摘要:
A system for direct visualization of the spine and the epidural and/or intra-discal space to facilitate diagnosis and treatment of spinal conditions and that is adapted for percutaneous introduction into the spinal space. The system includes a disposable flexible catheter, a fiber-optic bundle disposed within the catheter which is connected to a light source and camera. The bundle is removably and adjustably connected to the proximal end of the catheter to permit rotation of the bundle relative to the catheter. A mechanism for controllably deflecting the tip of the catheter is provided to vary the viewing angle of the fiber-optic bundle within and to assist in steering the catheter through the spinal space. The mechanism includes a deflection wire extending through the catheter and affixed at the distal end thereof. The proximal end of the deflection wire is affixed to a sleeve which is slidably disposed around the catheter and within a housing. The housing includes an internal flange that defines a stop surface which is contacted by the sleeve as the catheter and deflection wire is moved in a first direction. After the sleeve contacts the stop surface, further movement of the catheter in the first direction causes tension in the wire between the sleeve and the wire's securement to the catheter, thereby bending the catheter tip in the direction of the securement. The catheter can be rotated with the tip in its deflected position to provide a conical viewing region within the spinal space.
摘要:
An introduction apparatus for approximating a longitudinal member and an implant to permit fixation therebetween. The introduction apparatus having a gripping nose for securely engaging an implant, a lateral approximation mechanism for laterally aligning an implant and an offset longitudinal member, and a reduction mechanism for reducing the vertical distance between the implant and the longitudinal member. The introduction apparatus is provide with a gripping nose actuated by axial movement of a clamping shaft in an outer sleeve. The clamping shaft further includes an axial cannula for passage of a fastener to the implant.
摘要:
A method and an assembly for reducing a displaced vertebra and connecting the displaced vertebra to a spinal implant rod. The assembly has a reduction bolt with machine threads on one end and coarse threads on the other. A connection unit attaches the spinal rod to the reduction bolt, and until it is tightened, the connection unit allows the reduction bolt to slide within the connection unit. The connection unit includes a washer that rides against the side of the reduction bolt, and a nut is threaded onto the machine threads of the reduction bolt over a collar. The collar open is open at both ends and is of a size to readily slide over the reduction bolt. The posterior face of the collar has a notch to accept that portion of the lateral side of the washer as it presses against the reduction bolt. The notch is part of the open end of the collar into which is slide over the reduction bolt and down onto the connection unit. Arranged in this fashion, the nut can be tightened against the collar to move the displaced vertebra toward the longitudinal member. The third clamp can be tightened to secure the reduction bolt to the longitudinal member, and then the nut and the collar can be removed from the patient without the vertebra moving away from the longitudinal member.
摘要:
An introduction apparatus for approximating a longitudinal member and an implant to permit fixation therebetween. The introduction apparatus having a gripping nose for securely engaging an implant, a lateral approximation mechanism for laterally aligning an implant and an offset longitudinal member, and a reduction mechanism for reducing the vertical distance between the implant and the longitudinal member. The introduction apparatus is provide with a gripping nose actuated by axial movement of a clamping shaft in an outer sleeve. The clamping shaft further includes an axial cannula for passage of a fastener to the implant.
摘要:
Forceps are provided with a bifurcated gripping nose on one end adapted to pivotally engage an implant while a rod passes between the branches of the bifurcated gripping nose. The forceps further define a fulcrum adjacent the gripping nose. The pivotally engaging gripping nose and included fulcrum permit a surgeon to urge the rod into an opening in the implant with a single instrument while securely gripping the implant. With the implant pivotally engaged by the gripping nose, movement of the forceps towards the rod brings the fulcrum into contact with the rod and further movement urges the rod into an opening in the implant. In an alternative form, the gripping nose is laterally offset to urge a laterally offset rod into alignment with the implant upon rotation of the forceps.
摘要:
A spinal fixation system includes a relatively rigid fixation plate which is engaged to a plurality of vertebrae by bone screws or bolts. The plate includes a longitudinal slot defined therethrough with an arrangement of scallops formed at the edge of the slot on the upper and lower surfaces of the plate. The scallop arrangement includes a first set of scallops formed at one spherical radius and a second set of scallops nested within the first that are formed at a smaller radius. Thus, the fixation plate can accommodate bone screws or bolts, or other bone engagement or load transmitting components having curved engagement surfaces of various diameters and providing varying degrees of rigidity. In another feature of the invention, a C-shaped ring is provided which encircles the plate to entrap the side walls of the plate, thereby restricting the plate walls from spreading as the bone screws or bolts are tightened onto the plate. The side walls of the plate and the inner walls of the C-shaped ring are correspondingly curved to retain the ring on the plate.
摘要:
One external fixation frame, for immobilizing bone segments adjacent a fracture or joint, includes a fixation block with a pair of arms extending from the block across the fracture or joint. Another embodiment has but a single arm while a third embodiment includes one or two arms projecting from each end of the block. A ball and socket joint connects each arm to the block for universal movement thereabout. Length adjustment is accomplished via a turnbuckle formed in each arm. The outer end of each arm includes a slot for connecting to pins inserted in the respective bone segments. Set screws are provided for tightening the ball and socket joints and for holding the pins in the slots.
摘要:
An orthopedic stabilization system of implants that includes a bone attachment means that provides poly-axial fixation of the system to the vertebrae, and a connector means that connects the bone attachment means to the spinal rod in a fashion that allows variable height adjustment of the spinal rod (dorsal in the case of posterior spinal pedicle fixation). The orthopedic stabilization system includes a locking means with a tightenable ball-joint arrangement that locks a post means to the bone attachment means in a desired relative spatial orientation. Several embodiments are disclosed, some using traditional mechanical locking means such as screw fasteners, taper-locking interfaces and collets. Embodiments are described that use the austenitic transformation of shape memory alloy (SMA) material to effect a locking of both the ball-joint arrangement and the connector means.
摘要:
One embodiment of a spinal fixation system including a pair of longitudinal members 11, 12 positionable adjacent the spine, means for engaging longitudinal members to the spine 13, 14, a pair of wedge members 241 each having a bearing surface 242 configured to bear on a longitudinal member 11, 12, and a connector 200 configured to span a distance between the longitudinal members 11, 12. The connector 200 includes a pair of engaging members 205, 212 each having a fixation portion 207, 214 and a connecting portion 209, 216, and a bridge members 202 attachable to the connecting portions 209, 216. The engaging members 205, 212 each define a thru-hole 225 for receiving one of the wedge members 241. The thru-holes 225 are aligned so that when one of the wedge members 241 is advanced through the thru-hole 225, the bearing surface 242 will bear on a corresponding longitudinal member 11, 12 to force the longitudinal member 11, 12 into contact with the fixation surface 220, 221 and engage the longitudinal member 11, 12 to the connector 200. In a specific embodiment, the bridge member 200 defines a slot 203 and a fastener bore 227 having an axis D' intersecting the slot 203. In this embodiment, the second connecting portion 216 is insertable into the slot 203 to intersect the axis D' of the bone 227, whereby a fastener 230 received in the bore 227 will clamp the second connecting portion 216 to the bridge member 202.
摘要:
An apparatus for treating fractures of the femur including a screw and an intramedullary rod. The screw has a threaded portion and a smooth portion. The rod has a head and a stem. There is at least one opening through the head of the rod in an angled direction toward the femoral head relative to the longitudinal axis of the rod. The opening is adapted to slidingly receive the screw to permit the threaded portion of the screw, in use, to engage the femoral head and to allow sliding compression of a femoral neck or intertrochanteric fracture. An optional second opening and second screw which will also allow sliding compression may be provided to prevent rotation and to adapt the fracture device to a variety of applications.