A device for correction of distortions and stabilization of spinal segments with a set of tools

 

(57) Abstract:

The invention relates to medicine, namely to traumatology and orthopedics, and can be used in the treatment of the spine. A device for correction of distortions and stabilization of spinal segments represents distractor with ratchet closure upper supporting hook. Distractor deformed relative to the spinal deformity without losing its rigidity, and developed a form ratcheting mechanism virtually eliminates the possibility of fracture of the structure. A sharp hook with two grippers mounted on the bone support without prior formation of the bed acute way. Available on the hook side grooves provide a secure fit grips. The support plate provides a secure fit design on the lateral mass of the sacrum. The technical result is to simplify equipment installation distractor, reducing operative time, complications, obtaining a reliable fixation after the correction of spinal deformity at all stages of treatment. 1 Il.

The invention relates to medicine, namely to surgical traumatology and orthopedics, and is intended to carmelization of spinal segments proposed a significant number of devices, of which the most widespread are static devices submersible type. The most famous distracters static type Kazmina ("the Use of metal distractor in the treatment of severe forms of scoliosis". Orthopedics, traumatology and prosthetics N 6, 1961, page 11-16), Tiwana ("Surgical treatment of scoliosis". Novosibirsk, 1964), Raya ("Correction of scoliotic spinal deformities in children and adolescents". Bulletin of the surgery, so 123, pp. 123 - 127, 1979). But the device Kazmina and Ziviani can only be used for the correction of lumbar arc deformation and being threaded structures with closed cavities based on spongy bone elements (transverse vertebral processes), can be a source of complications such as samarasekera design, fistula formation due to the instability arising from bedsores supporting elements, secondary infectious complications. Devoid of the above disadvantages of the design of Paja does not allow you to develop great efforts in the correction of the deformation due to the fact that the risk breakdown structure in place to start ratcheting mechanism due to the uniform depth of the grooves on the distractor. This is especially dangerous when the kyphotic component allows you to have lasting effects on the deformation of the spine (Harrington, P. R. (1962 ): Treatment of caused by. Correction and internal fixation by spine instrumentation. J. Bone Jt. Surg. 44A, 591). However, this device has such disadvantages as

the possibility of damage to the structure of 2.6%-5,3% (depending on the angle of kyphosis and etiology deformation) (Norkin, 1989);

the inability to use when expressed rigid deformities in the sagittal plane (kyphosis, lordosis);

the need, in most cases, when the lower hook to perform a resection of the articular process, and sometimes part of the pedicles of the vertebra, which is located above the support;

used tools does not allow you to set the anchor hooks without the use of additional temporary andconnector and create a bed of the support hook acute way.

All this leads to some technical difficulties and complications during surgery, and complications as in the next, and late post-operative period in the form of a broken rod (2,6%), loss of correction due to a broken bone supports or offset hook (4.2%) and secondary suppurative complications (6,2%) (Surgical treatment of children and adolescents with progressive forms of scoliosis". Doctoral thesis I. A. Norkin, Saratov, 1994).

The aim of the invention is the s reliable fixation after the correction of spinal deformity at all stages of treatment.

This objective is achieved in that the rod distractor or at least part thereof is made variable cross-section in the form of a conical grooves of variable diameter increasing from the beginning of the rod to the middle of the same or variable length, the hook has a pointed shape and special lateral grooves, the lower support plate is made in the form of staples, which has one side has a notched groove, and the other length is twice the first and has a conical shape.

The implementation of the distractor rod of variable cross-section in the form of a conical grooves of variable diameter increasing from the beginning of the rod to the middle, greatly increase the structural strength. This allows you to bend the rod distractor relative to the deformation of the spine (lordoses and kyphotic component) in any place without the risk of losing the stiffness of the structure or fracture. The use of hook pointed shape allows it to be installed on bone support without prior formation of the bed acute way. Here is a manual control for the attached corrective effort and strength support. We use the grooves on the hooks protect against possible is the sacrum provides reliable fixation device for bone support not calling her resorption, and therefore, prevents the settling of the structure. Elongated side plate is wound in the front surface of the lateral mass of the sacrum, and pointed grooves on its shorter side are securely fixed to the rear surface of the sacrum, which provides a strong retention structure during the postoperative period.

For a better understanding of the design distractor here is the image on the drawing, where 1 is the core of the distractor with the grooves of variable cross-section, 2 - pointed hook, 3 - lower bearing plate.

Working with this device is as follows.

From the slit in the projection of the spinous processes intended for the operation of the site emit a subperiosteal the posterior elements of the vertebral bodies. The hook is placed under articular process required vertebra and the lateral mass of the sacrum set the support plate. The rod shape of the spine, and slid it into the hole hook and plate, and then perform a metered traction along the axis of the rod. Upon reaching the required correction fix the hook on the rod and will, if necessary, plastic bone, after which the layers USEPA is 56 years.

A device for correction of distortions and stabilization of spinal segments, consisting of a distractor, a hook, a platform, and two clamps, characterized in that the rod distractor or at least part thereof is made variable cross-section in the form of a conical grooves of variable diameter increasing from the beginning of the rod to the middle of the same length, and the hook has a pointed shape and lateral grooves that are the size of the fixture capture device, the lower support plate is made in the form of staples, which has one side has a notched groove, and the other length is twice the first and has a conical shape, the corresponding fixture capture device.

 

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