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CN106510834B - Installation tool for pedicle of vertebral arch fixing system - Google Patents

Installation tool for pedicle of vertebral arch fixing system Download PDF

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Publication number
CN106510834B
CN106510834B CN201611035518.4A CN201611035518A CN106510834B CN 106510834 B CN106510834 B CN 106510834B CN 201611035518 A CN201611035518 A CN 201611035518A CN 106510834 B CN106510834 B CN 106510834B
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China
Prior art keywords
central tube
pedicle
check
return
sheet
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CN201611035518.4A
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Chinese (zh)
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CN106510834A (en
Inventor
周锦
韦冬
朱雅龙
周建峰
虞晓俊
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Changzhou Huasen Medical Instrument Co.,Ltd.
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Changzhou Waston Medical Appliance Co Ltd
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Publication of CN106510834A publication Critical patent/CN106510834A/en
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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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • A61B17/7082—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/90—Guides 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
    • A61B2017/564—Methods for bone or joint treatment
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
    • A61B2017/922—Devices for impaction, impact element
    • A61B2017/924—Impact element driving means
    • A61B2017/925—Impact element driving means a spring

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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)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention relates to an installation tool for a pedicle fixing system, which comprises a central tube, a lifting assembly and a handle. The lifting component is sleeved on the central pipe by the lifting sleeve, can move up and down along the axis direction of the central pipe relative to the central pipe, and is blocked by the non-return device of the lifting component when the lifting component moves down; the non-return device also has the function of manually releasing non-return; when the central tube is used, the lower end part of the central tube can be downwards pressed on the connecting rod and is limited in the circumferential direction. The lifting sleeve is provided with a limiting device which can limit the tail of each opening sheet when in use so as to close the tail of the opening sheet. The handle is fixedly arranged on the upper end head of the central tube when in use. When an operator holds the handle to rotate, the pedicle fixing unit can be effectively and directly positioned to a required position by rotating the connecting rod, namely, the pedicle screw is rotated in place, so that the operation steps are greatly simplified, and a series of problems in installing the pedicle fixing system can be effectively solved.

Description

Installation tool for pedicle of vertebral arch fixing system
Technical Field
The invention relates to the technical field of medical instruments, in particular to an installation tool for a pedicle fixing system.
Background
A pedicle fixation system (hereinafter also referred to simply as a fixation system) is usually composed of a plurality of pedicle fixation units, each of which includes a pedicle screw, a clamping ring, a seat, a connecting rod, and a compression screw. The lower part of the support is provided with a through hole, the support is also provided with a side leg part, the side leg part is provided with an internal thread and 2 oppositely arranged side legs, and a U-shaped channel is formed between the 2 side legs. The upper part of the pressing ring is provided with a U-shaped groove, the pressing ring is sleeved and buckled on the head of the pedicle screw from the upper part of the pressing ring from the lower part of the pressing ring, and the pressing ring and the pedicle screw are in close contact. The pedicle screw passes through the through hole at the lower part of the support from top to bottom by the tail part of the pedicle screw, and the head part of the pedicle screw is limited at the through hole, at the moment, the U-shaped groove of the pressing ring and the U-shaped channel of the support are arranged along the same direction, and the U-shaped groove of the pressing ring is positioned in the U-shaped channel of the support. The connecting rod is matched with the U-shaped channel of the support and the U-shaped groove of the pressing ring.
When the pedicle screw is screwed into the pedicle, the pedicle screw is pressed by the pressing ring positioned above the pedicle screw, and the pressing ring is pressed by the pressing screw, so that the pedicle screw can be screwed into the pedicle. Then adjustments to the fixation system are made. Before adjustment, the connecting rod is required to be arranged between 2 adjacent pedicle fixing units or between 3 adjacent pedicle fixing units. The specific installation method comprises the following steps: after the compression screw is screwed down, one end of the connecting rod is embedded into the U-shaped channel of the support and the U-shaped groove of the pressing ring, and then the compression screw is screwed up and screwed, so that the head of the pedicle screw positioned below is pressed on the support through the pressing ring. The other end of the connecting rod is inserted into the U-shaped channel of the support of the adjacent other pedicle fixing unit and fixed on the other support in the same way, so that the adjacent 2 pedicle fixing units are fixedly connected with each other. According to the requirement, one connecting rod can be connected with 3 pedicle fixing units which are adjacent in sequence and located on a straight line. The entire fixation system can then be adjusted until the adjustment is complete.
The internal fixation technology of the vertebral pedicle screws of the vertebral column is a mature spinal surgery technology and is widely applied to treatment of spinal trauma and degenerative diseases such as spinal fracture, scoliosis, spinal slippage and the like. The traditional pedicle screw internal fixation technology needs to carry out open posterior surgery, corrects spinal deformity well and maintains the stability of the spine, but has large surgical trauma and more blood loss in the surgery due to the fact that extensive tissue incision and long-time traction of surrounding tissues are needed in the surgical process. Meanwhile, the lumbar and back muscles are subjected to ischemic necrosis and fibrosis due to excessive traction and damage to the paraspinal muscles in the operation process, so that the patient cannot get out of bed for early time due to chronic lumbar and back pain after the operation, and needs to lie in bed for a long time after the operation, and the complication incidence rate is obviously increased.
The minimally invasive surgery can be performed in a human body in a small wound environment by using modern medical equipment such as an endoscope and has the advantages of small wound, light pain and quick recovery. By combining the internal fixation technology of the vertebral pedicle screws and the minimally invasive surgery, the technical personnel in the field develop the internal fixation technology of the vertebral pedicle screws, and successfully solve the defects of large operation incision, more muscle stripping, more bleeding, large damage of a posterior stable structure, slow rehabilitation and the like in the traditional internal fixation technology of the vertebral pedicle screws. However, the percutaneous internal fixation of the spine needs to be performed by means of minimally invasive surgery, and the visual field of an operator is poor in the surgical process, so that the problems of complex surgical operation, long surgical time, high difficulty and the like are caused.
In order to solve the above problems, a technique of providing a distraction piece on a support of a pedicle fixation system to ensure that the entire surgical site is exposed in the visual field has been developed, and the use of the distraction piece enables an operator to push the tissue outside the spine outward from the distraction piece during surgery, thereby facilitating the replacement of the connecting rod and the adjustment of the entire fixation system. However, when the existing distraction sheet is fixedly connected with the support, the distraction sheet is required to be installed on the support by using a special instrument during fixation, or the distraction sheet is directly inserted into the upper part of the side leg part of the support, the special instrument can bring great inconvenience and troublesome operation to the operation when the distraction sheet is installed on the support, the special instrument can completely expose the operation part in the visual field, but the situation that the distraction sheet is directly inserted into the tail part of the support is easy to fall off in the operation process, and the smooth operation is not facilitated.
Chinese patent document CN204931830U discloses a pedicle of vertebral arch fixing system, which comprises a support and a spreading sheet, wherein the support tail has two symmetrical side legs, the spreading sheet comprises an integrated spreading sheet main body and a connector, the connector and the side legs can be disassembled to be fixed, the side legs are provided with a fixing groove, the connector is provided with a sliding groove along the length direction of the spreading sheet, the shape of the sliding groove is matched with the shape of the side legs, and a convex block which is matched with the fixing groove and is used for fixing the spreading sheet and the support is arranged in the sliding groove. "when the side leg along the spout slip in-process, the spout can produce little deformation under the effect of lug, when the side leg slides extreme position, the lug just in time card is established in the fixed slot, simple to operate to strutting the piece and having effectively avoided and having come off from the support".
However, when the pedicle fixation system with the distraction plate is installed, the distraction plate is usually installed on the pedicle seat first, and then the pedicle fixation system with the distraction plate is installed at the pedicle of the vertebral arch. If the spreader plates are simply mounted together, it is not conducive to rotating the instrument to fix the pedicle screws. If the opening sheet is firstly opened and then installed, the operation incision is inaccurate due to the influence of the opening sheet on the sight. If the incision is too large, unnecessary damage is caused to the patient; if the incision is too small, the distraction plate will shear the tissue surrounding the incision when the pedicle screw is installed. Thus, the installation of a pedicle fixation system with a spreader plate remains a significant problem for physicians in the field.
Disclosure of Invention
In order to solve the problems, the invention provides an installation tool for a pedicle fixing system, which can smoothly install the pedicle fixing system when in use, can effectively avoid the interference of the distraction piece on the installation process, and effectively solves the installation problem of the pedicle fixing system with the distraction piece.
The technical scheme adopted by the invention for solving the technical problems is as follows: the invention discloses a mounting tool for a pedicle fixing system, which comprises 2 distraction pieces. The structure is characterized in that: also comprises a central tube, a lifting component and a handle. The lifting assembly comprises a lifting sleeve and a check device; when the lifting assembly is used, the lifting sleeve is sleeved on the central pipe, can move up and down along the axis direction of the central pipe at the middle upper part of the central pipe relative to the central pipe, and is blocked by the non-return device when the lifting sleeve moves downwards along the axis direction of the central pipe; the non-return device also has the function of manually releasing non-return; when in use, the central tube can be arranged on the connecting rod of the pedicle fixing system in a downward pressing manner from the lower end part of the central tube and is limited in the circumferential direction, so that the central tube and the pedicle fixing system can rotate together; the lifting sleeve is provided with a corresponding limiting part which can limit the tail part of each sheet expanding piece when in use, each sheet expanding piece can be close to one corresponding side arranged on the left side and the right side of the central tube when in use, and the lower end of each sheet expanding piece can be fixedly connected to one corresponding side leg of the support when in use. The handle is fixedly arranged on the upper end head of the central tube when in use. When the pedicle screw is fixed by using the installation tool, the tail part of the supporting sheet is folded in the lifting assembly, so that an operator can hold the handle by hand or hold the handle and the lifting sleeve by hand simultaneously to press the installation tool against the connecting rod to adjust the pedicle fixing unit to a proper position, the pedicle screw can be screwed into the pedicle by the installation tool more easily, the working strength of the operator is greatly reduced, and the workload is reduced.
The front side plate and the rear side plate of the lower end part of the central tube are provided with a pair of arc-shaped clamping grooves, so that the central tube is clamped with the connecting rod through the pair of arc-shaped clamping grooves when in use, and the central tube is circumferentially limited with the connecting rod. The handle is a spherical handle made of rubber; when in use, the spherical handle is sleeved on the upper end head of the central tube in a tight fit manner. Because the lower extreme at the center tube sets up the arc draw-in groove and as the operation position to fixed unit, can be effective and directly to fixing the unit rotational positioning to required position through rotating the connective bar with the pedicle of vertebral arch. Meanwhile, the handle is arranged to be spherical and made of rubber materials, so that the operation is more facilitated.
The lifting assembly comprises a lifting sleeve and 2 check devices; the central tube is provided with a blocking part at each side of the front side and the rear side of the upper part of the central tube; when the pulling assembly is used, the pulling sleeve is sleeved on the central pipe, and when the pulling assembly is used, the pulling sleeve moves relative to the central pipe in the middle upper part of the central pipe along the axial direction of the central pipe; each side of the left side and the right side of the lifting sleeve is provided with a limiting part which can limit the tail part of a corresponding one of the spreading pieces; each non-return device is arranged on one corresponding side of the front side and the rear side of the pulling sleeve when in use and can prevent the pulling sleeve from moving downwards when the pulling sleeve moves along the axis direction of the central tube under the combined action of the corresponding blocking parts of the central tube. The provision of 2 non-return means is advantageous to increase the stability of the pulling sleeve when it moves relative to the central tube. The arrangement can be more beneficial to the operator to adjust the upper and lower positions of the lifting sleeve according to the requirements in the operation process, and the operation is convenient.
The blocking part at the middle upper part of the central tube is a plurality of non-return teeth which are arranged on the plate bodies of the front and rear side plates of the central tube, are positioned at the middle upper part of the plate bodies and face outwards; each non-return device comprises a non-return sheet, a rotating shaft and an elastic mechanism; the front side and the rear side of the lifting sleeve are respectively provided with a check groove part; each check groove part of the lifting sleeve is provided with a corresponding check groove; the rotating shaft is arranged on a corresponding non-return groove part of the lifting sleeve, the non-return sheet is sleeved on the rotating shaft and is positioned in the non-return groove of the non-return groove part, and the lower end of the non-return sheet is provided with a latch which can be meshed with the non-return teeth when in use; the elastic mechanism is arranged on the check sheet or on the check sheet and the rotating shaft simultaneously, and when the elastic mechanism is used, the latch of the check sheet can be elastically meshed with the corresponding check tooth by the elastic force of the elastic mechanism. This arrangement makes the operation of the non-return means more reliable and simple to operate.
The elastic mechanism is a compression spring which is arranged on the check sheet and positioned on the upper part of the check sheet, or the elastic mechanism is a torsion spring which is arranged on the check sheet and the rotating shaft. This arrangement makes the operation of the non-return means more reliable and simple to operate.
And each non-return groove part of the lifting sleeve is provided with a blocking plate positioned at the upper part of the non-return groove, and the blocking plate corresponds to the upper part of the corresponding non-return sheet. This arrangement makes the operation of the non-return means more reliable and simple to operate.
The elastic mechanism is a compression spring arranged on the check sheet, and the upper end part of the check sheet is provided with a limiting block. The arrangement is simple and quick when the non-return device is installed.
The limiting parts on each of the left side and the right side of the lifting sleeve are 1-2 positioning bulges arranged on each of the left side and the right side of the lifting sleeve and positioning clamping grooves arranged around the positioning bulges. This arrangement facilitates rapid positioning of the spreader blade.
The pulling assembly further comprises an outer sleeve; the outer sleeve is provided with 2 operation windows; when the outer sleeve is used, the outer sleeve is sleeved on the pulling sleeve, each operation window of the outer sleeve is aligned with the check piece of the corresponding check device, the upper portion of each check piece is located in the corresponding operation window under the condition that the latch of each check piece is elastically meshed with the corresponding check tooth, and therefore the upper portion of each check piece can be limited in the circumferential direction by the operation window. The outer sleeve is arranged to limit the radial outer side of the spreading piece, and the operation window is arranged to operate the check device through the window.
Each side of the left side and the right side of the lifting sleeve is provided with a pull lug positioned at the lower part, the two pull lugs are symmetrically arranged, and each pull lug is provided with a hollow channel which is penetrated up and down and is convenient for the tail part of the spreading piece to penetrate when in use. The pull lug is arranged, so that an operator can conveniently hold the lifting assembly by hands to perform corresponding operation.
The 2-piece expanding piece is an injection molding integrated piece or a titanium alloy integrated piece with the same shape. The spreading sheet comprises a spreading sheet main body, a connector, a spreading sheet tail (also called tail for short) and a bump. The connector, the main body of the spreading sheet and the tail part of the spreading sheet are connected in sequence. The main body of the spreading sheet and the tail part of the spreading sheet are in a straight flat plate shape. The connector is divided into a front limit part, a connecting plate and a rear limit part. Preceding spacing portion and back spacing portion front and back symmetry set up the front and back both sides towards the terminal surface of outside of terminal surface about the connecting plate, and form two relative spouts that set up, wherein form preceding spout between preceding spacing portion and the connecting plate, then form the back spout between connecting plate and the back spacing portion. The lug sets up and connects on the connecting plate, and stretches out towards the direction that sets up the spout. When the support is used, each spreading piece is fixedly connected with the upper section of the side leg of the corresponding side leg in the left side leg and the right side leg of the support through the connector of the spreading piece according to a detachable inserting and fixing mode. The main body of the distraction piece and the tail part of the distraction piece are arranged to be in a straight-line shape, so that 2 pieces of distraction pieces which are arranged oppositely can be conveniently distracted by a distracter, and the requirement of certain degree of elastic deformation during distraction is met.
The opening sheet main body is provided with a plurality of positioning holes, the positioning holes are waist-round holes, and the long axis direction of the waist-round holes is consistent with the length direction of the opening sheet. The specific number of pilot holes is 3-6, preferably 4. The design of the positioning hole can effectively solve the problem that the positioning of the distraction piece is difficult in the operation process; the waist round holes are selected as the positioning holes, and the opening amplitude of the opening sheet can be finely adjusted through the waist round holes after the opening position of the opening sheet is fixed, so that the operation is adapted, and the applicability of the opening sheet is further enhanced. The two distraction pieces are preferably the distraction pieces with the same shape and material, thereby being more beneficial to the operation.
The invention has the beneficial effects that: according to the installation tool for the pedicle fixing system, the distraction piece of the pedicle fixing system can be firstly folded by the sleeve and the lifting component, and meanwhile, the central tube, the lifting component and the connecting rod are matched to form the installation tool for the pedicle fixing system, so that the pedicle fixing system can be smoothly installed, and the interference of the distraction piece on the installation process can be effectively avoided. Meanwhile, in the installation and operation process, an operator sleeves a spherical handle on the upper end head of the central tube through tight fit and uses an arc-shaped clamping groove arranged at the lower end of the central tube as an operation part for the fixing unit, so that the pedicle fixing unit can be effectively and directly positioned to a required part in a rotating way by rotating the connecting rod; the workload of the operator is reduced. Meanwhile, the handle is arranged to be spherical and made of rubber, so that the operation is more facilitated; the installation problem of the pedicle fixing system with the distraction piece can be effectively solved through the arrangement.
Drawings
FIG. 1 is a schematic view of the installation tool of the present invention for installing a pedicle fixation system, which is divided into a left drawing, a middle drawing and a right drawing according to the position of the drawing. The middle drawing is a perspective schematic view of the installation tool for installing the pedicle fixing system, the left drawing is a partial enlarged schematic view of the circled part at the upper part of the middle drawing, and the right drawing is a partial enlarged schematic view of the circled part at the lower part of the middle drawing.
Fig. 2 is an exploded perspective view of fig. 1.
FIG. 3 is an exploded perspective view of the pull sleeve and backstop device of FIG. 2, with the view direction rotated 90 degrees relative to FIG. 2.
Fig. 4 is a schematic perspective view of the center tube of fig. 2.
Fig. 5 is a perspective view of the right side one of the spreader plates of fig. 2.
Fig. 6 is a schematic view of the assembly of the holder of the pedicle fixation system of fig. 1 in cooperation with the 2-piece spreader plate of the installation tool of the invention.
The reference numbers in the above figures are as follows:
the distraction piece 1, the distraction piece main body 11, the connector 12, the front limiting part 12-1, the connecting plate 12-2, the rear limiting part 12-3, the distraction piece tail 13, the bump 14, the positioning hole 15, the fixing hole 16, the sliding groove 17, the front sliding groove 17-1, the rear sliding groove 17-2, the support 2, the side leg 21, the side leg upper section 21-1, the side leg lower section 21-2, the fixing groove 22, the fracture opening 23, the central tube 3, the arc-shaped clamping groove 31, the non-return tooth 32, the front side plate 33, the connecting rod 41, the compression screw 42, the pedicle screw 43, the pressing ring 44, the lifting sleeve 5, the pulling lug 51, the hollow channel 52, the non-return groove 53, the positioning clamping groove 54, the positioning bulge 55, the blocking plate 56, the rotating shaft hole 57, the pressing spring hole 58, the outer sleeve 6, the operation window 61, the non-return piece 71, the clamping tooth 71-1, the limiting block 71-2 and, mounting post 73, knob 8.
Detailed Description
The present invention will be described in further detail with reference to the following drawings and examples. These drawings are simplified schematic views illustrating only the basic structure of the present invention in a schematic manner, and thus show only the constitution related to the present invention.
(example 1)
Referring to fig. 1 and 2, the installation tool for pedicle fixation system of the present embodiment includes: center tube 3, lifting component, knob 8 and 2 piece distraction piece 1.
Still referring to fig. 1 and 2, the pulling assembly can be sleeved on the central tube 3 and can move along the axial direction of the central tube 3 at the middle upper part of the central tube 3 relative to the central tube 3 when in use. When in use, the central tube 3 can be arranged on the connecting rod 41 of the pedicle fixing system in a downward pressing manner from the lower end of the central tube and is limited in the circumferential direction, so that the central tube 3 and the pedicle fixing system can rotate together. The lifting component is provided with a corresponding limiting part which can limit the tail part 13 of each sheet opening sheet 1 when in use, each sheet opening sheet 1 can be close to the corresponding side arranged on the left side and the right side of the central tube 3 when in use, and the lower end of each sheet opening sheet 1 is a part which can be fixedly connected on the corresponding side leg 21 of the support 2 when in use. The knob 8 is an integral piece of rubber. When in use, the spherical handle 8 is sleeved on the upper end head of the central tube 3 in a tight fit manner.
The central tube 3, see fig. 4, is a one-piece of steel, provided with a lower end portion and 2 stops. A pair of arc-shaped clamping grooves 31 are formed in the front side plate and the rear side plate of the lower end part, namely, when the central tube 3 is used, the connecting rod 41 is clamped through the pair of arc-shaped clamping grooves 31, so that the central tube and the connecting rod 41 are limited in the circumferential direction (figure 1). Each blocking part of the central tube 3 is arranged on a corresponding plate body on the front side and the rear side of the tube body, namely, each blocking part is a plurality of non-return teeth 32 which are arranged on a corresponding plate body of the front side plate and the rear side plate of the central tube 3, are positioned on the middle upper part of the plate body and face to the outer side.
Referring to fig. 3, the pull assembly includes a pull sleeve 5, an outer sleeve 6 and 2 non-return means. Referring to fig. 1, the pulling sleeve 5 of the pulling assembly is sleeved on the central tube 3 when the pulling assembly is in use, and the pulling sleeve 5 of the pulling assembly moves relative to the central tube 3 in the axial direction of the central tube 3 at the middle upper part of the central tube 3 when the pulling assembly is in use. Said non-return means are arranged, in use, on respective ones of the front and rear sides of the lifting sleeve 5 and are able to prevent the lifting sleeve 5 from moving downwards when it moves in the axial direction of the central tube 3, under the co-action of respective stops of the central tube 3.
Referring to fig. 1 and 3, the lifting sleeve 5 of the lifting assembly is an injection-molded integral piece, and is provided with a central portion, 2 limiting portions, 2 check groove portions, 2 pull lugs 51 and 2 blocking plates 56. The central part of the lifting sleeve 5 is provided with a central through hole, and the central through hole of the lifting sleeve 5 is sleeved on the central pipe 3 when in use. The 2 limiting parts are positioned at the left side and the right side of the central part, and the limiting part at each side can limit the tail part 13 of the corresponding spreading piece 1 when in use. The limiting part on each side of the left side and the right side is 2 positioning bulges 55 arranged on the corresponding side of the left side and the right side of the lifting sleeve 5 and a positioning clamping groove 54 arranged around the positioning bulges 55. The 2 non-return groove parts are positioned at the front side and the rear side of the central part, and the non-return groove part at each side is provided with a corresponding non-return groove 53. The 2 pulling lugs 51 are positioned at the left side and the right side of the central part and below the corresponding positioning bulges 55, the two pulling lugs 51 are symmetrically arranged, and each pulling lug 51 is provided with a hollow channel 52 which is convenient for the tail part 13 of the distraction piece 1 to penetrate through and penetrates through up and down when in use. Each of the 2-blocker plates 56 is positioned at an upper portion of the check groove 53 of the corresponding check groove portion. Each stop plate 56 is provided with a compression spring hole 58. Each non-return groove part of the lifting sleeve 5 is also provided with 2 rotating shaft holes 57 arranged along the left and right directions, and the axes of the 2 rotating shaft holes are on the same straight line.
Still referring to fig. 1 and 3, each of the 2 non-return devices of the pulling assembly includes a non-return tab 71, a rotating shaft 72, a spring mounting post 73 and a resilient mechanism. The check sheet 71 is an injection-molded integral piece, the rotating shaft 72 and the spring mounting column 73 are both steel integral pieces, and the elastic mechanism is a steel compression spring. The rotating shaft 72 is provided on a corresponding one of the check groove portions of the pulling-up sleeve 5, and passes through a corresponding rotating shaft hole 57. The check piece 71 is fitted over the rotary shaft 72 from the lower portion thereof, and the check piece 71 is located in the check groove 53 of the check groove portion. The lower end of the check sheet 71 is provided with a latch 71-1 which can be engaged with the check tooth 32 in use. The spring mounting posts 73 are provided as inserts on the check plate 71 when the check plate 71 is injection molded. The elastic mechanism is arranged on the check sheet 71, in this embodiment, a compression spring as the elastic mechanism is fixedly sleeved on the spring mounting post 73 by one end, and the other end of the compression spring passes through the spring hole of the corresponding stop plate 56 and is in elastic contact with a corresponding side plate of the front and rear side plates of the central tube 3 in use, so that the upper part of the check sheet 71 extends to the outward side of the front and rear sides under the action of elastic force, and the latch 71-1 of the check sheet 71 at the lower end is elastically engaged with the corresponding check tooth 32 of the central tube 3.
Referring to fig. 1 and 2, the outer sleeve 6 of the pull assembly is an injection molded unitary piece. The outer sleeve 6 is provided with 2 operating windows 61. The outer sleeve 6 is in use fitted over the lifting sleeve 5 with each of its operating windows 61 aligned with the non-return tab 71 of a respective one of the non-return means and with the non-return tabs 71 in their upper part in the operating windows 61 in the state of their latch teeth 71-1 resiliently engaging with the respective non-return teeth 32, so that the operating windows 61 now position the upper part of the non-return tabs 71 in the circumferential direction.
Referring to fig. 5 and 6, the 2-piece spreader plate 1 is an injection-molded integral piece with the same shape or a titanium alloy integral piece formed by printing a titanium alloy material through a 3D printer. The spreading sheet 1 comprises a spreading sheet main body 11, a connector 12, a spreading sheet tail 13 (also referred to as tail 13 for short) and a bump 14. The connector 12, the distraction piece main body 11 and the distraction piece tail 13 are connected in sequence. The connector 12 includes a front stopper 12-1, a connecting plate 12-2, and a rear stopper 12-3. The front limit part 12-1 and the rear limit part 12-3 are symmetrically arranged at the front and rear sides of one end surface facing to the outside of the front and rear end surfaces of the connecting plate 12-2 in front and rear directions and form two oppositely arranged sliding grooves 17, wherein the front sliding groove 17-1 is formed between the front limit part 12-1 and the connecting plate 12-2, and the rear sliding groove 17-2 is formed between the connecting plate 12-2 and the rear limit part 12-3. The projection 14 is disposed and connected to the connecting plate 12-2 and projects toward the direction in which the slide groove 17 is disposed. When in use, each opening sheet 1 is fixedly connected with the upper section 21-1 of the corresponding one 21 of the left and right side legs of the support 2 through the connector 12 thereof according to a detachable splicing and fixing mode.
Referring to fig. 5, the spreader body 11 is provided with a plurality of positioning holes 15, the positioning holes 15 are waist-shaped holes, and the long axis direction of the waist-shaped holes is consistent with the length direction of the spreader 1. The specific number of positioning holes 15 is 3-6. Preferably 4 in this embodiment. The positioning hole 15 is designed, so that the problem that the positioning of the distraction piece is difficult in the operation process can be effectively solved; the positioning hole 15 is a waist circular hole, and the opening amplitude of the opening sheet 1 can be finely adjusted through the waist circular hole after the opening position of the opening sheet 1 is fixed, so that the operation is adapted, and the applicability of the opening sheet 1 is further enhanced.
(application example 1)
Referring to fig. 1-6, this application uses the installation tool described in example 1 and connects the installation tool to the pedicle fixation system.
The pedicle fixation system of this application example includes a plurality of pedicle fixation units. As shown in fig. 1 and 2, each pedicle fixation unit includes a pedicle screw 43, a pressing ring 44, a holder 2, a connecting rod 41, and a compression screw 42. The lower part of the support 2 is provided with a through hole, the support 2 is also provided with a side leg part, the side leg part is provided with an internal thread and is provided with 2 oppositely arranged side legs 21, and a U-shaped channel is formed between the 2 side legs 21. The upper part of the pressing ring 44 is provided with a U-shaped groove, and the pressing ring 44 is sleeved on the head of the pedicle screw 43 from the upper part by the lower part thereof, and the pressing ring and the pedicle screw are in close contact. The pedicle screw 43 passes through the through hole at the lower part of the support 2 from the tail part thereof from the top to the bottom, and the head part thereof is limited at the through hole, at this time, the U-shaped groove of the pressing ring 44 and the U-shaped channel of the support 2 are arranged along the same direction, and the U-shaped groove of the pressing ring 44 is positioned in the U-shaped channel of the support 2. The connecting rod 41 cooperates with the U-shaped channel of the holder 2 and with the U-shaped groove of the clamping ring 44. For the connecting rod 41 to remain in the body, the connecting rod 41 can be pressed by its one end into the U-shaped channel of the holder 2 and into the U-shaped groove of the clamping ring 44 against the head of the pedicle screw 43 lying below. The compression screw 42 is screwed on the internal thread of the side leg part of the support 2, and compresses the connecting rod 41 from the upper part, thereby compressing the pedicle screw 43. The other end of the connecting rod 41 is inserted into the U-shaped channel groove of the holder of the adjacent other pedicle fixation unit and fixed on the other holder, so that the adjacent 2 pedicle fixation units are fixedly connected with each other. The connection between other adjacent pedicle fixing units of the whole pedicle fixing system can also be that one connecting rod is connected with 3 sequentially adjacent three pedicle fixing units on a straight line according to the requirement. When the pedicle screws 43 are screwed in after the holes are drilled in the pedicles, the length of the connecting rod 41 is shorter and only fixedly connected to one support 2, so that the pedicle screws 43 can be conveniently screwed into the pedicles along with the rotation of the installation tool.
When the installation tool and the pedicle fixing unit obtained in the embodiment 1 are used for performing operation together, the installation tool is assembled firstly, then the installation tool is connected with the pedicle fixing unit, and then the pedicle fixing unit is fixed until the operation of the whole pedicle fixing system is completed, wherein the method comprises the following specific main steps:
first, each check means is installed in a corresponding one of the check groove portions of the lifting sleeve 5, that is, one end of the compression spring is fitted over the installation post 73 fixed to the upper portion of the check piece 71, and the other end of the compression spring is made to protrude into the compression spring hole 58 of the blocking plate 56, and one surface of the stopper 71-2 of the check piece 71, which faces the outside of the front and rear sides, is made to face the inner wall of the central through hole of the lifting sleeve 5, which faces the central axis, thereby positioning the check piece 71 at the corresponding check groove 53 by the compression spring. The rotating shaft 53 is then passed through one of the rotating shaft holes 57 of the check groove portion, the corresponding mounting hole of the lower portion of the check piece 71 and the other rotating shaft hole 57 of the check groove portion in this order, whereby the check device is mounted on the pull-up sleeve 5. When the rotation shaft 72 is inserted through the mounting hole of the lower portion of the check piece 71, the check piece 71 is moved downward by a small distance with respect to the check groove 53, so that the stopper 71-2 of the check piece 71 enters the check groove 53. The installation mode enables the check device to be installed conveniently and quickly.
Secondly, each of the 2 spreading pieces 1 passes through the hollow channel 52 of the pull lug 51 of the lifting sleeve 5 from bottom to top from the tail part 13 thereof, then extends into the positioning slot 54 of the lifting sleeve 5, and is sleeved on the positioning protrusion 55 of the lifting sleeve 5 by the 2 fixing holes 16 thereof.
Third, the outer sleeve 6 is fitted over the pull sleeve 5 such that each of the operating windows 61 of the outer sleeve 6 is aligned with a corresponding one of the check tabs 71 and the tail portions 13 of the 2 spreader tabs 1 are also all located in the outer sleeve 6.
Fourthly, the spherical handle 8 is sleeved on the upper end head of the central tube 3, then the central tube 3 passes through the central through hole of the lifting sleeve 5 from top to bottom from the lower end head, and the front side and the rear side of the central tube 3 provided with the non-return teeth 32 correspond to the front side and the rear side of the lifting sleeve 5 provided with the non-return grooves 53. When the central tube 3 is inserted into the pulling sleeve 5, the front side plate 33 and the rear side plate thereof are both in elastic contact with the latch 71-1 of the check piece 71 and push the latch 71-1 outward until the central tube 3 reaches a desired position relative to the pulling sleeve 5. At this time, when the center tube 3 is moved upward relative to the pulling sleeve 5 by the compression spring, the lower end surface of the latch 71-1 of the check piece 71 is in contact with the upward end surface of the check tooth 32 of the center tube 3 to be stopped, and is thereby caught and stopped. At this time, the user needs to press the upper portion of the check tab 71 from outside to inside with his/her finger so that the lower end surface of the latch 71-1 is separated from the upper end surface of the check tooth 32 of the center tube 3, and the center tube 3 can be moved upward. So that the position of the central tube 3 relative to the pulling sleeve 5 can be adjusted.
Fifthly, when the position of the central tube 3 relative to the pulling sleeve 5 is adjusted to be in place, the connection between the pedicle fixing unit and the installation tool can be carried out. Referring to fig. 6, each side leg 21 of the support 2 is divided into an upper side leg section 21-1 and a lower side leg section 21-2, each upper side leg section 21-1 is provided with a fixing groove 22, and a break-off opening 23 for breaking off is arranged between the upper side leg section 21-1 and the lower side leg section 21-2.
When the strutting piece 1 is arranged on the support 2, the central tube 3 is aligned with the connecting rod of the fixing system from top to bottom through the arc clamping groove 31 and clamped. Then the front limit part 12-1 and the rear limit part 12-3 on the connecting head 12 of each expansion piece 1 are used for clamping the upper section 21-1 of the corresponding side leg 21, so that each expansion piece 1 is sleeved on the corresponding side leg 21 through the connecting head 12, and the convex block 14 of the expansion piece 1 is inserted into the fixing groove 22 of the upper section 21-1 of the corresponding side leg of the support 2, so that the expansion piece 1 is fixed on the upper section 21-1 of the corresponding side leg 21 of the support 2.
When each expansion piece 1 is sleeved on the corresponding side leg upper section 21-1 through the sliding grooves 17 on the two sides of the expansion piece and slides downwards along the two sides of the side leg upper section 21-1 until the convex block 14 is inserted into the fixing groove 22, the convex block 14 can be deformed to a certain extent, and under the action of elastic force generated by deformation of the convex block 14, the expansion piece 1 moves to the limit position relative to the side leg 21. The connecting plate 12-2 of the connector 12 is thin and 1-3mm thick, and the material is selected from elastic materials such as plastics, so that the problems of the existing pedicle fixing system can be completely solved, and the pedicle fixing system is convenient to use. Sixthly, when the fixing operation of the pedicle screw 43 is carried out, an operator holds the spherical handle 8 by the right hand, holds the pull lug 51 and the outer sleeve 6 of the lifting sleeve 5 by the left hand, adjusts the position of the lifting sleeve 5 relative to the central tube 3 by operating the non-return device, rotates the spherical handle 8 downwards to screw the spinal pedicle screw 43 positioned below the distraction piece 1 into the pedicle by the installation tool, sequentially removes the central tube 3 with the spherical handle 8 and the outer sleeve 6, and then releases the positioning connection of the tail part 13 of the distraction piece 1 and the lifting sleeve 5, so that the lifting sleeve 5 can be removed together with the non-return device carried by the lifting sleeve, and at the moment, the distracter can be used for distracting the 2 distraction pieces 1 oppositely arranged on the support 2 from each other. The position can be selected through the waist-circle positioning hole 15 in the opening process. The shorter connector rod 41 can then be replaced with the longer connector rod 41 as needed and the pedicle fixation system adjusted in a better field of view and range of operation until the adjustment is complete.
Seventhly, the upper section 21 of the side leg of the support 2 is broken at the breaking port 23 of the support 2 by a breaker, so that the support and the opening sheet 1 are taken down from the operation position, and then follow-up operations such as suturing and the like are carried out, thus completing the operation.
In light of the foregoing description of the preferred embodiment of the present invention, many modifications and variations will be apparent to those skilled in the art without departing from the spirit and scope of the invention. The technical scope of the present invention is not limited to the content of the specification, and must be determined according to the scope of the claims.

Claims (8)

1. An installation tool for a pedicle fixation system comprises 2 distraction plates (1); the method is characterized in that: the lifting device also comprises a central tube (3), a lifting component and a handle; the lifting assembly comprises a lifting sleeve (5) and 2 check devices; the central tube (3) is provided with a blocking part at each side of the front side and the rear side of the upper part of the central tube; when in use, the pulling assembly is sleeved on the central tube (3) by the pulling sleeve (5) and can move up and down along the axial direction of the central tube (3) relative to the central tube (3), and the non-return device stops when the pulling sleeve (5) moves down along the axial direction of the central tube (3); the non-return device also has the function of manually releasing non-return; when in use, the central tube (3) can be arranged on the connecting rod (41) of the pedicle fixing system in a downward pressing manner from the lower end part of the central tube and is limited in the circumferential direction, so that the central tube (3) and the pedicle fixing system can rotate together; the lifting sleeve (5) is provided with a corresponding limiting part which can limit the tail part (13) of each spreading piece (1) when in use, each spreading piece (1) can be close to the corresponding side arranged on the left side and the right side of the central tube (3) when in use, and the lower end of each spreading piece (1) can be fixedly connected to the corresponding side leg (21) of the support (2) when in use; the handle is fixedly arranged on the upper end head of the central tube (3) when in use;
each side of the left side and the right side of the lifting sleeve (5) is provided with a limiting part which can limit the tail part (13) of the corresponding spreading piece (1); the non-return device is arranged on one side of the front side and the rear side of the pulling sleeve (5) when in use and can prevent the pulling sleeve (5) from moving downwards when moving along the axial direction of the central tube (3) under the combined action of the corresponding blocking parts of the central tube (3);
the blocking part at the middle upper part of the central tube (3) is a plurality of check teeth (32) which are arranged on the plate bodies of the front side plate and the rear side plate of the central tube (3) and are positioned at the middle upper part of the plate bodies and face outwards; the non-return device comprises a non-return sheet (71), a rotating shaft (72) and an elastic mechanism; the front side and the rear side of the lifting sleeve (5) are respectively provided with a check groove part; each non-return groove part of the lifting sleeve (5) is provided with a corresponding non-return groove (53); the rotating shaft (72) is arranged on a corresponding non-return groove part of the lifting sleeve (5), the non-return sheet (71) is sleeved on the rotating shaft (72) and is positioned in the non-return groove (53) of the non-return groove part, and the lower end of the non-return sheet (71) is provided with a latch (71-1) which can be meshed with the non-return tooth (32) when in use; the elastic mechanism is arranged on the check sheet (71) or on the check sheet (71) and the rotating shaft (72) simultaneously, and when in use, the elastic mechanism can enable the latch (71-1) of the check sheet (71) to be elastically meshed with the corresponding check tooth (32) through the elastic force of the elastic mechanism.
2. The installation tool for pedicle fixation system as claimed in claim 1, wherein: a pair of arc-shaped clamping grooves (31) are formed in the front side plate and the rear side plate of the lower end part of the central tube (3), namely the central tube (3) clamps the connecting rod (41) through the pair of arc-shaped clamping grooves (31) when in use, so that the central tube and the connecting rod (41) are limited in the circumferential direction; the handle is a spherical handle (8) made of rubber; when in use, the spherical handle (8) is tightly sleeved on the upper end head of the central tube (3).
3. The installation tool for pedicle fixation system as claimed in claim 1, wherein: the elastic mechanism is a compression spring which is arranged on the check sheet (71) and is positioned at the upper part of the check sheet (71), or the elastic mechanism is a torsion spring which is arranged on the check sheet (71) and the rotating shaft (72).
4. The installation tool for pedicle fixation system as claimed in claim 3, wherein: each non-return groove part of the lifting sleeve (5) is provided with a blocking plate (56) positioned at the upper part of the non-return groove (53), and the blocking plate (56) corresponds to the upper part of the corresponding non-return sheet (71).
5. The installation tool for pedicle fixation system as claimed in claim 3, wherein: the elastic mechanism is a compression spring arranged on the check sheet (71), and the upper end part of the check sheet (71) is provided with a limit block (71-2).
6. The installation tool for pedicle fixation system as claimed in claim 1, wherein: the limiting parts on each side of the left side and the right side of the lifting sleeve (5) are 1-2 positioning bulges (55) arranged on each side of the left side and the right side of the lifting sleeve (5) and positioning clamping grooves (54) arranged around the positioning bulges (55).
7. The installation tool for pedicle fixation system as claimed in claim 1, wherein: the pulling assembly further comprises an outer sleeve (6); the outer sleeve (6) is provided with 2 operating windows (61); the outer sleeve (6) is used to be sleeved on the lifting sleeve (5), each operation window (61) of the outer sleeve is aligned with the check sheet (71) of the corresponding check device, the upper part of each check sheet (71) is positioned in the operation window (61) under the state that the latch teeth (71-1) of each check sheet (71) are elastically meshed with the corresponding check teeth (32), and therefore the operation windows (61) can limit the upper part of each check sheet (71) in the circumferential direction.
8. The installation tool for pedicle fixation system as claimed in claim 6, wherein: each side of the left side and the right side of the lifting sleeve (5) is provided with a pull lug (51) positioned at the lower part, the two pull lugs (51) are symmetrically arranged, and each pull lug (51) is provided with a hollow channel (52) which penetrates through the tail part (13) of the supporting sheet (1) conveniently when in use.
CN201611035518.4A 2016-11-22 2016-11-22 Installation tool for pedicle of vertebral arch fixing system Active CN106510834B (en)

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CN113545837B (en) * 2020-04-26 2024-07-12 上海三友医疗器械股份有限公司 Mounting tool for pedicle screw assembly
CN115281811B (en) * 2022-07-11 2025-04-04 河北瑞鹤医疗器械有限公司 A pedicle screw implantation tool

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US8066739B2 (en) * 2004-02-27 2011-11-29 Jackson Roger P Tool system for dynamic spinal implants
US8246538B2 (en) * 2008-02-28 2012-08-21 K2M, Inc. Minimally invasive retractor with separable blades and methods of use
EP2335629B1 (en) * 2009-04-07 2014-03-26 Biedermann Technologies GmbH & Co. KG Tool for use with a bone anchor, in particular for spinal surgery
CN102920502B (en) * 2012-11-09 2014-10-08 上海三友医疗器械有限公司 Extension sheets of pedicle screw tail, expander, and tamper reset rod
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Inventor after: Zhou Jin

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