阅读说明：本技术 一种acaf术使用的颈椎前路钢板、提拉器及内固定系统 (Anterior cervical steel plate, lifting device and internal fixing system used in ACAF (anterior cervical spine extension) operation ) 是由 史建刚 韩郸 于 2021-10-18 设计创作，主要内容包括：本发明涉及一种ACAF术使用的颈椎前路钢板、提拉器及内固定系统。所述颈椎前路钢板的头端和尾端均设有宽度≥8mm,高度≥10mm的融合窗口,中央纵轴上设有至少一个长条形的提拉槽,还可进一步包括辅助钢板,使用时所述辅助钢板覆于钢板本体的前侧。所述提拉器包括提拉钉和起子,所述提拉钉设有第一和第二行程控制体,所述起子设有套接于第二行程控制体外部并带动其旋动的起子套筒头。所述内固定系统包括所述颈椎前路钢板和所述提拉器。本发明能够实现ACAF技术理念——生理椎间隙高度,提拉致压复合体减压精准可控,恢复最佳生理曲度,使手术简化、可靠、精准,减少并发证,降低手术风险,提高手术疗效。(The invention relates to an anterior cervical steel plate, a puller and an internal fixing system used in ACAF operation. The head end and the tail end of the anterior cervical spine steel plate are both provided with fusion windows with the width being more than or equal to 8mm and the height being more than or equal to 10mm, the central longitudinal axis is provided with at least one elongated lifting groove, and the anterior cervical spine steel plate further comprises an auxiliary steel plate which covers the front side of the steel plate body when in use. The lifting device comprises a lifting nail and a screwdriver, the lifting nail is provided with a first stroke control body and a second stroke control body, and the screwdriver is provided with a screwdriver sleeve head which is sleeved outside the second stroke control body and drives the second stroke control body to rotate. The internal fixation system comprises the anterior cervical steel plate and the puller. The invention can realize the ACAF technical idea, namely the physiological intervertebral space height, accurately and controllably reduces the pressure of the pulling and pressing complex, recovers the optimal physiological curvature, simplifies, reliably and accurately performs the operation, reduces complications, reduces the operation risk and improves the operation curative effect.)

1. An anterior cervical steel plate used in ACAF (anterior cervical spine extension) operation is provided with a steel plate body and screw fixing holes, and is characterized in that fusion windows are arranged at the head end and the tail end of the steel plate body, the width of each fusion window is more than or equal to 8mm, and the height of each fusion window is more than or equal to 10 mm; the steel plate body is characterized in that at least one elongated lifting groove is formed in the central longitudinal axis of the steel plate body, and the length direction of the lifting groove is consistent with that of the steel plate body.

2. The anterior cervical steel plate for use in ACAF surgery of claim 1, further comprising an auxiliary steel plate which covers the front side of the steel plate body and exposes the fusion window, the lifting groove and the screw fixing hole of the steel plate body, and is fixed to the steel plate body.

3. The anterior cervical steel plate for use in ACAF procedure of claim 2, wherein the auxiliary steel plate is fixed to the steel plate body by means of screw fastening, bayonet locking or riveting; the auxiliary steel plate and the steel plate body are the same in shape.

4. The anterior cervical steel plate for use in ACAF procedure as claimed in claim 1, wherein the number of the pulling grooves is one, and the merging window at the head end, the merging window at the tail end and the pulling grooves are connected to each other.

5. The anterior cervical steel plate for use in ACAF surgery as claimed in claim 1, wherein the number of the lifting grooves is two or more, the merging window at the head end is connected to the lifting groove near the head end, the merging window at the tail end is connected to the lifting groove near the tail end, and the lifting grooves are not connected to each other.

6. The anterior cervical plate for use in ACAF procedures of claim 1, wherein the screw fixing holes comprise end screw fixing holes located at the head end and the tail end of the plate body and side screw fixing holes located at the left and right sides of the lifting groove.

7. The anterior cervical plate for use in ACAF surgery of claim 6, wherein the fusion window of the head end is below the end screw fixing hole of the head end and the fusion window of the tail end is above the end screw fixing hole of the tail end.

8. The anterior cervical plate for use in ACAF according to claim 1, wherein the plate body is made of stainless steel, silicon steel, carbon steel, titanium alloy, pure titanium, cobalt-nickel alloy or polymer material.

9. A puller for ACAF procedures, the puller comprising a puller nail and a driver; the lifting nail is provided with a lifting fixing body, a first stroke control body, a mounting joint and a second stroke control body, the second stroke control body is sleeved outside the first stroke control body and is provided with an internal thread matched with the external thread of the first stroke control body, and the outer surface of the second stroke control body is shaped with an axial ridge groove; the screwdriver is provided with a screwdriver handle, a screwdriver extension rod and a screwdriver sleeve head, and the screwdriver sleeve head is internally provided with a prismatic groove matched with the prismatic groove on the second stroke control body.

10. An ACAF intra-operative fixation system comprising an anterior cervical steel plate for use in the ACAF operation according to any one of claims 1 to 8 and a puller for use in the ACAF operation according to claim 9.

Technical Field

The invention relates to the technical field of medical instruments, in particular to an anterior cervical steel plate, a puller and an internal fixing system used in ACAF operation.

Background

The anterior approach is one of the commonly used surgical approaches for cervical vertebrae, and is widely applied to degenerative diseases, wounds, deformities, tumors and other lesions of the cervical vertebrae. The internal fixing system of the anterior cervical steel plate can provide strong fixation and is conventionally used in anterior cervical surgery at present. The steel plate internal fixing system used clinically consists of a steel plate and a plurality of screws, wherein the steel plate internal fixing system is divided into a plurality of models according to different locking nail modes, static pressure or dynamic pressure and the like. No matter what type of steel plate exists, because the bone grafting observation hole of steel plate is less, so the application method is to put into the fusion cage or bone grafting piece first, then put the steel plate and fix.

The operation of controllable anterior movement (ACAF) of cervical posterior longitudinal ligament ossified vertebral body is initiated by the professor of the inventor of the application, is an emerging technology of the cervical anterior approach in recent years, has the advantages of high safety, good nerve recovery and the like, is particularly suitable for spinal stenosis caused by long-segment and serious posterior longitudinal ligament ossification or other reasons, and is widely concerned. In the operation process, the anterior cervical steel plate/screw is used as a suspension bridge, and the cervical vertebra and the pressing object are moved forwards as a whole.

The technical problems existing at present are that the conventional anterior steel plate cannot realize the ACAF technical idea when being used for OPLL diseases, namely, the accurate lifting and pressing object cannot maintain the physiological height of the spine and recover the ideal physiological curvature of the cervical vertebra, and the reasons are that: 1. when the conventional anterior cervical steel plate is used, the fusion cage needs to be placed firstly, then the lifting operation is carried out, and the fusion cage can be tightly clamped with the residual vertebral body after being placed, so that the subsequent forward movement operation is influenced, and the phenomenon is particularly remarkable in the intervertebral space between the upper end and the lower end; 2. when the forward moving operation is carried out by utilizing the suspension bridge principle, the conventional forward steel plate needs screws screwed in by screw holes at two sides, and the rotation of residual vertebral bodies can be generated when the forces at two sides are unbalanced, so that the forward moving effect is influenced, and even nerve complications are caused. All the problems are that the effect of restoring the physiological curvature of the cervical vertebra of the traditional anterior steel plate in the operation is not obvious, and the phenomenon that the physiological curvature is difficult to restore in the operation or the physiological curvature is lost after the operation is easy to occur.

The patent application CN109288571A previously filed by the applicant provides a cervical vertebra natural height fixing plate which is provided with a plate body, wherein the plate body is provided with a fusion window, a locking piece and a screw fixing hole matched with a screw, the minimum distance between the upper side wall and the lower side wall of the fusion window along the vertical axis direction is 3-8mm, and the minimum distance between the left side wall and the right side wall of the fusion window along the horizontal axis direction is 12.1-18 mm. The cervical vertebra natural height fixing plate is used for cervical disc resection. The inventor summarizes and finds that the bone grafting fusion cage is larger than the height of an intervertebral disc to ensure that the bone grafting fusion cage is extruded with adjacent vertebral bodies to promote bone formation, but the bone grafting fusion cage can cause the upper vertebral body and the lower vertebral body to be expanded at the same time, if a plurality of intervertebral discs are cut off, a plurality of segments are excessively expanded, the natural height of the cervical vertebra is lost, and the neck pain operation complication is caused. Therefore, the fusion window of the fixing plate is designed to be large enough to allow the fusion device to pass through, and after the intervertebral disc is removed in the operation, the vertebral body is fixed and then the fusion device is implanted, so that the technical problem that the vertebral body is excessively expanded and loses the natural height to cause neck pain due to the implantation of the fusion device is solved.

The patent application CN109044572A previously filed by the applicant provides a lifting tool for cervical vertebra centrum forward movement fusion, the lifting tool comprises a lifting fixed body, a stroke control body, a connecting rod, a movable handle and a fixed handle; one end of the stroke control body is connected with the lifting fixing body, and the other end of the stroke control body is connected with the connecting rod; the movable handle is arranged on the peripheral surface of the connecting rod and is movably connected with the connecting rod; the fixed handle is arranged at one end part of the connecting rod; the stroke control body on be equipped with the external screw thread, the activity handle in be equipped with the internal thread, and when the internal thread on the activity handle and the external screw thread on the stroke control body cooperate the precession, produce relative motion between the stroke control body and the activity handle. The lifting tool for the cervical vertebra centrum forward movement fusion can realize controllable, vertical and stable lifting of the centrum.

At present, no cervical spine anterior steel plate and a matched internal fixing system which are suitable for ACAF operation and can realize the technical ideas of accurately lifting and pressing objects, maintaining the physiological height of the intervertebral and recovering the ideal physiological curvature of the cervical spine in the ACAF operation are available.

Disclosure of Invention

The first purpose of the invention is to provide an anterior cervical steel plate which is suitable for ACAF operation, and can realize the technical idea of accurately lifting and pressing objects, maintaining the physiological height of the spine and recovering the ideal physiological curvature of the cervical vertebra in ACAF operation.

The second purpose of the invention is to provide a puller which is suitable for ACAF operation, can stably pull a pressed object and effectively avoid vertebral body damage in the ACAF operation aiming at the defects in the prior art.

The third purpose of the invention is to provide an ACAF intra-operative fixing system which is suitable for ACAF operation, realizes accurate, controllable, stable and safe pulling of the object to be pressed in the ACAF operation, and obviously improves the operation effect.

In order to achieve the first purpose, the invention adopts the technical scheme that:

an anterior cervical steel plate used in ACAF (anterior cervical spine extension) operation is provided with a steel plate body and screw fixing holes, wherein fusion windows are arranged at the head end and the tail end of the steel plate body, the width of each fusion window is more than or equal to 8mm, and the height of each fusion window is more than or equal to 10 mm; the steel plate body is characterized in that at least one elongated lifting groove is formed in the central longitudinal axis of the steel plate body, and the length direction of the lifting groove is consistent with that of the steel plate body.

As a preferable example of the present invention, the anterior cervical steel plate used in the ACAF surgery further includes an auxiliary steel plate, the auxiliary steel plate covers the front side of the steel plate body and exposes the fusion window, the lifting groove and the screw fixing hole of the steel plate body, and the auxiliary steel plate is fixed to the steel plate body.

More preferably, the auxiliary steel plate and the steel plate body are fixed in a threaded manner, a bayonet lock is used for preventing rotation or riveting; the auxiliary steel plate and the steel plate body are the same in shape.

As another preferable example of the present invention, the number of the lifting grooves is one, and the fusion window at the head end, the fusion window at the tail end and the lifting grooves are communicated with each other.

As another preferable example of the present invention, the number of the lifting grooves is two or more, the fusion window at the head end is communicated with the lifting groove at the near-head end, the fusion window at the tail end is communicated with the lifting groove at the near-tail end, and the lifting grooves are not communicated with each other.

As another preferable example of the present invention, the screw fixing holes include end screw fixing holes located at the head end and the tail end of the steel plate body, and side screw fixing holes located at the left and right sides of the lifting groove.

More preferably, the fusion window of the cephalad end is below the end screw fixation hole of the cephalad end and the fusion window of the caudal end is above the end screw fixation hole of the caudal end.

More preferably, the screw fixing holes of the left and right sides of the lifting groove are symmetrically arranged.

As another preferable example of the present invention, the steel plate body is made of stainless steel, silicon steel, carbon steel, titanium alloy, pure titanium, cobalt-nickel alloy, or polymer material.

In order to achieve the second object, the invention adopts the technical scheme that:

a puller for use in ACAF procedures, the puller comprising a puller nail and a driver; the lifting nail is provided with a lifting fixing body, a first stroke control body, a mounting joint and a second stroke control body, the second stroke control body is sleeved outside the first stroke control body and is provided with an internal thread matched with the external thread of the first stroke control body, and the outer surface of the second stroke control body is shaped with an axial ridge groove; the screwdriver is provided with a screwdriver handle, a screwdriver extension rod and a screwdriver sleeve head, and the screwdriver sleeve head is internally provided with a prismatic groove matched with the prismatic groove on the second stroke control body.

In order to achieve the third object, the invention adopts the technical scheme that:

an ACAF intra-operative fixation system comprising an anterior cervical steel plate for use in an ACAF operation as described in any one of the above and a puller for use in an ACAF operation as described above.

The invention has the advantages that:

1. the head end and the tail end of the steel plate body are provided with the enlarged fusion windows, so that the centrum forward movement operation can be carried out firstly, and the interbody fusion cage is placed later, so that the centrum forward movement effect is ensured to the maximum extent.

2. The lifting groove is located in the central position of the steel plate body, so that the phenomenon of rotation in the lifting process of the pressure reduction reset body is avoided, the lifting groove is in a longitudinal strip shape, lifting can be carried out at any position, and accurate controllable decompression is realized.

3. The auxiliary steel plate is matched to ensure the strength, facilitate the correction of the physiological curvature in the operation and ensure the optimal recovery of the physiological curvature of the cervical vertebra.

4. The fusion window is only arranged at the head end and the tail end and is used for lifting the intervertebral space rear fusion device at the head end and the tail end outside the segment to be fused, the intervertebral space between the vertebral bodies in the segment is still firstly put into the fusion device or the bone grafting block, the accurate lifting of the vertebral bodies is not influenced, and the integral strength of the steel plate is also ensured.

5. The lifting device comprises a lifting nail and a screwdriver, the second stroke control body is driven by the longer screwdriver to lift the cone, stable lifting of the cone is facilitated, stress of the steel plate is more uniform, and damage to the cone possibly caused by an operation is avoided to the maximum extent.

Generally, the anterior cervical steel plate and the lifter used in the ACAF operation, namely the whole internal fixation system, can realize the ACAF technical idea, namely the physiological intervertebral space height, and the pressure reduction of the lifting pressure-inducing complex is accurate and controllable, so that the optimal physiological curvature is recovered, the operation is simplified, reliable and accurate, the complication is reduced, the operation risk is reduced, and the operation curative effect is improved.

Drawings

FIG. 1 is a front view of an anterior cervical steel plate used in the ACAF operation of example 1.

FIG. 2 is a perspective view of an anterior cervical steel plate used in the ACAF operation in example 1.

FIG. 3 is a front view of an anterior cervical steel plate used in the ACAF operation of example 2.

FIG. 4 is a perspective view of an anterior cervical steel plate used in the ACAF operation in example 2.

FIG. 5 is a front view of an anterior cervical steel plate used in the ACAF operation of example 3.

FIG. 6 is a perspective view of an anterior cervical steel plate used in the ACAF operation in example 3.

FIG. 7 is a schematic structural view of an anterior cervical steel plate used in the ACAF operation in example 4.

FIG. 8 is a schematic view showing the state of use of an anterior cervical steel plate used in the ACAF operation in example 4.

FIG. 9 is a first schematic view of the structure of the puller used in the ACAF technique of example 5.

FIG. 10 is a second schematic view of the structure of the puller used in the ACAF technique of example 5.

FIG. 11 is a schematic view of a human body measurement reference plane and reference axes.

Detailed Description

The following detailed description of the present invention will be made with reference to the accompanying drawings.

The reference numerals and components referred to in the drawings are as follows:

example 1

Referring to fig. 1 and 2, fig. 1 is a front view of an anterior cervical steel plate used in the ACAF procedure of example 1, and fig. 2 is a perspective view of the anterior cervical steel plate used in the ACAF procedure of example 1.

The anterior cervical steel plate used in the ACAF operation is provided with a steel plate body 1. Its head end of steel sheet body 1 and tail end all respectively are equipped with two tip screw fixing hole 2, and two tip screw fixing hole 2 are located the left and right sides respectively and are equipped with tip screw retaining member 3 between the two. Still be equipped with two rectangular fusion windows 4 on the steel plate body 1, one of them fuses window 4 and is located the below of the tip screw fixed orifices 2 of 1 head end of steel plate body, and another fuses window 4 and is located the top of the tip screw fixed orifices 2 of 1 tail end of steel plate body. The minimum distance (length) of the upper and lower side walls of each fusion window 4 along the vertical axis direction is 10mm, and the minimum distance (width) of the left and right side walls of each fusion window 4 along the horizontal axis direction is 8 mm. Still be equipped with on the steel sheet body 1 and carry pull groove 5, carry pull groove 5 and be rectangular shape groove, length direction is unanimous with the length direction of steel sheet body 1. The width of the lifting groove 5 is 3-6mm, and the length is 10-20 mm. The lifting groove 5 is communicated with the two fusion windows 4 at the head end and the tail end to form an I shape. The left side and the right side of the lifting groove 5 are respectively provided with a lateral screw fixing hole 6, and each lateral screw fixing hole 6 is provided with a lateral screw locking piece 7. The side screw fixing holes 6 and the side screw locking pieces 7 on the left side and the right side are symmetrically distributed.

The anterior cervical plate used in the ACAF procedure of the present embodiment may be customized to a suitable specification according to the strength of the plate and the physiological structure of the patient, and one example thereof is: the steel plate body 1 is 3.5mm thick, 51mm long and 16mm wide. The center axis of the end screw fixing hole 2 at the leading end is inclined 20 degrees toward the leading end, and the center axis of the end screw fixing hole 2 at the trailing end is inclined 20 degrees toward the trailing end. The central axis of each end screw fixing hole 2 is inclined inward by 6 °.

The anterior cervical steel plate used in the ACAF procedure of this embodiment is suitable for the case of lifting a single vertebral body.

The application method of the anterior cervical steel plate used in the ACAF operation of the embodiment comprises the following steps: (1) performing general anesthesia by adopting a supine position; (2) performing incision according to the length of the operation section and the neck condition of the patient, and exposing the relevant vertebral body; (3) treatment of the intervertebral space: for the treatment of intervertebral space in the lifting segment, only the posterior longitudinal ligament needs to be exposed, and for the lifting of intervertebral spaces at the head and the tail ends, the posterior longitudinal ligament of the intervertebral space is bitten off, and the dura mater is exposed; (4) removing the bone in the front of the vertebral body; (5) installing a steel plate and an intervertebral fusion cage: placing a cervical spine anterior steel plate with proper length and pre-bending for the ACAF operation on the front edge of a vertebral body, installing vertebral body nails on the vertebral bodies at the head end and the tail end outside a lifting section to end screw fixing holes 2 at the head end and the tail end of a steel plate body 1, and screwing the nail tail of the vertebral body nail to be attached to the steel plate body 1; (6) grooving at two sides of the vertebral body in the lifting section to free the vertebral body ossification complex; (7) advancing the vertebral body bone compound: screwing a lifting tool into the lifting groove 5, rotating the outer sleeve of the lifting tool, and driving the bone block to move upwards by the inner core until the vertebral body in the lifting segment is attached to the steel plate body 1; (8) the fusion device or bone grafting block is arranged in the head and tail intervertebral spaces of the near lifting segment outside the lifting segment through the fusion window 4, bones are implanted in the grooves at the two sides of the vertebral body in the lifting segment, hemostasis is realized, the incision is closed, and post-operation braking is realized.

Example 2

Referring to fig. 3 and 4, fig. 3 is a front view of an anterior cervical steel plate used in the ACAF procedure of example 2, and fig. 4 is a perspective view of the anterior cervical steel plate used in the ACAF procedure of example 2.

The anterior cervical steel plate used in the ACAF operation is provided with a steel plate body 1. Its head end of steel sheet body 1 and tail end all respectively are equipped with two tip screw fixing hole 2, and two tip screw fixing hole 2 are located the left and right sides respectively and are equipped with tip screw retaining member 3 between the two. Still be equipped with two rectangular fusion windows 4 on the steel plate body 1, one of them fuses window 4 and is located the below of the tip screw fixed orifices 2 of 1 head end of steel plate body, and another fuses window 4 and is located the top of the tip screw fixed orifices 2 of 1 tail end of steel plate body. The minimum distance (length) of the upper and lower side walls of each fusion window 4 along the vertical axis direction is 10mm, and the minimum distance (width) of the left and right side walls of each fusion window 4 along the horizontal axis direction is 8 mm. Still be equipped with two and carry pull groove 5 on the steel sheet body 1, carry pull groove 5 and be rectangular shape groove, length direction is unanimous with the length direction of steel sheet body 1. The width of the lifting groove 5 is 3-6mm, and the length is 10-20 mm. The lifting groove 5 at the head end is communicated with the fusion window 4 at the head end, the lifting groove 5 at the tail end is communicated with the fusion window 4 at the tail end, and the whole body forms an I shape, but the two lifting grooves 5 are not communicated. The left side and the right side of each lifting groove 5 are respectively provided with a lateral screw fixing hole 6, and each lateral screw fixing hole 6 is provided with a lateral screw locking piece 7. The side screw fixing holes 6 and the side screw locking pieces 7 on the left side and the right side are symmetrically distributed.

The anterior cervical plate used in the ACAF procedure of the present embodiment may be customized to a suitable specification according to the strength of the plate and the physiological structure of the patient, and one example thereof is: the thickness of the steel plate body 1 is 3.5mm, the length is 75mm, and the width is 16 mm. The center axis of the end screw fixing hole 2 at the leading end is inclined 20 degrees toward the leading end, and the center axis of the end screw fixing hole 2 at the trailing end is inclined 20 degrees toward the trailing end. The central axis of each end screw fixing hole 2 is inclined inward by 6 °.

The anterior cervical steel plate used in the ACAF procedure of this embodiment is suitable for the case of lifting two vertebral bodies.

The application method of the anterior cervical steel plate used in the ACAF operation of the embodiment comprises the following steps: (1) performing general anesthesia by adopting a supine position; (2) performing incision according to the length of the operation section and the neck condition of the patient, and exposing the relevant vertebral body; (3) treatment of the intervertebral space: for the treatment of intervertebral space in the lifting segment, only the posterior longitudinal ligament needs to be exposed, and for the lifting of intervertebral spaces at the head and the tail ends, the posterior longitudinal ligament of the intervertebral space is bitten off, and the dura mater is exposed; (4) removing the bone in the front of the vertebral body; (5) installing a steel plate and an intervertebral fusion cage: measuring the size of each intervertebral space according to a test model, installing an intervertebral fusion device in the intervertebral space between lifting segments, placing a cervical anterior steel plate with proper length and pre-bending for the ACAF operation on the front edge of a vertebral body, installing vertebral body nails on the vertebral bodies at the head end and the tail end outside the lifting segments to end screw fixing holes 2 at the head end and the tail end of a steel plate body 1, and screwing the nail tail of the vertebral body nail to the steel plate body 1; (6) grooving the two sides of each vertebral body in the lifting segment to free the vertebral body ossification complex; (7) advancing the vertebral body bone compound: screwing a lifting tool into the lifting groove 5, rotating the outer sleeve of the lifting tool, and driving the bone blocks to move upwards by the inner core until all the vertebral bodies in the lifting segment are attached to the steel plate body 1; (8) the fusion device or bone grafting block is arranged in the head and tail intervertebral spaces of the near lifting segment outside the lifting segment through the fusion window 4, bones are implanted in the grooves at the two sides of each vertebral body in the lifting segment, hemostasis is realized, the incision is closed, and post-operation braking is realized.

Example 3

Referring to fig. 5 and 6, fig. 5 is a front view of an anterior cervical steel plate used in the ACAF procedure of example 3, and fig. 6 is a perspective view of the anterior cervical steel plate used in the ACAF procedure of example 3.

The anterior cervical steel plate used in the ACAF operation is provided with a steel plate body 1. Its head end of steel sheet body 1 and tail end all respectively are equipped with two tip screw fixing hole 2, and two tip screw fixing hole 2 are located the left and right sides respectively and are equipped with tip screw retaining member 3 between the two. Still be equipped with two rectangular fusion windows 4 on the steel plate body 1, one of them fuses window 4 and is located the below of the tip screw fixed orifices 2 of 1 head end of steel plate body, and another fuses window 4 and is located the top of the tip screw fixed orifices 2 of 1 tail end of steel plate body. The minimum distance (length) of the upper and lower side walls of each fusion window 4 along the vertical axis direction is 10mm, and the minimum distance (width) of the left and right side walls of each fusion window 4 along the horizontal axis direction is 8 mm. The steel plate body 1 is further provided with five lifting grooves 5, the lifting grooves 5 are long-strip-shaped grooves, and the length direction of the lifting grooves is consistent with that of the steel plate body 1. The width of the lifting groove 5 is 3-6mm, and the length is 10-20 mm. Five lifting grooves 5 are arranged on the steel plate body 1 along the vertical axis direction, wherein the lifting groove 5 at the head end is communicated with the fusion window 4 at the head end, the lifting groove 5 at the tail end is communicated with the fusion window 4 at the tail end, and the lifting groove 5 and the fusion window 4 integrally form an I shape, but the adjacent lifting grooves 5 are not communicated. The left side and the right side of each lifting groove 5 are respectively provided with a lateral screw fixing hole 6, and each lateral screw fixing hole 6 is provided with a lateral screw locking piece 7. The side screw fixing holes 6 and the side screw locking pieces 7 on the left side and the right side are symmetrically distributed.

The anterior cervical plate used in the ACAF procedure of the present embodiment may be customized to a suitable specification according to the strength of the plate and the physiological structure of the patient, and one example thereof is: the thickness of the steel plate body 1 is 3.5mm, the length is 147mm, and the width is 16 mm. The center axis of the end screw fixing hole 2 at the leading end is inclined 20 degrees toward the leading end, and the center axis of the end screw fixing hole 2 at the trailing end is inclined 20 degrees toward the trailing end. The central axis of each end screw fixing hole 2 is inclined inward by 6 °.

The anterior cervical steel plate used in the ACAF procedure of this embodiment is suitable for the case of lifting five vertebral bodies.

The application method of the anterior cervical steel plate used in the ACAF operation of the embodiment comprises the following steps: (1) performing general anesthesia by adopting a supine position; (2) performing incision according to the length of the operation section and the neck condition of the patient, and exposing the relevant vertebral body; (3) treatment of the intervertebral space: for the treatment of intervertebral space in the lifting segment, only the posterior longitudinal ligament needs to be exposed, and for the lifting of intervertebral spaces at the head and the tail ends, the posterior longitudinal ligament of the intervertebral space is bitten off, and the dura mater is exposed; (4) removing the bone in the front of the vertebral body; (5) installing a steel plate and an intervertebral fusion cage: measuring the size of each intervertebral space according to a test model, installing an intervertebral fusion device in the intervertebral space between lifting segments, placing a cervical anterior steel plate with proper length and pre-bending for the ACAF operation on the front edge of a vertebral body, installing vertebral body nails on the vertebral bodies at the head end and the tail end outside the lifting segments to end screw fixing holes 2 at the head end and the tail end of a steel plate body 1, and screwing the nail tail of the vertebral body nail to the steel plate body 1; (6) grooving the two sides of each vertebral body in the lifting segment to free the vertebral body ossification complex; (7) advancing the vertebral body bone compound: screwing a lifting tool into the lifting groove 5, rotating the outer sleeve of the lifting tool, and driving the bone blocks to move upwards by the inner core until all the vertebral bodies in the lifting segment are attached to the steel plate body 1; (8) the fusion device or bone grafting block is arranged in the head and tail intervertebral spaces of the near lifting segment outside the lifting segment through the fusion window 4, bones are implanted in the grooves at the two sides of each vertebral body in the lifting segment, hemostasis is realized, the incision is closed, and post-operation braking is realized.

Example 4

Referring to fig. 7 and 8, fig. 7 is a schematic structural view of an anterior cervical steel plate used in the ACAF procedure of embodiment 4, and fig. 8 is a schematic view of a state of the anterior cervical steel plate used in the ACAF procedure of embodiment 4.

The anterior cervical steel plate used in the ACAF operation is provided with a steel plate body 1. Its head end of steel sheet body 1 and tail end all respectively are equipped with two tip screw fixing hole 2, and two tip screw fixing hole 2 are located the left and right sides respectively and are equipped with tip screw retaining member 3 between the two. Still be equipped with two rectangular fusion windows 4 on the steel plate body 1, one of them fuses window 4 and is located the below of the tip screw fixed orifices 2 of 1 head end of steel plate body, and another fuses window 4 and is located the top of the tip screw fixed orifices 2 of 1 tail end of steel plate body. The minimum distance (length) of the upper and lower side walls of each fusion window 4 along the vertical axis direction is 10mm, and the minimum distance (width) of the left and right side walls of each fusion window 4 along the horizontal axis direction is 8 mm. The steel plate body 1 is further provided with five lifting grooves 5, the lifting grooves 5 are long-strip-shaped grooves, and the length direction of the lifting grooves is consistent with that of the steel plate body 1. The width of the lifting groove 5 is 3-6mm, and the length is 10-20 mm. The lifting groove 5 at the head end is communicated with the fusion window 4 at the head end, the lifting groove 5 at the tail end is communicated with the fusion window 4 at the tail end, and the two fusion windows and the five lifting grooves form an I shape integrally but are not communicated with each other. The left side and the right side of each lifting groove 5 are respectively provided with a lateral screw fixing hole 6, and each lateral screw fixing hole 6 is provided with a lateral screw locking piece 7. The side screw fixing holes 6 and the side screw locking pieces 7 on the left side and the right side are symmetrically distributed. The anterior cervical steel plate used in the ACAF operation is also provided with an auxiliary steel plate 8. The shape of the auxiliary steel plate 8 is consistent with that of the steel plate body 1, the auxiliary steel plate 8 is provided with an end part screw fixing hole perspective window 82 at the position corresponding to each end part screw fixing hole 2 of the steel plate body 1, an end screw locking piece perspective window 83 is arranged at the position corresponding to each end screw locking piece 3 of the steel plate body 1, a fusion window perspective window 84 is arranged at the position corresponding to each fusion window 4 of the steel plate body 1, a lifting groove perspective window 85 is arranged at the position corresponding to each lifting groove 5 of the steel plate body 1, a side screw fixing hole perspective window 86 is arranged at the position corresponding to each side screw fixing hole 6 of the steel plate body 1, a side screw locking member perspective window 87 is provided at a position corresponding to each side screw locking member 7 of the steel plate body 1, and each side screw fixing hole perspective window 86 and the corresponding side screw locking member perspective window 87 are integrated. Still be equipped with second retaining member 88 on the supplementary steel sheet 8, second retaining member 88 specifically is two screw thread locks, corresponds the first retaining member 9 of assembling on steel sheet body 1 respectively under the user state, first retaining member 9 is two screw holes.

The anterior cervical plate used in the ACAF procedure of the present embodiment may be customized to a suitable specification according to the strength of the plate and the physiological structure of the patient, and one example thereof is: the thickness of the steel plate body 1 is 3.5mm, the length is 147mm, and the width is 16 mm. The center axis of the end screw fixing hole 2 at the leading end is inclined 20 degrees toward the leading end, and the center axis of the end screw fixing hole 2 at the trailing end is inclined 20 degrees toward the trailing end. The central axis of each end screw fixing hole 2 is inclined inward by 6 °. The auxiliary steel plate 8 is 3.5mm thick, 147mm long and 16mm wide.

The anterior cervical steel plate used in the ACAF procedure of this embodiment is suitable for the case of lifting five vertebral bodies.

The application method of the anterior cervical steel plate used in the ACAF operation of the embodiment comprises the following steps: (1) performing general anesthesia by adopting a supine position; (2) performing incision according to the length of the operation section and the neck condition of the patient, and exposing the relevant vertebral body; (3) treatment of the intervertebral space: for the treatment of intervertebral space in the lifting segment, only the posterior longitudinal ligament needs to be exposed, and for the lifting of intervertebral spaces at the head and the tail ends, the posterior longitudinal ligament of the intervertebral space is bitten off, and the dura mater is exposed; (4) removing the bone in the front of the vertebral body; (5) installing a steel plate and an intervertebral fusion cage: measuring the size of each intervertebral space according to a test model, installing an intervertebral fusion device in the intervertebral space between lifting segments, placing a cervical anterior steel plate with proper length and pre-bending for the ACAF operation on the front edge of a vertebral body, installing vertebral body nails on the vertebral bodies at the head end and the tail end outside the lifting segments to end screw fixing holes 2 at the head end and the tail end of a steel plate body 1, and screwing the nail tail of the vertebral body nail to the steel plate body 1; (6) grooving the two sides of each vertebral body in the lifting segment to free the vertebral body ossification complex; (7) the auxiliary steel plate 8 is assembled on the steel plate body 1 through the matching of the first locking piece 9 and the second locking piece 88, and the two are fastened; (8) advancing the vertebral body bone compound: screwing a lifting tool into the lifting groove 5, rotating the outer sleeve of the lifting tool, and driving the bone blocks to move upwards by the inner core until all the vertebral bodies in the lifting segment are attached to the steel plate body 1; (9) the auxiliary steel plate 8 is detached; (10) the fusion device or bone grafting block is arranged in the head and tail intervertebral spaces of the near lifting segment outside the lifting segment through the fusion window 4, bones are implanted in the grooves at the two sides of each vertebral body in the lifting segment, hemostasis is realized, the incision is closed, and post-operation braking is realized.

For the above examples 1-4, it is noted that:

herein, the terms "vertical axis", "longitudinal axis", "transverse axis", "coronal plane", "horizontal plane", "sagittal plane" are defined in terms of the anthropometric reference plane and the reference axis, see fig. 11. The terms "head", "tail", "upper", "lower", "left" and "right" referring to orientation are based on the viewing angle of the device of the present invention in its use position. The terms "first" and "second" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.

Compared with the current clinical anterior cervical steel plate, the anterior cervical steel plate for the ACAF operation can realize the purposes that the steel plate is placed and fixed firstly, the lifting operation is carried out, the lifting operation is finished and the fusion cage or bone grafting block is placed through the fusion windows 4 at the two ends after the steel plate is fixed really, so that the situation that the subsequent anterior cervical vertebra operation is influenced and the cervical vertebra body and a pressing object are blocked because the fusion cage is tightly clamped with the residual vertebra body after being placed in the operation sequence in the past is avoided, and finally, the recovery effect of the physiological curvature of the cervical vertebra in the operation is not obvious, the physiological curvature is difficult to recover in the operation or the physiological curvature is lost after the operation is easy to occur. The lifting groove 5 is a long-strip-shaped groove in the vertical axis direction, namely the longitudinal axis direction of the steel plate body 1, is positioned in the central position of the longitudinal axis of the steel plate body 1, and allows a lifting device to pass through, so that the lifting of each vertebral body is guaranteed to be completed in the center of the vertebral body, the rotation of the vertebral body in the lifting process is avoided, and the position of a lifting tool can be flexibly determined according to the vertebral bodies and the sizes of intervertebral discs of different patients, so that accurate controllable decompression can be realized, and the occurrence of complications such as nerve root pain and the like is remarkably reduced. The fusion window 4 is only designed at the head end and the tail end and is used for placing the fusion cage in the intervertebral space between the head end and the tail end outside the lifting segment, and the intervertebral space in the lifting segment is still placed in the fusion cage or the bone graft firstly, because the reason is that the vertebral body of the lifting segment is in a free state in clinical practice, when the intervertebral space is placed in the fusion cage or the bone graft firstly and then lifted, because each vertebral body has certain freedom degree, the condition of influencing the precise lifting of the vertebral body is not easy to occur, and the integral strength of the steel plate is ensured by the design. The fusion window 4 is communicated with the adjacent lifting groove 5, because the fusion window is the position of intervertebral space, the vertebral body end plate is arranged towards the middle position, the position of the vertebral body close to the end plate has higher strength, the stronger the holding force of the lifting nail is placed, the larger the lifting force is, and the design that the fusion window is connected with the lifting groove is convenient for placing the lifting nail at the optimal position. For the condition that the number of the lifting grooves 5 is two or more, the lifting grooves 5 are not communicated, the lifting grooves are designed into a whole in practice, the position for placing the lifting nail is convenient to freely select, for a long steel plate, the lifting grooves with the length corresponding to the length of the steel plate can influence the strength of the steel plate, therefore, according to mechanical mechanics, under the condition that the placement of the lifting nail is not influenced, a plurality of intervals are placed, the mechanical strength of the steel plate is increased through the design of the intervals, the positions of the intervals are intervertebral fusion positions, and the placement of the intervals do not influence the placement of the freely-selected lifting nail. The auxiliary steel plate 8 is beneficial to increasing the strength of the steel plate in the operation, and can obviously and reliably recover the whole physiological curvature of the cervical vertebra after the operation. The auxiliary steel plate 8 is preferably the same shape as the steel plate body 1, can cover the steel plate body 1 on the whole, and can buffer the force applied to the steel plate body 1 in the fixing process or the centrum lifting process to protect each part of the steel plate body 1. The lateral screw fixing holes 6 and the lateral screw locking pieces 7 on the left side and the right side of the lifting groove 5 are symmetrically arranged, and the symmetry of the screw fixing holes and the consistency of the placed nails enable the holding force strength of the two nails to be superposed to achieve the maximum lifting fixing strength.

The shape of the fusion window 4 of the present invention is not limited to a rectangle, and may be other shapes such as an ellipse, a circle, and a square. The width of the lifting groove 5 is preferably 3-6mm, and the length is preferably 10-20 mm. The auxiliary steel plate 8 and the steel plate body 1 need to be fixed in the operation, but the fixing mode is not limited to the buckling anti-rotation mode, the screw tightening mode and the riveting mode. The steel plate body 1 can be made of any material meeting the requirements of clinical vertebral body fixing strength and safety, such as stainless steel, silicon steel, carbon steel, titanium alloy, pure titanium, cobalt-nickel alloy, high polymer materials and the like. The surface of the steel plate body 1 can be designed with anti-skid grains, such as anti-skid particles, water ripples and the like. The anterior cervical steel plate used in the ACAF operation is not only suitable for treating various OPLL diseases of cervical vertebra by the ACAF operation, but also can be used for the conventional operation treatment of diseases such as cervical vertebra degeneration, fracture, tumor and the like.

Example 5

Referring to fig. 9 and 10, fig. 9 is a first structural diagram of a puller used in the ACAF procedure of embodiment 5, and fig. 10 is a second structural diagram of the puller used in the ACAF procedure of embodiment 5. The puller includes a puller pin 11 and a driver 12. The pull stud 11 is provided with a pull fixing body 111, a first stroke control body 112, a mounting joint 113 and a second stroke control body 114. One end of the first stroke control body 112 is connected with the lifting fixing body 111, the other end is connected with the mounting joint 113, and the first stroke control body 112 is provided with an external thread. The second stroke control body 114 is sleeved outside the first stroke control body 112 and is provided with an internal thread matched with the external thread of the first stroke control body 112. When the internal threads on the second stroke control body 114 and the external threads on the first stroke control body 112 are screwed in, relative movement is generated between the first stroke control body 112 and the second stroke control body 114, and the movement directions of the first stroke control body 112 and the second stroke control body 114 are coaxial. The outer surface of the second stroke control body 114 is shaped with an axial rib groove 1141. The driver 12 is provided with a driver handle 121, a driver extension rod 122 and a driver sleeve head 123. The lower end of the screwdriver extension rod 122 and the screwdriver sleeve head 123 are hollow, the screwdriver sleeve head 123 is internally provided with a prismatic groove matched with the prismatic groove 1141 on the second stroke control body 114, and the inner diameter of the screwdriver extension rod 122 is equal to the maximum outer diameter of the second stroke control body 114.

The use method of the puller used in the ACAF technology comprises the following steps: in the ACAF operation, a socket screwdriver matched with the mounting joint 113 of the lifting nail 11 is used, the lifting fixing body 111 of the lifting nail 11 is implanted into a vertebral body to be lifted along the lifting groove of a steel plate, the socket screwdriver is removed, the implantation depth is confirmed through perspective, then the screwdriver 12 is inserted along the upper part of the lifting nail 11, the second stroke control body 114 of the lifting nail 11 after being inserted just corresponds to the position of the screwdriver socket head 123, the edge grooves of the two are matched and meshed, the screwdriver handle 121 is rotated to link the rotation of the second stroke control body 114, and the vertebral body is lifted through the reaction force with the steel plate.

The lifting device used in the ACAF operation comprises two separable parts, namely a lifting nail 11 and a screwdriver 12, the second stroke control body 114 is driven by the longer screwdriver 12 to lift the cone, compared with the method of directly rotating the second stroke control body 114 to lift the cone, the force applied to the second stroke control body 114 is more uniform, so that the cone can be stably lifted under the action of more uniform force, meanwhile, the force applied to the steel plate is more uniform, and the steel plate can be effectively prevented from being twisted relative to the head-tail end cone outside the lifting section. Thereby avoiding the injury of the operation to the vertebral body as much as possible.

Example 6

The ACAF operation internal fixation system of the present invention includes an anterior cervical steel plate used in the ACAF operation described in any one of embodiments 1 to 4, and a puller used in the ACAF operation described in embodiment 5, wherein a maximum outer diameter of a pulling fixture of the puller is smaller than a width of a pulling groove of the anterior cervical steel plate. Under the cooperation of the two, the accurate, controllable, stable and safe lifting of the vertebral body can be realized to the greatest extent, and the operation effect of the ACAF operation is obviously improved.

The above description is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, several modifications and additions can be made without departing from the method of the present invention, and these modifications and additions should also be regarded as the protection scope of the present invention.