CN111035482B - A 3D printed bionic anti-dislocation movable artificial cervical vertebra and intervertebral connection complex - Google Patents
A 3D printed bionic anti-dislocation movable artificial cervical vertebra and intervertebral connection complex Download PDFInfo
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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
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
- A61F2/447—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
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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
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
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- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
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- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
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Abstract
The invention discloses a 3D printing bionic anti-dislocation movable artificial cervical vertebra and intervertebral connecting complex which comprises an upper end plate, a lower end plate, a bionic vertebral body and an anti-dislocation structure, wherein the bionic vertebral body comprises a vertebral body with a hollowed-out middle part, an upper joint socket is arranged at the upper part of the vertebral body, a lower joint socket is arranged at the lower part of the vertebral body, the upper joint socket is connected with the upper end plate through the upper end plate joint structure, and the lower part of the upper joint socket is connected with the lower end plate through the lower joint structure. The invention has the advantages of low implantation operation difficulty, small wound and convenient popularization.
Description
[ Field of technology ]
The invention relates to a 3D printing bionic dislocation-preventing movable artificial cervical vertebra and intervertebral connecting complex.
[ Background Art ]
With the change of times and the progress of working forms, the number of people who get on table for a long time is increased year by year, and the aging trend of the social population is gradually increased, so the incidence rate of cervical spondylosis (such as cervical spondylosis, vertebral tumor and the like) is increased year by year. The focus of surgical treatment of cervical spondylosis is to relieve the compression and simultaneously reconstruct the stability of the spine. Surgery requires excision of the pathological factors that lead to compression of the spinal cord and nerve roots, and immediate stability is achieved by implantation of different types of spinal implants, and long-term maintenance. At present, the cervical vertebra total excision and decompression combined vertebral fusion is one of the important methods for treating cervical vertebra diseases. The operation type anterior cervical approach reaches the vertebral body and the intervertebral disc, the adjacent upper and lower vertebral bodies of the target vertebral body are spread by using a vertebral body spreader, the diseased intervertebral disc is resected, the majority of vertebral bodies and posterior longitudinal ligaments in the double-side uncinate vertebral joint are resected completely, a proper spinal implant is implanted in a defect area, and the cervical anterior cervical approach steel plate is used for fixation. The titanium cage is used as one of fusion artificial vertebral bodies, has enough supporting strength and good biocompatibility, and is one of implants commonly used in cervical vertebra fusion. A great deal of literature reports that the cervical vertebra and vertebral body secondary total excision decompression combined titanium cage bone grafting fusion operation can obtain good clinical effect for corresponding patients (Moreland DB,Asch HL,Clabeaux DE,et al.Anterior cervical discectomy and fusion with implantable titanium cage:initial impressions,patient outcomes and comparison to fusion with allograft.The spine journal:official journal of the North American Spine Society.2004;4(2):184-191;discussion 191).
Hamdi in 1969, it was first reported that one patient with plasmacytoma and one patient with metastatic adenocarcinoma (Hamdi,F A.Prosthesis for an excised lumbar vertebra:a preliminary report.Can Med Assoc J,1969,100,12:576-80.). were treated by using an artificial vertebral body instead of an excised vertebral body, from which various nationologists conducted extensive studies around the artificial vertebral body. The artificial vertebral body is mainly divided into a fusion type artificial vertebral body and a movable type artificial vertebral body. The fusion type artificial bone is a spinal implant commonly used in clinic at present, and has the advantages of good mechanical property, strong immediate stability and the like, for example, a lower cervical vertebra 3D printing titanium cage (He Xijing, lu Teng, dong Jun, and the like), a lower cervical vertebra 3D printing titanium cage [ P ]. China, CN204931903U, 2016-01-06), winged adjustable REPLACEMENT SYSTEM (Sun Junkai, liu Jinglong, huang Jianhou), application of a winged adjustable displacement system in dislocation of lower cervical vertebra fracture (English) [ J ]. Chinese tissue engineering research, 2013,17 (22): 4025-4033) and the like. However, after the fusion artificial vertebral body is implanted, the original normal physiological activity of the vertebral column is lost, the internal stress of the adjacent intervertebral disc is increased, the adjacent intervertebral disc is degenerated after the activity of the adjacent intervertebral disc is increased (Dmitriev AE,Cunningham BW,Hu NB,et al.Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty-An In Vitro human cadaveric model.Spine.2005;30(10):1165-1172)、(Hilibrand AS,Carlson GD,Palumbo MA,et al.Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis.J Bone Joint Surg-Am Vol.1999;81A(4):519-528.), for a long time, and the vertebral body hyperosteogeny (Phillips FM,ReubenJ,Wetzel ft.Intervertebral disc degeneration adjacent to a lumbar fusion.An experimental rabbit model[J].J Bone Joint Surg Br,2002,84(2):289-294.)(Hilibrand AS,Robbins M.Adjacent segment degeneration and adjacent segment disease:the consequences of spinal fusionThe spine journal:official journal of the North American Spine Society.2004;4(6Suppl):190S-194S). is researched, and a learner discovers that after two years of follow-up research, the fusion operation is compared, the cervical vertebra activity is maintained, the symptomatic change of the adjacent intervertebral disc can be effectively prevented, and the change of the imaging index of the adjacent intervertebral disc is reduced (Robertson JT,Papadopoulos SM,Traynelis VC.Assessment of adjacent-segment disease in patientstreated with cervical fusion or arthroplasty:a prospective 2-year study.Journal of Neurosurgery-Spine.2005;3(6):417-423).
In order to preserve the original physiological activity of the spine and reduce the possibility of diseases occurring between adjacent vertebrae, the concept of non-fusion and mobility is becoming mainstream. Non-fusion procedures, such as artificial disc replacement, are typical of non-fusion procedures, where only the diseased disc is excised and replaced with an artificial disc. However, the artificial disc replacement has a narrow application range, is only suitable for the treatment of diseases existing in single-segment cervical vertebra physiological bending, and is not suitable for the situations (Sekhon LH.Cervical arthroplasty in the management of spondylotic myelopathy[J].J SpinalDisord Tech,2003,16(4):307-313). of pathological changes existing in vertebral bodies and multi-stage pathological changes, so that the problems existing in non-fusion operation are solved, and the movable artificial vertebral bodies become hot spots for research. The conventional movable artificial vertebral bodies comprise Artificial disc and vertebra system(Dong,J,LU M,LU T,et al.Artificial disc and vertebra system:a novel motion preservation device for cervical spinal disease after vertebral corpectomy[J].CLINICS,2015,70(7):493-499.),artificial cervical joint complex(YU J,LIU LT,ZHAO JN.Design and preliminary biomechanical analysis of artificial cervical joint complex[J].Arch Orthop Trauma Surg,2013,133(6):735-743.)., but the movable artificial vertebral bodies still have the problems that, for example, the movable joint surface is not protected enough, the joint dislocation risk exists, the contact surface between the artificial vertebral body structure design and the bone is too small, bone cells are not easy to grow in, and the fixed part of the artificial vertebral body exceeds the range of the vertebral body, so that local tissue and organ compression and damage can be caused.
3D printing is a processing technique for layering and integrating a model by means of laser sintering, photo-curing, etc. on the basis of a digital model through computer-aided design. The 3D printing technology has the advantages that a complex structure can be processed, the appearance and the structure can be personalized designed, meanwhile, the cost can be saved, the manufacturing efficiency can be improved, and the 3D printing technology has a wide development space (Bose S,Vahabzadeh S,Bandyopadhyay A.Bone tissue engineering using 3D printing.Mater Today.2013;16(12):496-504.. in the orthopedics field, so that the 3D printing technology is applied to the design and the manufacturing of the spinal implant, not only can the proper implant be personalized and customized according to the patient information, but also the performance improvement and innovation of the implant can be greatly promoted.
[ Invention ]
The invention aims to solve the problems in the prior art and provide a 3D printing bionic dislocation preventing movable artificial cervical vertebra and intervertebral connecting complex which has enough supporting function according to the bionic design of human body data, can keep the activity of normal cervical vertebra, has an dislocation preventing structure, can provide enough bone grafting space and bone contact surface, realizes the immediate stability after operation, can realize the immediate motion function reconstruction after anterior cervical operation, ensures the activity performance to be bionic with the normal cervical vertebra height, and maintains the stability and the motion function for a long time.
In order to achieve the purpose, the invention is realized by adopting the following technical scheme:
a 3D printing bionic dislocation preventing movable artificial cervical vertebra and intervertebral joint complex, comprising:
the bottom of the upper endplate is connected with the bionic vertebral body through an upper endplate joint structure;
The top of the lower endplate is connected with the bionic vertebral body through a lower endplate joint structure;
The bionic vertebral body comprises a vertebral body with a hollowed-out middle part, wherein an upper joint mortar is arranged at the upper part of the vertebral body, and a lower joint mortar is arranged at the lower part of the vertebral body;
The dislocation preventing structure comprises an upper limit tooth and a lower limit tooth which are respectively arranged on an upper joint socket and a lower joint socket, and a plurality of first clamping grooves and second clamping grooves which are respectively arranged on an upper end plate joint structure and a lower end plate joint structure, are respectively corresponding to the upper limit tooth and the lower limit tooth in number and position;
The upper end plate, the lower end plate and the bionic vertebral body are all manufactured by 3D printing.
The invention is further improved in that:
The upper end plate comprises a first platform, a pair of first nail channels with axes parallel and symmetrically distributed are formed in the front section of the first platform, included angles are formed between the axes of the two first nail channels and the plane of the first platform and are used for facilitating fixation of screws, and an arc-shaped supporting structure is arranged on the upper surface of the first platform.
The two first nail paths are arranged in the front structural area of the first platform, the supporting structure is arranged in the rear structural area of the first platform, the arc highest point of the supporting structure is positioned at the rear part of the first platform, and the height of the arc surface smoothly decreases to the periphery.
The lower end plate comprises a second platform, two second nail channels which are parallel to the axis and symmetrically distributed are arranged at the front section of the second platform, and an included angle is formed between the axes of the two second nail channels and the plane of the second platform, so that the screw can be conveniently fixed.
The two second nail paths are arranged in the front structural area of the second platform.
The upper endplate joint structure comprises a first joint ball handle, the top of the first joint ball handle is fixedly connected with the lower surface of the upper endplate, a first joint ball is arranged at the bottom of the first joint ball, and the first joint ball is arranged in an upper joint mortar;
The lower endplate joint structure comprises a second joint ball handle, the bottom of the second joint ball handle is fixedly connected with the upper surface of the lower endplate, the top of the second joint ball is provided with a second joint ball, and the second joint ball is installed in the lower joint socket.
The upper limiting teeth are arranged at the top of the upper joint socket, the lower limiting teeth are arranged at the bottom of the lower joint socket, the free ends of the upper limiting teeth and the lower limiting teeth are both pointed to the center of the joint socket, the first clamping grooves are formed in the first joint ball at equal intervals, and the second clamping grooves are formed in the second joint ball at equal intervals.
The inside of centrum body is provided with the support column, the support column is inclined plane cylinder, and its upper surface is connected with the bottommost end of last joint mortar to smoothly extend around, and the lower surface is connected with the topmost end of lower joint mortar, and smoothly extends around.
The diamond-shaped through holes on the front surface of the cone body are provided with 4 layers, and 3 layers of the diamond-shaped through holes are staggered; the back is provided with 3 layers, and every layer is 3 staggered.
Compared with the prior art, the invention has the following beneficial effects:
the invention has enough supporting structure, can provide stable support after the anterior vertebroplasty of cervical vertebra, can replace the movement function of normal cervical vertebra by the movement of the ball joint of the invention, can keep the original movement degree of the cervical vertebra and prevent the occurrence of adjacent cervical vertebra segment diseases caused by fusion operation, and has a matched dislocation preventing structure, which is placed in the movement of the joint. In addition, the present invention provides bone grafting windows and bone grafting spaces that enable rapid biological fusion and maintenance of long-term stability through intraoperative bone grafting. The invention has the advantages of low implantation operation difficulty, small wound and convenient popularization. With 3D printing personalized customization, production and carrying burden can be reduced and a suitable implant can be provided.
Furthermore, the upper surface supporting structure of the upper end plate is designed to be arc-shaped according to human body information data, accords with the surface concave form of the lower end plate of the cervical vertebra of a human body, improves the contact area between the upper end plate and the lower surface of the upper vertebral body, reduces the pressure born by the lower surface of the cervical vertebra vertebral body, and enhances the stability.
Furthermore, the invention can be self-fixed on the adjacent vertebral body by the nail channels in the upper and lower terminal plate platform structures without the assistance of an anterior steel plate, and the nail channels are positioned in the artificial vertebral body structure, so that the nail channels can not occupy local space after being fixed, and the functions of adjacent organs (such as esophagus, trachea and the like) are not affected.
Furthermore, the invention is provided with a clamping groove on the surfaces of the upper joint ball and the lower joint ball, which is matched with the dislocation preventing structure on the tops of the upper joint mortar and the lower joint mortar of the vertebral body component. When the upper and lower end plates are installed into the joint socket along the clamping grooves, the dislocation preventing structure can prevent the joint ball from being separated after the rotating end plates reach the proper positions.
Furthermore, bone grafting windows are arranged on two sides of the vertebral body part, the center of the vertebral body part is hollowed out, space is provided for surgical bone grafting, and fusion is facilitated to be improved.
Furthermore, the middle part of the vertebral body component is provided with the bearing column, so that the overall mechanical property can be improved, the sufficient stability can be provided, the consumption of peripheral materials can be reduced, and the internal bone grafting space can be further improved.
Furthermore, the middle part of the vertebral body part is provided with a bearing column, the angle of the bearing column is inclined by 10 degrees from front to back, and the bearing column is compounded with the angle between cervical vertebrae of a human body, so that the bearing column is beneficial to maintaining a normal physiological structure.
[ Description of the drawings ]
FIG. 1 is an isometric view of the overall structure of the present invention;
FIG. 2 is a schematic structural view of the upper endplate of the present invention;
FIG. 3 is a front view of FIG. 2;
FIG. 4 is a side view of FIG. 2;
FIG. 5 is a bottom view of FIG. 2;
FIG. 6 is a side view of the lower endplate of the present invention;
FIG. 7 is an elevation view of a vertebral body component of the present invention;
FIG. 8 is a side view of a vertebral body component of the present invention;
FIG.9 is a top view of a vertebral body component of the present invention;
FIG. 10 is a side half-sectional view of the overall structure of the present invention;
FIG. 11 is a side elevational view of the overall structure of the present invention;
fig. 12 is a top view of the overall structure of the present invention.
The artificial vertebral body comprises a 1-upper endplate, a 2-bionic vertebral body, a 3-lower endplate, a 4-first platform, a 5-supporting structure, a 6-first nail channel, a 7-first joint ball handle, an 8-first joint ball, a 9-first clamping groove, a 10-upper joint mortar, an 11-upper limit tooth, a 12-vertebral body, a 13-support column, a 14-bone grafting window, a 15-lower joint mortar, a 16-lower limit tooth, a 17-second clamping groove, a 18-second platform, a 19-second nail channel, a 20-second joint ball handle and a 21-second joint ball.
[ Detailed description ] of the invention
In order to make the present invention better understood by those skilled in the art, the following description will clearly and completely describe the technical solutions in the embodiments of the present invention with reference to the accompanying drawings, and it is apparent that the described embodiments are only some embodiments of the present invention, not all embodiments, but not intended to limit the scope of the present disclosure. In addition, in the following description, descriptions of well-known structures and techniques are omitted so as not to unnecessarily obscure the concepts of the present disclosure. 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.
Various structural schematic diagrams according to the disclosed embodiments of the present invention are shown in the accompanying drawings. The figures are not drawn to scale, wherein certain details are exaggerated for clarity of presentation and may have been omitted. The shapes of the various regions, layers and their relative sizes, positional relationships shown in the drawings are merely exemplary, may in practice deviate due to manufacturing tolerances or technical limitations, and one skilled in the art may additionally design regions/layers having different shapes, sizes, relative positions as actually required.
In the context of the present disclosure, when a layer/element is referred to as being "on" another layer/element, it can be directly on the other layer/element or intervening layers/elements may be present therebetween. In addition, if one layer/element is located "on" another layer/element in one orientation, that layer/element may be located "under" the other layer/element when the orientation is turned.
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, the 3D printing bionic dislocation preventing movable artificial cervical vertebra and intervertebral connecting complex of the invention comprises an upper endplate 1, a lower endplate 3, a bionic vertebral body 2 and an dislocation preventing structure. The upper endplate 1, the lower endplate 3 and the bionic vertebral body 2 are all made by 3D printing.
The bottom of the upper end plate 1 is connected with the bionic vertebral body 2 through an upper end plate joint structure, the upper end plate 1 comprises a first platform 4, a pair of first nail channels 6 with axes parallel and symmetrically distributed are formed in the front section of the first platform 4, included angles are formed between the axes of the two first nail channels 6 and the plane of the first platform 4 and are used for facilitating fixation of screws, and an arc-shaped supporting structure 5 is arranged on the upper surface of the first platform 4. Two first nail paths 6 are arranged in front of the first platform 4A structural region, a support structure 5 is arranged behind the first platform 4Structural region, and the arc highest point of the supporting structure 5 is positioned behind the first platform 4The height of the cambered surface is smoothly decreased to the periphery. The upper endplate joint structure comprises a first joint ball handle 7, the top of the first joint ball handle 7 is fixedly connected with the lower surface of the upper endplate 1, a first joint ball 8 is arranged at the bottom of the first joint ball 8, and the first joint ball 8 is arranged in an upper joint mortar 10;
the top of the lower end plate 3 is connected with the bionic vertebral body 2 through a lower end plate joint structure, the lower end plate 3 comprises a second platform 18, two second nail channels 19 which are parallel to the axis and symmetrically distributed are arranged at the front section of the second platform 18, and an included angle is formed between the axes of the two second nail channels 19 and the plane of the second platform 18, so that the screw is conveniently fixed. Two second nail paths 19 are arranged in front of the second platform 18 And a structural region. The lower endplate joint structure comprises a second joint ball handle 20, the bottom of the second joint ball handle 20 is fixedly connected with the upper surface of the lower endplate 3, a second joint ball 21 is arranged at the top of the second joint ball, and the second joint ball 21 is arranged in the lower joint socket 10.
The bionic vertebral body 2 comprises a vertebral body 12, wherein an upper joint mortar 10 is arranged at the upper part of the vertebral body 12, a lower joint mortar 15 is arranged at the lower part of the vertebral body 12, the upper joint mortar 10 is connected with an upper end plate 1 through an upper end plate joint structure, the lower part of the upper joint mortar is connected with a lower end plate 3 through a lower end plate joint structure, a plurality of diamond-shaped through holes are formed in the front surface and the back surface of the vertebral body 12, bone grafting windows 14 are formed in the side surfaces of the vertebral body 12, support columns 13 are arranged in the vertebral body 12, the support columns 13 are inclined plane cylinders, the upper surfaces of the support columns are connected with the bottommost end of the upper joint mortar 10 and extend to the periphery smoothly, and the lower surfaces of the support columns are connected with the topmost end of the lower joint mortar 15 and extend to the periphery smoothly.
The dislocation preventing structure comprises an upper limit tooth 11 and a lower limit tooth 16 which are respectively arranged on an upper joint mortar 10 and a lower joint mortar 15, a plurality of first clamping grooves 9 and second clamping grooves 17 which are respectively arranged on an upper end plate joint structure and a lower end plate joint structure, wherein the number and the positions of the first clamping grooves 9 and the second clamping grooves 17 are respectively corresponding to the upper limit tooth 11 and the lower limit tooth 16, the upper limit tooth 11 and the lower limit tooth 16 are distributed on the upper end table surface of the joint mortar at equal intervals, the upper limit tooth 11 is arranged on the top of the upper joint mortar 10, the lower limit tooth 16 is arranged on the bottom of the lower joint mortar 15, the free ends of the upper limit tooth 11 and the lower limit tooth 16 are respectively pointed to the center of the joint mortar, the first clamping grooves 9 are arranged on the first joint ball 8 at equal intervals, and the second clamping grooves 17 are arranged on the second joint ball 21 at equal intervals.
The invention has the following structural principle:
The invention relates to a 3D printing bionic dislocation-preventing movable artificial cervical vertebra and intervertebral connecting complex, which mainly comprises 3 parts, namely a bionic vertebral body 2, and an upper endplate 1 and a lower endplate 3 which are respectively connected with the bionic vertebral body 2 through joint ball structures. The bionic vertebral body 2 consists of an upper joint mortar 10, a vertebral body 12, a lower joint mortar 15 and a supporting column 13, wherein the upper joint mortar 10 and the lower joint mortar 15 both comprise dislocation preventing structures, the vertebral body 12 comprises a lateral bone grafting window 14, the upper end plate 1 and the lower end plate 3 both comprise a platform, a joint ball handle and a joint ball, the first platform 4 comprises a supporting structure 5 and a pair of first nail channels 6, and the joint ball structures of the upper end plate and the lower end plate both comprise clamping grooves formed in the surfaces of the upper end plate and the lower end plate.
The upper end plate 1 forms the upper surface of the 3D printing bionic dislocation-preventing movable artificial cervical vertebra and intervertebral connecting complex. The two nail paths are symmetrically arranged in the front 1/4 structural area of the first platform 4, the axis is at a certain angle with the plane of the first platform and allows screws to be fixed, the upper end supporting structure 5 is arranged on the upper surface of the rear 3/4 structural area of the first platform 4, is arc-shaped, and the highest point is positioned at the rear 4/7 of the first platform 4 and gradually decreases towards the front and rear sides and the two sides.
The upper endplate joint structure is formed by a cylinder and is connected with the center of a rear 3/4 structural area of the lower surface of the first platform 4. The upper endplate joint structure comprises a first joint ball 8 and 3 first clamping grooves 9, wherein the upper surface of the first joint ball 8 is connected with the center of the lower surface of the first joint ball handle 7, and the 3 first clamping grooves 9 are of cuboid groove-shaped structures and are distributed on the surface of the first joint ball 8 at equal intervals.
The bionic vertebral body 2 comprises a vertebral body 12, an upper joint socket 10 is arranged at the top of the vertebral body 12, 3 upper limit teeth 11 are arranged on the upper joint socket 10, the 3 upper limit teeth 11 are distributed on the upper end table top of the upper joint socket 10 at equal intervals, an upper dislocation preventing structure is formed by the upper limit teeth and 3 first clamping grooves 9, the upper joint socket 10 is formed by an arc surface, and a horizontal table top is arranged above the upper joint socket 10. The lower joint mortar 15 is arranged at the bottom of the vertebral body 12, 3 lower limiting teeth 16 are arranged on the lower joint mortar 15, the 3 lower limiting teeth 16 are distributed on the table top at the lower end of the lower joint mortar 15 at equal intervals, and form a lower dislocation preventing structure with 3 second clamping grooves 17, wherein the lower joint mortar 15 is composed of an arc surface, and a horizontal table top is arranged below the lower joint mortar 15.
The front of the vertebral body 12 is composed of 4 layers of diamond structures which are staggered, each layer of diamond structures is 3, the back of the vertebral body is composed of 3 layers of diamond structures which are staggered, each layer of diamond structures is 3, bone grafting windows 14 are arranged on the side surfaces of the vertebral body 12, and the vertebral body 12 is upwards connected with an upper joint mortar.
The cone body 12 is internally provided with a support column 13, the support column 13 is formed by an inclined plane cylinder, the upper surface is connected with the lowest end of the upper joint socket 10 and extends to the periphery, and the lower surface is connected with the topmost end of the lower joint socket 15 and extends to the periphery.
The lower end plate 3 forms the lower surface of the 3D printing bionic dislocation-preventing movable artificial cervical vertebra and intervertebral connecting complex. The two lanes are symmetrically located in the front 1/4 structural area of the second platform 18 with the axis at an angle to the plane of the second platform 18 allowing for screw fixation.
The inferior endplate articulating mechanism is formed of a cylinder that is centered about the posterior 3/4 structural area of the upper surface of the second platform 18. The lower endplate joint structure comprises a second joint ball 21 and 3 second clamping grooves 17, wherein the lower surface of the second joint ball 21 is connected with the center of the lower surface of the second joint ball handle 20, and the 3 second clamping grooves 17 are of cuboid groove-shaped structures and are distributed on the surface of the second joint ball 21 at equal intervals.
The joint ball structure comprises a joint ball structure of an upper end plate and a lower end plate, an upper joint socket and a lower joint socket, wherein the upper end part and the lower end part of a bionic vertebral body 2 are matched with the joint ball, the inner space of the joint socket is composed of hemispherical spaces with two intersecting sides, the upper limit teeth and the lower limit teeth of the dislocation preventing structure are respectively arranged at the top and the bottom of the hemispherical spaces, the first joint ball and the second joint ball are wrapped in the corresponding hemispherical spaces, and the dislocation of the first joint ball and the second joint ball is limited by the cooperation of clamping grooves on the surfaces of the joint balls and the limit teeth.
Examples:
Referring to fig. 1, 10, 11 and 12, in this embodiment, the 3D printed bionic dislocation preventing cervical vertebra movable artificial vertebral body has a front edge height of 23mm, a rear edge height of 21mm, a vertical highest height of 25mm along the supporting structure 5, an upper highest point at the rear 3/7 position, gradually decreasing toward both sides, a lower lowest point at the front, a front-rear diameter length of 15mm, and a left-right diameter of 13mm.
In this embodiment, as shown in fig. 2,3, 4,5 and 10, the height of the first platform 4 is 2mm, the front-back length is 15mm, the width is 13mm, the supporting structure 5 is located above the rear of the first platform 4 and is in a circular arc shape, the highest point is located at the rear 4/7, the height is 1.3mm, the height decreases towards the front and the rear and the two sides, the two first nail paths 6 are cylindrical with the diameter of 3mm, are symmetrically located at the front 1/4 structural area of the first platform 4, and the axis and the plane form an angle of 40 degrees, so that the screws are allowed to fix. The first joint ball handle 7 is a cylinder with the diameter of 7mm and the height of 3mm and is connected with the rear 3/4 structural area of the lower surface of the first platform 4. The diameter of the round surface of the first joint ball 8 is 9mm, the height is 2.5mm, and the round surface of the first joint ball is connected with the lower surface of the first joint ball handle 7. The 3 first clamping grooves 9 are of cuboid groove-shaped structures with the length of 1mm, the width of 0.75mm and the height of 2.5mm, and are distributed on the surface of the first joint ball 8 at intervals of 60 degrees. The supporting structure 5 is in fit with the curved surface of the lower terminal plate surface of the upper vertebral body, so that the contact area is enlarged, the pressure born by the lower surface of the cervical vertebral body is reduced, and the bone fracture is effectively prevented. The first nail way 6 is arranged on the first platform 4 of the upper end plate 1, belongs to a self-fixing mode, does not need to be fixed by an additional steel plate, and reduces the damage of surrounding tissues. The first clamping groove 9 is matched with the dislocation preventing structure and is a combined installation channel of the upper end plate 1 and the bionic vertebral body 2.
In this embodiment, as shown in fig. 2, 3,4, 5,6 and 10, the height of the second platform 18 is 2mm, the front-rear length is 15mm, the width is 13mm, the two second nail paths 19 are cylindrical with the diameter of 3mm, and are symmetrically located in the front 1/4 structural area of the second platform 18, and the axis and the plane form an angle of 40 degrees, so that the screws can be fixed. The second articulating knob 20 is a cylinder of 7mm diameter and 3mm height and is attached to the upper surface of the second platform 18 in the rear 3/4 structural area. The diameter of the round surface of the second joint ball 21 is 9mm, the height is 2.5mm, and the round surface of the second joint ball is connected with the upper surface of the second joint ball handle 20. The 3 second clamping grooves 17 are all of cuboid groove-shaped structures with the length of 0.75mm, the width of 0.5mm and the height of 2.5mm, and are distributed on the surface of the second joint ball 21 at intervals of 60 degrees. The second nail way 19 is positioned in the second platform 18 of the upper end plate 1, belongs to a self-fixing mode, does not need to be fixed by an additional steel plate, and reduces the damage to surrounding tissues. The second clamping groove 17 is matched with the dislocation preventing structure and is a combined installation channel of the lower end plate 3 and the bionic vertebral body 2.
As shown in fig. 2, 6, 7, 8, 9 and 10, in this embodiment, the upper joint socket 10 and the lower joint socket 15 are each formed of the same arc surface as the joint ball, and have a thickness of 1mm and an upper level. The dislocation preventing structure consists of 3 cubes with the side length of 1mm, and the spacing is distributed at the table top at the upper end of the arc surface of the joint socket at an angle of 60 degrees, and the distance between the dislocation preventing structure and the joint ball is 1mm. The height of the front edge of the vertebral body 12 is 15mm, the height of the rear edge is 12mm, the front and rear lengths are 9mm, the left and right widths are 10mm, the front face is composed of 4 layers of staggered diamond structures, each layer of the diamond structures comprises 3 layers of the diamond structures, and bone grafting windows 14 are respectively arranged on two side faces. The dislocation preventing structure is matched with the first clamping groove 9, and the upper endplate 1 and the lower endplate 3 are prevented from being separated from corresponding joint sockets after being installed. The vertebral body 12 is hollow, which increases the contact area between the bone particles implanted in the vertebral body and the surrounding bone, is beneficial to early fusion of the bone in the operation area, and improves long-term stability. The bone grafting window 14 has a large aperture, which is beneficial to the bone grafting operation in the operation. The support column 13 is a bevel cylinder with the diameter of 4mm and is respectively connected with the top cambered surface of the upper joint socket 10 and the bottom cambered surface of the lower joint socket 15. The vertebral body 12 and the support column 13 can be adjusted according to the personal imaging data.
As shown in fig. 2, 3, 4, 5,6, 9 and 10, the first joint socket 10 and the second joint socket 15 have a large internal space, and have a space capable of accommodating and moving the first joint ball 8 and the second joint ball 21. Taking the above endplate 1 as an example, the first clamping groove 9 is aligned with the upper limiting teeth 11 on the first joint socket 10 during installation, the upper endplate 1 is installed along the first clamping groove 9, and the upper endplate 1 is rotated by 60 degrees to reach the required standard position, as shown in fig. 1. The first joint ball 8 is wrapped in the second joint socket 10, is limited by the dislocation preventing structure, prevents the artificial vertebral endplate from being separated, and reserves enough movable space. The lower endplate 3 is installed in the same way as the upper endplate 1.
Because the cervical vertebrae heights are different among people, 5 different models are designed according to the imaging data so as to meet the requirements of different implant heights. Including 5 types of maximum, large, standard, small, and minimum. The standard model is the embodiment, and the maximum size is 2mm of lengthening the cone body 12 and the support column 13 on the basis of the standard model. The large size is to lengthen the cone body 12 and the support column 13 by 1mm on the basis of the standard model. The small size is to reduce the cone body 12 and the support column 13 by 1mm on the basis of the standard model. The minimum number is 2mm for the vertebral body 12 and support column 13 to be reduced on the basis of the standard model.
In summary, the 3D printing bionic dislocation-preventing movable artificial cervical vertebra and intervertebral connecting complex is suitable for diseases requiring a cervical vertebra and vertebral body sub-total cutting decompression combined implant fusion operation, and is particularly suitable for cervical vertebra diseases with two gaps of a single vertebral body, such as cervical spondylosis caused by protrusion of two segmental cervical intervertebral discs, cervical single vertebral body tumors, repair after artificial cervical intervertebral disc replacement operation and the like.
The following description is of specific embodiments of the intervertebral disc removal, secondary total vertebral body incision, and the present mobile artificial cervical and intervertebral joint complex implantation procedure:
For patients with indications, pre-operative examination is perfected, and patients without contraindications perform pre-operative exercises such as defecation and urination on bed and the like followed by the surgical treatment. The patient takes the supine position, the soft pillow is cushioned under the shoulders, the soft head ring is cushioned at the back cushion, and small sand bags are respectively placed at the two sides of the head. Conventional preoperative preparations, endotracheal intubation, general anesthesia, and cervical area sterilization drape. Soft tissues are separated layer by adopting a transverse incision in front of the neck, and the trachea and the esophagus are protected by pulling by using a drag hook. Exposing the targeted vertebral body area, installing a positioning needle, and positioning and confirming the targeted vertebral body by using a C-arm X-ray fluoroscopy machine. And installing cervical vertebra spreader screws on the upper and lower vertebrae of the target vertebrae, and spreading the spreaders. The annulus fibrosis of the intervertebral disc above and below the targeted vertebral body is incised, and the nucleus pulposus forceps are used for taking out the intervertebral disc tissues. The bone in front of the vertebral body is resected by using rongeur, and the intervertebral joint surface is repaired by curettes, rongeurs and round head files, but the bone end plate can not be damaged. The nerve stripper is used for separating the gap between the rear edge of the vertebral body and the rear longitudinal ligament, and the rongeur is used for cutting off the cortical bone and the ossified rear longitudinal ligament of the rear edge of the vertebral body. The grooving is decompressed to form a rectangular decompression groove with the width of approximately 13mm. Selecting a proper height of the composite body, shearing the cut vertebral bone to be crushed into about 2mm, and filling the bone grafting windows on two sides of the artificial vertebral body into the internal hollow structure. The upper and lower end plates are installed, the angle is adjusted to prevent the upper and lower end plates from falling out, and the upper end plate is attached to the lower end plate of the upper vertebral body by placing the upper end plate into the composite body. The upper and lower parts of the vertebral body fixing screws are respectively screwed into the vertebral body fixing screws to fix the composite body. The vertebral body spreader is loosened to tightly embed the composite body. The position of the implant is confirmed by X-ray machine perspective of the C-shaped arm, the wound is washed by normal saline, drainage is placed, and the suture is performed layer by layer. After the operation, the normal nursing is carried out, the drainage is pulled out after 1 day, and the neck support is braked for 3 months.
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 (6)
1. The utility model provides a 3D prints bionical dislocation prevention movable artificial cervical vertebra and intervertebral connection complex which characterized in that includes:
The upper end plate (1) is connected with the bionic vertebral body (2) through an upper end plate joint structure, the upper end plate (1) comprises a first platform (4), a pair of first nail channels (6) which are parallel to the axis and symmetrically distributed are formed in the front section of the first platform (4), included angles are formed between the axes of the two first nail channels (6) and the plane of the first platform (4) and are used for facilitating the fixation of screws, a circular arc-shaped supporting structure (5) is arranged on the upper surface of the first platform (4), the upper end plate joint structure comprises a first joint ball handle (7), the top of the first joint ball handle (7) is fixedly connected with the lower surface of the upper end plate (1), a first joint ball (8) is arranged at the bottom of the first joint ball (8), the first joint ball (8) is installed in an upper joint socket (10), the lower end plate joint structure comprises a second joint ball handle (20), the bottom of the second joint ball handle (20) is fixedly connected with the upper surface of the lower end plate (3), a second joint ball (21) is arranged at the top of the second joint ball (21), and the second joint ball (21) is installed in the lower joint ball (10);
The top of the lower end plate (3) is connected with the bionic vertebral body (2) through a lower end plate joint structure;
the bionic vertebral body (2) comprises a vertebral body (12) with a hollowed-out middle part, wherein an upper joint mortar (10) is arranged at the upper part of the vertebral body (12), and a lower joint mortar (15) is arranged at the lower part of the vertebral body (12), the upper joint mortar (10) is connected with an upper endplate (1) through an upper endplate joint structure, and the lower part of the vertebral body is connected with a lower endplate (3) through a lower joint structure;
The anti-dislocation structure comprises an upper limit tooth (11) and a lower limit tooth (16) which are respectively arranged on an upper joint socket (10) and a lower joint socket (15), and a plurality of first clamping grooves (9) and second clamping grooves (17) which are respectively arranged on the upper end plate joint structure and the lower end plate joint structure and correspond to the upper limit tooth (11) and the lower limit tooth (16) in number and position, wherein the upper limit tooth (11) is distributed at the upper end table surface of the upper joint socket (10) at equal intervals, the lower limit tooth (16) is distributed at the lower end table surface of the lower joint socket (15) at equal intervals, the upper limit tooth (11) is arranged at the top of the upper joint socket (10), the lower limit tooth (16) is arranged at the bottom of the lower joint socket (15), and the free ends of the upper limit tooth (11) and the lower limit tooth (16) are all pointed to the center of the joint socket;
The upper end plate (1), the lower end plate (3) and the bionic vertebral body (2) are all manufactured by 3D printing.
2. The 3D printing bionic dislocation preventing movable artificial cervical vertebra and intervertebral connecting complex according to claim 1, wherein two first nail channels (6) are arranged in front of the first platform (4)Structural area, support structure (5) is arranged behind the first platform (4)The structural area is provided with a circular arc highest point of the supporting structure (5) positioned behind the first platform (4)The height of the cambered surface is smoothly decreased to the periphery.
3. The 3D printing bionic anti-dislocation movable artificial cervical vertebra and intervertebral connecting complex according to claim 1, wherein the lower end plate (3) comprises a second platform (18), two second nail channels (19) which are parallel to the axis and symmetrically distributed are arranged at the front section of the second platform (18), and an included angle is formed between the axes of the two second nail channels (19) and the plane of the second platform (4) for facilitating the fixation of screws.
4. The 3D printing bionic dislocation preventing movable artificial cervical vertebra and intervertebral joint complex as recited in claim 3 wherein two second nail paths (19) are opened in front of a second platform (18)And a structural region.
5. The 3D printing bionic anti-dislocation movable artificial cervical vertebra and intervertebral joint complex according to claim 1, wherein a support column (13) is arranged inside the vertebral body (12), the support column (13) is a slant cylinder, the upper surface of the support column is connected with the bottommost end of the upper joint mortar (10) and extends smoothly to the periphery, and the lower surface of the support column is connected with the topmost end of the lower joint mortar (15) and extends smoothly to the periphery.
6. The 3D printing bionic dislocation preventing movable artificial cervical vertebra and intervertebral connecting complex according to claim 1, wherein the diamond-shaped through holes on the front surface of the vertebral body (12) are provided with 4 layers, 3 layers are arranged in a staggered manner, and 3 layers are arranged on the back surface, and 3 layers are arranged in a staggered manner.
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| CN111419484A (en) * | 2020-04-24 | 2020-07-17 | 钱永尚 | Anterior zero-notch fixed combined type movable artificial cervical vertebral body and using method thereof |
| TWM609706U (en) * | 2020-06-24 | 2021-04-01 | 好喜歡妮有限公司 | Interspinous stabilization device |
| CN114469458B (en) * | 2022-01-12 | 2025-07-11 | 汕头大学 | A 3D printed bionic artificial intervertebral joint prosthesis |
| CN115192271B (en) * | 2022-07-12 | 2024-11-22 | 郝定均 | Double-segment bionic cervical disc and vertebral body connection system |
| 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 |
| CN115444646B (en) * | 2022-09-17 | 2024-07-09 | 涿州新卓立航空精密科技有限公司 | Cervical vertebra joint sprain reduction fixer |
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| FR2934771B1 (en) * | 2008-08-07 | 2011-11-18 | Jean Philippe Lemaire | SELF-ADAPTIVE AND AUTOSTABLE INTERVERTEBRAL DISC PROSTHESIS. |
| CN101627931B (en) * | 2009-08-06 | 2010-12-01 | 雷伟 | A kind of artificial cervical compound joint |
| CN202409215U (en) * | 2011-06-29 | 2012-09-05 | 西安交通大学 | Adjustable artificial cervical vertebra and artificial intervertebral disk connection composite body |
| CN102240234B (en) * | 2011-06-29 | 2013-07-10 | 西安交通大学 | Adjustable artificial cervical vertebra and intervertebral connecting complex |
| CN207545273U (en) * | 2017-04-19 | 2018-06-29 | 中国人民解放军第四军医大学 | A kind of double acting joint cervical prosthesis |
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