CN202263044U - Percutaneous minimally invasive pedicle screw-rod internal fixing system - Google Patents
Percutaneous minimally invasive pedicle screw-rod internal fixing system Download PDFInfo
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- CN202263044U CN202263044U CN2011202933344U CN201120293334U CN202263044U CN 202263044 U CN202263044 U CN 202263044U CN 2011202933344 U CN2011202933344 U CN 2011202933344U CN 201120293334 U CN201120293334 U CN 201120293334U CN 202263044 U CN202263044 U CN 202263044U
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Abstract
The utility model provides a percutaneous minimally invasive pedicle screw-rod internal fixing system, which comprises a pedicle screw, a longitudinal connecting rod, a positioning trocar and a guide needle which are used for determining a screw placing position, an expanding core for expanding a screw placing channel, a screw placing guide sleeve, a nailing apparatus, a rod holder, a spreading presser, an arm breaker for breaking long arms of the pedicle screw, and a nailing seat; wherein, the pedicle screw comprises a screw body, a screw seat, two breakable long arms and a screw plug; the screw body is connected with the screw seat; the two breakable long arms are oppositely fixedly connected to the screw seat to form a U-shaped structure for embedding the longitudinal connecting rod; the two breakable long arms extend out of a skin incision; and the screw plug is screwed into the U-shaped structure of the breakable long arms to compact the longitudinal connecting rod. The percutaneous minimally invasive pedicle screw-rod internal fixing system for posterior thoracolumbar minimally invasive surgery produces little wound and little blood, is easy and flexible in operation, and can achieve an effect of open surgery.
Description
Technical field
This utility model belongs to the bone surgery medical instruments field, relates in particular to a kind of percutaneous Wicresoft pedicle screw-rod internal fixation system.
Background technology
The pedicle screw technology has fixedly advantage of three posts, is a kind of very sophisticated spinal surgery technology, is widely used.Sequela such as traditional method is to adopt way of escape otch open surgery, need extensively peel off structures such as paraspinal muscle, ligament, causes paraspinal muscle forfeiture innervation easily, and the patient is prone to leave over lumbar and back pain, and is stiff.This operation wound is big, hemorrhage many, and the hospital stays is long, increases less patient suffering and financial burden.Percutaneous Wicresoft pedicle screw technology was applied to clinically in recent years, and wound is little, and it is few to lose blood, and recovered fast, obtained certain curative effect.Percutaneous cervical arc root nail system and corresponding Minimally Invasive Surgery apparatus mainly are offshore company's development and the release in market at present, and it all adopts hollow pedicle nail, the length and the radian of preset rod; Device design is loaded down with trivial details; The processing technology difficulty is big, and especially the difficulty of processing of hollow pedicle nail is big, and cost of manufacture is high; Cost an arm and a leg, operation technique is complicated.The percutaneous Wicresoft pedicle screw-rod fixed system and the supporting apparatus of domestic employing divide two big types substantially, and one type still similar with external pedicle screw, adopt the design of hollow pedicle nail, and there are above-mentioned identical defective in the length and the radian of preset rod; The non-hollow pedicle screw of another kind of application; But in this non-hollow pedicle screw process of use, can't reach the locating effect of hollow pedicle nail; Pedicle screw is put the nail position and is difficult to accurate control; The needs that have perforate separately could be accomplished the vertical rod installation that connects, and need repeatedly load and unload attachment screw, extension rod and various sleeve, make operation technique very complicated.In addition; Pedicle screw-rod fixed system of the prior art lacks to put more accurately to follow closely puts pole member; And do not possess and effectively strut pressurizing tool,, do not reach the effect of open surgery though can accomplish the Minimally Invasive Surgery internal fixation; Particularly, lack distraction reduction and then can not effectively implement operation for the lumbar vertebra compression fracture operation.
The utility model content
This utility model solved loaded down with trivial details, the non-hollow pedicle nail operation technique of the hollow pedicle nail device design that exists in the prior art complicated, put nail and put excellent position and be difficult to accurately and do not possess the technical problem that effectively struts pressurizing tool.
This utility model provides a kind of percutaneous Wicresoft pedicle screw-rod internal fixation system, comprise pedicle screw, vertical location trocar and the guide pin that connects rod, is used to confirm to put the nail position, be used to enlarge the expansion core of putting the nail passage, put the nail pilot sleeve, on follow closely device, go up the nail seat, be used to install vertical connect rod hold excellent device, be used to strut or pressurize strut prelum, the long-armed folding arm device of the pedicle screw that is used to fracture; Wherein, Said pedicle screw comprises nail body, nail seat, two broken long-armed and plug screws, and the nail body is connected with the nail seat; Article two, broken long-armed on the spot being fixedly connected on upward formation U-shaped structure of nail seat; Be used to embed the vertical rod that connects, two broken long-armed extending to outside the skin incision, plug screw is used for being screwed into two broken long-armed U-shaped structures and compresses the vertical rod that connects.
The percutaneous Wicresoft pedicle screw-rod internal fixation system that this utility model provides; The pedicle screw that is wherein adopted is non-hollow-core construction, can follow closely body as required and be set to fixed or movable structure, forms fixed axis pedicle screw or movable axis pedicle screw; Simple in structure, make easily.In addition, this pedicle screw have two broken long-armed, said two broken long-armed exposing to otch skin, saved the step of loading and unloading attachment screw and extension rod, simplification operation technique.Can under direct-view, two long-armed directions of adjustment make the U-shaped structure direction of a plurality of pedicle screws consistent simultaneously; Be convenient to directly put rod; Putting rod motion simultaneously also carries out under direct-view; Through the synergism of putting nail pilot sleeve and last nail device pedicle screw is accurately inserted in the vertebral body simultaneously, hold excellent device then and firmly hold and tightly vertically connect rod and accurately put rod through putting the nail skin incision, therefore putting nail, to put the degree of accuracy of rod higher.Simultaneously, the said percutaneous of this utility model Wicresoft pedicle screw-rod internal fixation system comprises also and struts prelum that the said prelum that struts struts/pressurized operation through the skin incision of putting nail neatly, has powerful strutting/pressurization.Adopt the percutaneous Wicresoft pedicle screw-rod internal fixation system of this utility model to carry out way of escape breast lumbar vertebra Minimally Invasive Surgery, wound is little, goes out insufficiency of blood, and is simple to operate flexible, can reach the effect of open surgery.
As the further improvement of this utility model, described two broken long-armed inner surfacies have female thread, and the outer surface of plug screw has the external screw thread with broken long-armed inner surface female thread coupling, and an end of plug screw has the consent of holding.
As the further improvement of this utility model, described pedicle screw is the fixed axis pedicle screw, and the nail body is fixedly connected with the nail seat.
Further improvement as this utility model; Described pedicle screw is the movable axis pedicle screw, is provided with the bulb pressure pad of bulb and hollow between nail body and the nail seat, and the nail body is fixedly connected with bulb; Bulb flexibly connects with the nail seat, and the bulb pressure pad is arranged in the nail seat and is pressed on the bulb; The vertical company in two broken long-armed U-shaped structures of rod embedding also directly is pressed on the bulb pressure pad.
As the further improvement of this utility model, the described vertical rod that connects comprises barred body and the union joint that is positioned at the barred body two ends, and barred body is cylindrical, and union joint is used to hold rod, and barred body is used to embed in the U-shaped structure of pedicle screw;
Saidly hold excellent device and comprise and hollowly lead rod pipe and can insert hollow leading and be used to compress the vertical depression bar that connects rod in the rod pipe; A hollow end of leading the rod pipe has horizontal shape hole, and said horizontal shape hole is used to insert the vertical union joint that connects rod, and the hollow other end of leading the rod pipe expands, and the place's inner surface that expands has female thread; One end of depression bar has the 6th hand-held horizontal handle, expands near the 6th hand-held horizontal handle place on the depression bar, and the place's outer surface that expands has with the hollow rod pipe of leading and expands the external screw thread of place's female thread coupling; The hollow rod pipe of leading expands internal diameter and the depression bar at place to expand the external diameter located identical.
As the further improvement of this utility model, said location trocar comprises locating sleeve and awl, and there is scale on the locating sleeve surface, and awl is arranged in locating sleeve, exposes from an end of locating sleeve, and the head end of awl is tapered; The insertion locating sleeve confirmed to put the nail position after described guide pin was used for extracting awl, and there is scale on the guide pin surface, and its head end has screw thread;
Said expansion core comprises that along the cylinder that has the guide pin through hole on the axis cylindrical external diameter is identical with the nail seat external diameter of pedicle screw; It is conical that a cylindrical end is, and the other end is fixedly connected with the first hand-held horizontal handle.The said nail pilot sleeve of putting comprises along the cylinder that has the pedicle screw through hole on the axis; One end of cylinder is the band saw dentation; The other end is fixedly connected with the second hand-held horizontal handle; Its other end also opposes and is provided with and second hand-held two parallel U-lags of horizontal handle, and two U-lags are used to carry the first horizontal handle; The length of cylinder is identical with the cylindrical length of expansion core, and the length of cylinder is greater than nail body, nail seat and the broken long-armed total length of pedicle screw.
As the further improvement of this utility model, also comprise being used for hollow flat prominent file and/or hollow screw tap;
Described hollow flat prominent file comprises that along the file bar that has the guide pin through hole on the axis external diameter of file bar is identical with the nail body diameter of pedicle screw; One end of file bar is fixedly connected with the file head, and the other end is fixedly connected the 3rd hand-held horizontal handle; The file end surface is provided with roll flute, and periphery is provided with and bores the style screw thread;
Said hollow screw tap comprises that along the screw tap bar that has the guide pin through hole on the axis external diameter of screw tap bar is identical with the nail body diameter of pedicle screw; One end of screw tap bar is fixedly connected with the screw tap head, and the other end is fixedly connected the 4th hand-held horizontal handle; The periphery of screw tap head is provided with the thread road with pedicle screw nail body coupling;
The said nail device of going up comprises strut and chock plug that lays respectively at the strut two ends and the 5th hand-held horizontal handle;
Be arranged with rotating hammerlock pipe on the strut, the hammerlock pipe has the external screw thread that matees with broken long-armed inner surface female thread near an end outer surface of chock plug, and the other end of hammerlock pipe is fixedly connected with turncap, is used to rotate the hammerlock pipe;
Be arranged with screw guide ring and rotary handle on the hammerlock pipe, the screw guide ring is positioned near chock plug one side, and rotary handle is positioned near the 5th hand-held horizontal handle one side, and the external diameter of screw guide ring is identical with the nail seat external diameter of pedicle screw;
Also be provided with convexity on the said chock plug, the bulb that is used for inserting the movable axis pedicle screw is tightened the nail body of movable axis pedicle screw;
The said nail seat of going up comprises nail pedestal and the through hole on the nail pedestal; Through hole comprises different two sections in aperture, and wherein one section big internal diameter of aperture equates with the external diameter of the nail seat of pedicle screw, and one section little internal diameter of aperture equates with the external diameter of the nail body of pedicle screw.
As the further improvement of this utility model, also comprise and hold the plug screw device; The said plug screw device of holding is a pole, and the end opposition of pole is provided with two shell fragments, and the other end is provided with the 7th hand holding handle; Two shell fragment shape that forms and form fit of holding consent that opposition is provided with, two shell fragments are used for inserting holds consent and has held plug screw;
Said tight plug screw spanner comprises wrenching bar and the 8th hand-held horizontal handle that is fixedly connected on wrenching bar one end, and the other end of wrenching bar can insert holding of plug screw and rotate plug screw in the consent and compress the vertical rod that connects;
Also comprise the anti-spanner that revolves; Said anti-anti-handle and the anti-rotary sleeve of revolving that spanner comprises L shaped fixed connection that revolve; Anti-rotary sleeve is a hollow structure, is used to be sheathed on the pedicle screw periphery; Anti-rotary sleeve is provided with the symmetric groove of falling U away from an anti-end that revolves handle, is used to block the vertical rod that connects.
As the further improvement of this utility model, the said prelum that struts comprises two pillars, two crossbeams and a threaded bar; One end of two pillars is equipped with and is used to block the vertical groove of falling U that connects rod, the other end respectively with the end flexible connection of two crossbeams, flexibly connect between the other end of two crossbeams; Be equipped with screw thread coupling on two pillars, threaded bar is arranged on two screw thread couplings; The threaded bar outer surface is provided with two sections screw threads in the opposite direction, and two screw thread couplings lay respectively on threaded bar two sections screw threads in the opposite direction; Also be provided with on two pillars and be used for the broken long-armed armful armlet of socket pedicle screw.
As the further improvement of this utility model, also comprise leading cone device and spinous process awl;
Wherein, said leading cone device is used to guide the spinous process awl to carrying out taper hole between spinous process or spinous process; Said leading cone device comprises sliding rod, two connecting rods and two guiding tubes, and an end of two connecting rods is slidingly connected with sliding rod simultaneously, and the other end of two connecting rods is connected with guiding tube respectively; Connecting rod can move along sliding rod;
Said spinous process awl has Z-shaped three-stage structure, and the one of which end is a handle, and the other end is a cone tip shape, is used for carrying out taper hole between spinous process and spinous process;
Said folding arm device is antagonism folding arm device, comprises handle and the folding arm folder that is fixedly connected with handle, and the folding arm folder is used to block the broken long-armed of pedicle screw and it is fractureed.
Description of drawings
Fig. 1 is the structural representation of fixed axis pedicle screw.
Fig. 2 is the structural representation of movable axis pedicle screw.
Fig. 3 is the nail body and the ball head structure sketch map of movable axis pedicle screw.
Fig. 4 is the structural representation of the plug screw of movable axis pedicle screw.
Fig. 5 is the structural representation of the bulb pressure pad of movable axis pedicle screw.
Fig. 6 is the vertical structural representation that connects rod.
Fig. 7 is the structural representation of location trocar.
Fig. 8 is the structural representation of locating sleeve.
Fig. 9 is the structural representation of awl.
Figure 10 is the structural representation of guide pin.
Figure 11 is a structural representation of putting the nail pilot sleeve.
Figure 12 is the structural representation of expansion core.
Figure 13 is the structural representation of hollow flat prominent file.
Figure 14 is the structural representation of hollow screw tap.
Figure 15 is for holding plug screw device structural representation.
Figure 16 is the structural representation of nail device on the fixed axis pedicle screw.
Figure 17 is the structural representation of nail device on the movable axis pedicle screw.
Figure 18 is a structural representation of holding excellent device.
Figure 19 is the structural representation of depression bar.
Figure 20 is the structural representation of leading the rod pipe.
Figure 21 is an A-A profile among Figure 20.
Figure 22 is the structural representation of tight plug screw spanner.
Figure 23 is the anti-structural representation that revolves spanner.
Figure 24 is the structural representation of anti-rotary sleeve and tight plug screw spanner.
Figure 25 is the structural representation that struts prelum.
Figure 26 is the structural representation of screw thread coupling.
Figure 27 is the structural representation of leading cone device.
Figure 28 is the structural representation of spinous process awl.
Figure 29 struts the structural representation of fulcrum device for screw.
Figure 30 is the structural representation of antagonism folding arm device.
Figure 31 is the structural representation of last nail seat.
Figure 32 is a B-B profile among Figure 31.
Wherein, 1---pedicle screw, 2---the vertical rod that connects, 3---location trocar, 4---guide pin, 5---the expansion core, the tight plug screw spanner of 6---put the nail pilot sleeve, 7---on follow closely device, 8---, 9---antagonism folding arm device;
10---the nail body, 11---the nail seat, 12---broken long-armed, 13---plug screw, 14---the U-shaped structure, 15---bulb, 16---bulb pressure pad, the recessed incisura of 17---holding spiro pluging hole, 18---; 20---barred body, 21---union joint; 31---locating sleeve, 32---awl; 51---cylinder, 52---the first hand-held horizontal handle; 61---cylinder, 62---the second hand-held horizontal handle, 63---U-lag; 71---strut, 72---chock plug, 73---the 5th hand-held horizontal handle, 74---the hammerlock pipe, 75---turncap, 76---the screw guide ring, 77---rotary handle, 78---convexity; 81---wrenching bar, 82---the 8th hand-held horizontal handle, 83---polygon is protruding; 90---the folding arm folder, 91---the hands handle;
100---hollow flat prominent file, 101---the file bar, 102---the 3rd hand-held horizontal handle, 103---the file head; 200---hollow screw tap, 201---the screw tap bar, 202---the 4th hand-held horizontal handle, 203---the screw tap head; 300---hold the plug screw device, 301---the 7th hand holding handle, 302---shell fragment; 400---holding excellent device, 401---depression bar, 402---the body of rod, 403---depression bar expands the place, 404---the 6th hand-held horizontal handle, 405---hollow rod pipe, 406 of leading---body, 407---the hollow rod pipe of leading expands the place, 408---horizontal shape holes; The anti-rotary sleeve of 500---anti-revolve spanner, 501---, 502---anti-revolve handle, 503---groove of falling U; 600---strutting prelum, 601,602---pillar, 603,604---crossbeam, 605---threaded bar, 606---strutting the groove of falling U of prelum, 607---screw thread coupling, 608---embrace armlet; 700---the leading cone device, 701---the spinous process awl, 702---sliding rod, 703---connecting rod, 704---guiding tube; 800---screw struts the fulcrum device, and 801---the 9th hand-held horizontal handle, 802---montant, 803---steady arm, 804---barrier plate; 900---go up the nail seat, 901---the nail pedestal, 902---through hole.
The specific embodiment
Clearer for technical problem, technical scheme and beneficial effect that this utility model is solved, below in conjunction with accompanying drawing and embodiment, this utility model is further elaborated.Should be appreciated that specific embodiment described herein only in order to explanation this utility model, and be not used in qualification this utility model.
This utility model provides a kind of percutaneous Wicresoft pedicle screw-rod internal fixation system, comprise pedicle screw 1, vertical location trocar 3 and the guide pin 4 that connects rod 2, is used to confirm to put the nail position, be used to enlarge the expansion core 5 of putting the nail passage, put nail pilot sleeve 6, on follow closely device 7, go up nail seat 900, be used to install vertically connect the excellent device of holding of rod 2 400, be used to strut or pressurize strut prelum 600, the long-armed folding arm device 9 of the pedicle screw that is used to fracture.
Said pedicle screw 1; As shown in Figure 1, comprise nail body 10,11, two broken long-armed 12 of nail seats and plug screw 13, nail body 10 is connected with nail seat 11; Article two, broken long-armed 12 pairs on the spot are fixedly connected on formation U-shaped structure 14 on the nail seat 11, are used to embed the vertical rod 2 that connects in the U-shaped structure 14.Article two, broken long-armed 12 may extend to outside the skin incision, make follow-up broken long-armed 12 direction adjustment and vertically connect inserting all of rod 2 and under direct-view, carry out.The U-shaped structure 14 that plug screw 13 is used for being screwed into two broken long-armed 12 compresses the vertical rod 2 that connects.Nail body 10 is provided with screw thread.
Article two, broken long-armed 12 inner surface has female thread, and the outer surface of plug screw 13 has external screw thread, external screw thread and female thread lines coupling, so plug screw 13 can move up and down along the screw thread between broken long-armed 12.Head one end of plug screw 13 also is provided with holds consent 17.
In this utility model, said pedicle screw 1 can be arranged to fixed axis pedicle screw and/or movable axis pedicle screw as required.For example, the structure of fixed axis pedicle screw is as shown in Figure 1, because nail body 10 is fixedly connected with nail seat 13, makes nail body 10 can not follow closely seat 13 motions relatively, therefore forms the fixed axis pedicle screw.Nail seat 13 be a short cylindrical shape, two broken long-armed 12 with follow closely 11 and be fixedly connected.Compare with ordinary fixed axle pedicle screw, the fixed axis pedicle screw of this utility model has short cylindrical staple seat 11, and broken long-armed 12 prolong outside the emersion skin incision; 11 pairs of pedicle screws 1 of nail seat play the direction control action when putting the slip of following closely in the pilot sleeve 6 simultaneously; Broken long-armed 12 can limit to hold to make when excellent device 400 is put rod and vertical connect rod 2, U-shaped structure 14 and hold excellent device 400 threes at grade; Common pedicle screw and universal pedicle screw U bottom land have also been overcome not in conplane shortcoming.
The structure of movable axis pedicle screw is as shown in Figure 2, and nail seat 11 is a hollow-core construction, is built-in with bulb 15 and bulb pressure pad 16.Wherein follow closely body 10 and be fixedly connected with bulb 15, bulb pressure pad 16 is positioned at the hollow structure of nail seat 11, and is pressed on the bulb 15.Bulb pressure pad 16 also is hollow structure, and is as shown in Figure 5, makes vertical even rod 2 can embed in the U-shaped structure 14 and be pressed on the bulb pressure pad 16.The polygon groove is arranged on the bulb 15, as shown in Figure 4.Flexibly connect between bulb 15 and the nail seat 11.Under the pressure effect of the company's of indulging rod 2, nail body 10 is fixed with the position of following closely seat 11 in the U-shaped structure.Because bulb 15 and 11 flexible connections of nail seat make nail body 10 in all directions certain mobility arranged, be beneficial to above the fixing of three joint vertebral bodys in the movable axis pedicle screw.
The structure of said vertical even rod 2 is as shown in Figure 6, barred body 20 and the union joint 21 that is positioned at barred body 20 two ends.Barred body 20 is cylindrical, and union joint 21 is a polygon, the two ends of protrusion barred body 20.The size of union joint 21 is less than the size of barred body 20.Barred body 20 can embed in the U-shaped structure 14 of pedicle screw 1, thereby forms the excellent fixed structure of nail.The vertical rod 2 that connects can be cut into Len req according to actual needs, perhaps bends to required radian, and the vertical even rod 2 after being tailored must keep the union joint 21 of an end, is used for inserting the horizontal shape hole 408 of holding excellent device 400.
Said location trocar 3 is used to confirm to put the nail position with guide pin 4.As shown in Figure 7, said location trocar 3 comprises locating sleeve 31 and awl 32.Locating sleeve 31 is a hollow structure, and awl 32 inserts in the hollow structure of locating sleeve 31.There is scale on locating sleeve 31 surfaces, can measure the insertion depth of location trocar 3.Awl 32 inserts in the locating sleeve 31, exposes from locating sleeve 31 head ends, and the head end of awl 32 is tapered, and is as shown in Figure 9.Location trocar 3 percutaneous insert in the pedicle of vertebral arch under X line perspective, set up and lead to Intrapyramidal passage.
Said guide pin 4 is more elongated, shown in figure 10, is used for after locating sleeve 31 is extracted awl 32, inserting again, confirms to put the nail position.There is scale on the surface of guide pin 4, and its head end has screw thread.Guide pin 4 is extracted locating sleeve 31 after from locating sleeve 31, being inserted into the vertebral body middle part, keeps somewhere guide pin 4.
Said expansion core 5 comprises along the cylinder 51 that has guide pin 4 through holes on the axis, and is shown in figure 12.The external diameter of cylinder 51 is identical with nail seat 11 external diameters of pedicle screw 1.It is conical that one end of cylinder 51 is, and the other end is fixedly connected with the first hand-held horizontal handle 52.Expansion core 5 screws in along guide pin 4, and disposable expansion muscle passage, head end arrive at pedicle of vertebral arch inlet surface of bone.Because mini-incision 1.5cm cut skin, deep fascia, therefore expanding core 5 is easy to expand spatium intermusculare, simple to operate with tradition expanded phase ratio step by step, fast saves time.
The said nail pilot sleeve 6 of putting comprises along the cylinder 61 that has pedicle screw 1 through hole on the axis, and is shown in figure 11.One end of cylinder 61 is the band saw dentation, and the other end is fixedly connected with the second hand-held horizontal handle 62, and its other end also opposes to being provided with second hand-held parallel 63, two U-lags 63 of two U-lags of horizontal handle and is used to carry the first hand-held horizontal handle 52.Two U-lags 63 vertically flush with the second hand-held horizontal handle 62.Be used for along the insertion of expansion core 5 and pedicle screw 1 owing to put nail pilot sleeve 6, so the internal diameter of cylinder 61 equates with the external diameter of expansion core 5 and with the external diameter three of pedicle screw 1 nail seat 11.
The length of cylinder 61 is identical with the length of the cylinder 51 of expansion core 5; Therefore expand core 5 insert put nail pilot sleeve 6 after; The first hand-held horizontal handle 52 of expansion core 5 embeds in two U-lags 63; The tail end of expansion core 5 is equal with the afterbody of putting nail pilot sleeve 6, and the conical head end of expansion core 5 exposes outside the circular saw of cylinder 61 just, and is shown in figure 12.The length of cylinder 61 is greater than nail body 10, nail seat 11 and broken long-armed 12 the total length of pedicle screw 1.Therefore,, puts in the nail pilot sleeve 6 pedicle screw 1 when inserting, when nail body 10 points of pedicle screw 1 expose the circular saw of putting nail pilot sleeve 6 just, and certain distance in two broken long-armed 12 cylinders 61 that submerge of pedicle screw 1.To expand core 5 insertions and put in the nail pilot sleeve 6, and insert along guide pin 4, the head end of expansion core 5 arrives to surface of bone; Continuation will be put nail pilot sleeve 6 and inserted, to the circular saw spine of putting nail pilot sleeve 6 at vertebral plate, articular process surface of bone, compress the second hand-held horizontal handle 62 of putting nail pilot sleeve 6; Circular saw to keep putting nail pilot sleeve 6 does not move; Extract expansion core 5 then, keep and put nail pilot sleeve 6 and guide pin 4, this moment, guide pin 4 was in the circular saw central point of putting nail pilot sleeve 6 to the marrow.
Therefore, non-hollow pedicle screw 1 can be realized accurate location when putting coaxial insertions of nail pilot sleeve 6, has solved and can only from hollow screw, insert the accurate localized technical problem of guide pin ability in the prior art.
Find in the open surgery that because articular process is uneven, pedicle screw nail body tip is difficult to insert little pedicle of vertebral arch inlet, the easy kibe of cortex, displacement when twisting nail sometimes.Therefore; A kind of preferred implementation as this utility model; The percutaneous Wicresoft pedicle screw-rod internal fixation system of this utility model also comprises hollow flat prominent file 100; Be used for filing guide pin 4 cortical bone to the marrow mouthful, and pierce in the pedicle of vertebral arch several millimeters, makes a pedicle bone property inlet of putting down and the degree of depth being arranged.
Shown in figure 13, described hollow flat prominent file 100 be a T shape structure, comprises along the file bar 101 that has guide pin 4 through holes on the axis, and an end of file bar 101 is fixedly connected with file 103, and the other end is fixedly connected the 3rd and hands horizontal handle 102.File 102 end face are provided with roll flute, and periphery is provided with and bores style gear screw thread.Hollow flat prominent file 100 inserts the pedicle of vertebral arch inlet along guide pin 4, and therefore hollow flat prominent file 100 internal diameters are a bit larger tham guide pin 4, and the external diameter of its file bar 101 is identical with the external diameter of pedicle screw 1 nail body 10.
For making things convenient for inserting of pedicle screw 1, as the another kind of preferred implementation of this utility model, the percutaneous Wicresoft pedicle screw-rod internal fixation system of this utility model also comprises hollow screw tap 200, is used for opposed nail position and carries out tapping.Shown in figure 14, said hollow screw tap 200 is a T shape structure, comprises that along the screw tap bar 201 that has guide pin 4 through holes on the axis, an end of screw tap bar 201 is fixedly connected with screw tap head 203, and the other end is fixedly connected the 4th hand-held horizontal handle 202.The periphery of screw tap head 203 is provided with the thread road with pedicle screw 1 nail body 10 couplings.Hollow screw tap 200 inserts the pedicle of vertebral arch inlet along guide pin 4, and therefore the internal diameter of hollow screw tap 200 is a bit larger tham guide pin 4, and the external diameter of its screw tap bar 201 is identical with the external diameter of pedicle screw 1 nail body 10.The screw thread of the thread road of screw tap head 203 and pedicle screw 1 nail body 10 matches.Hollow screw tap 200 carries out tapping along 4 pairs of pedicle of vertebral arch vertebral bodys of guide pin portion, then need not to adopt hollow screw tap 200 to carry out tapping for the pedicle screw with self tapping ability.
The structure of said upward nail device 7 is shown in figure 16, comprises strut 71 and chock plug 72 that lays respectively at strut 71 two ends and the 5th hand-held horizontal handle 73.Be arranged with rotating hammerlock pipe 74 on the strut 71, hammerlock pipe 74 has the external screw thread that matees with broken long-armed 12 inner surface female threads near an end outer surface of chock plug 72, and the other end of hammerlock pipe 74 is fixedly connected with turncap 75, is used to rotate hammerlock pipe 74.Be arranged with screw guide ring 76 and rotary handle 77 on the hammerlock pipe 74, wherein, screw guide ring 76 is positioned near chock plug 72 1 sides, and rotary handle 77 is positioned near the 5th hand-held horizontal handle 73 1 sides.Screw guide ring 76 is enclosed within on the hammerlock pipe 74 with rotary handle 77, can independent separately rotation.
Chock plug 74 directly is inserted in U-shaped structure 14 bottoms of pedicle screw 1, rotates turncap 75 and makes the external screw thread of hammerlock pipe 74 tight with the female thread interlock of pedicle screw 1 broken long-armed 12 inner surfacies, follows closely on the device 7 thereby pedicle screw 1 is fixed on.The external diameter of screw guide ring 76 is followed closely seat 11 external diameters and is put the internal diameter of following closely pilot sleeve 6 with pedicle screw 1 and equates.When 6 insertions of nail pilot sleeve were put on the pedicle screw that is connected with last nail device 71 edge, screw guide ring 76 also gets into to be put in the nail pilot sleeve 76, and identical with the inwall of putting nail pilot sleeve 6.Therefore; The nail seat 11 that pedicle screw 1 is arranged at the middle front end of putting nail pilot sleeve 6; There is screw guide ring 76 rear end; Make pedicle screw 1 guarantee when nail slides in the pilot sleeve 6 that the tip of following closely body 10 aims at the center position of putting nail pilot sleeve 6 putting, thereby guarantee the most advanced and sophisticated pedicle bone property inlet that accurately inserts of the nail body 10 of pedicle screw 1.The circular saw thorn of putting nail pilot sleeve 6 is on vertebral plate, articular process cortical bone; Keep center position not rotate; After pedicle bone property inlet is inserted at the tip of nail body 10; Putting nail pilot sleeve 6 can change with last nail device 7 directions, and pedicle screw 1 is screwed into towards more definite direction, is similar to the open nail of putting.
And when pedicle screw is the movable axis pedicle screw, because nail seat 10 flexibly connects with nail body 10.Therefore only adopt 72 of chock plugs to go up the nail operation to the movable axis pedicle screw.Therefore; Go up nail device 7 in this utility model and also have another kind of preferred implementation, shown in figure 17, said going up also is provided with protruding 78 on the chock plug 72 of following closely device 7; Be used for inserting the groove of the bulb 15 of movable axis pedicle screw, directly twist the nail body 10 of movable axis pedicle screw.
For guaranteeing that pedicle screw inserts that time nail point is in the center in the nail pilot sleeve, the percutaneous Wicresoft pedicle screw-rod internal fixation system of this utility model also comprises nail 900.The said structure that goes up nail seat 900 is shown in figure 31, comprises nail pedestal 901 and the through hole 902 on the nail pedestal 901.Nail pedestal 901 can have various three-dimensional shapes, does not have particular determination in this utility model.The nail pedestal 901 of for example going up nail seat 900 described in Figure 31 is a cube structure.Through hole 902 comprises different two sections in aperture, and wherein one section big internal diameter of aperture equates with the external diameter of the nail seat 11 of pedicle screw, and one section little internal diameter of aperture equates with the internal diameter of the nail body 10 of pedicle screw.Said 900 pairs of fixed axis pedicle screws of upward nail seat and movable axis pedicle screw are all applicable.Pedicle screw 1 is placed the through hole 902 of nail seat 900; Wherein follow closely body 10 and be positioned at the small-bore section of through hole 902; Nail seat 11 is positioned at the large aperture section of through hole 902; It is vertical with nail seat 11 to guarantee to follow closely body 10 when nail device 7 connection pedicle screws, particularly movable axis pedicle screw are held nail in the utilization, places nail pilot sleeve 6 assurance nail points to be positioned at the center pedicle screw 1 then.
Shown in figure 18, saidly hold excellent device 400 and comprise and hollowly lead rod pipe 405 and can insert hollow leading and be used to compress the vertical depression bar 401 that connects rod 2 in the rod pipe 405.The hollow rod pipe 405 of leading comprises body 406, and an end of body 406 has horizontal shape hole 408, and said horizontal shape hole 408 is used to insert the vertical union joint 21 that connects rod 2.The hollow other end of leading rod pipe 405 expands, and place's 407 inner surfacies that expand have female thread.Depression bar 401 comprises the body of rod 402, and an end of the body of rod 402 has the 6th hand-held horizontal handle 404, expands near the 6th hand-held horizontal handle 404 places on the depression bar 401, and place's 403 outer surfaces that expand have with the hollow rod pipe 405 of leading and expand the external screw thread of place's 407 female threads coupling; The hollow rod pipe 405 of leading expands internal diameter and the depression bar 401 at place 407 and expands that to locate 403 external diameter identical.
The said hollow rod pipe 405 of leading promptly comprises two planes and two arcwall faces for oblate cylindricality, and is shown in figure 21.Two arcwall faces are passed in horizontal shape hole 408, and are vertical with the hollow axis through bore of leading rod pipe 405 and communicate.The vertical rod 2 that connects can insert in the horizontal shape hole 408 and hold excellent device 400 and is connected, and the vertical two edges that connect rod 2 flush with hollow two planes of leading rod pipe 405, and promptly hollow two planar spacings leading rod pipe 405 equate with the external diameter of the company of indulging excellent 2.
Lead in the rod pipe 405 when depression bar 401 insertions are hollow, the 6th hand-held horizontal handle 404 of rotation depression bar 401, the internal and external threads interlock, depression bar 401 advances, compresses vertical excellent 2 the union joint 21 that connects to a hollow end of leading excellent pipe 405, realizes holding excellent device 400 and is connected with the vertical rod 2 that connects.Get the directly vertical rod 2 that connects of another root and embed in the U-shaped structure 14 that rises from each pedicle screw 1 of extracutaneous the same side, U-shaped structure 14 directions that make each pedicle screw 1 of the same side are on same straight line.This moment will with hold vertical U-shaped structure 14 bottom lands of inserting pedicle screw 1 of excellent 2 other ends of vertical company that excellent device 400 is connected, the vertical rod 2 that connects is accurately inserted in the U-shaped structure 14 of a plurality of pedicle screws 1 of vertically arranging along the vertebral plate face, rod motion is put in completion smoothly.Need to prove especially: be connected with vertical rod 2 one ends that connect when holding excellent device 400; The other end is vertically inserted in U-shaped structure 14 bottom lands of pedicle screw 1; The vertical rod 2 that connects is become level from vertical position and inserts along the vertebral plate face in the process the U-shaped structure 14 of a plurality of pedicle screws 1 of vertically arranging; Holding excellent device 400 is embedded in broken long-armed 12 the U-shaped structure 14; This moment homonymy each pedicle screw broken long-armed U-shaped structure 14, vertically connect rod 2 and hold excellent device 400 threes on same fore-and-aft plane; Hold excellent device 400 and can swing, the front end of the company's of indulging rod 2 can be moved up and down on this plane, make and put rod flexibly, fast, accurately in this upper edge, plane U-shaped structure 14.
In this utility model,, also comprise and hold plug screw device 300 for guaranteeing accurately and fast being screwed into of pedicle screw.The said plug screw device 300 of holding is pole, and structure is shown in figure 15, and the end opposition of pole is provided with two shell fragments 302, and the other end is provided with the 7th hand holding handle 301.Two shell fragment 302 shape that forms and form fit of holding consent 17 that opposition is provided with, two shell fragments 302 are used for inserting holds consent 17 and has held plug screw 13.For the polygonal external diameter that makes things convenient for shell fragment 302 to hold plug screw 13, two shell fragments 302 formations is a bit larger tham the internal diameter of holding consent, utilize the elastic force between two shell fragments 302, held plug screw 13, and accurately be screwed in the U-shaped structure 14 of pedicle screw 1.
The structure of said tight plug screw spanner 8 is shown in figure 22, comprises wrenching bar 81 and the 8th hand-held horizontal handle 82 that is fixedly connected on wrenching bar 81 1 ends, and the other end of wrenching bar 81 can insert holding of plug screw 13 and rotate plug screw 13 in the consent 17 and compress the vertical rod 2 that connects.Particularly; The other end of wrenching bar 81 has polygon protruding 83; The shape of polygon protruding 83 and the form fit of holding consent 17, so this polygon protruding 83 can insert holding in the consent 17 of plug screw 13, rotates the 8th hand-held horizontal handle 82; With two broken long-armed 12 screw-ins of plug screw 13, compress the vertical rod 2 that connects along pedicle screw 1.
For preventing that tight plug screw spanner 8 from driving pedicle screw 1 in tightening plug screw 13 processes, cause pedicle screw 1 loosening, under the preferable case, the percutaneous Wicresoft pedicle screw-rod internal fixation system that this utility model provides also comprises the anti-spanner 500 that revolves.Said anti-anti-handle 502 and the anti-rotary sleeve 501 of revolving that spanner 500 comprises L shaped fixed connection that revolve.Anti-rotary sleeve 501 is a hollow structure, is used to be sheathed on pedicle screw 1 periphery, and therefore the internal diameter of anti-rotary sleeve 502 is a bit larger tham the external diameter of pedicle screw 1 nail seat 11.Anti-rotary sleeve 501 is provided with the symmetric groove of falling U 503 away from an anti-end that revolves handle 502, is used to block the vertical rod 2 that connects.The anti-spanner 500 that revolves is given prominence to two broken long-armed 12 insertions outside the skin incision along pedicle screw 1, and the groove of falling U 503 blocks the vertical rod 2 that connects; Tighten plug screw 13 when tight plug screw spanner 8 and compress and vertical connect excellently 2 the time, anti-ly revolve spanner 500 and resist, prevent that pedicle screw 1 from becoming flexible with tight plug screw spanner 8.Compare with traditional compressive resistance box spanner, anti-anti-rotary sleeve 501 center through hole of revolving spanner 500 of this utility model satisfy broken long-armed 12 of pedicle screw 1 fully and insert wherein; And traditional compressive resistance box spanner, the head end through hole is big, limited length, and little insertion of satisfying tight plug screw spanner of tail end through hole, so the head end through hole can be inserted in common pedicle screw, and can not be inserted in long-armed pedicle screw.
This utility model is provided with in the said percutaneous Wicresoft pedicle screw-rod internal fixation system and struts prelum 600, can strut neatly through the skin incision of putting nail/pressurized operation, has powerful strutting/pressurization.The said structure that struts prelum 600 comprises 603,604 and threaded bar 605 of 601,602, two crossbeams of two pillars like Figure 25, shown in 26.One end of two pillars 601,602 is equipped with and is used to block the vertical groove of falling U 606 that connects rod 2, the other end respectively with the end flexible connection of two crossbeams 603,604, flexibly connect between the other end of two crossbeams 603,604.Be equipped with screw thread coupling 607 on two pillars 601,602, threaded bar 605 is arranged on two screw thread couplings 607.Threaded bar 605 outer surfaces are provided with two sections screw threads in the opposite direction, and two screw thread couplings 607 lay respectively on threaded bar two sections screw threads in the opposite direction.
One end of threaded bar 605 is provided with flexible handle, and adapter 605 has screwed hole and screw thread latch, and each other vertical, threaded bar 605 can be screwed in the screwed hole of adapter 605, and the screw thread latch can insert in the hole of pillar 601,602 and connect.Adapter 607 is connected threaded bar 605 on the pillar 601,602, just or 601,602 on despining threaded bar 605, two pillars distance increase or shorten, work strutting or pressurization.Pillar 601,602 flexibly connects through two crossbeams 603,604, and is flexibly movable.Pillar 601,602 inserts through skin incision, embrace armlet 608 be enclosed within pedicle screw 1 broken long-armed 12 on, make the groove of falling U 606 of pillar 601,602 accurately be inserted in vertical the company on excellent 2; When two pillars 601,602 are inserted in vertical the company on the rod 2 respectively, two adapters 607 are connected threaded bar 605 on two pillars 601,602 and are fixing, and this moment is just changeing or despining threaded bar 605 struts or pressurization.
Also be provided with armful armlet 608 that is used for socket pedicle screw 1 broken long-armed 12 on two pillars 601,602.Two pillars 601,602 can change the direction of embracing armlet 608 around 360 ° of crossbeam rotations, and two pillars 601,602 have independent separately activity direction; Scope is big, helps strutting or pressurized operation through Wicresoft's skin incision, and pillar 601,602 can be close on the pedicle screw 1 along its axis; Parallel promotion pedicle screw 1, displacement is unrestricted, can satisfy the operation needs; It is strong that it struts pressurization power; Be particularly useful for distraction reduction in the lumbar vertebra compression fracture operation, reach the effect that struts of open surgery fully, increased the indication of this operation.Tradition struts pressurized clamp because self extended distance is limited; Usually when the distance that resets is big, adopt earlier and insist on excellent clamp greatly and be held in vertical Lian Bangshang and put forth effort fulcrum to provide, adopt again to strut the pincers distraction reduction; Need use two pincers simultaneously, also need do and hold the otch that excellent clamp is held the company's of indulging rod.Because tradition struts pincers two and struts arm and be fixedly connected together, places difficulty through mini-invasive incision, is difficult to reach the distraction reduction effect, it is limited and operation easier is big to strut spacing, is not suitable for the more lumbar vertebra compression fracture of vertebral body compression of requirement distraction reduction.
In this utility model, said percutaneous Wicresoft pedicle screw-rod internal fixation system also comprises leading cone device 700 and the spinous process awl 701 that is used to install horizontal connected device.
Horizontal connected device is the apparatus commonly used of common pedicle screw-rod internal fixation system, in this utility model, is able to use.Horizontal connected device comprises tranverse connecting rod and is arranged at two joints on the tranverse connecting rod, and tranverse connecting rod passes hole between spinous process or spinous process, and two joints are fixed in the vertical Lian Bangshang of both sides, and the pedicle screw of both sides is linked into an integrated entity.
Leading cone device 700 is used to guide between 701 pairs of spinous process of spinous process awl and spinous process and carries out taper hole; Shown in figure 27; Said leading cone device 700 comprises sliding 702, two connecting rods 703 of rod and two guiding tubes 704; One end of two connecting rods 703 is slidingly connected with sliding rod 702 simultaneously, and the other end of two connecting rods 703 is connected with guiding tube 704 respectively.Connecting rod 703 can move along sliding rod 702; Particularly, an end of two connecting rods 703 all is fixedly connected with slip ring, and slip ring sleeve can move along sliding rod 702 from slip ring on sliding rod 702, thereby realizes that connecting rod 703 moves along sliding rod 702.
Two connecting rods 703 can insert through Wicresoft's skin incision separately; Place the spinous process both sides respectively, sliding rod 702 inserts in the slip rings and is connected with two connecting rods 703, guiding tube 704 is positioned at vertically connects excellent 2 upper limb and be in a straight line; Accomplish on the spinous process and punch, make things convenient for the horizontal connected device of subsequent installation.
Said spinous process awl 701 has Z-shaped three-stage structure, and shown in figure 28, the one of which end is a handle, and the other end is a cone tip shape, is used for carrying out taper hole between spinous process and spinous process.Spinous process awl 701 can be to spinous process and interspinous ligament taper hole under the guiding of leading cone device 700, and places tranverse connecting rod.
In this utility model, said percutaneous Wicresoft pedicle screw-rod internal fixation system can comprise that also screw struts fulcrum device 800, is used for vertebral body is strutted effect not installing under the vertical situation that connects rod 2.It is shown in figure 29 that described screw struts the structure of fulcrum device 800, comprises the 9th hand-held horizontal handle 801, montant 802 and steady arm 803, and the two ends of montant 802 vertical fixing respectively are connected in an end of the 9th hand-held horizontal handle 801 middle parts and steady arm 803.Steady arm 803 middle parts are provided with barrier plate 804 connected vertically, and barrier plate 804 and the 9th hand-held horizontal handle 801 are parallel.Steady arm 803 can embed in the U-shaped structure 14 of pedicle screw 1 near a section of perpendicular thick stick 802, and the groove of falling U 606 that struts prelum 600 rides another section at steady arm 803, in that vertical the company under excellent 2 the situation is not installed, vertebral body is strutted.Particularly lumbar vertebra compression fracture operation; If need to hindering bone grafting in the vertebra space; Use screw to strut fulcrum device 800 and strut 600 pairs of prelums and hinder vertebra and strut temporarily,, and then install and vertically connect excellent 2 with the hollow vertebral body bone grafting of pedicle of vertebral arch device (patent No. 200610108291.1) percutaneous bone grafting in hindering vertebra; In Minimally Invasive Surgery, simplify the operation course, removed following operation from: install and vertically to connect rod 2, strut, unload and vertically connect rod 2, bone grafting, once more the vertical rod 2 that connects be installed.
In this utility model, said folding arm device adopts antagonism folding arm device, under antagonism, pedicle screw is carried out folding arm, can prevent effectively that pedicle screw is loosening.Said antagonism folding arm device 9 has structure shown in Figure 30, comprises handle 91 and the folding arm that is fixedly connected with handle 91 folder 90, folding arm folder 90 be used to block pedicle screw 1 broken long-armed 12 and it is fractureed.In this utility model, said antagonism folding arm device can be straight shape of branch and bending, promptly can the straight line setting between folding arm folder 90 and the handle 91, and also flexible setting, as shown in Figure 9.Folding arm folder 90 has two inner surfacies that are used for clamping broken long-armed 12, and one side is the plane, and another side is a taper seat.Simultaneously two antagonism folding arm device 9 opposition are inserted on the pedicle screw 1; Make two broken long-armed 12 of pedicle screw 1 to insert respectively in two folding arm folders 90; Fracture two broken long-armed 12 simultaneously in antagonism then; To the effect of pedicle screw, prevent that pedicle screw is loosening in the minimizing folding arm process.After vertical even rod 2 and horizontal connected device 702 were installed, the nail rod had become as a whole, can adopt two antagonism folding arm devices 9 to insert different pedicle screws respectively, can reduce the effect to pedicle screw equally, prevented that pedicle screw from becoming flexible.
Under the preferable case, long-armed for the pedicle screw that better fractures, the end place near nail seat 11 on two broken long-armed 12 of said pedicle screw 1 is provided with recessed incisura 18.A little less than recessed incisura 18 places are broken, can fracture herein broken long-armed 12.
In the percutaneous Wicresoft pedicle screw-rod internal fixation system of this utility model, pedicle screw, the vertical preferred medical titanium alloy that adopts of rod that connects are processed into, and other parts preferably adopt medical stainless steel materials processing to process, and are convenient to sterilize repeatedly, increase the service life.Wherein, the hand-held horizontal handle of each parts, handle can select for use the high-quality wood materials to process.
With the breast fracture of lumbar vertebral body is example, and the work process of the percutaneous Wicresoft pedicle screw-rod internal fixation system of this utility model is following:
1. after anaesthetizing successfully, the patient gets the ventricumbent position, and abdominal part is unsettled.
2.C the arm X-ray machine is had an X-rayed the location, labelling is hindered vertebra and is reached the pedicle of vertebral arch body surface projection of vertebra up and down, opens percutaneous with location trocar 3 in pedicle of vertebral arch body surface projection outer rim side and penetrates; Needle point reaches 2 or 10 of the outer upper limbs of pedicle bone property projection " eyes " and locates to wear out cortical layer; Slowly pierce and reach vertebral body middle part, extract the awl 32 of location trocar 3, insert guide pins 4 through locating sleeve 31 and reach the vertebral body middle part; Extract locating sleeve 31; Keep guide pin 4, insert guide pin 4 with method percutaneous in other pedicles of vertebral arch, positive side position perspective confirms that guide pin 4 positions are appropriate.
3. be that vertical skin incision of 1.5 centimetres is done at the center with guide pin 4, and cut deep fascia, along guide pin 4 disposable expansion passages, extract expansion core 5 with expansion core 5, will expand core 5 and be inserted in and put in the nail pilot sleeve 6, integral body is along guide pin 4 expanding channels again.After expansion core 5 front ends arrive at surface of bone, continue again to insert and put nail pilot sleeve 6, make the circular saw spine of its front end go into the surperficial cortex of vertebral plate, articular process; Nail pilot sleeve 6 is put in pressure fixing a little; Does not move the holding position, extracts expansion core 5, keeps to put nail pilot sleeve 6 and guide pin 4.
4. insert along guide pin 4 with hollow flat prominent file 100, polish guide pin 4 inlet cortical bone, and pierce a little degree of depth, extract hollow flat prominent awl 100, carry out tapping along 4 pairs of pedicle nail roads of guide pin, extract guide pin 4 with hollow screw tap 200.
5. pedicle screw 1 is inserted in the nail seat 900, on follow closely device 7 and pedicle screw 1 in the last nail seat 900 be connected after, follow closely pilot sleeve 6 insertions along putting; The most advanced and sophisticated pedicle of vertebral arch inlet that accurately inserts of nail body 10; Nail device 7 is screwed into pedicle screw 1 in the rotation, outside the broken long-armed 12 emersion skin incisions.Insert all the other pedicle screws with quadrat method, hinder vertebra in case of necessity and can insert one-sided or the bilateral screw.
6. carry out the correction and the vertical length that connects rod 2 of measurement of U-shaped structure 14 positions of pedicle screw 1 earlier: outside the broken long-armed 12 emersion skin incisions; In the U-shaped structure 14 of directly vertical even excellent 2 each pedicle screw 1 of embedding the same side of another root of skin external, the U-shaped structure 14 of each pedicle screw of the same side is located along the same line.
7 select the vertical even rod 2 and the pre-bendings of appropriate length; Will the company of indulging rod 2 with hold excellent device 400 and be connected, must make vertically to connect rod 2 and hold excellent device 400 and be in same plane the little otch of following closely through last position; The vertical far-end that connects rod 2 vertically is inserted into U-shaped structure 14 bottoms of pedicle screw 1; Owing to the interior empty width of the width of holding excellent device 400 and U-shaped structure 14 is equal, the vertical rod 2 that connects is become level and slotting to the U-shaped structure 14 of the next pedicle screw 1, in this process along the vertebral plate face from vertical; Holding excellent device 400 is embedded in the broken long-armed U-shaped structure 14 of upper pedicle screw 1; The broken long-armed U-shaped structure 14 of each pedicle screw of homonymy, vertical connect rod 2 and hold excellent device 400 threes on same fore-and-aft plane, in direct-view down, advance vertically to connect excellent 2 and is inserted in the U-shaped structure 14 of the next pedicle screw 1; To hold excellent device 400 and withdraw from U-shaped structure 14 slightly, the correct radian that adjustment pre-bending is vertical to connect rod 2 towards; Employing is held plug screw device 300 and plug screw 13 is screwed in the U-shaped structure 14 of the next pedicle screw 1, adopts anti-spanner 500 and the tight plug screw spanner 8 of revolving then, tightens the next plug screw 13 and compresses the vertical rod 2 that connects, and withdraws from and holds excellent device 400, and the vertical rod 2 that connects of offside is installed with method; Employing struts prelum 600, through last underlying nail skin incision, carries out distraction reduction, tightens upper plug screw 13 then and compresses the vertical rod 2 that connects.With quadrat method opposite side is carried out distraction reduction.If need be to hindering bone grafting in the vertebra space; Install that a side is vertical to be connected rod 2 and carry out distraction reduction, opposite side is not installed earlier the vertical rod 2 that connects, and struts fulcrum device 800 with screw and embeds U-shaped structures 14 bottoms; With strutting prelum 600 row distraction reductions; Hindering the vertebra pedicle of vertebral arch does not have the vertical rod 2 that connects and blocks, and adopts pedicle of vertebral arch hollow vertebral body bone grafting device (patent No. 200610108291.1) percutaneous bone grafting in hindering vertebra, and then the vertical rod 2 that connects is installed.
8. the skin incision through upper or the next both sides is inserted leading cone device 700 in pedicle screw 1 lower edge or upper limb, carries out taper hole with spinous process awl 701 along 700 pairs of spinous process of leading cone device, and horizontal connected device is installed then.C arm perspective is confirmed to reset and is fixed well.
9. adopt fracture two of pedicle screw 1 of antagonism folding arm device 9 antagonism broken long-armed 12, and take out.
10. wash little otch, holostrome interrupted suture deep fascia, subcutaneous tissue and skin, operation is accomplished.
The percutaneous Wicresoft pedicle screw-rod internal fixation system of this utility model, it is loaded down with trivial details to have solved the device design that present breast lumbar vertebra Wicresoft pedicle screw-rod internal fixation system exists, complicated operation; Lack and effectively strut or problem such as pressurizing tool and hollow pedicle nail processing technology difficulty is big, it is rational in infrastructure that this apparatus has, simple to operate; Put nail accurately, it is quick to put rod, effectively struts pressurization; Be prone to install horizontal connected device, advantages such as the interior bone grafting of vertebral body can reach the open surgery effect.
The above is merely the preferred embodiment of this utility model; Not in order to restriction this utility model; Any modification of being done within all spirit and principles at this utility model, be equal to replacement and improvement etc., all should be included within the protection domain of this utility model.
Claims (10)
1. percutaneous Wicresoft pedicle screw-rod internal fixation system; It is characterized in that, said percutaneous Wicresoft pedicle screw-rod internal fixation system comprises pedicle screw, vertical location trocar and the guide pin that connects rod, is used to confirm to put the nail position, be used to enlarge the expansion core of putting the nail passage, put the nail pilot sleeve, on follow closely device, go up the nail seat, be used to install vertical connect rod hold excellent device, be used to strut or pressurize strut prelum, the long-armed folding arm device of the pedicle screw that is used to fracture; Wherein, Said pedicle screw comprises nail body, nail seat, two broken long-armed and plug screws, and the nail body is connected with the nail seat; Article two, broken long-armed on the spot being fixedly connected on upward formation U-shaped structure of nail seat; Be used to embed the vertical rod that connects, two broken long-armed extending to outside the skin incision, plug screw is used for being screwed into two broken long-armed U-shaped structures and compresses the vertical rod that connects.
2. percutaneous according to claim 1 Wicresoft pedicle screw-rod internal fixation system; It is characterized in that; Article two, broken long-armed inner surface has female thread; The outer surface of plug screw has the external screw thread with broken long-armed inner surface female thread coupling, and an end of plug screw has the consent of holding, and two broken long-armed end places of going up near the nail seat of pedicle screw are equipped with recessed incisura.
3. percutaneous according to claim 1 Wicresoft pedicle screw-rod internal fixation system is characterized in that described pedicle screw is the fixed axis pedicle screw, and nail body and nail are fixedly connected.
4. percutaneous according to claim 1 Wicresoft pedicle screw-rod internal fixation system; It is characterized in that; Described pedicle screw is the movable axis pedicle screw, is provided with the bulb pressure pad of bulb and hollow between nail body and the nail seat, and the nail body is fixedly connected with bulb; Bulb flexibly connects with the nail seat, and the bulb pressure pad is arranged in the nail seat and is pressed on the bulb; The vertical company in two broken long-armed U-shaped structures of rod embedding also directly is pressed on the bulb pressure pad.
5. percutaneous according to claim 1 Wicresoft pedicle screw-rod internal fixation system; It is characterized in that the described vertical rod that connects comprises barred body and the union joint that is positioned at the barred body two ends, barred body is cylindrical; Union joint is used to hold rod, and barred body is used to embed in the U-shaped structure of pedicle screw; Saidly hold excellent device and comprise and hollowly lead rod pipe and can insert hollow leading and be used to compress the vertical depression bar that connects rod in the rod pipe; A hollow end of leading the rod pipe has horizontal shape hole, and said horizontal shape hole is used to insert the vertical union joint that connects rod, and the hollow other end of leading the rod pipe expands, and the place's inner surface that expands has female thread; One end of depression bar has the 6th hand-held horizontal handle, expands near the 6th hand-held horizontal handle place on the depression bar, and the place's outer surface that expands has with the hollow rod pipe of leading and expands the external screw thread of place's female thread coupling; The hollow rod pipe of leading expands internal diameter and the depression bar at place to expand the external diameter located identical.
6. percutaneous according to claim 1 Wicresoft pedicle screw-rod internal fixation system is characterized in that said location trocar comprises locating sleeve and awl; There is scale on the locating sleeve surface; Awl is arranged in locating sleeve, exposes from an end of locating sleeve, and the head end of awl is tapered; The insertion locating sleeve confirmed to put the nail position after described guide pin was used for extracting awl, and there is scale on the guide pin surface, and its head end has screw thread; Said expansion core comprises that along the cylinder that has the guide pin through hole on the axis cylindrical external diameter is identical with the nail seat external diameter of pedicle screw; It is conical that a cylindrical end is, and the other end is fixedly connected with the first hand-held horizontal handle; The said nail pilot sleeve of putting comprises along the cylinder that has the pedicle screw through hole on the axis; One end of cylinder is the band saw dentation; The other end is fixedly connected with the second hand-held horizontal handle; Its other end also opposes and is provided with and second hand-held two parallel U-lags of horizontal handle, and two U-lags are used to carry the first horizontal handle; The length of cylinder is identical with the cylindrical length of expansion core, and the length of cylinder is greater than nail body, nail seat and the broken long-armed total length of pedicle screw.
7. percutaneous according to claim 2 Wicresoft pedicle screw-rod internal fixation system is characterized in that, also comprises being used for hollow flat prominent file and/or hollow screw tap; Described hollow flat prominent file comprises that along the file bar that has the guide pin through hole on the axis external diameter of file bar is identical with the nail body diameter of pedicle screw; One end of file bar is fixedly connected with the file head, and the other end is fixedly connected the 3rd hand-held horizontal handle; The file end surface is provided with roll flute, and periphery is provided with and bores the style screw thread; Said hollow screw tap comprises that along the screw tap bar that has the guide pin through hole on the axis external diameter of screw tap bar is identical with the nail body diameter of pedicle screw; One end of screw tap bar is fixedly connected with the screw tap head, and the other end is fixedly connected the 4th hand-held horizontal handle; The periphery of screw tap head is provided with the thread road with pedicle screw nail body coupling;
The said nail device of going up comprises strut and chock plug that lays respectively at the strut two ends and the 5th hand-held horizontal handle; Be arranged with rotating hammerlock pipe on the strut, the hammerlock pipe has the external screw thread that matees with broken long-armed inner surface female thread near an end outer surface of chock plug, and the other end of hammerlock pipe is fixedly connected with turncap, is used to rotate the hammerlock pipe; Be arranged with screw guide ring and rotary handle on the hammerlock pipe, the screw guide ring is positioned near chock plug one side, and rotary handle is positioned near the 5th hand-held horizontal handle one side, and the external diameter of screw guide ring is identical with the nail seat external diameter of pedicle screw; Also be provided with convexity on the said chock plug, the bulb that is used for inserting the movable axis pedicle screw is tightened the nail body of movable axis pedicle screw; The said nail seat of going up comprises nail pedestal and the through hole on the nail pedestal; Through hole comprises different two sections in aperture, and wherein one section big internal diameter of aperture equates with the external diameter of the nail seat of pedicle screw, and one section little internal diameter of aperture equates with the external diameter of the nail body of pedicle screw.
8. percutaneous according to claim 2 Wicresoft pedicle screw-rod internal fixation system is characterized in that,
Also comprise and hold the plug screw device; The said plug screw device of holding is a pole, and the end opposition of pole is provided with two shell fragments, and the other end is provided with the 7th hand holding handle; Two shell fragment shape that forms and form fit of holding consent that opposition is provided with, two shell fragments are used for inserting holds consent and has held plug screw; Said tight plug screw spanner comprises wrenching bar and the 8th hand-held horizontal handle that is fixedly connected on wrenching bar one end, and the other end of wrenching bar can insert holding of plug screw and rotate plug screw in the consent and compress the vertical rod that connects;
Also comprise the anti-spanner that revolves; Said anti-anti-handle and the anti-rotary sleeve of revolving that spanner comprises L shaped fixed connection that revolve; Anti-rotary sleeve is a hollow structure, is used to be sheathed on the pedicle screw periphery; Anti-rotary sleeve is provided with the symmetric groove of falling U away from an anti-end that revolves handle, is used to block the vertical rod that connects.
9. percutaneous according to claim 1 Wicresoft pedicle screw-rod internal fixation system is characterized in that the said prelum that struts comprises two pillars, two crossbeams and a threaded bar; One end of two pillars is equipped with and is used to block the vertical groove of falling U that connects rod, the other end respectively with the end flexible connection of two crossbeams, flexibly connect between the other end of two crossbeams; Be equipped with screw thread coupling on two pillars, threaded bar is arranged on two screw thread couplings; The threaded bar outer surface is provided with two sections screw threads in the opposite direction, and two screw thread couplings lay respectively on threaded bar two sections screw threads in the opposite direction; Also be provided with on two pillars and be used for the broken long-armed armful armlet of socket pedicle screw.
10. percutaneous according to claim 1 Wicresoft pedicle screw-rod internal fixation system is characterized in that, also comprises leading cone device and spinous process awl; Wherein, said leading cone device is used to guide the spinous process awl to carrying out taper hole between spinous process or spinous process; Said leading cone device comprises sliding rod, two connecting rods and two guiding tubes, and an end of two connecting rods is slidingly connected with sliding rod simultaneously, and the other end of two connecting rods is connected with guiding tube respectively; Connecting rod can move along sliding rod;
Said spinous process awl has Z-shaped three-stage structure, and the one of which end is a handle, and the other end is a cone tip shape, is used for carrying out taper hole between spinous process and spinous process; Said folding arm device is antagonism folding arm device, comprises handle and the folding arm folder that is fixedly connected with handle, and the folding arm folder is used to block the broken long-armed of pedicle screw and it is fractureed.
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CN2011202933344U CN202263044U (en) | 2011-08-12 | 2011-08-12 | Percutaneous minimally invasive pedicle screw-rod internal fixing system |
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CN2011202933344U CN202263044U (en) | 2011-08-12 | 2011-08-12 | Percutaneous minimally invasive pedicle screw-rod internal fixing system |
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CN102247201A (en) * | 2011-08-12 | 2011-11-23 | 贺新宁 | Percutaneous minimally invasive pedicle screw/rod internal fixation system |
CN103815956A (en) * | 2013-12-02 | 2014-05-28 | 浙江康慈医疗科技有限公司 | Minimally-invasive hollow multi-side-pore pedicle screw |
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US9907582B1 (en) | 2011-04-25 | 2018-03-06 | Nuvasive, Inc. | Minimally invasive spinal fixation system and related methods |
US10716600B1 (en) | 2011-04-25 | 2020-07-21 | Nuvasive, Inc. | Minimally invasive spinal fixation system |
US11596453B2 (en) | 2011-04-25 | 2023-03-07 | Nuvasive, Inc. | Minimally invasive spinal fixation system |
CN102247201A (en) * | 2011-08-12 | 2011-11-23 | 贺新宁 | Percutaneous minimally invasive pedicle screw/rod internal fixation system |
CN103815956A (en) * | 2013-12-02 | 2014-05-28 | 浙江康慈医疗科技有限公司 | Minimally-invasive hollow multi-side-pore pedicle screw |
CN106691525A (en) * | 2017-01-06 | 2017-05-24 | 南京市六合区人民医院 | Fixing system for transplant in anterior cruciate ligament reconstruction |
CN109998656A (en) * | 2019-04-10 | 2019-07-12 | 晏怡果 | Vertebral pedicle nail fixer for cervical vertebrae, fixed system and fixing means |
CN110251222A (en) * | 2019-06-04 | 2019-09-20 | 迪恩医疗科技有限公司 | The horizontal even device of pedicle nail nail seat |
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