WO2019073048A1 - Instrument permettant de relier une tige correctrice à une vis à os - Google Patents

Instrument permettant de relier une tige correctrice à une vis à os Download PDF

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Publication number
WO2019073048A1
WO2019073048A1 PCT/EP2018/077912 EP2018077912W WO2019073048A1 WO 2019073048 A1 WO2019073048 A1 WO 2019073048A1 EP 2018077912 W EP2018077912 W EP 2018077912W WO 2019073048 A1 WO2019073048 A1 WO 2019073048A1
Authority
WO
WIPO (PCT)
Prior art keywords
housing part
instrument according
threaded portion
adjusting member
external thread
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/EP2018/077912
Other languages
German (de)
English (en)
Inventor
Frank Heuer
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Silony Medical International AG
Original Assignee
Silony Medical International AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Silony Medical International AG filed Critical Silony Medical International AG
Publication of WO2019073048A1 publication Critical patent/WO2019073048A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7083—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
    • A61B17/7086—Rod reducers, i.e. devices providing a mechanical advantage to allow a user to force a rod into or onto an anchor head other than by means of a rod-to-bone anchor locking element; rod removers

Definitions

  • the invention relates to an instrument for connecting a correction rod with a bone screw, with an axial longitudinal direction, a radial direction and a
  • Section is provided a female threaded portion, with an approximately half-shell-shaped outer second
  • Housing part which forms a second clip leg, which extends on the first clip leg via a pivot joint about an orthogonal to the axial longitudinal direction
  • Swivel axis limited hinged is articulated, and with a the outer housing parts axially interspersed and thus inside adjusting part, which has a male thread at a portion and thus in the female threaded portion in the outer first housing part can be screwed, with a proximal end of the adjustment is operable for this, and with a bar pressure member, which against the
  • Correcting rod is axially applied and is axially coupled to the adjusting member, but is rotatable relative to the adjusting member about the axial longitudinal direction, so that rotational movements of the adjusting member are not transmitted to the bar pressure member, and wherein the staple legs surround the rod pressure member shell-shaped and longitudinally displaceable record and each have a distal Have end portion, with which they at the
  • attacking bone screw wherein the second staple leg is preferably actuated by finger pressure on its proximal end by the user in the release position by the use of the surgeon.
  • Such an instrument is typically referred to as
  • Correction rod which should usually connect several bone screws, especially pedicle screws, with respect to a respective bone screw in the vom
  • Bone screw is fixed.
  • the bone screw has a shaft which can be introduced into the bone and a so-called fork head, which generally has two limbs, which forms a groove for receiving the correction rod.
  • Clevis is then a fastener, in particular a grub screw, and optionally other components, in particular a pressure piece inserted to the correction rod after positioning relative to the clevis or the
  • Instrument does not include an access channel to the
  • Bone screw forming housing components it is
  • Instrument is the female threaded portion formed directly in a sleeve-shaped portion of the first housing part. Since the rod pressure member and also the axially coupled, but rotatable adjusting member from proximal coming through this internal thread section extend, must
  • the present invention has for its object to further develop an instrument of the type mentioned that an available space can be used better.
  • This object is achieved according to the invention in an instrument of the type mentioned in that the internally threaded portion is adjustable at a transversely to the axial longitudinal direction
  • Carrier body is formed and that the carrier body
  • Internally threaded portion is internally spring-biased and in the opposite direction to the outside manually by finger pressure
  • an outer diameter (Dal) of a rotational coupling portion between the rod pressing member and the adjusting member is larger than a core diameter (Dkern) of the male thread of the
  • the internally threaded portion can thus either dip into the clear cross-sectional or opening area which is delimited by the first and also the second housing part, or it is located radially outside the clear cross-sectional or opening area. In the first case, it can interact with the external thread of the adjusting part, and in the second case, it is out of engagement with the
  • Core diameter (core) of the external thread of the adjustment no longer an upper limit for the outer diameter of the further extension of the adjustment and an adjoining bar pressure part is.
  • the carrier body for the thread is sleeve-shaped, which in no way implies a geometrically circular sleeve shape or opening shape, which would even be a hindrance. It also proves to be advantageous that the carrier body has an outwardly exposed operating area for manual finger pressure.
  • the actuating region is preferably formed diametrically opposite to the female thread section, since the direction of the
  • Carrier body spans in the circumferential direction
  • transversely displaceable guide of the support body is provided a radially outside of the first housing part arranged guide body which remains immovably fixed in the operating state with respect to the first housing body.
  • Guide body has at least one and preferably two in the axial longitudinal direction spaced apart and extended in the circumferential direction flange portions with which it surrounds the first housing part in the circumferential direction and is fixable on the first housing part.
  • Guide body has an extended in the axial longitudinal direction abutment portion against which the support body is supported with the interposition of a spring means.
  • Circumferentially closed is formed, but in
  • Area of the female threaded portion of the carrier body is designed to be open, that the carrier body with his
  • the first housing part in the region of the carrier body in turn cup-shaped, in particular approximately half-shell-shaped
  • Nominal diameter (Dnenn) of the external thread of the setting part almost an inner diameter (Di) of the first outer housing part corresponds, in particular at least 92%, in particular at least 95%, in particular at least 97% of the inner diameter (Di) of the first outer housing part. This makes it possible to achieve optimum utilization of the space available in the radial or transverse direction.
  • Outer diameter (Dal) of a rotational coupling portion between the rod pressing member and the adjusting member is larger than an outer diameter (Da2) of a proximal adjoining portion of the adjusting member and larger than a
  • Setting part is, in particular at least 0.97 times, in particular at least 0.99 times the nominal diameter.
  • Housing part separate guide body, the first housing part itself a guide body for the transversely displaceable
  • Carrier body forms.
  • the core idea of the present invention namely to provide a transversely adjustable carrier body with a female threaded portion, can also be applied to other surgical
  • Bone anchor with an axial longitudinal direction, a radial direction and a circumferential direction, with an outer first housing part, which may have an approximately half-shell-shaped portion, wherein the first housing part is provided a female threaded portion, and with the outer first housing part axially passing through and thus internal Setting part, which has a male thread at a portion and thus in the female threaded portion in the outer first housing part can be screwed, characterized in that the internally threaded portion at a transversely adjustable to the axial longitudinal direction
  • Carrier body is formed and that the carrier body
  • Internally threaded portion is internally spring biased and in the opposite direction can be displaced outward manually by finger pressure, so that the female threaded portion is disengaged from the external thread of the adjustment.
  • Figure 1 is a perspective view of
  • Instrument according to the invention in the attached state on a bone screw with indicated correction rod in a first
  • Figure 2 is a perspective view of
  • inventive instrument in the attached state of a bone screw with
  • Figure 3 is a perspective view of
  • FIG. 4 components of the instrument according to the invention comprising i.a. a first and
  • Figure 5a is a side view of the components of Figure 4 in the joined state
  • inventive instrument of Figure 1 internal components of the instrument of Figure 6a, namely an adjustment and a
  • a) to c) is a longitudinal sectional view, a plan view and a detailed view of the instrument of Figure 1 to illustrate the drive connection between the setting part and the outside lying
  • a) to c) is a longitudinal sectional view, a plan view and a detailed view of the instrument of Figure 1 to illustrate the drive connection between the setting part and the outside lying
  • Figures 1-8 show a variety of views of a first embodiment of an inventive instrument 2 for connecting a correction rod 4 with a bone screw 6.
  • the bone screw 6 is an example of a so-called pedicle screw for spine surgery, with a threaded shaft 8, the its proximal end one Head 10, which in turn in the example shown polyaxially pivotable in a two legs 12th
  • FIG. 4 illustrates an axial longitudinal direction A, a radial direction R and a circumferential direction U for this purpose.
  • the instrument according to the invention is a
  • the instrument 2 comprises a first
  • outer housing part 18 which has a first approximately half-shell-shaped portion 20 which forms a first clip leg 22, and a second outer housing part 24, which forms a second clip leg 26.
  • the first and the second clip legs 22, 26 are via a pivot joint 28 in a manner to be described in more detail
  • the setting part 30 has in the example and preferred illustrated case an external thread 34, with which it can be screwed in still to be described in detail with respect to the first outer housing part 18. This results in an axial adjustment or
  • the adjusting member 30 is connected by means of a rotary coupling portion 35 between the
  • Rod pressure member 32 is transmitted, so that the rod pressure member 32 with distal end portions 36 can bring the correction rod 4 in its intended mounting position on the bone screw 6.
  • the bar pressure part 32 is here longitudinally displaceable but rotationally fixed between the two
  • Swivel joint 28 is preferably formed in that the two clip legs 22, 26 have puzzle-like articulated areas 38, 40. They are from respective ones
  • Wall portions 42, 44 of the clip legs 22, 26 are formed.
  • the hinge portions 38, 40 include a tongue-shaped projection 46, for example, in the first clip leg 22, and a complementary recess 48 in the other
  • the recess 48 is two of one edge 50 of the second
  • Staple leg 26 projecting and around the projection 46 around each striving web portions 51, 52 limited.
  • the free ends of these web portions 51, 52 at the same time form a limit stop 54, 56 for the pivotability of
  • the two clip legs 22, 26 are preferably
  • a securing element 60 is provided in the form of a spring element 62, which is clipped onto the joined clip legs.
  • Securing element 60 itself is partially ring-shaped and held captive in the mounting situation shown in Figures 5a, 5b.
  • the staple legs 22, 26 has a circumferentially extending groove 64 in the axial
  • Lengthwise A is wider than the securing element 60th
  • the securing element 60 has a radially inwardly projecting projection 66 which engages in a recess 68 in the clip leg 26. Due to the backlash in the axial longitudinal direction A, the securing element 60 acts at the same time as a return spring between the
  • Staple legs 22, 26 When the staple legs 22, 26 are pivoted by finger pressure on a proximal portion 70 of the second staple leg 26 in the position shown in Figure 3, open the distal end portions 72, 74, the staple leg and simultaneously through the
  • the instrument 2 is opened and can be releasably fixed to the hintergreifbaren areas 16 of the clevis 14 of the bone screw 6.
  • the radial space of the pivot joint can be limited to the radial wall thickness of the wall portions 42, 44, which is considered a significant advantage of the preferred embodiment.
  • a female thread portion 90 is provided proximal to the approximately half-shell-shaped portion 20, but not directly from the first
  • Housing part 18 is formed, but is formed on a transverse to the axial longitudinal direction support body 92.
  • the internal thread portion 90 is also not continuous in the circumferential direction U, but it is formed only in a relatively small circumferential angle segment.
  • the carrier body 92 is preferably sleeve-shaped and further in the exemplary and preferred case shown in one
  • this guide body 94 is designed such that it is arranged radially outside the first housing part 18. It can be set with respect to the first housing part 18 immovable. In the case illustrated by way of example, it has two flange sections 96 which are spaced apart from each other and extend in the circumferential direction U and which extend around the first housing part 18. Between these flange portions 96, a bearing portion 98 extended in the axial longitudinal direction is formed. Between the inside of the bearing portion 98 and an outer side 100 of the support body 92 are
  • Carrier body 92 with its female threaded portion 90 in the clear opening 104 of the first housing part 18 a.
  • Adjusting member 30 is screwed in this position with its external thread 34 in the female threaded portion 90. It also turns against the non - rotatable between the
  • Housing parts received bar pressure member 32 and moves it in the distal direction or in opposite proximal
  • Guide body 94 is not formed in the circumferential direction U closed, but is designed to be open, that the support body 92 with its female threaded portion 90 radially inwardly into engagement with the external thread 34 of the
  • the carrier body 92 is diametrically opposite to the female threaded portion 90 a manual actuation area 108 in the form of a button with an ergonomically shaped depressor trough 110.
  • Housing parts 18, 24 is displaceable. As a result, a quick release function can be realized.
  • Setting member 30 almost an inner diameter (Di) of the first outer housing part 18 corresponds.
  • Outer diameter (Dal) of the rotational coupling portion 35 between the rod pressing member 32 and the adjusting member 30 is larger than an outer diameter (Da2) of a proximally adjoining portion of the adjusting member 30 and larger than a
  • Outside diameter (Dal) of the rotary coupling portion 35 between the rod pressing member 32 and the adjusting member 30 is between 0.95 and 1.05 times the nominal diameter of the external thread of the adjusting member 30.
  • FIGS. 9a to c show another one
  • Embodiment that differs from the previous embodiment only in terms of the quick-release mechanism. Instead of an additional guide body for the
  • Carrier body 92 for the internal thread 90 here forms the first housing part 18 at the same time a guide body 94 'for the transversely displaceable support body 92nd

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un instrument (2) pour relier une tige correctrice (4) à une vis à os (6), avec une première partie de logement (18) située à l'extérieur, un segment à filet interne étant prévu dans la première partie de logement (18), avec une seconde partie de logement (24) située à l'extérieur formant à peu près une demi-coque, et avec une partie de réglage (30) traversant axialement les parties de logement (18, 24) extérieures et s'insérant à l'intérieur de celles-ci, ladite partie de réglage présentant sur un segment un filet externe (34) avec lequel elle peut être vissée dans le segment à filet interne (90) dans la première partie de logement (18) située à l'extérieur, le segment à filet interne étant formé sur un corps de support (92) réglable transversalement à la direction longitudinale axiale (A) et de manière à ce que le corps de support soit réglable par rapport à la première partie de logement transversalement à la direction longitudinale axiale et soit précontraint par ressort vers l'intérieur par rapport à son segment à filet interne et, dans la direction opposée, de manière à ce qu'il puisse être déplacé manuellement vers l'extérieur par pression du doigt, de telle sorte que le segment à filet interne vienne en prise extérieure avec le filet externe de la partie de réglage.
PCT/EP2018/077912 2017-10-13 2018-10-12 Instrument permettant de relier une tige correctrice à une vis à os Ceased WO2019073048A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE102017123907.3 2017-10-13
DE102017123907.3A DE102017123907A1 (de) 2017-10-13 2017-10-13 Instrument zum Verbinden eines Korrekturstabs mit einer Knochenschraube
DE102017123906.5A DE102017123906B4 (de) 2017-10-13 2017-10-13 Instrument zum Verbinden eines Korrekturstabs mit einer Knochenschraube

Publications (1)

Publication Number Publication Date
WO2019073048A1 true WO2019073048A1 (fr) 2019-04-18

Family

ID=66747273

Family Applications (2)

Application Number Title Priority Date Filing Date
PCT/EP2018/077912 Ceased WO2019073048A1 (fr) 2017-10-13 2018-10-12 Instrument permettant de relier une tige correctrice à une vis à os
PCT/EP2018/077908 Ceased WO2019073046A1 (fr) 2017-10-13 2018-10-12 Instrument permettant de relier une tige correctrice à une vis à os

Family Applications After (1)

Application Number Title Priority Date Filing Date
PCT/EP2018/077908 Ceased WO2019073046A1 (fr) 2017-10-13 2018-10-12 Instrument permettant de relier une tige correctrice à une vis à os

Country Status (2)

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DE (2) DE102017123906B4 (fr)
WO (2) WO2019073048A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113440235A (zh) * 2021-06-22 2021-09-28 浙江德康医疗器械有限公司 一种用于脊柱微创手术的压棒系统及方法

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10952778B2 (en) * 2016-10-18 2021-03-23 K2M, Inc. Rod reducer
DE102024115884A1 (de) * 2024-06-06 2025-12-11 ORTHO HUB VENTURES UG (haftungsbeschränkt) Repositionsinstrument
CN119745495B (zh) * 2024-12-30 2025-10-21 浙江德康医疗器械有限公司 一种压棒方法和压棒器

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120078308A1 (en) * 2010-09-27 2012-03-29 Sara Dziedzic Rod reduction instrument and methods of rod reduction
US20130018419A1 (en) * 2011-07-13 2013-01-17 Warsaw Orthopedic, Inc. Spinal rod system and method
EP2792325A1 (fr) 2013-04-20 2014-10-22 Silony Medical International AG Instrument chirurgical
US20150100098A1 (en) 2013-10-07 2015-04-09 K2M, Inc. Rod reducer
EP2878276A2 (fr) * 2013-11-15 2015-06-03 K2M, Inc. Système de chirurgie spinale correctrice et procédé d'utilisation
DE102015205362A1 (de) 2015-03-24 2016-09-29 Silony Medical International AG Instrument zum Verbinden eines Korrekturstabs mit einer Knochenschraube
DE102016106608A1 (de) 2016-04-11 2017-10-12 Aesculap Ag Instrument zum Führen eines Stabs in eine Implantataufnahme

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7842044B2 (en) 2003-12-17 2010-11-30 Depuy Spine, Inc. Instruments and methods for bone anchor engagement and spinal rod reduction
US20130144346A1 (en) * 2004-11-23 2013-06-06 Roger P. Jackson Modular polyaxial bone anchor with retainer having interconnected pieces
US8764756B2 (en) * 2011-02-22 2014-07-01 K2M, Inc. Single action anti-torque rod reducer
US9011449B1 (en) * 2011-04-05 2015-04-21 Scott Cochran Screw and rod fixation system

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120078308A1 (en) * 2010-09-27 2012-03-29 Sara Dziedzic Rod reduction instrument and methods of rod reduction
US20130018419A1 (en) * 2011-07-13 2013-01-17 Warsaw Orthopedic, Inc. Spinal rod system and method
EP2792325A1 (fr) 2013-04-20 2014-10-22 Silony Medical International AG Instrument chirurgical
US20150100098A1 (en) 2013-10-07 2015-04-09 K2M, Inc. Rod reducer
EP2878276A2 (fr) * 2013-11-15 2015-06-03 K2M, Inc. Système de chirurgie spinale correctrice et procédé d'utilisation
DE102015205362A1 (de) 2015-03-24 2016-09-29 Silony Medical International AG Instrument zum Verbinden eines Korrekturstabs mit einer Knochenschraube
DE102016106608A1 (de) 2016-04-11 2017-10-12 Aesculap Ag Instrument zum Führen eines Stabs in eine Implantataufnahme

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113440235A (zh) * 2021-06-22 2021-09-28 浙江德康医疗器械有限公司 一种用于脊柱微创手术的压棒系统及方法
CN113440235B (zh) * 2021-06-22 2023-02-24 浙江德康医疗器械有限公司 一种用于脊柱微创手术的压棒系统及方法

Also Published As

Publication number Publication date
DE102017123906A1 (de) 2019-04-18
WO2019073046A1 (fr) 2019-04-18
DE102017123907A1 (de) 2019-04-18
DE102017123906B4 (de) 2019-05-29

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