CN101808597B - 用于植入在脊柱的椎体之间的植入体 - Google Patents

用于植入在脊柱的椎体之间的植入体 Download PDF

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CN101808597B
CN101808597B CN2008800193562A CN200880019356A CN101808597B CN 101808597 B CN101808597 B CN 101808597B CN 2008800193562 A CN2008800193562 A CN 2008800193562A CN 200880019356 A CN200880019356 A CN 200880019356A CN 101808597 B CN101808597 B CN 101808597B
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implant
vertebra
base plate
plate
implant part
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CN101808597A (zh
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E·卡斯特
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Ulrich GmbH and Co KG
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Ulrich GmbH and Co KG
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Abstract

本发明涉及一种用于植入在脊柱的椎体之间的植入体，即用于植入在脊柱的椎体(8)之间作为从脊柱移除的椎骨或者椎骨部分的占位件的植入体，该植入体具有第一植入体部分(2)和第二植入体部分(3)，所述第一植入体部分(2)和第二植入体部分(3)能够在其同轴的纵轴线方向上相对调节，以便改变植入体(1)的长度，还具有至少一个能固定在所述植入体部分(2，3)之一上的固定板(10)，该固定板(10)朝向邻接的椎骨并且至少部分地遮盖该椎骨。所述固定板(10)由椎骨贴靠板(11)和从该椎骨贴靠板竖立出的底板(12)构成，其中所述底板(12)用于相对其中一个植入体部分(2，3)径向调节固定板(11)并具有导轨(13)；并且为其中一个植入体部分(2，3)配备有用于径向固定底板(12)的机构。

Description

用于植入在脊柱的椎体之间的植入体
技术领域
本发明涉及一种用于植入在脊柱的椎体之间的、作为从脊柱移除的椎骨或者椎骨部分的占位件的植入体，该植入体具有第一植入体部分和第二植入体部分，第一植入体部分和第二植入体部分在其同轴的纵轴线方向上可以相对调节，以便改变植入体的长度；该植入体还具有至少一个可固定在植入体部分之一上的固定板，该固定板朝向邻接的椎骨并且至少部分地遮盖该椎骨。
背景技术
由EP 0 950 388A2公开了一种这样的植入体。该植入体由总共三个植入体部分组成，即两个位于末端的、用于贴靠在邻接的椎骨上固定的末端植入体部分和位于之间的中部植入体部分，它们通过螺纹互相连接。在末端植入体部分中构造有孔洞，它们主要用于形成植入体部分的内部的通道，以引入骨粘合剂或者接骨材料。该孔洞此外用于，能够将具有圆形台肩的固定板可选择地固定在末端植入体部分上，为此在所述台肩中构造开口，它能够与两个在末端植入体部分构造的孔洞对齐。通过该开口可以在孔洞中插入螺栓。固定板在纵向具有在其宽度上可以调节的槽缝，这样实现螺栓在孔洞中夹紧。结果是固定板固定在末端植入体部分的外周边上并且可以改善脊柱的稳定性，不会在此妨碍到植入体部分的可接近性。
不过对这种已知的植入体缺点是，它在扩展应用的情况下受制于现有最小侵入性外科手术限制，因为为了改变植入体的长度，中部的植入体相对末端的植入体部分必须通过要在圆弧中运动的工具进行调节，并且由于固定板在末端植入体部分的外周上的布置，无法匹配病人的特殊情况。
发明内容
因此本发明的任务在于，这样构造一种开头所述类型的植入体，即固定板相对植入体的位置可以改变。
该任务对于开头所述类型的植入体根据本发明由此解决，即固定板由椎骨贴靠板以及从该椎骨贴靠板竖立出的底板构成，其中所述底板用于相对其中一个植入体部分径向调节固定板并具有导轨，并且为其中一个植入体部分配备有用于径向固定底板的机构。
该植入体的特征在于，可以调节椎骨贴靠板到植入体部分的中心的不同距离，并且由此可以获得植入体部分在椎体之间的不同定位，不必放弃使用固定板。在此这个较大的柔性的优点与改善的稳定性的优点相结合，因为具有椎骨贴靠板的固定板相对植入体部分的径向可调节性可以通过用于径向固定底板的机构来终止。如果为两个植入体部分中的每一个植入体部分分别配备有固定板，在本发明的框架下是非常特别优选的，因为这样实现更加改善的稳定性。
此外如果植入体部分具有朝向邻接的椎骨的端板，该端板具有用于容纳作用在底板上面的夹紧机构的开口，已经证明是有利的，因为由此克服了为与固定板连接对植入体部分的周边的限制。如果该开口构造成螺纹孔，并且夹紧机构构造成止动螺钉，则对于结构化以及操作者的简单可操作性而言，是适宜的。
底板构造成具有至少两个叉臂的叉形，用于固定的机构作用在这些叉臂中，则有助于底板相对端板实现良好的导引。在此当然也可以设置多于两个叉臂，这样在增加多变性的意义上，用于固定的机构也可以与不同对的叉臂共同作用，即固定板适配于相对植入体部分侧面对齐。
如果叉臂在螺栓头的下面具有作用止动螺钉的夹板，则有助于特别牢固的连接。
椎骨贴靠板在横截面中成形为凸出的，并具有至少一个螺钉口并且在到底板的连接区域中具有窗口，这有助于匹配人体结构情况。螺钉口在此用于容纳骨螺钉，特别是膨胀螺钉，通过它实现固定板相对椎体的附加固定。在固定板中的窗口主要用于实现在椎骨贴靠板后面的区域中进行可视操控。
为了实现在椎体和植入体之间的更好的机械连接，底板在朝向邻接的椎骨的侧面上具有至少一个锚固钉。
此外如果第一植入体部分和第二植入体部分构造成管形的套筒，在本发明的框架下是非常特别优选的，其中为第一植入体部分配备有可旋转的具有齿部的螺纹环，该齿部通过环形螺纹与配备于第二植入体部分的螺纹相啮合，并且在第一植入体的壁中构造螺纹孔以插入用于旋转螺纹环的操作工具。这种构造方案和第一和第二植入体部分与操作工具的共同作用原则上由EP 1 219 266A1公开，其中这个在里面描述的并且因此这里不进一步说明的植入体在应用径向可调节的固定板的情况下，适合于根据本发明的构造方案，并且由此总体可以获得最小的侵入性介入。
为了不必强制地根据人体结构情况的分析在手术之前在原位置外实施固定板相对植入体部分的固定，可以在螺栓头上构造用于旋转止动螺钉的工具槽，这样通过窗口可以操作螺栓头，并且该止动螺钉也可以在原位置处牢固拧紧。在此，窗口和螺纹孔可以调整朝向同侧是有利的。
此外如果在底板和端板之间构造卡座，已经证明是有利的，它可以在通过止动螺钉的拧紧实现最终有效的位置固定之前，获得固定板相对植入体部分的最初的位置固定。在此，卡座通过横向于导轨的径向调节方向延伸的接板构成，是适宜的。
附图说明
接下来本发明借助在图中示出的实施例上进行详细说明，图中示出：
图1在示意图中示出了根据本发明的具有两个固定板的植入体，
图2是植入体的上面部分的透视图，具有在第一径向位置的固定板，
图3是植入体的上面部分的透视图，具有在第二径向位置的固定板
图4是图3的植入体从另一个视线方向的透视图，
图5在侧面透视图中示出了图4的植入体的示意图，
图6是根据本发明的植入体在原位置在脊柱的两个椎体之间的侧视图，以及
图7示出了图6的细节VII。
具体实施方式
在图1中示出了植入体1，它用于植入在脊柱的椎体8之间作为从脊柱移除的椎骨或者椎骨部分的占位件。该植入体1由第一植入体部分2和第二植入体部分3组成，它们在其同轴的纵轴线方向上可以相对调节，用于改变植入体1的长度。该调节性在此实现，措施是第一植入体部分2和第二植入体部分3构造成管状的套筒，其中第一植入体部分2在外侧包围第二植入体部分3，即利用配备于第一植入体部分2的可旋转的螺纹环4，螺纹环4在其内圆周面上具有环形螺纹，螺纹环4利用该环形螺纹啮合在配备于第二植入体部分3的螺纹5中。螺纹环4在外圆周面上设有齿部6，特别是锥齿轮齿部，这样通过借助于拧入第一植入体部分2的螺纹孔中的操作工具旋转螺纹环4，可以实现椎体8在牵引意义上的长度改变。
植入体部分2、3具有朝向邻接的椎骨的具有开口的端板9。该端板9被用于可松开地固定固定板10，固定板10可固定在相应的植入体部分2、3上并朝向邻接的椎骨并且至少部分地遮盖该椎骨，固定板10通过椎骨贴靠板11以及从该椎骨贴靠板竖立出的底板12构成，底板12用于相对植入体部分2、3径向调节固定板10并具有导轨13。对于在图1和图6中示出的实施例，为两个植入体部分2、3中的每一个分别配备一个固定板10，它们可以通过用于固定底板12的机构固定在相应的植入体2、3上，其中该机构在所示实施例中通过拧入在端板9的构造成螺纹孔的开口中的止动螺钉14构成。如特别由图4可以得知，底板12构造成具有两个叉臂15的叉形，止动螺钉14作用在叉臂15上面，即作用于在止动螺钉14的螺栓头7下面伸出的夹板16上。替代地在传力反向的意义上当然也可以考虑，底板12设有接板，该接板特别是按照燕尾槽导引机构的方式插入在端板9的叉臂之间。为了匹配椎体8的圆形，椎骨贴靠板11在横截面上成形为凸形的并且此外具有螺钉口17，骨螺钉18可以通过螺钉口17引导。图5在此可以看出，椎骨贴靠板11在到底板12的连接区域中具有窗口19，它允许对椎骨贴靠板11后面的区域进行操控，并且同时也提供了这种可能性，即通过窗口19引导工具或者器械。
如特别由图2至4可以看出，底板12在朝向邻接的椎骨的侧面上具有多个锚固钉20，它们可以钉入椎体8中，并且这样在通过螺钉口17插入的优选构造成膨胀螺钉的骨螺钉18定位之前已经产生位置固定。
为了应用根据本发明的植入体1，为了手术准备适宜地借助于一种成像方法求出固定板10相对植入体部分2、3必需的位置，并且固定板10可靠地安装在植入体部分2、3上。那么在手术期间可以借助于插入螺纹孔中的操作工具实施植入体1的牵引以实现必需的高度，从而接着实施植入体1借助于骨螺钉18的最终有效的固定。在这种情况下产生非常牢固的连接，其中特别是通过骨螺钉18实现角度稳定性。
如果固定板10相对植入体部分2、3的位置固定在原位置外无法进行，止动螺钉14的操作就困难了，因为它在原位置处被椎体8阻挡，从轴向不能接近。尽管如此还可以借助于通过窗口19的接近可能性保持基本的操作。根据未在图中示出的实施例，对这种应用情况，在底板12和端板9之间通过横向于导轨13的径向调节方向延伸的接板构成卡座。
附图标记列表
1    植入体
2    第一植入体部分
3    第二植入体部分
4    螺纹环
5    螺纹
6    齿部
7    螺栓头
8    椎体
9    端板
10   固定板
11   椎骨贴靠板
12   底板
13   导轨
14   止动螺钉
15   叉臂
16   夹板
17   螺钉口
18   骨螺钉
19   窗口
20   锚固钉

Claims (11)

1.用于植入在脊柱的椎体(8)之间作为从脊柱移除的椎骨或者椎骨部分的占位件的植入体，该植入体具有
-第一植入体部分(2)和第二植入体部分(3)，以及
-至少一个能固定在所述第一植入体部分(2)和所述第二植入体部分(3)之一上的固定板(10)，该固定板(10)朝向邻接的椎骨并且至少部分地遮盖该椎骨，
其中，所述固定板(10)由椎骨贴靠板(11)和从该椎骨贴靠板竖立出的底板(12)构成，其中所述底板(12)用于相对所述第一植入体部分(2)和所述第二植入体部分(3)中的一个径向调节固定板(10)并具有导轨(13)；并且为所述第一植入体部分(2)和所述第二植入体部分(3)中的一个配备有用于径向固定底板(12)的机构，
其特征在于，所述第一植入体部分(2)和第二植入体部分(3)能够在其同轴的纵轴线方向上相对调节，以便改变植入体(1)的长度，所述第一植入体部分(2)和所述第二植入体部分(3)具有朝向邻接的椎骨的端板(9)，所述端板(9)具有用于容纳作用在底板(12)上的夹紧机构即止动螺钉(14)的螺纹孔，并且所述椎骨贴靠板(11)在横截面中成形为凸形的，并具有至少一个螺钉口(17)，并在与底板(12)的连接区域中具有窗口(19)。
2.根据权利要求1所述的植入体，其特征在于，为所述第一植入体部分(2)和所述第二植入体部分(3)中的每一个分别配备固定板(10)。
3.根据权利要求1或2所述的植入体，其特征在于，所述底板(12)构造成具有至少两个叉臂(15)的叉形，所述用于固定的机构作用在这些叉臂(15)上。
4.根据权利要求3所述的植入体，其特征在于，所述叉臂(15)在螺栓头(7)下面具有作用于止动螺钉(14)的夹板(16)。
5.根据权利要求1或2所述的植入体，其特征在于，所述底板(12)设有用于插入端板(9)的叉臂的接板。
6.根据权利要求1或2所述的植入体，其特征在于，所述底板(12)在朝向邻接的椎骨的侧面上具有至少一个锚固钉(20)。
7.根据权利要求1或2所述的植入体，其特征在于，所述第一植入体部分(2)和第二植入体部分(3)构造成管形的套筒；为第一植入体部分(2)配备可旋转的具有齿部的螺纹环(4)，该螺纹环通过环形螺纹啮合到配备给第二植入体部分(3)的螺纹(5)中；并且在第一植入体部分(2)的壁中构造螺纹孔，用于插入用于旋转螺纹环(4)的操作工具。
8.根据权利要求4所述的植入体，其特征在于，在所述螺栓头上构造用于旋转止动螺钉(14)的工具槽。
9.根据权利要求7所述的植入体，其特征在于，所述窗口(19)和螺纹孔能够调整朝向同侧。
10.根据权利要求1或2所述的植入体，其特征在于，在所述底板(12)和端板(9)之间构造有卡座。
11.根据权利要求10所述的植入体，其特征在于，所述卡座通过横向于导轨(13)的径向调节方向延伸的接板构成。
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