CN213697364U - Posterior atlantoaxial lateral mass joint fusion fixator - Google Patents
Posterior atlantoaxial lateral mass joint fusion fixator Download PDFInfo
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- CN213697364U CN213697364U CN202021783756.5U CN202021783756U CN213697364U CN 213697364 U CN213697364 U CN 213697364U CN 202021783756 U CN202021783756 U CN 202021783756U CN 213697364 U CN213697364 U CN 213697364U
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- bone grafting
- fusion
- atlantoaxial
- lateral mass
- fixing plate
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Abstract
The utility model discloses a through way of escape atlantoaxial side piece joint fusion fixer, support bone grafting part, fixed plate, adapting unit, screw including fusing the ware, it is equipped with the bone grafting chamber to fuse the ware support bone grafting part, and the surface shape of fixed plate is the same with the bony nature surface at atlantoaxial side piece rear, and adapting unit one end is connected and is fused the ware and support bone grafting part, and the fixed plate is connected to the other end, is equipped with the screw hole with the screw adaptation on the fixed plate. The utility model has the advantages of biomechanics, can promote the atlantoaxial fusion, improve the fusion efficiency, and make the operation safer and simpler.
Description
Technical Field
The utility model relates to the field of medical equipment, especially, relate to a through way of escape atlantoaxial lateral mass joint fusion fixer.
Background
Instability or dislocation of the atlantoaxial bone is often caused by congenital malformation, trauma, tumor, inflammation, etc. of the atlantoaxial bone or joint. Unstable or dislocated atlantoaxial can cause serious spinal cord and medulla oblongata damage of patients, quadriplegia and respiratory dysfunction, even involve important structures such as vertebral artery and vein, internal carotid artery, etc. The atlantoaxial fusion is a main means for solving the instability or dislocation of the atlantoaxial, namely, the loose atlantoaxial is fixed with the adjacent atlantoaxial by an internal fixation method, and a bone is implanted between the atlantoaxial and the epistropheus to promote the fusion of the atlantoaxial and finally achieve the purpose of the stabilization of the atlantoaxial; internal fixation can only provide temporary stability after operation, and the bone grafting fusion can ensure permanent stability. The problem of bone graft non-fusion or pseudoarthroplasty remains one of the important causes of surgical failure. Axial stress stimulation can promote bone growth, and if there is no stress stimulation in one location, the bone will resorb by itself, as in osteoporosis for long-term bedridden patients.
As shown in fig. 1, currently, the most common bone grafting method for posterior fixation fusion is to place a granular, strip or block bone 300 between the posterior arch 100 and the spinous process lamina 200; the following drawbacks exist:
1. the replacement distance of the bone grafting crawling is long: the distance from the posterior arch of the atlas to the spinous process and the vertebral plate of the axis is far, the atlantoaxial posterior membrane is arranged in the middle, and no bony structure exists, so the bone grafting distance required by the posterior fusion is far, the crawling replacement distance is long, the required bone grafting amount is large, long time is required for achieving the final bony fusion, and the probability of fusion failure is relatively high.
2. An inappropriate biomechanical environment is prone to bone resorption: the front of the cervical vertebra is provided with a support, and the rear is provided with a pulling force, namely a tension force; the posterior granular, strip or block bones are subjected to biomechanical tensile stresses that are detrimental to fusion (in contrast, compressive stresses promote bone graft fusion). In the early work, in order to increase the contact area between the bone grafting material and the bone grafting bed, a large amount of granular and strip-shaped bone is commonly used for bone grafting, and the condition that the bone grafting is obviously absorbed is also found to be common in the follow-up process.
3. The intact posterior arch of the atlas becomes a necessary condition for implementing the fusion behind the atlantoaxial. However, in some patients with congenital defects of the posterior atlas, atlas osteochondrosis or reduced pressure after atlas resection, bone grafting behind the atlas cannot be performed.
4. The bone grafting bed has smaller surface area and poorer blood circulation; the success rate of bone graft fusion is related to the preparation of the bone graft bed and the area of the bone graft material in contact with it. The conventional bone grafting area of the atlantoaxial posterior fusion is between the atlas posterior arch and the epistropheus vertebral plate, the bone grafting bed area is small, and particularly, the atlas posterior arch is small and is the main part for forming the artificial joint. If a block bone is used for bone grafting, a fixing device is often required to be added, so that the operation is complicated, and the contact area between a bone grafting block and a bone grafting bed is smaller. On the other hand, the bone grafting beds are all harder cortical bones, so the atlas posterior arch and the epistropheus spinous process vertebral plate need to be decorticated before bone grafting. Adequate decortication provides a good blood supply to the bone healing surface as well as the necessary cytokines (e.g., BMP, etc.) and bone marrow osteoblasts. The atlas posterior arch can not provide enough blood supply, osteoblasts and cytokines for osteogenesis if the cortex is removed insufficiently; if the cortex is removed too much, the fracture of the posterior arch of the atlas is easy to cause, and the bone grafting fusion is also not facilitated.
SUMMERY OF THE UTILITY MODEL
The utility model aims at providing a through way of escape atlantoaxial lateral mass joint fusion fixer, can realize the atlantoaxial fusion under the condition that the atlas posterior arch is deficient to avoid the occipital neck to fuse, with reduce the wound as far as possible, remain the rotatory activity degree of patient's postoperative cervical vertebra.
In order to achieve the above purpose, the utility model adopts the following technical scheme:
the utility model discloses a through way of escape atlantoaxial lateral mass joint fusion fixer, support bone grafting part, fixed plate, adapting unit, set screw including fusing the ware, it is equipped with the bone grafting chamber to fuse the ware support bone grafting part, adapting unit one end is connected and is fused the ware and support bone grafting part, and the fixed plate is connected to the other end, is equipped with the screw hole with the set screw adaptation on the fixed plate.
Preferably, the transverse section that the bone grafting part was supported to the integration ware is the bar, and the lateral wall at one of them long limit place is the cambered surface of indent, and the lateral wall at another long limit place is the cambered surface of evagination, and the integration ware supports the uplift of bone grafting part top surface.
Preferably, the bone grafting cavity is long arc-shaped and is matched with the inner shape of the atlantoaxial lateral mass joint.
Furthermore, the side wall of the fusion cage supporting the bone grafting component is provided with a plurality of through holes, and the through holes are communicated with the bone grafting cavity.
Preferably, the connection of the connection member to the fusion cage support bone graft member is capable of micromotion.
Preferably, one end of the connecting component is a spherical end, the other end of the connecting component is connected with the fixing plate, the spherical end is located in the side wall of the fusion cage supporting bone grafting component, a gap is reserved between the spherical end and the side wall of the fusion cage supporting bone grafting component, a hole for the connecting component to pass through is formed in the outer side wall of the fusion cage supporting bone grafting component, and the fixing plate is provided with a connecting component mounting hole.
As another preference, the connecting part is a buckle.
Preferably, the fixing plate is attached to the surface of the bone behind the atlantoaxial side block, the number of the screw holes is at least two, after the fixing plate is attached to the surface of the bone behind the atlantoaxial side block, the screw holes are located on the inclined part of the fixing plate, and the fixing screws are used for connecting the fixing plate to the atlantoaxial.
Preferably, the fixing screw and the fixing plate can slightly move.
Preferably, the fusion cage supporting bone grafting part is made of PEEK material or medical titanium alloy material, and the fixing plate is made of titanium alloy material or absorbable screw. Of course, the fusion cage supporting bone grafting part can also adopt other fusion cage materials, and the fixing plate can also adopt other orthopedic implant fixing materials.
The utility model has the advantages as follows:
1. the utility model more meets the biomechanical requirements of cervical vertebra
The previous research shows that under the physiological state, the longitudinal pressure load of the atlantoaxial intervertebral is mainly transmitted to the lower cervical vertebra through the lateral mass of the atlantoaxial, and certain stress stimulation can promote the fusion of bone grafting. Therefore, more reasonable fusion should occur on the bilateral lateral mass articular surfaces, thereby relieving the tensile stress to which the bone graft is subjected during fusion behind the atlas to a certain extent.
2. The utility model discloses can be fit for going to plant the bone and fuse according to the anatomical features of atlantoaxial side piece joint
The upper and lower articular surfaces of the atlantoaxial lateral mass joint are mutually inosculated and are similar to an ellipse, previous researches prove that the bone grafting area of the joint is sufficient, the peripheral blood circulation is rich, the bone grafting distance between the lateral mass joints is more than 1cm, the creeping replacement distance and the required time of the new bone are both short, and the fast fusion of the bone grafting is facilitated.
3. The utility model discloses can increase and plant the bone point, further improve and plant the bone in the amalgamation rate atlantoaxial side piece joint than the tradition way of escape and plant the bone fusion multiplicable two and plant the bone fusion point to show the rotational stability who increases the atlantoaxial, can effectively improve and plant the bone fusion rate.
4. The utility model discloses can avoid occipital neck to fuse under the condition that the arcus posterior atlantis is absent
The fusion cage supports the bone grafting part and is combined with the reliable posterior fixation phase, and the atlantoaxial fusion can be realized under the condition of atlas posterior arch defect, so that the occipital-cervical fusion is avoided, the wound is reduced as far as possible, and more cervical vertebra mobility is reserved as far as possible.
5. The utility model adopts the atlas-axis joint anatomy adhesive dress structural design, the contact area is large and more stable.
6. The bone grafting space of the utility model is large.
7. The utility model has the advantages of small volume and convenient operation, and can be operated and implanted under a special matching minimally invasive channel.
8. The utility model discloses to the anatomical dimension in atlantoaxial side piece joint clearance, design into the arc of subsides clothes, the fixed plate of the surrounding of subsides clothes is designed into to outside fixed plate, can increase its adherence nature, stability.
9. The fixed plate that pastes the outside of clothes and the direction of screw hole is fixed, conveniently implants the screw, avoids the fusion cage position bad, avoids the screw to implant structures such as intraductal or damage peripheral nerve blood vessel.
10. The external surrounding fixation plate, which is conformable, allows for the position of the fusion cage supporting the bone graft member to be determined without falling out of the spinal canal or lateral shifting during implantation. The safety and the convenience of the implantation of the fusion device are improved.
Drawings
FIG. 1 is a schematic view of the posterior atlantoaxial lateral mass joint location;
fig. 2 is a schematic view of a cross-section of the present invention;
FIG. 3 is a schematic view of a fixation plate;
fig. 4 is a schematic view of the usage state of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more clearly understood, the present invention is further described in detail below with reference to the accompanying drawings.
As shown in fig. 2, fig. 3, fig. 4, the utility model discloses a through way of escape atlantoaxial lateral mass joint fusion fixer, support bone grafting part 1, fixed plate 2, adapting unit 3, set screw 4 including fusing the ware, fuse ware support bone grafting part 1 and be equipped with bone grafting cavity 11, adapting unit 3 one end is connected and is fused the ware and support bone grafting part 1, and fixed plate 2 is connected to the other end. The fusion cage supports the connection between the bone grafting part 1 and the fixing plate 2 to be capable of moving slightly.
The fixing plate 2 is provided with a screw hole 22 matched with the fixing screw 4; the fixing plate 2 is attached to the surface of the bone behind the atlantoaxial side block, the number of the screw holes 22 is at least two, after the fixing plate 2 is attached to the surface of the bone behind the atlantoaxial side block, the screw holes 4 are located on the inclined portion of the fixing plate 2, the fixing screws 4 are automatically guided, the screws can be automatically screwed into a safe area in the implantation process, and the spinal cord and the artery cannot be damaged.
The fixing screw 4 is used for connecting the fixing plate 2 to the atlantoaxial, and the fixing screw 4 and the fixing plate 2 can slightly move.
The fusion cage supporting bone grafting component 1 is made of PEEK material or medical titanium alloy material, and the fixing plate 2 is made of titanium alloy material or absorbable screw. Of course, the fusion cage supporting bone grafting component 1 can also be made of other fusion cage materials, and the fixing plate 2 can also be made of other orthopedic implant fixing materials.
The transverse section of the fusion cage supporting bone grafting component 1 is strip-shaped, the side wall of one long edge is an inward concave cambered surface, the side wall of the other long edge is an outward convex cambered surface, and the top surface of the fusion cage supporting bone grafting component is bulged upwards; the fusion cage supporting bone grafting component 1 is provided with a metal mark; the bone grafting cavity 11 is in a long arc shape; the side wall of the fusion cage supporting bone grafting component 1 is provided with a plurality of through holes 12, and the through holes 12 are communicated with a bone grafting cavity 11; the diameter of the through hole 12 is 0.5-2 mm, preferably 1 mm.
One connection mode of the fusion cage supporting bone grafting component 1 and the fixing plate 2 is as follows: one end of the connecting component 3 is a spherical end 31, the other end is fixedly connected with the fixing plate 2, the spherical end 31 is positioned in the side wall of the fusion cage supporting bone grafting component 1, a gap is reserved between the spherical end 31 and the side wall of the fusion cage supporting bone grafting component 1, the spherical end 31 can slightly move in the side wall of the fusion cage supporting bone grafting component 1, the outer side wall of the fusion cage supporting bone grafting component 1 is provided with a hole for the connecting component 3 to pass through, and the fixing plate is provided with a connecting component mounting hole 21; the number of the connecting members 3 may be 1 or two.
Another connection mode of the fusion cage supporting bone grafting part 1 and the fixing plate 2 is a snap connection.
As shown in figure 1, the fusion cage supporting bone grafting part 1 of the utility model is a part 400 which is installed at the posterior atlantoaxial lateral mass fusion, and compared with the prior art, the gap is smaller, the creeping substitution distance of the bone is shorter, more stress stimulation can be received, and the bone grafting fusion is easier. And the operation is simple, and the fixing mode is safe and reliable.
Specifically, the method comprises the following steps:
the utility model comprises a bone grafting part 1 supported by a fusion device with a bone grafting cavity, a fixing plate 2 which is in a pasting and surrounding structure with the bone surface at the back of the atlantoaxial lateral mass joint, a connecting part 3 between the fixing plate and the atlantoaxial lateral mass joint and a screw 4;
the fusion cage supporting bone grafting part 1 is slightly arc-shaped on a coronal plane when viewed from the back, is in a long-strip kidney shape on a plane when viewed from the top, and has a certain radian, because the articular surface is cambered and dome-shaped, the fusion cage supporting bone grafting part can be contacted with the articular surface to the maximum extent, thereby providing enough support and stability, increasing the contact surface and increasing the bone grafting space; the fusion cage supporting bone grafting component 1 is made of mature PEEK material, and the tail part of the fusion cage is provided with a metal mark for determining the position of the fusion cage under perspective; the fusion cage supporting bone grafting component 1 is internally provided with a long arc-shaped bone grafting cavity 11; the side wall is provided with a plurality of small through holes 12 with the diameter of 0.5-2 mm, preferably about 1mm, which are convenient to be communicated with surrounding tissues and promote blood, cells and the like to flow in to provide cells, cell factors and the like required by fusion; a special connecting hole is arranged at a position close to the fixed plate 2, and the connecting bolt and the fusion device supporting part can have slight micromotion, so that stress is prevented from being concentrated on the steel plate and the fixed bolt.
The fixing plate 2 is made of titanium alloy, is in a joint and surrounding structure with the bony surface behind the atlantoaxial lateral mass, can be automatically adhered after being installed, and assists the surgeon to determine the position of the fixing plate; after the fixing plate 2 is positioned, the position of the fusion cage for supporting the bone grafting part 1 is also determined, and the position is just in the preset atlantoaxial joint cavity, so that the nerve and blood vessel damage caused by the deviation is reduced; after the position of the fixing plate 2 is determined, the position of the screw hole on the fixing plate 2 is also determined, the direction of the screw hole can be determined in advance, and an operator can implant the screw into the safe screw placing area according to the set screw direction, so that the safety and the convenience of screw implantation are improved, and the difficulty of an operation is reduced.
The surrounding fit design can also increase the stability of the whole fixing system;
one side of the connecting component 3 is connected with the fusion cage supporting component 1, and the other side is connected with the fixing plate 2, one end of the connecting component 3 is spherical in the fusion cage, and a certain micro-motion is allowed to exist; the other side of the fusion cage is integrated with the connecting part 3, the connecting part 3 is very short, and only a 0.5mm gap exists between the PEEK material of the fusion cage and the fixing plate 2;
the direction of the screw hole on the fixing plate 2 is determined, and when the position of the fixing plate is determined, the direction of the screw hole points to a nail placing safety area, so that the fixing plate is convenient to implant; meanwhile, a certain micro-motion exists between the implanted screw and the fixing plate 2, stress concentration is avoided, and a locking device for preventing screw withdrawal is adopted.
Of course, the present invention may have other embodiments, and those skilled in the art may make various corresponding changes and modifications according to the present invention without departing from the spirit and the essence of the present invention, and these corresponding changes and modifications should fall within the protection scope of the appended claims.
Claims (10)
1. A posterior atlantoaxial lateral mass joint fusion fixator is characterized in that: including fusing ware support bone grafting part, fixed plate, adapting unit, set screw, it is equipped with the bone grafting chamber to fuse the ware support bone grafting part, adapting unit one end is connected and is fused the ware and support bone grafting part, and the fixed plate is connected to the other end, is equipped with the screw hole with the set screw adaptation on the fixed plate.
2. The posterior atlantoaxial lateral mass fusion fixator of claim 1, wherein: the transverse section that fuses the ware and supports the bone grafting part is the bar, and the lateral wall at one of them long limit place is the cambered surface of indent, and the lateral wall at another long limit place is the cambered surface of evagination, fuses the ware and supports the uplift that bone grafting part top surface upwards.
3. The posterior atlantoaxial lateral mass fusion fixator of claim 1, wherein: the bone grafting cavity is in a long arc shape and is matched with the inner shape of the atlantoaxial lateral mass joint.
4. The posterior atlantoaxial lateral mass fusion fixator of claim 1, wherein: the side wall of the fusion cage supporting bone grafting component is provided with a plurality of through holes, and the through holes are communicated with the bone grafting cavity.
5. The posterior atlantoaxial lateral mass fusion fixator of claim 1, wherein: the connection of the connecting component and the fusion cage supporting bone grafting component can be slightly moved.
6. The posterior atlantoaxial lateral mass fusion fixator of claim 5, wherein: one end of the connecting component is a spherical end, the other end of the connecting component is connected with the fixing plate, the spherical end is positioned in the side wall of the fusion cage supporting bone grafting component, a gap is reserved between the spherical end and the side wall of the fusion cage supporting bone grafting component, the outer side wall of the fusion cage supporting bone grafting component is provided with a hole for the connecting component to pass through, and the fixing plate is provided with a connecting component mounting hole.
7. The posterior atlantoaxial lateral mass fusion fixator of claim 5, wherein: the connecting part is a buckle.
8. The posterior atlantoaxial lateral mass fusion fixator of claim 1, wherein: the fixing plate is attached to the surface of the bone behind the atlantoaxial side block, at least two screw holes are arranged, the screw holes are located on the inclined portion of the fixing plate after the fixing plate is attached to the surface of the bone behind the atlantoaxial side block, and the fixing screws are used for connecting the fixing plate to the atlantoaxial.
9. The posterior atlantoaxial lateral mass fusion fixator of claim 8, wherein: the fixing screw and the fixing plate can slightly move.
10. The posterior atlantoaxial lateral mass fusion fixator of claim 1, wherein: the fusion cage supporting bone grafting part is made of PEEK material or medical titanium alloy material, and the fixing plate is made of titanium alloy material or absorbable screw.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202021783756.5U CN213697364U (en) | 2020-08-24 | 2020-08-24 | Posterior atlantoaxial lateral mass joint fusion fixator |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202021783756.5U CN213697364U (en) | 2020-08-24 | 2020-08-24 | Posterior atlantoaxial lateral mass joint fusion fixator |
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| CN213697364U true CN213697364U (en) | 2021-07-16 |
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| CN202021783756.5U Active CN213697364U (en) | 2020-08-24 | 2020-08-24 | Posterior atlantoaxial lateral mass joint fusion fixator |
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| CN (1) | CN213697364U (en) |
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