Abstract:
The present invention is a spine supporting system where a screw, with a head having an interior female thread, is attached to the spine. An interior bolt is temporarily held by the interior female threads of the outer cap, where the outer cap aligns the inner bolt with the interior female threads of the screw. The inner bolt attaches to the interior threads of the screw and the outer cap secures a support rod to the screw. The present invention allows the support rod to be secured to the screw in one step, using a single tool during an operation.

Description:
BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to a spine supporting system for correcting or fixing a spine to be a stable state at a diseased part in spine operation. 
     2. Background of the Related Art 
     Generally, a spinal column (referred to as a ‘spine’ in the followings) of a normal human body standing erectly appears to be a straight line in front view and ‘Lasy-S’ curved in side view. That is, the thoracic spine has a shape gently bent backwardly in side view, while the cervical spine and the lumber spine has a shape bent forwardly. 
     In the human body, the spine forms a curve of ‘Lasy-S’ by connecting a plurality of bodies of spine with a disk, one section of the spine consists of cylindrical body and the arch located backward, the posterior spinal arch comprises a spinal canal with a pair of pedicles, superior or inferior facets extending backwardly from the pedicles, laminas and a spinous process, and a nerve is located through the spinal canal. 
     In such a spine, when the disk connecting the body is degenerated and ruptured so that it is separated from regular position or a joint consist of a rear projection of the spine is damaged and degenerated, and when the external force is loaded to or press the nerve passing through the spinal canal with various reasons such that the spine has a deformity and displacement from the normal position, it is known that pains are caused. 
     Therefore, since the pain are occurred continuously when the spine is in unstable state as mentioned above, the diseased part of the spine should be decompressed in order to kill the pains, and an operation correcting or fixing a spine to be a stable state, is required due to the unstable state of the spine in decompressing. 
     Namely, in case of a patient of which a part of the spine is broken or damaged, a corresponding spine or adjacent spine is supported through an operation using the spine supporting system. The spine supporting system used in this case, comprises a screw inserted to the damaged or adjacent upper and lower spinal pedicle of the spine as a supporting structure, a rod inserted in each of the screw, and a inner bolt and outer cap for fixing the rod to the screw. 
     Referring to FIG.  1 -FIG. 3, the spine supporting system according to the prior art will be explained roughly. FIG. 1 is an exploded perspective view showing a structure of a spine supporting system according to the prior art, FIG. 2 is a perspective view showing an operation process by a spine supporting system of the prior art, FIG. 3 is a sectional view showing an operation state by a spine supporting system of the prior art, and FIG. 4 is a perspective view for describing difficulties of an operation by a spine supporting system of the prior art. 
     In these figures, a reference numeral  10  is a screw having a head  12  and a body  14  formed to be integrated with a lower part of the head  12 , a reference numeral  20  is an inner bolt screwed in the head  12  of the screw  10 , a reference numeral  30  is an outer cap for improving the holding force of the inner bolt  20  by covering the head  12  of the screw  10 , and a reference numeral  40  is a rod inserted in the head  12  of the screw  10  to connecting the screws  10  each other. 
     The head  12  of the screw  10  could be described divided into an inner structure and outer structure. The inner structure of the head  12  includes a female thread  11  for the inner bolt  20  and ‘U’ shaped groove  16  for passing and fixing the rod  40  which connects the spine supporting system described below, and the outer structure of the head  12  includes a cap-assembled surface  13  covered with the outer cap  30  to prevent the decrease of strength in the head  12  due to the formation of the groove  16  and to increase the fixation and a head block  17  formed at an lower part of a cap-assembled surface  13  and connected with the body  14 . 
     The body  14  of the screw  10  has a lengthy cone shape and is formed at a circumference thereof with a male thread, and an upper part thereof is integrated with the lower part of the head  12 . And, a point  18  for the insertion to the spine is formed at a lower end of the body  14 . 
     The upper surface of the inner bolt  20  is formed with a tool insertion hole  22  in which assembling tool is inserted and along with a whole circumference, a male thread  24  joined with the female thread  11  is formed. 
     The outer cap  30  includes an inner cavity  32  assembled with the cap assembled surface  17  and an upper surface  34  formed perpendicularly relative to the length direction. 
     The rod  40  has a diameter so as to be inserted in the groove  16  of the screw  16 . 
     The function of the spine supporting system according to the prior art will be described referring to the FIG.  2  and FIG.  3 . Firstly, describing the general operation procedure briefly, with incision and opening a skin of the operated part, the position in which the screw is inserted normal to the pedicle of the corresponding spine, is indicated, and then a hole is formed with a drill and the like. (Drilling Procedure) 
     A tapping matching a pitch of the spine supporting system, is performed at the drilling hole and the spine supporting system(specifically, the body  14 ) is driven in the spine with the tool  100  and so on. Then, when the required number of screw  10  is screwed to be fixed in the pedicle of the spine  200  as described above, the rod  40  which is bent suitable for the curvature of the spine, is inserted in the groove  16 . Subsequently, the inner bolt  20  set in the female thread  12   a  is rotated several times with the tool  100  so that the rod  40  is preliminarily fixed. After the outer cap  30  covers the cap assembled surface  13  of the head  12 , the rod  40  is fixed in the screw  10  rigidly by joining the inner bolt  20  tightly and the skin is sutured to complete the spine operation. 
     Therefore, as shown in FIG. 2, it is known that in the state the body  14  is fixed rigidly in the spine of the patient, the rod  40  is fixed rigidly in the groove  16 , and further in the inner bolt  20  and screw  10 , it is said that the fixation of the head  12  is stronger by the outer cap  30 . 
     However, in the operation by the spine supporting system according to the prior art, the following defects and problems are occurring. 
     1. The difficulties in the insertion of the outer cap  30  and the initial setting of the inner bolt  20 . 
     In the spine operation using the spine supporting system of the prior art wherein the rod  40  is fixed in the head  12  of the screw  10  by joining the inner bolt  20  in the female thread  12   a,  the outer cap  30  is joined after the inner bolt  20  is joined in the female thread  11 . 
     This joining sequence causes the following problems. In actual operation, since the incision area of the skin is adjusted as small as possible and the inner bolt  20  has a diameter only 4 mm, it is very difficult to join the small inner bolt  20  in the female thread  11  of the head  12  with initial centering in the narrow space of operation without any guide means. 
     On the other hand, referring to FIG. 4, according to conditions the rod  40  is not bent suitably. In this case the operation condition is worse, since the small inner bolt  20  is joined in the female thread  11  where the rod  40  is more curved upwardly in the groove  16 . That is, as the inner bolt  20  could be joined unsuitably interrupted by the rod  40 , the operator could be annoyed at the trial for centering in limited operation time. 
     According to the joining of the inner bolt  20  prior to the outer cap  30 , the centering of the inner bolt  20  is not achieved easily and the rapid joining is not easy due to the sliding and pitching during inserting, and therefore the operation is difficult and hard. 
     In addition, although the inner bolt  20  is inserted in the female thread  11 , the bulging-out effect of the cap assembled surface  13  is occurring by the strength decrease due to the groove  16  of the head  12  as the fixation of the inner bolt  20 , so that the insertion of the outer cap  30  to the cap assembled surface  13 , is difficult and is causing the delay of the operation. 
     Furthermore, when the length of the rod  40  is excessively short or long, the rod  40  bent unsuitably is not seated in the groove  16  and causes the rear part thereof to be lifted bent by elasticity itself, and thereby in joining the outer cap  30  and head  12 , the lower end of the outer cap  30  is interfered with by the rod  40  so that the stable fixation could not be maintained and the use there of is more difficult. These phenomena are more significant in the insertion of the rod  40  between the fifth lumbar and the first sacrum. 
     Though the outer cap  30  is joined smoothly, this outer cap  30  having only functions as a container could not operate to be associated with the inner bolt  20  so that the operation is failed by so-called loosening and separation which the rigid fixation between the inner bolt  20  and outer cap  30  is lost, and therefore the early recovery is not achieved as the patient complains of the pain. 
     Meanwhile, it may be assumed that the difficulties as mentioned above are solved by which the inner bolt  20  is inserted in the female thread  11  after the outer cap  30  is inserted to the head  12 . However, in case of the first insertion of the outer cap  30 , there is no means for holding the outer cap  30 , so that the separation or damage of the outer cap  30  in the insertion of the inner bolt  20 . Further, since the rod  40  is often lifted upwardly in the groove  16 , the lower part of the outer cap  30  is interfered with by the rod  40  and could not inserted in the head  12  stably in this state. Therefore, the spine supporting system of the prior art has an unreasonable structure to solve the problem by inserting the outer cap  30  to the head  12 . 
     2. The screw damages due to the design error 
     As the spine supporting system of the prior art is not designed to be proportional ideally with regard to the screw  10  and the head  12 , various problems of design due to this is caused and especially in case of the head  12  which is formed to be large excessively, the moment causing the damage is concentrated on the boundary of the head  12  and body  14 . This could be the fatal defect in the spine supporting system. 
     3. Strength decreases and unbalanced rotation in the spine supporting system that outer cap is integrated with the inner bolt. 
     In the spine supporting system of the prior art that outer cap is integrated with the inner bolt (not shown), as the inner bolt is joined only supported by the segment formed at the lower part of the outer cap, precise rotation could not be obtained and the fixation strength is weak due to the support of the inner bolt only in the lower part. 
     Since many defects in the spine supporting system of prior structure, is an obstacle in the spine operation requiring a rapid and accurate work, the solution thereon is desperately requested in the related academic field. 
     The basic concept of the spine supporting system set by the inventor, is to provide the apparatus that ensures the easiness in the insertion of the outer cap and initial setting of the inner bolt and is small and also easy to use, while exerting the rigid fixation. 
     The easiness in use is the concept from the doctor using the spine supporting system and is the factor, which should be considered, since the value thereof is degraded if it takes long that the doctor is accustomed to it or the operation takes long, however good the apparatus could be. To obtain such a reasonable design, the design factors are divided that the factor could be modified and not modified, and the factor could be modified is researched intensively so as to maximize the function thereof. 
     SUMMARY OF THE INVENTION 
     The present invention is contemplated to solve the aforementioned problem, and it is an object of the present invention to provide a spine supporting system, which could make the insertion of an outer cap and the initial centering of an inner bolt easy, strengthen the fixation, and contribute to the extension of life in the system by enabling the insertion of an inner bolt in a head to be guided by the outer cap and having the fixation of the outer cap, inner bolt, rod, and head to be integrated with each other after joining the outer cap rather than the inner bolt to head, departing from a fixed idea in the spine operation. 
     It is another object of the present invention to provide the spine supporting system, which is applied suitably to that the rod is lifted excessively in the head, and which has a double structure ensuring steady and forceful rotation and supporting a head part rigidly in the spine supporting system, which the inner bolt and outer cap is integrated. 
     According to one aspect of the present invention to accomplish the above object, it is provided a spine supporting system comprising: a screw having a cone shaped body and a head which includes at least a female thread, cap assembled surface, and a head block; a inner bolt having a male thread at an outer circumference to be inserted and mounted in the head of the screw; an outer cap having an inner cavity to cover the head of the screw; a rod inserted in the head of the screw and fixed by the outer cap and the inner bolt, being characterized that the outer cap is formed with a guide female thread at an upper part of an inner cavity, thereby joining the inner bolt to the guide female thread of the outer cap preliminary, and then joining the inner bolt to the female thread of the screw completely after mounting the outer cap to the head of the screw. 
     It is preferable that inner bolt is formed with a head part extending outwardly from an upper part thereof, and the outer cap is formed at an upper part of the guide female thread with a seat recess, in which the head part of the inner bolt is fastened and seated. 
     The inner cavity of the outer cap preferably includes a first and second step surface having different inner diameters in order to cover the cap-assembled surface and head block of the head. 
     It is preferable that the guide female thread is formed with a pitch with a limited number of a crest and root, which the inner bolt is only joined to the outer cap preliminarily and guided thereby such that the centering in the joining of the female thread of the screw and inner bolt is not interfered with. 
     It is preferable that the screw is formed with a first and second round surface at a boundary of the cap assembled surface and an upper surface, and a portion between the cap assembled surface and head block respectively, and the outer cap is formed with round surfaces at a portion between the first and second step surface, and an inner end of a lower part in the second step surface respectively. 
     More preferably, the outer cap is formed with a round cut part cutting a rod connected portion thereof as a semicircle with 2 mm depth to avoid the interference of outer cap insertion by the rod in the actual operation. 
     According to another aspect of the present invention to accomplish the above object, it is provided a spine supporting system comprising: an inner bolt formed with a respective fastening part of an upper part and fastening groove of the lower part; an outer cap formed with a supporting segment of an upper part, the supporting segment being joined rotatively with the fastening part of the inner bolt; and a reinforcement ring joined in the outer cap by tight fitting, a supporting segment in a lower part of the reinforcement ring being joined rotatively in the fastening groove of the inner bolt, wherein joining the inner bolt supported at the upper and lower part thereof by the outer cap and reinforcement ring. 
     In the present invention, after the small inner bolt is joined with the outer cap preliminarily in the outer circumstance of operation part, the outer cap larger than the inner bolt covers the head of the screw, and then the inner bolt guided by the outer cap is joined with the female thread. Therefore, the initial setting of the inner bolt and the female thread of the head and the insertion of the outer cap and head become very easy. Additionally, in the complete joining of the inner bolt, the inner bolt and the head of the screw joined, and the seat recess of the outer cap is fastened to the head part of the inner bolt, so that the screw, inner bolt, and outer cap are integrated and exert the rigid fixation. Further, since the lower part of the inner cavity in the outer cap is formed large and main contacting part of the outer cap and head of the screw is round, the outer cap could be inserted in the head without any difficulties. Also, when the inner bolt is rotated in the insertion of the outer cap to the head, the inner bolt is inserted accurately in the female thread of the head automatically, so that the rapid and accurate operation could be schemed. Furthermore, since the outer cap covers and supports the entire head part, the fixation is strengthened and the life of system is extended. 
     In the spine supporting system which the inner bolt and outer cap is integrated, since the upper and lower part of the inner bolt is supported by the double structure of the outer cap and reinforcement ring, steady and forceful rotation is ensured and the head part is supported rigidly. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The features and advantages of the present invention will be more described specifically in the following description of preferred embodiments of the invention with reference to the accompanying drawings wherein: 
     FIG. 1 is an exploded perspective view showing a structure of a spine supporting system according to the prior art; 
     FIG. 2 is a perspective view showing an operation process by a spine supporting system of the prior art; 
     FIG. 3 is a sectional view showing an operation state by a spine supporting system of the prior art; 
     FIG. 4 is a perspective view for describing difficulties of an operation by a spine supporting system of the prior art; 
     FIG. 5 is an exploded perspective view showing a structure of a spine supporting system according to the first embodiment of the present invention; 
     FIG. 6 is a sectional view showing a functional principle of a spine supporting system according to the first embodiment of the present invention; 
     FIG. 7 is a sectional view showing an operation sequence by a spine supporting system according to the first embodiment of the present invention; 
     FIG. 8 is a perspective view showing an example of operation by a spine supporting system according to the first embodiment of the present invention; 
     FIG. 9 is a sectional view showing another function of a spine supporting system according to the first embodiment of the present invention; 
     FIG. 10 is an exploded perspective view showing a structure of a spine supporting system according to the second embodiment of the present invention; 
     FIG. 11 is a sectional view showing a double structure of an outer cap and a reinforcement ring applied to a spine supporting system according to the second embodiment of the present invention; 
     FIG. 12 is an exploded perspective view showing a double structure of an outer cap and a reinforcement ring applied to a spine supporting system according to the second embodiment of the present invention; 
     FIG. 13 is an exploded perspective view showing an example of operation using a spine supporting system according to the second embodiment of the present invention; and 
     FIG. 14 is a sectional view showing a function of a spine supporting system according to the second embodiment of the present invention. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
     Reference will now be made in detail to the first and second embodiment of the present invention, examples of which are illustrated in the accompanying drawings. In explaining the present invention, the same names and reference numerals will be given to the same components, and explanations in the same will be omitted. 
     The first embodiment 
     The first embodiment of the present invention will be explained referring to FIG. 5 to FIG.  9 . FIG. 5 is an exploded perspective view showing a structure of a spine supporting system according to the first embodiment of the present invention, and FIG. 6 is a sectional view showing a functional principle of a spine supporting system according to the first embodiment of the present invention. 
     Generally in the spine supporting system, a screw  10  is a rigid screw in which a body  14  is integrated with a head  12  or a polyaxial screw, which could rotates at certain angle relative to a the head  12  by forming a sphere on an upper end of a body  14 . The first embodiment will be explained, with regard to the rigid screw. 
     In the drawings according the present embodiment the same numerals are given to the same components, and only differences to the prior art will be described in the followings. 
     A boundary of cap assembled surface  13  and an upper surface  13   b,  and a step portion between the cap assembled surface  13  and a head block  17  is formed as a round surface  13   a,    19  and is strengthened so that the shearing and breakage by the external force is prevented or the insertion of an outer cap  30  is archived smoothly. 
     An inner bolt  20  has a head part  26 , which extends and projects outwardly from an upper end thereof. 
     The outer cap  30  has a seat recess  33 , in which the head part  26  of the inner bolt  20  could be inserted, a guide female thread  35  is formed at an inner end of the seat recess  33 , and the inner bolt  20  is screwed in the guide female thread  35 . The guide female thread  35  is formed to permit only 1.5 turns, i.e. 540 degrees and the inner bolt  20  is joined loosely, so that the centering is not interfered with when a female thread  11  of the screw  10  and the inner bolt  20  are joined together. That is, with this guide female thread  35 , the inner bolt  20  is only joined with the outer cap  30  preliminarily. 
     Additionally, the outer cap  30  has a round cut part  36  of semicircle having a depth of 2 mm such that the rod  40  does not interfere with the insertion of the outer cap  30  in the operation. Also, to cover the entire head  12 , i.e. the entire cap assembled surface  13  and a part of the head block  17 , an inner cavity  37  comprises a first step surface  37   a  and a second step surface  37   b.  Further, to ensure the easy and smooth insertion with the round surface  13   a,    19  of the head  12 , a portion between the first step surface  37   a  and the second step surface  37   b  and an inner portion of the lower end is rounded. 
     The function and effectiveness of the first embodiment of the present invention will be explained referring to FIG.  7 . FIG. 7 is a sectional view showing an operation sequence by a spine supporting system according to the first embodiment of the present invention, and FIG. 8 is a perspective view showing an example of operation by a spine supporting system according to the first embodiment of the present invention. 
     Referring to these drawings, the general operation procedure described in the above is omitted, and only the function of the mechanism according to the present embodiment will be explained in detail. Firstly as illustrated in FIG.  7 (A), the rod  40  is mounted normal to be lifted slightly. In this state, the outer cap  30  of the present invention is joined with the female thread  11 , and as the first step, the inner bolt  20  is joined preliminarily with the guide female thread  35 . In this step, as the inner bolt  20  is caught in the guide female thread  35  by only rotation of 540 degrees, it could move to both side slightly. 
     This is for that no interference with regard to the centering of the inner bolt  20  to the female thread  11  occurs in a ‘pre-assembling step’, which the inner bolt  20  is joined with the female thread  11 . More specifically, when the inner bolt  20  is only caught in the guide female thread  35  and thus simply joined with the outer cap  30  preliminarily, the centering of the inner bolt  20  center easily to the female thread  11  and the sliding and pitching during the insertion is removed such that the insertion of the inner bolt  20  is to be accurate and swift, only by mounting the outer cap  30  to the head  12  in the initial entry of the inner bolt  20 . 
     When the preliminary joining of the inner bolt  20  and outer cap  30  is completed, the outer cap  30  is inserted to the head  12 . In the insertion, with the round surface  13   a,    19 , the round surface  38  between the first and second step surface  37   a,    37   b  of the inner surface of the outer cap  30 , and the round surface  39  in the inner portion of the lower end of the outer cap  30 , the insertion is achieved easily as follows. 
     In the initial insertion of the outer cap  30  to the head  12  of the screw  10 , the first and second step surfaces  37   a,    37   b  are in contact with the cap assembled surface  13  and an outer surface of the head block  17  respectively, and the round surfaces  38 ,  39  are in contact with the round surfaces  13   a,    19  individually, and thereby the outer cap  30  is inserted to the head  12  smoothly. That is, each round surfaces  13   a,    19 ,  38 ,  39  functions as an insertion guide. Also, these functions naturally and automatically as the insertion guide due to the harmony with a wider diameter and a narrower diameter. 
     When the outer cap  30  is completely inserted to the head  12  of the screw  10  as above, the first and second step surfaces  37   a,    37   b  is to cover the entire cap assembled surface  13  of the head  12  and a part of the head block  17 . 
     After the outer cap  30  is inserted to the head  12  as above, as joining the inner bolt  20  using the tool  100  as can be seen in FIG.  7 (B), the inner bolt  20  guided in the outer cap  30  is joined automatically in the female thread  11  of the screw  10 , and the rod  40  is inserted in the groove  16  of the screw  10  by the fixing force of the inner bolt  20 . And, as the inner bolt is joined further as shown in FIG.  7 (C), the bottom surface of the inner bolt  20  fixes the rod  20  in the head  12  of the screw  10  by pushing it, and at the same time the head part  26  of the inner bolt  20  is inserted and seated in the seat recess  33  of the outer cap  30 . 
     In such a complete joining of the inner bolt  20 , since the inner bolt  20  is inserted in the female thread  11  of the head  12  in the screw  10  and the head  12  covered with the head  12  maintains the integrated state which the seat recess  33  is fastened to the head part  26  of the inner bolt  20 , the rod  40  is fixed in the rod  40  rigidly. 
     As described above, the present invention fixes the rod  40  in the screw  10  by rotating and inserting the inner bolt  20  automatically in the female thread  11  of the head  12 . 
     FIG. 9 is a sectional view showing another function of a spine supporting system according to the first embodiment of the present invention. 
     It is often a case that the actual operation is not the same as that in the textbook according to the state of the patient. FIG. 9 illustrates the state that the inner bolt  20  is joined, as the rod  40  is not mounted accurately in the groove  16 , in other words the rod  40  is not in the well fitting. The rod  40  is lifted excessively to the upper part of the groove  16 . 
     In this state, as the outer cap  30  of the present invention is inserted to the head  12 , the outer cap  30  is inserted to the head  12  of the screw  10  preliminarily with the rod  40  is inserted in the round cut part  36  formed in the outer cap  30 . Subsequently, as the inner bolt  20  is fastened, the inner bolt  20  guided in the outer cap  30  is joined in the female thread  11  and this inserts the outer cap  30  to the head  12 , and thereby the rod  40  in the head  12  of the screw  10  is fixes as the above. 
     The second embodiment 
     FIG. 10 is an exploded perspective view showing a structure of a spine supporting system according to the second embodiment of the present invention, FIG. 11 is a sectional view showing a double structure of an outer cap and a reinforcement ring applied to a spine supporting system according to the second embodiment of the present invention, FIG. 12 is an exploded perspective view showing a double structure of an outer cap and a reinforcement ring applied to a spine supporting system according to the second embodiment of the present invention, FIG. 13 is an exploded perspective view showing an example of operation using a spine supporting system according to the second embodiment of the present invention, and FIG. 14 is a sectional view showing a function of a spine supporting system according to the second embodiment of the present invention. 
     FIG. 10 illustrates the spine support system that is suitable to apply to the patient who needs to reduce the spine to the normal position by a reaction from which the rod  40  connected to the plurality of the spine supporting system is tightened as the inner bolt  20  is joined where a cutting segment  51  is formed at an upper end of the head  12  of the screw  10 . This supporting system is applied to the operation, in which restores an abnormal fixed spine  202  to the normal position relatively the spine supporting system, and then cut the unnecessary cutting segment  51  along a cutting line  55 , while the rod  40  is forced to be pressed downwardly in the state that the rod  40  is lifted excessively in the groove  16 . 
     In the second embodiment, the same names and reference numerals will be given to the same components of the first embodiment, and in the drawings the numerals will be given to characterized part so as to give the explanation more apparently. 
     The inner bolt  20  and outer cap  30  are integrated, and a reinforcement ring  50  is joined in the outer cap  30  in the spine supporting system of the second embodiment 
     The inner bolt  20  is formed with a fastening part  23  at the upper part thereof and a fastening groove  25  at the lower part thereof. 
     The outer cap  30  is formed at the upper part thereof with a supporting segment  30   d  having a supporting end  30   c,  which has the curvature corresponding an outer diameter of a fastening part  23  of the inner bolt  20 , and is formed with a punching point  30   b  at the predetermined part of both sides. Also, the lower part of outer cap  30  is formed with a round cut part  30   f  at a contact part with the rod  40  in the insertion. 
     The reinforcement ring  50  has an outer diameter to be fitted tightly in an inner diameter of the outer cap, and is formed with a fixing opening  50   c  fastened at the punching point  30   b,  at an outer surface corresponding to the punching point  32   b  of the outer cap  30 . In addition, at the lower part thereof, a supporting segment  50   a  having a supporting end  50   b  which has the curvature corresponding an outer diameter of the fastening groove  25  of the inner bolt  20 , is formed. 
     In such a structure, the reinforcement ring  50  is inserted in the outer cap  30 , and the fastening part  23  and fastening groove  25  of the inner bolt  20  are inserted rotatively in the supporting segment  30   d  of the outer cap  30  and the supporting segment  50   a  of the reinforcement ring  50  respectively. 
     With respect to the function of the second embodiment according to the present invention, the explanation will be given referring FIG.  13  and FIG.  14 . The patient, to whom the present embodiment is applied, is in the state that the spine is separated and dislocated from the normal position so that it touches or presses the nerve system. As the cutting segment  51  extending from the upper part of a cap assembled surface  13  in the spine supporting system of the present embodiment, in case of separation of the spine, the rod  40  could be inserted in a groove  16  without any difficulties. 
     Referring to the FIG. 13, using the spine supporting system (A), (B), (C), a dislocated abnormal spine  202  and an adjacent normal spine  200  are connected with the curved rod  40 . In the state that the spine supporting system (C) in the normal spine  200  is fixed, the rod  40  is pressed by joining the inner bolt  20  tightly. The abnormal spine  202  is pulled up and restored to the normal position, as the spine supporting system (A),(B) fixed in the abnormal spine  202  moves up as a reaction. After that, the cutting segment  51  is cut and disposed using a proper operation tool and the cutting line  55 . 
     While the inner bolt  20  is joined by external force capable of restoring the abnormal spine  202  in fastening the inner bolt  20  tightly, the joining is not achieved and the initial centering is not easy, and thereby the operation becomes difficult, since the spine supporting system of the prior art supports the inner bolt  20  only in the lower part as the single outer cap  30 . However, since the present invention comprises a double structure of the outer cap and reinforcement ring  30 ,  50  and supports the upper and lower part of the inner bolt  20  rotatively, only by covering the head  12  with the outer cap  30 , the initial centering is achieved easily. Also, since the outer circumference of the head is supported rigidly by the double structure of the outer cap and reinforcement ring  30 ,  50  in the state that the inner bolt  20  is inserted completely in the head  12 , the head part is supported rigidly. 
     While the application of a rigid screw in which the body  14  and head  12  are integrated is described in the first and second embodiment, the a polyaxial screw in which the body  14  and the head  12  could rotate could be adapted to the present invention, and it is apparent that this falls into the scope of the present invention. 
     The effects of the present invention could be summarized as follows. 
     In the present invention, after the small inner bolt is joined with the outer cap preliminarily in the outer circumstance of operation part, the outer cap larger than the inner bolt covers the head of the screw, and then the inner bolt guided by the outer cap is joined with the female thread. Therefore, the initial setting of the inner bolt and the female thread of the head and the insertion of the outer cap and head become very easy. Additionally, in the complete joining of the inner bolt, the inner bolt and the head of the screw is joined, and the seat recess of the outer cap is fastened to the head part of the inner bolt, so that the screw, inner bolt, and outer cap are integrated with each other and exert the rigid fixation. Further, since the lower part of the inner cavity in the outer cap is formed large and main contacting part of the outer cap and head of the screw is round, the outer cap could be inserted in the head without any difficulties. Also, when the outer cap is inserted to the head, the inner bolt is inserted accurately in the female thread of the head automatically only by rotating the inner bolt, so that the rapid and accurate operation could be schemed. Furthermore, since the outer cap covers and supports the entire head part, the fixation is strengthened and the life of the supporting system is extended. 
     In the spine supporting system which the inner bolt and outer cap is integrated, since the upper and lower part of the inner bolt is supported by the double structure of the outer cap and reinforcement ring, steady and forceful rotation is ensured and the head part is supported rigidly. 
     Although a number of embodiment have described in the above specification, it should be apparent that the present invention could be embodied in many other specific mode included within the sprit and scope of the present invention. Thus, the present embodiments should be considered as illustrative, and the present invention could be modified within the scope of claims and the equivalent thereof.