CN111803197B - Spinal column orthopedic internal fixation system capable of automatically extending along with growth of spinal column - Google Patents
Spinal column orthopedic internal fixation system capable of automatically extending along with growth of spinal column Download PDFInfo
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- CN111803197B CN111803197B CN202010674911.8A CN202010674911A CN111803197B CN 111803197 B CN111803197 B CN 111803197B CN 202010674911 A CN202010674911 A CN 202010674911A CN 111803197 B CN111803197 B CN 111803197B
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- 230000000399 orthopedic effect Effects 0.000 title claims abstract description 30
- 230000000712 assembly Effects 0.000 claims description 7
- 238000000429 assembly Methods 0.000 claims description 7
- 210000000988 bone and bone Anatomy 0.000 claims description 6
- 241001391944 Commicarpus scandens Species 0.000 claims description 5
- 230000000149 penetrating effect Effects 0.000 claims description 3
- 230000007704 transition Effects 0.000 claims description 3
- 230000001105 regulatory effect Effects 0.000 abstract 1
- 201000002972 idiopathic scoliosis Diseases 0.000 description 6
- 230000006378 damage Effects 0.000 description 4
- 206010039722 scoliosis Diseases 0.000 description 4
- 206010048886 Onychoclasis Diseases 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 230000007547 defect Effects 0.000 description 2
- 210000003195 fascia Anatomy 0.000 description 2
- 210000001519 tissue Anatomy 0.000 description 2
- 230000000740 bleeding effect Effects 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000004927 fusion Effects 0.000 description 1
- 238000002695 general anesthesia Methods 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 238000002324 minimally invasive surgery Methods 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7043—Screws or hooks combined with longitudinal elements which do not contact vertebrae with a longitudinal element fixed to one or more transverse elements which connect multiple screws or hooks
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
- A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Neurology (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
The spine orthopedic internal fixation system capable of automatically extending along with the growth of the spine comprises a multi-section telescopic rod, a middle pedicle screw sleeve and an end pedicle screw sleeve; the multi-section telescopic rod is formed by alternately connecting fixed-length sections and variable-length sections, the fixed-length sections at two ends of the multi-section telescopic rod are defined as end fixed-length sections, the fixed-length sections between the fixed-length sections at two ends of the multi-section telescopic rod are defined as middle fixed-length sections, each end fixed-length section is connected with a set of end pedicle screw sleeve pieces, and each middle fixed-length section is connected with a set of middle pedicle screw sleeve pieces. The invention can meet the dynamic regulation requirement of the growth of the spine of a patient (multi-finger children), the multi-section telescopic rod can be automatically lengthened along with the growth of the spine of the patient, the length of each section is not required to be regulated by multiple operations, and the operation burden of the patient is reduced.
Description
Technical Field
The invention relates to the field of orthopedic medical instruments, in particular to a spinal column orthopedic internal fixation system capable of automatically extending along with the growth of a spinal column.
Background
At present, the children idiopathic scoliosis is treated at home and abroad by adopting an open operation, and the scoliosis spine is corrected by adopting a single-segment extending rigid orthopedic internal fixation system, but the following defects exist in the actual treatment process.
1. An open surgery is needed: the rigid orthopedic internal fixation system needs to be implanted into a patient through an open operation, has great damage to the patient, and is mainly characterized by long skin incision (about 20-40 cm), large tissue wound, great bleeding in the operation and difficult healing of the wound.
2. The patient undergoes multiple adjustment procedures: the extension structure of the rigid orthopedic internal fixation system is a single segment, and if the segment used for scoliosis orthopedic fixation is improperly selected, the extension growth of the spine can be affected; in addition, the spine longitudinally extends and grows in the body, the residual length of the orthopedic fixation rod is not easy to control, the situation that the residual length is too long or too short is easy to occur, the patient needs to be adjusted through operation, generally in the orthopedic treatment process, the patient needs to undergo 2-3 times of skin incision operation adjustment, namely, the rigid orthopedic internal fixation system cannot better adapt to the requirement of the spine growth.
3. The reliability is poor: the rigid orthopedic internal fixation system is rigid non-fusion fixation, the fixation time is long, and biological stress concentration is easy to occur, so that fatigue broken nails and broken rods are caused.
4. The orthopedic effect is difficult to ensure: the orthopedic fixation of the rigid orthopedic internal fixation system is a single rigid longitudinal extension structure, does not have an anti-rotation structure, and is easy to generate rotational extension growth of the scoliosis segment after operation.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provide a spine orthopedic internal fixation system capable of automatically extending along with the growth of a spine, which solves the problem that the existing rigid orthopedic internal fixation system for external treatment of the idiopathic scoliosis of children needs to be placed into a patient by adopting an open operation and has larger damage to the patient; the problem that the existing rigid orthopedic internal fixation system for external treatment of the idiopathic scoliosis of children cannot well adapt to the requirement of spinal growth, so that patients need to undergo multiple adjustment operations is solved; the problem that the existing rigid orthopedic internal fixation system for external treatment of the idiopathic scoliosis of children is easy to cause fatigue broken nails and fatigue broken rods is also solved; the problem that the rotation extension growth of the scoliosis section is easy to occur after the operation of the existing rigid orthopedic internal fixation system for external treatment of the idiopathic scoliosis of children and the orthopedic effect is difficult to guarantee is also solved.
The technical scheme of the invention is as follows: the spine orthopedic internal fixation system capable of automatically extending along with the growth of the spine comprises a multi-section telescopic rod, a middle pedicle screw sleeve and an end pedicle screw sleeve;
The multi-section telescopic rod is formed by alternately connecting fixed-length sections and variable-length sections, both ends of the multi-section telescopic rod are fixed-length sections, the variable-length sections are telescopic relative to the fixed-length sections connected with both ends of the variable-length sections, the variable-length sections cannot rotate relative to the fixed-length sections connected with both ends of the variable-length sections, the fixed-length sections at both ends of the multi-section telescopic rod are defined as end fixed-length sections, the fixed-length sections between the fixed-length sections at both ends of the multi-section telescopic rod are defined as middle fixed-length sections, each end fixed-length section is connected with a set of end pedicle screw assemblies, and each middle fixed-length section is connected with a set of middle pedicle screw assemblies;
The middle pedicle screw suite comprises a pedicle screw A and a positive clamping rod assembly, wherein the positive clamping rod assembly is detachably arranged on the pedicle screw A and is relatively fixed with a middle fixed-length section of the multi-section telescopic rod, so that the pedicle screw A and the multi-section telescopic rod are kept perpendicular to each other;
the end pedicle screw suite comprises a pedicle screw B and an oblique clamping rod assembly, wherein the oblique clamping rod assembly is detachably arranged on the pedicle screw B and is fixed relative to the end fixed-length section of the multi-section telescopic rod, so that the pedicle screw B and the multi-section telescopic rod are kept not perpendicular to each other.
The invention further adopts the technical scheme that: the pedicle screw A is provided with a cancellous bone thread A at one end of the tip part, an external thread A at one end of the head part, an anti-rotation plane A axially arranged and a positioning surface A longitudinally arranged and connected with the end part of the anti-rotation plane A, wherein the external thread A is arranged on the outer circular surface at one end of the head part; the positive clamping rod assembly comprises a lower fastener A, an upper fastener A and a nut A which are sequentially arranged on the pedicle screw A from the head of the pedicle screw A; the lower fastener A is movably sleeved on the pedicle screw A through the first through hole, and the lower fastener A is matched with an anti-rotation plane A of the head of the pedicle screw A through the first plane in the first through hole so as not to rotate on the pedicle screw A; the upper fastener A is provided with a second through hole and a second notch, the cross section of the second through hole is semicircular and is formed by connecting a second plane and a second arc surface, the upper fastener A is movably sleeved on the pedicle screw A through the second through hole, and the upper fastener A can not rotate on the pedicle screw A due to the fact that the second plane in the second through hole is matched with an anti-rotation plane A of the head of the pedicle screw A, and the second notch of the upper fastener A is opposite to the first notch of the lower fastener A; the nut A is in threaded connection with the external thread A of the pedicle screw A; when the middle fixed-length section of the multi-section telescopic rod stretches into the space between the first notch of the lower fastener A and the second notch of the upper fastener A, the middle fixed-length section and the lower fastener A are sequentially pressed on the positioning surface A by tightening the nut A, so that the pedicle screw A and the middle fixed-length section are relatively fixed;
The pedicle screw B is provided with a cancellous bone thread B at one end of the tip part, and is provided with an anti-rotation plane B axially arranged, a positioning surface B longitudinally arranged and connected with the end part of the anti-rotation plane B and an external thread B arranged on an external circular surface connected with the positioning surface B at one end of the head part; the oblique clamping rod assembly comprises a lower fastener B, an upper fastener B and a nut B which are sequentially arranged on the pedicle screw B from the head of the pedicle screw B; the lower fastener B is movably sleeved on the pedicle screw B through the third through hole, and the lower fastener B can not rotate on the pedicle screw B due to the fact that the third plane in the third through hole is matched with the anti-rotation plane B of the head of the pedicle screw B; the upper fastener B is movably sleeved on the pedicle screw B through the fourth through hole, and can not rotate on the pedicle screw B due to the fact that the fourth plane in the fourth through hole is matched with the anti-rotation plane B of the head of the pedicle screw B, and the fourth notch of the upper fastener B and the third notch of the lower fastener B are staggered; the nut B is in threaded connection with the external thread B of the pedicle screw B; when the middle fixed-length section of the multi-section telescopic rod stretches into a position between the third notch of the lower fastener B and the fourth notch of the upper fastener B, the middle fixed-length section and the lower fastener B are sequentially pressed on the positioning surface B by tightening the nut B, so that the pedicle screw B and the end fixed-length section are relatively fixed.
The invention further adopts the technical scheme that: when the lower fastener A and the upper fastener A are sleeved on the pedicle screw A from the head of the pedicle screw A in sequence, a first notch on the lower fastener A is opposite to a second notch on the upper fastener A; when the lower fastener B and the upper fastener B are sleeved on the pedicle screw B from the head of the pedicle screw B in sequence, a third notch on the lower fastener B and a fourth notch on the upper fastener B are staggered with each other.
The invention further adopts the technical scheme that: an annular easy-to-break incision A is arranged at one end of the head of the pedicle screw A, and an annular easy-to-break incision B is arranged at one end of the head of the pedicle screw B.
The invention further adopts the technical scheme that: the fixed-length section of the multi-section telescopic rod is a sleeve, a plurality of guide grooves are arranged in an inner hole of the sleeve, and a strip-shaped hole A penetrating into the inner hole of the sleeve is arranged on the outer wall of the sleeve; the length-variable section of the multi-section telescopic rod is a rod body, guide edges which are matched with the guide grooves in the inner holes of the sleeves are arranged on the rod body, and limit bosses are arranged at two ends of the rod body;
the rod body is inserted into the inner hole of the sleeve in a transition fit manner;
When the rod body is inserted into the sleeve, the guide ribs on the rod body are matched with the guide grooves of the sleeve so as to prevent the rod body from rotating relative to the sleeve, and the limit bosses at the two ends of the rod body extend into the strip-shaped holes A of the sleeve at the two ends of the rod body respectively so as to prevent the rod body from falling out of the inner hole of the sleeve.
Compared with the prior art, the invention has the following advantages:
1. Reducing physical damage to the patient: the spine orthopedic internal fixation system can be implanted by adopting a minimally invasive surgery, an incision for implanting pedicle screws is only needed to be cut on the skin during the surgery, the tissue trauma is small, compared with the existing rigid orthopedic internal fixation system, the damage to the body of a patient is smaller, and the postoperative recovery period is shorter.
2. The operation burden of the patient is lightened: the multi-section telescopic rod can meet the dynamic regulation requirement of the growth of the spine of a patient (multi-finger children), can be automatically lengthened along with the growth of the spine of the patient, does not need to adjust the length of each section by multiple operations, and reduces the operation burden of the patient.
3. The reliability is good: the multi-section telescopic rod can be adaptively elongated along with the growth of the spine of a patient (multi-finger children), so that the biological stress concentration can not occur, and further, the phenomena of fatigue broken nails and broken rods are avoided, and the multi-section telescopic rod has excellent reliability.
4. The orthopedic effect is good: the pedicle screw A, B and the multi-section telescopic rod can be respectively kept in firm relative fixed relation by the positive and oblique clamping rod assemblies, and the fixed-length section and the variable-length section of the multi-section telescopic rod can not rotate relatively; the structure ensures that the internal fixation system for spinal column correction keeps stable after being implanted into a patient, does not rotate or deviate, can only elongate along the growth direction of the spinal column, and avoids the influence on the correction effect caused by the rotation and extension of the spinal column.
The invention is further described below with reference to the drawings and examples.
Drawings
FIG. 1 is a schematic diagram of the structure of the present invention;
FIG. 2 is a schematic structural view of a central pedicle screw kit;
FIG. 3 is a schematic view of the construction of an end pedicle screw kit;
FIG. 4 is a schematic view of the structure of pedicle screw A;
FIG. 5 is a left side view of FIG. 4;
FIG. 6 is a top view of FIG. 4;
fig. 7 is a schematic structural view of the upper fastener a;
FIG. 8 is a top view of FIG. 7;
fig. 9 is a schematic structural view of the lower fastener a;
FIG. 10 is a top view of FIG. 9;
FIG. 11 is a schematic view of the structure of pedicle screw B;
FIG. 12 is a left side view of FIG. 11;
FIG. 13 is a top view of FIG. 11;
fig. 14 is a schematic structural view of the upper fastener B;
FIG. 15 is a top view of FIG. 14;
FIG. 16 is a schematic view of the structure of the lower fastener B;
FIG. 17 is a top view of FIG. 16;
FIG. 18 is a schematic view of a connection structure of a fixed length segment and a variable length segment of a multi-segment telescopic rod;
Fig. 19 is a cross-sectional view A-A of fig. 18.
Detailed Description
Example 1:
As shown in fig. 1-19, the spinal column orthopedic internal fixation system capable of self-extending along with the growth of the spinal column comprises a multi-section telescopic rod 1, a middle pedicle screw kit and an end pedicle screw kit.
The multi-section telescopic rod 1 is formed by alternately connecting fixed-length sections 11 and variable-length sections 12, the two ends of the multi-section telescopic rod 1 are fixed-length sections 11, the variable-length sections 12 are telescopic relative to the fixed-length sections 11 connected with the two ends of the variable-length sections 12, the variable-length sections 12 cannot rotate relative to the fixed-length sections 11 connected with the two ends of the variable-length sections, the fixed-length sections 11 which define the two ends of the multi-section telescopic rod 1 as end fixed-length sections, the fixed-length sections 11 which define the fixed-length sections 11 between the two ends of the multi-section telescopic rod 1 as middle fixed-length sections, a set of end pedicle screw assemblies are connected to each end fixed-length section, and a set of middle pedicle screw assemblies are connected to each middle fixed-length section.
The middle pedicle screw suite comprises a pedicle screw A21 and a positive clamping rod assembly, wherein the positive clamping rod assembly is detachably arranged on the pedicle screw A21 and is relatively fixed with the middle fixed-length section of the multi-section telescopic rod, so that the pedicle screw A21 and the multi-section telescopic rod are kept perpendicular to each other.
The pedicle screw A21 is provided with a cancellous bone thread A211 at one end of the tip, an external thread A214 at one end of the head, an anti-rotation plane A212 arranged along the axial direction, and a positioning surface A213 arranged along the longitudinal direction and connected with the end of the anti-rotation plane A212, wherein the external thread A214 is arranged on the outer circular surface at one end of the head. The positive clamping bar assembly includes a lower fastener a22, an upper fastener a23, and a nut a24 that are mounted on pedicle screw a21 in sequence from the head of pedicle screw a 21. The lower fastener A22 is provided with a first through hole 221 and a first notch 222, the cross section of the first through hole 221 is semicircular, the first through hole 221 is formed by connecting a first plane and a first arc surface, the lower fastener A22 is movably sleeved on the pedicle screw A21 through the first through hole 221, and the lower fastener A22 can not rotate relative to the pedicle screw A21 due to the fact that the first plane in the first through hole 221 is matched with an anti-rotation plane A212 of the head of the pedicle screw A21. The upper fastener A23 is provided with a second through hole 231 and a second notch 232, the cross section of the second through hole 231 is semicircular and is formed by connecting a second plane and a second arc surface, the upper fastener A23 is movably sleeved on the pedicle screw A21 through the second through hole 231, and the upper fastener A23 can not rotate relative to the pedicle screw A21 due to the fact that the second plane in the second through hole 231 is matched with an anti-rotation plane A212 of the head of the pedicle screw A21, and the second notch 232 of the upper fastener A23 is opposite to the first notch 222 of the lower fastener A21. The nut a23 is threaded onto the external thread a214 of the pedicle screw a 21. When the middle fixed-length section of the multi-section telescopic rod 1 stretches into the space between the first notch 222 of the lower fastener A22 and the second notch 232 of the upper fastener A23, the screw nut A23 is screwed to sequentially press the upper fastener A23, the middle fixed-length section and the lower fastener A22 on the positioning surface A213, so that the pedicle screw A21 and the middle fixed-length section are relatively fixed.
The end pedicle screw suite comprises a pedicle screw B31 and an oblique clamping rod assembly, wherein the oblique clamping rod assembly is detachably arranged on the pedicle screw B31 and is fixed relative to the end fixed-length section of the multi-section telescopic rod, so that the pedicle screw B31 and the multi-section telescopic rod are kept not perpendicular to each other.
The pedicle screw B31 is provided with a cancellous bone thread B311 at one end of the tip portion, an anti-rotation plane B312 arranged in the axial direction, a positioning surface B313 arranged in the longitudinal direction and connected with the end of the anti-rotation plane B312, and an external thread B314 provided on an outer circumferential surface connected with the positioning surface B313 at one end of the head portion. The oblique clamping rod assembly includes a lower fastener B32, an upper fastener B33, and a nut B34, which are sequentially attached to the pedicle screw B31 from the head of the pedicle screw B31. The lower fastener B32 is provided with a third through hole 321 and a third notch 322, the cross section of the third through hole 321 is semicircular, the third through hole 321 is formed by connecting a third plane and a third arc surface, the lower fastener B32 is movably sleeved on the pedicle screw B31 through the third through hole 321, and the lower fastener B32 can not rotate relative to the pedicle screw B31 due to the fact that the third plane in the third through hole 321 is matched with an anti-rotation plane B312 at the head of the pedicle screw B31. The upper fastener B33 is provided with a fourth through hole 331 and a fourth notch 332, the cross section of the fourth through hole 331 is semicircular and is formed by connecting a fourth plane and a fourth arc surface, the upper fastener B33 is movably sleeved on the pedicle screw B31 through the fourth through hole 331, and the upper fastener B33 cannot rotate relative to the pedicle screw B31 due to the fact that the fourth plane in the fourth through hole 331 is matched with an anti-rotation plane B312 of the head of the pedicle screw B31, and the fourth notch 332 of the upper fastener B33 and the third notch 322 of the lower fastener B32 are staggered (namely, are not in a right-facing state). The nut B34 is threaded onto the external thread B314 of the pedicle screw B31. When the middle fixed-length section of the multi-section telescopic rod 1 stretches into the space between the third notch 322 of the lower fastener B32 and the fourth notch 332 of the upper fastener B33, the tightening nut B34 is used for sequentially pressing the upper fastener B33, the middle fixed-length section and the lower fastener B32 on the positioning surface B313, so that the pedicle screw B31 and the end fixed-length section are relatively fixed.
Preferably, when the lower fastener A22 and the upper fastener A23 are sequentially sleeved on the pedicle screw A21 from the head of the pedicle screw A31, the first notch 222 on the lower fastener A22 is opposite to the second notch 232 on the upper fastener A23, so that the middle fixed-length section clamped between the upper fastener A23 and the lower fastener A22 is kept perpendicular to the pedicle screw A.
Preferably, when the lower fastener B32 and the upper fastener B33 are sequentially sleeved on the pedicle screw B31 from the head of the pedicle screw B31, the third notch 232 on the lower fastener B23 and the fourth notch 332 on the upper fastener B33 are staggered from each other, so that the end fixed-length section clamped between the upper fastener a23 and the lower fastener a22 is ensured to be mutually non-perpendicular to the pedicle screw a, and the angle between the end fixed-length section and the pedicle screw B31 can be changed by adjusting the tightness of the nut B34.
Preferably, the head end of pedicle screw A21 is provided with an annular frangible cut A215 and the head end of pedicle screw B31 is provided with an annular frangible cut B315 to facilitate the intraoperative breaking of the excess portion of pedicle screw A, B.
Preferably, the fixed-length section 11 of the multi-section telescopic rod 1 is a sleeve, a plurality of guide grooves 111 are arranged in the inner hole of the sleeve, and a strip-shaped hole A112 penetrating into the inner hole of the sleeve is arranged on the outer wall of the sleeve. The length-variable section 12 of the multi-section telescopic rod 1 is a rod body, a guide rib 121 which is matched with the guide groove 111 in the sleeve inner hole is arranged on the rod body, and limit bosses 122 are arranged at two ends of the rod body. The rod body is inserted into the inner hole of the sleeve in a transition fit manner. When the rod body is inserted into the sleeve, the guide ribs 121 on the rod body are matched with the guide grooves 111 of the sleeve so as to prevent the rod body from rotating relative to the sleeve, and the limit bosses 122 at the two ends of the rod body extend into the strip-shaped holes A112 of the sleeve connected with the two ends of the rod body respectively so as to prevent the rod body from falling out of the inner hole of the sleeve.
Brief description of the invention the surgical procedure for correcting idiopathic scoliosis in children:
1. The patient takes the prone position, under the monitoring of X rays, orthopedic fixing marking points and telescopic rod inserting marking points are made on the left side and the right side of the spine of the patient, after general anesthesia is effective, conventional disinfection towel is paved, and the skin is cut at each marking point for 1 cm to 1.5cm long.
2. Pedicle screws a21, B31 are implanted one by one into the vertebral body from the corresponding orthopedic fixation mark points under the supervision of a C-arm machine.
3. The lower fasteners A22 and B32 are respectively sleeved on the pedicle screws A21 and B31 and respectively pushed into the skin and between fascia.
4. The multi-segment telescopic rod 1 with proper length is pushed into the skin from the incision at the insertion mark point of the telescopic rod to be positioned between the skin and fascia, the length of the variable length segment 12 is adjusted, the end fixed length segment is dropped on the third notch 322 of the corresponding lower fastener B32, and the middle fixed length segment is dropped on the first notch 222 of the corresponding lower fastener A22.
5. The upper fasteners A22 and B32 are respectively sleeved on the pedicle screws A21 and B31 and respectively pushed into the skin to respectively buckle the corresponding middle fixed-length section and the corresponding end fixed-length section.
6. The nut A23 is screwed on the pedicle screw A21, so that the pedicle screw A21 and the middle fixed-length section are relatively fixed; the nut B34 is tightened onto the pedicle screw B31, thereby achieving a relative fixation of the pedicle screw B31 and the end fixed length segment.
7. The pedicle screws A21 and B31 are respectively broken from the annular easy-to-break cuts A215 and B315, the broken pedicle screws A21 and B31 are positioned in the skin, and then the operation is completed by stitching and cutting one by one.
Claims (2)
1. An orthopedic internal fixation system of spine that can extend by oneself along with the growth of backbone, characterized by: comprises a multi-section telescopic rod, a middle pedicle screw sleeve and an end pedicle screw sleeve;
The multi-section telescopic rod is formed by alternately connecting fixed-length sections and variable-length sections, both ends of the multi-section telescopic rod are fixed-length sections, the variable-length sections are telescopic relative to the fixed-length sections connected with both ends of the variable-length sections, the variable-length sections cannot rotate relative to the fixed-length sections connected with both ends of the variable-length sections, the fixed-length sections at both ends of the multi-section telescopic rod are defined as end fixed-length sections, the fixed-length sections between the fixed-length sections at both ends of the multi-section telescopic rod are defined as middle fixed-length sections, each end fixed-length section is connected with a set of end pedicle screw assemblies, and each middle fixed-length section is connected with a set of middle pedicle screw assemblies;
The middle pedicle screw suite comprises a pedicle screw A and a positive clamping rod assembly, wherein the positive clamping rod assembly is detachably arranged on the pedicle screw A and is relatively fixed with a middle fixed-length section of the multi-section telescopic rod, so that the pedicle screw A and the multi-section telescopic rod are kept perpendicular to each other;
The end pedicle screw suite comprises a pedicle screw B and an oblique clamping rod assembly, wherein the oblique clamping rod assembly is detachably arranged on the pedicle screw B and is fixed relative to the end fixed-length section of the multi-section telescopic rod, so that the pedicle screw B and the multi-section telescopic rod are kept not perpendicular to each other;
The pedicle screw A is provided with a cancellous bone thread A at one end of the tip part, an external thread A at one end of the head part, an anti-rotation plane A axially arranged and a positioning surface A longitudinally arranged and connected with the end part of the anti-rotation plane A, wherein the external thread A is arranged on the outer circular surface at one end of the head part; the positive clamping rod assembly comprises a lower fastener A, an upper fastener A and a nut A which are sequentially arranged on the pedicle screw A from the head of the pedicle screw A; the lower fastener A is movably sleeved on the pedicle screw A through the first through hole, and the lower fastener A is matched with an anti-rotation plane A of the head of the pedicle screw A through the first plane in the first through hole so as not to rotate on the pedicle screw A; the upper fastener A is provided with a second through hole and a second notch, the cross section of the second through hole is semicircular and is formed by connecting a second plane and a second arc surface, the upper fastener A is movably sleeved on the pedicle screw A through the second through hole, and the upper fastener A can not rotate on the pedicle screw A due to the fact that the second plane in the second through hole is matched with an anti-rotation plane A of the head of the pedicle screw A, and the second notch of the upper fastener A is opposite to the first notch of the lower fastener A; the nut A is in threaded connection with the external thread A of the pedicle screw A; when the middle fixed-length section of the multi-section telescopic rod stretches into the space between the first notch of the lower fastener A and the second notch of the upper fastener A, the middle fixed-length section and the lower fastener A are sequentially pressed on the positioning surface A by tightening the nut A, so that the pedicle screw A and the middle fixed-length section are relatively fixed;
the pedicle screw B is provided with a cancellous bone thread B at one end of the tip part, and is provided with an anti-rotation plane B axially arranged, a positioning surface B longitudinally arranged and connected with the end part of the anti-rotation plane B and an external thread B arranged on an external circular surface connected with the positioning surface B at one end of the head part; the oblique clamping rod assembly comprises a lower fastener B, an upper fastener B and a nut B which are sequentially arranged on the pedicle screw B from the head of the pedicle screw B; the lower fastener B is movably sleeved on the pedicle screw B through the third through hole, and the lower fastener B can not rotate on the pedicle screw B due to the fact that the third plane in the third through hole is matched with the anti-rotation plane B of the head of the pedicle screw B; the upper fastener B is movably sleeved on the pedicle screw B through the fourth through hole, and can not rotate on the pedicle screw B due to the fact that the fourth plane in the fourth through hole is matched with the anti-rotation plane B of the head of the pedicle screw B, and the fourth notch of the upper fastener B and the third notch of the lower fastener B are staggered; the nut B is in threaded connection with the external thread B of the pedicle screw B; when the middle fixed-length section of the multi-section telescopic rod stretches into a position between the third notch of the lower fastener B and the fourth notch of the upper fastener B, the middle fixed-length section and the lower fastener B are sequentially pressed on the positioning surface B by tightening the nut B, so that the pedicle screw B and the end fixed-length section are relatively fixed;
An annular easy-to-break incision A is formed at one end of the head of the pedicle screw A, and an annular easy-to-break incision B is formed at one end of the head of the pedicle screw B;
The fixed-length section of the multi-section telescopic rod is a sleeve, a plurality of guide grooves are arranged in an inner hole of the sleeve, and a strip-shaped hole A penetrating into the inner hole of the sleeve is arranged on the outer wall of the sleeve; the length-variable section of the multi-section telescopic rod is a rod body, guide edges which are matched with the guide grooves in the inner holes of the sleeves are arranged on the rod body, and limit bosses are arranged at two ends of the rod body;
the rod body is inserted into the inner hole of the sleeve in a transition fit manner;
When the rod body is inserted into the sleeve, the guide ribs on the rod body are matched with the guide grooves of the sleeve so as to prevent the rod body from rotating relative to the sleeve, and the limit bosses at the two ends of the rod body extend into the strip-shaped holes A of the sleeve at the two ends of the rod body respectively so as to prevent the rod body from falling out of the inner hole of the sleeve.
2. The internal fixation system for spinal column orthotics capable of self-extension with spinal column growth as recited in claim 1, wherein: when the lower fastener A and the upper fastener A are sleeved on the pedicle screw A from the head of the pedicle screw A in sequence, a first notch on the lower fastener A is opposite to a second notch on the upper fastener A; when the lower fastener B and the upper fastener B are sleeved on the pedicle screw B from the head of the pedicle screw B in sequence, a third notch on the lower fastener B and a fourth notch on the upper fastener B are staggered with each other.
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| CN212281583U (en) * | 2020-07-14 | 2021-01-05 | 重庆郭昌毕中医骨伤医院有限公司 | Spine orthopedic internal fixing device capable of automatically extending along with growth of spine |
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| CN2291126Y (en) * | 1997-07-21 | 1998-09-16 | 常州市郊区康华医疗器械厂 | Spinal angle-changing orthopedic internal fixation device |
| WO2006033503A1 (en) * | 2004-09-22 | 2006-03-30 | Kyung-Woo Park | Bio-flexible spinal fixation apparatus with shape memory alloy |
| CN101785695B (en) * | 2010-01-31 | 2011-12-21 | 赵胜 | Automatic-extending and anti-revolving scoliosis correcting system |
| CN102028531B (en) * | 2010-12-20 | 2013-07-10 | 常州市康辉医疗器械有限公司 | Dynamic scoliosis correction device |
| CN203619663U (en) * | 2013-10-22 | 2014-06-04 | 左建宏 | Split type percutaneous vertebral pedicle screw of minimally invasive spine prying reconstructive external fixator |
| CN105997210B (en) * | 2016-06-08 | 2018-10-12 | 迪恩医疗科技有限公司 | A kind of multi-faceted orthopedic external fixer of vertebral column minimally invasive |
| CN107307899A (en) * | 2016-12-31 | 2017-11-03 | 王文军 | Multi-segmental tandem spinal external fixator |
| CN106963465A (en) * | 2017-03-29 | 2017-07-21 | 石鹏 | KAFO is fixed in scoliosis in children |
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