Device for making posterior spondylodesis

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

 

The device is used in medicine, specifically in traumatology and neurosurgery. Designed to reposition and stabilize the vertebrae fractured their bodies and some other pathological changes in the spine.

Known devices for transpedicular fixation of the vertebral bodies, as, for example, internal transpedicular latch Roy-Camille [1]. The device comprises a plate with longitudinally spaced razzenkovannye holes, including a set of bone screws.

Another similar may serve as a device for posterior spinal fusion [2], the base of which has the form of a channel containing a Central threaded and located on either side of him razzenkovannye apertures, the plate and the fastening elements in the form of bone screws. The pad is made in the form of a flat curved spring presses the screw to the base and retainer in razzenkovannye holes head transpedicular introduced screws.

As negative qualities of both analogues should be noted is the lack of stability of fixation, leading to a rotational instability of the vertebral motor segment, along with the plates. This eventually leads to the loosening of the bone screws in the device Roy-Camille [1] with a tendency to loosening due to bone resorption, and increased concentration in the spine of the screws in the device for posterior spinal fusion [2], you cannot prevent the pad.

You should also indicate that a significant drawback of the device to the rear of fusion [2] is the formation of so-called "dead space" at the expense of gapping hard channel to the arches of the vertebrae, which can lead to formation depot streamed blood.

The closest in terms of its technical solution proposed is an internal transpedicular latch Steffe [3], adopted for the prototype. The device comprises a plate with longitudinal grooves having segmental countersunk on the outer surface. Through the slots on the outer surface of the plate is withdrawn threaded rods attached to the heads of the bone screws, transpedicular screwed in the body of the vertebrae and bearing conical washers and nuts. The disadvantage of the prototype is that the ends of the threaded rods are not deep enough under the skin that is traumatogenic factor. A significant drawback of the device is also reduced stability transpedicular fixation and, above all, its rotational component.

The invention consists in the combination of essential features, sufficient to achieve the desired technical result, namely the improvement of treatment outcomes by improving the stability of the transponder is dicumarol commit reduce trauma intervention and eliminate the risk of Deposit under plates streamed blood.

This entity lies in the fact that the device containing plates with segmental razzenkovannye the slots and the fastening elements in the form of a bone screw clamps, the clamps are made in the form of brackets with the screw hole in the top shelf and an open slot under the bone screws in the bottom shelf, in the threaded holes of the clamps installed the brakes with the screw head, hexagonal slot and a smooth cone-shaped part is placed in the hex slots of the heads of bone screws that are installed in the longitudinal segmental-razzenkovannye the slots of the plates, and passing the narrowed podvolochye areas through the slots of the bottom shelves clamps, plates are interconnected by a cross member made in the form of a rod with a hook at one end, the top shelf which has a threaded hole stopper with the screw head, hexagonal slot and a smooth hard part, fixing the cross member to one plate, and on the other, the free end of the cross member with riflescope, a clamp sleepers, made in the form of a bracket with the screw hole on the top shelf under the stopper with the screw head, hexagonal slot and a smooth hard part, rests on the corrugated surface of the cross bar, the locking section is to mend the second plate, in a rack connecting the shelf clip sleepers, made a hole, in which, with the possibility of moving and fixing posted free corrugated end of the cross.

The presence of the clamps allows to reliably fix the bone screws to prevent loosening of the bone due to the rigid fixation of their heads through obstacles.

Dip the screw heads stoppers into the threaded holes flush with the surfaces of the clamps and hook crossbar significantly reduces traumatogenic moment occurring when the protrusion of the ends of the threaded rods under the skin in the device prototype.

The presence of a cross-beam significantly increases the rigidity of the structure, eliminating, in the first rotational component of post-traumatic instability of the spine. In necessary cases (a considerable length of pathological area) can be used two or more crossbars.

The rigidity provided by the crossbars, it is possible to avoid the use of devices containing the channel, which prevents flexing of the plate, by configuring them in shape with the sides of the vertebrae, in order to avoid depositing streamed blood.

The device shown on the drawings. Figure 1 shows a General view figure 2 - plate, 3 - cross, 4 - clamp bone screw figure 5 - clip p is parachini, figure 6 - bone screws, 7 - stopper crossbar and clamp cross, Fig - stopper clamp the bone screw figure 9 - photo of the device.

The device comprises a plate 1, equipped with a longitudinal segmental razzenkovannye grooves 2. Plate 1 are interconnected by a cross member 3, made in the form of a rod, is fitted at one end of the hook 4, the top shelf which threaded hole stopper 5 with the screw head having a hexagonal slot and a smooth hard part, pressed against the plate 1.

Free the opposite end of the cross member 3 is equipped with riflescope 6 and placed, with the ability to be moved and fixed in the hole 7 of the clip cross bar 8, which also has a stopper 5.

Bone screws 9 are installed in the respective Zenkovich grooves so that over their heads, equipped hex slots placed the clamps 10, made in the form of brackets, the top shelf which is equipped with threaded holes with installed stoppers 11, having a threaded head, hex slots and smooth, cone-shaped part, immersed in hex slots of the heads of the bone screws 9.

The device is used as follows. Naked spinous processes of damaged and two (upstream and downstream) of the vertebrae. Usepreview soft tissue from the spinous processes adjacent to n is m dujkovic departments. Liberated from soft tissue space stack plate 1 with razzenkovannye grooves 2. Through the slots 2 transpedicular screwed into the body above and underlying vertebrae bone screws 9 not to dive head in razzenkovannye grooves. Then install the clamps bone screws 9 so that the bottom shelf clips 10 with an open slot was under the plates 7, and the upper shelves of the clamp 10 with the screw holes were above the plate 7, then install the crossmember 3: its hook on one plate 1, and the second plate 7 is fixed clamp cross bar 8 so that the rod cross member 3 with a knurled surface is seated in the bore of the clamp 7, the cross member 3. The crossmember is finally fixed by screwing the stoppers 5. After installation of the clamps 10 bone screws 9 and the cross-beams 3 bone screws 9 doverchivaya through the screw holes of the upper shelves of the clamps 10 to complete immersion of the heads of the bone screws in the countersink of the slots 2. In the screw holes of the clips 10 is screwed the stoppers 11 so that their smooth, cone-shaped part is in hex slots of the heads of the bone screws 9. The stoppers 11 of the clamp 10 press the heads of the bone screws 9, preventing them from loosening and unscrewing than remains stable fixation.

All stoppers screwed flush, thus preventing the likelihood is revereware soft tissue protruding parts.

If necessary (the great length of the plates 7) may use several cross-beams 3. Depending on the configuration of the plates 7 the length of the working part of the cross member 3 can be varied by moving its end with riflescope in the hole 7 of the clip cross bar 8 with its subsequent locking.

After layer-by-layer suturing of the wound management of patients is carried out according to the General principles of treatment of this pathology. The use of the device eliminates the need for application of plaster fixation.

Sources of information:

1. Roy-Camille R. et al. Montpellier chir. - 1976, No. 22, R-312.

2. RF patent № 2160067, bull., No. 34, 2000.

3. Steffe, A. et al. Clin.Orthop. in 1986, vol.203, p.45-54.

Device for posterior spinal fusion containing plates with longitudinal segmental razzenkovannye the slots and the fastening elements in the form of bone screws with clips, characterized in that the clamps are made in the form of brackets with the screw hole in the top shelf and an open slot under the bone screws in the bottom shelf, in the threaded holes of the clamps installed the brakes with the screw head, hexagonal slot and a smooth cone-shaped part is placed in the hex slots of the heads of bone screws that are installed in the longitudinal segmental-razzenkovannye the slots of the plates, and passing the narrowed podvolochye areas through the slots of the bottom shelves clamps, plates SV which are interconnected by a cross member, made in the form of a rod with a hook at one end, the top shelf which has a threaded hole stopper with the screw head, hexagonal slot and a smooth hard part, fixing the cross member to one plate, and on the other, the free end of the cross member with riflescope, a clamp sleepers, made in the form of a bracket with the screw hole on the top shelf under the stopper with the screw head, hexagonal slot and a smooth hard part, rests on the corrugated surface of the cross bar, the locking cross member to the second plate in the rack connecting shelf clip sleepers, made a hole in which, with the possibility of moving and fixing posted free corrugated end of the cross.



 

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