Method for transpedicular fixation of affected vertebral segment

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

 

The invention relates to medicine, namely to traumatology and orthopedics, and can be used when fixing the damaged spinal segment in the thoracic, lumbar and sacral spine.

Patients with complicated spinal cord injuries heal quickly, locking the affected segment of the spine bone autograft (Vvoice, Conforti, Kookana. Operative Orthopaedics and traumatology. Sofia, 1961. - S-771, 774-776). The main disadvantages of these operations are difficult to achieve intervertebral frets technically difficult and dangerous front-line access, additional tissue trauma associated with the capture of a bone graft, the need for long-term compliance with bed rest after surgery.

Known methods of surgical treatment of patients with spinal cord injuries, involving the application of various metal plates cyto, NIITO couplers of Ramya-Ziviani (Neurosurgical, Vamapaull, B.v.gaidar. Closed injuries of the spine in the thoracic and lumbar localization. Saint-Petersburg. - Mopcap AB, 2000. - Pp.62-64).

There is a method of fixing vertebrae with metal rods, which are located on the posterior surface of the spine and connected by screws conducted transpedicular above and below the area of poraj the deposits (Measurer, Allgower, Rsnyder, Vellinger. Manual of internal fixation. - Ad Marginem, Moscow, 1996. - S-670). The method provides an approximate parallel to the direction of holding adjacent supporting rods in the frontal plane. The support rod connects located transpedicular higher - and lower screws Trench placed on one side of a line drawn through the spinous processes. When you need to perform a laminectomy, the locking system is supplemented by a cross rod connecting the support rod. Transverse rod performs a dual function - protects the spinal cord and its roots in the zone of laminectomy, and is also the stabilizer of the entire locking system.

This method is used as a prototype, because it has common features with claimed: the creation of fusion by stabilizing by using implantable metal, the introduction of locking elements through the legs of the arc of a vertebra.

The disadvantages of the prototype is insufficient strength of fixation of the metal structure with respect to a complex rotation-flexion and rotation is inclined loads and high cost structures installed, limiting the applicability of the prototype in the treatment of patients with disorders of the spine.

The essence of the proposed method lies in the fact that during the stabilization of damaged spinal segment using implantable transpedicular metal as supporting elements use barbells, which perekrashivat in the frontal plane and are connected with the original mount. The result is improved reliability of fixing of a damaged spinal segment, Pets early activation of the patient in the postoperative period. You can use the proposed method in combination with decompression by laminectomy - created content protection of the spinal canal at the level of the decussation, reduced treatment costs by reducing the number of structural elements. When applying the weights to each other, we can model the intersection zone by bending one of the rods. The mount allows you to adjust the angle of the crossing rods depending on the emerging demands from 0 to 170 degrees. As transpedicular input elements use standard metal screws Trench or pedicularia the screws, open the side.

The method is illustrated in the drawings 1, 2. Figure 1 shows a schematic depiction of transpedicular fixation of the proposed method in the frontal plane. Figure 2 - attachment.

Description of the mount. The mount is presented in the form of two hollow cylinders with a diameter of 6.2 mm and a length of 15 mm. On one of the side surfaces of each cylinder has a support area of the trapezoidal shape. In the center of the support point of one of the of cilindrov is a round hole with the screw thread, corresponding to the diameter of the insertion of the screw. In the frame of another cylinder is provided by a longitudinal hole edges, razzenkovannye under the bonnet fixing screw.

The method is as follows. After installing transpedicular screws make the selection of the desired length rods with a diameter of 6 mm Rod is simulated with special plates, taking into account the physiological curves of the spine and specific biomechanical situation. If necessary, the spinous process of the fixed vertebra and speakers anatomical bone formation back complexes vertebrae sparingly resetinput for optimal adaptation of the rods to the bone structures.

Then on the supporting rod is placed cylinders that make up the mount by turning their foothold to each other. The design is mounted on the entered transpedicular screws with nodes so that rod, placed one above the other, overlap in the frontal plane. Then combine holes reference sites cylinders mounted on the cross support rod, overlaying on top of the support platform with a longitudinal hole. Get the stop on the top of foothold in the wall of the second cylinder. Fix foothold cylinders interconnected by means of screws, thus connecting the crossed rod and is our transpedicular screws in a single system.

Clinical example

Patient P., 46 years old, was admitted in the Samara regional clinical hospital. Kalinin 21.11.2000, 12 days after Calatrava with a diagnosis of Closed comminuted unstable, Pereloma-dislocation L2with injury and spinal cord compression, the lower prepares, dysfunction of the pelvic organs.

After the examination and detail of the nature of disorders, the patient was performed surgery decompressive laminectomy L2rear-side decompression of the spinal osteosynthesis L1-L2transpedicular vertebral rod device according to the proposed method. The postoperative period was uneventful.

The wound healed by first intention. The patient was allowed to stand and to walk with crutches in a week after surgery. The function of the pelvic organs were normal. Examined after 3 months. after surgical intervention. No complaints, neurological disorders are not identified. The control x-ray signs of bone ankylosis between the first, second and third lumbar vertebrae, no signs of instability.

Thus, the proposed method is simple in technique, low-impact and can be recommended for application in medical practice.

The way transpedicular f is xali damaged spinal segment, including the creation of fusion by stabilizing by using implantable metal, the introduction of locking elements through the legs of the arc of the vertebra, wherein the support elements are placed on the back surface of the spine, apply rod, crossing them in the frontal plane and connecting the attachment.



 

Same patents:

FIELD: medicine, in particular, equipment used in traumatology and orthopedics.

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7 cl, 6 dwg

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: 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.

6 dwg

FIELD: medicine; medical engineering.

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12 cl, 4 dwg

FIELD: medical engineering.

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EFFECT: enhanced effectiveness of treatment.

2 dwg

FIELD: medical engineering.

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EFFECT: enhanced effectiveness of treatment; reduced risk of traumatic complications; avoided blood deposit under plates.

9 dwg

FIELD: medicine; medical engineering.

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11 cl, 10 dwg

FIELD: medical engineering.

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2 cl, 3 dwg, 2 tbl

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2 cl, 1 tbl

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