阅读说明：本技术 一种脊柱侧凸外固定矫形工具 (Scoliosis external fixation orthopedic tool ) 是由 赵永刚 赵光宇 杨砚伟 胡代军 赵伟 杨捷 罗刚 罗顺天 于 2019-09-27 设计创作，主要内容包括：本发明公开了一种脊柱侧凸外固定矫形工具,属于医疗器械技术领域。它包括若干颗椎弓根螺钉(3),所述的椎弓根螺钉(3)上部为钉座,所述的钉座具有U型槽,U型槽内设有内螺纹,其特征在于：还包括用于矫正脊柱左右弯曲的若干个左右调节装置(4)、用于矫正脊柱前后弯曲的若干个前后调节装置,所述的左右调节装置(4)串联安放在两颗相邻的椎弓根螺钉(3)的钉座内,所述的U型槽内螺纹处设有用来压紧左右调节装置(4)的压紧螺丝(15),所述的前后调节装置设置在椎弓根螺钉(3)的钉座下方。该发明通过左右调节装置和前后调节装置,逐步对脊柱侧凸矢状和冠状面的畸形进行左右或前后矫正,提高了矫形治疗的安全性。(The invention discloses an external fixation orthopedic tool for scoliosis, and belongs to the technical field of medical instruments. It includes a plurality of pedicle of vertebral arch screws (3), pedicle of vertebral arch screw (3) upper portion be the nail seat, the nail seat U type groove has, U type inslot is equipped with internal thread, its characterized in that: still including being used for correcting crooked a plurality of about a plurality of adjusting device (4), be used for correcting crooked a plurality of fore-and-aft adjusting device around the backbone, controlling adjusting device (4) establish ties and lay in the nail seat of two adjacent pedicle of vertebral arch screws (3), U type inslot screw department be equipped with and be used for compressing tightly about adjusting device (4) housing screw (15), fore-and-aft adjusting device set up in the nail seat below of pedicle of vertebral arch screws (3). The invention gradually corrects the deformity of the sagittal and coronal planes of the scoliosis left and right or front and back through the left and right adjusting devices and the front and back adjusting devices, thereby improving the safety of orthopedic treatment.)

1. The utility model provides a scoliosis external fixation orthopedic instrument, includes a plurality of pedicle of vertebral arch screws (3), pedicle of vertebral arch screw (3) lower part be equipped with self tapping screw tooth, its middle part is the polished rod, its upper portion is the nail seat, the nail seat have U type groove, be equipped with the internal thread in the U type groove, its characterized in that: the spinal column correction device is characterized by further comprising a plurality of left and right adjusting devices (4) for correcting left and right curvature of the spinal column and a plurality of front and rear adjusting devices for correcting front and rear curvature of the spinal column, wherein the left and right adjusting devices (4) are arranged in series in screw seats of two adjacent pedicle screws (3), a compression screw (15) for compressing the left and right adjusting devices (4) is arranged at the internal thread position of a U-shaped groove, the front and rear adjusting devices are arranged below the screw seats of the pedicle screws (3), the left and right adjusting devices (4) comprise orthodontic nuts (5), adjusting nuts (6), anti-tooth nuts (7), anti-tooth lead screws (8) and orthodontic lead screws (9), one end of each orthodontic lead screw (9) is connected to an orthodontic end of each adjusting nut (6) after being worn by the orthodontic nuts (5), one end of each anti-tooth lead screw (8) is connected to an anti-tooth end of each adjusting nut (6) after being worn by the anti-tooth nuts (, the front and rear adjusting device comprises a support (12), locking nuts (13), a screw rod (14) and front and rear correcting rods (16), wherein two ends of each front and rear correcting rod (16) are sleeved in the screw rod (14) and are clamped by the two locking nuts (13) on the screw rod (14), connecting holes are formed in the middle of each front and rear correcting rod (16), and the front and rear correcting rods (16) are sleeved under the screw seats of the pedicle screws (3) through the connecting holes.

2. The scoliosis external fixation orthopedic tool of claim 1, wherein: the lower part of the support (12) is provided with an antiallergic rubber mat (11), and the support (12) is fixed on the skin (10) through the antiallergic rubber mat (11).

Technical Field

The invention belongs to the technical field of medical instruments, and particularly relates to an external fixation orthopedic tool for scoliosis.

Background

Scoliosis is a common deformity of the spine, usually meaning a normal vertical offset of the spine to the side, accompanied by rotation of the spine, resulting in a three-dimensional deformity of the spine in the sagittal, axial, and coronal planes. Surgical treatment may be considered when the patient presents with significant pain associated with scoliosis, scoliosis progression, and spinal decompensation. At present, the clinical operation treatment mainly aims at correcting the shape after the open operation is placed into a pedicle screw for fixation, and aims at obtaining the balance of the sagittal plane and the coronal plane of the spine, relieving pain and firmly fixing to prevent further deformity. However, the treatment mode has the defects of high operation difficulty, long operation time, much bleeding during operation, large tissue damage, high risk of infection and nerve damage, spinal column sequence correction only once, easy spinal cord ischemia, nerve root traction and other complications, and unsatisfactory orthopedic effect.

Disclosure of Invention

In view of the above-mentioned shortcomings existing in the current clinical work, the present invention aims to provide an external scoliosis fixing orthopedic tool which can gradually correct left and right or front and back deformities of sagittal and coronal planes of scoliosis, and improves the safety of orthopedic treatment.

In order to achieve the purpose, the invention adopts the following technical scheme: the utility model provides a scoliosis external fixation orthopedic instrument, includes a plurality of pedicle of vertebral arch screws, pedicle of vertebral arch screw lower part be equipped with self tapping screw tooth, its middle part is the polished rod, its upper portion is the nail seat, this nail seat has U type groove, is equipped with the internal thread in the U type groove, its characterized in that: the left and right adjusting devices are arranged in series in screw seats of two adjacent pedicle screws, a compression screw for compressing the left and right adjusting devices is arranged at an internal thread of the U-shaped groove, the front and rear adjusting devices are arranged below the screw seats of the pedicle screws, each left and right adjusting device comprises an orthodontic nut, an adjusting nut, an anti-dentition screw rod and an orthodontic screw rod, one end of the orthodontic screw rod is connected to an orthodontic end of the adjusting nut after being worn by the orthodontic nut, one end of the anti-dentition screw rod is connected to an anti-dentition end of the adjusting nut after being worn by the anti-dentition nut, each front and rear adjusting device comprises a support, a locking nut, a screw rod and a front and rear correcting rod, and two ends of the front and rear correcting rods are sleeved in the front and rear correcting rods, and is clamped by two locking nuts on the screw rod, connecting holes are arranged in the middle parts of the front and rear correcting rods, and the front and rear correcting rods are sleeved under the screw seat of the pedicle screw through the connecting holes. Each pedicle screw may be provided with an anterior-posterior adjustment mechanism as needed to correct anterior-posterior curvature of the spine.

The lower part of the support is provided with the anti-allergic rubber mat, and the support is fixed on the skin through the anti-allergic rubber mat.

Compared with the prior art, the invention has the beneficial effects that:

1. the operation implementation aspect is as follows: the invention fully measures and evaluates the malformation degree of the spine of a patient, the development condition of vertebral pedicle of each vertebral body and the like through the full-length X line of the spine, the spiral CT flat scanning and the three-dimensional reconstruction before the operation. According to the measurement result, a minimally invasive transpedicular screw implantation technology is adopted in the operation process, so that the injury of muscle soft tissue in the operation process is effectively reduced, the bleeding in the perioperative period is obviously reduced, the risk of postoperative surgical incision infection is greatly reduced, and the postoperative rehabilitation time of a patient is shortened;

2. the aspect of the orthopedic process is as follows: the patient regularly (weekly) rechecks the full-length X line of the spine after the operation, the correction scheme is designed in a personalized way according to the scoliosis degree and the correction effect of different patients, and the deformity of the sagittal and coronal planes of the scoliosis is corrected left and right or front and back gradually through the left and right adjusting device and the front and back adjusting device, so that the complications of spinal ischemia, nerve root traction and the like caused by the current one-time correction of the spinal sequence are effectively avoided, and the safety of the correction treatment is improved;

3. the orthopedic effect is as follows: the invention provides sufficient time for the establishment and adaptation of soft tissue balance and spinal cord and nerve root tension in the body of a patient through the mode of regularly rechecking and regularly adjusting the orthopedic degree, and compared with the traditional one-time forming operation, the invention has larger space on the orthopedic effect and can obtain larger deformity correction degree and satisfaction degree of the patient;

4. and (3) postoperative rehabilitation: the invention needs an outpatient clinic to completely take out the screw after obtaining satisfactory treatment effect, and the spinal column sequence is fixed through the balance reestablished by soft tissues after the screw is taken out and relapse is prevented. Compared with the traditional open operation which provides fixation through retention of a fixed object in the whole body and interbody bony fusion, the spine vertebral body of the patient after the operation has large mobility and good functional mobility. Because no metal internal fixture is left after treatment, the patient passes safety inspection in life, the magnetic resonance inspection is not different from normal people, and the life is more convenient.

The therapeutic effect of the present invention is illustrated below in conjunction with clinical trial data:

1. general data

The inventor collects 58 patients diagnosed as idiopathic scoliosis in hospital during 10 months from 2014 to 2018 and 10 months (wherein, the patients are female, 45 patients, male, 13 patients, age 16-23 years, Risser sign (-), Lenke I type 13 patients, Lenke II type 7 patients, Lenke III type 8 patients, Lenke 4 type 8 patients and Lenke 5 type 9 patients)

2. Test method

2.1 surgical mode: experimental groups used the scoliosis pedicle screw external fixation orthopedics of the present invention. The control group used traditional pedicle screw posterior approach open pedicle fixation orthopedics;

2.2 observation indexes: treating the cobb angle of the spine of the patient before and after treatment, the bleeding amount in the operation, the hospitalization time after the operation and the mobility of the lumbar vertebra after the operation;

3. the treatment results are as follows:

the curative effect is the ratio of cobb angle after the treatment and the cobb angle before the operation; the activity of the lumbar vertebra is the activity of the lumbar vertebra stretching forwards and backwards;

the statistical results of the therapeutic effects are shown in table 1.

Table 1: the results of comparing the therapeutic effects of the treated group and the control group

As can be seen from table 1, the present invention has greater advantages in orthopedic effect, surgical injury, intraoperative risk, postoperative rehabilitation, etc. compared with the traditional surgery, and particularly, the present invention significantly reduces the amount of bleeding and the hospitalization time, the amount of bleeding in the experimental group surgery is only about one tenth of that of the control group, the hospitalization time of the experimental group is only about one third of that of the control group, and the pain and hospitalization cost of the patient are significantly reduced.

Drawings

FIG. 1 is a schematic structural diagram of the present invention.

Fig. 2 is a schematic structural diagram of the left-right adjusting device of the present invention.

Fig. 3 is a schematic connection diagram of a plurality of left and right adjusting devices according to the present invention.

In the figure, 1-spine, 2-pedicle, 3-pedicle screw, 4-left and right adjusting device, 5-orthodontic nut, 6-adjusting nut, 7-contra-dental nut, 8-contra-dental screw, 9-orthodontic screw, 10-skin, 11-antiallergic rubber pad, 12-support, 13-locking nut, 14-screw, 15-compression screw and 16-front and back correcting rod.

Detailed Description

The present invention is further illustrated by, but is not limited to, the following examples.

As shown in fig. 1 and 3, the scoliosis external fixation orthopedic tool according to the present invention comprises a plurality of pedicle screws, a plurality of left and right adjusting devices for correcting left and right curvature of the spine, and a plurality of front and rear adjusting devices for correcting front and rear curvature of the spine. The lower part of the pedicle screw is provided with self-tapping screw teeth, the middle part of the pedicle screw is provided with a polished rod, the upper part of the pedicle screw is provided with a screw seat, the screw seat is provided with a U-shaped groove, and internal threads are arranged in the U-shaped groove. The left and right adjusting devices are serially arranged in the nail seats of two adjacent pedicle screws, and the internal thread of the U-shaped groove is provided with a compression screw for compressing the left and right adjusting devices.

As shown in figure 1, the front and back adjusting device comprises a support, locking nuts, a screw rod and front and back correcting rods, wherein two ends of each front and back correcting rod are sleeved in the screw rod and are clamped by the two locking nuts on the screw rod, a connecting hole is formed in the middle of each front and back correcting rod, and the front and back correcting rods are sleeved below a screw seat of a pedicle screw through the connecting holes.

As shown in fig. 2, the left-right adjusting device of the present invention includes an orthodontic nut, an adjusting nut, a counter screw, and an orthodontic screw, wherein one end of the orthodontic screw is connected to the orthodontic end of the adjusting nut after wearing the orthodontic nut, and one end of the counter screw is connected to the counter end of the adjusting nut after wearing the counter nut.

The working principle of the invention is as follows: when the left and right curvature of the spine is corrected, a plurality of pedicle screws are drilled into the pedicles connected with two sides of the vertebral body of the spine, screw seats of the pedicle screws are exposed out of the skin, then a plurality of left and right adjusting devices are placed in series in the screw seats of two adjacent pedicle screws, the left and right adjusting devices are tightly pressed and fixed on the pedicle screws through compression screws, and finally the orthodontic lead screw and the anti-orthodontic lead screw of each section are extended or shortened by adjusting nuts on the left and right adjusting devices of each section, and the orthodontic nuts and the anti-orthodontic nuts on the left and right adjusting devices are locked after the required length is reached. When the front and back curvature of the spine needs to be corrected, the front and back adjusting devices are assembled, the pedicle screws are inserted into the connecting holes in the middle of the front and back correcting rods, and then the pedicle screws are drilled into the pedicles. The supports at the two ends of the front and back adjusting devices are fixed on the skin through the anti-allergic rubber mats, then two locking nuts on the adjusting screw rods are adjusted to enable the front and back correcting rods to move up and down, finally the pedicle screws drive the pedicles of the section of the spine to move back and forth, and the front and back of the spine are corrected simultaneously through the front and back adjusting devices, so that the purpose of correcting the front and back of the spine is achieved.

Typical cases of treatment are listed below:

case 1, Liu Ji, male, 14 years old. As the result of 'finding that the shoulders are unequal and higher for more than 1 year' admission. Physical examination: the back of the razor has unequal heights on the shoulders and scoliosis deformity. The T11-L3 side is convex by 45 degrees, and the vertex is L1. Risser sign (-) the minimally invasive pedicle screw external fixation orthopedic treatment is carried out by using the invention, the bleeding is 50ml during the operation, and the patient is hospitalized for 5 days after the operation. After the operation, the treatment effect is 98 percent, the lumbar vertebra is anteflexed by 90 degrees and is stretched by 25 degrees, and no complication exists;

case 2: Luo-Shi, female, 16 years old, 2 years after menstrual onset, were admitted to the hospital for "scoliosis found for 3 years". Physical examination: the back of the razor has unequal heights on the shoulders and scoliosis deformity. The thoracic lobes T5-T12 are convex by 38 degrees and vertex T9. Lumbar convex vertex vertebra L3, right lateral convexity 73 degrees. Risser sign (-) the minimally invasive pedicle screw external fixation orthopedic treatment is carried out by using the invention, 75ml of bleeding is caused during the operation, and the patient is hospitalized for 7 days after the operation. After the operation of the traditional Chinese medicine, the traditional Chinese medicine is reviewed for 1 year, the curative effect is 98 percent, the lumbar vertebra is anteflexed by 80 degrees, the lumbar vertebra is stretched by 30 degrees, and no complication exists.