CN101365402A - 椎间盘假体及将假体插入椎骨之间的器械 - Google Patents

椎间盘假体及将假体插入椎骨之间的器械 Download PDF

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Publication number
CN101365402A
CN101365402A CNA2006800502162A CN200680050216A CN101365402A CN 101365402 A CN101365402 A CN 101365402A CN A2006800502162 A CNA2006800502162 A CN A2006800502162A CN 200680050216 A CN200680050216 A CN 200680050216A CN 101365402 A CN101365402 A CN 101365402A
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China
Prior art keywords
plate
intervertebral disk
disk prosthesis
core
prosthesis according
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Granted
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CNA2006800502162A
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CN101365402B (zh
Inventor
R·拉什鲍姆
K·D·金
H·贝
J-P·斯泰布
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LDR Medical SAS
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LDR Medical SAS
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/4627—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 the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
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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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    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
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Abstract

本发明涉及椎间盘假体及插入器械，所述假体包含至少第一和第二骨质锚定装置(42，41)，第一骨质锚定装置被设置在接近其所在的板的外围，而第二骨质锚定装置沿前后轴偏置，第二骨质锚定装置包含基部部分和宽度窄于基部部分的尖边缘部分。器械包含杆(50)，杆(50)装备有至少两个形成夹钳并在管(55)中滑动的腿架，使杆在管中沿操作端方向的滑动通过腿架的外部和管的截短部分之间的接触引起夹钳的闭合，而使杆在管中沿抓握端方向的滑动通过轴(550)和杆的腿架的内部之间的接触引起夹钳的打开。

Description

椎间盘假体及将假体插入椎骨之间的器械
技术领域
【0001】本发明涉及椎间盘假体，该椎间盘假体替代纤维软骨盘以确保到脊柱的椎骨之间的连接。
背景技术
【0002】现有技术中已知各种类型的椎间盘假体。多种假体，如专利申请WO 02 089 701和WO 2004/041129中所描述的假体，是由形成一种绕中心核心(central core)铰接的笼箱的下板和上板组成。其他假体，如美国专利US 5676701和专利申请WO 03/059212 A1中阐述的假体，仅包括依靠铰接表面的手段彼此铰接的下板和上板。这两种类型的铰接假体的优点在于：它们通过允许一个板相对另一个板倾斜和/或旋转，而允许佩戴假体的病人自由移动。包含可在板间移动的中心核心的假体的附加优点是：它们允许核心自发定位在理想位置从而吸收施加在假体上的约束。其中心核心可在板间移动的一些假体包含配合装置，所述配合装置位于核心和至少一个板上从而限制核心的偏移。在现有技术中公开的这些假体中，骨质锚定装置与将假体的每个板固定在每个椎骨中的已知的装置类似，其中假体将被植入所述椎骨之间。这些骨质锚定装置能够由翼片组成并且凹槽配合，其中所述翼片要被固定在假体的板上，所述凹槽被制造在椎骨板的表面上或者在将被植入椎骨主体中的锚定设备上。
【0003】然而，这些假体的缺陷在于：因为植入过程需要假体的不同构件彼此之间有很好的稳定性，所以不容易将假体插入椎骨之间。在现有技术已知的假体中经常缺失这种稳定性并且已知的器械通常不确保假体构件的稳定性。事实上，假体的铰接板拥有使病人感到舒适但使安装它们的外科医生感到不舒适的自由度。板具有绕它们的铰接表面倾斜和转动的风险。因此，外科医生不能保证构件完全地对准椎骨柱的前后轴。
发明内容
【0004】在此上下文中，感兴趣的是提出一种假体和相关联的器械，其能够使假体被植入到椎骨之间同时保留假体的不同构件彼此之间的必要对准。因此，本发明的目的是通过提供椎间盘假体和器械从而消除现有技术的某些缺陷，该器械用于将假体插入椎骨之间且允许沿限定轴植入假体。
【0005】这个目的通过椎间盘假体实现，该椎间盘假体包括至少两个板，所谓的第一板和第二板，它们依靠至少一个板的弯曲表面(所谓的关节)彼此铰接，来允许板通过分别绕基本垂直于板平面的轴和基本在板平面内的轴旋转来相对彼此转动和/或倾斜，每个板包含将与一个椎骨的椎骨板紧密结合的所谓的接触表面，而假体用于植入在所述椎骨之间，其特征在于至少一个板的接触表面包含至少第一骨质锚定装置和至少第二骨质锚定装置，第一骨质锚定装置延伸到其所处的板的外围附近，并且第二骨质锚定装置根据前后轴相对于第一骨质锚定装置偏置，所述第二骨质锚定装置的偏置包含与其所处的板紧密结合的所谓的基部部分和宽度窄于基部部分并形成引导刀片的所谓的尖边缘部分，所谓的尖边缘部分沿假体的插入轴取向，旨在防止假体的板相互之间旋转并有利于假体的插入。
【0006】根据另一个特定特征，第二板包含弯曲关节表面，该关节的至少一个部件和与其互补的第一板的弯曲关节表面配合从而允许板相对彼此转动和/或倾斜。
【0007】根据另一个特定特征，第一板的弯曲表面是凹面，而第二板的弯曲关节表面是凸面。
【0008】根据另一个特定特征，第一板的弯曲表面是凸面，而第二板的弯曲关节表面是凹面。
【0009】根据另一个特定特征，椎间盘假体也包括核心，该核心包括平面和弯曲关节表面，且其中仅第一板包含弯曲关节表面，该弯曲关节表面和与其互补的核心的弯曲表面的至少一个部件配合，以便允许板相对彼此转动和/或倾斜，核心的平面与第二板的平面的至少一个部件配合，从而允许核心相对于第二板在垂直于脊骨的垂直轴的至少一个方向上平移和/或旋转，该第二板包含与核心的配合装置互补的配合装置从而使得核心相对第二板的至少所述平移受到限制或被消除。
【0010】根据另一个特定特征，第一板的弯曲表面是凹面而核心的弯曲表面是凸面。
【0011】根据另一个特定特征，第一板的弯曲表面是凸面而核心的弯曲表面是凹面。
【0012】根据另一个特定特征，板的第一骨质锚定装置由至少一个翼组成，所述翼位于板的外围附近并且装备有槽口，所述槽口被定向为阻止假体从盘空间中取出。
【0013】根据另一个特定特征，第一骨质锚定装置的槽口的高度沿从后到前的方向逐渐增加，这样槽口在假体的前面的高度高于在假体的后面的高度，并且因而通过使槽口撞击尚未受到在前面的槽口撞击的骨组织而有利于使假体沿脊骨在前后方向内插入盘空间中。
【0014】根据另一个特定特征，假体的至少一个板的至少前边缘包含3个支撑面，其中的一个导引面基本上垂直于盘空间内假体的插入轴，而其中的在板的平面内的两个前侧面各自形成相对于板的前面和一个侧边缘的角度，这3个支撑面通过器具使假体在盘空间的插入过程中稳定，该器具中的至少一部分具有与这3个支撑面互补的形式。
【0015】根据另一个特定特征，至少一个板至少其后边缘具有至少一个有利于假体插入盘空间内的开槽。
【0016】根据另一个特定特征，板的第二骨质锚定装置由至少一个位于板的边缘附近并且沿椎骨之间假体的插入轴取向的副翼组成。
【0017】根据另一个特定特征，副翼在其前端的高度低于在其后端的高度，这种高度上的不同使副翼具有有利于其在盘空间内沿前后方向插入的倾斜轮廓。
【0018】根据另一个特定特征，至少一个板包含至少一个允许将抓握设备的端部装配到假体上的欠缺形状，例如槽口。
【0019】根据另一个特定特征，第二板的配合装置是位于第二板的边缘附近的并且与核心的母装置配合的公装置。
【0020】根据另一个特定特征，第二板的公配合装置是两个位于第二板的两个侧边缘上的立柱(stud)，而核心的母配合装置是在核心的侧边缘上制成的两个凹进处。
【0021】根据另一个特定特征，每个公配合装置的尺寸稍微小于每个母配合装置的尺寸以便允许关于相应于假体的关节中心的核心的中间位置在核心和第二板之间存在小间隙。
【0022】根据另一个特定特征，每个公配合装置的尺寸基本上与每个母配合装置的尺寸相同，以便防止在核心和第二板之间的任何间隙并将核心保持在相应于假体的关节中心的核心的中间位置上。
【0023】根据另一个特定特征，第二板的配合装置是位于第二板的边缘附近的并与核心的公装置配合的母装置。
【0024】根据另一个特定特征，每个公配合装置的尺寸稍微小于每个母配合装置的尺寸以便允许关于相应于假体的关节中心的核心的中间位置在核心和第二板之间存在小间隙。
【0025】根据另一个特定特征，每个公配合装置的尺寸基本上与每个母配合装置的尺寸相同，以便防止在核心和第二板之间的任何间隙并将核心保持在相应于假体的关节中心的核心的中间位置上。
【0026】根据另一个特定特征，核心的公配合装置是两个位于核心的两个侧边缘上的立柱，而第二板的母配合装置是四个壁体，所述四个壁体成对位于第二板的两个侧边缘中的每一个上。
【0027】根据另一个特定特征，第二板的母配合装置包含一个部分，其向板中心弯曲并部分覆盖核心的公配合装置，从而防止核心提升。
【0028】根据另一个特定特征，作为板的接触表面的平面装置基本上平行或形成锐角，由该角度获得的倾斜允许使假体的整个形状适应脊骨的解剖结构或可选择地校正要使用假体的病人的椎骨的倾斜欠缺。
【0029】根据另一个特定特征，相同的板可组装有不同厚度和/或尺寸和/或形状的核心。
【0030】本发明的另一个目的是通过提出在假体插入椎骨之间的过程中维持假体的不同构件相互之间的稳定性以便将椎间盘假体插入椎骨之间的器械，从而消除现有技术的某些缺陷。
【0031】这个目的通过将椎间盘假体插入椎骨之间的插入器械实现，该器械包含至少一个假体的抓握设备，抓握设备包含所谓的操作端和所谓的抓握端，抓握设备的特征在于：它包含在抓握端装备有至少一个旋转轴的杆，至少两个绕这个轴自由旋转的腿架被安置在所述旋转轴上，杆和腿架的整体形成可滑动地安置在空心管中的夹钳，其中抓握端具有截短形状的内部轮廓并包含垂直于夹钳的两个腿架平面的轴，由两个腿架形成的整体在夹钳的打开平面内的宽度大于杆的宽度，因此杆在管中沿操作端方向的滑动通过腿架的外部和管的截短部分之间的接触而引起夹钳的闭合，杆在管中沿抓握端方向的滑动通过管的轴和杆的腿架内部之间的接触而引起夹钳的打开。
【0032】根据另一个特定特征，杆在操作端装有把手以便允许用户操作杆在管中滑动。
【0033】根据另一个特定特征，管装备有相对管可旋转移动并且包含螺纹的环，该螺纹与杆的至少一个螺纹部分互补，环的螺纹和杆的螺纹的相对位置允许杆至少在夹钳闭合的位置被锁定在管中。
【0034】根据另一个特定特征，在抓握端杠杆的每个腿架端具有至少一个与假体的构件的至少一个边缘接触的接触表面，赋予夹钳与将被植入的假体的形状相符的轮廓。
【0035】根据另一个特定特征，与将被植入的假体的形状相符的轮廓由至少一个与假体的引导边缘接触的接触表面、至少一个与假体的中心核心的引导边缘接触的接触表面以及至少一个与位于假体的侧边缘的构件接触的接触表面组成。
【0036】根据另一个特定特征，至少一个与位于假体的侧边缘的构件接触的接触表面由在核心和假体的板之间的配合装置的抓握装置组成。
【0037】根据另一个特定特征，至少一个与位于假体的侧边缘的构件接触的接触表面由与假体的至少一个板的欠缺形状配合的配合装置组成。
【0038】根据另一个特定特征，与将被植入的假体的形状相符的轮廓至少由与假体的引导边缘接触的接触表面组成，轮廓包含与至少位于假体的至少一个板的引导边缘上的3个支撑面互补的3个支撑面，这3个支撑面包含基本上垂直于插入盘空间内假体的插入轴的引导面和两个前侧面，每个前侧面在板的平面内形成相对于引导面和板的一个侧边缘的角度，在这个器械轮廓和假体的这3个面之间的配合允许后者在它插入盘空间的过程中稳定。
附图说明
【0039】通过阅读在下文的阐述并参考附图，本发明的其他的特定特征和优点将更清楚地显现，在附图中：
—图1A和1B分别展示了根据本发明的实施例的椎间盘假体的后透视图和主透视图，
—图2A和2B分别展示了根据本发明的实施例的椎间盘假体的轮廓图和后视图，
—图3A、3B和3C分别展示了根据本发明的实施例的椎间盘假体的第一板的俯视图、后视图和轮廓图，
—图4A、4B和4C分别展示了根据本发明的实施例的椎间盘假体的第二板的俯视图、后视图和轮廓图，
—图5A、5B分别展示了根据本发明的实施例当设备处于打开位置并且未锁定在假体中时的假体的抓握设备的带有图5C的切面的轮廓图和根据这个切面的截面图，图5C和5D分别呈现了在图5B中圈出的5C部分的详细图和在图5C中圈出的5D部分的详细图，
—图6A、6B分别展示了根据本发明的实施例当设备处于闭合位置并且锁定在假体中时的假体的抓握设备的带有图6B的切面的轮廓图和根据这个切面的截面图，图6C和6D分别呈现了在图6B中的圈出6C部分的详细图和在图6C中的圈出6D部分的详细图.
具体实施方式
【0041】本发明涉及椎间盘假体，该椎间盘假体包含至少骨质锚定装置(41)，该骨质锚定装置(41)形成导引刀片并且沿假体的插入轴取向旨在防止假体的板彼此之间旋转并有利于假体的插入。更具体地，假体包含至少第一骨质锚定装置(42)和至少第二骨质锚定装置(41)，第一骨质锚定装置(42)延伸至接近其所在的板的外围，而第二骨质锚定装置(41)根据前后轴相对于第一骨质锚定装置(42)偏置。第二偏置骨质锚定装置(41)包含与其所在的板紧密结合的所谓的基部部分和宽度窄于基部部分的所谓的尖边缘部分。这个尖边缘部分形成一种刀片，在假体植入期间这种刀片旨在在与其接触的椎骨板的表面上刻痕，并且之后这个沿假体插入轴定向的刀片自然地在椎骨中形成导引轨道，从而防止假体的构件彼此之间的任何移动。在本文下面阐述的各种实施例中，假体包含至少两个板(1和2)，即所谓的第一(1)和第二(2)板，第一板和第二板依靠至少一个板的弯曲表面(所谓的关节表面)彼此之间铰接。这个弯曲关节表面通过绕基本上垂直于板的平面的轴旋转而允许板(1，2)相对于彼此旋转，并且/或者通过绕基本上在板(1，2)的平面内的轴旋转而允许板(1，2)相对于彼此倾斜。每个板(1，2)包含一个所述的接触表面，该接触表面旨在与要在其间插入假体的椎骨中的一个椎骨的椎骨板紧密结合。如在图1A到3C中展示的实施例中特别示出的，第一板(1)的接触表面包含与椎骨的下板表面的形状匹配的凸出部分(14)。如图1A到2B所示，根据本发明的假体可以仅包含依靠弯曲表面(未示出)彼此铰接的两个板或者依靠中心可移动核心(3)彼此铰接的两个板(1，2)，该中心可移动核心具有与一个板的弯曲表面的至少一部分配合的弯曲表面和与另一个板的平面表面的至少一部分配合的平面表面。
【0042】在这个所示的实施例中，第一板(1)包含弯曲的关节表面并且这个表面与其互补的核心(3)的弯曲表面的至少一部分配合，从而允许板(1，2)相对于彼此旋转和/或倾斜。核心(3)的平面表面与第二板(2)的平面表面的至少一部分配合从而允许核心(3)在垂直于脊柱的垂直轴的至少一个方向上相对于第二板(2)平移和/或通过绕基本上垂直于这些平面表面的平面的轴旋转而允许核心(3)相对于第二板(2)旋转。在图中所展示的实施例中，第一板(1)的弯曲表面是凹的，而核心(3)的弯曲表面是凸的。但是第一板(1)的弯曲表面是凸的而核心(3)的弯曲表面是凹的情况也可能发生。
【0043】第二板(2)包含与核心(3)的配合装置(32)互补的配合装置(22)，以便至少限制或者取消核心(3)相对于第二板(2)的这个平移。在图中所展示的实施例中，第二板(2)的配合装置(22)是位于第二板(2)的边缘附近并且与核心(3)的母装置(32)配合的公装置。在图中所展示的实施例中，第二板(2)的这些公配合装置(22)是两个位于第二板(2)的两个侧边缘上的立柱，而核心(3)的母配合装置(32)是两个在核心(3)的侧边缘上制成的凹进处。在其他的在此未展示出的可能的实施例中，核心(3)的这些配合装置(32)可能是由例如位于核心(3)的侧边缘上的两个立柱组成的公装置，并且因而第二板(2)的配合装置(22)可能是由例如成对位于第二板(2)的两个侧边缘的每一个上的四个壁体组成的母装置。在这两个实施例中，第二板(2)的配合装置(22)能够包含向板(2)的中心弯曲并部分覆盖于核心(3)的配合装置(32)从而防止核心(3)提升的部分。在根据本发明的一个实施例中，每个公配合装置(32，22)的尺寸可以稍微小于每个母配合装置(22，32)的尺寸从而允许绕相对于板(1，2)的核心(3)的中间位置在核心(3)和第二板(2)之间存在小间隙，这个中间位置相应于假体的关节中心。在另一个实施例中，每个公配合装置(32，22)的尺寸可以基本上与每个母配合装置(22，32)的尺寸相同以便防止在核心(3)和第二板(2)之间的任何间隙并将核心(3)保持在相应于关节中心的核心的中间位置上。应该注意的是，根据本发明的假体能够校正将要在其间植入假体的椎骨的倾斜缺陷。根据期望的结果，关节的这个中心可以被提供在假体的中心或者在垂直于脊柱的轴的至少一个方向上偏置。类似地，因此作为板(1，2)的接触表面(14)的平面装置可以是基本平行的或形成锐角。由这个角度获得的倾斜将允许使假体的整个形状适应脊柱的解剖结构或可选择地校正要用假体的病人的椎骨的倾斜缺陷。相同的板(1，2)可组装有不同厚度和/或尺寸和/或形状的核心(3)。
【0044】根据本发明的假体包含骨质锚定装置，在假体植入椎骨之间的过程中该骨质锚定装置确保假体的构件彼此之间具有很好的稳定性。为了这个目的，根据本发明假体包含至少第一骨质锚定装置(42)和至少第二骨质锚定装置(41)。第一骨质锚定装置(42)延伸至接近其所在的板的外围，而第二骨质锚定装置(41)根据前后轴相对于第一骨质锚定装置(42)偏置。因此，在在此未示出的一个实施例中，第一骨质锚定装置(42)可以由翼组成，该翼垂直于脊柱的前后轴取向并位于接近其所在的板的引导边缘或者后边缘上。因而第二骨质锚定装置(41)将分别地位于轨路或者引导边缘的附近。在图1A到4C图中所展示的实施例中，第一骨质锚定装置(42)由两个翼组成，这两个翼按照脊柱的前后轴取向并位于其所在的板的侧边缘附近。这些侧翼可以具有小于板长度的长度，且随之第二骨质锚定装置(41)可以位于板的一个轨路或者引导边缘附近。在这两个实施例中，每个翼均可以装备有被定向为阻止假体从盘空间中取出的槽口。由于它们的位置靠近板的外围，所以第一骨质锚定装置(42)具有将假体稳定在椎骨之间的功能。特别地由于它们的槽口使它们也具有附着到椎骨板的功能。由于它们的偏心位置和它们沿在椎骨之间的假体的插入轴的取向，第二骨质锚定装置(41)具有在插入过程中的导引功能和稳定假体构件的功能。图示出了沿前后轴取向的第一和第二(41，42)骨质锚定装置，但因为从现有技术中已知能够沿不同的轴植入椎间盘假体且因而骨质锚定装置的取向不一定是前后方向，所以图示仅作为非限制性实例。在不同的实施例中，如图4C中特别示出的，第一骨质锚定装置(42)的槽口的高度沿前后方向逐渐增加。更具体地，在假体前面的槽口的高度大于在假体后面的槽口的高度。因而，在假体沿椎骨的前后方向插入盘空间的过程中，翼的每个槽口撞击尚未受到在之前槽口撞击的骨组织从而有利于假体插入盘空间中。第二偏置骨质锚定装置(41)包含与其所在的板紧密结合的所谓的基部部分和宽度窄于基部部分并且形成引导刀片的所谓的尖边缘部分，该导引刀片旨在防止假体的板彼此之间转动并有利于假体的插入。这个尖边缘部分可以由例如在第二骨质锚定装置(41)的至少一个侧表面上制成的至少一个斜面获得。因此，这个第二骨质锚定装置(41)可以由例如位于板的边缘附近并沿在椎骨之间的假体的插入轴取向的至少一个副翼(41)或者鳍组成。当然，因为假体通常沿前后通道穿过在脊柱的两个邻近椎骨之间的盘空间而被植入并且因而这个后边缘最先被插入盘空间内，因此使得在后边缘处的副翼的作用更重要，即使如此也可以提供两个副翼或者鳍从而进一步稳定假体。在一个不同的实施例中，副翼或者鳍的高度在后端没有在前端重要。仅就翼的槽口的递增高度来说，副翼(41)在高度上的不同使其具有倾斜的轮廓，从而有利于沿前后方向插入盘空间中。另外，根据本发明在一个实施例中的假体的至少一个板(1，2)至少在它的轨路边缘上包含至少一个斜面从而有利于假体插入盘空间中。
【0045】在本发明的实施例中，如图3A和4A中特别明显所示，假体的至少一个板(1，2)的至少引导边缘可以包含3个支撑面。这3个面由基本上垂直于盘空间内假体的插入轴的引导面和两个前侧面组成，每个前侧面在板的平面中相对于引导面和板的一个侧边缘形成角度。装备有这3个支撑面而不是圆形的引导面的假体在其插入盘空间的过程中很容易稳定，例如依靠器具的手段，该器具中的至少一个部分具有与这3个支撑面互补的形状。如图1A、1B、2A、3A和3C中特别明显所示，至少一个板(1，2)可以包含允许安装假体的抓握设备(5)的末端的例如槽口的至少一个欠缺形状(43)。
【0046】本发明进一步涉及允许假体插入椎骨之间并且在植入的过程中确保假体的不同构件彼此之间稳定的器械。根据本发明这种器械包含至少一个假体的抓握设备(5)，该假体的抓握设备包含所谓的操作端和所谓的抓握端。这个抓握设备(5)包含一个杆(50)，该杆(50)在抓握端装备有至少一个旋转轴(501)，绕这个轴(501)自由旋转的至少两个腿架(500)被安置在该轴上。杆(50)和腿架(500)的整体形成了可滑动地安装在空心管(55)中的夹钳，其中抓握端具有截短形式(truncated shape)的内部轮廓。由两个腿架(500)形成的整体在夹钳的打开平面内的宽度大于杆(50)的宽度，从而配合空心管(55)的截短部分。管(55)包含垂直于夹钳的两个腿架(500)的平面并位于两个腿架之间的轴(550)，以便配合两个腿架。因此，杆(50)在管(55)中沿操作端方向滑动通过腿架(500)的外部和管(55)的截短部分之间的接触而导致夹钳闭合，而杆(50)在管(55)中沿抓握端方向的滑动通过管(55)的轴(550)和杆(50)的腿架(500)的内部之间的接触而导致夹钳打开。杆(50)可以在操作端安装有把手(56)以便允许用户操作杆(50)在管(55)中滑动。而且，可以利用这个把手促使假体插入盘空间中，例如，依靠如锤子的工具撞击把手。在发明的一个实施例中，管(55)可以安装有一个环(57)，该环(57)可相对管(55)旋转移动并且包含与杆(50)的至少一个螺纹部分(58)互补的螺纹。环(57)的螺纹和杆(50)的螺纹(58)的相对位置应该允许至少在夹钳闭合的位置能将杆(50)锁定在管(55)中。所以，例如当外科医生撞击把手从而将假体插入盘空间中时，使用抓握设备(5)将有助于确保夹钳固定在假体上。
【0047】在图中所示实施例中，在抓握端水平上的腿架(500)的每个末端均具有与假体构件的至少一个边缘接触的至少一个接触表面(51，52，53)，赋予夹钳与将被植入的假体的形状相符的轮廓。符合将被植入的假体形状的轮廓可以由与假体的引导边缘接触的至少一个接触表面(51)、与假体的中心核心的引导边缘接触的至少一个接触表面(53)和与位于假体的侧边缘上的构件接触的至少一个接触表面(52)组成。在假体包含装备有与至少一个板的配合装置配合的配合装置的中心核心的案例中，与位于假体的侧边缘上的构件接触的接触表面(52)因而可以由在假体的核心(3)和一个板(1，2)之间的至少一个配合装置的抓握装置组成。同样地，在假体包含具有欠缺形状(43)(例如槽口)的板的案例中，与位于假体的侧边缘上的构件接触的接触表面(52)可以由与这个欠缺形状(43)配合的配合装置组成。而且，根据该发明的器械可以用来完美地配合根据本发明的假体的不同变化实施例并且包含更符合假体形状的轮廓。特殊地，与假体的引导边缘接触的接触表面(51)和可选择的其他表面可以包含与在假体的至少一个板(1，2)的至少一个引导边缘上的3个支撑面互补的3个支撑面。之后，以互补于假体的支撑面的样式被放置的这3个支撑面包含基本上垂直于盘空间内假体的插入轴的引导面和两个前侧面，每个前侧面均在板的平面内相对于引导面和板的一个侧边缘形成角度。这个器械轮廓和假体的这3个面之间的配合将有助于使后者在它插入盘空间中的过程中保持稳定，例如防止它的旋转。
【0048】对本领域技术人员来说显而易见的是，本发明在不偏离如权利要求的发明的应用范畴的情况下允许实施例有多种其他具体形式。因此，本发明的实施例应当被认为是说明性的，并可在权利要求限定的范围内修改，且本发明不局限于前述具体说明。

Claims (33)

1.植入到脊柱的椎骨之间的椎间盘假体，其包含：
第一板和第二板，每个板均包含外围板边缘和被配置为与椎骨的椎骨板接触的椎骨接触表面，所述第一板或者所述第二板中的至少一个板的所述椎骨接触表面具有前后轴并且包含：
接近所述外围板边缘设置的第一骨质锚定装置，以及
沿所述前后轴相对于所述第一骨质锚定装置偏置设置的附装第二骨质锚定装置，所述第二骨质锚定装置具有用于所述附装的基部部分和窄于所述基部部分的尖边缘部分，所述第二骨质锚定装置被配置成形成刀片，该刀片沿所述假体的所述插入轴取向从而防止所述第一板和所述第二板相对彼此旋转并有利于所述假体的插入；以及
一个弯曲板关节表面，该弯曲板关节表面被设置在所述第一板或者所述第二板的至少一个板上，以致允许所述第一板和所述第二板通过分别绕基本上垂直于所述第一板或者所述第二板的平面的轴和基本上在所述第一板或者所述第二板的平面中的轴旋转从而相对彼此旋转或者倾斜。
2.根据权利要求1所述的椎间盘假体，其中，每个所述第一板和所述第二板均包含一个弯曲板关节表面，并且所述第二板的所述弯曲板关节表面的至少一部分与所述第一板的所述弯曲板关节表面配合。
3.根据权利要求2所述的椎间盘假体，其中，所述第一板的所述弯曲板关节表面是凹的，而所述第二板的所述弯曲板关节表面是凸的。
4.根据权利要求2所述的椎间盘假体，其中，所述第一板的所述弯曲板关节表面是凸的，而所述第二板的所述弯曲板关节表面是凹的。
5.根据权利要求1所述的椎间盘假体，进一步包含具有平面核心表面和弯曲核心关节表面的核心，其中
弯曲板关节表面被设置在所述第一板上；
所述弯曲核心关节表面的至少一部分与设置在所述第一板上的所述弯曲板关节表面配合；
平面板表面被设置在所述第二板上；
所述平面核心表面与所述平面板表面的至少一部分配合从而允许所述核心相对于所述第二板沿至少一个方向平移或旋转；并且
每个所述核心和所述第二板均包含配合装置，所述配合装置配合从而限制或者防止相对于所述第二板沿至少一个方向平移。
6.根据权利要求5所述的椎间盘假体，其中，所述第一板的所述弯曲板关节表面是凹的，而所述弯曲核心关节表面是凸的。
7.根据权利要求5所述的椎间盘假体，其中，所述第一板的所述弯曲板关节表面是凸的，而所述弯曲核心关节表面是凹的。
8.根据权利要求1所述的椎间盘假体，其中，第一骨质锚定装置包含至少一个具有槽口的翼。
9.根据权利要求8所述的椎间盘假体，其中，第一骨质锚定装置的每个槽口具有一个高度，所述槽口的所述高度沿所述前后轴的后前方向逐渐增加。
10.根据权利要求1所述的椎间盘假体，其中，所述第一板或者所述第二板中至少一个板的所述外围板边缘具有前边缘部分，所述前边缘部分包含至少3个支撑段，其中一个支撑段基本上垂直于所述前后轴，而另两个支撑段中的每一个相对于基本上垂直于所述前后轴的所述支撑段形成角度，所述至少3个支撑段被配置成与被设计用于将所述椎间盘假体插入脊柱的椎骨之间的器具的一部分的构造互补。
11.根据权利要求1所述的椎间盘假体，其中，所述第一板或者所述第二板中至少一个板的所述外围板边缘具有后边缘部分，所述后边缘部分具有至少一个斜面，所述斜面被配置成有利于所述椎间盘假体被插入到脊柱的两个椎骨之间。
12.根据权利要求1所述的椎间盘假体，其中，所述第二骨质锚定装置包含邻近所述外围板边缘设置并沿所述前后轴取向的副翼。
13.根据权利要求12所述的椎间盘假体，其中，所述副翼在其后端的高度小于在其前端的高度。
14根据权利要求1所述的椎间盘假体，其中，至少一个所述板包含一个欠缺形状，该欠缺形状被配置成与抓握设备的一末端配合。
15.根据权利要求5所述的椎间盘假体，其中，所述第二板的所述配合装置是邻近所述第二板的所述外围板边缘设置的公装置，而所述核心的所述配合装置是母装置。
16.根据权利要求15所述的椎间盘假体，其中：
所述第二板的的所述外围板边缘具有第一侧边缘和第二侧边缘；
所述第二板的所述公配合装置包含第一立柱和第二立柱，所述第一立柱邻近所述第二板的所述第一侧边缘设置，而所述第二立柱邻近所述第二板的所述第二侧边缘设置。
所述核心的所述母配合装置包含第一凹进处和第二凹进处，所述第一凹进处被设置在所述核心的第一侧边缘，而所述第二凹进处被设置在所述核心的第二侧边缘。
17.根据权利要求15所述的椎间盘假体，其中，所述公配合装置的尺寸小于所述母配合装置的尺寸。
18.根据权利要求15所述的椎间盘假体，其中，所述公配合装置的尺寸基本上与所述母配合装置的尺寸相同。
19.根据权利要求5所述的椎间盘假体，其中，所述第二板的所述配合装置是邻近所述第二板的所述外围板边缘设置的母装置，而所述核心的所述配合装置是公装置。
20.根据权利要求19所述的椎间盘假体，其中，所述公配合装置的尺寸小于所述母配合装置的尺寸。
21.根据权利要求19所述的椎间盘假体，其中，所述公配合装置的尺寸基本上与所述母配合装置的尺寸相同。
22.根据权利要求19所述的椎间盘假体，其中：
所述第二板的所述外围板边缘具有第一侧边缘和第二侧边缘；
所述第二板的所述母配合装置包含被配置成第一对和第二对的四个壁体，所述第一对邻近所述第二板的所述第一侧边缘设置，所述第二对邻近所述第二板的所述第二侧边缘设置；并且
所述核心的所述公配合装置包含第一立柱和第二立柱，所述第一立柱被设置在所述核心的第一侧边缘上，而所述第二立柱被设置在所述核心的第二侧边缘上。
23.根据权利要求22所述的椎间盘假体，其中，所述第二板的所述母配合装置的每个壁体均具有从所述第二板的所述外围板边缘向内弯曲并部分覆盖所述第一立柱或所述第二立柱的一部分的止动部分，所述母配合装置的所述壁体的所述止动部分共同被配置成限制所述核心远离所述第二板的移动。
24.根据权利要求1所述的椎间盘假体，其中：
所述椎间盘假体被配置成具有所述第一板和所述第二板的中立位置，所述中立位置相应于所述第一板和所述第二板相对彼此未倾斜；并且
当所述椎间盘假体处于所述中立位置时，所述第一板和所述第二板中每个板的所述椎骨接触表面被配置为基本上平行。
25.根据权利要求1所述的椎间盘假体，其中：
所述椎间盘假体被配置成具有所述第一板和所述第二板的中立位置，所述中立位置相应于所述第一板和所述第二板相对彼此未倾斜；并且
当所述椎间盘假体处于所述中立位置时，所述第一板和所述第二板中每个板的所述椎骨接触表面被配置为形成锐角。
26.根据权利要求5所述的椎间盘假体，其中，所述第一板和所述第二板被配置成使得所述核心能够具有选定厚度、选定尺寸或者选定形状。
27.用于将椎间盘假体插入脊柱的椎骨之间的器械，其包含：
具有操作端和抓握端的空心管，所述操作端具有多个接触表面和一个分离轴；
一个杆，该杆被可滑动地至少部分设置在所述管中并且具有操作端、抓握端、纵向轴以及宽度；
一个旋转轴，该旋转轴在邻近所述杆的所述抓握端处被附连到所述杆上；以及
可绕所述旋转轴旋转的脚架，所述脚架共同形成用于抓取所述椎间盘假体的夹钳，所述夹钳具有超过所述杆的所述宽度的宽度并且具有外脚架表面和内脚架表面；
其中，所述杆在所述管中沿所述管的所述操作端方向的滑动通过所述夹钳的所述外腿架表面和所述管的所述接触表面之间的接触而导致所述夹钳闭合；并且
所述杆在所述管中沿所述抓握端方向的滑动通过所述管的所述分离轴和所述内腿架表面之间的接触而导致所述夹钳打开。
28.根据权利要求27所述的用于插入椎间盘假体的器械，其中，所述杆在所述操作端配备有把手。
29.根据权利要求27所述的用于插入椎间盘假体的器械，其中，所述杆在螺纹部分具有螺纹，并且所述管配备有可绕所述管旋转并且具有与所述杆的螺纹互补的螺纹部分的环，借此通过使所述杆的螺纹与所述环的螺纹啮合而禁止所述杆在所述管中移动。
30.根据权利要求27所述的用于插入椎间盘假体的器械，其中，每个所述腿架均具有与所述椎间盘假体的表面的一部分互补的腿架接触表面，其中所述腿架接触表面共同形成具有符合所述椎间盘假体的所述轮廓的夹钳接触表面的夹钳轮廓。
31.根据权利要求30所述的用于插入椎间盘假体的器械，具有边缘表面、核心以及位于所述椎间盘假体的侧边缘上的构件，其中，所述夹钳轮廓包含：
互补于所述假体的所述边缘表面的夹钳接触表面；
互补于所述核心的夹钳接触表面；以及
互补于位于所述假体的侧边缘上的所述构件的夹钳接触表面。
32.根据权利要求30所述的用于插入椎间盘假体的器械，具有板、核心以及邻近椎间盘假体的侧边缘设置的在所述板和所述核心之间的配合设备，其中，夹钳接触表面互补于所述配合设备。
33.根据权利要求31所述的用于插入椎间盘假体的器械，具有带有欠缺形状的板，其中，与位于所述假体的侧边缘上的所述构件互补的所述夹钳接触表面被配置成为补充所述欠缺形状。
34.根据权利要求30所述的用于插入椎间盘假体的器械，具有前后轴和包含至少3个支撑段的前边缘部分，其中一个支撑段基本上垂直于所述前后轴，而另外两个支撑段均相对于基本上垂直于所述前后轴的所述支撑段形成角度，其中所述夹钳轮廓相应于所述前边缘部分。
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CN110650694A (zh) * 2017-05-23 2020-01-03 拜欧米特制造有限责任公司 偏置导向器
CN110650694B (zh) * 2017-05-23 2023-04-18 拜欧米特制造有限责任公司 偏置导向器

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US8771284B2 (en) 2014-07-08
CN101365402B (zh) 2011-09-07
US20150025638A1 (en) 2015-01-22
US20130013006A1 (en) 2013-01-10
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WO2007063398A2 (en) 2007-06-07
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EP1996126B1 (en) 2013-05-08
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US20160166402A1 (en) 2016-06-16
FR2893838B1 (fr) 2008-08-08

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