CN107072697A - 侧块固定植入件 - Google Patents

侧块固定植入件 Download PDF

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CN107072697A
CN107072697A CN201580040825.9A CN201580040825A CN107072697A CN 107072697 A CN107072697 A CN 107072697A CN 201580040825 A CN201580040825 A CN 201580040825A CN 107072697 A CN107072697 A CN 107072697A
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lateral mass
facet
component
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fixing component
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克里斯托弗·U·法纳
杰弗里·D·史密斯
托德·谢泼德·桑徳斯
克里西托夫·西明奥诺文
布鲁斯·M·麦科马克
爱德华·莱奥乌
希格鲁·坦埃克
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Providence Medical Technology Inc
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
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    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/809—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with bone-penetrating elements, e.g. blades or prongs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564—Methods for bone or joint treatment

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Abstract

此文描述的不同实施方式提供了侧块和小面固定植入件，该侧块和小面固定植入件可以使用最少程度的侵入或较少的侵入技术通过后侧路径***和应用。以下描述的实施方式一般包括小面内植入件(或“小面植入件”)和附接至或可附接至所述小面植入件的侧块固定构件。所述侧块固定构件可以包括一个或多个耳片，所述耳片从中间部延伸并且构造成将所述侧块固定构件固定至邻近椎骨的侧块。所述耳片可以是柔性的、半刚性的或刚性的，并且可以是可塌缩的以助于所述装置的***。还描述了用于输送所述侧块和小面固定植入件的方法。

Description

侧块固定植入件
相关申请的交叉参考
本申请要求于2014年5月27日提交的美国临时专利申请No.62/003,443,发明名称为“侧块固定植入件”的优先权，上述所列专利申请的全部公开通过参考因而引入于此。
技术领域
具有侧块固定的颈椎后路融合是最严格的颈部手术。其需要肌肉和韧带从后脊锥广泛的解剖开，从而使得外科医生能够直接可视以安全地操作所述步骤。这样的解剖引起急性和慢性软组织疼痛综合征。严重地，患者为了需要静脉注射(IV)麻醉剂的疼痛控制通常住院3-4天。这是相比较于不需要任何肌肉或软组织切开的前侧路径的1天住院。进行后侧路径的长期病人经常具有由于解剖的广泛性质的持续疼痛。有时，在后侧接近颈部融合手术后，软组织可能不能回到解剖位置并且可能永久地变形。在后侧手术路径之后的持续疼痛表示为椎面板切除术后综合征。(图1是C5和C6颈部椎骨的侧视图，图示了解剖结构。)
因此，由于认为对于患者是更小创伤的，相比后侧路径，前侧颈部脊椎融合手术一般优于后侧融合手术，同时，对于颈部脊椎的后侧路径的确比前侧路径具有某些优点。
侧块或椎弓根螺钉固定相比前侧板件、体内装置和棘突丝线提供了颈部脊椎的更加刚性的固定。对于创伤的不稳定性是最有利的，但是也已经用于退行性的情况。尽管是最佳的固定，如上所述，由于软组织解剖的发病率，侧块固定是经常避免的。(图2A和2B分别是颈部脊椎的后视图和侧视图，所述颈部脊椎具有应用于其的后侧固定装置。)
使用经皮路径目前不能实现开始钻孔或将螺钉***至椎骨侧块中。这是因为软组织在钻中被绊住，并且钻会滑离骨并且失去控制。没有直接可视化而通过螺钉将尖钻和稳固的压力置于骨上在后侧颈椎中是危险的，除非外科医生移除了软组织并且具有直接可视化。
因此，具有用于通过后侧接近路径实施颈部脊椎融合步骤的改进装置、***和方法是有利的。理想地，这些装置、***和方法允许最少程度地侵入的或较少地侵入的接近和固定，还有助于确保固定装置的合适放置。至少这些目标中的一些将通过此文所述的具体实施方式被实现。
发明内容
此文描述的不同的实施方式提供了侧块和小面固定植入件，所述侧块和小面固定植入件可以使用最低程度的侵入或较小的侵入技术通过后侧路径***和应用。如下所述的实施方式一般包括小面内植入件(或“小面植入件”)和附接至或可附接至所述小面植入件的侧块固定构件。所述侧块固定构件可以包括一个或多个耳片，所述耳片从中间部分延伸并且构造成将所述侧块固定构件固定至邻近椎骨的侧块。所述耳片可以是柔性的、半刚性的或刚性的，并且可以是可塌缩的以便于所述构件的***。
在一方面，公开了脊椎植入***。所述脊椎植入***包括用于定位在小面关节中的小面植入构件和附接至或可附接至所述小面植入构件的侧块固定构件。所述小面植入构件和侧块固定构件可以是在现场可附接的两个分开的装置或部件，或者它们可以是单个装置或属于单个构件或整体构造。在一些实施方式中，所述小面植入构件包括桩并且所述侧块固定构件包括穿过其形成的用于容纳所述桩的孔。所述桩可以具有圆形、正方形和多边形中的一个形状。
在一些方面，所述侧块固定构件包括板件，所述板件包括中间部、位于所述中间部的开口，所述开口构造成允许螺钉穿过以将所述板件与所述小面植入构件连接，和两个耳片，所述两个耳片从所述中间部的相反侧延伸以接触邻近椎骨的侧块。所述耳片可以包括一个或多个表面特征，例如从所述耳片延伸以将所述耳片固定至邻近椎骨的侧块的尖钉。所述耳片可以包括有一个或多个穿过其形成的用于容纳一个或多个固定装置的孔，所述固定装置被构造成将所述耳片固定至所述邻近椎骨的侧块。所述耳片可以通过铰链从所述中间部的侧部延伸并且所述耳片是相对于所述中间部围绕所述铰链是可旋转的。所述侧块固定构件可以包括两个从所述小面植入构件延伸以接触邻近椎骨的侧块的耳片。所述耳片能从用于输送所述***至患者内的塌缩构造移动到用于附接至邻近椎骨的侧块的展开构造。
在一些方面，所述***可以进一步包括用于将所述小面植入构件和所述侧块固定构件中的至少一个引导至脊椎以将其附接至该脊椎。
在一些方面，所述侧块固定构件包括被构造成附接至所述小面植入构件的第一面，和联接至所述第一面并与所述第一面形成角度的第二面，其中所述第二面被构造成将所述侧块固定构件固定至邻近椎骨的侧块。
在一些方面，所述侧块固定构件包括锚件，该锚件包括用于附接至所述小面植入件的附接装置和杆容纳构件。所述固定构件进一步包括具有足够接触邻近椎骨的侧块的长度的杆。
公开了一种用于植入脊椎固定植入件的方法。所述方法包括在小面关节中***小面植入构件和将侧块固定构件附接至所述小面植入构件。在一些实施方式中，将所述侧块固定构件附接包括将所述侧块固定构件拧紧至所述小面植入构件。所述方法可以进一步包括将引导杆附接至所述小面植入构件，将所述侧块固定构件通过所述引导杆邻近于所述小面植入件定位，和移除所述引导杆。在一些实施方式中，***所述小面植入件包括通过引导管输送所述小面植入件。
公开了一种用于植入脊椎固定植入件的方法。在一方面，所述方法包括在小面关节中***固定***的小面植入构件和展开所述固定***的侧块固定构件以接触邻近椎骨的侧块。在一些方面，所述方法进一步包括使用至少一个螺钉将所述侧块固定构件附接至所述侧块。
参照说明书附图，在以下进一步详述中描述这些和其他方面和实施方式。
附图说明
图1是C5和C6颈部椎骨的侧视图，图示了解剖结构。
图2A和2B分别是颈部脊椎的后视图和侧视图，所述颈部脊椎具有应用于其的现有技术后侧固定装置。
根据一个实施方式，图3A-3D是颈部脊椎的部分的立体图(3A-3C)和侧面剖视图(3D)，图示了小面植入件和用于将侧块固定构件附接于其的方法。
根据另一个实施方式，图4是颈部脊椎的部分的立体图，图示了具有圆柱形附接柱的小面植入件和用于附接于其的侧块固定构件。
根据另一实施方式，图5A和5B分别是颈部脊椎的部分的立体图和后视图，图示了的具有多边形附接柱的小面植入件和用于附接于其的侧块固定构件。
根据一个实施方式，图6A是联合的侧块固定构件的立体图。
根据一个实施方式，图6B和6C是颈部脊椎的部分的立体图，图示了的用于附接图6A的所述联合的侧块固定构件至小面植入件的方法。
根据一个实施方式，图7A是具有预附接的侧块固定构件的小面植入件的立体图。
根据一个实施方式，图7B-7D是颈部脊椎的部分的侧视图(7B)和立体图(7C-7D)，图示了用于植入和将所述小面植入件与图7A的预附接的侧块固定构件附接的方法。
根据一个实施方式，图8A是具有部分容纳在所述小面植入件中的预附接的侧块固定构件的小面植入件的立体视图。
根据一个实施方式，图8B-8G是不同的视图，一些包括颈部脊椎的部分，图示了用于植入和将所述小面植入件与图8A的预附接的侧块固定构件附接的方法。
根据一个实施方式，图9A-9D是颈部脊椎的部分的立体视图，图示了用于在引导杆上行进折叠的侧块固定构件以附接至小面植入件的方法。
根据一个实施方式，图10A和10B是的侧块固定构件的立体视图。
根据一个实施方式，图10C-10F是颈部脊椎的部分的立体视图，图示了用于将图10A和10B的所述侧块固定构件附接至小面植入件的方法。
图11A-11H是颈部脊椎的不同视图，图示了包括小面植入件和侧块固定构件的***和将所述侧块固定构件附接至小面植入件的方法。
具体实施方式
此文描述的不同的具体实施方式包括使用后侧接近、较少地侵入的或最少程度地侵入的***方法用于在所述颈部脊椎中提供侧块固定的***。通常，每个***包括小面部件和侧块固定部件。在一些实施方式中，所述小面部件和所述侧块固定部件是开分的装置直到它们在患者内部现场附接。在其他的实施方式中，所述小面部件和侧块固定部件可以结合成一个装置。一些实施方式可以包括单独的小面植入件本身，该小面植入件可以附接至一个或多个侧块固定装置或构件。类似地，侧块固定装置或构件可以由本身提供，并且可以与一个或多个小面植入件装置是兼容的。此文描述的实施方式还包括用于***、植入和附接此文描述的所述小面部件和侧块固定部件的方法。
侧块器械可以包括在侧块中的螺钉、U形钉或柱。其它器械例如杆或板件可以被用作张力带以连接吻部小面和尾部小面。该其它器械可以用来限制弯曲和展开以及侧弯。所述小面植入件与所述固定构件(或张力带)连接和/或所述小面植入件帮助引导所述固定构件(或张力带)就位。所述张力带装置(例如，板件、螺钉、杆或桥接所述吻部侧块和尾部侧块的其它材料)可以是模块化的。其可以用于横跨一个或多个运动节段。其可以在小面植入件之前或之后放入。所述小面植入件和所述侧块固定构件的结合将提供在弯曲和展开二者方向的联合的优越的固定性和稳定性。
外科医生可以通过最少程度的接近切口，使用******例如，但不限于，来源于Providence Medical Technology,Inc.(www.providencemt.com)的脊椎***，***所述小面植入件。在此文描述的实施方式中可以使用的小面植入件包括来源于Providence Medical Technology,Inc.(www.providencemt.com)的颈部笼架。由所述小面植入件提供的所述脊椎深处的固定点可以用来不直接可视从经皮途径将后侧颈部脊椎超过所述小面器安装器械。这避免了从所述脊椎撕下所有的软组织。在所述患者的脊椎深处的固定点防止器械从所述脊椎滑脱并且允许用于固定器械的定位、对准和锚定。并且，所述颈部小面具有相对于在所有患者中一致的侧块骨的固定解剖关系。固定器械可以不直接可视化离开所述小面植入件定位至所述侧块上可靠的标识。
现参照图3A-3D，在一个实施方式中，侧块固定***可以包括小面植入件10、侧块固定构件，例如板件12，和用于将所述板件12附接至所述小面植入件10的一个或多个螺钉14。所述板件12(或“条”)可以在所述吻部侧块和尾部侧块上延伸并且可以通过所述螺钉14附接至所述小面植入件10的背部，所述螺钉14紧贴所述侧块骨拉起所述板件12并且提供额外的固定。如以下进一步详述所讨论的，所述板件12可以具有中间部12a和从所述中间部12a延伸的两个延伸部12b、12c。所述中间部12a包括构造成容纳用于将所述板件12附接至所述小面植入件10的所述螺钉14的孔口13。所述板件12可以具有固定形状或可以通过，例如在所述中间部12a和所述延伸部12b、12c之间的铰链，是可调节的。在一些实施方式中，所述延伸部12b、12c可以是柔性的以允许所述板件12与所述侧块骨的形状相符合。所述小面植入件10可以包括穿过远端形成的用于容纳所述一个或多个螺钉14的一个或多个带螺纹的孔10a。在不同的实施方式中，所述螺钉可以拧紧到希望的张力，例如所述板件12牢固地附接至所述小面植入件10和所述侧块骨。参照图3D，所述板件12可以包括在所述板件12的吻部端和尾部端处可以穿入到所述侧块中并且帮助将所述板件12固定至所述侧块的一个或多个表面特征或尖钉16(或者另选的螺钉或其他附接构件)。所述小面植入件10、板件12和螺钉14可以由任何合适的生物相容的材料制造，通常由金属或金属的组合来制造。
参照图4，在一个实施方式中，侧块固定***可以包括具有圆柱状桩24(或“柱”)的小面植入件20和侧块固定构件，例如具有相应的圆形开口26以配合所述桩24的板件22。在不同的实施方式中，所述桩24可以定位在所述小面植入件20的近端处。所述圆柱状桩24可以具有穿过其形成的可以具有螺纹以容纳螺钉(例如，螺钉14)的孔以将所述板件22固定至所述小面植入件20。如此实施方式和其它实施方式所示，所述板件22可以包括中间部22a和从所述中间部成角度延伸的两个延伸部22b、22c。所述延伸角度可以构造用于配合邻近的侧块。在一些实施方式中，所述延伸部22b、22c可以是相对于所述中间部22a通过技术人员可调节的。
在另选的实施方式中，并且现参照图5A和5B。侧块固定***可以包括具有多边形桩34(例如“柱”，在此实施方式中该柱是正方形的但是在其它实施方式中可以具有另选的形状)的小面植入件30和侧块固定构件，例如具有相应多边形开口36以配合或容纳所述桩34的板件32。所述多边形桩34能够将所述板件32取向至相对于所述小面植入件30的轴预先确定的取向，所述多边形桩34能够确保在所述板件和侧块骨之间的合适的接触。如此实施方式和其他实施方式所示的，所述板件32可以包括中间部32a和从所述中间部成角度延伸的两个延伸部32b、32c。所述延伸角度可以构造用于配合邻近的侧块。在一些实施方式中，所述延伸部32b、32c可以是相对于所述中间部32a通过技术人员可调节的。
现参照图6A-6C，在另一个实施方式中，侧块固定***可以包括侧块固定构件，例如板件40，该板件40包括具有中央开口44的中间部42和通过两个铰链46附接至所述中间部42的相反的端的两个延伸部48。关于所述铰链46的所述延伸部48的接合将允许所述板件40的调节以配合不同的所述小面表面的解剖学角度。
图6B和6C图示了使用螺钉43将所述板件40附接至小面植入件41。可以从图6B理解，所述小面植入件41可以从后侧接近点***到小面关节39内。所述板件40还可以通过后侧接近点与所述小面植入件41同时地或顺序地***。如图6B所示，所述板件40可以具有两个延伸部48，所述两个延伸部48能够关于所述铰链46旋转或接合。在不同的实施方式中，所述板件40可以以基本线性的构造***，正如图6B所示。穿过所述板件40的中央开口或孔44可以与所述小面植入件41中的互补孔41a对准以容纳所述螺钉43，所述螺钉43将所述板件40固定至所述小面植入件41。所述延伸部48可以围绕所述铰链46相对于所述中间部42旋转以将所述板件40固定至所述侧块。在不同的实施方式中，所述延伸部48可以在***前预先旋转好或可以在***后调节。
现参照图7A-7D，在另一个实施方式中，侧块固定***可以包括组合的小面植入件/侧块固定装置50。所述装置50可以包括在患者内植入前连接在一起的小面植入件部分52和侧块固定构件或部分54。所述小面植入件部分52可以包括用于将所述小面植入件部分52固定在所述小面关节件中的多个齿53。在这个实施方式中，所述侧块固定部分54包括突出的或从所述小面植入件部分52的近端延伸的两个柔性、半刚性或刚性构件(或“耳片(tab)”)55。所述侧块固定部分可以包括一个或多个穿过所述构件55形成的孔57用于容纳固定装置，例如用于将所述侧块固定部分52固定至所述侧块的螺钉。
如图7B所示，在一个实施方式中，所述固定装置50可以通过引入装置56(或“引导管”)前进到所述患者中并且到小面关节件58中。参照图7C和7D，当所述小面植入件部分52植入在所述小面关节件58中，所述侧块固定部分54的耳片55可以弯曲或否则移动至在所述吻部和尾部侧块上延伸。在不同的另选实施方式中，当所述耳片55从所述引入装置56释放，所述耳片55可以通过弹簧力自动地移动，或可以手动地弯曲或通过机械驱动。将所述侧块固定部分54附接至所述小面植入件部分52允许所述耳片55放置在所述侧块的上方的希望位置中。
通过现参照图8A-8G，在另一个另选实施方式中，侧块固定装置60可以包括在患者内植入前连接在一起的小面植入件部分62和侧块固定构件或部分64。在这个实施方式中，所述侧块固定部分64包括在输送至所述患者内的过程中至少部分地容纳在所述小面植入件部分52的外部直径内的两个柔性、半刚性或刚性构件(或“耳片”)65。所述耳片65可以包括其中限定的用于容纳螺钉或其他固定装置的孔口或孔67。图8A和8B图示了在其输送构造中的所述固定装置60，所述固定装置60具有容纳在所述小面植入件部分62中的所述耳片65。图8C和8D图示了具有从所述小面植入件部分62向外(近端地)展开的一个耳片65的所述固定装置60。这个展开动作可以通过例如沿着所述小面植入件部分62中的狭槽滑动所述耳片65来实现。
图8E示出了具有展开的所述侧块固定部分64的两个耳片65的所述固定装置60。图8F示出了在弯曲构造中的所述耳片65以接触所述吻部和尾部侧块。图8G示出了通过容纳在所述孔口67中的螺钉66将所述耳片65附接至所述侧块。
在又另一个实施方式中，并且现参照图9A-9D，侧块固定***可以包括小面植入件70，可移除地附接至所述小面植入件70的所述近端70a的引导杆72和在所述引导杆72上可滑动的侧块固定构件74。如附图中所示的，所述侧块固定构件74在塌缩构造中可以在所述引导杆72上行进(图9A和图9B)并且然后展开以接触所述侧块(图9C)。然后所述引导杆72可以移除(图9D)，使所述小面植入件70和侧块固定构件74就位。螺钉(未示出)可以穿过所述孔75***在所述侧块固定构件74中以将所述侧块固定构件74附接至所述侧块。
现参照图10A-10F，在另一个实施方式中，侧块固定构件或板件80可以包括一个或多个表面特征，例如用于增强附接至骨的尖钉86。所述侧块固定板件80可以包括可以被设置基本彼此垂直的两个部80a、80b。第一部80a可以具有穿过其形成的孔81以容纳螺钉或其他附接装置。第二部80b可以具有从其延伸的所述尖钉86。所述尖钉86可以基本垂直于所述第一部80a延伸。图10C-10F图示了用于植入小面植入件82和通过螺钉84将所述侧块固定板件80附接至所述小面植入件82的方法。所述小面植入件82可以***到所述小面关节85中。可以***所述板件82从而将穿过所述第一部80a形成的孔81与所述小面植入件82中的孔82a对准。所述板件80的第二部80b可以邻接所述侧块，并且当所述螺钉84穿过所述板件80***到所述小面植入件82中时，将所述板件80和小面植入件82固定就位。在一个另选实施方式中，所述侧块固定板件80可以具有任何多个不同的性状、尺寸、尖钉或其他表面特征、和/或类似物。此外，在不同的实施方式中，所述侧块固定板件80可以是柔性的、半刚性的或分段的。
现参照图11A-11C，在一个实施方式中，侧块固定***可以包括小面植入件90和包括锚件94和杆96的侧块固定构件92。如图11A和其他附图所示，所述锚件94包括附接装置94a，例如螺钉，和杆容纳构件94b。所述杆容纳构件94b具有一般的圆柱状体，所述圆柱状体具有近端100a和远端100b，具有螺纹97和尺寸大小以在所述体的远端100b处容纳所述杆96的端开放的狭槽98。所述杆96可以交叉所述小面关节延伸并且可以通过所述锚件94附接至所述小面植入件90，所述锚件94将所述杆96拉起紧贴所述侧块骨并提供额外的固定。图11B图示了通过所述附接装置94a将所述锚件94附接至已经***到小面关节中的所述植入件90。可以从图11C-11F理解，所述杆96被引入到所述杆容纳构件94b的所述狭槽98中并且固定其中。如图11E-11F所示，图11E-11F是所述小面植入件90和侧块固定构件92的侧视图和后视图，所述侧块固定构件92可以通过所述锚件94的旋转被调节以将所述杆96紧贴所述侧块紧固或固定。在一些实施方式中，如图11G-11H所示，图11G-11H是所述***的后视图和后视等距图，多个小面植入件90持握所述杆96以稳定所述脊椎。
所有相关的方向参照(包括：上面、下面、向上、向下、左侧、右侧、向左、向右、顶部、底部、侧、上方、下方、前面、中间、后面、垂直、水平及等等)由实施例的方式给出以助于读者理解此文描述的所述具体实施方式。它们不应被解读为特别是对于所述位置、取向或用途的要求和限制，除非在权利要求中特别提出。连接参照(例如，附接、联接、连接、联合等等)被广泛的构造并且可以包括元件的连接和元件之间相对运动的中间构件。同样地，连接参照不必然表示两个元件直接连接并以彼此成固定关系，除非在权利要求中特别提出。
尽管此发明已经在这些实施方式和实施例的文中公开了，本发明超过具体公开的实施方式延伸到本发明其他另选实施方式和/或用途及其明显的变形和等同。因此，旨在此文公开的本发明的范围不应该受到以上描述的具体公开的实施方式的限制。

Claims (20)

1.一种脊椎植入***，包括：
用于定位在小面关节中的小面植入构件；和
附接至或可附接至所述小面植入构件的侧块固定构件。
2.根据权利要求1所述的***，其中所述小面植入构件和所述侧块固定构件是在现场可附接的两个分开的装置。
3.根据权利要求2所述的***，其中所述小面植入构件包括桩，并且所述侧块固定构件包括穿过其形成的用于容纳所述桩的孔。
4.根据权利要求3所述的***，其中所述桩具有圆形、正方形和多边形中的一个形状。
5.根据权利要求2所述的***，其中所述侧块固定构件包括板件，并且其中所述板件包括：
中间部；
位于所述中间部的开口，所述开口被构造成允许螺钉穿过以将所述板件与所述小面植入构件连接；和
两个耳片，所述两个耳片从所述中间部的相反侧延伸以接触邻近椎骨的侧块。
6.根据权利要求5所述的***，其中所述耳片包括一个或多个从所述耳片延伸以将所述耳片固定至所述邻近椎骨的侧块的表面特征。
7.根据权利要求5所述的***，其中所述耳片具有一个或多个穿过其形成的用于容纳一个或多个固定装置的孔，所述固定装置被构造成将所述耳片固定至所述邻近椎骨的侧块。
8.根据权利要求5所述的***，其中所述耳片通过铰链从所述中间部的侧部延伸并且所述耳片围绕所述铰链相对于所述中间部是可旋转的。
9.根据权利要求1所述的***，其中所述小面植入构件和所述侧块构件构成一个附接的装置。
10.根据权利要求9所述的***，其中所述侧块固定构件包括两个耳片，所述耳片从所述小面植入构件延伸以接触邻近椎骨的侧块。
11.根据权利要求10所述的***，其中所述耳片能从用于输送所述***至患者内的塌缩构造移动到用于附接至邻近椎骨的侧块的展开构造。
12.根据权利要求1所述的***，进一步包括引导构件，所述引导构件用于将所述小面植入构件和所述侧块固定构件中的至少一个引导至脊椎以将其附接至该脊椎。
13.根据权利要求1所述的***，其中所述侧块固定构件包括：
被构造成附接至所述小面植入构件的第一部分；和
联接至所述第一部分并且与所述第一部分形成角度的第二部分，其中所述第二部分被构造成将所述侧块固定构件固定至邻近椎骨的侧块。
14.根据权利要求1所述的***，其中所述侧块固定构件包括：
锚件，所述锚件包括用于附接至所述小面植入件的附接装置和杆容纳构件；和
杆，所述杆容纳在所述锚件中以将所述***固定至邻近椎骨的侧块。
15.一种用于植入脊椎固定植入件的方法，所述方法包括：
在小面关节中***小面植入构件；和
将侧块固定构件附接至所述小面植入构件。
16.根据权利要求15所述的方法，其中将所述侧块固定构件附接包括将所述侧块固定构件拧紧至所述小面植入构件。
17.根据权利要求16所述的方法，进一步包括：将引导杆附接至所述小面植入构件；
通过所述引导杆将所述侧块固定构件邻近于所述小面植入件定位；和
移除所述引导杆。
18.根据权利要求15所述的方法，其中***所述小面植入件包括通过引导管输送所述小面植入件。
19.一种用于植入脊椎固定植入件的方法，所述方法包括：
在小面关节中***固定***的小面植入构件；和
将所述固定***的侧块固定构件展开以接触邻近椎骨的侧块。
20.根据权利要求19所述的方法，进一步包括使用至少一个螺钉将所述侧块固定构件附接至所述侧块。
CN201580040825.9A 2014-05-27 2015-05-27 侧块固定植入件 Pending CN107072697A (zh)

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