CN111839835A - Lateral Anterior Approach Vertebral Body Reconstruction Interbody Fusion Fixator - Google Patents

Abstract

The invention discloses a lateral-anterior approach vertebral body reconstruction intervertebral fusion fixator, which relates to the field of medical devices and solves the technical problem of providing a fusion fixator used in conjunction with a cervical spine lateral-anterior approach operation. The technical scheme adopted in the present invention is: a lateral-anterior approach vertebral body reconstruction intervertebral fusion fixer, comprising a fusion fixation body and a screw, the fusion fixation body includes a vertebral body fusion part and an intervertebral fusion part, and the vertebral body fusion part is vertically arranged. Columnar structure, the vertebral body fusion part includes four sides, front and rear, left and right, and top and bottom surfaces, a first bone graft cavity is set between the top and bottom surfaces, and a second bone graft cavity is set between the left and right sides. The lower part of the lateral side, the upper part of the right side or the lower part of the right side is connected to the intervertebral fusion part, and the intervertebral fusion part is provided with a third bone graft cavity; The residual vertebral body and the adjacent vertebral bodies on the upper and lower sides are fixed. The present invention is suitable for the lateral anterior approach operation of the cervical vertebra.

Description

Lateral Anterior Approach Vertebral Body Reconstruction Interbody Fusion Fixator

technical field

The invention relates to the field of medical devices, in particular to an intervertebral fusion fixator in orthopedic medicine.

Background technique

Anterior cervical corpectomy decompression and fusion (ACCF) is suitable for patients who cannot achieve good spinal cord decompression by discectomy alone. For patients with both anterior and posterior spinal cord compression, combined posterior spinal canal enlargement can be considered on the basis of ACCF. ACCF is also an ideal choice for patients with vertebral body lesions (tumors, etc.), cervical dislocation, and kyphosis. Anterior cervical plate, titanium mesh and other implant materials improve the initial stability, support strength, and bone graft fusion rate of ACCF surgery.

According to the physiological structural characteristics of the vertebral body, there are esophagus and trachea in front of the cervical vertebral body. The existing anterior cervical approach requires pulling the trachea and esophagus to expose the front of the vertebral body, and then perform related surgical operations. The retraction of the esophagus and trachea in the anterior cervical approach increases the risk of postoperative dysphagia.

Dysphagia is a symptom caused by difficulty passing a bolus from the mouth into the stomach smoothly and safely. According to the location of dysphagia, it can be divided into oropharyngeal dysphagia and esophageal dysphagia. Dysphagia can be divided into functional, structural, and neurological dysphagia according to the cause of dysphagia. Cerebral central nervous system lesions, peripheral neuromuscular junction lesions, and esophageal smooth muscle damage can all cause dysphagia, see literature: Clave P, Shaker R. Dysphagia: current reality and scope of the problem[J].Nat Rev Gastroenterol Hepatol,2015 , 12(5):259-270. Any irritation and irritation to the esophagus, such as intraoperative esophageal stretch and anterior cervical plate stimulation, are thought to have an impact on the occurrence of postoperative dysphagia. Dysphagia is considered to be the result of a combination of factors, and its specific and complete mechanism remains to be further studied. At present, the factors that have been recognized by domestic and foreign scholars for dysphagia include: age, gender, C ₄ to C ₆ surgical segment, right Smith–Robinson approach, high-profile plate, intraoperative esophageal traction time and intensity, use of Hormones, application of BMP, etc., see literature: Rosenthal BD, Nair R, Hsu WK, etal. Dysphagia and Dysphonia Assessment Tools After Anterior Cervical SpineSurgery[J].Clin Spine Surg, 2016. Dysphagia can cause discomfort to patients, reduce patient satisfaction with surgery, and can also cause various complications such as aspiration pneumonia, dehydration, and malnutrition. Rihn et al reported that the incidence of dysphagia after anterior cervical surgery was as high as 70%, see literature: Rihn JA, Kane J, Albert TJ, et al.What is theincidence and severity of dysphagia after anterior cervical surgery[J].ClinOrthopRelat Res,2011 , 469(3):658-665. Yue WM et al conducted a clinical study with up to 7 years of follow-up and reported that at the last follow-up, 30% of patients still had dysphagia, see literature: Yue WM, Brodner W, Highland TR. Persistent swallowing and voice problems after anteriorcervical discectomy and fusion with allograft and plating: a 5to 11-year follow-up study[J]. Eur Spine J, 2005, 14(7):677-682.

In view of the problem that the anterior approach to the cervical spine, that is, the anterior ACCF surgery, may significantly increase the risk of dysphagia, a new surgical approach is proposed: the lateral anterior approach to the cervical spine. During the anterior approach on the side of the cervical spine, after the arterial sheath is stretched, the longus longus muscle is separated and exposed to reach the anterior position on the side of the vertebral body. There is no need to perform esophageal traction during the operation. Taking the partial resection and decompression of the C5 vertebral body as an example, during the resection, the incision is made almost parallel from the side, and then it is expanded when it reaches halfway, so as to expand the surgical field and complete the osteophyte and calcification in the rear of the vertebral body. The removal of the annulus fibrosus and other tissues completes the decompression of the spinal cord and relieves the compression on the nerves and spinal cord.

The lateral-anterior approach to the cervical spine is relatively minimally invasive and does not require pulling the esophagus. In theory, it can significantly reduce the incidence of postoperative dysphagia, while preserving normal structures such as the annulus fibrosus and anterior longitudinal ligament in front of the intervertebral space. Lateral anterior approach to the cervical spine can not only increase the stability of the surgical segment of patients after surgery, but also because of the existence of normal tissues such as annulus fibrosus and ligaments, the implants do not need to directly contact the esophagus, so it can reduce the occurrence of postoperative dysphagia in many aspects. Rate.

Implant devices such as fixation plates used in the anterior approach to the cervical spine cannot be used for the lateral anterior approach to the cervical spine. The field of vision of the anterior cervical approach surgery is different from that of the lateral anterior approach to the cervical spine. The former has a relatively small surgical field of view and reaches the lateral space of the vertebral body; while the latter has a larger field of view in front of the vertebral body, and it is still There is a lack of specialized matching endoplants. If the existing instruments are forcibly used for fusion and fixation, the following problems will occur: (1) it cannot be implanted, and even if it is implanted, the surrounding normal structures will be damaged; (2) it cannot be fixed; (3) the anterior annulus fibrosus and ligaments are damaged. , Violent pulling will damage surrounding muscles, ligaments, nerves and other structures. In addition, the front of the cervical spine is relatively flat and wide, and the existing screw fixation holes and fixation methods cannot be used in the field of view of the lateral front approach of the cervical spine, and there is also a lack of special supporting instruments.

The lateral anterior surgical approach of the cervical spine can reduce the risk of dysphagia, increase the postoperative segmental stability, promote early rehabilitation training, and enable patients to return to normal life as soon as possible. However, the operation space of the lateral anterior approach is small, and the existing fusion fixator cannot be used for screw fixation from the lateral approach. Therefore, there is a lack of a fusion fixator suitable for the lateral and anterior approach to the cervical spine.

SUMMARY OF THE INVENTION

The technical problem to be solved by the present invention is to provide a fusion fixator used in conjunction with the lateral anterior approach of the cervical vertebra, which aims to reduce the fusion time, improve the success rate of bone graft fusion, and reduce the probability of postoperative dysphagia.

The technical solution adopted by the present invention to solve the above technical problems is as follows: a lateral-anterior approach vertebral body reconstruction intervertebral fusion fixator, including a fusion fixation body and a screw, the fusion fixation body includes a vertebral body fusion part and an intervertebral fusion part, and the vertebral body fusion The vertebral body has a columnar structure in the vertical direction. The four sides of the vertebral fusion part are the anterior side, the rear side, the left side and the right side, respectively. A first bone graft cavity is set between the top and bottom surfaces of the vertebral fusion part. A second bone graft cavity is arranged between the left side and the right side, and the upper part of the left side, the lower part of the left side, the upper part of the right side or the lower part of the right side of the vertebral body fusion part is connected to the intervertebral fusion part. The intervertebral fusion part has a plate-like structure, and a third bone graft cavity is arranged between the top surface and the bottom surface of the intervertebral fusion part;

The fusion fixation body is also provided with at least two screw holes and suitable screws. One end of the screw holes used to enter the screw is located on the front side of the vertebral body fusion part or the front side of the intervertebral fusion part, and at least one screw hole is inserted from the fusion fixation body. The anterior side penetrates and points to the first screw in the area enclosed by the vertebral body fusion part and the intervertebral fusion part, and at least one second screw penetrates from the anterior side of the fusion fixation body and points to the upper or lower part of the intervertebral fusion part.

Further, there is an integral or movable connection between the vertebral body fusion part and the intervertebral fusion part. Specifically: the movable connection is the connection between the vertebral body fusion part and the intervertebral fusion part through a buckle or a ball groove.

Further, the first bone graft cavity and the second bone graft cavity are communicated with each other.

Specifically: the outer contour of the intervertebral fusion part on the horizontal section is a crescent shape, an ellipse shape or a fan ring shape.

Further, the upper part and the lower part of the left side of the vertebral body fusion part are connected to the intervertebral fusion part. The two structures of the intervertebral fusion part are axially symmetrical about the horizontal plane; The two structures of the fusion part are axially symmetrical about the horizontal plane; the upper part of the left side of the vertebral body fusion part and the upper part of the right side surface of the vertebral body fusion part are connected to the two structures of the intervertebral fusion part are symmetrical about the sagittal plane.

Specifically: the fusion fixation body is provided with two screw holes and equipped with two screws, the two screws are the first screw and the second screw respectively, and one end of the two screw holes for screw insertion is located on the anterior side of the vertebral body fusion. More specifically: the lower part of the right side of the vertebral body fusion part is connected to the intervertebral fusion part; the projection of the axial direction of the first screw on the sagittal plane is 40-50° obliquely upward relative to the horizontal plane, and the axial direction of the first screw is in the horizontal plane. The angle formed by the projection and the coronal plane is 15-30°; the projection of the axial direction of the second screw on the sagittal plane is 40-50° obliquely downward relative to the horizontal plane, and the projection of the axial direction of the second screw on the horizontal plane is formed with the coronal plane The included angle is 15 to 45°.

Alternatively, the fusion fixation body is provided with three screw holes and equipped with three screws, and one end of the three screw holes used to enter the screws is located on the anterior side of the vertebral body fusion part, and the three screws are the first screw, the second screw and the third screw respectively. Three screws; two screw holes of the three screw holes are located on the left side and the right side of the vertebral body fusion, and the screws in the two screw holes are the first screw and the third screw respectively. screw. Specifically: the lower part of the right side of the vertebral body fusion part is connected to the intervertebral fusion part; the projection of the axial direction of the first screw on the sagittal plane is 40-50° obliquely upward relative to the horizontal plane, and the projection of the axial direction of the first screw on the horizontal plane The angle formed with the coronal plane is 15-30°; the projection of the axial direction of the second screw on the sagittal plane is 40-50° obliquely downward relative to the horizontal plane, and the projection of the axial direction of the second screw on the horizontal plane is formed by the coronal plane. The included angle is 15-45°; the projection of the axial direction of the third screw on the sagittal plane is 40-50° obliquely upward relative to the horizontal plane, and the included angle formed by the projection of the axial direction of the third screw on the horizontal plane and the coronal plane is 45-50° 75°.

The beneficial effects of the present invention are as follows: first, through the lateral-anterior approach of the cervical spine and the lateral-anterior approach vertebral body reconstruction interbody fusion fixator of the present invention, the existing anterior ACCF operation is changed to two space fusion cervical vertebrae Anterior intervertebral discectomy, decompression and fusion (ACDF surgery) shortens the distance of bone crawling replacement, so the fusion time is shortened, the fusion efficiency of the patient is increased, and the postoperative recovery time is shortened, which is conducive to rapid recovery. Second, in the process of implanting cages, bone grafting, screw fixation, etc., because there is no need to pull the esophagus, and artificial materials such as implants have no direct contact with the esophagus, direct stimulation and interference to the esophagus can be avoided, and the esophagus can be significantly reduced. Incidence of postoperative dysphagia. Third, the first bone graft cavity is used to realize the intervertebral fusion between the resected vertebral body and the adjacent vertebral body, the second bone graft cavity is used to realize the healing between the two residual parts of the resected vertebral body, and the third bone graft cavity has It is beneficial to the healing of the excised vertebral body, and can also realize the bony union of the reconstructed part of the excised vertebral body and the adjacent vertebral body endplate. The fusion fixator of the invention improves the success rate of bone graft fusion, the patient does not need to wear external fixation devices such as a cervical collar for a long time after surgery, can return to normal work and life earlier, has less psychological impact on the patient, and is conducive to reducing health economic burden. Fourth, the fusion fixator of the present invention can meet the requirements of minimally invasive surgical operations in lateral-anterior approach surgery, can be implanted and perform screw fixation operations, and solve the problem that the existing internal fixation instruments for ACCF surgery cannot be used in lateral-anterior surgical approaches. question. Fifth, during the surgical operation of implanting the fusion fixator of the present invention, the anterior and contralateral annulus fibrosus and anterior longitudinal ligament of the patient can be preserved, the normal tissue of the patient can be preserved as much as possible, and the segment of the patient can be maintained to the maximum extent. Stability, no need to wear a neck brace after surgery, neck activities and rehabilitation training can be carried out earlier, which is helpful for patients to recover quickly.

The vertebral body fusion part and the intervertebral fusion part are movably connected, and the vertebral body fusion part and the intervertebral fusion part can be rotated in a relatively small range, so that the vertebral bodies can be rotated in a small range. The first bone graft cavity and the second bone graft cavity are communicated with each other, which is beneficial to the fusion of the bone graft.

Description of drawings

FIG. 1 is a schematic diagram of the procedure of the anterior approach to the cervical spine of the present invention.

FIG. 2 is a schematic structural diagram of a fusion anchor according to an embodiment of the present invention.

FIG. 3 is a schematic diagram of the positional relationship between the fusion fixation body and the vertebral body shown in FIG. 2 .

Reference numerals: vertebral body fusion part 1, anterior side 11, posterior side 12, left side 13, right side 14, top surface 15, bottom surface 16, first bone graft cavity 17, second bone graft cavity 18; Two screw holes 19-2, third screw holes 19-3; intervertebral fusion part 2, third bone graft cavity 21; first residual vertebral body 31, second residual vertebral body 32.

Detailed ways

As shown in FIG. 1 , the excision process of the anterior approach to the cervical spine according to the present invention is roughly as follows: first, the excision is performed parallel to the linear direction from the anterior side of the vertebral body, and the incision does not penetrate to the vertebral foramen. The incision can be arranged on the left anterior side or the right anterior side of the vertebral body. Figure 1 shows the incision on the left anterior side of the vertebral body. Then, the incision is expanded to both sides to expand the surgical field, see Figure 1. Finally, the resection of osteophytes, calcified annulus fibrosus and other tissues in the posterior range of the vertebral body is completed, and the resection process is completed, see Figure 1 right. For the convenience of description, the vertebral body to be resected is called the resected vertebral body, the upper and lower vertebral bodies are adjacent vertebral bodies, and the two residual parts on the left and right sides of the incision of the resected vertebral body are denoted as the first residual vertebral body 31 and the second residual vertebral body, respectively. The residual vertebral body 32 is shown on the right in FIG. 1 .

The lateral-anterior approach vertebral body reconstruction intervertebral fusion fixator of the invention is used for the reconstruction of the excised vertebral body, and at the same time, the excised vertebral body and the adjacent vertebral bodies on the upper and lower sides are fused and fixed. The present invention will be further described below in conjunction with the accompanying drawings.

The lateral-anterior approach vertebral body reconstruction intervertebral fusion fixator of the present invention includes a fusion fixation body and a screw, and a structure of the fusion fixation body is shown in FIG. 2 . The fusion fixation body includes a vertebral body fusion part 1 and an intervertebral fusion part 2. The vertebral body fusion part 1 has a columnar structure in the vertical direction. The four sides are respectively recorded as the front side 11, the back side 12, the left side 13 and the right side 14, wherein the front side 11, the back side 12, the left side 13 and the right side 14 are roughly the same as the front, back, left and right sides of the human body. correspond. The other two surfaces of the vertebral body fusion part 1 are the top surface 15 and the bottom surface 16 respectively, which correspond to the upper and lower parts of the human body respectively.

The vertebral body fusion part 1 is used to implant the incision position of the resected vertebral body, see FIG. 3 . The height of the vertebral body fusion portion 1 is approximately half the length of the resected vertebral body. The vertebral body fusion part 1 is quadrilateral in the horizontal section, and the corresponding sides of the left side 13 and the right side 14 are straight, and are respectively used for the resection surfaces of the first residual vertebral body 31 and the second residual vertebral body 32. together fixed. The sides corresponding to the anterior side surface 11 and the posterior side surface 12 of the vertebral body fusion part 1 can be straight, a better solution is to have a certain arc, and the anterior side surface 11 and the posterior side surface 12 are curved or curved, so that the vertebral body fusion part 1 It is better adapted to the physiological shape of the vertebral body. A first bone graft cavity 17 is provided between the top surface 15 and the bottom surface 16 of the vertebral body fusion part 1 . The first bone graft cavity 17 has a circular shape, an oval shape or other shapes on a horizontal cross section, and is used to achieve intervertebral fusion between the resected vertebral body and the adjacent vertebral body. A second bone graft cavity 18 is provided between the left side surface 13 and the right side surface 14 of the vertebral body fusion part 1, and the second bone graft cavity 18 is used for fusion between the two residual parts of the vertebral body, namely the first residual Fusion between the vertebral body 31 and the second residual vertebral body 32 . The first bone graft cavity 17 and the second bone graft cavity 18 communicate with each other.

The intervertebral fusion part 2 is connected to the upper part of the left side surface 13 , the lower part of the left side surface 13 , the upper part of the right side surface 14 , or the lower part of the right side surface 14 of the vertebral body fusion part 1 . Fusion fixation includes the above four schemes. When the incision is located on the left anterior side of the resected vertebral body, as shown in Figures 1 and 3, the two fusion fixtures that need to be used are the upper part of the right side 14 of the vertebral body fusion part 1 to connect the intervertebral fusion part 2 and the vertebral body fusion. The lower part of the right side 14 of the part 1 is connected to the intervertebral fusion part 2, the vertebral body fusion part 1 of the two fusion and fixation bodies is implanted into the incision, the intervertebral fusion part 2 is implanted into the upper and lower sides of the resected vertebral body, and the two fusion fixation bodies are implanted into the incision. The total height of the vertebral body fusion part 1 is consistent with the height of the resected vertebral body. The upper part of the right side surface 14 of the vertebral body fusion part 1 is connected to the intervertebral fusion part 2 and the lower part of the right side surface 14 is connected to the intervertebral fusion part 2 , and the structures of these two solutions are axially symmetrical about the horizontal plane. The solution shown in FIG. 2 is that the lower part of the right side surface 14 of the vertebral body fusion part 1 is connected to the intervertebral fusion part 2 .

When the incision is located on the right front side of the resected vertebral body, the two fusion fixation bodies that need to be used are the upper part of the left side 13 of the vertebral body fusion part 1 connecting the intervertebral fusion part 2 and the lower part of the left side 13 of the vertebral body fusion part 1 The intervertebral fusion part 2 is connected, and the total height of the vertebral body fusion part 1 of the two fusion fixed bodies is consistent with the height of the resected vertebral body. The upper part of the left side surface 13 of the vertebral body fusion part 1 is connected to the intervertebral fusion part 2 and the lower part of the left side surface 13 of the vertebral body fusion part 1 is connected to the intervertebral fusion part 2. The structures of the two schemes are axially symmetrical about the horizontal plane. In addition, the upper part of the left side 13 of the vertebral body fusion part 1 is connected to the intervertebral fusion part 2 and the upper part of the right side 14 of the vertebral body fusion part 1 is connected to the intervertebral fusion part 2. The two structures are symmetrical about the sagittal plane axis.

The intervertebral fusion part 2 has a plate-like structure, and a third bone graft cavity 21 is provided between the top surface 15 and the bottom surface 16 of the intervertebral fusion part 2 . The intervertebral fusion part 2 is used for implantation between the resected vertebral body and the upper and lower adjacent vertebral bodies, and the third bone graft cavity 21 is used for the intervertebral fusion of the resected vertebral body and the adjacent vertebral bodies. The outer contour of the intervertebral fusion part 2 on the horizontal section is in the shape of a crescent, an ellipse or a fan-shaped ring. The vertebral body fusion part 1 and the intervertebral fusion part 2 are integrally or movably connected, preferably movably connected, so that the vertebral body fusion part 1 and the intervertebral fusion part 2 can swing slightly. For example, the vertebral body fusion part 1 and the intervertebral fusion part 2 are connected by snaps or ball grooves.

The fusion fixation body is also provided with at least two screw holes and suitable screws, the screw holes are used for passing screws, and the screws pass through the screw holes of the fusion fixation body and then implant the resected vertebral body and the resected vertebral body, so as to realize the fusion fixation body and the vertebral body. fixation between bodies. In order to realize the implantation of screws after the fusion fixation body is placed into the incision of the vertebral body, the end of the screw hole for screw insertion is located at the anterior side of the fusion fixation body, that is, at the anterior side 11 of the vertebral body fusion part 1 or intervertebral fusion. The front side of the intervertebral fusion part 2 is the same side as the front side 11 of the vertebral fusion part 1 . Since the anterior surface of the vertebral body fusion part 1 is wider and higher than the anterior surface of the intervertebral fusion part 2 , the end of the screw hole for screw insertion is preferably arranged on the anterior surface 11 of the vertebral body fusion part 1 .

The fusion fixation body is provided with at least two screws, including at least one first screw and at least one second screw. On the basis of the first screw and the second screw provided in the fusion fixation body, a third screw may also be provided.

The first screw penetrates from the front surface 11 of the vertebral body fusion part 1 and points to the area enclosed by the vertebral body fusion part 1 and the intervertebral body fusion part 2 . The first screw is used to fix the vertebral body fusion part 1 with a relatively large residual vertebral body. When the incision is located on the left anterior side of the vertebral body, the first screw is used to implant the second residual vertebral body 32 , see FIG. 3 . When the incision is located anterior to the right of the resected vertebral body, the first screw is used to implant the first residual vertebral body on the left side of the incision. The first screw may be one or two, preferably one.

The second screw penetrates from the anterior side 11 of the vertebral body fusion 1 and is directed above or below the intervertebral fusion 2, and the second screw is used for implantation in the adjacent vertebrae. The end of the screw hole corresponding to the second screw for entering the screw is located on the anterior side 11 of the vertebral body fusion part 1, and the end of the screw hole corresponding to the second screw for exiting the screw is marked as the second screw passing hole 19-2. Two screw out-holes 19-2 are preferably arranged at the lower part of the posterior side surface 12 of the vertebral body fusion part 1, as shown in FIG. 2 . The second screw is preferably one or two.

The third screw is used to fix the vertebral body fusion 1 with the relatively small residual vertebral body. When the incision is located on the left anterior side of the vertebral body, the third screw is used to implant the first residual vertebral body 31 , see FIG. 2 . When the incision is located anterior to the right side of the vertebral body, a third screw is used to implant the second residual vertebral body to the right of the incision. The third screw may be one or two, preferably one, and preferably a screw shorter than the first screw and the second screw; in addition, the third screw may not be provided. In FIG. 2 , one end of the screw hole corresponding to the third screw for entering the screw is located on the front side 11 of the vertebral body fusion part 1 , and the end of the screw hole corresponding to the third screw for exiting the screw is the third screw passing hole 19 -3, the third screw passing hole 19 - 3 is arranged on the left side surface 13 of the vertebral body fusion part 1 .

Preferably, each of the first screw and the second screw is provided with one, and the third screw may be provided with one or not. Regardless of whether the fusion fixation body is provided with two screws or three screws, the angle of the screws is suitable for stable fixation. In the following, the lower part of the right side surface 14 of the vertebral body fusion part 1 is connected to the intervertebral fusion part 2 as an example, referring to FIG. 3 , the angle of the screw will be described.

The projection of the axial direction of the first screw on the sagittal plane is 40-50° obliquely upward relative to the horizontal plane, and 45° is the best; the angle formed by the projection of the axial direction of the first screw on the horizontal plane and the coronal plane is 15-30°, 20° °Best. The projection of the axial direction of the second screw on the sagittal plane is 40-50° obliquely downward relative to the horizontal plane, and 45° is the best; the projection of the axial direction of the second screw on the horizontal plane forms an angle of 15-45° with the coronal plane. 30° is the best. The projection of the axial direction of the third screw on the sagittal plane is 40 to 50° obliquely upward relative to the horizontal plane, and 45° is the best; the projection of the axial direction of the third screw on the horizontal plane forms an angle of 45 to 75° with the coronal plane. That is, the angle between the third screw and the line connecting the transverse foramen on both sides of the resected vertebral body (or the posterior wall of the vertebral body) in the horizontal plane is 45° to 75°.

Claims (10)

1. A lateral-anterior approach vertebral body reconstruction intervertebral fusion fixator, characterized in that: it comprises a fusion fixation body and a screw, and the fusion fixation body comprises a vertebral body fusion part (1) and an intervertebral fusion part (2), and the vertebral body fusion part (1) It has a columnar structure in the vertical direction. The four sides of the vertebral body fusion part (1) are the anterior side (11), the posterior side (12), the left side (13) and the right side (14). A first bone graft cavity (17) is arranged between the top surface (15) and the bottom surface (16) of the body fusion part (1), and a second bone graft cavity is arranged between the left side surface (13) and the right side surface (14) (18), the upper part of the left side (13), the lower part of the left side (13), the upper part of the right side (14) or the lower part of the right side (14) of the vertebral body fusion part (1) is connected to the intervertebral fusion part (2), the intervertebral fusion part (2) has a plate-like structure, and a third bone graft cavity (21) is arranged between the top surface and the bottom surface of the intervertebral fusion part (2); The fusion fixation body is further provided with at least two screw holes and adapted screws, and one end of the screw holes used for screw insertion is located on the anterior surface (11) of the vertebral body fusion part (1) or the anterior surface of the intervertebral fusion part (2). , at least one screw that penetrates from the anterior side of the fusion fixation body and points to the area enclosed by the vertebral body fusion part (1) and the intervertebral fusion part (2), and at least one screw penetrates from the anterior side surface of the fusion fixation body And point the second screw above or below the intervertebral fusion (2). 2. The lateral-anterior approach vertebral body reconstruction intervertebral fusion fixator according to claim 1, wherein the vertebral body fusion part (1) and the intervertebral fusion part (2) are an integral or movable connection . 3. The lateral-anterior approach vertebral body reconstruction interbody fusion fixator according to claim 2, characterized in that: the movable connection is through a buckle between the vertebral body fusion part (1) and the intervertebral fusion part (2). or ball-and-groove connection. 4. The lateral-anterior approach vertebral body reconstruction interbody fusion fixator according to claim 1, wherein the first bone graft cavity (17) and the second bone graft cavity (18) are communicated with each other. 5. The lateral-anterior approach vertebral body reconstruction interbody fusion fixator according to claim 1, wherein the outer contour of the intervertebral fusion part (2) on the horizontal section is a crescent shape, an ellipse shape or a fan ring shape. 6. The lateral-anterior approach vertebral body reconstruction interbody fusion fixator according to claim 1, characterized in that: the upper part of the left side surface (13) and the lower part of the left side surface (13) of the vertebral body fusion part (1) The two structures connecting the intervertebral fusion part (2) are axially symmetrical with respect to the horizontal plane, and the upper part of the right side surface (14) and the lower part of the right side surface (14) of the vertebral body fusion part (1) are connected to the two types of the intervertebral fusion part (2). The structure is axially symmetrical about the horizontal plane; the upper part of the left side surface (13) of the vertebral body fusion part (1) and the upper part of the right side surface (14) are connected to the intervertebral fusion part (2) and the two structures are symmetrical about the sagittal plane axis. 7. The lateral-anterior approach vertebral body reconstruction interbody fusion fixator according to any one of claims 1 to 6, wherein the fusion fixator is provided with two screw holes and equipped with two screws, and the two screws are respectively For the first screw and the second screw, one end of the two screw holes for screw insertion is located on the front side (11) of the vertebral body fusion part (1). 8. The lateral-anterior approach vertebral body reconstruction interbody fusion fixator according to claim 7, characterized in that: the lower part of the right side (14) of the vertebral body fusion part (1) is connected to the interbody fusion part (2) ; the projection of the axial direction of the first screw on the sagittal plane is 40-50° obliquely upward relative to the horizontal plane, and the angle formed by the projection of the axial direction of the first screw on the horizontal plane and the coronal plane is 15-30°; the axis of the second screw The projection on the sagittal plane is inclined downward by 40-50° relative to the horizontal plane, and the included angle formed by the projection of the axial direction of the second screw on the horizontal plane and the coronal plane is 15-45°. 9. The lateral-anterior approach vertebral body reconstruction interbody fusion fixator according to any one of claims 1 to 6, wherein the fusion fixation body is provided with three screw holes and equipped with three screws, three screw holes One end used for screw insertion is located on the front side (11) of the vertebral body fusion (1), and the three screws are respectively the first screw, the second screw and the third screw; two screw holes of the three screw holes are used for One end of the screw is located on the left side (13) and the right side (14) of the vertebral body fusion part (1) respectively, and the screws in the two screw holes are the first screw and the third screw respectively. 10. The lateral-anterior approach vertebral body reconstruction interbody fusion fixator according to claim 9, characterized in that: the lower part of the right side (14) of the vertebral body fusion part (1) is connected to the interbody fusion part (2) ; the projection of the axial direction of the first screw on the sagittal plane is 40-50° obliquely upward relative to the horizontal plane, and the angle formed by the projection of the axial direction of the first screw on the horizontal plane and the coronal plane is 15-30°; the axis of the second screw The projection on the sagittal plane is 40-50° obliquely downward relative to the horizontal plane, the angle formed by the projection of the axial direction of the second screw on the horizontal plane and the coronal plane is 15-45°; the axial direction of the third screw is on the sagittal plane The projection of the third screw is 40-50° obliquely upward relative to the horizontal plane, and the included angle formed by the projection of the axial direction of the third screw on the horizontal plane and the coronal plane is 45-75°.

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