WO2013104093A1 - Posterior cervical unilateral-open-door lateral-mass spinous process steel plate - Google Patents
Posterior cervical unilateral-open-door lateral-mass spinous process steel plate Download PDFInfo
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- WO2013104093A1 WO2013104093A1 PCT/CN2012/000493 CN2012000493W WO2013104093A1 WO 2013104093 A1 WO2013104093 A1 WO 2013104093A1 CN 2012000493 W CN2012000493 W CN 2012000493W WO 2013104093 A1 WO2013104093 A1 WO 2013104093A1
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- spinous process
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- side block
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- 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, e.g. stabilisers comprising fluid filler in an implant
- A61B17/7071—Implants for expanding or repairing the vertebral arch or wedged between laminae or pedicles; Tools therefor
Definitions
- the invention relates to a posterior cervical fixed plate, in particular to a cervical spine single-door side block spinous process plate. Background technique
- various cervical diseases such as spinal stenosis, cervical disc herniation, and cervical spinal cord injury often require posterior decompression.
- the conventional decompression surgery method is to perform laminectomy and decompression, and the spinous process and the lamina are bitten by a rongeur to expose the spinal canal of the corresponding segment. Internal fixation is carried out using a rear plate fixing material.
- this surgical method causes the patient's cervical dysfunction to be lost, often causes intractable pain after surgery, and the activity is limited, which affects the curative effect. If the plate is not decompressed and the plate is not fixed, it may form postoperative cervical instability and kyphosis.
- the yellow ligament and the laminae overlapping the upper and lower ends of the cardia area are cut off, and the soft tissue and vein of the capsule wall are separated. Open each segment of the lamina in turn.
- Posterior cervical spine The advantage of "single-door" surgery is that it can preserve the activity of the cervical spine, especially for long-segment surgery.
- the fixing component is composed of a connecting piece with threaded holes at both ends and two special screws; all are made of titanium alloy; the connecting piece can be shaped during surgery.
- One end of the connecting piece is screwed to the lamina stump which has not been removed, and the other end is screwed to the lamina which has just been reset, and the left and right side slits of the lamina are respectively fixed.
- the fixing plate is made of a narrow long steel plate, and has a lamina fixing plate and a side block fixing plate. Connecting plate, connecting plate connecting laminar fixing plate and side block fixing plate, laminar fixing plate and side block fixing plate
- the Confirmation Set at least two screw fixing holes.
- the lamina fixing plate, the side block fixing plate and the connecting plate have a stretched z shape. Further, there is a card that engages the lamina. Compared with the fixed plate disclosed in ZL201020135415.7, the stability of the fixed plate is greatly improved, but there is a slight deficiency. First, since the thickness of the cervical lamina is generally about 3 to 4 mm, the screw is not only fixed when the lamina is fixed.
- the first technical problem to be solved by the present invention is to provide a fixed steel plate for connecting a side block and a spinous process in a posterior cervical single-door surgery in view of the above state of the art.
- the existing 3 ⁇ 4mm length of the laminar fixation screw was changed to the spinous process screw, and the fixed length can reach 12mm. Since the thickness of the spinous process greatly exceeds the thickness of the lamina, the effect of the spinous process screw fixation is biomechanically better than the lamina.
- the second technical problem to be solved by the present invention is that the card for supporting the lamina of the spinous process plate of the single-door side of the cervical spine can be adjusted according to the difference of the actual lamina thickness of the patient and the length of the residual lamina.
- a cervical spine single-door side block spinous process steel plate the steel plate is a stretched Z-shape, comprising a first fixing portion, a second fixing portion and a connecting portion connecting the first fixing portion and the second fixing portion, wherein the first fixing portion and the connecting portion form an obtuse angle, and the second fixing portion and the connecting portion also form an obtuse angle, wherein the first fixing portion is The body portion disposed on the outer wall of the lamina and the spinous process fixing portion adapted to the outer wall of the spinous process, the spinous process fixing portion being bent upward from the end of the body portion and having the first passage for the spinous process screw to pass hole.
- a card is disposed on one side of the connecting portion, and a card slot for the residual lamina to be engaged is formed between the card and the body.
- the body portion is interlocked with the outer wall of the residual lamina
- the card plate supports the inner wall of the residual lamina
- the head of the residual lamina is disposed in the bayonet, and the arrangement of the card plate makes the overall skeleton more stable.
- the card board can be adapted to the difference between different individuals to ensure maximum safety and stability, and the card board can be movably disposed at the connecting portion along the length direction of the connecting portion. on.
- the connecting portion is provided with a supporting plate portion as a fulcrum when the spreader is opened, and the supporting plate portion is located below the clamping plate and adjacent to the second fixing portion.
- a spreader can be used.
- the spreader is composed of two first opening portions and a second opening portion which are rotatably connected to each other. When the card is adjusted, the front end of the first opening portion is adjusted.
- the front end of the second distracting portion is located on the supporting plate portion, and the position of the card board can be adjusted to an optimum state by controlling the distance between the front end of the first distracting portion and the front end of the second distracting portion.
- the adjusting structure of the card board is preferably designed as follows: the connecting portion is formed with a shape-shaped hole along the length direction, and correspondingly, the end portion of the card board has a convex head which can move back and forth in the strip-shaped hole.
- the protruding head has a screw hole therein.
- An adjusting screw is integrally connected to the screw hole through the strip hole.
- the convex head is adapted to the inner wall of the strip-shaped hole and is not rotatable, preferably square.
- the connecting portion is formed with a shape of a hole along the length direction, and a bone graft is disposed on the connecting portion and movable along the strip hole.
- the adjustment arrangement of the bone graft is preferably as follows: the end of the bone graft has a screw hole, and an adjustment screw is connected to the screw hole through the strip hole.
- the second fixing portion is formed with a second through hole through which the side block screws pass.
- the holes of the first fixing hole and the second fixing hole may be designed in a bell mouth shape to facilitate fine adjustment of the angle when the screw is placed.
- the invention has the advantages that: since the thickness of the spinous process greatly exceeds the thickness of the lamina, the spinous process screw is deeper, so the fixation is more stable, and the cervical spinal cord is not easily invaded, thereby ensuring postoperative safety.
- the card for supporting the lamina of the posterior canal of the cervical spine can be precisely adjusted according to the difference in the actual lamina thickness of the patient and the length of the residual lamina. It has important application significance in clinical practice.
- Embodiment 1 is a schematic structural view of Embodiment 1.
- Fig. 2 is an exploded assembly view of the first embodiment.
- FIG. 3 is a state diagram of the first embodiment after installation.
- Figure 4 is an enlarged view of a portion A in Figure 3.
- Fig. 5 is a view showing the state of the position adjustment of the card in the first embodiment.
- Fig. 6 is a schematic structural view of the second embodiment.
- Fig. 7 is a schematic structural view of the third embodiment.
- Fig. 8 is a schematic structural view of the fourth embodiment. detailed description
- Embodiment 1 is a diagrammatic representation of Embodiment 1:
- the cervical spine single-door side block spinous process steel plate of the present embodiment is generally a stretched Z-shape, including a first fixing portion 1 and a second fixing portion. 2, and the connecting portion 3 connecting the first fixing portion 1 and the second fixing portion 2, the first fixing portion 1 and the connecting portion 3 form an obtuse angle, the second fixing portion 2 and the connecting portion 3 also form an obtuse angle, and the first fixing portion 1 includes a body portion 11 disposed on the outer wall of the lamina and a spinous process fixing portion 4 adapted to the outer wall of the spinous process, the spinous process fixing portion 4 is bent upward from the distal end of the body portion 11 and has a first passage for the spinous process screw Through hole 41.
- a second through hole 21 through which the side block screws pass is formed on the second fixing portion 2.
- the connecting portion 3 and the second fixing portion 2 are an integral piece.
- the holes of the first fixing hole and the second fixing hole may be designed in a bell mouth shape to facilitate fine adjustment of the angle when the screw is placed.
- the connecting portion 3 is provided with a card plate 5 which is movable along the longitudinal direction of the connecting portion, and a latching opening 53 for the residual lamina is formed between the latching plate 5 and the first fixing portion 11.
- the connecting portion 3 is provided with a support portion 7 as a fulcrum when the spreader is opened to open the card, and the support portion 7 is located below the card 5 and adjacent to the second fixed portion 2.
- the adjustable structure of the card board is set as follows:
- the connecting portion 3 is formed with a shape-shaped hole 31 along the length direction, and correspondingly, the end portion of the card board 5 has a convex head portion 51 movable back and forth within the strip-shaped hole 31, the convex portion
- the head 51 has a screw hole 52 therein, and the adjusting screw 6 is integrally connected to the screw hole 52 through the strip hole 31.
- the convex head 51 is squarely fitted to the inner wall of the strip hole 31 and cannot be rotated.
- the posterior cervical single-door side block spinous process plate in the present embodiment is disposed in a state behind one of the cervical vertebras 10, and the spinous process fixing portion 4 is located on the outer wall of the spinous process 100 and passes through the spinous process screw 81.
- Fixed, the second fixing portion 2 is located on the side block 102 and fixed by the side block screws 82.
- the body portion 11 is interlocked with the outer wall of the residual lamina 101, the card plate 5 holds the inner wall of the residual lamina 101, and the head of the residual lamina 101 is disposed in the bayonet 53.
- the spreader 103 is composed of two first distracting portions 104 and a second distracting portion 105 which are rotatably connected to each other.
- the front end of the first gusset portion 104 is located at the card.
- the front end of the second distracting portion 105 is located on the supporting plate portion 7.
- Embodiment 3 As shown in FIG. 6, there is no card plate and support plate design in this embodiment, and other structures refer to Embodiment 1.
- Embodiment 3 As shown in FIG. 6, there is no card plate and support plate design in this embodiment, and other structures refer to Embodiment 1.
- the connecting portion 3 in this embodiment is formed with a shape of a hole 31 along the longitudinal direction, and the bone graft 9 is disposed on the connecting portion 3 and movable along the strip hole 31.
- the end of the bone graft has a screw hole, and the adjusting screw 91 is connected to the screw hole through the strip hole 31.
- This embodiment has no support plate design, and other structures refer to Embodiment 1.
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Description
颈椎后路单开门侧块棘突钢板 Cervical posterior single-door lateral block spinous process plate
技术领域 Technical field
本发明涉及一种颈椎后路固定钢板， 尤其涉及一种颈椎后路单开门侧块棘突钢板。 背景技术 The invention relates to a posterior cervical fixed plate, in particular to a cervical spine single-door side block spinous process plate. Background technique
目前临床上各种诸如椎管狭窄，颈椎间盘突出，颈髓损伤等各种颈椎疾病往往需要 后路的减压。 常规的减压手术方法是行椎板切除减压， 用咬骨钳将棘突和椎板咬除， 暴 露相应节段的椎管。 用后路钢板固定材料进行内固定。 然而这种手术方式使得患者的颈 椎活动功能丢失， 术后常常引起顽固性疼痛， 活动受限， 影响手术疗效。 如果椎板减压 后不行钢板固定， 则又可能形成术后颈椎失稳和后凸畸形。 At present, various cervical diseases such as spinal stenosis, cervical disc herniation, and cervical spinal cord injury often require posterior decompression. The conventional decompression surgery method is to perform laminectomy and decompression, and the spinous process and the lamina are bitten by a rongeur to expose the spinal canal of the corresponding segment. Internal fixation is carried out using a rear plate fixing material. However, this surgical method causes the patient's cervical dysfunction to be lost, often causes intractable pain after surgery, and the activity is limited, which affects the curative effect. If the plate is not decompressed and the plate is not fixed, it may form postoperative cervical instability and kyphosis.
近年来， 在颈椎后路"单开门"手术作为椎板切除术的一种替代方式得到发展， 不 仅可以用于治疗颈椎脊髓病， 而且可以预防椎板切除术后颈椎失稳和后凸畸形。 手术方 法是在 "开门侧"（门缝)椎板与侧块联合处磨出纵形骨槽，在 "开门侧"对侧 ( "铰链侧"） 相对应的部位作 "V"形开槽， 保留 1.0 mm厚度的松质骨和内层皮质骨。铰链侧开槽准 备好后，切断幵门区上下两端的黄韧带及椎板相互重叠的部分，分离囊壁软组织和静脉。 依次打开各个节段椎板。 颈椎后路 "单开门"手术比后路内固定融合的好处在于可以保 留颈椎的活动， 尤其适用于长节段的手术。 In recent years, "single-door" surgery in the posterior cervical spine has been developed as an alternative to laminectomy, which can be used not only to treat cervical spondylotic myelopathy, but also to prevent cervical instability and kyphosis after laminectomy. The surgical method is to grind the longitudinal bone groove at the joint of the "opening side" (door slit) lamina and the side block, and make a "V" shaped groove on the opposite side of the "opening side" ("hinge side"). , preserved 1.0 mm thick cancellous bone and inner cortical bone. After the hinge side groove is prepared, the yellow ligament and the laminae overlapping the upper and lower ends of the cardia area are cut off, and the soft tissue and vein of the capsule wall are separated. Open each segment of the lamina in turn. Posterior cervical spine The advantage of "single-door" surgery is that it can preserve the activity of the cervical spine, especially for long-segment surgery.
但 "单开门"手术后 "开门侧"椎板容易闭合， 引起 "再关门"， 重新引起椎管狭 窄的临床症状。 何防止椎板 "再关门"引起椎管再狭窄成为研究的焦点。 但是在目前的 脊柱后路中，尚无专用的适用于维持颈椎椎板开门位置，防止再关门的固定材料及器件。 临床上常用用钢丝或丝线等绑扎固定， 固定后很不可靠， 影响手术后效果， 或出现手术 并发症。 However, after the "single-opening" operation, the "opening side" lamina is easy to close, causing "re-closing", which again causes clinical symptoms of narrowing of the spinal canal. How to prevent the laminectomy "re-closing" caused spinal canal restenosis has become the focus of research. However, in the current posterior spinal column, there is no special fixing material and device suitable for maintaining the position of the cervical lamina opening to prevent reclosing. Clinically, it is often used for tying and fixing with steel wire or silk thread. It is very unreliable after fixation, affecting the postoperative effect, or complications of surgery.
为此， 现有技术中出现了一些专门用于颈椎后路开门手术的器件， 见专利号为 ZL201020135415.7 的中国实用新型专利 《新型脊柱后路手术椎板复位固定部件》（授权 公告号为 CN201617932U),该固定部件由一个两端带螺纹孔的连接片和两个特制螺钉组 成； 均采用钛合金为材料； 在手术中连接片可以塑形。 连接片一端用螺钉固定在没有拿 掉的椎板残端，另一端用螺钉固定在刚复位的椎板上，椎板的左右两侧开缝处分别固定。 To this end, there are some devices in the prior art that are specifically used for posterior cervical open surgery. See the Chinese utility model patent No. ZL201020135415.7, "New type of posterior spinal surgery laminar reduction and fixation components" (authorization bulletin number is CN201617932U), the fixing component is composed of a connecting piece with threaded holes at both ends and two special screws; all are made of titanium alloy; the connecting piece can be shaped during surgery. One end of the connecting piece is screwed to the lamina stump which has not been removed, and the other end is screwed to the lamina which has just been reset, and the left and right side slits of the lamina are respectively fixed.
又可以参考专利号为 ZL200620125952.7的中国实用新型专利 《颈椎开门固定板》 (授权公告号为 CN201022741Y), 该固定板由一块窄长钢板制成， 具有椎板固定板、 侧 块固定板、 连接板， 连接板连接椎板固定板和侧块固定板， 椎板固定板和侧块固定板上 It is also possible to refer to the Chinese utility model patent "Cervical Open Door Fixing Plate" (authorization bulletin number CN201022741Y) with the patent number ZL200620125952.7. The fixing plate is made of a narrow long steel plate, and has a lamina fixing plate and a side block fixing plate. Connecting plate, connecting plate connecting laminar fixing plate and side block fixing plate, laminar fixing plate and side block fixing plate
确认本 设置至少两个螺钉固定孔。 椎板固定板、 侧块固定板及连接板呈拉伸了的 z形。进一步 还具有一卡合椎板的卡板。 这种固定板与 ZL201020135415.7公开的固定板相比， 术后 稳定性大大提高， 但稍存在不足的地方， 首先， 由于颈椎椎板厚度一般为 3~4mm左右, 因此椎板固定时螺钉不仅较短， 固定不牢固， 而且可能突破椎板腹侧皮质进入椎管侵犯 颈髓； 椎板开口处各个病人存在个体差异， 如椎板厚度的差异， 椎板开口角度及残余椎 板的长度等， 而统一规格的固定板在安装角度及卡板的卡接位置上均是唯一的， 固定不 变的， 微调存在一定难度， 因而整体术后的稳定性还不是最佳， 可进一步提高。 发明内容 Confirmation Set at least two screw fixing holes. The lamina fixing plate, the side block fixing plate and the connecting plate have a stretched z shape. Further, there is a card that engages the lamina. Compared with the fixed plate disclosed in ZL201020135415.7, the stability of the fixed plate is greatly improved, but there is a slight deficiency. First, since the thickness of the cervical lamina is generally about 3 to 4 mm, the screw is not only fixed when the lamina is fixed. Short, fixed, and may break through the ventral cortex of the lamina into the spinal canal to invade the cervical spinal cord; individual differences in the patient's opening at the lamina, such as differences in lamina thickness, lamina opening angle and length of residual lamina The uniform specification of the fixed plate is unique in the installation angle and the clamping position of the card plate, and the fixed plate has a certain difficulty. Therefore, the overall postoperative stability is not optimal and can be further improved. Summary of the invention
本发明所要解决的第一个技术问题是针对上述的技术现状而提供一种在颈椎后路 单开门手术中用于连接侧块与棘突的固定钢板。 将现有 3~4mm长度的椎板固定螺钉改 为棘突螺钉， 固定长度可达到 12mm， 由于棘突厚度大大超过椎板的厚度， 使得棘突螺 钉固定效果在生物力学上好于在椎板上垂直置钉的稳定性， 且由于术中可以直视到棘突 螺钉的钉尖， 保证螺钉没有侵犯椎管， 损伤颈髓， 提高了手术安全性。 The first technical problem to be solved by the present invention is to provide a fixed steel plate for connecting a side block and a spinous process in a posterior cervical single-door surgery in view of the above state of the art. The existing 3~4mm length of the laminar fixation screw was changed to the spinous process screw, and the fixed length can reach 12mm. Since the thickness of the spinous process greatly exceeds the thickness of the lamina, the effect of the spinous process screw fixation is biomechanically better than the lamina. The stability of the vertical placement of the nail, and because the nail tip of the spinous process screw can be directly viewed during the operation, the screw is not invaded and the cervical spinal cord is damaged, thereby improving the safety of the operation.
本发明所要解决的第二个技术问题：颈椎后路单开门侧块棘突钢板的支撑椎板的卡 板可以根据病人实际的椎板厚度的差异和残余椎板的长度作出相应的调整。 The second technical problem to be solved by the present invention is that the card for supporting the lamina of the spinous process plate of the single-door side of the cervical spine can be adjusted according to the difference of the actual lamina thickness of the patient and the length of the residual lamina.
本发明解决上述第一个技术向题所采用的技术方案为：一种颈椎后路单开门侧块棘 突钢板， 该钢板呈拉伸的 Z型， 包括第一固定部、 第二固定部及连接前述第一固定部和 第二固定部的连接部， 前述的第一固定部与连接部成一钝角， 前述的第二固定部与连接 部也成一钝角，其特征在于所述的第一固定部包括置于椎板外壁的本体部及与棘突外壁 相适配的棘突固定部，前述的棘突固定部由本体部的末端向上弯折而成并具有供棘突螺 钉通过的第一通孔。 The technical solution adopted by the present invention to solve the above-mentioned first technical problem is: a cervical spine single-door side block spinous process steel plate, the steel plate is a stretched Z-shape, comprising a first fixing portion, a second fixing portion and a connecting portion connecting the first fixing portion and the second fixing portion, wherein the first fixing portion and the connecting portion form an obtuse angle, and the second fixing portion and the connecting portion also form an obtuse angle, wherein the first fixing portion is The body portion disposed on the outer wall of the lamina and the spinous process fixing portion adapted to the outer wall of the spinous process, the spinous process fixing portion being bent upward from the end of the body portion and having the first passage for the spinous process screw to pass hole.
所述的连接部一侧设有一卡板，该卡板与前述的本体之间形成一供残余椎板卡接的 卡口。 安装时， 本体部与残余椎板外壁相扣， 卡板托住残余椎板的内壁， 残余椎板的头 部则设置于卡口内， 卡板的设置使整体骨架更加稳固。 A card is disposed on one side of the connecting portion, and a card slot for the residual lamina to be engaged is formed between the card and the body. During installation, the body portion is interlocked with the outer wall of the residual lamina, the card plate supports the inner wall of the residual lamina, and the head of the residual lamina is disposed in the bayonet, and the arrangement of the card plate makes the overall skeleton more stable.
为进一步解决上述第二个技术问题，使卡板能适应不同个体之间的差异，保证最大 限度的安全性和稳固性， 所述的卡板沿着连接部长度方向能移动地设置于连接部上。 In order to further solve the above second technical problem, the card board can be adapted to the difference between different individuals to ensure maximum safety and stability, and the card board can be movably disposed at the connecting portion along the length direction of the connecting portion. on.
所述的连接部设置有一供撑开器撑开卡板时作为支点的支板部，该支板部位于卡板 下方并靠近第二固定部。 为使卡板准确快速设置， 可以采用撑开器， 撑开器由两个中 间相互转动连接的第一撑开部和第二撑开部组成， 卡板调节时， 第一撑开部的前端位于 卡板上， 第二撑开部的前端位于支板部上， 通过控制第一撑开部的前端与第二撑开部的 前端的距离， 就能将卡板位置调到最佳状态。 The connecting portion is provided with a supporting plate portion as a fulcrum when the spreader is opened, and the supporting plate portion is located below the clamping plate and adjacent to the second fixing portion. In order to make the card plate accurately and quickly set, a spreader can be used. The spreader is composed of two first opening portions and a second opening portion which are rotatably connected to each other. When the card is adjusted, the front end of the first opening portion is adjusted. Located on the card board, the front end of the second distracting portion is located on the supporting plate portion, and the position of the card board can be adjusted to an optimum state by controlling the distance between the front end of the first distracting portion and the front end of the second distracting portion.
卡板的调节结构优选如下设计：所述的连接部沿着长度方向成型有一条形孔，对应 地， 所述的卡板的端部具有一能在条形孔内来回移动的凸头部， 该凸头部内具有螺孔， 一调节螺钉穿过前述的条形孔与该螺孔连接为一体。 凸头部适配于条形孔内壁， 并且不 能转动， 优选方形。 The adjusting structure of the card board is preferably designed as follows: the connecting portion is formed with a shape-shaped hole along the length direction, and correspondingly, the end portion of the card board has a convex head which can move back and forth in the strip-shaped hole. The protruding head has a screw hole therein. An adjusting screw is integrally connected to the screw hole through the strip hole. The convex head is adapted to the inner wall of the strip-shaped hole and is not rotatable, preferably square.
所述的连接部沿着长度方向成型有一条形孔，一植骨块设置于连接部上并沿着该条 形孔能移动。 The connecting portion is formed with a shape of a hole along the length direction, and a bone graft is disposed on the connecting portion and movable along the strip hole.
植骨块的调节设置优选如下结构：所述的植骨块端面具有一螺钉孔，一调节螺钉穿 过所述的条形孔与该螺钉孔连接为一体。 The adjustment arrangement of the bone graft is preferably as follows: the end of the bone graft has a screw hole, and an adjustment screw is connected to the screw hole through the strip hole.
进一步， 所述的第二固定部上成型有一供侧块螺钉通过的第二通孔。 . 进一步，所述第一固定孔和第二固定孔的孔道可以设计成喇叭口状，便于螺钉置入 时角度上的微调。 Further, the second fixing portion is formed with a second through hole through which the side block screws pass. Further, the holes of the first fixing hole and the second fixing hole may be designed in a bell mouth shape to facilitate fine adjustment of the angle when the screw is placed.
与现有技术相比， 本发明的优点在于： 由于棘突厚度大大超过椎板的厚度， 使得棘 突螺钉打的更深， 因而固定更加稳固， 且不易侵犯颈髓， 保证术后的安全性。 此外， 颈 椎后路单开门侧块棘突钢板的支撑椎板的卡板可以根据病人实际的椎板厚度的差异和 残余椎板的长度作出精确调整。 在临床上具有重要的应用意义。 附图说明 Compared with the prior art, the invention has the advantages that: since the thickness of the spinous process greatly exceeds the thickness of the lamina, the spinous process screw is deeper, so the fixation is more stable, and the cervical spinal cord is not easily invaded, thereby ensuring postoperative safety. In addition, the card for supporting the lamina of the posterior canal of the cervical spine can be precisely adjusted according to the difference in the actual lamina thickness of the patient and the length of the residual lamina. It has important application significance in clinical practice. DRAWINGS
图 1为实施例一的结构示意图。 1 is a schematic structural view of Embodiment 1.
图 2为实施例一的分解装配图。 Fig. 2 is an exploded assembly view of the first embodiment.
图 3为实施例一安装后状态图。 FIG. 3 is a state diagram of the first embodiment after installation.
图 4为图 3中 A部的放大图。 Figure 4 is an enlarged view of a portion A in Figure 3.
图 5为实施例一中卡板位置调节时状态图。 Fig. 5 is a view showing the state of the position adjustment of the card in the first embodiment.
图 6为实施例二的结构示意图。 Fig. 6 is a schematic structural view of the second embodiment.
图 7为实施例三的结构示意图。 Fig. 7 is a schematic structural view of the third embodiment.
图 8为实施例四的结构示意图。 具体实施方式 Fig. 8 is a schematic structural view of the fourth embodiment. detailed description
以下结合附图实施例对本发明作进一步详细描述。 The invention will be further described in detail below with reference to the embodiments of the drawings.
实施例一： Embodiment 1:
本实施例为最佳实施例， 如图 1和图 2， 本实施例中的颈椎后路单开门侧块棘突钢 板大体呈拉伸的 Z型， 包括第一固定部 1、 第二固定部 2及连接第一固定部 1和第二固 定部 2的连接部 3 , 第一固定部 1与连接部 3成一钝角， 第二固定部 2与连接部 3也成 一钝角， 第一固定部 1包括置于椎板外壁的本体部 11及与棘突外壁相适配的棘突固定 部 4，棘突固定部 4由本体部 11的末端向上弯折而成并具有供棘突螺钉通过的第一通孔 41。第二固定部 2上成型有一供侧块螺钉通过的第二通孔 21。本实施例中的第一固定部 1、 连接部 3和第二固定部 2为一体件。 第一固定孔和第二固定孔的孔道可以设计成喇 叭口状， 便于螺钉置入时角度上的微调。 This embodiment is a preferred embodiment. As shown in FIG. 1 and FIG. 2, the cervical spine single-door side block spinous process steel plate of the present embodiment is generally a stretched Z-shape, including a first fixing portion 1 and a second fixing portion. 2, and the connecting portion 3 connecting the first fixing portion 1 and the second fixing portion 2, the first fixing portion 1 and the connecting portion 3 form an obtuse angle, the second fixing portion 2 and the connecting portion 3 also form an obtuse angle, and the first fixing portion 1 includes a body portion 11 disposed on the outer wall of the lamina and a spinous process fixing portion 4 adapted to the outer wall of the spinous process, the spinous process fixing portion 4 is bent upward from the distal end of the body portion 11 and has a first passage for the spinous process screw Through hole 41. A second through hole 21 through which the side block screws pass is formed on the second fixing portion 2. The first fixing portion in this embodiment 1. The connecting portion 3 and the second fixing portion 2 are an integral piece. The holes of the first fixing hole and the second fixing hole may be designed in a bell mouth shape to facilitate fine adjustment of the angle when the screw is placed.
连接部 3—侧设有一沿着连接部长度方向能移动的卡板 5， 该卡扳 5与第一固定部 11之间形成一供残余椎板卡接的卡口 53。 连接部 3设置有一供撑开器撑开卡板时作为 支点的支板部 7， 支板部 7位于卡板 5下方并靠近第二固定部 2。 The connecting portion 3 is provided with a card plate 5 which is movable along the longitudinal direction of the connecting portion, and a latching opening 53 for the residual lamina is formed between the latching plate 5 and the first fixing portion 11. The connecting portion 3 is provided with a support portion 7 as a fulcrum when the spreader is opened to open the card, and the support portion 7 is located below the card 5 and adjacent to the second fixed portion 2.
卡板的可调节结构设置如下： 连接部 3沿着长度方向成型有一条形孔 31， 对应地， 卡板 5的端部具有能在条形孔 31内来回移动的凸头部 51， 该凸头部 51内具有螺孔 52， 调节螺钉 6穿过条形孔 31与螺孔 52连接为一体。凸头部 51为方形适配于条形孔 31内 壁， 并且不能转动。 The adjustable structure of the card board is set as follows: The connecting portion 3 is formed with a shape-shaped hole 31 along the length direction, and correspondingly, the end portion of the card board 5 has a convex head portion 51 movable back and forth within the strip-shaped hole 31, the convex portion The head 51 has a screw hole 52 therein, and the adjusting screw 6 is integrally connected to the screw hole 52 through the strip hole 31. The convex head 51 is squarely fitted to the inner wall of the strip hole 31 and cannot be rotated.
如图 3和图 4所示，本实施例中的颈椎后路单开门侧块棘突钢板设置在其中一个颈 椎 10后的状态， 棘突固定部 4位于棘突 100外壁并通过棘突螺钉 81固定， 第二固定部 2位于侧块 102上并通过侧块螺钉 82固定。 本体部 11与残余椎板 101外壁相扣， 卡板 5托住残余椎板 101的内壁， 残余椎板 101的头部则设置于卡口 53内。 As shown in FIG. 3 and FIG. 4, the posterior cervical single-door side block spinous process plate in the present embodiment is disposed in a state behind one of the cervical vertebras 10, and the spinous process fixing portion 4 is located on the outer wall of the spinous process 100 and passes through the spinous process screw 81. Fixed, the second fixing portion 2 is located on the side block 102 and fixed by the side block screws 82. The body portion 11 is interlocked with the outer wall of the residual lamina 101, the card plate 5 holds the inner wall of the residual lamina 101, and the head of the residual lamina 101 is disposed in the bayonet 53.
结合图 5所示，撑开器 103由两个中间相互转动连接的第一撑开部 104和第二撑开 部 105组成，卡板 5位置调节时，第一撑幵部 104的前端位于卡板 5上，第二撑开部 105 的前端位于支板部 7上，通过控制第一撑开部 104的前端与第二撑开部 105的前端的距 离， 就能将卡板 5位置调到最佳状态。 调到合适的位置后用调节螺钉 6将卡板 5固定， 取出撑幵器 103即可。 实施例二： As shown in FIG. 5, the spreader 103 is composed of two first distracting portions 104 and a second distracting portion 105 which are rotatably connected to each other. When the position of the card 5 is adjusted, the front end of the first gusset portion 104 is located at the card. On the plate 5, the front end of the second distracting portion 105 is located on the supporting plate portion 7. By controlling the distance between the front end of the first distracting portion 104 and the front end of the second distracting portion 105, the position of the card 5 can be adjusted to Best state. After adjusting to the proper position, fix the card 5 with the adjusting screw 6 and take out the struts 103. Embodiment 2:
如图 6所示， 本实施例中没有卡板和支板部设计， 其他结构参考实施例 1。 实施例三： As shown in FIG. 6, there is no card plate and support plate design in this embodiment, and other structures refer to Embodiment 1. Embodiment 3:
如图 7所示， 本实施例中的卡板 5与连接部 3是一体成型的， 不能调节的， 也没有 支板部设计。 其他结构参考实施例 1。 实施例四： As shown in Fig. 7, the card board 5 and the connecting portion 3 in this embodiment are integrally formed, which cannot be adjusted, and have no design of the supporting plate portion. Other structures refer to Example 1. Embodiment 4:
如图 8所示， 本实施例中的连接部 3沿着长度方向成型有一条形孔 31， 植骨块 9 设置于连接部 3上并沿着该条形孔 31能移动。 植骨块 9端面具有螺钉孔， 调节螺钉 91 穿过条形孔 31与螺钉孔连接为一体。本实施例没有支板部设计，其他结构参考实施例 1。 As shown in Fig. 8, the connecting portion 3 in this embodiment is formed with a shape of a hole 31 along the longitudinal direction, and the bone graft 9 is disposed on the connecting portion 3 and movable along the strip hole 31. The end of the bone graft has a screw hole, and the adjusting screw 91 is connected to the screw hole through the strip hole 31. This embodiment has no support plate design, and other structures refer to Embodiment 1.
Claims
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201210006060.5 | 2012-01-10 | ||
| CN2012100060605A CN102551868A (en) | 2012-01-10 | 2012-01-10 | Posterior cervical spine single open door side block spinous process steel plate |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO2013104093A1 true WO2013104093A1 (en) | 2013-07-18 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/CN2012/000493 Ceased WO2013104093A1 (en) | 2012-01-10 | 2012-04-12 | Posterior cervical unilateral-open-door lateral-mass spinous process steel plate |
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| Country | Link |
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| CN (1) | CN102551868A (en) |
| WO (1) | WO2013104093A1 (en) |
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| CN112426217A (en) * | 2020-10-30 | 2021-03-02 | 北京大学第三医院（北京大学第三临床医学院） | Spinous process reconstruction opening door plate |
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| CN103549991B (en) * | 2013-11-01 | 2016-03-30 | 上海三友医疗器械有限公司 | For the bracing or strutting arrangement of vertebral plate expanding and shaping |
| CN103860245A (en) * | 2014-03-22 | 2014-06-18 | 常州市康辉医疗器械有限公司 | Anti-withdrawing stable cervical vertebra posterior single-opening door sheet nailing system |
| CN105266877A (en) * | 2015-11-26 | 2016-01-27 | 广州聚生生物科技有限公司 | Spinal column vertebral plate open-door fixing system |
| CN105411662A (en) * | 2015-12-31 | 2016-03-23 | 四川大学华西医院 | Self-locking micro steel plate fixing device for forming cervical posterior vertebral plate without screws |
| CN109171933A (en) * | 2018-10-11 | 2019-01-11 | 刘观燚 | A kind of screw steel plate system for spinous process of axis |
| CN110353793B (en) * | 2019-07-26 | 2024-12-03 | 北京市春立正达医疗器械股份有限公司 | Posterior cervical spine nail plate fixation device |
| CN111281509A (en) * | 2020-03-24 | 2020-06-16 | 福州市第二医院（福建省福州中西医结合医院、福州市职业病医院） | Vertebral plate fixing device for posterior cervical vertebra one-way open-door operation |
| CN114098939B (en) * | 2021-11-26 | 2024-07-05 | 中国人民解放军空军军医大学 | Cervical vertebra single door operation vertebral plate opener capable of accurately implementing door opening angle |
| CN114027959A (en) * | 2021-11-30 | 2022-02-11 | 迪恩医疗科技有限公司 | Hinged Laminar Fixation Plate |
| CN114052873A (en) * | 2021-12-11 | 2022-02-18 | 天津市康尔医疗器械有限公司 | Spinous process distraction system |
| CN115040223B (en) * | 2022-07-28 | 2025-08-26 | 苏州点合医疗科技有限公司 | A split steel plate end-fixed and clamped spinal canal shaping internal fixation device |
| CN115486913B (en) * | 2022-09-29 | 2025-12-30 | 首都医科大学附属北京世纪坛医院 | Conical laminated steel plates adaptable to different door opening sizes |
| CN118476853B (en) * | 2024-07-16 | 2024-09-24 | 厦门德朗格医疗科技有限公司 | Fastening nail and vertebral plate applying same |
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