CN103381105A - Lumbosacral portion and ilium combined device and method for combined fixation to lumbosacral portion and ilium through adopting same - Google Patents

Abstract

The invention discloses a lumbar-iliac joint and a method for fixing the lumbo-iliac joint, which comprises an iliac screw connection part and a rod connection part, which are connected together by three connecting shafts and two connecting rods, and are mainly used for increasing the spine Stability of lumbosacral and pelvic internal fixation. In the process of iliac screw fixation, by changing the position of the screw entry point and the screw path, the length of the screw is reduced, which significantly reduces the penetration of the iliac screw through the bone and damage to important organs in the pelvis. , the risk of nerves and blood vessels, and at the same time can increase the fixation strength, especially reduce the stress load between the lumbar 5 sacral 1 vertebral body; at the same time, through the connection of the lumbar iliac joint, it reduces the range of stripping of the surrounding tissue during the operation and Local trauma allows direct connection and fixation of the lumbar spine and pelvis, avoiding complications such as lumbosacral fixation failure and pseudarthrosis formation, especially for patients who cannot be fixed with sacral screws, it can significantly improve the internal fixation strength of the spine, lumbosacral region and pelvis.

Description

Lumbar-iliac joint device and its fixation method

technical field

The invention belongs to a supporting device for internal fixation of the spine, which is mainly used for increasing the internal fixation stability of the lumbosacral part of the spine and the pelvis.

Background technique

Lumbosacral spinal fusion has always been a challenging area in spine surgery. The local complex anatomical structure, unique biomechanical properties and poor bone quality of the sacrum are the reasons for the difficulty in fusion of the lumbosacral spine. Especially in patients with long segments that need to be fused to the sacrum, the sacrum 1 pedicle screw needs to bear a huge physiological load, which often leads to serious complications such as screw loosening at the lumbosacral joint and pseudarthrosis formation.

With the development of spinal surgery, the concept and technology of spinal-pelvic fixation are more and more widely accepted and applied, that is, lumbosacral iliac fixation and fusion through posterior lumbar, sacral and iliac screw placement have achieved satisfactory results. Especially for the cases of severe spondylolisthesis after fixation and fusion and long-segment scoliosis correction of the spine, a higher fusion rate can be obtained by placing iliac screws for lumbosacral-pelvic fixation and fusion.

However, in the clinical application of the iliac screw, how to place the iliac screw accurately and safely during the operation, and how to avoid damage to important structures such as blood vessels and nerves during the operation is also a major problem for doctors. Due to the complex anatomical structure of the ilium and its proximity to important organs, nerves, and blood vessels, the iliac screw is relatively long. During the insertion process, if the location of the screw entry point and the screw channel are not selected accurately, the iliac screw can easily penetrate the bone. , damage the important organs, nerves and blood vessels in the pelvis; moreover, the existing iliac screw entry point is often selected at the posterior superior iliac spine, for some sacral tumor resection and reconstruction and osteoporotic lumbosacral degeneration, it is impossible to perform sacral For fixed patients, the iliac bone entry point is exposed during the operation, which may easily cause excessive stripping to the distal end, causing unnecessary damage to the surrounding soft tissue and muscles, and greatly affecting the postoperative recovery of the patient.

Contents of the invention

In view of the defects or deficiencies in the above-mentioned prior art, the object of the present invention is to provide a lumbar-iliac combiner and a method for fixing the lumbar-iliac combiner using the lumbar-iliac combiner, which can significantly improve the internal fixation strength of the spine, lumbosacral region and pelvis. , in order to reduce the scope of tissue dissection and local trauma during the operation, reduce the complications of lumbosacral fixation failure and pseudarthrosis formation, and facilitate the stable fixation of lumbosacral and pelvis.

In order to realize above-mentioned task, the present invention takes following technical solution:

A lumbar iliac joint, characterized in that it includes an iliac screw connection part and a rod connection part, wherein:

The bottom end of the connecting portion of the ilium screw is cylindrical, and the outer surface of the cylinder has external threads matching the tail of the iliac screw, and a third connecting shaft is sleeved in the middle of the connecting portion of the ilium screw. One side of the connecting shaft is connected to the first connecting rod, and the third connecting shaft can rotate 360° in the coronal plane; there is a cylindrical first fixing knob on the upper part of the connecting part of the ilium screw, through which the first fixing knob is tightened , can limit the rotation of the third connecting shaft; the first connecting rod and the second connecting rod are connected to each other through the first connecting shaft, the first connecting shaft can rotate 180° on the frontal plane, and at the same time adjust the second connecting rod through the first connecting shaft The length of the connecting rod, the side of the first connecting shaft has an inner hexagonal third fixing knob, the rotation of the first connecting shaft can be limited by tightening the third fixing knob;

The bottom end of the rod connection part is an arched structure, the arched structure is used to place the fixing rod of the lumbar pedicle screw screw rod system, and the width and height of the arch are larger than the lumbar pedicle screws The diameter of the cross-section of the fixing rod of the rod system; an outer hexagonal second fixing knob is installed on the upper part of the arch structure, and the fixing of the rod connection part and the lumbar pedicle screw screw rod system can be achieved by tightening the second fixing knob. The rod can be firmly fixed. There is a first connecting shaft in the center of one side of the connecting part of the rod. The first connecting shaft makes the connecting part of the rod rotate 360° in the sagittal position. The other side of the first connecting shaft is connected with the second connecting rod.

Using the above-mentioned lumbo-iliac joint device for lumbo-iliac joint fixation method is characterized in that it comprises the following steps:

1) Routine exposure of the lumbar pedicle screw entry point, and at the same time continue to be exposed on the same plane to the outside, exposing the iliac crest;

2) The insertion point of the iliac screw is selected on the iliac crest of the lumbar 4/5 segmental plane, the screw insertion direction is pointing to the sciatic notch, and the screw insertion depth is 50 mm, and the iliac screw is inserted;

3) The lumbar pedicle screw-rod system is routinely placed. The lowermost ends of the fixation rods on both sides of the lumbar pedicle screw-rod system should be reserved for connecting the lumbar 5 pedicle screws while ensuring the connection with the lumbar pedicle screw. iliac syndesmosis;

4) Connect and tighten the external thread on the connecting part of the iliac screw with the tail of the iliac screw first, then adjust the lengths of the first connecting rod and the second connecting rod through the first connecting shaft; adjust the length of the third connecting shaft, The first connecting shaft and the first connecting shaft connect the rod connecting part with the fixing rod of the lumbar pedicle screw and rod system; finally, the first, second and third fixing knobs are tightened with a screwdriver.

The lumbar-iliac joint device of the present invention is characterized in that, in the fixation of the lumbosacral region and the pelvis, the length of the screw is reduced by changing the position of the screw entry point and the screw path, which significantly reduces the penetration of the iliac screw through the bone and the damage to the bone. The risk of important organs, nerves and blood vessels in the pelvis can increase the fixation strength, especially reduce the stress load between the lumbar 5 sacral and 1 vertebrae; at the same time, the connection of the lumbar iliac joint reduces the impact on the surrounding area during the operation. The range of tissue stripping and local trauma can directly connect and fix the lumbar spine and pelvis, avoiding complications such as lumbosacral fixation failure and pseudarthrosis formation, especially for patients who cannot be fixed with sacral screws, it can significantly improve the spine, lumbosacral and The strength of internal fixation in the pelvis.

Description of drawings

Fig. 1 is a three-dimensional schematic diagram of the structure of the lumboiliac combiner of the present invention;

Fig. 2 is a plan view of the structure of the lumboiliac combiner of the present invention, wherein (a) is a front view, and (b) is a top view of (a);

The marks in the figure represent respectively: 3. The connecting part of the ilium screw, 4. The second connecting shaft, 5. The first connecting rod, 6. The second connecting rod, 7. The third connecting shaft, 8. The first connecting shaft, 9. Rod connecting portion, 10. First fixed knob, 11. Second fixed knob, 12. Third fixed knob, 14. Arched structure, 15. Arched.

The structure of the present invention will be further described in detail below in conjunction with the accompanying drawings.

Detailed ways

Referring to Figures 1 and 2, this embodiment provides a lumboiliac joint, including an iliac screw connection part 3 and a rod connection part 9, wherein:

The bottom end of the iliac screw connection part 3 is cylindrical, and the outer surface of the cylinder has an external thread 13 matching the iliac screw tail, and the third connecting shaft 7 is socketed in the middle of the iliac screw connection part 3. One side of the three connecting shafts 7 is connected to the first connecting rod 5, and the third connecting shaft 7 can rotate 360° in the coronal plane; the upper part of the ilium screw connecting part 3 has a cylindrical first fixing knob 10, through which the first fixing knob The tightening of 10 can limit the rotation of the third connecting shaft 7; the first connecting rod 5 and the second connecting rod 6 are connected to each other through the second connecting shaft 4, and the second connecting shaft 4 can rotate 180° on the frontal plane, At the same time, the length of the second connecting rod 6 is adjusted through the second connecting shaft 4. The side of the second connecting shaft 4 has a third internal hexagonal fixing knob 12, which can limit the second connecting shaft by tightening the third fixing knob 12. 4 rotations;

The bottom end of the rod connection part 9 is an arched structure 14, the arched 15 of the arched structure 14 is used to place the fixing rod of the lumbar pedicle screw and rod system, and the width and height of the arched 15 are larger than the lumbar pedicle The diameter of the cross-section of the fixed rod of the screw nail rod system; an outer hexagonal second fixed knob 11 is installed on the top of the arched structure 14, and the rod connecting portion 9 is connected to the lumbar pedicle by tightening the second fixed knob 11. The fixing rod of the screw nail rod system can be firmly fixed. There is a first connecting shaft 8 in the center of one side of the rod connecting part 9. The first connecting shaft 8 makes the rod connecting part 9 rotate 360° in the sagittal position. The first connecting shaft 8 also One side is connected with the second connecting rod 6 .

The above-mentioned lumbo-iliac joint device is used for the fixation method of lumbo-iliac joint, comprising the following steps:

1) Routine exposure of the lumbar pedicle screw entry point, and at the same time continue to be exposed on the same plane to the outside, exposing the iliac crest;

2) The insertion point of the iliac screw is selected on the iliac crest of the lumbar 4/5 segmental plane, the screw insertion direction is pointing to the sciatic notch, and the screw insertion depth is 50 mm, and the iliac screw is inserted;

3) The lumbar pedicle screw-rod system is routinely placed. The lowermost ends of the fixation rods on both sides of the lumbar pedicle screw-rod system should be reserved for connecting the lumbar 5 pedicle screws while ensuring the connection with the lumbar pedicle screw. iliac syndesmosis;

4) Connect and tighten the external thread 13 on the connecting part 3 of the ilium screw with the tail of the iliac screw first, and then adjust the lengths of the first connecting rod 5 and the second connecting rod 6 through the second connecting shaft 4; The third connecting shaft 7, the first connecting shaft 8 and the second connecting shaft 4 make the rod connecting part 9 be connected with the fixed rod of the lumbar pedicle screw screw rod system; Three fixed knobs (10, 11, 12).

Using the above-mentioned lumboiliac combiner, in the fixation of the lumbosacral region and pelvis, by changing the position of the screw entry point and the screw path, the length of the screw is reduced, which significantly reduces the penetration of the iliac screw through the bone and damages important organs and nerves in the pelvis. With the risk of blood vessels, the fixation strength can be increased at the same time, especially the stress load between the lumbar 5 and sacral 1 vertebral body is reduced; at the same time, the range of stripping of the surrounding tissue and local trauma are reduced during the operation through the connection of the lumbar iliac joint , so that the lumbar spine and pelvis are directly connected and fixed, avoiding complications such as lumbosacral fixation failure and pseudarthrosis formation, especially for patients who cannot be fixed with sacral screws, it can significantly improve the internal fixation strength of the spine, lumbosacral region and pelvis.

Claims (2)

1. a waist ilium joint control, is characterized in that, comprises ilium nail connecting portion (3) and excellent connecting portion (9), wherein:

Described ilium nail connecting portion (3) bottom is cylindrical, columniform outer surface has the external screw thread (13) that matches with ilium nail nail tail, at the middle part of ilium nail connecting portion (3) socket the 3rd connecting axle (7), the 3rd connecting axle (7) one sides connect head rod (5), and described the 3rd connecting axle (7) can be in 360 ° of rotations of coronalplane; Columned the first fixed knob (10) is arranged at the top of ilium nail connecting portion (3), by screwing of this first fixed knob (10), can limit the rotation of the 3rd connecting axle (7); Interconnect by the second connecting axle (4) between head rod (5) and the second connecting rod (6), the second connecting axle (4) can be in 180 ° of rotations of face amount, regulate simultaneously the length of the second connecting rod (6) by the second connecting axle (4), there is interior hexagonal the 3rd fixed knob (12) side of the second connecting axle (4), by the rotation that can limit the second connecting axle (4) that screws of the 3rd fixed knob (12);

The bottom of described excellent connecting portion (9) is domes (14), be used for placing the hold-down bars of pedicle of lumbar vertebra screw nail-stick system in the arch (15) of these domes (14), the width of this arch (15) and highly all greater than the diameter of the hold-down bars cross section of pedicle of lumbar vertebra screw nail-stick system; Second fixed knob (11) of outer-hexagonal shape is installed on the top of domes (14), by screwing of this second fixed knob (11), excellent connecting portion (9) and the hold-down bars of pedicle of lumbar vertebra screw nail-stick system can be fixedly secured, there is the first connecting axle (8) in rod connecting portion (9) one side central authorities, this first connecting axle (8) makes excellent connecting portion (9) in 360 ° of rotations of sagittal plain, and the first connecting axle (8) opposite side is connected with the second connecting rod (6).

2. waist ilium joint control claimed in claim 1 is used for waist ilium associating fixing means, it is characterized in that, comprises the following steps:

1) routine appears pedicle of lumbar vertebral arch screw entry point, continues to appear laterally at same level simultaneously, exposes crista iliaca;

2) the iliac screw entry point is chosen on the crista iliaca on waist 4/5 sections plane, advances to follow closely direction for pointing to incisura ischiadica, and length is 50mm, inserts iliac screw;

3) routine is inserted pedicle of lumbar vertebra screw nail-stick system, the hold-down bars of pedicle of lumbar vertebra screw nail-stick system bilateral bottom when guaranteeing to connect waist 5 pedicle screws, should reserve certain length, in order to connect waist ilium joint control;

4) external screw thread (13) of first ilium being followed closely on connecting portion (3) is connected and screws with ilium nail tail, then adjusts the length of head rod (5) and the second connecting rod (6) by the second connecting axle (4); By adjusting the 3rd connecting axle (7), the first connecting axle (8) and the second connecting axle (4), excellent connecting portion (9) is connected with the hold-down bars of pedicle of lumbar vertebra screw nail-stick system; Screw first, second, and third fixed knob (10,11,12) with the spiral shell cutter at last.

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