A device for correction of spinal deformities

 

(57) Abstract:

The invention relates to medicine, namely to traumatology and orthopedics, and can be used in surgical treatment of spinal deformities. The grips of the device are rigidly fixed to each other with screws and notches. The main capture contains a ball bearing connected with andcollection. The technical result consists in the elimination of spinal deformity in patients with incomplete growth and systemic disease of the skeleton characterized by delayed maturation of bone tissue. 1 Il.

The invention relates to medicine, namely to traumatology and orthopedics, and can be used in surgical treatment of spinal deformities.

The known device for the treatment of spinal deformities /auth.St. N 1650120, And 61 In 17/60, Gorbunov T. C. et al; ed.St. N 1690732, And 61 In 17/60, Pavlenko N. N. et al./, based on the principle of distraction using andconnector with two points of support, permanently installed on the spine. Their design does not allow their use in the treatment of patients with incomplete growth, as well as patients with systemic pathology of the skeleton.

Swuh distraction rods, coupled with a hinge. The hinge consists of two lugs connected to a single axis, and the ends of the eyelets made reference sites, one of which is perpendicular to the axis of the housing, and the second at an angle open towards the kyphosis.

The device facilitates uniform distribution of load on the spine in the treatment of kyphoscoliosis and allows you to make corrections in different planes. However, the device has two points of support, which distributed the load correction that does not allow its use in patients with incomplete growth due to insufficient strength of the supporting bone structures.

Closest to the claimed is a device for correction of spinal /auth. St. N 1627157, And 61 In 17/60, fishchenko P. J. et al./ The device has more than two points of support on the spine, has mobility on the level of the main hook in the same plane through the keyholes for flexible connection with the bracket. The design features allow dynamic correction with the growth of the patient.

General characteristics of the prototype with the claimed invention:

1). polysegmental installation of the support structure elements /mnozhestvenoe design.

The disadvantages of this design include:

1) lack of rigidity of the support structure elements among themselves, that may be the cause of unstable fixation device;

2) direct shear type of mobility supporting elements of the structure, limiting its installation and adaptation of andconnector to change the spatial position of the spine.

The objective of the invention is the elimination of spinal deformity in patients with incomplete growth and systemic disease of the skeleton characterized by delayed maturation of bone tissue.

The problem is solved due to the fact that the body is resilient flat spring rigidly gripping the rail between the cranial end of the rail is made of a ball support mounted in the Central cranial capture, on the plane of the Central cranial capture are auxiliary cranial clamps, the articulated surface made in the form of notches, they are rigidly fixed to each other by screws, on a rack housing is located caudal capture, fixed to the rail nut.

The technical result is achieved by the fact that cranial notches. The Central grip contains a ball bearing connected with andcollection. Thus, the axial loads resulting from andconnector, distributed on 3 points of support, which greatly reduces the chance of fracture of the supporting bone structures. A connection cranial mount unit with andcollection through a ball bearing allows you to set the device on the spine for almost any strain.

The drawing shows a diagram of the proposed device, which consists of the response of the toothed profile of the rack 5 and the rack 6 housing 7. In the housing 7 is resilient flat spring 8, tightly gripping the rails 5 and 6 to each other. The cranial end of the slats 5 are made ball support 4 mounted in the Central cranial grip 3. On the plane of the Central cranial capture 3 are auxiliary cranial clamps 1, the articulated surface made in the form of notches, and rigidly fixed thereto by the screws 2. On a rack housing 6 is located caudal capture 9, fixed to the rail 6 by a nut 10.

The device operates as follows: the patient is placed on an orthopedic table in position on the abdomen. the deposits. The lower limb is fixed to a special consoles orthopedic table for traction. After processing the back with iodine and alcohol perform incision of the skin over the spinous processes throughout the deformation. Skeletonize the posterior elements of the vertebrae on the concave side. Auxiliary cranial grips 1 set under the lower articular process neutral and 1 segment of the lower vertebrae. Central cranial grip with ball joint and andcollection Assembly installed under the articular process of the vertebra between the auxiliary grips with this Central 3 and 1 auxiliary grippers, the articulated surface made in the form of notches, is rigidly connected by screws 2. By squeezing the resilient flat spring 8 slats 5 and 6 move relative to each other until the total length of the device becomes minimum. On a neutral lumbar vertebra establish caudal capture 9, is inserted into the aperture of the caudal end of the rail 6 and fix their nut 10. Special tool make moving gear racks 5 and 6 relative to each other to increase the overall length of the structure. Then the employee who is not participating operator special tool produces additional moving gear racks 6 and 5 relative to each other to tension elastic tissue, if this gets an additional correction of spinal deformity. Perform a careful hemostasis, the wound was sutured in layers to drainage, skin impose cosmetic seam.

Clinical example: patient R. L., 10 years, hospitalized in the Department of pediatric orthopedics city hospital # 7, Komsomolsk-on-Amur 8.09.95, surgical treatment regarding progressive scoliotic deformation of 3 degrees. Diagnosis at admission: progressive dysplastic compensated right thoracic scoliosis of 3 degrees. The Central angle of the main arc was 41oaccording to Cobb.

After a preliminary examination and postoperative preparation 29.09.95, performed surgery: correction of spinal deformity of the proposed device. The patient laid on orthopedic surgical table in position on the abdomen. In the armpit installed special stops. The lower extremity is fixed to the traction devices operating table. After treatment the skin back a solution of iodine and alcohol made the incision of the skin over the spinous processes from the level of T2to the level of L5. Skeletonema the posterior elements of the vertebrae on the concave side. Installed cranial somaly cranial grip with ball joint and andcollection Assembly installed under the articular process of the vertebra between the auxiliary grippers, Central 3 and 1 auxiliary grippers, the articulated surface made in the form of notches, is rigidly connected by screws 2. By squeezing the resilient flat spring 8 slats 5 and 6 are displaced relative to each other as long as the total length of the device was not minimal. On a neutral lumbar vertebra installed caudal grip 9 in his hole inserted caudal end of the rail 6, the latter is fixed by a nut 10. Special tool rack 5 and 6 are displaced relative to each other with increasing length of the structure. Then the employee who is not directly involved in the operation of the traction devices operating table made traction patient's lower limbs, at this time, we were moving gear racks 5 and 6 relative to each other by a special tool to elastic tension of the tissues, with the resulting additional correction of spinal deformity. Made a careful hemostasis, the wound was sutured in layers to drainage, skin cosmetic suture.

On the control radiographs in the postoperative period, the Central angle of the main arc was 20oaccording to Cobb (correction of more than 50%).

 

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