CN103619284B - 脊柱植入物和用于其的工具 - Google Patents

脊柱植入物和用于其的工具 Download PDF

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CN103619284B
CN103619284B CN201280031418.8A CN201280031418A CN103619284B CN 103619284 B CN103619284 B CN 103619284B CN 201280031418 A CN201280031418 A CN 201280031418A CN 103619284 B CN103619284 B CN 103619284B
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main body
stick
tumbler
receiving portion
spinal implant
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CN103619284A (zh
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彼得·麦茨-斯塔文哈根
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8872Instruments for putting said fixation devices against or away from the bone
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30428Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by inserting a protrusion into a slot
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
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    • A61FFILTERS 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
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30518Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
    • A61F2002/30523Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts by means of meshing gear teeth
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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Abstract

本发明的主题是一种用于脊柱植入物的工具(12),其带有杆状的操纵杆转动件(42)和连接在该操纵杆转动件上的把手(44),其中,操纵杆转动件(42)在其远端具有分布在其圆周上的多个齿(46),每个齿(46)同轴地定向。创造一种工具,使得能够以简单并精确的方式植入和伸缩脊柱植入物,每个齿(46)这样长地设计,即,使得所述齿能够同时啮合到脊柱植入物(10)的第一操纵杆容纳部(26)的相应壁齿(28)和第二操纵杆容纳部(30)的相应壁齿(32)中。

Description

脊柱植入物和用于其的工具
技术领域
本发明涉及一种按权利要求1的前序部分所述的脊柱植入物,以及一种用于此的、按权利要求4或5的前序部分所述的工具,和一种按权利要求8或9的前序部分所述的、用于伸缩(Distrahieren)该脊柱植入物的方法。
背景技术
由US7,029,498B2已知一种由两个U形的部件构成的、可伸缩的脊柱植入物,其中,两个部件可伸缩地、相对彼此轴向可移动地保持。在U形外部件的自由连接部上构造有输送承接部,抓钳可插入到该输送承接部中。治疗医生可以通过该抓钳抓住脊柱植入物并将其输送到希望的位置。
在定位脊柱植入物之后,将抓钳移除。为了伸缩脊柱植入物到希望的尺寸,首先将细长的导引杆从U形部件的开口插入到脊柱植入物内部,并且在中空的啮合器件移动通过导引杆之前拧到外部件上的螺纹上。在此,啮合器件被移动到脊柱植入物中,直至啮合器件上的外齿与脊柱植入物的内部件上相应构造的齿啮合。现在,如果围绕其纵轴转动啮合器件,则脊柱植入物的内部件相对外部件移动。
整个过程非常困难并且对治疗医生的手指灵活性的要求很高。因为啮合器件只是非常松地放置在导引杆上,在伸缩过程中可能会出现,啮合器件意外地从与齿的啮合中滑出,因此必须重新插入。
由US2006/0241770A1已知一种脊柱植入物,该脊柱植入物具有外部件和内部件,该内部件可滑动地保持在外部件中,其中在外部件的端侧可旋转地布置有一内侧设计有螺纹的旋转环,该螺纹与内部件的外螺纹啮合。 为了在轴向上相对于外部件而调整内部件的位置,将相应的具有一长销的工具穿过外部件和内部件中的第一开口伸至内部件内侧的操纵杆容纳部,其中,设置在工具上的齿圈与旋转环上相应的齿圈啮合。如果使该工具绕其纵轴旋转,则该旋转环沿该脊柱植入物的垂直轴移动。通过旋转环上的螺纹,该内部件相应于螺纹的导程移动。这种脊柱植入物包括许多单独部件,从而导致高生产成本。所述许多可相对运动的单个部件会产生更多摩擦并有错位的危险。对此,治疗医生必须具有较高的手指灵活性,从而使该工具利用其销首先穿过内部件和外部件的开口然后到达对侧的操纵杆容纳部,其中为了有效地使用该工具,齿圈和销必须同步地与旋转环上的操纵杆容纳部或齿圈啮合。
由在后公开的WO2011/134457A1已知一种具有外主体和可滑动地布置的内主体的脊柱植入物,其中在外主体上设置有用于容纳工具的螺纹容纳部。在此,该工具旋紧在外主体上并利用销与内主体上的长孔啮合。该销具有环绕的齿圈,该齿圈与相应布置在长孔上的齿圈啮合。旋转该销,则内主体在轴向上移动。
发明内容
由此出发,本发明所要解决的技术问题是,创造一种开头所述类型的脊柱植入物和用于脊柱植入物的工具,使得能以简单的方式并且精确地伸缩脊柱植入物。
作为该技术问题的解决方案,按照本发明建议开头所述类型的、具有权利要求1的特征的脊柱植入物,一种具有权利要求4的特征的工具和一种具有权利要求5的特征的工具,以及一种按权利要求8或9的特征的、用于伸缩脊柱植入物的方法。所述脊柱植入物、所述工具和所述方法的有利扩展设计可由相应的从属权利要求得出。
按照该技术教导构造的脊柱植入物具有这样的优点,即,由于内主体和外主体的相对运动,实现了快速伸缩,因为通过一个操纵运动同时移动两个主体。
另一个优点是,通过较大的行程实现了脊柱植入物的精确调整。
再另一个优点在于,由于工具形锁合地啮合在壁齿中,所以即便内主体和外主体已被植入甚至处于负载之下,也能用较小的力伸缩内主体或者外主体。
工具的两件式实施形式具有这样的优点,即,能够以非常精确的方式移动内主体和/或外主体。这使得治疗医生能够根据具体的情形仅移动内主体或仅移动外主体。
在一种优选的实施形式中,在内主体和外主体上设置引导结构,该引导结构防止内主体相对外主体的转动并且同时确保轴向导引。这具有这样的优点,即,在伸缩时可能出现的周向力不会使内主体转动。
引导结构有利地按照榫槽原理构造。在此,例如在内主体上构造同轴的槽,外主体的内壁上与之相应地构造的凸起嵌接在该槽内。通过榫槽结构,实现了内主体在脊柱植入物的一定长度上的导引,因此可靠地避免了(旋转)错位。
附图说明
按本发明的脊柱植入物、按本发明的工具和按本发明的方法的其它优点可由附图和以下描述的实施形式得出。另外,按照本发明,前述的和还将进一步描述的特征可以分别单独或以任意组合应用。所提及的实施形式不能理解为穷举,而是仅作为示例。在附图中示出:
图1是按本发明的脊柱植入物和按本发明的工具的第一实施例的透视图;
图2是按图1的脊柱植入物和工具沿着图1中的线II-II剖切的截面俯视图;
图3是按图1的脊柱植入物沿着图2中的线III-III剖切的截面侧视图;
图4是按图1的脊柱植入物和按本发明的工具的第二实施例的透视图;
图5是按图1的脊柱植入物和按图4的工具的截面俯视图;
图6是按图1的脊柱植入物沿着图5中的线VI-VI剖切的截面侧视图。
具体实施方式
在图1至3中示出了按本发明的脊柱植入物10和按本发明的工具12的第一实施例。
脊柱植入物包括外主体14和轴向可移动地保持在外主体中的内主体16,这两个主体在此处所示的实施例中设计为圆柱形。在两个主体14、16上构造有引导结构18,引导结构导引两个主体14、16的轴向移动,并且阻止主体14、16相对彼此的转动。引导结构18包括设置在内主体16的外侧上的、同轴定向的槽20和与槽20相应地构造在外主体14的内侧上的凸起22。
在内主体16上构造有设计为同轴定向的长孔的第一操纵杆容纳部26,在其竖直的侧面构造有多个壁齿28。在外主体14上构造有同样设计为同轴定向的长孔的第二操纵杆容纳部30,在其竖直的侧面构造有多个壁齿32。第一和第二操纵杆容纳部26、30的壁齿28、32应当设置在操纵杆容纳部26、30相互对置的侧面上。
这样布置内主体16和外主体14的槽20、凸起22,使得构造为长孔的第一操纵杆容纳部26与构造为长孔的第二操纵杆容纳部30至少部分对齐,从而工具12能够穿过第二操纵杆容纳部30插入到第一操纵杆容纳部26中。
按本发明的工具12的第一实施例包括杆状的操纵杆转动件42和连接在其上的把手44。在操纵杆转动件42的远端上设置有多个径向突出的齿46,所述齿与操纵杆转动件42的纵轴同轴地设置在操纵杆转动件的表面上。所述齿46紧密布置,从而形成齿圈。此外,每个齿46这样长地设计,即,其同时可以啮合到脊柱植入物10的第一操纵杆容纳部26的相应壁齿28和第二操纵杆容纳部30的相应壁齿32中。
在图4至6中示出了按本发明的工具112的第二实施例,其与在图1 至3中所示的第一实施例的区别仅在于,按图4至6的工具的操纵杆转动件142设计为两件式的,并且具有内转动件150和外转动件152。把手144也是两件式的,并且具有内把手154和外把手156。
内转动件150与内把手154作用连接,而外把手156与外转动件152作用连接,从而内转动件150可以通过内把手154操纵,而外转动件152可以通过外把手154操纵。在此两者可以相互独立地使用。为此,内转动件150和内把手154设计为中空的,使得外转动体152保持在该中空空间内。
在内转动体150的远端和外转动体152的远端径向突出地设置有内齿158和外齿160,这两种齿具有相同的长度。
在外科手术中,治疗医生确定待置入的脊柱植入物10的大小。之后,脊柱植入物在希望的位置安置到人体内。现在,为了伸缩,按照第一实施例(图1至3)的工具12这样置入脊柱植入物中,使得齿46既伸入到第一操纵杆容纳部26中,也伸入到第二操纵杆容纳部30中并且在此与壁齿28、32啮合。然后,治疗医生围绕该工具的纵轴旋转工具12的把手44。在此,操纵杆转动件42同时引起内主体16在一个方向上的移动和外主体14在另一方向上的移动。因为通过唯一一个操纵运动使两个主体14、16移动,可以非常迅速并且非常精确地执行伸缩。
在使用按图4至6的工具112时,外齿160啮合在内主体16中的第一操纵杆容纳部26中,而内齿158啮合在外主体14的第二操纵杆容纳部30中。现在,可通过旋转内把手154使外主体14轴向移动,或可通过旋转外把手156使内主体16轴向移动。

Claims (5)

1.一种脊柱植入物,带有外主体(14)和轴向可移动地保持在外主体中的内主体(16),其中,在所述外主体(14)上设有第一操纵杆容纳部(26)并且在所述内主体(16)上设有第二操纵杆容纳部(30),其特征在于,所述两个操纵杆容纳部(26,30)设计为长孔,所述两个操纵杆容纳部(26,30)相互对齐地布置成使得第一纵侧与第二纵侧相对;在第一和第二操纵杆容纳部(26,30)的纵侧构造有多个伸入到操纵杆容纳部(26,30)中的壁齿(28,32);所述第一操纵杆容纳部(26)的壁齿(28)设置在第一纵侧,所述第二操纵杆容纳部(30)的壁齿(32)设置在第二纵侧;并且在所述内主体(16)和所述外主体(14)上设置有引导结构(18),所述引导结构允许所述内主体(16)相对所述外主体(14)轴向移动,但是防止所述内主体(16)相对所述外主体(14)的转动。
2.根据权利要求1所述的脊柱植入物,其特征在于,所述引导结构(18)按照榫槽原理构造。
3.一种用于按权利要求1或2构造的脊柱植入物的工具,带有杆状的操纵杆转动件(142)和连接在该操纵杆转动件上的把手(144),其特征在于,所述操纵杆转动件(142)设计为两件式的,其中,所述操纵杆转动件(142)包括内转动件(150)和外转动件(152);所述内转动件(150)在其远端具有内齿(158),所述外转动件(152)在其远端具有外齿(160),使得所述内转动件(150)能独立于所述外转动件(152)使用。
4.根据权利要求3所述的工具,其特征在于,所述把手(144)设计为两件式的,其中,所述把手(144)包括内把手(154)和外把手(156);并且所述内转动件(150)与所述内把手(154)作用连接,而所述外转动件(152)与所述外把手(156)作用连接。
5.根据权利要求3或4所述的工具,其特征在于,所述内齿(158)和所述外齿(160)具有相同的长度。
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