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United States Patent 
[li] 4,401,112  Aug. 30, 1983
 SPINAL FIXATOR
 Inventor: Seyed M. Rezaian, The Hotel Isbla Garni, Niesenweg 10, CH 3012 Bern, Switzerland
 Appl. No.: 308,016
 Filed: Oct. 2, 1981
 Int. CU A61F 5/04; A61B 17/18
 U.S. CI 128/92 B; 128/84 R;
128/92 C; 128/92 E; 3/1.91
 Field of Search 128/92 R, 92 B, 92 C,
128/92 D, 92 E, 84 R, 92 G, 69. 75, 78; 3/1.9,
 References Cited
U.S. PATENT DOCUMENTS
3.741,205 6/1973 Markolfetal 128/92 D X
4,289,123 9/1981 Dunn 128/92 B X
4,309,777 1/1982 Patil 128/92 C X
FOREIGN PATENT DOCUMENTS
1051847 9/1953 France 128/92 D
1243353 8/1971 United Kingdom .
"Knodt Distraction-Fusion Instrumentation" Product
Encyclopedia, Zimmer-USA, Inc., 1978, pp. B203 and
Primary Examiner—Ronald L. Frinks
Attorney, Agent, or Firm—William D. Hall
A spinal fixator is in the form of a turnbuckle the end sections of which terminate as circular flat plates formed with upwardly and downwardly protruding spikes for engaging in the bone of respective vertebrae above and below a broken vertebra. Following decompression of the spinal cord, the fixator is inserted and extended to engage the spikes in the respective vertebrae and thereafter holds the spinal cord decompressed.
14 Claims, 4 Drawing Figures
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates to a spinal fixator.
2. Description of the Prior Art
Surgical treatment for fracture of the spine has been
known for very many years. However, various techniques have been used, with varying degrees of success.
It would appear that laminectomy is of no benefit in the management of spinal cord injury.
A simple plating and screw technique is known involving fixation on the spinal process, but, particularly [5 where the spinal process is broken, does not prevent redislocation.
In recent years, spring stabilization, plate and screws fixation into the pedicle, and external fixation have all been tried.
It has become more widely accepted nowadays that stability of the spine materially affects the ability of the injured neural tissue to heal. Furthermore, commonly in spinal injury the cord will swell owing to biochemical change and, in the limited space of the canal, become 25 squeezed. Moreover, a disc and ligaments are often ruptured and the cord compressed anteriorly. Therefore, in good management of spinal injury, not only stability of the spine but also decompression of the cord anteriorly are to be sought after.
According to the present invention, there is provided a spinal fixator, comprising first and second means having respective bearing portions for bearing against re- 35 spective vertebral portions respectively above and below a broken verebral portion and movable relative to each other, and adjusting means arranged to adjust the distance between said bearing portions for thereby setting the distance between said respective vertebral 40 portions.
Owing to the invention, it is possible to achieve a high degree of stabilization of the spine and reliably to maintain decompression of the cord.
The fixator can replace the whole or part of a broken 45 vertebra.
BRIEF DESCRIPTION OF THE DRAWINGS
In order that the invention may be clearly understood and readily carried into effect, reference will now be 50 made, by way of example, to the accompanying drawings, in which:
FIG. 1 shows a side elevation of an internal spinal fixator,
FIG. 2 shows a plan view thereof, 55 FIG. 3 shows a perspective view of a broken spine, and
FIG. 4 shows a perspective view of the fixator in use in the spine.
Commonly, in fracture of the spine, one or more discs 60 D and ligaments are ruptured and the spinal cord C is compressed anteriorly, as shown in FIG. 3. Moreover, owing to biochemical change, the cord swells and, in the limited space of the canal, therefore becomes squeezed. It would therefore appear that, for correct 65 management of spinal injury, not only is stabilization of the spine highly desirable, but also decompression of the cord C anteriorly is highly desirable.
Referring to FIGS. 1 and 2 the fixator is in the form of a turnbuckle. In practice, it is made of high quality stainless steel in three differing sizes. It consists of a rigid internally threaded intermediate section 1 and upper and lower externally threaded end sections 2 and 3. The end sections 2 and 3 of course have their external threadings of opposite hand. Moreover, the sections 2 and 3 terminate as flat plates 4 and 5, respectively, formed with respectively upwardly and downwardly protruding spikes 6 and 7, two for each plate. The middle 8 of the intermediate section 1 is of enlarged crosssection externally and is formed with two threaded holes 9 for receiving a tommy bar. By turning of the intermediate section 1 relative to the end sections 2 and 3, the turnbuckle can be extended by about half its length from its condition of minimum extension.
The use of the fixator will now be described with reference to FIGS. 3 and 4.
Through a standard antero-lateral approach, the spinal facture is exposed. Any ruptured disc, ruptured ligaments, broken bone fragments, and so on are removed. The spinal cord C is completely decompressed. Between the vertebrae VI and V2 immediately above and immediately below the broken vertebra V3 is inserted the fixator F. The fixator F is extended until the spikes 6 and 7 are engaged firmly in the bone of the vertebrae VI and V2, the flat plates 4 and 5 preventing excessive penetration into the bone. It is desirable that there should be inserted in addition to the fixator F a piece of rib R for biological bridging of the vertebra V3.
Even more reliable stabilization can be achieved by driving into the vertebrae VI and V2 the respective sharp forked ends 10 of a sheet metal staple 11 formed with a central vertical slot 12 which receives the shank, but not the head, of a bolt 3 which is screwed into one of the threaded holes 9. The staple 11 not only connects the vertebrae VI and V2 more stably together but the bolt 13 prevents rotation of the section 1 relative to the sections 2 and 3.
The fixator described above can be used with safety to immobilise securely the spine to facilitate nursing and rehabilitation procedures. It also decompresses the spinal cord to give the cord the maximum chance of recovery from any damage.
Use of the fixator described has a great advantage in that patients can be discharged from hospital between two and four weeks from the fixation operation, even if prior to the operation they were paralyzed in both legs owing to the compression of the spinal cord.
1. A spinal fixator, comprising:
first and second means having respective bearing portions for bearing against respective vertebral portions respectively above and below a broken vertebral portion and movable relative to each other,
adjusting means arranged to adjust the distance between said bearing portions for thereby setting the distance between said respective vertebral portions,
wherein said first and second means and said adjusting means are provided by upper and lower and intermediate sections, respectively, of a turnbuckle, and
a staple for bridging said respective vertebral portions, and
connecting means for connecting said staple to said intermediate section to prevent rotation of said