CN107374789B - 微创椎间融合器 - Google Patents

微创椎间融合器 Download PDF

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CN107374789B
CN107374789B CN201710478198.8A CN201710478198A CN107374789B CN 107374789 B CN107374789 B CN 107374789B CN 201710478198 A CN201710478198 A CN 201710478198A CN 107374789 B CN107374789 B CN 107374789B
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罗宗平
杨惠林
崔旭东
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Suzhou Boxi Medical Science & Technology Co Ltd
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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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455Joints 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
    • 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4601Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
    • 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • 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
    • 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • 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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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
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  • Neurology (AREA)
  • Prostheses (AREA)

Abstract

本发明公开了一种微创椎间融合器,包括一可收缩或扩张的撑开件和对撑开件撑开的空间进行支撑的支撑链;支撑链是由多个单元体相互铰接组成的一条可闭合长链,每个单元体的横截面呈梯形,外侧面的两条垂直边上设置铰接点,使得多个单元体可通过铰接点相互铰接,并且相邻的两个单元体之间可绕铰接点相互转动一定范围,使相邻的两个单元体相对的邻接面相互贴合。本发明的微创椎间融合器可以用于微创腰椎间盘、胸腰椎椎间融合手术中,通过小切口实现各部件的进出,时间短,操作简单方便,支撑效果好。支撑链形成的闭合结构可以在取出撑开件后保持紧密稳定的支撑;通过框架结构的支撑链进行支撑,增加了植骨面积和植骨空间,使植骨量增加,能促进腰椎椎间隙融合更好、更快的融合。

Description

微创椎间融合器
技术领域
本发明涉及一种微创椎间融合器及其使用方法。
背景技术
随着腰椎间盘突出症患者的日益增多,研究人员经过长期的研究,发明了一些人造椎间盘或可替代的椎间支撑物或者填充物。目前现有的椎间融合器很难在微创手术通道中植入椎间隙内并保持椎间隙稳定的支撑性,常常需要联合后路的钉棒螺钉固定系统,椎体终板之间植入楔形椎间融合器,该方案中,椎体前部和后部均需要固定,工作量大,手术时间长,必须采用开放式手术方式,手术区域大,费用高,病人术后所需恢复期长,不利于病人快速恢复。
发明内容
本发明要解决的技术问题是提供一种微创椎间融合器,适于微创腰椎间盘手术中使用,能快速促进椎间融合,恢复椎间稳定性。
本发明为解决上述技术问题所采用的技术方案:
一种微创椎间融合器,其特征是:包括一可收缩或扩张的撑开件和对撑开件撑开的空间进行支撑的支撑链;
所述支撑链是由多个单元体相互铰接组成的一条可闭合长链,每个单元体呈镂空的框架结构,外侧面的两条垂直边上设置铰接点,使得多个单元体可通过铰接点相互铰接,并且相邻的两个单元体之间可绕铰接点相互转动一定范围,使相邻的两个单元体相对的邻接面相互贴合。
还包括一导向丝,所述导向丝可环绕在所述撑开件外侧,为支撑链提供进入撑开的空间时的导向轨迹。
单元体外侧面为实平面或实弧面。
每个单元体为一横截面呈梯形的框架结构。
支撑链通过每个单元体上的由框架围成的两个邻接面套于导向丝上。
所述撑开件为球囊状的可纵向撑开的支撑物。
支撑链的顶面/底面和与其贴近的椎间终板的接触面形状相配合。
所述导向丝为一由操作人员控制软硬可变化的导向丝。
所述支撑链上设置一可将闭合后的支撑链在闭合连接处扎起形成封闭的扎口结构。
一种微创椎间融合器的使用方法,其特征是:包括以下步骤:
1)置入撑开件:将收缩的撑开件从入口处置于预定位置后,使撑开件扩张撑开至设定的高度;
2)送导向丝:向预定位置处送入导向丝,使导向丝环绕在撑开件外侧;
或者,将导向丝环绕在撑开件外侧随撑开件一起置入预定位置;
3)植入支撑链:将支撑链套于导向丝的近端上,沿着导向丝限定的轨迹将支撑链送入由撑开件撑开的空间中;
4)取出撑开件和导向丝:将导向丝及撑开件收缩后从入口处取出,由支撑链对预定位置处进行支撑;
5)植骨:向预定位置的空间中注入骨填充物。
本发明的有益效果:
本发明的微创椎间融合器,可以用于微创腰椎间盘、胸腰椎椎间融合手术中,植入人体腰椎的任意两个相邻的椎体之间,通过微创手术中的小切口实现各部件的进出,时间短,操作简单方便,支撑效果好。支撑链中的多个单元体依次铰接组成长链可以方便送入由撑开件撑起的空间中,并且各相邻的单元体之间的邻接面可以相互紧密贴合,使形成的闭合结构可以在取出撑开件后保持紧密稳定的支撑。通过框架结构的支撑链进行支撑,增加了植骨面积和植骨空间,使植骨量增加,能促进腰椎椎间隙融合更好、更快的融合。
附图说明
图1是本发明的微创椎间融合器的示意图;
图2是支撑链2上的单元体示意图;
图3是导向丝示意图。
具体实施方式
下面结合附图对本发明作进一步描述。以下实施例仅用于更加清楚地说明本发明的技术方案,而不能以此来限制本发明的保护范围。
如图1和图2所示,本发明的微创椎间融合器,包括撑开件1、支撑链2和导向丝3。
撑开件1为球囊,球囊干瘪收缩时,可以从较小的微创切口处进入纤维环已经损伤或破裂的两个椎间终板之间或从其中取出。收缩的球囊置入两个椎间终板之间后,向球囊内充气或注入液体等,可使球囊充盈,通过球囊的扩张,可将椎间终板撑开,恢复椎间高度。
在其它实施方式中,撑开件1也可以为其他大小可变化能撑开椎间终板的结构。
支撑链2是由多个单元体21相互铰接组成的一条可闭合长链,每个单元体21为一横截面呈梯形的框架体,框架体外侧面211为实平面或实弧面,其余的几个面即内侧面212、两个邻接面213及顶面214和底面215均为框架围成的中空面。外侧面211的两条垂直边上设置铰接点22,使得多个单元体21可以通过铰接点22相互铰接,并且相邻的两个单元体之间可以绕铰接点相互转动一定范围,使邻接面213相互贴合在一起。每个单元体上的由框架围成的两个邻接面均可容纳导向丝3从其中穿过。支撑链2中每个单元体的纵截面面积相对较小,因此,长链上的各单元体适合于在微创手术中通过微创的较小切口依次进入椎间终板间由撑开件撑开的空间中。
较佳地,支撑链的顶面和与其贴近的终板的接触面形状相配合。支撑链的底面和与其贴近的终板的接触面形状相配合。
多个单元体依次铰接组成的长链可以形成一个类似圆形或椭圆形的闭合结构,闭合时由各相邻的单元体之间的邻接面相互贴合,使形成的闭合结构保持紧密稳定,在撑开件取出后,可以独立支撑椎间终板已经恢复的椎间高度,保持支撑稳定。
所述支撑链采用适于留置在人体椎间盘内的材料。
如图3所示,导向丝3为一软硬可变化的导向丝,由操作人员通过控制,进而使导向丝根据需要表现为柔性或刚性。导向丝包括多个串连在一条引导丝31上的导向柱32,每个导向柱32的两个端面均为弧形面,相邻导向柱之间夹持一滚球33,通过转动导向丝使导向柱发生转动,或者通过拉紧引导丝31的方式,使各导向柱32端面与各夹持的滚球33形成挤压时,可以使导向丝形成较硬的刚性,而不发生转动或都不拉紧引导丝时,导向丝保持较软的柔性。显然,最两端的导向柱的最外侧的端面形状可以不限定为弧形面。
撑开件1置于两个相邻的椎体终板之间,通过膨胀扩张撑开终板之间的间距;导向丝3送入两终板间环绕着撑开件。支撑链2套于导向丝3上,沿着导向丝3限定的轨迹送入两个终板之间的间隙中,对两个相邻的椎体终板形成支撑。
微创椎间融合器的使用方法,包括以下步骤:
1.置入球囊:通过微创切口处将收缩的球囊置于两个相邻的椎体终板之间,向球囊内充气或注入液体使球囊充盈膨胀扩张,通过球囊的膨胀扩张撑开终板,恢复椎间高度:
2.送导向丝:向撑开的两块终板之间的空间中送入导向丝,此时导向丝为较软的柔性,使导向丝环绕在球囊外侧;在导向丝送入后,将导向丝由较软的柔性调节为较硬的刚性,使其限定的轨迹保持固定。
在其他实施方式中,也可以在步骤1中将导向丝环绕在球囊外一起置于两个相邻的椎体终板之间;
3.植入支撑链:将支撑链套于导向丝的近端上,沿着导向丝限定的轨迹将支撑链送入由球囊撑开的、恢复椎间高度的两个椎间终板之间的空间中;
4.取出球囊和导向丝:将球囊中的气体或液体放出,使球囊干瘪收缩,可以从微创切口处取出球囊;球囊取出后只由支撑链对椎间终板进行支撑;
将导向丝从支撑链中抽出;
5.植骨:从微创切口处向两个相邻的椎体终板之间的空间中注入骨填充物,由于支撑链为框架结构,可填充进去更多的骨填充物,使其与椎体终板能更好、更快的融合。
较佳地,支撑链上设置一扎口结构,在取出球囊、导向丝和植骨后,可将支撑链完全闭合后在闭合连接处扎起形成封闭。
以上所述仅是本发明的优选实施方式,应当指出,对于本技术领域的普通技术人员来说,在不脱离本发明技术原理的前提下,还可以做出若干改进和变形,这些改进和变形也应视为本发明的保护范围。

Claims (8)

1.一种微创椎间融合器,其特征是:包括一可收缩或扩张的撑开件和对撑开件撑开的空间进行支撑的支撑链;
所述支撑链是由多个单元体相互铰接组成的一条可闭合长链,每个单元体呈镂空的框架结构,外侧面的两条垂直边上设置铰接点,使得多个单元体可通过铰接点相互铰接,并且相邻的两个单元体之间可绕铰接点相互转动一定范围,使相邻的两个单元体相对的邻接面相互贴合;
还包括一导向丝,所述导向丝可环绕在所述撑开件外侧,为支撑链提供进入撑开的空间时的导向轨迹。
2.根据权利要求1所述的微创椎间融合器,其特征是:单元体外侧面为实平面或实弧面。
3.根据权利要求1所述的微创椎间融合器,其特征是:每个单元体为一横截面呈梯形的框架结构。
4.根据权利要求3所述的微创椎间融合器,其特征是:支撑链通过每个单元体上的由框架围成的两个邻接面套于导向丝上。
5.根据权利要求1所述的微创椎间融合器,其特征是:所述撑开件为球囊状的可纵向撑开的支撑物。
6.根据权利要求1所述的微创椎间融合器,其特征是:支撑链的顶面/底面和与其贴近的椎间终板的接触面形状相配合。
7.根据权利要求1所述的微创椎间融合器,其特征是:所述导向丝为一由操作人员控制软硬可变化的导向丝。
8.根据权利要求1所述的微创椎间融合器,其特征是:所述支撑链上设置一可将闭合后的支撑链在闭合连接处扎起形成封闭的扎口结构。
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