CN206543203U - Bilateral location type pedicle of vertebral arch puts nail sight - Google Patents

Abstract

Bilateral location type pedicle of vertebral arch puts nail sight, including body and guide sleeve；Body lower end is provided with bone binding face and bottom surface, and nail channel is put in upper end in body provided with nail plane is put provided with two, puts the insertion of nail channel one end to putting nail plane, other end insertion to bottom surface；Guide sleeve is arranged on and put in nail channel, and the two forms interference fits.The utility model can be attached with targeted vertebra positioning curved surface to coincide well, is easy to patient accurately and rapidly to implement pedicle screw internal fixation, both improves procedure efficiency, the accuracy and security of operation have been ensured again.The thread Pilot hole of pedicle screw can be got out in targeted vertebra pedicle of vertebral arch by guide sleeve, the pedicle screw being implanted into by thread Pilot hole, both it can ensure not wearing out pedicle of vertebral arch cortex, ensure that screw has maximum gauge in the range of the permission of vertebral arch radical space, so as to ensure the biomechanics characteristic after implantation and three-dimensional fixed effect to greatest extent, replicating again for vertebral joint biomechanics characteristic is realized.

Description

Bilateral location type pedicle of vertebral arch puts nail sight

Technical field

The utility model is related to technical field of medical instruments, and more particularly to a kind of bilateral location type pedicle of vertebral arch is put nail and aimed at Device.

Background technology

Fixed surgical indication is closed suitable for the tumor of spinal cord of backbone, retrogression pathological changes, rheumatoid in pedicle screw Section inflammation and infectious diseases, especially in the reset for the treatment of vertebral slippage, corrective procedure, pedicle of Vertebral Arch Fixation is the most reliable Fixed form.Because pedicle screw can play three-dimensional fixation, with mechanical strength is high, fixed and Fusion levels are few, The advantages of deformity of spine rectification effect is good, its clinical practice is more and more extensive.

Biomechanics experiment is proved, is only inserted screw along the dissection major axis of pedicle of vertebral arch and is reached depth desired, can just obtain Obtain preferable clinical effectiveness.Spinal vertebral surrounding anatomical structures are complicated, and front is adjacent with big blood vessel, internal organs, are on the inside of pedicle of vertebral arch Canalis spinalis, lower section are nerve root, and can the success or failure key of the pedicle screw internal fixation operation of pedicle is accurately by certainly Attack screw pedicle and be screwed into centrum, do not wear out pedicle of vertebral arch cortex.Screw is put by mistake can cause spinal cord, nerve damage, internal organs, blood Pipe is damaged, or even threat to life.Moreover, thoracic vertebrae, the pedicle diameter of cervical vertebra are gradually reduced from lumbar vertebrae upwards, cause operation difficult Degree increase, operation risk is improved.And personal vertebral arch root morphology has larger variability, cause screw to put nail fault rate and carry It is high.Cause the clinical report of the complication such as neurotrosis, pedicle screw loosening because pedicle screw implantation site is improper simultaneously It is not rare.Therefore, related medical technology and engineering technology how are relied on, helps doctor to complete operation pathway planning, accurately draw The implantation of implants is led, is always the problem that domestic and international basis and clinical research are extremely paid close attention to.

At present, determine that pedicle screw enters to follow closely angle and the main method of entry point and had：Anatomic landmark point method, vertebral lamina fenestration Method, X-ray examination method, computer navigation method, navigation template method etc..The entry point of anatomic points notation, enter to follow closely angle and mainly pass through The experience of patient judges, accurate to say that the feel and pedicle probe opposed nail channel that are to depend on patient are felt to ensure pedicle of vertebral arch The accurate of screw is inserted, and requires higher to the clinical experience of doctor, and precision is difficult to ensure that.Vertebral lamina fenestration inevitably increases Plus operating time and intraoperative blood loss.The operating time of X-ray examination auxiliary law is longer, the x-ray spoke that patient and medical personnel are subject to The amount of penetrating is larger.Gradually applied during computer navigation method is fixed in pedicle screw in recent years, utilize the real-time vertebra of patient Nut image information carrys out guided operation, reduces operation risk, the time that doctor and patient contacts ray is reduced, with larger excellent Gesture, but navigation equipment is expensive, complex operation, and clinic popularization still suffers from difficulty.Navigation template method is based on 3D printing technique Navigation template is produced, with to operation quick response and efficiency-cost ratio advantage, existing individuation navigation template is primarily present three The problem of aspect：One is that template thickness is relatively thin, rigid poor, is not easy to hold in art, template is also easy to produce deformation and shaken during drilling It is dynamic；Two be without the navigation template of sleeve conduit is easy to wear and fusing, and between its sleeve of the navigation template with sleeve and template Coordinate for gap and have relative rotation, this can influence orientation accuracy and using effect；Three be the planning that pedicle of vertebral arch puts nail channel Lack effective theoretical and means support, its optimization method, operating efficiency and planning effect have much room for improvement.

Therefore, need badly design it is a set of can it is accurate, efficiently planning pedicle screw entry point, insert angle, diameter with The method of length, and the result of calculation based on this method prepares " nail sight is put in personalization " applied to operation, in order to Pedicle screw is inserted in pedicle screw internal fixation operation safety and precise, realizes the multiple again of vertebra biomechanics characteristic System, improves patients ' life quality.

Utility model content

The purpose of this utility model is to overcome the deficiencies in the prior art, and provides a kind of bilateral location type pedicle of vertebral arch and put nail and take aim at Quasi- device, nail sight is put by bilateral location type pedicle of vertebral arch, patient can fast and accurately implement in pedical screw instrumentation into Nail, realizes that complicated operation safe, key operation simplification, apparatus are cost-effective.

The technical solution of the utility model is：Bilateral location type pedicle of vertebral arch puts nail sight, including body and guide sleeve；This Body lower end is provided with bone binding face and bottom surface, and upper end is provided with nail plane is put, and body is interior to put nail channel provided with two, puts nail channel one end Insertion is to putting nail plane, other end insertion to bottom surface；Guide sleeve is arranged on and put in nail channel, and the two forms interference fits.

The further technical scheme of the utility model is：Nail channel is put for shoulder hole, is provided with outside step surface, guide sleeve in it Wall is provided with ring-shaped step；Put when guide sleeve is arranged in nail channel, guide sleeve is by ring-shaped step thereon and puts nail channel Interior step surface is in contact and is axially located.

The further technical scheme of the utility model is：The front and rear sides wall of body is cheated provided with finger pressure.

The utility model further technical scheme is：Guide sleeve is shorter in length than the length for putting nail channel, works as guiding Set be arranged on put in nail channel, put one section of nail channel and contacted with guide sleeve, another section does not contact with guide sleeve, put nail channel not with One section of guide sleeve contact is chip removal chamber, and chip removal chamber is communicated to bottom surface.

The utility model further technical scheme is：Bone binding face can be with targeted vertebra vertebral plate, transverse process rear portion and spine The profile of prominent root dorsal part, which is attached, to coincide；When bone binding face and targeted vertebra, which are attached, coincide, put the central axis of nail channel with The axis of targeted vertebra pedicle of vertebral arch maximum inscribed cylinder is overlapped；The adjacent vertebrae is below targeted vertebra and and target One piece of vertebra of vertebrae adjacent.

The utility model further technical scheme is：Body left and right sides wall is provided with transverse process with body bottom surface intersection Avoid chamfering；The position on bone binding face correspondence targeted vertebra spinous process top avoids groove provided with spinous process；Bone binding face correspondence is adjacent The position of prezygapophysis avoids groove provided with processus articular superior.

The preparation method that described bilateral location type pedicle of vertebral arch puts nail sight is as follows：

S01, obtains targeted vertebra medical image：Transfer spiral CT examination data or nuclear magnetic resonance before patient's diagnosis Data are checked, the data of operative region targeted vertebra are selected, the recognizable form of medical image software is saved as；

S02, reconstructs the threedimensional model and central point point set of targeted vertebra：The medical image of targeted vertebra is imported into doctor Image software Mimics is learned, the threedimensional model of targeted vertebra is rebuild, then obtains the central point point set of targeted vertebra, central point point set It is made up of spacing for a discrete point, threedimensional model and central point point set is saved as into STL forms, IGS forms respectively；

In this step, a interval is 0.01mm~0.1mm；

S03, creates and to be modified once enters staple line：Threedimensional model and central point point set data file are imported into reverse-engineering In software I mageware, the central point point set in the pedicle of vertebral arch length range of side is then chosen, nurbs curve is created, M equidistant point is taken on nurbs curve, and makes tangent line of the nurbs curve this m positions, this m point is crossed and is respectively created Perpendicular to a m normal sections of each tangent line, n one including being extracted in a m normal sections comprising pedicle isthmus Secondary normal section, nurbs curve and this n normal section n intersection points of formation, obtain the least-squares line of this n intersection point, i.e., Once to enter staple line；

In this step, n >=7, m >=n；

S04, create it is secondary enter staple line：By n intersection point in S03 steps, it is respectively created perpendicular to the n for once entering staple line Individual secondary normal section；Extract the outer contour of pedicle of vertebral arch respectively on n secondary normal sections, then created in each outer contour Maximum inscribed circle A is built out, each maximum inscribed circle A center of circle is sequentially connected, a space broken line is formed, obtains the space broken line Least-squares line, as it is secondary enter staple line；

In this step, it is secondary enter staple line be that final pedicle screw enters to follow closely route；

S05, it is determined that along it is secondary enter staple line direction pedicle of vertebral arch maximum inscribed circle cylinder diameter：Pass through the n in S03 steps Individual intersection point, be respectively created perpendicular to it is secondary enter staple line n three normal sections, extract vertebra respectively on this n three normal sections The outer contour of nut, then by the n outer contour extracted along it is secondary enter staple line vector direction, near target vertebra Projected on three normal sections of bone centrum, be internally formed a closed interval after projection superposition, make in the closed interval Maximum inscribed circle B, maximum inscribed circle B diameter be along it is secondary enter staple line direction pedicle of vertebral arch maximum inscribed circle cylinder it is straight Footpath；

S06, determines pedicle screw and puts the interval of nail channel diameter：Maximum is inwardly made by offset distance value of x+y Inscribed circle B concentric circles, by the metal bone screw of concentric diameter of a circle and pharmaceuticals industry standard YY0018-2002 defineds External thread diameter size is compared and downward rounding, is determined pedicle screw external thread diameter d1, is looked into the spiral shell taken corresponding to d1 Line path d2, using d2 as the basic size of guide sleeve internal diameter, regard d2+2 δ as the basic size of guide sleeve external diameter, Ran Hougen Determine to put nail channel diameter according to guide sleeve and the matching relationship for putting nail channel；

In this step, x is the statistical value of targeted vertebra pedicle of vertebral arch thickness of cortex of bone, when targeted vertebra is cervical vertebra, x value Interval is 0.8~1.4mm, when targeted vertebra is thoracic vertebrae, and x interval is 1.2~1.6mm, when targeted vertebra is lumbar vertebrae, x Interval be 1.5~2.5mm；Y is that bilateral location type pedicle of vertebral arch puts nail sight because of manufacture, installation and uses error may Caused drilling offset distance, y interval is 0.3~0.5mm；δ is the wall thickness of guide sleeve, δ interval for 1.5~ 1.75mm；

S07, is repeated in S03~S06, obtains the opposite side pedicle of vertebral arch relative with " side pedicle of vertebral arch " in S03 steps It is secondary to enter staple line, pedicle screw and to put the interval of nail channel diameter；

S08, sets up this body three-dimensional models：The threedimensional model file of targeted vertebra and its adjacent vertebrae is imported into PRO/E In；According to the form of targeted vertebra, size and the position relationship with adjacent vertebrae, body initial configuration model is set up, further according to It is secondary enter staple line linear equation and selection put nail channel diameter, set up on body initial configuration model and put nail channel, then The body initial configuration model that targeted vertebra and band are put nail channel in Mimics is matched, using Boolean calculation in body Lower end generates the reverse curved surface of targeted vertebra locating surface, as the bone binding face of body, so as to realize building for this body three-dimensional models It is vertical；

S09, manufacture bilateral location type pedicle of vertebral arch puts nail sight：By designed body three-dimensional models 3D printing technique Manufacture, and designed guide sleeve is also manufactured, while producing the 3D printing model of targeted vertebra, be easy to doctor Preoperative experiment is with assessing.

It is preferred that, in step S08, when setting up body initial configuration model, it is considered to the convenience of clamping, in body front and rear sides Finger pressure is set to cheat on wall, holding position during nail sight work is put in finger pressure hole as bilateral location type pedicle of vertebral arch.

It is preferred that, in step S08, when setting up body initial configuration model, carry out at empty avoiding processing at three, described three at empty avoiding Reason is included in body left and right sides wall and sets transverse process to avoid chamfering with bottom surface intersection, to avoid the transverse process position pair of adjacent vertebrae Body installs the interference of positioning；The position on bone binding face correspondence targeted vertebra spinous process top sets spinous process to avoid groove, to avoid The interference effect that spinous process lateral protrusions are positioned to bone binding face curved surface；Bone binding face correspondence adjacent vertebrae processus articular superior is closed on position Section is prominent to avoid groove, bone binding face curved surface is positioned with to avoid the relative motion change in location between targeted vertebra and adjacent vertebrae Interference effect.

The utility model has the following advantages that compared with prior art：

1st, by " personalization " design customization, it can attach and be coincide well with targeted vertebra positioning curved surface, it has high accuracy Nail channel is put, is easy to patient accurately and rapidly to implement pedicle screw internal fixation, procedure efficiency is both improved, ensured again The accuracy and security of operation.

2nd, the bone binding face of the physical dimension of body and body lower end all in accordance with the form of targeted vertebra, size and with it is adjacent The position relationship of vertebra is designed, with obvious personalized customization feature.Body interior put nail channel space angle and Diameter is that the respective algorithms in its preparation method are calculated.Can be in targeted vertebra vertebra by the guide sleeve of body interior The thread Pilot hole of pedicle screw is got out in nut, the pedicle screw being implanted into by thread Pilot hole can both ensure not wear out vertebra Nut cortex, ensures that screw has maximum gauge in the range of the permission of vertebral arch radical space, so as to ensure to greatest extent There is excellent biomechanics characteristic and firm three-dimensional fixed effect after implantation, vertebral joint biomechanics characteristic is realized again Replicate.

3rd, finger pressure hole is provided with the wall of body front and rear sides, meets ergonomics, can be when sight works easily Held and pressed, not only can effectively reduce the vibration of sight, moreover it is possible to effectively prevent sight and targeted vertebra it Between, between patient's finger and sight occur skidding.

4th, body puts the guide sleeve that metal material is provided with nail channel, and guide sleeve is shorter in length than the length for putting nail channel Degree, puts in nail channel when guide sleeve is arranged on, puts one section of nail channel and contacted with guide sleeve, another section does not contact with guide sleeve, puts Nail channel do not contacted with guide sleeve one section is chip removal chamber, and chip removal chamber can accommodate the bone bits got out, can be prevented effectively from and spud in again When scratch of the drill edge wedge angle to guide sleeve endoporus.Carbon quenched and tempered steel (45 steel or medium carbon alloy steel 40Cr) during guide sleeve is used Prepare, make it that both there is good comprehensive mechanical performance and wearability, definite value reamer is easy to use again its small size internal diameter is entered Row Precision Machining.Guide sleeve not only gets out screw thread bottom outlet in pedicle of vertebral arch for drill bit and provides accurate guiding work in operation With, and good dimensional stability can be kept, so as to ensure to form high-precision cooperation (chip clearance between drill bit and guide sleeve With the ratio between bit diameter for 0.5~1).Metal guide sleeve can quick dispatch, reusable, both improve procedure efficiency, drop again Low apparatus cost.

5th, body, which is provided with three, optimizes structure：Body left and right sides wall avoids chamfering with bottom surface intersection provided with transverse process, It can avoid the transverse process position of adjacent vertebrae that the interference of positioning is installed to body；The portion on bone binding face correspondence targeted vertebra spinous process top Position avoids groove, the interference effect that spinous process lateral protrusions can be avoided to position bone binding face curved surface provided with spinous process；Bone binding face pair Answer the position of adjacent vertebrae processus articular superior to avoid groove provided with processus articular superior, can avoid relative between targeted vertebra and adjacent vertebrae The interference effect that movement position change is positioned to bone binding face curved surface.

The utility model is further described below in conjunction with figure and embodiment.

Brief description of the drawings

Fig. 1 is the front view that bilateral location type pedicle of vertebral arch puts nail sight；

Fig. 2 is Fig. 1 top view；

Fig. 3 is Fig. 1 left view；

Fig. 4 is the dimensional structure diagram that bilateral location type pedicle of vertebral arch puts nail sight；

Fig. 5 is the use state schematic diagram that bilateral location type pedicle of vertebral arch puts nail sight；

Fig. 6 is the structural representation of body；

Fig. 7 is the empty avoiding position view of targeted vertebra and adjacent vertebrae；

Fig. 8 is the threedimensional model of targeted vertebra and the matching status schematic diagram of its central point point set；

Fig. 9 is the generation view for once entering staple line to be modified；

Figure 10 for it is secondary enter staple line generation view；

Figure 11 is the generation view of three normal sections；

Figure 12 enters nail channel generation view for safety.

Explanation：For the structure of more intuitive show ontology, Fig. 3 uses broken section putting at nail channel.

Part marginal data：Body 1；Bone binding face 11；Put nail plane 12；Put nail channel 13；Finger pressure hole 14；Bottom surface 15； Transverse process avoids chamfering 16；Spinous process avoids groove 17；Processus articular superior avoids groove 18；Guide sleeve 2；Ring-shaped step 21；Targeted vertebra 31；Spinous process 311；Central point point set 32；Nurbs curve 33；Once enter staple line 34；Normal section 35；Secondary normal section 36；Most Big inscribed circle A37；Space broken line 38；It is secondary enter staple line 39；Three normal sections 40；Maximum inscribed circle B41；Concentric circles 42；It is adjacent Vertebra 9；Transverse process 91；Processus articular superior 92.

Embodiment

Embodiment 1：

As shown in figs. 1 to 6, bilateral location type pedicle of vertebral arch puts nail sight, including body 1 and guide sleeve 2.

The lower end of body 1 is provided with bone binding face 11 and bottom surface 15, and upper end, which is provided with, puts nail plane 12.Body puts nail provided with two Passage 13, put one end insertion of nail channel 13 to put nail plane 12, other end insertion to bottom surface 15.Bone binding face 11 and targeted vertebra The profile of 31 vertebral plates, transverse process rear portion and spinous process root dorsal part, which is attached, to coincide.It is coincide when bone binding face 11 and targeted vertebra 31 are attached When, the central axis 132 for putting nail channel 13 is overlapped with the axis of the pedicle of vertebral arch maximum inscribed cylinder of targeted vertebra 31.

Guide sleeve 2 is arranged on and put in nail channel 13, and the two forms interference fits, that is, forms gap or be interference fitted (optional Select H8/js7 or H8/k7), but gap value or the equal very little of the magnitude of interference, it is easily installed and dismantles again while orientation accuracy is ensured.

It is preferred that, the edge of the front and rear sides wall of body 1 is provided with finger pressure hole 14.

It is preferred that, nail channel 13 is put for shoulder hole, and it is interior provided with step surface 131, and the outer wall of guide sleeve 2 is provided with ring-shaped step 21；Put when guide sleeve 2 is arranged in nail channel 13, guide sleeve 2 is by ring-shaped step 21 thereon and puts the platform in nail channel 13 Terrace 131 is in contact and is axially located.

It is preferred that, as shown in Fig. 2,7, the left and right sides wall of body 1 avoids chamfering 16 with the intersection of bottom surface 15 provided with transverse process, can keep away The position of transverse process 91 for exempting from adjacent vertebrae 9 is installed by the interference of positioning to body；On the correspondence spinous process 311 of targeted vertebra 31 of bone binding face 11 The position in portion avoids groove 17, the interference effect that spinous process lateral protrusions can be avoided to position the curved surface of bone binding face 11 provided with spinous process； The position of the correspondence processus articular superior 92 of adjacent vertebrae 9 of bone binding face 11 avoids groove 18 provided with processus articular superior, can avoid targeted vertebra The interference effect that relative motion change in location between 31 and adjacent vertebrae 9 is positioned to the curved surface of bone binding face 11.

The preparation method that described bilateral location type pedicle of vertebral arch puts nail sight is as follows：

S01, obtains targeted vertebra medical image：Transfer spiral CT examination data or nuclear magnetic resonance before patient's diagnosis Data are checked, the data of operative region targeted vertebra are selected, medical image software Mimics is saved as and can recognize that form.

S02, reconstructs the threedimensional model and central point point set of targeted vertebra：The medical image of targeted vertebra 31 is imported Medical image software Mimics, takes filtering, noise reduction means to carry out the pre-treatment of two dimensional image, further according to the wheel of targeted vertebra 31 Exterior feature carries out threshold value separation, sets up mask, rebuilds the threedimensional model of targeted vertebra 31, then pass through " the center line plan built in Mimics Conjunction " function generates the central point point set 32 of targeted vertebra 31, and central point point set 32 is made up of spacing for 0.05mm discrete point, will The threedimensional model and central point point set 32 of targeted vertebra 31 save as STL forms, IGS forms respectively.

In this step, a interval is 0.01mm~0.1mm；The central point point set 32 is the barycenter of targeted vertebra 31 The point set of composition.

S03, creates and to be modified once enters staple line：The threedimensional model of targeted vertebra 31 and central point point set 32 are imported inverse Into engineering software Imageware (as shown in Figure 8), the central point point set 32 in the pedicle of vertebral arch length range of side is then chosen, Nurbs curve 33 is created, 21 equidistant points are taken on nurbs curve, and make nurbs curve 33 in this 21 positions 21 normal sections 35 perpendicular to each tangent line are respectively created in tangent line, excessively this 21 points, are extracted in 21 normal sections Normal section (as shown in Figure 9) of 7 gone out including pedicle isthmus；According to nurbs curve and 7 normal sections The D coordinates value of 7 intersection points, the M files based on Matlab obtain its least-squares line equation, and are painted in Imageware The least-squares line is made, the least-squares line is once to enter staple line 34 (as shown in Figure 9).

In this step, the nurbs curve is non-homogeneous B spline curve, is the central point point with pedicle area Integrate as node, the continuous smooth curve of created in Imageware.The isthmus is pedicle of vertebral arch most narrow one section of area Domain, accounts for the 5%~15% of pedicle of vertebral arch total length, on the premise of central point spacing is fine and close, it is easy to obtained in a m normal sections.

S04, create it is secondary enter staple line：Created by 7 intersection points being formed in S03 steps perpendicular to once entering staple line 34 7 secondary normal sections 36, extract the outer contour of pedicle of vertebral arch, then in each foreign steamer respectively on 7 secondary normal sections 36 Maximum inscribed circle A37 is created that in profile, the center of circle of 7 maximum inscribed circles is sequentially connected, a space broken line 38 is formed (such as Shown in Figure 10)；M files based on Matlab obtain the least-squares line equation of space broken line 38；Drawn in Imageware Go out the least-squares line of space broken line 38, the least-squares line be it is secondary enter staple line 39 (as shown in Figure 10).

In this step, it is secondary enter staple line 39 be that final pedicle screw enters to follow closely route.

S05, it is determined that along it is secondary enter staple line direction pedicle of vertebral arch maximum inscribed circle cylinder diameter：Pass through 7 in S03 steps Individual intersection point, be respectively created perpendicular to it is secondary enter staple line 39 7 three normal sections 40, carried respectively on 7 three normal sections 40 Take the outer contour (as shown in figure 11) of pedicle of vertebral arch, then by extract 7 outer contours along it is secondary enter staple line vector direction, Projected on three normal sections 40 near the centrum of targeted vertebra 31, a closing is internally formed after 7 projection superpositions Interval (as shown in figure 12)；The maximum inscribed circle B41 of the closed interval is made, maximum inscribed circle B41 diameter 8.6mm is edge It is secondary enter staple line direction pedicle of vertebral arch maximum inscribed circle cylinder diameter.

S06, determines pedicle screw and puts the interval of nail channel diameter：Maximum is inwardly made by offset distance value of 2mm Inscribed circle B41 concentric circles 42 (as shown in figure 12), a diameter of 4.6mm of concentric circles 42, by concentric circular diameter 4.6mm and medicine Professional standard YY0018-2002《Synosteosis implant metal bone screw》The external thread diameter of the metal bone screw of defined Size is compared, and rounding downwards, inquires about and determine that the model HA4.5 of pedicle screw, its external thread diameter d1 are 4.5mm, diameter of thread d2 are 3mm, so that it is determined that the basic size of guide sleeve internal diameter and the bit diameter for getting out thread Pilot hole are equal For 3mm；Using d2+2 δ (the wall thickness δ of guide sleeve is 1.5mm) as the basic size of guide sleeve external diameter, so that it is determined that putting nail channel Diameter and the basic size of guide sleeve external diameter be 6mm.

In this step, the statistical value x of the section pedicle of vertebral arch thickness of cortex of bone is 1.7mm, and the drilling offset distance y of body is 0.3mm, offset distance value is calculated for 2mm according to formula x+y.

S07, is repeated in S03~S06, obtains the opposite side pedicle of vertebral arch relative with " side pedicle of vertebral arch " in S03 steps It is secondary to enter staple line, pedicle screw and to put the interval of nail channel diameter.

S08, sets up the threedimensional model of body：By targeted vertebra 31 and its threedimensional model file (the STL lattice of adjacent vertebrae 9 Formula) it imported into PRO/E；According to the form of targeted vertebra 31, size and the position relationship with adjacent vertebrae 9, at the beginning of setting up body Beginning structural model, further according to both sides pedicle of vertebral arch it is secondary enter staple line linear equation and selection put nail channel diameter, at the beginning of body Set up on beginning structural model and put nail channel 13, the body that targeted vertebra 31 and band are then put nail channel 13 in Mimics is initial Structural model is matched, and is generated the reverse curved surface of the locating surface of targeted vertebra 31 in the lower end of body 1 using Boolean calculation, is used as this The bone binding face 11 of body 1, so as to realize the foundation of this body three-dimensional models.

S09, manufacture bilateral location type pedicle of vertebral arch puts nail sight：Bilateral location type pedicle of vertebral arch is put to the three-dimensional of nail sight Model file (STL forms) is imported in 3D printing software Cura, carries out 3D printing manufacture, and designed guide sleeve is also manufactured Out, while producing the 3D printing model of targeted vertebra, it is easy to the preoperative experiment of doctor with assessing.

The cad technique of uniqueness is employed to the planning for putting nail channel of body in above-mentioned preparation method, effectively lifted The quality and efficiency of planning.The key that nail channel is put in planning is the maximum inscribed circle cylinder for finding pedicle of vertebral arch, determines according to this Pedicle screw enters to follow closely direction and screw diameter.

Above-mentioned preparation method is primarily based on the central point point set in the pedicle of vertebral arch length range automatically generated in Mimics Data, create the pedicle of vertebral arch center line of nurbs curve form in Imageware, and in this, as seeking, pedicle of vertebral arch maximum is inscribed The primary data of cylinder axis, avoiding problems the blindness to pedicle of vertebral arch maximum inscribed circle cylinder initial plan and arbitrarily Property.

If next considering only to set pedicle of vertebral arch maximum inscribed circle to the normal of nurbs curve normal section with isthmus The axis vector of cylinder, then do not have ergodic in pedicle of vertebral arch length range, therefore n characteristic point for choosing nurbs curve is asked Solve and draw out least-squares line, as staple line is once entered, complete to enter to follow closely direction that is, maximum inscribed circle column axis to The first time amendment of amount.

It should be noted that as important mathematical modeling, least square method because theoretical ripe, algorithm is simple and easy to do and It is used widely in survey engineering, standard GB/T/T 1958-2004《Product geometric sense technical specification（GPS）Shape and position Put tolerance detection regulation》Also illustrate, on the premise of functional requirement is met, it is allowed to replace minimal condition to comment using approximation method Determine form error, including axis straightness error.

Next, it is contemplated that once enter the initial data of staple line from n not parallel section in pedicle of vertebral arch length range The central point in face (normal section), i.e. center of mass point, although the initial plan for pedicle of vertebral arch maximum inscribed circle cylinder is provided just Profit, but if entering to follow closely direction using it as final, then due to the complexity of pedicle of vertebral arch anatomic morphological occur it is larger to The center of circle for measuring the maximum inscribed circle in error, n secondary normal sections is larger at one along the vectorial projective distribution of staple line is once entered In the range of, this larger dislocation causes the diameter for the pedicle of vertebral arch maximum inscribed circle cylinder made less than normal, therefore correct feasible Way is the circle center line connecting by asking for maximum inscribed circle A, further ask for the least-squares line of the line as it is secondary enter Staple line, completes second of amendment to entering to follow closely direction that is, maximum inscribed circle column axis vector, can be obtained in the vector direction Bigger pedicle of vertebral arch maximum inscribed circle cylinder diameter.

By virtual experimental, find such as using it is secondary enter staple line isthmus normal section maximum inscribed circle as pedicle of vertebral arch most Cylinder diameter inscribed greatly, can produce slight broken wall phenomenon, therefore the pedicle of vertebral arch outer contour that will first be extracted on three normal sections Along it is secondary enter staple line vector direction project and be superimposed, ask for the maximum inscribed circle B of its internal closed interval, as along it is secondary enter nail The cross section of the maximum inscribed circle cylinder in line direction, the Virtual Test Validation security of this method.

Then it is because when implementing pedicle of vertebral arch operation, screw can not penetrate vertebral arch to make concentric circles in maximum inscribed circle B Root cortex bone, therefore the concentric circles that pedicle of vertebral arch thickness of cortex of bone and drilling offset distance are obtained is subtracted on the basis of maximum inscribed circle B, It is that can implement the pedicle of vertebral arch body of operation.

In summary, what is proposed in above-mentioned preparation method carries out second-order correction and acquisition pedicle of vertebral arch maximum to entering to follow closely direction The technology path of inscribed cylinder, is the build-in function of the anatomic morphological based on pedicle of vertebral arch, Least Square Theory and CAD software And carry out, effectively improve the quality and efficiency for putting nail channel planning.

Claims (7)

1. bilateral location type pedicle of vertebral arch puts nail sight, it is characterized in that：Including body (1) and guide sleeve (2)；Body (1) lower end Provided with bone binding face (11) and bottom surface (15), upper end is provided with nail plane (12) is put, and body (1) is interior to put nail channel provided with two (13), put nail channel (13) one end insertion to put nail plane (12), other end insertion to bone binding face (11)；Guide sleeve (2) is pacified Mounted in putting in nail channel (13), the two forms interference fits.

2. bilateral location type pedicle of vertebral arch as claimed in claim 1 puts nail sight, it is characterized in that：Nail channel (13) is put for ladder Hole, it is interior provided with step surface (131), and guide sleeve (2) outer wall is provided with ring-shaped step (21)；Nail is put when guide sleeve (2) is arranged on In passage (13), guide sleeve (2) is in contact by ring-shaped step (21) thereon with the step surface (131) put in nail channel (13) And be axially located.

3. bilateral location type pedicle of vertebral arch as claimed in claim 2 puts nail sight, it is characterized in that：The front and rear sides of body (1) Wall is provided with finger pressure hole (14).

4. bilateral location type pedicle of vertebral arch as claimed in claim 3 puts nail sight, it is characterized in that：The length of guide sleeve (2) is short In the length for putting nail channel (13), put when guide sleeve (2) is arranged in nail channel (13), put (13) one sections of nail channel and guide sleeve (2) contact, another section contact with guide sleeve (2), it is chip removal chamber to put one section that nail channel (13) do not contact with guide sleeve (2) (133), chip removal chamber (133) is communicated to bottom surface (15).

5. the bilateral location type pedicle of vertebral arch as any one of claim 1-4 puts nail sight, it is characterized in that：Bone binding face (11) it can attach and coincide with the profile of targeted vertebra (31) vertebral plate, transverse process rear portion and spinous process root dorsal part；When bone binding face (11) When attaching identical with targeted vertebra (31), the central axis (132) and targeted vertebra (31) pedicle of vertebral arch for putting nail channel (13) are maximum The axis of inscribed cylinder is overlapped；The adjacent vertebrae (9) be below the targeted vertebra (31) and with targeted vertebra (31) phase One piece of adjacent vertebra.

6. the bilateral location type pedicle of vertebral arch as any one of claim 1-4 puts nail sight, it is characterized in that：Body (1) Left and right sides wall avoids chamfering (16) with body (1) bottom surface (15) intersection provided with transverse process；Bone binding face (11) correspondence target vertebra The position on bone (31) spinous process (311) top avoids groove (17) provided with spinous process；Closed on bone binding face (11) correspondence adjacent vertebrae (9) The position of section prominent (92) avoids groove (18) provided with processus articular superior.

7. bilateral location type pedicle of vertebral arch as claimed in claim 5 puts nail sight, it is characterized in that：Body (1) left and right sides wall With body (1) bottom surface (15) intersection chamfering (16) is avoided provided with transverse process；Bone binding face (11) correspondence targeted vertebra (31) spinous process (311) position on top avoids groove (17) provided with spinous process；Bone binding face (11) correspondence adjacent vertebrae (9) processus articular superior (92) Position avoids groove (18) provided with processus articular superior.