CN105326585B - 具有可伸展骨固定部件的椎间植入件 - Google Patents
具有可伸展骨固定部件的椎间植入件 Download PDFInfo
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- CN105326585B CN105326585B CN201510587924.0A CN201510587924A CN105326585B CN 105326585 B CN105326585 B CN 105326585B CN 201510587924 A CN201510587924 A CN 201510587924A CN 105326585 B CN105326585 B CN 105326585B
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- Prior art keywords
- shell
- implantation piece
- pin
- intervertebral implant
- piece
- Prior art date
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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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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Neurology (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (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)
- Physical Education & Sports Medicine (AREA)
- Prostheses (AREA)
Abstract
本申请公开了一种椎间植入件(10),其设置成固定在由第一椎骨本体和第二椎骨本体(20)限定的椎间空间中。椎间植入件包括:植入件本体,该植入件本体的尺寸设置成***椎间空间中;以及固定组件(22),该固定组件设置成附接在植入件本体上。固定组件包括壳体(36),该壳体限定了面对第一椎骨本体的表面和面对第二椎骨本体的表面,面对第二椎骨本体的表面与面对第一椎骨本体的表面沿横向方向间隔开。固定组件还包括至少一个固定部件(38),该固定部件由壳体支承,并可从缩回位置运动至伸出位置,在伸出位置中,固定部件从壳体伸出和伸入其中一个椎骨本体中。
Description
本分案申请是基于申请号为201080048337.X(其国际申请号为PCT/US2010/049287)、申请日为2010年9月17日、发明名称为“具有可伸展骨固定部件的椎间植入件”的中国专利申请的分案申请。
相关申请的交叉引用
本发明要求美国临时专利申请No.61/243297的权益,该美国临时专利申请No.61/243297的申请日为2009年9月17日,本发明还要求美国临时专利申请No.61/260364的权益,该美国临时专利申请No.61/260364的申请日为2009年11月11日,各文献的全部内容如同在本文中阐述那样通过参考结合到本申请中。
背景技术
人的脊柱(也称为脊骨或脊椎)容纳位于它的脊椎管中的脊髓。脊柱由多个椎骨组成。普通椎骨包括两个主要部件,包括:前部部分,该前部部分包括椎骨本体;以及后部部分,该后部部分封闭孔。各椎骨本体限定了上部和下部椎骨端板,使得相邻椎骨限定了椎间空间,该椎间空间包括在各端板之间的椎间盘材料。
历史上,脊椎异常需要从椎间空间完全除去椎间盘,随后使得相邻椎骨融合在一起。这种“脊椎融合”处理过程(目前仍然使用)是广泛接受的外科手术治疗,用于有症状的腰部和颈部退化性椎间盘疾病。早期的融合处理使用由来自病人臀部或尸体骨的骨制造的植入件作为在椎间空间内的间隔件,以便合适定位相邻椎骨,直到椎骨融合在一起。更多现代处理过程使用由具有相对较低弹性模量的材料制造的植入件,以便促进骨生长。例如,植入件可以包括一些病人自己的骨(例如位于植入件的孔隙内)。普通的植入件能够由合适材料来制造,包括射线可透过材料,例如聚醚醚酮(PEEK)、超高分子量聚乙烯(UHMWPE)或聚砜(PSU)。希望的是,材料具有在3和5GPa之间的弹性模量。
普通的椎间植入件设计试图在椎间空间中实现植入件固定。
发明内容
根据一个实施例,椎间植入件设置成固定在由第一椎骨本体和第二椎骨本体限定的椎间空间中。椎间植入件包括:植入件本体,该植入件本体的尺寸设置成***椎间空间中;以及固定组件,该固定组件设置成附接在植入件本体上。固定组件包括壳体,该壳体限定了面对第一椎骨本体的表面和面对第二椎骨本体的表面,面对第二椎骨本体的表面与面对第一椎骨本体的表面沿横向(transverse)方向间隔开。壳体限定了槽道。固定组件还包括第一上部卡钉和第二下部卡钉,该第二下部卡钉与第一上部卡钉横向相对。各卡钉支承在槽道中,使得各卡钉包括横杆和一对间隔开的销,该对间隔开的销从横杆横向向外伸出。各横杆限定了相应的第一和第二凸轮表面。椎间植入件还包括促动器,该促动器设置成在壳体内沿远侧方向平移,该远侧方向基本正交于横向方向。促动器设置成基本同时与第一和第二凸轮表面接合,从而沿横向方向平移。
附图说明
当结合附图阅读时将更好地理解前面的概述以及后面对本申请的示例实施例的详细说明。为了示例说明本申请的示例实施例,下面将参考附图。不过应当知道,本申请并不局限于所示的确切结构和手段。附图中:
图1A是由椎间空间分开的一对椎骨本体的透视图;
图1B是图1中所示的椎骨本体和***在两个椎骨本体之间的椎间空间内的椎间植入件的透视图;
图2A是椎间植入件的透视图,该椎间植入件包括植入件本体和固定组件,该固定组件与椎间植入件连接,图中表示根据一个实施例的固定组件处于缩回位置;
图2B是如图2A中所示的椎间植入件的透视图,表示固定组件处于伸出位置;
图2C是图2A中所示的椎间植入件的分解装配图,表示固定组件与植入件本体连接;
图2D是图2A中所示的椎间植入件的俯视图,为了清楚,该椎间植入件的一部分除去;
图2E是图2A中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,该椎间植入件表示处于椎间空间中;
图2F是图2E中所示的椎间植入件的侧视图,为了清楚,该椎间植入件的一部分除去;
图2G是图2B中所示的固定组件的透视图;
图2H是图2B中所示的椎间植入件的俯视图,为了清楚,该椎间植入件的一部分除去;
图2I是图2B中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,该椎间植入件表示处于椎间空间中;
图2J是图2I中所示的椎间植入件的侧视图,为了清楚,该椎间植入件的一部分除去;
图3A是根据可选实施例构成的、包括植入件本体和固定组件的椎间植入件的俯视图,为了清楚,该椎间植入件的一部分除去,表示固定组件处于缩回位置;
图3B是图3A中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,该椎间植入件表示处于椎间空间中;
图3C是图3B中所示的椎间植入件的侧视图,为了清楚,该椎间植入件的一部分除去;
图3D是图3A中所示的椎间植入件的俯视图,但是表示固定组件处于伸出位置;
图3E是图3D中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,椎间植入件表示处于椎间空间中;
图3F是图3D中所示的椎间植入件的侧视图,为了清楚,该椎间植入件的一部分除去;
图3G是与图3D中所示的椎间植入件类似的椎间植入件的俯视图,但是根据本发明可选实施例构成;
图4A是根据可选实施例构成的、包括植入件本体和固定组件的椎间植入件的俯视图,为了清楚,该椎间植入件的一部分除去,表示固定组件处于缩回位置;
图4B是图4A中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,椎间植入件表示处于椎间空间中;
图4C是图4B中所示的椎间植入件的侧视图,为了清楚,该椎间植入件的一部分除去;
图4D是图4A中所示的椎间植入件的俯视图,但是表示固定组件处于伸出位置;
图4E是图4D中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,该椎间植入件表示处于椎间空间中;
图4F是图4D中所示的椎间植入件的侧视图,为了清楚,该椎间植入件的一部分除去;
图4G是与图4D中所示的椎间植入件类似的椎间植入件的俯视图,但是根据本发明可选实施例构成;
图5A是根据可选实施例构成的、包括植入件本体和固定组件的椎间植入件的俯视图,为了清楚,该椎间植入件的一部分除去,表示固定组件处于缩回位置;
图5B是图5A中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,该椎间植入件表示处于椎间空间中;
图5C是图5B中所示的椎间植入件的侧视图,为了清楚,该椎间植入件的一部分除去;
图5D是图5A中所示的椎间植入件的俯视图,但是表示固定组件处于伸出位置;
图5E是图5D中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,该椎间植入件表示处于椎间空间中;
图5F是图5D中所示的椎间植入件的侧视图,为了清楚,该椎间植入件的一部分除去;
图5G是与图5D中所示的椎间植入件类似的椎间植入件的俯视图,但是根据本发明可选实施例构成;
图6A是根据可选实施例构成的、包括植入件本体和固定组件的椎间植入件的俯视图,为了清楚,该椎间植入件的一部分除去,表示固定组件处于缩回位置;
图6B是图6A中所示的椎间植入件的正视图,该椎间植入件表示处于椎间空间中并处于缩回位置;
图6C是图6B中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去;
图6D是图6C中所示的椎间植入件的侧视图,为了清楚,该椎间植入件的一部分除去;
图6E是图6A中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,表示固定组件处于伸出位置;
图6F是图6E中所示的椎间植入件的侧视图,为了清楚,该椎间植入件的一部分除去;
图6G是图6A中所示的椎间植入件的抽取器(extractor)的侧视图,该抽取器设置成使得固定组件重复运动至缩回位置;
图6H是图6G中所示的抽取器的俯视图;
图6I是图6A中所示的植入件的侧视图,表示抽取器安装成使得固定组件处于伸出位置,且为了清楚,该植入件的一部分除去;
图6J是图6I中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去;
图6K是图6I中所示的椎间植入件的正视图,表示固定组件的促动器,且表示固定组件处于缩回位置;
图6L是图6K中所示的椎间植入件的正视图,但是为了清楚,表示为一部分除去;
图6M是图6L中所示的椎间植入件的侧视图,为了清楚,表示为一部分除去;
图6N是图6M中所示的椎间植入件的俯视图,为了清楚,表示为一部分除去;
图7A是根据可选实施例构成的、包括植入件本体和固定组件的椎间植入件的俯视图,为了清楚,椎间植入件的一部分除去,表示固定组件处于缩回位置;
图7B是图7A中所示的椎间植入件的正视图,为了清楚,表示为一部分除去,且它布置在椎间空间中;
图7C是图7B中所示的椎间植入件的侧视图,为了清楚,表示为一部分除去;
图7D是图7A中所示的椎间植入件的俯视图,表示固定组件处于伸出位置;
图7E是图7D中所示的椎间植入件的正视图,为了清楚,表示为一部分除去,且它布置在椎间空间中;
图7F是图7E中所示的椎间植入件的侧视图,为了清楚,表示为一部分除去;
图8A是与图7A中所示的椎间植入件类似的椎间植入件的侧视图,但是根据可选实施例构成,且为了清楚,该椎间植入件的一部分除去;
图8B是图8A中所示的椎间植入件的正视图;
图9A是根据可选实施例构成的、包括植入件本体和固定组件的椎间植入件的俯视图,为了清楚,该椎间植入件的一部分除去,表示固定组件处于缩回位置;
图9B是图9A中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,该椎间植入件表示为在椎间空间中;
图9C是图9B中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,表示固定组件处于伸出位置;
图9D是与图9B中所示的椎间植入件类似的椎间植入件的正视图,但是表示了根据可选实施例构成的固定组件的骨固定部件;
图9E是图9D中所示的椎间植入件的正视图,表示固定组件处于伸出位置;
图10A是根据可选实施例构成的、包括植入件本体和固定组件的椎间植入件的俯视图,为了清楚,该椎间植入件的一部分除去,表示固定组件处于缩回位置;
图10B是图10A中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,该椎间植入件表示为在椎间空间中,并表示固定组件处于缩回位置;
图10C是图10B中所示的椎间植入件的正视图,但是表示固定组件处于伸出位置;
图11A是根据可选实施例构成的、包括植入件本体和固定组件的椎间植入件的俯视图,为了清楚,该椎间植入件的一部分除去,表示固定组件处于缩回位置;
图11B是图11A中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,该椎间植入件表示为在椎间空间中,并表示固定组件处于缩回位置;
图11C是图11B中所示的椎间植入件的正视图,但是表示固定组件处于伸出位置;
图11D是图11B中所示的椎间植入件的正视图,表示椎间植入件处于装配(as-assembled)位置;
图11E是图11B中所示的椎间植入件的正视图,表示椎间植入件处于供给(as-supplied)位置;
图11F是图11E中所示的椎间植入件的俯视图;
图12A是根据可选实施例构成的、包括植入件本体和固定组件的椎间植入件的俯视图,为了清楚,该椎间植入件的一部分除去,表示固定组件处于缩回位置;
图12B是图12A中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,该椎间植入件表示为在椎间空间中;
图12C是图12B中所示的椎间植入件的正视图,但是表示固定组件处于伸出位置;
图13A是根据可选实施例构成的、包括植入件本体和固定组件的椎间植入件的俯视图,为了清楚,该椎间植入件的一部分除去,表示固定组件处于缩回位置;
图13B是图13A中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,该椎间植入件表示为在椎间空间中;
图13C是图13B中所示的椎间植入件的侧视图,为了清楚,该椎间植入件的一部分除去;
图13D是图13B中所示的椎间植入件的正视图,表示固定组件处于伸出位置;
图13E是图13D中所示的椎间植入件的侧视图,为了清楚,该椎间植入件的一部分除去;
图13F是与图13A中所示的椎间植入件类似的椎间植入件的示意俯视图,但是根据可选实施例构成;
图14A是根据可选实施例构成的、包括植入件本体和固定组件的椎间植入件的俯视图,为了清楚,该椎间植入件的一部分除去,表示固定组件处于缩回位置;
图14B是图14A中所示的椎间植入件的正视图,为了清楚,该椎间植入件的一部分除去,该椎间植入件表示为在椎间空间中;
图14C是图14B中所示的椎间植入件的正视图,表示固定组件处于伸出位置。
具体实施方式
参考图1A-B,第一上部椎骨本体12a限定了椎间空间14的上部椎骨端板13a,相邻的第二下部椎骨本体12b限定了椎间空间14的下部椎骨端板13b。因此,椎间空间14布置在椎骨本体12a-b之间。椎骨本体12a-b能够是解剖学上相邻的椎骨本体,或者能够是在进行椎间盘切除术后剩余的,该椎间盘切除术从位于椎骨本体12a-b之间的位置除去椎骨本体。如图所示,椎间空间14表示为在椎间盘切除术之后,因此椎间盘材料已经除去,以便准备椎间空间14来接收矫形植入件,例如图2中所示的椎间植入件10。因此,植入件10设置成***椎间空间14中,并获得高度恢复,同时保持活动性。椎间空间14能够根据需要布置在沿脊椎的任意位置。由下面的说明可知,植入件10的尺寸能够根据需要来设置,以便可植入任意脊椎区域中的椎间盘空间内,包括腰部区域、胸部区域、颈部区域、骶骨区域和尾骨区域。
下面的说明书中使用的某些术语只是为了方便,而不是限定。词语“右”、“左”、“下部”和“上部”表示所参考的图中的方向。词语“内侧”或“远侧”和“外侧”或“近侧”是指分别朝向和远离植入件和它的相关部件的几何中心的方向。词语“前面”、“后面”、“上面”、“下面”、“中部”、“侧部”和相关词语和/或短语是指所参考的人体的优选位置和方位,而不是进行限制。术语包括上述词语、衍生词和类似意思的词。
植入件10和植入件10的各个部件在这里介绍为沿纵向方向L和侧向方向A水平延伸,并沿横向方向T竖直延伸。除非另外明确说明,术语“侧向”、“纵向”和“横向”用于介绍各个部件的正交方向分量。侧向方向A和纵向方向L相对彼此和相对于横向方向T成角度地偏离例如基本正交。应当知道,尽管纵向和侧向方向表示为沿水平平面延伸,横向方向表示为沿竖直平面延伸,但是在使用过程中,包含这些方向的平面可以不同。例如,当植入件10植入椎间空间例如椎间空间14中时,横向方向T大致沿上-下(或头-尾)方向延伸,同时由纵向方向L和侧向方向A限定的平面大致处于由前-后方向和中间-侧部方向限定的解剖学平面内。因此,方向术语“竖直”和“水平”用于介绍植入件10和它的部件只是为了清楚示例说明的目的。
下面参考图2A-C,椎间植入件10包括植入件本体20和固定组件22,该固定组件22设置成在椎间空间14中将植入件本体20固定在第一和第二椎骨本体12a和12b上。植入件10和它的部件能够由任意可生物相容材料来形成,例如钴铬钼(CoCrMo)、钛和钛合金、不锈钢、陶瓷或者聚合物,如聚醚醚酮(PEEK)、超高分子量聚乙烯(UHMWPE)或聚砜(PSU)、可生物重新吸收材料和骨移植件(例如同种异体移植件和异种移植件)。涂层可以添加或施加在植入件10上,以便提高物理或化学特性。涂层可以帮助保证骨向内或向骨上生长或者药物治疗。涂层的示例包括等离子体喷涂钛涂层或羟磷灰石。
植入件本体20限定了前端24和纵向相对的后端26、顶端28和横向相对的底端30以及相对的侧部32和34。顶端和底端28和30能够设置成分别面对上部和下部椎骨本体12a和12b的相应椎骨端板13a和13b。在一些实施例中,顶端和底端28和30能够设置成抵靠相应椎骨端板13a和13b。植入件10能够沿***方向***椎间空间14中,该***方向在取向上能够为前-后进入(例如当椎骨本体12a和12b是颈部椎骨本体时),使得纵向前端24在纵向后端26的前面。
植入件本体的尺寸和形状能够根据需要来设置,且图中表示为基本“D”形,使得前端24沿侧向方向A基本直地延伸,侧部32和34沿向后方向朝着后端26朝向彼此弯曲。根据所示实施例,植入件本体20限定了基本中心的“D”形中心开口25,该“D”形中心开口25横向延伸至植入件本体20内(图中表示为穿过)。中心开口25能够接收任意合适的骨生长促进材料,例如同种异体移植件和异种移植件,以便在将植入件10植入椎间空间14内之后促进骨与椎骨本体12a-b的生长。植入件本体20能够为实心的,如图所示,或者能够限定延伸到植入件本体20内或延伸穿过该植入件本体20的孔,该孔例如能够接收骨生长促进材料。
植入件本体20限定了在顶端和底端28和30之间的横向高度H。该高度H能够从前端24至后端26基本恒定,或者能够从前端24至后端26变化,以便使得椎骨本体12a和12b具有脊柱前凸曲率或者恢复脊柱前凸曲率。因此,高度H能够从前端24朝着后端26沿向后方向减小,或者能够沿向后方向增加。而且,根据需要,高度H能够在侧部32和34之间恒定或变化。在这方面,顶端和底端28和30能够基本为平面的,或者能够根据需要弯曲、成波纹形或者以其它方式成形,以便与椎骨端板13a和13b相对应。还可以提供植入件10的成套工具,各成套工具有多个不同形状或尺寸的植入件本体20。例如,成套工具能够包括多个不同高度H的植入件本体20,使得在成套工具中的至少一个植入件本体20能够与沿给定病人的脊柱的椎间空间的相应不同高度相对应,或者与不同病人的椎间空间的相应不同高度相对应。
固定组件22包括固定壳体36,该固定壳体36设置成安装或者以其它方式连接至植入件本体20。固定壳体36直接或间接地支承至少一个骨或椎骨固定部件38以及至少一个促动器40,该促动器40设置成使得固定组件22和(特别是)该至少一个固定部件38在图2A中所示的缩回位置和图2B中所示的伸出位置之间重复,以便将固定组件22和(因此)植入件10固定在椎骨本体12a和12b上。固定壳体36限定了前端42和纵向相对的后端44、顶端46和横向相对的底端48以及相对的侧部50和52。顶端和底端46和48能够设置成分别面对上部和下部椎骨本体12a和12b的相应椎骨端板13a和13b。在一些实施例中,顶端46和底端48能够设置成抵靠相应椎骨端板13a和13b。根据所示实施例,前端42限定了固定壳体36的近端,后端44限定了固定壳体36的、沿中心纵向轴线37沿***方向与近端间隔开的远端。
固定壳体36和植入件本体20包括相应互补接合部件54和56,它们能够根据需要设置成使得固定壳体36安装或者以其它方式连接至植入件本体20。根据所示实施例,固定组件22的接合部件54设置为横向细长导轨58,该细长导轨58从固定壳体36的侧部50和52侧向向外凸出。导轨58能够终止于固定壳体36的底端48上面。根据所示实施例,植入件本体20的互补接合部件56设置为一对横向细长狭槽60,该细长狭槽60的尺寸设置成接收导轨58。狭槽60能够终止于植入件本体20的底端30上面。狭槽60布置在凹口62的相对侧,该凹口62由植入件本体20来限定,且尺寸设置成接收固定壳体36。
因此,固定组件22能够通过将固定壳体36***植入件本体20的凹口62中、以使得导轨58接收于狭槽60中而与植入件本体20连接。固定壳体36能够限定比植入件本体20的前端24大的纵向长度,使得固定壳体36纵向延伸到中心开口25中。导轨58和狭槽60的尺寸能够设置成使得固定壳体36的顶端46和底端48基本与植入件本体20的顶端28和底端30对齐或平齐。因此,固定壳体36的顶端和底端46和48以及植入件本体20的顶端28和底端30能够设置成抵靠椎骨端板13a和13b。也可选择,植入件本体20的顶端28和底端30和/或固定壳体的顶端46和底端48的一部分或全部能够相对于椎骨端板13a和13b凹入。不管顶端28和46以及底端30和48抵靠相应椎骨端板13a和13b还是从该椎骨端板13a和13b凹入,它们都能够面对具有横向方向分量的方向,从而可以说,顶端28和46以及底端30和48面对椎骨本体12a和12b,因此限定了面对椎骨本体的表面。如上所述,接合部件54和56能够根据需要设置成方便固定组件22与植入件本体20连接。例如,固定组件22能够与植入件本体20成一体。
还参考图2D-F,固定组件22包括:至少一个孔63,该孔63由固定壳体36来限定,它接收促动器40;以及至少一个槽道,该槽道接收至少一个固定部件38。根据所示实施例,固定壳体36限定了第一对侧向间隔开的上部槽道64和第二对侧向间隔开的下部槽道65,该对下部槽道65能够与上部槽道64竖直对齐。槽道64和65能够根据需要以任意方向延伸,且根据所示实施例沿具有纵向和横向方向分量的方向来延伸。例如,上部槽道64沿纵向和横向向上延伸,以便限定从固定壳体36的近端42延伸的第一近端以及延伸至顶端46的第二远端。下部槽道65沿纵向和横向向下延伸,以便限定从固定壳体36的近端42延伸的第一近端以及延伸至底端48的远端。槽道64和65的远端因此相对于槽道64和65的相应近端横向和纵向位移。
根据所示实施例,槽道64和65侧向延伸至固定壳体36的侧部50和52中,尽管它们能够根据需要可选择地进行定位。固定组件22能够包括一对盖板66,该对盖板66附接至固定壳体36的侧部50和52,以便侧向覆盖和侧向关闭槽道64和65。因此,盖板66能够包括接合导轨58,如上所述。
固定部件38能够设置为第一卡钉68,该第一卡钉68限定了近端77和相对的远端或末端79,该远端或末端79再限定了相应尖端73,该尖端73设置成***相应椎骨本体中(例如通过端板),以便将该固定组件22和(因此)植入件10固定在椎骨本体上。卡钉68包括在近端77处呈横杆70形式的基部(bass)以及在任意位置处(例如在横杆70的相对外端处,如图所示)从横杆70向外伸出的至少第一对侧向间隔开的销72。植入件10能够包括第二固定部件,该第二固定部件设置为第二卡钉69,该第二卡钉69还能够包括在任意位置处(例如在第二横杆71的相对外端处,如图所示)从第二横杆71向外伸出的第二对侧向间隔开的销74。
销72和74在它们的近端处附接在相应横杆70和75上,并在它们的远端处限定了尖端73。当卡钉68和69处于凹入位置时,销72和74能够完全凹入固定壳体36中,以使得尖端73并不从固定壳体36伸出。当固定部件38处于伸出位置时,第一和第二对销72和74的尖端73能够延伸到椎骨本体12a和12b中。因此,植入件10能够包括一对固定部件,该对固定部件限定了相应对销72和74,第一对销72限定了在它的远端或末端处的尖端73,该尖端73设置成在伸出位置中伸入第一椎骨本体12a内,第二对销74限定了尖端,该尖端设置成在伸出位置中伸入第二椎骨本体12b内。
根据所示实施例,第一对销72在上部槽道64中从横杆70向上和纵向向远侧延伸,第二对销74在下部槽道65中从横杆71向下和纵向向远侧延伸。不过应当知道,第一和第二对销72和74能够根据需要从相同横杆伸出。槽道64和65能够沿它们的长度沿恒定半径弯曲,以使得销72和74能够由任意合适的刚性材料来制造,或者槽道64和65能够沿它们的长度限定不同曲率,使得销72和74能够由任意合适的柔性材料来制造。例如,销72和74能够由钛或镍钛诺(镍钛)制造。如后面更详细所述,销72和74可在槽道64和65内从缩回位置运动至伸出位置,因此,当植入件10布置在椎间空间14中时,销72和74的远端从固定壳体36伸出和伸入相应椎骨本体12a和12b内。销72和74的远端能够基本沿横向方向T而从固定壳体36伸出。
继续参考图2A-F,促动器40设置成使得固定部件38从缩回位置至伸出位置重复。根据所示实施例,促动器40能够设置为螺钉76,该螺钉76限定了沿局部或全部螺钉杆89长度的外螺纹78,该外螺纹78与孔63的相应内螺纹80接合。因此,当螺钉76在孔63中相对于固定壳体36旋转时,螺钉76能够在孔63和(因此)固定壳体36内向远侧平移。在操作过程中,螺钉76能够沿具有纵向方向分量的方向(例如向远侧)从脱开位置平移至接合位置。当螺钉76处于脱开位置时,固定部件38处于缩回位置。当螺钉76运动至接合位置时,螺钉76使得固定部件38运动至伸出位置。
还参考图2G-J,螺钉76限定了第一接合部件,该第一接合部件表示为槽82,该槽82能够沿周向或者绕弧形环绕螺钉76延伸。横杆70和71限定了相应孔,该孔能够为圆柱形,纵向穿过横杆70和71延伸,使得横杆70和71限定了相应轴环84和85,该轴环84和85的尺寸设置成***槽82中。轴环84和85的周向尺寸能够设置成稍微大于槽82,使得螺钉76可相对于轴环旋转。轴环84和85的纵向尺寸能够基本等于槽82的纵向尺寸,以使得轴环84和85以及(因此)卡钉68和69基本纵向固定在螺钉76上,使得当螺钉76在孔63内平移时,卡钉68和69进行平移。因此,当螺钉76平移时,销72和74在相应槽道64和65中向远侧平移至伸出位置,因此,销72和74的远端和(因此)尖端73从固定壳体36横向向外伸出至从植入件本体20的至少一部分横向出来的位置。槽道64和65的远端能够基本横向延伸,使得从槽道64和65伸出的销72和74部分(包括尖端73)能够基本沿横向方向引导到相应椎骨本体12a和12b中。
螺钉76限定了接合部件,该接合部件表示为插口86,该插口86纵向伸入螺钉76的近端内。插口86表示为六边形形状,尽管它可以根据需要形成为任意合适的多边形形状,包括“加号”形状、“破折号”形状或者任意可选形状。因为插口86纵向伸入螺钉76中,因此插口86限定了与植入件10***椎间空间14内的***方向基本平行的深度。因此,前入路进入椎间空间14中能够方便植入件10***椎间空间中和使得促动器40从脱开位置运动至接合位置,从而相应地使得固定部件38从缩回位置运动至伸出位置。
因此,促动器工具(例如六角驱动器)能够***插口86中并人工或自动旋转,以便使得螺钉76相对于固定壳体36旋转和向远侧平移。根据所示实施例,当螺钉处于脱开位置时,螺钉76的近端纵向向外伸出至固定壳体36前端42近侧的位置。当螺钉76向远侧平移至接合位置时,螺钉76向远侧平移,直到螺钉76到达接合位置。例如,孔63能够终止于这样的位置,它在一旦螺钉76到达接合位置时就防止螺钉76进一步平移。根据所示实施例,当螺钉76处于接合位置时,螺钉76的近端基本与固定壳体的前端42平齐。当螺钉76向远侧平移时,固定部件38同样向远侧平移,这使得销72和74在它们的相应槽道64和65内向远侧运行,从而使得尖端73分别开始从固定壳体36的上端和下端46和48横向凸出。当螺钉76和销72、74继续向远侧平移时,尖端73从固定壳体36越来越向外伸出,直到螺钉76处于接合位置,在该位置点,销72和74的尖端73从固定壳体36中完全伸出和伸入椎骨本体12a和12b中。
如果希望销72和74缩回以便于将植入件10从椎间空间14中取出,螺钉76能够相对于固定壳体36以第二相反方向旋转,从而使得螺钉76从接合位置向近侧平移至脱开位置。当螺钉76向近侧平移时,固定部件38同样向近侧平移,从而使得销72和74的尖端朝着相应槽道64和65缩回。当螺钉76已经完全缩回、使得螺钉处于脱开位置时,销72和74的尖端73能够相对于椎骨本体12a和12b凹入,并完全缩回至相应槽道64和65中,这时,植入件10能够从椎间空间14中取出。
尽管已经根据一个实施例介绍了植入件,但是应当知道,植入件10能够根据需要根据任意可选实施例构成为具有至少一个固定部件,该固定部件设置成在缩回位置和伸出位置之间运动,如上所述。下面介绍多个这样的可选实施例,应当知道,这些实施例在这里介绍的目的是示例说明,其它可选实施例超过这里的确切说明被考虑,例如由附加权利要求来限定。
例如,参考图3A-C,图中表示了根据可选实施例的植入件10的固定组件22,其中固定壳体36包括一对侧向间隔开的固定壳体段36a和36b,该对固定壳体段36a和36b与植入件本体20的侧部32和34连接。各壳体段36a和36b限定了孔63,该孔63以上述方式来接收促动器40,该促动器40表示为螺钉76。上部槽道64从壳体段36b中的一个孔63沿中心伸出,下部槽道65从壳体段36a中的另一孔63沿中心伸出。各螺钉76能够限定沿中心伸入它们的远端内的孔81,使得至少第一固定部件(表示为第一销72)的近端伸入布置在壳体段36a中的螺钉76的中心孔81内。第一销72还伸入上部槽道64中。至少第二固定部件(表示为销74)的近端伸入布置在壳体段36b中的螺钉76的中心孔81内,使得第二销还伸入下部槽道65中。
还参考图3D-F,销72和74的近端与孔81内部的相应螺钉可旋转地连接,并能够通过粘接剂或焊接而附接在螺钉76上,或者可以选择能够与螺钉76连接成一体。因此,销72和74在平移和旋转时都与相应螺钉76连接,使得销72和74与和它们连接的相应螺钉76一起旋转和平移。销72和74伸入相应槽道64和65中,该槽道64和65分别向上和向下以及纵向向远侧延伸,如上所述。因此,当螺钉76在壳体36内以上述方式旋转时它们将平移,这使得销72和74在相应槽道64和65内向远侧运行时旋转。因此,它们的尖端73也在从固定壳体36向外平移时旋转。销72和74能够各自包括在它们尖端73处的切割钻,例如切割沟槽83,以便在销72旋转和从缩回位置平移至它们的伸出位置时方便切入椎骨本体12a和12b中。
螺钉76、槽道64和65以及销72和74能够基本相互平行地延伸(纵向,如图3A-F中所示),或者能够相对彼此有角度地偏离。例如,螺钉76和槽道64和65以及(因此)销72和74能够沿从它们的近端至它们的远端的方向朝着彼此会聚,如图3G中所示。还可以选择,槽道64和65能够沿从它们的近端至它们的远端的方向彼此远离地分散。
还可以选择,植入件10能够包括在各侧部32和34处的一对螺钉76。例如,各侧部32和34能够包括:上部螺钉76,该上部螺钉76以上述方式与上部销连接;以及下部螺钉76,该下部螺钉76相对于上部螺钉位于下侧,并以上述方式与下部销连接,使得植入件本体20的各侧部能够固定在上部椎骨本体12a和下部椎骨本体12b上。
下面参考图4A-C,图中表示了根据可选实施例的植入件10的固定组件22,其中,侧向间隔开的固定壳体段36a和36b各自包括上部孔63a和下部孔63b,各上部孔63a和下部孔63b以上述方式接收促动器40(表示为上部螺钉76a和下部螺钉76b)。上部孔63a和下部孔63b能够相互侧向偏移一定距离,该距离至少等于槽道64和65的厚度。因此,上部槽道64能够从下部孔63b伸出,下部槽道65能够从上部孔63a伸出,使得在各壳体段36a和36b中的槽道64和65相互交叉,并能够在并不相互干涉的情况下纵向和横向对齐。
上部槽道64从壳体段36a和36b中的下部孔63沿中心伸出,而下部槽道65从壳体段36a和36b中的孔63沿中心伸出。各螺钉76a和76b能够限定沿中心伸入它们的远端内的孔81。至少第一固定部件38(例如一对第一固定部件,表示为一对第一销72)的近端伸入相应对下部螺钉76b的中心孔81中,该对下部螺钉76b布置在下部孔63b中,并与上部槽道64对齐。第一销72还从下部螺钉76b伸入上部槽道64中。至少第二固定部件(例如一对第二固定部件,表示为一对第二销74)的近端伸入相应对上部螺钉76a的中心孔81中,该对上部螺钉76a布置在上部孔63a中,并与下部槽道65对齐。第二销74还从上部螺钉76a伸入下部槽道65中。
还参考图4D-F,销72和74的近端与在孔81内部的相应螺钉76a和76b可旋转地连接,并能够通过粘接剂或焊接而附接在螺钉76a和76b上,或者可选择地与螺钉76a和76b连接成一体。因此,销72和74在平移和旋转时都与相应螺钉76b和76a连接,使得销72和74与和它们连接的相应螺钉76b和76a一起旋转和平移。销72从下部螺钉76b伸入上部槽道64中,销74从上部螺钉76a伸入下部槽道65中。
槽道64和65都沿具有纵向和横向方向分量的方向而从相应孔63b和63a伸出。上部槽道64的近端相对于下部槽道65的近端在下侧,而上部槽道64的远端相对于下部槽道65的远端在上侧。例如,上部槽道64的远端穿过固定壳体36和/或植入件本体20的顶端延伸。下部槽道65的远端穿过固定壳体36和/或植入件本体20的底端延伸。在操作过程中,当螺钉76以上述方式在壳体36中旋转时它们进行平移,这使得销72和74在相应槽道64和65中向远侧运行时销72和74进行旋转。因此,尖端73在它们从固定壳体36向外平移时也旋转。销72和74能够各自包括在它们的尖端73处的切割钻,例如切割沟槽83,以便在销72旋转和从缩回位置平移至它们的伸出位置时方便切入椎骨本体12a和12b中。与下部螺钉76b连接的销72穿过上部槽道64延伸,使得当植入件10布置在椎间空间14中且销72重复至它们的伸出位置时,尖端73沿具有横向方向分量的方向相对于固定壳体36和/或植入件本体20横向向外延伸至上部椎骨本体12a中。与上部螺钉76a连接的销74穿过下部槽道65延伸,使得当植入件10布置在椎间空间14中且销74重复至它们的伸出位置时,尖端73沿具有横向方向分量的方向相对于固定壳体36和/或植入件本体20横向向外延伸至下部椎骨本体12b中。
槽道64和65能够基本相互平行地延伸(在图4A-F中表示为纵向),或者能够相对彼此成角度地偏离。例如,槽道64和65能够沿从它们的近端至它们的远端的方向朝向彼此会聚,如图4G中所示。还可以选择,槽道64和65能够沿从它们的近端至它们的远端的方向彼此远离地分散。
下面参考图5A-G,图中表示了基本如对于图4A-G所述的植入件10的固定组件22,不过,销72和74能够包括沿它们一部分长度或全部长度的外螺纹87,例如在从固定壳体36横向向外延伸的末端处。因此,当销72和74旋转至它们的伸出位置时,螺纹87与椎骨本体12a和12b接合。螺纹87的节距能够与相应螺钉76的外螺纹78的节距相同或不同。而且,销72和74表示为与螺钉76a和76b成一体。
下面参考图6A-6D,驱动组件22包括呈第一上部卡钉68和第二下部卡钉69形式的一对固定部件38。第一卡钉68包括呈横杆70形式的基部以及在任意位置处(例如在横杆70的相对外端处,如图所示)从横杆70向外伸出的至少第一对侧向间隔开的销72。第二卡钉69还能够包括在任意位置处(例如在横杆71的相对外端处,如图所示)从表示为第二横杆71的基部向外伸出的第二对侧向间隔开的销74。卡钉68和69能够布置在相应的上部和下部槽道64和65中,该上部和下部槽道64和65能够沿任意所需方向延伸,例如横向方向,如图所示。应当知道,槽道64和65能够连续成单个槽道,或者根据需要分叉和分离。
促动器40能够设置为螺钉76,该螺钉76设置成使得固定部件38重复地从缩回位置(在该缩回位置中,尖端73相对于固定壳体36和/或植入件本体20凹入)运动至伸出位置(在该伸出位置中,尖端73从固定壳体36和/或植入件本体20横向向外延伸)。根据所示实施例,促动器40能够设置为螺钉76,该螺钉76限定了沿它的一部分或全部长度的外螺纹78,该外螺纹78与孔63的相应内螺纹80接合。因此,当螺钉76在孔63中相对于固定壳体36旋转时,螺钉76能够在孔63和(因此)固定壳体36中向远侧平移。
螺钉76限定了倾斜远侧尖端88,该倾斜远侧尖端88沿纵向远侧方向横向向内逐渐变小。在操作过程中,螺钉76能够从脱开位置平移至接合位置。当螺钉76处于脱开位置时,固定部件38处于缩回位置。当螺钉76运动至接合位置时,螺钉76使得固定部件38运动至伸出位置。
当卡钉68和69处于它们的缩回位置时,相应横杆70和71布置成彼此相邻,因此分开第一距离,该第一距离能够基本等于零,以使得卡钉68和69相互抵靠。横杆70和71能够为圆形截面或者以其它方式成形,以便限定相应的第一和第二凸轮表面90和92,该第一和第二凸轮表面90和92能够沿纵向远侧方向横向向内延伸,从而如果它们在处于缩回位置时相互抵靠则产生在横杆70和71的近侧部分之间的间隙。
还参考图6E-F,在操作过程中螺钉76沿纵向远侧方向平移,使得螺钉76能够与卡钉68和69的第一和第二凸轮表面90和92接合或沿该凸轮表面越过,从而使得销72和74沿具有横向方向分量的方向沿槽道平移。例如,槽道64和65能够引导销,以便使得销72和74相对于固定壳体36基本沿横向方向平移。特别是,当螺钉76在壳体中向远侧平移时,倾斜尖端88与卡钉68和69的凸轮表面90和92接合。因为倾斜尖端88逐渐变小,因此当螺钉76继续向远侧平移时,尖端88横向向外偏压卡钉68和69。因此,倾斜尖端88能够被认为限定了第三凸轮表面,该第三凸轮表面设置成基本同时与第一和第二凸轮表面90和92接合,以便使得销72和74的末端73沿横向方向平移,直到螺钉76到达接合位置。当螺钉76处于接合位置时,卡钉68和69能够处于它们的伸出位置,以使得销72向上伸出固定壳体36外,使得销74向下伸出固定壳体36外。因此,当植入件10布置在椎间空间14中时,销72延伸到上部椎骨本体12a中,销74延伸到下部椎骨本体12b中。卡钉68和69(包括横杆70和71以及销72和74)能够根据需要基本为刚性或柔性。
应当知道,如果凸轮表面90和92相对于横向方向成角度偏离,或者螺钉的尖端88相对于横向方向成角度偏离,螺钉76的尖端88能够设置成当螺钉76沿纵向远侧方向运动时将卡钉68和69横向向外偏压。根据所示实施例,全部凸轮表面90和92以及由倾斜尖端88限定的凸轮表面相对于横向方向成角度偏离。凸轮表面可以基本为平的、弯曲、弯折或者其它所需形状。
下面还参考图6G-H,固定组件22还能够包括呈抽取器96形式的第二促动器,该第二促动器设置成与第一和第二卡钉68和69的横杆接合,以便使得第一卡钉68的销72的末端73向下缩回至固定壳体36内,还使得第二卡钉69的销74的末端73向上缩回至壳体内。
抽取器96能够设置为螺钉98,该螺钉98限定了沿它的一部分或全部长度的外螺纹轴100,该外螺纹轴100与固定壳体36中的孔63的内螺纹80接合。因此,当螺钉98在孔63中相对于固定壳体36旋转时,该螺钉98能够在孔63和(因此)固定壳体36中向远侧平移。螺钉98还限定了在它的远端处的轴环102,该轴环102可相对于螺纹轴100旋转。轴环102限定至少一个斜表面,例如一对斜表面104和106,该对斜表面104和106能够相对于横向方向成角度偏离。根据所示实施例,斜表面104和106沿与螺钉98***的远侧方向相反的近侧方向而朝向彼此渐缩。
横杆70和71能够限定相应的第一和第二抽取凸轮表面108和110,它们设置成分别与抽取器96的斜表面104和106接合。抽取凸轮表面108和110能够由凹槽112和114提供,该凹槽112和114横向向内伸入横杆70和71的横向外表面中,但是并不穿透。凹槽112和114的尺寸能够设置成接收相应的斜表面104和106。抽取凸轮表面108和110能够相对于横向方向成角度偏离,或者能够沿任意所需方向延伸。抽取凸轮表面108和110以及斜表面104和106能够基本平地延伸,或者能够根据需要弯曲、弯折或者以其它方式成形。
在操作过程中,螺钉76能够在卡钉68和69重复至它们的伸出位置或者以其它方式从它们的缩回位置出来之后取出。螺钉98能够在固定壳体36中从脱开位置向远侧平移至接合位置。当螺钉98处于脱开位置时,卡钉68和69保持在当由螺钉76驱动时的伸出位置。当螺钉98运动至接合位置时,螺钉98使得卡钉68和69重复至它们的缩回位置。特别是,当螺钉98从脱开位置平移至接合位置时,斜表面104和106接触横杆70和71,例如在凹槽112和114中,该横杆70和71能够在卡钉68和69处于它们的完全伸出位置时保持在固定壳体36中。
因为轴环102可相对于有螺纹的螺钉杆100旋转,因此,当螺钉杆100继续相对于固定壳体36旋转以便使得螺钉98在固定壳体36中向远侧平移时,斜表面104和106保持接合在凹槽112和114中。固定壳体36能够限定接收轴环的槽道,以便当螺钉98在固定壳体36中旋转时使得斜表面104和106保持与凹槽112和114对齐。当螺钉98向远侧平移时,横杆70和71沿斜表面104和106越过。因此,斜表面104偏压卡钉68和69,以便朝着中心纵向轴线37横向向内运动。因此,上部卡钉68和相应销72向下平移,直到销72从上部椎骨本体12a取出和凹入固定壳体36内。然后,植入件10能够从椎间空间12中取出,或者根据需要在椎间空间12内重新定位。而且,下部卡钉69和相应销74向上平移,直到销74从下部椎骨本体12b中取出和凹入固定壳体中。因此,斜表面104和106能够称为凸轮表面,它使得固定部件38沿从它们的伸出位置朝着它们的缩回位置的方向运动。
根据所示实施例,抽取器96能够设置为离散的促动器(相对于促动器40)。根据可选实施例,抽取器96能够附接在促动器40上或者与该促动器40形成一体,使得促动器40的一个纵向侧部限定了远侧尖端88,且促动器40的相对纵向侧部包括轴环102。
下面参考图7A-C,固定组件22能够根据可选实施例来构成。固定组件22能够包括至少一个促动器40,该促动器设置成使得至少一个固定部件38以上述方式在缩回位置和伸出位置之间重复。固定组件22还能够包括偏压部件118,该偏压部件118可操作地连接在促动器40和固定部件38之间。例如,偏压部件118能够在它的远端处附接在固定部件38上,并能够使得固定部件38在由促动器40施加在偏压部件118上的力的作用下从缩回位置运动至伸出位置。
该至少一个固定部件38能够呈第一上部固定部件(表示为第一上部卡钉68)和第二下部固定部件(表示为第二下部卡钉69)的形式,如上所述。因此,第一卡钉68包括呈横杆70形式的基部以及在任意位置处(例如在横杆70的相对外端处,如图所示)从横杆70向外伸出的至少第一对侧向间隔开的销72。第二卡钉69还能够包括在任意位置处(例如在横杆71的相对外端处,如图所示)从呈横杆71形式的基部向外伸出的第二对侧向间隔开的销74。卡钉68和69能够布置在相应的上部和下部槽道64和65中,该上部和下部槽道64和65能够沿任意所需方向延伸,例如横向方向,如图所示。应当知道,槽道64和65能够连续成单个槽道,或者根据需要分叉和分离。
根据所示实施例,促动器40能够设置为螺钉76,该螺钉76限定了沿螺钉杆89的一部分或全部纵向长度的外螺纹78。螺钉76限定了螺钉头部91,该螺钉头部91限定了外部凸轮表面93,并与螺钉杆89的远端连接,且能够有比螺钉杆89大的截面尺寸(例如直径)。螺纹78与在固定壳体36的前端42中的孔63的相应内螺纹80接合。因此,当螺钉76在孔63中相对于固定壳体36旋转时,螺钉76能够在孔63和(因此)固定壳体36中向远侧平移。在操作过程中,螺钉76能够从脱开位置平移至接合位置。当螺钉76处于脱开位置时,固定部件38处于缩回位置。当螺钉76运动至接合位置时,螺钉76使得固定部件38运动至伸出位置。
偏压部件118包括第一上部柔性偏压臂120和第二下部柔性偏压臂122。臂120和122限定了相应近端124和126,该近端124和126相对于一对中间段132和134横向向内延伸,该对中间段132和134沿向远侧纵向方向朝向彼此横向逐渐变小。近端124和126在各连接位置123和125处通过粘接剂、机械紧固件或者摩擦配合或者任意合适的可选固定件而固定在固定壳体36上。臂120和122限定了呈固定在横杆70和71上的钩133形式的远端。中间段132和134连接在柔性臂120和122的近端和远端之间。中间段132和134通过铰链127而与近端124和126连接。钩133相互横向间隔开一定距离,该距离能够在它们抵靠时等于零,这小于当卡钉68和69处于它们的缩回位置时螺钉凸轮表面93的横向尺寸。
还参考图7D-F,当螺钉76从它的脱开位置向远侧平移至它的接合位置时,螺钉76的外部凸轮表面93设置成基本同时接触柔性臂120和122以及沿该柔性臂120和122越过。柔性臂120和122因此能够限定与螺钉76的外部凸轮表面93接合的内部凸轮表面。外部凸轮表面93限定了这样的横向尺寸,使得当凸轮表面93沿中间段132和134越过时,柔性臂120和122绕铰链127横向向外弯曲,从而使得钩和相应销72和74在它们的相应槽道64和65内横向向外平移至它们的伸出位置,如图7F中所示,因此,销72的末端尖端73向上伸出固定壳体36外,销74的末端尖端73向下伸出固定壳体36外。这样,中间段132和134的内部横向表面能够称为凸轮表面。
下面参考图8A-B,可选地,偏压臂120和122能够基本为刚性,以便不会响应于与促动器40接合而弯曲。特别是,偏压臂120和122例如在铰链127处与固定壳体36可枢转地连接。因此,偏压臂120和122能够绕侧部枢转轴线相对于固定壳体36枢转。近端124和126能够与固定壳体36分开,且根据所示实施例布置在孔63中。远端能够设置为钩,该钩与固定部件连接,如上面对于图7A-F所述,或者也可选择,分别包括成一体的固定销72和74。
促动器40能够设置为螺钉76,该螺钉76限定了沿螺钉杆89的一部分或全部长度的外螺纹78,该外螺纹78与孔63的相应内螺纹80接合。因此,当螺钉76在孔63中相对于固定壳体36旋转时,螺钉76能够在孔63和(因此)固定壳体36中向远侧平移。在操作过程中,螺钉76能够从脱开位置向远侧平移至接合位置。螺钉76的远端能够限定凸轮表面93,该凸轮表面93的尺寸设置成与偏压臂120和122的近端124和126接触。因此,近端124和126的纵向近侧表面有相应凸轮表面,该凸轮表面设置成接收纵向偏压力,该纵向偏压力使得偏压臂120和122枢转,这又分别使得上部和下部固定销72和74在壳体36的上侧和下侧延伸到相应上部和下部椎骨本体12a和12b中。
下面参考图9A-B,根据可选实施例,固定组件22能够大致构成为推动器。固定壳体36能够定位成使得后端44与植入件本体20的中心开口25对齐,使得前端42向植入件本体20的前端24的近侧移动。固定组件22包括呈可旋转轮毂或轴89形式的促动器40,该可旋转轮毂或轴89与固定壳体36连接,以便可相对于固定壳体36旋转和可平移地固定在壳体上。可旋转轴89能够有螺纹或无螺纹,并能够设置成当它相对于固定壳体36旋转时保持基本固定的纵向位置(因此并不向近侧或向远侧进行较大的平移)。轴89限定了接合部件,该接合部件表示为纵向延伸到轴89的近端内的插口86。插口86表示为六边形形状,尽管它可以形成为任意合适的多边形形状,包括“加号”形状、“破折号”形状或者任意所需的可选形状,以便接收驱动该轴旋转的驱动部件。
该至少一个固定部件38能够包括至少一对固定叶片,例如第一上部固定叶片142和第二下部固定叶片144,它们与轴89可旋转地连接,以使得叶片142和144与轴89一起旋转。根据所示实施例,固定部件38包括近侧的第一对上部叶片142和下部叶片144以及远侧的第二对上部叶片142和下部叶片144。第一对叶片142和144布置在植入件本体20的前端24的近侧,第二对叶片142和144布置成与植入件本体20的中心空腔25对齐。两对叶片142和144能够与轴89可旋转地连接,以便与轴89一起旋转。叶片142和144能够沿侧向和横向方向A和T基本为平的,或者能够根据需要弯曲(例如当叶片142和144可相对于轴89平移时,或者当轴89可相对于固定壳体36平移时)。叶片142和144能够朝着远侧的末端尖端143逐渐变小。相对于从缩回位置向伸出位置的运动,各叶片142和144有前边缘145和后边缘146。
还参考图9C,固定壳体36限定了槽道(表示为狭槽),该槽道使得叶片142和144能够从它们的缩回位置旋转至它们的伸出位置。特别是,固定壳体36限定了接收上部叶片142的上部叶片狭槽148以及接收下部叶片144的下部叶片狭槽150。下部和上部叶片狭槽150和148都侧向和横向相对,且尺寸设置成使得当植入件10布置在椎间空间14中时,叶片142和144能够从第一缩回位置(其中,尖端143相对于椎骨本体12a和12b分别横向凹入至例如固定壳体36内)旋转至第二伸出位置(其中,尖端143从固定壳体36横向向外延伸至各椎骨本体12a和12b中)。例如,狭槽148延伸通过固定壳体本体36的顶端和侧端46和50。狭槽150延伸通过固定壳体36的底端和侧端48和52。第一对狭槽148和150布置在固定壳体36的前端的近侧,第二对狭槽148和150与中心空腔25对齐。
在操作过程中,轴89从第一旋转脱开位置(其中,固定叶片142和144处于凹入位置)旋转至第二旋转接合位置(其中,固定叶片142和144处于伸出位置)。轴89能够沿0度和180度之间(例如在20度和90度之间)的角度在脱开和接合位置之间旋转。当叶片142和144处于它们的缩回位置时,叶片142和144能够通过相应的叶片狭槽148和150而从轴89径向向外延伸,使得尖端143沿侧向从固定壳体向外布置在椎间空间14中。固定壳体36在顶端和底端46和50中的狭槽148和150的侧端处提供了止动器,该止动器防止叶片142和144经过伸出位置过度旋转。
如图9A-C中所示,前边缘和后边缘145和146能够沿径向向外方向从轴89至尖端143基本直地延伸。也可选择,前边缘和后边缘145和146中的一个或两个能够根据需要沿径向向外方向从轴89朝着尖端143弯曲。例如,如图9D-E中所示,前边缘145能够为凹形,后边缘146能够为凸形。也可选择,前边缘和后边缘145和146中的任意一个或两个能够根据需要为直的、凹形、凸形或者以其它方式弯曲。
下面参考图10A-C,固定组件22基本如对于图9A-C中所示的固定组件所述而构成。不过,如图10A-C中所示的固定叶片142和144能够构成为从轴89径向向外伸出一定距离,该距离小于如图9A-C中所示的叶片142和144伸出的距离。因此,当叶片142和144处于它们的缩回位置时,叶片142和144布置在固定壳体36中。上部叶片狭槽148能够延伸穿过固定壳体36的顶端46,而不穿过固定壳体的任一侧端。同样,下部叶片狭槽150能够延伸穿过固定壳体36的顶端46,而不穿过固定壳体的任一侧端。
下面参考图11A-B,固定组件22能够包括可旋转轴89,该可旋转轴89支承在固定壳体36中,基本如上面对于图9A-C所述。因此,固定组件22包括呈可旋转轴89形式的促动器40,可旋转轴89与固定壳体36连接,以便可相对于固定壳体36旋转和可平移地固定在壳体上。可旋转轴89能够有螺纹或无螺纹,并能够设置成当它相对于固定壳体36旋转时保持基本固定的纵向位置(因此并不向近侧或向远侧进行较大的平移)。轴89限定了接合部件,该接合部件表示为纵向延伸到轴89的近端内的插口86。插口86表示为六边形形状,尽管它可以形成为任意合适的多边形形状,包括“加号”形状、“破折号”形状或者任意合适的可选形状,以便接收驱动该轴旋转的驱动部件。
轴89限定了外周表面141和至少一个槽147,该槽147径向延伸到外周表面141中,并接收至少一个固定部件38,例如一对固定部件38。也可选择,轴89能够限定一对纵向间隔槽。槽147能够绕轴89的周边的一部分或整个周边延伸,或者能够可选择地包括一对离散槽,该对离散槽各自接收一对固定部件38。
该至少一个固定部件38能够包括在第一近侧槽147中与轴89连接的第一上部卡钉68和第二下部卡钉69以及在第二远侧槽147中与轴89连接的第一上部卡钉68和第二下部卡钉69。卡钉68和69能够在延伸到固定壳体36或延伸穿过固定壳体36的相应的上部和下部槽道64和65中而从轴89向外伸出。第一卡钉68包括呈横杆70形式的基部以及在任意位置处(例如在横杆70的相对外端处,如图所示)从横杆70向外伸出的至少第一对侧向间隔销72。第二卡钉69还能够包括在任意位置处(例如在横杆71的相对外端处,如图所示)从表示为第二横杆71的基部向外伸出的第二对侧向间隔销74。卡钉68和69能够布置在相应的上部和下部槽道64和65中,该上部和下部槽道64和65能够沿任意所需方向延伸,例如横向方向,如图所示。应当知道,槽道64和65能够连续成单个槽道,或者根据需要分叉和分离。卡钉68和69能够限定末端尖端73,该尖端73能够为刚性,并从轴89沿切向向外延伸和伸入相应槽道64和65中。卡钉68和69的近侧部分的至少一部分能够为柔性,以便当卡钉68和69处于缩回位置时卷绕该轴89,当卡钉68和69处于伸出位置时从轴89沿切向向外延伸。
还参考图11C,在操作过程中,轴89从第一旋转脱开位置(其中,卡钉68和69处于凹入位置)旋转至第二旋转接合位置(其中,卡钉68和69处于伸出位置)。卡钉68和69能够在它们从缩回位置运动至伸出位置时在它们的相应槽道64内运行。当卡钉68和69处于缩回位置时,尖端63布置在壳体36中,并不伸入相应椎骨本体12a和12b内。当卡钉68和69运动至伸出位置时,尖端63从固定壳体36横向向外伸出并伸入椎骨本体12a和12b中。固定壳体36能够提供任意合适的止动器,该止动器防止轴89经过接合位置过度旋转。
下面参考图11D-F,卡钉68和69的尖端73能够为柔性,并能够当轴89处于脱开位置以及卡钉68和69处于相应缩回位置时基本整个布置在轴89的槽147内。因此,当轴89从脱开位置旋转至接合位置时,尖端73伸入相应槽道64和65中,直到轴89处于接合位置,这使得卡钉68和69运动至伸出位置,从而尖端73从固定壳体36向外伸出和伸入相邻的椎骨本体12a和12b内。
参考图12A-C,固定组件22能够基本如上面对于图11A-C所述而构成,不过,轴89能够包括齿轮齿152,该齿轮齿152为纵向细长,并绕轴89的外周141周向间隔开。卡钉68能够包括互补齿条154的齿156,该齿156设置成当轴旋转时与该轴89的齿轮齿152配合,以便以上面所述方式将尖端73钉入椎骨本体12a和12b中。齿条154能够为柔性,且尖端73能够根据需要为柔性或刚性。应当知道,轴89能够沿相反方向从接合位置旋转至脱开位置,以便使得卡钉68和69从伸出位置缩回至缩回位置。
下面参考图13A-C,图中表示了根据可选实施例的植入件10的固定组件22,其中,固定壳体36包括一对侧向间隔开的固定壳体段36a和36b,该固定壳体段36a和36b与植入件本体20的侧部32和34连接。各壳体段36a和36b限定了孔63,该孔63以上面所述方式接收促动器40(表示为轴89)。轴89能够各自设置为具有相应螺旋形齿轮齿157的蜗轮155,该螺旋形齿轮齿157绕轴89的周边141纵向延伸。
固定组件22还能够包括至少一个固定部件38,该固定部件38表示为具有横向朝下的尖端73的第一上部销72以及具有横向朝上的尖端73的第二下部销74。销72和74能够各自包括螺旋齿轮齿158,该螺旋齿轮齿158设置成与相应轴89的齿轮齿157配合。销72和74分别布置在相应第一和第二上部和下部槽道64和65中,该第一和第二上部和下部槽道64和65在固定壳体36中横向延伸。在操作过程中,轴89能够布置在第一脱开位置,其中,尖端73凹入固定壳体36中,从而当植入件10布置在椎间空间14中时并不延伸到相邻椎骨本体12a和12b内。参考图13D-E,轴89能够旋转至接合位置,这使得蜗轮155驱动齿轮齿158,从而使得销72和74分别横向向上和向下平移,直到尖端73***相应椎骨本体12a和12b中。尖端73能够根据需要以上面所述方式包括切割沟槽和/或能够有螺纹,以便提高在椎骨本体12a和12b中的固定。
如图13A中所示,轴89能够基本相互平行地在相应固定壳体段36a和36b中延伸。也可选择,如图13F中所示,轴89能够相对彼此成角度地偏离。例如,槽道轴89能够沿从它们的近端至它们的远端的方向朝向彼此会聚,如图3F中所示。还可以选择,轴89能够沿从它们的近端至它们的远端的方向彼此远离地分开。
下面参考图14A-B,固定组件22能够包括支承在固定壳体36中的可旋转轴89,基本如上面参考图11A-C所述。因此,固定组件22包括呈可旋转轴89形式的促动器40,该可旋转轴89与固定壳体36连接,以便可相对于固定壳体36旋转和可平移地固定在固定壳体36上。可旋转轴89能够有螺纹或无螺纹,并能够设置成当它相对于固定壳体36旋转时保持基本固定的纵向位置(因此并不向近侧或向远侧进行较大的平移)。轴89限定了接合部件,该接合部件表示为纵向伸入轴89的近端内的插口86。插口86表示为六边形形状,尽管它可以形成为任意合适的多边形形状,包括“加号”形状、“破折号”形状或者任意合适的可选形状,以便接收驱动该轴旋转的驱动部件。
轴89能够限定近侧表面160和远侧表面162以及至少一个孔,该孔在近侧和远侧表面160和162之间沿纵向延伸穿过轴89。轴89能够包括第一上部孔164a和第二下部孔164b,该第二下部孔164b在相对于第一孔164a偏离180度的位置处穿过轴延伸。固定组件22能够包括至少固定部件38,该固定部件38呈第一上部卡钉68和第二下部卡钉69的形式。第一卡钉68包括呈横杆70形式的基部以及在任意位置处(例如在横杆70的相对外端处,如图所示)从横杆70向外延伸的至少第一对侧向间隔销72。第二卡钉69还能够包括在任意位置处(例如在横杆71的相对外端处,如图所示)从表示为第二横杆71的基部向外延伸的第二对侧向间隔销74。
卡钉68和69的横杆70和71能够分别穿过第一和第二孔洞164a和164b纵向延伸。横杆70和71能够松弛地接收于第一和第二孔洞164a和164b中,使得横杆70和71可在孔洞164a和164b内部旋转。因此,卡钉68和69以及相关联的销72和74能够相对于轴89绕分别由横杆70和71限定的纵向枢转轴线而枢转。因此,可以说,销72和74在相对于轴89的外周141向内间隔的位置处与轴89连接。销72和74在相应的上部和下部槽道64和65中沿基本横向方向从横杆70和71以及轴89向外延伸。销72和74能够根据需要为柔性或刚性,并能够沿相邻近侧和远侧轴表面延伸,以便针对相对轴89平移来固定卡钉68和69。
还参考图14C,在操作过程中,轴89从第一旋转脱开位置(其中,卡钉68和69处于凹入位置)旋转至第二旋转接合位置(其中,卡钉68和69处于伸出位置)。卡钉68和69能够在它们从缩回位置运动至伸出位置时在它们的相应槽道64内运行。当轴89绕纵向轴线从脱开位置旋转至接合位置时,销72和74能够绕纵向轴线枢转,以便当尖端73从固定壳体36伸出和伸入相邻椎骨本体12a和12b内时保持基本横向取向。当卡钉68和69处于缩回位置时,尖端63布置在壳体36中,并不延伸到相应椎骨本体12a和12b内。固定壳体36能够提供任意合适的止动器,该止动器防止轴89经过接合位置过度旋转。应当知道,轴89能够沿相反方向从接合位置旋转至脱开位置,以便使得卡钉68和69从伸出位置缩回至缩回位置。
应当知道,除非另外说明,术语“或”用于它的非排它形式(例如,“A或B”包括A、B、A和B,或者它们的任意组合,但是不必包括所有这些可能)。应当知道,除非另外说明,“和/或”也类似使用(例如,“A和/或B”包括A、B、A和B,或者它们的任意组合,但是不必包括所有这些可能)。应当知道,除非另外说明,术语“包括”的意思是“包含”(例如,包括或包含A和B的装置包含A和B,但是可以选择包含不同于A和B的C或者附加部件)。还应当知道,除非另外说明,冠词形式“一”和“该”是指一个或超过一个,除非在文字上以其它方式清楚规定。
尽管已经参考优选实施例或优选方法介绍了本发明,但是应当知道,这里使用的措辞是说明和示例的措辞,而不是限制的措辞。例如,应当知道,尽管椎间植入件在这里介绍为设置成固定在相邻椎骨本体上,但是植入件能够根据需要选择地***在任意骨或骨段(例如骨折的骨段)之间的空间内,且随后以这里所述的方式固定在相邻骨或骨段上。而且,尽管这里参考特殊结构、方法和实施例介绍了本发明,但是本发明并不局限于这里所述的特殊形式,因为本发明延伸至在本发明范围内的所有结构、方法和使用。除非另外说明,这里所述的各个实施例的结构和特征还能够根据需要包含在这里所述的其它实施例中。因此,本领域技术人员应当知道,本发明将包括包含在例如由附加权利要求提出的本发明精神和范围内的所有变化形式和可选结构。
Claims (15)
1.一种植入件(10),其设置成由锚固件固定在由第一椎骨本体(12a)和第二椎骨本体(12b)限定的椎间空间(14)中,所述植入件(10)具有顶部和底部,所述底部沿植入件(10)与顶部的横向相对侧设置,所述植入件(10)包括:
周向壁,所述周向壁包括:
前部壁部分,
后部壁部分,所述后部壁部分沿植入件(10)与前部壁部分的纵向相对侧设置,
第一侧壁部分,
第二侧壁部分,所述第二侧壁部分沿植入件(10)与第一侧壁部分的侧向相对侧设置,
顶部表面,所述顶部表面在植入件(10)的顶部沿前部壁部分、后部壁部分、第一侧壁部分和第二侧壁部分延伸,以及
底部表面,所述底部表面在植入件(10)的底部沿前部壁部分、后部壁部分、第一侧壁部分和第二侧壁部分延伸;
中心空腔,所述中心空腔至少部分地由周向壁界定,所述中心空腔从植入件(10)的顶部处的开口至植入件(10)的底部处的开口完全延伸穿过植入件(10);以及
固定组件,其特征在于,所述固定组件(22)包括:
壳体(36),所述壳体沿前部壁部分***周向壁中的凹口内,所述壳体包括:上表面,所述上表面在固定组件安装在周向壁上的情况下朝着植入件的顶部定向;下表面,所述下表面在固定组件(22)安装在周向壁上的情况下朝着植入件(10)的底部定向;前表面,所述前表面在上表面和下表面之间延伸;以及后表面,所述后表面在上表面和下表面之间延伸并在固定组件(22)安装在周向壁上的情况下沿壳体与上表面的纵向相对侧设置,
锚固件(38),所述锚固件设置在壳体(36)中并能在弯曲通路中在缩回位置与伸出位置之间运动,在所述缩回位置中,在固定组件安装在周向壁上的情况下,锚固件(38)的尖锐的尖端(73)布置在植入件(10)的顶部的下方,在所述伸出位置,在固定组件安装在周向壁上的情况下,锚固件(38)的尖锐的尖端(73)从壳体(36)横向向外伸出并布置在植入件(10)的顶部的上方,以及
促动器(40),所述促动器与锚固件(38)连接并布置在壳体(36)中,所述促动器能够在接合位置和脱开位置之间运动,在所述接合位置,锚固件(38)处于伸出位置,在所述脱开位置,锚固件(38)处于缩回位置。
2.根据权利要求1所述的植入件,其中:所述锚固件(38)包括第一臂,所述第一臂在枢转部与第二臂成角度地连接,其中,尖锐的尖端(73)沿第一臂设置且促动器(40)通过促动器(40)上的凸轮表面与沿第二臂远离枢转部布置的凸轮表面的接触而与第二臂连接。
3.根据权利要求2所述的植入件,其中:所述第一臂和第二臂各自布置在垂直于经过枢转部的枢转轴线的旋转平面中。
4.根据权利要求3所述的植入件,其中:所述锚固件(38)在缩回位置和伸出位置之间的运动包括锚固件(38)在旋转平面中的旋转,其中,枢转部在铰链处固定在壳体(36)上。
5.根据权利要求4所述的植入件,其中:所述促动器(40)在接合位置和脱开位置之间的运动包括具有纵向方向分量的平移。
6.根据权利要求4所述的植入件,其中:所述促动器(40)在接合位置和脱开位置之间的运动包括促动器(40)在设置于壳体(36)内的孔中平移,所述孔具有纵向方向分量。
7.根据权利要求1所述的植入件,其中:
所述壳体(36)包括延伸穿过壳体(36)的上表面和下表面的槽道;
所述促动器(40)包括可旋转地安装在壳体(36)中的轴;
所述锚固件(38)包括叶片,所述叶片固定在促动器(40)上并可随所述轴从缩回位置向伸出位置旋转;
当叶片处于它们的缩回位置时,所述尖端沿侧向从所述壳体向外布置在所述椎间空间中;
所述促动器(40)在接合位置和脱开位置之间的运动包括所述轴的角旋转;以及
所述锚固件在缩回位置和伸出位置之间的运动包括锚固件的一部分在槽道中的旋转,在所述锚固件(38)处于伸出位置的情况下,所述旋转使锚固件(38)的尖端沿壳体(36)的上表面和下表面侧向伸出槽道。
8.根据权利要求7所述的植入件,其中:所述叶片沿侧向方向A和横向方向T大致是平的。
9.根据权利要求8所述的植入件,其中:所述叶片的前边缘大致是弯曲的。
10.根据权利要求1所述的植入件,其中:
所述促动器(40)包括绕纵向旋转轴线可旋转地安装在壳体(36)中的轴和在所述轴中纵向延伸的孔洞,所述孔洞与所述纵向旋转轴线径向偏离;
所述壳体(36)包括在大致横向方位中设置的第一槽道和穿过壳体(36)的上表面的开口;
锚固件(38)包括可旋转地安装在孔洞中的横杆和附接在横杆上并伸出所述轴至第一槽道中的第一销;
所述促动器(40)在接合位置和脱开位置之间的运动包括所述轴的角旋转;以及
所述锚固件(38)在缩回位置和伸出位置之间的运动包括第一销在第一槽道中的平移,其中,在所述锚固件处于伸出位置的情况下,尖锐的尖端(73)在开口处穿过壳体(36)的上表面伸出第一槽道,在所述锚固件(38)处于缩回位置的情况下,尖锐的尖端(73)缩回至第一槽道中。
11.根据权利要求10所述的植入件,其中:
所述壳体(36)包括在大致横向方位中设置的第二槽道和穿过壳体(36)的上表面的开口;
所述锚固件(38)包括卡钉,所述卡钉包括横杆、第一销和第二销,所述第二销附接在横杆上并伸出轴至第二槽道中;以及
所述锚固件在缩回位置和伸出位置之间的运动还包括第二销在第二槽道中的平移,其中,在所述锚固件(38)处于伸出位置的情况下,锚固件(38)的尖锐的第二尖端(73)在开口处穿过壳体(36)的上表面伸出第二槽道,在所述锚固件(38)处于缩回位置的情况下,尖锐的第二尖端(73)缩回至第二槽道中。
12.根据权利要求10所述的植入件,其中:所述销是柔性的。
13.根据权利要求10所述的植入件,其中:所述销是刚性的。
14.根据权利要求1所述的植入件,其中:所述壳体(36)沿前部壁部分中的开口可拆卸地安装在周向壁上。
15.根据权利要求14所述的植入件,其中:在前部壁部分中的开口包括从植入件(10)的顶部延伸到植入件(10)的底部的间隙,所述间隙将前部壁部分分成两部分并在顶部表面和底部表面的每一个中都产生间隙。
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FR3005569B1 (fr) | 2013-05-16 | 2021-09-03 | Ldr Medical | Implant vertebral, dispositif de fixation vertebrale d'implant et instrumentation d'implantation |
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2010
- 2010-09-17 CN CN201510587924.0A patent/CN105326585B/zh not_active Expired - Fee Related
- 2010-09-17 JP JP2012529931A patent/JP5699353B2/ja not_active Expired - Fee Related
- 2010-09-17 ES ES15200239.0T patent/ES2659063T3/es active Active
- 2010-09-17 KR KR1020127009552A patent/KR101805935B1/ko active IP Right Grant
- 2010-09-17 EP EP10759773.4A patent/EP2477579B1/en active Active
- 2010-09-17 US US12/884,664 patent/US8617245B2/en active Active
- 2010-09-17 WO PCT/US2010/049287 patent/WO2011035126A1/en active Application Filing
- 2010-09-17 BR BR112012005663-8A patent/BR112012005663A2/pt not_active IP Right Cessation
- 2010-09-17 CA CA2773723A patent/CA2773723C/en not_active Expired - Fee Related
- 2010-09-17 EP EP15200239.0A patent/EP3011934B1/en not_active Not-in-force
- 2010-09-17 CN CN201080048337.XA patent/CN102596109B/zh not_active Expired - Fee Related
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2013
- 2013-10-28 US US14/064,434 patent/US8932359B2/en active Active
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2015
- 2015-01-12 US US14/594,770 patent/US9463091B2/en active Active
- 2015-01-21 JP JP2015009322A patent/JP5947923B2/ja not_active Expired - Fee Related
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2016
- 2016-07-29 HK HK16109095.7A patent/HK1220890A1/zh unknown
- 2016-10-10 US US15/289,861 patent/US9737412B2/en active Active
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2017
- 2017-08-22 US US15/682,549 patent/US20180064554A1/en not_active Abandoned
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KR101805935B1 (ko) | 2017-12-06 |
WO2011035126A1 (en) | 2011-03-24 |
EP3011934A1 (en) | 2016-04-27 |
US20180064554A1 (en) | 2018-03-08 |
JP5947923B2 (ja) | 2016-07-06 |
CA2773723C (en) | 2017-10-31 |
EP2477579A1 (en) | 2012-07-25 |
US8932359B2 (en) | 2015-01-13 |
ES2659063T3 (es) | 2018-03-13 |
US20110178599A1 (en) | 2011-07-21 |
HK1220890A1 (zh) | 2017-05-19 |
US9737412B2 (en) | 2017-08-22 |
CN102596109B (zh) | 2015-10-21 |
JP2013505073A (ja) | 2013-02-14 |
JP2015077467A (ja) | 2015-04-23 |
CN105326585A (zh) | 2016-02-17 |
KR20120081141A (ko) | 2012-07-18 |
EP3011934B1 (en) | 2017-12-13 |
US9463091B2 (en) | 2016-10-11 |
US20150127109A1 (en) | 2015-05-07 |
US20170095350A1 (en) | 2017-04-06 |
BR112012005663A2 (pt) | 2021-07-27 |
CN102596109A (zh) | 2012-07-18 |
JP5699353B2 (ja) | 2015-04-08 |
US8617245B2 (en) | 2013-12-31 |
US20140052262A1 (en) | 2014-02-20 |
EP2477579B1 (en) | 2015-12-23 |
CA2773723A1 (en) | 2011-03-24 |
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