CN211460470U - Anatomical titanium cage for lower cervical vertebra - Google Patents
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Description
Translated fromChinese技术领域technical field
本实用新型属于医用假体制造技术领域，涉及一种下颈椎解剖型钛笼。The utility model belongs to the technical field of medical prosthesis manufacturing, and relates to a lower cervical vertebra anatomical titanium cage.
背景技术Background technique
目前，颈椎椎体次全切除减压联合钛笼植骨融合术是治疗颈椎病、颈椎椎管狭窄、颈椎椎体骨折伴脊髓压迫者或陈旧性骨折脱位合并不完全性脊髓损伤等常用的手术方式。该手术方式采取经前路显露相应椎体及椎间盘，在拟切除之椎体相邻上下2个椎体分别安放椎体钉，放置椎体撑开器将上下椎体撑开一定高度。切除两端病变椎间盘，于双侧钩椎关节内侧行椎体次全切除该椎的大部椎体及后纵韧带，在减压槽内植入合适长度的钛笼(填充植骨粒)，选择合适颈前路钢板固定于上下椎体。大量临床研究已证实其具有较好的手术疗效。手术节段能获得术后即刻稳定性，为神经功能的恢复提供稳定的生物力学环境。At present, cervical vertebral subtotal resection and decompression combined with titanium cage bone grafting and fusion is a commonly used operation for the treatment of cervical spondylosis, cervical spinal stenosis, cervical vertebral body fractures with spinal cord compression, or old fractures and dislocations with incomplete spinal cord injury. Way. In this operation, the corresponding vertebral bodies and intervertebral discs are exposed through the anterior approach, vertebral body screws are placed on the upper and lower vertebral bodies adjacent to the vertebral body to be resected, and vertebral body distractors are placed to spread the upper and lower vertebral bodies to a certain height. The diseased intervertebral discs at both ends were excised, and most of the vertebral bodies and the posterior longitudinal ligament of the vertebra were subtotally removed on the medial side of the bilateral uncinate joints, and a titanium cage of appropriate length (filled with bone grafts) was implanted in the decompression groove. Select the appropriate anterior cervical plate to fix the upper and lower vertebral bodies. A large number of clinical studies have confirmed that it has a good surgical effect. The surgical segment can obtain immediate postoperative stability and provide a stable biomechanical environment for the recovery of neurological function.
然而，相关术后随访研究发现部分患者出现钛笼下沉塌陷情况，影响患者术后疗效。Yu Chen等对300例实施颈椎椎体次全切除减压联合钛笼植骨融合术的患者进行术后随访。随访结果发现182(60.7％)位患者出现轻度钛笼塌陷(1-3mm)，57位患者出现重度钛笼塌陷(＞3mm)。与术后未出现钛笼塌陷的患者相比，存在钛笼塌陷的患者神经功能恢复情况明显低于钛笼未塌陷患者。此外，严重的钛笼塌陷会导致颈部疼痛、神经功能受损、固定失败等并发症的出现。(Chen Y,Chen DY,Guo YF,et al.Subsidence of Titanium MeshCage A Study Based on 300Cases[J].Journal of Spinal Disorders&Techniques,2008,21(7):489-492.)引起钛笼术后塌陷一个重要的原因是钛笼与椎体终板的接触面积小。传统钛笼植入过程中，需要将钛笼的长度修剪至骨槽长度。钛笼未经裁剪一面为光滑结构，有6个平整的接触点，裁剪的一端多数情况下为12个锐利的接触点。这种点接触方式造成其椎体终板表面压力负荷较大，容易引起椎体终板结构破坏导致钛笼刺入椎体中，引起钛笼塌陷。(徐建伟，贾连顺，陈德玉，et al.颈椎前路椎体次全切除钛网植骨早期塌陷的探讨[J].中国矫形外科杂志，2002，10(z1):1267-1269.)However, related postoperative follow-up studies found that some patients suffered from subsidence and collapse of the titanium cage, which affected the postoperative efficacy of patients. Yu Chen et al. conducted postoperative follow-up of 300 patients who underwent cervical subtotal resection and decompression combined with titanium cage bone grafting and fusion. Follow-up results showed that 182 (60.7%) patients had mild titanium cage collapse (1-3 mm), and 57 patients had severe titanium cage collapse (>3 mm). Compared with patients without titanium cage collapse after surgery, the recovery of neurological function in patients with titanium cage collapse was significantly lower than that in patients without titanium cage collapse. In addition, severe titanium cage collapse can lead to complications such as neck pain, impaired nerve function, and failure of fixation. (Chen Y,Chen DY,Guo YF,et al.Subsidence of Titanium MeshCage A Study Based on 300Cases[J].Journal of Spinal Disorders&Techniques,2008,21(7):489-492.) Caused titanium cage to collapse after surgery The important reason is the small contact area between the titanium cage and the vertebral body endplate. During traditional titanium cage implantation, the length of the titanium cage needs to be trimmed to the length of the bone groove. The uncut side of the titanium cage has a smooth structure with 6 flat contact points, and the cut end has 12 sharp contact points in most cases. This point contact method results in a large pressure load on the surface of the vertebral body endplate, which is easy to cause the structural damage of the vertebral body endplate and lead to the penetration of the titanium cage into the vertebral body, causing the titanium cage to collapse. (Xu Jianwei, Jia Lianshun, Chen Deyu, et al. Discussion on early collapse of titanium mesh bone graft in anterior cervical subtotal corpectomy [J]. Chinese Journal of Orthopaedic Surgery, 2002, 10(z1): 1267-1269.)
为了防止颈椎椎体次全切除减压联合钛笼植骨融合术后钛笼的塌陷，避免因钛笼塌陷导致颈部疼痛、神经功能受损、固定失败等并发症的出现，我们测量了颈椎上下终板前后径、左右径、矢状面弧度半径、冠状面弧度半径、颈椎手术节段高度、手术节段角度等解剖参数，并根据据此参数设计了一种下颈椎解剖型钛笼。In order to prevent the collapse of the titanium cage after subtotal cervical corpectomy and decompression combined with titanium cage bone grafting and fusion, and to avoid complications such as neck pain, nerve function damage, and fixation failure due to the collapse of the titanium cage, we measured the cervical spine. Anatomical parameters such as the anterior and posterior diameters, left and right diameters of the upper and lower endplates, sagittal plane arc radius, coronal plane arc radius, cervical vertebra surgical segment height, and surgical segment angle were used to design a lower cervical spine anatomical titanium cage based on these parameters.
实用新型内容Utility model content
本实用新型的目的在于克服上述现有技术的缺点，提供一种下颈椎解剖型钛笼，通过增大钛笼与椎体终板的接触面积，降低了椎体终板表面的压强，减少了因压强过大引起的椎体终板破坏，从而克服了传统钛笼植入后存在的钛笼塌陷问题。The purpose of this utility model is to overcome the above-mentioned shortcomings of the prior art, and to provide a lower cervical vertebra anatomical titanium cage. The destruction of the vertebral body endplate caused by excessive pressure overcomes the problem of the collapse of the titanium cage after the traditional titanium cage is implanted.
为实现上述目的，本实用新型提供了如下技术方案：To achieve the above object, the utility model provides the following technical solutions:
一种下颈椎解剖型钛笼，包括：钛笼本体，所述钛笼本体的上端为穹隆结构，下端为斜型结构，所述穹隆结构与斜型结构之间设有网状结构，所述网状结构分别与穹隆结构、斜型结构相连接；所述网状结构包括依次连接的第一前表面、第一左侧面、第一后表面及第一右侧面，所述第一前表面、第一后表面均呈弧形结构，所述第一左侧面、第一右侧面均呈平面结构。A lower cervical vertebra anatomical titanium cage, comprising: a titanium cage body, the upper end of the titanium cage body is a dome structure, the lower end is an oblique structure, and a mesh structure is arranged between the dome structure and the oblique structure, and the The mesh structure is respectively connected with the dome structure and the oblique structure; the mesh structure includes a first front surface, a first left side, a first rear surface and a first right side which are connected in sequence, and the first front The surface and the first rear surface are both arc-shaped structures, and the first left side and the first right side are both planar structures.
进一步地，所述钛笼整体呈方形结构，将钛笼设计为方形可以充分利用终板后方及后外方的强度优势，使得手术节段获得更好的力学性能，有利于防止钛笼塌陷；在相同直径下，方型设计相比于传统圆形设计具有更大的植骨容积，可容纳更多的松质骨颗粒，有利于手术节段的植骨融合；方形设计使得钛笼两侧面为平面，增大了与残留椎体之间的接触面积，有利于与其之间的骨性融合。Further, the titanium cage has a square structure as a whole, and the design of the titanium cage in a square shape can make full use of the strength advantages of the rear and rear outer sides of the endplate, so that the surgical segment can obtain better mechanical properties, which is beneficial to prevent the collapse of the titanium cage; Under the same diameter, the square design has a larger bone graft volume than the traditional round design, which can accommodate more cancellous bone particles, which is conducive to the fusion of bone grafting of the surgical segment; the square design makes the two sides of the titanium cage It is a plane, which increases the contact area with the residual vertebral body, which is beneficial to the bony fusion therebetween.
进一步地，所述第一左侧面及第一右侧面相互平行。Further, the first left side and the first right side are parallel to each other.
进一步地，所述穹隆结构包括相连接的前、后、左、右四个弧形结构；所述左弧形结构的顶点、右弧形结构的顶点分别位于对应弧形结构的后1/3位置处，向两侧递减，所述前弧形结构的顶点、后弧形结构的顶点分别位于对应弧形结构的正中间位置，并向两侧递减。Further, the dome structure includes four connected front, rear, left and right arc structures; the apex of the left arc structure and the apex of the right arc structure are respectively located in the rear 1/3 of the corresponding arc structure. The apex of the front arc-shaped structure and the apex of the rear arc-shaped structure are respectively located in the middle position of the corresponding arc-shaped structure, and decrease to both sides.
进一步地，所述网状结构沿周向分布有若干菱形结构层，相邻的菱形结构层交错排列，每层菱形结构层包括若干菱形网孔。Further, a plurality of diamond-shaped structure layers are distributed along the circumferential direction of the network structure, adjacent diamond-shaped structure layers are staggered, and each diamond-shaped structure layer includes a plurality of diamond-shaped mesh holes.
进一步地，所述菱形结构层的层数为六层，每层菱形网孔的数量为九个。Further, the number of layers of the diamond structure layer is six, and the number of diamond meshes in each layer is nine.
进一步地，所述网状结构的高度为19mm，宽度为2mm，厚度为2mm，该网状结构的设计，主要目的在于增大钛笼内植骨粒与周围骨质的接触面积，有利于手术区域骨质的早期融合。Further, the height of the mesh structure is 19mm, the width is 2mm, and the thickness is 2mm. The main purpose of the design of the mesh structure is to increase the contact area between the bone graft particles in the titanium cage and the surrounding bone, which is conducive to surgery. Early fusion of regional bone.
进一步地，斜型结构包括依次连接的第二前表面、第二左侧面、第二后表面及第二右侧面，所述第二前表面、第二后表面均呈弧形结构，所述第二左侧面、第二右侧面均呈斜型结构。Further, the inclined structure includes a second front surface, a second left side, a second rear surface and a second right side connected in sequence, and the second front surface and the second rear surface are all arc-shaped structures, so The second left side surface and the second right side surface are both inclined structures.
进一步地，所述第二前表面的顶点、第二后表面的顶点分别位于第二前表面、第二后表面的中间位置处，且从顶点向两侧平滑递减，向上与网状结构相连。Further, the apex of the second front surface and the apex of the second rear surface are respectively located at the middle position of the second front surface and the second rear surface, and gradually decrease from the apex to both sides, and are connected to the mesh structure upward.
进一步地，所述第二左侧面的顶点、第二右侧面的顶点分别位于对应斜型结构的后端，且所述第二左侧面、第二右侧面的高度分别从对应斜型结构的前端向后端递增，向上与网状结构相连。Further, the apex of the second left side and the apex of the second right side are respectively located at the rear end of the corresponding inclined structure, and the heights of the second left side and the second right side are respectively from the corresponding oblique structures. The front end of the type structure increases to the rear end, and is connected to the mesh structure upward.
与现有技术相比，本实用新型提供的技术方案包括以下有益效果：根据颈椎解剖数据测量结果对下颈椎解剖型钛笼的上端采用穹隆结构的设计，并且在对下颈椎解剖型钛笼的下端采用斜型结构的设计，模拟颈椎手术节段角度，从而扩大了钛笼与颈椎终板之间的接触面积，降低应力集中现象，使得应力均匀地分布在终板表面，进而降低钛笼塌陷的发生率。Compared with the prior art, the technical solution provided by the present invention includes the following beneficial effects: the upper end of the lower cervical vertebra anatomical titanium cage is designed with a dome structure according to the measurement results of the cervical vertebra anatomical data, and the upper end of the lower cervical vertebra anatomical titanium cage is designed with a dome structure. The lower end is designed with an oblique structure to simulate the segmental angle of cervical spine surgery, thereby expanding the contact area between the titanium cage and the cervical spine endplate, reducing stress concentration, and making the stress evenly distributed on the surface of the endplate, thereby reducing the collapse of the titanium cage. incidence rate.
此外，通过将下颈椎解剖型钛笼设计为方形，在手术节段融合及支撑强度方面具有巨大优势：将钛笼设计为方形可以充分利用终板后方及后外方的强度优势，使得手术节段获得更好的力学性能，有利于防止钛笼塌陷；在相同直径下，方型设计相比于传统圆形设计具有更大的植骨容积，可容纳更多的松质骨颗粒，有利于手术节段的植骨融合；方形设计使得钛笼两侧面为平面，增大了与残留椎体之间的接触面积，有利于与其之间的骨性融合。In addition, by designing the lower cervical anatomical titanium cage into a square shape, it has great advantages in the fusion and support strength of the surgical segment. Compared with the traditional circular design, the square design has a larger bone graft volume and can accommodate more cancellous bone particles, which is conducive to the prevention of the collapse of the titanium cage. Bone graft fusion of the surgical segment; the square design makes the two sides of the titanium cage flat, which increases the contact area with the residual vertebral body, which is conducive to the bony fusion between them.
附图说明Description of drawings
此处的附图被并入说明书中并构成本说明书的一部分，与说明书一起用于解释本实用新型的原理。The accompanying drawings herein are incorporated into and constitute a part of this specification, and together with the description, serve to explain the principles of the invention.
为了更清楚地说明本实用新型实施例或现有技术中的技术方案，下面将对实施例或现有技术描述中所需要使用的附图作简单地介绍，显而易见地，对于本领域普通技术人员而言，在不付出创造性劳动性的前提下，还可以根据这些附图获得其他的附图。In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the following briefly introduces the accompanying drawings that need to be used in the description of the embodiments or the prior art. It is obvious to those skilled in the art that In other words, on the premise of no creative labor, other drawings can also be obtained based on these drawings.
图1为本实用新型提供的下颈椎解剖型钛笼的侧视图；Fig. 1 is the side view of lower cervical vertebra anatomical titanium cage provided by the utility model;
图2为本实用新型提供的下颈椎解剖型钛笼的前视图；Fig. 2 is the front view of the lower cervical vertebra anatomical titanium cage provided by the utility model;
图3为本实用新型提供的下颈椎解剖型钛笼的俯视图；Fig. 3 is the top view of the lower cervical vertebra anatomical titanium cage provided by the utility model;
图4为本实用新型提供的下颈椎解剖型钛笼的仰视图；Fig. 4 is the bottom view of the lower cervical vertebra anatomical titanium cage provided by the utility model;
图5为本实用新型提供的下颈椎解剖型钛笼的后视图；Fig. 5 is the rear view of the lower cervical vertebra anatomical titanium cage provided by the utility model;
图6为本实用新型提供的下颈椎解剖型钛笼的正等轴侧视图。6 is an isometric side view of the lower cervical vertebra anatomical titanium cage provided by the present invention.
其中：1为穹隆结构；2为斜型结构；3为网状结构；4为第一前表面；5为第一后表面；6为第一左侧面；7为第一右侧面；8为菱形网孔。Wherein: 1 is the dome structure; 2 is the oblique structure; 3 is the mesh structure; 4 is the first front surface; 5 is the first rear surface; 6 is the first left side; 7 is the first right side; 8 It is a diamond mesh.
具体实施方式Detailed ways
为了使本领域的技术人员更好地理解本实用新型的技术方案，下面结合附图及实施例对本实用新型作进一步详细描述。In order to make those skilled in the art better understand the technical solutions of the present invention, the present invention will be further described in detail below with reference to the accompanying drawings and embodiments.
实施例1：Example 1:
参见图1-6所示，本实用新型提供了一种下颈椎解剖型钛笼，该解剖型钛笼包括：钛笼本体，钛笼本体的上端为穹隆结构1，下端为斜型结构2，穹隆结构1与斜型结构2之间设有网状结构3，网状结构3分别与穹隆结构1、斜型结构2相连接；网状结构3包括依次连接的第一前表面4、第一左侧面6、第一后表面5及第一右侧面7，第一前表面4、第一后表面5均呈弧形结构，第一左侧面6、第一右侧面7均呈平面结构。1-6, the present invention provides a lower cervical vertebra anatomical titanium cage, the anatomical titanium cage includes: a titanium cage body, the upper end of the titanium cage body is a
进一步地，钛笼整体呈方形结构，在手术节段融合及支撑强度方面具有巨大优势：将钛笼设计为方形可以充分利用终板后方及后外方的强度优势，使得手术节段获得更好的力学性能，有利于防止钛笼塌陷；在相同直径下，方型设计相比于传统圆形设计具有更大的植骨容积，可容纳更多的松质骨颗粒，有利于手术节段的植骨融合；方形设计使得钛笼两侧面为平面，增大了与残留椎体之间的接触面积，有利于与其之间的骨性融合。Further, the titanium cage has a square structure as a whole, which has great advantages in terms of fusion and support strength of the surgical segment: the design of the titanium cage in a square shape can make full use of the strength advantages of the posterior and posterior outer parts of the endplate, so that the surgical segment can obtain better results. Compared with the traditional circular design, the square design has a larger bone graft volume and can accommodate more cancellous bone particles, which is beneficial to the operation of the surgical segment. Bone graft fusion; the square design makes the two sides of the titanium cage flat, which increases the contact area with the residual vertebral body, which is conducive to the bony fusion between them.
进一步地，第一左侧面6及第一右侧面7相互平行。优选地，第一左侧面6及第一右侧面7在整个钛笼本体后1/3处的中线上的高度为19mm，向两侧逐渐递减，由内向外厚度为2mm。平面结构的设计，增大了钛笼本体与残留椎体的之间接触面积，有利于钛笼与其之间的骨性融合。Further, the first
进一步地，穹隆结构1包括相连接的前、后、左、右四个弧形结构；所述左弧形结构的顶点A、右弧形结构的顶点B分别位于对应弧形结构的后1/3位置处，向两侧递减，所述前弧形结构的顶点C、后弧形结构的顶点D分别位于对应弧形结构的正中间位置，并向两侧递减。该穹窿结构1，向下与网状结构3相连。优选地，穹隆结构1的前后径、左右径为12mm，由内向外厚度为2mm。Further, the
进一步地，网状结构3沿周向分布有若干菱形结构层，相邻的菱形结构层交错排列，每层菱形结构层包括若干菱形网孔8。Further, the
进一步地，菱形结构层的层数为六层，每层菱形网孔8的数量为九个。Further, the number of layers of the diamond structure layer is six, and the number of diamond meshes 8 in each layer is nine.
进一步地，网状结构3的高度为19mm，宽度为2mm，厚度为2mm，该网状结构的设计，主要目的在于增大钛笼内植骨粒与周围骨质的接触面积，有利于手术区域骨质的早期融合。Further, the height of the
优选地，网状结构3在钛笼本体的正中线上的高度为19mm，向两侧逐渐递减，由内向外厚度为2mm，这增大了钛笼本体与颈椎椎体下面的接触面积，减少了颈椎椎体下面所承受的压强，从而有效预防塌陷情况的发生。Preferably, the height of the
进一步地，斜型结构2包括依次连接的第二前表面、第二左侧面、第二后表面及第二右侧面，所述第二前表面、第二后表面均呈弧形结构，所述第二左侧面、第二右侧面均呈斜型结构。Further, the
进一步地，第二前表面的顶点、第二后表面的顶点分别位于第二前表面、第二后表面的中间位置处，且从顶点向两侧平滑递减，向上与网状结构3相连。Further, the apex of the second front surface and the apex of the second rear surface are respectively located at the middle position of the second front surface and the second rear surface, and gradually decrease from the apex to both sides, and are connected to the
进一步地，所述第二左侧面的顶点、第二右侧面的顶点分别位于对应斜型结构的后端，且所述第二左侧面、第二右侧面的高度分别从对应斜型结构的前端向后端递增，向上与网状结构3相连。Further, the apex of the second left side and the apex of the second right side are respectively located at the rear end of the corresponding inclined structure, and the heights of the second left side and the second right side are respectively from the corresponding oblique structures. The front end of the type structure increases toward the rear end, and is connected to the
优选地，斜型结构2的前后径、左右径为12mm，由内向外厚度为2mm。Preferably, the front and rear diameters and the left and right diameters of the
综上，该下颈椎解剖型钛笼，总高度25mm，前后径、左右径为12mm。其上面最高点位于后1/3处，向两侧逐渐递减；其下面从前向后逐渐升高。本实用新型的下颈椎解剖型钛笼适用于颈椎椎体次全切除减压联合钛笼植骨融合术治疗的疾病，例如：神经根型或脊髓性脊椎病、颈椎椎管狭窄、相邻两节段颈椎间盘突出症、颈椎后凸畸形、椎体肿瘤、椎体结核、非神经功能受损的颈椎体爆裂性骨折、压缩性骨折等。以下就椎间盘摘除、椎体次全切及本钛笼植入术具体的实施方式予以说明：To sum up, the lower cervical vertebra anatomical titanium cage has a total height of 25mm, an anterior-posterior diameter, and a left-right diameter of 12mm. The highest point above it is located in the rear 1/3, and gradually decreases to both sides; the lower part gradually increases from front to back. The lower cervical vertebra anatomical type titanium cage of the utility model is suitable for diseases treated by subtotal cervical vertebral body resection and decompression combined with titanium cage bone grafting and fusion, such as: nerve root type or spinal spondylopathy, cervical spinal stenosis, adjacent two Segmental cervical disc herniation, cervical kyphosis, vertebral body tumors, vertebral body tuberculosis, non-neurologically impaired cervical vertebral body burst fractures, compression fractures, etc. The specific implementations of intervertebral disc extraction, vertebral subtotal resection and titanium cage implantation are described below:
对具备该术式适应症的患者行常规术前检查，并行推移气管和食管、床上排尿、排便练习。术中患者取仰卧位，患者气管内插管麻醉完成后，双肩垫以软枕，头颈自然向后仰伸，后枕部垫以软头圈，消毒铺巾后，在颈前中线偏右侧行横切口，切口长度一般为3～5cm。逐层向下钝性分离软组织，使用颈椎拉钩将气管、食管及向右侧牵拉保护，颈动脉鞘稍向两侧牵拉保护。抵达椎体和椎间盘前部后，使用C型臂确定需行椎体次全切的颈椎节段。于需行椎体次全切的椎体的上下位椎体中央分别拧入撑开器螺钉，在撑开螺钉上套入椎体撑开器，向上下两端撑开，撑开距离一般为4mm。确定相应椎体的上下方椎间盘，用尖刀切开纤维环，髓核钳取出破碎的椎间盘组织。在需行椎体次全切的椎体上纵行开槽减压，开槽宽度为两侧颈长肌内侧缘偏外侧1～2mm，以及相邻椎间盘直至后纵韧带表面。如存在后纵韧带骨化则先用后纵韧带钩在后纵韧带上开口，与硬膜间钝性分离后使用长喙状冲击式咬骨钳咬除，并扩大切除纵形骨槽，四周底边的骨质作潜行减压，包括切除上椎体后下缘、下椎体的后上缘和骨槽两侧椎体的骨赘，刮至相邻椎体终板软骨面呈点状出血。量取骨槽的长度后选取合适长度的这种下颈椎解剖型钛笼。钛笼内腔填充减压获得的碎骨块并嵌紧，然后将此钛网植入减压槽内，钛网周围辅以多余的碎骨。去除椎体前方的椎体撑开器及撑开落定，选取合适大小的颈前路钢板，采用专用器械按步骤安放并锁定，放置引流管后逐层关闭切口。术后常规护理，1天后拔出引流管。术后严格佩戴颈托3月，3月后摘除。Routine preoperative examinations were performed on patients with the indications for this operation, and the trachea and esophagus were pushed, and urination and defecation were practiced on the bed. During the operation, the patient was placed in a supine position. After the endotracheal intubation anesthesia was completed, the shoulders were placed with a soft pillow, the head and neck were naturally stretched backward, and the posterior occiput was placed with a soft headband. After disinfection, the towel was placed on the right side of the anterior midline of the neck. A transverse incision is made, and the length of the incision is generally 3 to 5 cm. The soft tissue was bluntly separated layer by layer, and the trachea, esophagus, and the trachea were pulled to the right with a cervical retractor, and the carotid sheath was slightly pulled to both sides for protection. Once the vertebral body and anterior disc are reached, the C-arm is used to identify the cervical segment for subtotal vertebrectomy. The distractor screws are screwed into the center of the upper and lower vertebral bodies of the vertebral body that needs to undergo subtotal vertebral resection, and a vertebral body distractor is sleeved on the distraction screw, and the upper and lower ends are opened. 4mm. Determine the upper and lower intervertebral discs of the corresponding vertebral bodies, cut the annulus fibrosus with a sharp knife, and take out the broken intervertebral disc tissue with the nucleus pulposus forceps. Longitudinal decompression is performed on the vertebral body requiring subtotal vertebral resection. The width of the groove is 1 to 2 mm lateral to the medial border of the longus longus muscle on both sides, and the adjacent intervertebral disc to the surface of the posterior longitudinal ligament. If there is ossification of the posterior longitudinal ligament, first use the posterior longitudinal ligament hook to open the posterior longitudinal ligament, bluntly separate it from the dura, and then use a long beak-shaped impact rongeur to bite off, and expand the longitudinal bone groove, surrounding The bottom edge of the bone is decompressed by stealth, including the removal of the posterior and inferior edges of the upper vertebral body, the posterior and superior edges of the lower vertebral body, and the osteophytes of the vertebral bodies on both sides of the bone groove. bleeding. After measuring the length of the bone groove, select the appropriate length of this lower cervical vertebra anatomical titanium cage. The inner cavity of the titanium cage is filled with the bone fragments obtained by decompression and fastened, and then the titanium mesh is implanted into the decompression groove, and the excess bone fragments are supplemented around the titanium mesh. The vertebral body distractor in front of the vertebral body was removed and the opening and settling were performed, an appropriate size of anterior cervical plate was selected, and special equipment was used to place and lock it in steps. After placing the drainage tube, the incision was closed layer by layer. Routine postoperative care, the drainage tube was pulled out 1 day later. The cervical collar was strictly worn for 3 months after surgery, and was removed after 3 months.
由于下颈椎椎体高度和大小在人群中存在差异，所以我们设计了10种不同型号以满足不同下颈椎椎体高度和大小的需求。包括1号、2号、3号、4号、5号、6号、7号、8号、9号、10号十种型号。标准型号即3号(钛笼总高度为25mm，前后径、左右径为12mm)已在上述实施例中进行了详细阐述。1号是在这种下颈椎解剖型钛笼标准型号的基础上将高度减少4mm；2号是在这种下颈椎解剖型钛笼标准型号的基础上将高度减少2mm；4号是在这种下颈椎解剖型钛笼标准型号的基础上将高度增加4mm；5号是在这种下颈椎解剖型钛笼标准型号的基础上将高度增加2mm；6号在这种下颈椎解剖型钛笼标准型号的基础上将前后径及左右径增加2mm，并将高度减少4mm；7号在这种下颈椎解剖型钛笼标准型号的基础上将前后径及左右径增加2mm，并将高度减少2mm；8号在这种下颈椎解剖型钛笼标准型号的基础上将前后径及左右径增加2mm；9号在这种下颈椎解剖型钛笼标准型号的基础上将前后径及左右径增加2mm，并将高度增加2mm；10号在这种下颈椎解剖型钛笼标准型号的基础上将前后径及左右径增加2mm，并将高度增加4mm。Due to the differences in the height and size of the lower cervical vertebral body in the population, we designed 10 different models to meet the needs of different lower cervical vertebral body heights and sizes. Including No. 1, No. 2, No. 3, No. 4, No. 5, No. 6, No. 7, No. 8, No. 9, No. 10 ten models. The standard model, namely No. 3 (the total height of the titanium cage is 25mm, the front-rear diameter and the left-right diameter are 12mm) has been described in detail in the above-mentioned embodiment. No. 1 is to reduce the height by 4mm based on the standard model of this lower cervical anatomical titanium cage; No. 2 is to reduce the height by 2mm on the basis of this standard model of this lower cervical anatomical titanium cage; No. 4 is in this The height of the lower cervical anatomical titanium cage is increased by 4mm on the basis of the standard model; the height of the 5th is increased by 2mm on the basis of this standard model of the lower cervical anatomical titanium cage; the 6th is the standard model of the lower cervical anatomical titanium cage. On the basis of the model, the anterior and posterior diameters and the left and right diameters are increased by 2mm, and the height is reduced by 4mm; on the basis of the standard model of this lower cervical anatomical titanium cage, the anterior and posterior diameters and the left and right diameters are increased by 2mm, and the height is reduced by 2mm; No. 8 increases the anteroposterior and left and right diameters by 2mm on the basis of this standard model of lower cervical anatomical titanium cage; No. 9 increases the anteroposterior and left and right diameters by 2mm on the basis of this standard model of lower cervical anatomical titanium cage. The height is increased by 2mm; on the basis of the standard model of this lower cervical anatomical titanium cage, the anterior and posterior diameters and the left and right diameters are increased by 2mm, and the height is increased by 4mm.
该下颈椎解剖型钛笼，根据颈椎解剖数据测量结果对下颈椎解剖型钛笼的上端采用穹隆结构的设计，并且在对下颈椎解剖型钛笼的下端采用斜型结构的设计，模拟颈椎手术节段角度，从而扩大了钛笼与颈椎终板之间的接触面积，降低应力集中现象，使得应力均匀地分布在终板表面，进而降低钛笼塌陷的发生率。The lower cervical vertebra anatomical titanium cage adopts a dome structure design on the upper end of the lower cervical vertebra anatomical titanium cage according to the measurement results of cervical vertebra anatomical data, and adopts an oblique structure design on the lower end of the lower cervical vertebra anatomical titanium cage to simulate cervical spine surgery. The segmental angle increases, thereby expanding the contact area between the titanium cage and the cervical endplate, reducing stress concentration, so that the stress is evenly distributed on the surface of the endplate, thereby reducing the incidence of titanium cage collapse.
以上所述仅是本实用新型的具体实施方式，使本领域技术人员能够理解或实现本实用新型。对这些实施例的多种修改对本领域的技术人员来说将是显而易见的，本文中所定义的一般原理可以在不脱离本实用新型的精神或范围的情况下，在其它实施例中实现。The above are only specific embodiments of the present invention, so that those skilled in the art can understand or realize the present invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be implemented in other embodiments without departing from the spirit or scope of the invention.
应当理解的是，本实用新型并不局限于上述已经描述的内容，并且可以在不脱离其范围进行各种修改和改变。本实用新型的范围仅由所附的权利要求来限制。It should be understood that the present invention is not limited to what has been described above, and various modifications and changes can be made without departing from its scope. The scope of the present invention is limited only by the appended claims.
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| CN110897695A (en)* | 2019-11-21 | 2020-03-24 | 西安交通大学第二附属医院 | Anatomical titanium cage for lower cervical vertebra |
| CN110897695B (en)* | 2019-11-21 | 2024-11-26 | 西安交通大学第二附属医院 | A titanium cage for lower cervical anatomical spine |
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