CN102240234A - Adjustable artificial cervical vertebra and intervertebral connecting complex - Google Patents
Adjustable artificial cervical vertebra and intervertebral connecting complex Download PDFInfo
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- CN102240234A CN102240234A CN2011101799662A CN201110179966A CN102240234A CN 102240234 A CN102240234 A CN 102240234A CN 2011101799662 A CN2011101799662 A CN 2011101799662A CN 201110179966 A CN201110179966 A CN 201110179966A CN 102240234 A CN102240234 A CN 102240234A
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- vertebral body
- soleplate
- intervertebral
- hypocentrum
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
Abstract
The invention relates to an adjustable artificial cervical vertebra and intervertebral connecting complex. The adjustable artificial cervical vertebra and intervertebral connecting complex comprises a centrum part and two end plate parts, wherein the two end plate parts are connected with the upper end and the lower end of the centrum part respectively through fetlock structures; the centrum part consists of an upper centrum part and a lower centrum part which are axially connected with each other through threads; a plurality of screw holes are formed on the side peripheral walls of the upper centrum part and the lower centrum part radially and correspondingly; a bolt with fixed length is arranged among the screw holes of the upper centrum part and the lower centrum part; and end plate part fixing bolts are arranged on the two end plate parts respectively. The adjustable artificial cervical vertebra and intervertebral connecting complex has the supporting function of an artificial centrum and the movability of an artificial intervertebral disk, is adjustable in length, can realize immediate stability after an anterior cervical operation, has the supporting function, can realize immediate movement function reconstruction after the anterior cervical operation, and has the highly bionic movability compared with the normal cervical vertebra.
Description
Technical field
The invention belongs to medical prosthesis manufacturing technology field, relate to the complex that a kind of length-adjustable artificial cervical vertebral body is connected with intervertebral.
Background technology
Because aged tendency of population, the person of bending over one's desk working and the computer user ratio is increased, the vehicle accident incidence rate such as increases at factor, and the number of cervical vertebra injury (as cervical spondylosis, fracture of cervical vertebra, cervical vertebra tumor etc.) increases thereupon.For various cervical spondylosis patients' operative treatment, the cervical spondylosis and the fracture of cervical vertebra that cause of prolapse of cervical intervertebral disc especially, the key of operation has two: one, decompression.The factor that needs subduction compressing spinal cord or nerve root is to promote the recovery early of postoperative function of nervous system.The 2nd, stable.By various types of fusion, adopt different embedded material (as from body bone, allograph bone and artificial vertebral body etc.) to realize the long-time stability of postoperative operation sections.Wherein, time full excision decompression of preceding road intervertebral disc marrow nuclear excising vertebral body and intervertebral fusion art are topmost at present, also are the operation art formulas that has application advantage most.Its advantage comprises that the simple disc removal art of decompression is thorough, and fusion rate is high.The method of preceding road intervertebral fusion comprises from the body bone, allograph bone and artificial vertebral body bone-graft fusion.Owing to have good osteoinductive, bone conductibility and bone formation from body bone bone grafting, so become the goldstandard of bone-graft fusion.Advantage from body bone bone graft fusion is not have immunogenicity, and fusion speed is fast.Shortcoming has postoperative height Loss Rate height, and causes the secondary damage of getting the bone district (as for hemorrhage, the fracture in bone district, infection etc.).The allograph bone bone grafting has been avoided above-mentioned shortcoming, but has immunogenicity, and fusion speed slow (usually needing more than 6 months even 9 months).
In order to overcome the above-mentioned shortcoming from body bone and allogenic bone transplantation, people are seeking the substitute behind the spinal operation always, and artificial vertebral body thus has been born.1969, Hamdi first report waist 2 plasmocytomas and adenocarcinoma metastatic patient implement the vertebral tumor excision, and with the alternative pathological changes vertebral body (Hamdi of artificial prosthesis, F A.Prosthesis for an excised lumbar vertebra:apreliminary report.Can Med Assoc J, 1969,100,12:576-80.).Can be divided into metal artificial vertebral body, advanced composite material (ACM) artificial vertebral body and other material artificial vertebral body three major types according to material.See mainly from structure and functional characteristics to be divided into simple support type, strut three types of fixed pattern and adjustable fixed patterns.Simple support type artificial vertebral body: the fixing of support type artificial vertebral body and last hypocentrum mainly is to rely on to fill bone cement in it, and purpose is that the bone behind the filling vertebral resection is damaged, and fixation is relatively poor.Can strut the fixed pattern artificial vertebral body: this class artificial vertebral body is to fix by spininess thing and last hypocentrum mostly, can reach the stability at once of spinal column.The titanium net is the strutted fixed pattern artificial vertebral body of the most normal use, is widely used in the reconstruction of vertebral body, but the length of titanium net own fixes and can not regulate, and is therefore very rigorous to the selection of vertebral body, otherwise is difficult to recover ideal vertebral height, and the danger that comes off is arranged.Adjustable fixed pattern artificial vertebral body: Chinese scholars has been developed the adjustable fixed pattern artificial vertebral body with various characteristics, is applied to clinical and has obtained certain curative effect.As the Synex artificial vertebral body, be titanium matter hollow network structure, adjustable in length, Knop etc. use it for the reconstruction of breast lumbar vertebra front pillar damage, and good spinal column three-dimensional stability can be provided.But owing to after the Synex artificial vertebral body length adjustment, implant difficulty, specification requirement height, therefore general preceding road of row or front and rear combined approach, operation wound big, of long duration (Knop, Christian from the way of escape; Lange, Uta; Reinhold, Maximilian; Blauth, Michael.Vertebral body replacement with Synex in combined posteroanterior surgery for treatment of thoracolumbar injuries.Oper Orthop Traumatol.2005,17 (3): 249-80.).Zhao Dinglin etc. (Zhao Dinglin, Chen Deshang, Zhao Jie, etc.The development of adjustable hollow artificial vertebral body and clinical practice.Chinese journal of orthopedics, 2001,21:222-224.) the adjustable titanium alloy artificial vertebral body of Yan Zhi hollow, can regulate the length of artificial vertebral body, reach the purpose of ideal recovery vertebral height, because be hollow structure, its inside can bone grafting, makes prosthese and vertebral body form the permanent bone fusion.But there only have the spininess thing to contact with last hypocentrum to be fixing, and this prosthese is and rigidly fixes problems such as the stress shielding of bone grafting and bone resorption in existing.
These artificial vertebral bodies in the hope of simplifying operating procedure, reduce operation wound by different shape, the adjustment of material, improvement, realize the stable at once of postoperative, accelerate fusion speed.But all there is a same problem in above-mentioned artificial vertebral body, executes the art spinal segments after just being to use and has completely lost original activeness.And this is considered to quicken the degeneration of postoperative cervical vertebra, causes adjacent segment intervertebral disc protrusion of cervical vertebra, vertebral body hyperosteogeny etc.The result of long term follow-up shows, after implementing the anterior cervical vertebrae fusion, the regression that has occurred closing on sections up to 92% patient is arranged, though clinical symptoms not with the X line on the consistent (Goffin of the order of severity, Jan, Geusens, Eric, Vantomme, Nicolaas, et al.Long-term follow-up after interbody fusion of the cervical spine.J Spinal Disord Tech, 2004,17 (2): 79-85.).Annual after the fusion of the preceding road of discoveries such as Hilibrand have 2.9% patient the clinical symptoms relevant with the adjacent segment regression to occur approximately, and credit is analysed and thought that the clinical symptoms that causes owing to the adjacent segment regression can appear in 25.6% patient in 10 years by statistics.(Hilibrand AS, Carlson GD, Palumbo MA, et al.Radiculopathy and myelopathy at segments adjacent to the site of a p revious anterior cervical arthrodesis[J] .J Bone Joint Surg Am, 1999,81 (4): 519-528.) result of biomechanics experiment has confirmed also to implement that the intervertebral disc internal pressure of adjacent segment increases after the fusion.The iconography evidence of power position shows that also the relative mobility of adjacent segment vertebral body strengthens behind the fusion.These factors have all very likely promoted to close on behind the fusion degeneration of sections.
At the shortcomings such as regression of executing the forfeiture of art sections mobility and closing on sections that produced behind the fusion, scientist and doctor have set up the non-fusion mode of spinal column both at home and abroad, and its theory is that motion keeps (motion preservation).And artificial disc replacement (claiming the intervertebral disc plasty) is typical case's representative of implementing non-fusion.The main clinically at present intervertebral disc of using has the Bryan prosthese, ProDisc-C prosthese, Prestige prosthese, PCM prosthese etc.Think at present, the best indication of artificial disc replacement is the single-unit section, the cervical vertebrae physiological bending exist (Sekhon LH.Cervical arthroplasty in the management of spondylotic myelopathy[J] .J SpinalDisord Tech, 2003,16 (4): 307-313).The contraindication of generally acknowledging has unstable (Wiffield CC between osteoporosis and vertebral body, Skrzyp iec D, Jackowski A, et al.Internal stress distribution in cervical intervertebral discs:the influence of an artificial cervical joint and simulated anterior interbody fusion[J] .J Spinal Disord Tech, 2003,16 (5): 441-449.).Though the material of various artificial intervertebral disks, come in every shape, the common shortcoming that their exist has: one, can only replace intervertebral disc separately, and be combined vertebral body pathological changes powerless (such as vertebral tumor, and the operation that need reduce pressure to vertebral body).Two, most scholars do not admit the disc replacement of multi-segmental, and two especially adjacent intervertebral disc carry out replacement simultaneously.
In sum, present existing technology can not solve the problem of activeness behind the cervical operation, the immobile problem in especially a plurality of sections operation backs, and the regression problem of adjacent segment behind the fusion that brings thus.
Therefore, the application has developed the artificial cervical vertebral body and the intervertebral junctional complex of adjustable in length of the activity performance of the support function that possesses artificial vertebral body when as follows and artificial intervertebral disk.
Summary of the invention
The objective of the invention is to overcome the shortcoming of above-mentioned prior art, a kind of adjustable artificial cervical and intervertebral junctional complex are provided, this junctional complex possesses activity performance, the adjustable in length of the support function and the artificial intervertebral disk of artificial vertebral body simultaneously, can realize stable at once behind the anterior cervical operation, can play a supporting role, also can realize the reconstruction of anterior cervical vertebrae immediate postoperative motor function, make its activity performance bionical with normal cervical vertebrae height.
The objective of the invention is to solve by the following technical programs:
This adjustable artificial cervical and intervertebral junctional complex comprise vertebral body parts and two soleplate parts that are connected in vertebral body parts upper and lower side respectively by the ball-joint structure; Described vertebral body parts are made up of last vertebral body parts and hypocentrum parts, and described upward vertebral body parts and hypocentrum component axial are by being threaded; On described on the side perisporium of vertebral body parts and hypocentrum parts radially correspondence be provided with some screws, between the screw of last vertebral body parts and hypocentrum parts, also be provided with a length hold-down screw; Be respectively equipped with soleplate parts hold-down screw on described two soleplate parts.
Above-mentioned ball-joint structure comprises the joint ball structure that is arranged on the soleplate parts and is arranged on the vertebral body parts or mortar mouth structure that hypocentrum ends and described joint ball structure adapt that the inner space of described mortar mouth structure is formed by the cylindrical space that is in the center and with the hemisphere space that the cylindrical space both sides are passed through mutually; And the inside of described mortar mouth structure is big, it is young to go out, with joint ball structure bag within it.
Above-mentioned soleplate parts comprise plectane, and in the medial surface edge of plectane vertical fixing joint ball structure, the lateral surface of plectane is fixed with two described soleplate parts hold-down screws in the edge away from described joint ball structure fixed position by two adjacent screws; Axial and the described plectane plane of described soleplate parts hold-down screw is angled.
The upper surface of above-mentioned plectane is a frosted sample coarse structure, and is provided with the biology hydroxyapatite coating layer.
The thickness of above-mentioned hydroxyapatite coating layer is 1 μ m, and the latter half of plectane upper surface has the little toothing of big or small 1 μ m.
The plate thickness of above-mentioned plectane is thin, thick in a side of fixing joint spherical structure in a side of fixing soleplate parts hold-down screw, see formation one tangent plane from the side of plectane, this tangent plane is approximately from the median line of soleplate structure, along the front lower place to, form one 10 ° tangent plane, this tangent plane makes soleplate parts and adjacent last vertebral body form 80 ° inclined-plane, forms 100 ° inclined-plane with adjacent hypocentrum.
Above-mentioned bottom necking down of going up the vertebral body parts is provided with external screw thread, and described hypocentrum component upper ends is the cylindrical structure that is provided with female thread, and the described bottom necking down end of vertebral body parts of going up is by in the female thread that is threaded into the hypocentrum parts; On described vertebral body parts and hypocentrum parts axially be evenly distributed with some radially tapped through holes, described length hold-down screw can be packed in the tapped through hole with fixing vertebral body parts and the hypocentrum parts relative position in the axial direction gone up by screw thread.
More than whole complex minimum length be 23mm, greatest length is 29mm, range of accommodation is 6mm.
The front end of above-mentioned soleplate parts hold-down screw is a tip, and the rear end of described hold-down screw is a nut, and the nearly nut end of this hold-down screw is slightly thicker than its nearly tip end.
The invention has the beneficial effects as follows:
The present invention can bring into play supporting role at once behind anterior cervical operation, and substitutes the motor function of normal cervical vertebra by the intervertebral coupling part that carries, can effectively prevent the regression of the adjacent segment that causes after the fusion.In addition, can realize merging and long-time stability biology by the hydroxyapatite coating layer of bone grafting and this complex surfaces.Operating difficulty is less, and wound is little, is convenient to promote.Because the controllability of this complex length itself can reduce to produce and carry burden, can be fit to most crowds.
Description of drawings
Fig. 1 is an overall structure sketch map of the present invention;
Fig. 2 is vertebral body parts 2 structural representations of going up of the present invention;
Fig. 3 is the vertical view of Fig. 2;
Fig. 4 is hypocentrum parts 3 structural representations of the present invention;
Fig. 5 is soleplate parts 1 structural representation figure of the present invention;
Fig. 6 is the vertical view of Fig. 5;
Wherein: 1 is the soleplate parts; 2 is last vertebral body parts; 3 is the hypocentrum parts; 4 is soleplate parts hold-down screws; 5 is the length hold-down screw; 6 is the joint ball structure; 7 is screw; 8 is little toothing; 9 is plectane; 10 is the mortar mouth structure.
The specific embodiment
Below in conjunction with accompanying drawing the present invention is done and to describe in further detail:
Referring to Fig. 1, adjustable artificial cervical of the present invention and intervertebral junctional complex comprise vertebral body parts and two soleplate parts 1 that are connected in vertebral body parts upper and lower side respectively by the ball-joint structure; The vertebral body parts are made up of last vertebral body parts 2 and hypocentrum parts 3, wherein go up vertebral body parts 2 and hypocentrum parts 3 axially by being threaded; Radially correspondence is provided with some screws on the side perisporium of last vertebral body parts 2 and hypocentrum parts 3, also is provided with a length hold-down screw 5 between the screw of last vertebral body parts 2 and hypocentrum parts 3; Be respectively equipped with soleplate parts hold-down screw 4 on two soleplate parts 1.Be described in detail forming each parts of the present invention below in conjunction with accompanying drawing:
Referring to Fig. 1, Fig. 2, Fig. 4 and Fig. 5, above-described ball-joint structure comprises the joint ball structure 6 that is arranged on the soleplate parts 1 and is arranged on vertebral body parts 2 or mortar mouth structure 10 that hypocentrum parts 3 ends and joint ball structure 6 adapt that the inner space of this mortar mouth structure 10 is formed by the cylindrical space that is in the center and with the hemisphere space that the cylindrical space both sides are passed through mutually; And the inside of mortar mouth structure 10 is big, it is young to go out, with joint ball structure 6 bags within it.Joint ball structure 6 cooperatively interacts with mortar mouth structure 10, realizes that intervertebral connects the movable function of four degree of freedom.
In most preferred embodiment of the present invention: joint ball structure 6 is linked to each other with the cylindrical-shaped structure that matches by 85% of the ball of diameter 4mm.This joint ball structure 6 matches with the mortar mouth structure 10 of last vertebral body parts and hypocentrum parts respectively.Mortar mouth structure 10 up and down fit like a glove with joint ball structure 6 in the left and right side (being that diameter is 4mm).Mortar mouth structure 10 is to be made of along X-axis (being the line of horizontal plane upper edge vertebral body front and rear edge mid point) stretching 1.5mm the circle that a diameter is 4mm.Spatial seeing, be the equal of hemisphere that a diameter is 4mm to add a bottom surface diameter be 4mm, highly be 85% of 1.5mm the cylindrical common nest rod structure of forming of hemisphere three parts that to add a diameter be 4mm.Such intervertebral is connected with following advantage: 1,85% matching can form the joint anastomose property above half, guarantees the absolute stability that this intervertebral connects, and can not cause the generation of the joint dislocation phenomenon behind the implantation; 2, the position after the intervertebral center pillar that connects active center deflection vertebral body slightly leans on meets the motion axle center of normal spinal column, and it is little to the biomechanical property influence of spinal column to insert the back; 3, this intervertebral connects the activity that can realize 4 degree of freedom, (line of setting horizontal plane upper edge vertebral body front and rear edge mid point is an X-axis, the line of the vertebral body left and right sides, horizontal plane upper edge edge mid point is a Y-axis, vertical direction is the Z axle), be respectively anteflexion and after stretch about 15 ° (promptly along Y-axis rotation), about 15 ° of left and right sides lateroflexion (promptly along the X-axis rotation), left rotation and right rotation is because the restriction of spinal column rear pillar, also can remain on 15 to 20 ° (promptly along the rotations of Z axle), the about 1.5mm of front and back translation (promptly along the X-axis translation).The most important thing is that wherein this intervertebral connection can realize the at present nearly all artificial intervertebral disk and the effect of artificial vertebral body all irrealizable front and back translation.Most literature confirms, people's spinal column can carry out anteflexion, after stretch, left and right sides lateroflexion in the time of the function of left rotation and right rotation, can also carry out interpyramidal front and back translation up and down, this front and back translation has positive effect to preventing intervertebral disc and cervical vertebra regression.But the distance of front and back translation is unsuitable excessive, if excessive, can cause the vertebral body unstability.Therefore, the intervertebral that the nest rod structure by unique design forms connects, and can make the front and back phorogenesis of the 1.5mm that has an appointment between vertebral body up and down.Can bionical to greatest extent human cervical spine and the postoperative regression that suppresses cervical spondylosis.
As Fig. 5 and Fig. 6, soleplate parts 1 comprise plectane 9, in the medial surface edge of plectane 9 vertical fixing joint ball structure 6, the lateral surface of plectane 9 is fixed with two soleplate parts hold-down screws 4 in the edge away from described joint ball structure 6 fixed positions by two adjacent screws 7; Axial and described plectane 9 planes angled (as shown in Figure 1) of soleplate parts hold-down screw 4.The plate thickness of plectane 9 is thin, thick in a side of fixing joint spherical structure 6 in a side of fixing soleplate parts hold-down screw 4.And the lateral surface of plectane 9 is provided with little toothing 8.
In most preferred embodiment of the present invention:
The upper surface of plectane 9 is a frosted sample coarse structure, and has the biology hydroxyapatite coating layer that utilizes the plasma oxidation technical finesse and form, the about 1 μ m of coating layer thickness, the latter half of upper surface that the little toothing 8 of the about 1 μ m of size is arranged.All upper surfaces are handled, and can quicken the early stage fusion of soleplate structure and adjacent vertebral bodies, help realizing biologic fusion and long-time stability.
Referring to Fig. 1 or Fig. 2 and Fig. 4, the bottom necking down of last vertebral body parts 2 also is provided with external screw thread, and hypocentrum parts 3 upper ends are the cylindrical structure that is provided with female thread, and the bottom necking down end of last vertebral body parts 2 is by in the female thread that is threaded into hypocentrum parts 3; The some radial screw bore 11 of axially being evenly distributed with of last vertebral body parts 2 and hypocentrum parts 3 and 12 (providing the situation with 3 radial screw bore 11,12 among Fig. 2,3), length hold-down screw 5 can be packed in the screwed hole with fixing vertebral body parts 2 and hypocentrum parts 3 relative position in the axial direction gone up by screw thread.
In most preferred embodiment of the present invention:
Hypocentrum parts 3 are partly formed (referring to Fig. 4) by the hollow cylinder structure of top (the about 12mm of diameter, high about 10mm, the about 2mm of wall thickness) and the solid cylinder of bottom (the about 12mm of diameter, high about 4mm).It is the fixing hole of 2mm that the dead ahead of the hollow cylinder structure on top has a diameter, the band female thread.Respectively there are four successive fusion screws the left and right side, and diameter is 2mm, and is not threaded.The outer surface of hypocentrum parts 3 is covered with the biology hydroxyapatite coating layer that is about 1 μ m through the thickness of plasma oxidation technical finesse.There is aforesaid mortar mouth structure 10 center, bottom, and the dotted line of bottom has shown the position of mortar mouth structure 10, and mortar mouth structure 10 is complementary with the joint ball structure 6 of the next soleplate parts 1.
The external screw thread of the bottom of last vertebral body parts 2 can match with the female thread on the top of hypocentrum parts 3.Because pitch is 1mm, the length that can make whole complex increases 1mm so every outward turning is turned around.The bottom of last vertebral body parts 2 each side has four to merge screw 12, and the left and right sides, top of hypocentrum parts 3 also respectively has four to merge screw 15, and the diameter that merges screw is 2mm, and is not threaded.Whenever revolve and take two turns, the fusion screw of last vertebral body parts 2 (being screw 12) will communicate with the fusion screw (being screw 11) of a part of hypocentrum parts 3.After long-term the implantation, the broken bone of filling in the lower hollow column structure of last vertebral body parts 2 can grow along merging screw, realizes stable vertebral body parts and executes the stable fusion of art vertebral body.In addition, reliably go up the hydroxyapatite coating layer of vertebral body parts and hypocentrum member outer surface, can quicken the fusion process of postoperative, realize merging biology, guaranteed long-time stability.
Four fixing threaded holes regulating screw 11 and hypocentrum parts 3 top dead aheads of last vertebral body parts 2 bottom dead aheads all are with female thread, are complementary with vertebral body length hold-down screw 5.Be 2mm owing to regulate the diameter of screw and fixing threaded hole, therefore whenever revolve and take two turns, the fixing threaded hole of the dead ahead of hypocentrum parts 3 will match with the adjusting screw of the dead ahead of last vertebral body parts 2, at this moment, available vertebral body length hold-down screw 5 is screwed into along fixing threaded hole and adjusting screw, the hold of the anastomose property of the female thread on the top of the external screw thread of the bottom of vertebral body parts 2 and hypocentrum parts 3 and screw 5 and fixing threaded hole and adjusting screw realizes the fixing of complex length in the dependence.Regulate the length adjustment 6mm that screw can guarantee to make whole complex for four, satisfy the length needs of normal person's cervical vertebra fully.
Both cooperatively interact more than to go up vertebral body parts 2 and hypocentrum parts 3, and (whole complex minimum length is 23mm, and greatest length is 29mm can to regulate the length of whole complex by rotation.Range of accommodation is 6mm).
In sum, adjustable cervical spine artificial vertebral body of the present invention and intervertebral junctional complex are particularly suitable for handling adjacent two cervical spondylosiss that prolapse of cervical intervertebral disc causes, and can go time full excision of disc removal, vertebral body, this complex replacement.Simultaneously, can go for cervical vertebra list vertebral tumor and suffer from vertebra and cut entirely and this complex replacement.In addition, for not being suitable for the metathetical patient of artificial cervical intercalated disc, overhaul behind the artificial cervical intercalated disc replacement, regression is serious behind the cervical spinal fusion etc., and multiple cervical spondylosis can use this complex.Below illustrate that with regard to time full excision of disc removal, vertebral body and this complex replacement the specific embodiment in the operation is for possessing indication, inspection does not see that the patient of contraindication carries out this operative treatment before the art, prepare before the conventional art, select the endotracheal intubation general anesthesia usually.Position is a dorsal position, the soft pillow of both shoulders pad, and the head nature is stretched to layback, the soft head circle of rear pillow part pad prevention pressure ulcer, little sandbag is respectively placed to prevent head rotation in the art in a both sides.Otch generally adopts the throat transverse incision, exposes to suffer from vertebra and intervertebral disc C shape arm X linear light fluoroscopic machine location in positioning needle and the art.Last the next vertebral body central authorities in the vertebral body of planning to implement time full excision are screwed into cervical vertebral body dilator screw respectively, are inserted in dilator on the screw strutting, and two ends strut up and down.Decompression: the fibrous ring of cutting the intervertebral disc of executing art vertebral body upper and lower with sharp knife, the vertebral pulp pincers take out disc tissue, sting frontal cortex bone and most spongy bone with the rongeur of three joints points mouth except that vertebral body, suspend during near the vertebral body trailing edge, the intervertebral disc of art vertebral body upper and lower is executed in excision fully, repair the articuli intervertebrales face to the cartilage bleed bottom with curet, rongeur and bur, make the soleplate almost parallel, can not destroy the bone soleplate.Isolate gap between vertebral body trailing edge and posterior longitudinal ligament with nerve dissector, progressively sting except that vertebral body trailing edge cortical bone with the rongeur of rifle formula, form a rectangular relief groove (can sting except that posterior longitudinal ligament as required sometimes), the width of relief groove is 12mm roughly.Regulate the height that the vertebral body dilator struts, make the height of cervical vertebra front pillar recover normal.At this moment, the vertebral body sclerotin of inferior full cutting-out is subtracted into broken bone about 2mm, be filled in the cylinder type hollow structure of vertebral body parts bottom on this complex.Insert this complex, according to the length that desired height is regulated this complex, the following soleplate of soleplate parts and upper vertebral body is fitted, the last soleplate of following soleplate parts and the next vertebral body fits.According to this length, be screwed into vertebral body length hold-down screw 5, fix this complex length.The last hypocentrum parts of this complex are driven into relief groove.According to the fixing threaded hole on the soleplate parts 7, soleplate upper shed on last the next vertebral body following respectively, again with soleplate hold-down screw 4 by becoming 20 ° of angles to be screwed into the next vertebral body with last the next anterior margin of vertebral body.Unclamp the vertebral body dilator, make the embedding of this complex tight.After C shape arm X ray machines perspective is errorless, irrigate, prevent drain, layer-by-layer suture.Postoperative neck brace braking 40 days, preventative use antibiotic, close observation, other are by throat road operation conventional treatment.
Claims (10)
1. adjustable artificial cervical and intervertebral junctional complex is characterized in that, comprise vertebral body parts and two the soleplate parts (1) that are connected in vertebral body parts upper and lower side respectively by the ball-joint structure; Described vertebral body parts are made up of last vertebral body parts (2) and hypocentrum parts (3), and described upward vertebral body parts (2) and hypocentrum parts (3) are axially by being threaded; On described on the side perisporium of vertebral body parts (2) and hypocentrum parts (3) radially correspondence be provided with some screws, between the screw of last vertebral body parts (2) and hypocentrum parts (3), also be provided with a length hold-down screw (5); Be respectively equipped with soleplate parts hold-down screw (4) on described two soleplate parts (1).
2. adjustable artificial cervical according to claim 1 and intervertebral junctional complex, it is characterized in that, described ball-joint structure comprises the joint ball structure (6) that is arranged on the soleplate parts (1) and is arranged on vertebral body parts (2) or mortar mouth structure (10) that hypocentrum parts (3) end and described joint ball structure (6) adapt that the inner space of described mortar mouth structure (10) is formed by the cylindrical space that is in the center and with the hemisphere space that the cylindrical space both sides are passed through mutually; And the inside of described mortar mouth structure (10) is big, it is young to go out, with joint ball structure (6) bag within it.
3. adjustable artificial cervical according to claim 2 and intervertebral junctional complex, it is characterized in that, described soleplate parts (1) comprise plectane (9), in the medial surface edge of plectane (9) vertical fixing joint ball structure (6), the lateral surface of plectane (9) is fixed with two described soleplate parts hold-down screws (4) in the edge away from described joint ball structure (6) fixed position by two adjacent screws; Axial and described plectane (9) plane of described soleplate parts hold-down screw (4) is angled.
4. adjustable artificial cervical according to claim 3 and intervertebral junctional complex is characterized in that, the upper surface of described plectane (9) is a frosted sample coarse structure, and are provided with the biology hydroxyapatite coating layer.
5. adjustable artificial cervical according to claim 4 and intervertebral junctional complex is characterized in that, the thickness of described hydroxyapatite coating layer is 20 μ m, and the latter half of plectane (9) upper surface has the little toothing (8) of big or small 20 μ m.
6. according to claim 3,4 or 5 described adjustable artificial cervical and intervertebral junctional complexs, it is characterized in that, the plate thickness of described plectane (9) is thin, thick in a side of fixing joint spherical structure (6) in a side of fixing soleplate parts hold-down screw (4), see formation one tangent plane from the side of plectane (9), this tangent plane is approximately from the median line of soleplate structure (9), along the front lower place to, form one 10 ° tangent plane, this tangent plane makes soleplate parts (1) and adjacent last vertebral body form 80 ° inclined-plane, forms 100 ° inclined-plane with adjacent hypocentrum.
7. adjustable artificial cervical according to claim 1 and intervertebral junctional complex, it is characterized in that, described bottom necking down of going up vertebral body parts (2) is provided with external screw thread, described hypocentrum parts (3) upper end is for being provided with the cylindrical structure of female thread, and the described bottom necking down end of vertebral body parts (2) of going up is by in the female thread that is threaded into hypocentrum parts (3); On described vertebral body parts (2) and hypocentrum parts (3) axially be evenly distributed with some radially tapped through holes, described length hold-down screw (5) can be packed in the tapped through hole with fixing vertebral body parts (2) and hypocentrum parts (3) relative position in the axial direction gone up by screw thread.
8. according to claim 1 or 7 described adjustable artificial cervical and intervertebral junctional complexs, it is characterized in that whole complex minimum length is 23mm, greatest length is 29mm, and range of accommodation is 6mm.
9. according to claim 1 or 7 described adjustable artificial cervical and intervertebral junctional complexs, it is characterized in that the thickness that the outer surface of described hypocentrum parts (3) is covered with through the plasma oxidation technical finesse is the biology hydroxyapatite coating layer of 20 μ m.
10. adjustable artificial cervical according to claim 1 and intervertebral junctional complex, it is characterized in that, the front end of described soleplate parts hold-down screw (4) is a tip, the rear end of described soleplate parts hold-down screw (4) is a nut, and the nearly nut end of this soleplate parts hold-down screw (4) is slightly thicker than its nearly tip end.
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| CN2011101799662A CN102240234B (en) | 2011-06-29 | 2011-06-29 | Adjustable artificial cervical vertebra and intervertebral connecting complex |
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| CN102240234A true CN102240234A (en) | 2011-11-16 |
| CN102240234B CN102240234B (en) | 2013-07-10 |
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| CN102715969A (en) * | 2012-07-06 | 2012-10-10 | 常州市康辉医疗器械有限公司 | Combined artificial vertebral body |
| CN103800101A (en) * | 2014-02-28 | 2014-05-21 | 西安交通大学 | Dislocation prevention type non-fusion artificial cervical vertebra and intervertebral disc system |
| CN104546095A (en) * | 2015-01-27 | 2015-04-29 | 范伟力 | Adaptive floating combined cervical interbody fusion cage |
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| CN105997309A (en) * | 2016-04-29 | 2016-10-12 | 西安交通大学第二附属医院 | Bionic anti-dislocation goat lumbar vertebra junction complex |
| CN105853031A (en) * | 2016-04-29 | 2016-08-17 | 西安交通大学第二附属医院 | Bionic lumbar vertebrae and intervertebral disc junction complex with dislocation prevention function |
| CN107049562A (en) * | 2017-04-19 | 2017-08-18 | 中国人民解放军第四军医大学 | A kind of double acting joint cervical prosthesis |
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