CN107106305B - 可膨胀的椎体间植入物 - Google Patents

可膨胀的椎体间植入物 Download PDF

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CN107106305B
CN107106305B CN201580071502.6A CN201580071502A CN107106305B CN 107106305 B CN107106305 B CN 107106305B CN 201580071502 A CN201580071502 A CN 201580071502A CN 107106305 B CN107106305 B CN 107106305B
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bone graft
implantation material
expandable
connecting piece
upper component
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CN107106305A (zh
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A·J·麦尔肯特
W·D·阿姆斯特朗
S·T·帕尔玛蒂尔
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Warsaw Orthopedic Inc
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Abstract

一种可膨胀的椎体间植入物适于至少插入在脊柱的两个相邻椎骨之间的椎间盘间隙中。上部构件和下部构件至少由驱动连结件可枢转地连接。骨移植物储存部分填充有所选体积的骨生长材料。平移壁设置骨移植物储存部分和植入物的后端之间。致动器接合骨移植物储存部分，将其向前推动以与驱动连结件接合，驱动连结件向上枢转，使上部构件向上远离下部构件移动。上部构件的向上移动将平移壁升高至有助于将所选体积的骨移植物材料保持在骨移植物储存部分的中空部分内的位置。驱动连结件的向上旋转使其面与骨移植物储存部分的前部接触，从而保持几乎恒定体积的骨移植物材料。

Description

可膨胀的椎体间植入物
技术领域
本发明整体涉及可膨胀的椎体间植入物，并且更具体地涉及脊柱前凸的可膨胀的椎体间植入物，其适于后斜位、前斜位、同轴后位或同轴前位地插入和放置在腰椎中的相邻椎体之间具有外科修正的高度的椎间盘间隙中。
背景技术
脊柱前凸的可膨胀脊柱融合植入物是本领域已知的。这样的已知植入物的脊柱前凸的渐缩构型有助于对腰椎中的脊柱前凸的复位或增强。这样的植入物的膨胀能力允许通过患者体内的较小开口放置可能较大的植入物，并且在所选方向上的选择性膨胀提供了如下优点，即，增加植入物高度和椎间盘间隙的对应撑开，而不需要同时增加植入物的宽度。然而，相关领域的植入物具有某些缺点。
例如，相关领域的植入物的前端的构型限制植入物在椎间盘间隙中的优选放置是沿着限定在椎间盘间隙的前部分和后部分之间的轴线进行。相关领域的植入物的斜向放置未被优化。
此外，相关领域的植入物通常采用斜坡接斜坡(ramp-on-ramp)的连结机构，已经证明该机构不能可靠地允许这样的植入物平滑且可靠地增加至外科医生希望的所选高度。
此外，相关领域的植入物在插入椎间盘间隙内并膨胀期间使所选体积的骨移植物材料保持储存在植入物内方面遇到困难。在这样的相关领域的植入物在椎间盘间隙内的膨胀期间，所储存的骨移植物材料中的一些常常逸出，从而减少储存在植入物内的骨移植物材料的所选体积。
发明内容
本发明的目的是提供适合允许通过患者体内较小的开口来放置可能较大的植入物的可膨胀的椎体间植入物，包括但不限于放入到脊柱的两相邻椎骨之间外科修正的椎间盘间隙中。
本发明的另一个目的是提供一种可膨胀的椎体间植入物，在一个实施例中，该植入物可相对于限定在椎间盘间隙的前表面和后表面之间的轴线以倾斜的角度插入，并且在其它实施例中还沿着所述轴线从前表面或后表面插入。
本发明的又一个目的是提供一种具有改善的驱动连结件的可膨胀的椎体间植入物，从而使外科医生能够将植入物平滑且可靠地膨胀至所选高度。
本发明的又一个目的是提供一种可膨胀的椎体间植入物，该植入物保持几乎恒定的移植物容积室，以免随着植入物膨胀而在骨移植物中形成凹坑。
本发明的又一个目的是提供一种可膨胀的椎体间植入物，该植入物在膨胀期间对储存在植入物内的骨移植物材料的损耗具有改善的控制。
本发明的这些和其它目的将从以下说明书和附图的回顾显而易见。
考虑到上述目的，根据本发明的可膨胀的椎体间植入物包括前端和后端，前端和后端适于至少插入在脊柱的两相邻椎骨之间的具有外科修正高度的椎间盘间隙中。
上部构件具有在前端和后端之间延伸的上表面和限定在上表面中的上部开口。
下部构件具有在前端和后端之间延伸的下表面，以及限定在下表面中的下部开口，并且至少经由驱动连结件可枢转地连接到上部构件。
骨移植物储存部分设置在前端和后端的中间，包括中空部分，该中空部分被构造成填充有所选体积的骨生长材料，并且适于允许经由上部和下部开口以及骨移植物储存部分而在相邻椎骨之间的骨生长。平移壁可移动地安装在骨移植物储存部分和后端之间。
致动器开口形成在靠近后端处，并且被构造用于在其中插入致动器。
致动器在被插入致动器开口之后将骨移植物储存部分朝前端推动并与驱动连结件接合，从而将驱动连结件向前推动并使上部构件向上移动而远离下部构件。
驱动连结件包括细长构件，细长构件具有相对的第一和第二端部以及斜坡部分，第一端部在靠近前端处可枢转地附接到上部构件，并且第二端部在靠近骨移植物储存部分处可移动地安装在下部构件上，斜坡部分具有限定在第一端部和第二端部之间的表面。
骨移植物储存部分在被致动器向前推动时适于接合驱动连结件的第二端部，沿着下部构件推动驱动连结件，从而导致在驱动连结件的第一端部和上部构件之间的可枢转平移。
在驱动连结件的第一端部和上部构件之间的可枢转平移持续进行，直到斜坡部分的表面接合骨移植物储存部分的前端。
平移壁安装到在中空部分的后部部分处的轨道中。向上枢转上部构件接合平移壁，从而使平移壁在轨道中向上升高。平移壁的上表面适于与上部构件的内表面保持基本上齐平，从而有助于防止骨移植物材料从骨移植物储存部分的中空部分损失。
驱动连结件的斜坡的表面与骨移植物储存部分的前端接触，从而防止在骨移植物材料中形成凹坑，并且使骨移植物材料的体积保持基本上恒定。
附图说明
图1是根据本发明的一个实施例的可膨胀的椎体间植入物的后端立体图；
图2是根据本发明的可膨胀的椎体间植入物的分解立体图；
图3是根据本发明的可膨胀的椎体间植入物的一个实施例的侧部正视图，其适于斜向、前位或后位地插入和放置在椎间盘间隙中；
图4是图3的实施例的俯视图；
图5是处于未膨胀位置的根据本发明的可膨胀的椎体间植入物的横截面侧视图；
图6是处于部分膨胀位置的根据本发明的可膨胀的椎体间植入物的横截面侧视图；
图7是处于部分膨胀位置的根据本发明的可膨胀的椎体间植入物的侧视图；
图8是根据本发明的可膨胀的椎体间植入物的另一个实施例的侧部正视图；
图9是根据本发明的可膨胀的椎体间植入物的俯视图，其具有斜的前端，相对于从椎间盘间隙的前部部分延伸至椎间盘间隙的后部部分的轴线以倾斜的角度插入脊柱的两个相邻椎骨之间的外科修正的椎间盘间隙中；以及
图10是根据本发明的可膨胀的椎体间植入物的俯视图，其具有基本上竖直的平坦前端，沿着从椎间盘间隙的后部部分延伸至椎间盘间隙的前部部分的轴线插入脊柱的两个相邻椎骨之间的外科修正的椎间盘间隙中。
具体实施方式
通过考虑说明书和实践本文所公开的本发明，其它实施例对于本领域的技术人员将显而易见。以下描述的实施例旨在仅被看作是示例性的，本发明的真正范围和精神由所附权利要求指示。
如图1-7所示，可膨胀的椎体间植入物20包括前端22和后端24。植入物20适于至少插入在脊柱的两个相邻椎骨之间具有外科修正高度的椎间盘间隙中。此外，植入物20适于从未膨胀位置移动至膨胀位置。
植入物20包括上部构件26，上部构件26具有在前端22和后端24之间延伸的上表面28，且具有形成在上表面28中的上部开口30。
植入物20还包括下部构件32，下部构件32具有在前端22和后端24之间延伸的下表面34，且具有形成在下表面34中的下部开口36。
骨移植物储存部分38优选地设置在前端22和后端24的中间。如图2和图5-6所示，骨移植物储存部分38包括向后延伸部分40、后端部部分41和中空部分46，中空部分46尺寸设计成接纳所选体积的骨移植物材料，该材料可以是本领域熟知的类型。如图2所示，中空部分46的侧壁与上部开口30和下部开口36的侧面的后部分对齐。一旦植入物20被植入椎间盘间隙中，骨移植物材料适于有利于经由上部开口30、中空部分46和下部开口36而在相邻椎骨之间的骨生长。在一个优选实施例中，如图2-6所示，端部部分41具有大体上半圆柱形的构型，其在形状上大体上对应于上部开口30的周边的一部分。
在一个优选实施例中，并且如图2-6所示，平移壁48可移动地设置在狭槽50中，狭槽50设置在后端部部分41和中空部分46之间的桶状部分38中。优选地，平移壁48包括一对竖直延伸部52，其可滑动地安装在限定于端部部分41中的一对轨道54中。如图2所示，竖直延伸部52和轨道54具有圆柱形构型，但任何构型(例如，矩形构型)都在本发明的范围内。此外，销56延伸穿过平移壁48中的小孔58。如图1-3和图7所示，销56插入穿过形成在上部构件26的侧壁62中的椭圆形小孔60。销56适于在椭圆形小孔60中滑动。
致动器68适于插入并移动通过植入物20的后端24中的致动器开口70。优选地，致动器68为带螺纹的致动器，其具有螺纹部分72和致动端74。限定在螺纹部分72上的螺纹被构造成通过螺纹来接合致动器开口70中的对应螺纹。带螺纹的致动器和带螺纹的开口是优选的，因为一旦植入物20膨胀，在致动器68和致动器开口70之间的螺纹接合有助于将植入物20保持在其膨胀位置。然而，本发明不限于使用带螺纹的致动器或带螺纹的致动器开口。本领域熟知的其它致动器构型和对应的致动器开口构型可被使用，并且在本发明的范围内。
植入物包括驱动连结件80。驱动连结件80优选地被构造为细长构件，其具有第一端部82和相对的第二端部90以及在两个相对的端部部分之间的斜坡部分81，斜坡部分81包括终止于峰部分83a中的面部分83。如图2和图5-6所示，第一端部82包括细长销84，其延伸穿过第一端部中的小孔86，并且还穿过在靠近前端22处形成在上部构件26的侧壁62中的小孔88。如图2和图5-6进一步所示，第二端部90可移动地安装在下部构件32的内表面92上。
下面将解释根据本发明的可膨胀的椎体间植入物的优选实施例的插入和放置：
如图5-7所示，致动器68的向前移动使致动端74与桶状部分38的后端部部分41接触。包括中空部分46的桶状部分38被向前推动，直到中空部分46的前部接合驱动连结件80的第二端部90。驱动连结件80的第二端部90在下部构件32的内表面92上被向前推动，导致第一端部82和驱动连结件80的斜坡部分81向上枢转。第一端部82的向上移动在向上枢转运动中将上部构件26向上且远离下部构件32地向上推动，下部构件32在插入穿过小孔102的一对销100上枢转，销100在靠近后端24处将上部构件26和下部构件32接合在一起。
随着上部构件26向上移动，销56在椭圆形小孔60中滑动，从而将平移壁48向上升高，如图6所示。如图5-6所示，由于此构型，在植入物20处于未膨胀位置时与上部构件26的内表面66基本上齐平的平移壁48的上表面64在上部构件26的整个向上枢转移动过程中，与上部构件26的内表面66持续地保持基本上齐平。如图6中进一步所示，对应于上部构件26的向上枢转移动的上壁48的向上移动将平移壁48升高至如下位置，在该位置处，基本上防止了填充到骨移植物储存部分46中的任何所选体积的骨移植物材料在植入物膨胀期间在平移壁48的方向上逸出骨移植物储存空间，从而有助于在植入物20内保持所选体积的骨移植物材料。
上部构件26的向上枢转膨胀被驱动连结件80的斜坡部分81的面部分83限制。面83最终与桶部分38的前表面49接触，从而充当止挡件，并且防止植入物20的进一步枢转膨胀。
此外，随着骨移植物储存部分38向前移动以致动植入物，由在“前端”上的面部分83上的骨移植物储存部分以及相邻椎体的上部和下部终板(分别经由上部开口30和下部开口36)所限定的移植物体积保持基本上恒定，因为随着植入物的顶部至底部尺寸随膨胀而增加，在平移壁48和与前表面49接触的面83之间的中空部分46的前后尺寸同时减小，从而减少储存在骨移植物储存部分38中的骨移植物材料中的凹坑的形成。
植入物20的前端22可具有不同构型。
在一个优选实施例中，如图1-2所示，前端22具有基本上倒圆的子弹形构型。
在另一个优选实施例中，如图3-4和图9所示，前端22具有斜表面β，其限定在上表面28和下表面34之间的倾斜角度α。倾斜角度α优选地为大约45°。如图9所示，该实施例的斜前端22能够相对于限定在椎间盘间隙的前部部分和后部部分之间的轴线以优选45°的倾斜角度来插入椎间盘间隙中。该实施例的斜前端还能够沿着限定在椎间盘的前部部分和后部部分之间的轴线来插入椎间盘间隙中。
在另一个实施例中，如图8所示，前端22具有大体上平坦的形状，其分别相对于上表面28和下表面34中的每一个限定出基本上直角的角度。如图10所示，该实施例的前端22也被构造用于将植入物至少沿着限定在椎间盘间隙的前部部分和后部部分之间的轴线而插入椎间盘间隙中。
在以上描述和附图中公开了全面且有效地实现本发明的目的的植入物。然而，应当显而易见，在不脱离本发明的原理或所附权利要求的范围的情况下，可以做出所公开的实施例的变型和修改。

Claims (20)

1.一种可膨胀的椎体间植入物，其具有前端和后端，适于至少插入在脊柱的两个相邻椎骨之间的、具有外科修正高度的椎间盘间隙中，包括：
上部构件，所述上部构件具有在所述前端和所述后端之间延伸的上表面以及形成在所述上表面中的上部开口；
下部构件，所述下部构件具有在所述前端和所述后端之间延伸的下表面以及形成在所述下表面中的下部开口，并且至少经由驱动连结件可枢转地连接到所述上部构件；
骨移植物储存部分，所述骨移植物储存部分设置在所述前端和所述后端的中间，包括：中空部分，所述中空部分被构造成填充有所选体积的骨生长材料，并且适于允许经由所述上部和下部开口以及所述骨移植物储存部分而在所述相邻椎骨之间的骨生长；以及平移壁，所述平移壁可移动地安装在所述骨移植物储存部分和所述后端之间；以及
致动器开口，所述致动器开口靠近所述后端，被构造用于插入致动器，
其中，在被插入所述致动器开口中之后，所述致动器适于将所述骨移植物储存部分朝向所述前端推动且与所述驱动连结件接合，由此将所述驱动连结件向前推动，并使所述上部构件向上枢转而远离所述下部构件；并且
其中，将所述上部构件向上枢转接合所述平移壁，从而将所述平移壁移动至适于有助于防止所述骨生长材料从所述骨移植物储存部分损失的位置。
2.根据权利要求1所述的可膨胀的椎体间植入物，其特征在于，所述驱动连结件包括具有相对的第一和第二端部的细长构件，所述第一端部在靠近所述前端处可枢转地附接到所述上部构件，而所述第二端部在靠近所述骨移植物储存部分处可移动地安装在所述下部构件上。
3.根据权利要求2所述的可膨胀的椎体间植入物，其特征在于，所述骨移植物储存部分在被所述致动器向前推动时适于接合所述驱动连结件的所述第二端部，沿着所述下部构件推动所述驱动连结件，从而导致在所述驱动连结件的所述第一端部和所述上部构件之间的可枢转平移。
4.根据权利要求3所述的可膨胀的椎体间植入物，其特征在于，所述驱动连结件还包括在所述第一和第二端部中间的斜坡部分，所述斜坡部分具有如下表面，其中，在所述驱动连结件的所述第一端部和所述上部构件之间的所述可枢转平移持续进行，直到所述斜坡部分的所述表面接合所述骨移植物储存部分的前端。
5.根据权利要求1所述的可膨胀的椎体间植入物，其特征在于，所述上部构件和所述下部构件在靠近所述后端处进一步可枢转地连接。
6.根据权利要求1所述的可膨胀的椎体间植入物，其特征在于，所述平移壁安装在所述中空部分的后部部分处的轨道中，并且对所述上部构件向上枢转使所述轨道中的所述平移壁升高。
7.根据权利要求6所述的可膨胀的椎体间植入物，其特征在于，所述平移壁的上表面适于与所述上部构件的内表面保持基本上齐平。
8.根据权利要求1所述的可膨胀的椎体间植入物，其特征在于，所述前端限定有基本上竖直的、基本上平坦的表面。
9.根据权利要求1所述的可膨胀的椎体间植入物，其特征在于，所述前端限定有斜表面。
10.根据权利要求1所述的可膨胀的椎体间植入物，其特征在于，所述前端限定有基本上倒圆的表面。
11.根据权利要求1所述的可膨胀的椎体间植入物，其特征在于，所述骨移植物储存部分适于与所述驱动连结件和所述平移壁中的至少一个相互作用，以在所述植入物膨胀期间在所述骨移植物储存部分中保持基本上恒定体积的所述骨生长材料。
12.一种可膨胀的椎体间植入物，其具有前端和后端，适于至少插入在脊柱的两个相邻椎骨之间的具有外科修正高度的椎间盘间隙中，包括：
上部构件，所述上部构件具有在所述前端和所述后端之间延伸的上表面以及形成在所述上表面中的上部开口；
下部构件，所述下部构件具有在所述前端和所述后端之间延伸的下表面以及形成在所述下表面中的下部开口；
骨移植物储存部分，所述骨移植物储存部分设置在所述前端和所述后端的中间，包括：中空部分，所述中空部分被构造成填充有所选体积的骨生长材料，并且适于允许经由所述上部和下部开口以及所述骨移植物储存部分而在所述相邻椎骨之间的骨生长；以及平移壁，所述平移壁可移动地安装在所述骨移植物储存部分和所述后端之间；
细长驱动连结件，所述细长驱动连结件可枢转地连接所述上部构件和所述下部构件，具有第一和第二端部，所述第一端部在靠近所述前端处可枢转地附接到所述上部构件，而所述第二端部在靠近所述骨移植物储存部分处可移动地安装在所述下部构件上；以及
致动器开口，所述致动器开口靠近所述后端，并且被构造用于插入致动器；
其中，所述致动器适于在被插入所述致动器开口中之后将所述骨移植物储存部分朝所述前端推动且与所述驱动连结件接合，从而将所述上部构件向上枢转至与所述相邻椎骨之间的所述外科修正高度基本上相等的高度。
13.根据权利要求12所述的可膨胀的椎体间植入物，其特征在于，所述上部构件的所述可枢转的向上移动接合所述平移壁，从而使所述平移壁向上移动。
14.根据权利要求12所述的可膨胀的椎体间植入物，其特征在于，所述平移壁包括销，所述销在大体上横向于所述植入物的纵向轴线的方向上插入并穿过所述平移壁，所述销的至少一个端部适于延伸穿过形成在所述上部构件的至少一个侧壁中的大体上椭圆形的小孔。
15.根据权利要求14所述的可膨胀的椎体间植入物，其特征在于，所述大体上椭圆形的小孔的长度适于使得当所述上部构件向上枢转所选距离时，所述销在所述大体上椭圆形的小孔中移动对应的量，以使所述平移壁向上移动，并使所述平移壁的上端与所述上部构件的内表面保持基本上齐平。
16.根据权利要求12所述的可膨胀的椎体间植入物，其特征在于，所述前端限定有基本上竖直的、基本上平坦的表面。
17.根据权利要求12所述的可膨胀的椎体间植入物，其特征在于，所述前端限定有斜表面。
18.根据权利要求12所述的可膨胀的椎体间植入物，其特征在于，所述前端限定有基本上倒圆的表面。
19.根据权利要求12所述的可膨胀的椎体间植入物，其特征在于，所述骨移植物储存部分适于与所述驱动连结件和所述平移壁中的至少一个相互作用，以在所述植入物膨胀期间在所述中空部分中基本上保持所述所选体积的骨生长材料。
20.一种可膨胀的椎体间植入物，其具有前端和后端，适于至少插入在脊柱的两个相邻椎骨之间的具有外科修正高度的椎间盘间隙中，包括：
上部构件，所述上部构件具有在所述前端和所述后端之间延伸的上表面以及形成在所述上表面中的上部开口；
下部构件，所述下部构件具有在所述前端和所述后端之间延伸的下表面以及形成在所述下表面中的下部开口；
骨移植物储存部分，所述骨移植物储存部分在所述前端和所述后端的中间，被构造成填充有所选体积的骨生长材料，且适于允许经由所述上部和下部开口在所述相邻椎骨之间的骨生长；
平移壁，所述平移壁可移动地安装在所述骨移植物储存部分和所述后端之间；以及
细长驱动连结件，所述细长驱动连结件可枢转地连接所述上部构件和所述下部构件，具有第一和第二端部，所述第一端部在靠近所述前端处可枢转地附接到所述上部构件，而所述第二端部在靠近所述骨移植物储存部分处可移动地安装在所述下部构件上；
其中，所述骨移植物储存部分被定位成且适于在所述植入物被致动时朝所述前端驱动所述驱动连结件的所述第二端部，从而使所述驱动连结件的所述第一端部向上移动；
其中，所述驱动连结件的所述第一端部适于可枢转地向上升高所述上部构件；并且
其中，所述上部构件的所述向上升高适于升高所述平移壁。
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