Spinal column holder

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

 

The invention relates to medicine, namely to neurosurgery, traumatology and orthopedics, and can be used to stabilize the damaged spinal segments.

Known construction, consisting of transpedicular introduced into the vertebral body screws and connecting beams or plates /Oganezov A.G., etc. // Bulletin of traumatology and orthopedics. - 2003. No. 3, - p.48-52/. Their use for fixation of the spine sometimes leads to complications due to too high rigidity compared with the rigidity of the spine. Especially this deficiency results in the case when the patient suffers from osteoporosis, and functional load on a stable segment of the spine lead to the destruction of bone around the screw, the migration of the latter and the loss of the stabilizing effect of the structure.

This disadvantage is trying to eliminate the creation of dynamic designs that should cushion the functional load on the operated segment of the spine. Thus, in the invention, which is selected for the prototype (patent RF №2197915 "Clamp for spine"), a longitudinal girder designs proposed to perform dynamic compensator formed by the sleeve to define the stiffness of the slits, which is made from metal with a high modulus of elasticity. However, this design of beams Pref is the CIO to increase, she takes in the body and has an open cavity filled in biological tissues. The latter will block the mobility of the dynamic compensator and injured when the action functional loads. Furthermore, the presence of dynamic compensator complicates the installation procedure release and makes it difficult to establish the correct position of the operated segment, so as to prevent the free movement of the attachment points on the longitudinal beam. It should also be noted that in this invention it is proposed to create a rough surface on the elements of the mount, not in contact with the longitudinal beam and transpedicular screw. This, in our opinion, does not provide sufficient ultimate joint between structural members and may lead to a reversal in the operation.

The objective of the proposed technical solution is to increase the reliability of stabilization of the injured spinal segment by reducing the rigidity of the retainer bending to values, the characteristic stiffness of healthy spinal segment, as well as simplification of the equipment installed and the extension of the indication for use.

An additional objective is to ensure the conservation achieved during the operation, reposition the structures of the spine by increasing the ultimate joint IOM is now, preventing rotation of the longitudinal beams and transpedicular screw relative to the mount, and a more complete integration of the screw and bone structures.

To achieve these objectives the latch for the spine contains transpedicular screws, longitudinal and transverse beams, the attachment points with two mutually perpendicular holes transpedicular screws and longitudinal beam, wherein the longitudinal beams are made of a material with shape memory effect, providing rigidity to the retainer by bending in the range from 10 to 80 N/mm

The increase in ultimate joint moments during rotation of the longitudinal beams and transpedicular screw relative to the mount to ensure the reliability of fixation can be realized by the fact that the beam has at least one chamfer and hole beam in the attachment has a cross-section shape corresponding to the cross section of the longitudinal beams, and/or the fact that the surface of the mount which is in contact with the longitudinal beam and transpedicular screw, is performed with a surface roughness in the range of Rzfrom 10 to 60 microns.

The use of the design of the release of the longitudinal beams with reduced stiffness reduces stresses on the boundary of transpedicular screw - bone structure of the vertebral body. This helps to ensure conditions for the who is one of integration of bone structures and screws. To accelerate this process, the surface of transpedicular screws in contact with the bony structures of the vertebrae, it is desirable to perform rough with Rzfrom 10 to 60 microns.

In addition, the longitudinal beam can have curves, corresponding anatomically correct bending of the spine in the place of its installation.

The experiments conducted on anatomical preparations nizhnegrudnogo and lumbar spine showed that the stiffness of the lock should range from 10 to 80 N/mm At higher stiffness values system of the spine - the latch becomes too Regina, leading to lysis of bone structures segment and resorption of the tissue around transpedicular screws. At smaller values of the stiffness of the latch is not able to provide the required stability of the injured spinal segment. The hardness of the retainer for the spine bending was conducted in accordance with ASTM F1717 (USA). In addition, the use of a material with shape memory effect to produce longitudinal beams allows to simplify the technology of installation of the lock on the spine and extend the indications to application design. This is achieved by the fact that the beam prior to its attachment to the transpedicular screws is cooled below the temperature of transformation of the material and easy may be the bent arms so to answer the form of an injured spine and pass through the attachment of transpedicular screws. After fastening the longitudinal beams to transpedicular screws and heated to human body temperature, it will tend to its original shape and provide on the spine efforts (distraction or compression), correcting the position of the injured vertebrae.

To ensure the greatest efficiency of this process the original form of the longitudinal beams must meet the anatomically correct shape of the spine is operated by the Department. So, for lumbosacral beam must be bent at 20-50 degrees, and for nizhnegrudnogo - direct. To increase efforts to unseat when the twisting longitudinal beams and transpedicular screw relative to the attachment beam is performed with at least one longitudinal flats, and the mount has a hole whose shape corresponds to the cross-sectional shape of the beam. In addition, the surface mount contact with the longitudinal beam and transpedicular screw, run rough with Rzfrom 10 to 60 microns.

The drawing shows a General view of the claimed device, where 1 - transpedicular screws, 2 - mount, 3 - longitudinal beams, 4 - cross-beam.

An example of use of the claimed device. The patient P. the settlement of Opel to the clinic with a diagnosis of complicated compression fracture of the L1 vertebral body as a result of falling from a height. In the operation of the rear access conducted laminectomy with revision spinal canal and decompression of the roots of the spinal cord and stabilize the injured segment retainer with the longitudinal beams of a material with shape memory (alloy based on Nickel-titanium, Ti-55.6% of Ni). To this end under x-ray control through legs (pediculi) in the body of the vertebrae T12 and L2 pairs introduced transpedicular screws, having a surface roughness Rz=30 μm, on which installed fasteners. Direct longitudinal beams with one chamfer is cooled in sterile physiological solution with a temperature of 5°C. Chilled beams hands were curved in accordance with the shape of the segment of the spine T12-L2. This segment in the norm has anatomical axis close to a straight line, but as a result of injury acquired kyphotic deformation of about 20 degrees. Therefore, the beams were curved so that their ends were an angle of about 20 degrees. In this state of a beam with attachment points installed on transpedicular screws. In the result due to the heat of the human body longitudinal beams are heated to a temperature of 35-37°in which they seek to return to the original straight shape and have a distraction effect on the vertebrae to which they are attached transpedicular screws. The wound was drained and laino was usuals. Check x-ray pictures taken the next day after the operation, showed that the longitudinal beams are fully straightened, and kyphotic deformity of the injured segment is missing. After 10 days the patient P. was discharged for outpatient treatment and after 3 months started to work.

Thus, using the stated release during operations on the spine can reduce complications in the postoperative period and stabilize the injured spinal segment. In addition, the use of the invention simplifies equipment installation lock provides reliable fixation, and also expands the indications for its use, as it allows to use the latch when the patient experiences osteoporosis, as well as to create a permanent distraction or compression, which is especially important in the treatment of scoliosis. Finally, in comparison with the prototype of the proposed release is significantly less.

1. The latch for the spine, containing transpedicular screws, longitudinal and transverse beams, the attachment points with two mutually perpendicular holes transpedicular screw and the longitudinal beam, wherein the longitudinal beams are made of a material with shape memory effect, ensuring the rigidity of the retainer is a bend in the range from 10 to 80 N/mm

2. The latch for the spine according to claim 1, characterized in that the longitudinal beam has at least one chamfer and hole beam in the attachment has a cross-section shape corresponding to the cross section of the longitudinal beams.

3. The latch for the spine according to claim 1 or 2, characterized in that the surface of the mount which is in contact with the longitudinal beam and transpedicular screw, made with a surface roughness in the range of Rzfrom 10 to 60 microns.

4. The latch for the spine according to claim 1, characterized in that the longitudinal beam has curves, corresponding anatomically correct bending of the spine in the place of its installation.

5. The latch for the spine according to claim 1, characterized in that the surface of transpedicular screws in contact with the bony structures of the vertebrae is made with a surface roughness in the range of Rzfrom 10 to 60 microns.



 

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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.

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FIELD: medicine; medical engineering.

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12 cl, 4 dwg

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FIELD: medical engineering.

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FIELD: medical engineering.

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6 dwg

FIELD: medicine; neurosurgery; traumatic surgery.

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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.

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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