CN109481101B - Anterior cervical self-fixing artificial vertebral body - Google Patents
Anterior cervical self-fixing artificial vertebral body Download PDFInfo
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- CN109481101B CN109481101B CN201811622585.5A CN201811622585A CN109481101B CN 109481101 B CN109481101 B CN 109481101B CN 201811622585 A CN201811622585 A CN 201811622585A CN 109481101 B CN109481101 B CN 109481101B
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Biomedical Technology (AREA)
- Vascular Medicine (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Neurology (AREA)
- Prostheses (AREA)
Abstract
The invention discloses a cervical anterior self-fixing artificial vertebral body, and belongs to the technical field of medical prosthesis manufacturing. The self-fixing screw hole structure is composed of an integrated centrum component and is mainly characterized by comprising an upper end cambered surface, a lower end inclined surface, an end surface sawtooth structure, an end surface micropore structure, a side wall diamond hole, a rear wall micropore structure, a front wall cambered surface structure, a rear wall cambered surface structure and a front wall self-fixing screw hole structure. The invention removes the use of the traditional anterior cervical titanium plate on the premise of keeping the stability of the spinal column segment after operation, and the breakthrough effectively reduces the complexity of the anterior cervical vertebral body secondary total excision fusion operation, shortens the operation time, reduces the bleeding amount in books, optimizes the biomechanical conduction mode of the anterior cervical implantation instrument and avoids a plurality of complications caused by the anterior cervical steel plate. Through the design invention, the anterior cervical self-fixing artificial vertebral body can effectively reduce a plurality of complications of the traditional titanium cage and improve prognosis of patients after anterior cervical vertebral body secondary total excision fusion operation.
Description
[ Field of technology ]
The invention belongs to the technical field of medical prosthesis manufacturing, and relates to a method for performing prosthesis transplantation after excision of cervical vertebral body and adjacent intervertebral disc lesions.
[ Background Art ]
With the improvement of the living standard and the change of the living style of modern people, the incidence rate of cervical spondylosis is gradually increased. Neck pain has become one of the main causes of clinical visits, as the number of patients with cervical spondylosis accounts for 1.5% of all diseases. The anterior cervical vertebral body sub-total excision fusion is one of the most commonly used surgical methods for treating cervical spondylosis, and is widely applied to cervical degenerative diseases, wounds, tumors and other diseases.
At present, the most commonly used instrument in anterior cervical vertebral sub-total excision fusion is a titanium cage combined with an anterior cervical plate, and the method proves to provide sufficient stability for postoperative reconstruction of cervical vertebral segments, thereby promoting fusion and preventing displacement or collapse of the titanium cage, and is widely adopted by spinal surgeons. However, there are a number of disadvantages to this approach: the installation of the front steel plate complicates the operation, prolongs the operation time and increases the bleeding amount; compression of the anterior steel plate to adjacent tissues can lead to esophageal and tracheal injury, dysphagia and accelerated adjacent segment degenerative changes; traditional titanium cage is simple cylinder structure, need rely on the skill of art person to prune its both ends in the art, pruned titanium cage terminal surface and can not laminate with the endplate, and area of contact is cut little to have sharp arch, finally leads to the endplate to destroy titanium cage subsidence, destroys the stability of postoperative cervical vertebra. The complications can seriously affect the postoperative rehabilitation and life safety of patients, and the problems are urgently needed to be solved.
At present, no effective and simple method or technology is available for solving the problems caused by the steel plates for the front neck road.
[ Invention ]
The invention aims to solve the defects of the traditional titanium cage titanium plate and provide the anterior cervical self-fixing artificial vertebral body with simple structure and anatomical form adaptation.
In order to achieve the purpose, the invention is realized by adopting the following technical scheme:
the anterior cervical self-fixing artificial vertebral body comprises a hollow vertebral body component, wherein the upper end, the front wall, the rear wall, the front side angle and the rear side wall of the vertebral body component are all cambered structures, and the lower end of the vertebral body component is not provided with a bevel structure; the upper end face and the lower end face of the cone component are saw-tooth, and the tops of the two side walls and the rear wall of the upper end face and the lower end face are provided with micropore structures; the side wall of the centrum part is provided with a diamond window hole, and the front wall is provided with a screw hole for self-fixing.
The invention is further improved in that:
The cone part is an integrated structure formed by 3D printing of titanium alloy and is fixedly installed through screws; the thickness of the front and rear walls and the left and right side walls of the cone part is 2mm, the left and right diameters are 13-16 mm, and the front and rear diameters are 12mm.
The cross section of the cone part is square with four corners and front and back arc angles, the radian radius of the front wall is 15mm, the radian radius of the rear wall is 33mm, the radian radius of the front two side angles is 2mm, and the radian radius of the rear two side angles is 3mm;
The front and rear walls of the vertebral body component are respectively provided with a front protruding radian which is matched with the front and rear radian of the secondary total excision vertebral body, so that the front end of the vertebral body component after being implanted does not exceed the connecting line of the front and rear walls of the upper and lower vertebral bodies, and the compression of any front and rear tissue structures of the cervical vertebrae is not caused; rounded corners for preventing stress concentration are poured at the junctions of the front side wall, the rear side wall, the left side wall and the right side wall of the cone component; the upper end and the lower end of the vertebral body component are both open, and a containing cavity for transplanting bone is reserved in the vertebral body component.
Four screw holes are arranged on the front wall of the centrum component.
The four screw holes are vertically symmetrically arranged, the screw holes on two sides of the central axis are distributed by taking the central axis as a symmetrical line, and the included angles between all the screw holes and the cross section surface are consistent and are 40 degrees+/-10 degrees; the diameters of the main body parts of the four screw holes are 3.5-4 mm; the four screw holes are all countersunk holes and are provided with threads, and the screws and the centrum components are self-locked; the diameters of the nut parts of the four screw holes are 5mm, and the heights are 1mm; and a wrapping structure with the thickness of 1mm is arranged around the four screw holes.
The back wall of the cone component is embedded with a layer of honeycomb micropore structure, the honeycomb micropore structure is formed by a rhombic hexahedral cell unit array, the size is 1 multiplied by 8 multiplied by 13.5mm, the pore size is 400 mu m, and the porosity is about 65%; all pores inside the honeycomb micropore structure are mutually communicated, so that blood vessels and soft tissues can grow in.
The upper end of the cone part is a cambered surface structure which is arranged on an inclined plane with the cross section having an included angle of 9 degrees, and the radian radius of the cambered surface in the sagittal plane is 10-18 degrees.
The lower end of the cone part is of an inclined plane structure and forms an angle of 10-15 degrees with the cross section.
The saw teeth comprise an upper saw tooth structure and a lower saw tooth structure, and the depth of the saw teeth is 0.7-1.0 mm.
The microporous structure comprises an upper microporous structure and a lower microporous structure.
The diamond window holes are formed by a plurality of diamond holes, and the area of each diamond hole accounts for more than 50% of the total area of the side wall of the vertebral body part.
Compared with the prior art, the invention has the following beneficial effects:
the anterior cervical self-fixing artificial vertebral body combines the anatomical features of the cervical vertebra, and the upper cambered surface and the lower inclined surface are tightly attached to the upper and lower adjacent vertebral body end plates, so that the anatomical form adaptation is satisfied. The serrated structure increases friction force between the vertebral body and the end plate, and the vertebral body displacement is effectively prevented. The micropore structures of the upper end face and the lower end face increase the contact area with the end plate to prevent sinking, and provide bone ingrowth space to promote early stability. The side wall is provided with large diamond holes, which is beneficial to promoting bone fusion. Screw holes provided in the anterior wall allow the vertebral body to be self-secured by screws.
Furthermore, the screw holes are formed in the front wall of the vertebral body, so that an operator can directly fix the artificial vertebral body on the upper and lower end plates by using screws without using an additional anterior cervical steel plate, thereby avoiding a plurality of complications caused by the anterior cervical steel plate and providing sufficient postoperative stability for the reconstructed segment. Meanwhile, the fixing mode changes the force supporting mode of the traditional titanium cage titanium plate and mainly adopts the force conduction mode, so that the stress of a screw-centrum interface can be effectively reduced, the loosening probability of the screw is reduced, the bone grafting stress is properly increased, the bone generation is promoted, and the fusion is promoted.
Furthermore, the diamond holes on the side wall of the vertebral body occupy a large proportion of the side wall, the large-area diamond holes are beneficial to the full contact between the bone grafting in the vertebral body and the residual osseous part of the sub-total cut vertebral body, the blood supply around the vertebral body is ensured to enter the artificial vertebral body, the full blood supply and the good osseous contact are important preconditions for bone growth fusion, and the design can effectively improve the postoperative fusion rate and the fusion speed.
Furthermore, the upper cambered surface and the bottom inclined surface of the vertebral body are designed by collecting anatomical structure data of the upper end endplate and the lower end endplate of the cervical vertebral body of a normal person, and the design ensures that the upper end and the lower end of the artificial vertebral body are tightly attached to the adjacent vertebral body endplate, so that the contact area is increased, the occurrence of stress concentration phenomenon widely existing in the traditional titanium cage is prevented, and the probability of vertebral collapse and subsidence can be effectively reduced.
Furthermore, the sawtooth structure at the upper end and the lower end of the vertebral body increases the friction force between the upper end face and the lower end face of the artificial vertebral body and the end plate, and greatly reduces the possibility of front or back shifting and falling-out of the artificial vertebral body, thereby reducing the possibility of damage to structures in front of the cervical vertebra such as esophagus and trachea and structures behind the cervical vertebra such as spinal cord.
Furthermore, the micropore structure at the upper end and the lower end of the vertebral body is designed according to the mechanical analysis structure, and can greatly increase the contact area between the end face of the vertebral body and the end plate on the premise of ensuring the strength of the vertebral body, reduce the actual elastic modulus of the artificial vertebral body, provide space for bone tissue ingrowth, reduce stress shielding, promote the fusion of the bone-artificial vertebral body and increase the structural stability of the cervical vertebra after operation.
Furthermore, the microporous structure on the back wall of the vertebral body provides an attachment point for attaching back soft tissues, so that the stability of the artificial vertebral body in early postoperative period is improved.
[ Description of the drawings ]
FIG. 1 is a front isometric view;
FIG. 2 is a rear isometric view;
FIG. 3 is a front view;
fig. 4 is a rear view;
FIG. 5 is a top view;
fig. 6 is a schematic view of the installation of the self-fixing cervical vertebra artificial vertebral body book.
Wherein: 1-a vertebral body component; 4-a front wall cambered surface structure; 5-a rear wall cambered surface structure; 6-a front side angle cambered surface structure; 7-a rear side wall cambered surface structure; 8 a-an upper sawtooth structure; 8 b-a lower end saw tooth structure; 9 a-an upper microporous structure; 9 b-a lower microporous structure; 10-a back wall microporous structure; 11-diamond-shaped fenestrations; 12-screw holes.
[ Detailed description ] of the invention
In order that those skilled in the art will better understand the present invention, a technical solution in the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in which it is apparent that the described embodiments are only some embodiments of the present invention, not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the present invention without making any inventive effort, shall fall within the scope of the present invention.
It should be noted that the terms "first," "second," and the like in the description and the claims of the present invention and the above figures are used for distinguishing between similar objects and not necessarily for describing a particular sequential or chronological order. It is to be understood that the data so used may be interchanged where appropriate such that the embodiments of the invention described herein may be implemented in sequences other than those illustrated or otherwise described herein. Furthermore, the terms "comprises," "comprising," and "having," and any variations thereof, are intended to cover a non-exclusive inclusion, such that a process, method, system, article, or apparatus that comprises a list of steps or elements is not necessarily limited to those steps or elements expressly listed but may include other steps or elements not expressly listed or inherent to such process, method, article, or apparatus.
The invention is described in further detail below with reference to the attached drawing figures:
referring to fig. 1, 2 and 3, the anterior cervical self-fixing artificial vertebral body of the present invention is composed of a vertebral body component 1 and screws of an integrated structure formed by 3D printing of titanium alloy, wherein the vertebral body component 1 comprises an upper end cambered surface structure, a lower end inclined surface structure, a front wall cambered surface structure 4, a rear wall cambered surface structure 5, a front side corner cambered surface structure 6, a rear side wall cambered surface structure 7, an upper end sawtooth structure 8a, a lower end sawtooth structure 8b, an upper end micropore structure 9a, a lower end micropore structure 9b, a rear wall micropore structure 10, side wall diamond window holes 11 and self-fixing screw holes 12 of a front wall.
The thickness of the front and rear walls and the left and right side walls of the vertebral body part 1 is 2mm so as to increase the contact area between the end face of the vertebral body part 1 and the end plate and provide enough supporting strength. The left and right diameters of the vertebral body component 1 are 13-16 mm, the excision amount of the operation vertebral body is reduced as much as possible on the premise of meeting the thorough decompression of the vertebral canal, and the bone structure is reserved as much as possible, so that the postoperative fusion is facilitated. The anterior-posterior diameter of the vertebral body component 1 is 12mm, and is matched with the anterior-posterior diameter of the cervical vertebral body of a human body. The front and rear walls of the vertebral body component 1 are respectively provided with a front protruding radian which is matched with the front and rear radian of the secondary total excision vertebral body, so that the front end of the implanted vertebral body component 1 does not exceed the connecting line of the front and rear walls of the upper and lower vertebral bodies, and the compression of any tissue structures in front and rear of the cervical vertebrae is avoided. The junction of the front and rear side walls and the left and right side walls of the cone part 1 is rounded to prevent stress concentration caused by the excessively sharp junction angle. The upper end and the lower end of the vertebral body part 1 are reserved with enough opening areas, and the interior of the vertebral body is reserved with a containing cavity with enough volume so as to facilitate the implantation of the bone graft.
Four screw holes 12 are arranged on the front wall of the vertebral body component 1, and the upper end and the lower end are respectively two. The screw holes on the two sides of the central axis are distributed by taking the central axis as a symmetrical line, and the included angles of all the screw holes and the cross section surface are consistent and are 40 degrees plus or minus 10 degrees. The angle is designed by combining the anatomical structure of the cervical vertebra of a normal person, so that the screw can be smoothly implanted into the vertebral body through the upper and lower end plates through the screw hole, and the screw can not penetrate out of the contralateral cortex of the vertebral body under the condition of using the screw with the universal length. The main body of all screw holes 12 has a diameter of 3.5-4 mm, which not only allows the use of a cortical nail with a larger diameter to ensure the fixation strength, but also can keep enough thickness of the side wall of the screw hole on the vertebral body component 1 with a smaller relative size to ensure the supporting strength of the vertebral body component 1. All screw holes 12 are countersunk holes and are provided with threads, so that the screws and the centrum component 1 are allowed to be self-locked, and the stability of the implanted component is ensured. The diameter of the nut part of the screw hole 12 is 5mm, the height is 1mm, and the parts are all arranged below the front wall of the vertebral body part 1, so that the top end of the nut is fully immersed into the nut part of the screw hole after the screw is screwed in, and the nut part is not protruded out of the front wall of the vertebral body part 1, thereby completely realizing the structural definition of zero notch and preventing the compression and the damage to the structure in front of the cervical vertebra. A wrapping structure with the thickness of 1mm is arranged around the screw hole 12, so that the stability and the integrity of the structure of the screw hole 12 are ensured.
The back wall of the vertebral body component 1 is embedded with a layer of honeycomb micropore structure 10, the structure is formed by a diamond hexahedral unit cell array, the pore size is 400 mu m, the porosity is about 65%, all pores in the structure are mutually communicated, the growth of blood vessels and soft tissues is allowed, the stability of an artificial vertebral body can be improved after the soft tissues grow in, and the vertebral body is not damaged by complete free falling even if unfused or false joint occurs.
The upper end of the cone part 1 is a cambered surface structure, the cambered surface structure 2 is established on an inclined plane with an included angle of 9 degrees with the cross section, and the radian radius of the cambered surface in the sagittal plane is 10-18 degrees. The end face of the traditional titanium cage is a sharp bulge, and the contact between the end face and the end plate is not considered, so that the sinking of the titanium cage occurs. The sagittal cambered surface structure designed by the invention enables the end face of the artificial vertebral body to be closely matched with the end plate, thereby greatly increasing the contact area and reducing the sinking incidence. The lower end of the cone part 1 is an inclined plane structure 3 which forms an angle of 10-15 degrees with the cross section. The inclined surface increases the contact area between the lower end surface of the cone component 1 and the end plate, and reduces the sinking incidence rate.
The upper end face and the lower end face of the cone part 1 are provided with saw teeth, and the depth of the saw teeth is about 0.7-1.0 mm. The saw teeth can effectively increase the friction force between the upper end surface and the lower end surface of the vertebral body part 1 and the end plates, and prevent the vertebral body part 1 from generating accumulated small slippage in the cervical vertebra movement process to induce dislocation of the vertebral body part 1.
The two side walls of the upper and lower end surfaces of the cone part 1 and the top end of the rear wall are provided with micropore structures. According to finite element mechanical analysis, the microporous structure is arranged in the area with the smallest stress of the vertebral body part 1, and under the condition of ensuring the strength of the vertebral body part 1, an elastic modulus adaptation area and a bone ingrowth space are provided for fusion of bones and the vertebral body part, so that the fusion is facilitated, the occurrence of dislocation of a pseudo joint and the vertebral body part is prevented, and the stability of the cervical vertebra after operation is improved.
The side wall of the cone part 1 is of a diamond window hole 11 structure, the size of the diamond hole structure is not strictly limited, but on the premise of ensuring the strength of the cone part 1, the diamond hole area accounts for more than 50% of the total area of the side wall of the cone part 1 so as to effectively ensure the sufficient blood supply of the transplanted bone and the contact with surrounding bone tissues to promote the growth and fusion of the bone.
The anterior cervical self-fixing artificial vertebral body of the invention, when in use:
After the secondary total excision of the pathological change centrum and the treatment of upper and lower adjacent end plates are completed, the upper and lower centrum is distracted by a distractor, the excised autologous bone or prepared allogenic bone is filled into the centrum part 1 from the upper and lower end openings of the centrum part 1, the centrum part 1 is clamped by hemostatic forceps and is put into the excised centrum part, the distractor is slowly loosened, and the centrum part 1 is adjusted until the vertebral part 1 is put into the correct part: in the operation, the cambered surface sawtooth structure 9a at the upper end of the cone part 1 is completely attached to the upper end plate, the inclined surface sawtooth structure 9b at the lower end of the cone part 1 is completely attached to the lower end plate, and the front wall of the cone part 1 does not exceed the connecting line of the front walls of the upper adjacent cone and the lower adjacent cone. And (3) loosening the spreader, drilling holes along the directions of four screw holes 12 on the front wall of the vertebral body component 1 by using a medical bone drill, screwing four screws with the diameter of 3.5mm along the drilling directions, ensuring that the top end surface of each screw does not exceed the front wall of the vertebral body component 1, and checking whether the positions of the screws are accurate or not by using X rays. And then completing the following conventional operation after the anterior cervical vertebral body secondary total excision fusion operation.
The invention also has the following advantages:
The invention removes the use of the traditional anterior cervical titanium plate on the premise of keeping the stability of the spinal column segment after operation, and the breakthrough effectively reduces the complexity of the anterior cervical vertebral body secondary total excision fusion operation, shortens the operation time, reduces the bleeding amount in books, optimizes the biomechanical conduction mode of the anterior cervical implantation instrument and avoids a plurality of complications caused by the anterior cervical steel plate. The invention greatly optimizes the anatomical form of the upper end face and the lower end face of the artificial vertebral body, so that the artificial vertebral body is more suitable for the anatomical form of the adjacent end plate. The anatomical fit optimization increases the contact area between the artificial vertebral body and the end plate, thereby effectively reducing the stress concentration of the end plate and avoiding the damage to the end plate structure and the subsequent sinking of the artificial vertebral body caused by overlarge stress. The invention combines the advantages of the 3D printing technology microporous structure and the traditional titanium cage, the side wall of the artificial vertebral body is still provided with the macropores, the full contact between the traditional titanium cage titanium mesh grafting bone and the residual osseous part of the secondary total excision vertebral body is reserved, and the bone fusion is facilitated to be accelerated. The 3D printing micropore structure is used on the end face of the artificial vertebral body, so that the local elastic modulus of the artificial vertebral body is improved, and the fusion of the artificial vertebral body and bones is promoted. Through the design invention, the anterior cervical self-fixing artificial vertebral body can effectively reduce a plurality of complications of the traditional titanium cage and improve prognosis of patients after anterior cervical vertebral body secondary total excision fusion operation.
The above is only for illustrating the technical idea of the present invention, and the protection scope of the present invention is not limited by this, and any modification made on the basis of the technical scheme according to the technical idea of the present invention falls within the protection scope of the claims of the present invention.
Claims (7)
1. The anterior cervical self-fixing artificial vertebral body is characterized by comprising a hollow vertebral body component (1), wherein the upper end, the front wall, the rear wall, the front side angle and the rear side wall of the vertebral body component (1) are all of cambered surface structures, and the lower end is not of an inclined surface structure; the upper end of the cone component (1) is provided with an arc surface structure (2), the arc surface structure (2) is arranged on an inclined plane with an included angle of 9 degrees with the cross section, and the radius of the arc surface in the sagittal plane is 10-18 degrees; the lower end of the cone component (1) is an inclined surface structure (3) and forms an angle of 10-15 degrees with the cross section; the upper end face and the lower end face of the cone component (1) are saw-tooth, and the tops of the two side walls and the rear wall of the upper end face and the lower end face are provided with micropore structures; the side wall of the centrum component (1) is provided with a diamond window hole (11), and the front wall is provided with a screw hole (12) for self-fixing;
The cone component (1) is of an integrated structure formed by 3D printing of titanium alloy and is fixedly installed through screws; the thicknesses of the front wall, the rear wall, the left wall and the right wall of the cone part (1) are 2mm, the left diameter and the right diameter are 13-16 mm, and the front diameter and the rear diameter are 12mm;
four screw holes (12) are arranged on the front wall of the centrum component (1).
2. The anterior cervical self-fixing artificial vertebral body according to claim 1, wherein the vertebral body component (1) is square with four corners in cross section and arc angles in front and back, the radius of the arc of the front wall is 15mm, the radius of the arc of the back wall is 33mm, the radius of the arc of the angles of the two sides in front is 2mm, and the radius of the arc of the angles of the two sides in back is 3mm;
The front and rear walls of the vertebral body component (1) are respectively provided with a front protruding radian which is matched with the front and rear radian of the secondary total excision vertebral body, so that the front end of the implanted vertebral body component (1) does not exceed the connecting line of the front and rear walls of the upper and lower vertebral bodies, and the compression of any front and rear tissue structures of the cervical vertebrae is avoided; rounded corners for preventing stress concentration are poured at the junctions of the front side wall, the rear side wall, the left side wall and the right side wall of the cone component (1); the upper end and the lower end of the vertebral body component (1) are both open, and a containing cavity for transplanting bone is reserved in the vertebral body component.
3. The anterior cervical self-fixing artificial vertebral body according to claim 1, wherein the four screw holes (12) are arranged symmetrically up and down, the screw holes on two sides of the central axis are distributed by taking the central axis as a symmetrical line, and the included angles between all the screw holes and the cross section surface are consistent and are 40 degrees plus or minus 10 degrees; the diameters of the main body parts of the four screw holes (12) are 3.5-4 mm; the four screw holes (12) are all countersunk holes and are provided with threads, and the screws and the centrum component (1) are self-locked; the diameters of the nut parts of the four screw holes (12) are all 5mm, and the heights are 1mm; a wrapping structure with the thickness of 1mm is arranged around the four screw holes (12).
4. The anterior cervical self-fixing artificial vertebral body according to claim 1, wherein the rear wall of the vertebral body component (1) is embedded with a layer of cellular microporous structure (10), the cellular microporous structure (10) is formed by an array of rhombohedral hexahedral unit cells, the size is 1 x 8 x 13.5mm, the pore size is 400 μm, and the porosity is about 65%; all pores inside the cellular microporous structure (10) are mutually communicated, so that blood vessels and soft tissues can grow in.
5. The anterior cervical self-fixing artificial vertebral body according to claim 1, wherein the serrations comprise an upper serration structure (8 a) and a lower serration structure (8 b), the serrations having a depth of 0.7-1.0 mm.
6. The anterior cervical self-fixing artificial vertebral body according to claim 1, wherein the microporous structure comprises an upper microporous structure (9 a) and a lower microporous structure (9 b).
7. The anterior cervical self-fixing artificial vertebral body according to claim 1, wherein the diamond-shaped window (11) is formed by a plurality of diamond-shaped holes, and the area of the diamond-shaped holes accounts for more than 50% of the total area of the side wall of the vertebral body component (1).
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| CN111714257A (en) * | 2019-03-21 | 2020-09-29 | 天津正天医疗器械有限公司 | Vertebral prosthesis |
| CN109953840A (en) * | 2019-04-04 | 2019-07-02 | 山东新华联合骨科器材股份有限公司 | Zero incisura anterior cervical interbody fusion cage of 3D printing |
| CN110929379B (en) * | 2019-10-25 | 2021-10-22 | 西安交通大学 | A topology-optimized artificial vertebral body and its design method |
| CN110897695B (en) * | 2019-11-21 | 2024-11-26 | 西安交通大学第二附属医院 | A titanium cage for lower cervical anatomical spine |
| CN111631844B (en) * | 2020-05-29 | 2022-12-23 | 四川大学华西医院 | A Double Cortical Elastic Fixation Fusion Device |
| CN114949092A (en) * | 2022-05-25 | 2022-08-30 | 西安交通大学医学院第二附属医院 | Traditional Chinese medicine ointment and plaster for treating rheumatic ostealgia and preparation method thereof |
| CN115300191A (en) * | 2022-08-06 | 2022-11-08 | 北京市富乐科技开发有限公司 | Integrated anterior cervical implant |
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