CN102240234A - Adjustable artificial cervical vertebra and intervertebral connecting complex - Google Patents

Abstract

The invention relates to an adjustable artificial cervical vertebra and an intervertebral connection complex, which includes a vertebral body part and two endplate parts respectively connected to the upper and lower ends of the vertebral body part through a ball joint structure; the vertebral body part consists of an upper vertebral body part and Composed of lower vertebral body parts, the upper vertebral body part and the lower vertebral body part are axially connected by threads; a number of screw holes are radially correspondingly provided on the side walls of the upper vertebral body part and the lower vertebral body part. A length fixing screw is also provided between the screw holes of the vertebral body part and the lower vertebral body part; the two end plate parts are respectively provided with end plate part fixing screws. The connection complex has both the support function of the artificial vertebral body and the activity performance of the artificial intervertebral disc, and its length can be adjusted. It can achieve immediate stability after anterior cervical surgery, can play a supporting role, and can also realize immediate movement after anterior cervical surgery. Functional reconstruction, so that its activity performance is highly bionic with the normal cervical spine.

Description

A kind of adjustable artificial cervical and intervertebral junctional complex

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:

Plectane 9 first halfs of soleplate parts 1 are thin than latter half, see the formation tangent plane from the side, and angle is about 10 °, and this tangent plane is approximately from the median line of plectane 9, along the front lower place to, form an about tangent plane of 10 °.This tangent plane makes soleplate parts 1 and adjacent last vertebral body form 80 ° inclined-plane, has formed 100 ° inclined-plane with adjacent hypocentrum.These two inclined-planes are very beneficial for and the soleplate of executing the adjacent last hypocentrum of art vertebral body is fitted closely.At the first half of plectane 9, two screws 7 are arranged, (screwhole position is referring to Fig. 6, and the direction of screw is to be 20 ° angle with the costa of adjacent vertebral bodies), these two screw band female threads match with soleplate parts hold-down screw 4.The front end of soleplate parts hold-down screw 4 of the present invention is a tip, and its rear end is nut (as shown in Figure 1), and the nearly nut end of this soleplate parts hold-down screw 4 is slightly thicker than its nearly tip end.Soleplate parts hold-down screw 4 can become the direction of 20 ° angle to insert adjacent vertebral bodies by the vertebral body adjacent with executing the art vertebral body.The nearly nut end of soleplate parts hold-down screw 4 cooperates with screw 7, because the female thread structure of screw 7 cooperates long soleplate parts hold-down screw 4, stable being fixed on of this complex can be executed on the adjacent vertebral body of art vertebral body, realize stablizing at once the supporting role of performance vertebral body.Simultaneously, such fixed form and the place ahead screw immobile phase ratio, the degree of depth that screw is screwed into is longer, more meets biomechanics characteristic.In addition, it is thin why the present invention is designed to front end with the nail body of soleplate parts hold-down screw 4, the end that the rear end cooperates with screw 7 is slightly thick, be because this structure is when being penetrated soleplate parts hold-down screw 4 by screw 7, can regulate the angle of soleplate parts hold-down screw 4 easily, when shooting in the adjacent vertebral body Deng soleplate parts hold-down screw 4, its nearly nut end just carries out threaded engagement with screw 7, thereby with the angle locking of soleplate parts hold-down screw 4.

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. an adjustable artificial cervical vertebra and intervertebral connection complex, is characterized in that, comprises vertebral body parts and two end plate parts (1) that are connected to the upper and lower ends of vertebral body parts by ball joint structure respectively; Described vertebral body parts It consists of an upper vertebral body part (2) and a lower vertebral body part (3), and the upper vertebral body part (2) and the lower vertebral body part (3) are axially connected by threads; ) and the side peripheral wall of the lower vertebral body part (3) are radially provided with some screw holes, and a length fixing screw ( 5); the two end plate components (1) are respectively provided with end plate component fixing screws (4). 2. The adjustable artificial cervical vertebra and intervertebral connection complex according to claim 1, characterized in that, the ball joint structure comprises a joint ball structure (6) arranged on the end plate component (1) and an articulation ball structure (6) arranged on the upper The socket structure (10) of the end of the vertebral body part (2) or the lower vertebral body part (3) is adapted to the joint ball structure (6), and the inner space of the socket structure (10) is formed by a central It is composed of a cylindrical space and a hemispherical space intersecting with both sides of the cylindrical space; and the socket structure (10) has a large inside and a small outlet, and the joint ball structure (6) is wrapped in it. 3. The adjustable artificial cervical vertebra and the intervertebral connection complex according to claim 2, characterized in that, the end plate component (1) comprises a circular plate (9), and the inner side edge of the circular plate (9) is vertical To fix the joint ball structure (6), the outer surface of the circular plate (9) is fixed with two fixing screws of the end plate part through two adjacent screw holes at the edge away from the fixed position of the joint ball structure (6) (4); the axial direction of the fixing screw (4) of the end plate part forms a certain angle with the plane of the circular plate (9). 4. The adjustable artificial cervical vertebra and the intervertebral connection complex according to claim 3, wherein the upper surface of the disc (9) is a matte-like rough structure, and is provided with a biological hydroxyapatite coating. layer. 5. adjustable artificial cervical vertebra and intervertebral connection complex according to claim 4, is characterized in that, the thickness of described hydroxyapatite coating is 20 μ m, and the second half of disc (9) upper surface has size 20 μm denticulate structures (8). 6. The adjustable artificial cervical vertebra and the intervertebral connection complex according to claim 3, 4 or 5, characterized in that, the plate thickness of the circular plate (9) is less than that of the fixed end plate component fixing screw (4). It is thinner on the side and thicker on the side of the fixed joint ball structure (6). Viewed from the side of the circular plate (9), it forms a cut plane. A 10° cutting plane, which makes the endplate part (1) form an 80° slope with the adjacent superior vertebral body and a 100° slope with the adjacent inferior vertebral body. 7. The adjustable artificial cervical vertebra and intervertebral connection complex according to claim 1, characterized in that, the lower constriction of the upper vertebral body part (2) is provided with an external thread, and the lower vertebral body part (3) ) upper end is a cylindrical structure provided with an internal thread, and the lower necking end of the upper vertebral body part (2) is screwed into the internal thread of the lower vertebral body part (3) by threads; in the upper vertebral body part ( 2) and the lower vertebral body parts (3) are axially evenly distributed with some radial threaded through holes, and the length fixing screws (5) can be threaded into the threaded through holes to fix the upper vertebral body parts (2) and The relative positions of the lower vertebral body parts (3) in the axial direction. 8. The adjustable artificial cervical spine and intervertebral connection complex according to claim 1 or 7, wherein the minimum length of the entire complex is 23 mm, the maximum length is 29 mm, and the adjustment range is 6 mm. 9. The adjustable artificial cervical vertebra and the intervertebral connection complex according to claim 1 or 7, wherein the outer surface of the lower vertebral body part (3) is covered with a 20 μm thick layer treated by plasma oxidation technology. of biological coatings with hydroxyapatite. 10. The adjustable artificial cervical vertebra and intervertebral connection complex according to claim 1, characterized in that, the front ends of the endplate component fixing screws (4) are pointed, and the endplate component fixing screws (4) The rear end is a nut, and the near nut end of this end plate component fixing screw (4) is slightly thicker than its near pointed end.

Images