CN101035476A - 使螺钉保持在板中的方法和器械 - Google Patents

使螺钉保持在板中的方法和器械 Download PDF

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CN101035476A
CN101035476A CNA2005800273953A CN200580027395A CN101035476A CN 101035476 A CN101035476 A CN 101035476A CN A2005800273953 A CNA2005800273953 A CN A2005800273953A CN 200580027395 A CN200580027395 A CN 200580027395A CN 101035476 A CN101035476 A CN 101035476A
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hole
plate
flexible member
screw
medicated cap
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CN100486540C (zh
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G·S·林德曼
L·高斯
R·A·法利斯
R·W·小海德
S·M·帕帕佐普洛斯
R·C·萨索
V·K·H·松他格
V·C·特雷纳利斯
I·卡尔法斯
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Warsaw Orthopedic Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8042Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers the additional component being a cover over the screw head
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7059Cortical plates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/82Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8047Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers wherein the additional element surrounds the screw head in the plate hole

Abstract

一种用于将螺钉固定于椎板的保持系统。一个或多个螺钉延伸穿过椎板内的孔。空穴位于孔附近且重叠入孔。环件位于空穴内并被帽件固定在适当位置。帽件附连到板上以防止环件脱出。环件可在能使螺钉插入孔和从孔中除去的第一形状与能防止螺钉从孔中脱出的第二形状之间偏转。还包括了使用上述系统的方法,该方法包括:将环件置于板中空穴内,通过附连帽件而使环件的位置固定于板,穿过孔插入螺钉并使板附连于椎骨体,以及使环件定位在螺钉头部上方并防止螺钉脱出。

Description

使螺钉保持在板中的方法和器械
背景技术
人的脊柱是由三十三个椎骨体构成的生物机械结构,负责保护脊髓、神经根和胸腹部的内部器官。脊柱还提供身体结构支持,同时又允许运动灵活性。在某些外科手术过程中,需要将两个或多个椎骨体固定在一起。例如,该过程可能是物理创伤或退化性疾病导致的结果。
一种类型的外科手术过程包括将椎板附连到椎骨体上。椎板的尺寸适合延伸跨过两个或多个椎骨体。一个或多个骨螺钉延伸穿过板中的孔并延伸入椎骨体以固定板。这种附连的一个问题是螺钉会松动并从椎骨体中脱出。需要螺钉保持装置以防止螺钉从椎骨体脱出。
一种类型的螺钉保持装置采用卡环,当螺钉插入孔中时卡环膨胀,一旦螺钉头通过卡环平面它又收缩回到其较小直径。已有卡环设计的一个问题是卡环不能用于各种不同的螺钉。这些设计无法对可变角和固定角螺钉都有效,或是需要仅为有限应用而设计的特殊螺钉。此外,上述已有设计还需要较大的板厚度以容纳卡环。另一个问题是一旦螺钉通过卡环平面,锁环件移至螺钉顶部上方时,外科医生难以视觉观察。一些设计还阻止或限制了外科医生在卡环移至螺钉顶部上方时对卡环移动的触感。此外,一些设计可干扰外科医生对螺钉插入骨中的感觉。
发明内容
本发明涉及一种使螺钉保持在椎板内并防止螺钉脱出的系统和方法。本发明包括多个实施方式,在一个实施方式中,板具有至少一个孔以接受螺钉。空穴位于板内且部分重叠入孔中。环件位于空穴内并被帽件固定在适当位置。环件具有回弹性,并且可在在孔上方部分延伸的初始形状与离开孔的偏转形状间变化。
还描述了保持螺钉的方法。一种方法包括将弹性元件置于板中的空穴内的适当位置,使其在孔上方部分延伸。下一步包括将帽件置于空穴上方,并将帽件附连到板上以防止弹性元件从板中退出。下一步包括将螺钉插入孔中,并使弹性元件偏转离开孔。螺钉插入椎骨体预定距离,弹性元件在孔上方和螺钉上方回到其的初始形状以防止螺钉从孔中脱出。
附图说明
图1是根据本发明一个实施方式的具有环件和帽件的板的部分分解正视图;
图2是根据本发明一个实施方式的帽件的正视立体图;
图3是根据本发明一个实施方式的帽件的后视立体图;
图4是根据本发明一个实施方式的横截面图,其中显示环件在一对螺钉上方延伸;
图5是根据本发明一个实施方式的横截面图,其中显示环件在第一孔上方延伸且向内离开第二孔偏置;
图6是根据本发明一个实施方式的环件的立体图;
图7是根据本发明一个实施方式的安装在板内的螺钉的横截面图;和
图8是根据本发明一个实施方式的板的后视立体图,其中帽件安装在邻近螺钉接受孔的空穴内。
具体实施方式
本发明涉及一种保持螺钉70相对于椎板20的位置的保持系统。图1显示了一个实施方式的具有一个或多个孔21的椎板20。空穴22位于孔21附近且重叠入孔21中。环件50位于空穴22内并被帽件30固定在适当位置。帽件30附连到板20上以防止环件50脱出。环件50具有回弹性,并且能够在延伸到孔21上方以防止螺钉脱出的初始形状与允许可将螺钉插入孔21和从孔21除去的偏转形状间变化(参见图4和5)。
板20的尺寸适合延伸跨过一个或多个椎骨体100。孔21在顶面23和底面24之间延伸穿过板20以接受骨螺钉70。孔21可具有各种尺寸和取向,这取决于特定应用。空穴22位于孔21附近,并包括从底面23向内延伸入板20的沉孔29。空穴22可完全延伸穿过板20,或者可从顶面23向板20内部仅延伸有限的距离。沉孔29延伸入顶面23的深度同样可根据应用而变化。沉孔29可形成上突出部分25以容纳后文描述的环件50。在一个实施方式中,空穴22和沉孔29同轴向对准且各自为基本圆形。也可采用各种其它形状,这些形状包括在本发明范围内。在一个实施方式中,空穴22和沉孔29的中心都在板20中间平面M中。板20可具有居中和前凸曲率以适应椎骨体100的尺寸。空穴22还可包括有助于保持帽件30的元件。例如,在板20的底面24上可形成第二沉孔28。
图2和3显示了从板20取下的帽件30的正视图和后视图。帽件30包括凸缘31和向外延伸的栓塞34。凸缘31包括上表面32和下表面33。当安装在板20中时,凸缘31位于沉孔29内,上表面32与板20的顶面23基本平齐。栓塞34具有基本上对应于空穴22尺寸的宽度。耳部36和槽39可位于与凸缘31相对的栓塞34的边缘,并与下沉孔28相匹配。
栓塞34中可形成窗口37,该窗口提供在外科手术期间抓住和操纵帽件30和/或板20的接触点。窗口37还可用于定位和定向外科器械,这些器械为例如板保持件、钻头、旋塞和螺钉导向器。窗口37可延伸穿过整个帽件30,或者可从凸缘31的上表面32向内仅延伸有限的距离。窗口37可具有能使板20居中对准的形状,例如附图所示的椭圆形。
帽件30附连于板20并使环件50保持在空穴22内。可采用各种方式使帽件30附连于板20,包括例如,干涉配合、搭扣配合(snap fit)、压凹接合和锻压。在一个实施方式中,帽件30具有沿栓塞34的外螺纹,该外螺纹与空穴22内壁上的螺纹相匹配。帽件30也可通过可拆式或不可拆式紧固件如螺钉、铆钉等附连。图4和5显示了使帽件30附连于板20的一种方法。栓塞34外部特征部分的尺寸适合接触空穴22的侧壁,并提供干涉配合。此外,耳部36向外延伸入下沉孔28以进一步固定帽件30。制造过程期间、或者在外科手术之前或手术期间由外科医生或其它医学工作者使耳部36变形进入下沉孔28中。在一个具体的实施方式中,由工具抓紧耳部36,使之从空穴向外弯曲,从而扩展宽度并防止帽件30从板20中脱出。在另一个实施方式中,帽件30由回弹性材料构成。当被插入空穴22时,耳部36向外回弹进入沉孔28。耳部36在沉孔28内的位置如图4和5所示。耳部36A显示出相邻的上帽件30(即,位置邻近截面切割中间帽件30的帽件30)的安装。在这些实施方式中,可仅通过干涉配合、仅通过变形耳部36、或同时通过这两者来保持帽件30。
环件50可位于空穴22内以防止螺钉70脱出。环件50可由回弹性弹簧材料构成,该环件具有弹性并可在安装到空穴22中时向外延伸进入孔21的初始形状与离开孔21以允许相对于孔21除去和插入螺钉70的偏转形状间转化。图6显示了环件50的一个实施方式,它基本上为具有内径和外径的圆形,在第一和第二端52、53间形成有压缩槽51。环件50具有上表面和下表面,下表面面向沉孔29的上突出部分25。在一个实施方式中,下表面大致为平面以在环件50延伸入孔21时接触螺钉70。图6显示了环件50的具有矩形截面形状的一个实施方式。另一种实施方式以三角形截面形状为特征。
环件50可由弹性材料构成。在一个实施方式中,环件50由镍-钛合金构成,当暴露于人体内温度范围时该环件经热处理以实现超弹性。环件50也可由其它材料构成,例如,peek、钛或不锈钢。术语“环件”在本文中广义使用,指位于空穴内的元件。应理解,该元件可具有各种不同的形状和尺寸。
在一个实施方式中,沉孔29的直径小于环件50的外径。这就导致当位于沉孔29中时,环件50在初始形状预先加载负荷。预先加载负荷的情况导致压缩槽51减小,并赋予环件50额外的膨胀力以在孔21上方向外延伸。环件30的偏转量可根据应用而不同。偏转可发生在环件30的一侧,或例如已插入螺钉70的图1、4和5所示实施方式中那样发生在两侧。
图7显示了螺钉70的一个实施方式,它包括头部71、支架72、球面曲率73和杆部74。支架72向外延伸超出头部71,并提供用于接受环件50的平台。支架72可大致为平面以提供给环件50的平面良好的接触表面。球面曲率73在支架72处具有最大宽度,在杆部74处降低至最小宽度。
图1、4和5显示了本发明的一个实施方式,空穴22位于两孔21之间并重叠入两孔21。各个孔21和空穴22具有大致圆形形状,空穴22具有重叠入孔的沉孔29。环件50具有向外延伸并重叠入孔21的初始形状,以及离开孔21而在非重叠位置中的偏转形状。在一个实施方式中,插入螺钉之前环件50处于初始形状,螺钉70插入孔21后,支架在环件50平面下方通过。图4显示环件50处于初始形状,支架72位于环件50平面下方。环件50的回弹性使其回到初始形状并在支架72上方延伸。在图1中,环件50在插入螺钉之前的位置被显示为在板20的中间空穴22和孔21内。
插入螺钉70以及将螺钉70从孔21除去导致环件50偏转并从孔21离开。图5所示左侧螺钉70描述了一个例子。插入或除去的力使环件50从孔21向内偏转并进一步进入沉孔29。
一旦插入螺钉70,环件50重叠入孔21一定距离以防止螺钉70的脱出。在一个实施方式中,环件50向外延伸超出帽件凸缘31的边缘以使外科医生可视觉证实定位。这可通过以下方法进一步促进:用对比色着色环件50和螺钉70,使得更易于视觉观察这些元件的相对位置。
帽件凸缘31可具有一定形状,该形状与相邻孔21相一致并在帽件30安装到板20时防止凸缘21延伸到孔21上方。如图2和3所示,凸缘31具有与孔21的外圆周相一致的弯曲边38。因此,凸缘31不会重叠入孔21,同时仍然允许环件50重叠入孔21。
环件50被设置在帽件30和空穴21间所产生的空间内。在一个实施方式中,帽件30和环件50同轴向对准地排列在空穴22内。在图2和3所示实施方式中,凸片35从帽件30向外延伸以匹配在环件槽51内并防止环件50的旋转。凸片35包括间隔开的第一和第二边缘,以匹配在环件50的槽51内。这可防止环件50旋转至槽51处于孔21上方并潜在地使螺钉70退出的位置。当帽件30位于空穴22中时,凸片35抵靠沉孔29的上突出部分25。
随着螺钉70插入孔21内,球面曲率73接触环件50并使其偏转离开孔21。随着螺钉70继续插入,环件50从其初始形状进一步偏转离开孔21。当插入进行至超过球面曲率73位于环件50下方的点时,环件50回到其初始形状以在支架72上方延伸。在支架72上方延伸的环件50的搭扣作用可由外科医生触觉探测,并确认环件50位于螺钉70上方以防止螺钉脱出。环件50的弹性可随螺钉通过而产生搭扣作用,无需外科医生主动啮合环件50。
装置的另一个实施方式包括附连于帽件30的环件50。环件50和帽件30组合可以是单一整体,或者环件50可以是牢固附连于帽件30的独立元件。在这些实施方式中,该组合使得环件50在初始形状中定位在孔21上方,并允许环件50在插入和除去螺钉70过程中发生偏转。
环件50的初始形状被定位成在一个或多个孔21上方延伸。初始形状可以不是环件50的中立位置。例如,环件50的形状可被沉孔29所制约,具有比当环件50较自由地位于较大空间内时要小的外部宽度。此外,插入螺钉70后,当环件50回到孔21上方时可处于更加偏转的状态。在一个例子中,螺钉70处于初始形状并在孔21上方延伸第一量。在插入螺钉70期间,环件50从孔21偏转至第二形状。插入螺钉70后,环件50轻弹回到螺钉70上方至第三形状。第三形状可与初始形状相同,或可不同,这取决于螺钉的位置和尺寸。例如,在第三形状中,环件50可与螺钉头部71相接触,防止环件50完全回到其初始形状。
环件50可沿单边或沿多于一个边进一步偏转。在图1、4和5所示实施方式中,环件50延伸入两个孔21,因而可随着螺钉70插入各个孔21中而沿两个独立的边偏转。在另一个实施方式中,环件50仅延伸入一个孔21,环件50将沿单边偏转。
术语椎骨体通常用于描述包括椎体、蒂、板和棘突的椎骨几何形状。可调节装置的尺寸和形状,且该装置具有足够的强度需要以用于椎骨不同区域内,包括颈椎、胸椎和腰椎区域。
部分地将图1包括在内以阐述板20、环件50和帽件30的相对位置。帽件30或环件50附连于上空穴22,以显示空穴22和沉孔29相对于相邻孔21的位置。帽件30和环件50安装在中间空穴中,以显示当没有螺钉70时向外延伸进入相邻的孔21中的环件50。下空穴22显示出帽件30和环件50的分解视图。
可以用与本文所示不同的其它具体方式实施本发明而不背离本发明的范围和实质特征。环件50也可以是圆形、椭圆形或长形截面形状。在一个实施方式中,耳部36位于下沉孔28内,与板的底面24平齐或陷入底面24中,从而不干扰椎骨体100的放置。在一个实施方式中,环件50在螺钉头部71上方延伸以防止螺钉脱出。在该实施方式中,螺钉70可包括或不包括支架72和球面曲率73。在一个实施方式中,栓塞34和凸缘31形成约90°的角。保持系统是在椎板内容中讨论的,但是,该系统也可应用于使用板和附连螺钉的其它体内应用。在空穴22位于两个孔21之间的一个实施方式中,空穴22被设置在沿两个孔21的中心之间形成的线上。因此,认为这些实施方式在所有方面都是示例性而非限制性的,所附权利要求书涵义和等价范围内的所有改变都包括在本发明内。

Claims (45)

1.一种螺钉保持系统,所述系统包括:
板,所述板具有接受螺钉的孔,所述孔在顶面和底面之间延伸;
从所述顶面延伸入板的空穴,所述空穴被设置成重叠入孔;
位于所述空穴内的弹性元件,所述弹性元件可在用于防止螺钉从孔中脱出的第一形状与允许螺钉从孔中脱出的第二形状之间变化;和
帽件,所述帽件附连在所述空穴内以防止所述弹性元件从板中退出;
在第一形状中,所述弹性元件从帽件向外延伸并进入所述孔中。
2.如权利要求1所述的系统,其特征在于,所述空穴位于所述板的中间区域。
3.如权利要求1所述的系统,其特征在于,所述空穴包括尺寸适合设置弹性元件的上突出部分以及在所述上突出部分与所述板底面之间的下部,所述上突出部分的宽度大于所述下部。
4.如权利要求3所述的系统,其特征在于,所述帽件包括位于所述上突出部分上的凸缘和附连在所述下部中的栓塞,以使帽件安装于板。
5.如权利要求1所述的系统,其特征在于,当弹性元件安装在板中时,所述帽件的上表面与所述板的顶面基本平齐。
6.如权利要求1所述的系统,其特征在于,所述弹性元件具有基本为平面的底面。
7.如权利要求1所述的系统,其特征在于,所述弹性元件基本上是具有弯曲主体的C形,具有在第一和第二端之间形成的槽。
8.如权利要求7所述的系统,其特征在于,所述帽件上的凸片位于所述弹性元件的槽内,以防止所述弹性元件在所述空穴内的旋转量超出预定的量。
9.如权利要求1所述的系统,其特征在于,所述帽件包括长形开口。
10.如权利要求1所述的系统,其特征在于,所述帽件边缘具有与所述孔对齐的弯曲表面,使得所述帽件离开所述孔定位且不会重叠入孔中。
11.如权利要求1所述的系统,其特征在于,所述弹性元件在第二形状中偏转。
12.如权利要求1所述的系统,其特征在于,在中立状态下,所述空穴比所述弹性元件窄,使得所述弹性元件在第一形状中处于预先加载负荷状态。
13.如权利要求1所述的系统,其特征在于,所述板为长形,以在多个椎骨体上延伸。
14.如权利要求1所述的系统,其特征在于,所述空穴完全延伸穿过板。
15.如权利要求14所述的系统,其特征在于,所述系统还包括位于所述板底面上的沉孔,以接受所述帽件下部上的耳部。
16.一种螺钉保持系统,所述系统包括:
板,所述板具有尺寸被设置成可接受螺钉的孔;
延伸入板的空穴,一沉孔重叠入所述孔中;
位于所述沉孔内的弹性元件,所述弹性元件可弹性偏转以控制螺钉到达所述孔;和
帽件,所述帽件具有凸缘和栓塞,所述凸缘至少部分地位于所述空穴上方,所述栓塞穿过所述弹性元件的内部并与所述板相匹配,以使帽件附连到板上。
17.如权利要求16所述的系统,其特征在于,所述栓塞包括耳部,所述耳部可变形以安装到所述空穴侧壁。
18.如权利要求16所述的系统,其特征在于,所述凸缘具有与所述孔对齐的弯曲边,使得所述凸缘不会延伸入所述孔中。
19.如权利要求16所述的系统,其特征在于,所述空穴位于所述板的中间部分。
20.如权利要求16所述的系统,其特征在于,所述帽件基本上为T形,所述栓塞以约90°的角从所述凸缘向外延伸。
21.如权利要求16所述的系统,其特征在于,所述帽件包括长形窗口,所述窗口通过所述凸缘且至少部分延伸通过所述栓塞。
22.一种螺钉保持系统,所述系统包括:
板,所述板具有位于第一和第二螺钉接受孔之间的空穴,所述空穴的尺寸为可重叠入所述第一和第二孔;
位于所述空穴内的弹性元件,所述弹性元件具有可偏转形状,第一形状可延伸入所述第一和第二孔中,第二形状离开所述第一和第二孔;和
帽件,所述帽件附连于所述板且安装在所述空穴上方,所述帽件具有一离开所述第一和第二孔定位的形状;
在第一形状中,所述弹性元件从所述帽件向外延伸,而在第二形状中,所述弹性元件位于所述帽件下方。
23.如权利要求22所述的系统,其特征在于,所述空穴在所述孔之间定位,所述帽件为沙漏形,具有与所述孔对齐的弯曲边缘。
24.如权利要求23所述的系统,其特征在于,所述空穴中心沿在所述第一和第二孔中心之间形成的线定位。
25.如权利要求22所述的系统,其特征在于,所述空穴包括沉孔和中央部分,所述沉孔从所述板的顶面延伸入板并具有延伸入所述第一和第二孔的宽度,所述中央部分延伸通过所述板且离开所述第一和第二板而定位。
26.一种螺钉保持系统,所述系统包括:
板,所述板具有空穴,沉孔可重叠入孔,所述孔延伸通过所述板,所述沉孔从顶面向所述板内部延伸有限距离;
位于所述沉孔内的弹性元件,该弹性元件具有延伸入孔的第一形状和尺寸为可离开所述孔的第二形状;和
帽件,所述帽件附连于所述板且安装在所述空穴上方,所述帽件具有离开所述孔定位的形状;
在第一形状中,所述弹性元件从所述帽件下方延伸,而在第二形状中,所述弹性元件位于所述帽件下方。
27.一种椎板系统,所述系统包括:
具有孔的板,所述孔在顶面和底面之间延伸;
沉孔,所述沉孔可从所述顶面延伸入所述板且深度小于所述孔,所述沉孔可重叠入所述孔定位;和
弹性元件,所述弹性元件具有大致为平面的底面,可定位在所述沉孔内并可在第一和第二形状间偏转;和
帽件,所述帽件附连于所述板以使所述弹性元件保持在所述沉孔内。
28.如权利要求27所述的系统,其特征在于,所述系统还包括螺钉,所述螺钉具有从所述螺钉的中心轴线向外延伸的支架,所述支架基本上为平面以在所述弹性元件处于第一形状时与所述弹性元件的基本为平面的底面相接触。
29.如权利要求28所述的系统,其特征在于,所述系统还包括邻近所述支架的球面曲率,在所述支架处具有最大宽度,并在离开所述支架而接近插入端处具有最小宽度。
30.如权利要求27所述的系统,其特征在于,所述弹性元件基本上为C形,具有弯曲主体,第一和第二端间隔开以形成槽。
31.如权利要求27所述的系统,其特征在于,所述弹性元件具有大致矩形的截面形状。
32.一种板系统,所述系统包括:
具有孔的板,所述孔在顶面和底面之间延伸以接受螺钉;
沉孔,所述沉孔可从所述顶面延伸入所述板且深度小于所述孔,所述沉孔可重叠入所述孔定位;和
弹性元件,所述弹性元件具有大致为平面的底面并可定位在所述沉孔内,所述弹性元件可在延伸入所述孔的第一形状与离开所述孔的第二形状间偏转;和
附连于板的帽件,所述帽件在至少一部分沉孔上方延伸。
33.如权利要求32所述的系统,其特征在于,所述空穴和沉孔同轴对齐。
34.一种将板安装到椎骨体的方法,所述方法包括以下步骤:
将弹性元件置于板中空穴内并使弹性元件在孔上方部分延伸;
将帽件置于空穴上方并使帽件附连于板以防止所述弹性元件从所述板中退出;
将螺钉插入孔中并使弹性元件偏转离开孔;
将螺钉安装在椎骨体内预定位置;和
使弹性元件回到孔上方和螺钉上方,以防止螺钉从孔中脱出。
35.如权利要求34所述的方法,其特征在于,所述使弹性元件回到孔上方的步骤包括弹性元件被动返回。
36.如权利要求34所述的方法,其特征在于,所述偏转弹性元件的步骤包括将弹性元件移至帽件下方的位置。
37.如权利要求34所述的方法,其特征在于,所述方法还包括将所述帽件下部插入空穴,所述弹性元件基本围绕所述下部延伸。
38.如权利要求34所述的方法,其特征在于,所述使弹性元件回到孔上方和螺钉上方以防止螺钉从孔中脱出的步骤包括使弹性元件的平底部分移至所述螺钉的基本为平面的部分上方。
39.一种安装板的方法,所述方法包括以下步骤:
将弹性元件置于板中空穴内,以在孔的上方部分延伸;
将帽件置于空穴上方,凸缘在至少一部分弹性元件上方延伸;
将螺钉插入孔中并使弹性元件偏转至凸缘下方的位置;
将螺钉插入至相对于板的预定深度;和
使弹性元件从凸缘下方回到螺钉上方延伸,防止螺钉从孔中脱出。
40.如权利要求39所述的方法,其特征在于,所述方法还包括:使帽件的栓塞延伸入空穴,使得帽件附连于板并防止弹性元件从板中退出。
41.一种相对于板保持螺钉的方法,所述方法包括以下步骤:
将弹性元件插入板中空穴内,弹性元件在孔上方部分延伸;
将帽件插入空穴内,使帽件上的耳部变形进入板内的特征部分,并将所述帽件附连于板;
将螺钉插入孔中并使弹性元件偏转离开孔;
将螺钉插入至相对于板的预定深度;和
使弹性元件回到螺钉上方延伸,以防止螺钉从孔中脱出。
42.一种相对于板保持螺钉的方法,所述方法包括以下步骤:
用帽件使弹性元件附连于板,所述弹性元件处于在孔上方延伸的第一形状中;
将螺钉沿第一方向插入孔中并使弹性元件偏转至第二形状;
沿第一方向移动螺钉并使一定长度的螺钉穿过孔;和
使弹性元件偏转至在螺钉上方延伸的第三形状,防止螺钉沿第二方向移动。
43.如权利要求42所述的方法,其特征在于,当偏转至第一形状和第三形状时,所述弹性元件尺寸相同。
44.一种螺钉保持系统,所述系统包括:
具有顶面和底面的板;
空穴,所述空穴位于板内并在顶面和底面间延伸;
孔,所述孔位于板内并在顶面和底面间延伸;
与空穴对齐的第一沉孔,所述第一沉孔从顶面延伸入板且重叠入孔,所述第一沉孔比空穴宽;
与空穴对齐的第二沉孔,所述第二沉孔从底面延伸入板,所述第二沉孔比空穴宽;
位于第一沉孔内的弹性元件,所述弹性元件具有延伸入孔的第一形状和离开孔的第二形状;和
帽件,所述帽件在至少一部分弹性元件上延伸,并具有至少一个位于第二沉孔中的耳部以使所述帽件附连于板。
45.如权利要求44所述的系统,其特征在于,所述第一和第二沉孔各自与所述空穴轴向对齐。
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KR100823791B1 (ko) 2008-04-21
EP1765208A1 (en) 2007-03-28
ZA200700480B (en) 2008-07-30
CA2572800A1 (en) 2006-01-26
US20050283152A1 (en) 2005-12-22
DE602005013527D1 (de) 2009-05-07
US8672984B2 (en) 2014-03-18
US20100222780A1 (en) 2010-09-02
CN100486540C (zh) 2009-05-13
AU2005265057A1 (en) 2006-01-26
ATE426367T1 (de) 2009-04-15
WO2006009795A1 (en) 2006-01-26
US7727266B2 (en) 2010-06-01
EP1765208B1 (en) 2009-03-25
KR20070056039A (ko) 2007-05-31
JP4746613B2 (ja) 2011-08-10
AU2005265057B2 (en) 2010-11-11
JP2008503267A (ja) 2008-02-07

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