CN204049816U - Anterior approach slope fixture - Google Patents
Anterior approach slope fixture Download PDFInfo
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- CN204049816U CN204049816U CN201420441488.7U CN201420441488U CN204049816U CN 204049816 U CN204049816 U CN 204049816U CN 201420441488 U CN201420441488 U CN 201420441488U CN 204049816 U CN204049816 U CN 204049816U
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- fixed part
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- vertebral body
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Abstract
This utility model relates to a kind of Orthopedic Clinical apparatus, particularly relates to a kind of anterior approach slope fixture.Anterior approach slope described in the utility model fixture comprises: mainboard, and the mainboard slope fixed part tilted by a section and the mainboard vertebral body fixed part of one section of level form; And wing plate, extend to form from the both sides of described mainboard vertebral body fixed part; Wherein, described mainboard slope fixed part and described mainboard vertebral body fixed part shape have a certain degree to cause described mainboard slope fixed part to be applicable to being adjacent to human body anterior approach slope and described mainboard vertebral body fixed part is applicable to being adjacent to human body neck 3 vertebral body.This utility model proposes first and is a kind ofly exclusively used in the fixture fixing to neck 3 vertebral body through anterior approach slope, has good three-dimensional stability, the stability of upper cervical spine in coordinating posterior occipitocervical to fix can better to rebuild, the advantageously rehabilitation of patient Yu.
Description
Technical field
This utility model relates to a kind of Orthopedic Clinical apparatus, particularly relates to a kind of anterior approach slope fixture.
Background technology
For row Reconstruction after the large portion excision of neck 1,2 vertebral tumor, performed the operation in the past and all adopt the direct screw of anterior approach abnormity titanium cage to fix (Suchomel P, Buchvald P, Barsa P, et al.Single-stage total C-2intralesionalspondylectomy for chordoma with three-column reconstruction.J Neurosurgery Spine 2007; 6:611 – 618.8.), or use bones of limbs fixture to be fixed (Rawlins JM, Batchelor AG, Liddington MI, et al.Tumor excision and reconstruction of the upper cervical spine:a multidisciplinary approach.PlastReconstrSurg 2004; 114:1534 – 8.; Goel A, Karapurkar AP.Transoral plate and screw fixation of the craniovertebral region--a preliminary report.Br J Neurosurg 1994; 8:743 – 745.; And Robin deAndradeJ; MacnabI.Anterioroccipitocervical fusion in rheumatoid arthritis:report of a case.Arthritis and Rheumatism, 1969 (12): 423-426).But these methods do not provide enough stablizes lasting fixed effect.Therefore, be necessary to develop the anterior approach fixture with more high stability.And, still do not have at present special through anterior approach slope to the fixture that neck 3 vertebral body is fixing.
Summary of the invention
The purpose of this utility model is to provide a kind of anterior approach slope fixture, it be a kind of propose first be exclusively used in the fixture fixing to neck 3 vertebral body through anterior approach slope, the fixed effect more more reliable and more stable than other anterior approach fixtures existing can be reached.
Anterior approach slope described in the utility model fixture comprises: mainboard, and the mainboard slope fixed part tilted by a section and the mainboard vertebral body fixed part of one section of level form; And wing plate, extend to form from the both sides of described mainboard vertebral body fixed part; Wherein, described mainboard slope fixed part and described mainboard vertebral body fixed part shape have a certain degree to cause described mainboard slope fixed part to be applicable to being adjacent to human body anterior approach slope and described mainboard vertebral body fixed part is applicable to being adjacent to human body neck 3 vertebral body.
According to the further feature of anterior approach slope described in the utility model fixture, the angle between described mainboard slope fixed part and described mainboard vertebral body fixed part is 114 ° to 148 °.This numerical value is measured according to the clinical anatomy that utility model people carries out and is determined.
According to the further feature of anterior approach slope described in the utility model fixture, described mainboard slope fixed part evenly arranges three screws, triangularity arranges, and makes screw, by described screw, described mainboard slope fixed part is fixed on anterior approach slope with activation.
According to the further feature of anterior approach slope described in the utility model fixture, the central authorities of described mainboard vertebral body fixed part are arranged to right locking screw, with activation, described mainboard vertebral body fixed part are fixed on titanium cage by screw by described locking screw.
According to the further feature of anterior approach slope described in the utility model fixture, the lower end of described mainboard vertebral body fixed part is arranged to screw, makes screw, by described paired screw, neck 3 vertebral body is fixed in the lower end of described mainboard vertebral body fixed part with activation.
According to the further feature of anterior approach slope described in the utility model fixture, every side of described wing plate arranges a side screw respectively, makes screw, by described side screw, described wing plate is fixed on the left and right lateral mass of atlas with activation.
Anterior approach slope described in the utility model fixture, be special through anterior approach slope to the fixture that neck 3 vertebral body is fixing, what used fixes through the direct screw of titanium cage more in the past, or use bones of limbs fixture to be fixed, device of the present utility model has good three-dimensional stability, the stability of upper cervical spine in coordinating posterior occipitocervical to fix can better to rebuild, the advantageously rehabilitation of patient Yu.
Accompanying drawing explanation
Fig. 1 is the front view of anterior approach slope described in the utility model fixture.
Fig. 2 is the side view of anterior approach slope described in the utility model fixture.
Fig. 3 is the front schematic view after anterior approach slope described in the utility model fixture is installed.
Fig. 4 is the side schematic view after anterior approach slope described in the utility model fixture is installed.
Reference numeral:
1,2,3: the screw of mainboard slope fixed part; 4,5: the locking screw in the middle of mainboard vertebral body fixed part; 6,7: the screw of mainboard vertebral body fixed part lower end; 8,9: the side screw of wing plate; 10: mainboard slope fixed part; 11: mainboard vertebral body fixed part; 12: wing plate; 13: titanium cage; 14: pillow neck fixture.
Detailed description of the invention
Embodiment one: the preparation of anterior approach slope described in the utility model fixture
Anterior approach slope described in the utility model fixture, as depicted in figs. 1 and 2, comprising: mainboard, and the mainboard slope fixed part 10 tilted by a section and the mainboard vertebral body fixed part 11 of one section of level form; And wing plate 12, extend to form from the both sides of mainboard vertebral body fixed part 11.Mainboard slope fixed part 10 and mainboard vertebral body fixed part 11 shape have a certain degree to cause described mainboard slope fixed part to be applicable to being adjacent to human body anterior approach slope and described mainboard vertebral body fixed part is applicable to being adjacent to human body neck 3 vertebral body.Preferably, the angle between mainboard slope fixed part 10 and mainboard vertebral body fixed part 11 is 114 ° to 148 °.
As shown in Figure 1, mainboard slope fixed part 10 is evenly arranged three screws 1,2 and 3, these screw triangularities arrange, and make screw, by these screws, mainboard slope fixed part 10 is fixed on anterior approach slope with activation.
As shown in Figure 1, the central authorities of mainboard vertebral body fixed part 11 are arranged to right locking screw 4 and 5, with activation, mainboard vertebral body fixed part 11 are fixed on titanium cage by screw by these locking screws.Titanium cage is the made mesh cage apparatus of existing titanium alloy, and be modelled as head end and firmly can be fitted in slope edge, tail end is fixed on C3 soleplate.
As shown in Figure 1, the lower end of mainboard vertebral body fixed part 11 is arranged to screw 6 and 7, makes screw, by these screws, neck 3 vertebral body is fixed in the lower end of mainboard vertebral body fixed part 11 with activation.
As shown in Figure 1, every side of wing plate 12 arranges a side screw 8 and 9 respectively, makes screw, by these side screws, wing plate 12 is fixed on the left and right lateral mass of atlas with activation.
Anterior approach slope described in the utility model fixture, can make with steel plate or similar material.
The concrete size of anterior approach slope described in the utility model fixture is individual variation because of different patient and specific design.In a preferred embodiment, anterior approach slope described in the utility model fixture is prepared according to following size.
It is 15mm that minister is fixed on mainboard slope, and the widest part is 20mm, evenly arranges three screws, and triangularity arranges, and is fixed on slope by screw 1,2,3.Mainboard vertebral body standing part is flank epimere 5mm, flank linkage section 10mm, flank hypomere 25mm (this value increases in units of 5mm, can be 30,35,40,45mm), the wide 15mm of mainboard vertebral body fixed part.Is arranged in the middle of mainboard vertebral body fixed part locking screw, the wide 5mm of screw, on the fixing plant bone mass of screw 8,9 or titanium cage, by rear titanium cage and slope fixture, by locking screw, to carry out entirety fixing.Mainboard vertebral body fixed part lower end is arranged to screw, and screw 6,7 is fixed on neck 3 vertebral body.The long 12.5mm of flank, wide 10mm, each flank arranges a screw respectively, and screw 4,5 is fixed on atlas left and right lateral mass.Mainboard slope fixed part and mainboard vertebral body fixed part have a certain degree, and angular range is 114 ° to 148 °.Fixture thickness is 1.6mm.Screw 8,9 diameter is 4.0mm, and remaining screw diameter is 3.5mm.
Embodiment two: the application of anterior approach slope described in the utility model fixture
It is below embodiment anterior approach slope described in the utility model fixture being used for clinical practice.
As shown in Figure 3,4, the patient lies supine of upper cervical spine pathological changes is on operation table, and through anaesthetizing successfully, the wild skin of sterilization operation on neck, spreads aseptic towel, list.
Get upper cervical spine throat pharynx posterior approach, expose body of cervical vertebra, Fluoroscopy location, excision C1 anterior arch and C2 vertebral body, row C2-3 diskectomy, select suitable titanium cage (Johson & Johnson) to mould head end firmly can be fitted in slope edge, tail end is fixed on C3 soleplate.Fill broken bone block in it, the outwardly extending lip of this titanium cage is stayed front and is fixed to slope and C3 vertebral body to allow screw.After the length of measuring bolt, the os integumentale screw of 4 3.5 mm dias is inserted and is fixed by titanium cage.Rear portion is aided with pillow neck fixture, extends downward the lateral mass of C4.The entrance of slope screw, lateral mass of atlas screw and neck 3 vertebral body screw is measured.Kirschner wire (diameter is 1.0mm) is used to bore a hole at predetermined entry point.Get out screw thread with the drill bit of diameter 2.5 millimeters, then use the reaming of diameter 3.5 millimeters of hand-power screwdrivers.After measuring the length of screw, mainboard slope fixed part three screws 1,2 and 3, triangularity arranges, and is fixed on slope by screw.Be arranged in the middle of mainboard vertebral body fixed part, to locking screw 4 and 5, be fixed on titanium cage by screw, by rear titanium cage and slope fixture, by locking screw, to carry out entirety fixing.Mainboard vertebral body fixed part lower end is arranged to, to screw 6 and 7, be fixed on neck 3 vertebral body by screw.Each flank arranges a screw 8 and 9 respectively, is fixed on the left and right lateral mass of atlas by screw.
C arm confirms that internal fixtion is in place, after repeatedly rinsing otch, looks into without active hemorrhage, in cervical incision built-in silica gel tube half Tube Drain one after cervical vertebra sequence is good with normal saline.Sew up subcutaneous tissue and subcutaneous.
Embodiment three: the Biomechanical evaluation on primary of anterior approach slope fixture stability
Experiment purpose
From the angle of biomechanics, inquire into the stability that this utility model patent is fixed for upper cervical spine.
Experiment material
Slope steel plate titanium cage Kirschner wire bone screw 6 tool fresh cadaver head-cervical specimens (from occipital condyle C0 to C4 vertebral body, man 4, female 2; Mean age, 46 years old; Scope 35 – 62 years old).
Experimental technique
2.1 sample disposal
The muscular tissue of Operated Specimens, retains bone ligament structure, and all Saving specimen, in sealing double-layer plastic bag, are kept in the refrigerator-freezer of ﹣ 20 °, before experiment take specimen to thaw at RT.General inspection and position, positive side X-ray film check whether specimen has deformity, and dual energy ray borne densitometers checks whether specimen exists osteoporosis.
2.2 biomechanical model
Each specimen adopts own control, carries out in the following order testing (1) good working condition; (2) titanium caged state: in labile state, a diameter 12 millimeters of titanium cages (Johson & Johnson) are pruned its head end and firmly can be fitted in slope edge, tail end is fixed on C3 soleplate.After the length of measuring bolt, the os integumentale screw of 4 3.5 mm dias is inserted.Rear portion is aided with pillow neck fixture, extends downward the lateral mass of C4; (3) slope steel plate state: in labile state, measures the entrance of slope screw, C1 lateral mass screw and C3 vertebral body screw.Kirschner wire (diameter is 1.0mm) is used to bore a hole at predetermined entry point.Get out screw thread with the drill bit of diameter 2.5 millimeters, then use the reaming of diameter 3.5 millimeters of hand-power screwdrivers.After measuring the length of screw, insert the screw of 3.5 millimeters.Rear portion is aided with pillow neck fixture, extends downward the lateral mass of C4.Namely labile state excises C1 anterior arch and C2 vertebral body, row C2-3 diskectomy, thus produces the biomechanical model of upper cervical spine shakiness.
2.3 three-dimensional motion test experiments
The spine test machine of autonomous Design, by a mechanical arm, is delivered to specimen immediately by the moment of torsion that dc motor produces, and makes specimen keep without constrained motion state simultaneously.The weight of plaster fixing block and grip device is balanced by pulley system weight.Maximum moment is 1.5Nm, and applies the translational speed of 1.0 °s/sec.Three load cycle, comprise left and right transverse curvature and axial-rotation.
Photoelectron movement measurement system (Optotrak 3020, Northern Digital, Waterloo, Ontario, Canada) is used to measure intervertebral motion.Range of movement (ROM) between occipitalia and C4 vertebra is main measurand.In this research, ROM is defined as the degree of rotation from neutral position to the position of maximum load.Pay special attention to keep specimen moistening in whole test process.
2.4 statistical analysis
SPSS13.0 version is adopted to analyze all results.Result is expressed as mean+SD.One way analysis of variance and Fisher least squares error is used to carry out statistical analysis for factor analysis.Statistically-significant difference is defined as the credibility interval of 95%.
Experimental result
Table 1 shows the kinematic data of C0-C4 in good working condition, titanium caged state and slope steel plate state.Compared with complete state, the ROM of titanium caged state and slope steel plate state, significantly declines (P<0.05) at lateral bending with when rotating.Compared with titanium caged state, the ROM of slope steel plate state at lateral bending and when rotating is decreased significantly (P<0.05).
The routine specimen of table 1 six is neck 0-neck 4 vertebral body range of activity (means standard deviation) under two kinds of different conditions
| ? | Good working condition (°) | Titanium caged state (°) | Slope steel plate state (°) |
| Lateral bending | 27.2±8.3 | 2.0±0.9 | 1.3±0.8 |
| Rotate | 105.2±17.9 | 7.83.6±1.9 | 2.1±1.3 |
4, experiment conclusion
Anterior approach slope described in the utility model fixture has good three-dimensional stability, the stability of upper cervical spine in coordinating posterior occipitocervical to fix can better to rebuild.
Claims (6)
1. an anterior approach slope fixture, is characterized in that, comprising:
Mainboard, the mainboard slope fixed part tilted by a section and the mainboard vertebral body fixed part of one section of level form; And
Wing plate, extends to form from the both sides of described mainboard vertebral body fixed part;
Wherein, described mainboard slope fixed part and described mainboard vertebral body fixed part shape have a certain degree to cause described mainboard slope fixed part to be applicable to being adjacent to human body anterior approach slope and described mainboard vertebral body fixed part is applicable to being adjacent to human body neck 3 vertebral body.
2. anterior approach slope according to claim 1 fixture, is characterized in that: the angle between described mainboard slope fixed part and described mainboard vertebral body fixed part is 114 ° to 148 °.
3. anterior approach slope according to claim 1 fixture, it is characterized in that: described mainboard slope fixed part evenly arranges three screws, triangularity arranges, and makes screw, by described screw, described mainboard slope fixed part is fixed on anterior approach slope with activation.
4. anterior approach slope according to claim 1 fixture, is characterized in that: the central authorities of described mainboard vertebral body fixed part are arranged to right locking screw, with activation, described mainboard vertebral body fixed part is fixed on titanium cage by screw by described locking screw.
5. anterior approach slope according to claim 1 fixture, is characterized in that: the lower end of described mainboard vertebral body fixed part is arranged to screw, makes screw, by described paired screw, neck 3 vertebral body is fixed in the lower end of described mainboard vertebral body fixed part with activation.
6. anterior approach slope according to claim 1 fixture, is characterized in that: every side of described wing plate arranges a side screw respectively, makes screw, by described side screw, described wing plate is fixed on the left and right lateral mass of atlas with activation.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201420441488.7U CN204049816U (en) | 2014-08-06 | 2014-08-06 | Anterior approach slope fixture |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201420441488.7U CN204049816U (en) | 2014-08-06 | 2014-08-06 | Anterior approach slope fixture |
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| Publication Number | Publication Date |
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| CN204049816U true CN204049816U (en) | 2014-12-31 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201420441488.7U Withdrawn - After Issue CN204049816U (en) | 2014-08-06 | 2014-08-06 | Anterior approach slope fixture |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104127229A (en) * | 2014-08-06 | 2014-11-05 | 南方医科大学南方医院 | Anterior cervical approach slope fixing device |
-
2014
- 2014-08-06 CN CN201420441488.7U patent/CN204049816U/en not_active Withdrawn - After Issue
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104127229A (en) * | 2014-08-06 | 2014-11-05 | 南方医科大学南方医院 | Anterior cervical approach slope fixing device |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| AV01 | Patent right actively abandoned |
Granted publication date: 20141231 Effective date of abandoning: 20160817 |
|
| AV01 | Patent right actively abandoned |
Granted publication date: 20141231 Effective date of abandoning: 20160817 |
|
| C25 | Abandonment of patent right or utility model to avoid double patenting |