CN110740711B - 可膨胀椎间植入物和相关方法 - Google Patents
可膨胀椎间植入物和相关方法 Download PDFInfo
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- CN110740711B CN110740711B CN201880039383.XA CN201880039383A CN110740711B CN 110740711 B CN110740711 B CN 110740711B CN 201880039383 A CN201880039383 A CN 201880039383A CN 110740711 B CN110740711 B CN 110740711B
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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
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special 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
- A61F2002/4625—Special 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 with relative movement between parts of the instrument during use
- A61F2002/4627—Special 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 with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
Abstract
本发明提供了一种可膨胀植入物,所述可膨胀植入物具有沿着第一方向彼此间隔开的第一板和第二板。所述板沿着第一方向限定相对的骨接触表面,所述相对的骨接触表面被构造成分别接触上椎体和下椎体。设置在所述板之间的致动构件限定第一轴线、第一端部和沿着所述轴线的第二方向与所述第一端部间隔开的第二端部。所述第二方向垂直于所述第一方向。所述植入物包括与所述板接合的所述致动构件上的第一楔形件和第二楔形件以及沿着第二轴线沿着第三方向间隔开的驱动构件,所述第三方向垂直于所述第一方向、沿着所述第二方向并且相对于所述第二方向偏离。所述驱动构件将力传送至所述致动构件以致使所述致动构件旋转,并且所述楔形构件中的一者响应于旋转而沿着所述第二方向平移以移动所述板中的一者。
Description
技术领域
本发明涉及可膨胀椎间植入物和相关方法。
背景技术
如果椎间盘退化,则通常期望移除椎间盘。脊柱融合术可用于治疗这样的病症,并涉及用诸如保持架或其它垫片之类的装置代替退化椎间盘,该装置恢复椎间隙的高度并允许骨生长通过该装置以融合相邻的椎骨。脊柱融合术试图恢复正常的脊柱排列,稳定脊柱节段以进行适当的融合,创建最佳的融合环境,并通过使对脊柱脉管系统、硬脑膜和神经元的损害最小化来允许早期主动活动。当脊柱融合术满足这些目标时,愈合加快,并且患者功能、舒适度和活动性得到改善。压紧到椎间隙中并允许骨从相邻椎体穿过植入物的上表面和下表面生长的垫片装置在本领域中是已知的。然而,仍然需要使过程侵入性最小化但稳定脊柱节段并创建用于脊柱融合术的最佳空间的装置。仍然需要可横向(即,沿着内侧-外侧方向)插入椎间间隙中的装置。
发明内容
根据本公开的一个实施方案,可膨胀植入物包括沿着第一方向彼此间隔开的第一板和第二板。第一板限定被构造成接触上椎体的第一骨接触表面,并且第二板沿着第一方向限定与第一骨接触表面相对的第二骨接触表面。第二骨接触表面被构造成接触下椎体。植入物包括相对于第一方向至少部分地设置在第一板和第二板之间的致动构件。该致动构件限定第一轴线、第一端部和沿着第一轴线沿着第二方向与第一端部间隔开的第二端部。第二方向垂直于第一方向。植入物包括由致动构件承载并与第一板和第二板接合的第一楔形构件和第二楔形构件,并且还包括驱动构件,该驱动构件限定第二轴线、近侧端部和沿着第二轴线沿着第三方向与近侧端部间隔开的远侧端部。第三方向垂直于第一方向并且相对于第二方向偏离。驱动构件被构造成将驱动力传送至致动构件,以便致使致动构件围绕第一轴线旋转,并且第一楔形构件和第二楔形构件中的至少一者被构造成响应于致动构件围绕第一轴线的旋转而沿着第二方向平移,以便使第一板和第二板中的至少一者相对于第一板和第二板中的另一者沿着第一方向移动。
附图说明
结合附图阅读将更好地理解上述发明内容以及以下对本申请的椎间植入物的说明性实施方案的详细说明。出于说明本申请的可膨胀椎间植入物的目的,附图中示出示例性实施方案。然而,应当理解,本专利申请并不局限于所示出的精确的布置方式和机构。在附图中:
图1示出根据本公开的实施方案的定位在椎体之间的植入物;
图2为处于塌缩构型的图1中所示的植入物的透视图;
图3为处于膨胀构型的图1中所示的植入物的透视图;
图4为处于塌缩构型的图1中所示的植入物的顶视图;
图5为处于膨胀构型的图1中所示的植入物的顶视图,其中移除了植入物的上板,示出了植入物的膨胀机构;
图6A为图5中所示的膨胀机构的分解透视图;
图6B为图1中所示的植入物的上板和下板的透视图,其中上板和下板以不同的角度示出以示出这些板的内表面;
图7为图6B中所示的植入物的上板的底部平面图;
图8为沿着图4的剖面线8-8截取的图7的植入物的上板的剖面端视图;
图9为沿着图4的剖面线8-8截取的图7中所示的植入物的底板的剖面端视图;
图10为沿着图4的剖面线10-10截取的植入物的上板的一部分的剖视图;
图11为图5和图6A中所示的膨胀机构的楔形构件的透视图;
图12为图11中所示的楔形构件的侧视图;
图13和图14为图11中所示的楔形构件的相对端视图;
图15为图5和图6A中所示的膨胀机构的另一楔形构件的透视图;
图16为图15中所示的楔形构件的侧视图;
图17和图18为图15中所示的楔形构件的相对端视图;
图19为图5和图6A中所示的膨胀机构的致动构件的分解透视图;
图20为图19中所示的致动构件的侧视图;
图21为沿着图4的剖面线21-21截取的植入物的剖面端视图,其示出处于塌缩构型的植入物;并且
图22为被示为处于膨胀构型的植入物的剖面端视图。
具体实施方式
参见图1,上椎体2和相邻下椎体4限定在椎体2、4之间延伸的椎间间隙5。上椎体2限定上椎骨表面6,并且相邻的下椎体4限定下椎骨表面8。椎体2、4可以是在解剖学上相邻的,或者可以是从椎体2、4之间的位置移除中间椎体之后的剩余椎体。图1中示出了椎间盘切除术之后的椎间间隙5,由此已经移除或至少部分地移除了椎间盘材料,以准备用于容纳可膨胀椎间植入物10的椎间间隙5。植入物10可被构造用于侧向插入(即,沿着内侧-外侧轨迹)在椎间间隙5内。一旦插入椎间间隙5中,植入物10就可在头-尾方向上膨胀以实现适当的高度恢复和脊柱前凸,如下文更详细讨论的。椎间间隙5可根据需要沿着脊柱设置在任何位置,包括在脊柱的腰椎、胸腔和颈椎区域处。应当理解,植入物10的某些特征可以类似于在2014年8月28日以Miller的名义发布的美国专利公布2014/0243982 A1中阐述的那些特征,该专利的整个公开内容以引用方式并入本文。
下述说明所使用的某些术语仅为了方便起见且并非限制性的。词汇“右”、“左”、“下”和“上”指定附图中的方向,以此作为参照。词汇“内”、“内部的”和“内部”是指朝向植入物的几何中心的方向,而词汇“外”、“外部的”和“外部”是指远离植入物的几何中心的方向。词汇“前”、“后”、“上”、“下”、“内侧”、“外侧”和相关词汇和/或短语用于指示所参照的人体内的各种位置和取向。当关于植入物10或其部件使用这些词汇时,应将它们理解为是指在植入体内时植入物10的相对位置,如图1所示。术语包括以上列举的词汇、它们的派生词以及具有类似含义的词汇。
现在参见图2,植入物10在本文中被描述为沿着纵向方向“L”和横向方向“T”水平延伸,并且沿着竖直方向“V”竖直延伸。除非本文中另外指明,否则术语“纵向”、“横向”和“竖直”用于描述各个植入物部件和植入物部件轴线的正交方向分量。应当理解,虽然纵向方向L和横向方向T被示出为沿着水平平面(在本文中也称为“纵向-横向平面”)延伸并且限定该水平平面,并且竖直方向被示出为沿着竖直平面(诸如在本文中分别称为“竖直-纵向平面”或“竖直-横向平面”)延伸,但涵盖各个方向的平面在使用期间可能会有所不同。例如,当植入物10被插入椎间间隙5中时,竖直方向V大致沿着上-下(或尾-头)方向延伸,而水平平面大致位于由前-后方向和内侧-外侧方向限定的解剖平面中。因此,方向术语“竖直”和“水平”可用于描述植入物10及其部件,仅出于清楚和说明的目的而示出。
在图2中,植入物10以塌缩构型C示出。植入物10可在近侧端部或后端12和远侧端部或前端14之间延伸,该远侧端部或前端沿着纵向植入物轴线X1与前端14间隔开,该纵向植入物轴线沿着纵向方向L延伸。前端12和后端14可分别如此称呼,因为植入物10的前端可首先被插入到椎间间隙5中。后端12可被构造成与一个或多个插入器械联接,所述一个或多个插入器械被构造成支撑植入物10并承载该植入物到椎间间隙5中。植入物10也可沿着横向方向T在前侧16和后侧18之间延伸。
植入物10可包括第一板或上板100以及沿着竖直方向V与上板100相对的第二板或下板200。上板100可限定上板主体102,该上板主体限定上骨接触表面或第一骨接触表面104,并且下板200可限定下板主体202,该下板主体限定与第一骨接触表面104沿着竖直方向V间隔开的下骨接触表面或第二骨接触表面204。上骨接触表面104和下骨接触表面204可被构造成分别接合相对的上椎体4和下椎体6。如图所示,每个骨接触表面104、204可以大体平的方式延伸。另外,上骨接触表面104和下骨接触表面204可相对于彼此在竖直-横向平面中成角度,以便限定植入物10的前凸角α。另外,为了有利于插入,上板主体102和下板主体202可各自限定邻近植入物10的前端14的锥形表面106、206,其中每个锥形表面106、206在远侧方向上大致朝向植入物10的竖直中点向内渐缩以有利于植入物10的插入。
虽然上骨接触表面104和下骨接触表面204各自被示出为大体平的,但在其他实施方案中,每个骨接触表面104、204可例如为大体凸形或至少部分凸形的,或者可限定凸的部分和平的另一部分。每个骨接触表面104、204还可例如至少部分地限定纹理(未示出),诸如尖峰、脊、锥、倒钩、凹痕或滚纹,其被构造成当将植入物10插入椎间间隙5中时接合相应的椎体4、6。
如本文所用,术语“远侧”及其衍生词是指从后端12朝向前端14的方向。如本文所用,术语“近侧”及其衍生词是指从前端14朝向后端12的方向。因此,如本文所用,术语“纵向方向L”是双向的,并且由单方向的远侧方向和相对的近侧方向限定。
如本文所用,术语“前”及其衍生词是指从植入物10的后侧18朝向该植入物的前侧16的方向。如本文所用,术语“后”及其衍生词是指从前侧16朝向后侧18的方向。因此,如本文所用,术语“横向方向L”是双向的,并且由单方向的前方向和相对的后方向限定。
如本文所用,术语“上”及其衍生词是指从第二骨接触表面204朝向第一骨接触表面104的方向。如本文所用,术语“下”及其衍生词是指从第一骨接触表面104朝向第二骨接触表面204的方向。因此,如本文所用,术语“竖直方向V”是双向的,并且由单方向的上方向和相对的下方向限定。
参见图2和3,植入物10可包括插置在上板100和下板200的各部分之间并且被构造成在竖直方向V上相对于彼此分离上板100和下板200的膨胀机构300。例如,膨胀机构300可被构造成将植入物10从如图2中所示的塌缩构型C致动为如图3中所示的膨胀构型E。植入物10可被构造成扩展植入物10的竖直高度和前凸角α,各自在上骨接触表面104和下骨接触表面204之间测量。例如,当植入物10处于塌缩构型(图2)时,植入物10的塌缩前高度HA1可介于约4mm和约18mm之间,植入物10的塌缩后高度HP1可介于约3mm和约17mm之间,并且植入物10的塌缩(即,“内置”)前凸角α1可介于0度和约15度之间。当植入物10处于膨胀构型E(图3)时,膨胀前高度HA2可介于约8mm和约24mm之间,膨胀后高度HP2可介于约7mm和约21mm之间,并且膨胀前凸角α2可介于约15度和约45度之间。应当理解,在一些实施方案中,植入物10可被构造成使得膨胀前高度HA2可比塌缩前高度HA1大约3倍,并且膨胀后高度HP2也可比塌缩后高度HP1大约3倍。
前板100和后板200可各自限定被构造成容纳膨胀机构300的部件的特征部。例如,如图2和图3所示,上板主体102可限定第一内腔108和在远侧方向上与第一内腔108间隔开的第二内腔110。因此,第一内腔108可被称为“近侧”内腔,并且第二内腔210可被称为“远侧”内腔。另外,虽然在图2或图3中不可见,但是下板主体202可限定第三内腔208和在远侧方向上与第三内腔208间隔开的第四内腔210。类似地,第三内腔208可被称为“近侧”内腔,并且第四内腔210可被称为“远侧”内腔。上板100的第一内腔108和第二内腔110可分别沿着竖直方向V与下板200的第三内腔208和第四内腔210对齐和相对。内腔108、110、208、210中的每一者可从第一内腔侧或前内腔侧108a沿着横向方向T延伸到与第一侧108a间隔开的第二内腔侧或后内腔侧108b。植入物10被构造成使得当植入物10处于塌缩构型C时,膨胀机构300的各个部分可至少部分地设置在内腔108、110、208、210、210内,如下面更详细描述的。作为参考,下板200的第三内腔208和第四内腔210在图5和图6B中均可见,第三内腔208在图21和图22中也可见,并且第四内腔210在图9中也可见。
参见图4,植入物10可限定在约25mm和约70mm之间的植入物长度L0,该植入物长度沿着纵向方向L从植入物10的后端12到前端14进行测量。植入物还可限定在约20mm和约50mm之间的植入物宽度W0,该植入物长度沿着横向方向T从植入物10的前侧16到后侧18进行测量。植入物10还可限定中心孔111,该中心孔沿着竖直方向V延伸穿过植入物10(即,从第一骨接触表面104到第二骨接触表面204)。相对于纵向方向L,中心孔111可位于上板100的第一内腔108和第二内腔110之间以及位于下板200的第三内腔208和第四内腔210之间。中心孔111可限定第一侧或前侧111a以及沿着横向方向T与前侧间隔开的第二侧或后侧111b。中心孔111还可限定第三侧或近侧111c以及沿着纵向方向L与近侧间隔开的第四侧或远侧111d。中心孔111可沿着垂直方向V基本完全不阻塞地延伸穿过植入物10。中心孔111可占据显著体积的植入物10,并且可在插入植入物10之前预填充或填充有骨生长材料,以便增强上椎体2和下椎体4之间的后续骨融合。
现在参见图5和图6A,膨胀机构300可包括驱动组件301和一个或多个致动组件,诸如第一致动组件302a和第二致动组件302b,它们被构造成被驱动组件301驱动并且致动上板100和下板200中的至少一者相对于板100、200中的另一者沿着竖直方向V运动。第二致动组件302b可在远侧方向上与第一致动组件302a间隔开。因此,第一致动组件302a可被称为“近侧”致动组件,并且第二致动组件302b可被称为“远侧”致动组件。第一致动组件302a可包括第一对楔形构件或近侧对楔形构件303,并且第二致动组件302b可包括第二对楔形构件或远侧对楔形构件304。每对楔形构件303、304可包括沿着横向方向T彼此间隔开的第一楔形构件306和第二楔形构件308。第一楔形构件306可位于前侧16附近并且远离植入物10的后侧18。第二楔形构件308可位于后侧18附近并且远离植入物10的前侧16。因此,每对中的第一楔形构件306可被称为“前”楔形构件,并且每对中的第二楔形构件308可被称为“后”楔形构件。每对303、304中的第一楔形构件306和第二楔形构件308可被构造成在横向方向T上相对于彼此平移。在其他实施方案中,每对中的楔形构件306、308中的仅一者需要沿着横向方向T相对于另一个楔形构件平移。
楔形构件的第一对303和第二对304可被构造成使得第一楔形构件306相对于第二楔形构件308沿着横向方向T的平移驱动上板100和下板200在竖直方向V上彼此远离地扩张。这样,可将植入物10从塌缩构型C致动为膨胀构型E。出于例示性目的,图5示出了处于分离构型的每对中的楔形构件306、308,而图6A的楔形构件的近侧对303示出为处于收缩构型。每对303、304中的上板100和下板200以及第一楔形构件306和第二楔形构件308可分别被成形、取向和以其他方式被构造成使得楔形构件306、308的收缩构型对应于植入物10的塌缩构型C,并且使得楔形构件306、308的分离构型对应于植入物10的膨胀构型E。然而,应当理解,在其他实施方案中,楔形构件306、308的分离构型可对应于植入物10的塌缩构型,并且楔形构件306、308的收缩构型可对应于植入物10的膨胀构型。
继续参见图5和图6A,第一致动组件302a可包括联接到第一对楔形构件303的第一致动构件或近侧致动构件310,并且第二致动组件302b可包括联接到第二对楔形构件304的第二致动构件或远侧致动构件312。第一致动构件310和第二致动构件312可彼此类似地或甚至基本上相同地构造。因此,应当理解,下文结合第一致动构件310示出的以下描述和参考标号也可结合第二致动构件312使用。
每个致动构件310可包括致动杆314,该致动杆限定沿着横向方向T延伸的中心杆轴线Y1和沿着中心杆轴线Y1与相对的第二端部320间隔开的第一端部318。致动杆314还可限定在第一端部318和第二端部320之间延伸的外表面321。每个致动杆314还可限定从第一端部318朝向第二端部320延伸的第一部分322和从第二端部320朝向第一端部318延伸的第二部分324。第一部分322和第二部分324可沿着横向方向T彼此分开和间隔开。第一端部318和第一部分322可各自位于前侧16附近并且远离植入物10的后侧18。第二端部320和第二部分324可各自位于后侧18附近并且远离植入物10的前侧16。因此,第一端部318、第一部分322或与其相关联的任何部件可被称为相应的“前”端部、部分或部件,并且第二端部320、第二部分324或与其相关联的任何部件可被称为“后”端部、部分或部件。致动杆310还可限定保持特征,诸如形成于杆310的外表面321中的环形凹部326,该环形凹部位于第一部分322和第二部分324之间并且沿着横向方向T分离该第一部分和该第二部分。第一部分322可限定第一螺纹区域或前螺纹区域328,并且第二部分324可限定第二螺纹区域或后螺纹区域330。第一部分322还可任选地限定沿着横向方向T插置在第一螺纹区域328和保持特征326之间的第一无螺纹区域332。第二部分324还可任选地限定沿着横向方向T插置在保持结构326和第二螺纹区域330之间的第二无螺纹区域334,以及在后方向上从第二螺纹区域330延伸到致动杆314的第二端部320的第三无螺纹区域335。致动杆314还可限定沿着横向方向T插置在第二螺纹区域330和第三无螺纹区域335之间的邻接表面335a。邻接表面335a可面向后方向。每对303、304的第一楔形构件306可被构造成沿着相关联的致动杆314的第一螺纹区域328平移,并且每对303、304的第二楔形构件308可被构造成响应于杆314围绕中心杆轴线Y1的旋转而沿着杆314的第二螺纹区域330平移,如下面更详细描述的。
第一致动组件302a可包括第一传输构件,诸如第一齿轮336,用于将由医师操作的驱动工具施加的驱动力的至少一部分转换成第一致动构件310围绕其中心杆轴线Y1的第一旋转力。类似地,第二致动组件302b可包括第二传输构件,诸如第二齿轮338,用于将驱动力的另一部分转换成第二致动构件312围绕其中心杆轴线Y1的第二旋转力。例如,如图所示,第一齿轮336和第二齿轮338可以是位于致动杆314的后端320附近的锥齿轮。然而,作为非限制性示例,其他齿轮类型(包括蜗轮和螺旋齿轮)在本发明实施方案的范围内。
驱动组件301可包括旋转地联接到第一致动构件310和第二致动构件312中的每一者的驱动构件,诸如驱动轴340。驱动轴340可包括用于容纳由医师操作的驱动工具的接合特征,诸如承窝342。驱动轴340还可包括第三传输构件诸如第三齿轮344和第四传输构件诸如第四齿轮346,用于将驱动力传递到致动组件302a、302b的相应的第一传输构件336和第二传输构件338。第三齿轮344和第四齿轮346可通过焊接、钎焊、机械紧固件或任何其他技术联接到驱动轴340。在其他实施方案中,第三齿轮344和第四齿轮346中的任一者或两者可与驱动轴340一体地形成。
如图所示,驱动轴340可限定中心轴轴线X2、轴近侧端部350和轴远侧端部352,该轴远侧端部沿着纵向方向L沿着中心轴轴线X2与轴近侧端部350间隔开。第三齿轮344和第四齿轮346可包括被构造成与相应的第一齿轮336和第二齿轮338啮合的锥齿轮。第四齿轮346可在远侧方向上与第三齿轮344间隔开;因此,第三齿轮344可被称为“近侧”齿轮,并且第四齿轮346可被称为“远侧”齿轮。当齿轮344、346为锥齿轮时,如图所示,第一齿轮336和第三齿轮344可相对于彼此取向成90度,并且第二齿轮338和第四齿轮346可相对于彼此取向成90度,但其他相对取向在本发明所公开的实施方案的范围内。
承窝342可从轴近侧端部350凹入驱动轴340中。承窝342可由驱动轴340的头部354限定,该驱动轴在远侧方向上从轴近侧端部350延伸。承窝342可以是六边形、五边形、正方形、三角形、十字形、加号形、线形、星形或被配置为接合驱动工具的任何其他形状中的任一者。驱动轴340的头部354可限定第一外轴表面356,并且该轴位于头部354的远侧的一部分可限定第二轴外表面358,使得第一外轴表面356的直径大于第二外轴表面358的直径。
驱动轴340还可限定与承窝342流体连通的中心孔360和与中心孔360流体连通的多个孔362。所述多个孔362可从第二外表面358径向向内延伸(即,在垂直于中心轴轴线X2的径向方向上)到中心孔360,使得承窝342、中心孔360和孔362限定连续流体通路。所述多个孔362可邻近植入物10的中心孔111定位,使得附加骨生长材料可被注入到承窝342中(任选地利用漏斗),穿过中心孔360并流出驱动轴340的所述多个孔并进入植入物10的中心孔111,特别是当植入物处于膨胀构型E时。
一旦根据需要将植入物10插入椎间间隙5中,医师就可通过将驱动工具插入驱动轴340的承窝342中并旋转驱动工具来将植入物10从塌缩构型C致动到膨胀构型E。旋转驱动工具可旋转驱动轴340以及第三齿轮344和第四齿轮346,继而旋转第一齿轮336和第二齿轮338以及联接到其上的致动杆314。随着致动杆314旋转,每对303、304中的第一楔形构件306和第二楔形构件308沿着横向方向T沿着致动杆310、312的相应的第一螺纹区域328和第二螺纹区域330彼此远离,从而迫使上板100和下板200在竖直方向V上彼此分离。在植入物10处于膨胀构型E的情况下,医师可以上述方式将附加骨生长材料注入到中心孔111中。
膨胀机构300可包括第一安装元件,诸如第一托架或近侧托架364,以及第二安装元件,诸如第二托架或远侧托架366,用于分别将驱动轴340联接到第一致动构件310和第二致动构件312。例如,第一托架364和第二托架366可各自为关于水平平面的正方形(即,“直角”)托架。具体地讲,每个托架364、366可限定第一托架部分368,该第一托架部分被构造成在前方向上从后托架端部370延伸到与后托架端部370间隔开的弯曲部372。每个托架364、366还可限定在纵向方向L上从弯曲部372延伸到与弯曲部372间隔开的保持元件376的第二托架部分374。如图6A中更清楚地示出,第一托架部分368可限定邻近后托架端部370的孔联接件378,并且其尺寸和构造被设置成容纳驱动轴340的第二外表面358。孔联接件378可限定中心联接轴线X3,该中心联接轴线被配置为当托架364、366联接到驱动轴340时与中心轴轴线X2共延。每个孔联接件378可邻近驱动轴340的相关联的邻接凸缘定位。
每个托架364、366的保持元件376可被构造成以至少部分地将致动构件310、312相对于驱动轴340保持在适当位置的方式接合相关联的致动构件310、312的保持特征326。保持元件376可限定在纵向方向L上延伸并且在竖直方向V上彼此间隔开的一对相对的臂380a、380b,使得臂380a、380b的内表面381a、381b可在相关联的致动构件310、312的环形凹部326内延伸。内臂表面381a、381b可各自为基本线性的并且与纵向方向L平行。臂380a、380b可进一步限定弯曲且凸出的外臂表面382a、382b,以便在竖直-纵向平面中共同限定C形状。保持元件376可进一步限定在竖直方向V上结合内臂表面381a、381b的弯曲且凹陷的中间表面383。中间表面383可具有轮廓以匹配环形凹部326内的相关联的致动杆314的外表面321的轮廓。当托架364、366联接到其相关联的致动构件310、312时,每个保持元件376的内臂表面381a、381b和中间表面383可轻轻地邻接或紧邻环形凹部326内的相关联的致动杆314的外表面321,以便在横向方向T、竖直方向V以及内侧纵向方向和外侧纵向方向中的至少一者上基本上将致动杆314保持在相对于驱动轴340的位置。换句话说,每个托架364、366的保持元件376可被构造成基本上充当轴向轴承,并且至少部分地充当相关联的致动杆314的轴颈轴承。
如所描绘的,近侧托架364和远侧托架366可定位在驱动轴340上,使得第一致动构件310和第二致动构件312相对于纵向方向L定位在相应的第一托架部分368之间。在此类实施方案中,近侧托架364的保持元件376的臂380a、380b可在远侧方向上打开,并且远侧托架366的保持元件376的臂380a、380b可在近侧方向上打开。因此,在组装植入物10期间,每个保持元件376的臂380a、380b可被容纳在凹部326内的杆314的外表面321的相对竖直侧上。另选地,近侧托架364和远侧托架366可定位在驱动轴340上,使得相应的第一托架部分368相对于纵向方向L定位在相应的致动构件310、312之间。在此类实施方案中,近侧托架364的臂380a、380b可在近侧方向上打开,并且远侧托架366的臂380a、380b可在远侧方向上打开。
现在参见图6B,上板主体102可限定第一内面112,该第一内面沿着竖直方向V与第一骨接触表面104间隔开并且定位成与该第一骨接触表面相对,并且下板主体202可限定第二内面212,该第二内面沿着竖直方向V与第二骨接触表面204间隔开并且定位成与该第二骨接触表面相对。第一内表面112和第二内表面212可定位成彼此相对并且可沿着竖直方向V基本上面向彼此。第一内面112和第二内面212可各自从植入物10的后端12延伸到前端14,并且从植入物10的前侧16延伸到后侧18。第一内面112和第二内面212可各自被构造成与楔形构件306、308联接,如下文更详细阐述的。
第一内面112可限定第一内板接触表面114,并且第二内面212可限定第二内板接触表面214。第一内板接触表面114和第二内板接触表面214可被构造成在植入物10处于塌缩构型C时彼此邻接。第一内板接触表面114和第二内板接触表面214中的每一者可包括沿着纵向方向L和横向方向T彼此分开的多个接触表面。
上板主体102的第一内面112可限定第一腔116和在远侧方向上与第一腔116间隔开的第二腔118。因此,第一腔116可被称为“近侧”腔,并且第二腔118可被称为“远侧”腔。第一腔116和第二腔118可各自沿着竖直方向V从第一内板接触表面114朝向第一骨接触表面104延伸,并且可各自沿着横向方向T从邻近植入物10的前侧16或与植入物的前侧邻接的位置延伸到邻近植入物10的后侧18的位置。第一腔116可与第一内腔108邻接,并且第二腔118可与第二内腔110邻接。下板主体202的第二内面212可限定第三腔216和在远侧方向上与第三腔216间隔开的第四腔218。因此,第三腔216可被称为“近侧”腔,并且第四腔218可被称为“远侧”腔。第三腔216和第四腔218可各自沿着竖直方向V从第二内板接触表面214朝向第二骨接触表面204延伸,并且可各自沿着横向方向T从邻近植入物10的前侧16或与植入物的前侧邻接的位置延伸到邻近植入物10的后侧18的位置。第三腔216可与第三内腔208邻接,并且第四腔218可与第四内腔210邻接。
第一腔116和第三腔216可彼此相对并且沿着竖直方向V面向彼此,使得第一腔116和第三腔216可至少在植入物10处于塌缩构型C时共同容纳第一对楔形构件303、第一致动构件310和第一托架364的至少一部分。类似地,第二腔118和第四腔218可相对并且沿着竖直方向V面向彼此,以便至少在植入物10处于塌缩位置C时共同容纳第二对楔形构件304、第二致动构件312和第二托架366的至少一部分。
参见图6B和图7,上板主体102的第一腔116和第二腔118可类似地成形。第一腔116和第二腔118可彼此类似地或甚至基本上相同地构造。此外,第三腔216和第四腔218可以与第一腔116和第二腔118被构造在上板主体102内的方式类似或基本上相同的方式被构造在下板主体202内。因此,应当理解,下文结合第一腔116示出的以下描述和参考标号还可结合第二腔118、第三腔216和第四腔218中的任一者使用。
参见图7,每个腔116、118可沿着中心腔轴线Y2从第一腔端部或前腔端部120延伸到第二腔端部或后腔端部122,该中心腔轴线沿着横向方向T延伸。前腔端部120可与植入物10的前侧16邻接,并且后腔端部122可邻近植入物10的后侧18定位。每个腔116、118还可限定第一侧或外侧124以及沿着纵向方向L与第一侧间隔开的相对的第二侧或内侧126。每个腔116的第一侧和第二侧可沿着纵向方向L面向彼此。
上板100和下板200中的每一者可包括一个或多个接合元件,所述接合元件被构造成以允许膨胀机构300沿着竖直方向V分离板100、200的方式接合膨胀机构300的对应接合元件。例如,在腔116中的每一个内,板主体102可限定接合元件,诸如被构造成与第一楔形构件306和第二楔形构件308的各部分配合并沿着其滑动的一对斜坡表面。该对斜坡表面可包括第一斜坡表面或前斜坡表面130以及沿着横向方向T与第一斜坡表面130间隔开的第二斜坡表面或后斜坡表面132。第一斜坡表面130和第二斜坡表面132可相对于横向方向T定位在与腔116连通的内腔108、110的相对侧108a、108b上。第一斜坡表面130可从内腔的前腔端部120延伸到前侧108a,并且第二斜坡表面132可从内腔的后侧108b延伸到后腔端部122。
第一斜坡表面130倾斜以邻接并滑动地容纳第一楔形构件306的一部分,并且第二斜坡表面132倾斜以邻接并滑动地容纳第二楔形构件308的一部分。第一斜坡表面130可以是倾斜的,使得从相关联的板主体102的内板接触表面114到第一斜坡表面130所测量的竖直距离沿着横向方向T从前斜坡端部到后斜坡端部增大。第二斜坡表面132可以是倾斜的,使得从相关联的板主体的内板接触表面到第二斜坡表面132所测量的竖直距离沿着横向方向T从前斜坡端部到后斜坡端部减小。如图8相对于上板主体102所示,第一斜坡表面130可相对于内板接触表面114以介于约10度和约40度之间的第一斜坡锐角βS1倾斜。第二斜坡表面132可相对于内板接触表面114以介于约10度和约60度之间的第二斜坡锐角βS2倾斜。类似地,如图9相对于下板主体202所示,下板主体202的相关联的腔216内的第一斜坡表面130可相对于内板接触表面214以介于约10度和约40度之间的第一斜坡锐角βI1倾斜。下板主体202的相关联的腔216内的第二斜坡表面132可相对于内板接触表面214以介于约10度和约60度之间的第二斜坡锐角βI2倾斜。应当理解,每个腔116、118、216、218内的斜坡表面130、132的第一斜坡角和第二斜坡角βS1、βS2βI1、βI2可根据需要而变化。
板主体102还可在每个腔116、118内限定设置在植入物10的前侧16处并且与第一斜坡表面130连通的第一曲线部分134,以及设置在腔116的后端122处并且与第二斜坡表面132连通的第二曲线部分136。第一曲线部分134和第二曲线部分136可沿着竖直方向V朝向板主体102的骨接触表面104分别从第一斜坡表面130和第二斜坡表面132凹陷。第一曲线部分134和第二曲线部分136可各自在竖直-纵向平面中限定曲线轮廓。当上板100和下板200处于塌缩构型C时,上板主体102和下板主体202的竖直相对的第一曲线部分134可共同限定相关联的致动构件310、312的第一部分322的第一出入口或前出入口,并且板主体102、202的竖直相对的第二曲线部分136可共同限定相关联的致动构件310、312的第二部分324的第二出入口或后出入口。
在腔116的外侧124和内侧126中的每一者处,板主体102可限定沿着纵向方向L朝向中心腔轴线Y2向内突出的一个或多个突出部138。突出部138可至少部分地限定一个或多个通道140,所述一个或多个通道竖直地定位在腔116内的一个或多个突出部138和相关联的斜坡表面130、132之间。突出部138和通道140可由腔116内的各种表面限定。例如,如图10所示,在腔116的外侧124和内侧126中的每一者处,板主体102可限定各自在竖直方向V和横向方向T上延伸的第一表面142和第二表面144。第一表面可与板主体102的内接触表面114邻接。第二表面144可与腔116内的第一斜坡表面130和第二斜坡表面132中的一者或多者邻接,并且可相对于竖直方向V位于第一表面142和相关联的斜坡表面130、132之间。相对于纵向方向L,第一表面142可位于第二表面144和中心腔轴线Y2之间。板主体102可限定在第一表面142和第二表面144之间沿着纵向方向L延伸的第三表面或悬伸表面146。悬伸表面146可与第一表面142和第二表面144中的一者或两者邻接。第一表面142和第二表面144可基本上彼此平行。悬伸表面146可相对于第一表面142和第二表面144中的一者或两者基本上正交。所述一个或多个突出部138可至少部分地由悬伸表面146和第一表面142限定。类似地,所述一个或多个通道140可至少部分地由第二表面144和悬伸表面146限定。因此,所述一个或多个突出部130可在纵向方向L上与第一斜坡表面130和第二斜坡表面132的至少一部分重叠。
在腔116的每一侧上,所述一个或多个突出部138可包括在纵向方向L上与第一146斜坡表面130部分重叠的第一突出部或前突出部138a,以及在纵向方向L上与第二斜坡表面132部分重叠的第二突出部或后突出部138b。另外,所述一个或多个通道140可包括竖直地定位在第一突出部138a和第一斜坡表面130之间的第一通道或前通道140a,以及竖直地定位在第二突出部138b和第二斜坡表面132之间的第二通道或后通道140b。这样,第一通道140a和第二通道140b可分别被表征为定位在第一突出部138a和第二突出部138b的“下面”。第一通道140a可倾斜以便与第一斜坡表面130平行,并且第二通道140b可倾斜以便与第二斜坡表面132平行。因此,如图8和9所示,上板主体102和下板主体202的相关联的腔116、118、216、218内的第一通道140a可各自相对于它们的内板接触表面114、214以介于约10度和约40度之间的第一通道锐角δS1、δI1倾斜,并且第二通道140b可各自相对于它们的内板接触表面114、214以介于约10度和约60度之间的第二通道锐角δS2、δI2倾斜。
应当理解,腔116的内侧126上的突出部138和通道140的尺寸、形状和取向可类似于腔116的外侧124上的那些进行设置。换句话说,腔116的外侧124和内侧126上的特征实际上可以是彼此关于沿着中心腔轴线Y2延伸的竖直平面的镜像。
与每个腔116、118相关联,板主体102还可限定第一纵向狭槽或外纵向狭槽148以及在该腔的相对侧124、126上彼此对齐的第二纵向狭槽或内纵向狭槽150。第一狭槽148可沿着纵向方向L从板主体102的外部延伸到腔,并且第二狭槽150可沿着纵向方向L从腔朝向板主体102的内部延伸。每个腔116的外侧124上的前突出部138a和后突出部138b可由第一狭槽148沿着横向方向T彼此分离,并且每个腔116的内侧126上的前突出部138a和后突出部138b可由第二狭槽150沿着横向方向T彼此分离。另外,每个腔116的每一侧124、126上的前通道140a和后通道140b也可相对于横向方向T位于相应的狭槽148、150的相对侧上。
板主体还可限定与第一腔116相关联的第一着陆表面或近侧着陆表面152,以及与第二腔118相关联的第二着陆表面或远侧着陆表面154。第一着陆表面152和第二着陆表面154可各自在竖直方向V上从其内板接触表面114凹入到板主体102中。第二着陆表面154可在远侧方向上与第一着陆表面152间隔开,使得第一腔116和第二腔118均沿着纵向方向L定位在第一着陆表面152和第二着陆表面154之间。第一着陆表面152可邻近植入物10的后端12并任选地与植入物的后端邻接,并且第二着陆表面154可邻近植入物10的前端14并任选地与植入物的前端邻接。第一着陆表面152和第二着陆表面154可各自邻近植入物10的后侧18并且远离前侧16。第一着陆表面152和第二着陆表面154可各自在后方向上从相关联的腔116、118的外狭槽148延伸。
相对于纵向方向L,第一着陆表面152可通过由板主体102限定的第一壁156与第一腔116的外侧124分离,并且第二着陆表面154可通过由板主体102限定的第二壁158与第二腔118的外侧124分离。
每个腔116、118及其相关联的第一狭槽148和第二狭槽150以及相关联的着陆表面152、154被构造成容纳相关联的托架364、366。例如,相对于第一腔116,第一托架364的第一部分368可在横向方向T上横跨第一着陆表面152延伸,并且托架364的第二部分374可沿着纵向方向L横跨第一腔116延伸,并且可在与其相关联的外狭槽148和内狭槽150内延伸。类似地,第二托架366的第一部分368可在横向方向T上横跨第二着陆表面154延伸,并且托架366的第二部分374可沿着纵向方向L横跨第二腔118延伸,并且可在与其相关联的外狭槽148和内狭槽150内延伸。这样,托架364、366可例如相对于相关联的板主体102至少部分地保持在适当位置,如图5所示。内狭槽150可任选地各自在竖直-纵向平面中具有弯曲且凹陷的轮廓,以便对应于相关联的托架364、366的保持元件378的外臂表面382a、382b的弯曲且凸出的轮廓。外狭槽148和内狭槽150可在横向方向T上各自具有宽度,该宽度大于托架364、366的第二部分374的横向宽度,使得托架364、366可在植入物10从塌缩构型C扩张到膨胀构型E期间沿着横向方向T调节它们相对于上板主体102和下板主体202的位置。
板主体102的内表面112还可限定邻近植入物10的后侧18并且任选地与其邻接的第三着陆表面160。第三着陆表面160可沿着纵向方向L从植入物10的近侧端部12延伸到远侧端部14,并且可在后方向上从第一腔116和第二腔118延伸到植入物10的后侧18。第三着陆表面160可与第一腔116和第二腔118、第一着陆表面152和第二着陆表面154,以及板主体102的第一壁156和第二壁158中的一者或多者邻接。第三着陆表面160可被构造成至少部分地容纳驱动轴340和膨胀机构300的第一传输构件336和第二传输构件338。因此,第三着陆表面160可以是倾斜的,使得从第三着陆表面160到板主体102的骨接触表面104所测量的竖直距离沿着后方向减小。与第一腔116和第二腔118邻接的第三着陆表面160的一部分可在竖直-横向平面中限定弯曲且凹陷的倾斜度轮廓。板主体102的内表面112还可限定分别邻近第一腔116和第二腔118的后端122或任选地与其邻接的第一凹部162和第二凹部164,以便至少部分地容纳第一传输构件336和第二传输构件338。
下板200和上板100可类似地构造。例如,如例示的实施方案所示,上板主体102和下板主体202可以是彼此关于延伸穿过植入物10的几何中心的水平面的镜像。因此,下板200可包括对应于上文相对于上板100描述的那些的结构特征。因此,上板主体102的特征的参考标号可结合下板主体202的对应特征使用。例如,由下板主体202限定的第三腔216和第四腔218与上板主体102的第一腔116和第二腔118可类似地构造。因此,尽管本文可能未明确地论述第三腔216和第四腔218的某些特征,作为非限制性示例,诸如后斜坡表面130和前斜坡表面132、突出部138和通道140,但应当理解,第三腔216和第四腔218的这些特征可被构造成基本上与第一腔116和第二腔118的那些特征相同,并且那些特征的参考标号可互换使用。
现在参见图11至图14,其示出了第一楔形构件或前楔形构件306的各种视图。近侧对303和远侧对304中的每一者的第一楔形构件306可类似地构造。第一楔形构件306可限定第一楔形主体400,该第一楔形主体沿着第一中心楔形轴线Y3在外端402和内端404之间延伸,该内端相对于第一中心楔形轴线Y3与外端402间隔开。外端402可限定外面406,并且内端404可限定内面408,并且每个面406、408可任选地为平的并且垂直于第一中心楔形轴线Y3取向。第一中心楔形轴线Y3大致与承载第一楔形构件306的致动杆314的中心杆轴线Y2对齐。因此,第一中心楔形轴线Y3和中心杆轴线Y2可各自沿着横向方向T延伸。如图5和图6A所示,第一楔形主体400的外端402被定位成面向前方向,并且内端404被定位成面向后方向。第一楔形主体400可限定从第一楔形主体400的外端402到内端404测量的介于约1.5mm和约10mm之间的第一楔形长度L1。
第一楔形主体400可限定一个或多个接合元件,所述一个或多个接合元件被构造成以在竖直方向V上驱动板100、200之间的分离的方式接合上板100和下板200的对应接合元件。第一楔形主体400的所述一个或多个接合元件可包括第一倾斜表面或上倾斜表面410以及沿着竖直方向V彼此相对且彼此间隔开的第二倾斜表面的或下倾斜表面412。上倾斜表面410和下倾斜表面412可沿着横向方向T从第一楔形主体400的外端402延伸到内端404。上倾斜表面410和下倾斜表面412可各自相对于第一中心楔形轴线Y3倾斜,使得外端在竖直方向V上比内端窄,从而为第一楔形主体400提供其楔形形状。第一楔形主体400的外端402在竖直方向V上的高度H1可在约2mm至约15mm的范围内,并且第一楔形主体400的内端404在竖直方向V上的高度H2可在约3.5mm至约17.5mm的范围内。上倾斜表面410可与上板主体102的相关联的腔116、118内的第一斜坡表面130可滑动地配合,并且第二下倾斜表面78可与下板主体202的相关联的腔216、218内的第一斜坡表面130可滑动地配合。
第一楔形主体400还可限定沿着纵向方向L彼此间隔开的第一侧表面414和相对的第二侧表面416。第一侧表面414和第二侧表面416可沿着横向方向T从第一楔形主体400的外端402延伸到内端404,并且沿着竖直方向V在上倾斜表面410和下倾斜表面412之间延伸。第一侧表面414和第二侧表面416可各自为平的并且彼此平行,但其他取向在本公开的范围内。
第一楔形主体400还可限定沿着纵向方向L从第一侧表面414和第二侧表面416突出的一个或多个脊420。这些脊420被构造成将第一楔形构件306与上板100和下板200中的一者或两者联锁,以便将上板100和下板200联接在一起。例如,所述一个或多个脊420被构造成可滑动地容纳在相关联的腔116内的前通道140a中的一个或多个内。因此,第一楔形主体400的脊420中的每一个通常可与容纳它们的相关联的通道140a平行。
所述一个或多个脊420可包括沿着纵向方向L从第一楔形主体400的第一侧表面414向外突出的第一脊420a和第二脊420b,并且还可包括沿着纵向方向L从第一楔形主体400的第二侧表面416向外突出的第三脊420c和第四脊420d。第一脊420a和第三脊420可各自邻近第一楔形主体400的上倾斜表面410定位或任选地与其邻接。因此,第一脊420a和第三脊420c可各自被称为上脊。第二脊420b和第四脊420d可各自邻近第一楔形主体400的下倾斜表面412定位或任选地与其邻接,并且因此可各自被称为下脊。第一脊420a和第三脊420c中的一者或两者可从第一楔形主体400的内端404延伸到外端402并且可平行于楔形主体400的上倾斜表面410。类似地,第二脊420b和第四脊420d中的一者或两者可从第一楔形主体400的内端404延伸到外端402并且可平行于楔形主体400的下倾斜表面412。然而,在其他实施方案中,脊420中的任一个可延伸小于第一楔形主体400的外端402和内端404之间的整个距离。
脊420a、420b、420c、420d中的每一者可限定上脊表面422、相对的下脊表面424,以及在竖直方向V上在上脊表面422和下脊表面424之间延伸的外脊表面426。第一脊420a和第三脊420c的上脊表面422可邻近第一楔形主体400的上倾斜表面410、与其邻接,或者如例示的实施方案中所示,可限定该上倾斜表面的一部分。类似地,第二脊420b和第四脊420d的下脊表面424可邻近第一楔形主体400的下倾斜表面412、与其邻接,或如图所示可限定该下倾斜表面的一部分。应当理解,第一楔形主体400的上倾斜表面410和下倾斜表面412可为平的,或者如图6A和图11至图14,可在竖直-横向平面中限定一个或多个弯曲轮廓。例如,上倾斜表面410和下倾斜表面412可各自限定邻近外端402或与其邻接的第一区域428,邻近内端404或与其邻接的第二区域430,以及相对于横向方向T位于第一区域428和第二区域430之间的第三中间区域432。如图所示,第一区域428和第二区域430可分别限定第一弯曲凸出轮廓和第二弯曲凸出轮廓,并且中间轮廓432可限定竖直-横向平面中的线性轮廓。第一区域428和第二区域430的弯曲轮廓可根据需要限定相同的曲率半径或不同的曲率半径。应当理解,上述第一、第二和中间轮廓还可存在于第一脊420a和第三脊420c的上脊表面422以及第二脊420b和第四脊420d的下脊表面424,特别是当上脊表面422和下脊表面424限定第一楔形主体400的上倾斜表面410和下倾斜表面412的一部分时。
上倾斜表面410和下倾斜表面412中的每一者的第一区域428和第二区域430的弯曲轮廓可在第一楔形主体400沿着横向方向T的平移期间减小第一楔形主体400和上板主体102和下板主体202之间的摩擦。弯曲轮廓还可提供上骨接触表面104和下骨接触表面204的各个前凸角α之间的更平滑的过渡,并且减小在植入物10的膨胀期间分别施加到第一楔形主体400和板主体102、202的内部应力。
如图13和14中最佳所示,第一楔形主体400可限定沿着纵向方向L从第一脊420a和第三脊420c(或第二脊420b和第四脊420d)的外表面426测量的介于约4mm和约7mm之间的第一最大楔形宽度W1。另外,上倾斜表面410可任选地相对于沿着第一中心楔形轴线Y3的每个位置在竖直-纵向平面中限定线性轮廓。
具体参见图12,第一脊420a的外脊表面426和下脊表面424之间的第一边缘434a以及第二脊420b的外表面426和上表面422之间的第二边缘434b可各自在竖直-横向平面中限定线性轮廓。类似地,第三脊420c的外脊表面426和下脊表面424之间的相应的第三边缘434c以及第四脊420d的外表面426和上表面422之间的第四边缘434d分别可各自在竖直-横向平面中限定线性轮廓。这些边缘434a、434b、434c、434d中的每一者可平行于其中容纳该边缘的相应通道140a延伸。应当理解,第一边缘434a、第二边缘434b、第三边缘434c和第四边缘434d可被认为分别限定第一脊420a、第二脊420b、第三脊420c和第四脊420d的倾斜角度θ。即使考虑到第一脊420a和第三脊420c的上表面422以及第二脊420b和第四脊420d的下表面424可各自在竖直-横向平面中限定一个或多个弯曲轮廓,也是如此。因此,第一边缘434a和第三边缘434c可彼此平行并且在上板主体102的相关联的腔116、118的相对侧上具有前通道140a,并且可各自相对于第一中心楔形轴线Y3(或相对于其上容纳第一楔形主体400的致动构件310的中心杆轴线Y1)以介于约10度和40度之间的第一脊倾斜角度或上脊倾斜角度θS倾斜。类似地,第二边缘434b和第四边缘434d可彼此平行并且在下板主体202的相关联的腔216、218的相对侧上具有前通道140a,并且可各自相对于第一中心楔形轴线Y3(或相对于其上容纳第一楔形主体400的致动构件310的中心杆轴线Y1)以介于约10度和40度之间的第二脊倾斜角度或下脊倾斜角度θI倾斜。第一脊倾斜角度θS和第二脊倾斜角度θI可根据需要而变化。应当理解,虽然第一楔形主体400的上倾斜表面410和下倾斜表面412可在竖直-横向平面中限定一个或多个弯曲轮廓,但上表面410和下表面412的一般倾斜角度可分别由上脊倾斜角度θS和下脊倾斜角度θI限定或至少近似。
第一脊420a的下脊表面424和第二脊420b的上脊表面422可各自邻近第一楔形主体400的第一侧表面414或与其邻接,并且第三脊420c的下脊表面424和第四脊420d的上脊表面422可各自邻近第一楔形主体400的第二侧表面416或与其邻接。第一脊420a和第三脊420c的外脊表面426可沿着纵向方向L彼此相对,并且第二脊420b和第四脊420d的外脊表面426可沿着纵向方向L彼此相对。第一脊420a的下脊表面424和第二脊420b的上脊表面422可相对并且相对于竖直方向V面向彼此,使得第一中心楔形轴线Y3相对于竖直方向V定位在第一脊420a的下脊表面424和第二脊420b的上脊表面422之间。类似地,第三脊420c的下脊表面424和第四脊420d的上脊表面422可相对并且相对于竖直方向V面向彼此,使得第一中心楔形轴线Y3相对于竖直方向V定位在第三脊420c的下脊表面424和第四脊420d的上脊表面422之间。
第一脊420a的下脊表面424、第二脊420b的上脊表面422和第一侧表面424可共同限定第一楔形主体400的第一凹部部分436,该第一凹部部分可分别容纳限定在上板主体102和下板主体202的相关联的腔116、216的相关联的侧面124、126上的前突出部138a。类似地,第三脊420c的下脊表面424、第四脊420d的上脊表面422和第二侧表面416可共同限定第一楔形主体400的第二凹部部分438,该第二凹部部分可分别容纳限定在上板主体102和下板主体202的相关联的腔116、216的相关联的相对侧面126、124上的前突出部138a。同时,第一脊420a和第三脊420c可被容纳在上板主体102的前通道140a内,并且第二脊420b和第四脊420d可被容纳在下板主体202的前通道140a内。因此,板主体102、202的突出部138可在纵向方向L上与相关联的脊420重叠。不同的是,每个突出部138的悬伸表面146可以在第一楔形主体400和上板主体102和下板主体202之间沿着竖直方向V提供抗机械干扰分离的方式在纵向方向L上在相关联的脊420的边缘434和第一楔形主体400的相关联的侧表面414、416之间延伸。这样,脊420可将第一楔形主体400联锁到上板100和下板200中的每一者,以便将上板100和下板200联接在一起。
第一楔形主体400还可限定第一孔440,该第一孔沿着第一中心楔形轴线Y3从外端402延伸穿过内端404。第一孔440可被构造成容纳相关联的致动构件310的至少一部分。例如,第一孔440可在内部成螺纹以与致动构件310的第一螺纹区域或前螺纹区域328配合。
现在参见图15至图18,其示出了第二楔形构件或后楔形构件308的各种视图。楔形构件的近侧对303和远侧对304的第二楔形构件308可类似地构造。此外,还应当理解,第二楔形构件308可与第一楔形构件306基本上类似或任选地几乎相同地构造。因此,应当理解,以上关于第一楔形构件306描述的特征和参考标号中的每一者可关于第二楔形构件308复制,当结合第二楔形构件308使用时,本文以“撇号”符号指示该楔形构件。因此,第二楔形主体400'可限定一个或多个接合元件诸如上倾斜表面410'和下倾斜表面412',所述一个或多个接合元件被构造成以沿着竖直方向V驱动板100、200之间的分离的方式接合上板100和下板200的对应接合元件。为了简洁起见,以下对第二楔形主体400'的描述将集中于例示的实施方案的第一楔形构件306和第二楔形构件308之间的差异。
第二楔形主体400'的上倾斜表面410'和下倾斜表面412'可各自在从外端402'到内端404'的竖直-横向平面中限定线性轮廓。第二楔形主体400'的上倾斜表面410'和下倾斜表面412'可各自以介于约10度和约60度之间的倾斜角度θS'、θI'从第二中心楔形轴线Y3'(或从其上容纳第二楔形主体400'的致动构件310的中心杆轴线Y1)取向到相应的上倾斜表面410'和下倾斜表面412'。第二楔形主体400'可限定介于约1.5mm和约10mm之间的第二楔形长度L1'、介于约4mm和约7mm之间的第二最大楔形宽度W1'、介于约2mm和约15mm之间的外端高度H1',以及介于约3.5mm和约17.5mm之间的内端高度H2'。上倾斜表面410'可与上板主体102的相关联的腔116、118内的第二斜坡表面或后斜坡表面132可滑动地配合,并且第二下倾斜表面412'可与下板主体202的相关联的腔216、218内的第二斜坡表面或后斜坡表面132可滑动地配合。
第二楔形主体400'的所述一个或多个脊420'被构造成可滑动地容纳在上板主体102和下板主体202的相关联的腔116、118、216、218内的对应后通道140b内并与其大致平行。在第二楔形主体400'上,上倾斜表面410'可平行于上表面422'和下表面424'中的每一者以及第一(上)脊420a'和第三(上)脊420c'的边缘434a'、434c',而下倾斜表面412'可平行于上表面422'和下表面424'中的每一者以及第二(下)脊420b'和第四(下)脊420d的边缘434a'、434c'。
第二楔形主体400'的第一凹部部分436'可容纳限定在上板主体102和下板主体202的相关联的腔116、118、216、218的相关联的侧面124、126上的后突出部138b,并且第二楔形主体400'的第二凹部部分438'可容纳分别限定在上板主体102和下板主体202的相关联的腔116、118、216、218的相关联的相对侧面126、124上的后突出部138b。同时,第二楔形主体400'的脊420'可被容纳在相关联的腔116、118、216、218的后通道140b内。因此,板主体102、202的突出部138可在纵向方向L上与第二楔形主体400'的相关联的脊420'重叠,以便将第二楔形主体400'与上板100和下板200中的每一者联锁。由第二楔形主体400'限定的第二孔440'可在内部成螺纹以与相关联的致动构件310的第二螺纹区域或后螺纹区域330配合。另外,第一楔形主体400和第二楔形主体400'中的一者或两者可包括嵌入其中的放射线照相术标记物(未示出)。
现在参见图19和图20,第一和第二(即,近侧和远侧)致动构件310、312被构造成将每对303、304中的第一楔形构件306和第二楔形构件308联接在一起,同时还在植入物10的膨胀期间为上板100和下板200提供稳定性。第一致动构件310和第二致动构件312可基本上彼此类似地或甚至任选地几乎相同地构造。因此,尽管图19和图20中仅示出了第一致动构件310,但应当理解,也可结合第二致动构件312使用以下描述和参考标号。
第一螺纹区域或前螺纹区域328可具有长度L2,该长度比第二螺纹区域或后螺纹区域330的长度L6大约1.5至4倍。第一无螺纹区域或前无螺纹区域332可具有长度L3,该长度小于前楔形件306的长度L1。类似地,第二无螺纹区域或后无螺纹区域334可具有长度L5,该长度小于第二楔形件或后楔形件308的长度L1'。在一些实施方案中,第一无螺纹区域332和第二无螺纹区域334的长度L3和L5可各自小至为零。环形凹部326可具有在约0.25mm至约2mm的范围内的长度L4。第三无螺纹区域335可具有至少约3mm的长度L7。致动杆314可具有介于约18mm和约48mm之间的总长度L8。前述长度L2-L8中的每一者沿着中心杆轴线Y1测量。环形凹部326内的致动杆314的外表面321可限定大于约1mm的直径D1。
后螺纹区域330可邻近相关联的第一传输构件336或第二传输构件338定位。例如,在例示的实施方案中,后螺纹区域330可与相关联的锥齿轮336的后面384邻接。另外,致动杆310的第三无螺纹区域335可限定安装结构诸如键控连接器386,该安装结构被构造成配合地容纳在限定在锥齿轮336的后面384中的中心键控狭槽388内。这样,为了将至少第二楔形构件或后楔形构件308组装在致动杆314上,技术人员可将第二螺纹区域330插入第二楔形构件308的第二孔440',并且相对于第二楔形构件308旋转致动杆314,直到第二楔形构件308沿着第二螺纹部分330平移,直到第二楔形主体400'的外面402'在前方向上远离邻接表面335a定位,或至少与其间隔开。一旦第二楔形构件308如此定位在致动杆314上,技术人员就可将键控连接器386插入锥齿轮336的中心键控狭槽388,直到锥齿轮336的后面384邻接邻接表面335a。中心键控狭槽388可沿着横向方向T从锥齿轮336的后面384延伸到正面390。锥齿轮336和中心键控狭槽388可各自具有基本上等于第三无螺纹区域335的长度L7的长度L9,使得当齿轮336的后面384邻接邻接表面355a时,致动杆314的后端320至少基本上与锥齿轮336的正面390齐平。因此,一旦锥齿轮336的后面384邻接邻接表面355a,技术人员就可将锥齿轮336焊接到致动杆314。例如,可在致动杆314的后端320和锥齿轮336的正面390之间的接头处形成焊接。然而,应当理解,将锥齿轮336附连到致动杆314的其他方法或技术在本公开的范围内。
每个致动杆314被构造成分别延伸穿过第一楔形主体400和第二楔形主体400'的第一孔440和第二孔440',并且在植入物10处于塌缩构型C时延伸到上板100和下板200的相关联的竖直相对的腔116、216和118、218的第一曲线部分134和第二曲线部分136中。
致动杆314的第一螺纹区域328可具有螺纹图案,该螺纹图案以与形成在第二螺纹区域330上的螺纹图案相反的方向取向。因此,第一孔440和第二孔440'的内螺纹可处于相对的取向,使得当致动杆314旋转时,第一楔形构件306和第二楔形构件308沿着致动杆314朝彼此平移或远离彼此平移,这取决于致动杆314的旋转方向。每个螺纹区域328、330上的螺纹图案可具有不同的螺纹节距,使得第一楔形构件306和第二楔形构件308沿着第一螺纹区域328和第二螺纹区域330以不同的相应速率平移。例如,在例示的实施方案中,第一螺纹区域328的螺纹节距可大于第二螺纹区域330的螺纹节距,使得响应于致动杆314围绕中心杆轴线Y1的旋转,第一楔形构件306沿着第一螺纹区域328平移大于第二楔形构件308沿着第二螺纹区域330平移的横向距离。这样,植入物10的前凸角α可随着植入物10从塌缩构型C膨胀至膨胀构型E而增大。致动杆314可限定第一螺纹区域328和第二螺纹区域330之间约3:1的节距比。在其他实施方案中,节距比可在约1:1至约6:1的范围内。
然而,应当理解,在植入物10膨胀期间,也可通过调节附加因素中的任一个或组合来增加植入物10的前凸角,这些附加因素诸如:第一楔形主体400和第二楔形主体400'的上倾斜表面410和下倾斜表面412的相应倾斜角度θS、θI、θS'、θI';上板主体102和下板主体202的竖直相对的腔116、216和118、218内的前斜坡130和后斜坡132的斜坡角βS1、βI1、βS2、βI2;作为非限制性示例,第一楔形主体400和第二楔形主体400'的外端402和内端404的相对高度H1、H2、H1'、H2'。任何上述因素(单独地或组合地)可根据需要进行调节或定制,以在植入物10处于膨胀构型E时提供预先确定的前凸分心轮廓。也应当理解,医师可在将植入物10插入椎间间隙5之前通过使其围绕纵向植入物轴线X1旋转180度(即,倒置植入物10)来获得后凸分心轮廓。因此,本文所公开的植入物10的简单设计提供了如下有益效果:根据需要允许相邻椎体2、4的前凸分心或后凸分心。
参照图21和图22,植入物10的剖面端视图提供塌缩构型C(图21)和膨胀构型E(图22)两者,每个视图沿着骨板100、200的第一(即近侧)腔116和第三(即近侧)腔216的外侧124截取且面向远侧方向。虽然图21和图22示出了第一腔116和第三腔216、第一致动构件310、第一对楔形构件303和第一托架364中的每一者的各个方面、特征和相对位置,但是应当理解,其以下描述也可与第二腔118和第四腔218、第二致动构件312、第二对楔形构件304和第二托架366相一致。
现在参见图21,在塌缩构型C中,上板100和下板200的内板接触面114、214可彼此邻接。第一腔116和第三腔216可提供足以容纳第一致动构件310、第一对楔形构件303和第一托架364的保持元件376的至少一部分的空间。第一楔形构件306和第二楔形构件308的内端404、404'面向彼此并且彼此间隔开以在两者间限定间隙。第一托架364的保持元件376可沿着横向方向T定位在第一楔形构件306和第二楔形构件308的内端404、404'之间。内端404、404'中的至少一者可邻近保持元件376或者可任选地邻接该保持元件。虽然在图21中不可见,但是致动杆314的第一螺纹区域328可设置在第一楔形构件306的第一孔440内,并且杆314的第二螺纹区域330可设置在第二楔形构件308的第二孔440'内。上板主体102和下板主体202的第三着陆表面160可至少部分地与第三齿轮344的外半径相符。
另外,当植入物10处于塌缩构型C时,楔形构件306、308的上倾斜表面410、410'可邻近或邻接第一腔116内的相应的第一斜坡表面130和第二斜坡表面132,而楔形构件306、308的下倾斜表面412、412'可邻近或邻接第三腔216内的相应的第一斜坡表面130和第二斜坡表面132。楔形件的第一脊420a、420a'可设置在第一腔116内的相应前通道140a和后通道140b中,并且第二脊420b、420b'可设置在第三腔216内的相应前通道140a和后通道140b中。虽然在图21中不可见,但是应当理解,楔形构件306、308的第三脊420c、420c'和第四脊420d、420d'也可设置在与其相关联的通道140a、140b内。继续参见图21,第一楔形构件306和第二楔形构件308的各部分可延伸到与第一腔116连通的第一内腔108中并且延伸到与第三腔216连通的第三内腔208中,这增强了紧凑性并且减小了植入物10的总体横向宽度W0。在植入物10被植入椎间间隙5中之后,内腔108、208具有促进骨生长的附加有益效果。
在植入物10的膨胀期间(即,在图21和图22中所示的相应构型之间),驱动轴340可围绕中心轴轴线X2旋转,该中心轴轴线旋转第三齿轮344和第四齿轮346,第三齿轮和第四齿轮继而使第一齿轮336和第二齿轮338以及致动杆314围绕它们的中心杆轴线Y1旋转。致动杆314的旋转致使每对302、304中的第一楔形构件306在前方向上(即,朝向植入物10的前侧16)沿着第一螺纹区域328平移,并且使得每对302、304中的第二楔形构件308在后方向上(即,朝向植入物10的后侧18)沿着第二螺纹区域330平移。第一楔形构件306和第二楔形构件308的上倾斜表面410、412'和下倾斜表面410'、412'承靠板主体102、202的相关联的斜坡表面130、132,以沿着竖直方向V将上板主体102与下板主体202隔开。脊420a、420c、420a'、420c'沿着相关联的通道140a、140b滑动。托架364的保持元件376可保持设置在致动杆214的环形凹部326内,并且也可保持在外狭槽148和内狭槽150内。如图22所示,在膨胀构型E中,第二楔形构件308的外端404'可邻接第一锥齿轮336的后面384,这有效地引起膨胀机构300的制动作用。另外,在膨胀构型E中,每对303、304中的第一楔形构件306的外端404可从植入物10的前侧16略微突出。然而,在其他实施方案中,当植入物10处于膨胀构型E时,第一楔形构件306的外端404可在后方向上与植入物10的前侧16间隔开。应当理解,致动杆314、第一锥齿轮336和第二锥齿轮338,以及第一楔形构件306和第二楔形构件308可被共同构造成使得第一楔形构件306不需要止动表面或特征。
本文所述的实施方案证明植入物10具有许多有益效果。例如,无论植入物10是否处于塌缩构型C或膨胀构型E,植入物10的纵向长度L0可为一致的。在其中第一楔形构件306不从处于膨胀构型E的植入物10的前侧16突出的实施方案中,无论植入物10是否处于塌缩构型C或膨胀构型E,植入物10的宽度W0也可为一致的。
应当理解,上板主体102和下板主体202中的任一者的各部分和/或膨胀机构300的任何部件可包括被构造成接合用于插入、定位和/或使植入物10膨胀的一个或多个工具的特征。上板主体102和下板主体202可各自包括沿着竖直方向彼此对齐的一个或多个放射线照相术标记物(未示出),使得通过图像分析,可通过观察对齐的放射线照相术标记物的相对竖直位置来确定或指示板分离的程度。
还应当理解,可改变致动构件310、312和驱动轴340相对于彼此并且相对于上板100和下板200的相对取向。例如,每个致动构件310、312的中心杆轴线Y1可相对于驱动轴340的中心轴轴线X2成钝角取向。另外,在其他实施方案中,植入物可仅包括一个致动构件310和一对相关联的楔形构件303。
还应当理解,可对本文所公开的植入物10的特征进行修改,使得例如在植入物10的膨胀期间,楔形构件306、308中的仅一者响应于驱动轴340的旋转而沿着横向方向平移,或者使得上板100和下板200中的仅一者沿着竖直方向移动。
还应当理解,上文针对植入物10的各种部件示出的尺寸仅代表前述部件的尺寸的示例。前述部件的尺寸可根据需要进行调节。此外,植入物10及其各种部件也可按比例大于或小于本文所公开的尺寸。
本文所述的组件中的每一个可由生物相容性金属诸如钛、钢或其任何合金诸如钛钼合金或任何生物相容性聚合材料诸如聚醚醚酮(PEEK)或任何其他合适的生物相容性材料形成。
尽管已详细描述了本公开,然而应当理解,在不背离如随附权利要求书所限定的本发明的精神和范围的条件下,可对本文作出各种改变、替代和更改。此外,本公开的范围并非旨在仅限于本说明书中所述的具体实施方案。本领域的普通技术人员将容易理解可根据本公开采用与本文所述的相应实施方案执行基本上相同的功能或实现基本上相同结果的现有或以后将开发出的工艺、机器、制造、物质的组成、装置、方法或步骤。
Claims (26)
1.一种可膨胀植入物,包括:
第一板和第二板,所述第一板和所述第二板沿着第一方向彼此间隔开,所述第一板限定被构造成接触上椎体的第一骨接触表面,所述第二板限定第二骨接触表面,所述第二骨接触表面沿着所述第一方向与所述第一骨接触表面相对,所述第二骨接触表面被构造成接触下椎体;
第一致动构件,所述第一致动构件相对于所述第一方向至少部分地设置在所述第一板和所述第二板之间,所述第一致动构件限定第一轴线、第一端部和沿着所述第一轴线沿着第二方向与所述第一端部间隔开的第二端部,其中所述第二方向垂直于所述第一方向;
第一传输构件,所述第一传输构件由所述第一致动构件承载;
第一楔形构件和第二楔形构件,所述第一楔形构件和所述第二楔形构件由所述第一致动构件承载并且与所述第一板和所述第二板接合;
驱动构件,所述驱动构件限定第二轴线、近侧端部和沿着所述第二轴线沿着第三方向与所述近侧端部间隔开的远侧端部,所述第三方向垂直于所述第一方向并且相对于所述第二方向偏离;
第二传输构件,所述第二传输构件由所述驱动构件承载,其中所述第一传输构件和所述第二传输构件被构造成彼此接合,以便将驱动力的至少一部分传递到所述第一致动构件,以便使所述第一致动构件围绕所述第一轴线旋转;以及
第二致动构件,所述第二致动构件沿着所述第三方向与所述第一致动构件间隔开;
其中所述驱动构件被构造成将所述驱动力的所述至少一部分传送至所述第一致动构件,以便致使所述第一致动构件围绕所述第一轴线旋转,并且第一楔形构件和第二楔形构件中的至少一者被构造成响应于所述第一致动构件围绕所述第一轴线的旋转而沿着所述第二方向平移,以便使所述第一板和所述第二板中的至少一者相对于所述第一板和所述第二板中的另一者沿着所述第一方向移动。
2.根据权利要求1所述的植入物,其中所述第一楔形构件限定第一楔形主体,所述第一楔形主体限定第一中心楔形轴线、第一端部和沿着所述第二方向与所述第一端部间隔开的第二端部,其中所述第一中心楔形轴线平行于所述第二方向。
3.根据权利要求2所述的植入物,其中所述第二楔形构件限定第二楔形主体,所述第二楔形主体限定第二中心楔形轴线,并且所述第二楔形主体的第一端部和第二端部沿着所述第二方向彼此间隔开,其中所述第二中心楔形轴线平行于所述第二方向。
4.根据权利要求3所述的植入物,其中所述第一致动构件限定杆,所述杆包括沿着所述第二方向彼此间隔开的第一螺纹区域和第二螺纹区域,所述第一楔形主体限定被构造成接合所述第一螺纹区域的第一螺纹,并且所述第二楔形主体限定被构造成接合所述第二螺纹区域的第二螺纹。
5.根据权利要求4所述的植入物,其中所述第一楔形主体限定沿着所述第一中心楔形轴线延伸穿过所述第一楔形主体的第一中心孔,所述第一中心孔限定所述第一螺纹,并且所述第二楔形主体限定沿着所述第二中心楔形轴线延伸穿过所述第二楔形主体的第二中心孔,并且所述第二中心孔限定所述第二螺纹。
6.根据权利要求5所述的植入物,其中所述第一楔形主体和所述第二楔形主体中的每一者限定在所述相应的第一端部和第二端部之间延伸的上倾斜表面和下倾斜表面。
7.根据权利要求6所述的植入物,其中所述第一楔形主体和所述第二楔形主体的所述第二端部沿着所述第二方向面向彼此,并且所述第一楔形主体和所述第二楔形主体的所述第一端部沿着所述第二方向背向彼此。
8.根据权利要求7所述的植入物,其中所述第一楔形主体的所述上倾斜表面和所述下倾斜表面相对于彼此取向,使得1)所述第一楔形主体的所述第一端部沿着所述第一方向限定第一最大尺寸,2)所述第一楔形主体的所述第二端部沿着所述第一方向限定第二最大尺寸,并且3)所述第二最大尺寸大于所述第一最大尺寸。
9.根据权利要求8所述的植入物,其中所述第一楔形主体的所述上倾斜表面和所述下倾斜表面各自相对于所述第一轴线以介于15度和30度之间的角度取向。
10.根据权利要求9所述的植入物,其中锐角介于21度和25度之间。
11.根据权利要求7所述的植入物,其中所述第二楔形主体的所述上倾斜表面和所述下倾斜表面相对于彼此取向,使得1)所述第二楔形主体的所述第一端部沿着所述第一方向限定第三最大尺寸,2)所述第二楔形主体的所述第二端部沿着所述第一方向限定第四最大尺寸,并且3)所述第四最大尺寸大于所述第三最大尺寸。
12.根据权利要求8所述的植入物,其中所述第二楔形主体的所述上倾斜表面和所述下倾斜表面各自相对于所述第一轴线以介于30度和60度之间的第二角度取向。
13.根据权利要求9所述的植入物,其中第二锐角介于40度和50度之间。
14.根据权利要求1所述的植入物,其中所述第一传输构件为第一齿轮,并且所述第二传输构件为第二齿轮。
15.根据权利要求14所述的植入物,其中第一齿轮被构造成围绕所述第一轴线旋转,并且所述第二齿轮被构造成围绕所述第二轴线旋转。
16.根据权利要求15所述的植入物,其中所述第一齿轮和所述第二齿轮均为锥齿轮。
17.根据权利要求15所述的植入物,其中所述第一轴线和所述第二轴线彼此垂直。
18.根据权利要求17所述的植入物,其中所述第一轴线和所述第二轴线各自垂直于所述第一方向。
19.根据权利要求1所述的植入物,其中当所述第一板和所述第二板沿着所述第一方向彼此最小地间隔开时,所述第一骨接触表面和所述第二骨接触表面相对于彼此在与所述第一方向和所述第二方向共延的平面中以介于5度和10度之间的角度取向。
20.根据权利要求19所述的植入物,其中当所述第一板和所述第二板中的至少一者沿着所述第一方向移动到相对于所述第一板和所述第二板中的另一者的最大距离时,所述第一骨接触表面和所述第二骨接触表面相对于彼此在所述平面中以介于12度和18度之间的角度取向。
21.根据权利要求1所述的植入物,其中所述第二致动构件限定沿着所述第二方向延伸的第三轴线,所述第二致动构件还限定第一端部和沿着所述第二方向与所述第一端部间隔开的第二端部。
22.根据权利要求21所述的植入物,还包括由所述第二致动构件承载的第三楔形构件和第四楔形构件,其中所述第三楔形构件和所述第四楔形构件与所述第一板和所述第二板接合,所述第三楔形构件和所述第四楔形构件被构造成响应于所述第二致动构件围绕所述第三轴线的旋转而沿着所述第三轴线进行朝向彼此平移和远离彼此平移中的至少一者,以便在所述第一方向上至少部分地远离彼此移动所述第一板和所述第二板。
23.根据权利要求22所述的植入物,还包括:
第三传输构件,所述第三传输构件由所述第二致动构件承载;
第四传输构件,所述第四传输构件由所述驱动构件承载,其中所述第三传输构件和所述第四传输构件被构造成彼此接合,以便将所述驱动力的至少第二部分传递到所述第二致动构件,以便使所述第二致动构件围绕所述第三轴线旋转。
24.根据权利要求23所述的植入物,其中所述第一传输构件为第一齿轮,所述第二传输构件为第二齿轮,所述第三传输构件为第三齿轮,并且所述第四传输构件为第四齿轮。
25.根据权利要求24所述的植入物,其中所述第一齿轮、所述第二齿轮、所述第三齿轮和所述第四齿轮中的每一者为锥齿轮。
26.根据权利要求25所述的植入物,其中第一锥齿轮被构造成围绕所述第一轴线旋转,第三锥齿轮被构造成围绕所述第三轴线旋转,并且第二锥齿轮和第四锥齿轮各自被构造成围绕所述第二轴线旋转。
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