Percutaneous spinal stabilization system

Abstract

To provide a percutaneous spine stabilization system that can simplify a surgical procedure, while minimizing the total size in multiple incision holes to a patient.SOLUTION: An implantable material 4 employed in a percutaneous spine stabilization system comprises: a pedicle screw 10 fixed in each vertebra along the spinal cranial caudal direction, respectively, and fixed in a pair along the horizontal direction to one vertebral body; a rod member 11 arranged along the spinal cranial caudal direction, and connected to a rod receiving part 20 of each pedicle screw 10; a connector member 12 connected to the rod receiving part 20 of the pedicle screw 10; and a crossbar 13 connected to the connector member 12 connected to the pair of left and right pedicle screws 10. As a result, the total size in the multiple incision holes to a patient can be minimized.SELECTED DRAWING: Figure 3

Description

Technical Field

[0001] The present invention relates to a percutaneous spinal stabilization system capable of stabilizing the spine by inserting various implant materials such as vertebral fixators, rod members, and crossbars into the body percutaneously using various surgical instruments and attaching them to the spine.

Background Art

[0002] Conventionally, a large incision has been made in the midline of the patient's back, and pedicle screws, rod members, etc. have been inserted into the body through the incision and attached to the spine to enhance the stability of the spine, correct spinal deformities, etc., and perform surgical treatment to stabilize the spine. In recent years, as a minimally invasive surgery, a surgical method has been adopted in which pedicle screws, rod members, etc. are inserted into the body percutaneously (through several small incisions) from the patient's back and fixed to each vertebra to stabilize the spine. The method of stabilizing the spine by such a percutaneous surgical method is advantageous for the patient in many respects, such as a reduction in the amount of bleeding associated with the surgery, a shortening of the surgical time, and a reduction in surgical site infections, compared to the surgical method of making a large incision in the back.

[0003] Therefore, as a conventional method of attaching pedicle screws, rod members, etc. to the spine by the latter percutaneous surgical method, Patent Document 1 discloses a percutaneous spinal cross-link system. That is, in the percutaneous spinal cross-link system according to Patent Document 1, as a percutaneous spinal stabilization system that is inserted into the body percutaneously and fixed to the spine, a plurality of pedicle screws that are screwed into and fixed to the respective pedicles of a plurality of vertebral bodies along the cranial-caudal direction of the spine, a rod member that is connected to the plurality of pedicle screws arranged along the cranial-caudal direction of the spine, and a crossbar that connects a pair of left and right rod members via respective connecting members are provided (see FIG. 2 of Patent Document 1).

Prior Art Documents

Patent Documents

[0004]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0005] However, in the percutaneous spinal cross-linking system according to Patent Document 1, although the crossbar is connected to a pair of left and right rod members via each connecting member, the structure of the connecting member integrated with the operating blade is complicated, and there are many problems such as the fixing force between the connecting member and the rod member cannot be sufficiently ensured, and improvement is required. In addition, the connecting member is arranged at an interval adjacent to the pedicle screw, and the shaft member supporting the pedicle screw and the operating blade extending from the connecting member extend outwardly from the body surface with a large interval (see FIG. 8 of Patent Document 1), so a considerably large incision hole is required on the body surface of the patient. Therefore, the effect of the above-described percutaneous surgical procedure (minimally invasive surgery) is reduced, and improvement is required.

[0006] And the present invention has been made in view of such points, and an object thereof is to provide a percutaneous spinal stabilization system capable of minimizing the total size of a plurality of incision holes in a patient and simplifying the surgical technique and the like.

Means for Solving the Problems

[0007] (Aspects of the Invention) The aspects of the invention shown below illustrate the configuration of the present invention, and are described separately for the purpose of facilitating the understanding of various configurations of the present invention. Each item does not limit the technical scope of the present invention, and even when a part of the constituent elements of each item is replaced, deleted, or other constituent elements are further added while taking into consideration the best mode for carrying out the invention, it is included in the technical scope of the present invention.

[0008] (1) A percutaneous spinal stabilization system comprising various implantable materials for stabilizing the spine by being attached to each vertebra of the spine, and various surgical instruments for percutaneously attaching each implantable material to the spine from outside the body, wherein the implantable material includes vertebral fixators respectively fixed to each vertebra along the cranio-caudal direction of the spine and fixed in a pair along the left-right direction with respect to one vertebral body, a rod member disposed along the cranio-caudal direction of the spine and connected to the head of each vertebral fixator, a connector member connected to the head of the vertebral fixator, and a crossbar connected to the connector members connected to the pair of left and right vertebral fixators. Look, the connector member has a fixture engagement portion that engages with the head of the vertebral fixing device and a bar receiving portion that receives and connects the crossbar. The bar receiving portion is supported on a support rod portion protruding from the fixture engagement portion so as to be swingable within a predetermined range about the axis of the support rod portion with respect to the fixture engagement portion. , a percutaneous spinal stabilization system (corresponding to the invention of claim 1). In the percutaneous spinal stabilization system according to (1), as the implantable material, since the connector member is connected to the head of the vertebral fixator, the connector member can be inserted into the body through the small incision through which the vertebral fixator is inserted into the body. As a result, the total size of the plurality of small incisions can be minimized, and maximum effects such as reduction of the amount of bleeding during surgery and shortening of the surgery time can be achieved. Further, the bar receiving portion of the connector member is swingable within a predetermined range along the left - right direction of the patient with respect to the fixture engagement portion (the bar receiving portion is integrally connected to the support rod portion protruding from the fixture engagement portion so as to be swingable within a predetermined range about the axis of the support rod portion with respect to the fixture engagement portion). Therefore, after connecting the connector members to the heads of the pair of left - right vertebral fixing devices respectively, when accommodating the crossbar in the bar receiving portion of each connector member, the crossbar can be easily guided into the bar receiving portion of each connector member. As a result, the surgical procedure can be simplified, the surgical time can be further shortened, and ultimately, the burden on the patient can be further reduced.

[0010] (2)(1) item A percutaneous spinal stabilization system according to claim, wherein the implantable material includes a screw member having a first screw portion for connecting the rod member to the head of the vertebral fixator and a second screw portion for connecting the connector member to the head of the vertebral fixator (corresponding to the invention of claim 2 ). (2) item In the percutaneous spinal stabilization system according to claim, the first screw portion and the second screw portion of the screw member can connect both the rod member and the connector member to the head of the vertebral fixator. As a result, the structure is not complicated, and the number of constituent members of the implantable material can be minimized. Thereby, the surgical procedure can be simplified, the surgery time can be further shortened, and thus the burden on the patient can be further reduced.

[0011] (3)(1) item The percutaneous spinal stabilization system according to the description, wherein the rod member is connected to each vertebral fixator, and the fixture engaging portion of the connector member is connected to the vertebral fixator, and the bar receiving portion of the connector member is located above the rod member. (Claim 3 corresponding to the invention). (3) item In the percutaneous spinal stabilization system according to the description, the crossbar can be easily guided into the bar receiving portions of the pair of left and right connector members. Thereby, the surgical procedure can be further simplified and the surgical time can be further shortened.

[0012] (4) A percutaneous spinal stabilization system comprising various implant materials for stabilizing the spine by being attached to each vertebra of the spine and various surgical instruments for percutaneously attaching each implant material to the spine from outside the body. The implant material includes vertebral fixing devices that are respectively fixed to each vertebra along the cranio - caudal direction of the spine and are fixed in a pair along the left - right direction with respect to one vertebra, a rod member arranged along the cranio - caudal direction of the spine and connected to the heads of the respective vertebral fixing devices, a connector member connected to the heads of the vertebral fixing devices, and a crossbar connected to the connector members connected to the pair of left - right vertebral fixing devices. The connector member has a fixture engagement portion that engages with the head of the vertebral fixing device and a bar receiving portion that receives and connects the crossbar. The surgical instrument includes a cross-link adjuster capable of percutaneously supporting the connector member from outside the body. The cross-link adjuster is formed in a shaft shape, and the bar receiving portion of the connector member is detachably attached to the tip thereof. (Claim 4 corresponding to the invention). (4) item In the percutaneous spinal stabilization system according to the description, by operating the cross-link adjuster protruding outside the body by the operator, the bar receiving portion of the connector member can be easily swung with respect to the fixture engaging portion. As a result, the crossbar can be easily guided into the bar receiving portions of the pair of left and right connector members.

[0013] (5) A percutaneous spinal stabilization system comprising various implant materials for stabilizing the spine by being attached to each vertebra of the spine, and various surgical instruments for percutaneously attaching each implant material to the spine from outside the body, wherein the implant material includes vertebral fixators that are respectively fixed to each vertebra along the cranial-caudal direction of the spine and are fixed in a pair along the left-right direction with respect to one vertebral body, a rod member arranged along the cranial-caudal direction of the spine and connected to the heads of the respective vertebral fixators, a connector member connected to the heads of the vertebral fixators, a crossbar connected to the connector members connected to the pair of left and right vertebral fixators, and a screw member having a first screw portion for connecting the rod member to the head of the vertebral fixator and a second screw portion for connecting the connector member to the head of the vertebral fixator. The surgical instrument includes a guide shaft capable of percutaneously supporting the screw member from outside the body. The connector member is guided along the guide shaft to the head of the vertebral fixator. (Claim 5 corresponding to the invention). (5) item In the percutaneous spinal stabilization system according to the description, the guide shaft can easily, in other words, accurately guide the connector member to the head of the vertebral fixator.

Effect of the Invention

[0014] With the percutaneous spinal stabilization system according to the present invention, it is possible to minimize the total size of multiple incisions in a patient and simplify the surgical procedure and the like.

Brief Description of the Drawings

[0015]

Figure 1

Figure 2

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Figure 17

Figure 18

Mode for Carrying Out the Invention

[0016] Hereinafter, embodiments for carrying out the present invention will be described in detail with reference to FIGS. 1 to 18. The percutaneous spinal stabilization system 1 according to the present embodiment is for adult spinal deformities and is employed in various surgical treatments such as, for example, degenerative scoliosis, lumbar spondylolisthesis, and metastatic spinal tumors. As shown in FIG. 1, the percutaneous spinal stabilization system 1 according to the present embodiment fixes the spine between a plurality of vertebrae along its cranial-caudal direction by, for example, various implant materials 4 to stabilize the spine. Further, the percutaneous spinal stabilization system 1 according to the present embodiment can be adapted to a percutaneous (minimally invasive) surgical procedure using various surgical instruments 5. Note that illustrations of small incisions and the like provided on the body surface of the patient are omitted. The percutaneous spinal stabilization system 1 according to the present embodiment includes various implant materials 4 for fixing and stabilizing a desired range along the cranial-caudal direction of the spine by being attached to each vertebra of the spine, and various surgical instruments 5 for percutaneously attaching each of the implant materials 4 to the spine from outside the body. The implant materials 4 are illustrated in detail in FIGS. 1 to 4. On the other hand, the surgical instruments 5 are illustrated in detail in FIGS. 5 to 18.

[0017] First, various implant materials 4 employed in the percutaneous spinal stabilization system 1 according to the present embodiment will be described in detail with reference to FIGS. 1 to 4. As shown in FIGS. 1 to 3, the implant 4 includes a plurality of pedicle screws 10 (vertebral fixing devices) screwed into the vertebral body through the pedicle of each vertebra of the spine, a rod member 11 connected to the rod receiving portion 20 (head portion) of each pedicle screw 10 arranged along the cranial-caudal direction of the spine, a connector member 12 connected to the rod receiving portion 20 of each pedicle screw 10, a crossbar 13 connected to the connector members 12, 12 connected to a pair of left and right pedicle screws 10, 10, a large-diameter male screw portion 88 (first screw portion) for connecting the rod member 11 to the rod receiving portion 20 of the pedicle screw 10, and a small-diameter male screw portion 89 (second screw portion) for connecting the connector member 12 to the rod receiving portion 20 of the pedicle screw 10, a first set of screws 14 (screw members), a nut member 15 screwed into the small-diameter male screw portion 89 of the first set of screws 14 to connect the connector member 12 to the rod receiving portion 20 of the pedicle screw 10, and a second set of screws 16 for pressing and fixing the crossbar 13 guided in the bar receiving portion 36 (inside the bar receiving groove portion 57) of the connector member 12.

[0018] The pedicle screws 10, rod member 11, connector member 12, crossbar 13, first set of screws 14, nut member 15, and second set of screws 16, which are configured as the implant 4, are formed of the same material, and are formed of a material having excellent biocompatibility such as a titanium alloy, for example. As shown in FIGS. 2 and 3, the pedicle screws 10 are selectively fixed to a plurality of vertebrae along the head direction from the rear of the spine. The pedicle screws 10 are each screwed into the vertebral body through a pair of left and right pedicles of one vertebra. The pedicle screws 10 are generally also referred to as pedicle screws. The pedicle screws 10 include a rod receiving portion 20 (head portion) having a groove portion 28 for receiving the rod member 11, and a screw portion 21 connected to the rod receiving portion 20 and screwed into the vertebral body through the pedicle of the vertebra.

[0019] The rod receiving portion 20 is formed in a block shape having a pair of flat portions 24, 24 and a pair of arc portions 25, 25 in a plan view. An upwardly open U-shaped groove portion 28 is formed on the upper surface of the rod receiving portion 20. The groove portion 28 is formed along the axial direction of the rod member 11 in a state of being attached to the spine. The groove portion 28 is formed so as to penetrate through the pair of flat portions 24, 24. The rod member 11 is received in the groove portion 28. In the rod receiving portion 20, female screw portions 31 are respectively formed on the inner wall surfaces of a pair of wall portions 30, 30 facing each other with the groove portion 28 as a boundary. The large-diameter male screw portion 88 of the first set screw 14 is screwed into the female screw portion 31.

[0020] The screw portion 21 is swingably connected to the rod receiving portion 20 in all directions. In this embodiment, the swing range of the screw portion 21 with respect to the rod receiving portion 20 is in the range of approximately 32° from the swing center on one side in all directions (total swing range approximately 64°). In the pedicle screw 10, a form in which the screw portion 21 is swingably connected to the rod receiving portion 20 along one direction may be adopted. In this embodiment, the swing range of the screw portion 21 with respect to the rod receiving portion 20 is in the range of approximately 45° from the swing center on one side in one direction (total swing range approximately 90°). The structure that enables the screw portion 21 to swing with respect to the rod receiving portion 20 is well-known, and thus detailed description thereof is omitted here.

[0021] Referring to FIGS. 2 to 4, the rod member 11 is formed with a circular cross-section. The length of the rod member 11 is appropriately set based on the fixation range of the spine by the in-vivo implant 4. The rod member 11 is attached to the groove portion 28 provided in the rod receiving portion 20 of the pedicle screw 10 by the first set screw 14. The connector member 12 includes a screw engaging portion 35 (fixture engaging portion) engaged with the rod receiving portion 20 (head portion) of the pedicle screw 10, and a bar receiving portion 36 integrally connected to the side of the screw engaging portion 35 for receiving the cross bar 13. As can be clearly seen from FIG. 4, the screw engaging portion 35 includes a cylindrical portion 39 and a support rod portion 40 protruding radially outward from the outer peripheral surface near the axial end (near the lower end) of the cylindrical portion 39. The cylindrical portion 39 is formed with a large-diameter opening 43 engaged with the rod receiving portion 20 (head portion) of the pedicle screw 10, and a small-diameter opening 44 provided continuously upward from the large-diameter opening 43, having a smaller diameter than the large-diameter opening 43 and through which the intermediate cylindrical portion 90 and the small-diameter male screw portion 89 of the first set screw 14 described later are inserted. It should be noted that a guide shaft 111, which is a surgical instrument 5 described later, can be inserted into the cylindrical portion 39.

[0022] Referring to FIG. 4, a pair of flat portions 47, 47 and a pair of arc portions 48, 48 that contact the pair of flat portions 24, 24 and the pair of arc portions 25, 25 provided in the rod receiving portion 20 of the pedicle screw 10 are formed on the inner peripheral surface of the large-diameter opening 43. The small-diameter opening 44 is formed with a circular cross-section. The cylindrical portion 39 is formed with an outer wall protrusion 50 whose outer wall portion protrudes slightly radially outward. The outer wall protrusion 50 is substantially in the shape of a rectangular parallelepiped and protrudes radially outward from the entire axial direction of the cylindrical portion 39. The support rod portion 40 protrudes radially outward from the outer surface of the outer wall protrusion 50. The support rod portion 40 is formed with a circular cross-section. A female screw portion 54 for screwing the mounting screw 80 is formed at the tip of the support rod portion 40. It should be noted that an arc-shaped concave surface 55 is formed on the lower surface of the screw engaging portion 35 to avoid interference with the rod member 11 in the state of being attached to the spine.

[0023] On one hand, the bar receiving portion 36 of the connector member 12 is formed in a block shape substantially composed of a rectangular parallelepiped. The bar receiving portion 36 is connected to the support rod portion 40 provided in the screw engaging portion 35 so as to be swingable within a predetermined angular range (refer to the white arrow in Fig. 4(c)). In the bar receiving portion 36, a U-shaped bar receiving groove portion 57 with an open upper surface is formed. The bar receiving groove portion 57 extends in a direction orthogonal to the axial direction of the rod member 11 in a state of being attached to the spine. The cross bar 13 is received in the bar receiving groove portion 57. Female screw portions 60 for screwing the second set of screws 16 for fixing the cross bar 13 to the bar receiving groove portion 57 are formed on a pair of opposing wall portions 59, 59 with the bar receiving groove portion 57 as a boundary.

[0024] On the upper surfaces of the opposing wall portions 59, 59 of the bar receiving portion 36, female screw portions 61, 61 into which male screw portions 132 (refer to Fig. 8) of the standing shaft 126 of the surgical instrument 5 described later are screwed are respectively formed. The pair of female screw portions 61, 16 are respectively positioned on the diagonal with respect to the radial center of the female screw portion 60 for the second set of screws 16. In the bar receiving portion 36, an insertion hole 63 through which the support rod portion 40 provided in the screw engaging portion 35 is inserted is formed penetratingly below the bar receiving groove portion 57. The insertion hole 63 is formed in a direction orthogonal to the extending direction of the bar receiving groove portion 57. The insertion hole 63 is formed at the center in the extending direction of the bar receiving groove portion 57. Note that on the lower surface of the bar receiving portion 36, a bulging portion 64 extending in the same direction as the insertion hole 63 is formed at substantially the same position as the insertion hole 63.

[0025] The insertion hole 63 is formed as a slightly elongated hole along the vertical direction. In the bar receiving portion 36, on one end surface along the extending direction of the insertion hole 63, that is, on one end surface far from the screw engaging portion 35, a stopper housing recess 69 is formed around the insertion hole 63. On the other hand, in the bar receiving portion 36, on the other end surface along the extending direction of the insertion hole 63, that is, on the other end surface close to the screw engaging portion 35, a washer housing recess 70 is formed. Referring to FIG. 4(c), the stopper housing recess 69 is slightly larger than the width length of the insertion hole 63 and includes a pair of wide wall surfaces 72, 72 extending parallel to each other and a pair of inclined wall surfaces 73, 73 formed in a V shape with their width lengths gradually increasing downward from the pair of wide wall surfaces 72, 72. The inclined wall surfaces 73 extend at an angle of approximately 15° with respect to the vertical direction. The stopper 75 is housed in this stopper housing recess 69.

[0026] The stopper 75 is attached to the tip of the support rod portion 40 provided in the screw engaging portion 35. The stopper 75 is formed in a plate shape having an attachment hole 77 through which the attachment screw 80 is inserted. Referring to FIG. 4(c), on both side walls of the upper part of the stopper 75, a pair of inclined wall surfaces 82, 82 extending in a direction approaching each other are formed so as to be continuous with the pair of inclined wall surfaces 73, 73 of the stopper housing recess 69. The inclined wall surfaces 82 extend at an angle of approximately 15° with respect to the vertical direction. The stopper 75 is disposed in the stopper housing recess 69 of the bar receiving portion 36. Then, the attachment screw 80 is inserted through the attachment hole 77 of the stopper 75 and screwed into the female screw portion 54 of the support rod portion 40. As a result, the bar receiving portion 36 and the screw engaging portion 35 are integrally connected by the stopper 75.

[0027] Also, a shim 85 is interposed between the upper surface of the insertion hole 63 of the bar receiving portion 36 and the support rod portion 40 of the screw engaging portion 35. A wave washer 86 is disposed in the washer accommodation recess 70 of the bar receiving portion 36. By the wave washer 86, the screw engaging portion 35 and the bar receiving portion 36 are biased in a direction away from each other. And the bar receiving portion 36 is connected to the screw engaging portion 35 so as to be swingable within a range of 15° on one side (total 30°) along the left - right direction about the axis of the support rod portion 40 (see the white arrow in Fig. 4). In the connector member 12, the upper surface of the bar receiving portion 36 is set higher than the upper surface of the screw engaging portion 35. Also, in the connector member 12, the lower surface of the bar receiving portion 36 is set slightly higher than the lower surface of the screw engaging portion 35. The bottom most part of the arc - shaped concave surface 55 provided on the lower surface of the screw engaging portion 35 and the top most part of the bulging portion 64 provided on the lower surface of the bar receiving portion 36 substantially coincide in the height direction.

[0028] Then, when the screw engaging portion 35 of the connector member 12 is attached to the rod receiving portion 20 of the pedicle screw 10, the pair of flat portions 47, 47 and the pair of arc portions 48, 48 provided on the screw engaging portion 35 of the connector member 12 are fitted so as to contact the pair of flat portions 24, 24 and the pair of arc portions 25, 25 (see Fig. 3) provided on the rod receiving portion 20 (large - diameter opening portion 43) of the pedicle screw 10. As a result, the circumferential position of the connector member 12 with respect to the rod receiving portion 20 of the pedicle screw 10 is positioned. Specifically, when the screw engaging portion 35 of the connector member 12 is attached to the rod receiving portion 20 of the pedicle screw 10, the connector member 12 is arranged such that the extending direction of its bar receiving groove portion 57 is orthogonal to the extending direction of the groove portion 28 (see Fig. 3) of the rod receiving portion 20 of the pedicle screw 10.

[0029] Referring to FIG. 4, the first set screw 14 is formed in a cylindrical shape. The first set screw 14 has a large-diameter male screw portion 88 for connecting the rod member 11 to the rod receiving portion 20 of the pedicle screw 10, a small-diameter male screw portion 89 for connecting the connector member 12 to the rod receiving portion 20 of the pedicle screw 10, and an intermediate cylindrical portion 90 located between the large-diameter male screw portion 88 and the small-diameter male screw portion 89. A through hole 92 extending in the axial direction is formed in a hexagonal star shape in plan view at the portion where the small-diameter male screw portion 89 is formed. A female screw portion 93 is formed on the inner peripheral surface of the portion where the large-diameter male screw portion 88 is formed. The inner diameter of the female screw portion 93 is formed to be smaller than the inner diameter of the intermediate cylindrical portion 90 and the minimum inner diameter in the hexagonal star-shaped through hole 92 provided on the inner peripheral surface of the small-diameter male screw portion 89. The outer diameter of the large-diameter male screw portion 88 is larger than the outer diameter of the intermediate cylindrical portion 90. The outer diameter of the intermediate cylindrical portion 90 is larger than the outer diameter of the small-diameter male screw portion 89.

[0030] The large-diameter male screw portion 88 of the first set screw 14 is screwed into the female screw portion 31 (see FIG. 3) provided in the rod receiving portion 20 of the pedicle screw 10. After fitting the rod member 11 into the groove portion 28 of the rod receiving portion 20 of the pedicle screw 10, by screwing the large-diameter male screw portion 88 of the first set screw 14 into the female screw portion 31 provided in the rod receiving portion 20, the rod member 11 can be fixed to the rod receiving portion 20 (groove portion 28) of the pedicle screw 10. The outer diameter of the intermediate cylindrical portion 90 is smaller than the inner diameter of the small-diameter opening 44 provided in the screw engaging portion 35 of the connector member 12.

[0031] Referring to FIGS. 3 and 4, after fitting the screw engagement portion 35 of the connector member 12 into the rod receiving portion 20 of the pedicle screw 10, the nut member 15 is screwed onto the small-diameter male screw portion 89 of the first set of screws 14 protruding from the screw engagement portion 35 of the connector member 12, whereby the connector member 12 is fixed to the pedicle screw 10. The nut member 15 has an outer shape formed in a hexagonal shape. In a state where the nut member 15 is screwed onto the small-diameter male screw portion 89 of the first set of screws 14 protruding from the screw engagement portion 35 of the connector member 12, the upper surface of the nut member 15 and the upper surface of the bar receiving portion 36 of the connector member 12 are located on the same plane.

[0032] Referring to FIGS. 3 and 4, the crossbar 13 is formed in a rectangular cross-sectional shape. The crossbar 13 is fitted into the bar receiving portion 36 (within the bar receiving groove portion 57) of the connector member 12. Then, after disposing the crossbar 13 in the bar receiving portion 36 (bar receiving groove portion 57) of the connector member 12, the second set of screws 16 is screwed into the female screw portion 60 provided in the bar receiving portion 36 of the connector member 12, whereby the crossbar 13 is pressed and fixed to the bar receiving portion 36 (bar receiving groove portion 57) of the connector member 12 by the second set of screws 16. The second set of screws 16 is formed in a cylindrical shape. In the second set of screws 16, a through-hole 95 in a hexagonal star shape in plan view is formed in the same manner as the through-hole 92 of the first set of screws 14. And in a state where the crossbar 13 is pressed and fixed to the bar receiving portion 36 (bar receiving groove portion 57) of the connector member 12 by the second set of screws 16, the upper surface of the second set of screws 16 and the upper surface of the bar receiving portion 36 of the connector member 12 are located on the same plane.

[0033] Next, a main surgical instrument 5 for percutaneously inserting the in-vivo implant 4 into the body and fixing the range between each vertebra with the in-vivo implant 4 will be described. The surgical instrument 5 is a special one adopted as the present percutaneous spinal stabilization system 1. The surgical instrument 5 extends into the body through a small incision hole or a minimally invasive incision hole provided in the patient from outside the body. The surgical instrument 5 includes an extender 110 (see FIGS. 5 and 6) for supporting the rod receiving portion 20 of the pedicle screw 10, a screw driver (not shown) for screwing the pedicle screw 10 into the vertebral body through the pedicle of the vertebra, a rod holder (not shown) for gripping the rod member 11, a driver for the first set of screws (not shown) for detachably supporting the first set of screws 14 and tightening the first set of screws 14, a guide shaft 111 (see FIGS. 6 and 7) for detachably supporting the first set of screws 14 and guiding the connector member 12 to the rod receiving portion 20 of the pedicle screw 10, a cross-link adjuster 112 (see FIGS. 8, 10, and 11) whose tip is detachably attached to the bar receiving portion 36 of the connector member 12, a nut holder (not shown) for detachably gripping the nut member 15 and tightening the nut member 15, a cross-bar holder 113 (see FIG. 12) for detachably gripping the cross-bar 13, and a driver 114 for the second set of screws (see FIGS. 14 and 15) for gripping the second set of screws 16 and tightening the second set of screws 16.

[0034] Referring to FIG. 5, the extender 110 is formed in a shaft shape. The extender 110 is formed in a cylindrical shape. A screw driver, a driver for the first set of screws, and the guide shaft 111 can also be inserted into the extender 110. The extender 110 extends into the body through a small incision provided on the body surface from outside the body. The extender 110 includes a screw support portion 117 provided at its tip (lower end portion) for supporting the rod receiving portion 20 of the pedicle screw 10, and a slit portion 118 that penetrates along the radial direction in a predetermined range from the tip to the base end.

[0035] The screw support portion 117 is configured as a pair of screw gripping portions 119, 119 that face each other with a gap therebetween due to the formation of the slit portion 118. The pair of screw gripping portions 119, 119 are configured to support the outer peripheral surfaces of the pair of arc portions 25, 25 of the rod receiving portion 20 provided on the pedicle screw 10 so as not to be relatively rotatable from the outside and not to be relatively movable along the axial direction. When the rod receiving portion 20 of the pedicle screw 10 is supported by the extender 110, the slit portion 118 of the extender 110 is arranged in the same direction as the groove portion 28 provided in the rod receiving portion 20 of the pedicle screw 10. The opening width of the slit portion 118 is formed larger than the outer diameter of the rod member 11. On the inner peripheral surfaces of the pair of wall portions 121, 121 that face each other with the slit portion 118 above the pair of screw gripping portions 119, 119 as a boundary in the extender 110, a female screw portion 120 into which the large-diameter male screw portion 88 of the first set screw 14 is screwed is provided. Referring to FIG. 7, on the inner peripheral surfaces of the pair of screw gripping portions 119, 119, the male screw portion 120 is not formed, and relief recesses 122, 122 are respectively formed.

[0036] When the rod receiving portion 20 of the pedicle screw 10 is supported by the screw support portion 117 (the pair of screw gripping portions 119, 119) of the extender 110, the pair of arc portions 25, 25 of the pedicle screw 10 are fitted into the relief recesses 122, 122 of the pair of screw gripping portions 119, 119, and the helically extending threads (thread grooves) of the female screw portion 120 provided on the inner peripheral surfaces of the opposing wall portions 121, 121 of the extender 110 and the helically extending threads (thread grooves) of the female screw portion 31 provided on the inner peripheral surfaces of the pair of wall portions 30, 30 of the rod receiving portion 20 of the pedicle screw 10 are connected so as to be continuous. The screwdriver can be inserted into the extender 110. The screwdriver is configured such that its tip is inserted into the rod receiving portion 20 of the pedicle screw 10 and supports the rod receiving portion 20 and the screw portion 21 of the pedicle screw 10 so as not to be relatively rotatable.

[0037] The driver for the first set of screws is configured such that its tip can be inserted into and gripped by the through-hole 92 of the first set of screws 14. Referring to FIGS. 6, 7, and 18, the guide shaft 111 has a substantially circular cross-section and is formed in a shaft shape. A male screw portion 123 is formed at the tip (lower end portion) of the guide shaft 111. This male screw portion 123 is screwed into the female screw portion 93 of the first set of screws 14 (see also FIG. 4(b)). Referring to FIG. 8, the cross-link adjuster 112 is composed of a pipe member 125 and a plurality of standing shafts 126, 126 that are inserted along the axial direction thereof into the pipe member 125. In the present embodiment, two standing shafts 126, 126 are employed. The pipe member 125 is formed such that its outer shape in plan view is substantially the same rectangular shape as the upper surface of the bar receiving portion 36 of the connector member 12. The pipe member 125 is formed with a main opening 128 that is located at the center and extends through in the axial direction. A driver 114 for the second set of screws (see FIG. 14) can be inserted into the main opening 128. A pair of through-holes 129, 129 are formed on the diagonal line around the main opening 128 of the pipe member 125. Each through-hole 129 is provided to penetrate along the axial direction. The standing shaft 126 can be inserted into the through-hole 129.

[0038] Referring to FIG. 8, at the upper end of the standing shaft 126, a large-diameter shaft portion 131 having an outer diameter larger than the inner diameter of the through hole 129 of the pipe member 125 is formed. Referring also to FIG. 9, at the lower end of the standing shaft 126, a male screw portion 132 that is screwed into a female screw portion 61 provided on the upper surface of the bar receiving portion 36 of the connector member 12 is formed. The axial length of the standing shaft 126 is set to be longer than the axial length of the pipe member 125. Then, referring also to FIG. 9, the lower surface of the pipe member 125 is brought into contact with the upper surface of the bar receiving portion 36 of the connector member 12, and the standing shaft 126 is inserted through each through hole 129 of the pipe member 125, and the male screw portion 132 at the lower end thereof is screwed into the female screw portion 61 provided on the upper surface of the bar receiving portion 36. Then, the large-diameter shaft portion 131 of each standing shaft 126 protrudes upward from the upper surface of the pipe member 125, and the bar receiving portion 36 of the connector member 12 is supported by the cross-link adjuster 112 with the pipe member 125 sandwiched between the large-diameter shaft portion 131 of the standing shaft 126 and the bar receiving portion 36.

[0039] Referring to FIG. 12, the cross-bar holder 113 is for gripping one axial end of the cross-bar 13 and operating the cross-bar 13. The cross-bar holder 113 includes a shaft main body portion 134 having an opening end portion 139 that is expandable and contractible along the radial direction for fitting one end of the cross-bar 13 at the tip, a cylindrical slide pipe portion 135 that is disposed on the outer periphery of the shaft main body portion 134 and is slidable along the axial direction with respect to the shaft main body portion 134, and a grip 136 that is integrally connected to the base end portion of the shaft main body portion 134. Then, referring to FIG. 12(a), when gripping one end of the cross-bar 13, the slide pipe portion 135 is slid toward the grip 136 side to expose and expand the opening end portion 139 of the shaft main body portion 134.

[0040] Next, referring to FIG. 12(b), after covering the opening end portion 139 of the shaft main body portion 134 at one end of the crossbar 13, the slide pipe portion 135 is slid to a position covering the opening end portion 139. Then, the opening end portion 139 of the shaft main body portion 134 is reduced in diameter, so that one end of the crossbar 13 is supported by the opening end portion 139 of the shaft main body portion 134. On the other hand, when detaching the crossbar holder 113 from the crossbar 13, if the slide pipe portion 135 is slid toward the grip 136 side, the opening end portion 139 of the shaft main body portion 134 is exposed and expanded in diameter, and the crossbar 13 can be detached.

[0041] Referring to FIG. 14, the second set screw driver 114 includes a thin-diameter shaft portion 142 and a grip 143 provided at the upper end of the shaft portion 142. A fitting portion 146 protruding in a hexagonal star shape is formed at the lower end of the shaft portion 142. The fitting portion 146 is fitted into the hexagonal star-shaped through hole 95 of the second set screw 16. Then, by gripping the second set screw 16 with the second set screw driver 114 and screwing the second set screw 16 into the female screw portion 60 provided in the bar receiving portion 36 of the connector member 12, the crossbar 13 is pressed and fixed to the bar receiving portion 36 (bar receiving groove portion 57) of the connector member 12.

[0042] Next, a method for stabilizing the spine by fixing a desired range in the cranial-caudal direction using the percutaneous spinal stabilization system 1 according to the embodiment of the present invention will be described. In the present embodiment, a form of stabilizing a range between, for example, two vertebrae (for example, between thoracic vertebra T11 and lumbar vertebra L2) selectively determined along the cranial-caudal direction by the implant 4 in the body will be described. First, as shown in FIG. 5, the rod receiving portion 20 of the pedicle screw 10 is supported by the screw support portion 117 (a pair of screw gripping portions 119, 119) of the extender 110. Subsequently, a screwdriver is inserted into the extender 110, and the tip of the screwdriver supports the rod receiving portion 20 and the screw portion 21 of the pedicle screw 10 so as not to rotate relative to each other, and the screwdriver, the extender 110, and the pedicle screw 10 are integrally connected. Subsequently, the integrated screwdriver, extender 110, and pedicle screw 10 are inserted into the body through a small incision provided in the patient's back.

[0043] Next, by rotating the screwdriver by the operator, the screw portion 21 of the pedicle screw 10 is screwed into a predetermined vertebra through the pedicle of the vertebra and into the vertebral body. Subsequently, the next screwdriver and pedicle screw 10 are set in the next extender 110, and the screwing operation is performed on the next vertebra as described above, and this screwing operation is repeated for the predetermined vertebra. Note that since the pedicle screw 10 is screwed along a pair of left and right pedicles for one vertebral body, a pair (two) is screwed along the left and right directions for one vertebral body.

[0044] In the present embodiment, as shown in FIG. 1, for example, the pedicle screws 10 are respectively screwed (a total of four) into two vertebral bodies (thoracic vertebra T11 and lumbar vertebra L2) spaced apart from each other along the cranial-caudal direction of the spine. When the screwing operation of the pedicle screw 10 for a predetermined vertebra is completed, the screwdriver is removed from all the extenders 110 and taken out of the body. As a result, all four extenders 110 are in a state of protruding outward from the respective small incisions provided on the body surface. In addition, the rotational position of each extender 110 is determined so that its slit portion 118 faces in the cranial-caudal direction inside the body. At this time, by each extender 110, the rod receiving portion 20 of each pedicle screw 10 is held so that its U-shaped groove portion 28 faces in the cranial-caudal direction. Note that a plurality of small incisions provided on the body surface are provided corresponding to the number of pedicle screws 10.

[0045] Next, the operator grips the rod member 11 with a rod holder (not shown). Subsequently, the rod member 11 is inserted into the body through one of the small incision holes along the cephalocaudal direction, and inserted into the slit portions 118, 118 of the respective extensors 110, 110 adjacent to each other in the cephalocaudal direction of the spine. Subsequently, while referring to FIG. 5, the tip of a first set screw driver (not shown) is inserted into and gripped by the through hole 92 of the first set screw 14. Subsequently, the first set screw driver together with the first set screw 14 is inserted into each extensor 110, and the large-diameter male screw portion 88 of the first set screw 14 is screwed into the female screw portion 120 provided on the pair of wall portions 121, 121 of the extensor 110. Subsequently, by rotating the first set screw driver to rotate the first set screw 14 while advancing it, the rod member 11 is pushed on its lower surface and made to penetrate into the groove portion 28 of the rod receiving portion 20 of the pedicle screw 10.

[0046] Subsequently, the first set screw driver is rotated to continuously screw the large-diameter male screw portion 88 of the first set screw 14 from the female screw portion 120 of the extensor 110 into the female screw portion 31 of the rod receiving portion 20 of the pedicle screw 10. Finally, the rod member 11 is temporarily fixed to the groove portion 28 of the rod receiving portion 20 of the pedicle screw 10 by the first set screw 14. Referring to FIG. 1, by repeating this operation, the rod member 11 is temporarily fixed to the rod receiving portion 20 of each pedicle screw 10 along the cephalocaudal direction. At this time, each extensor 110 protrudes outside the body through the small incision hole, and the operator corrects the alignment of the spine so as to align it by gripping the upper part of these extensors 110 or displacing the upper part of each extensor 110 in the cephalocaudal direction, the left-right direction, or the like using a surgical instrument such as a compressor (not shown).

[0047] Next, using a driver for the first set of screws, fully tighten the first set of screws 14 to firmly fix the rod member 11 to the rod receiving portions 20 of the respective pedicle screws 10. The rod member 11 is arranged in a pair on the left and right with respect to the pair of left and right pedicle screws 10, 10. Subsequently, after removing the driver for the first set of screws from the extender 110, referring to FIG. 6, insert the guide shaft 111 into the extender 110, and thread the male threaded portion 123 at its lower end into the female threaded portion 93 of the first set of screws 14 to support the first set of screws 14. Repeat this operation to support all the first set of screws 14 with all the guide shafts 111. At this time, the upper end of the guide shaft 111 protrudes upward from the upper end of the extender 110.

[0048] Next, referring to FIG. 7, the surgeon removes all the extenders 110 from the rod receiving portions 20 of the respective pedicle screws 10 and takes them out of the body along the respective guide shafts 111. Subsequently, referring to FIGS. 8 and 9, connect the cross-link adjuster 112 to the bar receiving portion 36 of the connector member 12. Specifically, as described above, bring the lower surface of the pipe member 125 of the cross-link adjuster 112 into contact with the upper surface of the bar receiving portion 36 of the connector member 12, insert each standing shaft 126 through each through-hole 129 of the pipe member 125, and thread the male threaded portion 132 at its lower end into the female threaded portion 61 provided on the upper surface of the bar receiving portion 36. Then, with the pipe member 125 sandwiched between the large-diameter shaft portion 131 of the standing shaft 126 and the bar receiving portion 36 of the connector member 12, support the bar receiving portion 36 of the connector member 12 with the cross-link adjuster 112.

[0049] Next, referring to FIG. 10, the operator grips the cross-link adjuster 112, inserts the cylindrical portion 39 of the screw engagement portion 35 of the connector member 12 into the guide shaft 111, moves it along the guide shaft 111, and engages it so as to cover the rod receiving portion 20 of the pedicle screw 10. Then, a pair of flat portions 47, 47 and a pair of arc portions 48, 48 (see FIG. 4) within the cylindrical portion 39 (within the large-diameter opening 43) of the screw engagement portion 35 abut against a pair of flat portions 24, 24 and a pair of arc portions 25, 25 (see FIG. 3) of the rod receiving portion 20 of the pedicle screw 10, respectively, whereby the connector member 12 is positioned with respect to the rod receiving portion 20 of the pedicle screw 10. At this time, the bar receiving portion 36 of the connector member 12 is positioned above the rod member 11. Also, the small-diameter male screw portion 89 of the first set screw 14 protrudes upward from the screw engagement portion 35 of the connector member 12.

[0050] Next, referring to FIG. 11, the operator grips the nut member 15 with a nut holder (not shown). The nut member 15 is inserted into the guide shaft 111 and guided along the guide shaft 111 to the small-diameter male screw portion 89 of the first set screw 14. Subsequently, by rotating the nut holder, the nut member 15 is screwed onto the small-diameter male screw portion 89 of the first set screw 14. Then, by fastening (temporarily tightening) the nut member 15, the connector member 12 is connected to the rod receiving portion 20 of the pedicle screw 10. By repeating this operation, the connector member 12 is temporarily fixed to the rod receiving portion 20 of each of all the pedicle screws 10. In the present embodiment, as shown in FIG. 1, the connector member 12 is fixed to the rod receiving portion 20 of each of all the pedicle screws 10. However, for example, there is also a surgical procedure in which the connector member 12 is connected only to an appropriately selected pair of left and right pedicle screws 10, 10 out of a pair of left and right pedicle screws 10, 10 provided in plurality along the cranial-caudal direction of the spine.

[0051] Next, the operator grips one axial end of the crossbar 13 with the crossbar holder 113. Specifically, as described above, referring to FIG. 12(a), when gripping one axial end of the crossbar 13 with the crossbar holder 113, the slide pipe portion 135 is slid toward the grip 136 side to expose and expand the opening end portion 139 of the shaft main body portion 134. Subsequently, referring to FIG. 12(b), after covering the opening end portion 139 of the shaft main body portion 134 on one end of the crossbar 13, the slide pipe portion 135 is slid to a position covering the opening end portion 139 in a direction opposite to the grip 136 side. As a result, the opening end portion 139 of the shaft main body portion 134 is reduced in diameter, and one end of the crossbar 13 is supported by the opening end portion 139 of the shaft main body portion 134.

[0052] Next, referring to FIG. 13, with one axial end of the crossbar 13 gripped by the crossbar holder 113, the crossbar 13 is inserted into the body through a mini-incision hole provided on the side of the patient. Subsequently, the crossbar 13 is inserted into the bar receiving portions 36, 36 (bar receiving groove portions 57, 57) of the respective connector members 12, 12 connected to the pair of left and right pedicle screws 10, 10. At this time, since the pipe members 125 of the cross-link adjuster 112 are respectively arranged on the upper surfaces of the bar receiving portions 36 of the respective connector members 12, the upper part of the bar receiving groove portion 57 of the bar receiving portion 36 is not open. Under such circumstances, the crossbar 13 is inserted laterally into the bar receiving portion 36 (bar receiving groove portion 57) of each connector member 12.

[0053] And at this time, the operator swings the cross-link adjuster 112 along the left-right direction, so that the bar receiving portion 36 of each connector member 12 can be swung along the left-right direction within a range of 15° on one side (30° in total) around the axis of the support rod portion 40 with respect to the screw engagement portion 35 (see the white arrow in FIG. 13). As a result, the cross bar 13 can be easily guided into the bar receiving portion 36 (bar receiving groove portion 57) of each connector member 12. By repeating this operation, the cross bar 13 is guided into the bar receiving portions 36 (bar receiving groove portions 57) of the pair of left and right connector members 12, 12 on the head side, and the cross bar 13 is guided into the bar receiving portions 36 (bar receiving groove portions 57) of the pair of left and right connector members 12, 12 on the tail side. Then, one axial end of the cross bar 13 is kept held by the cross bar holder 113.

[0054] Next, referring to FIG. 14, the operator fits and supports the fitting portion 146 of the second set screw driver 114 into the through hole 95 of the second set screw 16. Subsequently, the second set screw driver 114 and the second set screw 16 are inserted into the pipe member 125 (main opening 128) of the cross-link adjuster 112, and by rotating the second set screw driver 114, the second set screw 16 is screwed into the female screw portion 60 of the bar receiving portion 36 of the connector member 12 (see FIGS. 3 and 4(b)), and the cross bar 13 is pressed and fixed to the bar receiving portion 36 (bar receiving groove portion 57) of the connector member 12.

[0055] Next, referring to FIG. 15, remove the second set screw driver 114 from within the pipe member 125 (main opening 128) of the cross-link adjuster 112 and take it out of the body. Further, by sliding the slide pipe portion 135 of the cross-bar holder 113 toward the grip 136 side, remove the cross-bar holder 113 from the cross-bar 13 and take it out of the body. Subsequently, referring to FIG. 16, tighten all the nut members 15 with a torque wrench (not shown). Subsequently, referring to FIG. 17, disengage the male screw portion 132 of each standing shaft 126 of the cross-link adjuster 112 from each female screw portion 61 of the bar receiving portion 36 of the connector member 12, remove the cross-link adjuster 112 from the connector member 12, and take it out of the body. Subsequently, referring to FIG. 18, disengage the male screw portion 123 of the guide shaft 111 from the female screw portion 93 (see FIG. 4(b)) of the first set screw 14 and take it out of the body. When this operation is completed, as shown in FIG. 1, the operation of attaching various in-vivo implants 4 to the spine with various surgical instruments 5 is completed, and it becomes possible to stabilize the spine.

[0056] And in the percutaneous spinal stabilization system 1 according to the present embodiment, basically, small incision holes for inserting each pedicle screw 10 are provided corresponding to the pedicle screws 10 on the body surface of the patient. In the present embodiment, four small incision holes are formed corresponding to the four pedicle screws 10. Using the small incision hole corresponding to one pedicle screw 10, the rod member 11 and the connector member 12 are inserted into the body. Also, using the small incision hole, the extender 110, the guide shaft 111, the cross-link adjuster 112, the first set screw driver, and the second set screw driver 114, etc. are operated. In other words, during the operation, the extender 110, the guide shaft 111, and the cross-link adjuster 112 protrude outside the body through the small incision hole.

[0057] In addition, a minimally invasive incision hole for inserting the crossbar 13 into the body is provided on the body surface on the side of the patient. In this embodiment, two such minimally invasive incision holes are required along the cranio-caudal direction. Using these minimally invasive incision holes, the crossbar 13 is inserted into the body by the crossbar holder 113, and the left and right pair of connector members 12, 12 are connected so as to span therebetween. As a result, by adopting the percutaneous spinal stabilization system 1 according to this embodiment, without making a large incision in the patient's back, at least small incision holes (four in this embodiment) corresponding to the pedicle screws 10 and minimally invasive incision holes (two) corresponding to the crossbar 13 are provided on the body surface of the patient, and the effect of the percutaneous surgical procedure can be further enhanced.

[0058] As described above, in the percutaneous spinal stabilization system 1 according to this embodiment, a connector member 12 connected to the rod receiving portion 20 of the pedicle screw 10 and a crossbar 13 connected to the left and right pair of connector members 12, 12 connected to the rod receiving portions 20 of the left and right pair of pedicle screws 10 are provided. Thereby, the connector member 12 can be inserted into the body through the small incision hole through which the pedicle screw 10 is inserted into the body, and the total size of the small incision hole can be minimized. As a result, maximum effects as a percutaneous surgical procedure, such as a reduction in the amount of bleeding associated with the surgery and a shortening of the surgery time, can be achieved.

[0059] Further, in the percutaneous spinal stabilization system 1 according to this embodiment, since the connector member 12 is connected to the rod receiving portion 20 of the pedicle screw 10, the configuration of the connector member 12 can be simplified, and the bar receiving portion 36 of the connector member 12 can be brought as close as possible to the rod receiving portion 20 of the pedicle screw 10. Thereby, the guide shaft 111 and the link adjuster 112 can be brought as close as possible to each other, and the incision hole provided on the body surface of the patient can be made significantly smaller than the invention described in Patent Document 1, and maximum effects as a percutaneous surgical procedure can be achieved.

[0060] Furthermore, in the percutaneous spinal stabilization system 1 according to the present embodiment, the bar receiving portion 36 of the connector member 12 is integrally connected to be swingable along the left-right direction within a predetermined range with respect to the screw engagement portion 35. As a result, when the cross bar 13 is accommodated in the bar receiving portions 36 of the pair of left and right connector members 12, 12, the cross bar 13 can be easily guided into the bar receiving portion 36 of each connector member 12. Thereby, the surgical procedure can be simplified, the surgical time can be further shortened, and thus the burden on the patient can be further reduced.

[0061] Furthermore, in the percutaneous spinal stabilization system 1 according to the present embodiment, the first set screw 14 as the implant material 4 has a large-diameter male screw portion 88 for connecting the rod member 11 to the rod receiving portion 20 of the pedicle screw 10, and a small-diameter male screw portion 89 for connecting the screw engagement portion 35 of the connector member 12 to the rod receiving portion 20 of the pedicle screw 10. Then, by the large-diameter male screw portion 88 and the small-diameter male screw portion 89 of the first set screw 14, both the rod member 11 and the connector member 12 can be connected to the rod receiving portion 20 of the pedicle screw 10. As a result, the structure is not complicated, and the number of constituent members of the implant material 4 can be minimized. Thereby, the surgical procedure can be further simplified, the surgical time can be further shortened, and thus the burden on the patient can be further reduced.

[0062] Furthermore, in the percutaneous spinal stabilization system 1 according to the present embodiment, with the rod member 11 connected to each pedicle screw 10 and the screw engagement portion 35 of the connector member 12 connected to the pedicle screw 10, the bar receiving portion 36 of the connector member 12 is located above the rod member 11. As a result, the bar receiving grooves 57, 57 of the pair of left and right connector members 12, 12 face in the left-right direction (a direction orthogonal to the axial direction of the rod member 11), so that the cross bar 13 can be easily guided to the bar receiving portions 36, 36 (bar receiving grooves 57, 57) of the pair of left and right connector members 12, 12. Thereby, the surgical procedure can be further simplified and the surgical time can be further shortened.

[0063] Furthermore, in the percutaneous spinal stabilization system 1 according to the present embodiment, as the surgical instrument 5, it includes a cross-link adjuster 112 capable of percutaneously supporting the connector member 12 from outside the body, and the cross-link adjuster 112 has the bar receiving portion 36 of the connector member 12 detachably attached to its tip. Thereby, by operating the cross-link adjuster 112 protruding outside the body by the operator, the bar receiving portion 36 of the connector member 12 can be easily swung with respect to the screw engagement portion 35. As a result, the cross bar 13 can be easily guided to each of the bar receiving portions 36, 36 of the pair of left and right connector members 12, 12.

[0064] Furthermore, in the percutaneous spinal stabilization system 1 according to the present embodiment, as the surgical instrument 5, it includes a guide shaft 111 capable of percutaneously supporting the first set of screws 14 from outside the body, and the connector member 12 is guided to the rod receiving portion 20 of the pedicle screw 10 along the guide shaft 111. Thereby, the connector member 12 can be easily and accurately guided to the rod receiving portion 20 of the pedicle screw 10.

Explanation of Reference Numerals

[0065] 1 Percutaneous spinal stabilization system, 4 Implant material in the body, 5 Surgical instrument, 10 Pedicle screw (vertebral fixing device), 11 Rod member, 12 Connector member, 13 Cross bar, 14 First set of screws (screw member), 20 Rod receiving portion (head portion), 35 Screw engagement portion (fixing device engagement portion), 36 Bar receiving portion, 88 Large-diameter male screw portion (first screw portion), 89 Small-diameter male screw portion (second screw portion), 111 Guide shaft, 112 Cross-link adjuster

Claims

1. A percutaneous spinal stabilization system comprising various implant materials for stabilizing the spine by being attached to each vertebra of the spine, and various surgical instruments for percutaneously attaching each implant material to the spine from outside the body, wherein the implant material includes vertebral fixators respectively fixed to each vertebra along the cranio-caudal direction of the spine and fixed in a pair along the left-right direction with respect to one vertebral body, a rod member arranged along the cranio-caudal direction of the spine and connected to the heads of the respective vertebral fixators, a connector member connected to the heads of the vertebral fixators, and a crossbar connected to the connector members connected to the pair of left and right vertebral fixators, wherein the connector member has a fixator engagement portion engaged with the head of the vertebral fixator and a bar receiving portion for receiving and connecting the crossbar, and the bar receiving portion is supported on a support rod portion protruding from the fixator engagement portion so as to be swingable within a predetermined range about the axis of the support rod portion with respect to the fixator engagement portion. A percutaneous spinal stabilization system characterized by this.

2. The implant material includes a screw member having a first screw portion for connecting the rod member to the head of the vertebral fixator and a second screw portion for connecting the connector member to the head of the vertebral fixator. The percutaneous spinal stabilization system according to claim 1, characterized by this.

3. With the rod member connected to each vertebral fixator and the fixator engagement portion of the connector member connected to the vertebral fixator, the bar receiving portion of the connector member is located above the rod member. The percutaneous spinal stabilization system according to claim 1, characterized by this.

4. A percutaneous spinal stabilization system comprising various implant materials for stabilizing the spine by being attached to each vertebra of the spine, and various surgical instruments for percutaneously attaching each implant material to the spine from outside the body, wherein the implant material includes vertebral fixators respectively fixed to each vertebra along the cranio-caudal direction of the spine and fixed in a pair along the left-right direction with respect to one vertebral body, a rod member arranged along the cranio-caudal direction of the spine and connected to the heads of the respective vertebral fixators, a connector member connected to the heads of the vertebral fixators, and a crossbar connected to the connector members connected to the pair of left and right vertebral fixators, wherein the connector member A fixing tool engaging portion engaged with the head of the vertebral fixing tool, and a bar receiving portion for receiving and connecting the cross bar, The surgical instrument includes a cross-link adjuster capable of supporting the connector member percutaneously from outside the body, The cross-link adjuster is formed in a shaft shape, and the bar receiving portion of the connector member is detachably attached to the tip thereof. A percutaneous spinal stabilization system characterized by this.

5. A percutaneous spinal stabilization system comprising various implant materials for stabilizing the spine by being attached to each vertebra of the spine, and various surgical instruments for attaching each implant material to the spine percutaneously from outside the body, The implant material includes vertebral fixing tools respectively fixed to each vertebra along the cranial-caudal direction of the spine and fixed in a pair along the left-right direction with respect to one vertebra, a rod member arranged along the cranial-caudal direction of the spine and connected to the head of each vertebral fixing tool, a connector member connected to the head of the vertebral fixing tool, a cross bar connected to the connector members connected to the pair of left and right vertebral fixing tools, a screw member having a first screw portion for connecting the rod member to the head of the vertebral fixing tool and a second screw portion for connecting the connector member to the head of the vertebral fixing tool, and includes The surgical instrument includes a guide shaft capable of supporting the screw member percutaneously from outside the body, The connector member is guided to the head of the vertebral fixing tool along the guide shaft. A percutaneous spinal stabilization system characterized by this.

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