CN101772330A

CN101772330A - A deflection rod system for a dynamic stabilization and motion preservation spinal implantation system and method

Info

Publication number: CN101772330A
Application number: CN200880101782A
Authority: CN
Inventors: 查尔斯·J·温斯洛; 约翰·J·弗林; 詹姆斯·F·楚克尔曼; 肯·Y·赫苏; 唐纳德·L·卡因; 亨里·A·克雷斯; H·亚当·R·克雷斯
Original assignee: Spartek Medical Inc
Current assignee: Spartek Medical Inc
Priority date: 2007-06-05
Filing date: 2008-05-30
Publication date: 2010-07-07
Also published as: EP2162099A4; CN102940521A; EP2162099A1; WO2008151097A1

Abstract

A dynamic stabilization, motion preservation spinal implant system includes an anchor system, a horizontal rod system and a vertical rod system. The systems are modular so that various constructs and configurations can be created and customized to a patient.

Description

The deflecting bar system that is used for dynamic stability and motion preservation spinal implant system and method

Priority request

The application requires all following priority of submitting to, comprising: on June 5th, 2007 submitted to, name is called the U.S. Provisional Application No.60/942 of " DYNAMIC STABILIZATION AND MOTIONPRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD ", 162 (attorney docket No.SPART-01010US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " SHAPED HORIZONTAL RODFOR DYNAMIC STABILIZATION AND MOTION PRESERVATIONSPINALIMPLANTATION SYSTEM AND METHOD ", 260 (attorney docket No.SPART-01006US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " MULTI-DIRECTIONALDEFLECTION PROFILE FOR A DYNAMIC STABILIZATION ANDMOTION PRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD ", 273 (attorney docket No.SPART-01007US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " A HORIZONTAL ROD WITH AMOUNTING PLATFORM FOR A DYNAMIC STABILIZATION ANDMOTION PRESERVATION SPINAL IMPLANT SYSTEM ANDMETHOD ", 305 (attorney docket No.SPART-01008US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " MULTI-DIMENSIONALHORIZONTAL ROD FOR A DYNAMIC STABILIZATION ANDMOTION PRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD ", 330 (attorney docket No.SPART-01009US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " A BONE ANCHOR WITH AYOKE-SHAPED ANCHOR HEAD FOR A DYNAMICSTABILIZATION AND MOTION PRESERVATION SPINALIMPLANTATION SYSTEM AND METHOD ", 338 (attorney docket No.SPART-01010US1);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " A BONE ANCHOR WITH ACURVED MOUNTING ELEMENT FOR A DYNAMICSTABILIZATION AND MOTION PRESERVATION SPINALIMPLANTATION SYSTEM AND METHOD ", 358 (attorney docket No.SPART-01011US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " REINFORCED BONE ANCHORFOR A DYNAMIC STABILIZATION AND MOTION PRESERVATIONSPINAL IMPLANTATION SYSTEM AND METHOD ", 377 (attorney docket No.SPART-01012US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " A BONE ANCHOR WITH ACOMPRESSOR ELEMENT FOR RECEIVING A ROD FOR ADYNAMIC STABILIZATION AND MOTION PRESERVATIONSPINALIMPLANTATION SYSTEM AND METHOD ", 400 (attorney docket No.SPART-01013US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " DYNAMIC STABILIZATION ANDMOTION PRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD WITH A DEFLECTION ROD ", 413 (attorney docket No.SPART-01014US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No 11/832,426 (attorney docket No.SPART-01015US0) of " DYNAMIC STABILIZATION ANDMOTION PRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD WITH A DEFLECTION ROD MOUNTED IN CLOSEPROXIMITY TO A MOUNTING ROD ";

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " DYNAMIC STABILIZATION ANDMOTION PRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD ", 436 (attorney docket No.SPART-01016US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " SUPER-ELASTIC DEFLECTIONROD FOR A DYNAMIC STABILIZATION AND MOTIONPRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD ", 446 (attorney docket No.SPART-01017US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " REVISION SYSTEM ANDMETHOD FOR A DYNAMIC STABILIZATION AND MOTIONPRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD ", 470 (attorney docket No.SPART-01020US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " REVISION SYSTEM FOR ADYNAMIC STABILIZATION AND MOTION PRESERVATIONSPINALIMPLANTATION SYSTEM AND METHOD ", 485 (attorney docket No.SPART-01021US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " DYNAMIC STABILIZATION ANDMOTION PRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD ", 494 (attorney docket No.SPART-01022US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " IMPLANTATION METHOD FORDYNAMIC STABILIZATION AND MOTION PRESERVATIONSPINALIMPLANTATION SYSTEM AND METHOD ", 517 (attorney docket No.SPART-01023US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " MODULAR SPINE TREATMENTKIT FOR DYNAMIC STABILIZATION AND MOTIONPRESERVATION OF THE SPINE ", 527 (attorney docket No.SPART-01024US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " HORIZONTALLY LOADEDDYNAMIC STABILIZATION AND MOTION PRESERVATIONSPINALIMPLANTATION SYSTEM AND METHOD ", 534 (attorney docket No.SPART-01025US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " the vertical bar of DYNAMIC STABILIZATION ANDMOTION PRESERVATION SPINAL IMPLANTATION SYSTEMWITH HORIZONTAL DEFLECTION ROD AND ARTICULATINGVERTICAL RODS ", 548 (attorney docket No.SPART-01029US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " AN ANCHOR SYSTEM FOR ASPINE IMPLANTATION SYSTEM THAT CAN MOVE ABOUTTHREE AXES ", 557 (attorney docket No.SPART-01030US0);

On August 1st, 2007 submitted to, name is called the U.S. Patent application No.11/832 of " ROD CAPTUREMECHANISMFOR DYNAMIC STABILIZATION AND MOTION PRESERVATIONSPINAL IMPLANTATION SYSTEM AND METHOD ", 562 (attorney docket No.SPART-01031US0);

On February 14th, 2008 submitted to, name is called the U.S. Provisional Application No.61/028 of " A DEFLECTION ROD SYSTEMFOR A DYNAMIC STABILIZATION AND MOTION PRESERVATIONSPINALIMPLANTATION SYSTEM AND METHOD ", 792 (attorney docket No.SPART-01035US0); And

On February 26th, 2008 submitted to, name is called the U.S. Provisional Application No.61/031 of " A DEFLECTION ROD SYSTEMFOR A DYNAMIC STABILIZATION AND MOTION PRESERVATIONSPINAL IMPLANTATION SYSTEM AND METHOD ", 598 (attorney docket No.SPART-01037US0).

The full text of all above-mentioned submissions all is combined in herein in the mode of reference.

The relevant cross reference of submitting to

The application relates to all following applications, comprising: on May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A DEFLECTION ROD SYSTEM FOR A SPINE IMPLANTINCLUDING AN INNER ROD AND AN OUTER SHELL ANDMETHOD ", 335 (attorney docket No.SPART-01035US1);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A DEFLECTION ROD SYSTEMWITH A DEFLECTION CONTOURING SHIELD FOR A SPINEIMPLANT AND METHOD ", 359 (attorney docket No.SPART-01035US2);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " DYNAMIC STABILIZATIONAND MOTION PRESERVATION SPINAL IMPLANTATION SYSTEMWITH A SHIELDED DEFLECTION ROD SYSTEM AND METHOD ", 367 (attorney docket No.SPART-01035US3);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A DEFLECTION ROD SYSTEMFOR SPINE IMPLANT WITH END CONNECTORS AND METHOD ", 377 (attorney docket No.SPART-01035US4);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A DEFLECTION ROD SYSTEMFOR A DYNAMIC STABILIZATION AND MOTION PRESERVATIONSPINAL IMPLANTATION SYSTEM AND METHOD ", 383 (attorney docket No.SPART-01035US5);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A DEFLECTION ROD SYSTEMFOR A DYNAMIC STABILIZATION AND MOTION PRESERVATIONSPINAL IMPLANTATION SYSTEM AND METHOD ", 395 (attorney docket No.SPART-01037US1);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A DEFLECTION ROD SYSTEMWITH MOUNT FOR DYNAMIC STABILIZATION AND MOTIONPRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD ", 411 (attorney docket No.SPART-01037US2);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A DEFLECTION ROD SYSTEMWITH A NON-LINEAR DEFLECTION TO LOADCHARACTERISTIC FOR DYNAMIC STABILIZATION ANDMOTION PRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD ", 423 (attorney docket No.SPART-01037US3);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A DEFLECTION ROD SYSTEMDIMENSIONED FOR DEFLECTION TO A LOADCHARACTERISTIC FOR DYNAMIC STABILIZATION ANDMOTION PRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD ", 454 (attorney docket No.SPART-01037US4);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A DEFLECTION ROD SYSTEMFOR USE WITH A VERTEBRAL FUSION IMPLANT FOR DYNAMICSTABILIZATION AND MOTION PRESERVATION SPINALIMPLANTATION SYSTEM AND METHOD ", 457 (attorney docket No.SPART-01037US5);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A DUAL DEFLECTION RODSYSTEM FOR DYNAMIC STABILIZATION AND MOTIONPRESERVATION SPINAL IMPLANTATION SYSTEM ANDMETHOD ", 467 (attorney docket No.SPART-01037US6);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " METHOD FOR IMPLANTINGA DEFLECTION ROD SYSTEM AND CUSTOMIZING THEDEFLECTION ROD SYSTEM FOR A PARTICULAR PATIENT NEEDFOR DYNAMIC STABILIZATION AND MOTION PRESERVATIONSPINAL IMPLANTATION SYSTEM ", 475 (attorney docket No.SPART-01037US7);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A SPINE IMPLANT WITH ADEFLECTION ROD SYSTEM ANCHORED TO A BONE ANCHORAND METHOD ", 032 (attorney docket No.SPART-01039US1);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A SPINE IMPLANT WITH ADEFLECTION ROD SYSTEM INCLUDING A DEFLECTIONLIMITING SHIELD ASSOCIATED WITH A BONE SCREW ANDMETHOD ", 095 (attorney docket No.SPART-01039US2);

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A SPINE IMPLANT WITH ADUAL DEFLECTION ROD SYSTEM INCLUDING A DEFLECTIONLIMITING SHIELD ASSOCIATED WITH A BONE SCREW ANDMETHOD ", 127 (attorney docket No.SPART-01039US4); And

On May 30th, 2008 submitted to, name is called the U.S. Patent application No.12/130 of " A SPINE IMPLANT WITH ADEFLECTION ROD SYSTEM AND CONNECTING LINKAGES ANDMETHOD ", 152 (attorney docket No.SPART-01039US7).

Background technology

In the past decade most active part is that design is in order to merge spinal column to treat the spinal device of degenerative spinal disease on a large scale always in orthopedics and the neurosurgery medical practice.Back pain be the clinical problem given prominence to and by operation and medicine to its annual cost for the treatment of estimation above 2,000,000,000 dollars.Yet, the motion retaining device that can treat back and limbs pain realized alternative fusion or with the bonded Therapeutic Method of fusion to degenerative disc disease.These devices make it possible to eliminate the acceleration degeneration with on the adjacent discs sections of merging spinal column and change the long-term clinical consequences that is associated.

Description of drawings

Fig. 1 is the axonometric chart of a kind of embodiment of dynamic spinal stabilisation systems of the present invention.

Figure 1A is a rearview of implanting the embodiment of the Fig. 1 in the spinal column.

Fig. 2 is the vertical view of the embodiment of Fig. 1.

Fig. 3 is the axonometric chart that is used for the embodiment of the horizon bar of the present invention system that uses with for example dynamic spinal stabilisation systems shown in Fig. 1.

Fig. 4 is the axonometric chart that is used for the substituting embodiment of the horizon bar of the present invention system that uses with for example dynamic spinal stabilisation systems shown in Fig. 1.

Fig. 5 is the axonometric chart that is used for the embodiment of the anchor system of the present invention that uses with for example dynamic spinal stabilisation systems shown in Fig. 1.

Fig. 6 is another axonometric chart of the anchor system of Fig. 5.

Fig. 7 is the exploded view that is used for the substituting embodiment of the anchor system of the present invention that uses with for example dynamic spinal stabilisation systems shown in Fig. 1.

Fig. 8 is the cutaway view of a part of embodiment of the substituting anchor system of Fig. 7 of the present invention.

Fig. 9 is the side view of the anchor system of Fig. 7, shows the motion of one degree of freedom of the anchor system of Fig. 7.

Fig. 9 A is the end-view of the anchor system of Fig. 9.

Figure 10 is the side view of the anchor system of Fig. 7, shows the motion of another degree of freedom of the anchor system of Fig. 7.

Figure 11 is the side view of the anchor system of Fig. 7, shows the motion of another degree of freedom of the anchor system of Fig. 7.

Figure 12 is the axonometric chart of another embodiment of anchor system of the present invention.

Figure 13 is the exploded perspective view of embodiment of the anchor system of the present invention of Figure 12.

Figure 14 is the axonometric chart of another embodiment of anchor system of the present invention.

Figure 15 is the exploded perspective view of embodiment of the anchor system of the present invention of Figure 14.

Figure 16 is another exploded perspective view of embodiment of the anchor system of the present invention of Figure 14.

Figure 17 is the exploded perspective view of the another embodiment of anchor system of the present invention.

Figure 18 is the axonometric chart of an embodiment again of anchor system of the present invention.

Figure 19 is the axonometric chart of another kind of embodiment that has the dynamic spinal stabilisation systems of the present invention of another horizon bar system.

Figure 19 A is as shown in Figure 19 and the axonometric chart of another horizon bar system of the present invention of showing with the form of diplopia of part.

Figure 19 B is the exploded perspective view of the embodiment of Figure 19.

Figure 19 C is the side view of the embodiment of Figure 19.

Figure 20 is the vertical view of another kind of embodiment of the dynamic spinal stabilisation systems of the present invention of Figure 19.

Figure 20 A is the top side of the embodiment shown in Figure 19 A.

Figure 21 is another axonometric chart of embodiment of the dynamic spinal stabilisation systems of the present invention of Figure 19.

Figure 22 is the side view of embodiment of horizon bar of the present invention system of make position that is configured to be in implantation as shown in Figure 19.

Figure 22 A is the end-view of the embodiment shown in Figure 22.

Figure 23 is the side view of part diplopia form of the horizon bar system of Figure 22.

Figure 24 is the embodiment among Figure 22 is in the open position that is adopted when it uses in spinal column a side view.

Figure 25 is the end-view of the embodiment shown in Figure 24.

Figure 26 is the axonometric chart of another embodiment of horizon bar of the present invention system.

Figure 27 is the side view of embodiment of the horizon bar of the present invention system of Figure 26.

Figure 28 is the axonometric chart of another embodiment of horizon bar of the present invention system.

Figure 29 is the side view of embodiment of the horizon bar of the present invention system of Figure 28.

Figure 30 is the vertical view of the another kind of embodiment of horizon bar of the present invention system as shown in fig. 1, and wherein the horizon bar system is in not the use location and prepares to implant.

Figure 31 is the vertical view of embodiment of horizon bar system that is in Figure 30 of use location after implantation.

Figure 32 is the side view of the part diplopia of the embodiment shown in Figure 30.

Figure 33 is the side view of the substituting embodiment of horizon bar of the present invention system.

Figure 33 A is the side view of the another kind of embodiment of horizon bar of the present invention system.

Figure 34 is the side view of another substituting embodiment of horizon bar of the present invention system.

Figure 34 A is the axonometric chart of another embodiment of horizon bar of the present invention system.

Figure 34 B is the side view of the embodiment of Figure 34 A.

Figure 34 C is the vertical view of the embodiment of Figure 34 A.

Figure 35 is the side view of the another substituting embodiment of horizon bar of the present invention system.

Figure 36 is the side view of the another substituting embodiment of horizon bar of the present invention system.

Figure 37 is the side view of the another substituting embodiment of horizon bar of the present invention system.

Figure 38 is the side view of the another substituting embodiment of horizon bar of the present invention system.

Figure 39 is the side view of the another substituting embodiment of horizon bar of the present invention system.

Figure 39 A is the another embodiment of horizon bar system of the present invention and anchor system.

Figure 39 B is another embodiment of horizon bar system of the present invention and anchor system.

Figure 40 is the axonometric chart of the another kind of embodiment of dynamic spinal stabilisation systems of the present invention.

Figure 41 is the axonometric chart of another embodiment of dynamic spinal stabilisation systems of the present invention.

Figure 42 is the side view of a kind of embodiment of The two-stage dynamic spinal stabilization system of the present invention.

Figure 43 is the side view of another embodiment of The two-stage dynamic spinal stabilization system of the present invention.

Figure 43 A is the side view of the substituting embodiment of dynamic spinal stabilisation systems of the present invention.

Figure 44 is the side view of a kind of embodiment of emerging system of the present invention.

Figure 45 is the side view of a kind of embodiment of secondary emerging system of the present invention.

Figure 45 A, 45B are the axonometric chart and the side views of another emerging system with embodiment of the present invention of transstage.

Figure 46 is the flow chart of the embodiment of method of the present invention.

Figure 47 is the another embodiment of horizon bar of the present invention system.

Figure 48 is the axonometric chart of the embodiment of dynamic spinal stabilisation systems of the present invention.

Figure 49 is the rearview of the embodiment of dynamic spinal stabilisation systems of the present invention.

Figure 50 A is the axonometric chart of the embodiment of horizon bar system of the present invention and connecting device.

Figure 50 B is horizon bar of the present invention system, the vertical axonometric chart of a kind of embodiment of lever system and connecting device.

Figure 51 is horizon bar of the present invention system, the vertical axonometric chart of a kind of embodiment of lever system and connecting device.

Figure 52 is horizon bar of the present invention system, the vertical axonometric chart of a kind of embodiment of lever system and connecting device.

Figure 53 is horizon bar of the present invention system, the vertical axonometric chart of a kind of embodiment of lever system and connecting device.

Figure 54 is horizon bar of the present invention system, the vertical cutaway view of a kind of embodiment of lever system and connecting device.

Figure 55 A is horizon bar of the present invention system, the vertical cutaway view of a kind of embodiment of lever system and connecting device.

Figure 55 B is horizon bar of the present invention system, the vertical cutaway view of a kind of embodiment of lever system and connecting device.

Figure 56 A is horizon bar of the present invention system, the vertical front view of a kind of embodiment of lever system and connecting device.

Figure 56 B is horizon bar of the present invention system, the vertical front view of a kind of embodiment of lever system and connecting device.

Figure 57 is the axonometric chart of a kind of embodiment of vertical lever system of the present invention.

Figure 58 is the axonometric chart of embodiment of the lock tabs of connecting device of the present invention.

Figure 59 is the cutaway view of the embodiment of vertical lever system of the present invention and connecting device.

Figure 60 is horizon bar of the present invention system, the vertical axonometric chart of a kind of embodiment of lever system and connecting device.

Figure 61 is the axonometric chart of a kind of embodiment of connecting device of the present invention.

Figure 62 A is a kind of axonometric chart of embodiment of the slide tab of connecting device of the present invention.

Figure 62 B is a kind of axonometric chart of embodiment of the slide tab of connecting device of the present invention.

Figure 63 is horizon bar of the present invention system, the vertical axonometric chart of a kind of embodiment of lever system and connecting device.

Figure 64 is the axonometric chart of a kind of embodiment of vertical bar of the present invention.

Figure 65 is horizon bar of the present invention system, the vertical axonometric chart of a kind of embodiment of lever system and connecting device.

Figure 66 is the axonometric chart of a kind of embodiment of connecting device of the present invention.

Figure 67 is the axonometric chart of a kind of embodiment of vertical bar of the present invention.

Figure 68 is the axonometric chart of a kind of embodiment of deflecting bar of the present invention.

Figure 69 is the three-dimensional exploded view of a kind of embodiment of deflecting bar of the present invention.

Figure 70 is the front view of a kind of embodiment of deflecting bar of the present invention.

Figure 71 is the front view of a kind of embodiment of deflecting bar of the present invention.

Figure 72 A is horizon bar of the present invention system, the vertical axonometric chart of a kind of embodiment of lever system and connecting device.

Figure 72 B is horizon bar of the present invention system, the vertical axonometric chart of a kind of embodiment of lever system and connecting device.

Figure 72 C is horizon bar of the present invention system, the vertical partial sectional view cutaway view of a kind of embodiment of lever system and connecting device.

Figure 73 A is the axonometric chart of a kind of embodiment of horizon bar system of the present invention and connecting device.

Figure 73 B is the front view of a kind of embodiment of horizon bar of the present invention system.

Figure 73 C is the cutaway view of a kind of embodiment of horizon bar of the present invention system.

Figure 74 is the axonometric chart of a kind of embodiment of horizon bar of the present invention.

Figure 75 is the axonometric chart of a kind of embodiment of horizon bar of the present invention.

Figure 76 is the axonometric chart of a kind of embodiment of horizon bar of the present invention.

Figure 77 A is the axonometric chart of a kind of embodiment of cam of the present invention.

Figure 77 B is the vertical view of a kind of embodiment of cam of the present invention.

Figure 78 is the axonometric chart of a kind of embodiment of cam of the present invention.

Figure 79 A is the axonometric chart of a kind of embodiment of horizon bar system of the present invention and connecting device.

Figure 79 B is horizon bar of the present invention system, the vertical axonometric chart of a kind of embodiment of lever system and connecting device.

Figure 80 is the axonometric chart of a kind of embodiment of connecting device of the present invention.

Figure 81 is the axonometric chart of a kind of embodiment of connecting device of the present invention.

Figure 82 is horizon bar of the present invention system, the vertical axonometric chart of a kind of embodiment of lever system and connecting device.

Figure 83 is a kind of axonometric chart of embodiment of the rotation connecting rod of connecting device of the present invention.

Figure 84 is horizon bar of the present invention system, the vertical cutaway view of a kind of embodiment of lever system and connecting device.

Figure 85 is horizon bar of the present invention system, the vertical cutaway view of a kind of embodiment of lever system and connecting device.

Figure 86 A is the axonometric chart of a kind of embodiment of the dynamic spinal stabilisation systems of finally finishing of the present invention.

Figure 86 B is the axonometric chart of the another kind of embodiment of the dynamic spinal stabilisation systems of finally finishing of the present invention.

Figure 87 A is the rearview of a kind of embodiment of twin-stage dynamic spinal stabilisation systems of the present invention.

Figure 87 B is the side view of a kind of embodiment of the dynamic spinal stabilisation systems of finally finishing of the present invention.

Figure 88 A and 88B are the plane graphs of the embodiment of deflecting bar of the present invention.

Figure 89 is the rearview of a kind of embodiment of single-stage dynamic spinal stabilisation systems of the present invention.

Figure 90 is the axonometric chart of a kind of embodiment of single-stage dynamic spinal stabilisation systems of the present invention.

Figure 91 is the side view of a kind of embodiment of single-stage dynamic spinal stabilisation systems of the present invention.

Figure 92 A, 92B and 92C are the rearviews of the embodiment of single-stage dynamic spinal stabilisation systems of the present invention.

Figure 93 is the axonometric chart of a kind of embodiment of connecting device of the present invention.

Figure 94 A and 94B are the axonometric charts of a kind of embodiment of the vertical bar that is attached to deflecting bar of the present invention.

Figure 95 is the part exploded perspective view of a kind of embodiment of dynamic spinal stabilisation systems of the present invention.

Figure 96 is the cutaway view of a kind of embodiment of the deflecting bar system that has a deflecting bar that is positioned at sheath and deflection guider of the present invention.

Figure 96 A is the cutaway view of a kind of embodiment of the deflecting bar system that has a deflecting bar that is positioned at sheath and deflection guider of the present invention.

Figure 97 is the front view of a kind of embodiment of deflecting bar of the present invention.

Figure 98 A is the cutaway view of a kind of embodiment of deflecting bar of the present invention.

Figure 98 B is a kind of deflection of embodiment of deflecting bar of the present invention system and the graph of a relation of deflecting force.

Figure 99 is the axonometric chart of a kind of embodiment of twin-stage dynamic spinal stabilisation systems of the present invention.

Figure 100 A-100C is the cutaway view of a kind of embodiment of twin-stage dynamic spinal stabilisation systems of the present invention.

Figure 101 A and 101B are the vertical views of a kind of embodiment of twin-stage dynamic spinal stabilisation systems of the present invention.

Figure 102 is the unify a kind of cutaway view of embodiment of horizon bar of deflection rod of the present invention.

Figure 103 A and 104 is vertical views of the embodiment of twin-stage dynamic spinal stabilisation systems of the present invention.

Figure 105 is the axonometric chart of a kind of embodiment of dynamic spinal stabilisation systems of the present invention.

Figure 106 is the side view of a kind of embodiment of dynamic spinal stabilisation systems of the present invention, and wherein the head of anchoring screw is transparent.

Figure 107 is a kind of rearview of embodiment that is attached to the dynamic spinal stabilisation systems of the present invention of vertebra.

Figure 108 A, 108B are the axonometric charts of another embodiment of dynamic spinal stabilisation systems of the present invention.

Figure 109 A is the axonometric chart of a kind of embodiment of deflecting bar of the present invention system, wherein the horizon bar bearing and vertically bar be connected to the deflecting bar system.

Figure 109 B is the cutaway view by the longitudinal axis of the deflecting bar system of Figure 109 A of the present invention.

Figure 110 is Figure 108 A of the present invention, the axonometric chart of a kind of embodiment of the connecting device of the dynamic spinal stabilisation systems of 108B.

Figure 111 A, 111B are respectively Figure 108 A of the present invention, the vertical view and the cutaway view of a kind of embodiment of the deflecting bar system of the dynamic spinal stabilisation systems of 108B.

The specific embodiment

Embodiments of the present invention comprise system or implanting device and the method that stabilizing spine dynamically simultaneously can the preservation spinal motor function.Substituting embodiment can be used for spinal fusion.

Embodiments of the present invention comprise a kind of like this structure: it has anchor system; The horizon bar system that is associated with anchor system; And the vertical lever system that is associated with anchor system and horizon bar system.

The advantage and the aspect of described system are that described anchor system comprises head or dimple, and it makes it possible to place anchor system suitably, effectively and easily so that reduce to place the power of anchor system with respect to spinal column.Described anchor system has the degree of freedom of increase, and this helps easily to implant anchor system.Therefore, thus the remainder that described anchor system is designed to make the remainder of head and screw and dynamic stabilization system to isolate dynamic stabilization system may act on the power on the interface between anchor system and anchor system/skeleton.Therefore, described anchor system can provide safe and reliable firmly grasping in spinal column.

Another advantage of the present invention and aspect are, described horizon bar components of system as directed is made of elastic material, described elastic material makes it possible to respect to anchor system position level lever system and make it possible to horizon bar system and anchor system are isolated easily, thereby makes less power from the horizon bar systemic effect in anchor system with act on interface between anchor system/skeleton.Therefore, be different from conventional device, anchor system can be treated in the skeleton of spinal column safely and reliably.

One aspect of the present invention and advantage are the range of movement maximizations that can make spinal column in the implanted patient of embodiment of dynamic stability motion reservation implant of the present invention afterwards.Although the traditional solution of backache comprises the artificial implant of fusion, excision and replacement spine structure, move on a large scale but embodiments of the present invention have kept the skeleton of spinal column and ligament structure and kept spinal column, make simultaneously before this owing to degenerating and other spinal disease causes unsettled spinal stabilization.

The natural motion that another aspect of the present invention is a preservation spinal also keeps the quality of motion and big range of movement, makes spinal motion as far as possible near the motion of natural spinal column.But current embodiment of the present invention allows to select the implant of not too hard dynamic stability to be used for non-fusion situation.But the implant of not too hard dynamic stability is directly related with the favourable patient result who comprises patient's comfortableness and spinal motion quality.

In another aspect of the present invention, the deflecting bar of this embodiment, especially this embodiment or load beam provide load balancing.For embodiments of the present invention, term " deflecting bar " and " load beam " can exchange use.Therefore this aspect of the present invention relates at the proper motion that recovers spinal column.This embodiment provides flintiness and supports and is applied to epispinal load with during being supported on normal spinal motion in the place of needs, and softish spinal tissues can not be accepted such load again, and reason is these spinal tissues degenerations or destroyed.Owing to can select to have the deflecting bar of suitable flintiness or load beam so that therefore the load balancing of coupling expectation has strengthened load balancing.Deflecting bar by selecting to have suitable flintiness or load beam are with coupling patient's physiology and the load that the patient places spinal column, and the patient realizes better result.Before implanting this embodiment, can be in the middle of a lot of load beams the flintiness of the implant of system be selected.In other words, depend on selected deflecting bar or load beam, flintiness is variable.In one aspect of the method, load balancing is between spinal column and embodiments of the present invention.

In another aspect of the present invention, deflecting bar or load beam are cantilevered.Deflecting bar or load beam are from the horizon bar cantilever in one aspect of the method.Deflecting bar or load beam are from being connected the horizon bar cantilever between two anchors that are fixed to same vertebrae in a further aspect.In a further aspect, be roughly parallel to horizon bar at lay-down position deflecting bar or load beam.In aspect another, deflecting bar or load beam from the horizon bar the bearing cantilever and be roughly parallel to horizon bar at described deflecting bar of lay-down position or load beam.

In another aspect of the present invention, the horizon bar that directly is attached to relative anchor is hard with inflexible, and cantilever deflection bar or cantilevered load bar are shared the load that acts on spinal column that is produced by the patient's body motion.

In aspect another of embodiments of the present invention, absorb or the load of bearing distributes along at least a portion of the length of deflecting bar or load beam by its embodiment.In another aspect of the present invention, the load that is absorbed by its embodiment or bear distributes along at least a portion of the length of horizontal boom deflecting bar or horizontal boom load beam.

Because load flatly rather than is vertically carried along deflecting bar or load beam, so embodiments of the present invention can be made littler so that fit in the more space with respect to spinal column.Advantageously, these embodiments can fit in the L5-S1 space of spinal column.

One aspect of the present invention be by the level of the embodiment of the present invention of using suitable selection and vertically bar keep rather than limit motion between the pedicle of vertebral arch of spinal column.

The load that one aspect of the present invention provides on the horizontal cell of for example horizon bar is born, rather than perpendicular elements or bar, especially is connected on the perpendicular elements between the skeleton anchor system.

One aspect of the present invention is that the usage level bar and makes it possible to needs customization implant system according to the patient so that thereby each grade implant system and other grade are isolated from each other and can apply unsuitable power and/or moment of torsion to the anchor system of embodiment of the present invention and the skeleton that is associated in embodiments of the present invention.Therefore, one aspect of the present invention is to make the load minimizes on the interface between skeleton/implant system.In a preferred embodiment, customization can realize by the horizon bar of selecting to have expectation flintiness and flintiness characteristic.Different materials makes it possible to select various flintiness characteristics with different implant structures.

Another aspect of the present invention is can control flintiness so that stretching, extension, flexing, lateral thrust and axially rotation, and can flintiness make each motion in these motions all be independent of other motion.

One aspect of the present invention is to utilize the flintiness of elastic material and load to bear characteristic.

Another aspect of the present invention is to use elastic material to customize implant according to patient's motion reservation and dynamic stability needs.An aspect of such embodiment of the present invention provides a kind of platform of power, on this platform the motion of implant system continuously and not can to the skeleton anchor system or in other words the interface between skeleton/implant system apply additional force.

Therefore, one aspect of the present invention is to utilize horizon bar to be offset the load that acts on usually on anchor system and the implant system.

Therefore, one aspect of the present invention is can optionally change flintiness by the structure that changes implant system of the present invention and optionally change to experience the orientation and the direction of flintiness, and changes the flintiness of horizon bar of the present invention system particularly.

Another aspect of embodiments of the present invention is to place degree of freedom by the implant that makes implant system can have increase to prevent from anyly to implant from axle.Embodiments of the present invention provide placing from axle of bone anchors fixing apparatus or pedicle screw system.

Embodiments of the present invention be on the other hand control from small movements to big stretching, extension, flexing, the axially spinal stabilization motion of rotation and lateral thrust motion.

Another aspect of embodiments of the present invention is to merge implant if desired then can revise the dynamic stability implant.This process for example can replace these bars to realize by the horizon bar in the removal implant system and with harder bar.Therefore, one aspect of the present invention is that a kind of approach that makes things convenient for that is used to revise original implant system is provided when needed.

Because implant anchor system easily and easily vertical bar is fixed to horizon bar of the present invention, another aspect of the present invention is the bone structure that can adapt to spinal column, even relative to each other misalignment of adjacent vertebrae.

Another aspect of the present invention is for example spinous process structure of characteristic that implant centers on spinal column, therefore need not to remove the proper motion that such characteristic and implant can not hinder the spinal column characteristic, and the characteristic of spinal column also can not hinder the operation of implant.

Another aspect of embodiments of the present invention be can be by selecting to be used for to implant the patient the of the present invention suitable embodiment and the parts of embodiment come two, three of stabilizing spine and/or multi-segmental more.The further embodiment of the present invention allows by identical implant system the contiguous dynamic stability sections of fusion sections (combining with skeletal graph if necessary) to be placed.This embodiment of the present invention makes it possible to protect the contiguous vertebral levels that merges sections by avoiding merging sections from rigidity to dynamic stability motion reservation and the more unexpected variation of sections.

Therefore, another aspect of embodiments of the present invention provides a kind of modular system that can customize according to patient's needs.Can optionally select horizon bar at the concrete sections of concrete patient and spinal vertebrae to be treated.Further, can select flintiness and stability are controlled in the location of different selected level bars.

Another aspect of embodiments of the present invention is that these embodiments can be constructed to provide higher flintiness and fusion at a sections, allows lower flintiness and allows dynamic stability at another adjacent segment simultaneously.

Another aspect of the present invention provides dynamic stability and motion keeps, and the skeleton and the tissue of preservation spinal simultaneously are so that reduce patient's wound and combine with embodiments of the present invention and utilize patient's prior function skeleton and tissue as far as possible best.

Another target of the present invention is to implant embodiments of the present invention so that unload from the power of spinal column facet with other posterior spinal structure and intervertebral disc.

Another aspect of the present invention is to adopt the process of not removing or changing skeleton or tear or cut off tissue to implant embodiments of the present invention.In one aspect of the invention, can during implantation process of the present invention, muscle and other tissue be pushed open.

Therefore, one aspect of the present invention provides a kind of Wicresoft's implantation process of novelty.

The dynamic stability, the motion retention system that are used for spinal column:

The embodiment of dynamic stability motion retention system 100 of the present invention is shown in Figure 1, and comprises anchor system 102, horizon bar system 104 and vertical lever system 106.For these embodiments, level is meant the horizontal alignment with respect to the patient who stands, and vertically is meant vertical orientated (Figure 1A) with respect to the patient who stands.As will be disclosed more fully below herein, a kind of embodiment of anchor system 102 comprises the bone screw 108 that is installed to head or dimple 110.Alternately, bone screw 108 can be substituted by a kind of hamulus of hamate bone of as more abundant description in following document: on June 14th, 2006 submitted to, name is called the U.S. Provisional Patent Application No.60/801 of " AN IMPLANTPOSITION BETWEEN THE LAMINA TO TREAT DEGENERATIVEDISORDERS OF THE SPINE ", 871, and in this mode with reference it is combined in herein in full.Head or dimple 110 are installed to bone screw 108 and allow a plurality of degree of freedom, so that bone screw 108 can suitably, easily and easily be placed in the skeleton of spinal column and help the bone screw 108 and the remainder of system 100 are isolated, make that the power that is applied on the anchor system 102 and is applied on bone screw/bone interface is less.Use some one type of prior art syringe of such bone screw that bone screw is got loose from spinal column, and present embodiment has been designed to reduce the power on the bone screw and on bone screw/bone interface.Preferably, anchor system 102 is made of titanium.Yet, can use other biocompatible material of rustless steel for example and/or PEEK (polyether-ether-ketone).

In the embodiment of Fig. 1, horizon bar system 104 is preferably by the lock screw 112 fastening heads 110 that pass anchor system 102.This embodiment comprises first horizon bar 114 and second horizon bar 116.First horizon bar 114 has fixed with it first and second deflecting bars or load beam 118 and 120.In a preferred embodiment, first horizon bar can be made of titanium, rustless steel or PEEK or other biocompatible material, and first and second deflecting bars or load beam can be made of elastic material.Preferably, elastic material constitutes based on Nitinol (NiTi).Except Nitinol or Nitinol (NiTi), other elastic material comprises cu-zn-al alloy and Batterium.Yet for biocompatibility, Nitinol is a preferable material.

Such layout can be isolated the power and the anchor system 102 that are applied thereto horizon bar system 104, and therefore can isolate may be applied on the bone screw 108 and the bone screw/bone interface of spinal column on power, thereby prevent the loosening of bone screw 108 in the spinal column.As shown in Figure 1, in this preferred implementation, deflecting bar or

load beam

118 and 120 central authorities at first horizon bar 114 are installed to bearing 122.Preferably, deflecting bar or

load beam

118 and 120 are press fit in the bearing 122.Alternately, deflecting bar or load beam can be threaded, bonding or be laser-welded to bearing 122 and be arranged on endoporus in the bearing 122.Other tightening technology is in scope and spirit of the present invention.At Fig. 1, can see that first horizon bar 114 comprises that the both sides that are positioned at bearing 122 and the length to small part along first horizon bar 114 are towards first and second spines 124,126 that the respective end of horizon bar 114 is extended in 3 and 4.These spines 124,126 have increased the rigidity of bearing 122 with respect to the remainder of horizon bar system 104.

As seen in Figure 1, deflecting bar or load beam 118,120 have the constant diameter that outwards extends towards each end 128,130 of deflecting bar or load beam 118,120.Alternately, deflecting bar or load beam 118,120 can have along with bar 118,120 moves closer to each end 128,130 and the diameter of variation.Preferably, as following description with discuss, bar 118 and 120 can have along with bar move closer to each 128,130 and the diameter that reduces.The diameter that reduces makes along with super-elasticity bar 118,120 move closer to end 128,130 these bars can have stronger flexible and flexible along the length of bar, and make super-elasticity bar 118,120 to distribute more equably to be applied to load in the system 100 by spinal column.Preferably, the diameter of deflecting bar or load beam reduces on diameter continuously.Yet, being appreciated that its diameter can reduce along the mode of length with discontinuous step, the diameter of a step and the diameter of next adjacent step are discontinuous.Alternately, bear standard for different power and load, the diameter of deflecting bar or load beam can 128,130 extend and increases increasing continuously on the diameter or can have discontinuous step on diameter along the length of deflecting bar or load beam towards two ends along with bar.Further, according to deflecting bar or load beam 118, the needs of characteristic are born in 120 power and load, these bars can move closer to two ends 128,130 and have the step that step that at least one diameter reduces and at least one diameter increase along the length of deflecting bar or load beam with any order along with them.

Referring to Fig. 3, for example, horizon bar system 104, especially deflecting bar 118,120 is shared the load that spinal column bears.This load balancing is intended to recover the proper motion function of spinal column.This embodiment, especially deflecting bar or load beam 118 when needs, 120 provide flintiness and support the load that puts on spinal column during the spinal motion to be supported on, the soft tissue of spinal column can not bear these loads again, and reason is these spinal tissues or degeneration or damage.Deflecting bar by can selecting to have suitable flintiness or load beam 118,120 are so that match with the load balancing of expectation and strengthened such load balancing.By selecting deflecting bar or load beam with suitable flintiness, thereby match with load that patient's physiological function and patient puts on spinal column, the patient has obtained better result.Before implanting, deflecting bar or the load beam that can from a plurality of deflecting bars or load beam, select to have required flintiness.Depend on selected deflecting bar or load beam, flintiness is variable.When what point out in this article, the flintiness of deflecting bar or load beam can change by the shape of bar and the selection of material.Only list several variations, the shape variable can comprise the direction and the step tapering of diameter, tapering, tapering, and material variables can comprise the formation of material.

Should be appreciated that load that deflecting bar or load beam bear distributes along at least a portion of the length of deflecting bar or load beam.Preferably, load is along the whole distribution of lengths of deflecting bar or load beam.Further, can change along horizontal member owing to flatly bear load and flintiness, rather than vertical, so embodiments of the present invention can be made littler so that fit in the more space with respect to spinal column.Advantageously, except the spatial space of L4-L5 of common less limited for example spinal column, these embodiments can fit in the L5-S1 space of spinal column for example.

Referring to the embodiment of example horizon bar of the present invention system as shown in FIG. 3, deflecting bar or load beam 118,120 stretch out from bearing 122 in the mode of cantilever.Therefore, these deflecting bars 118,120 have free end and by the bearing 112 fixed ends that are positioned on the horizon bar 114.Apparent in Fig. 3, cantilevered deflecting bar 118,120 is roughly parallel to horizon bar 114 at lay-down position, and in this embodiment, horizon bar is directly connected to anchor system, and is connected to the head or the dimple of anchor system particularly.Preferably, particularly compare with deflecting bar, horizon bar 114 is hard and inflexible.In this arrangement, horizon bar system, especially deflecting bar 118,120 are shared the load that is produced by the patient's body motion.

Property embodiment as an alternative, second horizon bar 116 can replace (Figure 43 A) by the horizon bar 114 with deflecting bar or load beam.Therefore, two horizon bars all have deflecting bar or load beam.Be installed in one on the horizon bar deflecting bar or load beam will be connected to vertical bar and vertically bar will be connected to deflecting bar or the load beam that is installed on another horizon bar.Such embodiment has bigger flexible.Further, deflecting bar or load beam 118,120 can have other configuration and these configurations also within the spirit and scope of the present invention.

Further, in Fig. 1, can see, vertical in this embodiment lever system is by the first and second vertical bars 132,134 constitute, the first and second vertical bars are fastened to and are positioned at first and second deflecting bars or load beam 118, first and second connecting devices 136,138 at 120 128,130 places, end.As will be described below, vertically bar 132,134 preferably connect into pivotable so that implant the patient and increase the flexible and dynamic stability of system on the whole.These vertical bars 132,134 are preferably by the titanium manufacturing.Yet, can use other biocompatible material.Vertically bar 132,134 also is connected to second horizon bar 116 by being received in the C shape bearing 140,142 that is positioned on second horizon bar, and C shape bearing 140,142 is held in place by dog screw 144,146 in this embodiment.Those of ordinary skill in the art is to be understood that other structure also can be used for vertical bar is connected to horizon bar.

Preferably, vertically bar only is connected to horizon bar and is free of attachment to anchor system 102, so that with anchor system 102, head 110 is isolated with may being applied to stress on the head and power and being connected to the power that is delivered to head under the situation of head at vertical bar particularly.Therefore, system 100 realizes that by vertical bar and horizon bar dynamic stability can not cause unsuitable power to put on the head of anchor system with moving on a large scale.These embodiments also allow each sections of spinal column as far as possible freely to move and can suitably carry the baby in other sections.

Vertically bar has bigger flintiness and easier method for implantation by the following method is provided towards the head side of anchor system morely when placement makes lateral thrust: for example people such as Leon L.Wiltse at " The Paraspinal Sacraspinalis-SplittingApproach to the Lumber Spine " (The Journal 0f Bone ﹠amp; Joint Surgery, Vol 50-A, No.5, July nineteen sixty-eight) described in the Wiltse method, above-mentioned document is incorporated in this as a reference.

The flintiness of system 100 preferably can be regulated by the selection of material and the placement and the diameter of horizon bar, vertical bar and deflecting bar or load beam.The bar that diameter is bigger will increase flexing, stretching, extension, rotation and the crooked tolerance of 100 pairs of spinal columns of system, and the less bar of diameter will reduce flexing, stretching, extension, rotation and the crooked tolerance of 100 pairs of spinal columns of system.Further, for example the diameter of bar such as deflecting bar or load beam can change the flintiness characteristic along the continuous or discrete variation of the length of bar.Therefore, from bearing 122 towards the end under 128, the 130 gradually narrow situations, system can have bigger flexible in the flexing of spinal column with in stretching at deflecting bar or load beam 118,120.Further, except horizontal deflection bar or load beam, also elastic material being used for horizon bar has increased the flexible of system 100 with vertical bar.Further, harder if desired system 100, except deflecting bar or load beam, all horizon bars and vertical bar also can be by titanium or rustless steel or PEEK manufacturings.Therefore, be appreciated that depend on that material uses, the placement of the element of the diameter of material and system 100, system 100 can easily have the firm flintiness of patient's expectation.

Transform implant system 100 if desired, can by remove and replace horizon bar and/or vertically bar realize, to obtain the flintiness of expectation.As just example, if expect harder modernization system, more be similar to and merge or in fact merge, thereby then can remove horizon bar and replace the flintiness that the horizon bar with the deflecting bar made by titanium or rustless steel or load beam or non-super-elasticity bar increases system with deflecting bar or load beam.This can be in the appropriate location by making anchor system 102,110 removes existing horizon bar and harder horizon bar and the vertical bar that is associated is replaced horizon bar and realized from the head.

Fig. 3 shows the view of aforesaid horizon bar 104.In this embodiment, connecting device 136,138 is shown as on the end that is positioned at deflecting bar or load beam 118,120.Connecting device can be press fit into deflecting bar or fastening with other method that is used for this material known in the art, as described further below.Connecting device 136,138 has otch 148,150 and with help connecting device is placed on the end of deflecting bar.Apparent from Fig. 3, connecting device 136,138 includes the last underarm 160,162 that vertical bar 132,134 can be fixed betwixt.Each arm includes aperture 168,170, and it can receive pin or the screw 176,178 (Fig. 1) that is used for fixing or the fastening vertical bar 132,134 of pivotable mode.In this embodiment, vertically bar comprise can interference fit or be threaded onto head 162,164 on the remainder of vertical bar.These heads comprise the aperture 172,174 that is used for receiving pin or screw 176,178.

For system 100 has alap profile and extends advantageously as close as possible first horizon bar, 114 placement deflecting bar or load beams 118,120 from spinal column as few as possible.In order to realize this low profile, groove 152,154 preferably is set in horizon bar 114 with ccontaining connecting device 136,138.

Therefore, the purpose of groove have make horizon bar have low profile for example make when its with respect to the skeleton of spinal column with organize existence when implanted to be used for the gap of the motion of implant and implant, its purpose keeps deflecting bar or the as close as possible horizon bar of load beam in addition so that reduce any potential arm of force with respect to the bearing on the horizon bar.

Fig. 4 shows the another kind of embodiment of the horizon bar 114 that has deflecting bar or load beam 118,120 and different connecting devices 156,158.Connecting device 156,158 includes in opposite direction two couple who extends and goes up underarm 160,162 so that each connecting device 156,158 is installed down vertical bar, as about shown in Figure 46.This structure allows three-level system, and this will be described below.

The embodiment of anchor system of the present invention

Can in Fig. 5, see a kind of preferred implementation of anchor system 102 of the present invention.It is similar to the anchor system 102 shown in Fig. 1.Particularly, this anchor system 102 comprises the bone screw 108 that has head 110, and described head adopts the form of the U-shaped yoke 180 that has arm 182,184.As will further discussing, the hook that preferably has bone engagement barb or teat can replace bone screw 108.The hook embodiment quote in the above and the provisional application that comprises in further be described.Hook is used for hook and links for example skeleton of vertebra, rather than screw is anchored in the skeleton.Each arm 182,814 of yoke 180 includes aperture 186,188, and pin 190 can pass aperture 186,188 and place.Pin 190 laser weld or interference fit or be glued in the yoke 180 as required.Pin 190 as described below can be level and smooth or coarse.Further, pin 190 can be for cylindrical or comprise a plurality of sides as shown in Figure 7.In Fig. 7, pin 190 has one or more sides that match that also can comprise in six sides and the ccontaining aperture 186,188 so that the position of steady pin 190 in yoke 180.Compressing ball 200 is arranged on the pin 190.If desired, compress ball 200 and can have rough surface, thus as described below helping with the ball locks in place.Compress ball 200 and can comprise that thereby one or more otch 202 help ball 200 is compressed around pin 190.Compressing ball 200 can have cylindrical or have a plurality of lateral endoporus so that conform to pin 190 and be received on the pin 190.In Fig. 8, can see, help the range of movement and the degree of freedom that provide favourable embodiments of the present invention thereby one or more spacer ring 204 can be used at interval pressure ring and yoke 180.

Head or dimple 110 are installed around compressing ball 200.Fig. 7, the head 110 in 8 is slightly different with the head 110 among Fig. 1, and this will be described below.Fig. 7, the head 110 in 8 comprises the cylindrical body 206 that has the bottom, its bottom has can receive the aperture 208 that compresses ball 200.As Fig. 7, shown in 8, aperture 208 can have concave surface.Therefore, compress inside and as described below the moving freely therein that ball 200 is assemblied in the concave surface in aperture 208 up to being limited.Apparent from figure, the bottom around aperture 208 of cylindrical body 206 has been removed some and has been constituted the material of wall 224 so that the motion of the yoke 180 of ccontaining bone screw 108.Basically, the part of the arm 182,184 of the contiguous yoke 180 of wall 224 is removed the range of movement with ccontaining yoke 180 and yoke.

The head 110 of anchor system 102 comprises the interior cylindrical hole 210 of the longitudinal axis that preferably is basically parallel to head 110.This hole 210 open to the aperture 208 and open to and preferably be basically perpendicular to the far-end 212 of head 110.At far-end 212 places of head 110, hole 210 is threaded and can receives dog screw 112.Side along head 110 is limited with the aligning U-lag mouth that extends to hole 210 from outer surface by head 110.These U-lag mouths are also opened to the far-end 212 of head 110 and are received dog screw 112 so that pass through the screw thread in hole 210.Clamping element or carriage 220 are positioned in the hole 210 and at dog screw 112 and compress between the ball 200.Clamping element or carriage 220 can slide in hole 210 slightly, but clamping element or carriage 220 are limited by the pin 222 (Fig. 7) that the wall 224 that passes head 110 receives in clamping element or the carriage 220.Therefore, clamping element or carriage 220 can slide in hole 210 before the locks in place slightly.

Clamping element or carriage 220 have the general cylindrical body makes clamping element 220 can be assemblied in the hole 210.The upper end 226 of clamping element 220 comprises concave surface 228.This surface 228 is shaped as adaptive horizon bar system 104, and adaptive particularly horizon bar 114,116.The bottom of clamping element 220 comprises the concave surface 230 that can ccontainingly compress ball 200.The bottom of the contiguous concave surface 230 of clamping element 220 has additional concave surface 232 (Fig. 8), and it is used for the motion of the upper end of ccontaining yoke 180 when head 110 moves with respect to bone screw 108.If desired, can make

concave surface

228 and 230 coarse, thereby help with respect to bone screw 108 locking heads 110.(Fig. 5,6) in the present embodiment do not have top clamping element or carriage (for example referring to Fig. 7,13) so that reduce the profile of the head of anchor system.

Apparent from figure, assemble and horizon bar 114 at anchor system 102, under 116 situations about being received in the U-lag mouth 216, dog screw can press horizon bar 114,116, and horizon bar 114,116 can press clamping element or carriage 220, and clamping element or carriage 220 can press and compress ball 220, compress ball and can press pin 190 again, thereby with respect to head 110 locking horizon bars 114,116 with respect to bone screw 108 locking heads 110.Be to be understood that if desired, can make all contact surfaces coarse to facilitate this locking.Alternately, these surfaces can be level and smooth, and these elements are pressed against together and therefore locking by means of the power of dog screw 112.

At Fig. 5, can see in 6, show substituting horizon bar 114,116.This substituting horizon bar 114,116 comprises first and second recessed mouthfuls 234,236, and they for example can receive the vertically vertical bar of bar 132,134 (Fig. 1).Horizon bar 114,116 be cylindrical substantially, is thickeied around the zone of recessed mouth 234,236 as required or strengthens with holding capacity.In addition, being provided with screwed hole and these holes for contiguous recessed mouthful 234,236 can receive and have the screw that can be used for the head that vertical rod lock is in place.Alternately, these screws can keep protruding in the quarter butt of recessed mouthful 234,236 tops so that with vertical bar fix in position (Figure 34).If desired, the short bar that keeps also has recessed mouthful, and the female mouth conforms to the shape of vertical bar and receives at least a portion of vertical bar, during with convenient 100 implanted patients of system vertical bar is held in place.

Refer again to Fig. 1,2,5 and 6, shown head 110 is a kind of preferred implementations and slightly different with head shown in Figure 8.Particularly, head body 206, the outer surface 218 of head and the wall 224 of head are configured to prevent opening of head 110 when dog screw 112 locks anchor systems 102 as mentioned above.As Fig. 1, seen in 2, head 110, wall 224 is reinforced around the U-lag mouth 216 that receives horizon bar system 104 particularly.By strengthening or the zone around U-lag mouth 216 of thickened wall, avoided putting on dog screw 214 so that head 110 is opened when locking anchor system 102 when power.Head 110 can adopt the multiple shape that can strengthen to open so that prevent.Fig. 1, the illustrative embodiments in 2 comprises as the pitched roof shape seen at the vertical view of the far-end 212 of looking down head 110.Particularly, if desired, around the wall thickening of U-lag mouth 216, and the part away from the U-lag mouth of head can be not too thick, so that reduce the volume and the size of head 110, and head 110 is had than low profile when implanting the patient with respect to skeleton and organizational structure.Further, as described below, low profile makes system 100 can have bigger freedom of motion.And, being to be understood that design owing to aforesaid anchor system 102, shorter and therefore head 110 can not stand on outside the skeleton when time in bone screw 108 implanted for example patients' the spinal column too significantly.

The freedom of motion of the embodiment of anchor system of the present invention

In order to regulate the embodiment of horizon bar of the present invention system 104, thereby allow bigger degree of freedom and the littler implantation profile of implanting the patient is provided when placing horizon bar system and anchor system 102 with respect to for example patient's spinal column, anchor system 102 comprises the motion of a plurality of degree of freedom.The motion of these degree of freedom is at Fig. 9,9A, and 10,10A and 11 is shown in the 11A.

Fig. 9 has set up referential, this referential comprises the longitudinal axis x along the longitudinal length of bone screw 108, the y axle that extends perpendicular to the x axle, and simultaneously perpendicular to x axle and y axle and from the pin 190 of the yoke 180 of anchor system 102 outwards and the transverse axis z that extends of parallel pin 190.As shown in the figure, especially shown in Fig. 9 and 9A, thereby can make head 110 rotate to about zero degree and x axle conllinear from about 80 degree by the resulting system 100 of embodiment disclosed herein, and rotate to about 80 degree positions of x axle opposite side from the zero degree position around the z axle.Therefore, head can rotate about 160 degree around the z axle with respect to bone screw 108.Seen in Figure 10 and 10A, head 110 can tilt with respect to the x axle and in x axle both sides about 0.08 inch (2mm).Therefore, head 110 can tilt to the zero degree that is roughly parallel to the x axle from about 12 degree around the y axle, and tilts to 12 degree of x axle opposite side from zero degree.Therefore, head can tilt to pass about 24 degree around the y axle.Shown in Figure 11 and 11A, head 110 can rotate about altogether 40 degree around the x axle.Referring to Figure 11 A, head 110 can turn to zero degree and turn to about 20 degree at the opposite side of z axle from zero degree from about 20 degree around the x axle in a side of z axle.Head basically can all these degree of freedom of disposable enforcement, and therefore can be by simultaneously around about 160 degree (Fig. 9) of z axle, around about 24 degree (Figure 10) of y axle and in the scope of about 40 degree (Figure 11 A) of x axle moving-head and have recombination site with respect to bone screw.

Therefore, referring to Fig. 9 and 9A, the range of movement in axial plane is about 180 degree or at each about 90 degree of each side of Central Line.At Figure 10, among the 10A, the range of movement on head and the tail orientations is about 4mm or at each about 2mm of each side of Central Line or for about 24 degree or at each about 12 degree of each side of Central Line.At Figure 11, among the 11A, the range of movement in coronalplane is about 40 degree or at each about 20 degree of each side of Central Line.

Figure 12,13 show another embodiment of anchor system 102 of the present invention, and the element that wherein is similar to the element of other embodiment has similar Reference numeral.

As shown in figure 13, this embodiment comprises the carriage of the embodiment that is similar to Fig. 7 or the bottom bracket or the following clamping element 220 of clamping element 220, and head 110 is similar to the head 110 shown in Fig. 7.Compress ball 200 and be similar to and compress ball 200 among Fig. 7, and this compresses bag and draws together a plurality of otch that are provided with around the rotation axis 238 of ball 200.In this embodiment, otch 202 has alternative opening between in the face of the South Pole of arctic of the rotation axis of ball 200 and the rotation axis of facing ball 200.Alternately, otch can be located in the ball and not have with respect to the arctic of the rotation axis of ball 200 or the opening in the South Pole.Further, otch can be only with respect to an opening in the arctic or the South Pole.

At Figure 12, in 13 the embodiment, positioned adjacent screw 214 (also referring to Fig. 7) localized bracket is also arranged or go up clamping element 240.Bracket or last clamping element 240 have the general cylindrical body, and it can slide in the cylindrical hole of head 110 and its upper end has the finger 242 of extending from the upper end.Finger 242 can connect on (spring over) hole in the lower surface that is formed at dog screw 214 so that keep carriage 240 and carriage 240 can be rotated with respect to dog screw 214 with respect to dog screw 214 by spring.The lower surface of carriage 240 comprises that the concave surface 244 that can cooperate with horizon bar 114,116 is so that with respect to head 110 securing rods and with respect to bone screw 108 locking heads 110.If desired, thus can make the concave surface 244 coarse locking systems 100 that help.

Further, Figure 12 has illustrated retaining ring 246 in 13.This retaining ring can be force-fitted on the outer surface 218 of head 110, perhaps prominent more and be buckled in spine 248 belows of the far-end 212 that is positioned at head 110, perhaps can have with the outer surface 218 that is positioned at head 110 on the female thread that matches of external screw thread.At anchor system 102 in place and horizon bar 114 in patient's body, under 116 situations about being received in the anchor system, thereby before screwed in place screw 214 locking horizon bars and anchor system, retaining ring 246 can be attached to head 110 and open when dog screw 214 locking systems 110 to prevent head 110.

In Figure 14,15 and 16, illustrated anchor system 102 can side loading horizon bar 114,116 further embodiment, the element that wherein is similar to other embodiment of anchor system is endowed similar Reference numeral.Referring to the embodiment among Figure 15, head side wall 224 comprises side direction or lateral opening 250, and it is communicated with the cylindrical hole 210 that is arranged in head 110.Side direction or lateral opening preferably extend beyond 180 degree around the outer surface of head.Lateral opening 250 comprises lip limit 252, extends into the profile that is communicated with and follows the concave surface 228 of carriage 220 with cylindrical hole 210 below the lip limit downwards.Therefore, horizon bar 114,116 can pass lateral opening 250 location and be pushed downwards to be pressed into the concave surface 228 of carriage 220 and contact.Carriage 220 comprises protruded stigma 254 down in this embodiment.And this embodiment does not comprise and compresses ball, but the 190 big pins 190 of the pin in comparable other embodiment directly touch with posts 254 by diameter when dog screw 112 locking anchor systems 100.If desired, thus pin 190 can have coarse surperficial 256 and helps to lock anchor system 100.As from Figure 14,15 and 16 conspicuous, because this embodiment has side loading head 110, so the far-end of head is complete columniform, is not communicated with the side direction U-lag mouth in any other embodiment.Therefore, this embodiment does not comprise and can be used to prevent any retaining ring or the reinforced region opened.

Figure 17 shows the another embodiment with side direction or side loading head 110 of anchor system 102.In this embodiment, on pin 190, be placed with and compress cylinder 258.Like this compress the motion that cylinder 258 can make the anchor system 100 of less degree of freedom, have the stability of increase.If desired, compressing cylinder 258 can slide along the longitudinal axis 260 of pin 190.Head 110 can and compress cylinder 258 rotations around pin 190.Head 110 also can be along the longitudinal axis 260 of pin and longitudinal axis slip or the translation that compresses cylinder 258.Compress cylinder 258 and have otch 262, described otch can be configured to be similar to the otch 202 of other embodiment of described herein and the anchor system 100 that illustrates.

Figure 18 shows the embodiment with side direction or side loading head 110 again of anchor system 100.This embodiment comprises being located at and compresses ball 200 on the pin 190, this compress ball be similar to shown herein and describe other compress ball 200.Therefore, present embodiment has about use and compresses the degree of freedom motion that other embodiment of ball is described.

Be to be understood that, although each embodiment of anchor system might not show all elements of other embodiment of anchor system, those of ordinary skill in the art should be used for the element of a kind of embodiment of anchor system other embodiment of anchor system.

The embodiment of horizon bar of the present invention system

Except following embodiment, the embodiment of horizon bar of the present invention system 104 comprises above-mentioned embodiment.An aspect of horizon bar system 104 is to isolate anchor system 102 and the stress and the power that reduce on the anchor system.By will not be for example being delivered to anchor system and realizing this aspect by the flexing of spinal column, stretching, extension, rotation or crooked such stress in the horizon bar system and the power of putting on.This aspect therefore kept the integrity of the placement of anchor system in spinal column for example and prevent the bone screw of anchor system or hamulus of hamate bone loosening.In addition, the various elements that comprise the horizon bar system can utilize various horizon bar system to control rigidity, flintiness and/or the elasticity of dynamic stabilization system 100.Further, the horizon bar system can be used for then having along a different direction along rigidity, flintiness and/or elasticity that a direction has a level rigidity, flintiness and/or the elasticity of another level.For example, the horizon bar system can provide the flintiness of a level when the spinal column flexing, and the flintiness of varying level then is provided when spinal extension.In addition, can control perverted toleration by the horizon bar system.The horizon bar system of selecting makes that bending has stronger toleration to side direction, and the horizon bar system of other selection makes that bending has less toleration to side direction.As discussed below, vertically the placement of bar also influences lateral thrust.Side direction is placed vertical bar more, and it is strong more that embodiment resists perverted flintiness.

Apparent from scheming, the horizon bar system is connected to the head of anchor system, and vertically lever system is free of attachment to head.Usually, all be fastened with two anchor systems on each vertebral levels, the horizon bar system is connected between two anchor systems.This has guaranteed that further less stress and power are applied on the anchor system that is anchored on each sections and make the vertebra of spinal column can have dynamic stability.Therefore, when spinal extension, flexing, rotation and when crooked horizon bar and whole system 100 make vertebra relative to each other motion stabilization and do not have over-drastic power or stress puts on anchor system, reason is not have vertical bar that the anchor system of a vertebral levels is connected with the anchor system of another vertebra.

Referring to Figure 19 to Figure 25, show the another kind of embodiment of the horizon bar system 304 of the dynamic stabilization system 300 that the anchor system 102 with embodiment shown in Figure 1 uses.At Figure 19, also show vertical lever system 306 among the 19A.Horizon bar system 304 comprises first and second horizon bars 308,310.Being to be understood that Figure 19 A has only shown is in first second image of the horizon bar 308 of use location and Figure 19 has not shown use location that horizon bar 308 is connected with vertical bar 306 and so shown whole system 300.

Horizon bar 308 comprises that first and second aim between end bars 312,314, the first and second end bars 312,314 and link together by the offset staff between them 316.In this embodiment, horizon bar 308 is the spitting image of yoke, and wherein offset staff connects each end bar 312,314 by sweep 318,320.Have and the first end bar, 312 aligned first holes 322 in the attachment of the first end bar 312 with offset staff 316, the second end bar 314 and the attachment of offset staff 316 have aim at the second end bar 314 so that also with the first end bar, 312 aligned second holes 324.First deflecting bar or load beam 326 are positioned in first hole 322 and from first hole 322 and extend, and second deflecting bar or load beam 328 are positioned in second hole 324 and from second hole 324 and extend.Identical with the situation of other deflecting bar or load beam, preferably deflecting bar or load beam 324,328 by the elastic material manufacturing such as for example Nitinol (NiTi), and the remainder of system 300 is made of the bioavailable polymer of titanium, rustless steel, for example PEEK or other biocompatible material.Except Nitinol or Nitinol (NiTi), other elastic material comprises cu-zn-al alloy and Batterium.Yet for biocompatibility, Nitinol is a desirable material.Elastic material is selected for the deflecting bar reason and is that the stress of elastic material or power/deflection curve figure have power along with deflection increases and constant relatively steady section.In other words, the load of super-elasticity bar (y) axle/deflection (x) axial curve has along with deflection increase load reaches steady statue or flattens smooth steady section in certain level.In other words, continue deflection and load keeps constant at the steady section bar.In one embodiment, the load steady section is that about 250 newton are to about 300 newton.Be to be understood that this steady section can select to customize by type and formation to elastic material according to patient's needs.For some patients, steady section should be lower, and for other people, steady section should be higher.Therefore for example at steady section, extra power can not put on anchor system 102, therefore extra power also can not be applied to the implantation zone of bone screw 108 and implant bone screw 108 spinal column around on the skeleton.Deflecting bar or load beam 326,328 as required by interference fit, be threaded, weld or be glued in the hole 322,324.

First and second deflecting bars or load beam 326,328 extend toward each other from hole 322,324 separately and are connect by Y shape connecting device 330.Y shape connecting device 330 comprises having relative mating holes 334,336 pedestal 332, described hole 334,336 can receive deflecting bar or load beam 326 by this way, 328: the longitudinal axis that preferably makes Y shape connecting device to wind to be limited by aligned first and second deflecting bars or load beam 326,328 pivots.Y shape connecting device 330 comprises first and second arms that preferably terminate in the screwed hole 342,344, and described screwed hole 342,344 can receive the threaded end of vertical lever system 306 as described below.Be right after recess 346,348 (Figure 24) after the screwed hole 342,344, recess 346,348 is shaped as at horizon bar 308 and is in reception offset staff 316 under the situation of not using configuration shown in Figure 19 A.Do not use under the configuration described, horizon bar 308 can be easier to implant between the tissue and skeleton of spinal column, especially can be easier to channeling conduct between spinous process.In case first horizon bar 308 is implanted, can by with about 90 degree of Y shape connecting device 330 rotation or as required the anatomical structure of the spinal column by the patient make its use and be connected with vertical lever system 306.

Second horizon bar 310 is similar to second horizon bar 116 of the embodiment of Fig. 1.This second horizon bar 310 is preferably constituted and is comprised first and second bearings 350,352 of the end that can receive vertical lever system 306 by titanium or other biocompatible material.Bearing 350,352 comprises the corresponding recess 354,356 of the vertical bar 358,360 that can receive vertical lever system 306.Bearing 350,352 also comprises the lug 362,364 that vertical bar 358,360 can be fixed in respective recess 354,356.Lug 362,364 can be fastened to bearing 350,352 by screw thread or other suitable clamp device.

The first and second vertical bars 358,360 preferably are made of titanium or other biocompatible material and comprise the end of thread and non-threaded end.The end of thread can be formed on the end of bar or can or be glued to the end of vertical bar 358,360 with threaded element interference fit.In case first and second horizon bars use in patient's body, the first and second vertical bars can be threaded onto in the Y shape connecting device 330 of first horizon bar 308 or otherwise be fixed by the Y shape connecting device 330 of first horizon bar 308, and the first and second vertical bars can fix or otherwise be fastened to second horizon bar 310.

Figure 26,27 and Figure 28,29 show the how substituting embodiment of horizon bar of the present invention system.Figure 26, the horizon bar 370 in 27 is similar to the horizon bar 118 among Fig. 1.Horizon bar 370 comprises the foraminous bearing 372 of tool, and described hole can receive first and second deflecting bars or the load beam of preferably being made by elastic material 374,376.Connecting device is in the end of first and second deflecting bars or load beam 374,376, and described connecting device comprises having the lug that runs through screwed hole wherein.Connecting device can be used for vertical bar is connected to deflecting bar or load beam.

Figure 28,29 show the horizon bar 380 that has first bearing 382 and second bearing 384.Each bearing 382,384 includes the hole that is basically parallel to horizon bar 380.First and second deflecting bars or load beam 386,388 extend from the hole of first and second bearings 382,382 respectively.Deflecting bar or load beam 386,388 are parallel to horizon bar 380 and directed towards each other in illustrated embodiment.Alternately, deflecting bar or load beam 386,388 can be directed away from each other.In such structure, bearing 382,384 will be shorter with spaced apart and deflecting bar or load beam, and reason is that deflecting bar or load beam are parallel to and extend towards the end of horizon bar 380.

Figure 30,31,32 show another embodiment of horizon bar of the present invention system 390, and it is similar to horizon bar system 104 as shown in fig. 1.Horizon bar system 390 comprises taper deflecting bar or load beam 392,394.Deflecting bar or load beam are that 390 end reduces from bearing 396 towards horizon bar for taper and diameter.Deflecting bar as discussed previously or load beam can be continuously or are tapered and diameter also can be from end the reducing towards bearing 396 of deflecting bar or load beam gradually in the mode of discontinuous step.In other words, opposite with the tapering shown in Figure 30.Vertically bar 402,404 is connected to deflecting bar or load beam 392,394.Vertically bar 402,404 is connected to deflecting bar or load beam 392,394 as mentioned above.

Coniform shape or taper deflecting bar or load beam can form by the material that draws or grinding is preferably elastic material.When bar from center support outwards when extend the end of horizon bar the conical in shape of deflecting bar or load beam spinal column is applied on the relatively short length that load in the system or power is evenly distributed in deflecting bar or load beam.In this embodiment, for respect to spinal column and between anchor system location operationally, deflecting bar or load beam are shorter than half of length of horizon bar.

Figure 30 shows and is in the not vertical bar 402,404 that is roughly parallel to horizon bar 390 of use location, and vertically bar 402,404 away from each other and towards two end orientations of horizon bar 390.Horizon bar 390 can be conducted through the skeleton and the tissue of spinal column more easily in this position, and for example is directed into implantation position between spinous process.In case in place, vertical as shown in Figure 31 bar 402,404 can be used and make that vertical bar is parallel to each other and be roughly parallel to horizon bar 390.Therefore, this embodiment can shown in Figure 30 do not use under the configuration in be inserted into from the side of spinal column and then vertically bar all can rotate or use about 90 degree (from Figure 30 to Figure 31) to enter patient's the coronalplane.Vertically bar can also rotate freely about 180 degree around deflecting bar in patient's sagittal plane.This makes this embodiment can meet the different sagittal profiles relevant with the spinal column patient that may run into.Deflecting bar or load beam are connected to horizon bar rigidly, allow easier surgical technic, and reason is needn't remove the part of spinal column, especially spinous process and related ligament and tissue so that ccontaining implant system 100.The motion of the flexing of the shift action of system, especially deflecting bar and the vertical bar that is connected to deflecting bar or load beam takes place with related tissue and ligament on every side at spinous process, so spinous process can not interfered this motion.Further, making horizon bar more be lateral to central authorities also allows by for example simpler surgical technic of Wiltse method.

In order to help to implant, cone 406 can horizon bar 390 and vertically on the end of bar 402 slip tissue related with spinal column and skeleton are pushed open helping.In case horizon bar is implanted, just can remove cone 406.Cone 406 comprise can be point or the diameter of globular end 408 and cone 406 on the direction of sleeve pipe 410 parts of cone 406, increasing.Sleeve pipe can be columniform and receive the end of horizon bar and the end of deflecting bar or load beam 402.

Figure 32 shows connecting device 412,414 and how to be fastened to corresponding deflecting bar 392,394.Deflecting bar has flange, for example isolated flange 416,418 on deflecting bar 392.Connecting device 412,414 can buckle and remain on separately flange between.

Figure 33 shows another embodiment of horizon bar of the present invention system 430.Horizon bar system 430 comprises preferably the horizon bar 432 that the elastic material by for example Nitinol constitutes.Horizon bar 432 comprises the platform 434 that is positioned at central authorities substantially, and central platform 434 both sides are first and second towards last recess or recess 436,438.Both sides towards last recess or recess 436 are prone recess or recess 440,442.Both sides towards last recess or recess 438 are downward recess or recesses 444,446.Platform 434 receives the connecting device (Figure 40) that is used for horizon bar is connected to vertical bar, and this will be described below, and the recess 436,440,442 of platform 434 1 sides serves as spring, and the recess 438,444,446 of platform 434 opposite sides also serves as spring.These springs help platform to bear spinal column can to put on the load of horizon bar and isolate anchor system 102 and avoid this load.This isolated advantage is to prevent when anchor system is in implanting patient's body loosening.Be to be understood that by changing the form of recess, can be according to the flintiness and the rigidity of each patient's change and tailored levels bar.Recess still less will obtain the bigger horizon bar of flintiness usually and more recess obtains the littler horizon bar of rigidity usually.In addition, according to the direction of the power that puts on horizon bar of orientation that depends on recess and position, flintiness can be different.For the embodiment shown in Figure 33, be directed upwards towards under the situation of foot that patient's head and recess 440,442,444,446 point to patients downwards at recess 436,438, horizon bar flintiness in stretching, extension big and in flexing flintiness less.It should be noted that bar has uniform diameter in this embodiment, although its diameter can be heterogeneous, for example big and reduce gradually towards the end of horizon bar 432 at platform 434 places, perhaps have than major diameter at place, the end of horizon bar 432, be decreased to gradually platform 434 places than minor diameter.In this embodiment of basic homogeneous diameter was all arranged, recess formed in the homogeneous diameter part.In other form, recess is molded in the horizon bar or by the machined of preform horizon bar and forms.By this configuration, horizon bar is easier to be inserted in the spinal column and between the skeleton and tissue of spinal column.Further, because diameter is evenly basic so this horizon bar can be transported to spinal column by intubate easilier.In order to form recess, can use the machining technique that is called as wire electric discharge machine processing or claims line EDM.Therefore, the method for the elastic material that is used to be shaped is by line EDM, carries out electropolishing afterwards.In addition, the elastic material in present embodiment and other embodiment can by cold rolling, draw or process so that increase the super-elasticity of material.

In this embodiment, deflection is almost only at the mid portion of horizon bar and take place at platform and spring place substantially, therefore alleviated load or power on the interface between the end of horizon bar and anchor system/skeleton.

Therefore, in this preferred implementation, two upper notch in the sensing are arranged, compare it and have relative demulcent radius with the tighter radius of following recess under pointing to.Be to be understood that in this preferred implementation it is symmetric that following recess does not resemble the upper notch.Lateral incision under two side direction in the recess is steep and rounding not.These otch allow bar crooked at these points, have strengthened spring.Upper notch is two-to-one with the ratio of the radius of following recess in this preferred implementation.Consequently produce two bendings and smooth (in cross section) part, each these two flat of one of the platform both sides in this preferred implementation have roughly same homogeneous thickness.And in this embodiment, recess and platform form the cylindrical bar of other homogeneous diameter.Therefore, these forming elements all do not extend beyond the diameter of bar in this preferred implementation.In this preferred implementation, the diameter of horizon bar is about 4mm.

If desired, bar can bend to outside the diameter that makes platform and/or recess extend to cylindrical bar.Yet such configuration will not be adapted to pass through intubate like that with aforesaid horizon bar as shown in Figure 33 or implant through skin.

Be to be understood that in order to strengthen flexiblely, torsion bar that uses in the horizon bar embodiment of Fig. 1 and Connection Element can use with the horizon bar of Figure 33.(Figure 47) in this embodiment, connecting device is fastened to the platform of the horizon bar of Figure 33, and two deflecting bars or load beam are towards the end of the horizon bar of Figure 33 and be roughly parallel to this horizon bar and extend.

The another kind of embodiment of horizon bar 433 has been shown in Figure 33 A.Horizon bar 433 is similar to the horizon bar of Figure 33 in this embodiment, and difference is that platform and recess are replaced by the middle body 448 that diameter reduces.Increasing gradually up to diameter on two end diameter of middle body 448 is the full diameter of the end of horizon bar 433.This embodiment can be formed and is ground to the shape that diameter reduces by the bar blank of elastic material by elastic material.The bar blank also can be drawn into this shape.Usually horizon bar will be by electropolishing after such operation.In this embodiment, the connecting device shown in connecting device, for example Figure 40 can be used for vertical bar is connected to the centre of preferred middle body 448.

Figure 34 A, 34B, 34C for example show another substituting embodiment of the horizon bar 280 of horizon bar 116 as shown in fig. 1, and it is intended to be maintained fixed rigidly vertical bar thereunto.The bearing 282,284 that is formed in this horizon bar 280 comprises the body that can be formed with bar 280.Bearing is provided with the removable fixing arm 286,288 with recess then, and described fixing arm preferably fixes arm and still forms from bearing by the line EDM method that hinges is connected to horizon bar by making.Inclined to one side dog screw 290,292 is installed on the horizon bar.Under vertical bar fixes situation in the recess that is fixing arm, overcome the hinges pushing and fix arm thereby can rotate inclined to one side dog screw, and thus vertical bar is fixed in the recess that fixes arm.

Figure 40 shows the dynamic stabilization system 450 of use horizon bar of the present invention system 454.System 450 additionally use as shown in fig. 1 anchor system 102 and as Figure 19, another horizon bar 310 shown in 34.Platform 434 and vertical bar that connecting device 452 is fastened to horizon bar 454 are connected to connecting device and another horizon bar 310.Among Figure 40 for horizon bar 454, form recess rather than recess is formed in the horizontal straight-bar shown in the horizon bar 432 of Figure 33 by bent stick.The horizon bar 430 of Figure 33 also can be used for the embodiment of Figure 40.

Figure 35 shows a kind of substituting embodiment of horizon bar of the present invention system 460.Horizon bar system 460 comprises horizon bar 462, the first and second spring zones 466,468 that it has central platform 464 and is positioned at the both sides of platform 464.Two ends of horizon bar 462 stretch out from each spring zone.The spring zone comprises the coil of reeling around the longitudinal axis of horizon bar 462.If desired, whole horizon bar 462 can be made of the bar of reeling around longitudinal axis, reels more tightly and/or have less diameter in the end of platform 464 and horizon bar, and reels than loose ground and/or have bigger diameter in spring zone 466,468.Such horizon bar 462 can be preferably by for example Nitinol or alternately elastic material or other biocompatible material of titanium constitute with repetition flexion capabilities.

Figure 36 shows another substituting embodiment of the horizon bar system 480 that comprises first and second horizon bars 482,484, and described if necessary first and second horizon bars can be flat bars.Horizon bar 482,484 comprises spring zone 494,496.Horizon bar forms arc in the spring zone, resembles very much the sheet spring.Spacer portion 488,490,492 are positioned between end, central platform 486 places and the horizon bar 482,484.Spacer portion is gluing, bonding, welding or otherwise be fastened on first and second horizon bars 482, thereby forms horizon bar system 480 between 484.This system 480 can constitute by elastic material or with biocompatible other material of patient.

Figure 37 shows the another kind of embodiment of the horizon bar system 500 that comprises horizon bar 502.In this embodiment, be formed with recess 504 in the horizon bar so that limit the flintiness of horizon bar 502.This system can be formed by elastic material or other biocompatible material.

Figure 38 shows another embodiment that has horizon bar 522 of horizon bar of the present invention system 520.Horizon bar 522 comprise around and the recess 524 that distributes along horizon bar 522.Identical with other embodiment, according to the distribution of recess, can determine the flintiness of horizon bar 522.Further, arranging more recess on the lower surface than on upper surface, in the time of in being placed on patient's body, horizon bar 522 will tend in stretching, extension than flintiness big and in flexing flintiness less.This horizon bar 522 also can be made by elastic material or other biocompatible material.

Figure 39 shows the another kind of embodiment of horizon bar of the present invention system 530, and described horizon bar system has the horizon bar 432 similar horizon bars 532 with Figure 33, and therefore like will be used like reference numerals.In addition, the end 534,536th of horizon bar 532, crooked, can be thereby produce around the hook of the part assembling of vertebra so that horizon bar 532 is fastened to vertebra.In this embodiment, preferably bar is made of elastic material or other biocompatible material.In order to implant bar, the hook that is positioned at 534,536 places, end flicks and allows to close around the vertebra bullet.The anchor system that comprises hook (as mentioned above) can be used for this system.

Figure 39 A, 39B is similar to Figure 39.At Figure 39 A, among the 39B, horizon bar 532 is in place with respect to spinal fixation by two anchor systems 102.This anchor system is similar to the anchor system shown in Fig. 1.Anchor system 102 comprises holdfast or bone screw 108 or has the hamulus of hamate bone 109 (Figure 39 B) of burr 111, and horizon bar is received in head 110 wherein.Dog screw 112 is with respect to the fastening horizon bar of anchor system.

Figure 41 shows the another kind of embodiment of dynamic stabilization system 540 of the present invention.This embodiment comprises aforesaid side loading anchor system 542, also is suitable for this embodiment although anchor system is loaded at the top.In this embodiment horizon bar 544,546 preferably constitute by the polymer of for example PEEK and its on first and second connecting devices 548,550 are installed.Vertically bar 552 and 554 is connected to first and second connecting devices 548,550 at point 556 places by screw, rivet or other device and makes that it is inflexible connecting, and perhaps alternately, makes vertical bar 552,554 to pivot or rotation around described point.Because horizon bar is made of PEEK, therefore compare this system to tend to rigidity bigger with the situation that bar is made of elastic material.Rigidity also depends on the diameter of bar.

The embodiment of vertical lever system of the present invention

For example vertically the embodiment of the vertical lever system of the present invention of lever system 106 runs through description of the present invention and provides.Usually, vertically lever system is made of vertical bar, and these vertical bars can pivot after horizon bar uses in patient's body or be inserted into the appropriate location.Vertically bar preferably is connected to horizon bar and is free of attachment to anchor system so that reduce to act on power and stress on the anchor system.Vertically bar is connected to the horizon bar system, and described horizon bar system comprises that as described herein reducing acts on the power on the anchor system and the mechanism of stress.Vertically bar can be made of titanium, rustless steel, PEEK or other biocompatible material usually.If expect bigger flexiblely, then vertically bar can be made of elastic material.

The substituting embodiment that is used for the multistage dynamic stabilization system of spinal column

Figure 42 and 43 shows multistage dynamic stabilization system 560,580.These systems 560,580 all are two-stage systems.All these systems use anchor system as described herein.In the system 560 of Figure 42, middle level horizon bar 562 is fastened to vertebra and comprises for example horizon bar system 104 with first and second deflecting bars or load beam shown in Fig. 4, thus, the first pair of vertical bar 564 can extend upward and second pair of vertical bar 566 can extend downwards from the horizon bar system from the horizon bar system.Upwardly extending vertical bar is connected to the last vertical bar 568 shown in Figure 34 for example and the vertical bar that extends downwards is connected to for example following horizon bar 568 shown in Figure 34.Last horizon bar 568 is fastened to the vertebra that is positioned on 562 fastening vertebras of middle level horizon bar by anchor system.Following horizon bar 570 is fastened to the vertebra that is positioned under 562 fastening vertebras of middle level horizon bar by anchor system.This embodiment makes the middle level vertebra have bigger stability with respect to vertebra up and down, allows stretching, extension, flexing, rotation and bending with respect to the middle level vertebra simultaneously.

Figure 43 shows another multistage dynamic stabilization system 580.All these systems use anchor system as described herein.In the system 580 of Figure 43, middle level horizon bar 582 is fastened to vertebra and comprises for example horizon bar shown in Figure 34.Upper and lower horizon bar 586,590 can be similar to the horizon bar 114 shown in Fig. 3, and it comprises deflecting bar or load beam and deflecting bar or load beam bearing.Vertically bar to be can pivoting and rotatable mode is installed to upper and lower horizon bar 586,590 and is respectively installed to their deflecting bar or load beam, and is installed to middle level horizon bar 582 rigidly.Last horizon bar 586 is fastened to the vertebra that is positioned on 582 fastening vertebras of middle level horizon bar by anchor system.Following horizon bar 590 is fastened to the vertebra that is positioned under 582 fastening vertebras of middle level horizon bar by anchor system.Vertebra had bigger dynamic stability with respect to the middle level vertebra about this embodiment made, and allowed stretching, extension, flexing, rotation and bending with respect to the middle level vertebra simultaneously.Alternately, middle level horizon bar 582 has two bearings shown in four bearings rather than Figure 34 or Figure 34 A, and making wins can be fastened to middle level horizon bar 582 from the vertical bars 566 of the second couple that descend horizon bar 590 to extend upward and to extend from last horizon bar 586 downwards to vertical bar 588.

The embodiment of spinal fusion of the present invention system

Figure 44,45 show one-level and the two-stage system that is more preferably used in fusion.System 600 shown in Figure 44 is similar to the system shown in Figure 41.When PEEK was used for horizon bar at 602,604 o'clock, system be substantially rigid and can be used in combination with spinal fusion.For example, this system can be used for skeleton or merge cage being placed between the attached vertebra of this system.In fusion, bone can be placed between the vertebral body, perhaps alternately, realizes in the depression of each side that fusion can be by being placed on bone spinous process.Horizon bar 602,604 also can be constituted and is used for spinal fusion by titanium or other biocompatible material.For this embodiment, the vertically use of the horizon bar that has bearing that bar 606 can be by as shown in Figure 34 and be attached to horizon bar rigidly makes vertical bar 606 can not move or pivot with respect to horizon bar.

Figure 45 shows and more preferably is used for the two-stage system 620 that two segment merges.The anchor system that each stage for example all can use the anchor system 102 with reference to Fig. 1 to be described.Horizon bar 622,624,626 can be similar to the horizon bar among Figure 34, have two vertical bars that are used for upper and lower horizon bar 622,626 or are used for four vertical bars of middle level horizon bar 624.For this embodiment, the vertically use of the horizon bar that has bearing that bar 628,630 can be by as shown in Figure 34 and be attached to horizon bar rigidly makes vertical bar 628,630 can not move or pivot with respect to horizon bar.Vertically bar 628 extends between last and middle horizon bar 622,624, and vertically bar 630 is extending between the horizon bar 624,626 under the neutralization.System 620 shown in Figure 44 is similar to the system shown in Figure 41, but is about trilaminar.When PEEK is used for horizon bar 622,624,626 o'clock, system be substantially rigid and can be used in combination with spinal fusion.For example, this system can be used for skeleton or merge cage being placed between the attached vertebra of this system.For this system, skeleton also can be placed along the depression in the both sides of spinous process.Horizon bar 622,624,626 also can be constituted and are used for spinal fusion by titanium, PEEK or other biocompatible material.

About Figure 45, in order to carry out the transition to the one-level integration region of spinal column gentlely, can retrofit by replace 622 pairs of these two-bed systems of horizon bar with horizon bar 115 (Figure 45 A, 45B), horizon bar 115 resembles the horizon bar 104 that has deflecting bar or load beam 118,120 of Fig. 1 very much.This embodiment has been shown in Figure 45 A.Therefore, fusion realizes between two following horizon bars 117, these two following horizon bars are similar to those shown in Figure 34, perhaps be similar to the horizon bar 116 among Fig. 1, and preferably by the titanium manufacturing, flexiblely provided by last horizon bar 115, the described horizon bar of going up is similar to the horizon bar that has deflecting bar or load beam 114 shown in Fig. 1.Therefore, from spinal column the healthy part on the horizon bar 115 through horizon bar 115 to spinal column the horizon bar 624 of Figure 45 and horizon bar 606 or the fusion between the horizon bar 117 (Figure 45 A) transition of more gradual change is partly arranged.

The embodiment of other embodiment of dynamic stabilization system and connecting device, horizon bar system and vertical lever system

Show and described the various embodiments of dynamic stabilization system in the above.Figure 48-85 provides more embodiments of dynamic stabilization system.With reference now to Figure 48 and 49,, can see the axonometric chart and the rearview of the another kind of embodiment of dynamic stabilization system 700.Usually, identical with above-mentioned embodiment situation, dynamic stabilization system 700 comprises anchor system 702, horizon bar system 704 and vertical lever system 706.Represent horizontal alignment for these embodiment levels with respect to the patient who stands, and vertical expression being vertically oriented with respect to the patient who stands.Horizon bar system 704 can comprise first horizon bar 708, second horizon bar 710 and deflecting bar system 712.Vertically lever system 706 can comprise vertical bar 716, and described vertical bar can use vertical bar 716 be attached to the deflecting bar system 712 that is connected with first horizon bar 708 and can use connecting device 1210 that vertical bar 716 is attached to second horizon bar 710 with separate connection device 718.

As shown in Figure 48-49, deflecting bar system 712 is attached to the central authorities of first horizon bar 708 by bearing 714 in this embodiment, is connected to vertical bar 716 at its 722,724 places, end simultaneously.Deflecting bar system 712 is roughly parallel to first horizon bar, 708 location, and first horizon bar 708 is attached to anchor system 702, and particularly, is attached to the head or the carriage of anchor system 702.Preferably, horizon bar 708,710th, hard and inflexible (and, for example by the titanium manufacturing), particularly compare with deflecting bar system 712 (for example, it can be made by the elastic material (intrinsic deflection bar 720 (Figure 50 A)) of for example Nitinol and the polymer (shell 721) of for example PEEK).In this structure, horizon bar system 704, especially deflecting bar system 712 share and distribute load by patient's body motion generation.Vertical bar 716, connecting

device

718,1210, the numerous embodiments of deflecting bar system 712 and horizon bar 708,710 can be as the part of dynamic stabilization system 700, and this will be described in greater detail below.

Figure 50 A-55B shows the deflecting bar system 712 that uses in the dynamic stabilization system 700, vertically the embodiment of bar 716 and connecting device 718.Referring now to Figure 50 A-55B,, deflecting bar system 712 comprises intrinsic deflection bar 720, retaining ring 726 and bulb or the joint 728 with first end 722 and the second end 724.As further describing about Figure 68-71, deflecting bar system 712 comprises: the interior bar of for example being made by the elastic material of for example Nitinol 720 preferably; With the shell of making by for example PEEK polymer 721.In this embodiment, the first end 722 of the intrinsic deflection bar 720 of deflecting bar system 712 can pass retaining ring 726 and for example by be threaded, welding, gluing, interference fit and/or laser welding technology be attached to bulb or joint 728 (as shown in Figure 51).In this embodiment, bulb or joint 728 only are connected to the deflecting bar 720 of deflecting bar system 712 and are free of attachment to shell 721.Then, globe joint 728 can be positioned in the nest shape chamber 768 of connecting device 718.In the time of in globe joint 728 is positioned in connecting device 718, just retaining ring 726 can for example can be threaded, welding, gluing, interference fit and/or be laser-welded to connecting device 718, with the ball-and-socket hinge style ways of connecting deflecting bar 712 is fastened to connecting device 718 (as shown in Figure 52) thus.In this structure, allow deflecting bar system 712 to be rotated and/or inclination and/or rotational motion around corresponding center, center with bulb or joint 728.

With reference to Figure 51 and 52, the vertical bar 716 that is used for this embodiment of dynamic stabilization system 700 comprises: head 730, and it has the aperture 732 that can receive screw 734; With the rectangle shell portion or the recess 736 that are used to receive connecting device 718.Additionally referring to Figure 53 and 54, vertically the aperture 732 of bar 716 comprises first hole 738 and second hole 740.First hole 738 in aperture 732 can be configured to encase the head 742 of connecting device screw 734, and second portion 740 can be configured to fix the cervical region 735 of screw 734.Therefore, the diameter of the first 738 in aperture 732 is greater than second hole 740 in aperture 732, and the overall shape in aperture 732 conforms to the shape of connecting device screw 734.

Return with reference to Figure 52, vertically the rectangle shell portion or the recess 736 of club head 730 are configured to receive regularly and encase connecting device 718.Therefore, the inner surface of rectangle shell portion or recess 736 comprises top surface 746, inner lateral surfaces 748,750 and inside front surface 752 and inner rear surface 754.In this embodiment, inside top surface 746, inside front surface 752 and inner rear surface 754 are smooth and are being rectangle in shape, and inner lateral surfaces 748, the 750th, smooth, have saddle and cut out portion, it can allow deflecting bar system 712 and/or vertically bar 716 motion relative to each other.And in this embodiment, the basal surface 756 of head 730 exceeds the basal surface 758 of vertical bar axle 760 so that provide the space for the connecting device 718 of the bottom to head 730 to be attached.The degree that exceeds can change according to the size of the connecting device 718 that is attached to the there.

Return with reference to Figure 51, the connecting device 718 that uses in this embodiment of dynamic stabilization system 700 comprises the housing 764 that is used to receive the threaded bores 762 of connecting device screw 734 and is used to receive deflecting bar system 712.In its use location, the aperture 762 in the connecting device 718 is aimed at and place in the contiguous aperture 732 that is positioned on the vertical bar 716, and connecting device screw 734 inserts in two apertures 732,762 connecting device 718 is fixed to vertical bar 716.

Figure 51 and 52 further shows the housing 764 of connecting device 718, and it has the cardinal principle cylindrical outer surface 765 that has planar top surface 766.Housing 764 also comprises the opening 770 on the front surface 772 that is positioned at connecting device 718, and this opening leads to nest shape or the spherical chamber 768 that is formed in the housing 764.Nest shape or spherical chamber 768 can be configured to engage the bulb or the joint 728 of deflecting bar system 712.In this structure, in the pit-shaped or spherical chamber 768 that the bulb of permission deflecting bar system 712 or joint 728 pivotally join connecting device 718 to, allow deflecting bar 720 to extend away from connecting device 718 simultaneously via the opening 770 of the front surface 772 of housing 764.Retaining ring 726 remains on appropriate location in the connecting device 718 with ball 728.

Return with reference to Figure 52, punctual with 762 pairs in aperture in the connecting device 718 when the aperture in the vertical bar 716 732, vertically the recess or the shell portion 736 of bar also can aim at the housing 764 of connecting device 718.Connecting device housing 764 can insert in vertical bar recess or the shell portion 736 up to the inner surface engage top 750 of connecting device housing 764 along vertical bar shell portion 736, side 748,750,752,754.In this structure, the motion of connecting device 718 in the head 730 of vertical bar 716 is minimized and/or eliminates.This structure also makes vertical rod shell 736 can absorb during use by deflecting bar system 712 and vertical any pressure of producing of the motion of bar 716, and restriction puts on the pressure of screw 734 during use thus.

Figure 55 A further shows deflecting bar system 712 in this embodiment, connecting device 718 and the vertically connection between the bar 716.Can see that in Figure 55 A the overall diameter of retaining ring 726 is slightly less than the diameter of opening 770 on the front surface 772 of connecting device 718.Retaining ring 726 has flat front 774, and the inner surface of retaining ring 726 comprises sweep 776, and the radius of curvature of sweep 776 is identical with the radius of curvature of bulb or joint 728.Therefore, retaining ring 726 can the front surface 772 by connecting device 718 be inserted in the openings 770 up to it and bulb or joint 728 and is slidably engaged.Connecting device 718 can also comprise spine 778 on its inner surface, the degree of depth that this spine's restriction retaining ring 726 is inserted in the connecting device 718.Retaining ring 726 can be threaded then, welding, gluing, interference fit and/or be laser-welded to connecting device 718.

Figure 55 B shows a kind of alternative tightening technology.In this embodiment, bulb or joint 728 insert connecting device 718 via the opening on the rear surface 780 that is arranged in connecting device 718 780, and deflecting bar 720 inserts in the connecting device 718 via the opening on the front surface 772 of connecting device 718 770.In case parts are inserted into, globe joint 728 is connected in connecting device 718 with deflecting bar 720.Alternately, can be before being placed into globe joint 728 in the connecting device 718 by for example be threaded, gluing, interference fit and/or laser weld assemble bulb or joint 728 and deflecting bar 720 in advance.Can prevent that globe joint 728 from leaving connecting device 718 via the opening 780 on the rear surface 782 of connecting device 718 with retaining ring 726 then.Retaining ring 726 can be threaded, welding, gluing, interference fit and/or be laser-welded to connecting device 718.Other tightening technology is also in scope and spirit of the present invention.

In case deflecting bar system 712 is secured to connecting device 718, just can as shown in Figure 53 connecting device 718 be fastened to vertical bar 716.In this structure, connecting device 718 cooperates with the head 730 of vertical bar 716.When connecting device 718 was coupled to the head 730 of vertical bar 716, vertically the aperture 732 in the bar 716 was aimed at the aperture 762 of connecting device 718.Connecting device screw 734 can be fastened to connecting device 718 with vertical bar 716 then.

Figure 56 A-59 shows the another kind of embodiment of the deflecting bar system 800 that can be used in the dynamic stabilization system 700, vertical bar 802 and connecting device 804.In this embodiment, comprise that the cylindrical connecting device 804 of U-lag mouth 810 is used for vertical bar 802 is attached to deflecting bar system 800, this will be described in greater detail below.

With reference now to Figure 56 A and 56B,, the connecting device 804 in this embodiment is shown as and comprises cylindrical body 806, and it has interior cylindrical hole 808, U-lag mouth 810 and lock tabs 812.Deflecting bar system 800 in this embodiment comprises deflecting bar 814 (preferably being made by Nitinol, NiTi or other elastic material) and bulb or joint 816, and deflecting bar 814 has shell 815 (preferably by PEEK or other suitable polymer manufacturing).Connecting device 804 comprises nest shape chamber 818, and this nest shape chamber is formed at bulb or the joint 816 that is used to receive deflecting bar system 800 in the U-lag mouth 810.In case the bulb of deflecting bar system 800 or joint 816 are positioned in the nest shape chamber 818, the outside plate 820 of lock tabs 812 can move to the use structure (as shown in Figure 56 B) of its closure from its not use of opening structure (as shown in Figure 56 A), closes opening around the U-lag mouth 810 of the bulb of deflecting bar system 800 or joint 816 thus so that deflecting bar system 800 is fastened to connecting device 804.The particular organization of outside plate 820 that is used for mobile lock tabs 812 at this embodiment of the present invention is shown in Figure 59, and it will be described in greater detail below.In the use structure of connecting device 804, deflecting bar system 800 pivotally joins in the nest shape chamber 818 of connecting device 804, and deflecting bar axle 814 extends away from connecting device 804 simultaneously.Therefore, allow vertical bar 802 to be rotated and/or inclination and/or rotational motion around center corresponding to the center of globe joint 816.

Figure 57 shows the vertical bar 802 that is used for this embodiment of the present invention.Vertically bar 802 comprises vertical bar axle 822, and thread belt 824 and having is used to receive the end cap 826 in hole 828 of the lock tabs 812 of connecting device 804.In this embodiment, thread belt 824 and end cap 826 all are close to first end, 830 location of vertical bar 822.The diameter of thread belt 824 can be greater than the diameter of vertical bar axle 822 and end cap 826.In one embodiment, vertically bar 802 can not comprise end cap 826, and thread belt 824 will comprise the hole of the lock tabs 814 that is used to receive connecting device 804 in this case.

Figure 58 provides the detail drawing of the lock tabs 812 that is used for this embodiment of the present invention.Lock tabs 812 comprises outside plate 820, cylindrical bar 832 and teat 834.In this embodiment, outside plate 820 can comprise convex surface 836 and concave inner surface 838.Cylindrical bar 832 is along inner surface 838 location of outside plate 820, and the top surface 840 of cylindrical bar 832 is parallel to the top surface 842 of outside plate 820.Teat 834 is medially located along the top surface 842 of cylindrical bar 832.When using in connecting device 804, teat 834 can be used for lock tabs 812 is fastened to vertical bar 802, and the inner surface 838 of outside plate 820 and teat all conform to the shape of the end cap 826 of vertical bar 802 thus, as shown in Figure 59.For teat 834 being fastened to vertical bar 802, teat 834 comprises cylindrical base 844 and the U-shaped otch 848 with taper neck ring 846.In the time of in the hole 828 in teat 834 inserts the end cap 826 of vertical bar 802, the top that extends beyond the end cap 826 of the vertical bar 802 of hollow up to neck ring 846 is clamp-oned in the end 850 of U-shaped otch 848 permission teats 834.In case neck ring 846 extends beyond the top of end cap 826, neck ring 846 be stuck in lower lip 84 and be returned to it initially be not subjected to squeeze structure, thus vertical bar 802 is fastened to lock tabs 812 (as shown in Figure 59).

With reference to Figure 59, can see deflecting bar system 800 and the cross-sectional figure that is positioned at the vertical bar 802 of connecting device 804.Connecting device 804 has the interior cylindrical hole 808 that is used to receive vertical bar 802, and described vertical bar is basically parallel to the longitudinal axis location of cylindrical body 806.The inner surface of cylindrical body 806 comprises the screw thread 852 of the thread belt 824 that is used to engage vertical bar 802.In this embodiment, vertically bar 802 can be threaded onto in the cylindrical body 806 teat 834 that end cap 826 up to vertical bar 802 is placed with lock tabs 812 and is slidably engaged.As mentioned above, extend beyond the lip limit 847 of end cap 826 in the hole 828 of the end cap 826 by teat 834 being inserted vertical bar 802 up to the neck ring 846 of teat 834, the neck ring 846 of teat 834 is fixed to lock tabs 812 with vertical bar 802 thus, thereby realizes that vertical bar 802 joins lock tabs 812 to.In this structure, vertically the end cap 826 of bar 802 rotates freely around the teat 834 of lock tabs 812, and vertically bar 802 keeps joining to lock tabs 812.In case vertically bar 802 is placed with lock tabs 812 and engages, lock tabs 812 can move up and down in the cylindrical body 806 of connecting device 804 by the screw thread motion of vertical bar 802.In the use structure of connecting device 804, the bulb of deflecting bar system 800 or joint 816 insert in the U-lag mouth 810 of connecting device.In case the ball 816 of deflecting bar system 800 is positioned at wherein, thereby outside plate 820 and then lock tabs 812 just can move down the opening of the U-lag mouth 810 that blocks connecting device 804.In one embodiment, the following inner surface 854 of lock tabs 812 can be the circle that is recessed into to engage the bulb or the joint 816 of deflecting bar system 800.

Figure 60-64 shows another embodiment of the deflecting bar system 900 that is used in the dynamic stabilization system 700, vertical bar 902 and connecting device 904.As shown in Figure 60, the deflecting bar system 900 that is used for this embodiment comprises the deflecting bar 906 with shell 907, and deflecting bar 900 also comprises attached with it tubular end cap 908, and the circumference with the end that is attached to end cap 908 keeps spine 915.End cap 908 can be threaded, gluing, interference fit, welding and/or be laser-welded on the deflecting bar 906.In this embodiment, tubular medicated cap 908 is free of attachment to shell 907.But shell 907 extends and no show end cap 908 along bar 906.Identical with other embodiment, deflecting bar 906 can be made of and housing 907 can be made of the polymer of for example PEEK elastic material.The rigidity of shell 907 guard bars 906 and increase deflecting bar system 900, and bar 906 comprises the deflection and the recovery characteristic of elastic material.Those having ordinary skill in the art will appreciate that, other embodiment of deflecting bar system 900, the for example embodiment shown in Figure 68-71 or any other embodiment as herein described may be used in this embodiment of dynamic stabilization system 700 and do not depart from the scope of the present invention.

Figure 60 shows the connecting device 904 that is used for one embodiment of the present invention.Can see that connecting device 904 comprises: the C shape notch 910 that is used to receive the tubular end cap 908 of deflecting bar system 900; Be fastened to the slide tab 912 of connecting device 904 with tubular end cap 908 with the opening that can close C shape notch 910 with deflecting bar system 900.

With reference now to Figure 61,, provides the detail drawing of the connecting device 904 of this embodiment.Can see that connecting device 904 comprises C shape notch 910, this C shape notch comprises the groove 914 of the side surface 916 of two contiguous connecting devices 904.C shape notch 910 can be conformed to (as shown in Figure 60) with the shape of the end cap 908 of deflecting bar system 900 groove 914 thereby the circumference that receives end cap 908 keeps spine 915.This structure defines the motion of deflecting bar 900 in connecting device 904.Connecting device 904 also comprises L shaped lug holding device 918, and this lug holding device has along a pair of groove 820 of its inner surface and along the groove 922 of the following inner surface of C shape notch 910.L shaped lug holding device 918 and a plurality of groove 920,922 help slide tab 912 is fastened to connecting device 904, and this will be described in greater detail below.

With reference now to Figure 62 A and Figure 62 B,, illustrate in greater detail the embodiment of the slide tab 912 shown in Figure 60.The slide tab 912 of this embodiment comprises first end 924 and the second end 926.Slide tab 912 also comprises U-lag mouth 928, the collateral part 930 that is positioned at 924 places, end, the lip limit, the end 932 that is positioned at 926 places, end and back holding device 934.The first end 924 localized U-lag mouths 928 of contiguous slide tab 912 are parallel to the longitudinal axis location of slide tab 912.U-lag mouth 928 can squeeze the first end 924 of slide tab 912 to lump together in the L shaped lug holding device 918 (shown in Figure 61) that enters connecting device 904 when slide tab 912 is placed on its use location.Collateral part 930 is positioned on the side surface 936 of slide tab 912 and conforms to groove 920 (shown in Figure 61) along the inner surface of the lug holding device 918 of connecting device 904.The lip limit, the 924 localized end of the second end 932 of contiguous slide tab 912 meets and may be received in the groove 922 (shown in Figure 61) of the following inner surface of the C shape notch 910 of connecting device 904.With reference to figure 62B, can see that the rear surface 938 of slide tab 912 comprises sweep 940, this sweep can be constructed to meet the cylindrical shape of tubular end cap 908.The rear surface 938 of slide tab 912 can also comprise back holding device 934.In this embodiment, back holding device 934 can insert in the notch 948 (shown in Figure 64) in the vertical bar 902, thus with respect to the vertical bar 902 in connecting device 904 location so that in patient's body, use.Collateral part 930 and lip limit, the end 932 also help slide tab 912 is fastened to connecting device 904 (as shown in Figure 63).

Figure 63 shows and is in the connecting device 904 that it uses structure.As shown in the figure, the C shape notch 910 of connecting device 904 in deflecting bar system 900 is fastened to by slide tab 912.In this structure, collateral part 930 cooperates with groove 920 along the inner surface of lug holding device 918 and lip limit, the end 932 cooperates with groove 922 along the following inner surface of C shape notch 910, thus slide tab 912 is locked in its use location that is positioned at connecting device 904 and around tubular end cap 904 locking connecting devices 904.Therefore, vertically bar can be around end cap 904 rotations and then around the longitudinal axis rotation of torsion bar system 900.

As shown in Figure 64, the vertical bar 902 that is used for this embodiment of the present invention comprises vertical bar axle 944, be used to second notch 948 that receives first notch 946 of connecting device 904 and be used to receive the back holding device 934 of slide tab 912.Vertically bar 902 also comprises the aperture 950 that is used to receive screw, rivet or pin.In this embodiment, the rear portion of connecting device 904 can be configured as the shape that meets vertical bar 902.Therefore, vertically bar 902 can cooperate with connecting device 904 as shown in Figure 60, and screw, rivet or pin can by the aperture 950 of vertical bar 902 insert in the connecting devices 904 with vertical bar 902 is fastened to connecting device 904 and/or allow vertical bar 902 around screw, rivet or pin with respect to horizon bar 900 pivots (referring to arrow 905).Thereby can use before 918 fixings of tubular end cap are in C shape notch 910 back holding device 934 is remained in the notch 948 on slide tab 912 locking ground.

Figure 65-67 shows the deflecting bar system 1000 that can be used as the part of dynamic stabilization system 700, vertically another embodiment of bar 1002 and connecting device 1004.With reference now to Figure 65,, can see that deflecting bar system 1000 comprises deflecting bar 1006, it is similar to tubular end cap 1008 and shell 1007 that the embodiment shown in Figure 60 has the end that is attached to axle 1006.Should be understood that other embodiment that those having ordinary skill in the art will appreciate that deflecting bar system 1000, the for example embodiment shown in Figure 68-71 or any other embodiment as herein described may be used in this embodiment of dynamic stabilization system 700 and do not depart from the scope of the present invention.

Figure 66 shows the connecting device 1004 of this embodiment of the present invention.Can see that connecting device 1004 has: be positioned at the U-lag mouth 1010 on the first end 1012 of connecting device 1004; Be numbered 1014 clamping device usually on the second end 1016 that is positioned at connecting device 1004.U-lag mouth 1010 can be constructed to receive vertical bar 1002.In one embodiment, connecting device 1004 comprises the

aperture

1018,1020 that is used to receive pin or screw 1022 along the side of U-lag mouth 1010.In case vertically the aperture 1036 (Figure 67) of bar 1002 is placed in the U-lag mouth 1010, pin or screw 1022 aperture 1018 that just can insert connecting device 1004, thus 1020 and vertically in the bar 1002 with vertical bar 1002 with or fix or pivotable mode is fastened to connecting device 1004.Pin or screw 1022 can weldings, gluing, be threaded, interference fit and/or be laser-welded to connecting device 1004.

Clamping device 1014 comprises C shape arm 1024 and the C shape lock pawl 1026 that is attached to connecting device 1004 by pivot pin 1028 pivotally.Clamping device 1014 also comprises the clamping device dog screw 1030 of the position that can regulate lock pawl 1026.In this embodiment, the end cap 1008 of deflecting bar 1000 can be secured in the closed structure of clamping device 1014 as shown in Figure 65 between the C shape arm 1024 of connecting device 1004 and the lock pawl 1026 and by dog screw 1030 fix in position.Therefore, vertically bar can pivot around deflecting bar 1006 under end cap 1008 remains on situation in the clamping device 1014.

With reference now to Figure 67,, can see that the vertical bar 1002 that is used for this embodiment of the present invention comprises: cylindrical shaft 1032; Head 1034 with the aperture 1036 that is used to receive pin or screw; And the spacer portion 1038 between head 1034 and axle 1032.In this embodiment, vertically the head 1034 of bar 1002 conforms to the U-lag mouth 1010 of connecting device 1004.

The unify alternate embodiment of first horizon bar of deflection rod of the present invention

Figure 68-71 shows the another kind of embodiment of the deflecting bar system 1100 in the embodiment that can be used for dynamic stabilization system 700 as herein described.Deflecting bar system 1100 generally includes deflecting bar 1108 and two end caps 1104.As about shown in other embodiment, end cap 1104 for example can be tubular or sphere.Deflecting bar system 1100 can also comprise shell 1106.In one embodiment, deflecting bar 1108 is cylindrical and by the elastic material manufacturing of preferred Nitinol (NiTi).The diameter of deflecting bar 1108 is constant in this embodiment.In this embodiment, the shell 1106 of deflecting bar system 1100 is by biocompatible material or the polymer manufacturing of the preferred PEEK littler than deflecting bar 1108 elasticity.At this embodiment, the shell 1106 of deflecting bar comprises the hollow pipe of common taper.Central part 1110 towards shell 1106 increases the diameter of this pipe from the end 1118 of shell 1106.Can be provided with groove 1112 to help deflecting bar system 1100 remained in the bearing on the horizon bar, for example in the bearing 714 on the horizon bar among Figure 45 708 at the central part of shell 1106.Replace groove 1112, can limit the annular high platform or the table top (Figure 70) of maximum gauge with shell 1106.Groove 1112 or high platform may be received in the bearing 714 as the horizon bar system seen in Figure 48.In one embodiment, end cap 1104 can be by the bioavailable polymer manufacturing of titanium, rustless steel, for example PEEK or other biocompatible material.In this embodiment, end cap 1104 is tubular or cylindrical and comprise central groove 1114.

Deflecting bar 1108 can insert and make the end 1116 of deflecting bar 1108 extend beyond from the end 1118 of shell 1106 in the shell 1106 of deflecting bar system 1100.End cap 1104 can be attached to the end 1116 of deflecting bar 1108 then.The shell 1106 of deflecting bar is in order to protect by the deflecting bar 1108 of elastic material manufacturing and the motion of support and limit rod 1108.Shell 1106 also is used for reducing the strain on the deflecting bar 1108 when power puts on the end 1116 of deflecting bar 1108.When the end 1116 that puts on deflecting bar 1108 and when the strain that the whole length of deflecting bar 1108 is scattered increases, deflecting bar shell 1106 can tolerate along the strain of the whole length of shell 1106.The shell 1106 of deflecting bar system 1100 helps to limit maximum deflection amount and support and the protection deflecting bar 1108 that deflecting bar system 1100 is allowed.

Figure 70 and 71 shows other embodiment of deflecting bar system 1100.At first with reference to Figure 70, this embodiment of deflecting bar system 1100 is similar to the deflecting bar system 1100 that embodies in Figure 68.Yet in this embodiment, the middle body of deflecting bar shell 1106 comprises central rings opposite with groove or high platform 1120.With reference now to Figure 71,, this embodiment of deflecting bar system 1100 comprises the deflecting bar axle 1122 with constant diameter and has two end caps 1124 of constant diameter equally.Can see that in Figure 71 the diameter of deflecting bar axle 1122 is greater than the diameter of end cap 1124.It should be noted that identically with the deflecting bar system 1100 shown in Figure 68 and 69, the embodiment of the deflecting bar system shown in Figure 70-71 comprises aforesaid deflecting bar or core body 1108 and deflecting bar shell 1106.Embodiment shown in Figure 68-71 is not intended to limit, and can infer deflecting bar system 1100 and can comprise that those skilled in the art obviously and other embodiment that does not depart from the scope of the present invention.

Figure 72 A-73C shows the alternate embodiment of first horizon bar 708.With reference now to Figure 72 A,, a kind of embodiment of first horizon bar 708 is shown as and comprises: bearing 714; A pair of guiding or deflection limitation ring 1200; With near and be positioned at a pair of groove 1202 in guide ring 1200 outsides.In this embodiment, deflecting bar system 712 is fixed in the bearing 714 of first horizon bar 708.Deflecting bar system 712 further is contained in the guide ring 1200 of end of contiguous deflecting bar system 712.Guide ring 1200 can be used in use limiting the amount of deflection of deflecting bar system 712 and prevent that deflecting bar system 712 from excessively stretching out during use.In this embodiment, guide ring 1200 is vesica piscises, and wherein the vertical diameter of guide ring 1200 is greater than the horizontal diameter (Figure 72 C) of guide ring.Again, level is represented the horizontal alignment with respect to the patient who stands, and vertically represents being vertically oriented with respect to the patient who stands.The structure of guide ring 1200 allows the vertical deflection of deflecting bar system 712 greater than horizontal deflection.Can infer guide ring 1200 can have other structure and still fall within the scope of the present invention.

First horizon bar 708 also comprises groove 1202, and described groove can cooperate with the corresponding teat 1204 on the end cap 1206 that is positioned at vertical bar 716, thereby keeps end cap 1206 and/or vertical bar 716 to aim at when using in patient's body.Alternately, primary like this technique of alignment can be omitted.In this embodiment, vertically bar 716 comprises end cap 1206 and main vertical axes 1208, and wherein main vertical axes 1208 can be threaded onto in the end cap 1206.Be to be understood that and under the not attached situation of main vertical axes 1208, at first system horizontal inserted (as shown in Figure 72 B) among the patient.In case system horizontal is successfully inserted, 1208 of main vertical axes can be attached to end cap 1206, and wherein groove 1202 and teat 1204 can be used for aiming at and stable end cap 1206 (as shown in Figure 72 C) when inserting main vertical axes 1208 in the end cap 1206.

With reference now to Figure 73 A-73C,, shows the another kind of embodiment of first horizon bar.Can see that in Figure 73 A and 73B first horizon bar 708 of this embodiment comprises deflecting bar neck ring or sheath and the deflection guider 1210 that surrounds deflecting bar system 1100.This sheath and deflection guider 1210 also can be called as sheath 1210 and/or deflection guider 1210 in this article.Deflecting bar sheath and deflection guider 1210 preferably hard and inflexible (and for example by titanium manufacturing).Deflecting bar sheath and deflection guider 1210 can be used to protect deflecting bar 712 to avoid damaging during use.Further, as described herein, deflecting bar sheath and deflection guider can be used to guide, limit and limit the amount of deflection of deflecting bar.Deflecting bar system 1100 comprises the bar 1108 and the shell 1106 of the deflecting bar system 1100 that is used for as shown in Figure 69.Deflecting bar sheath and deflection guider 1210 can also be used to limit the amount of deflection of deflecting bar system 1100 and prevent that deflecting bar system 1100 from excessively stretching out during use.With reference now to Figure 73 C,, the inner surface 1212 that can see deflecting bar sheath and deflection guider 1210 is taper, wherein the diameter of the inner surface 1212 of deflecting bar sheath and deflection guider 1210 is bigger at central authorities 1218 places of deflecting bar sheath and deflection guider 1210 at 1214,1216 places, end of deflecting bar sheath and deflection guider 1210 ratio.In this structure, the surface of deflecting bar system 1100 can contact the inner surface 1212 of deflecting bar sheath and deflection guider 1210 during use.Therefore, deflecting bar shell 1210 can limit the motion of deflecting bar system 1100 and help and act on load and strain in the deflecting bar system 1100 along the whole distribution of lengths of deflecting bar system 1100.Equally in this embodiment, first horizon bar 708 comprises that hole 1220 is positioned at the deflecting bar system 1100 of deflecting bar sheath and deflection guider 1210 with encirclement, thereby makes that first horizon bar 708 has littler profile when among the implantation patient.Can infer deflecting bar system 1100 and can be installed to the horizon bar of any other type, this is conspicuous and do not depart from the scope of the present invention for a person skilled in the art.

Be used for vertical lever system is coupled to the alternate embodiment of the connecting device of second system horizontal

Figure 74-79B shows the embodiment that can be used for second horizon bar 710 in the above-mentioned dynamic stabilization system 700.With reference now to Figure 74,, can see two cylindrical shafts 1302 that horizon bar 710 generally includes main body 1300 and extends away from two sidepieces of main body 1300.Main body 1300 comprises the cylindrical notch 1304 and the nest portion 1310 that is used to receive cam 1312 of the

end

1306,1308 of contiguous main body 1300.In this embodiment, cylindrical notch 1304 is approximately perpendicular to cylindrical shaft 1302.Two cylindrical shafts 1302 can be connected to anchor system 702, and cylindrical notch 1304 can be used to receive vertical bar 716 and it is fastened to as shown in Figure 48 second horizon bar 710.

With reference now to Figure 75,, can see the nest portion 1310 that is used to receive the cylindrical notch 1304 of vertical bar 716 and is used to receive cam 1312 in more detail.As shown in Figure 75, cylindrical notch 1304 locatees and is approximately perpendicular to the vertical axis extension of second horizon bar 710 along the top surface 1314 of main body 1300.In this embodiment, otch 1316 is arranged in cylindrical notch 1304 belows so that allow the side of cylindrical notch 1304 to bear against together around vertical bar 716 at the use of second horizon bar 710 structure.

Be used to receive nest portion 1310 contiguous cylindrical notches, 1304 location of cam 1312.A purpose of cam 1312 provides a kind of machinery the sidepiece of cylindrical notch 1304 is born against together so that vertical bar 716 is fastened to second horizon bar 710.The nest portion 1310 of this embodiment comprises flat front surface 1318, circular rear surface 1320 and two round sides 1322,1324.Front surface 1318 comprises groove 1328, and back 1320 comprises groove 1326, and both may be used to help to keep cam 1312 to be fastened in second horizon bar 710.Preceding and rear surface 1318,1320 also exceeds side 1322,1324.In this structure, the cam 1312 with the first side lug 1330 and second side lug 1332 (as Figure 77 A, shown in the 77B) can insert in the nest portion 1310, and wherein place the side 1322,1324 of side lug 1330,1332 initial contiguous second horizon bars 710.When being placed on vertical bar 716 in the cylindrical notch 1304, thereby can reversing in the groove 1328 that cam 1312 is positioned at the first side lug 1332 front surface 1318 and the second side lug 1330 is positioned in the groove 1326 of rear surface 1320.In this structure, the first side lug 1332 of cam 1312 and the second side lug 1334 make cam 1312 be fastened to second horizon bar 710, and the sidepiece of cylindrical notch 1304 is closed toward squeezing together, thus vertical bar 716 are fastened to second horizon bar 710.In one embodiment, cam 1312 can also comprise taper spine 1334 (as Figure 77 A, shown in the 77B), and described taper spine further helps the sidepiece with cylindrical notch 1204 to squeeze around vertical bar 716 to be incorporated into together.

With reference now to Figure 76,, nest portion 1310 can also comprise aperture 1340, and aperture 1340 extends to the basal surface 1342 of second horizon bar 710 from the bottom surface 1336 of nest portion 1310.Aperture 1340 can comprise first 1344 and second portion 1346.In this embodiment, the diameter of the first 1344 in aperture 1340 is less than the diameter of the second portion 1346 in aperture 1340.The height of the first 1344 in aperture 1340 and diameter can be designed as and meet the shape that is positioned at the securing member on the bottom that can insert cam wherein.For example, the cam shown in Figure 77 A 1312 comprises the securing member 1348 on the bottom that is positioned at cam 1312.Cam securing member 1348 comprises the end 1350 of extending away from the main body 1352 of securing member 1348.In use, when securing member 1348 inserted in the aperture 1340 of nest portions 1310, securing member 1348 was clamp-oned up to its end 1350 firsts 1344 that extend beyond aperture 1340.In case the end 1350 of tightly returning part 1348 extends beyond the first 1344 in aperture 1340, securing member 1348 is replied their lax structure again, and engagement lip 1347, wherein 1340 first 1344 engages second horizon bar 710 to the main body 1352 of securing member 1348 along the aperture, and the end 1350 of securing member 1348 and engagement lip 1347 help prevent cam 1312 to break away from from second horizon bar 710.

Figure 78-79C shows a kind of alternate embodiment of cam 1354.With reference now to Figure 78,, the cam 1354 that can see this embodiment comprises top 1356, cylindrical body 1358 and is positioned at securing member 1360 on the bottom of cam 1354.Top portion 1356 further comprises restriction lug 1362 and is positioned at two side lugs 1364 between the groove 1366,1368.Figure 79 A shows and is force-fitted in the cam 1354 that is in its nest portion 1310 that does not use second horizon bar 710 in the structure.Cam 1354 is with top use by securing member 1360 is fastened to second horizon bar 710 about cam 1312 described same way as.Figure 79 B shows being in it and uses cam 1354 in second horizon bar 710 in the structure.In this structure, in case vertically bar 716 is placed in the cylindrical notch 1304 of second horizon bar 710, just can rotating cam 1354 aim at the groove 1328 of the front surface 1318 of nest portion 1310 and the restriction lug 1362 of cam 1354 is placed in the breach 1370 of front surface 1318 of nest portion 1310 up to the side lug 1364 of cam 1354.Side lug 1362 causes cylindrical notch 1304 sides to bear against together, thus vertical bar 716 is fastened to second horizon bar 710.

Figure 80-85 shows a kind of alternate embodiment that can be used for second horizon bar in the above-mentioned dynamic stabilization system 700.With reference now to Figure 80,, second horizon bar 1400 (before being shown as second horizon bar 710 in Figure 74) comprises that connecting device 1402 is to be fastened to vertical bar 716 with second horizon bar 1400.The connecting device 1402 of this embodiment comprises main body 1404 and rotation connecting rod 1406.Figure 81 and 82 shows this embodiment that is included in second horizon bar 1400 and the single parts in the connecting device 1402.

With reference now to Figure 81,, can see that the main body 1404 of connecting device 1402 comprises the C shape notch 1408 that is used for ccontaining rotation connecting rod 1406 along the front surface 1410 of main body 1404.Main body 1404 also comprises first aperture 1412 and second aperture 1416.Vertical bar 716 is located and be constructed to receive in first aperture 1412 along the rear surface 1414 of main body 1404.Second aperture 1416 be positioned at main body 1404 1418 places, top and can be by tapping to receive threaded fastening device or dog screw 1420.

With reference now to Figure 83,, can see that rotation connecting rod 1406 comprises the saddle groove 1422 that is positioned on its top surface, this groove 1422 is basically perpendicular to the longitudinal axis location of rotation connecting rod 1406.Saddle groove 1422 comprises the aperture 1426 that extends to basal surface 1428 from the top 1424 of rotation connecting rod 1406.At last, rotation connecting rod 1406 comprises the interior cylindrical hole 1430 that is used to receive second horizon bar 1400, and it is basically parallel to the longitudinal axis location of rotation connecting rod 1406.

Return with reference to Figure 80, can see being in this embodiment that it uses second horizon bar 1400 of structure.In this structure, second horizon bar 1400 inserts in the cylindrical hole 1430 of rotation connecting rod 1306.In this embodiment, second horizon bar 1400 can comprise double pointed nail 1432 (as shown in Figure 82), and described double pointed nail extends through along the aperture 1426 (as shown in Figure 83) of the basal surface 1428 of rotation connecting rod 1406 when second horizon bar 1400 inserts in the rotation connecting rod 1406.A purpose of alignment pin 1432 be keep rotation connecting rod 1306 to be positioned on the bar 1400 and its along bar 1400 vertically on and limitation of movement system on the circumference of bar 1400, this will be described in greater detail below.Can also see that in Figure 80 rotation connecting rod 1406 is placed in the C shape notch 1408 of main body 1404, vertically bar 716 is positioned in the saddle groove 1422 of rotation connecting rod 1406.In this embodiment, vertically bar 716 can insert in the 1414 localized apertures 1412, rear surface of main body 1404 perpendicular to second horizon bar 1400 and rotation connecting rod 1406.Vertically the degree in the bar 716 insertion apertures 1412 can change to adapt to concrete affected vertebra.Trip bolt 1420 is used for vertical bar 716 and rotation connecting rod 1406 are fastened to main body 1404.

As Figure 82, shown in 84 and 85, second horizon bar 1400 can also comprise that the part 1434 with screw thread or groove 1438 is to engage screw thread or the groove 1436 on the vertical bar 716.In this embodiment, screw thread on the part 1434 or groove 1438 engage the part 1436 of recessed, the threaded or trough of belt on the vertical bar 716 that is positioned at part 1,434 one sides.And double pointed nail 1432 extends at opposite side, and double pointed nail 1432 extends through along the aperture 1426 of the basal surface 1428 of rotation connecting rod 1406.In this structure, allow vertical bar 716 in the main body 1404 of connecting device 1402, to have limited vertical motion.Double pointed nail 1432 extends through the aperture 1426 of rotation connecting rod 1406, the degree of freedom of constrained motion and by means of the position of dog screw 1420 with respect to vertical bar 716 fixing horizontal bars 1400 thus.A kind of substituting embodiment of connecting device can be removed rotation connecting rod 1406, double pointed nail 1432, one or two in screw thread or groove 1438 and threaded or the trough of belt part 1436 or a plurality of any combinations.Should be understood that second horizon bar 1400 can be the straight-bar (as shown in Figure 84) with constant diameter, it can be made by hard and inflexible material (for example titanium).Should also be pointed out that the connecting device that also can use other type, this is conspicuous and do not depart from the scope of the present invention for a person skilled in the art.

More embodiments of dynamic spinal stabilisation systems of the present invention

The dynamic spinal of auxiliary spinal fusion is stablized closedtop (topping off) system

Illustrated and described the numerous embodiments of dynamic spinal stabilisation systems in this article.Figure 86 A-112 provides more embodiments of dynamic spinal stabilisation systems.Represent horizontal alignment for these embodiment levels with respect to the patient who stands, and vertical expression being vertically oriented with respect to the patient who stands.

With reference now to Figure 86 A,, the dynamic spinal stabilisation systems 1500 of this embodiment is the closedtop system 1500 that has the parts related with vertebra 1502,1504, and described vertebra is related with two intervertebral disc that can be adjacent discs.System 1500 comprises anchor system 1506, first horizon bar 1520 and deflecting bar 1522, the first pair of vertical bar 1516,1518, second pair of horizon bar 1512,1514 and second pair of vertical bar 1508,1510.First parts 1502 of system 1500 are used in combination with the spinal fusion process.During the spinal fusion process, for example, skeleton or the fusion cage of filling skeleton can be placed in the intervertebral disc space between the adjacent vertebrae.After after a while, described skeleton can be united with vertebra, forms solid fusion between adjacent vertebrae.In order to promote the spinal fusion process, first parts 1502 of system 1500 can be used to stablize affected vertebra.In order to realize this function, described a pair of vertical bar 1508,1510 can use the anchor system 1506 as shown in Figure 86 A to be fastened to the adjacent fused vertebrae for the treatment of.In this embodiment, can use any one anchor system as herein described.When between the vertebra and the fusion by intervertebral disc space when forming, vertically bar 1508,1510 is used to stablize, support and keeps expectation fractional dose between the adjacent vertebrae in this structure.

Second parts 1504 of system 1500 can be used as the closedtop parts, and it makes the transition between the vertebra of the integration region of spinal column and contiguous fused vertebrae gentle.This makes it possible to more gradual change ground carries out the transition to spinal column from the healthy part of spinal column the part that has merged.As shown in Figure 86 A, second parts of system 1500 comprise horizon bar 1512,1514, a pair of vertical bar 1516,1518 and first horizon bar 1520 and deflecting bar 1522, wherein horizon bar 1512,1514 is combined in first parts 1502 and second parts 1504 of system simultaneously.In this embodiment, described a pair of vertical bar 1516,1518, first horizon bar 1520 and deflecting bar 1522 can comprise any corresponding embodiment as herein described.In this embodiment, vertically the first end 1524,1526 of bar 1516,1518 is connected to deflecting bar 1522, and deflecting bar is attached to first horizon bar 1520.First horizon bar 1520 also is connected to a pair of anchor system 1506 as shown in Figure 86.It should be noted that for this embodiment and for other embodiment of this paper horizon bar 1520 can reach 360 degree (arrow 1570) locks in place in anchor 1506 then with respect to anchor 1506 rotations.This makes system 1500 can additionally meet the anatomical structure of patient's spinal column.

Referring now to the horizon bar 1512,1514 of this embodiment,, can see that horizon bar 1512,1514 is attached to the first end 1528,1530 of a pair of vertical bar 1508,1510 and the second end 1532,1534 of a pair of vertical bar 1516,1518 respectively.More specifically, the first end 1536,1538 of horizon bar 1512,1514 can pivotally be attached to the first end 1528,1530 of a pair of vertical bar 1508,1510.Figure 86 A has set up the referential that comprises x axle, y axle and z axle, and wherein the x axle all is basically parallel to patient's body and relative to each other vertical with the y axle, and the z axle is perpendicular to patient's body and perpendicular to x axle and y axle.In one embodiment, horizon bar 1512,1514 can be fixing with respect to vertical bar 1508,1510 and vertical bar 1516,1518.Alternately, horizon bar 1512,1514 can be constructed to around vertical bar 1508,1510 first end 1528,1530 pivot in the x-y plane, in system 1500 implanted after the x-y plane be basically parallel to patient's body (shown in double-head arrow 1552,1554).In this embodiment, when being connected respectively to a pair of vertical bar 1516,1518 o'clock, the second end 1540,1542 of horizon bar 1512,1514 is positioned between a pair of vertical bar 1508,1510.In another embodiment, when being connected respectively to a pair of vertical bar 1516,1518 o'clock, the second end 1540,1542 of horizon bar 1512,1514 can be positioned at the outside of a pair of vertical bar 1508,1510.A pair of vertical bar 1516,1518 the second end 1532,1534 also can be at horizon bar 1512,1514 first end 1536,1538 with the second end 1540,1542 between any position be attached to horizon bar 1512,1514 pivotally or directly be attached to horizon bar 1512,1514 second end 1540,1542.In this embodiment, vertically bar 1516,1518 can be constructed to the rotation around horizon bar 1512,1514 along the y-z plane, and the y-z plane is perpendicular to x-y plane (shown in double-head arrow 1556,1558).In this embodiment, independently connecting device 1544,1546 is used for horizon bar 1512,1514 is connected to a pair of vertical bar 1516,1518.

Vertical bar

1508,1510 can keep making that with the pivot between the corresponding

horizontal bar

1512,1514 is attached horizon bar can be pivoted relative to each other with vertical bar after implanting.In addition, can be provided with dog screw with after in implanting patient's spinal column with respect to corresponding vertically rod lock horizon bar, thereby make that it is inflexible connecting.Therefore, can be under situation with horizon bar and the vertically motility that can relative to each other move of bar implant system 1500, after implantation, can use dog screw relative to each other to lock the position of vertical bar and corresponding horizontal bar then.Alternately, vertically bar 1508,1510 and/or vertically bar 1516,1518 can be inflexible with connection between the corresponding

horizontal bar

1512,1514 and not allow motion between

vertical bar

1508,1510 and the corresponding

horizontal bar

1512,1514.

Be to be understood that in substituting

embodiment horizon bar

1512 and 1514 can change the single pole that is connected between the anchoring screw into.So vertically bar 1516,1518 will be connected to single pole.In substituting embodiment, single horizon bar can replace

horizon bar

1512,1514, and this single pole is connected to and is positioned between the vertical bar 1508,1510.Vertically bar 1516,1518 will be connected to the single horizon bar related with merging sections then.

With shown in Figure 68-71 identical with above-mentioned deflecting bar 1100, the deflecting bar 1522 that is preferred in this embodiment of the present invention can comprise inner core of being made by the elastic material of preferred Nitinol (NiTi) and the shell of being made by biocompatible material or the polymer of preferred PEEK, and the elasticity of shell is less than inner core.Alternately, deflecting bar 1522 can be made of elastic material.Further, can on deflecting bar, place sheath and deflection guider to form the deflecting bar system.

Figure 86 category-B is similar to Figure 86 A part and is, the system 1500 of this embodiment is intended to as the auxiliary or contiguous closedtop sections that merges sections.Has similar Reference numeral with the element of system among the similar Figure 86 B of element in the system among Figure 86 A.System 1500 among Figure 86 B comprises the deflecting bar 1522 that is installed on the horizon bar 1520.Horizon bar is installed to anchor 1506 at place, two ends, and described anchor can comprise bone screw anchor as described herein.The far-end of deflecting bar 1522 is fastened to vertical bar 1516,1518 by device as described herein.Vertically bar 1516,1518 is fastened to anchor as described herein or bone screw anchor 1506 at place, their relative separately ends.Horizon bar 1520 attached bone screw anchors 1506 itself are used for first vertebra, and the bone screw anchor 1506 that is positioned at the opposed end place of vertical bar 1516,1518 is used for preferably being close to second vertebra of first vertebra.This embodiment can use with emerging system, for example two threaded fusion cages 1580 that use between the 3rd vertebra of preferred second vertebra and vicinity.So second vertebra and the 3rd spinal vertebrae, this system 1500 is connected to first and second vertebras and is used for closedtop and merges, and first vertebra is dynamically fastening and stable with respect to the second and the 3rd vertebra that merges.

With reference now to Figure 87 A and 87B,, can see the rearview and the side view of system 1500.Particularly with reference to figure 87A, the system 1500 that can see this embodiment comprise deflecting bar 1522 with ripple or rib 1550 (Figure 88 A, 88B).More specifically the shell 1523 of deflecting bar 1522 comprises ripple or rib 1550.For the shell 1523 of the deflecting bar of for example being made by PEEK 1522, ripple or rib 1550 can machineds or are molded in the shell 1523.The character that has ripple of the shell of deflecting bar 1522 helps to increase during use or reduces or limit the flexible of deflecting bar 1522.In one embodiment, the ripple 1550 of the shell of deflecting bar 1522 has consistent shape and size (as shown in Figure 88 A) on the whole length of deflecting bar 1522.In another embodiment, the ripple 1550 of the shell of the deflecting bar 1522 of the bearing 1548 of close first horizon bar 1520 is than the ripple narrower (as shown in Figure 88 B) near second pair of vertical bar 1516,1518.In other words, ripple 1550 is narrower near the central authorities of deflecting bar 1522.In this structure, narrower ripple 1550 makes deflecting bar 1522 can deflect into bigger degree near the central authorities of deflecting bar 1522.Shape, size and the position of ripple 1550 that is to be understood that the shell of deflecting bar 1522 can change, so that limit the flexible of shell 1523 and deflecting bar 1522.Alternately, and as example, deflecting bar 1522 can have the narrower ripple of width 1550 away from bearing 1548 localized ends, and more can broad near bearing 1548 localized ripples 1550 so that provide bigger flexible at the far-end of deflecting bar 1522.The deflecting bar 1522 that also is to be understood that system 1500 can be constructed to consistent with the deflecting bar 1100 of other embodiment as herein described in addition.Further, can center on deflecting bar placement sheath and deflection guider to form the deflecting bar system.

The first-stage dynamic spinal stabilization system

Figure 89-104 shows the another kind of embodiment of deflecting bar of the present invention system and a level system preferably.One-level optimum system choosing ground be used to cross over an intervertebral disc space and be fastened to vertebra on this intervertebral disc space and this intervertebral disc space under vertebra.Level two is crossed over two intervertebral disc spaces, and system's the second and the 3rd vertebra of being attached to first and second vertebras that are positioned at the first intervertebral disc space both sides and being positioned at the second intervertebral disc space both sides.Although be to be understood that a level system will be attached to two adjacent vertebraes usually and level two will be attached to three adjacent vertebraes usually, in other embodiments, system also can be attached to non-conterminous vertebra.Therefore a level system can be fastened to non-conterminous two vertebras.Level two can be attached to some or all three vertebras not adjacent one another are similarly.In this embodiment, the deflection rod turnkey is drawn together the deflecting bar with the interior bar that has trocar sheath, and sheath and deflection guider are around the sleeve pipe location.With identical in other embodiment, sheath and deflection guider also can be called as sheath and/or deflection guider.As just example, interior bar can be by the elastic material manufacturing of for example Nitinol, and trocar sheath can be by the bioavailable polymer manufacturing of for example PEEK, and sheath and deflection guider can be by the biocompatible material manufacturings of for example titanium.In this embodiment, mounting bracket is equipped with or includes sheath and the deflection guider makes the deflecting bar system to be installed on the horizon bar easily.Thus, can be suitable for the support of other spinal implant system and the deflecting bar system is installed on various spinal implant systems and other skeleton implant system easily by change, thereby the novel speciality of this deflecting bar system is offered other system.In this embodiment,, screw anchor and horizon bar can be installed in patient's the spinal column, afterwards the deflecting bar system be installed to horizon bar because the deflecting bar system is not installed to horizon bar in advance.Such configuration can strengthen the easiness among such implantation patient of system.In addition, as described herein, the deflecting bar system can be designed as the flintiness with different sizes.By the selection of material and size, can and still provide under the situation of dynamic stability in the scope of structure the deflecting bar system is provided for spinal column from high rigid construction to high flexible.In other words, select to be installed in deflecting bar system on the horizon bar, flexible or the rigidity and/or the flintiness of expectation size is provided to the patient according to the rigidity of deflecting bar system or flintiness.Further, each deflecting bar system can have different flintinesses or rigidity or flexible.Therefore, on the par bar, the first deflecting bar system can have first flexible or flintiness or the rigidity, and the second deflecting bar system can have second different flexible or flintiness or the rigidity.Such configuration can be used for proofreading and correct because of the odd-shaped spinal column of for example skoliosis.

In Figure 89-91, the embodiment of system 1600 comprises anchor system 1602 (not shown dog screw), first horizon bar 1604, second horizon bar 1606,

vertical bar

1608,1610, deflecting

bar

1612,1614 and a pair of connecting device 1620,1622 (not shown dog screw) that

vertical bar

1608,1610 is connected to second horizon bar 1604, wherein, deflecting

bar

1612,1614 is installed in respectively in the sheath and

deflection guider

1616,1618 that is connected to first horizon bar 1604.Deflecting

bar system

1617,1619 in this embodiment can comprise intrinsic deflection bar, shell and sheath and deflection guider, and deflecting bar can comprise interior bar and shell.

Deflecting bar system

1617,1619 is between first and second horizon bars in this embodiment.

With reference to figure 89-92A, can see that first horizon bar 1604 comprises main body 1624 and two cylindrical shafts 1626,1628 that extend away from each side of main body 1624.First horizon bar 1604 also comprises a pair of screwed hole 1696,1698 (in Figure 95, can see), described screwed hole is near the end 1630 of main body 1624,1632 are provided with, be used to receive dog screw 1634, described dog screw is used for the sheath of deflecting bar system 1617,1619 and deflection guider 1616,1618 are fastened to first horizon bar 1604.In the use structure of horizon bar 1604, two cylindrical shafts 1626,1628 can be attached to anchor system 1602, are attached to the head or the dimple of the anchor system 1602 that inserts in the patient's vertebrae particularly.Horizon bar, particularly be positioned at the cylindrical shaft 1626,1628 of far-end can be in the head of screw anchor or dimple rotation so that as described herein advantageously with respect to patient's anatomical structure position level bar and deflecting bar system.Anchor system 1602 can comprise any one shown in this paper and/or in the described anchor system.In this embodiment, main body 1624 has cube mounting portion (Figure 95), and hole 1696,1698 is positioned at this place, and described part has far-end 1630,1632 and main body 1624 and has cylindrical central authorities between the cube mounting portion.Far-end 1630 and 1632 can provide retainer with help horizon bar to be positioned between the bone screw anchor.Cylindrical shaft 1626,1628 extends beyond far-end, and the bone screw anchor can be attached to cylindrical shaft 1626,1628 along the length of cylindrical shaft.Horizon bar can rotate with respect to anchor.

Can see that second horizon bar 1606 comprises the cylindrical bar with two ends 1636,1638.Identical with first horizon bar 1604, in the use structure of second horizon bar 1606, second horizon bar 1606 can be attached to anchor system 1602, especially is attached to the head or the dimple of the anchor system 1602 that inserts in the patient's vertebrae.Anchor can receive the

end

1636,1638 of second horizon bar 1606.Anchor system 1602 can comprise any one shown in this paper and/or in the described anchor system.In a preferred embodiment, first and second horizon bars 1604,1606 can be made by titanium, rustless steel or PEEK or other biocompatible material.

Should be noted that for this embodiment and other embodiment as herein described horizon bar is implanted and be installed between two bone screw anchors implanting in the vertebra under the horizontal tectonics with respect to upright patient.Be to be understood that the horizon bar that deflecting

bar system

1617,1619 for example is installed can be located between two bone screw anchors that are used for adjacent vertebrae in other structure.Horizon bar will be mounted vertically with respect to the patient that stands in this structure.Horizon bar can be installed in and make horizon bar with the angle setting between horizontal angle and vertical angle between the anchor in addition.Further as mentioned above, deflecting

bar system

1617,1619 itself can be installed to the spinal column of any amount or skeleton implant and within the spirit and scope of the present invention.

Vertically bar 1608,1610 comprises cylindrical shaft, and they have

first end

1640,1642 and the second end 1644,1646.Vertically bar 1608,1610 can be attached to second horizon bar 1606 near its

first end

1640,1642, and vertically the

second end

1644,1646 of

bar

1608,1610 can be attached to deflecting

bar

1612,1614, and this will be described in greater detail below.

With reference now to Figure 93,, illustrates in greater detail the connecting device 1620 that is used for vertical bar 1608 is connected to second horizon bar 1606.In this embodiment, can see that connecting device 1620 comprises the body 1648 of the substantially cylindrical that has bottom 1650, bottom 1650 has the aperture 1652 that can receive second horizon bar 1606.Body 1648 comprises the interior cylindrical hole 1654 of the longitudinal axis that is parallel to body 1648.At distal portion 1656 places of body 1648, hole 1654 is by tapping and can receive the dog screw (not shown).Sidepiece along body 1648 is aligned

U-lag mouth

1658,1660, and they 1654 run through body 1648 and extend to the hole from outer surface 1662.These

U-lag mouths

1658,1660 also lead to the distal portion 1656 of body 1648 so that make the screw thread by hole 1654 receive dog screw.In the use structure of system 1600,

U-lag mouth

1658,1660 is received in vertical bar 1608 in the body 1648, and the aperture 1652 in the bottom 1650 of connecting device 1620 receives second horizon bar 1606.Vertically bar 1608 can use dog screw to be fastened to connecting device 1620 to hide (cap off) interior cylindrical hole 1654.

With reference now to Figure 94 A,, illustrates in greater detail being connected between vertical bar 1608 and the deflecting bar 1612.Identical with the deflecting bar 720 shown in Figure 50 A-50B, deflecting bar 1612 comprises: bulb or joint 1664; Preferably by the interior bar of for example making 1666 such as the elastic material of Nitinol; With the shell of making by for example PEEK 1668.These elements can be assembled to sheath and deflection guider (not shown in Figure 94 A) to constitute the deflecting bar system in this embodiment.In this embodiment, vertically the second end 1644,1646 of bar 1608,1610 is shaped as the plate-like housing.In this embodiment, the first end 1670 of interior bar 1666 can pass the aperture 1672 that is positioned at the second end 1644 (the vertically plate-like housing of bar 1608), and wherein the diameter of interior bar 1666 is less than the diameter in aperture 1672.In case the first end 1670 of interior bar 1666 passes aperture 1672, just can by for example be threaded, welding, gluing, interference fit and/or laser welding technology be attached to bulb or joint 1664 with the first end 1670 of interior bar 1666.The diameter in aperture 1,672 1672 is return through the aperture to prevent bulb or joint 1664 less than the diameter of bulb or joint 1664.In case bulb or joint 1664 are positioned in the second end 1644 of vertical bar 1608, just retaining ring 1674 for example can be threaded, welding, gluing, interference fit and/or be laser-welded to the second end 1644 of vertical bar 1608, connect with ball-and-socket hinge style thus bulb or joint 1664 (and deflecting bar 1612) be fastened to vertical bar 1608 (as shown in Figure 94 B).In this structure, allow deflecting bar 1612 around rotating with corresponding center, the center of bulb or joint 1664 and/or tilting and/or rotational motion.

Return the 89-92A with reference to figure, the sheath and the deflection guider 1616,1618 that first horizon bar 1604 are fastened to deflecting bar 1612,1614 are general cylindrical and comprise arm 1676,1678.Pay close attention to sheath and deflection guider 1616, the arm 1676 that can see sheath and deflection guider 1616 for example uses that the securing member of screw 1634 is attached to first horizon bar 1604.(Figure 96) as described herein, sheath and deflection guider 1616 comprise the endoporus 1688 that is used to receive deflecting bar 1612, in this embodiment, hole 1688 is parallel to the longitudinal axis location of sheath and deflection guider 1616.Deflecting bar 1612 can by for example be threaded, welding, gluing, interference fit and/or laser welding technology be attached in the hole 1688 of sheath and deflection guider 1616.In one embodiment, because system 1600 comprises the left avertence bull stick system with sheath and deflection guider 1616 and has the independent right deflecting bar system that separates of sheath and deflection guider 1618, therefore can according to patient's the concrete needs deflecting bar system 1617,1619 that flintiness is different with connectivity mix and collocation in system.In the embodiment shown in Figure 89, comprise that the deflecting bar system 1617,1619 of sheath and deflection guider 1680,1682 is positioned between first horizon bar 1604 and second horizon bar 1606.In another embodiment, the deflecting bar system that comprises sheath 1680,1682 can be positioned at first horizon bar, 1604 tops and make before being fastened to second horizon bar 1606 vertically bar 1608,1610 and first horizon bar, 1604 crossovers, as shown in Figure 92 A.In another embodiment, sheath 1680,1682 are positioned at as shown in Figure 89 between first horizon bar 1604 and second horizon bar 1606, yet, vertical bar 1608,1610 can be attached to the outside (Figure 92 C) of the deflecting bar system of system 1600, opposite with the inboard that is positioned at deflecting bar system 1616,1618 as shown in Figure 89 and 92A.In Figure 92 A, interior bar 1612,1614 protrudes into outside the sheath and deflection guider of deflecting bar system, thereby towards each other or towards middle directed.Bar 1612,1614 protrudes into outside the sheath and deflection guider of deflecting bar system 1617,1619 in Figure 92 B, thus orientation or oriented sideways away from each other.By how deflecting bar system 1617,1619 is attached to horizon bar oppositely retrofit, the apparent vertically distance between the bar can be increased to the width shown in Figure 92 B from the width of Figure 92 A.If for the needs that dynamic stability especially bends right and left, this provides wideer attitude for implant.This also makes implant can be configured to adapt to various patients' various anatomical structures.Figure 92 C be similar to Figure 92 B part be in bar away from each other and more laterally protrude so that increase width between the vertical bar.In this embodiment, be used for the arm 1676,1678 that deflecting bar system 1617,1619 is fastened to horizon bar is positioned at the rear portion of deflecting bar system, away from interior bar from end that sheath and deflection guider protrude.

Figure 95 illustrates in greater detail a kind of embodiment of deflecting bar system 1619.In this embodiment, the arm 1678 of deflecting bar system 1619 comprises the U-lag mouth 1692 around first horizon bar 1604, thereby helps deflecting bar system 1619 is fastened to horizon bar 1604.The first arm 1678 also comprises the aperture 1694 that is used to receive screw 1634, and described screw is used for system 1619 is attached to first horizon bar 1604.Notch limits groove, described in this embodiment groove limits the cube space that can match with the cube zone of horizon bar to provide adaptive, described adaptive, thus deflecting bar system 1619 is locked onto the fixed position of horizon bar 1604 with dog screw.Should be appreciated that the shape of the mating part of shape by changing groove and horizon bar, make as described herein both to have a fit key slot type attached, like this can be with different orientation and fixed angle deflecting bar system position with respect to horizon bar.In addition, can a plurality of

holes

1696,1698 be set, so that according to the dynamic stability speciality of for example flintiness that is suitable for concrete patient of patient's anatomical structure and expectation and optionally locate deflecting

bar system

1617,1619 along horizon bar along horizon bar.

Figure 96 shows the cutaway view that passes through interior bar 1666 of a kind of embodiment of deflecting bar system 1617.Can see that in Figure 96 the interior bar of deflecting bar 1612 is cylindrical, and shell 1668 is for taper and therefore be constructed to from base portion 1686 towards shell 1668 end 1684 and narrow down gradually.This part ground for deflecting bar 1612 provide space 1688 with in use along with deflecting bar system 1617 from sheath and 1616 deflections of deflection guider.The inner surface 1690 of the sheath of deflecting bar system 1617 and deflection guider 1616 also serves as the guider of deflecting bar 1612 to limit the degree of deflection of deflecting bar 1612 effectively.In this embodiment, the inner surface 1690 of sheath 1616 forms coniform shape, and 1686 its diameters are more little the closer to the end, and 1684 its diameters are big more the closer to the end.Therefore, because the taper or the coniform shape of this coniform shape and shell 1688, deflecting bar 1612 can deflect into shell always and contact with inner surface 1690.Particularly, and as described herein, deflecting bar 1612 comes in contact up to the part of the shell of the deflecting bar inner surface with sheath along the length deflection of described deflecting bar.The further part of the more and more close end 1684 of shell still can also contact with the inner surface of sheath up to these further parts in deflection.Therefore, the stiff end along deflecting bar from deflecting bar of the coniform shape of the inner surface of sheath and deflection guider control deflecting bar is to the size and the position of the free-ended deflection of deflecting bar, and bar extends beyond the shell of deflecting bar in described free end.In one embodiment, according to the needs of user, for each side of system 1600, the deflection characteristic of deflecting bar 1612,1614 can be different.In other words, based on the deflecting bar 1612,1614 with different flintiness characteristics, a side of system 1600 can provide bigger exercise tolerance than opposite side, benefits the patient if this is configured with.This can help proofreading and correct the shape of the lopsided spinal column that can occur under scoliotic situation.

Again, Figure 96 shows the cross section by the whole deflecting bar system that comprises interior bar, shell and sheath and deflection guider.Obviously, the interior bar of the cross section of shell from the approximate midpoint of shell towards shell protrudes the end that surpasses to shell and reduces.When the measurement of longitudinal axis from sheath and deflection guider, the diameter of the inner surface of sheath and deflection guider increases along the direction that the interior bar towards the deflecting bar system protrudes the end that surpasses shell.In other words, in this embodiment, shell protrudes the position diameter minimum that surpasses shell about interior bar greatly, and has maximum gauge from the measurement of longitudinal axis sheath of sheath and deflection guider and the surface of deflection guider in roughly the same position.Therefore, the inner surface of shell and sheath and deflection guider restriction is as the boundary of the motion of the characteristic of the deflecting bar system of this design and flintiness and limit the scope of described motion and flintiness.The diameter and/or the diameter variation rate of the inner surface by changing shell and sheath and deflection guider can change these characteristics.Therefore, the diameter of diameter that for example can be by increasing shell and/or the inner surface by reducing sheath and deflection guider increases the flintiness of deflecting bar system, and reason is to leave place that shell extends at interior bar both are approaching.In addition, the diameter of bar will increase the flintiness of deflecting bar system in increasing, and the diameter that reduces interior bar will reduce the flintiness of deflecting bar system.The tapering of the inner surface of sheath and deflection guider can be constructed to the natural dynamic motion near spinal column, thereby gives spinal column in this zone with dynamic support.Except varying sized, the material that changes the parts that constitute the deflecting bar system also can influence the flintiness and the range of movement of deflecting bar system.For example, by titanium or steel make in bar with ratio as providing bigger flintiness by bar in the Nitinol manufacturing.Further, will provide more hard shell by the material manufacture shell harder than PEEK.

Figure 98 B is the figure of the preferred deflection of the deflecting force on the interior bar at bar place in the vertical bar of basis of bar and shell is connected in showing.In Figure 98 B, the diameter of PEEK shell is about 0.165 inch and be about 0.080 inch by the diameter of the interior bar of Nitinol manufacturing at its maximum gauge place.The active length of deflecting bar system is about 1.04 inches.The load of Figure 98 B/deflection figure or curve show that for the design of this deflecting bar system, load increases, and system responses is hard more.Figure 98 B provides the example to the concrete amount of deflection of fixed load in response spinal column and the deflecting bar system.For example can expect, the flintiness of this deflecting bar system can be manufactured to motion and the motion flexible, 50% scope of intact spinal column naturally and the motion flexible and 30% scope of intact spinal column naturally and flexible of 70% scope that can duplicate the intact spinal column of nature, thereby as becoming sets of plan to use for the doctor.For example be to be understood that the motion of different range, flexible and flintiness can be provided by the modification that this paper has pointed out.The curve chart of Figure 98 B shows the deflecting bar system more bigger than the deflecting bar system flintiness of 70% flintiness.Apparent from Figure 98 B, this curve is a nonlinear curve, and the maximum non-linear partial of curve increases and forms along with load.That is to say that response is applied on the spinal column and then is applied to load in the deflecting bar system, the flintiness of deflecting bar system increases along with load and increases in quicker and nonlinear mode.Therefore, the all mistakes of the deflection rod of this example provide certain range of movement and dynamic stability are provided, in this range of movement,, deflection increases along with increasing the load substantial linear ground that can bear, the load that can bear when deflection increases again increases more quickly with nonlinear way then, thereby dynamic stability is provided.In other words, when the load in the deflecting bar system or power increased, amount of deflection changed with nonlinear way or reduces and/or the rate of change of amount of deflection reduces with nonlinear way.Therefore, as shown in Figure 98 B and for this embodiment, when load or power began to put on the deflecting bar system by spinal column, the deflection of deflecting bar system was to the increase substantial linear ground response of load.After about 0.060 inch deflection, the deflecting bar system responds with nonlinear way.In this zone, for the equal deflection amount that obtains to realize before this point, bigger load or power need be applied in the deflecting bar system.Further, the rate of change based on the amount of deflection of the power that applies also can be a nonlinear function.Curve on this figure can as described hereinly customize based on the selection to size and material.Therefore, the deflecting bar system can be designed as the motion of other expectation percentage ratio of about 30% motion of about 50% motion of about 70% motion that intact spinal column for example is provided or intact spinal column or intact spinal column or intact spinal column.Further, in disclosed embodiment, the flexible and motion of left avertence bull stick system can be different from the deflecting bar system that install on the right side in the deflection response.

It should be noted that also can be by for example being adjusted into the inner surface of sheath and deflection guider the characteristic that symmetric shape that asymmetric (Figure 96 A) substitute Figure 96 changes the deflecting bar system.For example, can introduce in the deflecting bar system by inner surface will be setovered about the asymmetric setting of the longitudinal axis of interior bar 1666.Therefore, interior bar 1666 and shell 1668 can be in one direction than bigger at another direction upper deflecting.For example, if the top of inner surface than the lower part of inner surface further from the longitudinal axis of interior bar at interval, then deflecting bar is can deflection can deflection greatly and when spinal column stretches less when spinal column carries out flexing.It is big and less to the motion restriction of spinal column when the spinal column flexing when in fact, this is arranged in spinal extension to the motion of spinal column restriction.Similarly and for example, if the lower part of inner surface than the top of inner surface further from the longitudinal axis of interior bar at interval, then deflecting bar is can deflection can deflection greatly and when spinal column carries out flexing less when spinal column stretches.It is big and less to the motion restriction of spinal column when spinal extension when in fact, this is arranged in the spinal column flexing to the motion of spinal column restriction.

With reference now to Figure 97 and 98A,, can see the preferred size of the shell 1668 of deflecting bar 1612,1614.As shown in Figure 97,1684 total length is 0.950 inch to shell 1668 to the end from its base portion 1686.First of the base portion 1686 of the adjacent housings 1668 of shell 1668 comprises 0.165 diameter for 0.500 inch.The length (as shown in Figure 96) of the inner surface to sheath and deflection guider 1616 to be joined of shell 1668 is 0.20 inch.After first 0.500 inch of adjacent base 1686, shell 1668 beginnings are gradually narrow with 4.0 ° of angles towards the end 1684 of shell 1668.The active length of the interior bar 1666 of deflecting bar 1612 is about 0.840 inch.As shown in Figure 98, the diameter of interior bar 1666 is 0.080 inch and keeps constant on the whole length of deflecting bar 1612.

Multistage dynamic spinal stabilisation systems

Relative with single level system, may need to adopt multistage dynamic stabilization system.If this is the case, dynamic stabilization system 1600 for example can be constructed to cover in the multilevel system.The deflecting bar system that has horizon bar and vertical bar of twin-stage dynamic spinal stabilisation systems has been shown in Figure 99.

With reference now to Figure 99,, shows the dynamic spinal stabilisation systems 1700 that is used for multistage dynamic stabilization system.In this embodiment, at vertical bar 1706,1708 and vertically each end of bar 1710,1712 system 1700 that all has an anchor can constitute two-bed system, this two-bed system is attached to three preferred adjacent vertebras and leap and is limited to two intervertebral disc spaces between the vertebra.Anchor shown in Figure 99 can be deployed in the central vertebra and the anchor that is attached to vertical bar 1706 and 1708 will be fastened to the vertebra that is arranged on central vertebra one side, and the anchor that is fastened to other vertical bar 1710,1712 can be fastened to the vertebra on the opposite side that is positioned at central vertebra.Be to be understood that such system can cross over plural intervertebral disc space, the anchor that for example is attached to vertical bar be deployed in the non-conterminous vertebra of central vertebra in.Spare system can be configured and use in the spinal column with the system 1700 shown in two or more Figure 99.As just example, first and second systems 1700 can be with common vertical bar, for example vertically bar 1706 and 1708 tightens together.The anchor that extends from system 1700 can be fastened on other central vertebra of two branches.Other the vertical bar that extends from first and second systems, 1700 tops can use anchor to be fastened to the 3rd vertebra then, and the vertical bar that extends from first and second systems, 1700 belows can be fastened to the 4th vertebra.

System 1700 comprises the vertical bar of deflecting

bar system

1702,1704,

first pair

1706,1708, second pair of

vertical bar

1710,1712,

anchor system

1714,1716 and horizon bar 1718.

Deflecting bar system

1702,1704 comprises deflecting

bar

1720 and 1722 and 1724 and 1726 respectively.It should be noted that

vertical bar

1706 and 1708 can come the

vertical bar

1608,1610 of the system shown in Figure 89 1600 freely.System 1700 consists essentially of the parts identical with system 1600.Therefore,

anchor system

1714,1716, horizon bar 1718, vertically bar 1706,1708,1710 and 1712 and deflecting

bar

1720,1722,1724 can be identical with 1726 physical characteristic with similar homologue as herein described.

Deflecting bar system 1702,1704 in the system 1700 is attached to vertical bar 1718 to be similar to herein about system's 1600 described similar manners.Further, the sheath of the first deflecting bar system 1702 and deflection guider 1728 and 1730 usefulness common arm 1729 tighten together, and described common arm comprises can receive the hole 1731 that is used for the deflecting bar system is fastened to the screw of horizon bar.Similarly, deflecting bar system 1704 can comprise the deflecting bar 1732 and 1734 that tightens together by the arm 1733 that comprises hole 1735.Another screw can be disposed and pass hole 1735 so that the second deflecting bar system is fastened to horizon bar.Deflecting bar system 1702,1704 comprises sheath and deflection guider 1728,1732 and sheath and deflection guider 1730,1734 respectively.These sheaths and deflection guider comprise the endoporus 1736,1738 and 1740,1742 that is used to receive deflecting bar 1720,1722 and 1724,1726 respectively, and described deflecting bar has the shell that is provided with around deflecting bar.Sheath and deflection guider 1728,1730 and 1732,1734 are positioned at the both sides of horizon bar 1718 and are parallel to horizon bar 1718 location.Vertically bar 1706,1708 is attached to deflecting bar 1720,1721 and extends vertically away from deflecting bar system 1702,1704.Vertically bar 1710,1712 is attached to deflecting bar 1722,1726 and extends vertically away from deflecting bar system 1702,1704 along the opposite direction of vertical bar 1706,1708.In one embodiment, a pair of or two pairs of another horizon bars that are attached to adjacent vertebrae that are fastened to as shown in Figure 89 in the vertical bar 1706,1708 and 1710,1712.In another embodiment, vertically a pair of in the bar 1706,1708 and 1710,1712 or two pairs be attached to be similar to connecting device 1702,1704 another to the deflecting bar system, thus along producing a series of deflecting bar system between a plurality of vertebras of spinal column.In another embodiment, vertically a pair of in the bar 1706,1708 and 1710,1712 or two pairs are connected to the deflecting bar 1612,1614 that is connected with another horizon bar 1604.In another embodiment, vertically pole pair can be connected to the bone anchors fixing apparatus.In another embodiment, vertically bar 1706,1708,1710 and 1712 can be attached to deflecting bar outwards or the system 1700 of oriented sideways.

With reference now to Figure 100 A,, 100B and 100C can see two sheaths of deflecting bar system 1702,1704 and the cutaway view of deflection guider 1730,1734 and deflecting bar 1724,1726.As Figure 100 A, (and as previously described herein) shown in 100B and the 100C, deflecting bar 1722,1726 comprise interior bar and shell, and can see that shell is in deflecting bar system 1702, slightly tapered in 1704 sheath and the deflection guider 1730,1734 to allow deflecting bar 1722,1726 deflection therein.And, can see that deflecting bar 1722,1726 includes interior bar 1740,1742 and the preferred shell of preferably being made by the elastic material of for example Nitinol of being made by PEEK 1736,1738.As shown in Figure 100 C, can see that deflecting bar system 1702,1704 comprises the U-lag mouth 1744,1746 that surrounds horizon bar 1718, thereby help connecting device 1702,1704 is fastened to horizon bar 1718.Can also see that sheath and deflection guider 1730,1734 comprise the inclined-plane 1748,1750 of contiguous anchor system 1716.Inclined-plane 1748,1750 makes deflecting bar system 1702,1704 have low profile with respect to anchor system 1716, still allows anchor system 1716 to be connected to horizon bar 1718 with different angles simultaneously and contact arm 1730,1734 not.

The dynamic stabilization system that Figure 101 A and 101B show deflecting

bar

1720,1722 and 1724,1726 side direction and point to away from each other.The interior bar of deflecting bar is towards side direction rather than towards middle directed in these embodiments.Such result is that

vertical bar

1706,1710 and 1708,1712 can be more towards side direction but not towards interfix, thereby changes the dynamic stability of system and make system's rigidity more when bending right and left.Embodiment among Figure 101 A and the 101B is similar to the embodiment among Figure 92 C and the 92B respectively on theory, the interior bar that is deflecting bar along side direction rather than third side to extending beyond shell.In the embodiment of Figure 101 A and 101B, each deflecting bar system includes two sheaths and the deflection guider that has the D.D bar, and described deflecting bar comprises shell and the interior bar in each that is positioned at two sheaths and deflecting bar.In Figure 101 A,

common arm

1729,1733 is extended from the position at the rear portion of sheath and the extension of deflection guider away from deflecting bar from the deflecting bar system.

With reference now to Figure 102,, can see the cutaway view of a kind of embodiment of horizon bar 1718 and deflecting bar system 1702.In this embodiment, the part of the contiguous deflecting bar system 1702 of horizon bar 1718 is cylindrical.Can also see that horizon bar 1718 comprises a plurality of teeth or spline 1752 along its outer surface.In this structure, tooth 1752 can be bonded in the notch 1744 of deflecting bar system 1702 by deflecting bar system 1702, and described notch correspondingly is constructed to receive the tooth 1752 of horizon bar 1604.This structure makes deflecting bar system 1702 locate and to be fastened to horizon bar 1718 with different angles with respect to horizon bar 1718.In Figure 102, tooth 1752 is shaped as similar triangle, but should be appreciated that tooth 1752 can have the Any shape of various gear shapes for example and still contains within the scope of the invention.

With reference now to Figure 103,, 104, show the vertical view of a kind of embodiment of deflecting bar system 1702.In this embodiment, be different to have and be used to receive the single hole that deflecting bar system 1702 can be fastened to the screw of horizon bar 1718, the deflecting bar system 1702 of this embodiment comprises a plurality of

holes

1754,1756,1758, be used for receiving screw along the diverse location place of deflecting bar system 1702 or being used in two or more holes receiving a plurality of screws in 1754,1756,1758.This can be for the surgeon provides greater flexibility when implanting system 1700 among the patient, and reason is a side or the opposite side that can to a greater degree the deflecting bar system be placed into horizon bar.

Except that single hole 1756 is microscler and comprises and be used for trip bolt is fixed the scallop of several position that Figure 104 is similar to Figure 103.Dog screw can be fixed three diverse locations between scallop in the embodiment of Figure 101 B.Therefore, in central scallop, identical with the situation of screw in the medium pore of Figure 101 A for screw, the deflecting bar system can be placed in the middle on horizon bar.In one of scallop hole that is arranged in central scallop hole both sides or be positioned in the hole 1754,1758 (Figure 103) of both sides of medium pore 1756, the deflecting bar system can move with respect to horizon bar for screw.That is to say that in this embodiment, the deflecting bar system can move straight up or straight down, so that adapt to the anatomical structure of the spinal column of the position that is arranged in anchoring screw implantation spinal column.

Figure 105 shows another embodiment of dynamic spinal stabilisation systems.Can see that system 1900 comprises: vertical bar 1902; The bone screw 1904 that comprises head 1906 with endoporus 1908; With deflecting bar 1910.The deflecting bar of bar and shell constitutes deflecting bar system 1905 together with lumping together the sheath that is similar in other embodiment and the foraminous head of being with of deflection guider in comprising.This deflecting bar system 1905 can be similar to deflecting bar as herein described system on Design and Features.In this embodiment, the deflecting bar system be combined in the head of bone screw anchor and with the axis conllinear of the bar portion of bone screw anchor or coaxial with the axle of the bar portion of bone screw anchor.For such layout, it is the adjacent deflecting bar system that adjacent vertebra can be fastened to the anchor implanted in the adjacent vertebrae that system 1900 can not need to have horizon bar, reason in some constructions.In this embodiment, the vertical bar 1902 of system is directly fastened to bone screw 1904 by deflecting bar 1910, is different to be attached to horizon bar, and horizon bar is attached to the anchor system with bone screw again, for example as shown in Figure 48.More specifically, deflecting bar 1910 comprises first end 1912 and the second end 1914, as shown in Figure 106.Vertically bar 1902 is attached to the first end 1912 of deflecting bar 1910, and in the endoporus 1908 that the second end 1914 of deflecting bar 1910 inserts in the anchoring screw heads 1906 and for example by be threaded, in the head of welding, gluing, interference fit and/or the attached anchoring screw 1094 of laser welding technology.In one embodiment, vertically bar 1902 pivotally is attached to deflecting bar 1910, and wherein vertically bar 1902 can pivot around the axis corresponding with the longitudinal axis of anchoring screw 1904.This pivot to connect can for example be as other embodiment of this paper seen in spherically dispose with the nest shape.

With reference now to Figure 106,, in one embodiment, can see that the endoporus 1908 in the anchoring screw head 1906 is taper and/or coniform shape, and the diameter of endoporus 1908 in the hole 1908 first end 1916 places than in the hole 1908 the second end 1918 places bigger, as top about as described in Figure 96.Therefore, allow deflecting bar 1910 deflection in the head 1906 of anchoring screw 1904, and the inner surface 1920 of head 1906 serves as the traction guider of deflecting bar 1910 to limit the maximum deflection degree of deflecting bar 1910 effectively.

With reference now to Figure 107,, shown a kind of embodiment of system 1900.In this embodiment,

vertical bar

1922,1924 respectively by anchoring

screw

1930,1932 and 1934,1936 are attached to

adjacent vertebrae

1926,1928, wherein deflecting bar with top about Figure 105 and 106 described same way as with

vertical bar

1922,1924 are connected respectively to anchoring

screw

1930,1932 and 1934,1936.Therefore, in this structure of system 1900,

adjacent vertebrae

1926,1928 is all relative to each other stable, and the motion between the

adjacent vertebrae

1926,1928 simultaneously is retained.

The method that method for implantation and modification are implanted

A kind of that method in the described implantation patient's of system the spinal column is as follows.At first confirm to treat the vertebral levels of receiving system.Implant anchor system then, usually two anchor systems of each sections.Can implant anchor system by intubate and by means of the guiding imaging of for example x radial imaging.Alternately, can use traditional spinal operation method to implant anchor system.Usually laterally insert horizon bar then and it is fastened to anchor system.Can or for example import cone via intubate and laterally insert horizon bar by notch and use.Alternately, can adopt routine techniques and after the step of before implantation anchor system, insert horizon bar.Then, vertical bar can be connected to proper level bar or vertical bar pivot changeed, rotates or be placed to be communicated with the proper level bar and be fastened to described proper level bar.

If for example the dynamic stabilization system of system 100 is originally implanted, wish to make more rigidity or realize merging of system then, can comprise the horizon bar 104 of deflecting bar or load beam and it comes modification system 100 with having vertical rod bearing (Figure 34) thereby 106 replacements of obviously more inflexible horizon bar by removal.Therefore can be so that the minimized mode of wound of the skeleton of spinal column and organizational structure be implemented to the transformation of fusion constructs.

For the system 1600 as shown in Figure 92 A, anchor and horizon bar dispose finish after, can single deflecting

bar system

1617,1619 be fastened to horizon bar by dog screw 1634.Can use as herein described connecting device

vertical bar

1608,1610 be fastened to second vertical bar thereafter.

Another kind of single-stage dynamic spinal stabilisation systems

Figure 108 A-111B shows another embodiment of single-stage dynamic spinal stabilisation systems 2000 of the present invention.Be constructed to single level system although should be appreciated that this embodiment, under the situation of removing second horizon bar, this system can combine with spinal fusion device as described herein as the closedtop system.System 2000 comprises first and second horizon bars 2004 and 2006 of the head that is fastened to bone screw anchor system 2002.System 2000 also comprises the first and second deflecting bar systems 2017,1019, described deflection rod turnkey is drawn together the interior bar that constitutes deflecting bar 2012,2104 and shell and covering and in this embodiment around deflecting bar 2012,2014 sheath and deflecting bar guider 2016,2018.System 2000 comprises the vertical bar 1608,1610 that is connected to deflecting bar.In this embodiment, deflecting bar system 2017,2019 can be manufactured into prefabricated unit and offer the surgeon so that implant by the horizon bar that is fastened to implantation.Alternately, the surgeon can be assembled into horizon bar with the deflecting bar system in advance before implanting horizon bar among the patient.Horizon bar can with shown in dog screw be fastened to anchor, and the deflecting bar system can be fastened to first horizon bar with dog screw 2034.Vertically bar 1608,1610 can be connected to second horizon bar with connecting device 2020.Connecting device 2020 (Figure 110) comprises the J-shaped opening that can receive second horizon bar and can receive the port 2042 of vertical bar.Further, connecting device 2020 can comprise the screwed hole 2044 that can receive dog screw 2046.Second bar and vertically bar be received under the situation in the connecting device 2020, can tighten dog screw 2046, thereby be pressed against vertical bar on the horizon bar securely and be pressed against on the connecting device 2020.In addition, the part of level that all locks together and vertical bar and connecting device and dog screw can be annular knurls, so that become the part of locking mechanism when needed.

Figure 111 A shows the vertical view of deflecting bar system 2019, and Figure 111 B shows along the cutaway view of the deflecting bar system 2019 that the longitudinal axis of deflecting bar obtains.Preferably deflecting bar system 2019 is assembled in advance.Figure 111 B shows the preferred size of this embodiment.In this embodiment, preferred size comprises:

About 0.080 inch of the diameter of interior bar.

The full diameter of shell about 0.165 inch and tapering part are gradually narrow with about 2.5 degree in every side.

About 0.265 inch of the ccontaining diameter of sheath and deflection guider.

Deflecting bar is fastened to the deflection guider from the end of deflecting bar system along about 0.200 inch length.

The deflecting bar system has from the end of system central about 1.040 active length to ball pivot, and interference fit length is little more about 0.200 than it, and interference fit length is about 0.840.

The total length of deflecting bar system is about 1.100 inches.

Vertical bar is fastened to about 0.188 inch of the diameter of the sphere of deflecting bar system and the bulb in the nest shape joint.

Vertically the diameter of bar is about 0.150 inch.

The material of embodiments of the present invention

Except Nitinol or Nitinol (NiTi), other elastic material comprises cu-zn-al alloy and Batterium.Yet for the biocompatibility Nitinol is a preferable material.

As required, implant can be partly by titanium or rustless steel manufacturing.As just example, other suitable material comprises polyether-ether-ketone (PEEK), PEKK (PEKK), polyether-ketone (PEK), polyetherketoneetherketoneketone (PEKEKK) and polyether ether ketone ketone (PEEKK).Again more specifically, material can be PEEK 450G, it is to check and approve to be used for the not filling PEEK that medical treatment is implanted, and can buy (the Victrex address is www.matweb.com or sees Boedeker www.boedeker.com) from the Victrex company in Britain Lancashire city.Other source of this material comprises the Gharda company (www.ghardapolymers.com) that is positioned at India Panoli city.

Those skilled in the art will appreciate that, but can use endurance, have good Memorability, have flexible and/or deflection, have other suitable similar bio-compatible thermoplastic materials or thermoplastic condensed polymer's material of very low hygroscopicity and excellent durability and/or wearability, and not depart from the scope of the present invention.

Can be for the suitable polymers that can be used for spacer portion with reference to following document.These documents comprise: on January 10th, 2002, disclosed name was called the PCT communique No.WO 02/02158A1 of " BIO-COMPATIBLEPOLYMERIC MATERIALS "; On January 3rd, 2002, disclosed name was called the PCT communique No.WO 02/00275A1 of " BIO-COMPATIBLE POLYMERICMATERIALS "; With disclosed PCT communique No.WO 02/00270A1 that is called " BIO-COMPATIBLE POLYMERIC MATERIALS " on January 3rd, 2002.

The above description of preferred implementation of the present invention is provided for explanation and describes.It is not to be intended to exhaustive or to limit the invention to disclosed exact form.Many embodiments are selected and describe so that explain principle of the present invention and practical application thereof best, make others skilled in the art can understand various embodiment of the present invention and the various modifications of the application-specific that is suitable for expecting thus.Scope of the present invention should be limited by claim and equivalent thereof.

Claims

1. spinal implant comprises:

Be suitable for being inserted into the anchor in patient's the skeleton;

Anchor head from described anchor extension;

Described anchor head comprises the deflection guider, is formed with deflection guiding hole in the described deflection guider; And

Be located at the deflecting bar in the described deflection guiding hole.

2. implant according to claim 1 comprises:

Bar and shell in described deflecting bar comprises.

3. implant according to claim 1 comprises:

Bar and shell in described deflecting bar comprises;

Described shell is coniform shape; And

Described deflection guiding hole is coniform shape.

4. implant according to claim 1 comprises:

Bar and shell in described deflecting bar comprises;

Described shell is coniform shape, and the size of its diameter reduces along the direction away from described anchor; And

Described deflection guiding hole is coniform shape, and the size in described hole increases along the direction away from described anchor.

5. implant according to claim 1 comprises:

Described anchor head comprises towards the end of described deflection guiding hole opening;

Bar and shell in described deflecting bar comprises; And

Bar extends beyond the described end of described anchor head in described.

6. implant according to claim 1, wherein, described deflecting bar is made of elastic material.

7. implant according to claim 2, wherein, described interior bar is made of elastic material.

8. implant according to claim 2, wherein, described interior bar is made of elastic material, and described shell is made of bioavailable polymer.

9. implant according to claim 2, wherein, described interior bar is made of Nitinol and described shell is made of polyether-ether-ketone.

10. implant according to claim 2, wherein said interior bar has more deflection than described shell.

11. implant according to claim 1, wherein, described anchor and described deflecting bar are conllinear.

12. an implant that is suitable for implanting in patient's spinal column comprises:

The sheath that has the sheath hole;

Be installed in the deflecting bar in the described sheath hole, described deflecting bar can deflection in described sheath hole, and the motion of described deflecting bar is subjected to described sheath hole confinement;

Be positioned at the connecting device at the place, end of described deflecting bar;

Be connected to the bar of described connecting device; And

Bearing from described sheath extension.

13. implant according to claim 12 comprises:

Bar and outer sleeve in described deflecting bar comprises.

14. implant according to claim 12 comprises:

Described deflecting bar comprises the interior bar made by elastic material and the outer sleeve of coniform shape.

15. implant according to claim 12 comprises:

Can with place described in the outer sleeve of the coniform shape that distributes along described bar of load on the bar.

16. implant according to claim 12, wherein, described sheath hole is coniform shape.

17. implant according to claim 12, wherein, bar and shell in described deflecting bar comprises, described interior bar extends beyond described shell and extends to outside the described sheath hole.

18. an implant that is suitable for implanting in patient's spinal column comprises:

The deflecting bar system, it comprises the deflecting bar with deflection nonlinearity-load characteristic.

19. implant according to claim 18 wherein, places the load in the described deflecting bar system big more by patient's spinal column, described deflecting bar deflection must be more little.

20. implant according to claim 18, wherein, the load characteristic of described deflecting bar in initial load zone for linear be nonlinear at another load area then with more high capacity.

21. implant according to claim 18, wherein, described nonlinear deflection-load characteristic depends on the size of described deflecting bar system.

22. implant according to claim 18 wherein, places the load in the described deflecting bar system big more by patient's spinal column, it is hard more that described deflecting bar becomes.

23. implant according to claim 18, wherein, described deflection rod turnkey is drawn together the interior bar that has shell.

24. implant according to claim 18, wherein, described deflection rod turnkey is drawn together the interior bar that is made of elastic material and the shell of coniform shape.

25. implant according to claim 18, wherein, described deflection rod turnkey is drawn together the interior bar of the shell that has coniform shape and is had the sheath in sheath hole, and the shell of described interior bar and outer conical shape is installed in the described sheath hole.

26. an implant that is suitable for implanting in patient's spinal column comprises:

The body that comprises sheath, described sheath has the sheath hole, and

Be installed in the deflecting bar in the described sheath hole,

Described deflecting bar can be in described sheath hole the motion of deflection and described deflecting bar be subjected to described sheath hole confinement, and

Described deflecting bar has nonlinear deflection-load characteristic.

27. implant according to claim 26 comprises:

Bar and outer sleeve in described deflecting bar comprises.

28. implant according to claim 26 comprises:

29. implant according to claim 26 comprises:

30. implant according to claim 26, wherein, described sheath hole is coniform shape.

31. the implant in patient's spinal column is implanted in a position that is suitable for contiguous spinal fusion implant, comprising:

The deflecting bar system, it comprises interior bar, centers on the described interior localized shell of bar and centers on the localized sheath of described shell;

The deflection of bar and described shell in described sheath restriction is described;

Bearing;

The bone anchors fixing apparatus;

The described bearing of all mistakes of described deflection rod is fixed to described bone anchors fixing apparatus;

Connecting device;

Bar;

Bar has first end in described, and described first end extends beyond described shell and described sheath;

Described connecting device is fastened to described bar the described first end of described interior bar; And

Described bar comprises among the vertebra that is suitable for being fastened to the spinal fusion implant and being fused to another vertebra, so that the transition between the spine regions in spinal fusion zone and contiguous described spinal fusion zone is eased up.

32. implant according to claim 31 comprises:

Another bone anchors fixing apparatus and the bar that is connected described bone anchors fixing apparatus and described another bone anchors fixing apparatus; And

Described deflecting bar system is connected to described bar.

33. implant according to claim 31, wherein,

Described sheath has from the described bearing of described sheath extension and the bar that extends from described anchor, and described bearing is connected to described bar.

34. implant according to claim 31 comprises:

Described deflecting bar system directly is fastened to described anchor by described bearing.

35. implant according to claim 31 comprises:

Described bearing is located in the described bone anchors fixing apparatus.

36. implant according to claim 31 comprises:

Described bearing is located on the described bone anchors fixing apparatus.