CN105213007B - A kind of preceding road dissection template of self-resetting atlantoaxial dislocation - Google Patents

A kind of preceding road dissection template of self-resetting atlantoaxial dislocation Download PDF

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Publication number
CN105213007B
CN105213007B CN201510698708.3A CN201510698708A CN105213007B CN 105213007 B CN105213007 B CN 105213007B CN 201510698708 A CN201510698708 A CN 201510698708A CN 105213007 B CN105213007 B CN 105213007B
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dentata
atlas
part arc
template
resetting
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CN105213007A (en
Inventor
贺西京
臧全金
李浩鹏
杨平林
吕慧茹
卢腾
韦冬
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Shaanxi Zhongyi Weikang Medical Equipment Co ltd
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Second Affiliated Hospital School of Medicine of Xian Jiaotong University
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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
    • A61B17/7062Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A61B17/7067Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor
    • 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
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • 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
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/808Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
    • 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
    • A61B2017/564Methods for bone or joint treatment

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Neurology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

The invention discloses a kind of preceding road dissection template of self-resetting atlantoaxial dislocation, including atlas part, dentata part, coupling part, atlantic part is divided into arc, both sides are designed with symmetrical screw hole, and dentata part is located at the atlas part back lower place, and it matches with dentata centrum Front Frame, five pieces of screw nail are designed with thereon, four pieces are located at both sides, are distributed symmetrically that centre has an oblong sliding screw nail.Atlas part is connected with dentata part by coupling part.Slip of the present invention by screw in sliding screw nail, plays a part of resetting atlantoaxial dislocation;And fixed by screw, atlas and axis is reached in the purpose of reset, form and match completely with atlas, the anatomic form of dentata, more fit, good appearance, better reduction.

Description

A kind of preceding road dissection template of self-resetting atlantoaxial dislocation
Technical field
The invention belongs to medical inside-fixture manufacturing technology field, more particularly to a kind of preceding road of self-resetting atlantoaxial dislocation Dissect template.
Background technology
Human body upper cervical spine is the one or two cervical vertebra, i.e. atlas and axis.The atlantoaxial dislocation incidence of disease is low, but because adjoining oblongata, takes off There is Odontoid procen spinal cord behind position, tetraplegia, or even influence medullary respiratory center easily occur, life danger occur.
When current atlanto-axial instability causes the upper cervical cord to oppress stimulation and nervous symptoms occur, rear is selected generally according to situation Direct reduction fusion fix, or Anterior release decompression cuts off cdontoid process, is fixed or spacious puts.But simple cdontoid process Unstability increase between normal configuration, atlas and axis is destroyed after resection, scope of activities is increased, and the excitant for nerve adds Greatly.Therefore, many merged using front or behind is fixed.Rear fusion fixation is relatively simple, for the patient for being easier to reset It can be adopted and be treated by the way of being screwed after posterior approach operative reduction.But posterior approach fusion is fixed to need dissection The terminal of numerous rear muscle groups is cut off, the muscular atrophy of neck portion is caused, neck portion pain incidence is high;And in the implantation of rear Fixture needs the soft tissue of one fixed width to separate, during soft tissue is separated and during implantation internal fixation screw Often there are the complication such as vertebral artery injuries.The substantial amounts of fiber on road connects before some cases are occurred in that after atlantoaxial dislocation simultaneously Connect or bone connection, be difficult to reset merely from posterior approach, it is necessary to a Qi Congqian roads loosen after again row posterior approach fix, increase Operation wound, and need to stand up in multiple art, add the danger of operation.Also some cases rear fixed knot simultaneously There is the presence of the factors such as destruction, or rear infection in structure, lead to not be performed the operation from the way of escape.And use preceding road to fix can be with Avoid the generation of these drawbacks.
Anterior approach can carry out loosening fiber connection between atlas and axis with direct oral cavity or bone is connected, and be resetted It is fixed.
Atlas and axis is different from lower section instability, and no intervertebral disc structure, its centrum is irregular, it is impossible to by conventional interior fixed Thing come complete fix.The preceding road replacement and fixation steel plate of direct oral cavity that only Guangzhou servicemen norm is designed both at home and abroad at present.But its Steel plate application operating difficulty is big, and resetting needs extra device for spreading to realize.The design of its steel plate is straight steel on atlas Plate, and to there is certain radian in front of atlas, this allow for steel plate can not docile completely, between steel plate and sclerotin outside the screw of part Dew;The screw nail design of dentata is wider, it is necessary to larger organization exposure.Extra screw and dilator is needed to come real in reset Reset between existing atlas and axis, it is impossible to reach the purpose resetted by self structure.
In summary, at present both at home and abroad not yet successful design go out to comply fully with human physiological structure, by self structure come Realize that the preceding road that atlantoaxial dislocation resets resets anatomical plate.
The content of the invention
The drawbacks of it is an object of the invention to overcome posterior fusion, while in order that most of atlantoaxial dislocation can Resets, the fixed purpose merged are reached by itself design of anterior plate, the characteristics of for atlantoaxial dislocation, with reference to atlas and axis There is provided a kind of preceding road dissection template of self-resetting atlantoaxial dislocation for front anatomical features.
To reach above-mentioned purpose, present invention employs following technical scheme:
The dissection template includes the atlas part arc contacted with atlas front and the dentata contacted with dentata front Part arc, is connected with and extensive region pivot between the lower end of atlas part arc and the upper end of dentata part arc The adaptable connecting plate of step between vertebra;Atlas part arc is provided at both ends with lock screw nail, the dentata Part arc is provided at both ends with the cunning that Longitudinal extending is provided with the middle part of lock screw nail, dentata part arc It is ramped shaped in dynamic screw nail, the sliding screw nail, the higher one end in the slope is close to dentata part arc The outer surface of plate upper end (near-end), relatively low one end in the slope is interior close to the dentata part arc lower end (distal end) Side surface.
The inner surface of atlas part arc is consistent with anterior arch of atlas radian, the atlas part arc two ends Lock screw nail it is corresponding with lateral mass of atlas portion.
Dentata part arc is made up of the plate body being matched with form in front of dentata centrum, dentata part arc The two ends of plate are provided with two lock screw nail, and the lock screw nail at the dentata part arc two ends is arranged symmetrically And the position arrangement of inverted trapezoidal is formed on the arc of the dentata part, it is located at dentata part arc in the position arrangement Shape plate two ends and two lock screw nail in the outer part are corresponding with axis arch root position, are located at described in the position arrangement Dentata part arc two ends and two lock screw nail and the sliding screw nail in the inner part and dentata centrum position Put correspondence.
Dentata part arc is located at the back lower place of atlas part arc, and the dissection template is in zigzag Bending.
The angle of the connecting plate and atlas part arc is 120 °~127 °, the connecting plate and the dentata The angle of part arc is 120 °~132 °.
The dissection template is formed in one.
The inner surface of the dissection template is provided with hydroxyapatite coating layer.
The dissection template also includes the screw being arranged in each lock screw nail and the sliding screw nail.
The screw being arranged in the sliding screw nail has the inclined-plane sprig stern construction coordinated with the slope.
The dissection template (including screw) is made of titanium alloy.
Beneficial effects of the present invention are embodied in:
The preceding road dissection template of self-resetting atlantoaxial dislocation of the present invention is set according to anatomic form feature in front of atlas and axis Meter, enables dissection template sclerotin laminating corresponding with atlas, dentata part well, adds fixed stability.And lead to The slope shape design that sliding screw nail is carried itself is crossed, the extruding followed closely using screw between the slope and nail slope of tail is made With, dentata is slided to distal end in tightening screw, so that drive fixed dentata centrum to slide downwards, folding where connecting plate Difference in height between bight portion and atlas and axis is matched, and the dissection template is played the purpose for resetting atlantoaxial dislocation, with more preferable Replacement and fixation effect.
Further, atlas part arc both sides nail correspondence lateral mass of atlas, fixing intensity is big;Dentata part arc The settable totally five pieces of screws of upper nail, wherein two pieces of screws of outermost are fixed in axis arch root, and middle three pieces are fixed on pivot Vertebra centrum;Relative to existing dissection template, add three pieces of screws and fix design, fixed intensity is greatly enhanced, reduce interior The probability that fixture comes off.
Further, on the face being in contact with cortex bone of dissection template of the present invention, hydroxyapatite coat is added Layer, can increase Bone Ingrowth probability, add the fastness of dissection template.
Further, many pieces of screws can be fixed from different perspectives, add angle stability, reduce screw loosening abjection Risk.
Brief description of the drawings
Fig. 1 is front view of the invention;
Fig. 2 is rearview of the invention;
Fig. 3 is top view of the invention;
Fig. 4 is upward view of the invention;
Fig. 5 for the present invention center side sectional view, section view direction be Fig. 1 in A to;
Fig. 6 is the profile in sliding screw hole of the present invention;
Screw when Fig. 7 is present invention application in sliding screw nail hits exactly profile when being not completely tightened, and screw is located at Nail near-end, atlantoaxial dislocation does not reset;
Screw when Fig. 8 is present invention application in sliding screw nail hits exactly profile when tightening completely, and screw slides to nail Hole tail end, atlantoaxial dislocation resets completely;
In figure:1 is atlas part arc, and 2 be lock screw nail, and 3 be dentata part arc, and 4 be that bending is connected Part, 5 be sliding screw nail, and 5A is sliding screw nail near-end, and 5B is sliding screw nail distal end, and 5C follows closely for sliding screw Slope in hole, 6 be the screw in sliding screw nail, and 7 be atlas vertical section, and 8 be dentata vertical section.
Embodiment
The present invention is elaborated with reference to the accompanying drawings and examples.
Referring to Fig. 1~Fig. 8, the preceding road dissection template of self-resetting atlantoaxial dislocation of the present invention includes atlas part, pivot Vertebra part, bending coupling part and screw.
The atlantic part is divided into arc, is open towards in front of atlas, the arc both sides consistent with anterior arch of atlas radian Being designed with symmetrical screw hole, (lock screw nail 2, is the hole that outer radius is big, inner radius is small, to follow closely tail inclined-plane with screw Coordinate, realize locking), screw hole location correspondence lateral mass of atlas part.
The dentata part is located at the atlas part back lower place, is spill after lordosis (i.e. away from atlas and axis direction protrusion Arc), form is consistent in front of form and dentata centrum.It is designed with five screw holes, wherein symmetrical four screws in both sides Hole (lock screw nail 2, is the hole that outer radius is big, inner radius is small, to coordinate with screw nail tail inclined-plane, realizes locking) is in In inverted trapezoidal, inverted trapezoidal, two screw hole correspondence axis arch roots of outermost, middle two screw holes correspondence dentata centrum, most Middle one is stringer oblong sliding screw nail 5.The lower section of atlas part arc 1 and the top of dentata part arc 3 It is connected, in zigzag bending, bending coupling part is in the back lower place to step is adapted between bending radian and atlas and axis on preceding (difference in height is adapted i.e. between atlas and axis), width is identical with dentata centrum top half.
Atlas part arc 1 is made up of middle rectangle part and both sides semi-circular portion, and overall width is 48mm, height For 10.9mm, thickness is 2mm.Distance is 36mm between the screw hole center of circle on atlas part arc 1, and screw pore radius is 3.5mm.The inner surface of atlas part arc 1 (i.e. with the bone contact surface of atlas and axis) is coated with hydroxyapatite coating layer.
The thickness of dentata part arc 3 is 2mm, and total height is 22.5mm.Cambered surface inside diameter is 61mm.Dentata part arc Shape plate 3 is generally edge and justifies blunt rhombus, and form is matched with dentata centrum Front Frame, the near-end of dentata part arc 3 (on End) width be 12mm, be connected with atlas part with bending coupling part 4.The inner surface of dentata part arc 3 is coated with hydroxyl Apatite coating.
Most middle one is in stringer oblong sliding screw nail on dentata part arc 3, and width is 2.7mm, is indulged It is 5.5mm to length, it is in ramped shaped that it is interior, and near-end (upper end, close to human body head) is high, and distal end (lower end) is low, and near-end is relatively distally High about 1mm.Remaining four a diameter of 2.7mm of screw hole on dentata part arc 3.
Bending coupling part 4 (be strip connecting plate) is in preceding upper to the back lower place to connection atlas part and dentata portion respectively Point, wide about 12mm, and about 120 °~127 ° of atlas Partial angle, with about 120 °~132 ° of dentata Partial angle, specific angle root Factually border structural adjustment, thickness 2mm, front and rear 3~4mm of width, bending coupling part 4 contacts a side surface (inner surface) with bone It is coated with hydroxyapatite coating layer.
During reset:Atlas part is fixed on atlas with two pieces of screws, one piece of screw is then fixed on sliding screw The slope near-end of nail 5, by tightening screw, using screw follow closely tail slope and nail in squeezing action between slope, Dentata is set to be slided to distal end during tightening screw, so that by dissecting template reset itself atlantoaxial dislocation.By dentata portion after reset Divide remaining upper four pieces of screw to fix, complete replacement and fixation.
Atlas part arc 1, dentata part arc 3, bending coupling part 4 and screw can use medical titanium alloy Material is made, and atlas part arc 1, dentata part arc 3 can be integrally formed with bending coupling part 4.
In a word, dissection template proposed by the present invention can not only be in appearance with anatomical structure in front of normal human's atlas and axis Laminating well, and the narrow range that needs appear, tissue irritation are small, and wound is small;The slope shape carried by itself is slided Screw hole is designed, and the squeezing action between the slope and nail slope of tail is followed closely using screw, dentata is made in tightening screw to remote End is slided, so as to play the purpose for resetting atlantoaxial dislocation.It is not only more attractive in appearance, and integrate reset with fixing, Extra resetting means is not needed, it is more practical.

Claims (8)

1. a kind of preceding road dissection template of self-resetting atlantoaxial dislocation, it is characterised in that:The dissection template includes and atlas front The atlas part arc (1) of contact and the dentata part arc (3) contacted with dentata front, atlas part arc The adaptable company of step between atlas and axis is connected between the lower end of plate (1) and the upper end of dentata part arc (3) Fishplate bar;Atlas part arc (1) is provided at both ends with lock screw nail (2), dentata part arc (3) It is provided at both ends with the sliding screw that Longitudinal extending is provided with the middle part of lock screw nail (2), dentata part arc (3) It is ramped shaped in nail (5), the sliding screw nail (5), the higher one end in the slope is close to dentata part arc The outer surface of plate (3) upper end, inner side table of the relatively low one end in the slope close to the dentata part arc (3) lower end Face;
Dentata part arc (3) is made up of the plate body being matched with form in front of dentata centrum, dentata part arc The two ends of plate (3) are provided with two lock screw nail (2), the lock screw nail at the dentata part arc (3) two ends Hole is arranged symmetrically and the position arrangement of inverted trapezoidal is formed on dentata part arc (3), is located in the position arrangement Dentata part arc (3) two ends and two lock screw nail in the outer part are corresponding with axis arch root position, it is described It is located at dentata part arc (3) two ends and two lock screw nail in the inner part and the slip in the arrangement of position Screw nail (5) is corresponding with dentata centrum position;
The angle of the connecting plate and atlas part arc (1) is 120 °~127 °, the connecting plate and the dentata The angle of part arc (3) is 120 °~132 °.
2. template is dissected on a kind of preceding road of self-resetting atlantoaxial dislocation according to claim 1, it is characterised in that:The atlas The inner surface of part arc (1) is consistent with anterior arch of atlas radian, the lock screw at the atlas part arc (1) two ends Nail (2) is corresponding with lateral mass of atlas portion.
3. template is dissected on a kind of preceding road of self-resetting atlantoaxial dislocation according to claim 1, it is characterised in that:The dentata Part arc (3) is located at the back lower place of atlas part arc (1), and the dissection template is in zigzag bending.
4. template is dissected on a kind of preceding road of self-resetting atlantoaxial dislocation according to claim 1, it is characterised in that:The dissection Template is formed in one.
5. template is dissected on a kind of preceding road of self-resetting atlantoaxial dislocation according to claim 1, it is characterised in that:The dissection The inner surface of template is provided with hydroxyapatite coating layer.
6. template is dissected on a kind of preceding road of self-resetting atlantoaxial dislocation according to claim 1, it is characterised in that:The dissection Template also includes the screw being arranged in each lock screw nail (2) and the sliding screw nail (5).
7. template is dissected on a kind of preceding road of self-resetting atlantoaxial dislocation according to claim 6, it is characterised in that:It is arranged on institute The screw stated in sliding screw nail (5) has the inclined-plane sprig stern construction coordinated with the slope.
8. template is dissected on a kind of preceding road of self-resetting atlantoaxial dislocation according to claim 6, it is characterised in that:The dissection Template is made of titanium alloy.
CN201510698708.3A 2015-10-23 2015-10-23 A kind of preceding road dissection template of self-resetting atlantoaxial dislocation Active CN105213007B (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108378915A (en) * 2018-02-09 2018-08-10 北京奥精医药科技有限公司 A kind of preceding road fixed plate of atlas and axis and preparation method

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Publication number Priority date Publication date Assignee Title
CN107049454A (en) * 2017-05-05 2017-08-18 兰州大学 The preceding road of atlas and axis, which resets, to be rebuild internal fixation plate and uses supporting apparatus with fixed plate
CN109700517B (en) * 2019-02-01 2024-03-19 西安增材制造国家研究院有限公司 Auxiliary resetting device for atlantoaxial dislocation and manufacturing method thereof
CN115553898B (en) * 2022-09-13 2024-01-02 陆宁 Module combined type internal fixation device suitable for anterior atlas internal fixation

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CN2347551Y (en) * 1998-10-28 1999-11-10 王卫平 Compression U-shape bone plate
CN202184787U (en) * 2011-04-29 2012-04-11 中国人民解放军广州军区武汉总医院 Anterior submandibular approach resetting and fixing titanium-plate through joint atlas and dentata
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CN203763300U (en) * 2014-03-07 2014-08-13 西安交通大学医学院第二附属医院 Bionic low-friction artificial atlanto-odontoid joint
CN204260813U (en) * 2014-11-13 2015-04-15 无锡市闻泰百得医疗器械有限公司 Locking bone fracture plate structure
CN104434287B (en) * 2014-12-25 2017-01-25 南方医科大学南方医院 Anterior cervical and craniocervical fixing device
CN205054394U (en) * 2015-10-23 2016-03-02 西安交通大学第二附属医院 Preceding way dissection template of extensive region dentata dislocation that restores to throne by oneself

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108378915A (en) * 2018-02-09 2018-08-10 北京奥精医药科技有限公司 A kind of preceding road fixed plate of atlas and axis and preparation method
CN108378915B (en) * 2018-02-09 2020-09-01 奥精医疗科技股份有限公司 Atlantoaxial anterior fixing plate and preparation method thereof

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