CN113040983A - Expansion type vertebral body fusion device - Google Patents

Abstract

Translated fromChinese

本发明公开了一种扩展式椎体融合装置，包括植入机构、推送机构和支撑机构。植入机构呈可介入脊柱患者相邻两个椎体之间的椎间隙、并在介入后能够维持或扩大椎间隙的结构，植入机构设置有可连通到椎间隙内的植入腔；推送机构呈可插入植入腔、并在插入后能够沿植入腔往返移动的结构，推送机构用于推送和控制支撑机构穿过植入腔植入到椎间隙内；支撑机构呈可在植入腔内部处于收缩状态、在植入腔外部处于展开状态的结构，支撑机构在被植入到椎间隙内后被动形变扩展成为椎间隙支撑体，从而实现与相邻两个椎体的融合。其能够有效克服现有技术中需要通过复杂手段植入柔性袋囊来扩大椎间隙的难题，简化操作步骤，降低手术难度，提高手术效率。

The invention discloses an expanded vertebral body fusion device, comprising an implanting mechanism, a pushing mechanism and a supporting mechanism. The implantation mechanism is a structure that can intervene in the intervertebral space between two adjacent vertebral bodies of a spinal patient, and can maintain or expand the intervertebral space after the intervention, and the implantation mechanism is provided with an implantation cavity that can be connected to the intervertebral space; push; The mechanism is a structure that can be inserted into the implant cavity and can move back and forth along the implant cavity after insertion. The push mechanism is used to push and control the support mechanism to be implanted into the intervertebral space through the implant cavity; the support mechanism can be implanted in the intervertebral space. The structure is in a contracted state inside the cavity and in an expanded state outside the implant cavity. After being implanted into the intervertebral space, the support mechanism is passively deformed and expanded into a support body of the intervertebral space, thereby realizing fusion with two adjacent vertebral bodies. It can effectively overcome the problem in the prior art that a flexible bag needs to be implanted to expand the intervertebral space, simplify the operation steps, reduce the difficulty of the operation, and improve the operation efficiency.

Description

Expansion type vertebral body fusion device

Technical Field

The invention relates to a medical instrument for spinal surgery, in particular to an expansion type vertebral body fusion device.

Background

One of the main means for treating patients with degenerative spinal diseases or spinal structural injuries is to perform a vertebral body fusion operation and implant an intervertebral fusion cage between two adjacent vertebral bodies of the patient with pathological changes. The working principle of the interbody fusion cage is that a diseased intervertebral space is taken as a center, and after the interspinous fusion cage is implanted, the muscle, the fibrous ring, the anterior and posterior longitudinal ligaments of a fused segment of a patient are in a continuous tension state by utilizing the distraction force of the interbody fusion cage, so that the fused segment and the interbody fusion cage are fixed in a three-dimensional super-static manner. The intervertebral fusion device recovers and reconstructs the stress and the stability of the front and middle columns of the spine by recovering the pathological spinal space of a patient to a normal sequence or height, further recovers and maintains the inherent physiological bulge of the spine, enlarges intervertebral foramen, relieves the pressure of the dural sac and nerve roots, and eliminates the symptoms of pain, numbness and the like of waist and legs of the patient. The hollow structure of the intervertebral fusion cage also provides a good mechanical environment for the fusion of the cancellous bone therein, thereby achieving the effect of interface permanent fusion.

Currently, there are several types of interbody cages that are used in spinal surgery. The Chinese patent application with publication number CN106983586A provides a vertebral body fusion system accessed through a minimally invasive access, and aims to solve the problem that the contact area between the existing intervertebral fusion device and the upper and lower vertebral bodies cannot be controlled, so that the bone grafting space is too small to influence the fusion effect of the upper and lower vertebral bodies. The vertebral body fusion system is provided with a foldable or telescopic bag, after the bag is implanted into the intervertebral disc of a patient, the bag is inflated and forms an I-shaped or rectangular supporting body by injecting supporting materials into the bag, so that the effect of adapting to the height of the intervertebral space of the patient in a stepless manner is realized, and the contact area between the bag and the upper vertebral body and the lower vertebral body is easy to control.

However, the above-mentioned vertebral body fusion system adopts the mode of firstly implanting the bag and then filling the bag to adjust the height of the intervertebral space, and because of the inherent flexible characteristic of the bag, the implantation is difficult, the operation steps become complicated, the operation time tends to be prolonged, and the operation difficulty is correspondingly increased. In order to solve the above problems, medical researchers have made efforts to improve and improve the existing vertebral body fusion system in order to improve the efficiency of fusion surgery, delay the progress of spinal lesions, relieve pain symptoms of patients and improve the quality of life of patients, but no satisfactory progress has been achieved at present.

Disclosure of Invention

The invention aims to provide an expansion type vertebral body fusion device which is simple and stable in structure, convenient and easy to implant, capable of simplifying operation, mechanically expanding intervertebral space and safe and reliable in curative effect.

In order to achieve the purpose, the invention designs an expansion type vertebral body fusion device which is mainly formed by combining an implantation mechanism, a pushing mechanism and a supporting mechanism, and is characterized in that:

the implantation mechanism is of a structure which can intervene in the intervertebral space between two adjacent vertebral bodies of a spinal patient and can maintain or enlarge the intervertebral space after intervention, and is also provided with an implantation cavity which can be communicated into the intervertebral space;

the pushing mechanism is in a structure which can be inserted into the implantation cavity and can move back and forth along the implantation cavity after being inserted, and the pushing mechanism is used for pushing and controlling the supporting mechanism to penetrate through the implantation cavity to be implanted into the intervertebral space;

the support mechanism is in a structure which can be in a contraction state inside the implantation cavity and in an expansion state outside the implantation cavity, and passively deforms and expands after being implanted into the intervertebral space to form an intervertebral space support body, so that fusion with two adjacent vertebral bodies is realized.

As a preferred embodiment:

the implantation mechanism is provided with an implantation tube, one end of the implantation tube can extend into the intervertebral space, an axial inner cavity of the implantation tube forms the implantation cavity, and the other end of the implantation tube is provided with a holding handle;

the pushing mechanism is provided with an operating rod, one end of the operating rod can be inserted into the implantation cavity, and the other end of the operating rod is provided with an operating handle;

the supporting mechanism is provided with a first connecting rod, a second connecting rod, a third connecting rod and a fourth connecting rod, and the first connecting rod, the second connecting rod, the third connecting rod and the fourth connecting rod are sequentially hinged end to form a retractable and expandable four-bar mechanism;

the hinge portion of the first connecting rod and the second connecting rod is provided with a yielding notch, the hinge portion of the third connecting rod and the fourth connecting rod is provided with a rod end connector, and one end of the operating rod penetrates through the yielding notch to be detachably connected with the rod end connector.

More specifically described are:

the first connecting rod and the second connecting rod are hinged and connected through a pair of first pin shafts which are coaxially arranged, and a clearance between the pair of first pin shafts forms the yielding notch;

the second connecting rod is hinged with the third connecting rod through a second pin shaft;

the third connecting rod and the fourth connecting rod are hinged through a third pin shaft, an internal thread sleeve which is perpendicular to the third pin shaft is arranged in the middle of the third pin shaft, and the internal thread sleeve forms the rod end joint;

the fourth connecting rod is hinged with the first connecting rod through a fourth pin shaft;

one end of the operating rod which can be inserted into the implantation cavity is provided with a threaded head; the thread head penetrates through the yielding notch and is detachably connected with the internal thread sleeve.

As another preferable scheme:

a first rope pulling channel penetrates through the middle of the rod body of the first connecting rod, one end of the first rope pulling channel extends to the yielding notch, and the other end of the first rope pulling channel faces to the hinge joint of the fourth connecting rod;

the fourth connecting rod is provided with a fourth inner connecting rod playing a role in lifting and a fourth outer connecting rod bearing a hinging function, the fourth inner connecting rod can be embedded in the fourth outer connecting rod in a vertically movable mode, a first wedge slide block is arranged between the fourth inner connecting rod and the fourth outer connecting rod and connected with one end of a first pull rope, and the other end of the first pull rope sequentially penetrates through a through hole formed in the fourth outer connecting rod, a first pull rope channel and a yielding notch and then is led out along the implantation cavity;

a second rope pulling channel penetrates through the middle of the rod body of the second connecting rod, one end of the second rope pulling channel extends to the yielding notch, and the other end of the second rope pulling channel faces to the hinge joint of the third connecting rod;

the third connecting rod has a third inner connecting rod with a lifting function and a third outer connecting rod with a hinge function, the third inner connecting rod is embedded in the third outer connecting rod in a vertically movable mode, a second wedge slide block is arranged between the third inner connecting rod and the third outer connecting rod and connected with one end of a second pull rope, and the other end of the second pull rope sequentially penetrates through a through hole formed in the third outer connecting rod, a second pull rope channel and a yielding notch and then is led out of the implantation cavity.

Furthermore, the other end of the first pull rope is led out along the implantation cavity, enters the holding handle and is connected with a pull rope operating mechanism arranged in the holding handle; the other end of the second pull rope is led out along the implantation cavity and then enters the holding handle, and is also connected with a pull rope operating mechanism arranged in the holding handle. Therefore, the first wedge slide block and the second wedge slide block can be pulled to move simultaneously through the pull rope operating mechanism, so that the fourth inner connecting rod and the third inner connecting rod are controlled to be lifted to the set height synchronously.

Furthermore, the cross section of the first wedge slide block is of a cross structure, and the upper end and the lower end of the first wedge slide block are respectively provided with a first slide block flange which is embedded and matched with the sliding grooves in the fourth inner connecting rod and the fourth outer connecting rod; the cross section of the second wedge slide block is of a cross structure, and the upper end and the lower end of the second wedge slide block are respectively provided with a second slide block flange which is embedded and matched with the sliding grooves in the third inner connecting rod and the third outer connecting rod. Therefore, the structure is simple and reliable, the embedding matching is precise, the inner and outer connecting rods can be effectively prevented from shaking, and the lifting action of the inner connecting rod is ensured to be stable.

Furthermore, a first mounting through hole is formed in the center of the first wedge sliding block, and one end of the first pull rope penetrates through the first mounting through hole to be fixedly connected with the first pull rope; and a second mounting through hole is formed in the center of the second wedge sliding block, and one end of the second pull rope penetrates through the second mounting through hole to be fixedly connected with the second pull rope. Because the tapered wedge slider's among the actual finished product small in size is exquisite, its center sets up the installation through-hole can increase with the area of contact who corresponds the stay cord, ensures that both firm in connection are stable.

Still further, one end of the first pull rope is provided with a first connecting cap, and the first connecting cap is riveted or welded with the first mounting through hole; and a second connecting cap is arranged at one end of the second pull rope and is riveted or welded with the second mounting through hole. Therefore, the connection is stable and reliable, and the assembly is convenient and quick.

The implantation tube in the vertebral body fusion device mainly has two types of structure forms, wherein the first type of structure is that the cross section of the implantation tube is one of a square or a round, so that the implantation tube can always keep consistent vertical height in the intervertebral space, and the intervertebral space is ensured to be always stable and unchanged. The second structure is that the cross section of the implantation tube is one of rectangle, polygon or ellipse which is more than four, thereby the implantation tube can change the vertical height in the intervertebral space through rotation, the intervertebral space is forced to be further enlarged, and enough implementation space is reserved for the subsequent treatment.

The working principle of the invention is as follows: the designed expansion type vertebral body fusion device is specially used for the intervertebral space between two adjacent vertebral bodies of a spinal patient with pathological changes. In a surgical procedure, a vertebral body is inserted into an intervertebral disc space after removal of a portion of the transverse process, lamina and annulus. Wherein the implant mechanism can mechanically force two adjacent vertebral bodies apart in the direction of the spinal column axis to enable the intervertebral space to be maintained or enlarged. At the same time, the implantation mechanism provides an implantation chamber connected into the intervertebral disc as a passageway so that the pushing mechanism can conveniently push the support mechanism through the passageway into the intervertebral disc after the nucleus pulposus of the intervertebral disc is emptied. And the supporting mechanism can passively expand and deform under the operation of the pushing mechanism to form an intervertebral space supporting body with the upper end surface and the lower end surface respectively and reliably abutted against two adjacent vertebral bodies, so that the intervertebral space can be kept at a vertical height with the effect of treating or relieving pain after the implantation mechanism is withdrawn.

The invention has the advantages that: the designed expansion type vertebral body fusion device can conveniently operate a rigid implantation mechanism to be inserted into the diseased intervertebral space of a patient, and mechanically maintain or enlarge the intervertebral space by utilizing the rigidity of the implantation mechanism; meanwhile, the pushing mechanism can rapidly push the contracted supporting mechanism to pass through the implantation cavity to enter the intervertebral disc, and the supporting mechanism is held to be mechanically expanded and deformed in the intervertebral disc to become a stable intervertebral space supporting body. Therefore, the technical problem that the intervertebral space needs to be expanded by implanting the flexible bag through a complex means in the background technology is effectively solved, the operation steps are simplified, the operation difficulty is reduced, and the operation efficiency is improved. Moreover, the expansion type vertebral body fusion device is formed by combining pure mechanical parts, has simple and exquisite structure, can be implanted into the intervertebral space with the minimum space, avoids destructively raising the intervertebral space and has small damage to the tissues of a patient; meanwhile, the mechanical expansion deformation area is large, the support is stable, the curative effect is good after the spinal column is implanted into the intervertebral space, the recovery is fast after the operation, the spinal pathological change process can be effectively delayed, the pain symptom of the patient is relieved, and the life quality of the patient is improved.

Drawings

FIG. 1 is a schematic view of an expanded vertebral body fusion device of the present invention in an orientation configuration for implantation in an intervertebral space of a patient;

FIG. 2 is a perspective view of the vertebral body fusion device illustrated in FIG. 1 with the support mechanism in a collapsed configuration;

FIG. 3 is a perspective view of the vertebral body fusion device illustrated in FIG. 1 with the support mechanism in an expanded configuration;

FIG. 4 is a schematic perspective exploded view of the vertebral body fusion device illustrated in FIG. 3;

FIG. 5 is a cross-sectional view of the implant mechanism of the interbody fusion device of FIG. 3;

FIG. 6 is a schematic cross-sectional view of the pushing mechanism of the interbody fusion device of FIG. 3;

FIG. 7 is a schematic perspective exploded view of a highly fixed support mechanism of the vertebral body fusion device of example 1;

FIG. 8 is a schematic perspective view of a highly adjustable support mechanism of the vertebral body fusion device according to example 2;

FIG. 9 is a schematic perspective view of the height adjustable support mechanism shown in FIG. 8;

FIG. 10 is a perspective view of the first link shown in FIG. 9;

FIG. 11 is a longitudinal cross-sectional view of the first link shown in FIG. 10;

FIG. 12 is a perspective view of the fourth outer link shown in FIG. 9;

FIG. 13 is a longitudinal cross-sectional view of the fourth outer link shown in FIG. 12;

FIG. 14 is a schematic perspective view of the first pull cord of FIG. 9 engaged with the first cam slider;

FIG. 15 is a schematic longitudinal cross-sectional view of the first cam slider of FIG. 14;

FIG. 16 is a schematic perspective view of the second pull cord of FIG. 9 engaged with the second cam slider;

FIG. 17 is a schematic longitudinal cross-sectional view of the second cam slider of FIG. 16.

The components in the figures are numbered as follows:

animplant mechanism 100, comprising:implant cavity 110,implant tube 120,grip 130;

a pushingmechanism 200, comprising: ascrew head 210, alever 220, alever 230;

thesupport mechanism 300 includes: afirst link 310, asecond link 320, a third link 330 (among them, a thirdinner link 331, a third outer link 332), a fourth link 340 (among them, a fourthinner link 341, a fourth outer link 342);

afirst cable passageway 311, afirst cable 344, afirst cam slider 343, a first mounting through-hole 345, afirst slider flange 346, afirst connector cap 347;

asecond cable passage 321, asecond cable 334, asecond cam slider 333, a second mounting through-hole 335, asecond slider flange 336, a second connectingcap 337;

a pair offirst pins 411, 412, asecond pin 420, athird pin 430, and afourth pin 440;

an internal threadedsleeve 500, anintervertebral space 600, and arelief notch 700.

Detailed Description

The invention is described in further detail below with reference to the figures and specific examples, which should not be construed as limiting the invention.

As shown in fig. 1:

the invention describes an expandable vertebral body fusion device comprising animplantation mechanism 100, a pushingmechanism 200 and asupport mechanism 300. Theimplant mechanism 100 is adapted to access and maintain or enlarge anintervertebral space 600 between two adjacent vertebral bodies of a patient, and theimplant mechanism 100 defines animplant cavity 110 therein communicating with theintervertebral space 600. The pushingmechanism 200 may be inserted into and reciprocally move within theimplantation chamber 110 for pushing and controlling the implantation of thesupport mechanism 300 into theintervertebral space 600 through theimplantation chamber 110. Thesupport mechanism 300 may be in a collapsed state inside theimplantation chamber 110 and in an expanded state outside theimplantation chamber 110. When a patient is operated, after a part of transverse processes, vertebral plates and fibrous rings of a vertebral body are cut off, theimplantation mechanism 100 is firstly inserted into theintervertebral space 600 to mechanically separate two adjacent vertebral bodies in the vertical direction, so that theintervertebral space 600 can be expanded; then the pushingmechanism 200 controls the supportingmechanism 300 to penetrate through theimplantation cavity 110 and enter theintervertebral space 600, and forces the supportingmechanism 300 to expand and deform into an intervertebral space supporting body with the upper end surface and the lower end surface respectively and tightly abutted to the two vertebral bodies, so that after theimplantation mechanism 100 is withdrawn, the vertical height of theintervertebral space 600 at the pathological change position of the patient can be effectively maintained, the stress condition of the vertebral column of the patient is improved, the compression between the two adjacent pathological change vertebral bodies is reduced, and the effect of treating or relieving the pain of the patient is achieved.

As shown in FIGS. 2-6:

the above-mentionedimplant mechanism 100 has animplant tube 120 having one end which is inserted into theintervertebral space 600, an axial inner cavity of theimplant tube 120 forms animplant chamber 110, theimplant tube 120 can communicate the outside to the position originally filled with the nuclear bone marrow in theintervertebral space 600 through theimplant chamber 110 in an arbitrary rotation state, and the other end of theimplant tube 120 is provided with agrip 130.

In a conventional option, the cross-section of theimplant 120 may be one of square or circular. The circular cross-section ensures that theimplant tube 120 maintains a consistent vertical height of the spine throughout any angle of rotation within theintervertebral space 600, and the square cross-section at least maintains the same vertical height of theimplant tube 120 during a 90 rotation within theintervertebral space 600. These two configurations are relatively simple to operate, can ignore the rotational offset of theimplantation tube 120, and are suitable for conditions where theintervertebral space 600 is relatively stable or does not change much at the lesion of the patient.

Preferably, the cross-section of theimplant 120 may be rectangular or polygonal, greater than four. The rectangular or polygonal cross-section enables theimplant 120 to be maintained in a larger-sized position or a smaller-sized position in the vertical direction of the spinal column according to the rotation state, so that theimplant 120 can be changed in vertical height by rotation. Wherein, the smaller size should be less than or equal to the maximum gap diameter at theintervertebral space 600 where the patient is affected, and the larger size should be greater than the maximum gap diameter but should not exceed the limit state of tissue expansion such as the stop collar.

Thus, when a vertebral body fusion operation is performed at the diseasedintervertebral space 600 of the patient, theimplant tube 120 is initially kept at a small size in the vertical direction of the spinal column, so that theimplant tube 120 can be smoothly inserted into theintervertebral space 600; rotation of theimplant 120 by 90 ° after insertion into theintervertebral space 600 changes theimplant 120 from a smaller size to a larger size in the vertical direction of the spine, and theimplant 120 can mechanically force theintervertebral space 600 to expand and eventually maintain a vertical height equal to the larger size, thereby allowing sufficient room for subsequent treatments to be performed.

More preferably, theimplant 120 may be elliptical in cross-section. Theimplant 120 with the oval cross section has the advantages of ensuring that theintervertebral space 600 is smoother in the process of being enlarged and reducing the injury and pain of the operation to the body of a patient.

The pushingmechanism 200 has anoperating rod 220 with one end inserted into theimplantation chamber 110, and the end of the operatingrod 220 inserted into theimplantation chamber 110 is provided with ascrew head 210, and the other end of the operatingrod 220 is provided with anoperating handle 230.

Thesupport mechanism 300 is a four-bar linkage mechanism formed by sequentially hinging afirst link 310, asecond link 320, athird link 330 and afourth link 340 end to end. An escape notch is formed in a hinge portion of thefirst link 310 and thesecond link 320, a rod end connector connected to thescrew head 210 is formed in a hinge portion of thethird link 330 and thefourth link 340, and thescrew head 210 at one end of the operatingrod 220 passes through the escape notch to be detachably connected to the rod end connector through a screw.

More specifically, the above-describedsupport mechanism 300 has two embodiments:

example 1

Fig. 7 shows a highly fixedsupport mechanism 300. Wherein: thefirst link 310 and thesecond link 320 are hinged by a pair of coaxially arrangedfirst pins 411, 412, and the clearance between the pair offirst pins 411, 412 forms theaforementioned relief notch 700. Thesecond link 320 is hinged to thethird link 330 by asecond pin 420. The thirdconnecting rod 330 is hinged to the fourth connectingrod 340 through athird pin 430, and aninternal thread sleeve 500 which is vertically arranged with thethird pin 430 is nested in the middle of thethird pin 430, and theinternal thread sleeve 500 forms the rod end joint; thefourth link 340 is hingedly connected to thefirst link 310 by afourth pin 440.

When the vertebral body fusion operation is carried out, thethread head 210 at one end of the operatingrod 220 passes through theconcession notch 700 to be in threaded connection with theinternal thread sleeve 500, and the supportingmechanism 300 is in a linear contraction state in theimplantation cavity 110, namely all the connecting rods are kept parallel to each other; after thesupport mechanism 300 has passed through theimplantation chamber 110 and into theintervertebral space 600, all the links are pivoted about the pin axis by pulling the operatingrods 220 outward and spread apart from each other into a diamond shape that acts as a support for theintervertebral space 600 against the disc. After thesupport mechanism 300 is expanded into the diamond shape, the threaded connection between the threadedhead 210 and the internally threadedsleeve 500 is released by reverse rotation, so that the operatingrod 220 is withdrawn from theintervertebral space 600 from theimplantation chamber 110.

Example 2

Referring to FIGS. 8-17, another heightadjustable support mechanism 300 is shown. Wherein: afirst rope passage 311 is formed through the middle of the shaft of thefirst link 310, one end of thefirst rope passage 311 extends to the yieldingnotch 700, and the other end of thefirst rope passage 311 faces the hinge of thefourth link 340. Thefourth link 340 has a fourthinner link 341 for lifting and a fourthouter link 342 for performing a hinge function, and the fourthinner link 341 is movably inserted in the fourthouter link 342 in the up-and-down direction. Afirst wedge slider 343 is arranged between the fourth inner connectingrod 341 and the fourth outer connectingrod 342, thefirst wedge slider 343 is fixedly connected with one end of a first pullingrope 344, and the other end of the first pullingrope 344 sequentially passes through a through hole formed in the fourth outer connectingrod 342, the first pullingrope channel 311 and the yieldingnotch 700 and then is led out along the implantation cavity 110 (see fig. 8-13).

More specifically, the cross section of thefirst cam slider 343 is cross-shaped, and the upper and lower ends thereof are respectively provided with afirst slider flange 346 that fits into the sliding grooves of the fourthinner link 341 and the fourthouter link 342, so that thefirst cam slider 343 can be precisely and stably fitted into the fourthinner link 341 and the fourthouter link 342. A first installation throughhole 345 is formed in the center of thefirst wedge slider 343, and one end of thefirst pull rope 344 passes through the first installation throughhole 345 and is fixedly connected with the first installation throughhole 345, so that the contact friction area between the first installation through hole and the first pull rope can be effectively increased, and the connection is ensured to be firm. In this embodiment, a first connectingcap 347 is fixed to one end of the first pullingrope 344, and the first connectingcap 347 is disposed in a countersunk end of the first mounting throughhole 345 and connected to the first mounting through hole by riveting or welding, so that the operation is simple and easy (see fig. 14 to 15). In operation, the other end of thefirst pull cord 344 is extended out of theimplantation chamber 110 and into thegrip 130 and connected to a pull cord actuator (not shown) disposed within thegrip 130. Of course, thefirst pull cord 344 may be manually or other mechanical means known in the art.

Similarly, asecond rope passage 321 extends through the middle of the shaft of thesecond link 320, one end of thesecond rope passage 321 extends to theclearance gap 700, and the other end of thesecond rope passage 321 faces the hinge of thethird link 330. Thethird link 330 has a thirdinner link 331 for lifting and a thirdouter link 332 for performing a hinge function, and the thirdinner link 331 is movably inserted in the thirdouter link 332 up and down. Asecond wedge slider 333 is arranged between the third inner connectingrod 331 and the third outer connectingrod 332, thesecond wedge slider 333 is connected with one end of asecond pull rope 334, and the other end of thesecond pull rope 334 sequentially passes through a through hole formed in the third outer connectingrod 332, the secondpull rope channel 321 and the yieldingnotch 700 and then is led out along the implantation cavity 110 (see fig. 8-9).

More specifically, the cross section of thesecond cam slider 333 is cross-shaped, and the upper and lower ends of the second cam slider are respectively provided with asecond slider flange 336 which is embedded and matched with the sliding grooves in the third inner connectingrod 331 and the third outer connectingrod 332, so that thesecond cam slider 333 can be ensured to be precisely and stably matched with the third inner connectingrod 331 and the third outer connectingrod 332. A second mounting throughhole 335 is formed in the center of thesecond wedge slider 333, and one end of thesecond pull rope 334 passes through the second mounting throughhole 335 to be fixedly connected with the second mounting through hole, so that the contact friction area between the two can be effectively increased, and the connection is ensured to be firm. In this embodiment, a second connectingcap 337 is disposed at one end of the second pullingrope 334, and the second connectingcap 337 is disposed in a countersunk head at an end of the second mounting throughhole 335 and connected thereto by riveting or welding, so that the operation is simple and easy (see fig. 16 to 17). In operation, the other end of thesecond pull cord 334 is extended along theimplantation chamber 110 and into thegrip 130, and is also connected to a pull cord operating mechanism (not shown) disposed within thegrip 130. Of course, thesecond pull cord 334 may be manually or other mechanical means known in the art.

When a vertebral body fusion operation is performed, the operation process is substantially the same as that of example 1. The difference lies in that: after thesupport mechanism 300 is unfolded into the diamond-shaped state by theoperation lever 220, thefirst wedge slider 343 can be controlled to slide along the inclined plane between the fourthinner link 341 and the fourthouter link 342 by operating thefirst pull cord 344, thereby realizing the lifting action of the fourthinner link 341; meanwhile, thesecond cam slider 333 can be controlled to slide along the slope between the thirdinner link 331 and the thirdouter link 332 by operating thesecond pull cord 334, thereby realizing the lifting operation of the thirdinner link 331. Thus, the height of the vertical direction of the vertebral column can be adjusted by lifting the supportingmechanism 300 in theintervertebral space 600 in situ so as to adapt to the difference of individual anatomical structures of patients, and the supportingmechanism 300 is ensured to form an intervertebral space supporting body which is tightly fitted, stable and reliable in the implantedintervertebral space 600, thereby realizing the fusion between two adjacent vertebral bodies.

In conclusion, by means of the technical scheme, the technical problem that the intervertebral space needs to be expanded by implanting the flexible bag through a complex means in the background art can be effectively solved, the operation steps are simplified, the operation difficulty is reduced, and the operation efficiency is improved. Meanwhile, the intervertebral disc space supporting device is simple and reliable in structure, the supporting mechanism is stable in mechanical expansion and deformation, and a stable intervertebral space supporting body can be formed in an intervertebral disc, so that a good curative effect is guaranteed after the intervertebral disc space supporting device is implanted into the intervertebral disc space, the process of spinal pathological changes of a patient is delayed, pain symptoms of the patient are relieved, and the life quality of the patient is improved.

The above description is only exemplary of the present invention and should not be taken as limiting the invention, as any modification, equivalent replacement, or improvement made without departing from the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims (10)

Translated fromChinese

1.一种扩展式椎体融合装置，包括植入机构(100)、推送机构(200)和支撑机构(300)，其特征在于：1. An expansion type vertebral body fusion device, comprising an implantation mechanism (100), a push mechanism (200) and a support mechanism (300), characterized in that:所述植入机构(100)呈可介入脊柱患者相邻两个椎体之间的椎间隙(600)、并在介入后能够维持或扩大所述椎间隙(600)的结构，所述植入机构(100)还设置有可连通到所述椎间隙(600)内的植入腔(110)；The implantation mechanism (100) is a structure capable of intervening in the intervertebral space (600) between two adjacent vertebral bodies of a spinal patient, and can maintain or expand the intervertebral space (600) after the intervention, the implantation The mechanism (100) is further provided with an implant cavity (110) that can be communicated into the intervertebral space (600);所述推送机构(200)呈可插入所述植入腔(110)、并在插入后能够沿所述植入腔(110)往返移动的结构，所述推送机构(200)用于推送和控制所述支撑机构(300)穿过所述植入腔(110)植入到所述椎间隙(600)内；The pushing mechanism (200) has a structure that can be inserted into the implantation cavity (110) and can move back and forth along the implantation cavity (110) after being inserted, and the pushing mechanism (200) is used for pushing and controlling The support mechanism (300) is implanted into the intervertebral space (600) through the implant cavity (110);所述支撑机构(300)呈可在所述植入腔(110)内部处于收缩状态、在所述植入腔(110)外部处于展开状态的结构，所述支撑机构(300)在被植入到所述椎间隙(600)内后被动形变扩展成为椎间隙支撑体，从而实现与相邻两个椎体的融合。The support mechanism (300) is in a structure that can be in a contracted state inside the implant cavity (110) and in an expanded state outside the implant cavity (110), and the support mechanism (300) is implanted. After entering the intervertebral space (600), it is passively deformed and expanded into a supporting body of the intervertebral space, thereby realizing fusion with two adjacent vertebral bodies.2.根据权利要求1所述的扩展式椎体融合装置，其特征在于：2. The expanded vertebral body fusion device according to claim 1, wherein:所述植入机构(100)具有一端可伸入到所述椎间隙(600)内的植入管(120)，所述植入管(120)的轴向内腔形成所述的植入腔(110)，所述植入管(120)的另一端设置有握持柄(130)；The implantation mechanism (100) has an implantation tube (120) whose one end can extend into the intervertebral space (600), and the axial inner cavity of the implantation tube (120) forms the implantation cavity (110), the other end of the implant tube (120) is provided with a handle (130);所述推送机构(200)具有一端可插入到所述植入腔(110)内的操作杆(220)，所述操作杆(220)的另一端设置有操作柄(230)；The pushing mechanism (200) has an operating rod (220), one end of which can be inserted into the implant cavity (110), and the other end of the operating rod (220) is provided with an operating handle (230);所述支撑机构(300)具有第一连杆(310)、第二连杆(320)、第三连杆(330)和第四连杆(340)，所述第一连杆(310)、第二连杆(320)、第三连杆(330)和第四连杆(340)依次首尾铰接形成可收缩扩展的四连杆机构；The support mechanism (300) has a first link (310), a second link (320), a third link (330) and a fourth link (340). The first link (310), The second connecting rod (320), the third connecting rod (330) and the fourth connecting rod (340) are hinged end to end in sequence to form a retractable and expandable four-bar linkage mechanism;所述第一连杆(310)与第二连杆(320)的铰接部设置有退让缺口，所述第三连杆(330)与第四连杆(340)的铰接部设置有杆端接头，所述操作杆(220)的一端穿过所述退让缺口与所述杆端接头可拆卸式相连。The hinged portion of the first connecting rod (310) and the second connecting rod (320) is provided with an escape notch, and the hinged portion of the third connecting rod (330) and the fourth connecting rod (340) is provided with a rod end joint , and one end of the operating rod (220) is detachably connected to the rod end joint through the escape notch.3.根据权利要求2所述的扩展式椎体融合装置，其特征在于：3. The expanded vertebral body fusion device according to claim 2, wherein:所述第一连杆(310)与第二连杆(320)通过一对同轴布置的第一销轴(411、412)铰接相连，且该对第一销轴(411、412)之间的空隙形成所述的退让缺口(700)；The first link (310) and the second link (320) are hingedly connected through a pair of coaxially arranged first pins (411, 412), and the pair of first pins (411, 412) is connected between The space formed by the vacant gap (700);所述第二连杆(320)与第三连杆(330)通过一根第二销轴(420)铰接相连；The second connecting rod (320) is hingedly connected with the third connecting rod (330) through a second pin shaft (420);所述第三连杆(330)与第四连杆(340)通过一根第三销轴(430)铰接相连，且该根第三销轴(430)中部设置有与其垂直布置的内螺纹套(500)，所述内螺纹套(500)构成所述的杆端接头；The third connecting rod (330) and the fourth connecting rod (340) are hingedly connected through a third pin shaft (430), and the middle of the third pin shaft (430) is provided with an internal thread sleeve vertically arranged therewith (500), the internal thread sleeve (500) constitutes the rod end joint;所述第四连杆(340)与第一连杆(310)通过一根第四销轴(440)铰接相连；The fourth connecting rod (340) is hingedly connected with the first connecting rod (310) through a fourth pin shaft (440);所述操作杆(220)可插入到所述植入腔(110)内的一端设置有螺纹头(210)；所述螺纹头(210)穿过所述退让缺口(700)与内螺纹套(500)可拆卸式相连。A thread head (210) is provided at one end of the operating rod (220) which can be inserted into the implant cavity (110); 500) detachable connection.4.根据权利要求3所述的扩展式椎体融合装置，其特征在于：4. The expanded vertebral body fusion device according to claim 3, wherein:所述第一连杆(310)的杆身中间贯穿开设有第一拉绳通道(311)，所述第一拉绳通道(311)的一端延伸至所述退让缺口(700)，所述第一拉绳通道(311)的另一端朝向第四连杆(340)的铰接处；A first cable channel (311) is formed through the middle of the shaft of the first link (310), and one end of the first cable channel (311) extends to the retreat gap (700). The other end of a pulling rope channel (311) faces the hinge of the fourth link (340);所述第四连杆(340)具有起抬升作用的第四内连杆(341)和承担铰接功能的第四外连杆(342)，所述第四内连杆(341)可上下移动地嵌置在第四外连杆(342)中，所述第四内连杆(341)与第四外连杆(342)之间设置有第一斜楔滑块(343)，所述第一斜楔滑块(343)与第一拉绳(344)的一端相连，所述第一拉绳(344)的另一端依次穿过第四外连杆(342)上开设的通孔、第一拉绳通道(311)、退让缺口(700)后沿所述植入腔(110)引出；The fourth link (340) has a fourth inner link (341) for lifting and a fourth outer link (342) for a hinge function, and the fourth inner link (341) can move up and down Embedded in the fourth outer link (342), a first wedge slider (343) is arranged between the fourth inner link (341) and the fourth outer link (342). The wedge slider (343) is connected to one end of the first pull rope (344), and the other end of the first pull rope (344) sequentially passes through the through hole opened on the fourth outer link (342), the first pull rope (344) The pulling rope channel (311) and the retreating notch (700) are led out along the implant cavity (110);所述第二连杆(320)的杆身中间贯穿开设有第二拉绳通道(321)，所述第二拉绳通道(321)的一端延伸至所述退让缺口(700)，所述第二拉绳通道(321)的另一端朝向第三连杆(330)的铰接处；A second pulling rope channel (321) runs through the middle of the shaft of the second connecting rod (320), and one end of the second pulling rope channel (321) extends to the receding gap (700). The other ends of the two pull rope channels (321) face the hinge joint of the third link (330);所述第三连杆(330)具有起抬升作用的第三内连杆(331)和承担铰接功能的第三外连杆(332)，所述第三内连杆(331)可上下移动地嵌置在第三外连杆(332)中，所述第三内连杆(331)与第三外连杆(332)之间设置有第二斜楔滑块(333)，所述第二斜楔滑块(333)与第二拉绳(334)的一端相连，所述第二拉绳(334)的另一端依次穿过第三外连杆(332)上开设的通孔、第二拉绳通道(321)、退让缺口(700)后沿所述植入腔(110)引出。The third link (330) has a third inner link (331) for lifting and a third outer link (332) for a hinge function, and the third inner link (331) can move up and down Embedded in the third outer link (332), a second wedge slider (333) is arranged between the third inner link (331) and the third outer link (332). The wedge slider (333) is connected with one end of the second pull rope (334), and the other end of the second pull rope (334) sequentially passes through the through hole opened on the third outer link (332), the second pull rope (334) The pulling rope channel (321) and the retreating notch (700) are led out along the implant cavity (110).5.根据权利要求4所述的扩展式椎体融合装置，其特征在于：5. The expanded vertebral body fusion device according to claim 4, wherein:所述第一拉绳(344)的另一端沿所述植入腔(110)引出后进入所述握持柄(130)，并与设置在握持柄(130)内的拉绳操作机构相连；The other end of the first pulling rope (344) is drawn out along the implant cavity (110) and then enters the holding handle (130), and is connected with the pulling rope operating mechanism arranged in the holding handle (130);所述第二拉绳(334)的另一端沿所述植入腔(110)引出后进入所述握持柄(130)，也与设置在握持柄(130)内的拉绳操作机构相连。The other end of the second pulling rope (334) is drawn out along the implant cavity (110) and then enters the holding handle (130), and is also connected to the pulling rope operating mechanism provided in the holding handle (130).6.根据权利要求4所述的扩展式椎体融合装置，其特征在于：6. The expanded vertebral body fusion device according to claim 4, wherein:所述第一斜楔滑块(343)的横截面呈十字型结构，其上下两端分别设置有与第四内连杆(341)和第四外连杆(342)中的滑槽嵌置配合的第一滑块凸缘(346)；The cross section of the first wedge slider (343) is a cross-shaped structure, and its upper and lower ends are respectively provided with sliding grooves embedded in the fourth inner link (341) and the fourth outer link (342) a mating first slider flange (346);所述第二斜楔滑块(333)的横截面呈十字型结构，其上下两端分别设置有与第三内连杆(331)和第三外连杆(332)中的滑槽嵌置配合的第二滑块凸缘(336)。The cross section of the second wedge slider (333) is a cross-shaped structure, and its upper and lower ends are respectively provided with sliding grooves embedded in the third inner link (331) and the third outer link (332) A mating second slider flange (336).7.根据权利要求6所述的扩展式椎体融合装置，其特征在于：7. The expanded vertebral body fusion device according to claim 6, wherein:所述第一斜楔滑块(343)的中心开设有第一安装通孔(345)，所述第一拉绳(344)的一端穿过第一安装通孔(345)与其固定相连；A first installation through hole (345) is formed in the center of the first wedge slider (343), and one end of the first pull rope (344) passes through the first installation through hole (345) and is fixedly connected to it;所述第二斜楔滑块(333)的中心开设有第二安装通孔(335)，所述第二拉绳(334)的一端穿过第二安装通孔(335)与其固定相连。A second installation through hole (335) is formed in the center of the second wedge slider (333), and one end of the second pull cord (334) is fixedly connected to the second installation through hole (335) through the second installation through hole (335).8.根据权利要求7所述的扩展式椎体融合装置，其特征在于：8. The expanded vertebral body fusion device according to claim 7, wherein:所述第一拉绳(344)的一端设置有第一连接帽(347)，所述第一连接帽(347)与第一安装通孔(345)铆接或焊接相连；One end of the first pull cord (344) is provided with a first connection cap (347), and the first connection cap (347) is connected with the first installation through hole (345) by riveting or welding;所述第二拉绳(334)的一端设置第二连接帽(337)，所述第二连接帽(337)与第二安装通孔(335)铆接或焊接相连。One end of the second pull cord (334) is provided with a second connection cap (337), and the second connection cap (337) is connected with the second installation through hole (335) by riveting or welding.9.根据权利要求1～8中任一项所述的扩展式椎体融合装置，其特征在于：9. The expanded vertebral body fusion device according to any one of claims 1 to 8, wherein:所述植入管(120)的横截面为正方形或者圆形中的一种，从而能够使植入管(120)在所述椎间隙(600)内始终保持一致的竖直高度。The cross section of the implant (120) is one of a square or a circle, so that the implant (120) can always maintain a consistent vertical height in the intervertebral space (600).10.根据权利要求1～8中任一项所述的扩展式椎体融合装置，其特征在于：10. The expanded vertebral body fusion device according to any one of claims 1 to 8, wherein:所述植入管(120)的横截面为长方形、大于四的多边形或者椭圆形中的一种，从而能够使植入管(120)在所述椎间隙(600)内通过旋转改变竖直高度。The cross-section of the implant tube (120) is one of a rectangle, a polygon larger than four, or an ellipse, so that the implant tube (120) can be rotated in the intervertebral space (600) to change the vertical height .

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