CN201658439U - Compound of artificial cervical vertebral body and intervertebral disc - Google Patents

Compound of artificial cervical vertebral body and intervertebral disc Download PDF

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Publication number
CN201658439U
CN201658439U CN201020176384XU CN201020176384U CN201658439U CN 201658439 U CN201658439 U CN 201658439U CN 201020176384X U CN201020176384X U CN 201020176384XU CN 201020176384 U CN201020176384 U CN 201020176384U CN 201658439 U CN201658439 U CN 201658439U
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China
Prior art keywords
vertebral body
intervertebral disc
cervical vertebral
prosthesis
supporting prostheses
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Expired - Lifetime
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CN201020176384XU
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Chinese (zh)
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杨晋才
海涌
斯扬
谢靖
潘振宇
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杨晋才
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Priority to CN201020176384XU priority Critical patent/CN201658439U/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof

Abstract

The utility model relates to a compound of an artificial cervical vertebral body and an intervertebral disc. The compound is characterized by comprising a supporting prosthesis arranged on a surgical defect part of the human cervical vertebral body, a superior intervertebral disc prosthesis movably connected between the supporting prosthesis and a last section of cervical vertebral body, and an inferior intervertebral disc prosthesis movably connected between the supporting prosthesis and a next section of cervical vertebral body. The supporting prosthesis has a 'mouth'-shaped bracket structure for keeping the defect part stable; and the superior intervertebral disc prosthesis and the inferior intervertebral disc prosthesis are provided with spherical contact structures for keeping relative movement with the supporting prosthesis. The compound realizes movable connection of the upper, middle and lower sections of vertebral body through the middle supporting prosthesis, the upper intervertebral disc prosthesis and the lower intervertebral disc prosthesis, can realize normal motion of the cervical vertebra, has good stability, and is a product and a technique with practical value and popularization.

Description

A kind of artificial cervical vertebral body and intervertebral disc complex
Technical field
This utility model relates to a kind of cervical prosthesis, particularly keeps cervical vertebra mobilizable a kind of artificial cervical vertebral body of binodal section and intervertebral disc complex about cervical vertebra time full excision back.
Background technology
The operative treatment of cervical spondylosis is divided into throat road intervertebral disc (or vertebral body time complete) resection-grafting-fusion and the neck way of escape single (or two) canalis spinalis that opens the door and enlarges plasty.
Time full excision of anterior cervical vertebrae intervertebral disc or vertebral body, interbody bone graft fusion are the classical modus operandis of treatment cervical spondylosis, the full excision of vertebral body time is exactly the intercentrum (vertebral body of curing the disease in the excision when performing the operation, or title " responsibility vertebra ") middle body, about 10~12mm, excision simultaneously is two intervertebral disc up and down.The full excision of intervertebral disc or vertebral body time is a committed step of removing spinal cord, nerve root compression, and the purpose of bone-graft fusion then is to fill up the space that intervertebral disc or vertebral body part stay after cut.Adopt this operation method, though the problem of spinal cord, nerve root compression has solved, but existing bone-graft fusion method can make the componental movement sections of cervical vertebra merge and lose motor function, as shown in Figure 1 and Figure 2, after carrying out resection operation on the middle joint vertebral body 1, want to reach the purpose of fusion, just must use screw 4 and steel plate 5 that the cervical vertebral body of bone piece 6 and three sections is fixed together, must lose movable function between such three sections vertebral bodys.Therefore, bone-graft fusion is to be prerequisite with the motion segment of sacrificing cervical vertebra in fact, is caving-in bash, is again the operation of running counter to the biomechanics ultimate principle simultaneously.But the operation of anterior cervical vertebrae bone-graft fusion is used over half a century, has become " goldstandard " modus operandi of treatment myeloid form and cervical spondylotic radiculopathy.
Clinical experience and scientific research are told us, and for the cervical vertebra degenerative disease, what we treated is not whole disease itself, and only is that this disease is in the hurtful result of specific part.In other words, when we had treated cervical spondylosis by the fusion of the single or multiple sections of anterior cervical vertebrae, the cervical vertebra regression was still continuing, and the bone-graft fusion operation also can be quickened the regression of cervical vertebra except the motion of meeting restriction cervical vertebra, cause new disease to decrease.Therefore, behind the cervical vertebra time full resection operation, guarantee the proper motion of cervical vertebra and prevent that effectively the regression of adjacent segment from becoming the new way that spinal surgeons is sought technological improvement.
The beginning of this century " artificial cervical intercalated disc " (list of references 1:Goffin J, Casey A, Kehr P, et al.Prelim inary clinical experience with the Bryan cervical disc prosthesis[J] .Neurosurg, 2002,51 (3): 840-847) be designed and be applied to clinical, introduced China in 2003, a lot of hospitals have carried out this new technique (list of references 2: Sun Yu, Pan Shengfa, Zhang Fengshan, etc. the early stage clinical observation [J] of cervical vertebra artificial disc replacement treatment cervical intervertebral disk illness. JISUI ZAZHI AUTHOR AND, 2006,16 (2): 85-98; List of references 3: Wang Zheng, Wang Yan, Zhang Xuesong, Deng. the short-term effect of cervical intervertebral disk prosthesis replacement treatment cervical spondylotic myelopathy is observed [J]. JISUI ZAZHI AUTHOR AND 2006,16 (6): 420-423), obtained the approval of medical circle, it is very satisfied that personal attendant visits the result in 6 years.A kind of " artificial cervical intercalated disc " prevailing for the time being in force as shown in Figure 3, Figure 4, it is by last soleplate 7, down soleplate 8 and intermediary spherical nuclei 9 are formed.Spherical nuclei 9 are embedded in soleplate 7 and the following soleplate 8, and therefore, last soleplate 7 and following soleplate 8 can be that media has rotated mutually with spherical nuclei 9 just.Last soleplate 7 and following soleplate 8 are connected to the joint vertebral body and save on the vertebral body down.
Though representative " artificial cervical intercalated disc " displacement non-fusion technology has become the most Utopian technology of present treatment cervical spondylosis, the metathetical indication of cervical vertebra artificial intervertebral disk is limited.The first, simple cervical intervertebral disk displacement only is adapted to single-unit section discectomy and can reaches the patient who removes the spinal compression purpose; The second, metathetical prerequisite is that intervertebral space does not subside, and has retained the intervertebral free gap.A lot of clinically heavier patients of regression excise intervertebral disc merely can not remove compressing to spinal cord, because vertebral body trailing edge hypertrophy has to select cervical vertebra time full resection operation, the cervical vertebral body of three sections merges the most at last.
The multi-segmental fusion quickens the regression of cervical vertebra adjacent segment than single-unit section fusion is easier, and this point is proved.Therefore, it is very necessary designing the prosthese that still can keep cervical vertebral body to move behind a kind of cervical vertebra time full resection operation.
Summary of the invention
At the problems referred to above, the purpose of this utility model plays and supports and the artificial cervical vertebral body of flexible connection effect and the complex of intervertebral disc after providing time full excision of a kind of cervical spondylosis vertebral body.
For achieving the above object, this utility model is taked following technical scheme: a kind of artificial cervical vertebral body and intervertebral disc complex, it comprises that one is installed on the pathological changes cervical vertebral body, the supporting prostheses that matches with the operation defect, one be connected supporting prostheses and on upper intervertebral disk prosthesis between the sections body of cervical vertebra, a next intervertebral disk prosthesis that is connected between supporting prostheses and next sections body of cervical vertebra; Described supporting prostheses has the firm rack-like structures of the described defect of maintenance, has the sphere contact structures that keep relative motion with described supporting prostheses on described upper intervertebral disk prosthesis, the next intervertebral disk prosthesis.
Described supporting prostheses comprises and arranged on left and right sides plate and upper and lower two cover plates, form " mouth " font structure, the outer end edges position of described biside plate is manufactured with the hook edge that turns up, and after described supporting prostheses was implanted described defect, described hook edge was stuck on the edge of defect.
Lateral surface at described side plate is provided with double wedge, and described double wedge is complementary with the groove of offering on the defect sidewall in advance.
Near on the position of defect outer end, be provided with holding tank and clamping hole at described side plate.
When described side plate and described upper and lower cover plate were the split part, the upper/lower terminal of described side plate was respectively arranged with chute, and described upper and lower cover plate is inserted on the side plate along described chute respectively, was provided with the lock tooth that pins chute in the side of described upper and lower cover plate.
Described upper and lower intervertebral disk prosthesis includes upper and lower two soleplates and a middle nucleome, nucleome is the part of spheroid in the middle of described, being embedded is folded between upper and lower two soleplates, being that sphere is movable with upper and lower two soleplates contacts, wherein the cover plate of a described soleplate and described supporting prostheses is fixedly linked, and another described soleplate and adjacent vertebral body are fixedly linked.
The described soleplate that is fixedly linked with adjacent vertebral bodies is provided with ridge, and described ridge is embedded in the described adjacent vertebral bodies.
Each organizes corresponding guide rail/sliver and the lockhole/lock tooth of being provided with between interconnective described supporting prostheses cover plate and the soleplate.Perhaps, each organizes interconnective soleplate and the supporting prostheses cover plate is an integral production spare.
This utility model is owing to take above technical scheme, and it has the following advantages: 1, this utility model causes the vertebral body middle body to design a supporting prostheses on damaged at cervical vertebra because of operation.Described prosthese by the design feature of self realize with vertebral body between firmly be connected.2, described artificial vertebral body supporting prostheses by the design feature of self realize with upper and lower adjacent artificial intervertebral disk prosthese between the stable locking connection mechanism of formation.3, this utility model excises " artificial intervertebral disk-artificial vertebral body supporter-artificial intervertebral disk " composite construction prosthese of design on the vacancy of cervical vertebra mid portion and upper and lower adjacent discs in cervical operation.The intersegmental movable connection of three vertebral bodys in upper, middle and lower that relates in realizing performing the operation, the physiological status of answer cervical vertebra, the normal physiological motion function of realization cervical vertebra.Be one and have very high use value, new product that is worth promoting and new technique.
Description of drawings
Fig. 1 is existing bone-graft fusion method vertebral body structure sketch map
Fig. 2 is the sectional view of Fig. 1
Fig. 3 is the sketch map of existing artificial cervical intercalated disc
Fig. 4 is the sectional view of Fig. 3
Fig. 5 is this utility model structural representation
Fig. 6 is this utility model supporting prostheses one embodiment sketch map
Fig. 7 is the lateral plate structure sketch map of supporting prostheses
Fig. 8 is the cover plate sketch map of supporting prostheses
Fig. 9 is the structural representation of this utility model intervertebral disk prosthesis
Figure 10 is the following soleplate sketch map of intervertebral disk prosthesis
Figure 11 is the elevational schematic view of Figure 10
Figure 12 is the last soleplate sketch map of intervertebral disk prosthesis
Figure 13 is the sketch map behind the implantation vertebral body of supporting prostheses
Figure 14 is the sketch map after supporting prostheses and intervertebral disk prosthesis are all implanted vertebral body
The specific embodiment
Be described in detail of the present utility model below in conjunction with drawings and Examples.
As shown in Figure 5, this utility model comprises three partial component: 1, with the operation vertebral resection after, the supporting prostheses 10 that the vertebral body defect is complementary; 2, reach the upper intervertebral disk prosthesis 20 that a last cervical vertebral body is complementary with supporting prostheses 10; 3, the next intervertebral disk prosthesis 30 that is complementary with supporting prostheses 10 and next cervical vertebral body.
Supporting prostheses 10 be one can the replacement bone piece or artificial vertebral body play a supporting role, the rack-like structures that can conveniently connect upper and lower intervertebral disk prosthesis 20,30 again, usually include side plate and upper and lower cover plate, upper and lower cover plate also can be designed to be replaced by the structure of upper intervertebral disk prosthesis 20 and the next intervertebral disk prosthesis 30.
As a specific embodiment, as shown in Figure 6, supporting prostheses 10 can be one " mouth " font prosthese, and this " mouth " font prosthese is made up of two side plates 101, upper cover plate 102, a lower cover 103.Biside plate 101 and upper cover plate 102, lower cover 103 both can be integral productions in advance, also can be field-installed.For make borrowed structure firm and install, lower cover is convenient, being everlasting connects a riser 104 between the biside plate, as shown in Figure 7, offer on the riser 104 porose, penetrating with the front and back that guarantee cavity.Riser 104 also can with side plate 101 integral productions.
The marginal portion that side plate 101 is exposed is made as the hook edge shape that turns up, and after supporting prostheses 10 was encased in vertebral body defect certain depth, the hook edge 105 that turns up was stuck on the gap edge of vertebral body, thus the restriction prosthese continue stretch into.
Lateral surface at side plate 101 is provided with double wedge 106.Make supporting prostheses 10 when the vertebral body defect is inserted when applying suitable external force, double wedge 106 embeds the corresponding with it groove of offering at the breach sidewall of cut vertebral body in advance, and supporting prostheses 10 is fixed in the vertebral body defect.
Near on the position of vertebral body defect outer end, also be respectively arranged with holding tank 107 and clamping hole 108 at side plate 101.Holding tank 107 with the effect of clamping hole 108 is: when packing into or take off supporting prostheses 10, convenient use special tool kit the holding tank 107 of biside plate and with clamping hole 108 positions, make supporting prostheses 10 slightly become contraction-like and enter into the vertebral body defect or take out from the vertebral body defect.
The front mentions, and two side plates 101 and upper cover plate 102, lower cover 103 both can be integral productions in advance, also can be field-installed.When upper cover plate 102, lower cover 103 are the split part with side plate 101, as shown in Figure 7, can offer chute 109 respectively at the upper/lower terminal of two side plates 101, on chute 109, also offer lockhole 110.Accordingly, as shown in Figure 8, be example with upper cover plate 102, be manufactured with draw runner 111 (the upper and lower cover plate structure is the same, is that example is introduced with the upper cover plate therefore only) in the both sides of cover plate, draw runner 111 be provided with chute 109 on lockhole 110 corresponding lock teeth 112.After cover plate inserted along slide rail, lock tooth 112 was relative locked with lockhole 110, and therefore cover plate is fixed on the side plate.
As shown in Figure 8, when upper cover plate 102 and upper intervertebral disk prosthesis 20 (or lower cover 103 and the next intervertebral disk prosthesis 30) each other during separate piece, on upper cover plate 102, also should be provided with guide rail 113 that upper intervertebral disk prosthesis 20 is installed, lockhole 114 etc., concrete condition should be looked the structure of upper intervertebral disk prosthesis 20 and be determined, the guide rail 113 and the lockhole 114 that on the cover board are provided with in the present embodiment are for correspondence intervertebral disk prosthesis structure (it is the same with the structure of following intervertebral disk prosthesis 30 to go up intervertebral disk prosthesis 20) as shown in Figure 9.
Figure 9 shows that intervertebral disk prosthesis 20, the structure of it and following intervertebral disk prosthesis 30 is the same, they are with respect to supporting prostheses 10 upper and lower being symmetrical arranged, therefore, be introduced for example at this above intervertebral disk prosthesis 20: last intervertebral disk prosthesis 20 comprises soleplate 201, last soleplate 202 and middle nucleome 203 down.In some prior art, used the intervertebral disk prosthesis of similar structures, but they all are directly to be connected between the two joint vertebral bodys, not with the example of epicentral supporting prostheses in conjunction with application.Shown in Figure 10,11, in the present embodiment, the bottom of following soleplate 201 be provided with can with the guide rail 113, sliver 204, the lock tooth 205 (as shown in Figure 8) that lockhole 114 matches that are provided with on the upper cover plate 102, and the gathering sill 206 that can match with the guide block 115 that is provided with on the side plate 101.
The top of following soleplate 201 has a ball recess 207, nucleome 203 in the middle of embedded being placed with in ball recess 207.Accordingly, as shown in figure 12, be provided with onesize hemispherical groove 207 in the bottom of last soleplate 202, the first half of nucleome 203 is embedded in this groove in the middle of making.Descending soleplate 201 like this can be that media is relative movable with middle nucleome 203 just with last soleplate 202.Because ball recess is movable contact surface, therefore, medically normal custom claims that this ball recess contact surface is the ball-and-socket joint face.
The top of the last soleplate 202 of upper intervertebral disk prosthesis has the ridge 208 that can be embedded in the sections cervical vertebral body.A final last sections vertebral body is by realizing upper intervertebral disk prosthesis and being connected of supporting prostheses and being connected of interstitial segment vertebral body, and can also keep the mutual motion between two sections vertebral bodys.
Also link up according to as above method for middle intercentrum and next sections vertebral body by the next intervertebral disk prosthesis 30.The next intervertebral disk prosthesis 30 is installed for symmetry with respect to supporting prostheses 10 with upper intervertebral disk prosthesis 20, and structure is identical, does not therefore do too much introduction at this.
Structure situation for the upper and lower cover plate 102,103 of cancelling supporting prostheses 10, the last soleplate of the following soleplate of upper intervertebral disk prosthesis 20 and the next intervertebral disk prosthesis 30 can be respectively installed to side plate 101 upper/lower terminals of supporting prostheses 10, the effect of serving as upper and lower cover plate.
During operation, at first excise the middle body of a joint cervical vertebral body at the position of performing an operation, and excise this and save the upper and lower intervertebral disc of vertebral body, use particular tool clamping supporting prostheses 10 to implant the vertebral body defect, as shown in figure 13, side plate 101 is pressed close to mutually with the section sclerotin of cervical vertebral body, and double wedge 106 inserts in the vertebral body sclerotin, inserts upper and lower cover plate 102,103 again.Use then the next intervertebral disk prosthesis of particular tool clamping 30 implant supporting prostheses 10 and with lower cover 103 lockings, the ridge of the following soleplate of the next intervertebral disk prosthesis 30 is embedded in the sclerotin of adjacent cervical vertebrae vertebral body; Again upper intervertebral space is strutted, implant upper intervertebral disk prosthesis 20, upper intervertebral disk prosthesis 20 need be squeezed into, and the process of squeezing into is embedded in the adjacent cervical vertebrae vertebral body ridge of soleplate, simultaneously can auto lock (as shown in figure 14) between upper intervertebral disk prosthesis 20 and upper cover plate 102 plates.
The used material of each parts is titanium alloy or high-molecular polythene in the foregoing description, can middlely from commercial channels obtain fully.
The foregoing description only is used to illustrate this utility model; wherein the structure of each parts, connected mode etc. all can change to some extent; every equivalents of carrying out on the basis of technical solutions of the utility model and improvement all should not got rid of outside protection domain of the present utility model.

Claims (10)

1. artificial cervical vertebral body and intervertebral disc complex, it is characterized in that: it comprises that one cooperates the supporting prostheses, be installed in operation defect on the pathological changes cervical vertebral body to be connected upper intervertebral disk prosthesis, between a supporting prostheses and the last sections body of cervical vertebra to be connected the next intervertebral disk prosthesis between supporting prostheses and next the sections body of cervical vertebra, described supporting prostheses has the firm rack-like structures of the described defect of maintenance, all has the sphere contact structures that keep with described supporting prostheses relative motion on described upper intervertebral disk prosthesis, the next intervertebral disk prosthesis.
2. a kind of artificial cervical vertebral body as claimed in claim 1 and intervertebral disc complex, it is characterized in that: described supporting prostheses comprises and arranged on left and right sides plate and upper and lower two cover plates, form " mouth " font structure, the outer end edges position of described biside plate is manufactured with the hook edge that turns up, after described supporting prostheses was implanted described defect, described hook edge was stuck on the edge of defect.
3. a kind of artificial cervical vertebral body as claimed in claim 2 and intervertebral disc complex, it is characterized in that: the lateral surface at described side plate is provided with double wedge, and described double wedge is complementary with the groove of offering on the defect sidewall in advance.
4. a kind of artificial cervical vertebral body as claimed in claim 2 and intervertebral disc complex is characterized in that: near on the position of defect outer end, be provided with holding tank and clamping hole at described side plate.
5. a kind of artificial cervical vertebral body as claimed in claim 3 and intervertebral disc complex is characterized in that: near on the position of defect outer end, be provided with holding tank and clamping hole at described side plate.
6. as claim 2 or 3 or 4 or 5 described a kind of artificial cervical vertebral body and intervertebral disc complexs, it is characterized in that: when described side plate and described upper and lower cover plate are the split part, the upper/lower terminal of described side plate is respectively arranged with chute, described upper and lower cover plate is inserted on the side plate along described chute respectively, is provided with the lock tooth that pins chute in the side of described upper and lower cover plate.
7. a kind of artificial cervical vertebral body as claimed in claim 1 or 2 and intervertebral disc complex, it is characterized in that: described upper and lower intervertebral disk prosthesis includes upper and lower two soleplates and a middle nucleome, nucleome is the part of spheroid in the middle of described, being embedded is folded between upper and lower two soleplates, being that sphere is movable with upper and lower two soleplates contacts, wherein the cover plate of a described soleplate and described supporting prostheses is fixedly linked, and another described soleplate and adjacent vertebral body are fixedly linked.
8. a kind of artificial cervical vertebral body as claimed in claim 7 and intervertebral disc complex is characterized in that: the described soleplate that is fixedly linked with adjacent vertebral bodies is provided with ridge, and described ridge is embedded in the described adjacent vertebral bodies.
9. a kind of artificial cervical vertebral body as claimed in claim 7 and intervertebral disc complex is characterized in that: each organizes corresponding guide rail/sliver and the lockhole/lock tooth of being provided with between interconnective described supporting prostheses cover plate and the soleplate.
10. a kind of artificial cervical vertebral body as claimed in claim 7 and intervertebral disc complex is characterized in that: each organizes interconnective soleplate and the supporting prostheses cover plate is an integral production spare.
CN201020176384XU 2010-04-29 2010-04-29 Compound of artificial cervical vertebral body and intervertebral disc Expired - Lifetime CN201658439U (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101828979A (en) * 2010-04-29 2010-09-15 杨晋才 Artificial cervical vertebral body and intervertebral disc composite body
US9700425B1 (en) 2011-03-20 2017-07-11 Nuvasive, Inc. Vertebral body replacement and insertion methods

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101828979A (en) * 2010-04-29 2010-09-15 杨晋才 Artificial cervical vertebral body and intervertebral disc composite body
US9700425B1 (en) 2011-03-20 2017-07-11 Nuvasive, Inc. Vertebral body replacement and insertion methods
US10485672B2 (en) 2011-03-20 2019-11-26 Nuvasive, Inc. Vertebral body replacement and insertion methods
US11389301B2 (en) 2011-03-20 2022-07-19 Nuvasive, Inc. Vertebral body replacement and insertion methods

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