CN1925816A - 椎间盘假体或人造的椎骨体 - Google Patents

椎间盘假体或人造的椎骨体 Download PDF

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CN1925816A
CN1925816A CNA2004800426564A CN200480042656A CN1925816A CN 1925816 A CN1925816 A CN 1925816A CN A2004800426564 A CNA2004800426564 A CN A2004800426564A CN 200480042656 A CN200480042656 A CN 200480042656A CN 1925816 A CN1925816 A CN 1925816A
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intervertebral disk
disk prosthesis
spring
central part
approximation
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CN100508915C (zh
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A·施图德
M·加格
J·特拉赫塞尔
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AO Technology AG
Synthes GmbH
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    • AHUMAN NECESSITIES
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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
    • A61F2/02Prostheses implantable into the body
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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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    • 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
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    • A61F2/02Prostheses implantable into the body
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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/30362Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/30369Limited lateral translation of the protrusion within a larger recess
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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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30565Special structural features of bone or joint prostheses not otherwise provided for having spring elements
    • A61F2002/30566Helical springs
    • 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
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30565Special structural features of bone or joint prostheses not otherwise provided for having spring elements
    • A61F2002/30571Leaf springs
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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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    • A61F2/30Joints
    • 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
    • A61F2002/443Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
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    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • 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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Abstract

本发明涉及一种椎间盘假体或椎间植入物,包括:一空心体形的中心件(2),其具有中心的纵轴线(6)、一上端(4)和一下端(5);一在中心件(2)的上端(4)上横向于纵轴线(6)设置的上对合板(7),其适用于支承在一椎骨体的底板上;以及一在中心件(2)的下端(5)上横向于纵轴线(6)设置的下对合板(8),其适用于支承在一椎骨体的盖板上。中心件(2)包括一由至少两个同轴设置的碟簧(20)构成的弹性的装置(19),其中弹性的装置(19)具有一递增的弹簧特性曲线。

Description

椎间盘假体或人造的椎骨体
技术领域
本发明涉及一种按照权利要求1的前序部分所述的椎间盘假体或人造的椎骨体。
背景技术
由FEHLING(费林)的DE 101 32 588已知一同类的椎间盘假体,其包括两个对合板(Appositionsplatte)与一位于之间的压簧元件。围绕压簧元件设置一空心圆柱形的外套。压簧元件由一记忆金属合金构成,其在体温下具有超弹性特性,或在另一实施形式中由一碟簧柱构成,其由多个等刚度的碟簧组成。对该已知的椎间盘假体不利的是压簧元件的线性的弹簧特性曲线,从而在一压簧元件中,其还应该吸收冲击力,特别在小的压力的情况下支配一过小的压簧元件的柔度并因此将脊柱的运动自由度限制在该范围内。
发明内容
在这里本发明将消除这样的弊端。本发明的目的在于,提供一种椎间盘假体或人造的椎骨体,其具有一由商业上通用的元件可组合的弹性的中心件,该中心件具有一递增的弹簧特性曲线。
本发明利用具有权利要求1的特征的椎间盘假体或人造的椎骨体达到提出的目的。
通过本发明达到的优点可看出基本上在于,由于本发明的椎间盘假体或人造的椎骨体达到:
在小的压力的情况下确保一足够大的弹性柔度和缓冲,由此确保脊柱在该范围内的足够的运动自由度;
在高的压力载荷或冲击载荷的情况下为了吸收压力不需要大的弹簧位移;以及
可以调和地减小在一健全的椎骨段与设有一假体的椎骨段之间的刚度跃变,从而达到一如同在健全的椎间盘情况下一样的特性。
在一优选的实施形式中,弹性的装置包括至少两个同轴设置的碟簧。
在一特别的实施形式中,设置一用于弹性的装置的定心装置。通过该定心装置碟簧不会滑落并保持在其位置。并且彼此靠紧的各碟簧通过定心装置可以吸收很大的力并且用作安全性。
在另一实施形式中,定心装置构成柔性的,从而其允许在一锥形范围内轴向导向。由此可达到的优点在于,椎间盘假体不仅同轴弹性地构成,而且各对合板还可以倾斜或彼此转动地运动。
在另一实施形式中,各碟簧具有中心孔并且定心装置构成为通过这些孔的内部的波纹管。
在另一实施形式中,至少两个碟簧具有不同的刚度。由此可以单独通过由各碟簧组成的弹簧产生递增的弹簧特性曲线。另一优点在于大的支承面积,这导致小的单位面积压力和微小的磨损。
在另一实施形式中,各碟簧组成包括多个方向相同地成层的碟簧的碟簧组。其优点是,可只通过由各碟簧组成的弹簧产生递增的弹簧特性曲线。在与一波纹管组合的情况下产生附加的优点,因为可附加地影响弹簧特性曲线。
在另一实施形式中,中心件包括一同轴设置的弹簧,其既起拉簧又起压簧的作用。由此可以采用螺旋弹簧也可以采用扭簧。
在另一实施形式中,直到一轴向弹簧位移X≠0只各弹簧紧贴两对合板。可达到的优点在于递增的弹簧特性曲线。第二弹簧也可以用作为碟簧的定心装置。其他的优点有理由地在于。可能出现的磨损粒子不可能进入病人的体内。该实施形式还以低的刚度允许伸展/屈曲运动并且防止结缔组织向内生长。
在另一实施形式中,中心件在外面具有一由一波纹管组成的外套。该外套防止体液透入。
在另一实施形式中,中心件可借助于一卡锁(Schnappverschluβ)可拆式连接于两对合板。
在另一实施形式中,各对合板经由优选由陶瓷材料构成的滑动轴承与中心件相连接。滑动轴承有利地构成使各对合板相对于中心件可以实施有限的横向于纵轴线的平移。
该平移优选为+/-0.5mm。因此经由滑动轴承和经由碟簧的承接以及经由绕假体的纵轴线的可能的约+/-30°的转动覆盖全部六个自由度。
在另一实施形式中,碟簧具有一挡块,其限制碟簧的可压缩性。该挡块防止碟簧超负荷。因此在这种情况下即使可能承受较大的力,碟簧也不过载。
附图说明
以下借助多个实施例的部分示意图还要更详细地说明本发明和本发明的进一步构成。其中:
图1本发明椎间盘假体的一个实施形式的中间外侧的剖面图;
图2本发明椎间盘假体的另一实施形式的中间外侧的剖面图。
具体实施方式
图1中所示的椎间盘假体1的实施形式基本上包括一空心圆柱形的弹性的中心件2,其具有一构成为波纹管12的外套3、一上端4、一下端5和一中心的纵轴线6,还包括一在中心件2的上端4上横向于纵轴线6设置的上对合板7,该对合板适用于支承在一椎骨体的底板上,以及一在中心件2的下端5上横向于纵轴线6设置的下对合板8,该对合板适用于支承在一椎骨体的盖板上。两对合板7、8具有向外凸面拱形的表面9和具有向内定向的轴向榫头10和11。外套3在该实施形式中包括一波纹管12,其固定在两对合板7、8上。根据材料波纹管12可以焊接、敛缝或压入在对合板7、8上。
上对合板7具有一指向中心件2的下表面13并且下对合板8类似地具有一指向中心件2的上表面14。下表面13和上表面14在这里设有各一个圆环形设置的凹槽15,用以容纳在波纹管12的各端16、17上固定的盖板26。椎头10、11同心于纵轴线6伸进同心于纵轴线6在各盖板26的外表面上的凹槽29内。借此对合板7、8可相对于中心件2侧向移动,各凹槽29横向于纵轴线6的直径大于可在其中移动的对合板7、8上的榫头10、11的直径。在对合板7、8的下表面和上表面13、14中的圆环形凹槽15内同心于纵轴线6嵌入各外面的环形元件28,所述环形元件支承在嵌入盖板26的外表面内的内部的环形元件27上。成对相互支承的内部的和外面的环形元件27、28构成各一个滑动轴承25,而使对合板7、8在通过榫头10、11和各凹槽29允许的间隙内可侧向相对于中心件2移动。
围绕螺旋弹簧21设置弹性的装置19,其由多个碟簧20组成。在图中所示的实施形式中在椎间盘假体1的无载的状态下只螺旋弹簧21接触两盖板26,从而在椎间盘假体负载时首先只压缩螺旋弹簧21。在缩回弹簧位移S=X以后弹性的装置19也与两对合板7、8发生接触,从而在两对合板7、8相互相对继续移动S>X时一较高的弹簧刚度起作用。在图中所示的实施形式中弹性的装置19由包括相同的碟簧20的碟簧组22a、22b、22c、22d组成,但其中第一碟簧组22a由一包括三个方向相同的成层的碟簧20的碟簧分组组成,第二和第三碟簧组22b、22c包括各两个相互相对定向的分组,其由各两个方向相同的成层的碟簧20组成,而第四碟簧组22d由两个相互相对定向的碟簧20构成。通过碟簧组22a、22b、22c、22d的这样的结构可达到弹性的装置19的一递增的弹簧特性曲线。
图2中所示的椎间盘假体1的实施形式与图1中所示的实施形式的区别只在于,首先代替弹簧18在对合板7、8之间设置一内部的波纹管23,其次弹性的装置19由包括各第一碟簧20a的第一碟簧组22a和四个包括各第二碟簧20b的其他的碟簧组22b、22c、22d、22e构成,并且再次中心件2无盖板26(图1)地连接于对合板7、8。其中各第一碟簧20a的刚度高于各第二碟簧20b,从而弹性的装置19具有一递增的弹簧特性曲线。内部的波纹管23平行于纵轴线6通过各碟簧20的孔24并且用作为各碟簧20的定心装置。内部的波纹管23轴向和关于弯曲是柔性的,从而对合板7、8也可以倾斜地相互相对地运动并且纵轴线6可以在一锥形范围内弯曲。
权利要求书
(按照条约第19条的修改)
1.椎间盘假体(1)或椎间植入物,包括:
A)一中心件(2),其具有中心的纵轴线(6)、一上端(4)和一下端(5);
B)一在中心件(2)的上端(4)上横向于纵轴线(6)设置的上对合板(7),该对合板适用于支承在一椎骨体的底板上;
C)一在中心件(2)的下端(5)上横向于纵轴线(6)设置的下对合板(8),该下对合板适用于支承在一椎骨体的盖板上;以及其中
D)中心件(2)包括弹性的装置(19);
其特征在于,
E)弹性的装置(19)具有一递增的弹簧特性曲线;以及
F)设置一用于弹性的装置(19)的定心装置。
2.按照权利要求1所述的椎间盘假体(1),其特征在于,弹性的装置(19)包括至少两个同轴设置的碟簧(20)。
3.按照权利要求2所述的椎间盘假体(1),其特征在于,所述碟簧(20)中的至少两个具有不同的刚度。
4.按照权利要求2或3所述的椎间盘假体(1),其特征在于,各碟簧(20)组成包括多个方向相同的成层的碟簧(20)的碟簧组(22)。
5.按照权利要求1至4之一项所述的椎间盘假体(1),其特征在于,中心件(2)构成空心体形的。
6.按照权利要求1至5之一项所述的椎间盘假体(1),其特征在于,定心装置构成柔性的并且允许在一锥形范围内轴向导向。
7.按照权利要求1至6之一项所述的椎间盘假体(1),其特征在于,各碟簧(20)具有中心孔(24)并且定心装置构成为通过这些孔(24)的内部的波纹管。
8.按照权利要求1至7之一项所述的椎间盘假体(1),其特征在于,中心件(2)包括一同轴设置的弹簧(18),该弹簧既起拉簧又起压簧的作用。
9.按照权利要求8所述的椎间盘假体(1),其特征在于,直到一轴向弹簧位移X≠0只各弹簧(18)紧贴两对合板(7、8)。
10.按照权利要求1至9之一项所述的椎间盘假体(1),其特征在于,中心件(2)在外面具有一由一波纹管(12)组成的外套(3)。
11.按照权利要求1至10之一项所述的椎间盘假体(1),其特征在于,中心件(2)可借助于卡锁可拆式连接于两对合板(7、8)。
12.按照权利要求1至11之一项所述的椎间盘假体(1),其特征在于,对合板(7、8)经由优选由陶瓷材料构成的滑动轴承(25)与中心件(2)相连接。
13.按照权利要求12所述的椎间盘假体(1),其特征在于,滑动轴承(25)构成为使对合板(7、8)相对于中心件(2)可以实施有限的横向于纵轴线(6)的平移。
14.按照权利要求2至13之一项所述的椎间盘假体(1),其特征在于,各碟簧(20)具有一挡块,该挡块限定碟簧的可压缩性。

Claims (15)

1.椎间盘假体(1)或椎间植入物,包括:
A)一中心件(2),其具有中心的纵轴线(6)、一上端(4)和一下端(5);
B)一在中心件(2)的上端(4)上横向于纵轴线(6)设置的上对合板(7),该对合板适用于支承在一椎骨体的底板上;
C)一在中心件(2)的下端(5)上横向于纵轴线(6)设置的下对合板(8),该下对合板适用于支承在一椎骨体的盖板上;以及其中
D)中心件(2)包括弹性的装置(19);
其特征在于,
E)弹性的装置(19)具有一递增的弹簧特性曲线。
2.按照权利要求1所述的椎间盘假体(1),其特征在于,弹性的装置(19)包括至少两个同轴设置的碟簧(20)。
3.按照权利要求2所述的椎间盘假体(1),其特征在于,所述碟簧(20)中的至少两个具有不同的刚度。
4.按照权利要求2或3所述的椎间盘假体(1),其特征在于,各碟簧(20)组成包括多个方向相同的成层的碟簧(20)的碟簧组(22)。
5.按照权利要求1至4之一项所述的椎间盘假体(1),其特征在于,中心件(2)构成空心体形的。
6.按照权利要求1至5之一项所述的椎间盘假体(1),其特征在于,设置一用于弹性装置(19)的定心装置。
7.按照权利要求6所述的椎间盘假体(1),其特征在于,定心装置构成柔性的并且允许在一锥形范围内轴向导向。
8.按照权利要求1至7之一项所述的椎间盘假体(1),其特征在于,各碟簧(20)具有中心孔(24)并且定心装置构成为通过这些孔(24)的内部的波纹管。
9.按照权利要求1至8之一项所述的椎间盘假体(1),其特征在于,中心件(2)包括一同轴设置的弹簧(18),该弹簧既起拉簧又起压簧的作用。
10.按照权利要求9所述的椎间盘假体(1),其特征在于,直到一轴向弹簧位移X≠0只各弹簧(18)紧贴两对合板(7、8)。
11.按照权利要求1至10之一项所述的椎间盘假体(1),其特征在于,中心件(2)在外面具有一由一波纹管(12)组成的外套(3)。
12.按照权利要求1至11之一项所述的椎间盘假体(1),其特征在于,中心件(2)可借助于卡锁可拆式连接于两对合板(7、8)。
13.按照权利要求1至12之一项所述的椎间盘假体(1),其特征在于,对合板(7、8)经由优选由陶瓷材料构成的滑动轴承(25)与中心件(2)相连接。
14.按照权利要求13所述的椎间盘假体(1),其特征在于,滑动轴承(25)构成为使对合板(7、8)相对于中心件(2)可以实施有限的横向于纵轴线(6)的平移。
15.按照权利要求2至14之一项所述的椎间盘假体(1),其特征在于,各碟簧(20)具有一挡块,该挡块限定碟簧的可压缩性。
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