In and the fixture of actions between two vertebral bodies
Technical field
The invention provides a kind of in and the fixture of actions between two vertebral bodies, especially refer to be applied in two adjacent thoracic vertebra, lumbar vertebras ... between vertebral body Deng vertebra, so that can keep stable between two adjacent vertebral bodys, not adjacent interpyramidal activity of reason two-phase such as antecurvature, layback, about incline and about reverse, and problems such as two vertebral fusion are bad take place.
Background technology
Press, general alleged " waist interbody fusion (interbody fusion) ", it mainly is to carry out from the way of escape (with the strip off of lumbar vertebra neurocele dura mater) or the past road (the vertebra dish the place ahead from the preabdomen to the pneumoretroperitoneum), earlier the intervertebral disc of degenerating is removed, make between adjacent two lumbar vertebra bodies till the no remaining soft tissue, again human body bone (from body or allosome) is implanted between adjacent two lumbar vertebra bodies, after the several months merges, make two lumbar vertebra bodies respectively with the lumbar vertebra body of human body bone formation one monoblock, so as to reaching elimination because of lumbar intervertebral disc is degenerated and pathological changes caused lower back pain problem.
In order to promote the fusion rate between lumbar vertebra body and human body bone, medical circle is to develop the instrument of " pedicle nail system (pedical screwsystem) " and " metal cage (cage) ", wherein said pedicle nail uses in operation on vertebra, be fused to example with the way of escape, see also Figure 1 and Figure 2, it is lower back portion muscle strip off with the patient, transverse process 11 up to both sides, a vertebra 10 rear exposes, after running through a metallic rod 21 with screw 20 again, squeeze in the pedicle of vertebral arch 12 of described vertebra 10, with two adjacent vertebral bodys 101,102 is example, for making described two adjacent vertebral bodys 101,102 can be maintained fixed the gap, be total to four screws 20 of palpus and two metallic rod 21, wherein each metallic rod 21 needs two screws 20, on it and lower end is fixed to respectively and hypocentrum 101, in 102 the corresponding pedicle of vertebral arch 12, so that described two adjacent vertebral bodys 101,102 unlikely activities, again the human body bone is implanted between two adjacent lumbar vertebra bodies 101 afterwards, 102 the intervertebral disc space of having removed, so, this two lumbar vertebras body 101,102 respectively with the human body bone through several months bone growth, can form a monoblock lumbar vertebra body, realize eliminating the lumbago problem that lumbar intervertebral disc is degenerated and pathological changes caused.
Yet use " pedicle nail system " to carry out operation on vertebra, though can keep the fixing of 101,102 of two adjacent vertebral bodys, at first, because the active force that bears on each rear metallic rod 21, be two the place ahead screws 20 that see through its upper and lower side, conduct to the intersection of screw 20 and metallic rod 21, cause screw 20 easily with the intersection of metallic rod 21, the problem of fracture takes place; Secondly, for osteoporotic patient, the problem that screw 20 gets loose takes place easily also, place another big problem of pedicle nail system simultaneously from the back, be very easily the little joint of dorsal muscles and vertebra back of the body side to be damaged, cause meat fiberization, cause the operation back to continue the problem of back pain.If screw 20 when squeezing into the position partially in, still can cause nerve root injury.
In view of this a problem, medical circle is to develop " metal cage " to use in operation on vertebra, see also shown in Figure 3, described metal cage 31 is a kind of cellular and the hollow column that is hollow out, materials such as material by titanium or compatible human body are made, modus operandi is the mode that the road or the way of escape before the metal cage 31 are merged, be placed on two adjacent vertebral bodys 301,302, bear and suppress two adjacent vertebral bodys 301 with metal cage 31,302 pressure and interaction, make two adjacent vertebral bodys 301,302 can remain a fixed interval (FI), make the human body bones of filling in the metal cage 31 can pass through hole 310 on the metal cage 31, respectively with two adjacent vertebral bodys 301,302 touch mutually, and stable growth, and then with last hypocentrum 301, the final purpose that merges between vertebral body is reached in 302 combinations.
Research report shows that the practice of using pedicle nail is to have increased the joint generation degeneration of adjacent vertebral and the probability of pathological changes, in operation and after the operation, will cause following negative effect to the human physiological structure simultaneously:
1. see also Figure 1 and Figure 2, insert the practice of pedicle nail, because of need go deep into vertebra 10 rears in way of escape mode, very easily dorsal muscles and little joint are damaged, cause the patient after operation, the back still pain endlessly, this also be patient back, operation back constant pain main cause one.
2. see also Figure 1 and Figure 2, screw 20 is squeezed into pedicle of vertebral arch 12, very easily in operation, injure the nervous tissue of pedicle of vertebral arch 12 inboards,, cause the patient to undergo surgery once more with degeneration that causes adjacent discs and pathological changes in the future.
3. see also Figure 1 and Figure 2, because metallic rod 21 must be born vertebral body 101 fully, 102 six directions are (antecurvature, layback, about incline and about reverse) active force and torsion, and described active force and the torsion of waiting is two screws 20 that see through its upper and lower side, conduct to the fixing point that is driven into screw 20 on the pedicle of vertebral arch 12, very easily make vertebral body 101, porotic bone is because of bearing huge unit active force and torsion repeatedly in 102, and cause vertebral body 101, porotic bone softer in 102 bursts apart, thereby causes screw 20 from vertebral body 101, get loose in 102 the porotic bone.
4. see also Figure 1 and Figure 2, the active force of six direction and torsion on the metallic rod 21, be that minimum section via screw 20 bears, so very easily because of secular stress concentration, cause metal tired, and then make screw 20 in the position, boundary of metallic rod 21 with vertebral body 101,102, rupture.
In addition, see also shown in Figure 3, road or way of escape mode were used the practice of metal cage separately in the past, though there are not the deutero-problems of pedicle nail, but because metal cage 31 is merely to be placed on 301,302 of two adjacent vertebral bodys, so according to biomechanics Research, the pedicle nail system can effectively control the activity of the six direction of 301,302 of two adjacent vertebral bodys really, independent metal cage 31 then only can be controlled left and right activity of inclining, for the active control of other four direction (antecurvature, layback and about reverse) all than the pedicle nail system for poor.
Therefore, need develop a new technique and avoid aforementioned every shortcoming, effectively control the activity of six direction between vertebral body, and human body is caused minimum destruction, promptly become now medical circle and still make great efforts to research and develop and desire most ardently an important goal of reaching.
Summary of the invention
Because the problems referred to above, the inventor through the permanent research and experiment of making great efforts, and cooperates relevant scientific principle according to the correlation experience of being engaged in this problem for many years, and development and Design goes out a kind of the fixture of actions between two vertebral bodies " in and " of the present invention finally.
A purpose of the present invention can effectively solve between habitual two adjacent vertebral bodys providing a kind of, not adjacent interpyramidal antecurvature, the layback of reason described two, about incline and about the activity reversed, and the fixture that the metal cage displacement takes place or do not merge etc.;
Another object of the present invention, be that described fixture can be used with a supporting component (as: metal cage) simultaneously, described supporting component will bear intervertebral activity pressure a part of between two adjacent vertebral bodys, thereby the pressure load of described fixture is reduced, so can effectively reduce the metal fatigue of described fixture or loosening probability.
The technical scheme taked of the present invention is to achieve these goals: in a kind of and the fixture of actions between two vertebral bodies, especially refer to be applied in two adjacent interpyramidal fixtures, it is characterized in that, described fixture is a plate body, one side of described plate body has a nail portion, by described nail portion implant described fixture in one or the two corresponding vertebral bodys and intervertebral disc in.Because described fixture is a plate body, and a side has nail portion, so be fixed near the axle center of two adjacent vertebral bodys embedding by vertebral body, can realize effectively the active control of six direction between described two adjacent vertebral bodys, make implantation described two adjacent interpyramidal from the body bone, before merging fully with vertebral body, the not interpyramidal activity of reason, and (non-union) or pseudo-problem of closing knot (psuedarthrosis) take place not merge.
Described nail portion is selected from a kind of in a two-sided skiving and the single face skiving.
Described fixture is also set up a supporting component, and in the intervertebral disc of inserting described two corresponding vertebral bodys, described supporting component is a cellular and the hollow column that is hollow out.
The central authorities of described fixture also are provided with a through hole, are used for a locked assembly and pass described through hole, and locking is combined into one in a fixing hole of described supporting component.
The central authorities of described fixture also are provided with a through hole, and two ends of described fixture are respectively equipped with the L-shaped panel of a vertical section, and a side of each described panel has described nail portion, and offers at least one perforation on each described panel.
The central authorities of described fixture also are provided with a through hole, two ends of described fixture are respectively equipped with a panel, and the centrage of described panel and described fixture keeps a predetermined angle, and a side of each described panel has described nail portion, and offers at least one perforation on each described panel.
The central authorities of described fixture also are provided with a through hole, two ends of described fixture respectively are provided with two panels respectively, and be to keep a predetermined interval to each other, and keep a predetermined angle with the centrage of described fixture, one side of each described panel respectively has described nail portion, and offers at least one perforation on each described panel.
Described fixture material is to be selected from a titanium, a rustless steel, a plastic-steel, a polyether etherketone (PEEK) and any compatible human body to be suitable for a kind of in the material.
Beneficial effect of the present invention can be summarized as two aspects:
1. compared to existing technology, fixture of the present invention is a plate body, and a side has nail portion, so be fixed near the axle center of two adjacent vertebral bodys embedding by vertebral body, can realize effectively the active control of six direction between described two adjacent vertebral bodys, make implantation described two adjacent interpyramidal, before merging fully with vertebral body from the body bone, the not interpyramidal activity of reason, and (non-union) or pseudo-problem of closing knot (psuedarthrosis) take place not merge;
2. compared to existing technology, supporting component of the present invention will bear intervertebral activity pressure a part of between two adjacent vertebral bodys, thereby the pressure load of described fixture is reduced, so can effectively reduce the metal fatigue of described fixture or loosening probability.
Description of drawings
Fig. 1 is to use traditional pedicle nail to support the three-dimensional appearance sketch map of lumbar vertebra body;
Fig. 2 is to use traditional pedicle nail to support the cross sectional plan view of lumbar vertebra body;
Fig. 3 inserts the interpyramidal front view of waist with the conventional metals cage;
Fig. 4 is a fixture sketch map of the present invention;
Fig. 5 is that fixture of the present invention is implanted between the lumbar vertebra body, the side view that is combined into one with supporting component;
Fig. 6 is that fixture of the present invention is implanted between the lumbar vertebra body, the front view that is combined into one with supporting component;
Fig. 7 is the various variation aspect example 1 of fixture of the present invention;
Fig. 8 is the various variation aspect example 2 of fixture of the present invention;
Fig. 9 is the various variation aspect example 3 of fixture of the present invention.
The specific embodiment
The invention will be further described below in conjunction with the drawings and specific embodiments, but not as a limitation of the invention.
The present invention shown in Fig. 4,5 and 6 be a kind of in and the fixture of actions between two vertebral bodies, it is applied in thoracic vertebra, lumbar vertebra ... Deng between vertebra, so that can keep stable fixture between two adjacent vertebral bodys, described fixture 40 is a plate body, one side of described plate body has a nail portion 41 (as shown in Figure 4), in order to via described nail portion 41 described fixture 40 being implanted in one or the two corresponding vertebral bodys 501,502 and in the intervertebral disc 510, wherein said nail portion 41 is selected from wherein a kind of of a two-sided skiving and a single face skiving.
Further, described fixture 40 can also with the intervertebral disc 510 of two corresponding vertebral bodys 501,502 as described in a supporting component 70 (metal cage shown in Fig. 5,6) is implanted in one-body moldedly in, to strengthen fixed effect.
Therefore, when described fixture 40 is combined into one with described supporting component 70, can effectively control the activity of 501,502 six directions of described two adjacent vertebral bodys, wherein antecurvature, layback and about the activity of four direction such as reverse, be to bear by described fixture 40.And the activity of left and right two directions such as incline then is to be born by described supporting component 70.And then make implant 510 of described intervertebral disc from the body bone, before merging fully with vertebral body 501,502, the not activity of 501,502 of reason vertebral bodys, and generation is not merged or the problem in pseudo-joint.
Aforesaid fixture 40 materials are to be selected from a titanium, a rustless steel, a plastic-steel, a polyether etherketone (PEEK) and any compatible human body to be suitable for a kind of in the material.
Aforesaid supporting component 70 (metal cage) is a kind of cellular and the hollow column that is hollow out, be viewed as an I shape from its side surface direction, and can coincide the just anatomical shape of normal disc 510 of its external form, the porous of described supporting component 70 and hollow out position 702 be in order to hold spinal fusion required from the body bone.
It below is the various variation aspect that is respectively fixture 40 of the present invention, see also shown in Figure 7, described fixture 40 is a plate body, its central authorities are provided with a through hole 401, two ends of described fixture 40 are respectively equipped with the L-shaped panel 42 of a vertical section, one side of each described panel 42 has a nail portion 421, in order to via described nail portion 421, described fixture 40 is implanted one or two corresponding vertebral bodys 501, in 502 and in the intervertebral disc 510 (as shown in Figure 5), wherein offer at least one perforation 422 on each described panel 42, be in order to make after surgery in the osteocyte of body bone is grown into perforation 422, to make described fixture 40 and described vertebral body 501,502 merge the formation one fully.
See also shown in Figure 8, described fixture 40 is a plate body, its central authorities are provided with a through hole 401, two ends of described fixture 40 are respectively equipped with a panel 43, and the centrage 402 of described panel and described fixture 40 keeps a predetermined angle theta, one side of each described panel 43 has a nail portion 431, in order to via described nail portion 431, described fixture 40 is implanted one or two corresponding vertebral bodys 501, in 502 and in the intervertebral disc 510 (as shown in Figure 5), wherein offer at least one perforation 432 on each described panel 43, be in order to make after surgery in the osteocyte of body bone is grown into perforation 432, to make described fixture 40 and described vertebral body 501,502 merge the formation one fully.
See also shown in Figure 9, described fixture 40 is a plate body, its central authorities are provided with a through hole 401, two ends of described fixture 40 respectively are provided with two panels 44 respectively, 45, and be to keep a predetermined interval to each other, and keep a predetermined angle with the centrage (not shown) of described fixture 40, each described panel 44, a side of 45 respectively has a nail portion 441,451, in order to via each described nail portion 441,451, described fixture 40 is implanted one or two corresponding vertebral bodys 501, in 502 and in the intervertebral disc 510 (as shown in Figure 5), each described panel 44 wherein, offer at least one perforation 442 on 45,452, be in order to make after surgery from the osteocyte of body bone grow into the perforation 442, in 452, make described fixture 40 and described vertebral body 501,502 merge the formation one fully.
Need special one to carry at this, the above only is some most preferred embodiments of the present invention, at first, the present invention is when actual applying, be not limited thereto, secondly, all familiar described skill personages, according to previous embodiment of the present invention, no matter be the panel 42 that changes described fixture 40,43,44, vertical section configuration of 45, or change the panel 42 of described fixture 40,43,44,45 quantity, or change the panel 42 of described fixture 40,43,44,45 with the corner dimension of centreline space, or on described fixture 40, offer hole 422,432,442,452, or on the surface of described fixture 40, form matsurface, as long as the identical person of its purpose all is that the present invention is in this alleged fixture 40.
In sum, carrying out and patient that fixture 40 of the present invention can be " waist interbody fusion ", bring following benefit:
1, when using described fixture 40 and described supporting component 70 simultaneously, described supporting component 70 will bear the intervertebral activity pressure of 501,502 somes of two adjacent vertebral bodys, thereby the pressure load of described fixture 40 is reduced, so can effectively reduce the metal fatigue of described fixture 40 or loosening probability, to strengthen fixed effect.
2, because described fixture 40 is to be embedded by vertebral body to be fixed near the axle center of two adjacent vertebral bodys 501,502, so can realize effectively to 501,502 active controls of six direction of two adjacent vertebral bodys.
3, because of the different vertically panels 42,43,44,45 of section configurations, quantity or angle on the described fixture 40, can effectively control the activity of 501,502 of two adjacent vertebral bodys, make it can bear huge unit active force and torsion repeatedly, and avoid that softer porotic bone bursts apart in the two adjacent vertebral bodys 501,502.
4, described fixture 40 is implanted in the two adjacent vertebral bodys 501,502, its operation process is very simple and easy fast, and with described fixture 40 implant into body the time, only vertebral body 501,502 structures are caused minimum destruction, and unlikely important blood vessels and the neural risk of jeopardizing.
5, in the future if described fixture 40 need be taken out with described supporting component 70 time because it is to be seated in the two adjacent vertebral bodys 501,502, make the process of taking out, easily tradition by the mode of the preceding road or the way of escape, more simple and easy.
So fixture 40 tool novelties of the present invention, progressive and practicality.
Above-described embodiment, the present invention specific embodiment a kind of more preferably just, the common variation that those skilled in the art carries out in the technical solution of the present invention scope and replacing all should be included in protection scope of the present invention.