CN101534752B - Systems and methods for sizing, inserting and securing an implant intervertebral space - Google Patents
Systems and methods for sizing, inserting and securing an implant intervertebral space Download PDFInfo
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- CN101534752B CN101534752B CN2007800424628A CN200780042462A CN101534752B CN 101534752 B CN101534752 B CN 101534752B CN 2007800424628 A CN2007800424628 A CN 2007800424628A CN 200780042462 A CN200780042462 A CN 200780042462A CN 101534752 B CN101534752 B CN 101534752B
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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
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
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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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- Oral & Maxillofacial Surgery (AREA)
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Abstract
A prosthetic spinal implant having a deployable securing mechanism that is deployable into a portion of the vertebral space for affixing the implant between the vertebrae, the securing mechanism having tactile feedback means comprising a surface for transmitting tactile feedback during deployment of the securing mechanism. A spinal implant having deployable securing means that interface with the implant to prevent the deployable securing means from retracting after deployment. An implant that utilizes its resilient properties to provide the user with tactile feedback with which the user may ascertain the position of the securing mechanism. A system and tools for sizing and implanting implants with the aforementioned characteristics.
Description
Related application
The sequence number that the application requires on JIUYUE 15th, 2006 to submit to is that 60/825,865 U.S. Provisional Application and the sequence number submitted on April 16th, 2007 are the rights and interests of 60/912,138 U.S. Provisional Application, incorporates said two pieces of application full text into this paper by reference.
Technical field
The System and method for that the present invention relates to regulate the intervertebral space size and place the implant of appropriate size therein more specifically, relates to the System and method for of in intervertebral space, regulating size, insertion and fixation implant.
Background technology
The joint is aging to be a general problem, and it can occur in all joints of human body whole body.This situation is typically more common when skeletal system is aging, and often needs Drug therapy and physical therapy.These expectant treatments sometimes only obtain limited success.If unsuccessful, patient typically will continue through suffer and limitation of activity.
Usually cause whole embolias the course of treatment.These of (for example hip and knee) reset and need carry out the several years on the joint.Resetting means generally includes some metal structure assemblies or the centre is the end plate of polyethylene core.Before needs were corrected some angles, these devices often used 15 to 20 years and are used to reset.
In spinal column, select the aging treatment of operative treatment and intervertebral disc to combine.The spinal column intervertebral disc is proved to be in the spinal column most important joint and between vertebral body.Spinal disc comprises the hard outer shroud that is called the body ring, is called the gluey implant of nuclear.Believe that the fusion that removes between ill spinal disc and the influenced horizontal level can not produce obvious difference on the whole mobility of spinal column.Yet spinal fusion is proved to be the deterioration that has caused increasing other spinal level positions, and it must compensate and merge the mobile loss of horizontal level, and this causes the recurrence of patient's disease usually and misery and activity are more limited more.
Recently, about improving the implant of spinal fusion, begun to pay close attention to the use of " movement protection " implant.These movement protection implants (with the form of joint replacement in the spinal column) hope to alleviate with spinal column in the relevant a lot of problems of fusing device.Today, being seen replacement device typically comprised a pair of biocompatibility metal plate, and its upper joint is connected with polymer, elastic kernel or metallic plate.
Metal on the metal implant has unsuccessful history in life-time service, yet the Precision Machining order uses the implant of these materials to reappear, and has increased substantially wearability because believe the change in the manufacturing.But, thus metal implant be radiopaque and continue hinder operation owing to be difficult to illustrate involved area.Other implants between the metallic plate (for example using polymer, elastic kernel) are owing to metal assembly bears identical radiopaque defective, and said metal assembly has increased the complexity of design in addition because single implantation need utilize multiple material.
Prior art discloses the detailed bill of biocompatible materials, comprises metal, pottery and polymer, and it can be used for making these implants, and when the interface linked together and in articulation, test, these materials had had a lot of failure logging (record)s.When polymer connected against the polymer joint of load-bearing artificial joint, then failure logging (record) was more.Because its failure logging (record), polymer combine not to be used for the weight-bearing joint displacement as the acceptable connection material combination from the joint.
For example, PEEK (polyethers ether cave) is to a great extent because its intensity, radiolucent character and biocompatibility are considered to be used to make the suitable material of implant device.Especially the implant in structure does not have under the situation of joint assembly.Proposition is used for low wearing and tearing non-bearing joint (for example finger-joint) with the folded PEEK of PEEK.Yet because the failure logging (record) that biocompatible polymer leans on self joint to connect, prior art is from careful and not have to propose to fold PEEK as the suitable combination of materials in the weight-bearing joint displacement apparatus with the PEEK that connects from the joint.
Summary of the invention
Yet we have drawn difference and unpredictable consequence at breadboard test.In mimic load-bearing artificial joint structure, PEEK carries out very wellly against PEEK.PEEK has showed unexpected required mechanical performance and the biocompatibility characteristic of in human body and other animal bodies, using of loading support artificial joint against the joint connection of PEEK.The all right fibre-reinforced form manufacturing of PEEK, said fiber is generally carbon fiber, and it also successfully realizes function against self with against no fibre-reinforced PEEK.
In case it is the feasible selection that connects from the joint that PEEK is realized, becoming is apparent that the joint that whole joints connect can be by the material manufacture of the assembly that need not the connection of metal structure or joint.This discovery simplified basically the load-bearing artificial joint reset design essence and formed very big benefit.The part inventory of these benefits comprises: artificial joint because the integrated characteristic of same components (before owing in order to realize that function needs a plurality of materials; Think isolating) and have less assembly; Because good wear-resisting characteristic is with last much longer; Basically be radiolucent, have elastic modelling quantity, and finally lowered cost near the osseous tissue of implanting.Be important to note that less organizing typically is equal to and reduced failure mode, reduced the stock and simplified manufacturing and assembly.Though be not very preferably, can select to keep the metal assembly of implant system significantly and on each connection surface, joint of the artificial joint that the folded PEEK of PEEK connects, use PEEK.
The folded PEEK intervertebral implant of the PEEK of two joint connections is proposed in female case application by identical inventor.These implants are carried out dorsal column nucleus well and are resetted.Yet a lot of indications require the implant of this character also to comprise improved binding characteristic, especially in load-bearing is used.
For example, the radiolucent artificial disc device of need simplifying, it has remarkable wear-resisting characteristic and device is fixed to the vertebrae end plate or the characteristic of restraint device between vertebral body.Such a artificial disc will be useful especially for lumbar inter vertebral disc reduction, and it is more useful to reset for cervical intervertebral disk.The space that cervical intervertebral disk occupies is more much smaller than lumbar intervertebral disc.At least because of this reason, utilizing still less, the simplified design of parts is favourable.
In all cases, the articular surface that the joint connects preferably combines the folded PEEK joint of PEEK to connect, and the folded carbon of PEEK strengthens (CR) PEEK, or the folded CR PEEK of CR PEEK.The bone of these implants integrate can be from this paper other local ready bone conduction surfaces of describing or apply in benefit.
Preferably, radiolucent implant comprises one or more little radiation opaque labellings, and it will show to come the assisted surgery doctor in operation process, to arrange implant on the x-ray image.The preferable material of these labellings is tantalums.Typically, these labellings will be included in its peripheral precalculated position in the implant.Also can use coating, it shows accurately describing as implant device on image.
Also preferred (although not necessarily) be, the disclosed implant of this paper is included in bone conduction or bone induced surface or the coat on these implant surfaces, it contacts with assisting bone or tissue that implant is fixed on the precalculated position.Typically, this will apply or the bone of the bone of implant surface is integrated and taken place through having.The example of this type of coating is for example tricalcium phosphate or POROUS TITANIUM spraying of hydroxyapatite, calcium phosphate.
The intervertebral disc that the disclosed implant device of this paper is particularly suitable for all or part of natural vertebra intercalated disc resets.In addition, the disclosed fixed mechanism of this paper also is suitable for other spinal implants, and for example vertebral body resets, spinal bone shelf structure and other merge and promote implant, and other known movement protection implants.Device has the parts of minimal structure and preferably by radiolucent special material manufacturing basically, PEEK or carbon fiber PEEK in for example structure and the coupling part, the joint joint.
Usually; Various System and method for described herein allows implant (for example artificial disc) suitably to set size, implant and be fixed in the intervertebral space with dish; Said dish has support interface; Motion between its protection upper and lower vertebrae, dish is implanted and is fixed between the vertebrae of upper and lower.In every kind of form described herein; The test separator not only is used to estimate the feasible dish implant that can select appropriate size of intervertebral space size; Also be used for assisting at vertebrae and/or its end plate (after this being called " vertebral body ") producing characteristic, be used for fixing mechanism and in intervertebral space, keep and the holding tray implant.
In some forms, fixed mechanism is with relevant with the implant of inserting intervertebral space.After dish and fixed mechanism insertion intervertebral space, fixed mechanism can be deployed in the preformed parts the contiguous vertebral body from the dish implant.In a form, the insertion instrument is used for fixed mechanism and the preformed part bonding of intercentrum.In another form, fixed mechanism is directly activated the preformed part bonding with fixed mechanism and vertebral body.
In another form, fixed mechanism inserted intervertebral space through the test separator before insertion dish implant.In this form, fixed mechanism is directly activated and is deployed in the parts of the contiguous vertebral body with dish implant, inserts intervertebral space then.After this, fixed mechanism activated with this and engages implant and vertebral body so that implant is fixed in the intervertebral space.
Under any situation, using required limit levels for bone surgery will change.The disclosure has also been described various fixed mechanisms or has been suitable for the interchangeable examples of members of the restraint device in the precalculated position.Fixed mechanism has the structure that allows the implant dynamic fixing usually.Replace the deposition or the bone that rely on the bone around the implant component separately and inwardly grow, fixed mechanism active engagement bone with fast with reliably implant is fixed to vertebrae.In one embodiment, the rotatable shaft that will have at least one bone places on the implant with engaging of main body, is used for implant is fixed in the intervertebral space.At expanded position not, bone is with in engaging of main body places the implant main body.When axle rotated, bone was deployed into vertebrae and therefore implant is fixed to vertebrae to prevent moving of implant with engaging of main body.
In addition, when fixed mechanism rotates, can combine to give surgical design with tactile feedback according to fixed mechanism of the present invention.Because in operation process, the surgeon is difficult to visually confirm the position and its security feature of implant.The surgeon also will use his feel to feel from the tactile feedback of implant transmission and his instrument of process.In one embodiment; Fixed mechanism has cam face; Be used for interacting causing that fixed mechanism leans on implant biased with corresponding cam face, thereby the prevention to the fixed mechanism motion is provided, said fixed mechanism motion can be through surgical instrument perception.In this way, the surgeon can confirm easily when fixed mechanism fully stretches out or launch.The tactile feedback feature of fixed mechanism prevents that also the mistake of fixed mechanism from activating or owing to activate, that is, exceed predetermined range of movement and launch the fixed mechanism or the fixed mechanism of failing to launch fully.This situation can cause implant inappropriate fixing and cause spinal column peripheral region implant, spinal column, nerve, the damage of vascular system or its hetero-organization.
Another aspect of the present invention comprises fixed mechanism, and it is used to have the implant of anti-withdrawal or anti-reverse mechanism.Fixed mechanisms more according to the present invention for example launch or reach in the bone through rotating shaft through activating fixed mechanism.Yet As time goes on, owing to be applied to the power on the implant, fixed mechanism can be withdrawn or reverse and got back to its not expanded position.Therefore, in order to prevent this type of incident, fixed mechanism can have and prevents the device of withdrawing or reversing.In one embodiment, anti-reverse mechanism is arranged to the form of the respective cam surface on the cam implant on the fixed mechanism.When fixed mechanism was in complete expanded position, these cam faces were configured to be bonded with each other or interfere to prevent the fixed mechanism counter-rotating.
Description of drawings
In order to understand the present invention, will the present invention be described by way of example with reference to accompanying drawing, wherein:
Fig. 1 is the forward perspective view of spinal column, spinal column have place in the intervertebral space according to two implants of the present invention;
Fig. 2 is the preceding outer side perspective view according to implant of the present invention;
Fig. 3 is according to the present invention, has the perspective view of parts of the movement protection implant of recessed articular surface;
Fig. 4 is according to the present invention, has the perspective view of corresponding component of movement protection implant of the Fig. 3 on buttknuckle surface;
Fig. 5 is the preceding outer side perspective view of implant, implant have implant in the intervertebral space according to fixture of the present invention;
Fig. 6 is the preceding outer side perspective view of implant, and implant has according to fixture of the present invention;
Fig. 6 A is the preceding outer side perspective view of implant assembly, and the implant assembly has according to fixture of the present invention and the instrument of insertion docking facilities;
Fig. 7 is the side view of implant assembly, and the implant assembly has according to fixture of the present invention;
Fig. 8 is the preceding outer side perspective view of implant, implant have implant in the intervertebral space according to fixed mechanism of the present invention;
Fig. 9 is the surface-supported perspective view of implant assembly, and the implant assembly has according to fixed mechanism of the present invention;
Figure 10 is the perspective view of fixation kit, and fixation kit is the form according to extensible oar of the present invention or cam;
Figure 11 is the surface-supported perspective view of implant assembly, and the implant assembly has according to extensible fixed mechanism of the present invention;
Figure 12 is the preceding outer side perspective view of implant, implant have implant in the intervertebral space according to fixed mechanism of the present invention;
Figure 13 is the perspective view of implant, and implant has according to fixed mechanism of the present invention;
Figure 13 A is the perspective view of implant assembly, the implant assembly have the adjacent vertebral bone according to fixed mechanism of the present invention;
Figure 14 is the preceding outer side perspective view of two implants, two implants have implant in the intervertebral space according to fixed mechanism of the present invention;
Figure 15 is the preceding outer side perspective view of implant, and implant has according to fixed mechanism of the present invention;
Figure 16 is the preceding outer side perspective view of two implants, two implants have implant in the intervertebral space according to fixed mechanism of the present invention;
Figure 17 is the preceding outer side perspective view of two implants, two implants have implant in the intervertebral space according to fixed mechanism of the present invention;
Figure 18 is the preceding outer side perspective view of the implant of Figure 17;
Figure 19 is the preceding outer side perspective view of two implants, two implants have implant in the intervertebral space according to fixed mechanism of the present invention;
Figure 20 is the perspective view of the bottom implant member of Figure 19;
Figure 21 is the perspective view of securing member, and securing member is used in the fixed mechanism of Figure 20;
Figure 22 is the preceding outer side perspective view of two implants, two implants have implant in the intervertebral space according to fixed mechanism of the present invention;
Figure 23 is the preceding outer side perspective view of implant of Figure 22 of adjacent vertebral bone, and vertebrae has groove and the angled hole that is formed on wherein, is used for engaging with fixed mechanism;
Figure 24 is the perspective view of the implant of Figure 22;
Figure 25 is the preceding outer side perspective view of implant member, and the implant member has according to deflectable retainer of the present invention;
Figure 26 is the back outer side perspective view of vertebrae, and the recess that vertebrae has formation is used to engage the deflectable retainer of Figure 25;
Figure 27 is the preceding outer side perspective view of implant, implant have implant in the intervertebral space according to fixed mechanism of the present invention;
Figure 28 is the perspective view of the implant of Figure 27;
Figure 29 is the perspective view of implant member of the implant of Figure 27;
Figure 30 is the preceding outer side perspective view of vertebrae, and vertebrae has the recess of formation, is used for interacting with fixed mechanism;
Figure 31 is the preceding outer side perspective view of two implants, two implants have implant in the intervertebral space according to fixed mechanism of the present invention;
Figure 32 is the surface-supported perspective view of bottom implant member of the implant of Figure 31;
Figure 33 is the vertical view of vertebrae end plate, and the vertebrae end plate has the groove that is formed on wherein, is used for cooperating with the fixed mechanism of the implant of Figure 31;
Figure 34 is the perspective view according to implant assembly of the present invention, and the implant assembly has the restraint module that places on the articular surface;
Figure 35 is the perspective view of the restraint module of Figure 34;
Figure 36 is the perspective view of the corresponding implant assembly of implant assembly with Figure 34 of restraint recess;
Figure 37 implants intravertebral preceding outer side perspective view according to support member implant of the present invention;
Figure 38 is the side perspective view of the implant of Figure 37;
Figure 39 is the preceding outer side perspective view of implant member of the implant of Figure 37;
Figure 40 is the upward view of the implant member of Figure 39;
Figure 41 is the back outer side perspective view according to artificial disc implant of the present invention;
Figure 42 is the back outer side perspective view of the top artificial disc implant member of Figure 41;
Figure 43 is the back outer side perspective view of the bottom artificial disc implant member of Figure 41;
Figure 44 is the preceding outer side perspective view according to test barrier assembly of the present invention that inserts between two adjacent vertebral bones;
Figure 45 is the preceding outer side perspective view of the test barrier assembly of Figure 44, and the test barrier assembly has the upper ridge vertebra, and it is hidden for the graphic extension purpose;
Figure 46 is the preceding outer side perspective view of the test barrier assembly of Figure 44;
Figure 47 is the preceding outer side perspective view of intraware of the test separator of Figure 44;
Figure 48 is the preceding outer side perspective view of the assembly of Figure 47, comprises the extension fixture that places between the vertebrae;
Figure 49 is the back outer side perspective view of the test separator intraware of Figure 47;
Figure 50 is the perspective view of the closing device of test barrier assembly;
Figure 51 is the preceding outer side perspective view of the artificial disc implant of Figure 41, and the artificial disc implant has the implant insert;
Figure 52 is the preceding outer side perspective view of implant of Figure 41 that is written into the insert of Figure 51;
Figure 53 inserts the preceding outer side perspective view of the implant of Figure 41 of the insert that is written into Figure 51 of vicinity intervertebral space before;
Figure 54 is the implant of Figure 53 and the preceding outer side perspective view of insert, and the upper arm of insert is from implant deflection;
Figure 55 is a side view of implanting the implant of the Figure 41 in the intervertebral space;
Figure 56 is the preceding outer side perspective view according to test barrier assembly of the present invention;
Figure 57 is the back outer side perspective view of the test barrier assembly of Figure 56;
Figure 58 is the preceding outer side perspective view of test barrier assembly of removing Figure 56 of footstalk;
Figure 59 is the back outer side perspective view of the test barrier assembly of Figure 58;
Figure 60 is the preceding outer side perspective view of footstalk of the test barrier assembly of Figure 56;
Figure 61 is the back outer side perspective view of footstalk of the test barrier assembly of Figure 56;
Figure 62 is the preceding outer side perspective view of test barrier assembly that inserts Figure 56 of intervertebral space;
Figure 63 is the preceding outer side perspective view of test barrier assembly of Figure 56 of removing the insertion intervertebral space of handle portion;
Figure 64 is the preceding outer side perspective view according to drilling guide device of the present invention;
Figure 65 is the preceding outer side perspective view that is inserted in the drilling guide device of the Figure 64 on the test barrier assembly;
Figure 66 is the test separator of Figure 65 and the front view of drilling guide device;
Figure 67 is the preceding outer side perspective view that Figure 65 with awl tests separator and drilling guide device;
Figure 68 is after groove is holed, the preceding outer side perspective view of the test separator of Figure 67 that drilling guide device is removed;
Figure 69 is the preceding outer side perspective view of the test separator of Figure 68, and the cam cutter guide slides on axle and cam cutter before cam being cut vertebrae;
Figure 70 is the perspective view of the cam cutter of Figure 69;
Figure 71 is the preceding outer side perspective view of the intervertebral space after groove and cam are cut out by boring machine and cam cutter;
Figure 72 is the preceding outer side perspective view according to artificial disc implant of the present invention, comprises the fixed mechanism of the form of three camshafts with extensible cam lobe member;
Figure 73 is the preceding outer side perspective view of amplification of the artificial disc implant of Figure 72, has removed a camshaft, is used to show retaining member;
Figure 74 is a side view of implanting the implant of the Figure 72 in the intervertebral space;
Figure 75 is the preceding outer side perspective view of the implant of Figure 72, and cam member has the edge of sharpening, is used for when being deployed into vertebrae, cutting in the bone;
Figure 76 is the preceding outer side perspective view of the implant of Figure 75, and cam member is unfolded fully;
Figure 77 is the front perspective view according to test insulating element of the present invention that inserts intervertebral space;
Figure 78 is the preceding outer side perspective view of the test insulating element of Figure 77, and drilling guide device is inserted on the test separator, is used on vertebrae, getting out deviation groove and directly camshaft is installed to vertebrae;
Figure 79 is the preceding outer side perspective view of the test insulating element of Figure 77, and camshaft is inserted in the test separator, is used for before inserting implant, embedding vertebrae;
Figure 80 is the preceding outer side perspective view of the test separator of Figure 79, and camshaft embeds in the deviation groove of vertebrae;
Figure 81-84 has shown the sequence of the detail operations of camshaft with backsight point; The initial trial point of the test separator of camshaft from Figure 81; In Figure 82 and 83, cam is installed in the vertebrae, in Figure 84, embed in the vertebrae, make that the test separator can be removed and implant can be inserted;
Figure 85 is the preceding outer side perspective view according to artificial disc implant of the present invention, has hidden a camshaft, and wherein camshaft at first embedded vertebrae before implant is inserted;
Figure 86 is the front view of the artificial disc implant of Figure 85, and wherein camshaft revolves to turn 90 degrees implant is fixed with respect to vertebrae;
Figure 87 is the back outer side view of the test separator of Figure 79, and the camshaft actuated device drives and arrives the upper ridge vertebra on the camshaft, and it is hidden for purpose is shown;
Figure 88 is a test shielding system side perspective view, and the test shielding system comprises that test barrier assembly, drill set and test separator insert instrument;
Figure 89 is the back outer side perspective view of the test barrier assembly of Figure 88;
Figure 90 is the preceding outer side perspective view of the test barrier assembly of Figure 88;
Figure 91 is the amplification longitdinal cross-section diagram of the test barrier assembly of Figure 88, and the grasping mechanism that inserts instrument inserts wherein;
Figure 92 is the side perspective view of the insertion instrument of Figure 88;
Figure 93 is the decomposition view of the insertion instrument of Figure 88;
Figure 94 is the insertion instrument of Figure 88 and the longitdinal cross-section diagram of test barrier assembly;
Figure 95 is the preceding outer side perspective view according to artificial disc implant of the present invention, and fixed mechanism launches fully;
Figure 96 is the back outer side perspective view according to camshaft fixed mechanism of the present invention, shows cam face;
Figure 97 is the preceding outer side perspective view of the camshaft of Figure 96, and the camshaft that head is hidden places the test block of the fixed mechanism of imitation implant to be used to illustrate the operation of camshaft.The not expanded position, part expanded position and the complete expanded position that have from left to right shown camshaft;
Figure 98 is the back outer side perspective view according to camshaft fixed mechanism of the present invention, shows flat cam face;
Figure 99 is the preceding outer side perspective view of the camshaft of Figure 98, and the camshaft that head is hidden places the test block of the fixed mechanism of imitation implant to be used to illustrate the operation of camshaft.The not expanded position, part expanded position and the complete expanded position that have from left to right shown camshaft;
Figure 100 is the back outer side perspective view according to camshaft fixed mechanism of the present invention, shows the cam face of two chamferings;
Figure 101 is the preceding outside decomposition view of the artificial disc implant of Figure 95;
Figure 102 is the preceding outer side perspective view according to the alternative embodiment of camshaft fixed mechanism of the present invention;
Figure 103 is the side view according to the alternative embodiment of camshaft fixed mechanism of the present invention, shows cupped cam member;
Figure 104 is the side view according to the alternative embodiment of camshaft fixed mechanism of the present invention, shows the cam member of molding;
Figure 105 is the vertical view according to the alternative embodiment of camshaft fixed mechanism of the present invention, shows the cam member of molding;
Figure 106 is the preceding outer side perspective view according to the alternative embodiment of artificial disc implant of the present invention;
Figure 107 is the reverse preceding outside decomposition view of the artificial disc implant of Figure 95;
Figure 108 is the perspective view that inserts instrument and artificial disc implant according to implant of the present invention;
Figure 109 is the decomposition view that the implant of Figure 108 is inserted instrument;
Figure 110 is the enlarged perspective that implant and the implant of Figure 108 inserted instrument, for the upper disc member of the purpose instrument of graphic extension and upper case member by hiding;
Figure 111 A is the implant of Figure 108 and the enlarged perspective that implant is inserted instrument, shows the joint of the implant and the instrument of insertion;
Figure 111 B is the implant of Figure 108 and the enlarged perspective that implant is inserted the downside of instrument, shows the joint of the implant and the instrument of insertion;
Figure 112 A is the side view that the implant of Figure 108 is inserted instrument, shows the initial disengaging configuration of insertion instrument;
Figure 112 B is the enlarged side view of grasping mechanism of the insertion instrument of Figure 108, shows the position of the grasping mechanism of initial disengaging configuration;
Figure 113 A is the side view that the implant of Figure 108 is inserted instrument, shows the bonding station of insertion instrument;
Figure 113 B is the enlarged side view of grasping mechanism of the insertion instrument of Figure 108, shows the grasping mechanism of bonding station.
The specific embodiment
In a preferred embodiment, for example shown in Fig. 1-4, artificial disc device 001 comprises upper case 100 and lower case 110.Upper case 100 comprises the recess 120 of basic fovea superior, and lower case 110 comprises the protuberance 130 of basic epirelief.Though be not preferred, recess and protuberance interchangeable are so that upper case 100 comprises protuberance 130 alternatively.
Preferably, the bottom profile of artificial disc device 001 is similar to the bottom profile of end plate, but the trace of artificial disc device 001 is less to be assemblied in the intervertebral space usually.Preferably, the outline of end sheet surface 142 is in the profile of end plate 141.For example, if the end plate that the surgeon prepares is put down, preferably, end sheet surface 142 is also put down.Likewise, if the end plate of preparing 141 is recessed, preferably, end sheet surface 142 is similar convexs.It should be noted because install 001 between vertebrae, become cup-shaped, so recessed end plate 141 will keep artificial disc device 001 usually better.
Can need other constraint component to assist is held in a predetermined position artificial disc device 001.What the application described is various fixed mechanisms, coating or the surface preparation that can be used for retraining on the end sheet surface 142 implant.
Another embodiment that has shown the constraint of artificial disc device 001 illustrated among Fig. 5.In the present embodiment, the surgeon can be chosen in and form recess 002 in the leading edge of upper and lower vertebrae and hold constraint protruding 200.Constraint protruding 200 is preferably the wall that extends from end sheet surface 142 or antelabium and has suitable thickness and stops further motion of back.If recess 002 suitably forms a bag shape, constraint protruding 200 also will assist shell 100 or 110 to carry out unnecessary lateral movement.Replacedly, constraint is protruding can be positioned on the preceding bone surface of the vertebral body that does not have recess 002.Constraint protruding 200 can be included in one or two shell 100,110.
Based on the insertion of artificial disc device 001, when constraint protruding 200 was directed to the precalculated position, it was as the retainer of shell 100,110.Protruding 200 guarantee that also device can not be subsequently moves and causes damage to spinal cord.Preferably, recess 002 is identical with protruding 200 thickness basically, makes protruding 200 can flush basically with the front surface of vertebral body 144.
Shell 100,110 preferably includes accessories section 210, and it can be the form of convexity, hole, post, recess, ridge, flange or other structures, is used for that device is inserted or removed to implant and fixedly comes to assist implant to insert or remove intervertebral space.For example; In the described embodiment of Fig. 6 A, accessories section 210 comprises window 211 and connecting hole 212, and said window is used to insert or remove the head insertion of device; Said connecting hole is used for being occupied by extensible pin, and said pin is on each end of the window that is arranged in device 211.
As described before; Constriction 220 on the end sheet surface 142 can be the form of directed tooth 140; Thereby it has angle to be convenient to cross epiphysis plate 141 as sawtooth to insert like a cork, and is beneficial to anterior moving and the precalculated position that helps mould component 100,110 is remained between the intercentrum.The actual form of constriction 220, promptly directed tooth 140 or surface-coated can be confirmed on one or two shell 100,110 members.Constriction 220 can be included in the multi-form constraint on each shell 100,110.In addition, can on each constriction 220, use the constraint that surpasses a kind of form.For example, shell 100 can comprise constriction 220, and said constriction comprises having the for example directed tooth 140 of hydroxyapatite of bone conduction surface-coated.
Shell 100,110 can comprise the hole, its placement that is used for securing member for example bone screw after insertion, shell 100,110 is fixed to end plate 141.Preferably, securing member also by radiolucent material for example PEEK make, yet the surgeon can select to use by the biocompatibility metal securing member processed of titanium group or rustless steel for example.Preferably, during screw appearance profile beyond can reducing shell 100,110 periphery, these holes are counterbore.If it is protruding 200 that device is provided with constraint, this protruding front surface is the optimum position in these holes 520, and its mesopore 520 is preferably towards the center oriented of vertebral body.
In some forms, constraint protruding 200 can be left or right avertence move, shown in figure 16.In this mode, artificial disc device 001 can be used on the vertebrae height and position of a plurality of vicinities and does not interfere contiguous constraint protruding 200.Similarly, constraint convexity 200 can have such profile and hold proximity constraint protruding 200 with the recess 240 through convexity.And this orientation makes artificial disc device can be used in the vertebrae height and position of a plurality of vicinities and does not interfere contiguous constraint protruding 200.Figure 18 further shows this embodiment.
In other forms, constraint protruding 200 can not constitute one with shell 100,110.Instead,, then protruding 200 can be configured to platelet if protruding 200 be provided with the geometry of interlocking, be fixed to the front surface of vertebral body and just the extend past end plate to stop the sidesway with shell 100,110 that withdraws from of shell 100,110.In addition, but the withdrawing from of wide flexible net barrier disc device, said flexible net preferably by polymer for example PEEK process and be fixed to another vertebral body from the front surface of a vertebral body.
In optional embodiment, artificial disc device 001 shown in Figure 8 comprises constriction 220, and said constriction has the form of extensible oar 300.Oar 300 is contained in the mould component 100,110 shown in Figure 9.Oar 300 can be by a series of biocompatible materials manufacturings, and said biocompatible materials includes but not limited to for example for example titanium or stainless steel alloy of PEEK or metal of polymer, however preferably radiolucent material.Preferably, oar 300 is fixed on by oar constrainer 310 in the main body of shell 100,110, and said slurry constrainer is the form with spring fastenings (snapjoint) in this example.Oar comprises restraining arm 330, in case driving head 320 along with appropriate device rotation, said restraining arm is deployed in the end plate 141 of vertebrae 143.If necessary, restraining arm 330 comprises the edge of sharpening.The cervical region 340 of oar 300 keeps also preferably being constructed with the section that is suitable for rotating by oar constrainer 310.Restraining arm 330 can comprise that hole or slot are beneficial to bone and pass restraining arm 330 growths.
In another optional embodiment, for example shown in Figure 13, artificial disc device 001 comprises constriction 220, and it has from the form of the integrated fin 400 of end sheet surface 142 extensions.Fin 400 can change thickness and length as required to help position constraint artificial disc device 001 between predetermined vertebra.Fin 400 can comprise osteogenesis hole 410, groove or be beneficial to other structures that bone passes the fin growth, and provide thus installing other restriction.In addition, can on one or two shell 100,110, find restrictions 220.Alternatively, although implant is typically inserted with vertical mode, fin 400 can be directed on this equidirectional.For example, the fin 400 among Figure 13 A has shown the fin 400 of crossing over end sheet surface 142 horizontal expansions.In the present embodiment, about beam entrance 420 lateral dissection of also passing through end plate 141.Can not get into about beam entrance 420 from the neighboring of vertebral body.Therefore, the surgeon can select at first to shift or excessively stretch intervertebral space, for fin 400 excessive height making spaces in fin 400 can fall into about beam entrance 420 so that implant is fixed on the precalculated position.Fin 400 can be provided with the introducing part of inclination, and wherein this introducing part can be used for helping to shift vertebrae.
In optional embodiment, artificial disc device 001 shown in Figure 14 can comprise the constriction 220 of the form with fin 400, and wherein the hold bone securing member 510.Preferably, bone securing member 510 be with the form of bone screw and by radiolucent material for example PEEK make, yet the surgeon can select to use by the biocompatibility metal bone securing member 510 processed of titanium family or rustless steel for example.Preferably, in the time can reducing the screw appearance profile in shell 100, the 110 periphery outsides, fastener hole 520 is a counterbore.Fastener hole 520 can comprise that the securing member constrainer for example interferes spring to prevent that securing member 510 from withdrawing from.For example, fastener hole 520 can have groove as herein described and hold spring, in case said spring extends to beyond the path of securing member 510 and the head of securing member just covers the head of securing member through spring when driving securing member.
Figure 19-21 shows the other interchangeable embodiment of artificial disc device 001, comprises the constriction 220 of fin 400 forms, and wherein fin 400 comprises one or more deflectable wall parts 600.Fin 400 also comprise fastener hole 520 hold the expansion securing member 610.In a preferred form, expansion securing member 610 comprises thread spindle 630 and extended axis 640, and said thread spindle is the 520 driving securing members 610 along the hole when rotated, and said extended axis 640 is separated deflectable wall part 600 when driving forwards securing member 610.Hole 520 in this structure preferably includes screw thread 620 and thread spindle 630 complementations.When driving expansion securing member 610 and causing wall part 600 to the extrinsic deflection scheduled volume, these wall parts 600 will will coil device 001 and firmly remain on the appropriate location at about beam entrance 420 internal interferences.Deflection otch 650 is beneficial to wall part 600 about 660 deflections of securing member block.Deflection otch 650 can be directed on different directions, and wherein, for example wall part can be along vertical or along the horizontal plane lateral deflection.Because dish device 001 will be typically by the OP insertion of pro-basically, preferably, fin 400 is also directed from front to back usually.
The other optional embodiment of artificial disc device 001 is illustrated among Figure 22-24 and comprises the constriction 220 of fin 400 forms, and the fin 400 in the present embodiment preferably laterally is displaced to a side or opposite side.Fin 400 preferably includes interference portion 710, typically is screw thread or does not have the hole of screw thread or the form of recess.After the shell with this characteristic 100,110 is inserted in the precalculated position, comprise that the aligning apparatus (not shown) to the directed drilling guide device of implant can be used for producing the pilot hole 720 that passes vertebrae, it is directed in interference portion 710.The bone securing member 510 that preferably has the bone screw form is ordered about then gets into pilot hole 720, and interferes relation for 710 one-tenth with interference portion, will coil device 001 and be fixed on the precalculated position.Securing member 510 in the present embodiment is preferably threaded, its contact bone at said screw thread place, and can pass through fin 400 tappings, extend past fin 400, adjacent fin 400, or other interference techniques make it interfere fin 400 arbitrarily.In such embodiment, wherein securing member 510 has screw thread or joins in the deformable implant material, and (that is) by the implant of PEEK manufacturing, material self can prevent suitably that securing member 510 from withdrawing from.
In interchangeable embodiment, but the shell 100,110 shown in Figure 25 comprises the constriction 220 of deflection retainer 800 forms.But deflection retainer 800 preferably is attached to the end sheet surface 142 of contiguous shell 100,110 rear ends.On deflection orientation not and from this binding site, deflectable retainer 800 progressively extends forward and away from end sheet surface 142.When shell 100,110 inserted between the vertebrae, deflectable retainer 800 can be along with shown in figure 26 being deflected in the stop recess 810 by the complementary about beam entrance 420 of profile of surgeon's generation of shell process.In case shell 100,110 is positioned at its precalculated position, deflectable retainer 800 and 420 alignment of about beam entrance will be so that retainer 800 will bounce back into about beam entrance 420, and said about beam entrance 420 firmly remains on shell 100,110 on the position.
Similarly, in another optional embodiment, artificial disc device 001 mainly is illustrated among Figure 27-29, but said artificial disc device 001 comprises the constriction of deflection catcher 900 forms, preferably in the end sheet surface 142 that is attached to contiguous shell 100,110 rear ends.Interlocking pin 910 is arranged in preformed about beam entrance 420 shown in figure 30, said interlocking pin comprise bone protruding 930 with have with interlocking pin 910 complementary interlocking structures be connected siliqua (connection pod) 940.When shell 100,110 inserted vertebrae end plates 141, deflection arm 960 is connected siliquas 940 to be pushed open and is seated in the pod shape ditch 950 and deflection arm 960 can bounce back into siliqua 940 latched positions up to siliqua 940.Pod shape ditch 950 can comprise complementary structure, and for example tongue and groove arrange 920, siliqua 940 is fixed to shell 100,110.
Another optional embodiment is illustrated among Figure 31, and wherein artificial disc device 001 comprises that the constriction 220 of nonretractable fins 400 forms locks fin 1000 with inserting.About beam entrance 420 is molded in the vertebrae end plate 141, and is with the locations complementary of nonretractable fins 400 on the shell 100,110 and locking fin 1000, shown in figure 33.Along with locking fin 1000 is removed, shell 100,110 is inserted into the precalculated position between the end plate between vertebra.Locking fin 1000 preferably includes the frictional fit interlocking structure, and for example tongue and groove and shell 100,110 are fixed to shell 100,110 and limit it and withdraw from thereby will lock fin.Locking fin 1000 is directed in parallel to each other with nonretractable fins 400, so that in a single day insert locking fin 1000, corresponding shell is constrained to the desired location on the end plate 141.
The form that artificial disc device 001 can take unrestricted joint to connect, wherein, device 001 is not based upon on such characteristic the motion between the said feature limits articular surface 121 and 131.In some cases; If do not carry out this function through user dissection hard or that soft tissue carries out; This possibly have problem, because possibly can dislocate from other shells 100,110 by shell 100,110, and the possibility cause clogging; The not natural motion of in addition, installing many degree at 001 place can cause the injury to the user.Owing to these reasons, advantageously limit the motion that takes place between articular surface 121 and 131.
Artificial disc device can comprise the restraint part.In the embodiment of shell 110 shown in Figure 36, this restraint partly is with restraint retainer 1100 forms, and said retainer is the discontinuous protuberate of curvature with buttknuckle surface 131.Alternatively, retainer alternately is formed on the shell 100, or on two shells 100,110.When a shell leans on other shell joints to connect, retainer will limit the degree of freedom of generable motion.
The restraint part can be taked a lot of forms.For example, a shell 100,110 can comprise that stopper keeper 1120 holds restriction post 1130.Alternatively, restriction post 1130 can be attached to the articular surface of shell 100,110.Restriction post 1130 extends in the restriction recess 1110, and said restriction recess is preferably by limiting wall 1140 confines.When shell 100,110 is abutting against each other the connection of one-tenth joint, contingent motion between the interference restriction shell 100 and 110 between restriction post 1130 and the limiting wall 1140.Significantly, through regulating the shape and/or the size of restriction recess 1110, motion can be limited in different amounts in different directions.For example, it is crooked but have only 5 degree lateral bendings to be restricted to 10 degree in joint motion.
When all or part of vertebral body 144 for example is removed in the vertebral resection operation, configurable use artificial disc device 001.As visible in Figure 37 and 38, vertebral body 144 major parts are removed and replace vertebrae support member 1200.Support member 1200 comprises the combination in any of buttknuckle surface 131 and/or recessed articular surface 121.In addition, the main body of support member 1200 preferably includes bone securing member 510 (not shown) that fastener hole 520 is held the maintenance bone 1210 that is fixed to vertebrae 143, and said bone securing member is fixed on the precalculated position with vertebrae support member 1200.Complementary shell 100,110 is connected with 1200 one-tenth joints of vertebrae support member.The vertebrae support member also can comprise the hole, and it is used for bone inwardly growth or coating of other bone conduction or surface.
Figure 41 has shown the artificial disc implant 1310 with top assembly or member 1312 and lower component or member 1314; Wherein have support interface 1316 between the member 1312 and 1314, said support interface allows member 1312 and 1314 mutual translations or hinged when implant is implanted and is fixed on intervertebral space.Support interface 1316 can be the form of the inner surface that is formed on upper disc member 1312 (Figure 42) or the recessed recess 1318 in the lower surface 1320 and from the inner surface of lower disc member 1314 (Figure 43) or upper surface 1324 form to the protruding dome 1322 of upper process.Significantly, support interface 1316, specifically recessed recess 18 can be put upside down with the orientation of protruding dome 1322, make recess 18 be formed on the bottom implant member 1314, and dome 1322 is formed on the upper component 1312.Preferably, for slick slip joint between the two, recessed recess 1318 is identical with the radius of curvature of protruding dome 1322, but if necessary, different curvature radii also capable of using.
Preferably; Upper and lower dish member 1312 and 1314 is all formed by PEEK (polyethers ether cave) material; Said material has been found to be dish implant 1310 fabulous intensity and wear-resisting characteristic is provided, and this is desirable for the joint that is used for movement protection artificial disc implant for example described herein.
With reference to Figure 44, represented test barrier assembly 1326, said assembly comprises test isolated part 1328 forward, it inserts the intervertebral space 1330 between the contiguous upper and lower vertebral body 1332 and 1334.Test isolated part 1328 has basically the tongue shape structure, and it comprises rounded tip end 1336 and upper surface and lower surface 1338 and 1340 of putting down basically, as Figure 45 and 46 best shown in.Be inserted in the intervertebral space 1330 for smooth, the outer surface of test isolated part 1328 demonstrates the periphery of slick basically successive test isolated part 1328.This slick tongue structure of test isolated part 1328 correspond essentially to deduct bonded fixed mechanism the peripheral configuration of dish implant 1310, be described below.
Preceding test isolated part 1328 connects the rear portion 1342 that enlarges, and said rear portion is inserted fully in the intervertebral space at test isolated part 1328 and remained on intervertebral space 1330 outsides afterwards, and is shown in figure 44.Test isolated part 1328 has hollow with rear portion 1342, and its postmedian 1342 has the substantial rectangular box-like configuration usually.As shown in the figure, have horizontal shoulder surface 1343 between test isolated part 1328 and the rear portion 1342, it engages vertebral body 1332 and 1334 as retainer with the test isolated part 1328 that inserts intervertebral space 1330 fully.
The hollow space of tongue 1328 comprises a pair of plate 1344 and 1346, wherein upper board 1344 comprise some right cylinders 1348 and lower panel 1346 be included on the position corresponding to post 1348 some sagging post 1350, shown in Figure 47-49. Post 1348 and 1350 is used for forming the opening that correspondingly distributes on the surface of vertebral body 1332 and 1334.As shown in the figure, post 1348 and 1350 has blunt end face, but also can use other structures of these ends so that drive post 1348 and 1350 gets into bone surface simply.
With reference to Figure 47, upper board 1344 comprises uplifted side terrace part 1352, and each terrace part 1352 has along said terrace part 1352 uniform distribution and axial above that three posts 1348.Central authorities' ramp portion 1354 is recessed and to the extension that upwards turns forward of the front end 1382 of upper board 1344 from uplifted side part 1352 in its back-end.Intermediate vertical wall part 1356 extends along the both sides of ramp portion 1354 so that the ramp portion 1354 of upper board 1344 and 1352 interconnection of side terrace part.Lower panel 46 has with upper board 1344 similarly constructs, and it also has decline side terrace part 1358, and each terrace part 1358 comprises along said terrace part 1358 and evenly separating and three sagging above that posts 1350.Central authorities' ramp portion 1360 is extended between side sections 1358 and is risen to the back-end at it, and to the extension that turns forward downwards of the front end 1384 of lower panel 1346.Intermediate vertical wall part 1352 makes side terrace part 1358 and central ramp portion 1360 interconnection.
The surface 1364 and 1366 that plate 1344 and 1346 corresponding terrace parts 1352 and 1358 pass through their inclination cooperates formation wedge shape elongated openings or passage 1367 and 1369.More specifically, corresponding wall part 1356 and 1362 cooperates formation wedge shape wing passage 1367 and 1369 with the surface 1364 and 1366 that tilts, and it is used for ordering about plate 1344 and opened in 1346 minutes to produce dentation or bag shape opening vertebral body, as hereinafter described.
With reference to Figure 48, except upper and lower plate 1344 and 1346, the intraware of test barrier assembly 1326 comprises the extension fixture 1368 and the closing device 1370 of piece shape basically, and said device is represented with their compactness or the structure that inserts/remove.With reference to Figure 50, closed wedge device 1370 has upper and lower protruded arm 1372 and 1374, and it comprises inclined surface 1376 and 1378 respectively.Surface 1376 and 1378 cooperates formation V-arrangement opening 1380.In inserting structure, closing device 1370 makes the ramp portion 1354 and 1360 of plate 1344 and 1346 received fully by V-arrangement opening 1380, and wherein surface 1376 and 1378 is bonded on ramp portion 1354 and 1360 fully, shown in Figure 48 and 49.In this way, the mode that plate 1344 and 1346 engages with front end 1382 and 1384 separately keeps together, as Figure 49 best shown in.
Therefore; In order to order about plate 1344 and to open in 1346 minutes; Extension fixture 1368 moves with wedge device 1370 in the opposite direction; Wherein push ahead wedge device 1370 like this so that the surface 1392 and 1394 that tilts abuts against the inclined surface 1364 and 1366 of corresponding plate, thereby on the direction that makes progress, drive upper board 1344 and drive lower panel 1346 downwards towards vertebral body 1334 towards vertebral body 1332.The rear section 1386 of extension fixture 1368 has window 1396 and allows closing device 1370 to be assemblied in wherein; Make that when extension fixture 1368 advances wedge device 1370 ejecting plate 1344 that can contract also separates with permission plate 1344 and 1346 expansion through window 1396 with 1360 with 1346 ramp portion 1354.In addition, test isolated part 1328 has opening 1398 so that post 1348 and 1350 can be ordered about through wherein and get into the surface of vertebral body 1332 and 1334.Shown in figure 45, demonstrate opening 1398 in the top part of test isolated part 1328, upper post 1350 is ordered about through said opening.Similarly the hole is provided in the bottom part of testing isolated part 1328 to be used for lower post 1350.
Remove from intervertebral space 1330 in order to test isolated part 1328, test barrier assembly 1326 becomes it again and inserts/remove or the structure of compactness from its expansion or expanded configuration with 1346 through the plate 1344 that keeps together with closing device 1370.For this purpose, the operation of extension fixture 1368 and closing device 1370 push ahead through the window 1396 of extension fixture 1368 with closing device 1370 and extension fixture 1368 withdraw backward up to plate end 1382 and 1384 shown in figure 49ly be brought to, wherein the operation that is bonded on fully on ramped surfaces 1354 and 1360 again of the surface 1376 and 1378 of closing device 1370 is opposite.When test barrier assembly 1326 became its compact structure again, post 1348 and 1350 was retracted in the test isolated part 1328 at the corresponding opening 1398 of testing isolated part 1328 through them and also gets into wherein absolutely empty.
After test barrier assembly 1326 was used on the surface of vertebral body 1332 and 1334, forming opening or breach 1398 as stated, implant 1310 was inserted intervertebral space 1330 through insertion instrument 1400.Insertion instrument 1400 has slender axles 1402 and in the enlarged head 1404 of its end, insertion instrument 1400 carries the dish implant of inserting wherein 1310 in enlarged head 1404.Axle 1402 and head 1404 be respectively by top elongated tool component with shaft portion 1410 and 1,412 1406 and lower elongate tool component 1408, and in their the associated head part 1414 and 1416 formation of opposite end.Upper and lower tool component 1406 and 1408 can reciprocatingly slide relative to each other and will coil 1310 and remove from intervertebral space 1330, as will be below more fully as described in.
Shown in Figure 51, tool head 1404 has open front 1318 between the upper and lower plate portion 1420 and 1422 of separately upper and lower head part 1414 and 1416.Opening 1418 between the plate portion 1420 and 1422 is conditioned size to hold implant 1310 therein.To this, each plate portion 1420 and 1422 has the corresponding side channel 1424 and 1426 that is formed on wherein.Groove 1424 and 1426 allows fixed mechanism to be assembled to wherein; Said fixed mechanism is combining with upper disc member 1312 and from the right cylinder 1428 of upper disc member 1312 to upper process, and combines with lower disc member 1314 and from the form of lower disc member 1314 to the right cylinder 1430 of lower process.Groove 1424 and 1426 limits through the side fork, and said side fork extends along the both sides of each tool component head part 1414 and 1416.More specifically, top head part 1414 has side fork 1432 on the both sides of central protrusion 1434, and lower head part 1416 has side fork 1436 on the both sides of central protrusion 1438.Post 1428 forms two row; Every side at upper disc element 1312 has three even posts spaced apart 1428; Lower post 1430 forms two row similarly; Every side at lower disc member 1314 has three lower post that evenly separate 1430, makes post 1428 and 1430 corresponding to the post 1348 of plate 1344 and 1346 or 1350 interval and location, and their openings 1398 of in vertebral body 1332 and 1334, forming.
Shown in Figure 51, thereby implant 1310 is arranged and makes that the dish in their butt tool heads 1404 holds the rear end of opening 1418 to straight upper and lower end 1438 and 1440 towards the back.To this, thereby it is in the tail end that coils implant 1310 when upper and lower actuator end 1445 and 1447 is arranged forward in inserting tool head opening 1418.For making upper board 1420 and 1422 mate the structure of upper and lower dish member 1312 and 1314 basically, it is so far away that fork 1432 and 1436 does not extend to adjacent central projection 1434 and 1438 separately forward.In addition, side fork 1432 and 1436 has the actuating chamfering with the periphery edge of central protrusion separately 1434 and 1438 and distinguishes the end 1445 of matching disc member 1312 and 1314 and 1447 periphery edge.In this way; Be contained in fully in the tool head opening 1418 through the dish shown in Figure 52 1310, the projecting end 1445 and 1447 of dish implant 1310 demonstrates and the bonded smooth and continuous of the fork 1432 and 1436 and the corresponding neighboring edge of central protrusion 1434 and 1438 surface.
With reference to Figure 52, implant post 1428 and 1430 is received in the groove 1424 and 1426 separately.As shown in, the end of rearmost post 1428 butt grooves 1424, wherein dish member end 1439 and 1440 in upper and lower abuts against shouldered wall 1442 and 1444 joints, is contained in fully in the tool head opening 1418 with hour indicator implant 1310.Similarly, rearmost lower post 1430 is closed in the termination of lower channel 1426, and wherein upper and lower dish end 1439 and 1440 abuts against shouldered wall 1442 and 1444 joints, is contained in fully in the tool head opening 1418 with hour indicator implant 1310.As shown in the figure, it is such separating plate 1420 and 1422, is contained in groove 1424 and 1426 through post 1428 and 1430, and post 1428 and 1430 upper end flush with the top and the lower surface 1446 and 1448 of plate portion 1420 and 1422 respectively basically.In this way, dish implant 1310 utilizes insertion instrument 1400 to insert intervertebral space 1330 glossily.Also have, insert tool palette 1420 and 1422 and be spaced and vertebral body 1332 and 1334 transfers are separated and will coil implant 1310 and be assembled to wherein with this.In other words, the interval between each plate 1420 and 1422 the surface 1446 and 1448 is a bit larger tham the interval between the surface 1338 and 1340 of the test isolated part 1328 of testing barrier assembly 1326.This permission dish post 1428 and 1430 is assembled in the opening 1398.
More specifically, upper and lower tool component 1406 and 1408 preferably comprises respectively and extends laterally stopper element 1450 and 1452, and its groove 1424 and 1426 rear end separate backward a little.Push ahead instrument 1400 to be assembled in the intervertebral space 1330 with tool head 1404 with by the artificial disc 1310 of its carrying.Continue the instrument of pushing ahead 1404 up to retainer 1450 and 1452 butt vertebral bodys 1332 and 1334, be contained in fully in the intervertebral space 1330 with the artificial disc 1310 of pointing out user instrument head 1404 and its carrying.Engage against separately vertebral body 1332 and 1334 through retainer 1450 and 1452, post 1428 with 1430 be formed on each vertebral body 1332 and 1334 in bag shape opening 1398 of formation suitably align.
As previously mentioned; Tool component 1406 and 1408 can slide relative to each other and make that working as other members 1406 or 1408 remains on its progressive position; Simultaneously corresponding retainer 1450 or 1452 when corresponding vertebral body 1332 or 1334 engages, member 1406 and 1408 regractings.Shown in Figure 54, when bottom tool component 1408 remains on its retainer 1452 of its progressive position while against vertebral body 1334 joints, 1406 withdrawals of upper tool member.Withdraw from from intervertebral space 1330 through plate 1420, the vertebral body 1332 of transfer will be towards vertebral body 1334 downward translations, and the post 1428 that causes coiling upper component 1312 is accommodated in the corresponding preformed bag shape opening 1398 of vertebral body 1332.After this, lower tool member 1408 withdrawal makes post 1430 to fall into to be formed on the corresponding preformed bag shape opening 1398 on the vertebral body 1334 so that board member 1422 is pulled out from intervertebral space 1330, shown in Figure 55.Through post 1428 and 1430 is assembled to cave opening 1398; Dish implant 1310 is fixed in the intervertebral space 1330 between the vertebral body 1332 and 1334 of vertebral body 1332 and 1334, the risk that dish 1310 is extruded from intervertebral space 1330 since vertebral body 1332 and 1334 move relative to each other and reduce to minimum basically through the support interface 16 between the dish member 1312 and 1314 of fixed upper and lower.
In next one test separator and dish implantation and fixed system, adopted the test barrier assembly 1450 shown in Figure 56.Test barrier assembly 1450 also is used for being formed for holding vertebral body 1334 and 1336 characteristic (Figure 52) of the fixed mechanism relevant with artificial disc implant 1452.Dish implant 1452 only is the fixed mechanism that adopted with respect to the variation of dish implant 1310, and the common trait of therefore coiling between implant 1310 and 1452 will not be described in detail later.
Second assembly of test barrier assembly 1450 is head cover and handle component 1472.Member 1472 comprises head cover part 1474, and it comprises laterally the back flange portion 1474 that extends, and central lower fork 1476 and pair of upper fork 1478 extend forward from flange portion 1474.Footstalk part 1480 extends back and has a hollow via-hole 1482 from flange portion 1474, and said hollow via-hole extend past opening is to flange portion 1474, like Figure 60 and 61 visible.
Figure 62 has shown 1330 test isolated part 1454 of the intervertebral space that inserts between the contiguous vertebral body 1332 and 1334, thereby the size that is used to estimate intervertebral space 1330 can be selected the implantation artificial disc 1452 wherein of appropriate size exactly.Shown in Figure 62, test isolated part 1454 is contained in the intervertebral space 1330 fully, and retainer 1484 and 1486 engages against vertebral body 1332 and 1334, and shaft portion 1462 extends to beyond the intervertebral space 1330 laterally.After this, head cover and handle component 1472 skid off and remove from test insulating element 1458, and slotted test isolated part 1460 is stayed in the intervertebral space 1330, and wherein shaft portion 1462 extends back from that, shown in Figure 63.
To this, test insulating element 1458 is used for cooperating with drilling guide device 1488 and is used for drill flute on the surface of vertebral body 1332 and 1334.With reference to Figure 64, drilling guide device 1488 has triangle stop body 1490, and this main body has the pair of upper through hole 1492 of main body of extending through 1490, and between the upper side through hole 1492 with under erose expansion center through hole 1494.The size of the center through hole 1494 that enlarges makes drilling guide device 1488 to slide along test insulating element 1458, and shaft portion 1462 is assemblied in the top part of center through hole 1494, shown in Figure 65.Below with reference to Figure 66, visible be upper side through hole 1492 align with the upper slot 1468 and 1470 of test isolated part 1460 be mated guide drill bit 1496 (Figure 67) thus vertebral body 1332 cuts out groove on top.Similarly; Lower channel 1464 in the bottom of the center through hole 1494 of drilling guide device 1488 and the shaft portion 1462 cooperates with the formation opening with lower channel 1466 in the test isolated part 1460, and drill bit 1496 is directed through said opening that vertebral body 1334 cuts out groove in the bottom to be used for.Figure 68 has shown along the lower channel 1500 of the pair of upper groove 1498 of the both sides formation on the surface of vertebral body 1332 and the surface central authorities formation of vertebral body 1334 in the bottom; Wherein for the purpose of groove 1490 and 1500 is shown, drilling guide device 1488 shifts out from shaft portion 1462.
Below, cam cutter 1502 advances with the mode of similar drill bit 1496 and passes hole 1492 and 1494.Cam cutter 1502 has the cutting end 1504 of the radial deflection that reduces size, comprises the counterbore cutting tip 1508 at some cutting tip parts 1506 and its rear portion.Enlarging axle 1510 extends back from contiguous counterbore cutting tip 1508.The size of axle 1510 confirms that so said opening cooperates molding with test insulating element 1458, as preceding said about drill bit 1496 to be assembled in the opening that passes drilling guide device 1488.The cam cutter 1502 of Figure 70 has shown the bell structure and the counterbore cutting tip part 1508 of cutting tip part 1506.Cam cutter 1502 is operable in to cut out in groove 1498 and 1500 and radially enlarges recess 1512, and cuts out the counterbore part 1514 of expansion in the rear end of groove 1498 and 1500.Alternatively, drill 1496 can have terrace structure to form counterbore 1514 with groove 1498 and 1500 boring time.Similarly,, can avoid cam cutter 1502 fully, be described below if the fixed mechanism of artificial disc implant 1452 has the drag cam.
With reference to Figure 72; The fixed mechanism of dish implant 1452 is taked the form of top jaw axle 216 and lower cam axle 1520; Said top jaw axle 216 is fixed on upper disc implant member 1518 both sides, and lower cam axle 1520 central authorities are fixed to lower disc implant member 1522.In order camshaft 1516 and 1520 to be fixed to corresponding dish member 1518 and 1522, each has the open U-shaped limiting member 1524 of making progress of a plurality of intervals.Limiting member 1524 has upwardly extending arm 1526, and it is spaced from each other and makes the frictional fit of shaft portion 1528 through therebetween of camshaft 1516 and 1520 be received.To this; Thereby preferred PEEK material will provide the fastening frictional fit with resilient engagement shaft portion 1528 betwixt for arm 1526 provides enough intensity and elasticity; The dish member 1518 and 1522 that comprises limiting member 1524 is formed by said PEEK material, allows shaft portion rotation simultaneously and will coil member 1518 and 1522 and be fixed to corresponding vertebrae 1332 and 1334.
More specifically, each camshaft 1516 and 1522 comprises some cam lobe members 1530 of distributing along its intervals of lengths and from the nearest dish indicating element 1532 of driving head 1534.At first, camshaft 1516 and 1520 from shown in Figure 72 they direction to turn over 1480 degree directed, be used for artificial disc 1452 is inserted intervertebral spaces 1330, said camshaft 1516 and 1520 is accommodated in the corresponding groove 1498 and 1500 of vertebral body 1332 and 1334.To this, cam lobe 1530 is rotated down in the recessed groove 1536 on the upper surface that is formed on upper disc member 1518.Through the fixed-direction that its hexagon driving head 1534 is spent them with camshaft 1516 and 1520 from their direction of insertion rotation 1480, this makes cam lobe 1530 be moved in the recess 1512 of incision vertebral body groove 1498 and 1500, shown in Figure 74.In this way, artificial disc implant 1452 is fixed in the intervertebral space 1330 and prevents producing upper and lower dish member 1518 and 1522 be in the process that the joint is connected and therefrom extruded via being formed on the arch support Interface Moving between member 1518 and 1522 along with upper and lower vertebrae 1332 and 1334.The size of dish indicating element 1532 makes in its counterbore part 1514 that is accommodated in groove 1498 and 1500.Dish member 1532 can have a pair of radially relative otch 1538 around its periphery; Said otch matches with the raised nubs 1540 of dish on the member 1518; To the user tactile cue to be provided, said tactile cue representes that camshaft 1516 and 1520 comes translating cam salient angle 1530 to make them be contained in fully the geosynclinal concave portion 1512 basically from their direction of insertion rotation 1480 degree.
Figure 75 and 76 has shown interchangeable top jaw axle 1542 and interchangeable lower cam axle 1544.In this form, cam member 1546 has more flat mushroom structure, and this structure has sharp-pointed angular edge 1548 to be used to cut vertebral body 1332 and 1334.In this way, need not use independent cam cutter 1502 to cut out recess 1512 at vertebral body groove 1498 and 1500.Also have, can find that driving head 1534 can have the hexagon driving structure that cross drives recess 1550 rather than driving head 1534.
Next test is isolated and artificial disc is implanted and fixed system is similar to system before; Except fixed mechanism is not related with artificial disc when it inserts intervertebral space 1330, also after this therefrom launch in the preformed parts on vertebral body 1332 and 1334 with vertebral body and artificial disc implant 1552 are interconnected (Figure 85) but at first insert to be formed on.With reference to Figure 77, the lower central groove 1558 that shown test insulating element 1554 has the upper lateral part groove 1556 in its fore head part 1557 and in its hind axle part 1560 and fore head part 1557, extends.The cover and the handle component of not shown test insulating element 1554 for the diagram purpose; Cover and the handle component described before but being similar to, it is configured to guarantee to comprise that the test isolated part of the front of slotted head part 1557 can smooth insertion intervertebral space 1330 rather than dig into vertebral body 1332 and 1334.
Shown in Figure 78, shaft component 1560 holds drilling guide device 1562 therein, and said drilling guide device 1562 has through hole 1563, and said through hole departs from the corresponding groove 1556 and 1558 of testing insulating element 1554 a little.Therefore, drill bit 1565 is directed through via hole 1563 groove 1569 being pierced in the vertebral body 1332, and said groove is from the upwards skew a little of upper slot 1556 of test insulating element; And groove 1569 pierced in the vertebral body 1334, said vertebral body 1334 is from lower channel 1558 skew a little downwards of test insulating element 1554.
Below; Camshaft 1567 is inserted in the intervertebral space 1330 through the groove 1556 and 1558 guiding of test insulating element 1554; They are rotated then; Upwards pushed up in the deviation groove 1569 that is formed on top vertebral body 1332, pushed up downwards in the deviation groove 1569 that is formed on bottom vertebral body 1334, shown in Figure 79 and 80.In Figure 81-84, shown the butt action of camshaft 1567.
In Figure 81, at its initial position, camshaft 1567 is still in the groove 1556 of test insulating element 1554 from the camshaft shown in the backsight point 1567.The head of camshaft engages through the driven tool 1570 with eccentric cam 1573 (Figure 87), is used for the preceding platform or the platform 1555 (Figure 77 and 79) of butt test insulating element 1554.Camshaft 1567 is at their axle head far away 1568 butts, shown in Figure 81-85 and 87, and abuts against at the near-end that they and driven tool 1570 are had a common boundary.In Figure 82, driven tool 1570 turn 90 degrees along platform 1555 dextrorotations of preceding test insulating element 1554.This causes camshaft 1567 to revolve turning 90 degrees and cam lobe 1572 begins to engage and himself is embedded the upper ridge vertebra.In Figure 83, shown in the abundant Rotate 180 degree in the home position of camshaft 1567 from its Figure 81.In this, cam lobe 1572 embeds in the vertebrae, and goes up owing to the frictional engagement between cam lobe 1572 and the bone is held in position.Finally, driver 1570 can be removed, shown in Figure 84.In case camshaft 1567 abundant Rotate 180 degree, cam lobe 1572 are fully removed from the main body of test insulating element 1554.Therefore, test separator 1554 can be removed.
As Figure 84 rotating cam axle 1567 make its sharp-pointed cam lobe 1572 through the stock removal action that in this rotary course, produces by cam upwards (or downwards) screw in vertebral body, dish implant 1552 is inserted intervertebral space 1330 then.Shown in Figure 85; Upper disc member 1564 surface at an upper portion thereof has spiral and cuts out portion 1566; Make rotating cam axle 1562 cause cam lobe 1572 to be bonded in two grooves of vertebral body 1332 and 1334 once more; And closely engage or embed and define the salient rib 1571 that spiral cuts out portion 1566, make implant 1552 in its articulated procedures, firmly keep and be retained in the intervertebral space 1330.
In another form, the test shielding system 1600 shown in Figure 88 is used to regulate size and prepares implant implantation point.Test shielding system 1600 comprises test barrier assembly 1750, drill set 1900 and insertion instrument 1902.In Figure 56 the disclosed embodiments, test barrier assembly 1750 is used for being formed for holding vertebral body 1330,1332 characteristic of the fixed mechanism that is associated with artificial disc implant 1752.Main difference between the test barrier assembly 1450 of Figure 56 and the current test barrier assembly 1750 is that current assembly has been removed shaft portion 1462 and drilling guide device 1488 and test isolated part 1454 are combined.Be different from other characteristics of embodiment before of test barrier assembly 1450, comprise insertion instrument 1902, be described below.
The drill guide of test barrier assembly 1750 is divided 1788 similar with the drilling guide device 1488 of Figure 64 except several obvious characteristics.For example, current drill guide divides 1788 with lower through-hole 1794 alternative irregular shape through holes 1494, and the diameter of said lower through-hole 1794 is similar to top through hole 1792, shown in Figure 90.Shown in Figure 91, lower through-hole 1794 has annular recessed portion 1910, and the grasping mechanism 1912 that is used to hold insertion instrument 1902 firmly is attached to test barrier assembly 1750 with permission instrument 1902.Referring now to Figure 90, drill guide divides 1788 to have surface, back 1914, and each through hole 1792,1794 terminates in surface, said back.Be one group of three recess 1916,1918 on the face 1914 of adjacent lower through hole 1794, be used to provide three positions, insertion instrument 1902 can be at said engagement position test barrier assembly 1750.The size of each recess 1916,1918 is set for the single corresponding pilot pin 1920 of tube on 1922 of insertion instrument 1902 and is complementary.When the pin 1920 of middle recess 1916 through insertion instrument 1902 engages (shown in Figure 91), test barrier assembly 1750 remains on intermediate angle, and the vertical axis of assembly (with " V " expression) is parallel with the vertical axis of insertion instrument 1902.Two to the either side of medial concavity 1916 keep recesses 1918 to allow users to catch test barrier assembly 1750 about vertical axis 45 or-45 degree.This allows the surgeon at a plurality of position maneuvering test separators 1750, and has given instrument 1902 greater flexibility.Therefore, instrument 1902 has a plurality of relative positions between tool barrel 1922 and test barrier assembly 1750.Drill guide divides 1788 also to limit side holes 1924, in case insert in the patient body, said side holes provided reference point to help positioning component 1750 for the doctor when orthopaedic surgical operations doctor utilized fluoroscopy to watch test separator 1750.Use hole 1924 to be because test barrier assembly 1750 is preferably processed by rustless steel or titanium.
Referring now to Figure 88, each drill bit 1930,1932,1934 front end at axle 1928 of device 1900 have identical cutting surface 1806,1808.Preceding cutting tip 1806 comprises cutting surface at the tip of drill bit 1796, and elongated slot 1498 is cut in its front portion that is suitable for the fixed mechanism of implant 1752 in vertebrae 1332,1334.Rear end at first cutting tip 1806 begins counterbore cutting tip 1808, is used for producing the gap that counterbore provides the head of fixed mechanism at vertebrae.
Each drill bit 1796 has the axle collar 1926, is used to provide abutment surface to limit the distance that drill bit 1796 can insert test barrier assembly 1750.The axle collar 1926 be the enlargement steps down of drill bit shaft 1928 and when drill bit 1796 fully inserts in abutting connection with the back 1914 of test barrier assembly 1750.This prevents that the unconscious ground auger of surgeon is too far away and damages surrounding tissue, bone, nerve and other live bodies zone.
Shown in Figure 88, boring machine device 1900 comprises three drill 1930,1932,1934, and it has the axle 1928 of different length.Each length difference of 1928 makes drill bit 1930-34 can stay in the boring guiding 1788 and uses from being short to most Changshun preface, and do not interfere awl.First and the shortest drill bit 1930 are used for producing first groove 1798 at upper ridge vertebra 1332; Second and intermediary drill bit 1932 produce 1798, the three of second grooves and the longest drill bit 1934 at upper ridge vertebra 1332, and vertebrae 1334 produces grooves 1800 in the bottom.Like this, first and second drill bits 1930,1932 need not removed from test barrier assembly 1750 before the 3rd drill 1934 is inserted.In case first and second drill bits have cut out groove 1798 in upper ridge vertebra 1332, during their keep in position with in the new groove 1798 that forms as Position Keeper.In this way, drill 1900 helps test and isolates 1750 and be fixed on the appropriate location to prevent when cut out other grooves and when insertion instrument 1902 quilts are removed, to test barrier assembly 1750 and move about vertebrae 1332,1334.Advantageously, do not need other fixtures (for example bone screw) will test separator 1750 and be fixed to vertebrae 1332,1334.
Referring now to Figure 92, test is isolated insert 1902 and is comprised promptly assembly 1912, and it is connected to handle 1936 through tube 1922 and with the actuator of trigger 1938 forms.Shown in Figure 93 and 94; Preferably by polymer; For example
handle 1936 of processing has the part hollow; It comprises annular recessed portion 1940, is used for receiving to extending below Handle axis 1942, and said Handle axis 1942 has threaded recess 1944 in the bottom.Securing member 1946 is through being attached to the threaded end 1944 of being threaded io of securing member 1946 to the Handle axis that extends below 1942 with handle 1936.Handle axis 1942 is soldered or other modes are attached to the yoke shell 1948 of insert 1902.Trigger 1938 is attached to the elongated trigger link rod 1950 of the link rod lower end with two pins 1952.Trigger link rod 1950 parts place within the inside of handle 1936 and about swivel pin 1954 and pivot, and said swivel pin 1954 is outstanding to be passed trigger link rod 1950 and be accommodated in the handle 1936.Hold at an upper portion thereof, trigger link rod 1950 has the head of actuating part 1956, is used to activate grasping mechanism 1912.
Particularly, the head part 1956 direct joint yokes 1958 of trigger link rod 1950 move it and activate grasping mechanism in yoke shell 1948.Yoke 1958 is for having the cylinder in hole 1960, and head part 1956 and this yoke that said hole 1960 is used to receive trigger link rod 1950 are directly advanced thus.Yoke 1958 is attached to push rod 1962 in the rear section of the front end of yoke.Place spring 1964 between the inside end wall of yoke 1958 and yoke shell 1948 that the bias voltage resistance to trigger 1938 is provided when yoke is activated by trigger link rod 1950.
Solid cylinder end cap 1978 in the rear end of instrument 1902 connects yoke shells 1948, thereby contact surface is provided so that striking in test barrier assembly 1750 insertion process for the surgeon.
In operation, grasping mechanism 1912 inserts the lower through-hole 1794 of test barrier assemblies 1750, is pressed into trigger 1938 and promotes the flexible small pieces 1970 that plunger 1966 engages grasping mechanism 1912 forward.In case the insert end inserts test barrier assembly 1750 fully, trigger 1938 is released, and causes plunger 1966 to be pulled and to make flexible small pieces radially outward to tilt.Flexible small pieces 1970 are forced to the inner surface of lower through-hole 1794 and promptly engage, and pilot pin 1920 engages drill guide and divides a recess 1916,1918 in 1788 the back 1914 to provide other stable and control.Test separator 1750 inserts intervertebral space 1330 then.If 1750 is suitable size at interval, so the surgeon will prepare vertebrae 1332,1334 for implant 1752.When continuing to test barrier assembly 1750 and testing isolation insert 1902 to remain on the position, first drill bit 1930 is fixed to awl, inserts the top through hole 1792 of a test barrier assembly 1750 then.First groove 1798 is holed.When drill 1930 was still fully in test barrier assembly 1750, drill 1930 was released and stays on the appropriate location from boring machine.Below, second neutral drill 1932 be attached to awl then second upper slot 1798 holed.And second drill 1932 is stayed on the appropriate location.Insert 1902 is removed from test barrier assembly 1750 then.This engages grasping mechanism 1912 through pulls trigger 1938 and insert 1902 is pulled out away and realizes.Insertion instrument 1902 is removed then and lower channel 1800 uses the 3rd to be holed with long drill bit 1934 quilts.In case all grooves are holed, all three drill bit 1930-34 manually remove.In a preferred embodiment, the cam cutting step of describing among Figure 69-71 is omitted, because artificial disc implant 1752 has aforesaid drag cam 1846.So in order to shift out test barrier assembly 1750, insertion instrument 1902 inserts lower through-hole 1794 again, trigger 1938 is released promptly tests barrier assembly 1750, and assembly 1750 uses insertion instrument 1902 outwards to extract.So between the stage of preparation that inserts implant 1752, preferably wash surgery location.
The artificial disc implant 1752 of present embodiment is only changing aspect the minority than the artificial disc implant shown in Figure 72-76.For example, present embodiment has different dish indicating element 232 forms., fixed mechanism the tactile feedback about the position of fixed mechanism is provided when launching among the embodiment of back for the surgeon.Because bone is softer relatively than the projection that is expanded to bone, bone is hardly to the outstanding resistance that provides when they are deployed into bone.Therefore, importantly for the surgeon provides tactile feedback, make him can not cross or owe to launch to give prominence to and cause implant 1752 to be attached to bone irrelevantly.In addition, importantly the barrier structure of just withdrawing is provided for fixed mechanism.Because vertebrae only provides limited resistance to extensible projection, so As time goes on projection can be easy to withdraw, reverse or begin to return their former beginning and end expanded position.Therefore, on dish implant 1752, provide the withdrawal barrier structure to avoid this situation.
Fixed mechanism can adopt a lot of forms.In an embodiment according to Figure 96, fixed mechanism is taked the form of camshaft 1816.Camshaft 1816 has the cam projection 1979 of radially extending, and it comprises that tactile feedback produces the surface, and it is the form with the wedge cams surface 1980 that is close to driving head 1834.When camshaft 1816 rotates to the part expanded position from its not unfolded initial position (Figure 97 left side); Then to when the complete expanded position of its original position 180 degree; The corresponding cam face 1982 of cam face 1980 frictional engagement; Said cam face place on the proximity restriction member 1824 shown in Figure 97 (the test block, hidden the head 1834 of camshaft 1816 for purpose is shown). Cam face 1980 and 1982 tilts with respect to the longitudinal axis 1981, makes that camshaft 1816 is forwards to axial translation (installing in spinal column) when the mutual butt of cam face 1980,1982.
In case whole 180 degree of camshaft 1816 rotations, owing to the biasing force that is applied to camshaft 1816 through the limiting member 1824 of bending, the cam face 1980 of camshaft is snapped to the recess 1984 that is formed in the proximity restriction member 1824.Recess 1984 forms the counter-rotating that makes cam face 1980 be absorbed in the recess 1984 and stop camshaft 1816 with cam surface of camshaft 1980.More specifically, cam projection 1979 has straight trailing edge surface 1983, and it turns to the straight edge surface 1985 of recess 1984.In case trailing edge surface 1983 inswept recess surface 1985, cam face 1980 will pass through corresponding cam face 1982, make cam face 1980 and 1982 break away from each other.This butt that has removed them engages the axial bias power that is produced, and makes cam projection 1979 axially return or bounce back into recess 1984.On this orientation, straight edge surface is each other in the face of making cam projection 1979 not go out recess 1984 to travelling backwards.
Referring now to Figure 98 and 99, an embodiment of disclosed fixed mechanism provides tactile feedback for the surgeon and prevents the withdrawal of fixed mechanism.Camshaft 1816 has the flat cam face 1986 of contiguous driving head 1834.Shown in Figure 99 (configuration of test block is similar to Figure 97), flat cam face 1986 frictional engagement are formed on the corresponding cam face 1988 on the contiguous limiting member 1824.Cam face 1986,1988 class of operation are similar to wedge cams surface 1980 and corresponding cam face 1982, except them substantially perpendicularly bias voltage camshaft 1816 rather than axially bias voltage camshaft 1816.When camshaft 1816 rotates to complete expanded position when (leave and launch original position 180 degree) from its original position, the corresponding cam face 1988 of the flat cam face 1986 joint limiting members 1824 of camshaft 1816.This actuating cam axle 1816 that makes progress basically is away from limiting member 1824; Said limiting member extends upward arm 1826 bias voltage camshafts 1816 against retaining member 1824, is that the surgeon provides tactile feedback with the rotational resistance that increases camshaft 1816 up to the form that axle almost rotates whole 180 degree.Resistance dissipates when cam face begins to break away from each other fast.In fact, the distortion of retaining member 1824 can help to order about camshaft to complete expanded position.This of resistance orders about and dissipates forms other tactile feedback, and it changes in the fixed mechanism expansion process and notifies surgeon's cam member 1846 to launch fully.In case whole 180 degree of camshaft 1816 rotations, because the biasing force of the perpendicular that crooked limiting member 1824 is applied, flat cam face 1986 is snapped to the recess 1990 that is formed on proximity restriction member 1824.Recess 1990 forms with cam surface of camshaft 1986 like this, makes cam face 1986 be absorbed in the recess 1990 and prevents the counter-rotating of camshaft 1816.
More specifically, cam projection 1987 has straight trailing edge surface 1989, and it turns to the straight edge surface 1991 of recess 1990.In case trailing edge surface 1989 inswept recess surface 1991, cam face 1986 will pass through corresponding cam face 1988, make cam face 1986 and 1988 break away from each other.The vertical bias power that this has removed their cam engagement makes cam projection 1987 axially advance to or spring into recess 1990 downwards.On this orientation, straight edge surface 1989,1991 shifts out recess 1990 in the face of making cam projection 1987 not retreat each other.
In another form, shown in Figure 100 and 101, camshaft 1816 has two chamfering cam faces 1992, and it is used to the counter-rotating that the surgeon provides tactile feedback and prevents camshaft 1816.In the present embodiment, in the expansion process of cam lobe 1846, be used to provide the chamfer surface 1994 of resisting feedback to be set at a side of cam face 1992, when camshaft 1816 rotated in a clockwise direction, said chamfer surface 1994 was engaged.Another chamfer surface 1996 is set at the opposite side of cam face 1992, and being used for provides the opposing feedback in the withdrawal process of cam lobe 1846, and when camshaft 1816 rotated in a counter-clockwise direction, said chamfer surface 1996 was engaged.The embodiment of the top direct discussion of picture, cam face 1992 engages the cam face 1998 that is formed on the corresponding basic fovea superior on the contiguous limiting member 1824.Corresponding cam face 1998 forms like this, makes the chamfering cam face 1992 of contiguous driving head engage corresponding cam face 1998, and it is biased and provide sense of touch or opposing to feed back as stated to cause camshaft 1816 to abut against limiting member 1824.Unlike the foregoing description, cam 1816 can be through in the counterclockwise direction with camshaft 1816 back Rotate 180 degree and manual refraction.This orthopaedic surgical operations doctor is desirable when wanting to regulate implant 1752 or further preparing the implantation point.Prevent the rotation on excessively rotation and the opposite way round through protruding the opposite side of staying corresponding cam face 1998 in surface 2000, thereby rotating cam axle 1816 almost is impossible on the opposite way round owing to the interference between cam face on the cam 1,816 1992 and the protrusion surface 2000 causes.
Camshaft 1816, cam member, salient angle or fin 1846 can be taked different geometric shape and the directed performance of improving fixed mechanism.For example, the cam fin can comprise sawtooth 2002, and shown in Figure 102, divot (divot) or recess 2002 promote bone inwardly to grow.When cam 1816 rotations, sawtooth 2002 also can help to cut bone.In addition, cam fin 1846 can be cupped or inclination, shown in Figure 103, is fixed to vertebrae 1332,1334 with further promotion implant 1752.In a preferred embodiment, cam fin 1846 is the cupping of about 8 degree.And shown in Figure 104 and 105, cam fin 1846 can have such lateral profile, makes shape or the size of cam fin 1846 change from the end to end of camshaft 1816.Profile can mate the profile of end plate, to utilize the cartilage in vertebrae 1332,1334 central authorities relative with the hard compact bone of vertebrae 1332,1334 peripheries.And camshaft 1816 can have the cam member 1846 of any amount.In a preferred embodiment, each camshaft 1816 has three to five cam members 1846.Each camshaft 1816 of bigger implant can have five members 1846, and littler implant can only have three.Camshaft 1816 is preferably processed by titanium or rustless steel, and can apply with bone growth promoting substance, for example hydroxyapatite, tricalcium phosphate or calcium phosphate.
The cam member 1846 of self being cut or embeds bone provides the advantage that is superior to other fixed mechanisms.For example, using static projection for example to sting fixed mechanism with rib can rely on the bone apposition around the fixed mechanism to fix implant.Stationary mechanism is not ideal, begins deposition around fixed mechanism because they can not suitably be fixed to implant in the bone up to bone.Therefore, implant can be tending towards mobile before bone apposition.Yet the dynamic fixing mechanism that is similar to cam member 1846 utilizes cutting surface 1848 that self is initiatively cut or embeds in the bone, replaces to rely on bone apposition.In this way, dynamic fixing mechanism produces more reliable and stable implant 1752 and vertebrae 1332, the connection between 1334.These benefits are converted into more strong and reliable implant 1752, and it means faster recovery time and increases patient mobility.
In another form, the camshaft 1816 of upper disc implant member 1818 can be assembled or the walk-off angle setting, shown in Figure 106.This orientation not only prevent implant 1752 pro-/rear to, but also prevent moving on the side direction basically.Naturally, lower disc implant member 1822 can be used this structure.
It should be noted that camshaft 1816 provides and has been superior to the for example certain benefits of screw of other fixed mechanisms.For example, screw does not provide significant tactile feedback.The surgeon is difficult to confirm how far screw has been revolved, so he possibly cross or underwinding changes screw, has increased the risk that implant moves and lost efficacy.In addition, if the metal screw is crossed the fastening implant of damaging.If implant by soft relatively material for example PEEK process, if the metal screw will easily peel off and cross and fasteningly will damage implant.And the surgeon is fastening excessively probably to be contained in the screw in the polymer, because screw is hard more a lot of than polymer, he can not feel when screw has been crossed when fastening.In order to alleviate this problem, implant 1752 can be processed by the metal section and part conjugated polymer that holds screw, but this has increased the difficulty aspect manufacturing implant 1752 greatly, has also increased cost, so be not desirable.In addition, the excessive rotation of screw can make screw advance above its predetermined range of movement, and can cause its from implant the outstanding and spinal column with spinal column around the damage in live body zone.Because cam does not advance when they rotate or withdraws, will there be cam 1846 all of a sudden to charge into the danger in other live body zones.
Figure 108-113B has shown according to insertion instrument 2008 of the present invention.Insertion instrument 2008 is made up of handle portion 2016, actuator and grasping mechanism 2020 basically.Particularly, handle portion 2016 is attached to Handle axis 2022.Handle axis 2022 has the annular aperture 2024 of wearing it and crossing, and is used for surrounding slidably push rod 2026.Actuator is the form with cam lever 2018 of relative cam face; Said actuator is attached to Handle axis 2022 and push rod 2026, wherein sells connector 2030 and between cam face 2028, extends and pass the opening opposing 2032 of Handle axis 2022 and the hole 2034 in the push rod 2026.Handle axis 2022 is attached to upper and lower casing component 2036,2038 at its front end, and said upper and lower casing component surrounds grasping mechanism 2020.Rear spring 2040 is around push rod 2026 and biased between the lasso 2042 of Handle axis 2022 and fork keeper 2044.Fork keeper 2044 is for having the rectangular block (seeing Figure 110) of four L shaped recesses 2046, two on upper surface, two on lower surface, be used to catch the L shaped stiff end 2048 of four forks 2050,2052.Fork keeper 2044 has cylindrical hole 2054, extends between its pro-and the surface, back, is used to allow push rod 2026 to pass wherein.The end extend past front spring 2056 of push rod 2026, it is hunted down between fork keeper 2044 and compression stop 2058, and is attached to the end of push rod 2026.Compression stop 2058 is the rectangle link stopper, and it has the hole that is used to be attached to push rod 2026 in the back.In addition; Block 2058 has the hole 2060 of pair of vertical alignment; It extends laterally the sidewall that passes block 2058, is used to keep two pins 2062 can operate through temporarily making two fork 2050,2052 distortion between the pin activate fork 2050,2052 and gets into disengaging configuration.
Grasping mechanism 2020 comprises two tops and two lower flexible fork 2050,2052, and itself and upper and lower small pieces 2064,2066 serial operations are used for promptly also holding tray implant 1752 (shown in Figure 111 A-B).Fork 2050,2052 is processed by the thin shaft-like thing of rectangle rustless steel with a series of knees 2068,2072.Upper tine 2050 is extended and is had consecutive two knees 2068 that are inclined upwardly along the longitudinal axis of insertion instrument 2008 basically, makes the implant of fork 2050 promptly hold 2070 vertically to be higher than the anchored end that places fork keeper 2044.Lower tine 2052 is shaped in a similar fashion, except they have consecutive two downward-sloping knees 2072, makes the implant of fork 2052 promptly hold 2070 vertically to be lower than the anchored end that places fork keeper 2044.Upper and lower fork 2050,2052 in pairs contiguous each other and with along other of the outer ledge of shell to relatively, make axle 2026 and compression stop 2058 can be at one group of fork 2050, move between 2052.Upper and lower casing component 2036,2038 has the guiding surface 2074 of the inner surface of being formed on, and is used for guiding and fixation fork 2050,2052, thereby preventing that them from becoming does not line up.Fork 2050,2052 promptly hold 2070 to have L shapedly, be used for the recess 2012 of insertion dish implant 1752.
In operation, implant insertion instrument fork 2050,2052 removable joint and disengaging dish implant 1752 on vertical and horizontal direction.At the initial disengaging configuration shown in Figure 112 A-B, bar 2018 is in the off-position.Compression stop 2058 promotes forward through push rod 2026.Two relative pins 2062 of extend past compression stop 2058 are pushed on the inclination knee 2068,2072 of fork 2050,2052; What this made fork 2050,2052 local deformations and forced fork 2050,2052 promptly holds 2070 together, make effectively upper tine 2050 promptly hold 2070 descend and make lower tine 2052 promptly hold 2070 to rise.In this way, the front portion of insertion instrument 2008 can insert upper and lower dish implant member 1818, between 1822.In order to engage implant 1752, bar 2018 is pressed forward, shown in Figure 113 A-B.This causes push rod 2026 to promote compression stop 2058 backward.Therefore relative pin 2062 is removed from pitching 2050,2052 sloping portion 2068,2072, and it allows fork 2050,2052 to turn back to their former beginning and end curved shape.In this way, promptly hold 2070 will vertically scatter and the promptly recess 2012 of bond pad implant 1752.In order to provide opposing to be applied to the moment of reaction of the power on the implant 1752 by fork 2050,2052; Place the small pieces 2064,2066 of the front end of casing component 2036,2038 to engage the implant 1752 on the shelf 2006,2010 of the rear section that places dish member 1818,1822, shown in Figure 111.In addition, when bar 2018 was pushed forward, it is biased that compression stop 2058 abuts against front spring 2056, causes pitching keeper 2044 and abut against rear spring 2040 quilts bias voltage backward.This cause pitching keeper 2044 and fork 2050,2052 backward translation nestle up the implant 1752 of the front surface of casing component 2036,2038 with pulling.The restrained motion scope of bar 2018 prevents to damage implant 1752, and this damage can cause by crossing fastening grasping mechanism 2020.
In case implant 1752 is fixed to insert 2008, so dish implant 1752 is inserted intervertebral space 1330.The position of implant 1752 can be used the fluoroscopy that implant 1752 is shown and confirmed.Place the tantalum labelling of the front of upper and lower dish member 1818,1822 to allow the surgeon to discern the position of the insertion end of implant 1752.In addition, camshaft 1816 can be used for confirming the orientation of implant 1752, and it also is a radiation opaque when being processed by titanium or rustless steel).Orthopaedic surgical operations doctor places implant 1752 after the desired location, and he discharges implant 1752 through lifting arm 2018. Fork 2050,2052 promotes forward and inwardly vertical withdrawal, and it has discharged implant 1752.So the surgeon is fixed on implant 1752 on the appropriate location through activating fixed mechanism.Particularly, the surgeon uses driver with each cam 1816 Rotate 180 degree, thus cam member 1846 is expanded in the bone of upper and lower vertebrae 1332,1334.When launching cam member 1846, the surgeon can feel the resistance that the interaction between the cam face of camshaft 1816 and limiting member 1824 provides.In this way, he can determine when that cam member 1846 launches fully.In addition, the cam face of camshaft 1816 and limiting member 1824 will prevent cam 1816 counter-rotatings and prevent that cam from move implant 1752.
In other forms of the present invention, implant 1752 can comprise the medicament that is used to treat various spinal conditions, comprises the disc disease of degeneration, and joint of vertebral column is scorching, and spinal column infects, tumor of spine and osteoporosis.This type of medicament comprises antibiotic, analgesic, antibiotic medicine, comprises hormone and combination thereof.Other these type of medicaments also are known for the technical staff.These medicaments also use with the dosage that therapeutic effect is arranged.This type of dosage can be confirmed based on concrete condition through the technical staff.
If medicament is arranged, be dispersed in the implant 1752 to be used for live body release pharmacy optimization.Medicament can be immersed in the suitable solution that comprises medicament through the implant 1752 with formation, or be dispersed in the distance piece through known other appropriate method of technical staff through when it forms, adding medicament to implant 1752.In other forms of the present invention, medicament can be chemically or is otherwise relevant with implant 1752.For example, medicament can chemically be attached to the outer surface of implant 1752.
Although described fixed mechanism and insertion instrument with reference to dish replacement implant, fixed mechanism and instrument can easily be revised for use in other artificial implantations, for example promote the implant of fusion, comprise that vertebral body resets, spinal bone shelf structure or the like.In addition, the present invention described herein also can be used for other movement protection implants, for example has the movement protection implant of articular surface, comprises nucleus replacement implant.In addition, fixed mechanism described herein, inserting tool and method can be in other weight-bearing joint implant, ankle for example, knee, or buttocks joint implant.
Although about comprising that the object lesson of realizing current preferred pattern of the present invention described the present invention, person of skill in the art will appreciate that the many changes and the replacement of said system and technology will fall in the described the spirit and scope of the present invention of claim.
Claims (22)
1. reparation property spinal implant comprises:
Upper disc implant member;
Lower disc implant member;
Relative to each other move to allow said upper disc implant member and said lower disc implant member between said upper disc implant member and said lower disc implant member at arch support interface, this arch support interface;
The implant main body of a member in said upper disc implant member and the said lower disc implant member may be operably coupled to extensible fixed mechanism;
Said extensible fixed mechanism comprises the rotatable shaft with projection; This projection was arranged on the said rotatable shaft at said implant main body internal fixation before launching; And in can rotary expansion to a part of vertebrae through rotatable shaft so that said implant main body is fixed to said vertebrae; Said extensible fixed mechanism has at least one surface, transmits tactile feedback thereby be used for frictionally engaging the corresponding surface of said implant at said fixed mechanism expansion process.
2. implant according to claim 1 is characterized in that, the said tactile feedback through said fixed mechanism transmission comprises counteracting force, and said counteracting force is that the said expansion of said fixed mechanism provides adjustable resistance.
3. implant according to claim 1; It is characterized in that; In the expansion process of said fixed mechanism; Said tactile feedback is provided by the strain of said implant at least in part, and said strain is caused by the said interaction between the respective surfaces of the said surface of said fixed mechanism and said implant.
4. implant according to claim 1 is characterized in that, in the expansion process of said fixed mechanism, said tactile feedback is provided by the plastic deformation of said implant at least in part.
5. implant according to claim 1 is characterized in that said tactile feedback is provided by the distortion of said fixed mechanism at least in part.
6. implant according to claim 1 is characterized in that said projection has cutting surface, makes said projection be easy to be expanded to said vertebrae thereby this cutting surface is used for cutting a part of said vertebrae.
7. implant according to claim 1 is characterized in that said projection has cutting surface, and this cutting surface is used for when said projection is unfolded, cutting said bone.
8. implant according to claim 1 is characterized in that, said implant is the movement protection implant.
9. implant according to claim 8 is characterized in that, in the expansion process of said fixed mechanism, said tactile feedback is provided by the distortion of said implant at least in part.
10. implant according to claim 8 is characterized in that, said implant has articular surface and is used to provide the movement protection joint, and wherein, said articular surface comprises polymer.
11. implant according to claim 9 is characterized in that, said polymer comprises PEEK.
12. implant according to claim 1 is characterized in that, the said implant of at least a portion is coated with coating and promotes bone inwardly to grow.
Implant in the said spinal column 13. a spinal implant, its size are set for, comprising:
Upper disc implant member and lower disc implant member separately, said upper disc implant member constitute each other with lower disc implant member, and the joint is connected so that the movement protection joint to be provided;
Extensible fixture; It may be operably coupled to said upper disc implant member or the lower disc implant member with anti-retracting device; Said anti-retracting device and said upper disc implant member or lower disc implant member interact in case said extensible fixture is withdrawn after expansion; Said extensible fixture comprises rotatable axle, and it is fixedly connected projection, is used for when rotating said rotatable axle and launch said projection and the vertebrae interaction.
14. spinal implant according to claim 13; It is characterized in that; Said extensible fixture comprises cam face; Said cam face be used for said upper disc implant member or lower disc implant member on corresponding cam face interact, thereby tactile feedback is provided, said tactile feedback is that said user provides the tactile data about the position of said fixture through said extensible fixture transmission.
15. spinal implant according to claim 14; It is characterized in that; Through said extensible fixture tactile feedback is provided by the interact distortion of the said implant that causes of said cam face and corresponding cam face, thereby the information about the position of said fixture is provided.
16. spinal implant according to claim 13; It is characterized in that; Said anti-retracting device comprises the cam face that places on the said extensible fixture, and its bias voltage said upper disc implant member or lower disc implant member prevent said extensible fixture withdrawal.
17. spinal implant according to claim 13 is characterized in that, said extensible fixture comprises axle and projection, and said projection may be operably coupled to said axle, through rotating said axle said axle is configured in the vertebrae.
18. spinal implant according to claim 13 is characterized in that, said tactile feedback is produced by the distortion of the said implant that expansion caused of said fixture at least in part.
19. spinal implant according to claim 13 is characterized in that, said implant comprises polymer, and said extensible fixture comprises axle and the projection that is operably connected to said axle, and said projection is launched through the said axle of rotation.
20. one kind is used to implant the load-bearing implant in the weight-bearing joint, it is configured as at least partly and is assemblied in the weight-bearing joint, and it comprises:
Upper disc implant member and lower disc implant member separately, said upper disc implant member constitute each other with lower disc implant member, and the joint is connected so that the movement protection joint to be provided;
Extensible fixed mechanism; It may be operably coupled to said upper disc implant member or lower disc implant member; Said extensible fixed mechanism has cam face; Said cam face is used to be bonded on the respective cam surface on said upper disc implant member or the lower disc implant member, thus provide the said extensible fixed mechanism of opposing expansion and withdrawal resistance and tactile feedback is provided, wherein said extensible fixture comprises rotatable axle; This rotatable axle is fixedly attached to a projection, be used for when rotating said rotatable axle and launch said projection with the vertebrae interaction.
21. implant according to claim 20 is characterized in that, said resistance is variable when said fixed mechanism launches.
22. implant according to claim 20; It is characterized in that; Said implant also comprises the fixed mechanism retaining part; It has and said fixed mechanism between elastic interface, wherein, said elastic interface provides the resistance of the expansion of resisting said extensible fixed mechanism and withdrawal and tactile feedback is provided.
Applications Claiming Priority (5)
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| US82586506P | 2006-09-15 | 2006-09-15 | |
| US60/825,865 | 2006-09-15 | ||
| US91213807P | 2007-04-16 | 2007-04-16 | |
| US60/912,138 | 2007-04-16 | ||
| PCT/US2007/078679 WO2008034140A2 (en) | 2006-09-15 | 2007-09-17 | Systems and methods for sizing, inserting and securing an implant intervertebral space |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN101534752A CN101534752A (en) | 2009-09-16 |
| CN101534752B true CN101534752B (en) | 2012-01-04 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNA2007800406507A Pending CN101534751A (en) | 2006-09-15 | 2007-09-17 | Joint arthroplasty devices having articulating members |
| CN2007800424628A Expired - Fee Related CN101534752B (en) | 2006-09-15 | 2007-09-17 | Systems and methods for sizing, inserting and securing an implant intervertebral space |
Family Applications Before (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNA2007800406507A Pending CN101534751A (en) | 2006-09-15 | 2007-09-17 | Joint arthroplasty devices having articulating members |
Country Status (1)
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|---|---|
| CN (2) | CN101534751A (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| FR3136960A1 (en) * | 2022-06-28 | 2023-12-29 | Hassan Razian | Intervertebral cage |
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| CN102048600B (en) * | 2009-10-27 | 2013-06-12 | 上海交通大学医学院附属第九人民医院 | Total ankle plus total talus prosthesis |
| GB0922339D0 (en) | 2009-12-21 | 2010-02-03 | Mcminn Derek J W | Acetabular cup prothesis and introducer thereof |
| US8591596B2 (en) * | 2010-05-28 | 2013-11-26 | DePuy Synthes Products, LLC | Semi-constrained ankle prosthesis having a rotating bearing insert |
| US20140131924A1 (en) * | 2011-06-15 | 2014-05-15 | Derek James Wallace McMinn | Methods of forming a polymeric component |
| US20140336776A1 (en) * | 2011-11-23 | 2014-11-13 | Depuy (Ireland) | Medical implant, instrument head and assembly |
| GB2500918A (en) | 2012-04-05 | 2013-10-09 | Biomet Uk Healthcare Ltd | A prosthetic ankle with sliding engaging components |
| CN105310802B (en) * | 2014-06-03 | 2017-09-19 | 深圳兰度生物材料有限公司 | Artificial intervertebral disk and preparation method thereof |
| CN105147420B (en) * | 2014-06-03 | 2017-07-28 | 深圳兰度生物材料有限公司 | Artificial intervertebral disk and preparation method thereof |
| EP3242636B1 (en) * | 2015-01-07 | 2019-11-06 | Wright Medical Technology, Inc. | Fixation mechanism for an implant |
| CN105030383A (en) * | 2015-05-08 | 2015-11-11 | 江苏奥康尼医疗科技发展有限公司 | Combined type full-organic-polymer-material artificial unicondylar knee joint |
| CN105030385A (en) * | 2015-08-27 | 2015-11-11 | 江苏奥康尼医疗科技发展有限公司 | All-organic high molecular material ankle joint prosthesis |
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| EP3512435B1 (en) | 2016-09-14 | 2023-11-01 | Intuitive Surgical Operations, Inc. | Joint assemblies with cross-axis flexural pivots |
| HUE055578T2 (en) * | 2017-02-17 | 2021-12-28 | Inst Nat Sante Rech Med | Temporo-mandibular prosthesis |
| CN107874873B (en) * | 2017-09-29 | 2024-01-23 | 辽宁禾润新材料科技有限公司 | Stretchable artificial rib with peek coating |
| CN107536660A (en) * | 2017-09-29 | 2018-01-05 | 大连派思益科技有限公司 | A kind of Artificial Rib attachment structure of band peek coatings |
| CN107736956B (en) * | 2017-09-30 | 2023-07-21 | 四川大学华西医院 | Artificial intelligent cervical intervertebral disc capable of recording pressure and motion |
| CN111437076A (en) * | 2020-04-02 | 2020-07-24 | 青岛大学附属医院 | Multi-piece combined artificial joint mortar cup structure |
| CN111568431A (en) * | 2020-05-06 | 2020-08-25 | 山东师范大学 | Spinal column bending biomechanics and mobility testing device and method |
| CN112656498A (en) * | 2020-05-27 | 2021-04-16 | 北京科仪邦恩医疗器械科技有限公司 | Surface treatment method for nail rod system and nail rod system |
| CN112190757B (en) * | 2020-11-10 | 2024-07-19 | 北京大学人民医院 | Tumor type knee joint prosthesis containing CFR-PEEK material |
| CN112387488A (en) * | 2020-11-11 | 2021-02-23 | 中国铁建重工集团股份有限公司 | Mechanical profiling automatic spraying positioning device for magnetic levitation track panel |
| CN113081405B (en) * | 2021-04-08 | 2023-11-03 | 新疆大学 | Artificial vertebral body and manufacturing method thereof |
| CN113386161B (en) * | 2021-07-05 | 2022-08-30 | 四川中科彭成机器人技术有限公司 | Creep-resistant rope-driven mechanical finger |
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2007
- 2007-09-17 CN CNA2007800406507A patent/CN101534751A/en active Pending
- 2007-09-17 CN CN2007800424628A patent/CN101534752B/en not_active Expired - Fee Related
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| FR3136960A1 (en) * | 2022-06-28 | 2023-12-29 | Hassan Razian | Intervertebral cage |
Also Published As
| Publication number | Publication date |
|---|---|
| CN101534752A (en) | 2009-09-16 |
| CN101534751A (en) | 2009-09-16 |
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