CN101617953B - 带塞构件的骨锚固件及用于将塞构件插入骨锚固件的工具 - Google Patents

带塞构件的骨锚固件及用于将塞构件插入骨锚固件的工具 Download PDF

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CN101617953B
CN101617953B CN200910150573.1A CN200910150573A CN101617953B CN 101617953 B CN101617953 B CN 101617953B CN 200910150573 A CN200910150573 A CN 200910150573A CN 101617953 B CN101617953 B CN 101617953B
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bone anchor
plug member
bone
cylindrical part
coaxial aperture
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CN101617953A (zh
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L·比德曼
W·马蒂斯
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Biedermann Technologies GmbH and Co KG
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Abstract

本发明提供一种骨锚固件，该骨锚固件包括：锚杆(7)，其具有第一端(8)和第二端(9)；通道(11，12)，其从第一端(8)延伸到第二端(9)；和塞构件(30，40，41)，其能够插入通道中并且能够被引导穿过通道，以便在第二端处闭合通道。所述骨锚固件适用于微创外科手术，这样可以将导丝引导穿过骨锚固件，并且在将骨锚固件锚固在骨中之后，插入塞构件以闭合骨锚固件的开口端。骨接合剂或药物可以被引入骨锚固件中。

Description

带塞构件的骨锚固件及用于将塞构件插入骨锚固件的工具
技术领域
本发明涉及一种骨锚固件，所述骨锚固件具有装有插管的锚杆(cannulated shaft)以及塞构件(plug member)，所述塞构件能够插入所述锚杆中以在一端闭合所述锚杆。本发明还涉及一种用于引入塞构件的工具。所述骨锚固件特别地适用于微创外科手术。
背景技术
WO01/26568A1描述了一种骨螺钉形式的骨锚固件，所述骨螺钉具有螺钉头部和带螺纹的锚杆，所述锚杆包括一个轴向孔和多个径向孔。所述轴向孔在螺钉头部一侧开口而在螺钉锚杆的自由端闭合。这种已知的骨螺钉可以通过将骨接合剂注射进锚杆中而锚固在骨中。这样致使骨锚固件被永久地和安全地固定。
另外还从US5,047,030中已知一种骨螺钉形式的骨锚固件，所述骨螺钉具有装有插管的锚杆。所述骨螺钉的内部具有一个连续的纵向沟槽以及若干个沿径向延伸的横向沟槽，所述横向沟槽与所述纵向沟槽接触。所述纵向沟槽在螺钉的两端开口，并且可以将真空泵经由管连接到螺钉头部周围的区域中，以施加真空来抽吸血液或其它物质。
WO02/38054A2、US2004/0122431A1和US2004/0147929A1公开了具有管状螺纹部分和可以连接到该管状螺纹部分的尖端部分的骨螺钉。所述管状螺纹部分在其壁中具有多个凹槽。可以用骨接合剂填充所述管状螺纹部分。
微创外科手术应用在日益增多的情况下。在某些情况下的微创外科手术中，使用导丝将植入物放置在植入部位。通常微创口经穿过皮肤经皮地形成。
发明内容
本发明的目的是提供一种骨锚固件，所述骨锚固件具有广泛的应用范围，例如所述骨锚固件适用于在微创外科手术中被放置在植入部位，并且所述骨锚固件可以填充有骨接合剂或其它物质。
上述目的通过本发明的骨锚固件和工具实现。
根据本发明，提供了一种骨锚固件，包括：锚杆，该锚杆具有第一端和第二端，通道，该通道从第一端延伸到第二端，和塞构件，该塞构件能够从第一端插入所述通道中并且可被引导穿过所述通道，以便在第二端处闭合所述通道；其中，所述塞构件包括用于与工具接合的接合结构。
根据本发明的骨锚固件具有的优点在于：所述骨锚固件可以用于常规的外科手术和微创外科手术两种情况中。可以为已有的装有插管的骨螺钉提供塞构件，以便致使已有的装有插管的骨螺钉适用于微创外科手术。
具有塞构件的骨锚固件防止了注射在骨锚固件尖端处的骨接合剂的泄漏。这样减小了对脉管结构的可能的损害。
附图说明
从借助于附图对本发明实施例的描述中，其它特征和优点将变得显而易见。附图中：
图1示出根据一个实施例的骨锚固件的分解透视图。
图2示出图1的骨锚固件处于杆被固定时的组装状态下。
图3示出图2骨锚固件的沿包含杆轴线的平面截取的截面图。
图4示出图1至3的骨锚固件中使用的塞构件的俯视图。
图5示出图4的塞构件的透视图。
图6示出塞构件的侧视图。
图7示出塞构件的截面图。
图8示出正在插入骨锚固件中的图4至7的塞构件的放大截面图。
图9示出具有另一种塞构件的第二实施例的骨锚固件的放大截面图。
图10示出具有又一种塞构件的第三实施例的骨锚固件的放大截面图。
图11示出用于将塞构件插入骨锚固件中的工具的第一实施例的分解视图。
图12示出用图11的工具组装有塞构件的骨锚固件的透视图。
图13示出骨锚固件连同处于注射骨接合剂位置的第二实施例的工具的透视图。
图14以分解视图示出骨锚固件连同第二实施例的工具。
图15示出在微创外科手术中使用骨锚固件的步骤1)至3)。
图16a)-16c)示出在微创外科手术中使用骨锚固件的步骤4)。
具体实施方式
图1至8示出根据本发明第一实施例的骨锚固件。骨锚固装置1包括用于锚固在骨中的骨锚固件2、用于接收杆4的接收部分3、作用在骨锚固件2上的压力元件5以及固定元件6。根据所描述实施例的骨锚固装置1设计成所谓的多轴骨螺钉，其特征在于：骨锚固件2被可枢转地保持在接收部分3中，接收部分3将骨锚固件结合到脊柱杆4。骨锚固件相对于杆的角位置可以借助于固定元件6固定。
特别地如图3所示，骨锚固件2包括锚杆7，所述锚杆7具有在第一端的头部8和自由第二端9，所述第二端9可以成形为一个尖端。在所示的实施例中，头部8具有球截形形状。另外，在锚杆7的至少一部分外表面上设置骨螺纹10。
骨锚固件2装有插管。骨锚固件2包括基本同轴的孔11，该孔11从第一端穿过头部8和锚杆7延伸至第二端9。在邻接第二端9的部分12中的孔的直径小于锚杆7的主要部分中的孔的直径，由此在锚杆7内形成一个肩部13。在头部8的自由端处设置用于与工具接合的接合结构14。在锚杆7的壁中设置多个开孔15，所述多个开孔15连接孔11和外部。开孔15的数量、尺寸和布置根据骨锚固件2的总体尺寸设计，以形成用于待引入骨锚固件中的骨接合剂或药物的出口。
孔11的直径，特别是部分12的直径设计成使得通常用于微创外科手术的导丝可以被引导穿过骨锚固件2。
特别地如图1至3所示，接收部分3基本为圆筒形形状并具有第一端3a和相对的第二端3b。接收部分3包括同轴孔16，该孔16从第一端在到第二端的方向上延伸并且朝着第二端16渐缩，从而骨锚固件的头部8被可枢转地保持在接收部分3中。另外，接收部分具有基本为U形的凹槽17，所述凹槽17始于第一端3a并且延伸进第二端3b的方向中，借助于所述U形凹槽17形成两个自由支腿18a、18b。在所述自由支腿18a、18b的用于拧入固定元件6的部分处设置内螺纹19。在该实施例中，固定元件6是内螺钉。
压力元件5用于在内螺钉6被紧固从而该内螺钉压在杆4上时在骨锚固件的头部8上施加压力。压力元件5设计成使得它可以被引入同轴孔16中并且在该同轴孔16中沿轴向方向运动。压力元件5在其面向头部8的一侧上包括基本为球面的凹槽20，以便将压力散布在头部8上，压力元件5在其相对侧上包括基本为圆柱形的凹槽21以用于接收杆4。压力元件5还包括同轴孔22，该孔22用于引导导丝或者旋拧工具穿过其中。
如图4至8所示，骨锚固件还包括塞构件30，该塞构件30用于在自由第二端9的端部部分12处闭合锚杆7的孔11。塞构件30是可以引入孔11中的单独的部件。在图4至8所示的实施例中，塞构件30包括第一圆柱形部分31，该第一圆柱形部分31的直径使得第一圆柱形部分装配进锚杆7的所述部分12中。在第一圆柱形部分31的自由端处可以设置倒角部分32，所述倒角部分32用于方便塞构件的引入。塞构件包括与倒角部分32相对的第二圆柱形部分33，该第二圆柱形部分33的直径使得第二圆柱形部分装配进孔11的内径中。在第一圆柱形部分31和第二圆柱形部分33之间设置过渡部分34，该过渡部分34可以成形为用于匹配孔11的主要部分和具有减小直径的端部部分12之间的肩部13的形状。因此，肩部13形成用于塞构件的引入的止挡。
在第二圆柱形部分33的自由端处设置多个直立的保持弹簧35。所述保持弹簧35布置成一圆圈，所述圆圈的直径小于第二圆柱形部分33的直径并且具有弹性以便可以朝外和/或朝内地运动。保持弹簧35在它们的自由端处分别包括卡爪36，这些卡爪36用于与稍后描述的工具可分离地接合。保持弹簧35布置成它们的卡爪36的外部部分没有突出于第二圆柱形部分33直径的外部。
如图8所示，当塞构件30完全插入孔11中时，塞构件30在第二部分12处闭合孔，从而引入孔11中的任何骨接合剂或药物均不能穿过第二端9而漏出。
制成骨锚固件、接收部分、压力元件和固定螺钉的材料可以是用于这些种类装置的任何材料，所述材料特别地是生物相容金属(诸如钛、不锈钢或金属合金)或者是任何生物相容塑料(诸如PEEK)。依据应用，即依据杆应该提供纯粹的固定还是提供动态稳定，杆可以由金属或塑料制成。塞构件的材料可以与骨锚固件的材料相同，或者可以是不同的材料。用于塞构件的合适的材料特别地是钛和钛合金、用于植入物的不锈钢以及PEEK。
图9中示出塞构件的第二实施例。塞构件40是球形形状的，球的直径大于在第二部分12中的孔11的内径而小于在锚杆7的主要部分中的孔11的内径。球形形状的塞构件40有利地由具有高比重的材料(诸如金属)制成，从而塞构件40可以通过其自身的重量被引入并落下。
图10示出具有塞构件41的第三实施例的骨锚固件，塞构件41与塞构件30的区别仅仅在于不包括保持弹簧35，而是代替保持弹簧35在用于与工具接合的第二圆柱形部分中设置凹槽42。所有其它部分与塞构件30均相同。
尽管已经将多轴骨螺钉示出为包括骨锚固件的骨锚固装置，但是任何其它骨锚固件也由本发明所包含。例如可以使用一种单轴骨螺钉，其中骨锚固件2的头部成形为用于接收杆。另外，骨锚固件不是必须在锚杆上设置骨螺纹。另外骨锚固件还可以设计成推动转动锚固件，这种锚固件具有用于保持在骨中的倒刺元件。骨锚固件还可以设计成具有光滑外表面的骨钉。
还可以想到塞构件的其它改进实施例。例如，塞构件可以是盘形、锥形或者可以具有任何其它形状。
下面参考图11和12描述用于将塞构件插入骨锚固件中的工具的第一实施例。工具50特别地适用于插入图4至8中所示类型的塞构件。工具50包括用于抓握的手柄51和延伸穿过手柄51的插入管52。插入管52是中空的并且具有一定的长度，所述长度至少与锚杆的长度一样，从而能够将塞构件30定位在孔11的端部处。管52的内径使得管52能够被放置在塞构件的保持弹簧35上，从而具有卡爪36的保持弹簧向内运动到一定程度。这样，保持弹簧被夹紧在管52的端部处。插入管52可以在其端部内具有与卡爪36配合的凹槽。管52的外径略小于孔11的内径，从而插入管52可以被引入孔11中。插入管52延伸穿过手柄51，从而管52的开口端53基本与手柄51的端部部分齐平。图11以透视图示出骨锚固件2、塞构件30以及工具50。在图12的图示中，塞构件30由工具50夹紧。因为管52延伸穿过手柄51，所以可以引导导丝穿过开口端53进入管部分中。
图13和14示出第二实施例的工具相对于骨锚固件的两个位置。
根据该实施例的工具60由注射器60形成。所述注射器60特别地适用于将骨接合剂或药物注射进骨锚固件2中。所述工具60包括筒，所述筒具有用于抓握的手柄61和用于将骨接合剂或药物推进针或管63中的柱塞62。所述针或管63设计成能够夹紧塞构件30或者能够接合到塞构件41的凹槽42中。所述针或管63足够长从而塞构件可以被放置在孔11的端部处。
还可以想到这些工具的改进实施例。例如，插入管52或63可以是柔性的，从而可适于骨锚固件中的非直的通道。任何具有例如用于夹紧的释放功能和释放塞构件的夹紧机构均是可以的。
下面参考图15和16描述骨锚固件的使用。图15和16示出通过微创外科手术植入骨锚固件。在步骤1)中，经皮地将导丝100放置成穿过皮肤101到达骨锚固件在脊柱的椎骨102中的最终位置。在所述过程的该阶段不插入塞构件。此后，提供骨锚固件2或者如图15所示的预组装有接收部分3和压力元件5的骨锚固件，并且引导导丝100从骨锚固件的第一端9穿过骨锚固件和接收部分3。接着，如步骤2)所示，沿着导丝100将骨锚固装置1引导到是最终植入部位并且是最终拧入椎弓根的椎骨102。此后，如步骤3)所示，移除导丝。
图16a至16c)示出引入塞构件的步骤4)。如图16a)所示，使用工具50将塞构件30引入骨锚固件2中。图16b)和16c)是骨锚固件2连同通过管52插入的塞构件30的侧视图和放大部分的截面图。由工具50的管52夹紧塞构件30并且将管52引入骨锚固件中。然后通过以下动作从工具上分离塞构件30：通过插入导丝100(未示出)并将导丝100推靠到塞构件30上，从而塞构件最终搁置在肩部13上并闭合骨锚固件。此后，注射骨接合剂或药物，所述骨接合剂或药物穿过开孔15离开而进入周围的骨材料中。所述骨接合剂或药物不能穿过骨锚固件的自由第二端9离开，因为自由第二端9由塞构件闭合。这样形成了安全的固定，因为在自由第二端9处没有骨接合剂的泄漏，骨接合剂的泄漏会使骨锚固件变松或者损害脉管结构。
在球形形状的塞构件40的情况中，塞构件40仅仅被引入孔11的上面部分中，从而塞构件40由于其自身重量而落下并闭合自由第二端9。
在可供选择的方式中，塞构件30或41由注射器60的针63夹紧，所述注射器60装有骨接合剂或药物，并且塞构件通过骨接合剂或药物的注射而进入孔11中直到塞构件闭合自由端。
在锚固好至少两个骨锚固件之后，插入杆4并且通过固定元件固定杆4。

Claims (10)

1.一种骨锚固件，包括：
锚杆(7)，该锚杆具有第一端(8)和第二端(9)，所述锚杆(7)由主要部分和邻近所述第二端(9)的部分(12)形成，
同轴孔(11)，该同轴孔从第一端(8)延伸到第二端(9)，所述同轴孔(11)在所述部分(12)中的直径小于在所述主要部分中的直径，其中在所述同轴孔中靠近第二端(9)设置止挡(13)，所述止挡用于限制塞构件的插入，其中所述锚杆(7)在所述锚杆的壁中包括多个开孔(15)，用于连接所述同轴孔(11)和外部；
塞构件(30，40，41)能够从第一端(8)插入所述同轴孔中并且可被引导穿过所述同轴孔，以便在第二端(9)处闭合所述同轴孔；其中，所述塞构件包括：用于与工具接合的接合结构(35，42)；第一圆柱形部分(31)，该第一圆柱形部分(31)的直径使得所述第一圆柱形部分装配进邻近第二端(9)的所述部分(12)中；在所述第一圆柱形部分(31)的自由端处的倒角部分(32)；与倒角部分(32)相对的第二圆柱形部分(33)，所述第二圆柱形部分的直径使得所述第二圆柱形部分装配进所述同轴孔(11)的在所述主要部分内的内径中；第一圆柱形部分(31)的直径小于第二圆柱形部分(33)的直径；过渡部分(34)在第一圆柱形部分(31)和第二圆柱形部分(33)之间成形为用于匹配止挡(13)的形状。
2.根据权利要求1所述的骨锚固件，其中所述同轴孔的尺寸制成为用于在其中容纳用于微创外科手术的导丝(100)。
3.根据权利要求1或2所述的骨锚固件，其中所述塞构件(30，41)基本是销形形状的。
4.根据权利要求1或2所述的骨锚固件，其中所述接合结构包括保持弹簧(35)。
5.根据权利要求1或2所述的骨锚固件，其中所述接合结构包括凹槽(42)。
6.根据权利要求1或2所述的骨锚固件，其中所述第一端(8)包括头部。
7.根据权利要求6所述的骨锚固件，其中所述头部(8)连接到用于接收杆(4)的接收部分(3)。
8.一种用于将塞构件插入根据权利要求1-7之一所述的骨锚固件中的工具，所述工具包括用于夹紧塞构件(30，41)的接合部分(52，63)。
9.根据权利要求8所述的工具，所述工具还包括引入部分(52，63)，所述引入部分是管形的并且设计成能够容纳于所述同轴孔(11)中。
10.根据权利要求9所述的工具，其中所述引入部分由用于注射骨接合剂的注射器的针形成。
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US9730745B2 (en) 2017-08-15
US9265539B2 (en) 2016-02-23
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TWI533837B (zh) 2016-05-21
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US20160220292A1 (en) 2016-08-04
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US8690930B2 (en) 2014-04-08
EP2140824A1 (en) 2010-01-06
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