CN1090485A

CN1090485A - Intervertebral disk prosthesis

Info

Publication number: CN1090485A
Application number: CN93118231A
Authority: CN
Inventors: 凯万·玛斯达
Original assignee: Societe de Fabrication de Material Orthopedique en Abrege SOFAMOR SNC
Current assignee: Societe de Fabrication de Material Orthopedique en Abrege SOFAMOR SNC
Priority date: 1992-08-24
Filing date: 1993-08-24
Publication date: 1994-08-10
Also published as: TW280767B; TR26927A; WO1994004100A1; AU4964593A; ZA936156B; FR2694882B1; MX9305071A; FR2694882A1

Abstract

This prosthese comprises that two are fixed to corresponding vertebra (L ₄, L ₅) on plate (1,2), with be used for plate with the interconnected ball adapter in joint (3), its pro-back plane (OX, OY) Nei center of rotation (C) be in the aft section of plate to back biasing, (OX is positioned at the centre of each plate in OY) at transverse plane, (OX is positioned at vertebra (L down in OZ) at vertical plane ₅) plate (1) below; This prosthese also comprises with flexible material system, the ballistic ring of absorption (10) that dress inserts, and ring (10) has an opening (10a) that is used for the passage of ball adapter (3), and the space that has been suitable for being delimited between around plate and the ball adapter.This location of the center of curvature (C) prevents when vertebral body moves the stress to the joint apophysis, and flexible ring (10) makes prosthese be suitable for lordosis on the physiology of lumbar spine, and a large amount of stress that produces when being absorbed in motion.

Description

Intervertebral disk prosthesis

The present invention relates to intervertebral disk prosthesis.

As everyone knows, intervertebral disc has by its surface attachment in the shape of the biconvex lens of vertebral body articular surface, it comprises a hard edge part (ring) of being made up of the concentric fibers layer, with gelationus, soft center is (nuclear marrow sample) partly, this partly by by with minute ooze mucous organize the filling space isolating thin fibre bundle form.Intervertebral disc is a deformable element, and it allows all possible relative motion (six-freedom degree), but has limited the scope of these motions, particularly with respect to the twist motion of ligamenta intervertebralia and bone buffer.Intervertebral disc is that a kind of viscoelastic energy absorbs ballistic tissue, and when the spinal column stand under load, it provides intensity and stability for spinal column is kept upright.

Intervertebral disc can be impaired owing to a variety of causes, and particularly with advancing age with aging, they may cause making the intervertebral disc slippage.

Originally intervertebral disc is aging is on the intervertebral disc function, then is the structural damage of dish, they seemingly since the stress of machinery to align the influence of the intervertebral disc that becomes disorderly structure caused.The aging mechanical performance that has changed it of intervertebral disc, and cause body wall reducing of (intersomatic) height at interval, this will cause the imbalance of intervertebral disc/function of joint combination.Consequently a kind of unstability, this unstability can have disagreeable clinical consequences, particularly lumbago.Therefore, the unstability of body segment causes unusual function of joint, causes arthritis, also is the root of pain and hyperosteogeny prominent (osteophytic proceeses).

Therefore, the someone proposes with the impaired intervertebral disc of artificial disc replacement, and has imagined many schemes.Thus, some prostheses contain the joint of not limiting any degree of freedom, and other by contrast, give no thought to some motion, and have only one degree of freedom at the most.The designer of first kind of prosthese thinks that artificial intervertebral disc should stipulate a kind of motion in no instance, and promptly the stability of functional unit is by keeping the remaining tough assurance that brings, and the not subjected to pressure joint guarantees the connection between persistent bone/prosthese.

Second type of prosthetic designs person thinks that some degree of freedom are unwanted on physiology, and recovers one and be considered to critical degree of freedom, and therefore, a kind of well-known prosthese forms and allows the Movable joint of only rotating around transverse axis.

Articulate prosthese can be various, and particularly, it can be made up of the material of tool certain flexibility, otherwise, use machinery, as spring.

Yet these known prostheses all can not meet the demands fully, for example because at the friction of joint too big (as the prosthese described at patent FR-2659226), or because in rotation process the unstability of viewed prosthese.Moreover the prosthese described in above-mentioned patent only allows a kind of inclination, and is limited to 10 ° of stretching, extension bendings in the scope in all planes, this than the natural motility of vertebra, attitude is too low.

At present, also has a difficulty comparatively speaking in addition, how to determine index for the intervertebral disc joint plasty exactly, particularly recommendation is used for the index of the treatment of lumbago and sciatica, and these diseases are owing to unstability, and (post-discecfomg) the waist ischias and the spondylolisthesis of I degree of discectomy postoperative are caused.

According to suggestion of the present invention, use the purpose of implant that intervertebral disk prosthesis constitutes to be actually three kinds of situations:

A) by following manner, that is can return to body wall at interval normally highly select size.In fact intervertebral disc is aging, the change of intervertebral disc mechanical function and cause body wall at interval in height minimizing all can cause the imbalance of intervertebral disc/function of joint combination.This minimizing in height causes the mechanical overload of joint facet and possible lumbago root, and it may cause that the upper joint of following vertebra makes progress and displacement forward, causes connecting hole to narrow down, thereby may cause sciatica.

B) close internode at two that cooperate and allow physiological mobility.

Unstability may be intervertebral disc result aging or that caused by surgical operation, and the boundary between normal and improper mobility so far can not precise definition, and the unstability of body segment causes the improper function in joint, causes arthritis as already noted.

C) has intrinsic stability and allow to move between body wall.

It is the case of arthrodesis (anthrodeses) that arthroplasty is used for having shown so far, it can be a kind of useful alternative method for this operation, this operation is not influence to the zone of adjoining, in fact, all joint of lumbar vertebra fixationes cause in the adjacency body segment on stress and increase and the center of rotation displacement that they may cause super mobility.

The monitored for prolonged periods of time of adjacent joints fixed area represents constant compression, particularly slippage or the angular displacement since the intervertebral disc in the 5th year, and its frequency increases in time.Also can observe the intervertebral disc of substantial arthrosis, slippage or from this new spondylolysis that Movable joint obtained.

Be made up of two boards according to the intervertebral disk prosthesis that the present invention proposes, said strip is used for they are fixed to corresponding supraspinal device, with the device that is used for above-mentioned those plates are linked to each other with the joint.

According to the present invention, joint arrangement is a ball adapter, its center of rotation in the plane of front-back is to the back skew in the aft section of the aft section of plate and vertebral body, in transverse plane, in fact it be positioned at the mid point of plate and vertebral body, and in vertical plane, be positioned at following vertebra plate below; And this prosthese comprises a ballistic ring of being made by flexible material of insertable absorption, said ring has the opening of the passage that is used for the ball adapter, and form required size, and the shape of matching disc basically so that adapt to the space of having been delimited between around plate and the ball adapter.

As the present invention was determined, the location of the center of curvature of ball adapter had the advantage of avoiding joint apophysis (apophyses) pressurization, and as in natural vertebra, this is not reach in the hitherto known prosthese.

Therefore, have required mechanical strength simultaneously, and on the pitch plane of pass, reduce friction by means of the corresponding size of ball connector system according to prosthese of the present invention.In fact, center of rotation neither abscission joint is too far away, but neither be very approaching, therefore, makes it can reappear the mobility that approaches the nature mobility.

Other features and advantages of the present invention are by the following describes and will be clearer with reference to the explanation as an embodiment of non-limiting example shown in the accompanying drawing.

Fig. 1 is a pair of decomposition diagram that is equipped with according to the vertebra of the intervertebral disc building block of one embodiment of the present of invention;

Fig. 2 is the plane graph of the lower plate of the intervertebral disc in Fig. 1;

Fig. 3 is according to the longitudinal sectional drawing of prosthese of the present invention along 3/3 line of Fig. 2, and is to be in longitudinal sectional drawing on the parallel position at two boards;

Fig. 4 is an extremely prosthese shown in Figure 3 of Fig. 1, and is the locational front view that inclines towards each other at two boards;

Fig. 5 is the longitudinal sectional drawing along the 5-5 hatching in Fig. 6 of second embodiment of the present invention;

Fig. 6 is the plan view of the prosthese in Fig. 5;

Fig. 7 is at Fig. 5 and prosthese shown in Figure 6 and its plate vertical front view when being parallel;

Fig. 8 is the view that is similar to Fig. 7, and shape is at an angle between plate;

Fig. 9,10,11 and 12 is four alternative embodiment that connect according to prosthese of the present invention.

Shown in Figure 1 is two adjacent vertebras, for example, and lumbar spine L ₅And L ₄, they can connect by intervertebral disk prosthesis, and this prosthese comprises that two are separately fixed at down vertebra L ₅With last vertebra L ₄Plate 1 and 2, with one two boards 1 and the 2 ball adapters 3 that link to each other with the joint each other, and be inserted between two

boards

1 and 2 and impact ring 10 by the flexible absorbent of ball adapter 3.

Plate

1 and 2 is similarly, has the vertebra of being substantially equal to L ₅, L ₄Size (it can be used in and is positioned at non-L ₅-L ₄These vertebras on the level, comprise non-waist level), and mate the shape on adjacent segment surface haply, therefore, each

piece plate

1,2 has curved limit 4, limit 4 is oval or avette basically, it also has a straight line 5, and plan makes the contiguous spinal canal in this limit and is connected with two truncated ends of ellipse 4, in addition, each

piece plate

1,2 heart therein partly is drilled with a through hole 6, in this hole, insert a granule 7,8 respectively, their size is to determine by following mode, that is, it can be meshed with corresponding hole 6.The latter is preferably tapered, because it can become the additional seat of granule 7,8, in this case, can be connected on the

corresponding plate

1,2 by mode movably.

Granule 7,8 constitutes ball adapter joint 3 together.First granule 7 of the plate 1 below inserting has convex spherical 9, and on its outstanding respective surfaces that is contained in plate 1, and its opposite surfaces 11 is level and smooth, and the outside face opposite with plate 1 flushes.The granule 8 of upper plate 2 is also outstanding from its face towards plate 1, and has recessed spherical surface 12.The latter's radius of curvature equals the radius (r) of sphere 9, so that can slide on the latter, thus, forms ball adapter joint.The relative face 14 of granule 8 is flat, and flushes with the outside face of plate 2.

Locate by following method away from the center of curvature or the center of rotation c of the ball adapter 3 on

surface

9 and 12 by radius of curvature≤r:

-this center c is on the pro-back plane (ox, oy), and be the back of

plate

1,2 and vertebral body partly in to retrodeviate from;

-in transverse plane (ox, oz), center of rotation c is positioned at the centre of

plate

1,2 and vertebral body in fact;

-in vertical plane (oy, oz), center c be positioned at just the upper surface that covers down vertebra plate 1 below, the L of example as shown in FIG. 1 ₅

This location of this center c is corresponding to the radius of curvature r that approximately is between the prosthese height, and is parallel when plate the 1, the 2nd, and it is half of this height.

In fact, center of rotation c can be positioned at the lower surface S1 of plate 1 following (Fig. 3) (0 millimeter that is surperficial S1 originally on one's body) and between about 5 millimeters apart from d ₁, this is decided by concrete condition.

Yet the center C of rotation is positioned in from the mid point M of the straight flange 5 of the plate 1 of contiguous spinal canal, apart from straight flange 5 for the width L of the plate 1 that begins from mid point M about 1/3 to 1/2 distance last; Therefore, in Fig. 3, in fact center C is positioned at apart from d ₂=L/3 and apart from d ₃Between=the L/2.

Lift a unrestriced numerical example, d ₂=4 millimeters, d ₃=10 millimeters, the L=20 millimeter, in this case, it is 6 millimeters zone that C is arranged in approximately wide.

Prosthese also comprises the absorption that the is inserted into impact ring 10 with suitable flexible material system, and it has an opening 10a as the passage of ball adapter 3.The size of flexible ring 10 is to determine by such method, the midfeather of having been decided between promptly can being adapted at around

plate

1,2 and the ball adapter 3, and in fact the profile with plate is complementary.

Freely, not (Fig. 1) under the state of pressurized, flexible ring 10 has from its front thickness variable to the back.Its layered front portion has maximum thickness H, and this thickness H is to reduce equably from the mid point of this layered front portion seamed edge partly to the back of encircling 10 always, and therefore, its thickness h is obviously less than H.So ring 10 has an asymmetrical shape, its opposite face is tilted in relation to each other, and close to each otherly tilts towards rear face part.

Each

piece plate

1,2 has a cyclic central thickened

part

14,15 at the corresponding granule 7,8 of having of it from the outstanding face of its face.The latter in abutting connection with it around, the granule 7,8 followed, the latter is around the integral body of granule with a reinforcement of remainder formation of plate.As shown in the figure, strengthen the surface that

part

14 and 15 preferably has cone shape, its thickness reduces on the direction away from granule 7,8.

Form one group of aperture 16 in each

piece plate

1,2, these apertures suitably distribute along the limit of plate.16 designs of these holes are held with any suitable method and are fixed on pin 17 in the

plate

1,2, for example, screw in 17a bottom their cylindrical shape.Their the most advanced and sophisticated partly 17b that hammers into the subchondral bone of intervertebral

disc guarantees plate

1,2 is fixed on the vertebra, as L ₅L ₄, L ₅...

The granule 7,8 that forms ball adapter joint 3 has the size littler than

plate

1,2, and is best tribology characteristic (mechanical property: static, dynamic and anti abrasive) from having possibility normally, and still biological certainly going up in the stable material chosen.Their coefficient of friction must be very low, and their service life, and the sample in service life of

plate

1,2, must be very long (for example, 40 years).

These granules 7,8 can be with suitable material manufacture, for example pottery, particularly sintered oxide, and as aluminium oxide or zirconium oxide, synthetic cut stone, surface-treated metal alloy (diamond) coating, or the like).

Flexible absorbent is impacted ring 10 and preferably preferably is made of the elastomeric material of suitable hardness.

The standard No. of the

plate

1,2 of imagination is suitable for the form of all possible vertebral body.Ball adapter 3 is than large size to be the form that is suitable for each one form and each spine surface, therefore, can make the disc height that is suitable for all patients of certain limit and permission is suitable for each special case with the combination of infinite number part (

plate

1,2 in addition, ball adapter 3, flexible ring 10).

Except that the technical advantages of having mentioned, have the following advantages according to intervertebral disk prosthesis of the present invention.

By means of the size of suitable ball adapter 3 and as above determined its position at c center, joint, friction surface is reduced, and because the caused friction of

plate

1,2 inclinations respect to one another will keep low-level (Fig. 4).The wearing and tearing of granule 7,8 have consequently been reduced, in addition,

articular surface

9,12 has to be enough to guarantee to prevent the excessive unsettled radius of curvature of prosthese, and makes it that suitable mobility in three dimensions is arranged simultaneously, and this mobility is actually that mobility with natural vertebra is equal to.

When

plate

1,2 and corresponding vertebra three-dimensional motion, flexible ring 10 has the opposite that absorbs a large amount of stress, constrained motion ring 10 and keeps and the contacted performance of face of plate 1 accordingly in that institute is free.On the height or encircle variation on 10 the thickness from the front to the back and have and make it be suitable for the lordotic advantage of physiology of lumbar spine.Therefore, the H/h ratio is suitable for spinal column profile statics, because it is a kind of function of above-mentioned intervertebral disc level.Encircle the function that 10 two face inclinations each other can be used as vertebra level and patient's body.For one thing, it can be at L ₅/ S1 place reaches 15 °.

The thickness that should be noted that ring 10 layered front portion is than much bigger this fact of its aft section, and it considers the difficulty (involuement) of the flexible material that constitutes this ring as previously mentioned.Thus, this has caused producing the absorption percussion once the motion of the vertebral body that takes place to combine with prosthese.Moreover suitable selection is used to encircle 10 flexible material makes it can reach best rigidity, tilts so that obtain to reproduce the rotation of healthy intervertebral disc under different stress.At last, according to prosthese of the present invention make it can reach with the intervertebral disc of nature very similar in addition be equal to fully, certain rigid and the ballistic ability of absorption.

Prosthese described above is to implant in place by the surgeon by following method.

(L for example at first, on surgeon's infra vertebra ₅) insert corresponding plate 1, make it suitably with the vertebral body centring, and screw in vertebras with pin 17 it fixed.

Then, the surgeon is at last vertebra (L for example ₄) upper plate 2 of packing into, make it suitably with respect to lower plate 1 location.

Afterwards, pack between

plate

1,2 molectron of the ball connecting device 3 that " sandwich " this structure of combination forms by flexible ring 10 with by granule 7,8 of surgeon is formed, he this molectron be contained between the

plate

1,2 in the middle of the band in, and granule 7,8 is towards bellmouth 6, then, loosen on the vertebral body that is applied to

dash receiver

1,2 traction on that.So finally form embedding, said embedding is to realize by making the conical seat of granule 7,8 enter hole 6 to

plate

1,2 application of forces and connecting their.

The amount of the range of angular motion that can reach according to prosthese of the present invention approaches the range of movement of healthy intervertebral disc, is listed as follows:

L ₄/L ₅L ₅/S ₁

24 ° 18 ° of flexion/extension

Tilt 14 °≤14 °

Axle rotates 4 ° 4 °

Because its compactibility, guaranteed the answer of body wall interbody spacer height H according to prosthese of the present invention, and meanwhile, it has intrinsic stability, this that is to say and has prevented unphysiologic mobility, particularly translational motion.

Certainly, the material that can be used to form prosthese should be biocompatible, and must be bio-neutral, and it must be nontoxic, uncorroded in other words.And they must not can cause inflammation, and their machinery and biological quality can be owing to selected sterilization method do not changed yet, and for instance,

plate

1,2 can be used rustless steel, titanium carbide alloy or titanium alloy manufacturing.

Titanium alloy has the good radiation and the advantage of magnetic characteristic for the pathological image monitoring of vertebra, and also has good biological tolerance (bictolerance) and favorable mechanical performance.

Fig. 5 to shown in Figure 8 be second embodiment of the present invention, each

granule

21,22 is received in respectively in the received

block

23,24 that forms on the

support plate

25,26 that is associated,

granule

21,22 is outstanding from its

acceptance seat

23,24 partially, in this seat, they are freely to pack into rather than be pressed into cooperation.Around each seat and each granule, annular thickening parts the 29, the 31st, coning, and at the thickness of the as many as

plate

25,26 of the height h1 at top.

Granule the 21, the 22nd, tapered, its received

block

23,24 also is tapered, and has about 1 °-7 ° cone angle, preferably 5 °.

Fig. 5 to prosthese shown in Figure 8 others and Fig. 1 to shown in Figure 4 be similarly, be noted that the location of center of rotation c especially.Yet, the ballistic ring 10 of the absorption of not shown flexibility.

The seat that is used to hold

granule

21,22 by arrangement, a tangible advantage is provided, be the inside dimension of the outside dimension of

granule

21,22 corresponding to seat, they are not in fixing being present, and after certain hour, if desired, can from seat, take out at an easy rate, also not need to pull down

plate

25,26 and replace them from vertebra.In fact, this can make plate be avoided local compliance on the plane of through hole 6 of a pro-embodiment, because the suffered local clamping force of granule, said flexibility is not needed.

Certainly, the latter also can be transformed into cylindrical, and is same, and corresponding seat wall also should be columniform, and still, this geometry can not help the location, and perhaps, secondly, granule may be thrown off.In fact, what have been found that significant is short grained wall to be bonded on the wall of seat significantly can produce a kind of character, as prevents to throw off.

For this reason, dreamed up

granule

21,22 and

seat

23,24 has some taperings comparatively favourable a little, because it has prevented this shortcoming.

The stress that is applied on the

plate

25,26 by patient's body can reduce owing to the bottom 27,28 that has adequate thickness e, for example is 3/4 of each plate thickness d, or very causes and equal d.Therefore, bending weakening of any local mechanical intensity can not appear and in plate.

And, every

plate

25,26

parts

29,31 that strengthen or the annular thickening have increased the tapered wall of

seat

23,24 and the surface of the contact surface between

granule

21,22 tapered wall, and this is by means of partly 14,15 comparing the height that increases them with the thickening of previous embodiment.The structure of the bottom 27,28 really of this increase is necessary.

A kind of like this structure makes it can be used for the prosthese that will constitute, and behind the result of the local vertebra of reference patient system X ray, the total height of this prosthese can be suitable for the desired height by the surgeon.

In order to obtain the total height of required prosthese, the surgeon have one group several increase progressively the

height ball adapter

21,22, for example, 11,13 and 15 centimeters, for these the group in each, be suitable for forming the radius of curvature of the

contact surface

9,12 of ball adapter, therefore, when plate the 25, the 26th, (as shown in Figure 7) parallel to each other, and be a half of this height, this is the height H 1 that approaches between prosthese.

The maximum angular opening A(that is respectively at

plate

25,26 shown in Figure 8 for example is approximately 32 °) position of

plate

25,26 under the situation.

Fig. 9 is to the various possible alternative embodiment that is used for plate is fixed to the device of alternative pin 17 on the vertebral body shown in Figure 12.Therefore,

plate

32,33 shown in Figure 9, it is an annular knurl towards the surface 34 of vertebra,

plate

35,36 shown in Figure 10 has corrugated surface 37, and plate 38,39 shown in Figure 11 comprises the surface 41 of protrusion.

Figure 12 shows plate 42,43, and their surface 44 that is pressed on the vertebral body has lived through suitable processing: by known method fixing metal fabric, and the spraying of metal or pottery, or adhesive coated.

And this surface treatment can with Fig. 9 to the various selections among Figure 11 combine be applied to the

surface

34,37 and 41 on.

Pin 17 also can substitute with screw thread or pin.

On the contrary, fixedly be inconceivable with binding agent (methylmethacrylate), because close neural unit and release heat when polymerization.For non-lumbar region, there is not described the sort of asymmetry in flexible ring 10, and therefore, it can have homogeneous thickness.

Should be noted that according to intervertebral disk prosthesis of the present invention not comprise any part in addition freely, these are different with some known intervertebral disk prosthesis, and just because of this point, it has eliminates that any such part in addition faces toward aorta or the advantage of the danger of extruding towards spinal canal.

Claims

1, a kind of intervertebral disk prosthesis comprises two boards (1,2), and said plate has and is used for they are fixed to corresponding vertebra (L ₄, L ₅) on device, with the device that plate is linked to each other with the joint each other (7,8), it is characterized in that said joint arrangement comprises a ball adapter (3), its pro-back plane (ox, oy) center of rotation in (c) is partly biasing backward in the back of plate and vertebral body, and (ox is positioned at the centre of plate and vertebral body in oz) in fact at transverse plane, (oy is positioned at vertebra (L down in oz) at vertical plane ₅) plate (1) below, and this prosthese also comprises a ballistic ring of the absorption with the insertion of beformable body material manufacture (10), said ring (10) has an opening (10a) that is used for ball adapter (3) passage, described ring (10) forms required size, so that the space that quilt between adapting to around each plate and the described ball adapter has been delimited, and basically with the form fit of plate.

2, according to the described prosthese of claim 1, it is characterized in that ball adapter (3) comprises second granule (8) of first granule (7) with protruding sphere (9) and the concave spherical surface (12) that is used to hold this protruding sphere, these two spheres have identical radius of curvature (r), said granule is contained in the centre of plate (1,2) separately, and their outstanding face is aspectant.

3,, it is characterized in that each piece plate (1,22 according to the described prosthese of claim 2; 25,26) have one near the locational straight line of spinal canal (5), and whole profile (4) is actually oval or avette, has the granule (7 of protruding sphere (9); 22) be contained in down the plate (1 of vertebra, 26) in, its center of rotation (c) is positioned at the mid point (M) of the straight line of the plate that originates in the adjacent vertebral pipe, approximate 1/3rd (d of the width (L) of the plate on distance below said limit is approximately the plate that originates in said mid point and following vertebra ₂) and 1/2nd (d ₃) between, described center of rotation apart from above-mentioned plate be 0 and approximate 5mm between locate.

4,, it is characterized in that every block of plate (1,2 according to the prosthese of claim 2 or 3; 25,26) at granule (7,8; 21,22) a thickening part (14,15 of adjoining short grained center annular is arranged on the Tu Chu face; 29,31), this partly centers on granule and forms one and strengthens partly.

5,, it is characterized in that said reinforcement part (14,15 according to the described prosthese of claim 4; 29,31) have conical surface, its thickness reduces on the direction away from granule (7,8).

6, according to a described prosthese in the claim 2 to 5, it is characterized in that granule (7,8; 21,22) have and adapt to accordingly at plate (1,2; 25,26) sloped footing of the bellmouth that upward forms.

7, according to a described prosthese in the claim 1 to 6, it is characterized in that being used for plate (1,2; 25,26) be fixed to vertebra (L ₅, L ₄) on device comprise tapered dowel (17) in the hole (16) that screw in to form onboard and on whole plate, suitably distribute, or embossed surface (34), or corrugated surface (37), or the surface (41) of protruding.

8, according to any the described prosthese among the claim 1-7, it is characterized in that plate (42,43) be to be fixed to supraspinal by metal structure (44), metal or pottery have been sprayed at plate in the face of on the surface of vertebra, perhaps use adhesives, or also can be one of these methods and embossed surface (34), or one of corrugated surface (37) or protrusion surface (41) combination.

9, according to a described prosthese among the claim 1-8, it is characterized in that plate (1,2; 25,26) has the identical size of as many as vertebra, particularly lumbar spine.

10, according to a described prosthese among the claim 1-9, it is characterized in that flexible absorbent impact ring (10) has the layered front portion of maximum ga(u)ge (H), this thickness (H) is greater than the thickness (h) of its aft section, said thickness (h) is to successively decrease from the facial part rule of the center back on the limit of layered front portion, and at non-compressed state, the relative face of ring (10) tilts each other.

11,, it is characterized in that the granule (7,8 of ball adapter (3) according to a described prosthese among the claim 1-10; 21,22) be to make by one of following material: pottery, particularly sintered oxide, as aluminium oxide or zirconium oxide, synthetic cut stone, or any surface-treated metal alloy.

12,, it is characterized in that flexible ring (10) is because the elastomeric material of suitable hardness is made according to a described prosthese among the claim 1-11.

13,, it is characterized in that each granule (21,22) is suitable in gripper shoe (25 according to a described prosthese among the claim 2-12,26) received block (23 that forms in, 24) in, said granule is given prominence in this seat partially, and this seat of can freely packing into.