Fixing and strengthening device for locking nail plate with angle based on lumbar vertebra oblique lateral approach

Abstract

The invention provides a lumbar oblique lateral approach-based angled locking nail plate fixation strengthening device, which comprises a locking plate, hollow screws, a fusion cage and a bone cement injection assembly, the locking plate is attached to a target position of a vertebral body, the two hollow screws are fixedly connected with the locking plate, the two hollow screws are obliquely arranged, and the fusion cage is fixedly connected with the locking plate. The vertical distance between the upper vertebral body and the lower vertebral body is gradually increased along the side close to the locking plate and attached to the vertebral body; the fusion cage is arranged in an intervertebral space between the upper vertebral body and the lower vertebral body and is fixedly connected with the locking plate; a pushing and injecting channel is formed in the bone cement pushing and injecting assembly, a drainage channel is formed in the hollow screw, and when the bone cement pushing and injecting assembly and the hollow screw are fixedly connected in place, the pushing and injecting channel is communicated with the drainage channel, so that the bone cement enters the vertebral body from the drainage channel. By means of double-hollow-screw locking and bone cement reinforcement of the screw channel, the stability of the whole structure is improved, stable internal fixation can be achieved, and the fusion rate is increased.

Description

Technical Field

[0001] The invention relates to the technical field of medical equipment, and in particular to a lumbar oblique lateral approach with an angle-locked nail plate fixation reinforcement device. Background Art

[0002] Spinal fusion was proposed by Hibbs and Albee in 1911. After more than 100 years of development, it has become one of the most commonly used surgical techniques in spinal surgery. There are various fusion techniques used to treat lumbar diseases, such as anterior lumbar interbody fusion [ALIF], posterior lumbar interbody fusion [PLIF], transforaminal lumbar interbody fusion [TLIF], and extreme lateral interbody fusion [XLIF], to meet the requirements of changing indications, safety, and effectiveness. In the past 20 years, minimally invasive spinal technology has continued to develop and become popular. With its ability to reduce trauma, intraoperative bleeding, bed rest time, and complications while ensuring clinical efficacy, people are increasingly hoping to solve lumbar diseases through minimally invasive surgery. Among them, oblique lateral approach interbody fusion [OLIF] is the most common.

[0003] There are three ways to add internal fixation after Cage placement in oblique lateral approach interbody fusion. The first is no internal fixation, the second is lateral screwing, and the third is posterior pedicle screw internal fixation. If posterior pedicle screw internal fixation is used, the position needs to be changed for secondary disinfection, which prolongs the operation time. For single-segment patients, lateral screwing is the best choice. However, due to the well-developed psoas major muscle, the lateral approach uses a traditional screw-rod system, and the protruding tail cap and screw rod of the screw can easily cause psoas major muscle irritation.

[0004] The applicant has found that the prior art has at least the following technical problems:

[0005] In the prior art, parallel endplate screws are used for fixation. However, this fixation structure has poor stability, and low bone density increases the risk of fusion device sinking, especially in patients with severe osteoporosis, where the sparse trabecular structure greatly reduces the holding force of the vertebral body on the screw. In cases of lumbar spinal stenosis with osteoporosis, the vertebral body strength is insufficient, resulting in micro-motion at the interface between the fusion device and the endplate that has not been completely fused after surgery. Over time, this leads to endplate collapse and an increased probability of fusion device sinking.

[0006] For patients with osteoporosis, posterior pedicle screw bone cement reinforcement treatment is usually performed in one or two stages on the basis of lateral fusion, or bone cement is poured into the upper and lower vertebral screw channels under direct vision after the screws are screwed out, and then the screws are screwed in. The former requires changing the body position and performing secondary disinfection, which prolongs the operation time. The latter requires repeated screwing out, which causes damage to the screw channel.

[0007] In summary, the prior art methods of parallel endplate nail-rod fixation and bone cement treatment have poor stability, complex operation, low surgical efficiency, and increase the pain of patients. Summary of the invention

[0008] The purpose of the present invention is to provide a lumbar oblique lateral approach with angled locking nail plate fixation reinforcement device to solve the technical problems of poor stability, complicated operation and low surgical efficiency in the parallel end plate nail rod fixation method in the prior art. The preferred technical solutions among the many technical solutions provided by the present invention can produce many technical effects as described below.

[0009] To achieve the above object, the present invention provides the following technical solutions:

[0010] The invention provides a lumbar oblique lateral approach angled locking nail plate fixation reinforcement device, comprising a locking plate, a hollow screw, a fusion device and a bone cement injection assembly, wherein:

[0011] The locking plate fits the target position of the vertebral body, and there are two hollow screws fixedly connected to the locking plate. The two hollow screws are arranged obliquely and screwed into the upper vertebral body and the lower vertebral body respectively, and the vertical distance between the two gradually increases along the side close to the locking plate fitting the vertebral body;

[0012] The fusion device is placed in the intervertebral space between the upper vertebral body and the lower vertebral body and is fixedly connected to the locking plate;

[0013] The bone cement push assembly is provided with a push channel, and the hollow screw is provided with a drainage channel. When the bone cement push assembly is fixedly connected to the hollow screw, the push channel is connected to the drainage channel, so that the bone cement enters the vertebral body through the drainage channel.

[0014] Preferably, the locking plate is provided with upper vertebral body screw holes, a center hole, and lower vertebral body screw holes at intervals along its length direction, wherein:

[0015] The upper vertebral body screw hole and the lower vertebral body screw hole are both oblique holes, and the distance between the upper vertebral body screw hole and the lower vertebral body screw hole gradually increases along the side close to the locking plate that fits the vertebral body;

[0016] One of the hollow screws passes through the upper vertebral body screw hole and is screwed into the upper vertebral body, and the other hollow screw passes through the lower vertebral body screw hole and is screwed into the lower vertebral body. The fusion device is fixedly connected with a screw rod, and the screw rod is threadedly connected to the center hole.

[0017] Preferably, the upper vertebral body screw hole is arranged along a side close to the locking plate that abuts against the vertebral body and is inclined upward, and the angle between the screw hole and the horizontal plane is 5°-10°;

[0018] The lower vertebral body screw hole is arranged along a side close to the locking plate that is attached to the vertebral body and is inclined downward, and the angle between the screw hole and the horizontal plane is 5°-10°;

[0019] When the locking plate fits the target position of the vertebral body, the upper vertebral body screw hole is located at the lower 1 / 3 of the front edge of the upper vertebral body, and the lower vertebral body screw hole is located at the upper 1 / 3 of the front edge of the lower vertebral body.

[0020] Preferably, the locking plate has a contoured surface that fits anatomically with the arcuate surface of the lateral edge of the vertebral body, and the end angle of the locking plate is arc-shaped.

[0021] Preferably, the drainage channel comprises a hollow cavity and a side opening, wherein:

[0022] The hollow cavity is located in the hollow screw and is arranged along its central axis, and only one end of the hollow cavity is open for inserting the bone cement push assembly;

[0023] The side openings are formed on the side walls of the hollow screw and are communicated with the hollow cavity. The side openings are arranged at intervals along the length direction of the hollow screw.

[0024] Preferably, the hollow screw comprises an integrally formed screw body and a screw head, the outer diameter of the screw head gradually increases in a direction away from the screw body, and the screw head is positioned in the upper vertebral body screw hole or the lower vertebral body screw hole;

[0025] The pitch of the external thread on the hollow screw gradually decreases along the direction from the conical end of the screw body to the screw head.

[0026] Preferably, the fusion device is provided with a side threaded hole for threaded connection with the nail rod, and the surface of the fusion device is provided with concave and convex patterns, and the surface shape of the fusion device matches the vertebral body.

[0027] Preferably, the bone cement injection assembly comprises an extension tube, a guide and an injector, wherein:

[0028] The extension tube is provided with an insertion portion, the hollow screw is provided with a slot, and the insertion portion is plugged and fixed in the slot;

[0029] The guide is fixedly connected to the extension tube, and a portion of the guide extends into the extension tube;

[0030] The push channel is formed in the pusher, one end of the pusher is fixedly connected to the guide, a part of the pusher extends into the guide and the drainage channel, and the push channel is connected to the drainage channel for injecting bone mud into the drainage channel.

[0031] Preferably, the hollow screw is provided with a positioning center groove, and one end of the guide located in the extension tube is inserted into the positioning center groove;

[0032] The guide is located at one end of the extension tube and is provided with a fixed ring groove. The injector comprises a hook body, and the hook body is fixedly engaged with the fixed ring groove.

[0033] Preferably, the injector further comprises an injection tube, wherein:

[0034] The push injection tube passes through the hook body and is fixedly connected to the hook body, the push injection channel is formed in the push injection tube, the push injection channel is arranged along the axis of the push injection tube and passes through the opposite ends of the push injection tube, and the push injection tube passes through the cavity of the guide and extends into the drainage channel.

[0035] The device for fixing and strengthening the lumbar spine with an angled locking nail plate based on an oblique lateral approach provided by the present invention has the following beneficial effects compared with the prior art: the two hollow screws are both arranged obliquely and screwed into the upper vertebral body and the lower vertebral body respectively to prevent the hollow screws from coming out, the fusion device is located in the intervertebral space, and the stability of the overall structure is increased by locking the double hollow screws and strengthening the nail channel with bone cement. The device solves the problem of lumbar internal fixation with a single approach and position, and can directly perform bone cement strengthening operations under the OLIF channel, strengthen the vertebral body, reconstruct the vertebral endplate, and can largely solve the problems of loose internal fixation, sinking of the fusion device, and postoperative psoas muscle irritation and trauma. At the same time, it can achieve stable internal fixation and improve the fusion rate. BRIEF DESCRIPTION OF THE DRAWINGS

[0036] In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings required for use in the embodiments or the description of the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative work.

[0037] Figure 1 It is a schematic diagram of the fixation structure of the lumbar oblique lateral approach with angled locking screw plate fixation reinforcement device and the vertebral body;

[0038] Figure 2 It is a schematic diagram of the fixing structure of the locking plate, hollow screws, fusion cage and vertebral body;

[0039] Figure 3 It is a schematic diagram of the position of the fusion device;

[0040] Figure 4 is a schematic diagram of the structure of the locking plate;

[0041] Figure 5It is a schematic diagram of the overall structure of the hollow screw;

[0042] Figure 6 is a schematic diagram of the axial cross-sectional structure of a hollow screw;

[0043] Figure 7 Schematic diagram of the matching structure of the fusion device and the nail rod;

[0044] Figure 8 It is a schematic diagram of the coordination structure of the locking plate, the hollow screw and the fusion device;

[0045] Fig. 9 It is a schematic diagram of the matching structure of the bone cement push injection component and the hollow screw;

[0046] Fig.10 It is an axial schematic diagram of the cooperation between the bone cement push assembly and the hollow screw;

[0047] Fig.11 yes Fig.10 A partial enlarged view of point A in the middle.

[0048] In the figure, 100, upper vertebral body; 200, lower vertebral body; 1, locking plate; 11, upper vertebral body screw hole; 12, center hole; 13, lower vertebral body screw hole; 2, hollow screw; 21, drainage channel; 211, hollow cavity; 212, side opening; 22, screw body; 23, screw head; 24, slot; 25, positioning center groove; 3, fusion device; 31, side threaded hole; 32, concave and convex pattern; 4, bone cement injection assembly; 41, extension tube; 411, insertion part; 42, guide; 421, fixing ring groove; 43, injector; 430, injection channel; 431, injection tube; 5, nail rod. DETAILED DESCRIPTION

[0049] To make the purpose, technical solution and advantages of the present invention clearer, the technical solution of the present invention will be described in detail below. Obviously, the described embodiments are only part of the embodiments of the present invention, rather than all the embodiments. Based on the embodiments of the present invention, all other implementation methods obtained by ordinary technicians in this field without creative work belong to the scope of protection of the present invention.

[0050] In the description of the present invention, it should be understood that the terms "center", "length", "width", "height", "up", "down", "front", "back", "left", "right", "vertical", "horizontal", "top", "bottom", "inside", "outside", "side" and the like indicate positions or positional relationships based on the positions or positional relationships shown in the drawings, and are only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore cannot be understood as limiting the present invention. In the description of the present invention, unless otherwise specified, "plurality" means two or more.

[0051] The embodiment of the present invention provides an angle-locked nail plate fixation reinforcement device based on the lumbar oblique lateral approach, which can largely solve the internal fixation loosening, fusion device sinking, and postoperative psoas muscle irritation and trauma. At the same time, it can achieve stable internal fixation and improve the fusion rate.

[0052] Combine the following Figure 1-Figure 11 The technical solution provided by the present invention is described in more detail.

[0053] The invention provides a lumbar oblique lateral approach angled locking nail plate fixation reinforcement device, comprising a locking plate 1, a hollow screw 2, a fusion device 3 and a bone cement injection assembly 4, wherein: the locking plate 1 is fitted with the target position of the vertebral body, and there are two hollow screws 2 fixedly connected to the locking plate 1, and the two hollow screws 2 are both inclined and screwed into the upper vertebral body 100 and the lower vertebral body 200, respectively, and the vertical distance between the two gradually increases along the side close to the locking plate 1 fitting the vertebral body; see Figure 1-Figure 3 As shown, Figure 3 In order to clearly illustrate the position of the fusion device 3, some bone structures are omitted. The fusion device 3 is placed in the intervertebral space between the upper vertebral body 100 and the lower vertebral body 200, and is fixedly connected to the locking plate 1; a pushing channel 430 is provided in the bone cement pushing assembly 4, and a drainage channel 21 is provided in the hollow screw 2. When the bone cement pushing assembly 4 and the hollow screw 2 are fixedly connected in place, the pushing channel 430 is connected to the drainage channel 21, so that the bone cement enters the vertebral body through the drainage channel 21.

[0054] The locking plate 1 may be a steel plate to improve the structural strength. Figure 1 and Figure 2 As shown, the locking plate 1 is installed on the lateral side of the vertebral body and fits the vertebral body. Specifically, the locking plate 1 is installed at the position of 1 / 2 of the vertebral body in the lateral X-ray.

[0055] See also Figure 8As shown, after the hollow screw 2 and the locking plate 1 are fixed in place, the hollow screw 2 is tilted and has a non-zero angle with the horizontal plane. The fixation effect of the angled hollow screw 2 is better than that of the parallel end plate nail rod fixation. The tilted setting of the hollow screw 2 can obtain better segment stability, and the risk of damaging blood vessels and nerves can be reduced due to the middle position of the nail. Therefore, it is an OLIF-assisted lateral fixation method with clinical promotion value. The use of lateral fixation combined with angled nail placement can further increase the stability of the surgical segment.

[0056] As an optional embodiment, the locking plate 1 has a contoured surface that fits the vertebral body side arc surface anatomically, and the end angle of the locking plate 1 is arc-shaped. Specifically, the locking plate 1 has a width of 10 mm (not limited), a thickness of 5 mm (not limited), and a length determined according to the measurement results.

[0057] This structure enables the locking plate 1 to better fit the outer contour of the vertebral body, thereby improving the fixation effect.

[0058] As an alternative embodiment, see Figure 4 and Figure 8 As shown, the locking plate 1 is provided with an upper vertebral screw hole 11, a center hole 12, and a lower vertebral screw hole 13 at intervals along its length direction, wherein: the upper vertebral screw hole 11 and the lower vertebral screw hole 13 are both oblique holes, and the distance between the upper vertebral screw hole 11 and the lower vertebral screw hole 13 gradually increases along the side close to the locking plate 1 that fits the vertebral body; one of the hollow screws 2 passes through the upper vertebral screw hole 11 and is screwed into the upper vertebral body 100, and the other hollow screw 2 passes through the lower vertebral screw hole 13 and is screwed into the lower vertebral body 200, and the fusion device 3 is fixedly connected with a nail rod 5, and the nail rod 5 is threadedly connected to the center hole 12.

[0059] Since the upper vertebral body screw hole 11 and the lower vertebral body screw hole 13 are both oblique holes, the distance between the upper vertebral body screw hole 11 and the lower vertebral body screw hole 13 gradually increases along the side close to the locking plate 1 that fits the vertebral body. When one of the hollow screws 2 passes through the upper vertebral body screw hole 11, it is in an inclined state, and the other hollow screw 2 passes through the lower vertebral body screw hole 13, and it is also in an inclined state. Figure 8 shown.

[0060] The above structure facilitates the hollow screw 2 to be in an inclined state after being detachably connected to the locking plate 1, and facilitates the hollow screw 2 to be screwed into the upper vertebral body 100 or the lower vertebral body 200 in an inclined state, thereby improving the stability of the structure and further increasing the stability of the surgical segment.

[0061] As an alternative embodiment, see Figure 4As shown, the upper vertebral screw hole 11 is inclined upward along the side close to the locking plate 1 that fits the vertebral body, and the angle between it and the horizontal plane is 5°-10°; the lower vertebral screw hole 13 is inclined downward along the side close to the locking plate 1 that fits the vertebral body, and the angle between it and the horizontal plane is 5°-10°; preferably, the angle between the upper vertebral screw hole 11 and the horizontal plane is 5°, and the angle between the lower vertebral screw hole 13 and the horizontal plane is 5°; when the locking plate 1 fits the target position of the vertebral body, the upper vertebral screw hole 11 is located at the lower 1 / 3 of the front edge of the upper vertebral body 100, and the lower vertebral screw hole 13 is located at the upper 1 / 3 of the front edge of the lower vertebral body 200.

[0062] In the prior art, with the large-scale development of OLIF, the incidence of complications caused by it has gradually increased, among which the incidence of fusion cage 3 sinking and endplate fracture is as high as 18.7%. Fusion cage 3 sinking is the most common complication of OLIF. There are various reasons for the sinking of fusion cage 3. At present, most scholars generally agree that lower bone density values ​​will increase the risk of sinking of fusion cage 3, especially in patients with severe osteoporosis. The sparse trabecular structure leads to a significant reduction in the holding force of the vertebral body on the screw. In cases of lumbar spinal stenosis accompanied by osteoporosis, the vertebral body strength is insufficient, resulting in micro-motion between the fusion cage 3 and the endplate interface that has not been completely fused after surgery. In the long run, the probability of endplate collapse and sinking of fusion cage 3 increases. Therefore, the loss of intervertebral disc height and sinking of fusion cage 3 are the main reasons for the failure of lateral surgery. OLIF relieves patient symptoms by indirect decompression. When the fusion cage 3 sinks, the area of ​​the lateral recess of the corresponding vertebral segment is severely lost, the sagittal diameter of the spinal canal narrows again, and the tension of the posterior longitudinal ligament decreases. Patients are very likely to have lower limb neurological symptoms again. Therefore, usually the cage 3 and the vertebral endplates must have sufficient strength to effectively prevent the cage 3 from sinking.

[0063] In the lumbar oblique lateral approach angled locking screw plate fixation reinforcement device of this embodiment, the hollow screw 2 is fixed to the locking plate 1, and at least two hollow screws 2 are screwed into the upper vertebral body 100 and the lower vertebral body 200 at an inclined angle, thereby reducing the risk of screw withdrawal; at the same time, the fusion device 3 is locked with the locking plate 1, which can prevent the fusion device 3 from shifting while dispersing the stress on the vertebral end plate. The device has sufficient strength and can effectively prevent the fusion device 3 from sinking.

[0064] As an alternative embodiment, see Figure 5 and Figure 6 As shown, the drainage channel 21 includes a hollow cavity body 211 and a side opening 212, wherein: the hollow cavity body 211 is located in the hollow screw 2 and is arranged along its axis, and the hollow cavity body 211 is open only at one end for inserting the bone cement injection assembly 4; the side opening 212 is opened on the side wall of the hollow screw 2 and is connected to the hollow cavity body 211, and the side openings 212 are arranged at intervals along the length direction of the hollow screw 2.

[0065] When the bone cement push assembly 4 is fixedly connected to the hollow screw 2, the push channel 430 is connected to the drainage channel 21, and the bone cement enters the hollow cavity 211 from the push channel 430, flows out from the multiple side openings 212, enters the vertebral body, performs the bone cement strengthening operation, and reconstructs the vertebral end plate.

[0066] As an alternative embodiment, see Figure 5 As shown, the hollow screw 2 includes an integrally formed screw body 22 and a screw head 23, the outer diameter of the screw head 23 gradually increases in the direction away from the screw body 22, and the screw head 23 is positioned in the upper vertebral screw hole 11 or the lower vertebral screw hole 13; the pitch of the external thread on the hollow screw 2 gradually decreases in the direction from the tapered end of the screw body 22 to the screw head 23.

[0067] Specifically, the screw body 22 is screwed into the corresponding vertebral body, and the screw head 23 is positioned in the upper vertebral body screw hole 11 or the lower vertebral body screw hole 13 to prevent the hollow screw 2 from being separated from the locking plate 1 .

[0068] The proximal thread pitch of the hollow screw 2 is 1 mm (not limited), and the distal thread pitch is 3 mm, thereby increasing the holding force of the hollow screw 2, optimizing the locking effect, and preventing the hollow screw 2 from backing out. Specifically, the diameter of the screw head 23 is 6.5 mm, and the diameter of the screw body 22 is 6 mm.

[0069] As an alternative embodiment, see Figure 7 As shown, the fusion device 3 is provided with a side threaded hole 31 for threaded connection with the nail rod 5, and the surface of the fusion device 3 is provided with a concave-convex pattern 32. The surface shape of the fusion device 3 matches the vertebral body to improve the fixation effect with the vertebral body.

[0070] The side threaded hole 31 on the side of the fusion device 3 of this embodiment is 5 mm deep (not limited), the nail rod 5 has a diameter of 2.5 mm and a length of 10 mm. The nail rod 5 is used to fix the fusion device 3 and the locking plate 1, which can prevent the fusion device 3 from shifting and prevent the locking plate 1 from moving and affecting the operation when the nail is placed.

[0071] In the prior art, for patients with osteoporosis, a posterior pedicle screw bone cement reinforcement treatment is performed in one or two stages on the basis of lateral fusion, or bone cement is poured into the screw channel of the upper and lower vertebrae 200 under direct vision after the screw is screwed out, and then the screw is screwed in. The former requires changing the body position for secondary disinfection, which prolongs the operation time. The latter requires repeatedly screwing out the screw, causing damage to the screw channel. Therefore, the screws in the prior art are difficult to match for bone cement injection, resulting in complicated surgical operations.

[0072] This embodiment provides a specific implementation of a bone cement injection assembly 4:

[0073] See also Figure 1 , Figure 9-11As shown, the bone cement injection assembly 4 includes an extension tube 41, a guide 42 and an injection device 43, wherein: Fig.11 The extension tube 41 is provided with an inserting portion 411, see Figure 6 , a slot 24 is provided on the hollow screw 2, see Fig.11 , the insertion portion 411 is plugged and fixed with the slot 24; see Fig.10 and Fig.11 As shown, the guide 42 is fixedly connected to the extension tube 41, and a portion of the guide 42 extends into the extension tube 41; the push channel 430 is formed in the pusher 43, one end of the pusher 43 is fixedly connected to the guide 42, a portion of the pusher 43 extends into the guide 42 and the drainage channel 21, and the push channel 430 is connected to the drainage channel 21 for injecting bone mud into the drainage channel 21.

[0074] The extension tube 41 is interference fit with the hollow screw 2 and can be pulled out and separated under the action of external force. The guide 42 extends into the extension tube 41, and a part of the pusher 43 extends into the guide 42. The bone cement enters the hollow body 211 of the hollow screw 2 through the pusher channel 430 in the pusher 43, flows out from the side opening 212, enters the vertebral body, and strengthens the vertebral end plate.

[0075] The bone cement push component 4 of this embodiment does not need to be withdrawn when injecting bone cement. The bone cement push component and the hollow screw 2 are positioned to achieve conduction between the push channel 430 and the drainage channel 21. The bone cement can then be directly injected into the vertebral body through the push channel 430 and the drainage channel 21 (the hollow cavity 211 and the side opening 212) in sequence to reconstruct the vertebral end plate. The operation is simple.

[0076] As an alternative embodiment, see Figure 6 As shown, the hollow screw 2 is provided with a positioning center groove 25, see Fig.11 , one end of the guide 42 located in the extension tube 41 is inserted into the positioning center groove 25. This structure realizes the positioning of the guide 42 and the hollow screw 2, improves the fixing effect, and prevents the guide 42 from shifting.

[0077] See also Fig. 9 The guide 42 is located at one end of the extension tube 41 and is provided with a fixed annular groove 421. The pusher 43 includes a hook body, which is fixedly engaged with the fixed annular groove 421. This structure realizes the positioning of the pusher 43 and the guide 42, improves the fixing effect, and prevents the pusher 43 from shifting.

[0078] As an alternative embodiment, see Fig.11As shown, the pusher 43 also includes a push tube 431, wherein: the push tube 431 passes through the hook body and is fixedly connected to the hook body, the push channel 430 is formed in the push tube 431, the push channel 430 is arranged along the axis of the push tube 431, and passes through the opposite ends of the push tube 431, and the push tube 431 passes through the cavity of the guide 42 and extends into the drainage channel 21.

[0079] The push tube 431 extends from the cavity of the guide tube into the hollow body 211 of the hollow screw 2. When injecting bone cement, the bone cement directly enters the hollow body 211 from the push channel 430 and flows into the vertebral body from multiple side openings 212 to prevent the bone cement from overflowing.

[0080] The device is used in conjunction with a special measuring instrument, such as a vernier caliper. The head end is a fixed rod that can be inserted into the screw slot of the fusion device 3, and the other side is a movable linear rod. The movable rod is moved to the center of the screw entry point of the upper and lower vertebrae 200, and the length of the locking plate 1 is determined by measuring its length.

[0081] The present embodiment is based on the lumbar oblique lateral approach angled locking nail plate fixation reinforcement device. During operation, the locking plate 1 is installed on the lateral side of the vertebral body. Specifically, the screw rod 5 is used to lock the fusion device 3 and the locking plate 1. After the trial mold, the position of the nail entry point is measured and determined by the special measuring instrument to make the nail entry point symmetrical, and the length of the locking plate 1 can be determined. After the fusion device 3 is placed in the intervertebral space, the locking plate 1 is locked with it by the hollow screw 2, and then the nail placement operation is performed to prevent the locking plate 1 from shifting and affecting the nail placement. The locking plate 1 is installed at the position of 1 / 2 of the vertebral body in the lateral X-ray, which conforms to the exposed position of the lumbar oblique lateral approach. Figure 2 and Figure 3 As shown, if the locking plate 1 is close to the posterior 1 / 2 of the upper vertebral body 100 and the lower vertebral body 200 in the lateral position, more abdominal organs and vascular tissues need to be exposed, and the traction injury is also greater, which increases the degree of postoperative pain and related surgical complications. The extension tube 41 is fixed to the hollow screw 2, the guide 42 is inserted into the extension tube 41 and fixed to the hollow screw 2, the pusher 43 is locked with the guide 42, the pusher tube 431 is inserted into the guide 42 and the hollow body 211, and the bone cement is injected into the hollow body 211 from the pusher channel 430 and enters the vertebral body from the side opening 212.

[0082] The lumbar oblique lateral approach with angled locking screw plate fixation reinforcement device of this embodiment can be performed through a single lateral approach to the vertebral body and a single body position, thereby solving the problems of the existing screw-rod technology, such as protruding screw tail cap and screw rod causing psoas muscle irritation, weak stability of the lateral screw-rod system, displacement of the fusion device 3, affecting the surgical efficacy, or requiring a change of body position for secondary disinfection, prolonging the operation time and increasing iatrogenic trauma for posterior pedicle screw internal fixation. Figure 1 and Figure 5As shown, the stability of the internal fixation system is increased by locking the bicortical bihollow screw 2 and reinforcing the screw channel with bone cement. At the same time, the vertebral endplate is strengthened by bone cement to reconstruct the vertebral endplate and solve the problem of sinking of the fusion device 3. The fusion device 3 is fixed to the locking plate 1 to prevent the locking plate 1 and the fusion device 3 from shifting.

[0083] In the description of this specification, specific features, structures or characteristics may be combined in an appropriate manner in any one or more embodiments or examples.

[0084] In the description of this specification, the description with reference to the terms "one embodiment", "some embodiments", "example", "specific example", or "some examples" etc. means that the specific features, structures, materials or characteristics described in conjunction with the embodiment or example are included in at least one embodiment or example of the present invention. In this specification, the schematic representations of the above terms do not necessarily refer to the same embodiment or example. Moreover, the specific features, structures, materials or characteristics described may be combined in any one or more embodiments or examples in a suitable manner. In addition, those skilled in the art may combine and combine the different embodiments or examples described in this specification and the features of the different embodiments or examples, without contradiction.

[0085] The above is only a specific embodiment of the present invention, but the protection scope of the present invention is not limited thereto. Any person skilled in the art who is familiar with the technical field can easily think of changes or substitutions within the technical scope disclosed by the present invention, which should be included in the protection scope of the present invention. Therefore, the protection scope of the present invention should be based on the protection scope of the claims.

Claims

1. A device for strengthening the fixation of lumbar spine with angled locking nail plates based on an oblique lateral approach, characterized in that: The invention comprises a locking plate, a cannulated screw, a fusion cage and a bone cement injection assembly, wherein: The locking plate fits the target position of the vertebral body, and there are two hollow screws fixedly connected to the locking plate. The two hollow screws are arranged obliquely and screwed into the upper vertebral body and the lower vertebral body respectively, and the vertical distance between the two gradually increases along the side close to the locking plate fitting the vertebral body; The fusion device is placed in the intervertebral space between the upper vertebral body and the lower vertebral body and is fixedly connected to the locking plate; The bone cement push assembly is provided with a push channel, and the hollow screw is provided with a drainage channel. When the bone cement push assembly is fixedly connected to the hollow screw, the push channel is connected to the drainage channel, so that the bone cement enters the vertebral body through the drainage channel.

2. The device for strengthening fixation of lumbar oblique lateral approach with angle locking nail plate according to claim 1, characterized in that: The locking plate is provided with upper vertebral body screw holes, a center hole, and lower vertebral body screw holes at intervals along its length direction, wherein: The upper vertebral body screw hole and the lower vertebral body screw hole are both oblique holes, and the distance between the upper vertebral body screw hole and the lower vertebral body screw hole gradually increases along the side close to the locking plate that fits the vertebral body; One of the hollow screws passes through the upper vertebral body screw hole and is screwed into the upper vertebral body, and the other hollow screw passes through the lower vertebral body screw hole and is screwed into the lower vertebral body. The fusion device is fixedly connected with a screw rod, and the screw rod is threadedly connected to the center hole.

3. The device for strengthening fixation of lumbar oblique lateral approach with angle locking nail plate according to claim 2 is characterized in that: The upper vertebral body screw hole is arranged along a side close to the locking plate that is attached to the vertebral body and is inclined upward, and the angle between the screw hole and the horizontal plane is 5°-10°; The lower vertebral body screw hole is arranged along a side close to the locking plate that is attached to the vertebral body and is inclined downward, and the angle between the screw hole and the horizontal plane is 5°-10°; When the locking plate fits the target position of the vertebral body, the upper vertebral body screw hole is located at the lower 1 / 3 of the front edge of the upper vertebral body, and the lower vertebral body screw hole is located at the upper 1 / 3 of the front edge of the lower vertebral body.

4. The device for strengthening the fixation of the lumbar oblique lateral approach with angled locking nail plate according to claim 1, characterized in that: The locking plate has a contoured surface that fits anatomically with the arc-shaped surface of the lateral edge of the vertebral body, and the end angle of the locking plate is in an arc shape.

5. The device for strengthening fixation of lumbar vertebrae with angled locking nail plate based on oblique lateral approach according to claim 1 is characterized in that: The drainage channel comprises a hollow cavity and a side opening, wherein: The hollow cavity is located in the hollow screw and is arranged along its central axis, and only one end of the hollow cavity is open for inserting the bone cement push assembly; The side openings are formed on the side walls of the hollow screw and are communicated with the hollow cavity. The side openings are arranged at intervals along the length direction of the hollow screw.

6. The device for strengthening fixation of lumbar vertebrae with angled locking nail plate based on oblique lateral approach according to claim 2, characterized in that: The hollow screw comprises an integrally formed screw body and a screw head, the outer diameter of the screw head gradually increases in a direction away from the screw body, and the screw head is positioned in the upper vertebral body screw hole or the lower vertebral body screw hole; The pitch of the external thread on the hollow screw gradually decreases along the direction from the conical end of the screw body to the screw head.

7. The device for strengthening fixation with angle-locked nail plates based on the lumbar oblique lateral approach according to claim 1 is characterized in that: The fusion device is provided with a side threaded hole for threaded connection with a nail rod. The surface of the fusion device is provided with concave and convex patterns, and the surface shape of the fusion device matches the vertebral body.

8. The device for strengthening fixation of lumbar vertebrae with angled locking nail plate based on oblique lateral approach according to claim 1 is characterized in that: The bone cement push injection assembly comprises an extension tube, a guide and a push injector, wherein: The extension tube is provided with an insertion portion, the hollow screw is provided with a slot, and the insertion portion is plugged and fixed in the slot; The guide is fixedly connected to the extension tube, and a portion of the guide extends into the extension tube; The push channel is formed in the pusher, one end of the pusher is fixedly connected to the guide, a part of the pusher extends into the guide and the drainage channel, and the push channel is connected to the drainage channel for injecting bone mud into the drainage channel.

9. The device for strengthening fixation of lumbar oblique lateral approach with angle locking nail plate according to claim 8, characterized in that: The hollow screw is provided with a positioning center groove, and one end of the guide located in the extension tube is inserted into the positioning center groove; The guide is located at one end of the extension tube and is provided with a fixed ring groove. The injector comprises a hook body, and the hook body is fixedly engaged with the fixed ring groove.

10. The device for strengthening fixation of lumbar vertebrae with angled locking nail plate based on oblique lateral approach according to claim 9, characterized in that: The injector further comprises an injection tube, wherein: The push injection tube passes through the hook body and is fixedly connected to the hook body, the push injection channel is formed in the push injection tube, the push injection channel is arranged along the axis of the push injection tube and passes through the opposite ends of the push injection tube, and the push injection tube passes through the cavity of the guide and extends into the drainage channel.

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