CN111904671A

CN111904671A - Fusion cage and implantation instrument

Info

Publication number: CN111904671A
Application number: CN202010916569.8A
Authority: CN
Inventors: 陆云涛; 漆松涛; 彭林; 周强; 李宏; 李俊杰
Original assignee: Individual
Current assignee: Individual
Priority date: 2020-09-03
Filing date: 2020-09-03
Publication date: 2020-11-10
Also published as: WO2022048507A1

Abstract

The invention provides a fusion device and an implantation instrument, belongs to the technical field of medical instruments, and is used for being arranged between two joints of a to-be-reset area along a first direction, and the fusion device comprises a conical head and two conical columns which are respectively connected with the conical head and are arranged oppositely in parallel, wherein the conical columns are in an isosceles trapezoid shape along the first direction, an included angle between the waist of the isosceles trapezoid and the axis of the isosceles trapezoid is 0-20 degrees, and the height of the fusion device along the first direction is 4-12 cm. Use through the cooperation of series not co-altitude and contained angle, can follow horizontal direction and vertical direction and reset respectively, except that to extensive region axis dislocation reset, can also effectual slope axis angle that resets, image data reach the effect that the ration resets before the combination, the operation effect is better.

Description

Fusion cage and implantation instrument

Technical Field

The invention relates to the technical field of medical instruments, in particular to a fusion device and an implantation instrument.

Background

At present, aiming at the restoration of the malformation of the atlantoaxial junction area, the posterior occipital-cervical fusion technology is mostly adopted to restore the dislocation between the atlantoaxial odontoid and the atlantoaxial. However, most of the defects of the atlantoaxial junction area are caused by the developmental defects of the lateral joints of the neck 1/2, and the simple posterior reduction often causes the displacement (anterior opening or posterior opening) of the lateral joints of the neck 1/2, so the reduction effect is often unsatisfactory, and the clinical symptoms of a patient cannot be well relieved; and the stress between joints is completely concentrated on the nail rod system at the rear, thereby causing the risk of post-operation nail rod fracture to be greatly increased.

The current method of application is to use a fusion cage that is implanted between the lateral joints of the neck 1/2. The existing fusion cage simply recovers the malformed joint from the pituitary direction, but the malformed occipital cervical junction area is often combined with the reduction of the angle of the slope axis and causes the retroversion of the dentate process, the existing fusion cage can not change the angle of the slope axis well, so that the postoperative medulla and the upper cervical medulla ventral side are still pressed, and the symptoms can not be relieved.

Disclosure of Invention

The invention aims to provide a fusion cage and an implantation instrument, which can respectively reset from the horizontal direction and the vertical direction, and improve the resetting effect.

The embodiment of the invention is realized by the following steps:

the fusion cage comprises a conical head and two conical columns which are oppositely arranged in parallel and respectively connected with the conical head, the conical columns are isosceles trapezoids along the first direction, an included angle between the waist of each isosceles trapezoid and the axis of each isosceles trapezoid is 0-20 degrees, and the height of the fusion cage along the first direction is 4-12 cm.

Optionally, a plurality of convex teeth connected in sequence are arranged on the waist surface of the waist of the isosceles trapezoid along a second direction, the convex teeth are used for meshing with the tooth-shaped protrusions on the joint surface of the joint, and the second direction is perpendicular to the first direction.

Optionally, the length of the cage in the direction of the axis is between 16cm and 18 cm.

Optionally, the cone head is of a step structure, the cone head includes a rectangular top surface and four trapezoidal side surfaces extending along four sides of the top surface in the direction of the axis, and the trapezoidal side surfaces are connected with the cone columns through connecting surfaces.

Optionally, an included angle between the trapezoidal side surface located in the second direction and the horizontal line is a cone included angle, and the cone included angle is between 20 ° and 30 °.

Optionally, the taper head structure further comprises a groove body, the groove body is located at the end part, away from the taper head, of the two taper columns and connected with the two taper columns, a groove is formed in the groove body, and the notch of the groove is away from the taper head.

Optionally, a threaded hole is formed in the groove body along the axis.

Optionally, the material of the fusion cage is a polyetheretherketone material.

Another aspect of an embodiment of the present invention provides an implantation instrument comprising the fusion cage described above.

The embodiment of the invention has the beneficial effects that:

the fusion device and the implantation instrument provided by the embodiment of the invention can improve the skull base depression and partial horizontal dislocation of the atlanto-odontoid through the matching of different heights and included angles and the recovery of the height direction, and can complete the horizontal dislocation of the atlanto-odontoid through the shaping of the nail rod at the back and the rod pressing technology through the recovery of the included angle. Through the cooperation use of height and contained angle, reset from vertical direction and horizontal direction two directions, the basis of cranii is sunken and slope axis angle are reset to the ration, and the effectual oppression that improves medulla oblongata and upper cervical marrow ventral side can give cranium cervical junction area biomechanics support in both sides simultaneously, has avoided the stress to concentrate on the nail stick system at rear alone to the risk of disconnected nail disconnected stick of postoperative has been reduced. Through the cooperation use of serial different height and contained angle, except that to the dislocation of atlantoaxial and reset, can also effectual slope axis angle that resets, image data reach the effect that the ration resets before combining, the operation effect is better.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings needed to be used in the embodiments will be briefly described below, it should be understood that the following drawings only illustrate some embodiments of the present invention and therefore should not be considered as limiting the scope, and for those skilled in the art, other related drawings can be obtained according to the drawings without inventive efforts.

FIG. 1 is a schematic structural diagram of a fusion cage according to an embodiment of the present invention;

FIG. 2 is a second schematic structural diagram of a fusion cage according to an embodiment of the present invention;

FIG. 3 is a third schematic view of a fusion cage according to an embodiment of the present invention;

FIG. 4 is a fourth schematic structural diagram of a fusion cage according to an embodiment of the present invention;

FIG. 5 is a schematic diagram of a fusion cage according to an embodiment of the present invention;

FIG. 6 is a schematic diagram of a fusion cage according to an embodiment of the present invention;

fig. 7 is a second schematic diagram illustrating the use of the fusion device according to the embodiment of the present invention.

Icon: 10-a fusion device; 11-a cone head; 12-a conical cylinder; 121-convex teeth; 13-a trough body; 21-joint; 22-pedicle screws; 23-pressing a rod; h-height; h1 — first height; l-length; l1-first length; d-width; d1 — first width; a-included angle; b-cone included angle.

Detailed Description

In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all, embodiments of the present invention. The components of embodiments of the present invention generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.

Thus, the following detailed description of the embodiments of the present invention, presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus, once an item is defined in one figure, it need not be further defined and explained in subsequent figures.

In the description of the present invention, it should be noted that the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc. indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings or the orientations or positional relationships that the products of the present invention are conventionally placed in use, and are only used for convenience in describing the present invention and simplifying the description, but do not indicate or imply that the devices or elements referred to must have a specific orientation, be constructed and operated in a specific orientation, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first," "second," "third," and the like are used solely to distinguish one from another and are not to be construed as indicating or implying relative importance.

Furthermore, the terms "horizontal", "vertical" and the like do not imply that the components are required to be absolutely horizontal or pendant, but rather may be slightly inclined. For example, "horizontal" merely means that the direction is more horizontal than "vertical" and does not mean that the structure must be perfectly horizontal, but may be slightly inclined.

In the description of the present invention, it should also be noted that, unless otherwise explicitly specified or limited, the terms "disposed," "mounted," "connected," and "connected" are to be construed broadly and may, for example, be fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.

Referring to fig. 1, the present embodiment provides a fusion cage 10, which can be used for the reduction of malformation of atlantoaxial junction between joints 21, and also for the reduction of joints 21 caused by fracture of upper cervical vertebra, skull base depression, hernia of cerebellar tonsillar hernia, and syringomyelia.

The fusion cage 10 is arranged between two joints 21 of a to-be-reset area along a first direction and comprises a conical head 11 and two conical columns 12 which are arranged oppositely in parallel and respectively connected with the conical head 11, the conical columns 12 are isosceles trapezoid-shaped along the first direction, an included angle a between the waist of the isosceles trapezoid and the axis of the isosceles trapezoid is 0-20 degrees, and the height H of the fusion cage 10 along the first direction is 4-12 cm.

The fusion cage 10 is a conical body, the fusion cage 10 is hollow inside, autogenous bone can be implanted into the hollow part, fusion between the neck 1/2 joints 21 is promoted, the atlantoaxial junction area deformity reduction is completed, meanwhile, the fusion efficiency can be promoted, the risk of post-operation broken nails and broken rods is reduced, and the risk of secondary operations of patients is reduced.

The two conical columns 12 are arranged oppositely in parallel and are respectively connected with the conical heads 11. The shape of the side surface of the tapered column 12 in the first direction is an isosceles trapezoid, the large end of the isosceles trapezoid is connected with the tapered head 11, as shown in fig. 2, the included angle a between the waist of the isosceles trapezoid and the axis of the isosceles trapezoid is between 0 ° and 20 °, and by setting the range of the included angle a, the inclination of the waist of the isosceles trapezoid is also limited, so that the fusion cage 10 becomes an angled fusion cage 10.

The conical column 12 is further provided with a hole on the surface in the first direction for connecting a surgical instrument.

When the fusion device 10 is applied to the joints 21 for the deformed reduction of the atlantoaxial junction region, the more common included angle a is generally 0 degrees, 5 degrees, 7 degrees, 10 degrees, 14 degrees or 20 degrees so as to meet the requirements of different atlantoaxial junction region malformations. Of course, the present embodiment does not specifically limit the value of the included angle a, and the included angle a is applicable to the range from 0 ° to 20 °.

When the fusion cage 10 is arranged between the two joints 21 of the region to be restored, the fusion cage 10 is arranged between the two joints 21 along the first direction of the fusion cage 10, and the height H of the fusion cage 10 in the first direction is between 4cm and 12 cm.

By height H restoration of the fusion cage 10, the skull base depression and partial atlanto-odontal dislocation can be improved. The horizontal dislocation of the atlanto-odontoid can be reset in the horizontal direction by the shaping of the nail rod at the rear and the rod pressing technology after the included angle a of the fusion device 10 is restored. The reduction is performed from both the vertical direction and the horizontal direction by the cooperation of the height H and the included angle a, which are selected according to different displacement conditions of each patient and the loosening condition of the lateral side joint 21 during the operation.

When the fusion cage 10 is used, firstly, the neck 1/2 lateral joint 21 is exposed through a posterior neck surgery, then the lateral joint 21 is loosened through reamers with different heights H, then the height H of fusion placement between the neck 1/2 joints 21 is tested by using a test model, and a proper fusion cage 10 is selected; selecting a fusion cage 10 with a proper angle according to preoperative planning, selecting the fusion cage 10 by combining with a proper height H measured in the operation, and implanting the fusion cage 10 between the lateral joints 21 of the neck 1/2; then the pedicle screw 22 is inserted into the bilateral cervical pedicle arch root value, the occipital bone plate is arranged, the deformity of the atlantoaxial junction area is recovered by the angle of the fusion device 10 by using the pressing rod 23 technology through the shaping of a posterior titanium rod; and finally, performing perspective in C-arm operation to determine that the position of the fusion cage 10 and the nail rod is good, and finishing the operation.

For example, as shown in fig. 6 and 7, the fusion cage 10 is driven between two joints 21 of the region to be restored, and the restoration in the vertical direction can be achieved by first spreading in the vertical direction; then, the pedicle screws 22 are implanted, the molded titanium plate is used, and the rod pressing 23 mode is adopted, so that the rotation can be realized, and the horizontal reduction can be realized.

The fusion cage 10 can quantitatively reset skull base depression and slope axis angle through the matching of different heights H and included angles a, effectively improves the compression of medulla oblongata and upper cervical medulla ventral side, and can provide biomechanical support for skull cervical junction areas on two sides, thereby avoiding the stress from being simply concentrated on a nail rod system at the rear, and further reducing the risk of post-operation broken nails and broken rods. In addition, aiming at the matched tool of the operation, the joint 21 at two sides of the skull-neck junction area is gradually expanded to achieve the purpose of thorough loosening, so as to facilitate the implantation of the fusion device 10. The fusion cage 10 is different from the previous fusion cage 10 in that the atlantoaxial dislocation can be reduced and the slope axis angle can be effectively reduced through the matching use of the series of fusion cages with different heights H and included angles a. The present cage 10 is capable of repositioning from both the vertical and horizontal directions, rather than just a single vertical direction. Meanwhile, by the design of the fusion cage 10 with different included angles a and heights H, the effect of quantitative reduction can be achieved by combining the preoperative imaging data, and the operation effect is better.

Specifically, the waist surface of the waist of the isosceles trapezoid is provided with a plurality of convex teeth 121 connected in sequence along a second direction, the convex teeth 121 are used for being engaged with the tooth-shaped protrusions on the surface of the joint 21, and the second direction is perpendicular to the first direction.

The waist of the isosceles trapezoid is provided with a plurality of convex teeth 121 which are connected in sequence, when the fusion cage 10 is arranged between the two joints 21, the convex teeth 121 on the two waist surfaces of the isosceles trapezoid are respectively meshed with the dentate processes on the joint 21 surfaces of the upper joint 21 and the lower joint 21, so that the fusion cage 10 can be stably fixed with the upper joint 21 and the lower joint 21, the resetting is facilitated, the dislocation and the deviation of the fusion cage 10 and the upper joint 21 and the lower joint 21 are avoided, and the fusion cage 10 is withdrawn from the space between the upper joint 21 and the lower joint 21.

As shown in fig. 3, the cone head 11 is of a step structure, the cone head 11 includes a rectangular top surface, and four trapezoidal side surfaces extending along four sides of the top surface toward the axial direction, respectively, and the trapezoidal side surfaces are connected to the cone posts 12 through connecting surfaces.

The conical head 11 extends from the rectangular top surface to the conical column 12 to form a conical structure with a large end and a small end, and the large end of the conical head 11 is connected with the large end of the conical column 12.

The cone head 11 has four side faces, each of which is a trapezoidal side face and is formed by extending four edges along the top face to the axial direction, and the trapezoidal side faces are connected with the cone column 12 through connecting faces.

When the fusion cage 10 is driven between the upper and lower joints 21, the rectangular top surface and the trapezoidal side surface play a role of buffering during driving, and do not injure the joints 21.

As shown in fig. 4, the included angle between the trapezoidal side surface in the second direction and the horizontal line is a cone head included angle b, and the cone head included angle b is between 20 ° and 30 °, so that the shape of the formed cone head 11 is small in resistance when the fusion cage 10 is driven between the upper joint 21 and the lower joint 21, and the fusion cage is convenient to drive.

The width D of the conical head 11 along the first direction, the conical head 11 has a first width D1 in the direction of the conical head included angle b, and the width D and the first width D1 are arranged to match the conical head included angle b. The cage 10 also has a first height H1 in the direction of angle b.

In order to adapt to the joint 21 of the human body, the length L of the fusion cage 10 in the axial direction is between 16cm and 18cm to match the length of the joint 21.

As shown in fig. 5, the fusion cage 10 further includes a groove 13, the groove 13 is connected to the conical columns 12, the groove 13 is located at the end of the two conical columns 12 far away from the conical head 11 and is connected to the two conical columns 12, a groove is arranged on the groove 13, the notch of the groove is far away from the conical head 11, that is, the opening direction of the groove is far away from the conical head 11. Threaded holes are formed in the groove body 13, and the groove body 13 and the threaded holes are used for conveniently connecting surgical instruments.

The fusion cage 10 is made of polyetheretherketone, biocompatibility is the most basic factor for determining whether a material is suitable for human implantation, and the material must be free of cytotoxicity, mutagenicity and carcinogenicity and cause no allergy. The polyether-ether-ketone material has excellent biocompatibility and no side effect. And the elasticity modulus of the polyetheretherketone material is very close to that of human skeleton, and the stress borne by the skeleton is not completely borne by the implant, so that the skeleton is healthier after the fusion cage 10 is implanted.

The sum of the lengths of the tapered column 12 and the groove 13 in the axial direction is a first length L1, and is provided to match the length L of the fusion cage 10.

Several specific specifications of the cage 10 are given below to accommodate different repositioning situations:

the angle a is 0 °, the height H is 4cm, the width D is 2cm, the length L is 16cm, the first length L1 is 10.7cm, the first height H1 is 8cm, the first width D1 is 3.2cm, and the angle b is 60 °.

The angle a is 5 °, the height H is 5cm, the width D is 2cm, the length L is 16cm, the first length L1 is 10.7cm, the first height H1 is 8cm, the first width D1 is 3.2cm, and the angle b is 60 °.

The angle a is 7 °, the height H is 6cm, the width D is 2cm, the length L is 16cm, the first length L1 is 10.7cm, the first height H1 is 8cm, the first width D1 is 3.2cm, and the angle b is 60 °.

The angle a is 7 °, the height H is 7cm, the width D is 2cm, the length L is 18cm, the first length L1 is 10.7cm, the first height H1 is 8cm, the first width D1 is 3.2cm, and the angle b is 60 °.

The angle a is 10 °, the height H is 8cm, the width D is 2cm, the length L is 18cm, the first length L1 is 10.7cm, the first height H1 is 8cm, the first width D1 is 3.2cm, and the angle b is 60 °.

The angle a is 10 °, the height H is 9cm, the width D is 2cm, the length L is 18cm, the first length L1 is 10.7cm, the first height H1 is 8cm, the first width D1 is 3.2cm, and the angle b is 60 °.

The angle a is 10 °, the height H is 10cm, the width D is 2cm, the length L is 18cm, the first length L1 is 10.7cm, the first height H1 is 8cm, the first width D1 is 3.2cm, and the angle b is 60 °.

The embodiment of the invention also discloses an implantation instrument, which comprises the fusion cage 10 of the embodiment. The implantation instrument comprises the same structure and benefits as the cage 10 of the previous embodiment. The structure and advantages of the fusion cage 10 have been described in detail in the foregoing embodiments, and are not described in detail herein. The corresponding matching tools are arranged, so that the operation in the operation is convenient, and the popularization of the technology is facilitated.

The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. A fusion cage is arranged between two joints of a to-be-reset area along a first direction and is characterized by comprising a conical head and two conical columns which are connected with the conical head and are arranged oppositely in parallel, the conical columns are isosceles trapezoids along the first direction, an included angle between the waist of each isosceles trapezoid and the axis of each isosceles trapezoid is 0-20 degrees, and the height of the fusion cage along the first direction is 4-12 cm.

2. The fusion device according to claim 1, wherein the waist surface of the waist of the isosceles trapezoid is provided with a plurality of teeth connected in sequence along a second direction, the teeth are used for being engaged with the tooth-like protrusions on the joint surface of the joint, and the second direction is perpendicular to the first direction.

3. The fusion cage of claim 1, wherein the length of the cage in the direction of the axis is between 16cm and 18 cm.

4. The fusion device defined in claim 2 wherein the cone head is of a stepped configuration, the cone head including a rectangular top surface and four trapezoidal side surfaces extending along four sides of the top surface in the direction of the axis, the trapezoidal side surfaces being connected to the cone posts by connecting surfaces.

5. The fusion device defined in claim 4 wherein the angle between the trapezoidal side in the second direction and the horizontal is a cone angle, and the cone angle is between 20 ° and 30 °.

6. The fusion cage according to claim 1, further comprising a slot body, wherein the slot body is located at the end part of the two conical columns far away from the conical head and is connected with the two conical columns, a groove is arranged on the slot body, and the notch of the groove is far away from the conical head.

7. The fusion cage according to claim 6, wherein the slot is provided with a threaded hole along the direction of the axis.

8. The fusion cage of claim 1, wherein the cage material is a polyetheretherketone material.

9. An implantation instrument comprising a fusion device according to any one of claims 1 to 8.