CN1976650A - 修复用椎间盘 - Google Patents

修复用椎间盘 Download PDF

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Publication number
CN1976650A
CN1976650A CNA2005800124145A CN200580012414A CN1976650A CN 1976650 A CN1976650 A CN 1976650A CN A2005800124145 A CNA2005800124145 A CN A2005800124145A CN 200580012414 A CN200580012414 A CN 200580012414A CN 1976650 A CN1976650 A CN 1976650A
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CN
China
Prior art keywords
parts
relative orientation
predefined type
lateral bending
translation
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
CNA2005800124145A
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English (en)
Inventor
H·H·特里优
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Warsaw Orthopedic Inc
Original Assignee
Warsaw Orthopedic Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Warsaw Orthopedic Inc filed Critical Warsaw Orthopedic Inc
Publication of CN1976650A publication Critical patent/CN1976650A/zh
Pending legal-status Critical Current

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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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    • 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
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Abstract

装置(10)包括一盘修复物或人工盘(12)，该盘修复物或人工盘(12)具有一上板(14)和一下板(16)。应该理解，该盘是一关节连接的关节，构造成用于设置于在一人体脊椎中的邻近椎骨本体之间的一椎间间隔内，通过提供在椎骨本体之间的相对弯曲和旋转运动来维持或恢复运动。一凸形突起物(26)延伸自下板，并接合一关节表面，该关节表面由在上板中形成的一凹入凹处(28)所限定。一柔性结构(30)从上板垂直延伸至下板。该结构被确定尺寸，从而当盘在其中间位置时，它是放松的且不承受拉力。在上板枢转至某个预先确定的角度之后，结构被拉紧，从而它开始抵抗或限制弯曲。

Description

修复用椎间盘
背景
本发明总地涉及修复装置，尤其涉及给脊椎提供稳定性的修复装置。
在人体脊椎中，椎间或脊椎盘位于邻近的椎骨(或邻近的脊骨)的终板之间，以在椎骨和缓冲椎骨本体之间分配压力。在某些情形下，脊椎盘可能破裂或退化到需要外科手术修正的程度。
典型地，外科手术修正包括脊椎盘的去除，且为了保持对于适当脊柱功能的椎间盘间隔，有时将一修复装置***邻近的椎骨之间。在这方面，修复装置可以被称为椎间修复关节、修复植入物、盘修复物或人造盘以及其它名称。
当保持对于适当脊柱功能的椎间盘间隔时，大多数修复装置允许邻近椎骨中的至少一个相对于另一个经受不同类型的运动，包括弯曲或旋转。弯曲可能发生在几个方向：屈曲或向前弯曲、延伸或向后弯曲、左侧弯曲(向人体的左侧弯曲)、右侧弯曲(向人体的右侧弯曲)、或其任意组合。旋转可能发生在不同方向：左旋转，即随着脊柱通常充当一旋转的假想轴、向人体的左侧旋转；和右旋转，即随着脊柱再次通常充当一旋转的假想轴、向人体的右侧旋转。
除了上述的运动类型之外，一些修复装置还允许在邻近的椎骨之间在前-后(前面到后面)、后-前(后面到前面)、中-侧右(中间到右侧)、中-侧左(中间到左侧)方向或其任意组合作相对平移。同样，修复装置可以允许不同运动类型的组合。
然而，典型的修复装置有时不适宜稳定脊椎。例如，韧带和其它自然或人工结构可以连接至邻近的椎骨，和/或可以在其间、自和/或沿着邻近的椎骨延伸。这些结构可以用来抵抗、限制或防止多种相对定向运动类型，来限制在一特定方向的一特定运动类型至容许范围，从而稳定脊椎。假如因为任何原因这些结构缺少或不能工作，则典型的修复装置不能补偿稳定功能的伴随损失。在没有限制或稳定结构的情况下，大多数修复装置允许多种类型运动的相对大范围，且在多种方向可能导致脊椎不稳定。
因此，需要的是一修复装置和/或提供脊椎稳定的方法。
附图简述
图1a是根据一实施例的一修复装置一立体图，该装置包括一柔性结构以及上部和下部部件。
图1b是图1a的装置沿线1b-1b的一剖视图。
图1c是与图1b类似的视图，但描述了装置的另一运作模式。
图1d是与图1c类似的视图，但描述了装置的另一运作模式。
图2a是根据另一实施例的一修复装置一立体图，该装置包括一柔性结构以及上部和下部部件。
图2b是图2a的装置的一部分沿线2b-2b的一详细剖视图。
图2c是与图2a类似的视图，但描述了装置的另一运作模式。
图2d是与图2c类似的视图，但描述了装置的另一运作模式。
图3是类似于图1a的实施例的一修复装置的一剖视图，但具有另一连接至装置的柔性结构。
图4是类似于图1a的实施例的一修复装置的一前视图，但具有另一连接至装置的柔性结构。
图5是类似于图1a的实施例的一修复装置的一前视图，但具有一更宽的柔性结构。
图6是类似于图1a的实施例的一修复装置的一前视图，但具有另一连接至装置的柔性结构。
图7是类似于图6的实施例的一修复装置的一前视图，但具有另一连接至装置的柔性结构。
图8是根据另一实施例的一修复装置的一前视图。
图9是类似于图8的实施例的一修复装置的一前视图，但具有另一连接至装置的柔性结构。
图10a是根据另一实施例的一修复装置的一立体图。
图10b是图10a的装置沿线10b-10b的一剖视图。
图11a是根据另一实施例的一修复装置的一立体图。
图11b是图11a的装置沿线11b-11b的一剖视图。
图11c是与图11b类似的视图，但描述了装置的另一运作模式。
图12a是根据另一实施例的一修复装置的一立体图。
图12b是图12a的装置沿线12b-12b的一剖视图。
图13a是根据另一实施例的一修复装置的一立体图。
图13b是图13a的装置沿线13b-13b的一剖视图。
图13c是图13a的装置的一前视图。
图14是类似于图1b的一部分的视图，但描述了一带齿垫圈。
图15是类似于图2b的视图，但描述了一带齿垫圈。
图16是描述了用于连接一结构至一部件的另外装置的视图。
图17-20是类似于图1b的视图，但描述了具有另外的盘修复物的另外的实施例。
详细描述
参见图1a和1b，一修复装置通常被称为参考标号10。装置10包括一盘修复物或人工盘12，该盘修复物或人工盘12具有一上部板状部件14和一下部板状部件16。应该理解，盘12是一关节连接的关节，构造成用于设置于在一人体脊椎中的邻近椎骨本体之间的一椎间间隔内，通过提供在椎骨本体之间的相对弯曲和旋转运动来维持或恢复运动。盘12连同部件14和16，包括一前面18、一后面20、一左侧面22和一右侧面24。一凸形突起物26延伸自部件16，并接合一关节表面，该关节表面由在部件14中形成的一凹入凹处28所限定。盘12可以包括附加的结构和其它未显示但在其它专利和/或专利公开中详细公开的特征，这些专利和/或专利公开例如美国专利公开第2003/0208273号(序列号10/042,589)，其内容结合于此作为参照。
一柔性结构30在右侧面24从部件14垂直地延伸至部件16，在盘12的外部且围绕部件的外边缘。螺纹固定件32和34分别连接结构30至部件14和16。如图1b所示，凹处36和38分别形成于部件14和16中来接纳结构30。结构30被确定尺寸，从而如图1b所示，当盘12在其中间位置时，它是放松的且不承受拉力。
部件14和16可以相对于彼此枢转和/或旋转。尤其参见图1c，装置10可以承受左侧弯曲，即部件14可以如箭头所示向部件16的左侧面22枢转。在部件14枢转至某个预先确定的角度之后，结构30被拉紧，从而它开始抵抗或限制此弯曲。当部件14继续枢转时，结构30继续限制或抵抗左侧弯曲，直到结构被拉紧至如图1c所示防止任何附加枢转的位置为止，从而限制左侧弯曲至容许范围，并稳定盘12及其接合的脊椎。
参见图1d，装置10可以承受右侧弯曲，即部件14可以如箭头所示向部件16的右侧面24枢转。不同于左侧弯曲期间，结构30不提供抵抗和限制，来允许盘12承受最大的右侧弯曲，仅仅通过包括其部件14和16的盘12的结构设计来限制。
装置10可以承受向前弯曲或屈曲，其中部件14向部件16的前面18枢转，或者向后弯曲或延伸，其中部件14向部件16的后面20枢转。结构30不抵抗、限制或约束此屈曲或延伸。
同样，装置10可以承受左旋转，其中部件14逆时针旋转，或者右旋转，其中部件14顺时针旋转。结构30被确定尺寸来抵抗或限制部件14的左和右旋转，并最终防止部件14的左和右旋转的预先确定的过多程度，从而限制左和右旋转至容许范围，并稳定盘12及其接合的脊椎。应该理解，在某些条件下，部件16也可以经历上述的与部件14相关的相对定向运动类型，相对于部件14移动。
由于结构30的最初垂直延伸，应该理解，左侧弯曲可以被认为是关心的主要运动限制，而左和右旋转可以被认为是关心的次要运动限制。而且，应该理解，结构30可以被确定尺寸，以致于它不“松弛”，从而基本防止任何左侧弯曲。因此，应该理解，在中间位置的结构30中松弛的程度控制了在选定方向运动的容许范围，即运动的左侧弯曲范围。
此外，应该理解，可以在装置10中控制运动的不同类型，即结构30可以在前面18、后面20或左侧面22连接至部件14和16，从而最初分别限制延伸、屈曲或右侧弯曲(同时也继续限制左和右旋转)。
图2a-20描述了根据另外的实施例的修复装置。应该理解，如上所述，在这些实施例中所有人工盘都构造成用于设置于在一人体脊椎的邻近椎骨本体之间的一椎间间隔内，通过提供在椎骨本体之间的相对弯曲和旋转运动来维持或恢复运动。同样，术语“屈曲”、“延伸”、“左侧弯曲”、“右侧弯曲”、“左旋转”、“右旋转”、“中-侧右平移”、“中-侧左平移”、“前-后平移”和“后-前平移”，如上所述，可应用于下述的实施例中的一个或多个。
参见图2a和2b，一修复装置的另一实施例通常被称为参考标号40，并类似于图1a-1d，并包括实施例的几个部件，给这些部件相同的参考标号。在图2a和2b的实施例中，一柔性结构42在左侧面22对角地从部件14延伸至部件16。
随着固定件44向后面20定位以及固定件46向前面18定位，螺纹固定件44和46分别连接结构42至部件14和16。如图2b所示，一凹处46形成于部件14中来接纳结构42。尽管隐藏于图2a中，应该理解，一凹处也形成于部件16中来接纳结构42。结构42被确定尺寸，从而如图2a所示，当盘12在其中间位置时，它是放松的且不承受拉力。
在运作中，部件14和16可以相对于彼此枢转和/或旋转。参见图2c，装置40可以承受左旋转(或逆时针旋转)。如箭头所示，部件14相对于部件16逆时针旋转，且结构42被拉紧，从而它开始限制或抵抗旋转。当部件14继续旋转时，结构30继续限制或抵抗旋转，直到结构如图2c所示基本防止任何附加旋转为止，从而稳定盘12及其接合的脊椎。
参见图2d，装置40可以承受如箭头所示的右旋转。不同于左旋转期间，结构42不提供抵抗，允许盘12承受最大右旋转，仅仅通过包括其部件14和16的盘12的结构设计来限制。类似地，结构42不限制或抵抗屈曲、延伸、左侧弯曲或右侧弯曲。
由于结构42的最初对角延伸，应该理解，对于此实施例，左旋转是关心的主要运动限制。而且，应该理解，结构42可以被确定尺寸，从而它基本防止任何左旋转。此外，应该理解，结构42可以以一方式对角延伸，该方式是固定件44向前面18定位以及固定件46向后面20定位，从而限制右旋转。此外，应该理解，结构42可以在前面18、后面20或左侧面22从部件14延伸至部件16。
参见图3-6，在每个图中显示了一修复装置的另一实施例，且每个实施例包括图1a-1d的实施例的几个部件，给这些部件相同的参考标号。每个实施例关于柔性结构的数量和构造不同。
在图3中，一修复装置48包括在左侧面22连接至部件14和16的一附加的垂直延伸柔性结构50。在运作中，通过结构30和50抵抗或限制和/或防止左和右侧弯曲。同样，通过结构30和50抵抗或限制并最终可以防止左或右旋转。屈曲和延伸不被约束或限制。应该理解，代替左侧面22和右侧面24，结构30和50可以分别在前面18和后面20连接至部件14和16，来首先限制和/或防止屈曲和延伸，其次限制左和右旋转，然而允许左侧和右侧弯曲。
如图4所示，一修复装置52包括在右侧面24连接至部件14和16的两个垂直延伸柔性结构54和56。在运作中，结构54和56首先限制和/或防止左侧弯曲，其次限制左和右旋转。同样，可以限制屈曲和延伸，然而不限制或约束右侧弯曲。应该理解，假如结构54和56与图1a-1d的实施例的结构30相同，则结构54和56提供大约两倍于结构30的左侧弯曲抵抗。
图5描述了包括一垂直延伸柔性结构60的一修复装置58，该结构60在右侧面24连接至部件14和16，它比装置10的结构30更宽。在运作中，结构60首先抵抗和/或防止左侧弯曲，其次抵抗左和右旋转。同样，由于结构60的宽度，可以限制屈曲和延伸。不约束或限制右侧弯曲。
在图6中，一修复装置62包括在后面20连接至部件14和16的一垂直延伸柔性结构64。在运作中，除了涉及结构30的上述运作之外，结构64首先限制和/或防止屈曲，其次限制左和右旋转。不约束或限制延伸和右侧弯曲。
参见图7，一修复装置的另一实施例通常被称为参考标号66，并类似于图6，并包括实施例的给予相同参考标号的几个部件。在图7的实施例中，一柔性结构68在右侧面24从部件14对角延伸至部件16。随着固定件70向后面20定位以及固定件72向前面18定位，螺纹连接件70和72分别连接结构68至部件14和16。在运作中，除了涉及结构30和64的上述运作之外，结构68限制和/或防止右旋转。不约束或限制延伸和右侧弯曲。
参见图8，一修复装置的另一实施例通常被称为参考标号74，并类似于图1a-1d，并包括实施例的给予相同参考标号的几个部件。在图8的实施例中，一柔性结构76在右侧面24从部件14对角延伸至部件16。
随着固定件78向后面20定位以及固定件80向前面18定位，螺纹连接件78和80分别连接结构76至部件14和16。类似地，一柔性结构82在右侧面24从部件14连接至和对角延伸至部件16。随着固定件84向前面18定位以及固定件86向后面20定位，螺纹连接件84和86分别连接结构82至部件14和16。在运作中，结构76限制右旋转，而结构82限制左旋转。不约束或限制左侧弯曲、右侧弯曲、屈曲和延伸。
参见图9，一修复装置的另一实施例通常被称为参考标号88，并类似于图8，并包括实施例的给予相同参考标号的几个部件。在图9的实施例中，一垂直延伸柔性结构90在右侧面24连接至部件14和16。螺纹固定件92和94分别连接结构90至部件14和16。在运作中，除了涉及结构76和82的上述旋转限制之外，结构90首先限制和/或抵抗左侧弯曲，其次抵抗左和右旋转。不约束或限制右侧弯曲、屈曲和延伸。
对于图3-9的实施例，应该理解，可以安装附加的柔性结构在盘12的另一面上，且柔性结构的数量和相对位置可以是多种的，来形成无限数量的组合或实施例。这些实施例可以通过多种关心的运动来指示，这些运动要被抵抗或限制和/或基本防止，从而稳定盘12及其接合的脊椎。此外，对于图7-9的实施例，诸结构的位置可以关于至盘12的中心的相对距离而不同，盘12的中心即盘12的突起物26。在这些实施例中显示的任何一个结构可以位于其它结构的外部(最远离突起物26)、结构之间或其它结构的内部(最接近突起物26)。
参见图10a和10b，一修复装置的另一实施例通常被称为参考标号96，并类似于图1a-1d，并包括实施例的给予相同参考标号的几个部件。在图10的实施例中，一对柔性结构98和100分别沿相反的方向、在突起物26的前面18和后面20上连接至部件14和16和在部件14和16之间对角延伸。不同于图1a-9的实施例，其中结构设置于盘12的外部，而结构98和100在部件14和16之间的一空间102内延伸，该空间102由两部件的偏移间隔限定。结构98的末端设置通过分别形成于部件14和16中的开口104和106中。螺纹固定件108和110分别固定结构98至部件14和16。类似地，结构100的末端设置通过形成于部件14和16中的开口112和114中并分别通过螺纹固定件116和118固定至其。
在运作中，由于它们相反的延伸方向，结构98和100都抵抗或限制和/或防止左旋转。不抵抗、约束或限制右旋转、左侧弯曲、右侧弯曲、屈曲和延伸。应该理解，在图1a-9的实施例中发现的所有结构及其变化和组合，可以以类似于图10的实施例的方式，设置于部件14和16之间和通过由两部件的间隔限定的一空间内。此外，应该理解，这样设置诸结构可用于缓冲部件14，和/或当部件14在结构位于的方向承受最大弯曲时，防止部件14的至少一部分接触部件16，如同通过盘12的结构设计所允许的一样。
而且，应该理解，对应于结构98和100的相对位置，通道可以形成于部件16中，以在屈曲或延伸期间接纳结构，从而干涉弯曲运动，包括盘12的结构设计所允许的最大弯曲运动。这些类型的通道将在下面更详细地描述。
参见图11a和11b，一修复装置的另一实施例通常被称为参考标号120，并类似于图1a-1d，并包括实施例的给予相同参考标号的几个部件。在图11a和11b的实施例中，一对相反的较宽的柔性结构122和124分别在突起物26的左侧面22和右侧面24上、在由两部件的偏移间隔所限定的一空间125中连接至部件14和16和在部件14和16之间垂直延伸。一对开口126和128形成于部件14中，分别设置结构122和124穿过两开口。同样地，一对开口130和132形成于部件16中，分别设置结构122和124穿过两开口。多个螺纹固定件134和136分别连接结构122至部件14和16，且相反的多个螺纹固定件138和140分别连接结构124至部件14和16。通道142和144形成于部件16中，并被确定尺寸和设置，从而如图11b所示，它们相对较宽并通常分别与开口130和132相连。
在运作中，结构122和124首先分别限制右和左侧弯曲，其次限制左和右旋转。同样，由于结构122和124的宽度，可以约束和限制屈曲和延伸。在左或右侧弯曲的容许范围内，通道142或144分别接纳结构122或124，从而不干涉弯曲运动。如图11c所示，盘12承受右侧弯曲，且结构124接纳于通道144从而不干涉弯曲运动。应该理解，类似的通道可以形成于其它实施例中，其中诸结构设置于部件14和16之间，从而在放松状态的结构不干涉任何类型的、所需的、在盘12的部件14和16之间的相对运动。
参见图12a和12b，一修复装置的另一实施例通常被称为参考标号146，并类似于图11a-11c，并包括实施例的给予相同参考标号的几个部件。在图12a和12b的实施例中，一单一的结构148以一连续的圈的形式连接至部件14和16。U形通路150和152分别形成于部件14和16中。结构148设置于通路150和152中，从而结构在突起物的每一侧上、部件14和16之间延伸。图12a和12b的实施例的运作类似于图11a-11c，将不再描述。可以理解，固定件134、136、138和140的位置可以是不同的，从而在多个方向调整运动的容许范围。
在图13a和13b中，一修复装置的另一实施例通常被称为参考标号154，并类似于图10a-10b，并包括实施例的给予相同参考标号的几个部件。在图13a和13b的实施例中，一单一连续的结构156连接至部件14和16。通路158和160分别形成于部件14和16中。结构156设置于通路158和160中，从而结构如图13a所示，在突起物26的每一侧上沿相反的两方向、在部件14和16之间对角延伸。分别通过给通路158和160提供入口的开口166和168，螺纹固定件162和164连接结构156至部件14和16。图13a和13b的实施例的运作类似于图10a-10b，将不再描述。可以理解，固定件162和164的位置可以是多种的，从而沿多个方向调整运动的容许范围。
应该理解，在图12a-13b的实施例中的结构的连续的圈构造可以应用于修复装置的上述实施例及其所有变化和/或组合，其中有两个结构从部件14延伸至部件16。
基于前述的，容易意识到，通过有策略地设置一个或多个柔性结构于一盘修复物间隔的部件的外部或之间，可以抵抗、约束、限制和/或基本防止在选定的或较佳的方向的运动容许范围，从而根据需要稳定人工盘及其接合脊椎。
除了在结构和图1-13b，尤其在图1b和图2b，发现的实施例中的部件14和16之间的上述连接及其所有变换和/或组合之外，应该理解，可以使用多种方式将上述结构连接至部件14和16。例如，如图14所示，此实施例类似于图1b，并包括实施例的给予相同参考标号的几个部件。然而，在图14的实施例中，一具有延伸自其的齿的垫圈或板170设置于固定件32的头部和结构30之间，齿突出进入结构来促进连接。同样地，图15的实施例类似于图2b，并包括实施例的给予相同参考标号的几个部件。然而，在图15的实施例中，一具有延伸自其的齿的垫圈或板172设置于固定件44的头部和结构42之间，齿突出进入结构。
参见图16，此实施例类似于图1b，并包括实施例的给予相同参考标号的几个部件。在图16的实施例中，一柔性结构174的末端具有对应于右侧面24的长度的一宽度，它围绕了一杆176并缝合回其本身，形成一接缝178。开口180和182朝向右侧面形成于部件14中，并沿面的长度方向延伸。杆176设置于开口180中，且接缝178设置于开口182中。应该理解，可以减小结构174的宽度以及对应的开口180和182的延伸长度。
除了在上述实施例中发现的结构-部件连接方式之外，可以采用其它方式连接柔性结构至盘12的部件14和16。可以使用螺钉、销、铆钉、锚、带齿垫圈或板、结、圈、粘合剂或其任意组合，来将结构固定、牢固、锚定或锁定至部件14和16。
除了上述的盘12之外，应该理解，上述的修复装置可以包含盘修复物或人工盘的所有类型，包括关节连接、非关节连接、弹性关节连接、弹性或柔性盘设计。尽管盘12是一关节连接盘的例子，但可以使用其它类型的关节连接盘。
例如，参见图17，一修复装置通常被称为参考标号184。装置184包括一人工盘186，该人工盘186具有一对部件或终板188和190、一左侧面191和一右侧面192。一半球状关节连接部件193设置于形成于终板190中的一空穴194中，且一垫圈196置于其间。盘186可以包括附加的结构和其它未显示的特征，且类似于在其它实施例中的PRODISC模块植入物，来修复由Marnay发明的美国专利第5,314,477号中公开的实施例，其内容结合于此作为参照。
一柔性结构198在右侧面192、在盘186的外部和围绕终板190的外边缘从终板188垂直延伸至终板190。螺纹连接件200和202分别连接结构198至终板188和190。结构198被确定尺寸，从而当盘186如图所示在其中间位置时，它是放松的且不承受拉力。图17的实施例的运作与图1a-1d的实施例类似，将不再描述。
参见图18，一修复装置的另一实施例通常被称为参考标号204，并类似于图17，并包括实施例的给予相同参考标号的几个部件。在图18的实施例中，一人工盘206包括一对部件或终板208和210以及设置于终板之间的一两面凸的关节连接部件212。结构198分别通过固定件200和202连接至终板208和210。盘206可以包括附加的结构和未显示的其它特征，并类似于在其它实施例中的CHARITE椎间盘修复物，来修复由Buttner-Janz等发明的美国专利第5,401,269号中公开的实施例，其内容结合于此作为参照。
在运作中，结构198以类似于图1a-1d的实施例的方式运作，至少关于终板208相对于终板210的任何运动——这样的运动可以被认为对应于任何部件14相对于图1a-1d的部件16的运动。在图18的实施例中，结构198也可以限制或抵抗和/或防止终板210向终板208的左侧面191弯曲，以及终板210相对于终板208的左和右旋转。
参见图19，一修复装置的另一实施例通常被称为参考标号214，并类似于图17，并包括实施例的给予相同参考标号的几个部件。在图19的实施例中，一人工盘216包括一对部件或终板218和220以及设置于终板之间的一弹性芯部222。结构198分别通过固定件200和202连接至终板218和220。盘216可以包括附加的结构和其它未显示的特征，并类似于在其它实施例中的ACROFLEX盘，来修复由Fraser等发明的美国专利第6,592,624号中公开的实施例，其内容结合于此作为参照。
在运作中，结构198以类似于图1a-1d的实施例的方式运作，至少关于任何终板228相对于终板220的弯曲运动或旋转——这样的运动可以被认为对应于任何部件14相对于图1a-1d的部件16的弯曲运动或旋转。在图19的实施例中，结构198也可以限制或抵抗和最终基本防止终板220向终板218的左侧面191弯曲，以及终板220相对于终板218的左和右旋转。而且，机构198可以限制或抵抗和最终基本防止终板218或220相对于另一终板的平移。平移的限制可以发生在任何上述的平移方向或其任意组合，且可以减小在弹性芯部222上的剪切载荷或其与终板218和220的干涉。
参见图20，一修复装置的另一实施例通常被称为参考标号224，并类似于图17，并包括实施例的给予相同参考标号的几个部件。在图20的实施例中，一人工盘226包括一对部件或外壳228和230以及设置于外壳之间的一中心本体232。结构198分别通过固定件200和202连接至外壳228和230。在美国专利公开第2003/0135277号(序列号10/303,569)中公开了附加的结构和其它显示的特征，其内容结合于此作为参照。盘226类似于BRYAN盘修复物。在运作中，结构198以类似于图19的实施例的方式运作，将不再描述。
可以理解，与图1a-16有关的、讨论和/或指明的所有变换和/或组合，包括结构形状、尺寸、位置、延伸方向、数量、运作和连接方式等等可以应用于图17-20的实施例。
附加的变化
应该理解，多种柔性结构应用于图1-20的实施例及其所有变换和/或组合。例如，可以使用柔性结构和多种尺寸，包括多种宽度、长度和厚度，如同通过限制和稳定目的所指示的一样，导致多种结构硬度。
同样，结构设计、柔性结构的材料和/或制造方法可以是相当多样的。关于结构设计，柔性结构可以以多种形式存在，例如，交织的带子和其它类型的带子、胶带、管材、绳子、缆索、绳索、织物、网状织物、片、链或其任意组合。组合的例子可以包括但不限于在交织管材中交织的绳索、纤维增强胶带和折叠的交织管材。另外可能的组合可以是植入例如聚合物的其它材料的交织管材或交织带子，来具有两阶段的性能，即，结构对于一范围的拉力(第一阶段)是刚性的，而对于另一范围的拉力(第二阶段)是柔性的。
柔性结构可以包括例如纤维衍生材料或任何其它固体材料，不可再吸收或可再吸收的聚合物、金属或其任意组合。聚合物类型可以包括但不限于聚乙烯、聚酯、聚芳基酮醚、聚酰胺、聚四氟乙烯、聚亚胺酯、硅酮、带有或不带有端基修正的硅酮和聚亚胺酯的共聚物、水凝胶、聚烯烃基橡胶、聚异丁烯、聚异戊二烯、氯丁橡胶、丁腈橡胶和硫化橡胶。生物可再吸收的聚合物类型可以包括但不限于聚乳酸、聚乙交酯和多种其它共聚物。金属类型可以包括但不限于不锈钢、钛、钛合金、形状记忆合金或其任意组合。
柔性结构可以通过例如交织、编织、成型、挤压、铸造、拉拔或其任意组合或者本领域中通常已知的其它制造方法来制造，以制成使用上述材料等的上述结构设计。可以选择制造方法以沿一选定的或较佳的方向促进限制。例如，柔性结构的交织或编织模式可以是多样的，来修正柔性结构的刚度和提供的在不同方向的运动抵抗程度。
而且，应该理解，在图1-16的实施例中的部件14和16，在图17-19中的实施例中各自的终板180和190、208和210、218和220以及在图20的实施例中的外壳228和230可以包括例如钴-铬(Co-Cr)合金、不锈钢、钛合金、氧化铝、氧化锆、多晶金刚石复合片、热解碳、聚醚醚酮(PEEK)、碳增强PEEK、超高分子量聚乙烯(UHMWPE)、交联UHMWPE或其任意组合或变化，或者对于部件、终板或外壳的不同部分的其多重组合或变化。同样，应该理解，部件、终板或外壳的表面可以包括锯齿、齿、脊或翅片，被喷砂或被涂敷有例如多孔珠状涂层、多孔网状涂层、有机磷灰石(OA)涂层、骨原肽涂层、生长因子涂层、重组人骨形态蛋白质(rh-BMP)涂层或其任意组合或变化。
同样，应该理解，上述的实施例可以使用诸如前、前侧、侧或后进入的典型技术来安装于邻近的椎骨之间。
为了说明和描述，已经呈现了本发明的特定实施例的前述描述。它们不想成为毫无遗漏的或限制本发明至严格的公开形式，显然根据上面的指示，许多修正和变化是可能的。例如，本发明不局限于一椎间盘修复装置和/或方法，但可以发现在人体其它区域的另外应用，例如与膝盖相关的区域。
选择和描述了实施例以便最好地解释了本发明的原理及其实际应用，从而使得本领域普通技术人员能够最好地利用本发明，带有多种修正的多种实施例适于预期的特定使用。想要通过所附的权利要求书及其等同物来限定本发明范围。在权利要求书中，装置加功能的条款想要覆盖在此描述的作为完成所述功能的结构，且不仅是结构等同物也是等同的结构。

Claims (32)

1.一种修复装置，包括一第一部件、一第二部件以及至少一个连接于所述第一和第二部件的结构，用于抵抗所述第一和第二部件之间的至少一个预定类型的相对定向运动，以及用于允许所述第一和第二部件之间的至少一个另外的预定类型的相对定向运动。
2.如权利要求1所述的装置，其特征在于，所述第一和第二部件之间的所述至少一个另外的预定类型的相对定向运动，其方向与所述第一和第二部件之间的所述至少一个预定类型的相对定向运动的方向相反。
3.如权利要求1所述的装置，其特征在于，所述第一和第二部件之间的所述至少一个预定类型的相对定向运动选自以下集合，该集合包括屈曲、延伸、左侧弯曲、右侧弯曲、左旋转、右旋转、中-侧右平移、中-侧左平移、前-后平移或后-前平移。
4.如权利要求1所述的装置，其特征在于，所述第一和第二部件之间的所述至少一个另外的预定类型的相对定向运动选自以下集合，该集合包括屈曲、延伸、左侧弯曲、右侧弯曲、左旋转、右旋转、中-侧右平移、中-侧左平移、前-后平移或后-前平移。
5.如权利要求1所述的装置，其特征在于，还包括连接于所述第一和第二部件的至少一个另外的结构。
6.如权利要求1所述的装置，其特征在于，还包括用于连接所述结构至每个所述第一和第二部件的装置。
7.如权利要求6所述的装置，其特征在于，所述连接装置包括一元件，该元件设置在形成于所述第一或第二部件中的一开口内，所述元件连接于所述结构。
8.如权利要求7所述的装置，其特征在于，所述元件成一杆的形式，且所述结构围绕所述杆。
9.如权利要求1所述的装置，其特征在于，所述结构是可操作的，来缓冲所述部件之间的接触。
10.如权利要求1所述的装置，其特征在于，还包括形成于至少一个所述部件中的一通道，用于接纳所述结构的至少一部分。
11.如权利要求1所述的装置，其特征在于，所述结构形成一连续的圈。
12.如权利要求11所述的装置，其特征在于，所述结构的至少两部分从所述第一部件延伸至所述第二部件。
13.如权利要求1所述的装置，其特征在于，还包括形成于至少一个所述部件中的一通路，其中所述结构的至少一部分设置于所述通路中。
14.如权利要求1所述的装置，其特征在于，所述两部件间隔分离。
15.如权利要求14所述的装置，其特征在于，所述结构设置于所述部件之间的所述间隔内。
16.如权利要求14所述的装置，其特征在于，所述结构设置于所述部件之间的所述间隔外侧。
17.如权利要求14所述的装置，其特征在于，所述结构的至少一部分在所述部件之间的所述间隔外侧延伸。
18.如权利要求1所述的装置，其特征在于，还包括设置于所述第一和第二部件之间的一两面凸的关节连接部件。
19.如权利要求1所述的装置，其特征在于，还包括设置于所述第一和第二部件之间的一半球状关节连接部件。
20.如权利要求1所述的装置，其特征在于，还包括设置于所述第一和第二部件之间的凸形突起物。
21.如权利要求1所述的装置，其特征在于，还包括设置于所述第一和第二部件之间的一弹性芯部。
22.如权利要求1所述的装置，其特征在于，还包括设置于所述第一和第二部件之间的一中心本体。
23.一种在一修复装置中控制运动的方法，包括对所述装置的两部件之间的至少一个预定类型的相对定向运动提供抵抗，以及允许所述两部件之间的至少一个另外的预定类型的相对定向运动。
24.如权利要求23所述的方法，其特征在于，还包括将所述修复装置与一脊椎中的多个椎骨本体接合。
25.如权利要求23所述的方法，其特征在于，提供抵抗的步骤包括将至少一个结构连接于所述两部件。
26.如权利要求23所述的方法，其特征在于，所述两部件之间的所述至少一个预定类型的相对定向运动选自以下集合，该集合包括屈曲、延伸、左侧弯曲、右侧弯曲、左旋转、右旋转、中-侧右平移、中-侧左平移、前-后平移或后-前平移。
27.如权利要求23所述的方法，其特征在于，所述两部件之间的所述至少一个另外的预定类型的相对定向运动选自以下集合，该集合包括屈曲、延伸、左侧弯曲、右侧弯曲、左旋转、右旋转、中-侧右平移、中-侧左平移、前-后平移或后-前平移。
28.如权利要求23所述的方法，其特征在于，所述两部件之间的所述至少一个另外的预定类型的相对定向运动，其方向与所述两部件之间的所述至少一个预定类型的相对定向运动的方向相反。
29.一种包括一修复装置和可连接至所述装置的至少一个结构的套件，用于抵抗所述装置的两部件之间的至少一个预定类型的相对定向运动，以及用于允许所述两部件之间的至少一个另外的预定类型的相对定向运动。
30.如权利要求29所述的套件，其特征在于，所述两部件之间的所述至少一个预定类型的相对定向运动选自以下集合，该集合包括屈曲、延伸、左侧弯曲、右侧弯曲、左旋转、右旋转、中-侧右平移、中-侧左平移、前-后平移或后-前平移。
31.如权利要求29所述的套件，其特征在于，所述两部件之间的所述至少一个另外的预定类型的相对定向运动选自以下集合，该集合包括屈曲、延伸、左侧弯曲、右侧弯曲、左旋转、右旋转、中-侧右平移、中-侧左平移、前-后平移或后-前平移。
32.如权利要求29所述的套件，其特征在于，所述两部件之间的所述至少一个另外的预定类型的相对定向运动，其方向与所述两部件之间的所述至少一个预定类型的相对定向运动的方向相反。
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CN101972179B (zh) * 2010-10-26 2012-09-05 申勇 一种可调式颈椎椎间融合器
CN101972179A (zh) * 2010-10-26 2011-02-16 申勇 一种可调式颈椎椎间融合器
TWI573598B (zh) * 2010-11-03 2017-03-11 Spine fill block construct
CN103417313A (zh) * 2012-05-18 2013-12-04 朱悦 一种人工椎间盘假体
CN103417313B (zh) * 2012-05-18 2016-07-06 朱悦 一种人工颈腰椎间盘
CN103479451A (zh) * 2013-10-10 2014-01-01 北京贝思达生物技术有限公司 一种聚醚醚酮人工脊柱椎间盘
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CN109157312A (zh) * 2018-10-23 2019-01-08 福州大学 一种基于金属橡胶的腰椎间盘假体结构及其工作方法
CN109157312B (zh) * 2018-10-23 2023-09-12 福州大学 一种基于金属橡胶的腰椎间盘假体结构及其工作方法
CN110368149A (zh) * 2019-08-05 2019-10-25 北京爱康宜诚医疗器材有限公司 椎间盘假体
CN110368149B (zh) * 2019-08-05 2024-03-15 北京爱康宜诚医疗器材有限公司 椎间盘假体
CN112237499A (zh) * 2020-11-17 2021-01-19 北京爱康宜诚医疗器材有限公司 椎间融合器
CN112237499B (zh) * 2020-11-17 2022-06-14 北京爱康宜诚医疗器材有限公司 椎间融合器

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WO2005107654A1 (en) 2005-11-17
CA2562476A1 (en) 2005-11-17

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