CN102697586B - 植入物 - Google Patents

植入物 Download PDF

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CN102697586B
CN102697586B CN201210078942.2A CN201210078942A CN102697586B CN 102697586 B CN102697586 B CN 102697586B CN 201210078942 A CN201210078942 A CN 201210078942A CN 102697586 B CN102697586 B CN 102697586B
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implant
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CN102697586A (zh
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T·温克勒
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Ulrich GmbH and Co KG
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/302—Three-dimensional shapes toroidal, e.g. rings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30624—Hinged joint, e.g. with transverse axle restricting the movement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30624—Hinged joint, e.g. with transverse axle restricting the movement
    • A61F2002/30634—Hinged joint, e.g. with transverse axle restricting the movement biaxial

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Abstract

本发明涉及一种植入物，用于***脊柱的脊椎体之间，该植入物带有植入部件(1)，该植入部件(1)在其自由的端部的至少一个处具有端部环(2)。端部环(2)以可绕第一轴线(3)摆动的方式支承在以可绕第二轴线(4)旋转的方式支承在植入部件(2)上的环(5)上，其中，第一轴线(3)和第二轴线(4)以彼此不平行的方式定向。

Description

植入物
技术领域
本发明涉及一种用于***脊柱的脊椎体之间的植入物，其带有植入部件(Implantatteil)，植入部件在其自由的端部的至少一个处具有端部环。
背景技术
当脊椎体及其从属的椎间盘遭受退化的或创伤的疾病时，应用这种类型的植入物以用于替代一个或多个脊椎体及其从属的椎间盘。
因为椎间盘使脊柱的运动性成为可能，因此在用于替代脊椎体的植入物中令人感兴趣的是，尽可能稳定地且尽可能可动地设计该植入物。
已经从文件WO 2010/145627中已知代表该问题的植入物，其中，贴靠在脊椎体的端板(Endplatte)处的植入物的板在指向植入部件的侧边上显示出旋转对称的凹入部(Ausnehmung)，其穿过侧壁在植入部件的通过环槽限制的环形凸缘(Ringbund)处被引导。这种类型的植入物允许板的不同的角度位置或定向，然而具有的缺点为，在板相对于植入部件倾斜(Verkippen)时其可卡住(verkanten)。可仅仅通过在相反的侧边上在板处的非常大的压力再次处理该卡住。
发明内容
因此本发明的目的为，如此构造开头提及的类型的植入物，即，保证板的角度可变的且不太受阻的运动。
在开头提及的类型的植入物中，该目的通过以下方式实现，即，端部环以可绕第一轴线摆动的方式支承在以可绕第二轴线旋转的方式支承在植入部件上的环上，其中，第一轴线和第二轴线以彼此不平行的方式定向。
与该实施形式相关的优点为，实现无级的且无限制的运动性并且由此实现与端板几何形状和端板角度的最好的匹配。通过无级地与端板角度匹配可避免逐点的(punktuell)峰值负载并且避免由此引入的到脊椎体中的侵入。该多轴的接头(Gelenk)至少部分地维持脊柱的运动性。此外，在应用时得到更高的精度。与传统的作为脊椎体替代物起作用的植入物相比，本发明的植入物由更少的部件组成。可利用唯一的植入物覆盖多个角度位置，其中，保证简单地选择正确的植入物、简单地操纵植入物以及更少的存放(Lagerhaltung)。
已证实为有利的是，第一轴线和/或第二轴线分别垂直于植入物纵轴线定向，由此实现简单地建立支承(Lagerung)。在此可能的是，第一轴线和第二轴线距离植入物的面对端板的端部不一样远，即，其布置成轴向上错位。
此外有利的是，第一轴线和第二轴线如此定向，即，以未偏转的方式展开平面。由此，第一轴线和第二轴线相交，其结果为可靠的应用。
通过在植入部件处的环形凸缘的有利的构造方案给出环和端部环的加强的安全性。
尤其适宜的是，端部环具有至少一个销容纳部，以用于容纳至少一个与环相关联的沿着第一轴线构造的销。销轴承使植入物的简化的装配成为可能并且保证可靠的支承。
已证实为有益的是，双倍地设置销容纳部和与环相关联的销，因为由此实现环在植入部件处稳定的且可靠的支承。
此外有利的是，环具有至少一个植入销容纳部以用于容纳至少一个与植入部件相关联的沿着第二轴线构造的植入销。同样在此环借助于销支承在植入部件上是有意义的，因为由此使绕第二轴线的摆动更容易。
此外有意义的是，双倍地设置植入销容纳部和与植入部件相关联的沿着第二轴线构造的植入销，以便保证环在植入部件处安全的且稳定的支承。
另一有利的实施形式的特征在于，环和/或端部环在背离脊椎体的侧边上具有至少一个轴向地构造的凹口，由此，在绕第一轴线或绕第二轴线倾斜时环或端部环稍后才贴靠在植入部件处并且由此实现更大的摆动的角度。
此外适宜的是，环和/或端部环在面对植入部件的侧边处具有至少一个径向地构造的凹口，由此，同样增大环或端部环的偏转角度。
已证实为尤其有意义的是，植入部件在外缘处具有环槽。该环槽用作用于环或端部环的运动的止动部，由此增大用于其摆动的角度。
另一优点同样与此相关，即，环和/或端部环在面对植入部件的侧边处具有凹地构造的表面，由此更谨慎地在植入部件或环上引导环和/或端部环。通过以下方式改进该滑动引导，即，根据有利的实施形式，环在背离植入部件的侧边处具有凸地构造的表面。
附图说明
下面针对在图纸中示出的实施例详细解释本发明。其中：
图1以部分剖切的方式显示了本发明的透视的视图，
图2a-2c显示了植入物的未剖切地显示的透视的视图，
图3显示了本发明的俯视图，
图4显示了植入物的侧视图，
图5显示了相对于图4的视图绕植入物纵轴线旋转了90°的视图，
图6显示了图3中的截面a-a，
图7显示了图4中的截面b-b，以及
图8显示了图5的截面c-c。
参考标号列表
1    植入部件
2    端部环
3    第一轴线
4    第二轴线
5    环
6    植入物纵轴线
7    环形凸缘
8    销容纳部
9    销
10   植入销容纳部
11   植入销
12   环槽
具体实施方式
图1至图8的图示显示了根据本发明的用于***脊柱的脊椎体之间的植入物的实施例，其带有植入部件1，该植入部件在其自由的端部的至少一个处具有用于贴靠在脊椎体的端板的表面处的端部环2。在退化的或创伤的疾病之后该植入物可替代脊柱的一个或多个脊椎体。
端部环2以可绕第一轴线3摆动的方式支承在以可绕第二轴线4旋转的方式支承在植入部件1上的环5上，其中，第一轴线3和第二轴线4以彼此不平行的方式定向。
通过该接头维持脊柱的运动性，从而一方面实现最优地与脊椎体的端板角度匹配并且由此实现带有减小的表面压力的优化的贴靠，其减小侵入脊椎体中的风险。另一方面也可在手术后进行匹配，以用于避免在使用中通过微运动产生的峰值负载。相应地，利用本发明的优选的实施形式同样可能的是，取消替代脊椎体，并且仅仅替代在两个脊椎体之间的椎间盘。通常有意义的是，在植入部件1的两个自由的端部处设置通过环5和端部环2形成的多轴的接头。
在该实施例中，定向第一轴线3，其与第二轴线4相交，并且在环5和端部环2未偏转的状态中，第一轴线和第二轴线展开垂直于植入物纵轴线6的平面。第一轴线3垂直于第二轴线4定向。
在该实施例中，端部环2具有两个销容纳部8以用于容纳两个与环5相关联的沿着第一轴线3构造的销9。此外，环5具有两个植入销容纳部10以用于容纳两个与植入部件1相关联的沿着第二轴线4构造的植入销11。
植入部件1在外缘处具有环槽12，其中，环5和端部环2的面对植入部件1的表面构造成凹的。在背离植入部件1的侧边上以凸的方式形成环5的表面。
在透视地且部分剖切地显示了植入物的图1中，可明显地看出销9和植入销11，其使端部环2的多轴的取向成为可能以用于与脊椎体的端板相匹配。
图2a显示了在未偏转的状态中的植入物，其中，在图2b中示出了带有绕第二轴线4旋转了的环5的植入物。此外，以补充图2b的方式，在图2c中以绕第一轴线3摆动了的方式显示了端部环2。

Claims (11)

1.一种用于***脊柱的脊椎体之间的植入物，该植入物带有植入部件(1)，所述植入部件(1)在其自由的端部的至少一个处具有端部环(2)，其特征在于，所述端部环(2)以可绕第一轴线(3)摆动的方式支承在以可绕第二轴线(4)旋转的方式支承在所述植入部件(1)上的环(5)上，其中，所述第一轴线(3)和所述第二轴线(4)以彼此不平行的方式定向，其中所述环(5)和/或所述端部环(2)在面对所述植入部件(1)的侧边处具有凹地构造的表面，其中所述环(5)在背离所述植入部件(1)的侧边处具有凸地构造的表面。
2.根据权利要求1所述的植入物，其特征在于，在未偏转的状态中，所述第一轴线(3)和/或所述第二轴线(4)垂直于植入物纵轴线(6)定向。
3.根据权利要求1或2所述的植入物，其特征在于，所述第一轴线(3)和所述第二轴线(4)如此定向，即，以未偏转的方式展开平面。
4.根据权利要求1或2所述的植入物，其特征在于，在所述植入部件(1)处构造有环形凸缘(7)。
5.根据权利要求1或2所述的植入物，其特征在于，所述端部环(2)具有至少一个销容纳部(8)，以用于容纳至少一个与所述环(5)相关联的沿着所述第一轴线(3)构造的销(9)。
6.根据权利要求5所述的植入物，其特征在于，双倍地设置所述销容纳部(8)和与所述环(5)相关联的销(9)。
7.根据权利要求1或2所述的植入物，其特征在于，所述环(5)具有至少一个植入销容纳部(10)以用于容纳至少一个与所述植入部件(1)相关联的沿着所述第二轴线(4)构造的植入销(11)。
8.根据权利要求7所述的植入物，其特征在于，双倍地设置所述植入销容纳部(10)和与所述植入部件(1)相关联的植入销(11)。
9.根据权利要求1或2所述的植入物，其特征在于，所述环(5)和/或所述端部环(2)在背离所述脊椎体的侧边上具有至少一个轴向地构造的凹口。
10.根据权利要求1或2所述的植入物，其特征在于，所述环(5)和/或所述端部环(2)在面对所述植入部件(1)的侧边处具有至少一个径向地构造的凹口。
11.根据权利要求1或2所述的植入物，其特征在于，所述植入部件(1)在外缘处具有环槽(12)。
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