Anterior cervical spine plate, elevator, and internal fixation system for ACAF

Abstract

The present invention relates to an anterior cervical plate, a lifter and an internal fixation system used in ACAF surgery. The head and tail ends of the anterior cervical plate are both provided with fusion windows with a width ≥8mm and a height ≥10mm, and at least one long lifting groove is provided on the central longitudinal axis. It may further include an auxiliary plate, which covers the front side of the plate body when in use. The lifter includes a lifting pin and a screwdriver, the lifting pin is provided with a first and a second stroke control body, and the screwdriver is provided with a screwdriver sleeve head that is sleeved on the outside of the second stroke control body and drives it to rotate. The internal fixation system includes the anterior cervical plate and the lifter. The present invention can realize the ACAF technical concept - physiological intervertebral space height, precise and controllable decompression of the lifting and pressure complex, restoration of the optimal physiological curvature, simplification, reliability and precision of the surgery, reduction of complications, reduction of surgical risks and improvement of surgical efficacy.

Description

Technical Field

[0001] The present invention relates to the technical field of medical devices, and in particular to an anterior cervical spine steel plate, a lifting device and an internal fixation system used in ACAF surgery. Background Art

[0002] The anterior approach is one of the commonly used surgical approaches for the cervical spine, and it is widely used in cervical degenerative diseases, trauma, deformities, tumors and other lesions. The anterior cervical plate internal fixation system can provide strong fixation and is currently used routinely in anterior cervical spine surgery. The plate internal fixation systems used clinically are composed of a steel plate and several screws, which are divided into various models according to the locking method, static pressure or dynamic pressure, etc. Regardless of the existing model of steel plate, since the bone graft observation hole of the steel plate is small, the method of use is to first insert the fusion device or bone graft block, and then place the steel plate for fixation.

[0003] The cervical spine anterior controlled anterior displacement and fusion (ACAF) procedure, pioneered by the inventor of this application, Professor Shi Jiangang, is an emerging anterior cervical spine technique with advantages such as high safety and excellent neurological recovery. It is particularly suitable for long-segment, severe OPLL-induced spinal stenosis or other causes of spinal stenosis, and has garnered widespread attention. During the procedure, an anterior cervical plate / screw acts as a "suspension bridge," advancing the cervical vertebral body and the compressive material as a whole.

[0004] The current technical problem is that conventional anterior plates used in OPLL diseases cannot realize the ACAF technology concept - precise lifting and compressing of the object, and cannot maintain the physiological height between vertebrae and restore the ideal physiological curvature of the cervical spine. The reasons are: 1. During the use of conventional anterior cervical plates, the fusion cage needs to be placed first, and then the lifting operation is performed. After the fusion cage is placed, it may get stuck with the residual vertebrae, thereby affecting the subsequent forward movement operation, and this phenomenon is particularly prominent in the intervertebral space at the upper and lower ends; 2. When the forward movement operation is performed using the "suspension bridge" principle, conventional anterior plates require the use of screws screwed into the screw holes on both sides. When the force on both sides is unbalanced, the residual vertebrae may rotate, thereby affecting the forward movement effect and even causing neurological complications. This has led to the traditional anterior plate having an insignificant effect in restoring the physiological curvature of the cervical spine during surgery, and it is easy to find it difficult to restore the physiological curvature during surgery, or lose the physiological curvature after surgery.

[0005] Patent application CN109288571A previously submitted by the applicant provides a cervical spine natural height fixation plate, which is provided with a plate body, and the plate body is provided with a fusion window, a locking piece and a screw fixing hole that cooperates with the screw. The minimum distance between the upper and lower side walls of the fusion window along the vertical axis is 3-8 mm, and the minimum distance between the left and right side walls of the fusion window along the horizontal axis is 12.1-18 mm. The cervical spine natural height fixation plate is used for use in cervical discectomy. The inventor has summarized and found in long-term clinical work that the bone graft fusion device itself is larger than the height of the intervertebral disc to ensure compression with the adjacent vertebral body and promote osteogenesis, but at the same time it will cause the upper and lower vertebral bodies to be stretched. If multiple intervertebral discs are removed, multiple segments will be stretched too much, causing the cervical spine to lose its natural height and causing surgical complications such as neck pain. Therefore, the fusion window of the fixation plate is designed to be large enough to allow the fusion device to pass through. During the operation, after removing the intervertebral disc, the vertebral body is fixed first and then the fusion device is implanted. This solves the technical problem of neck pain caused by excessive expansion of the vertebral body and loss of natural height due to fusion device implantation.

[0006] Patent application CN109044572A previously submitted by the applicant provides a lifting tool for cervical vertebral advancement and fusion surgery, the lifting tool comprising a lifting fixture, a stroke control body, a connecting rod, a movable handle, and a fixed handle; one end of the stroke control body is connected to the lifting fixture, and the other end is connected to the connecting rod; the movable handle is arranged on the outer circumference of the connecting rod and is movably connected to the connecting rod; the fixed handle is arranged at one end of the connecting rod; the stroke control body is provided with an external thread, and the movable handle is provided with an internal thread, and when the internal thread on the movable handle and the external thread on the stroke control body are screwed in, relative movement is generated between the stroke control body and the movable handle. The lifting tool for cervical vertebral advancement and fusion surgery can achieve controllable, vertical, and stable lifting of the vertebral body.

[0007] However, there is currently no anterior cervical plate and supporting internal fixation system suitable for use in ACAF surgery, which can realize the technical concept of ACAF surgery to accurately lift the pressure-inducing object, maintain the physiological height between vertebrae, and restore the ideal physiological curvature of the cervical spine. Summary of the Invention

[0008] The first purpose of the present invention is to address the deficiencies in the existing technology and provide an anterior cervical plate suitable for use in ACAF surgery, which can achieve the technical concept of accurately lifting the pressure-inducing object in ACAF surgery, maintaining the physiological height between vertebrae, and restoring the ideal physiological curvature of the cervical spine.

[0009] The second purpose of the present invention is to address the deficiencies in the prior art and provide a lifting device suitable for use in ACAF surgery, which can smoothly lift the pressure-inducing object in ACAF surgery and effectively avoid damage to the vertebral body.

[0010] The third purpose of the present invention is to address the deficiencies in the existing technology and provide an ACAF internal fixation system suitable for use in ACAF surgery, which can achieve accurate, controllable, stable and safe lifting of the pressure object in ACAF surgery and significantly improve the surgical effect.

[0011] In order to achieve the above first purpose, the technical solution adopted by the present invention is:

[0012] A cervical anterior plate used in ACAF surgery is provided with a plate body and screw fixation holes. The head and tail ends of the plate body are provided with fusion windows, the width of the fusion window is ≥8mm and the height is ≥10mm; the central longitudinal axis of the plate body is provided with at least one long pulling groove, and the length direction of the pulling groove is consistent with the length direction of the plate body.

[0013] As a preferred example of the present invention, the anterior cervical plate used in the ACAF surgery also includes an auxiliary steel plate. When in use, the auxiliary steel plate covers the front side of the steel plate body and exposes the fusion window, lifting groove and screw fixation hole of the steel plate body, and the auxiliary steel plate is fixed to the steel plate body.

[0014] More preferably, the auxiliary steel plate and the steel plate body are fixed by threaded fixing, anti-rotation pin or riveting; the auxiliary steel plate and the steel plate body have the same shape.

[0015] As another preferred example of the present invention, the number of the pulling groove is one, and the fusion window at the head end, the fusion window at the tail end and the pulling groove are connected.

[0016] As another preferred example of the present invention, the number of the pulling grooves is two or more, the fusion window at the head end is connected to the pulling groove near the head end, the fusion window at the tail end is connected to the pulling groove near the tail end, and the pulling grooves are not connected to each other.

[0017] As another preferred example of the present invention, the screw fixing holes include end screw fixing holes and side screw fixing holes, the end screw fixing holes are located at the head end and the tail end of the steel plate body, and the side screw fixing holes are located on the left and right sides of the pulling groove.

[0018] More preferably, the fusion window at the head end is below the end screw fixing hole at the head end, and the fusion window at the tail end is above the end screw fixing hole at the tail end.

[0019] More preferably, the side screw fixing holes on the left and right sides of the pulling groove are symmetrically arranged.

[0020] As another preferred example of the present invention, the material of the steel plate body is stainless steel, silicon steel, carbon steel, titanium alloy, pure titanium, cobalt-nickel alloy or polymer material.

[0021] To achieve the above second purpose, the technical solution adopted by the present invention is:

[0022] A lifting device used in ACAF surgery, the lifting device includes a lifting pin and a screwdriver; the lifting pin 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 on the outside of the first stroke control body, and is provided with an internal thread matching the external thread of the first stroke control body, and the outer surface of the second stroke control body is molded with an axial rib groove; the screwdriver is provided with a screwdriver handle, a screwdriver extension rod and a screwdriver sleeve head, and the inside of the screwdriver sleeve head is provided with a rib groove matching the rib groove on the second stroke control body.

[0023] To achieve the third purpose, the present invention adopts the following technical solutions:

[0024] An internal fixation system for ACAF surgery comprises an anterior cervical spine plate used in any of the above-described ACAF surgeries and a lifting device used in the above-described ACAF surgery.

[0025] The advantages of the present invention are:

[0026] 1. The head and tail ends of the plate body are equipped with enlarged fusion windows, which allow the vertebral body to be moved forward first and then the intervertebral fusion cage to be inserted, thus ensuring the vertebral body movement forward effect to the greatest extent.

[0027] 2. The pulling groove is located in the center of the steel plate body, which avoids the rotation of the pressure reduction body during the pulling process. The pulling groove is a longitudinal strip, which can be pulled at any position to achieve precise and controllable decompression.

[0028] 3. Equipped with auxiliary steel plates to ensure strength, facilitate the correction of physiological curvature during surgery, and ensure the best recovery of the physiological curvature of the cervical spine.

[0029] 4. The fusion windows are only set at the head and tail ends, which are used for fusion of the intervertebral spaces at the head and tail ends outside the lifting segment. The intervertebral spaces between the vertebrae within the lifting segment are still first filled with fusion devices or bone grafts, which does not affect the precise lifting of the vertebrae and also ensures the overall strength of the steel plate.

[0030] 5. The lifting device consists of two parts: a lifting pin and a screwdriver. The longer screwdriver drives the second stroke control body to lift the cone, which is conducive to the smooth lifting of the vertebral body. The force on the steel plate is also more uniform, which minimizes the damage to the vertebral body caused by surgery.

[0031] In general, the anterior cervical plate and elevator used in the ACAF surgery of the present invention, that is, the entire internal fixation system, can realize the ACAF technical concept - physiological intervertebral disc height, precise and controllable decompression of the lifting and compression complex, restoration of the optimal physiological curvature, making the surgery simpler, more reliable, and more precise, reducing complications, lowering surgical risks, and improving surgical efficacy. BRIEF DESCRIPTION OF THE DRAWINGS

[0032] Attachment Figure 1 This is a front view of the anterior cervical plate used in the ACAF procedure of Example 1.

[0033] Attachment Figure 2 This is a stereoscopic view of the anterior cervical spine plate used in the ACAF procedure of Example 1.

[0034] Attachment Figure 3 This is a front view of the anterior cervical spine plate used in the ACAF procedure of Example 2.

[0035] Attachment Figure 4 This is a stereoscopic view of the anterior cervical plate used in the ACAF procedure of Example 2.

[0036] Attachment Figure 5 This is a front view of the anterior cervical spine plate used in the ACAF procedure of Example 3.

[0037] Attachment Figure 6 This is a stereoscopic view of the anterior cervical spine plate used in the ACAF procedure of Example 3.

[0038] Attachment Figure 7 Schematic diagram of the anterior cervical plate structure used in the ACAF procedure of Example 4.

[0039] Attachment Figure 8 This is a schematic diagram of the usage status of the anterior cervical spine plate used in the ACAF surgery of Example 4.

[0040] Attachment Figure 9 This is a schematic diagram of the structure of the lifter used in the ACAF technique of Example 5. Figure 1 .

[0041] Attachment Figure 10 This is a schematic diagram of the structure of the lifter used in the ACAF technique of Example 5. Figure 2 .

[0042] Attachment Figure 11 It is a schematic diagram of the human body measurement reference plane and reference axis. DETAILED DESCRIPTION

[0043] The specific embodiments of the present invention are described in detail below with reference to the accompanying drawings.

[0044] The reference numerals and components in the drawings are as follows:

[0045]

[0046]

[0047] Example 1

[0048] See Figure 1 and Figure 2 , Figure 1 This is a front view of the anterior cervical spine plate used in the ACAF procedure of Example 1. Figure 2 This is a stereoscopic view of the anterior cervical spine plate used in the ACAF procedure of Example 1.

[0049] The anterior cervical spine plate used in the ACAF procedure comprises a plate body 1. The plate body 1 is provided with two end screw holes 2 at both its head and tail ends, located on either side, with an end screw locking member 3 positioned between them. The plate body 1 also has two rectangular fusion windows 4: one located below the end screw hole 2 at the head end, and the other located above the end screw hole 2 at the tail end. The minimum vertical distance (length) between the upper and lower side walls of each fusion window 4 is 10 mm, and the minimum horizontal distance (width) between the left and right side walls of each fusion window 4 is 8 mm. The plate body 1 also has a lifting groove 5, which is an elongated groove extending in the same direction as the plate body 1. The lifting groove 5 is 3-6 mm wide and 10-20 mm long. The lifting groove 5 connects with the two fusion windows 4 at the head and tail ends, forming an "I" shape. The left and right sides of the pulling groove 5 are each provided with a side screw fixing hole 6, and each side screw fixing hole 6 is equipped with a side screw locking piece 7. The side screw fixing holes 6 and the side screw locking pieces 7 on the left and right sides are symmetrically distributed.

[0050] The anterior cervical spine plate used in this embodiment of the ACAF procedure can be customized to appropriate specifications based on the plate's strength and the patient's anatomy. For example, the plate body 1 is 3.5 mm thick, 51 mm long, and 16 mm wide. The central axis of the end screw fixation hole 2 at the cranial end is tilted 20° toward the cranial end, while the central axis of the end screw fixation hole 2 at the caudal end is tilted 20° toward the caudal end. The central axis of each end screw fixation hole 2 is tilted 6° inward.

[0051] The anterior cervical plate used in the ACAF procedure of this embodiment is suitable for lifting a single vertebra.

[0052] The method of using the anterior cervical plate used in the ACAF surgery of this embodiment is as follows: (1) perform general anesthesia and adopt a supine position; (2) make an incision according to the length of the surgical segment and the condition of the patient's neck to expose the relevant vertebrae; (3) process the intervertebral space: for the treatment of the intervertebral space within the lifting segment, it is only necessary to expose the posterior longitudinal ligament; for the treatment of the intervertebral space at the head and tail ends of the lifting segment, the posterior longitudinal ligament of the intervertebral space is bitten off to expose the dura mater; (4) remove the bone in the front part of the vertebral body; (5) install the plate and intervertebral fusion device: place the cervical plate used in the ACAF surgery of the present invention with a suitable length and pre-bent on the front edge of the vertebral body, and install it on the head and tail ends of the vertebrae outside the lifting segment. The vertebral body is screwed into the end screw fixing holes 2 at the head and tail ends of the steel plate body 1. Be careful to screw the tail of the vertebral body screw until it fits the steel plate body 1; (6) Slots are made on both sides of the vertebral body in the lifting segment to free the vertebral ossification complex; (7) The vertebral ossification complex is moved forward: the lifting tool is screwed into the lifting groove 5, the lifting tool outer sleeve is rotated, and the inner core drives the bone block to move upward until the vertebral body in the lifting segment fits the steel plate body 1; (8) A fusion device or bone graft is inserted into the intervertebral space near the lifting segment outside the lifting segment through the fusion window 4, and bone is grafted into the grooves on both sides of the vertebral body in the lifting segment, hemostasis is stopped, the incision is closed, and postoperative immobilization is performed.

[0053] Example 2

[0054] See Figure 3 and Figure 4 , Figure 3 This is a front view of the anterior cervical spine plate used in the ACAF procedure of Example 2. Figure 4 This is a stereoscopic view of the anterior cervical plate used in the ACAF procedure of Example 2.

[0055] The anterior cervical spine plate used in the ACAF procedure is provided with a plate body 1. The plate body 1 is provided with two end screw fixing holes 2 at both its head and tail ends. The two end screw fixing holes 2 are located on the left and right sides, respectively, with an end screw locking member 3 located between them. The plate body 1 is also provided with two rectangular fusion windows 4, one of which is located below the end screw fixing hole 2 at the head end of the plate body 1, and the other is located above the end screw fixing hole 2 at the tail end of the plate body 1. The minimum distance (length) between the upper and lower side walls of each fusion window 4 along the vertical axis is 10 mm, and the minimum distance (width) between the left and right side walls of each fusion window 4 along the horizontal axis is 8 mm. The plate body 1 is also provided with two lifting grooves 5, which are elongated grooves whose length direction is consistent with the length direction of the plate body 1. The lifting grooves 5 are 3-6 mm wide and 10-20 mm long. The lifting groove 5 at the head end communicates with the fusion window 4 at the head end, and the lifting groove 5 at the tail end communicates with the fusion window 4 at the tail end. The four together form an "I" shape, but the two lifting grooves 5 are not connected. Each lifting groove 5 has a side screw fixing hole 6 on either side, and each side screw fixing hole 6 is equipped with a side screw locking member 7. The side screw fixing holes 6 and side screw locking members 7 on the left and right sides are symmetrically distributed.

[0056] The anterior cervical spine plate used in this embodiment of the ACAF procedure can be customized to appropriate specifications based on the plate's strength and the patient's anatomy. For example, the plate body 1 is 3.5 mm thick, 75 mm long, and 16 mm wide. The central axis of the end screw fixation hole 2 at the cranial end is tilted 20° toward the cranial end, while the central axis of the end screw fixation hole 2 at the caudal end is tilted 20° toward the caudal end. The central axis of each end screw fixation hole 2 is tilted 6° inward.

[0057] The anterior cervical plate used in the ACAF procedure of this embodiment is suitable for lifting two vertebrae.

[0058] The method of using the anterior cervical plate used in the ACAF surgery of this embodiment is as follows: (1) perform general anesthesia and adopt a supine position; (2) make an incision according to the length of the surgical segment and the condition of the patient's neck to expose the relevant vertebrae; (3) process the intervertebral space: for the treatment of the intervertebral space within the lifting segment, it is only necessary to expose the posterior longitudinal ligament. For the intervertebral space at the beginning and end of the lifting segment, the posterior longitudinal ligament of the intervertebral space is bitten off to expose the dura mater; (4) remove the bone in the front part of the vertebral body; (5) install the plate and intervertebral fusion device: measure the size of each intervertebral space according to the test mold, install the intervertebral fusion device in the intervertebral space between the lifting segments, place the cervical plate used in the ACAF surgery of the present invention with a suitable length and pre-bent on the front edge of the vertebral body, and Vertebral screws are installed on the vertebrae at the head and tail ends outside the segment to the end screw fixing holes 2 at the head and tail ends of the steel plate body 1. Note that the tail of the vertebral screw is screwed until it fits the steel plate body 1; (6) Slots are made on both sides of each vertebra in the lifting segment to free the vertebral ossification complex; (7) The vertebral ossification complex is moved forward: the lifting tool is screwed into the lifting groove 5, the lifting tool outer sleeve is rotated, and the inner core drives the bone block to move upward until each vertebra in the lifting segment fits the steel plate body 1; (8) A fusion device or bone graft is inserted into the intervertebral space near the head and tail of the lifting segment outside the lifting segment through the fusion window 4, and bone is grafted into the slots on both sides of each vertebra in the lifting segment to stop bleeding, close the incision, and apply braking after surgery.

[0059] Example 3

[0060] See Figure 5 and Figure 6 , Figure 5 This is a front view of the anterior cervical spine plate used in the ACAF procedure of Example 3. Figure 6 This is a stereoscopic view of the anterior cervical spine plate used in the ACAF procedure of Example 3.

[0061] The anterior cervical spine plate used in the ACAF procedure is provided with a plate body 1. The plate body 1 is provided with two end screw fixing holes 2 at both its head and tail ends. The two end screw fixing holes 2 are located on the left and right sides, respectively, with an end screw locking member 3 located between them. The plate body 1 is also provided with two rectangular fusion windows 4, one of which is located below the end screw fixing hole 2 at the head end of the plate body 1, and the other is located above the end screw fixing hole 2 at the tail end of the plate body 1. The minimum distance (length) between the upper and lower side walls of each fusion window 4 along the vertical axis is 10 mm, and the minimum distance (width) between the left and right side walls of each fusion window 4 along the horizontal axis is 8 mm. The plate body 1 is also provided with five lifting grooves 5, which are long strip-shaped grooves whose length direction is consistent with the length direction of the plate body 1. The lifting grooves 5 are 3-6 mm wide and 10-20 mm long. Five pulling grooves 5 are arranged along the vertical axis of the steel plate body 1. The leading groove 5 connects to the leading fusion window 4, while the trailing groove 5 connects to the trailing fusion window 4. The pulling grooves 5 and fusion window 4 form an "I" shape, but adjacent pulling grooves 5 are not connected. Each pulling groove 5 has a side screw fixing hole 6 on either side, and each side screw fixing hole 6 is equipped with a side screw locking member 7. The side screw fixing holes 6 and side screw locking members 7 on the left and right sides are symmetrically distributed.

[0062] The anterior cervical spine plate used in this embodiment of the ACAF procedure can be customized to appropriate specifications based on the plate's strength and the patient's anatomy. For example, the plate body 1 is 3.5 mm thick, 147 mm long, and 16 mm wide. The central axis of the end screw fixation hole 2 at the cranial end is tilted 20° toward the cranial end, while the central axis of the end screw fixation hole 2 at the caudal end is tilted 20° toward the caudal end. The central axis of each end screw fixation hole 2 is tilted 6° inward.

[0063] The anterior cervical plate used in the ACAF procedure of this embodiment is suitable for lifting five vertebrae.

[0064] The method of using the anterior cervical plate used in the ACAF surgery of this embodiment is as follows: (1) perform general anesthesia and adopt a supine position; (2) make an incision according to the length of the surgical segment and the condition of the patient's neck to expose the relevant vertebrae; (3) process the intervertebral space: for the treatment of the intervertebral space within the lifting segment, it is only necessary to expose the posterior longitudinal ligament. For the intervertebral space at the beginning and end of the lifting segment, the posterior longitudinal ligament of the intervertebral space is bitten off to expose the dura mater; (4) remove the bone in the front part of the vertebral body; (5) install the plate and intervertebral fusion device: measure the size of each intervertebral space according to the test mold, install the intervertebral fusion device in the intervertebral space between the lifting segments, place the cervical plate used in the ACAF surgery of the present invention with a suitable length and pre-bent on the front edge of the vertebral body, and Vertebral screws are installed on the vertebrae at the head and tail ends outside the segment to the end screw fixing holes 2 at the head and tail ends of the steel plate body 1. Note that the tail of the vertebral screw is screwed until it fits the steel plate body 1; (6) Slots are made on both sides of each vertebra in the lifting segment to free the vertebral ossification complex; (7) The vertebral ossification complex is moved forward: the lifting tool is screwed into the lifting groove 5, the lifting tool outer sleeve is rotated, and the inner core drives the bone block to move upward until each vertebra in the lifting segment fits the steel plate body 1; (8) A fusion device or bone graft is inserted into the intervertebral space near the head and tail of the lifting segment outside the lifting segment through the fusion window 4, and bone is grafted into the slots on both sides of each vertebra in the lifting segment to stop bleeding, close the incision, and apply braking after surgery.

[0065] Example 4

[0066] See Figure 7 and Figure 8 , Figure 7 Schematic diagram of the anterior cervical plate structure used in the ACAF procedure of Example 4. Figure 8 This is a schematic diagram of the usage status of the anterior cervical spine plate used in the ACAF surgery of Example 4.

[0067] The anterior cervical spine plate used in the ACAF procedure is provided with a plate body 1. The plate body 1 is provided with two end screw fixing holes 2 at both its head and tail ends. The two end screw fixing holes 2 are located on the left and right sides, respectively, with an end screw locking member 3 located between them. The plate body 1 is also provided with two rectangular fusion windows 4, one of which is located below the end screw fixing hole 2 at the head end of the plate body 1, and the other is located above the end screw fixing hole 2 at the tail end of the plate body 1. The minimum distance (length) between the upper and lower side walls of each fusion window 4 along the vertical axis is 10 mm, and the minimum distance (width) between the left and right side walls of each fusion window 4 along the horizontal axis is 8 mm. The plate body 1 is also provided with five lifting grooves 5, which are long strip-shaped grooves whose length direction is consistent with the length direction of the plate body 1. The lifting grooves 5 are 3-6 mm wide and 10-20 mm long. The lifting groove 5 at the head end is connected to the fusion window 4 at the head end, and the lifting groove 5 at the tail end is connected to the fusion window 4 at the tail end. The two fusion windows and the five lifting grooves form an "I" shape as a whole, but the lifting grooves 5 are not connected to each other. Each lifting groove 5 is provided with a side screw fixing hole 6 on the left and right sides, and each side screw fixing hole 6 is equipped with a side screw locking member 7. The side screw fixing holes 6 and side screw locking members 7 on the left and right sides are symmetrically distributed. The anterior cervical spine plate used in the ACAF procedure is also provided with an auxiliary plate 8. The auxiliary steel plate 8 is shaped like the main steel plate 1. The auxiliary steel plate 8 is provided with end screw fixing hole perspective windows 82 at positions corresponding to the end screw fixing holes 2 of the main steel plate 1, end screw locking member perspective windows 83 at positions corresponding to the end screw locking members 3 of the main steel plate 1, fusion window perspective windows 84 at positions corresponding to the fusion windows 4 of the main steel plate 1, pulling groove perspective windows 85 at positions corresponding to the pulling grooves 5 of the main steel plate 1, side screw fixing hole perspective windows 86 at positions corresponding to the side screw fixing holes 6 of the main steel plate 1, and side screw locking member perspective windows 87 at positions corresponding to the side screw locking members 7 of the main steel plate 1. Each side screw fixing hole perspective window 86 and its corresponding side screw locking member perspective window 87 are integral. The auxiliary steel plate 8 is also provided with a second locking member 88, which is specifically two threaded locks. When in use, they correspond to the first locking member 9 assembled on the main steel plate 1, which is two threaded holes.

[0068] The anterior cervical spine steel plate used in the ACAF surgery of this embodiment can be customized to appropriate specifications based on the strength of the steel plate and the patient's physiological structure. An example is: the steel plate body 1 is 3.5mm thick, 147mm long, and 16mm wide. The center axis of the end screw fixing hole 2 located at the head end is tilted 20° toward the head end, and the center axis of the end screw fixing hole 2 located at the tail end is tilted 20° toward the tail end. The center axis of each end screw fixing hole 2 is tilted 6° inward. The auxiliary steel plate 8 is 3.5mm thick, 147mm long, and 16mm wide.

[0069] The anterior cervical plate used in the ACAF procedure of this embodiment is suitable for lifting five vertebrae.

[0070] The method of using the anterior cervical plate used in the ACAF surgery of this embodiment is as follows: (1) perform general anesthesia and adopt a supine position; (2) make an incision according to the length of the surgical segment and the condition of the patient's neck to expose the relevant vertebrae; (3) process the intervertebral space: for the treatment of the intervertebral space within the lifting segment, it is only necessary to expose the posterior longitudinal ligament. For the intervertebral space at the head and tail ends of the lifting segment, the posterior longitudinal ligament of the intervertebral space is bitten off to expose the dura mater; (4) remove the bone in the front part of the vertebral body; (5) install the plate and intervertebral fusion device: measure the size of each intervertebral space according to the test mold, install the intervertebral fusion device in the intervertebral space between the lifting segments, place the cervical plate used in the ACAF surgery of the present invention with a suitable length and pre-bent on the front edge of the vertebral body, and install vertebral nails on the head and tail ends of the vertebral bodies outside the lifting segment to the head and tail ends of the plate body 1. The end screw fixing hole 2 is used to fix the end of the vertebral screw, and it is necessary to screw the tail of the vertebral screw until it fits the steel plate body 1; (6) Slots are made on both sides of each vertebra in the lifting segment to free the vertebral ossification complex; (7) The auxiliary steel plate 8 is assembled on the steel plate body 1 through the cooperation of the first locking piece 9 and the second locking piece 88, and the two are fastened; (8) The vertebral ossification complex is moved forward: the lifting tool is screwed into the lifting groove 5, the lifting tool outer sleeve is rotated, and the inner core drives the bone block to move upward until each vertebra in the lifting segment fits the steel plate body 1; (9) The auxiliary steel plate 8 is removed; (10) A fusion device or bone graft is inserted into the intervertebral space near the lifting segment outside the lifting segment through the fusion window 4, and bone is grafted into the slots on both sides of each vertebra in the lifting segment, hemostasis is stopped, the incision is closed, and postoperative braking is performed.

[0071] Regarding the above embodiments 1-4, it should be noted that:

[0072] In this article, the terms "vertical axis," "longitudinal axis," "transverse axis," "coronal plane," "horizontal plane," and "sagittal plane" are defined according to anthropometric reference planes and axes, see Figure 11The terms "head," "tail," "upper," "lower," "left," and "right" that indicate orientation are based on the perspective of the device of the present invention when in use. The terms "first" and "second" are used for descriptive purposes only and should not be understood as indicating or implying relative importance.

[0073] The anterior cervical plate used in the ACAF surgery of the present invention is provided with fusion windows 4 at the head and tail ends of the plate body 1, and the size of the fusion window 4 is large, allowing the intervertebral fusion device (10mm*5-8mm) to be inserted after the plate is fixed. Compared with the anterior cervical plate currently used in clinical practice, it is possible to place and fix the plate first, perform a pulling operation, and after the pulling operation is completed and the plate is fixed, insert the fusion device or bone graft through the fusion windows 4 at both ends. This avoids the problem that in the previous surgical operation sequence, the fusion device is stuck with the residual vertebral body after insertion, affecting the subsequent forward movement operation, resulting in the obstruction of the forward movement of the cervical vertebral body and the pressure-inducing object, and ultimately the intraoperative recovery effect of the cervical physiological curvature is not obvious, and it is easy to find it difficult to restore the physiological curvature during the operation, or the physiological curvature is lost after the operation. The lifting groove 5 is an elongated groove extending along the vertical axis, i.e., the longitudinal axis of the plate body 1, and is located centrally along the longitudinal axis of the plate body 1, allowing passage of a lifting tool. This ensures that each vertebral body is lifted centrally, preventing rotation of the vertebral body during the lifting process. Furthermore, the lifting tool position can be flexibly determined based on the size of the vertebral body and intervertebral disc of each patient, thereby achieving precise and controllable decompression and significantly reducing complications such as nerve root pain. The fusion window 4 is designed only at the cranial and caudal ends, allowing for placement of a fusion device in the intervertebral spaces outside the lifting segment. The intervertebral spaces within the lifting segment are still filled with a fusion device or bone graft first. This is because, in our clinical practice, we have found that because the vertebral bodies of the lifting segment are already free, placing a fusion device or bone graft first in their intervertebral spaces and then lifting them reduces the risk of problems affecting the precise lifting of the vertebral bodies, as each vertebra has a certain degree of freedom. Furthermore, this design ensures the overall strength of the plate. The fusion window 4 and its adjacent lifting groove 5 are connected. This is because the fusion window is the location of the intervertebral disc, and the vertebral endplate is located in the middle. The vertebral position near the endplate has higher strength. The stronger the lifting pin is placed here, the greater the lifting force. The design of the fusion window and the lifting groove connected facilitates the placement of the lifting pin in the optimal position. In the case of two or more lifting grooves 5, the lifting grooves 5 are not connected to each other. In fact, the lifting grooves should be designed as a whole to facilitate the free selection of the optimal location for the lifting pin. For long steel plates, lifting grooves of the same length as the steel plate will affect the strength of the steel plate. Therefore, according to mechanical mechanics, several spacers are placed without affecting the placement of the lifting pins. The spacers are designed to increase the mechanical strength of the steel plate. Moreover, the spacers are located at the intervertebral disc fusion site, and the placement of the spacers here does not affect the free selection of the lifting pin placement. The auxiliary steel plate 8 is beneficial for increasing the strength of the steel plate during surgery, and can significantly and reliably restore the overall physiological curvature of the cervical spine both during and after surgery. The auxiliary steel plate 8 is preferably of the same shape as the steel plate body 1 , and can fully cover the steel plate body 1 , buffering the force exerted on the steel plate body 1 during fixation or vertebral lifting, and protecting various parts of the steel plate body 1 .The side screw fixing holes 6 and side screw locking pieces 7 on the left and right sides of the pulling groove 5 are symmetrically arranged. The symmetry of the screw fixing holes and the consistency of the nail placement allow the holding force strength of the two nails to be superimposed, achieving maximum pulling and fixing strength.

[0074] The shape of the fusion window 4 of the present invention is not limited to a rectangle, but can also be other shapes such as an ellipse, a circle, a square, etc. The width of the pulling groove 5 is preferably 3-6 mm, and the length is preferably 10-20 mm. The auxiliary steel plate 8 and the steel plate body 1 need to be fixed during the operation, but the fixing method is not limited to the snap anti-rotation, screw tightening, and riveting. The steel plate body 1 can be made of any material that meets the clinical vertebral fixation strength and safety requirements, such as stainless steel, silicon steel, carbon steel, titanium alloy, pure titanium, cobalt-nickel alloy, polymer material, etc. On the surface of the steel plate body 1, anti-slip patterns can be designed, such as anti-slip particles, water ripples, etc. The anterior cervical steel plate used in the ACAF surgery of the present invention is not only suitable for ACAF surgery to treat various types of OPLL diseases of the cervical spine, but can also be conventionally used in the surgical treatment of diseases such as cervical degeneration, fractures, and tumors.

[0075] Example 5

[0076] See Figure 9 and Figure 10 , Figure 9 This is a schematic diagram of the structure of the lifter used in the ACAF technique of Example 5. Figure 1 , Figure 10 This is a schematic diagram of the structure of the lifter used in the ACAF technique of Example 5. Figure 2. The puller includes a lifting pin 11 and a screwdriver 12. The lifting pin 11 is provided with a lifting fixed 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 to the lifting fixed body 111, and the other end is connected to the mounting joint 113. The first stroke control body 112 is provided with an external thread. The second stroke control body 114 is sleeved on the outside of the first stroke control body 112 and is provided with an internal thread that matches the external thread of the first stroke control body 112. When the internal thread on the second stroke control body 114 and the external thread on the first stroke control body 112 are screwed in, relative movement occurs 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 molded with an axial rib groove 1141. The screwdriver 12 includes a screwdriver handle 121, a screwdriver extension rod 122, and a screwdriver sleeve 123. The lower end of the screwdriver extension rod 122 and the screwdriver sleeve 123 are hollow. The screwdriver sleeve 123 has a rib groove that matches the rib groove 1141 on the second stroke control body 114. The inner diameter of the screwdriver extension rod 122 is equal to the maximum outer diameter of the second stroke control body 114.

[0077] The method of using the lifting device used in the ACAF surgery of the present invention is as follows: during the ACAF surgery, use a socket screwdriver that matches the installation joint 113 of the lifting pin 11 to implant the lifting fixing body 111 of the lifting pin 11 into the vertebral body to be lifted along the lifting groove of the steel plate, remove the socket screwdriver, confirm the implantation depth through fluoroscopy, and then insert the screwdriver 12 along the top of the lifting pin 11. After insertion, the second stroke control body 114 of the lifting pin 11 corresponds exactly to the position of the screwdriver sleeve head 123, and the ridges of the two match and engage. Rotate the screwdriver handle 121 to link the second stroke control body 114 to rotate, and lift the vertebral body through the reaction force with the steel plate.

[0078] The lifting device used in the ACAF procedure of the present invention comprises two detachable components: a lifting pin 11 and a screwdriver 12. The longer screwdriver 12 drives a second stroke control body 114 to lift the cone. Compared to 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, resulting in a smooth and even lift of the vertebral body. Simultaneously, the force applied to the steel plate is also more uniform, effectively preventing the steel plate from twisting relative to the cranial and caudal vertebral bodies outside the lifting segment. This minimizes surgical damage to the vertebral body.

[0079] Example 6

[0080] The ACAF internal fixation system of the present invention comprises the anterior cervical spine plate used in ACAF surgery as described in any of Examples 1-4 and the lifting device used in ACAF surgery as described in Example 5, wherein the maximum outer diameter of the lifting fixture of the lifting device is smaller than the width of the lifting groove of the anterior cervical spine plate. The combination of these two systems maximizes the precise, controllable, stable, and safe lifting of the vertebral body, significantly improving the surgical effectiveness of ACAF surgery.

[0081] The above is only a preferred embodiment of the present invention. It should be pointed out that ordinary technicians in this technical field can make several improvements and supplements without departing from the method of the present invention. These improvements and supplements should also be regarded as the scope of protection of the present invention.

Claims

1. A cervical spine anterior plate for ACAF surgery, comprising a plate body and screw fixation holes, characterized in that: The steel plate body is provided with fusion windows at both the head and tail ends, with a width of ≥8mm and a height of ≥10mm; the steel plate body is provided with at least one long strip-shaped pulling groove on its central longitudinal axis, with the length direction of the pulling groove being consistent with the length direction of the steel plate body; The anterior cervical vertebrae steel plate used in the ACAF surgery is also provided with an auxiliary steel plate, the shape of the auxiliary steel plate is consistent with the shape of the steel plate body, the auxiliary steel plate is provided with end screw fixing hole perspective windows at positions corresponding to the end screw fixing holes of the steel plate body, end screw locking piece perspective windows are provided at positions corresponding to the end screw locking pieces of the steel plate body, fusion window perspective windows are provided at positions corresponding to each fusion window of the steel plate body, pulling groove perspective windows are provided at positions corresponding to each pulling groove of the steel plate body, side screw fixing hole perspective windows are provided at positions corresponding to each side screw fixing hole of the steel plate body, side screw locking piece perspective windows are provided at positions corresponding to each side screw locking piece of the steel plate body, and each side screw fixing hole perspective window and the corresponding side screw locking piece perspective window are integrated; The auxiliary steel plate is also provided with a second locking member, which is specifically two threaded locks, which correspond to the first locking members assembled on the steel plate body in the use state, and the first locking member is two threaded holes; Fasten the auxiliary steel plate to the steel plate body; screw the pulling tool into the pulling groove, rotate the outer shell of the pulling tool, and the inner core drives the bone block to move upward until each vertebra in the pulling segment fits with the steel plate body; remove the auxiliary steel plate; The auxiliary steel plate and the steel plate body are fixed by threaded fixing, bayonet anti-rotation or riveting; the auxiliary steel plate and the steel plate body have the same shape.

2. The anterior cervical plate used in ACAF surgery according to claim 1, characterized in that: The number of the pulling groove is one, and the fusion window at the head end, the fusion window at the tail end and the pulling groove are connected.

3. The anterior cervical plate used in ACAF surgery according to claim 1, characterized in that: The number of the pulling grooves is two or more, the fusion window at the head end is connected to the pulling groove near the head end, the fusion window at the tail end is connected to the pulling groove near the tail end, and the pulling grooves are not connected to each other.

4. The anterior cervical plate for ACAF surgery according to claim 1, characterized in that: The screw fixing holes include end screw fixing holes and side screw fixing holes. The end screw fixing holes are located at the head end and the tail end of the steel plate body, and the side screw fixing holes are located on the left and right sides of the pulling groove.

5. The anterior cervical plate used in ACAF surgery according to claim 4, characterized in that: The fusion window at the head end is below the end screw fixing hole at the head end, and the fusion window at the tail end is above the end screw fixing hole at the tail end.

6. The anterior cervical plate for ACAF surgery according to claim 1, characterized in that: The material of the steel plate body is stainless steel, silicon steel, carbon steel, titanium alloy, pure titanium, cobalt-nickel alloy or polymer material.

7. An ACAF intraoperative fixation system, characterized in that: Comprising the anterior cervical spine plate used in the ACAF surgery according to any one of claims 1 to 6 and the lifting device used in the ACAF surgery; The lifter includes a lifting pin and a screwdriver; the lifting pin 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 on the outside of the first stroke control body, and is provided with an internal thread matching the external thread of the first stroke control body, and the outer surface of the second stroke control body is shaped with an axial rib groove; the screwdriver is provided with a screwdriver handle, a screwdriver extension rod and a screwdriver sleeve head, and the inside of the screwdriver sleeve head is provided with a rib groove matching the rib groove on the second stroke control body.

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