CN1953715A - Spine insert - Google Patents

Abstract

Provided is an intervertebral implant which is fixedly- placed between spinous processes of adjacent vertebrae to maintain a predetermined space between the spinous processes and to prevent a relative displacement between, superior and inferior facets of adjacent vertebrae. The intervertebral implant includes a spacer having two opposing notches for receiving two adjacent spinous processes and a band for securing the two spinous processes and the spacer, the spacer comprising a through-hole bored through sides of the spacer to allow the band to pass therethrough and depressions curved inwardly from outsides of the spacer to facilitate fastening of the band passed through the through-hole, and the band binding the two spinous processes and the spacer in a figure 8 form while passing through the through-hole to secure the two spinous processes and the spacer.

Description

Spine insert

Technical field

The present invention relates to a kind of intervertebral implant, keeping predetermined space between spinous process, and prevent between adjacent upper and lower articular surface the intervertebral implant of displacement relatively between particularly a kind of spinous process that is fixedly placed in adjacent vertebrae.

Background technology

Fig. 1 is the side view of typical human spinal column.With reference to Fig. 1, a plurality of spinous process 3 are positioned at human body back, and a plurality of vertebral bodys 8 are positioned at offside.Spinal nerves 1 is in the interval between spinous process 3 and the vertebral body 8.Interspinal ligaments 7 and ligamenta flava 6 are between spinous process 3.Supraspinal ligament 5 and skin 20 spread along the rear side of spinous process 3.

With advancing age, the human spinal column change that stands to degenerate.Cause the interval between the spinous process 3 to reduce (with dotted line (A) expression), ligamenta flava 6 thickens when following the string and side-prominent forward (with dotted line (B) expression).Therefore, spinous process 3 or ligamenta flava 6 are oppressed spinal nerves 1 or are connected to the nerve synapse (not shown) of spinal nerves 1, and this is called as " spinal canal stenosis ".

Spinal canal stenosis adopts pharmacotherapy, physiotherapy and operative therapy to treat.Treatment just undergos surgery in the time can't handling spinal canal stenosis by non-operative treatment.The prevailing type of surgery of treatment spinal canal stenosis is skeleton or the tissue that removes the compressing spinal nerves, then drive screw is inserted vertebra to overcome because of removing the vertebra unstability that skeleton or tissue bring.Yet this operation is because will remove the skeleton of large volume or tissue and comprise general anesthesia.In addition, also need tediously long operation and restore cycle.Therefore, it is very difficult the old people who has a delicate constitution to be implemented this operation meeting.And for example complication often takes place unfavorable surgical effect and operation is expensive.

As the solution of these problems, patent application publication number is that the korean patent application of 2002-0068035 discloses a kind of insertion two interspinal intervertebral implants.Its up-to-date relevant technologies is shown among Fig. 2.

With reference to Fig. 2, will comprise that the intervertebral implant of cushion block 2 inserts between two spinous process 3a and the 3b, this cushion block has two relative grooves that are suitable for receiving two neural spine 3a and 3b.Here, two upper flange 11a and 12a and inwall form in two relative grooves, and two lower flange 11b and 12b and inwall form another groove.Intervertebral implant also comprise be used for cushion block 2 be fixed to two spinous process 3a and 3b between frenulum 13a and 13b.This frenulum 13a and 13b are looped around the surperficial position of spinous process 3a and 3b.

Intervertebral implant is inserted after two spinous process 3a and the 3b, and the end tension with frenulum 13a and 13b puts in place so that frenulum 13a and 13b are fastening.Thereby cushion block 2 is fixed between two spinous process 3a and the 3b.In addition, in order to detect the position of inserting cushion block 2 between spinous process 3a and 3b, the intransitable lateral direction element of X ray can be inserted in the cushion block 2.Lateral direction element is very tiny, the observation of unlikely like this interference X ray, and it is packed in the center 14.

Description of drawings

Fig. 1 is the side view of typical human spinal column.

Fig. 2 is the sketch map of traditional intervertebral implant.

Fig. 3 is the perspective view of cushion block according to an embodiment of the invention.

Fig. 4 is the front view of cushion block according to an embodiment of the invention.

Fig. 5 is the right view of cushion block according to an embodiment of the invention.

Fig. 6 is the perspective view according to bandage of the present invention.

Fig. 7 and Fig. 8 are for inserting cushion block the sketch map of human body.

Fig. 9 is the sketch of spinal column, shows the cushion block that inserts between adjacent spinous processes.

Figure 10 to Figure 13 is the continuous sketch map that cushion block is installed with bandage according to first embodiment of the invention.

Figure 14 is according to the sketch map of second embodiment of the invention with the cushion block of bandage installation.

Figure 15 and Figure 16 are the continuous sketch map that cushion block is installed with bandage according to second embodiment of the invention.

Figure 17 is the diagrammatic side views of spinal column, shows according to the cushion block between one embodiment of the invention insertion adjacent spinous processes.

Figure 18 is the sketch of lever system in the human body.

Figure 19 is the sketch of human spinal column, illustrates that normal interface joint connects.

Figure 20 is the sketch according to the spinal conditions behind the conventional art insertion cushion block.

Figure 21 is for inserting the sketch of the spinal conditions behind the cushion block according to the present invention.

Figure 22 is plotted in the x-y plane graph curve chart of explanation according to the profile slope of first groove of one embodiment of the invention intervertebral implant.

Figure 23 is the 3rd spinous process lower surface slope measurement result's a column scattergram.

Figure 24 is the 4th spinous process lower surface slope measurement result's a column scattergram.

Figure 25 is for making the flow chart of the method for intervertebral implant first groove according to an embodiment of the invention.

Figure 26 is the curve chart that is plotted in the 3rd spinous process lower surface slope in the x-y plane graph.

Figure 27 is the curve chart that is plotted in the 4th spinous process lower surface slope in the x-y plane graph.

Figure 28 is the curve chart that is plotted in the average lower surface slope of third and fourth spinous process in the x-y plane graph.

Figure 29 represents the block diagram of vertebra image clustering system according to an embodiment of the invention.

Figure 30 represents the flow chart of vertebra image clustering according to an embodiment of the invention.

Figure 31 is the detail flowchart of the preparatory function S210 of vertebra image clustering among Figure 30.

The GTG that Figure 32 represents to have selected relevant volume (VOI) is 256 vertebra profile image.

It is that 256 profile image and the GTG that passes through image binaryzation are 256 binaryzation profile image that Figure 33 and Figure 34 are respectively the GTG with selected VOI.

Figure 35 is the detail flowchart of the cluster operation S220 of vertebra image clustering among Figure 30.

Figure 36 is the detail flowchart of the representative image matching operation S270 of vertebra image clustering among Figure 30.

Figure 37 is the exemplary view of representative image matching operation according to an embodiment of the invention.

Figure 38 to Figure 40 is for being assigned to the GTG value picture group of the domain of dependence (ROI) of case image and matching template according to an embodiment of the invention.

Figure 41 is the perspective view of the scanned variable space of matching template in a case according to an embodiment of the invention.

Figure 42 is the perspective view of cushion block according to another embodiment of the present invention.

Figure 43 is the diagrammatic side views of spinal column, the position of cushion block shown in Figure 42 between the expression adjacent spinous processes.

Figure 44 is the profile that is equipped with the cushion block shown in Figure 43 of belt.

Figure 45 is the perspective view of cushion block according to another embodiment of the present invention.

Figure 46 is the left view of cushion block shown in Figure 45.

Figure 47 is the diagrammatic side views of spinal column, the position of cushion block shown in Figure 45 between the expression adjacent spinous processes.

Detailed description of the invention

Technical problem

In traditional intervertebral implant shown in Figure 2, except the spinous process 3a that will insert cushion block 2 and the interspinal ligaments between the 3b, high-order interspinal ligaments and low level interspinal ligaments also will remove, then spinous process 3a and 3b by frenulum 13a and 13b institute around.Like this, owing to unaffected ligament also is removed, so need long operation and recovery time.In addition, owing to upper flange 11a and 12a and the spinous process 3a of frenulum 13a around cushion block 2, frenulum 13b makes that around lower flange 11b and the 12b and the spinous process 3b of cushion block 2 cushion block 2 bearing capacity in the horizontal direction is lower.Therefore, when cushion block 2 applied external force, cushion block 2 may be dislocated in the horizontal direction in the horizontal direction.

Except above-mentioned spinal canal stenosis, when human body when weak or intervertebral disc 4 has illness because of the age, may produce relative displacement between superior articular surface and the inferior articular surface, or have the adjacent vertebrae of diseased intervertebral discs may stand the motion of horizontal or vertical direction, thereby cause patient's pain.

Therefore, need a kind of intervertebral implant that can reduce patient suffering and inconvenience of exploitation, it is easy to operative treatment, can two adjacent vertebras of held stationary.

The present invention promptly makes at the problems referred to above.The invention provides predetermined space between a kind of maintenance two neural spine, and prevent the intervertebral implant of relative displacement between two vertebras.

The present invention also provides a kind of interspinal intervertebral implant that is fixedly placed in after the intervertebral disc that only removes illness.

Summary of the invention

According to an aspect of the present invention, a kind of intervertebral implant is provided, it comprises having two cushion blocks that are used to receive the relative groove of two adjacent spinous process, and the belt that is used for fixing two spinous process and cushion block, this cushion block comprises that is passed the lateral through hole of cushion block, this hole can make belt therefrom pass, and from the outside aduncate depression of cushion block, it is convenient to the just fastening belt that passes through hole, becomes 8 fonts to bundle two spinous process and cushion block when belt passes through hole, to fix two spinous process and cushion block.

According to a further aspect in the invention, a kind of intervertebral implant is provided, it comprises having two cushion blocks that are used to receive the relative groove of two adjacent spinous process, one connects two relative grooves and produces the elastic bending part of elastic-restoring force with the external force of resisting the generation of two spinous process, be formed at two through holes of two relative grooves respectively, and the belt that passes two through hole binding cushion block and two spinous process.

According to a further aspect in the invention, a kind of intervertebral implant is provided, it comprises the upper end body with first groove, lower end body with second groove relative with first groove, be formed at the cylindrical accepter of body bottom, upper end, and the plug-in package that is formed at body top, lower end, its part is inserted cylindrical accepter, and have and be formed near inserting forward first bight and being formed near second bight of inserting the rear portion, first bight has different slopes with second bight.

The specific embodiment

With accompanying drawing preferred embodiment of the present invention is described below.Represented preferred embodiment of the present invention in the accompanying drawing, can more fully illustrate the present invention with reference to it.With reference to following detailed description and accompanying drawing, can advantages and features of the invention and its implementation be more readily understood preferred embodiment.Yet the present invention can be implemented in many ways, should not be construed as to only limit to listed specific embodiment herein.Just the opposite, the specific embodiment that is provided is in order to make content disclosed by the invention thoroughly intactly fully transmit thought of the present invention to the person of ordinary skill in the field, and the present invention should only be limited by claim.Same reference numerals is represented components identical in the whole description.

Intervertebral implant according to the present invention comprises the cushion block that keeps predetermined space between two adjacent spinous process, and the belt of binding cushion block and two spinous process.

Fig. 3 is the perspective view of the one specific embodiment cushion block 30 according to the present invention.With reference to Fig. 3, cushion block 30 comprises the first groove 33a, the second groove 33b, and first flange 31a and the 32a, second flange 31b and the 32b, first depression 34 is positioned at the second depression (not shown) on the first depression opposite and through hole 35.

Fig. 4 represents the observed cushion block 30 shown in Figure 1 from the top.As shown in Figure 4, cushion block 30 is about last-following axial symmetry, and is still asymmetric about the L-R axle.

Cushion block 30 inserts between the two adjacent spinous process 3a and 3b that are subjected to the spinal canal stenosis invasion and attack.Cushion block 30 has the first groove 33a that is used for receiving spinous process bottom, two spinous process top, and is used for receiving another spinous process of two spinous process, i.e. the second groove 33b on spinous process top, below.First and second groove 33a and 33b are in opposite direction, support the pressure up and down of upper and lower spinous process.

Usually, the upper and lower part of spinous process has different shapes.That is, the bottom of spinous process is narrow relatively and grow, and lacks and top is wide relatively.Therefore, the size of the first groove 33a and the first flange 31a and 32a is different with the second groove 33b and the second flange 31b and 32b preferably, the bottom of the such first groove 33a and the first flange 31a and 32a and top spinous process matches, and the top of the second groove 33b and the second flange 31b and 32b and below spinous process matches.

The first groove 33a is formed by the first flange 31a and 32a, and it prevents the displacement on the right of upper aristate process, and the second groove 33b is formed by the second flange 31b and 32b, and it prevents down the displacement on the spinous process left and right directions.

First depression 34 is formed at the left side of cushion block 30, and second depression 36 is formed at the right side of cushion block 30.First and second depressions 34 and 36 are convenient to pull the bandage two ends of passing through hole 35.For cushion block 30 is installed between the adjacent spinous process, first depression 34 is from the left-external side neck-in of the first flange 31a and the second flange 31b, and second depression 36 curves inwardly from the right outer ledge of the first flange 32a and the second flange 32b.Inside curvature can change according to the needs of user.

Through hole 35 is for punching a hole of cushion block about 30 parts, and it has the shape of slotted hole, and is enough wide, can hold the width of bandage.The structure of through hole 35 and the detailed description of shape can provide by reference Fig. 5.

Fig. 5 represents the observed cushion block 30 shown in Figure 4 in the right side (D) from Fig. 4.As shown in Figure 5, cushion block right side part is asymmetric about last-lower shaft.Like this, when cushion block 30 when (E) direction is inserted between the two adjacent spinous process, the first and second groove 33a and 33b can match with two spinous process.Consider the overall shape of spinous process, the first and second groove 33a and 33b can have steeper gradient from inserting the front portion to inserting the rear portion.

Through hole 35 passes the left and right portion of cushion block 30, has the enough wide width b that can hold bandage 40 width.Through hole 35 has the height h that three strands of bandages are penetrated, and gets final product so that three strands of bandages just pass through.That is to say, must produce predetermined frictional force because pass between the bandage of through hole 35, so need compress bandage.Therefore, through hole 35 preferably is configured as three demultiplications that highly equal bandage thickness and goes a predetermined value (α).The α value is big more, and the frictional force between the bandage is more little, and the α value is more little, and the frictional force between the bandage is more little.In this, the α value is determined according to frictional force between required bandage.The α value can determine by rule of thumb, but its can be very near the thickness of bandage.

Preferably, cushion block 30 can by harmless robust metallic for example titanium make.

Fig. 6 is for forming the perspective view of the bandage 40 of intervertebral implant according to the present invention.Bandage 40 bundlees two spinous process and cushion block in 8 font modes.Bandage 40 comprises the belt 43 that is used for fastening cushion block, is formed at the hook at belt 43 two ends, and the connecting portion 42 and 45 of butt hook and belt 43.

Two hooks are arranged: first hook 41 and second hook 44.First hook 41 passes the interspinal ligaments above the spinous process of top, and the shape of first hook 41 is by the top shape decision of top spinous process.Second hook 44 passes the interspinal ligaments below the spinous process of below, and the shape of second hook 44 is by the bottom shape decision of below spinous process.Therefore, the size of first hook 41 and radius of curvature are generally greater than second hook 44.

Belt 43 has relatively large width w and relative less thickness t.The two ends of belt 43 all have narrower width, belt 43 is connected to first and second hooks 41 and 44.Belt 43 can be by having certain coefficient of friction and harmless material is made, for example the synthetic fibers of being made by polyester, natural leather, dermatine or analog.

Fig. 7 and Fig. 8 insert the intravital sketch map of patient with cushion block 30.At first, as shown in Figure 7, mention supraspinal ligament 5, remove interspinal ligaments 7a corresponding with it.Then, as shown in Figure 8, will remove in the interval of interspinal ligaments 7a between cushion block 30 insertion two adjacent spinous process 3a and 3b.

Fig. 9 represents to observe through being inserted into the cushion block between adjacent spinous processes 3a and 3b after Fig. 7 and the described step of Fig. 8 from the health rear.As shown in Figure 9, cushion block 30 inserts between two spinous process 3a and 3b, and two spinous process 3a are fastening by the relative groove 33a and the 33b of cushion block 30 with 3b.Yet each spinous process can be because of the activity of spinal column move left and right slightly.Like this, cushion block 30 must be installed with bandage.For convenience of explanation, with reference to Fig. 9 (F) to bandage fixedly cushion block describe.

Below will provide according to of the present invention with fixing two embodiment of cushion block of bandage.

Figure 10 to Figure 13 explanation according to the first embodiment of the present invention with the fixing cushion block of bandage.At first, with reference to Figure 10, first hook 41 is passed through hole 35 (not shown)s of cushion block 30.Then, with reference to Figure 11, first hook 41 is passed the zone of the interspinal ligaments 7b on close spinous process 3a top, top.With reference to Figure 12, first hook 41 is passed the through hole 35 of cushion block 30 once more, second hook 44 is passed a zone near the interspinal ligaments 7c of spinous process 3b bottom, below.

At last, remove first hook 41 and second hook 44, the two ends of belt 43 are strained along the direction of arrow among Figure 13.When straining the two ends of belt 43, belt 43 closely contacts (not shown) with the depression 34 of cushion block 30 with 36, guarantees cushion block 30 and upper and lower spinous process 3a and 3b fastening more reliably.Be tied to form a knot 46 with the first Wugou end of belt 43, one of belt 43 put below spinous process 3b on the spot, is tied to form a knot 47, spinous process 3a above one of belt 43 put on the spot with the second Wugou end of belt 43.

According to the foregoing description, the knot 46 and 47 that cushion block 30 is beaten by the two ends of belt 43 is fixed to upper and lower spinous process 3a and 3b.Yet, according to another embodiment (will illustrate subsequently), with belt fixedly cushion block can utilize the friction between belt knotting and belt to finish.

The cushion block 30 that Figure 14 explanation is installed with bandage 40 according to a second embodiment of the present invention.With reference to Figure 14, when 43 one-tenth 8 fonts of belt of bandage 40 pass through hole 35 three times, produce pressure Fc along direction shown in the arrow among Figure 14.Pressure Fc also appears between the adjacent belt 43.Frictional force Ft is created between the belt 43, and is directly proportional with pressure Fc and belt 43 coefficient of frictions.Certainly, also produce frictional force between the inner surface of through hole 35 and the belt 43.Yet, because the frictional force that produces between the inner surface of through hole 35 and the belt 43 is much smaller than the frictional force Ft that produces between the belt 43, so only consider the frictional force Ft of generation between the belt 43.According to another embodiment, can adjust the inner surface and the frictional force between the belt 43 of through hole 35 greater than the frictional force Ft that produces between the belt 43.For this reason, can carry out structural transformation to belt 43 and through hole 35 with the mode that is fit to.

Figure 15 and Figure 16 explanation are installed cushion block 30 according to second embodiment of the invention with bandage 40.Figure 15 and Figure 16 illustrate that Figure 10 is to subsequent step shown in Figure 12.Therefore, as first embodiment, at first carry out Figure 10 in a second embodiment to step shown in Figure 12.

With reference to Figure 10 to Figure 12 and Figure 14 to Figure 16, at first first hook 41 is penetrated and passes the through hole 35 of cushion block 30.Then, first hook 41 is passed the zone of the interspinal ligaments 7b on close spinous process 3a top, top.First hook 41 is passed the through hole 35 of cushion block 30 once more, second hook 44 is passed a zone near the interspinal ligaments 7c of spinous process 3b bottom, below.

Then, as first hook 41, second hook 44 is passed through hole 35 once more.Afterwards, remove first and second hooks 41 and 44 that are connected to belt 43 two ends, the two ends of belt 43 are strained along the direction of arrow among Figure 15.Like this, the frictional force between the belt 43 makes the bradykinesia of belt 43, and upper and lower spinous process 3a and 3b firmly are fastened in the groove of cushion block 30.Like this, the frictional force between the belt 43 makes the bradykinesia of belt 43, and the depression of belt 43 and cushion block 30 34 closely contacts with 36, guarantees cushion block 30 and upper and lower spinous process 3a and 3b fastening more reliably.

At last, be tied in a knot 48 and 49 with the two ends of belt 43, belt 43 is put upper and lower spinous process 3a and 3b on the spot.Utilize belt 43 that cushion block 30 is fixed to upper and lower spinous process 3a and 3b mainly by the frictional force between the belt 43 and be aided with knot 48 and 49.

Figure 17 is the side view of spinal column, shows according to one embodiment of the invention to insert the compound intervertebral implant of cushion block-belt between two adjacent spinous process 3a and the 3b.With reference to Figure 17, cushion block 30 is kept the predetermined space (preset distance between groove) between two spinous process 3a and the 3b, and supporting appears at the pressure F2 between two spinous process 3a and the 3b.Belt 43 is bundled into one with cushion block 30 and two spinous process 3a and 3b, produces predetermined load forces F1 on two spinous process 3a and 3b, thereby prevents that the sour jujube interbody spacer from broadening.Like this, because belt 43 has prevented that the sour jujube interbody spacer from broadening, thus can correct some problems, for example because of the spinal canal stenosis that narrows down at interval between corresponding vertebral body 8a and the 8b.

That is to say that external load is dispersed to vertebral body and interface joint with suitable ratio, thereby reduce pressure that is applied to the interface joint and the pressure that is applied on the intervertebral disc.Therefore, intervertebral disc can well be protected, and intervertebral space can suitably be kept.Like this, can prevent according to intervertebral implant of the present invention various because of intervertebral space the narrow down disease that causes and the various various diseases that narrows down and cause because of the sour jujube interbody spacer.

In intervertebral implant according to the present invention, belt 43 can also prevent the relative displacement between superior articular surface 9b and the inferior articular surface 9a.That is, belt 43 also is responsible for the fastening of interface joint.The mankind's spinal column ratio is done one lever system, and upper and lower articular surface 9a and 9b are as fulcrum, and vertebral body 8a and 8b are as the load that will move, muscle working.Specifically, fastening upper and lower articular surface 9a and 9b (as fulcrum) are a key factor in suitable movable spinal column in order to prevent damage.The pain that is caused by the interface joint motions can be eliminated in fastening interface joint, reduces the operation sequela, and prevention spinal canal stenosis (by the joint motions of restriction interface).

Understand spinal column for the mode by lever system, primary lever system describes with Figure 18.Belt 43 is positioned at the position of the power that need apply, and it produces the power F1 of extruding two spinous process 3a and 3b.By the effect of power F1, on the sagittal plane of spinal column, produce lordosis.Simultaneously, thus extensor is pulled the length that increases lever arm.As a result, power F1 is applied to load W on vertebral body 8a and the 8b by come balance as the upper and lower articular surface 9a of fulcrum and 9b.Here, extensor is offset the moment of trunk, produces the back side shearing force of offsetting the front shearing force that is produced by top vertebral body or external load.

The load W that is applied on vertebral body 8a and the 8b is mainly determined by the muscular strength of the extensor (ridge erects flesh) of carrying on the back the bottom.Like this, can be by this system be explained in the explanation that acts on epicentral muscular strength.According to formula: F * a=W * b, along with the lever arm length corresponding to extensor increases, the sphere of action of extensor increases on the vertebral body.

When by syndesmoplasty two spinous process being pressurizeed, lumbar spinal column is antecurvature normally can recover according to the present invention, thereby increases extensor, the i.e. length of lever arm.If lever arm increases, the sphere of action of muscular strength increases, and acting on epicentral load therefore can be cancelled.

Figure 19 to Figure 21 is the sketch according to conventional art and intervertebral implant effect of the present invention.Figure 19 is the sketch of the normal condition in vertebra and interface joint.With reference to Figure 19, interface joint 9a and 9b are as the fulcrum of vertebral level.Upper and lower spinous process 3a and 3b and upper and lower vertebral body 8a and 8b lay respectively at the end of interface joint 9a and 9b.Among Figure 19, it is normal that sour jujube interbody spacer and intervertebral space keep.

Figure 20 is the sketch according to vertebra state behind the conventional art insertion cushion block.In this case shown in Figure 2 and conventional art, upper and lower spinous process 3a and 3b and cushion block 2 usefulness frenulum 13a and 13b binding, because upper and lower spinous process 3a and 3b and cushion block 2 are not tightened to an integral body, top spinous process 3a may produce relative displacement with below spinous process 3b.And, when a predetermined masterpiece is used for as the interface joint 9a of vertebral level fulcrum and 9b, can produce displacement relatively between interface joint 9a and the 9b, thereby cause the various diseases of following fulcrum to worsen.As a result, vertebral level cisco unity malfunction.In addition, slight sour jujube interbody spacer also can occur broadens.Like this, owing to intervertebral space reduces, can deterioration after operation such as the disease of spinal canal stenosis.

Figure 21 is for inserting the sketch of vertebra state behind the cushion block according to the present invention.With reference to Figure 21, cushion block 30 usefulness belts 43 firmly are fastened between upper and lower spinous process 3a and the 3b.Therefore, can not produce relative displacement between interface joint 9a and the 9b, so vertebral level even operate as normal also after surgery.And, can prevent interface joint 9a and 9b motion or appear at various diseases among interface joint 9a and the 9b when being squeezed.

In addition, even narrow down when intervertebral space, when promptly spinal canal stenosis occurs, vertebral body 8a and 8b also can by strengthen the muscle bearing capacity come disconnected from each other must be greater than predetermined space.And normal lordosis disease also can be recovered by tightening with belt 43.Yet.Consider individual variation, preferably regulate height h shown in Figure 21, local kyphosis can not taken place.

Below, the cluster of the lower surface of spinous process 3a is elaborated above will being assembled to the first groove 33a.As everyone knows, individuality has different body structures, and the shape of spinous process also can distribute different.Therefore, according to the shape of each individual spinous process tailor and the operative treatment intervertebral implant hardly may.From this point, need utilize statistical data to finish the shape cluster of the first groove 33a, to obtain the predetermined number of first groove shapes.

Certainly, the shape cluster of the second groove 33b also can be finished in the same way.Yet the shape of the common second groove 33b is constant, and the profile of the second groove 33b may be thought of as horizontal linear.Therefore, the cluster to the second groove 33b is nonsensical.From this point, the present invention will describe the cluster of the first groove 33a.

With reference to Fig. 5, the profile of the first groove 33a has the shape that a line segment by different functions has connected a plurality of points.For instance, the profile of the first groove 33a may not be to be the rectilinear(-al) of 20 degree by an independent slope, but is connected and forms three flex points with the straightway of 20 degree Different Slope by three 40,30.Certainly, the profile of the first groove 33a can also have a shape that has been connected a plurality of points by the curve with different predetermined curvatures.

Specifically, consider that the shape of the lower surface of top spinous process 3a will be supported by the first groove 33a, the profile of the first groove 33a has one from inserting the rear portion to inserting the anterior shape that relatively slowly tilts.

Figure 22 is plotted in the x-y plane graph curve chart of explanation according to the profile slope of first groove of one embodiment of the invention intervertebral implant.

With reference to Figure 22, suppose that the first groove 33a is the initial point of x-y plane graph near the end that inserts the rear portion, the depositional dip degree of the first groove 33a profile is 40 degree.But, become 30,20 and 0 degree angle at the predetermined point slope.

The optional profile slope range of the first groove 33a is carried out statistical analysis to data then by the spinous process lower surface slope of measuring a large amount of patient's desires insertion cushion blocks and is obtained.In a specific embodiment of the present invention, angle (following usefulness " L45 " expression) between angle (following usefulness " L34 " expression) and the 4th and the 5th spinous process between measurement main on position the 3rd of intervertebral implant and the 4th spinous process.That is to say the slope of the slope of the 3rd spinous process lower surface of measurement L34 and the 4th spinous process lower surface of L45.

The measurement result of the slope of the 3rd spinous process lower surface is shown in the following table 1.For this reason, (computed tomography CT) obtains 10 CT images through axle bit machine tomoscan to 103 spinal canal stenosis patients.Listed lower surface slope measurement result utilizes the CT image of the 3rd spinous process to obtain in the table 1.

Table 1

Project	1	2	3	4	5	6	7	8	9	10	11
												1	17	27.2	10.2	20.4	23.8	23.8	23.8	27.2	27.2	20.4	10.2
2	20.4	20.4	20.4	17	13.6	30.6	37.4	23.8	27.2	20.4	27.2
												3	17	23.8	17	20.4	13.6	27.2	30.6	20.4	27.2	34	2O.4
4	17	17	2O.4	20.4	17	27.2	13.6	27.2	27.2	30.6
												5	23.8	23.8	17	27.2	23.8	23.8	23.8	27.2	27.2	13.6
6	27.2	23.8	17	17	27.2	10.2	27.2	27.2	23.8	20.4
												7	10.2	20.4	20.4	13.6	40.8	20.4	13.6	17	13.6	20.4
8	13.6	27.2	23.8	17	13.6	23.8	27.2	27.2	23.8	6.8
												9	20.4	23.8	19.7	23.8	27.2	23.8	23.8	17	27.2	27.2
10	13.6	23.8	13.6	0	20.4	6.8	23.8	37.4	27.2	30.6

The measurement result of the slope of the 4th spinous process lower surface is shown in the following table 2.For this reason, 103 spinal canal stenosis patients are obtained 10 CT images through axle position CT scan.Listed lower surface slope measurement result utilizes the CT image of the 4th spinous process to obtain in the table 2.

Table 2

Project	1	2	3	4	5	6	7	8	9	10	11
												1	0	20.4	3.4	17	0	20.4	34	23.8	17	10.2	10.2
2	17	0	17	13.6	6.8	30.6	27.2	13.6	20.4	13.6	23.8
												3	3.4	17	1O.2	17	20.4	30.6	27.2	17	17	13.6	13.6
4	3.4	13.6	20.4	13.6	20.4	13.6	10.2	17	13.6	13.6
												5	17	20.4	27.2	23.8	17	17	17	23.8	23.8	10.2
6	2O.4	23.8	6.8	13.6	20.4	3.4	3.4	20.4	10.2	20.4
												7	13.6	13.6	13.6	10.2	27.2	23.8	10.2	30.6	13.6	13.6
8	17	17	17	20.4	10.2	30.6	34	13.6	6.8	10.2
												9	17	10.2	13.6	17	23.8	17	17	34	30.6	17
10	6.8	10.2	13.6	0	13.6	6.8	13.6	0	17	23.8

As shown in Table 1 and Table 2, L34 has different lower surface slope distribution with L45.That is, concerning L45, the lower surface slope is spent to the distribution of 15 degree higher relatively from 0.

The table 3 expression third and fourth spinous process lower surface slope measurement result.The third and fourth spinous process lower surface slope with 50 spinal canal stenosis patients of X-ray measurement.In the slope of lower surface shown in table 1 and the table 2 CT scan measurement result, image blurring influence can appear in the CT image.And, may some inaccuracy based on the slope of tangent plane picture conversion.Radioscopic image can be got rid of these probabilities.

Table 3

Project	The 3rd spinous process lower surface gradient					The 4th spinous process lower surface gradient
											1	12	29.3	9.7	25.3	20.4	0	36	6.3	17.3	-5
2	34	26.6	37	0	12.5	24	3.3	16	0	11
											3	0	6	22.3	18	0	3	4.1	22.1	29.5	10.7
4	5.5	20	11.1	19.3	26	12.5	12	8.3	3.7	5.6
											5	35	0	11.4	6.1	23.3	8	0	0	2.1	18
6	25.3	24	17.3	0	16.2	0	11	4.3	14	2
											7	15	25	0	0	24	12	0	2.3	0	0
8	11.4	19	29.3	18.6	1	4	22.6	21	11.4	0
											9	13.4	34	35.9	14	21	4.5	6	8	6.5	0
10	24.6	14	7	13.6	8.2	7	20	12.3	9.3	3

Figure 23 is the 3rd spinous process lower surface slope measurement result's a column scattergram.The 3rd spinous process lower surface slope measurement result's distribution be by with the 3rd spinous process lower surface slope measurement result shown in the table 3 by per five the degree be that a component group is represented.

With reference to Figure 23, the 3rd spinous process lower surface slope measurement result's distribution similar normal state distribution curve.Specifically, 26 patients are distributed in 15 to 25 ° the scope.

Figure 24 is the 4th spinous process lower surface slope measurement result's a column scattergram.The 4th spinous process lower surface slope measurement result's distribution be by with the 3rd spinous process lower surface slope measurement result shown in the table 3 by per five the degree be that a component group is represented.

With reference to Figure 24, the 4th spinous process lower surface slope measurement result is distributed as the left avertence normal distribution.Specifically, 39 patients are distributed in 0 to 15 ° the scope.As Figure 23 and shown in Figure 24, the 3rd spinous process lower surface slope characteristics is different from the 4th spinous process.Used cushion block mainly inserts L34 or L45 at present, does not notice where it is inserted into.

Like this, profile slope is that first grooves of 20 degree generally can be used for L34, and may just need do very big transformation when being used for L45.And when the cushion blocks that with one first groove profile slope are 20 degree inserted between patients' the L34 that L3 lower surface slopes are far from 20 degree, the bearing capacity that is used for the cushion block vertical direction of L34 can reduce.When adopting digital assay to connect the point that a plurality of statistics obtain with different function line segments, cushion block 30 according to the above embodiment of the present invention is more suitable.

Figure 25 is a flow chart of making the method for intervertebral implant first groove according to one embodiment of the invention.

With reference to Figure 25, at first, from the crowd who comprises a plurality of patients, extract the predetermined sample group out, measure the spinous process lower surface slope (operation S10) of member in the sample group.Lower surface slope with third and fourth spinous process shown in the his-and-hers watches 3 in the present embodiment describes, and it comprises the data by the sample group of 50 member compositions.

Spinous process lower surface slope measurement result is assigned to (operation S20) in the predetermined slope interval.In the present embodiment, the slope interval is 10 degree.Yet the person of ordinary skill in the field can at random select to determine the slope interval.The slope interval of 10 degree is for the ease of describing in the present embodiment.But, preferably shorten the slope interval gradually to obtain curve in essence.That is to say that the point that a plurality of statistics can be obtained couples together by polynomial interopolation, spline interpolation and forms a curve, perhaps can select they to be connected into a substantial curve by the straightway that shortens the slope interval.

The third and fourth spinous process lower surface measurement result (50 member's sample groups) in the table 3 in table 4 expression 10 degree slope intervals.Particularly, L345 represents the meansigma methods of the third and fourth spinous process lower surface measurement result.That is, L345 is the mean of the third and fourth spinous process lower surface measurement result, and the purpose of calculating it is both can insert the cushion block that L34 also can insert L45 in order to make.

Table 4

Project	L34	L45	L345 (＝(L34+L45)/2)
				40°～50°	1	1	1
30°～40°	9	1	1
				20°～30°	16	8	8
10°～20°	16	22	22
				0°～10°	8	17	17
-10°～0°	0	1	1

Spinous process slope measurement result is assigned to after each slope interval, determines the representative value (operation S30) in each slope interval.The representative value in each slope interval can be the meansigma methods in low limit value, ceiling value or each slope interval, and perhaps it can be selected arbitrarily by the person of ordinary skill in the field.For example, in the present embodiment, the low limit value in each slope interval is as representative value.Therefore, the representative value in slope interval is 40,30,20,10,0 and-10 degree.Determine and then the slope measurement result to be assigned to behind the operation S30 of representative value the operation S20 in each slope interval.

With the representative value in each slope interval and be assigned in each slope interval slope measurement as a result number be illustrated in (operation S40) in the x-y plane graph.The x axle is the slope measurement result's that distributed an accumulative total number, and the y axle is the height of first groove.Figure 26 represents to be plotted in the slope of the 3rd spinous process lower surface in the x-y plane graph.

With reference to Figure 26, the slope measurement result's who is distributed accumulative total number is represented with the x axle.Numeral 131 expression slopes are the line segments of 40 degree, and its accumulative total number that is in initial point and is assigned to the slope measurement result in the 40-50 degree interval is between 1 the point; Numeral 132 expression slopes are the line segments of 30 degree, and its accumulative total number that is in the end points of line segment 131 and is assigned to the slope measurement result in the 30-40 degree interval is between the point of 10 (1+9); Numeral 133 expression slopes are the line segments of 20 degree, and its accumulative total number that is in the end points of line segment 132 and is assigned to the slope measurement result in the 20-30 degree interval is between the point of 26 (10+16); Numeral 134 and 135 is respectively the line segment that slope is 10 and 0 degree, draws in the mode identical with above-mentioned line segment.

Above-mentioned line segment can be represented with formula 1.

$y=\underset{m=1}{\overset{n}{\mathrm{\Σ}}}\{{\mathrm{tar\θ}}_m(x-N_{m-1})+{\tan \mathrm{\θ}}_{m-1}{N}_{m-1}\}*u(N_{m-1},N_m)$

N ₀＝0，θ ₀＝0 ...(1)

The y function that the straightway of the Different Slope that connect a plurality of statistics institute's invocation points and obtain is formed of serving as reasons wherein, x are the slope measurement result's that distributed number, and n is the n interval, N _nBe the slope measurement result's that distributed in the n interval accumulative total number, θ _nBe the representative value in n interval, u (N _N-1, N _n) be interval (N _N-1, N _n) in value be 1 monotropic function, N ₀And θ ₀All be zero.

Figure 27 is the curve chart that is plotted in the 4th spinous process lower surface slope in the x-y plane graph.

Figure 28 is the curve chart that is plotted in the average lower surface slope of third and fourth spinous process in the x-y plane graph.The average lower surface slope of third and fourth spinous process also can be plotted in the x-y plane graph in the same way.

Among Figure 28, D1 is the function curve diagram of L34 among Figure 26, and D2 is the function curve diagram of L45 among Figure 27, and D3 is the function curve diagram of L345.With reference to Figure 28, as can be seen, D3 is between D1 and the D2.To describe in detail below the advantage of function L345.

At last, make the first groove 33a (operation S50) have with the slope same profile slope of Figure 26 to Figure 28 gained function.According to said method, can make intervertebral implant with cushion block, it has first groove that connects the profile slope that a plurality of points obtain by the line segment with different functions.

As mentioned above, the bottom of first groove 33a supporting top spinous process 3a.Therefore, when the profile slope of the first groove 33a is identical with top spinous process 3a lower surface slope, the bearing capacity of the pressure on the vertical direction is increased.The same with the above embodiment of the present invention, when the first groove 33a comprises a plurality of plane with Different Slope, comprise that the intervertebral implant of the cushion block with first groove 33a can be used to have the top spinous process of different lower surface slopes generally.

In addition, because first groove of the present invention is made based on a plurality of spinal canal stenosis patients' spinous process lower surface slope, compare with having equally distributed first groove of differently contoured slope, statistics distributes a large amount of patients' slope interval to account for higher ratio, can improve the bearing capacity to vertical direction pressure.And, comprise that the intervertebral implant of the cushion block with first such groove 33a can be used for more patient.

Also have, the cushion block that is used for L34 can separately be made with the cushion block that is used for L45.Selectively, can also make a kind of can be general the cushion block of insertion L34 and L45.Therefore, can need not in operation finishing first groove 33a or part remove above the bottom of spinous process 3a.

In the above-described embodiments, a plurality of points are coupled together by straightway.Yet, should be appreciated that a plurality of points can be connected by the curve of predetermined curvature.Preferably, the profile of intervertebral implant cushion block can be used polynomial interopolation, spline interpolation or other method curveization.Especially, in utilizing the situation of spline method, can a plurality of points be coupled together smoothly with polynomial interpolation.In addition, can generate smoothed curve by utilizing quadratic function, cubic function, biquadratic function or higher function to connect line segment with spline method according to the slope interval.

Though the foregoing description is illustrated the first groove 33a, it also can be used for the second groove 33b.

So far, the profile cluster to the first groove 33a is described from different patient's groups.In addition, consider various factors in order to carry out general cluster, for example shape, size, and the spacing of flange, a kind of method of vertebra image clustering can consider to utilize the situation of osteogram picture.Though the size of spinous process and shape are according to sex and individual variation and can be different, the number of the intervertebral implant that will make must be restricted in fact.For this reason, must know prevailing spinous process shape and size.Below, the numeral that explanation is distributed according to user is sought the shape of common spinous process and the method for size.

Usually, cluster analysis can be used for reducible data and sort out similar data.This cluster analysis is widely used in information processing.A purpose of clustering algorithm provides and is used to carry out or the auxiliary automation tools of sorting out and classifying.Cluster does not need to distinguish the accumulative classification formerly of independent variable and dependent variable and number.The target of cluster is to seek similar group under the expected value of similar behavior there being similar record to have.

Therefore, be exactly to reduce the accumulative size of number and the internal characteristics that do not lose data to the comparison of data and comprehensive most important consideration.Select a kind of computational efficiency that can guarantee also can find the accumulative method of the number that to describe initial data very important.Seeking number assembles mainly based on the meansigma methods of calculating measured value.Among the present invention, provide the average clustering algorithm of a kind of k-of improvement as the method for seeking the spinous process distribution of shapes.

Figure 29 is the block diagram according to one embodiment of the invention vertebra image clustering system.With reference to Figure 29, vertebra image clustering system comprises user interface 110, classification distribution control module 120, control module 130, raw image data storehouse 140, data representing image storehouse 150, binary image data base 160, image collection module 170, relevant volume (VOI) extraction module 180 and VOI binaryzation control module 190.

User interface 110 receives the I/O that the user selects VOI or its managing image to collect in the vertebra image of the full visual field.

Classification distributes control module 120 according to the similarity threshold value of being determined by study module case to be assigned to existing classification or it creates new classification.

Control module 130 is mainly used in and corrects representative image when the new case is included in the existing classification.In addition, control module 130 will go up a circulation representative image and this circulation representative image compares in order to assemble, and it causes cluster again by increasing the similarity threshold value when distributing the classification number less than predetermined number.

Raw image data storehouse 140 stores by image collection module 170 without correcting the image of collecting, and provides original image when representing the classification image creating binary image or correct.

Data representing image storehouse 150 stores the representative image of reflection category feature.Here, representative image represents to belong to the original image of classification.

Binary image data base 160 stores the VOI image of the binaryzation of extracting from original image.The binary image of representative image also is stored among the binary image data base 160.Binary image data base 160 is used to contrast the binary image of the binary image of case and representative image in order to case is assigned to corresponding classification.

Image collection module 170 receives original image from external source, then the original image that receives is stored in the raw image data storehouse 140, or it is sent to VOI extraction module 150 with the original image that receives.

VOI extraction module 180 receives original image from image collection module 170, and when the user extracted VOI, VOI extraction module 180 was sent to VOI binaryzation control module 190 with the VOI that extracts.

VOI binaryzation control module 190 receives VOI from VOI extraction module 170, the VOI that receives according to the preassigned binaryzation, and the VOI of binaryzation is sent to binary image data base 160.

With reference to Figure 30 to 41, will the automated image classification and the management of employing vertebra image clustering of the present invention system be elaborated.

Figure 30 is the flow chart according to one embodiment of the invention vertebra image clustering.With reference to Figure 30, before cluster, carry out the VOI preparation.That is, extract and binaryzation VOI, first case is assigned to first category (hereinafter to be referred as " classification A ") S210.

The binaryzation VOI image of second case and the binaryzation representative image carries out image of classification A are mated.The binaryzation VOI image of second case and the binaryzation representative image of classification A are complementary, and second case is included among the classification A, and corrects the representative image of classification A.On the contrary, when the binaryzation representative image of the binaryzation VOI of second case image and classification A is not complementary, second case is assigned among the new-create classification B.This step repeats all cases.That is to say that when the binaryzation VOI of n case compared with the binaryzation representative image of existing classification A to P, the n case was assigned in its coupling classification.If during the binaryzation representative image that not is not complementary with the binaryzation VOI of n case, the n case is assigned among the new-create classification P+1.When the distribution of last case stops, reject contained case (based on total case) and be less than the certain proportion classification of (for example, being less than 2%) (operation S230).The case of rejecting can be used to reach the unusual and difform purpose of indivedual extractions by selectivity.

Remove after the abnormal class, investigate the representative image of each classification and whether corrected.If representative image is corrected, carry out cluster and classification once more and reject; But,, just determine the number of classification if finished convergence.Repeat above-mentioned steps, all corrected (operation S240) up to all representative image.

Next, calculate the error rate (operation S247) of assembling classification.If utilize the definite classification number of similarity threshold value, utilize the similarity threshold value of increase to repeat cluster operation, classification rejecting operation and assemble definite operation S250 less than the maximum number that allows classification.

In addition, will mate to select more general representative image S260 according to representative image matching template and case that above-mentioned steps is finished.

Be described in detail hereinafter with reference to accompanying drawing each operation Figure 30.

Figure 31 is the detail flowchart of the preparatory function S210 of Figure 30.

Preparatory function comprises selects the VOI image from the vertebra image of the full visual field, and binaryzation VOI image.

Shown in figure 32, when providing GTG to be 256 full visual field vertebra profile image (child-operation S211), the user extracts the VOI image.In the present embodiment, adopt the xyz-coordinate to represent VOI with 3 dimensional drawing.At first, select the image slices zone of implant and in section, determine domain of dependence (ROIs).By being added additional volume, the position that intervertebral implant is installed determines VOI, and in the different sections of the selection up and down of z-axle.The same all images of handling ROIs.For example, can select ten sections at the z-direction of principal axis, all images can be made up of the 64*64 pixel.In addition, in a case, ROIs can be identical in all sections.These patient charts are shown: (S ₁, S ₂... S _N).

Then, utilize following formula 2 to carry out binaryzation (child-operation S213).All cases are divided into k cluster { P ^t _j, 1≤j≤k}.If a case belongs to cluster P ^t _j, this case is categorized into the representative image vector _cμ ^t _j(j=1 ..., k).Here, t is circulation, and c is the numeral that j upgrades.B ( _cμ ^t _j(x, y, z)) for being used for binaryzation representative image vector at (x, y, z) function of the GTG of each voxel on the position.

The threshold value that is used for the vertebra image binaryzation can be selected arbitrarily in from 190 to 240 the scope.Yet, consider minimum noise and vertebra density, preferably 230.For people, can select 200 threshold values as the vertebra image binaryzation with low bone density.The threshold value of vertebra image binaryzation is not limited to above-mentioned value.Figure 33 represents to have the ROI image of 64*64 pixel, and Figure 34 represents the binary image of ROI image among Figure 33.

Finish beamhouse operation (child-operation S214) by first case being assigned to classification A.

Figure 35 is the detail flowchart of cluster operation S220 among Figure 30.

With reference to Figure 35, at first, when t=0, determine that is used for the initial similarity threshold value (Th that classification is distributed _s=Th _Start) (child-operation S221).Initial similarity threshold value can directly be determined by the user or determine at random in preset range.For example, initial similarity threshold value can be selected in from 70 to 100% the scope.In the present embodiment, select 76% as initial similarity threshold value.Yet, because initial similarity threshold value is not remarkable to the influence of cluster result, so should select a suitable value as initial similarity threshold value.

Then, the n case is assigned to (child-operation S222) in the p classification.According to formula 3 (as follows), the binaryzation GTG of the case that will handle is compared with the binaryzation GTG of the representative image of given voxel position classification, and calculates the matching rate of two binaryzation GTGs.That is to say, represent the pixel aggregate-value of binaryzation GTG in matching area of the representative image of the binaryzation GTG of case and classification with percentage ratio.In the formula 3, A _CaseBe the pixel count among the VOI, i.e. pixel count * number of slices among the ROI.In the present embodiment, A _Case Be 64*64*10.Con[S _i, _cμ ^t _j] for contrasting A repeatedly _CaseThe function that is used to calculate the GTG matching rate during binary image of inferior case binary image and classification representative image.

$S_i{:}_c{{\mathrm{\μ}}^t}_j$ $(\%)=\frac{\underset{1}{\overset{A_{\mathrm{case}}}{\mathrm{\Σ}}}\{S_i(x,y,z)/B\left(S_i\right(x,y,z)=B{(}_c{{\mathrm{\μ}}^t}_j(x,y,z)\}}{A_{\mathrm{case}}}$ $(\%)$ $...\left(3\right)$

In the matching rate computational methods, compare GTG and positional information simultaneously.Therefore, the GTG matching rate of full field of view volume can calculate by the GTG of the corresponding voxel of contrast.

After carrying out coupling, with Con[S _i, _cμ ^t _j] with the initial similarity threshold ratio of determining before.If Con[S _i, _cμ ^t _j] less than initial similarity threshold value, the n case is assigned to (child-operation S223) in the new-create p+1 classification.If Con[S _i, _cμ ^t _j] greater than initial similarity threshold value, correct representative image (child-operation S224).

In more detail, when being assigned to case in the classification, the first case S ₁Be assigned to classification 1.For the second case S ₂, the GTG and the second case S of classification 1 representative image that will distribute as cluster 1 ₂Comparing of corresponding voxel.If the matching rate of two GTGs is less than initial similarity threshold value, with the second case S ₂Be assigned to cluster 2.On the contrary, if it is greater than initial similarity threshold value, with the second case S ₂Be assigned to cluster 1, and correct the representative image of cluster 1.For i case S _i(i is greater than 2), the j classification P that utilizes formula 4 (as follows) to create before _j(j=1 ..., the comparing of the voxel that the GTG of binaryzation representative image k) and i case Si are corresponding.With i case S _iBe assigned to the demonstration j classification P of high matching rate _jAt i case S _iAssigned j classification P _jThe rectification of middle representative image is essential.

$S_i\∈\{{P^t}_j/\mathrm{MAX}(\mathrm{Con},[S_i:{{\mathrm{\μ}}^t}_j\left]\right)\},(j=\mathrm{1,2}...k)...\left(4\right)$

In child-operation S224 (rectification representative image), replace binary image with the corrigent pixel gray level of 256 GTGs.If belong to j classification P _jCase load be c before correcting, usefulness formula 5 (as follows) is represented new representative image.The step of correcting representative image with formula 5 is called " learning procedure ", and is new _C+1μ ^t _jWith before _cμ ^t _jRatio be called " learning rate ".

$\mathrm{\μ}_j^t{}_{c+1}=\left(\frac{c}{c+1}\right)*\mathrm{\μ}_j^t{}_c+\left(\frac{1}{c+1}\right)*S_i...\left(5\right)$

New representative image shown in the formula 5 is determined on the basis of average existing case and new distribution case.According to the method for determining representative image like this, the simple average that is different from the existing case that will belong to same classification is considered as the representative image vector and the method for definite representative image, obtained and to have been distributed the variable representative image vector of change by the new case, thereby guaranteed accurate cluster and obtain representative image.

Learning rate is inversely proportional to the classification number that is assigned to respective classes.Under the situation of handling the exercise case, because the representative image value of classification is determined in advance by the existing case of c under the exercise case, the learning rate of single case reduces when the existing case load of determining representative image increases.

The reason that learning rate reduces is that representative image is to be determined by all case aggregate-values that are assigned to respective classes.The representative image of each classification is considered to be assigned to the representative image of all cases of each classification.Therefore, only distinguish classification by such representative image, each case is assigned in the classification with immediate representative image.

After image was corrected, duplicon operation S222 to S224 assigned up to all cases, promptly last certain case SN processed (child-operation S225).

Distribute when last case and to finish, from the listed classification of formula 6, reject contained case (based on total case) and be less than 2% classification (operation S230).Owing to rejected abnormal class, the significant classification of k remains.Therefore, can solve shortcoming for k value and the sensitivity of exceptional value algorithm.So operation 230 can be used for the extraction of separating abnormality and special shape.

The rejecting result of the classification of 100 cases of table 5 expression.For the similarity threshold value is 76% L34 top, has created four classifications, contains 2 or still less the classification of case is disallowable.As a result, reject four cases altogether.

Table 5

Project	The L34 top		The L34 below
					The similarity threshold value	The K value	Reject case load	The K value	Reject case load
76	4	4	2	2
					77	4	3	2	3
78	4	4	2	6
					79	4	4	2	6
80	5	5	2	6
					81	6	3	3	6

When the classification rejecting finishes, carry out in order to the convergence of stablizing each classification and determine operation S240.

In assembling definite operation, investigate the representative image of each classification and whether corrected.Circulate repeatedly up to the convergence of finishing representative image.Here, " circulation " repetition of referring to cluster and rejecting classification.So, " 3 circulation are repeatedly " expression triplicate cluster and rejecting classification.

As shown in Equation 7, repetitive cycling surpasses predetermined percentage up to the matching rate of the representative image of the representative image of previous each classification of circulation and new-create classification.Matching rate can be determined arbitrarily by the user.For example, can repetitive cycling be 100% up to matching rate.

$\mathrm{Con}[\mathrm{\μ}_j^t{}_i:\mathrm{\μ}_j^{t-1}{}_i](\%)=100(\%)...\left(7\right)$

If matching rate can not surpass predetermined percentage, should consider to assemble and also not finish.In this case, must carry out case once more distributes.Therefore, case load is initialized as " 1 " (operation S245), repetitive cycling then.Finish if assemble, carry out the operation S247 of error of calculation rate.

Here, calculate the error rate S247 that assembles classification.As shown in Equation 8, error rate is represented in the classification quadratic sum of the spacing of representative image in each case and classification." spacing " is conceptual.In fact, error rate represents by observation error, and observation error is by being to calculate on 100% the supposition in the dissmilarity between each case and its representative image.Calculated after the error rate based on spacing between each case and its representative image, carried out again cluster and determine operation S250.

$E=\underset{j=1}{\overset{k}{\mathrm{\Σ}}}\underset{\mathrm{Si}}{\mathrm{\Σ}}$ $d^2(S_i,{\mathrm{\μ}}_j)$ $...\left(8\right)$

Determine in the operation in cluster again, when not correcting representative image and classification number, carry out the operation S255 that utilizes formula 9 to increase the similarity threshold values less than predetermined permission classification maximum number.Cluster again utilizes the similarity threshold value that increases to carry out cluster S255 once more if desired.If do not need cluster again, determine similarity threshold value and k value S260.Because initial similarity threshold value (Th _Start) be approximation, the k value of being determined by initial similarity threshold value also not exclusively is applicable to given case.Therefore, by above-mentioned steps, maximum comparability threshold value (Th _s) can in allowing classification, obtain.For example, if the classification number is less than allowing the classification number, program is got back to cluster operation S220, and increases similarity threshold value 1%, again all cases are assigned in the classification.

When $J=\underset{1}{\overset{j}{\mathrm{\Σ}}}{P}_j^t$ And J＜K _L, th _s++ ... (9)

Determine to determine only similarity threshold value and k value among the operation S260 of similarity threshold value and k value that it is corresponding to the minimum error rate in the error rate of using the similarity threshold calculations that increases.According to the spacing of similarity threshold value square, reject in classification and to repel error rate that case calculates after disallowable in the operation and be listed in the table below in 6.As shown in table 6, be 82% o'clock acquisition minimum error rate 67414 in the similarity threshold value.Therefore, as can be seen, initial similarity threshold value is preferably 82%.

Table 6

Similarity threshold value (Th)	Square (d) of spacing	The error case load	15 error rates
				80	9312	6	69312
81	7800	6	67800
				82	7414	6	67414
83	7293	7	77293
				84	7226	9	97226
85	6662	7	76662 20

Determine after similarity threshold value and the k value, can carry out representative image matching operation S270 by selectivity.After all case utilizations were suitable for the intervertebral implant scanning of classification representative image, the classification number can reduce, and can create general representative image.In scanning, when intervertebral implant and spinous process mismatched on specific point, scanning stopped, and then carries out another point.In scanning, search and record minimum error point, i.e. minimum error spatial point.This coupling step by to case 271 ' and template 273 ' based on voxel to recently finishing, it is provided for three-dimensional intervertebral implant.For example, the full visual field of a case has the volume of 64 (length) * 64 (wide) * 10 (number of slices), and template has the volume of 48*48*4.According to searching for the full visual field corresponding to the per 1 voxel template conversion of case.In this case, and range of variables (x, y, z)=(17,17,5).

Figure 36 is the detail flowchart of representative image matching operation S220 among Figure 30, and Figure 37 is the exemplary view of representative image coupling.The representative image coupling can be used to make the general intervertebral implant that is fit to most of cases effectively.

In addition, the target of representative image coupling can be divided into two groups.At first, intervertebral implant has geometric curved surfaces, thereby is different from the 3D shape of representative image.The representative image coupling passes through a large amount of measurements of the error space between intervertebral implant and case are reduced the number of intervertebral implants, and guarantees that intervertebral implant has better suitable shape.Secondly, because the error rate between representative image and single case equals the similarity threshold value, consider error rate, intervertebral implant manufactures large scale.The representative image coupling just is used to veritify the size of amplification.

Determine after similarity threshold value and the k value, a case (child-operation S271) is provided.Case with comparability shape is provided.In the present embodiment, provide a case with 64*64*10 volume.

Then, provide a two dimensional image (child-operation S272) that is suitable for the intervertebral implant of representative image.At first, in representative image, measure the width, sour jujube interbody spacer, spinous process lower surface slope, the spinous process degree of depth of spinous process and other.Then, make intervertebral implant, make it have the size of being a bit larger tham representative image.Intervertebral implant is called " representative pattern " now.In addition, can make a plurality of representative patterns according to the rank of size allowance.Represent the adaptability of pattern to determine by the coupling step.

Provide the two dimensional image of intervertebral implant so that matching template can be provided and from matching template, extract domain of dependence (ROI).For this reason, the two dimensional image of intervertebral implant can provide with the mode identical with case.Preferably, intervertebral implant provides with the stereo-picture of 64*64*10.

The matching template (child-operation S273) of the two dimensional image that is fit to intervertebral implant is provided then.This child-operation is used in template inside and outside based on the center of gravity of representing the pattern bottom, detects the apparent of spinous process in 180 degree scopes.Matching template has the volume of 48*48*4.With reference to Figure 37, matching template 273 ' more bigger to finish coupling with the case image than the two dimensional image of intervertebral implant.

Then, from matching template, extract ROI (child-operation S274).With reference to Figure 37, a part of selecting matching template is as ROI274 '.For example, when utilizing size for the matching template of 64*64, ROI's can size be 48*48.Like this, the ROI of 48*48 can scan the case zone of 64*64 together with the variable space of 17*17.When having determined ROI, the ROI that GTG is assigned to case image and matching template is in order to differentiate ROI (child-operation S275) from the case image of object as a comparison.With reference to Figure 38 and Figure 39, in the case image, zero (0) is assigned to spinous process A, 255 are assigned to background B.In the ROI of matching template, be assigned to background C with 100,255 are assigned to matching template D.Because distributing, GTG can also utilize another GTG to realize differentiating the ability in four zones, so the invention is not restricted to above-mentioned example.

Distribute after the GTG, by the ROI and the case of matching template are mated error of calculation rate (child-operation S276).The analysis result of coupling provides with reference to Figure 40 is following.

With reference to Figure 40, there are four zones.Zone 1 only comprises a template with (255+255)/2 GTG, and has skipped processing.Zone 2 is for having the case of (0+255)/2 GTG and the overlapping region of template.In zone 2, because the spinous process of case is bigger than intervertebral implant, so there is a projection of coming the spinous process of self-template.When detecting voxel in the processing, it is inappropriate that intervertebral implant is considered to.Zone 3 only comprises the case spinous process, and it has the GTG of (0+100)/2.The same with zone 1, processing has also been skipped in zone 3, because it does not influence processing.Zone 4 only comprises the background of two images, the error space between expression template and case.Zone 4 has the GTG of (255+100)/2, and the three dimensional image prime number is added up.The aggregate-value of zoning 4 is as error amount, and it is used to calculate the similarity threshold value.Analysis result is summarised in the table 7:

Table 7

Area code	Project	Case	Template	Gray scale	Handle
							1	Template	-	0	(255+255)/2	Skip
2	Spinous process+template	0	0	(0+255)/2	Be not suitable for
						3	Spinous process	0	-	(0+100)/2	Skip
4	Background	-	-	(255+100)/2	Error amount calculates

In zone 4, spinous process and intervertebral implant do not match.Along with the growth of error amount, the interval between intervertebral implant and the spinous process also increases.Therefore, the minimizing error amount is very important., the cumulative errors value is calculated during corresponding to the full field-of-view image of case based on whole errors of calculation along variable space scanning matching template.That is, under the situation that with size is the single matching template of 48*48*4 and four section couplings, calculate the cumulative errors value of section.

With reference to Figure 41, along the variable space (17*17*5) scanning matching template 920, calculate the cumulative errors value of each position of the variable space in x, the y of case 910 or z direction.By doing like this, even work as matching template image and case image accurate record aspect length, width, height and angle, the position of matching template also can be detected.

For example, the calculating of above-mentioned coupling and error rate can utilize following Visual C++ to realize.

For(Z_range){

For(X_range){

For(Y_range){

if(region_①)

；

else if(region_②)

loop exit；

else if(region_③)

；

else

error_rate++；

}

}

}

If(error_rate>threshold)

exit；

" x_range ", " y_range ", and " z_range " repeat by initial " For ", if when zone 1 and 3 occurs, skip processing; If zone 2 occurs, winding takes place withdraw from (loop exit); If zone 4 occurs, accumulation error of calculation value.

When calculating 17*17*5 cumulative errors value by this process, minimum cumulative errors value is defined as being used for the representative error amount of case of the intervertebral implant of representative image.

To each representative image and each case, scan and determine and represent error amount to repeat.Scanning repeats and can be calculated by formula 10.

Repetition=x_range*y_range*z_range*k*case ... (10)

Wherein " x_range ", " y_range " and " z_range " are respectively x, y and the z value of the variable space, and k is predetermined classification number or representative image, and " case " is case load.According to formula 10, the scanning variable space is that 1,445 (17*17*5*1*1) is inferior repeatedly for the single representative image of 17*17*5 and single case.5,780,000 (17*17*5*40*100) is inferior repeatedly to scan 40 representative image and 100 cases.

When being used for representing error amount by repeated calculation, case is assigned to has in the minimum classification of representing error amount (child-operation S277) corresponding to the case of the intervertebral implant of the representative image of each classification.As shown in table 8 below, case 1 is assigned to classification B, because it has the minimum error amount of representing in classification B.On behalf of error rate, the case distribution can also utilize realize, it has reflected the ratio that each represents error amount and chief representative's error amount.In the case, case is assigned to has minimum the representative in the classification of error rate.In the classification of calculating (100-represents error rate) %, case can also be assigned to (100-the represents error rate) % that has maximum.Therefore, case is distributed and be can't help parameter and limit.

Table 8

Case	Intervertebral implant corresponding to representative image	Represent error amount	Distribute
				Case 1	Classification A	69,300	Classification B
Classification B	67,800
		Classification C	Do not match
...	...
		Classification J	76,666

Intervertebral implant is made having under the error allowance, so itself and sour jujube interbody spacer extremely do not match.Therefore, same intervertebral implant can be used for the representative image of another classification.In addition, because the minute differences that is caused by high k value and similarity threshold value can be realized case is assigned to another classification.Like this, the representative image coupling can generate more general intervertebral implant.Yet when needs were made dissimilar intervertebral implants, the representative image coupling can be ignored.

(100-represents error rate) % of each case in each classification of table 9 expression.As mentioned above, represent error amount or represent the error rate can be with (100-represent error rate) % replacement.Table 9 is represented in each case and each classification corresponding to the matching result between the intervertebral implant of representative image.From matching result, can estimate matching rate.And, remove classification owing to can screen with very low matching rate, matching result can be used as main evaluation criteria in the table 9.

Table 9

Project	Classification A	Classification B	Classification D	Classification F	Classification H
						Case
1	86.4	81.2	72.7	80.6	69.7
						Case 2	0	81.9	79.4	0	82.1
Case 3	0	0	79.9	0	77.6
						Case 4	0	0	79.5	0	77.2
Case 5	0	76.9	72.8	81.1	66.9
						Case 6	0	88.1	76.7	0	78.8
Case 7	88.5	90	82.9	0	78.5
						Case 8	0	90	82.9	0	78.5
Case 9	77.2	61.5	51.9	59.9	47.5
						Case 10	0	92.8	85.9	0	82.5
Case 11	0	84	73.6	0	71.3
						Case 12	0	89.3	83.1	0	77.9
Case 13	83	78.5	68.4	0	65.4
						Case 14	0	81.5	66.2	0	68.7
Case 15	0	83.8	68.8	0	73.4
						Case 16	0	0	77.7	0	71.7
Case 17	0	93.1	87.1	0	86.9
						…	…	…	…	…	…
Case 95	0	88.2	76.5	0	80.6

The average matching rate of each classification of table 10 expression, distribution case load and best definite rate.Average matching rate is represented the meansigma methods of (100-represents error rate) shown in the table 9 % value, and case load represents to be assigned to the case load of each classification, and best definite rate represents to be assigned to the case of each classification and the ratio (%) of total case load.For example, the best of classification A determines that rate is (19/95) * 100=20%.

Table 10

Project	Classification A	Classification B	Classification D	Classification F	Classification H
						The average matching rate (%) of each classification	13.94	75.99	72.79	12.51	74.84
Case load	19	60	4	1	11
						Best definite rate (%)	20	63	4	1	12

According to the foregoing description, cushion block is made with sturdy material and is kept predetermined space between two spinous process.After the operation, vertebra can the generation activity.In this case, if cushion block is securely fixed between the spinous process very much, patient's activity may be restricted, and other normal vertebral may also can be adversely affected.Therefore, need a kind of rubber-like cushion block of design, so that the partition adjustable between the upper and lower part of cushion block (being in the restricted portion) can adapt to motion of the vertebra.

Observe the problems referred to above, below will several cushion blocks of the other embodiment according to the present invention be described.Figure 42 is the perspective view according to another embodiment of the present invention cushion block 50.

With reference to Figure 42, cushion block 50 comprises flange 51a, 51b, 52a, reaches 52b and first and second groove 53a and 53b as above-mentioned cushion block 30.Yet cushion block 50 has fine distinction with cushion block 30, be that it also comprises to give cushion block 50 elastic elastic bending parts 54, and first and second groove 53a and 53b is formed by through hole 55a and 55b respectively.

Elastic bending part 54 is positioned at and inserts the front portion, has one or more curved to provide elasticity to cushion block 50.Because such structure, though cushion block 50 by sturdy material for example titanium make, the interval between cushion block 50 upper and lower parts also can elasticity change in preset range.More particularly, elastic bending part 54 can comprise the 57a of vertical line portion that is connected to the first groove 53a, is connected to the 57b of vertical line portion of the second groove 53b, and the bending section 56 that connects two line parts.

Line part 57a and 57b are used to guarantee the spinous process interbody spacer, and it too stretches to prevent vertebra corresponding to being at least line part 57a and 57b height sum.Bending section 56 is used to guarantee that elastic bending part 54 stretches or crooked elasticity.

Figure 43 is the diagrammatic side views of spinal column, and the position of cushion block 50 shown in Figure 42 between the adjacent spinous processes is described.With reference to Figure 43,3 embodiment are the same for image pattern, and belt 43 inserts the through hole 55a and the 55b of cushion block 50.Belt 43 binding top spinous process 3a, below spinous process 3b and cushion block 50.The cross-section illustration that is tied with belt 43 cushion blocks 50 is in Figure 44.Belt 43 with 8 fonts around top spinous process 3a and below spinous process 3b one or many.Then, the end knotting of belt 43 is fixing.

In order to prevent that elastic bending part 54 and belt 43 from contacting, and preferably separates a preset distance with elastic bending part 54 with belt 43 on left and right direction shown in Figure 43 when belt 43 inserts among through hole 55a and the 55b.

When cushion block 50 places two between spinous process 3a and 3b the time as shown in figure 43, the interval that connects between spinous process 3a and the 3b can elasticity change.Therefore, cushion block 50 is keeping connecing the motion that can also adapt to the patient between spinous process 3a and the 3b in the interval.That is to say, can limit unusual motion of the vertebra when allowing normal motion of the vertebra.In addition, owing to cushion block 50 relative grooves directly contact with 3b with spinous process 3a by belt 43, so can cushion external impact.

Simultaneously, cushion block 60 is shown in Figure 45 according to another embodiment of the present invention.With reference to Figure 45, cushion block 60 is divided into the upper and lower end body 61 and 62 with groove.

The bottom of upper end body 61 forms has a cylindrical accepter 63, and the top of lower end body 62 forms has a plug-in unit 64.Plug-in unit 64 parts are inserted cylindrical accepter 63.The independent connector of connecting plug-in element 64 and cylindrical accepter 63 is not provided.

Referring now to Figure 46, describe the connection between plug-in unit 64 and the cylindrical accepter 63 in detail.Cylindrical accepter 63 has simple cylinder form.Plug-in unit 64 has the shape that can partly insert cylindrical accepter 63.Plug-in unit 64 has cone shape, and the first bight 66a is steeper than its right (insertion rear portion) second bight 66b on its left side (inserting anterior).Because do not connect the independent connector of cylindrical accepter 63 and plug-in unit 64, the first bight 66a preferably has the curved shape that can guarantee cylindrical accepter 63 and plug-in unit 64 relative displacements with the second bight 66b.

When the first bight 66a was steeper than the second bight 66b, cylindrical accepter 63 relative plug-in units 64 turned right slow and conveniently turn left.That is, excessively extension can be prevented, slight elasticity can be guaranteed simultaneously.

With reference to Figure 45, upper and lower end body 61 and 62 forms respectively has belt fixed lobe 65a and 65b, to use belt (among Figure 43 43) binding fixed lobe 65a and 65b.Because the gradually inclined-plane of the second bight 66b, belt 43 can allow the slight bending in the elastic range, but because the greatly sloped side of the first bight 66a, it does not allow to stretch elasticity.Because the slight elasticity of belt 43, groove can natural kissing spines when lordosis.

Figure 47 is the diagrammatic side views of spinal column, and the position of cushion block 60 shown in Figure 45 between the adjacent spinous processes is described.With reference to Figure 45 to Figure 47, belt fixed lobe 65a and 65b bundle with belt 43.The tensioned state that to keep belt 43 that contacts of the first bight 66a by plug-in unit 64 and the inner surface of cylindrical accepter 63.Also can near the pivot of cushion block 60, bundle upper and lower spinous process 3a and 3b with independent belt.

As mentioned above, cushion block 60 has the independent end body of separate support spinous process.Therefore, can farthest allow the spinous process motion.And, owing to an independent power occurred, can guarantee the natural lever system of human Spine.

In the embodiment of Figure 42 and Figure 45, groove has the contour shape perpendicular to flange 44.Yet the person of ordinary skill in the field can recognize that the contour shape of groove can be adaptive curved to match with the spinous process lower surface.

In addition, Figure 42 and groove profile shape shown in Figure 45 can be by determining with reference to the described clustering method of Figure 22 to Figure 28.

The commercial application

The present invention is illustrated with reference to better embodiment. Obviously, after reading and having understood above-mentioned detailed explanation, other people can make and revise and improve. Should be appreciated that in the time of within it enters claim or the scope identical with its meaning, such modification and improvement comprise within the scope of the invention.

According to the present invention, do not need to remove unaffected interspinal ligaments. Therefore, guaranteed to reduce patient burden's simple operative treatment. Specifically, during the operative treatment, do not need the extensor that is positioned at rear side is excised and anaesthetizes.

In addition, according to the present invention, can when preventing that intervertebral space from narrowing down, keep predetermined space two in abutting connection with between spinous process, and relative shift can not occur between upper joint face and ShiShimonoseki nodal section.

In addition, implant the human spinous process that thing can be applicable to have different lower surface slope between vertebra of the present invention.

Claims (17)

1. an intervertebral implant is characterized in that comprising the cushion block with two relative grooves, and this groove is used to receive two in abutting connection with spinous process, and the belt that is used for fixing two spinous process and cushion block,

This cushion block comprises one and passes the lateral through hole of cushion block, and this hole can make belt therefrom pass, and from the outside aduncate depression of cushion block, it is convenient to the fastening belt that passes through hole, and

When passing through hole, belt become 8 fonts to bundle two spinous process and cushion block, to fix two spinous process and cushion block.

2. intervertebral implant according to claim 1 is characterized in that the belt part with 8 fonts, by the two ends knotting is fixed two spinous process and cushion block with belt.

3. intervertebral implant according to claim 2 is characterized in that fixing two spinous process and cushion block with belt, so that relative displacement can not take place between the superior articular surface of below spinous process in the top inferior articular surface of spinous process and two spinous process in two spinous process.

4. intervertebral implant according to claim 3 is characterized in that fixing two spinous process and cushion block with belt, so that the antecurvature recovery of lumbar spine.

5. intervertebral implant according to claim 1 is characterized in that at least one groove has by the line segment with different functions in the two relative grooves and connects the profile that a plurality of points obtain.

6. intervertebral implant according to claim 5 is characterized in that above-mentioned a plurality of by having the straightway connection of Different Slope.

7. intervertebral implant according to claim 5 is characterized in that above-mentioned a plurality of by having the curved section connection of predetermined curvature.

8. intervertebral implant according to claim 5 is characterized in that the profile of at least one groove has from inserting the rear portion to inserting the anterior shape that slowly tilts.

9. intervertebral implant according to claim 5, it is characterized in that with on the spinous process of a large amount of individualities or the lower surface slope be assigned to n interval, the representative value in n interval is θ _n, one in the two relative grooves is the initial point of x-y plane graph near the end that inserts the rear portion, being assigned to n interval slope aggregate-value is N _n, a plurality of points are initial point and (N _n, N _nTan θ _n).

10. intervertebral implant according to claim 5, it is characterized in that with on the spinous process of a large amount of individualities or the lower surface slope be assigned to n interval, the representative value in n interval is θ _n, one in the two relative grooves is the initial point of x-y plane graph near the end that inserts the rear portion, being assigned to n interval slope aggregate-value is N _n, interval (N _N-1, N _n) the inner function value is that 1 monotropic function is u (N _N-1, N _n), distributing the slope number is x, connects initial point and (N with straight line _n, N _nTan θ _n) gained function y provides by following formula:

$y=\underset{m=1}{\overset{n}{\mathrm{\Σ}}}\{\tan {\mathrm{\θ}}_m(x-N_{m-1})+\tan {\mathrm{\θ}}_{m-1}{N}_{m-1}{\}}^{*}u(N_{m-1},N_m)$

N ₀＝0，θ ₀＝0

11. an intervertebral implant is characterized in that comprising:

Cushion block has two relative grooves that are used to receive two adjacent spinous process;

Elastic bending part connects two relative grooves and produces elastic-restoring force, to resist the external force that two spinous process generate;

Two through holes are formed at two relative grooves respectively; And

Pass the belt of two through hole binding cushion block and two spinous process.

12. intervertebral implant according to claim 11 is characterized in that elastic bending part comprises to be connected to one of them the first vertical line portion of two relative grooves, is connected to the second vertical line portion of another groove, and the bending section that connects two line parts.

13. intervertebral implant according to claim 11 is characterized in that two through hole and elastic bending part open a preset distance so that belt when passing two through hole elastic bending part can not contact with belt.

14. intervertebral implant according to claim 11 is characterized in that at least one groove has by the line segment with different functions in the two relative grooves and connects the profile that a plurality of points obtain.

15. an intervertebral implant is characterized in that comprising:

The upper end body has first groove;

The lower end body has second groove relative with first groove;

Cylindrical accepter is formed at body bottom, upper end; And

Be formed at the plug-in package on body top, lower end, its part is inserted cylindrical accepter, and has near anterior first bight of the insertion of being formed at and second bight that is formed near the insertion rear portion, and first bight has different slopes with second bight.

16. intervertebral implant according to claim 15 is characterized in that also comprising:

Belt, and

The belt fixed lobe is formed at the upper and lower end body respectively, is used for belt binding upper and lower end body.

17. intervertebral implant according to claim 16 is characterized in that in first groove and second groove at least one has by the line segment with different functions and is connected the profile that a plurality of points obtain.

Images