TARP (transoral anterior reduction plate) based guide template for axis anterior transpedicular fixation

Abstract

The invention relates to a TARP (transoral anterior reduction plate) based guide template for axis anterior transpedicular fixation. The guide template comprises a base plate. A longitudinal rectangular boss and a transverse rectangular boss are arranged on one side of the base plate. Two guide sleeves matched with vertebral pedicle screws in inner diameter are arranged on the other side of the base plate. The upper surface of the transverse rectangular boss is a transverse positioning curved surface matched with the outer surface, facing the lower side of the oropharynx, of the axis. The upper surface of the longitudinal rectangular boss is a longitudinal positioning curved surface matched with the outer surface, facing the middle of the oropharynx, of the axis. The surfaces of the tail ends of the guide sleeves are in contact. Holes of the guide sleeves extend to penetrate the base plate respectively. The axis of each hole is the extension line of the central axis of the corresponding vertebral pedicle. The guide template is simple in structure and accurate in positioning.

Description

technical field [0001] The invention relates to a surgical instrument in the medical field, in particular to a guide for implanting an osteosynthetic internal fixator. Background technique [0002] Irreversible atlantoaxial dislocation caused by various reasons is a common clinical disease, and the most commonly used treatment methods are anterior oropharyngeal release and decompression and posterior internal fixation, but it is difficult to reset immediately, and a combination of anterior and posterior operations is required Or two-stage surgery, the reduction is not ideal, and the treatment cycle is long. The invention and application of transoral anterior reduction plate (TARP) fixation technology is one of the important advances in upper cervical spine surgery in the past decade. This technique can be effectively combined with the transoropharyngeal atlantoaxial release technique, and solve the problem of release-reduction-fixation of refractory atlantoaxial dislocation...

AI Technical Summary

Problems solved by technology

However, the TARP plate designed in the early stage was fixed by vertebral body screw. According to the follow-up of some patients with osteoporosis, it was found that some patients had long-term loosening of the plate.

In order to solve this problem, the third-generation TARP, which is fixed by pedicle screws through the anterior approach of the axis, is gradually being applied clinically. It was found that the best entry point for the anterior axis pedicle screw was 5 mm below the upper articular surface of the axis, 7.8 mm from the anterior mid-sagittal plane, and the direction of screw insertion was inclined outward by 18° and downward by 14°. It is still difficult to place screws accurately by hand during surgery

Moreover, because there are important structures such as the vertebral artery and cervical spinal cord near the pedicle of the axis, a slight deviation in screw placement can cause serious complications.

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