CN114569230A - Lower cervical vertebra pedicle positioning guide plate and manufacturing method thereof - Google Patents
Lower cervical vertebra pedicle positioning guide plate and manufacturing method thereof Download PDFInfo
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- CN114569230A CN114569230A CN202210206046.3A CN202210206046A CN114569230A CN 114569230 A CN114569230 A CN 114569230A CN 202210206046 A CN202210206046 A CN 202210206046A CN 114569230 A CN114569230 A CN 114569230A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00526—Methods of manufacturing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/107—Visualisation of planned trajectories or target regions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02P—CLIMATE CHANGE MITIGATION TECHNOLOGIES IN THE PRODUCTION OR PROCESSING OF GOODS
- Y02P10/00—Technologies related to metal processing
- Y02P10/25—Process efficiency
Abstract
The invention belongs to the technical field of medical instruments, and relates to a lower cervical pedicle positioning guide plate and a manufacturing method thereof. The location baffle includes the baffle body, locates the bone nail guiding hole on the baffle body, the baffle body is bow-shaped, and the both ends of baffle body all are equipped with the binding face that is used for with the laminating of cervical vertebra lateral mass surface, and the middle part of baffle body is equipped with the locating surface that is used for with the laminating of cervical vertebra spinous process surface. By adopting the lower cervical pedicle positioning guide plate, the screw is directly implanted through the guide hole, so that the screw can be placed along the pre-designed non-anatomical shaft.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and relates to a lower cervical vertebral pedicle positioning guide plate and a manufacturing method thereof.
Background
Pedicle screw technology (CPS) has been proven to be superior to other posterior cervical spine instruments in mechanical strength, and due to the fact that the diameter of the lower cervical spine pedicle is small, the cohesive angle (PTA) on the cross section is far larger than that of the thoracolumbar spine, and in addition, due to the interference of soft tissues such as rich muscles at the back of the neck and the like on the screw implantation process, the lower cervical spine pedicle screw implantation has great difficulty and is easier to enter the vertebral artery hole by mistake.
Disclosure of Invention
In view of this, the invention aims to solve the problem of accuracy of the existing pedicle screw implantation in the lower cervical vertebra, and provides a pedicle positioning guide plate for the lower cervical vertebra and a manufacturing method thereof.
In order to achieve the purpose, the invention provides the following technical scheme:
a lower cervical vertebra pedicle positioning guide plate comprises a guide plate body and bone screw guide holes arranged on the guide plate body, wherein the guide plate body is arched, two ends of the guide plate body are respectively provided with a binding surface for being bound with the surface of a cervical vertebra lateral mass, and the middle part of the guide plate body is provided with a positioning surface for being bound with the surface of a cervical vertebra spinous process; the bone nail guide hole is arranged on the binding surface and used for guiding the drilling of the cervical vertebral pedicle.
Furthermore, the axis of the guide hole is a nail feeding axis, and the nail feeding axis respectively forms an included angle of 90 degrees with a connecting line between a nail feeding point on the cervical vertebra and the root of the spinous process of the cervical vertebra and a common tangent line between the rear surface of the lateral block of the cervical vertebra and the rear surface of the lateral block of the lower cervical vertebra.
Further, the guide plate body and the guide hole are of an integrated structure and are integrally formed in an additive manufacturing mode; the guide plate body and the guide hole are both made of 3D printing materials.
Further, still include the handle, be equipped with 1 screw hole on the baffle body at least, the handle passes through the screw hole and is connected with the baffle body is detachable.
Further, the handle is made of stainless steel materials.
A method for manufacturing a lower cervical vertebra pedicle positioning guide plate is used for manufacturing the lower cervical vertebra pedicle positioning guide plate and comprises the following steps:
s1, acquiring a cervical vertebra three-dimensional digital model; scanning cervical vertebra through CT to obtain three-dimensional scanning data of the cross section, the coronal plane and the sagittal plane of the cervical vertebra, and carrying out image reconstruction on the scanning data to obtain a medical image of the cervical vertebra; acquiring a three-dimensional digital model of the cervical vertebra based on medical image data of the cervical vertebra;
s2, modeling the pedicle positioning guide plate of the inferior cervical vertebra, comprising the following steps:
s21, carrying out regional division on the surface of the three-dimensional digital model of the cervical vertebra according to curvature distribution, calibrating the cervical vertebra to be drilled, identifying side block regions on the left side and the right side in the cervical vertebra, using the side block regions as fitting surfaces of two fitting surfaces, identifying the back surface of the spinous process, and using the back surface as a fitting surface of a positioning surface;
s22, dividing the identified lateral mass area into an upper half part and a lower half part along the vertical direction, drawing a bisector of the upper half part, and taking the middle point of the bisector as a nail feeding point;
s23, making a common tangent plane of the back surface of the lateral mass of the cervical vertebra to be drilled and the back surface of the lateral mass of the lower cervical vertebra, and making a vertical plane of the common tangent plane along the direction vertical to the sagittal plane through the nail feeding point as a first orthogonal plane; meanwhile, a connecting line between the nail feeding point and the root of the cervical vertebra spinous process to be drilled is made, and a vertical plane of the connecting line is made through the nail feeding point and is used as a second orthogonal plane; the intersection line of the first orthogonal surface and the second orthogonal surface is the axis of the bone nail guide hole;
s24, constructing and generating a model of the lower cervical vertebra pedicle positioning guide plate according to the obtained fitting surface, the screw feeding point and the screw feeding axis;
s3, manufacturing the lower cervical pedicle positioning guide plate through additive manufacturing equipment according to the three-dimensional model of the lower cervical pedicle positioning guide plate.
Further, in step S2, the fitting surfaces of the attaching surface and the positioning surface each include at least two curved surfaces with different curvatures.
Further, in step S4, the screw feeding direction is verified by calculating the distance between the axis of the bone screw guide hole and the pedicle of the lower cervical vertebra.
The invention has the beneficial effects that:
1. according to the invention, the original patient image is obtained through CT, the three-dimensional digital model is established to determine the nail feeding axis, the spatial relationship between the back surface of the cervical vertebra lateral mass and the spinous process is taken as the basis for quick positioning, the nail path is verified in the three-dimensional model, the accuracy of the nail feeding axis is improved, and the operation risk is reduced.
2. The lower cervical vertebra pedicle positioning guide plate is positioned and fixed by utilizing the surface of the cervical vertebra lateral mass and the surface of the spinous process, and screws are directly implanted through the guide holes without polishing off the outer half part of the lateral mass, so that the outer half part of the lateral mass is complete even if the pedicle screw fails to be prepared.
3. Compared with the included angle PTA of the projection of the centrum centerline and the vertebral pedicle axis adopted in the traditional mode, the included angle nPTA of the screw feeding axis and the centrum centerline determined in the invention has the advantages that the cohesive degree of the nPTA is far smaller than that of the PTA, the difference of the nPTA between different centrums is smaller, and the higher consistency is realized by mutual reference during screw placement. Therefore, the existing mode of adopting the dissecting shaft as the basis for nail placement is broken through, and a non-dissecting shaft nail placement mode with better effect and higher reference is formed.
Additional advantages, objects, and features of the invention will be set forth in part in the description which follows and in part will become apparent to those having ordinary skill in the art upon examination of the following or may be learned from practice of the invention. The objectives and other advantages of the invention may be realized and attained by the means of the instrumentalities and combinations particularly pointed out hereinafter.
Drawings
For a better understanding of the objects, aspects and advantages of the present invention, reference will now be made to the following detailed description taken in conjunction with the accompanying drawings in which:
FIG. 1 is a schematic view of the lower cervical pedicle positioning guide plate according to the present invention;
FIG. 2 is a schematic view of a lateral mass of the cervical spine;
FIG. 3 is a first orthogonal plane view;
FIG. 4 is a second orthogonal plane view;
fig. 5 is a schematic view of the nail feeding axis.
Reference numerals are as follows: 1-a guide plate body; 2-guiding holes for bone nails; 3-a handle; 11-a binding face; 12-a positioning surface; 13-a threaded hole; 4-a first orthogonal face; 5-a second orthogonal face; 6-centrum midline; 7-cervical vertebrae to be drilled; 8-lower cervical vertebra.
Detailed Description
The embodiments of the present invention are described below with reference to specific embodiments, and other advantages and effects of the present invention will be easily understood by those skilled in the art from the disclosure of the present specification. The invention is capable of other and different embodiments and of being practiced or of being carried out in various ways, and its several details are capable of modification in various respects, all without departing from the spirit and scope of the present invention. It should be noted that the drawings provided in the following embodiments are only for illustrating the basic idea of the present invention in a schematic way, and the features in the following embodiments and examples may be combined with each other without conflict.
Wherein the showings are for the purpose of illustrating the invention only and not for the purpose of limiting the same, and in which there is shown by way of illustration only and not in the drawings in which there is no intention to limit the invention thereto; to better illustrate the embodiments of the present invention, some parts of the drawings may be omitted, enlarged or reduced, and do not represent the size of an actual product; it will be understood by those skilled in the art that certain well-known structures in the drawings and descriptions thereof may be omitted.
The same or similar reference numerals in the drawings of the embodiments of the present invention correspond to the same or similar components; in the description of the present invention, it should be understood that if there is an orientation or positional relationship indicated by terms such as "upper", "lower", "left", "right", "front", "rear", etc., based on the orientation or positional relationship shown in the drawings, it is only for convenience of description and simplification of description, but it is not an indication or suggestion that the referred device or element must have a specific orientation, be constructed in a specific orientation, and be operated, and therefore, the terms describing the positional relationship in the drawings are only used for illustrative purposes, and are not to be construed as limiting the present invention, and the specific meaning of the terms may be understood by those skilled in the art according to specific situations.
Please refer to fig. 1, which is a lower cervical pedicle positioning guide plate, comprising a guide plate body 1 and a bone screw guiding hole 2 arranged on the guide plate body 1, wherein the guide plate body 1 is arc-shaped, both ends of the guide plate body 1 are provided with attaching surfaces 11 for attaching to the surfaces of cervical vertebra lateral masses, and the middle part of the guide plate body 1 is provided with a positioning surface 12 for attaching to the surface of cervical vertebra spinous processes; the bone nail guiding hole 2 is arranged on the binding surface 11 and used for guiding the drilling of the cervical pedicle of vertebral arch. Wherein the axis of the guide hole is a nail feeding axis, and the nail feeding axis respectively forms an included angle of 90 degrees with the connecting line of the nail feeding point on the cervical vertebra and the root of the spinous process of the cervical vertebra and the common tangent line of the rear surface of the cervical vertebra side block and the rear surface of the side block of the lower cervical vertebra 8. Still be provided with screw hole 13 on the baffle body 1, handle 3 passes through screw hole 13 and is connected with the baffle body 1 is detachable, and handle 3 adopts stainless steel material to make, can use repeatedly after the disinfection.
Referring to fig. 2 to 5, the method for manufacturing the lower cervical pedicle positioning guide plate of the present invention includes the following steps:
s1, acquiring a cervical vertebra three-dimensional digital model; scanning cervical vertebra by CT with the patient in a neutral position to obtain three-dimensional scanning data of the cross section, the coronal plane and the sagittal plane of the cervical vertebra, and carrying out image reconstruction on the scanning data to obtain a medical image of the cervical vertebra; obtaining a three-dimensional digital model of the cervical vertebra based on the medical image data of the cervical vertebra;
s2, modeling the lower cervical pedicle positioning guide plate, comprising the following steps:
s21, performing area division on the surface of the three-dimensional digital model of the cervical vertebra according to curvature distribution, calibrating the cervical vertebra 7 to be drilled, identifying the lateral mass areas on the left side and the right side in the cervical vertebra, using the lateral mass areas as fitting surfaces of two binding surfaces 11, identifying the back surface of the spinous process, and using the back surface as a fitting surface of a positioning surface 12; the fitting surfaces of the fitting surface 11 and the positioning surface 12 each include at least two curved surfaces with different curvatures.
S22, dividing the identified lateral mass area into an upper half part and a lower half part along the vertical direction, drawing a bisector of the upper half part, and taking the middle point of the bisector as a nail feeding point EP;
s23, making a common tangent plane of the posterior surface of the lateral mass of the cervical vertebra 7 to be drilled and the posterior surface of the lateral mass of the lower cervical vertebra 8, and making a vertical plane of the common tangent plane along a direction perpendicular to a sagittal plane through the nail feeding point EP to be used as a first orthogonal plane 4; meanwhile, a connecting line of the nail feeding point and the root of the spinous process of the cervical vertebra 7 to be drilled is made, and a vertical plane of the connecting line is made through the nail feeding point EP and is used as a second orthogonal plane 5; the intersection line of the first orthogonal surface 4 and the second orthogonal surface 5 is the axis of the bone nail guide hole 2; meanwhile, the screw feeding direction is verified through the distance between the axis of the bone screw guide hole 2 obtained through calculation and the vertebral pedicle of the cervical vertebra.
S24, constructing and generating a model of the lower cervical vertebra pedicle positioning guide plate according to the obtained fitting surface, the nail feeding point EP and the nail feeding axis;
s3, manufacturing the lower cervical pedicle positioning guide plate through additive manufacturing equipment according to the three-dimensional model of the lower cervical pedicle positioning guide plate.
By CT scanning, comparing the included angle nPTA between the axis of the screw and the centrum midline 6 in the invention with the projected included angle PTA between the centrum midline 6 and the axis of the vertebral pedicle, please refer to the following table, it can be known that the cohesive degree of nPTA is far less than PTA, the difference of nPTA between different centrums is smaller, and the mutual reference has higher consistency when the screw is placed.
Finally, the above embodiments are only intended to illustrate the technical solutions of the present invention and not to limit the present invention, and although the present invention has been described in detail with reference to the preferred embodiments, it will be understood by those skilled in the art that modifications or equivalent substitutions may be made on the technical solutions of the present invention without departing from the spirit and scope of the technical solutions, and all of them should be covered by the claims of the present invention.
Claims (8)
1. The utility model provides a lower cervical vertebra pedicle of vertebral arch location baffle, includes the baffle body, locates the bone nail guiding hole on the baffle body, its characterized in that: the guide plate body is in an arc shape, two ends of the guide plate body are respectively provided with a binding surface for binding with the surface of the cervical vertebra side block, and the middle part of the guide plate body is provided with a positioning surface for binding with the surface of the cervical vertebra spinous process; the bone nail guide hole is arranged on the binding surface and used for guiding the drilling of the cervical vertebral pedicle.
2. The lower cervical pedicle positioning guide as claimed in claim 1, wherein: the axis of the guide hole is a nail feeding axis, and the nail feeding axis respectively forms an included angle of 90 degrees with a connecting line between a nail feeding point on the cervical vertebra and the root of the spinous process of the cervical vertebra and a common tangent line between the rear surface of the cervical vertebra side block and the rear surface of the side block of the lower cervical vertebra.
3. The lower cervical pedicle positioning guide as claimed in claim 1, wherein: the guide plate body and the guide hole are of an integrated structure and are integrally formed in an additive manufacturing mode; the guide plate body and the guide hole are both made of 3D printing materials.
4. The lower cervical pedicle positioning guide as claimed in claim 1, wherein: still include the handle, be equipped with 1 screw hole on the baffle body at least, the handle passes through the screw hole and is connected with the baffle body is detachable.
5. The lower cervical pedicle positioning guide plate according to claim 4, wherein: the handle is made of stainless steel materials.
6. A manufacturing method of a lower cervical vertebra pedicle positioning guide plate is characterized in that: the positioning guide plate for the pedicle of vertebral arch of lower cervical vertebra according to any one of claims 1 to 5, comprising the following steps:
s1, acquiring a cervical vertebra three-dimensional digital model; scanning cervical vertebrae through CT to obtain three-dimensional scanning data of cross sections, coronal planes and sagittal planes of the cervical vertebrae, and performing image reconstruction on the scanning data to obtain medical images of the cervical vertebrae; obtaining a three-dimensional digital model of the cervical vertebra based on the medical image data of the cervical vertebra;
s2, modeling the lower cervical pedicle positioning guide plate, comprising the following steps:
s21, performing area division on the surface of the three-dimensional digital model of the cervical vertebra according to curvature distribution, calibrating the cervical vertebra to be drilled, identifying the lateral mass areas on the left side and the right side in the cervical vertebra, using the lateral mass areas as fitting surfaces of two binding surfaces, identifying the back surface of the spinous process, and using the back surface as a fitting surface of a positioning surface;
s22, dividing the identified lateral mass area into an upper half part and a lower half part along the vertical direction, drawing a bisector of the upper half part, and taking the middle point of the bisector as a nail feeding point;
s23, making a common tangent plane of the back surface of the lateral mass of the cervical vertebra to be drilled and the back surface of the lateral mass of the lower cervical vertebra, and making a vertical plane of the common tangent plane along the direction vertical to the sagittal plane through the nail feeding point as a first orthogonal plane; meanwhile, a connecting line between the nail feeding point and the root of the cervical spinous process to be drilled is made, and a vertical plane of the connecting line is made to pass through the nail feeding point and is used as a second orthogonal plane; the intersection line of the first orthogonal surface and the second orthogonal surface is a nail feeding axis;
s24, constructing and generating a model of the lower cervical vertebra pedicle positioning guide plate according to the obtained fitting surface, the screw feeding point and the screw feeding axis;
s3, manufacturing the lower cervical pedicle positioning guide plate through additive manufacturing equipment according to the three-dimensional model of the lower cervical pedicle positioning guide plate.
7. The method for manufacturing the lower cervical pedicle positioning guide plate according to claim 6, wherein the method comprises the following steps: in step S2, the fitting surfaces of the attachment surface and the positioning surface each include at least two curved surfaces with different curvatures.
8. The method for manufacturing the pedicle positioning guide for lower cervical vertebrae according to claim 6, wherein: and step S4, checking the screw feeding direction through the distance between the axis of the bone screw guide hole obtained by calculation and the cervical vertebral pedicle to be drilled.
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| Application Number | Priority Date | Filing Date | Title |
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| CN202210206046.3A CN114569230B (en) | 2022-02-28 | 2022-02-28 | Lower cervical pedicle positioning guide plate and manufacturing method thereof |
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| CN202210206046.3A CN114569230B (en) | 2022-02-28 | 2022-02-28 | Lower cervical pedicle positioning guide plate and manufacturing method thereof |
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| CN114569230B CN114569230B (en) | 2023-07-07 |
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| Publication number | Publication date |
|---|---|
| CN114569230B (en) | 2023-07-07 |
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