CN218792654U

CN218792654U - Sacrum prosthesis

Info

Publication number: CN218792654U
Application number: CN202222045071.6U
Authority: CN
Inventors: 赵浩鑫; 岳术俊; 荀世界; 董浩; 许奎雪
Original assignee: Xingtai Langtai Benyuan Medical Instrument Co ltd; Beijing Chunlizhengda Medical Instruments Co Ltd
Current assignee: Xingtai Langtai Benyuan Medical Instrument Co ltd; Beijing Chunlizhengda Medical Instruments Co Ltd
Priority date: 2022-08-04
Filing date: 2022-08-04
Publication date: 2023-04-07
Anticipated expiration: 2032-08-04

Abstract

The utility model discloses a sacrum prosthesis, belonging to the medical technical field; the solid structure of the prosthesis mainly comprises a left wing part used for connecting the left ilium of a patient, a right wing part used for connecting the right ilium of the patient and a middle part used for connecting the healthy sacrum or the fifth lumbar vertebra of the patient; the left wing part, the right wing part and the middle part are of an integrated structure; the left wing part and the right wing part are folded inwards and are in mirror symmetry; the bottom of the middle part is provided with a connecting section which faces to two sides and is used for connecting the left wing part and the right wing part; a sacral foramen for transnervous is also provided between the left and middle wing portions and between the right and middle wing portions; the sacral aperture is positioned directly above the corresponding connecting segment. The utility model discloses can hang down the operation degree of difficulty, increase the adaptability of false body and sclerotin, size error between patient's sacrum and the sacrum false body after can effectual control operation makes the sacrum false body physical stamina and patient phase-match.

Description

Sacrum prosthesis

Technical Field

The utility model relates to the technical field of medical prosthesis, in particular to sacral prosthesis.

Background

The sacrum is formed by fusing five sacral vertebrae and is in an inverted triangle. The wide face at the upper end of the sacrum and the 5 th lumbar vertebra are combined to form a lumbosacral angle, and the two sides are connected with the ilium through sacroiliac joints. The sacrum, which is the root of the human spine and the central part of the pelvis, directly determines the stability of the pelvis and the stability of the spine.

The sacral tumor is a common disease in the related diseases of the sacrum, the common benign tumor of the sacrum comprises osteoblast tumor, giant cell tumor of the bone, aneurysmal bone cyst and the like, and the common malignant tumor of the sacrum comprises chordoma, chondrosarcoma and the like. With the continuous development of surgical technology, the pathogenesis characteristics of the sacral tumor and the biological characteristics of different sacral tumors are deeply understood, and an ideal surgical margin can be obtained by planned sacral nerve sacrifice, so that the surgical treatment of the sacral malignant tumor generally can obtain relatively good treatment effect. For patients with sacral tumors, a partial complete resection or even a complete resection of the sacrum is often required, and sometimes a partial resection of the ilium is also required to enlarge to obtain a satisfactory margin of cut, but the curvature and shape of the spine, the angle of the pelvis, the shape of the sacrum and the like are different for different patients, which poses many problems for reconstruction of the sacral function of the patients after surgery.

The prior art sacral prosthesis has the following problems:

1. the size is not matched with the actual requirement.

2. After the whole sacrum of a patient is removed, the sacrum is not connected with one another, the whole weight of the upper body cannot be transmitted to the lower limbs through the pelvis, and the human body cannot stand or walk.

3. The traditional fixing system of the nail rod and the lateral connecting block is easy to break and loosen, and the problems of lumbar vertebra subsidence and pelvic ring separation can also occur.

4. The combination degree of the prosthesis and the lumbar vertebra bone surface and the later bone growth effect are poor, and meanwhile, the problem of structural design for increasing the long-term biological fixation of the prosthesis is lacked.

5. The prior art has the problem of functional deficiency of a human body caused by complete resection of the sacrum due to sacral tumor.

6. The problem that the prosthesis cannot be installed or the prosthesis is seriously dislocated with the osteotomy surface after the prosthesis is installed due to inaccurate osteotomy in the operation is solved, a selective scheme in the operation is lacked, and the operation difficulty is increased.

SUMMERY OF THE UTILITY MODEL

In view of the above problems in the background art, the present invention provides a sacral prosthesis. The prosthesis can reduce the operation difficulty, increase the adaptability of the prosthesis and the bone, and effectively control the size error between the sacrum of a patient after the operation and the sacrum prosthesis, so that the sacrum prosthesis can be matched with the patient.

In order to achieve the above purpose, the utility model adopts the following technical scheme:

a sacral prosthesis comprising a plurality of screws, and further comprising a solid structure; the solid structure mainly comprises a left wing part used for connecting the left ilium of the patient, a right wing part used for connecting the right ilium of the patient and a middle part used for connecting the healthy sacrum or the fifth lumbar vertebra of the patient; the left wing part, the right wing part and the middle part are of an integrated structure; the left wing part and the right wing part are folded inwards and are in mirror symmetry; the bottom of the middle part is provided with a connecting section which faces to two sides and is used for connecting the left wing part and the right wing part; a sacral foramina structure for denervation is also provided between the left and middle alar portions and between the right and middle alar portions; the sacral foraminal structure is positioned directly above the corresponding connecting segment;

countersunk head screw holes are formed in the left wing part, the right wing part and the middle part, and the countersunk head screw holes correspond to the screws one to one;

the connecting section of the middle part is provided with a universal nail hole for connecting with the fifth lumbar vertebra.

Further, the left wing part and the right wing part are both triangular structures.

Further, the threaded section of the screw is located outside the solid structure.

Further, the lateral sides of the left wing part and the right wing part are provided with trabecular bone layers.

Further, the top of the middle portion has a trabecular bone structure.

Further, the sacral foramina structure is a U-shaped groove.

The utility model adopts the beneficial effects of the above technical scheme to produce lie in:

1. the design of prior art false body is a whole, and the false body is the same with the sclerotin form that originally excision was cut off, because original sclerotin has already been amputated, the unordered state appears in the soft tissue that leaves, has the sutural problem of hardly packing into in the art like this, the utility model discloses well refer to the sclerotin form, dwindle the shape of false body as far as, install and settle free soft tissue ligament of rule more easily in the art like this.

2. The artificial body of prior art designs too and crosses the slabby, if the osteotomy is not accurate in the doctor's operation, the artificial body of prior art can be improper to directly lead to the unable installation to pack into or just load into and can't laminate each osteotomy face completely, the partial structure of false body is unsettled like this, the design has just lacked meaning stability and also can be unreliable, and the utility model discloses in adopt to cut the installation of false body in the supplementary art of bone baffle, can make things convenient for the doctor to cut the bone, reduce the operation degree of difficulty, increased the suitability of false body with sclerotin again, size error between patient's sacrum and the sacrum false body after can effectual control, make sacrum false body can and patient phase-match.

3. The cracked condition of nail stick appears easily in the fixing system of traditional nail stick with side connecting block among the prior art, and the nail stick system of adopting in this design is comparatively stable, and the use of universal nail can adjust nail stick and prosthetic connection fixed direction and angle at will, and the use of pedicle of vertebral arch makes prosthetic and sclerotin connect more stably.

4. In the prior art, the bone ingrowth effect of the prosthesis and the sclerotin is poor, the long-term biological fixation of the prosthesis is lacked, the prosthesis in the design adopts a bone trabecula structure on the sacrum osteotomy surface to facilitate the bone ingrowth, and the long-term combination of the sclerotin and the prosthesis can be achieved.

5. In the prior art, partial function of a human body is lost after the sacrum is resected, and the prosthesis in the design can reserve normal bone as much as possible after the tumor is completely resected and preserve partial functions of a patient.

6. The sacrum prosthesis in the prior art adopts a method of not reserving a sacrum hole part, so that sacral nerves are positioned everywhere and influence is caused to a patient.

Drawings

Fig. 1 is a schematic structural diagram of an embodiment of the present invention.

Fig. 2 is a schematic diagram of a simulation installation according to an embodiment of the present invention.

Fig. 3 is a schematic view of the position of the sacral back guide in an embodiment of the invention.

Fig. 4 is a schematic view showing the positions of the left and right iliac guides of the embodiment of the present invention.

Fig. 5 is a schematic view of the position of the front sacral guide plate in an embodiment of the invention.

In the figure: 01-1, a sacrum prosthesis solid structure, 01-2, a sacrum hole structure, 01-3, a sacrum prosthesis bone trabecular structure, 01-4, screws, 02-1, a sacrum back guide plate, 02-2, a left ilium guide plate, 02-3, a right ilium guide plate, 02-4, a sacrum front guide plate, 03-1, universal nails, 03-2 and nail rods; 03-3, pedicle screws; 4. the left ilium; 5. lumbar vertebrae; 6. a sacrum; 7. the right ilium.

Detailed Description

The present invention will be further described with reference to the accompanying drawings and specific embodiments.

In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings of the embodiments will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art that other drawings can be obtained according to these drawings without inventive labor.

A sacral prosthesis comprising a plurality of screws, and further comprising a solid structure; the solid structure mainly consists of a left wing part for connecting the left ilium of the patient, a right wing part for connecting the right ilium of the patient and a middle part for connecting the healthy sacrum or the fifth lumbar vertebra of the patient; the left wing part, the right wing part and the middle part are of an integrated structure; the left wing part and the right wing part are folded inwards and are in mirror symmetry; the bottom of the middle part is provided with a connecting section which faces to two sides and is used for connecting the left wing part and the right wing part; a sacral foramina structure for transnervousing is also provided between the left and middle wing portions and between the right and middle wing portions; the sacral foraminal structure is positioned directly above the corresponding connecting segment;

Further, the top of the middle portion has a trabecular bone structure.

Further, the sacral foramina structure is a U-shaped groove.

The following is a more specific example:

referring to fig. 2, the device is mainly composed of three parts, namely a prosthesis part 01, a guide plate part 02 and a nail rod system 03.

The sacral prosthesis 01 mainly comprises a sacral prosthesis solid structure 01-1, a sacral foramen structure 01-2, a sacral prosthesis trabecular structure 01-3 and screws 01-4.

The guide plate part 02 mainly comprises a sacrum back guide plate 02-1, a left ilium guide plate 02-2, a right ilium guide plate 02-3 and a sacrum front guide plate 02-4.

The nail-rod system 03 mainly comprises a universal nail 03-1, a nail rod 03-2 and a pedicle screw 03-3.

A solid prosthesis structure part 01-1, a sacrum foramen structure 01-2 and a trabecular bone structure 01-3 of the sacrum prosthesis 01 are integrally formed by 3D printing, and the whole sacrum prosthesis has a three-part structure. The surface of the solid structure is polished, the sacrum foramen structure needs to be polished, the trabecular bone structure part is blunt-ended at an acute angle, and the thickness is 4mm.

The driving nail is a self-tapping screw, the maximum length which can be driven in the operation is measured and given, namely the maximum reference length which can give a limit, the specific use length can be selected according to the requirement in the operation, the diameter of the nut of the screw and the bolt is 8mm, and the nail thickness is 6mm; the prosthesis part, the bolt and the screw are made of titanium alloy materials harmless to the human body.

The sacrum prosthesis solid structure 01-1 is a main body of the sacrum prosthesis, the sacrum prosthesis solid structure has the function of replacing the resected sacrum and part of ilia on two sides, soft tissues cannot be damaged, a plurality of nail positions are arranged on the surface of the sacrum prosthesis solid structure, and the nail positions are designed by countersunk heads and solid nail channels, so that the driven bone nails can be completely sunk into the prosthesis. Because the sacrum is special and is full of a plurality of nerves, sacral foramen and various soft tissues, the requirements on the cloth nails are relatively strict, the inserted nails are required to be ensured not to damage the nerves, the sacral foramen and other parts, and the cloth nails are arranged as many as possible, so that the multi-nail position also provides more selectivity for the doctor in the operation, and the doctor can select according to the specific conditions in the operation and can drive the nails only at the required positions. The overall shape of the sacrum prosthesis is much smaller than that of the original sacrum, the sacrum prosthesis is not designed according to the original shape of the sacrum during the design of the prosthesis, after the original bone is removed, the arrangement sequence of soft tissues is disordered from regular to disordered, and the space in a human body cannot be well utilized as before.

The sacral prosthesis sacral foramina structure 01-2 is located at the sacral foramina position of the sacrum, considering that part of nerves need to pass through the sacral foramina, the sacral foramina is designed according to the physiological characteristics of the sacrum, the nerves can smoothly pass through the sacral foramina structure of the sacral prosthesis in the operation, and the structure needs to be polished.

The sacrum prosthesis bone trabecular structure 01-3 is positioned on the osteotomy surface, the thickness is 5mm, the bone trabecular structure aims to facilitate the bone of a patient to grow in the structure and reach the bone of the prosthesis and the bone to grow in, the long-term stable effect of the prosthesis in the body of the patient can be achieved, and the size of the structure is basically the same as that of the osteotomy surface in order to ensure sufficient bone growth.

Screws 01-4, which are the means for fixing the prosthesis to the patient's bone, connect the prosthesis to the bone by means of the screws.

The prosthesis osteotomy guide plate 02 mainly comprises a sacrum back guide plate 02-1, a left ilium guide plate 02-2, a right ilium guide plate 02-3 and a sacrum front guide plate 02-4. Before the patient is cut, the tumor condition needs to be known in advance, and the patient needs to be cut at a safe position. The guide plate is manufactured according to the bone shape, when a patient needs to perform an operation, the guide plate can be used for effectively controlling the size error between the sacrum and the sacrum prosthesis of the patient after the operation, so that the sacrum prosthesis can be matched with the patient, and the size and the shape of the sacrum prosthesis are accurately matched with the actual requirements of the patient.

The sacrum back guide plate 02-1 is placed on the back of the sacrum in an operation, positioning and bone cutting can be carried out on the sacrum, the guide plate is a baffle type guide plate, the guide plate is placed on the back of the sacrum, kirschner wire holes are formed in the guide plate, the guide plate is fixed through Kirschner wires, the sacrum can be kept as far as possible and nerve functions can be kept when the guide plate is used for cutting the sacrum on the basis of tumor removal, the guide plate is placed on the ilium on two sides, positioning is carried out according to prostheses on the two sides, the purpose of accurate bone cutting is achieved through line data or line drawing marks according to bone cutting grooves in the guide plate, and bone cutting can be carried out on two sides of the ilium and two sides of the sacrum according to the guide plate, and reference is made to fig. 3.

A left ilium guide plate 02-2 which is placed on the left ilium at the back position and positioned to cut the left ilium and the left side of the sacrum, and which uses a knife-slot type guide plate and can cut the bone by using a swing in the operation, see fig. 4.

A right ilium guide plate 02-3, which functions similarly to the left ilium guide plate 02-2, is positioned to cut the right ilium and right side of the sacrum, see fig. 4.

A sacral anterior guide plate 02-4 provided with a plurality of k-wire holes and capable of being removed in various ways with respect to a portion of the sacrum to be resected below the sacrum, according to the inserted plurality of k-wire holes as a resection line, referring to fig. 5.

The screw rod system 03 mainly comprises universal screws 03-1, screw rods 03-2 and pedicle screws 03-3, and the screw rod system can fix the prosthesis and the lumbar part and increase the stability of the prosthesis.

Referring to fig. 1, the solid structure is mainly composed of a left wing part for connecting the patient's left ilium, a right wing part for connecting the patient's right ilium, and a middle part for connecting the patient's healthy sacrum or fifth lumbar vertebra; the left wing part, the right wing part and the middle part are of an integrated structure; the left wing part and the right wing part are folded inwards and are in mirror symmetry; the bottom of the middle part is provided with a connecting section which faces to two sides and is used for connecting the left wing part and the right wing part; a sacral foramina structure for transnervousing is also provided between the left and middle wing portions and between the right and middle wing portions; the sacral foraminal structure is positioned directly above the corresponding connecting segment; countersunk head screw holes are formed in the left wing part, the right wing part and the middle part, and the countersunk head screw holes correspond to the screws one to one.

Claims

1. A sacral prosthesis comprising a plurality of screws, characterized by a solid structure; the solid structure mainly comprises a left wing part used for connecting the left ilium of the patient, a right wing part used for connecting the right ilium of the patient and a middle part used for connecting the healthy sacrum or the fifth lumbar vertebra of the patient; the left wing part, the right wing part and the middle part are of an integrated structure; the left wing part and the right wing part are folded inwards and are in mirror symmetry; the bottom of the middle part is provided with a connecting section which faces to two sides and is used for connecting the left wing part and the right wing part; a sacral foramina structure for transnervousing is also provided between the left and middle wing portions and between the right and middle wing portions; the sacral foraminal structure is positioned directly above the corresponding connecting segment;

countersunk head screw holes are formed in the left wing part, the right wing part and the middle part, and the countersunk head screw holes correspond to the screws one by one;

2. The sacral prosthesis as recited in claim 1, wherein said left and right alar portions are each of triangular configuration.

3. The sacral prosthesis of claim 1 wherein said threaded segment of said screw is located outside of said solid structure.

4. The sacral prosthesis of claim 1 wherein the lateral side of said left and right wing portions each have a trabecular bone layer.

5. The sacral prosthesis as recited in claim 1, wherein a top of said intermediate portion has a trabecular bone structure.

6. The sacral prosthesis as recited in claim 1, wherein said sacral foraminal structure is a U-shaped channel.