CN108348343A - 小面分离和融合假体 - Google Patents

小面分离和融合假体 Download PDF

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CN108348343A
CN108348343A CN201680053157.8A CN201680053157A CN108348343A CN 108348343 A CN108348343 A CN 108348343A CN 201680053157 A CN201680053157 A CN 201680053157A CN 108348343 A CN108348343 A CN 108348343A
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facet
prosthese
base members
separation
joint
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乌里·阿宁
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Zygofix Ltd
Trellex Co Ltd
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    • 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
    • A61F2/4405—Joints for the spine, e.g. vertebrae, spinal discs for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes
    • 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
    • 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
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A61B17/7064—Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
    • 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
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30092—Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
    • 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
    • A61F2002/4415—Joints for the spine, e.g. vertebrae, spinal discs elements of the prosthesis being arranged in a chain like manner

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  • Health & Medical Sciences (AREA)
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  • Biomedical Technology (AREA)
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  • Neurology (AREA)
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Abstract

小面分离假体(10、30)包括通过一个或更多个接头元件(14、34)彼此连接的小面分离基底元件(12、32)的阵列。斜对相邻的一对基底元件(12、32)通过一组或更多个接头元件(14、34)彼此连接，这组或更多个接头元件(14、34)与连接斜对相邻的另一对基底元件(12、32)的另一组一个或更多个接头元件(14、34)交错。接头元件(14、34)是柔性的，使得基底元件(12、32)能够相对于彼此挠曲并适用于小面关节的几何结构。

Description

小面分离和融合假体
技术领域
本发明总体上涉及脊柱植入物和假体，且特别涉及小面分离和融合假体，该小面分离和融合假体被设计成被放置于脊柱小面关节的两个骨质元件之间。
背景技术
脊柱狭窄影响相当一部分的人群。当前的外科手术脊柱融合使用椎间椎弓根螺钉和脊柱笼，其被设计用于连接至两个或更多个椎骨。
然而，使用标准笼和椎弓根螺钉系统是非常侵入性的，其具有已知的负面影响。将有利的是具有一种能够以明显较小的侵入方式获得类似的疼痛缓解和临床结果的系统。
另一问题是不同患者之间以及同一患者的不同脊柱水平之间的小面关节的几何结构的显著差异。难以使脊柱植入物适用于变化的几何结构。
发明内容
本发明追求提供一种改进的脊柱假体，该脊柱假体能够被放置于脊柱小面关节的两个骨质元件之间并适应不同患者之间以及同一患者的不同脊柱水平之间的小面关节的几何结构的显著变化性。
该系统的临床目的是增加两个骨质元件之间的距离并以这种方式执行脊神经的间接减压。该系统还可以牢固地固定至骨以使得小面关节能够长期融合。
因此根据本发明的实施例提供一种小面分离假体，其包括：小面分离基底元件的阵列，相邻的所述基底元件通过一个或更多个接头元件彼此连接；其中斜对相邻的一对所述基底元件通过一组或更多个接头元件彼此连接，所述组或更多个接头元件与连接斜对相邻的另一对所述基底元件的另一组一个或更多个接头元件交错，并且其中所述接头元件是柔性的，使得相邻的所述基底元件能够相对于彼此挠曲并适用于小面关节的几何结构。一个或更多个龙骨可从基底元件的上面和/或下面延伸。
附图说明
根据结合附图作出的以下详细描述，将更充分地理解和认识本发明，其中：
图1是在分离之前具有邻接椎骨的一部分脊柱的简化图解示意图；
图2A-2C分别是根据本发明的非限制实施例构造和可操作的小面分离假体的简化图解及两个不同剖面示意图，其中图2B和图2C分别沿图2A中的线B-B和C-C来得到；
图3是被安装在小面关节中的小面分离假体的简化图解示意图；并且
图4A-4D分别是根据本发明的另一非限制实施例构造和可操作的具有附加的龙骨的小面分离假体的顶视图、透视图及两个不同侧视示意图。
具体实施方式
为了更好理解安装小面分离和融合假体的环境，参照图1，其示意了在分离之前具有邻接椎骨的一部分脊柱。在该示意图中，在第一椎骨1和第二椎骨2之间的神经孔NF是狭窄的。在关节突关节囊3处，相应地在头部和尾部小面4和5之间没有间隙。因此推荐进行分离来创建小面之间的间隙并解除神经孔的狭窄。
现在参照图2A-2C，其示意根据本发明的非限制实施例构造和可操作的小面分离和融合假体10。
小面分离假体10包括小面分离基底元件12的阵列，相邻的基底元件12通过一个或更多个接头元件14彼此连接。
基底元件12可具有任何几何形状，诸如但不限于环形、椭圆形、圆形、方形、矩形、三角形、六边形、多边形、不规则形状等。一个或更多个基底元件12可具有形成于所述一个或更多个基底元件12中的孔口15。孔口15可以是盲孔或通孔。
在所示意的实施例中，斜对相邻的一对基底元件12通过一组或更多个接头元件14彼此连接，所述组或更多个接头元件14与连接斜对相邻的另一对基底元件12的另一组一个或更多个接头元件14交错。交叉或交错的两组接头元件14可以彼此垂直，或者可以以除了90°之外的其它角度成角度。小面分离假体10的周边处的基底元件12可以通过一个或更多个接头元件14彼此连接。
接头元件14可具有其它形状诸如环，且并非必须彼此交错。
接头元件14可由与基底元件12相同的材料或不同的材料(诸如但不限于不锈钢合金、钛合金、形状记忆或超弹性材料、塑料及其它或其任何组合)制成。接头元件14可以是扁平的、圆形的、或任何其它几何形状。接头元件14是柔性的，使得相邻基底元件12能够相对于彼此挠曲并适用于小面关节的几何结构。
小面分离假体10可具有前导面16和拖尾面18。该前导面16是在安装假体时首先进入小面关节的区域的面。前导面16如从顶部(图2A)以及从侧面(图2B)观察可具有锥形形状，这便于假体的插入。抓握构件20(例如，环)可从拖尾面18延伸，用于抓握假体以容易取回、调节或撤回。
如在图2B和图2C中看出，基底元件12的侧壁可选地是斜切的，即，从上表面或下表面朝向基底元件12的中间倾斜。该斜切帮助基底元件12来相对于彼此移动，从而它们能够是自排列的以适合小面关节的几何结构。
现在参照图3，其是在插入到小面的骨质元件之间后的小面分离假体10的简化图解示意图。固定元件22(诸如但不限于板、杆、棒以及任何合适形状的类似物)可用于锁定小面分离假体10，并可通过骨螺钉24固定至骨。
现在参照图4A-4D，其示意根据本发明的另一非限制实施例构造和可操作的小面分离假体30。
与小面分离假体10类似，小面分离假体30包括小面分离基底元件32的阵列，相邻基底元件32通过一个或更多个接头元件34彼此连接。
基底元件32可具有如上针对图2A所描述的任何几何形状。一个或更多个基底元件32可具有形成于所述一个或更多个基底元件32中的孔口35。孔口35可以是盲孔或通孔。
斜对相邻的一对基底元件32通过一组或更多个接头元件34彼此连接，所述组或更多个接头元件34与连接斜对相邻的另一对基底元件32的另一组一个或更多个接头元件34交错。交叉或交错的两组接头元件34可以彼此垂直，或者可以以除了90°之外的其它角度成角度。小面分离假体30的周边处的基底元件32可以通过一个或更多个接头元件34彼此连接。如上所提到的，也能够使用例如呈环的形状、具有圆形或不规则形状的接头元件。不像小面分离假体10，在小面分离假体30中，可以有共用于沿小面分离假体30的周边的一个或更多个侧面的所有基底元件32的一个接头元件34。
与之前一样，接头元件34是柔性的，使得相邻基底元件32能够相对于彼此挠曲并适用于小面关节的几何结构。
小面分离假体30可具有前导面36和拖尾面38。前导面36如从顶部和侧面观察可具有锥形形状。小面分离假体30可包括拖尾锥形元件40，该拖尾锥形元件40在拖尾面38的方向上逐渐增加厚度，用于抓握假体以容易取回、调节或撤回。拖尾面38可具有这里未示出的其它止动结构的扩大端，该扩大端能够抵靠小面骨并限制插入深度。
与之前一样，基底元件32的侧壁可以可选地是斜切的。
小面分离假体30可包括从基底元件32的上和/或下面延伸的一个或更多个龙骨42，所述一个或更多个龙骨42咬入脊柱结构用于增加将假体在脊柱结构中保持到位的保持力。如在图4A中看出，龙骨42可以对准以指向前导面和拖尾面36和38。在前导面36的附近的龙骨42可以朝向前导面36的方向斜切。如在图4D中看出，龙骨42可以相对于基底元件32的上和下表面不垂直。龙骨42可成形为容易插入但难以拉回，以便防止迁移。
应该指出的是，本发明的任何实施例可填充有骨移植物，以促进骨质元件的彼此融合。

Claims (12)

1.一种小面分离假体(10、30)，包括：
小面分离基底元件(12、32)的阵列，相邻的所述基底元件(12、32)通过一个或更多个接头元件(14、34)彼此连接；
其中斜对相邻的一对所述基底元件(12、32)通过一组或更多个接头元件(14、34)彼此连接，所述组或更多个接头元件(14、34)与连接斜对相邻的另一对所述基底元件(12、32)的另一组一个或更多个接头元件(14、34)交错，并且其中所述接头元件(14、34)是柔性的，使得相邻的所述基底元件(12、32)能够相对于彼此挠曲并适用于小面关节的几何结构。
2.根据权利要求1所述的小面分离假体(10、30)，其中一个或更多个所述基底元件(12、32)具有形成于所述一个或更多个所述基底元件(12、32)中的孔口(15、35)。
3.根据权利要求1所述的小面分离假体(10、30)，其中所述交错的组的所述接头元件(14、34)彼此垂直。
4.根据权利要求1所述的小面分离假体(10、30)，其中所述小面分离假体(10、30)包括前导面(16、36)和拖尾面(18、38)。
5.根据权利要求4所述的小面分离假体(10、30)，其中当从所述前导面(16、36)的顶侧和所述前导面(16、36)的侧面观察时，所述前导面(16、36)具有锥形形状。
6.根据权利要求4所述的小面分离假体(10、30)，其中抓握构件(20)从所述拖尾面(18)延伸。
7.根据权利要求1所述的小面分离假体(10、30)，其中所述基底元件(12、32)的侧壁从所述基底元件(12、32)的所述侧壁的上表面和下表面向中间倾斜。
8.根据权利要求4所述的小面分离假体(30)，进一步包括拖尾锥形元件(40)，所述拖尾锥形元件(40)在所述拖尾面(38)的方向上逐渐增加厚度。
9.根据权利要求1所述的小面分离假体(30)，进一步包括一个或更多个龙骨(42)，所述一个或更多个龙骨(42)从所述基底元件(32)的上面和/或下面延伸。
10.根据权利要求9所述的小面分离假体(30)，其中所述一个或更多个龙骨(42)对准，以指向所述小面分离假体(30)的前导面和拖尾面(36、38)。
11.根据权利要求9所述的小面分离假体(30)，其中所述一个或更多个龙骨(42)中的一些龙骨(42)朝向所述小面分离假体(30)的前导面(36)的方向被斜切。
12.根据权利要求9所述的小面分离假体(30)，其中所述一个或更多个龙骨(42)相对于所述基底元件(32)的上表面和下表面非垂直。
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