CN100544686C - 椎间植入物 - Google Patents

椎间植入物 Download PDF

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Publication number
CN100544686C
CN100544686C CNB038262878A CN03826287A CN100544686C CN 100544686 C CN100544686 C CN 100544686C CN B038262878 A CNB038262878 A CN B038262878A CN 03826287 A CN03826287 A CN 03826287A CN 100544686 C CN100544686 C CN 100544686C
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CN
China
Prior art keywords
intervertebral implant
central axis
anchor log
fixture
cavity
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Fee Related
Application number
CNB038262878A
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English (en)
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CN1764425A (zh
Inventor
丹尼尔·鲍姆加特纳
克劳德·马蒂厄
艾德里安·布里
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AO Technology AG
Original Assignee
Synthes AG Chur
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Publication date
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Publication of CN1764425A publication Critical patent/CN1764425A/zh
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Publication of CN100544686C publication Critical patent/CN100544686C/zh
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
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    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F01—MACHINES OR ENGINES IN GENERAL; ENGINE PLANTS IN GENERAL; STEAM ENGINES
    • F01C—ROTARY-PISTON OR OSCILLATING-PISTON MACHINES OR ENGINES
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    • F01C1/063—Rotary-piston machines or engines of arcuate-engagement type, i.e. with circular translatory movement of co-operating members, each member having the same number of teeth or tooth-equivalents with coaxially-mounted members having continuously-changing circumferential spacing between them
    • F01C1/067—Rotary-piston machines or engines of arcuate-engagement type, i.e. with circular translatory movement of co-operating members, each member having the same number of teeth or tooth-equivalents with coaxially-mounted members having continuously-changing circumferential spacing between them having cam-and-follower type drive
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    • H01Q1/27—Adaptation for use in or on movable bodies
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    • H01Q1/3291—Adaptation for use in or on road or rail vehicles characterised by the location of the antenna on the vehicle mounted in or on other locations inside the vehicle or vehicle body
    • H—ELECTRICITY
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Abstract

用于将椎间植入物(15)固定到一椎骨体(19、20)的终板上的锚定装置，其具有A)一锚定件(1)，它包括一中心轴线(6)和两个横向于中心轴线(6)的端面(4、5)；B)包括至少两个凸出于一端面(4、5)的、平行于中心轴线(6)并且可压入一椎骨体(19、20)的一终板中的尖钉(7)；其中，B)锚定件(1)包括一沿中心轴线(6)的方向贯穿锚定件(1)的空腔(3)；以及C)锚定件(1)包括固定装置(9)，借其锚定件能够可拆式锁定在椎间植入物(15)上。

Description

椎间植入物
技术领域
本发明涉及一种椎间植入物。
背景技术
椎间植入物，其例如可以构成为椎间盘内假体并且在去除一受损的天然的椎间盘或一椎间盘的一受损的核以后***两邻接的椎骨体之间的椎间空隙中，必须固定在各邻接的椎骨体的终端面上，以便植入物不能随时间而移动。在植入物固定在各椎骨体的终板上时区别最初的稳定和二次的稳定。最初的稳定直接在手术以后是必要的并且优选通过由在植入物上设置的锚定装置***各邻接的椎骨体的终板中来产生。二次的稳定通过骨在植入物上的生长来达到，但此时要考虑到为达到植入物的充分固定需要约6周的时间。
由SHINN的US 5683465已知一种椎间盘内假体，其在一实施形式中借助通过在植入物外面设置的可通过各盖板的各个销固定在各邻接的椎骨体的终板上。对这种借助这些销的固定不利的是，各销或者在椎间盘内假体***椎间空隙以前必须固定在各盖板上，这在植入物***椎间空隙时需要两椎骨体的加大的分离，或者将各销在植入物***椎间空隙以后必须分别压入各邻接的椎骨体的终板中，这可能提高手术持续时间。
发明内容
在这里本发明将提供帮助。本发明的目的在于，提供用于椎间植入物的锚定装置，其为了将植入物***排空的椎间空隙中可置于一第一位置，在该位置锚定装置的终端不凸出于各盖板，并且按简单的方式在***植入物以后可置于一可锁定的第二位置，在该位置锚定装置压入各邻接的椎骨体的终板中并且用于植入物的最初的稳定。
本发明利用一种椎间植入物达到提出的目的，它具有两个用于将椎间植入物固定到一椎骨体的终板上的锚定装置，其中
A)每一锚定装置包括一锚定件，该锚定件包括一中心轴线和两个横向于中心轴线的端面；以及
B)每一锚定装置包括至少两个凸出于一端面的、平行于中心轴线并且可压入一椎骨体的一终板中的尖钉；
其特征在于，
C)锚定件包括一平行于中心轴线贯穿的空腔；
D)锚定件包括固定装置，借助这些固定装置锚定件能够可拆式锁定在椎间植入物上；
E)椎间植入物在终端分别包括一个与中心轴线相交的端接板；以及
F)端接板可穿过锚定件中的空腔。
本发明的锚定装置用于将椎间植入物固定在各椎骨体的终板上并且基本上包括一锚定件，其具有一中心轴线、一沿中心轴线方向贯穿锚定件的空腔和两个横向于中心轴线的端面、至少两个凸出于端面之一的尖钉，它们可压入一椎骨体的终板中，以及具有固定装置，借其可将锚定件与尖钉一起可拆式锁定在一椎间植入物上。
可看出由本发明达到的优点基本上在于，由于按照本发明的锚定装置达到：
-在椎间植入物植入椎间空隙中时只需要两邻接的椎骨体的最小的分离；以及
-椎间植入物借助本发明的锚定装置可简便地固定在与椎间植入物邻接的各椎骨体上。
固定装置可以例如横向于锚定件的中心轴线嵌接在一椎间植入物上并且可弹性变形、可横向于中心轴线***或拧入锚定件中，或通过空腔壁与椎间植入物之间的锥形连接实现。
在一优选的实施形式中固定装置可横向于锚定件的中心轴线弹性变形并且在未变形的状态下突入锚定件的空腔中。可弹性变形的固定装置的优点是，锚定件可制成一件的并且可避免丢失构件的危险。
优选将固定装置构成为钩，其具有朝中心轴线定向的凸耳。
在另一实施形式中固定装置设置在锚定件的空腔中。借此可达到的优点是，锚定件可制成没有轴向凸出于各轴面的部分并且例如借助一适合的外科器械将尖钉压入一邻接的椎骨体的底板或盖板中不受凸出部分的妨碍。
在又一实施形式中各钩嵌入平行于中心轴线的空腔壁中的凹槽内，使得在钩未横向于中心轴线变形时钩的凸耳突进空腔内并且在钩横向于中心轴线变形时钩包括其朝中心轴线定向的凸耳可容纳于凹槽中，从而一椎间植入物可***空腔中。
在另一实施形式中锚定件构成环形的，其中空腔的垂直于中心轴线的横截面积和/或锚定件的通过外壳体表面限制的并垂直于中心轴线的横截面积可以是圆面积、椭圆面积、卵形面积或多边形面积。
在本发明的椎间植入物的一优选的实施形式中，它包括两个轴向终端的端接板，其外表面用于贴靠到两邻接的椎骨体的盖板或底板上，并且包括两个锚定装置。各端接板可以通过各锚定件中的空腔，从而锚定件相对于端接板可轴向移动。借此可达到的优点是：
-在椎间植入物***椎间空隙以前可以轴向移动锚定件，直到各尖钉不凸出于端接板的终端的端面并从而在椎间植入物***椎间空腔时只须将各邻接的椎骨体最小地相互分开；以及
-在椎间植入物***椎间空隙以后可用简单的器械移动两锚定件，直到备尖钉压入各邻接的椎骨体的底板或盖板中。
在另一实施形式中，各端接板无间隙地支承于各锚定件的空腔中并且可平行于中心轴线相对于端接板移动。借此可达到的优点是，在锚定装置固定于各邻接的椎骨体的底板或盖板中以后椎间植入物没有任何的径向间隙。
在另一实施形式中端接板包括第二固定装置，在锚定件上的固定装置可嵌接到第二固定装置中。该第二固定装置可以例如在于，椎间植入物的备端接板在其外壳表面上具有平行于中心轴线的各切槽，它们用于容纳在钩上设置的凸耳。该具有切槽的构造的优点是，通过嵌入切槽中的凸耳可以防止端接板相对于锚定件扭转。
在又一实施形式中，在各锚定件上的固定装置相对于在椎间植入物上设置的第二固定装置具有间隙，而使在固定装置固定时允许锚定件绕中心轴线相对于端接板作微小的旋转。借此可达到的优点是，通过锚定件与椎间植入物之间的连接允许各邻接的椎骨体的扭转运动，其在某一范围内是允许的。
在又一实施形式中第二固定装置在于，各端接板设有沿轴向位于外面的直径缩小的部分，从而可嵌入钩的凸耳。
本发明的用于将植入物、特别是椎间植入物固定在两邻接的椎骨体的终板上的方法基本上包括下列步骤：
a)借助前外侧的、前侧的、经腹膜的或腹膜后的外科手术可得到一向椎间空隙的通道；
b)分离两个与椎间空隙邻接的椎骨体；
c)排空椎间空隙；
d)***椎间植入物包括相互推在一起的各锚定装置。此时将两锚定件相互推在一起直到各尖钉不再凸出于各端接板的外表面；
e)移动各锚定件使其相互轴向分开直到各尖钉充分地压入各邻接的椎骨体的底板或盖板中；以及
f)将固定装置固定在椎间植入物上。如果各固定装置构成为弹性的，只要各锚定件相互移开直到其轴向的终端位置，就在没有外科手术医生的进一步帮助下立即自动实现其固定。但如果各固定装置构成为螺钉或类似的装置，则其必须用一适合的工具固定。
附图说明
以下借助多个实施例的部分示意图还要更详细地说明本发明及其进一步构成。其中：
图1本发明的锚定装置的一个实施形式的剖面图；
图2图1中所示的本发明锚定装置的实施形式的俯视图；
图3在一椎间植入物上设置的两个按照图1和2中所示实施形式的锚定装置的剖面图；
图4一脊柱的一部分包括一植入的椎间植入物和两个按照图1和2中所示实施形式的锚定装置；以及
图5一椎间植入物包括两个按照图1和2中所示实施形式的锚定装置的纵剖面图。
具体实施方式
图1和2中示出本发明的锚定装置21的一个优选的实施形式，其基本上包括一锚定件1，该锚定件1具有一中心轴线6和一平行于中心轴线6贯穿锚定件1的空腔3、平行于中心轴线6的多个例如四个尖钉7和固定装置9。锚定件1在这里朝垂直于中心轴线6的横截面内观察构成为圆环形的，但也可以构成内和/或外椭圆形的、卵形的、肾形的或多边形的，并且具有第一端面4和一与其平行的第二端面5。两端面4、5垂直于中心轴线6设置。四个尖钉7与锚定件1是一体的并且直立在第一端面4上。各尖钉7可以例如构成为使其如图中所示轴向朝其自由端逐渐缩小或其可以在终端在其自由端构成为尖的或凸出的，从而其在植入时通过锚定件1平行于中心轴线6的移动可压入一邻接的椎骨体的终板中。作为固定装置9，在平行于中心轴线6的空腔壁12上设置在圆周上均匀分布的四个可横向于中心轴线6弹性变形的钩10，其凸耳11设置在锚定件1的第一端面4中并且突入空腔3中。各钩10以凸耳11可拆式嵌接在一***空腔3中的椎间植入物15上(图3)。各钩10在空腔壁12的凹槽8中设置成使得在钩10未变形时只有凸耳11横向于中心轴线6突入空腔3中。各凹槽8具有垂直于中心轴线6测量的深度T，而各凸耳11具有同样垂直于中心轴线6测量的长度L，其中L＜T。
图3示出两个相同的按图1和2中所述实施形式的锚定装置21’、21”，它们分别设置在椎间植入物15的一端上，其中在锚定件1’、1”上设置的各尖钉7在终端凸出于椎间植入物的端面17。椎间植入物15的各端面17如图中所示可以构成为平面的，或也可以构成拱形的。在此示出一锚定装置21’处于其锁定的第二位置而另一锚定装置21”处于第一位置，在该位置上它平行于中心轴线6沿椎间植入物15已移动到使各尖钉7不凸出于椎间植入物15的终端的端面17。在椎间植入物15***空腔3中时各钩10可以弯入凹槽8中，从而椎间植入物15可平行于中心轴线6通过空腔3并在凸耳11旁移动。这种情况示例性表示在锚定件1”上。椎间植入物15的端接板13、14具有轴向终端的直径缩小的部分22，从而钩10的凸耳11可嵌入台阶中，该台阶在端接板13、14上由缩小的部分22构成。借此可使端接板13、14的外端面17贴紧在邻接的椎骨体的底板或盖板上。因为由此锚定件1的端面4并不贴紧在邻接的椎骨体上，确保只有椎间植入物15是轴向负重的并且该负重被传到整个的端面17上。
图4示出一脊柱的一部分包括一***两邻接的椎骨体19、20之间的椎间植入物15。椎间植入物15各由一锚定装置21’、21”固定在邻接的椎骨体19、20的终板上。为了将锚定装置21’21”固定到椎骨体19、20上，将在锚定件1’、1”上设置的尖钉7’、7”压入椎骨体19、20的终板中。在椎间植入物15被植入排空的椎间空隙中时将锚定件1’、1”沿椎间植入物15移动而使各尖钉7不凸出于椎间植入物15的终端的端面17(图3)。在椎间植入物15与两锚定件1’、1”一起***排空的椎间空隙中以后才借助一扩张钳将下面的和上面的锚定件1’、1”向与椎间植入物15邻接的椎骨体19、20的方向移动并且将各尖钉7压入邻接的椎骨体19、20的终板中。在各尖钉7完全被压入终板和锚定件1’、1”已达到其终端位置之后，两个钩10(图2)由其凸耳11例如嵌接椎间植入物的终端的端面17上，或嵌入在椎间植入物15的平行于中心轴线6的外面的外壳表面16上的互补于凸耳11的凹槽18(图5)中。
图5中示出椎间植入物15的一个实施形式，其具有一个分别在轴向终端设置的锚定装置21’、21”。锚定装置21’、21”相当于图1和2中描述的锚定装置并且各包括一个锚定件1’、1”和在锚定件1’、1”的轴向终端的端面4上的尖钉7’、7”。椎间植入物15设有各一个轴向终端的端接板13、14，其中在垂直于中心轴线6的横截面内观察端接板13、14构成为互补于锚定件1’、1”的空腔3。端接板13、14在外面的外壳表面16上设有各切槽18，其类似于如固定装置9那样在锚定件1’、1”上沿圆周分布并且构成为互补于固定装置9上的凸耳11。此外各切槽18具有平行于中心轴线6测量的长度l并且通入配属于椎间植入物15的端接板13、14的轴向终端的端面17。长度l的尺寸确定成使得在锚定件21’、21”向椎间植入物15的端面17轴向移动时各钩10的凸耳可嵌入切槽18中。椎间植入物15的外面的端面17轴向凸出于锚定件1’、1”的终端的端面4，从而确保重量由两邻接的椎骨体经由各端面17传到椎间植入物15上。上面的锚定装置21’在这里以嵌入的固定装置9示出，而下面的锚定装置21”在端接板14上向相反设置的端接板14方向已移动到使尖钉7”不凸出于椎间植入物15的端面17。类似于图3，下面的锚定装置21”的固定装置9横向于中心轴线6变形并且压入锚定件1”的空腔3中的凹槽8内。

Claims (14)

1.一种椎间植入物(15)，具有两个用于将椎间植入物(15)固定到一椎骨体(19、20)的终板上的锚定装置(21)，其中
A)每一锚定装置(21)包括一锚定件(1)，该锚定件包括一中心轴线(6)和两个横向于中心轴线(6)的端面(4、5)；以及
B)每一锚定装置(21)包括至少两个凸出于一端面(4、5)的、平行于中心轴线(6)并且可压入一椎骨体(19、20)的一终板中的尖钉(7)；
其特征在于，
C)锚定件(1)包括一平行于中心轴线(6)贯穿的空腔(3)；
D)锚定件(1)包括固定装置(9)，借助这些固定装置锚定件能够可拆式锁定在椎间植入物(15)上；
E)椎间植入物(15)在终端分别包括一个与中心轴线(6)相交的端接板(13、14)；以及
F)端接板(13、14)可穿过锚定件(1)中的空腔(3)。
2.按照权利要求1所述的椎间植入物(15)，其特征在于，固定装置(9)可横向于中心轴线(6)弹性变形并且在未变形的状态下突入空腔(3)内。
3.按照权利要求2所述的椎间植入物(15)，其特征在于，固定装置(9)为可横向于中心轴线(6)弹性变形的钩(10)，这些钩具有朝中心轴线(6)定向的凸耳(11)。
4.按照权利要求3所述的椎间植入物(15)，其特征在于，所述各钩(10)设置于空腔(3)中。
5.按照权利要求1至4之一项所述的椎间植入物(15)，其特征在于，固定装置(9)和锚定件(1)是一体的。
6.按照权利要求3所述的椎间植入物(15)，其特征在于，空腔(3)包括凹槽(8)，在这些凹槽中设置各个钩(10)。
7.按照权利要求6所述的椎间植入物(15)，其特征在于，各凹槽(8)垂直于中心轴线(6)具有一深度T并且各凸耳(11)具有垂直于中心轴线(6)测量的最大长度L，其中L＜T。
8.按照权利要求1至4之一项所述的椎间植入物(15)，其特征在于，锚定件(1)构成为环形的，并且空腔(3)的垂直于中心轴线(6)的横截面积和/或锚定件(1)的通过外面的外壳表面所限定的、垂直于中心轴线(6)的横截面积是圆面积、椭圆面积、多边形面积或卵形面积。
9.按照权利要求1所述的椎间植入物(15)，其特征在于，所述空腔(3)的形状适配于端接板(13、14)。
10.按照权利要求9所述的椎间植入物(15)，其特征在于，端接板(13、14)无空隙地支承于各锚定件(1)的空腔(3)中并且可平行于中心轴线(6)移动。
11.按照权利要求1所述的椎间植入物(15)，其特征在于，端接板(13、14)包括第二固定装置，锚定件(1)上的固定装置(9)可嵌入所述第二固定装置中。
12.按照权利要求11所述的椎间植入物(15)，其特征在于，在各锚定件上的所述固定装置相对于所述第二固定装置具有间隙，使得在各锚定件上的所述固定装置固定时允许锚定件绕中心轴线相对于端接板作微小的旋转。
13.按照权利要求12所述的椎间植入物(15)，其特征在于，该椎间植入物具有一外面的外壳表面(16)，并且包括横向于中心轴线(6)切入外壳表面(16)中的各切槽(18)作为第二固定装置，用以部分地容纳固定装置(9)。
14.按照权利要求1至4之一项所述的椎间植入物(15)，其特征在于，各端接板(13、14)包括沿轴向处于外面的、直径缩小的部分(22)。
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CA2529564A1 (en) 2004-10-21
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NZ543464A (zh) 2007-04-27
CN1764425A (zh) 2006-04-26
US7628815B2 (en) 2009-12-08
DE50308821D1 (de) 2008-01-24
ATE380532T1 (de) 2007-12-15
AU2003213972B2 (en) 2007-06-28
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EP1622549B1 (de) 2007-12-12
NZ543434A (en) 2007-04-27
JP4291779B2 (ja) 2009-07-08
WO2004089256A1 (de) 2004-10-21
AU2003213972A1 (en) 2004-11-01
ES2297132T3 (es) 2008-05-01
US20070073395A1 (en) 2007-03-29
AU2003213972C1 (en) 2004-11-01
JP2006513795A (ja) 2006-04-27
BR0318243A (pt) 2006-04-04

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