DE3922044A1 - Treatment of fractured vertebra - by instrument which avoids any force on intact adjacent to vertebrae - Google Patents
Treatment of fractured vertebra - by instrument which avoids any force on intact adjacent to vertebraeInfo
- Publication number
- DE3922044A1 DE3922044A1 DE19893922044 DE3922044A DE3922044A1 DE 3922044 A1 DE3922044 A1 DE 3922044A1 DE 19893922044 DE19893922044 DE 19893922044 DE 3922044 A DE3922044 A DE 3922044A DE 3922044 A1 DE3922044 A1 DE 3922044A1
- Authority
- DE
- Germany
- Prior art keywords
- instrument according
- tube
- threaded rod
- instrument
- expansion tube
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/885—Tools for expanding or compacting bones or discs or cavities therein
- A61B17/8852—Tools for expanding or compacting bones or discs or cavities therein capable of being assembled or enlarged, or changing shape, inside the bone or disc
- A61B17/8858—Tools for expanding or compacting bones or discs or cavities therein capable of being assembled or enlarged, or changing shape, inside the bone or disc laterally or radially expansible
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
Abstract
Description
Die bisherigen Verfahren zur Behandlung von gebrochenen Wirbelkörpern beziehen die benachbarten Wirbelkörper mit ein. Die benutzten Instrumentarien sind auf diese Vorgehensweise abgestellt. Die Einbeziehung von intakten Nachbarwirbeln ist jedoch nachteilig, da eine Schädigung derselben zu befürchten ist.The previous procedures for the treatment of broken Vertebral bodies include the neighboring vertebral bodies. The used instruments are on this approach switched off. The inclusion of intact neighboring vertebrae is however, disadvantageous since there is a risk of damage to the same is.
Aufgabe der vorliegenden Erfindung ist es, mit einem einfachen Instrumentarium eine Wiederaufrichtung gebrochener Wirbelkörper von dorsal zu erreichen, ohne dabei die intakten benachbarten Wirbelkörper einzubeziehen.The object of the present invention is with a simple Instrumentarium a rebuilding broken Reach vertebral body from the dorsal without losing the intact include adjacent vertebrae.
Gelöst wird diese Aufgabe durch ein Instrumentarium wie es in Anspruch 1 gekennzeichnet ist. Vorteilhafte Ausbildungen der Erfindung sind in Ansprüchen 2-19 angegeben.This task is solved by an instrument like the one in Claim 1 is marked. Advantageous training of the Invention are set out in claims 2-19.
Als Mittel zur Spreizung des inneren Endes des Spreizrohres kann eine Gewindestange dienen. Das Gewinde kann auch entfallen, wenn durch andere Mittel, z. B. am äußeren Ende, eine Arretierung gewährleistet ist. Es sind jedoch auch andere Mittel zur Spreizung, wie Druck-Zug-Stangen, an einem Seil geführter konischer Kopf etc. möglich, die eine Aufspreizung des Spreizrohres bewirken.As a means of spreading the inner end of the expansion tube serve a threaded rod. The thread can also be omitted if by other means, e.g. B. at the outer end, a lock is guaranteed. However, there are other means of Spreading, like push-pull rods, guided on a rope conical head etc. possible, which spread the Cause expansion tube.
Mit dem erfindungsgemäßen Instrumentarium wird eine operative Aufrichtung gebrochener Wirbelkörper von dorsal möglich.With the instruments according to the invention, an operative Broken vertebrae can be erected from the dorsal direction.
Nach transcutaner oder nach operativer Freilegung des Wirbelbogens des verletzten Wirbels von dorsal werden die Bogenwurzeln des Wirbels unter Röntgenkontrolle aufgebohrt. Sodann wird das Instrumentarium in Form eines Arbeitsrohres beidseits bis in den Wirbelkörper plaziert. Durch den Arbeitskanal wird dann das erfindungsgemäße Instrumentarium vorgeschoben, bis es ausreichend weit im Wirbelkörper steckt. Die Arme des Spreizers können dann je nach Bruchform nach vorn, zur Mitte oder nach hinten geöffnet werden, um so die komprimierte Berstung wieder aufzurichten.After transcutaneous or after surgical exposure of the Vertebral arch of the injured vertebra from dorsal become the Arch roots of the vertebra drilled out under X-ray control. Then the instruments in the form of a working tube on both sides placed in the vertebral body. Then through the working channel advanced the instruments according to the invention until it is sufficiently far in the vertebral body. The arms of the spreader can then move forward, towards the center or towards the rear, depending on the shape of the fracture opened at the back, so the compressed bursting again to erect.
Unter endoskopischer oder offener Kontrolle kann dann zusätzlich transspinal ein Arbeitsrohr in den Bandscheibenraum eingebracht werden. Mit feinen Biopsiezangen wird das restliche zerstörte Bandscheibengewebe, das durch die Verletzung nicht in den Wirbel körper eingedrungen ist, entfernt. Der geleerte Bandscheibenraum wird schließlich über die Arbeitsrohre mit Spongiosamehl aufgefül lt.Then, under endoscopic or open control, additional A working tube is inserted transspinally into the intervertebral disc space will. The rest is destroyed with fine biopsy forceps Intervertebral disc tissue that is not injured in the vertebra body has penetrated, removed. The empty disc space is finally filled with cancellous bone flour through the working pipes according to
Mit dem erfindungsgemäßen Instrumentarium läßt sich die endoskopische Operation von Bandscheiben ebenfalls durchführen.With the instruments according to the invention, the also perform endoscopic surgery of intervertebral discs.
Weitere Einzelheiten und Vorteile der Erfindung werden im folgenden an einem Ausführungsbeispiel näher erläutert. Es zeigtFurther details and advantages of the invention are described in following explained in more detail using an exemplary embodiment. It shows
Fig. 1 ein erfindungsgemäßes Arbeitsrohr, Fig. 1 shows an inventive working tube,
Fig. 2 eine erste Variante des erfindungsgemäßen Instrumentes, das in einen aufzurichtenden Wirbelkörper eingeführt ist, Fig. 2 shows a first variant of the instrument according to the invention, which is inserted into a vertebral body righted,
Fig. 3 eine zweite Variante des erfindungsgemäßen Instrumentariums und Fig. 3 shows a second variant of the instruments according to the invention and
Fig. 4 eine weitere Variante des erfindungsgemäßen Instrumentariums. Fig. 4 shows a further variant of the instruments according to the invention.
In Fig. 2 ist ein erfindungsgemäßes Instrumentarium in einem aufzurichtenden Wirbelkörper 10 dargestellt. Die anliegenden Wirbelkörper 9 werden zur Wiederaufrichtung nicht benötigt. Das "äußere" Rohrende ist mit einem Gewinde 4 versehen, auf das ein Trichter 5 oder ein Schlagschutzring (Fig. 1) aufgeschraubt werden kann. Das Arbeitsrohr weist eine Dichte von 4-12 mm, bevorzugt 8 mm auf.In FIG. 2, an inventive instrument is illustrated in a righted vertebral body 10. The adjacent vertebral bodies 9 are not required for straightening up. The "outer" pipe end is provided with a thread 4 onto which a funnel 5 or an impact protection ring ( FIG. 1) can be screwed. The working tube has a density of 4-12 mm, preferably 8 mm.
Der Wirbelspreizer Typ 1 gemäß Fig. 2 weist eine ca. 20 cm lange Gewindestange 3, deren "inneres" Ende einen konischen Kopf 11 trägt. Die Gewindestange 3 ist eingedreht in ein mit Innengewin de ausgestattetem Spreizrohr 2, dessen Außendurchmesser bündig dem Innendurchmesser des Arbeitsrohres 1 entspricht, so daß es durch dieses hindurchgeschoben werden kann. Das "innere" Ende des Spreiz rohres 2 ist auf einer Länge von 2,5 cm geschlitzt, um aufgespreizt werden zu können. Das "innere" Ende der Gewindestange 3 trägt einen nach außen konisch erweiterten Kopf 11 (bis auf den Innendurchmesser des Arbeitsrohres). Bei Rückdrehung der Gewindestange 3 paßt sich die ser in das Spreizrohr 2 und drängt die Repositionsschenkel 12 auseinan der (Fig. 2).The vortex spreader type 1 according to FIG. 2 has an approximately 20 cm long threaded rod 3 , the "inner" end of which carries a conical head 11 . The threaded rod 3 is screwed into a spreader tube 2 equipped with internal thread de, the outer diameter of which corresponds flush to the inner diameter of the working tube 1 , so that it can be pushed through it. The "inner" end of the expansion tube 2 is slotted to a length of 2.5 cm in order to be able to be expanded. The "inner" end of the threaded rod 3 carries an outwardly conically widened head 11 (except for the inner diameter of the working tube). When the threaded rod 3 is turned back, the water fits into the expansion tube 2 and urges the reduction leg 12 apart ( FIG. 2).
Der Wirbelspreizer Typ 2 gemäß Fig. 3 weist im wesentlichen das Bauprinzip des Wirbelspreizers Typ 1 auf. Im Gegensatz zum Typ 1 ist die Schlitzung des "inneren" Endes jedoch nicht durchgezogen, sondern endet ca. 2 mm vor dem Ende. Bei Rückdrehung der Gewindestange 3 wird dadurch eine in etwa rautenförmige oder bauchige Aufspreizung bewirkt, die zur Reposition der Deck- und Grundplatte im mittleren Bereich führt (Fig. 3). Dabei kann ein Gelenk 8 angeordnet sein. Die Aufspreizung kann jedoch auch durch elastisches Ausbiegen der Gewindestange 3 erfolgen.The vortex spreader type 2 according to FIG. 3 essentially has the construction principle of the vortex spreader type 1. In contrast to type 1, the slit of the "inner" end is not pulled through, but ends approx. 2 mm before the end. When the threaded rod 3 is turned back, an approximately diamond-shaped or bulbous expansion is brought about, which leads to the reduction of the cover and base plate in the central region ( FIG. 3). A joint 8 can be arranged. However, the spreading can also be done by elastic bending of the threaded rod 3 .
Fig. 3 zeigt den Wirbelspreizer Typ 3 mit einer Gewindestange 3 mit Innengewinde. Die Gewindestange 3 liegt bündig dem Arbeitsrohr 1 an. In die Gewindestange 3 ist ein Spreizrohr 2 mit Außengewinde geführt, welches an seinem inneren Ende gelenkig verbundene Abspreizschenkel 6 trägt. Die nach hinten öffnenden Abspreizschenkel 6 weisen eine Länge von 0,5 bis 4 cm, bevorzugt 2,5 cm auf und liegen in nicht abgespreiztem Zustand auf der Gewindestange auf. Durch Drehen der Gewindestange werden die Abspreizschenkel dorsal abgespreizt, wodurch die dorsale Aufrichtung der Deck- und Grundplatte sowie der Hinterkante des Wirbelkörpers bewirkt wird (Fig. 4). Fig. 3 shows the vortex spreader type 3 with a threaded rod 3 with an internal thread. The threaded rod 3 lies flush with the working tube 1 . In the threaded rod 3 , an expansion pipe 2 with an external thread is guided, which carries at its inner end articulated expansion legs 6 . The expansion legs 6 opening towards the rear have a length of 0.5 to 4 cm, preferably 2.5 cm, and lie on the threaded rod in the non-expanded state. By turning the threaded rod, the spreading legs are spread out dorsally, which causes the dorsal erection of the cover and base plate and the rear edge of the vertebral body ( FIG. 4).
Die Erfindung ist keineswegs auf das dargestellte Ausführungsbeispiel beschränkt. Vielseitige Anwendungen sind im Rahmen der Erfindung, wie sie in den Ansprüchen gekennzeichnet ist, möglich.The invention is by no means based on that illustrated Embodiment limited. Versatile applications are in Framework of the invention as characterized in the claims is possible.
Claims (19)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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DE19893922044 DE3922044A1 (en) | 1989-07-05 | 1989-07-05 | Treatment of fractured vertebra - by instrument which avoids any force on intact adjacent to vertebrae |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19893922044 DE3922044A1 (en) | 1989-07-05 | 1989-07-05 | Treatment of fractured vertebra - by instrument which avoids any force on intact adjacent to vertebrae |
Publications (2)
Publication Number | Publication Date |
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DE3922044A1 true DE3922044A1 (en) | 1991-02-07 |
DE3922044C2 DE3922044C2 (en) | 1991-05-29 |
Family
ID=6384317
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE19893922044 Granted DE3922044A1 (en) | 1989-07-05 | 1989-07-05 | Treatment of fractured vertebra - by instrument which avoids any force on intact adjacent to vertebrae |
Country Status (1)
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DE (1) | DE3922044A1 (en) |
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WO1994004086A1 (en) * | 1992-08-25 | 1994-03-03 | Alexandre Worcel | Osteosynthesis device |
DE4328690A1 (en) * | 1993-08-26 | 1995-03-02 | Man Ceramics Gmbh | Vertebral blockage |
AT402222B (en) * | 1994-05-10 | 1997-03-25 | Waniek Gerhard Dr | Device for fitting an anchor |
WO2001028443A1 (en) * | 1999-10-22 | 2001-04-26 | Mark Levy | Expandable orthopedic device |
US6554833B2 (en) | 1998-10-26 | 2003-04-29 | Expanding Orthopedics, Inc. | Expandable orthopedic device |
WO2005011507A1 (en) * | 2003-08-04 | 2005-02-10 | Dewei Zou | A dilator for forming a cavity within the vertebral body |
US7052498B2 (en) | 1998-10-26 | 2006-05-30 | Expanding Orthopedics, Inc. | Expandable orthopedic device |
CN100389728C (en) * | 2006-07-11 | 2008-05-28 | 张祖仁 | Expander for vertebroplasty |
CN100434046C (en) * | 2006-03-16 | 2008-11-19 | 刘小勇 | Nickel titanium temperature memory alloy centrum compression fracture orthopedic repositor and device |
EP2056919A1 (en) * | 2006-08-07 | 2009-05-13 | Strathmore Industries Inc. | Bone tamp apparatus and method |
US7662187B2 (en) | 2002-10-29 | 2010-02-16 | Kyphon Sarl | Interspinous process implants and methods of use |
US7666209B2 (en) | 1997-01-02 | 2010-02-23 | Kyphon Sarl | Spine distraction implant and method |
US7682376B2 (en) | 2006-01-27 | 2010-03-23 | Warsaw Orthopedic, Inc. | Interspinous devices and methods of use |
US7691130B2 (en) | 2006-01-27 | 2010-04-06 | Warsaw Orthopedic, Inc. | Spinal implants including a sensor and methods of use |
US7695513B2 (en) | 2003-05-22 | 2010-04-13 | Kyphon Sarl | Distractible interspinous process implant and method of implantation |
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US7803190B2 (en) | 2002-10-29 | 2010-09-28 | Kyphon SÀRL | Interspinous process apparatus and method with a selectably expandable spacer |
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US7846186B2 (en) | 2005-06-28 | 2010-12-07 | Kyphon SÀRL | Equipment for surgical treatment of two vertebrae |
US7879104B2 (en) | 2006-11-15 | 2011-02-01 | Warsaw Orthopedic, Inc. | Spinal implant system |
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US5437674A (en) * | 1992-08-25 | 1995-08-01 | Alexandre Worcel | Osteosynthesis device |
WO1994004086A1 (en) * | 1992-08-25 | 1994-03-03 | Alexandre Worcel | Osteosynthesis device |
DE4328690B4 (en) * | 1993-08-26 | 2006-08-17 | SDGI Holdings, Inc., Wilmington | Intervertebral implant for vertebral body blocking and implantation instrument for positioning the intervertebral implant |
DE4328690A1 (en) * | 1993-08-26 | 1995-03-02 | Man Ceramics Gmbh | Vertebral blockage |
US5571109A (en) * | 1993-08-26 | 1996-11-05 | Man Ceramics Gmbh | System for the immobilization of vertebrae |
AT402222B (en) * | 1994-05-10 | 1997-03-25 | Waniek Gerhard Dr | Device for fitting an anchor |
US8540751B2 (en) | 1997-01-02 | 2013-09-24 | Warsaw Orthopedic, Inc. | Spine distraction implant and method |
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