CN101972179B

CN101972179B - Adjustable cervical interbody fusion cage

Info

Publication number: CN101972179B
Application number: CN201010519973A
Authority: CN
Inventors: 李鹏飞; 申勇; 张为; 丁文元
Original assignee: Individual
Current assignee: Individual
Priority date: 2010-10-26
Filing date: 2010-10-26
Publication date: 2012-09-05
Anticipated expiration: 2030-10-26
Also published as: CN101972179A

Abstract

The invention discloses an adjustable cervical interbody fusion cage, which is used for solving the problems of low applicability, adjustment incapability and inconvenient intraoperative operation of an interbody fusion cage. The technical scheme is that: the adjustable cervical interbody fusion cage comprises a main body structure and a sliding lock; the main body structure consists of upper and lower main body plates which are separately arranged, and a polyester tensile belt coated around the upper and lower main body plates; a middle part of the main body structure is provided with a bone-accommodating groove; middles parts of two sides of the upper and lower main body plates are symmetrically provided with I-shaped support coupling shafts; upper shafts and lower shafts of the support coupling shafts are rotatably connected with the upper and lower main body plates through a pad respectively; and the sliding lock is positioned at one end of the main body structure. The angle adjustment function of the adjustable cervical interbody fusion cage makes the whole system more accord with the human body structure, facilitates the arrangement of the system, and integrates the system into a support structure of the vertebral column to accord with the human body mechanics, and the excellent postoperative fusion also reduces hazards of fracture and removal of an anterior cervical spine steel plate and a bolt.

Description

A kind of adjustable cervical spine Invasive lumbar fusion device

Technical field

The present invention relates to a kind of medical operation utensil,, belong to field of medical article technology especially for the adjustable cervical spine Invasive lumbar fusion device of anterior cervical operation.

Background technology

Cervical spondylotic myelopathy and cervical spondylotic radiculopathy are commonly encountered diseases, the frequently-occurring diseases of mid-aged population, and along with the change of life style, its sickness rate also improves year by year, and demonstrate the trend of rejuvenation.The pathogenesis of cervical spondylosis is outstanding backward or interior spinal cord and the nerve root of vertebral body trailing edge hyperosteogeny formation hyperosteogeny compressing cervical spinal canal behind the intervertebral disc degradation; Because a little less than the neurocyte in the myeloid tissue is highly brittle, oppress function of nervous system that pathological change such as caused hypoxic-ischemic causes lose irreversible.Therefore answer the early operation treatment to remove compressing for cervical spondylotic myelopathy, also should take positive operative treatment for the root property cervical spondylosis of serious symptom.Anterior cervical decompression bone graft fusion (being called for short ACDF) is the standard procedures method of treating cervical spondylotic myelopathy and cervical spondylotic radiculopathy at present clinically.Its principle is the vertebral body through outstanding intervertebral disc, outgrowth hyperosteogeny even whole narrow sections of cervical vertebra excision; After excision causes laminated structure; Prop up a support bone piece or an Invasive lumbar fusion device (Cage or titanium net) in implanting between the sections up and down of pathological changes, with height and the sagittal sequence of keeping intervertebral.(material is a polyether-ether-ketone, and is PEEK) because of its good biocompatibility, easy to use, becomes the new material that is applied to spinal surgery in recent years for said titanium cylinder mould and cage.Titanium cylinder mould and cage are hollow structure, can fill sclerotin therebetween and the stability of spine structure is provided.The spongy bone of excision vertebral body can satisfy the filling of cylinder mould or cage in the art.Autologous ilium and titanium net follow-up investigation at a specified future date is shown: titanium cylinder mould and cage are superior to ilium at the long-term effect of keeping aspect vertebral height and the lordosis, and vertebral height at a specified future date is lost not obvious, has progressively replaced now from three cortical bones of body.But also there are some cases postoperative and long term follow-up to find the cervical curvature poor recovery.Through finding to the difficulty analysis that run in the anterior cervical decompression bone-graft fusion operation and to patient's postoperative long term follow-up; Titanium cylinder mould and cage itself exist following problem to cause its operability and modulability poor: 1) though cervical vertebra titanium cylinder mould can prune; But mainly judge angle with patient's experience; Its operating system does not also quantize its angle, and because the titanium cylinder mould costs an arm and a leg the disposable pruning success of should trying one's best.If implant intervertebral space after find that angle is relatively poor after the C type arm X-ray shooting inspection in the art, also can not in intervertebral space, do any adjustment to its angle.At this moment, pruning can cause titanium cylinder mould height to lose again, need spend the plenty of time and change the titanium cylinder mould.This impacts operation rhythm undoubtedly, and operating time is prolonged, and increases the patient suffering.And extract the titanium cylinder mould and will inevitably cause damage, postoperative syncretizing effect, disc height are recovered and maintenance generation harmful effect neck bone property soleplate.2) used clinically cervical cage is polyether-ether-ketone (PEEK) material mostly, and it is once property machine-shaping on production line, though can select different models in the art, model is very limited, can not satisfy the multiformity of numerous conditions of patients at all.Can not prune cage in the operation process, promptly can not do any adjustment, not have adjustability its intrinsic height and angle.If find that the cage angle is improper, also can not carry out any adjustment to it behind the implantation intervertebral space, must powerful intervertebral space be also extracted in its hammering gradually and change cage, this can produce vibrations to spinal cord undoubtedly, and can destroy bone property soleplate in various degree.

Summary of the invention

The present invention is used to overcome the defective of above-mentioned prior art and a kind of adjustable cervical spine Invasive lumbar fusion device that satisfies different patient's multiformity needs, is convenient to operation technique is provided.

The alleged problem of the present invention is solved by following technical scheme:

A kind of adjustable cervical spine Invasive lumbar fusion device; Its special feature is: comprise agent structure and sliding latch device in the formation; Said agent structure constitutes by separating the upper and lower main board that is provided with and being coated on upper and lower main board polyester tension force ligament all around; Appearance bone groove is set at the agent structure middle part; The dual-side middle part of said upper and lower main board is symmetrical set I shape and supports universal driving shaft, and the upward axle and the lower shaft that support universal driving shaft are rotationally connected through liner and upper and lower main board respectively, and said sliding latch device is positioned at an end of agent structure.

Above-mentioned adjustable cervical spine Invasive lumbar fusion device; Said sliding latch device is made up of upper and lower locking plate; Upper and lower locking plate is affixed upper and lower main board respectively; The ratchet of mutual coupling engagement is set respectively on the upper and lower locking plate contact surface, and following locking plate is provided with lock groove, is provided with lock bolt with the lock groove correspondence position on the last locking plate.

Above-mentioned adjustable cervical spine Invasive lumbar fusion device, the last main board upper surface of said agent structure, last main board lower surface are provided with anti-slide teeth.

Above-mentioned adjustable cervical spine Invasive lumbar fusion device, the end face that said agent structure is installed the sliding latch structure is provided with the apparatus connecting hole.

The present invention is directed to existing cervical fusion cage applicable surface narrow, can not adjust and art in problem such as operation inconvenience improve; On the basis of existing cage, set up the side and supported universal driving shaft, peripheral polyester tension force ligament, sliding latch device and anti-skidding design; Its main feature is following: 1) the present invention is implanted between the vertebral body; Constitute three-dimensional fixation, the universal driving shaft structure is supported in the power of providing support in its side, also can play the connection and the axle property motion effect of similar human synovial.This structure can keep or increase disc height, prevents to subside and kyphosis deformity, thereby enlarges intervertebral foramina, alleviates nerve root compression, ligament and fibrous ring elastic force is improved and increase canalis spinalis anteroposterior diameter.The present invention can accomplish the angular displacement in the certain limit, satisfies the durability requirements of cervical vertebra, and can make and merge sections and reach enough instant stable and reach satisfied combination; 2) the present invention follows the notion of human anatomic structure globality; Using its angle regulating function makes whole system more meet organization of human body; Not only made things convenient for the arrangement of system; The supporting construction that more makes system incorporate spinal column meets the body mechanics, and the good fusion of postoperative has also reduced the risk factor that throat road steel plate and screw fracture, pull out; 3) the present invention periphery polyester tension force is tough has good toughness, anti-tractive property and can provide than high tension; Acting as the adjustable Invasive lumbar fusion device angle of restriction at this excessively adjusts; And in intervertebral space adjustment angle process trickle plant bone mass deviates to fall into canalis spinalis from the fusion device gap defective, the appearance of having stopped the vertebra pressure symptom of plant bone mass source property have been overcome fully; 4) resistance to compression type and tensile type sliding latch device can play the reliable fixation effect, and anti-skidding ratchet can effectively prevent the displacement of agent structure postoperative in the fixing back of locking, have also just avoided following up a case by regular visits to the phenomenon that loss angle changes in the process fully; 5) the present invention is simple to operate, can effectively reduce operating time, hommization more, has satisfied the multifarious needs of different conditions of patients, has solved common problem through simple structure, is easy to grasp promote.

Description of drawings

Fig. 1 is a structural representation of the present invention;

Fig. 2 is the right view of Fig. 1;

Fig. 3 is the vertical view of Fig. 1;

Fig. 4 is the A-A cutaway view of Fig. 3;

Fig. 5 is the B-B cutaway view of Fig. 3;

Fig. 6 goes up the locking plate sketch map;

Fig. 7 is following locking plate sketch map;

Fig. 8 is a resistance to compression type sliding latch device;

Fig. 9 is a tensile type sliding latch device;

Figure 10 is that the present invention implants the cervical intervertebral sketch map.

Label is represented as follows among the figure: descend main board 1.; 2. go up main board; 3. go up locking plate; 3-1. lock bolt; 3-2. last locking plate ratchet; 4. descend locking plate; 4-1. lock groove; 4-2. following locking plate ratchet; 5. polyester tension force ligament; 6. hold bone groove, 7. hold-down screw; 8. apparatus connecting hole; 9. support universal driving shaft; 10. anti-slop serrations; 11. liner.

The specific embodiment

Referring to Fig. 1-3; The present invention comprises agent structure and sliding latch device in constituting; Said agent structure is by main board 2 on two rectangles that separate to be provided with up and down, main board 1 and the polyester tension force ligament 5 that is coated on around the upper and lower main board constitute down, and upper and lower main board adopts polyether-ether-ketone (PEEK) material, and their form the framework of agent structure; Appearance bone groove 6 is set at the agent structure middle part, and said sliding latch device is used to adjust and lock the relative position of main board up and down.

Referring to Fig. 4, Fig. 5; Be symmetrical set I shape at the dual-side middle part of upper and lower main board and support universal driving shaft 9; The upward axle of this support universal driving shaft and lower shaft form with upper and lower main board through liner 11 respectively and are rotationally connected, and support universal driving shaft 9 and liner 11 and are titanium spare.Support universal driving shaft when providing support power for agent structure; Also can play the connection and the motion effect of similar human synovial; Make angle between the upper and lower main board that the range of accommodation of tens degree can be arranged, agent structure periphery polyester tension force ligament 5 plays the excessively effect of adjustment of angle between the upper and lower main board of restriction.

Referring to Fig. 1, Fig. 2, Fig. 4; Said sliding latch device is installed in an end of agent structure; The sliding latch device is by last locking plate 3, locking plate 4 is formed down, and last locking plate inserts in the groove of following locking plate, and upper and lower locking plate is affixed by trip bolt 7 and upper and lower main board respectively.Visible by Fig. 1, Fig. 4 and Fig. 6, Fig. 7; Ratchet 3-2, the 4-2 of mutual coupling engagement are set respectively on the contact surface of upper and lower locking plate; For ease of slip adjustment and cross spacing and have locking action; Infra locking plate 4 is provided with lock groove 4-1, and the position corresponding with lock groove is provided with lock bolt 3-1 on last locking plate 3.Visible by Fig. 8, Fig. 9, the ratchet direction of upper and lower locking plate is different, and it is decide according to different patients' needs, when reverse as if patient's cervical curvature, uses resistance to compression type sliding latch device shown in Figure 8; If when patient's cervical vertebra is anteflexion, use tensile type sliding latch device shown in Figure 9.

Referring to Fig. 2, on the end face of agent structure installation sliding latch device, be provided with operating theater instruments connecting holes 8 such as introducer, dilator, approximator.

Referring to Fig. 3, Fig. 4, the last main board upper surface of agent structure, last main board lower surface are provided with anti-slop serrations 10.

Effect and concrete applying step when the present invention is used for being correlated with cervical operation are following:

1) patient gets dorsal position after anaesthetizing successfully, gets the throat otch after the sterilization shop is single, appears the place ahead of pathological changes cervical vertebra sections and adjacent segment vertebral body the place ahead of lesion segment downwards through the sternocleidomastoid inner edge.

2) adopt conventional ACDF method, intervertebral disc, the hyperosteogeny of excision lesion segment are struck off hypocentrum cartilage endplate cartilage to oozing of blood, keep bone property soleplate, thoroughly are decompressed to spinal cord the place ahead.

3) use height measuring gauge and draw disc height, select the adjustable cervical spine Invasive lumbar fusion device of proper height according to measurement data in the art.The adjustable cervical spine Invasive lumbar fusion device has the angle of regulation range of tens degree, and it can carry out angular adjustment in intervertebral space.In the art decompression place being filled in adjustable Invasive lumbar fusion device from the body spongy bone holds in the bone groove 6.Use introducer and directly it is implanted intervertebral space.

4) after the adjustable cervical spine Invasive lumbar fusion device is implanted the lesion segment intervertebral space; Take off introducer, locate through C type arm in cervical vertebra side position X-ray film and the art before patient's art and judge that cervical curvature is excessively anteflexion or curvature is reverse: excessive anteflexion selection approximator and tensile type sliding latch device; Curvature is oppositely then selected dilator and resistance to compression type sliding latch device.

5) patient's cervical vertebra is excessive when anteflexion, in the art approximator is connected with the adjustable cervical spine Invasive lumbar fusion device and carries out angle adjustment, can and can further adjust through C type arm inspection cervical curvature recovery situation afterwards.Adjustable Invasive lumbar fusion device sharpest edges are can carry out dynamically adjustment of whole process through the observation of C type arm, recover the patient physiological curvature its appearance bone groove interface and bone property soleplate are fitted tightly.Afterwards tensile type sliding latch device is installed in agent structure one end, and inserts hold-down screw 7 lockings.Adjustment tensile type sliding latch device makes between ratchet engagedly, uses lock bolt 3-1 to its locking and pressurizing.When patient's cervical curvature is reverse, use dilator in the art and carry out angle adjustment, recover the patient physiological curvature; Resistance to compression type sliding latch device is installed in agent structure one end and locking; Adjustment resistance to compression type sliding latch device makes between latch engagedly, uses lock bolt 3-1 to its locking and pressurizing.

6) the throat road steel plate of selection appropriate length is placed in the place ahead of merging the sections vertebral body, is screwed into four pieces of hold-down screws and fixes.

7) the back layer-by-layer suture that irrigates, operation finishes.

Claims

1. adjustable cervical spine Invasive lumbar fusion device; It is characterized in that: it comprises agent structure and sliding latch device; Said agent structure constitutes by separating the upper and lower main board (2,1) that is provided with and being coated on upper and lower main board polyester tension force ligament (5) all around; At the agent structure middle part appearance bone groove (6) is set; The dual-side middle part of said upper and lower main board is symmetrical set I shape and supports universal driving shaft (9), and the upward axle and the lower shaft that support universal driving shaft are rotationally connected through liner (11) and upper and lower main board respectively, and said sliding latch device is positioned at an end of agent structure.

2. adjustable cervical spine Invasive lumbar fusion device according to claim 1; It is characterized in that: said sliding latch device is made up of upper and lower locking plate (3,4); Upper and lower locking plate is affixed upper and lower main board respectively; The ratchet (3-2,4-2) of mutual coupling engagement is set respectively on the upper and lower locking plate contact surface, and following locking plate is provided with lock groove (4-1), is provided with lock bolt (3-1) with the lock groove correspondence position on the last locking plate.

3. adjustable cervical spine Invasive lumbar fusion device according to claim 2 is characterized in that: the last main board upper surface of said agent structure, last main board lower surface are provided with anti-slop serrations (10).

4. according to claim 1 or 2 or 3 described adjustable cervical spine Invasive lumbar fusion devices, it is characterized in that: the end face of the sliding latch device that said agent structure is installed is provided with apparatus connecting hole (8).