CN109700517B - Auxiliary resetting device for atlantoaxial dislocation and manufacturing method thereof - Google Patents
Auxiliary resetting device for atlantoaxial dislocation and manufacturing method thereof Download PDFInfo
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- CN109700517B CN109700517B CN201910104130.2A CN201910104130A CN109700517B CN 109700517 B CN109700517 B CN 109700517B CN 201910104130 A CN201910104130 A CN 201910104130A CN 109700517 B CN109700517 B CN 109700517B
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- 238000003754 machining Methods 0.000 claims description 7
- 210000000988 bone and bone Anatomy 0.000 claims description 6
- 238000004659 sterilization and disinfection Methods 0.000 claims description 6
- 238000011282 treatment Methods 0.000 claims description 5
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- 230000001154 acute effect Effects 0.000 claims description 3
- 230000008021 deposition Effects 0.000 claims description 3
- 230000008018 melting Effects 0.000 claims description 3
- 238000002844 melting Methods 0.000 claims description 3
- 238000005498 polishing Methods 0.000 claims description 3
- 230000011218 segmentation Effects 0.000 claims description 3
- 238000000110 selective laser sintering Methods 0.000 claims description 3
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Abstract
The invention discloses an auxiliary resetting device for atlantoaxial dislocation and a manufacturing method thereof, wherein the resetting device comprises an atlas attaching part, a skull attaching part, an axial attaching part and an adjusting part; the adjusting part comprises a supporting bridge, an adjusting column and a nut; one end of the supporting bridge is fixedly connected with the skull attaching part, and the other end is fixedly connected with the pivoxil attaching part; an adjusting column is inserted in the middle of the supporting bridge, one end of the adjusting column is connected with a nut in a threaded manner, and the other end of the adjusting column is fixedly connected with the atlas attaching part; the inner surface of the atlas attaching part is completely matched with the patient atlas surface; the inner surface of the skull attaching part is completely matched with the skull surface of the patient; the inner surface of the pivot joint part is completely matched with the pivot surface of the patient; the atlas attaching part, the skull attaching part and the axial attaching part are processed and molded in a 3D printing mode. The device can safely and reliably realize accurate reduction of the atlantoaxial of a patient, and does not influence subsequent fixation of the atlantoaxial.
Description
Technical Field
The invention relates to the field of digital medical treatment and medical appliances, in particular to an auxiliary resetting appliance for atlantoaxial dislocation and a manufacturing method thereof.
Background
Atlantoaxial dislocation, or atlantoaxial dislocation, refers to the loss of normal involutory relationship of the joints between the first (atlas) and second (axis) segments of the cervical spine.
Atlantoaxial dislocation types include anterior dislocation, posterior dislocation, bilateral asymmetric dislocation, and rotational dislocation. Atlantoaxial dislocation can directly or indirectly stimulate spinal cord, nerve and blood vessel, and causes a series of diseases, typical symptoms are: 1) Occipital and cervical pain; 2) The torticollis and neck movement is limited; 3) Superior spinal cord injury can be manifested as general muscle tension, unstable or weak hand grip; walking weakness; weakness of urination and defecation; muscle atrophy of limbs; general paralysis can occur in severe cases; 4) Dizziness, tinnitus, blurred vision, chest distress, palpitations, and elevated blood pressure. The atlantoaxial dislocation can even press the upper cervical marrow due to slight injury of the head and neck or excessive flexion and extension of the cervical vertebra, and the patient can suddenly suffer from hard paralysis and even die due to paralysis of respiratory muscle, so that the patient needs to diagnose and treat in time.
For treating atlantoaxial dislocation, firstly, the atlantoaxial needs to be reset, spinal cord compression is relieved, then cervical vertebra joint is stabilized, and the dislocation is prevented. The atlantoaxial dislocation parting can be divided into traction reposition type, operation reposition type and non-reposition type. The atlantoaxial surgery has great risk and high difficulty, and a series of achievements are achieved in recent years aiming at clinical researches of atlantoaxial dislocation, but the atlantoaxial dislocation still has the conditions of difficult reduction and incapacity of reduction. In surgical reduction, the conventional atlantoaxial surgical reduction instrument has the following problems:
(1) The traditional skull traction device is fixed on the skull of a patient, and the skull is pulled out through a heavy object, so that the stressed area of the skull is narrow, and the skull is heavy and original and has potential safety hazards;
(2) The resetting effect of the cranium traction mode is not ideal, and accurate resetting cannot be realized.
Disclosure of Invention
Aiming at the problems of the traditional traction type resetting device in the background technology, the auxiliary resetting device for atlantoaxial dislocation and the manufacturing method thereof are provided, and the resetting device is designed according to the biomechanical distribution of the individual atlantoaxial dislocation parting characteristic of a patient, surrounding ligament muscles and the like by combining digital medical simulation analysis and 3D printing technology, so that the accurate resetting of the patient atlantoaxial is realized safely and reliably, and the subsequent fixation of the atlantoaxial is not influenced.
The specific technical scheme of the invention is as follows:
the invention provides an auxiliary reduction device for atlantoaxial dislocation, which comprises a main body, a main body and a main body, wherein the main body is provided with a main body and a main body:
comprises an atlas attaching part, a skull attaching part, an epistropheus attaching part and an adjusting part;
the adjusting part comprises a supporting bridge, an adjusting column and a nut;
one end of the supporting bridge is fixedly connected with the skull attaching part, and the other end is fixedly connected with the pivoxil attaching part;
an adjusting column is inserted in the middle of the supporting bridge, one end of the adjusting column is connected with a nut in a threaded manner, and the other end of the adjusting column is fixedly connected with the atlas attaching part;
the inner surface of the atlas attaching part is completely matched with the patient atlas surface;
the inner surface of the skull attaching part is completely matched with the skull surface of the patient;
the inner surface of the pivot joint part is completely matched with the pivot surface of the patient;
the atlas attaching part, the skull attaching part and the axial attaching part are formed by processing in a 3D printing mode. When in use, the nut is rotated, so that the adjusting column slides in the supporting bridge, and the atlas attaching part, the skull attaching part and the axis attaching part are stressed to reset the atlantoaxial dislocation.
Further, in order to save manufacturing steps and ensure manufacturing accuracy, the support bridge and the adjusting column in the adjusting part are integrally formed with the atlas attaching part, the skull attaching part and the axis attaching part in a 3D printing mode.
Furthermore, the supporting bridge and the adjusting column in the adjusting part can be machined and formed in a machining mode.
Further, for some patients with rotary dislocation, an included angle alpha is formed between the adjusting direction of the adjusting column in the adjusting part and the sagittal plane of the human body; the angle alpha is more than or equal to 90 degrees and more than or equal to 0 degrees. The angle is determined based on the actual dislocation angle of the patient. The sagittal plane of the human body is a technical term of human anatomy, namely, the human body is divided into a left part and a right part, and the left and right tangential planes are the sagittal plane of the human body.
Further, for some patients with rotary dislocation, another scheme of resetting the apparatus is provided, namely, two groups of adjusting parts are manufactured; wherein, the contained angle between the adjusting columns in two groups of adjusting parts is the acute angle. The adjusting parts are used for front and back dislocation resetting and rotating dislocation resetting.
Further, when the supporting bridge and the adjusting column in the adjusting part are manufactured in a machining mode, the supporting bridge is fixedly connected with the skull attaching part and the pivotal attaching part in a threaded connection mode respectively; the adjusting column is fixedly connected with the atlas attaching part in a threaded connection mode, and the screwing direction of the adjusting column and the screw threads of the nut is opposite to that of the adjusting column and the atlas attaching part in threaded connection.
Further, the nut may be a hexagonal nut or a nut with a handle for the convenience of the doctor.
Based on the above description of the structure of the auxiliary reduction device for atlantoaxial dislocation, a method for manufacturing the reduction device will now be described, comprising the following steps,
step A1, establishing a three-dimensional model of the skull and the vertebra of a patient;
collecting medical image data of an affected part of an atlantoaxial dislocation patient, carrying out noise reduction, threshold segmentation and three-dimensional reconstruction on the collected medical image data by utilizing medical image data processing software, reconstructing a three-dimensional model of the skull and the spine of the patient, and restoring the dislocation state and the position information of the atlantoaxial;
a2, designing the resetting instrument model by utilizing the three-dimensional model;
introducing the three-dimensional model into 3-matic software, designing a skull attaching part, an atlas attaching part and an axis attaching part which can be completely attached to the skull, the atlas surface and the axis surface of a patient based on the bone surfaces of the skull and the atlas of the patient and the actual dislocation symptom characteristics by using the 3-matic software, and designing a supporting bridge and an adjusting column at the same time;
a3, performing 3D printing on the atlas attaching part, the skull attaching part, the epistropheus attaching part, the supporting bridge and the adjusting column designed in the step A2 by utilizing a selective laser melting technology or a selective laser sintering technology or a fusion deposition technology, and then performing surface polishing and thread machining processes;
and A4, carrying out disinfection and sterilization treatment on the parts manufactured in the step A3.
The beneficial effects of the invention are as follows:
1. according to the invention, the atlas attaching part, the skull attaching part and the epistropheus attaching part are manufactured in a 3D printing mode and are completely attached to the bone surface of the human body, the bone surface is uniformly and dispersedly stressed by a wide contact area, the risks of damage caused by uneven bone stress and overlarge local stress are greatly reduced, and the reliability and safety of the instrument are improved.
2. The adjusting part of the invention can rotate the nut in the operation application, so that after the atlantoaxial is reset, the nut and the stud can realize self-locking, after the current reset state is fixed, the atlantoaxial fixation operation can be implemented immediately, the reset operation is simple and convenient, the subsequent atlantoaxial fixation operation can not be influenced, and the safety and the reliability of the operation are further improved.
3. The invention adopts a mode of two groups of adjusting parts or a mode of setting an included angle between the adjusting direction of the adjusting column and the front and back dislocation direction of the atlantoaxial, which is not only suitable for any one of the front dislocation and the rotation dislocation of the atlantoaxial to happen independently, but also suitable for the two cases of the front dislocation and the rotation dislocation of the atlantoaxial to happen simultaneously, thereby improving the applicability of the instrument.
4. In the process of performing operation resetting, the resetting device does not occupy an operating table and the peripheral space thereof, does not influence the normal operation of a clinician, and greatly saves the operation space.
Drawings
Fig. 1 is a schematic view of the structure of a reducing instrument.
Fig. 2 is a schematic view of a first optimized configuration of the reducing instrument.
Fig. 3 is a schematic view of a second optimized configuration of the reducing instrument.
The reference numerals are as follows:
1-atlas attaching part, 2-skull attaching part, 3-axis attaching part, 4-adjusting part, 5-supporting bridge, 6-adjusting column and 7-nut.
Detailed Description
The reduction device and the manufacturing method of the present invention are further described below by way of examples and accompanying drawings:
examples:
structure of the
As shown in fig. 1, an auxiliary reduction device for atlantoaxial dislocation comprises an atlas fitting part 1, a skull fitting part 2, an axis fitting part 3 and an adjusting part 4; the adjusting part 4 comprises a supporting bridge 5, an adjusting column 6 and a nut 7; one end of the supporting bridge 5 is fixedly connected with the skull attaching part 2, and the other end is fixedly connected with the pivoxil attaching part 3;
an adjusting column 6 is inserted in the middle of the supporting bridge 5, one end of the adjusting column 6 is in threaded connection with a nut 7, and the other end of the adjusting column 6 is fixedly connected with the atlas attaching part 1; the inner surface of the atlas fitting part 1 is completely matched with the patient atlas surface; the inner surface of the skull attaching part 2 is completely matched with the skull surface of a patient; the inner surface of the pivot joint part 3 is completely matched with the pivot surface of the patient;
wherein, atlas laminating portion 1, skull laminating portion 2, pivot laminating portion 3 adopt 3D printing mode machine-shaping, and supporting bridge, adjusting column adopt the mode machine-shaping in the adjusting part.
Or the atlas attaching part 1, the skull attaching part 2, the axial attaching part 3, the supporting bridge 5 in the adjusting part 4 and the adjusting column 6 are integrally formed in a 3D printing mode.
Based on the above structure, the present embodiment further provides the following optimization design:
for some patients with front and back dislocation and rotation dislocation, two instrument structures are provided for convenient manufacture:
as shown in fig. 2, an included angle alpha is formed between the adjusting direction of the adjusting column 6 in the adjusting part and the sagittal plane of the human body; the angle alpha is more than or equal to 90 degrees and more than or equal to 0 degrees. The angle is determined based on the actual dislocation angle of the patient.
As shown in fig. 3, the 2-reduction instrument comprises two groups of adjusting parts 4; wherein, the contained angle between the adjusting columns 6 in the two groups of adjusting parts 4 is an acute angle. The adjusting parts are used for front and back dislocation resetting and rotating dislocation resetting.
3. Further, when the supporting bridge 5 and the adjusting column 6 in the adjusting part are manufactured in a machining mode, the supporting bridge 5 is fixedly connected with the skull attaching part 2 and the pivotal attaching part 3 in a threaded connection mode; the adjusting column 6 is fixedly connected with the atlas attaching part 1 in a threaded connection mode, and the screw thread screwing direction of the adjusting column 6 and the nut 7 is opposite to the screw thread screwing direction of the adjusting column 6 and the atlas attaching part 1.
4. The nut 7 may be a hexagonal nut or a nut with a handle for the convenience of the doctor.
Manufacturing method
Step A1, establishing a three-dimensional model of the skull and the vertebra of a patient;
collecting medical image data (including but not limited to CT data) of an affected part of an atlantoaxial dislocation patient, performing operations such as noise reduction, threshold segmentation, three-dimensional reconstruction and the like on the collected medical image data by utilizing medical image data processing software (including but not limited to Mimi cs software), reconstructing a three-dimensional model of the skull and the spine (at least including atlantoaxial and axial) of the patient, and restoring information such as atlantoaxial dislocation state and position;
a2, designing the resetting instrument model by utilizing the three-dimensional model;
the three-dimensional model reconstructed in the step A1 is imported into 3-matic software, and based on the bone surfaces of the cranium and the atlantoaxial of a patient and the actual dislocation symptom characteristics, a skull attaching part, an atlantoaxial attaching part and an axial attaching part which can be completely attached to the cranium, the atlantoaxial surface and the axial surface of the patient are designed by utilizing the 3-matic software, and a supporting bridge and an adjusting column are designed at the same time;
step A3, performing 3D printing manufacture on the personalized support bridge and the atlas connecting piece designed in the step 2 by utilizing a selective laser melting technology (SLM), a selective laser sintering technology (SLS) or a fused deposition technology (FDM), and then performing surface polishing, thread machining and other post-treatments;
and A4, carrying out disinfection and sterilization treatment on the parts manufactured in the step A3.
Application method
In the step B1, the head frame is firstly utilized to adjust the position states of the skull and the cervical vertebra, so that the reposition instrument processed in the step A4 can be completely attached to the skull surface, the pivot vertebral surface and the atlanto vertebral surface of a patient respectively;
step B2, when the resetting device needs to be fixed, drilling holes at the proper positions of the skull of the patient, winding the fixed support bridge and the skull attaching part by using steel wire perforation, and winding the fixed support bridge and the axis attaching part and the atlas attaching part by using steel wire;
and B3, after the parts of the instrument to be reset are attached and fixed, screwing the nut, continuing to rotate, driving the atlas to move and rotate, and after the atlas is reset, implementing the atlantoaxial fixation operation to treat the atlantoaxial dislocation of the patient.
Claims (7)
1. An auxiliary reduction device for atlantoaxial dislocation, which is characterized in that:
comprises an atlas attaching part, a skull attaching part, an epistropheus attaching part and an adjusting part;
the adjusting part comprises a supporting bridge, an adjusting column and a nut;
one end of the supporting bridge is fixedly connected with the skull attaching part, and the other end is fixedly connected with the pivoxil attaching part;
an adjusting column is inserted in the middle of the supporting bridge, one end of the adjusting column is connected with a nut in a threaded manner, and the other end of the adjusting column is fixedly connected with the atlas attaching part;
the inner surface of the atlas attaching part is completely matched with the patient atlas surface;
the inner surface of the skull attaching part is completely matched with the skull surface of the patient;
the inner surface of the pivot joint part is completely matched with the pivot surface of the patient;
the atlas attaching part, the skull attaching part and the axial attaching part are processed and formed in a 3D printing mode;
an included angle alpha is formed between the adjusting direction of the adjusting column in the adjusting part and the sagittal plane of the human body; the angle alpha is more than or equal to 90 degrees and more than or equal to 0 degrees.
2. The auxiliary reduction device for atlantoaxial dislocation according to claim 1, wherein: and the supporting bridge and the adjusting column in the adjusting part are formed by processing in a 3D printing mode.
3. The auxiliary reduction device for atlantoaxial dislocation according to claim 1, wherein: the supporting bridge and the adjusting column in the adjusting part are machined and formed in a machining mode.
4. An auxiliary reduction device for atlantoaxial dislocation according to claim 2 or 3, characterized in that:
the adjusting parts are two groups;
wherein, the contained angle between the adjusting columns in two groups of adjusting parts is the acute angle.
5. An auxiliary reduction device for atlantoaxial dislocation according to claim 3, wherein: the supporting bridge is fixedly connected with the skull attaching part and the pivotal attaching part in a threaded connection mode; the adjusting column is fixedly connected with the atlas attaching part in a threaded connection mode, and the screwing direction of the adjusting column and the screw threads of the nut is opposite to that of the adjusting column and the atlas attaching part in threaded connection.
6. An auxiliary reduction device for atlantoaxial dislocation according to claim 4, wherein: the nut is a hexagonal nut or a nut with a handle.
7. A method for manufacturing an auxiliary reduction device for atlantoaxial dislocation based on claim 2, which is characterized in that: comprises the steps of,
step A1, establishing a three-dimensional model of the skull and the vertebra of a patient;
collecting medical image data of an affected part of an atlantoaxial dislocation patient, carrying out noise reduction, threshold segmentation and three-dimensional reconstruction on the collected medical image data by utilizing medical image data processing software, reconstructing a three-dimensional model of the skull and the spine of the patient, and restoring the dislocation state and the position information of the atlantoaxial;
a2, designing the resetting instrument model by utilizing the three-dimensional model;
introducing the three-dimensional model into 3-matic software, designing a skull attaching part, an atlas attaching part and an axis attaching part which can be completely attached to the skull, the atlas surface and the axis surface of a patient based on the bone surfaces of the skull and the atlas of the patient and the actual dislocation symptom characteristics by using the 3-matic software, and designing a supporting bridge and an adjusting column at the same time;
a3, performing 3D printing on the atlas attaching part, the skull attaching part, the epistropheus attaching part, the supporting bridge and the adjusting column designed in the step A2 by utilizing a selective laser melting technology or a selective laser sintering technology or a fusion deposition technology, and then performing surface polishing and thread machining processes;
and A4, carrying out disinfection and sterilization treatment on the parts manufactured in the step A3.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201910104130.2A CN109700517B (en) | 2019-02-01 | 2019-02-01 | Auxiliary resetting device for atlantoaxial dislocation and manufacturing method thereof |
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| CN201910104130.2A CN109700517B (en) | 2019-02-01 | 2019-02-01 | Auxiliary resetting device for atlantoaxial dislocation and manufacturing method thereof |
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| CN109700517B true CN109700517B (en) | 2024-03-19 |
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| CN112263314A (en) * | 2020-09-28 | 2021-01-26 | 西安增材制造国家研究院有限公司 | Resetting and fixing device for atlantoaxial dislocation |
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| CN202724045U (en) * | 2011-12-28 | 2013-02-13 | 北京爱康宜诚医疗器材股份有限公司 | Atlas fusion prosthesis |
| CN102784001A (en) * | 2012-09-10 | 2012-11-21 | 董大明 | Posterior atlantoaxial resetting device |
| CN203089338U (en) * | 2013-01-30 | 2013-07-31 | 广州军区广州总医院 | Atlantoaxial anterior approach restoration inner fixing device |
| CN104434287A (en) * | 2014-12-25 | 2015-03-25 | 南方医科大学南方医院 | Anterior cervical and craniocervical fixing device |
| CN204410945U (en) * | 2014-12-25 | 2015-06-24 | 南方医科大学南方医院 | The anterior approach cranium neck fixture improved |
| CN204890260U (en) * | 2015-06-02 | 2015-12-23 | 张宝成 | Fuse ware through oropharynx atlantoaxial joint internal fixation |
| CN105213007A (en) * | 2015-10-23 | 2016-01-06 | 西安交通大学第二附属医院 | Template is dissected on a kind of front road of self-resetting atlantoaxial dislocation |
| CN106175997A (en) * | 2016-07-01 | 2016-12-07 | 广州军区广州总医院 | A kind of artificial dentata supporter |
| 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 |
| CN209916168U (en) * | 2019-02-01 | 2020-01-10 | 西安增材制造国家研究院有限公司 | Auxiliary resetting instrument for atlantoaxial dislocation |
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