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CN104939902B - 单平面椎弓根螺钉 - Google Patents

单平面椎弓根螺钉 Download PDF

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CN104939902B
CN104939902B CN201510225966.XA CN201510225966A CN104939902B CN 104939902 B CN104939902 B CN 104939902B CN 201510225966 A CN201510225966 A CN 201510225966A CN 104939902 B CN104939902 B CN 104939902B
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screw
arc
pressure ring
ball
positioning pressure
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CN104939902A (zh
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罗卓荆
郑修军
邬春晖
谢宁
寇万福
王晗
高亚军
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Fourth Military Medical University FMMU
Shandong Weigao Orthopedic Materials Co Ltd
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Shandong Weigao Orthopedic Materials Co Ltd
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Priority to US15/571,854 priority patent/US20180132902A1/en
Priority to PCT/CN2016/080674 priority patent/WO2016177297A1/zh
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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, e.g. 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
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A61B17/7005—Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit in the screw or hook heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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, e.g. stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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, e.g. stabilisers comprising fluid filler in an implant
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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, e.g. 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
    • 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 or setting implements
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone
    • A61B17/861—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver
    • A61B17/8615—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver at the central region of the screw head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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
    • A61B17/8635—Tips of screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
    • A61B2090/035—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself preventing further rotation

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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)
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  • Surgical Instruments (AREA)

Abstract

一种单平面椎弓根螺钉，涉及骨科医疗器械技术领域，包括螺钉座、定位压环和球头螺钉，其特征在于球头螺钉的球头上部左右两侧上设有上侧面呈圆弧状向上凸起的侧台，两个侧台之间的球头螺钉的球头上设有上侧面呈圆弧状向上凸起的中央凸台，中央凸台的圆弧圆心与两个侧台的圆弧圆心的连线在同一条直线上，定位压环下部、置棒槽左右两侧上设有与两个侧台相配合的圆弧形凹面，两个圆弧形凹面中部的定位压环内设有与中央凸台相配合的圆弧形凹槽。本发明具有受力均匀、整体强度高，使用过程中螺钉不易出现形变、钉棒系统的整体稳定性好，安全可靠等优点。

Description

单平面椎弓根螺钉
技术领域
本发明涉及骨科医疗器械技术领域，详细讲是一种整体强度高，使用过程中不易出现形变失效、钉棒系统的整体结构稳定性好，术中操作安全可靠，术后固定效果好的单平面椎弓根螺钉。
背景技术
我们知道，现有的椎弓根螺钉主要为单轴椎弓根螺钉和万向椎弓根螺钉。使用的单轴椎弓根螺钉进行二个以上椎体的固定时，常因一侧椎弓根螺钉植入后钉帽方向固定、两个钉帽U 型槽不在同一直线而使连接棒置入困难。万向椎弓根螺钉虽然克服了上述缺点，但由于其万向特征，使其不适用于脊柱侧弯矫形手术。单平面椎弓根螺钉的问世解决了上述技术问题。但现有的单平面椎弓根螺钉实现钉体单平面摆动的结构，都是在万向椎弓根螺钉的基础上，以改变螺钉座下部的球窝形状以及与球窝相配合的球头螺钉的球头形状来实现的。如国家知识产权局2013年05月15日公开的名称为：微创复位用单平面椎弓根螺钉、专利号为：201220532862.5的实用新型专利；2013年06月12日公开的名称为：一种可撑开加压的水平单摆椎弓根螺钉、专利号为：201220647516.1的实用新型专利。相互配合的球窝与球头的形状改变后，使二者间受力不均衡，影响椎弓根钉的整体强度，使用过程中容易出现变形，容易发生术中螺钉失效,严重影响手术安全,给病人带来手术风险。同时,由于和底部球窝接触面小,钉棒系统的结构稳定性差，球头和球窝之间容易打滑，导致病人在术后出现螺钉固定角度丢失,影响手术效果。
发明内容
本发明的目的是解决上述现有技术的不足，提供一种整体强度高，使用过程中不易出现形变失效、钉棒系统的整体稳定性好，术中操作安全可靠，术后固定的单平面椎弓根螺钉。
一种单平面椎弓根螺钉，包括螺钉座、定位压环和球头螺钉，螺钉座上部设有用于穿设连接棒的U形槽，U形槽两侧的螺钉座内壁上设有内螺纹，螺钉座内设有纵向贯通的装配孔，螺钉座下部的装配孔内设有下球窝，球头螺钉的球头与下球窝相配合的装配在螺钉座内，球头螺钉的球头上部设有用于压紧球头的定位压环，定位压环上部设有U形置棒槽，其特征在于球头螺钉的球头上部左右两侧上设有上侧面呈圆弧状向上凸起的侧台，两个侧台之间的球头螺钉的球头上设有上侧面呈圆弧状向上凸起的中央凸台，中央凸台的圆弧圆心与两个侧台的圆弧圆心的连线在同一条直线上，定位压环下部、置棒槽左右两侧上设有与两个侧台相配合的圆弧形凹面，两个圆弧形凹面中部的定位压环内设有与中央凸台相配合的圆弧形凹槽。
本发明中所述的置棒槽左右两侧的定位压环外侧壁上设有防转凸起，螺钉座内壁上与旋转凸起相对应处设有防转卡槽。
本发明中所述的螺钉座内壁上的内螺纹下侧的U形槽两侧的螺钉座内壁上设有卡合凸起，置棒槽左右两侧的环体上端部周向设有向外凸起、与卡合凸起相配合的限位凸环，限位凸环下侧面为斜面，限位凸环下侧的环体外壁上设有外凸起的防转凸台，卡合凸起和卡合凸起下部的螺钉座内壁上设有防转槽。当限位凸环嵌入卡合凸起下时，防转凸台嵌入防转槽内。
本发明中所述的中央凸台的圆弧圆心与两个侧台的圆弧圆心的连线经过球头螺钉球头的球心，中央凸台的圆弧半径与是球头螺钉球头半径的0.9-1.2倍，优选1.1倍，两个侧台的圆弧半径为球头螺钉球头的半径0.4-0.8倍。优选0.5-0.6倍.
本发明中所述的定位压环外周呈与装配孔相配合的柱状。
本发明在使用时，当定位压环卡入卡合凸起下侧、压在球头螺钉的球头上时，球头上的侧台与定位压环置棒槽左右两侧上的圆弧形凹面相配合，中央凸台与定位压环中部的圆弧形凹槽相配合，定位压环两侧的两个圆弧形凹向其中部的圆弧形凹槽过渡的两个侧面，与球头上的两个侧台向其中央凸台过渡的两个侧面相贴配合，由于球头上的两个侧台向其中央凸台过渡的两个侧面与球头螺钉的轴线平行，限定球头只能沿圆弧形凹面的周向摆动。本发明具有受力均匀、整体强度高，使用过程中螺钉不易出现形变、钉棒系统的整体稳定性好，安全可靠等优点。
附图说明
图1是本发明的结构示意图。
图2是本发明中螺钉座的立体结构示意图。
图3是本发明中定位压环的结构示意图。
图4是图3的右视图。
图5是图3的A-A剖视图。
图6是本发明中定位压环的立体结构示意图。
图7是本发明中球头螺钉的结构示意图。
图8是图7的右视图。
图9是本发明中球头螺钉的立体结构示意图。
具体实施方式
如图1-9所示的单平面椎弓根螺钉，包括螺钉座1、定位压环2和球头螺钉3，螺钉座1上部设有用于穿设连接棒的U形槽，U形槽两侧的螺钉座内壁上设有内螺纹，螺钉座内设有纵向贯通的装配孔，螺钉座下部的装配孔内设有下球窝，球头螺钉3的球头4与下球窝相配合的装配在螺钉座1内，球头螺钉3的球头4上部的装配孔内设有用于压紧球头4的定位压环2，定位压环2外周呈与装配孔相配合的柱状。定位压环2上部设有U形置棒槽，其特征在于球头螺钉3的球头4上部左右两侧上设有上侧面呈圆弧状向上凸起的侧台5，侧台5上侧的圆弧面的旋转轴线通过球头的中心。两个侧台5之间的球头螺钉的球头4上设有上侧面呈圆弧状向上凸起的中央凸台6，中央凸台6上侧面圆弧的圆心与两个侧台的圆弧圆心的连线在同一条直线上，中央凸台6上侧面的圆弧直径大于侧台5的圆弧直径，中央凸台6与两个侧台相连的两个侧面7为竖直平面、与球头螺钉3的轴线平行，中央凸台6的圆弧圆心与两个侧台的圆弧圆心的连线经过球头螺钉球头的球心，中央凸台的圆弧半径是球头螺钉球头半径的0.9-1.2倍，优选1.1倍，两个侧台的圆弧半径为球头螺钉球头的半径0.4-0.8倍。优选0.5-0.6倍。定位压环2下部、置棒槽左右两侧上设有与两个侧台5相配合的圆弧形凹面8，两个圆弧形凹面8中部的定位压环内设有与中央凸台6相配合的圆弧形凹槽9；两个圆弧形凹面8与圆弧形凹槽9间的连接面为竖直平面。
本发明进一步改进，所述的螺钉座1内壁上的内螺纹下侧的U形槽两侧的钉座主体内壁上设有卡合凸起10，置棒槽左右两侧的定位压环2的环体上端部周向设有向外凸起、与卡合凸起10相配合的限位凸环11，限位凸环11下侧面为斜面，限位凸环11下侧的环体外壁上设有外凸起的防转凸台12，卡合凸起10和卡合凸起下部的螺钉座内壁上设有防转槽13。当限位凸环嵌入卡合凸起下时，防转凸台12嵌入防转槽13内。
本发明在使用时，当定位压环卡入卡合凸起下侧、压在球头螺钉的球头上时，球头上的侧台与定位压环置棒槽左右两侧上的圆弧形凹面相配合，中央凸台与定位压环中部的圆弧形凹槽相配合，定位压环两侧的两个圆弧形凹向其中部的圆弧形凹槽过渡的两个侧面与球头上的两个侧台向其中央凸台过渡的两个侧面相贴配合，由于球头上的两个侧台向其中央凸台过渡的两个侧面与球头螺钉的轴线平行，限定球头只能沿圆弧形凹面的周向摆动。本发明具有受力均匀、整体强度高，术中操作安全可靠，术后固定效果好。

Claims (5)

1.一种单平面椎弓根螺钉，包括螺钉座、定位压环和球头螺钉，螺钉座上部设有用于穿设连接棒的U 形槽，U 形槽两侧的螺钉座内壁上设有内螺纹，螺钉座内设有纵向贯通的装配孔，螺钉座下部的装配孔内设有下球窝，球头螺钉的球头与下球窝相配合的装配在螺钉座内，球头螺钉的球头上部的装配孔内设有用于压紧球头的定位压环，定位压环上部设有U形置棒槽，其特征在于球头螺钉的球头上部左右两侧上设有上侧面呈圆弧状向上凸起的侧台，两个侧台之间的球头螺钉的球头上设有上侧面呈圆弧状向上凸起的中央凸台，中央凸台的圆弧圆心与两个侧台的圆弧圆心的连线在同一条直线上，定位压环下部、置棒槽左右两侧上设有与两个侧台相配合的圆弧形凹面，两个圆弧形凹面中部的定位压环内设有与中央凸台相配合的圆弧形凹槽。
2.根据权利要求1 所述的单平面椎弓根螺钉，其特征在于所述的置棒槽左右两侧的定位压环外侧壁上设有防转凸起，螺钉座内壁上与旋转凸起相对应处设有防转卡槽。
3.根据权利要求1 所述的单平面椎弓根螺钉，其特征在于所述的螺钉座内壁上的内螺纹下侧的U 形槽两侧的螺钉座内壁上设有卡合凸起，置棒槽左右两侧的环体上端部周向设有向外凸起、与卡合凸起相配合的限位凸环，限位凸环下侧面为斜面，限位凸环下侧的环体外壁上设有外凸起的防转凸台，卡合凸起和卡合凸起下部的螺钉座内壁上设有防转槽。
4.根据权利要求1 或2 或3 所述的单平面椎弓根螺钉，其特征在于所述的中央凸台的圆弧圆心与两个侧台的圆弧圆心的连线经过球头螺钉球头的球心，中央凸台的圆弧半径是球头螺钉球头半径的0.9-1.2 倍，两个侧台的圆弧半径为球头螺钉球头的半径0.4-0.8倍，。
5.根据权利要求4 所述的单平面椎弓根螺钉，其特征在于所述的定位压环外周呈与装配孔相配合的柱状。
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