CN102429747A

Movatterモバイル変換

Info

Publication number: CN102429747A
Application number: CN2011104485192A
Authority: CN
Inventors: 刘忠军
Original assignee: Beijing AK Medical Co Ltd
Current assignee: Peking University Third Hospital
Priority date: 2011-12-28
Filing date: 2011-12-28
Publication date: 2012-05-02

Abstract

The present invention provides an atlas fusion prosthesis, which is arranged between an occipital bone and an axis to replace a physiological atlas, comprising: a prosthesis body; the upper joint fusion surface is arranged at the upper part of the prosthesis main body and is used for being jointed with the occipital condyle joint surface of the occipital bone; the lower joint fusion surface is arranged at the lower part of the prosthesis main body and is used for being jointed with the upper joint surface of the axis. The main advantages of the invention are that the atlas prosthesis with a fusion surface matched with the occipital bone and the epistropheus is implanted to replace the physiological atlas, so that the function of the atlas can be quickly recovered, the bone fusion is promoted, the purpose of reconstructing the cervical vertebra to be stable is achieved, and the postoperative recovery is facilitated.

Description

Translated fromChinese

寰椎融合假体Atlas Fusion Prosthesis

技术领域technical field

本发明涉及骨科植入物领域，特别是一种替代自然寰枢关节的寰椎融合假体。The invention relates to the field of orthopedic implants, in particular to an atlas fusion prosthesis replacing natural atlantoaxial joints.

背景技术Background technique

寰枢关节是连接颅骨与脊柱的非常特殊而重要的脊椎结构。但是，由于各种原因如创伤、肿瘤、先天畸形、结核、类风湿关节炎等病变而导致的寰椎损伤及缺失在骨科治疗中时有遇到。由于寰枢关节所处部位及其解剖结构极其特殊，常规的颈椎融合器无法适用，目前尚没有针对寰椎的假体植入替代方案。临床中只能由医生根据具体情况临时采用自体或异体骨进行植骨或者植入改造钛笼或钛网的办法进行骨融合，这种技术在手术后需要较长时间的头颈肩部固定直至完全融合，给病人的生活带来极大不便。The atlantoaxial joint is a very special and important spinal structure that connects the skull to the spine. However, due to various reasons such as trauma, tumors, congenital malformations, tuberculosis, rheumatoid arthritis and other pathological changes, atlas damage and loss are sometimes encountered in orthopedic treatment. Due to the extremely special location and anatomical structure of the atlantoaxial joint, conventional cervical fusion cages cannot be applied, and there is currently no alternative for atlas prosthetic implantation. In clinical practice, doctors can only temporarily use autologous or allogeneic bone for bone grafting or implant modified titanium cage or titanium mesh for bone fusion according to the specific situation. Fusion brings great inconvenience to patients' lives.

发明内容Contents of the invention

本发明提供一种寰椎融合假体，以解决现有的植骨和植入钛笼造成的融合缓慢，需长时间固定的问题。The invention provides an atlas fusion prosthesis to solve the problems of slow fusion and long-term fixation caused by the existing bone grafting and titanium cage implantation.

本发明通过如下技术方案实现：一种寰椎融合假体，设置在枕骨和枢椎之间以替代生理寰椎，包括：假体主体；上关节融合面，设置在假体主体上部，用于与枕骨的枕髁关节面贴合；下关节融合面，设置在假体主体下部，用于与枢椎的上关节面贴合。The present invention is realized through the following technical solutions: an atlas fusion prosthesis, which is arranged between the occipital bone and the axis to replace the physiological atlas, comprising: a prosthesis main body; an upper articular fusion surface, which is arranged on the upper part of the prosthesis main body for It fits with the articular surface of the occipital condyle of the occipital bone; the lower articular fusion surface is set at the lower part of the main body of the prosthesis, and is used to fit with the upper articular surface of the axis.

进一步地，还包括，齿突结合凹面，设置在假体主体的侧面，与生理寰椎的齿突结合凹面面形状一致，用于容纳枢椎的齿突。Further, it also includes that the odontoid joint concave surface is arranged on the side of the prosthesis main body, conforms to the shape of the odontoid joint concave surface of the physiological atlas, and is used for accommodating the odontoid process of the axis.

进一步地，上关节融合面、下关节融合面和齿突结合面的表面具有微孔结构。Further, the surfaces of the upper joint fusion surface, the lower joint fusion surface and the odontoid joint surface have a microporous structure.

进一步地，微孔结构是相互连通的多向微孔隙结构，孔隙直径为100μm至1800μm。Further, the microporous structure is an interconnected multidirectional microporous structure with a pore diameter of 100 μm to 1800 μm.

进一步地，假体主体为医用金属制成的微孔结构。Further, the main body of the prosthesis is a microporous structure made of medical metal.

进一步地，假体主体的形状中不包括与生理寰椎的横突和后弓对应的凸起结构。Further, the shape of the main body of the prosthesis does not include a convex structure corresponding to the transverse process and posterior arch of the physiological atlas.

进一步地，假体主体在正前方的表面与生理寰椎正前方生理表面平齐或相对位于该生理寰椎正前方生理表面以内。Further, the surface of the prosthesis main body in front is flush with the physiological surface in front of the physiological atlas or relatively located within the physiological surface in front of the physiological atlas.

进一步地，假体主体上端设有上螺钉孔，假体主体下端设有下螺钉孔。Further, the upper end of the prosthesis main body is provided with an upper screw hole, and the lower end of the prosthesis main body is provided with a lower screw hole.

进一步地，寰椎融合假体的占位高度与生理寰椎一致。Further, the space-occupying height of the atlas fusion prosthesis is consistent with the physiological atlas.

进一步地，寰椎融合假体向下延伸直至替代枢椎或第三颈椎或更多的颈椎椎体，下关节融合面与寰椎融合假体下方的颈椎椎体上关节面贴合。Further, the atlas fusion prosthesis extends downward until it replaces the axis or the third cervical vertebra or more cervical vertebral bodies, and the lower articular fusion surface fits with the upper articular surface of the cervical vertebral body below the atlas fusion prosthesis.

进一步地，假体主体上设有多个植骨孔。Further, the main body of the prosthesis is provided with a plurality of bone grafting holes.

进一步地，植骨孔的孔径为2mm至30mm。Further, the diameter of the bone graft hole is 2mm to 30mm.

进一步地，假体主体的表面和/或内部设置有加强筋或加强板。Further, the surface and/or inside of the prosthesis main body are provided with reinforcing ribs or reinforcing plates.

进一步地，假体主体的外表面和/或内部表面的全部或局部涂敷有羟基磷灰石涂层。Further, the whole or part of the outer surface and/or inner surface of the prosthesis body is coated with hydroxyapatite coating.

通过上述技术方案，本发明的主要优点是，植入具有与枕骨和枢椎契合的融合面的寰椎假体，替代生理寰椎，可以很快恢复寰椎的功能，促进骨融合，达到重建颈椎稳定的目的，有利于术后恢复。Through the above technical solution, the main advantage of the present invention is that implanting an atlas prosthesis with a fusion surface that fits the occipital bone and the axis, replacing the physiological atlas, can quickly restore the function of the atlas, promote bone fusion, and achieve reconstruction The purpose of stabilizing the cervical spine is conducive to postoperative recovery.

附图说明Description of drawings

构成本发明的一部分的附图用来提供对本发明的进一步理解，本发明的示意性实施例及其说明用于解释本发明，并不构成对本发明的不当限定。在附图中：The drawings constituting a part of the present invention are used to provide a further understanding of the present invention, and the schematic embodiments and descriptions of the present invention are used to explain the present invention, and do not constitute an improper limitation of the present invention. In the attached picture:

图1示出了本发明的寰椎融合假体的立体示意图；Fig. 1 shows the three-dimensional schematic view of the atlas fusion prosthesis of the present invention;

图2示出了本发明的寰椎融合假体的与上下骨结构配合示意图；Fig. 2 shows the schematic diagram of the atlas fusion prosthesis of the present invention cooperating with the upper and lower bone structures;

图3示出了本发明的寰椎融合假体与下部枢椎配合的连接状态示意图；以及Fig. 3 shows the schematic diagram of the connection state of the atlas fusion prosthesis of the present invention and the lower axis; and

图4示出了本发明的寰椎融合假体的延伸加长实施例的状态示意图。Fig. 4 shows a schematic view of the extended embodiment of the atlas fusion prosthesis of the present invention.

具体实施方式Detailed ways

以下结合附图对本发明的实施例进行详细说明，但是本发明可以由权利要求限定和覆盖的多种不同方式实施。The embodiments of the present invention will be described in detail below with reference to the accompanying drawings, but the present invention can be implemented in many different ways defined and covered by the claims.

图1中示出了本发明的一个实施例的寰椎融合假体，包括：寰椎融合假体主体10，在寰椎融合假体主体10上设有上关节融合面20和下关节融合面。上下关节融合面是分别提取枕骨下部的枕髁关节面和枢椎上关节面的曲面数据后由数控机床加工，也可以利用激光烧结或高能电子束熔融等快速成型技术建造具有曲面高度拟合特性的表面，寰椎融合假体上关节融合面20依据枕骨的枕髁关节面数据建造并与枕骨的枕髁关节面良好吻合，寰椎融合假体下关节融合面依据枢椎上关节面数据建造并与枢椎上关节面良好吻合。寰椎融合假体正面内侧位置设置有与原寰椎齿突凹形状一致的可以容纳枢椎齿突的齿突结合凹面30。关节融合面和齿突结合凹面30表面为微孔结构，该微孔结构是一种相互连通的多向微孔隙结构，孔隙直径为100μm～1800μm，该孔隙有利于骨细胞爬行长入，术后寰椎融合假体齿突结合面将与枢椎齿突发生骨融合以达到长期稳定。Fig. 1 shows the atlas fusion prosthesis of an embodiment of the present invention, comprises: atlas fusion prosthesismain body 10, on the atlas fusion prosthesismain body 10 is provided with upperarticular fusion surface 20 and lower articular fusion surface . The upper and lower joint fusion surfaces are processed by CNC machine tools after extracting the surface data of the occipital condyle articular surface of the lower part of the occipital bone and the upper articular surface of the axial vertebrae respectively. It can also be constructed by rapid prototyping technologies such as laser sintering or high-energy electron beam melting, with curved surface height fitting characteristics. The upper joint fusion surface of the atlas fusion prosthesis was constructed according to the data of the occipital condyle articular surface of the occipital bone and was in good agreement with the occipital condyle articular surface of the occipital bone, and the lower joint fusion surface of the atlas fusion prosthesis was constructed based on the data of the upper articular surface of the axis And it fits well with the upper articular surface of the axis. The front inner side of the atlas fusion prosthesis is provided with an odontoid jointconcave surface 30 which is consistent with the shape of the original atlas odontoid process and can accommodate the axial vertebral odontoid process. The surface of the articular fusion surface and theconcavity 30 of the odontoid process is a microporous structure, which is an interconnected multi-directional microporous structure with a pore diameter of 100 μm to 1800 μm, which is conducive to the crawling growth of bone cells. The odontoid process of the atlas fusion prosthesis will undergo bone fusion with the odontoid process of the axis to achieve long-term stability.

如图2所示，出于手术入路的需要，该寰椎融合假体可以不保留横突、后弓结构，除必要的功能性设计改变外该寰椎融合假体在尺寸上与患者原生理寰椎椎体保持基本一致，寰椎融合假体植入人体后其总体占位高度与原生理寰枢关节一致，以保证颈椎周围组织保持原有位置状态。所述枢椎融合假体上下两端均设有关节融合面分别与枕骨40的枕髁关节面和枢椎50的上关节面51良好吻合；所述寰椎融合假体设有植骨孔80可以容纳自体或异体骨块和骨颗粒，术前或术中在该植骨孔内植入自体或异体骨块和骨颗粒可以起到诱导骨细胞爬行长入促进骨融合的作用；所述寰椎融合假体在术中直接固定于枕骨40下方与枢椎50上方以替代寰椎，所述寰椎融合假体上下两端分别设有螺钉孔70、90以与枕骨40和枢椎50通过螺钉60固定进行早期稳定，待骨融合完成后即可达到重建颈椎稳定的目的。As shown in Figure 2, due to the needs of the surgical approach, the atlas fusion prosthesis may not retain the transverse process and posterior arch structure. Except for the necessary functional design changes, the atlas fusion prosthesis is similar in size to the patient's original The physiological atlantoaxial vertebral body remains basically the same. After the atlas fusion prosthesis is implanted into the human body, its overall occupying height is consistent with the original physiological atlantoaxial joint, so as to ensure that the tissues around the cervical spine maintain their original position. The upper and lower ends of the fusion prosthesis of the axis are provided with articular fusion surfaces that are in good agreement with the articular surface of the occipital condyle of theoccipital bone 40 and the upperarticular surface 51 of theaxial vertebra 50; the fusion prosthesis of the atlas is provided with abone graft hole 80 It can accommodate autologous or allogeneic bone blocks and bone particles, and implanting autologous or allogeneic bone blocks and bone particles in the bone graft hole before or during operation can induce bone cells to crawl and grow into and promote bone fusion; the atlas The vertebral fusion prosthesis is directly fixed under theoccipital bone 40 and above theaxis vertebra 50 to replace the atlas during the operation. The upper and lower ends of the atlas fusion prosthesis are respectively provided withscrew holes 70 and 90 to pass through theoccipital bone 40 and theaxis vertebra 50. Fixation with 60 screws is used for early stabilization, and the purpose of rebuilding the stability of the cervical spine can be achieved after the bone fusion is completed.

如图3所示，所述寰椎融合假体在植入后其正前方表面不突出于原寰椎正前方生理表面即医学界所说的零切迹，因此对寰椎前方各种软组织解剖位置无任何不良影响。As shown in Figure 3, the front surface of the atlas fusion prosthesis does not protrude beyond the physiological surface of the original atlas after implantation, which is the zero notch in the medical field. The location has no ill effects.

如图4所示，所述寰椎融合假体前弓左右两侧设置有1～2个斜向后上方的上螺钉孔70，所述寰椎融合假体下端对应于枢椎上关节面的位置上亦设有1～3个斜向后下方的下螺钉孔90，术中通过螺钉60固定以达到与枕骨40和枢椎50之间的早期稳定。优选地，如图4所示，当患者寰椎、枢椎或更多颈椎阶段均需要由假体替代时，所述寰椎融合假体主体1可根据患者个体需要向下延伸加长以涵盖替代枢椎乃至第三颈椎直至更多的颈椎椎体节段。此时所述寰椎融合假体将与第三或其他节段颈椎椎体衔接固定，其固定融合方式与上述与枢椎对接固定的方式相同。As shown in Figure 4, the left and right sides of the anterior arch of the atlas fusion prosthesis are provided with 1 to 2upper screw holes 70 obliquely backward and upward, and the lower end of the atlas fusion prosthesis corresponds to the upper articular surface of the axis. There are also 1 to 3lower screw holes 90 obliquely backward and downward at the position, which are fixed byscrews 60 during the operation to achieve early stability with theoccipital bone 40 and theaxis vertebra 50 . Preferably, as shown in Figure 4, when the patient's atlas, axis or more cervical stages need to be replaced by prosthesis, the atlas fusion prosthesis main body 1 can be extended downward according to the individual needs of the patient to cover the replacement Axis to the third cervical vertebrae to more cervical vertebral body segments. At this time, the fusion prosthesis of the atlas will be connected and fixed with the third or other segments of the cervical vertebral body, and the fixing and fusion method is the same as the above-mentioned method of butt-fixing with the axis.

优选地，所述寰椎融合假体主体1上设有若干植骨孔80，植骨孔80孔径为2mm～30mm，植骨孔之间相互贯通或通过微孔连接，所述微孔孔径100μm～1800μm。该植骨孔可以容纳自体或异体骨块和骨颗粒，术前或术中在该植骨孔内植入自体或异体骨块和骨颗粒可以起到诱导骨细胞爬行长入促进骨融合的作用。Preferably, the main body 1 of the atlas fusion prosthesis is provided with severalbone graft holes 80, the diameter of thebone graft holes 80 is 2 mm to 30 mm, and the bone graft holes are connected to each other or connected through micropores, and the diameter of the micropores is 100 μm. ~1800μm. The bone graft hole can accommodate autologous or allogeneic bone blocks and bone particles. Implanting autologous or allogeneic bone blocks and bone particles in the bone graft hole before or during operation can induce bone cells to crawl and grow into bone fusion. .

优选地，所述寰椎融合假体主体为医用金属制成的微孔结构，该微孔结构的表面及内部孔隙相互贯通，所述微孔结构的孔隙直径100μm～1800μm，因此其具有良好生物相容性。Preferably, the main body of the atlas fusion prosthesis is a microporous structure made of medical metal, the surface and internal pores of the microporous structure are interconnected, and the pore diameter of the microporous structure is 100 μm to 1800 μm, so it has good biological compatibility.

优选地，所述寰椎融合假体主体表面和/或内部设置有加强筋或加强板。Preferably, the surface and/or inside of the main body of the atlas fusion prosthesis are provided with reinforcing ribs or reinforcing plates.

优选地，所述寰椎融合假体的主体表面和/或内部的全部或局部涂敷有羟基磷灰石涂层，具有诱导骨细胞生长的功能。该羟基磷灰石涂层的加工方法是：采用常规的等离子喷涂法或电化学沉积法以及烧结法形成。Preferably, the surface and/or the inside of the main body of the atlas fusion prosthesis are all or partially coated with hydroxyapatite coating, which has the function of inducing bone cell growth. The processing method of the hydroxyapatite coating is: a conventional plasma spraying method, an electrochemical deposition method and a sintering method are used to form.

本发明所述寰椎融合假体的加工方法是：获得患者颈椎部位CT/MRI/UCT等断层扫描数据→在计算机中建立颈椎病变部位的三维数据模型→提取寰椎模型并进行修改设计生成寰椎融合假体三维数据模型→用寰椎融合假体三维数据模型模拟替代生理寰椎以检查并验证设计方案→加工成型。The processing method of the atlas fusion prosthesis in the present invention is as follows: obtain tomographic scan data such as CT/MRI/UCT of the patient's cervical spine → establish a three-dimensional data model of the cervical spine lesion in the computer → extract the atlas model and modify the design to generate the atlas Three-dimensional data model of the vertebral fusion prosthesis → use the three-dimensional data model of the atlas fusion prosthesis to simulate and replace the physiological atlas to check and verify the design plan → process and shape.

根据目前的加工技术有两条较理想的加工路径：According to the current processing technology, there are two ideal processing paths:

a.采用数控加工机床依据在计算机中生成的寰椎融合假体数据转换成的加工程序进行加工成型，然后使用电火花加工、化学腐蚀、机械钻孔切削、高温等离子金属喷涂等方法钻铣加工以及涂覆出所需要的植骨孔、螺钉孔与微孔结构；a. Use CNC machine tools to process and shape according to the processing program converted from the atlas fusion prosthesis data generated in the computer, and then use EDM, chemical corrosion, mechanical drilling and cutting, high-temperature plasma metal spraying and other methods for drilling and milling And coating the required bone graft hole, screw hole and microporous structure;

b.利用激光烧结或高能电子束熔融等快速成型技术熔融成型，具体方法如下：b. Use rapid prototyping technologies such as laser sintering or high-energy electron beam melting to melt and form, and the specific methods are as follows:

a)使用专业软件对在计算机中设计建造的寰椎融合假体三维数据模型进行分层，以获得一系列单层切片的轮廓数据；a) Use professional software to layer the three-dimensional data model of the atlas fusion prosthesis designed and constructed in the computer to obtain the contour data of a series of single-layer slices;

b)向激光或高能电子束快速成型设备输入上述系列层片数据；b) Input the above-mentioned series of ply data into the laser or high-energy electron beam rapid prototyping equipment;

c)在激光或高能电子束快速成型设备加工舱内铺设与前述三维数据模型分层时层高相应厚度的医用金属粉末；c) Lay medical metal powder with a thickness corresponding to the layer height when the aforementioned three-dimensional data model is layered in the laser or high-energy electron beam rapid prototyping equipment processing cabin;

d)由计算机控制激光束或高能电子束对医用金属粉末进行扫描并有选择的熔化；d) Scanning and selective melting of medical metal powder by computer-controlled laser beam or high-energy electron beam;

e)重复前述铺设粉末、扫描熔化步骤以使各层被选择熔化的材料相互熔结成整体；e) repeating the steps of laying the powder, scanning and melting to make each layer of selectively melted material mutually fused into a whole;

f)完成全部层面的熔融过程后去除未熔融的粉末即可得到所需要形状结构的寰椎融合假体；f) After the melting process of all layers is completed, the unfused powder can be removed to obtain the atlas fusion prosthesis with the required shape and structure;

g)由于在建造寰椎融合假体三维数据模型时已经将所需要的实体、植骨孔、螺钉孔、微孔等等结构一并设计在数据文件中，因此上述各种结构在激光烧结或高能电子束熔融过程中将一次性完成制造。g) Since the required entities, bone graft holes, screw holes, microholes and other structures have been designed in the data file when building the three-dimensional data model of the atlas fusion prosthesis, the above-mentioned various structures can be obtained after laser sintering or It will be fabricated in one shot during the high-energy electron beam melting process.

根据本发明的寰椎融合假体，具有如下有益效果：According to the atlas fusion prosthesis of the present invention, it has the following beneficial effects:

在尺寸上与患者原生理寰椎椎体保持一致，保证颈椎周围组织保持原有位置状态；寰椎融合假体关节融合面依据枕骨和枢椎关节面数据建造并与其关节面良好吻合；假体植入人体后将与枢椎的齿突良好嵌合并形成骨融合以达到长期稳定。The size is consistent with the patient's original physiological atlas vertebral body to ensure that the tissues around the cervical spine maintain the original position; the articular fusion surface of the atlas fusion prosthesis is constructed according to the data of the occipital and axial articular surfaces and is in good agreement with the articular surfaces; the prosthesis After implanted in the human body, it will fit well with the odontoid process of the axis and form bone fusion to achieve long-term stability.

以上所述仅为本发明的优选实施例而已，并不用于限制本发明，对于本领域的技术人员来说，本发明可以有各种更改和变化。凡在本发明的精神和原则之内，所作的任何修改、等同替换、改进等，均应包含在本发明的保护范围之内。The above descriptions are only preferred embodiments of the present invention, and are not intended to limit the present invention. For those skilled in the art, the present invention may have various modifications and changes. Any modifications, equivalent replacements, improvements, etc. made within the spirit and principles of the present invention shall be included within the protection scope of the present invention.

Claims

1. an atlas merges prosthese, is arranged between occipital bone (40) and the dentata (50) with alternative physiology atlas, it is characterized in that, comprising:

Prosthetic main (10);

Upper joint merges face (20), is arranged on said prosthetic main (10) top, is used for fitting with the occipital condyle articular surface of said occipital bone (40);

Hypozygal merges face, is arranged on said prosthetic main (10) bottom, is used for fitting with the superior articular surface (51) of said dentata (50).

2. atlas according to claim 1 merges prosthese, it is characterized in that, also comprises; The prominent concave surface (30) that combines of tooth; Be arranged on the side surface of said prosthetic main (10), consistent with the prominent concave that combines of the tooth of said physiology atlas, the tooth that is used to hold said dentata (50) is dashed forward.

3. atlas according to claim 2 merges prosthese, it is characterized in that, the surface that said upper joint merges face (20), said hypozygal fusion face and the prominent faying face (30) of said tooth has microcellular structure.

4. atlas according to claim 3 merges prosthese, it is characterized in that said microcellular structure is the multidirectional micro hole structure that is interconnected, and pore diameter is 100 μ m to 1800 μ m.

5. atlas according to claim 1 merges prosthese, it is characterized in that the microcellular structure that said prosthetic main (10) is processed for medical metal.

6. atlas according to claim 1 merges prosthese, it is characterized in that, does not comprise transverse process and the corresponding bulge-structure of cantle with said physiology atlas in the shape of said prosthetic main (10).

7. atlas according to claim 1 merges prosthese, it is characterized in that, said prosthetic main (10) is surperficial concordant with said physiology atlas dead ahead physiology or be positioned at relatively in the said physiology atlas dead ahead physiology surface on the surface of dead ahead.

8. atlas according to claim 1 merges prosthese, it is characterized in that, said prosthetic main (10) upper end is provided with screwing hole (70), and said prosthetic main (10) lower end is provided with lower screw hole (90).

9. atlas according to claim 1 merges prosthese, it is characterized in that, the occupy-place height of said atlas fusion prosthese is consistent with said physiology atlas.

10. atlas according to claim 1 merges prosthese; It is characterized in that; Said atlas merges prosthese to extending below until alternative said dentata (50) or third cervical vertebra or more cervical vertebral body, and the cervical vertebral body superior articular surface that said hypozygal merges below face and the said atlas fusion prosthese is fitted.

11. atlas according to claim 1 merges prosthese, it is characterized in that said prosthetic main (10) is provided with a plurality of bone graftings hole (80).

12. atlas according to claim 11 merges prosthese, it is characterized in that the aperture in said bone grafting hole (80) is 2mm to 30mm.

13. atlas according to claim 1 merges prosthese, it is characterized in that the surface and/or the set inside of said prosthetic main (10) have reinforcement or stiffener.

14. atlas according to claim 1 merges prosthese, it is characterized in that the outer surface of said prosthetic main (10) and/or the whole or local coating of inner surface have hydroxyapatite coating layer.