CN101627931A - 一种人工颈椎复合关节 - Google Patents

一种人工颈椎复合关节 Download PDF

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CN101627931A
CN101627931A CN200910023517A CN200910023517A CN101627931A CN 101627931 A CN101627931 A CN 101627931A CN 200910023517 A CN200910023517 A CN 200910023517A CN 200910023517 A CN200910023517 A CN 200910023517A CN 101627931 A CN101627931 A CN 101627931A
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vertebral body
fixed part
body parts
retainer ring
spherical surface
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CN101627931B (zh
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雷伟
韩宝君
周江军
吴子祥
赵雄
付索超
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Fourth Military Medical University FMMU
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00Filters 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
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    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
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    • A61F2/00Filters 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
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    • A61F2/00Filters 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
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    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30904Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves serrated profile, i.e. saw-toothed
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    • AHUMAN NECESSITIES
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    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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Abstract

本发明公开了一种人工颈椎复合关节,由两个上下对称设置的固定部件和一个椎体部件及两个连接部件组成,椎体部件通过连接部件连接在固定部件之间;固定部件的形状为L型,分为固定件前翼部和固定部件基底部,在固定件前翼部上有锁定螺钉孔,在固定部件基底部中间有设凸起的倒齿状防滑槽;椎体部件的中间部位设有横向贯通的植骨孔,在椎体部件轴线中心的上下两侧设有用于安装连接部件的型腔;连接部件的一端通过固定环安装在型腔内,另一端与固定部件相连接,构成稳定的球窝滑槽关节。本发明有望取代现行的植骨融合的方法成为临床行椎体重建的标准方法。

Description

一种人工颈椎复合关节
技术领域
本发明涉及一种颈椎椎体次全切除后进行颈椎重建的装置,特别涉及一种人工颈椎复合关节,该人工颈椎复合关节采用模拟正常颈椎进行颈椎解剖、稳定性和运动三方面生理性重建的仿生而得以实现。
背景技术
临床上对于颈椎的感染、肿瘤或退变性疾病,很多情况下需要进行颈椎椎体次全切除,之后则需要对切除的节段进行重建。目前,临床上常见的重建方法主要包括两种,即节段植骨融合和人工椎体置换。植骨融合的方法,作为现在临床行颈椎椎体次全切除后重建的标准方法,是用自体或异体骨组织充填缺损节段,同时附加内固定进行颈椎稳定性重建。这种方法通过植骨与上下位椎体间的骨性融合实现了颈椎的稳定性重建,消除了疼痛,但是这种重建方式并不是理想的解剖重建,而且使重建节段完全丧失了活动,影响了颈椎的整体运动功能,同时远期也会造成临近节段椎间盘因应力集中引起的退变。人工椎体至今已有多种设计,但都是通过植骨融合或自固定或附加内固定的方式,来重建颈椎的稳定性,同样存在节段活动丧失,远期邻近节段椎间盘退变的问题,都不是真正意义上的生理性重建。少数考虑到运动重建而设计的人工椎体,皆因为其运动方式与生理情况下的运动方式不同,或稳定性差的原因,而导致最终失败。目前临床上非融性重建已经成为发展趋势,针对这一问题,产生了人工髋关节、膝关节、踝关节、肘关节及人工椎间盘等各式各样的产品,并且大量应用于临床,治愈快,效果良好,临床远期效果可靠,对于脊柱外科,人工椎间盘的产生无疑具有划时代意义,目前人工椎间盘已经逐渐成熟,颈椎单节段的非融合重建,产生了诸如Bryandisc、Prestige等优良的产品,但对于颈椎次全切除术后的非融合重建,目前还没有很好的方法来解决这个问题,因此,申请人前期设计了一种人工颈椎复合关节,初步生物力学研究表明,其球窝关节在一定程度上保留了颈椎活动度,在非融合重建之路上,提出了新的思路,在此基础上,申请人进一步研究了颈椎的正常运动模式,综合以往研究得出结论,颈椎的运动不是单纯的旋转,而是旋转与平移的耦合运动,相邻椎体之间在旋转的同时耦合有椎体间的相对位移,上位椎体相对下位椎体具有可变的旋转运动中心,这样人工颈椎复合关节的初期设计—球窝关节具有固定的旋转运动中心,它的运动模式为单纯的旋转运动,与正常颈椎的运动模式存在较大差别。
根据申请人所作的资料检索,迄今为止,还没有一种方法能够兼顾稳定性和活动度及颈椎特殊的耦合运动模式,真正实现生理性重建,只有设计一种独特的人工关节,模拟正常颈椎的运动模式,才能真正意义上实现颈椎重建的仿生。
发明内容
本发明的目的在于,提供一种人工颈椎复合关节,该人工颈椎复合关节通过“再造”原来的椎间盘和椎体,能够恢复椎体间活动度,实现了颈椎的生理性重建,既恢复了颈椎的解剖序列和稳定性,同时又保留了缺损节段的正常生理活动度。
为了实现上述任务,本发明采取如下的技术解决方案:
一种人工颈椎复合关节,其特征在于,该人工颈椎复合关节由两个上下对称设置的固定部件、一个椎体部件及两个连接部件组成,椎体部件通过连接部件连接在固定部件之间;
所述的固定部件分为上固定件和下固定件,上固定件和下固定件的形状均为L型,固定件上分为前翼部和基底部,其中,上固定件的前翼部与其基底部形成小于90°夹角,下固定件的前翼部与其基底部形成大于90°夹角;在前翼部上有锁定螺钉孔,在基底部中间设有凸起的倒齿状防滑槽;
所述的椎体部件的中间部位设有横向贯通的植骨孔,在椎体部件轴线中心的上下两侧设有用于安装连接部件的型腔,该型腔包括圆柱形凹腔及位于凹腔底面中心的球面凸起;
所述的连接部件的形状分为柱状体和球面结构,球面结构包括凹球面,凹球面与椎体部件型腔内的球面凸起相吻合;椎体部件两侧分别设有定位销锁定孔,固定环上设有固定环锁定孔,通过定位销将固定环锁定在圆柱形凹腔中;
连接部件一端通过固定环安装在型腔内,另一端与固定部件相连接,构成稳定的球窝滑槽关节。
所述的固定部件与椎体部件之间的相对运动方式为连接部件的球面结构沿着椎体部件型腔内的球面凸起滑动。
所述的连接部件的球面结构沿着椎体部件型腔内的球面凸起旋转,固定部件与椎体部件之间在各个方向产生0-14度的旋转动度,连接部件的柱状体在其与固定环之间的空隙内摆动,固定部件与椎体部件之间产生0-2mm的位移,形成球窝滑槽关节的耦合运动模式。
本发明的人工颈椎复合关节带来的技术特点是,可以在重建颈椎稳定性的同时,恢复颈椎节段正常情况下的耦合运动方式,从而达到真正的生理性重建。有望取代现行的植骨融合的方法成为临床行椎体重建的标准方法。
附图说明
图1是本发明的人工颈椎复合关节外形结构示意图。
图2是图1的垂直向剖面图。
图3是图1的侧面结构示意图。
图4是图1的正面结构示意图。
图5是图1中固定部件球面立体结构示意图。
图6是图1中固定部件球面垂直向剖面图。
图7是图1中固定环的结构示意图。
图8是图1中固定环垂直向剖面图。
图9是图1中固定部件的结构示意图。
图10是图1中椎体部件的结构示意图。
图中:1、固定部件;2、椎体部件;3、连接部件;4、固定部件基底部;5、锁定螺钉孔;6、固定部件前翼部;7、定位销锁定孔;8、倒齿状防滑槽;9、固定环;10、固定环锁定孔;11、固定环弧形面;12、连接部件的柱状体;13、球面结构;14、球面凸起;15、凹球面;16、圆柱形凹腔;17、固定环出口直径;18、固定环入口直径;19、柱状体直径;20、球面结构剖面圆弧对应弦;21、植骨孔。
下面结合附图和实施例对本发明作进一步详细说明。
具体实施方式
研究表明,单纯进行椎体置换和植骨融合来对相当于两个椎间盘和一个椎体的缺损节段进行重建,不能从根本上解决颈椎生理性重建的难题。只有完全“再造”原来的椎间盘和椎体,恢复椎间关节的活动度,才能在真正意义上对颈椎进行生理性重建。
参见附图1、图2,本发明的人工颈椎复合关节,由两个上下对称设置的固定部件1和一个椎体部件2以及两个连接部件3组成,椎体部件2通过连接部件3连接在固定部件1之间;
固定部件1分为上固定件和下固定件,上固定件和下固定件的形状均为L型,固定件上分为前翼部6和基底部4,其中,上固定件的前翼部6与其基底部4形成小于90°夹角,下固定件的前翼部6与其基底部4形成大于90°夹角;在前翼部6上有锁定螺钉孔5,在基底部4中间设有凸起的倒齿状防滑槽8;
椎体部件为上下对称结构,椎体部件2的中间部位设有横向贯通的植骨孔21,在椎体部件2轴线中心的上下两侧设有用于安装连接部件3的型腔,该型腔包括圆柱形凹腔16及位于凹腔底面中心的球面凸起14;
连接部件3的形状分为柱状体12和球面结构13,球面结构13包括凹球面15,凹球面15与椎体部件型腔内的球面凸起14相吻合;
椎体部件2两侧分别设有定位销锁定孔7,固定环9上设有固定环锁定孔10,通过定位销将固定环9锁定在圆柱形凹腔16中;连接部件3一端通过固定环9安装在型腔内,另一端与固定部件1相连接,构成稳定的球窝滑槽关节。
凹球面15与椎体部件型腔内的球面凸起14共心,球面结构13与球面凸起14半径相差1mm,即为球面结构13的厚度,固定环出口直径17比连接部件柱状体直径19大2mm,但固定环入口直径18小于球面结构13剖面圆弧对应弦20的长度,不仅保证关节滑动时,连接部件的柱状体12不会脱出,并且实现了关节旋转的同时,固定部件1与椎体部件2之间的相对位移,其运动方式为连接部件的球面结构13沿着椎体部件的球面体凸起14滑动。
连接部件3的球面结构13沿着椎体部件型腔内的球面凸起14旋转,固定部件1与椎体部件2之间在各个方向产生0-14度的旋转动度,连接部件的柱状体12在其与固定环9之间的空隙内摆动,固定部件1与椎体部件2之间产生0-2mm的位移,形成球窝滑槽关节的耦合运动模式。
以下是发明人给出的一个具体的实施例,需要说明的是,本发明不限于该实施例。
在图1、2、3、4中显示了本实施例的人工颈椎复合关节的构成。由两个对称的固定部件1、中间的一个椎体部件2及两个连接部件3组成。固定部件1分为上固定件和下固定件,上固定件和下固定件的形状均为L型,固定件上分为前翼部6和基底部4,前翼部6上有2个锁定螺钉孔5,其中,上、下两个固定件的前翼部6分别与各自的基底部4形成的夹角不同,分别为80度、100度,以适应颈椎的正常曲度;基底部4的中心有倒齿状防滑槽8,用于固定人工颈椎复合关节系统,基底部4在与前翼部6相对一侧的中心与连接部件3的柱状体12连接,连接部件3由柱状体12及球面结构13构成,球面结构13包括凹球面15;椎体部件2为长方体结构,在椎体部件2上下两侧的轴线中心有用于安装连接部件3的型腔,型腔之间不贯通,型腔包括圆柱形凹腔16及位于凹腔底面中心的球面凸起14;固定部件1与椎体部件2之间为连接部件3的球面结构13与球面凸起14紧密结合;椎体部件2两侧分别设有定位销锁定孔7,固定环9上设有固定环锁定孔10,通过定位销将固定环9锁定在凹腔中;连接部件3一端通过固定环9安装在型腔内,另一端与固定部件1相连接,形成稳定的球窝滑槽关节。
在制作中,应当使连接部件部件3的凹球面15与椎体部件2的圆柱形凹腔16底面中心的球面凸起14共心,固定环9的出口直径17比连接部件的柱状体12的直径19大2mm,但固定环9的入口直径18小于球面结构13剖面圆弧对应弦20的长度,不仅保证关节滑动时,连接部件的柱状体12不会脱出,并且实现了关节旋转的同时,固定部件1与椎体部件2之间的相对位移,其运动方式为连接部件的球面结构13沿着椎体部件的球面凸起14滑动;而且应当使固定部件1与椎体部件2之间在各个方向存在0-14度的旋转动度,在旋转的同时产生0-2mm的位移,形成球窝滑槽关节的耦合运动模式。其最大位移即为固定环出口直径17与连接部件3的柱状体直径19之差。椎体部件2的中间部位设有横向贯通的植骨孔21,用作植骨。
如图5、6所示连接部件3的形状分为柱状体12和球面结构13,球面结构13包括凹球面15,凹球面15与椎体部件型腔内的球面凸起14相吻合;固定部件基底部4与固定部件前翼部6相对一侧的中心通过螺纹与连接部件的柱状体12相连接,连接部件3的凹球面15与椎体部件2的圆柱形凹腔16底面中心的球面凸起14共心,球面结构13与球面凸起14半径相差1mm,即为球面结构13的厚度。
如图7所示固定环的结构,为一圆环状结构,固定环出口直径17比连接部件柱状体直径19大2mm,但固定环入口直径18小于球面结构13剖面圆弧对应弦20的长度,其下表面的弧形面11与球面结构13相接触,定位销通过固定环锁定孔10将固定环9锁定,形成稳定的球窝滑槽关节。
如图8所示固定部件1结构,固定部件1分为上固定件和下固定件,其形状呈L形,固定件上分为前翼部6和基底部4,前翼部6有一定弧度,可与颈椎椎体前缘更好贴合,前翼部6上设有2个锁定螺钉孔5,锁定螺钉通过锁定螺钉孔5植入椎体,上、下两个固定件的前翼部6分别与其基底部4形成的夹角不同,分别为80度和100度,适应颈椎的正常的曲度变化,基底部4与前翼部6同侧的中心有倒齿状防滑槽8,用于固定人工颈椎复合关节。
如图9所示椎体部件的结构,椎体部件2为长方体,椎体部件2的中间部位设有横向贯通的植骨孔21,在椎体部件2轴线中心的上下两侧设有用于安装连接部件3的型腔,该型腔包括圆柱形凹腔16及位于凹腔底面中心的球面凸起14,定位销穿过定位销锁定孔7,终止于固定环锁定孔10,锁定固定环9;椎体部件2的植骨孔21周围形成毛糙状羟基磷灰石涂层。
本实施例制备的人工颈椎复合关节实现了颈椎的生理性重建,首先该结构实现了稳定性,恢复了颈椎的生理活动度,另外该结构在滑动的同时,连接部件的柱状体12与椎体部件2型腔底面的球面凸起14之间产生了相对位移,通过固定环9限制其位移的大小,保证该关节的稳定性和颈椎运动模式的生理性重建。
本实施例制备的人工颈椎复合关节的制作材料选择钴铬钼合金。
本发明的人工颈椎复合关节工作原理是,植入时,通过椎间盘使固定件前翼部6上的锁定螺钉孔5向相邻正常椎体内植入螺钉,通过锁定螺钉孔的螺纹锁定螺钉,以及使倒齿状防滑槽8与相邻椎体间的紧密结合,从而获得固定部件1的即刻稳定;通过固定部件基底部4背侧的钛多孔涂层诱导骨长入获得远期稳定。通过椎体部件一侧的毛糙状羟基磷灰石涂层的强大摩擦力,来达到椎体部件2的即刻稳定;通过贯通的植骨管道内植骨与次全切除后两端残余的部分椎体融合,以及侧方粗糙面的骨长入,获得椎体的远期稳定。通过固定环9以及定位销的锁定,形成稳定的球窝滑槽关节,使球窝滑槽关节间难以脱位,来达到椎间关节的近远期稳定。这样对椎间盘和椎体进行解剖性重建,既恢复了颈椎的稳定性,又恢复了椎间关节的活动度,实现了椎体间在活动过程中的相对位移,该关节的耦合运动模式达到模拟正常颈椎的运动模式的效果。

Claims (6)

1.一种人工颈椎复合关节,其特征在于,该人工颈椎复合关节由两个上下对称设置的固定部件(1)和一个椎体部件(2)以及两个连接部件(3)组成,椎体部件(2)通过连接部件(3)连接在固定部件(1)之间;
所述的固定部件(1)分为上固定件和下固定件,上固定件和下固定件的形状均为L型,固定件上分为前翼部(6)和基底部(4),其中,上固定件的前翼部(6)与其基底部(4)形成小于90°夹角,下固定件的前翼部(6)与其基底部(4)形成大于90°夹角;在前翼部(6)上有锁定螺钉孔(5),在基底部(4)中间设有凸起的倒齿状防滑槽(8);
所述的椎体部件(2)的中间部位设有横向贯通的植骨孔(21),在椎体部件(2)轴线中心的上下两侧设有用于安装连接部件(3)的型腔,该型腔包括圆柱形凹腔(16)及位于凹腔底面中心的球面凸起(14);
所述的连接部件(3)的形状分为柱状体(12)和球面结构(13),球面结构(13)包括凹球面(15),凹球面(15)与椎体部件型腔内的球面凸起(14)相吻合;
所述的椎体部件(2)两侧分别设有定位销锁定孔(7),固定环(9)上设有固定环锁定孔(10),通过定位销将固定环(9)锁定在圆柱形凹腔(16)中;
连接部件(3)的一端通过固定环(9)安装在型腔内,另一端与固定部件(1)相连接,构成稳定的球窝滑槽关节。
2、如权利要求1所述的人工颈椎复合关节,其特征在于,所述的固定部件(1)与椎体部件(2)之间的相对运动方式为连接部件(3)的球面结构(13)沿着椎体部件型腔内的球面凸起(14)滑动。
3、如权利要求1所述的人工颈椎复合关节,其特征在于,所述连接部件(3)的球面结构(13)沿着椎体部件型腔内的球面凸起(14)旋转,固定部件(1)与椎体部件(2)之间在各个方向产生0-14度的旋转动度,连接部件的柱状体(12)在其与固定环(9)之间的空隙内摆动,固定部件(1)与椎体部件(2)之间产生0-2mm的位移,形成球窝滑槽关节的耦合运动模式。
4、如权利要求1所述的人工颈椎复合关节,其特征在于,所述的凹球面(15)与所述球面凸起(14)共心。
5、如权利要求1所述的人工颈椎复合关节,其特征在于,所述的固定环(9)的出口直径比连接部件(3)上的柱状体(12)直径大2mm,但固定环(9)入口直径小于球面结构剖面圆弧对应弦(20)的长度。
6、如权利要求1所述的人工颈椎复合关节,其特征在于,所述的椎体部件(2)为长方体结构,其侧面上涂覆有毛糙状羟基磷灰石涂层。
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CN101828979A (zh) * 2010-04-29 2010-09-15 杨晋才 一种人工颈椎椎体与椎间盘复合体
CN103293057B (zh) * 2013-06-04 2015-10-28 南京航空航天大学 基于仿生学原理的用于人工颈椎间盘假体疲劳试验的专用夹具
CN103293057A (zh) * 2013-06-04 2013-09-11 南京航空航天大学 基于仿生学原理的用于人工颈椎间盘假体疲劳试验的专用夹具
CN103800101B (zh) * 2014-02-28 2016-01-13 西安交通大学 一种防脱位式非融合人工颈椎及椎间盘系统
CN103800101A (zh) * 2014-02-28 2014-05-21 西安交通大学 一种防脱位式非融合人工颈椎及椎间盘系统
CN105997309A (zh) * 2016-04-29 2016-10-12 西安交通大学第二附属医院 一种仿生防脱位山羊腰椎连接复合体
WO2017185754A1 (zh) * 2016-04-29 2017-11-02 西安交通大学 一种仿生防脱位人工腰椎及椎间盘连接复合体
CN106491249A (zh) * 2017-01-11 2017-03-15 南京市第医院 一种仿真人工脊柱
CN110494102A (zh) * 2017-04-04 2019-11-22 罗伯特·B·齐奥巴 用于恢复脊柱运动能力的移动笼式系统
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