Surgical fixation system

Abstract

The invention relates to a surgical fixation system comprising at least one anchoring element (12) having an anchoring section (24) for anchoring at a bone (20) and having a receiving section (26) for a stabilizing element (16) for connecting with a further anchoring element (12), wherein the stabilizing element (16) can be arranged in the receiving section (26) and can be fixed therein by means of a fixation element (44), wherein the fixation system (10) comprises a counter element (22) arranged at the receiving section (26) and counter to the anchoring section (24) to counter the stabilizing element (16), wherein the counter element (22) has at least one deformation region (58) to deform depending on a fixation force of the stabilizing element (16) by the loading of the fixation element (44).

Description

Technical Field

[0001] The present invention relates to a surgical fixation system comprising at least one anchoring element having an anchoring section for anchoring to bone and a receiving section for a stabilizing element for connection to another anchoring element, wherein the stabilizing element can be disposed in the receiving section and can be fixed in the receiving section by means of a fixation element. Background Technology

[0002] This type of fixation system is used, for example, in the treatment of fractures in the spine. An anchoring element, such as a bone screw, particularly a stump screw, can be incorporated. For example, a rod-shaped stabilizing element can be inserted into the corresponding receiving section of the bone screw and clamped therein, for example, by means of a helical element. The receiving section can, for example, have two spaced-apart segments with an opening between them for the stabilizing element. The segments can, for example, have internal threads to be screwed onto the external threads of the helical element.

[0003] Depending on the treatment, it may be desirable or necessary, for example, to adapt stabilizing elements with different properties to anchoring elements. Stabilizing elements can, for example, be made of different materials and / or have different diameters in the case of rod elements.

[0004] US 2005 / 0277928 A1 describes a fixation system in which a receiving section with a substantially U-shaped mating element is provided to accommodate anchoring elements of different rod diameters. While rod elements of different diameters can be accommodated better in this case compared to conventional fixation systems, the U-shaped mating element results in varying spacing between the rod elements and the anchoring element. This is undesirable for treatment. The characteristics of the mating element also result in line or point support of the rod elements, with the risk of unstable fixation within the receiving section. Line and point supports can lead to loosening and / or corrosion effects due to the high fixation force applied by the fixation element. Fixation of bent rod elements is often clinically necessary, but may result in unfavorable mating of the rod elements to the mating element. This can therefore lead to restraint, loosening, breakage, and corrosion.

[0005] US 2005 / 0277928 A1 also describes that arms can be arranged at the docking element, which can be spread apart relative to each other for the introduction of the stabilizing element and can be brought closer together after introduction. This allows the stabilizing element to be temporarily fixed in the receiving section. Summary of the Invention

[0006] The objective of this invention is to provide a universal fixing system that can be used in a more diverse manner.

[0007] This task is accomplished in a fixing system of the type described at the beginning of this document according to the invention by means of a fixing system comprising a docking element arranged at the receiving section and mating with the anchoring section for docking with a stabilizing element, wherein the docking element has at least one deformable region to deform according to the fixing force of the fixing element on the stabilizing element.

[0008] In the fixation system according to the invention, it is possible for the stabilizing element to be fixed at the receiving section by a fixing element with a fixing force, particularly a clamping force. A mating element is provided at the receiving section, which is deformable at at least one deformation area due to the fixing force. Preferably, the mating element can be deformed in a defined deformation area. This allows different stabilizing elements, differing from each other in material and / or geometry (e.g., diameter), to better adapt to the receiving section. Simultaneously, the mating element engages at the anchoring section, thereby preferably allowing for better placement of the stabilizing element at the anchoring element. The anchoring element is preferably usable with multiple different stabilizing elements, wherein a consistent spacing with the anchoring elements is preferably achieved. The fixation system thus has greater versatility. This significantly simplifies the provision of fixation systems for different treatments. Preferably, the force acting on the stabilizing element can be homogenized due to the deformation of the mating element and / or a planar engagement can be achieved on the mating element when particularly reliably placed at the anchoring element. This allows for more reliable fixation of the stabilizing element compared to conventional fixation systems.

[0009] In a preferred embodiment of the invention, the docking element can be formed and arranged separately from the receiving section. This increases the versatility of the fixation system. For example, different docking elements can be provided, which can be selectively positioned in the receiving section depending on the treatment to be performed. In particular, there is the possibility of modularly constructing the fixation system. The respective advantages of these two components can be demonstrated with regard to the best possible supply by manufacturing the receiving section and at least one docking element separately.

[0010] In another advantageous embodiment, it can be specified that the receiving section includes or constitutes the docking element. This, for example, allows for simple manufacturing in terms of design structure.

[0011] Dating components are particularly prone to wrinkling due to the holding force of the fixing components.

[0012] It can be specified that the docking element is configured to be elastically deformable at least in at least one deformation region.

[0013] It can be specified that the docking element is configured to undergo plastic deformation at least in one deformation region.

[0014] In a preferred embodiment of the invention, the docking element can be integral.

[0015] It can be proven advantageous that at least one deformable region is arranged at or below one or more mating regions of the mating element used for stabilizing the element. The force of the fixing element can be directed, in particular through the stabilizing element, towards the mating region, especially the support region, or at least one deformable region of the mating element located below the mating element.

[0016] At least one deformable region can be alternatively or supplementarily arranged at or near the lateral mating region of the stabilizing element. The mating element, for example, has a lateral support mechanism for the stabilizing element, each of which includes a mating region. Lateral adaptation of the mating element and the stabilizing element can be achieved through deformation of the support mechanism.

[0017] In a preferred embodiment of the invention, the docking element can be defined as comprising a first docking element section facing the stabilizing element and a second docking element section facing the anchoring section. It is particularly advantageous that the first docking element section includes or constitutes at least one deformable region and has a higher deformability than the second docking element section, at least partially due to the fixing force. Adaptation to the stabilizing element and preferably a plurality of stabilizing elements can be achieved through the first docking element section, as already mentioned. Here, at least one deformable region can deform in terms of the size and / or shape of the stabilizing element according to the fixing force, and the docking element can thereby adapt to the stabilizing element. At the second docking element section, the docking element has a smaller deformability than at the first docking element section. Currently, this specifically refers to the docking element section being "stiffer" at the second docking element section than at the first docking element section. This allows for a more reliable placement at the anchoring section, preferably through force transmission and / or form-locking.

[0018] The mating element sections can be made of different materials, or when made of the same material, they can have different properties in terms of deformability.

[0019] The mating element segments can be formed separately from each other and then joined together. Alternatively, it can be specified that the mating element segments are formed integrally with each other.

[0020] Regarding the deformability of the mating elements, for example, discontinuous segment boundaries can be set between the first mating element segment and the second mating element segment. The deformability at the mating element segment can, for example, vary stepwise.

[0021] The section boundary is oriented, for example, laterally and especially perpendicularly to the fixing direction of the fixing element toward the anchoring section.

[0022] In a preferred embodiment, it can be specified that there is a transition section regarding the deformability of the docking elements, through which the first docking element section and the second docking element section can merge with each other.

[0023] In a preferred embodiment, at least one deformable region can have an extension parallel to the docking region of the docking element used for stabilizing elements.

[0024] It can be specified that at least one deformable region is symmetrically arranged or formed at the mating element about a plane of symmetry containing the receiving section. The mating element can be positioned coaxially with the receiving section. The plane of symmetry is, for example, the central plane of the receiving section. The symmetrical arrangement of the deformable regions advantageously enables the homogenization of the fixing force.

[0025] Advantageously, at least one deformable region is formed by or includes at least one material groove at the mating element.

[0026] Material grooves are, for example, grooves on the surface of mating elements, wherein the mating elements can deform at the edges of the grooves. It is advantageously possible to specify that the stabilizing element is shape-locked into the groove.

[0027] In a preferred embodiment of the invention, the material groove is or includes a through opening for the mating element. By forming one or more through openings, a simple structural transformation of the invention can be achieved. The mating element is, for example, wrinkled under a holding force, wherein the through opening has a shape change.

[0028] The through opening can have, for example, a circular, elliptical, olive-shaped, round, elongated, or non-circular cross-section. "Circular" can be understood in particular as non-angular in the present context.

[0029] It can be specified that the material groove has an extension along a stabilizing element arranged in the receiving section. The stabilizing element can have a preferred orientation due to the design of the receiving section, particularly having two segments arranged spaced apart from each other. The material groove can extend along this preferred orientation. This allows the mating element to better adapt to the geometry of the stabilizing element in terms of the most favorable possible deformation.

[0030] It can be specified that the material groove has a radial extension relative to the axis defined by the mating element.

[0031] In a preferred embodiment of the invention, the material groove is a fully enclosed cavity formed in the receiving element.

[0032] Advantageously, the mating element has two or more deformable sections, which are made of different materials or made of different materials in terms of their deformability, wherein at least one deformable region is formed due to the different properties of the materials of the two or more deformable sections.

[0033] Two deformation sections with different deformation capabilities are, for example, adjacent to each other. Due to force loading, the mating element can deform at the softer deformation section and / or in the transition section between the softer and less softer deformation sections.

[0034] Two or more deformable sections can be deformable sections formed separately from each other and joined together by the mating elements.

[0035] The alternative site can be specified that two or more deformation sections are formed integrally with each other.

[0036] Advantageously, a first deformable section is provided, which is at least partially surrounded by at least one second deformable section, wherein the deformability of the first deformable section is greater than the deformability of the at least one second deformable section. The second deformable section can completely surround the first deformable section.

[0037] In a preferred embodiment, three or more deformation sections can be provided, wherein the deformation capacity of a corresponding deformation section that at least partially surrounds another deformation section is less than the deformation capacity of the surrounded deformation section.

[0038] It can be specified that deformation zones with different deformation capacities are directly adjacent, so that the deformation capacity at the docking element changes discontinuously and gradually.

[0039] Alternatively, it can be specified that there are transition zones between deformation zones with different deformation capacities, so that the deformation capacity changes gradually and, in particular, continuously.

[0040] Advantageously, the mating element includes multiple deformable regions, particularly having multiple material grooves.

[0041] It can be specifically stipulated here that two or more deformation areas with identical designs be set.

[0042] It is possible to optionally or supplementarily set two or more differently designed deformation regions.

[0043] Two or more through openings at the mating element can be arranged and oriented, for example, parallel to each other.

[0044] It can be stipulated that multiple through openings are arranged "with gaps" relative to each other.

[0045] It can be proven advantageous to set up two deformation zones that are spaced apart from each other and arranged flush with each other at the mating element.

[0046] For example, the mating element, in a sleeve-shaped design, has two deformable regions that are exactly opposite to each other. These deformable regions, formed by a through opening or deformable sections with different deformable capacities, are preferably flush with each other. The direction of this flushing advantageously corresponds to the extension direction of the stabilizing element in the receiving section.

[0047] The docking element is preferably designed in a sleeve shape in at least a portion of its length, wherein the docking element has a docking area at one end for stabilizing the element. This end can be opposed, for example, to another end, through which the docking element can dock at the anchoring section.

[0048] The first mating element section mentioned above can include or form a mating area at the end side, for example.

[0049] In a preferred embodiment, the docking element can have two spaced-apart support mechanisms that laterally define a narrowed recess, wherein a stabilizing element can be positioned within the recess between the support mechanisms. The stabilizing element can be laterally supported by the support mechanisms and thereby advantageously secured in the receiving section.

[0050] Preferably, a deformation zone is arranged at at least one support structure, and more preferably at two support structures.

[0051] The docking element can preferably be oriented coaxially with or can be oriented with the receiving section and / or anchoring section.

[0052] Advantageously, the anchoring section and the mating element include mating areas that are adapted to each other, particularly at least partially crustal in shape. The anchoring element is, for example, a multi-axis screw with a spherical anchoring section. The corresponding mating element can thus be preferably fitted into the mating area of ​​the anchoring section in a form-locking manner and occupy a defined position relative to the anchoring section.

[0053] The second mating element section mentioned above can include or form a mating area at its end side. The mating area allows for reliable placement of the mating element using a preferred and optimized press fit at the anchoring section.

[0054] The mating elements are advantageously arranged in a form-locking configuration within the receiving section. The mating elements are, for example, positioned in a form-locking configuration between two spaced-apart segments of the receiving section.

[0055] The anchoring system can include, for example, two or more anchoring elements. The anchoring elements can preferably be designed uniformly.

[0056] The fixing system preferably includes two or more mating elements. It is possible to provide at least two mating elements with identical and / or at least two different designs.

[0057] The stationary system preferably includes at least one stabilizing element, and more particularly multiple stabilizing elements. At least two stabilizing elements can be designed identically. Alternatively, at least two stabilizing elements can be designed differently.

[0058] The fixing system preferably includes at least one fixing element, and more particularly multiple fixing elements. At least two fixing elements can be designed identically. At least two fixing elements can alternatively or additionally be designed differently.

[0059] At least one anchoring element is, for example, a bone screw. The bone screw can be a uniaxial screw. Alternatively, the bone screw can be a multiaxial screw, in which the receiving segment can pivot relative to the anchoring segment.

[0060] At least one stabilizing element is preferably a rod element.

[0061] At least one fixing element is preferably a screw element that can be screwed onto the receiving section.

[0062] For example, Ti6Al4V, titanium, PEEK, or CoCr alloys can be used as materials for mating components. Combinations of the aforementioned materials are conceivable.

[0063] The mating element, particularly in the deformation region, has an elastic modulus of approximately 50,000 to 150,000 MPa, or for example, approximately 100,000 to 120,000 MPa, for Ti6Al4V. The elastic modulus can be approximately 2,000 to 6,000 MPa (e.g., 3,000 to 4,000 MPa) for Peek and approximately 200,000 to 300,000 MPa, preferably approximately 230,000 to 270,000 MPa, for CoCr.

[0064] The fixation force exerted by the fixation element on the stabilizing element in the spinal fixation system is approximately 3 kN to about 7 kN in the lumbar region and approximately 0.8 kN to 2.5 kN in the cervical region.

[0065] In contrast, the forces acting on the stabilizing element are typically significantly smaller in the implanted state. For example, axial forces on the stabilizing element can reach up to approximately 300 N. Bending moments can reach, for example, approximately 8 Nm.

[0066] The deformation of the docking element according to the invention can be, for example, in the range of about 0.1 mm to 3 mm, preferably in the range of 0.2 mm to 1.5 mm. Attached Figure Description

[0067] The following description of preferred embodiments of the invention is intended to illustrate the invention in more detail with reference to the accompanying drawings. In the drawings: Figure 1 A schematic perspective view of a fixation system according to the invention for connecting two vertebrae to each other is shown. Figure 2 It shows Figure 1 A three-dimensional view of the docking components of the fixed system; Figure 3 The partial diagram shows Figure 1 A cross-sectional view of a fixed system, wherein the stabilizing element is mated according to Figure 2 The mating element is not yet loaded with a fixing force by the fixing element; Figure 4 It shows the corresponding Figure 3 The diagram shows that the stabilizing element is loaded with a fixed force by means of the fixing element and is thus clamped and fixed. Figure 5 and Figure 6 It shows the corresponding Figure 3 and Figure 4 A partial view, in which other types of docking elements are used; Figure 7 and Figure 8 It shows the corresponding Figure 3 and Figure 4 A partial view, in which other types of docking elements are used; Figure 9 and Figure 10 It shows the corresponding Figure 3 and Figure 4 A partial view, in which other types of docking elements are used; Figure 11 A perspective view of other types of docking elements used for stabilizing components is shown; Figure 12 and Figure 13 It shows the corresponding Figure 3 and Figure 4 A partial view, in which, using Figure 11 docking components; Figures 14 to 18 It shows the corresponding Figure 3 The corresponding partial diagrams show the use of other types of docking elements. Detailed Implementation

[0068] Figure 1 In a preferred embodiment of the invention, a fixation system generally labeled 10 is shown. The fixation system 10 includes, for example, an anchoring element 12 shaped like a bone screw 14.

[0069] The fixation system 10 includes four anchoring elements, wherein, according to the invention, at least one bone screw 14 is provided.

[0070] The fixation system 10 also includes at least one stabilizing element 16, wherein currently there are two stabilizing elements 16, which are designed as rod elements 18. Each pair of bone screws 14 is connected to each other via a rod element 18.

[0071] The fixation system 10 is used to stabilize the bone, in the currently adjacent vertebral body 20. For this purpose, bone screws 14 are used, especially for the stump.

[0072] The four bone screws 14 and two rod elements 18 are designed identically. We will now discuss only one of the bone screws 14 and one rod element 18.

[0073] The fixing system 10 also includes at least one docking element 22. A preferred embodiment of the docking element 22 is... Figures 2 to 4 As shown in the figure. Advantageously, each bone screw 14 is equipped with a mating element 22.

[0074] In particular, it can be specified that the docking element 22 is designed to be consistent.

[0075] Such as especially by Figure 3 and Figure 4 It is understood that the bone screw 14 includes an anchoring section 24 for anchoring in the bone and a receiving section 26 for the rod element 18. The bone screw 14 is currently a multi-axis screw, in which the receiving section 26 is pivotable relative to the anchoring section 24. For this purpose, the anchoring section 24 includes a spherical head 28 in the present case. The head 28 defines at least a portion of a crust-shaped mating region 30.

[0076] Anchorage section 24 defines axis 32. Receiving section 26 defines axis 34. In the relative orientation shown in the attached drawings of anchorage section 24 and receiving section 26, axes 32 and 34 coincide.

[0077] The receiving section 26 has two segments 36 arranged spaced apart from each other. Internal threads 38 are provided at the respective segments 36.

[0078] A through opening 40 is formed between the segments 36, through which the rod element 18 can be guided. The extension direction of the rod element 18 is preferably aligned with the axis 42 of the through opening 40.

[0079] To secure the rod element 18 within the receiving section 26, the securing system 10 includes a securing element 44. The securing element 44 is currently a helical element 46. The helical element 46 is capable of being tightened into the thread 38 of the section 36. This allows the rod element 18 to be loaded with a securing force directed towards the anchoring section 24 along the securing direction 47.

[0080] The docking element 22 is configured to support the rod element 18 relative to the anchoring section 24 in the present case. Here, the docking element 22 and the helical element 46 are arranged on opposite sides of the rod element 18.

[0081] The mating element 22 is formed separately from and arranged within the receiving section 26. Currently, the mating element 22 is designed such that it is shape-locked and positioned within the through opening 40 between the sections 36. The outer contour of the mating element 22 preferably matches the inner contour of the section 36. Currently, this corresponding contour is circular or arc-shaped. This allows the mating element 22 to be fixedly positioned within the receiving section 26 in a plane transverse to and, in particular, perpendicular to the axis 34.

[0082] As by Figures 2 to 4 Furthermore, in this example, the docking element 22 is designed in a sleeve shape with a central through opening, which defines axis 48. In the receiving section 26, the docking element 22 is arranged and oriented coaxially with this receiving section, wherein axes 34 and 48 are flush with each other. Depending on the relative orientation of the anchoring section and the receiving section 26, the docking element 22 can also be oriented coaxially with the anchoring section 24.

[0083] The docking element 22 currently includes an outer circumferential surface 50, an inner circumferential surface 52, a docking area 54 at the end facing the rod element 18, and a docking area 56 at the end facing the head 28.

[0084] The mating element 22 includes a first mating element section 55 and a second mating element section 57. The first mating element section 55 faces the rod element 18 and forms a mating area 54 on its end side. The second mating element section 57 faces the anchoring section 24, particularly the head 28 of the anchoring section. The second mating element section 57 forms a mating area 56 on its end side.

[0085] Referring to the fixed direction 47, the first mating element section 55 is arranged proximal to the rod element 18, and the second mating element section is arranged distal to the rod element 18. The opposite is true for the anchoring section 24, and particularly the head 28.

[0086] For the purpose of explanation, Figure 3 and Figure 4 The figure shows a fictitious separation plane between the docking element sections, indicated by dashed line 59. Docking element sections 55 and 57 are currently merged together, particularly in terms of their deformability, along a fixed direction 47. The transition section associated with this is not shown separately in the figure.

[0087] In other advantageous embodiments, it is possible to specify discontinuous segment boundaries between the mating element segments 55 and 57, particularly in terms of their deformability. These segment boundaries are, for example, transverse to and particularly perpendicular to the fixed orientation 47 (currently transverse to and particularly perpendicular to the drawing plane).

[0088] The docking area 56 is designed in a spherical shape and is adapted in shape to the docking area 30. When the receiving section 26 pivots relative to the anchoring section 24, the docking element 22 pivots along with it as long as the fixing element 44 is not fixed, wherein the docking area 56 is always in planar contact with the head 28.

[0089] The mating area 54 is currently designed as a planar surface and is formed by the annular end face of the mating element 22. The rod element 18 can mat with the mating area 54 and, in particular, lie flat on the mating area. Figure 3 and Figure 4 ).

[0090] The mating element 22 includes at least one deformable region 58. Currently, there are two deformable regions 58, which are arranged in sections of the mating element 22 that are exactly opposite to each other about the axis 48.

[0091] In the docking element 22, the first docking element segment 55 includes or forms at least one deformable region 58. In contrast, the second docking element segment 57 does not currently include or form a deformable region.

[0092] Due to at least one deformable region 58 (currently two deformable regions), the first mating element segment 55 has a greater deformability than the second mating element segment 57. Deformation is achieved by the retaining force of the fixing element 44 and enables the mating of the mating element 22 with the rod element 18. This is explained below.

[0093] In contrast, the second mating element section 57 is "harder" or "more rigid" than the first mating element section 55. This enables reliable placement at the head 28, thereby ensuring, for example, the planar contact mentioned above through the mating area 56.

[0094] The second docking element section 57 is able to remain largely undeformed, as previously explained, under the fixing force that typically occurs with the fixing element 44.

[0095] The deformability can gradually decrease from the first docking element segment 55 through the aforementioned transition segment to the second docking element segment 57. If segment boundaries are provided as previously mentioned, then a gradual change in deformability can occur, for example, from the first docking element segment to the second docking element segments 55 and 57.

[0096] The deformable region 58 is designed symmetrically with respect to each other about a first plane containing axes 34 and 48. This plane is in Figure 3 and Figure 4 The center extends in the plane of the attached drawing. Furthermore, the deformable region 58 is constructed symmetrically about the plane containing axes 34 and 48. This involves perpendicularity to... Figure 3 and Figure 4 The attached drawing plane is plane 60, wherein plane 60 is the center plane of receiving section 26 when the fixing system 10 is used as specified.

[0097] The deformation area 58 is located below the docking area 54.

[0098] At least one material groove exists at the corresponding deformation region 58. Currently, each deformation region 58 includes three material grooves designed as through openings 62 for mating with the element 22. The through openings 62 have a circular, and particularly perfectly circular, cross-section.

[0099] Of these through openings, two through openings 62 are designed identically and arranged symmetrically with respect to plane 60. A third through opening 62 is arranged with a gap relative to the two through openings 62 and is also arranged symmetrically with respect to plane 60. The last through opening 62 mentioned has a larger diameter than the first through opening 62 mentioned.

[0100] The through openings 62 are flush with each other at the deformable regions 58 that are opposite each other about the axis 48. Here, the through openings 62 are oriented along the extension direction of the rod element 18. The through openings 62 are preferably oriented parallel to the axis 42.

[0101] The through opening 62 is currently parallel to the plane defined by the docking area 54.

[0102] When using the fixing system 10, the rod element 18 is loaded by the helical element 46 with a fixing force pointing towards the docking element 22 and through this docking element towards the head 28. Figure 4 The fixing force causes deformation of the mating element 22 at the deformation region 58. Preferably, targeted deformation can be achieved.

[0103] The possibility exists that rod elements 18 with different properties, especially different materials and / or different diameters, can be adapted to bone screws 14. Individual bone screws 14 are not required. This increases the versatility of the fixation system 10.

[0104] The deformation of the mating element 22 enables a planar contact area, particularly between the rod element 18 and the mating element 22. This facilitates uniformity of the press fit and helps avoid point and line contacts. In this way, reliable fixation of the rod element 18 is ensured, thus resisting potential corrosion formation.

[0105] The more rigid mating element section 57 compared to the mating element section 55 ensures a reliable fit with the head 28.

[0106] The deformation of the docking element 22 can be plastic or elastic.

[0107] The docking element 22 is preferably constructed as a single unit.

[0108] Regarding the advantageous materials and the forces that arise when using the fixing system 10, refer to the aforementioned implementation scheme.

[0109] Next reference Figures 5 to 18 Further preferred embodiments of the invention will be explored. Here, each is replaced with the one in the present invention. Figures 1 to 4 The mating element 22 shown is used in conjunction with other types of mating elements. The use of bone screw 14 and rod element 18 is shown respectively.

[0110] The advantages described above can also be achieved when using the mating components described below, and the aforementioned implementation scheme can be referred to in this regard. Figure 5 and Figure 6 , Figure 7 and Figure 8 , Figure 9 and Figure 10 as well as Figure 12 and Figure 13 The diagram corresponds to Figure 3 or Figure 4 The illustration is shown in partial view.

[0111] Figures 14 to 18 The diagram corresponds to the one based on Figure 3 The illustration is shown in a partial view. Here, the corresponding mating element 22 is not loaded with a fixing force, but is shown in its unloaded state for clearer illustration.

[0112] Figures 5 to 18 The embodiments shown each have a docking element 22, which preferably has docking element sections 55 and 57 for the rod element 18 or for the anchoring section 24, especially the head 28. Here, the deformation capacity at the docking element section 55 is higher than that at the docking element section 57, wherein the docking element section 55 includes or constitutes at least one deformation region 58.

[0113] according to Figure 5 and Figure 6 The mating element 22 has only one through opening 62 at the corresponding deformation region 58. In the unloaded state, the through opening 62 is approximately rounded, an isosceles triangle stretched in width, or a wankelform shape. In the loaded state, the through opening 62, depending on the fixing force, is, for example, arc-shaped.

[0114] exist Figures 7 to 10 In the embodiment shown, each deformable region 58 is also provided with only one through opening 62.

[0115] According to Figure 7 and Figure 8 In this embodiment, the through opening 62 is elliptical in the unloaded state. In the loaded state, the through opening 62 is arc-shaped, depending on the fixing force.

[0116] Through opening 62 according to Figure 9 and Figure 10 In the embodiment, the unloaded end is approximately C-shaped, with a corresponding "C" pointing towards the rod element 18. In the loaded state, the through opening 62 has an approximately U-shaped shape with an edge pointing towards the rod element 18.

[0117] Figure 11 One embodiment of the docking element 22 is shown, which includes a sleeve-shaped section 64. Two support mechanisms 66, opposing each other about axis 48, protrude from the section 64. The respective support mechanisms 66 form a lateral docking area 68 for the rod element 18.

[0118] Deformation regions 58 are arranged at the corresponding support mechanism 66. Each deformation region 58 has a through opening 62 with an elongated cross-section, which extends parallel to the axis 42.

[0119] A recess 70 is arranged between the support mechanisms 66, which narrows along the guide direction of the rod element 18. The recess 70 ensures that the rod element 18 is centered and oriented relative to the receiving section 26.

[0120] The rod element 18 can contact the mating area 68. The contact between the rod element 18 and the mating area 54 can also be specified (not shown).

[0121] In the embodiments described so far, the deformable regions 58 each include at least one material groove, particularly in the shape of a through opening 62.

[0122] In contrast, Figures 14 to 18The corresponding mating element 22 shown does not have a material groove. Instead, the corresponding deformation region 58 is formed by deformation sections of the mating element 22 that have different deformation capabilities.

[0123] According to Figures 14 to 17 The diagram shows two deformable regions 58 that are opposite each other about axis 48. The attached diagram only shows one deformable region 58.

[0124] according to Figure 14 The docking element 22 includes a first deformable section 72 and a second deformable section 74. The second deformable section 74 is formed from a sleeve-shaped base of the docking element 22, with a concave groove partially slotted from the base on the side facing the rod element 18. This groove is filled by the first deformable section 72.

[0125] The deformation capacity of the first deformation section 72 is higher than that of the second deformation section 74. Under load, the mating element 22 therefore deforms more strongly at the first deformation section 72 than at the second deformation section 74 to accommodate the rod element 18.

[0126] According to Figure 15 The docking element 22 also has two deformation sections 72 and 74.

[0127] According to Figure 14 In the embodiment, the second deformed section 74 only partially surrounds the first deformed section 72, while according to Figure 15 In this embodiment, the deformable section 72 is completely surrounded by the deformable section 74 in the circumferential direction. However, the deformable section 72 can extend, for example, from the outer circumferential surface 50 to the inner circumferential surface 52.

[0128] In cross-section, the deformed section 72 has an approximately elliptical shape.

[0129] according to Figure 16 Implementation methods and basis Figure 14 The difference in the implementation method lies in that the first deformable section 72 is arranged within the groove of the second deformable section 74, which itself is arranged within the groove of the substrate of the mating element 22 that constitutes the third deformable section 76. The second deformable section 74, to a certain extent, constitutes a transition section from the first deformable section 72 to the third deformable section 76, wherein this deformable section 76 corresponds to... Figure 14 The second modified section 74 in the implementation method.

[0130] The deformation capacity at the second deformation section 74 is particularly smaller than that at the first deformation section 72, and the deformation capacity at the third deformation section 76 is smaller than that at the second deformation section 74.

[0131] according to Figure 17 Implementation methods and basis Figure 15 The difference in the implementation method is that, as in accordance with Figure 16 In this embodiment, three deformation sections 72 to 76 are provided. Here, deformation section 72 is completely surrounded by deformation section 74, and deformation section 74 is completely surrounded by deformation section 76. The deformation capability of the docking element 72 increases from the first deformation section 72 through the second deformation section 74 to the third deformation section 76.

[0132] It can be specified that the deformation capacity increases discontinuously between adjacent deformation sections. It can also be specified that the deformation capacity increases continuously.

[0133] according to Figure 18 The docking element 22 in the embodiment has a base 78, the shape of which is as close as possible to... Figures 11 to 13 The shapes of the docking elements are consistent. A sleeve-shaped section 64 with a support mechanism 66 is provided. However, no deformation area 58 is provided at the support mechanism 66, and in particular, no through opening 62 is provided.

[0134] Another section 80 of the mating element 22 is positioned in the recess 70, and the rod element 18 mats at this other section. Section 80 has a higher deformability than the base 78 and forms a basin-shaped receiving portion for the rod element 18.

[0135] According to Figure 14 and Figure 18 In the implementation, it can be specified that the corresponding segments of the docking element 22 are formed independently of each other and connected to each other. An alternative design scheme for the corresponding docking element 22 as an integral unit is conceivable.

[0136] List of reference numerals in the attached diagram: 10 Fixed System 12 Anchoring elements 14 Bone screws 16 Stabilizing Elements 18-bar component 20 vertebra body 22. Dating components 24 Anchorage Section 26 Acceptance Section 28 heads 30 docking areas Axis lines 32 and 34 36 segments 38 internal thread 40 through opening 42 axis 44 Fixing elements 47 Fixed direction 46. ​​Spiral element 48 axis 50 and 52 circumferential surfaces Docking areas 54 and 56 55 and 57 docking component sections 58 Deformation Area 59 Separation plane 60 symmetry plane 62 Through opening Section 64 66 Supporting Institutions 68 docking area 70 recess Deformation sections 72, 74, and 76 78 matrix Section 80.

Claims

1. A surgical fixation system comprising at least one anchoring element (12) having an anchoring section (24) for anchoring to bone (20) and a receiving section (26) for a stabilizing element (16) for connection to another anchoring element (12), wherein, The stabilizing element (16) can be arranged in the receiving section (26) and fixed in the receiving section by means of the fixing element (44), wherein the fixing system (10) includes a docking element (22) arranged in the receiving section (26) and docking with the anchoring section (24) to dock with the stabilizing element (16), wherein the docking element (22) has at least one deformable region (58) to deform according to the fixing force of the fixing element (44) loading the stabilizing element (16), wherein the docking element (22) has a docking region (54) for the stabilizing element (16) at its end side, characterized in that the docking element (22) is at least partially segmentally designed as a sleeve shape, and at least one deformable region (58) is arranged below or at the docking region (54) of the docking element (22) for the stabilizing element (16) and configured to adapt the docking region (54) to the size and / or shape of the stabilizing element (16).

2. The fixing system according to claim 1, characterized in that, The docking element (22) a) Formed separately from and arranged in the receiving section (26), or the receiving section (26) includes or constitutes the docking element (22). and / or b) Constructed at least one deformation region (58) to be elastically or plastically deformable.

3. The fixing system according to claim 1 or 2, characterized in that, The docking element (22) includes two support mechanisms (66) arranged spaced apart from each other, and at least one deformable region (58) is arranged at or near the lateral docking region (68) of the support mechanism (66) for the stabilizing element (16).

4. The fixing system according to claim 1 or 2, characterized in that, The docking element (22) includes a first docking element section (55) facing the stabilizing element (16) and a second docking element section (57) facing the anchoring section (12), wherein the first docking element section (55) includes or constitutes at least one deformable region (58) and has a higher deformation capacity than the second docking element section (57) due to the fixing force.

5. The fixing system according to claim 4, characterized in that... At least one of the following: a) The boundary of the segment between the first docking element segment (55) and the second docking element segment (57) where the deformability of the docking element (22) is discontinuous. and b) Regarding the deformation capability of the docking element (22), there is a transition section through which the first docking element section (55) and the second docking element section (57) merge with each other.

6. The fixing system according to claim 5, characterized in that, The boundary of the section is oriented laterally to the anchoring section (24) in the direction of the fixing direction of the fixing element (44).

7. The fixing system according to claim 6, characterized in that, The boundary of the section is oriented laterally and perpendicularly to the fixing direction of the fixing element (44) toward the anchoring section (24).

8. The fixing system according to claim 1 or 2, characterized in that, The at least one deformable region (58) has an extension parallel to the docking region (54) of the docking element (22) for the stabilizing element (16).

9. The fixing system according to claim 1 or 2, characterized in that, The at least one deformable region (58) is symmetrically arranged or formed at the docking element (22) about a plane (60) of symmetry about the axis (34) of the receiving section and / or the docking element (22).

10. The fixing system according to claim 1 or 2, characterized in that, The at least one deformable region (58) is formed by or includes at least one material groove at the docking element (22).

11. The fixing system according to claim 10, characterized in that, The material groove a) is a material groove on the surface of the mating element (22), wherein the mating element (22) is deformable at the edge of the groove. or b) is or includes the through opening (62) of the docking element (22).

12. The fixing system according to claim 11, characterized in that, The through opening (62) has a circular or non-circular cross-section.

13. The fixing system according to claim 12, characterized in that, The through opening has an elliptical, olive-shaped, annular, or elongated cross-section.

14. The fixing system according to claim 10, characterized in that, The material groove shall have at least one of the following: a) Having an extension along the stabilizing element (16) arranged in the receiving section (26), and b) Having a radial extension relative to the axis (48) defined by the docking element (22), and c) is a fully enclosed cavity formed in the docking element (22).

15. The fixing system according to claim 1 or 2, characterized in that, The docking element (22) includes two or more deformable sections (72, 74, 76), the deformable sections being made of different materials or made of different materials with respect to their deformability, wherein at least one deformable region (58) is formed due to the different material properties of the two or more deformable sections (72, 74, 76).

16. The fixing system according to claim 15, characterized in that, The two or more deformable sections (72, 74, 76) are deformable sections of the docking element (22) that are formed separately from each other and joined together.

17. The fixing system according to claim 16, characterized in that, A first deformable section (72) is provided, which is at least partially surrounded by at least one second deformable section (74), wherein the deformability of the first deformable section (72) is greater than the deformability of the at least one second deformable section (74).

18. The fixing system according to claim 15, characterized in that, There are three or more deformation sections (72, 74, 76), wherein the deformation capacity of the corresponding deformation section (72, 74, 76) that at least partially surrounds another deformation section (72, 74, 76) is less than the deformation capacity of the surrounded deformation section (72, 74, 76).

19. The fixing system according to claim 1 or 2, characterized in that, The docking element (22) includes multiple deformable regions (58).

20. The fixing system according to claim 19, characterized in that, The multiple deformation regions (58) include multiple material grooves.

21. The fixing system according to claim 19, characterized in that, The system may provide two or more identically designed deformation regions (58), or two or more differently designed deformation regions (58).

22. The fixing system according to claim 19, characterized in that, Two deformable regions (58) are provided, which are spaced apart from each other and arranged flush with each other at the mating element (22).

23. The fixing system according to claim 3, characterized in that, The docking element (22) shall have at least one of the following: a) It has two deformable regions that are exactly opposite to each other (58). and b) The two support mechanisms (66) laterally define a narrowed recess (70), wherein the stabilizing element (16) is positionable between the support mechanisms (66) within the recess (70). and c) Oriented coaxially with the receiving section (26) and / or the anchoring section (24).

24. The fixing system according to claim 23, characterized in that, A deformation zone (58) is arranged at at least one support structure (66).

25. The fixing system according to claim 1 or 2, characterized in that, The anchoring section (24) and the docking element (22) include docking areas that are adapted to each other.

26. The fixing system according to claim 25, characterized in that, The docking area is at least partially shaped like the Earth's crust.

27. The fixing system according to claim 1 or 2, characterized in that, The fixed system includes at least one of the following: - Two or more anchoring elements (12); - Two or more mating elements (22); - At least one stabilizing element (16); - At least one fixing element (44).

28. The fixing system according to claim 27, characterized in that, The fixing system includes multiple fixing elements (44).

29. The fixing system according to claim 27, characterized in that, The fixing system includes multiple stabilizing elements (16).

30. The fixing system according to claim 1 or 2, characterized in that... At least one of the following: - The at least one anchoring element (12) is a bone screw (14). - The at least one stabilizing element (16) is a rod element (18). - The at least one fixing element (44) is a screw element (46) that can be screwed onto the receiving section (26).

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