Device for anterior spinal fusion in unstable fractures and dislocations fractures of the cervical spine
The invention relates to medicine, namely to surgical treatment of the cervical spine. The device includes two fixing plate, spacer-coupling sleeve with internal thread and the connecting rod with threads that are screwed along the axis of the coupling on both ends. The clutch is made hexagonal and with a passing hole through which a threaded pin-screws with lock nuts shall pulling the injured vertebra and an additional fastening device is a screw. The internal thread in the sleeve is made from one side the left, and on the other the right. The thread on the rod is made along the entire length, and each bar is made with right-hand thread and the other with the left. Each of the mounting plates have their edges holes for attachment to above - and downstream relative to the injured vertebrae and the screw holes, and in one plate with right-hand thread and the other on the left for screwing the threaded connecting rods. The invention provides for maintaining the stability of the osteosynthesis for the entire postoperative period by secure attachment of the device to a healthy vertebrae adjacent to damaged, as well as making it possible to discharge the
The invention relates to medicine, namely to surgical treatment of the cervical spine.
A device for the osteosynthesis when dislocations fractures of the vertebrae, used under the name of the latch-plate of Sadika consisting of two l-shaped hooks connected to the threads in the frame (D. Nikitin, Etc., in the Saldun, N. In. Kornilov and other Bone and metal fixation of spine diseases, injuries and their consequences. - SPb.: Russian graphics, 1998. - 448 S. p. 110). In this device, the rotation of the screws on the corners of the framework provide the convergence of the short arm of the frame and in between the spinous processes.
The disadvantage of this device is its massiveness, the inconvenience during installation during operation and the possibility of loosening the screws in the postoperative period, resulting in the need for re-operations.
Not less known in surgical practice on the spine of a device called a coupler Tkachenko (Practical neurosurgery: a Guide for physicians./Ed. by B. C. Gaidar. - SPb.: Hippocrates, 2002. - 648 S. p. 217, 218). The coupler consists of two hook with opposite threads, screw in the clutch.
Nedostatki.serezny period and the related emergence of secondary wedge-shaped deformation, which also leads to re-operation.
The technical result provided by the present invention is to maintain the stability of the osteosynthesis for the entire postoperative period by secure attachment of the device to a healthy vertebrae adjacent to damaged, as well as creating the possibility of unloading the damaged vertebra to the preset value and the possibility of stabilizing the vertical position of the spine.
This technical result is achieved due to the fact that the device contains two mounting brackets, spacer-coupling sleeve with internal thread and the connecting rod with threads that are screwed along the axis of the coupling at both ends, has a clutch made hexagonal and with a passing hole through which a threaded pin-screws with lock nuts shall pulling the injured vertebra and an additional fastening device is a screw, threaded in the sleeve, made with one side left, and on the other, the right, the threads on rods made along the entire length, one rod is made with right-hand thread and the other with the left, at the end of each of the fixing plates - holes for fastening to the up - and underlying Rel is Oh - left for screwing the threaded connecting rods.
The invention is illustrated by the following drawings: Fig.1 shows the device in top view; Fig.2 - the same, front view; Fig.3 shows the mounting plate from the side; Fig.4 shows the grub screw is the screw that is designed to pull the vertebrae of Fig.5 shows the plate after installation on the spine.
The device contains a figure of the fixing plate 1, hex spacer-coupling clutch 2 with internal thread, the connecting rod 3 with threads that are screwed along the axis of the clutch 2 at both ends, and nuts 4. The clutch 2 is made with a through hole 5 in the middle, through which by means of the threaded pin-screw 6 with lock nuts 4 carry out the tightening of the injured vertebra and an additional fastening device is a screw. The internal thread in the sleeve 2 is made with one side left, and on the other the right. The threads on the rod 3 is made along the entire length, with one rod 3 is made with right-hand thread and the other with the left. Each of the mounting plate 1 has on the outer edges of the openings 7 for attachment to the upstream and downstream relative to the injured vertebrae and the screw holes 8, with one plate on the right is for controlling the movement of the threaded connecting rod 3 by screwing it into the plate and unscrewing.
The device for its size can be attributed to very small; its length corresponds to the length of three vertebrae with two intervertebral disks, and the diameter of the spacer-coupling clutch can be 5-6 mm, the diameter of the threaded connecting rods - 2-3 mm. Such dimensions provide free wound closure after installation.
The material from which made the device - nickelide titanium.
Indications for use of device: the instability of the cervical spine in napravlennogo perelomova vertebra, progressive kyphotic deformity in heraklinos compression fracture of the vertebrae with compression of roots.
The use of the device provide front access as follows.
In a known manner (for example, by the method described by Moscovice I. A.: Operative Orthopaedics. A guide for physicians. - M.: Medicine, 1983, 416 S., ill., page 315-371) perform anterior fusion of the cervical spine. After exposure of the vertebral bodies prepare a bed for the device according to its form in the assembled condition. To do this, use a mill drill. The depth of the bed should be 7-8 mm, and its length along the axis of the spine are selected so that the holes of the upper Castine 1 was at the level of the transverse axis downstream (relative to the damaged vertebra. When this bed for turnbuckles 2 is combined with the vertical axis of the spine. After preparing the bed device stack and fix it with screws through the holes 7 in the mounting plate 1 to the upstream and downstream relative to the damaged vertebrae. Then the rotation of the spacer-coupling clutch 2 in one direction or another, depending on the situation, provide the necessary degree of compression or decompression and tighten contragate 4. This manipulation is performed under visual control through the hole 8. The device is fixed to the damaged vertebra screw through the hole 5. If there are significant dislocation and fracture to hold the device screw is produced tightening rejected vertebra by means of the threaded pin-screw 6. After pulling the vertebra pin-screw is removed, while maintaining the damaged vertebra to avoid the repeated rejection and instead of pin-screw 6 is screwed a screw. The wound is sutured in layers, treated with alcohol and apply a sterile dressing. After 2 weeks carry out the fixation of the vertebra posterior access in a known manner.
The device was tested in a clinical setting for 3 years on 42 patients. Postoperative period was patient started with 8-10 days after surgery. The hospital was 3-3,5 weeks, after this period of rehabilitation - up to 2 months. Surgery to remove the device was made in some cases for 6-8 months, and after 2-3 weeks the patient was fully able-bodied. Experience shows that removing device is not required.
The device in use can reduce treatment time by 25-35%, to provide a reliable result of treatment, reduce costs, achieve earlier the quality of life of patients.
Device for anterior spinal fusion in unstable fractures and dislocations fractures in the cervical spine, containing two mounting brackets, spacer-coupling sleeve with internal thread and the connecting rod with threads that are screwed along the axis of the coupling at both ends, characterized in that the coupling is made hexagonal and with a passing hole through which a threaded pin-screws with lock nuts shall pulling the injured vertebra and an additional fastening device is a screw and the internal thread in the sleeve is made from one side the left, and on the other, the right, the threads on the rods performed throughout gleam holes for mounting to the upstream and downstream relative to the injured vertebrae and the screw holes, moreover, in the same plate with right-hand thread and the other on the left for screwing the threaded connecting rods.
FIELD: medical engineering.
SUBSTANCE: device has two elastic plates and unit for fastening the plates to vertebral arches by means of two hooks placed under the arches on both sides of spinous process, two pins attached to corresponding hook with threaded connection and thrown over the hook with support given by its thrust journal for fastening arches in corresponding hook. The pins have restricting rest means. Connection strap is manufactured as a whole with elastic plate holders building U-shaped clamp having locking protrusions at pedicle ends turned inward. Plate holders are formed by clamp pedicles and locking protrusions. Elongated slot is available in clamp crossbar. The clamp is put over the pins via the elongated slot of the crossbar thrusting against restricting rest means of pins and connected to the pins by means of two nuts screwed over the corresponding pin from the external clamp side. Catching cells are produced in thrust journal of each hook for making additional fixation of the pins.
EFFECT: increased rigidity; fixation stability; accelerated operation process; reduced risk of traumatic complications.
2 cl, 3 dwg
FIELD: medicine; medical engineering.
SUBSTANCE: device is rectangular and has four or more slits for fixing means to pass through each of them. Two slits have exit to lateral side of plate to enable one to set the plate at required position and fix it without preliminarily removing the instrument for correcting orientation relative to vertebral column. Lateral plate surface runs from edge pointing the same direction with longitudinal plate direction. The latter exactly coincides with the vertebral column direction. The system comprises several vertebral column osteosynthesis plates to keep orientation correction relative to the vertebral column unchanged. Correction is carried out by means of the instrument for correcting orientation.
EFFECT: less number of holes to be drilled for mounting the device.
11 cl, 10 dwg
FIELD: medical engineering.
SUBSTANCE: device has plates having longitudinal segmentally counterbored slots and fastening members manufactured as bone screws with clamps. The clamps are manufactured as cramps having threaded openings in lower shelf. Locking members are mounted in threaded openings of the clamps. The locking members have threaded heads, hexagonal slot and smooth conic part set in hexagonal bone screw head slots. The bone screws are set in longitudinal segmentally counterbored slots of the plates. Their narrow parts under the heads pass through slits in the lower shelves of the clamps. The plates are connected to each other with cross-bar manufactured as rod ending with hook on one end which upper shelf has threaded hole for receiving locking member having threaded head, hexagonal slot and smooth thrusting part for fixing the cross-bar to a plate, the other free cross-bar end having corrugated part, has cross-bar clamp manufactured as cramps having threaded opening in upper shelf for receiving locking member having threaded head, hexagonal slot and smooth thrusting part supported by corrugated surface of the cross-bar to fix the cross-bar to the second plate. A hole is available in the upright connecting crossbar clamp shelves. The corrugated free crossbar end is movable and fixable in the hole.
EFFECT: enhanced effectiveness of treatment; reduced risk of traumatic complications; avoided blood deposit under plates.
FIELD: medical engineering.
SUBSTANCE: device has supporting frame and threaded rods mounted thereon to enable their transpedicular introduction into displaced vertebra body to take place with triangular structure being formed which apex is directed towards vertebral body. The supporting frame has screws introduced in transpedicular way into vertebral bodies adjacent to the displaced one, and connective bars building rigid structure by means of crossbars. The device has additional removable reposition frame resting upon the connective bars and joined to the threaded rods by means of transverse beam serving as triangular rigid structure base movable relative to the supporting frame. The screws and threaded rods have two threaded parts separated with spherical head, one of which is used for being introduced into bone tissue, and the other one is used for making connection to the connective bars. The connection is made as detachable floating fixing members having concave spherical surface for receiving rod and screw heads with variable connection angle. The detachable floating fixing members of the threaded rods have slots for receiving fingers connecting the threaded rods to the supporting frame allowing variable connection distances from the connective bars.
EFFECT: enhanced effectiveness of treatment.
FIELD: medicine; medical engineering.
SUBSTANCE: device has at least one connection member shaped as rod, at least two fixing means each fixable on vertebra body. The means have fork-shaped head parts which two branches determine U-shaped receiving space for the connection member to fit into it. Head is, as a rule, saddle-shaped, has locking screw for screwing-in into receiving space for fixing the connection member between two fork-shaped head branches. The head is guiding member for independent locking piece usable for carrying out fixation on the head after having set connection member into head fork. The locking piece is usually U-shaped, its branches being engageable with fork-shaped head part branches and its bottom part having opening with internal thread engageable with the locking screw. The guiding member available on the head part is formed with arc-shaped flanges available on lateral external surfaces of fork-shaped area. Fixing member has fork head, two branches of which determine receiving space of strictly U-shaped form for receiving connection member. Head is, as a rule, saddle-shaped. It serves as guiding member for independent locking piece usable for carrying out fixation on the head after having set connection member into head fork. The locking piece is usually U-shaped, its branches being engageable with fork-shaped head part branches and its bottom part having opening with internal thread engageable with the blocking screw. The guiding means available on the head part is formed with arc-shaped flanges available on lateral external surfaces of fork-shaped area. Auxiliary member has two end pieces positionable in slots available on implant head part and a means for applying force to the rod for causing lateral or vertical displacement to allow rod to be positionable in the slot.
EFFECT: retained correction degree and final fixation and tightening of screws selected by surgeon during operation.
12 cl, 4 dwg
FIELD: medical engineering.
SUBSTANCE: device has ball and socket joint casings having cylindrical and supporting parts, transpedicular screws having spherical heads, axial rods and transverse tie rods. Lower unseparable lips are available on external surfaces of supporting parts of ball-and-socket joints. The upper lips are separable and they are mounted on cylindrical parts of the casings. Cylindrical grooves which radii are equal to the axial rod radii are available on opposite surfaces of the upper separable and lower unseparable lips of the ball-and-socket joints. External thread is available in cylindrical parts of the casings with fastening nuts mounted thereon for fixing the separable lips. Locking members controlling angular displacements of spherical heads along transpedicular screw axes are manufactured as fixing screws having ring-shaped cutting edge on contact side to enable one to introduce them into internal threaded openings of the cylindrical parts. The axial rods are manufactured as pivot levers having rod part on one end and bushings on the other end arranged in perpendicular to each other. Locking member for controlling bushings rotation of pivot levers relative to each other is manufactured as radial teeth on plug plane and locking screws for positioning in bushing holes.
EFFECT: rigid fixation of injured vertebral column segment; small-sized fixing members; reduced risk of traumatic complications.
FIELD: medicine; neurosurgery; traumatic surgery.
SUBSTANCE: holder can be used for stabilization of damaged sectors of spinal column. Holder has transpedicular screws, longitudinal and lateral beams, fixing unit with two mutually perpendicular holes for screws and longitudinal beam. Longitudinal beams are made of shape-memory-effect material, which provides flexural rigidity of holder within 10 to 80 H/mm.
EFFECT: reduced risk of post-operational complications; stabilized traumatized segment of spinal column.
5 cl, 1 dwg
FIELD: medicine, in particular, equipment used in traumatology and orthopedics.
SUBSTANCE: apparatus has connection member 5, sealing cap 12, tightening means 13, locking means 21 for fixation, fixation means 35 used for securing of screw head 30 of bone fixation means in cavity 8 of connection member 5. Connection member 5 is positioned coaxially relative to central axis 2 and has upper end 6, lower end 7, cavity 8 arranged coaxially relative to central axis 2 extending through connection member 5 from its upper end 6 to its lower end 7, said cavity converging to its lower end 7 formed as at least one flange 9, and channel 10 extending through connection member 5 transverse to longitudinal axis 2 for receiving of longitudinal holder 11. Sealing cap 12 has front end 20, rear end 19, second cavity 18 open at its front end 20 for locating therein of connection member 5, and second channel 17 extending transverse to central axis 2 and opening toward front end 20 of sealing cap 12. Tightening means 13 may be fixed at rear end 19 of sealing cap 12 for retaining of longitudinal holder 11 located in channel 10 in connection member 5. Locking means 21 are positioned outside connection member 5 and in second cavity 18 of sealing cap 12 so as to mate each other and serve for fixation of sealing cap 12 on connection member 5.
EFFECT: increased efficiency owing to reduced space for implantation which is due to the possibility of introducing surgical instrument having diameter smaller than that of implant for preventing surrounding tissues from injury.
7 cl, 6 dwg
FIELD: medicine, traumatology, orthopedics.
SUBSTANCE: the present innovation deals with fixing affected segment in thoracic, lumbar and sacral vertebral departments. One should apply supporting elements of transpedicular system of bars which should be crossed in frontal plane and connected together with a fixing knot to regulate the angle of bars' crossing depending upon the requirements appeared, moreover, supporting elements should be applied through pedicles of vertebral arches that increases reliability of fixation at achieving osseous ankylosis.
EFFECT: higher efficiency.
2 dwg, 1 ex
FIELD: medicine; traumatic surgery; orthopedic devices.
SUBSTANCE: device for applying lengthening or stretching force to patient's body has aid for fastening first and second components to bones or to adjacent bones. Mentioned components are connected by increasing-length connecting aid. Device also has magnet connected with connecting aid and drive unit disposed outside patient's body for generating moving or changing electromagnetic field which results in rotation of magnet and elongation of connecting aid. Connecting aid has screw and nut. Magnet is connected with screw and nut by means of transmission box to generate relative rotation for elongating the device. Endoprosthesis replacement device to be elongated has first and second components that are connected by increasing-length unit. The first component has fraction of extremity joint. The second component has aid for fastening to resected long bone, magnet connected with connecting unit, and aid adjusted for disposition outside patient's body for generation of moving electromagnetic field which results in rotation of magnet and elongation of connecting unit. Magnet is connected with connecting unit by means of reduction gear. Device for correcting curvature of the spine has first and second shafts for elongation. Any shaft has its end to be connected with aid for fastening to corresponding vertebra. Connecting unit is adjusted in such a way that ends provided with fastening means were relatively movable. Mentioned connecting unit is connected with drive mechanism, which has rotated magnet, reduction gear, and drive aid for disposition outside patient's body. Generated moving or changing electric/magnetic field induces rotation of magnet and motion of fastening aid, disposed onto one shaft, relatively fastening aid, disposed at the other shaft.
EFFECT: elongation of bones or implants without surgical operation.
15 cl, 5 dwg