| 摘要 |
Devices, instrumentation, and surgical techniques are described for a more structured coupling of lamina to an alignment rod. A body having an aperture formed therethrough to receive the rod includes a mechanism to lock the body in place once a desired position and two or more holes to receive a cable wrapped around a lamina to be stabilized. A sleeve may also be provided over the cable where it wraps around the lamina to distribute the force of the cable against the bone to prevent damage. The mechanism to lock the body in place preferably includes a threaded fastener having an exposed proximal end for tightening and a distal end that bears against the rod. The body may be unitary, or provided in sections, one with the aperture and the other with the cable receiving holes, and with the two sections being rotatable relative to one another. At least one of the cable-receiving holes may also be flared or ring-shaped to facilitate a range of motion to avoid cable fatigue. The invention also provides instrumentation facilitating sublaminar cable fixation, comprising a tool having a proximal end with a handle and a distal end. The distal end terminates in a curved, cannulated section between two cable-receiving holes, the length of the curved section and the distance between the holes being such that the proximal end may be positioned under a lamina to feed the cable therearound.
|
