CN102166140B - High-simulation customized combined artificial vertebra - Google Patents

Abstract

The invention discloses a high-simulation customized combined artificial spine. The high-simulated customized combined artificial spine is a high-simulated prosthetic implant reconstructed according to the CT three-dimensional data of the patient's spinal lesion, and its outer surface is made of porous titanium. structure, which is composed of the upper part of the vertebral body with a porous structure, the lower part of the vertebral body and the vertebral attachment, so that after the vertebral body is resected, the fixation is more firm through the screw-in combination of the upper and lower ends of the artificial vertebral body, and it can be implanted inside the vertebral body. Carry out autologous bone or allogeneic bone graft in the bone cage and ensure the stable position of the bone graft; through the small drug reinjection hole reserved on the side of the vertebral body and the optional screw-in joint, the local lesion can be injected with drugs, especially It is suitable for patients with spinal tuberculosis and tumors. In addition, the outer surface is made of porous titanium material, which makes the artificial vertebral body have better biocompatibility. It can not only be used as a carrier for osteoblast co-culture in vitro, but also a good carrier for the growth of blood vessels and bone tissue.

Description

High simulation customized combined artificial spine

technical field

The invention relates to an orthopedic prosthesis device in the medical field, in particular to a highly simulated customized combined artificial spine, which can replace the thoracic and lumbar vertebrae according to different conditions of patients, and correct spinal fractures , tuberculosis, tumors and deformities and other diseases after vertebral body resection of spinal instability, to maintain spinal stability.

Background technique

At present, the number of patients with spinal tumors, tuberculosis, fractures and deformities is increasing, which can seriously affect the daily life, work, and quality of life of patients, and even endanger the lives of patients. Surgery is one of the effective treatment methods at present. With the advent of various new surgical theories (such as the Tomita procedure) and the improvement of spinal internal fixation techniques, clinical surgical methods have also been continuously improved. At present, most of the vertebral body excision, titanium alloy artificial vertebral body or titanium mesh implantation and internal bone graft fusion are used at home and abroad to fill the vertebral body defect and rebuild the stability of the spine. However, the currently used methods of implanting vertebral body prosthesis or titanium mesh still have some shortcomings:

1) The currently used artificial vertebral body or titanium mesh structure is not a simulation structure. Although it can restore the stability of the spine and reconstruct the bony integrity of the spine after implantation, there is no vertebral canal protection for the spinal cord after surgery due to the absence of the vertebral body accessory structure. , seriously affecting the patient's postoperative spinal stability and functional recovery;

2) The titanium mesh bone graft may embed the titanium mesh into the upper and lower vertebral body, resulting in the loss of the height of the reconstructed vertebral body, the volume of the intervertebral foramen is reduced, the nerve root is locally stimulated, and the cervical spine is in an unstable state of force line as a whole, which is very easy to Causes radicular symptoms, especially in patients with osteoporosis.

3) Part of the artificial vertebral body and titanium mesh are not connected to the spinal internal fixator after implantation. As time goes by after the operation, once the pre-tightening force disappears, the loosening of the implant will inevitably cause spinal instability, and even worse, it will affect the surrounding area. Nerve roots and blood vessels can be damaged, causing serious complications.

4) Most of the existing artificial vertebral bodies are made of metal materials such as titanium alloys. The common feature is that the elastic modulus is greater than that of the vertebral body, and the interface between the vertebral bone and the artificial vertebral body is prone to generate large stress. Due to poor biocompatibility , it is difficult to achieve a satisfactory intervertebral fusion effect.

5) After most of the artificial vertebral bodies currently used are implanted, due to the limitation of their overall structure, local drug treatment cannot be performed after surgery, especially for patients with vertebral body tumors and tuberculosis, which may cause recurrence of local lesions after surgery greatly increase.

Contents of the invention

In view of the defects and deficiencies in the above-mentioned prior art, the purpose of the present invention is to provide a high-simulation customized combined artificial spine designed according to different patients' conditions and surgical methods through rapid prototyping technology, so that it can completely restore the surgical resection The biological shape of the vertebral body can be implanted smoothly through a new design; after implantation, it can match the currently commonly used screw-rod system in clinical practice, making the artificial spine more stable; and through its special materials and special design, high simulation customization The combined artificial vertebra has better biocompatibility and practicability than the existing artificial vertebra.

In order to achieve the above tasks, the present invention takes the following technical solutions:

A highly simulated customized combined artificial spine, characterized in that the highly simulated customized combined artificial spine is a highly simulated prosthetic implant reconstructed according to the CT three-dimensional data of the patient's spinal lesion, and its outer surface is made of porous titanium , which is composed of the upper part of the vertebral body, the lower part of the vertebral body and the attachment of the vertebral body with a porous structure.

The upper part of the vertebral body accounts for 2/3 of the height of the entire customized high-simulation combined artificial spine. The outside is in the shape of a vertebral body. There are prefabricated through circular pedicle screw holes on both sides of the rear, and a cylindrical screw channel is prefabricated in the pedicle screw holes.

The lower part of the vertebral body accounts for 1/3 of the height of the entire customized high-simulation combined artificial spine, and is also in the shape of a vertebral body. There are cones on the lower surface of the lower part of the vertebral body; there is a cylindrical bone graft cage on the lower part of the vertebral body. The outer surface of the cylindrical bone graft cage is prefabricated with external threads, which match the internal threaded holes in the upper part of the vertebral body; there are also a pair of reinjection channels around the cylindrical bone graft cage in the lower part of the vertebral body. The hole reaches to the edge of the lower part of the vertebral body, and the outlet of the reinjection hole is prefabricated with an internal thread and a small circular hole.

The vertebral appendages include bilaterally symmetrical pedicles, transverse processes, spinous processes, lamina, superior articular processes and inferior articular processes, and there are penetrating pedicle screw holes on both sides of the vertebral appendages, and the pedicle screws The inner thread of the pedicle screw for installing the pedicle screw channel is prefabricated in the hole.

The high-simulation customized combined artificial spine of the present invention can be safely implanted because the artificial vertebral body structure and its accessories can be connected by pedicle screws, and can be safely implanted and matched with the commonly used clinical spinal internal fixation system and firmly Fixation; secondly, through the screw-in combination of the upper and lower parts of the vertebral body, autologous bone or allogeneic bone transplantation can be performed in the bone graft cage inside the vertebral body and the position of the bone graft block is guaranteed to be stable; moreover, through the artificial vertebral body There are 2 reserved drug reinjection holes on the lower side, optional screw-in joints and injection hoses, which can be used for postoperative local injection of drugs to the lesion, especially for patients with spinal tuberculosis and tumors. In addition, due to the high-simulation customized combined artificial vertebra of the present invention, the unique design of porous titanium is used on the outer surface, so that the artificial vertebra has better biocompatibility, not only can be used as a carrier for osteoblast co-culture in vitro, but also It will further become a good carrier for the ingrowth of blood vessels and bone tissue. The artificial vertebral body and the appendage of the spine can be connected by pedicle screws, so that the implanted artificial spine can better restore the stability of the spine and reconstruct the bony integrity of the spine.

Description of drawings

Fig. 1 is the overall structure schematic diagram of the highly simulated customized combined artificial spine of the present invention;

Figure 2 is a schematic diagram of the structure of the upper part of the vertebral body in the rear view (direction A);

Fig. 3 is a schematic diagram of the structure above the upper side of the vertebral body in Fig. 1;

Figure 4 is a schematic diagram of the posterior view (direction A) of the lower part of the vertebral body;

Fig. 5 is a schematic diagram of the structure above the lower part of the vertebral body and the structure of the local reinjection channel;

Fig. 6 is the structural representation after the upper part of the vertebral body and the lower part of the vertebral body are connected;

Fig. 7 is a top view of the structure of the spine attachment part;

Fig. 8 is a schematic diagram of the local structure after being connected and fixed with pedicle screws;

FIG. 9 is a top sectional view of FIG. 1 .

The reference numerals in the figure represent respectively: 1, the upper part of the vertebral body, 2, the lower part of the vertebral body, 3, the appendage of the vertebra, 4, the cylindrical screw path in the upper part of the vertebral body, 5, the threaded hole in the upper part of the vertebral body, 6, the pedicle screw Nail hole, 7. Cylindrical bone graft cage, 8. External thread, 9. Round hole, 10. Internal thread, 11. Reinjection channel, 12. Rough surface, 13. Cone, 14. Vertebral arch Root, 15, transverse process, 16, spinous process, 17, lamina, 18, superior articular process, 19, inferior articular process, 20, pedicle screw hole, 21, pedicle screw channel of vertebral attachment, 22, Pedicle screw internal thread.

The present invention will be further described in detail below in conjunction with the accompanying drawings.

Detailed ways

Referring to accompanying drawings 1 to 9, the high-simulation customized combined artificial spine of the present invention is based on the CT three-dimensional reconstruction data of the patient's spinal lesion, to manufacture a high-simulation prosthetic implant consistent with the shape of the local spinal lesion. The surface is porous titanium, which is composed of the upper part 1 of the vertebral body, the lower part 2 of the vertebral body and the appendage 3 of the vertebral body with a porous structure. After implantation, the high-simulation customized combined artificial spine enables patients to achieve better recovery in terms of postoperative spinal integrity, function and appearance.

The upper part 1 of the vertebral body occupies the upper 2/3 of the height of the entire vertebral body. The exterior is in the shape of a vertebral body. The interior is prefabricated with a cylindrical threaded hole 5 that can match the bone graft cage 7. The two sides behind the upper part of the vertebral body are prefabricated circular pedicles. The screw hole 6 is prefabricated with a cylindrical screw channel 4 and an internal thread 22 that can match the pedicle screw in the pedicle screw hole 6 . It is convenient to be connected with the spine attachment 3 and fixed by the nail-rod system according to the need later.

The lower part 2 of the vertebral body accounts for the lower 1/3 of the height of the vertebral body, and the outside is also in the shape of a vertebral body. A cylindrical bone graft cage 7 protrudes from the upper surface of the lower vertebral body 2, and the outer surface of the cylindrical bone graft cage 7 is prefabricated with The external thread 8 matches the internal threaded hole 5 of the upper part of the vertebral body 1 and can be screwed together with the upper part of the vertebral body 1 . There is also a pair of reinjection channels 11 around the cylinder shape bone graft cage 7 of the vertebral body bottom 2, the reinjection channels 11 are cylinders, and the outer surface of the reinjection channels 11 has a circular small hole 9, and the reinjection channels 11 are oblique Outward and downward until the edge of the outer surface of the lower part of the vertebral body 2, the proximal end of the circular small hole 9 is prefabricated with an internal thread 10, which is convenient for connecting the drug reinjection pipe joint.

The upper surface of the upper part 1 of the vertebral body and the lower surface of the lower part 2 of the vertebral body are both rough surfaces 12, and each has three cones 13 protruding from the surface, which is convenient for increasing the friction between the adjacent upper and lower vertebral bodies after implantation. The spine attachment 3 is a highly simulated and customized back of the spine, including symmetrical pedicles 14, transverse processes 15, spinous processes 16, lamina 17, and upper and lower facet processes (18, 19). There is a pedicle screw hole 20 on the side, and a penetrating pedicle screw channel 21 and an internal thread 22 matching the pedicle screw are prefabricated in the pedicle screw hole 20 . It can be connected with the upper part 1 of the vertebral body and the lower part 2 of the vertebral body through pedicle screws.

When the present invention is in use, the upper and lower parts of the vertebral body are tightened and put into proper positions, and then the artificial vertebral body and accessories are connected with the selected spinal internal fixator according to the prefabricated screw channel, which can make it safely implanted. And it matches with the commonly used clinical spinal internal fixator, and it is firmly fixed. In addition, through the small hole for drug reinjection reserved on the side of the vertebral body, the optional screw-in connector and the injection hose, it is possible to inject drugs into the lesion, especially for patients with spinal tuberculosis and tumors. In addition, because the present invention adopts the unique design of porous titanium material on the outer surface of the artificial vertebral body, the artificial vertebral body has better biocompatibility, and can not only be used as a carrier for osteoblast co-culture in vitro, but also become a blood vessel and Good vehicle for ingrowth of bone tissue. The artificial vertebral body and the appendage of the spine can be connected by pedicle screws, so that the implanted artificial spine can better restore the stability of the spine and reconstruct the bony integrity of the spine.

Claims (3)

1. A high-simulation customized combined artificial spine is characterized in that the high-simulated customized combined artificial spine is a high-simulated prosthetic implant reconstructed according to the CT three-dimensional data of the patient's spinal lesion, and its outer surface is Porous titanium structure, which is composed of the upper part of the vertebral body (1), the lower part of the vertebral body (2) and the vertebral attachment (3) of the porous structure; The upper part of the vertebral body (1) accounts for 2/3 of the height of the entire customized high-simulation combined artificial spine, and the outside is in the shape of a vertebral body. The upper surface of the upper part of the vertebral body (1) is a rough surface (12), and its surface has three The cone (13), the upper part of the vertebral body (1) is prefabricated with a cylindrical threaded hole (5) that can match the bone graft cage (7), and the upper part of the vertebral body (1) is prefabricated with circular pedicle screws on both sides of the rear The screw hole (6), the pedicle screw screw hole (6) is prefabricated with a cylindrical screw channel (4) and an internal thread (22) that can match the pedicle screw; The lower part of the vertebral body (2) accounts for 1/3 of the height of the entire customized high-simulation combined artificial spine, and is also in the shape of a vertebral body. The lower surface of the lower part of the vertebral body (2) is a rough surface (12), and its surface has three A cone (13), a cylindrical bone graft cage (7) is arranged above the lower part of the vertebral body (2), and an external thread (8) is prefabricated on the outer surface of the cylindrical bone graft cage (7). The external thread (8) ) matches the internal threaded hole (5) of the upper part of the vertebral body (1); The vertebral attachment (3) includes bilaterally symmetrical pedicles (14), transverse processes (15), spinous processes (16), lamina (17), superior articular processes (18) and inferior articular processes (19 ), there are pedicle screw holes (20) on both sides of the vertebral attachment (3), the pedicle screw holes (20) are prefabricated with a penetrating pedicle screw channel (21) and an inner matching pedicle screw Thread (22). 2. The high-simulation customized combined artificial spine according to claim 1, characterized in that there are a pair of reinjection channels (11) around the cylindrical bone graft cage (7) of the lower part of the vertebral body (2) ), the reinjection channel (11) is obliquely outward and downward until the edge of the outer surface of the lower part of the vertebral body (2), the reinjection channel (11) is a cylinder, and the outer surface of the reinjection channel (11) has a small circular hole ( 9), the inside of the proximal end of the circular small hole (9) is prefabricated with an internal thread (10) for easy connection of the drug reinjection tube joint. 3. The high-simulation customized combined artificial spine according to claim 2, characterized in that, the reinjection channel (11) is a cylinder, which leads obliquely inwardly and upwardly to the cylindrical bone graft cage (7) internal.

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