Method, fixing member and auxiliary member for carrying out vertebral column osteosynthesis and stabilizing vertebrae in particular

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

 

The present invention relates to the field of restoration of the broken bones of the spine (hereinafter - application), and is intended for spine surgery for the correction of birth defects or degenerative idiomatic categories or neuromuscular, or neoplastic, or traumatic.

The prior art known to use tools, containing implants, which are secured to the bone by means of threaded elements or hooks and fasteners, which allow the surgeon to have an impact for straightening or stabilization of the spine.

As an example, European patent EP 626828 describes such a system, giving the possibility to perform osteosynthesis of the spine, and also describes a connecting element of this system and the tools used for Assembly or disassembly. This document describes a system for osteosynthesis of the spine, in particular, to stabilize the vertebrae, including:

at least one coupling element in the form of a rod,

at least two fixation means, each designed for attachment to the vertebra, and these funds with the head in the fork of two branches which define a receiving space, strictly U-shaped, the connecting element is,

- the locking screw is intended for screwing into the receiving space for mounting the coupling element between the two branches of the screw head fork "

- head, the bottom of which in the receiving space made in the form of a concave Cup in accordance with the liner element having the ability to swing mounted between the bottom of the receiving space, and a connecting element, the element liner, bearing surface which is in contact with the bottom of the receiving space has a more convex shape, wherein this element of the liner having the ability to swing, is provided with a hemispherical bearing surface in accordance with the bottom of the receiving space. This item is made with a recess, the open side of the clamping screw for receiving the coupling element in the form of a rod. The liner element having the ability to swing, is held near the bottom of the receiving space so that he had the ability to swing in a plane parallel to the median plane of the receiving space, and in the perpendicular plane.

Also known application for international patent WO 91/01691, describes a device for straightening and strengthening of the spine, formed by the implant, twisted pair or with hooks connected, at least two rods, with replenine each other via connecting elements. These rods is injected longitudinally into the grooves perpendicular to the screw provided for these purposes in buildings implants or hooks, then block them in the depth of the grooves. The fastening rods between them get by means of a threaded transverse. Deformation through the convergence of the sides of the slots made in the cases of implants or hooks to lock the rod in the depth of the groove is carried out through a system of cylindrical screws and nuts with tapered threads.

Also known application for international patent WO 94/14437, which published an implant containing one plot for bone attachment, and the attachment point on the rod, having two lateral branches, limiting the channel, and this implant also contains a threaded plug that can be screwed into the inner walls of the two branches. Application for international patent WO 94/10944 describes a device that includes a connecting element between the rod or other longitudinal implant and the bone fixation screw set into the damaged vertebra. This coupling element includes a ring, the size of which is made such that the rod could pass through it. The ring is equipped with a screw for fixation of the rod and has an elongation in the radial direction due to the cylindrical bracket made for the be secured by the screw bone fixation and briefly on the screw. Bracket and ring are integral. This device allows the surgeon to avoid further deformation of the rod when the latter is not exposed shoots, giving the surgeon complete freedom of choice of the position of the two axes of the bone fixation screw and rod.

The closest technical solution according to the essential features and the achieved result is a system for osteosynthesis of the spine and the fixation element, known from a European patent application EP 346521. The known system includes at least one coupling element in the form of a rod, at least two fixation means, each designed for attachment to the vertebra, and these funds with the head in the fork of two branches which define a receiving space, strictly U-shaped, coupling element, and the head has a generally saddle-type shape, locking screw, designed for screwing into the receiving space for locking the coupling element between the two branches of the head in the form of a fork. There is described an element for fixing, suitable for fixing on a single vertebra, for instrumentation for osteosynthesis of the spine, which is a head in the fork of two branches which define a receiving space is strictly U-breznay form for the coupling element, the bottom head has, as a rule, the shape of the saddle.

The problem is not solved by existing devices is to hold the orientation selected by the surgeon during the final fixing, between the location of the connecting element and set the bone implant and separation. The device includes a tightening screw, the tightening of this screw has a tendency to change the relative orientation of the connecting rod and the fixation element.

Another problem is the alignment adjustment screws on stage additional billing spine by rotating the rod for adjustment. This rod to adjust passes through several vertebral implants, for example from 10 to 15 vertebral implants and/or screws. Each of these implants contain, as a rule, one locking screw. The locking screw must be tight enough to prevent vertebral implant to slip, but not too much to make possible the rotation of the rod without excessive friction. Adjusting the degree of screwing of each of these locking screws is a delicate and exhausting operation.

The present invention is a challenge to get rid of these nuisances by the proposed system and the implant, allowing SOH is unity degree of correction, selected by the surgeon during operations final fixing and tightening of the locking screws of the connecting element, as well as providing the core capabilities of rotation with minimal friction in the exercise of its rotation, regardless of the degree of tightening of the locking screw.

The present invention relates in its broadest meaning to a device for osteosynthesis of the spine, in particular for the stabilization of the vertebrae. The problem is solved in that the system for osteosynthesis of the spine, containing at least one coupling element in the form of a rod or plate, at least two fixation means, each designed for attachment to the vertebra, and these funds with the head in the fork of two branches which define a receiving space, strictly U-shaped, the connecting element having a generally saddle-type shape, locking screw, designed for screwing into the receiving space for locking the connecting element installed between the two branches of the head in the form of a fork, according to the invention, the head is a guiding tool for independent locking parts, suitable for fixing on the head after installation of the connecting element in the plug head, with the above-mentioned locking part has, the AK rule, U-shaped, the branches of which are able to interact with the branches section of the head in the form of a Y-shaped fork and the bottom of which has a hole with an internal thread for engagement with the locking screw, and guide means provided on the head, formed arcuate shoulder on the lateral external surfaces of the plot in the form of a fork. In an embodiment of the invention shouldered represent the contact surface, converging strictly to the hole with internal thread designed to receive the locking screw.

Saddle-type form can be defined as an inverted parabolic hyperboloid, as a special form of execution, but not limited to one shape defined by the surface of the second order, corresponding to the hyperbolic paraboloid. This run gives the opportunity to establish, first of all, the means of fixation of the spine, then the connecting elements, if necessary, at the same time as the locking part, then correct the correction regardless of the locking elements and after optimal correction block each implant blocking screw. Tightening of the locking screw does not change the orientation of the means of fixation due to the freedom of movement of the locking part with respect to the housing means of fixation. Locked the first part has lateral provideproperty branches with curved shoulder on the inner surfaces, the size and shape of the branches and shoulder is defined in such a way as to be able to set in place the locking part due to elastic extension branches and stiffening of the shoulder. The final locking of the locking parts and the implant is performed by tightening the locking screw. Guiding means for locking the parts in the cylinder and formed additional arcuate shoulder provided on the outer lateral surfaces of the land in the form of plugs. These curved shouldered enable the locking parts to rotate relative to the head of the implant. One option is to manufacture the locking part from a material with shape memory. This item is in working order apart branches, which allows its installation on site in the form of a fork. After it is installed in place on the head, having continued in the form of a hook, the temperature change causes the straightening of the branches, which corresponds to the position of the lock on the plug. According to a variant, the position of the locking part fixed relative to the plug head. Shouldered or latching means do not allow, according to this variant, the angular degrees of freedom for locking the details.

The angle of convergence is not very critical. It is important that the contact surface would be oriented towards the on the locking parts. In any case, the angle of ten degrees relative to the transverse plane has already given to be able to obtain a satisfactory direction.

According to a variant implementation, the head on its lower section has continued in the form of a hook support spine for installation on the process or on the transverse incisure, and the above-mentioned hook contains an elastic plate for temporarily storing the commit.

The invention relates also to a system comprising a set of components (rod for correction, implants, locking parts locking screw). It applies in any case also the fixation element, suitable for fixation to the vertebrae to be instrumented osteosynthesis of the spine type with the head of the fork, the two branches of which define a receiving space is strictly U-shaped connection element, and the head has a generally saddle-type form, in which, according to the invention, the head is a guiding tool for independent locking parts, suitable for fixing on the head after installation of the connecting element in the plug head, while the locking part has a generally U-shaped, the branches of which are able to interact with the branches section head fork and the bottom of which has a hole with internal what ezibuy to interact with the locking screw, and guide means provided on the head, formed arcuate shoulder on the lateral external surfaces of the head in the form of a fork.

When the locking part has an additional shouldered, and the size and shape of shoulder defined in such a way as to be able to set in place the locking part due to elastic extension or shape memory branches and mounting as a result of coming in contact lateral surfaces of shoulder when tightening the locking screw. Shouldered provided on the lateral surfaces of the head in the form of a fork, take the form of an arc of a circle, giving one degree of freedom to pivot relative to the implant fixation to the spine. The fixation element, suitable for fixation to the vertebrae to be instrumented osteosynthesis is the contact surface, converging strictly to the hole with internal thread designed to receive the locking screw. In its lower part, the fixation element has a sequel in the form of a hook for mounting on a vertebra, and the above-mentioned hook contains an elastic plate for temporarily storing the commit.

The fixation element can be used not only with connecting elements in the form of rods, but with other, for example, with connecting elements trapezoidal and the and variable cross-section or with the plates, in particular, with the plates having the connection zone of circular cross-section. The invention also relates to an auxiliary element for the use of osteosynthesis of the spine, which, according to the invention, consists of two tip that can be placed in the slots provided on the head of the implant, and a device that can create a force on the rod to ensure positioning of the rod in the plug. This force may be transmitted to the rod by a locking part, which interacts supporting element during the phase of installation of the terminal in the plug implant. The interaction may be carried out by temporarily screwing auxiliary element in the hole with internal thread in the locking element.

The invention will be more clear from the description below with reference to the accompanying drawings, on which:

- figure 1 represents a longitudinal section of one example implementation of the system of osteosynthesis of the spine, according to the invention;

- figure 2 represents schematically a system according to the invention, side view,

- figure 3 and 4 represent the implant in two mutually perpendicular projections.

System for osteosynthesis of the spine, according to the proposed invention, includes a connecting element 1, the implant is 2, with an additional locking piece 3 and a locking screw 13.

The connecting element 1 in the form of a rod will not be described in detail because it is known from the prior art and may take various forms. In the described example is a metal rod of circular section.

The implant has a head 5 in the form of a fork with two side branches 6, 7, limiting the space available for receiving the coupling element 1.

The bottom 8 of the plug has a generally horseshoe shape with the concavity in the transverse plane corresponding to the plane of figure 1, and the bulge in additional planes.

The radius of curvature of the concave surface is strictly corresponds to the outer radius of the coupling element 1. The latter comes in contact on the peripheral line of the bottom.

Such contact line, and not on the annular surface allows you to rotate and provides at the same time, more effective lockout after screed than a simple point contact.

The locking piece 3 has a generally U-shaped with two branches 10, 11 and a bottom having a hole 12 with internal thread for mounting the locking screw.

The distance between the branches 10, 11 is to ensure that the installation of the crown. The branches 10, 11 have their lower ends curved shouldered 14, 15 with the inclined upper surface 16, 17.

These curved shouldered 14, 15 have the possibility of interaction is interacted with the additional guide means 20, 21 provided on the cylinder head 5. These guide means are also arcuate contact surface 22, 23 and have the opportunity to interact with the arcuate shoulder 14, 15, when the locking part is installed on the cylinder 5. As a result, they provide direction allowing rotation of the locking parts around the transverse axis 24, and ensure the locking of the locking part 3 on the cylinder head 5 and, consequently, the locking rod 1 after tightening of the screw 13.

Figure 2 is a side view which shows that the terminal has one degree of freedom, being able to swing relative to the transverse axis 24. This allows you to give independence to implanto and install it on the process by means of a hook 26 and independently to find the best orientation of the rod without interference on the part of these two effects. Horseshoe shape and mobility of the locking parts allows to adapt the locking and prevent rotation or movement of the rod when tightening the locking screw 13.

The hook 26 limits the space 27 of the V-shaped connection plate of the vertebra. Within this space, a U-shape is placed elastic plate 28, which provides temporary fixation to the bone so that the plate hook does not create the risk of damage to the bone marrow or other patterns.

Elastic plate 28 pushes the hook in the rear direction with respect to the patient and virtually eliminates damage to noble fabrics during the phase correction due to the rotation of the shaft.

3 and 4 show the implant without locking parts on the side view.

The implant has two slots 30, 31 allows the passage of the instrument representing two tip with the possibility of their location in the slots 30, 31, and the device has the ability to create force on the rod to ensure its lateral and/or vertical displacement in order to be able to position the terminal in the plug using the locking parts 3. In this case, the implant is temporarily rigidly fastened with the locking part with the screw, twisted pair in the hole with internal thread 12 in the locking part 3.

The invention is described above as a non-limiting example. It is clear that the specialist can carry out different ways, in particular by replacing the hook troshkovi screw or screws for the spine to install it on the front lateral side of the spine.

1. System for osteosynthesis of the spine, in particular for stabilizing vertebrae, containing at least one connecting element (1) in the form of a rod, at least two fixation means, each designed for C is mounted on a vertebra, moreover, these tools with the head (5) in the form of a fork, two branches of which defines a receiving space is strictly U-shaped connection element, and the head (5) has a generally saddle-type shape, a locking screw (13)intended for screwing into the receiving space for locking the coupling element (1) between the two branches of the head (5) in the form of a plug, characterized in that the cylinder (5) is a guiding tool for independent locking parts, suitable for fixing on the head (5) after the installation of the connecting element (1) in the plug head (5), the above-mentioned locking part (3) has a generally U-shaped, the branches of which are able to interact with the branches section of the head (5) in the form of a fork and the bottom of which has a hole with an internal thread for engagement with the locking screw (13), and the fact that the guiding means provided on the head (5), formed arcuate shoulder on the lateral external surfaces of the plot in the form of a fork.

2. System for osteosynthesis of the spine according to claim 1, characterized in that the locking part has an additional shouldered guide means, and the size and shape of shoulder defined in such a way as to be able to set in place the locking part (3) due to elastic rasd the position or shape memory branches and secure as a result of entering into contact with lateral surfaces of the shoulder when tightening the locking screw (13).

3. System for osteosynthesis of the spine according to claim 2, characterized in that the shouldered provided on the lateral surfaces of the section head (5) in the form of a fork, take the form of an arc of a circle.

4. System for osteosynthesis of the spine according to claim 2 or 3, characterized in that the shouldered represent the contact surface, converging strictly to the hole with internal thread designed to receive the locking screw (13).

5. System for osteosynthesis of the spine according to any one of claims 1 to 4, characterized in that the head (5) at its lower section has continued in the form of a hook for mounting on a place in the process or in another place, and the hook includes an elastic plate for temporarily storing the commit.

6. The fixation element, suitable for attachment to the vertebra to be instrumented osteosynthesis of the spine, of the type provided with a head (5) fork, two branches of which defines a receiving space is strictly U-shaped connection element, and the head (5) has a generally saddle-type form, characterized in that the cylinder (5) is a guiding tool for independent locking parts, suitable for fixing on the head (5) after the installation of the connecting element (1) in the plug head (5), the locking part (3) has, as a rule, U-shaped, the branches of which have a capacity is interact with branches section head (5) in the form of a fork and the bottom of which has a hole with an internal thread for engagement with the locking screw (13), and the fact that the guiding means provided on the head (5), formed arcuate shoulder on the lateral external surfaces of the head in the form of a fork.

7. The fixation element according to claim 6, characterized in that the locking part (3) has an additional shouldered, and the size and shape of shoulder defined in such a way as to be able to set in place the locking part (3) due to elastic extension or shape memory branches and mounting as a result of coming in contact lateral surfaces of shoulder when tightening the locking screw.

8. The fixation element, suitable for attachment to the vertebra to be instrumented osteosynthesis according to claim 7, characterized in that the shouldered provided on the lateral surfaces of the head (5) in the form of a fork, take the form of an arc of a circle, giving one degree of freedom to pivot relative to the implant fixation to the spine.

9. The fixation element, suitable for attachment to the vertebra to be instrumented osteosynthesis according to claim 6 or 7, characterized in that a represents the contact surface, converging strictly to the hole with internal thread designed to receive the locking screw (13).

10. The fixation element, suitable for attachment to the vertebra to be instrumented osteosynthesis according to any one of p-9, characterized in that the bottom part has continued in the form of a hook for mounting on a vertebra, moreover, the above-mentioned hook contains an elastic plate (28) for temporarily storing the commit.

11. A supporting element for the application of the fixation element in accordance with claim 9 or 10, characterized in that it consists of two tip that can be placed in grooves (30, 31)provided on the head (5) of the implant, and a device that can create a force on the rod to provide lateral or vertical movement to ensure positioning of the rod in the plug.

12. A supporting element for the application of the fixation element in accordance with claim 11, characterized in that it has a connection zone with the locking part (3) via a temporary screw, screw it into the hole (12) with internal thread.



 

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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

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