CN102740788B - 具有术后可调尺寸的脊椎融合器 - Google Patents

具有术后可调尺寸的脊椎融合器 Download PDF

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Publication number
CN102740788B
CN102740788B CN201080053465.3A CN201080053465A CN102740788B CN 102740788 B CN102740788 B CN 102740788B CN 201080053465 A CN201080053465 A CN 201080053465A CN 102740788 B CN102740788 B CN 102740788B
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spinal implant
guide rail
implant according
vertebra
attachment components
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CN201080053465.3A
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CN102740788A (zh
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乌里·阿宁
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Spine21 Ltd
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Spine21 Ltd
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    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
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    • A61F2/447—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
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Abstract

一种脊椎植入物(100)包括：用于附接到第一脊椎部分(101)的第一脊椎附接部件(104)；用于附接到第二脊椎部分的第二脊椎附接部件(103)；以及设置在第一和第二脊椎附接部件之间的植入后可变尺寸装置，其在完成将所述脊椎植入物安装入患者体内的手术后可操作，以促使在第一和第二脊椎附接部件之间的相对运动。

Description

具有术后可调尺寸的脊椎融合器
技术领域
本发明一般而言涉及脊椎植入物和假体，并且尤其涉及一种具有术后可调尺寸的脊椎融合器。
背景技术
具有高度调整能力的脊椎植入物是已知的。在本申请人的PCT专利申请PCT/IL2008/001423(WO2009/060427)中示出和描述了一种装置。其中示出的装置中的一种使用了在第一和第二支承板之间的倾斜的螺纹接口，如现在参考附图1描述的。
现有技术的装置是脊椎植入物50，其包括植入后可变尺寸装置52，用于改变相邻的脊椎51和53的位置。脊椎植入物50包括具有螺纹槽的第一(上)支承板54，螺钉55通过螺纹被接收在该螺纹槽中。脊椎植入物50包括第二(下)支承板56，该第二(下)支承板56包括凹进，电动马达(或致动器)57安装在该凹进中。(可遥控的)电动马达57转动螺钉55，使得第一支承板54相对于第二支承板56滑动。在第一和第二支承板(脊椎附接部件)54和56之间的倾斜匹配使得两节脊椎之间的相邻位置在矢状平面和垂直平面两者中发生改变。
发明内容
本发明寻求提供一种具有术后可调尺寸的改进的脊椎植入物(或假体，所述术语可互换使用)，以放置在相邻的两块脊椎之间，具有调整脊椎之间的高度和一块脊椎相对于另一脊椎的矢状位置的能力。对比以上的现有技术，在本发明中，倾斜接口不是螺纹的，而是脊椎附接部件通过倾斜对准导轨而在彼此之上滑动。
在一个实施例中，脊椎植入物的尺寸中的至少一个尺寸可以在植入后借助于远程控制改变。调整机构(也称为可变尺寸机构)可以具有倾斜对准导轨。对支架部件相对于彼此的高度和矢状定位的调整可以采用电动方式，例如通过(由电池或远程感应供电的)电动马达的电动方式，并且被遥控控制。
假体被构造为桥接在两节脊椎之间，最优选但不限于，桥接相邻的脊椎。假体包括构造为附接到多个骨附接点的多个附接部件(端部特征)，例如但不限于，脊椎端板。
因此，根据本发明的非限制性实施例提供了脊椎植入物，其包括用于附接到第一脊椎部分的第一脊椎附接部件、用于附接到第二脊椎部分的第二脊椎附接部件，以及设置在第一和第二脊椎附接部件之间的植入后可变尺寸装置，该装置在完成将所述脊椎植入物安装入患者体内的手术后可操作，以促使在第一和第二脊椎附接部件之间的相对运动。
根据本发明的实施例，第一和第二脊椎附接部件包括倾斜对准导轨。
根据本发明的实施例，植入后可变尺寸装置改变在第一和第二脊椎附接部件之间的距离。
根据本发明的实施例，植入后可变尺寸装置改变第一和第二脊椎附接部件在矢状平面和垂直平面上的位置。
根据本发明的实施例，第一脊椎附接部件包括狭缝(通道)，并且设置在该狭缝中的牵引元件相对于第二附接部件拉或推该第一附接部件。
根据本发明的实施例，牵引元件由螺杆致动，该螺杆由齿轮系旋转，其中齿轮系的旋转改变第一和第二支承板之间的距离。
根据本发明的实施例，第一和第二脊椎附接部件包括相对于彼此倾斜的第一和第二对准导轨。
根据本发明的实施例，植入后可变尺寸装置是液压致动的或空气致动的。
根据本发明的实施例，植入后可变尺寸装置是电致动的。
根据本发明的实施例，植入后可变尺寸装置包括内部的植入的部分。内部部分可以包括活塞、泵、微处理器、RF发射器/传送器、LVDT(线性可变差分换能器)、应变传感器、电子线圈、电池和电容器中的至少一个。
根据本发明的实施例，植入后可变尺寸装置包括外部控制部分。外部控制部分可以包括控制面板、处理器、RF传送器/发射器、磁电源、电子线圈和蜂窝通信装置中的至少一个。外部控制部分和植入部分之间的通信可以由编码或口令控制，以保护内部装置不被不期望的操作。
附图的简要说明
结合附图，从以下的详细描述将更充分地了解和理解本发明，其中：
图1是包括现有技术的植入后可变尺寸装置的脊椎植入物的简化图示；
图2是根据本发明的实施例构建和操作的包括植入后可变尺寸装置的脊椎植入物的简化部分横截面图；
图3是根据本发明的实施例的图2装置的倾斜对准导轨的简化图示；
图4是根据本发明的另一实施例构建和操作的包括植入后可变尺寸装置的脊椎植入物的简化图示；
图5是根据本发明的又一实施例构建和操作的包括植入后可变尺寸装置的脊椎植入物的简化图示；
图6是图4的实施例的构造中的流体致动活塞的简化图示。
具体实施方式
现在参考图2，其中示出了根据本发明的非限制性实施例构建和操作的脊椎植入物100。
脊椎植入物100显示为植入在两块相邻脊椎101和102之间。脊椎植入物100包括布置为用于在第二(例如下)脊椎附接部件103上滑动的第一(例如上)脊椎附接部件104。更具体地，第一和第二附接部件104和103包括至少一个倾斜对准导轨110，该倾斜对准导轨110在至少一个倾斜通道109上滑动(导轨或各导轨形成在附接部件中的一个中，通道或各通道形成在另一附接部件中)。(导轨和通道在图2的截面中不可见，图3中示出了它们的示例)。通过牵引元件107的拉或推，第一附接部件104在第二附接部件103上滑动。第一和第二附接部件104和103形成具有术后可调尺寸的脊椎融合器。
附接部件的与骨接触的表面可以被涂层以促进骨整合。
根据本发明的非限制性实施例，牵引元件107包括远端舌状物111，该远端舌状物111被接收在形成在第一附接部件104中的凹进112中。牵引元件107的近端113具有内螺纹以与螺杆105(也称为螺钉105)配合。第一附接部件104足够中空以允许螺杆105进入并行进到第一附接部件104中。
螺杆105可以由齿轮系统108旋转，齿轮系统通过由通过致动马达驱动的齿轮系致动，致动马达在此未示出，而在图4中示出。可以在位于封闭仓中的构件和暴露于人体的元件之间设置密封件106。
根据本发明的非限制性实施例，牵引元件107和螺杆105完全地或部分地设置在附接部件103中。轴承元件，例如任何类型的轴承、润滑剂、表面处理等，可以用于降低在牵引元件107和/或螺杆105与附接部件104和/或103之间的摩擦。
根据本发明的实施例，齿轮系统108可以是直齿轮、蜗轮、皮带、链条或其他已知的机构以传送运动。
现在参考图3，其中示出了根据本发明的非限制性实施例的倾斜对准导轨110。对准导轨110可以具有预先设计的角度以在矢状平移和垂直平移之间建立不同的关系。至少一个对准导轨110可以关于装置的中心对称设置或关于中心不对称设置(例如偏心)。通道109的滑动表面可以包括轴承元件117，例如任何类型的轴承、润滑剂、表面处理等，以降低摩擦。
图示的实施例示出了具有大体矩形形状的至少一个对准导轨110；然而，也可以使用不同构型来实施本发明，例如但不包括，燕尾形、圆形、T形或其他任意形状。
现在参考图4，其示出了根据本发明的实施例构建和操作的包括植入后可变尺寸装置的脊椎植入物的横截面。
牵引元件305由螺杆304牵拉。螺杆304连接到齿轮系309，齿轮系309由致动马达303驱动。电池306和印刷电路307用于控制马达303。密封件308用于在封装元件和人体(未示出)之间分离。
根据本发明的实施例，印刷电路307可以包括微控制器、无线电系统、遥控开关、电容器和感应线圈中的至少一个。电子构件可以由外部单元经由遥控(无线电、光、声音等)控制。代替电致动，致动马达303可以是液压的或气动的。
现在参考图5，其示出了根据本发明的另一实施例构建和操作的包括植入后可变尺寸的脊椎植入物的横截面。在该实施例中，牵引元件包括具有杆321的活塞320。位于杆321的远端处的舌状物322被接收在形成于第一附接部件104中的凹进323内。活塞320可以是电操作的、气动操作的或液压(即流体)操作的。
图6示出在图4的实施例的构造中的液压的或气动的活塞320的示例。牵引元件305位于杆321的远端处。活塞320可由气动的或液压的(即流体)泵324操作，活塞320通过管325而与泵相连接。
图2至图6的各实施例可以互换和/或彼此以不同组合相整合。

Claims (11)

1.一种脊椎植入物(100)，包括：
第一和第二脊椎附接部件(104,103)，所述第一和第二脊椎附接部件(104,103)包括至少一个倾斜对准导轨(110)，所述至少一个倾斜对准导轨(110)在至少一个倾斜通道(109)上滑动；以及
牵引元件(107)，所述牵引元件布置为促使所述第一和第二脊椎附接部件(104,103)经由所述至少一个倾斜对准导轨(110)和所述至少一个倾斜通道(109)相对于彼此滑动，其中所述牵引元件(107)包括远端舌状物(111)，所述远端舌状物(111)被接收在形成于所述第一附接部件(104)中的凹进(112)中。
2.根据权利要求1的脊椎植入物(100)，其中所述牵引元件(107)的近端(113)具有内螺纹，以与螺杆(105)配合。
3.根据权利要求2的脊椎植入物(100)，其中所述螺杆(105)被由致动马达(303)驱动的齿轮系统(108)旋转。
4.根据权利要求1的脊椎植入物(100)，其中所述至少一个对准导轨(110)具有预先设计的角度，以当所述第一和第二脊椎附接部件(104,103)相对于彼此滑动时，在所述第一和第二脊椎附接部件(104,103)的矢状平移和垂直平移之间建立不同的关系。
5.根据权利要求1的脊椎植入物(100)，其中所述至少一个对准导轨(110)关于所述植入物(100)的中心对称设置。
6.根据权利要求1的脊椎植入物(100)，其中所述至少一个对准导轨(110)关于所述植入物(100)的中心不对称设置。
7.根据权利要求3的脊椎植入物(100)，其中所述致动马达(303)由印刷电路(307)控制，所述印刷电路(307)包括微控制器、无线电系统、遥控开关、电容器和感应线圈中的至少一个。
8.根据权利要求1的脊椎植入物(100)，其中所述第一和第二脊椎附接部件(104,103)的与骨接触的表面被涂层以促进骨整合。
9.根据权利要求1的脊椎植入物(100)，其中所述通道(109)的滑动表面包括轴承元件(117)。
10.根据权利要求1的脊椎植入物(100)，其中所述牵引元件由带有杆(321)的活塞(320)移动。
11.根据权利要求10的脊椎植入物(100)，其中所述活塞(320)是流体致动的活塞，所述活塞通过管(325)连接到流体泵(324)。
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