CN103006356A - Bionic type hydraulic movable artificial vertebral body - Google Patents
Bionic type hydraulic movable artificial vertebral body Download PDFInfo
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- CN103006356A CN103006356A CN2013100039647A CN201310003964A CN103006356A CN 103006356 A CN103006356 A CN 103006356A CN 2013100039647 A CN2013100039647 A CN 2013100039647A CN 201310003964 A CN201310003964 A CN 201310003964A CN 103006356 A CN103006356 A CN 103006356A
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- intervertebral disc
- vertebral
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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
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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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
Abstract
The invention discloses a bionic type hydraulic artificial vertebral body design for spinal physiological function reconstruction. The bionic type hydraulic artificial vertebral body comprises a main cylindrical artificial vertebral body with a core structure, wherein the inner part of the core structure contains pistons (13 and 14) and hydraulic bags (10 and 11). An upper end plate (24) and a lower end plate (25), which are matched with semielliptical (spherical) motion shafts (21 and 22) in structure, are arranged at two ends of each piston. The end plates of the artificial vertebral body are normal adjacent vertebral end plate flats (cemented fixation) or fixed stings (31 and 32) with metal millipores and biological material coating millipores (biological type fixation), and the rear edge of the vertebral body can be further fixedly arranged at a pedicle of vertebral arch through card slots (40 and 41) of the fixed structure of a pedicle of vertebral arch staple bolt (45). The vertebral body design can be further shrunk as a hydraulic artificial intervertebral disc design (60).
Description
Technical field
The present invention relates to a kind of medical device, particularly rebuild the movable artificial vertebral body of bionic-type fluid pressure type of spinal column physiological function after a kind of spinal defect pathological changes.
Background technology
Spinal fusion techniques is the main flow idea of modern spinal surgery, plays good clinical effectiveness in treatment spinal defect pathological changes.
Adopt the pattern of fusion artificial vertebral body for the comminuted vertebral fracture of explosion and vertebral tumor clinically more, rebuild the vertebral body part of disappearance, and the pathological changes execution vertebral body excision post-fusion of a joint vertebral body will be lost two intervertebral disc functions clinically, namely merge the vertebral body of at least three sections, sacrificed the motor function of original spinal vertebral intervertebral disc.
Extensive clinical practice along with spinal fusion, the new problem that complication after the fusion and the forfeiture of spinal function bring manifests day by day, so that the clinician progressively recognizes probability and necessity that the spinal column original function is rebuild: the multi-segmental vertebral fusion produces straight back of the body deformity easily, because of losing of intervertebral disc function, so that the change of the original mechanical property of spinal column, can produce the acceleration regression at the intervertebral disc that merges the vertebral body two ends, the cervical vertebra motor function loses and technical problem that operation itself brings behind the Cervical Fusion.
The invention of artificial vertebral body and application and people are familiar with structure and mechanical characteristic and the at that time residing social environment and manufacturing Horizontal correlation of spinal column.Initial artificial vertebral body is applied to cervical vertebra, is a metal ball, places the cervical intervertebral disk place of excision, is absorbed in vertebral body but the spherical cervical intervertebral disk in position appears replacing in the patient who replaces immediately, and vertebral height is lost, compression of spinal cord.Thereafter, the various countries clinician performs the operation to do to intervertebral disc replacement and makes great efforts and trial, comprises the Bryand cervical intervertebral disk, designs various sample artificial vertebral bodies or intervertebral disc, but because of the limitation that spine structure is familiar with, all has its shortcoming.
Look back to merge with the spinal function reconstruction operations historical with clinical gain and loss, when we when carrying out intervertebral disc and spinal column related surgical, be necessary further to be familiar with structure and the mechanical property of vertebral body intervertebral disc.How comparatively structure and the mechanical characteristic of the understanding spinal vertebral of science and intervertebral disc?
Is is can see a lot of phenomenons clinically: why spinal fracture more common in the soleplate fracture and subsided and rarely descend soleplate to fracture and subside? the acute common vertebral fracture of violence effect spinal column and rare nucleus pulposus is outstanding (except original intervertebral disc degeneration, it is outstanding that cervical vertebra can merge the cervical intervertebral disk avulsion)? intervertebral disc degeneration is outstanding to see strain and rarely in traumatic violence (after often being that chronic back pain is arranged once unexpected sprain or prudent thing causes intervertebral disk hernia)? is intervertebral disc degeneration fibrous ring regression or Nucleus Pulposus to occur first? is the Shumor tuberosity more common in the breast intervertebral disc of lumbar vertebra? the common Lumbar Intervertebral Disc Degeneration of lower lumbar spine, is the age of onset group more common in person between twenty and fifty? does the intervertebral disk hernia sickness rate have minimizing trend after the human body age increases? in the gerontal patient, lymphogranuloma inguinale shape Wedging appears in vertebral body, does and intervertebral disc become elliposoidal? the multiple lower lumbar spine gap of being born in of intervertebral disc degeneration, and is upper lumbar spine rare? Black intervertebral disc phenomenon appears behind the intervertebral disc degeneration, can intervertebral disc trailing edge MRI highlighted signal occur and levy? does Modic sign appear in the vertebral body of lumbar instability? gerontal patient's vertebral fracture occurs easily and nervous symptoms is common not as between twenty and fifty patient.
Why? can be there there unified understanding?
Do all these pathological changes or phenomenon have its inherent essential connection? do these pathological changes rules have its structural endogenous cause of ill? how to disclose and be familiar with these phenomenons? medical procedures? biological method?
At this, analyzed by superficial geometry principle and physics principle.
Human body is natural evolution body, gravitate.Human body produces two macrostructures that good motor function depends on human body: the coordination exercise balance of bone structure balance and muscle, the complicated body movement of generation human body under the nervous system domination is such as work, wushu, gymnastics etc.Organization of human body has the one side of physics characteristic, and Principle of Natural Science is followed in human motion equally.
Observe the dry N/D spinal vertebral of the complete Chinese of 10 tools specimen (man 6, woman 4), minimum scale is 0.5 millimeter steel rule, measures the vertebral body the widest transverse diameter L in cross section and the longest radius vector H.
Spinal vertebral cross section structure: C
2Lower section is to S
1Upper section, cervical vertebra 11, thoracic vertebra 24, lumbar vertebra 11 be totally 46 cross sections.C
2To T
3The approximate Semen Sojae Preparatum shape in cross section is oval, T
4To T
12Approximate peach-shaped, L
1To S
1The cross section is similar to the shape of a hoof, the similar and continuity of geometry that these cross sections are adjacent.Thus, can utilize mathematics and physics principle to make an explanation.
At this, introduce the 1st geometry mathematical principle: similar Area Ratio equals the ratio of any corresponding reticule product.
The architecture basics in spinal vertebral cross section: intervertebral disc adjacent vertebral bodies horizontal cross-section structural similarity meets the similar principle of plane geometry, that is: ellipse area S=π * a*b (a, b is respectively oval two radius), estimate that thus the vertebral body area of section is that (L*H is area index to S=π * L/2*H/2, π is pi, it is a constant, it is oval that each vertebral body cross section is approximately, at this, do a standard ellipse take the transverse diameter radius vector in vertebral body cross section as parameter, the area usable area is approximate between standard ellipse geometric figure and actual vertebral body sectional view cuts reinforcement conversion: namely oval the place ahead area of marking the vertebral body part can be filled mutually and offsets be cut mutually part by ellipse with rear, vertebral body cross section, obtains thus the vertebral body sectional area that is similar to).
π is pi, is a constant, can further simplify thus each other area relationship, i.e. area index K between each vertebral body cross section
S=transverse diameter (L) * radius vector (H).
The intervertebral disc structure periphery is fibrous ring sealing, and inner nearly terminal plate of vertebral body place is cartilage endplate in order to contain the vertebral pulp collagen tissue of 80% left and right sides moisture, and with cortex soleplate close proximity.Whole intervertebral disc structure is the moisture abundant elastic macromolecule nucleus pulposus of certain space that has again of a closed state.The liquid water molecule has the physics characteristic of himself: meet again in confined conditions the hydrostatics action principle; The vertebral pulp collagen tissue has elastic physics characteristic, i.e. Hooke's law on the physics is to the free cushioning effect of external force.
Thus, introduce the 2nd physics principle: hydrostatics pressure transfer law: enclosed liquid is subjected to be converted to pressure behind the External Force Acting, and the inner external amount of force of enclosed liquid is relevant with the external active area size that enclosed liquid contacts, that is: P=F/S=F
1/ S
1=F
2/ S
2
The variation of airtight internal fluid pressure is all worked under malleation, negative pressure, and suction function is as Magdeburg hemispheres, and namely enclosed liquid all need overcome equal large low-force under direct draught enclosed liquid and the negative pressure.Moisture abundant complete airtight intradiscal pressure fluctuation is so that spinal column becomes a continuous mechanical function body that passes through, be the stressed spinal column that will prolong by the Laws of Mechanics of enclosed liquid of spinal column one end to stressed other end transmission, and the transmittance process intradiscal pressure meets hydrostatic hydraulic pressure and changes.
Inner at same intervertebral disc, pressure P equates that stressed size of hypocentrum is on it: F
1=P*S
1(S
1=π * L
1/ 2*H
1/ 2), F
2=P*S
2(S
2=π * L
2/ 2*H
2/ 2).Thus, vertebral body is stressed to be that vertebral body area of section size is consistent with vertebral body and intervertebral disc contact area size, that is: vertebral body-stressed index in intervertebral disc cross section is reduced to K
F, K
F=L*H namely with on the area index numerical value equates, and is relevant with vertebral body transverse diameter radius vector product size in the measurement.At this, draw reasoning imagination: the static pressure of human spine's intervertebral disc equates (if does not wait pressure difference must occur cause vertebral body to hang down a side shifting to pressure).
To sum up, by above-mentioned two mathematics-geometry, mathematics-physics principle reasoning, on understanding spinal column Laws of Mechanics, the effect core of power is airtight intervertebral disc, and is not to be the vertebral body at disease damage position of usually performing the operation.Set up thus centered by intervertebral disc, the motion structure unit that adjacent vertebral bodies consists of spinal column carries out the analysis of structure and sport dynamics, and intervertebral disc is " the stressed hinge of spinal column ", its structural area S=(π/4) * L*H, π/4 are a constant, and with stressed F=P*S=P* (π/4) * L*H, P equates in the intervertebral disc, π/4 are constant, there is a variable, can uses area of section-stressed index K to express K=L*H.
By the result that said method is measured, the area of section index is from C about the spinal vertebral
2Lower section-L
4Lower section is the curvilinear motion that increases progressively, to L
4It is maximum that vertebral body lower section area reaches; L
4Lower section is to S
1Upper section is long-pending to successively decrease.Each corresponding vertebral body area of section of women is slightly less than the male, and variation tendency is identical.
Vertebral body-intervertebral disc area index K
S=L*H; The stressed index K in vertebral body-intervertebral disc cross section
F=L*H.Vertebral body cross section transverse diameter radius vector can calculate the area index size variation (the results are shown in Table 1) in each cross section.
Each area of section of table 1 vertebral body-stressed index result
Spongy bone is the trabecular bone structure of the netted branch in space in the vertebral body, and the vertebral body periphery is that (this mesh space structure is the adaptation result on the spinal column mechanics: maximum mechanics peptizaiton is unified mutually with the lightest and the handiest own wt structure for the structure that contains cortical bone; It is again best storeroom that interior spatial structure is rich in liquid blood, carry out bio-regeneration and metabolic function etc., simultaneously, the blood flow of relative closed state produces again the physics characteristic of hydraulic pressure), nearly terminal plate of vertebral body place is soleplate cortex, and the hard cortical bone of vertebral body periphery plays vertebral body and is supported in fixedly protective effect; Nearly soleplate place is endplate cartilage in the intervertebral disc, and periphery is fibrous ring, and the center is nucleus pulposus.The external mechanical property of complete vertebral body structure is near mechanical rigid body; Intervertebral disc is the approximate airtight hydraulic pressure structure that has again certain elastic reaction.
According to the up and down measurement and analysis and how much physics principles of soleplate transverse diameter radius vector of above-mentioned vertebral body, can therefrom draw following rule or explain relevant clinical picture:
1, human spine's terminal plate of vertebral body area of section is from C
2Lower section is to L
4Lower section increases gradually, L
4Lower section is to S
1Successively decreasing appears again in upper section, corrects in the past to think spinal vertebral sectional area S on the anatomy
1Wrong understanding for maximum area; L
4The lower section maximum has its anatomical basis, most people L on the anatomy
4,5Intervertebral space parallels with crista iliaca, and crista iliaca decomposes and a part of strength of bearing trunk, and namely stress force shelter reaction has objectively reduced the pressure stresses to the intervertebral disc vertebral body.
2, this structure law of human spine also has the Special Significance of its biological evolution.Human body is upright walking organism.In motor process, produce momentum MV, the vertical momentum mv that prolongs the skeleton transmission acts on the spinal column, and this momentum is converted to momentum fT.The viscoelastic structure of each cross section of spinal column and intervertebral disc separately; the size of sectional area S determines the stressed size of intervertebral disc; successively decreased to cervical vertebra by lumbar vertebra in human spine vertebral body cross section; ground also successively decreases the impulsive force of uploading along skeleton when being conducive to protect brain to avoid walking in the face of the recoil active force of human body head thereupon.When being subjected to the ultraviolence effect to cause vertebral fracture, the anterior vertebral of explosion or compression has lost the continuity conduction function of original mechanics; On the other hand, the instantaneous interruption of the power that causes because of vertebral fracture has been protected the vital center brain, prevents the direct transfer function of larger violence in brain and fatal.
3, take intervertebral disc as spinal column mechanics study center, " the stressed hinge of spinal column ", the upper soleplate area of intervertebral disc is less than its next soleplate area; Foundation can disclose spinal column Laws of Mechanics and most clinical medicine phenomenon take intervertebral disc as the mechanics study center.Spinal fracture is under the active force of relatively vertical spinal column, intervertebral disc is subject to the active force of hypocentrum, internal pressure moment increase, but vertebral pulp collagen in the intervertebral disc, in conjunction with water, produce the elastic potential energy transduction between cartilage and the fibrous ring and obtain buffering, intervertebral disc can bear huge impulsive force, the potential energy of vertebral pulp moment and hydrostatic pressing discharge the pressure to terminal plate of vertebral body that produces, react on contiguous terminal plate of vertebral body, soleplate is used for Intrapyramidal Grafting Cancellous Bone Bolt girder with suffered masterpiece, the local bone girder is not enough to bear the huge local fracture of active force generation of moment, this local fracture produces the domino effect of moment under huge intervertebral disc action of compressive stress, at the inner instant exploding of vertebral body, up and down terminal plate of vertebral body with the intervertebral disc adjacency, subsiding of burst must occur first in the next vertebral body of stressed larger intervertebral disc, the advantage function principle of nature power: power finally causes the vertebral body explosion of spinal column always to the failure effect of minimum resistance position.Here it is clinically spinal fracture be more common in the spinal column mechanical structure basis of the upper soleplate fracture of vertebral body.
4, the structure of intervertebral disc and regression
L
4,5And L
5S
1The gap is main account for more than 96% of clinical intervertebral disc prolapse, C
5,6, C
4,5Being the Major Segments of intervertebral disc degradation at cervical vertebra, is main motion segment in the motion of corresponding sections, and the summit that its structure is the Human Physiology lordosis, and the natural summit of stress namely becomes the position of stressed strain.
Crista iliaca and L
4,5Intervertebral disc parallels, at L
4,5Form trunk skeleton triangle and lower limb skeletons triangle formation mechanics and turn the point of contact, the rotation of human body waist and activity are finally at L
4,5Compile; L
5S
1Regression is relevant with the front bent mechanics point of contact of human body lumbar vertebra physiology, and the action of gravity of trunk is finally at L simultaneously
5S
1Turn the point of contact in the formation.Because of L
4,5Intervertebral space on the crista iliaca plane, the major function activity of bearing the rotation of body the first half and bending and stretching, L
4,5The easiest regression appears clinically, with L
5S
1Because of different mainly due to the shear stress regression of spinal column self axial force behind the crista iliaca stress shielding, L
5S
1There is no L on the regression imaging observation of intervertebral disc
4,5It is serious that the gap is destroyed.The effect of revolving force produces the destruction that tractive reverses to annulus fibrosus disci intervertebralis, cause annulus fibrosus disci intervertebralis to be torn at the small avulsion fracture of vertebral body trailing edge (vertebral body trailing edge fibrous ring is weak), the small avulsion fracture of fibrous ring causes the original airtight performance of intervertebral disc to destroy.This performance can obtain fine explanation in industrial jack, jack jack mechanical performance that oil leakage phenomenon causes occurs and descends or lose with rear for a long time.Original mechanical performance descended thereupon after the intervertebral disc volume increased, original hydrostatic pressing effect reduces to nucleus pulposus to cause adjacent vertebral bodies, the mechanical presses effect strengthens, what vertebral pulp was interior becomes free water in conjunction with water, the dehydration degeneration of vertebral pulp causes Black intervertebral disc phenomenon, can be simultaneously on MRI, " water droplet " image of high signal appears in the intervertebral disc rear; The local stress effect is so that intervertebral disc cartilage and periphery because of the destruction of original keeping passage, produce aseptic chemistry pro-inflammatory cytokine under the oxygen free condition, and entering local organization stimulates local nerve, produces clinical lumbago symptom.When regression continues, the vertebral pulp dehydration further increases the weight of, space in the intervertebral disc increases, the impact forces of contiguous vertebral body increases, the clinical regression symptom of two kinds of approach can occur: fibrous ring is torn and is increased the weight of, vertebral pulp is stressed outstanding to the intervertebral disc rear because of the trunk flexing, the neural sciatic nerve symptom that produces of the outstanding compressing of clinical generation vertebral pulp intervertebral foramina, and this symptom is the most common to be to occur behind a heavy physical labour behind the chronic lumbar strain; Intervertebral space is because of the vertebral pulp effect of being squeezed, moisture is further lost, intervertebral disc space further enlarges, clinical generation degenerative lumbar scoliosis is unstable, cause the contiguous vertebral body of intervertebral disc mutually to produce effect of impact, terminal plate of vertebral body generation regression causes the direct collision effect of regression intervertebral disc adjacent vertebral bodies, and little fracture edema of vertebral body inside produces Modic sign clinically.The damage of intervertebral disc structure causes structural deterioration between vertebral body, i.e. textural anomaly between the articular process of adjacent vertebral bodies, and the variation that produces thus local mechanical structure causes the regression hypertrophy of articular process cartilage and ligament.
In the case of spondyloschisis lumbar spondylolisthesis, the intervertebral disc ligament has lost the rock-steady structure of bone, suffers the External Force Acting regression more obvious.Intervertebral disc degeneration further increases the weight of the vertebral pulp loss of moist and the intervertebral disc volume further reduces, the foundation failure of original mechanical structure, clinical generation Degenerative spondylolisthesis.
In breast waist section, the spinal column intervertebral disc is stressed as main take vertical direction, when the vertebral body self structure unusual, cause the vertebral body cancellous bone structure unusual such as aberrant angiogenesis in the vertebral body, under the stressed effect of spinal column vertical direction, terminal plate of vertebral body strength can not provide the intervertebral disc abutment pressure, vertebral pulp occurring charges in vertebral body, be the mechanical foundation of Shumor tuberosity, therefore, the terminal plate of vertebral body cartilage that the Shumor tuberosity is considered to subside or the calcification of part fibrous ring.
5, terminal plate of vertebral body deformation and senile vertebral body regression
The image check of MRI, X sheet etc. is observed terminal plate of vertebral body and is engendered deformation with the age.Most old peoples' terminal plate of vertebral body is curved, and arc is towards the vertebral body direction, in osteoporotic crowd performance more obvious, the severe patient terminal plate of vertebral body can be Pisces mouth shape.In the geometry, it is long-pending that the sphere object has maximized surface.In physics principle, area increases, and has increased the active area between object.This rule has then increased the active force to vertebral body in intervertebral disc and vertebral body structure.The bone trabecular structure of vertebral body provides the mechanical support power of vertebral body.When making vertebral body internal skeleton girder bone loss, bone degeneration bone trabecula mechanical performance, the factors such as old body degeneration reduce, cause bone trabecula that the supporting role of terminal plate of vertebral body is descended, the degeneration of body causes hemopoietic function decline in the spongy bone, the hydraulic performance that Intrapyramidal blood produces also descends thereupon, and namely the complete external mechanical property of vertebral body reduces along with the aging of body; Intervertebral disc is because of the change of original soleplate structure, moisture enters intervertebral disc to be increased, the increase of intervertebral disc moisture directly causes the rigidity of intervertebral disc to increase, make intervertebral disc produce spherical the change, the spherical intervertebral disc endplate surface that becomes is long-pending to be increased, the terminal plate of vertebral body active force is also increased, that is: F=P*S has destroyed hydrostatic pressing and vertebral body sclerotin supporting role equilibrium of forces in the intervertebral disc of terminal plate of vertebral body interface thus.In vertebral body structure, the vertebral body periphery is cortical bone, inside is spongy bone, the mechanical structure basis is better than in the middle of the vertebral body for vertebral body periphery mechanics supports, and old vertebral body spongy bone bone loss causes the vertebral body mechanical properties decrease, little fracture of the inner spongy bone of vertebral body can not in time obtain repairing, under the terminal plate of vertebral body active force, the inner appearance of vertebral body is fractured at dmm, and final terminal plate of vertebral body regression is the concave surface arc.Among the iconography MRI, can see intervertebral disc change spherical in shape, moisture increases.In elderly population, because of the intervertebral disc moisture varying, volume increases, and terminal plate of vertebral body descends to the squeezing action power of intervertebral disc, clinically on the contrary between twenty and fifty minimizing of the patient of intervertebral disc degeneration herniation of nucleus pulposus.
6, moisture changes and the pressure adjusting in the normal disc
Human intervertebral disc is the vertebral pulp collagen structure that is rich in moisture in the fibrous ring sealing, and vertebral body is up and down endplate cartilage.Hydrone discrepancy concrete ways is still not clear at present in the intervertebral disc, supposition is under different stress conditions, hydrone is combined with organic macromolecule by the polarity of terminal plate of vertebral body carrtilage space or hydrone in intervertebral disc and is separated the turnover intervertebral disc, discrepancy in a small amount of hydrone intervertebral disc, not only finish the needs of physiologically substance exchange, what is more important moisture turnover intervertebral disc, and fibrous ring structural flexibility, can make the intervertebral disc volume that few trace occurs changes, intervertebral disc under the external force high pressure conditions is particularly important for being subjected in moment, on the one hand the intervertebral disc volume is regulated, also spinal column intradiscal pressure power is regulated on the other hand, make vertebral pulp and water finish elasticity-hydraulic cushion and change, discharge the quick-fried power effect of moment; On the other hand, work with terminal plate of vertebral body cartilage one, buffer limit pressure is to the destruction of terminal plate of vertebral body.This is common vertebral fracture under the violence effect clinically namely, and rare intervertebral disk hernia (except the existing annulus fibrosus disci intervertebralis Nucleus Pulposus).Thus reasoning, the destruction of intervertebral disc is the architecture basics of intervertebral disc degeneration, for intervertebral disc prolapse patient's operation, the fibrous ring structure will inevitably cause the outstanding again of intervertebral disc after the part of intervertebral disc was extractd the intervertebral disc that destroys.
7, vertebral body self structure
Complete vertebral body can be used as rigid body and realizes the mechanics of intervertebral disc is continued, but the space multistory network structure of vertebral body inside self, comply with each side's strength and decompose each side's strength on the one hand, the blood sinus that inside is full of not only provides the metabolism of vertebral body spongy bone, and the liquid physics characteristic of blood also provides the decompression of the hydraulic pressure on the mechanics; On the other hand, this structure is under extreme External Force Acting, the space multistory network structure of vertebral bone Domino effect can occur because of the bone trabecular local fracture of vertebral body, instant exploding appears, the impulsive force of vertebral body internal liquid (mainly being blood) explosion is that (nerve injury is many by due to the impulsive force of vertebral body internal liquid for the mechanical foundation of spinal fracture nerve injury, the compressing of bone piece mostly is the follow-up damage after the fracture, between twenty and fifty vertebral body bursting fracture is stressed large, the probability of spinal cord injury is much larger than gerontal patient's spinal fracture, and nervous symptoms relative when occurring bone piece Spinal canal encroachment behind gerontal patient's the osteoporotic fracture is light or few on the contrary).
Summary of the invention
According to above-mentioned understanding reasoning, at this spinal column intervertebral disc-vertebral body mechanics complex structure model take intervertebral disc as " stressed hinge " is proposed.
The objective of the invention is: the segmental that causes for clinical spinal vertebral fracture lacks problem, for the full vertebral fracture of pathologic due to the tumor subsides and the clinical column reconstruction treatment of serious bursting fracture of vertebral body provides a kind of movable artificial vertebral body of bionic-type fluid pressure type of rebuilding the spinal column physiological function, rebuild the spinal column physiological function.
Technical scheme of the present invention is: structure comprises mobilizable joint, two ends spline structure (20-21), fluid pressure type cylindrical bodies (12), wherein the fluid pressure type cylindrical bodies is the vertebral body columnar shape, be the core structure of this piston type biomimetic prosthetic vertebral body structure, the both sides piston space is airtight high-molecular biologic glue; The two ends piston is an elliposoidal groove, the pellet shapes post (20 that one antiskid is arranged in the groove, 23), elliposoidal groove and soleplate connecting plate convex ellipsoid are complementary, consist of the movable structure of this vertebral body design, the soleplate position is plane (bone cement is fixed) or the barbed fixed structure of micropore (biotype is fixed), reaches one with contiguous normal vertebral body soleplate and fixes.
The manufactured materials of the movable artificial vertebral body of bionic-type fluid pressure type of reconstruction spinal column physiological function of the present invention is compound, the limiting plate that is connected with terminal plate of vertebral body and artificial vertebral body post can adopt clinical biocompatible materials commonly used, such as vitallium, titanium alloy, tantalum, bioceramic, polyethylene etc. make up composition mutually as artificial hip joint, knee joint structure; The core component hydraulic means is that the airtight capsule of superpolyester biomaterial consists of with the biological colloidal sol of inner biocompatible polymer.
The movable artificial vertebral body of bionic-type fluid pressure type that the present invention rebuilds the spinal column physiological function is mainly used in the reconstruction operations that the spinal fracture vertebral body lacks.Operating procedure is roughly the same with clinical existing spinal fusion type artificial vertebral body implantation.
The pedicle of vertebral arch bail of the movable artificial vertebral body of bionic-type fluid pressure type of reconstruction spinal column physiological function of the present invention can be fixed in by the percutaneous cervical arc root screw technology fixes artificial vertebral body of the present invention itself on the pedicle of vertebral arch, prevent the slippage of the design's artificial vertebral body.
Hydraulic pressure composite construction of the present invention is the design's technological core, also is the design's critical technological point.The well-known saying of mechanical industry: " getting the hydraulic pressure person gets the world ", hydraulic pressure all is the technology emphasis of mechanical industry in each fields such as industry, war industrys, be used for the conduction (undercarriage of aircraft, the arrester wires of aircraft carrier, tank buffer bed etc.) of buffering and the mechanicals efforts of various machineries.At human body, the hydraulic function of spinal vertebral-intervertebral disc can't reach completely with the industrial level day after tomorrow, and function replaces, strong muscles and bones is that organism adapts to the result that the Nature is evolved and tempered (the body development period of maturation of human body before 20 years old) day after tomorrow, ligament originates from bone and is better than bone, have powerful mechanical function, but Here it is muscle knochenbruch and muscle is continuous.Modern industry still can not be realized pliable and tough airtight water pressure resistance structure and the durable applications of the shearing force between rigid objects.Correct posture is to reduce the best way to keep in good health of body regression.The intervertebral disc of nature is a structure lifelong, that hydraulic function is arranged, flexible pooling feature in human body interior mechanics performance.The present invention is intended to the biomechanics structure of understanding spinal column on the theory, and continue to use the intervertebral disc function of naturalness: airtight hydraulic structure can be converted to pressure with strength, according to its contact area conduction strength, reaches bionical biotype structure when contacting with solid.
The present invention rebuilds the movable artificial vertebral body of bionic-type fluid pressure type of spinal column physiological function, adopts two elliposoidals (or spherical) structure matching with the terminal plate of vertebral body contact surface, and purpose is to go back the micromotion structure of intervertebral disc between archecenra.
Advantage of the present invention:
The present invention rebuilds the movable artificial vertebral body of bionic-type fluid pressure type of spinal column physiological function, made by the combination of materials that biocompatibility is arranged, when the support of rebuilding spinal column, the physiological movement function of recovery spinal column reduces the intervertebral disc degeneration at a specified future date of pattern of fusion artificial vertebral body and iatrogenic spinal column is stiff and the regression at a specified future date of adjacent discs; Sought the thinking of a understanding spinal biomechanics performance in theory.
In advantage compared to existing technology, also have the shortcoming of himself:
1, the present invention only proposes the innovation of spinal column technology in theory, far can not reach the physiological function of nature spinal column on existing industrial technology;
2, the present invention is only in the imagination of mechanical structure proposition to human spine's mechanics reconstruction, the not reproduction of the complete biological function of vertebral body (metabolism, hemopoietic function etc.).
Perfectly the spinal function reconstruction technique is the vertebral body that carries out biological allosome-intervertebral disc complex allosome displacement, but nonetheless, still has the destruction of biological antigens, pathophoresis, original spinal column integrity, the defective of initial unstable etc. factor.
Description of drawings
Fig. 1, corpus vertebrae transverse diameter, radius vector are measured diagram;
Fig. 2, sample vertebral body transverse diameter, radius vector measurement result;
Fig. 3, sample vertebral body area-pressure index;
Fig. 4, vertebral body area-pressure index cartogram;
(carrying pedicle screw) seen in Fig. 5, the whole side of the design's artificial vertebral body;
Fig. 6, the design's artificial hydraulic pressure vertebral body overlook, normotopia, side position perspective, vertebral pedicle bolt structure diagram;
Fig. 7, the design's artificial vertebral body and pedicle screw connected structure diagram;
Fig. 8, the design's vertebral pedicle bolt structure;
Fig. 9, the design's artificial hydraulic pressure vertebral body Facad structure diagram;
Figure 10, the design's artificial hydraulic pressure vertebral body side structure diagram;
Figure 11, the design's artificial hydraulic pressure intervertebral disc structure diagram;
Figure 12, the design embodiment diagram.
Attached: the structural representation diagram:
10---high-molecular biologic glue hydraulic bag;
11---cyst wall;
12---the vertebral body column jacket;
13,14---piston;
20,23---cleat;
21,22---axle moves hemisphere;
24,25,26,27---the upper and lower soleplate of artificial vertebral body (different parts front and rear edge difference in height can be contour);
31,32---the upper and lower soleplate nail of artificial vertebral body thorn;
40,41---pedicle of vertebral arch vertebral body notch;
42---pedicle of vertebral arch bail head; 42-1---pedicle of vertebral arch bail head illustrates at vertebral body draw-in groove half-twist;
43---pedicle of vertebral arch bail afterbody hold-doun nut;
44---pedicle of vertebral arch bail tailing screw flight;
45---pedicle of vertebral arch bail urceolus;
46---pedicle of vertebral arch bail front end screw thread;
47---pedicle of vertebral arch bail tail end bolt;
60---the fluid pressure type artificial intervertebral disk;
61---high-molecular biologic glue; 62---piston plate; 63,64---the movable axis composite construction.
The specific embodiment
Behind the pathological changes vertebral resection, this example artificial vertebral body is inserted, percutaneous is inserted pedicle screw and fix this example artificial vertebral body.Art finishes.
Claims (8)
1. movable artificial vertebral body of bionic-type fluid pressure type that is used for Vertebral body defect reconstruction spinal column physiological function, it is characterized by the cylindricality artificial vertebral body main body (12) that comprises hydraulic bag (11) core texture that includes piston (13) (14) and high-molecular biologic compatible liquid (10), the piston two ends are up and down soleplate (24 of the artificial vertebral body that is connected of the moving structure of semielliptical shape or hemispherical (21) (22) axle, 25), the trailing edge fixing bail (45) of pedicle of vertebral arch that can be aided with fixing artificial vertebral body.
2. described according to claim 1, the design's the movable artificial vertebral body of bionic-type fluid pressure type, it is characterized by the difformity that cylindrical bodies horizontal cross sectional geometry (12) is designed to adapt according to spinal column different parts vertebral body horizontal cross-section, cervical vertebra is that the Semen Sojae Preparatum shape is oval, thoracic vertebra is that the peach shape is oval, and lumbar vertebra is that horse-hof shape is oval; Be connected mutually artificial vertebral body soleplate (24,25) with the adjacent vertebral bodies soleplate and be dull and stereotyped (bone cement is fixed) or metal micro-holes and biomaterial coating micropore (biotype is fixed), there is the nail thorn structure (31,32) of fixation on its surface.
3. described according to claim 1, the axis of the piston at the design's the movable artificial vertebral body of bionic-type fluid pressure type two ends moves structure, it is characterized by semielliptical shape or sphere (21,22) with artificial vertebral body soleplate (24 up and down, 25) one, the moving piston of axle has the moving structure (20-21,23-22) of pellet shapes post jointly stabilizing axle of the slippage of preventing.
4. described according to claim 1, the design's the movable artificial vertebral body of bionic-type fluid pressure type rear end is provided with the fixedly artificial vertebral body trailing edge notch (40) of pedicle screw bail (45), fixedly the design's artificial vertebral body.
5. according to claim 1,4 described, the pedicle of vertebral arch bail of the design's artificial vertebral body is characterized by, bail top (42) are the smooth corner angle geometry designs of oblate spheroid or deltiod, to be connected draw-in groove (40) flat entrance consistent with the vertebral body trailing edge; Bail front end and tail end are the design of Double helix push-in type, namely fixedly pedicle screw was in vertebral body after bail top (42) entered the draw-in groove half-twist, and rotation urceolus spiral (45-46) can snap in urceolus (45) artificial vertebral body trailing edge connecting groove (41); Afterbody spiral (43-44) can be fixed on the bail afterbody pedicle of vertebral arch vertebral plate place, and fixedly the design's artificial vertebral body is on spinal column vacancy vertebral body position.
6. according to claim 1,3 described, the kinematic axis (21,22) that the movable artificial vertebral body soleplate of bionic-type fluid pressure type and piston consist of is slightly elliposoidal or sphere or an elliposoidal and the spherical mutually structure of combination, formation artificial vertebral body kinematic axis main body.
The movable artificial vertebral body of bionic-type fluid pressure type according to claim 1 further micro be designed to artificial intervertebral disk (60), it is characterized by artificial vertebral body hydraulic bag piston structure is reduced to a sealing hydraulic bag (61-62) around movable axis complex (63-64) structure, the physiological function that is suitable for cervical vertebra and lumbar disc disease is rebuild.
8. according to claim 1, the movable artificial vertebral body of 2,7 described bionic-type fluid pressure types adapts with corresponding sections terminal plate of vertebral body cross section transverse diameter L radius vector H with the artificial intervertebral disk soleplate; Artificial vertebral body is relevant with the transverse diameter L radius vector H in corresponding sections vertebral body cross section with artificial intervertebral disk soleplate area of section and stressed relation, has an approximate mathematical relationship, its area-pressure index K=L*H.
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| CN103006356B (en) | 2018-03-16 |
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