Biomimetic prosthetic atlanto-odontoid joint
Technical field
The invention belongs to medical prosthesis manufacturing technology field, particularly relate to a kind of biomimetic prosthetic atlanto-odontoid joint retaining three-dimensional motion.
Background technology
Human body upper cervical spine is the one or two cervical vertebra, i.e. atlas and axis.Atlas and axis is different from below instability, without intervertebral disc structure, be made up of three joints and many ligaments, the i.e. joint, center of dentoid process of axis and anterior arch of atlas posterior condylar face and transverse ligament of atlas, alar ligaments composition, the articular surface composition that two level of approximation that the facies articulares inferiores atlantis of both sides and dentata superior articular surface are formed slightly tilt.Joint, extensive region tooth center is class axletree shape, and the Lateral mass joint collaborate of both sides completes multidirectional activity between atlas and axis: main rotary motion and a small amount of lateroflexion and anterior flexion and rear stretching action.
At present, due to the healing of odontoid fracture old or the atlanto-axial instability that causes such as rheumatic arthritis, wound cause upper cervical cord oppress stimulation there is nervous symptoms time, usually the direct reduction at rear is according to circumstances selected to merge fixing, or Anterior release reduces pressure, excision Odontoid process, is fixed or spaciously puts.But two kinds of equal effects of operation plan are undesirable.Simple Odontoidectomy is postoperative destroys normal configuration, and between atlas and axis, unstability increases, and range of activity strengthens, and the zest for nerve strengthens.Front or rear post-fusion shakiness are eliminated, but new problem occurs.The spinfunction of cervical vertebra about 50% is positioned at atlas and axis, after merging, cervical vertebra rotary moveable degree reduces, larger for human normal life impact, and the cervical vertebra after merging is due to motion and spring function forfeiture, Human Cervical Spine Modeling changes, may occur that stress is concentrated to neighbouring section and wait change, and may occur corresponding complication, facing second operation may.
The appearance of non-fusion technology makes people turn one's attention to atlas and axis, how non-fusion technology is applied to atlas and axis, while removing nerve compression, local deformity, retain the focus that local function just becomes research.
On this basis, the people such as domestic Chen Jian, Cao Zhenglin, Tan Mingsheng, Hu Yong, He Xijing are studied analysis, DATA REASONING to Atlantoaxial anatomic form respectively, and design form difference, functionally similar artificial atlanto-odontoid joint respectively.Such as: the artificial atlanto-odontoid joint of the research design such as Cao Zhenglin, be made up of artificial Odontoid process and artificial anterior arch of atlas.The similar hollow nail of artificial Odontoid process, be divided into continuous print 2 part such as vertebral body portion and tooth teat, dentata vertebral body is fixed in vertebral body portion, and tooth teat gives prominence to body of axis, to dash forward ring portion phase retaining ring with the tooth of artificial anterior arch of atlas.Artificial anterior arch of atlas is symmetrical, the lateral mass screw identical with 2 pieces by l block anterior arch plate forms, artificial anterior arch of atlas is divided into the lateral mass plate of both sides, the tooth of connecting plate and centre dashes forward the continuous print such as ring 3 part, and tooth ring of dashing forward is circular, with the tooth teat associated section of artificial Odontoid process.And the artificial atlas-dens half joint of the development such as Tan Mingsheng, this design is all different with other artificial atlanto-odontoid joints, mainly lay particular emphasis on the stability of the restoration and reconstruction articulatio atlantodentalis dorsalis by extensive region pivot transverse ligament, atlas can be prevented to anterior dislocation, the main spinfunction of atlanto-odontoid joint can be retained again.Although form exists part variation between different artificial joint, mentality of designing is substantially identical, namely bionical to greatest extent and retain the spinfunction of normal atlanto-odontoid joint.
All there is the effect of certain reservation function of joint in above artificial atlanto-odontoid joint.Above-mentioned designation of artificial atlanto-odontoid joint only remains spinfunction, is class trochoid joint.But by connections such as the alar ligaments at rear and ligamentum cruciatums between human body atlanto-odontoid joint, except spinfunction, also there is a small amount of bending and stretching and lateroflexion function.Therefore above-mentioned artificial joint does not reach the function in normal human joint completely, there is segmental defect.
For found shortcoming, He Xijing etc. have carried out upgrading design to artificial atlanto-odontoid joint, devise second filial generation artificial atlanto-odontoid joint.Joint is divided into upper and lower two joints: top adopts trochoid joint, below adopts ball-and-socket joint.The mobility of ball-and-socket joint ensure that close internode can multi-direction activity, reach atlas and axis and rotate and lateroflexion, the object of direction activity such as to bend and stretch.
But the second filial generation artificial atlanto-odontoid joint of the design such as He Xijing still has following deficiency:
1) have employed two joints, add the complexity of design, the high flexibility ratio in joint increases the probability of joint dislocation.
2) ball-and-socket joint contact surface is little, and local stress is large.
3) joint is for being inverted, and is not inconsistent with human body physiological state.
4) directly contact between joint with bone, Bone Ingrowth is without probability, and dislocation risk is larger.
In sum, domestic and international not yet successful design goes out to meet completely the biomimetic prosthetic atlanto-odontoid joint of human body physiological state at present.
Summary of the invention
The object of the invention is to the shortcoming overcoming traditional integration technology, and the shortcoming of existing artificial atlanto-odontoid joint is improved, a kind of biomimetic prosthetic atlanto-odontoid joint is provided, this biomimetic prosthetic atlanto-odontoid joint can not only be close with normal human's atlanto-odontoid joint in appearance, and can limit range of motion on mechanics, retain spinfunction, and effectively retain a small amount of lateroflexion and anterior flexion and rear stretching function between atlas and axis, more close to physiological status.
For achieving the above object, present invention employs following technical scheme:
This artificial atlanto-odontoid joint comprises atlas parts and dentata parts, described atlas parts are made up of pestle nest joint and the curved side wing plate that is connected with pestle nest joint, the two ends of curved side wing plate are symmetrically distributed in both sides, pestle nest joint, pestle nest joint is made up of ball-and-socket and the round table-like housing that is connected with ball-and-socket lower end, round table-like housing is connected with ball-and-socket, dentata parts are made up of bulb joint and arc, bulb joint is made up of bulb and the cylinder that is connected with bulb lower end, arc is connected with cylindrical lower end, and bulb joint is arranged at pestle nest intraarticular.
The two ends of described curved side wing plate offer screw hole, arc offers several screw holes.
Described arc offers the screw hole of three arrangements in isosceles triangle.
Described artificial atlanto-odontoid joint also comprises the screw in the screw hole that is arranged on curved side wing plate and arc.
Described atlas parts, dentata parts and screw adopt medical titanium alloy material.
Described pestle nest joint and curved side wing plate adopt one-body molded.
Described cylindrical bottom surface is zigzag.
The surface of described curved side wing plate, pestle nest joint and arc is provided with hydroxyapatite coating layer.
Beneficial effect of the present invention is embodied in:
Biomimetic prosthetic atlanto-odontoid joint of the present invention carries out bionical from form and biomechanical characterization, by coordinating of bulb joint and pestle nest joint corresponding part, not only remain spinfunction, and add lateroflexion and anterior flexion and rear stretching function, compared with existing artificial atlanto-odontoid joint, amount of articulation is relatively less, and the complexity of structure reduces, and be normal condition forward joint, more meet physiological status; Meanwhile, and angle can be bent and stretched limit lateroflexion, more meet the mobility of normal physiological condition, decrease the probability of dislocation, the present invention can carry out bionical to normal atlanto-odontoid joint better, remains close to normal motor function, and provides and fix reliability better.
Cylindrical bottom surface of the present invention is the face contacted with bone cross section, and cylindrical bottom surface is laciniation, makes to add serrated contact face on the face contacted with bone cross section, adds the probability of Bone Ingrowth, decreases the risk of dislocation; In the present invention on the face contacted with cortical bone, such as, the surface of curved side wing plate, pestle nest joint and arc, adds hydroxyapatite coating layer, can increase Bone Ingrowth, enhance the fastness in joint.
The present invention is held by many pieces of screws in the screw hole on curved side wing plate and arc, can fix from different perspectives, add angle stability, reduce the risk loosening.
Accompanying drawing explanation
Fig. 1 is front view of the present invention;
Fig. 2 is rearview of the present invention;
Fig. 3 is top view of the present invention;
Fig. 4 is upward view of the present invention;
Fig. 5 is the A-A sectional view of Fig. 1;
Fig. 6 is the schematic cross-section of round table-like housing of the present invention;
Fig. 7 is the structural representation of curved side wing plate of the present invention;
Fig. 8 is using state figure of the present invention;
In figure: 1 is curved side wing plate, 2 is screw hole, and 3 is ball-and-socket, and 4 is round table-like housing, and 5 is bulb, and 6 is cylinder, and 7 is arc, and 8 is screw, and 9 is many dentalations.
Detailed description of the invention
Below in conjunction with drawings and Examples, the present invention is elaborated.
See Fig. 1-Fig. 5, biomimetic prosthetic atlanto-odontoid joint of the present invention comprises atlas parts and dentata parts, described atlas parts are made up of pestle nest joint and the curved side wing plate 1 that is connected with pestle nest joint, the two ends of curved side wing plate 1 are symmetrically distributed in both sides, pestle nest joint, pestle nest joint is made up of ball-and-socket 3 and the round table-like housing 4 that is connected with ball-and-socket lower end, round table-like housing 4 is connected with ball-and-socket 3, described pestle nest joint and curved side wing plate 1 adopt one-body molded, dentata parts are made up of bulb joint and arc 7, bulb joint is made up of bulb 5 and the cylinder 6 that is connected with bulb lower end, arc 7 is connected with the lower end of cylinder 6, the bottom surface of described cylinder 6 is zigzag, bulb joint is arranged at pestle nest intraarticular.
The two ends of described curved side wing plate 1 offer screw hole 2, described arc 7 offers several screw holes 2(such as, the screw hole 2 of three arrangements in isosceles triangle), described artificial atlanto-odontoid joint also comprises the screw 8 in the screw hole that is arranged on curved side wing plate 1 and arc 7, the surface of described curved side wing plate 1, pestle nest joint and arc 7 is provided with hydroxyapatite coating layer, and described atlas parts, dentata parts and screw 8 adopt medical titanium alloy material.
In atlas parts, curved side wing plate 1 adopts screw 8 to be positioned lateral mass of atlas mid point by the screw hole 2 on curved side wing plate, in dentata parts, arc 7 adopts screw 8 to be positioned dentata vertebral body by the screw hole 2 on arc, bulb 5 matches with ball-and-socket 3, cylinder 6 matches with the medial surface of round table-like housing 4, not only makes joint have spinfunction, and remains limited lateroflexion and anterior flexion and rear stretching function.
Embodiment
See Fig. 1-Fig. 5, a kind of biomimetic prosthetic atlanto-odontoid joint, comprises atlas parts, dentata parts and screw.Described atlas parts are by being positioned at middle pestle nest joint and the arc flank that is connected with pestle nest joint forms, and on arc flank, symmetric design has screw hole respectively; Pestle nest joint by be positioned at top ball-and-socket and be positioned at below round table-like housing form, round table-like housing is connected with ball-and-socket; Described dentata parts are made up of the bulb joint of upper part and the arc of lower part; Bulb joint is made up of the bulb of top and the cylinder of below, and cylinder bottom surface and surface of bone contact portion are designed to laciniation; Arc is designed with the screw hole of three pieces of arrangements in isosceles triangle; Bulb joint is positioned in pestle nest joint, and bulb matches with ball-and-socket, and cylinder matches with the medial surface of round table-like housing.Pestle nest joint holds below bulb joint, bulb matches with ball-and-socket and can ensure that bulb joint is rotated wherein, cylinder matches with the medial surface of round table-like housing and bulb joint can be allowed to carry out anterior flexion and rear stretching and lateral flexion at pestle nest intraarticular, and limit, it is unconfined significantly movable to prevent.Described screw is located in screw hole respectively.
The external diameter radius of top, pestle nest joint ball-and-socket is 10.2mm, and internal diameter radius is 5.35mm, is highly 2.5mm; Frustum cone height is 10.9mm, and round platform lateral wall angle a is 10 °, and round platform medial wall angle b is 20 ° (see Fig. 6).
Arc flank is made up of the parallel portion of centre and the downward arch section of both sides, and the angle c of the downward arch section in both sides is 160 ° (see Fig. 7), and inner edge diameter is 97.5mm, external profile diameter is 100mm, overall width is 48mm, is highly 10.9mm, and thickness is 2.5mm.
Screw hole center of circle spacing on arc flank is 36mm, and screw hole radius is 3.5mm.Arc flank inner face is coated with hydroxyapatite coating layer.
Pestle nest joint and arc flank are formed in one, and two parts junction is that 1.5mm arc connects with radius.
The diameter on bulb joint top hemisphere (bulb) is 10.7mm, and the cylinder total height that below connects is 10.9mm, and the tooth height of cylinder bottom surface is 0.3mm, and width is 0.43mm, and between cog angle is 60 °, forms zigzag bone contact surface.
Arc thickness: below is 2mm, top is 3mm, and total height is 22.5mm.Bone contact surface and the cylinder bottom surface angle of arc are 125 °.Cambered surface inside diameter is 61mm.Be semicircle below arc, diameter is 18.3mm, and arc upper width is 10.7mm, and consistent with cylinder diameter, upper and lower connects with inclined-plane.Arc inner face (bone contact surface) is coated with hydroxyapatite coating layer.
Arc upper bolt aperture is isosceles triangle dispersion, and top screw hole is positioned at arc center line, perpendicular to arc.Two screw holes in below are positioned at center line both sides, and semicircle center, screw hole distance below is about 3mm, tilts about 5 ° respectively to inner side.Three screw hole diameters are 2.7mm.
Atlas parts, dentata parts and screw all adopt medical titanium alloy material, and contact surface of bone part is coated with hydroxyapatite coating layer.
See Fig. 8, the assembly relation of biomimetic prosthetic atlanto-odontoid joint of the present invention is as follows: bulb joint is positioned over pestle nest intraarticular, and screw lays respectively in screw hole.Pestle nest joint and bulb joint face are high polish, ensure the friction and wear that joint is less in motor process.The arc flank of atlas parts have downwardly towards after radian, match with the form of anterior arch of atlas.Pestle nest joint and bulb joint match and can ensure that rotary moveable is carried out in joint, and the angle of side can ensure that atlas and axis carries out a small amount of motion of lateroflexion and anterior flexion and rear stretching, and reduce friction, and design is more reasonable, more meets physiological status.When the present invention is installed on atlas and axis, atlas parts adopt screw to be positioned lateral mass of atlas mid point, and screw and sagittal plane are 10 ° of outside angles; Dentata parts adopt a screw point angle to fix, and entry point is positioned at dentata vertebral body.
In a word, biomimetic prosthetic atlanto-odontoid joint of the present invention, is made up of atlas parts, dentata parts and screw.Atlas parts are made up of pestle nest joint and arc flank, and pestle nest joint designs is top ball-and-socket part and below round platform part composition, and ball-and-socket section diameter and below bulb diameter match; Arc flank both sides are designed with symmetrical screw hole, fix at lateral mass of atlas with screw.Dentata parts are divided into upper and lower two parts, and top is divided into the articular portion of alternative Odontoid process, are made up of the bulb on top and the cylinder of below, cylinder bottom surface and surface of bone contact portion are designed to many dentalations, increase contact area, be beneficial to Bone Ingrowth, form rock-steady structure.Inferior portion and dentata vertebral body Front Frame match, and it are designed with the screw holes of three pieces of arrangements in isosceles triangle, and the screw hole that screw is arranged by isosceles triangle and dentata vertebral body fix.Hydroxyapatite coating layer is all designed in this biomimetic prosthetic atlanto-odontoid joint and surface of bone contact position, is beneficial to bone structure and grows into, and increases stability of joint.The present invention, under the prerequisite retaining atlas and axis spinfunction, remains the limited lateroflexion of atlas and axis and bends and stretches function, and the projected depth in pestle nest joint is large, reduces the risk of dislocation, closer to human body physiological state on bionics.