CN101631517A - 具有三个接触点的椎间植入体部件 - Google Patents

具有三个接触点的椎间植入体部件 Download PDF

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CN101631517A
CN101631517A CN200880008255A CN200880008255A CN101631517A CN 101631517 A CN101631517 A CN 101631517A CN 200880008255 A CN200880008255 A CN 200880008255A CN 200880008255 A CN200880008255 A CN 200880008255A CN 101631517 A CN101631517 A CN 101631517A
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intervertebral implant
trace
vertebra
implant component
implant
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CN101631517B (zh
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H·坎农
E·卡姆
T·马内
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AO Technology AG
Synthes USA LLC
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Synthes AG Chur
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Abstract

本发明公开了一种椎间植入体由多个部件组成，各部件有内表面和外表面，该外表面与相邻椎骨接合，且只有三个不同的接触点与椎骨的皮层缘接触。优选是，外表面具有印迹，该印迹的尺寸设置成在皮层缘的印迹内。在所述实施例中，印迹可以为半凸半凹形形状、D形形状或肾形形状。椎间植入体可以提供有上部和底部(或者第一和第二)部件，该部件与相邻的第一和第二椎骨接合，并彼此相对运动。植入体的第一和第二部件的外表面的尺寸设置成有相应印迹，该印迹足以使得两个侧部的前部接触点和一个后部接触点与相应第一和第二椎骨的相邻皮质缘接触。

Description

具有三个接触点的椎间植入体部件
背景技术
在历史上，当需要从相邻椎骨之间完全除去椎间盘时，普通方法是将相邻椎骨熔合在一起。对于有症状腰椎退化椎间盘疾病，目前仍然使用的该“脊椎熔合”处理是可以广泛接受的外科手术治疗。不过，报告的临床效果差异很大，且一些人认为并发症发生率高到不可接受。
近来，已经在椎间盘更换(即椎间盘关节造形术)领域有了重要的发展，它包括将人造椎间盘植入体插入在相邻椎骨之间的椎间空间中，且它能够限制相邻椎骨的彼此相对的一般运动。总体椎间盘更换的目的是除去疼痛产生源(由变坏的椎间盘引起)，恢复解剖学结构(椎间盘高度)，并保持功能脊椎单元的活动性，这样，脊椎保持合适的矢状(sagittal)平衡。矢状平衡定义为躯干与腿和骨盆的平衡，以便保持协调的矢状曲线。与熔合技术相反，总体椎间盘更换将保持运动段的活动性，并模拟生理情况。
一种这样的椎间植入体包括：上部部件，该上部部件能够与相邻椎骨连接；底部部件，该底部部件能够与相邻椎骨连接；以及插入件，该插入件位于这两个部件之间。这种植入体的实例在美国专利No.5314477(Marnay)中公开。
尽管这种和其它的已知植入体表示了在人造椎间植入体技术中的改进，但是仍然需要在该领域中进行改进。
发明内容
根据本发明，椎间植入体的部件提供有内表面和外表面。外表面与相邻椎骨接合，且只有三个不同的接触点与相邻椎骨的皮层缘接触。优选是，外表面具有印迹(footprint)，该印迹的尺寸设置成在皮层缘的印迹内。在所述实施例中，外表面的印迹具有主要的凸形侧，并可以为半凸半凹形形状、D形形状或肾形形状。
优选是，外表面的印迹的、与皮层缘接触的三个接触点是两个侧部的前部点和一个后部点。此外，外表面的印迹包括相对端，该相对端提供两个侧部的前部接触点。
在优选实施例中，部件的外表面包括至少一个椎骨接合凸起。凸起可以包括位于相对或纵向端附近的凸出龙骨(keel)，该龙骨可以弯曲。
还在优选实施例中，内表面包括伸向它的相邻外边缘的一对切口。切口优选是中心向内倾斜，并为燕尾形截面。
还根据本发明，椎间植入体可以提供有上部和底部(或者第一和第二)部件，各部件如上所述，且该部件中的每个都与相邻的第一和第二椎骨接合。植入体还包括用于使得第一和第二部件能够彼此相对运动的装置。植入体可以使得第一和第二部件的外表面的尺寸设置成有相应印迹，该印迹足以使得只有三个接触点与各第一和第二椎骨的相邻皮质缘接触。
本发明的优点是提供了最小尺寸的椎间植入体。
本发明的还一优点是椎间植入体只有在相邻椎骨的皮层缘上的三个接触点。
本发明的还一优点是椎间植入体的主要凸面侧形状具有较小的插入尺寸，它可以沿弧形通路插入。
通过下面对本发明优选实施例的详细说明，将清楚本发明的其它特征和优点。
附图说明
图1是本发明的植入体的分解透视图。
图2是邻近椎骨的、图1中所示的植入体的俯视平面图。
图3是局部插入椎间空间中的、图2中所示的植入体的俯视平面图。
图4是完全插入椎间空间中的、图2中所示的植入体的俯视平面图。
图5是插入椎间空间中的、图2中所示的植入体的左侧视图。
图6是图5中所示的植入体的在前的视图。
图7是可选形状的本发明植入体的分解透视图。
图8是与图1类似的植入体的分解透视图，但表示了本发明的变化形式。
图9是可选形状的本发明植入体的部件的透视图，表示了本发明的改进形式。
图10表示了用于插入本发明植入体的仪器的操作部分。
图11表示了具有图9中的部件的植入体，该部件与图10中所示的仪器接合。
具体实施方式
下面参考附图，在全部附图中，相同参考标号表示相同元件，图1-6中表示了本发明的椎间植入体10。广义地说，最好如图1中所示，植入体10由三个部件形成，即上部部件12、底部部件14和活动插入件16，该活动插入件16使得上部部件12能够相对于底部部件14运动。相对的一对凸面18布置在上部和底部部件12和14的各内表面19上(尽管只表示了底部部件16的凸面18)，在插入件16的相对侧的凹面20(只表示了上部凹面20)与相邻凸面18匹配。通常，这些部件12、14、16以及它们提供的运动为本领域已知，例如在USPA2006/0116769(Marnay等)中，该文献被本文参引，因此它们不需要进一步说明。应当知道，在本领域还已知，插入件16可以是从一个部件成一体伸出的凸面，它与成一体在另一部件中的凹面匹配，因此，对本发明插入件16的单独说明只是本领域已知的一种活动插入件装置的实例。
上部和底部部件12和14都各自有外表面24。如本领域已知，外表面24各自设计成与相邻椎骨接触，例如图2-6中所示的上部和底部椎骨26和28。如图2-4中所示，椎骨28(和通常类似的椎骨)包括骨的相对刚性皮层缘30，该皮层缘30包围更小刚性的松质骨32。现有技术的椎骨植入体设计成覆盖皮层缘30。不过，这种覆盖导致不需要的多个接触点(或区域)。因此，本发明的植入体10提供了更紧凑和因此更容易插入的植入体，它还与相邻椎骨进行良好和充分的接触。
因此，本发明的特征是，外表面24设计成或者尺寸设置成提供与相邻皮层缘30接触的三个不同接触点(或较小区域)34a、34b和34c(或通称为点34)，如图4中所示。应当知道，图4中所示的接触点34是上部部件12的外表面24的、将与上部椎骨26(未示出)接触的点，接触方式与底部部件14的底侧接触点34(该底侧接触点34不能看见，因为它们由上部部件12覆盖)接触所示的底部椎骨28的方式相同。应当知道，外表面24还包括从它上面竖立的一系列较小齿或长钉36或者其它凸起，它们用于在植入后将上部和底部部件12和14锚固就位，如本领域已知的。
如上所述，根据本发明，外表面24形成为具有主要的凸形侧，以便表示印迹，因此只提供三个接触点34。因为椎骨尺寸根据位置和各用户而变化，因此植入体10将对个人进行调节，从而只形成三个接触点34。外表面24的印迹的尺寸通过选择要位于皮层缘30的印迹内的外表面24印迹而方便地确定。接触点34是左右侧的前部点34a和34c(它们优选是对称定位，如图所示)以及后部点34b。优选是，外表面24的印迹包括提供有左右侧前部点34a和34c的相对端。提供三个接触点34的合适印迹包括：a)半凸半凹形印迹，如图1-4中的植入体10(以及图8中的植入体210)所示；b)D形印迹，如图7中的植入体110所示；或者c)肾形印迹，如图9和11中的植入体310所示。
利用这样的较小印迹和只有三个接触点34(其中一个在后部或前部)使得植入体10、110、210和310能够具有在左右侧点34a和34c之间的、相对狭窄或较小的最大宽度，由上述三个印迹可知。与植入体沿所有方向都跨过皮层缘30时的情况相比，这样的狭窄最大宽度(特别是当通过纵向凹面或向内弯曲而增加时，如植入体10、210和310)使得植入体10、110、210和310能够通过更小的切口来插入相邻椎骨26和28之间。在图2-4中，应当知道，植入体10的尺寸和形状使得植入体10的植入能够从所示角度沿所示通路很容易地实现。
图7中所示的植入体110公开了上部和底部部件112和114具有D形印迹的外表面124。与图1中相同，如上所述，插入件116表示了它的上部凹面(与它的类似底部凹面相对)。
图8中表示了植入体210，该植入体210也为半凸半凹形状，与植入体10类似。不过，植入体210包括龙骨262，该龙骨从各外表面在邻近外表面的相对或纵向端处伸出，且优选的是，具有相对纵向端的、最后插入椎骨26和28之间的相对端(见图3)具有稍微的切角，以便容易插入。除了通过较小长钉236来提供锚固(如图8中所示)，在植入后，各龙骨262用于将植入体210的相关上部和底部部件212和214在相邻椎骨26和28中提供的切口或狭槽内锚固就位，如本领域已知。龙骨262表示为弯曲或弧形，以便与弧形插入通路匹配，植入体210将沿该插入通路植入椎骨之间(如图2-4中所示的、植入体10的三个位置所示)；不过当植入体210沿直线方向植入时，龙骨262将改为直的。需要时，可以提供沿弧形或直线定位的两个或更多龙骨。龙骨262所需的切口将在植入前形成，或者龙骨262将自身切割成在引入端具有凿子形切割边缘，如本领域已知。
在图9中，整个植入体由标号310表示，尽管只详细表示了它的底部部件314。上部部件312为底部部件的镜像，插入件与上述插入件16相同。底部部件314具有外表面324，该外表面具有肾形印迹，如图所示。还表示了在底部部件314上在内表面319中有相对的一对切口372。切口372为燕尾形，也就是，它的垂直壁向内倾斜(或者各自朝着另一切口372倾斜)，且当切口372从相邻相对端伸出时，它们优选是中心向内或彼此相向收敛地(或者朝着凸面318)纵向倾斜。切口372布置成这样，具有一对匹配形状接合部件的仪器能够牢固夹住底部部件314(和类似的上部部件312)，以便将植入体310插入椎骨26和28之间，如本领域公知的；具有燕尾形状和收敛性而增加的可靠性使得切口372还能够用于在需要时重新定位植入体310或者甚至取出植入体310。当然，当需要由仪器施加较小保持力时，切口372在需要时还可以相互平行，而不是收敛。
图10和11中表示了可以用于插入植入体310(或者其它所述植入体，当它们提供有切口372时)的插入仪器400的一部分。仪器400包括基座402，该基座402安装在插入器轴403上。纵向固定臂404从基座402(远离插入器轴403)向远侧伸出。固定臂404形成为具有顶部和底部的、横向朝内的凸起406a和406b。凸起406设计成匹配装入切口372中，因此有匹配的燕尾设计。活动臂408与固定臂404横向相对，该活动臂408有顶部和底部的、横向朝内的凸起410a和410b，它们有与凸起406类似的形状，但是朝向相对。与凸起406类似，凸起410设计成匹配装入切口372中，但是在植入体310的相对侧。如本领域已知的，活动臂408可绕布置在基座402中的枢轴412而朝着固定臂404运动，该运动通过在插入器轴403中引导的杆414来实现，该杆414压靠与活动臂408成一体的销416，并置于基座402的狭槽418中。
在使用时，仪器400用于通过将凸起406和410布置在植入体310的各侧并邻近各切口372而夹住植入体310。然后，通过杆414的操作，活动臂408朝着固定臂404运动，这样，凸起406和410接收于切口372中并锁定在该切口372中。一旦凸起406和410在切口372中锁定就位，植入体310就牢固安装在基座402上，这样，植入体310能够通过操作插入器轴403而插入椎骨之间，如本领域已知的。
尽管已经通过本发明的示例实施例介绍了本发明，但是本领域普通技术人员应当知道，在本发明的范围和精神内可以进行变化和改变。

Claims (26)

1.一种椎间植入体部件，包括：
外表面，用于与相邻椎骨接合；以及内表面；
其中，所述外表面只有三个不同的接触点与相邻椎骨的皮层缘接触。
2.根据权利要求1所述的椎间植入体部件，其中：所述外表面具有印迹，该印迹的尺寸设置成在皮层缘的印迹内。
3.根据权利要求2所述的椎间植入体部件，其中：所述外表面的所述印迹具有半凸半凹形形状。
4.根据权利要求2所述的椎间植入体部件，其中：所述外表面的所述印迹具有D形形状。
5.根据权利要求2所述的椎间植入体部件，其中：所述外表面的所述印迹具有肾形形状。
6.根据权利要求1所述的椎间植入体部件，其中：所述外表面的所述印迹的、与皮层缘接触的所述三个接触点是两个侧部的前部点和一个后部点。
7.根据权利要求6所述的椎间植入体部件，其中：所述外表面的印迹包括相对端，该相对端提供两个侧部的前部接触点。
8.根据权利要求1所述的椎间植入体部件，其中：所述外表面包括至少一个椎骨接合凸起。
9.根据权利要求8所述的椎间植入体部件，其中：所述至少一个椎骨接合凸起包括位于所述外表面的纵向端附近的凸出龙骨。
10.根据权利要求9所述的椎间植入体部件，其中：所述龙骨弯曲。
11.根据权利要求1所述的椎间植入体部件，其中：所述内表面包括伸向它的相邻外边缘的一对仪器接收切口。
12.根据权利要求11所述的椎间植入体部件，其中：所述切口中心向内倾斜。
13.根据权利要求12所述的椎间植入体部件，其中：所述切口为燕尾形截面。
14.一种椎间植入体，包括：
第一部件，该第一部件有：第一外表面，用于与第一椎骨接合；以及第一内表面；
第二部件，该第二部件有：第二外表面，用于与第二椎骨接合；以及第二内表面；以及
所述第一和第二部件可彼此相对运动；
其中，所述第一和第二外表面的尺寸设置成有相应印迹，该印迹足以使得只有三个接触点与各第一和第二椎骨的相邻皮质缘接触。
15.根据权利要求14所述的椎间植入体，其中：所述第一和第二部件的所述外表面的所述印迹的尺寸设置成在相邻皮层缘的印迹内。
16.根据权利要求15所述的椎间植入体，其中：所述外表面的所述印迹具有半凸半凹形形状。
17.根据权利要求15所述的椎间植入体，其中：所述外表面的所述印迹具有D形形状。
18.根据权利要求15所述的椎间植入体，其中：所述外表面的所述印迹具有肾形形状。
19.根据权利要求14所述的椎间植入体，其中：所述外表面的各所述印迹的、与相邻的皮层缘接触的所述三个接触点是两个侧部的前部点和一个后部点。
20.根据权利要求19所述的椎间植入体，其中：所述外表面的各所述印迹包括相对端，该相对端提供两个侧部的前部接触点。
21.根据权利要求14所述的椎间植入体，其中：各所述外表面包括至少一个椎骨接合凸起。
22.根据权利要求21所述的椎间植入体，其中：各所述至少一个椎骨接合凸起包括位于各所述外表面的纵向端附近的凸出龙骨。
23.根据权利要求22所述的椎间植入体，其中：各所述龙骨弯曲。
24.根据权利要求14所述的椎间植入体，其中：各所述内表面包括伸向它的相邻外边缘的一对仪器接收切口。
25.根据权利要求24所述的椎间植入体，其中：各所述切口中心向内倾斜。
26.根据权利要求25所述的椎间植入体，其中：各所述切口为燕尾形截面。
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KR101399299B1 (ko) 2014-05-27
ZA200905900B (en) 2010-05-26
CN101631517B (zh) 2013-01-23
CA2680541A1 (en) 2008-09-18
US20080228275A1 (en) 2008-09-18
EP2120799A4 (en) 2012-12-19
AU2008224898A1 (en) 2008-09-18
US20100324690A1 (en) 2010-12-23
US7811325B2 (en) 2010-10-12
KR20090121318A (ko) 2009-11-25
BRPI0808747A2 (pt) 2014-08-19
JP2010521244A (ja) 2010-06-24
EP2120799A1 (en) 2009-11-25
WO2008112956A1 (en) 2008-09-18
US20080300688A1 (en) 2008-12-04

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