CN114176748B - Atlantoaxial joint fusion device - Google Patents

Atlantoaxial joint fusion device Download PDF

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Publication number
CN114176748B
CN114176748B CN202010970916.5A CN202010970916A CN114176748B CN 114176748 B CN114176748 B CN 114176748B CN 202010970916 A CN202010970916 A CN 202010970916A CN 114176748 B CN114176748 B CN 114176748B
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CN
China
Prior art keywords
moving block
cover plate
screw
main body
screw rod
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Active
Application number
CN202010970916.5A
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Chinese (zh)
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CN114176748A (en
Inventor
赵军
唐志珂
董骧
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Beijing Naton Institute Of Medical Technology Co ltd
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Beijing Naton Institute Of Medical Technology Co ltd
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Priority to CN202010970916.5A priority Critical patent/CN114176748B/en
Publication of CN114176748A publication Critical patent/CN114176748A/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • 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
    • A61B17/7059Cortical plates
    • 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
    • A61B17/7064Devices acting on, attached to, or simulating the effect of, vertebral facets; 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
    • A61B2017/564Methods for bone or joint treatment

Abstract

The invention discloses an atlantoaxial joint fusion device, which belongs to the technical field of orthopedic implants, and comprises a vertical hollow main body, wherein a cover plate is arranged above and/or below the main body, and the rear end of the cover plate is hinged on the rear side wall of the main body; the screw rod is arranged in an inclined mode in the front-back direction in the main body and can rotate in situ, the screw rod is in threaded connection with a moving block for supporting the cover plate, and the moving block can be driven to move forwards by driving the screw rod to rotate, so that the front end of the cover plate is unfolded. The anterior lobe degree can be adjusted in the operation, the atlantoaxial joint kyphosis deformity can be corrected better, and the physiological kyphosis can be recovered; the anterior lobe angle is greater and the indication is wider.

Description

Atlantoaxial joint fusion device
Technical Field
The invention relates to the technical field of orthopedic implants, in particular to an atlantoaxial joint fusion cage.
Background
There are two main types of surgical treatment for the depression of the skull base with atlantoaxial dislocation (basilar invagination-atlantoaxial dislocation, BI-ADD), the traditional anterior cervical surgery which releases the atlantoaxial or abrades the odontoid process via the oropharyngeal access. Although the anterior cervical approach can directly relieve the compression, the postoperative complications such as infection, eating difficulty and the like are often caused, so the anterior cervical approach is gradually replaced by the posterior cervical approach reduction internal fixation fusion technique.
Posterior atlantoaxial joint fusion devices are used in posterior cervical reduction internal fixation fusion surgery, however, most of the existing posterior atlantoaxial joint fusion devices are designed with fixed inclination angles (anterior lobes), and products of the fusion devices are designed with different specifications, and proper length, width and height are selected in the surgery to be matched with the products, so that the specifications of the products are diversified, and the stock cost is increased; and because of the spans among different specifications, the atlantoaxial joint kyphosis deformity is difficult to be completely corrected, and the physiological lordosis is restored.
Disclosure of Invention
The invention aims to provide an atlantoaxial joint fusion device with an adjustable anterior lobe.
In order to solve the technical problems, the invention provides the following technical scheme:
an atlantoaxial joint fusion device comprises a vertical hollow main body, wherein a cover plate is arranged above and/or below the main body, and the rear end of the cover plate is hinged on the rear side wall of the main body; the screw rod is arranged in an inclined mode in the front-back direction in the main body and can rotate in situ, the screw rod is in threaded connection with a moving block for supporting the cover plate, and the moving block can be driven to move forwards by driving the screw rod to rotate, so that the front end of the cover plate is unfolded.
Further, the cover plate comprises an upper cover plate positioned above the main body and a lower cover plate positioned below the main body, and the rear ends of the upper cover plate and the lower cover plate are hinged on the rear side wall of the main body;
the screw comprises an upper screw and a lower screw, the moving block comprises an upper moving block for supporting the upper cover plate and a lower moving block for supporting the lower cover plate, the upper screw is in threaded connection with the upper moving block, and the lower screw is in threaded connection with the lower moving block;
the upper screw rod and the lower screw rod are driven to rotate, so that the upper moving block and the lower moving block can move forwards, and the front ends of the upper cover plate and the lower cover plate are opened to the upper side and the lower side of the main body.
Further, the upper screw is inclined forward and upward, and the lower screw is inclined forward and downward.
Further, an upper mounting hole and a lower mounting hole are formed in the front side wall of the main body, the front end of the upper screw rod is located in the upper mounting hole, and the front end of the lower screw rod is located in the lower mounting hole.
Further, an upper jack and a lower jack for respectively accommodating the tail ends of the upper screw and the lower screw are arranged on the rear side wall of the main body.
Further, the upper moving block and the lower moving block are both rectangular plates;
screw holes are formed in the middle of the upper moving block and the middle of the lower moving block, and the upper moving block and the lower moving block are connected with the upper screw rod and the lower screw rod through screw threads of the screw holes.
Further, a pair of upper support columns are arranged on two sides above the upper moving block, and a pair of lower support columns are arranged on two sides below the lower moving block.
Further, the end surfaces of the upper support column and the lower support column are inclined planes.
Further, a driving mechanism for driving the upper screw and the lower screw to rotate is arranged at the rear part of the main body, a middle mounting hole is formed in the middle of the rear side wall of the main body, and the driving mechanism is a driving gear which is arranged in the middle mounting hole and can rotate in situ and is used for driving the upper screw and the lower screw to rotate simultaneously.
Further, the driving gear comprises a rotating shaft and a frustum-shaped gear fixedly arranged at the front part of the rotating shaft, and the rear part of the rotating shaft is positioned in the middle mounting hole;
tooth surfaces meshed with the frustum-shaped gears are arranged at the tail ends of the upper screw rod and the lower screw rod;
the outer end face of the tail part of the rotating shaft is provided with an instrument operation hole.
The invention has the following beneficial effects:
in order to correct the posterior projection deformity of the atlantoaxial joint and recover the physiological lordosis, compared with the traditional fusion device with fixed lordosis, the fusion device has the characteristic of adjustable lordosis angle in operation, the specification of the fusion device is reduced, and the stock cost is reduced; the anterior lobe angle is greater and the indication is wider.
Drawings
FIG. 1 is a schematic view showing an exploded structure of an atlantoaxial joint fusion cage according to the present invention;
FIG. 2 is a schematic view of the combined structure of the atlantoaxial cage of FIG. 1, wherein (a) and (b) are in a closed state, (c), (d) and (e) are in a distracted state, and the main body is omitted from (b) and (d);
FIG. 3 is a schematic view of the body of FIG. 1, wherein (a) is a perspective view and (b) is a front end elevational view;
FIG. 4 is a schematic view of the structure of the upper screw of FIG. 1;
FIG. 5 is a schematic view of the upper block of FIG. 1, wherein (a) is a rear end elevational view and (b) is a left side view;
fig. 6 is a schematic diagram of the driving mechanism of fig. 1, wherein (a) is a side elevation view and (b) is a left side view.
Detailed Description
In order to make the technical problems, technical solutions and advantages to be solved more apparent, the following detailed description will be given with reference to the accompanying drawings and specific embodiments.
The invention provides an atlantoaxial joint fusion device, as shown in figures 1-6, comprising a vertical hollow main body 1, wherein a cover plate is arranged above and/or below the main body 1, and the rear end of the cover plate is hinged on the rear side wall of the main body 1; the screw rod which is obliquely arranged and can rotate in situ (axially stop and circumferentially rotate) is arranged in the front-back direction in the main body 1, the screw rod is in threaded connection with a moving block for supporting the cover plate, and the moving block can be moved forwards by driving the screw rod to rotate, so that the front end of the cover plate is opened.
In the embodiment shown in the figures, the cover plate comprises an upper cover plate 2 positioned above the main body 1 and a lower cover plate 3 positioned below the main body 1, wherein the rear ends of the upper cover plate 2 and the lower cover plate 3 are hinged on the rear side wall of the main body 1, and in particular can be hinged through a rotating shaft 4;
the screw rod comprises an upper screw rod 5 and a lower screw rod 6, the moving blocks comprise an upper moving block 7 for supporting the upper cover plate 2 and a lower moving block 8 for supporting the lower cover plate 3, the upper screw rod 5 is in threaded connection with the upper moving block 7, and the lower screw rod 6 is in threaded connection with the lower moving block 8;
the upper screw 5 and the lower screw 6 are driven to rotate, so that the upper moving block 7 and the lower moving block 8 can move forwards, and the front ends of the upper cover plate 2 and the lower cover plate 3 are spread towards the upper side and the lower side of the main body 1.
It is conceivable that if the fusion device only needs to be spread on one side, only the upper cover plate or only the lower cover plate can be arranged, if the upper cover plate is spread, only the upper screw rod and the upper moving block are correspondingly arranged, and if the lower cover plate is spread, only the lower screw rod and the lower moving block are correspondingly arranged.
When the atlantoaxial joint fusion device is used, firstly, the atlantoaxial joint fusion device is in a closed state shown in (a) and (b) in fig. 2, after the atlantoaxial joint fusion device is implanted into a human body, an upper screw 5 and a lower screw 6 are driven to rotate by an instrument, so that an upper moving block 7 and a lower moving block 8 move forwards, the front ends of an upper cover plate 2 and a lower cover plate 3 are opened towards the upper side and the lower side of a main body 1, and then the atlantoaxial joint fusion device is changed into an opened state shown in (c), (d) and (e) in fig. 2, wherein an included angle (i.e. a front lobe) between the upper cover plate 2 and the lower cover plate 3 after the atlantoaxial joint fusion device is opened is alpha, and the included angle can be flexibly set according to requirements, for example, the included angle can be 0-20 degrees, such as 5 degrees, 10 degrees, 15 degrees and the like.
The invention has the following beneficial effects:
1. the fusion device can be changed between the closed state and the open state by means of driving the instrument, and is simple to operate;
2. the screw rod is in threaded connection with the moving block, so that the stress is stable, and the angle self-locking can be realized after the cover plate of the fusion device is spread for a certain angle;
3. the main body is in a ring shape, and can provide maximized bone grafting space after being matched with the upper cover plate and the lower cover plate; the upper cover plate and the lower cover plate can be unfolded, and when the fusion device is implanted, the upper cover plate and the lower cover plate are in a closed state, so that the volume of the fusion device is not increased, the fusion device can be implanted in the existing mode, and the implantation difficulty is not caused; after the fusion device is implanted, the upper cover plate and the lower cover plate are in an open state, so that the atlantoaxial joint kyphosis deformity can be corrected well, and the physiological lordosis is recovered.
In summary, in order to correct the posterior projection deformity of the atlantoaxial joint and recover the physiological lordosis, compared with the traditional fusion device with fixed lordosis, the fusion device has the characteristic of adjustable lordosis angle in operation, the specification of the fusion device is reduced, and the stock cost is reduced; the angle of the front lobe is larger, and the indication is wider; the operation is simple, the front lobe can be flexibly adjusted in the operation, and the angle self-locking can be realized; simple implantation, large bone grafting quantity and good bone fusion effect. The invention is suitable for being used as a posterior atlantoaxial joint fusion device in posterior cervical reduction internal fixation fusion operation.
For the convenience of adjusting the front lobe, it is preferable that the upper screw 5 is inclined in a forward upper direction and the lower screw 6 is inclined in a forward lower direction as shown in fig. 2 (b) and (d).
In the present invention, when the screw drives the moving block to move, in order to achieve axial stop of the screw and circumferential rotation of the screw, thereby achieving in-situ rotation of the screw without dislocation, various means which can be easily conceived by those skilled in the art, such as a blocking arm extending in the main body to block the screw in the axial direction without blocking the moving block, may be adopted, however, the following structural forms are preferably adopted in combination:
as shown in fig. 1, 3-4, the front side wall of the main body 1 is provided with an upper mounting hole 11 and a lower mounting hole 12;
the front end of the upper screw rod 5 is positioned in the upper mounting hole 11, the front end of the upper screw rod 5 is a polished rod and is provided with an annular groove 51, an upper fixing pin 13 is arranged in the upper mounting hole 11, and the front end of the upper fixing pin 13 is inserted into the annular groove 51 of the upper screw rod 5;
the front end of the lower screw rod 6 is positioned in the lower mounting hole 12, the front end of the lower screw rod 6 is a polished rod and is provided with an annular groove 61, a lower fixing pin 14 is arranged in the lower mounting hole 12, and the front end of the lower fixing pin 14 is inserted into the annular groove 61 of the lower screw rod 6.
Therefore, the screw can be conveniently rotated in situ in the mounting hole without dislocation through the mode that the fixing pin is matched with the annular groove at the head part of the screw.
For better stabilizing the screws, the tail ends of the upper screw 5 and the lower screw 6 are polished rods, and an upper jack 15 and a lower jack 16 for respectively accommodating the polished rods at the tail ends of the upper screw 5 and the lower screw 6 are arranged on the rear side wall of the main body 1.
In the present invention, preferably, the upper moving block 7 and the lower moving block 8 are rectangular plates, and the widths of the upper moving block 7 and the lower moving block 8 are consistent with or slightly smaller than the inner width of the main body 1; the middle parts of the upper moving block 7 and the lower moving block 8 are respectively provided with screw holes 71 and 81, the upper moving block 7 and the lower moving block 8 are connected with the upper screw 5 and the lower screw 6 through the screw holes 71 and 81 in a threaded manner, and the moving block can move back and forth on the screw more stably in the structural mode. And, the upper both sides of the upper movable block 7 can be provided with a pair of upper support columns 72 for supporting the upper cover plate 2, and the lower both sides of the lower movable block 8 can be provided with a pair of lower support columns 82 for supporting the lower cover plate 3, so that the contact area with the cover plate can be reduced by adopting the support columns, and the contact friction resistance in the process of supporting the cover plate is reduced. The end surfaces of the upper support columns 72 and the lower support columns 82 are preferably beveled (as shown in fig. 5 (b)) to better support the upper and lower cover plates.
In the invention, the rear part of the main body 1 can be provided with a driving mechanism for driving the upper screw 5 and the lower screw 6 to rotate, and the driving mechanism can be an instrument operation hole arranged on the tail end surfaces of the upper screw and the lower screw, so that the upper cover plate and the lower cover plate are respectively unfolded by respectively driving the upper screw and the lower screw; however, in order to improve the convenience of driving, the following structural form is preferably adopted:
the middle part of the rear side wall of the main body 1 (between the upper jack 15 and the lower jack 16) is provided with a middle mounting hole 17, and the driving mechanism is a driving gear 9 which is arranged in the middle mounting hole 17 and can rotate in situ (axially stop and circumferentially rotate) and is used for simultaneously driving the upper screw 5 and the lower screw 6 to rotate, so that the upper screw and the lower screw can be simultaneously driven to rotate through the driving gear, and the operation is more convenient.
Specifically, as shown in fig. 1 and 6, the driving gear 9 may include a rotating shaft 91 and a conical gear 92 (conical gear) fixed at the front of the rotating shaft 91, wherein the rear of the rotating shaft 91 is disposed in the middle mounting hole 17, the rear of the rotating shaft 91 is provided with an annular groove 911, the middle mounting hole 17 is provided with a transverse fixing pin 18, and the front end of the transverse fixing pin 18 is inserted into the annular groove 911 of the rotating shaft 91 to realize the in-situ rotation of the rotating shaft 91 in the middle mounting hole 17 without dislocation;
the tail ends of the upper screw 5 and the lower screw 6 are respectively provided with tooth surfaces 52 and 62 meshed with a frustum-shaped gear 92 of the driving gear 9;
the outer end surface of the tail portion of the rotary shaft 91 is provided with an instrument operation hole 912, which may be, for example, a hexagonal hole.
In addition, the upper cover plate 2 may be provided at the center thereof with an upper through hole 21, and the lower cover plate 3 may be provided at the center thereof with a lower through hole 31 to enhance bone grafting fusion.
While the foregoing is directed to the preferred embodiments of the present invention, it will be appreciated by those skilled in the art that various modifications and adaptations can be made without departing from the principles of the present invention, and such modifications and adaptations are intended to be comprehended within the scope of the present invention.

Claims (8)

1. The posterior atlantoaxial joint fusion device comprises a vertical hollow main body, and is characterized in that a cover plate is arranged above and/or below the main body, and the rear end of the cover plate is hinged on the rear side wall of the main body; the screw rod is obliquely arranged in the front-back direction in the main body and can rotate in situ, the screw rod is in threaded connection with a moving block for supporting the cover plate, and the moving block can be driven to move forwards by driving the screw rod to rotate, so that the front end of the cover plate is unfolded;
the cover plate comprises an upper cover plate positioned above the main body and a lower cover plate positioned below the main body, and the rear ends of the upper cover plate and the lower cover plate are hinged on the rear side wall of the main body;
the screw comprises an upper screw and a lower screw, the moving block comprises an upper moving block for supporting the upper cover plate and a lower moving block for supporting the lower cover plate, the upper screw is in threaded connection with the upper moving block, and the lower screw is in threaded connection with the lower moving block;
the upper screw rod and the lower screw rod are driven to rotate, so that the upper moving block and the lower moving block can move forwards, and the front ends of the upper cover plate and the lower cover plate are propped up to the upper side and the lower side of the main body;
the upper screw rod is inclined forward and upward, and the lower screw rod is inclined forward and downward.
2. The posterior atlantoaxial joint fusion apparatus according to claim 1, wherein an upper mounting hole and a lower mounting hole are provided on a front side wall of the main body, a front end of the upper screw is located in the upper mounting hole, and a front end of the lower screw is located in the lower mounting hole.
3. The posterior atlantoaxial joint fusion apparatus according to claim 2, wherein a posterior sidewall of the main body is provided with an upper receptacle and a lower receptacle for receiving the upper screw and the lower screw tail, respectively.
4. The posterior atlantoaxial joint fusion apparatus according to claim 1, wherein the upper moving block and the lower moving block are each rectangular plate-shaped;
screw holes are formed in the middle of the upper moving block and the middle of the lower moving block, and the upper moving block and the lower moving block are connected with the upper screw rod and the lower screw rod through screw threads of the screw holes.
5. The posterior atlantoaxial joint fusion apparatus according to claim 4, wherein a pair of upper support columns are provided on both sides of the upper side of the upper moving block, and a pair of lower support columns are provided on both sides of the lower side of the lower moving block.
6. The posterior atlantoaxial joint fusion apparatus according to claim 5, wherein the end surfaces of the upper support column and the lower support column are beveled.
7. The posterior atlantoaxial fusion apparatus according to any one of claims 1-6, wherein a driving mechanism for driving the upper screw and the lower screw to rotate is provided at a rear portion of the main body, a middle mounting hole is provided in a middle portion of a rear sidewall of the main body, and the driving mechanism is a driving gear which is installed in the middle mounting hole to be rotatable in situ and is used for driving the upper screw and the lower screw to rotate simultaneously.
8. The posterior atlantoaxial joint fusion apparatus according to claim 7, wherein the driving gear comprises a rotation shaft and a frustum-shaped gear fixed at the front part of the rotation shaft, and the rear part of the rotation shaft is positioned in the middle mounting hole;
tooth surfaces meshed with the frustum-shaped gears are arranged at the tail ends of the upper screw rod and the lower screw rod;
the outer end face of the tail part of the rotating shaft is provided with an instrument operation hole.
CN202010970916.5A 2020-09-15 2020-09-15 Atlantoaxial joint fusion device Active CN114176748B (en)

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Application Number Priority Date Filing Date Title
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CN114176748B true CN114176748B (en) 2023-12-08

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2003079649A (en) * 2001-09-12 2003-03-18 Pentax Corp Spacer for fixing atlantoaxial vertebra
CN201108492Y (en) * 2007-11-20 2008-09-03 中国人民解放军第二军医大学 Synarthrosis machine within atlantoaxial
CN107411855A (en) * 2017-08-30 2017-12-01 西安市红会医院 Atlas and axis fusion of intervertebral joints device
CN209301406U (en) * 2017-12-22 2019-08-27 北京大学第三医院 Atlas and axis Lateral mass joint fixes fusing device

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7942903B2 (en) * 2005-04-12 2011-05-17 Moskowitz Ahmnon D Bi-directional fixating transvertebral body screws and posterior cervical and lumbar interarticulating joint calibrated stapling devices for spinal fusion
FR3026294A1 (en) * 2014-09-30 2016-04-01 Yellowsteps INTERSOMATIC CAGE WITH ADJUSTABLE COVER AND METHOD OF MANUFACTURING THE SAME

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2003079649A (en) * 2001-09-12 2003-03-18 Pentax Corp Spacer for fixing atlantoaxial vertebra
CN201108492Y (en) * 2007-11-20 2008-09-03 中国人民解放军第二军医大学 Synarthrosis machine within atlantoaxial
CN107411855A (en) * 2017-08-30 2017-12-01 西安市红会医院 Atlas and axis fusion of intervertebral joints device
CN209301406U (en) * 2017-12-22 2019-08-27 北京大学第三医院 Atlas and axis Lateral mass joint fixes fusing device

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