CN101365394A - 通过脊柱前路微创伤方式治疗脊椎前移的方法和器械 - Google Patents

通过脊柱前路微创伤方式治疗脊椎前移的方法和器械 Download PDF

Info

Publication number
CN101365394A
CN101365394A CNA2006800481560A CN200680048156A CN101365394A CN 101365394 A CN101365394 A CN 101365394A CN A2006800481560 A CNA2006800481560 A CN A2006800481560A CN 200680048156 A CN200680048156 A CN 200680048156A CN 101365394 A CN101365394 A CN 101365394A
Authority
CN
China
Prior art keywords
vertebra
screw
distance piece
vertebras
attached
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
CNA2006800481560A
Other languages
English (en)
Inventor
A·格菲勒
R·安赫尔德
T·施托尔
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.)
Synthes GmbH
Original Assignee
Synthes GmbH
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 Synthes GmbH filed Critical Synthes GmbH
Publication of CN101365394A publication Critical patent/CN101365394A/zh
Pending legal-status Critical Current

Links

Images

Classifications

    • 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
    • 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
    • A61B17/7059—Cortical plates
    • 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
    • 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
    • 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
    • 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
    • A61B17/562—Implants for placement in joint gaps without restricting joint motion, e.g. to reduce arthritic pain
    • 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
    • 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
    • A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
    • A61B17/66—Alignment, compression or distraction mechanisms
    • 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
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • A61B17/7077—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae
    • 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
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • A61B17/7077—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae
    • A61B17/7079—Tools requiring anchors to be already mounted on an implanted longitudinal or transverse element, e.g. where said element guides the anchor motion
    • 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
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • 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
    • 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
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • 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
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8866—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices for gripping or pushing bones, e.g. approximators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025—Joint distractors
    • A61B2017/0256—Joint distractors for the spine
    • 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
    • A61F2002/30433—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
    • 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
    • A61F2002/30476—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
    • 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
    • A61F2002/30518—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
    • A61F2002/3052—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts unrestrained in only one direction, e.g. moving unidirectionally
    • 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
    • A61F2002/30537—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
    • 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
    • A61F2002/30576—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
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
    • A61F2250/0008—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting a position by translation along an axis or two perpendicular axes

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Pain & Pain Management (AREA)
  • Rheumatology (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Abstract

本发明涉及一种椎间间隔件，其中该椎间间隔件构造成植入到第一和第二椎骨之间，第一和第二椎骨彼此相对地移动椎骨滑脱距离，间隔件包括：第一元件，具有接触第一椎骨的至少一部分的上表面、下表面以及接收至少一个骨固定元件以便将第一元件固定到第一椎骨的至少一个钻孔；第二元件，具有接触第二椎骨的至少一部分的下表面、上表面以及接收至少一个骨固定元件以便将第二元件固定到第二椎骨的至少一个钻孔；以及调节机构，定位在第一和第二元件之间，适于实施脊椎前移复位，其中调节机构的操作彼此相对地移动第一元件和第二元件，从而减小椎骨滑脱距离。

Description

通过脊柱前路微创伤方式治疗脊椎前移的方法和器械
技术领域
本发明涉及可以应用于通过脊柱前路微创伤方式进行脊椎前移的术中外科手术治疗的方法和器械。
背景技术
脊椎前移是习惯用于描述脊椎骨在其下面的脊椎骨上的向前滑动的术语(图1)。脊椎前移发生通常是因为在较高的脊椎骨上具有椎骨脱离。脊柱具有两主要部分用于保持脊椎骨对准，即椎间盘和小关节。当椎骨脱离发生时，小关节不再能够拉住脊椎骨。在增强的压力下，椎间盘可以慢慢地伸长并允许上面的脊椎骨向前滑动。在大多数的案例中，椎间盘的伸长仅仅允许少量地向前滑动。
脊椎前移的外科手术治疗需要处理机械症状和压缩症状，如果这些症状存在的话。通常这就意味着脊柱里的神经将免受压迫和疼痛。实施完全的椎板切除术(去除薄层)通常可以实现减轻作用在脊柱内的神经上的压力和疼痛。薄层的去除可以为神经提供更多的空间。也可以使外科手术医生去除环绕脊柱脱离缺陷的组织肿块。该结果减少了神经上的疼痛和炎症。一旦神经自由，脊柱融合通常被实施以控制部分的不稳定性。(来源：www.spineuniversitv.com)
外科手术目的是去除脊柱神经上的压力(即减压)和给腰椎提供稳定性。在多数脊椎前移的案例中，腰椎减压将与利用脊柱使用仪器(即植入，其常常用于帮助辅助康复过程)联合一个脊椎骨到下一个脊椎骨(即脊柱融合)一同发生。外科手术可以从背部或者后部逼近脊椎骨(即在固定后部固定之前完成牵拉和复位)和/或从前面或前部逼近脊椎骨(即前部融合)。这样的方法不利地影响生命的后部肌肉结构。
发明内容
本发明提供了一种实施脊椎前移复位的方法。优选地，该方法、器械和植入保持了重要的后部肌肉结构，从而减少了与融合外科手术相关的外科手术并发率，优选地包括腰椎融合外科手术。
该方法包括插入体内间隔件到两椎骨之间和通过两个螺钉将符合解剖结构的复位板连接到两椎骨之间的步骤。该复位板包括上部的和下部钻孔，其中使用稳定的板-螺钉连接，将至少一个螺钉固定到脊椎骨内，该脊椎骨比另一脊椎骨位置更向前，另一个非锁定螺钉被固定到另一脊椎骨内。该方法还包括操纵该非锁定螺钉以减小椎骨的滑脱距离。
在另一个实施例中，该方法包括将体内间隔件插入两椎骨之间，利用至少一个非锁定螺钉将符合解剖结构的复位板连接到至少两椎骨之一的步骤，并通过穿过复位板和体内间隔件的钻孔的紧固装置，将该体内间隔件连接到复位板，优选地是中央钻孔。该体内间隔件可以通过至少一个骨螺钉连接到前部定位的椎骨上。该方法还包括旋转该非锁定螺钉以减小椎骨的滑脱距离。
在另一个实施例中，该方法包括将体内间隔件插入到两椎骨之间，其中通过锁定螺钉，该体内间隔件可以被连接到椎骨。该方法还包括插入锁定螺旋机构，并调节锁定螺旋机构从而使得椎骨被垂直对准，其中较高的或上面的椎骨相对于较低的或者下面的椎骨移动。
在另一的实施例中，该方法包括将椎弓根螺钉连接到椎骨周围的呈现脊椎前移情形的椎骨上，将预先组装的椎弓根螺钉连接到呈现脊椎前移情形的椎骨，以及将杆连接到椎弓根螺钉。该方法还包括利用复位器械重新定位呈现椎骨前移情形的椎骨，从而使得预先组装椎弓根螺钉的头与该杆相符，并通过利用锁定帽和螺丝起子将该预先组装椎弓根螺钉附接到该杆。
在另一的实施例中，该方法包括将螺钉插入到邻近椎骨的前部区域，其中邻近椎骨之一呈现脊椎前移的情形，并将连接到不呈现脊椎前移情形的椎骨上的螺钉固定到外部刚性元件上。该方法还包括利用可调节机构来调节插入呈现脊椎前移情形的椎骨的螺钉，直到减小椎骨的滑脱距离为止。该方法可以在切口区域的外部实施。
除了上面讨论的那些，在随后的本发明优选实施例的描述过程中，其他的目的和益处对本领域技术人员来说将变得显而易见。在该描述中，参考伴随附图而形成，其形成其中的一部分，并举例说明本发明的一个实例。但是，这样的实例并不是本发明各种各样的实施例的详尽，随后的实施例将不局限于所示的实例。
附图说明
在随后的示例性附图中，脊椎前移复位的方法和使用仪器被更详尽的说明，其中使用仪器和方法的操作可以更好的理解，其中相同的参考标号代表相同的元件。附图仅仅是示例性的举例说明治疗脊椎前移的结构、操作和方法，并且某些特征可以单独地或者与其他特征的组合使用，本发明将不局限于所示的实施例。
图1描述了脊椎的一段，其中一个椎间盘已经相对于另一椎骨移动或者向前滑动(脊椎前移)；
图2是本发明一个实施例的侧视图；
图3是图2中描述的实施例的修改的侧视图；
图4A是本发明另一个实施例的侧视图；
图4B和4C是图4A中描述的实施例的植体表面的位置之前和之后的侧视图；
图5A和5B是图4A-C中植体的不同实施例的透视图；
图6A和B是本发明另一个实施例的侧视图；
图7A-D是复位器械的侧视图；
图8A和B是另一实施例的侧视图；
图9A-D是另一实施例的侧视图；以及
图10A和10B是另一实施例的视图。
具体实施方式
脊椎前移复位可以在创伤位置内(in situ)或者创伤位置外(ex situ)实施，在此创伤位置参考切口区域。
创伤位置内方法允许通过微创伤以脊椎前移复位，优选地利用植体作为复位设备。
在一个优选地实施例中，如图2所描述的，体内间隔件10(例如金属的，同种异体移植物或者聚合骨架)可以被放置在两椎骨1、2之间。具有上部和下部钻孔的符合解剖结构的复位板20可以被放置在治疗段(位置)的前面，并通过至少一个上部螺钉24和至少一个下部螺钉25附接于椎骨。该复位板20可以是直的或者是弯曲的(预应力的)。经由稳定或锁定的板-螺钉连接26，通过将螺钉24固定在定位在更前部的椎骨内(LCP锁定螺钉的概念)，通过如图2所示在方向A驱动螺钉，另一非锁定螺钉25可以用于减小椎骨滑脱距离B。这通过当螺钉25的头与复位板20接触时产生的“滞后特征”来实现，进一步旋转螺钉25导致转移的椎骨向后部移动并与另一椎骨垂直对准。
在图2中描述的实施例的一个可选择结构(图3)中，通过至少一个螺钉25，复位板20可以被附接在向前滑动的椎骨2，并且任选的第二螺钉24可以连接到另一椎骨1。另外，体内间隔件10可以被选择地连接到复位板20，并可选择地在高度上是可扩张的。该复位板20可以具有中央钻孔23，优选地，具有内螺纹(未示出)，并优选平行于上部和下部钻孔21、22。与此相对应，该体内间隔件10可以具有内螺纹(未示出)的中央钻孔23以容纳例如螺钉的紧固装置27，从而将复位板20紧固到体内间隔件10。该体内间隔件10可以具有另外的钻孔13，这些钻孔13的轴线不彼此之间或与中央钻孔23平行。从体内间隔件10的前表面，另外的钻孔可以是发散的。例如骨螺钉的至少一个纵向固定元件12可以用于进一步将该体内间隔件10连接到椎骨1，从而增加了复位元件的旋转稳定性。通过以图2中描述的实施例的类似方式旋转螺钉，非锁定螺钉25可以用于复位椎骨滑脱B。
图4A-C描述了另一优选实施例中的体内间隔件30(例如SynCage，SynFix)。该体内间隔件30可以包括具有上半部31和下半部32的两个水平半部。该体内间隔件30可以被放置在两椎骨1、2之间，从而上半部31的接触面33和下半部32的接触面34分别地适应椎骨上部终板3和下部终板4的曲率。通过锁定螺旋机构40，该体内间隔件30的上半部31和下半部32被固定到邻近的椎骨。通过相应的锁定螺钉35，体内间隔件30可以进一步被附接到邻近的上部和下部椎骨1、2上。
通过锁定螺旋机构40，椎骨的滑脱距离B可以被减小，该锁定螺旋机构40使得体内间隔件的半部31、32彼此垂直对准，从而重新对准脊椎骨，如图4C所示。锁定螺旋机构40优选地移动体内间隔件30的下半部32到相应的体内间隔件30的上半部31。
体内间隔件30的锁定螺旋机构40可以包括中央螺旋(图5A)，其向上旋转可以向前或者向后移动半部31、32之一。在图5B中，螺旋机构40可以是中央轨道，该轨道允许上部和下部半部31、32以及横向销/杆或棘齿41的前后运动，从而将两个半部31、32固定就位。横向销4可伸出穿过半部31、32之一的横向侧36、37。如图5B所示，横向销插入到体内间隔件30的上半部31中。
在另一个实施例中，如图6A和6B所示，脊椎前移复位可以通过使用椎弓根螺钉、椎骨螺钉或类似物70、杆71、复位器械50和预先组装椎弓根螺钉72而实现。在本实施例中，脊椎前移复位从后部完成。
复位器械50(图7A-D)可以包括三个主要组件，即内管51、复位套55和导管61。内管51可以包括线性杆52，其远端64具有槽54，近端62具有垂直手柄53。复位套55也可以具有线性杆56，其远端65具有槽60。线性杆56在近端63具有与螺母59附接的外螺纹57。螺母59可以用于将预先组装的椎弓根螺钉72拉向杆71。同样手柄58附接于复位套55的近端63，其垂直于线性杆56。复位套55的线性杆56是中空的，以允许内管51插入到复位套55的近端63。复位器械50的第三主要组件是导管61，导管61配合在复位套55之上，固定地将器械紧固到植体上。
椎弓根螺钉70附接到转移椎骨的任一侧的椎骨上。一个或多个预先组装椎弓根螺钉72附接到转移椎骨。杆71插入并锁定到附接到转移椎骨的任一侧的椎骨上的椎弓根螺钉70上。复位器械50放置在每个预先组装椎弓根螺钉72之上。复位器械50上的螺母59和复位套55被同时旋转，以便将预先组装椎弓根螺钉72逐渐地拉到杆71，从而移动移位的椎骨。更具体地是，当螺母59旋转时，导管61向远端移动，从而导管61的远端66连接到设置在复位套55的槽60内的杆。进一步旋转以相对导管61移动复位套55，该旋转拉动预先组装椎弓根螺钉72，从而使椎骨向上。一旦预先组装椎弓根螺钉72与杆71一致，杆就位于预先组装椎弓根螺钉72顶部的通道内(未示出)，复位器械50的内管51被再次移动，具有锁定帽(未示出)的长螺丝起子插入到复位套55的近端63。锁定帽可以附接于预先组装椎弓根螺钉72的头上，从而将杆71固定在预先组装椎弓根螺钉72上。
用于脊柱前移复位的创伤位置外方法允许使用适当的器械在创伤外部进行微创伤操作。
在创伤位置外方法的一个实施例中，如图8A和8B所示，在要被减小的高度处，螺钉80插入到每个椎骨体的前部。螺钉80之一固定到附接在例如手术台上的外部刚性元件90(例如SynFrame)。不固定到手术台的第二螺钉80附接到可调节机构83(例如螺纹元件)。第二螺钉80可以被可调节机构83移位，直到减小滑脱距离为止。值得注意的是，可调节机构83可以是螺纹元件，使得第二螺钉80的螺纹与可调节机构的螺纹相对应，以形成螺钉与螺钉式结构，从而使得当可调节机构旋转时将向上(后部方向)拉动移位的椎骨。
在另一个实施例中，如图9A-D所示，脊椎前移复位可以通过利用替代支承件系统100完成。替代支承件系统100可以包括外部支承件110、一个或多个骨螺钉120、内部支承件130和一个或多个位移螺钉140。
例如，外部支承件110可以是具有两侧111、112和连接件113的U形形状。一侧111可以具有至少两个孔114和115。孔115的壁可以具有螺纹，以接合螺钉的螺纹。但是，孔114的壁优选是光滑的。另一侧112可以具有至少一个孔116，其壁也优选是光滑的。
类似于外部支承件110，内部支承件130也可以是具有两侧131和132和连接件133的U形形状。两侧131、132各自具有至少一个孔134、136。孔134的壁优选是光滑的，而孔136的壁优选具有螺纹。内部支承件130可以比外部支承件110小，从而可以定位在侧111和112之间。
下面描述使用替代支承件系统100的组件和方法。在已经移动/牵引脊椎骨段后，间隔件90可以被插入到两椎骨之间。通过锁定螺钉机构300，间隔件90可以被固定到第一椎骨200。替代支承件系统100可以被组装，从而通过穿过孔115的螺钉101或其他固定设备使得外部支承件110附接到间隔件90。一个或多个骨螺钉120或类似的固定装置可以旋进第二椎骨400。延伸穿过孔114和134的一个或多个骨螺钉120被支承但并不固定到外部支承件110和内部支承件130。侧112和132通过一个或多个位移螺钉140连接，从而一个或多个位移螺钉被外部支承件110支承，而通过螺钉以及孔136的壁的相应的螺纹与内部支承件130相连接。一个或多个位移螺钉140的旋转允许内部支承件130相对于外部支承件110运动。运动包括拉或推回第二椎骨之一。
在替代支承件系统100已经安装到椎骨之后，通过旋转一个或多个位移螺钉140，第二椎骨400可被拉或推回，直到第一和第二椎骨对准为止，使得间隔件90被固定到第二椎骨400上。随后的复位过程中，一个或多个螺钉300可以插入到间隔件90和第二椎骨400中，将间隔件90固定到第二椎骨400(图9B和9C)。一旦固定间隔件90和第二椎骨400的一个或多个螺钉300就位，替代支承件系统100可以被取出(图9D)。
在另一个实施例中，间隔件500可以扩张，以允许椎骨的重新定位和牵引。间隔件500可以包括上部和下部间隔件板510、520。间隔件板510、520可以具有类似于现有的体内融合植体几何的形状和覆盖区。间隔件板510、520可以通过两个或多个棒530、540连接。通过铰链、关节或一些类似连接装置531、532、541、542，棒530、540可以被连接到间隔件板510、520。如图10A所示，间隔件500处于未扩张形状，其中棒530、540与间隔件板510、520基本平行。在图10B中，间隔件500处于扩张形状，其中间隔件板510、520定位成进一步彼此分开，并且棒530、540基本垂直于间隔件板510、520。根据复位和牵引需要的数量，棒530、540相对于间隔件板510、520的角度是可确定/选择的。关节/铰链里的固定机构(未示出)保持棒530、540相对于间隔件板510、520的角度，稳定间隔件500的结构，并确保椎骨复位不随后移动。
在未扩张形状，间隔件500可以插入到呈现脊椎前移的两椎骨之间(未示出)。上部和下部间隔件板510、520可以利用螺钉(未示出)固定到椎骨。在上部和下部间隔件板510、520被固定到椎骨之后，通过扩张间隔件500，脊椎骨段被复位和牵引，从而椎骨之间的空间增加，并同时重新定位椎骨，直到它们被对准为止。棒530、540和固定机构确保间隔件500保持它的扩张形状，从而稳定脊椎骨段。在间隔件板510、520之间形成的空间可以利用自体骨或骨替代品填充，以允许上部和下部椎骨之间的融合。间隔件500的侧部和后部可以被最初固定到间隔件板510，520上的薄膜围绕，以防止自体骨或骨替代品脱离。
虽然已经在此详细描述了本发明和其优点，可以理解到这里可以进行各种各样的改变、替代和变更，而不脱离本发明附加权利要求的精神和范围。此外，并不打算将本申请的范围局限于说明书中描述的过程、机械、制造、物质成份、装置、方法和步骤的特殊实施例。本领域普通技术人员从本发明所公开的内容中将容易意识到，可以根据本发明来利用目前存在的或将来开发的并可实现大致相同的作用或实现与这里描述相应实施例大致相同的结果的过程、机械、制造、物质成份、装置、方法和步骤。因此，所打算的是附加权利要求在其范围内包括这样的过程、机械、制造、物质成份、装置、方法和步骤。
本领域技术人员将会意识到，可以获得本发明的各种各样的修改和变更，而不脱离附加权利要求的广义的范围。它们其中的一些已经在上面讨论，其他一些对本领域技术人员来说是显而易见的。

Claims (13)

1.一种复位板的使用，适用于利用至少两个螺钉通过将复位板附接到第一和第二椎骨上来实施脊椎前移复位，其中复位板包括上部和下部钻孔，并且至少一个螺钉用作与第一椎骨稳定地板-螺钉连接，并且至少另一固定到第二椎骨的螺钉是非锁定螺钉，从而非锁定螺钉的旋转减小椎骨滑脱距离。
2.如权利要求1所述的使用，其特征在于，体内间隔件插入到第一和第二椎骨之间。
3.如权利要求1所述的使用，其特征在于，复位板是直的。
4.如权利要求1所述的使用，其特征在于，复位板是弯曲的，处于预应力的状态。
5.如权利要求1所述的使用，其特征在于，复位板可以在外科手术进行时调节，以便椎骨在解剖结构上对准。
6.如权利要求1所述的使用，其特征在于，复位板包括中央钻孔，以便通过螺钉将体内间隔件固定到复位板。
7.一种复位支承组件的使用，适用于在第一和第二椎骨上实施脊椎前移复位，第一和第二椎骨具有插入到两椎骨之间的体内间隔件，从而体内间隔件附接到第一椎骨，复位支承组件包括：
内部支承件；
附接到体内间隔件的外部支承件；
至少一个骨螺钉，附接到第二椎骨，其中至少一个螺钉被支承并不固定到内部支承件和外部支承件上；以及
至少一个位移螺钉，旋进内部支承件，其中至少一个位移螺钉被外部支承件支承；
其中至少一个位移螺钉的旋转减小椎骨滑脱距离，直到第一和第二椎骨对准为止。
8.如权利要求7所述的使用，其特征在于，第一和第二椎骨对准之后，至少一个螺钉固定第二椎骨和体内间隔件，复位支承组件从体内间隔件分开。
9.如权利要求7所述的使用，其特征在于，内部支承件和外部支承件是U形的。
10.如权利要求7所述的使用，其特征在于，通过位移螺钉拉动第二椎骨来实现椎骨滑脱的复位。
11.如权利要求7所述的使用，其特征在于，通过位移螺钉推动第二椎骨来实现椎骨滑脱的复位。
12.一种体内间隔件的使用，适用于实施脊椎前移复位，包括第一元件、第二元件和调节机构，体内间隔件插入到第一和第二椎骨之间，
其中第一元件和第二元件通过锁定螺钉附接到第一和第二椎骨，以及
其中调节机构的操作彼此相对地横向移动第一元件和第二元件，对准椎骨。
13.一种外部支承元件的使用，适用于在第一和第二椎骨上实施脊椎前移复位，每一个外部支承元件具有螺钉，螺钉被附接以便将第一椎骨附接到外部支承元件上，并且将第二椎骨附接到可调节机构，外部支承元件的部分，并且操作可调节机构以减小椎骨滑脱距离，直到第一椎骨和第二椎骨对准为止。
CNA2006800481560A 2005-10-21 2006-10-20 通过脊柱前路微创伤方式治疗脊椎前移的方法和器械 Pending CN101365394A (zh)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US72891905P 2005-10-21 2005-10-21
US60/728,919 2005-10-21

Publications (1)

Publication Number Publication Date
CN101365394A true CN101365394A (zh) 2009-02-11

Family

ID=37800180

Family Applications (1)

Application Number Title Priority Date Filing Date
CNA2006800481560A Pending CN101365394A (zh) 2005-10-21 2006-10-20 通过脊柱前路微创伤方式治疗脊椎前移的方法和器械

Country Status (11)

Country Link
US (1) US20070123989A1 (zh)
EP (1) EP1937170A1 (zh)
JP (1) JP2009512520A (zh)
KR (1) KR20080068672A (zh)
CN (1) CN101365394A (zh)
AU (1) AU2006304821A1 (zh)
BR (1) BRPI0617639A2 (zh)
CA (1) CA2626687A1 (zh)
TW (1) TW200724078A (zh)
WO (1) WO2007048012A2 (zh)
ZA (1) ZA200804175B (zh)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110251221A (zh) * 2018-03-12 2019-09-20 捷迈拜欧米特脊柱有限公司 杆复位器棘齿锁定机构

Families Citing this family (102)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080027548A9 (en) 2002-04-12 2008-01-31 Ferree Bret A Spacerless artificial disc replacements
US8038713B2 (en) 2002-04-23 2011-10-18 Spinecore, Inc. Two-component artificial disc replacements
US6793678B2 (en) 2002-06-27 2004-09-21 Depuy Acromed, Inc. Prosthetic intervertebral motion disc having dampening
WO2004073563A2 (en) 2003-02-14 2004-09-02 Depuy Spine, Inc. In-situ formed intervertebral fusion device
US6908484B2 (en) 2003-03-06 2005-06-21 Spinecore, Inc. Cervical disc replacement
US20040267367A1 (en) 2003-06-30 2004-12-30 Depuy Acromed, Inc Intervertebral implant with conformable endplate
US8636802B2 (en) 2004-03-06 2014-01-28 DePuy Synthes Products, LLC Dynamized interspinal implant
US8267969B2 (en) 2004-10-20 2012-09-18 Exactech, Inc. Screw systems and methods for use in stabilization of bone structures
US8226690B2 (en) 2005-07-22 2012-07-24 The Board Of Trustees Of The Leland Stanford Junior University Systems and methods for stabilization of bone structures
US8777959B2 (en) 2005-05-27 2014-07-15 Spinecore, Inc. Intervertebral disc and insertion methods therefor
US8523865B2 (en) 2005-07-22 2013-09-03 Exactech, Inc. Tissue splitter
US7862502B2 (en) 2006-10-20 2011-01-04 Ellipse Technologies, Inc. Method and apparatus for adjusting a gastrointestinal restriction device
US8096996B2 (en) 2007-03-20 2012-01-17 Exactech, Inc. Rod reducer
WO2008070863A2 (en) 2006-12-07 2008-06-12 Interventional Spine, Inc. Intervertebral implant
US7744649B2 (en) * 2007-06-25 2010-06-29 Moore Mark R Spondylolisthesis correction apparatus and method
US8900307B2 (en) 2007-06-26 2014-12-02 DePuy Synthes Products, LLC Highly lordosed fusion cage
US20090112262A1 (en) 2007-10-30 2009-04-30 Scott Pool Skeletal manipulation system
EP2237748B1 (en) 2008-01-17 2012-09-05 Synthes GmbH An expandable intervertebral implant
CA2847598A1 (en) 2008-01-18 2009-07-23 Spinecore, Inc. Instruments and methods for inserting artificial intervertebral implants
WO2009124269A1 (en) 2008-04-05 2009-10-08 Synthes Usa, Llc Expandable intervertebral implant
US8388659B1 (en) 2008-10-17 2013-03-05 Theken Spine, Llc Spondylolisthesis screw and instrument for implantation
US8382756B2 (en) 2008-11-10 2013-02-26 Ellipse Technologies, Inc. External adjustment device for distraction device
US8197490B2 (en) 2009-02-23 2012-06-12 Ellipse Technologies, Inc. Non-invasive adjustable distraction system
ES2560206T3 (es) * 2009-02-25 2016-02-17 Spinewelding Ag Dispositivo de estabilización de columna vertebral y juego para su implantación
US9526620B2 (en) 2009-03-30 2016-12-27 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
US10842642B2 (en) 2009-04-16 2020-11-24 Nuvasive, Inc. Methods and apparatus of performing spine surgery
FR2944692B1 (fr) 2009-04-27 2011-04-15 Medicrea International Materiel d'osteosynthese vertebrale
WO2010129697A1 (en) * 2009-05-06 2010-11-11 Thibodeau Lee L Expandable spinal implant apparatus and method of use
US9439691B2 (en) * 2009-05-22 2016-09-13 Clifford Tribus Fixation-based surgery
CA2767403C (en) 2009-07-06 2017-08-29 Synthes Usa, Llc Expandable fixation assemblies
US9011500B2 (en) * 2009-07-29 2015-04-21 Globus Medical, Inc. Clivus plate
PL215752B1 (pl) 2009-09-28 2014-01-31 Lfc Spolka Z Ograniczona Odpowiedzialnoscia Urzadzenie do chirurgicznego przemieszczania kregów
US9028553B2 (en) 2009-11-05 2015-05-12 DePuy Synthes Products, Inc. Self-pivoting spinal implant and associated instrumentation
US9393129B2 (en) 2009-12-10 2016-07-19 DePuy Synthes Products, Inc. Bellows-like expandable interbody fusion cage
US9907560B2 (en) 2010-06-24 2018-03-06 DePuy Synthes Products, Inc. Flexible vertebral body shavers
US8979860B2 (en) 2010-06-24 2015-03-17 DePuy Synthes Products. LLC Enhanced cage insertion device
US8623091B2 (en) 2010-06-29 2014-01-07 DePuy Synthes Products, LLC Distractible intervertebral implant
US9248043B2 (en) 2010-06-30 2016-02-02 Ellipse Technologies, Inc. External adjustment device for distraction device
WO2012021378A2 (en) 2010-08-09 2012-02-16 Ellipse Technologies, Inc. Maintenance feature in magnetic implant
IT1401713B1 (it) 2010-08-26 2013-08-02 Guizzardi Supporto intervertebrale.
US9351848B2 (en) 2010-09-03 2016-05-31 Globus Medical, Inc. Expandable fusion device and method of installation thereof
US9566168B2 (en) 2010-09-03 2017-02-14 Globus Medical, Inc. Expandable fusion device and method of installation thereof
DE102010041959A1 (de) 2010-10-05 2012-04-05 Aces Gmbh Medizinisches Implantat
US9402732B2 (en) 2010-10-11 2016-08-02 DePuy Synthes Products, Inc. Expandable interspinous process spacer implant
WO2012074809A1 (en) * 2010-11-30 2012-06-07 Depuy Spine Inc. Lateral spondylolisthesis reduction cage
US8715282B2 (en) 2011-02-14 2014-05-06 Ellipse Technologies, Inc. System and method for altering rotational alignment of bone sections
AU2012231108B2 (en) 2011-03-22 2015-10-22 DePuy Synthes Products, LLC Universal trial for lateral cages
US9248027B2 (en) * 2011-07-12 2016-02-02 Spinesmith Partners, L.P. Cervical implant with exterior face plate
US20140058446A1 (en) * 2011-09-28 2014-02-27 Avi Bernstein Spinal implant system
US10743794B2 (en) 2011-10-04 2020-08-18 Nuvasive Specialized Orthopedics, Inc. Devices and methods for non-invasive implant length sensing
WO2013066946A1 (en) 2011-11-01 2013-05-10 Ellipse Technologies, Inc. Adjustable magnetic devices and methods of using same
WO2013159823A1 (en) 2012-04-27 2013-10-31 Lfc Spólka Z O.O. Intervertebral implant, instrument for use in placing it
US20130325071A1 (en) * 2012-05-30 2013-12-05 Marcin Niemiec Aligning Vertebral Bodies
US10709482B2 (en) * 2012-05-30 2020-07-14 Globus Medical, Inc. Laminoplasty system
US8940052B2 (en) 2012-07-26 2015-01-27 DePuy Synthes Products, LLC Expandable implant
RU2626961C2 (ru) 2012-10-29 2017-08-02 Нувэйсив Спешилайзд Ортопэдикс, Инк. Корректируемые устройства для лечения артрита колена
US10022245B2 (en) 2012-12-17 2018-07-17 DePuy Synthes Products, Inc. Polyaxial articulating instrument
US10105239B2 (en) 2013-02-14 2018-10-23 Globus Medical, Inc. Devices and methods for correcting vertebral misalignment
US9585765B2 (en) * 2013-02-14 2017-03-07 Globus Medical, Inc Devices and methods for correcting vertebral misalignment
US9402738B2 (en) 2013-02-14 2016-08-02 Globus Medical, Inc. Devices and methods for correcting vertebral misalignment
US9782265B2 (en) 2013-02-15 2017-10-10 Globus Medical, Inc Articulating and expandable vertebral implant
US10117754B2 (en) 2013-02-25 2018-11-06 Globus Medical, Inc. Expandable intervertebral implant
US9717601B2 (en) 2013-02-28 2017-08-01 DePuy Synthes Products, Inc. Expandable intervertebral implant, system, kit and method
US9204972B2 (en) 2013-03-01 2015-12-08 Globus Medical, Inc. Articulating expandable intervertebral implant
US9522070B2 (en) 2013-03-07 2016-12-20 Interventional Spine, Inc. Intervertebral implant
US9186258B2 (en) 2013-03-15 2015-11-17 Globus Medical, Inc. Expandable intervertebral implant
US9149367B2 (en) 2013-03-15 2015-10-06 Globus Medical Inc Expandable intervertebral implant
US9034045B2 (en) 2013-03-15 2015-05-19 Globus Medical, Inc Expandable intervertebral implant
US10751094B2 (en) 2013-10-10 2020-08-25 Nuvasive Specialized Orthopedics, Inc. Adjustable spinal implant
US9402739B2 (en) 2014-02-07 2016-08-02 Globus Medical, Inc. Variable lordosis spacer and related methods of use
WO2015123693A1 (en) * 2014-02-14 2015-08-20 Spectrum Spine Ip Holdings, Llc Cervical minimal access fusion system
TWI624244B (zh) * 2014-03-28 2018-05-21 Paonan Biotech Co Ltd Spinal facet joint fusion fixture with three-dimensional mesh body
CN111345867A (zh) 2014-04-28 2020-06-30 诺威适骨科专科公司 遥控装置
US9439773B2 (en) 2014-05-07 2016-09-13 Perumala Corporation Enhanced artificial disk
US9198768B1 (en) * 2014-05-07 2015-12-01 Perumala Corporation Enhanced artificial disk
BR112017013834A2 (pt) 2014-12-26 2019-11-19 Nuvasive Specialized Orthopedics Inc sistemas e métodos para distração
WO2016134326A2 (en) 2015-02-19 2016-08-25 Nuvasive, Inc. Systems and methods for vertebral adjustment
US11426290B2 (en) 2015-03-06 2022-08-30 DePuy Synthes Products, Inc. Expandable intervertebral implant, system, kit and method
US20180049754A1 (en) * 2015-03-13 2018-02-22 Redemed S.R.L. Intervertebral prosthesis, apparatus for implanting intervertebral prostheses and surgical method for implanting intervertebral prostheses, particularly for percutaneous mini-invasive surgery procedures
US10123829B1 (en) 2015-06-15 2018-11-13 Nuvasive, Inc. Reduction instruments and methods
US9913727B2 (en) 2015-07-02 2018-03-13 Medos International Sarl Expandable implant
AU2016368167B2 (en) 2015-12-10 2021-04-22 Nuvasive Specialized Orthopedics, Inc. External adjustment device for distraction device
DK3407812T3 (da) 2016-01-28 2020-09-21 Nuvasive Specialized Orthopedics Inc System til knogletransport
JP6713061B2 (ja) 2016-05-13 2020-06-24 ムスク ファウンデーション フォー リサーチ デベロップメント 脊椎アラインメント異常を低減するための前脊椎移植および関連のシステム並びに方法
JP7023877B2 (ja) 2016-06-28 2022-02-22 イーアイティー・エマージング・インプラント・テクノロジーズ・ゲーエムベーハー 拡張可能かつ角度調節可能な関節運動式の椎間ケージ
CN109688981A (zh) 2016-06-28 2019-04-26 Eit 新兴移植技术股份有限公司 可扩张的、角度可调整的椎间笼
US10537436B2 (en) 2016-11-01 2020-01-21 DePuy Synthes Products, Inc. Curved expandable cage
US10888433B2 (en) 2016-12-14 2021-01-12 DePuy Synthes Products, Inc. Intervertebral implant inserter and related methods
US10398563B2 (en) 2017-05-08 2019-09-03 Medos International Sarl Expandable cage
US11344424B2 (en) 2017-06-14 2022-05-31 Medos International Sarl Expandable intervertebral implant and related methods
US10940016B2 (en) 2017-07-05 2021-03-09 Medos International Sarl Expandable intervertebral fusion cage
US10966843B2 (en) 2017-07-18 2021-04-06 DePuy Synthes Products, Inc. Implant inserters and related methods
US11045331B2 (en) 2017-08-14 2021-06-29 DePuy Synthes Products, Inc. Intervertebral implant inserters and related methods
CN108904033A (zh) * 2018-09-11 2018-11-30 李国庆 一种下颈椎脱位前路复位装置
US11446156B2 (en) 2018-10-25 2022-09-20 Medos International Sarl Expandable intervertebral implant, inserter instrument, and related methods
FR3102926A1 (fr) * 2019-11-07 2021-05-14 Hassan Razian Cage intervertébrale
US11426286B2 (en) 2020-03-06 2022-08-30 Eit Emerging Implant Technologies Gmbh Expandable intervertebral implant
US11850160B2 (en) 2021-03-26 2023-12-26 Medos International Sarl Expandable lordotic intervertebral fusion cage
US11752009B2 (en) 2021-04-06 2023-09-12 Medos International Sarl Expandable intervertebral fusion cage
US11529173B1 (en) * 2021-11-12 2022-12-20 Spinal Simplicity, Llc Reduction system for spondylolisthesis
US12090064B2 (en) 2022-03-01 2024-09-17 Medos International Sarl Stabilization members for expandable intervertebral implants, and related systems and methods
KR102489379B1 (ko) 2022-09-08 2023-01-18 신흥섭 척추전방전위증 정복을 위한 수술도구 세트

Family Cites Families (38)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4289123A (en) * 1980-03-31 1981-09-15 Dunn Harold K Orthopedic appliance
GB2083754B (en) * 1980-09-15 1984-04-26 Rezaian Seyed Mahmoud Spinal fixator
US4553273A (en) * 1983-11-23 1985-11-19 Henry Ford Hospital Vertebral body prosthesis and spine stabilizing method
US4599086A (en) * 1985-06-07 1986-07-08 Doty James R Spine stabilization device and method
GB8620937D0 (en) * 1986-08-29 1986-10-08 Shepperd J A N Spinal implant
CA1333209C (en) * 1988-06-28 1994-11-29 Gary Karlin Michelson Artificial spinal fusion implants
US5290312A (en) * 1991-09-03 1994-03-01 Alphatec Artificial vertebral body
US5382248A (en) * 1992-09-10 1995-01-17 H. D. Medical, Inc. System and method for stabilizing bone segments
US6066175A (en) * 1993-02-16 2000-05-23 Henderson; Fraser C. Fusion stabilization chamber
US5458641A (en) * 1993-09-08 1995-10-17 Ramirez Jimenez; Juan J. Vertebral body prosthesis
US6093207A (en) * 1994-03-18 2000-07-25 Pisharodi; Madhavan Middle expanded, removable intervertebral disk stabilizer disk
US6206922B1 (en) * 1995-03-27 2001-03-27 Sdgi Holdings, Inc. Methods and instruments for interbody fusion
US6190414B1 (en) * 1996-10-31 2001-02-20 Surgical Dynamics Inc. Apparatus for fusion of adjacent bone structures
EP1011503B1 (en) * 1997-02-06 2009-04-22 Howmedica Osteonics Corp. Expandable non-threaded spinal fusion device
US5865848A (en) * 1997-09-12 1999-02-02 Artifex, Ltd. Dynamic intervertebral spacer and method of use
DE19750382A1 (de) * 1997-11-13 1999-05-20 Augustin Prof Dr Med Betz Gerätesystem zur operativen Korrektur von Wirbelverschiebungen
DE19816782A1 (de) * 1998-04-16 1999-10-28 Ulrich Gmbh & Co Kg Implantat zum Einsetzen zwischen Wirbelkörper der Wirbelsäule
US6332887B1 (en) * 1999-04-06 2001-12-25 Benjamin D. Knox Spinal fusion instrumentation system
FR2794357B1 (fr) * 1999-06-01 2001-09-14 Frederic Fortin Dispositif de distraction pour les os d'enfants possedant des moyens d'accrochage et de reglage permettant de suivre leur croissance
WO2002009626A1 (en) * 1999-07-26 2002-02-07 Advanced Prosthetic Technologies, Inc. Improved spinal surgical prosthesis
US6491695B1 (en) * 1999-11-05 2002-12-10 Carl Roggenbuck Apparatus and method for aligning vertebrae
US6461359B1 (en) * 1999-11-10 2002-10-08 Clifford Tribus Spine stabilization device
US6610093B1 (en) * 2000-07-28 2003-08-26 Perumala Corporation Method and apparatus for stabilizing adjacent vertebrae
US6666891B2 (en) * 2000-11-13 2003-12-23 Frank H. Boehm, Jr. Device and method for lumbar interbody fusion
DE10116412C1 (de) * 2001-04-02 2003-01-16 Ulrich Gmbh & Co Kg Implantat zum Einsetzen zwischen Wirbelkörper der Wirbelsäule
US7018415B1 (en) * 2002-09-23 2006-03-28 Sdgi Holdings, Inc. Expandable spinal fusion device and methods of promoting spinal fusion
US6685742B1 (en) * 2002-11-12 2004-02-03 Roger P. Jackson Articulated anterior expandable spinal fusion cage system
US7364589B2 (en) * 2003-02-12 2008-04-29 Warsaw Orthopedic, Inc. Mobile bearing articulating disc
US7291152B2 (en) * 2003-04-18 2007-11-06 Abdou M Samy Bone fixation system and method of implantation
JP2007509636A (ja) * 2003-10-30 2007-04-19 ジンテーズ ゲゼルシャフト ミト ベシュレンクテル ハフツング 椎間インプラント
US20050283237A1 (en) * 2003-11-24 2005-12-22 St. Francis Medical Technologies, Inc. Artificial spinal disk replacement device with staggered vertebral body attachments
US7211112B2 (en) * 2004-02-10 2007-05-01 Atlas Spine Spinal fusion device
US7531002B2 (en) * 2004-04-16 2009-05-12 Depuy Spine, Inc. Intervertebral disc with monitoring and adjusting capabilities
US7776091B2 (en) * 2004-06-30 2010-08-17 Depuy Spine, Inc. Adjustable posterior spinal column positioner
US7883543B2 (en) * 2004-10-01 2011-02-08 Spinal Generations, Llc Vertebral prosthesis and spinal fixation system
US8128660B2 (en) * 2004-12-13 2012-03-06 Kyphon Sarl Inter-cervical facet joint implant with locking screw system
EP1879527A4 (en) * 2005-05-02 2009-08-26 Kinetic Spine Technologies Inc ARTIFICIAL BODY
US7744649B2 (en) * 2007-06-25 2010-06-29 Moore Mark R Spondylolisthesis correction apparatus and method

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110251221A (zh) * 2018-03-12 2019-09-20 捷迈拜欧米特脊柱有限公司 杆复位器棘齿锁定机构
CN110251221B (zh) * 2018-03-12 2022-06-07 捷迈拜欧米特脊柱有限公司 杆复位器棘齿锁定机构
US11730523B2 (en) 2018-03-12 2023-08-22 Zimmer Biomet Spine, Inc. Rod reducer ratchet lock-out mechanism

Also Published As

Publication number Publication date
WO2007048012A2 (en) 2007-04-26
EP1937170A1 (en) 2008-07-02
CA2626687A1 (en) 2007-04-26
KR20080068672A (ko) 2008-07-23
JP2009512520A (ja) 2009-03-26
ZA200804175B (en) 2009-10-28
BRPI0617639A2 (pt) 2011-08-02
TW200724078A (en) 2007-07-01
AU2006304821A1 (en) 2007-04-26
US20070123989A1 (en) 2007-05-31

Similar Documents

Publication Publication Date Title
CN101365394A (zh) 通过脊柱前路微创伤方式治疗脊椎前移的方法和器械
US10646258B2 (en) Implant assembly for low profile spinopelvic fixation and sacroiliac joint fusion
US20200315679A1 (en) Bone fusion system
US10779959B2 (en) Surgical instrument for implant insertion
US11813172B2 (en) Facet screw and delivery device
US7744635B2 (en) Spinal fixation system
US9480502B2 (en) Expansion interspinous fixation device and method
US8574266B2 (en) Percutaneous facet fixation system
CN102133132B (zh) 动态椎弓根螺钉植入物
US20120323326A1 (en) Insertion of artificial/prosthetic facet joints with ballotable/compressible joint space component
US20070055239A1 (en) Spinal fixation system
US20160128740A1 (en) Spinous process fixation devices and methods of use
US20160038309A1 (en) Spinal fusion apparatus and related methods
US20220395301A1 (en) Laminoplasty plates, systems, and devices, and methods relating to the same
US20210259847A1 (en) Distally Expanding Facet Joint Implant And Delivery Device
US20220330994A1 (en) Bi-directional drill point screw
CN101573081B (zh) 后路机能动态稳定系统
Vrionis et al. Bone fusion system

Legal Events

Date Code Title Description
C06 Publication
PB01 Publication
C10 Entry into substantive examination
SE01 Entry into force of request for substantive examination
C02 Deemed withdrawal of patent application after publication (patent law 2001)
WD01 Invention patent application deemed withdrawn after publication

Open date: 20090211