U.S. patent application number 14/846611 was filed with the patent office on 2016-03-10 for bone anchoring device.
This patent application is currently assigned to Biedermann Technologies GmbH & Co. KG. The applicant listed for this patent is Biedermann Technologies GmbH & Co. KG. Invention is credited to Lutz Biedermann, Wilfried Matthis.
Application Number | 20160066961 14/846611 |
Document ID | / |
Family ID | 41323425 |
Filed Date | 2016-03-10 |
United States Patent
Application |
20160066961 |
Kind Code |
A1 |
Biedermann; Lutz ; et
al. |
March 10, 2016 |
BONE ANCHORING DEVICE
Abstract
A bone anchoring device includes an anchoring element having a
shaft and a head; a receiving part for receiving the head and a
rod, the receiving part being formed in one piece and having a top
end and a bottom end, a bore extending from the top end to the
bottom end, an inner wall defined by the bore, a substantially
U-shaped channel adjacent to the top end for receiving the rod and
a seat adjacent to the bottom end for accommodating the head; a
pressure element; and a spring element having a spring force. The
anchoring element is inserted from the top end and is pivotable
with respect to the receiving part. The pressure element is movable
in the bore so as to be able to fix the anchoring element at an
angle with respect to the receiving part by exerting pressure onto
the head. The spring element acts between the pressure element and
the receiving part and allows the pressure element to be introduced
from the top end but withstands against removal of the pressure
element through the top end.
Inventors: |
Biedermann; Lutz;
(VS-Villingen, DE) ; Matthis; Wilfried; (Weisweil,
DE) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Biedermann Technologies GmbH & Co. KG |
Donaueschingen |
|
DE |
|
|
Assignee: |
Biedermann Technologies GmbH &
Co. KG
|
Family ID: |
41323425 |
Appl. No.: |
14/846611 |
Filed: |
September 4, 2015 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
14272353 |
May 7, 2014 |
9149300 |
|
|
14846611 |
|
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|
12890341 |
Sep 24, 2010 |
8764810 |
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14272353 |
|
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61245940 |
Sep 25, 2009 |
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Current U.S.
Class: |
606/266 |
Current CPC
Class: |
A61B 17/7032 20130101;
A61B 17/7037 20130101; A61B 17/8605 20130101 |
International
Class: |
A61B 17/70 20060101
A61B017/70 |
Foreign Application Data
Date |
Code |
Application Number |
Sep 25, 2009 |
EP |
09171416.2 |
Claims
1. A bone anchoring device comprising: an anchoring element
comprising a shaft for anchoring in the bone, and a head; a
receiving part for receiving the head and for receiving a rod to be
connected to the anchoring element, the receiving part being formed
in one piece and having a top end and a bottom end, a bore
extending from the top end to the bottom end, an inner wall defined
by the bore, a substantially U-shaped channel adjacent to the top
end for receiving the rod, and a seat adjacent to the bottom end
for accommodating the head, wherein the anchoring element is to be
inserted from the top end; a pressure element that is able to exert
pressure onto the head, wherein the anchoring element is pivotable
with respect to the receiving part and can be fixed at an angle by
exerting pressure via the pressure element onto the head; and a
spring element having a spring force, wherein a bottom portion of
the spring element facing the bottom end projects farther into the
bore than a top portion of the spring element facing the top end,
and wherein the spring element acts between the pressure element
and the receiving part and allows the pressure element to be
introduced from the top end but withstands against removal of the
pressure element through the top end.
2. The bone anchoring device of claim 1, wherein the spring element
is asymmetric in the direction of insertion.
3. (canceled)
4. The bone anchoring device of claim 1, wherein the spring element
is designed such that the pressure element can be moved into a
first holding position and a second holding position, wherein in
the first holding position, the pressure element exerts a biasing
force against the head sufficient to hold the anchoring element
stationary with respect to the receiving part, yet still allow
pivoting of the anchoring element when an external force is
applied, and wherein in the second holding position, the pressure
element locks the anchoring element with respect to the receiving
part.
5. The bone anchoring device of claim 4, wherein the pressure
element snaps into the first holding position against the spring
force of the spring element.
6-11. (canceled)
12. The bone anchoring device of claim 1, wherein the spring
element provides a stop surface to prevent removal of the pressure
element through the top end.
13. (canceled)
14. The bone anchoring device of claim 1, wherein the pressure
element is located in a pre-assembled condition at a position in
which it exerts a slight biasing force against the head.
15. A modular system comprising the bone anchoring device according
to claim 1, wherein a plurality of different shanks and/or a
plurality of different heads are provided.
16. A bone anchoring device comprising: an anchoring element
comprising a shaft for anchoring in the bone, and a head; a
receiving part for receiving the head and for receiving a rod to be
connected to the anchoring element, the receiving part being formed
in one piece and having a top end and a bottom end, a bore
extending from the top end to the bottom end, an inner wall defined
by the bore, a substantially U-shaped channel adjacent to the top
end for receiving the rod, and a seat adjacent to the bottom end
for accommodating the head, wherein the anchoring element is to be
inserted from the top end; a pressure element that is able to exert
pressure onto the head, wherein the anchoring element is pivotable
with respect to the receiving part and can be fixed at an angle by
exerting pressure via the pressure element onto the head; and a
spring element having a spring force, wherein the inner wall of the
receiving part comprises the spring element, and wherein the spring
element acts between the pressure element and the receiving part
and allows the pressure element to be introduced from the top end
but withstands against removal of the pressure element through the
top end.
17. The bone anchoring device of claim 16, wherein the spring
element is formed by at least one elastic finger that can
resiliently move into and out of a recess in the inner wall of the
receiving part.
18. The bone anchoring device of claim 16, wherein the spring
element is provided at a side wall of the channel.
19. The bone anchoring device of claim 16, wherein the spring
element is asymmetric in the direction of insertion.
20. The bone anchoring device of claim 16, wherein the spring
element is designed such that the pressure element can be moved
into a first holding position and a second holding position,
wherein in the first holding position, the pressure element exerts
a biasing force against the head sufficient to hold the anchoring
element stationary with respect to the receiving part, yet still
allow pivoting of the anchoring element when an external force is
applied, and wherein in the second holding position, the pressure
element locks the anchoring element with respect to the receiving
part.
21. The bone anchoring device of claim 20, wherein the pressure
element snaps into the first holding position against the spring
force of the spring element.
22. The bone anchoring device of claim 16, wherein the spring
element provides a stop surface to prevent removal of the pressure
element through the top end.
23. The bone anchoring device of claim 16, wherein the spring
element has an inclined surface that allows the pressure element to
gradually expand the spring element during insertion.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. patent
application Ser. No. 14/272,353, filed May 7, 2014, which is a
continuation of U.S. patent application Ser. No. 12/890,341, filed
Sep. 24, 2010, now U.S. Pat. No. 8,764,810, which claims priority
to and the benefit of U.S. Provisional Patent Application Ser. No.
61/245,940, filed Sep. 25, 2009, and claims priority to and the
benefit of European Patent Application Number EP09171416.2, filed
Sep. 25, 2009, the entire contents of which are incorporated herein
by reference.
BACKGROUND
[0002] The invention relates to a bone anchoring device for
anchoring a stabilization rod in a bone or in a vertebra. The bone
anchoring device includes an anchoring element, a receiving part
for receiving a head of the bone anchoring element and for
receiving a stabilization rod to be connected to the anchoring
element. The anchoring element is pivotably connected to the
receiving part and can be fixed at an angle by exerting pressure
onto the head via a pressure element that is arranged in the
receiving part. The anchoring element and the pressure element are
to be inserted from a top end of the receiving part and a spring
element withstands against removal of the pressure element through
the top end once the pressure element is inserted.
[0003] U.S. Pat. No. 5,716,356 describes a polyaxial bone screw
including a screw element and a receiving part that is pivotably
connected to the screw element and a pressure element to exert
pressure onto the head of the screw element to fix the angle
between the screw element and the receiving part. The receiving
part as an U-shaped channel for receiving a stabilization rod. The
pressure element comprises a cylindrical recess that is to be
aligned with the U-shaped channel to receive the rod therein. In
order to hold the pressure element in a position aligned with the
U-shaped channel, the position of the pressure element is fixed by
crimping through bores provided in the receiving part.
[0004] US 2005/0080420 A1 describes a multi-axial bone screw that
includes a screw element and a receiver member, a base member for
retaining the screw element in the receiver member and a crown
element exerting pressure onto the head of the screw element. The
crown element comprises a snap-ring assisting in holding the crown
element within the receiving part by interfering with a stop
surface of the receiving part. The multi-axial bone screw is a
so-called bottom loading type screw wherein the screw element is
introduced from the bottom into the receiving part.
[0005] WO 2006/116437 A2 describes a bone anchor for spinal
fixation in form of a polyaxial bone screw including a screw
element, a housing, a sleeve and a collet arranged in the housing
for exerting pressure onto the head of the screw element. The head
of the screw element is introduced through the bottom of the
housing. The sleeve has retention tabs that snap into slots in
opposite wall portions of the housing. Alternatively, the retention
tabs may be formed on the housing and the slots may be fowled on
the sleeve.
[0006] Usually, the polyaxial bone screws of the above described
type are delivered, for example by the manufacturer, in a
pre-assembled condition. In this condition a specific screw
element, e.g. a screw element having a specific length and shaft
diameter of a specific thread form, is connected to receiving part
and the pressure element is arranged therein so that it can not
escape. For the surgery, the necessary number and types of such
pre-assembled polyaxial bone screws are selected and provided in
advance as a full set of implants.
[0007] When the known polyaxial bone screws are in the
pre-assembled condition, the pressure element in is a position that
enables the head to freely pivot within the receiving part. In
certain situations during surgery such an unrestrained pivoting is
not desirable.
SUMMARY
[0008] It is the object of the invention to provide a bone
anchoring device wherein parts can be selected and assembled by the
surgeon or by any other personnel in a simple manner at the
operation site or at any other place after the parts have been
manufactured. In addition, the bone anchoring device shall provide
an improved handling during surgery.
[0009] The bone anchoring device has only few parts. The parts are
of a simple design. This provides for a lower cost manufacturing
and a convenient handling. It is possible to assemble the bone
anchoring device in any condition of the delivery after the parts
have been manufactured and before the screw element is inserted
into the bone. Therefore, the assembling of the polyaxial bone
screw can be carried out by anybody, in particular by the surgeon
or any personnel assisting him or her before or during surgery.
[0010] With the bone anchoring device a modular system can be
provided, which allows the combination of various anchoring
elements with any suitable receiver on demand, depending on the
actual clinical requirements. This reduces the costs of polyaxial
screws, reduces the inventory and gives the surgeon a substantial
choice of implants. In addition, existing receiving parts may be
upgraded to form the bone anchoring device according to the
invention.
[0011] With the bone anchoring device it is possible to exert a
slight biasing force onto the head of the screw element in the
pre-assembled condition, so that a force, which can be applied by
hand, for example, is needed to pivot the head. In certain
situations, this improves the handling of the bone anchoring device
during surgery. Different pressure elements can be provided so that
the degree of biasing the pressure element against the head can be
selected by selecting an appropriate pressure element when
assembling the bone anchoring device.
[0012] Further features and advantages of the invention will become
apparent from the description of embodiments by means of the
accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] FIG. 1 shows a perspective side view of a first embodiment
of the bone anchoring device.
[0014] FIG. 2 shows a perspective side view of the bone anchoring
device of FIG. 1 in an assembled state.
[0015] FIG. 3 shows a sectional view of the bone anchoring device
of FIG. 2, the section being taken perpendicular to the rod
axis.
[0016] FIG. 4 shows an enlarged view of a portion of FIG. 3.
[0017] FIG. 5 shows a perspective view of the snap-ring of the
first embodiment.
[0018] FIG. 6 shows a top view of the snap-ring of the first
embodiment.
[0019] FIG. 7 shows a sectional view of the snap-ring of FIG. 6
along line A-A in FIG. 6.
[0020] FIG. 8 shows a perspective view of a modified embodiment of
the snap-ring.
[0021] FIGS. 9-11 show steps of assembling the bone anchoring
device according to the first embodiment in a sectional view,
respectively.
[0022] FIG. 12 shows a perspective exploded view of a bone
anchoring device according to a second embodiment.
[0023] FIG. 13 shows a perspective side view of the bone anchoring
device of FIG. 12 in an assembled state.
[0024] FIG. 14 shows a perspective view of the receiving part of
the second embodiment according to FIGS. 12 and 13.
[0025] FIG. 15 shows a sectional view of the bone anchoring device
according to the second embodiment of FIG. 13 in a sectional view,
the section being taken perpendicular to the rod axis.
[0026] FIG. 16 shows an enlarged view of a portion of the bone
anchoring device of FIG. 15.
[0027] FIG. 17 shows the step of assembling the bone anchoring
device according to the second embodiment.
DETAILED DESCRIPTION
[0028] The bone anchoring device 1 according to a first embodiment
shown in FIGS. 1 to 4 includes a bone anchoring element, in this
case a screw member 2 having a threaded shaft 3 and a head 4. The
head 4 is, for example, shaped as a spherical segment. The head 4
has a recess 4' at its free end for engagement with a tool. The
bone anchoring device 1 further includes a receiving part 5 for
connecting the screw member 2 to a rod 20. A pressure element 6 is
arranged in the receiving part 5 on top of the head 4. For securing
the rod 20 in the receiving part 5 and for exerting pressure onto
the pressure element 6, a locking device in form of an inner screw
7 is provided. It should be understood that the locking device
shown is exemplary and can be realized in many other designs, in
particular as a two-part locking device and with different thread
form. In addition, a spring element is provided in the form of
snap-ring 8, which serves for holding the pressure element 6 within
the receiving part 5.
[0029] The receiving part 5, as shown in particular in FIGS. 1 to
3, is formed in one piece. In the example shown, it is
substantially cylindrical. It has a top end 51 and a bottom end 52
and a plane of symmetry M. A coaxial bore 53 extends from the top
end 51 to the bottom end 52. The diameter of the bore 53 becomes
smaller towards the bottom end 52, thereby providing a seat 54 for
accommodating the screw head 4. The shape of the seat 54 can be
spherical, conical or otherwise tapering. It can have any other
shape that allows to accommodate the head 4 so that it can pivot
with respect to the receiving part 5. The diameter of the bore 53
at the bottom end is sized such that the threaded shaft 3 can pass
therethrough. The diameter of the bore 53 in the middle portion and
until the top end 51 is sized such that the threaded shaft 3 and
the head 4 of the screw element 2 can pass therethrough. At the top
end 51, the receiving part has a substantially U-shaped recess 55
by means of which a channel is formed for receiving the rod 20. An
internal thread 56 is provided near the top end 51 for cooperating
with the inner screw 7 of the locking device.
[0030] The pressure element 6 is formed in one piece. It is of
substantially cylindrical design construction and has an outer
diameter that allows it to be inserted from the top end 51 and to
be moved in axial direction within the coaxial bore 53 of the
receiving part 5. On its side facing the head 4 of the screw
element 2, a spherical recess 61 is provided that is adapted to the
size of the head 4. Any other shapes of the underside of the
pressure element 6 are conceivable, such as a flat surface or any
other structure, however, a surface that is adapted to the head 4
of the screw element 2 provides a homogenous load distribution onto
the head 4. On its side opposite to the head 4, the pressure
element 6 has a cylindrical recess 62 adapted to receive the rod 20
therein. By means of this recess 62, a channel to receive the rod
is formed. In the embodiment shown, the depth of the recess 62 is
smaller than the diameter of the rod so that the inner screw 7 can
come into contact with the rod 20. A coaxial bore 63 extends
through the pressure element to allow access to the recess 4' with
a tool for screwing-in the screw element 2.
[0031] The pressure element 6 further comprises a circumferential
groove 64 that is provided in a portion of the outer surface of the
pressure element below the cylindrical recess 62. The cross-section
of the groove 64 is rectangular, however, it can also be
square-shaped or can have rounded corners. It can also have another
shape, for example, it can be asymmetric. The diameter of the
groove 64 is such that it can accommodate a portion of the
snap-ring 8. By means of the slot 63, the snap ring is resilient
and can vary in its diameter.
[0032] The pressure element 5 comprises a corresponding
circumferential groove 57, which is located below the bottom of the
channel 55 so that when the snap-ring 8 is inserted, it is located
below the rod 20. The groove 57 is sized so as to allow
accommodation of a portion of the snap-ring 8. Like the groove 64
in the pressure element 6, the groove 57 in the receiving part 5
has a rectangular cross-section, a square-shaped cross-section or
can have rounded corners. It can also have another shape, for
example, it can be asymmetric.
[0033] The snap-ring 8 is described with reference to FIGS. 5 to 7.
The snap-ring according to the first embodiment is circular. It has
a top side 81, a bottom side 82 and a slot 83 extending completely
through the snap-ring from the top side to the bottom side. The
inner diameter of the snap-ring is smaller at the bottom side 82
than at the top side 81 and the cross-section of the snap-ring is
substantially trapezoidal and an inclined surface 84 is formed on
the top side 81. By means of this, the snap-ring is shaped
asymmetrical in the direction of movement of the pressure element.
The position of the groove 57 is such that when the snap-ring 8 is
inserted in the groove 57 and the pressure element 6 is then
inserted so that the snap-ring engages the groove 64 of the
pressure element 6, the pressure element 6 is in a holding position
that still allows pivoting of the head. The inner diameter of the
snap-ring 8 is such that if the snap-ring is located in the groove
57, it can expand therein when the pressure element 6 is introduced
until it snaps into the groove 64 of the pressure element.
[0034] The inner screw 7 of the locking device can be screwed into
the internal thread 56 of the receiving part 5 until the inner
screw 7 presses onto the upper side of the pressure element 6,
which moves the pressure element 6 downward until it presses onto
the head 4 to lock the head 4 in the receiving part 5.
[0035] The parts of the bone anchoring device are all made of a
body-compatible material, such as titanium or stainless steel, a
body-compatible metal alloy, for example a Ti--Ni alloy, or a
body-compatible plastic material, such as PEEK. In particular, the
snap-ring 8 can be made of a body-compatible plastic material that
allows for an easy manufacture and a safe function of the spring
element.
[0036] FIG. 8 shows a modified example of a snap-ring 8'. A
snap-ring 8' is not circular but has the shape of a star. It also
has a slot 83' and inclined surfaces 84' that are preferably
located in the valleys between the peaks of the star. The
star-shaped snap-ring 8' can be made more flexible than the
circular snap-ring 8. Other shapes are also conceivable, for
example other wave-shaped rings with peaks and valleys.
[0037] In a further modification, the cross-section of the
snap-ring can be symmetric in the direction of insertion and the
cross-section of the grooves can be asymmetric.
[0038] FIGS. 9 to 11 show the steps of assembly of the bone
anchoring device. In a first step, shown in FIG. 9, the snap-ring 8
is introduced into the receiving part 5 until it rests in the
groove 57. The orientation of the snap-ring 8 is such that the
inclined surface 84 faces the top end 51 of the receiving part 5.
The orientation of the snap-ring 8 in a circumferential direction
is such that the slot 83 can be positioned at around 90.degree.
with respect to the longitudinal axis of the channel 55.
[0039] In a next step, as shown in FIG. 10, the screw element 2 and
the pressure element 6 are inserted into the receiving part 5 from
the top end 51, so that the threaded shaft 3 passes through the
bore 53 at the second end 52.
[0040] Then, as shown in FIG. 11, the pressure element 6 and the
head 4 are moved downward toward the second end 52, thereby passing
the snap-ring 8 that projects radially into the bore 53. Since the
inclined surface 84 faces the top end 51 of the receiving part, the
insertion force for the screw head 4 and the pressure element 6 is
reduced. The screw head 4 and a lower edge of the pressure element
6 slide along the inclined surface 84, thereby expanding the
snap-ring 8. The pressure element 6 is pushed downwards until the
snap-ring 8 snaps into the groove 64 of the pressure element 6.
Once the snap-ring is accommodated in the groove 64, the force
necessary for removing the pressure element 6, i.e. removing the
snap-ring from the groove 64, is increased since the upper part of
the grooves 64, 57 act as a stop. Therefore, the pressure element 6
cannot fall out and can not be removed through the first end 51
without using a specific tool. Hence, the assembly of the pressure
element 6 and the screw element 2 is unidirectional.
[0041] The position of the snap-ring 8 can be selected such that
the pressure element 6 exerts a slight biasing force onto the head
4 in the pre-assembled condition. In this way, different pressure
elements, for example, a first pressure element with a groove that
is located higher than that of a second pressure element can be
provided. When assembling the bone anchoring device, the
appropriate pressure element to have a desired amount of biasing
force can be selected.
[0042] Receiving parts and pressure elements of existing polyaxial
screws can be upgraded with the grooves and the snap-ring.
[0043] In use, after assembly of the bone anchoring device 1, the
screw element 2 is inserted into the bone. Thereafter, the
receiving part 5 is pivoted until it has the correct orientation to
take up the rod 20. The rod 20, which connects several bone
anchoring devices, is inserted and the inner screw 7 is tightened
to move the pressure element 6 downward to clamp the head 4 such
that it is locked. Simultaneously the rod 20 is fixed by the inner
screw 7. Since the inclined surface 84 faces the first end 51, the
force needed for further pressing down the pressure element 6 is
small because the upper edge of the groove 64 of the pressure
element 6 slides along the inclined surface 84.
[0044] A second embodiment is shown with respect to FIGS. 12-17.
The second embodiment differs from the first embodiment in that the
spring element is not provided as a snap-ring but is provided as a
portion of a receiving part. The description of features of the
second embodiment that are the same as features of the first
embodiment is not repeated. A receiving part 5' has on its two
opposite sides longitudinal recesses 58, in which resilient fingers
59 are arranged.
[0045] The resilient fingers 59 extend from the bases of the
recesses 58 that are facing the second end 52, in the direction of
the first end 51 and are flexible in a direction into and out of
the recesses 58, respectively. Hence, the recesses 58 provide a
space for taking up the resilient fingers 59 when they are pressed
outward by a pressure element 6'. At their end facing the first
end, the fingers 59 have a stop surfaces 59a, respectively,
extending substantially perpendicular to the plane M. On the
opposite side of each stop surface 59a there is an inclined surface
59b that faces the first end 51. The surface 59b is inclined
downward to provide a sliding face along which the pressure element
6' can slide. The inner diameter between the resilient fingers 59
in the region of the stop surface 59a is smaller than the outer
diameter of the pressure element 6'.
[0046] The pressure element 6' is shaped like the pressure element
6 of the previous embodiment, however, without the groove 64. An
upper side 65 of the pressure element 6' comes into contact with
the stop surface 59a of the resilient fingers 59.
[0047] The steps of assembly of the bone anchoring device according
to the second embodiment include first providing the receiving part
5' and then inserting the screw element 2 with pressure element 6',
as shown in FIG. 17, from the top end 51 of the receiving part 5'.
The pressure element 6' and the head 4 are moved downward until the
pressure element 6' contacts the inclined upper surface 59b of the
resilient fingers 59, thereby pressing the resilient fingers 59
outward into the recesses 58 respectively. Since the inclined
surface 59b faces the first end 51, the insertion force is small.
When the pressure element 6' has passed the resilient fingers 59,
the resilient fingers 59 snap back toward the bore 53 and removal
of the pressure element 6' in the direction to the first end 51 is
prevented by the stop surfaces 59a. Therefore, the assembly of the
pressure element 6', the screw element 2 and the receiving part 5'
is also unidirectional.
[0048] Further modifications of the embodiments are conceivable.
For example, for the anchoring element, all kinds of anchoring
elements can be used and combined with a receiving part. These
anchoring elements are e.g. screws of different length, with
different diameters, cannulated screws, screws with different
thread forms, nails, etc.
[0049] All kinds of receiving parts can be used, in particular such
with different locking elements, e.g. such as two-part locking
devices that have an outer screw and an inner screw, which lock the
rod and the head separately. In this case, the pressure element has
a channel for the rod the depth of which is larger than the
diameter of the rod. Other locking devices such as outer nuts,
outer caps, bayonet locking devices or others are conceivable. The
shape of the receiving part is not limited to the embodiments
shown. For example, the receiving part can have an asymmetric end
portion for allowing a greater pivot angle of the screw member to
one side.
[0050] The shape of the pressure element is also not limited to the
embodiments shown. For example, the pressure element can be
designed so as to exert pressure onto the head from the side of the
head, e.g. via a conically tapering portion and/or can have a
slotted portion clamping the head or can have other shapes.
* * * * *