TWI465228B - Implanted intervertebral implant between the spine - Google Patents

Implanted intervertebral implant between the spine Download PDF

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Publication number
TWI465228B
TWI465228B TW098128955A TW98128955A TWI465228B TW I465228 B TWI465228 B TW I465228B TW 098128955 A TW098128955 A TW 098128955A TW 98128955 A TW98128955 A TW 98128955A TW I465228 B TWI465228 B TW I465228B
Authority
TW
Taiwan
Prior art keywords
implant
plate
spine
fixing plate
bottom plate
Prior art date
Application number
TW098128955A
Other languages
Chinese (zh)
Other versions
TW201021774A (en
Inventor
Erich Kast
Original Assignee
Ulrich Gmbh & Co Kg
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 Ulrich Gmbh & Co Kg filed Critical Ulrich Gmbh & Co Kg
Publication of TW201021774A publication Critical patent/TW201021774A/en
Application granted granted Critical
Publication of TWI465228B publication Critical patent/TWI465228B/en

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Classifications

    • 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
    • A61F2/30721—Accessories
    • A61F2/30744—End caps, e.g. for closing an endoprosthetic cavity
    • 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
    • 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/30369—Limited lateral translation of the protrusion within a larger recess
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    • A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
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    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30495—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking ring
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
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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
    • A61F2/02—Prostheses implantable into the body
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    • 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
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/3055—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting length
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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
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30553—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting a position by translation along an axis
    • A—HUMAN NECESSITIES
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Neurology (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)

Description

植入脊椎之脊椎體間之植入物 Implant implanted between the spine of the spine

本發明係關於一種植入脊椎之脊椎體間之植入物，作為由脊柱脫出之脊椎或脊椎部之位置保持器，具有一第一植入物部及一第二植入物部，其於其同軸之縱軸軸線方向上可相對調整，改變植入物之長度，並具有至少一固定板，該固定板可固定於植入物部其中之一上，面向鄰接之脊椎，並至少局部將其遮蔽。 The present invention relates to an implant implanted between the vertebral bodies of the spine, as a position holder for the spine or the spine portion which is dislodged by the spine, having a first implant portion and a second implant portion. Adjustable relative to the axis of the longitudinal axis of the coaxial axis, changing the length of the implant, and having at least one fixing plate fixed to one of the implant portions, facing the adjacent spine, and at least partially Shade it.

在歐洲專利案EP 0 950 388 A2中公開一該類之植入物。該植入物由總共三個植入物部構成，亦即位於兩末端之末端植入物部，用於接觸在鄰接之脊椎上，及一介於其間之中間植入物部，三部分透過螺紋互相連接。在末端之植入物部上有孔洞，主要作為進入植入物部內部之通道，便於置入骨膠或骨質材料。該孔洞另外之作用在於，使一具有圓形凸緣之固定板能夠以最佳方式固定在一末端之植入物部上，為此在凸緣中形成開孔，可與兩個末端植入物部之孔洞產生遮蓋作用。螺栓可通過開孔***孔洞。固定板在縱向具有一槽，在其寬度方向可調，使螺栓被夾緊在孔洞中。結果是，固定板固定在末端之植入物部外周緣，可改善脊柱之穩定性，而不妨礙對植入物部接觸。 An implant of this type is disclosed in European Patent No. EP 0 950 388 A2. The implant consists of a total of three implant portions, that is, an end implant portion at both ends for contacting the adjacent vertebrae, and an intermediate portion between them, the three portions are threaded through the thread Connect to each other. There is a hole in the end of the implant portion, mainly as a passage into the interior of the implant portion, facilitating the placement of bone glue or bone material. The additional function of the hole is to enable a fixing plate having a circular flange to be optimally fixed to the implant portion at one end, for which purpose an opening is formed in the flange and can be implanted with both ends The hole in the object creates a covering effect. Bolts can be inserted into the holes through the holes. The fixing plate has a groove in the longitudinal direction and is adjustable in the width direction thereof so that the bolt is clamped in the hole. As a result, the fixation plate is fixed to the outer periphery of the implant portion at the distal end, which improves the stability of the spine without hindering contact with the implant portion.

然而該習知之植入物缺點在於，其在日益普及之最小侵入性外科手術中之應用有侷限性，其係由於為了植入物長度改變，必須藉一做圓弧運動之工具對中間之植入物做相對於末端植入物之調整，且固定板裝設在末端植入物部之外周緣，無法針對病患個別情況做調整。 However, the disadvantage of this conventional implant is that its application in the increasingly popular minimally invasive surgery is limited, because of the change in the length of the implant, it is necessary to use a tool for circular motion to the middle of the plant. The input is adjusted relative to the end implant, and the fixed plate is mounted on the outer periphery of the distal implant portion, and cannot be adjusted for individual cases of the patient.

本發明之目的因此在於，提出一種前述類型之植入物，其固 定板位置可相對於植入物改變。 The object of the invention is therefore to provide an implant of the aforementioned type, which is solid The plate position can be varied relative to the implant.

本發明之該目的在前述類型之植入物上係藉由以下方法達成，即，固定板由一脊椎接觸板及一由其突出且具有一導軌之底板構成，突出之底板係用於將固定板相對於一植入物部做徑向調整，同時，對一植入物部配置用以徑向固定底板之物件。 This object of the invention is achieved by implants of the type described above in that the fixing plate consists of a spinal contact plate and a base plate projecting therefrom and having a guide rail for fixing the base plate The plate is radially adjusted relative to an implant portion, and an implant portion is configured to radially secure the bottom member.

此植入物之特徵在於，脊椎接觸板對植入物部中心之距離可調，因而植入物在脊椎體間之位置可不同，不必放棄使用固定板。該較大變化之優點與改善之穩定性結合，其係由於可透過徑向固定底板之物件終止具有脊椎接觸板之固定板相對於植入物部之徑向可調性。在本發明之範疇內，特別有利的是，兩個植入物部皆配有固定板，這可獲得更佳之穩定性。 The implant is characterized in that the distance of the spinal contact plate from the center of the implant is adjustable so that the position of the implant between the vertebral bodies can be different without having to abandon the use of the fixed plate. The advantage of this larger variation is combined with improved stability by terminating the radial adjustability of the fixation plate with the spinal contact plate relative to the implant portion through the article that is radially secured to the base plate. Within the scope of the invention, it is particularly advantageous if both implant parts are provided with a fixing plate, which results in better stability.

另外證明有利的是，植入物部具有一前端板，面向鄰接之脊椎，板上有孔，用以容納作用在底板上之上緊物件，此作法克服在植入物部周緣上連接固定板之限制。考慮構造簡化及施作簡單，有利之作法是該開孔為螺紋孔，且該上緊物件為上緊螺絲。 In addition, it has proven to be advantageous if the implant part has a front end plate facing the adjacent vertebra and having a hole in the plate for receiving a tight object on the base plate, which overcomes the attachment of the fixing plate on the periphery of the implant part. The limit. Considering that the construction is simplified and the application is simple, it is advantageous that the opening is a threaded hole, and the tightening object is a tightening screw.

將底板設計成叉狀，具有至少兩根叉臂，固定物件齧入叉中，則底板相對於前端板具有良好之導引。顯而易見的是，亦可設計成多於兩根叉臂，在強化微調性上，固定物件可與多個成對之叉臂互相作用，而固定板在其側向方向可對植入物部調整。 The bottom plate is designed in the shape of a fork, having at least two fork arms, and the fixed object is engaged in the fork, so that the bottom plate has a good guiding with respect to the front end plate. Obviously, it can also be designed as more than two fork arms. In the enhanced fine adjustment, the fixed object can interact with a plurality of pairs of fork arms, and the fixing plate can adjust the implant portion in the lateral direction thereof. .

一種特別穩固之連接在於，叉臂具有夾緊邊，可伸入上緊螺絲之螺絲頭下方。 A particularly robust connection is that the wishbone has a clamping edge that extends below the screw head of the tightening screw.

一種對解剖特性較佳之適應性在於，脊椎接觸板在截面形成外凸，具有至少一螺絲孔及在對底板之連接區具有一窗口。螺絲孔用以容納骨螺絲，特別是裂頭螺絲，使用裂頭螺絲可使固定板相對於脊椎體獲得更大保固。固定板之窗口主要功效在於，可在脊椎接觸板後方區域做視覺控制。 A preferred adaptability to the anatomical feature is that the spinal contact plate is convex in cross section, has at least one screw hole and has a window in the connection region to the bottom plate. The screw holes are used to accommodate the bone screws, especially the split head screws, and the split screws can be used to obtain greater protection of the fixed plate relative to the vertebral body. The main function of the fixed plate window is that it can be visually controlled in the area behind the spinal contact plate.

為達脊椎體與植入物間較佳之機械連接，底板在面向鄰接脊椎之側至少具有一錨刺。 In order to achieve a better mechanical connection between the vertebral body and the implant, the base plate has at least one anchor thorn on the side facing the adjacent vertebra.

在本發明之範疇中另外特別有利的是，第一植入物部及第二植入物部設計成管狀套筒，對第一植入物部配置一可旋轉之螺紋環，環上有齒，該螺紋環以一環繞螺紋螺入配置給第二植入物部之螺紋，且在第一置入物部之壁殼中形成一螺紋孔，用以置入一操作器，轉動螺紋環。該設計及該種第一及第二植入物部與操作器間之相互作用由歐洲專利案EP 1 219 266 A1基本上係已習知，其中對植入物已有說明，此處不再贅述，該植入物適用本發明使用徑向可調固定板之設計，因而整體之侵入性最小。 It is further advantageous in the context of the invention that the first implant part and the second implant part are embodied as tubular sleeves, a rotatable threaded ring is arranged on the first implant part, and the ring is toothed. The threaded ring is threaded into the thread of the second implant portion by a surrounding thread, and a threaded hole is formed in the wall of the first insert portion for inserting an operator to rotate the threaded ring. The design and the interaction between the first and second implant portions and the operator are basically known from the European patent application EP 1 219 266 A1, in which the implant has been described, no longer here. It is to be noted that the implant is suitable for use with the design of the radially adjustable fixing plate of the present invention, and thus the overall intrusion is minimal.

在解剖特性分析之後，實際操作之前，為避免必須做固定板對植入物部之先行(ex situ)固定，可採以下作法，即在螺絲頭形成工具容室，供轉動上緊螺絲，使得透過窗口即可操作螺絲頭部，且上緊螺絲亦可在現場(in situ)被拉得更緊。其中有利者為，窗口與螺紋孔面向相同方向可調。 After the analysis of the anatomical characteristics, before the actual operation, in order to avoid the need to make the fixed plate to the ex situ fixation of the implant portion, the following method may be adopted, that is, the tool head is formed in the screw head for rotating the tightening screw, so that The screw head can be operated through the window and the tightening screw can be pulled tighter in situ. Advantageously, the window and the threaded hole face are adjustable in the same direction.

另外證明有利為，在底板與前端板間形成卡座，在經由拉緊上緊螺絲確保最終位置前，確保固定板相對於植入物部之初始位置之穩固。有利之作法是，卡座由橫對導軌徑向調整方向之窄邊構成。 It has also proven to be advantageous to form a card seat between the bottom plate and the front end plate, ensuring the stability of the initial position of the fixing plate relative to the implant portion before the final position is ensured by tightening the tightening screws. Advantageously, the deck is formed by a narrow side that is oriented transversely to the rail.

1‧‧‧植入物 1‧‧‧ implants

2‧‧‧第一植入物部 2‧‧‧First Implants

3‧‧‧第二植入物部 3‧‧‧Second Implants

4‧‧‧螺紋環 4‧‧‧Threaded ring

5‧‧‧螺紋 5‧‧‧ thread

6‧‧‧齒 6‧‧‧ teeth

7‧‧‧螺絲頭 7‧‧‧ screw head

8‧‧‧脊椎體 8‧‧‧ vertebral body

9‧‧‧前端板 9‧‧‧ front panel

10‧‧‧固定板 10‧‧‧ fixed board

11‧‧‧脊椎接觸板 11‧‧‧Spine contact plate

12‧‧‧底板 12‧‧‧floor

13‧‧‧導軌 13‧‧‧rails

14‧‧‧上緊螺絲 14‧‧‧ tightening screws

15‧‧‧叉臂 15‧‧‧Fork

16‧‧‧夾緊邊 16‧‧‧Clamping edge

17‧‧‧螺絲孔 17‧‧‧ screw holes

18‧‧‧骨螺絲 18‧‧‧ bone screws

19‧‧‧窗口 19‧‧‧ window

20‧‧‧錨刺 20‧‧‧ Anchor

以下將根據圖式中之實施例對本發明進一步說明；各圖所示為：圖一 一具有二以示意方式顯示固定板之根據本發明之植入物；圖二 一植入物上部之立體圖，其固定板處於第一徑向位置；圖三 一植入物上部之立體圖，其固定板處於第二徑向位置；圖四 圖三中植入物另一角度之立體視圖； 圖五 圖四中植入物之立體側視圖；圖六 根據本發明植入物之脊柱兩脊椎體間在實際位置之側視圖，及圖七 為圖六中VII之細部情形。 The invention will be further described in the following with reference to the embodiments in the drawings; FIG. 1 shows two embodiments of the implant according to the invention in a schematic manner showing the fixing plate; FIG. 2 is a perspective view of the upper part of the implant, The fixing plate is in a first radial position; FIG. 3 is a perspective view of the upper part of the implant, the fixing plate is in a second radial position; and FIG. 4 is a perspective view of the implant at another angle; Figure 5 is a perspective side view of the implant in Figure 4. Figure 6 is a side view of the actual position of the spine of the implant according to the present invention, and Figure 7 is a detail of Figure VII.

圖一顯示一植入物1，用於置入脊椎之脊椎體8之間，作為由脊柱脫出之脊椎或脊椎部之位置保持器。此植入物1由一第一植入物部2及一第二植入物部3組成，兩植入物部在其共軸之縱軸方向可相對調整，以改變植入物之長度。此可調性之達成方法為，第一植入物部2及第二植入物部3設計成圓形套筒，其中該第一植入物部2在外側包圍第二植入物部3，具有一配置給第一植入物部2之可旋轉螺紋環4，其內周緣面上具有環繞螺紋，與配置給第二植入物部3之螺紋5齧合。螺紋環4在外周緣面上設有齒6，特別是傘齒輪之齒，藉由螺入第一植入物部2之螺紋孔之操作器可旋轉螺紋環4，改變長度，撐開脊椎體8。 Figure 1 shows an implant 1 for placement between the vertebral bodies 8 of the spine as a position retainer for the spine or spine that is dislodged by the spine. The implant 1 consists of a first implant portion 2 and a second implant portion 3, the two implant portions being relatively adjustable in the direction of the longitudinal axis of the coaxial axis to change the length of the implant. This adjustability is achieved in that the first implant portion 2 and the second implant portion 3 are designed as circular sleeves, wherein the first implant portion 2 surrounds the second implant portion 3 on the outside. There is a rotatable threaded ring 4 disposed to the first implant portion 2 having a circumferential thread on its inner peripheral surface for engagement with a thread 5 disposed for the second implant portion 3. The threaded ring 4 is provided with teeth 6 on the outer peripheral surface, in particular the teeth of the bevel gear, which can be rotated by the operator screwed into the threaded hole of the first implant portion 2 to change the length and open the vertebral body 8 .

該植入物部2、3具有面向鄰接之脊椎之前端板9，前端板上有孔。該前端板9以可鬆脫方式固定一固定板10，固定板可固定在植入物部2、3上，面向鄰接之脊椎，並至少局部遮蔽鄰接之脊椎，固定板由一脊椎接觸板11及一由脊椎接觸板突起之底板12構成，底板具有一導軌13，係用以相對於植入物部2、3徑向調整固定板10。在圖一及圖六所示之實施例中，植入物部2、3各有一固定板10，可經由固定底板12之物件固定在各該植入物部2、3上，其中該物件在所示之實施例中設計成一上緊螺絲14，可螺入在前端板9上以螺紋孔形式開設之孔中。特別由圖四可以看出，底板12設計成叉狀，具有雙叉臂15，上緊螺絲14接觸在雙叉臂上，亦即接觸在伸進上緊螺絲14之螺絲頭7下方之夾緊邊16上。 顯而易見的是，依照運動學上轉換方向之另外作法是底板12具有一窄邊，介於前端板9之叉臂間，特別是依照燕尾導引法導入。為配合脊椎體8之圓弧，脊椎接觸板11在截面形成外凸，並另外具有螺絲孔17，骨螺絲18可穿過螺絲孔17。由圖五可看出，脊椎接觸板11在對底板12連接之區域有一窗口19，容許對脊椎接觸板11後方區域做控制，且進一步容許工具或儀器穿過窗口19。 The implant portions 2, 3 have a front end plate 9 facing the adjacent vertebra, with a hole in the front end plate. The front end plate 9 is detachably fixed to a fixing plate 10, and the fixing plate can be fixed on the implant portions 2, 3, facing the adjacent vertebrae, and at least partially shielding the adjacent vertebra, and the fixing plate is covered by a spinal contact plate 11 And a bottom plate 12 protruding from the spinal contact plate, the bottom plate having a guide rail 13 for radially adjusting the fixing plate 10 with respect to the implant portions 2, 3. In the embodiment shown in FIG. 1 and FIG. 6, the implant portions 2, 3 each have a fixing plate 10 which can be fixed to each of the implant portions 2, 3 via an object of the fixed bottom plate 12, wherein the object is The illustrated embodiment is designed as a tightening screw 14 that can be threaded into a hole in the front end plate 9 that is formed as a threaded hole. As can be seen in particular from Figure 4, the bottom plate 12 is designed in the shape of a fork with a double wishbone 15 which is in contact with the double wishbone, i.e. the contact is clamped under the screw head 7 which extends into the tightening screw 14. On the side 16. It will be apparent that, in addition to the kinematically changing direction, the bottom plate 12 has a narrow side interposed between the fork arms of the front end plate 9, particularly in accordance with the dovetail guiding method. In order to cooperate with the arc of the vertebral body 8, the spinal contact plate 11 is convex in cross section and additionally has a screw hole 17 through which the bone screw 18 can pass. As can be seen in Figure 5, the spinal contact plate 11 has a window 19 in the region where the base plate 12 is joined, allowing control of the area behind the spinal contact plate 11, and further allowing the tool or instrument to pass through the window 19.

特別由圖二至圖四可以看出，底板12在面向鄰接之脊椎側具有若干錨刺20，可刺入脊椎體8，在設計成裂頭螺絲之骨螺絲18通過螺絲孔17扎入前，先行提供定位穩固性。 2 to 4, the bottom plate 12 has a plurality of anchors 20 on the side facing the adjacent side of the spine, which can be inserted into the vertebral body 8, before the bone screw 18 designed as a split screw is inserted through the screw hole 17, Provide positioning stability first.

在應用本發明之植入物1時，在操作準備上，最好藉由一產生圖像之檢測法找出固定板10相對於植入物部2、3之必要位置，並將固定板10妥善安裝在植入物部2、3上。在操作中，可藉由置入螺紋孔之操作器將植入物1撐開，到需要之高度，接著用骨螺絲18永久固定植入物1。此操作產生極穩定之連接，其中特別值得一提者是骨螺絲18所達到之角度穩定性。 In the application of the implant 1 of the present invention, in the preparation of the operation, it is preferable to find the necessary position of the fixing plate 10 with respect to the implant portions 2, 3 by an image detecting method, and fix the plate 10 Properly mounted on the implant parts 2, 3. In operation, the implant 1 can be opened by an operator placed in a threaded hole to the desired height, followed by permanent fixation of the implant 1 with a bone screw 18. This operation results in a very stable connection, with particular mention of the angular stability achieved by the bone screw 18.

若固定板10相對於植入物部2、3無法事先(ex situ)做位置固定，則操作上緊螺絲14比較困難，其係由於脊椎體8在實際位置(in situ)上有阻擋作用，由軸方向無法接觸。原則上，操作仍能經由窗口19進行。在圖式中未顯示之一實施例中，針對此狀況，在底板12及前端板9之間設有卡座，橫過對導軌13之對徑向調整方向延伸之窄邊。 If the fixing plate 10 cannot be positionally fixed with respect to the implant portions 2, 3, it is difficult to operate the tightening screw 14, which is because the vertebral body 8 has a blocking effect in the actual position. Cannot be contacted by the axis direction. In principle, the operation can still take place via window 19. In an embodiment not shown in the drawings, in this case, a card holder is provided between the bottom plate 12 and the front end plate 9 across the narrow side extending in the radial adjustment direction of the guide rail 13.

1‧‧‧植入物 1‧‧‧ implants

2‧‧‧第一植入物部 2‧‧‧First Implants

3‧‧‧第二植入物部 3‧‧‧Second Implants

4‧‧‧螺紋環 4‧‧‧Threaded ring

5‧‧‧螺紋 5‧‧‧ thread

6‧‧‧齒 6‧‧‧ teeth

9‧‧‧前端板 9‧‧‧ front panel

10‧‧‧固定板 10‧‧‧ fixed board

11‧‧‧脊椎接觸板 11‧‧‧Spine contact plate

12‧‧‧底板 12‧‧‧floor

14‧‧‧上緊螺絲 14‧‧‧ tightening screws

17‧‧‧螺絲孔 17‧‧‧ screw holes

19‧‧‧窗口 19‧‧‧ window

20‧‧‧錨刺 20‧‧‧ Anchor

Claims (8)

一種植入脊椎之脊椎體(8)間之植入物(1)，作為由脊柱脫出之脊椎或脊椎部之位置保持器，該植入物(1)包括一第一植入物部(2)及一第二植入物部(3)，形成為圓形套筒且沿一軸線延伸，該第二植入物部(3)具有一外螺紋(5)，及該第一植入物部(2)具有一徑向開放孔；一螺紋環(4)，具有齒(6)，設於該第一植入物部(2)上，其螺入該第二植入物部(3)上，且其可旋轉以改變該等植入物部(2，3)之總軸向長度，該第一植入物部(2)形成有一孔，以供轉動該螺紋環(4)之一外科器具***；第一與第二固定板(10)，各具有一接觸板(11)，可固定至各別脊椎體(8)，及一底板(12)，連接至各植入物部(2，3)，每一該接觸板(11)在截面上為外凸，至少具有一螺絲孔(17)，且在對底板(12)之連接區域有一窗口(19)，該窗口(19)與該第一植入物部(2)側邊上之該孔可調方向，以沿徑向面朝相同方向；一前端板(9)，設於該第一植入物部(2)上，具有一螺紋孔，且沿軸向支承於該第一固定板(10)之該底板(12)上；一導軌(13)，介於該第一固定板(10)之該底板(12)與該第一植入物部(2)之間，以在該第一固定板(10)之該底板(12)上沿徑向移動該第一植入物部(2)；及一上緊螺絲(14)配有一螺絲頭(7)，貫穿該第一固定板(10)之該基板(12)且齧合入該前端板(9)之該螺紋孔中，以將該第一固定板(10)之該基板(12)與該第一植入物部(2)固定在複數個徑向偏移位置中任一處。 An implant (1) implanted between the vertebral bodies (8) of the spine as a position holder for the spine or the spine that is dislodged by the spine, the implant (1) comprising a first implant portion ( 2) and a second implant portion (3) formed as a circular sleeve and extending along an axis, the second implant portion (3) having an external thread (5), and the first implant The object portion (2) has a radial opening; a threaded ring (4) having teeth (6) disposed on the first implant portion (2) and screwed into the second implant portion ( 3) upper, and rotatable to change the total axial length of the implant portions (2, 3), the first implant portion (2) is formed with a hole for rotating the threaded ring (4) Inserting a surgical instrument; first and second fixing plates (10) each having a contact plate (11) fixed to each vertebral body (8) and a bottom plate (12) connected to each implant Parts (2, 3), each of the contact plates (11) is convex in cross section, has at least one screw hole (17), and has a window (19) in a connection area to the bottom plate (12), the window ( 19) the hole on the side of the first implant portion (2) is adjustable in direction to face the same direction in the radial direction; The end plate (9) is disposed on the first implant portion (2) and has a threaded hole and is axially supported on the bottom plate (12) of the first fixing plate (10); a guide rail ( 13) between the bottom plate (12) of the first fixing plate (10) and the first implant portion (2) on the bottom plate (12) of the first fixing plate (10) Moving the first implant portion (2) radially; and a tightening screw (14) is provided with a screw head (7) extending through the substrate (12) of the first fixing plate (10) and engaging In the threaded hole of the front end plate (9), the substrate (12) of the first fixing plate (10) and the first implant portion (2) are fixed in a plurality of radial offset positions. one place. 根據申請專利範圍第1項所述之植入物，其特徵為，該第一固定板(10)設計成叉狀，具有至少兩個叉臂(15)，該上緊螺絲(14)齧合在該等叉臂之間。 The implant according to claim 1, wherein the first fixing plate (10) is designed in the shape of a fork and has at least two fork arms (15), and the tightening screws (14) are engaged Between the fork arms. 根據申請專利範圍第2項所述之植入物，其特徵為，叉臂(15)具有伸入上緊螺絲(14)之該螺絲頭(7)下方之夾緊邊(16)。 The implant according to claim 2, characterized in that the wishbone (15) has a clamping edge (16) which extends below the screw head (7) of the tightening screw (14). 根據申請專利範圍第3項所述之植入物，其特徵為，該底板(12)配有一窄邊，配合於該第一固定板(10)之該等叉臂(15)之間。 The implant of claim 3, wherein the bottom plate (12) is provided with a narrow side that fits between the fork arms (15) of the first fixing plate (10). 根據申請專利範圍第1項所述之植入物，其特徵為，在螺絲頭(7)上形成工具容室，用以轉動上緊螺絲(14)。 The implant according to claim 1, characterized in that a tool chamber is formed on the screw head (7) for rotating the tightening screw (14). 根據申請專利範圍第1項所述之植入物，其特徵為，該窗口(19)及螺紋孔面向同一方向可調。 The implant according to claim 1, wherein the window (19) and the threaded hole are adjustable in the same direction. 根據申請專利範圍第1項所述之植入物，其特徵為，在底板(12)與前端板(9)之間形成卡座。 The implant according to claim 1, characterized in that a card seat is formed between the bottom plate (12) and the front end plate (9). 根據申請專利範圍第7項所述之植入物，其特徵為，該卡座由橫向相對導軌(13)徑向調整方向之窄邊構成。 The implant according to claim 7 is characterized in that the card seat is constituted by a narrow side laterally opposite to the guide rail (13) in the radial direction.
TW098128955A 2008-10-24 2009-08-28 Implanted intervertebral implant between the spine TWI465228B (en)

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