Patent RU-2541823-C1 (RU)
Inventor: VALEEV EL GIZAR KASIMOVICH
IPC: A61F2/44
Filed: 2014-01-10
Granted: 2015-02-20
Abstract: FIELD: medicine. 
     SUBSTANCE: device for the correction of displaced cervical articular process positions comprises a composite body of a head and a cylindrical base, upper and lower supporting platforms, outer surfaces of which face the vertebral bodies and have pointed flanges. The upper supporting platform is mounted on the head of the composite body. The upper portion of the base comprises a T-flange, projection sides of which are guides for female grooves mounted in the lower portions of the head. The head and base are connected by a thread rod having smooth ends, a diameter of which is less than the diameter of the middle thread portion of the rod. One end of the rod is provided with a closed hole for a box spanner, is mounted in a transfer sleeve having a thread along the outer side surface and a slot at the end face. The sleeved rod is mounted in a through hole in the composite body perpendicular to its long axis. The threaded sleeve thread is created in the hole only in the portion of the base, while the thread of the middle of the threaded rod - on the portion of the head of the composite body. The device also comprises an end plate that can be detachably laid on the head of the composite body The upper surface of the above plate has a horizontal portion with notches inserted into the vertebral body at the side of the dislocation, while two adjacent smooth portions inclined at various angles are mounted on the side of the intact articular process. The lower supporting platform having four diametrical vertical notches on the side surface is integrated with vertical and central threaded rod having four long grooves, a position of which corresponds to the position of the above notches, and a recess on the free end. A cup with a through hole in the middle provided with a long projection is formed on the rod; the hole has the shape and size corresponding to the long grooves on the rod; the notch of the side surface is coaxial with the flange in the hole on the vertical threaded rod. The cup bottom comprises a nut having radical through holes along the mid-line of the outer surface. The vertical rod with the mounted nut is mounted in a step cylindrical cavity arranged axially in the cylindrical base of the composite body. The nut is provided in the cavity with the greater diameter open to the bottom of the cylindrical base. Along the outer surface of the bottom of the base and the inner surface of the cup, there is a thread used to flush connect these parts along the outer surface of the cup and base. There is a window formed from the cup bottom to the height of the nut by the surface section at the mid-diameter. The upper portion of the head comprises a T-flange identical to that on the base of the composite body, side flanges of which are guides for the female grooves mounted in the lower portions of the end plate. Along the inner horizontal surface of the plate, above the grooves, there is a rectangular hollow for mounting the upper supporting platform. Two thread holes for a retainer are created along the side surfaces of the base of the body, and one - along the front surface of the end plate under the horizontal flange. A method for the correction of displaced cervical articular process positions involves placing the patient on a table in the lying position with a roller placed under his/her shoulders under general anaesthesia, performing a standard approach to anterior structures of the vertebral body under its dislocated or fractured body with removing super- and subjacent disks and bone fragments. The above device is laid into the formed compartment. The end plate is laid on the head of the composite body; the angles on the upper surface of the plate shall correspond to the fracture nature, right- or left-sided, of a different height and length so that the upper horizontal platform of the end plate is arranged on the side of the dislocation close to the articular processes of the vertebrae, while its inclined surfaces faces the intact articular process. The nut is rotated with a special instrument, and a working end is alternatively inserted into radial surfaces to lift the composite body in relation to the lower supporting platform. That is followed by performing distraction until translation of the body along the vertical threaded rod along the lower supporting platform is blocked. The device is rotated with the instrument mounted into the holes on the side surfaces of the body. Geared articular processes of the vertebrae are disconnected by EOP control according to pre-calculated CT or visual data, the base is kept to be rotated until the flange on the cup bottom falls into the long groove on the vertical threaded rod. The distraction is reduced by rotating the nut backwards to place the dislocated articular process back into its physiological position. The distraction is kept to be released to enable removing the end plate with an instrument freely. Tension in the vertebral compartment with the installed device is created by generating slight distraction. The device is remained installed in the bed as a body-substitute implant. Layered sutures are applied. 
     EFFECT: more effective reduction of one-side dislocations and dislocation fractures of cervical spines, lower labour input and injuries accompanying manipulations, enabled prevention of potential undesired complications. 
     2 cl, 4 dwg