Device for correcting the vertebral column

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

 

The invention relates to medical equipment, namely, devices for the surgical treatment of spinal curvature.

Known concealer spine, containing two pairs of dual plates of titanium alloy and the mount plate to the spine. In the device attachment made in the form of the connecting straps, holders of elastic plates, beneath the arch of the vertebrae wire retainers, bonded staple made through the staple holes (see A.S. SU # 1063404, CL IPC And 61 In 17/00, 1983).

A disadvantage of this device is to use for the correction of spinal wire retainers, which can lead to injury of the spinal cord during surgery, to neurotic complications and limited in application, because in the surgical treatment of young children may damage the weak arches of the vertebrae. In addition, low rigidity leads to the risk of postoperative loss of correction, indicating a lower efficiency of treatment. In addition, this device does not solve the problem of correction of the spine in the horizontal plane.

In the device for correction of spine A.S. SU # 1544400, 1990, for correction of curvature along the entire length of the spine at the free end of each pair of plates mounted movable relative activities the plates but hard clips moreover, one pair of plates fastened with staples in the frontal plane and the other pair in the sagittal plane.

In this device brackets attached to the sides of the vertebrae with wire retainers, which leads to the disadvantages listed above. In addition, the device is difficult, has low reliability, and surgery with the use of this device requires a considerable time.

Known corrector of the spine, which contains two plates and the mount plates to the sides of the vertebrae, including hooks for institutions under the pedicles of the vertebrae and staples, which are symmetrically placed on the vertebrae and attached to the spine by means of hooks (see A.S. SU # 1685423, 1988). The hooks in this device is made of two parts, one of which is summed up under the arch of the vertebra, and the other on the outside of the arm and the bracket consists of an outer and an extended curved inner lining.

In this device, the size of the inner lining of the bracket and the necessary bending of elastic plates pick up each time by modeling the contour of the spine of the patient, taking into account its curvature. The device operates laying and fixing plates and double brackets on the arc of curvature of the spine on both sides of the spinous processes, and correction of the spine is due to the pressure on the vertebrae extended and bent vnutrennego brackets. The device is very difficult, and a surgical operation performed with this device may lead to injury of the spine and requires much time and high cost.

The closest analogue is a device for correction of spinal containing two elastic plates and mount plates to the sides of the vertebrae, each of which contains two hooks for institutions under the arms on both sides of the spinous process, two studs, and fastened with the corresponding hooks threaded and passed through the hook with a focus in his heel to lock the arms in the corresponding hook interposer with an elongated groove and the holders of elastic plates symmetrically located relative to the strips, nuts (see U.S. Pat. RU # 2077283, class. And 61 In 17/70, 1997).

However, holders of elastic plates and connecting straps attachment points in the form of individual parts that must be fastened during operation between a and connected with the spine, leading to lack of rigidity and the need to perform in a single operation 60 compounds on 10 attachment points (taking into account 6 connections on each node). When this operation on the spine involving this device requires the use of 60 specially trained fasteners and can be performed not less than che is 3 hours. Besides the lack stiletto limit stops can lead to injury of the membranes of the spinal cord, and to the injury of the soft tissues of the spine and, as a consequence, to infectious complications. In addition, the absence of heel hook special means for fixing the ends of the rods may lead to the displacement of the pins relative to the heel, which is inconvenient when carrying out the operation.

The analysis showed that all of these analogues do not provide stable fixation device spine in the postoperative period.

The objective of the proposed technical solution is to increase the rigidity and stability of the fixation device on the spine in the postoperative period while reducing the time for the operation, the reduction of its cost, the elimination of injuries of the spinal cord and soft tissues of the spine and reducing the risk of infectious complications.

To solve the tasks in the proposed device for the correction of the spine, containing two elastic plates and mount plates to the sides of the vertebrae, each of which contains two hooks for institutions under the arms on both sides of the spinous process, two studs, and fastened with a corresponding hook threaded and passed through the hook with a focus in his heel to lock the arms in sootvetstvujusceje, interposer with an elongated groove and the holders of elastic plates symmetrically located relative to the strips, nuts, according to the invention, each pin is made with a restrictive focus, and interposer attachment point is made in one piece with the holders of elastic plates with the formation of the U-shaped bracket, having at the ends of the legs facing the inside locking tabs, and the holders of the plates formed by the legs of the bracket and the locking protrusions, the elongated groove is made in the jumper bracket, and the bracket mounted on the stud through an elongated slot jumpers based on restrictive lugs studs and fastened to studs with two nuts screwed on the corresponding the stud on the outer side of the bracket, while in the heel of each hook is made of hole-catchers for additional fixing pins. In addition, in the proposed device according to the invention restrictive emphasis has the shape of a hexagonal nut.

Technical result achieved in this case, is to increase the rigidity and guarantee the stability of the fastening device on the spine in the postoperative period, the ability to perform the bonding of the elastic plates with the sides of the vertebrae using a minimum number of fastening elements, and reduce the time of operation 2 times, CH the terms of its value with simultaneous elimination of the spinal cord and soft tissues of the spine and decreased infectious complications, as well as to improve the ease of removal of the device after treatment.

Figure 1 shows the General view of the device for the correction of the spine.

Figure 2 shows the hook Assembly with the stud.

Figure 3 shows the attachment Assembly with the elastic plates.

A device for correction of the spine contains two elastic plates 1 and the mount 2 elastic plates to the sides of the vertebrae.

Each node attachment 2 contains two hook 3 with the screw holes 4, two studs 5, the nut 6 and the U-shaped bracket 7. U-shaped bracket 7 is made with a facing the inside locking protrusions 8 on the ends of the legs 9 of the bracket and is formed by combining the interposer 10 in one piece with the holders 11 of elastic plates, which are symmetrically located relative to the interposer.

The holders 11 of elastic plates formed legs 9 of the bracket and the locking protrusions 8 on the ends of legs 9 and serve to lock the plates during operation. The role of the interposer 10 performs jumper bracket 7 in which the elongated groove 12.

Hooks 3 attachment points are designed for fastening on the sides of the vertebrae that is provided by institutions hooks under the pedicles of the spine on either side of the spinous process. Studs 5 are intended for fastening hooks 3 bracket 7 and the bows of the spine and is made with restrictive KJV is AMI 13, serving for fixing the position of the bracket 7 on pins 5. Restrictive emphasis 13 has the shape of a hex nut, which facilitates removal and increases the ease of removal of the device in operation after treatment. In the heel 14 of each of the hook 3 is made of a hole-catchers 15, designed to increase the convenience of operation.

Device installation, perform the following way.

Under General anesthesia in the position of the patient on his stomach on both sides of the spinous processes reveal the arc of curvature of the spine.

Under bare arch of the vertebrae get the hooks 3 and have them on both sides of the spinous processes of the corresponding vertebra. Fixing hooks 3 on the shackle carried out by means of studs 5. For this purpose, the stud 5 is screwed into the threaded holes 4 made in the corresponding hook 3, passed through the shackle of the vertebra and fix advanced in the hole-the safety device 15, which is made in the heel 14 of the hook 3. The presence of holes of the safety device 15 can improve the operation convenience.

Next, on both sides of the spinous processes along the arc of a curvature of the spine stack of the elastic plate 1, which have been previously bent in the frontal and sagittal planes corresponding to the contour of the spine of the patient, taking into account its curvature.

Then perform the installation of the U-shaped bracket 7. For this purpose the bracket 7 through UDL is United groove 12 is put on studs 5, visually keeping the symmetrical position of the bracket 7 on pins 5. After the jumper bracket 7 will sit on restrictive lugs 13 pins 5, plate 1 due to their elastic forces klapivad and self-aligning in the holders 11. At this edge of the plate 1 is located on the locking protrusions 8 of the legs 9 of the bracket 7, and the wide side of the plate 1 adjacent to the plane of the legs 9 on the inner side of the bracket. This is achieved by simplifying installation and reducing installation time plates, and, therefore, reduce the time of the operation.

Simultaneously, the bracket 7 on the stud 5 is fixed by means of two nuts 6, which screw on the appropriate pin 5 on the outer side of the bracket 7. The implementation of the interposer 10 attachment 2 in one piece with the holders 11 of elastic plates 1 with the formation of the detachable connection in the form of a U-shaped bracket 7 allows you to increase rigidity, reduce the number of fasteners and to provide a connection of each of the mount 2 with the arms of the spine with only two nuts 6 screwed on related hooks studs 5. For carrying out all operations required in the average setting of 10 attachment points, which is solved using 20 nuts. This reduces the total time of operation in 2 times.

In the process operation to the plates 1 spare no effort in the sagittal and the frontal planes aside, opposite the scoliosis patient. This effort is determined by the size of the thoracic kyphosis and lumbar lordosis, which were determined by x-rays before surgery. The bracket passes the specified force plates over the studs 5 and the hooks 3 of attachment 2 to the pedicles of the vertebrae. In the result, the load on the vertebral body located on an arc of curvature, redistributed specified manner than is achieved and the necessary corrective action from the device.

This bracket 7 share the two hooks 3 of attachment 2, screwed into the studs. Alternating movement of the pins 5 on the threaded holes 4 corresponding hook 3 perform additionally a consistent correction of the position of the bows of the spine in the horizontal plane.

The existence of the limit stops 13 eliminates the trauma of the membranes of the spinal cord and trauma of the soft tissues of the spine and reduce the risk of infectious complications during the hospital stay and postoperative period. The implementation of restrictive lock 13 in the form of a hexagonal nut allows us to simplify the dismantling of the device and to reduce the operation time after treatment due to the possibility of dismantling the device with a single hex key under the lugs 13 and the nut 6.

The proposed device has been successfully tested in Opera is the second of surgical treatment of patients with scoliosis in Moscow city clinical hospital №13.

Technical and economic effect of the proposed technical solution is to increase the rigidity and stability of the fastening device on the spine in the postoperative period with a simultaneous decrease in operative time 2 times, reducing its cost, with the exception of spinal cord injury and reduce the probability of infectious complications.

1. A device for correction of spinal containing two elastic plates and mount plates to the sides of the vertebrae, each of which contains two hooks for institutions under the arms on both sides of the spinous process, two studs, and fastened with a corresponding hook threaded and passed through the hook with a focus in his heel to lock the arms in the corresponding hook interposer with an elongated groove and the holders of elastic plates symmetrically located relative to the strips, nuts, characterized in that each stud is made with limiting stops, and the connecting strap attachment point is made in one piece with the holders of elastic plates with the formation of the U-shaped bracket, having at the ends of the legs facing the inside locking tabs, and the holders of the plates formed by the legs of the bracket and the locking protrusions, the elongated groove is made in the jumper bracket, and the bracket mounted on the stud through the elongated groove is eimicke based on restrictive lugs studs and fastened to studs with two nuts, screwed on the corresponding pin on the outer side of the bracket, while in the heel of each hook is made of hole-catchers for additional fixing pins.

2. A device for correction of the spine according to claim 1, characterized in that a restrictive emphasis has the shape of a hexagonal nut.



 

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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.

9 dwg

FIELD: medical engineering.

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EFFECT: enhanced effectiveness of treatment.

2 dwg

FIELD: medicine; medical engineering.

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EFFECT: retained correction degree and final fixation and tightening of screws selected by surgeon during operation.

12 cl, 4 dwg

FIELD: medical engineering.

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EFFECT: rigid fixation of injured vertebral column segment; small-sized fixing members; reduced risk of traumatic complications.

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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.

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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.

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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

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