CN111888056A

CN111888056A - Vertebral body X-shaped excision decompression vertebral body shaping intervertebral fusion fixator

Info

Publication number: CN111888056A
Application number: CN202010778828.5A
Authority: CN
Inventors: 杨毅; 刘浩
Original assignee: West China Hospital of Sichuan University
Current assignee: West China Hospital of Sichuan University
Priority date: 2020-08-05
Filing date: 2020-08-05
Publication date: 2020-11-06
Anticipated expiration: 2040-08-05
Also published as: CN111888056B

Abstract

The invention discloses an intervertebral fusion fixator, relates to the field of medical instruments, and aims to provide a fusion fixator which is matched with an anterior cervical vertebral body X-shaped excision decompression vertebroplasty and can shorten the crawling substitution distance of bones, reduce fusion time and improve the success rate of bone grafting fusion. The technical scheme adopted by the invention is as follows: the interbody fusion fixator comprises a fusion fixing body and screws, wherein the fusion fixing body is provided with three bone implanting cavities, the horizontal section of a first bone implanting cavity is fan-shaped, the outer sides of two fan-shaped radiuses are respectively provided with a second bone implanting cavity and a third bone implanting cavity, a fixing blocking piece is arranged above or below a fan-shaped arc edge, the fixing blocking piece is provided with a through hole and is provided with the first screw, and the first screw is used for implanting back implanted bone blocks; the arc edge of the first bone grafting cavity is provided with a fixing hole, and screws used for implanting residual vertebral bodies on two sides and adjacent normal vertebral bodies are respectively arranged in the fixing hole. The invention is suitable for X-shaped excision decompression vertebroplasty on the cervical anterior vertebral body.

Description

Vertebral body X-shaped excision decompression vertebral body shaping intervertebral fusion fixator

Technical Field

The invention relates to the field of medical instruments, in particular to an intervertebral fusion fixator in orthopedic medicine.

Background

Cervical spondylolisthesis (achf) is suitable for patients who do not achieve good spinal decompression after simple discectomy. For patients with both anterior and posterior spinal compression, combined posterior canal enlargement can be considered on the basis of ACCF. The ACCF is also an ideal choice for patients with vertebral body lesions (tumors, etc.), cervical dislocation and kyphotic deformity.

At present, the cervical spondylosis vertebral body secondary total resection operation comprises the following steps:

first, cut, expose and position. Adopt anterior cervical way right side crosscut, this incision scar is less, and the postoperative outward appearance is better, and incision length generally is 3 ~ 5 cm. Cutting skin and subcutaneous tissue, cutting platysma muscle, performing blunt and sharp separation on the deep surface of platysma muscle after hemostasis, wherein the upper part and the lower part are 2-3 cm respectively, and the longitudinal exposure range is enlarged. The space between the intramuscular lateral margin of the sternocleidomastoid and the internal organ sheath of the neck is loose, which is an ideal surgical approach. Accurately determining a carotid artery sheath and a cervical viscera sheath, lifting the combined fascia between the inner side of sternocleidomastoid muscle and the cervical viscera sheath by using a pair of long forceps with teeth, cutting the fascia, and respectively expanding and cutting the fascia upwards and downwards along a gap between the fascia and the cervical viscera sheath, wherein the part is loose connective tissue and is easy to separate. The scapular-hyoid muscles are visible on the outside of the cervical visceral sheath, either directly exposed from the inside or accessible from the outside. During operation, the fingers perform blunt loosening along the separated gap and then slightly separate to the deep part to reach the vertebral body and the front part of the intervertebral disc. When the superior thyroid artery emerges, the superior laryngeal nerve is visible above it. If not, probing and dissociating are not necessary to avoid damage. After the internal organ sheath of the neck and the carotid artery sheath are separated, the draw hook is used for drawing the trachea and the esophagus to the midline, and the carotid artery sheath is drawn to the right side slightly, so that the anterior space of the vertebral body and the intervertebral disc can be reached. The anterior fascia is lifted with long forceps and then cut layer by layer, the fascia is separated longitudinally, and the exposed vertebral body and intervertebral space, usually 1 or 2 discs, are gradually enlarged upward and downward. The bilateral separation is preferably not more than 2 to 3mm from the medial edge of the long cervical muscle, and if the bilateral separation is too large, the vertebral artery and sympathetic plexus running through the transverse foramen may be damaged. The fresh cervical vertebra trauma with vertebral body fracture or anterior longitudinal ligament injury can be positioned by visual observation. For old fracture or simple intervertebral disc injury, the patients are sometimes difficult to distinguish under direct vision, and the most reliable method is to remove the tip of an injection needle, keep the length of the tip at 1.5cm, insert the intervertebral disc, take an X-ray film at the lateral position of the whole cervical vertebra, and perform perspective positioning according to the X-ray film or a C-arm machine.

Secondly, the cervical vertebra distracter which is applied more at present is used for distracting the vertebra. The center of the upper vertebral body and the center of the lower vertebral body of the diseased vertebra are respectively screwed into a spreader screw, and the spreader is sleeved on the spreader screw and spread towards the upper end and the lower end. The distraction of the vertebral body is beneficial to recovering the height of the injured vertebral body and intervertebral disc, relieves the compression on the spinal cord and is beneficial to the operation when the vertebral body is removed.

Thirdly, decompressing to determine the intervertebral discs above and below the fractured vertebral body, cutting the fibrous ring by a sharp knife, and taking out the broken intervertebral disc tissues by nucleus pulposus pincers. The anterior cortical bone and most cancellous bone of the fractured vertebral body are bitten and removed by using the three-joint rongeur, the process is suspended when the three-joint rongeur approaches the posterior edge of the vertebral body, the intervertebral disc and the end plate are all scraped by using a curette, the gap between the posterior edge of the vertebral body and the posterior longitudinal ligament is separated by using a nerve stripper, and the thin impact type rongeur is stretched into the three-joint rongeur to gradually bite and remove the posterior cortical bone of the vertebral body. At this point, a rectangular relief groove is formed, and the posterior longitudinal ligament bulge is visible. Carefully using an impact rongeur or curette to enlarge the bottom edge of the pressure reduction groove, so as to completely cut off the pressure-reducing object. If the posterior longitudinal ligament has scar formation, the posterior longitudinal ligament can be hooked by a nerve detacher or a posterior longitudinal ligament hook under direct vision, and the posterior longitudinal ligament is gradually cut off by a sharp knife to complete decompression.

Fourthly, the bone grafting adjusts the distraction height of the vertebral body distracter, so that the height of the cervical vertebra front column is recovered to be normal. Chiseling a rectangular bone graft at the iliac crest, trimming, implanting into a decompression groove, loosening the vertebral body spreader to enable the bone graft to be embedded tightly, and completing bone grafting. The titanium mesh cage with the diameter of 10mm or 12mm can be also selected to be trimmed to the length which is consistent with the height of the decompression area, and the spongy bone obtained by cutting the vertebral body is filled in the titanium mesh cage and implanted in the decompression area, so that the pain and possible complications brought to the patient by cutting the ilium are avoided.

Fifthly, for the explosive fracture of cervical vertebra centrum, especially for the bone grafting with titanium mesh, the anterior cervical steel plate should be used for fixation. The steel plate is fixed, so that the cervical vertebra can obtain immediate stability, and postoperative care and early recovery work are facilitated. Meanwhile, the use of internal fixation is beneficial to the healing of the bone grafting block, the height of the vertebral body is maintained in the healing process, and the collapse of the bone grafting block in the healing crawling replacement process is avoided, so that the radian of the cervical vertebra disappears.

And sixthly, repeatedly flushing the wound by using normal saline for suturing the incision, suturing the anterior fascia of the neck, placing one half-tube drainage strip, and suturing the incision layer by layer to close the incision.

Referring to fig. 1, the anterior cervical vertebral body is completely resected according to the existing operation method, the resection range A is square, the resection is performed by combining a grinding drill or a rongeur, and the resected broken bone is used for filling a titanium mesh and is used as a bone grafting material. ACCF surgery suffers from a number of deficiencies, including in particular: (1) the crossing distance after the vertebral body is removed by the ACCF operation is longer, and the creeping substitution distance of bones is longer, so that the fusion time is longer, the fusion efficiency is lower, and the re-operation revision risk is higher. (2) The bone grafting has poor healing effect and long time, so that a lot of patients still do not heal in 6 months and 12 months, the external cervical fixing brace needs to be worn for a long time, and the early rehabilitation and the return to normal life and work of the patients are not facilitated. (3) At present, the titanium mesh and the like which are mainly adopted are used as internal plants, and the titanium mesh is not fixed and is easy to shift into the vertebral canal to cause paralysis and the like; in addition, the titanium mesh is relatively sharp, the contact area is small, and the vertebral end plate is easy to puncture, so that the implant sinks. (4) If the support such as autologous ilium, rib, fibula and the like is adopted, although the success rate of the operative fusion can be increased, operative trauma and additional injury are caused to the patient, and complications such as pain, hematoma, infection and the like of the operative bone taking area of the patient are increased. (5) In the prior art, the excised vertebral body mainly adopts the following two modes: firstly, grinding by a grinding drill, wherein when the grinding drill grinds the bone of the vertebral body, water is used for flushing and radiating, and bone chips are wasted along with flushing fluid; secondly, the bone is bitten off by rongeur and filled into the titanium mesh as broken bone, and the cut vertebral body bone can not be reused as bone grafting material with the function of supporting vertebral body.

Therefore, how to convert the crawling replacement distance of bones spanning the length of one vertebral body or even a plurality of vertebral bodies into intervertebral fusion, improve the fusion rate, shorten the fusion time, reduce the work delay time and promote early rehabilitation is a problem faced by the ACCF operation at the present stage.

Disclosure of Invention

The invention provides an intervertebral fusion fixator which is matched with an anterior cervical vertebral body X-shaped excision decompression vertebroplasty and can shorten the crawling substitution distance of bones, reduce the fusion time and improve the success rate of bone grafting fusion.

The technical scheme adopted by the invention for solving the technical problems is as follows: the interbody fusion fixator comprises a fusion fixing body and screws, wherein the fusion fixing body is flat in the horizontal direction, the fusion fixing body is provided with three bone grafting cavities which are a first bone grafting cavity, a second bone grafting cavity and a third bone grafting cavity respectively, the horizontal section of the first bone grafting cavity is fan-shaped, the outer sides of two fan-shaped radiuses are the second bone grafting cavity and the third bone grafting cavity respectively, an upward-convex or downward-convex fixing separation blade is arranged above or below a fan-shaped arc edge, the fixing separation blade is provided with a through hole, and the through hole is internally provided with the first screw matched with the fixing separation blade;

the arc edge of the first bone grafting cavity is provided with at least three fixing holes, one of the fixing holes is internally provided with a second screw which points to the direction of the second bone grafting cavity and inclines towards the direction of the fixed separation blade, the other fixing hole is internally provided with a third screw which points to the direction of the third bone grafting cavity and inclines towards the direction of the fixed separation blade, and the rest fixing holes are internally provided with fourth screws which incline towards the opposite direction of the fixed separation blade.

Further, the method comprises the following steps: the implantation direction of the second screw is an included angle of 30-45 degrees from the inside to the outside in the coronal plane, and the included angle between the second screw and the plane where the fusion fixing body is located in the sagittal plane is 40-50 degrees; the implantation direction of the third screw coincides with the implantation direction of the second screw.

Further, the method comprises the following steps: one or two fixing holes for assembling a fourth screw are formed in the arc edge of the first bone grafting cavity; when one fourth screw is used, the implantation direction of the fourth screw is 45 degrees in a sagittal plane, and the inclination angle in a coronal plane is 0 degree; when two fourth screws are used, the implantation direction of the fourth screws is 45 degrees inclined in the sagittal plane, and 0-15 degrees inclined outwards in the coronal plane.

Further, the method comprises the following steps: the cavity walls of the three bone grafting cavities are respectively provided with a plurality of through holes communicated with the outside.

Further, the method comprises the following steps: the partition plate between the first bone grafting cavity and the second bone grafting cavity is provided with a plurality of through holes, and the partition plate between the first bone grafting cavity and the third bone grafting cavity is provided with a plurality of through holes.

Specifically, the method comprises the following steps: the arc edge of the first bone grafting cavity is provided with at least 3-4 fixing holes.

Further, the method comprises the following steps: the fusion fixing body is of an axisymmetric structure, and the symmetry axis is the central line of the circle center of the fan-shaped first bone grafting cavity.

Specifically, the method comprises the following steps: the outer contour of the fusion fixing body on the horizontal section is crescent, semicircular, elliptic or fan-shaped.

Specifically, the method comprises the following steps: the fusion fixing body is made of PEEK material, titanium alloy or composite material.

Specifically, the method comprises the following steps: the screw is a titanium alloy screw or an absorbable fixing screw.

The invention has the beneficial effects that: firstly, through the X-shaped excision decompression vertebral body forming intervertebral fusion fixer of the vertebral body, the ACCF operation is changed into the Anterior cervical intervertebral disc excision decompression fusion (ACDF) operation of two clearance fusions, namely the X-shaped excision decompression vertebral body of the vertebral body rebuilds the intervertebral fusion fixation, the crawl replacement distance of the bone is shortened, therefore, the fusion time is shortened, the fusion efficiency of the patient is increased, the work delay time is shortened, and the quick rehabilitation of the patient is facilitated. Second, increased the bone grafting and fused the success rate, the postoperative patient need not wear external fixation such as neck brace for a long time, can be earlier return normal work and life, and is less to patient psychological influence, is favorable to reducing patient's health economic burden. And thirdly, compared with the traditional ACCF operation in which a titanium mesh is used, the risk that the spinal cord is injured due to the fact that the titanium mesh sinks, shifts and protrudes into the vertebral canal is avoided, and operation-related complications are reduced. Fourthly, the intervertebral fusion fixator does not need to additionally perform an operation to obtain autogenous bone, but performs secondary utilization on the autogenous vertebral body bone needing to be cut off, so that the autogenous vertebral body bone is made into bone grafting material with a supporting effect, the materials such as artificial bone and the like used in the operation are avoided, the risks of postoperative infection, rejection reaction and the like are reduced, and the operation cost of a patient is reduced. Fifthly, compared with the scheme of supporting the ilium, the rib, the fibula and the like by adopting the autologous ilium, the rib, the fibula and the like, the operation wound and the additional injury caused by bone taking of the patient are avoided, and the complications of pain, hematoma, infection and the like of the bone taking area in the operation are avoided. And sixthly, the fusion fixing body is provided with a fixing blocking piece, the bone block can be fixed by the aid of the first screw, stress of the posterior side of the bone block can be increased, and bone healing of the residual vertebral bodies on the posterior side and the two sides of the bone block can be promoted. Meanwhile, the first screw plays a role in stably fixing the reimplantation bone block, so that the reimplantation bone block is ensured to be relatively fixed with the upper and lower adjacent vertebral bodies, and the fusion fixing body also has the function of bridging the reimplantation bone block and the residual vertebral bodies on two sides. And seventhly, the fusion fixing body is provided with three bone grafting cavities which respectively play a role in connecting the bone replantation block and the residual vertebral bodies at two sides, so that the bone replacement and fusion of the cut vertebral bodies and the upper and lower adjacent vertebral bodies can be promoted while the supporting effect is formed. Eighth, complications such as dysphagia caused by esophagus stimulation and the like caused by fixation of the anterior cervical steel plate in the traditional ACCF operation, and complications such as poor position of the titanium plate, screw looseness and the like are avoided.

The fusion fixing body is provided with a through hole, which is beneficial to the mutual communication of nutrient substances such as blood and the like and the fusion. The outer contour of the fusion fixing body on the horizontal section is crescent, semicircular, elliptical or fan-shaped, and can well support the residual vertebral bodies on the two sides and the replantation vertebral body part.

Drawings

Fig. 1 is a schematic view of a conventional cervical fusion resection range of a cervical vertebrae sub-total resection of an anterior cervical vertebral body.

Fig. 2 is a schematic view of the first resection of a reduced pressure vertebroplasty for an anterior cervical vertebral body according to the invention.

Fig. 3 is a schematic view of a second range of removal of a reduced pressure vertebroplasty of an anterior cervical vertebral body according to the invention.

Fig. 4 is a schematic view of a first resected bone block replanted by an anterior cervical vertebroplasty reduced pressure vertebroplasty in accordance with the present invention.

Fig. 5 is a schematic view of a fusion anchor of an embodiment of the present vertebroplasty reduced pressure vertebroplasty intervertebral fusion anchor.

Reference numerals: cutting off the range A; the bone fusion fixing device comprises a fusion fixing body 1, a first bone grafting cavity 11, a second bone grafting cavity 12, a third bone grafting cavity 13, a fixing separation blade 14 and a through hole 15; a first screw hole site 16, a second screw hole site 17, a third screw hole site 18, and a fourth screw hole site 19; the bone block 21, the first residual vertebral body 22 and the second residual vertebral body 23 are implanted.

Detailed Description

As shown in figures 2-4, the operation process of the X-shaped excision decompression vertebral body reconstruction intervertebral fusion fixation of the anterior cervical vertebral body comprises the following steps: first, a cross-sectional fan-shaped resection is made into the vertebral body, as shown in FIG. 2. The excised vertebral body is subsequently used as a replantation bone block 21, and the radius of the fan-shaped contour of the replantation bone block 21 accounts for about 60 percent of the anteroposterior diameter of the whole vertebral body. Next, the incision is made with rongeur and burr to the posterior of the vertebral body and is X-shaped, i.e., the incision is small and large, as shown in FIG. 3. The X-shaped incision can ensure the visual field during the operation, can complete the excision of osteophyte, posterior longitudinal ligament ossification and the like which press spinal nerves at the back, achieves the purpose of decompression during the operation, and simultaneously reduces the damage to the vertebral body. The two sides of the X-shaped incision are the residual vertebral bodies respectively, and for the convenience of distinction, the residual vertebral bodies are respectively marked as a first residual vertebral body 22 on the left side and a second residual vertebral body 23 on the right side according to the relative positions of the residual vertebral bodies in the human body. Again, a bone block 21 is implanted into the anterior side of the X-shape, see FIG. 4. Finally, the cut vertebral bodies are respectively fixed with the upper and lower adjacent vertebral bodies through the intervertebral fusion fixator provided by the invention. Wherein cutting the vertebral body refers to the vertebral body where the incision is made, i.e., the vertebral bodies corresponding to the first residual vertebral body 22 and the second residual vertebral body 23. The invention will be further explained with reference to the drawings.

The invention relates to a vertebral body X-shaped excision decompression vertebral body forming intervertebral fusion fixator which is used for fusing and fixing a cut vertebral body and upper and lower adjacent vertebral bodies. Referring to fig. 5, the vertebral body X-shaped resection decompression vertebroplasty intervertebral fusion fixator comprises a fusion fixing body 1 and screws which are divided into a first screw, a second screw, a third screw and a fourth screw according to the implantation objects and effects of the screws, wherein the screws are not shown in fig. 5, and only hole positions corresponding to the screws are shown. The fusion fixing body 1 is in a flat plate shape in the horizontal direction, is used for being implanted into the upper end and the lower end of a cutting vertebral body and is fixed with the normal vertebral bodies at the upper end and the lower end. The fusion fixing body 1 is provided with three bone grafting cavities, namely a first bone grafting cavity 11, a second bone grafting cavity 12 and a third bone grafting cavity 13. Wherein, the horizontal cross section of first bone grafting cavity 11 is fan-shaped, and first bone grafting cavity 11 is used for cooperating with the one end of replanting bone piece 21, and fan-shaped circular arc limit is the front side. The outside of two fan-shaped radiuses of first bone grafting chamber 11 is second bone grafting chamber 12 and third bone grafting chamber 13 respectively, separates through the baffle between first bone grafting chamber 11 and the second bone grafting chamber 12, separates through the baffle between first bone grafting chamber 11 and the third bone grafting chamber 13. The second bone graft cavity 12 is adapted to cooperate with the first residual vertebral body 22 and the third bone graft cavity 13 is adapted to cooperate with the second residual vertebral body 23.

In order to facilitate the through flow of nutrients such as blood, a plurality of through holes 15 communicated with the outside are respectively arranged on the cavity walls of the three bone grafting cavities, and the through holes 15 are positioned in the horizontal direction. In addition, a plurality of through holes 15 are also formed in the partition plate between the first bone grafting cavity 11 and the second bone grafting cavity 12, and a plurality of through holes 15 are formed in the partition plate between the first bone grafting cavity 11 and the third bone grafting cavity 13.

An upward-convex or downward-convex fixing baffle 14 is arranged above or below the fan-shaped arc edge of the fusion fixing body 1, the fixing baffle 14 is provided with a through hole, and a first screw matched with the through hole is arranged in the through hole. An upward convex fixing baffle 14 is arranged above the arc edge, and as shown in fig. 5, the fusion fixing body 1 is used for fusion fixation between the cutting vertebral body and the normal vertebral body on the lower side. Correspondingly, when the concave fixing baffle 14 is arranged below the arc edge, the fusion fixing body 1 is used for fusion fixation between the cutting vertebral body and the normal vertebral body on the upper side. In fig. 5, the through hole of the fixing plate 14 is the first screw hole 16, the first screw hole 16 is used for installing the first screw, and the first screw is used for implanting into the bone block 21. The fixing stopper 14 is preferably formed integrally with the fusion-fastening body 1 in a sheet-like, circular shape.

The fusion fixing body 1 needs to be implanted and fixed with the replantation bone block 21, the first residual vertebral body 22, the second residual vertebral body 23 and the adjacent normal vertebral body at the same time, and the fusion fixing body 1 and the replantation bone block 21 are fixed through a first screw, so that the arc edge of the first bone implantation cavity 11 is also respectively provided with at least three fixing holes, and screws are arranged in the fixing holes and are respectively used for implanting and fixing the fusion fixing body 1 and the first residual vertebral body 22, the second residual vertebral body 23 and the adjacent normal vertebral body. At least three fixing holes are formed, wherein a second screw which is inclined towards the direction of the fixing separation blade 14 and points to the second bone grafting cavity 12 is arranged in one fixing hole, and the installation position of the second screw is a second screw hole position 17; a third screw which is inclined towards the direction of the fixed separation blade 14 and points to the third bone grafting cavity 13 is arranged in the fixed hole, and the installation position of the third screw is a third screw hole position 18; and fourth screws inclined towards the opposite direction of the fixed baffle plate 14 are arranged in other fixing holes, and the mounting positions of the fourth screws are fourth screw hole positions 19.

The second screw is used for implantation in the first residual vertebral body 22, so that the second screw points in the direction of the second bone implantation chamber 12 and is inclined in the direction of the fixation flap 14. The implantation direction of the second screw is preferably an angle of 30-45 degrees from the oblique direction to the outer direction in the coronal plane, and the angle between the second screw and the plane of the fusion and fixation body 1 in the sagittal plane is 40-50 degrees, so as to ensure the stability of the second screw after implantation into the first residual vertebral body 22. The third screw is used for implantation in the second residual vertebral body 23, whereby the third screw points in the direction of the third bone implantation chamber 13 and is inclined in the direction of the fixation flap 14. The implantation direction of the third screw corresponds to the implantation direction of the second screw. The fourth screw is used for implantation into a normal vertebral body cutting the upper or lower part of the vertebral body, so that at least one of the fourth screws is only required to ensure that the fusion fixture 1 can be stably connected with the adjacent normal vertebral body. For example, as shown in fig. 5, the fusion fixation body 1 is provided with two fourth screw hole sites 19, i.e. two fourth screws are implanted in the normal vertebral body. When one fourth screw is adopted, the fourth screw is preferably screwed into the adjacent vertebral body in a sagittal plane with an inclination angle of 45 degrees, and the inclination angle in a coronal plane is 0 degree; when two fourth screws are provided, the implantation direction of the fourth screws is preferably 45 degrees inclined in the sagittal plane and 0-15 degrees inclined outwards in the coronal plane.

Since the first residual vertebral body 22 and the second residual vertebral body 23 are substantially axisymmetric, the fusion fixation body 1 has an axisymmetric structure, and the axis of symmetry is a central line passing through the center of the circle of the sector of the first bone graft cavity 11. The fusion fixture 1 of the axisymmetric structure can be universally used for cutting the upper and lower sides of the vertebral body. The outer profile of the fusion fixing body 1 on the horizontal cross section corresponds to the shape of the vertebral body as long as the spinal nerves at the rear are not pressed, for example, the shape is crescent, semicircular, oval or fan ring, wherein the outer side arc line of crescent is the first circular arc edge of the bone grafting cavity 11, the semicircular arc line is the first circular arc edge of the bone grafting cavity 11, and the outer side arc line of fan ring is the first circular arc edge of the bone grafting cavity 11. The fusion fixing body 1 is made of PEEK material, titanium alloy or composite material. The screws, namely the first screw, the second screw, the third screw and the fourth screw are titanium alloy screws or absorbable fixing screws, and the absorbable fixing screws can be polylactic acid absorbable screws, levorotatory polylactic acid (PLLA) -Hydroxyapatite (HA) composite material absorbable screws and the like.

Claims

1. X-shaped excision decompression vertebral body shaping intervertebral fusion fixer of centrum, its characterized in that: the bone fusion fixation device comprises a fusion fixation body (1) and screws, wherein the fusion fixation body (1) is flat in the horizontal direction, the fusion fixation body (1) is provided with three bone grafting cavities, namely a first bone grafting cavity (11), a second bone grafting cavity (12) and a third bone grafting cavity (13), the horizontal section of the first bone grafting cavity (11) is fan-shaped, the outer sides of two fan-shaped radiuses are the second bone grafting cavity (12) and the third bone grafting cavity (13), an upward-convex or downward-convex fixing separation blade (14) is arranged above or below a fan-shaped arc edge, the fixing separation blade (14) is provided with a through hole, and the through hole is internally provided with a first screw matched with the through hole;

at least three fixing holes are formed in the arc edge of the first bone grafting cavity (11), a second screw which points to the direction of the second bone grafting cavity (12) and inclines towards the direction of the fixing separation blade (14) is arranged in one fixing hole, a third screw which points to the direction of the third bone grafting cavity (13) and inclines towards the direction of the fixing separation blade (14) is arranged in the other fixing hole, and a fourth screw which inclines towards the opposite direction of the fixing separation blade (14) is arranged in the other fixing holes.

2. The vertebroplasty reduced pressure vertebroplasty intervertebral fusion cage of claim 1, wherein: the implantation direction of the second screw is an included angle of 30-45 degrees from the inside to the outside in the coronal plane, and the included angle between the second screw and the plane where the fusion fixing body (1) is located in the sagittal plane is 40-50 degrees; the implantation direction of the third screw coincides with the implantation direction of the second screw.

3. The vertebroplasty reduced pressure vertebroplasty intervertebral fusion cage of claim 2, wherein: one or two fixing holes for assembling a fourth screw are arranged on the arc edge of the first bone grafting cavity (11); when one fourth screw is used, the implantation direction of the fourth screw is 45 degrees in a sagittal plane, and the inclination angle in a coronal plane is 0 degree; when two fourth screws are used, the implantation direction of the fourth screws is 45 degrees inclined in the sagittal plane, and 0-15 degrees inclined outwards in the coronal plane.

4. The vertebroplasty reduced pressure vertebroplasty intervertebral fusion cage of claim 1, wherein: the cavity walls of the three bone grafting cavities are respectively provided with a plurality of through holes (15) communicated with the outside.

5. The vertebroplasty reduced pressure vertebroplasty intervertebral fusion cage of claim 4, wherein: a plurality of through holes (15) are formed in a partition plate between the first bone grafting cavity (11) and the second bone grafting cavity (12), and a plurality of through holes (15) are formed in a partition plate between the first bone grafting cavity (11) and the third bone grafting cavity (13).

6. The vertebroplasty reduced pressure vertebroplasty intervertebral fusion cage of claim 1, wherein: the arc edge of the first bone grafting cavity (11) is provided with at least 3-4 fixing holes.

7. The vertebroplasty reduced pressure vertebroplasty intervertebral fusion cage of any of claims 1 to 6, wherein: the fusion fixing body (1) is of an axisymmetric structure, and the symmetric axis is the central line of the circle center of the sector of the first bone grafting cavity (11).

8. The vertebroplasty reduced pressure vertebroplasty intervertebral fusion cage of claim 7, wherein: the outer contour of the fusion fixing body (1) on the horizontal section is crescent, semicircular, elliptic or fan-shaped.

9. The vertebroplasty reduced pressure vertebroplasty intervertebral fusion cage of claim 7, wherein: the fusion fixing body (1) is made of PEEK material, titanium alloy or composite material.

10. The vertebroplasty reduced pressure vertebroplasty intervertebral fusion cage of claim 7, wherein: the screw is a titanium alloy screw or an absorbable fixing screw.