RU2541823C1 - Device for correction of displaced cervical articular process positions and method for using it - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: device for the correction of displaced cervical articular process positions comprises a composite body of a head and a cylindrical base, upper and lower supporting platforms, outer surfaces of which face the vertebral bodies and have pointed flanges. The upper supporting platform is mounted on the head of the composite body. The upper portion of the base comprises a T-flange, projection sides of which are guides for female grooves mounted in the lower portions of the head. The head and base are connected by a thread rod having smooth ends, a diameter of which is less than the diameter of the middle thread portion of the rod. One end of the rod is provided with a closed hole for a box spanner, is mounted in a transfer sleeve having a thread along the outer side surface and a slot at the end face. The sleeved rod is mounted in a through hole in the composite body perpendicular to its long axis. The threaded sleeve thread is created in the hole only in the portion of the base, while the thread of the middle of the threaded rod - on the portion of the head of the composite body. The device also comprises an end plate that can be detachably laid on the head of the composite body The upper surface of the above plate has a horizontal portion with notches inserted into the vertebral body at the side of the dislocation, while two adjacent smooth portions inclined at various angles are mounted on the side of the intact articular process. The lower supporting platform having four diametrical vertical notches on the side surface is integrated with vertical and central threaded rod having four long grooves, a position of which corresponds to the position of the above notches, and a recess on the free end. A cup with a through hole in the middle provided with a long projection is formed on the rod; the hole has the shape and size corresponding to the long grooves on the rod; the notch of the side surface is coaxial with the flange in the hole on the vertical threaded rod. The cup bottom comprises a nut having radical through holes along the mid-line of the outer surface. The vertical rod with the mounted nut is mounted in a step cylindrical cavity arranged axially in the cylindrical base of the composite body. The nut is provided in the cavity with the greater diameter open to the bottom of the cylindrical base. Along the outer surface of the bottom of the base and the inner surface of the cup, there is a thread used to flush connect these parts along the outer surface of the cup and base. There is a window formed from the cup bottom to the height of the nut by the surface section at the mid-diameter. The upper portion of the head comprises a T-flange identical to that on the base of the composite body, side flanges of which are guides for the female grooves mounted in the lower portions of the end plate. Along the inner horizontal surface of the plate, above the grooves, there is a rectangular hollow for mounting the upper supporting platform. Two thread holes for a retainer are created along the side surfaces of the base of the body, and one - along the front surface of the end plate under the horizontal flange. A method for the correction of displaced cervical articular process positions involves placing the patient on a table in the lying position with a roller placed under his/her shoulders under general anaesthesia, performing a standard approach to anterior structures of the vertebral body under its dislocated or fractured body with removing super- and subjacent disks and bone fragments. The above device is laid into the formed compartment. The end plate is laid on the head of the composite body; the angles on the upper surface of the plate shall correspond to the fracture nature, right- or left-sided, of a different height and length so that the upper horizontal platform of the end plate is arranged on the side of the dislocation close to the articular processes of the vertebrae, while its inclined surfaces faces the intact articular process. The nut is rotated with a special instrument, and a working end is alternatively inserted into radial surfaces to lift the composite body in relation to the lower supporting platform. That is followed by performing distraction until translation of the body along the vertical threaded rod along the lower supporting platform is blocked. The device is rotated with the instrument mounted into the holes on the side surfaces of the body. Geared articular processes of the vertebrae are disconnected by EOP control according to pre-calculated CT or visual data, the base is kept to be rotated until the flange on the cup bottom falls into the long groove on the vertical threaded rod. The distraction is reduced by rotating the nut backwards to place the dislocated articular process back into its physiological position. The distraction is kept to be released to enable removing the end plate with an instrument freely. Tension in the vertebral compartment with the installed device is created by generating slight distraction. The device is remained installed in the bed as a body-substitute implant. Layered sutures are applied.

EFFECT: more effective reduction of one-side dislocations and dislocation fractures of cervical spines, lower labour input and injuries accompanying manipulations, enabled prevention of potential undesired complications.

2 cl, 4 dwg

Description

The invention relates to medicine, in particular to spinal surgery, and can be used in the treatment of fractures of the cervical spine.

It is known that dislocations and fractures in the cervical spine are a frequent type of damage and are caused by a violation of the normal relationship between the articular processes of two adjacent vertebrae. A complete dislocation or some types of subluxations are most often accompanied by damage to the ligamentous apparatus, capsule of the synovial joints, rupture of the fibrous ring of the intervertebral disc, fracture of the body and arches of the vertebra, its articular processes. Depending on the mechanism of injury, dislocations can be unilateral and bilateral, mating, etc.

The basis for the treatment of dislocations and fractures of the cervical vertebrae is the timely elimination of the conflict between the contents of the spinal canal and the damaged vertebra, i.e. removal of the posterior-inferior articular process of the superior vertebrae dislocated anteriorly to the apex of the anterior-superior articular process of the underlying vertebra, its posterior movement and reduction downward. At the same time, due to the concomitant disorders indicated above, these manipulations may not be feasible and very time-consuming, as well as cause additional neurological and vascular complications due to overstretching of the vertebral artery, trauma to the spinal cord and its roots, insertion of bone fragments and disc into the spinal canal.

Known telescopic vertebral system TeCorp [1], which allows to replace the body of the cervical vertebra and restore the intervertebral distance, as well as provide lordosis from 0 to 7 ° using modulated end plates. This system is not adapted and is not used to reposition dislocations of the vertebrae, since with its help only distraction and the creation of the corresponding lordosis are carried out, there is no reposition mechanism.

The closest to the proposed device is a universal prosthesis of the vertebral body for the treatment of fractures and stabilization of the cervical spine [2], designed to eliminate dislocation and fracture of the vertebra by separating the articular processes of the dislocated and underlying vertebrae and returning the displaced vertebra to its physiological position. However, with unilateral dislocations during spinal distraction, both articular processes of the overlying vertebra rise, i.e. the intact vertebra is traumatized, and when it is fractured during the displacement of the dislocated vertebra and installation to the articular sites, the process can move to the spinal canal.

Existing methods for reposition of dislocations of the cervical vertebrae are currently based on the principle of leverage. So, the method according to Rüsch-Gueter [3] includes: 1) traction over the head; 2) with a unilateral dislocation perform lateral flexion in the direction opposite to the dislocation, with the axis of inclination at the level of dislocation; and with bilateral dislocation - one side is conditionally taken as “healthy”; 3) rotation of the head and neck towards dislocation. During the operation, the torso is fixed to the table with straps or a special belt, on the patient’s head is attached a Glisson loop, the straps of which are tied to the lower back of the surgeon, standing at the head of the patient. An assistant is standing on the side. Then carry out the above methods. However, this requires additional devices and an assistant, and, most importantly, there is no visual control and dosed distraction with the dislocated vertebra moving posteriorly, which does not always allow us to obtain the desired result, and various complications may even develop.

A known method of treating injuries of the cervical spine [4], including discectomy and spinal fusion with a plate fixed in a state of deformation on adjacent vertebral bodies, where the reduction of the displaced vertebra is carried out with a compression (reduction) screw, and the plate is used as a support. The disadvantages of this method include the impossibility of repositioning with coupled and unilateral dislocations, since the anatomical relationships of the articular processes are not taken into account, the element of distraction is completely absent.

The aim of the invention is to provide a device for correcting the positions of the displaced articular processes of the cervical vertebrae while eliminating dislocations and fractures, and a method that allows using this device to make the mentioned correction.

The essence of the claimed invention consists in the combination of essential features sufficient to achieve the desired technical result, which allows to completely eliminate the displacement of the posterior-lower articular process of the overlying vertebra dislocated anteriorly.

The technical result consists in increasing the efficiency of reposition of unilateral dislocations and fractures of the cervical vertebrae, reducing the complexity and morbidity of manipulations, and the possibility of preventing undesirable complications.

The essence of the invention lies in the fact that the device for correcting the positions of the displaced articular processes of the cervical vertebrae contains a composite body of the head and cylindrical base, upper and lower supporting platforms, the outer surfaces of which are facing the vertebral bodies, have pointed protrusions, the upper supporting platform is made on the head of the composite case, in the upper part of the base a T-shaped protrusion is made, the protruding lateral parts of which are guides for the grooves of the reciprocal form located in the lower part STI head. The head and base are connected by a threaded rod having smooth ends whose diameter is less than the diameter of the middle threaded part of the rod. One end of the rod is equipped with a blind hole for the socket wrench, placed in the bushing, having a thread on the outer side surface, and a slot at the end. A rod with a sleeve is installed in the through hole in the composite housing, perpendicular to its longitudinal axis, while the thread for the threaded sleeve is cut in the hole only in the part belonging to the base, and the thread for the middle part of the threaded rod is cut into the part belonging to the head of the composite case. The device has an end plate that can be installed on the head of the composite housing with the possibility of removal. The upper surface of the said lining has a horizontal section with notches for insertion into the vertebral body on the side of the dislocation, and two adjacent smooth sections with an inclination at different angles are intended to be installed on the side of the intact articular process. The lower supporting platform, having four diametrically located vertical notches on the side surface, is made integral with a threaded rod installed vertically and centrally, having four longitudinal grooves, the position of which corresponds to the position of the said notches, and a groove at the free end. A glass is installed on the rod, having a through hole in the center of the bottom, equipped with a longitudinal protrusion, corresponding in shape and size to the longitudinal grooves on the rod, and a notch on the side surface located coaxially with the protrusion in the hole. On a vertical threaded rod, at the bottom of the glass, a nut is installed having radial through holes along the midline of the outer surface. A vertical rod with a nut installed on it is located in a stepped cylindrical cavity made along the axis of the cylindrical base of the composite housing. The nut is installed in a cavity with a large diameter open to the bottom of the cylindrical base. A thread is made on the outer surface of the lower part of the base and the inner surface of the glass to ensure that these parts are flush connected. A window is made along the outer surface of the glass and the base, from the bottom of the glass, to the height of the nut, by a longitudinal cut of the surface by half the diameter. A T-shaped protrusion is made in the upper part of the head, which is identical to the protrusion on the basis of the composite body, the lateral protrusions of which are guides for the grooves of the reciprocal form in the lower part of the end plate. On the inner horizontal surface of the lining, above the grooves, a rectangular recess is made for installing the upper supporting platform. Two threaded holes for the holding tool are made on the side surfaces of the housing base, and one on the front surface of the end plate under the horizontal protrusion.

The implementation of the reference site at the same time with a threaded rod installed vertically and in the center ensures the strength of the structure and its performance.

A glass mounted on the rod, having a through hole in the center of the bottom, equipped with a protrusion, with dimensions corresponding to the dimensions of said longitudinal grooves on the rod, has the ability to move along the grooves of the rod under the action of force.

Placing a vertical rod with a nut installed on it in a stepped cylindrical cavity made along the axis of the base, with the installation of a nut in a cavity with a large diameter open down to the cylindrical base, allows the nut to rotate in this cavity. The execution of the cavity, open down, provides the ability to install in it a rod with a nut. A step formed by the transition to an overlying cavity of a smaller diameter in which a vertical shaft is mounted prevents the nut from moving along the shaft.

Radial through holes located along the midline of the outer surface of the nut are designed to install a tool, the use of which makes it possible to rotate this nut on the shaft.

A window made on the outer surface of the glass and the base, from the bottom of the glass to the height of the nut, with a longitudinal cut to half the diameter, provides access to the holes for the tool to rotate the nut along the shaft.

The thread on the outer surface of the lower part of the base and the inner surface of the glass, providing a connection of these parts flush, creates a node for converting rotational motion into translational. When the nut rotates, the step in the cylindrical cavity of the base and the bottom of the cup prevent the longitudinal movement of the nut, while the cup, fastened with a protrusion in the bottom made on the inner surface of the hole, with one of the longitudinal grooves on the side surface of the vertical threaded rod, moves up along with the base of the composite case . The threaded connection made flush allows you to not increase the overall dimensions of the device, which must be installed in the prepared bed in the front part of the body of the damaged or underlying, located under the dislocated vertebra.

The implementation of four longitudinal grooves on the surface of the threaded rod facilitates the possibility of removing distraction after placing the vertebra in its physiological position, reduces the time of this manipulation. Four diametrically located vertical notches on the lateral surface of the support platform, the position of which corresponds to the position of the longitudinal grooves on the threaded rod, and the notch on the lateral surface of the glass, corresponding to the position of the protrusion in the hole, make it possible to determine the angle of the required rotation of the device during the operation.

A groove at the free end of the threaded rod allows rotation of the composite body with an end plate around the axis of the device using the tool in order to return the damaged vertebra to its place.

The grooves in the lower part of the end plate allow you to install and move it along the T-shaped protrusions of the reciprocal form on the head of the composite body as on the guides made in the upper part of the head.

A rectangular recess along the inner horizontal surface of the end plate above the grooves is made under the pointed protrusions on the head of the composite housing and provides the ability to install and move the plate on the T-shaped side protrusions of the head.

The end patch, which has a horizontal section on the upper surface, equipped with notches, and two smooth adjacent to it, with a slope at different angles, is used to eliminate one-sided dislocation of the vertebra and allows distraction without affecting the intact side. The return of the displaced vertebra to its physiological position occurs without traumatic manipulations; there is also no need for additional medical personnel and equipment.

Two holes for the holding tool, made on the side surfaces of the base of the housing, allow you to hold the device during installation and when removing the end plate.

A threaded hole for the holding tool, made on the front surface of the end plate, under the horizontal protrusion, allows you to install and remove the end plate.

The essence of the method for correcting the positions of displaced articular processes of the cervical vertebrae includes placing the patient on the table in a supine position with a roller placed under the shoulders under general anesthesia, standard access to the anterior structures of the cervical spine, resection of the anterior part of the vertebral body located under its dislocated or broken body, with the removal of higher and lower discs and bone fragments. A device for correcting the positions of the displaced articular processes of the cervical vertebrae is placed in the formed “niche”. In this case, the end plate is mounted on the head of the composite body, the angles on the upper surface of the plate must correspond to the nature of the dislocation, right- or left-sided, varying in height and length. The upper horizontal platform of the end lining should be located on the side of the dislocation, closer to the articular processes of the vertebra, and its beveled surfaces are set towards the intact articular process. Rotating the nut, using a special tool, alternately introducing the working end into the radial holes, lift the composite housing relative to the lower supporting platform. Distraction is carried out until the translational movement of the housing is completely blocked along the vertical threaded rod of the lower supporting platform. Carry out the rotation of the device with a tool installed in the holes on the side surfaces of the housing. Separation of the adhered articular processes of the vertebrae is determined by EOP control, according to preliminary calculations according to CT or visually. Continue the rotation of the base until the protrusion on the bottom of the glass enters the longitudinal groove on the vertical threaded rod. Reduce distraction by rotating the nut in the opposite direction, returning the dislocated articular process to its physiological position. Removal of distraction continues until the possibility of free removal of the end lining with the tool. To create a stress state in the "niche" of the vertebra with the installed device, a small distraction is again carried out. The device remains installed in the bed as a body-replacing implant. Layered seams.

During distraction of the lesion area by rotation of the nut along a threaded vertical rod, made integral with the lower supporting platform, using radial holes on the nut body, the introduction of pointed protrusions on the contact pads of the device, thereby securing the device in the created niche.

Holding the device with a holding tool installed in the holes on the side surfaces of the body during the distraction of the affected area helps prevent distortions and displacements in the position of the device.

Control of the separation of the articular articular processes of the dislocated vertebra ensures the correctness of the manipulations.

With a one-sided dislocation, the device is placed in a “niche” with an end plate mounted on the head of the body, taking into account the nature of the dislocation, right- or left-sided, varying in height and length so that the upper horizontal platform of the end plate is located on the side of the dislocation, closer to the articular processes of the vertebra, and its beveled surfaces are installed in the direction of the intact articular process, it is necessary to prevent trauma to intact or broken upper and lower articular processes.

Distraction to complete blockage of the translational movement of the body along a vertical threaded rod, the dimensions of which are guaranteed to ensure separation of the adhering processes, without trauma to the surrounding tissues and adjacent structures located in the fracture area.

Rotation with the help of a holding device installed in the holes on the side surfaces of the housing allows you to prepare the vertebra for installation in its physiological position.

When distraction is removed, the previously dislocated articular process returns to its physiological position without applying mechanical forces to the “intact” or “broken” articular process of the dislocated vertebra.

Removing the end lining with a tool installed in a blind threaded hole, while holding the device itself with a tool installed in the holes on the base of the composite body, restores the vertical axis of the spine.

The design of the device is illustrated by illustrations, where:

In FIG. 1 shows a front view of the device;

Figure 2 is a side view;

Figure 3 is a top view;

Figure 4 is a section aa.

A device for correcting the positions of displaced articular processes of the cervical vertebrae contains a support platform 1, the end surface of which is decorated with pointed protrusions, made at the same time with a threaded rod 2 installed vertically and centrally, having four longitudinal grooves 3 and a groove 4 at the free end. On the lateral surface of the support platform 1, longitudinal notches are applied coaxially to the grooves 3. A glass 6 is mounted on the rod 2, having a through hole 7 in the center of the bottom, equipped with a protrusion 8 for the longitudinal grooves 3 of the rod 2 and a notch 9, a pine protrusion 8. On a vertical threaded rod 2, a nut 10 is installed inside the cup 6, having radial through holes 11. The rod 2 with the cup 6 mounted on it and the nut 10 is located in a stepped cylindrical cavity 12, made along the axis and open with a large diameter down to the cylindrical base 13 of the composite housing 14. On the outer surface of the lower part of the base 13 and the inner surface of the glass 6, a thread 15 is made, which ensures the connection of the parts 13 and 6 flush. On the outer surface of the cup 6 and the base 13 from the bottom of the cup 6 to a height exceeding the height of the nut 10, a window 16 is made by a longitudinal cut of the surface by half the diameter 16. The upper end of the composite housing 14 is equipped with a head 17 mounted on the base 13, in the upper part of which T -shaped protrusion 18. The protruding lateral parts 19 of the protrusion 18 are guides for mates of a reciprocal shape located in the lower part of the head 17 having in the upper part a T-shaped protrusion 20 identical to the protrusion 18 of the base 13. The head 17 and the base 13 the main body 14 are connected by a threaded rod 21 having smooth ends whose diameter is smaller than the diameter of the middle threaded part of the rod 21, and are installed in diametrically located holes of the composite body 14. The end 22 of the rod 21 is equipped with a blind hole 23 for the socket wrench, located in the passage bush 24, having a thread on the outer side surface, and a slot 25 at the end.

The rod 21 with the sleeve 24 is installed in the through hole of the composite housing 14, perpendicular to its longitudinal axis, while the thread for the threaded sleeve 24 is cut in the hole only in the part belonging to the base 13, and the thread for the middle part of the threaded rod 21 is on the part belonging to the head 17 of the composite housing 14. The upper end of the head 17 is the upper supporting platform of the device, and has pointed protrusions identical to the protrusions on the supporting platform 1. The lateral protrusions 26 of the T-shaped protrusion 20 of the head 17 are guides for a reciprocal call located in the lower part of the end plate 27, on the inner horizontal surface of which, above the grooves for the side protrusions 26, a rectangular recess 28 is made. The upper surface of the plate 27 has a horizontal section 29, equipped with notches, and sections 30 and beveled at different angles 31. Under the horizontal section 29 of the lining 27, along the grooves under the guide protrusions 26, a blind threaded hole 32 is placed for installing the holding tool. On the basis of 13 of the composite housing 14, blind holes 33 are made for mounting the holding tool.

Device application

Correction of the provisions of the displaced articular processes of the cervical vertebrae is as follows.

Under general anesthesia, in the patient’s position on the back with a roller placed under the shoulders and an inserted gastric tube, the front structures of the cervical spine are opened with standard access. After detecting the area of damage with the help of mills, the anterior parts of the vertebral body under the displaced vertebra are resected. The anterior sections of the spinal canal are revised, the upper and lower discs and bone fragments, if any, are removed.

With a one-sided dislocation, a device for correcting the positions of the displaced articular processes of the cervical vertebrae is assembled using the end lining 27, for which the lining 27 is slid over the protrusions 26 of the head 17 of the composite body 14. At the same time, the supporting platform on the head 17, having pointed protrusions, it turns out to be installed in a rectangular recess 28, made on the inner horizontal surface of the end plates 27. In this case, the upper horizontal platform 29 of the end plates 27 d To create kyphosis, it should be located on the side of the dislocation, closer to the articular processes of the vertebra, and the beveled surfaces 30 and 31 of the lining 27 are installed towards the intact articular process. This arrangement of the sites of the end lining contributes to the local rise of the corresponding side of the vertebral body, allows you to free the articulated articular process without additional trauma to the intact articular process. By rotating the nut 10 through the window 16, using a special tool (not shown), alternately introducing the working end into the radial holes 11, the composite housing 14 is lifted relative to the lower supporting platform 2. When the nut 10 is rotated in a cylindrical cavity 12 of a larger diameter open to the bottom of the cylindrical base 13, the step formed by the transition to a cavity of smaller diameter prevents the nut 10 from moving along the rod 2. The glass 6, fastened by the protrusion 8 with the longitudinal groove 3 of the threaded rod 2, moves upward with a composite body 14. In this case, the horizontal surface 29 of the end plate 27, having notches, and the lower supporting platform 1, having pointed protrusions, are embedded in healthy, pre-processed vertebral bodies, reliably hold the device in a “niche” and carry out distraction until it is completely blocked translational movement of the housing 14 along the vertical threaded rod 2. This ensures a guaranteed separation of the articulated articular processes of the vertebrae, the protrusion 8 at the bottom of the glass 6 enters the groove 4 at the free end of screw rod 2, allowing rotation of the displaced vertebra around the axis of the vertebral column, ensuring the removal of the posterior-inferior articular process of the overlying vertebra dislocated anteriorly beyond the apex of the anterior-superior articular process of the underlying vertebra. The rotation is carried out using a tool installed in the holes 33 on the base 13 of the housing 14. The separation of the articulated articular processes of the vertebrae is determined by image intensifier testing, according to preliminary calculations according to CT or visually. With the same tool, in the same direction, continue the rotation of the base 13 until the protrusion 8 hits the groove 3, which is determined by the coincidence of the notch 5 on the side surface of the support platform 2 with the notch 9 on the side surface of the cup 6. After this manipulation, the distraction is reduced by rotating the nut 10 with the help of a tool in the opposite direction - the dislocated articular process returns to its physiological position without applying mechanical forces to the "intact" or "broken" articular process of the dislocated vertebra. Removal of distraction is continued until it is possible to freely remove the end plate 27 with a tool installed in a blind threaded hole 32, while the device itself is held by a tool installed in the holes 33 on the base 13 of the composite body 14. To create a stress state in the “niche” of the vertebra with the installed device again carry out a small distraction. The device remains installed in the bed as a body-replacing implant. Layered seams.

Information sources

1. NEUROMED Product Catalog 09/10, p. 15.

2. RF patent No. 2482818, A61F 2/44, BI No. 15, 2013.

3. Polishuk N.E. et al. “Damage to the spine and spinal cord”, “Book Plus”, Kiev, 2011, pp. 91-92.

4. RF patent No. 2434598, A61B17 / 56, BI No. 33, 2011

Claims (2)

1. A device for correcting the positions of the displaced articular processes of the cervical vertebrae, comprising a composite body of the head and cylindrical base, upper and lower supporting platforms, the outer surfaces of which are facing the vertebral bodies, have pointed protrusions, the upper supporting platform is made on the head of the composite body, in the upper part of the base is made of a T-shaped protrusion, the protruding side parts of which are guides for the grooves of the reciprocal form located in the lower part of the head, the head and base with are unified by a threaded rod having smooth ends whose diameter is smaller than the diameter of the middle threaded part of the rod, one end of the rod is equipped with a blind hole for the socket wrench, is located in the bushing having threads on the outer side surface, and the slot on the end, the rod with the sleeve is installed in the through holes in the composite housing, perpendicular to its longitudinal axis, while the thread for the threaded sleeve is cut in the hole only in the part belonging to the base, and the thread for the middle part of the threaded rod is cut into parts to the adjacent head of the composite body, characterized in that it has an end plate that can be mounted on the head of the composite body with the possibility of removal, and the upper surface of the said plate has a horizontal section with notches for insertion into the vertebral body on the dislocation side, and two adjacent smooth the site has a slope at different angles, designed to be installed on the side of the intact articular process, the lower supporting platform having four diametrically located vertical on The grooves on the side surface are made at the same time with a threaded rod installed vertically and in the center, having four longitudinal grooves, the position of which corresponds to the position of the mentioned notches, and a groove at the free end, a glass is installed on the rod having a through hole in the center of the bottom equipped with a longitudinal protrusion, in shape and size corresponding to the longitudinal grooves on the rod, and a notch on the side surface, located coaxially to the protrusion in the hole, on the vertical threaded rod, at the bottom of the glass, a nut having radial through holes along the midline of the outer surface, a vertical rod with a nut mounted on it is located in a stepped cylindrical cavity made along the axis of the cylindrical base of the composite housing, and the nut is installed in a cavity with a large diameter, open down to the cylindrical base, on the outer surface the bottom of the base and the inner surface of the glass is made thread, providing a connection of these parts flush on the outer surface of the glass and the base a window is made from the bottom of the cup to the height of the nut by a longitudinal cut of the surface by half the diameter, a T-shaped protrusion is made in the upper part of the head, identical to the protrusion on the basis of the composite body, the lateral protrusions of which are guides for the grooves of the reciprocal form in the lower part of the end plate on the horizontal surface of the lining above the grooves, a rectangular recess is made for installing the upper supporting platform, two threaded holes for the holding tool are made on the side surfaces of Considerations housing and one - on the front surface of the terminal pads at a horizontal projection. 2. A method for correcting the positions of displaced articular processes of the cervical vertebrae, including placing the patient on the table in a supine position with a roller placed under the shoulders under general anesthesia, standard access to the anterior structures of the cervical spine, resection of the anterior part of the vertebral body located under its dislocated or a broken body, with the removal of the upper and lower discs and bone fragments, the device according to claim 1 is placed in the formed “niche”, while the end patch is mounted on the head of the composite body ca, the angles on the upper surface of the lining must correspond to the nature of the dislocation, right- or left-sided, varying in height and length so that the upper horizontal platform of the end lining is located on the side of the dislocation, closer to the articular processes of the vertebra, and its beveled surfaces are set to the side of the intact the articular process, by rotating the nut, using a special tool, alternately introducing the working end into the radial holes, lift the composite body relative to neither days of the support site, carry out distraction until the translational movement of the body is completely blocked along the vertical, threaded rod of the lower support site, rotate the device with the tool installed in the holes on the side surfaces of the body, the separation of the mating articular processes of the vertebrae is determined by EOP control, according to preliminary calculations according to CT or visually, continue to rotate the base until the protrusion on the bottom of the glass enters the longitudinal groove on the vertical threaded rod, reduce rotation with a nut in the opposite direction, returning the dislocated articular process to its physiological position, the removal of distraction is continued until the possibility of free removal of the end lining with the tool, to create a stress state in the "niche" of the vertebra with the installed device, again carry out a small distraction, the device remains installed in the bed as a body-replacing implant; layered seams.

Images