas screw penetrates through the through hole; the atlas screw is axially provided with a through central hole.
[0010] Optionally, the clamping ring sleeve and a limit pin are further provided in the through hole; the clamping ring sleeve is provided with a notch; the limit pin is provided on a side wall of the through hole and within the notch of the clamping ring sleeve; an inner wall of the clamping ring sleeve is provided with threads; and a screw head of the atlas screw is in threaded connection with the clamping ring sleeve.
[0011] Optionally, the bottom of the clamping ring sleeve and the bottom of the through hole form a ball and socket structure.
[0012] Optionally, the outer wall of the clamping ring sleeve is provided with threads.
[0013] Optionally, the outer wall of the screw head is provided with threads; a screw stem of the atlas screw penetrates through a clamping ring sleeve, a screw head is provided in the clamping ring sleeve, and the screw head and the clamping ring sleeve can be in threaded connection.
[0014] Optionally, the screw head has an inverted trapezoidal truncated cone structure; and the clamping ring sleeve has an inner cavity of a trapezoidal truncated cone structure matched with the inverted trapezoidal truncated cone structure.
[0015] Optionally, the clamping ring sleeve is placed within the through-hole and the top does not extend beyond the upper surface of the main plate.
[0016] Optionally, the arc-shaped end of one main plate is provided with a chute, and the arc-shaped end of the other main plate is provided with a threaded hole; and the adjusting bolt penetrates through the chute on one main plate to be fixed with a threaded hole on the other main plate.
[0017] Optionally, the arc-shaped upper and lower contacts of the two main plates are toothed structures configured in an upper and lower meshing mode.
[0018] Optionally, the two toothed structures are helical teeth.
[0019] [0016] Compared with the prior art, the present invention has the beneficial effects:
[0020] according to the posterior atlas reduction and fixation system provided by the present invention, the atlas screw used clinically at present is set to be a hollow atlas screw; in the operation, the hollow atlas screw only needs to be gradually screwed along the guide wire directly through the guide wire preset to the screw channel, so that the operation can be carried out quickly and accurately regardless of whether the visual field is blocked or not; further, it can be ensured the direction of the screw is consistent with that of the original screw channel; moreover, the problem of difficulty in finding a screw channel due to unclear visual field is solved, greatly reducing the probability that the spinal cord and vertebral artery are injured by sliding inwards and outwards when a screw is implanted, and shortening the operation time. After the atlas screw is implanted into the screw channel and fixed, the guide wire can be directly pulled out along the central hole, and the clamping ring sleeve is connected with the through hole to fix the atlas screw, so that the atlas screw cannot slide out backwards.
[0021] Further, the bottom of the clamping ring sleeve and the bottom of the through hole form the ball and socket structure, which can adapt to screw channels in different directions, and is also beneficial to reduction of burst atlas lateral mass and anterior and posterior arch fracture towards the midline.
[0022] Furthermore, the posterior part of the atlas plate is arranged as an upper and lower toothed structure, which facilitates the posterior occlusion in the reduction process, reduces sliding to both sides again after reduction, and enhances the reduction capability; and after the position is fixed, locking can be realized, and sliding is not easy to occur.
BRIEF DESCRIPTION OF THE DRAWINGS
[0023] FIG. 1 is a schematic view of a posterior atlas reduction and fixation system;
[0024] FIG. 2 is a vertical sectional view of a posterior atlas reduction and fixation system;
[0025] FIG. 3is an enlarged partial view of FIG. 2;
[0026] FIG. 4 is a sectional view A-A of FIG. 3;
[0027] FIG. 5 is a schematic illustration | of a posterior atlas reduction and fixation system in a surgery;
[0028] FIG. 6 is a schematic illustration Il of a posterior atlas reduction and fixation system in a surgery;
[0029] FIG. 7 is a schematic illustration lll of a posterior atlas reduction and fixation system in a surgery; and
[0030] FIG. 8 is a schematic illustration IV of a posterior atlas reduction and fixation system in a surgery.
[0031] List of reference numerals in the drawings: 100 atlas screw 200 clamping ring sleeve 300 atlas plate 400 adjusting bolt 500 guide wire 600 limit pin 101 screw head 102 screw stem
103 central hole 301 main plate 302 through hole 303 chute 5 304 toothed structure
DESCRIPTION OF THE EMBODIMENTS
[0032] In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings used in the description of the examples are briefly described below, and it is obvious that the drawings in the description below are only some examples of the present invention, and that other drawings can be obtained from these drawings without involving any inventive effort for a person skilled in the art.
[0033] To further clarify the objects, aspects and advantages of the present invention, reference is made to the accompanying drawings and examples, which illustrate, but do not limit, specific embodiments of the present invention.
[0034] As shown in FIGS. 1 to 4, the posterior atlas reduction and fixation system comprises an atlas screw 100, a clamping ring sleeve 200, an atlas plate 300 and an adjusting bolt 400; both ends of the atlas plate 300 are provided with atlas screws 100 and clamping ring sleeves 200.
[0035] The atlas plate 300 comprises two main plates 301, wherein one end of each main plate 301 is arc-shaped, and the other end is flat; the two main plates 301 are provided with through holes 302 on each flat end, and arc-shaped surfaces of the two main plates 301 are configured in an upper and lower contacting mode and in sliding connection.
[0036] The atlas screw 100 penetrates through the through hole 302; the atlas screw 100 is axially provided with a through central hole 103.
[0037] For limiting and fixing the atlas screw 100, the clamping ring sleeve 200 and a limit pin 600 are further provided in the through hole 302; the clamping ring sleeve 200 is provided with a notch; the limit pin 600 is provided on a side wall of the through hole 302 and within the notch of the clamping ring sleeve 200; an inner wall of the clamping ring sleeve 200 is provided with threads; and a screw head 101 of the atlas screw 100 is in threaded connection with the clamping ring sleeve 200.
[0038] The bottom of the clamping ring sleeve 200 and the bottom of the through hole 302 form a ball and socket structure in order to allow local adjustment and holding reduction before locking the screw. This allows the atlas screw 100 to be disturbed about the clamping ring sleeve 200 prior to locking.
[0039] To reduce the amplitude of the disturbance, an outer wall of the clamping ring sleeve 200 is provided with threads. Certain friction force may be increased.
[0040] Specifically, the outer wall of the screw head 101 is provided with threads; the screw stem 102 of the atlas screw 100 penetrates through the clamping ring sleeve 200, the screw head 101 is provided in the clamping ring sleeve 200, and the screw head 101 and the clamping ring sleeve 200 can be in threaded connection.
[0041] Preferably, the screw head 101 has an inverted trapezoidal truncated cone structure; and the clamping ring sleeve 200 has an inner cavity of a trapezoidal truncated cone structure matched with the inverted trapezoidal truncated cone structure. This also makes the clamping ring sleeve 200 to be pressed more and more during the tightening process of the screw head 101 and the clamping ring sleeve 200. Due to the action of the limit pin 600, the clamping ring sleeve 200 cannot rotate, so that the atlas screw 100 become tighter and tighter, the clamping ring sleeve 200 is finally in tight contact with the inner wall of the through hole 302, so that the through hole 302, the clamping ring sleeve 200 and the screw head 101 form an integrated structure, reducing looseness in subsequent operations.
[0042] Here, the clamping ring sleeve 200 is a spring member.
[0043] Specifically, the atlas plate 300 comprises two main plates 301, wherein one end of each main plate 301 is arc-shaped, and the other end of each main plate 301 is flat. The arc-shaped end of one main plate 301 is provided with a chute 303, and the arc-shaped end of the other main plate 301 is provided with a threaded hole. The other ends of the two main plates 301 both are provided with through holes 302, and the arc surfaces of the two main plates 301 are configured in an upper and lower contacting mode, and are fixed to the threaded holes on the other main plate 301 by an adjusting bolt 400 passing through the chute 30 on one main plate 301.
[0044] When the distance between the two main plates 301 needs to be adjusted, after the horizontal positions of the two main plates 301 are adjusted by loosening the adjusting bolts 400, the fixing adjusting bolts 400 are locked. The adjustable structure is beneficial to adapting to atlas burst fracture operations of different patients.
[0045] As a preferred embodiment of the present invention, the connection part of the two main plates 301 is a toothed structure 305 configured in an upper and lower meshing mode, and the atlas plate is arranged as a toothed structure configured in an upper and lower meshing mode at the rear, which facilitates the posterior occlusion in the reduction process, reduces sliding to both sides again after reduction, and enhances the reduction capability; preferably, the toothed structure is helical teeth.
[0046] Wherein, the atlas screw 100 comprises a screw head 101 and a screw stem 102, wherein both the screw head 101 and the screw stem 102 are provided with central holes 103, the screw head 101 is provided at the end of the screw stem 102, the atlas screw 100 is provided in a through hole 302 and in threaded connection with a side wall of the through hole 302 through a clamping ring sleeve 200 for fixation.
[0047] To ensure that the surgical device is free of excessive protrusions, the clamping ring sleeve 200 is an insert nut and the clamping ring sleeve 200 is placed within the through bore 302 with the top not exceeding the top of the flat surface. The screw head 101 is an internal hexagonal screw head.
[0048] As a preferred embodiment of the present invention, the atlas screw is designed as a hollow screw with a diameter of 3.5-4.0 mm. The guide wire 1.0 mm is placed into a 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 of difficulty in finding the screw channel due to unclear visual field can be solved.
[0049] As a preferred embodiment of the present invention, the bottom of the clamping ring sleeve 200 and the bottom of the through-hole 302 form a ball and socket structure so that the atlas screw 100 can be screwed in along the through-hole 302 before being tightened. The design of the ball and socket structure between the screw and the atlas plate is beneficial to the reduction of the burst atlas lateral mass towards the midline.
[0050] As shown in FIGS. 5 to 8, in the actual surgery of the present invention, the specific operation method is as follows:
[0051] S100, surgically exposing the posterior arch of the atlas, and preparing bilateral atlas pedicle or lateral mass screw channels by using an open-circuit cone and a tap; and inserting a guide wire 500 into each screw channel,
[0052] S200, movably connecting one ends of two main plates 301 through adjusting bolts 400 to form an atlas plate 300; inserting the guide wire 500 into the central hole 103 of the atlas screw 100, and gradually sliding the atlas screw 300 along the guide wire and gradually screwing in to realize the finding and fixing of the screw channel,
[0053] S300, tightening the adjusting bolts 400 on the two sides by using a tightening clamp, sliding the two atlas plates 300 along the transverse direction, and locking the middle screws and the adjusting bolts 400 on the two sides, so that realizing the contact and pressing between the atlas plate and the posterior atlas, and promoting the posterior holding reduction.
[0054] S400, after atlas screw being fixed, pulling the guide wire 500 out along the central hole 103, and screwing the tightening the ring sleeve 200 and the through hole
302.
[0055] S500, the atlas screw 300 and the adjustment screw 400 used are all an internal hexagonal screw head. The wrench used in surgery can make the guide wire 500 pass through because of the hollow wrench.
[0056] The embodiments described above are merely illustrative of implementations of the present invention that enable any person skilled in the art to make or use the present invention and are not intended to be limiting. Therefore, the present invention will not be limited to the embodiments shown herein, and any additions and equivalent replacements made according to the technical features of the present invention belong to the scope of this application.

Claims (10)

CONCLUSIESCONCLUSIONS 1. Een reduceer- en fixatiesysteem voor de posterior atlas wervel, gekenmerkt doordat het een atlas schroef (100), een klemring bus (200), een atlas plaat (300) en een instelbout (400) omvat; waarbij de atlas plaat (300) twee hoofdplaten (301) omvat, waarbij een einde van elke hoofdplaat (301) boogvormig is en het andere einde plat is; waarbij een doorgaande opening (302) is aangebracht op elk plat einde van de twee hoofdplaten (301), en de boogvormige oppervlakken van de twee hoofdplaten (301) zijn ingericht in een bovenste en onderste verbindingsmodus en in een schuivende verbinding; en waarbij de atlas schroef (100) door de doorgaande opening (302) reikt; en de atlas-schroef (100) is voorzien van een axiaal gerichte doorgaande centrale opening (103).A reduction and fixation system for the posterior atlas vertebra, characterized in that it comprises an atlas screw (100), a clamping ring bush (200), an atlas plate (300) and an adjustment bolt (400); wherein the atlas plate (300) comprises two main plates (301), one end of each main plate (301) being arcuate and the other end being flat; wherein a through-hole (302) is provided on each flat end of the two main plates (301), and the arcuate surfaces of the two main plates (301) are arranged in an upper and lower connection mode and in a sliding connection; and wherein the atlas screw (100) extends through the through-hole (302); and the atlas screw (100) has an axially directed through central opening (103). 2. Het reduceer- en fixatiesysteem voor de posterior atlas wervel volgens conclusie 1, met het kenmerk, dat een klemring bus (200) en een begrenzingspen (600) zijn aangebracht in de doorgaande opening (302); waarbij de klemring bus (200) is voorzien van een uitsparing; waarbij de begrenzingspen (600) is aangebracht op een zijwand van de doorgaande opening (302) en in de uitsparing van de klemring bus (200); waarbij een binnenwand van de klemring bus (200) is voorzien van schroefdraad; en waarbij een schroefkop (101) van de atlas schroef (100) in schroefdraadverbinding is met de klemring bus (200).The posterior atlas vertebra reduction and fixation system according to claim 1, characterized in that a clamping ring bush (200) and a limiting pin (600) are arranged in the through-hole (302); wherein the clamping ring bush (200) is provided with a recess; wherein the limiting pin (600) is mounted on a side wall of the through-hole (302) and in the recess of the ferrule sleeve (200); wherein an inner wall of the ferrule sleeve (200) is threaded; and wherein a screw head (101) of the atlas screw (100) is in threaded engagement with the ferrule sleeve (200). 3. Het reduceer- en fixatiesysteem voor de posterior atlas wervel volgens conclusie 2, met het kenmerk, dat de onderzijde van de klemring bus (200) en de onderzijde van de doorgaande opening (302) een kogelgewrichtsconstructie vormen.The posterior atlas vertebra reduction and fixation system according to claim 2, characterized in that the underside of the clamping ring bush (200) and the underside of the through-hole (302) form a ball joint structure. 4 Het reduceer- en fixatiesysteem voor de posterior atlas wervel volgens conclusie 2, met het kenmerk, dat een buitenwand van de klemring bus (200) is voorzien van schroefdraad.The reduction and fixation system for the posterior atlas vertebra according to claim 2, characterized in that an outer wall of the clamping ring bush (200) is threaded. 5. Het reduceer- en fixatiesysteem voor de posterior atlas wervel volgens conclusie 2, met het kenmerk, dat een buitenwand van de schroefkop (101) is voorzien van schroefdraad; waarbij een schroefspil (102) van de atlas schroef (100) door de klemring bus (200) reikt, waarbij de schroefkop (101) is opgenomen in de klemring bus (200) en de schroefkop (101) en de klemring bus (200) in schroefdraadverbinding kunnen zijn.The posterior atlas vertebra reduction and fixation system according to claim 2, characterized in that an outer wall of the screw head (101) is threaded; wherein a lead screw (102) of the atlas screw (100) extends through the clamping ring bushing (200), the screw head (101) being received in the clamping ring bushing (200) and the screw head (101) and the clamping ring bushing (200) may be in threaded connection. 6. Het reduceer- en fixatiesysteem voor de posterior atlas wervel volgens conclusie 2, waarbij de schroefkop (101) een omgekeerde trapeziumvormige afgeknotte kegelstructuur bezit; en waarbij de klemring bus (200) een binnenruimte bezit als een trapeziumvormige afgeknotte kegelstructuur, die overeenkomt met bij de omgekeerde trapeziumvormige afgeknotte kegelstructuur.The posterior atlas vertebra reduction and fixation system of claim 2, wherein the screw head (101) has an inverted trapezoidal frustoconical structure; and wherein the ferrule sleeve (200) has an inner space as a trapezoidal frustoconical structure, which corresponds to the inverted trapezoidal frustoconical structure. 7. Het reduceer- en fixatiesysteem voor de posterior atlas wervel volgens conclusie 2, met het kenmerk, dat de klemring bus (200) binnen de doorgaande opening (302) is geplaatst, waarbij de bovenkant niet buiten een bovenoppervlak van de hoofdplaat (301) reikt.The posterior atlas vertebra reduction and fixation system according to claim 2, characterized in that the ferrule sleeve (200) is disposed within the through-hole (302), the top not being outside an upper surface of the main plate (301). reaches. 8. Het reduceer- en fixatiesysteem voor de posterior atlas wervel volgens een van de conclusies 1 tot 7, met het kenmerk, dat het boogvormige uiteinde van een hoofdplaat (301) is voorzien van een schuifsleuf (303), en waarbij het boogvormige uiteinde van de andere hoofdplaat (301) is voorzien van een met een schroefdraad voorziene opening; en waarbij een instelbout (400) door de schuifsleuf (303) op één hoofdplaat (301) reikt, teneinde te worden vastgezet met een van schroefdraad voorziene opening op de andere hoofdplaat (301).The posterior atlas vertebra reduction and fixation system according to any one of claims 1 to 7, characterized in that the arcuate end of a main plate (301) is provided with a sliding slot (303), and wherein the arcuate end of a main plate (301) is provided with a sliding slot (303). the other main plate (301) has a threaded opening; and wherein an adjusting bolt (400) extends through the sliding slot (303) on one main plate (301) to be secured with a threaded hole on the other main plate (301). 9. Het reduceer- en fixatiesysteem voor de posterior atlas wervel volgens een van de conclusies 1 tot 7, met het kenmerk, dat de boogvormige bovenste en onderste contactvlakken van de twee hoofdplaten (301) getande structuren (305) zijn, die zijn gevormd in een bovenste en onderste aangrijping-modus.The posterior atlas vertebra reduction and fixation system according to any one of claims 1 to 7, characterized in that the arcuate upper and lower contact surfaces of the two main plates (301) are toothed structures (305) formed in an upper and lower engagement mode. 10. Het reduceer- en fixatiesysteem voor de posterior atlas wervel volgens conclusie 9, met het kenmerk, dat de twee getande structuren spiraalvormige tanden zijn.The posterior atlas vertebra reduction and fixation system according to claim 9, characterized in that the two tooth structures are helical teeth.
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