阅读说明：本技术 脊柱骨折椎体解剖复位并椎体内植骨的内固定系统 (Internal fixation system for vertebral anatomy reduction and bone implantation in vertebral body for spine fracture ) 是由 郝定均 张海平 于 2021-10-15 设计创作，主要内容包括：本发明公开一种脊柱骨折椎体解剖复位并椎体内植骨的内固定系统,包括至少两个伤椎置钉,每个伤椎置钉均连接有复位连接夹部,所有复位连接夹部通过连接棒连接；复位连接夹部包括固定螺丝、复位连接螺母和复位连接螺头；复位连接螺母具有连接通孔和固定螺孔,所述复位连接棒端部伸入所述连接通孔；固定螺丝与所述固定螺孔螺纹连接以固定所述复位连接棒；复位连接螺头具有连接孔,伤椎置钉上端部伸入所述连接孔并固定；复位连接螺头和复位连接螺母连接,且连接处具有单向齿轮结构。本发明最大限度的恢复和保持伤椎椎体有效的高度,减少术后的椎体塌陷及后凸畸形,同时减少椎弓根螺钉及连接棒的断裂。(The invention discloses an internal fixation system for vertebral body dissection reduction of spinal fracture and bone implantation in a vertebral body, which comprises at least two injured vertebra placing nails, wherein each injured vertebra placing nail is connected with a reduction connecting clamp part, and all reduction connecting clamp parts are connected through a connecting rod; the reset connecting clamp part comprises a fixing screw, a reset connecting nut and a reset connecting screw head; the reset connecting nut is provided with a connecting through hole and a fixing screw hole, and the end part of the reset connecting rod extends into the connecting through hole; the fixing screw is in threaded connection with the fixing screw hole so as to fix the reset connecting rod; the reposition connecting screw head is provided with a connecting hole, and the upper end part of the injured vertebra placing nail extends into the connecting hole and is fixed; the reset connecting screw head is connected with the reset connecting nut, and the joint is provided with a one-way gear structure. The invention recovers and maintains the effective height of the injured vertebral body to the maximum extent, reduces the vertebral body collapse and the kyphosis after the operation, and simultaneously reduces the fracture of the pedicle screw and the connecting rod.)

1. An internal fixation system for vertebral anatomy reduction and bone implantation in vertebral bodies in spinal fracture is characterized by comprising at least two injured vertebral setting nails (100), wherein each injured vertebral setting nail (100) is connected with a reduction connecting clamp part (200), and all reduction connecting clamp parts (200) are connected through a connecting rod (300);

the reset connecting clamp part (200) comprises a fixing screw (201), a reset connecting nut (202) and a reset connecting screw head (203); the reset connecting nut (202) is provided with a connecting through hole (204) and a fixing screw hole (209), and the end part of the reset connecting rod (300) extends into the connecting through hole (204); the fixing screw (201) is in threaded connection with the fixing screw hole (209) to fix the reset connecting rod (300); the reduction connecting screw head (203) is provided with a connecting hole (205), and the upper end part of the injured vertebra placing nail (100) extends into the connecting hole (205) and is fixed;

the reset connecting screw head (203) is connected with the reset connecting nut (202), the joint is provided with a one-way gear structure, and the reset connecting screw head (203) and the reset connecting nut (202) can rotate in a one-way mode relatively.

2. The internal fixation system for anatomic reduction of vertebral bodies with vertebral column fracture and the intravertebral bone grafting according to claim 1, characterized in that said injured vertebral nail (100) comprises a connecting screw head (101), an intermediate nut (102) and an insertion screw (103) connected in sequence; the connecting screw head (101) is placed into the connecting hole (205) and is fixed with the connecting screw head (101) through a connecting nut (210) in a threaded connection mode.

3. The internal fixation system for anatomical reduction of a vertebral body with vertebral column fracture and bone grafting in a vertebral body according to claim 2, characterized in that the connecting screw head (101) is further provided with a fracture groove (104).

4. The internal fixation system for the anatomical reduction of a vertebral body with vertebral column fracture and the bone grafting in the vertebral body as claimed in claim 2, characterized in that the reduction connection screw head (203) is further provided with a limiting groove (206), the limiting groove (206) is arranged at the other side of the connection hole (205), and the limiting groove (206) is communicated with the connection hole (205); the connecting nut (210) is arranged in the limiting groove (206).

5. The system as claimed in claim 4, wherein the limiting groove (206) and the coupling nut (210) are non-circular structures matching with each other.

6. The internal fixation system for anatomical reduction of vertebral body with vertebral column fracture and bone grafting in vertebral body according to claim 1, characterized in that the one-way gear structure comprises an internal gear ring (208) arranged on the reduction connection nut (202) and an external gear ring (207) arranged on the reduction connection screw head (203), the internal gear ring (208) and the external gear ring (207) forming a mutual matching helical gear mechanism.

7. The internal fixation system for vertebral anatomical reduction and interbody bone grafting in vertebral column fracture according to claim 6, characterized in that the angle between the adjacent teeth of the inner gear ring (208) and the outer gear ring (207) is 3 °.

8. The internal fixation system for the anatomical reduction of the vertebral body with vertebral column fracture and the bone grafting in the vertebral body according to claim 6, characterized in that the reduction connection nut (202) is provided with an inner hole (211) along the axial direction, the inner hole (211) is communicated with the connection through hole (204) and the fixing screw hole (209), the inner gear ring (208) is arranged at one side of the inner hole (211), and the outer edge of the inner gear ring (208) is provided with a limiting ring (212).

9. The internal fixation system for the anatomical reduction of a vertebral body with vertebral column fracture and the bone grafting in the vertebral body as claimed in claim 8, wherein the reduction connection screw head (203) has a gear end at one end, the external gear ring (207) is arranged on the gear end, the other end is a limiting end, the connection hole (205) is arranged on the limiting end, the diameter of the limiting end is smaller than that of the gear end, and the diameter of the limiting end is smaller than the inner diameter of the limiting ring (212).

10. The internal fixation system for anatomical reduction of a vertebral body with vertebral column fracture and bone grafting in a vertebral body according to claim 1, characterized in that the fixation screw (201) is a hollow cylindrical body, the exterior of the cylindrical body is provided with external threads, and the interior of the cylindrical body forms a tool operation cavity (2011).

Technical Field

The invention relates to the technical field of spine fracture surgical instruments, in particular to an internal fixation system for spine fracture vertebral body anatomical reduction and vertebral body bone implantation.

Background

With the rapid development of the house and land industry, the transportation industry and the agriculture, the incidence rate of accidents is high, the incidence rate of spine fracture is in an increasing trend and has high disability rate, and most fractures need to be treated by operation. At present, the spine fracture is clinically treated by adopting a classical operation mode through posterior pedicle screw internal fixation, and the principle is that after pedicle screws are placed in screws, intervertebral discs above and below a damaged vertebra and bone blocks connected with anterior and posterior longitudinal ligaments are axially drawn through a connecting rod and rearranged, the appearance of the damaged vertebra is recovered, and the satisfactory vertebral body height is obtained.

However, ideal load distribution requirements for the injured anterior-medial column are difficult to achieve with only posterior pedicle screws. Meanwhile, because the cortex of the injured vertebra and the trabecular bone in the vertebral body are compressed and broken to different degrees, most of patients with vertebral column fracture often cause the formation of a cavity in the vertebral body after the height of the vertebral body is restored, namely the phenomenon of eggshell deformation which is commonly called clinically. The defect is also lost again after the fracture correction height is recovered, so that the serious consequences of fracture nonunion, vertebral body height loss, progressive kyphosis, intractable low back pain, even internal fixation fracture and the like are easy to occur, and the operation is required to be rebuilt again; the bone grafting from the damaged vertebral pedicle to the front center pillar of the burst vertebral body can effectively solve the centrum hollow phenomenon, provide relatively stable internal support of the fractured vertebral body and provide good conditions for fracture healing; therefore, rebuilding the shape of the injured vertebra by implanting bone into the injured vertebra centrum, recovering the bionic shape, and the bionic mechanics and movement are hot topics studied in the last 10 years.

At present, the reduction principle of the spine fracture reduction system which is clinically applied is that after a connecting rod on the left side and the right side is bent, or a pedicle screw of the connecting rod is expanded up and down to obtain the height of a damaged vertebra, no matter the bending degree or the expanding distance, an operator needs to continuously loosen a nut of the pedicle screw for secondary installation and locking, repeated adjustment is carried out, the exposure time of a patient in the operation is prolonged, the infection and bleeding risks are increased, and secondly, the main problem is that when bone grafting is carried out to the damaged vertebra through the pedicle of a vertebral arch to fill the bone defect, the connecting rods on the two sides block a channel for bone grafting of the damaged vertebra through the pedicle of the vertebral arch, a student carries out reduction support on the connecting rod on one side, bone grafting is carried out to the opposite side through the pedicle of the vertebral arch, the method has limited height of the vertebral arch reduction vertebra, and secondly, the stress of the damaged vertebra is not uniform. How to reduce the operation in the operation can obtain satisfactory reduction of the injured vertebra, and the key point of solving the problem clinically can be achieved by fully grafting the bone at the bone defect position in the injured vertebra.

Disclosure of Invention

In order to solve the problems in the prior art, the invention provides an internal fixation system for anatomical reduction of vertebral bodies with vertebral column fracture and bone implantation in the vertebral bodies.

In order to achieve the above object, the present invention provides the following technical solutions.

An internal fixation system for vertebral anatomy reduction and vertebral bone implantation in spinal column fracture comprises at least two injured vertebra placing nails, wherein each injured vertebra placing nail is connected with a reduction connecting clamp part, and all reduction connecting clamp parts are connected through a connecting rod;

the reset connecting clamp part comprises a fixing screw, a reset connecting nut and a reset connecting screw head; the reset connecting nut is provided with a connecting through hole and a fixing screw hole, and the end part of the reset connecting rod extends into the connecting through hole; the fixing screw is in threaded connection with the fixing screw hole so as to fix the reset connecting rod; the reduction connecting screw head is provided with a connecting hole, and the upper end part of the injured vertebra placing nail extends into the connecting hole and is fixed;

the reset connecting screw head is connected with the reset connecting nut, the joint is provided with a one-way gear structure, and the reset connecting screw head and the reset connecting nut can rotate in a one-way mode relatively.

As a further improvement of the invention, the injured vertebra placing nail comprises a connecting screw head, a middle nut and a placing screw which are connected in sequence; the connecting screw head is arranged in the connecting hole and is fixed by connecting a connecting nut and the connecting screw head through threads.

As a further improvement of the invention, the connecting screw head is also provided with a breaking groove.

As a further improvement of the invention, the reset connecting screw head is also provided with a limiting groove, the limiting groove is arranged at the other side of the connecting hole, and the limiting groove is communicated with the connecting hole; the connecting nut is arranged in the limiting groove.

As a further improvement of the invention, the limiting groove and the connecting nut are of non-circular structures matched with each other.

As a further improvement of the invention, the one-way gear structure comprises an inner gear ring arranged on the reset connecting nut and an outer gear ring arranged on the reset connecting screw head, and the inner gear ring and the outer gear ring form a helical gear mechanism matched with each other.

As a further improvement of the invention, the included angle between the adjacent two teeth on the inner gear ring and the outer gear ring and the center is 3 degrees.

As a further improvement of the invention, the reset connecting nut is provided with an inner hole along the axial direction, the inner hole is communicated with the connecting through hole and the fixing screw hole, the inner gear ring is arranged on one side of the inner hole, and the outer edge of the inner gear ring is provided with a limiting ring.

As a further improvement of the invention, one end of the reset connecting screw is a gear end, the outer gear ring is arranged on the gear end, the other end of the reset connecting screw is a limiting end, the connecting hole is arranged on the limiting end, the diameter of the limiting end is smaller than that of the gear end, and the diameter of the limiting end is smaller than the inner diameter of the limiting ring.

As a further improvement of the invention, the fixing screw is a hollow cylindrical body, external threads are arranged outside the cylindrical body, and a tool operation cavity is formed inside the cylindrical body.

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

according to the internal fixation system for the anatomical reduction of the vertebral body and the bone implantation in the vertebral body for the spine fracture, the reduction connecting rod is connected with the two injured vertebral setting nails through the reduction connecting clamp part, so that the reduction connecting rod and the two injured vertebral setting nails are not in the same straight line, and further when the reduction system connecting rod is positioned on the outer side in an operation, the stimulation interference on the upper and lower articular process joint capsules is reduced, the joint capsules are effectively protected, and the postoperative pain and the degeneration of the articular process are reduced. The reduction system adopts the automatic reduction connecting clamp part, ensures the recovery of the height of the injured vertebra, and can perform bone grafting in the vertebra body; secondly, the stability of the front and middle pillars of the injured vertebra is improved; the risk of changing the eggshell shape is effectively reduced; fourthly, the height of the injured vertebra is prevented from being lost again; when the secondary connecting rod is located outside, the occurrence of ASD is effectively reduced; when this connective bar resets is located the inboard, has avoided the needle insertion department of the pedicle of vertebral arch of injured vertebra, can carry out the internal reinforcement of vertebra or bone grafting through the pedicle of vertebral arch in the art, furthest's recovery with keep injuring the effectual height of vertebra centrum, reduce the centrum of postoperative and sink and the back convex deformity, reduce the fracture of pedicle of vertebral arch screw and connective bar simultaneously.

Furthermore, the reset principle of the system does not depend on the traditional connecting rod to be bent or the lever principle of the screw setting of the injured vertebra and the reset of the upper and lower connecting rods after the distraction, but the reset is carried out by the automatic reset connecting clamp part, the reset connecting clamp is designed to be a rotatable one-way gear structure, the angulation of a gear screw and the connecting rod is adjusted to be 3 degrees upwards or downwards every time, so that the automatic adjustment is carried out according to different degrees of fracture in the operation until the fracture is reset satisfactorily, the degree estimation of the bent rod is reduced, the time for repeatedly disassembling the screw plug to adjust the bent rod is reduced, and the possibility that the fracture end is excessively separated and the fracture is not healed due to the excessive distraction of the pursuit of the reset is also avoided.

Drawings

The drawings described herein are for illustration purposes only and are not intended to limit the scope of the present disclosure in any way. In addition, the shapes, the proportional sizes, and the like of the respective members in the drawings are merely schematic for facilitating the understanding of the present invention, and do not specifically limit the shapes, the proportional sizes, and the like of the respective members of the present invention. In the drawings:

FIG. 1 is a schematic view of an internal fixation system for vertebral anatomical reduction and bone grafting in a vertebral body for spinal fractures;

FIG. 2 is a partial schematic view of an internal fixation system for vertebral anatomical reduction and bone grafting within a vertebral body of a spinal fracture;

FIG. 3 is a schematic view of a damaged vertebra nail;

FIG. 4 is a schematic view of a reset attachment clip;

FIG. 5 is another perspective view of the reset attachment clip portion;

FIG. 6 is a schematic view of a reduction coupling nut;

FIG. 7 is a schematic view of a reset connection screw head;

FIG. 8 is a schematic view of a set screw;

FIG. 9 is a first diagram illustrating a usage state of the present invention;

FIG. 10 is a second schematic view illustrating a usage state of the present invention;

FIG. 11 is a third schematic view of the present invention in use;

FIG. 12 is a fourth schematic view illustrating a usage state of the present invention;

FIG. 13 is a fifth schematic view illustrating a usage state of the present invention.

Detailed Description

In order to make those skilled in the art better understand the technical solution of the present invention, the technical solution in the embodiment of the present invention will be clearly and completely described below with reference to the drawings in the embodiment of the present invention, and it is obvious that the described embodiment is only a part of the embodiment of the present invention, and not all embodiments. All other embodiments, which can be obtained by a person skilled in the art without any inventive step based on the embodiments of the present invention, shall fall within the scope of protection of the present invention.

It will be understood that when an element is referred to as being "disposed on" another element, it can be directly on the other element or intervening elements may also be present. When an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present. The terms "vertical," "horizontal," "left," "right," and the like as used herein are for illustrative purposes only and do not denote a single embodiment.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The terminology used in the description of the invention herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items.

As shown in fig. 1 to 2, the present invention provides an internal fixation system for vertebral anatomical reduction and bone grafting in vertebral body of spinal fracture, comprising at least two injured vertebra nails 100, each injured vertebra nail 100 is connected with a reduction connecting clip 200, all reduction connecting clips 200 are connected by a reduction connecting rod 300;

the reset connecting clamp part 200 comprises a fixing screw 201, a reset connecting nut 202 and a reset connecting screw head 203; the reset connecting nut 202 is provided with a connecting through hole 204 and a fixing screw hole 209, and the end part of the reset connecting rod 300 extends into the connecting through hole 204; the fixing screw 201 is in threaded connection with the fixing screw hole 209 to fix the reset connecting rod 300; the reduction connecting screw head 203 is provided with a connecting hole 205, and the upper end part of the injured vertebra placing nail 100 extends into the connecting hole 205 and is fixed;

the reset connecting screw head 203 is connected with the reset connecting nut 202, the joint has a one-way gear structure, and the reset connecting screw head 203 and the reset connecting nut 202 can rotate in a one-way mode relatively.

Because the reset connecting rod 300 is connected with the two vertebra-injured nails 100 through the reset connecting clamp part 200, the reset connecting rod 300 and the two vertebra-injured nails 100 are not in the same straight line, and further when the connecting rod of the reset system is positioned at the outer side in an operation, the stimulation interference to the articular capsule of the superior and inferior articular processes is reduced, the articular capsule is effectively protected, and the postoperative pain and the degeneration of the articular processes are reduced.

Specifically, as shown in fig. 3, the injured vertebra placing nail 100 comprises a connecting screw head 101, an intermediate nut 102 and an placing screw 103 which are connected in sequence; the connecting screw head 101 is inserted into the connecting hole 205 and is fixed to the connecting screw head 101 through a connecting nut 210.

The connecting screw head 101 is further provided with a breaking groove 104, the thread on the connecting screw head 101 is divided into an upper part and a lower part by the breaking groove 104, and the breaking groove 104 is used for breaking off the redundant part when the protruding end part affects the operation.

As shown in fig. 4 and 5, the reset connecting screw head 203 is further provided with a limiting groove 206, the limiting groove 206 is arranged at the other side of the connecting hole 205, and the limiting groove 206 is communicated with the connecting hole 205; the coupling nut 210 is disposed in the retaining groove 206.

The limiting groove 206 and the connecting nut 210 are of non-circular structures matched with each other. In a preferred embodiment of the present invention, the non-circular structure is a regular hexagon. Coupling nut 210 is hexagonal. The limiting groove 206 is an internal hexagon. Of course, the shape is not limited to the second, and other three-dimensional shapes, quadrangles, pentagons, or irregular shapes may be used.

As shown in fig. 5 to 7, the one-way gear structure includes an inner gear ring 208 provided on the reset coupling nut 202 and an outer gear ring 207 provided on the reset coupling head 203, and the inner gear ring 208 and the outer gear ring 207 form a helical gear mechanism matched with each other.

In the preferred embodiment, the angle between the adjacent two teeth of the inner gear ring 208 and the outer gear ring 207 and the center is 3 degrees. When the angle of the two injured vertebra nail placing 100 is needed to be adjusted, the gear is adjusted through the one-way gear structure to realize 3-degree adjustment.

Preferably, as shown in fig. 6, the reset connection nut 202 is provided with an inner hole 211 along the axial direction, the inner hole 211 is communicated with the connection through hole 204 and the fixing screw hole 209, the inner gear ring 208 is arranged on one side of the inner hole 211, and the outer edge of the inner gear ring 208 is provided with a limiting ring 212. The connection is needed, the reset connecting screw head 203 passes through the inner hole 211 of the reset connecting nut 202, the inner gear ring 208 is engaged with the outer gear ring 207, and the limiting ring 212 prevents the reset connecting screw head 203 from sliding out.

Specifically, the reset connection screw head 203 has a gear end, the outer gear ring 207 is arranged on the gear end, the other end is a limiting end, the connection hole 205 is arranged on the limiting end, the diameter of the limiting end is smaller than that of the gear end, and the diameter of the limiting end is smaller than the inner diameter of the limiting ring 212.

The fixing screw 201 is a hollow cylindrical body, an external thread is arranged outside the cylindrical body, and a tool operation cavity 2011 is formed inside the cylindrical body. The tool operation cavity 2011 is, for example, hexagonal inside, which facilitates hexagonal wrench operation. The fixing screw 20 adopts a built-in structure, has no protruding part after being screwed, and does not influence the operation of the operation.

As shown in fig. 9 to 13, which are schematic views of the operation process of the present invention, the operation process is as follows:

the patient takes the prone position after anesthesia is successfully performed, the abdomen is suspended, and the patient is disinfected and paved by a conventional method.

Taking the spinous process of the diseased vertebra as a central posterior median longitudinal incision, incising the skin and subcutaneous tissues layer by layer to the fascia of the chest, waist and back, and stripping the left and right side approach of the spinous process to expose the vertebral plate to the zygapophyseal joint. Protecting upper and lower joint capsules, determining the point of entry of a pedicle screw, preparing a nail path for the upper and lower vertebral bodies of a damaged vertebra through bilateral pedicles by using an opener, placing the pedicle screw and installing a reset connecting clamp, measuring a connecting rod with a proper length, installing the connecting rod and the upper and lower reset clamps, screwing the connecting rod into a screw plug, connecting the tail end of the pedicle screw by using a special reset tool, performing rear compression automatic reset by using the connecting clamp as a central shaft, stopping reset and locking the screw plug after the height recovery of the damaged vertebra is confirmed by C-shaped arm perspective, placing a bone grafting funnel through bilateral damaged vertebrae, performing bone grafting, filling an eggshell cavity in the damaged vertebra, observing fracture reduction satisfaction through C-shaped arm perspective again, and removing the bone grafting funnel and sealing the nail path of the pedicle screw by bone wax. Washing with a large amount of physiological saline, stopping bleeding, counting instruments and gauze kerchief, placing drainage tube, and closing layer by layer. The medicine is wrapped and the operation is finished.

In fig. 12, it can be clearly seen that the connecting rod does not block the implantation of the injured vertebra bone grafting funnel.

When this connective bar resets is located the inboard, has avoided the needle insertion department of the pedicle of vertebral arch of injured vertebra, can carry out the internal reinforcement of vertebra or bone grafting through the pedicle of vertebral arch in the art, furthest's recovery with keep injuring the effectual height of vertebra centrum, reduce the centrum of postoperative and sink and the back convex deformity, reduce the fracture of pedicle of vertebral arch screw and connective bar simultaneously.

The reset principle of the system does not depend on the traditional connecting rod to be bent or the rod for placing the screw of the injured vertebra and the upper and lower connecting rods for resetting after being unfolded, the reset is carried out by the automatic reset connecting clamp part, the reset connecting clamp is designed to be a rotatable one-way gear structure, the angle between a gear screw and the connecting rod is adjusted to be 3 degrees upwards or downwards, so that automatic adjustment is carried out according to different degrees of fracture in the operation until the fracture is reset satisfactorily, the degree estimation of the bent rod is reduced, the time for repeatedly disassembling the screw plug to adjust the bent rod is reduced, and the possibility that the fracture end is excessively separated and the bone is not healed due to excessive unfolding of pursuit of reset is also avoided.

It should be noted that, in the description of the present invention, the terms "first", "second", and the like are used for descriptive purposes only and for distinguishing similar objects, and no precedence between the two is considered as indicating or implying relative importance. In addition, in the description of the present invention, "a plurality" means two or more unless otherwise specified.

It is to be understood that the above description is intended to be illustrative, and not restrictive. Many embodiments and many applications other than the examples provided would be apparent to those of skill in the art upon reading the above description. The scope of the present teachings should, therefore, be determined not with reference to the above description, but should instead be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. The disclosures of all articles and references, including patent applications and publications, are hereby incorporated by reference for all purposes. The omission in the foregoing claims of any aspect of subject matter that is disclosed herein is not intended to forego such subject matter, nor should the applicant consider that such subject matter is not considered part of the disclosed subject matter.