CN106068110A - 具有临时固定板的垫片 - Google Patents
具有临时固定板的垫片 Download PDFInfo
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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
- 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
- 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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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7059—Cortical plates
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8625—Shanks, i.e. parts contacting bone tissue
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- 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
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- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- 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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- 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
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- A61F2/446—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 having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
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- 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
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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
- A61F2/4465—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 having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
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- A—HUMAN NECESSITIES
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- 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
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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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
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
- A61F2002/30672—Features concerning an interaction with the environment or a particular use of the prosthesis temporary
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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
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- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2002/4435—Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes
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- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0008—Fixation appliances for connecting prostheses to the body
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- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
Abstract
一种用于脊柱融合的系统,其包括:垫片、板、附接元件,和第一临时固定螺钉。所述垫片包括第一连接孔,该第一连接孔具有第一螺纹,该第一螺纹的螺距大于或等于该第一连接孔的深度的三分之一。所述板包括第一附接孔和第二附接孔。所述附接元件包括与所述第一螺纹配对的配对螺纹。所述附接元件被配置成当插入所述第二连接孔中并转动以接合所述第一连接孔的第一螺纹时,连接所述垫片和所述板。所述第一临时固定螺钉被配置成当插入所述第一附接孔并驱入第一椎骨中时,将所述板附接至所述第一椎骨。
Description
相关申请的交叉引用
本申请要求系列号为62/117,384,2015年2月17号提交的,标题为“Lateral Spacerwith Temporary Fixation Plate”的美国临时申请的优先权。本申请还要求序列号为14/634,107,2015年2月27号提交的,标题为“Spacer with Temporary Fixation Plate” 的美国非临时申请的优先权,其全部内容通过引用结合于本文中。
技术领域
本发明一般涉及脊柱手术,并且更特别地,涉及具有临时固定板的椎体间垫片。
背景技术
脊柱为由多块称为椎骨的骨头形成的柔性柱。椎骨为中空的并且彼此堆叠,形成支撑颅骨和躯干的强有力的中空柱。脊柱的中空核心容纳并保护脊髓神经。不同的椎骨通过关节突和椎间盘,纤维软骨组织彼此连接。各种脊柱疾病可能导致脊柱错位、弯曲和/或扭曲或者导致椎骨破裂和/或压缩。通常需要手术矫正这些脊柱疾病
脊柱包括7块颈(颈部)椎,12块胸(胸部)椎,5块腰(下背)椎,和骶骨、尾骨中有助于形成髋部的融合椎骨。虽然在这些部位中各个椎骨的形状不同,然而每块椎骨基本上是较短的中空骨干,含有被称为脊髓的神经束。各个神经,比如携带传递至手臂或腿部的信息的那些神经,经由椎骨之间间隙进入和离开脊髓。
脊柱间盘充当减震器,缓冲脊柱,并防止各个骨头彼此接触。椎间盘也有助于使椎骨保持在一起。上身重量通过脊柱传递到髋部和腿。脊柱通过背部肌肉的工作保持直立,背部肌肉附接椎骨。虽然正常脊柱没有左右曲线,但它确实具有一列前后曲线,使其显出温和的“S”形。如果由于脊柱侧凸、神经肌肉疾病、脑瘫,或其它病症而没有呈现适当的成形和/或曲率,可能有必要将脊柱拉直或调节至合适曲率。
一般地,通过将椎骨摆布至其合适的位置,并用螺钉、杆、椎间垫片,和/或板的刚性系统固定该位置而获得正确曲率。可以通过开放性手术或微创手术用手术插入该系统的各种部件。也可以通过包括前侧,外侧,和后侧入路的各种方法以及之间的其它方法将该部件插入脊柱。
手术中可以使用脊柱固定系统以矫直、调节和/或修复脊柱部分(即,椎骨)相对彼此的期望空间关系。为了各种治疗目的,许多脊柱固定系统采用脊柱杆以支撑脊柱并适当地定位脊柱部件。椎骨锚固件,包括销、螺栓、螺钉,以及钩,接合椎骨并将支撑杆连接至不同椎骨。圆柱形杆的尺寸、长度,和形状取决于待由该装置相对于彼此保持期望的空间关系的椎骨的尺寸、数量和位置。
在外侧脊柱手术中,首先可以将患者侧放。在移除一些或全部椎间盘之后,可以将垫片/保持架/椎体插入在相邻椎骨之间的椎间盘间隙中。接着,患者必须转至其背面或正面以便安装另外的固定结构比如螺钉和杆和/或板。但是,在转动患者的同时,垫片可能向前方或向后方迁移。这种迁移可能损伤邻近组织如血管系统或神经系统的部分。由这种迁移引起的伤害可能会危及患者康复,甚至可能导致瘫痪,严重失血,或其它不可逆的伤害。因此,本发明包括一个或多个特征以在将患者转至合适位置以附接固定结构的同时,能够临时固定垫片。
发明内容
用于脊柱融合的系统包括垫片、板、附接元件,和第一临时固定螺钉。该垫片包括第一连接孔,该第一连接孔具有第一螺纹,并且螺距大于或等于该第一连接孔的深度的三分之一。该板包括第一附接孔和第二连接孔。该附接元件包括与第一螺纹配对的配对螺纹。该附接元件被配置成当插入第二连接孔中并转动以接合该第一连接孔的第一螺纹时,连接该垫片和该板。该第一临时固定螺钉被配置成当插入第一附接孔中并驱入第一椎骨中时,将该板附接至该第一椎骨。
在其它特征中,所述螺距大于或等于该垫片的第一连接孔的深度。在其它特征中,该螺距大于或等于该垫片的第一连接孔的深度的2倍。
在其它特征中,第一合成孔包括第二螺纹,并且第二螺距等于该第一螺距。
在其它特征中,该第一螺纹包括长引线梯形螺纹。
在另外的其它特征中,半转的附接元件与少于一个全螺纹的第一螺纹接合,并且该第一连接孔连接垫片和板。
在另外的其它特征中,该板包括成对的突起,该成对的突起以叉的形式向远端延伸以与该垫片的成对的凹部接合。该垫片进一步包括远端、中段,和近端,所述远端插在两块椎骨之间,所述中段包括在该中段的外表面上的成对的凹部,所述近端包括连接孔。
在其它特征中,该板包括第二附接孔。该系统进一步包括第二临时固定螺钉,该第二临时固定螺钉被配置成当插入该第二附接孔并驱入该第二椎骨中时,将该板附接第二椎骨。
附图说明
图1为根据本发明的原理的典型的种植体的等距视图。
图2为在图1的相反方向看时图1的种植体的等距视图。
图3为图1中展示的种植体的侧视图。
图4为图1中展示的种植体的俯视图。
图5和6为图1的种植体的分解图。
图7为从图1的种植体的板看过去的侧视图。
图8为沿图7的平面A剖开的种植体的剖视图。
图9为根据本发明的原理的另一典型的种植体的等距视图。
图10为从图9的相反方向看的图9的种植体的等距视图。
图11-12展示了根据本发明的原理的典型的种植体的附接元件。
图13展示了该附接元件的仰视图。
图14为沿图13的平面B剖开的附接元件的剖视图。
具体实施方式
现在结合附图,描述本发明的实施例,其中相同的附图标记表示相同的元件。在此使用的术语不能以任何受限或约束的方式进行解释,因为其仅用于结合本发明的一些特定实施例进行具体描述。此外,本发明的实施例可以包括若干新特征,其中没有任何一个特征单独为其期望的属性负责,或是实践在此所述的发明所必不可少的。在此应用的词语近和远表示在此描述的机构的部件的特定末端。近端指的是使用该机构时靠近该机构的操作者的机构末端。远端指的是远离操作者并朝患者的手术区和/或种植体延伸的部件末端。
结合附图,从详细说明的典型实施例可以明白本发明的前述特征和其它特征。详细说明和附图仅用于展示本发明而非限制,本发明的范围由权利要求及其等效元件限定。
参考图1-8,典型的种植体100包括垫片102、板104、一个或多个临时固定螺钉106,和附接元件108。该垫片102可以被配置成通过脊柱的侧面插入并进入两块相邻椎骨之间的椎间盘空间中。该垫片102可以包括各种凹槽和用于接收板104和附接元件108的配对特征的孔。该固定螺钉106可以用于使所述板104附接至两块相邻的椎骨。
在外侧脊柱融合术中,该垫片102可以首先通过患者侧面的开口插入患者中。例如,在外侧腰椎椎体间融合术(LLIF)中,可以将患者侧放,同时在腹部至脊柱的侧边产生开口。该垫片102可以压紧在提供一定量的力以限制该垫片102运动的椎骨之间。但是,通常推荐由另外的压缩力使垫片102保持在合适位置,该另外的压缩力由固定结构,比如,杆、螺钉,和板施加。为了插入该固定结构,必须将患者从其侧边转到腹部或背侧。
转动期间,该垫片102可能离开原位并朝患者脊髓向后或朝患者血管结构向前迁移。因此,利用临时固定螺钉106和附接元件108,所述板104可以附接至垫片102和相邻的椎骨。该固定螺钉106可以包括用于接合的螺纹。
该垫片102包括用于接合相邻椎骨的上表面110和下表面112。两个表面110和112可以包括齿114或脊以抵抗种植体100的侧向迁移。在该垫片102的远端,子弹式凸块116可以减轻该垫片102插入椎间盘空间的痛苦。所述垫片102包括前壁118和后壁120,前壁118和后壁120由近侧壁122和远侧壁124连接。中间壁126可从前壁118延伸至后壁120,从而为该垫片102提供额外的加固作用。该垫片102进一步包括凹部128,该凹部128通过近侧壁122的一部分部分地延伸并延伸至前壁118和后壁120。该凹部128可以包括被配置成接收插入机构的突起或从板104延伸的突起130的轮廓。该近侧壁122还包括第一连接孔132,该第一连接孔132被配置成接收附接元件108。
该板104包括孔134,该孔134被配置成接收临时固定螺钉106。所述孔134的直径可以小于所述螺钉106的头部直径。该板104包括突起130,该突起130远离板104沿远端方向延伸以与该垫片102的凹部128接合。该板104包括附接孔136,该附接孔136被配置成接收该附接元件108。该附接孔136的直径小于该附接元件108的头部直径。
该附接元件108可以包括螺纹138,该螺纹138用于与垫片102的配对螺纹140接合。用于板和垫片的现有连接特征包括这样的螺纹:螺距TP典型地小于垫片中的螺纹孔的深度D,有时小于至少三倍的级数,并且通常更多,在六倍的级数上,使得螺纹的至少六个牙顶接合该垫片。因此,该螺距为至少D/3或更典型地在大约D/6的级数。
现在参考图11-14,该附接元件108的螺纹138的螺距TP可以大于现有螺距。例如,该螺纹138的TP大于在垫片102的近壁122中的第一连接孔132的深度D的三分之一。通过半转的附接元件108与少于一个全牙顶的螺纹138接合,所述螺纹138允许垫片102与板104连接。
在一些实施例中,如图14的剖视图可见,该螺纹138包括长引线(螺距)梯形螺纹。在一些实施例中,该螺纹138包括修正过的Acme螺纹。在一些实施例中,该螺纹包括第一螺纹138a和第二螺纹138b,并且两条独立的引线形成双引线双螺纹。在一些实施例中,该螺纹138的双引线和非常大的螺距大于或等于大约2倍的D,其中D为垫片102的第一连接孔132的深度(或近壁122的厚度)。在一些实施例中,通过将连接元件108转动180度,该螺纹138允许垫片102牢固地连接至板104。
图9-10展示了包括与第一种植体100相同或相似特征的另一典型的种植体200。但是,在种植体200中,设有单个临时固定螺钉106。在其它方面,呈现与上述种植体100相同的特征。
在此已经描述了本发明的方法和系统的实施例。如其它地方所述,所描述的这些实施例仅用于展示的目的,而不是限制。可能有其它实施例并且本发明涵盖了这些实施例。对本领域技术人员来说,基于包含在此的教导,这样的实施例是显而易见的。因此,本发明的广度和范围不应该被上述任何一个典型实施例所限,而应该仅仅限定在权利要求书及其等效元件中。
虽然本发明与各种实施例一起进行描述,应该理解,本发明能够进行另外的修改。本申请意在涵盖本发明的任何变化、使用或改写,这些变化、使用或改写通常遵循本发明的原理并且包括在本发明所属领域中的公知常识内对本发明的变更。
Claims (10)
1.一种用于脊柱融合的系统,其包括:
垫片,其包括第一连接孔,所述第一连接孔具有第一螺纹,该第一螺纹的螺距大于或等于所述第一连接孔的深度的三分之一;
板,其包括第一附接孔和第二附接孔;
附接元件,其包括与所述第一螺纹配对的配对螺纹,所述附接元件被配置成当插入所述第二连接孔中并转动以接合所述第一连接孔的第一螺纹时,连接所述垫片和所述板;以及
第一临时固定螺钉,其被配置成当插入所述第一附接孔并驱入第一椎骨中时,使所述板附接至所述第一椎骨。
2.根据权利要求1所述的系统,其特征在于,所述螺距大于或等于所述垫片的第一连接孔的深度。
3.根据权利要求1或2所述的系统,其特征在于,所述螺距大于或等于所述垫片的第一连接孔的深度的两倍。
4.根据前面任一项权利要求所述的系统,其特征在于,其包括在第一连接孔内的第二螺纹,所述第二螺纹包括第二螺距,该第二螺距等于所述第一螺距。
5.根据前面任一项权利要求所述的系统,其特征在于,所述第一螺纹包括长引线梯形螺纹。
6.根据前面任一项权利要求所述的系统,其特征在于,半转的附接元件与少于一全螺纹的第一螺纹接合,并且所述第一连接孔使所述垫片与所述板接合。
7.根据前面任一项权利要求所述的系统,其特征在于,所述板包括成对的突起,所述突起以叉的形式向远端延伸以与所述垫片的成对的凹部接合。
8.根据前面任一项权利要求所述的系统,其特征在于,所述垫片进一步包括:
远端,用于插入在两块椎骨之间;
中段,其包括在中段的外表面上的成对的凹部;以及
近端,其包括连接孔。
9.根据前面任一项权利要求所述的系统,其特征在于,其进一步包括在所述板中的第二附接孔。
10.根据权利要求9所述的系统,其特征在于, 其进一步包括第二临时固定螺钉,所述第二临时固定螺钉被配置成当插入第二附接孔并驱入第二椎骨时,使所述板附接至第二椎骨。
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