CN112107355B - Cervical door fixation device - Google Patents
Cervical door fixation device Download PDFInfo
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- CN112107355B CN112107355B CN202011026115.XA CN202011026115A CN112107355B CN 112107355 B CN112107355 B CN 112107355B CN 202011026115 A CN202011026115 A CN 202011026115A CN 112107355 B CN112107355 B CN 112107355B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
- A61B17/7071—Implants for expanding or repairing the vertebral arch or wedged between laminae or pedicles; Tools therefor
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Abstract
本发明公开了一种颈椎开门固定装置，属于骨科植入物技术领域，所述颈椎开门固定装置包括管状主体，管状主体内部用作为植骨腔，管状主体具有曲度并在两端分别形成用于卡接侧块断端的第一卡口和用于卡接棘突断端的第二卡口，第二卡口为插接式卡口。本发明的颈椎开门固定装置，通过在管状主体两端形成卡口分别卡接连接侧块断端和棘突断端，抗弯性能好，维持椎管结构的能力强，骨融合效果好。本发明适用于椎管成形术。
The present invention discloses a cervical vertebra open-door fixing device, which belongs to the technical field of orthopedic implants. The cervical vertebra open-door fixing device comprises a tubular body, the interior of the tubular body is used as a bone grafting cavity, the tubular body has a curvature and a first bayonet for clamping the lateral mass end and a second bayonet for clamping the spinous process end are formed at both ends, respectively, and the second bayonet is a plug-in bayonet. The cervical vertebra open-door fixing device of the present invention has good bending resistance, strong ability to maintain the spinal canal structure, and good bone fusion effect by forming bayonet ports at both ends of the tubular body to clamp and connect the lateral mass end and the spinous process end. The present invention is suitable for laminoplasty.
Description
Technical Field
The invention relates to the technical field of orthopedic implants, in particular to a cervical vertebra door opening fixing device.
Background
The internal fixation modes used in the cervical vertebra single-door operation mainly comprise a joint capsule suspension method, an anchoring method and a micro titanium plate-titanium nail internal fixation method. Along with the development of clinical use and research analysis, the method finds that the fixation of the micro titanium plate-titanium nail internal fixation method has better spine movement range stability and lower door opening and closing phenomenon than other two fixation modes.
The main structure of the miniature titanium plate is Z-shaped, the principle is the same as that of a bone screw plate, and the miniature titanium plate is fixed by driving screws into the side block end and the door opening end respectively, so that the door opening state is maintained through the titanium plate. The titanium plate in the market has various designs, but has a single structure, and is of a single-layer plate structure. The retaining of the vertebral canal structure after the fixation of the nail plate mainly depends on the bending resistance of the titanium plate. The greater the bending stiffness, the less the titanium plate will bend and deform, and the greater the ability to maintain the spinal structure. While single-layer plate structures have the inherent disadvantage under bending loads, in terms of:
Firstly, the fixation of the titanium plate depends on the holding force of the screw, and the holding force of the screw is related to various factors such as bone, so that the same holding effect can not be ensured when different patients and different doctors operate, and the bending resistance of the titanium plate can not be ensured to be maintained at a higher level;
Secondly, the single-layer plate structure has an inherent disadvantage in bending resistance, and the thickness is very thin, usually 0.5-0.7mm, and the calculation formula of bending stiffness is as follows:
E×Iz＝E×∫Ay2dA
Wherein E is elastic modulus, I Z is moment of inertia, A is area, y is distance from the neutral plane in the thickness direction of the titanium plate, and the neutral plane is positioned in the middle section of the titanium plate, so that the maximum value of y is 1/2 of the thickness of the titanium plate. Since the titanium plate is very thin, the value of the bending stiffness is not significantly increased, regardless of other designs.
Disclosure of Invention
The invention aims to solve the technical problem of providing a cervical vertebra door opening fixing device with good bending resistance.
In order to solve the technical problems, the invention provides the following technical scheme:
The utility model provides a cervical vertebra fixing device that opens door, includes the tubular main part, the inside bone grafting chamber that is used of tubular main part, the tubular main part has the curvature and forms the first bayonet socket that is used for joint side piece broken end and the second bayonet socket that is used for joint spinous process broken end respectively at both ends, the second bayonet socket is the grafting bayonet socket.
Further, a spinous process broken end limiting plate is arranged in the second bayonet.
Further, a plurality of through holes are arranged on the spinous process broken end limiting plate.
Further, the first bayonet is a plug-in bayonet, a side block broken end limiting plate is arranged in the first bayonet, and a plurality of through holes are formed in the side block broken end limiting plate;
or the first bayonet is a plug-in bayonet, and a screw mounting hole is formed in the side wall of the first bayonet.
Further, the first bayonet is a wrapping type bayonet, the end face of the tubular main body is used as one wrapping side wall of the wrapping type bayonet, and an extension plate used as the other wrapping side wall of the wrapping type bayonet is arranged on the end face of the tubular main body.
Further, the end face of the tubular main body is provided with a side block broken end limiting plate, and the side block broken end limiting plate is provided with a plurality of through holes.
Further, screw mounting holes are formed in the extension plate, and/or the extension plate is arc-shaped.
Further, the inner dimension of the second bayonet is gradually reduced from outside to inside, and the spinous process broken end limiting plate is detachably clamped in the second bayonet.
Further, an included angle between the end face of the first bayonet and the end face of the second bayonet is 30-70 degrees.
Further, the tubular main body is provided with an opening extending along the longitudinal direction, so that the cross section of the tubular main body is U-shaped or C-shaped, the opening is positioned at the top, the bottom or the outer side surface of the tubular main body, and a cover plate is arranged on the opening.
The invention has the following beneficial effects:
According to the cervical vertebra door opening fixing device, the bayonet is formed at the two ends of the tubular main body to be respectively clamped and connected with the lateral block broken end and the spinous process broken end, so that the cervical vertebra door opening fixing device is good in bending resistance, strong in capability of maintaining a vertebral canal structure and good in bone fusion effect. The invention is suitable for vertebroplasty.
Drawings
FIG. 1 is a perspective view of a structure of one embodiment of a cervical spine door opening fixation device of the present invention;
FIG. 2 is a view showing another angular construction of the cervical spine door opening fixation device of FIG. 1, wherein (a) is an angular perspective view, (b) is another angular perspective view, and (c) is a sectional perspective view;
FIG. 3 is a view showing a state of use of the cervical vertebrae door opening fixing apparatus shown in FIG. 1, wherein (a) is a perspective view and (b) is a perspective view;
FIG. 4 is a perspective view showing another embodiment of the cervical vertebra opening fixing apparatus of the present invention;
FIG. 5 is a view showing a structure of other angles of the cervical vertebrae door opening fixing apparatus shown in FIG. 4, wherein (a) is a perspective view, (b) is a sectional perspective view, and (c) is a perspective view;
FIG. 6 is a view showing a state of use of the cervical vertebrae fixing apparatus shown in FIG. 4, in which (a) is a perspective view and (b) is a perspective view;
FIG. 7 is a schematic longitudinal section of the cervical spine door opening fixation device of FIG. 1;
FIG. 8 is a graph showing the results of comparing the fixed stiffness of the titanium plate product of the present invention and the conventional titanium plate product in a single door operation.
Detailed Description
In order to make the technical problems, technical solutions and advantages to be solved more apparent, the following detailed description will be given with reference to the accompanying drawings and specific embodiments.
The invention provides a cervical vertebra door opening fixing device, as shown in figures 1-6, comprising a tubular main body 1, wherein:
The inside of the tubular main body 1 is used as a bone grafting cavity 2, and the bone grafting cavity 2 is used for loading bone fusion inducing materials, such as autologous bone, artificial bone powder, artificial bone blocks and the like;
The tubular body 1 has a curvature and forms at both ends a first bayonet 3, 3' for clamping the lateral mass break 16 and a second bayonet 4 for clamping the spinous process (lateral) break 15, respectively;
Considering the structural characteristics (relatively slender) and connection convenience of the spinous process broken end 15, the second bayonet 4 is a plug-in bayonet (i.e. the spinous process broken end 15 is plugged into the second bayonet 4), the spinous process broken end limiting plate 5 for limiting the plugging depth of the spinous process broken end 15 is preferably arranged in the second bayonet 4, and in order to not limit the fusion of the bone grafting and the broken end, for example, the width of the spinous process broken end limiting plate 5 is smaller than the width of the broken end surface or the length of the broken end surface, i.e. the spinous process broken end limiting plate 5 cannot completely seal the whole second bayonet 4 so as to facilitate the fusion of the bone grafting and the broken end surface, and meanwhile, the clamping strength of the cervical vertebra door opening fixing device and the spinous process broken end 15 can be enhanced by adding the spinous process broken end limiting plate 5.
As another example, as shown in fig. 1-6, although the spinous process broken end limiting plate 5 has a structure of closing the second bayonet 4, a plurality of through holes may be provided on the spinous process broken end limiting plate 5, so as to facilitate the connection of the spinous process broken end 15 with the bone grafting growth in the bone grafting cavity 2.
When the cervical vertebra is subjected to single-door operation, firstly, a vertebral plate at one side of a cervical vertebra at a lesion part is cut, a groove is formed at the portal side of the vertebral plate, the cut vertebral plate can rotate slightly around the portal side groove, then, the cervical vertebra door opening fixing device is implanted, the side block broken end 16 is clamped in the first bayonet 3 and 3', the spinous process broken end 15 is clamped in the second bayonet 4, and the clamping part of the second bayonet 4 and the spinous process broken end 15 is connected with the tubular main body 1 (four surfaces of the clamping part are integrally formed or fixedly connected with the tubular main body), so that the degree of freedom limitation of the clamping part on the spinous process broken end 15 is increased, and a powerful support is provided for the opening of the vertebral plate, the opening of the vertebral plate is prevented from being closed again, the expansion effect of the vertebral canal is kept, and effective decompression of the inside the vertebral canal is realized.
The present invention may have the following specific embodiments according to the structural form of the first bayonet.
Example 1
As shown in fig. 1-3, the first bayonet 3 is also a plugging bayonet (i.e. the side block broken end 16 is plugged into the first bayonet 3), a side block broken end limiting plate 6 for limiting the plugging depth of the side block broken end 16 is arranged in the first bayonet 3, and a plurality of through holes are arranged on the side block broken end limiting plate 6 so as to facilitate the connection of the side block broken end 16 with the bone grafting growth in the bone grafting cavity 2. Here, since the clamping part of the first bayonet 3 and the lateral block broken end 16 is connected with the tubular main body 1 (the four surfaces of the clamping part are integrally formed or fixedly connected with the tubular main body), the degree of freedom restriction of the clamping part on the lateral block broken end 16 is increased, the degree of freedom restriction of the spinous process broken end 15 is combined with the second bayonet 4, the two sides are combined to realize stable connection of the vertebral plate, the opening of the vertebral plate is avoided from being closed again, the expansion effect of the vertebral canal is kept, and the effective decompression of the inside of the vertebral canal is realized. And, this solution does not require the use of screws for fixation.
As an alternative implementation, screw mounting holes (not shown) may be provided on the side wall of the first bayonet 3 to further improve the fixing strength of the whole device by being screwed to the side block break 16.
The spinous process broken end limiting plate 5 and the lateral block broken end limiting plate 6 are both fixed on the inner wall of the tubular main body 1 and can be connected with three sides of the inner wall of the tubular main body 1 or can be connected with two sides or one side. The connecting device can be integrally formed, clamped, welded and other connecting modes.
The spinous process broken end limiting plate 5 and the lateral block broken end limiting plate 6 are used for realizing the function of limiting movement of the broken end and simultaneously allowing the bone grafting to be contacted with the broken end so as to achieve the effect of promoting bone grafting fusion. In this embodiment, the tubular body 1, the spinous process break end limiting plate 5 and the lateral mass break end limiting plate 6 together form the bone grafting cavity 2.
It is conceivable that the side block broken end limiting plate 6 may be omitted, and a screw mounting hole may be provided on a side wall of the omitted rear first bayonet 3, and the side block broken end limiting plate is realized and the fixing strength of the whole device is ensured by fixing the screw to the side block broken end 16.
In this embodiment, the tubular main body 1 may be provided with an opening 8 extending along a longitudinal direction, so that the cross section of the tubular main body 1 is U-shaped, the opening 8 is used as a bone grafting window to facilitate bone grafting into the bone grafting cavity 2, and on the other hand, the opening 8 can enable the tubular main body 1 to have a certain elasticity due to the difference in the sizes of the broken ends of different vertebral plates, so that the bayonets at the two ends of the tubular main body 1 can be opened by a certain angle when being clamped into the broken ends of the vertebral plates with different sizes, thereby facilitating a doctor to smoothly clamp the broken ends of the vertebral plates. The opening 8 may be located at the top or bottom of the tubular main body 1, in the embodiment shown in fig. 1-3, the opening 8 is located at the bottom, in order to avoid bone grafting dropping, a cover plate 9 is disposed on the opening 8, in order to facilitate connection with the cover plate 9 in practical implementation, a sliding slot 81 may be disposed on an inner wall of the opening 8, and the cover plate 9 is inserted into the sliding slot 81.
The first embodiment has the following beneficial effects:
(1) The structural design of the tubular main body enables more materials of the product to be placed at a position far away from a neutral axis (as shown in fig. 7, the distance y between the thickness direction of the titanium plate and the neutral plane z in the bending stiffness calculation formula is obviously increased compared with that of the single-layer plate structure in the prior art), and the bending resistance section coefficient can be increased under the condition that the sectional areas are the same, so that the bending stiffness is greatly increased, the postoperative stability of the vertebral plate is ensured, and the phenomenon of postoperative re-closing is avoided;
(2) The design can be fixed without using screws, so that the problems of unsatisfactory operation effect and the like caused by unstable screw anchoring do not need to be worried about, the operation time and risk (the problem of easy screw deviation caused by small broken end area) are reduced, and the screw is prevented from being taken out in the secondary operation;
(3) The broken ends of the side blocks extend into the first bayonet, and the broken ends of the spinous processes extend into the second bayonet, so that the bone grafting in the bone grafting cavity can be prevented from falling from the two ends;
(4) In the scheme of the prior art, the bone grafting cavity and the broken end of the vertebral plate are in a split connection relationship, when the structure of the bone grafting cavity is stressed, the bone at the broken end of the vertebral plate can generate relative displacement with the bone grafting, and when the fracture end generates relative displacement larger than 150 mu m, the bone can not be fused, and the bone fusion failure occurs. According to the invention, the bone and the bone grafting cavity of the broken end of the vertebral plate are fixed in an integrally formed structure (the clamping parts at the two ends and the tubular main body are integrally formed), so that a stable bone fusion environment can be provided for the bone grafting and the broken end, relative displacement between the broken end and the cervical vertebra door opening fixing device can not occur, and excessive broken end micro motion is avoided, so that the bone is not fused.
(5) The cervical vertebra door opening fixing device provided by the embodiment of the invention can be made of a material absorbable by a human body, so that the effect of no fixing object in the body can be realized after final bone healing and bone fusion, and the problem that the broken nails and broken plates are caused by taking out the traditional implant through a secondary operation or not taking out the implant for a long time is solved.
Example two
As shown in fig. 4-6, the first bayonet 3' is a wrapping type bayonet, the end surface of the tubular main body 1 is used as one wrapping side wall of the wrapping type bayonet, and the end surface of the tubular main body 1 is provided with an extension plate 7 used as the other wrapping side wall of the wrapping type bayonet (namely, the wrapping type bayonet is in an L shape), so that the side block broken end 16 can be clamped in the wrapping type bayonet due to the matching of the shapes.
In order to avoid bone grafting from falling, the end face of the tubular main body 1 may be provided with a side block broken end limiting plate 5, and a plurality of through holes may be provided on the side block broken end limiting plate 5, so that the side block broken end 16 is connected with bone grafting growth in the bone grafting cavity 2.
The extension plate 7 may be provided with screw mounting holes 71 by which the extension plate 7 is fixed to the side block broken end 16, thereby improving the fixing strength of the whole device. The extension plate 7 may be arc-shaped to match with the outer side surface of the side block broken end 16, so as to further improve the fastening firmness of the side block broken end 16 and the first bayonet 3'.
In this embodiment, the tubular main body 1 may be provided with an opening 8 extending along a longitudinal direction, so that the cross section of the tubular main body 1 is C-shaped, the opening 8 is used as a bone grafting window to facilitate bone grafting into the bone grafting cavity 2, and on the other hand, the opening 8 can enable the tubular main body 1 to have a certain elasticity due to the difference in the sizes of the broken ends of different vertebral plates, so that the bayonets at the two ends of the tubular main body 1 can be opened by a certain angle when being clamped into the broken ends of the vertebral plates with different sizes, thereby facilitating a doctor to smoothly clamp the broken ends of the vertebral plates. The opening 8 is located on the outer side of the tubular body 1, and the tubular body 1 can prevent the bone grafting from falling off, so that no cover plate is required to be additionally arranged on the opening 8.
The second embodiment has the following beneficial effects:
(1) The structural design of the tubular main body enables more materials of the product to be placed at a position far away from a neutral axis (referring to fig. 7, the distance y between the thickness direction of the titanium plate and the neutral plane z in a bending stiffness calculation formula is obviously increased compared with that of a single-layer plate structure in the prior art), and the bending resistance section coefficient can be increased under the condition that the sectional areas are the same, so that the bending stiffness is greatly increased, the postoperative stability of the vertebral plate is ensured, and the phenomenon of postoperative re-closing is avoided;
(2) In the scheme in the prior art, in order to ensure the connection strength, the plate body is necessarily made of non-absorbable materials, so that the plate body still needs to be made of the screw by secondary operation;
(3) The broken ends of the spinous processes extend into the second bayonets, and the broken ends of the side blocks are provided with the limit plates of the broken ends of the side blocks, so that the bone grafting can be prevented from falling from the two ends;
(4) In the scheme of the prior art, the bone grafting cavity and the broken end of the vertebral plate are in a split connection relationship, when the structure of the bone grafting cavity is stressed, the bone at the broken end of the vertebral plate can generate relative displacement with the bone grafting, and when the fracture end generates relative displacement larger than 150 mu m, the bone can not be fused, and the bone fusion failure occurs. According to the invention, the bone and the bone grafting cavity of the broken end of the vertebral plate are fixed in an integrally formed structure (the clamping parts at the two ends and the tubular main body are integrally formed), so that a stable bone fusion environment can be provided for the bone grafting and the broken end, relative displacement between the broken end and the cervical vertebra door opening fixing device is avoided, and excessive broken end micro motion is avoided, so that the bone is not fused;
(5) When the structure is made of materials absorbable by human body, the effect of no fixture in the body can be realized after the final bone healing and bone fusion, and the problem that the traditional implant needs to be taken out by a secondary operation or is not taken out for a long time to cause broken nails and broken plates is solved.
In addition, it should be noted that the cervical vertebra door opening fixing device provided by the embodiment of the invention can be used by designing a plurality of specifications according to the sizes of different vertebral plates.
In summary, according to the cervical vertebra door opening fixing device, the bayonet is formed at the two ends of the tubular main body to be respectively clamped and connected with the lateral block broken end and the spinous process broken end, so that the cervical vertebra door opening fixing device has good bending resistance, strong capability of maintaining a vertebral canal structure and good bone fusion effect. The cervical vertebra door opening fixing device is suitable for cervical vertebra single door opening operation and can be applied to cervical vertebra double door opening operation under special conditions.
In the embodiment of the present invention, the inner dimension of the second bayonet 4 is preferably gradually reduced from outside to inside to improve the clamping strength, and the spinous process broken end limiting plate 5 is preferably detachably clamped in the second bayonet 4. Therefore, the spinous process broken end limiting plate 5 can be manufactured into various different specifications, and the spinous process broken end limiting plate 5 with the proper specification is selected to be clamped in the second opening 4 according to the opening size of the vertebral plate of a patient and the requirement of the insertion depth of the spinous process broken end 15 into the bayonet. In order to further improve the clamping strength, the inner walls of the first bayonet 3, 3' and the second bayonet 4 may be provided with a pawl structure for increasing friction and preventing withdrawal, as shown by reference numeral 41 in fig. 2 (a).
For a better simultaneous clamping of the spinous process break-off end 15 and the lateral mass break-off end 16, the curvature of the tubular body 1 is preferably designed such that the angle between the end face of the first bayonet 3, 3' and the end face of the second bayonet 4 is 30-70 degrees, preferably 45-60 degrees, wherein the spinous process break-off end connection end (i.e. the second bayonet 4) curvature is preferably parallel to the anatomical left-right direction, as shown in fig. 3 (b) and fig. 6 (b).
In order to better verify the bending resistance effect of the cervical vertebra door opening fixing device, the simulation method is used for comparing the cervical vertebra door opening fixing device with a traditional titanium plate product. The titanium alloy material has the elastic modulus of 110Gpa, the elastic modulus of the design material is 4Gpa, and the design material is the average elastic modulus of the absorbable polylactic acid material. The same load applied in the worst condition (i.e. perpendicular to the closing direction) was applied separately, the resistance to deformation immediately after surgery was compared for the bone and implant structures as a whole, and the stresses on the bone and on the implant were compared, demonstrating the performance of the product of the invention. The loading load was 100N. As a result of comparison, as shown in FIG. 8, the stiffness of the titanium plate in the door closing direction is 4532.7N/mm, the stiffness of the conventional titanium plate is 3861.7N/mm, the design of the titanium plate has better deformation resistance, namely the bending stiffness is higher, the stress on the bone is obviously smaller than that of the conventional titanium plate when the same force is loaded, and the stress on the implant is obviously smaller than that of the conventional titanium plate. The above results demonstrate that the present invention has superior fixation properties to conventional titanium plate products and the ability to facilitate initial stability of bone tissue.
While the foregoing is directed to the preferred embodiments of the present invention, it will be appreciated by those skilled in the art that various modifications and adaptations can be made without departing from the principles of the present invention, and such modifications and adaptations are intended to be comprehended within the scope of the present invention.
Claims (6)
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| CN202011026115.XA CN112107355B (en) | 2020-09-25 | 2020-09-25 | Cervical door fixation device |
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| CN202011026115.XA CN112107355B (en) | 2020-09-25 | 2020-09-25 | Cervical door fixation device |
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| CN112107355B true CN112107355B (en) | 2025-05-13 |
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| CN113384333B (en) * | 2021-07-05 | 2025-04-04 | 天津市康尔医疗器械有限公司 | Vertebral locking plate |
| CN113855200B (en) * | 2021-09-15 | 2023-07-04 | 北京纳通医疗科技控股有限公司 | Cervical vertebra rear road single door opening fixture |
Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6712852B1 (en) * | 2002-09-30 | 2004-03-30 | Depuy Spine, Inc. | Laminoplasty cage |
| CN213697143U (en) * | 2020-09-25 | 2021-07-16 | 北京大学第三医院（北京大学第三临床医学院） | Cervical vertebra open door fixation device |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101584601B (en) * | 2009-06-11 | 2011-02-09 | 陈哲 | Bone fracture plate formed by a vertebral plate |
| CN102247207B (en) * | 2011-04-07 | 2013-03-20 | 雷伟 | Universal omni-posterior-double lateral mass bridging board for cervical vertebra |
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Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6712852B1 (en) * | 2002-09-30 | 2004-03-30 | Depuy Spine, Inc. | Laminoplasty cage |
| CN213697143U (en) * | 2020-09-25 | 2021-07-16 | 北京大学第三医院（北京大学第三临床医学院） | Cervical vertebra open door fixation device |
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