The present invention relates to a pedicle screw with a closure device for securing a rod for stabilization of the vertebral column, comprising a screw-in part, a head part provided on the screw-in part, a U-shaped recess disposed in the head part, which recess is formed by the inner surfaces of two arms and a bottom surface connecting the two inner surfaces, in which recess the rod is insertable and is held by the closure device.
Pedicle screws with a closure device for securing a rod are known from the state of the art in diverse designs. These screws serve to stabilize the vertebral column of patients who have severely damaged vertebral columns. For stabilization, one pedicle screw each is screwed into a number of vertebral bodies, and a rod is placed in the head parts of these pedicle screws, which rod is then connected in each case to the respective pedicle screw, closure devices being used for this purpose. Two different forms of stabilization can be achieved, depending upon which type of rod is used. With use of a rigid rod, a stiffening of the affected vertebral bodies is achieved. When a supportive stabilization of the vertebral bodies is supposed to be achieved, an elastic rod is used, enabling a certain flexibility to be permitted between the individual vertebral bodies.
Regardless of which system is used, an optimal connection between inserted rods and pedicle screws is to be aimed for, which is supposed to be achieved through the closure devices used.
Known from EP-B-1 119 304 is a device for securing spinal rods, which device consists of a pedicle screw having a head portion and a U-shaped recess, in which the rod to be secured is inserted. Serving as closure device is a rotatable element with two laterally protruding projections opposite each other, which have a helical inclination. Through turning of this rotational element, these projections end up in corresponding slot-shaped recesses of the two arms of the U-shaped recess. By turning this rotational element, the rod is held in a clamped way. In order to be able to prevent a release of this rotational element, the clamping surface facing the rod is provided with transversely running recesses which are supposed to engage in the surface of the rod upon reaching of the clamping position.
This device is simple to operate. It is difficult, however, with the predetermined positions of the recesses which are supposed to engage in the rod, to obtain the right tensional force for the rod to be held in the pedicle screw in an optimal way. In addition, there is the risk that the two arms are pressed apart elastically by the projections of the rotational element, which could interfere with the desired tensional force.
The object of the present invention is therefore to create a pedicle screw with a closure device for securing a rod for stabilization of the vertebral column which is easy to manipulate and with which the desired and optimal tensional force can be achieved with any type of rods used.
This object is achieved according to the invention in that the closure device comprises a yoke-shaped locking element having a collar at each of the two end regions opposite each other, on each of which collars projections are provided, directed toward each other. Outside on each of the two arms a groove is provided, running transversely to these arms, such that the yoke-shaped locking element is placeable on the arms and is rotatable, and, to reach the locking position, the projections each end up in the corresponding groove. A tension screw is screwable into the yoke-shaped locking element, which tension screw is connected in a rotatable way to a tension element, which tension element is insertable in a guided way between the arms, and, in the locked state of the locking element, is able to be tensioned, by means of the tension screw, against the rod inserted in the recess.
This closure device is very easy to operate. In particular, a pre-assembled closure device with the locking element, tension screw screwed therein, and tension element connected thereto allows itself to be put as a unit on the pedicle screw. The tension element, with which the tension screw, screwed into the locking element, is rotatably connected, is guided between the arms forming the U-shaped recess of the pedicle screw for receiving the rod, and is moved in after insertion of the rod. The locking element is brought into the locking position by rotation. The tension screw can be tightened, so that the tension element is pressed with the desired force against the rod to be secured. Achieved by pressing the tension element against the rod is that the projections of the locking element are pressed with the corresponding counterforce against the corresponding surfaces of the respective groove, so that the locking element is also secured by friction locking, and a turning back of the locking element is made impossible.
The locking position of the yoke-shaped locking element is preferably determined by stops in the head part. It is thereby ensured that the correct locking position of the yoke-shaped locking element is achieved.
The tension element is preferably provided with guides, by means of which the tension element is placeable in a guided way on the two arms of the head part, which contributes to simplification of operation.
These guides preferably consist of guide ribs provided on the tension element that co-operate with guide surfaces provided on the arms, whereby manufacture of the corresponding elements becomes very easy.
This rotatable connection between tension screw and tension element is preferably achieved by the tension screw having a threaded part which is extended by a bolt piece, and by a support surface being formed between threaded part and bolt piece. To receive the bolt piece, the tension element is provided with a central bore. The end region of the bolt piece remote from the threaded part is provided with a swelling, which can be achieved in a simple and advantageous way by bending up this end region to form a kind of flange.
The support surface is preferably supported on a surface correspondingly provided on the tension element, whereby an optimal transfer of the tension forces is achievable.
A further advantageous embodiment of the invention consists in the rod being made of an elastic material, the cylindrical surface of which is provided with ridges and grooves, and the bottom surface, connecting the inner surfaces of the arms, and the surface of the yoke-shaped locking element facing the rod are provided with corresponding ridges and grooves. Thereby achieved is an optimal formfitting connection between rod and pedicle screw, which is particularly advantageous when the rod is made of an elastic material, for instance a biocompatible plastic, in particular a polyurethane-based material.
An embodiment of the invention will be explained more closely in the following, by way of example, with reference to the attached drawing.
Shown are:
As can be seen from
The two lateral regions of the respective arms 7 and 8 are each provided with a guide surface 10, 11. Provided in the upper region of the two arms 7 and 8 on the outside is one groove 12 each, running transversely to these arms. The floor of the groove and the surfaces adjacent to the groove 12 are of circular design.
The U-shaped recess 4 of the head part 3 of the pedicle screw 1 can be closed by a closure device 13. This closure device 13 is composed of a tension element 14, a locking element 15 and a tension screw 16. The tension element 14 allows itself to be inserted between the two arms 7 and 8. For this purpose, this tension element 14 is provided with two guide ribs 17 and 18 each, opposite each other, which, together with the guide surfaces 10 and 11 of the two arms 7 and 8, form the guide. The surface 19 of the tension element 14 turned toward the bottom surface 9 likewise has a shape adapted to the form of the rod.
The locking element 15 has the shape of a yoke, and is provided with a collar 20 on each of the two end regions opposite each other. Provided on each of these collars 20 is a projection 21, which projections are directed toward each other. In addition, the locking element 15 is provided with a bore 22 that is provided with a threading 23. The tension screw 16 is able to be screwed into the threading 23 of this bore 22, which tension screw is provided with a hexagonal socket 24. With this closure device 13, the U-shaped recess 4 in the head part 3 of the pedicle screw 1 can be closed; the rod inserted in this U-shaped recess is thereby securely held, as will still be seen later on.
As can be seen from
This closure device 13, put together to form a unit, then allows itself to be put on the head part 3 of the pedicle screw 1. As can be seen from
Shown in
The situation where the locking element 15 has reached the locking position is shown in
When a pedicle screw is inserted into the vertebral body of a vertebral column, the rod 33 is of course inserted before placement of the closure device 13, as can be seen in the sectional drawing according to
Since the locking element 15 encloses the two arms 7 and 8 of the U-shaped recess 4 from the outside, these two arms 7 and 8 are kept in the correct position even in the tensioned state, i.e. a spreading apart of the two arms 7 and 8 is rendered impossible. The head part 3 of this pedicle screw 1 can thus be constructed very compactly. In particular, the height can be kept very minimal.
As shown in
Pedicle screws of this kind as well as the closure device are usually made of a titanium alloy. Of course other suitable materials would also be conceivable.
In the embodiment example shown in the drawings, pedicle screw 1 and tension element 14 of the closure device 13 as well as the rod 33 are provided with corresponding ridges and grooves. Of course the respective surfaces could be smooth, in particular if a relatively rigid rod, made for instance of a titanium alloy, is used. When securing this rod having a smooth surface in the pedicle screw, a pure friction connection is obtained, which, however, likewise results in a secure anchorage by corresponding tightening of the tension screw.
With this design, a pedicle screw with closure device is obtained with which both elastic rods and rigid rods can be secured in the respective pedicle screw in an optimal way. By means of the design shown, a very compact construction is achieved. Moreover the insertion of the rod in the pedicle screw, the fitting of the closure device, the locking and the tensioning are very easily feasible and require only very simple tools.
Number | Date | Country | Kind |
---|---|---|---|
07150489 | Dec 2007 | EP | regional |
Number | Name | Date | Kind |
---|---|---|---|
7294128 | Alleyne et al. | Nov 2007 | B2 |
20020116001 | Schafer et al. | Aug 2002 | A1 |
20030125741 | Biedermann et al. | Jul 2003 | A1 |
20030187434 | Lin | Oct 2003 | A1 |
20050171542 | Biedermann et al. | Aug 2005 | A1 |
20060173456 | Hawkes et al. | Aug 2006 | A1 |
Number | Date | Country |
---|---|---|
94 03 231 | Jun 1994 | DE |
1 234 547 | Aug 2002 | EP |
1795134 | Jun 2007 | EP |
1 815 812 | Aug 2007 | EP |
WO 9501132 | Jan 1995 | WO |
WO 2005102195 | Nov 2005 | WO |
WO 2007130840 | Nov 2007 | WO |
Number | Date | Country | |
---|---|---|---|
20090171401 A1 | Jul 2009 | US |