CN107072794A - 脊柱架 - Google Patents

脊柱架 Download PDF

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CN107072794A
CN107072794A CN201580038178.8A CN201580038178A CN107072794A CN 107072794 A CN107072794 A CN 107072794A CN 201580038178 A CN201580038178 A CN 201580038178A CN 107072794 A CN107072794 A CN 107072794A
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乌里·阿宁
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Aifu Co Ltd
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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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    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
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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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    • 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
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
    • A61F2/30—Joints
    • 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30471—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
    • 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
    • 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
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • 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
    • 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
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30556—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting thickness
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
    • A61F2/30—Joints
    • 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
    • A61F2002/30579—Special structural features of bone or joint prostheses not otherwise provided for with mechanically expandable devices, e.g. fixation devices

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Abstract

脊柱架(10)包括：能够附接到椎骨的第一和第二脊柱附接部件(12、14)，该第一和第二脊柱附接部件(12、14)借助于铰接接头(11)彼此铰接；以及楔元件(20)，楔元件(20)被布置为楔入在第一和第二脊柱附接部件(12、14)之间。致动器(22)连结到楔元件(20)，用于关于第一和第二脊柱附接部件(12、14)轴向地移动楔元件(20)。致动器包括与楔元件(20)相邻的螺纹部件(24)。在转动螺纹部件(24)时，楔元件(20)关于铰接接头(11)前移，使得第一和第二脊柱附接部件(12、14)关于彼此倾斜或平行。

Description

脊柱架
技术领域
本发明总体上涉及脊柱植入物和假体，并且特别地涉及一种可旋转的脊柱架。
背景技术
脊柱侧凸是一种影响很多人的脊柱畸形。当前的手术治疗包括借助椎弓根螺钉将长的融合杆加接至脊椎。杆系统旨在将变形的脊椎强制推到更为健康的位置。通常通过融合来治疗的其它脊柱错位包括脊柱后凸过度和脊柱前凸过度。
PCT专利申请PCT/US2013/020454描述了一种脊柱架，其具有可旋转枢轴以及允许在一个方向上旋转而防止在相反方向上旋转的机构。
发明内容
本发明也致力于提供一种通过使用插入在相邻的椎骨本体之间的脊柱架来矫正脊柱畸形的改进方法。脊柱架以这样的方式构建，即，其具有可旋转枢轴以及允许在一个方向上旋转而防止在相反方向上旋转的机构。该脊柱架可例如用于矫正脊柱的前凸或其它错位。
在本发明的一个实施例中，脊柱架包括：能够附接到椎骨的第一和第二脊柱附接部件，该第一和第二脊柱附接部件借助于铰接接头彼此铰接；以及楔元件，该楔元件布置为楔入第一和第二脊柱附接部件之间。致动器连结到楔元件，用于关于第一和第二脊柱附接部件轴向地移动楔元件。致动器包括螺纹部件和偏压装置，螺纹部件附接到楔元件，偏压装置定位在第一和第二脊柱附接部件中的至少一个与楔元件之间。在转动螺纹部件时，楔元件关于铰接接头前移或缩回，使得第一和第二脊柱附接部件关于彼此倾斜或平行。偏压装置在楔元件上施加偏压力以轴向地移动楔元件。
附图说明
根据结合附图做出的以下详细描述，将更充分地理解和领会本发明，其中：
图1是现有技术PCT专利申请PCT/US2013/020454的单向可旋转脊柱架的纵截面的简化图形示意；
图2和图3分别是根据本发明的非限制实施例构造和操作的具有第一和第二脊柱附接部件的脊柱架的简化形象视图和顶视图示意，其中第一脊柱附接部件分别处于倾斜和水平定向；并且
图4和图5是脊柱架的简化侧视图示意，其中第一脊柱附接部件分别处于倾斜和水平定向。
具体实施方式
现在参照图1，其示意了现有技术PCT专利申请PCT/US2013/020454的可旋转脊柱架80。
脊柱架80包括第一脊柱附接部件82和第二脊柱附接部件84，诸如平板。第一脊柱附接部件82和第二脊柱附接部件84分别附接到两个相邻的椎骨83和85。所述板可以具有与椎骨接合的粗糙或不平整的表面，用以增强与椎骨或组织的结合(也可以使用其它粘合增强物，诸如用于与组织等结合的涂层等)。例如，脊柱架80的固定能够借助于长钉、螺钉或本领域技术人员已知的其它装置来增强。
第一脊柱附接部件82和第二脊柱附接部件84借助于铰接接头相互铰接。因而，脊柱架80能够以一个旋转自由度绕铰接接头枢转。在所示意的实施例中，铰接接头包括阳部件86，该阳部件86以可枢转方式接纳在阴部件88中。在所示意的实施例中，阳部件86从第一脊柱附接部件82延伸出，并且阴部件88形成在第二脊柱附接部件84中。也能够制成为是相反的。
楔元件90布置成楔入在第一脊柱附接部件82和第二脊柱附接部件84之间。楔元件90可具有大体锥形或梯形形状或能够被第一脊柱附接部件82和第二脊柱附接部件84容纳的其它形状。致动器92连结到楔元件90，用以在使楔元件90在部件82和84之间进一步楔入(即，增加楔入效果)或进一步远离部件82和84(即，减弱楔入效果)的方向上移动楔元件90。致动器92能够但不限于是弹簧、马达、线性致动器、螺线管等。致动器92能够直接地或通过线绳、杆、或任何其它连接元件推动或拉动楔元件90。
第一脊柱附接部件82和第二脊柱附接部件84的接触楔元件90的表面能够被抛光、不平整化、有沟槽等，以增加在楔子和部件之间的摩擦。在一个实施例中，楔元件90能够具有螺纹孔、销、沟槽等，用于利用工具来抓持从而能够拉动楔子并释放该单向机构并且允许附接部件82和84朝另一方向的旋转。
应该指出的是，现有技术的楔机构具有若干特征。
首先，楔元件90和致动器92定位在铰接接头的相反侧上。
其次，由于楔元件90通过单向机构仅在楔入方向上运动(除非通过一些抓持工具在与楔入方向相反的方向上释放和牵拉)，所以期望增加在楔元件90与脊柱附接部件82和84之间的摩擦，使得楔元件90不会滑动。
现在参照图2-5，其示意了根据本发明的非限制实施例构造和操作的脊柱架10。
脊柱架10包括第一脊柱附接部件12和第二脊柱附接部件14，第一脊柱附接部件12和第二脊柱附接部件14中的每个分别具有能够附接至椎骨的骨接合表面13和15。骨接合表面13和15可构造为通过增加它们的表面区域来促进骨整合。例如，在所示意实施例中，诸如通过多个齿来使骨接合表面13和15不平整化。另外地或可替代地，可以通过其它方式，诸如通过酸蚀、喷砂和/或机加工，来使表面13和15不平整化。另外地或可替代地，能够对表面13和15进行涂覆以促进骨整合。磷酸钙陶瓷，诸如磷酸三钙(TCP)和羟磷灰石(HA)，是能够增强表面13和15的骨整合的材料的示例。另外地或可替代地，表面13和15能够包括被构造成促进骨整合并且能够单独地使用或与上面所述的不平整结构和/或涂层一起使用的宏观结构，诸如，例如，滚珠、微珠、刻痕和/或沟槽。
第一脊柱附接部件12和第二脊柱附接部件14分别具有(与骨接合表面13和15相反的)内表面3和5。内表面3和5的远侧和/或近侧部分可以弯曲，用以提供第一脊柱附接部件12和第二脊柱附接部件14之间的增加的倾斜。例如，第一脊柱附接部件12的内表面3的远侧和/或近侧部分可以凸形的，而第二脊柱附接部件14的内表面5的远侧部分可以是凹形的。
第一脊柱附接部件12和第二脊柱附接部件14的骨接合表面13和15可以是平坦的。可替代地，表面13和15可以是弯曲的或其它形状的，以匹配它们被设计为附接到的椎骨或其它脊椎结构的解剖形状。另外地或可替代地，第一脊柱附接部件12和第二脊柱附接部件14的几何形状可构造为适应相邻的椎骨之间的前凸角度。
第一脊柱附接部件12和第二脊柱附接部件14借助于铰接接头11相互铰接。在所示意的实施例中，铰接接头11包括阳部件16，该阳部件16以可枢转方式接纳在阴部件18中。在所示意的实施例中，阳部件16从第二脊柱附接部件14延伸出，并且阴部件18形成在第一脊柱附接部件12中。当然，还能够制成为是相反的。
楔元件20(图4)布置成楔入在第一脊柱附接部件12和第二脊柱附接部件14之间。楔元件20可具有大体锥形或梯形形状或能够被第一脊柱附接部件12和第二脊柱附接部件14容纳的其它形状。在所示意的实施例中，楔元件20具有大体平坦表面20A和斜切表面20B，平坦表面20A在第二脊柱附接部件14的内表面5上滑动，斜切表面20B楔靠在第一脊柱附接部件12的内表面3上(图4)。楔元件20可以成形为使得在任意位置处，其关于第一脊柱附接部件12和第二脊柱附接部件14被几何锁定。
致动器24连结到楔元件20，用于在部件12和14之间轴向地移动楔元件20，从而改变部件12和14之间的倾斜。致动器22包括附接至楔元件20的螺纹部件24(诸如螺钉)和定位在第一脊柱附接部件12或第二脊柱附接部件14与楔元件20之间的偏压装置26(诸如弹簧)。通过适当地转动螺纹部件24，楔元件20关于铰接接头11前移，使得第一脊柱附接部件12和第二脊柱附接部件14关于彼此倾斜(图2和4)或平行(图3和5)。
在一种操作模式中，外科医生诸如借助于患者中的侧向通路安装脊柱架10，并调节螺纹部件24以将楔元件20放置在第一脊柱附接部件12和第二脊柱附接部件14的初始构造处(例如，期望的倾斜构造)，从而帮助矫正患者的脊椎的弯曲。在手术后，如果患者在某一时刻继续做出趋于进一步矫正脊柱弯曲的运动(诸如借助于术后侧向弯曲练习等)，则偏压装置26将立即在楔元件20上施加偏压力以进一步轴向地移动楔元件20至新位置，该新位置将脊柱的当前位置维持在新矫正的位置处。楔元件20通过被几何锁定在位而保持在其被偏压装置26推动到的新位置。这样，经过一段时间并且通过患者的逐渐进一步矫正运动，该系统逐渐地进一步矫正脊柱的弯曲。
与现有技术相反，在本发明中，螺纹部件24和偏压装置26两者都处于铰接接头11的相同一侧上。另外，与现有技术相反，在本发明中，楔元件20(特别是斜切表面20B)可以被涂覆以减少楔元件20与第一脊柱附接部件12或第二脊柱附接部件14的内表面之间的摩擦。

Claims (11)

1.一种脊柱架(10)，包括：
能够附接到椎骨的第一脊柱附接部件和第二脊柱附接部件(12、14)，所述第一脊柱附接部件和所述第二脊柱附接部件(12、14)借助于铰接接头(11)彼此铰接；以及
楔元件(20)，所述楔元件(20)被布置为楔入在所述第一脊柱附接部件和所述第二脊柱附接部件(12、14)之间；
其特征在于致动器(22)，所述致动器(22)连结到所述楔元件(20)，用于关于所述第一脊柱附接部件和所述第二脊柱附接部件(12、14)轴向地移动所述楔元件(20)，所述致动器包括与所述楔元件(20)相邻的螺纹部件(24)，并且其中，在转动所述螺纹部件(24)时，所述楔元件(20)关于所述铰接接头(11)前移，使得所述第一脊柱附接部件和所述第二脊柱附接部件(12、14)关于彼此倾斜或平行。
2.根据权利要求1所述的脊柱架(10)，还包括偏压装置(26)，所述偏压装置(26)定位在所述第一脊柱附接部件和所述第二脊柱附接部件(12、14)中的至少一个脊柱附接部件与所述楔元件(20)之间，并且其中，所述偏压装置(26)在所述楔元件(20)上施加偏压力以轴向地移动所述楔元件(20)。
3.根据权利要求1所述的脊柱架(10)，其中，所述螺纹部件(24)和所述偏压装置(26)在所述铰接接头(11)的同一侧上。
4.根据权利要求1所述的脊柱架(10)，其中，所述楔元件(20)被涂覆以减小在所述楔元件(20)与所述第一脊柱附接部件和所述第二脊柱附接部件(12、14)的内表面之间的摩擦。
5.根据权利要求1所述的脊柱架(10)，其中，所述铰接接头包括以可枢转方式接纳在阴部件(18)中的阳部件(16)。
6.根据权利要求1所述的脊柱架(10)，其中，所述铰接接头(11)允许在一个旋转自由度上绕所述铰接接头铰接枢转。
7.根据权利要求1所述的脊柱架(10)，其中，所述第一脊柱附接部件和所述第二脊柱附接部件(12、14)中的每个脊柱附接部件包括骨接合表面(13、15)，所述骨接合表面(13、15)能够附接到椎骨，并且所述骨接合表面(13、15)被构造成促进骨整合。
8.根据权利要求1所述的脊柱架(10)，其中，所述楔元件(20)具有大体平坦表面(20A)和斜切表面(20B)，所述大体平坦表面(20A)在所述第二脊柱附接部件(14)的内表面(5)上滑动，所述斜切表面(20B)楔靠在所述第一脊柱附接部件(12)的内表面(3)上。
9.根据权利要求1所述的脊柱架(10)，其中，所述楔元件(20)被成形为在所述楔元件(20)的任意位置处关于所述第一脊柱附接部件和所述第二脊柱附接部件(12、14)几何锁定。
10.根据权利要求6所述的脊柱架(10)，其中，所述骨接合表面(13、15)被成形为匹配所述第一脊柱附接部件和所述第二脊柱附接部件(12、14)要附接到的脊椎结构的解剖形状。
11.根据权利要求1所述的脊柱架(10)，其中，所述第一脊柱附接部件和所述第二脊柱附接部件(12、14)的几何形状构造成适应相邻的椎骨之间的前凸角度。
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