CN104185452A - 具有侧向延伸的燕尾接合特征的新型植入物***器 - Google Patents

具有侧向延伸的燕尾接合特征的新型植入物***器 Download PDF

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Publication number
CN104185452A
CN104185452A CN201280025053.8A CN201280025053A CN104185452A CN 104185452 A CN104185452 A CN 104185452A CN 201280025053 A CN201280025053 A CN 201280025053A CN 104185452 A CN104185452 A CN 104185452A
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China
Prior art keywords
implant
antetheca
inserter
pair
distal
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Granted
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CN201280025053.8A
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CN104185452B (zh
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T.加马彻
M.D.索伦蒂
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DePuy Spine LLC
DePuy Products Inc
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DePuy Products Inc
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    • 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
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Abstract

本发明提供一种脊柱植入物***器，所述脊柱植入物***器具有：a)具有镗孔的外部套管；和b)叉状内轴，其具有近侧杆和从所述近侧杆延伸的一对远侧叉尖，每个远侧叉尖包括接合特征，所述接合特征具有侧向延伸的燕尾结构。本发明还提供一种组件，其包括植入物***器和具有一对配合燕尾结构的植入物。

Description

具有侧向延伸的燕尾接合特征的新型植入物***器
背景技术
脊柱外科医生期望利用低垂直剖面器械来定位植入物，以使回缩最小化并且提高植入物的可视性。理想地，器械和其连接点定尺寸完全容纳在植入物的外形内，因此小于植入物并且使得能够容易地定位或放置植入物。另外，与器械的连接应有利地为刚性的，而不在任何平面内进行切换或旋转。此种刚性能够防止植入物在器械传递期间或接骨螺丝***期间运动。
传统的***器器械加工斜面结构通常在一个平面内工作，其中夹持器末端在植入物处于内／外方向时塌缩，从而将植入物固定到器械。然而，即使在严格的公差下，如果传统器械的使用者欲在一个平面内对植入物(处于挠曲／伸展状态)的后边缘施加力矩，则常常会出现切换。具有斜面结构的传统***器不能利用界面处的不止一个平面中的不同角度，且因此不能确保植入物的前表面在***器夹持器末端上降到最低点。
美国专利号5443514(Steffee)公开了一种夹持脊柱植入物侧面的***器。参见Steffee的图4-6。
美国专利公布号2005-0143749(Zalenski)公开了一种***器，所述***器具有形成竖直延伸的燕尾形状的接合特征。参见Zalenski的图2A-2C。
发明内容
本发明涉及一种具有新型“复合角”凹槽(例如燕尾形状)的椎间植入物，所述凹槽被设计成且定尺寸联接于递送器械。植入物与固定器械之间的界面设计有侧向延伸的有角度的斜面结构，所述斜面结构沿不止一个方向延伸，以防止切换和旋转。一旦分开的末端器械塌缩至其闭合位置，植入物便被牵拉到所述***器中并且能够在***器的远侧壁上降到最低点。
本发明的器械优于具有螺纹和其他已知夹持器结构的传统***器器械，传统***器器械有时需要承受冲击并且可在穿过装置***骨锚或器械时运动。
本发明的双角度性质确保植入物在轴向上是直角的和／或与器械是共线的，从而进一步确保器械的较大表面积能够吸收任何所需的冲击。
本发明还可具有补角，其中所述结构的前部上定尺寸小于所述结构的后部。见图6。
在特定的实施例中，本发明的器械具有叉状内轴，所述内轴具有从其延伸的远侧叉尖，其中每个远侧叉尖形成向中间延伸的燕尾结构。此种燕尾结构具有复合角，该复合角能够防止上述不期望的运动。
在本发明的优选实施例中，植入物的近侧壁具有对应的一对凹槽，所述凹槽开口至植入物的相应侧壁上。这些凹槽中的每一个在植入物的相应侧壁上形成燕尾轮廓。
本发明总体地讲涉及用于辅助将植入物安全地单手***的方法和设备。植入物植入装置一般包括(i)包括触发机构的框架；(ii)机械地联接于所述框架的外部套管；(iii)具有用于机械接合植入物的远侧叉尖的叉状内轴，所述叉状内轴滑动地设置在所述外部套管内；以及(iv)保持元件，其用于朝闭合位置导向所述远侧叉尖。所述保持元件可为弹簧。
***器上的任选元件可包括旋钮、阻力调整螺丝、至少一个突起，以及深度控制构件。所述旋钮可机械地联接于所述外部套管，以使所述外部套管和所述叉状内轴围绕所述框架旋转。所述阻力调整螺丝可在所述触发机构与所述叉状内轴之间提供张力。所述至少一个突起可位于所述外部套管上，用于滑动地接合牵张器械。所述深度控制构件可滑动地联接于所述外部套管，以提供植入物的预定***深度。
在将植入物***到椎骨之间的过程中，***器的远侧叉尖将植入物保持在其间。每个远侧叉尖在其末端处包括接合特征，用于机械地接合植入物。所述接合特征包括沿侧向延伸的燕尾形突起。一般来讲，所述接合特征可具有中间面，每个中间面包括具有高度的近端部分和具有高度的远端部分，其中所述远端部分的高度大于所述近端部分的高度。同时，植入物的前壁包括一对配合的侧向延伸的燕尾凹槽，所述燕尾凹槽开口到相应的侧壁上并且在每个侧壁上形成燕尾轮廓，其中器械的每个接合特征容纳在脊柱植入物的相应凹槽中。
叉状内轴可包括至少一个标记，以识别植入物相对于患者的位置。所述标记可为位于所述叉状内轴的表面上的销。所述标记可为位于所述叉状内轴的表面上的多个机器加工的狭槽。
将植入器械机械地接合到植入物可包括以下步骤：(i)打开位于所述植入器械的端部上的叉状内轴；(ii)将所述叉状内轴的叉尖与植入物的凹槽对齐；以及(iii)闭合所述叉尖，以将所述叉尖机械地接合到所述植入物。
所述方法还可包括以下步骤：(iv)用牵张器械牵张预备盘间隙；(v)用植入器械将植入物***到所述预备盘间隙中；(vi)从所述植入器械释放所述植入物；以及(vii)移除所述植入器械和牵张器械。
在一些实施例中，将植入物***到预备盘间隙中可包括将植入器械与牵张器械对齐的步骤。
本发明具有许多优点。例如，通过本发明能够安全地将植入物单手***到预备盘间隙中。本发明能够减少完成外科手术所需的时间量。本发明还能实现在不与植入物发生物理接触的情况下对植入物进行各种操纵。例如，本发明可径向地对齐植入物的终板并且提供用于植入的脊柱前凸角度。本发明可用于包装植入物，且本发明可用于在植入物消毒过程中保持植入物。
因此，根据本发明，提供一种用于***植入物的器械，其包括：
a)具有镗孔外部套管，和
b)叉状构件，其具有近侧杆和从所述近侧杆延伸的一对远侧叉尖，每个远侧叉尖包括近侧部分和远侧部分，所述远侧部分具有远侧壁，所述远侧壁具有从其朝远侧延伸的接合构件，每个接合构件具有形成燕尾形状的中间面，
其中所述近侧杆和每个叉尖的近侧部分滑动地容纳在所述外部套管的所述镗孔内，并且
其中每个叉尖的远侧部分从所述外部套管的镗孔延伸出。
根据本发明，还提供一种组件，其包括：
a)上述***器，和
b)脊柱植入物，其具有前壁、一对相对的侧壁，以及后壁，
其中所述前壁包括一对凹槽，所述一对凹槽开口至相应的侧壁上，以在每个相应的侧壁中形成燕尾形状，
其中所述器械的每个接合特征容纳在所述脊柱植入物的相应凹槽中。根据本发明，还提供一种整形植入物，其具有前壁、一对相对的侧壁、后壁，以及顶面和底面，其中所述前壁包括一对凹槽，每个凹槽开口至相应的侧壁上并且在相应的侧壁中形成燕尾形状。
附图说明
图1A显示本发明的***器械的剖视图。
图1B显示了图1A的***器械的平面图。
图2A-2C显示了本发明的叉状内轴的三种实施例的透视图。
图3显示了利用图1A-2C的***器械将植入物***到预备盘间隙中的透视图。
图4显示了本发明的具有燕尾夹持结构的器械靠近具有对应的燕尾凹槽结构的植入物的两个视图。
图5公开了本发明的椎间融合器。
图6公开了侧壁中具有凹槽的植入物的拐角，其中所述凹槽包括两个锐角α和β。
图7公开了本发明的***器末端的透视图。
图8公开了本发明的发光***器末端的透视图。
图8A-8F公开了柔性螺丝***器和预弯的套管。
具体实施方式
根据下文中对附图所示的本发明的优选实施例更具体的描述，本发明的上述和其他目的、特征和优点将变得显而易见，在附图的所有不同视图中，相似的参考编号指示相同的部件。出现在不同附图中的相同编号表示相同的项。附图未必按比例绘制，相反，将重点放在示出本发明的原理上。
一般来讲，本发明涉及用于将植入物安全地***脊柱中的设备和方法。植入物可为人工椎间盘或脊柱融合器或脊柱板。参见图1A和1B，其分别显示***器械100的侧面剖视图和平面图。***器械100包括框架或起子主体组件110、致动器组件126和叉状内轴160(图2A-2C)。***器械100是常闭装置，即，叉状内轴160的近侧杆通常基本上容纳在致动器组件126中。
致动器组件126包括外部套管130、近侧内轴140和保持销148。外部套管130包括渐缩的端部175，该端部滑动地接合叉状内轴160上的渐缩件163(图2A-2C)，以使叉状内轴160在使用时能够压缩和伸展。内轴140包括凹形的螺纹端142和凸形的螺纹端144。凹形的螺纹端142与弹簧保持螺丝152相配合，且凸形的螺纹端144与叉状内轴160相配合。内部压缩弹簧150被紧固到致动器组件126，且被弹簧保持螺丝152保持就位。一旦致动器组件126被组装，其便被***到起子主体组件110中且由保持销148保持在组件110内。任选的旋钮170可机械地附接到外部套管130，以允许外部套管130和近侧内轴140围绕起子主体组件110旋转。任选的引导件171可附接到外部套管130，以滑动地与椎间盘牵张器械950(图3)相配合。深度控制构件173也可固定地或滑动地附接到外部套管130上，以提供植入物的预定***深度。
起子主体组件110包括柄部112、柄部过渡区114、击打轴套116、触发机构120和枢轴销122。触发机构120可为本领域中已知的任何类型的触发机构。触发机构120围绕起子主体组件110中的枢轴销122枢转。当触发机构120朝柄部112被挤压时，叉状内轴160(图2A-2C)从致动器组件126延伸并且伸展以释放植入物。当触发机构120被释放时，叉状内轴160后退到致动器组件126中并且压缩，从而接合植入物并且返回至其常规闭合位置。任选的阻力调整螺丝124可旋转地联接于起子主体组件110，用于调整触发机构120与致动器组件126的弹簧保持螺丝152之间的阻力。
图2A-2C显示了本发明的各种叉状内轴160。每个叉状内轴160包括接合特征162，用于机械地接合植入物，接合特征162根据植入物的选择可具有各种形状和尺寸。如图所示，接合特征162可为燕尾形的(162a，162b，162c，162d)接合特征162可接合具有多种高度的植入物。应当理解，接合特征162可具有能够与任何类型的植入物相接合的任何形状。在替代实施例中，近侧内轴140和叉状内轴160可为一体的。
每个叉状内轴160包括凹形的螺纹孔161，用于与致动器组件126的近侧内轴140的凸形螺纹端144相配合。应当理解，可使用本领域中已知的任何方式来将叉状内轴160附接到近侧内轴140。
每个叉状内轴160包括渐缩件163和相对长的伸展／压缩狭槽164，以使叉状内轴160能够在使用期间伸展和压缩。图2A-2C显示了处于伸展位置的内轴160。每个叉状内轴160还包括尺寸设定狭槽166，以能够实现插片与叉状内轴狭槽尺寸差异的变型。伸展／压缩狭槽169(图2B)是尺寸设定狭槽166的替代实施例。在一些实施例中，叉状构件具有快速连接结构。
叉状内轴160的表面上可包括头向标记物168，以使使用者能够确定植入物的位置。标记物168可为销168a或机器加工的狭槽168b。在一些实施例中，***器(挤压柄部)具有快速连接结构。
在一种利用本发明的方法中，现在参见图4a和图4b，使用者首先挤压植入器械100上的触发机构120(图1)，从而使器械上的接合特征162c，162d分开。然后，使用者可用植入器械来接近目标植入物(在这种情况下为颈椎钢板201)，使得这两个装置的燕尾结构对齐，从而接合特征162跨坐于植入物上的相对的接合齿906上。一旦接合特征162跨坐在接合齿906上，使用者便释放触发机构120，从而使接合特征162向内塌缩并且接合植入物上的接合齿906。
在其他实施例中则相反，使用者挤压器械来接合植入物。
现在参见图5，提供本发明的椎间融合器301。此种融合器包括：前壁303；后壁304；连接所述前壁和后壁的一对相对的侧壁305；适合于接合上椎骨的顶面306；适合于接合下椎骨的底面(未示出)；以及在所述顶面与所述底面之间延伸的通孔307，用于穿过该通孔来促进融合，其中所述前壁包括一对凹槽311，每个凹槽开口至相应的侧壁并且在相应的侧壁中形成燕尾形状。此种特定融合器的前壁还具有贯穿其中而延伸的螺丝孔313。螺丝孔通常具有螺纹，并且适合于容纳接骨螺丝，以将融合器固定到相对的椎体而无需后部器械，从而提供“独立”能力。
现在参见图6，根据本发明，还提供一种脊柱植入物，其具有前壁、一对相对的侧壁、后壁，以及顶面和底面，其中所述前壁包括一对凹槽，每个凹槽开口至相应的侧壁上并且在相应的侧壁中形成至少两个锐角α和β。同一凹槽中的两个锐角的性质会形成防止切换和旋转所需的条件。
在一些实施例中，植入物的顶面和底面间隔开适合于接触相对的椎骨终板的距离。此种结构有利于将脊柱植入物***到盘间隙中。
在一些实施例中，本发明的植入物具有从其顶面延伸到其底面的通孔。此通孔结构促进通过植入物的骨融合，因此提供本发明融合器实施例的性能优势。
在一些实施例中，融合器的通孔中包含骨移植材料。此种移植材料也会促进通过植入物的融合，因此提供本发明融合器实施例的性能优势。
在一些植入物实施例中，融合器具有前壁，该前壁与植入物的其余部分分开制造。优选地，所述前壁是金属的，而植入物的其余部分是聚合物的。此种优选的实施例有利地提供前壁的强度，使得螺丝孔可从其中通过而不使壁破裂。
在一些实施例中，第一骨紧固件和第二骨紧固件延伸穿过位于融合器的前壁中的螺丝孔。此种结构使得融合器能够固定到相对的椎骨从而无需后部器械。在一些实施例中，第一紧固件进一步延伸穿过植入物的顶面，而第二紧固件进一步延伸穿过植入物的底面。
在一些实施例中，第一骨紧固件和第二骨紧固件仅延伸穿过前壁，如在板实施例中。
在一些实施例中，植入物具有关节联接界面，如在关节联接运动盘中。
图3公开了本发明的器械将本发明的植入物***到盘间隙中。
如图3所示，牵张器械950***到固定在椎体962，964中的销(未示出)之上。利用植入器械100(图1A-1B)使颈椎融合器330从牵张器械950的叉之间经过。在替代实施例中，***器械100上的引导件170滑动地接合牵张器械950的叉中的狭槽，以帮助使用者将颈椎融合器330引导到预备盘间隙970中。一旦颈椎融合器330位于预备盘间隙970内的期望位置中，使用者便致动(例如，挤压或释放或旋转旋钮)触发机构120(图1A)，该触发机构会将颈椎融合器330释放到预备盘间隙970中。使用者可通过观察位于叉状内轴160表面上的向头侧标记物168(图3A-3B)来确定所期望的位置。在替代实施例中，植入器械100可包括深度控制构件173(图1A)(其可为可调整的和可滑动的)，使得颈椎融合器330可***到预备盘间隙970中的预定深度处。
最后，将植入器械100和牵张器械950移除，从而使上椎骨962和下椎骨964接合颈椎融合器330。
现在参见图7，其提供本发明的***器末端701的一个实施例。此种***器末端包括圆筒止挡件703，该圆筒止挡件防止接骨螺丝被剥除。存在远侧快速连接／释放结构705，该结构能够容易地连接到***器器械的其余部分。圆筒707防止植入物被过远地放置在后侧。燕尾上的释放结构709允许接合特征容易地从植入物脱离。最后，圆筒711可为固定的圆筒，或者可经由滑动构件(例如棘轮结构)进行调整。
现在参见图8，其提供本发明的发光***器末端801的一个实施例。***器插管配有至少一个次内腔803，所述至少一个次内腔适合于递送光或递送光纤。在图8中用虚线显示从次内腔发出的光。作为另外一种选择，光可被馈送到用于保持***器末端(未示出)的主内腔。在一个实施例中，至少所述末端的接合特征805由硬的透明塑料制成，所述塑料允许穿过所述圆筒的其他器械可见。
在执行诸如颈椎前路椎间盘切除融合术(ACDF)等脊柱手术时，外科医生常常具有可实现保持椎间盘高度和缓解疼痛的期望临床结果的多个植入物选项。由于其临床有益效果，用于接纳骨锚且被固定到相邻解剖结构的零形融合器的用途增多且能够在ACDF手术中采用。这些融合器通常具有有角度的骨锚(诸如螺丝)，所述骨锚穿过融合器前壁的一部分并且进入相邻的椎骨终板中。
然而，如果外科医生欲选择低剖面的独立式融合装置(例如包括一个或多个接骨螺丝的固定融合器)，则存在与螺丝的***相关联的外科技术难题。传统上，使用具有直轴的器械以陡斜角度穿过融合器而***螺丝，以确保穿透骨。然而，在患者的颏或胸骨上方附近的位置处用直轴器械***螺丝会产生一些具有挑战性的接近角。近来，已对***器械进行了改良，以有利于以困难的接近角来放置螺丝。这些改良中的一些包括采用万向接头和柔性***器器械，以允许扭矩传递，同时仍将其柄部定位成与螺丝的轨线离轴。例如，一些柔性***器器械通过对仅位于其远侧工作末端近侧的多个互锁区段进行处理来实现柔性。一旦此种柔性起子的末端***到钻导引器中，起子的柄部便可被重新定位到期望的位置，并且可传递扭矩以推进螺丝。
然而，与此种柔性技术相关联的其中一个难题是：柔性轴在其静止构型中通常是直的。因此，需要执行以下两个工序中的一个。在第一工序中，必须临时增大软组织回缩的量，以将起子的末端接合到钻导引器中，且一旦接合，便可再次将软组织回缩最小化，并且可将柄部保持在期望的位置，例如接***行于植入物***器。在第二工序中，可以陡斜角度小于螺丝轨线(但不完全平行于***器)的角度将末端***到钻导引器中，且必须克服挠曲区段的弹簧力以使末端找到钻导引器轨线。在此“拐弯”步骤中，由于提供下压力，因此螺丝的自保持可脱离。
因此，为克服这些问题，在本发明的一个方面，现在参见图8A-8F，提供对柔性轴技术的改良，以利于患者和外科医生。所述改良是接骨螺丝起子，其具有：a)近侧柄部(未示出)；b)中间轴851；c)柔性远端部分853，其包括多个互锁区段855和远侧末端857(其中所述柔性远端部分在其未加载构型中为基本上直的)；以及d)预弯套管861，其被放置于柔性区段之上和周围，从而预先确定末端的轨线，并且有利于以适当的和期望的***角度将螺丝***到钻导引器中而无需增大回缩量。如图8a-8f所示，此预弯套管(其具有纵向狭缝863)允许螺丝起子柄部在需要时与融合器***器完全共线，同时仍在其弯曲位置中利用触感和挠曲区段的扭矩传递。因此，外科医生可限制回缩量并且保持起子柄部靠近***器，而无需克服柔性区段的自然直形构型的力。所述套管可为固定的、可滑动的、或可移除的，并且可完全或部分地包围柔性区段。所述套管可具有几何形状，所述几何形状允许在需要时挠曲、附接(按扣)到起子，以及移除以进行清洁。所述套管可由保持所期望形状的任何生物相容性材料(诸如金属或塑料)制成。
因此，根据本发明，提供一种柔性接骨螺丝起子，其包括：
a)近侧柄部，
b)中间轴，
c)柔性远端部分，其包括多个互锁区段和
适合于接合螺丝头部的远侧末端，以及
d)预弯套管，其放置在所述多个互锁区段之上和周围。
根据本发明，还提供一种组件，其包括：
a)融合器，包括前壁、一对相对的侧壁、后壁，以及顶面和底面，所述顶面和底面适合于夹持相对的椎骨终板，其中所述前壁包括至少一个螺纹通孔，
b)容纳在所述螺纹通孔中的接骨螺丝，所述接骨螺丝具有螺纹轴和近侧头部，
c)图8A-8F的***器，
其中所述***器的远侧末端容纳在所述接骨螺丝的近侧头部中。
虽然通过参照本文的优选实施例来具体示出和描述本发明，但本领域的技术人员将理解可以在不脱离所附权利要求书所涵盖的本发明范围的情况下对其形式和细节进行各种改变。

Claims (27)

1.一种柔性接骨螺丝起子，其包括：
a)近侧柄部，
b)中间轴，
c)柔性远端部分，其包括多个互锁区段和
适合于接合螺丝头部的远侧末端，以及
d)预弯套管，其放置在所述多个互锁区段之上和周围。
2.根据权利要求1所述的起子，其特征在于，所述预弯套管包括纵向狭缝。
3.根据权利要求1所述的起子，其特征在于，所述柔性远端部分在其未加载构型中为基本上直的。
4.一种组件，其包括：
a)融合器，其包括前壁、一对相对的侧壁、后壁，以及顶面和底面，所述顶面和底面适合于夹持相对的椎骨终板，其中，所述前壁包括至少一个螺纹通孔，
b)容纳在所述螺纹通孔中的接骨螺丝，所述接骨螺丝具有螺纹轴和近侧头部，
c)根据权利要求1所述的***器，
其中，所述***器的远侧末端容纳在所述接骨螺丝的近侧头部中。
5.根据权利要求4所述的组件，所述起子的柔性远端部分在其未加载构型中为基本上直的。
6.一种用于***植入物的器械，其包括：
a)具有镗孔的外部套管，和
b)叉状构件，其具有近侧杆和从所述近侧杆延伸的一对远侧叉尖，每个远侧叉尖包括近侧部分和远侧部分，所述远侧部分具有远侧壁，所述远侧壁具有从其朝远侧延伸的接合构件，每个接合构件具有形成燕尾形状的中间面，
其中，所述近侧杆和每个叉尖的近侧部分滑动地容纳在所述外部套管的镗孔内，并且
其中，每个叉尖的远侧部分从所述外部套管的镗孔延伸出。
7.根据权利要求6所述的器械，其特征在于，还包括：
c)具有致动器的框架；其中，所述外部套管机械地联接于所述框架。
8.根据权利要求7所述的器械，其特征在于，还包括：
d)具有近端和远端的内轴，
其中，所述内轴的远端联接于所述叉状构件的近侧杆，并且
其中，所述内轴的近端联接于所述触发机构。
9.根据权利要求8所述的器械，其特征在于，所述致动器包括触发机构。
10.根据权利要求8所述的器械，其特征在于，所述致动器包括旋钮。
11.一种组件，其包括：
a)根据权利要求6所述的***器，和
b)脊柱植入物，其具有前壁、一对相对的侧壁，以及后壁，
其中，所述前壁包括一对凹槽，所述一对凹槽开口至相应的侧壁上，以在每个相应的侧壁中形成燕尾形状，
其中，所述器械的每个接合特征容纳在所述脊柱植入物的相应凹槽中。
12.根据权利要求11所述的组件，其特征在于，所述脊柱植入物的前壁偏置抵靠所述***器的每个远侧叉尖的远侧壁。
13.根据权利要求11所述的组件，其特征在于，所述脊柱植入物具有限定植入物高度的顶面和底面，其中，所述叉状构件具有限定***器高度的顶面和底面，并且其中，所述***器高度小于所述植入物高度。
14.根据权利要求11所述的组件，其特征在于，所述***器的每个接合特征完全容纳在所述脊柱植入物的相应凹槽中。
15.一种整形植入物，其具有前壁、一对相对的侧壁、后壁，以及顶面和底面，
其中，所述前壁包括一对凹槽，每个凹槽开口至相应的侧壁上并且在
所述相应的侧壁中形成燕尾形状。
16.根据权利要求15所述的植入物，其特征在于，具有从所述顶面延伸到所述底面的通孔，用于贯穿所述通孔来促进融合。
17.根据权利要求16所述的植入物，其特征在于，具有包含在所述通孔中的骨移植材料。
18.根据权利要求15所述的植入物，其特征在于，包括所述前壁的部件与所述植入物的其余部分分开地制造。
19.根据权利要求18所述的植入物，其特征在于，包括所述前壁的所述部件是金属的，并且所述植入物的其余部分是聚合物的。
20.根据权利要求15所述的植入物，其特征在于，所述顶面和底面隔开一距离，所述距离定尺寸用于接触相对的椎骨终板。
21.根据权利要求15所述的植入物，其特征在于，具有延伸穿过所述前壁的第一骨紧固件和第二骨紧固件。
22.根据权利要求21所述的植入物，其特征在于，所述第一紧固件进一步延伸穿过所述顶面。
23.根据权利要求22所述的植入物，其特征在于，所述第二紧固件进一步延伸穿过所述底面。
24.根据权利要求15所述的植入物，其特征在于，所述第一骨紧固件和所述第二骨紧固件仅延伸穿过所述前壁。
25.根据权利要求15所述的植入物，其特征在于，具有关节联接界面。
26.根据权利要求15所述的植入物，其特征在于，为脊柱植入物。
27.一种脊柱植入物，其具有前壁、一对相对的侧壁、后壁，以及顶面和底面，
其中，所述前壁包括一对凹槽，每个凹槽开口至相应的侧壁，并且在
所述相应的侧壁中的每一个中形成至少两个锐角α和β。
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