Closure assembly for fixing a stabilization element in a receptacle of a bone anchoring device
阅读说明:本技术 用于将稳定元件固定于骨锚固装置的接收部中的封闭组件 (Closure assembly for fixing a stabilization element in a receptacle of a bone anchoring device ) 是由 T·比德尔曼 B·丹内克尔 于 2020-04-22 设计创作,主要内容包括:提供一种用于将细长的稳定元件固定于骨锚固装置的接收部件(5)中的封闭组件,封闭组件(7a,7b,7c,7d,7e)包含:第一封闭构件(70a,70b,70c,70d,70e),所述第一封闭构件具有旋转轴线(R)和外表面,中心通道(70)轴向地位于第一封闭构件中并且穿过第一封闭构件,所述通道的内表面在其至少一部分中包括内螺纹(76);其中第一封闭构件构造成被接收于所述骨锚固装置的接收部件(5)的一对支腿(55,56)之间;第二封闭构件(700a,700b,700c,700d,700e),其具有旋转轴线(R)和外表面,该外表面包括构造成与第一封闭构件的内螺纹(76)配合的外螺纹(703);其中外螺纹(703)包含多头螺纹,所述多头螺纹包括至少两个螺纹起始部(704,707)。(There is provided a closure assembly for securing an elongate stabilization element in a receiving part (5) of a bone anchoring device, the closure assembly (7a, 7b, 7c, 7d, 7e) comprising: a first closure member (70a, 70b, 70c, 70d, 70e) having an axis of rotation (R) and an outer surface, a central passage (70) axially in and through the first closure member, the inner surface of the passage including an internal thread (76) in at least a portion thereof; wherein the first closure member is configured to be received between a pair of legs (55, 56) of a receiving part (5) of the bone anchoring device; a second closure member (700a, 700b, 700c, 700d, 700e) having an axis of rotation (R) and an outer surface comprising an external thread (703) configured to mate with the internal thread (76) of the first closure member; wherein the external thread (703) comprises a multi-start thread comprising at least two thread starts (704, 707).)
1. A closure assembly for securing an elongate stabilization element in a receiving part of a bone anchoring device, the closure assembly (7a, 7b, 7c, 7d, 7e) comprising:
a first closure member (70a, 70b, 70c, 70d, 70e) having an axis of rotation (R) and an outer surface, a central passage (70) axially in and through the first closure member, the inner surface of the central passage including an internal thread (76) in at least a portion thereof;
wherein the first closure member is configured to be received between a pair of legs (55, 56) of a receiving part (5) of the bone anchoring device;
a second closure member (700a, 700b, 700c, 700d, 700e) having an axis of rotation (R) and an outer surface comprising an external thread (703) configured to mate with the internal thread (76) of the first closure member;
Wherein the external thread (703) comprises a multi-start thread comprising at least two thread starts (704, 707).
2. A closure assembly as claimed in claim 1, wherein the internal thread (76) of the first closure member (70a, 70b, 70c, 70d, 70e) comprises a multi-start thread comprising at least two thread starts.
3. A closure assembly according to claim 1 or 2, wherein the external thread (703) of the second closure member (700a, 700b, 700c, 700d, 700e) comprises a flat thread.
4. A closure assembly as claimed in any one of claims 1 to 3, wherein the internal thread (76) of the first closure member (70a, 70b, 70c, 70d, 70e) comprises a flat thread.
5. The closure assembly according to any one of claims 1 to 4, wherein the second closure member (700a, 700b, 700c, 700d, 700e) comprises a first end (701) and an opposite second end (702), wherein the external thread (703) terminates at a distance from the second end (702), and at the second end (702) a radially extending protrusion (780) is provided, which is configured to abut a thread turn of the internal thread (76) of the first closure member (70a, 70b, 70c, 70d, 70 e).
6. A closure assembly according to any one of claims 1 to 5, wherein the second closure member (700a, 700b) comprises an axial channel (795, 795c), which preferably extends completely through the second closure member, and preferably the second closure member further comprises an engagement portion (796, 796b, 796c, 796d, 796e) for engagement with a driving means.
7. A closure assembly according to any one of claims 1 to 6, wherein the external thread (703) of the second closure member (700a, 700b, 700c, 700d, 700e) is a first external thread and the internal thread (76) of the first closure member (70a, 70b, 70c, 70d, 70e) is a first internal thread, the first closure member (70a, 70b, 70c, 70d, 70e) comprising a second external thread (73) in at least a portion of an outer surface, the second external thread being configured to mate with a second internal thread (57, 57 ', 57 ", 57"') provided at a leg (55, 56) of the receiving part (5).
8. A closure assembly as claimed in claim 7, wherein the second external thread (73) and the second internal thread (57, 57 ', 57 ", 57"') are single-start threads.
9. A closure assembly as claimed in claim 7 or 8, wherein the second external thread (73) comprises a flat thread.
10. A closure assembly as claimed in any one of claims 7 to 9, wherein the second internal thread (57, 57 ', 57 ", 57"') is one of the group comprising a flat thread, a negative angle thread, a helical flange thread, a trapezoidal thread or a buttress thread.
11. A closure assembly according to any one of claims 1 to 10, wherein the first closure member (70a, 70b, 70c, 70d, 70e) has a first end (71) and a second end (72), wherein at the first end (71) an engagement arrangement is provided for engagement with a drive arrangement for advancing the first closure member between the legs (55, 56) of the receiving part (5).
12. A closure assembly as claimed in claim 11, wherein the engagement structure comprises a plurality of axially and radially extending grooves (78a, 78b, 78c, 78d, 78e), and preferably the grooves (78d, 78e) are open towards the first end (71) and closed towards the inner surface, more preferably the grooves (78e) are open towards the outer surface of the first closure member.
13. A bone anchoring device, comprising:
a handle (2) for anchoring in a bone and a receiving part (5) connected to the handle, wherein the receiving part is substantially cylindrical and comprises a substantially U-shaped groove (54) forming two legs (55) for receiving a stabilizing element (101, 102) between the two legs,
and a closure assembly according to any one of claims 1 to 12 for securing the stabilizing element (101, 102) in the recess (54).
14. The bone anchoring device according to claim 13, wherein the shank (2) is pivotably connectable to the receiving part (5), and the first closing member (70a, 70b, 70c, 70d, 70e) is configured to lock the angular position of the receiving part (5) relative to the shank (2), and the second closing member (700a, 700b, 700c, 700d, 700e) is configured to lock the stabilization element (101, 102) in the groove (54).
15. The bone anchoring device according to any one of claims 13 or 14, further comprising a pressure element (6) configured to exert pressure onto an inserted head (3), which forms an end portion of the shank (2), wherein the pressure member (6) comprises a support surface (69) for the elongated stabilization element, which preferably has a substantially V-shaped profile as seen in a direction perpendicular to the central axis (C), and preferably side walls (67, 68) on both sides of the support surface (69) extend beyond the stabilization element (101, 102) supported on the support surface (69).
Technical Field
The present invention relates to a closure assembly for fixing a stabilization element in a receiving part of a bone anchoring device, and to a bone anchoring device comprising such a closure assembly. In particular, the invention is applicable to orthopaedic surgery, more particularly to orthopaedic spinal surgery.
Background
In orthopedic spinal surgery, pedicle screws and rods are commonly used to stabilize spinal segments. Pedicle screws are bone anchoring devices that include a shank for anchoring in bone and a receiving member for coupling a stabilization rod to the shank. The shank can be polyaxially connected to the receiving part in a so-called polyaxial bone anchoring device or can be fixedly connected to the receiving part in a so-called monoaxial bone anchoring device (wherein the shank and the receiving part usually form a zero angle). Various closure assemblies are known that capture a rod in a receiving member, lock the angular position of a handle pivotally connected to the receiving member, and lock the rod.
Two-piece closure assemblies are well known, for example from US 6,224,598B 1 for monoaxial bone anchoring devices and US8,828,060B 2 for polyaxial bone anchoring devices. On the other hand, various one-piece closure devices are known, for example from US 5,005,562 or also from US8,828,060B 2.
In particular, US 9,636,146B 2 proposes a one-piece cylindrical closure member comprising first and second helically wound thread forms on the closure member, the first helically wound thread form having a first start and the second helically wound thread form having a second start cooperating with a first helically wound thread form on the first arm of the receiver member and a second helically wound thread form on the second arm of the receiver member, the second helically wound thread form on the second arm of the receiver member being opposite to the first helically wound thread form.
Although various closure assemblies have been described in the prior art in an attempt to overcome the disadvantages resulting from the distribution and transmission of forces during tightening or tightening of the closure assembly, there remains a need for an improved closure assembly for use in conjunction with a bone anchoring device for stabilizing vertebrae or bone portions.
Disclosure of Invention
It is therefore an object of the present invention to provide an improved closure assembly and a bone anchoring device with such a closure assembly, which provides a better distribution of the forces generated by the closure assembly and a locking force.
This object is solved by a closure assembly according to claim 1 and a bone anchoring device according to claim 13. Further developments are given in the dependent claims.
According to one aspect, a closure assembly for securing an elongated stabilizing member in a receiving part of a bone anchoring device, the closure assembly comprising: a first closure member having an axis of rotation and an outer surface; a central passage axially in and through the first closure member, an inner surface of the passage including internal threads in at least a portion thereof; wherein the first closure member is configured to be received between a pair of legs of a receiving part of a bone anchoring device; a second closure member having an axis of rotation and an outer surface comprising external threads configured to mate with the internal threads of the first closure member; wherein the external thread comprises a multi-start thread comprising at least two thread starts.
With a multi-start thread, the force resulting from screwing the second closure member relative to the first closure member is distributed not only to one thread but to at least two or more threads. As a result, the force may be more evenly transferred to the first closure member. Furthermore, the likelihood of the legs splaying or twisting during locking of the head of the bone anchoring element may be further reduced.
According to another aspect, the thread form of the multiple start thread is a flat thread. By means of the flat thread, the force distribution can be further improved.
According to another aspect, the first closure member includes external threads configured to mate with internal threads provided on an inner surface of the leg of the receiving component. The external thread of the first closure member and the internal thread of the receiving part may be single-start threads. Also, the thread form of the external thread of the first closure member and the thread form of the internal thread of the receiving part may be different. For example, the thread form of the external thread may be a flat thread, and the thread form of the internal thread may be a trapezoidal thread, a buttress thread, a helical flange thread (helical flange), a negative angle thread, or another thread form sized and shaped to mate with the flat thread of the external thread of the first closure member. This allows the closure assembly to be used as a closure assembly for various types of receiving parts which differ in their internal thread provided on the leg.
The drive portions of the first and second closure members may have various shapes so as to be suitable for instruments used to insert and tighten the closure assembly.
According to yet another aspect, a bone anchoring device comprises: a stem for anchoring in a bone; and a receiving component connected to the handle; wherein the receiving member is generally cylindrical and comprises a generally U-shaped recess forming two legs for receiving an elongate stabilising element therebetween. The bone-anchoring device also includes the closure assembly. When the handle is pivotably connected to the receiving part, the closure assembly may be configured such that the first closure member is adapted to lock the angular position of the receiving part relative to the handle and the second closure member is adapted to lock the elongate stabilizing member in the groove. A pressure member may further be provided in the receiving part to apply pressure onto the head forming an end portion of the handle. The pressure member may be configured to selectively receive rods of different diameters.
In combination with closure assemblies of various shapes, a wide variety of bone anchoring devices can be assembled using only a small number of basic components.
Drawings
Further features and advantages of the invention will become apparent from the description of embodiments with the aid of the drawings. Wherein:
fig. 1 shows an exploded perspective view of an embodiment of a bone-anchoring device with a first embodiment of a closure assembly.
Fig. 2 shows a cross-sectional view of the bone-anchoring device and closure assembly of fig. 1, wherein the cross-section is taken in a plane extending through the center of the legs of the receiving member and perpendicular to the rod axis of the first rod having the first diameter.
Fig. 3 shows a cross-sectional view of the bone-anchoring device of fig. 1, wherein the cross-section is taken in a plane extending through the center of the legs of the receiving part and perpendicular to the rod axis of the second rod having the second diameter.
Fig. 4 shows a cross-sectional view of an enlarged portion of fig. 2.
Fig. 5a to 5e show exploded perspective views of embodiments of the closure assembly.
Fig. 6 shows a perspective view from the top of the first closure member of the first embodiment of the closure assembly shown in fig. 1-3 and 5 a.
Fig. 7 shows a perspective view of the first closure member of fig. 6 from the bottom.
Fig. 8 shows a side view of the first closure member of fig. 6 and 7.
Fig. 9 shows a perspective view from the top of the second closure member of the first embodiment of the closure assembly shown in fig. 1-3 and 5 a.
Fig. 10 shows a perspective view of the second closure member of fig. 9 from the bottom.
Figure 11 shows a side view of the second closure member of figures 9 and 10.
Figure 12 shows a perspective view from the top of the first closure member of the second embodiment of the closure assembly shown in figure 5 b.
Fig. 13 shows a perspective view of the first closure member of fig. 12 from the bottom.
Figure 14 shows a side view of the first closure member of figures 12 and 13.
Figure 15 shows a second closure member of the second embodiment of the closure assembly shown in figure 5 b.
Fig. 16 shows a perspective view of the second closure member of fig. 15 from the bottom.
Fig. 17 shows a side view of the second closure member of fig. 15 and 16.
Figure 18 shows a perspective view from the top of the first closure member of the third embodiment of the closure assembly shown in figure 5 c.
Fig. 19 shows a perspective view of the first closure member of fig. 18 from the bottom.
Figure 20 shows a perspective view from the top of the second closure member of the third embodiment of the closure assembly shown in figure 5 c.
Fig. 21 shows a perspective view of the second closure member of fig. 20 from the bottom.
Figure 22 shows a perspective view from the top of the first closure member of the fourth embodiment of the closure assembly shown in figure 5 d.
Figure 23 shows a perspective view from the top of the second closure member of the fourth embodiment of the closure assembly shown in figure 5 d.
Figure 24 shows a perspective view of the first closure member of the fifth embodiment of the closure assembly shown in figure 5 e.
Fig. 25 shows a perspective view of the first closure member of fig. 24 from the bottom.
Figure 26 shows a perspective view from the top of the second closure member of the fifth embodiment of the closure assembly shown in figure 5 e.
Fig. 27 shows a perspective view of the second closure member of fig. 26 from the bottom.
Fig. 28 shows an enlarged portion of the closure assembly of fig. 5a with a modified embodiment of the bone anchoring device in cross-section.
Fig. 29 shows an enlarged portion of a cross-sectional view of the closure assembly of fig. 5a with another modified embodiment of a bone anchoring device.
Fig. 30 shows an enlarged portion of a cross-sectional view of the closure assembly of fig. 5a with yet another modified embodiment of a bone anchoring device.
DETAILED DESCRIPTION OF EMBODIMENT (S) OF INVENTION
A closure assembly including a closure assembly according to a first embodiment will be described with reference to fig. 1 to 3The bone anchoring device of (1). The bone anchoring device comprises a bone anchoring element 1 having a shank 2 with a threaded portion and a
In addition, the bone anchoring device comprises a closure member 7 a. The closure assembly 7a includes a first or
The receiving
The receiving
On the inner surfaces of the
Furthermore, the transverse bore 58 may extend through one of the
The
Adjacent the
Furthermore, the
With additional reference to fig. 5a and 6 to 11, a closure assembly 7a according to a first embodiment will be described. The
In the exemplary embodiment,
The
The
Finally, the
The
On the outer surface of the
As can be seen in particular in fig. 10, the
Finally, the
The closure assembly 7a is assembled by screwing the
Turning again to fig. 1 to 3, the first and
The components and elements of the bone-anchoring device and the closure assembly may preferably be made of biocompatible materials, such as titanium or stainless steel, biocompatible alloys, such as NiTi alloys, e.g. nitinol, magnesium or magnesium alloys, biocompatible plastic materials, such as Polyetheretherketone (PEEK) or levorotatory polylactic acid (PLLA). The components may be made of the same or different materials from each other.
In use, the receiving
To connect the two bone anchoring devices after insertion into the bone parts or vertebrae, one of the
It is also possible to achieve independently the locking of the
When the
Turning now to fig. 5b and 12-17, a second embodiment of the closure assembly will be described. The same or similar components and portions to those of the first embodiment have the same reference numerals, and the description thereof will not be repeated. The second embodiment of the closure assembly 7b includes a
The
A third exemplary embodiment of a closure assembly will be described with reference to fig. 18 to 21. The
The second closure member 700c differs from the second closure member of the second embodiment in that the second closure element 700c is closed at a
A fourth embodiment of the closure assembly will be described with reference to fig. 5d and 22 to 23. The
The second locking member 700d differs from the second locking members of the second and third embodiments in that it is a solid body and the engagement structure is formed as a cruciform slot 796d in the
A fifth embodiment of the closure assembly will be described with reference to fig. 5e and fig. 24 to 27. The
The
It should be noted that the features of the first and second closure members of the first to fifth embodiments may be mixed and matched between each other to create further embodiments of the closure assembly. Many other shapes of the engaging structure of the first and second closure members are envisaged.
A modification of the bone anchor assembly will be described with reference to fig. 28 to 30. The modification relates to an
In another modification, the
Another modified embodiment of the receiving
It should be noted that various other thread forms may be used for the internal thread on the receiving
The external thread of the first closure member is not limited to a flat thread but may be another thread form configured to mate with the internal thread of the receiving part.
Also, the thread forms of the internal thread of the first closing member and the external thread of the second closing member are not limited to flat threads. Thread forms such as V-threads, trapezoidal threads, buttress threads, etc. may also be suitable.
Various further modifications of the bone anchoring device and of the closure assembly are conceivable. Although the polyaxial bone anchoring device shown is a particular type of bottom-loading polyaxial bone anchoring device, top-loading polyaxial bone anchoring devices may also be used. In this type, the anchoring element is inserted into the receiving part from the top end. In such embodiments, the pressure element may be configured to press onto an upper portion of the head, which upper portion is located in a seat in a lower portion of the receiving component. Furthermore, the shape of the receiving part and the pressure element is not limited to the shown embodiment. Many different shapes of the receiving part and/or the pressure element are possible. The receiving part and/or the pressure element can also have a two-part design.
For the bone anchoring elements, all types of bone anchoring elements, in particular bone screws, suitable for anchoring in bones or vertebrae can be used. The elongate stabilizing element may be any rod or other stabilizing element configured to be received between the legs of the receiving member.
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