 Intervertebral disc prosthesis
专利摘要:
1. INTERLESSIONAL DISK PROTESIS, containing a 4-sided body with two ends, made of a biocompatible material, that is, with the aim of eliminating pain when using the prosthesis mainly in the cervical spine, The opposite sides are flat, and the other two are convex, the surface of the body is made in the form of alternating protrusions and depressions, ODH1, the end of the body has a threaded hole or flange protruding above the convex sides, and the other end of the body is en wedge-shaped. 2. Prosthesis pop. 1, which differs from the fact that the projections and depressions of the body form closed grooves parallel to each other and to the ends of the body. 3. The prosthesis according to claim 1, characterized in that, in order to ensure the flexibility of the articulation, the body is made of two elements that are connected pivotally in the form of a hemispherical protrusion {and hollow. CO 4. The prosthesis according to claim 1, which also means that, in order to prevent the body from growing through the bone tissue, the said biologically compatible material is polymethyl methacrylate and nickel-nickel alloys. 公开号:SU1127522A3 申请号:SU813301457 申请日:1981-06-12 公开日:1984-11-30 发明作者:Кунц Дж.Дэвид 申请人:и； IPC主号:
专利说明:
The invention relates to medicine, more specifically to traumatology and orthopedics, and is used in operadia. The intervertebral disc prosthesis, made in the form of a kidney-shaped body, the material of which is a porous synthetic membrane, is known. . Scraping the prosthesis will result in a narrowing of the surface area by the vessels. . Also known is an intervertebral disc prosthesis containing a 4-sided research institute case with two ends, made of a biologically compatible material 2J. However, the disadvantage of this known prosthesis is also the possibility of painful sensations when used in the cervical spine. In addition, the shape of the body does not match the shape of the adjacent surfaces of the vertebrae, which ultimately will lead to their destruction. The purpose of the invention is to eliminate pain when using the prosthesis mainly in the cervical spine. The goal is achieved in those in an intervertebral disc prosthesis containing a 4-sided body with two ends made of a biologically compatible material, two opposite sides are made flat, and the other two are convex, the surface of the body is alternate protrusions and troughs, one end of the body has a threaded bore or a french protruding above the tight sides, and the other end of the body is wedge-shaped, in addition, the projections and cavities of the body form closed grooves parallel to yourself and the ends of the hull. In addition, the casing is made of two elements that are hingedly connected in the form of a hemispherical protrusion and a hollow, which provides flexibility of articulation, besides that, polymethylmethacrylate and nickel-nickel alloys are biologically compatible. FIG. Figure 1 shows a horizontal projection of an intervertebral disc prosthesis; in fig. 2 shows a frontal projection of the prosthesis in FIG. 3 is an axonometric projection of FIG. 4 - scheme of the vertebral column with intervertebral disc, prosthesis; in fig. 5-10 - on the lumbar intervertebral spaces, in the plan, in which the steps of the intervertebral disk prosthesis installation according to the second use case are shown; Fig. 11 is a front projection of the prosthesis that is installed in the lumbar spine of Fig. 12 — installation of the prosthesis in the spinal column according to the third use case J on; FIG. 13-. prosthesis with a screw hole instead of a flange. The intervertebral disk prosthesis has a body 1, made of a thin block of biocompatible material, having slightly narrow sides 2,3, grooves 4, on the sides 2,3 and flat sides 5 flange 6, protruding above the convex sides 2,3 on one end of the body, and another wedge-shaped end 7. Although transverse grooves 4 are preferred for creating frictional mating, because the main deformation forces tend to displace the prosthesis in the longitudinal (anterior-posterior) direction, other surface waviness may be used, ystupy and cavities, e.g., pyramidal, rhomboid, as rasps or ruled protrusions. In general, any small protrusions, grooves, or undulations may be used to interfere with the movement of the prosthesis. The wedge-shaped end 7 allows for an easier insertion of the prosthesis into the disc gap. The wedge shape allows the vertebrae to be separated to the required distance when the prosthesis is in place. In addition, the wedge-shaped form is better adapted at the back of the disc gap and it does not interact with the outer edges of the vertebrae. The flange 6 is necessary in order to protect the surgeon from inadvertently bringing the prosthesis far enough into the disk gap, for example, into the nerve canal, which can lead to quadriplegia. It also prevents the prosthesis from migrating after the end of the operation and, in addition to the growth of fibrous-cartilage tissue in the grooves 4, helps to fix the prosthesis precisely in place. flange b is shown projecting over convex sides 2,3. If necessary, flange 6 can form a protrusion only on one of the convex dimensions. In addition, fpanec 6 does not necessarily have to be horizontal over the entire width of the body f, but it can only be part of this width. The fan b also greatly facilitates the clamping of the housing 1, especially during the insertion and removal from the disk space. The extreme difficulty of clamping a double-prosthetic prosthesis with a B1 # Iman1 from the Disk Punch can be well represented, since the tool, gripping the body 1, tends to shoot them further into the disc gap. The disk space must be expanded to a sufficient distance in order to empower the complete introduction of the installation tool. However, the presence of fpantz b makes taking out relatively simple, since it remains outside the disk and can easily be pinched. Despite the noted advantages of the flange 6, it can be excluded if the posterior edge of the prosthesis is instead equipped with a threaded hole 8 (Fig. 13) so that the body 1 can be attached to the retaining tool 9 when inserted or removed. When the prosthesis is set up accordingly, the instrument 9 can be removed and the reattachment 8 is filled with a screw (not until ZS1) in order to prevent ny fibrous tissue. . I. ... It is a gasket and can be made of any biocompatible material of sufficient strength and durability, for example, high density polyethylene, polymethyl methacrylate, stainless steel or chromium-cobalt C alloys. The simplest material for the prosthesis is a polymer, preferably high-density polyethylene, which may contain an X-ray-opaque label that allows radiological location of the prosthesis. FIG. 4, a frontal projection of a part of the spinal column is shown, in which the vertebrae 10 are separated by a normal disk 11, a narrowed disk 12 resulting from injury, illness or reincarnation, and proposes a 1st prosthesis. It shows how the prosthesis can be used to restore the normal intervertebral disc gap. The prosthesis shown in FIG. 1-4, is intended primarily for use as a cervical disc prosthesis. When a prosthesis is required for the lumbar region, it is best to make it from two halves 13, 14, and the separation is performed in a longitudinal vertical plane. At the same time, both halves 13, 14 have a width equal to the total size of the gap created when performing bilateral bilateral lumbar dissection. Regardless of the two-sided structure of the lumbar prosthesis and the difference in all sizes, it is the same as the cervical prosthesis described above. Another variant of the proposed disk prosthesis is shown in FIG. 12 and is the body 15 of the two halves in position between the vertebrae 16, 17.g Case 15 is similar to case 1 ; except that it is made of two halves 18 and 19, so that 1WHT bend and extend movements within the hull structure 15. One half of 18 has hemispherical protrusion 20, and the other half 19 has a hemispherical hollow 21. Hemispherical protrusion 20 and the hollow. 21 are interlinked to form a simple point of support allowing the body 15 to bend. In addition, when stretching the spinal spine, both halves of t8, 19 can separate by a small amount, since the hemispherical protrusion 20 can simply be retracted from the cavity 21. In this way, elongation can be made without impairment of the articulation of the vertebral prosthesis and, consequently, of the fibro-cartilage membrane of these articulations. Despite the half construction, body 15 is similar to body 1 in that IT also has transverse canals 4, convex sides 2,3, over which flange 6 protrudes at one end. In addition, the other end 7 is also wedge-shaped. One of the halves 18 may be made of stainless steel, and the other half 19 is made of high-density polyethylene. These dissimilar materials create a low coefficient of friction at the fulcrum. The housing 15 may be used as a cervical prosthesis or as one half of a replacement prosthesis. The operation to replace the cervical disk with an intervertebral disk prosthesis is carried out in the following way. The patient is prepared on the table in the operating room under general anesthesia with the introduction of an intratracheal tube and with the engagement of the neck loop. Between the shoulders have a bag. with sand or a folded towel, and a small pad is placed under the head in order to create a certain degree of neck stretching and lengthening to facilitate access during the operation. The neck is prepared and a square lining is placed at the back. A right anterior transverse cervical incision is made approximately two to three fingers wide above the top notch. The incision level depends on the level of the cervical disc or the affected discs. The incision is located higher if the lesions of the disks are located high in the neck. The wide muscle is dissected. After identification, the stornocleidomastoid and carotid arterial ligaments are horizontally retracted. The banana & trachea and esophagus are retracted into the middle. Large discs are identified visually and by palpation. The needle marker is located in place and a horizontal X-ray translucence is performed in the operating room to establish the level of the needle and, therefore, the level of the acting discs. Straps are put on the patient's wrist for retracting during x-ray imaging. As soon as the level of diseased disks identified before surgery is positively identified in the operating room, the affected disks are cut out and the gap is scraped out with the removal of the entire disk. Subsequent longitudinal ligament is not removed and the nerve canal is not viewed during the procedure. The periosteal uplift of the arm is then located in the disc gap and rotated in order to widen the gaps and restore the width of the spinal disc gap to normal. When you open the gap and divide the vertebrae, the slash is clicked. The importance of this signal lies in the fact that the sticking between the both sides of the exit aperture and the edges, as well as the back side of the vertebral body, ceases. The height of the outlet, therefore, is restored in the front-rear plane at this point in time. Once the gap has been scraped to the back of the body and at the same time that the force is applied to the neck from the anesthesiologist, the intervertebral disk prosthesis is replaced. It is completely stable in its position, and after removal of the force, it is precisely positioned between adjacent vertebrae. At this time, fluoroscopy can be used in the operating room to confirm the restoration of the width of the disc gap. It is recommended that all recognized constricted discs detected by fluoroscopy be replaced during surgery, and can be restored from one to four levels at a time. The wound is then healed in layers and an absorbent suture material is used on the skin. Overlapping is easy. The cervical collar is not beneficial as the prosthesis has inherent stability during installation. The average hospital stay is approximately three days and after surgery the neck mobilization is not required. It is noted that headaches, pain in the neck and pain in the hands of cervical disc syndrome usually subside on the day of surgery. Dizziness, memory lapses (blurring of vision, as well as tinnitus related to vertebral artery syndrome also disappear on the day of surgery. However, there are some postoperative inconveniences for up to one month and related to the swelling of wrinkled lungs 2. Replacing the lumbar disc. Replacing the lumbar disc should be done through the posterior quo part of the body. This allows the surgeon to release any nerve ending or part of the nerve canal that is prone to stenosis during surgery. cutting any free disc fragments in the nerve canal Replacing the lumbar disc via the anterior or posterior abdominal approach is impractical, since the surgeon cannot in this case lead or unclench the nerve endings or the nerve canal. Moreover, the surgery is preceded by increased pain, including problems, as male impotence due to the tearing of the fibers of the autonomic nervous system; te1 "l, lying on top .. The disk prosthesis should be inserted into the remaining space after the usual dissection by the surgeon. Dissectomi should ideally be made with a double-sided incision of the entire back ring and simply removed soft core. The disc prosthesis should be designed specifically for the lumbar region. This prosthesis consists of two halves 13 and 14, which together comprise a diameter equal to the entire gap size, resulting from a bilateral lumbar dissectomy. One component is inserted from each side at the expense of diversion. Neither Canda egiiina n withdrawal | end on the opposite side to the centerline, while cutting the disc and removing the disc. .. Etage of this surgical technology is shown in FIG. 5-11. Figure 5 shows a schematic top view of the intervertebral disc space above the lumbar vertebra 22, showing the nerve canal 23 containing the appendix 24 (Canda eguina), the back ring 25, the front ring 26 and the soft nucleus 27 of the natural disc. As shown in FIG. 6, the process 24 (Canda eguina) is moved to one side by the surgeon by means of the contractile muscle 28 of the nerve ending, the ring 25 is cut to the midline, and the soft core 27 is removed. A half 13 of the lumbar disc prosthesis is inserted (as shown) in FIG. 7), and thereafter, the procedure is repeated on the other hand (as shown in Figs. 8 and 9) in order to introduce the second half 14 of the lumbar disc prosthesis. The process (Canda eguina) is then released, as shown in FIG. 10, and the wound is closed in the usual way. FIG. 11 is a front view of the implanted prosthesis, with only half of the 14 prostheses visible. In this illustration, it is clear that: the front ring 26 remains intact. The halves of the prosthesis 13 and 14 work together as well as a single unit. Each of them has two convex sides 2,3, grooves 4, flange 6 and a wedge-shaped end 7. The horizontal width of each half of 13 and 14 is such that together they occupy most of the cavity, previously occupied by that soft gentle 27. Two convex sides 2.3 are intended to create a frictional engagement by means of the grooves 4, since the laminate gasket is removed and an excessively loosened gap can return to normal width. Friction clutch can be created at the expense of other features of the surface, as in the previous version. The flanges 6 are designed to prevent parts of the prosthesis 13 and 14 from migrating forward towards the cavity. They also allow for ease of removal as well as insertion of the prosthesis. In case of infection of the disc gap, the flanges 6 allow for quick removal of parts of the prosthesis. The wedge-shaped end 7 is intended for an easy start of work, after parts of the prosthesis are installed in place. Dual cowling for natural disc spacing makes it possible a stable prosthesis that works as natural, especially when inserted into a friction surface design. It is recommended to produce bilateral laminectomy, and both sides or components must be inserted. However, this prosthesis is used by a surgeon who wishes to perform a semi-ainectomy, removing an isolated fragment without an approach from the opposite side, as this will further prevent many of the problems currently present in disk surgery. However, when using both halves, 13, 14 of the prosthesis, as recommended, the total load or area of application of weight doubles, and this is more satisfying and less likely to result in some problems related to erosion of the prosthesis in the vertebral end plates due to uneven load distribution. The advantages of replacement by the lingual disc using the proposed prosthesis are as follows. Dislocation of the apofit joint after a narrowing of the gap does not occur if a disk prosthesis is installed. Progressive posterior deflection of residual posterior fibrosis does not occur, as it is notched in the order of the surgical preparation of the gap for the prosthesis. Progressive frontal deflection of the nervous kgshala does not occur at the back as it is also Vfezan during surgery. Progressive deformity of the bone canal due to increased deviation or increased lumbar lizardosis does not occur, as the height of the back of the disc is maintained. Progressive contact does not occur between the spinal processes as they are excised during a surgical operation. Moreover, if the Interval cannot be narrowed, the dorsal processes will not be in contact in the future. Progressive creeping out of any residual fragments of soft core, pieces of crystalline cartilage and laminae, or anterior ringlets of the annular fiber, do not occur, since the prosthetic disk acts as a sample-preventing migration into ka the reverse direction of these tissues due to a defect arising during surgery in the posterior ring. The operating time spent on thoroughly cleaning and scraping the disc material is reduced, since these tissues cannot migrate later when the stopper of the prosthetic disc is installed. The danger of fatal bleeding due to the perforation of the anterior ring with the following damage to the iliac vessels or veins lying in front does not exist, since the surgeon should no longer penetrate meticulously into the depth of the disk when trying to clean all the fragments that can crawl out later. Since the prosthesis works like a cork, it will not allow migrations back to these fragments. Since these fragments are soft in nature, if they are pushed forward towards the abdominal cavity by the prosthesis, damage cannot occur to the vessels. The advantage of replacing the disc in the cervical spine with a prosthesis is as follows. Replacing cervical discs with prostheses is intended to restore the width of the intervertebral disc gap. Due to this, in turn, the upper-lower diameter or the height of the outlet opening is restored, which has been reduced by the contraction of the disc gap. It also restores the anatomy of the surface of the apophilous joint after surgery to the normal anatomical effect of the ratio. By opening the orifice, the compression of the nerve ending through the narrow orifice decreases accordingly. This, in turn, leads to a reduction in the symptoms of headache, pain in the neck that spreads to the shoulders and arms, associated with them weakness and stiffness in the hands and cysts. four ig.7. 2 one Fig.Z ten eleven 12 ten ten 28 13 25 26 ig.7 P yn.5 fui.W FIG. 11 Fig.12
权利要求:
Claims (4) [1] 1. Intervertebral disk prosthesis, containing a 4-sided body with two ends, made of biologically compatible material, with the fact that, in order to exclude pain when using the prosthesis mainly in the cervical spine, two opposite sides are made flat, and the other two are convex, the surface of the body is made In the form of alternating protrusions and depressions, one end of the housing has a threaded hole or flange protruding above the convex sides, and the other end of the housing is wedge-shaped. [2] 2. The prosthesis according to claim 1, characterized in that the protrusions and depressions of the body form closed grooves parallel to each other and to the ends of the body. [3] 3. The prosthesis according to π. 1, characterized in that in order to ensure joint flexibility, the housing is made of two elements pivotally connected in the form of a hemispherical protrusion and a hollow. [4] 4. The prosthesis according to claim 1, which is related to the fact that, in order to exclude bone tissue from invading the body, the aforementioned biocompatible material is polymethyl methacrylate and chromium-nickel alloys. Figure 1 .SUni. 1127522
类似技术:
公开号 | 公开日 | 专利标题 SU1127522A3|1984-11-30|Intervertebral disc prosthesis US6579318B2|2003-06-17|Intervertebral spacer JP6309981B2|2018-04-11|Articulating expandable intervertebral implant US6936070B1|2005-08-30|Intervertebral disc prosthesis and methods of implantation JP4173009B2|2008-10-29|Spherical spinal implant KR100488032B1|2005-05-06|Spinal fusion implant KR101190761B1|2012-10-12|Systems and techniques for restoring and maintaining intervertebral anatomy US6805715B2|2004-10-19|Method and device for treating intervertebral disc herniations US6723058B2|2004-04-20|Device and method for determining parameters of blind voids US20080015699A1|2008-01-17|Postero-Lateral Intervertebral Disc Prosthesis EP1405616A1|2004-04-07|Method for correcting a deformity in the spinal column and its corresponding implant PL209138B1|2011-07-29|A pair of lumbar inter-vertebral implants and integration of adjacent vertebra JPH08511701A|1996-12-10|Intervertebral disc prosthesis David1993|Lumbar disc prosthesis JP2016527061A|2016-09-08|Articulating expandable intervertebral implant JPH09122160A|1997-05-13|Artificial intervertebral spacer Leopard1987|Surgery of the non-ankylosed temporomandibular joint Hagert1975|Metacarpophalangeal Joint Implants: II. Roentgenographic Study of the Niebauer™ Cutter Metacarpophalangeal Joint Prosthesis Haas1940|Influence of fusion of the spine on the growth of the vertebrae Rhinelander1977|A flexible composite as a coating for metallic implants microvascular and histological studies Silberstein et al.2000|Shape-memory implants in spinal surgery: long-term results | Dobyns et al.1989|Congenital anomalies of the upper extremity RU2254084C2|2005-06-20|Method for carrying out anterior spine fusion EP1278487B1|2006-09-13|Rotating, locking intervertebral disk stabilizer RU2559275C1|2015-08-10|Method for spinal osteosynthesis in injuries and diseases
同族专利:
公开号 | 公开日 US4349921A|1982-09-21| BR8103700A|1982-03-02| EP0042271A1|1981-12-23| JPS5729348A|1982-02-17| CA1146301A|1983-05-17| EP0042271B1|1984-09-05| AU7169081A|1981-12-17|
引用文献:
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申请号 | 申请日 | 专利标题 CA000353938A|CA1146301A|1980-06-13|1980-06-13|Intervertebral disc prosthesis| US06/159,843|US4349921A|1980-06-13|1980-06-16|Intervertebral disc prosthesis| 相关专利
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