CN103356275A - Micro-movement lumber pedicle screw elastic-fixation system - Google Patents
Micro-movement lumber pedicle screw elastic-fixation system Download PDFInfo
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- CN103356275A CN103356275A CN2012100879823A CN201210087982A CN103356275A CN 103356275 A CN103356275 A CN 103356275A CN 2012100879823 A CN2012100879823 A CN 2012100879823A CN 201210087982 A CN201210087982 A CN 201210087982A CN 103356275 A CN103356275 A CN 103356275A
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- pedicle
- flexible rod
- sleeve
- fixation system
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Abstract
A micro-movement lumber pedicle screw elastic-fixation system comprises a support bar and at least two pedicle screws. The support bar is composed of an elastically deformable elastic bar and a highly rigid limit sheath. The elastic bar can finely move properly with motion of a human body. The highly rigid limit sheath limits micro-movement amplitude of the elastic bar. Therefore, load sharing is better while spinal fixation stability is unchanged, and the clinical requirements for stress shielding and stress concentration are lowered.
Description
Technical field
The present invention relates to a kind of implanted surgical operating instrument pedicle of lumbar vertebral arch follows closely excellent fixed system, particularly pedicle of lumbar vertebral arch and follows closely excellent elastic fixation system.
Background technology
The lumbar degenerative unstability be the commonly encountered diseases that causes lumbago and skelalgia because of, lumbar spinal fusion is the main modus operandi for the treatment of at present this class disease, whether fusion remains the goldstandard of judging its curative effect, although the traditional bilateral pedicle screw-rod that generally adopts is at present fixed (being called for short the bilateral flexible fastening), can obtain to surpass 90% postoperative fusion rate, but and fail correspondingly to improve its general curative effect, the dissatisfied rate of curative effect even up to 35%.Cause the curative effect cause of dissatisfaction except with canalis spinalis in operation technique the tractive of dural sac and nerve root stimulated cause cesarean delivery adhesion cicatrix, paravertebral muscles extensively to peel off outside the Pass stretch injury has, in bilateral rigidly fixes sections, also be prone to osteoporosis, osteanabrosis, the decline of bone fusion mass and pseudoarticulation formation, and because stress concentration easily causes broken nail and disconnected rod generation in inside-fixture.Because traditional bilateral rigidly fixes and has born most load, fixed-segment is shared load and is greatly reduced, thereby generation stress-shielding effect, the load in neighbouring section intervertebral disc and little joint is changed, dmm increases, mobility increases, then middle long term Adjacent segment degeneration occurs after surgery, its incidence rate is up to 30%～45%, and range of fusion is longer, the Adjacent segment degeneration incidence rate is higher, this wherein partly can produce corresponding clinical symptoms, therefore needs again operative treatment.
Desirable lumbar vertebra internal fixation method is under the prerequisite of not sacrificing the spinal column stability maintenance, increases load and shares, and reduces stress shielding and stress concentration.Therefore, the pedicle screw-rod fixed system of prior art need to improve, and to satisfy under the prerequisite of not sacrificing the spinal column stability maintenance, increases load and shares, and reduces the clinical requirement of stress shielding and stress concentration.
Summary of the invention
The object of the present invention is to provide a kind of fine motion pedicle of lumbar vertebral arch to follow closely excellent elastic fixation system, under the prerequisite of not sacrificing the spinal column stability maintenance, can increase load and share, reduced stress shielding and stress concentration.
A kind of fine motion pedicle of lumbar vertebral arch of the present invention is followed closely excellent elastic fixation system and is achieved in that
A kind of fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system, is made of support stick 2 and at least 2 pedicle nails 1, and pedicle nail 1 is installed on the support stick 2, it is characterized in that:
A. the described fine motion pedicle of lumbar vertebral arch support stick 2 of following closely excellent elastic fixation system contains flexible rod 21 and spacing sheath pipe 22;
B. described flexible rod 21 is under external force strain to occur, and can return to again the elastomer of original form after external force is removed;
C. described spacing sheath pipe 22 position-limit mechanism 201 that contains sleeve 202 and can limit the motion amplitude of flexible rod 21; Described sleeve 202 is provided with position-limit mechanism 201;
D. described flexible rod 21 is fixed in the centre bore 203 of sleeve 202 of spacing sheath pipe 22.
Further, described position-limit mechanism 201 is to be made of a pair of limited block that cooperatively interacts 2011 and slotted eye 207.
Described flexible rod 21 is medical elastic material manufacture, and the shape of the cross section of described flexible rod 21 is selected from: circular, oval, and square, rectangle is with the geometries such as rectangle of circular arc.
Described flexible rod 21 is latch plates that the stratiform stacked system of medical elastic plate of material manufacturing consists of.
Shape and the flexible rod 21 of the centre bore 203 of described sleeve 202 are complementary, and the shape of the cross section of described centre bore 203 is selected from: circular, oval, and square, rectangle is with the geometries such as rectangle of circular arc.
Described flexible rod 21 is installed in the centre bore 203 of sleeve; Between corresponding to the proximity of the limited block 2011 on the sleeve of described support stick, in the L2, be provided with movement clearance δ between flexible rod 21 and the sleeve 202; Between the proximity that pedicle nail 1 is installed corresponding to the sleeve of described support stick 2, in the L1, be tight fit between flexible rod 21 and the sleeve 202.
Further, be provided with movement clearance δ less than 0.6mm between described flexible rod 21 and the sleeve 202.
The sleeve 202 of described spacing sheath pipe contains at least a pair of upper bush that cooperatively interacts 204 and lower sleeve 205 consists of; Upper bush 204 is connected with lower sleeve and is connected with flexible rod 21 by pin 206, upper bush 204 and lower sleeve 205 along the axial movement clearance H of spacing sheath pipe 22 less than 0.5mm.
The material that the described fine motion pedicle of lumbar vertebral arch of further manufacturing is followed closely excellent elastic fixation system is selected from: the medical metal materials such as medical titanium alloy, medical titanium nickel shape memory alloy, medical high elasticity beta Ti alloy, medical titanium zirconium-niobium alloy, medical titanium base amorphous alloy, medical niobio amorphous alloy, medical iron-based non-crystalline alloy, medical stainless steel.
The core of the present invention's technical scheme is:
The fine motion pedicle of lumbar vertebral arch that consists of the present invention is followed closely the support stick 2 of excellent elastic fixation system, by the flexible rod 21 that can produce strain and rigidity preferably spacing sheath pipe 22 form.The fine motion of appropriateness can occur along with the motion of human body in flexible rod 21, rigidity preferably spacing sheath pipe 22 has then limited the fine motion amplitude of flexible rod 21, like this, has just reached under the prerequisite of not sacrificing the spinal column stability maintenance, increase load and share, reduce the clinical requirement of stress shielding and stress concentration.
In recent years, one-sided pedicle screw-rod technique for fixing is applied to clinical gradually, its purpose is when reducing wound, what is more important can reduce the rigidity of implants, its curative effect and stability are confirmed by clinical and biomechanics Research, that adopts is traditional pedicle screw-rod, namely rigidly fixes system but at present.The present invention's fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system and not only be can be applicable to the flexible fastening of lumbar vertebra bilateral, and more be expected to and be applied to one-sided flexible fastening, thus fixing in the lumbar vertebra of realizing ideal.
Description of drawings
Fig. 1 is the structural representation that the present invention's fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system.
Fig. 2 is the perspective view that the present invention's fine motion pedicle of lumbar vertebral arch is followed closely the support stick of excellent elastic fixation system.
Fig. 3 is the perspective view of Fig. 2.
Fig. 4 is the front view of Fig. 2.
Fig. 5 is the side view of Fig. 2.
Fig. 6 is the A-A cutaway view of Fig. 2.
Fig. 7 is the B-B cutaway view of Fig. 2.
Fig. 8 is the partial enlarged drawing at the R place of Fig. 7.
Fig. 9 is the top view of Fig. 2.
Figure 10 is that the present invention's fine motion pedicle of lumbar vertebral arch is followed closely the structural representation of excellent elastic fixation system when stretching.
Figure 11 is that the present invention's fine motion pedicle of lumbar vertebral arch is followed closely the structural representation of excellent elastic fixation system when bent position.
Figure 12 is that the present invention's fine motion pedicle of lumbar vertebral arch is followed closely the structural representation of excellent elastic fixation system flexible rod.
Figure 13 is the cutaway view at C-C place.
Figure 14 is the structural representation of the cross section of the present invention's the fine motion pedicle of lumbar vertebral arch oval flexible rod of following closely excellent elastic fixation system.
Figure 15 is the structural representation of the cross section of the present invention's the fine motion pedicle of lumbar vertebral arch square flexible rod of following closely excellent elastic fixation system.
Figure 16 is the structural representation of the cross section of the present invention's the fine motion pedicle of lumbar vertebral arch rectangle flexible rod of following closely excellent elastic fixation system.
Figure 17 is the structural representation with the cross section of the rectangle flexible rod of circular arc that the present invention's fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system.
Figure 18 is the structural representation of cross section of the oval flexible rod of the present invention's the fine motion pedicle of lumbar vertebral arch layer structure of following closely excellent elastic fixation system.
Figure 19 is the structural representation of the cross section of the present invention's the fine motion pedicle of lumbar vertebral arch stratiform rectangle flexible rod of following closely excellent elastic fixation system.
Figure 20 is the structural representation of cross section of the rectangle flexible rod of the present invention's the fine motion pedicle of lumbar vertebral arch stratiform band circular arc of following closely excellent elastic fixation system.
Figure 21 is the structural representation that the present invention's fine motion pedicle of lumbar vertebral arch is followed closely the stratiform flexible rod of excellent elastic fixation system.In the present embodiment, 3 layers of medical elastic metallic plate 209 of flexible rod 21 usefulness are formed by stacking.The flexible rod 21 of layer structure is fixed in the spacing sheath pipe 22 of support stick, and at the position near pedicle nail 1, the flexible rod 21 of layer structure forms tight fit with spacing sheath pipe 22.And the elastic deformation area, namely near position-limit mechanism 201, having movement clearance δ between the flexible rod 21 of layer structure and the spacing sheath pipe 22, common described movement clearance δ is less than 0.6mm.
Figure 22 be containing of the present invention a pair of upper bush that cooperatively interacts and the fine motion pedicle of lumbar vertebral arch of lower sleeve follow closely the structural representation of excellent elastic fixation system.
Figure 23 is the structural representation that fine motion pedicle of lumbar vertebral arch that being provided with of the present invention preset angle of bend is followed closely excellent elastic fixation system.In the present embodiment, the present invention's the fine motion pedicle of lumbar vertebral arch support stick of following closely excellent elastic fixation system has been preset angle of bend β.Angle of bend β is the axis of support stick 2 and the angle of vertical direction, and the angle of bend β that usually presets has the physiologic radian that adapts with the human body lumbar vertebra less than 5 ° so that consist of flexible rod 21 and the spacing sheath pipe 22 of described support stick 2.Gap between the limited block 2011 that arranges on the sleeve 202 has consisted of the slotted eye 207 of position-limit mechanism, and the size of slotted eye 207 has determined that pedicle of lumbar vertebral arch follows closely the range of movement of excellent elastic fixation system.The two ends of the flexible rod 21 of support stick 2 are separately fixed on the sleeve 202, and the middle part of flexible rod 21 is installed in the sleeve centre bore 203 of sleeve 202, and the external diameter at the middle part of flexible rod 21 is less than the internal diameter of sleeve centre bore 203.This structure is avoided the concentrated distortion corresponding to slotted eye 207 places of position-limit mechanism, thereby is improved the service life of flexible rod 21 so that uniform strain can be carried out in that sleeve centre bore 203 is interior in the middle part of flexible rod 21.
Among the above-mentioned figure: 1 is pedicle nail, 2 is support stick, 21 is the flexible rod of support stick, and 22 is the spacing sheath pipe of support stick, and 201 is position-limit mechanism, 202 is sleeve, 203 is the centre bore of sleeve, and 204 is upper bush, and 205 is lower sleeve, 206 is pin, 207 is the slotted eye of position-limit mechanism, and 208 is rivet hole, and 209 is the medical elastic metallic plate, 2011 is the limited block on the position-limit mechanism, L1 is the contiguous interval of pedicle nail, and L2 is the contiguous interval of position-limit mechanism, and L3 is the spacing gap of position-limit mechanism, H is the axially-movable gap between upper bush and the lower sleeve, δ is the movement clearance between flexible rod and the sleeve, and d1 is flexible rod corresponding to the diameter at the interval L1 place that connects pedicle nail, and d2 is that flexible rod is corresponding to the diameter at L2 place, strain interval, d3 is the internal diameter of the sleeve of spacing sheath pipe, and β is the angle of bend that support stick presets.
The specific embodiment
Embodiment 1: the present invention's fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system
Referring to figs. 1 to Figure 13, in the present embodiment, the fine motion pedicle of lumbar vertebral arch that discloses a kind of the present invention is followed closely excellent elastic fixation system.Described fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system and is made of support stick 2 and at least 2 pedicle nails 1, and pedicle nail 1 is installed on the support stick 2.Described support stick 2 contains flexible rod 21 and spacing sheath pipe 22, and flexible rod 21 is under external force strain to occur, and can return to again the elastomer of original form after external force is removed.The position-limit mechanism 201 that spacing sheath pipe 22 contains sleeve 202 and can limit the motion amplitude of flexible rod 21, sleeve 202 is provided with position-limit mechanism 201, and flexible rod 21 is fixed in the centre bore 203 of sleeve 202 of spacing sheath pipe 22.
Described flexible rod 21 adopts medical high elasticity beta Ti alloy manufacturing or medical super elastic Ti base amorphous alloy to make.Described flexible rod 21 is in the diameter d 1 corresponding to the interval L1 of connection pedicle nail place, and described flexible rod 21 is d2 at the diameter of the interval L2 of strain.Described sleeve 202 adopts the manufacturing of medical titanium nickel shape memory alloy, and the internal diameter of sleeve 202 is d3.Described flexible rod 21 is d3 at the internal diameter that is slightly larger than sleeve 202 corresponding to the diameter d 1 that connects the interval L1 of pedicle nail place, shape interference tight fit.First at low temperatures, in 0 ℃～15 ℃ cold water, the inner diameter d 3 of sleeve 202 is suitably enlarged, so that it is greater than the diameter d 1 of flexible rod 21, then be placed in 33 ℃～37 ℃ the hot water, the inner diameter d 3 of the sleeve 202 of medical titanium nickel shape memory alloy manufacturing returns to original size, because the inner diameter d 3 of described sleeve is less than the outside diameter d 1 of flexible rod, so sleeve 201 is forming tight fit with flexible rod 21 corresponding to the interval L1 place that is connected pedicle nail.Described flexible rod 21 is fixed with sleeve 202, has consisted of support stick 2.
In the zone of sleeve 202 corresponding to the contiguous interval L2 of position-limit mechanism, namely L2 place, strain zone is provided with slotted eye 207.The top and bottom among of described slotted eye 207 is provided with 2011,2 locating pieces that cooperatively interact 2011 of locating piece and slotted eye 207 has consisted of position-limit mechanism 201 jointly.When body forward was crooked, the flexible rod 21 of support stick 2 is bend forward also, and the slotted eye 207 on right side is progressively closed, and locating piece is in contact with one another up and down, played and bent the spacing effect in position, with reference to Figure 11.Equally, when health stretched backward, the slotted eye 207 in left side was progressively closed, and locating piece is in contact with one another up and down, plays and stretches the spacing effect in position, with reference to Figure 10.
Owing between the outside diameter d 2 of the inner diameter d 3 of support stick 2 sleeve 202 of interval L2 corresponding to strain and flexible rod 21, have gap delta, appropriate fine motion, the bending of flexible rod 21 had both been guaranteed, certain position-limiting action is arranged again, so that flexible rod 21 can not hyperkinesia and bending.The existence of described gap delta and described position-limit mechanism 201 and combined effect, the fine motion pedicle of lumbar vertebral arch that had both guaranteed the present invention is followed closely the flexible rod 21 of excellent elastic fixation system can carry out fine motion, the bending of appropriateness, played again spacing effect, like this, just reached under the prerequisite of not sacrificing the spinal column stability maintenance, increase load and share, reduce power is blocked clinical requirement with stress concentration.
In addition, when the fine motion pedicle of lumbar vertebral arch that adopts Ti-Ni marmem manufacturing invention is followed closely excellent elastic fixation system, by the typing Technology for Heating Processing, flexible rod 21 and the spacing sheath pipe 22 that consists of described support stick 2 can also be designed to have the physiologic radian that adapts with the human body lumbar vertebra, usually the angle of bend β that presets is less than 5 °, with reference to Figure 23.
The material that manufacturing the present invention's fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system can also be selected from: the medical metal materials such as medical titanium alloy, medical titanium nickel shape memory alloy, medical high elasticity beta Ti alloy, medical titanium zirconium-niobium alloy, medical titanium base amorphous alloy, medical niobio amorphous alloy, medical iron-based non-crystalline alloy, medical stainless steel.
Embodiment 2: the fine motion pedicle of lumbar vertebral arch of the present invention's layer structure is followed closely excellent elastic fixation system
With reference to Figure 22, and Figure 18, Figure 19, Figure 20.In the present embodiment, its basic structure is identical with embodiment 1, and its difference is:
The sleeve 202 of described support stick 2 is made of upper bush 204 and lower sleeve 205.The upper end of described flexible rod 21 is fixed on the upper bush 204 by pin 206, and the lower end of described flexible rod 21 is fixed on the lower sleeve 205 by pin 206; Slotted eye 207 between the locating piece of the locating piece 2011 on the upper bush 204, the locating piece 2011 on the lower sleeve 205 and upper and lower sleeve has consisted of position-limit mechanism 201 jointly.
Described flexible rod 21 is the latch plate structures by the layer structure of medical elastic plate of material layering stack manufacturing.The top and bottom of the flexible rod 21 of laminated spring plate structure respectively are provided with rivet hole 208.The slightly larger in diameter of rivet hole 208 is in the diameter of the pin 206 that is used for riveting, so that described flexible rod 21 can be done suitable axially-movable around pin 206.The gap H of axially-movable namely is the difference between the diameter of the diameter of rivet hole 208 and pin 206, and usually, described gap H is less than 0.5mm.
Present embodiment is not only being stretched position and the better anti-fatigue performance of Qu Weiyou so that the present invention's fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system owing to adopted the flexible rod 21 of laminated spring plate structure; And, axially, namely upper and lower to, also suitably fine motion can be satisfied better under the prerequisite of not sacrificing the spinal column stability maintenance, increases load and shares, and reduces the clinical requirement of stress shielding and stress concentration.
Should be noted that open structure with illustrating can replace with the identical structure of other effect herein, the embodiment that simultaneously the present invention introduces realizes unique structure of the present invention.Although preferential embodiment of the present invention is introduced in this article and is illustrated; but those skilled in the art know and know that these embodiment illustrate; those skilled in the art can make countless variations, improvement and replacement; and can not break away from the present invention; therefore, should limit protection scope of the present invention according to the spirit and scope of appending claims of the present invention.
Claims (9)
1. a fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system, is made of support stick (2) and at least 2 pedicle nails (1), and pedicle nail (1) is installed on the support stick (2), it is characterized in that:
A. the described fine motion pedicle of lumbar vertebral arch support stick (2) of following closely excellent elastic fixation system contains flexible rod (21) and spacing sheath pipe (22);
B. described flexible rod (21) is under external force strain to occur, and can return to again the elastomer of original form after external force is removed;
C. described spacing sheath pipe (22) position-limit mechanism (201) that contains sleeve (202) and can limit the motion amplitude of flexible rod (21); Described sleeve (202) is provided with position-limit mechanism (201);
D. described flexible rod (21) is fixed in the centre bore (203) of sleeve (202) of spacing sheath pipe (22).
2. described fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system according to claim 1, it is characterized in that described position-limit mechanism (201) is to be made of a pair of limited block that cooperatively interacts (2011) and slotted eye (207).
3. described fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system according to claim 1, it is characterized in that described flexible rod (21) is the medical elastic material manufacture, the shape of the cross section of described flexible rod (21) is selected from: circular, oval, square, rectangle is with the rectangle of circular arc.
4. described fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system according to claim 1, it is characterized in that described flexible rod (21) is the latch plate of the stratiform stacked system formation of medical elastic plate of material manufacturing.
5. described fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system according to claim 1, the shape and the flexible rod (21) that it is characterized in that the centre bore (203) of described sleeve (202) are complementary, the shape of the cross section of described centre bore (203) is selected from: circular, oval, square, rectangle is with the rectangle of circular arc.
6. described fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system according to claim 1, it is characterized in that described flexible rod (21) is installed in the centre bore (203) of sleeve; Between the proximity corresponding to the limited block on the sleeve of described support stick (2011), in (L2), be provided with movement clearance δ between flexible rod (21) and the sleeve (202); Between the proximity that pedicle nail (1) is installed corresponding to the sleeve of described support stick (2), in (L1), be tight fit between flexible rod (21) and the sleeve (202).
7. described fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system according to claim 1, it is characterized in that being provided with movement clearance δ less than 0.6mm between described flexible rod (21) and the sleeve (202).
8. described fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system according to claim 1, it is characterized in that the sleeve (202) of described spacing sheath pipe contains a pair of upper bush that cooperatively interacts (204) and lower sleeve (205) formation at least; Upper bush (204) is connected 205 with lower sleeve) be connected with flexible rod (21) by pin (206), upper bush (204) and lower sleeve (205) along the axial movement clearance H of spacing sheath pipe (22) less than 0.5mm.
9. described fine motion pedicle of lumbar vertebral arch is followed closely excellent elastic fixation system according to claim 1, it is characterized in that making the material that described fine motion pedicle of lumbar vertebral arch follows closely excellent elastic fixation system and is selected from: medical titanium alloy, medical titanium nickel shape memory alloy, medical high elasticity beta Ti alloy, medical titanium zirconium-niobium alloy, medical titanium base amorphous alloy, medical niobio amorphous alloy, medical iron-based non-crystalline alloy, medical stainless steel.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201210087982.3A CN103356275B (en) | 2012-03-29 | 2012-03-29 | A kind of Micro-movement lumber pedicle screw elastic-fixation system |
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| CN201210087982.3A CN103356275B (en) | 2012-03-29 | 2012-03-29 | A kind of Micro-movement lumber pedicle screw elastic-fixation system |
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| CN103356275B CN103356275B (en) | 2016-06-01 |
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| CN103356275B (en) | 2016-06-01 |
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