CN115670756A

CN115670756A - Lumbar posterior zero-notch fusion system and using method thereof

Info

Publication number: CN115670756A
Application number: CN202110853375.2A
Authority: CN
Inventors: 黄振强
Original assignee: Individual
Current assignee: Individual
Priority date: 2021-07-27
Filing date: 2021-07-27
Publication date: 2023-02-03

Abstract

The invention discloses a lumbar posterior zero-notch fusion system and a using method thereof. The fusion cage system comprises a fusion cage and an impactor; the driver comprises a connecting seat which is detachably connected to the fusion device; the front side of the fusion cage is provided with at least two inclined locking holes; the axial height of the connecting seat is more than 1.5 cm; the connecting seat is provided with at least two obliquely penetrating channels, and the outlet end of each channel corresponds to a locking hole; the included angle between the axis of the channel and the axis of the connecting seat is 30-35 degrees. The nerve tissues such as nerve roots, dura mater sac and the like are retracted only once through the invention, the connecting seat is not directly removed after the fusion device is placed between the centrums through the impactor, the locking nail and the screwdriver are completely carried out on the connecting seat and the fusion device in the process of screwing the locking nail, the locking nail and the screwdriver are not contacted with the peripheral nerve tissues to avoid damaging the peripheral nerve tissues of the centrum, only one posterior incision of the vertebral canal is needed, and the operation cost, the operation risk, the operation wound and the operation time can be greatly reduced.

Description

Lumbar posterior zero-notch fusion device system and using method thereof

Technical Field

The invention relates to the technical field of lumbar posterior implantation, in particular to a lumbar posterior zero notch fusion system and a using method thereof.

Background

The spine is composed of a bone structure consisting of a vertebral body, two vertebral pedicles, two vertebral plates, two transverse processes, four articular processes and a spinous process, cervical vertebra, thoracic vertebra, lumbar vertebra, sacral vertebra and caudal vertebra. Lumbar spine disease can result from poor habits or from transient inappropriate behavior. At present, with the frequent morbidity of people's spine diseases, the treatment means to the spine is more and more targeted, and the present lumbar vertebrae fusion operation is the main means of treatment lumbar vertebrae disease at present, and the lumbar vertebrae fusion ware plays more and more important effect as important built-in thing in the lumbar vertebrae intervertebral interface fusion technique. The lumbar fusion cage is generally divided into a cage applied to the anterior approach and a cage applied to the posterior approach. Because the operable space of the anterior lumbar spine is large, the application risk of the anterior fusion cage is smaller than that of the posterior fusion cage, the anterior fusion cage has good effect at present but needs two surgical incisions, and the surgery is complex, the wound is large and the risk is high. Therefore, a posterior fusion cage has been developed in the industry, such as the chinese utility model CN203693843U discloses a lumbar vertebrae posterior intervertebral fixation fusion cage, and such as the chinese utility model CN209316161U discloses a zero-incisure lumbar vertebrae posterior fusion cage.

The operation process of the lumbar vertebra posterior approach fusion cage comprises the following steps: the transverse diameter of the vertebral canal is about 2.5 cm, the dura mater sac is arranged in the vertebral canal, the nerve roots are arranged on two sides, when the fusion cage is placed in, the nerve root and the dura mater sac on one side are firstly retracted towards the opposite side to expose the intervertebral disc, the fusion cage is placed after the protruded intervertebral disc is cut, and the top end of the placed fusion cage (namely the top of the front side of the fusion cage) is about 2-4 mm deeper than the rear edge of the vertebral body.

After the lumbar vertebra posterior fusion cage (at least including but not limited to the posterior fusion cages disclosed by the two utility models) in the prior art is placed into the fusion cage between the vertebral bodies through the impactor, after the impactor is withdrawn, the top end of the fusion cage is covered or partially covered due to the return of the nerve root and the dural sac, so that the top end can hardly be directly observed, and the locking nail can not be screwed into the top end of the fusion cage; the existing posterior fusion device cannot be operated in specific clinical practice, and the reasons are as follows: the nerve root and the dura mater sac are retracted towards the opposite side and can only reach the central line of the vertebral canal, about 1.3 cm, a fusion device with the width of 1 cm is arranged under the width, the nerve root and the dura mater sac need to be retracted secondarily for screwing in the locking nail, the nerve root is damaged by excessive retraction or frequent retraction, and the nerve tissues such as the peripheral nerve root, the dura mater sac and the like are easily damaged by abrasion when the locking nail is screwed in, so that the risk is very high.

Even if the fixing body with the locking hole with the guiding function is adopted in the fusion cage disclosed by the Chinese utility model CN209316161U, in the actual posterior vertebral body clinical operation, because the fixing body is fixedly connected with the fusion cage main body and is arranged in the vertebral body, the top end of the fixing body at least does not exceed the rear edge of the vertebral body after the fusion cage is arranged, the situation that the locking hole cannot be directly viewed as above, namely the locking nail cannot be screwed in still exists; even if nerve tissues such as nerve roots, dura mater sac and the like can be retracted in some cases, the top end of the fusion device is partially exposed to see the locking hole, but the locking hole is only seen, and when a locking nail with a certain length is screwed into the vertebral body through the locking hole in an inclined angle, not only is the thread on the outer peripheral surface of the locking hole high risk of contacting and damaging the nerve tissues such as the nerve roots, the dura mater sac and the like, but also the inclined screwing of the locking nail causes greater operation risk compared with the vertical screwing which needs to retract the nerve tissues such as the nerve roots, the dura mater sac and the like.

Although the existing zero-notch lumbar posterior fusion cage has a complex lumbar posterior structure and a small operable space, the existing zero-notch lumbar posterior fusion cage has low operability in specific application, nerve tissues such as nerve roots and dura mater sac need to be retracted for many times, and the inclined screwing process of the locking nails has a great risk of damaging the nerve tissues such as the nerve roots and the dura mater sac, so that the existing zero-notch lumbar posterior fusion cage is really applied to clinical operation and has great challenge and operation risk.

Disclosure of Invention

In order to solve the technical problems, the invention provides a lumbar posterior zero notch fusion system and a using method thereof.

The technical problem to be solved by the invention is realized by the following technical scheme:

a lumbar posterior zero-incisure fusion device system, which comprises a fusion device and a driver; the impactor comprises a connecting seat which is detachably connected to the fusion device; at least two inclined locking holes are formed in the front side of the fusion cage; the axial height of the connecting seat is more than 1.5 cm; the connecting seat is provided with at least two obliquely penetrating channels, and the outlet end of each channel corresponds to one locking hole; the included angle between the axis of the channel and the axis of the connecting seat is 30-35 degrees.

As a preferred embodiment of the lumbar posterior zero notch fusion system provided by the present invention, the locking hole is coaxially disposed with the channel.

As a preferred embodiment of the lumbar posterior zero-notch fusion cage system provided by the invention, the axial height of the connecting seat is 1.5-2.0 cm.

As a preferred embodiment of the lumbar posterior zero-notch fusion cage system provided by the present invention, the detachable connection between the fusion cage and the connection seat is a screw-type connection structure or a snap-type connection structure.

As a preferred embodiment of the lumbar spine posterior zero-notch fusion cage system provided by the present invention, the threaded connection structure comprises a threaded hole disposed at the top of the front side of the fusion cage and a threaded head disposed on the connection seat, and the threaded head is matched with the threaded hole.

As a preferred embodiment of the lumbar posterior zero-notch fusion cage system provided by the present invention, the inlet end of the channel is disposed at the top of the front side of the connecting seat.

As a preferable embodiment of the zero notch fusion cage system for posterior lumbar spine provided by the present invention, the inlet end of the passage is disposed at the front side of the connecting seat.

As a preferred embodiment of the zero notch lumbar spine fusion cage system provided by the present invention, the fusion cage comprises a fusion cage body and an artificial bone filling hole provided on the fusion cage body.

As a preferred embodiment of the lumbar posterior zero-notch fusion cage system provided by the present invention, a corrugated structure is disposed on an outer surface of the fusion cage body.

As a preferred embodiment of the lumbar posterior zero-notch fusion cage system provided by the present invention, two locking holes are provided at both end portions of the front side of the fusion cage; the two locking holes are inclined in opposite directions.

A use method of a lumbar posterior zero-notch fusion device system comprises the following steps: after the decompression of the lumbar posterior spinal canal and the discectomy are completed, the fusion cage and the connecting seat which are connected with each other are placed between the vertebral bodies from back to front through the spinal canal by the driver main body, the locking nail with the required length is selected to be loaded into the channel, the locking nail is screwed out from the locking hole to enter the vertebral body, so that the locking nail is locked at the front side of the fusion cage and in the vertebral body to complete the locking of the fusion cage and the vertebral body; after all the locking nails are screwed in, the connecting seat is detached from the fusion cage through the impactor body.

The invention has the following beneficial effects:

the axial height of a connecting seat detachably connected with a fusion device is more than 1.5cm, at least two obliquely penetrating channels are arranged in the connecting seat, and the outlet end of each channel corresponds to one locking hole; the included angle between the axis of the channel and the axis of the connecting seat is 30-35 degrees. So design, accomplish lumbar vertebrae way canalis spinalis decompression, discectomy postoperative, to mutual connection's fusion ware and connecting seat, through the canalis spinalis by the backward forward between the centrum, reuse elastic screwdriver inserts required length's locking nail the passageway and from the locking hole back-out get into in the centrum to lock the locking nail in accomplish in the front side of fusion ware and the centrum fusion ware with the locking of centrum, remove at last when moving away the ware together with remove the connecting seat.

The fusion cage system only needs to retract nerve tissues such as nerve roots, dura mater sac and the like once, the fusion cage is placed between the vertebral bodies through the driver without directly removing the connecting seat, the locking nail with proper length is selected according to the actual nailing depth, then the locking nail is inserted into an inclined channel in the connecting seat, enters the locking hole and is screwed into the vertebral body, the axial height of the connecting seat is more than 1.5cm, the included angle between the axis of the channel and the axis of the connecting seat is 30-35 degrees, the inlet end of the inclined channel is completely higher than the nerve tissues such as the nerve roots, the dura mater sac and the like, the inclined channel is used as a conduit, so that the nerve tissues outside the fusion cage and around the connecting seat are protected, the locking nail and the screw are completely carried out on the connecting seat and the fusion cage during screwing in the locking nail process, the contact with the peripheral nerve tissues is avoided, the accident that the nerve tissues around the vertebral body are damaged during screwing in the locking nail screwing in is avoided, and the posterior zero-notch fusion cage system only needs to carry out a posterior approach incision of the vertebral canal, thereby greatly reducing the cost of the operation, the operation and greatly reducing the operation cost and the surgical benefit of the surgery.

The inclined channel arranged in the connecting seat is used for accommodating and limiting the whole or most of locking nails and screwdriver in-out paths so as to avoid the problem that the locking nails sway and deviate from a preset inclination angle when the locking nails start to be screwed in due to the fact that only the head of the existing fusion cage is provided with the guide holes, and the included angle between the axis of the channel and the axis of the connecting seat is 30-35 degrees so that the length of the channel is long enough to accommodate the locking nails with different lengths, so that the locking nails with proper lengths can be selected according to the condition of vertebral bodies to further improve the locking stability of the fusion cage and the vertebral bodies on two sides, and the problem that the length of the locking nails cannot be flexibly adjusted after the existing fusion cage with the locking nails inside is placed between the vertebral bodies is solved.

Drawings

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

FIG. 2 is an exploded view of the present invention cage system;

FIG. 3 isbase:Sub>A cross-sectional view taken at A-A of FIG. 1;

FIG. 4 is a flow chart of a method of using the fuser system of the present invention;

fig. 5 is a schematic diagram of the use of the fusion cage system of the present invention.

Detailed Description

The technical solutions of the present invention are further described in detail below with reference to specific examples and drawings, it should be understood that the following examples are merely illustrative of the present invention and are not intended to limit the present invention.

Referring to fig. 1 to 3, the present invention provides a lumbar posterior zero-incisure fusion cage system, which includes a fusion cage 1 and an impactor for inserting the fusion cage 1 into the vertebral body from the lumbar posterior. Specifically, the impactor comprises an impactor body (not shown in the figure) and a connecting seat 2 connected with the impactor body, wherein the connecting seat 2 is detachably connected to the fusion device 1, and the impactor body is used for placing the connecting seat 2 and the fusion device 1 together into the vertebral bodies and detaching the connecting seat 2 from the fusion device 1 so as to move the connecting seat 2 out of the vertebral bodies. The front side of the fusion cage 1 is provided with at least two inclined locking holes 11, and the locking holes 11 are used for locking nails 3 to pass through so as to be screwed into vertebral bodies and fix the vertebral bodies on the fusion cage 1 in a limiting way. The axial height h of the connecting seat 2 is more than 1.5 cm; the connecting seat 2 is provided with at least two passages 21 which are obliquely penetrated, the outlet end of each passage 21 corresponds to one locking hole 11, and the locking nail 3 can directly enter and penetrate through the locking hole 11 along the passage 21 after being inserted into the passage 21; the included angle a between the axis of the channel 21 and the axis of the connecting seat 2 is 30-35 degrees, so that the length of the channel 21 is ensured to be long enough, and the locking nail 3 is ensured to be screwed into the vertebral body at an effective inclination angle, so that the fusion device 1 is more stably connected with the vertebral body.

In the invention, the locking hole 11 and the channel 21 are coaxially arranged, so that the locking nail 3 can smoothly enter along the channel 21 without deviation and pass through the locking hole 11, and the locking nail 3 can be effectively screwed into a vertebral body at a preset inclination angle. It will also be appreciated that the angle of inclination of the locking hole 11 with respect to the axis of the cage 1 is the same as the angle of inclination of the channel 21 with respect to the axis of the attachment socket 2.

In the invention, the connecting seat 2 has an axial height of 1.5-2.0 cm and a too short height design, is similar to the leading-in hole arranged at the head of the existing posterior fusion device 1, is difficult to effectively expose the locking hole 11 and play a role of protecting posterior nerve tissues, and is too long in height design and not beneficial to operation.

In the invention, the detachable connection between the fusion device 1 and the connecting seat 2 is a threaded connection structure or a snap-in connection structure. Specifically, the threaded connection structure comprises a threaded hole 12 formed in the top of the front side of the fusion cage 1 and a threaded head arranged on the connection seat 2, and the threaded head is matched with the threaded hole 12. In concrete implementation, the driver body can rotate to drive the thread head of the connecting seat 2 to be screwed out of the threaded hole 12, so that the connecting seat 2 can be detached from the fusion cage 1. It should be noted that the impactor body is an existing conventional component, and it is sufficient to insert the connecting socket 2 and the fusion cage 1 between the vertebral bodies and detach the connecting socket 2 from the fusion cage 1. It should be noted that the driver body and the connecting socket 2 may be integrally connected or may be independently connected, where the independent connection means that the driver body and the connecting socket 2 are independent from each other, and when the driver body needs to act on the connecting socket 2, the driver body is connected to the connecting socket 2. Further, the driver body is detachably connected to the connecting socket 2 via a connecting member, so that the driver body drives the connecting socket 2 to move, rotate, and the like via the connecting member.

In some embodiments of the present invention, the inlet end 211 of the channel 21 is disposed at the top of the front side of the connection socket 2, and in other embodiments, the inlet end 211 of the channel 21 is disposed at the side of the front side of the connection socket 2. Because the axial height h of the connecting seat 2 is more than 1.5cm, in addition, the axis of the channel 21 and the included angle a between the axes of the connecting seat 2 are 30-35 degrees, the inlet end 211 of the inclined channel 21 is designed at the top or the side part of the front side of the connecting seat 2 and is completely higher than nerve tissues such as nerve roots, dura sac and the like, the inclined channel 21 is equivalent to a conduit effect, so that the nerve tissues outside the fusion device 1 and around the connecting seat 2 are protected, in the process of screwing the locking nail 3, the locking nail 3 and the screwdriver are completely carried out on the connecting seat 2 and the fusion device 1 and do not contact with the surrounding nerve tissues, and the accident that the nerve tissues around the vertebral body are damaged in the process of screwing the locking nail 3 is avoided or even stopped.

In the present invention, the fusion cage 1 includes a cage body 13 and an artificial bone filling hole 14 provided through the cage body 13. Specifically, the artificial bone filling hole 14 can be filled with artificial bone materials, and the artificial bone can be integrated with the lumbar vertebra, so that the postoperative recovery is accelerated. Specifically, in the present embodiment, the artificial bone filling hole 14 is provided in the direction of the vertebral body of the fusion device 1 and penetrates both sides thereof, thus facilitating the artificial bone material to directly contact both vertebral bodies.

In the present invention, the fusion cage body 13 is provided with a corrugated structure 15 on an outer surface thereof. The corrugations 15 protrude from the outer surface of the cage 1 and prevent the cage 1 from sliding relative to the vertebrae during use. It will be appreciated that the bellows 15 may be provided in other similar friction-increasing configurations.

In the present invention, two locking holes 11 are provided at both end portions of the front side of the fusion cage 1; the two locking holes 11 are inclined in opposite directions. It will be appreciated that more than two locking holes 11 may be provided as required to enhance the stability of the locking connection of the cage 1 to the vertebral bodies.

As shown in fig. 4 and 5, the process of the invention is as follows:

after the decompression of the lumbar posterior vertebral canal and the discectomy are completed, the fusion cage 1 and the connecting seat 2, which are connected with each other, are placed between the vertebral bodies through the vertebral canal from the back to the front (as shown in fig. 5- (a)), the locking nail 3 of a desired length is selected to be loaded into the channel 21 (as shown in fig. 5- (b)), then the locking nail 3 is unscrewed from the locking hole 11 into the vertebral body by using an elastic screwdriver, so that the locking nail 3 is locked at the front side of the fusion cage 1 and in the vertebral body, the locking of the fusion cage 1 and the vertebral body is completed, after all the locking nails 3 are screwed (as shown in fig. 5- (c)), the connecting seat 2 is detached from the fusion cage 1 by the driver body, and finally the connecting seat 2 is removed together with the driver when the driver is removed (as shown in fig. 5- (d)).

Through the fusion cage system, nerve tissues such as nerve roots, dura mater sac and the like are only required to be retracted once, the fusion cage 1 is placed between vertebral bodies through a driver without directly removing the connecting seat 2, the locking nail 3 with proper length is selected according to the actual nailing depth, then the locking nail is inserted into an inclined channel 21 in the connecting seat 2, enters the locking hole 11 and is screwed into the vertebral body, the axial height of the connecting seat 2 is more than 1.5cm, the included angle a between the axis of the channel 21 and the axis of the connecting seat 2 is 30-35 degrees, the inlet end 211 of the inclined channel 21 is completely higher than the nerve tissues such as the nerve roots, the dura mater sac and the like, the inclined channel 21 acts as a catheter, so that the nerve tissues outside the fusion cage 1 and around the connecting seat 2 are protected, in the process of screwing the locking nail 3, the locking nail 3 and a screw driver are completely carried out on the connecting seat 2 and the fusion cage 1 without contacting with the surrounding nerve tissues, accidents of damaging the nerve tissues around the nerve tissues in the process of screwing the fusion cage 3 are avoided, and the risk of injury of the vertebral body and the operation of the operation can be greatly reduced without the cost and the operation cost of other lumbar vertebra tube incision caused by the operation.

The inclined channel 21 arranged in the connecting seat 2 is used for accommodating and limiting the whole or most of the locking nails 3 and the screw inlet and outlet paths so as to avoid the problem that the locking nails 3 shake and deviate from a preset inclination angle when the locking nails 3 start to be screwed in due to the fact that only the head of the existing fusion cage 1 is provided with the guide hole, and the included angle a between the axis of the channel 21 and the axis of the connecting seat 2 is 30-35 degrees, so that the length of the channel 21 is long enough to accommodate the locking nails 3 with different lengths, the locking stability of the fusion cage 1 and vertebral bodies on two sides is further improved by selecting the locking nails 3 with proper length according to the condition of the vertebral bodies, and the problem that the length of the locking nails 3 cannot be flexibly adjusted after the fusion cage 1 with the locking nails 3 inside is arranged between the vertebral bodies is solved.

The above embodiments only express the embodiments of the present invention, and the description is specific and detailed, but it should not be understood as the limitation of the patent scope of the present invention, but all the technical solutions obtained by using the equivalent substitution or the equivalent transformation should fall within the protection scope of the present invention.

Claims

1. A lumbar posterior zero-incisura fusion system comprises a fusion device and a driver; the driver comprises a connecting seat which is detachably connected to the fusion device; at least two inclined locking holes are formed in the front side of the fusion cage; the connecting seat is characterized in that the axial height of the connecting seat is more than 1.5 cm; the connecting seat is provided with at least two obliquely penetrating channels, and the outlet end of each channel corresponds to one locking hole; the included angle between the axis of the channel and the axis of the connecting seat is 30-35 degrees.

2. The posterior lumbar spine zero notch fusion system according to claim 1, wherein the locking hole is disposed coaxially with the channel.

3. The lumbar posterior zero-notch fusion cage system according to claim 1, wherein the axial height of the connecting seat is 1.5-2.0 cm.

4. The lumbar posterior zero notch fusion cage system according to claim 1, wherein the detachable connection between the fusion cage and the connecting seat is a threaded connection structure or a snap-fit connection structure.

5. The posterior lumbar zero-notch fusion system according to claim 4, wherein said threaded connection structure comprises a threaded hole provided at the top of the front side of said fusion device and a threaded head provided on said connection seat, said threaded head being fitted with said threaded hole.

6. The posterior lumbar spine zero notch fusion system according to claim 1, wherein the inlet end of the channel is disposed at the top of the front side of the connecting seat.

7. The posterior lumbar spine zero notch fusion system according to claim 1, wherein the inlet end of the passage is disposed at a front side of the connection seat.

8. The posterior lumbar zero notch fusion system of claim 1, wherein said fusion cage comprises a cage body and an artificial bone filling hole disposed therethrough.

9. The posterior lumbar spine zero-notch fusion system according to claim 1, wherein two locking holes are provided at both ends of the front side of the fusion device; the two locking holes are inclined in opposite directions.

10. A method of using the posterior lumbar spine zero notch fusion system according to any one of claims 1-9, comprising the steps of: after lumbar posterior spinal canal decompression and discectomy are completed, the mutually connected fusion device and the connecting seat are placed into the vertebral bodies through the driver body from back to front through the spinal canal, the locking nail with the required length is selected to be loaded into the channel, the locking nail is screwed out of the locking hole to enter the vertebral body, so that the locking nail is locked at the front side of the fusion device and in the vertebral body, and the fusion device and the vertebral body are locked; after all the locking nails are screwed in, the connecting seat is detached from the fusion cage through the driver body.