CN103784220B - Multipurpose adsorbable artificial vertebral plate - Google Patents

Abstract

The invention discloses a multi-purpose absorbable artificial lamina, which includes a lamina body, the lamina body is composed of a base body with an arched structure, and outer and inner fixing pieces arranged on both sides of the base body. Autologous bone fragments can be implanted above the matrix, and the two ends of the matrix are respectively provided with an upper edge and a lower edge, and the upper edge and the lower edge are respectively arc-shaped protrusions, and the lower surface of the upper edge and the The upper surface of the lower edge is respectively provided with a first arc-shaped groove and a second arc-shaped groove, and the second arc-shaped groove on the upper surface of the lower edge of the last lamina body can be connected with the next lamina body. The first arc-shaped grooves on the lower surface of the upper edge are seamlessly spliced; the outer side of the fixed piece and the inner side of the fixed piece near the base are respectively symmetrically provided with several suture holes for suturing. The invention has suitable physical properties and mechanical strength, and can be widely used in the repair of various structural defects of the cervical spine, thoracic spine, lumbar spine, sacrococcygeal spine, posterolateral and lateral sides.

Description

Multi-purpose absorbable artificial lamina

technical field

The invention relates to a multipurpose absorbable artificial lamina.

Background technique

Laminectomy is a commonly used surgical method in spinal surgery. It usually refers to the removal of part or all of the lamina through the posterior approach to expose the spinal canal and clean up the lesions in the spinal canal. However, after the laminectomy, the structure of the posterior column of the spine was destroyed by the operation, causing corresponding spinal instability, and scar tissue hyperplasia was formed in the laminar defect area, which adhered to the dura mater and nerve roots, involved, and compressed neurovascular tissues. Symptoms recur afterward, leading to failure after spinal surgery (FBSS), which seriously affects the long-term effect of spinal surgery. How to prevent the occurrence of this complication is an urgent issue in the field of spinal surgery.

Artificial lamina (artificial lamina, AL) is when the human spine lamina, rear or posterolateral structure is resected or lost due to other reasons such as lesions, it can be used as a kind of implant repair for the resected or missing part. artificial implants. The artificial lamina has a preventive effect on the secondary scar adhesion caused by laminectomy, which leads to compression of the dural sac and nerve roots and spinal instability, and can effectively separate the dura mater from the rough surface of the sacral spinous muscle To prevent posterior fibrous tissue from growing into the spinal canal, it can also prevent scar tissue from compressing the dura sac and spinal cord.

The ideal artificial lamina should conform to the physiological structure and functional anatomical characteristics of the human lamina, and should also have the ability to differentiate into functional living bone, provide support for the deposition and growth of new bone cells, and completely repair the lamina. Defects, participating in the formation of the spinal canal, protecting the dural sac from compression, avoiding adhesions, stabilizing the spine, and preventing postoperative restenosis and other complications.

The artificial lamina that adopts in the prior art mainly has following shortcoming:

1. The structure is relatively simple and cannot provide good deposition support for new bone cells, which is not conducive to the growth of new bone. Such as Chinese invention patent ZL02275837.2 (authorized announcement date: 2003.6.25) discloses a kind of artificial lamina, and this lamina is a matrix whose cross-section is an arc-shaped curved surface form and has an axial length at the same time, at least on its arc-shaped curved surface The cross-section of the concave side in the form cross-section is arc-shaped, and the matrix of the artificial lamina lacks support on each side, which is not conducive to the deposition of new bone cells, nor can the hemorrhage after operation be discharged in time. Moreover, the artificial lamina cannot be used to repair small defects of the spinal canal fenestration caused by minimally invasive surgery, nor can it be used to repair large irregular defects of the spine caused by major operations such as severe trauma and spinal tumors.

2. The artificial lamina of the prior art has poor ability to induce target cells to differentiate into osteocytes, which is not conducive to inducing the growth of new bone.

Contents of the invention

In order to overcome the disadvantages of uncontrollable mechanical strength and unfavorable induction of new bone growth in the existing artificial lamina, the present invention provides a multi-purpose absorbable artificial lamina with suitable mechanical strength and favorable induction of new bone hyperplasia and fusion.

The technical scheme adopted in the present invention is:

Multi-purpose absorbable artificial lamina, including lamina body, is characterized in that: the lamina body is composed of a base body with an arched structure, and outer and inner fixing plates arranged on both sides of the base body, the base body Autogenous bone fragments can be implanted above, and the two ends of the base body are respectively provided with an upper edge and a lower edge, and the upper edge and the lower edge are respectively arc-shaped protrusions, and the lower surface of the upper edge and the A first arc-shaped groove and a second arc-shaped groove are respectively opened on the upper surface of the lower edge of the upper edge of the vertebral plate body. The first arc-shaped grooves on the lower surface of the bottom surface are seamlessly spliced; the inner side of the fixed piece and the side of the outer fixed piece close to the base are respectively symmetrically provided with several suture holes for suturing.

Further, the inner surface of the inner fixation piece is provided with a first slope, and the slope of the first slope is adapted to the shape of the fixed joint of the spinous process base.

Further, the outer surface of the outer fixing piece is provided with a second slope, the slope of the second slope is used in conjunction with the first slope on the inner fixing piece of the other lamina body, and the two sides can be realized through the suture hole. The lateral connection of the lamina body.

Furthermore, the diameter of the suture hole is 1-1.5mm.

The multi-purpose absorbable artificial lamina of the present invention is a single piece or different combinations of multiple pieces, which is widely applicable to various minimally invasive fenestration operations of cervical spine, thoracic spine, lumbar spine, sacrococcygeal posterior approach, or posterolateral approach. Repair of local spinal canal wall defects, or postoperative repair of total laminectomy (removal of both lamina and spinous processes) in posterior approach surgery, even suitable for cervical posterior single-door, double-door, Or the filling of the spinal canal wall on the side of the local opening after "Z"-shaped laminoplasty. It can cover various irregular defect areas, reconstruct the sealed state of the spinal canal, and maintain the normal sagittal and transverse diameters of the spinal canal.

The front view of the substrate of the artificial lamina of the present invention can be rectangular or square, and its size can be:

Square dimensions:

10*10mm, 15*15mm, 20*20mm, 25*25mm, 30*30mm, 35*35mm, 40*40mm, and so on;

Dimensions of the rectangle:

10*15mm, 10*20mm, 10*25mm, and so on;

15*20mm, 15*25mm, 15*30mm, and so on;

20*25mm, 20*30mm, 20*35mm, and so on;

25*30mm, 25*35mm, 25*40mm, and so on;

35*40mm, 35*45mm, 35*50mm, and so on.

A plurality of artificial lamellae of the present invention are superimposed and jointed up and down, and are suitable for repairing spinal canal wall defects of various lengths. It not only ensures the airtightness of the spinal canal, prevents the autologous bone fragments implanted above from falling into the spinal canal, effectively prevents scar tissue from climbing into the spinal canal; at the same time, when the human body is active, the whole body can be stretched, rotated and other activities along with the vertebral body , which simulates the physiological state of the human body; and during the exercise, the upper and lower edges make orbital rotation in the arc-shaped groove, so that the upper and lower lamina always maintain a good covering state, ensuring the sealing state of the spinal canal.

The lateral connection of the two artificial lamina, the superposition of the outer fixation plate and the inner fixation plate in the middle part acts as a middle beam, and it is not easy to collapse after the autologous bone fragments are implanted on top. The lateral connection of the artificial lamina is suitable for the repair of various irregular defects in the rear structure of the spinal canal, the posterolateral structure, or the lateral structure.

In the present invention, after the hyperplasia and fusion of bone fragments above the lamina, the reconstructed spinal canal shape, effective sagittal diameter and transverse diameter, and effective spinal canal volume are all close to the normal physiological state.

The artificial lamina of the present invention enables the new bone to grow rapidly according to the predetermined shape of the artificial lamina; meanwhile, the material of the artificial lamina is non-toxic and has good biocompatibility, and the material has a relatively low ability to induce target cells to differentiate into bone cells Strong, so it is more conducive to the development of new bone. The artificial lamina is gradually degraded during use, and finally completely degraded and absorbed by the body when new bone is formed, which is very safe.

The beneficial effects of the present invention are reflected in:

1. The physical properties, mechanical strength, tissue compatibility, and complete absorption time in the body are ideal, and there is no immunoreactivity, no risk of bacterial or viral infection;

2. After the artificial lamina is used, the operator can make full use of the autologous bone fragments obtained during the decompression during the operation for bone grafting, and reconstruct the integrity and stability of the rear spine structure;

3. Before the bone grafts are fused with each other to form a new lamina, the artificial lamina can provide enough support to prevent the bone graft from collapsing and prevent scars from creeping in; while the bone grafts are fused to form a new Behind the strong and strong lamina, it can self-dissolve and completely absorb without leaving foreign matter, and has no toxic side effects on surrounding tissue cells;

4. It can provide sufficient mechanical strength to ensure the proliferation and fusion of autologous bone graft fragments above it, and re-form a complete bony spinal canal;

5. It can effectively prevent scar hyperplasia, compression, and adhesion of dural sac and nerve roots outside the spinal canal;

6. After being implanted in the body, the artificial lamina can fully maintain the effective mechanical strength for 2-3 months, providing enough time for the proliferation and fusion of autologous bone fragments;

7. The artificial lamina can be completely absorbed in the body, and no foreign matter remains;

8. The artificial lamina has excellent compatibility with adjacent tissues and cells in the body, and has no toxic or side effects.

Description of drawings

Fig. 1 is a schematic diagram of the overall structure of the present invention.

Fig. 2 is a schematic view of the lateral structure of the present invention.

Fig. 3 is a schematic cross-sectional view at B-B' of the present invention.

Fig. 4 is a schematic cross-sectional view at A-A' of the present invention.

Fig. 5a is a schematic diagram of superimposing and splicing two artificial lamina according to the present invention.

Fig. 5b is a side view of two artificial lamina of the present invention superimposed and spliced up and down.

Fig. 6 is a schematic view of the use state of the partial fenestration operation of the present invention.

Fig. 7 is a schematic diagram of the lateral connection of two lamina of the present invention.

Figure 8 is a schematic diagram of artificial lamina implantation after local fenestration surgery with partial defect of lamina and posterior structure (autologous bone fragments excised during the operation are reimplanted on top of artificial lamina).

Figure 9 is a schematic diagram of artificial laminar implantation after total laminectomy with complete defects of bilateral laminae, spinous processes, and posterior structures (autologous bone fragments excised during the operation are reimplanted above the artificial laminae).

Figure 10 is a schematic diagram of repairing a single artificial lamina when both the posterior and lateral structures of the spine are irregularly defective.

Figure 11 is a schematic diagram of lateral splicing and repair of multiple artificial lamina when the posterior and lateral structures of the spine are simultaneously irregular.

detailed description

Referring to Figures 1 to 9, the artificial lamina includes a lamina body, the lamina body is composed of a base 1 with an arched structure, and outer fixation pieces 2 and inner fixation pieces 3 arranged on both sides of the base 1. Autologous bone fragments can be implanted above the matrix 1, and the two ends of the matrix 1 are respectively provided with an upper edge and a lower edge, and the upper edge and the lower edge are respectively arc-shaped protrusions 4, and the upper edge The lower surface of the lower edge and the upper surface of the lower edge are respectively provided with a first arc-shaped groove 5 and a second arc-shaped groove 6, and the second arc-shaped groove 6 on the upper surface of the lower edge of the upper lamina body can be It is seamlessly spliced with the first arc-shaped groove 5 on the lower surface of the upper edge of the next lamina body; on the side of the outer fixing sheet and the inner fixing sheet that is close to the base 1, there are respectively symmetrically provided several suturing holes. Suture hole 7.

Further, the inner surface of the inner fixing plate 3 is provided with a first slope 31, and the slope of the first slope 31 is adapted to the shape of the fixed connection of the spinous process base.

Further, the outer surface of the outer fixing piece 2 is provided with a second inclined surface 21, the slope of the second inclined surface 21 is used in conjunction with the first inclined surface 31 on the inner fixing piece 3 of another lamina body, The lateral connection of the two lamina bodies can be realized through the suture hole 7 .

Further, the diameter of the suture hole 7 is 1-1.5mm.

The present invention can absorb different combinations of single or multiple artificial lamina for multiple purposes, and is widely applicable to the posterior approach of the cervical spine, thoracic spine, lumbar spine, sacrococcygeal spine, or posterolateral approach to the local spinal canal wall after minimally invasive fenestration surgery Repair of defects, or postoperative repair of total laminectomy (both laminectomy and spinous process resection) in posterior approach surgery, even for cervical posterior single-door, double-door, or "Z" Filling of the spinal canal wall on the side of the local opening after laminoplasty. It can cover various irregular defect areas, reconstruct the sealed state of the spinal canal, and maintain the normal sagittal and transverse diameters of the spinal canal.

Posterior lumbar surgery as shown in Figure 8: After partial fenestration surgery, the lamina and posterior structures are partially defective, and the artificial lamina is implanted and repaired, and the autologous bone fragments excised during the operation are reimplanted into the artificial lamina. above the lamina.

Posterior lumbar surgery as shown in Figure 9: After total lumbar laminectomy, the bilateral lamina, spinous processes, and rear structures are completely defective, and artificial lamina is implanted and repaired. Autologous bone fragments were reimplanted above the artificial lamina.

As shown in Figure 10, the posterior and lateral structures of the spine are irregularly defective at the same time. When the defect is small, it can be repaired directly with a single artificial lamina, and then bone grafting of autologous bone fragments is performed on the outer side of the artificial lamina for reconstruction. Integrity and tightness of the spinal canal.

As shown in Figure 11, the posterior and lateral structures of the spine are irregularly defective at the same time. If the defect is large, it can be repaired by splicing multiple pieces of artificial lamina laterally, and then performing bone grafting of autologous bone fragments on the outer side of the artificial lamina. , to rebuild the integrity and tightness of the spinal canal.

In this embodiment, the artificial lamina is made of medical absorbable materials, mainly natural biological materials and artificial synthetic materials. The former is mainly prepared with collagen fibers, chitin (chitosan), oxidized cellulose, etc. The latter mainly includes polylactic acid, polytetrafluoroethylene, silicone rubber, etc.

Compared with the above two materials, the solid material cross-linked with recombinant human serum albumin can be used in particular. The recombinant human serum albumin material has the following advantages: 1. Low immunity of human source materials; 2. No Risk of virus infection; 3. Controllable degradation rate; 4. Adjustable mechanical strength; 5. Excellent biocompatibility; 6. Degradation products are safe and have the effect of nutrition and tissue repair.

In this embodiment, the artificial lamina can also be made of biodegradable synthetic bone: nanocrystalline collagen-based bone repair material. Nanocrystalline collagen-based bone repair material is a bionic bone with good biocompatibility, no possibility of immune rejection and cross-infection diseases, and can be acted on by osteoblasts and osteoclasts to form new bone while degrading. bone.

The content described in the embodiments of this specification is only an enumeration of the implementation forms of the inventive concept. The protection scope of the present invention should not be regarded as limited to the specific forms stated in the embodiments. Equivalent technical means that a person can think of based on the concept of the present invention.

Claims (2)

1. multipurpose adsorbable artificial vertebral plate, comprise vertebral plate body, it is characterized in that: described vertebral plate body is by having the matrix of domes and being located at the outside stator of matrix both sides and inner side stator is formed, implantable autologous osteomiosis block above described matrix, the two ends of described matrix are respectively arranged with upper limb and lower edge, described upper limb and lower edge are respectively arc-shaped protrusions, the lower surface of described upper limb and the upper surface of described lower edge offer the first arc groove and the second arc groove respectively, second arc groove of the upper surface of lastblock vertebral plate body lower edge can be seamless spliced with the first arc groove of the lower surface of next block vertebral plate body upper limb, the side of the close matrix on described inner side stator and outside stator is symmetrically arranged with several sewing holes for sewing up respectively,

The inner surface of described inner side stator is provided with the first inclined-plane, the gradient on the first described inclined-plane and the shape of spinous process basilar part fixed connection place suitable;

The outer surface of described outside stator is provided with the second inclined-plane, and the first inclined-plane on the gradient on the second described inclined-plane and the inner side stator of another block vertebral plate body is used in combination, and the side direction realizing two pieces of vertebral plate bodies by sewing hole connects.

2. artificial neural plate as claimed in claim 1, is characterized in that: the diameter of described sewing hole is 1 ~ 1.5mm.