WO2014094551A1

WO2014094551A1 - Lumbosacral anterior approach steel plate fixing device

Info

Publication number: WO2014094551A1
Application number: PCT/CN2013/088736
Authority: WO
Inventors: 高耀平; 田芳; 林忠; 陈伟
Original assignee: 上海微创骨科医疗科技有限公司; 苏州海欧斯医疗器械有限公司
Priority date: 2012-12-19
Filing date: 2013-12-06
Publication date: 2014-06-26
Also published as: CN103876816A

Abstract

A lumbosacral anterior approach steel plate fixing device comprises a steel plate (2) and screws (2). Screw holes (4) are formed in the steel plate (1), and screw heads (6) of the screws (2) can be contained in the screw holes (4). The lumbosacral anterior approach steel plate fixing device further comprises locking nuts (3), the locking nut holes (12) which are adjacent to the screw holes (4) are arranged in the steel plate (1), and the locking nuts (3) can be maintained in the locking nut holes (12) in a rotatable mode. Concave surface parts (7) and convex surface parts (8) are arranged along the periphery of the locking nuts (3). In first locking nut rotating positions in which the concave surface parts (7) of the locking nuts (3) face the screw holes (4), the locking nuts (3) do not block the screw holes (4); while in second locking nut rotating positions in which the convex surface parts (8) of the locking nuts (3) face the screw holes (4), and the convex surface parts (8) can press the screw heads (6) of the screws (2) located in the screw holes (4). The present invention can simplify operation steps, lower the operation operating difficulty, and enable the complete set of the device to be compact in structure.

Description

Lumbar anterior road plate fixation device

The present invention relates to a fixed implant in the field of medical devices for use in orthopedic spinal surgery. In particular, the present invention relates to a lumbosacral anterior plate fixation device. Background technique

The human spine is an organic whole structure composed of vertebral bones. The vertebrae include 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 atlases and 4 caudal vertebrae. Fractures, dislocations, and lateral processes are likely to occur between the fifth lumbar vertebrae and the first atlas. If fractures, dislocations, and lateral processes occur, they should be fixed in time to restore their normal physiological state and stability. In the past ten years, common fixation methods include: posterior tibial rod fixation, lag screw fixation, and anterior plate fixation. Posterior tibial rod fixation requires that both sides of the posterior superior iliac spine are intact, and excessive compression may damage the phrenic nerve, so it cannot be used for bilateral ankle dislocation. The lag screw fixation requires the ankle joint to be completely reset, the surgical conditions are high, and repeated fluoroscopy during the operation, such as improper placement of the nail, can cause blood vessel or nerve damage. The advantages of anterior plate fixation are as follows: 1 The anterior plate fixation is safer, firmer and simpler, can be dissected and reset, reduce the damage of soft tissue in the posterior aspect of the ankle joint, reduce the incidence of wound infection and skin flap necrosis, and facilitate the inguinal inguinal hernia. The approach to the ipsilateral hip anterior column or anterior wall fracture and pubic fracture reduction and internal fixation improved the surgical outcome. 2 The anterior approach facilitates the exploration of life-threatening abdominal injuries, and the anatomical reduction and fixation of the pelvic ring. 3 Complete fixation and fixation under direct vision can reduce complications such as neurovascular injury. 4 internal fixation can only maintain the fixation in a short period of time, long-term stability depends on the healing strength of local injury, the use of ankle bone graft fusion can achieve permanent stability, solve the problem of fracture relocation and ankle instability, and avoid 骶髂The occurrence of joint traumatic arthritis. 5 anterior incision is convenient to expose, less complications, And it is conducive to the treatment of combined injuries. At present, the anterior lumbosacral plate fixation system consists essentially of steel plates and screws. In order to prevent the nail from being retracted after the screw is implanted into the human body, various nail removal structures have been designed in the prior art. For example, one of Syndius' existing products is the threaded locking of steel plates and screws. The disadvantage of this design is the stress shielding. One of Medtronic's existing products is to add a pressure plate, press the screw, and then fix the pressure plate and the steel plate with a locking screw. The disadvantage of this design is that the operation is cumbersome and difficult, because when installing the pressure plate. The pressure plate is easy to slide into the human body. In addition, Chinese related patents CN201055419Y and CN202184786U also disclose some related fixing devices. Summary of the invention

In view of the deficiencies of the prior art, it is an object of the present invention to develop a lumbosacral anterior plate fixation device which simplifies the surgical procedure, reduces the difficulty of the surgical operation, and enables the entire package to be compact. According to the present invention, there is provided a lumbosacral anterior plate fixation device comprising a steel plate and a screw, wherein the steel plate is provided with a screw hole, and a screw head of the screw can be received in the screw hole,

among them,

The lumbosacral anterior plate fixing device further includes a lock cap, and a lock cap hole is disposed adjacent to the screw hole in the steel plate, and the lock cap is rotatably held in the lock cap hole The lock cap has a concave portion and a convex portion along an outer circumference thereof, wherein in a first rotational position of the lock cap of the locking cap facing the screw hole, the lock cap does not block the screw hole, but The convex portion facing the locking cap faces the second rotating position of the locking cap of the screw hole, and the convex portion can press the screw head of the screw located in the screw hole. Preferably, in the steel sheet, two or more of the screw holes are provided adjacent to the lock cap hole, and the lock cap has two or more of the concave and convex surfaces, respectively. a portion in which each of the two concave surfaces faces the phase of the two or more screw holes In a first rotational position of the locking cap of a screw hole, the locking cap does not block the screw hole, and each of the convex portions faces a corresponding one of the two or more screw holes In the second rotational position of the lock cap, each of the convex portions is capable of pressing a screw head of a screw located in the corresponding one of the screw holes. Preferably, two or more of the lock cap holes are provided in the steel plate to accommodate two or more of the lock caps. Preferably, the lock cap hole is composed of a coaxial large hole and a small hole, the large hole has a diameter larger than a diameter of the small hole, and the large hole and the small hole communicate with each other; the lock cap The upper portion of the lock cap and the lower portion of the lock cap are configured to fit into the large hole of the lock cap hole, and the concave portion and the convex portion are located in the upper portion of the lock cap, and the lower portion of the lock cap The small hole that can pass through the lock cap hole, wherein an outer diameter of the upper portion of the lock cap is less than or equal to a diameter of the large hole and larger than a diameter of the small hole, and an outer diameter of a lower portion of the lock cap Less than or equal to the diameter of the small hole; a rivet portion is integrally formed at a bottom end of the lower portion of the lock cap, and an outer diameter of the rivet portion is smaller than a diameter of the small hole before riveting, so that the rivet portion can Passing through the small hole to rive the steel plate, the outer diameter of the riveting portion after riveting is larger than the diameter of the small hole, so that the lock cap is fixed relative to the steel plate in the longitudinal axis direction thereof, but At the same time, the lock cap is rotatable relative to the steel plate about its longitudinal axis . Preferably, the screw hole is a spherical hole, and the screw head has a spherical fitting portion, and the spherical fitting portion cooperates with the spherical hole. Preferably, the steel plate is provided with a spherical arc surface at a portion joined to the vertebral body. According to the above technical solution of the present invention, the surgical procedure can be simplified, the operation difficulty of the operation can be reduced, and the entire device can be made compact. Specifically, the present invention has the following advantages:

1. The lumbosacral anterior plate fixation device of the present invention is mainly composed of a steel plate and a screw, Dunle's existing products have fewer parts, and the entire device is compact in structure, which can reduce the number of operating steps, simplify the surgical procedure, reduce the difficulty of operation, and increase the safety and effectiveness of the operation.

2. The existing product of Syndius Company is that the steel plate and the screw are locked by thread, which causes stress shielding; in contrast, in the lumbosacral front plate fixing device of the present invention, the steel plate and the screw are spherically combined, And the screw is also locked by the lock cap, so that no stress shielding occurs during the fusion contraction.

3. In the anterior sacral plate fixation device of the present invention, the steel plate is provided with a spherical arc surface at a portion bonded to the vertebral body, so that the curved surface design at the joint portion between the steel plate and the vertebral body conforms to the anatomical structure, thereby The device of the invention has good fit, does not require osteotomy during surgery, and is stable and reliable after fixation, without stress shielding. DRAWINGS

In order to more clearly illustrate the technical solutions in the embodiments of the present application, the drawings to be used in the description of the embodiments will be briefly described below. Obviously, the drawings in the following description relate only to the exemplary embodiments described in the present application, and those skilled in the art can obtain other drawings and drawings according to the drawings without any creative work. Example.

1 is a perspective view of a lumbosacral anterior steel plate fixing device according to an embodiment of the present invention as viewed from above;

Figure 2 is a top plan view of a lumbosacral anterior plate steel fixture according to an embodiment of the present invention as viewed from above;

Figure 3 is a perspective view of a lock cap in accordance with one embodiment of the present invention;

Figure 4 is a perspective view of a steel sheet according to an embodiment of the present invention, from which the front side of the steel sheet can be observed;

Figure 5 is a perspective view of a steel sheet according to an embodiment of the present invention, from which the back surface of the steel sheet can be observed;

Figure 6 is a perspective view of a screw according to an embodiment of the present invention;

Figure 7 is a perspective view of a lumbosacral anterior plate fixation device applied to a vertebral body in accordance with one embodiment of the present invention. Description of the reference signs:

1, steel plate

2, the screw

3, lock cap

4, screw hole

5, the ball arc surface

6, screw head

7, concave face

8, convex face

9, lumbar vertebra

10, atlas

1 1 , screw body

12, lock cap hole

13, spherical matching part

14, the upper part of the lock cap

15, the lower part of the lock cap

16, riveting

17, large holes

18, small hole

Preferred embodiments of the present invention are described in detail below with reference to the accompanying drawings. As shown in FIGS. 1 to 4, the lumbosacral anterior plate fixing device of the present invention comprises a steel plate 1 and a screw 2, wherein the steel plate 1 is provided with a screw hole 4. In the embodiment of Figures 1-4, the steel sheet 1 is generally rectangular in shape and four screw holes 4 are provided at substantially four corners of the rectangle. The screw 2 is used to fix the steel plate 1 to a human vertebral body. As shown in FIG. 6, the screw 2 is composed of a screw head 6 and a screw body 11, and a screw head 6 and a screw body 11 are integrally formed, and a screw is provided on the outer circumference of the screw body 11 to facilitate fastening of the screw 2. The screw body 11 of the screw 2 can pass through the screw hole 4, and the screw head 6 of the screw 2 It can be accommodated in the screw hole 4 of the steel plate 1, so that the steel plate 1 can be fixed to the human body vertebral body. As shown in FIGS. 1 to 4, the lumbosacral anterior plate fixing device further includes a lock cap 3 in which a lock cap hole 12 is provided adjacent to the screw hole 4. The lock cap 3 is rotatably held in the lock cap hole 12. Gp, the lock cap 3 is fixed in the lock cap hole 12 in the direction of its longitudinal axis, but can be rotated about its longitudinal axis in the lock cap hole 12. In the embodiment of FIGS. 1 to 4, the lock cap hole 12 has a stepped hole shape, that is, a coaxial large hole 17 and a small hole 18, and the diameter of the large hole 17 is larger than the diameter of the small hole 18. The large hole 17 and the small hole 18 communicate with each other; the lock cap 3 includes a lock cap upper portion 14 and a lock cap lower portion 15, and the lock cap upper portion 14 is adapted to be fitted to the lock cap hole 12 In the large hole 17, the lower portion 15 of the lock cap can pass through the small hole 18 of the lock cap hole 12, wherein the outer diameter of the upper portion 14 of the lock cap is smaller than or equal to the diameter of the large hole 17 and larger than The diameter of the small hole 18, the outer diameter of the lower portion 15 of the lock cap is less than or equal to the diameter of the small hole 18; a rivet portion 16 is integrally formed at the bottom end of the lower portion 15 of the lock cap, before riveting The outer diameter of the rivet portion 16 is smaller than the diameter of the small hole 18, so that the rivet portion 16 can be riveted to the steel plate 1 through the small hole 18, and the outer diameter of the rivet portion 16 after riveting is larger than The diameter of the small hole 18 such that the lock cap 3 is fixed relative to the steel plate 1 in the longitudinal axis direction thereof, but at the same time the lock cap 3 can Its longitudinal axis relative to the rotating plate. As shown in FIG. 3, the lock cap 3 has a concave portion 7 and a convex portion 8 along its outer circumference, and in particular, the concave portion 7 and the convex portion 8 are located in the upper portion 14 of the lock cap. As shown in FIG. 1 to 2, in the first rotational position of the locking cap of the locking cap 3 facing the screw hole 4, the locking cap 3 does not block the screw hole 4, so that the screw 2 It can be freely inserted into the screw hole 4; and in the second rotational position of the locking cap of the locking cap 3 facing the screw hole 4, the convex portion 8 can be pressed against the screw hole 4 The screw head 6 of the screw 2 inside, so that the screw 2 that has been inserted into the screw hole 4 cannot be withdrawn from the screw hole 4. The concave portion 7 and the convex portion 8 can be formed by cutting one or more curved portions from a cylindrical base. As shown in Figures 2 and 4, the lock cap hole 12 and the wheel of the adjacent screw hole 4 A portion of the profile overlaps each other such that the lock cap hole 12 and the adjacent screw hole 4 communicate with each other such that in the second rotational position of the lock cap, the convex portion 8 of the lock cap 3 can protrude to the adjacent screw hole 4, thereby blocking the screw head 6 of the screw 2. In the present invention, in the steel sheet 1, two or more of the screw holes 4 may be provided adjacent to the cap hole 12, and the lock cap 3 has two or more correspondingly a plurality of said concave surface portions 7 and convex portions 8, wherein in each of said concave concave portions 7 facing the lock cap first rotational position of a corresponding one of said two or more screw holes 4, The lock cap 3 does not block the screw hole 4, and in a second rotation position of the lock cap of each of the two or more screw holes 4 facing each of the convex portions 8 Each of the convex portions 8 is capable of pressing the screw head 6 of the screw 2 located in the corresponding one of the screw holes 4. With the above arrangement, one lock cap 3 can be used to simultaneously lock two or more screws 2. In the present invention, two or more of the lock cap holes 12 may be provided in the steel sheet 1 to accommodate two or more of the lock caps 3. An embodiment with two lock caps 3 and two lock cap holes 12 and four screws 2 and four screw holes 4 is shown in Figures 1-2. As shown in FIGS. 4-6, in the present invention, the screw hole 4 may be a spherical hole, and the screw head portion 6 may have a spherical fitting portion 13 that cooperates with the spherical hole. The fit of the steel plate 1 to the screw 2 is a spherical fit, which avoids the occurrence of stress occlusion. As shown in Fig. 5, in the present invention, the steel plate 1 may be provided with a spherical arc surface 5 at a portion joined to the vertebral body. In the embodiment of Fig. 5, the steel sheet 1 is provided with a ball-arc surface 5 at the upper and lower portions of the back surface thereof for combining with the corresponding human vertebral bodies. The joint of the steel plate 1 with the lumbar vertebrae 9 and the atlantoaxial vertebra 10 has a spherical arc surface design, which conforms to the human anatomy, so that the device of the present invention has good adhesion and is stable and reliable after fixation. In actual operation, as shown in Figures 1 and 2, before the screw 2 is implanted, the concave surface portion 7 of the lock cap 3 should face the screw hole 4, thereby allowing the screw 2 to be inserted into the screw hole 4; when the screw 2 is all After screwing into the screw hole 4, the operator can rotate the lock cap 3 to rotate it by 90 °. Thereby, the convex portion 8 of the lock cap 3 can be pressed against the screw head portion 6, which can prevent the screw head portion 6 from being withdrawn from the screw hole 4, thereby preventing the screw 2 from being withdrawn from the screw hole 4. Moreover, in the embodiment of Figures 1 and 2, one of the lock caps 3 can simultaneously lock the two screws 2. Figure 7 is a perspective view of a lumbosacral anterior plate fixation device applied to a vertebral body in accordance with one embodiment of the present invention. As shown in Fig. 7, the steel plate 1 is fixed to the lumbar vertebra 9 by the upper two screws 2, and the steel plate 1 is fixed to the atlas 10 by the lower two screws 2, which employs two lock caps 3, each of which has a lock cap 3 Both screws 2 can be locked at the same time. According to the above technical solution of the present invention, the surgical procedure can be simplified, the operation difficulty of the operation can be reduced, and the entire device can be made compact. The above description is only an exemplary embodiment of the present application. It should be noted that those skilled in the art can also make several improvements and modifications without departing from the principles and inventive concepts of the present invention. These modifications and variations are also considered to fall within the scope of the present application. Within the scope of protection.

Claims

claims

1. An anterior lumbosacral plate fixation device, including a steel plate (1) and a screw (2), wherein the steel plate (1) is provided with a screw hole (4), and the screw head (2) of the screw (2) 6) can be accommodated in said screw hole (4),

It is characterized by,

The anterior lumbosacral steel plate fixation device also includes a lock cap (3). A lock cap hole (12) is provided in the steel plate (1) adjacent to the screw hole (4). The lock cap (12) 3) Rotatably held in the lock cap hole (12), the lock cap (3) has a concave portion (7) and a convex portion (8) along its outer circumference, wherein the lock cap (3) ) of the lock cap (7) facing the screw hole (4) in the first rotation position, the lock cap (3) does not block the screw hole (4), and the lock cap (3) ), the convex portion (8) of the lock cap faces the screw hole (4) in the second rotation position, and the convex portion (8) can press the screw (2) located in the screw hole (4). Screw head (6).

2. The anterior lumbosacral steel plate fixation device according to claim 1, characterized in that, in the steel plate (1), two or more are provided adjacent to the locking cap hole (12). The screw hole (4), and the lock cap (3) correspondingly has two or more concave portions (7) and convex portions (8), wherein each of the concave portions (7) In the first rotational position of the lock cap facing a corresponding one of the two or more screw holes (4), the lock cap (3) does not block the screw hole (4), In the second rotational position of the lock cap in which each convex portion (8) faces a corresponding one of the two or more screw holes (4), each convex portion (8) can press the screw head (6) of the screw (2) located in the corresponding screw hole (4).

3. The anterior lumbosacral steel plate fixation device according to claim 2, characterized in that two or more locking cap holes (12) are provided in the steel plate (1) to accommodate two or more of the lock caps (3).

4. The lumbosacral anterior steel plate fixation device according to any one of claims 1 to 3, It is characterized in that the lock cap hole (12) is composed of a coaxial large hole (17) and a small hole (18), and the diameter of the large hole (17) is larger than the diameter of the small hole (18), so The large hole (17) and the small hole (18) are connected to each other; the lock cap (3) includes an upper part of the lock cap (14) and a lower part of the lock cap (15), and the upper part of the lock cap (14) is used to match In the large hole (17) of the lock cap hole (12), the concave portion (7) and the convex portion (8) are located in the upper part of the lock cap (14), and the lower part of the lock cap (15 ) can pass through the small hole (18) of the lock cap hole (12), wherein the outer diameter of the upper part of the lock cap (14) is less than or equal to the diameter of the large hole (17) and larger than the diameter of the large hole (17). The diameter of the small hole (18), the outer diameter of the lower part of the lock cap (15) is less than or equal to the diameter of the small hole (18); a riveted part is integrally formed at the bottom of the lower part of the lock cap (15) (16), before riveting, the outer diameter of the riveted part (16) is smaller than the diameter of the small hole (18), so the riveted part (16) can pass through the small hole (18) and connect with the small hole (18). The steel plate (1) is riveted. After riveting, the outer diameter of the riveted part (16) is larger than the diameter of the small hole (18), so that the lock cap (3) is positioned relative to the steel plate (3) along its longitudinal axis. 1) is fixed, but at the same time the locking cap (3) can rotate about its longitudinal axis relative to the steel plate (1).

5. The anterior lumbosacral plate fixation device according to any one of claims 1 to 3, characterized in that the screw hole (4) is a spherical hole, and the screw head (6) has a spherical fit. part (13), the spherical fitting part (13) matches the spherical hole.

6. The anterior lumbosacral plate fixation device according to any one of claims 1 to 3, characterized in that the steel plate (1) is provided with a spherical arc surface (5) at the part combined with the vertebral body. .