CN104739501B - 3D-printed cervical vertebra pedicle screw guide and implantation plate and preparation method thereof - Google Patents
3D-printed cervical vertebra pedicle screw guide and implantation plate and preparation method thereof Download PDFInfo
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- CN104739501B CN104739501B CN201510149309.1A CN201510149309A CN104739501B CN 104739501 B CN104739501 B CN 104739501B CN 201510149309 A CN201510149309 A CN 201510149309A CN 104739501 B CN104739501 B CN 104739501B
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- 238000002513 implantation Methods 0.000 title claims abstract description 48
- 238000002360 preparation method Methods 0.000 title claims abstract description 7
- 238000000034 method Methods 0.000 claims abstract description 135
- 239000007943 implant Substances 0.000 claims description 11
- 239000000463 material Substances 0.000 claims description 10
- 238000005481 NMR spectroscopy Methods 0.000 claims description 8
- 238000004141 dimensional analysis Methods 0.000 claims description 3
- 230000008676 import Effects 0.000 claims description 3
- 230000001815 facial effect Effects 0.000 claims 1
- 238000005516 engineering process Methods 0.000 abstract description 3
- 238000010146 3D printing Methods 0.000 abstract 1
- 210000003739 neck Anatomy 0.000 description 12
- 230000006837 decompression Effects 0.000 description 7
- 238000009434 installation Methods 0.000 description 7
- 239000011347 resin Substances 0.000 description 7
- 229920005989 resin Polymers 0.000 description 7
- 229910052751 metal Inorganic materials 0.000 description 3
- 239000002184 metal Substances 0.000 description 3
- 230000002146 bilateral effect Effects 0.000 description 2
- 230000006378 damage Effects 0.000 description 2
- 238000004519 manufacturing process Methods 0.000 description 2
- 210000000278 spinal cord Anatomy 0.000 description 2
- 208000010392 Bone Fractures Diseases 0.000 description 1
- 208000007356 Fracture Dislocation Diseases 0.000 description 1
- 206010023509 Kyphosis Diseases 0.000 description 1
- 239000004677 Nylon Substances 0.000 description 1
- 206010041591 Spinal osteoarthritis Diseases 0.000 description 1
- 229910000831 Steel Inorganic materials 0.000 description 1
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 208000036319 cervical spondylosis Diseases 0.000 description 1
- 230000004927 fusion Effects 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 230000001788 irregular Effects 0.000 description 1
- 210000005036 nerve Anatomy 0.000 description 1
- 229920001778 nylon Polymers 0.000 description 1
- 238000005457 optimization Methods 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 239000011435 rock Substances 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 210000000273 spinal nerve root Anatomy 0.000 description 1
- 208000005801 spondylosis Diseases 0.000 description 1
- 239000010959 steel Substances 0.000 description 1
- 239000010936 titanium Substances 0.000 description 1
- 229910052719 titanium Inorganic materials 0.000 description 1
- 210000002385 vertebral artery Anatomy 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
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Abstract
The invention relates to a 3D-printed cervical vertebra pedicle screw (cervical spine 2-7) guide and implantation plate and a preparation method thereof. The implantation plate is printed through the 3D printing technology and comprises one or more guide plates, one or more cervical vertebra pedicle screw guide screw ways and one or more spinous process holes where spinous processes are inserted, wherein the cervical vertebra pedicle screw guide screw ways and the spinous process holes are formed in the guide plates, a plane is arranged on the upper portion of each guide plate, a curve surface is arranged on the bottom of each guide plate and consistent with the vertebral plate reversely, and the plane on the upper portion of each guide plate extends to a screw inlet way and extends for 2-5 mm on the outlet of the plane on the upper portion. When many guide plates are provided, connectors are arranged between the guide plates. Several fixing pins are arranged on the guide plates in order to guarantee stability of the guide and implantation plate, and fixing clamps are arranged near the spinous process holes. The 3D-printed cervical vertebra pedicle screw guide and implantation plate is simple and reasonable in structure, convenient to use and capable of effectively providing individual screw inlet guide hole ways for cervical vertebra pedicle screws, guaranteeing screw inlet accuracy, reducing operation difficulty and operation risks.
Description
Technical field
The invention belongs to cervical posterior approach introductory medical apparatus and instruments and in particular to for 3d print pedicle for cervical vertebra arch spiral shell
Nail guiding implantation plate.
Background technology
The fixing biomechanical stability of Pedicle Screw Placement in Lower Cervical is better than other various technique for fixing of cervical vertebra, even more than
The fixing stability of front road titanium plate+way of escape lateral mass, it is to correct cervical kyphosis, carry out the fixing fusion of cervical vertebra and treat
The preferable fixing meanss of the cervical spondylosis such as fracture-dislocation of cervical spine.But pedicle for cervical vertebra arch not only tiny and also also in surrounding by vertebra
In the narrow space that tremulous pulse, spinal cord and upper and lower nerve root are formed, make pedicle screw inserts difficulty and danger all phases
Should increase.The free-hand nail method of putting commonly used at present is to put nail method according to the free-hand of anatomic landmark.Free-hand exactly insert cervical vertebra vertebra
It is critical only that of pedicle screw accurately enters to follow closely point, enters to follow closely direction, feel and side position perspective in art, but is likely to result in after error
The irreversibility infringement even threat to life such as spinal cord and nerve rootses damage and vertebral artery injuries, high to the technical requirements of doctor.Grind
The auxiliary method for posting studying carefully Pedicle Screw Placement in Lower Cervical has important clinical meaning.
With the progress of 3d printing technique, in medical domain, people attempt reverse engineering is combined with 3d printing technique
Mode, gather the shape data at human organ, skeleton, the position such as joint using the equipment such as ct or nuclear magnetic resonance, NMR (mri), rebuild
Three-dimensional digitalization model, then uses 3d printing type manufacture teaching and referential model of performing the operation, and is usually used in helping manufacture artificial limb
Or carry out surgical repair.Prepare pedicle screw guiding die plate using this kind of mode also not very to popularize, for pedicle for cervical vertebra arch spiral shell
The guiding die plate of nail does not relate to.And prior art exist for pedicle screw enter nail guiding device irregular and wall is thin,
No fixing device after placement, easily rocks, and enters to advance nail guiding just for one piece of vertebral body, is needing continuous polylith vertebral body is entered
When nail of advancing is fixing, also there is irrational place.
The present invention does not have Pedicle Screw Placement in Lower Cervical accurately to enter the problem of the guider of nail guiding for prior art, provides
A kind of rational in infrastructure, using simple, can be guided for pedicle screw very well, and can be effectively to 1 piece to polylith vertebra
Body enters nail of advancing and guides, and can realize the guiding die plate entering nail guiding to bilateral or pleurocentrum.
Content of the invention
In order to overcome existing technology can not enter to advance nail guiding it is impossible to polylith neck to Pedicle Screw Placement in Lower Cervical well
The problem that vertebra vertebral body is guided, it is an object of the invention to provide the cervical vertebra (neck 2 that a kind of 3d that can solve the above problems prints
Neck 7) Pedicle Screw Placement in Lower Cervical guiding implantation plate.
The purpose of the present invention is achieved through the following technical solutions:
The Pedicle Screw Placement in Lower Cervical guiding implantation plate that a kind of 3d prints, including one or a few blocks guide plate, one or several setting
Pedicle screw guiding screw way on guide plate, described guide plate also sets up one or several spinous process hole；Described guide plate top is one
Plane, guide plate bottom curved surface is reversely consistent with vertebral plate；Guide plate upper plane extends to guiding screw way in the exit of upper plane
After re-extend several millimeters；It is reversely consistent that guiding screw way direction and pedicle screw enter screw way direction, guiding screw way axis
Through entering the entry point of screw way；Connecting elements is set between polylith guide plate.Spinous process hole is used for the insertion of spinous process.Guiding screw way is vertebra
Pedicle screw is provided into nail guide channel, pedicle screw can be made accurately to enter pedicle of vertebral arch, prevent the fracture of pedicle of vertebral arch；
The plane on guide plate top can make operation technique be more prone to.
Further, the guide plate number described in such scheme is set to one or more mode,
Guide plate number is that one piece of technical scheme is:
Further, described guide plate can cover the continuous cervical vertebra plate of 1-6 block (neck 2- neck 7), it is possible to achieve to continuously multiple necks
The purpose that vertebra is performed the operation simultaneously.
Further, described spinous process hole is arranged on guide plate central authorities, arranges 1-6 spinous process hole；Described pedicle screw guide pin
Road is arranged on guide plate both sides, and setting 1-6, to guiding screw way, can achieve the mesh that Pedicle Screw Placement in Lower Cervicals multiple to bilateral are guided
's.
Or described spinous process hole is arranged on guide plate side, 1-6 spinous process hole is set；Described pedicle screw guiding screw way sets
It is placed in the opposite side of guide plate, 1-6 guiding screw way of setting, can achieve the mesh that one side boil on the nape opposite the mouth vertebral body pedicle screw is guided
's.
Guide plate number is that technical scheme during polylith is:
Further, described guide plate number arranges 1-6 block, and each guide plate can cover one piece of vertebral body, and each guide plate arranges one
Individual or a pair of pedicle screw guides screw way and a spinous process hole, has been provided with the connecting elements of interconnection function between two guide plates.
Further, in each guide plate central authorities, setting 1 on each guide plate guides described spinous process hole position to described pedicle screw
Screw way, described guiding screw way is arranged on guide plate both sides；Or described spinous process hole position is in each guide plate side, each guide plate is arranged
1 described pedicle of vertebral arch guides screw way, and described guiding screw way is arranged at the opposite side of guide plate.
Further, described connecting elements is used for connecting two adjacent guide plates, connecting elements scalable, makes to be easier during operation
The position of each vertebral plate identical.
Further, connecting elements includes the attachment structure between the connecting hole being arranged on guide plate and guide plate, and attachment structure is
The material of interconnection function, wherein preferably soft steel bar or nylon rope arbitrarily can be played, this setting can be adjusted between guide plate
Distance, can also adjust the angle between guide plate, apply convenient during operation.
On the basis of the plan of establishment with several piece guide plate for the above-mentioned one piece of guide plate, optimization scheme of the invention further:
Further, described bottom curved surface is reversely consistent with cervical vertebra plate, and curved surface is reversely unanimously to outside side plate.
Further, described spinous process hole shape and spinous process form fit, the internal diameter in spinous process hole is consistent with the external diameter of spinous process, spinous process
Hole is effectively enclosed within spinous process.
Further, described guide plate upper plane and the distance of bottom curved surface peak are 3-5mm.
Further, guide plate also sets up one or several fixing nail, fixing nail arranges different numbers because guide plate is of different sizes,
Guide plate can cover setting 2-4 root fixing nail during one piece of vertebral plate, and guide plate can cover setting 4-8 root when 2 pieces or 3 pieces of vertebral plate sizes and fix
Nail, fixing nail is positioned close on the position of guiding screw way, and guide plate middle edge position.The setting of fixing nail can effectively be protected
Card guide plate coincide and stability on vertebral body.
Further, described spinous process hole site is provided with spinous process fixation clamp, and fixation clamp is elastic fixing clip, can be tight when using
Tight clamps spinous process, so that guide plate is more fitted with vertebral plate, stable.
Further, described pedicle screw guiding screw way position is provided with screw way buckle, and buckle controls screw to be in screw way
Center, and the various sizes of screw of scalable accurately passes through guiding screw way.
The invention also discloses the preparation method that the Pedicle Screw Placement in Lower Cervical guiding that described 3d prints implants plate is,
Step 1: obtain the original number of cervical vertebra motion segment (neck 2- neck 7) by scanning techniques such as thin layer ct or nuclear magnetic resonance, NMR
According to；
Step 2: using three-dimensional reconstruction software, set up the threedimensional model of cervical vertebral body and adnexa, and pedicle screw is entered
Nail screw way entry point (c2: lateral mass midpoint, c3-6: near the midpoint of lateral mass outside upper quadrant, c7: 2mm above lateral mass midpoint, partially
Outside about 1mm), enter to follow closely direction and spinous process external diameter carries out three dimensional analysis；
Step 3: the entry point that to the threedimensional model of vertebral body, enters screw way and enter to follow closely direction and carry out reverse matching, form one
The individual fitting surface coincideing with vertebral body, has guide pin road junction and spinous process aperture thereon；
Step 4: curved surface is reversely thickened, makes each put and thicken in a plane, nail side is entered on guide pin road junction edge
Oppositely extending to carrying out, another opening forms in the plane, and spinous process aperture extends along spinous process size, forms another spine in the plane
Prominent aperture, sets up the threedimensional model of Pedicle Screw Placement in Lower Cervical guiding implantation plate；
Step 5: the three-dimensional modeling data being directed to implant plate imports 3d printer, loads printed material, prints guiding
Implantation plate.
Further, described enter screw way cervical posterior approach entry point according to operation need or doctor custom select not
With entry point and enter to follow closely the setting in direction, wherein preferably entry point c2: lateral mass midpoint, c3-6: lateral mass outside upper quadrant
Midpoint near, c7: 2mm above lateral mass midpoint, partially outside about 1mm；The upper soleplate of inserting needle direction and vertebral body angle (c2:
25 °, c3-7:0 ° ±), in the angle (c2:25 ° of leaning angle, c3-6:45 °, c7:40 °) of horizontal plane.
Further, the fitting surface described in methods described step 3 at spinous process matching to spinous process bottom.
Further, the plan range curved surface peak that each point described in methods described step 4 thickens is 2-5mm.
During use, after decompression or during sham operated, implantation plate is placed on corresponding vertebral plate, by pedicle of vertebral arch
Screw guiding screw way is holed on lateral mass, and guiding implantation plate, the use of complete twin installation are taken off in boring after terminating.
Compared with prior art, the invention has the beneficial effects as follows: the setting in spinous process hole can make guiding implantation plate use when
With vertebral plate fitness more preferably, more stable, and without matching to spinous process top during matching, reduce matching difficulty；Implant setting of plate
Put the guiding reaching to different numbers and not homonymy pedicle screw；The setting of guide plate upper plane, makes the simpler appearance of operation
Easily；The setting of fixing nail and spinous process fixation clamp can make device using more stable；The setting of guiding screw way buckle can effectively be protected
Demonstrate,prove the accuracy into nail direction；The setting of attachment structure makes convenient adjustment during operation, can intend to faster every piece of vertebral plate
Close.
Brief description
Fig. 1 is the embodiment of the present invention 1 structural representation；
Fig. 2 embodiment of the present invention 2 structural representation；
Fig. 3 embodiment of the present invention 3 structural representation；
Fig. 4 embodiment of the present invention 4 structural representation；
Fig. 5 embodiment of the present invention 5 structural representation；
Fig. 6 embodiment of the present invention 6 structural representation；
In figure, 1, guide plate；11st, guide plate upper plane；12nd, guide plate bottom curved surface；2nd, guide screw way；3rd, spinous process hole；31st, solid
Clamp；4th, fixing nail；51st, connecting hole；52nd, soft metal bar.
Specific embodiment
The Pedicle Screw Placement in Lower Cervical guiding that embodiment 1 3d prints implants hardened structure
The Pedicle Screw Placement in Lower Cervical guiding implantation plate that a kind of 3d prints, including an entity guide plate 1, the big I of guide plate 1 covers 1
Individual cervical vertebra plate；The pedicle screw guiding screw way 2 that 1 is arranged on guide plate 1, guide plate 1 also sets up 1 spinous process hole 3；Spinous process
Hole 3 is located at guide plate 1 side, and guiding screw way 2 is arranged at the opposite side of guide plate 1, and guiding screw way 2 direction and pedicle screw enter nail nail
Road direction is consistent, and by guiding screw way 2, screw can accurately enter pedicle of vertebral arch.Guide plate 1 top is a plane 11, guide plate 1 bottom
Curved surface 12 is reversely consistent with operation vertebral plate.After guide plate 1 upper plane 11 side extends to guiding screw way 2 exit, then to extension
Stretch 5mm.Side to spinous process opposite side, guide plate upper plane 11 is corresponding with bottom curved surface 12 position.Spinous process hole 3 shape and spinous process
Shape is consistent, and the internal diameter in spinous process hole 3 is consistent with the external diameter shifting of spinous process, and spinous process hole 3 can effectively be enclosed within spinous process.Guide plate 1 top
Plane 11 is 3mm with the distance of bottom curved surface 12 peak.The material of guide plate 1 is medical resin.
During use, after decompression or during sham operated, it is directed to plate and is placed on corresponding cervical vertebra plate, by vertebra
Pedicle screw guiding screw way 2 is holed on cervical lateral mass, and guiding implantation plate, the use of complete twin installation are taken off in boring after terminating.
The Pedicle Screw Placement in Lower Cervical guiding that embodiment 2 3d prints implants hardened structure
The Pedicle Screw Placement in Lower Cervical guiding implantation plate that a kind of 3d prints, including an entity guide plate 1, the big I of guide plate 1 covers 1
Individual cervical vertebra plate；The pedicle screw guiding screw way 2 that 2 are arranged on guide plate 1, guide plate 1 also sets up 1 spinous process hole 3；Spinous process
Hole 3 is located at guide plate 1 central authorities, and 2 guiding screw ways 2 are arranged on guide plate 1 both sides, and guiding screw way 2 direction and pedicle screw enter nail nail
Road direction is consistent, and by guiding screw way 2, screw can accurately enter pedicle of vertebral arch.Guide plate 1 top is a plane 11, guide plate 1 bottom
Curved surface 12 can be reversely consistent with operation vertebral plate；Guide plate 1 bottom curved surface 12 to the lateral mass of both sides, guide plate 1 upper plane 11 to two
Side guiding screw way 2 is behind upper plane 11 exit, then the 4mm that stretches out.Spinous process hole 3 shape is consistent with spinous process shape, spinous process
The internal diameter in hole 3 is consistent with the external diameter shifting of spinous process, and spinous process hole 3 is effectively enclosed within spinous process.Guide plate 1 upper plane 11 and bottom curved surface
The distance of 12 peaks is 4mm.Also set up on the position that 4 fixing nails 4,2 are positioned close to guide screw way 2 on guide plate 1,2
Individual guide plate 1 middle edge position.The setting of fixing nail 4 can be effectively ensured guide plate 1 and coincide and stability on cervical vertebra plate.Lead
The material of plate 1 is medical resin.
During use, after decompression or during sham operated, implantation plate is placed on corresponding cervical vertebra plate, by vertebra
Pedicle screw guiding screw way 2 is holed on cervical lateral mass, and guiding implantation plate, the use of complete twin installation are taken off in boring after terminating.
The Pedicle Screw Placement in Lower Cervical guiding that embodiment 3 3d prints implants hardened structure
The Pedicle Screw Placement in Lower Cervical guiding implantation plate that a kind of 3d prints, including an entity guide plate 1, the big I of guide plate 1 covers
Three cervical vertebra plates；The pedicle screw guiding screw way 2 that 3 are arranged on guide plate 1, guide plate 1 also sets up 3 spinous process holes 3；Spine
Prominent hole 3 is located at guide plate 1 side, and guiding screw way 2 is arranged at the opposite side of guide plate 1, and guiding screw way 2 direction and pedicle screw enter nail
Screw way direction is consistent, and by guiding screw way 2, screw can accurately enter pedicle of vertebral arch.Guide plate 1 top is a plane 11, guide plate 1 bottom
Portion's curved surface 12 is reversely consistent with operation vertebral plate；Guide plate 1 bottom curved surface 12 side to lateral mass, the opposite side of side to spinous process.
Guide plate 1 upper plane 11 side then extends to screw way behind guiding screw way 2 exit of upper plane 11, then the 5mm that stretches out,
Side to spinous process opposite side.Spinous process hole 3 shape is consistent with corresponding spinous process shape respectively, and the internal diameter in spinous process hole 3 is outer with spinous process
Footpath is moved unanimously, and spinous process hole 3 can effectively be enclosed within spinous process.Guide plate 1 upper plane 11 with the distance of bottom curved surface 12 peak is
3mm.The material of guide plate 1 is medical resin.6 fixing nails 4,3 are also set up on guide plate 1 be positioned close to accordingly guide screw way 2
Position on, 3 are arranged on by corresponding spinous process hole 3.The setting of fixing nail 4 can be effectively ensured guide plate 1 on cervical vertebra plate
It coincide and stability.Each spinous process hole 3 position is provided with spinous process fixation clamp 31, and fixation clamp 31 is elastic fixing clip 31, can make
Used time tightly clamp spinous process, so that guide plate 1 is more fitted with cervical vertebra plate, stable.
During use, after decompression or during sham operated, implantation plate is placed on corresponding cervical vertebra plate, by vertebra
Pedicle screw guiding screw way 2 is holed on cervical lateral mass, and guiding implantation plate, the use of complete twin installation are taken off in boring after terminating.
The Pedicle Screw Placement in Lower Cervical guiding that embodiment 4 3d prints implants hardened structure
The Pedicle Screw Placement in Lower Cervical guiding implantation plate that a kind of 3d prints, including an entity guide plate 1, the big I of guide plate 1 covers 3
Individual cervical vertebra plate；The pedicle screw guiding screw way 2 that 6 are arranged on guide plate 1, guide plate 1 also sets up 3 spinous process holes 3；Spinous process
Hole 3 is located at guide plate 1 central authorities, and 6 guiding screw ways 2 are arranged on guide plate 1 both sides, and guiding screw way 2 direction and pedicle screw enter nail nail
Road direction is consistent, and by guiding screw way 2, screw can accurately enter pedicle of vertebral arch.Guide plate 1 top is a plane 11, guide plate 1 bottom
Curved surface 12 can be with the operation reverse matching of vertebral plate；Guide plate 1 bottom curved surface 12 to the lateral mass of both sides, guide plate 1 upper plane 11 to two
Side guiding screw way 2 is behind upper plane 11 exit, then the 4mm that stretches out.Spinous process hole 3 shape is consistent with spinous process shape, spinous process
The internal diameter in hole 3 is consistent with the external diameter shifting of spinous process, and spinous process hole 3 is effectively enclosed within spinous process.Guide plate 1 upper plane 11 and bottom curved surface
The distance of 12 peaks is 4mm.8 fixing nails 4,6 are also set up on guide plate 1 be positioned close to accordingly guide the position of screw way 2
On, 2 guide plate 1 middle edge positions.The setting of fixing nail 4 can be effectively ensured guide plate 1 and coincide on cervical vertebra plate and stable
Property.Spinous process hole 3 position is provided with spinous process fixation clamp 31, and fixation clamp 31 is elastic fixing clip 31, can when using clamping tightly
Spinous process, makes guide plate 1 more fit with cervical vertebra plate, stable.Pedicle screw guiding screw way 2 position is provided with guiding screw way 2 buckle,
Buckle controls screw to be in the center of screw way, and the various sizes of screw of scalable accurately passes through to guide screw way 2.Guide plate 1
Material is medical resin.
During use, after decompression or during sham operated, implantation plate is placed on corresponding cervical vertebra plate, by vertebra
Pedicle screw guiding screw way 2 is holed on cervical lateral mass, and guiding implantation plate, the use of complete twin installation are taken off in boring after terminating.
The Pedicle Screw Placement in Lower Cervical guiding that embodiment 5 3d prints implants hardened structure
The Pedicle Screw Placement in Lower Cervical guiding implantation plate that a kind of 3d prints, including 6 pieces of guide plates 1, each guide plate 1 arranges one
Spinous process hole 3 and a pedicle screw guide screw way 2, and spinous process hole 3 is located at guide plate 1 side, and guiding screw way 2 is arranged at guide plate 1
Opposite side, guiding screw way 2 direction and pedicle screw enter that screw way direction is consistent, and by guiding screw way 2, screw can accurately enter
Enter pedicle of vertebral arch.Guide plate side is provided with connecting hole, connects in the hole setting and connects soft metal bar；Guide plate 1 top is a plane 11, leads
Plate 1 bottom curved surface 12 can be with the operation reverse matching of vertebral plate；Guide plate 1 bottom curved surface 12 side extends to outside lateral mass, and side extends
To by spinous process, guide plate 1 upper plane 11 side extends to guiding screw way 2 behind upper plane 11 exit, then stretches out
4mm, opposite side extends to by spinous process.Spinous process hole 3 shape is consistent with spinous process shape, and the internal diameter in spinous process hole 3 is moved with the external diameter of spinous process
Unanimously, spinous process hole 3 is effectively enclosed within spinous process.Guide plate 1 upper plane 11 is 4mm with the distance of bottom curved surface 12 peak.Often
2 fixing nails 4 are arranged on individual guide plate 1, on a position being positioned close to accordingly guide screw way 2, one is arranged on spinous process hole
Side.The setting of fixing nail 4 can be effectively ensured guide plate 1 and coincide and stability on cervical vertebra plate.Spinous process hole 3 position is provided with
Spinous process fixation clamp 31, fixation clamp 31 is elastic fixing clip 31, can when using tightly clamp spinous process, make guide plate 1 and cervical vertebra vertebra
Plate is more fitted, stable.Pedicle screw guiding screw way 2 position is provided with guiding screw way 2 buckle, and buckle controls screw to be in screw way
Center, and the various sizes of screw of scalable accurately pass through guide screw way 2.The material of guide plate 1 is medical resin.
During use, after decompression or during sham operated, implantation plate is placed on corresponding cervical vertebra plate, by vertebra
Pedicle screw guiding screw way 2 is holed on cervical lateral mass, and guiding implantation plate, the use of complete twin installation are taken off in boring after terminating.
The Pedicle Screw Placement in Lower Cervical guiding that embodiment 6 3d prints implants hardened structure
The Pedicle Screw Placement in Lower Cervical guiding implantation plate that a kind of 3d prints, including 6 pieces of guide plates 1, each guide plate 1 arranges one
Spinous process hole 3 and a pair of pedicle screw guide screw way 2, and spinous process hole 3 is located at guide plate 1 central authorities, and guiding screw way 2 is arranged on 1 liang of guide plate
Side, guiding screw way 2 direction and pedicle screw enter that screw way direction is consistent, and by guiding screw way 2, screw can accurately enter vertebra
Nut.Guide plate side is provided with connecting hole, connects in the hole setting and connects soft metal bar；Guide plate 1 top is a plane 11, guide plate 1
Bottom curved surface 12 can be with the operation reverse matching of vertebral plate；Guide plate 1 bottom curved surface 12 extends to outside the lateral mass of both sides, guide plate 1 upper flat
Face 11 extends to both sides guiding screw way 2 behind upper plane 11 exit, then the 4mm that stretches out.Spinous process hole 3 shape and spinous process shape
Shape is consistent, and the internal diameter in spinous process hole 3 is consistent with the external diameter shifting of spinous process, and spinous process hole 3 is effectively enclosed within spinous process.Guide plate 1 upper plane
11 is 4mm with the distance of bottom curved surface 12 peak.8 fixing nails 4,6 are also set up on guide plate 1 be positioned close to accordingly guide
On the position of screw way 2,2 guide plate 1 middle edge positions.The setting of fixing nail 4 can be effectively ensured guide plate 1 on cervical vertebra plate
It coincide and stability.Spinous process hole 3 position is provided with spinous process fixation clamp 31, and fixation clamp 31 is elastic fixing clip 31, can be when using
Tightly clamp spinous process, so that guide plate 1 is more fitted with cervical vertebra plate, stable.Pedicle screw guiding screw way 2 position is provided with guiding
Screw way 2 buckle, buckle controls screw to be in the center of screw way, and the various sizes of screw of scalable accurately passes through to guide screw way
2.The material of guide plate 1 is medical resin.
During use, after decompression or during sham operated, implantation plate is placed on corresponding cervical vertebra plate, by vertebra
Pedicle screw guiding screw way 2 is holed on cervical lateral mass, and guiding implantation plate, the use of complete twin installation are taken off in boring after terminating.
The preparation method of the Pedicle Screw Placement in Lower Cervical guiding implantation plate that embodiment 7 3d prints
3d print Pedicle Screw Placement in Lower Cervical guiding implantation plate preparation method be,
Step 1: obtain the original number of patients with cervical motion segment (neck 2- neck 7) by scanning techniques such as ct or nuclear magnetic resonance, NMR
According to；
Step 2: using three-dimensional reconstruction software, set up the threedimensional model of Cervical 2- neck 7 vertebral body and adnexa, and to pedicle of vertebral arch
Screw enters the entry point of screw way, enter to follow closely direction and spinous process external diameter carries out three dimensional analysis；
Step 3: the entry point that to the threedimensional model of vertebral body, enters screw way and enter to follow closely direction and carry out reverse matching, form one
The individual fitting surface 12 coincideing with Cervical 2- neck 7 vertebral plate, has 2 mouthfuls of screw way of guiding and 3 mouthfuls of spinous process hole thereon；Fitting surface 12 exists
At spinous process, matching is to spinous process bottom.
Step 4: guide pin road junction carries out oppositely extending along entering to follow closely direction, and another opening is formed in plane 11, spinous process hole
Opening's edge spinous process size extends, and forms another spinous process aperture in the plane, sets up the three-dimensional of Pedicle Screw Placement in Lower Cervical guiding implantation plate
Model；Plane 11 Distance surface 12 peak that each point thickens is 2-5mm.
Step 5: the three-dimensional modeling data being directed to implant plate imports 3d printer, loads medical resin printed material, beats
Print off guiding implantation plate.
The Pedicle Screw Placement in Lower Cervical guiding implantation plate printing is performed the operation altogether or is used during sham operated.
The explanation of above-described embodiment is only intended to understand the present invention.It should be pointed out that for those of ordinary skill in the art
For, under the premise without departing from the principles of the invention, some improvement can also be carried out to the present invention, these improvement also will fall into this
In invention scope of the claims.
Claims (10)
1. the Pedicle Screw Placement in Lower Cervical guiding implantation plate that a kind of 3d prints, including one or a few blocks guide plate (1), one or several set
Be placed on guide plate (1) Pedicle Screw Placement in Lower Cervical guiding screw way (2), guide plate (1) also sets up one or several for inserting spinous process
Spinous process hole (3)；Described guide plate (1) top is a plane (11), and guide plate bottom curved surface is reversely consistent with vertebral plate；On guide plate (1)
Facial planes (11) side extends to pedicle of vertebral arch guiding screw way and re-extends several millimeters after the outlet of upper plane (11)；Guide pin
Road (2) direction enters with pedicle screw that screw way direction is reversely consistent, and nail is entered through enter screw way in guiding screw way (2) axis
Point；Connecting elements is set between polylith guide plate (1).
2. 3d according to claim 1 prints Pedicle Screw Placement in Lower Cervical guiding implantation plate is it is characterised in that described guide plate
(1) number is one piece, and guide plate (1) can cover the continuous vertebral plate of 1-6 block, setting and covering vertebral plate number corresponding guiding screw way on guide plate
And spinous process hole (3) (2).
3. 3d according to claim 2 prints Pedicle Screw Placement in Lower Cervical guiding implantation plate is it is characterised in that described spinous process
Hole (3) is located at guide plate (1) side, arranges 1-6 spinous process hole (3), and described pedicle screw guiding screw way (2) is arranged at guide plate
(1) opposite side, 1-6 guiding screw way (2) of setting.
4. 3d according to claim 2 prints Pedicle Screw Placement in Lower Cervical guiding implantation plate is it is characterised in that described spinous process
Hole (3) is located at guide plate (1) central authorities, arranges 1-6 spinous process hole (3), and described pedicle screw guiding screw way (2) is arranged on guide plate
(1) both sides, setting 1-6 is to guiding screw way (2).
5. 3d according to claim 1 prints Pedicle Screw Placement in Lower Cervical guiding implantation plate is it is characterised in that described guide plate
(1) number setting 1-6, each guide plate (1) covers one piece of vertebral plate, and on each guide plate, setting one or a pair of pedicle screw are led
To screw way (2) and a spinous process hole (3), between two guide plates (1), it has been provided with the connecting elements (5) of interconnection function.
6. 3d according to claim 5 prints Pedicle Screw Placement in Lower Cervical guiding implantation plate is it is characterised in that described spinous process
Hole (3) is located at each guide plate (1) side, 1 described pedicle of vertebral arch guiding screw way (2) of the upper setting of each guide plate (1), described pedicle of vertebral arch
Screw guides the opposite side that screw way (2) is arranged at guide plate (1).
7. 3d according to claim 5 prints Pedicle Screw Placement in Lower Cervical guiding implantation plate is it is characterised in that described spinous process
Hole (3) is located at each guide plate (1) central authorities, and the upper setting 1 of each guide plate (1) is to described pedicle of vertebral arch guiding screw way (2), described pedicle of vertebral arch
Screw guiding screw way (2) is arranged on guide plate (1) both sides.
8. the Pedicle Screw Placement in Lower Cervical guiding implantation plate that the 3d according to claim 1-7 any one prints, its feature exists
In one or several fixing nail (4) is also set up on guide plate (1).
9. the Pedicle Screw Placement in Lower Cervical guiding implantation plate that the 3d according to claim 1-7 any one prints, its feature exists
In described spinous process hole (3) position is provided with spinous process fixation clamp (31).
10. the preparation method of the Pedicle Screw Placement in Lower Cervical guiding implantation plate that the 3d described in claim 1-7 any one prints is:
Step 1: obtain the initial data of cervical vertebra motion segment (neck 2- neck 7) by scanning techniques such as thin layer ct or nuclear magnetic resonance, NMR；
Step 2: using three-dimensional reconstruction software, set up the threedimensional model of cervical vertebral body and adnexa, and pedicle screw is entered with nail nail
The entry point in road, enter to follow closely direction and spinous process external diameter carries out three dimensional analysis；
Step 3: the entry point that to the threedimensional model of vertebral body, enters screw way and enter to follow closely direction and carry out reverse matching, formed one with
The fitting surface (12) that vertebral body coincide, has guiding screw way (2) mouth and spinous process hole (3) mouth thereon；
Step 4: curved surface is reversely thickened, makes each put and thicken on a plane (11), nail side is entered on guide pin road junction edge
Oppositely extending to carrying out, another opening is formed in plane (11), and spinous process hole (3) opening's edge spinous process size extends, shape in the plane
Become another spinous process aperture, set up the threedimensional model of Pedicle Screw Placement in Lower Cervical guiding implantation plate；
Step 5: the three-dimensional modeling data being directed to implant plate imports 3d printer, loads printed material, prints guiding implantation
Plate.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510149309.1A CN104739501B (en) | 2015-03-31 | 2015-03-31 | 3D-printed cervical vertebra pedicle screw guide and implantation plate and preparation method thereof |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510149309.1A CN104739501B (en) | 2015-03-31 | 2015-03-31 | 3D-printed cervical vertebra pedicle screw guide and implantation plate and preparation method thereof |
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| CN104739501A CN104739501A (en) | 2015-07-01 |
| CN104739501B true CN104739501B (en) | 2017-02-01 |
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| CN110537969B (en) * | 2019-09-10 | 2024-03-19 | 陕西东望科技有限公司 | Auxiliary nail placing device for thoracolumbar vertebra nail placing operation |
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| CN111529038A (en) * | 2020-04-16 | 2020-08-14 | 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 | Split type guide plate for spinal surgery |
| CN114569230B (en) * | 2022-02-28 | 2023-07-07 | 中国人民解放军陆军特色医学中心 | Lower cervical pedicle positioning guide plate and manufacturing method thereof |
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