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CN1720010A - 椎间盘假体 - Google Patents

椎间盘假体 Download PDF

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Publication number
CN1720010A
CN1720010A CN 200380104667 CN200380104667A CN1720010A CN 1720010 A CN1720010 A CN 1720010A CN 200380104667 CN200380104667 CN 200380104667 CN 200380104667 A CN200380104667 A CN 200380104667A CN 1720010 A CN1720010 A CN 1720010A
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CN
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Patent type
Prior art keywords
intervertebral
disk
prosthesis
intervertebral disk
disk prosthesis
Prior art date
Application number
CN 200380104667
Other languages
English (en)
Inventor
J·博兰
J-M·菲恩特斯
J-M·维塔尔
T·迪富尔
J·于佩尔
Original Assignee
Ldr医学公司
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Publication date

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    • AHUMAN NECESSITIES
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    • 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
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    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425Intervertebral or spinal discs, e.g. resilient made of articulated components
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    • 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
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    • A61B17/0642Surgical staples, i.e. penetrating the tissue for bones, e.g. for osteosynthesis or connecting tendon to bone
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    • A61B17/0644Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
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    • A61B2017/0647Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
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    • A61F2002/30383Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/3039Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
    • A61F2002/30392Rotation
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    • A61F2220/0016Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
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    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • A61F2220/0033Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
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    • A61F2220/0041Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws

Abstract

本发明涉及了一个包括至少三个部分的椎间盘假体,它包括:一个称为上板(1)的第一板、一个称为下板(2)的第二板、以及一个芯子(3),芯子(3)的上表面与上板(1)的至少一部分下表面(10)接触,芯子(3)的下表面与下板(2)的至少一部分上表面接触,并且上板(1)至少相对于芯子(3)可以运动,特征在于:下板(2)和芯子(3)之间有配合装置,从而限制或消除了芯子(3)相对于下板(2)的沿着基本上平行于下板(2)的轴线的移动,并且限制或消除了芯子(3)相对于下板(2)环绕基本上垂直于下板(2)的轴线的转动,通过上板(1)和下板(2)的两个平面形成了一个基本上不变的角度。

Description

椎间盘假体

本发明涉及了一个椎间盘假体,用于在脊柱中,特别是在颈椎上,替代连接椎骨的纤维软骨盘。

在先前技术中已知有各种假体形式。其中有些假体,由于它们用可压缩材料制成,或由于它们容许假体的不同组成部分相互过度的运动,可能比较容易地引起至少假体的一部分被挤出在椎骨之外,这对病人是不希望的。

本发明的目的是采用一个简单的椎间盘假体,来纠正先前技术的某些缺点,使得可以限制假体不同组成部分相互的运动。

一个包括至少三个部分的椎间盘假体达到了这个目的,它包括:一个称为上板的第一板、一个称为下板的第二板、以及一个芯子,芯子的上表面与上板的至少一部分下表面接触,芯子的下表面与下板的至少一部分上表面接触,并且上板至少相对于芯子可以运动,特征在于:下板和芯子之间有配合装置,从而沿着基本上平行于下板的轴线,限制或消除了芯子相对于下板的移动,并且环绕基本上垂直于下板的轴线,限制或消除了芯子相对于下板的转动,通过上板和下板的两个平面形成了一个基本上不变的角度。

按照另一个特征,下板包括与芯子的凹形装置配合的凸形装置。

按照另一个特征,下板包括与芯子的凸形装置配合的凹形装置。

按照另一个特征,得到的角度使得芯子沿着从前到后的方向形成一个锐角。

按照另一个特征,相同的板可以与不同厚度的芯子装配。

按照另一个特征,在上板和下板之间的角度在0°和15°之间。

按照另一个特征,芯子可以相对于上板和/或下板运动,使得可以补偿假体的三个部分的相互定位缺陷。

按照另一个特征,至少上板下表面的一部分为凹的,并且与芯子的上表面相补。

按照另一个特征,每个凸形装置的尺寸稍小于每个凹形装置的尺寸,从而能够在芯子和下板之间具有微小的间隙。

按照另一个特征,每个凸形装置的尺寸基本上相同于每个凹形装置的尺寸,从而防止在芯子和下板之间的任何间隙。

按照另一个特征,下板的凸形装置是两个扣销,向着假体的内部弯曲,并且相互对着位于假体的两边,以及芯子的凹形装置是两个凹区。

按照另一个特征,至少一个扣销被一个设有钻孔的凸耳替代,采用进入钻孔的一个销钉把一个舌片固定在凸耳上。

按照另一个特征,下板的凸形装置是两个位于下板中心附近的销钉,芯子的凹形装置是两个凹坑。

按照另一个特征,下板的凸形装置是相互对着位于假体两边附近的两个壁,芯子的凹形装置是凹区。

按照另一个特征,下板的凸形装置是位于假体中心的一个肋,芯子的凹形装置是一个槽。

按照另一个特征,芯子由聚乙烯制成。

按照另一个特征,下板在其前边附近包括一个或几个开孔,用于在一个椎骨中容纳假体固定装置。

按照另一个特征,下板的开孔为矩形,固定装置包括一个与下板形成锐角的本体和一个头部。

按照另一个特征,下板的开孔为圆形,固定装置为钉子形。

按照另一个特征,上板至少在其上表面的一部分上为凸形,以配合椎骨的形状。

在参照附图、阅读以下的描述之后,对本发明的其他特征和优点将会看得更清楚,其中:图1a和1b分别代表了一个实施例的上板的底视图和底透视图,图2a和2b分别代表了一个实施例的下板的顶视图和顶透视图,图3a和3b分别代表了一个实施例的芯子的顶视图和顶透视图,

图4a和4b分别代表了图1a,1b,2a,2b,3a和3b实施例的椎间盘假体的顶透视图和侧视图,图5a和5b分别代表了第二个实施例的椎间盘假体的侧视图和沿着图5a平面D-D的剖视图,图6a代表了第三个实施例的椎间盘假体的侧视图,图6b和6d代表了沿着图6a平面A-A的剖视图,芯子相对于下板分别具有微小间隙和不具有间隙,图6c和6e分别代表了沿着图6b和6d平面B-B的椎间盘的剖视图,图7a和8a分别代表了另外两个实施例的下板的顶视图和底透视图,图7b和8b分别代表了图7a和8a下板的侧透视图和顶透视图,其中按照两个不同实施例插入了假体固定装置,图9a代表了第四个实施例的下板的顶视图,图9b代表了沿着图9a平面C-C的下板的剖视图,图10a和10b分别代表了另一个实施例的上板的后视图和侧视图。

本发明的椎间盘假体由一个上板1构成,它依靠一个芯子3相对于一个下板形成关节式连接,如在图4a,4b,5a和6a中可以明显看出。本发明假体的一个优点是它包括了简单的部分,可以设计成使得假体配装在颈椎上。

在图1a和1b中可以明显看出,上板1至少在其下表面的一部分10上稍凹,从而与芯子3的稍凸的上表面配合。芯子3的上表面与上板1的凹形部分10相补,使得能够在上板1和芯子3之间运动。

在一个供替代的实施例中,上板1上表面的一部分为凸形,如图10a和10b所示,以便更好地配合在要配装假体的椎骨上,椎骨的底部是凹的,此时,上板1的凸形部分位于上板的前部,如在图10b中可明显看出。

下板2基本上为平的。实际上,其下表面不需要凸或凹,因为椎骨顶部基本上是平的。在图2a,2b,7a和8a的实施例中,在下板2的两个基本上平行的边21、22上,下板2包括两个位置相互对着的扣销20。每个扣销20向着假体内部弯曲,因此可以进入位于芯子3上的凹区30。在图3a和3b中可明显看出,芯子3包括一个基本上平的下表面。用于配合在下板2上。对于颈椎假体,芯子3较薄(例如3mm厚),或者对于腰椎假体较厚(例如15mm)。

在图3a,3b,4a和4b的实施例中,芯子3的每个凹区30尺寸稍大于下板2的每个扣销20尺寸,从而沿着基本上平行于下板2的轴线的移动,以及环绕基本上垂直于下板2的轴线的转动,均限制了芯子3相对于下板2的间隙。上板1和芯子3之间的运动,以及芯子3相对于下板2的间隙,使得病人能够运动,并且如果需要,可以补偿假体定位的缺陷。间隙也提供了一个优点,防止作用于假体上应力造成过早磨损。

在图5a和5b的实施例中,芯子3的每个凹区30的尺寸基本上与下板2的每个扣销20尺寸相同,从而在移动和转动上,均防止芯子3相对于下板2的任何间隙。此时,容许假体的唯一运动是上板1相对于芯子3的运动。

在9a和9b的实施例中,扣销20之一用一个设有钻孔200的凸耳替代。用一个进入钻孔200的销钉24把一个舌片23固定在凸耳上。在一个供替代的实施例中,两个扣销均用固定了舌片23的凸耳替代。

在图6a,6b,6c,6d和6e的实施例中,下板2不包括任何扣销20,而包括位于下板2中心附近的两个销钉25。此时,作为相补,芯子3不包括任何凹区30,而在其下表面包括两个凹坑35。下板2的销钉25尺寸和芯子3的凹坑35尺寸,在图6b和6c实施例中容许有微小的移动和转动间隙,在图6d和6e实施例中不容许有间隙。

在图中未示的另一个实施例中,下板2在其上表面上包括一个肋,没有扣销20或销钉25。作为相补,芯子3在其下表面包括一个槽。下板的肋尺寸和芯子的槽尺寸,在一个实施例中容许有微小的移动和转动间隙,在另一个实施例中不容许有间隙。

在图中未示的另一个实施例中,替代扣销20,下板2包括两个壁,相互对着设置在下板的两个基本上平行的边21,22附近,它们设置在假体内,但不是扣销20。芯子3包括相对于壁的相补凹区。在该实施例中,芯子的每个凹区尺寸稍大于,或者基本上等于下板的每个壁尺寸,从而使得能够有或没有微小的移动和转动间隙。

在图中未示的另一个实施例中,凹形装置位于下板和凸形装置位于芯子。

本发明的椎间盘假体可以纠正脊椎前凸的缺陷和对脊椎,例如对颈椎增加脊椎前凸。因此,沿着图4的从前到后的方向F,在假体的上板1和下板2之间,需要存在一个锐角。例如,这个角度在0°到15°之间。为了根据病人来调整所需的角度,简单地需要选择一个芯子,在代表其上表面的中面和通过其下表面的平面之间具有一个适当的角度。

如果凹形件位于下板和凸形件位于芯子,则依靠进入下板空腔或开孔的一个突起,沿从前向后的方向形成一个锐角的脊椎前凸芯子可以与板成为整体。

当上述芯子为平时依靠上板的形状,或者当上述芯子为凸时依靠上板相对于芯子的位置,可以得到先前技术中已知的假体倾角。对于上述先前技术的第一种情形,本发明假体的机加工更加经济,因为芯子用比板更便宜的材料(例如,聚乙烯)组成。对于上述先前技术的第二种情形,本发明的芯子不容易被挤出假体之外,因为板之间的角度在假体定位时基本上不变。

如果外科医生需要一个病人的确定的脊椎前凸,则他们将选择一个相对于下板2不容许有间隙的芯子3。另一方面,如果他们简单地需要脊椎前凸保持在一定范围值内,则他们将选择一个相对于下板2容许微小移动和转动间隙的芯子。

在图7a,7b,8a和8b中代表的一个供替代的实施例中,本发明的椎间盘假体可以固定在脊椎中,防止在脊椎对定位假体施加的横向合力(它随着脊椎前凸而增加)影响下假体移位。此时,下板2包括位于假体后侧边附近的一个或几个开孔28,29,使得可以容纳固定装置4,5。

这样,在图7a和7b情形中,下板2的开孔28为矩形,固定装置4由一个本体40和一个头部41构成。头部41的尺寸稍大于下板2的开孔28的尺寸,使得一旦固定装置4在一个椎骨中定位时,下板2夹在固定装置4的头部41和上述椎骨之间。在固定装置4的本体40和下板2之间具有一个小于或等于90°的角度。

在图8a和8b的情形中,在下板2中具有两个圆形开孔29,固定装置5为钉子形,具有一个比开孔29尺寸大的头部,使得可以把下板2夹在固定装置5的头部和固定假体的椎骨之间。

对于熟悉该技术的人员应该清楚,本发明能够形成无数其他具体形式的实施例而不偏离如权利要求中规定的范围。因此,必须认为本实施例仅是举例说明,而可以在所附权利要求范围规定的领域中修改,并且本发明不一定限于以上给出的细节。

Claims (20)

1.一个椎间盘假体,包括至少三个部分,该三部分包括:一个称为上板(1)的第一板、一个称为下板(2)的第二板、以及一个芯子(3),芯子(3)的上表面与上板(1)的至少一部分下表面(10)接触,芯子(3)的下表面与下板(2)的至少一部分上表面接触,并且上板(1)至少可相对于芯子(3)运动,特征在于:下板(2)和芯子(3)之间有配合装置,从而限制或消除了芯子(3)相对于下板(2)的沿着基本上平行于下板(2)的轴线的移动,并且限制或消除了芯子(3)相对于下板(2)环绕基本上垂直于下板(2)的轴线的转动,通过上板(1)和下板(2)的平面形成了一个基本上不变的角度。
2.按照权利要求1的椎间盘假体,特征在于:下板(2)包括与芯子(3)的凹形装置配合的凸形装置。
3.按照权利要求1的椎间盘假体,特征在于:下板(2)包括与芯子的凸形装置配合的凹形装置。
4.按照权利要求1到3的任何一条的椎间盘假体,特征在于:得到的角度使得芯子(3)沿着从前到后的方向(F)形成一个锐角。
5.按照权利要求4的椎间盘假体,特征在于:相同的板(1,2)可以与不同厚度的芯子(3)装配。
6.按照权利要求4或5的任何一条的椎间盘假体,特征在于:在上板(1)和下板(2)之间的角度在0°和15°之间。
7.按照权利要求1到6的任何一条的椎间盘假体,特征在于:芯子(3)可以相对于上板(1)和/或下板(2)运动,使得可以补偿假体的三个部分(1,2,3)的相互定位缺陷。
8.按照权利要求1到7的任何一条的椎间盘假体,特征在于:至少上板(1)下表面的一部分(10)为凹的,并且与芯子(3)的上表面(31)相补。
9.按照权利要求1到8的任何一条的椎间盘假体,特征在于:每个凸形装置的尺寸稍小于每个凹形装置的尺寸,从而能够在芯子(3)和下板(2)之间具有微小的间隙。
10.按照权利要求1到8的任何一条的椎间盘假体,特征在于:每个凸形装置的尺寸基本上相同于每个凹形装置的尺寸,从而防止在芯子(3)和下板(2)之间的任何间隙。
11.按照权利要求2和4到10的任何一条的椎间盘假体,特征在于:下板(2)的凸形装置是两个扣销(20),向着假体的内部弯曲,并且相互对着位于假体的两边(21,22),以及芯子(3)的凹形装置是两个凹区(30)。
12.按照权利要求11的椎间盘假体,特征在于:至少一个扣销(20)被一个设有钻孔(200)的凸耳替代,采用进入钻孔(200)的一个销钉(24)把一个舌片(23)固定在凸耳上。
13.按照权利要求2和4到10的任何一条的椎间盘假体,特征在于:下板(2)的凸形装置是两个位于下板(2)中心附近的销钉(25),芯子(3)的凹形装置是两个凹坑(35)。
14.按照权利要求2和4到10的任何一条的椎间盘假体,特征在于:下板(2)的凸形装置是相互对着位于假体两边(21,22)附近的两个壁,芯子(3)的凹形装置是凹区。
15.按照权利要求2和4到10的任何一条的椎间盘假体,特征在于:下板(2)的凸形装置是位于假体中心的一个肋,芯子(3)的凹形装置是一个槽。
16.按照权利要求1到15的任何一条的椎间盘假体,特征在于:芯子(3)由聚乙烯制成。
17.按照权利要求1到16的任何一条的椎间盘假体,特征在于:下板(2)在其前边附近包括一个或几个开孔(28,29),用于在一个椎骨中容纳假体固定装置(4,5)。
18.按照权利要求17的椎间盘假体,特征在于:下板(2)的开孔(28)为矩形,固定装置(4)包括一个与下板(2)形成锐角的本体(40)和一个头部(41)。
19.按照权利要求17的椎间盘假体,特征在于:下板(2)的开孔(29)为圆形,固定装置(5)为钉子形。
20.按照权利要求1到19的任何一条的椎间盘假体,特征在于:上板(1)至少在其上表面的一部分上为凸形,以配合椎骨的形状。
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