CN109009581B - Assembled artificial vertebral body - Google Patents
Assembled artificial vertebral body Download PDFInfo
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- CN109009581B CN109009581B CN201811065731.9A CN201811065731A CN109009581B CN 109009581 B CN109009581 B CN 109009581B CN 201811065731 A CN201811065731 A CN 201811065731A CN 109009581 B CN109009581 B CN 109009581B
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- 238000010146 3D printing Methods 0.000 claims abstract description 13
- 210000000988 bone and bone Anatomy 0.000 claims description 66
- 210000000115 thoracic cavity Anatomy 0.000 claims description 5
- 229910003460 diamond Inorganic materials 0.000 claims description 4
- 239000010432 diamond Substances 0.000 claims description 4
- 239000011148 porous material Substances 0.000 claims description 4
- 230000000712 assembly Effects 0.000 claims description 3
- 238000000429 assembly Methods 0.000 claims description 3
- 230000007704 transition Effects 0.000 claims description 3
- 238000004519 manufacturing process Methods 0.000 abstract description 9
- 238000010923 batch production Methods 0.000 abstract description 2
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 21
- 239000010936 titanium Substances 0.000 description 20
- 229910052719 titanium Inorganic materials 0.000 description 20
- 230000004927 fusion Effects 0.000 description 11
- 239000004698 Polyethylene Substances 0.000 description 9
- 230000009286 beneficial effect Effects 0.000 description 9
- -1 polyethylene Polymers 0.000 description 9
- 229920000573 polyethylene Polymers 0.000 description 9
- 238000002513 implantation Methods 0.000 description 8
- 239000007787 solid Substances 0.000 description 8
- 238000009434 installation Methods 0.000 description 6
- 208000037959 spinal tumor Diseases 0.000 description 6
- 230000000694 effects Effects 0.000 description 5
- 238000005516 engineering process Methods 0.000 description 5
- 230000002980 postoperative effect Effects 0.000 description 4
- 238000007639 printing Methods 0.000 description 4
- 230000008467 tissue growth Effects 0.000 description 4
- 206010028980 Neoplasm Diseases 0.000 description 3
- 239000007943 implant Substances 0.000 description 3
- 230000007774 longterm Effects 0.000 description 3
- 238000012856 packing Methods 0.000 description 3
- 201000011510 cancer Diseases 0.000 description 2
- 230000009194 climbing Effects 0.000 description 2
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- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 2
- 230000005484 gravity Effects 0.000 description 2
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- 210000005036 nerve Anatomy 0.000 description 2
- 230000000149 penetrating effect Effects 0.000 description 2
- 238000002271 resection Methods 0.000 description 2
- 208000024891 symptom Diseases 0.000 description 2
- 206010005949 Bone cancer Diseases 0.000 description 1
- 206010028836 Neck pain Diseases 0.000 description 1
- 208000002193 Pain Diseases 0.000 description 1
- 208000000133 Spinal Neoplasms Diseases 0.000 description 1
- 241001079814 Symphyotrichum pilosum Species 0.000 description 1
- 235000004224 Typha angustifolia Nutrition 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 238000007792 addition Methods 0.000 description 1
- 230000006837 decompression Effects 0.000 description 1
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- 230000002349 favourable effect Effects 0.000 description 1
- 238000005242 forging Methods 0.000 description 1
- 230000001771 impaired effect Effects 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 230000000366 juvenile effect Effects 0.000 description 1
- 210000004705 lumbosacral region Anatomy 0.000 description 1
- 230000036210 malignancy Effects 0.000 description 1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
-
- 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
- A61F2002/448—Joints for the spine, e.g. vertebrae, spinal discs comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
- A61F2002/4485—Joints for the spine, e.g. vertebrae, spinal discs comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants comprising three or more adjacent spinal implants
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Neurology (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
The invention discloses a combined artificial vertebral body, which is formed by combining an upper fixed body, a lower fixed body and a middle connecting body, wherein the upper fixed body and the lower fixed body are fixed parts, and the middle connecting body is a universal part; the custom piece is a personalized accessory formed according to 3D printing, and the universal piece is a batched standard piece. The personalized design of the contact surfaces of the upper fixing body and the lower fixing body with the vertebral body meets the requirement of accurate medical treatment, the middle connecting body is a batched standard part, and the cost of the whole artificial vertebral body can be greatly reduced through batch production, so that the personalized treatment requirement under lower cost is realized through the combination of the fixing part and the universal part, the requirement of patients is met, and the popularization space and the receiving degree of personalized treatment are enlarged; on the other hand, the upper fixing body and the lower fixing body are only required to be individually designed, so that the requirement of individual design is simplified, the manufacturing time and the consumption are shortened, and the flexible design of an individual scheme is facilitated.
Description
Technical Field
The invention belongs to the technical field of medical implant prostheses, and relates to a combined artificial vertebral body.
Background
Spinal neoplasms (spinal tumor) refer to primary and secondary neoplasms that occur in the spine. The overall incidence of primary spinal tumors is about 0.4%. Most juvenile spinal tumors are benign, while young and middle-aged patients have a high likelihood of malignancy. Benign tumors involve more posterior structures, while malignant tumors involve more vertebral bodies. Primary benign spinal tumors generally progress slowly and have long disease course; malignant spinal tumors progress faster, the course of disease is short, and clinical symptoms appear faster, accounting for about 10% of new malignant bone tumors every year. Aiming at malignant spinal tumors affecting spinal stability, surgical tumor excision and internal fixation of the spinal column are generally adopted to achieve the purposes of relieving symptoms and maintaining spinal stability, and the traditional internal fixation of the spinal column generally adopts a titanium cage to replace an original pathological change vertebral body, but due to the limitation of the manufacturing process and specification of the titanium cage, the titanium cage cannot be completely matched with a patient affected part, so that the titanium cage slips, displaces and even the vertebral body collapses, the use risk is increased especially when the vertebral body at the position with larger stress such as lumbar vertebra is replaced, and secondary injury and pain are caused to the patient.
However, the related postoperative follow-up study finds that the sinking and collapsing condition of the titanium cage occurs in part of patients, and the postoperative curative effect of the patients is affected. YuChen et al performed post-operative follow-up for 300 patients who performed cervical vertebral sub-total resection decompression in combination with titanium cage bone fusion. Follow-up results revealed that 182 (60.7%) patients had mild titanium cage collapse (1-3 mm) and 57 patients had severe titanium cage collapse (> 3 mm). Compared with a patient without titanium cage collapse after operation, the nerve function recovery condition of the patient with titanium cage collapse is obviously lower than that of the patient with titanium cage collapse. Serious titanium cage collapse can lead to complications such as neck pain, impaired nerve function, failure to fix, and the like. (ChenY, chenDY, guoYF, etal.SubsidenceofTitaniumMesh CageAStudyBase don, 300Cases [ J ]. Journ spinalalryldistresses & Techniques,2008,21 (7): 489-492.) causes post-operative collapse of the titanium cage due to the small contact area of the titanium cage with the vertebral endplates. In the conventional titanium cage implantation process, the length of the titanium cage needs to be trimmed to the length of the bone groove. One surface of the titanium cage which is not cut is of a smooth structure, and has 6 flat contact points, and the cut end is 12 sharp contact points in most cases. The point contact mode causes larger pressure load on the surface of the vertebral endplate, which is easy to cause the destruction of the vertebral endplate structure to lead the titanium cage to penetrate into the vertebral body and cause the titanium cage to collapse (Xu Jianwei, gu Lianshun, chen Deyu, et al, discussion of early collapse of the titanium mesh bone graft of the cervical anterior vertebral body by secondary total excision [ J ]. J2002,10 (z 1): 1267-1269).
The 3D printing technology is a technology for constructing an object by using a bonding material such as powdered metal or plastic in a layer-by-layer printing manner based on a digital model. Compared with the traditional manufacturing technology, the 3D printing technology has the following advantages: (1) saving materials and manufacturing costs. (2) And large forging equipment and special dies are not needed, so that the manufacturing time is saved, and the manufacturing efficiency is improved. (3) products with complex structures and difficult processing can be manufactured. (4) available for personalized customization. With the advantages, the 3D printing technology has great application value in manufacturing human implants.
Disclosure of Invention
The invention solves the problem of providing a combined artificial vertebral body, which is formed by combining a customized piece and a universal piece, wherein the customized piece meets the personalized requirement, the universal piece can be selected and replaced, and the defects of unstable installation of the traditional titanium cage prosthesis and single body number of the traditional customized artificial vertebral body are overcome.
The invention is realized by the following technical scheme:
the assembled artificial vertebral body is formed by assembling an upper fixing body, a lower fixing body and a middle connecting body, wherein the upper fixing body and the lower fixing body are fixed parts, and the middle connecting body is a universal part; the custom piece is a personalized accessory based on 3D printing and forming, and the universal piece is a standard piece prepared in batches;
the upper fixing body comprises an upper spandrel girder, an upper cone contact surface and an assembly boss, wherein the upper spandrel girder is of a bearing structure, and a plurality of conical fixing thorns are uniformly distributed on the upper surface of the upper spandrel girder; the upper vertebral body contact surface is a porous structure arranged between the upper bolster and is also provided with a hollow bone grafting hole; the upper cone contact surface and the upper bolster are personalized designs matched with the anatomical shape of the cone surface which is contacted with the upper bolster; the assembling boss is positioned at the bottom of the upper fixing body and is matched with the shape of the middle connecting body;
the lower fixing body comprises a lower spandrel girder, a lower cone contact surface and an assembly boss, wherein the lower spandrel girder is of a bearing structure, and a plurality of conical fixing thorns are uniformly distributed on the lower surface of the lower spandrel girder; the lower cone contact surface is a porous structure arranged between the lower bolster and is also provided with a hollow bone grafting hole; the lower cone contact surface and the lower bolster are personalized designs matched with the anatomical shape of the cone surface which is contacted with the lower bolster; the assembling boss is positioned at the top of the lower fixing body and is matched with the shape of the middle connecting body;
the middle connector consists of a solid middle frame and a hollow structure between the solid middle frame and the middle frame, and the middle space forms a bone grafting cavity; the middle frame is formed by connecting a middle cross beam and a longitudinal beam, and the upper end and the lower end of the middle connecting body are respectively provided with a connecting structure; the middle connector is provided with various length specification models.
The upper fixing body, the lower fixing body and the middle connecting body are assembled through the connecting assembly:
the connecting component is a soft gasket with an annular structure, the inner wall and the outer wall of the soft gasket are both provided with annular buckles, and the cross section of each annular buckle is of a semicircular convex structure; the inner wall annular buckle is matched with the assembling boss, and the outer wall annular buckle is matched with the middle connector;
the connecting components are respectively arranged at the outer edges of the assembling bosses of the upper fixing body and the lower fixing body, and the inner walls of the connecting components are respectively meshed with the outer walls of the assembling bosses; the connecting assembly is used for respectively installing the upper fixing body and the lower fixing body on the middle connecting body, the annular buckle on the outer wall of the connecting assembly is meshed with the inner wall of the connecting structure of the middle connecting body, and after assembly, all the assemblies are fastened and connected.
The upper fixing body, the lower fixing body and the middle connecting body are assembled as follows:
the connecting structures of the assembling boss of the upper fixing body and the upper end of the middle connecting body are respectively conical surfaces matched with each other, and the assembling boss and the connecting structure are in interference fit with each other; when the upper fixing body is pressed from top to bottom, the conical surface of the assembling boss of the upper fixing body is sleeved on the inner side of the conical surface at the upper end of the middle connecting body, and the fastening connection is obtained by the pressure from top to bottom and the elastic pressure of the surface of the contact surface;
the connecting structure at the lower end of the middle connecting body and the assembling boss of the lower fixing body are respectively conical surfaces matched with each other, and the connecting structure and the assembling boss are in interference fit with each other; when the pressure from top to bottom is applied, the conical surface of the connecting structure at the lower end of the middle connecting body is sleeved outside the assembling boss of the lower fixing body, and the fastening connection is obtained by the pressure from top to bottom and the elastic pressure of the surface of the contact surface.
The extension nesting length of the assembly boss of the upper fixing body and the assembly boss of the lower fixing body is 1/4-1/3 of that of the middle connecting body; the extended part of the assembling boss consists of a frame body matched with the middle connecting body and a hollow structure; the frame bodies contacted with the middle connector are respectively inclined inwards; the assembling boss of the upper fixing body and the assembling boss of the lower fixing body are symmetrical.
The inclination angles of the assembly boss of the upper fixing body and the assembly boss of the lower fixing body and the vertical direction are 2-5 degrees; sufficient bone ingrowth space is reserved between the assembly protrusions which are embedded into the middle connector in an extending manner and the bone grafting cavities of the middle connector.
The hollow structure of the extension part can induce the bone grafting inside the vertebral body to grow from inside to outside, so that the components of the artificial vertebral body are connected in a bone manner.
The middle frame of the middle connector is of a waisted structure, the cross section structure of the middle cross beam is nearly circular or elliptical, and the horizontal longest distance of the middle cross beam is 0.8-0.9 times of the horizontal longest distance of the upper bolster;
the longitudinal beams are respectively smooth connection of the middle cross beam corresponding to the upper bolster and the lower bolster in the vertical directions of different nodes, and have certain curvature;
the hollow structure is a reticular structure formed by dodecahedron or diamond structural units of each supporting node, the pore diameter of each reticular unit in the reticular structure is 0.3-0.6 mm, and the wire diameter is 0.2-0.4 mm.
The upper surface of the upper bolster is uniformly provided with a plurality of conical fixing thorns, and the lower surface of the lower bolster is uniformly provided with a plurality of conical fixing thorns; the intersection of the middle cross beam and the longitudinal beam is in arc transition connection.
The universal parts are prepared in batches based on 3D printing and forming and are divided into various types and specifications according to different parts;
if the two-dimensional artificial cervical vertebra is used for thoracic vertebra segments, the length of the two-dimensional artificial cervical vertebra is 15-30 mm, and each specification is 1-5mm apart;
if used for lumbar vertebrae segments, the length is 30-40mm, and each specification is 1-5mm apart.
Screw fixing edges are respectively arranged in front of the sides of the upper fixing body and the lower fixing body, and screw fixing holes are formed in the screw fixing edges.
Compared with the prior art, the invention has the following beneficial technical effects:
the invention provides a combined artificial vertebral body, wherein an upper fixed body and a lower fixed body are personalized customized parts, a middle connecting body is a batched standard part, and the fastening of components is completed through combination; the personalized design of the contact surfaces of the upper fixing body and the lower fixing body with the vertebral body meets the requirement of accurate medical treatment, the middle connecting body is a batched standard part (all three can be realized by 3D printing forming), the cost of the whole artificial vertebral body can be greatly reduced through batch production (only the set parameters can be manufactured and formed when 3D printing is carried out), and therefore, the personalized treatment requirement under the lower cost is realized through the combination of the fixing part and the universal part, the requirement of patients is met, and the popularization space and the receiving degree of personalized treatment are enlarged; on the other hand, the upper fixing body and the lower fixing body are only required to be individually designed, so that the requirement of individual design is simplified, the manufacturing time and the consumption are shortened, and the flexible design of an individual scheme is facilitated.
The assembled artificial vertebral body provided by the invention has the advantages that the fastening of the upper fixing body, the lower fixing body and the middle connecting body can meet the fastening requirement of the whole assembly through assembly connection or structural fit; the soft gaskets are assembled to realize complete close fit, have certain deformability, bring a certain fine tuning space for the artificial vertebral body and improve the application range of the artificial vertebral body; when the two are assembled by interference fit of the conical surfaces, the conical surfaces with the inclined angles enable the two to be assembled more easily; by utilizing the interference fit principle, the artificial vertebral body is pressed from top to bottom by the gravity of a patient after implantation, and simultaneously the elastic pressure is generated on the surface of the contact surface, so that the tight connection is obtained; and the bone grafting inside the vertebral body grows from inside to outside through the extension part, so that the osseous connection among all components of the artificial vertebral body is finally realized, and the assembly is more stable and firm.
Drawings
FIG. 1 is a schematic diagram of the structure of the present invention;
FIG. 2 is a schematic perspective view of the present invention;
FIG. 3 is a schematic view of an exploded view of an embodiment of the present invention connected by a module;
FIG. 4 is a schematic view of an explosion structure of an embodiment of the invention with tapered surface connection;
FIG. 5 is a schematic view of the upper fixture of the present invention;
FIG. 6 is a second schematic view of the upper fixture of the present invention;
FIG. 7 is a schematic view of a lower fixture according to the present invention;
FIG. 8 is a second schematic view of the structure of the lower fixture of the present invention;
FIG. 9 is a schematic view of the structure of the middle connector of the present invention;
FIG. 10 is a cross-sectional view of a middle connector of the present invention;
FIG. 11 is a schematic view of a connecting assembly according to the present invention;
FIG. 12 is a schematic view of a taper connection according to the present invention;
FIG. 13 is a third schematic view of the upper fixture of the present invention;
FIG. 14 is a third schematic view of the structure of the lower fixture of the present invention.
Wherein 1 is an upper fixing body; 2 is a middle connector; 3 is a lower fixing body; 4 is a hollow structure; 5 is a connecting component; 6 is a conical fixing thorn; 7 is the upper cone contact surface; 8 is a bone grafting hole; 9 is an upper bolster; 10 is an assembly boss; 11 is an annular groove; 12 is the inferior cone contact surface; 13 is a lower bolster; 14 longitudinal beams; 15 middle cross beams; 16 is an assembly groove; 17 is a bone grafting cavity; 18 is a conical surface.
Detailed Description
The invention will now be described in further detail with reference to specific examples, which are intended to illustrate, but not to limit, the invention.
Referring to fig. 1-4, an assembled artificial vertebral body is assembled by an upper fixing body, a lower fixing body and a middle connecting body, wherein the upper fixing body and the lower fixing body are fixing parts, and the middle connecting body is a universal part; the custom piece is a personalized accessory based on 3D printing and forming, and the universal piece is a standard piece prepared in batches;
the upper fixing body comprises an upper spandrel girder, an upper cone contact surface and an assembly boss, and the upper spandrel girder is of a bearing structure; the upper vertebral body contact surface is a porous structure arranged between the upper bolster and is also provided with a hollow bone grafting hole; the upper cone contact surface and the upper bolster are personalized designs matched with the anatomical shape of the cone surface which is contacted with the upper bolster; the assembling boss is positioned at the bottom of the upper fixing body and is matched with the shape of the middle connecting body;
the lower fixing body comprises a lower spandrel girder, a lower cone contact surface and an assembly boss, and the lower spandrel girder is of a bearing structure; the lower cone contact surface is a porous structure arranged between the lower bolster and is also provided with a hollow bone grafting hole; the lower cone contact surface and the lower bolster are personalized designs matched with the anatomical shape of the cone surface which is contacted with the lower bolster; the assembling boss is positioned at the top of the lower fixing body and is matched with the shape of the middle connecting body;
the middle connector consists of a middle frame and a hollow structure between the middle frame and the middle frame, and the middle space forms a bone grafting cavity; the middle frame is formed by connecting a middle cross beam and a longitudinal beam, and the upper end and the lower end of the middle connecting body are respectively provided with a connecting structure; the middle connector is provided with various length specification models.
Referring to fig. 2, 3, and 5-8, the upper fixing body, the lower fixing body, and the middle connecting body are assembled by a connecting assembly:
the connecting component is a soft gasket with an annular structure, the inner wall and the outer wall of the soft gasket are both provided with annular buckles, and the cross section of each annular buckle is of a semicircular convex structure; the inner wall annular buckle is matched with the assembling boss, and the outer wall annular buckle is matched with the middle connector;
the connecting components are respectively arranged at the outer edges of the assembling bosses of the upper fixing body and the lower fixing body, and the inner walls of the connecting components are respectively meshed with the outer walls of the assembling bosses; the connecting assembly is used for respectively installing the upper fixing body and the lower fixing body on the middle connecting body, the annular buckle on the outer wall of the connecting assembly is meshed with the inner wall of the connecting structure of the middle connecting body, and after assembly, all the assemblies are fastened and connected.
Referring to fig. 4, 12-14, the upper fixing body, the lower fixing body and the middle connecting body are assembled as follows:
the connecting structures of the assembling boss of the upper fixing body and the upper end of the middle connecting body are respectively conical surfaces matched with each other, and the assembling boss and the connecting structure are in interference fit with each other; when the upper fixing body is pressed from top to bottom, the conical surface of the assembling boss of the upper fixing body is sleeved on the inner side of the conical surface at the upper end of the middle connecting body, and the fastening connection is obtained by the pressure from top to bottom and the elastic pressure of the surface of the contact surface;
the connecting structure at the lower end of the middle connecting body and the assembling boss of the lower fixing body are respectively conical surfaces matched with each other, and the connecting structure and the assembling boss are in interference fit with each other; when the pressure from top to bottom is applied, the conical surface of the connecting structure at the lower end of the middle connecting body is sleeved outside the assembling boss of the lower fixing body, and the fastening connection is obtained by the pressure from top to bottom and the elastic pressure of the surface of the contact surface.
Specifically, referring to fig. 5-8, the extension nesting length of the assembly boss of the upper fixing body and the assembly boss of the lower fixing body is 1/4-1/3 of that of the middle connecting body; the extended part of the assembling boss consists of a frame body matched with the middle connecting body and a hollow structure; the frame bodies contacted with the middle connector are respectively inclined inwards; the assembling boss of the upper fixing body and the assembling boss of the lower fixing body are symmetrical.
Specifically, the inclination angles of the assembling boss of the upper fixing body and the assembling boss of the lower fixing body and the vertical direction are 2-5 degrees; and enough bone ingrowth space is reserved between the extended assembling boss embedded in the middle connector and the bone grafting cavity of the middle connector. The hollow structure of the extension part can induce the bone grafting inside the vertebral body to grow from inside to outside, so that the components of the artificial vertebral body are connected in a bone manner.
Referring to fig. 9 and 10, the middle frame of the middle connector is of a waisted structure, the cross section of the middle cross beam is of a nearly circular or oval shape, and the horizontal longest distance of the middle cross beam is 0.8-0.9 times of the horizontal longest distance of the upper bolster;
the longitudinal beams are respectively smooth connection of the middle cross beam corresponding to the upper bolster and the lower bolster in the vertical directions of different nodes, and have certain curvature;
the hollow structure is a reticular structure formed by dodecahedron or diamond structural units of each supporting node, the pore diameter of each reticular unit in the reticular structure is 0.3-0.6 mm, and the wire diameter is 0.2-0.4 mm.
The upper surface of the upper bolster is uniformly distributed with a plurality of conical fixing thorns, and the lower surface of the lower bolster is uniformly distributed with a plurality of conical fixing thorns.
Specifically, the universal parts are prepared in batches based on 3D printing and forming and are divided into various types and specifications according to different parts;
if the two-dimensional artificial cervical vertebra is used for thoracic vertebra segments, the length of the two-dimensional artificial cervical vertebra is 15-30 mm, and each specification is 1-5mm apart;
if used for lumbar vertebrae segments, the length is 30-40mm, and each specification is 1-5mm apart.
Referring to fig. 5 and 7, the upper bolster and the lower bolster are individually designed according to the contacted vertebral bodies, and the cross section structure of the middle cross beam is nearly circular or elliptical;
the intersection of the middle cross beam and the longitudinal beam is in arc transition connection;
the hollow structure is a reticular structure formed by dodecahedron or diamond structural units of each supporting node, the pore diameter of each reticular unit in the reticular structure is 0.3-0.6 mm, and the wire diameter is 0.2-0.4 mm.
Screw fixing edges are respectively arranged in front of the sides of the upper fixing body and the lower fixing body, and screw fixing holes are formed in the screw fixing edges.
Specific examples are given below.
Example 1
Referring to fig. 1-3 and fig. 5-8, the assembled artificial vertebral body provided by the invention consists of three parts, namely an upper fixed body, a lower fixed body and a middle connecting body, wherein the three parts are formed by 3D printing; the upper fixing body and the lower fixing body are fixing parts, and are custom designed and produced for printing according to the requirements of different patients; the middle connector is a universal piece, can be designed into various universal specifications and is printed in batches; the doctor selects a proper middle linking body to be assembled and connected with the customized printed upper fixing body and the customized printed lower fixing body according to specific conditions in the operation and then implants the customized printing upper fixing body and the customized printing lower fixing body into a patient. In addition, the product comprises two groups of polyethylene gaskets as connecting components, which are respectively arranged on the upper fixing body and the lower fixing body and are used for fastening the upper fixing body, the lower fixing body and the middle connecting body.
The upper fixing body comprises an upper cone contact surface, an upper spandrel girder and an assembly boss.
(1) The upper cone contact surface is designed in a personalized way according to the anatomical shape of the cone surface in contact with the upper cone contact surface, and is completely attached to the corresponding cone surface during installation; a bone grafting hole is arranged in the middle of the upper vertebral body contact surface and is used for filling bone tissues in the vertebral body; the whole upper vertebral body contact surface is designed into a porous structure, which is beneficial to the fusion of the artificial vertebral body and the bone surface of the corresponding upper vertebral body.
(2) The upper bolster is designed as a solid body and is a main bearing structure; further, a plurality of conical fixing thorns are uniformly distributed on the surface of the fixing thorns so as to strengthen the holding force and ensure that the vertebral body is fixed more firmly.
(3) The assembly boss is located the fixed body bottom of going up, and the outside designs two rings of annular grooves, and the ring channel cross-section is semi-circular sunk structure for match polyethylene packing ring.
(4) The inner wall of the upper fixing body is designed with a hollowed-out structure, which is beneficial to bone tissue climbing and growth.
The lower fixing body comprises a lower cone contact surface, a lower bolster and an assembly boss.
(1) The lower cone contact surface is designed in a personalized way according to the anatomical shape of the cone surface in contact with the lower cone contact surface, and is completely attached to the corresponding cone surface during installation; a bone grafting hole is arranged in the middle of the contact surface of the lower vertebral body and is used for filling bone tissue in the vertebral body; the whole contact surface of the lower vertebral body is designed into a porous structure, which is beneficial to the fusion of the artificial vertebral body and the bone surface of the corresponding lower vertebral body.
(2) The lower bolster is designed as a solid body and is a main bearing structure; the surface of the device is uniformly distributed with a plurality of conical fixing thorns, so that the holding force is enhanced, and the fixation of the vertebral body is more stable.
(3) The assembly boss is located the fixed body top down, and the outside designs two rings of annular grooves, and the ring channel cross-section is semi-circular sunk structure for match polyethylene packing ring.
(4) The inner wall of the lower fixing body is provided with a hollowed-out structure, which is favorable for bone tissue climbing and growth.
The middle connector integrally consists of a solid middle frame and an inner wall hollow structure, and comprises an assembly groove and a bone grafting cavity.
(1) The assembly groove is located middle part connector top, bottom respectively, and the inboard designs two rings of annular grooves, and the ring channel cross-section is semi-circular sunk structure for match polyethylene packing ring.
(2) The middle section of the middle connector is provided with a plurality of middle cross beams and longitudinal beams, the middle cross beams, the longitudinal beams and the assembly grooves integrally form a main bearing structure of the middle connector, a bone grafting cavity penetrating from top to bottom is formed in the main bearing structure, and the inner wall of the bone grafting cavity is provided with a hollow structure, so that bone tissue growth and fusion are facilitated.
(3) The middle connector is designed into various length specification models, can be produced in batch, and a doctor selects a proper model to be matched with other components for use according to actual conditions in different operations, so that the optimal operation effect is achieved.
In this embodiment, the connection assembly includes two sets of polyethylene washers, and the polyethylene washers are annular structure, and inner wall and outer wall design annular knot respectively, and annular knot cross-section is semi-circular protruding structure. When the assembly clamp is used, two groups of polyethylene gaskets are respectively arranged at the outer edges of the assembly bosses of the upper fixing body and the lower fixing body, and annular buckles on the inner wall of the polyethylene gaskets are respectively meshed with the assembly grooves at the top end and the bottom end of the middle connecting body; and then the upper fixing body and the lower fixing body are respectively arranged on the middle connecting body, at the moment, the annular buckles on the outer wall of the polyethylene gasket are respectively meshed with the assembly grooves (annular grooves), and after the assembly is completed, all components of the assembled artificial vertebral body reach a fastening state.
In the operation, the doctor can perform the operation steps of bone tissue filling, prosthesis installation and the like after the assembly is completed.
Example 2
Referring to fig. 1, fig. 4 and fig. 9-14, the assembled artificial vertebral body provided by the invention is composed of three parts, namely an upper fixing body, a lower fixing body and a middle connecting body, wherein the three parts are formed by 3D printing; the upper fixing body and the lower fixing body are customized to design and print in production according to the requirements of different patients, the middle connecting body is designed to print in batches in various general specification models, and the proper middle connecting body is selected to be assembled and connected with the customized printed upper fixing body and lower fixing body in a matched mode and implanted into the patients.
The upper fixing body comprises an upper cone contact surface, an upper spandrel girder and an assembling boss.
(1) The upper cone contact surface is designed by referring to the anatomical shape of the cone surface in contact with the upper cone contact surface, and is completely attached to the corresponding cone surface during installation; a bone grafting hole is arranged in the middle of the upper vertebral body contact surface and is used for filling bone tissues in the vertebral body; the whole upper vertebral body contact surface is designed into a porous structure, which is beneficial to the fusion of the artificial vertebral body and the bone surface of the corresponding upper vertebral body.
(2) The upper bolster is designed as a solid body and is a main bearing structure; the surface of the device is uniformly distributed with a plurality of conical fixing thorns, so that the holding force is enhanced, and the fixation of the vertebral body is more stable.
(3) The assembly boss is positioned at the bottom of the upper fixing body, a bone grafting cavity is designed in the assembly boss, and hollow structures are designed on the inner wall and the outer wall, so that bone tissue growth and fusion are facilitated; the assembling boss of the upper fixing body and the connecting structure at the upper end of the middle connecting body are respectively matched conical surfaces, and the assembling boss and the connecting structure are in interference fit; when the upper fixing body is pressed from top to bottom, the conical surface of the assembling boss of the upper fixing body is sleeved on the inner side of the conical surface of the upper end of the middle connecting body, and the fastening connection is obtained by the pressure from top to bottom and the elastic pressure of the surface of the contact surface.
The lower fixing body comprises a lower cone contact surface, a lower bolster and an assembly boss.
(1) The lower cone contact surface is designed by referring to the anatomical shape of the cone surface in contact with the lower cone contact surface, and is completely attached to the corresponding cone surface during installation; a bone grafting hole is arranged in the middle of the contact surface of the lower vertebral body and is used for filling bone tissue in the vertebral body; the whole contact surface of the lower vertebral body is designed into a porous structure, which is beneficial to the fusion of the artificial vertebral body and the bone surface of the corresponding lower vertebral body.
(2) The lower bolster is designed as a solid body and is a main bearing structure; the surface of the device is uniformly distributed with a plurality of conical fixing thorns, so that the holding force is enhanced, and the fixation of the vertebral body is more stable.
(3) The assembly boss is positioned at the bottom of the upper fixing body, a bone grafting cavity is designed in the assembly boss, and hollow structures are designed on the inner wall and the outer wall, so that bone tissue growth and fusion are facilitated; the connecting structure at the lower end of the middle connecting body and the assembling boss of the lower fixing body are respectively conical surfaces matched with each other, and the connecting structure and the assembling boss are in interference fit with each other; when the pressure from top to bottom is applied, the conical surface of the connecting structure at the lower end of the middle connecting body is sleeved outside the assembling boss of the lower fixing body, and the fastening connection is obtained by the pressure from top to bottom and the elastic pressure of the surface of the contact surface.
The middle connector integrally consists of a solid middle frame and a hollow structure;
(1) the upper end of the middle connecting body is matched with the assembling boss of the upper fixing body, porous structures are distributed on the surface of the middle connecting body, and the characteristics of the porous structures beneficial to bone ingrowth are utilized to realize osseous fusion with the upper fixing body so as to achieve long-term stability.
(2) The lower end of the middle connecting body is matched with the assembling boss of the lower fixing body, porous structures are distributed on the surface of the middle connecting body, and the characteristics of the porous structures beneficial to bone ingrowth are utilized to realize osseous fusion with the lower fixing body so as to achieve long-term stability.
(3) The middle connector is integrally designed with a plurality of middle cross beams and longitudinal beams to form a main bearing structure; the upper end and the lower end of the middle cross beam and the longitudinal beam are corresponding components connected with conical surfaces; the hollow part of the hollow part forms a bone grafting cavity penetrating from top to bottom, and the inner wall of the bone grafting cavity is provided with a hollow structure, thereby being beneficial to bone tissue growth and fusion.
(4) The middle connector is designed into various length specification models, can be produced in batch, and a doctor selects a proper model to be matched with other components for use according to actual conditions in different operations, so that the optimal operation effect is achieved.
The upper fixing body and the lower fixing body are respectively arranged on the middle connecting body before operation,
at the moment, the bone grafting cavity and the bone grafting cavity are completely communicated from top to bottom, bone tissues are filled into the cavity through the bone grafting hole and the bone grafting hole, and the artificial vertebral body replacement operation can be implemented after the filling is completed.
Specifically, the extension nesting length of the assembly boss of the upper fixing body and the assembly boss of the lower fixing body is 1/4-1/3 of that of the middle connecting body; the extended part of the assembling boss consists of a frame body matched with the middle connecting body and a hollow structure; the frame bodies contacted with the middle connector are respectively inclined inwards; the assembling boss of the upper fixing body and the assembling boss of the lower fixing body are symmetrical.
The inclination angles of the assembly boss of the upper fixing body and the assembly boss of the lower fixing body and the vertical direction are 2-5 degrees; sufficient bone ingrowth space is reserved between the assembly protrusions which are embedded into the middle connector in an extending manner and the bone grafting cavities of the middle connector. The hollow structure of the extension part can induce the bone grafting inside the vertebral body to grow from inside to outside, so that the components of the artificial vertebral body are connected in a bone manner.
Furthermore, the assembling lug boss of the upper fixing body and the assembling lug boss of the lower fixing body are extended and nested in the middle connecting body, and in addition, the middle frame of the assembling lug boss and the contact inner wall of the middle connecting body are all designed with a 3-degree draft angle, so that the assembling lug boss and the lower fixing body are easier to assemble; by utilizing the interference fit principle, the artificial vertebral body is pressurized from top to bottom by the gravity of the patient after implantation, and the elastic pressure is generated on the surface of the contact surface, so that the fastening connection is obtained.
The assembling boss is nested in the middle connecting body by about 1/3, so that the side wall of the assembling boss and the bone grafting cavity of the middle connecting body can be ensured to have enough bone ingrowth space; the hollow structure of the extension part enables the bone grafting inside the vertebral body to grow from inside to outside, and finally realizes the osseous connection between the components of the artificial vertebral body, so that the assembly is more stable and firm.
Furthermore, depending on the location of the use of the artificial vertebral body, it may be considered whether additional fixation devices are designed. The rear operation implantation way is adopted for the implantation of the artificial vertebral body of the thoracic vertebral segment of the spine, an additional fixing structure is not suitable to be designed due to the operation exposure range and the operation bow-and-arrow relation, and meanwhile, the rear path nail rod system can completely meet the implantation stability of the artificial vertebral body due to the small self-activity degree and high stability of the thoracic vertebral segment; the artificial vertebral body implantation of the lumbar spine is generally fixed by adopting a posterior resection and nailing rod system, and then the anterior artificial vertebral body implantation is carried out, so that screw fixing edges can be respectively designed in front of the sides of the upper fixing body and the lower fixing body, screw fixing holes are designed on the screw fixing edges, and the artificial vertebral body is fixed with the upper vertebral body and the lower vertebral body through the screw fixing holes, thereby ensuring the long-term stability of the artificial vertebral body.
The embodiments given above are preferred examples for realizing the present invention, and the present invention is not limited to the above-described embodiments. Any immaterial additions and substitutions made by those skilled in the art according to the technical features of the technical scheme of the invention are all within the protection scope of the invention.
Claims (7)
1. The assembled artificial vertebral body is characterized by being assembled by an upper fixing body, a lower fixing body and a middle connecting body, wherein the upper fixing body and the lower fixing body are fixed parts, and the middle connecting body is a universal part; the custom piece is a personalized accessory based on 3D printing and forming, and the universal piece is a standard piece prepared in batches;
the upper fixing body comprises an upper spandrel girder, an upper cone contact surface and an assembly boss, and the upper spandrel girder is of a bearing structure; the upper vertebral body contact surface is a porous structure arranged between the upper bolster and is also provided with a hollow bone grafting hole; the upper cone contact surface and the upper bolster are personalized designs matched with the anatomical shape of the cone surface which is contacted with the upper bolster; the assembling boss is positioned at the bottom of the upper fixing body and is matched with the shape of the middle connecting body;
the lower fixing body comprises a lower spandrel girder, a lower cone contact surface and an assembly boss, and the lower spandrel girder is of a bearing structure; the lower cone contact surface is a porous structure arranged between the lower bolster and is also provided with a hollow bone grafting hole; the lower cone contact surface and the lower bolster are personalized designs matched with the anatomical shape of the cone surface which is contacted with the lower bolster; the assembling boss is positioned at the top of the lower fixing body and is matched with the shape of the middle connecting body;
the middle connector consists of a middle frame and a hollow structure between the middle frame and the middle frame, and the middle space forms a bone grafting cavity; the middle frame is formed by connecting a middle cross beam and a longitudinal beam, and the upper end and the lower end of the middle connecting body are respectively provided with a connecting structure; the middle connector is divided into various types and specifications according to different used parts; if the two-dimensional artificial cervical vertebra is used for thoracic vertebra segments, the length of the two-dimensional artificial cervical vertebra is 15-30 mm, and each specification is 1-5mm apart; if the lumbar vertebra is used for lumbar vertebra segments, the length is 30-40mm, and each specification is 1-5mm apart;
wherein, the upper fixing body, the lower fixing body and the middle connecting body of the artificial vertebral body are assembled by connecting components or by structural fit, and are respectively as follows:
1) Assembled by the connecting component: the connecting component is a soft gasket with an annular structure, the inner wall and the outer wall of the connecting component are both provided with annular buckles, and the cross section of each annular buckle is of a semicircular convex structure; the inner wall annular buckle is matched with the assembling boss, and the outer wall annular buckle is matched with the middle connector;
the connecting components are respectively arranged at the outer edges of the assembling bosses of the upper fixing body and the lower fixing body, and the inner walls of the connecting components are respectively meshed with the outer walls of the assembling bosses; the connecting assembly is used for respectively installing the upper fixing body and the lower fixing body on the middle connecting body, the annular buckle on the outer wall of the connecting assembly is meshed with the inner wall of the connecting structure of the middle connecting body, and after assembly, all the assemblies are fastened and connected;
2) The components are assembled by structural cooperation: the connecting structures of the assembling boss of the upper fixing body and the upper end of the middle connecting body are respectively matched conical surfaces, and the assembling boss and the connecting structure are in interference fit; when the upper fixing body is pressed from top to bottom, the conical surface of the assembling boss of the upper fixing body is sleeved on the inner side of the conical surface at the upper end of the middle connecting body, and the fastening connection is obtained by the pressure from top to bottom and the elastic pressure of the surface of the contact surface;
the connecting structure at the lower end of the middle connecting body and the assembling boss of the lower fixing body are respectively conical surfaces matched with each other, and the connecting structure and the assembling boss are in interference fit with each other; when the pressure from top to bottom is applied, the conical surface of the connecting structure at the lower end of the middle connecting body is sleeved outside the assembling boss of the lower fixing body, and the fastening connection is obtained by the pressure from top to bottom and the elastic pressure of the surface of the contact surface.
2. The assembled artificial vertebral body according to claim 1, wherein the extension nesting length of the assembly boss of the upper fixing body and the assembly boss of the lower fixing body is 1/4-1/3 of that of the middle connecting body; the extended part of the assembling boss consists of a frame body matched with the middle connecting body and a hollow structure; the frame bodies contacted with the middle connector are respectively inclined inwards; the assembling boss of the upper fixing body and the assembling boss of the lower fixing body are symmetrical.
3. The assembled artificial vertebral body according to claim 1 or 2, wherein the inclination angle between the assembling boss of the upper fixing body and the assembling boss of the lower fixing body and the vertical direction is 2-5 °; and enough bone ingrowth space is reserved between the extended assembling boss embedded in the middle connector and the bone grafting cavity of the middle connector.
4. The modular artificial vertebral body of claim 2 wherein the hollowed-out configuration of the extension portion induces bone grafting inside the vertebral body to grow from inside to outside such that a bony connection is created between the components of the artificial vertebral body.
5. The assembled artificial vertebral body according to claim 1, wherein the middle frame of the middle connecting body is a waisted structure, the cross section of the middle cross beam is approximately circular or elliptical, and the horizontal longest distance is 0.8-0.9 times of the horizontal longest distance of the upper bolster;
the longitudinal beams are respectively smooth connection of the middle cross beam corresponding to the upper bolster and the lower bolster in the vertical directions of different nodes, and have certain curvature;
the hollow structure is a reticular structure formed by dodecahedron or diamond structural units of each supporting node, the pore diameter of each reticular unit in the reticular structure is 0.3-0.6 mm, and the wire diameter is 0.2-0.4 mm.
6. The assembled artificial vertebral body of claim 1 or 5 wherein the upper surface of the upper bolster is uniformly distributed with a plurality of tapered fixation thorns and the lower surface of the lower bolster is uniformly distributed with a plurality of tapered fixation thorns; the intersection of the middle cross beam and the longitudinal beam is in arc transition connection.
7. The assembled artificial vertebral body of claim 1 wherein screw fixation edges are respectively provided at lateral front sides of the upper and lower fixing bodies, and screw fixation holes are formed in the screw fixation edges.
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| CN110200728A (en) * | 2019-07-01 | 2019-09-06 | 中国人民解放军第四军医大学 | A kind of Vertebral defect method for reconstructing of individuation in conjunction with generalization |
| CN110934671B (en) * | 2019-12-16 | 2021-12-21 | 淮阴工学院 | Artificial cervical intervertebral disc prosthesis |
| CN111603280B (en) * | 2020-05-28 | 2022-10-14 | 北京市春立正达医疗器械股份有限公司 | Vertebral body prosthesis |
| CN113081405B (en) * | 2021-04-08 | 2023-11-03 | 新疆大学 | Artificial vertebral body and manufacturing method thereof |
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