CN106037993A - Sacrum prosthesis - Google Patents

Abstract

The present invention provides a sacral prosthesis, comprising: a prosthetic body, the prosthetic body includes two first prosthetic bodies and a second prosthetic body connected between the two first prosthetic bodies, the first end of each first prosthetic body Connected with the second prosthesis, the two first prosthesis and the second prosthesis are integrally formed, the second end of each first prosthesis extends in a direction away from the second prosthesis and contacts with the ilium, and the second prosthesis The top of the restoration is in contact with the lumbar vertebral body; the nail-rod structure includes a connecting seat and a rod body, the connecting seat is connected to the restoration main body, and the rod body is fixed on the connecting seat. The technical solution of the invention can effectively solve the problem of unreliable support and easy fatigue fracture of the nail-rod system in the prior art.

Description

Sacral prosthesis

technical field

The invention relates to the field of medical devices, in particular to a sacral restoration.

Background technique

The sacrum is an important bony structure connecting the human trunk and limbs. The upper part forms the lumbosacral joint with the lumbar spine, and the two sides form the sacroiliac joint with the pelvis. Because there are not only important sacral nerves inside the sacrum, but also the sacroiliac joint is the only structure that connects the axial bone and the bones of the lower limbs. Therefore, surgical resection of this site has a greater impact on neurological function and structural stability. For patients with sacral tumors, the combination of radiotherapy, chemotherapy and tumor resection is the first choice for most sacral tumors. However, since sacral tumors have few early symptoms and are often huge when discovered, for sacral tumors, the resection range is relatively large during surgery, which seriously damages the local stability, and the recovery and stability of lumbosacral stress conduction after resection Sexual reconstruction directly determines the postoperative function and quality of life of patients. Restore the three most important structures in the lumbosacral region: the lumbosacrum, the posterior pelvic ring, and the anterior column of the vertebral body. Especially for patients with total sacral resection, the bone defect after total sacral resection will cause the human trunk to lose contact with the pelvis, and the patient may be unable to stand, walk, and take care of himself after surgery. Without effective reconstruction of the sacrum, severe lumbar subsidence and lumbosacral nerve traction can occur postoperatively. The above-mentioned reconstruction after sacral resection is a major difficulty in the field of bone oncology in the world. At present, there are a variety of sacral tumor resection and reconstruction operations, and the most commonly used surgical method is structural bone graft reconstruction. Structural bone graft reconstruction is mainly divided into two categories: one is "church-style" reconstruction, that is, the lower lumbar spine is directly supported on the ilium through the iliac screw and screw rod system; although the above-mentioned structural bone graft reconstruction can achieve load-bearing in the short term However, according to long-term follow-up observations, the nail rod is prone to breakage or loosening, and the bone quality is damaged. The patient will fall into the state of being unable to stand, walk, and take care of himself again, and he must undergo another fixation operation. Another type of structural bone graft reconstruction is through iliac bone rod reconstruction, that is, the two sides of the ilium are connected through bone graft blocks or implants to restore the posterior pelvic ring, and through the screw rod system and the horizontal metal rod or bone graft and other structures Make connections to re-establish stress transfer from the lumbar spine to the ilium. The early stability of the aforementioned structural bone graft reconstruction requires metal implants, but the long-term stability requires bony fusion, so biological reconstruction is crucial for long-term lumbosacral stability. From a biomechanical point of view, due to the long moment of lumbar pelvic fixation, the lumbosacral region will bear high stress and shear force. The above reconstruction method cannot achieve complete fusion of the lumbar pelvis, resulting in stress mainly concentrated on the metal. Inplants. If this happens for a long time, it will lead to fatigue fracture of the metal implant, and then the metal implant will lose its fixing effect and be pulled out passively. Although methods such as bone grafting, hydroxyapatite, bone cement, and long screws can reduce the pull-out of metal implants, the problem of fatigue fracture of metal implants has not been solved, and it is difficult to achieve effective reconstruction.

Contents of the invention

The present invention aims to provide a sacral prosthetic body to solve the problems of unreliable support and easy fatigue fracture of the nail-rod system in the prior art.

In order to achieve the above object, the present invention provides a sacral prosthetic body, comprising: a prosthetic body, the prosthetic body includes two first prosthetic bodies and a second prosthetic body connected between the two first prosthetic bodies, each of the first prosthetic bodies The first end of the first prosthesis is connected with the second prosthetic body, the two first prosthetic bodies and the second prosthetic body are integrally formed, and the second end of each first prosthetic body extends away from the second prosthetic body and connects with the ilium Contact fit, the top of the second prosthesis is in contact with the lumbar vertebral body; the nail-rod structure includes a connecting seat and a rod body, the connecting seat is connected to the restoration main body, and the rod body is fixed on the connecting seat.

Further, the first prosthesis is provided with a first screw hole, the first screw hole is a tapered hole, a first nail seat is provided in the first screw hole, the first nail seat has a spherical inner surface, and/or the second prosthesis The body is provided with a second screw hole, the second screw hole is a tapered hole, a second nail seat is arranged in the second screw hole, and the second nail seat has a spherical inner surface.

Further, the connecting base includes: a connecting screw, one end of the connecting screw is connected with the repair main body, and the other end of the connecting screw has a spherical nail head; a rod fixing part is used to fix the rod, and one end of the rod fixing part has a spherical nail The spherical hole matched with the head, so that the rod fixing part can be rotatably arranged on the connecting screw.

Further, the rod fixing part includes a U-shaped support and a fixed cap, and the rod is sandwiched between the U-shaped support and the fixed cap.

Further, the repair body is a hollow truss structure, and the repair body is formed by 3D printing.

Further, the second end of the first prosthesis and/or the top of the second prosthesis is provided with a porous structure.

Further, the second end of the first prosthesis and/or the top of the second prosthesis are provided with needle-shaped protrusions.

Further, the surface of the prosthetic body facing the pelvic cavity is a smooth surface.

Further, the repair body is provided with an anti-off mechanism, which is sandwiched between the repair body and the connecting seat, and the anti-off mechanism includes a first anti-off antenna that cooperates with the screw accommodated in the first screw hole.

Further, the anti-off mechanism also includes an anti-off main body, the anti-off main body is sandwiched between the repair main body and the connecting seat, the anti-off mechanism also includes a second anti-off antenna, the first anti-off antenna and the second anti-off antenna are connected to the The anti-off main body is connected and extends outward, and the second anti-off antenna is provided with a limit sleeve matched with the rod.

Applying the technical solution of the present invention, the sacral prosthetic body includes a prosthetic body, the prosthetic body includes two first prosthetic bodies and a second prosthetic body connected between the two first prosthetic bodies, and the first end of each first prosthetic body is connected to the The second prosthetic body is connected, the second end of each first prosthetic body extends away from the second prosthetic body and contacts and fits with the ilium, and the top of the second prosthetic body contacts and fits with the lumbar vertebral body. The profile of the above-mentioned restoration main body forms a "character-eight" structure, which has good mechanical properties and improves the internal force distribution of the structure. In the case of high stress and shear force, it can maintain the rigidity of the sacral prosthesis, so that the bone is not easy to be damaged. Therefore, the above-mentioned structure solves the problem that the nail-rod system in the prior art is unreliable in support, prone to fatigue and fracture, and finally leads to the problem that the bone is easily damaged. In addition, applying the technical solution of the present invention, the nail-rod structure includes a connecting seat and a rod body, the connecting seat is connected to the repair main body, and the rod body is fixed on the connecting seat. The above structure strengthens the fixation between the restoration main body and the lumbar vertebral body, increases the stability of the lumbar vertebral body, and avoids the sinking of the lumbar vertebrae.

Description of drawings

The accompanying drawings constituting a part of the present application are used to provide a further understanding of the present invention, and the schematic embodiments and descriptions of the present invention are used to explain the present invention, and do not constitute an improper limitation of the present invention. In the attached picture:

Fig. 1 shows the assembly schematic diagram of the embodiment of sacral prosthesis according to the present invention;

Fig. 2 shows a schematic perspective view of the three-dimensional structure of the connecting seat of the sacral prosthesis in Fig. 1;

Fig. 3 shows a schematic diagram of the longitudinal section of the connecting seat in Fig. 2;

Fig. 4 shows a schematic perspective view of another connection seat of the sacral prosthesis in Fig. 1;

Fig. 5 shows a schematic view of the longitudinal section of another connecting seat in Fig. 4; and

FIG. 6 shows a schematic perspective view of the three-dimensional structure of the anti-off mechanism of the sacral prosthesis in FIG. 1 .

Wherein, the above-mentioned accompanying drawings include the following reference signs:

1. Ilium; 2. Lumbar vertebrae; 11. The first prosthesis; 111. The first screw hole; 12. The second prosthesis; 121. The second screw hole; 21. Connecting seat; 211. Connecting screw; 2111 , spherical nail head; 212, rod body fixing part; 2121, U-shaped support; 2122, fixing cap; 22, connecting seat; 221, connecting screw; 2211, spherical nail head; 2222, fixed cap; 23, rod body; 30, anti-off mechanism; 31, first anti-off antenna; 32, anti-off main body; 33, second anti-off antenna; 34, limit sleeve.

detailed description

It should be noted that, in the case of no conflict, the embodiments in the present application and the features in the embodiments can be combined with each other. The present invention will be described in detail below with reference to the accompanying drawings and examples.

As shown in FIG. 1 , the sacral prosthesis of this embodiment includes a prosthetic body and a nail-rod structure. Wherein, the prosthetic body includes two first prosthetic bodies 11 and a second prosthetic body 12 connected between the two first prosthetic bodies 11, the first end of each first prosthetic body 11 is connected with the second prosthetic body 12, and the two The first prosthetic body 11 and the second prosthetic body 12 are integrally formed structures, and the second end of each first prosthetic body 11 extends in a direction away from the second prosthetic body 12 and contacts with the ilium 1, and the second prosthetic body 12 The top of the top is in contact with the lumbar vertebral body 2; the nail-rod structure includes a connecting seat 22 and a rod body 23, the connecting seat 22 is connected to the repair main body, and the rod body 23 is fixed on the connecting seat 22.

Applying the technical solution of this embodiment, the sacral prosthetic body includes a prosthetic body, the prosthetic body includes two first prosthetic bodies 11 and a second prosthetic body 12 connected between the two first prosthetic bodies 11, and each first prosthetic body 11 The first end of each first prosthesis 11 is connected to the second prosthetic body 12, the second end of each first prosthetic body 11 extends in a direction away from the second prosthetic body 12 and contacts with the ilium 1, and the top of the second prosthetic body 12 is in contact with the lumbar vertebrae. Body 2 contact fit. The above repair body forms a "character-eight" structure, which has good mechanical properties and improves the internal force distribution of the structure. In the case of high stress and shear force, it can maintain the rigidity of the sacral prosthesis, so that the bone is not easy to be damaged. Therefore, the above-mentioned structure solves the problem that the nail-rod system in the prior art is unreliable in support, prone to fatigue and fracture, and finally leads to the problem that the bone is easily damaged. In addition, applying the technical solution of this embodiment, the nail-rod structure includes a connecting seat 22 and a rod body 23 , the connecting seat 22 is connected to the repair body, and the rod body 23 is fixed on the connecting seat 22 . The above structure strengthens the fixation between the restoration main body and the lumbar vertebral body 2, increases the stability of the lumbar vertebral body 2, and avoids the sinking of the lumbar vertebral body.

As shown in Figure 3, in the present embodiment, the nail rod structure also includes a connection seat 21, the connection seat 21 is connected with the lumbar vertebral body, and the rod body 23 is fixed on the connection seat 21, and the connection seat 21 includes: a connection screw 211, a connection screw One end of 211 is connected with the lumbar vertebral body 2, and the other end of the connecting screw 211 has a spherical nail head 2111; the rod body fixing part 212 is used to fix the rod body 23, and one end of the rod body fixing part 212 has a spherical nail head 2111 to match spherical hole. The above structure enables the rod fixing part 212 to be rotatably disposed on the connecting screw 211 . In this way, the doctor can adjust the position of the rod body 23 according to actual needs, so that the installation position is more accurate and the installation process is simpler.

As shown in FIG. 2 , in this embodiment, the rod fixing portion 212 includes a U-shaped support 2121 and a fixing cap 2122 , and the rod 23 is sandwiched between the U-shaped support 2121 and the fixing cap 2122 . Specifically, the U-shaped inner wall of the U-shaped support 2121 forms an installation space, and the rod body 23 is inserted into the above-mentioned installation space. The upper part of the U-shaped inner wall of the U-shaped support 2121 has internal threads, and the fixing cap 2122 has external threads adapted to the internal threads of the U-shaped support 2121 . When installing the rod body 23 , it is necessary to pass the rod body 23 out of the installation space first, and then screw the fixing cap 2122 on the U-shaped support 2121 . The above structure is simple and easy to install.

As shown in Figure 5, in this embodiment, the nail rod structure also includes a connection base 22, the connection base 22 is connected with the repair body, the connection base 22 includes: a connection screw 221, one end of the connection screw 221 is connected with the repair body, the connection screw The other end of 221 has a spherical nail head 2211 ; the rod body fixing part 222 is used to fix the rod body 23 , and one end of the rod body fixing part 222 has a spherical hole matched with the spherical nail head 2211 . The above structure enables the rod fixing part 222 to be rotatably disposed on the connecting screw 221 . In this way, the doctor can adjust the position of the rod body 23 according to actual needs, so that the installation position is more accurate and the installation process is simpler.

As shown in FIG. 4 , in this embodiment, the rod fixing portion 222 includes a U-shaped support 2221 and a fixing cap 2222 , and the rod 23 is sandwiched between the U-shaped support 2221 and the fixing cap 2222 . Specifically, the U-shaped inner wall of the U-shaped support 2221 forms an installation space, and the rod body 23 is inserted into the above-mentioned installation space. The upper part of the U-shaped inner wall of the U-shaped support 2221 has internal threads, and the fixing cap 2222 has external threads adapted to the internal threads of the U-shaped support 2221 . When installing the rod body 23 , it is necessary to pass the rod body 23 out of the installation space first, and then screw the fixing cap 2222 on the U-shaped support 2221 . The above structure is simple and easy to install.

In this embodiment, the repair body is a hollow truss structure. On the one hand, the above-mentioned truss structure can greatly reduce the mass of the restoration main body, improve the utilization rate of materials, and at the same time ensure the strength and rigidity of the restoration main body. On the other hand, using the above-mentioned structure can make the prosthetic body closer to the adjacent bone, so that the effect of bony fusion is better. Anatomical reconstruction after pelvic tumor resection not only needs to meet precise and complex requirements, but also requires one-time, tailor-made requirements. Therefore, in this embodiment, the restoration body is shaped by 3D printing. The above-mentioned processes are inherently precise, capable of producing complex parts and capable of individual customization.

It should be noted that 3D printing rapid prototyping technology is a new manufacturing technology based on material accumulation method, which is different from traditional material removal processing technology, also known as additive manufacturing (AM, Additive Manufacturing). 3D printing technology uses the data of three-dimensional CAD to accumulate layers of materials into solid objects through rapid prototyping machines. Different types of rapid prototyping systems have different forming principles and system characteristics due to the different forming materials used, but the basic principle is the same, that is, "layer-by-layer manufacturing, layer-by-layer stacking", just like a "three-dimensional printer", hence the name . With the rapid development of cutting-edge technologies such as manufacturing technology, digital modeling technology, numerical control technology, information technology, material science and chemistry, and biotechnology, as well as the close cooperation of multiple disciplines, the development of 3D printing technology has become one of the hottest new technologies today. one. 3D printing will present broad application prospects in the field of orthopedics in the future. The fundamental reason is that the characteristics of 3D printing meet the special requirements of orthopedics. First, bone tissue is a typical representative of complex structures, and it is difficult for existing bionic technologies to replicate its unique three-dimensional shape and physiological functions. 3D printing is suitable for the rapid manufacture of complex structures, and can obtain nearly ideal bone repair materials; second, due to the high degree of individual specificity of the human body, traditional large-scale and mass-produced medical products cannot meet individual needs, and In the past, personalized and customized products produced through manufacturing processes such as molds had high costs and long cycles. With the wide application of digital imaging technology in the medical field, bones are the easiest organs to obtain accurate digital images. Combining them with 3D printing can produce personalized medical products accurately, quickly and at low cost; therefore, with the help of 3D Printing technology can "cast" implants with any shape and ideal biomechanical strength in a short time, making the development of individualized and customized bone implants a reality.

As shown in Figure 1, in this embodiment, the first prosthesis 11 is provided with a first screw hole 111, the first screw hole 111 is a tapered hole, and a first nail seat is arranged in the first screw hole 111, and the first screw hole 111 is provided with a first screw hole. The nail seat has a spherical inner surface. When the doctor needs to fix the main body of the repair on the ilium 1 with screws, the screw is first inserted into the first screw hole 111. Since the first screw hole 111 is a tapered hole, the head of the screw is a ball head, and the first nail seat has The spherical inner surface matched with the ball head, so that the screw can rotate within a certain range, and the doctor can choose the driving direction of the screw according to the actual situation. The above structure enables the doctor to select the screw fixation position according to the actual situation, so that the fixation effect between the prosthetic main body and the ilium 1 is better. It should be noted that the dotted line in FIG. 1 is the direction in which the screw is inserted. Similarly, the second prosthetic body 12 is provided with a second screw hole 121 , the second screw hole 121 is a tapered hole, and a second nail seat is arranged in the second screw hole 121 , and the second nail seat has a spherical inner surface. The above structure enables the doctor to select the screw fixation position according to the actual situation, so that the fixation effect between the prosthetic main body and the lumbar vertebral body 2 is better.

In this embodiment, the second end of the first prosthesis 11 is provided with a first porous structure (not shown in the figure). The above-mentioned structure can quickly promote the generation of osteocytes, and is easy to integrate with the bone (iliac crest), so as to achieve a mid-term and long-term fixation effect. Compared with the traditional operation mode, it has the advantages of high strength, high stability and strong osseointegration ability.

In this embodiment, the top of the second restoration body 12 is provided with a second porous structure (not shown in the figure). The above-mentioned structure can quickly promote the generation of osteocytes, and is easy to integrate with the bone (lumbar vertebral body), so as to achieve mid-term and long-term fixation effects. Compared with the traditional operation mode, it has the advantages of high strength, high stability and strong osseointegration ability.

In this embodiment, the second end of the first prosthesis 11 is provided with a first needle-shaped protrusion (not shown in the figure). The above-mentioned first needle-shaped protrusion has the function of cutting and anchoring, so that the iliac bone and the second end of the first prosthetic body 11 are fixed together.

In this embodiment, the top of the second prosthesis 12 is provided with a second needle-shaped protrusion (not shown in the figure). The above-mentioned second needle-shaped protrusion has the function of cutting and anchoring, so as to fix the lumbar vertebral body and the top of the second prosthetic body 12 together.

In this embodiment, the surface of the prosthetic body facing the pelvis is a smooth surface (not shown in the figure). The above-mentioned structure can reduce the contusion of the soft tissue such as the intestinal tract in the pelvic cavity caused by the sacral prosthesis, and thus play a certain protective role on the soft tissue such as the intestinal tract in the pelvic cavity of the patient.

As shown in Figure 6, in this embodiment, the repair main body is provided with an anti-off mechanism 30, the anti-off mechanism 30 is interposed between the repair main body and the connecting seat 22, and the anti-off mechanism 30 includes and is accommodated in the first screw hole The first anti-off contactor 31 that the screw fits in 111. During use, when the connecting seat 22 is tightened, the first anti-off contactor 31 will withstand the screw contained in the first screw hole 111, and the tighter the connecting screw 221 of the connecting seat 22, the first anti-off contactor 31 will withstand the screw. The greater the force. Therefore, the above structure can prevent the screw from coming out of the first screw hole 111 . In addition, in the prior art, the connection screw 221 screwed into the bone is often loosened. Applying the above-mentioned anti-loosening mechanism 30 can also provide a pre-tightening force for the connecting seat 22 to prevent the connecting seat 22 from loosening.

As shown in Figure 6, in this embodiment, the anti-off mechanism 30 also includes an anti-off main body 32, and the anti-off main body 32 is sandwiched between the repair main body and the connecting seat 22, and the anti-off mechanism 30 also includes a second anti-off contactor 33 , the first anti-off antenna 31 and the second anti-off antenna 33 are both connected to the anti-off body 32 and extend outward, and the second anti-off antenna 33 is provided with a limit sleeve 34 that cooperates with the rod body 23 . Preferably, there are a plurality of first anti-off contactors 31 matched with the first screw holes 111 . Since the plurality of first anti-off contactors 31 extend outward into the first screw hole 111 , and the anti-off main body 32 is sandwiched between the repair main body and the connecting seat 22 , the anti-off mechanism 30 is limited and cannot rotate. And because the limit sleeve 34 is set on the second anti-off antenna 33, the limit sleeve 34 cooperates with the rod body 23, so the rod body 23 is also limited and cannot rotate. The above structure avoids the rotation of the rod body 23, thereby increasing the stability of the system.

Preferably, the anti-off mechanism 30 is a leaf spring, the tail end of the second anti-off antenna 33 of the spring plate is tilted upward, and the limit sleeve 34 is arranged on the tail end of the second anti-off antenna 33 .

The above descriptions are only preferred embodiments of the present invention, and are not intended to limit the present invention. For those skilled in the art, the present invention may have various modifications and changes. Any modifications, equivalent replacements, improvements, etc. made within the spirit and principles of the present invention shall be included within the protection scope of the present invention.

Claims (10)

1. a sacrum bone repair, it is characterised in that including:

Repairing main body, described reparation main body includes two the first dummies (11) and is connected to two described first dummies (11) the second dummy (12) between, the first end of each described first dummy (11) is with described second dummy (12) even Connecing, two described first dummies (11) and described second dummy (12) are formed in one structure, each described first dummy (11) the second end extends along the direction away from described second dummy (12) and contacts cooperation with ilium (1), and described second repaiies The top of complex (12) contacts cooperation with lumbar vertebra (2)；

Nail bar structure, described nail bar structure bag connects seat (22) and barred body (23), and described connection seat (22) repairs master with described Body connects, and described barred body (23) is fixed on described connection seat (22).

Sacrum bone repair the most according to claim 1, it is characterised in that

Being provided with the first screw hole (111) on described first dummy (11), described first screw hole (111) is taper hole, described Being provided with the first nail seat in first screw hole (111), described first nail seat has spherical inside surface, and/or

Being provided with the second screw hole (121) on described second dummy (12), described second screw hole (121) is taper hole, described Being provided with the second nail seat in second screw hole (121), described second nail seat has spherical inside surface.

Sacrum bone repair the most according to claim 1, it is characterised in that described connection seat (22) including:

Attachment screw (221), one end of described attachment screw (221) is connected with described reparation main body, described attachment screw (221) The other end there is spherical ailhead (2211)；

Barred body fixed part (222), in order to fixing described barred body (23), one end of described barred body fixed part (222) has with described The spherical pore that spherical ailhead (2211) matches, so that described barred body fixed part (222) can be rotatably set in described connection spiral shell On nail (221).

Sacrum bone repair the most according to claim 3, it is characterised in that described barred body fixed part (222) includes U-shaped bearing (2221) and locking cap (2222), described barred body (23) be folded in described U-shaped bearing (2221) and described locking cap (2222) it Between.

Sacrum bone repair the most according to claim 1, it is characterised in that described reparation main body is hollow truss structure, institute State reparation main body by 3D printing shaping.

Sacrum bone repair the most according to claim 1, it is characterised in that the second end of described first dummy (11) and/ Or the top of described second dummy (12) is provided with loose structure.

Sacrum bone repair the most according to claim 1, it is characterised in that the second end of described first dummy (11) and/ Or to be provided with needle-like protruding at the top of described second dummy (12).

Sacrum bone repair the most according to claim 1, it is characterised in that described reparation main body is light towards the surface of pelvic cavity Sliding surface.

Sacrum bone repair the most according to claim 2, it is characterised in that be provided with escapement (30) in described reparation main body, Described escapement (30) is folded in described reparation main body and is connected between seat (22) with described, described escapement (30) include with First anticreep feeler (31) of the screw fit being contained in described first screw hole (111).

Sacrum bone repair the most according to claim 9, it is characterised in that described escapement (30) also includes anticreep main body (32), described anticreep main body (32) is folded in described reparation main body and is connected between seat (22) with described, described escapement (30) Also include that the second anticreep feeler (33), described first anticreep feeler (31) and described second anticreep feeler (33) are all anti-with described De-main body (32) connects and stretches out, and described second anticreep feeler (33) is provided with spacing with what described barred body (23) coordinated Set (34).