CN102247207B - Universal omni-posterior-double lateral mass bridging board for cervical vertebra - Google Patents

Universal omni-posterior-double lateral mass bridging board for cervical vertebra Download PDF

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Publication number
CN102247207B
CN102247207B CN 201110085934 CN201110085934A CN102247207B CN 102247207 B CN102247207 B CN 102247207B CN 201110085934 CN201110085934 CN 201110085934 CN 201110085934 A CN201110085934 A CN 201110085934A CN 102247207 B CN102247207 B CN 102247207B
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China
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fixing head
lateral mass
vertebral plate
posterior
cervical vertebra
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CN102247207A (en
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雷伟
严亚波
刘帅
吴子祥
漆伟
张扬
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Fourth Military Medical University FMMU
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雷伟
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7071Implants for expanding or repairing the vertebral arch or wedged between laminae or pedicles; Tools therefor

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Neurology (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
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  • Surgical Instruments (AREA)
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Abstract

The invention discloses a universal omni-posterior-double lateral mass bridging board for cervical vertebra. The bridging board is in an arched whole made of a narrow and long metal plate, and comprises two lateral mass fixing plates, two vertebral lamina fixing plates, a spinous platform fixing plate and a bone grafting fixing plate. The bridging board is mainly used for reconstructing a vertebral canal structure after posterior expansive laminoplasty of cervical spine, can simultaneously fulfill fixation of open door side and hinge side in the expansive laminoplasty, the length of each fixing plate and angles among the fixing plates are in accordance with the characteristics of human cervical vertebra dissection; the bridging board has strong biological attachment and can furthest resist posterior pressure, so that the expansive laminoplasty failure caused by crack reclosing at the vertebral open door side and hinge fracture is avoided; the whole structure adapts to the posterior anatomy structure of human cervical vertebra and the characteristics of biological mechanics; and the bridging board can be pre-bent properly in use. The universal omni-posterior-double lateral mass bridging board for cervical vertebra is expected to replace the conventional posterior cervical single open door fixing plate to become a clinical standard postoperative physiology and stability reconstructing method after the posterior cervical single open door expansive laminoplasty.

Description

A kind of Full vertebral plate-bilateral-mass centerpiece universal for cervical vertebra
Technical field
The present invention relates to a kind of medical auxiliary apparatus, carry out the problem that way of escape open-door laminoplasty enlarges the plasty failure for the spinal canal stenosis Disease especially, a kind of Full vertebral plate-bilateral-mass centerpiece universal for cervical vertebra that is applicable to posterior cervical open-door laminoplasty expansion plasty of design.
Background technology
For spinal canal stenosis, good operative effect depends on the selecting properly of modus operandi and to the abundant decompression of spinal cord.It is can treat spinal canal stenosis can keep in good condition one of most effectual way of vertebral plate again that cervical spinal canal enlarges plasty, and especially open-door laminoplasty enlarges plasty, is widely used clinically because it has more advantage.For the situation such as congenital developmental character spinal canal stenosis, multi-segmental ossification of posterior longitudinal ligament and anterior approach effect of easing stress be not obvious, operative treatment adopts the posterior cervical open-door laminoplasty to enlarge plasty more, and the vertebral plate that needs in the operation process to split reveal is fixed and rebuilds canalis spinalis.At present common fixing, reconstruction biomaterials is mainly cervical vertebra single open-door fixing head clinically, but only be fixed in the side of opening the door, not simultaneously fixedly door-hinge side vertebral plate and lateral mass, can't form an integral body, fail physiology posterior cervical vertebral canal reconstruction on the whole anatomical structure, so its compressive property is relatively poor, can't effectively disperse the pressure from the cervical vertebra dead astern, the vertebral canal plastic operation postoperative may occur under certain physical stress load open the door and close, cause operative failure.In addition, the way of escape fixing head operation complex operation step of using at present is not suitable for fixedly open the door simultaneously side and door-hinge side.
The data-searching of carrying out according to the applicant, up to now, the fixing head that exists does not at present all have maximized realization posterior cervical open-door laminoplasty to enlarge shaping postoperative canalis spinalis stability reconstruction, and its ease for use of fixing head and the versatility that exist at present are unsatisfactory, and final surgical effect also is difficult to realize the physiological reconstruction of cervical vertebra rear pillar.The arch-shaped general cervical vertebra plate of applicant's design-lateral mass bridging board has been taken into account stability and ease for use simultaneously, has realized that the bio-imitability of cervical vertebra rear pillar is rebuild.
Summary of the invention
The object of the invention is to, the general full vertebral plate of a kind of cervical vertebra-bilateral piece bridging board is provided, the integrated arch-shaped structural design of this bridging board, Simultaneous Stabilization the structure of open the door side and door-hinge side, recover the connection of posterior cervical vertebral plate and lateral mass, realize the physiological reconstruction of Cervical Vertebral Canal Procedures, increased to greatest extent the stability of rear pillar.
To achieve these goals, the present invention takes following technical solution:
A kind of Full vertebral plate-bilateral-mass centerpiece universal for cervical vertebra is characterized in that, it is made by a long narrow metallic plate, and wherein: both sides are the first lateral mass fixing head and the second lateral mass fixing head; Adjacent with the first lateral mass fixing head is the first vertebral plate fixing head, and the angle of the first lateral mass fixing head the first vertebral plate fixing head lower edge extension line is 10 °; Adjacent with the second lateral mass fixing head is the bone grafting fixing head, and the angle of the second lateral mass fixing head and bone grafting fixing head lower edge extension line is 10 °; The first vertebral plate fixing head is adjacent with spinous process platform fixing head, and angle between the two is 140 ° at front view; The second vertebral plate fixing head is between spinous process platform fixing head and bone grafting fixing head; And be 140 ° on the angle front view between the second vertebral plate fixing head and spinous process platform fixing head and the bone grafting fixing head, it is whole to consist of arch;
On above-mentioned the first lateral mass fixing head, the second lateral mass fixing head, spinous process platform fixing head, bone grafting fixing head, the first vertebral plate fixing head and the second vertebral plate fixing head all with screw fixed hole.
Full vertebral plate-bilateral-mass centerpiece universal for cervical vertebra of the present invention can when recover the reconstruction of Cervical Vertebral Canal Procedures physiological, increase its stability, thereby reach the purpose of physiological and stability reconstruction to greatest extent; And this bridging board each several part length and between angle consistent with the human cervical spine anatomical features, biology, attaching property was good.The present invention is expected to replace existing posterior cervical single open-door fixing head, realizes that clinically posterior cervical canalis spinalis open-door laminoplasty enlarges the standard method of shaping postoperative physiological and stability reconstruction thereby become.
Description of drawings
Fig. 1 is Full vertebral plate-bilateral-mass centerpiece universal for cervical vertebra front view of the present invention.
Fig. 2 is the top view of Fig. 1.
Fig. 3 is the side view of Fig. 1.
Fig. 4 is the Full vertebral plate-bilateral-mass centerpiece universal for cervical vertebra axonometric chart of invention.
Labelling among the figure represents respectively: 1, the first lateral mass fixing head, the 6, second lateral mass fixing head, the 2, first vertebral plate fixing head, the 4, second vertebral plate fixing head; 3, spinous process platform fixing head, 5, the bone grafting fixing head, the 7, first lateral mass fixing screw hole, 12, the second lateral mass fixing screw hole, the 8, first vertebral plate fixing screw hole, the 10, second vertebral plate fixing screw hole, 9, spinous process platform fixing screw hole, 11, bone grafting fixing head fixing screw hole.
Below in conjunction with accompanying drawing structure of the present invention is described in further detail.
The specific embodiment
Studies show that present posterior cervical vertebral canal plastic operation art is carried out the bone grafting fixing head at the place of opening the door and fixed, its opposing rear pressure ability is relatively poor, and the side vertebral plate that usually causes opening the door is closed, and causes operative failure.Therefore, existing fixing head can not fundamentally be realized the physiological reconstruction of posterior cervical canalis spinalis.Integrated arch of the present invention connects the full vertebral plate of general cervical vertebra of design-bilateral piece bridging board, has rebuild way of escape vertebral plate fully and has been connected physiological with lateral mass and connects.Fix simultaneously open the door side and door-hinge side structure, truly the posterior cervical canalis spinalis has been carried out physiological and stability reconstruction.
The applicant had once designed a kind of new and improved single open-door Miniscrew titanium plate, adopt arch-shaped structure, at first effectively rebuild by plant bone mass and the vertebral plate that opens the door and form a complete bone canalis spinalis, rebuild the original arch-shaped structure of cervical spinal canal from anatomical structure, then titanium nail, titanium plate and plant bone mass, spinous process platform, both sides lateral mass and both sides vertebral plate are fixedly secured, thereby outside the bone canalis spinalis, form again the protection of second layer rigid conduit by bridging board, this kind method can obtain rigidity but not flexible fastening, also can obtain good Initial stability; This titanium nail titanium plate can bear larger pressure, can be by screw and vertebral body lateral mass with it well with its dispersion, can effectively keep the width that opens the door and the volume of angle and canalis spinalis, thereby keep good effect, with stability, the fastness maximization of the postoperative vertebral plate that opens the door.Prove by biomechanics experiment, the biomechanical property of this titanium nail titanium plate obviously is better than at present the clinically traditional axle fishplate bar (centerpiece bridging board) of use, its peak load, at closing time the load and power consumption all be higher than the latter, can reach respectively about 6,11 and 7 times of the latter, the biomechanics results contrast has significant significant difference.But find in the experiment that there is the not good problem of attaching property in it, after this, the applicant has done further improvement to the design of this new and improved single open-door Miniscrew titanium plate, its objective is can be better and plant bone mass, the spinous process platform, both sides lateral mass and both sides vertebral plate attach, overall structure more meets the construction features of human cervical spine, biology, attaching property was better, and to the design of the chamfering structure of transition position, in operation, can allow the surgeon in art according at any time pre-bending of different situations, in time adjust angle, make things convenient for the surgeon to operate, shorten operating time, reduce manufacturing cost.Finally formed Full vertebral plate-bilateral-mass centerpiece universal for cervical vertebra of the present invention.
Such as Fig. 1~shown in Figure 4, Full vertebral plate-bilateral-mass centerpiece universal for cervical vertebra of the present invention, made by a long narrow metallic plate, adjacent with the first lateral mass fixing head 1 is the first vertebral plate fixing head 2, and the angle of the first lateral mass fixing head 1 and the first vertebral plate fixing head 2 lower edge extended lines (Fig. 3 is not shown, and the angle A among Fig. 3 is symmetrical arranged) is 10 °; Adjacent with the second lateral mass fixing head 6 is bone grafting fixing head 5, and the angle of the second lateral mass fixing head 6 and bone grafting fixing head 5 lower edge extended lines is 10 ° (angle A among Fig. 3); The first vertebral plate fixing head 2 is adjacent with spinous process platform fixing head 3, and angle between the two (labelling 13 of Fig. 1) on front view is 140 °; The second vertebral plate fixing head 4 is between spinous process platform fixing head 3 and bone grafting fixing head 5; And the angle of (labelling 14 of Fig. 1 and labelling 15) is 140 ° between the second vertebral plate fixing head 4 and spinous process platform fixing head 3 and the bone grafting fixing head 5, and it is whole to consist of arch.
On above-mentioned the first lateral mass fixing head 1, the second lateral mass fixing head 6, spinous process platform fixing head 3, bone grafting fixing head 5, the first vertebral plate fixing head 2 and the second vertebral plate fixing head 4 all with screw fixed hole.
Connect metallic plate thickness of slab 1mm between above-mentioned each fixing head with the chamfering transition; Wherein the screw hole of two screw holes of first, second lateral mass fixing head (1,6) and spinous process platform fixing head 3 is circular, and the screw hole of all the other fixing heads is oval slotted hole.
First, second lateral mass fixing head (1,6) is 10 ° (Fig. 3) with the first vertebral plate fixing head 2 and the included angle A of bone grafting fixing head 5 lower edge extended lines on side view, and is consistent with the physiology inclination angle of human cervical spine lateral mass.
The circular screw fixed hole (7,12) of two longitudinal arrangements is arranged on the first lateral mass fixing head 1 and the second lateral mass fixing head 6.Be fixed in the cervical vertebral body lateral mass by two pieces of screws, bone grafting fixing head 5 passes through fixedly plant bone mass of oval long screw hole 11 by one piece of screw, the first vertebral plate fixing head 2 and the second vertebral plate fixing head 4 pass through oval long screw hole (8 by one piece of screw respectively, 10) be fixed in cervical vertebra plate, spinous process platform fixing head 3 passes through fixedly spinous process platform of circular screw hole 9 with one piece of screw.
In the mill, the material of metallic plate is selected medical titanium alloy.The length of the first lateral mass fixing head 1 and the second lateral mass fixing head 6 is 5mm, and the length of spinous process platform fixing head 3 is 8mm, and the length of bone grafting fixing head 4 and the first vertebral plate fixing head 2 and the second vertebral plate fixing head 5 is 14mm.Certainly, the size of its each fixing head can also be adjusted according to actual needs.
Operation principle of the present invention is, during implantation, the first lateral mass fixing head 1 by both sides and the second lateral mass fixing head 6, spinous process platform fixing head 3, bone grafting fixing head 5, the first vertebral plate fixing head 2 and the second vertebral plate fixing head 4 are respectively by screw hole fixedly cervical lateral mass, spinous process platform, plant bone mass and vertebral plate, the structure of side and the door-hinge side of opening the door in the realization laminoplasty is fixed, simultaneously with integrated arch-shaped reconstruction Cervical Vertebral Canal Procedures, realized that physiological that Cervical Vertebral Canal Procedures enlarges shaping postoperative Cervical Vertebral Canal Procedures is rebuild and stability reconstruction to greatest extent.

Claims (4)

1. a Full vertebral plate-bilateral-mass centerpiece universal for cervical vertebra is characterized in that, it is made by a long narrow metallic plate, and wherein: both sides are the first lateral mass fixing head (1) and the second lateral mass fixing head (6); Adjacent with the first lateral mass fixing head (1) is the first vertebral plate fixing head (2), and the angle of the first lateral mass fixing head (1) and the first vertebral plate fixing head (2) lower edge extended line is 10 °; Adjacent with the second lateral mass fixing head (6) is bone grafting fixing head (5), and the second lateral mass fixing head (6) is 10 ° with the angle of bone grafting fixing head (5) lower edge extended line on side view; The first vertebral plate fixing head (2) is adjacent with spinous process platform fixing head (3), and angle is 140 ° between the two; The second vertebral plate fixing head (4) is positioned between spinous process platform fixing head (3) and the bone grafting fixing head (5); And the angle between the second vertebral plate fixing head (4) and spinous process platform fixing head (3) and the bone grafting fixing head (5) is respectively 140 °, and it is whole to consist of arch;
On described the first lateral mass fixing head (1), the second lateral mass fixing head (6), spinous process platform fixing head (3), bone grafting fixing head (5), the first vertebral plate fixing head (2) and the second vertebral plate fixing head (4) all with screw fixed hole;
The length of described the first lateral mass fixing head (1) and the second lateral mass fixing head (6) is 5mm, the length of spinous process platform fixing head (3) is 8mm, and the length of bone grafting fixing head (5) and the first vertebral plate fixing head (2) and the second vertebral plate fixing head (4) is 14mm.
2. Full vertebral plate-bilateral-mass centerpiece universal for cervical vertebra as claimed in claim 1 is characterized in that, the thickness of slab of described metallic plate is 1mm.
3. Full vertebral plate-bilateral-mass centerpiece universal for cervical vertebra as claimed in claim 1 is characterized in that, the circular screw fixed hole of two longitudinal arrangements is arranged on described the first lateral mass fixing head (1) and the second lateral mass fixing head (6).
4. Full vertebral plate-bilateral-mass centerpiece universal for cervical vertebra as claimed in claim 1, it is characterized in that the screw fixed hole on described spinous process platform fixing head (3), bone grafting fixing head (5), the first vertebral plate fixing head (2) and the second vertebral plate fixing head (4) is oval slotted hole.
CN 201110085934 2011-04-07 2011-04-07 Universal omni-posterior-double lateral mass bridging board for cervical vertebra Expired - Fee Related CN102247207B (en)

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CN102551868A (en) * 2012-01-10 2012-07-11 刘观燚 Posterior cervical spine single open door side block spinous process steel plate
CN103845107B (en) * 2014-01-13 2015-10-28 侯勇 Posterior cervical opens the door and supports fixing head
US9717541B2 (en) 2015-04-13 2017-08-01 DePuy Synthes Products, Inc. Lamina implants and methods for spinal decompression
CN105078567B (en) * 2015-09-23 2017-12-15 自贡市第四人民医院 A kind of personalized neckpillow fixing screws are entered to follow closely navigation template
CN106333738B (en) * 2016-11-10 2019-11-01 山东大学齐鲁医院 Support plate and its manufacturing method between a kind of approach double door spinous process of cervical vertebra multifidus gap
CN109009386A (en) * 2018-09-17 2018-12-18 北京市富乐科技开发有限公司 Posterior cervical plate
CN110226959A (en) * 2019-04-01 2019-09-13 上海交通大学医学院附属第九人民医院 Neck way of escape dynamic fixation device
US11389209B2 (en) 2019-07-19 2022-07-19 Medos International Sarl Surgical plating systems, devices, and related methods
CN112426217B (en) * 2020-10-30 2022-03-04 北京大学第三医院(北京大学第三临床医学院) Spinous process reconstruction opening door plate

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