CN215129920U - Lumbar lateral-front anatomical minimally invasive steel plate - Google Patents
Lumbar lateral-front anatomical minimally invasive steel plate Download PDFInfo
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- CN215129920U CN215129920U CN202121374755.XU CN202121374755U CN215129920U CN 215129920 U CN215129920 U CN 215129920U CN 202121374755 U CN202121374755 U CN 202121374755U CN 215129920 U CN215129920 U CN 215129920U
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Abstract
The utility model relates to a lumbar vertebrae side the place ahead dissection type wicresoft steel sheet, including being used for attached steel sheet main part in lumbar vertebrae side the place ahead, the inboard transverse curvature of steel sheet main part is 0.60cm‑1(ii) a An upper through hole I and an upper through hole II are arranged in the upper half area of the steel plate main body, the outlet of the upper through hole I at the inner side is positioned on the side wall of the upper lumbar vertebral body, and the outlet of the upper through hole II at the inner side is positioned in the bone end plate area of the upper lumbar vertebral body; a lower through hole I and a lower through hole II are arranged in the lower half area of the steel plate main body, wherein the lower through hole I is arranged insideThe lateral outlet is positioned on the lateral wall of the lumbar vertebral body below, and the outlet of the lower through hole II on the inner side is positioned in the bony endplate area of the lumbar vertebral body below. The beneficial effects of the utility model are that fill the supporting internal fixation of present OLIF art machinery breach, help reducing main complication emergence risks such as the fusion ware subsides, improve postoperative curative effect.
Description
Technical Field
The utility model relates to an orthopedic instrument, in particular to a lumbar vertebra side-ahead dissection type minimally invasive steel plate.
Background
Oblique lateral lumbar interbody fusion (OLIF) is a currently emerging lumbar minimally invasive fusion technique, which mainly uses the cavity space between the anterior and lateral lumbar vascular sheaths located behind the peritoneum and the psoas major. The oblique lateral lumbar interbody fusion has the advantages of small tissue damage, less blood loss during operation, quick postoperative recovery and the like due to the unique surgical approach, and the probability of complications such as lumbar plexus injury is relatively low. Therefore, the current operation is rapidly popularized and applied clinically, and becomes an important operation for lumbar interbody fusion.
However, there are still some problems and deficiencies in clinical application of this approach. One of the outstanding problems is the lack of lumbar anterior lateral internal fixation instruments that match the procedure. At present, clinicians usually adopt the following two treatment methods, the first method is a stand-alone technology which adopts the simple placement of an anterior fusion cage without any additional internal fixation, and the method has the problems and disadvantages of insufficient immediate stability, easy fusion cage displacement, long post-operation braking time and the like; the second method is to add percutaneous pedicle screw internal fixation, but the method needs to be changed to a prone position under the general anesthesia state of a patient, and the posterior percutaneous pedicle screw internal fixation needs the patient and an operating doctor to receive a large amount of radioactive ray exposure, so that the operation time is long, the injury risk of the patient is increased, the medical expense is obviously increased, and other problems and disadvantages are caused.
If the side steel plate is simply and directly used for fixing, the following problems exist: (1) the design of the device lacks support of anatomical research data, so that the risk of damaging peripheral structures is high, and even the life of a patient is threatened; (2) a small number of screws may result in insufficient strength and stability, increasing the risk of internal fixation failure and non-fusion between the vertebrae.
Based on the clinical situation, designing, researching and developing a lumbar vertebra side front minimally invasive steel plate internal fixation system matched with the operation type is a task which needs to be solved urgently at present.
SUMMERY OF THE UTILITY MODEL
The utility model aims to overcome the defects of the prior art and solve the problem of minimally invasive steel plate modeling adaptation in the oblique lateral lumbar interbody fusion.
In order to achieve the above object, the present invention provides a lumbar vertebrae side front dissecting type minimally invasive steel plate, which comprises a steel plate main body attached to the lumbar vertebrae side front, wherein the transverse curvature of the inner side of the steel plate main body is 0.60cm-1The steel plate main body is divided into an upper half area which is attached to the lumbar vertebral body above the interbody fusion cage and a lower half area which is attached to the lumbar vertebral body below the interbody fusion cage; an upper through hole I for the penetration of a cortical bone screw and an upper through hole II for the penetration of a cancellous bone screw are arranged in the upper half area, an outlet of the upper through hole I at the inner side is positioned on the side wall of the upper lumbar vertebral body, an outlet of the upper through hole II at the inner side is positioned in the bone end plate area of the upper lumbar vertebral body, and the extending direction of the upper through hole II points to the inside of the upper lumbar vertebral body; the lower half is equipped with lower through-hole I that supplies the cortical bone screw to penetrate and supplies the lower through-hole II that the cancellous bone screw penetrates in the region, the export of through-hole I inboard is located below lumbar vertebrae centrum lateral wall down, the export of through-hole II inboard is located below lumbar vertebrae centrum bone end plate region down, the extending direction of through-hole II points to inside the lumbar vertebrae centrum below.
The steel plate is a non-limiting steel plate. An interbody fusion cage is arranged between the upper lumbar vertebral body and the lower lumbar vertebral body, and the upper half area and the lower half area are respectively positioned at two sides of the interbody fusion cage. The upper through hole I and the lower through hole I on the surface of the steel plate main body are matched with the cortical bone screw, no thread exists in the upper through hole and the lower through hole, the cortical bone screw is directly screwed in the operation to reach the cortex of the opposite side bone end plate, and double-cortical fixation is carried out. The upper through hole II and the lower through hole II are matched with the cancellous screws, and the upper through hole II and the lower through hole II are inclined relative to the axis of the lumbar vertebral body, so that the cancellous screws can be driven into the lumbar vertebral body joint from the bony endplate region of the lumbar vertebral body. The inner side of the steel plate main body is one side facing to the lumbar vertebra, and the outer side of the steel plate main body is one side far away from the lumbar vertebra.
Preferably, the central line of the upper through hole II and the lower through hole II at the outside inlet divides the steel plate body into an area adjacent to the abdominal aorta and an area far away from the abdominal aorta; the upper through holes I are respectively arranged in the area close to the abdominal aorta and the area far away from the abdominal aorta, and the lower through holes I are respectively arranged in the area close to the abdominal aorta and the area far away from the abdominal aorta.
Preferably, the distance between the inlets at the outer side of the two upper through holes I is smaller than that between the outlets at the inner side; the distance between the two lower through holes I at the outer side inlet is smaller than that at the inner side outlet.
Preferably, the length of the steel plate main body is 27mm adapting to the lumbar vertebra L2-3 or 35mm adapting to the lumbar vertebra L4-5.
The width of the steel plate main body can be designed to be 12-15 mm, and an operator can select the width according to the width of the operation window.
Preferably, the inner longitudinal curvature of the steel plate body is 6 degrees for adapting to the lumbar vertebra L2-3 segment or 15 degrees for adapting to the lumbar vertebra L4-5 segment.
When the lumbar vertebra fixing device is actually used, an operator can properly bend the preset longitudinal radian to further strengthen the anatomical fit between the lumbar vertebra fixing device and the lumbar vertebra and increase the fixing strength.
Preferably, the cortical screw has a diameter of 3.5mm and a length of any one of 25mm, 30mm, 35mm and 40 mm.
Preferably, the cancellous screw is 5.5mm in diameter and any one of 25mm, 30mm and 35mm in length.
The steel plate main body plays a role in limiting the movement of the screw and dispersing the stress of the screw. The cancellous bone screws face to the center of the vertebral body, the height of the vertebral body is fully utilized, and certain fixing strength is provided. The steel plate, the cortical bone screw and the cancellous bone screw have the synergistic effect of limiting the movement of the vertebral body, so that the intervertebral fusion rate is improved, the stress can be dispersed, the maximum stress borne by the fusion cage is reduced, and the sedimentation rate of the fusion cage is reduced.
Three screws are respectively arranged in the upper half area and the lower half area, so that three-point positioning is respectively formed in the upper half area and the lower half area, and stable positioning and fixing are realized in a limited space.
Two screws in the through hole I form an angle with each other, so that the anti-pull-out force is enhanced.
The beneficial effects of the utility model are that can help filling the supporting internal fixation of present OLIF art formula machinery breach, help reducing main complications such as the fusion ware subsides and take place the risk, improve postoperative curative effect. In addition, the application of the minimally invasive steel plate is beneficial to relieving the injury and radiation exposure of patients, accelerating the recovery of the patients and reducing the medical cost of the patients, and brings recent and long-term benefits to the patients, families and society.
Drawings
FIG. 1 is a schematic view of the assembled lumbar lateral-anterior anatomical minimally invasive steel plate of the present invention;
FIG. 2 is a schematic side view of the lumbar vertebrae after the assembly of the anatomical minimally invasive steel plate in lateral front of the lumbar vertebrae of the present invention;
FIG. 3 is a schematic perspective view of a main body of a minimally invasive steel plate for a lateral anterior anatomical lumbar spine of the present invention;
FIG. 4 is a front schematic view of a main body of a minimally invasive steel plate for a lateral front anatomical form of lumbar vertebrae;
wherein:
1-steel plate main body 2-interbody fusion cage 3-cortical bone screw
31-upper through hole I32-lower through hole I4-cancellous bone screw
41-upper through hole II 42-lower through hole II
Detailed Description
The present invention will be further described with reference to the accompanying drawings and specific embodiments.
The minimally invasive steel plate for the lateral front of the lumbar vertebra shown in fig. 1 to 4 comprises a steel plate main body 1 attached to the lateral front of the lumbar vertebra, wherein the steel plate main body 1 is divided into an upper half area attached to the lumbar vertebra above an interbody fusion cage 2 and a lower half area attached to the lumbar vertebra below the interbody fusion cage 2; an upper through hole I31 for cortical bone screws 3 to penetrate and an upper through hole II41 for cancellous bone screws 4 to penetrate are arranged in the upper half area, an outlet of the upper through hole I31 at the inner side is positioned on the side wall of the upper lumbar vertebral body, an outlet of the upper through hole II41 at the inner side is positioned in the bone end plate area of the upper lumbar vertebral body, and the extending direction of the upper through hole II41 points to the inside of the upper lumbar vertebral body; the lower half area is provided with a lower through hole I32 for the penetration of a cortical bone screw 3 and a lower through hole II42 for the penetration of a cancellous bone screw 4, the outlet of the lower through hole I32 at the inner side is positioned on the side wall of the lumbar vertebral body below, the outlet of the lower through hole II42 at the inner side is positioned in the bone end plate area of the lumbar vertebral body below, and the extending direction of the lower through hole II42 points to the inside of the lumbar vertebral body below.
The central connection line of the upper through hole II41 and the lower through hole II42 at the outside inlet divides the steel plate main body 1 into an area adjacent to the abdominal aorta and an area far away from the abdominal aorta; the upper through holes I31 are respectively arranged in the area adjacent to the abdominal aorta and the area far away from the abdominal aorta, and the lower through holes I32 are respectively arranged in the area adjacent to the abdominal aorta and the area far away from the abdominal aorta. The distance between the two upper through holes I31 at the outer side inlet is smaller than that at the inner side outlet; the distance between the two lower through holes I32 at the outer inlet is smaller than that at the inner outlet, so that an included angle is formed between the cortical screws 3.
The specific dimensions are designed as follows:
the length of the steel plate main body 1 is 27mm adapting to the lumbar vertebra L2-3 segment or 35mm adapting to the lumbar vertebra L4-5 segment. The width of the steel plate body 1 can be designed to be 12-15 mm for the selection of the operator.
The inner longitudinal radian of the steel plate main body 1 is 6 degrees adaptive to the lumbar vertebra L2-3 or 15 degrees adaptive to the lumbar vertebra L4-5. When the lumbar vertebra fixing device is actually used, an operator can properly bend the preset longitudinal radian to further strengthen the anatomical fit between the lumbar vertebra fixing device and the lumbar vertebra and increase the fixing strength. The transverse curvature of the inner side of the steel plate main body 1 is 0.60cm-1。
The diameter of the cortical bone screw 3 is 3.5mm, the length of the cortical bone screw is any one of 25mm, 30mm, 35mm and 40mm, and the cortical bone screw is selected according to the image data of the lumbar vertebral body during operation. The diameter of the cancellous screw 4 is 5.5mm, the length of the cancellous screw is any one of 25mm, 30mm and 35mm, and the cancellous screw is selected according to the image data of the lumbar vertebral body during operation.
The steel sheet, when used, represents a non-limiting steel sheet. An interbody fusion cage 2 is arranged between the upper lumbar vertebral body and the lower lumbar vertebral body, and the upper half area and the lower half area are respectively positioned at two sides of the interbody fusion cage 2. The upper through hole I and the lower through hole I on the surface of the steel plate main body 1 are matched with the cortical bone screw 3, no thread exists in the upper through hole and the lower through hole, the cortical bone screw 3 is directly screwed in the operation, the cortex of the opposite side bone end plate is reached, and double-cortical fixation is carried out. The inner side of the steel plate main body 1 is the side facing to the lumbar vertebra, and the outer side is the side far away from the lumbar vertebra. The upper and lower through holes II are matched with the spongy bone screws 4. The upper and lower through holes II are inclined relative to the axis of the lumbar vertebral body, so that the cancellous screws 4 are driven into the interior of the lumbar vertebral body from the area of the bony endplates of the articular surface of the lumbar vertebral body.
Biomechanical pre-experiments of three-dimensional finite element analysis were performed based on the L4-5 lumbar model. The preliminary experiment results show that the corresponding minimally invasive steel plates are applied to the lumbar vertebra models of the two sections, so that the mobility of the intervening sections can be reduced, the maximum stress of the fusion cage is reduced, and the sedimentation of the fusion cage and the risk of forming the intervertebral prosthetic joint are reduced. In addition, the result of preliminary experiments also shows that the minimally invasive steel plate has better effect than the conventional steel plate, and the failure risk of internal fixation of the scheme is not found to be higher than that of the bilateral pedicle screw fixation scheme.
In the motion state activity index data of each internal fixation scheme of the L4-5 segment, the scheme of the minimally invasive steel plate for lumbar lateral anterior anatomy is superior to a pedicle screw scheme and a lateral single nail bar and contralateral articular process screw scheme in the forward flexion and backward extension activity degrees, and superior to the lateral single nail bar and contralateral articular process screw scheme and the lateral single nail bar scheme in the left side flexion and right side flexion activity degrees.
In the maximum stress value data of the fusion cage in each motion state under each internal fixation scheme of the L4-5 segment, the index of the scheme of the lumbar side front anatomical minimally invasive steel plate is superior to that of a single fusion cage scheme, a side single nail rod scheme and a common steel plate scheme under the rear extension state, and the index of the scheme of the lumbar side front anatomical minimally invasive steel plate is superior to that of all the existing schemes under the front bending state, the left bending state, the right bending state, the left rotation state and the right rotation state.
In the internal fixation maximum stress value data of each motion state under each internal fixation scheme of the L4-5 segments, the index of the scheme of the anatomical minimally invasive steel plate at the front of the lumbar vertebra side is superior to that of a 'side single nail bar' scheme and a 'common steel plate' scheme under the right side bending state, and the index is superior to all the current schemes except that of a 'pedicle screw' scheme under the front bending state, the rear stretching state, the left side bending state, the right side bending state, the left rotation state and the right rotation state.
While the preferred embodiments of the present invention have been described in detail, it will be understood by those skilled in the art that the invention is not limited to the embodiments disclosed, and that various changes and modifications may be made, which are within the scope of the appended claims.
Claims (7)
1. The minimally invasive steel plate for lateral and front dissection of lumbar vertebra is characterized by comprising a steel plate main body attached to the lateral and front side of the lumbar vertebra, wherein the transverse curvature of the inner side of the steel plate main body is 0.60cm-1The steel plate main body is divided into an upper half area which is attached to the lumbar vertebral body above the interbody fusion cage and a lower half area which is attached to the lumbar vertebral body below the interbody fusion cage; an upper through hole I for the penetration of a cortical bone screw and an upper through hole II for the penetration of a cancellous bone screw are arranged in the upper half area, an outlet of the upper through hole I at the inner side is positioned on the side wall of the upper lumbar vertebral body, an outlet of the upper through hole II at the inner side is positioned in the bone end plate area of the upper lumbar vertebral body, and the extending direction of the upper through hole II points to the inside of the upper lumbar vertebral body; the lower half is equipped with lower through-hole I that supplies the cortical bone screw to penetrate and supplies the lower through-hole II that the cancellous bone screw penetrates in the region, the export of through-hole I inboard is located below lumbar vertebrae centrum lateral wall down, the export of through-hole II inboard is located below lumbar vertebrae centrum bone end plate region down, the extending direction of through-hole II points to inside the lumbar vertebrae centrum below.
2. The minimally invasive steel plate for lumbar lateral anterior anatomy according to claim 1, wherein a central line connecting the upper through hole II and the lower through hole II at the lateral entrance divides the steel plate body into an area adjacent to the abdominal aorta and an area away from the abdominal aorta; the upper through holes I are respectively arranged in the area close to the abdominal aorta and the area far away from the abdominal aorta, and the lower through holes I are respectively arranged in the area close to the abdominal aorta and the area far away from the abdominal aorta.
3. The minimally invasive steel plate for dissection of the front side of the lumbar vertebra according to claim 2, wherein the distance between the two upper through holes I at the outer side inlet is smaller than the distance between the two upper through holes I at the inner side outlet; the distance between the two lower through holes I at the outer side inlet is smaller than that at the inner side outlet.
4. The minimally invasive steel plate of the anterior lumbar lateral anatomy of claim 1, wherein the length of the steel plate body is 27mm adapted to lumbar vertebra L2-3 segment or 35mm adapted to lumbar vertebra L4-5 segment.
5. The minimally invasive steel plate of the anterior lumbar lateral anatomy of claim 1, wherein the medial longitudinal curvature of the steel plate body is 6 ° for lumbar vertebra L2-3 segment or 15 ° for lumbar vertebra L4-5 segment.
6. The minimally invasive steel plate for the anterior lumbar vertebra dissection according to claim 1, wherein the cortical screw has a diameter of 3.5mm and a length of any one of 25mm, 30mm, 35mm and 40 mm.
7. The minimally invasive steel plate for the lumbar lateral anterior anatomy according to claim 1, wherein the cancellous screw has a diameter of 5.5mm and a length of any one of 25mm, 30mm and 35 mm.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202121374755.XU CN215129920U (en) | 2021-06-21 | 2021-06-21 | Lumbar lateral-front anatomical minimally invasive steel plate |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202121374755.XU CN215129920U (en) | 2021-06-21 | 2021-06-21 | Lumbar lateral-front anatomical minimally invasive steel plate |
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| CN215129920U true CN215129920U (en) | 2021-12-14 |
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| CN202121374755.XU Active CN215129920U (en) | 2021-06-21 | 2021-06-21 | Lumbar lateral-front anatomical minimally invasive steel plate |
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