CN204931903U - A kind of Cervical vertebra 3D prints titanium cage - Google Patents

Abstract

The utility model discloses a kind of Cervical vertebra 3D and print titanium cage, comprise central web structure, some upper ends columnar stays structure, some upper ends column syndeton, upper end circular support structure, some lower ends lead angle supporting construction, some lower ends column syndeton and lower end circular support structure; This utility model can effectively avoid titanium cage to subside.

Description

A 3D printed titanium cage for the lower cervical spine

technical field

The utility model belongs to the technical field of medical prosthesis manufacturing and relates to a 3D printed titanium cage for lower cervical vertebrae.

Background technique

At present, subtotal cervical corpectomy and decompression combined with titanium cage bone graft fusion is a commonly used surgical method for the treatment of cervical spondylosis, cervical spinal stenosis, cervical vertebral fracture with spinal cord compression, or old fracture and dislocation with incomplete spinal cord injury. . In this operation, the corresponding vertebral bodies and intervertebral discs are exposed through the anterior approach, and vertebral screws are respectively placed in the upper and lower vertebral bodies adjacent to the vertebral body to be resected, and a vertebral body spreader is placed to stretch the upper and lower vertebral bodies to a certain height. The diseased intervertebral discs at both ends were resected, and most of the vertebral body and posterior longitudinal ligament of the vertebral body were subtotally resected on the medial side of the bilateral uncinate joints, and a titanium cage of appropriate length (filled with bone grafts) was implanted in the decompression groove. Select the appropriate anterior cervical plate fixation and upper and lower vertebral bodies. A large number of clinical studies have confirmed that it has a good surgical effect. The surgical segment can obtain immediate postoperative stability and provide a stable biomechanical environment for the recovery of neurological function. However, relevant postoperative follow-up studies found that some patients had subsidence and collapse of the titanium cage, which affected the postoperative efficacy of patients. YuChen et al conducted postoperative follow-up on 300 patients who underwent subtotal cervical corpectomy and decompression combined with titanium cage bone graft fusion. According to follow-up results, 182 (60.7%) patients had mild titanium cage collapse (1-3mm), and 57 patients had severe titanium cage collapse (>3mm). Compared with patients without titanium cage collapse after operation, the neurological recovery of patients with titanium cage collapse was significantly lower than that of patients with titanium cage collapse. Moreover, severe titanium cage collapse can lead to complications such as neck pain, impaired nerve function, and fixation failure. (ChenY, ChenDY, GuoYF, et al.SubsidenceofTitaniumMeshCageAStudyBasedon300Cases[J].JournalofSpinalDisorders&Techniques,2008,21(7):489-492.) An important reason for the postoperative collapse of the titanium cage is the small contact area between the titanium cage and the vertebral body endplate . During traditional titanium cage implantation, the length of the titanium cage needs to be trimmed to the length of the bone socket. The uncut side of the titanium cage is a smooth structure with 6 flat contact points and the trimmed end has mostly 12 sharp contact points. This point contact method causes a large pressure load on the surface of the vertebral body endplate, which can easily cause the structural damage of the vertebral body endplate and cause the titanium cage to penetrate into the vertebral body, causing the titanium cage to collapse (Xu Jianwei, Jia Lianshun, Chen Deyu, et al. Discussion on early collapse of titanium mesh bone graft in subtotal vertebral body resection [J]. Chinese Journal of Orthopedic Surgery, 2002, 10 (z1): 1267-1269.).

3D printing technology is a technology that uses a digital model as the basis and uses bonding materials such as powdered metal or plastic to construct objects by layer-by-layer printing. Compared with traditional manufacturing technology, 3D printing technology has the following advantages: (1) saving materials and manufacturing costs. (2) There is no need for large-scale forging equipment and special molds, which saves manufacturing time and improves production efficiency. (3) Products with complex structures and difficult processing can be produced. (4) Can be used for personalized customization. (MurrLE, QuinonesSA, GaytanSM, et al. Microstructure and mechanical behavior of Ti-6Al-4V produced by rapid-layer manufacturing, for biomedical applications [J]. Journal of the Mechanical Behavior of Biomedical Materials, 2009, 2 (1): 20-32. has great application value.

In order to prevent the collapse of the titanium cage after subtotal cervical corpectomy and decompression combined with titanium cage bone graft fusion, and to avoid complications such as neck pain, nerve function damage, and fixation failure caused by the collapse of the titanium cage, it is urgent to design a A new type of 3D printed titanium cage for the lower cervical spine.

Utility model content

The purpose of the utility model is to overcome the above-mentioned shortcomings of the prior art, and provide a 3D printed titanium cage for the lower cervical spine, which can effectively avoid the collapse of the titanium cage.

In order to achieve the above purpose, the 3D printed titanium cage for the lower cervical spine of the present invention includes a middle mesh structure, several upper end columnar support structures, several upper end columnar connection structures, upper end circular support structures, several lower end chamfer support structures, and several lower end support structures. Columnar connection structure, and a circular support structure at the lower end;

One end of each upper columnar connection structure is connected to the outer surface of the upper circular support structure, the lower surface of the other end of any upper columnar connection structure is connected to the upper end surface of the corresponding upper columnar support structure, and the lower end surface of each upper columnar support structure Connected with the upper end surface of the middle network structure;

The upper end surfaces of each lower chamfer support structure are respectively connected to the lower end surface of the middle network structure, the lower end surface of any lower chamfer support structure is connected to the upper end surface of the corresponding lower end columnar connection structure, and the inner surface of the lower chamfer support structure The inner surface of the columnar connection structure at the lower end is connected with the outer surface of the lower circular support structure;

The upper surface of the upper columnar connection structure is flush with the upper surface of the upper circular support structure;

The lower surface of the lower columnar connection structure is flush with the lower surface of the lower circular support structure.

The side of the middle network structure is provided with several layers of diamond-shaped meshes, and the meshes of two adjacent layers are alternately distributed.

The number of meshes in each layer is 9, the number of layers of meshes is 6 layers, the height of the middle mesh structure is 19mm, the wall thickness of the mesh holes is 1mm, and the wall thickness of the middle mesh structure is 2mm.

Each columnar support structure at the upper end is distributed along the circumferential direction;

Each columnar connection structure at the upper end is distributed along the circumferential direction;

The supporting structures of each lower chamfer are distributed along the circumferential direction;

The columnar connecting structures at the lower ends are distributed along the circumferential direction.

The upper columnar support structure is perpendicular to the corresponding upper columnar connection structure.

Both the upper circular support structure and the lower columnar connection structure are ring-shaped structures;

The inner diameter, outer diameter and height of the circular support structure at the upper end and the inner diameter, outer diameter and height of the columnar connection structure at the lower end are 7.5 mm, 8.5 mm and 2 mm, respectively.

The lower chamfer support structure is a right-angled trapezoidal structure.

The upper surface of the lower circular support structure is provided with several grooves, and each groove is located between two corresponding adjacent lower chamfer support structures.

The utility model has the following beneficial effects:

The lower cervical spine 3D printing titanium cage described in the utility model includes a middle mesh structure, an upper columnar connection structure, an upper circular support structure, a lower columnar connection structure and a lower circular support structure, an upper columnar connection structure and an upper circular support structure Located on the upper part of the middle network structure, the lower end columnar connection structure and the lower end circular support structure are located at the lower part of the middle network structure, the upper surface of the upper end columnar connection structure is flush with the upper surface of the upper end circular support structure, through the upper end columnar connection structure The upper surface of the upper surface of the upper circular support structure and the upper surface of the upper circular support structure constitute the upper surface of the lower cervical vertebra 3D printing titanium cage described in the utility model, and the lower surface of the lower end columnar connection structure and the lower surface of the lower circular support structure form the utility model The lower surface of the lower cervical vertebra 3D prints the titanium cage, thereby effectively increasing the contact area between the utility model and the upper and lower surfaces of the cervical vertebral body, reducing the pressure per unit area of the upper surface and the lower surface of the cervical vertebral body, thereby effectively to avoid titanium cage collapse. The mesh structure in the middle can effectively increase the contact area between the bone graft particles in the titanium cage and the surrounding bone, which is beneficial to the early fusion of the bone in the surgical area.

Description of drawings

Fig. 1 is a side view of the utility model;

Fig. 2 is the front view of the utility model;

Fig. 3 is the top view of the utility model;

Fig. 4 is the bottom view of the utility model;

Fig. 5 is the rear view of the utility model;

Fig. 6 is a perspective view of the utility model.

Among them, 1 is the middle mesh structure, 2 is the upper columnar support structure, 3 is the upper columnar connection structure, 4 is the upper circular support structure, 5 is the lower chamfer support structure, 6 is the lower columnar connection structure, 7 is the lower end circle Shaped support structure, 8 are grooves.

detailed description

Below in conjunction with accompanying drawing, the utility model is described in further detail:

Referring to Figure 1, the 3D printed titanium cage for the lower cervical spine of the present invention includes a middle mesh structure 1, several upper columnar support structures 2, several upper columnar connection structures 3, upper circular support structures 4, and several lower end chamfer support structures 5. A number of lower columnar connection structures 6 and lower circular support structures 7; one end of each upper columnar connection structure 3 is connected to the outer surface of the upper circular support structure 4, and the lower surface of the other end of any upper columnar connection structure 3 They are all connected to the upper end faces of the corresponding upper columnar support structures 2, and the lower end faces of each upper end columnar support structures 2 are connected to the upper end faces of the middle network structure 1; The lower end surface of any lower chamfer support structure 5 is connected to the upper end surface of the corresponding lower end columnar connection structure 6, and the inner surface of the lower end chamfer support structure 5 and the inner surface of the lower end columnar connection structure 6 are connected to the lower end The outer surfaces of the circular support structure 7 are connected; the upper surface of the upper columnar connection structure 3 is flush with the upper surface of the upper circular support structure 4; the lower surface of the lower columnar connection structure 6 is connected to the lower circular support structure 7 lower surface is flush.

It should be noted that the side of the intermediate network structure 1 is provided with several layers of diamond-shaped meshes, and the adjacent two layers of meshes are distributed alternately; the number of meshes in each layer is 9, and the number of layers of meshes is 6. layer, the height of the middle network structure 1 is 19mm, the wall thickness of the mesh is 1mm, and the wall thickness of the middle network structure 1 is 2mm; the upper columnar support structures 2 are distributed along the circumferential direction; the upper columnar connection structures 3 are distributed along the circumference distributed along the circumferential direction; each lower chamfer support structure 5 is distributed along the circumferential direction; each lower end columnar connection structure 6 is distributed along the circumferential direction; the upper end columnar support structure 2 is perpendicular to the corresponding upper end columnar connection structure 3; the upper end circular support structure 4 The inner diameter, outer diameter and height of the upper circular support structure 4 and the inner diameter, outer diameter and height of the lower end columnar connection structure 6 are 7.5mm, 8.5mm and 2mm respectively; The lower chamfer support structure 5 is a right-angled trapezoidal structure; the upper surface of the lower round support structure 7 is provided with a number of grooves 8, and each groove 8 is located between two corresponding adjacent lower chamfer support structures 5.

The height of the lower cervical vertebra 3D printing titanium cage described in the utility model is 26mm, the width of the middle length of the lower cervical vertebra 3D printing titanium cage is 14mm, and the diameter of the lower cervical vertebra 3D printing titanium cage gradually decreases from the middle position to the upper and lower ends , the width of the middle position of the lower cervical spine 3D printed titanium cage is 12mm. The upper surface of the intermediate mesh structure 1 is a curved surface matching the upper surface of the patient's cervical spine, and the upper surface of the intermediate mesh structure 1 is the highest point of the curved surface at 3/7 from the back to the front, And the height gradually decreases toward both sides, and the lowest point of the upper surface of the middle network structure 1 is located at the forefront of the upper surface of the middle network structure 1 .

The number of the upper columnar support structures 2 is 9, and four are located on the rear side, one is located on the left side, one is located on the right side, and three are located on the front, and the upper columnar support structures 2 on the front and the left side are The width and thickness of the upper columnar support structure 2 and the upper columnar support structure 2 on the right side are 1.5mm and 2mm respectively, and the width and thickness of the upper columnar support structure 2 on the rear side are 1mm and 2mm respectively.

The number of the lower end columnar connection structures 6 is 9, and four are located on the rear side, one is located on the left side, one is located on the right side, and three are located on the front side. The lower end columnar connection structures 6 on the front side and the left side side The widths of the lower end columnar connection structure 6 and the lower end columnar connection structure 6 on the right side are both 1.5 mm and 2 mm, and the widths of the lower end columnar connection structure 6 on the rear side are both 1 mm.

In summary, the 3D printed titanium cage for the lower cervical spine of the present utility model is suitable for diseases of subtotal cervical vertebral body resection and decompression combined with titanium cage bone graft fusion, such as: nerve root type or spinal spondylosis, cervical spinal canal Stenosis, cervical disc herniation at two adjacent segments, cervical kyphosis, vertebral body tumors, vertebral body tuberculosis, non-nervous function impaired cervical vertebral burst fractures and compression fractures, etc. The specific implementation methods of intervertebral disc removal, subtotal vertebral body resection, and implantation of the titanium cage will be described below.

Routine preoperative examinations are performed for patients with indications for this operation, and the trachea and esophagus are moved in parallel, and urination and defecation exercises are performed on the bed. During the operation, the patient is placed in the supine position. Stretch back naturally, place a soft headband on the back of the occiput, and after sterilizing the drape, make a transverse incision on the right side of the anterior midline of the neck. The length of the incision is generally 3-5 cm. The retractor pulls and protects the trachea and esophagus to the right, and the carotid sheath pulls and protects slightly to both sides. Once the vertebral bodies and anterior discs are reached, the C-arm is used to identify the cervical segment for subtotal corpectomy. The spreader screws are respectively screwed into the center of the upper and lower vertebral bodies of the vertebral bodies that need subtotal vertebral body resection, and the vertebral body spreaders are inserted on the spreader screws, and the upper and lower ends are spread out, and the spreader distance is generally 4mm, determine the upper and lower intervertebral discs of the corresponding vertebral body, cut the fibrous annulus with a sharp knife, take out the broken intervertebral disc tissue with a nucleus pulposus forceps, and longitudinally make a slot for decompression on the vertebral body that needs subtotal vertebral body resection, and the width of the slot is The medial edge of the longus colli muscle on both sides is 1-2 mm lateral, and the adjacent intervertebral disc reaches the surface of the posterior longitudinal ligament. If there is ossification of the posterior longitudinal ligament, first use the posterior longitudinal ligament hook to open the opening on the posterior longitudinal ligament, and bluntly contact the dura. After the separation, the long-beak-shaped impact rongeur was used to bite off, and the longitudinal bone groove was enlarged, and the bone around the bottom edge was used for sneak decompression, including resection of the posterior inferior border of the upper vertebral body, the posterior superior border of the lower vertebral body and The osteophytes of the vertebral bodies on both sides of the bone trough scraped to the cartilage surface of the adjacent vertebral body endplate and showed spot-like bleeding. After measuring the length of the bone groove 8, select the appropriate length of the 3D printed titanium cage for the lower cervical spine. The inner cavity of the titanium cage is filled with bone fragments obtained by decompression and embedded tightly, and then the titanium mesh is implanted into the decompression groove 8. The titanium mesh is surrounded by excess bone fragments. Remove the vertebral body spreader and settling set in front of the vertebral body, select an anterior cervical plate of appropriate size, place and lock it step by step with special instruments, and close the incision layer by layer after placing the drainage tube; routine postoperative care, 1 day later The drainage tube was pulled out; the cervical collar was strictly worn for 3 months after the operation and removed after 3 months.

Claims (8)

1. A 3D printed titanium cage for the lower cervical spine, characterized in that it includes a middle mesh structure (1), several upper columnar support structures (2), several upper columnar connection structures (3), and an upper circular support structure (4) , several lower end chamfer support structures (5), several lower end columnar connection structures (6), and lower end circular support structures (7); One end of each upper columnar connection structure (3) is connected to the outer surface of the upper circular support structure (4), and the lower surface of the other end of any upper columnar connection structure (3) is connected to the corresponding upper columnar support structure (2). The upper end surfaces are connected, and the lower end surfaces of each upper columnar support structure (2) are connected with the upper end surface of the middle network structure (1); The upper end surfaces of each lower chamfer support structure (5) are respectively connected to the lower end surface of the middle mesh structure (1), and the lower end surface of any lower chamfer support structure (5) is connected to the corresponding lower columnar connection structure (6). The upper end surfaces are connected, and the inner surface of the lower chamfer support structure (5) is connected with the inner surface of the lower columnar connection structure (6) and the outer surface of the lower circular support structure (7); The upper surface of the upper columnar connection structure (3) is flush with the upper surface of the upper circular support structure (4); The lower surface of the lower columnar connection structure (6) is flush with the lower surface of the lower circular support structure (7). 2. The 3D printed titanium cage for the lower cervical spine according to claim 1, characterized in that, the side of the intermediate mesh structure (1) is provided with several layers of diamond-shaped meshes, and two adjacent layers of meshes are distributed alternately. 3. The lower cervical spine 3D printing titanium cage according to claim 2, characterized in that the number of meshes in each layer is 9, the number of layers of meshes is 6 layers, and the height of the middle mesh structure (1) is 19mm , the wall thickness of the mesh is 1 mm, and the wall thickness of the middle mesh structure (1) is 2 mm. 4. The lower cervical vertebra 3D printing titanium cage according to claim 1, characterized in that, Each columnar support structure (2) at the upper end is distributed along the circumferential direction; Each columnar connection structure (3) at the upper end is distributed along the circumferential direction; The support structures (5) at the lower end chamfers are distributed along the circumferential direction; The columnar connection structures (6) at the lower ends are distributed along the circumferential direction. 5. The 3D printed titanium cage for the lower cervical spine according to claim 1, characterized in that the upper columnar support structure (2) is perpendicular to the corresponding upper columnar connection structure (3). 6. The lower cervical spine 3D printing titanium cage according to claim 1, characterized in that, the upper circular support structure (4) and the lower columnar connection structure (6) are circular structures; The inner diameter, outer diameter and height of the upper circular support structure (4) and the inner diameter, outer diameter and height of the lower cylindrical connection structure (6) are 7.5mm, 8.5mm and 2mm respectively. 7. The 3D printed titanium cage for the lower cervical spine according to claim 1, characterized in that, the lower chamfer support structure (5) is a right-angled trapezoidal structure. 8. The lower cervical vertebra 3D printing titanium cage according to claim 1, characterized in that, the upper surface of the lower circular support structure (7) is provided with several grooves (8), and each groove (8) is located in the corresponding adjacent Between the two lower chamfer support structures (5).