CN103932772A - Sustainable flushing and drainage pedicle screw for treating spinal tuberculosis and screw bar system - Google Patents
Sustainable flushing and drainage pedicle screw for treating spinal tuberculosis and screw bar system Download PDFInfo
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- CN103932772A CN103932772A CN201410045979.4A CN201410045979A CN103932772A CN 103932772 A CN103932772 A CN 103932772A CN 201410045979 A CN201410045979 A CN 201410045979A CN 103932772 A CN103932772 A CN 103932772A
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- tail
- nail
- screw
- flushing
- rivet nut
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
- A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
- A61B17/7008—Longitudinal elements, e.g. rods with a cross-section which varies along its length with parts of, or attached to, the longitudinal elements, bearing against an outside of the screw or hook heads, e.g. nuts on threaded rods
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7041—Screws or hooks combined with longitudinal elements which do not contact vertebrae with single longitudinal rod offset laterally from single row of screws or hooks
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7061—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant for stabilising vertebrae or discs by improving the condition of their tissues, e.g. using implanted medication or fluid exchange
Abstract
The invention discloses a sustainable flushing and drainage pedicle screw for treating the spinal tuberculosis and a screw bar system composed of the pedicle screw. The pedicle screw comprises a screw body, a screw tail and a body-tail expansion part, wherein the screw body, the screw tail and the body-tail expansion part are integrated and hollow, and the body-tail expansion part is arranged between the screw body and the screw tail. The tail end of the screw tail is communicated with a flushing/drainage tube, a plurality of micropores and a plurality of main holes used for flushing/drainage are formed in the screw body, a prism is arranged on the outer side face of the body-tail expansion part and used for assembling or disassembling the screw, and the tail face is used for bearing a screw bar connecting piece. The screw bar system comprises the pedicle screw, the screw bar connecting structure and a connecting bar, wherein the screw bar connecting structure is positioned between the screw tail and the connecting bar and supported on the big tail face of the body-tail expansion part, and the connecting bar is fixedly connected to the screw tail through the screw bar connecting structure. The sustainable flushing and drainage pedicle screw and the screw bar system play a role in spine fixing, abscess drainage, flushing, nidus dosing and diseased area dosing, improve adaptability to a spinal tuberculosis operation and achieve a better treatment effect; multi-point flushing, drainage and dosing are achieved, it is avoided that mycobacterium tuberculosis adheres on the screw body and breeds, and the adaptability is high. The sustainable flushing and drainage pedicle screw and the screw bar system are simple in structure, easy to operate and small in wound.
Description
Technical field
The present invention relates to a kind of medical apparatus and instruments that is used for the treatment of spinal tuberculosis, be particularly related to a kind of sustainable flushing, the pedicle nail of the treatment spinal tuberculosis of drain, also relate to the nail-stick system being formed by above-mentioned pedicle nail, can be used for the flushing of tuberculose focus, drain and medication, row internal fixation of spine simultaneously, play spinal tuberculosis early operation, fully drain, coordinate focus medication, play and expand spinal tuberculosis operative indication, promote tuberculosis recovery from illness, stable disease spinal column, reduce the generation of complication, promote spinal column, the recovery of spinal function, finally reach the object that improves curative effect.
Background technology
Spinal tuberculosis is that tuberculosis infection causes due to Vertebral body.Spinal tuberculosis is many with abscess, can be before vertebra, intervertebral space or, form abscess in vertebral body, the even appendix of vertebra of invading, seriously invades and canalis spinalis often, deformation of spinal column, shakiness, compressing spinal cord, affects the confession of spinal cord blood, causes spinal function obstacle, even causes paraplegia.Therefore, how early operation when Drug therapy, fully drain focus, removes spinal compression, and protection spinal function promotes spinal function to recover, and rebuilds spinal stability, is the key for the treatment of.
At present, conventional Therapeutic Method is first antituberculosis drugs treat to erythrocyte sedimentation rate < row spinal decompression after 40mm/ hour, carries out in spinal column focal cleaning, bone grafting, screw-rod system fixing simultaneously.Requirements of operation can thoroughly be removed focus, guarantee successful surgery.But focus is often difficult for being completely removed, and often needs anterior-posterior, operation wound is large, and risk is high.To suffering from the sufferer of huge abscess focus, when antituberculosis drugs treat is difficult to reduce erythrocyte sedimentation rate, existing method is catheter drainage, as shown in Figure 1, 2, adopts the method for single-point puncture, by drainage tube 1 from external insertion tuberculose focus 2.There is following defect in this mode: (1) catheter drainage quantity and limited location, and drainage tube is placed 1 more, by the other soft tissue of vertebra, enters abscess, only can be applicable to by vertebra, prevertebral abscess drain, bad adaptability; (2) at present drainage tube main purpose only for drain pus, dwindle vomica, temporarily without vomica is carried out to the operation of continual rinsing, even if rinse and administration, because of the limited location of drainage tube, make the uncertainty of rinsing and administration has larger effect blank and acts on; (3), because vomica may exist barrier film, likely can cause drain not thorough; (4) because drainage tube is only fixed on skin surface soft tissue, so the position of drainage tube is variable, easily deviates from; (5) adopt the other puncture mode of vertebra to insert drainage tube, wound is large, and operation easier is high, causes the risk of blood vessel, visceral organ injury high, even may make abscess break after thoracic cavity, peritoneum, causes tuberculosis diffusion, causes serious adverse consequences; (6) tubercule bacillus can be attached to growth on drainage tube, breeding, affects the treatment.
Based on above reason, in clinical treatment, operation is usually controlled not good enough cannot operation in time because of focus, affects the final recovery of spinal function; And, drain, the flushing of focus in for want of long period after operation, the course of disease is long, and easily recurrence causes huge body and mind painful to patient.
Summary of the invention
First object of the present invention be to provide a kind of simple in structure, easy to operate, wound is little, the pedicle nail of the treatment spinal tuberculosis of sustainable flushing, drain focus, by the administration of multiple spot intralesional, flushing, drain, expand operative indication, the simplification art formula of spinal tuberculosis, realize early operation, reduce wound, shorten the course of disease, reduce recurrence, promote to recover, improve the object of cure rate.
The nail-stick system that second object of the present invention is to provide the pedicle nail by the treatment spinal tuberculosis of above-mentioned sustainable flushing, drain to form, can follow closely, excellent cooperation, and early stage spinal fixation, reaches the objects such as stabilizing spine, backbone correcting.
First object of the present invention realizes by the following technical solutions: the pedicle nail of the treatment spinal tuberculosis of a kind of sustainable flushing, drain, it is characterized in that: it comprise the one of hollow rivet nut, nail tail and between body-tail expand, described nail tail tail end is communicated with flushing/drainage tube, in described rivet nut, have several micropores for rinse/drain and main aperture, it is the handling of prism for following closely that described rivet nut-tail expands lateral surface, and tail surface is followed closely excellent connector for support.
In use, rivet nut is implanted vertebral body and can be broken through anterior margin of vertebral body through pedicle of vertebral arch from spinal column rear and enters prevertebral abscess in the present invention, and nail tail is exposed at spinal column rear side outward.Main aperture requires in abscess, to the drain/developing result having reached; Micropore extensively contacts with lesion region, mainly plays rivet nut peripheral region flushing/drainage.The two is in conjunction with the effect that can better play the drain of abscess multiple spot, flushing, focus and lesion region administration, avoided rivet nut to have treatment dead angle around, can effectively reduce lesion region bacterium amount and improve antitubercular agent substrate concentration, avoid causing because flushing/drain/administration is insufficient tubercule bacillus around the growth around of the pedicle nail as foreign body, even diffusion of breeding, promote the recovery from illness of focus.With this type of pedicle nail bar system fix, flushing, drain spinal tuberculosis, can expand the indication of spinal tuberculosis operation, early operation, reaches better therapeutic effect.In addition, the present invention can insert by the little otch of percutaneous, and wound is little, and simple in structure, easy to operate.The present invention need to both can be used as flushing use according to treatment, also can be used as drain use, also can intralesional administration.
As a kind of optimal way of the present invention, described micropore is several and is rule and is distributed on described rivet nut wall, and described main aperture is 1-2 and is positioned on described rivet nut wall.The shape of described main aperture can be ellipse, circle or rectangle etc., and according to the position of focus, main aperture is also predeterminable on the differing heights of rivet nut wall, as is arranged on ailhead side.In art, can select the different rivet nut in main aperture position according to lesions position.For guaranteeing the intensity of rivet nut, main aperture is generally 1-2, according to state of an illness needs, can select the pedicle screw of different preset holes in preoperative, art.
As a modification of the present invention, the tail end of described rivet nut is provided with tail cap, and the end face of described tail cap is provided with connecting hole, and described flushing/drainage tube is connected on described connecting hole to be communicated with rivet nut and flushing/drainage tube.
As one embodiment of the present invention, body-tail connecting portion of described rivet nut expand place lateral surface be prism side.As six prism sides or quadrangular side, can use kit rotation rivet nut, reach the object of installation/taking-up, facilitate operation technique.
As a further improvement on the present invention, described tail cap thread is connected on the tail end of described nail tail, and the outer wall of described nail tail is provided with screw thread; Described main aperture and micropore are positioned at rivet nut wall, and rivet nut outer wall is provided with screw thread, facilitate rivet nut to implant, and can prevent that rivet nut from deviating from simultaneously.Tighten after tail cap (nut), nail-pipe forms a set of airtight sustainable flushing, the pipeline of drain, by flushing/drainage tube, can generally rinse or drain, also can pressure flush or negative pressure drainage, also can coordinate intralesional Drug therapy.
The present invention can also do following improvement, on the inner surface of described tail cap end face, is provided with mounting groove, in described mounting groove, is provided with sealing ring, and described sealing ring is pressed on the tail end opening of described nail tail.
As one embodiment of the present invention, the cross section outer margin contour of described rivet nut is oval, and on the outer wall of rivet nut, be provided with the fin of anti-rotation, can prevent rivet nut rotation, increase the intensity of rivet nut and the area of increase rivet nut inner chamber cross section simultaneously, to better play fixing and flushing, drainage, during use, rivet nut can directly hammer pedicle of vertebral arch.
As one embodiment of the present invention, the blunt circle of the ailhead of described rivet nut, described ailhead has guide pinhole, and described rivet nut is enclosed within outward on the guide pin of having implanted vertebral body by guide pinhole, thus guiding rivet nut is implanted cone.The blunt circle of ailhead can make rivet nut break through anterior margin of vertebral body and not injure blood vessel, the nerve in the place ahead.
The present invention can also do following improvement, in from drain/syringe pipe to described rivet nut, penetrate for detecting, the seal wire of separated vomica barrier film, described seal wire enters vomica to run through abscess interval through described main aperture, after extracting seal wire out, can, better to there being the rinse/drain of vomica barrier film focus, guarantee that drain is thorough, unobstructed.
On above-mentioned basis, overcoat conduit on described seal wire as a further improvement on the present invention, described conduit enters abscess along seal wire, selects flushings/drain point, after extraction seal wire by conduit to flushing/drain in vomica barrier film.
The present invention arranges microtubular in described flushing/drainage tube, and described microtubular connects flushing source, and described flushing/drainage tube is only done the use of drain, and described microtubular is along described rivet nut inner chamber flushing action from extending focus main aperture.Now, an independent pedicle nail can form airtight flushing, a drainage system, realizes the self-loopa of single nail, realizes flushing, drainage simultaneously.
The present invention carries out antibacterial surface processing on described rivet nut outer wall.Can avoid tubercule bacillus to depend on rivet nut growth, breeding, can further improve curative effect.
The present invention can also have following improvement, connecting tee pipe valve is set on described drain/syringe pipe, and described tee T connects respectively flushing source and negative pressure suction device, controls that single rivet nut self is rinsed, drain hockets by valve.
Second object of the present invention realizes by the following technical solutions: the nail-stick system that a kind of pedicle nail of the treatment spinal tuberculosis by sustainable flushing, drain forms, it is characterized in that: comprise pedicle screw, follow closely excellent syndeton and pitman, the excellent syndeton of described nail is located between described nail tail and pitman, support is expanded tail surface in rivet nut-tail, and described pitman is connected and fixed described nail tail by following closely excellent syndeton.
As a kind of optimal way of the present invention, it is plane that rivet nut-tail expands tail surface, facilitates support to follow closely excellent connector, and dignity is cambered surface, can increase support intensity.
As a kind of optimal way of the present invention, described micropore is several and is rule and is distributed on described rivet nut wall, and described main aperture is 1-2 and is positioned on described rivet nut wall.
As a modification of the present invention, described nail tail end is provided with tail cap, the end face of described tail cap is provided with connecting hole, described flushing/drainage tube is connected on described connecting hole to be communicated with rivet nut and flushing/drainage tube, the excellent syndeton of described nail is docked and is formed up and down by the excellent connector of a pair of nail, the excellent connector of described nail is comprised of half hole that is placed on the cylindrical shell of rivet nut afterbody and stretched out by barrel wall, and the excellent connector of described nail docks latter two half hole and forms a jaws, and described pitman is pressed in described jaws; The afterbody of described nail is placed on bar Duan Wei in the cylindrical shell of the excellent connector of described nail, and to be provided with screw thread be non-threaded district, and the length of this bar section is slightly less than the length of cylindrical shell, and the diameter of this bar section is consistent with connector cylinder internal diameter, described tail cap thread is connected to threaded area on described nail tail end, threaded area major diameter of thread is consistent with non-threaded district diameter, making to follow closely excellent connector cylindrical shell can be overlapped to expanding place's tail surface by nail tail end, and is closely placed on the non-threaded district of described rivet nut afterbody.
As one embodiment of the present invention, between described tail cap and described nail rod connector, set up clamp nut, described clamp nut is connected with the tailing screw flight of rivet nut, by clamp nut, be screwed down the excellent connector of nail is compressed, described tail cap and described clamp nut are also tight, to pitman is fixed in jaws.
As one embodiment of the present invention, described rivet nut-tail expands tail surface and can be the coarse sphere that can match with described connector cylindrical shell, can increase contact surface and frictional force.
As one embodiment of the present invention, described main aperture and micropore are positioned at rivet nut wall, and rivet nut outer wall is provided with screw thread.
As the present invention, further improve, on the inner surface of described tail cap end face, be provided with mounting groove, in described mounting groove, be provided with sealing ring, described sealing ring is pressed on the tail end opening of described nail tail.
The present invention can have following embodiment:
Body-tail connecting portion of described rivet nut expand place support follow closely excellent connector, lateral surface is prism.Can use kit rotation rivet nut, reach the object of installation/taking-up, facilitate operation technique.
The cross section outer margin contour of described rivet nut is oval, and on the outer wall of rivet nut, be provided with the fin of anti-rotation, can prevent rivet nut rotation, increase the intensity of rivet nut and the area of increase rivet nut inner chamber cross section simultaneously, to better play fixing and flushing, drainage, during use, rivet nut can directly hammer pedicle of vertebral arch.
The blunt circle of ailhead of described rivet nut, described ailhead has guide pinhole, and described rivet nut is enclosed within outward on the guide pin of having implanted vertebral body by guide pinhole, thus guiding rivet nut is implanted cone.
In from drain/syringe pipe to described rivet nut, penetrate for detecting, the seal wire of separated vomica barrier film, described seal wire enters vomica to run through abscess interval through described main aperture, extracts out can break vomica barrier film after seal wire and carry out drain.
Overcoat conduit on described seal wire, described conduit enters abscess along seal wire, selects flushings/drain point, after extraction seal wire by conduit to flushing/drain in vomica barrier film.Can guarantee to rinse thorough, unobstructed.
In described flushing/drainage tube, microtubular is set, described microtubular connects flushing source, described flushing/drainage tube is only done the use of drain, and described microtubular, along described rivet nut inner chamber flushing action from extending focus main aperture, is realized the self-loopa of single nail and realized flushing, drainage simultaneously.
On described rivet nut outer wall, carry out antibacterial surface processing.Avoid tubercule bacillus to depend on rivet nut growth, breeding, can further improve curative effect.
Compared with prior art, the present invention has following significant effect:
(1) the present invention can play the effect of spinal column fixing and abscess drain, flushing, focus and lesion region administration simultaneously, can effectively reduce lesion region bacterium amount and improve antitubercular agent substrate concentration, be expected to expand the indication of spinal tuberculosis operation, getting up early operation, reaches better therapeutic effect.
(2) the present invention can multi-point flushing, drain, administration, reach better therapeutic effect, solved the technical problem of existing catheter drainage quantity and limited location.
(3) flushing of the present invention and drainage are convertible, also can in flushing/drainage tube, arrange after microtubular, in same pedicle nail, realize and rinsing and drain simultaneously.
(4) the present invention goes for intervertebral space, Intrapyramidal flushing, drain, can be applicable to treat the spinal tuberculosis of diverse location, and the suitability is strong.
(5) multiple spot administration Ke Shi focus of the present invention local application extensively, evenly, avoids traditional administration position limitation, and it is not enough that drug effect blank waits more, can avoid tubercule bacillus to depend on rivet nut growth, breeding simultaneously.
(6) the present invention can detect by seal wire, conduit, separated vomica barrier film, guarantee drain and rinse thorough, unobstructed.
(7) rivet nut of the present invention is implanted pedicle of vertebral arch, fixing reliable, avoids traditional drainage setting position variable, easily deviates to wait deficiency.
(8) the present invention simple in structure, easily operation, can squeeze into by the little otch of percutaneous, wound is little.
Accompanying drawing explanation
Below in conjunction with the drawings and specific embodiments, the present invention is described in further detail.
The cross-sectional view of the existing drainage tube of Fig. 1 to the drain of spinal tuberculosis abscess;
The mistake shape bitmap of the existing drainage tube of Fig. 2 to the drain of spinal tuberculosis abscess;
Fig. 3 is the structural representation of the embodiment of the present invention 1 pedicle nail;
Fig. 4 is longitudinally cross-sectional schematic (main aperture is positioned at the side of ailhead) of the embodiment of the present invention 1 pedicle nail;
Fig. 5 is longitudinally cross-sectional schematic (main aperture is positioned at rivet nut wall middle part) of the embodiment of the present invention 2 pedicle nails;
Fig. 6 is the structural representation of the nail-stick system of the embodiment of the present invention 1 pedicle nail composition;
Fig. 7 is that the embodiment of the present invention 1 pedicle nail bar system is for the schematic diagram of prevertebral abscess flushing/drain;
Fig. 8 is that the embodiment of the present invention 3 pedicle nail bar systems are for separating of connecting abscess mediastinum schematic diagram;
Fig. 9 is that the embodiment of the present invention 4 pedicle nail bar systems are for the schematic diagram of abscess flushing/drain in intervertebral, vertebral body;
Figure 10 is one of schematic diagram of the embodiment of the present invention 4 pedicle nail bar systems (only draws single rivet nut and follow closely excellent connector);
Figure 11 is two (only draw single rivet nut and follow closely excellent connector) of the schematic diagram of the embodiment of the present invention 4 pedicle nail bar systems;
Figure 12 is the schematic diagram that the embodiment of the present invention 5 is used for the treatment of swollen thing drain/administration in osteomyelitis, bone;
Figure 13 is the enlarged diagram of pedicle nail in Figure 12.
the specific embodiment
Embodiment 1
As shown in Figure 3,4, it is the pedicle nail of the treatment spinal tuberculosis of a kind of sustainable flushing of the present invention, drain, it comprise the one of hollow rivet nut 3, nail tail and between body-tail expand 40, on rivet nut 3 outer walls, carry out antibacterial surface processing, the blunt circle of ailhead of rivet nut 3, the blunt circle of ailhead can make rivet nut break through anterior margin of vertebral body and not injure blood vessel, nerve or pass abscess wall.Nail tail tail end is communicated with flushing/drainage tube, has several micropores for rinse/drain and main aperture in rivet nut 3, and it is the handling of prism for following closely that rivet nut-tail expands 40 lateral surface, and tail surface is followed closely excellent connector for support.It is plane that rivet nut-tail expands 40 tail surfaces, facilitates support to follow closely excellent connector, and dignity is cambered surface, can increase support intensity.Micropore 33 quantity are more, are rule and are distributed on rivet nut wall; Main aperture 32 is for 1-2 and be positioned on rivet nut wall, requires the main aperture should be in focus, and the pore diameter range of main aperture approximately equates with the hollow channel of nail, can be ellipse or other shapes.In the present embodiment, nail tail end is provided with tail cap 31, and the end face of tail cap 31 is provided with connecting hole, and flushing/drainage tube 4 is connected on connecting hole to be communicated with rivet nut 3 and flushing/drainage tube 4.Rivet nut-tail connecting portion expand place lateral surface be prism side.As six prism sides, to can use kit rotation rivet nut, reach the object of installation/taking-up, facilitate operation technique.Tail cap 31 is threaded on the tail end of nail tail, and main aperture and micropore are positioned at rivet nut wall, and the outer wall of rivet nut tail is provided with screw thread, and rivet nut outer wall is provided with position between screw thread; On the inner surface of tail cap 31 end faces, be provided with mounting groove, be provided with sealing ring 5 in mounting groove, sealing ring 5 is pressed on the tail end opening of nail tail.Ailhead has guide pinhole 34, and rivet nut 3 is enclosed within on the guide pin of implanting vertebral body by guide pinhole 34 is outer, thereby guiding rivet nut 3 is implanted cone.
As shown in Figure 6,7, the nail-stick system that a kind of pedicle nail of the treatment spinal tuberculosis by sustainable flushing, drain forms, comprise pedicle screw, follow closely excellent syndeton and pitman 6, following closely excellent syndeton is located between nail tail and pitman 6, support is expanded 40 tail surfaces in rivet nut-tail, rivet nut-tail expands 40 tail surfaces and can be the coarse sphere that can match with connector cylindrical shell, can increase contact surface and frictional force.Pitman 6 is fastened on nail tail by following closely excellent syndeton.
In the present embodiment, following closely excellent syndeton is docked and forms up and down by the excellent connector 7 of a pair of nail, following closely excellent connector 7 forms by being placed on the cylindrical shell 71 of rivet nut afterbody and half hole 72 of being located on barrel wall, in the present embodiment, follow closely the cylindrical shell 71 of excellent connector 7 and the afterbody of rivet nut 3 is non-threaded connection, follow closely excellent connector 7 latter two half holes of docking and form a jaws 8, pitman 6 is pressed in jaws 8, jaws 8 for laterally towards, pitman can be connected with a plurality of nails; Nail afterbody is placed on bar Duan Wei in the cylindrical shell 71 of the excellent connector of nail, and to be provided with screw thread be non-threaded district, and the length of this bar section is slightly less than the length of cylindrical shell, and the diameter of this bar section is consistent with connector cylinder internal diameter, tail cap 31 is threaded on nail tail end, threaded area major diameter of thread is consistent with non-threaded district diameter, make to follow closely excellent connector cylindrical shell by following closely tail end cover to expanding place's tail surface, and be closely placed on the non-threaded district of rivet nut afterbody.At tail cap 31 with follow closely between excellent connector 7 and set up clamp nut 20, clamp nut 20 is connected with nail tailing screw flight, by clamp nut 20, be screwed down the excellent connector 7 of nail compressed, tail cap 31 and clamp nut 20 also tightly, to pitman 6 is fixed in jaws 8.Pitman is connected a plurality of pedicle nails be fixed by clamp nut, plays the effect of stabilizing spine.
Use procedure of the present invention is: rivet nut is implanted to vertebral arch pedicle of vertebral column, the abscess 12 of anterior margin of vertebral body or intervertebral space is pointed in tip, nail tail is exposed to spinal column rear side, pilot nail rod connector on nail tail, housing pin can make two and half holes hold with a firm grip and be fixedly connected with rod while compressing, tighten tail cap flushing/drainage tube is closely connected with nail tail, form the path of a sealing, guarantee the sealing system of flushing and vacuum suction; As non-main staple, ailhead also can be squeezed into the capable intervertebral space flushing of intervertebral space, drain, administration; When suction catheter is negative pressure, main aperture can be by pus sucking-off in abscess, and micropore can be by the pus of rivet nut periphery and toxicant sucking-off; During as flushing, flushing liquor is flowed into by syringe pipe, through main aperture, pours vomica, through micropore, enters rivet nut around and disperse towards periphery; When nail A rinses, nail B can do vacuum suction, and flushing and drain are carried out simultaneously, reach good flushing, drainage effect, and drain can suitably give vacuum suction to improve drainage effect; Its upper and lower healthy sections vertebral body, as leading edge has abscess, can be used the present invention, as nothing, rivet nut, nail tail can be made as to non-hollow-core construction, can increase the intensity of rivet nut.
Embodiment 2
As shown in Figure 5, the difference part of the present embodiment and embodiment 1 is: for tuberculose focus in vertebral body, it is upper that the main aperture 32 in rivet nut 3 is positioned at rivet nut wall middle part, guarantees that main aperture and focus communicate, and reach better flushing, drain, administration.
Embodiment 3
As shown in Figure 8, the difference part of the present embodiment and embodiment 1 is: during inadequate drainage, can dredge duct with seal wire, focus is detected and connect vomica.In from drain/syringe pipe 4 to rivet nut 3, penetrate for detecting, the seal wire 10 of separated vomica barrier film, seal wire 10 enters vomica to run through abscess interval through main aperture 32, extracts out can break vomica barrier film after seal wire 10 and carry out drain, guarantees that drain is thorough, unobstructed.
Overcoat conduit (not shown in FIG.) on seal wire 10, conduit enters abscess along seal wire, selects flushings/drain point, after extraction seal wire by conduit to flushing/drain in vomica barrier film.While inserting conduit, the syndeton between tail cap and flushing/drainage tube can, by the sealing of nail tail sealing cap, the locking cap that match, to guarantee to follow closely tail and sealing around, avoid drain pollute nail tail surrounding tissue and keep good attraction effect to reach.
Embodiment 4
As shown in Fig. 9～11, the difference part of the present embodiment and embodiment 1 is: when ailhead is positioned at intervertebral space for abscess, one of them follow closely excellent connector jaws towards difference, install after pitman, rivet nut 13 is angle with pitman 6, is about to pedicle nail and is inclined upwardly, ailhead and main aperture enter intervertebral space and carry out focus flushing, drain, administration, and can coordinate the main aperture of ailhead before vertebral body, form rinse, the circulation approach of drain, also can carry out self being interrupted rinse, drain.Follow closely excellent connector jaws towards difference, can better correct deformity of spine, be beneficial to the connection of pitman simultaneously.
Embodiment 5
As shown in figure 12, the difference part of the present embodiment and embodiment 1 is: for osteomyelitis, treat, main aperture and micropore are only distributed on the bottom of rivet nut 3, screw thread in rivet nut 3 is also positioned on the bottom of rivet nut 3, in the bottom implantable bone 11 of rivet nut 3, can be to the drain/flushing of osteomyelitis percutaneous Minimally Invasive Surgery; To also can the draw materials/administration of thing etc. of swelling in bone, expanded the range of application of described pedicle nail.
Embodiment 6
The difference part of the present embodiment and embodiment 1 is: the cross section outer margin contour of rivet nut is ellipse, and on the outer wall of rivet nut, is provided with the fin of anti-rotation.When preventing rivet nut rotation, increase the intensity of rivet nut and increased the area of rivet nut inner chamber cross section, to better play fixing and flushing, drainage.
Embodiment 7
The difference part of the present embodiment and embodiment 1 is: microtubular is set in flushing/drainage tube, microtubular connects flushing source, flushing/drainage tube is only done the use of drain, microtubular, along rivet nut inner chamber flushing action from extending focus main aperture, is realized the self-loopa of single nail and is realized flushing, drainage simultaneously.
Main aperture of the present invention can be selected to be opened on the diverse location of ailhead or rivet nut, according to mechanical test and model test, determine that the best in aperture is big or small, under the prerequisite of proof strength, can one nail porous, and the labelling, the parameter that at nail tail, have opening, in operation, can select according to lesions position the pedicle screw of respective openings, guarantee that main aperture directly arrives focus or abscess basilar part, be beneficial to focus flushing, drain and administration; The shallow thread design of pedicle nail or the improvement of abnormity design and material, can improve the hollow internal diameter of nail, better drain, flushing; The rivet nut focus of can going directly, collection flushing, drain, delivers medicine to one, and applies in a flexible way according to lesions position; It is optional that the jaws of following closely excellent connector can be designed to angle, facilitates the connection of pitman and better play orthopedic effect; The shape of rivet nut, perforate can be done various deformation, and as porose in most advanced and sophisticated 2～4cm only and screw thread, can be used as flushing, drain, administration for osteomyelitis treatment, also can be used as the object passages such as bone tumor pathologic sampling, topical.
When spinal column adnexa tuberculosis, abscess is positioned at vertebral body side, and pedicle of vertebral arch is owed complete situation, vertebral body can be implanted in pedicle of the present invention outside, or break through pedicle of vertebral arch outer webs and enter vertebral body, possible fixed effect weakens or loses, and now mainly plays flushing, drainage effect.
In addition, can connecting tee pipe on drain/syringe pipe and valve is set, tee T connects respectively flushing source and negative pressure suction device, controls that single rivet nut self is rinsed, drain hockets by valve.
Embodiments of the present invention are not limited to this; according to foregoing of the present invention; according to ordinary skill knowledge and the customary means of this area; do not departing under the above-mentioned basic fundamental thought of the present invention prerequisite; the present invention also has modification, replacement or the change of various ways, within all dropping on rights protection scope of the present invention.
Claims (10)
1. the pedicle nail of the treatment spinal tuberculosis of a sustainable flushing, drain, it is characterized in that: it comprise the one of hollow rivet nut, nail tail and between body-tail expand, described nail tail tail end is communicated with flushing/drainage tube, in described rivet nut, have several micropores for rinse/drain and main aperture, it is the handling of prism for following closely that described rivet nut-tail expands lateral surface, and tail surface is followed closely excellent connector for support.
2. the pedicle nail of the treatment spinal tuberculosis of sustainable flushing according to claim 1, drain, is characterized in that: it is plane that rivet nut-tail expands tail surface, facilitates support to follow closely excellent connector, and dignity is cambered surface, can increase support intensity.
3. the pedicle nail of the treatment spinal tuberculosis of sustainable flushing according to claim 2, drain, is characterized in that: described micropore is several and is rule and is distributed on described rivet nut wall, and described main aperture is 1-2 and is positioned on described rivet nut wall.
4. the pedicle nail of the treatment spinal tuberculosis of sustainable flushing according to claim 3, drain, it is characterized in that: described nail tail end is provided with tail cap, the end face of described tail cap is provided with connecting hole, and described flushing/drainage tube is connected on described connecting hole to be communicated with rivet nut and flushing/drainage tube.
5. the pedicle nail of the treatment spinal tuberculosis of sustainable flushing according to claim 4, drain, is characterized in that: it is prism side that body-tail connecting portion of described rivet nut expands place's lateral surface.
6. the nail-stick system being formed by the pedicle nail of the treatment spinal tuberculosis of sustainable flushing claimed in claim 1, drain, it is characterized in that: comprise pedicle screw, follow closely excellent syndeton and pitman, the excellent syndeton of described nail is located between described nail tail and pitman, support is expanded tail surface in rivet nut-tail, and described pitman is connected and fixed described nail tail by following closely excellent syndeton.
7. nail-stick system according to claim 6, is characterized in that: it is plane that rivet nut-tail expands tail surface, facilitates support to follow closely excellent connector, and dignity is cambered surface, can increase support intensity.
8. nail-stick system according to claim 7, is characterized in that: described micropore is several and is rule and is distributed on described rivet nut wall, and described main aperture is 1-2 and is positioned on described rivet nut wall.
9. nail-stick system according to claim 8, it is characterized in that: described nail tail end is provided with tail cap, the end face of described tail cap is provided with connecting hole, described flushing/drainage tube is connected on described connecting hole to be communicated with rivet nut and flushing/drainage tube, the excellent syndeton of described nail is docked and is formed up and down by the excellent connector of a pair of nail, the excellent connector of described nail is comprised of half hole that is placed on the cylindrical shell of rivet nut afterbody and stretched out by barrel wall, the excellent connector of described nail docks latter two half hole and forms a jaws, and described pitman is pressed in described jaws; The afterbody of described nail is placed on bar Duan Wei in the cylindrical shell of the excellent connector of described nail, and to be provided with screw thread be non-threaded district, and the length of this bar section is slightly less than the length of cylindrical shell, and the diameter of this bar section is consistent with connector cylinder internal diameter, described tail cap thread is connected to threaded area on described nail tail end, threaded area major diameter of thread is consistent with non-threaded district diameter, making to follow closely excellent connector cylindrical shell can be overlapped to expanding place's tail surface by nail tail end, and is closely placed on the non-threaded district of described rivet nut afterbody.
10. nail-stick system according to claim 9, it is characterized in that: between described tail cap and described nail rod connector, set up clamp nut, described clamp nut is connected with the tailing screw flight of rivet nut, by clamp nut, be screwed down the excellent connector of nail is compressed, described tail cap and described clamp nut are also tight, to pitman is fixed in jaws.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201410045979.4A CN103932772B (en) | 2014-02-07 | 2014-02-07 | Sustainable flushing and drainage pedicle screw for treating spinal tuberculosis and screw bar system |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201410045979.4A CN103932772B (en) | 2014-02-07 | 2014-02-07 | Sustainable flushing and drainage pedicle screw for treating spinal tuberculosis and screw bar system |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN103932772A true CN103932772A (en) | 2014-07-23 |
| CN103932772B CN103932772B (en) | 2017-03-22 |
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|---|---|---|---|
| CN201410045979.4A Expired - Fee Related CN103932772B (en) | 2014-02-07 | 2014-02-07 | Sustainable flushing and drainage pedicle screw for treating spinal tuberculosis and screw bar system |
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| CN (1) | CN103932772B (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111317598A (en) * | 2020-02-27 | 2020-06-23 | 河北医科大学第三医院 | Vertebral body repair assembly |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20010021852A1 (en) * | 2000-04-10 | 2001-09-13 | Chappius James L. | Fenestrated surgical screw and method |
| US20050015061A1 (en) * | 2003-07-15 | 2005-01-20 | Sweeney Patrick J. | Method and device for delivering medicine to bone |
| CA2759445A1 (en) * | 2009-04-20 | 2010-10-28 | Osteo Innovations Llc | System and method for self filling bone screws |
| WO2011057178A1 (en) * | 2009-11-06 | 2011-05-12 | Dean Lin | System and method for stabilizing and fixating lumbar vertebrae |
| CN203693728U (en) * | 2014-02-07 | 2014-07-09 | 丁柱 | Spinal tuberculosis treatment pedicle screw with continuous washing and drainage functions and screw-rod system |
-
2014
- 2014-02-07 CN CN201410045979.4A patent/CN103932772B/en not_active Expired - Fee Related
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20010021852A1 (en) * | 2000-04-10 | 2001-09-13 | Chappius James L. | Fenestrated surgical screw and method |
| US20050015061A1 (en) * | 2003-07-15 | 2005-01-20 | Sweeney Patrick J. | Method and device for delivering medicine to bone |
| CA2759445A1 (en) * | 2009-04-20 | 2010-10-28 | Osteo Innovations Llc | System and method for self filling bone screws |
| WO2011057178A1 (en) * | 2009-11-06 | 2011-05-12 | Dean Lin | System and method for stabilizing and fixating lumbar vertebrae |
| CN203693728U (en) * | 2014-02-07 | 2014-07-09 | 丁柱 | Spinal tuberculosis treatment pedicle screw with continuous washing and drainage functions and screw-rod system |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111317598A (en) * | 2020-02-27 | 2020-06-23 | 河北医科大学第三医院 | Vertebral body repair assembly |
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| Publication number | Publication date |
|---|---|
| CN103932772B (en) | 2017-03-22 |
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