CN113100900B - Intelligent screw plate system for thoracolumbar anterior approach and control method - Google Patents

Intelligent screw plate system for thoracolumbar anterior approach and control method Download PDF

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CN113100900B
CN113100900B CN202110423931.2A CN202110423931A CN113100900B CN 113100900 B CN113100900 B CN 113100900B CN 202110423931 A CN202110423931 A CN 202110423931A CN 113100900 B CN113100900 B CN 113100900B
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electrode layer
pedicle screw
shape
pressure
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CN113100900A (en
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冉龙骐
周吴
于慧君
魏敦文
曾志
吴一川
彭倍
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University of Electronic Science and Technology of China
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/808—Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7059—Cortical plates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8085—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with pliable or malleable elements or having a mesh-like structure, e.g. small strips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00544—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00893—Material properties pharmaceutically effective
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02E—REDUCTION OF GREENHOUSE GAS [GHG] EMISSIONS, RELATED TO ENERGY GENERATION, TRANSMISSION OR DISTRIBUTION
    • Y02E60/00—Enabling technologies; Technologies with a potential or indirect contribution to GHG emissions mitigation
    • Y02E60/14—Thermal energy storage

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
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Abstract

An intelligent nail plate system of a thoracolumbar anterior approach and a control method thereof are provided, wherein the intelligent nail plate system consists of a nail plate 1, a piezoelectric detection sheet 2 and a pedicle screw 3. After the patient completes the fixation operation of the screw plate, the pedicle screw 3 is fixed on the screw plate 1, the piezoelectric sheet 2 is arranged between the screw plate 1 and the pedicle screw 3, due to the effect of the piezoelectric effect, the piezoelectric sheet 2 can generate potential difference under the action of the pressure between the pedicle screw 3 and the screw plate 1, the pressure between the current pedicle screw and the screw plate can be obtained through detecting, amplifying and transmitting the voltage to an upper computer through a wireless transmission module, and the current screw can be considered to be loosened when the pressure is smaller than a preset threshold value.

Description

Intelligent screw plate system for thoracolumbar anterior approach and control method
Technical Field
The present invention relates generally to a smart plate system and control method for the anterior thoracolumbar spine and, more particularly, to a spinal column that may be secured to a patient for use in a anterolateral surgical procedure for correcting conditions such as scoliosis, also known as spinal curvature.
Background
At present, after an operation is performed on a uncinate joint of a patient in medicine, a nail plate system is commonly used for fixing vertebrae of the patient, however, as time goes by, the vertebrae of the patient may displace somewhat, so that screws are loosened, and the treatment effect is reduced. Threaded fixation elements such as threaded rods or bone nails, as well as slotted fixation elements such as fixation plates or lateral fixation blocks of conventional bone fixation devices, are often deficient in design because they do not form an angle of exactly 90 degrees and the nut cannot be securely fastened to the threaded fixation element. To overcome these drawbacks as described above. The prior art bone fixation plate arrangement aims to enhance the effect of tightening the threaded fixation element with the grooved fixation element of a conventional bone fixation device. However, the bone fixation plates described above fail to provide effective remedial measures. The prior art fixing elements are typically provided on both sides of the groove or through hole, respectively, with a concave arcuate surface capable of engaging with the arcuate protruding surface of the protruding arcuate surface fixing nut of the detent portion of the fixing element having a threaded portion and the fixing element. Considering that the centers of the two arc-shaped concave surfaces are fixed, the fixing element is positioned on a line connecting the two centers when the fixing nut is screwed down. When screwed down, the fixing element with the threaded portion and the fixing element with the slot form a fixed and unchangeable angle. However, if the fixing nut is not tightened, the angle may be slightly adjusted. It must be noted here that the fixing nut must be tightened to enable the fixing device to work effectively. Even if the fixation nut is tightened, the risk of loosening the screw increases as the patient's activity increases.
Disclosure of Invention
In order to solve the problem, the invention designs an intelligent screw plate system suitable for the anterior approach of the thoracolumbar, which can monitor the fastening condition of screw plate screws in real time so as to avoid the phenomenon of screw loosening.
The intelligent nail plate system consists of a nail plate 1, a piezoelectric detection piece 2 and pedicle screws 3, as shown in figure 1.
After the patient completes the fixation operation of the screw plate, the pedicle screw 3 is fixed on the screw plate 1, a piezoelectric detection sheet 2 is arranged between the screw plate 1 and the pedicle screw 3, and due to the action of the piezoelectric effect, the piezoelectric detection sheet 2 can generate potential difference under the action of the pressure between the pedicle screw 3 and the screw plate 1, the pressure between the current pedicle screw and the screw plate can be obtained through detecting, amplifying the voltage and transmitting the voltage to an upper computer through a wireless transmission module, and when the pressure is smaller than a preset threshold value, the current screw can be considered to be loosened.
The piezoelectric detection patch includes insulating layers 4, 8, electrode layers 5, 7, and a piezoelectric ceramic layer 6, as shown in fig. 2.
The electrode layer 5 and/or the electrode layer 7 have a variable shape A and a variable shape B, a micro heater is arranged on the electrode layer 5 and/or the electrode layer 7, the electrode layer 5 and/or the electrode layer 7 keeps the shape A with smaller thickness along the direction of the pedicle screw 3 at normal temperature, and the shape A is deformed into the shape B with larger thickness along the direction of the pedicle screw 3 after being heated; when the pressure between the pedicle screw and the pegboard is less than a predetermined threshold, the micro-heater is activated and the electrode layer 5 and/or the electrode layer 7 changes from shape a to shape B.
The control method of the intelligent screw plate system for the anterior thoracolumbar vertebra comprises the steps of detecting and amplifying the voltage of the piezoelectric detecting plate 2 and transmitting the voltage to an upper computer through a wireless transmission module to obtain the pressure between the current pedicle screw and the screw plate, and when the pressure is smaller than a preset threshold value, the current screw can be considered to be loosened.
By heating the insulating layers 4, 8 and/or the electrode layers 5, 7, the pressure between the pedicle screw and the pegboard is controlled to be kept within a preset range.
According to the technical scheme, the pressure change between the pedicle screw and the nail plate can be effectively monitored, the pressure between the pedicle screw and the nail plate is ensured to be in a reasonable range, the service life of the intelligent nail plate system of the thoracolumbar anterior approach is prolonged, and when the pressure between the pedicle screw and the nail plate is abnormal, early warning is timely carried out, so that the risk of disease deterioration is reduced.
Drawings
FIG. 1 is a schematic diagram of the overall structure of an intelligent pegboard system;
FIG. 2 is a schematic diagram of a piezoelectric test patch;
fig. 3 is a schematic diagram of a layered structure.
Detailed Description
The invention is further illustrated below with reference to examples.
The present invention will be described in detail with reference to the accompanying drawings, in order to make the objects and technical advantages of the present invention more clear.
An intelligent nail plate system comprises a nail plate 1, a piezoelectric detection piece 2 and a pedicle screw 3, as shown in figure 1.
After the patient completes the fixation operation of the screw plate, the pedicle screw 3 is fixed on the screw plate 1, a piezoelectric detection sheet 2 is arranged between the screw plate 1 and the pedicle screw 3, and due to the action of the piezoelectric effect, the piezoelectric detection sheet 2 can generate potential difference under the action of the pressure between the pedicle screw 3 and the screw plate 1, the pressure between the current pedicle screw and the screw plate can be obtained through detecting, amplifying the voltage and transmitting the voltage to an upper computer through a wireless transmission module, and when the pressure is smaller than a preset threshold value, the current screw can be considered to be loosened.
The piezoelectric detection patch includes insulating layers 4, 8, electrode layers 5, 7 and a piezoelectric ceramic layer 6 as shown in fig. 2.
The friction force between the insulating layer 4 and the electrode layer 5 is E 1 The friction force between the electrode layer 5 and the piezoelectric ceramic layer 6 is F 1 ，E 1 Less than F 1 The method comprises the steps of carrying out a first treatment on the surface of the The friction force between the insulating layer 8 and the electrode layer 7 is E 2 The friction force between the electrode layer 7 and the piezoelectric ceramic layer 6 is F 2 ，E 2 Less than F 2 。
In another embodiment, alternatively, the electrode layer 5 and/or the electrode layer 7 have a variable shape a and a variable shape B, and the electrode layer 5 and/or the electrode layer 7 are provided with micro heaters, and the electrode layer 5 and/or the electrode layer 7 maintain the shape a with a smaller thickness along the direction of the pedicle screw 3 at normal temperature, and after being heated, are deformed into the shape B with a larger thickness along the direction of the pedicle screw 3. When the pressure between the pedicle screw and the pegboard is less than a predetermined threshold, the micro-heater is activated and the electrode layer 5 and/or the electrode layer 7 changes from shape a to shape B.
In another embodiment, alternatively, the electrode layer 5 and/or the electrode layer 7 have a variable shape a and a variable shape B, and the electrode layer 5 and/or the electrode layer 7 are provided with micro heaters, and the electrode layer 5 and/or the electrode layer 7 maintains the shape B with a larger thickness along the direction of the pedicle screw 3 at normal temperature, and is deformed into the shape a with a smaller thickness along the direction of the pedicle screw 3 after being heated. When the pressure between the pedicle screw and the pegboard is greater than a predetermined threshold, the micro-heater is activated and the electrode layer 5 and/or the electrode layer 7 changes from shape B to shape a.
In another embodiment, alternatively, the insulating layer 4 and/or the insulating layer 8 are in a balloon structure, a micro heater and a communication device are arranged in the balloon, when the pressure between the pedicle screw and the nail plate is smaller than a preset threshold value, the micro heater is started, the thickness of the balloon is increased, and the pressure between the pedicle screw and the nail plate is controlled to be kept within a preset range.
In another embodiment, alternatively, the insulating layer 4 and/or the insulating layer 8 are in a balloon structure, and an exhaust device and communication equipment are arranged inside the balloon, when the pressure between the pedicle screw and the nail plate is greater than a preset threshold value, the exhaust device is started, the thickness of the balloon is reduced, and the pressure between the pedicle screw and the nail plate is controlled to be kept within a preset range.
The components of the intelligent pegboard system can be made of biologically acceptable materials suitable for medical applications, including metals, synthetic polymers, ceramics, and bone materials, and/or composites thereof. For example, components of the intelligent external fixation clamp for spinal rehabilitation status monitoring, individually or collectively, may be made of materials such as stainless steel alloys, pure titanium, titanium alloys, superelastic titanium alloys, cobalt chromium alloys, superelastic metals, alloys, ceramics and composites thereof, such as calcium phosphates, thermoplastics such as polyaryletherketones, including Polyetheretherketone (PEEK), polyetherketoneketone (PEKK) and Polyetherketone (PEK), carbon-PEEK composites, PEEK-BaSO 4 polymer rubber, polyethylene terephthalate (PET), fabrics, silicones, polyurethanes, silicone-polyurethane copolymers, polymer rubbers, polyolefin rubbers, hydrogels, semi-rigid and rigid materials, elastomers, rubbers, thermoplastic elastomers, thermoset elastomers, elastomer composites, polymers including polyphenylene, polyamides, polyimides, polyetherimides, polyethylene, epoxy resins. But also autograft bone material, allograft, xenograft or transgenic cortical and/or cortical cancellous bone, as well as tissue growth or differentiation factors, partially resorbable materials, e.g. composite metals and calcium-based ceramics, composite materials of PEEK and resorbable polymers, fully resorbable materials, e.g. calcium-based ceramics, e.g. calcium phosphate, tricalcium phosphate (TCP), hydroxyapatite (HA) -TCP, calcium sulfate or other resorbable polymers, e.g. polyglycolide, polytyrosine carbonate, polycarboxylic acid and combinations thereof.
The components of the intelligent pegboard system can have a composite of materials, including the materials described above, to achieve various desired characteristics, such as strength, stiffness, elasticity, compliance, biomechanical properties, durability, and radiolucency or imaging preferences. The components of the intelligent pegboard system, individually or collectively, can also be made of heterogeneous materials, such as a combination of two or more of the foregoing materials. The components of the intelligent pegboard system can be integrally formed, integrally connected or include fastening elements and/or instruments.
The intelligent pegboard system can be open or minimally open, minimally invasive, and/or include percutaneous surgical techniques to deliver and introduce instrumentation and/or spinal implants, such as bone nails. The surgical site in the patient includes a single or multiple vertebrae. A plurality of set screws and/or superangulation are placed to resist pullout from the vertebral tissue. In some embodiments, the spinal implant may include a spinal construct, one or more bone fasteners, an interbody implant, a spinal rod, a tether, and/or a connector.
Preferably, as shown in fig. 3, the pedicle screw comprises a layered structure, namely a protective layer 9, a sealing layer, a phase change layer 10, a sealing layer and a central layer 11 from outside to inside; the protective layer 9 and the central layer 11 may be titanium, titanium alloy, stainless steel, cobalt chromium or any combination thereof; the sealing layer is typically a thin film material; the phase change layer 10 comprises a phase change material that switches between a solid state, a liquid/glassy state, preferably below 20 c, a liquid/glassy state above 30 c, remains solid during the surgical procedure to provide sufficient rigidity support to the patient's spine and gradually changes to a liquid/glassy state after the surgical procedure is completed to provide better comfort to the patient.
Preferably, the surface layer of the pedicle screw is coated with a double-layer film, micropores are formed in the double-layer film, and the inside of the double-layer film is filled with various medicaments or therapeutic medicaments for helping the bone to grow rapidly.
Although the present invention has been described with respect to the preferred embodiments, it will be understood by those skilled in the art that the foregoing and various other changes, substitutions and alterations can be made herein without departing from the spirit and scope of the invention as defined by the appended claims.

Claims (5)

1. An intelligence nail board system in chest lumbar vertebrae anterior road, its characterized in that: the device comprises a nail plate (1), a piezoelectric detection piece (2) and a pedicle screw (3), wherein the pedicle screw (3) is fixed on the nail plate (1), the piezoelectric detection piece (2) is arranged between the nail plate (1) and the pedicle screw (3), due to the effect of a piezoelectric effect, the piezoelectric detection piece (2) can generate potential difference under the effect of the pressure between the pedicle screw (3) and the nail plate (1), and the current pressure between the pedicle screw and the nail plate can be obtained by detecting, amplifying and transmitting the voltage to an upper computer through a wireless transmission module; the piezoelectric detection piece comprises an insulating layer (4), an electrode layer (5) and a piezoelectric ceramic layer (6); the friction force between the insulating layer (4) and the electrode layer (5) is E 1 The friction force between the electrode layer (5) and the piezoelectric ceramic layer (6) is F 1 ，E 1 Less than F 1 The method comprises the steps of carrying out a first treatment on the surface of the The friction force between the insulating layer (8) and the electrode layer (7) is E 2 The friction force between the electrode layer (7) and the piezoelectric ceramic layer (6) is F 2 ，E 2 Less than F 2 ；
The surface layer of the pedicle screw is coated with a double-layer film, micropores are formed in the double-layer film, and the inside of the double-layer film is filled with a therapeutic drug for helping bone to grow rapidly;
the pedicle screw comprises a layered structure, and a protective layer (9), a sealing layer, a phase-change layer (10), a sealing layer and a central layer (11) are sequentially arranged from outside to inside; the protective layer (9) and the central layer (11) are metal; the sealing layer is a film material; the phase change material of the phase change layer (10) switches between solid and liquid states.
2. The intelligent pegboard system of the anterior thoracolumbar spine of claim 1, wherein: the electrode layer (5) and/or the electrode layer (7) have a variable shape A and a variable shape B, a micro heater is arranged on the electrode layer (5) and/or the electrode layer (7), the electrode layer (5) and/or the electrode layer (7) keep the shape B with larger thickness along the direction of the pedicle screw (3) at normal temperature, and the shape B is deformed into the shape A with smaller thickness along the direction of the pedicle screw (3) after being heated; when the pressure between the pedicle screw and the pegboard is greater than a predetermined threshold, the micro-heater is activated and the electrode layer (5) and/or the electrode layer (7) changes from shape B to shape A.
3. The intelligent pegboard system of the anterior thoracolumbar spine of claim 1, wherein: the electrode layer (5) and/or the electrode layer (7) have a variable shape A and a variable shape B, a micro heater is arranged on the electrode layer (5) and/or the electrode layer (7), the electrode layer (5) and/or the electrode layer (7) keep the shape A with smaller thickness along the direction of the pedicle screw (3) at normal temperature, and after being heated, the shape A is deformed into the shape B with larger thickness along the direction of the pedicle screw (3); when the pressure between the pedicle screw and the pegboard is less than a predetermined threshold, the micro-heater is activated and the electrode layer (5) and/or the electrode layer (7) changes from shape a to shape B.
4. The intelligent pegboard system of the anterior thoracolumbar spine of claim 1, wherein: the insulation layer (4) and/or the insulation layer (8) are/is of an air bag structure, a micro heater and communication equipment are arranged in the air bag, when the pressure between the pedicle screw and the nail plate is smaller than a preset threshold value, the micro heater is started, the thickness of the air bag is increased, and the pressure between the pedicle screw and the nail plate is controlled to be kept within a preset range.
5. The intelligent pegboard system of the anterior thoracolumbar spine of claim 1, wherein: the insulating layer (4) and/or the insulating layer (8) are/is of an air bag structure, an exhaust device and communication equipment are arranged in the air bag, when the pressure between the pedicle screw and the nail plate is larger than a preset threshold value, the exhaust device is started, the thickness of the air bag is reduced, and the pressure between the pedicle screw and the nail plate is controlled to be kept within a preset range.
CN202110423931.2A 2021-04-20 2021-04-20 Intelligent screw plate system for thoracolumbar anterior approach and control method Active CN113100900B (en)

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