CN102240234B - 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

An adjustable artificial cervical vertebra and intervertebral connection complex

technical field

The invention belongs to the technical field of medical prosthesis manufacturing, and relates to a composite body of an artificial cervical vertebral body and an intervertebral connection with adjustable length.

Background technique

Due to the aging of the population, the increase in the proportion of desk workers and computer users, and the increase in the incidence of traffic accidents, the number of cervical spine injuries (such as cervical spondylosis, cervical spine fractures, cervical spine tumors, etc.) has increased accordingly. For the surgical treatment of patients with various cervical spondylosis, especially cervical spondylosis and cervical spine fractures caused by cervical disc herniation, there are two keys to surgery: one is decompression. It is necessary to reduce the factors that compress the spinal cord or nerve roots to promote the early recovery of neurological function after surgery. The second is stability. Through various types of fusion surgery, different implant materials (such as autologous bone, allogeneic bone, and artificial vertebral body, etc.) are used to achieve long-term stability of the surgical segment after surgery. Among them, anterior discectomy and subtotal corpectomy decompression followed by intervertebral fusion is currently the most important and most advantageous surgical procedure. Its advantages include that the decompression is more complete than the simple discectomy, and the fusion rate is higher. The methods of anterior intervertebral fusion include autologous bone, allograft bone and artificial vertebral bone graft fusion. Because of its good osteoinductivity, osteoconductivity and bone formation, autologous bone graft has become the gold standard for bone graft fusion. The advantages of autologous bone graft fusion are no immunogenicity and fast fusion. Disadvantages include a high postoperative height loss rate and secondary damage to the bone harvesting area (such as bleeding, fracture, infection, etc.) in the bone donor area. Allogeneic bone graft avoids the above disadvantages, but has immunogenicity and slow fusion speed (often takes 6 months or even more than 9 months).

In order to overcome the above-mentioned shortcomings of autologous bone and allograft bone graft, people have been looking for a substitute after spinal surgery, thus the artificial vertebral body was born. In 1969, Hamdi reported for the first time that patients with lumbar 2 plasmacytoma and metastatic adenocarcinoma underwent vertebral tumor resection and replaced the diseased vertebra with artificial prosthesis (Hamdi, F A. Prosthesis for an excised lumbar vertebra: apreliminary report. Can Med Assoc J, 1969, 100, 12:576-80.). According to the material, it can be divided into three categories: metal artificial vertebral body, new composite material artificial vertebral body and other materials artificial vertebral body. From the perspective of structure and functional characteristics, it can be divided into three types: simple support type, open fixed type and adjustable fixed type. Simple support type artificial vertebral body: The fixation between the support type artificial vertebral body and the upper and lower vertebral bodies mainly depends on the filling of bone cement in it, the purpose is to fill the bone defect after vertebral body resection, and the fixation effect is poor. Expandable and fixed artificial vertebral body: Most of these artificial vertebral bodies are fixed with the upper and lower vertebral bodies through spikes, which can achieve immediate stability of the spine. Titanium mesh is the most commonly used expandable and fixed artificial vertebral body. It is widely used in the reconstruction of vertebral bodies. However, the length of titanium mesh itself is fixed and cannot be adjusted. Therefore, the selection of vertebral bodies is very strict, otherwise it will be difficult to restore the ideal vertebral body height and there is a risk of falling off. Adjustable and fixed artificial vertebral bodies: Scholars at home and abroad have developed adjustable and fixed artificial vertebral bodies with various characteristics, which have been used clinically and achieved certain curative effects. For example, the Synex artificial vertebral body is a titanium hollow mesh structure with an adjustable length. Knop et al. used it for the reconstruction of thoracolumbar anterior column injuries, which can provide good three-dimensional stability of the spine. However, after the length adjustment of the Synex artificial vertebral body, it is difficult to implant from the posterior approach, and the technical requirements are high, so the anterior approach or combined anterior-posterior approach is generally performed, and the surgical trauma is large and the time is long (Knop, Christian; 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 et al. (Zhao Dinglin, Chen Deshang, Zhao Jie, etc. Development and clinical application of adjustable hollow artificial vertebral body. Chinese Journal of Orthopedics, 2001, 21: 222-224.) developed a hollow adjustable titanium alloy artificial vertebral body, The length of the artificial vertebral body can be adjusted to achieve the ideal purpose of restoring the height of the vertebral body. Because it is a hollow structure, bone can be grafted inside to form a permanent bone fusion between the prosthesis and the vertebral body. However, only the spikes are fixed in contact with the upper and lower vertebral bodies, and the prosthesis is rigidly fixed, so there are problems such as stress shielding and bone resorption of the implanted bone.

These artificial vertebral bodies are adjusted and improved through various shapes and materials in order to simplify the operation steps, reduce the operation trauma, achieve immediate postoperative stability and speed up the fusion speed. However, the above-mentioned artificial vertebral bodies all have the same problem, that is, the spinal segment completely loses its original mobility after use. This is considered to accelerate the degeneration of the cervical spine after surgery, leading to disc herniation in the adjacent segment of the cervical spine and hyperosteogeny in the vertebral body. The results of long-term follow-up showed that after anterior cervical fusion surgery, up to 92% of patients had degeneration of adjacent segments, although the clinical symptoms were not consistent with the severity of the X-ray (Goffin, Jan, Geusens, Eric , Vantomme, Nicolaas, et al. Long-term follow-up after interbody fusion of the cervical spine. J Spinal DisordTech, 2004, 17(2): 79-85.). Hilibrand et al. found that about 2.9% of patients had clinical symptoms related to adjacent segment degeneration every year after anterior fusion surgery, and statistical analysis showed that 25.6% of patients would experience symptoms due to adjacent segment degeneration within 10 years. Clinical symptoms caused by changes. (Hilibrand AS, Carlson GD, Palumbo MA, et al. Radiculopathy and myelopathy at segments adjacent to the site of a p previous anterior cervical arthritis[J]. J Bone Joint Surg Am, 1999, 81(4): 519-528.) The results of mechanical experiments also confirmed that the intervertebral disc pressure in the adjacent segments increased after the fusion operation. The imaging evidence of the dynamic position also showed that the relative motion of the vertebral bodies of adjacent segments increased after fusion. These factors are very likely to promote the degeneration of adjacent segments after fusion.

Aiming at the disadvantages of loss of mobility of the operating segment and degeneration of adjacent segments after fusion, scientists and doctors at home and abroad have established non-fusion spinal surgery with the concept of motion preservation. Artificial disc replacement (also known as intervertebral disc plastic surgery) is a typical representative of non-fusion surgery. At present, the main clinically used intervertebral discs include Bryan prosthesis, ProDisc-C prosthesis, Prestige prosthesis, PCM prosthesis, etc. At present, it is believed that the best indication for artificial intervertebral disc replacement is single-segment cervical spine physiological curvature (Sekhon LH. ). Recognized contraindications are osteoporosis and intervertebral instability (Wiffield CC, Skrzyp iecD, Jackowski A, et al.Internal stress distribution in cervical intervertebraldiscs: the influence of an artificial cervical joint and simulated anterior interbody fusion[J].J Spinal Disord Tech, 2003, 16(5): 441-449.). Although the materials and shapes of various artificial intervertebral discs are different, they have the following common disadvantages: 1. They can only replace the intervertebral disc alone, but they are powerless to merged vertebral body lesions (such as vertebral body tumors, and need to decompress the vertebral body. surgery). 2. Most scholars do not agree with multi-segment intervertebral disc replacement, especially when two adjacent intervertebral discs are replaced at the same time.

To sum up, the current existing technology cannot solve the problem of mobility after cervical spine surgery, especially the problem of inability to move after multiple segmental surgery, and the resulting degeneration of adjacent segments after fusion .

Therefore, the present applicant has developed the following artificial cervical vertebral body and intervertebral connection complex with adjustable length, which have both the supporting function of the artificial vertebral body and the mobility of the artificial intervertebral disc.

Contents of the invention

The object of the present invention is to overcome the above-mentioned shortcoming of prior art, provide a kind of adjustable artificial cervical vertebra and intervertebral connecting complex, this connecting complex has the supporting function of artificial vertebral body and the activity performance of artificial intervertebral disc at the same time, and the length can be adjusted, It can achieve immediate stability after anterior cervical surgery, can play a supporting role, and can also realize immediate reconstruction of motion function after anterior cervical surgery, making its activity performance and normal cervical spine highly bionic.

The purpose of the present invention is solved by the following technical solutions:

This adjustable artificial cervical vertebra and intervertebral connection complex includes a vertebral body component and two endplate components connected to the upper and lower ends of the vertebral body component through a ball joint structure; the vertebral body component consists of an upper vertebral body component and a lower vertebral body Composed of components, 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, and the upper vertebral body part There is also a length fixing screw between the screw hole of the lower vertebral body part and the screw hole of the lower vertebral body part; the two end plate parts are respectively provided with end plate part fixing screws.

The above-mentioned ball joint structure includes the joint ball structure arranged on the end plate part and the socket structure arranged at the end of the upper vertebral body part or the lower vertebral body part and adapted to the joint ball structure, and the inner space of the socket structure It is composed of a cylindrical space in the center and a hemispherical space intersecting with both sides of the cylindrical space; and the socket structure has a large inside and a small outlet, and the joint ball structure is wrapped in it.

The above-mentioned end plate component includes a circular plate, and the joint ball structure is vertically fixed on the inner surface edge of the circular plate, and two adjacent screw holes are fixed on the outer surface of the circular plate at the edge far away from the fixed position of the joint ball structure. The end plate component is fixed with a screw; the axial direction of the end plate component fixed screw forms a certain angle with the plane of the circular plate.

The upper surface of the above-mentioned circular plate has a frosted rough structure and is provided with a biological hydroxyapatite coating.

The thickness of the above-mentioned hydroxyapatite coating is 1 μm, and the rear half of the upper surface of the circular plate has a denticulate structure with a size of 1 μm.

The plate thickness of the above-mentioned circular plate is thinner on the side where the endplate component is fixed and the screw is fixed, and thicker on the side where the joint ball structure is fixed. Viewed from the side of the circular plate, a cut plane is formed, and the cut plane begins approximately from the midline of the endplate structure. In the anterior-inferior direction, a 10° cut plane is formed, which causes the endplate component to form an 80° bevel with the adjacent superior vertebral body and a 100° bevel with the adjacent inferior vertebral body.

The lower constriction of the upper vertebral body part is provided with external threads, the upper end of the lower vertebral body part is a cylindrical structure provided with internal threads, and the lower constriction end of the upper vertebral body part is screwed into the lower vertebral body part by threads In the internal thread of the upper vertebral body part and the lower vertebral body part, there are several radial threaded through holes evenly distributed in the axial direction, and the length fixing screw can be threaded into the threaded through hole to fix the upper vertebral body part relative to the lower vertebral body component in the axial direction.

The minimum length of the entire complex above is 23mm, the maximum length is 29mm, and the adjustment range is 6mm.

The front end of the fixing screw of the end plate part is pointed, the rear end of the fixing screw is a nut, and the end near the nut of the fixing screw is slightly thicker than the end near the tip.

The beneficial effects of the present invention are:

The present invention can play a supporting role immediately after anterior cervical surgery, and can replace the normal cervical motion function through the self-contained intervertebral connection part, and can effectively prevent the degeneration of adjacent segments after fusion surgery. In addition, biological fusion and long-term stability can be achieved by the bone graft and the hydroxyapatite coating on the surface of the present composite. The operation is less difficult, the trauma is small, and it is easy to promote. Due to the adjustability of the length of the complex itself, the burden of production and carrying can be reduced, and it can be suitable for most people.

Description of drawings

Fig. 1 is the overall structural representation of the present invention;

Fig. 2 is a schematic structural view of the upper vertebral body part 2 of the present invention;

Fig. 3 is the top view of Fig. 2;

Fig. 4 is a schematic structural view of the lower vertebral body part 3 of the present invention;

Fig. 5 is a schematic diagram of the structure of the endplate component 1 of the present invention;

Figure 6 is a top view of Figure 5;

Among them: 1 is the end plate part; 2 is the upper vertebral body part; 3 is the lower vertebral body part; 4 is the fixing screw of the end plate part; 5 is the length fixing screw; 6 is the joint ball structure; 7 is the screw hole; 8 is the small Tooth structure; 9 is a circular plate; 10 is a socket structure.

Detailed ways

The present invention is described in further detail below in conjunction with accompanying drawing:

Referring to Fig. 1, the adjustable artificial cervical vertebra of the present invention and the intervertebral connection complex include vertebral body parts and two endplate parts 1 that are connected to the upper and lower ends of the vertebral body parts through a ball joint structure respectively; 2 and the lower vertebral body part 3, wherein the upper vertebral body part 2 and the lower vertebral body part 3 are connected axially by threads; A length fixing screw 5 is also provided between the screw holes of the upper vertebral body part 2 and the lower vertebral body part 3; the two endplate parts 1 are respectively provided with endplate part fixing screws 4. Each component that forms the present invention is described in detail below in conjunction with accompanying drawing:

Referring to Fig. 1, Fig. 2, Fig. 4 and Fig. 5, the ball joint structure described above includes the joint ball structure 6 arranged on the end plate part 1 and the joint ball structure 6 arranged at the end of the upper vertebral body part 2 or the lower vertebral body part 3 and The socket structure 10 that is compatible with the joint ball structure 6, the internal space of the socket structure 10 is composed of a cylindrical space in the center and a hemispherical space intersecting with the two sides of the cylindrical space; and the socket structure 10 has a large interior and a small outlet , enclosing the joint ball structure 6 therein. The joint ball structure 6 cooperates with the socket structure 10 to realize the activity function of the four degrees of freedom of the intervertebral connection.

In the best embodiment of the present invention: the joint ball structure 6 is connected by 85% of a sphere with a diameter of 4mm and a matching cylindrical structure. The articular ball structure 6 matches the socket structures 10 of the upper vertebral body part and the lower vertebral body part respectively. The upper and lower socket structures 10 completely coincide with the joint ball structure 6 on the left and right sides (that is, the diameter is 4 mm). The socket structure 10 is formed by stretching a circle with a diameter of 4mm for 1.5mm along the X-axis (that is, the line connecting the midpoints of the anterior and posterior edges of the vertebral bodies on the horizontal plane). Three-dimensionally, it is equivalent to a hemisphere with a diameter of 4mm plus a cylinder with a diameter of 4mm at the bottom and a height of 1.5mm plus a hemisphere with a diameter of 4mm to form 85% of the fossa-pillar structure. Such intervertebral connection has the following advantages: 1. 85% matching can form more than half of the joint anastomosis, ensuring the absolute stability of the intervertebral connection, and will not cause joint dislocation after implantation; 2. The center of the intervertebral connection is slightly behind the middle column of the vertebral body, which is in line with the movement axis of the normal spine, and has little effect on the biomechanical properties of the spine after insertion; 3. The intervertebral connection can realize 4 free (set the line connecting the midpoints along the front and rear edges of the vertebral body on the horizontal plane as the X axis, the line connecting the midpoints along the left and right edges of the vertebral body on the horizontal plane as the Y axis, and the vertical direction as the Z axis), respectively. And stretch back about 15° (that is, rotate along the Y axis), left and right lateral flexion about 15° (that is, rotate along the X axis), and the left and right rotation can also be maintained at 15 to 20° due to the restriction of the posterior column of the spine (that is, along the Z axis). axis rotation), about 1.5mm forward and backward translation (that is, translation along the X axis). The most important thing is that the intervertebral connection can realize the effect of forward and backward translation that almost all artificial intervertebral discs and artificial vertebral bodies cannot realize at present. Most literatures have confirmed that the human spine can not only perform the functions of forward flexion, backward extension, left and right lateral flexion, and left and right rotation, but also perform forward and backward translation between the upper and lower vertebrae. role. However, the distance of forward and backward translation should not be too large, if it is too large, it will cause vertebral body instability. Therefore, the intervertebral connection formed by the uniquely designed socket-column structure can make about 1.5mm of front-back translation between the upper and lower vertebral bodies. It can maximize the bionic human cervical spine and inhibit postoperative degeneration of cervical spine diseases.

As shown in Fig. 5 and Fig. 6, the end plate component 1 includes a circular plate 9, and the joint ball structure 6 is vertically fixed on the inner surface edge of the circular plate 9, and the outer surface of the circular plate 9 is at the edge away from the fixed position of the joint ball structure 6 Two endplate component fixing screws 4 are fixed through two adjacent screw holes 7; the axial direction of the endplate component fixing screws 4 forms a certain angle with the plane of the circular plate 9 (as shown in FIG. 1 ). The plate thickness of the circular plate 9 is thinner on the side where the endplate component fixing screw 4 is fixed, and thicker on the side where the joint ball structure 6 is fixed. And the small tooth structure 8 is arranged on the outer surface of the circular plate 9 .

In the preferred embodiment of the present invention:

The front half of the circular plate 9 of the end plate component 1 is thinner than the rear half, and forms a cut plane at an angle of about 10° when viewed from the side. section. This cutting plane makes the endplate component 1 form an 80° slope with the adjacent upper vertebral body, and a 100° slope with the adjacent lower vertebral body. These two slopes are very conducive to closely fitting the end plates of the upper and lower vertebral bodies adjacent to the operating vertebral body. In the front half of the circular plate 9, there are two screw holes 7, (see Fig. 6 for the position of the screw holes, the direction of the screw holes is at an angle of 20° with the front edge line of the adjacent vertebral body), these two screw holes With internal thread, it matches with the fixing screw 4 of the end plate part. The front end of end plate component fixing screw 4 of the present invention is pointed, and its rear end is a nut (as shown in Figure 1), and the near nut end of this end plate component fixing screw 4 is slightly thicker than its near tip end. The endplate component fixing screw 4 can be inserted into the adjacent vertebral body in a direction at an angle of 20° to the vertebral body adjacent to the operating vertebral body. The end near the nut of the endplate component fixing screw 4 cooperates with the screw hole 7. Due to the internal thread structure of the screw hole 7 and the longer endplate component fixing screw 4, the complex can be stably fixed on the operating vertebral body On the adjacent vertebral body, it can achieve immediate stability and exert the support function of the vertebral body. At the same time, compared with the front screw fixation, this fixation method has a longer screw depth and is more in line with biomechanical characteristics. In addition, the reason why the present invention designs the nail body of the endplate component fixing screw 4 to have a thinner front end and a slightly thicker end where the rear end cooperates with the screw hole 7 is because this structure connects the endplate component fixing screw 4 to the screw hole 7. When penetrating, the angle of the endplate component fixing screw 4 can be adjusted conveniently, and when the endplate component fixing screw 4 breaks into the adjacent vertebral body, its near nut end is just threaded with the screw hole 7, so that Angular locking of the endplate component set screw 4.

The upper surface of the circular plate 9 has a frosted rough structure, and has a biological hydroxyapatite coating formed by plasma oxidation technology. The thickness of the coating is about 1 μm. tooth structure 8. All the upper surface treatments can accelerate the early fusion of the endplate structure with the adjacent vertebral body, which is beneficial to achieve biological fusion and long-term stability.

Referring to Fig. 1 or Fig. 2 and Fig. 4, the lower part of the upper vertebral body part 2 is constricted and provided with external threads, the upper end of the lower vertebral body part 3 is a cylindrical structure provided with internal threads, and the lower part of the upper vertebral body part 2 is constricted The end is screwed into the internal thread of the lower vertebral body part 3 by threads; some radial threaded holes 11 and 12 are evenly distributed in the axial direction of the upper vertebral body part 2 and the lower vertebral body part 3 (provided in Fig. 2, 3 with 3 radial threaded holes 11, 12), the length fixing screw 5 can be threaded into the threaded hole to fix the relative position of the upper vertebral body part 2 and the lower vertebral body part 3 in the axial direction.

In the preferred embodiment of the present invention:

The lower vertebral body part 3 is composed of a hollow cylindrical structure at the top (about 12 mm in diameter, about 10 mm in height, and about 2 mm in wall thickness) and a solid cylindrical part at the bottom (about 12 mm in diameter, about 4 mm in height) (see FIG. 4 ). There is a fixing hole with a diameter of 2mm and an internal thread directly in front of the upper hollow cylindrical structure. There are four consecutive fusion screw holes on the left and right sides, each with a diameter of 2mm, without threads. The outer surface of the lower vertebral body part 3 is coated with biological hydroxyapatite coating with a thickness of about 1 μm treated by plasma oxidation technology. There is the aforementioned socket structure 10 in the middle of the lower part, and the dotted line in the lower part shows the position of the socket structure 10 , which matches the joint ball structure 6 of the lower endplate component 1 .

The external thread of the lower part of the upper vertebral body part 2 can coincide with the upper part of the internal thread of the lower vertebral body part 3 . Since the thread pitch is 1 mm, each outer turn increases the length of the entire complex by 1 mm. There are respectively four fusion screw holes 12 on the left and right sides of the bottom of the upper vertebral body part 2, and four fusion screw holes 15 are respectively arranged on the left and right sides of the upper part of the lower vertebral body part 3, and the diameter of the fusion screw holes is 2mm. thread. Every two rotations, the fusion screw hole (ie screw hole 12 ) of the upper vertebral body part 2 communicates with the fusion screw hole (ie screw hole 11 ) of a part of the lower vertebral body part 3 . After long-term implantation, the bone fragments filled in the lower hollow cylindrical structure of the upper vertebral body part 2 can grow out along the fusion screw hole, so as to realize the stable fusion of the stable vertebral body part and the operating vertebral body. In addition, the reliable hydroxyapatite coating on the outer surface of the upper and lower vertebral body parts can accelerate the postoperative fusion process, achieve biological fusion, and ensure long-term stability.

Four adjusting screw holes 11 directly in front of the lower part of the upper vertebral body part 2 and a fixing screw hole directly in front of the upper part of the lower part of the vertebral body part 3 are all with internal threads, which match the length of the vertebral body with the fixing screw 5 . Because the diameters of the adjusting screw hole and the fixing screw hole are 2 mm, the fixing screw hole directly in front of the lower vertebral body part 3 will coincide with the adjusting screw hole directly in front of the upper vertebral body part 2 every two turns. Now, available vertebral body length fixing screw 5 is screwed in along fixing screw hole and adjustment screw hole, depends on the conformity of the external thread of the bottom of upper vertebral body part 2 and the internal thread of the top of lower vertebral body part 3 and screw 5 and Fix the screw hole and adjust the holding force of the screw hole to realize the fixation of the length of the complex. The four adjusting screw holes can ensure that the length of the entire complex can be adjusted by 6mm, which fully meets the length needs of the normal human cervical spine.

The above upper vertebral body part 2 and the lower vertebral body part 3 cooperate with each other, and the length of the whole complex can be adjusted by rotation (the minimum length of the whole complex is 23mm, and the maximum length is 29mm. The adjustment range is 6mm).

In summary, the adjustable cervical artificial vertebral body and intervertebral connection complex of the present invention are especially suitable for treating cervical spondylosis caused by herniation of two adjacent cervical intervertebral discs. replacement surgery. At the same time, subtotal vertebral resection and complex replacement can be performed for cervical single vertebral body tumors. In addition, for patients who are not suitable for artificial cervical disc replacement, this complex can be used for various cervical diseases such as revision after artificial cervical disc replacement and severe degeneration after cervical fusion. The following describes the specific implementation of the operation in terms of intervertebral disc removal, subtotal vertebral body resection and replacement of this complex. General anesthesia with endotracheal intubation. The body position is supine, the shoulders are padded with soft pillows, the head is naturally stretched back, the back pillow is padded with a soft headband to prevent pressure sores, and small sandbags are placed on both sides of the head to prevent head rotation during the operation. The incision is generally made through an anterior cervical transverse incision to expose the affected vertebra and intervertebral disc, and the needle is positioned using a C-arm X-ray fluoroscopy machine during the operation. Cervical vertebral body spreader screws are respectively screwed into the center of the upper and lower vertebral bodies of the vertebral body to be subjected to subtotal resection, and the spreader is inserted on the spreader screws, and the upper and lower ends are spread apart. Decompression: use a sharp knife to incise the fibrous annulus of the intervertebral disc above and below the operated vertebral body, remove the intervertebral disc tissue with a nucleus pulposus forceps, and bite off the anterior cortical bone and most of the cancellous bone of the vertebral body with a three-joint sharp-nose rongeur. Pause when approaching the posterior edge of the vertebral body, completely resect the upper and lower intervertebral discs of the operating vertebral body, and repair the intervertebral articular surface to the subchondral hemorrhage with curettes, rongeurs, and round-head files, so that the endplates are roughly parallel and the bone cannot be damaged endplate. Use a nerve stripper to separate the gap between the posterior edge of the vertebral body and the posterior longitudinal ligament, and gradually bite off the cortical bone at the posterior edge of the vertebral body with a gun-style rongeur to form a rectangular decompression groove (sometimes the posterior longitudinal ligament can be bitten off as needed). ligament), the width of the decompression groove is about 12mm. Adjust the height of the vertebral body spreader to restore the height of the cervical anterior column to normal. At this time, the subtotal excised vertebral body bone is reduced to about 2 mm bone fragments, and filled in the cylindrical hollow structure at the lower part of the upper vertebral body part of the complex. Put this complex, adjust the length of this complex according to the required height, make the upper endplate part fit the lower endplate of the upper vertebral body, and the lower endplate part fit the upper endplate of the lower vertebral body. According to this length, screw in the vertebral body length fixing screw 5 to fix the length of the complex. The upper and lower vertebral body parts of this complex are driven into the relief grooves. According to the fixing screw holes 7 on the endplate parts, open on the lower and upper endplates of the upper and lower vertebral bodies respectively, and then screw the endplate fixing screws 4 into the upper and lower vertebral bodies at an angle of 20° with the front edge of the upper and lower vertebral bodies . Loosen the vertebral body spreader to make the complex embedded tightly. After the fluoroscopy of the C-arm X-ray machine is correct, the wound is washed to prevent drainage and sutured layer by layer. Postoperative cervical immobilization for 40 days, prophylactic use of antibiotics, close observation, other routine treatment of anterior cervical surgery.

Claims (8)

1. an 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);

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;

Described bottom necking down of going up vertebral body parts (2) is provided with external screw thread, and 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 screws, described length hold-down screw (5) can be packed in the screw with fixing vertebral body parts (2) and hypocentrum parts (3) relative position in the axial direction gone up by screw thread.

2. adjustable artificial cervical according to claim 1 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) fixedly has 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.

3. adjustable artificial cervical according to claim 2 and intervertebral junctional complex is characterized in that, the upper surface of described plectane (9) is frosted sample coarse structure, and are provided with the biology hydroxyapatite coating layer.

4. adjustable artificial cervical according to claim 3 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.

5. according to claim 2,3 or 4 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 plectane (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.

6. adjustable artificial cervical according to claim 1 and intervertebral junctional complex is characterized in that, whole complex minimum length is 23mm, and greatest length is 29mm, and range of accommodation is 6mm.

7. adjustable artificial cervical according to claim 1 and intervertebral junctional complex 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.

8. 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 tip, the rear end of described soleplate parts hold-down screw (4) is 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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