• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    Surgical assembly comprising: - a plug (2) comprising an external thread (2c) and a central recess for the engagement of a screwdriver bit; a plug-holder in the form of a hollow sleeve (10) comprising a connection end (11) with the plug (2), and a locking rod (15) slidably mounted in the hollow sleeve (10) between a position neutral and a blocking position of the cap; • the plug (2) comprises at least two diametrically opposite radial notches (7), formed from an outer side wall of said plug (2), each of the notches (7) comprising at least one lateral groove (8); The connection end (11) is extended longitudinally by two diametrically opposite lugs (12) adapted to engage in the notches (7) and each comprising a lateral shoulder (12a) complementary to the groove (8) of the notch (7) adapted to engage in said groove for axially locking the sleeve (10) on the plug.
    公开号:FR3040284A1
    申请号:FR1557966
    申请日:2015-08-27
    公开日:2017-03-03
    发明作者:Julien Bazille
    申请人:Spineway；
    IPC主号:
    专利说明:

    Surgical assembly for setting up a screw cap
    PEDICULAR TECHNICAL FIELD
    The present invention relates to the technical sector of surgical instruments and relates more particularly to a surgical assembly for the implementation of a plug in a pedicle screw, in particular for the treatment of pathologies of the spine.
    PRIOR ART In general, a spinal implant comprises at least two pedicle screws intended to be screwed onto a variable anatomical element of the vertebra (blade, pedicle, vertebral body), and a connecting system (plate or stem ) joining the two pedicle screws together.
    It is well known to use a threaded plug adapted to be screwed into the head of the pedicle screw and to hold in place a connecting rod. The plug used is either in the form of a simple plug comprising an external thread, and a central clamping recess comprising, for example, a connection for a star screwdriver, or in the form of a double plug comprising a internal cap and an external cap screwed into one another. The inner cap includes a central clamping recess and an external thread, and the outer cap includes an internal thread and an external thread and clamping recesses.
    It is also known instruments for the establishment of these caps. These instruments form, for example, an assembly generally comprising the plug as such, and a cork holder. The instruments are especially designed for so-called minimally invasive surgical operations, during which the surgeon has no visibility on the implants.
    It is known from the state of the art a surgical assembly comprising a cap and a cork holder, in particular disclosed in US 2011166610. The cork holder comprises two longitudinal branches elastic and diametrically opposed, surrounded by a sliding sleeve. The branches each include an internal boss facing each other. The plug comprises two diametrically opposite radial slots, and formed from an outer side wall of said plug. The two slots each comprise a recess complementary to the boss of the branches, arranged in the direction of the inside of the plug.
    In order to carry the plug, the two branches come, by elastic deformation, in the slots with their boss in engagement in the complementary recesses to grip the plug. The cork holder sleeve is slid towards the stopper to prevent the elastic limbs from moving apart from one another and to lock the connection between the cork holder and the stopper.
    It is also known a plug and a cork holder, in particular disclosed in US 2012123431. The plug comprises a central recess with an internal annular groove. The cap holder comprises a hollow sleeve having a plurality of longitudinal slots defining resilient legs. The elastic branches each comprise a bead protruding outwardly of the sleeve, adapted to be housed, by the elastic deformation of the branches, inside the annular groove of the plug. The insertion of a locking rod into the hollow sleeve makes it possible to lock the connection between the stopper and the stopper by preventing the elastic branches from coming together.
    A disadvantage of the surgical assemblies of the prior art described above lies in the fact that they can not adapt to both types of plug, single or double, allowing both the screwing of the inner plug and screwing external cap. Indeed, the state of the art described above does not allow the surgeon to exert, via the cap holder, a significant tightening torque on the plug, regardless of its type.
    SUMMARY OF THE INVENTION One of the aims of the invention is therefore to remedy at least the aforementioned drawbacks by proposing a surgical assembly for the insertion of a single or double plug into a pedicle screw, the connection between which is plug and the cap-holder is relatively secure to avoid the risk of disconnection during the installation of the cap, allowing easy reconnection in-situ of the cap and the cap-holder, while being sufficiently resistant to allow the surgeon to exercise , through the cork holder, a large tightening torque on the plug, namely at least equivalent to 5 Nm.
    Another object of the present invention is to reinforce the locking between the stopper and the stopper and to further secure their connection. For this purpose, it has been developed a surgical assembly comprising: - a pedicular screw plug, the cap comprising at least one external thread and a central recess for the engagement of a screwdriver bit; a stopper in the form of a hollow sleeve comprising a connection end with the stopper, and a locking rod slidably mounted in the hollow sleeve between a neutral position and a locking position of the stopper.
    According to the invention: the plug comprises at least two diametrically opposite radial notches, formed from an external lateral wall of said plug, each of the notches comprising at least one lateral groove; The connection end of the sleeve of the cork holder extends longitudinally by two diametrically opposite lugs adapted to engage in the notches and each comprising a lateral shoulder complementary to the groove of the notch adapted to engage in said groove for axially locking the sleeve on the plug.
    By the lateral direction of the grooves and shoulders means a direction perpendicular to the radial direction respectively of the plug or the sleeve. In this way, the present invention makes it possible to grasp, via the stopper, a stopper for its placement in a pedicle screw. In practice, in this embodiment, the plug is grasped by inserting the pins of the sleeve in the notches of said plug, and by rotating said sleeve in the screwing direction to engage the shoulders in the grooves and axially block the sleeve on the cork. To maintain this axial locking securely, it is necessary to slide the locking rod in the locking position, that is to say until said locking rod comes to exert an axial pressure on the cap to maintain the shoulders engaged in the grooves. The invention has the advantage of being able to be implemented with a simple plug comprising an external thread and a central clamping recess with the notches formed around the central recess, or with a double plug comprising the notches formed in the plug external, around the inner cap.
    In this way, the shouldered lugs allow the surgeon to exert, via the cap holder, a large tightening torque on the single cap or on the outer cap of the double cap, namely at least an equivalent tightening torque. at 5 Nm.
    To screw the inner cap, you must disconnect and remove the cap holder and insert a screwdriver into the clamping recess for screwing itself.
    The connection / disconnection between the cap and the cap holder is simple. In addition, the configuration of the cap holder is such that it has, in practice, a sleeve having a diameter of less than 10 mm to fit into an extension tube used for the establishment of a pedicle screw .
    According to a particular embodiment, the grooves of the notches and the shoulders of the lugs are inclined so that the rotation of the sleeve in the screwing direction forces the axial locking.
    Advantageously, the notches and lugs each comprise and each respectively a second opposite lateral groove and a second opposite lateral shoulder, which allows an axial locking of the cork holder on the plug also in the direction of unscrewing the plug.
    In this latter configuration, and according to another advantageous embodiment of the invention, the connection end of the sleeve comprises two diametrically opposed longitudinal slots so as to form two elastic branches, said slots passing through the lugs to form two pairs of pairs. dewclaws. The lugs of each pair of lugs are able to engage, coming closer to one another by the elastic deformation of the branches, in the corresponding notch until the shoulders of the lugs come s' snap into the grooves of the notches.
    This configuration makes it possible to lock the connection between the cork holder and the stopper in a more secure and snap-lock manner.
    In this configuration, and advantageously, the cap comprises two additional radial slots, diametrically opposed and evenly distributed on either side of the first notches, and the sleeve comprises clamping tabs longitudinally extending the connection end of the sleeve, diametrically opposite. and regularly distributed on either side of the lugs, said clamping lugs being intended to fitly engage in the notches to facilitate screwing / unscrewing of the plug by optimally transmitting to said plug the tightening torque / loosening exerted by the hollow sleeve.
    In this embodiment, and in order to further secure the connection between the stopper and the stopper, the locking rod includes an outer diameter fitted to the inner diameter of the hollow sleeve, so that in the locking position the locking rod is positioned between the elastic branches of the sleeve and prevents the unlocking of the cork-holder by preventing the approximation of the elastic branches and the disengagement of the pairs of lugs. Advantageously, the locking rod is secured in the upper part to a trigger for the passage of the locking rod from the neutral position to the locking position.
    According to a particular embodiment, the locking rod comprises a screwing tip adapted to come into engagement, in the locking position, in the central recess for screwing the plug.
    Thus, the inner cap can be screwed with the locking rod in locking position. It is therefore not necessary to remove the cap holder to screw the inner cap, nor to use a separate clamp.
    According to another advantageous embodiment, the locking rod is hollow and allows the insertion of a screw member in the form of a rod with a screwdriver bit. Thus, the screwing of the inner cap can be performed without removing the cap holder.
    Preferably, the clamping tabs are longer than the lugs to allow guiding the engagement of said lugs in the notches.
    As mentioned above, the cap is either in the form of a single cap or in the form of a double cap. In the case of a double cap, the inner cap comprises a lower annular bead forming a stop during unscrewing of the inner cap, or during screwing of the outer cap thus preventing the accidental disassembly of the two plugs during the surgical operation.
    BRIEF DESCRIPTION OF THE DRAWINGS Other features and advantages of the invention will emerge clearly from the description which is given hereinafter, by way of indication and in no way limiting, with reference to the appended figures in which: FIG. 1 is a schematic representation in perspective of a simple plug according to the invention; FIG. 2 is a schematic representation illustrating the simple plug seen from the side; FIG. 3 is a schematic perspective representation of a double plug according to the invention; - Figure 4 is a schematic perspective view of a double cap side view; - Figure 5 is a schematic representation illustrating the double plug seen in longitudinal section; - Figure 6 is a schematic perspective view of the connection end of the cork holder according to the invention; FIG. 7 is a schematic side view illustrating the pairs of lugs of the front cap holder engaging in the notches of a double cap; - Figure 8 is a schematic side view illustrating the clamping lugs of the front cap holder engagement in the notches of a double cap; - Figure 9 is a schematic representation illustrating the side of the stopper connected to the plug, with a particular embodiment of the lugs of said stopper; - Figure 10 is a schematic representation similar to that of Figure 9, illustrating another possible embodiment of the pins of the cork holder; - Figure 11 is a schematic representation illustrating the connecting end of the cap holder and the cap in longitudinal section along the axis A-A shown in Figures 9 and 10; - Figure 12 is a schematic perspective view of the surgical assembly according to the invention, the locking rod of the cap-holder being unlocked; - Figure 13 is a longitudinal sectional view of the connection end of the cap holder, with the locking rod in the unlocked position; - Figure 14 is a schematic perspective view of the surgical assembly according to the invention, the locking rod being locked and the cap holder being connected to the plug; - Figure 15 is a longitudinal sectional view of the connecting end of the cork holder, with the locking rod in the locking position. - Figure 16 is a schematic perspective view illustrating the connecting end of the cap holder connected to the plug.
    DETAILED DESCRIPTION OF THE INVENTION The invention relates to a surgical assembly (1) for the establishment of a plug (2) in a pedicle screw, in particular for the treatment of pathologies of the spine. The surgical assembly (1) according to the invention comprises the stopper (2) as such and a stopper (3).
    The plug (2) is adapted to be screwed into the head of the pedicle screw to hold in place a connecting rod of at least two pedicle screws. For this purpose, and with reference to FIGS. 1 to 2, the plug (2) used may be in the form of a single plug (2a) comprising an external thread (2c) capable of cooperating with the head of the pedicle screw and a central clamping recess (4) comprising, for example, a star-screw connection for screwing the plug (2) as such.
    With reference to FIGS. 3 to 4, the plug (2) can also be in the form of a double plug (2b) comprising an internal plug (5) and an external plug (6) screwed into one another . The inner plug (5) comprises the central recess (4) for connection and an external thread (5a) for cooperating with the outer plug (6), and the outer plug (6) comprises an internal thread (6a) to cooperate with the inner cap (5), and the external thread (2c) to cooperate with the pedicle screw.
    According to a preferred embodiment of the invention, the two types of stopper (2) comprise four identical radial notches (7) uniformly distributed around the circumference of said stopper (2), and formed from an external lateral wall of said cap (2). In the case of the single plug (2a) the notches (7) are formed around the central recess (4), and in the case of the double plug (2b) they are formed in the outer plug (6), around the plug internal (5).
    Each notch (7) comprises two lateral grooves (8), that is to say formed in a wall of the notch (7) perpendicular to the radial direction of the plug (2). The grooves (8) comprise an upper pan (8a) inclined towards a lower part of the plug (2).
    With reference to FIG. 5, and in the case of a double plug (2b), the inner plug (5) comprises a lower annular bead (9) forming a stop when the internal plug (5) is unscrewed, or during screwing the outer cap (6) thus preventing the accidental disassembly of the two plugs (2) during the surgical operation.
    With reference to FIGS. 6 to 8, the stopper (3) comprises a hollow sleeve (10) comprising a connection end (11) with the stopper (2). The connection end (11) of the sleeve (10) extends longitudinally by two lugs (12) diametrically opposed and by two clamping lugs (13), also diametrically opposed and regularly distributed on either side of the lugs (12). ). The connecting end (11) further comprises two longitudinal slots (14) diametrically opposed so as to form two elastic branches (11a). The slots (14) are arranged so as to separate the lugs (12) in two pairs of lugs (12). Each lug (12) comprises a lateral shoulder (12a) complementary to the groove (8) of the notch (7).
    In this way, and with reference to FIG. 7, the lugs (12) of each pair of lugs (12) are able to engage, coming closer to one another by the elastic deformation of the branches (11a), in the corresponding notch (7) until the shoulders (12a) of the lugs (12) snap into the grooves (8). The connection between the cap holder (3) and the cap (2) is securely latched and latched.
    In the same way, the two clamping tabs (13) are each intended to engage in a corresponding notch (7). The width of the clamping lugs (13) notably corresponds substantially to the width of the notches (7) so that the engagement of the clamping lugs (13) is adjusted. The clamping lugs (13) are longer than the lugs (12) to engage first in the notches (7) and allow guiding the engagement of the lugs (12). The clamping lugs (13) make it possible to optimally transmit to the plug (2) the tightening / loosening torque exerted by the hollow sleeve (10). This configuration makes it possible in particular to exert on the plug (2) a consequent tightening torque, namely at least a tightening torque equivalent to 5 Nm. According to the invention, the tightening torque can be transmitted both to the single plug ( 2a) to the outer cap (6) of the double cap (2b).
    The fact that the four notches (7) are identical makes it possible to connect the stopper (3) more easily on the stopper (2), in particular in situ. Indeed, each lug (12) and each clamping lug (13) can cooperate with any one of the four notches (7), which allows four possible connection positions.
    Referring to Figures 12 to 16, the cap holder (3) comprises a locking rod (15) slidably mounted in the hollow sleeve (10) between a neutral position and a locking position of the plug (2). The locking rod (15) comprises an outer diameter fitted to the inner diameter of the hollow sleeve (10) and is secured in the upper part to a trigger (16) for the passage of the locking rod (15) from the neutral high position ( Figures 12 and 13) in which it does not prevent the approximation of the elastic branches (11a) of the hollow sleeve (10), to a low locking position (FIGS. 14 and 15), towards the plug (2), in which it prevents the unlocking of the cork holder (3) by preventing the approximation of the elastic branches (11a) and the disengagement of the pairs of lugs (12). With reference to FIG. 16, when the stopper (3) is connected to the stopper (2), the clamping lugs (13) and the lugs (12) are engaged in the notches (7) and the clamping of the stopper ( 2) is possible.
    In a particular embodiment illustrated in FIGS. 9 to 11, the hollow sleeve (10) of the cap holder (3) comprises four lugs (12) evenly distributed around the circumference of the hollow sleeve (10), and does not include any clamping lugs or longitudinal slots. The plug (2) is grasped by inserting the lugs (12) in the notches (7) of said plug (2), and by rotating said sleeve (10) in the screwing direction to axially lock the sleeve (10). on the plug (2). To maintain this axial locking securely, it is necessary to slide the locking rod (15) to the locking position, that is to say until said locking rod (15) exerts a pressure axial on the plug (2) to maintain the shoulders (12a) of the lugs (12) in engagement in the grooves (8) of the notches (7). Advantageously, the shoulders (12a) of the lugs (12) are inclined to bear against the inclined faces (8a) of the grooves (8) so that the rotation of the sleeve (10) in the screwing direction forces the axial locking.
    According to a particular embodiment illustrated in FIG. 10, the flaps (8a) of the grooves (8) can be inclined so as to form stop-tail locking systems, able to cooperate with the complementary shoulders in tails. arondes (12a) of the hollow sleeve (10). In this embodiment, to secure the sleeve (10) on the plug (2), it is necessary to turn the sleeve (10) in the direction of screwing or unscrewing to match the daisy-tailed shapes. and exerting pressure on the stopper (2) with the locking pin (15) to engage said dovetail shapes and prevent unlocking of the stopper (2).
    According to another embodiment not shown, the locking rod (15) comprises a screwing tip adapted to come into engagement, in the locking position, in the central recess (4) for screwing the plug (2).
    In practice, in order to disconnect the cap holder (3) from the plug (2), it is necessary to slide the locking rod (15) to the neutral position by actuating the trigger (16), possibly to rotate the sleeve (10). ) for the embodiments illustrated in Figures 9 and 10, and pull on both sides of the cap holder (3) and the cap (2) to separate them from each other. When the cap (2) is screwed and fixed in the pedicle screw, it is simply necessary, after sliding the locking rod (15) in the neutral position, to pull on the cap holder (3). In the embodiment illustrated in Figure 7, the inclined faces of the shoulders (12a) of the lugs (12) allow to exert a force on the elastic branches (11a) tending to bring them closer to each other. In this way, the pairs of lugs (12) can disengage from the notches (7). In the same way, the shoulders (12a) are inclined to allow the approximation of the elastic branches (1 la) when the lugs (12) are engaged in the notches (7).
    As is apparent from the above, the invention provides a surgical assembly (1) for the introduction of a single plug (2a) or a double plug (2b) in a pedicle screw, the connection between the plug (2) and the cap-holder (3) is reinforced and secured by snapping lugs (12) and locking that provides the locking rod (15). The risks of disconnection during the installation of the plug (2) are thus avoided. The surgical assembly (1) according to the invention allows a facilitated reconnection in-situ of the cap (2) and the cap holder (3), while providing a sufficiently strong connection to allow the surgeon to exercise, by the intermediate of the cap-holder (3), a consequent tightening torque on the single plug (2a) or on the outer plug (6) of the double plug (2b), namely at least equivalent to 5 Nm.
    权利要求:
    Claims (10)
    [1" id="c-fr-0001]
    claims
    1. Surgical assembly (1) comprising: - a plug (2) of pedicle screw, the plug (2) comprising at least one external thread (2c) and a central recess (4) for the engagement of a screwdriver bit ; a plug holder (3) in the form of a hollow sleeve (10) comprising a connection end (11) with the plug (2), and a locking rod (15) slidably mounted in the hollow sleeve (10) between a neutral position and a locking position of the plug (2), characterized in that: • the plug (2) comprises at least two diametrically opposite radial notches (7), formed from an external lateral wall of said plug ( 2), each of the notches (7) comprising at least one lateral groove (8); The connecting end (11) of the sleeve (10) of the stopper carrier (3) is extended longitudinally by two diametrically opposite lugs (12) able to engage in the notches (7) and each comprising a lateral shoulder (12a) complementary to the groove (8) of the notch (7) adapted to engage in said groove (8) for axially locking the sleeve (10) on the plug (2).
    [2" id="c-fr-0002]
    2. Surgical assembly (1) according to claim 1, characterized in that the grooves (8) of the notches (7) and the shoulders (12a) of the lugs (12) are inclined so that the rotation of the sleeve (10) in the screwing direction forces the axial locking.
    [3" id="c-fr-0003]
    3. Surgical assembly (1) according to any one of claims 1 to 2, characterized in that the notches (7) each comprise a second lateral groove (8) opposite, and the lugs (12) each comprise a second lateral shoulder (12a) opposite.
    [4" id="c-fr-0004]
    4. Surgical assembly (1) according to claim 3, characterized in that the connection end (11) of the sleeve (10) comprises two longitudinal slots (14) diametrically opposed so as to form two elastic branches (11a), said slots (14) passing through the lugs (12) to form two pairs of lugs (12), the lugs (12) of each pair of lugs (12) being able to engage, approaching one the other by the elastic deformation of the branches (11a), in the corresponding notch (7) until the shoulders (12a) of the lugs (12) snap into the grooves (8) of the notches ( 7).
    [5" id="c-fr-0005]
    5. surgical assembly (1) according to claim 4, characterized in that the plug (2) comprises two radial notches (7) additional, diametrically opposed and evenly distributed on either side of the first notches (7), and the sleeve (10) comprises clamping lugs (13) longitudinally extending the connection end (11) of the sleeve (10), diametrically opposed and regularly distributed on either side of the lugs (12), said clamping lugs ( 13) being adapted to engage fitly in the notches (7).
    [6" id="c-fr-0006]
    6. Surgical assembly (1) according to any one of claims 4 to 5, characterized in that the locking rod (15) comprises an outer diameter fitted to the inner diameter of the hollow sleeve (10), so that in position for blocking the locking rod is positioned between the elastic branches (11a) of the sleeve (10) and prevents the unlocking of the cap-holder (3) by preventing the approximation of the elastic branches (1a) and the disengagement of the pairs of pins (12).
    [7" id="c-fr-0007]
    7. Surgical assembly (1) according to any one of claims 1 to 6, characterized in that the locking rod (15) is secured in the upper part to a trigger (16) for the passage of the locking rod (15). ) from the neutral position to the blocking position.
    [8" id="c-fr-0008]
    8. Surgical assembly (1) according to any one of claims 1 to 7, characterized in that the locking rod comprises a screw bit adapted to come into engagement, in the locking position, in the central recess (4) for screwing the plug (2).
    [9" id="c-fr-0009]
    9. Surgical assembly (1) according to any one of claims 5 to 8 characterized in that the clamping lugs (13) are longer than the lugs (12) to allow guiding the engagement of said lugs (12). ) in the notches (7).
    [10" id="c-fr-0010]
    10. Surgical assembly (1) according to any one of claims 1 to 9, characterized in that the plug (2) consists of two plugs screwed into one another, an outer plug (6) comprising the notches (7), and an inner plug (5) comprising the central recess (4) for screwing.
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    同族专利:
    公开号 | 公开日
    BR112018003543A2|2018-09-25|
    CN107920847A|2018-04-17|
    WO2017032938A1|2017-03-02|
    US10512491B2|2019-12-24|
    US20190083150A1|2019-03-21|
    FR3040284B1|2017-08-11|
    EP3340909B1|2019-07-31|
    KR20180050296A|2018-05-14|
    ES2742520T3|2020-02-14|
    CN107920847B|2021-06-22|
    EP3340909A1|2018-07-04|
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    法律状态:
    2016-08-30| PLFP| Fee payment|Year of fee payment: 2 |
    2017-03-03| PLSC| Search report ready|Effective date: 20170303 |
    2017-08-30| PLFP| Fee payment|Year of fee payment: 3 |
    2018-08-28| PLFP| Fee payment|Year of fee payment: 4 |
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    优先权:
    申请号 | 申请日 | 专利标题
    FR1557966A|FR3040284B1|2015-08-27|2015-08-27|SURGICAL ASSEMBLY FOR PLACING A SCREW SCREW CAP|FR1557966A| FR3040284B1|2015-08-27|2015-08-27|SURGICAL ASSEMBLY FOR PLACING A SCREW SCREW CAP|
    PCT/FR2016/052049| WO2017032938A1|2015-08-27|2016-08-08|Surgical assembly for placing a pedicle screw cover|
    BR112018003543-2A| BR112018003543A2|2015-08-27|2016-08-08|surgical set|
    KR1020187004046A| KR20180050296A|2015-08-27|2016-08-08|Surgical assembly for positioning a pedicle screw cap|
    CN201680046762.2A| CN107920847B|2015-08-27|2016-08-08|Surgical assembly for deploying pedicle screw caps|
    US15/746,804| US10512491B2|2015-08-27|2016-08-08|Surgical assembly for placing a pedicle-screw cap|
    ES16763894T| ES2742520T3|2015-08-27|2016-08-08|Surgical set for placing a pedicle screw cap|
    EP16763894.9A| EP3340909B1|2015-08-27|2016-08-08|Surgical assembly for placing a pedicle screw cover|
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