CN100528105C - 颈部假体用的植入器械 - Google Patents

颈部假体用的植入器械 Download PDF

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CN100528105C
CN100528105C CNB2004800202366A CN200480020236A CN100528105C CN 100528105 C CN100528105 C CN 100528105C CN B2004800202366 A CNB2004800202366 A CN B2004800202366A CN 200480020236 A CN200480020236 A CN 200480020236A CN 100528105 C CN100528105 C CN 100528105C
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intervertebral endoprosthesis
implantation instrument
pliers
projection
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CN1822804A (zh
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A·克勒
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Waldemar Link GmbH and Co KG
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    • 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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • 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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
    • 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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • 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
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30904—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves serrated profile, i.e. saw-toothed
    • 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
    • A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
    • A61F2002/443—Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
    • 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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4622—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof having the shape of a forceps or a clamp
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4625—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
    • A61F2002/4628—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about an axis transverse to the instrument axis or to the implantation direction, e.g. clamping

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Abstract

多部件椎间内假体(9)用的植入器械，其中多部件椎间内假体包括两个终板(91，92)和在终板之间布置的滑动核心(93)，植入器械带有手柄部分(21，31)，将终板保持在其间的抓取部分，和用于向椎间内假体(9)施加植入力的受力部分，抓取部分通过铰链(4)可相向来回运动地引导并可夹紧在椎间内假体(9)上，布置了指向夹紧方向(12)的凸起(51，52)或者凹口以将椎间内假体(9)形状锁合地保持在抓取部分上，设置了在纵向(10)上被引导的带有止动面(62)的方块件(61)，该方块件可借助操纵装置(7)运动以贴靠在椎间内假体上，并在其前部位置将椎间内假体(9)固定靠在凸起(51，52)或凹口上。

Description

颈部假体用的植入器械
技术领域
本发明涉及多部件椎间内假体用的植入器械，其中多部件椎间内假体包括两个终板和在终板之间布置的滑动核心，植入器械带有手柄部分，将终板保持在其间的抓取部分，和用于向椎间内假体施加植入力的受力部分。
背景技术
为植入椎间内假体，已知一种植入器械(EP-A-1 306 064)，在其前端具有两个用于分别接收假体终板的假体保持部分，该假体保持部分由两个刚性相互连接的抓取部分组成，通过摩擦力将终板保持在其间。对于如在颈部脊柱区域使用的并且必须非常精确定位的非常小的植入物来说，这会导致不可靠。
发明内容
本发明的任务在于，提供一种改善的用于植入椎间假体的器械，其特别满足如主要在颈部脊柱区域的狭窄条件下的植入的需要。
为此，本发明提出一种多部件椎间内假体用的植入器械，其中多部件椎间内假体包括两个终板和在终板之间布置的滑动核心，植入器械带有手柄部分，将终板保持在其间的抓取部分，和用于向椎间内假体施加植入力的受力部分，其特征在于，抓取部分通过铰链可相向来回运动地引导并可夹紧在椎间内假体上，布置了指向夹紧方向的凸起或者凹口以将椎间内假体形状锁合地保持在抓取部分上，设置了在纵向上被引导的带有止动面的方块件，该方块件可借助操纵装置运动以贴靠在椎间内假体上，并在其前部位置将椎间内假体固定靠在凸起或凹口上。
根据本发明，在多部件椎间内假体，特别是颈部假体用的植入器械情况下，其中所述颈部假体包括两个终板和在终板之间的滑动核心，所述植入器械带有手柄部分，将终板保持在其间的抓取部分，和用于向椎间内假体施加植入力的受力部分，抓取部分通过铰链可相向来回运动地引导并可夹紧在椎间内假体上，布置了指向夹紧方向的凸起或者凹口以将椎间内假体形状锁合地保持在抓取部分上，设置了在纵向上被引导的带有止动面的方块件，该方块件可借助操纵装置向椎间内假体运动并在其前部位置将椎间内假体固定靠在凸起或凹口上。通过铰链相互连接的抓取部分在闭合钳子形植入器械情况下相向运动，并以其凸起(或凹口)形状锁合地接合在椎间内假体的相应凹陷(或凸起)内并由此在与植入器械纵轴垂直的方向上将其夹紧。可纵向移动引导的方块件可向椎间内假体方向移动，直到其止动面贴靠在椎间内假体上并将其固定靠在凸起(或凹口)上为止。由此椎间内假体在纵向上也被夹紧。由此椎间内假体无间隙并且精确定位地被植入器械保持。由于紧靠在椎间内假体上的方块件，从而还能可靠地传递如在敲入椎间内假体情况下出现的大力。由于大的力通过方块件及其止动面传递，所以凸起(或凹口)不需要承受该力。所以凸起(或凹口)的尺寸可以做成如精确定位所希望的那样纤细，而不用考虑敲击时的高力载荷。此外，方块件通过贴靠在椎间内假体上防止了椎间内假体意外转动或者其单个元件展开。从而由于本发明，椎间内假体可以定位精确地、可靠地并且以简单的方式保持在植入器械上并被植入。
下面解释几个概念：
钳子的纵轴应理解为一条中线，该中线是钳子半体和钳子半体的钳口部分之间的角平分线。
夹紧方向应理解为抓取部分相向运动的方向。相反的方向是打开方向。这些方向一般约垂直于植入器械的纵轴。
形状锁合保持应理解为凸起接合到相应设计的椎间内假体接收开口内或者反过来。以纵轴方向上看，凸起接合在侧面凹口内。
最好植入器械是钳子，其钳口部分构成抓取部分。这使得构造节省空间并且操作简单，特别在颈椎区域的狭窄条件上这是特别有利的。
为使使用简单，操纵装置具有杆，杆带有在手柄后部区域内布置的把手。这允许外科医生在使用操纵装置时易于将其抓住。当方块件必须往回运动时，特别在颈部假体狭窄的位置条件情况下，植入椎间内假体之后取出植入器械时，这是特别重要的。可取的是，为此杆备有螺纹，并在固定在器械上的、最好布置在铰链内的配对螺纹内被引导。这样通过向一个方向转动，方块件被引导靠在椎间内假体上并从而将其固定，而通过向相反方向转动使方块件离开并释放椎间内假体以取下植入器械。另外，螺旋装置还具有自锁的优点，从而不需要单独的用于预防发生意外移动的安全装置。但螺旋装置不是必需的，还可以设置其它的最好自锁的操纵装置。
特别可取的构造方式是操纵装置由铰链引导。这不仅是特别节省空间的实施方式，而且还保证了在中心附近的结构。该结构保证了植入器械即使在敲击时的较高力载荷情况下，也不会向侧面偏移。由此在植入椎间内假体时达到了高的定位精度。
可取的是操纵装置在其手柄侧端部具有冲击头。由此可通过操纵装置和方块件直接作用于椎间内假体，以将其放入到植入位置。可取的是为此把手本身设计为冲击头。这实现了节省空间的结构，特别在颈部脊柱区域狭窄的条件情况下，这非常重要。
为在较高力载荷情况下也能避免植入器械意外打开，可取的是设置用于将手柄部分固定在压到一起的位置的定位器，该定位器具有操纵装置用的导向装置。特别在比较靠后布置的冲击头情况下，这防止了操纵装置在高载荷下的纵弯曲。定位器可以本身已知的方式设置在手柄部分的后端上。重要的是，定位器在尺寸上应做得足够坚固，从而能够承受住在冲击时出现的载荷，但易于脱开以取下器械。
在可取的实施形式情况下，凸起或凹口布置在钳口镶块上，钳口镶块可更换地固定在钳口部分上。这允许在需要时易于更换钳口镶块及其上面布置的凸起或凹口，以使植入器械适应其它类型或大小的椎间内假体。
附图说明
下面参考示出了优选实施例的附图解释本发明。其中：
图1为带有椎间内假体的、从上侧看到的根据本发明植入器械的总体视图；
图2为从下侧看到的根据本发明植入器械的总体视图；
图3为以纵轴剖面示出的植入器械钳口部分放大局部视图；
图4为另一个钳口镶块的局部视图；
图5为带有上面布置的椎间内假体的植入器械的局部视图。
具体实施方式
图中示出的根据本发明植入器械的实施例是钳子，该钳子总体上用附图标记1表示。该钳子用于将颈部假体9植入到颈部脊柱(未示出)的两个相邻椎骨之间的空间内。
钳子1由两个钳子半体2，3构成，这两个钳子半体通过回转接头4可运动地相互连接。钳子半体2，3在其后部区域各有一个手柄部分21，31，并在其前部区域各有一个钳口部分22，32。回转接头布置在手柄区域21，31和钳口部分22，32之间的过渡部分中。回转接头由钳子半体2上的轴颈42构成(在图1中它从附图平面向上延伸)，该轴颈支承在另一个钳子半体3中部区域的合适开口43内。轴颈42具有通孔44，该通孔从钳子半体2，3的手柄侧区域向钳口侧区域延伸。后面还要对其进行详细说明。回转轴承4允许钳子半体2，3的手柄部分21，31一个在另一个上运动，由此闭合和打开钳口部分22，32。
钳口部分22，32起到抓取部分的作用。它们在前部区域在其相互面向的内侧，各具有两个指向夹紧方向的凸起51，52。这些凸起不是直接布置在钳口部分22，32上，而是布置在钳口镶块53上，镶块借助螺栓(未示出)可更换地在钳口部分22，32的外侧固定在相应的接收部内。每个钳口镶块各具有一个凸起51和一起凸起52。凸起51是销钉形的并位于上部区域，而凸起52是薄片形的并位于钳口镶块53的下部区域。凸起51，52的尺寸和布置与要接收的颈部假体9的相应接收开口相匹配。下面对此详细说明。
在钳口部分22上布置了导轨60，被该导轨保持的方块件61可在钳子半体2上向前后方向纵向移动。导轨60设计为钳口部件22的钳口镶块53中的长孔。侧面在方块件61内布置的埋头止动螺钉接合在构成导轨60的长孔内并在纵向上引导方块件。替代长孔还可以设置其它的允许在纵向上可前后移动地引导方块件的导向元件，例如燕尾槽导向装置。方块件61在其前端备有止动面62，该止动面与颈部假体9相互作用。
操作装置7作用在方块件61上，该操作装置从方块件61的后部区域穿过通孔44延伸到手柄部分21，31之间的区域。操作装置包括与方块件61的连接元件70，在所示实施例中，该连接元件是适合传递推力的旋转轴承(Wirbellager)，此外操作装置还包括杆71和用于操作的把手72。在杆71的前部区域设置了外螺纹73，该外螺纹与作为固定在器械上的导向装置的轴颈42的通孔44内的互补内螺纹(未示出)共同起作用。由此能够通过转动把手72来沿着导轨60前后移动杆71，并从而通过连接元件70来移动方块件61。把手72是球形把手，在其外壳表面上具有合适的表面造型，如粗糙的沟形75，以为外科医生提供良好的抓握性。
把手72的后端备有凸出的拱形件76。其作用操作装置7的冲击头。将作用在冲击头的拱形件76上的冲击的冲力通过操作装置7的杆71、止推旋转轴承70和方块件61传递到方块件的止动面62上。
在钳子1后部区域为手柄部分21，31设置了定位器8。定位器包括可摆动的定位元件83和止动销84(它们分别面对面布置在手柄部分21，31上)，脱开装置81，底座82和弹簧87。手柄部分21的后端为叉形件，其中止动销84由叉形件基点的倒角构成。定位元件83通过底座82支承在由手柄部分21，31展成的平面内。弹簧87是片弹簧，作用于支承在底座82内的定位元件83的端部，使得该端部被向前压向止动销84。从底座82开始，定位元件83具有宽的区域和窄的区域。在其窄的区域中，定位元件83在其前端具有齿部86，在钳子1闭合状态，止动销84接合并定位在该齿部内，从而手柄部分21，31不能相互分离，从而确保植入器械1意外展开。由此还能够向钳子1上施加大载荷，如例如作用在拱形件76上的锤击，而不用担心意外打开，并且外科医生也不需要用手的力保证手柄部分21，31不要意外打开。为在植入之后打开钳子1，通过向后压脱开元件81使元件83向后摆动，由此止动销84离开定位元件83，从而手柄部分21，31在弹簧11的作用下相互分离。在钳子1的打开状态，定位元件83克服弹簧87的力向后摆动。在定位元件83的宽区域中设置了设计为长孔的导向装置85，该导向装置用于在钳子1打开时也将杆71保持在纵轴10的规定位置，并在受到较高冲击载荷时也能避免杆71纵弯曲。
此外，在手柄部分31上固定了片弹簧11，该片弹簧围绕杆71伸向另一个手柄部分21。在钳子1闭合情况下，该片弹簧11受压并使植入器械1在定位元件83脱开后能够自动打开，以便能够取下。
下面借助图3和5描述与颈部假体9的相互作用。颈部假体9由上终板91，下终板92和在两个终板之间布置的滑动核心93组成。该颈部假体用于植入在人颈部脊柱的两个相邻椎骨之间的空间内。在此上终板91固定在头椎上，下终板92固定在尾椎上。为将颈部假体9可靠地布置在钳子1上以插入到椎间空间内，上和下终板91，92在其前部法兰94，95区域的侧面上具有接收开口。在此上终板91上的接收开口为带有附加沉孔的孔97。下终板92上的接收开口为狭槽96。滑动核心93在其法兰侧区域同样设有狭槽96’，该狭槽布置为与下终板92的狭槽对齐。由此狭槽96，96’形成连续的沟槽。
为用钳子1接收颈部假体9，将颈部假体9放到钳口部分22，32之间的区域中并闭合钳子1，由此钳口部分22，32相向运动。在此凸起51，52接合到两个终板91，92的相应接收开口内，其中销51接合到孔97内，薄片52接合到狭槽96，96’内。由此颈部假体9在夹紧方向上被无间隙地保持在钳子1上。凸起51，52和孔97和狭槽96形式的接收开口的不同实施形式保证颈部假体9只能以正确的定位被保持在钳子1上。如果钳子1如在所示实施例中还另外备有上侧用的标记14，则实际上排除了由于颈部假体9定向颠倒导致的错误植入。在这样将颈部假体9以正确定位接收在钳子1上之后，可借助操作装置7通过转动把手72使杆71向前运动，从而方块件61以其止动面62从后面贴靠到颈部假体9的法兰94，95上。在此方块件使颈部假体9张紧靠在凸起51，52上，并从而将颈部假体9安置在规定的位置。最终以这种方式消除了在凸起51，52和孔97和狭槽96之间的纵轴方向上存在的间隙。由此颈部假体9被可靠并且精确定位地保持在植入器械1上。此外，方块件61贴靠在两个终板91，92的法兰93，94上还防止两个终板91，92在其前端相互分开。由此避免了颈部假体展开，颈部假体展开会妨碍成功进入椎间空间。
此外，还可不必改变钳子1就能植入其它高度的颈部假体。在图3b中示出了这种颈部假体9’，其具有较厚的滑动核心93’。滑动核心93’(和滑动核心93一样)备有狭槽96”，该狭槽与下终板92的狭槽96对齐。接收开口在下终板92上作为狭槽96并且其延伸部分作为在滑动核心93’中的狭槽96”，使得能够用不改变凸起51，52布置的同一钳子1抓取并可靠地保持颈部假体9’。在此通过接合到孔97内的销钉形凸起51保证了定位精度。
但在需要时，如图4中所示，还可设置其它的钳口镶块53’，该钳口镶块具有布置不同的凸起51’，52’。由此钳子1可适用于其它的椎间内假体，例如适用于特别小的治疗儿童的椎间内假体。
方块件61以其止动面62提供了尺寸足够大的传力表面，以将施加到作为冲击头的拱形件76上的冲力传递到颈部假体9上。这具有很大的优点，即为精确定位而做得纤细的凸起51，52不必传递冲击力，从而即使在较高冲击载荷情况下，由于方块件61以其止动面62承担了传力，也排除了由于过载导致凸起51，52弯曲或者甚至折断的危险。
根据本发明的钳子1能够防止搞错并精确定位地将颈部假体9布置在钳子1上，其中防止了颈部假体9意外打开。此外，由于带有止动面62的方块件61，即使在小尺寸钳子1的情况下也能够传递较大的力。由此保证了可靠植入假体。小的尺寸还具有另外的优点，即为外科医生提供了良好的观察和达到植入位置的条件。

Claims (8)

1.多部件椎间内假体(9)用的植入器械，其中多部件椎间内假体包括两个终板(91，92)和在终板之间布置的滑动核心(93)，植入器械带有手柄部分(21，31)，将终板保持在其间的抓取部分，和用于向椎间内假体(9)施加植入力的受力部分，
其特征在于，
抓取部分通过铰链(4)可相向来回运动地引导并可夹紧在椎间内假体(9)上，布置了指向夹紧方向(12)的凸起(51，52)或者凹口以将椎间内假体(9)形状锁合地保持在抓取部分上，设置了在纵向(10)上被引导的带有止动面(62)的方块件(61)，该方块件可借助操纵装置(7)运动以贴靠在椎间内假体上，并在其前部位置将椎间内假体(9)固定靠在凸起(51，52)或凹口上。
2.根据权利要求1的植入器械，其特征在于，
植入器械是钳子(1)，其钳口部分(22，23)构成抓取部分。
3.根据权利要求1或2的植入器械，其特征在于，
操纵装置(7)是杆(71)，杆带有在手柄部分(21)后部区域中布置的把手(72)。
4.根据权利要求3的植入器械，其特征在于，
杆(71)备有螺纹(73)，并在固定在器械上的、在铰链(4)中布置的配对螺纹中被引导。
5.根据权利要求3的植入器械，其特征在于，
把手(72)是冲击头(76)。
6.根据权利要求3的植入器械，其特征在于，
操纵装置(7)由铰链(4)引导。
7.根据权利要求1或2的植入器械，其特征在于，
设置了用于将手柄部分(21，31)固定在压在一起的位置的定位器(8)，该定位器具有供操纵装置(7)用的导向装置(85)。
8.根据权利要求2的植入器械，其特征在于，
凸起(51，52)布置在钳口镶块(53)上，钳口镶块可更换地固定在钳口部分(22，32)上。
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AR056619A1 (es) 2007-10-17
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US7569067B2 (en) 2009-08-04
CN1822804A (zh) 2006-08-23
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US20060004377A1 (en) 2006-01-05
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US20050015095A1 (en) 2005-01-20
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