CN101257866A - 用于引入椎间盘腔隙中的笼架 - Google Patents

用于引入椎间盘腔隙中的笼架 Download PDF

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Publication number
CN101257866A
CN101257866A CNA2006800324875A CN200680032487A CN101257866A CN 101257866 A CN101257866 A CN 101257866A CN A2006800324875 A CNA2006800324875 A CN A2006800324875A CN 200680032487 A CN200680032487 A CN 200680032487A CN 101257866 A CN101257866 A CN 101257866A
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China
Prior art keywords
cage
intervertebral
disc compartment
cover plate
substrate
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CNA2006800324875A
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弗朗茨·小科弗
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Individual
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Individual
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Abstract

本发明涉及一种将被引入形成在两相邻椎骨之间的椎间盘腔隙中的刚性笼架(110)，该笼架由两构成元件(110a，110b)沿平行于笼架的横向侧面延伸的接合面组装而成。根据另一实施例，可在笼架(210)上紧固有操作装置、例如一对杆件(231，233)，以便在椎间盘腔隙中旋转所述笼架。所述两种方法都能使可通过具有非常小的直径的入口通道引入笼架。

Description

用于引入椎间盘腔隙中的笼架
相关申请的交叉引用
本申请要求2005年7月6日提出的美国临时申请US No.60/696,889的权益。该较早申请的全部公开结合于此作为参考。
技术领域
本发明涉及一种将被引入形成在两相邻椎骨之间的椎间盘腔隙(intervertebral-disc compartment)的笼架。
背景技术
术语“笼架”应理解成是指通过外科手术定位到形成在人体脊柱的两相邻椎骨之间的椎间盘腔隙内的笼状体。所述笼架具有替换椎间盘并通过融合后者固定两相邻椎骨之间的间隔的任务。
大多数笼架具有大致圆柱形的总体形状，并经由腹侧入口通道(ventralaccess canal)旋拧到椎间盘腔隙内。这种笼架例如从US 2003/0045938A1和DE 19957339C2中已知。这些已知的笼架可经由具有较小直径的腹侧入口通道被引入椎间盘腔隙中。这样，在手术期间腹侧血管被损伤的危险较小。
但是，接合椎间盘腔隙的椎骨被圆柱形笼架非常不均匀地压迫，这会导致这些椎骨恶化。另外，由于圆柱形笼架，难以将限定椎间盘腔隙的椎骨准确定位在预期位置。
DE 19827515A1公开了一种其总体形状为楔形的笼架。该笼架减小了在圆柱形笼架的情况下可观察到的相邻椎骨恶化的危险。但是，由于其尺寸较大，所以引入沟道也必须较大。这大大增加了在植入手术期间损伤血管的危险。
发明内容
为此，本发明的一个目的在于提供一种笼架，该笼架即使具有比已知的圆柱形笼架更大的尺寸，也能通过具有小的直径的入口通道被引入椎间盘腔隙中。
根据本发明的第一方面，通过由至少两个构成元件组装成的笼架解决所述问题，其中，所述至少两个构成元件优选地具有基本相同的尺寸。
笼架的这种构成使得两构成元件可经由(腹侧或腹边)入口通道依次地被引入椎间盘腔隙中。因此，笼架不作为整体而是部分地被引入，只有在各部分被引入椎间盘腔隙之后，笼架才被完整地组装起来。
通常，笼架沿边侧具有最长的尺寸。因此，将笼架沿平行于笼架的横向侧面延伸的对称平面分成两个构成元件是有利地。这种构造确保了两个构成部分具有相同的边侧尺寸，该尺寸决定了入口通道的直径。
为了有助于用两构成元件组装笼架，所述构成元件可设有在构成元件相连接时相互接合的导向面。所述导向面使得构成元件在至少两个正交方向上相互对齐。所述导向面可设计成能够通过即使在通过小的入口通道的情况下也能产生的滑动运动连接定位在椎间盘腔隙内的构成元件。但是，也可设想用于连接构成元件的其它手段。例如，构成元件可使用螺栓、支架或胶水相连接。
将笼架分成两个(或多个)构成元件并在椎间盘腔隙内组装这些构成元件还使得能够植入比现有技术中已知的笼架远远较大的笼架。具有较大的基板和盖板的笼架是有利的，这是因为它们将完全贴靠形成相邻椎骨表面的硬骨组织(密质)。在迄今使用的较小笼架的情况下，位于椎骨中部的较软的骨组织(松质)承受非常大的力。这种传统方法将导致作用在密质上的过大的力造成骨质恶化的严重危险。
在基板和/或在盖板上可设置有平行于横向侧面延伸、并优选地垂直于所述板的翅片。所述翅片由设置在各构成元件上的相邻的翅片元件形成。如果在引入之前利用凿子在相邻椎骨内凿出用于接纳翅片的凹槽，则所述翅片将使笼架能够相对于所述椎骨固定。
在基板和/或在盖板上，在向外的表面上还可至少部分地设有平行于所述板的纵向侧面延伸的波纹。所述波纹的任务是增加笼架相对于相邻椎骨的摩擦阻力，并通过这种方式防止笼架被压出。这在笼架具有楔形总体形状、或者不设有翅片时特别有用。为此，所述波纹优选具有带波纹翼侧的锯齿状轮廓，所述波纹翼侧沿引入方向的斜度小于沿相反方向的斜度。这样，当笼架被引入椎间盘腔隙时，波纹产生的阻力将小于其在被拉出时产生的阻力。
根据本发明的另一方面，通过一种笼架系统解决上述问题，所述笼架系统包括笼架和可与该笼架可分离地连接的操作装置。所述操作装置构造成当连接到笼架时通过操作该操作装置使该笼架旋转。
由于笼架在椎间盘腔隙中通常定向成其较长的纵向侧面定向成与腹侧入口通道的纵向轴线成直角，因此，腹侧或腹边入口通道必须通常具有至少等于笼架的长度的直径。但是，如果将笼架在其较窄的横向侧面在前的情况下通过入口通道引入椎间盘腔隙，并然后利用操作装置在椎间盘腔隙中将其旋转到其最终位置，则入口通道的直径可大大减小。这样还减小了对创建入口通道的过程中必须被移位的血管造成损伤的危险。
在最简单的情况下，所述操作装置可包括两个杆件，它们可以铰接的方式可分离地连接到所述笼架。但是，还可设想更加复杂的操作装置。例如，操作装置可以是可分离地、却是固定地联接到所述笼架，并且操作装置可包括铰接件，这些铰接件使得能够通过致动控制杆或转轮旋转固定的笼架。
附图说明
参照下文结合附图的详细说明将能更容易地理解本发明的各种特征和优点，在附图中：
图1是根据本发明的第一示例性实施例的腹侧笼架的透视图；
图2是图1所示笼架的侧视图；
图3是根据第一示例性实施例的变型的腹侧笼架的侧视图；
图4是根据本发明的第二示例性实施例的腹侧笼架对应于图1的透视图，其中笼架由两个构成元件组装而成；
图5是图4所示的笼架的主视图；
图6是图4所示的笼架的构成元件的侧视图；
图7是根据本发明的第三示例性实施例的腹侧笼架的透视图，其中，所述笼架能够通过两个操作杆围绕椎间盘腔隙中的垂直轴线旋转；
图8是原理上适用于操作杆的可分离铰接钩状连接的示例性透视图；
图9a至9c用简化的俯视图示出在不同旋转位置的图7的笼架；
图10a至10c是对应于图9a至9c的视图，但是具有其它操作杆铰接点；
图11是根据本发明的笼架的另一实施例的透视图；
图12是通过图11所示的笼架的对称平面的中央断面视图。
具体实施方式
图1是总体用10指示的腹侧笼架的透视图。笼架10具有向上的盖板12，该盖板12具有大致矩形的基本形状。盖板12具有凸出弯曲的腹侧纵向侧面14，该侧面14在笼架10被引入椎间盘腔隙之后沿腹侧定向。在相对侧，盖板12由与两横向侧面18、20成直角的背侧纵向侧面16界定。
在盖板12中，相对于垂直通过盖板12并延伸通过弯曲的纵向侧面14的顶点的对称平面对称地设置有两个窗口状开口22、24，这两个开口在它们之间限定了横档26。
在所示的实施例中，横档26具有梯形的第一翅片28，该翅片28在笼架10的上述对称平面内延伸。在翅片28中具有三个孔，这三个孔在图2的侧视图中用30、32、34指示。
与盖板12相对地定位有基板36，基板36的构造与盖板12相同。仅在图2的侧视图中可看到第二翅片38，翅片38由位于基板36中的两开口42、44之间的横档40支承。
盖板12和基板36的腹侧纵向侧面14通过前板46连接，该前板46同样具有两个窗口状开口48、50。在相对侧，盖板12和基板36经由不具有开口的闭合背板52相互连接。在盖板12和基板36的横向侧面之间延伸有具有开口53和55的侧板。
除两翅片28、38外，笼架10的所有向外的拐角和边缘都是圆弧的。
在图2中可最好地看到，盖板12和基板36不是平行的，而是设置成相对于彼此成楔角α。因此，盖板12和基板36的纵向侧面相互平行地延伸，而盖板12的横向侧面18、20与基板36的横向侧面成楔角α。
为了说明笼架10的形状，可使用笼架10的长度和图2中所示的量值--所述长度是指背侧纵向侧面16的长度。所述量值是指楔角α、笼架10的最大高度h和最小宽度b。为了说明前板46的曲率，可使用曲率半径。
整个笼架可用适宜的材料例如钛制造成一体件。在使用不同材料的情况下，应确保背板52不能穿透X射线，以便在手术期间可利用成像方法监控笼架10向椎间盘腔隙中的引入过程。此外，有利地，至少在盖板12和基板36的外侧上具有粗糙的涂层，以防止笼架10由于是楔形的而滑出。
可通过以下方式将图1和图2所示的笼架引入两相邻椎骨之间的椎间盘腔隙中：
首先，利用生物测定方法测量笼架将被经由腹侧入口通道引入其中的椎间盘腔隙。在该方面，例如可利用诸如磁共振成像的成像方法。利用这种方法，可确定椎间盘腔隙的宽度、深度和最大高度、以及椎间盘腔隙的突角。尤其是在颈椎骨的情况下，必须通过材料磨蚀的方式例如研磨对相邻椎骨的表面进行机加工。
原理上可制造出具有通过此种方法测量的椎间盘腔隙的精确尺寸的笼架。但是，由于生物测定法测量的精度有限，而较小的偏差是不可避免的并且不一定不利，所以个体生产仅在个体情况下才是明智的。相反，提供其上述几何参数各不相同的一组不同的笼架往往就足够了。
现在从所述一组笼架中选择其几何参数最接近在椎间盘腔隙测量期间获得的生物测定数据的笼架。然后通过外科手术创建通往所关心的椎间盘腔隙的腹侧入口通道，并除去在该处存在的材料、例如椎间盘或替代所述椎间盘的骨移植物。在许多情况下、尤其是在脊柱的颈椎部分中，还需要进行椎间盘腔隙的材料磨蚀预处理。在利用成像方法的持续监控下，利用凿子在限定椎间盘腔隙的两椎骨中凿出用于接纳翅片28、38的凹槽。然后经由引入沟道将选中的笼架10引入暴露的椎间盘腔隙中，使背板52朝向椎管。
在笼架10被引入椎间盘腔隙中时，翅片28、38与先前在椎骨中凿出的凹槽接合，从而沿边侧固定笼架10。通过翅片28、38在凹槽中的摩擦实现沿引入方向的固定。在引入状态下，盖板12和基板36支承在已知为密质的硬骨组织上。这样，沿脊柱的纵向起作用的力最优地在与椎间盘腔隙相邻的椎骨之间传递。作用在椎骨的较软的中部区域(松质)上的力保持较小。
在手术结束后，周围的海绵组织能够通过所述开口生长到笼架10内。通过周围组织对笼架10的渗透，可实现额外的在椎间盘腔隙内的固定。
图3用与图2相对应的侧视图示出图1和图2所示的笼架10的变型，其中盖板12′和基板36′在它们的向外的表面上承载具有大致锯齿状轮廓的纵向波纹60。在图3中可见，轮廓翼侧在该情况下倾斜成变化地很大程度，从而尽管具有波纹60，但是笼架10仍可借助于其后侧52′被容易地引入椎间盘腔隙，而借助于基本垂直延伸的阶梯部62抵抗沿相反方向的运动。
图4至6分别通过对应于图1的透视图、正面的主视图以及接合面的构成元件的侧视图示出第二实施例。
与笼架10的部件相对应的部件用增加100的附图标记指示，并在一些情况下将不再详细说明。
图4至6所示的笼架110与图1和2所示的笼架10的主要区别在于，笼架110沿上述对称平面划分成两个构成元件110a、110b。在图4中，构成元件110a、110b之间的周缘接缝用111指示。在此实施例中，两构成元件110a、110b经由凹槽和导向隆起部相互对齐，从而笼架110仍具有光滑表面。
在图5中示出笼架110的主视图，为清楚起见，两构成元件110a、110b相互分开一定距离。在该视图中可见，各构成元件110a、110b分别具有自身的翅片128a、138a和128b、138b。在两构成元件110a、110b的接合状态下，翅片128a、128b和翅片138a、138b以平面方式相互靠接，从而尽管笼架10分成两部分，但是仅需要在限定椎间盘腔隙的每个椎骨内凿出一个凹槽即可。但是，各构成元件110a、110b被独立地沿边侧方向固定以抵抗在凹槽内的滑动。
在图5中还可看到，在右手侧的构成元件110b中，在位于盖板112b和基板136b水平面的接合面上分别陷设有断面为矩形的凹槽115和117，但是，如图6的侧视图所示，所述凹槽不在盖板112b或基板136b的整个横向上延伸。相反，凹槽115、117在朝向背板152b的方向上分别通过停止部119和121限定边界。
左手侧的构成元件110a在其位于盖板112a和基板136a水平面的接合面上分别具有导向隆起部123和125。导向隆起部123、125表现为凹槽115、117的互补件的形式。具体地，如图6可见，这意味着导向隆起部123、125的长度与凹槽115、117的长度一致。
笼架110分成两个构成元件110a、110b使得在将笼架110引入椎间盘腔隙中时可执行以下过程：
首先，通过生物测定法测量椎间盘腔隙，并从一组预制笼架中选择一笼架，或者制造一其尺寸与椎间盘腔隙的通过生物测定法确定的尺寸尽可能地一致的笼架。然后，使椎间盘或存在于椎间盘腔隙中的替代结构经由腹侧入口通道被暴露。应注意，所述入口通道现在可远小于一体件笼架的情况。
接下来，使椎间盘腔隙的一半被暴露，并用加固元件加固。按照与上文参照图1至3所述的实施例的情况相同的方式，利用凿子在相邻椎骨内凿出用于翅片128、138的凹槽。
接下来，使椎间盘腔隙的另一半被暴露，并经由腹侧入口通道引入与该侧相关的构成元件110a或110b。现在已被引入的构成元件110a或110b加固椎间盘腔隙，从而可拆除先前插入的加固元件。现在加固元件曾位于其中的那一半被完全暴露，以便能够接纳笼架110的另一半。在插入另一构成元件的过程中，导向隆起部123、125与凹槽115、117接合，并最终到达停止部119、121。这样，两构成元件110a、110b沿除引入方向之外的所有方向相对于彼此固定。
所述过程的优点在于，省去了取出大的加固元件并实际同时引入笼架的传统步骤。作为替换，仅加固椎间盘腔隙的一个半部，从而笼架的一构成元件可被容易地插入暴露的椎间盘腔隙的另一半中。该构成元件在开始插入的加固元件被拆除以产生用于笼架的另一构成元件的空间时用作加固元件。
图7用类似于图1的视图示出根据第三实施例的笼架210。与笼架10的部件相对应的部件用增加200的附图标记指示，并在一些情况下将不再详细说明。
笼架210与图1所示的笼架10的不同之处在于，在笼架210的前板246上铰接有操作杆231、233。为此所需的用于铰接操作杆231、233的接合元件(在图7中不可见)位于笼架210的相对的横向侧面上，并使得操作杆231、233可分离地连接到笼架210，以便操作杆231、233可在与基板236基本平行的平面内转动。通过在所述平面内拉或推操作杆231、233，笼架210可围绕在图7中用A指示的垂直轴线旋转。
在最简单的情况下，用于操作杆231、233的接合元件(在图7中不可见)可以是如在图8中单独示出的垂直延伸的短的支脚237。支脚237与紧固在操作杆231、233端部的钩件235一起形成上文所述的使操作杆231、233能转动的接合件。为了释放连接，只要从支脚237上松开钩件235即可。当然，存在许多其它的操作杆231、233或其它操作元件可通过其以铰接的方式可分离地连接到笼架210的紧固元件。
笼架210的使用操作杆231、233围绕垂直轴线A的可旋转性使得笼架可通过窄的腹侧入口通道沿纵向被引入，并使笼架在椎间盘腔隙内或在非常靠近椎间盘腔隙的情况下便可被使用操作杆231、233旋转到最终的/确定的横向位置。
这将在下文中参照图9a至9c进行说明，图9a至9c示出笼架210和操作杆231、233的简化的俯视图。用于操作杆231、233的紧固元件的旋转轴线在图9a至9c中分别用239和241指示。
在图9a中，笼架210被示出在其与在图7中所示位置相同的初始位置。假设笼架210将沿该方位定位在椎间盘腔隙中。笼架210的背板252因此将指向椎管，而凸出弯曲的前板246沿腹侧对齐。
如果笼架210将被沿该方位引入腹侧入口通道，则入口通道的直径d必须不小于笼架210的长度。如果现在分别沿箭头234和245所示方向在操作杆231、233上施加力--用手或借助于操作装置，则笼架210将沿箭头247所示方向旋转。
如在图9b中可见，笼架210看上去在该旋转后的方向上明显较窄。在引入已按所述方式旋转的笼架的过程中，腹侧入口通道仅需要稍大于笼架210的最大总体宽度的直径d′即可。为了比较，在图9b中示出有在图9a所示笼架210方位的情况下所需的腹侧入口通道的直径d。
在所述沿横向放置的方位上，笼架210通过腹侧入口通道被引入，直到其部分延伸到椎间盘腔隙内。分别如图9b中的箭头249和251所示在操作杆231、233上施加力。笼架沿箭头253所示的方向在椎间盘腔隙内旋转，并最终在椎间盘腔隙内位于其预期位置，如图9c所示。到达此位置后，操作元件231、233与笼架210分开，并被引导出腹侧入口通道。为使笼架210能在椎间盘腔隙内或在椎间盘腔隙附近旋转，笼架210不具有翅片。如上文参照图3所述，通过在基板和盖板的表面上设置波纹60来产生足够的摩擦。
在图10a至10c中示出该实施例的一个变型，其中，在笼架201′上的沿对角线彼此相对的位置处设有具有旋转轴线239′、241′的接合元件。这种沿对角线设置的优点在于，笼架210′能够围绕垂直轴线进一步旋转、即完全旋转90°。这可在图10b中最好地看出。与图9b相比较表明，腹侧入口通道仅需要具有与笼架210′的最大直径相等的直径d”即可。因此，腹侧入口通道的直径可比图7至9所示的笼架210的情况更小。
图11和图12用类似于图1的透视图和通过对称平面的中央断面视图示出笼架310的另一实施例。
笼架310具有盖板312，盖板312在其周界处具有平面环形邻接区域370，该邻接区域370可以是粗糙的，以便增加与骨组织的摩擦系数。横档326在腹侧纵向侧面314和背侧纵向侧面316之间沿X方向延伸。类似于图1所示的实施例，横档326分隔两开口322、324。但是，在该实施例中，横档326的向外的表面372凸出弯曲。在图12的断面视图中可最好地看到在XZ平面内的弯曲。在YZ平面内，横档326也相对于横档326的中间平面凸出地对称。由于所述弯曲，表面372具有位于其顶部的顶点374。
图12中所示的断面造成横档326的具有主侧部376和较陡的反向侧部378的斜坡状形状。因此，横档的形状与形成在相邻椎骨的骨突环内的穹隆的形状尽管不完全相同却也基本相同。在图12的断面视图中，椎骨380用虚线表示，其穹隆382在骨突环384之间形成。在该视图中可见，横档326比穹隆382更加弯曲。这是有利地，因为如果横档326与穹隆382相接触，则横档326以及整个笼架310便可相对于椎骨380围绕轴线390旋转、优选地旋转10°。该旋转可借助于操作杆231、233开始，以及/或者其可以是围绕椎骨的韧带所产生的压力的结果。可旋转的能力非常有助于笼架310在椎间盘腔隙内的正确的角定向。另外，由于穹隆382和横档324具有不对称的形状，因此可实现自动定心的效果，从而调整过程对于外科医生而言并不那么关键。
为了有助于横档324在穹隆382内的旋转，横档的表面372应相对于限定穹隆382的软骨组织(松质)具有非常小的动摩擦系数。这种小的动摩擦系数可例如通过在表面372上涂覆光滑涂层进行抛光来实现。可应用使用离子束淀积或溅射淀积技术由类金刚石碳(DLC)制成的表面，该表面不仅生物相容，而且非常硬，并具有摩擦非常小的光滑表面。利用这种涂层可容易地实现小于10μm、甚至小于1μm的算术粗糙度Ra，从而得到相对于相邻骨材料的非常小的动摩擦系数。
由于穹隆382的形状通常在不同椎骨之间不同，并且还因患者不同而不同，所以向外科医生提供具有不同的横档324形状的笼架是有用的。还可设想通过生物测定法确定各椎骨的穹隆382的形状，并根据测得的数据制造笼架310。
如果压力进一步增加，则顶点374周围的区域将沉入骨突环384内的软骨组织(松质)中，从而使该骨组织发生一定程度的变形和移位，直到平面环形邻接区域370抵靠在硬的骨突环384上。尽管最终在横档326和骨突环384中的软骨组织(松质)之间实现了密切连接，但是，主要负荷却由环形邻接区域370和骨突环384承载。
如图12可见，基板336以相同的方式构造。因此，所有上述说明相应地也适用于基板336。

Claims (44)

1.用于引入形成在两相邻椎骨之间的椎间盘腔隙中的笼架(110，210)，其特征在于，所述笼架由至少两个构成元件(110a，110b)组装而成，所述至少两个构成元件优选具有至少基本相同的尺寸。
2.根据权利要求1所述的笼架，其特征在于，所述组装而成的笼架(110)具有基板(136a，136b)和盖板(112a，112b)，所述基板和盖板分别具有两个纵向侧面和两个横向侧面。
3.根据权利要求2所述的笼架，其特征在于，在所述基板(136a，136b)和盖板(112a，112b)之间延伸有背侧背板(152a，152b)和腹侧前板(146a，146b)。
4.根据权利要求3所述的笼架，其特征在于，所述腹侧前板(146a，146b)具有至少一个开口(148，150)。
5.根据权利要求3或4所述的笼架，其特征在于，所述背侧背板(152a，152b)不具有开口。
6.根据权利要求3至5中任一项所述的笼架，其特征在于，所述腹侧前板(146a，146b)凸出地弯曲。
7.根据权利要求2至6中任一项所述的笼架，其特征在于，所述基板(136a，136b)具有至少一个开口。
8.根据权利要求2至7中任一项所述的笼架，其特征在于，所述盖板(112a，112b)具有至少一个开口。
9.根据权利要求2至8中任一项所述的笼架，其特征在于，在所述各构成元件(110a，110b)的基板(136a，136b)上设置有平行于横向侧面延伸的翅片(138a，138b)，在组装所述笼架(110)时，所述翅片(138a，138b)形成单个翅片。
10.根据权利要求2至9中任一项所述的笼架，其特征在于，在所述各构成元件(110a，110b)的盖板(112a，112b)上设置有平行于横向侧面延伸的翅片(128a，128b)，在组装所述笼架(110)时，所述翅片(128a，128b)形成单个翅片。
11.根据权利要求2至10中任一项所述的笼架，其特征在于，所述基板(36′)在其向外的表面上至少部分地具有平行于纵向侧面延伸的波纹(60)。
12.根据权利要求2至11中任一项所述的笼架，其特征在于，所述盖板(12′)在其向的外表面上至少部分地具有平行于纵向侧面(18，20)延伸的波纹(60)。
13.根据权利要求11或12所述的笼架，其特征在于，所述波纹(60)具有锯齿状轮廓，该轮廓具有陡峭地倾斜的波纹翼侧(62)和较平缓地倾斜的反向翼侧，以确保沿引入方向的摩擦小于沿与其相反方向的摩擦。
14.根据权利要求2至13中任一项所述的笼架，其特征在于，所述笼架(110)具有至少大致楔形形状。
15.根据权利要求14所述的笼架，其特征在于，所述基板(136a，136b)和盖板(112a，112b)相对于彼此设置成使得纵向侧面相互平行地延伸，而所述基板(136a，136b)的横向侧面与所述盖板(112a，112b)的横向侧面具有楔角α。
16.根据权利要求2至15中任一项所述的笼架，其特征在于，所述两构成元件(110a，110b)能够沿平行于笼架(110)的横向侧面延伸的接合面接合在一起。
17.根据权利要求16所述的笼架，其特征在于，所述接合面在笼架(110)的对称平面内延伸。
18.根据前述权利要求中任一项所述的笼架，其特征在于，所述构成元件(110a，110b)具有导向面(115，117，123，125)，这些导向面在所述构成元件(110a，110b)相接时相互接合，并使所述构成元件(110a，110b)相对于彼此沿至少两个正交方向对齐。
19.根据权利要求18所述的笼架，其特征在于，所述导向面(115，117，123，125)平行于横向侧面延伸。
20.笼架系统，该笼架系统包括用于引入形成在两相邻椎骨之间的椎间盘腔隙中的笼架(210)，
其特征在于，
所述系统包括可与笼架可分离地连接的操作装置(231，233)，其中，该操作装置构造成当连接到笼架上时通过操作该操作装置使该笼架旋转。
21.根据权利要求20所述的笼架系统，其特征在于，所述笼架(210)包括基板(236)和盖板，该基板和盖板在笼架(210)被引入椎间盘腔隙中时抵靠椎骨；所述操作装置(231，233)构造成使笼架围绕至少基本垂直于基板(236)的轴线(A)旋转。
22.根据权利要求20或21所述的笼架系统，其特征在于，所述笼架(210)包括适于与所述操作装置(231，233)配合以将所述操作装置连接到所述笼架上的连接元件(237)。
23.根据权利要求22所述的笼架系统，其特征在于，所述笼架(210)包括腹侧前板和背侧背板；所述连接元件(237)设置在笼架(210)的腹侧前板的相对的横向侧面上。
24.根据权利要求22所述的笼架系统，其特征在于，所述笼架(210)包括腹侧前板和背侧背板；在腹侧前板的横向侧面上设置有一个连接元件(237)，在相对的背侧背板的横向侧面上设置有另一连接元件(237)。
25.根据权利要求20至24中任一项所述的笼架系统，其特征在于，所述连接元件是使笼架和操作装置之间能够进行铰接运动的接合元件。
26.根据权利要求27至32中任一项所述的笼架系统，其特征在于，所述操作装置包括两个杆件。
27.用于引入形成在两相邻椎骨之间的椎间盘腔隙中的笼架(110，210)，其特征在于，所述笼架由至少两个构成元件(110a，110b)组装而成，所述至少两个构成元件优选具有基本相同的尺寸。
28.用于将笼架引入形成在两相邻椎骨之间的椎间盘腔隙中的方法，其特征在于，包括以下步骤：
a)暴露通往椎间盘腔隙的入口通道；
b)暴露椎间盘腔隙的第一部分；
c)向椎间盘腔隙的第一部分中引入加固元件；
d)暴露椎间盘腔隙的第二部分；
e)提供由第一和第二构成元件(110a，110b)组装而成的笼架(210)；
f)将第一构成元件(110a)引入椎间盘腔隙的第二部分；
g)从椎间盘腔隙的第一部分中拆除所述加固元件；
h)将第二构成元件(110b)引入椎间盘腔隙的第一部分。
29.根据权利要求27所述的方法，其特征在于，在步骤h)中，所述第二构成元件(110b)与所述第一构成元件(110a)在形成于两构成元件(110a，110b)上的导向面(115，117，123，125)上对齐。
30.用于将笼架引入形成在两相邻椎骨之间的椎间盘腔隙中的方法，其特征在于，包括以下步骤：
a)暴露通往椎间盘腔隙的入口通道；
b)暴露椎间盘腔隙；
c)提供具有至少基本楔形形状的笼架(210)，该笼架包括具有纵向侧面的细长的基部表面；
d)将笼架(210)引入椎间盘腔隙，使得所述基部表面的纵向侧面至少基本平行于腹侧入口通道的纵向轴线延伸；
e)利用与笼架(210)可分离地连接的操作装置(231，233)在椎间盘腔隙内旋转所述笼架。
31.根据权利要求29所述的方法，其特征在于，为按照步骤e)进行旋转，所述笼架(210)连接有两个与笼架的相对的横向侧面接合的操作杆件(231，233)。
32.根据权利要求29或30所述的方法，其特征在于，在步骤e)中，使所述笼架旋转70°至110°的旋转角度。
33.用于插入形成在第一和第二椎骨之间的椎间盘腔隙中的笼架(310)的制造方法，其特征在于，包括以下步骤：
a)通过生物测定法确定形成在第一椎骨的骨突环内的第一穹隆的形状；
b)制造具有第一凸出弯曲的邻接面的笼架，当笼架(310)被插入椎间盘腔隙中时，所述邻接面抵靠第一椎骨；其中，所述第一邻接面具有存在顶点(388)的形状，该形状构造成使得当第一邻接面的顶点(388)与穹隆的顶点接触时笼架(310)可在第一穹隆内旋转。
34.根据权利要求33所述的方法，其特征在于，所述笼架(310)可旋转至少10°。
35.用于引入形成在两相邻椎骨之间的椎间盘腔隙中的笼架，其特征在于，所述笼架(310)包括具有凸出弯曲区域(326)的盖板(312)。
36.根据权利要求35所述的笼架，其特征在于，所述盖板(312)具有通过横档(326)进行分隔的至少两个开口；所述凸出弯曲区域(326)由所述横档(326)形成。
37.根据权利要求35或36所述的笼架，其特征在于，所述盖板(312)包括围绕所述凸出弯曲区域的平面环形区域(370)。
38.根据权利要求37所述的笼架，其特征在于，所述平面环形区域(370)具有比所述弯曲区域更粗糙的表面。
39.根据权利要求35至38中任一项所述的笼架，其特征在于，所述弯曲区域的表面(372)被抛光。
40.根据权利要求35至39中任一项所述的笼架，其特征在于，所述弯曲区域的表面(372)具有相对于骨材料的小于0.1的动摩擦系数。
41.根据权利要求35至40中任一项所述的笼架，其特征在于，所述弯曲区域的表面(372)具有小于10μm、优选小于1μm的算术粗糙度Ra。
42.根据权利要求35至41中任一项所述的笼架，其特征在于，所述弯曲区域的表面(372)由类金刚石碳涂层形成。
43.根据权利要求35至42中任一项所述的笼架，其特征在于，所述平面区域(370)的表面具有相对于骨材料的大于1.0的动摩擦系数。
44.根据权利要求35至43中任一项所述的笼架，其特征在于，所述弯曲区域具有至少基本斜坡形形状。
CNA2006800324875A 2005-07-06 2006-07-06 用于引入椎间盘腔隙中的笼架 Pending CN101257866A (zh)

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